The association between gastroesophageal reflux (GER) and asthma is not fortuitous. The objective of our study was to test a group of children with asthma by, 24 hr gastroesophageal pH monitoring and to relate the results to the patients medical history and clinical data. We studied 77 children aged from 39 to 170 months suffering from particularly recurrent and/or therapy-resistant asthma. Medical history data were collected for each patient and included: severity and characteristics of respiratory symptoms, presence, if any of allergy; presence, if any, of GER-related symptoms; and presence, if any, of esophagitis-related symptoms. Esophageal pH was measured by 24 hr computerized monitoring of the main measures in all patients. Forty-seven children were also examined by gastroesophageal endoscopy. The prevalence of GER was 61% on the basis of the reflux index (cutoff: 4.2%). Gastroesophageal reflux in these asthmatic children was characterized mainly by short-lasting daytime episodes. The patients tended to present GER mainly associated with vomiting but not with signs and symptoms of esophagitis. The short-lasting nature of the reflux episodes demonstrates good esophageal clearance. The time of onset of respiratory symptoms (day/night) was not associated with any particular type of GER, the severity of which tends to be proportional to the seriousness of the asthma. No correlation was found between GER and allergy. No statistically significant differences were found in clinical or medical history findings between patients with pathologic and nonpathologic GER.
Objective: To evaluate substrate utilization in full-term newborn infants, fed every 3±4 h with glucose 10% solution, within 30 h from birth. Design: Random. Setting: Full term newborn infants at the Paediatric Division City Major Hospital, Chair of Paediatrics, Verona University. Subjects: Forty-six newborn infants, 24 females and 22 males of 39 AE 2 weeks gestational age. Methods: Oxygen consumption (VO 2 ) and CO 2 production (VCO 2 ) were measured. Permitting the computation of the respiratory quotient (RQ), which expresses substrate oxidation, at 6 and 30 h from birth. An indirect calorimeter (Deltratrac TMII-MBM-200-DATEX) was used to measure components of energy-balance. Results: Energy expenditure calculated at 6 h was 8.130 (AE1.5757) kJakgah. At 30 h the value changed to 8.858 (AE1.483) kJakgah. Statistical evaluation (t-student) showed a signi®cant (P 0.000) variation in RQ values (6 h: RQ 0.94; 30 h: RQ 0.88). Conclusions: Respiratory quotient suggests an increase of energy derived from fat metabolism at 30 h from birth. Our data con®rm that early breast feeding or formula milk feeding could represent a physiological approach to nutritional regimen of the newborn infant.
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