Feeding Disorders In Children With Gastro-esophageal Reflux Disease

Background: feeding/eating disorders are frequent in pediatric patients and, in some cases, can be associated to an upper digestive motility disorder. Gastro-esophageal reflux is, nowadays, considered a risk factor for the development of feeding/eating disorders. Aim: to verify the occurrence of feeding/eating disorders in patients with Gastro-Esophageal Reflux Disease (GERD) determined by the 24-H esophageal pH monitoring evaluation. Method: an analytical observational cross-sectional study of the stomathognatic system and feeding/eating behavior in healthy children and in children with GERD. Results: 25 children (ages 45,68 ± 34,22 months; mean ± SD) with the diagnosis of GERD determined by the 24-H esophageal pH monitoring evaluation and 40 children (ages 60,65 ± 36,07 months; mean ± SD) randomized from their school group. The criteria for the pH monitoring were: vomiting, regurgitation, wheezing and recurrent pneumonia. There was no significant difference in age mean between groups. Children with GERD presented an significantly higher frequency (p<0.05) of feeding/eating problems (F/EP) and of oral motor-sensory disturbances (sucking, chewing and swallowing). Behavioral F/EP was present in 44% of the cases and oral motor-sensory F/EP in 80%. About 64% of the children had a history of feeding/eating complaints, 36% presented an extended feeding/eating time, 68% presented problems in the development of the oral feeding patterns and 60% presented alterations in the nasal breathing pattern. Conclusion: children with GERD presented a higher prevalence of behavioral and stomathognatic feeding/eating problems when compared to healthy children.1915966AHMAD, I., BATH, A.J.G., Acid reflux management: ENT perspective (2004) J. Laryngol. Otol, 118, pp. 25-30. , Birmingham UK, v, janBURKLOW, K. A.PHELPS, A. N.SCHULTZ, J.MCCONNELL, K.RUDOLPH, C. Classifying complex pediatric feeding disorders. J. Pediatr. Gastroenterol. Nutr., Philadelphia, v. 27, n. 2, p. 143-147, ago. 1998CATTONI, D.M., ANDRADE, D.R.F., ZACKIEWICZ, D.M., NEIVA, F.C.B., Levantamento da consistência do alimento recebido no primeiro ano de vida (2001) R. Soc. Bras. Fonoaudiol, 6 (1), pp. 59-64. , São Paulo, v, junCOOPER, P.J., WHELAN, E., WOOLGAR, M., MORRELL, J., MURRAY, L., Association between childhood feeding problems and maternal eating disorder: Role of the family environment (2004) Br. J. Psychiatry, 184, pp. 210-215. , Londres, v, marDELLERT, S.F., HYAMS, S.J., WILLIAM, R.T., GEERTSMA, A., Feeding resistance and gastroesophageal reflux in infancy (1993) J. Pediatr. Gastroenterol. Nutr, 17 (1), pp. 66-71. , Philadelphia, v, aprDOUGLAS, J.E., BYRON, M., Interview data on severe behavioral eating difficulties in young children (1996) Arch. Dis. Child, 75 (4), pp. 304-308. , Nova York, v, octFERRIOLI, E., OLIVEIRA, R.B., MATSUDA, N.M., BRAGA, F.J., DANTAS, R.O., Aging, esophageal motility and gastroesophageals reflux (1998) J. Am. Geriatr. Soc, 46 (12), pp. 1534-1537. , Nova York, v, decGILLESPIE, A.H., ACTERBERG, C.L., Comparison of family interaction patterns related to food and nutrition (1989) J. Am. Diet. Assoc, 89 (4), pp. 509-512. , Chicago, v, abrGOLDANI, H.A.S., (1999) Motilidade do trato digestivo superior em crianças com problemas de alimentação e refluxo gastroesofágico, , 99 f. Tese Doutorado em puericultura e pediatria, Faculdade de Medicina, Universidade de São Paulo. Ribeirão PretoJUNQUEIRA, P.COSTA, M. M. B. Protocolo para avaliação videofluoroscópica da dinâmica da fase oral da deglutição de líquido. Pró-Fono R. Atual. Cient., Carapicuíba (SP), v. 13, n. 2, p. 165-168, set. 2001JUNQUEIRA, P. A. de S.FRANCESCO, R. C. D.TREZZA, P.ZERATTI, F. E.FRIZZARINI, R.FARIA, M. E. J. de. Alterações funcionais do sistema estomatognático pré e pós-adenoamigdalectomia. Pró-Fono R. Atual. Cient., Carapicuíba (SP), v. 4, n. 1, p. 17-22, jan.-abr. 2002MADEIRA, I.R., AQUINO, L.A., Problemas de abordagem dificil: "não come" e "não dorme (2003) J. Pediatr, 79 (SUPL. 1), pp. S43-S54. , Rio de Janeiro, v, mayMANIKAN, R., PERLMAN, J.A., Pediatric feeding disorder (2000) J. Clin. Gastroenterol., New York, 30 (1), pp. 34-46. , janMARCHESAN, I.Q., (1998) Uma visão compreensiva das práticas fonoaudiológicas: A influência da alimentação no crescimento e desenvolvimento craniofacial e nas alterações miofuncionais, , São Paulo: Pancast, 238 pMARCHESAN, I.Q., Avaliação e terapia dos problemas da respiração (1998) Fundamentos da fonoaudiologia: Aspectos clínicos da motricidade oral, pp. 23-26. , Rio de Janeiro: Guanabara KooganMEIRA, R. R. S. Refluxo gastroesofágico: uma demanda na clínica pediátrica e a intervenção fonoaudiológica. In: MARCHESAN, I. Q.ZORZI, J. L.GOMES, I. C. D. (Org). Tópicos em fonoaudiologia. São Paulo: Lovise, 1998. p. 479-487MORALLES, R. C. O. Sucção, deglutição e mastigação fisiológicas. In: MORALLES, R. C. O. Terapia de regulação orofacial: conceito RMC. São Paulo: Memnon, 2002. p. 45-56MORRIS, S.E., KLEIN, M.D., (2000) Pre-feeding skills: A comprehensive resource for mealtime development, pp. 31-41. , 2. ed. Arizona USA, Therapy Skill BuildersMOTTA, A. R.COSTA, H. O. de O. A mastigação no período intertransicional da dentição mista. R. Dent. Press. Ortodon. Ortoped. Facial, Maringá (PR), v. 7, n. 5, p. 77-86, set-out. 2002NELSON, S.P., CHEN, E.H., SYNIAR, G.M., CHRISTOFFEL, K.K., One-year follow-up of symptoms of gastroesophageal reflux during infancy (1998) Pediatrics, 102, pp. 1470-1481. , Springfield, v, dezRABINOWITZ, S.S., PIECUCH, S., JIBLY, R., GOLDSMITH, A., SCHWARZ, S.M., Optimizing the diagnosis of gastroesophageal reflux in children with otolaryngologic symptoms (2003) Int. J. Pediatr. Otorhinolaryngol, 67 (6), pp. 621-626. , Amsterdam, v, junRAMSAY, M., GISEL, E.G., McCUSKER, J., BELLAVANCE, F., PLATT, R., Infant sucking ability, nonorganic failure to thrive, maternal characteristics, and feeding practices: A prospective cohort study (2002) Dev. Med. Child. Neurol, 44 (6), pp. 405-414. , London, v, junRICHTER, J.E., Ear, nose and throat and respiratory manifestations of gastro-esophageal reflux disease: An increasing conundrum (2004) Eur. J. Gastroenterol. Hepatol, 16 (9), pp. 837-845. , London, v, sepROMMEL, N., DE MEYER, A.M., FEENSTRA, L., VEEREMAN-WAUTERS, G., The complexity of feeding problems in 700 infants and young children presenting to a tertiary care institution (2003) J. Pediatr. Gastroenterol. Nutr, 37 (1), pp. 75-84. , New York, v, marRUDOLPH, C.D., MAZUR, L.J., LIPTAK, G.S., BAKER, R.D., BOYLE, J.T., COLLETTI, R.B., GERSON, W.T., WERLIN, S.L., Guidelines for evaluation and treatment of gastroesophageal reflux in infants and children: Recommendations of the North American Society for Pediatric Gastroenterology and Nutrition (2001) J. Pediatr. Gastroenterol. Nutr, 32 (SUPPL. 2), pp. S1-31. , New York, vRUDOLPH, C.D., LINK, D.T., Feeding disorder in infants and children (2002) Pediatr. Clin. North Am, 49 (1), pp. 97-112. , Philadelphia, v, febSOMANI, S.K., GHOSHAL, U.C., SARASWAT, V.A., AGGARWAL, R., MISRA, A., KRISHNAMI, N., NAIK, S.R., Correlation of esophageal pH and motor abnormalities with endoscopic severity of reflux esophagius. Dis. Esophagus (2004) New York, 17 (1), pp. 58-62. , aprSOUZA, L. P. de.BITAR, M. L. Alimentação de lactentes com refluxo gastresofágico (RGE). Pró-Fono R. Atual. Cient., Barueri (SP), v. 15, n. 2, p. 117-124, ago. 2003STAIANO, A., Food refusal in toddlers with chronic diseases (2003) J. Pediatr. Gastroenterol. Nutr, 37 (3), pp. 225-227. , Philadelphia, v, sepSTRUDWICK, S. Gastro-oesophageal reflux and feeding: the speech and language therapist's perspective. Int. J. Pediatr. Otorhinolaryngol., Amsterdam, v. 67, n. 1, p. S101-S102, dec. 2003. suppl. 1SUSS-BURGHART, H., Feeding disorders and failure to thrive in small and/ or handicapped children (2000) Z. Kinder Jugendpsychiat. Psychother, 28 (4), pp. 285-296. , Alemanha, v, novTUCHMAN, D. N. Disorders of deglutition. In: WALKER, W. A.DURIE, P. R.HAMILTON, J. R.WALKER-SMITH, J. A.WATKINS, J. B. Pediatric Gastrintestinal Disorders. Ontário (Canadá): BC Decker Inc Hamilton, 2000. p. 277-288YUAN, Q.WINTER, H. S. Gastroesophageal reflux in children. In: FASS, R. GERD: dyspepsia. Filadélfia: Hanley & Belfus Inc, 2004. p. 289-25

An Evolutionary Perspective on Sedentary Behavior

Funding Information Royal Society wolfson merit award Natural Science Foundation of China. Grant Number: 91731303Peer reviewedPostprin

Individual variation in age‐dependent reproduction: Fast explorers live fast but senesce young?

Adaptive integration of life history and behaviour is expected to result in variation in the pace‐of‐life. Previous work focused on whether ‘risky’ phenotypes live fast but die young, but reported conflicting support. We posit that individuals exhibiting risky phenotypes may alternatively invest heavily in early‐life reproduction but consequently suffer greater reproductive senescence. We used a 7‐year longitudinal dataset with >1,200 breeding records of >800 female great tits assayed annually for exploratory behaviour to test whether within‐individual age dependency of reproduction varied with exploratory behaviour. We controlled for biasing effects of selective (dis)appearance and within‐individual behavioural plasticity. Slower and faster explorers produced moderate‐sized clutches when young; faster explorers subsequently showed an increase in clutch size that diminished with age (with moderate support for declines when old), whereas slower explorers produced moderate‐sized clutches throughout their lives. There was some evidence that the same pattern characterized annual fledgling success, if so, unpredictable environmental effects diluted personality‐related differences in this downstream reproductive trait. Support for age‐related selective appearance was apparent, but only when failing to appreciate within‐individual plasticity in reproduction and behaviour. Our study identifies within‐individual age‐dependent reproduction, and reproductive senescence, as key components of life‐history strategies that vary between individuals differing in risky behaviour. Future research should thus incorporate age‐dependent reproduction in pace‐of‐life studies

Drd4 gene polymorphisms are associated with personality variation in a passerine bird

Polymorphisms in several neurotransmitter-associated genes have been associated with variation in human personality traits. Among the more promising of such associations is that between the human dopamine receptor D4 gene (Drd4) variants and novelty-seeking behaviour. However, genetic epistasis, genotype–environment interactions and confounding environmental factors all act to obscure genotype–personality relationships. Such problems can be addressed by measuring personality under standardized conditions and by selection experiments, with both approaches only feasible with non-human animals. Looking for similar Drd4 genotype–personality associations in a free-living bird, the great tit (Parus major), we detected 73 polymorphisms (66 SNPs, 7 indels) in the P. major Drd4 orthologue. Two of the P. major Drd4 gene polymorphisms were investigated for evidence of association with novelty-seeking behaviour: a coding region synonymous single nucleotide polymorphism (SNP830) and a 15 bp indel (ID15) located 5′ to the putative transcription initiation site. Frequencies of the three Drd4 SNP830 genotypes, but not the ID15 genotypes, differed significantly between two P. major lines selected over four generations for divergent levels of ‘early exploratory behaviour’ (EEB). Strong corroborating evidence for the significance of this finding comes from the analysis of free-living, unselected birds where we found a significant association between SNP830 genotypes and differing mean EEB levels. These findings suggest that an association between Drd4 gene polymorphisms and animal personality variation predates the divergence of the avian and mammalian lineages. Furthermore, this work heralds the possibility of following microevolutionary changes in frequencies of behaviourally relevant Drd4 polymorphisms within populations where natural selection acts differentially on different personality types

Potential biomarkers for diagnosis of sarcoidosis using proteomics in serum

SummaryBackgroundSarcoidosis is a multi-systemic inflammatory disorder, which affects the lungs in 90% of the cases. The main pathologic feature is chronic inflammation resulting in non-caseating granuloma formation. Until now there is no satisfying biomarker for diagnosis or prognosis of sarcoidosis. This study is focused on the detection of potential biomarkers in serum for the diagnosis of sarcoidosis using surface-enhanced laser desorption ionization-time of flight-mass spectrometry (SELDI-TOF-MS).MethodsFor detection of potential biomarkers, protein profiles of anion exchange fractionated serum of 35 sarcoidosis patients and 35 healthy controls were compared using SELDI-TOF-MS. Sensitivities and specificities of the potential biomarkers obtained with SELDI-TOF-MS, generated with decision tree algorithm, were compared to the conventional markers angiotensin converting enzyme (ACE) and soluble interleukin-2 receptor (sIL-2R).ResultsOptimal classification was achieved with metal affinity binding arrays. A single marker with a mass-to-charge (m/z) value of 11,955 resulted in a sensitivity and specificity of 86% and 63%, respectively. A multimarker approach of two peaks, m/z values of 11,734 and 17,377, resulted in a sensitivity and specificity of 74% and 71%, respectively. These sensitivities and specificities were higher compared to measurements of ACE and sIL-2R. Identification of the peak at m/z 17,377 resulted in the α-2chain of haptoglobin.ConclusionsThis study acts as a proof-of-principle for the use of SELDI-TOF-MS in the detection of new biomarkers for sarcoidosis. The peak of the multimarker at m/z 17,377 was identified as the α-2chain of haptoglobin

Quantitative ultrasound does not identify patients with an inflammatory disease at risk of vertebral deformities

<p>Abstract</p> <p>Background</p> <p>Previous studies from our group have shown that a high prevalence of vertebral deformities suggestive of fracture can be found in patients with an inflammatory disease, despite a near normal bone mineral density (BMD). As quantitative ultrasound (QUS) of the heel can be used for refined assessment of bone strength, we evaluated whether QUS can be used to identify subjects with an inflammatory disease with an increased chance of having a vertebral fracture.</p> <p>Methods</p> <p>246 patients (mean age: 44 ± 12.4 years) with an inflammatory disease (sarcoidosis or inflammatory bowel disease (IBD)) were studied. QUS of the heel and BMD of the hip (by dual X-ray absorptiometry (DXA)) were measured. Furthermore lateral single energy densitometry of the spine for assessment of vertebral deformities was done. Logistic regression analysis was performed to assess the strength of association between the prevalence of a vertebral deformity and BMD and QUS parameters, adjusted for gender and age.</p> <p>Results</p> <p>Vertebral deformities (ratio of <0.80) were found in 72 vertebrae of 54 subjects (22%). In contrast to the QUS parameters BUA (broadband ultrasound attenuation) and SOS (speed of sound), T-score of QUS and T-scores of the femoral neck and trochanter (DXA) were lower in the group of patients with vertebral deformities. Logistic regression analysis showed that the vertebral deformity risk increases by about 60 to 90% per 1 SD reduction of BMD (T-score) determined with DXA but not with QUS.</p> <p>Conclusion</p> <p>Our findings imply that QUS measurements of the calcaneus in patients with an inflammatory condition, such as sarcoidosis and IBD, are likely of limited value to identify patients with a vertebral fracture.</p

Competitor phenology as a social cue in breeding site selection

Predicting habitat quality is a major challenge for animals selecting a breeding patch, because it affects reproductive success. Breeding site selection may be based on previous experience, or on social information from the density and success of competitors with an earlier phenology. Variation in animal breeding phenology is often correlated with variation in habitat quality. Generally, animals breed earlier in high-quality habitats that allow them to reach a nutritional threshold required for breeding earlier or avoid nest predation. In addition, habitat quality may affect phenological overlap between species and thereby interspecific competition. Therefore, we hypothesized that competitor breeding phenology can be used as social cue by settling migrants to locate high-quality breeding sites. To test this hypothesis, we experimentally advanced and delayed hatching phenology of two resident tit species on the level of study plots and studied male and female settlement patterns of migratory pied flycatchers Ficedula hypoleuca. The manipulations were assigned at random in two consecutive years, and treatments were swapped between years in sites that were used in both years. In both years, males settled in equal numbers across treatments, but later arriving females avoided pairing with males in delayed phenology plots. Moreover, male pairing probability declined strongly with arrival date on the breeding grounds. Our results demonstrate that competitor phenology may be used to assess habitat quality by settling migrants, but we cannot pinpoint the exact mechanism (e.g. resource quality, predation pressure or competition) that has given rise to this pattern. In addition, we show that opposing selection pressures for arrival timing may give rise to different social information availabilities between sexes. We discuss our findings in the context of climate warming, social information use and the evolution of protandry in migratory animals

Increased circulating desmosine and age-dependent elastinolysis in idiopathic pulmonary fibrosis

Abstract Although chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis (IPF) seem to be opposite entities from a clinical perspective, common initial pathogenic steps have been suggested in both lung diseases. Emphysema is caused by an elastase/anti-elastase imbalance leading to accelerated elastin degradation. Elastinolysis is however, also accelerated in the IPF patients’ lungs. The amino acids desmosine and isodesmosine (DES) are unique to elastin. During the degradation process, elastases liberate DES from elastin fibers. Blood DES levels consequently reflect the rate of systemic elastinolysis and are increased in COPD. This is the first report describing elevated DES levels in IPF patients. We also demonstrated that the age-related increment of DES concentrations is enhanced in IPF. Our current study suggests that elastinolysis is a shared pathogenic step in both COPD and IPF. Further investigation is required to establish the relevance of accelerated elastin degradation in IPF and to determine whether decelerating this process leads to slower progression of lung fibrosis and better survival for patients with IPF.https://deepblue.lib.umich.edu/bitstream/2027.42/142803/1/12931_2018_Article_747.pd