Objective: There are few previously published studies of feeding problems and/or gastrointestinal dysfunction among children with Asperger syndrome (AS) or Pervasive Developmental Disorder (PDD-NOS), compared to sibli...Objective: There are few previously published studies of feeding problems and/or gastrointestinal dysfunction among children with Asperger syndrome (AS) or Pervasive Developmental Disorder (PDD-NOS), compared to sibling controls. Study Design: On-line parent autism groups 90% from North America. Statistical analysis: Chi square and binomial logistic regression statistical analysis Results: Completed surveys were received for 64 children with AS, 44 with PDD-NOS, total = 108), and 82 normal sibling matches. Children with high-functioning autism had higher likelihood of frequent (>50% of the time) problematic feeding behaviors and gastrointestinal dysfunction, such as unusual food preferences (OR 23.9, 95% CI 7.3 - 78.7), insistence on unusual food presentation (OR 5.8, 95% CI 1.8 - 18.4), and poor mealtime social behavior (OR 16.1, 95% CI 4.1 - 64.1). These children also had higher odds of frequent constipation (OR 8.3, 95% CI 2.2 - 31.9) and fecal incontinence (OR 5.4, 95% CI 1.1 - 27.3). Nine children in AS/PDD-NOS group (4%) were believed by parent to have celiac disease (3 or 1% had intestinal biopsy), compared to 2 in control group. Conclusion: 57% of the AS/PDD-NOS group had frequent unusual food preferences vs. 5% of controls. Forty-eight percent of children with AS/PDD-NOS had frequent dislikes of new foods, compared to 6% of controls. For symptoms of specific gastrointestinal dysfunction, children with AS/PDD-NOS had higher prevalence of frequent constipation (30% vs. 4%) and fecal incontinence (22% vs. 2%).展开更多
BACKGROUND Although endoscopic sphincterotomy(EST)has a positive therapeutic effect on biliary-type sphincter of Oddi dysfunction(SOD),some patients still have little relief after EST,which implies that other function...BACKGROUND Although endoscopic sphincterotomy(EST)has a positive therapeutic effect on biliary-type sphincter of Oddi dysfunction(SOD),some patients still have little relief after EST,which implies that other functional abdominal pain may also be present with biliary-type SOD and interfere with the diagnosis and treatment of it.AIM To retrospectively assess EST as a treatment for biliary-type SOD and analyze the importance of functional gastrointestinal disorder(FGID)in guiding endoscopic treatment of SOD.METHODS Clinical data of 79 patients with biliary-type SOD(type I and type II)treated with EST at Affiliated Hospital of Guizhou Medical University from January 2014 to January 2019 were retrospectively collected to evaluate the clinical therapeutic effect of EST.The significance of relationship between FGID and biliary-type SOD was analyzed.RESULTS Seventy-nine patients with biliary-type SOD received EST,including 29 type 1 patients and 50 type 2 patients.The verbal rating scale-5(VRS-5)scores before EST were all 3 or 4 points,and the scores decreased after EST;the difference was statistically significant(P<0.05).After EST,the serum indexes of alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase and total bilirubin in biliary-type SOD were significantly lower than before(P<0.05).After EST,67(84.8%)and 8(10.1%)of the 79 patients with biliary-type SOD had obviously effective(VRS-5=0 points)and effective treatment(VRS-5=1-2 points),with an overall effectiveness rate of 94.9%(75/79).There was no difference in VRS-5 scores between biliary-type SOD patients with or without FGID before EST(P>0.05).Of 12 biliary-type SOD(with FGID)patients,11 had abdominal pain after EST;of 67 biliary-type SOD(without FGID)patients,0 had abdominal pain after EST.The difference was statistically significant(P<0.05).The 11 biliary-type SOD(with FGID)patients with recurrence of symptoms,the recurrence time was about half a year after the EST,and the symptoms were significantly relieved after regular medical treatment.There were 4 cases of postendoscopic retrograde cholangiopancreatography pancreatitis(5.1%),and no cholangitis,bleeding or perforation occurred.Patients were followed up for 1 year to 5 years after EST,with an average follow-up time of 2.34 years,and there were no long-term adverse events such as sphincter of Oddi restenosis or cholangitis caused by intestinal bile reflux during the follow-up.CONCLUSION EST is a safe and effective treatment for SOD.For patients with type I and II SOD combined with FGID,single EST or medical treatment has limited efficacy.It is recommended that EST and medicine be combined to improve the cure rate of such patients.展开更多
目的:调查国内多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS)患者胃肠功能损伤的流行病学情况。方法:采用多中心、前瞻性调查方法,分析2002年3月—2005年1月全国11省市的37家三级医院1087例MODS患者的病历资料。结果...目的:调查国内多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS)患者胃肠功能损伤的流行病学情况。方法:采用多中心、前瞻性调查方法,分析2002年3月—2005年1月全国11省市的37家三级医院1087例MODS患者的病历资料。结果:1087例患者中,胃肠功能损伤的发生率、病死率分别为78.8%、61.7%。其中入住重症监护室(ICU)患者其28d病死率为58.9%。MODS患者胃肠功能损伤发生及死亡的高危因素分别为存在腹水、未应用或未适当应用肠内营养,用用肾上腺素等。结论:MODS患者胃肠功能损伤发生率高,其发生高危因素及死亡高危因素与腹水、肠内营养的应用等相关。患有胃肠功能损伤的MODS患者其入住ICU28d病死率较非胃肠功能损伤患者显著升高。展开更多
文摘Objective: There are few previously published studies of feeding problems and/or gastrointestinal dysfunction among children with Asperger syndrome (AS) or Pervasive Developmental Disorder (PDD-NOS), compared to sibling controls. Study Design: On-line parent autism groups 90% from North America. Statistical analysis: Chi square and binomial logistic regression statistical analysis Results: Completed surveys were received for 64 children with AS, 44 with PDD-NOS, total = 108), and 82 normal sibling matches. Children with high-functioning autism had higher likelihood of frequent (>50% of the time) problematic feeding behaviors and gastrointestinal dysfunction, such as unusual food preferences (OR 23.9, 95% CI 7.3 - 78.7), insistence on unusual food presentation (OR 5.8, 95% CI 1.8 - 18.4), and poor mealtime social behavior (OR 16.1, 95% CI 4.1 - 64.1). These children also had higher odds of frequent constipation (OR 8.3, 95% CI 2.2 - 31.9) and fecal incontinence (OR 5.4, 95% CI 1.1 - 27.3). Nine children in AS/PDD-NOS group (4%) were believed by parent to have celiac disease (3 or 1% had intestinal biopsy), compared to 2 in control group. Conclusion: 57% of the AS/PDD-NOS group had frequent unusual food preferences vs. 5% of controls. Forty-eight percent of children with AS/PDD-NOS had frequent dislikes of new foods, compared to 6% of controls. For symptoms of specific gastrointestinal dysfunction, children with AS/PDD-NOS had higher prevalence of frequent constipation (30% vs. 4%) and fecal incontinence (22% vs. 2%).
文摘BACKGROUND Although endoscopic sphincterotomy(EST)has a positive therapeutic effect on biliary-type sphincter of Oddi dysfunction(SOD),some patients still have little relief after EST,which implies that other functional abdominal pain may also be present with biliary-type SOD and interfere with the diagnosis and treatment of it.AIM To retrospectively assess EST as a treatment for biliary-type SOD and analyze the importance of functional gastrointestinal disorder(FGID)in guiding endoscopic treatment of SOD.METHODS Clinical data of 79 patients with biliary-type SOD(type I and type II)treated with EST at Affiliated Hospital of Guizhou Medical University from January 2014 to January 2019 were retrospectively collected to evaluate the clinical therapeutic effect of EST.The significance of relationship between FGID and biliary-type SOD was analyzed.RESULTS Seventy-nine patients with biliary-type SOD received EST,including 29 type 1 patients and 50 type 2 patients.The verbal rating scale-5(VRS-5)scores before EST were all 3 or 4 points,and the scores decreased after EST;the difference was statistically significant(P<0.05).After EST,the serum indexes of alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase and total bilirubin in biliary-type SOD were significantly lower than before(P<0.05).After EST,67(84.8%)and 8(10.1%)of the 79 patients with biliary-type SOD had obviously effective(VRS-5=0 points)and effective treatment(VRS-5=1-2 points),with an overall effectiveness rate of 94.9%(75/79).There was no difference in VRS-5 scores between biliary-type SOD patients with or without FGID before EST(P>0.05).Of 12 biliary-type SOD(with FGID)patients,11 had abdominal pain after EST;of 67 biliary-type SOD(without FGID)patients,0 had abdominal pain after EST.The difference was statistically significant(P<0.05).The 11 biliary-type SOD(with FGID)patients with recurrence of symptoms,the recurrence time was about half a year after the EST,and the symptoms were significantly relieved after regular medical treatment.There were 4 cases of postendoscopic retrograde cholangiopancreatography pancreatitis(5.1%),and no cholangitis,bleeding or perforation occurred.Patients were followed up for 1 year to 5 years after EST,with an average follow-up time of 2.34 years,and there were no long-term adverse events such as sphincter of Oddi restenosis or cholangitis caused by intestinal bile reflux during the follow-up.CONCLUSION EST is a safe and effective treatment for SOD.For patients with type I and II SOD combined with FGID,single EST or medical treatment has limited efficacy.It is recommended that EST and medicine be combined to improve the cure rate of such patients.
文摘目的:调查国内多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS)患者胃肠功能损伤的流行病学情况。方法:采用多中心、前瞻性调查方法,分析2002年3月—2005年1月全国11省市的37家三级医院1087例MODS患者的病历资料。结果:1087例患者中,胃肠功能损伤的发生率、病死率分别为78.8%、61.7%。其中入住重症监护室(ICU)患者其28d病死率为58.9%。MODS患者胃肠功能损伤发生及死亡的高危因素分别为存在腹水、未应用或未适当应用肠内营养,用用肾上腺素等。结论:MODS患者胃肠功能损伤发生率高,其发生高危因素及死亡高危因素与腹水、肠内营养的应用等相关。患有胃肠功能损伤的MODS患者其入住ICU28d病死率较非胃肠功能损伤患者显著升高。