Thirty children (aged 2 months to 3 years) with clinical evidence of gastroesophageal reflux (GER) and respiratory disease were investigated. Eighteen patients had normal nutritional status, four had mild undernutrition and eight were severely undernourished. Barium swallow and radionuclide gastroesophageal and lung scintigrams were carried out in all patient. Barium swallow showed evidence of GER in 86.6%, esophageal scintigraphy in 90% and, the combined results of both methods in 100%of our cases. Pulmonary aspirates from esophageal contents were detected in 26.7% of the patients, all showing severe clinical and radiological evidence of pulmonary disease. Our results suggest that radionuclide gastroesophageal and lung scintigraphy are useful tools for the diagnosis of GER and pulmonary aspiration, respectively. However radiological studies remain necessary for the accurate description of the anatomical features of the esophagus. (
Persistent diarrheaInformation about persistent diarrhea is scarse despite the fact that it is a frequent cause of death in children who live in developing countries. The 36,358 pediatric consultations performed at a Primary Health Care Center in Southeastern Santiago in 1984 were retrospectively evaluated. Diairheic syndromes represented 5.1% of consultations and corresponded to 909 episodes; of these, 6.3% were cases of persistent diarrhea (> 15 days). The highest frequency occurred among children under 2 years of age (60.7%). In 68.7% of cases feces were liquid and in 37.5% mucus, pus or blood was present in stools. Persistent diarrhea was more frequent among malnourished patients (p < 0.001) who, in turn, suffered the greatest nutritional deterioration in relation to the episode of diarrhea. Intravenous fluids were required by 23,3% of patients while 27.9% were admitted to hospital. This contrasts with patients who suffer episodes which lasted less than 15 days, who were all orally hydrated and only 7.8% required hospitalization (p < 0.01).
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