bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Gum Arabic in an Oral Rehydration Solution on Recovery From Diarrhea in Rats
Authors: Teichberg Saul , Wingertzahn Mark A. , Moyse Jeffrey , Wapnir Raul A.
Published: February 2024

Background:

It has been shown that gum arabic, a soluble fiber, enhances water, electrolyte, and glucose absorption from oral rehydration solutions in jejunal perfusion of healthy rats and in animals with theophylline‐induced secretion or chronic osmotic‐secretory diarrhea. This report concerns a study of the effectiveness of an oral rehydration solution supplemented with gum arabic, during recovery from chronic osmotic secretory diarrhea in free‐living rats.

Methods:

Chronic diarrhea was induced in 60‐ to 80‐g juvenile rats by providing a magnesium citrate‐phenolphthalein solution as the sole fluid source for 7 days. This led to diarrhea characterized by dehydration, soft stools, increased cecal volume, decreased food and fluid intake and failure to gain weight. After 7 days of diarrhea, rats recovered for 24 hours with either tap water or an oral rehydration solution (90 mM Na, 111 mM glucose, 20 mM K, 80 mM chloride, 20 mM citrate) with or without 2.5 g/l gum arabic.

Results:

Although all three solutions improved the diarrhea, optimal recovery from diarrhea was achieved with the gum arabic‐supplemented oral rehydration solution. After 4 hours and 24 hours, rats drinking the gum arabic‐supplemented solution gained more weight and had lower fecal output than rats receiving water or the rehydration solution without gum arabic. All three solutions normalized plasma osmolality after 24 hours.

Conclusions:

The positive effects of the gum arabic‐supplemented rehydration solution on fluid and electrolyte absorption seen during jejunal perfusion also occurred during recovery from chronic osmotic secretory diarrhea, when free‐living animals drank the solution ad libitum.
High Viral Load and Mild Liver Injury in Children with Hemophilia Compared with Other Children with Chronic Hepatitis C Virus Infection
Authors: Zellos Aglaia , Thomas David L. , Mocilnikar Cathleen , Perlman Elizabeth J. , Boitnott John K. , Casella James F. , Schwarz Kathleen B.
Published: February 2024

Background:

In adults with hepatitis C virus (HCV) infection, the severity of liver disease may be influenced by the mode of transmission. The purpose of this study was to evaluate whether the mode of transmission affects liver injury and viral load in children with chronic HCV infection, independent of duration of infection and/or HCV genotype.

Methods:

Thirty‐nine anti‐HCV (EIA‐2) positive patients, were divided into three groups: group 1, children with a history of blood transfusion (n = 9; age, 13.3 ± 1.3 years), group 2, children with hemophilia (n = 19; age, 11.6 ± 0.8 years); and group 3, children with maternal‐fetal transmitted disease (n = 10; age, 4.7 ± 1.1 years). Serum alanine aminotransferase, HCV viral load, HCV genotype, and liver histology were assessed.

Results:

Serum HCV viral load was higher in group 2 (4.27 ± 1.0 × 106 copies/ml; p = 0.006) than in group 1 (0.73 ± 0.3 × 106 copies/ml) and in group 3 (0.83 ± 0.2 × 106 copies/ml). Conversely, group 2 had less severe liver injury compared with children of similar age in group 1 (p = 0.022). Despite a shorter duration of infection, group 3 had liver injury similar to that in group 1. Hepatitis C virus genotype did not influence the level of viremia or liver injury.

Conclusions:

Although children with hemophilia exhibited a high HCV viral load, liver histopathology was less severe than in children who had acquired HCV by blood transfusion or maternal‐fetal transmission. These observations support the need to investigate the role of host immune response rather than the virus per se in the pathogenesis of HCV infection in children.
Characteristics and Prevalence of Helicobacter heilmannii Infection in Children Undergoing Upper Gastrointestinal Endoscopy
Authors: Mention Karine , Michaud Laurent , Guimber Dominique , Martin De Lasalle Elisabeth , Vincent Pascal , Turck Dominique , Gottrand Frédéric
Published: February 2024

Background:

Helicobacter heilmannii, described in 1983 as a new cause of chronic gastritis, has been reported rarely in children. The purpose of this study was to determine the clinical characteristics and the prevalence of H. heilmannii infection, in comparison with Helicobacter pylori infection in children undergoing upper digestive endoscopy.

Methods:

Diagnosis of H. heilmannii was based on its morphologic characteristics in gastric biopsy specimens (two from the antrum, one from the fundus), whereas H. pylori infection was defined by histology and/or culture (one specimen from the antrum, one from the fundus). Respective prevalences of H. heilmannii and H. pylori were calculated in 518 patients studied prospectively who underwent systematic biopsies.

Results:

The prevalence of H. pylori was 8.9% (46/518) and increased with age (from 2% before 3 years of age to 18% after 10 years). On the contrary, the prevalence of H. heilmannii infection was low, 0.4% (2/518), and no different from that published in adults. After completion of the study period, a third H. heilmannii‐infected child was diagnosed. Characteristics of H. heilmannii infection could be studied in these three children 5, 9, and 14 years old. Two of three had abdominal pain and one had dysphagia. Nodular gastritis was observed at endoscopy in two children. H. heilmannii chronic active gastritis (n = 3) was localized in the antrum, associated with an interstitial infiltrate, and could not be distinguished from H. pylori gastritis (n = 46).

Conclusion:

Clinical characteristics, endoscopic features and gastric histopathology did not allow H. heilmannii to be distinguished from H. pylori gastritis in our pediatric population. H. heilmannii infection should be considered and carefully looked for during histologic examination of gastric specimens in cases of H. pylori‐negative gastritis.
Dietary Modulation of Intestinal Fructose Transport and GLUT5 mRNA Expression in Hypothyroid Rat Pups
Authors: Monteiro Iona M. , Jiang Lan , Ferraris Ronaldo P.
Published: February 2024

Background:

Intestinal fructose transport rates or GLUT5 mRNA levels typically show a two‐ to threefold increase after weaning in rats allowed to wean normally but can be enhanced precociously by high‐fructose diets during early weaning. Developmental increases in serum thyroxine levels coincide with the onset of weaning and have been linked to changes in intestinal sucrase and lactase activities.

Methods:

Rat pups were made hypothyroid by giving the dam 0.01% propylthiouracil as drinking water from day 18 of gestation. The hypothyroid pups and age‐matched euthyroid control pups were then fed high‐fructose or high‐glucose solutions by gavage, twice a day starting at 17 days of age for 3 days, and then killed at 20 days of age.

Results:

Serum thyroxine levels were five times lower in the hypothyroid pups. Rates of intestinal fructose uptake in the proximal and middle small intestine were 2.0 to 2.5 times higher in the hypothyroid and euthyroid pups fed high‐fructose solution than in littermates fed high‐glucose solution or those allowed to wean normally with the dam. Intestinal glucose uptake also increased in hypothyroid but not in euthyroid pups fed high‐fructose or high‐glucose solutions. GLUT5 mRNA levels increased in euthyroid and hypothyroid pups fed high fructose and paralleled the increase in fructose uptake.

Conclusion:

During weaning, dietary fructose can precociously enhance intestinal fructose uptake and GLUT5 mRNA expression, independent of developmental increases in serum thyroxine levels. Modest changes in glucose transport rates indicate that nonspecific mechanisms may provide a minor contribution to diet‐induced changes in nutrient absorption in hypothyroid pups.
Age at Time of Hepatitis Be Antibody Seroconversion in Childhood Chronic Hepatitis B Infection and Mutant Viral Strain Detection Rates
Authors: Ando Toshihiro , Sugiyama Kohachiro , Goto Kenji , Miyake Yoshishige , Li Rou , Kawabe Yoshikazu , Wada Yoshiro
Published: February 2024

Background:

Investigations of adult patients have demonstrated that with seroconversion, changes occur from wild‐type strains of the infecting virus to mutant strains. However, to date, there have been few reports and insufficient investigation of this issue in children.

Methods:

The presence or absence of nucleotide base and amino acid sequence mutations in a portion of the X region containing the core promoter region, the pre‐C region, and the C region of HBV genomic DNA were investigated using a polymerase chain reaction‐direct sequencing method on serum samples collected from 14 children who were hepatitis Be antibody (HBeAb)‐positive carriers. Samples from three children who were HBe antigen (HBeAg)‐positive carriers served as the control subjects.

Results:

When patients were grouped based on whether they had had documented seroconversion before age 6 or at age 6 or older, differences in mutant viral detection rates involving the core promoter region and the pre‐C region were apparent. Specifically, a mutant strain showing a G‐to‐A substitution at nucleotide 83 in the pre‐C region, or a mutant strain showing an A‐to‐T substitution at nucleotide 1762 and a G‐to‐A substitution at nucleotide 1764, was detected in only two of eight cases (25%) from the HBeAb‐positive carriers with documented seroconversion before age 6. In contrast, these findings were present in six of six patients (100%) with documented serocon‐version at age 6 or older.

Conclusions:

The results of the present study suggest that the mechanism of onset of HBeAb seroconversion differs between children aged less than 6 years and those who are aged 6 or more.
Intestinal Absorption and Permeability in Paediatric Short‐Bowel Syndrome: A Pilot Study
Authors: D'Antiga Lorenzo , Dhawan Anil , Davenport Mark , Mieli‐Vergani Giorgina , Bjarnason Ingvar
Published: February 2024

Background:

Sugar absorption tests are an effective, noninvasive way to assess intestinal permeability. The role of intestinal barrier integrity in complications and outcome of short‐bowel syndrome is not known. The purpose of the study was to evaluate whether such tests provide information on the status of intestinal mucosa of these patients.

Methods:

Six children with short‐bowel syndrome‐median age, 12 months, and median small bowel length at birth, 30 cm‐had a sugar test with 3‐o‐methyl‐D‐glucose, D‐xylose, D‐rhamnose, and melibiose approximately 2 months after operation. The melibiose/L‐rhamnose ratio was used as an index of permeability, and percentages of 3‐o‐methyl‐D‐glucose and D‐xylose absorbed were used as indices of absorption. Parenteral nutrition requirement, bowel length, liver disease, recent sepsis, and bacterial overgrowth were recorded.

Results:

Three patients had increased permeability, and all of them had had a recent episode of sepsis and severe liver disease. All subjects had malabsorption of 3‐o‐methyl‐D‐glucose, and five of six had malabsorption of D‐xylose and L‐rhamnose. The absorption of 3‐o‐methyl‐D‐glucose correlated with bowel length (r2 = 0.78; P = 0.04), whereas the absorption of D‐xylose correlated with parenteral requirement (r2 = 0.66; P = 0.04) at that time.

Conclusions:

Increased permeability was observed in three of six patients with short‐bowel syndrome associated with a recent episode of sepsis and severe liver disease. Other indices of malabsorption correlated significantly with different clinical features of the disease. A prospective larger scale study in a homogeneous population is indicated to assess at multiple points during the disease course whether the test can be helpful in the management of these patients.
Quality of Life in Children with Crohn's Disease: A Pilot Study
Authors: Akobeng Anthony K. , Suresh‐Babu Mirajkar V. , Firth David , Miller Victor , Mir Pervaiz , Thomas Adrian G.
Published: February 2024

Background:

Focus group meetings were held with two groups, each containing 12 children with Crohn's disease aged 8 to 12 and 12 to 17 years. The children were asked broad questions about how Crohn's disease and its treatment affected their lives. To explore these areas in more detail, an 88‐item questionnaire was developed and read to an additional 16 of 20 children with Crohn's disease selected at random from outpatients. At first, many of the children denied that Crohn's disease affected their lives at all, but it soon became apparent that many were frustrated or angry about physical symptoms, lack of understanding about Crohn's disease, unpleasant investigations, treatment, and hospitalisation.

Methods:

The questionnaire covered six domains of health‐related quality of life including symptoms and treatment, social, emotional, family, educational, and future aspects.

Results:

Elemental diet was the preferred treatment, although surgery was more effective in controlling symptoms. Children receiving steroids had more depressive symptoms. Absenteeism from school and inability to engage in school sports, swimming, and running were frequent problems. There were also difficulties with taking holidays and staying at friends' houses. Worry was reported in 14 of 16 children, anger and frustration and feeling fed up in 12 of 16.

Conclusions:

In addition to being a symptomatically disabling condition, Crohn's disease has a great impact on the health‐related quality of life of affected children. Future studies of treatment in children with inflammatory bowel disease should include an attempt to assess the impact on the child's health‐related quality of life.
Quality of Life of Parents and Siblings of Children with Inflammatory Bowel Disease
Authors: Akobeng Anthony K. , Miller Victor , Firth David , Suresh‐Babu Mirajkar V. , Mir Pervaiz , Thomas Adrian G.
Published: February 2024

Background:

Few investigators have reported on the quality of life of family members of children with inflammatory bowel disease. Psychological symptoms have been reported in parents and siblings, but the problems that which give rise to these symptoms are seldom examined. In this pilot study, some of the issues that affect the quality of life of parents and siblings of children with inflammatory bowel disease were examined.

Methods:

Focus group meetings were held separately with 20 parents and 7 siblings of children with inflammatory bowel disease. The participants were encouraged to identify voluntarily problems related to the disease that affected their lives, and the discussions were taped recorded. Each participants subsequently wrote down the three most important concerns.

Results:

Thirteen (65%) parents were very concerned about the effect of the disease on the child's future (jobs, marriage, independence) and 11 (55%) were worried about problems the ill child was encountering at school. Other issues of most concern to parents included side effects of medication (n = 7), limited job prospects (n = 3), persistent feelings of guilt (n = 3), and restricted family lifestyle (n = 1). Most siblings (57%) were concerned about their parents' keeping information about the illness from them, and three (43%) of them were also concerned about others bullying the ill child at school. Other issues of concern to siblings included fear about the disease and treatment (n = 3), parents overprotecting the ill child, and feelings of jealousy (n = 1).

Conclusion:

Families of children with inflammatory bowel disease experience many problems that may affect their quality of life. Resources should be made available to help families with these concerns.
Assessment of Quality of Life in the Younger Child: The Use of an Animated Computer Program
Authors: Büller Hans
Published: February 2024

Background:

In the past, quality of life was primarily assessed using objective measurements of the condition of the patient. Today, most quality‐of‐life measurements include several aspects regarding the patient's opinions and feelings. There has been an extensive development of quality‐of‐life instruments particularly in adults, including those for people with inflammatory bowel disease (IBD). However, only a few instruments, mostly questionnaires, have been developed for the pediatric population. It has been noted, even in young patients with IBD, that there is reduced self‐esteem and more anxiety and depression. Altogether, these are important aspects for early measurement of psychosocial functioning and possibly intervention during the treatment of children with IBD.

Methods:

For the current study, an instrument was developed for young children aged 5 years or more in which a computer‐based animated program was used to measure quality of life in children with inflammatory bowel disease. The instrument was designed to be similar for boys and girls with no reference to racial identity. In addition, it was culturally acceptable for all Dutch children. The program was in the form of a story of a bear and a clown playing in an attic of an old house where they come across many objects with which they play and where many adventures occur. All 35 questions were interwoven in this story.

Results:

The animated computer program was well accepted and easily used by 16 children between the ages of 5 and 12 in a small pilot study. In those older than 11 years, another approach is probably necessary, using an age‐appropriate animated program.

Conclusions:

The computer program can easily be used in an outpatient setting and thus ensures that quality‐of‐life measurement will become a routine part of a medical visit.
Zinc Homeostasis in Healthy Infants Fed a Casein Hydrolysate Formula
Authors: Krebs Nancy F. , Reidinger Carol J. , Miller Leland V. , Borschel Marlene W.
Published: February 2024

Background:

The results of earlier, nonquantitative studies suggested that absorption of zinc from a semielemental (casein hydrolysate) formula was inferior to absorption from a cow's milk–based formula. The objective of this study was to compare fractional, total and net zinc absorption, and fecal excretion of endogenous zinc in the same healthy young infants when fed a casein hydrolysate versus cow's milk–based formula.

Methods:

Fractional absorption of zinc and fecal excretion of endogenous zinc were determined from measurement of cumulative fecal excretion of unabsorbed tracer and by an isotope dilution technique, respectively, after oral administration of a 70Zn tracer with all formula feedings for 1 day. Six infants were assigned randomly to receive the test or control formula, and the other formula was administered 2 to 5 weeks later.

Results:

Mean (±SD) fractional absorption of zinc from the casein hydrolysate formula (0.47 ± 0.17) was double that from the cow's milk–based formula (0.22 ± 0.04;P = 0.01) with a correspondingly greater total zinc absorption (3.23 ± 1.67 mg Zn/day vs. 1.55 ± 0.55 mg Zn/day;P = 0.05). Because the excretion of endogenous zinc in the feces did not differ between formulas (0.90 ± 0.44 mg Zn/day vs. 0.91 ± 0.29 mg Zn/day), net absorption of zinc was also higher with the casein hydrolysate formula (2.33 ± 1.65 mg Zn/day vs. 0.81 ± 0.67 mg Zn/day;P = 0.02).

Conclusions:

Retention of zinc appeared to be adequate to meet the needs for growth during feeding with cow's milk–based formula and was more than adequate during short‐term feeding with the casein hydrolysate formula.
Human Colostrum and Serum Contain Antibodies Reactive to the Intimin‐Binding Region of the Enteropathogenic Escherichia coli Translocated Intimin Receptor
Authors: Sanches Marcela Imperio , Keller Rogeria , Hartland Elizabeth L. , Figueiredo Dayse M. M. , Batchelor Miranda , Martinez Marina B. , Dougan Gordon , Careiro–Sampaio Magda M. S. , Frankel Gad , Trabulsi Luiz R.
Published: February 2024

Background:

In Brazil, enteropathogenic Escherichia coli (EPEC) diarrhoea is endemic in young infants. A characteristic feature of EPEC adhesion to host cells is intimate attachment leading to the formation of distinctive “attaching and effacing” (A/E) lesions on mammalian cells. Two genes directly involved in intimate adhesion, eae and tir, encode the adhesion molecule intimin and its translocated receptor Tir, respectively. The intimin‐binding domain of Tir was recently mapped to the middle part of the polypeptide (Tir‐M), and the amino (Tir‐N) and carboxy (Tir‐C) termini were found to be located within infected host cells. Recently, it was shown that colostrum samples from mothers living in Sao Paulo contain IgA‐class antibodies reactive with a number of proteins associated with EPEC virulence. It has also been shown that patients infected with verocytotoxin‐producing E. coli O157 can produce antibodies to Tir. In the current study antibody responses to the different Tir domains were analyzed in sera and colostrum samples collected in an EPEC‐endemic area of Brazil.

Methods:

Recombinant Tir, Tir‐N, Tir‐M, and Tir‐C were expressed as His‐tagged protein in E. coli BL21a and purified on nickel columns. Western blot analysis was used to investigate colostrum IgA‐and serum IgG‐class antibodies reactive with the Tir fragments.

Results:

Anti‐Tir IgG antibodies were detected in the serum of children, with (63%) or without (50%) diarrhoea. Anti‐Tir IgA‐class antibodies were detected in all the colostrum pools tested. With the use of both serum IgG‐and colostrum IgA‐class antibodies, an immunodominant domain of the Tir‐polypeptide, Tir M, was identified.

Conclusion:

The intimin‐binding region of Tir (Tir‐M) is the immunodominant region of the polypeptide in humans. Both serum IgG‐class and colostrum IgA‐class antibodies reacted predominantly with the Tir‐M domain.
Mucosal Immunity and Gastrointestinal Antigen Processing
Authors: Mayer Lloyd , Simpson Hugh A. , Anderson John A.
Published: February 2024

The intestine is the largest lymphoid organ in the body by virtue of lymphocyte numbers and quantity of immunoglobulin produced. This is largely related to the enormous antigen load to which these cells are exposed on a daily basis. However, despite this, the mucosa‐associated lymphoid tissue appears to be regulated by unique mechanisms, and this is reflected in specific phenomena (oral tolerance, controlled or physiologic inflammation) as well as unusual lymphoid populations (intra‐epithelial lymphocytes) that respond to alternative pathways of activation. This, coupled with the existence of novel antigen‐presenting cells (intestinal epithelial cells) sets the scene for distinct immune responses. It is these distinct regulatory factors that support immunosuppression or tolerance rather than active immunity at a site juxtaposed to the external environment. This review defines these novel interactions and suggests how alteration in normal function may result in allergic or inflammatory responses. A clearer understanding of mucosal immunoregulation may lead to new therapeutic approaches for these diseases.
Milk‐Induced Reflux in Infants Less Than One Year of Age
Authors: Cavataio Francesca , Carroccio Antonio , Iacono Giuseppe , Simpson Hugh A. , Anderson John A.
Published: February 2024

Cow's milk allergy (CMA) and gastroesophageal reflux are considered to be among the most common disturbances in infants less than 1 year of age. In recent years, the relationship existing between these two entities has been investigated and some important conclusions have been reached: In just under half the cases of GER in infants less than 1 one year of age there is an association with CMA; in a high proportion of cases, GER is not only CMA‐associated but also CMA‐induced; the frequency of this association should induce pediatricians to screen for possible concomitant CMA in all infants with GER less than 1 year old; with the exception of some patients with mild typical CMA manifestations (diarrhea, dermatitis, or rhinitis), the symptoms of GER associated with CMA are the same as those observed in primary GER; immunologic tests are useful in a suspected association between GER and CMA; and subjects with GER secondary to CMA show a typical pH‐monitoring tracing pattern, characterized by a progressive, slow decrease in esophageal pH between feedings. This article reviews the main features of the two diseases, stressing the aspects in common between them and comments on all the listed points.
Food Protein‐Induced Enterocolitis Syndrome: Clinical Perspectives
Authors: Sicherer Scott H. , Simpson Hugh A. , Anderson John A.
Published: February 2024

Food Protein‐Induced Enterocolitis Syndrome (FPIES) is a symptom complex of severe vomiting and diarrhea caused by non‐IgE‐mediated allergy to cow's milk and/or soy in infants. Symptoms typically begin in the first month of life in association with failure to thrive and may progress to acidemia and methemoglobinemia. Symptoms resolve after the causal protein (usually sensitivity to both cow's milk and soy) is removed from the diet. Symptoms recur approximately 2 hours after reintroduction of the protein along with a coincident elevation of the peripheral blood polymorphonuclear leukocyte count. The sensitivity is usually outgrown by 3 years of age. The purpose of this review is to delineate the characteristic clinical features, diagnosis and management of FPIES. Furthermore, infantile FPIES will be discussed in relation to clinical syndromes that share features with it (“atypical FPIES”) and other food‐allergic disorders affecting the gastrointestinal tract.
Magnetic Resonance Imaging to Distinguish the Type and Severity of Pediatric Inflammatory Bowel Diseases
Authors: Durno Carol A. , Sherman Philip , Williams Tara , Shuckett Bruce , Dupuis Annie , Griffiths Anne M.
Published: February 2024

Background:

The distinction between ulcerative colitis and Crohn's disease is important, because treatment options and clinical course may vary. Magnetic resonance imaging (MRI) allows noninvasive transmural assessment of the intestine and may facilitate differentiation of ulcerative colitis from Crohn's disease. The objective of this prospective study was to determine whether MRI differentiates Crohn's disease from ulcerative colitis in children as effectively as colonoscopy with mucosal biopsies.

Methods:

Fifteen patients underwent colonoscopy with biopsies followed by abdominal MRI. The MRI diagnosis, determined by two radiologists independently completing a standardized form was compared with the gastroenterologic diagnosis.

Results:

After colonoscopy and review of histology, Crohn's disease was diagnosed in nine patients, ulcerative colitis in five, and indeterminate colitis in one, who was excluded from study. Agreement of the MRI diagnosis with the gastroenterologic diagnosis was 4 of 4 (100%) for ulcerative colitis, 4 of 10 (40%) for Crohn's disease considering both radiologists, and 5 of 10 (50%) for Crohn's disease for each radiologist individually. Percentage of enhancement by MRI did not correlate with the severity of inflammation determined at endoscopy among the patients with Crohn's disease (r = −0.3, P = 0.366). There was agreement on severity of inflammation in three of four patients with ulcerative colitis.

Conclusions:

Current MRI interpretation of inflammatory bowel disease did not adequately recognize Crohn's disease in children. Therefore, colonoscopy with biopsy remains the most accurate tool for determining the type and severity of inflammatory bowel disease in children and adolescents.
Transpyloric Enteral Nutrition Reduces the Complication Rate and Cost in the Critically Ill Child
Authors: de Lucas Carmen , Moreno María , López–Herce Jesús , Ruiz Fernando , Pérez–Palencia Mercedes , Carrillo Angel
Published: February 2024

Background:

Studies in adults have shown that transpyloric enteral nutrition (TEN) is useful in certain patients who cannot tolerate oral or gastric feeding. This study was conducted to compare TEN with parenteral nutrition (PN) in critically ill pediatric patients.

Methods:

A retrospective descriptive study conducted in the pediatric intensive care unit of a tertiary pediatric referral center. All patients in the pediatric intensive care unit (PICU) receiving PN and/or TEN from January 1993 through December 1996 were included in the study.

Results:

Two hundred forty patients (14.6% of all patients admitted to the PICU) received PN and/or TEN (168 exclusively PN, 21 exclusively TEN, and 51 a combined regimen). The number of patients receiving PN and duration of PN declined significantly from 1993 (65 patients, 703 days) through 1996 (48 patients, 395 days). This was mirrored by the increase in the number of patients receiving TEN and duration of TEN. The incidence of complications (hyperglycemia, hypertriglyceridemia, and cholestasis) was higher in the PN group. There was no difference in the incidence of hospital‐acquired infection or mortality between the two groups. The cost of TEN was lower than that of PN, with an estimated annual saving of $5,422.

Conclusions:

Transpyloric enteral nutrition is a suitable method of nutritional support for critically ill pediatric patients. It has fewer complications and a lower cost than PN.
Celiac Disease and Human Leukocyte Antigen Genotype: Accuracy of Diagnosis in Self‐Diagnosed Individuals, Dosage Effect, and Sibling Risk
Authors: Lewis Cathryn , Book Linda , Black Jeff , Sawitzke Allen , Cannon‐Albright Lisa , Zone John , Neuhausen Susan
Published: February 2024

Background:

Celiac disease is an autoimmune disorder of the small intestine characterized by intolerance to gluten. Traditionally, diagnosis is made by intestinal biopsy. Testing for immunoglobulin (Ig) A endomysial antibodies in the serum also is used for diagnosis. Biopsy and serology revert to normal with adherence to a gluten‐free diet. Often, after an index case is diagnosed, siblings with symptoms adhere to a gluten‐free diet without biopsy or serologic confirmation. More than 90% of patients with celiac disease have the human leukocyte antigen (HLA) DQA1*0501‐DQB1*0201 genotype. Non‐HLA genes also have been implicated.

Methods:

One hundred ninety‐five individuals with confirmed or suspected celiac disease were identified in 73 families affected by the disease. IgA endomysial antibody testing was performed for all symptomatic family members who did not have biopsy‐confirmed diagnoses. DNA samples were genotyped at D6S276 and the HLA class II loci DQA and DQB.

Results:

At the time sampling was begun in families, 88 of 177 (49.7%) individuals were self‐diagnosed and adhering to a gluten‐free diet. Ninety percent (91/101) of confirmed cases (biopsy or serology) had at least 1 copy of the DQA1*0501‐DQB1*0201 genotype, whereas only 67% (46/69) of cases self‐diagnosed (adherence to gluten‐free diet without confirmation) had at least 1 copy. Of confirmed cases, 61% carried two copies of DQB*0201. It is estimated that the HLA association and other unlinked genes contribute approximately equally to the sibling risk of celiac disease.

Conclusions:

A dosage effect of DQB1*0201 may be associated with an increased risk of celiac disease. Self‐diagnosis of celiac disease is as common as confirmed diagnosis in families in the United States. Diagnosis of celiac disease on the basis of clinical response to gluten restriction is inaccurate. With long‐term adherence to a gluten‐free diet, serologic test results are likely to be negative. Based on HLA genotype, approximately one third of self‐diagnosed individuals are unlikely to have celiac disease. However, it is not possible to determine which individuals consuming a gluten‐free diet have the disease. Therefore, before starting a gluten‐free diet, serologic screening and biopsy confirmation are necessary.
Molybdenum Supplementation in Phenylketonuria Diets: Adequate in Early Infancy?
Authors: Sievers Erika , Arpe Thomas , Schleyerbach Urte , Schaub Jürgen
Published: February 2024

Background:

Molybdenum concentrations in formulas exceed those in human milk by far. Infants with phenylketonuria require semisynthetic phenylalanine‐restricted diets. Because these diets are presently supplemented with molybdenum, a study was conducted to determine whether retention and plasma concentration in the recipients are equivalent to those of healthy breast‐fed infants.

Methods:

Balance and plasma studies were conducted in healthy breast‐fed infants (n = 17) and in patients with phenylketonuria (n = 4) at the age of 4 weeks, and the plasma investigations were repeated at the ages of 4 and 12 months. The samples were analyzed by atomic absorption spectroscopy (balance studies) and high‐resolution inductively coupled plasma mass spectrometry (plasma).

Results:

Molybdenum intake and retention in all infants with phenylketonuria were more than 18 times those of breast‐fed infants. The plasma concentrations reflected these differences. A median of 0.04 μg/l was assessed in breast‐fed infants at 4 weeks and less than 0.02 μg/l at 4 months of age. Comparative results of infants with phenylketonuria were 2.9 μg/l and 2.5 μg/l, respectively. There were no significant differences between the groups at 12 months of age.

Conclusions:

The phenylketonuria diets investigated showed excessive retention and plasma concentrations of the essential trace element molybdenum in early infancy. In view of these findings, the present practice of molybdenum fortification should be revised.
Euro‐Growth References for Length, Weight, and Body Circumferences
Authors: Haschke Ferdinand , van't Hof Martin A. ,   Euro‐Growth Study Group
Published: February 2024

Background:

Several concerns have been raised by World Health Organization (WHO) expert groups regarding the adequacy of currently existing growth references, including those currently supported by WHO. As part of a concerted action of the European Union, new references were developed that were based on a well‐defined sample of the European population and were compared with existing references.

Methods:

During the longitudinal, observational multicenter study, anthropometric measurements using standardized methodology were performed in 2245 children between 1 and 36 months of age, and sex‐and age‐specific growth references for recumbent length, weight, mid‐upper arm, thigh, and calf circumferences were developed.

Results:

The validity of the curve‐fitting programs was demonstrated by comparing the selected sex‐specific percentile distributions for all indices with the smoothed references. Comparison with the National Center for Health Statistics (NCHS)‐WHO references for length and weight for age indicated that the ‐2 z‐score value of the WHO reference as cutoff value shows that a substantial part of the children with suspected failure to thrive should be classified as normal. The references also indicate that the mid‐upper arm circumference is age and sex dependent and that a single cutoff value for children less than 5 years of age should no longer be used. Mid‐parental height was the best single predictor of recumbent length until 36 months of age.

Conclusions:

The Euro‐Growth references that were developed reflect growth of a well‐defined, large cohort of healthy infants and can be used for international comparisons.
Euro‐Growth References on Increments in Length, Weight, and Head and Arm Circumferences During the First 3 Years of Life
Authors: van't Hof Martin A. , Haschke Ferdinand , Darvay Sarolta ,   Euro‐Growth Study Group
Published: February 2024

Background:

Reliable assessment of growth performance of infants and young children requires reference data increments. Available increment references are based on data fitted to mathematical models, a process that diminishes variation in increment values.

Methods:

Fully longitudinal data from the multicenter Euro‐Growth Study (21 study sites;n = 2145 children) were used to develop sex‐specific percentiles for increments in length, weight, and head and mid‐upper arm circumferences for selected intervals during the first 36 months of life. Increments (per unit of time) were calculated for 2‐, 3‐and 6‐month intervals from birth to 12 months of age and for 6‐month intervals from 12 to 36 months of age. Weight increments were also calculated for 1‐month intervals from birth to 6 months of age. The influence of sex, mid‐parental height, and study site was determined using analysis of covariance. Comparison with other references was accomplished using percentile values.

Results:

Mean and standard deviation values as well as selected percentiles (P; P3, P5, P10, P25, P50, P75, P90, P95, and P97) of increments are presented. Length increments of boys were higher than those of girls until 5 months of age but tended to be lower thereafter. Weight increments of boys were higher until 9 months of age. Sex, mid‐parental height, and study site explained only between 2% and 13% of the variances of increments. Mean increments were comparable but P10 and P90 substantially differed from published data.

Conclusions:

The new Euro‐Growth references for increments in length, weight, and head and mid‐upper arm circumferences provide tools for health workers that should be useful in screening for adequacy of growth during the first 3 years of life.
Euro‐Growth References for Body Mass Index and Weight for Length
Authors: van't Hof Martin A. , Haschke Ferdinand ,   Euro‐Growth Study Group
Published: February 2024

Background:

Fully longitudinal data from the multicenter Euro‐Growth study (21 study sites;n = 2145 children) were used to develop sex‐specific percentiles and z‐scores for body mass index (BMI) and weight for length (WfL) during the first 36 months of life.

Methods:

Smoothed percentile curves for BMI against age were constructed and checked against raw percentiles. Smoothed percentile curves for WfL were constructed according to established procedures and were checked against raw percentiles. The relation of BMI with length and of WfL with age was examined. The relation between BMI and WfL was tested using z‐scores of each. The influence of gender, geographic location (study site), and genetic factors on BMI and WfL was examined. Finally, the new references for BMI and WfL were compared with other published references.

Results:

Selected percentiles (P; P3, P5, PI0, P25, P50, P75, P90, P95, and P97) for BMI showed a sharp increase from 1 to 6 months of age and a gradual decline between 12 and 36 months. Smoothed percentiles for WfL showed only small deviations from raw percentiles. BMI was found to be essentially independent of length, whereas WfL showed some degree of dependence on age. Values for BMI and WfL showed very good agreement, except at the extremes of the age range. A modest degree of influence of geographic location on BMI and WfL was found. Correlations with parental BMI and WfL were very weak, however. Comparison with the National Center for Health Statistics (NCHS) references showed the latter to have a narrower range of values.

Conclusions:

The new Euro‐Growth references for BMI and WfL provide improved tools for health workers and researchers dealing with childhood obesity.
Patterns of Milk and Food Intake in Infants From Birth to Age 36 Months: The Euro‐Growth Study
Authors: Freeman Valerie , van't Hof Martin , Haschke Ferdinand ,   Euro‐Growth Study Group
Published: February 2024

Background:

Little detailed information is available on feeding practices of infants in Europe. The Euro‐Growth Study is a longitudinal, observational, multicenter study of milk feeding, the introduction of complementary solid foods, and vitamin and mineral supplementation. Current practice is compared with international feeding recommendations.

Method:

Healthy term infants (n = 2245) were recruited at birth or during the first month of life. Dietary records were completed at the ages 1, 2, 3, 4, 5, 6, 9, 12, 18, 24, 30, and 36 months by semiquantitative dietary recall.

Results:

At the age of 1 month, 52% of the infants were exclusively breast fed and 26% were exclusively formula fed. At the age of 9 months, 18% of infants were fed only cow's milk. At the ages of 3, 4, and 5 months, 50%, 67%, and 95% of infants were fed solid foods, respectively.

Conclusions:

Feeding practices vary considerably throughout Europe. High rates of breast‐feeding initiation are found in Umea, Sweden, and in Athens, Greece; and low rates in Dublin, Ireland, in Toulouse, France, and in Glasgow, United Kingdom. The use of cow's milk as the main milk drink before the age of 12 months is still common in certain European centers.
Writing manuscripts for peer review
Authors: Weinstein Robert
Published: February 2024

Little instruction in writing manuscripts for peer review is provided in nursing school or medical school. To relatively inexperienced would‐be authors, including junior physicians and allied health professionals, this avenue of professional communication may sometimes seem to be unattainable. Yet many of them are energetic and insightful, and have the potential to make contributions to the literature. This article aims to provide an explanation of the components of the peer review manuscript and advice regarding how to go about writing one so as to overcome the writer's block that inexperienced authors may frequently experience.
Circulating microvesicles miR139‐3p from bronchopulmonary dysplasia aggravates pulmonary vascular simplification by targeting 4E binding protein 1
Authors: Yu Linchao , He Rui , Liu Chan , Shi Yuan , Wang Daoxin
Published: February 2024

Background

Microvesicles (MVs) play a crucial role in bronchopulmonary dysplasia (BPD). There are many MVs in circulating plasma, and they are in direct contact with lung endothelial cells. However, the molecular mechanism and causative effect of circulating MVs on BPD remain unclear.

Methods

Clinical plasma samples were collected, circulating MVs were isolated, and microRNA (miRNA) sequencing was performed. The BPD model was established, and different MVs were administered. Alveoli and pulmonary vessels were examined by hematoxylin–eosin staining, and body weight and length were measured. In vitro, gene expression was disrupted by miRNA mimics, miRNA inhibitors or plasmid transfection. Cell proliferation and protein expression were detected by cell scratch assay, accurate 5‐ethynyl‐2‐deoxyuridine test, western blotting, or immunofluorescence assay.

Results

BPD‐derived MVs further aggravated pulmonary vascular simplification, while circulating MVs from control mice mitigated pulmonary vascular simplification. Micro‐RNA sequencing and independent sample verification revealed that miR139‐3p, but not miR6125 or miR193b‐3p, was the most critical effector molecule in MVs. Mechanism studies showed that eukaryotic translation initiation factor 4E binding protein 1 was the target gene for miR139‐3p. In addition, we found that supplementation of miR139‐3p inhibitor partially alleviated pulmonary vascular simplification.

Conclusions

These results indicate that circulating MVs are involved in forming BPD by carrying miR139‐3p molecules and support miR139‐3p inhibitors as a potential therapeutic strategy for alleviating pulmonary vascular simplification in BPD.
Blue carbon additionality: New insights from the radiocarbon content of saltmarsh soils and their respired CO2
Authors: Houston Alex , Garnett Mark H , Austin William E. N.
Published: February 2024

International policy frameworks recognize the net drawdown and storage of atmospheric greenhouse gases through management interventions on blue carbon ecosystems (saltmarshes, mangroves, seagrasses) as potential emissions offset strategies. However, key questions remain around the “additionality” of the carbon sequestered by these ecosystems, and whether some fraction of the organic carbon (OC) that does not derive from in situ production (allochthonous) should be included in carbon budgets. This study compares the radiocarbon (14C) contents of saltmarsh soils and CO2 evolved from aerobic laboratory incubations to show that young OC is preferentially respired over aged OC, and that the latter is also vulnerable to remineralization under oxic conditions. This highlights that management interventions which reduce the exposure of saltmarsh soils to oxic conditions support the inclusion of some portion of allochthonous OC in carbon budgets. Elevated temperature incubations provide preliminary evidence that the predominant source of respired OC will not change under predicted future warmer conditions. Saltmarsh typology also influences the 14C content of both the bulk soil and respired CO2, highlighting the importance of site selection for optimized blue carbon additionality.
The effect of reinforcement particles weight percentage on the mechanical properties and plastic flow behaviour of aluminum alloy 7075 matrix material
Authors: Gupta T. K. , Saxena A.
Published: February 2024

In the present investigation, an aluminum 7075 based hybrid metal matrix composite has been prepared by utilizing the primary reinforcement element (boron carbide with 9 %, 7 %, 5 %, 3 %, and 1 % weight percentage) and secondary reinforcement particles (silicon carbide with 1 %, 3 %, 5 %, 7 %, and 9 % weight percentage) through the well‐known stir‐casting method. Further, the tensile, hardness and Charpy impact tests were performed on the prepared composite material for mechanical properties evaluation. In addition, an attempt has also been performed to analyze the effect of reinforcement weight percentages (primary and secondary) on the strength coefficient, strain hardening rate and strain hardening exponent of the prepared composite material compositions. The results revealed that sample 1 (aluminum 7075/9 weight percentage boron carbide/1 weight percentage silicon carbide) exhibited the maximum 14.12 percent, 14.25 percent and 19.56 percentage increase in hardness, ultimate tensile strength and yield strength respectively than the matrix material. The strain hardening exponent has been increased with the increase in the weight percentage of silicon carbide. Further, the value of the strength coefficient was decreased with the increase in the weight percentage of boron carbide particles. In addition, stage III hardening was associated with the all developed composite material compositions.
The influence of chemical and technological parameters of materials in the design of objects in industrial design on the example of state facilities
Authors: Zijing W.
Published: February 2024

The purpose of this study is to generalise the thermodynamic model describing the fragmentation of metals or alloys at integrated project delivery, and to study the features and conditions for the formation of limit (stationary) structures of various types. Thus, a Project Delivery is constructed in the two‐defect model approximation with dislocation density and grain boundaries taken into account, which establishes the conditions for the formation of limit (stationary) structures of different types. In addition, the article studies in detail the evolution of the main structural defects and their interaction during the implementation of the stationary regime, and also establishes the dependence of the type of limit structure formed on the values of landslide deformation and the initial state of the material. It is found that the change of states of the system is of solid‐state phase transformation nature. It follows from the methods of description that the limit (stationary) structure is not immutable, but represents a dynamic equilibrium of the processes of generation and annihilation of structural defects.