No abstract

Enemas and PEG were equally effective in treating RFI in children. Compared with enemas, PEG caused more fecal incontinence, with comparable behavior scores. The treatments should be considered equally as first-line therapy for RFI.

Our study shows that the most severely ill children with septic shock had signs of adrenal insufficiency. Bioavailable cortisol levels were not more informative on adrenal function than total cortisol levels. Besides disease severity, one single bolus of etomidate during intubation was related to decreased adrenal function and 11beta-hydroxylase activity. Decreased adrenal function was not related to decreased 21-hydroxylase activity. Based on our results, it seems of vital importance to take considerable caution using etomidate and consider combining its administration with glucocorticoids during intubation of children with septic shock.

We evaluated the validity of using a single fatty acid tracer to assess total plasma long-chain free fatty acid (FFA) kinetics and the relationship between the rate of appearance (R a ) of fatty acids in plasma and the fatty acid composition of adipose tissue triglyceride (TG A dipose tissue triglycerides (TGs) are the major endogenous source of fuel in humans. The mobilization of this fuel store involves the hydrolysis of TGs and the release of free fatty acids (FFAs) into the bloodstream. Although adequate availability of plasma FFA is critical for normal function and survival, excessive FFA release into plasma can have adverse medical effects by increasing hepatic glucose production (1,2), decreasing insulin-mediated glucose disposal (1,2), and stimulating VLDL-TG production (3). Therefore, understanding FFA kinetics has important physiological and clinical implications.Fatty acid kinetics are usually determined by assessing the dilution of a labeled fatty acid tracer that is infused into the bloodstream. It is assumed that the dilution of the fatty acid tracer in plasma is predominantly caused by entry of unlabelled fatty acids released by hydrolysis of adipose tissue TG. The rate of appearance (R a ) of a single fatty acid in plasma is often used to estimate total FFA kinetics, by dividing the individual fatty acid R a by the relative contribution of this fatty acid to total plasma FFA concentration (4 -6). This extrapolation assumes that the R a of the fatty acid being traced is representative of the release of other fatty acids from adipose tissue and that the relative concentration of this fatty acid in plasma represents its relative release rate from adipose tissue. Data from studies conducted in isolated adipocytes and in regional subcutaneous adipose tissue suggest that the relative rate of release of specific fatty acids from adipose tissue into plasma is influenced by fatty acid structure (7-14). However, the relationship between whole-body systemic fatty acid kinetics and adipose tissue fatty acid composition is not known. The purpose of the present study was to evaluate whether a single fatty acid tracer provides a reliable estimate of total plasma FFA kinetics and whether the systemic release of individual fatty acids into plasma reflects fatty acid composition in adipose tissue TG in human subjects during different physiological conditions. We measured the R a of five fatty acids (myristate, palmitate, stearate, oleate, and linoleate) into plasma, using stable isotope-labeled tracer methods, in the basal postabsorptive state and during conditions that stimulate (epinephrine infusion) and inhibit (insulin infusion) lipolysis of adipose tissue TG. Adipose tissue TG fatty acid composition was determined in biopsy samples from upper (abdominal) and lower (gluteal) subcutaneous fat depots. We hypothesized that the accuracy of estimating total FFA R a with a single fatty acid tracer and the relationship between the R a of individual fatty acids and adipose tissue TG fatty acid composition depends on t...

Background: Inconsistent data exist about the efficacy of probiotics in the treatment of constipation. Several studies in adults with constipation showed positive effects of probiotics on constipation. Inconsistent data exist regarding the effect of a single probiotic strain in constipated children. The aim of this pilot study was to determine the effect of a mixture of probiotics containing bifidobacteria and lactobacilli in the treatment of childhood constipation.

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In almost 70% of children with lower urinary tract symptoms rectal distention significantly but unpredictably affected bladder capacity, sensation and overactivity regardless of whether the children had constipation, and independent of clinical features and baseline urodynamic findings. Urodynamics and management protocols for lower urinary tract symptoms that fail to recognize the effects of rectal distention may lead to unpredictable outcomes.

Our study confirms a high frequency of functional constipation in children with obesity, using the Rome III criteria. However, abnormal colonic motility, as measured by CTT, was delayed in only a minority of patients. No relation was found between constipation in these children and fiber or fat intake.