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Objective: Considering that leukopenia and anemia are commonly observed in anorexia nervosa (AN) and that growth hormone (GH) and insulin-like growth factor-I (IGF-I) markedly influence the activation, growth and survival of hemopoietic cells, we sought for possible relationships between hematologic parameters and the GH-IGF-I axis in a group of patients with AN., Method: Twenty patients were studied. Leukocyte and erythrocyte counts, as well as baseline serum GH levels and IGF-I standard deviation score (SDS) values, were determined in each participant and correlations between parameters were searched., Results: Leukocyte and erythrocyte counts, as well as IGF-I SDS values, were significantly lower, conversely GH was significantly higher in AN patients than in normal weight participants. In patients, IGF-I SDS values were positively correlated with leukocyte count and BMI, whereas no correlation was found between IGF-I SDS and hemoglobin or erythrocytes., Conclusion: The demonstration of a positive correlation between leukocyte number and circulating IGF-I in AN suggests a likely pathogenetic role of IGF-I deficiency in this hematologic abnormality., (Copyright 2008 by Wiley Periodicals, Inc.)

Background & Aims: High-resolution manometry demonstrates a chain of 3 sequential pressure segments that represent esophageal peristalsis in children and adults. We performed high-resolution manometry in preterm and term neonates to determine the ontogenesis of esophageal motility with regard to this segmental architecture., Methods: Sixteen preterm (gestational age 32.9 +/- 2.6 weeks at examination) and 14 term neonates (38.9 +/- 1.6 weeks) underwent manometry with a 9-lumen perfused catheter having recording side holes spaced at 1-cm intervals. Pressure responses to swallows were evaluated for the presence of peristaltic segments on isobaric contour maps by an investigator who was blinded to gestational age., Results: The second segment was well developed in > or =50% of swallows in all preterm and term neonates. In contrast, the first segment was present in > or =50% of swallows in only 2 preterm neonates (12.5%) and 8 term neonates (57.1%; P < .05 for each compared with second segment) with identical findings for the third segment (12.5% preterm and 57.1% term neonates; P < .05 for each). Completed peristalses with intact segmental contraction sequences throughout the esophageal body were present in 26% +/- 6% of swallows in preterm neonates vs 55% +/- 9% in term neonates (P = .01)., Conclusions: The second pressure segment in the midesophagus (proximal smooth-muscle region) is well developed before term. Presence of other segments significantly improves at term, but peristalsis remains incomplete in nearly half of swallows. Control mechanisms for both striated- and smooth-muscle esophageal regions are incompletely developed in neonates, the outcome of which could participate in infant reflux disease.

Objective: Silent pericardial effusion is frequently observed in patients with anorexia nervosa. The nature of the pericardial fluid could never be established, as pericardiocentesis was ethically unfeasible., Method: We describe the case of a girl with anorexia nervosa in whom an initial, clinically irrelevant pericardial effusion increased rapidly, making pericardiocentesis necessary to prevent cardiac tamponade., Results: It was thus possible to exclude the inflammatory or infectious nature of the pericardial fluid, although the pathogenesis of this cardiac alteration remains obscure., Conclusion: Echocardiographic examination appears to be strongly advisable in patients with anorexia nervosa., ((c) 2006 by Wiley Periodicals, Inc.)