bluuebunny/crossref_metadata_2025 huggingface dataset:
Chronic Propranolol Treatment Affects Parietal Cells of the Developing Rat Gastric Mucosa
Authors: Henriksson Roger , Hellström Sten
Published: February 2024

The nonselective β‐adrenoceptor antagonist propranolol (0.3 mg/kg body weight) was given to rats, twice daily, from the day of birth to 5 weeks of age. The animals were then killed, and sections from gastric mucosa were prepared for light and electron microscopy. Proprànolol treatment significantly reduced the thickness of the mucosa as compared with that of the controls. The parietal cell volume density and the number of parietal cells were markedly decreased following propranolol. The volume density of lamina propria and of other epithelial cells in the gastric mucosa were not significantly different from the control group. The secretory canaliculi of the parietal cells seemed markedly increased, indicating enhanced secretory activity. These findings suggest an important role for the adrenergic‐sympathetic system in the development of parietal cells in the maturing gastric mucosa.
Prognostic Factors Associated with Patient Survival During Nutritional Rehabilitation in Malnourished Children and Adolescents with Cystic Fibrosis
Authors: Levy L. , Durie P. , Pencharz P. , Corey M.
Published: February 2024

Nineteen children and adolescents with cystic fibrosis and malnutrition were given intensive nutritional support in an effort to reverse malnutrition. Standard techniques of enteral and parenteral feeding were used. As 10 of 19 patients died shortly after nutritional intervention began, we retrospectively analyzed patient data in order to discover whether or not any patient characteristics were associated with survival. Using a multivariate analysis, a linear discriminant function was derived employing average heart rate, the presence or absence of Pseudomonas cepacia in the sputum culture, PaCO2, and the patient's age at the time of intervention. This function correctly classified these 19 patients. A further 10 nonselected CF patients who also received nutritional support were similarly assessed using the function, and again, survival was accurately predicted. Therefore, this function can be used to predict the likelihood of patient survival during the provision of advanced nutritional support. It may be helpful in deciding whether or not advanced nutritional support is warranted in certain CF patients.
Safe Oral Rehydration of Hypertonic Dehydration
Authors: Blum D. , Brasseur D. , Kahn A. , Brachet E.
Published: February 2024

Eighteen infants with severe hypernatremic dehydration secondary to acute gastroenteritis were rehydrated during the 1st day with an oral glucose electrolyte solution containing 60 mmol sodium/L at a mean rate of 120 ml/kg/24 h. These 18 children were safely treated with oral therapy alone. No convulsions were observed during treatment. The mean decrease in natremia was 0.32 mmol/L/h, which compared favorably with the mean fall in natremia of 26 other infants in similar initial conditions who were treated intravenously. The present study lends additional support to the opinion that a slow decrease in plasma sodium (<0.5 mmol/L/h) helps to avoid seizures during treatment. As no other untoward effects were observed, this study also confirms that oral solutions given at a slow rate can effectively replace intravenous fluids in the majority of such children.
Milk Versus No Milk in Rapid Refeeding After Acute Gastroenteritis
Authors: Isolauri E. , Vesikari T. , Saha P. , Viander M.
Published: February 2024

Sixty‐five infants (mean age 14.7 months, range 6‐34 months), hospitalized for acute gastroenteritis, were treated with oral rehydration and rapid reintroduction of full feedings appropriate for age. Cow's milk and milk products were eliminated from the diet of 27 infants, whereas the remaining 38 children continued to receive their usual milk and milk products as parts of the mixed diet. There was no difference between the groups in the clinical recovery from diarrhea. No child had prolonged diarrhea. No new cases of clinical atopy were observed at 1‐month follow‐up, and there were no significant increases in the total or milk‐specific IgE levels. Serum IgG and IgA antibodies to β‐lactoglobulin and α‐casein were initially present in the majority of the children, but there were no appreciable changes in these cow's milk antibodies after gastroenteritis, regardless of the type of diet. It is concluded that cow's milk and milk products can be safely given in acute gastroenteritis as parts of the mixed diet for children over 6 months of age. Rapid reintroduction of feedings is beneficial for recovery from diarrhea, and there appears to be little need for dietary restrictions in this age group.
Functional Gastrointestinal Obstruction in a Child with Chronic Granulomatous Disease
Authors: Granot E. , Matoth I. , Korman S. H. , Ludomirsky A. , Lax E.
Published: February 2024

A child with chronic granulomatous disease developed an antral‐pyloric obstruction, followed a month later by a postbulbar duodenal obstruction. At both areas, there was no evidence of an anatomical lesion, and some improvement in the passage of barium was observed following glucagon and metoclopramide administration. Presumably, symptoms have resulted from a functional disturbance of gastrointestinal motility.
Intestinal Permeability to [51Cr]EDTA in Children with Cystic Fibrosis
Authors: Leclercq‐Foucart Jacqueline , Forget Philippe , Sodoyez‐Goffaux FrançLoise , Zappitelli Ada
Published: February 2024

Summary: Intestinal permeability was investigated in 14 children with cystic fibrosis making use of [51Cr]EDTA as probe molecule. Ten normal young adults and 11 children served as controls. After oral administration of [51Cr]‐EDTA, 24 h urine was collected. Urinary radioactivity was calculated and results expressed as percentage of oral dose excreted in 24 h urine. Mean and SEM were as follows: 2.51 ± 0.21, 2.35 ± 0.24, and 13.19 ± 1.72 for control children, normal adults, and cystic fibrosis patients, respectively. The permeability differences between cystic fibrosis patients and either control children or control adults are significant (p < 0.001).
Intestinal Retinol Esterification and Serum Retinol in Children with Cystic Fibrosis
Authors: Rasmussen Magnhild , Michalsen Helge , Lie Sverre O. , Nilsson Astrid , Petersen Lizette B. , Norum Kaare R.
Published: February 2024

Summary: Children with cystic fibrosis (CF) often have a poor vitamin A status. We found in the present work a reduced level of serum retinol in older children with this disease. As retinol enters intestinal lymph as retinyl esters, the enzyme acyl‐CoA: retinol acyltransferase (ARAT) may be of importance for retinol absorption. We have assayed ARAT activity in duodenal mucosal homogenate from children with CF. There was a large variation within the group. However, mean ARAT activity was not significantly decreased, as compared with controls. Thus, the lack of pancreatic enzymes probably is the main reason for reduced vitamin A absorption in CF. In celiac disease and in lactose intolerance—both mucosal disorders — a significant reduction of mean ARAT activity was found.
Mesenchyme‐Dependent Differentiation of Epithelial Progenitor Cells in the Gut
Authors: Haffen K. , Kedinger M. , Simon‐Assmann P.
Published: February 2024

The digestive tract and the gut as a paradigm represents an attractive system for the study of mechanisms involved in the differentiation of two types of progenitor cells: the endodermal cells during embryonic life and the undifferentiated crypt cells during epithelial renewal of the adult intestine. The morphological and functional events that accompany the differentiation processes of progenitor cells into the polarized epithelial cell types characteristic of the intestine appear comparable in both situations (1,2). During organogenesis of the gut, histological observations underlined a close relationship between epithelial cells and their underlying mesenchymal cells (3,4). Developmental biologists have emphasized experimentally the importance of interactions between the endoderm and mesenchyme during organogenesis of the digestive tract. In the adult intestine, gastroenterologists have focused their attention on a specialized mesenchymal cell type (the pericryptal fibroblasts) that displays, like epithelial cells, proliferative activities and migrating properties. The aim of this review is to provide current knowledge on epithelial‐mesenchymal interactions during ontogenesis of the digestive tract and also to relate some experiments supporting the view of the perpetuation of epithelial‐mesenchymal interactions beyond embryonic life.
Long‐Term Home Parenteral Nutrition in Pediatrics
Authors: Vargas Jorge H. , Ament Marvin E. , Berquist William E.
Published: February 2024

One hundred two pediatric patients received all or part of their nutritional needs parenterally at home during the past decade. All received total parenteral nutrition (TPN) at night during an 8‐to 12‐h infusion. Patients with short bowel syndrome (33%), inflammatory bowel disease (23%), chronic intractable diarrhea (15%), chronic idiopathic intestinal pseudo‐obstruction syndrome (10%), and malignancy (10%) made up the largest groups. The mean duration of parenteral support was 735 days (range, 90–3650 days); the mean number of catheters per patient was 2.1 (range, 1–8). Twenty‐one patients continue to receive full or partial home TPN: four for more than 10 years and seven for more than 5 years. Fifty‐one no longer require it and have had healing of mucosa or bowel adaptation. Complications related to administration of fluid and electrolytes were quite rare. Biotin deficiency was recognized once. Thirty‐one have died, but only 13 deaths were related to TPN. Sepsis in nine and liver failure in two were the most common causes of death in the TPN‐related group. Three of 21 still on home TPN have graduated either from high school or college. All but one of the school age children attend regular school; one attends a school for the medically disabled, another attends a school for the mentally gifted.
In Vivo Intestinal Uptake of Immunoreactive Bovine Albumin in Piglet Enteritis
Authors: Keljo David J. , Bloch Kurt J. , Bloch Margot , Arighi Mimi , Hamilton J. R.
Published: February 2024

We examined the uptake of bovine serum albumin (BSA) from the intestine into the circulation of 3‐week‐old piglets infected with transmissible gastroenteritis virus. Transfer of immunoreactive bovine serum albumin (iBSA) from the intestinal lumen into the circulation was enhanced during both the early invasive phase of this viral enteritis (12‐h postinoculation) and the diarrheal phase (84‐h postinoculation). In some animals, enhanced uptake persisted into the recovery phase, 324 h after inoculation. Gel filtration studies suggested that iBSA had the molecular size characteristic of native BSA; no immunoreactive fragments of BSA were detected. Based on studies of two animal she half‐life of iBSA approximated that of porcine albumin. Further study is required to determine the immunological consequences of the enhanced uptake of protein occurring during viral infection of the intestine.
Congenital Diarrhea with Intestinal Inflammation and Epithelial Immaturity
Authors: Kanof Marjorie E. , Ranee Naomi E. , Hamilton Stanley R. , Luk Gordon D. , Lake Alan M.
Published: February 2024

We report an interesting case of congenital inflammatory bowel disease and intestinal epithelial immaturity that presented as secretory diarrhea. No infectious, metabolic, or anatomical basis for these findings was identified. As differentiated from previous reports of neonatal enteropathies, this infant demonstrated involvement of both the small and large intestine with histopathologic findings of acute and chronic inflammation, extensive submucosal fibrosis, and “flat” small intestine mucosa. In addition, this patient had a polyamine deficiency (a primary or secondary phenomenon), which may have contributed to delayed epithelial maturation. These findings suggest that the inflammatory bowel disease and altered epithelial maturation contributed to a fatal intractable diarrhea.
Lymphoblastic Stimulation Test with Food Proteins in Digestive Intolerance to Cow's Milk and in Infant Diarrheas
Authors: Baudon J. J. , Mougenot J. F. , Didry J. R.
Published: February 2024

The lymphoblastic stimulation test (LST) with cow's milk proteins was performed in 114 infants. In 42 infants, digestive intolerance to cow's milk proteins (CMI) was suspected; withdrawal‐rechallenge test confirmed intolerance in 34, and disproved it in the other eight patients. Of the other patients, 17 had acute gastroenteritis, 11 had postgastroenteritis subacute diarrhea, 12 had gluten intolerance, 14 had intractable diarrhea, and 18 had no digestive disorders. Of the 34 infants with CMI, 27 (79%) had a positive LST to one or more cow's milk proteins. Of the 34 positive LST patients, 12 also had soya intolerance; nine of these 12 infants (75%) had positive LST to soya. Of the eight infants who had a negative cow's milk rechallenge test, five (62%) had a positive LST. In the other groups, results were also positive in 12–27% of those having diarrhea of infectious origin or gluten intolerance, and in none of the infants without digestive disorders. Of the 14 cases of severe intractable diarrhea, 12 (86%) were also LST‐positive, but CMI could not be excluded. LST was positive, particularly in diarrheas of neonatal origin. Lymphoblastic stimulation was induced more frequently by casein than by β lactoglobulin, and least frequently by a lactalbutnin. In conclusion, LST is frequently positive in CMI, but is not sufficiently specific to be a reliable diagnostic examination.
Effects of Gliadin Peptides B1‐B4 in Celiac Disease.
Authors: Stallmach Andreas , Belitz Hans‐Dieter , Gellermann Barbara , Schäfer Hansjörg , Wieser Herbert , Stern Martin
Published: February 2024

Small intestinal organ culture was used as an in vitro system to study the enterotoxic effects of gliadin peptides. Measurement of enterocyte height proved to be a reliable and reproducible way of assessing mucosal change during organ culture. Enterocyte height decreases nonspecifically in normal cultured mucosa, whereas the height of enterocytes of celiac mucosa increases in vitro in controls. All the gliadin peptide fractions (B1, B2, B3, B4) that had been prepared by peptic‐tryptic hydrolysis, ultrafiltration, and gel chromatography, equally inhibited the morphological increase of enterocyte height normally observed without gliadin in untreated celiac mucosa. Electrophoretic studies and amino acid analysis of B1‐B4 revealed similarity between gliadin fractions with quantitative differences in molecular weight distribution of the peptide components. Our studies suggest that organ culture assessed by morphometry is a suitable model for the investigation of toxic peptides of gliadin in celiac disease. In the future, pure gliadin peptides will have to be examined.
Intestinal Mucosa in Nephropathic Cystinosis
Authors: Iancu Theodore C. , Lerner Aaron , Shiloh Hanna
Published: February 2024

The major manifestations of nephropathic cystinosis are renal tubular acidosis, vitamin D‐resistant rickets, and dwarfism. Cystine crystals are deposited in a variety of cells, mainly phagocytic, including macro‐phages of the intestinal lamina propria. Previously, ultrastructural changes were suggested to occur in the absorptive epithelium as well, possibly as a result of local cystine toxicity. We report here on the light‐ and electron‐microscopic findings in the jejunal mucosa of two patients, aged 4 and 9 years with nephropathic cystinosis. Cystine crystals were easily identified in semithin sections of plastic‐embedded specimens as brick‐ and hexagon‐shaped spaces in macrophages. Electron microscopy showed that all crystals were in single‐membrane‐limited bodies (lysosomes), within phagocytic cells, and exclusively located in the lamina propria. In contrast to previous findings, the absorptive epithelium showed no abnormalities. We conclude that the growth failure in cystinosis is not a consequence of morphological toxic alterations in the intestinal epithelium, but is related to the known metabolic abnormalities of this condition. The use of rectal suction biopsy as a means of diagnosing cystinosis is also suggested as an alternative to other diagnostic methods.
Histochemical and Morphological Analysis of Colonic Epithelium from Children with Gardner's Syndrome and Adults Bearing Adenomatous Polyps
Authors: Lev Robert , Lebenthal Emanuel , Rossi Thomas , Lance Peter
Published: February 2024

Normal and adenomatous colonic tissues from children with Gardner's syndrome were compared to analogous tissues from adults bearing adenomatous polyps using mucin histochemical and lectin‐binding techniques. Adenomatous tissue from children exhibited general morphological similarity to its adult homologue, but showed less dysplasia. Its goblet cells stained weaker for mucins and the lectins Dolichos biflorus agglutinin (DBA) and peanut agglutinin (PNA). This suggested un‐derglycosylation of side chains of mucins in these childhood adenomas. The weak DBA and relatively intense sulfomucin staining in these adenomas suggested that they arose from deep crypt cells. Adult adenomas shared certain histochemical properties with carcinomas, namely, increased affinity for periodic acid‐Schiff (PAS) and focally for PNA. There is evidence based on the effects of saponification and sialidase treatments that the weak initial PAS reaction in normal and adenomatous colonic goblet cells from both age groups results from sub‐stituents on sialic acid and, in the case of normal colon from children, on other monosaccharides as well. Finally, there was a frequent lack of parellelism between PAS and lectin staining suggesting that different groups within the sugars are responsible for reactivity with those compounds.
Development of Five Metabolic Activities Associated with the Intestinal Microflora of Healthy Infants
Authors: Midtvedt Ann‐Christine , Carlstedt‐Duke Bodil , Norin Karin Elisabeth , Saxerholt Henri , Midtvedt Tore
Published: February 2024

The establishment of a functionally active intestinal flora was followed in 17 healthy Swedish children from birth up to 6 months of age. Utilizing gas chroma‐tography, spectrophotometry, and gel electrophoresis, feces were analyzed on certain biochemical markers that reflect the action of the intestinal flora in vivo. The establishment of the following five flora‐related functions was investigated: production of short chain fatty acids (SCFAs), degradation of mucin, conversion of bilirubin to urobilinogen and of cholesterol to coprostanol, and inactivation of fecal tryptic activity (FTA). Production of SCFAs was the first function to be established, followed by bilirubin conversion and mucin degradation. No child showed conversion of cholesterol. The values of FTA were lower than in adults. This study indicates that the establishment of a functionally active flora is a slow process and that some functions are almost fully established before other functions have started to develop. Environmental factors, such as the diet, seem to be of importance. In general, the functions seem to develop slower in those children receiving breast milk exclusively than in those receiving formula supplements.
Acute Obstructive Pancreatitis Secondary to a Duodenal Hematoma
Authors: Glassman Mark S. , Rodrigues Roy , Bussel James , Spivak William , Hilgartner Margaret
Published: February 2024

An 18‐year‐old male with hemophilia presented with symptoms and signs of upper intestinal obstruction. Evaluation was consistent with an intramural duodenal hematoma and obstructive pancreatitis. As it is not possible to distinguish between these two disorders on a clinical basis, it is important to realize that pancreatitis may occur in such patients more often than is recognized.
Dumping in Infancy Diagnosed by Radionuclide Gastric Emptying Technique
Authors: Lavine Joel E. , Hattner Robert S. , Heyman Melvin B.
Published: February 2024

Two infants were diagnosed with dumping syndrome by a radionuclide gastric emptying method. Both patients presented with anorexia, weight loss, agitation and diaphoresis following bolus feeding by gastrostomy tube. One had documented hyperglycemia and glycosuria. Symptoms and signs of dumping in one patient were due to a gastrostomy placed in the antrum, whereby bolus tube feedings were inadvertently introduced directly into the duodenum. The second patient developed dumping symptoms after a Waterston colonie interposition was performed to correct a long gap esophageal atresia. Gastric emptying, measured by administering 99mTc‐sulfur colloid‐labeled formula, demonstrated an initial extremely rapid appearance of isotope in the small intestine, with greater than one‐third of the formula leaving the stomach in less than 2 min. The gastric emptying pattern in both patients appeared biphasic; after the initial “dumping” phase, the remaining formula emptied slowly, with monoexponential decay kinetics.
Maternal‐Neonatal Serum Vitamin A Concentrations
Authors: Shirali Girish S. , Oelberg David G. , Mehta Kumud P.
Published: February 2024

Prevention of neonatal vitamin A deficiency is related to the adequacy of maternal vitamin A stores. In this study we investigated maternal and cord serum vitamin A and retinol‐binding protein (RBP) values in an Indian population including, for the first time, clinically vitamin A‐deficient mothers. Twenty‐eight maternalneonatal pairs were selected from maternal cohorts of high socioeconomic status without clinical evidence of vitamin A deficiency (group I) and low socioeconomic status with conjunctival xerosis and Bitot's spots (group II). Maternal education, caloric and vitamin A intakes, weight, height, hemoglobin, and birth weight were significantly lower in group II. Serum vitamin A levels were significantly higher in group I mothers and newborns as were RBP levels in group I mothers. However, a significant difference between groups I and II in cord blood RBP was not observed. Upon correlation of maternal vitamin A levels with cord blood vitamin A levels, a logarithmic relationship was revealed, suggesting saturable transplacental transport of vitamin A.
Arthritis as the Initial Manifestation of Inflammatory Bowel Disease in Early Infancy
Authors: Israel David M. , Olson Allan D. , Ilowite Norman T. , Davidson Murray
Published: February 2024

We report a 10‐month‐old infant who had arthritis as the initial clinical manifestation of ulcerative colitis. Arthritis is considered to be the most common extraintestinal manifestation of IBD in adults and children. This case emphasizes that arthritis may be the earliest manifestation of IBD even in the very young infant.
Decompensated Cardiomyopathy Mimicking Hepatitis in a 13‐Year‐Old Girl
Authors: Sisto Alfred , Van Doesburg Nicolaas , Deal Cheri , Brochu Pierre , Ki Leung Tack , Roy Claude C.
Published: February 2024

The name of a 13‐year‐old girl diagnosed as having idiopathic dilated cardiomyopathy was removed from the cardiac transplant list because a hepatitis‐like picture developed that coincided with evidence of decompensation of her cardiac function. On admission, there was only modest evidence of cytolysis (ALT level, 115 U/L) and of cholestasis (bilirubin level, 3.0 mg/dl), but there was severe prolongation of her prothrombin time (28 s). This was followed by elevation of both her transaminases and bilirubin levels. A liver biopsy sample showed extensive necrosis involving both the central and midlobular zones, while periportal areas revealed dilated sinusoids and steatotic multinucleated hepatocytes. A brief improvement of both her liver and her heart was followed by rapid deterioration of the functions of both. Attention is drawn to the relationship between reduced cardiac output and hepatic dysfunction secondary to massive cytolysis.
Gallbladder Motility in Children With Down Syndrome
Authors: Taşdemir Haydar Ali , Çetinkaya Melih Cevdet , Polat Cafer , Belet Umit , Kalayci Ayhan Gazi , Akbaş Seval
Published: February 2024

Objective:

The aim of this study was to investigate gallbladder motility in children with Down syndrome by measuring gall‐bladder volume and contraction index.

Methods:

This study, performed between January 2001 and December 2002 at the Ondokuz Mayis University, School of Medicine, Department of Paediatric Neurology, Samsun, Turkey, included 21 patients with Down syndrome (study group) and 22 healthy children (control group). After an 8‐hour fast, gallbladder diameters in both groups were measured in length, width, and height by ultrasonography before and 30 minutes after a test meal. The volume of gallbladder before and after a test meal was determined, and the contraction index was calculated. Blood triglyceride and cholesterol levels were measured, and 5‐hydroxyindoleacetic acid (5‐HIAA) levels in urine were determined.

Results:

Mean gallbladder volume before test meal in the study group and controls was 8,412.4 ± 5,174 mm3 and 16,516.8 ± 6,796.1 mm3 (P < 0.001), respectively. The mean contraction index of the study group was 41.2% ± 19.4% and of controls, 75.0% ± 12.3% (P < 0.001). The mean triglyceride level of the study group was significantly higher than controls (P < 0.05). The mean urine 5‐HIAA level of the study group was lower than controls (P < 0.05).

Conclusion:

CI was lower in patients with Down syndrome, suggesting gallbladder hypomotility. Hypomotility may be a feature associated with the high prevalence of gallstones in Down syndrome.
Serum Transaminases in Children with Wilson's Disease
Authors: Iorio Raffaele , D'Ambrosi Mariangela , Marcellini Matilde , Barbera Cristiana , Maggiore Giuseppe , Zancan Lucia , Giacchino Raffaella , Vajro Pietro , Marazzi Maria Grazia , Francavilla Ruggiero , Michielutti Fabio , Resti Massimo , Frediani Tullio , Pastore Maria , Mazzarella Giuseppina , Fusco Giuseppina , Cirillo Francesco ,   Angela Vegnente on behalf of the Hepatology Committee of Italian Society of Paediatric Gastroenterology Hepatology and Nutrition
Published: February 2024

Objectives:

The response of serum transaminase levels to penicillamine and zinc treatment in Wilson's disease is poorly understood. The aim of this multicenter retrospective study was to evaluate transaminase levels after penicillamine and zinc treatment in children with Wilson's disease.

Patients and Methods:

One hundred and nine patients with Wilson's disease (median age at diagnosis, 7.2 years; range, 1 to 18 years), treated for at least 12 months and observed in the last 20 years at 11 Paediatric Departments were studied. Clinical, laboratory and histologic features at diagnosis and initial treatment were recorded. Efficacy parameters were normalization of serum transaminase level and improved clinical and/or laboratory signs. One hundred and two patients had clinical or laboratory signs of liver disease.

Results:

Fifty‐six of 87 patients (64%) given penicillamine normalized serum alanine aminotransferase (ALT) levels within a median of 17 months (range, 2 to 96 months). Of the 29 patients with persistent hyper‐ALT, 17 (59%) switched to zinc; only four of these normalized ALT on zinc within a median period of 38 months (range, 7 to 48 months). Eleven (50%) of the 22 patients given zinc alone normalized ALT within a median period of 6 months (range, 1 to 36 months). Of the 11 patients with persistent hyper‐ALT, five switched to penicillamine. Three of the five normalized ALT within a median period of 6 months (range, 6 to 9 months). Overall, in penicillamine‐treated and zinc‐treated patients with persistent hypertransaminasemia, ALT decreased from a basal median of 236 IU/L (range, 54 to 640 IU/L) to a median of 78 (range, 46 to 960 IU/L) at the end of follow‐up (P = 0.0245). Poor compliance was suspected in only 10% of cases. No predictive factor of persistent hypertransaminasemia was identified. Liver disease did not worsen in any patient during the study.

Conclusions:

Although the efficacy of penicillamine and zinc is well documented, it is notable that a subset of children with Wilson's disease‐related liver disease (36%) had hypertransaminasemia despite appropriate treatment with penicillamine or zinc.
Goat Milk is Less Immunogenic than Cow Milk in a Murine Model of Atopy
Authors: Lara‐Villoslada Federico , Olivares Mónica , Jiménez Jesús , Boza Julio , Xaus Jordi
Published: February 2024

Objectives:

Cow milk protein allergy occurs in 2% to 6% of infants population. Goat milk has been used as an alternative to cow milk, but there is probably some cross‐reactivity between the milks. Little is known about the allergenicity of goat milk per se. The aim of this study is to compare cow and goat milk allergenicity in a mouse atopy model.

Methods:

Balb/C mice were intragastrically sensitized to cow or goat milk by five doses administrated weekly. Six weeks after the first dose mice were killed, sera were collected and spleens removed for analysis.

Results:

The number of mice with diarrhea was significantly higher in the cow milk‐sensitized group than in the goat milk‐sensitized group. Serum cow milk‐specific immunoglobulin G1 and histamine levels were also significantly higher in cow milk‐sensitized mice. Cytokine production by spleen derived T cells showed a Th2 response with high levels of interleukin‐4 production and low levels of interferon‐γ in cow milk‐sensitized mice. In addition, goat milk induced a lower lymphocyte sensitization as a result of a significant decrease in the specific proliferation ratio of these cells.

Conclusion:

Goat milk, when used as the first source of protein after a breast‐feeding period, is less allergenic than cow milk in mice. Further studies are needed to clarify if goat milk is suitable as an alternative to cow milk in milk based formulas for infant nutrition.
Meat Consumption is Positively Associated with Psychomotor Outcome in Children up to 24 Months of Age
Authors: Morgan Jane , Taylor Andrew , Fewtrell Mary
Published: February 2024

Objective:

The impact of specific complementary foods on health outcomes has been poorly studied. We aimed to determine if meat consumption and breastfeeding influence growth and neurocognitive outcome in infants up to 24 months of age.

Methods:

In a longitudinal cohort study, 144 full‐term infants were recruited at 4 months. Their red and white meat consumption was recorded in sequential 7‐day weighed food intake diaries at 4, 8, 12, 16, 20 and 24 months. Growth data were collected at the same census points as the dietary data. Neurocognitive outcome (psychomotor developmental indices and mental developmental indices) derived from the Bayley Scales of Infant Development II was measured at 22 months.

Results:

Meat intake from 4‐12 months was positively and significantly related to weight gain (P < 0.05); further analysis suggested this association might be mediated via protein intake but was independent of energy, zinc or iron intake. There was no interaction between meat intake and breastfeeding on growth. Meat intake from 4‐12 and 4‐16 months was positively and significantly related to psychomotor developmental indices (P < 0.02 and 0.013, respectively) but there was no association between breastfeeding and psychomotor developmental indices nor any interaction between meat intake and breastfeeding. Conversely, breastfeeding was positively and significantly related to mental developmental indices (P < 0.01) but there was no association between meat intake and mental developmental indices nor any interaction between breastfeeding and meat intake. These findings remained after adjustment for potential confounding factors.

Conclusion:

Meat intake, possibly via its effect on protein intake, is associated with increased weight gain in infants up to 12 months of age. Meat intake is also positively associated with psychomotor development at 22 months. These findings highlight the need for further investigation of the role of complementary foods in relation to health outcomes.
Herpes Simplex Virus Esophagitis in Immunocompetent Children
Authors: Rodrigues Fernanda , Brandão Nogueira , Duque Vitor , Ribeiro Catarina , António Armando Mendes
Published: February 2024

Objectives:

To review clinical, laboratory, endoscopic and histologic features, treatment and outcome of immunocompetent children with Herpes simplex virus esophagitis.

Methods:

Retrospective analysis of the medical records of six children (five males) referred to our unit between 1997‐2001.

Results:

The median age at presentation was 4 years. Fever was present in all, odynophagia/dysphagia in five, retrosternal pain in four, vomiting in three, drooling in two and irritability and drowsiness in one. The median time between the onset of symptoms and the diagnosis was 6.5 days. Endoscopy, performed in all, showed friable mucosa and erosive‐ulcerative involvement, with histology showing inflammation and ulcerated esophagitis. Tissue viral culture was performed in five patients and was positive in three, and polymerase chain reaction was positive in two of four tested. Serology was consistent with primary Herpes simplex virus infection in all. All received nasogastric feeding and acyclovir. The outcome was very good.

Conclusions:

This is an uncommon and under‐recognized condition in the immunocompetent child. The most common symptoms are sometimes not diagnostic, particularly in very young children. The presence of unusual clinical signs may lead to a difficult and delayed diagnosis. Treatment with acyclovir may have hastened the resolution of symptoms, but a controlled clinical study was not performed.
The Effect of Zinc Salts on Serum Bilirubin Levels in Hyperbilirubinemic Rats
Authors: Vítek Libor , Muchová Lucie , Zelenka Jaroslav , Zadinová Marie , Malina Jiří
Published: February 2024

Objectives:

Intestinal metabolism of bilirubin is implicated in the pathogenesis of neonatal jaundice and Crigler‐Najjar syndrome. In the present study the authors investigated the effect of oral administration of zinc salts on serum bilirubin levels in hyperbilirubinemic rats.

Methods:

Bilirubin‐binding activities of zinc sulfate and water‐insoluble zinc methacrylate were determined in vitro. Congenitally hyperbilirubinemic Gunn rats and artificially hyperbilirubinemic Wistar rats were used in in vivo studies. Animals were fed a normal diet for 1 week and then a treatment diet of either zinc sulfate or zinc methacrylate for additional 2 weeks. Serum and fecal bile pigments were determined at the end of each phase. Biliary bilirubin secretion rates were determined in hyperbilirubinemic Wistar rats fed zinc methacrylate.

Results:

Substantial bilirubin‐binding activities of zinc salts were demonstrated in in vitro experiments. Treatment with oral zinc salts significantly decreased serum bilirubin levels in Gunn rats (166 ± 53 versus 123 ± 38 and 206 ± 34 versus 131 ± 31 μmol/L, P < 0.05 for zinc methacrylate and zinc sulfate, respectively). A similar effect of zinc methacrylate was also observed in hyperbilirubinemic Wistar rats (102 ± 10 versus 14 ± 4 μmol/L, P < 0.0001). In accord, biliary bilirubin secretion decreased significantly in these animals (45 ± 11 versus 28 ± 4 nmol/h 100g body weight, P < 0.02). In contrast to zinc sulfate, treatment with zinc methacrylate did not lead to the elevation of serum zinc levels.

Conclusions:

Oral administration of zinc salts efficiently decreased serum bilirubin levels in hyperbilirubinemic rats, presumably as a result of inhibition of enterohepatic circulation of bilirubin. This approach might be useful in the treatment of severe unconjugated hyperbilirubinemias.
Antiendomysial Antibody Detection in Biopsy Culture Allows Avoidance of Gluten Challenge in Celiac Children
Authors: Bonamico Margherita , Sabbatella Luigi , Di Tola Marco , Vetrano Stefania , Ferri Mirella , Nenna Raffaella , Mariani Paolo , Picarelli Antonio
Published: February 2024

Objective:

Antiendomysial antibody (EMA) production has been induced in vitro by the small bowel mucosa of celiac disease (CD) patients in clinical remission cultured in the presence of gliadin peptides. The aim of the present study was to use this in vitro system to determine whether it could be used to predict the clinical or histologic relapse to gluten challenge in CD children on a gluten‐free diet (GFD).

Methods:

Enrolled were 32 CD children and adolescents on GFD (group 1), and 80 controls (group 2) who underwent in vitro gliadin challenge. Subsequently, 24 group 1 CD children underwent in vivo gluten challenge to confirm the diagnosis. Biopsy cultures, with and without gliadin, morphometric analysis, immunoglobulin (Ig)A and IgG1 EMA detection, both in sera and culture supernatants, were performed.

Results:

Of the 32 group 1 CD patients, 23 were IgA EMA positive in culture supernatants. The other nine were IgG1 EMA positive. All 24 children who had in vivo gluten challenge showed clinical or histologic relapse. All culture supernatants from disease controls belonging to group 2 were both IgA and IgG1 EMA negative, irrespective of gliadin challenge.

Conclusions:

Organ culture with in vitro gliadin challenge is able to reproduce the results of in vivo challenge. This system could reduce the need for gluten challenge in celiac children.
Diagnostic Utility of the Water Load Test in Children With Chronic Abdominal Pain
Authors: Schurman Jennifer Verrill , Friesen Craig A , Andre Linda , Welchert Elly , Lavenbarg Teri , Danda Caroline Elder , Cocjin Jose T , Hyman Paul E
Published: February 2024

Objectives:

To compare water load test consumption patterns between children with functional gastrointestinal disorders and healthy control children.

Methods:

Seventy‐one children with recurrent abdominal pain completed the Behavioral Assessment Scale for Children–Self‐ Report Form and the Questionnaire on Pediatric Gastrointestinal Symptoms during their first visit to a pediatric gastroenterology clinic. Parent‐ and child‐report functional gastrointestinal diagnoses were based on the Questionnaire on Pediatric Gastrointestinal Symptoms scoring criteria, whereas the clinician's diagnosis was based on clinical impression from history and physical examination completed at this visit. Twenty‐six healthy children also participated as controls. Statistical comparisons involved Student t tests, whereas receiver operating characteristic curves estimated sensitivity/specificity of the water load test and linear regression determined the amount of variance accounted for in water volume consumption.

Results:

Children with recurrent abdominal pain, particularly those with a diagnosis of functional dyspepsia, consumed less water than healthy children on the water load test. The water load test demonstrated good specificity, but poor sensitivity, in identifying patients with functional dyspepsia. Clinician evaluation provided the greatest differentiation between functional gastrointestinal disorders on the water load test.

Conclusions:

The water load test seems to be a poor diagnostic test for functional dyspepsia because of poor sensitivity. However, future research should examine whether the water load test is identifying a subset of children with functional dyspepsia experiencing a specific mechanosensory dysfunction and whether the water load test can predict clinical response to specific therapeutic interventions.
Esomeprazole for the Treatment of GERD in Infants Ages 1–11 Months
Authors: Winter Harland , Gunasekaran Thirumazhisai , Tolia Vasundhara , Gottrand Frederic , Barker Peter N. , Illueca Marta
Published: February 2024

Objectives:

Gastroesophageal reflux disease (GERD) is present in pediatric patients when reflux of gastric contents causes troublesome symptoms and/or complications. The present study evaluates the efficacy and safety of esomeprazole in infants ages 1 to 11 months with GERD.

Methods:

In this multicenter randomized, double‐blind, placebo‐controlled, parallel‐group, treatment‐withdrawal study, infants received open‐label, weight‐adjusted doses of esomeprazole (2.5–10 mg) once daily for 2 weeks. Infants with symptom improvement were randomized to esomeprazole (weight‐adjusted doses [2.5–10 mg]) or placebo for 4 weeks. The primary endpoint was time to discontinuation owing to symptom worsening based on global assessments by the parent/guardian and physician. Adverse events were recorded.

Results:

Of the 98 patients enrolled, 81 (82.7%) experienced symptom improvement determined by physician global assessment (PGA) during open‐label esomeprazole treatment; 80 entered the double‐blind phase. During this phase, discontinuation rates owing to symptom worsening were 48.8% (20/41) for placebo‐treated versus 38.5% (15/39) for esomeprazole‐treated patients (hazard ratio 0.69; P = 0.28). Posthoc analysis of infants with symptomatic GERD (ie, no diagnostic procedure performed) revealed that time to discontinuation was significantly longer with esomeprazole than placebo (hazard ratio 0.24; P = 0.01); the complementary subgroup difference was not significant (hazard ratio 1.39; P = 0.48). Esomeprazole was well tolerated.

Conclusions:

The discontinuation rate owing to symptom worsening did not differ significantly between infants receiving esomeprazole versus those receiving placebo. Improved diagnostic criteria in this age group are needed to identify infants with GERD who may benefit from acid suppression therapy.
Effects of flood‐induced financial stress on the viability of a cooperative production system and its farmers: A multilevel study
Authors: Nortes Martínez David , Grelot Frédéric , Brémond Pauline , Farolfi Stefano , Rouchier Juliette
Published: February 2024

Floods can severely disrupt agricultural activities. When these activities are part of production chains, domino effects can occur. We use agent‐based modeling to simulate the production dynamics of a French cooperative winery as an example of a production chain, adopting a dual individual‐collective perspective. The cash‐flow analysis shows that there are nonexplicit mechanisms in the cooperative organization that allow the propagation of flood impacts throughout the chain and influence the winegrowers' ability to cope, thus threatening the continuity of the winegrowers' activity and the cooperative winery itself.
Within‐family associations of parent–adolescent relationship quality and adolescent affective well‐being
Authors: Arslan İldeniz B. , Boele Savannah , Dietvorst Evelien , Lucassen Nicole , Keijsers Loes
Published: February 2024

Background

Parent–adolescent relationship quality is theorized to be an important correlate of adolescent affective well‐being. Little is known about the within‐family processes underlying parent–adolescent relationship quality and affective well‐being over a period of months. This three‐wave, preregistered study examined within‐ and between‐family associations between parent–adolescent relationship quality (support and conflict) and adolescent well‐being (negative and positive affect). In addition, we examined whether the associations differed between mothers and fathers, and for adolescents' affective well‐being in different social contexts (at home, at school, with peers).

Methods

The sample consisted of 244 Dutch adolescents (61.5% girls; age range: 12–17 years; mean age = 13.8 years). Random‐intercept cross‐lagged panel models were used.

Results

At the between‐family level, higher levels of support and lower levels of conflict were associated with higher levels of positive affect and lower levels of negative affect. At the within‐family level, increases in support and decreases in conflict were concurrently associated with increases in positive affect and decreases in negative affect. More parent–adolescent conflict than typical also predicted increases in negative affect, 3 months later, and more negative affect and less positive affect than typical predicted increased conflict, 3 months later. These within‐family effects were largely similar for fathers and mothers. Associations for conflict occurred through bidirectional processes: Parent–adolescent conflict shaped and was shaped by adolescents' emotions at home, at school, and with peers.

Conclusion

Results suggest that parent–adolescent relationship quality (especially conflict) and adolescent affective well‐being cofluctuate and predict each other over time within families.
Variable‐volume accelerated system to evaluate the carbaryl biodegradation dynamics of a microbial community by differential analysis
Authors: Pérez‐Suárez Cristian , Ruiz‐Ordaz Nora , Galíndez‐Mayer Juvencio , Santoyo‐Tepole Fortunata , Juárez‐Ramírez Cleotilde
Published: February 2024

BACKGROUND

One of the continuous cultivation methods for acquiring quantitative data on microbial metabolism under various environmental conditions within a single experiment is the accelerostat culture system (A‐stat). It allows the rapid analysis and quantitative evaluation of the effect of environmental on the functional response of microorganisms, which is reflected by the cultural biokinetic parameters. In a classical accelerostat system, equipment and control programs maintain a constant acceleration (a) of the culture's dilution rate D[t] = Do + at. Unlike the conventional A‐stat, in which a linear change in the dilution rate is obtained, a new variant, here named a variable‐volume accelerated (VVA) system, the acceleration is variable (a = f[t]); thus, D[t] = Do + a[t]. This system requires minimal manual intervention and presents operational advantages over the classical A‐stat; the reactor's D[t] change is achieved under a simple condition: the input and output flow rates are unequal; Fin ≠ Fout.

RESULTS

Using carbaryl as a study model, the dynamic behavior of the VVA system was evaluated by differential analysis of the experimental data obtained by cultivating a carbaryl‐degrading microbial community. Mathematical analysis of the VVA system established the acceleration profile a[t] for the study, quantifying the impact of dilution rate on the microbial community's biokinetic and stoichiometric parameters.

CONCLUSION

The VVA system allowed observation of the effect of the D[t] gradient on the rate of change of kinetic parameters that define the physiological state of the microbial culture, together with the microbial community's macromolecular composition. © 2024 Society of Chemical Industry (SCI).
Assessment of the students’ performance and support needs in a novel digital carving exercise
Authors: Maragha Tala , Chehroudi Babak
Published: February 2024

Objectives

In recent years, digital technology has been rapidly expanding in dental practice, which entails an early integration of digital dentistry into the preclinical dental curriculum. This study introduces first‐year dental students to a digital carving exercise and investigates its role in enhancing their understanding and performance in traditional wax carving activities. Another objective was to explore the students’ challenges and needs for support in the digital carving activity.

Methods

Digital carving exercise was introduced into the first‐year dental morphology curriculum in 2020. Students’ performance in anterior wax carving was quantitively compared prior to and following the implementation of the exercise. The students’ grades in the digital carving exercise were also compared across three academic years: 2020, 2021, and 2022. Qualitatively, an interpretive description approach using focus group with 31 first‐year dental students was utilized to explore their perspectives regarding the digital exercise.

Results

A statistically significant improvement was found in the students wax carving performance following the incorporation of the digital carving activity (p‐value = 0.0001). Students’ performance in the digital carving exercise also statistically improved over the years. Students’ challenges included the technology's unfamiliarity, and a perceived irrelevance of the exercise. Additional guidance, resources, and timely feedback were reported among the students’ support needs during the exercise.

Conclusion

Digital carving is a promising tool in anatomical education that can improve the students’ spatial understanding and manual dexterity. However, educators need to carefully integrate it into the curriculum to address the students’ challenges and optimize their learning experience.