Infant and toddler nutrition sets the stage for future health and development. Infancy, considered as the time of birth until erect posture is assumed, is a highly vulnerable period of life, especially where nutrition is concerned. Growth rate peaks. Infants, at least until 4-6 months, rely on a single nutrient source. Toddlers, described in this chapter as children aged 1 to 3 years, have less rapid growth, but rapidly changing diet. They rely on the provision of all necessary nutrients to achieve optimum health. Feeding toddlers requires attention to their budding concepts of like, dislikes, and willingness to accept new foods. This chapter reviews the nutrients necessary for infants and toddlers to achieve their growth and developmental potential.

Objective: These studies evaluated the safety and efficacy of enteric-coated budesonide for the induction and maintenance of remission of mild-to-moderate Crohn's disease (CD) in children.Methods: The consecutive, multicenter, open-label, non-comparative studies enrolled patients aged 6-17 years. In the induction study, patients with active CD of the ileum and/or ascending colon received budesonide 9mg or 6mg once daily for 8 weeks; in the maintenance study, patients in remission received budesonide 6mg once daily for 12 weeks. The primary objective was assessment of safety, including glucocorticosteroid-related side effects and serum cortisol levels. Efficacy was assessed using the Pediatric Crohn's Disease Activity Index (PCDAI), and health-related quality of life (HRQoL) using the IMPACT-III questionnaire.Results: In the induction study (n=108), most adverse events were related to CD, commonly abdominal pain; possible glucocorticosteroid-related effects included acne and increased appetite but without significant weight gain. Subnormal morning cortisol levels were observed in 32 of 103 patients after 8 weeks. Budesonide reduced disease activity from baseline (meanstandard deviation, 9.1 +/- 8.5 vs. 19.1 +/- 10.1, p<.001) with 58.1% of patients reaching remission (PCDAI <10); HRQoL improved (p<.001). In the maintenance study (n=50), mean disease activity worsened (p=.047) with HRQoL unchanged (p=.33).Conclusions: Budesonide treatment was generally well tolerated, although the potential for adrenal suppression was noted. Budesonide was effective for induction of remission in children with mild-to-moderate CD but not for maintaining remission (ClinicalTrials.gov identifiers: NCT01444092, NCT01453946).

Endometriosis is a chronic estrogen-dependent disease that occurs in approximately 10% of reproductive age women. Baboons offer a clear benefit for studying the initiation and progression of endometriosis since baboon is very close to humans phylogenetically. Progestins are used in the treatment of endometriosis. The therapeutic window of progestins depends on the ratio of its affinity towards progesterone receptor agonism verses antagonism. The present study is to determine the role of pure antiprogestin in baboon endometriosis. We hypothesize that pure antiprogestin will induce unopposed estrogenicity and spontaneous endometriosis in baboons. The rate of endometrial invasion and attachment through modeled peritoneum in the presence and absence of progesterone and antiprogestin was evaluated in this study. A baboon model of endometriosis induced by unopposed estrogenicity using progesterone receptor antagonist (EC304) was used in this study. We observed EC304 has induced unopposed estrogenicity that deregulated proteins involved in attachment, invasion, cell growth, and steroid hormone receptors in this model. Our data suggest that depleting progesterone levels in the endometrium will increase estrogen hyper-responsiveness that leads to increased endometriotic lesion progression in the baboon (Papio anubis) model. This study reports a refined model of human endometriosis in baboons that could potentially be used to develop new diagnostic and therapeutic strategies for the benefit of women suffering from endometriosis.

Introduction: Before any procedure can be performed a patient must give informed consent, the situation where a person, (in the case of a child, a parent or guardian), agrees to the procedure based upon an appreciation and understanding of the facts and implications of the procedure. It is acknowledged that barriers to obtaining consent in general and for endoscopic procedures exist. Some of the barriers include: differences in physician communication styles, time constraints, language barriers, health care providers' use of jargon, and differences in patient and family members' literacy skills and learning styles. The aim of this study was to compare the usual procedure for obtaining informed consent to a procedure that was designed for easy understanding and for reproducibility. The experimental procedure incorporated a video with both visual and verbal information. Methods: 50 parents of child patients were randomly assigned to a control (usual procedure) or experimental condition. Participants in the experimental condition viewed an interactive multimedia presentation on upper and lower endoscopic procedures. All participants met with the physician performing the procedure. For the experimental group, consent was obtained after they had viewed the video and the usual process for obtaining consent was completed. All participants filled out pre and post measures, and answered a 12 question test on the endoscopic procedure that was to be performed. Results: Participants in the experimental group scored significantly higher than those in the control group on the 12 question test (p < .0001). The physician providing the informed consent perceived the experimental group as more knowledgeable than the control group (p = 0.04). Analysis of the post assessment results revealed an inverse relationship between participants' perceptions of how well they understood the procedure and their reported state anxiety (r = −.49, p < 0.0001). There was a significant positive correlation between how well participants understood the procedure and their reported level of satisfaction with medical care received (r = .58, p <0.0001). While both the experimental and control groups showed an increase in reported levels of state anxiety following the informed consent, participants in the experimental group showed less of an increase. Conclusion: These preliminary findings suggest that interactive multimedia presentations can increase patients' (or parent) understanding of upper and lower endoscopic procedures. When patient (or parent) understanding increases they report less anxiety and greater satisfaction with the medical care received.

Journal of Pediatric Gastroenterology and NutritionVolume 25, Issue 4 p. 459-459 Annual Meeting of the North American Society for Pediatric Gastroenterology and Nutrition; Toronto, October 30 - November 2, 1997 PANCREATITIS AND COMMON BILE DUCT STENOSIS AS A PRESENTING SYMPTOM OF KAWASAKI SYNDROME:70 V Marchand, V Marchand Department of Pediatric Gastroenterology, Medical University of South Carolina, Charleston, SCSearch for more papers by this authorS S Baker, S S Baker Department of Pediatric Gastroenterology, Medical University of South Carolina, Charleston, SCSearch for more papers by this authorR D Baker, R D Baker Department of Pediatric Gastroenterology, Medical University of South Carolina, Charleston, SCSearch for more papers by this author V Marchand, V Marchand Department of Pediatric Gastroenterology, Medical University of South Carolina, Charleston, SCSearch for more papers by this authorS S Baker, S S Baker Department of Pediatric Gastroenterology, Medical University of South Carolina, Charleston, SCSearch for more papers by this authorR D Baker, R D Baker Department of Pediatric Gastroenterology, Medical University of South Carolina, Charleston, SCSearch for more papers by this author First published: 01 October 1997 https://doi.org/10.1002/j.1536-4801.1997.tb01884.xRead the full textAbout ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume25, Issue4October 1997Pages 459-459 RelatedInformation

Responding to challenges of seemingly unending reductions in capital and maintenance budgets, the process industry has increasingly turned toward the purchase of lower cost, recycled equipment including salvaged control valves and instrumentation. Although it may be acceptable from a functional perspective, depending on equipment age, repair history, application severity and other factors, this "reconditioned" equipment may be out of compliance with safety standards, or with manufacturer's specifications as originally designed to applicable industry codes, for safe use in hazardous locations. If the use of these devices does not meet an original equipment manufacturer's technical specifications for the process application, there are possible implications with respect to the Process Safety Information and Mechanical Integrity elements of OSHA's Process Safety Management (PSM) Standard (29 CFR 1910.119) 1 and EPA's Risk Management Program Rule (RMP) (40 CFR 68) 2 . Another possible implication exists with respect to OSHA's Hazardous (Classified) Locations Standard (29 CFR 1910.307) 3 . This manuscript describes the issues and offers recommendations buyers can use to increase their confidence that salvaged, remanufactured, refurbished or new-surplus equipment meets plant design safety standards and regulatory requirements. Investigations into process plant explosions and fires have resulted in regulatory and investigative agencies issuing reports, fines and recommendations. Plant managers are responsible for assessing whether their site programs are adequately addressing safety requirements, yet the potential issues associated with reconditioned and new surplus equipment may not be known and/or included in such assessments. Two issues are: