Human papillomaviruses (HPVs) play an important part in the development of cervical cancer, but the role of other infectious agents, such as herpes simplex virus (HSV), is not clear. We assayed serum samples collected from 219 women with cervical cancer and from 387 controls for antibody to infectious agents. HPV 16-E7 and/or HPV 18-E7 antibodies were significantly related to cervical cancer risk (RR 1.9, 95% CI 1.2-3.2). Antibodies to HSV types 1 and 2, Chlamydia trachomatis, and to multiple infectious agents were associated with cervical cancer when seroprevalence rates in all cases and controls were compared, but when HPV-seropositive cases and controls were compared these associations were weaker and non-significant. This finding suggests that past infections with sexually transmitted infections other than HPV may be surrogate markers of exposure to HPV, and of no separate aetiological significance.

STUDY OBJECTIVES:To compare the changes in resting energy expenditure (REE) to concomitant changes in clinical status and pulmonary function in cystic fibrosis (CF) patients during treatment for acute pulmonary exacerbation. To determine if weight loss during exacerbation in CF is related to decreased calorie intake or increased energy needs. DESIGN:Measurements of REE, pulmonary function tests, oxygen saturation, respiratory rate, maximal inspiratory pressure (MIP), white blood cell count, chest x-ray films and attribution of clinical score (ACS) on admission, mid-hospitalization, and discharge. Anthropometric measurements on admission, assessment of dietary intake and nitrogen balance upon admission and prior to discharge. SUBJECTS:Thirteen CF patients admitted for treatment of acute pulmonary exacerbation with a mean age of 11.0 +/- 7.9 (SD) years. RESULTS:From admission to discharge, REE decreased from 44.5 +/- 9.0 to 33.8 +/- 8.5 kilocalorie (kcal)/kg/d (p < 0.003). Similarly, the ACS improved from 7.5 +/- 2.0 to 4.0 +/- 2.2 (p < 0.0001); the absolute neutrophil count decreased from 10,685 +/- 6,226/microliters to 6,363 +/- 168/microliters (p < 0.005); respiratory rate decreased from 32.6 +/- 6.2 to 25.0 +/- 3.7 breaths per minute (p < 0.01); and MIP increased from 77.5 +/- 20.0 to 90.0 +/- 20.4 cm H2O (p < 0.01). In parallel, less significant improvements occurred in pulmonary function tests, oxygen saturation and chest x-ray film scores. Calorie intake was 1,893 +/- 635 and 2,054 +/- 707 kcal/d on admission and discharge, respectively (p = NS); during hospitalization, weight increased from 23.6 +/- 10.1 to 25.7 +/- 10.1 kg (p < 0.005). While carbohydrate and fat content of the diet remained essentially unchanged, a significant increase in protein intake (3.15 +/- 0.92 to 3.5 +/- 0.81 g/kg/d [p < 0.05]) and in nitrogen balance (1.8 +/- 2.5 to 5.6 +/- 2.9 g of nitrogen per day [p < 0.05]) were observed. CONCLUSIONS:In acute CF, pulmonary exacerbation, changes in REE parallel those of clinical improvements and are more sensitive than pulmonary function tests and chest x-ray films as an objective clinical correlate. Increased metabolic requirements but not decreased dietary intake are the cause of weight loss in CF patients.

Two methods for the determination of plasma vitamin E—high—pressure liquid chromatography and spectrophotofluorometry—were compared on samples from four groups of pediatric patients: children and infants receiving lipid emulsion as part of their parenteral nutrition regimen, neonates receiving parenteral nutrition who were not receiving lipid emulsion at the time of blood sampling, and short admission surgery control subjects. In control subjects and patients not receiving lipid emulsions, both methods yielded similar results for vitamin E as α‐tocopherol. In contrast, in patients receiving lipid emulsion, the fluorometric method yielded values ranging from 200% to 300% greater than did high‐pressure liquid chromatography. The source of the discrepancy is most probably the presence of naturally occurring non‐α‐tocopherol isomers in the lipid products, which add to the fluorescent measurement but are resolved by high‐pressure liquid chromatography. This study confirms clinically that fluorescent measurement of vitamin E is no longer the method of choice for monitoring tocopherol status in intensive care nurseries. (Journal of Parenteral and Enteral Nutrition. 16: 133–135, 1992)

Nutrition in Clinical PracticeVolume 3, Issue 2 p. 47-64 Article Invited Review: Infant Feeding and Enteral Nutrition Russell J. Merritt, Russell J. Merritt Nutrition Support Team, Childrens Hospital of Los Angeles, the School of Medicine, University of Southern CaliforniaSearch for more papers by this authorShirley Hack, Shirley Hack Nutrition Support Team, Childrens Hospital of Los AngelesSearch for more papers by this author Russell J. Merritt, Russell J. Merritt Nutrition Support Team, Childrens Hospital of Los Angeles, the School of Medicine, University of Southern CaliforniaSearch for more papers by this authorShirley Hack, Shirley Hack Nutrition Support Team, Childrens Hospital of Los AngelesSearch for more papers by this author First published: 01 April 1988 https://doi.org/10.1177/011542658800300247Citations: 2AboutPDF 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 References 1Fitzhardinge PM, Stevens EM The small-for-date infant. I. Later growth patterns. Pediatrics 1972; 49: 671-81. PubMedGoogle Scholar 2Waterlow JC, Alleyne GAO. Protein malnutrition in children : advances in knowledge in the last 10 years. Adv Protein Chem 1971; 25: 117-241. 10.1016/S0065-3233(08)60280-6 PubMedGoogle Scholar 3Butler N. Late postnatal consequences of fetal malnutrition. In: Winick M, ed. Nutrition and fetal development. New York: John Wiley and Sons, 1974 : 173-8. Google Scholar 4Lloyd-Still JD Clinical studies on the effects of malnutrition during infancy and subsequent physical and intellectual development. In: Lloyd-Still JD, ed. Malnutrition and intellectual development. Littleton, MA: Publishing Sciences Group, 1976; 103-59. Google Scholar 5Gross SJ, Oehler JM, Eckerman CO Head growth and developmental outlook in very low-birth-weight infants. Pediatrics 1983; 71: 70-5. PubMedWeb of Science®Google Scholar 6Ferguson AC Prolonged impairment of cellular immunity in children with intrauterine growth retardation. J Pediatr 1978; 93: 52-6. 10.1016/S0022-3476(78)80599-X PubMedWeb of Science®Google Scholar 7Moran J. The preschool child: diet, growth and obesity. J Hum Nutr 1980; 34: 117-30. PubMedGoogle Scholar 8Butte NF, Garza C., Smith EOB, Nichols BL Human milk intake and growth in exclusively breast-fed infants. J Pediatr 1984; 104: 187-95. 10.1016/S0022-3476(84)80990-7 PubMedWeb of Science®Google Scholar 9Fomon SJ Infant nutrition. Philadelphia: WB Saunders, 1974: 575 pp. Google Scholar 10Young VR, Steffee WP, Pencharz PB, et al. Total human body protein synthesis in relation to protein requirements at various ages. Nature 1975; 253: 192-4. 10.1038/253192a0 PubMedWeb of Science®Google Scholar 11Flodin NW, Morgan PH, Mercer LP The problem of human protein requirements: some kinetic and metabolic considerations. Med Hypotheses 1977; 3: 94-110. 10.1016/0306-9877(77)90021-4 PubMedWeb of Science®Google Scholar 12Ziegler EE, Biga RL, Fomon SJ Nutritional requirements of the premature infant. In: Suskind RM, ed. Textbook of pediatric nutrition. New York: Raven Press, 1981: 29-40. Google Scholar 13Kashyap S., Forsyth M., Zucker C., et al. Effects of varying protein and energy intakes on growth and metabolic response in low-birth-weight infants. J Pediatr 1986; 108: 955-63. 10.1016/S0022-3476(86)80940-4 PubMedWeb of Science®Google Scholar 14 Joint FAO/WHO Ad Hoc Expert Committee on Energy and Protein Requirements. Geneva: World Health Organization, 1973: 40-53. (World Health Organization technical reprint series no. 522). Google Scholar 15Raija N., Boehm G. Protein and nitrogen metabolism in low-birth-weight infants. In: Stern L, ed. Feeding the sick neonate. New York: Vevey/Raven Press; 1987: 63-9. (Nestle Nutrition Workshop series; vol II). Google Scholar 16Committee on Dietary Allowances Food and Nutrition Board. Recommended dietary allowances. Washington DC: National Academy of Sciences/ National Research Council, 1980. Google Scholar 17Shaw JCL. Trace elements in the fetus and young infant. I. Zinc. Am J Dis Child 1979; 133: 1260-8. 10.1001/archpedi.1979.02130120052011 PubMedWeb of Science®Google Scholar 18Siegel M., Lebenthal E. Development of gastrointestinal motility and gastric emptying during the fetal and newborn periods. In: Lebenthal E, ed. Textbook of gastroenterology and nutrition in infancy. New York: Raven Press, 1981 : 121-38. Google Scholar 19Krauss AN, Brown J., Waldman S., et al. Pulmonary function following feeding in low-birth-weight infants. Am J Dis Child 1978; 132: 139-42. PubMedWeb of Science®Google Scholar 20Duritz G., Oltorf C. Lactobezoar formation associated with high-density caloric formula. Pediatrics 1979; 63: 647-9. PubMedWeb of Science®Google Scholar 21Lebenthal E., Lee PC Development of functional response in human exocrine pancreas. Pediatrics 1980; 66: 556-60. PubMedWeb of Science®Google Scholar 22Zoppi G., Andreotti G., Pajno-Ferrara F., et al. Exocrine pancreas function in premature and full term neonates. Pediatr Res 1972; 6: 880-6. 10.1203/00006450-197212000-00005 PubMedWeb of Science®Google Scholar 23Alemi B., Hamosh M., Scanlon JW, et al. Fat digestion in very low-birth-weight infants: effects of addition of human milk to low-birth-weight formula. Pediatrics 1981; 68: 484-9. PubMedWeb of Science®Google Scholar 24Watkins JB, Ingall D., Szczpanik P., et al. Bile-salt metabolism in the newborn. N Engl J Med 1973; 288: 431-4. 10.1056/NEJM197303012880902 PubMedWeb of Science®Google Scholar 25Watkins JB, Szczpanik P., Gould JB, et al. Bile-salt metabolism in the human premature infant. Gastroenterology 1975; 69: 706-13. PubMedWeb of Science®Google Scholar 26American Academy of Pediatrics. Committee on Nutrition. Nutritional needs of low-birth-weight babies. In: Pediatric Nutrition Handbook. Evanston, IL: American Academy of Pediatrics, 1979:98. Google Scholar 27Greenberger NJ, Skillman TG Medium chain triglycerides: physiologic considerations and clinical implication. N Engl J Med 1969; 280: 1045-58. 10.1056/NEJM196905082801906 PubMedWeb of Science®Google Scholar 28Watkins JB Developmental aspects of carbohydrate malabsorption in the premature infant. In: Lifshitz F, ed. Carbohydrate intolerance in infancy. New York: Marcel Dekker, 1982: 61-74. Google Scholar 29Aurricchio S., Rubino A., Murset G. Intestinal glucosidase activities in the human embryo, fetus and newborn. Pediatrics 1965; 35: 944-54. PubMedGoogle Scholar 30MacLean WC, Fink BB Lactose malabsorption by premature infants: magnitude and clinical significance. J Pediatr 1980; 97: 383-8. 10.1016/S0022-3476(80)80186-7 PubMedWeb of Science®Google Scholar 31Bond JH, Levitt MD Fate of soluble carbohydrate in the colon of rats and man. J Clin Invest 1976; 57: 1158-64. 10.1172/JCI108383 PubMedWeb of Science®Google Scholar 32Walker WA, Isselbacher KJ Uptake and transport of macromolecules by the intestine. Gastroenterology 1974; 67: 531-50. PubMedWeb of Science®Google Scholar 33Lake AM, Whittington PF, Hamilton SR Dietary protein-induced colitis in breast-fed infants. J Pediatr 1982; 101: 906-10. 10.1016/S0022-3476(82)80008-5 PubMedWeb of Science®Google Scholar 34Chantler C. Newborn disorders. In: Lieberman E, ed. Clinical pediatric nephrology. Philadelphia : J.B. Lippincott, 1976: 312-5. Google Scholar 35Waterlow J. Some aspects of childhood malnutrition as a public health problem. Br Med J 1974; 4: 88. 10.1136/bmj.4.5936.88 PubMedWeb of Science®Google Scholar 36Merritt RJ, Ashley JM, Siegel SE, et al. Calorie and protein requirements of pediatric patients with acute nonlymphocytic leukemia. JPEN 1981; 5: 20-3. 10.1177/014860718100500120 Web of Science®Google Scholar 37Walker WA, Hendricks KM Manual of pediatric nutrition. Philadelphia: WB Saunders, 1985: 160 pp. Google Scholar 38Trevorrow V., Kaser M., Patterson JP, Hill RH Plasma albumin globulin and fibrinogen in healthy individuals from birth to adulthood. J Lab Clin Med 1942; 27: 471-86. Google Scholar 39Giacoia GP, Watson S., West K. Rapid turnover transport proteins, plasma albumin and growth in low-birth-weight infants. JPEN 1984; 8: 367-70. 10.1177/0148607184008004367 Web of Science®Google Scholar 40Merritt RJ, Blackburn GC Nutritional assessment and metabolic response to illness of the hospitalized child. In: Suskind RM, ed. Textbook of pediatric nutrition. New York: Raven Press, 1981: 285-308. Google Scholar 41Koerper MA, Dallman PR Serum iron concentration and transferrin saturation in the diagnosis of iron deficiency in children. J Pediatr 1977; 91: 870-4. 10.1016/S0022-3476(77)80879-2 PubMedWeb of Science®Google Scholar 42Therapeutic trials in mild iron deficiency in infants. Nutr Rev 1982; 40: 139-41. 10.1111/j.1753-4887.1982.tb05290.x PubMedWeb of Science®Google Scholar 43Merritt RJ, Suskind RM Nutritional survey of hospitalized pediatric patients. Am J Clin Nutr 1979; 32: 1320-5. PubMedWeb of Science®Google Scholar 44Merritt RJ Enteral feeding: who needs support? In: Balistreri WF, Farrell MK, eds. 94th Ross Conference on Pediatric Research. Columbus, OH: Ross Laboratories; 1988 (in press). Google Scholar 45Cooper A., Heird WC Nutritional assessment of the pediatric patient including the low-birth-weight infant. Am J Clin Nutr 1982; 35: 1132-41. PubMedWeb of Science®Google Scholar 46Kerry KR, Anderson CM A ward test for sugar in feces. Lancet 1964; 1: 981-2. 10.1016/S0140-6736(64)91777-5 PubMedWeb of Science®Google Scholar 47Shmerling DH, Forrer JCW, Prader A. Fecal fat and nitrogen in healthy children and in children with malabsorption or maldigestion. Pediatrics 1970; 46: 690-5. PubMedWeb of Science®Google Scholar 48Lawrence RA Breast feeding: a guide for the medical profession. St. Louis, MO: CV Mosby, 1980. Google Scholar 49Hill RM Breast feeding. Evanston, IL: American Academy of Pediatrics, 1981: 23pp. Google Scholar 50Saul KL, Warburton D. Increased incidence of early-onset hyperbilirubinemia in breast-fed versus bottle-fed infants. J Perinatol 1984; 4: 36-40. Google Scholar 51Anand SK, Sandberg C., Robinson RG, Lieberman E. Neonatal hypernatremia associated with elevated sodium concentration of breast milk. J Pediatr 1980; 96: 66-8. 10.1016/S0022-3476(80)80330-1 PubMedWeb of Science®Google Scholar 52Higginbottom MC, Sweetman L., Nyhan WL A syndrome of methylmalonic aciduria, homocystinuria, megaloblastic anemia and neurologic abnormalities in a vitamin B12-deficient breast-fed infant of a strict vegetarian. N Engl J Med 1978; 299: 317-23. 10.1056/NEJM197808172990701 PubMedGoogle Scholar 53Gilmore HE, Rowland TW Critical malnutrition in breast-fed infants-three case reports. Am J Dis Child 1978; 132: 885-7. 10.1001/archpedi.1978.02120340061011 PubMedWeb of Science®Google Scholar 54Asquith MT, Harrod JR Reduction of bacterial contamination in banked human milk. J Pediatr 1979; 95: 993-4. 10.1016/S0022-3476(79)80291-7 PubMedWeb of Science®Google Scholar 55Botsford KB, Weinstein RA, Boyer KM, et al. Gram negative bacilli in human milk feedings: quantitation and clinical consequences for premature infants. J Pediatr 1986; 109: 707-10. 10.1016/S0022-3476(86)80246-3 PubMedWeb of Science®Google Scholar 56Committee on Nutrition. Vitamin and mineral supplement needs in normal children in the United States. Pediatrics 1980; 66: 1015-21. PubMedGoogle Scholar 57Adequacy of lactatation in well-nourished mothers. Nutr Rev 1982; 40: 136-8. 10.1111/j.1753-4887.1982.tb05289.x PubMedWeb of Science®Google Scholar 58Fomon SJ Bioavailability of supplemental iron in commercially prepared dry infant cereals. J Pediatr 1987; 110: 660-1. 10.1016/S0022-3476(87)80575-9 PubMedWeb of Science®Google Scholar 59Neuman CG, Alpaugh M. Birth weight doubling time: a fresh look. Pediatrics 1976; 57: 469-73. PubMedGoogle Scholar 60Duncan B., Schaefer C., Sibley B., Fowsela NM Reduced growth velocity in exclusively breast-fed infants. Am J Dis Child 1984; 138: 309-13. PubMedWeb of Science®Google Scholar 61Committee on Nutrition. Vitamin and mineral supplement needs of normal children in the United States. In: Pediatric nutrition handbook. Evanston, IL: American Academy of Pediatrics, 1985: 37-48. Google Scholar 62Oski F. Iron-fortified formulas and gastrointestinal symptoms in infants: a controlled study. Pediatrics 1980; 66: 168-70. PubMedWeb of Science®Google Scholar 63Vasquez-Seonane P., Windom R., Pearson HA Disappearance of iron-deficiency anemia in a high-risk infant population given supplemental iron. N Engl J Med 1985; 313: 239-40. Google Scholar 64Declining anemia prevalence among children enrolled in public nutrition and health programs-selected states, 1975–1985. MMWR 1986; 35: 565-6. PubMedGoogle Scholar 65Finberg L., Kiley J., Luttrell CN Mass accidental salt poisoning in infants. JAMA 1963; 184: 187-90. 10.1001/jama.1963.03700160063009 PubMedWeb of Science®Google Scholar 66Linslaw MA, Harrison HL, Gruskin AB, et al. Hypochloremic alkalosis in infants associated with soy protein formula. J Pediatr 1980; 96: 635-40. 10.1016/S0022-3476(80)80728-1 PubMedWeb of Science®Google Scholar 67Edidin DU, Levitsky LL, Schey W., et al. Resurgence of nutritional rickets associated with breast-feeding and special dietary practices. Pediatrics 1980; 65: 232-5. PubMedGoogle Scholar 68Faybius RJ, Merritt RJ, Fleiss PM, Ashley JM Malnutrition associated with a formula of barley water, corn syrup and whole milk. Am J Dis Child 1981; 135: 615-7. PubMedGoogle Scholar 69Bell EF, Warburton D., Stonestreet BS, Oh W. Effect of fluid administration on the development of symptomatic patent ductus arteriosus and congestive heart failure in premature infants. N Engl J Med 1980; 302: 598-604. 10.1056/NEJM198003133021103 PubMedWeb of Science®Google Scholar 70Brown ER, Stack A., Sosenko I., et al. Bronchopulmonary dysplasia: possible relationship to pulmonary edema. J Pediatr 1978; 92: 982-4. 10.1016/S0022-3476(78)80382-5 PubMedWeb of Science®Google Scholar 71Bell EF, Neidich GA, Cashore WJ, Oh W. Combined effect of radiant warmer and phototherapy on insensible water loss in low-birth-weight infants. J Pediatr 1979; 94: 810-3. 10.1016/S0022-3476(79)80164-X PubMedWeb of Science®Google Scholar 72Bell EF, Weinstein MR, Oh W. Heat balance in premature infants: comparative effects of convectively heated incubator and radiant warmer with and without plastic heat shield. J Pediatr 1980; 96: 460-5. 10.1016/S0022-3476(80)80698-6 PubMedWeb of Science®Google Scholar 73Baumgart S., Engle WD, Fox WW, Polin RA Effect of heat shielding on convective and evaporative heat losses and on radiant heat transfer in the premature infant. J Pediatr 1981; 99: 948-56. 10.1016/S0022-3476(81)80030-3 PubMedWeb of Science®Google Scholar 74Fomon SJ Voluntary food intake and its regulation. In: Foman SJ, ed. Infant nutrition. Philadelphia : WB Saunders, 1974, 1974: 23. Google Scholar 75Sinclair JC, Driscoll JM Jr, Heird WC, Winters RW, Supportive management of the sick neonate. Pediatr Clin North Am 1970; 17: 863-93. 10.1016/S0031-3955(16)32485-3 PubMedWeb of Science®Google Scholar 76Ziegler E., Fomon SJ Major minerals. In: Fomon SJ, ed. Infant nutrition. Philadelphia: WB Saunders, 1974: 267-97. Google Scholar 77Fomon SJ Normal growth, failure to thrive and obesity. In: Fomon SJ, ed. Infant nutrition. Philadelphia : WB Saunders, 1974 :71. Google Scholar 78Engelke SC, Shah BL, Vasan U., Raye JR Sodium balance in very low-birth-weight infants. J Pediatr 1978; 93: 837-41. 10.1016/S0022-3476(78)81097-X PubMedWeb of Science®Google Scholar 79Shenai JP, Reynolds JW, Babson SG Nutritional balance studies in very-low-birth-weight infants: enhanced nutrient retention rates by an experimental formula. Pediatrics 1980; 66: 233-8. PubMedWeb of Science®Google Scholar 80Schanler RJ, Oh W. Composition of breast milk obtained from mothers of premature infants as compared to breast milk obtained from donors. J Pediatr 1980; 96: 679-81. 10.1016/S0022-3476(80)80738-4 PubMedWeb of Science®Google Scholar 81Gross SJ, David RJ, Bauman L., Tomarelli RM Nutritional composition of milk produced by mothers delivering preterm. J Pediatr 1980; 96: 641-4. 10.1016/S0022-3476(80)80729-3 PubMedWeb of Science®Google Scholar 82Modanlou HD, Lim MO, Hansen JW, Sickles V. Growth, biochemical status, and mineral metabolism in very low-birth-weight infants receiving fortified preterm human milk. J Pediatr Gastroenterol Nutr 1986; 5: 762-7. 10.1097/00005176-198609000-00017 PubMedWeb of Science®Google Scholar 83Willis DM, Chabot J., Ingeborg CR, Graham WC Unsuspected hyperosmolarity of oral solutions contributing to necrotizing enterocolitis in very low-birth-weight infants. Pediatrics 1977; 60: 535-8. PubMedWeb of Science®Google Scholar 84Brown E., Sweet AY Preventing necrotizing enterocolitis in neonates. JAMA 1978; 240: 2452-4. PubMedWeb of Science®Google Scholar 85Yu WYH, James B., Hendry P., MacMahon RA Total parenteral nutrition in very low-birth-weight infants: a controlled trial. Arch Dis Child 1979; 54: 653-61. 10.1136/adc.54.9.653 PubMedGoogle Scholar 86Ostertag SG, LaGamma EF, Reisen LE, Ferrentino FL Early enteral feeding does not affect the incidence of necrotizing enterocolitis. Pediatrics 1986; 77: 275-80. PubMedWeb of Science®Google Scholar 87Sunshine P., Sinatra FR, Mitchell CH Diseases of the gastrointestinal system. In: Behrman RE, ed. Neonatal-perinatal medicine. St. Louis, MO: CV Mosby, 1977: 610-4. Google Scholar 88Grosfeld JL, Schreiner RL, Franken EA, et al. The changing pattern of gastrointestinal bezoars in infants and children. Surgery 1980; 88: 425-32. PubMedWeb of Science®Google Scholar 89Roy RN, Pollnitz RP, Hamilton JR, Chance GW Impaired assimilation of nasojejunal feeds in healthy low-birth-weight infants. J Pediatr 1977; 90: 431-4. 10.1016/S0022-3476(77)80710-5 PubMedWeb of Science®Google Scholar 90Fogle RS, Smith WL, Aresham EL Perforation of feeding tube into right renal pelvis. J Pediatr 1978; 93: 122-4. 10.1016/S0022-3476(78)80622-2 PubMedWeb of Science®Google Scholar 91McAlister WH, Siegel MJ, Shackelford GD, et al. Intestinal perforations by tube feedings in small infants: clinical and experimental studies. AJR 1985; 145: 687-91. 10.2214/ajr.145.4.687 PubMedWeb of Science®Google Scholar 92Perez-Rodriques J., Quero J., Frias EG, et al. Duodenal perforation in a neonate by a tube of silicone rubber during transpyloric feeding. J Pediatr 1978; 92: 113-6. 10.1016/S0022-3476(78)80089-4 PubMedWeb of Science®Google Scholar 93Dallman PR Iron, vitamin E and folate in the preterm infant. J Pediatr 1974; 85: 742-52. 10.1016/S0022-3476(74)80334-3 PubMedWeb of Science®Google Scholar 94Stevens D., Burma D., Strelling MK, Morris A. Folic acid supplementation in low-birth-weight infants. Pediatrics 1979; 64: 333-5. PubMedWeb of Science®Google Scholar 95Bell EF, Filer LJ The role of vitamin E in the nutrition of premature infants. Am J Clin Nutr 1981; 34: 414-22. PubMedWeb of Science®Google Scholar 96Merritt RJ, Sinatra FR, Smith GA Nutritional support of the hospitalized child. In: Draper HH, ed. Advances in nutrition research. New York: Plenum Press, 1983: 77-103. 10.1007/978-1-4613-9937-7_5 Google Scholar 97Kerr D., Ashworth A., Picou D., et al. Accelerated recovery from infant malnutrition with high calorie feeding. In: Gardner LI, Amachere P. eds. Endocrine aspects of malnutrition. Santa Ynez, CA: KROC Foundation, 1975: 467-86. Google Scholar 98Robbins S., Thorp JW, Wadsworth C. Tube feeding of infants and children. Silver Spring, MD : American Society for Parenteral and Enteral Nutrition, 1981. Google Scholar 99Weinstein MR, Oh W. Oxygen consumption in infants with bronchopulmonary dysplasia. J Pediatr 1981; 99: 958-61. 10.1016/S0022-3476(81)80032-7 PubMedWeb of Science®Google Scholar 100Kurzner S., Garg M., Bautista DB, et al. Growth failure in bronchopulmonary dysplasia: nutrition and elevated resting metabolic expenditure. Pediatrics (in press) Google Scholar 101Cavell B. Effect of feeding an infant formula with high energy density on gastric emptying in infants with congenital heart disease. Acta Paediatr Scand 1981; 70: 513-6. 10.1111/j.1651-2227.1981.tb05732.x PubMedWeb of Science®Google Scholar 102Carre IJ The natural history of partial thoracic stomach (hiatus hernia) in children. Arch Dis Child 1959; 34: 344-53. 10.1136/adc.34.176.344 PubMedWeb of Science®Google Scholar 103Orenstein SR, Magill HL, Brooks P. Thickening of infant feedings for therapy of gastroesophageal reflux. J Pediatr 1987; 110: 181-6. 10.1016/S0022-3476(87)80150-6 PubMedWeb of Science®Google Scholar 104Meyers WF, Herbst JJ Effectiveness of positioning therapy for gastroesophageal reflux. Pediatrics 1982; 69: 768-72. PubMedWeb of Science®Google Scholar 105Orenstein SR, Whitington PF Positioning for prevention of infant gastroesophageal reflux. J Pediatr 1983; 103: 534-7. 10.1016/S0022-3476(83)80578-2 PubMedWeb of Science®Google Scholar 106Issenman RM, Henson S., Pirhonen D., et al. Are chronic digestive complaints the result of abnormal dietary patterns? Diet and digestive complaints in children at 22 and 40 months of age. Am J Dis Child 1987; 141: 679-82. 10.1001/archpedi.1987.04460060095043 PubMedWeb of Science®Google Scholar 107Carey WB Maternal anxiety and infantile colic-is there a relationship? Clin Pediatr 1968; 7: 590-5. 10.1177/000992286800701007 Web of Science®Google Scholar 108Taubman B. Clinical trial of the treatment of colic by modification of parent-infant interaction. Pediatrics 1984; 74: 998-1003. PubMedWeb of Science®Google Scholar 109Harris MJ, Petts V., Penny R. Cow's milk allergy as a cause of infantile colic: immunofluorescent studies on jejunal mucosa. Aust Pediatr J 1977; 13: 276-81. Web of Science®Google Scholar 110Liebman WM Infantile colic-association with lactose and milk intolerance. JAMA 1981; 245: 732-3. PubMedWeb of Science®Google Scholar 111Thomas DW, McGilligan K., Eisenberg LD, et al. Infantile colic and type of milk feeding. Am J Dis Child 1987; 141: 451-3. PubMedWeb of Science®Google Scholar 112Kahn A., Mozin MJ, Casimir G., et al. Insomnia and cow's milk allergy in infants. Pediatrics 1985; 76: 880-4. PubMedWeb of Science®Google Scholar 113Lothe L., Lindberg T., Jacobsson I. Cow's milk formula as a cause of infantile colic: a double-blind study. Pediatrics 1982; 70: 7-10. PubMedWeb of Science®Google Scholar 114Jacobsson I., Lindberg T. Cow's milk proteins cause infantile colic in breast-fed infants: a double-blind crossover study. Pediatrics 1983; 71: 268-71. PubMedGoogle Scholar 115Weissbluth M., Christoffel KK, Davis AT Treatment of infantile colic with dicyclomine hydrochloride. J Pediatr 1984; 104: 951-5. 10.1016/S0022-3476(84)80506-5 PubMedWeb of Science®Google Scholar 116Oseas RS, Phelps DL, Kaplan SA Near fatal hyperkalemia from a dangerous treatment for colic. Pediatrics 1982; 69: 117-8. PubMedWeb of Science®Google Scholar 117Chung AW, Viscorova B. The effect of early oral feeding versus early oral starvation on the course of infantile diarrhea. J Pediatr 1948; 33: 14-22. 10.1016/S0022-3476(48)80148-4 PubMedWeb of Science®Google Scholar 118Molla AM, Rahman M., Sarker SA, et al. Stool electrolyte content and purging rates in diarrhea caused by rotavirus enterotoxigenic E. coli and V. cholera in children. J Pediatr 1981; 98: 835-8. 10.1016/S0022-3476(81)80863-3 PubMedWeb of Science®Google Scholar 119Tamer AM, Friedman LB, Maxwell SR, et al. Oral rehydration of infants. J Pediatr 1985; 107: 14-9. 10.1016/S0022-3476(85)80606-5 PubMedWeb of Science®Google Scholar 120Santosham M., Daum RS, Dillman L., et al. Oral rehydration therapy of infantile diarrhea-a controlled study of well-nourished children hospitalized in the United States and Panama. N Engl J Med 1982; 306: 1070-6. 10.1056/NEJM198205063061802 PubMedWeb of Science®Google Scholar 121Santosham M., Foster S., Reid R., et al. Role of soy based lactose-free formula during treatment of acute diarrhea. Pediatrics 1985; 76: 292-8. PubMedWeb of Science®Google Scholar 122Keating JP, Schwarz KB, Bell MJ, Ternberg JL An experience with total parenteral nutrition in children. Am J Clin Nutr 1977; 30: 1506-9. PubMedWeb of Science®Google Scholar 123Cohen SA, Hendricks KM, Mathis RK, et al. Chronic nonspecific diarrhea: dietary relationships. Pediatrics 1979; 64: 402-7. PubMedWeb of Science®Google Scholar 124Lloyd-Still JD Chronic diarrhea of childhood and the misuse of elimination diets. J Pediatr 1979; 95: 10-3. 10.1016/S0022-3476(79)80074-8 PubMedWeb of Science®Google Scholar 125Sinatra FR, Merritt RJ latrogenic kwashiorkor in infants. Am J Dis Child 1981; 135: 21-3. PubMedWeb of Science®Google Scholar 126Woodruff CW, Clark JL The role of fresh cow's milk on iron deficiency. I. Albumin turnover in infants with iron deficiency anemia. Am J Dis Child 1972; 124: 18-23. 10.1001/archpedi.1972.02110130020003 PubMedWeb of Science®Google Scholar 127Hill DJ, Firer MA, Shelton MJ, Hosking CS Manifestations of milk allergy in infancy: clinical and immunologic findings. J Pediatr 1986; 109: 270-6. 10.1016/S0022-3476(86)80384-5 PubMedWeb of Science®Google Scholar 128Iyngkaran N., Abdin Z., Davis K., et al. Acquired carbohydrate intolerance and cow milk protein-sensitive enteropathy in young infants. J Pediatr 1979; 95: 373-8. 10.1016/S0022-3476(79)80509-0 PubMedWeb of Science®Google Scholar 129Greene HL, McCabe DR, Merenstein GB Protracted diarrhea and malnutrition in infancy: changes in intestinal morphology and disacharidase activities during treatment with total intravenous nutrition or oral elemental diets. J Pediatr 1975; 87: 695-704. 10.1016/S0022-3476(75)80290-3 PubMedWeb of Science®Google Scholar 130Orenstein SR Enteral versus parenteral therapy for intractable diarrhea of infancy: a prospective randomized trial. J Pediatr 1986; 109: 277-86. 10.1016/S0022-3476(86)80385-7 PubMedWeb of Science®Google Scholar 131Halpin TC, Byrne WJ, Ament ME Colitis, persistent diarrhea and soy protein intolerance. J Pediatr 1977; 91: 404-7. 10.1016/S0022-3476(77)81308-5 PubMedWeb of Science®Google Scholar 132Lebenthal E., Branski D. Childhood celiac disease: a reappraisal. J Pediatr 1981; 98: 681-90. 10.1016/S0022-3476(81)80825-6 PubMedWeb of Science®Google Scholar 133Hyams JS, Krause PJ, Gleason PA Lactose malabsorption following rotavirus infection in young children. J Pediatr 1981; 99: 916-8. 10.1016/S0022-3476(81)80020-0 PubMedWeb of Science®Google Scholar 134Leslie J., MacLean WC Jr, Graham GG Effect of an episode of severe malnutrition and age on lactose absorption by recovered infants and children. Am J Clin Nutr 1979; 32: 971-4. PubMedWeb of Science®Google Scholar 135Lifshitz F., Coello-Ramirez P., Contreras-Guiterrez ML The response of infants to carbohydrate oral loads after recovery from diarrhea. J Pediatr 1971; 79: 612-7. 10.1016/S0022-3476(71)80308-6 PubMedWeb of Science®Google Scholar 136Asp NG, Dahlquist A., Kuitunen P., et al. Complete deficiency of brush-border lactase in congenital lactose malabsorption. Lancet 1973; 2: 329-30. 10.1016/S0140-6736(73)90841-6 PubMedWeb of Science®Google Scholar 137Batshaw ML, Thomas GH, Brusilow SW New approaches to the diagnosis and treatment of inborn errors of urea synthesis. Pediatrics 1981; 68: 290-7. PubMedWeb of Science®Google Scholar 138Nyhan WL Nutritional treatment of children with inborn errors of metabolism. In: Suskind RM, ed. Textbook of pediatric nutrition. New York: Raven Press, 1981: 563-76. Google Scholar 139Eisenberg LE, Merritt RJ, Sinatra FR Nutrition in hepatic disorders. In: Grand RJ, Sutphen JL, Dietz WH Jr., eds. Pediatric nutrition-Theory and practice. Boston: Butterworths, 1987: 513-24. Google Scholar 140Chase HP, Long MA, Lavin MH Cystic fibrosis and malnutrition. J Pediatr 95: 337-47. Google Scholar 141Pereira GR, Lemons JA Controlled study of transpyloric and intermittent gavage feeding in the small preterm infant. Pediatrics 1981; 67: 68-72. PubMedWeb of Science®Google Scholar 142Mollitt DL, Golladay ES, Seibert J. Symptomatic gastroesophageal reflux following gastrostomy in neurologically impaired patients. Pediatrics 1985; 75: 1124-6. PubMedWeb of Science®Google Scholar 143Andrassy RJ, Mahour GH, Harrison MR, et al. The role and safety of early postoperative feeding in the pediatric surgical patient. J Pediatr Surg 1979; 14: 381-5. 10.1016/S0022-3468(79)80504-7 PubMedWeb of Science®Google Scholar 144Parker P., Stroop S., Greene H. A controlled comparison of continuous versus intermittent feeding in the treatment of infants with intestinal disease. J Pediatr 1981; 99: 360-4. 10.1016/S0022-3476(81)80318-6 PubMedWeb of Science®Google Scholar 145Greene HL, Slonim AE, Burr IM, Moran JR Type I glycogen storate disease: five years of management with nocturnal intragastric feeding. J Pediatr 1980; 96: 590-5. 10.1016/S0022-3476(80)80871-7 PubMedWeb of Science®Google Scholar 146Chen Y.-S, Cornblath M., Sidbury JB Cornstarch therapy in type I glycogen storage disease. N Engl J Med 1984; 310: 171-5. 10.1056/NEJM198401193100306 PubMedWeb of Science®Google Scholar 147Galambos JT, Hersh T., Spalding S., Wenger J. Loperamide: a new agent in the treatment of chronic diarrhea. Gastroenterology 1976; 70: 1026-9. PubMedWeb of Science®Google Scholar 148Hofmann AF The enterohepatic circulation of bile acids. In: Sleisenger MH, Fordtran JS eds. Gastrointestinal disease. Philadelphia : WB Saunders, 1978: 101-3. Google Scholar 149Bohane TD, Haka-Ikse K., Biggar WD, et al. A clinical study of young infants after intestinal resection. J Pediatr 1979; 94: 552-8. 10.1016/S0022-3476(79)80009-8 PubMedWeb of Science®Google Scholar 150Cortot A., Fleming LR, Malagelada J-R. Improved nutrient absorption after cimetidine in short-bowel syndrome with gastric hypersecretion. N Engl J Med 1979; 300: 79-81. 10.1056/NEJM197901113000207 PubMedWeb of Science®Google Scholar Citing Literature Volume3, Issue2April 1988Pages 47-64 ReferencesRelatedInformation

Elevated serum retinol concentrations have been previously reported in patients with renal failure, although overt clinical toxicity has been described only rarely. We present three patients with renal failure receiving total parenteral nutrition (TPN) who developed biochemical and clinical findings of hypervitaminosis A. Improvement followed deletion of vitamin A from the TPN. These cases demonstrate that patients with renal failure may be at risk for symptomatic vitamin A toxicity if given TPN with standard retinol supplementation. Such patients should be carefully observed clinically and biochemically if supplementation is given.