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1.
Neurogastroenterol Motil ; 32(4): e13785, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32017336

RESUMEN

BACKGROUND: Meal-related symptoms are common in paediatric functional dyspepsia (FD). There are only a small number of paediatric studies assessing mechanisms for meal-related symptoms, and these have not utilized Rome IV criteria. The aim of the current study was to assess gastric myoelectric and autonomic nervous system (ANS) responses to both liquid and solid meals in youth with Rome IV-defined FD. METHODS: In healthy controls (N = 14) and youth with FD (N = 12), we recorded electrocardiograph (to assess heart rate variability; HRV) and electrogastrograph (EGG) signals before and after two test meals, one liquid and one solid. EGG parameters and HRV were assessed for the entire pre- and postprandial periods and in short time intervals. Additionally, liquid gastric emptying was assessed utilizing a 13 C-acetate breath test. KEY RESULTS: During the EGG, the dominant power increased with both meals in controls but not patients with FD. During HRV assessment, the low frequency to high frequency ratio was higher after the liquid meal in controls, despite being similar preprandial, as compared to patients with FD. In controls, both standard deviation of normal to normal waves (SDNN) and root mean square of successive ECG R peaks (R-R interval) differences (rMSSD) increased after the liquid meal (but not after the solid meal) in controls but not patients with FD. CONCLUSIONS AND INFERENCES: Youth with Rome IV-defined FD lacks the normal postprandial EGG dominant power response or autonomic nervous system response following a liquid meal. The latter appears to indicate a lack of ANS flexibility.


Asunto(s)
Sistema Nervioso Autónomo/fisiopatología , Dispepsia/fisiopatología , Adolescente , Niño , Electrocardiografía , Electromiografía , Femenino , Frecuencia Cardíaca/fisiología , Humanos , Masculino , Comidas , Periodo Posprandial/fisiología
2.
Dig Dis Sci ; 65(4): 1074-1081, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-31549333

RESUMEN

BACKGROUND/AIMS: While stress has been implicated in functional dyspepsia (FD), the mechanisms by which stress results in symptoms are not well defined. The aim of the current study was to assess gastric myoelectric and autonomic changes in response to a physical stressor in youth with FD. METHODS: In a group of healthy controls and pediatric FD subjects, we recorded ECG and EGG signals 30 min before and 60 min after, a cold pressor task (CPT). Gastric EGG and heart rate variability (HRV) parameters were calculated in pre- and post-CPT stages and in short intervals. RESULTS: The pre-CPT percent tachygastria was higher in FD subjects as compared to controls. However, CPT did not induce any EGG changes in either controls or FD subjects and the two groups did not differ from each other post-CPT. The CPT resulted in an increase in HRV and standard deviation of NN intervals in controls; there was no change in any HRV parameter in FD subjects. CONCLUSIONS: Acute physical stress does not appear to induce gastric electrical abnormalities in youth with FD. Youth with FD appear to lack the normal flexible autonomic response to a physical stressor.


Asunto(s)
Frío/efectos adversos , Dispepsia/diagnóstico , Dispepsia/fisiopatología , Motilidad Gastrointestinal/fisiología , Frecuencia Cardíaca/fisiología , Estrés Fisiológico/fisiología , Adolescente , Niño , Electrocardiografía/métodos , Fenómenos Electromagnéticos , Femenino , Humanos , Masculino , Dimensión del Dolor/métodos
3.
J Pediatr ; 144(4): 541-4, 2004 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-15069408

RESUMEN

We report a case of chronic recurrent clavicular osteomyelitis in association with Crohn disease. Steroid therapy resulted in partial remission; however, intractable shoulder pain and an enlarging clavicular mass subsequently recurred. Infliximab therapy resulted in significant improvement in the degree of bone pain and resolution of the large sclerotic clavicular lesion.


Asunto(s)
Anticuerpos Monoclonales/uso terapéutico , Clavícula , Enfermedad de Crohn/tratamiento farmacológico , Fármacos Gastrointestinales/uso terapéutico , Osteomielitis/tratamiento farmacológico , Niño , Enfermedad Crónica , Enfermedad de Crohn/complicaciones , Femenino , Humanos , Infliximab , Osteomielitis/complicaciones , Dolor/tratamiento farmacológico , Dolor/etiología
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