bluuebunny/crossref_metadata_2025 huggingface dataset:
Safety of Rapid Intravenous Rehydration and Comparative Efficacy of 3 Oral Rehydration Solutions in the Treatment of Severely Malnourished Children With Dehydrating Cholera
Authors: Alam Nur H , Islam Sufia , Sattar Samima , Monira Shirajum , Desjeux Jehan‐François
Published: May 2009

Objectives:

Assess the safety of rapid intravenous rehydration of severely malnourished children and compare the efficacy of 3 formulations of oral rehydration salts solutions.

Patients and Methods:

A group of 175 severely malnourished children of either sex (weight/length <70% of National Center for Health Statistics median), ages 6 to 36 months with cholera, were randomly assigned to receive 1 of 3 oral rehydration solutions (ORSs): glucose‐ORS (n = 58), glucose‐ORS plus 50 g/L of amylase‐resistant starch (n = 59), or rice‐ORS (n = 58). Severely dehydrated children at enrollment were administered 100 mL/kg of an intravenous solution for 4 to 6 hours before randomisation, and those with some dehydration were randomised on enrollment. The electrolytes of the 3 ORSs were identical. In acute and convalescence phases, treatment was similar other than the nature of the ORSs.

Results:

Intravenous fluid (mean) administered to 149 study children was 103 mL/kg (95% confidence interval [CI] 96–109), and all were rehydrated within 6 hours. None of them developed overhydration or heart failure. During the first 24 hours, stool output (31%; 95% CI 14%–42%; P = 0.004) and the ORS intake (26%; 95% CI 12%–37%; P = 0.002) of children receiving rice‐ORS were significantly less compared with children receiving glucose‐ORS. The mean duration of diarrhoea in all children (66 hours; 95% CI 62–71), and time to attain 80% of median weight/length (7.15 ± 2.81 days) were not different.

Conclusions:

Dehydration in severely malnourished children can safely be corrected within 6 hours. All study ORSs were equally efficient in correcting dehydration. Rice‐ORS significantly reduced the stool output and ORS intake, confirming previous reports.
Time Course of Bacterial Diversity in Stool Samples of Malnourished Children With Cholera Receiving Treatment
Authors: Monira Shirajum , Alam Nur Haque , Suau Antonia , Magne Fabien , Nair Gopinath Balakrish , Karmakar Polash Chandra , Rahman Motiur , Pochart Philippe , Desjeux Jehan‐Francois
Published: May 2009

Background:

Recent nutritional interventions have targeted colonic functions in patients with infectious diarrhea during rehydration and during recovery from malnutrition, with the assumption that the effects will be influenced by metabolism of complex carbohydrates by colonic bacteria. However, the diversity of colonic bacteria in patients with cholera is not known.

Aim:

To study the diversity of colonic bacteria in malnourished children with cholera before and during treatment with oral rehydration salt solutions containing 1 of these 3 substrates: glucose, rice, or amylase‐resistant starch.

Patients and Methods:

Serial fecal samples were collected from 30 malnourished children with cholera until completion of rehydration and partial nutritional recovery; 11 malnourished children without diarrhea; and 6 better nourished children. Polymerase chain reaction, using universal primers for 16S rDNA, was performed on chromosomal DNA extracted from the stool samples, and the products were separated by temporal temperature gradient gel electrophoresis.

Results:

The Vibrio cholerae band was detected in all children at enrollment and disappeared within 2 days. On day 2, a rapid and significant increase in the band numbers was observed, which was followed by a steady increase until day 28. After full recovery from cholera and partial recovery from malnutrition, the number of bands (11.5 ± 2.8) was lower than in healthy children (22.2 ± 1.3). On day 3, the number of bands was greater with rice or amylase‐resistant starch than with glucose (P < 0.05).

Conclusions:

Bacterial diversity was markedly but transiently altered in severely malnourished children with cholera receiving therapy.
Intestinal Microbiota During Infancy and Its Implications for Obesity
Authors: Reinhardt Christoph , Reigstad Christopher S , Bäckhed Fredrik
Published: May 2009

Obesity is a worldwide epidemic, threatening both industrialized and developing countries, and is accompanied by a dramatic increase in obesity‐related disorders, including type 2 diabetes mellitus, hypertension, cardiovascular diseases, and nonalcoholic fatty liver disease. Recent studies have shown that the gut microbial community (microbiota) is an environmental factor that regulates obesity by increasing energy harvest from the diet and by regulating peripheral metabolism. However, there are no data on how obesogenic microbiotas are established and whether this process is determined during infancy. The sterile fetus is born into a microbial world and is immediately colonized by numerous species originating from the surrounding ecosystems, especially the maternal vaginal and fecal microflora. This initial microbiota develops into a complex ecosystem in a predictable fashion determined by internal (eg, oxygen depletion) and external (eg, mode of birth, impact of environment, diet, hospitalization, application of antibiotics) factors. We discuss how the gut microbiota regulates obesity and how environmental factors that affect the establishment of the gut microbiota during infancy may contribute to obesity later in life.
Impact of Hepatitis C Virus Infection on Children and Their Caregivers: Quality of Life, Cognitive, and Emotional Outcomes
Authors: Rodrigue James R , Balistreri William , Haber Barbara , Jonas Maureen M , Mohan Parvathi , Molleston Jean P , Murray Karen F , Narkewicz Michael R , Rosenthal Philip , Smith Lesley J , Schwarz Kathleen B , Robuck Patricia , Barton Bruce , González‐Peralta Regino P
Published: May 2009

Objective:

Hepatitis C virus (HCV) infection is associated with decreased quality of life (QOL) and neurocognitive dysfunction in adults, but little is known about its impact on children and their caregivers.

Patients and Methods:

We studied the QOL, behavioral, emotional, and cognitive functioning of 114 treatment‐naïve children with HCV enrolled in a placebo‐controlled, randomized, multisite clinical trial evaluating peginterferon α‐2a alone or with ribavirin. Baseline assessment included measures of children's QOL, cognitive functioning, behavioral adaptation, and depression. Caregivers' QOL also was assessed.

Results:

Relative to published normative data, caregivers were more likely to believe that their children's health was poor and would likely worsen (t = 3.93; P < 0.0001), and reported higher concern about their children's health status (t = 6.63; P < 0.0001) and that this concern limited family activities (t = 2.45; P < 0.01); they also viewed their children as having more internalizing behavioral problems (t = 1.98; P < 0.05). Only 2 (2%) children had a score in the clinically depressed range. Children with HCV had worse cognitive functioning than the normative sample but significantly better functioning than children with attention‐deficit/hyperactivity disorder. Caregivers' QOL scores did not differ significantly from the normative sample, but infected mothers had lower QOL than noninfected caregivers. Caregivers were highly distressed about their children's medical circumstances.

Conclusions:

Although HCV infection, in its early stages, does not lead to global impairment in QOL, cognitive, behavioral, or emotional functioning in children, it is associated with higher caregiver stress and strain on the family system, and it may be associated with some cognitive changes in children.
Long‐term Outcome of Children With Biliary Atresia Who Were Not Transplanted After the Kasai Operation: >20‐year Experience at a Children's Hospital
Authors: Shinkai Masato , Ohhama Youkatsu , Take Hiroshi , Kitagawa Norihiko , Kudo Hironori , Mochizuki Kyoko , Hatata Tomoko
Published: May 2009

Objective:

Sequential strategies combining the Kasai operation as a first‐line treatment and liver transplantation as a second‐line option, if necessary, have been accepted for patients with biliary atresia (BA). To understand the role of the Kasai operation in the treatment of BA, it is necessary to analyze the long‐term outcome of the operation alone and to evaluate the present status of survivors retaining their native livers.

Materials and Methods:

A retrospective chart review was carried out for a group of 80 patients who had undergone the Kasai operation between 1970 and 1986 at the Kanagawa Children's Medical Center.

Results:

The 5‐, 10‐, and 20‐year survival rates of patients with their native livers were 63%, 54%, and 44%, respectively. The survival rates varied significantly depending on the type of BA, age at initial Kasai operation, era of surgery, and surgical method. By age 20, nearly half of the adult survivors had already developed liver cirrhosis and its sequelae. Episodes of cholangitis and gastrointestinal bleeding occurred after 20 years of age in 37% and 17% of the adult patients, respectively, and 20% of the adult patients died of liver failure or underwent living‐related partial liver transplantation in their 20s. Five female patients gave birth to a total of 9 children, and 1 male patient fathered a child.

Conclusions:

Although increasing numbers of patients with BA survive 20 years or more after the Kasai operation, meticulous lifelong postoperative care should be continued for the survivors because of the possibility of hepatic deterioration.
Diagnostic Clues for Identification of Nonorganic vs Organic Causes of Food Refusal and Poor Feeding
Authors: Levy Yuval , Levy Anat , Zangen Tsili , Kornfeld Lia , Dalal Ilan , Samuel Eli , Boaz Mona , Ben David Nophar , Dunitz Marguerite , Levine Arie
Published: May 2009

Objectives:

Food refusal, poor feeding, and somatic symptoms such as vomiting, gagging, irritability and failure to thrive (FTT) are commonly found in both infantile feeding disorders (IFD) and common treatable medical conditions. Present diagnostic classifications for diagnosing IFD are complex and difficult to apply in daily practice, leading to underdiagnosis and delay in diagnosis of IFD. We attempted to identify parental and infantile behaviour patterns or symptoms that could help distinguish between organic or behavioural causes for these symptoms.

Methods:

We screened 226 children with poor feeding. After exclusion criteria, we divided the remaining 151 into 2 groups. The nonorganic group (n = 83) included patients with onset of symptoms before age 2, persistent food aversion longer than 1 month, and a response to behavioural intervention. The second group consisted of children (n = 68) presenting with similar characteristics, who responded to medical or nutritional therapy in which a final diagnosis of gastro‐esophageal reflux disease, milk allergy, or idiopathic or nutritional FTT was made.

Results:

Poor intake, poor weight gain, or vomiting did not discriminate between organic and nonorganic causes. Factors indicating the presence of a behavioural cause included food refusal, food fixation, abnormal parental feeding practices, onset after a specific trigger, and presence of anticipatory gagging (P < 0.0001 for all).

Conclusions:

Integration of a few structured questions regarding infant behaviour, parental feeding practices, infant symptoms, and triggers for the onset of symptoms may help clinicians distinguish between organic and nonorganic causes for food refusal or low intake FTT.
Is Gluten Challenge Really Necessary for the Diagnosis of Coeliac Disease in Children Younger Than Age 2 Years?
Authors: Wolters Victorien M , van de Nadort Cissy , Gerritsen Susan AM , Kneepkens CM Frank , Ten Kate Fiebo JW , Gijsbers Caroline FM , Schweizer Joachim J , Nikkels Peter GJ , Benninga Marc A , Houwen Roderick HJ
Published: May 2009

Objective:

In the diagnosis of coeliac disease (CD), gluten challenge is recommended for children under the age of 2 years at initial biopsy. The aim of the study was to investigate the diagnostic yield of gluten challenge in this group of children.

Patients and Methods:

We included children aged 2 years or younger who were analysed for possible CD and who had villous atrophy at initial small bowel biopsy in the period 1993–2004. We subsequently identified all patients who underwent a complete gluten challenge.

Results:

We identified 333 children with possible CD. In 100 children (30%), a gluten challenge was performed, with the diagnosis being confirmed in 97. Retrospectively, in 2 of the 3 children without mucosal relapse, data available before gluten challenge did not justify the initial diagnosis of CD. In the third patient, transient gluten intolerance could not be excluded. At first biopsy, the 2 children without mucosal relapse had negative serological parameters, whereas the third patient had IgA anti‐gliadin antibodies, but no IgA anti‐endomysium antibodies (EMA). Indeed, all of the patients with EMA at diagnosis had a relapse at gluten challenge.

Conclusions:

Routine gluten challenge in children younger than 2 years at initial diagnosis of CD has an extremely low diagnostic yield. We suggest that routine gluten challenge in this group of patients is not necessary when patients have villous atrophy in combination with EMA. Therefore, a revision of the current diagnostic criteria has to be considered.
Does the Enteral Feeding Advancement Affect Short‐term Outcomes in Very Low Birth Weight Infants?
Authors: Härtel Christoph , Haase Berit , Browning‐Carmo Kathryn , Gebauer Corinna , Kattner Evelyn , Kribs Angela , Segerer Hugo , Teig Norbert , Wense Axel von der , Wieg Christian , Herting Egbert , Göpel Wolfgang
Published: May 2009

Background and Objectives:

Controversy exists regarding the optimal enteral feeding regimen of very low birth weight infants (VLBW). Rapid advancement of enteral feeding has been associated with an increased rate of necrotizing enterocolitis. In contrast, delaying enteral feeding may have unfavorable effects on nutrition, growth, and neurodevelopment. The aim is to compare the short‐term outcomes of VLBW infants in tertiary care centers according to their enteral feeding advancement.

Patients and Methods:

We prospectively studied the influence of center‐specific enteral feeding advancement in 1430 VLBW infants recruited from 13 tertiary neonatal intensive care units in Germany on short‐term outcome parameters. The centers were post hoc stratified to “rapid advancement to full enteral feeds” (median duration of advancement to full enteral feeds ≤12.5 days; 6 centers), that is, rapid advancement (RA), or “slow advancement to full enteral feeds” (median duration of advancement to full enteral feeds >12.5 days; 7 centers), that is, slow advancement (SA).

Results:

VLBW infants born in centers with SA (n = 713) had a significantly higher rate of sepsis compared with VLBW infants born in centers with RA (n = 717), which was particularly evident for late‐onset sepsis (14.0% vs 20.4%; P = 0.002). Furthermore, more central venous lines (48.6% vs 31.1%, P < 0.001) and antibiotics (92.4% vs 77.7%, P < 0.001) were used in centers with SA.

Conclusions:

Center differences in enteral feeding advancement occur and may have a significant impact on short‐term outcomes such as nosocomial sepsis. Large, multicenter, prospective trials are required to further elucidate the optimal feeding strategy for VLBW infants.
Peptide YY Induces Intestinal Proliferation in Peptide YY Knockout Mice With Total Enteral Nutrition After Massive Small Bowel Resection
Authors: Zhu Weiming , Zhang Wei , Gong Jianfeng , Huang Qian , Shi Yichao , Li Qiurong , Li Ning , Li Jieshou
Published: May 2009

Objective:

In previous research, peptide YY (PYY) administered in supraphysiological doses did not induce significant proliferative effects in rats that were allowed to feed ad libitum after massive small bowel resection (SBR). The main reason may well have been the interference of endogenous PYY released from L cells in the distal bowel in response to the presence of augmented unabsorbed intraluminal nutrients. The purpose of the present study was to explore the effect of PYY on intestinal proliferation with total enteral nutrition (TEN) in a SBR model of PYY knockout (Pyy−/−) mice, which do not produce endogenous PYY.

Materials and Methods:

Pyy−/− mice were assigned into 3 experimental groups: sham mice (sham group) underwent bowel transection and reanastomosis, and received TEN; SBR mice (SBR group) underwent a 50% small bowel resection, and received TEN; and SBR‐PYY mice (SBR‐PYY group) underwent a 50% small bowel resection, received TEN, and were treated with PYY1–36 subcutaneously from day 2 postoperatively. Parameters of enterocyte proliferation and apoptosis were determined on day 8 following operation.

Results:

SBR‐PYY mice demonstrated a significant increase in (vs SBR) bowel and mucosal weights, mucosal DNA and protein, villus height, and crypt depth in jejunum and ileum. SBR‐PYY mice also showed an increased crypt cell proliferation index in jejunum and ileum and decreased villus cell apoptotic index in ileum compared with SBR animals.

Conclusions:

In an SBR model of Pyy−/− mice, PYY induces proliferation of residual intestine with TEN.
Bone Health in Children With Inflammatory Bowel Disease: Adjusting for Bone Age
Authors: Hill Rebecca J , Brookes Denise SK , Lewindon Peter J , Withers Geoffrey D , Ee Looi C , Connor Frances L , Cleghorn Geoffrey J , Davies Peter SW
Published: May 2009

Objectives:

Clinical results of bone mineral density for children with inflammatory bowel disease are commonly reported using reference data for chronological age. It is known that these children, particularly those with Crohn disease, experience delayed growth and maturation. Therefore, it is more appropriate to compare clinical results with bone age rather than chronological age.

Materials and Methods:

Areal bone mineral density (aBMD) was measured using dual energy x‐ray absorptiometry, and bone age was assessed using the Tanner‐Whitehouse 3 method from a standard hand/wrist radiograph. Results were available for 44 children ages 7.99 to 16.89 years. Areal bone mineral density measurements were converted to z scores using both chronological and bone ages for each subject.

Results:

Areal bone mineral density z scores calculated using bone age, as opposed to chronological age, were significantly improved for both the total body and lumbar spine regions of interest. When subjects were grouped according to diagnosis, bone age generated z scores remained significantly improved for those with Crohn disease but not for those diagnosed with ulcerative colitis. Grouping of children with Crohn disease into younger and older ages produced significantly higher z scores using bone age compared with chronological for the older age group, but not the younger age group.

Conclusions:

Our findings, in accordance with those presented in the literature, suggest that aBMD results in children with Crohn disease should include the consideration of bone age, rather than merely chronological age. Bone size, although not as easily available, would also be an important consideration for interpreting results in paediatric populations.
Methotrexate Treatment in Pediatric Crohn Disease Patients Intolerant or Resistant to Purine Analogues
Authors: Weiss B , Lerner A , Shapiro R , Broide E , Levine A , Fradkin A , Bujanover Y
Published: May 2009

Background:

Immunomodulatory drugs play a major role in maintaining remission and steroid sparing in children with Crohn disease. Although thiopurine agents are commonly used, unresponsiveness or intolerance to these drugs is common. The efficacy of methotrexate in maintenance of remission has been shown in adult Crohn disease; however, pediatric data are limited. Our goal was to evaluate the efficacy and safety of methotrexate in induction and maintenance of clinical remission in children with active Crohn disease who failed thiopurine treatment.

Patients and Methods:

In a retrospective multicenter study, efficacy of methotrexate in inducing and maintaining remission or response was assessed by Harvey‐Bradshaw activity index, paediatric Crohn disease activity index and steroid use, in 25 children with Crohn disease, refractory or intolerant to thiopurine analogues.

Results:

Crohn disease was diagnosed at a mean age of 11.1 ± 3.1 years and methotrexate was initiated at age 14.5 ± 3.1 years. The median methotrexate dose was 12.5 mg/m2. Remission was achieved in 16 patients (64%), and response in 6 patients (24%). Out of 18 patients treated for longer than 6 months, 83% were in remission or response after 12 months of treatment. The mean duration of remission and response was 10.8 ± 8.8 months. Steroid withdrawal was possible in 12/16 patients (75%) receiving steroids at methotrexate introduction. Adverse effects were observed in 6 patients (24%) including nausea and vomiting in 3, elevation of liver enzymes in 2 and pancreatitis in 1 patient.

Conclusions:

Methotrexate is beneficial in maintaining remission and steroid‐sparing treatment in children with Crohn disease following failure of thiopurine therapy.
Management of Chronic Hepatitis B in Children
Authors: Shah Uzma , Kelly Deirdre , Chang Mei‐Hwei , Fujisawa Tomoo , Heller Solange , González‐Peralta Regino P , Jara Paloma , Mieli‐Vergani Giorgina , Mohan Neelam , Murray Karen F
Published: May 2009

Hepatitis B virus (HBV) infection is a worldwide problem and can cause acute liver failure, acute hepatitis, chronic hepatitis, liver cirrhosis, and liver cancer. In areas of high prevalence such as in Asia, Africa, southern Europe, and Latin America, the hepatitis B surface antigen positive rate ranges from 2% to 20%.

In endemic areas, HBV infection occurs mainly during infancy and early childhood. Mother‐to‐infant transmission accounts for approximately half of the chronic HBV infections. In contrast to infection in adults, HBV infection during early childhood results in a much higher rate of persistent infection and long‐term serious complications such as liver cirrhosis and HCC.

Three phases of chronic hepatitis B have been identified: the immune‐tolerant phase, the immune‐active phase, and the inactive hepatitis B phase. These phases of infection are characterized by variations in viral replication, hepatic inflammation, spontaneous clearance, and response to antiviral therapy.

The optimal goal of antiviral therapy for chronic HBV infection is to eradicate HBV and to prevent its related liver complications. However, due to the limited effect of available therapies in viral eradication, the goal of treatment is to reduce viral replication, to minimize liver injury, and to reduce infectivity. In this review the current recommendations for monitoring and treating chronic HBV infection in children are reviewed.
Advances in Understanding Colonic Function
Authors: Milla Peter J
Published: May 2009

The colon is an organ of conservation that salvages water, electrolytes, and energy. The organization of colonic function is determined by the roles played by the luminal flora, the function of the different mucosal epithelial cell types, immunocompetent cells, and the neuromusculature. These different components of the colon interact with one another and with the colonic flora, and different areas of the colon serve different functions. In the normal adult during the course of a day the colon absorbs approximately 1.5 L of fluid, but under the influence of aldosterone increases up to 5 to 6 L. Diarrhoea occurs when secretion exceeds absorptive processes by either small intestinal secretion overwhelming colonic salvage or salvage being impaired by reduced colonic absorption or increased colonic secretion.
Role of the Colon in Short Bowel Syndrome and Intestinal Transplantation
Authors: Goulet Olivier , Colomb‐Jung Virginie , Joly Francisca
Published: May 2009

Colon is a crucial partner for small intestinal adaptation and function in patients who underwent extensive small intestinal resection or transplantation. This short review deals with the different properties and roles of the colon in these settings, involving fluid and electrolytes absorption, absorption of medium‐chain triglycerides, and production of short‐chain fatty acids for malabsorbed energy salvage. The colon may adapt after small intestinal resection, whereas it hosts the most important part of the intestinal microbiota, which plays a crucial role in intestinal function and health. Also, colon may be responsible for D‐lactic acidosis as well, as it can be injured by noninfectious colitis. Finally, the relevance of a simultaneous colon grafting is discussed as it is occasionally considered in specific patients requiring intestinal transplantation.
Nutritional Challenge in Pseudo‐obstruction: The Bridge Between Motility and Nutrition
Authors: Cucchiara Salvatore , Borrelli Osvaldo
Published: May 2009

Chronic intestinal pseudo‐obstruction is a severe syndrome characterized by a profound derangement of the intestinal propulsive motility that resembles mechanical obstruction, in the absence of any mechanical obstruction. This syndrome represents one of the main causes of intestinal failure and is characterized by impairment of physical growth and development as well as by a high rate of morbidity and mortality. It may be idiopathic or secondary to a variety of diseases. Most cases are sporadic, even though familial forms with either dominant or recessive autosomal inheritance have been described. Based on histological features intestinal pseudo‐obstruction is classified into 3 main groups: neuropathies, mesenchymopathies, and myopathies, according to the predominant involvement of enteric neurones, interstitial cells of Cajal, and smooth muscle cells, respectively. Treatment of intestinal pseudo‐obstruction involves nutritional, pharmacological, and surgical therapies, but it is often frustrating and does not change the natural course in the majority of cases. The nutritional management has a crucial importance in pediatric age and involves the administration of special formulae, the enteral delivery of nutrients, by a nasogastric tube, percutaneous gastrostomy, or jejunostomy. In the most severe cases, parenteral nutrition becomes mandatory in order to satisfy nutritional requirements and manage appropriately obstructive episodes.
Postinfectious Irritable Bowel Syndrome
Authors: Barbara Giovanni , Cremon Cesare , Pallotti Francesca , De Giorgio Roberto , Stanghellini Vincenzo , Corinaldesi Roberto
Published: May 2009

Irritable bowel syndrome (IBS) is a gastrointestinal disorder characterized by abdominal pain and changes in bowel habits, not sustained by structural changes. There is now consistent evidence indicating that IBS may be the adverse outcome of an acute episode of infectious gastroenteritis, the so‐called postinfectious (PI) IBS. The infectious agents involved in the development of PI‐IBS include pathogenic bacteria, parasites, and viruses. Abdominal pain and diarrhea are the most common symptoms of PI‐IBS. Several studies identified a number of risk factors increasing the susceptibility for PI‐IBS development. These include the virulence of the pathogen, the severity, and duration of the acute enteritis, younger age, female sex, and psychological disturbances. Several mucosal abnormalities in the colon or ileum of patients who develop PI‐IBS have been described. These changes include increased mucosal permeability, an increased amount of intraepithelial lymphocytes, lamina propria T cells, and mast cells, as well as serotonin‐containing enteroendocrine cells. The mediators released by these activated cells may evoke enteric nervous system responses, excite sensory afferent pathways, and induce visceral hyperalgesia. Little is known about the prognosis of PI‐IBS, although it is likely better than that of nonspecific IBS. There is little evidence about a specific treatment for PI‐IBS. Although probiotics and antibiotics may be promising in the prevention of PI‐IBS, the efficacy of these treatments should be assessed in an ad hoc designed study.
Functional Nonretentive Fecal Incontinence in Children: A Frustrating and Long‐lasting Clinical Entity
Authors: Burgers Rosa , Benninga Marc A
Published: May 2009

Fecal incontinence is defined as the passage of stools in an inappropriate place at least once per month, for a minimum period of 2 months. This frustrating symptom is a source of considerable distress and embarrassment for the child and the family. According to the Rome III criteria fecal incontinence can be subdivided into constipation‐associated fecal incontinence and functional nonretentive fecal incontinence. This short review mainly addresses functional nonretentive fecal incontinence in children. Definition, prevalence, pathophysiology, and recent updates on treatment and long‐term follow‐up of fecal incontinence are discussed.
Probiotics and Functional Gastrointestinal Disorders in Children
Authors: Vandenplas Yvan , Benninga Marc
Published: May 2009

Chronic constipation is one of the most frequent complaints in childhood. Although there is evidence that gastrointestinal flora is important in gut motility, there is little evidence that gut flora is abnormal in constipation. Lactobacilli and bifidobacteria increase stool frequency and decrease consistency in normal individuals. But, according to several reviews, the evidence of probiotics for efficacy in constipation is limited. Fiber supplements, lactose‐free diets, and lactobacillus supplementation are effective in the management of children with recurrent abdominal pain and irritable bowel syndrome. Several studies with Lactobacillus GG in children showed negative results in children with chronic constipation. Because Bifidobacterium animalis DN‐173 010 has been shown to be effective in adults with constipation‐predominant irritable bowel syndrome this study should also be performed in a well‐designed large placebo‐controlled trial in children with constipation.
Large population sizes mitigate negative effects of variable weather conditions on fruit set in two spring woodland orchids
Authors: Jacquemyn Hans , Brys Rein , Honnay Olivier
Published: May 2009

Global circulation models predict increased climatic variability, which could increase variability in demographic rates and affect long-term population viability. In animal-pollinated species, pollination services, and thus fruit and seed set, may be highly variable among years and sites, and depend on both local environmental conditions and climatic variables. Orchid species may be particularly vulnerable to disruption of their pollination services, as most species depend on pollinators for successful fruit set and because seed germination and seedling recruitment are to some extent dependent on the amount of fruits and seeds produced. Better insights into the factors determining fruit and seed set are therefore indispensable for a better understanding of population dynamics and viability of orchid populations under changing climatic conditions. However, very few studies have investigated spatio-temporal variation in fruit set in orchids. Here, we quantified fruit production in eight populations of the orchid
Orchis purpurea
that does not reward pollinators and 13 populations of the rewarding
Neottia
(
Listera
)
ovata
during five consecutive years (2002–2006). Fruit production in large populations showed much higher stability than that in small populations and was less affected by extreme weather conditions. Our results highlight the potential vulnerability of small orchid populations to an increasingly variable climate through highly unpredictable fruit-set patterns.
Patterns of split sex ratio in ants have multiple evolutionary causes based on different within-colony conflicts
Authors: Kümmerli Rolf , Keller Laurent
Published: May 2009

Split sex ratio—a pattern where colonies within a population specialize in either male or queen production—is a widespread phenomenon in ants and other social Hymenoptera. It has often been attributed to variation in colony kin structure, which affects the degree of queen–worker conflict over optimal sex allocation. However, recent findings suggest that split sex ratio is a more diverse phenomenon, which can evolve for multiple reasons. Here, we provide an overview of the main conditions favouring split sex ratio. We show that each split sex-ratio type arises due to a different combination of factors determining colony kin structure, queen or worker control over sex ratio and the type of conflict between colony members.
Bertrand Russell (1872–1970), man of dissent
Authors: Grattan-Guinness Ivor
Published: May 2009

Russell argued against the Great War, but he also wanted to drop atomic bombs on the Soviet Union after World War II, and later he advocated nuclear disarmament. How could a great logician accommodate such inconsistencies? How, as a private citizen, did he make such a world-wide impact in his late years?
What drives community dynamics?
Authors: Mutshinda Crispin M. , O'Hara Robert B. , Woiwod Ian P.
Published: May 2009

The search for general mechanisms of community assembly is a major focus of community ecology. The common practice so far has been to examine alternative assembly theories using dichotomist approaches of the form neutrality versus niche, or compensatory dynamics versus environmental forcing. In reality, all these mechanisms will be operating, albeit with different strengths. While there have been different approaches to community structure and dynamics, including neutrality and niche differentiation, less work has gone into separating out the temporal variation in species abundances into relative contributions from different components. Here we use a refined statistical machinery to decompose temporal fluctuations in species abundances into contributions from environmental stochasticity and inter-/intraspecific interactions, to see which ones dominate. We apply the methodology to community data from a range of taxa. Our results show that communities are largely driven by environmental fluctuations, and that member populations are, to different extents, regulated through intraspecific interactions, the effects of interspecific interactions remaining broadly minor. By decomposing the temporal variation in this way, we have been able to show directly what has been previously inferred indirectly: compensatory dynamics are in fact largely outweighed by environmental forcing, and the latter tends to synchronize the population dynamics.
Conserved introns reveal novel transcripts in Drosophila melanogaster
Authors: Hiller Michael , Findeiß Sven , Lein Sandro , Marz Manja , Nickel Claudia , Rose Dominic , Schulz Christine , Backofen Rolf , Prohaska Sonja J. , Reuter Gunter , Stadler Peter F.
Published: May 2009

Noncoding RNAs that are—like mRNAs—spliced, capped, and polyadenylated have important functions in cellular processes. The inventory of these mRNA-like noncoding RNAs (mlncRNAs), however, is incomplete even in well-studied organisms, and so far, no computational methods exist to predict such RNAs from genomic sequences only. The subclass of these transcripts that is evolutionarily conserved usually has conserved intron positions. We demonstrate here that a genome-wide comparative genomics approach searching for short conserved introns is capable of identifying conserved transcripts with a high specificity. Our approach requires neither an open reading frame nor substantial sequence or secondary structure conservation in the surrounding exons. Thus it identifies spliced transcripts in an unbiased way. After applying our approach to insect genomes, we predict 369 introns outside annotated coding transcripts, of which 131 are confirmed by expressed sequence tags (ESTs) and/or noncoding FlyBase transcripts. Of the remaining 238 novel introns, about half are associated with protein-coding genes—either extending coding or untranslated regions or likely belonging to unannotated coding genes. The remaining 129 introns belong to novel mlncRNAs that are largely unstructured. Using RT-PCR, we verified seven of 12 tested introns in novel mlncRNAs and 11 of 17 introns in novel coding genes. The expression level of all verified mlncRNA transcripts is low but varies during development, which suggests regulation. As conserved introns indicate both purifying selection on the exon–intron structure and conserved expression of the transcript in related species, the novel mlncRNAs are good candidates for functional transcripts.
The Tryptophan Conjugates of Jasmonic and Indole-3-Acetic Acids Are Endogenous Auxin Inhibitors
Authors: Staswick Paul E.
Published: May 2009

Most conjugates of plant hormones are inactive, and some function to reduce the active hormone pool. This study characterized the activity of the tryptophan (Trp) conjugate of jasmonic acid (JA-Trp) in Arabidopsis (Arabidopsis thaliana). Unexpectedly, JA-Trp caused agravitropic root growth in seedlings, unlike JA or nine other JA-amino acid conjugates. The response was dose dependent from 1 to100 μm, was independent of the COI1 jasmonate signaling locus, and unlike the jasmonate signal JA-isoleucine, JA-Trp minimally inhibited root growth. The Trp conjugate with indole-3-acetic acid (IAA-Trp) produced a similar response, while Trp alone and conjugates with benzoic and cinnamic acids did not. JA-Trp and IAA-Trp at 25 μm nearly eliminated seedling root inhibition caused by 2 μm IAA. The TIR1 auxin receptor is required for activity because roots of tir1-1 grew only approximately 60% of wild-type length on IAA plus JA-Trp, even though tir1-1 is auxin resistant. However, neither JA-Trp nor IAA-Trp interfered with IAA-dependent interaction between TIR1 and Aux/IAA7 in cell-free assays. Trp conjugates inhibited IAA-stimulated lateral root production and DR5-β-glucuronidase gene expression. JA-deficient mutants were hypersensitive to IAA and a Trp-overaccumulating mutant was less sensitive, suggesting endogenous conjugates affect auxin sensitivity. Conjugates were present at 5.8 pmol g−1 fresh weight or less in roots, seedlings, leaves, and flowers, and the values increased approximately 10-fold in roots incubated in 25 μm Trp and IAA or JA at 2 μm. These results show that JA-Trp and IAA-Trp constitute a previously unrecognized mechanism to regulate auxin action.
CDKB1;1 Forms a Functional Complex with CYCA2;3 to Suppress Endocycle Onset
Authors: Boudolf Véronique , Lammens Tim , Boruc Joanna , Van Leene Jelle , Van Den Daele Hilde , Maes Sara , Van Isterdael Gert , Russinova Eugenia , Kondorosi Eva , Witters Erwin , De Jaeger Geert , Inzé Dirk , De Veylder Lieven
Published: May 2009

The mitosis-to-endocycle transition requires the controlled inactivation of M phase-associated cyclin-dependent kinase (CDK) activity. Previously, the B-type CDKB1;1 was identified as an important negative regulator of endocycle onset. Here, we demonstrate that CDKB1;1 copurifies and associates with the A2-type cyclin CYCA2;3. Coexpression of CYCA2;3 with CDKB1;1 triggered ectopic cell divisions and inhibited endoreduplication. Moreover, the enhanced endoreduplication phenotype observed after overexpression of a dominant-negative allele of CDKB1;1 could be partially complemented by CYCA2;3 co-overexpression, illustrating that both subunits unite in vivo to form a functional complex. CYCA2;3 protein stability was found to be controlled by CCS52A1, an activator of the anaphase-promoting complex. We conclude that CCS52A1 participates in endocycle onset by down-regulating CDKB1;1 activity through the destruction of CYCA2;3.
Phylogenetic relationships and generic delimitation in Inuleae subtribe Inulinae (Asteraceae) based on ITS and cpDNA sequence data
Authors: Englund Markus , Pornpongrungrueng Pimwadee , Gustafsson Mats H. G. , Anderberg Arne A.
Published: May 2009

Phylogenetic relationships in Inuleae subtribe Inulinae (Asteraceae) were investigated. DNA sequence data from three chloroplast regions (ndhF, trnL–F and psbA–trnH) and the nuclear ribosomal internal transcribed spacer (ITS) region were analysed separately and in combination using parsimony and Bayesian inference. A total of 163 ingroup taxa were included, of which 60 were sampled for all four markers. Conflicts between chloroplast and nuclear data were assessed using partitioned Bremer support (PBS). Rather than averaging PBS over several trees from constrained searches, individual trees were considered by evaluating PBS ranges. Criteria to be used in the detection of a significant conflict between data partitions are proposed. Three nodes in the total data tree were found to encompass significant conflict that could result from ancient hybridization. Neither of the large, heterogeneous and widespread genera Inula and Pulicaria is monophyletic. A monophyletic group (“the Inula complex”) that comprises all species of Inula includes also Telekia, Carpesium, Chrysophthalmum, Rhanteriopsis, Amblyocarpum, and Pentanema sensu stricto. Two species of Pentanema were found to be closer to Blumea (including Blumeopsis and Merrittia) and Caesulia. The monophyletic “Pulicaria complex” includes all taxa with heteromorphic pappus. Within this group, Francoeuria is distinct from Pulicaria and merits recognition as a separate genus.

 © The Willi Hennig Society 2009.
Hennig’s enkaptic system
Authors: Rieppel Olivier
Published: May 2009

Hennig’s phylogenetic system is characterized by an asymmetry between (sexually reproducing) species that form tokogenetic systems, versus monophyletic taxa that form a phylogenetic system. This was claimed to reflect a conflict between two hierarchies, i.e. the hierarchy of species‐lineages splitting and splitting again as opposed to the phylogenetic hierarchy of groups within groups. Some cladists have sought the unification of the phylogenetic system by abandoning the species concept. In contrast, contemporary commentators (Klaus Günther, Walter Zimmermann) characterized Hennig’s system as an enkaptic hierarchy. This paper explores the concept of enkapsis, and the way Hennig used it as a basis for the unification of his phylogenetic system.

 © The Willi Hennig Society 2009.
Clone clusters in autoreactive CD4 T‐cell lines from probable multiple sclerosis patients form disease‐characteristic signatures
Authors: Mandel Mathilda , Achiron Anat , Tuller Tamir , Barliya Tilda , Rechavi Gideon , Amariglio Ninette , Loewenthal Ron , Lavie Gad
Published: May 2009

We developed a method for selectively propagating disease‐related autoreactive T‐cell lines (auTCLs) based on their increased resistance to apoptosis. The generated auTCLs homogeneously co‐express CD45RO and CD49a, adhere strongly to extracellular matrix proteins and express high interleukin‐17 (IL‐17) messenger RNA levels, resembling a T‐cell subset proposed to transmigrate into tissues and induce systemic and local inflammation in rheumatoid arthritis. The combinations of T‐cell oligoclones that comprise probable multiple sclerosis (pMS) disease‐related lines use a unique portfolio of T‐cell receptor β‐chain variable allele (BV genes) combinations forming ‘disease‐specific cluster patterns’. The auTCL derived from different patients and from different myelin epitopes display striking similarities in BV gene allele clusters and are derived primarily from a disease‐prone hotspot residing in the BV gene locus between Vβ6 and Vβ9. Conversely, healthy subject TCLs use different BV gene allele sets, forming ‘healthy responder usage formats’. These formats were absent from the pMS patient V‐β gene allele combinations evaluated in this study. Hierarchical clustering of the BV gene combinations, distinguish three pMS auTCL groups, implying existence of up to three disease‐related immune response patterns. These subgroup patterns may reflect different disease subclasses or alternatively they may suggest immune reactivity to different aetiological agents. Analyses of clonal‐clustering patterns may potentially aid in subclassification of MS or in characterizing aetiological agents of this disease.
Response of macrophage Toll‐like receptor 4 to a Sporothrix schenckii lipid extract during experimental sporotrichosis
Authors: Sassá Micheli F. , Saturi Ana E. T. , Souza Lucas F. , De Abreu Ribeiro Livia C. , Da Graça Sgarbi Diana B. , Carlos Iracilda Z.
Published: May 2009

Toll‐like receptors have been implicated in the recognition of various pathogens, including bacteria, viruses, protozoa and fungi. However, no information is available about Toll‐like receptor 4 (TLR4) participation in Sporothrix schenckii recognition and the consequent triggering of the immune response to this fungal pathogen. Following activation of TLRs by ligands of microbial origin, several responses are provoked, including reactions in immune cells that may lead them to produce signalling factors that trigger inflammation. The present study was designed to elucidate the role of TLR4 during the host response to S. schenckii. TLR4‐deficient (C3H/HeJ) and control mice (C3H/HePas) were infected with S. schenckii yeast cells and immune response was assessed over 10 weeks by assaying production of pro‐inflammatory mediator (nitric oxide and tumour necrosis factor‐α) and anti‐inflammatory cytokine (interleukin‐10) by peritoneal macrophages and their correlation with apoptosis in peritoneal exudate cells. We found that both pro‐inflammatory and anti‐inflammatory mediators are reduced in TLR4‐deficient mice, suggesting the involvement of this receptor in the recognition of this infectious agent. Translocation into the nucleus of nuclear transcription factor, nuclear factor‐κB, was also evaluated and showed higher levels in TLR‐4 normal mice, consistent with the results found for cytokine production. We are showing here, for the first time, the involvement of TLR4 in S. schenckii recognition. Taken together, our results demonstrate that the activation of peritoneal macrophages in response to S. schenckii lipid extracts has different responses in these two mouse strains which differ in TLR4 expression, suggesting an important role for TLR4 in governing the functions of macrophages in this fungal infection.
Natural killer cell cytotoxicity: how do they pull the trigger?
Authors: Topham Nicola J. , Hewitt Eric W.
Published: May 2009

Natural killer (NK) cells target and kill aberrant cells, such as virally infected and tumorigenic cells. Killing is mediated by cytotoxic molecules which are stored within secretory lysosomes, a specialized exocytic organelle found in NK cells. Target cell recognition induces the formation of a lytic immunological synapse between the NK cell and its target. The polarized exocytosis of secretory lysosomes is then activated and these organelles release their cytotoxic contents at the lytic synapse, specifically killing the target cell. The essential role that secretory lysosome exocytosis plays in the cytotoxic function of NK cells is highlighted by immune disorders that are caused by the mutation of critical components of the exocytic machinery. This review will discuss recent studies on the molecular basis for NK cell secretory lysosome exocytosis and the immunological consequences of defects in the exocytic machinery.