Gastric pneumatosis following cardiac surgery.

Infiltration of the stomach wall by air, first described by Fraenkel in 1889 [3], is a very rare condition. We describe the first reported case of gastric pneumatosis occurring in a child with complex congenital heart disease after cardiac surgery.

Diet and physical activity in restrained eaters.

Food choices, nutrient intakes, activity patterns and restrained eating scores were obtained from 249 normal-weight, young adults using self-reported questionnaires. Restrained eaters reported that they consumed more fat-free dairy products, fewer full-fat dairy products, fewer servings of fats and oils, less red meat and more fruits and vegetables than unrestrained eaters. In contrast to previous research, we found no overall difference in estimated daily energy intakes between restrained and unrestrained eaters, although there was a strong trend for restrained men to consume fewer calories per day. However, restrained eaters consumed less fat and more carbohydrate than unrestrained eaters. Restrained eaters in general were not more physically active than unrestrained eaters, but among the most active women, the restrained eaters were estimated to consume 13.3% less fat then the unrestrained eaters. This relationship was not observed in men. These data suggest that: (1) restrained eating influenced macronutrient composition in our respondents, but these effects were somewhat different in men and women; and (2) exercise played an important role in the dieting practices of restrained women but not restrained men. Examining only the food intakes of restrained women without considering their physical activity patterns may provide an incomplete picture of their dieting strategies.

Symptomatic Helicobacter pylori infection in young patients with severe neurologic impairment.

Helicobacter pylori infection was identified in five patients with profound neurologic impairment who were undergoing evaluation for gastrointestinal symptoms, and it was subsequently identified in 7 of 61 patients with symptoms whose condition was evaluated prospectively. Institutionalized patients were at greater risk of infection. Treatment of H. pylori infection resulted in symptomatic improvement for the majority of patients.

Effects of learned flavor cues on single meal and daily food intake in humans.

This study examined the effects of learned flavor cues on lunch-meal and daily food intake in 39, normal-weight, free-living adults. Subjects were fed distinctly flavored high-calorie (HC) and low-calorie (LC) milkshake preloads. Following the repeated flavor-calorie pairings, the flavors of the milkshakes were covertly switched. Twenty-three percent of the participants were classified as sensory responders. That is, their lunch intake reflected the anticipated caloric content of the preloads based on the sensory properties rather than the true energy value. Short-term sensory learning did not reliably alter 24-h energy intake in these subjects. The remaining subjects (i.e., sensory nonresponders) ignored the flavor cues and consumed the same size lunches across all phases of the study. Compensation for the preloads was examined during the training period (i.e., before the flavors were switched). Sensory responders accurately adjusted lunch intakes on the first day of exposure to both preloads, demonstrating unlearned compensation for energy density. Compensation continued to be accurate across training days for the HC (85%) but not the LC preload (65%). Sensory nonresponders did not compensate accurately for either of the preloads. Thus, sensory responders were initially more responsive to the caloric density of the preloads and continued to make accurate adjustments when the flavor cue matched the caloric load (i.e., during training) but were misled by the flavor cue when it did not match the caloric consequence (i.e., when the flavors were switched). Sensory nonresponders ignored the sensory cues and ate the same size lunches regardless of the caloric value of the preload.(ABSTRACT TRUNCATED AT 250 WORDS)

Renal function and renal failure in the newborn.

Renal function in the newborn infant varies with conceptual age and should be evaluated in this context. Very preterm infants less than 34 weeks' conceptual age have reduced GFR and tubular immaturity in the handling of filtered solutes when compared to term infants. Premature infants between 34 and 37 weeks' conceptual age undergo rapid maturation of renal function similar to term infants, with establishment of glomerulotubular balance early in the postnatal period. ARF in neonates differs from that seen in older children and adults in that ischemic (e.g., hypoxic) insults and congenital malformations constitute the major pathophysiologic mechanisms responsible for clinically observed oliguria and azotemia. Principles of conservative management are similar to those used in older children except for the greatly increased insensible water loss requirements of the very preterm and premature infant. Technical advances have added peritoneal dialysis and CAVH to the therapeutic regimen for persistent ARF or life-threatening complications of reduced renal function.