No abstract

Serum gastrin was measured by radio-immunoassay during postvagotomy insulin tests in 33 patients. In 11, the study was preceded by propranolol 20 mg, orally. Gastric acid output was lower in the group pretreated with propranolol. There was no difference in serum gastrin between Hollander ‘positive’ versus Hollander ‘negative’ insulin tests. Propranolol affects insulin-stimulated gastric secretion in ways other than by affecting total serum gastrin.

The authors report a case of classic esophagitis simulating candidiasis radiographically. Endoscopy provided pathological conformation of herpes infection, showing typical multinucleated cells with intranuclear inclusion bodies.

OBJECTIVE No studies, to our knowledge, have determined the relationship between symptom resolution and timing of antimicrobial discontinuation in necrotizing enterocolitis (NEC). Our study seeks to determine the period to NEC resolution by using severity-guided management, based on surrogate markers used in the diagnosis of NEC. METHODS This retrospective, observational review included patients in our NICU with NEC from June 1, 2012, to June 1, 2018. Patients were excluded for surgical NEC, a positive blood culture or transfer from an outside institution at the time of NEC, presence of a peritoneal drain, or death prior to NEC resolution. The primary outcome was time to resolution of NEC, measured by return to baseline of surrogate markers used in the diagnosis of NEC. RESULTS The median times to resolution in days, based on our institution's NEC severity group, were as follows: mild 3 (range, 1–4); moderate 4 (range, 1–17); severe 9 (range, 5–21). No difference in NEC recurrence was found based on antibiotic duration (OR 0.803; 95% CI, 0.142–4.225). CONCLUSIONS Time to resolution of NEC differs by severity group, suggesting a need for different treatment durations. Recurrence of NEC did not differ between groups, suggesting that shorter antibiotic durations do not lead to an increased incidence of NEC recurrence. Further exploration of the optimal antimicrobial treatment duration for NEC is warranted.