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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Like other segments of the child's development, eating behavior follows a sequential pattern. To understand the infant's or child's feeding problems which can lead to failure to thrive or dwarfism we propose that a child's progression be studied through three stages of development: homeostasis, attachment and separation-individuation. Specific feeding problems can arise at each of these stages of development and consequently impede the child's weight gain. During the period of homeostasis the infant learns to regulate himself, to suck, to swallow and to time the onset and termination of feedings by giving signals of hunger and fullness. If he is unable to master these, he cannot be fed effectively. Failure to master these basic feeding skills interferes with the next developmental task of attachment and also impedes development of motor skills, language and affective engagement. During the period of attachment, the infant establishes distinct interactional patterns with his caretakers. Lack of engagement between mother and infant leads to lack of pleasure and lack of appetite or even to severe dysfunctional feeding patterns like vomiting and rumination. Feeding problems in the third developmental stage of separation and individuation can arise because of maladaption in the attachment phase or because of new difficulties which center around issues of autonomy vs. dependency. At this stage, the infant learns means-end differentiation and begins to understand that his actions elicit certain consequences. If the infant's struggle between autonomy and dependency gets caught in the feeding situation, the infant's emotional needs can dictate his eating behavior. The infant refuses to eat either to have his emotional hunger for mother's attention met or to assert his autonomy and to express his anger toward her. In order for the infant to learn to differentiate between his physiological feelings of hunger and his emotional need states, the caregiver needs to give contingent responses by offering food when the infant is hungry and comfort when the infant is distressed. Feeding problems which can create, co-exist with, or result from a growth problem must be considered within a developmental context. As the infant progresses through the developmental stages of homeostasis, attachment, and separation, he masters phase-appropriate feeding skills which help him to progress from reflex sucking to autonomous feeding. Early identification of maladaptive feeding behavior will assist the pediatrician in making timely interventions.
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PMID:Non-organic failure to thrive: a developmental perspective. 659 32

There are major differences in gastroesophageal reflux between children and adults. Vomiting, failure to thrive, and respiratory symptoms are more common in children as is a spontaneous, complete resolution of symptoms over time. Abnormalities of gastric emptying are noted in both adults and children and may aggravate the reflux. Children have a better response than adults to surgery, both in the early and late postoperative period.
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PMID:Gastroesophageal reflux and gastric emptying. 664 77

Giardia lamblia is the first protozoan to be identified and recognized as an important pathogen in human disease. We studied 8 pediatric patients with giardiasis in order to examine the clinical spectrum, the structural changes of the small intestinal mucosa and mainly the protozoan's ultrastructural features. The most common clinical manifestations were diarrhea, abdominal pain, anorexia, vomiting, failure to thrive. Infection was confirmed by excreted cysts in the stools in one patient, by the presence of trophozoites in duodenal aspirate and on jejunal mucosa. Giardiasis was not associated with hypogammaglobulinemia in our patients and no or only slight mucosal abnormalities were present in jejunal biopsies, except one which showed a flat mucosa. Specimens for transmissions and scanning electron microscopy were taken. We could establish the protozoan's features, its normal distribution, its relationship to intestinal mucosa and structural indications of the normal reaction of intestine with the use of ultrastructural techniques. The trophozoites colonized the proximal intestine, adhered to microvilli of columnar cells near the bases of villi, wedged or lodged in mucus. The sticky mucus producing an effective diffusion barrier to nutrients could explain malabsorption phenomena. Numerous intraluminal lymphocytes were seen, suggesting an immune response. These observations indicate that in giardiasis the clinical spectrum and structural changes of the small intestinal mucosa vary widely, suggesting a different reaction of immune system and/or a different degree of infection.
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PMID:[Giardiasis in children. Ultrastructural study of the parasite]. 664 80

To evaluate response to fundoplication, clinical results for 66 consecutive pediatric patients operated on for gastroesophageal reflux were retrospectively reviewed. Indications for operation were gastroesophageal reflux with apnea, repeated emesis, recurrent pneumonia, failure to thrive, stricture, and esophagitis. All patients had preoperative documentation of significant gastroesophageal reflux by either cinefluoroscopic reflux esophagogram or reflux nuclear scan. Fundoplication was effective in 56 (87%) of 64 patients. None of the patients considered to be operative failures had persistent gastroesophageal reflux. Operative failures occurred primarily in patients with gastroesophageal reflux and apnea or recurrent pneumonia. More advanced diagnostic tests, such as pH monitoring, may help to select patients whose symptoms of apnea and recurrent pneumonia are truly due to reflux. Gastroesophageal reflux produces significant morbidity in pediatric patients and is well treated operatively by fundoplication.
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PMID:Management of severe gastroesophageal reflux in children. 671 68

Three cases of diencephalic syndrome, associated with brain tumors, are reported in this paper. Case 1. A 2-2/12-year old boy was initially admitted to our hospital because of failure to thrive which began at the age of three months. Physical examination revealed emaciation (weight, 7.8 kg), irritability and pallor without anemia. Horizontal nystagmus was seen. Laboratory studies were normal except for abnormally high plasma growth hormone (p-GH) which was incompletely suppressed by hyperglycemia (induced by glucose) and was not elevated by hypoglycemia (induced by insulin). A low grade astrocytoma of the optic nerve compression the hypothalamus was partially removed. After the operation followed by irradiation, p-GH returned to normal both in its basal level and in its reaction to insulin loading, then his gain of weight was accelerated. He was readmitted, however, at the age of 6 8/12 years with headache and vomiting. Since subtotal removal of the recurrent tumor and irradiation, preoperative symptoms have disappeared up to the present (7 9/12 years old). Case 2. A 3-9/12-year old girl was initially admitted because of failure to thrive since the age of 2 years. Examination on admission revealed emaciation (10.5 kg), irritability and right hemiparesis. Laboratory studies were normal except for high serum cholesterol (290 mg/dl). (p-HG was not measured) The patient had been well after the subtotal removal of the hypothalamic astrocytoma except occasional headache until the age of 6 years. She was readmitted at the age of 9 years with progressive emaciation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Diencephalic syndrome--report of three cases]. 671 44

Achalasia in infancy is rare. A male infant who started to have symptoms at the age of 4 months, and who was operated at the age of 17 months is described. Post operatively the symptoms subsided and normal growth and development were regained. Achalasia should be included in the differential diagnosis of children with regurgitation, vomiting and failure to thrive.
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PMID:Infantile achalasia. 672 34

Clinical course and special diagnostic procedures in a 7 1/2 weeks old dystrophic infant with propionic acidemia are described. The disorder manifested with vomiting and diarrhea within the first week of life when the child was on a cow milk formula. Parenteral nutrition with glucose and electrolytes led to improvement. When oral nutrition with a cow milk formula was implemented again, an acute deterioration with diarrhoea and vomiting occurred. Thus, a diagnosis of cow milk allergy was suggested. There was also a severe muscular hypotony. Oral nutrition with a soybean formula did not prevent further clinical deterioration. At 7 1/2 weeks of age the patient died with symptoms of cardiogenic shock. The correct diagnosis was considered too late and confirmed post mortem. Clinical symptoms in the neonatal period like vomiting, muscular hypotony and failure to thrive should alert the physician to a possible diagnosis of a hereditary organic aciduria. Gas chromatography-mass spectrometry of urinary organics acids, in the present case, established the diagnosis. On autopsy, spongy degenerations were found in CNS.
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PMID:[Propionic acidemia with myelination disorders of the CNS]. 673 46

This is the first known reported case of autosomal recessive syndrome of renal tubular acidosis and sensorineural deafness in the otorhinolaryngological literature. Ten cases in six families have been reported in the pediatric literature. Most cases manifested at birth or soon after with vomiting, dehydration, polydipsia, polyuria, hyposthenuria, and failure to thrive. Renal tubular acidosis is a clinical syndrome of disordered acidification out of proportion to the impairment of glomerular filtration, and is associated with alkaline urine. Sensorineural deafness is variable and, in most cases, present in early childhood.
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PMID:Renal tubular acidosis and sensorineural deafness: an autosomal recessive syndrome. 676 50

Lysinuric protein intolerance is an autosomal recessive disease, due to a defect in intestinal, renal and hepatic dibasic amino acid transport. Two new cases in the same family are reported. The disease appears progressively during the first months of life with failure to thrive, anorexia, vomiting, diarrhea, hepatosplenomegaly, muscular weakness, osteoporosis, anemia, leukothrombocytopenia, hyperammonemia and orotic aciduria after a high-protein intake. Hyperdibasicamino-aciduria was associated with subnormal plasma concentrations of the same aminoacids. Oral l-arginine, l-ornithine, l-lysine, and lysyl-glycine loads confirmed the diagnosis. The supplementation of the diet with l-citrulline resulted in normal levels of blood ammonia. However, hepatosplenomegaly, muscular weakness, osteoporosis remained unchanged and growth was not improved. These may be due to lysine deficiency.
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PMID:[Lysinuric protein intolerance: a severe hyperammonemia secondary to l-arginine deficiency (author's transl)]]. 680 Mar 34

Review of hospital records of 122 infants, aged between 1 and 25 months, admitted to a teaching hospital with the diagnosis of failure to thrive but without an underlying disease apparent at admission, showed that about one-third of them had no diagnosis after evaluation. Thirty-two per cent were thought to have a social or environmental explantation for poor growth, and 31% were given a specific organic or physiological diagnosis. Of the last group, 2 out 3 were diagnosed as having either gastro-oesophageal reflux or non-specific chronic diarrhoea. Vomiting was often associated with organic or structural disease. On average about 40 laboratory tests and x-ray films were performed per infant, but only 0.8% of all tests showed an abnormality which contributed to the diagnosis of the cause of failure to thrive. Our results stress the importance of social and environmental factors as basic causes of failure to thrive, and suggest that admission to hospital and laboratory testing is unlikely to lead to a specific organic diagnose in a child whose failure to thrive is unexplained after careful history taking and a physical examination.
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PMID:Failure to thrive: diagnostic yield of hospitalisation. 680 15


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