No abstract

SUMMARY In this article the authors propose that non‐organic failure to thrive (FTT) is a growth failure secondary to feeding‐skills disorder, and that this disorder is neurophysiological in origin. The symptoms of feeding‐skills disorder were suggestive of an oral sensorimotor impairment which is usually present from birth or early life, but tends to go unrecognized. Data from 38 infants with non‐organic and 22 infants with organic FTT demonstrated that early clinical symptoms of feeding impairment, and observed maternal and infant feeding behaviours and interactions, were similar for both groups, suggesting a need to redefine the term ‘non‐organic. RÉSUMÉ Défaut non organique de croissance: déficit de croissance seconduire à des troubles du comportement alimentaire Dans cet article les auteurs suggerent que le defaut non organique de croissance (FTT) peut ětre lié à un déficit de croissance provoque par un trouble du comportement alimentaire, et que le trouble est neurophysiotogique a I'origine. Les symptǒmes du trouble des conduite alimentaires suggèrent un trouble sensori‐moteur oral, habituellement presént à la naissance ou dans les premiers mois, et qui tend à ětre méconnu. Les données provenant de 38 nourrissons avec FFT non organique et de 22 nourrissons avec FFT organique démontrent que les symptǒmes cliniques du trouble alimentaire. les comportements alimentaires observés chez les mères et les nourrissons sont sernblables dans les deux, groupes, suggérant une nécessité de redéfinir le terme ‘non‐organique. ZUSAMMENFASSUNG Nicht‐organische Gedeihstörung: Wachstunssiörung durch Fütterungsschwierighkeiten In dieser Arbeit vertreten die Autoren die Meinung, daβ die nich‐organische Geihstörung (FTT) eine Waschstumsstörung durch Fütterngesschwierigkeiten ist und daβ dises Erkrankung eine neurophysiologische ursache hat. Die Symptome der Fütterungsschwierigkeiten seien ein Hinweis auf eine orale sensomotorische Störung, die in the Regel von Geburt ordervom frühen Lebensalter and besteht, aber häfing nicht rekannt wird. Die Daten von 38 Kindern mit nicht‐organischer und 22 Kindern mit organischer FTT zeigten daβ die frühen klinischen symptome der Fütterungsschwierigkeiten und das beobachtete Fütterungsverhalten und ide Interaktionen zwischen Mutter und Kind ür beide Gruppen ähnlich Waren, was bedeutet, daβ der Begriff ‘nicht‐organisch’ neu definiert werden muβ. RESUMEN Fallo no orgánico en el crecimiento: fallo secundario a alteraciones en las formas de alimentacióon En est articulo los autores proponen que el fallo no orgánico del crecimiento (FNOC) es secundario a alteraciones en las formas de alimentación y que esta alteración es neurofisiológica en su origen. Los sintomas de una alteractón en la forma de alimentarse eran sugestivos de una alteractón oral sensorio‐motora, generalmente ya presente en el nacimiento o en los primeron tiempos de la vida, pero que tiende a ser no reconocida. Los datas recogidos en 38 lactantes con FNOC no orgánico y de 22 con sindrome orgánico demost...

No abstract

Limited maternal problem-solving abilities may contribute to FTT by interfering directly with the quality of nurturance, feeling, and caloric intake the child receives. Recommendations are made for future research and interventions with mothers of children with FTT.

The effects of oleate and hydroxycitrate on the rate of long-chain fatty acid and 3-P-hydroxysterol synthesis were measured in perfused rat livers. Metabolite measurements show that in livers from fed animals inhibition of fatty acid synthesis by oleate or hydroxycitrate is associated with an increase in the tissue content of glucose 6-phosphate and fructose 6-phosphate, and a diminution in glycolytic intermediates from fructose diphosphate to phosphoenolpyruvate. Oleate also causes an increase in the tissue content of long-chain fatty acyl-CoA and citrate. The increase in long-chain fatty acyl-CoA i s larger in livers from starved as compared to fed rats, while the increase in citrate is larger in livers from fed as compared to starved rats. However, the increase in the citrate content of livers from fed rats occurs in a range where it causes no further activation of acetyl-CoA carboxylase irt v i m .Ketogenesis by livers from fed rats perfused without free fatty acids is strongly inhibited by hydroxycitrate. Ilowever, ketogenesis is not inhibited by hydroxycitrate when livers from starved rats are perfused with oleate, and ketogenesis is increased somewhat by hydroxycitrate when livers from fed rats are perfused with oleate. These results are interpreted in terms of an extramitochondrial pathway of ketogenesis which operates in carbohydrate-fed animals. The intramitochondrial pathway predominates in starved animals, or when the concentration of fatty acids is high, or both. Other interpretations, which cannot be ruled out at present, are also considered.

No abstract

Objective. To determine the relationship between diet history and microcytic anemia, a proxy for iron deficiency, and the utility of a brief dietary history in screening for microcytic anemia. Design. Cross-sectional study based on review of clinical records. Setting. Urban academic primary care clinic. Subjects. A total of 305 healthy, African-American inner-city children, presenting for well child care at 15 to 60 months of age. Children with recent minor illness or medicinal iron intake, hemoglobinopathies, chronic illnesses, failure to thrive, or elevated lead levels were excluded. Method. A brief dietary history was taken in the course of primary care visits. Dietary deficiency was defined as: (1) less than five servings each of meat, grains, vegetables, and fruit per week; (2) more than 16 oz of milk per day; or (3) daily intake of fatty snacks, sweets, or more than 16 oz of soft drink. Hematologic indices were obtained. Results. The prevalence of microcytic anemia (hemoglobin, < 11 g/dL; mean corpuscular volume, <73 fL) was 8% (24 of 305). The prevalence of low hemoglobin (<11 g/dL) with or without microcytosis was 12% (38 of 305). Dietary deficiency was associated with microcytic anemia (x2 = 26.8). As a screening test for microcytic anemia, dietary deficiency had a sensitivity of 71% (17 of 24), specificity of 79% (222 of 281), and negative predictive value of 97% (222 of 229). Conclusion. Microcytic anemia was associated with a deficient diet among low-income African-American children. A brief dietary history correctly identified children at low risk for microcytic anemia 97% of the time.

No abstract