A245 DETERMINING THE PREVALENCE OF DELAYED GASTRIC EMPTYING IN PEDIATRIC PATIENTS WITH CONSTIPATION USING NUCLEAR SCINTIGRAPHY
Notice bibliographique
Résumé
Abstract Background Gastrointestinal motility is coordinated by complex neurohormonal circuits existing between different segments of the gastrointestinal tract. It has been hypothesized that one of these pathways, the “cologastric brake,” acts as a negative feedback system to inhibit gastric motility when there is loading of stool within the colon in conditions such as constipation. Aims To assess gastric emptying in pediatric patients presenting with constipation using whole-gut nuclear scintigraphy. We hypothesize that children with constipation are likely to exhibit delayed gastric emptying due to neurohormonal pathways such as the cologastric brake. Methods A retrospective review of all patients under 18 years of age who underwent a whole-gut nuclear scintigraphy study for the work-up of constipation at The Hospital for Sick Children between January 2014 and May 2021 was completed. Demographic and clinical data at the time of presentation was summarized. The proportion of patients with delayed gastric emptying and delayed small and large bowel transit were calculated. Exploratory univariable analyses were performed to identify clinical predictors of delayed gastric emptying. Results This study identified 140 patients meeting inclusion criteria of whom 72 were male (51.4%), (meanage = 10.04 ± 4.79). The prevalence of patients with delayed gastric emptying was 61.9% (n = 86). Despite this, only 5.0% (n = 7) and 21.8% (n = 29) had delayed small and large bowel transit respectively. Children with delayed gastric emptying were significantly younger (meanage = 9.15 ± 4.60) than those with normal gastric emptying (meanage = 11.53 ± 4.79), p = .01. A chi-square test of independence showed that there was no significant relationship between use of a promotility agent and delayed gastric emptying ( p = .48). There was also no significant association between the presence of upper gastrointestinal symptoms and delayed gastric emptying ( p = .79). Conclusions We found that children with constipation have a high prevalence of delayed gastric emptying. However, only a small proportion of these patients have delayed bowel transit. This supports the idea that delayed gastric emptying in children with constipation is likely not due to intrinsic neuromuscular defects of the gut but rather, secondary to a neurohormonal “cologastric brake.” This is important information for clinicians as it suggests that a key step in managing delayed gastric emptying in this scenario is to treat patients’ constipation as opposed to initiating therapies, such as prokinetic agents, which attempt to directly improve gastric emptying. Funding Agencies None
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».