Abstract:
AIM:gastrostomy feeding children with spastic quadriplegic cerebral palsy (SQCP) improves weight gain but may cause excess deposition of body fat. This study was designed to investigate whether weight gain could be achieved without an adverse effect on body composition by using a low-energy feed in gastrostomy-fed children with SQCP. METHOD:ourteen children (seven male; seven female; median age 2y; range 10mo-11y) with SQCP were studied, 13 of whom were classified as Gross Motor Function Classification Score (GMFCS) level V and one as GMFCS level IV. Children were eligible for the study if they weighed between 8 and 30kg with a diagnosis of severe SQCP and significant feeding difficulties in whom a clinical decision had been made to insert a gastrostomy feeding tube. The feed used in the study had an energy concentration of 0.75kcal/mL (Nutrini Low Energy Multi Fibre). Assessments were performed before gastrostomy insertion (baseline) and after 6months, and included body composition, growth, nutritional intake, and gastrointestinal symptoms. RESULTS:there was a significant increase in weight (median difference 1.9kg; 95% confidence interval [CI] 0.85-3.03kg; p=0.012), mid-upper arm circumference (median difference 1.45cm; 95% CI -0.36cm to 3.47cm; p=0.043), and lower leg length (median difference 1.62cm; 95% CI 0.44-3.95cm; p=0.012) over the 6 months. There was no significant increase in fat mass index (median diff 1.21, 95% CI -1.15 to 2.94, p=0.345) or fat free mass index (median diff -1.43, 95% CI -1.15 to 2.94, p=0.249). Micronutrient levels remained within reference ranges with the exception of elevated chromium. The median percentage intake of the estimated average requirements for energy (kcal) was 43% at the beginning of the study and 48.8% after 6 months on the low-energy feed. INTERPRETATION:children with SQCP who are fed a low-energy, micronutrient-complete, high-fibre feed continue to grow even with energy intakes below 75% of the estimated average requirements. This was not associated with a disproportionate rise in fat mass or fat percentage, and the majority of micronutrient levels remained within the reference range.
journal_name
Dev Med Child Neuroljournal_title
Developmental medicine and child neurologyauthors
Vernon-Roberts A,Wells J,Grant H,Alder N,Vadamalayan B,Eltumi M,Sullivan PBdoi
10.1111/j.1469-8749.2010.03789.xsubject
Has Abstractpub_date
2010-12-01 00:00:00pages
1099-105issue
12eissn
0012-1622issn
1469-8749journal_volume
52pub_type
临床试验,杂志文章abstract::Individuals with congenital adrenal hyperplasia (CAH) provide a test population for the theory that elevated testosterone levels alter prenatal brain development and increase the risk of learning disabilities. Eleven subjects with CAH, five of their non-CAH siblings and 16 matched control subjects participated in two ...
journal_title:Developmental medicine and child neurology
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doi:10.1111/j.1469-8749.1996.tb15100.x
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abstract::Of 115 children with dyskinetic cerebral palsy (CP) in the Mersey region, 17 were born at term and at an appropriate weight for age, and have preserved cognitive abilities. 10 of these are likely to have sustained intrapartum asphyxial brain-damage as the cause of their CP. In such circumstances, a characteristic patt...
journal_title:Developmental medicine and child neurology
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journal_title:Developmental medicine and child neurology
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doi:10.1111/j.1469-8749.1987.tb02488.x
更新日期:1987-06-01 00:00:00
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journal_title:Developmental medicine and child neurology
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journal_title:Developmental medicine and child neurology
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journal_title:Developmental medicine and child neurology
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journal_title:Developmental medicine and child neurology
pub_type: 杂志文章
doi:10.1111/j.1469-8749.1986.tb03922.x
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journal_title:Developmental medicine and child neurology
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doi:10.1111/j.1469-8749.1980.tb04329.x
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abstract::Thirteen embryos with various central nervous system (cns) defects were examined macroscopically and by serial sectioning, and were compared with seven control embryos. All had been aborted spontaneously. Examples of anencephaly, anencephaly with spina bifida, spina bifida alone, encephalocele, iniencephaly and cyclop...
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doi:10.1111/j.1469-8749.1979.tb01624.x
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pub_type: 杂志文章
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journal_title:Developmental medicine and child neurology
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journal_title:Developmental medicine and child neurology
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