bluuebunny/crossref_metadata_2025_split huggingface dataset:
Kawasaki Disease and the Pediatric Gastroenterologist
Authors: Eladawy Mohammed , Dominguez Samuel R. , Anderson Marsha S. , Glodé Mary P. 
Published: November 2012

ABSTRACTBackground and Objectives:Gastrointestinal symptoms and signs are rarely the main clinical presentation of Kawasaki disease (KD). In the present study, we report a series of patients with KD in whom a gastroenterology consult was obtained before consideration of the diagnosis of KD.Methods:We retrospectively reviewed all patients with KD admitted to Children's Hospital Colorado from January 2009 through February 2011 with prominent gastrointestinal symptoms, resulting in gastrointestinal service consultation before their diagnosis of KD.Results:We identified 7 of 118 (6%) patients with KD who met our criteria. All 7 patients were males, and the median age at admission was 9.7 years. All patients had abdominal pain and fever at presentation. Vomiting, diarrhea, and clinical jaundice were present in 70%, 50%, and 43% of patients, respectively. Aminotransferases and/or γ‐glutamyl transpeptidase abnormalities were observed in 6 (89%) patients. All of the patients had fever and rash on admission, and 86% had nonexudative conjunctivitis and 71% had mucosal changes. Median duration of illness at gastroenterology consultation was 5 days, whereas median duration of illness at infectious disease consultation was 6 days. One patient developed coronary artery dilation and 2 patients had intravenous immunoglobulin‐resistant KD.Conclusions:Gastroenterologists should be aware of gastrointestinal presentations of KD. Unexplained gastrointestinal symptoms in the presence of fever, and 1 or 2 of the major clinical signs of KD, should prompt consideration of KD in the differential diagnosis.
Percutaneous Endoscopic Gastrostomy Tubes in Pediatric Bone Marrow Transplant Patients
Authors: Kaur Sunpreet , Ceballos Clare , Bao Ruijun , Pittman Nanci , Benkov Keith 
Published: November 2012

ABSTRACTBackground and Objectives:Nourishing a child undergoing bone marrow transplant (BMT) is essential, but the optimal method to achieve this is not established. The objectives of the study were to investigate the incidence and risk factors for complications of gastrostomy tubes in patients with BMT.Methods:A retrospective chart review was conducted of pediatric patients who received a percutaneous endoscopic gastrostomy (PEG) either for BMT or for other indications during a 3‐year period. Occurrences of complications, absolute neutrophil count (ANC) at time of PEG placement, and ANC at time of complication were reviewed for both BMT and the comparison group.Results:Of the 11 subjects in the BMT group, 4 (36%) had a major complication of infection related to PEG and 3 of those required PEG removal. Two of the 4 subjects who developed a major complication were moderately neutropenic at the time of PEG placement and all subjects were neutropenic at the time of complication. Of the 30 subjects in the comparison group, only 1 (2.8%) had a major complication with cellulitis. There were no statistically significant differences between the 2 groups before PEG placement for age, weight, albumin, or white blood cell count. The incidence of complication in BMT compared with the comparison group was significant (P = 0.01).Conclusions:Our findings support that ANC should be considered before placement of PEG, significant neutropenia may be a contraindication for PEG placement in BMT patients, and other modalities for nutrition support might need to be considered.
Clinical Features Distinguish Eosinophilic and Reflux‐induced Esophagitis
Authors: Mulder Daniel J. , Hurlbut David J. , Noble Angela J. , Justinich Christopher J. 
Published: November 2012

ABSTRACTBackground and Objectives: Diagnosing eosinophilic esophagitis (EoE) depends on intraepithelial eosinophil count of ≥15 eosinophils per high‐power field (HPF); however, differentiating EoE from gastroesophageal reflux disease (GERD) continues to be a challenge because no true “criterion standard” criteria exist. Identifying clinical and endoscopic characteristics that distinguish EoE could provide a more comprehensive diagnostic strategy than the present criteria. The aim of the study was to determine symptoms and signs that can be used to distinguish EoE from reflux esophagitis.Methods:Adult and pediatric patients with EoE were identified by present diagnostic guidelines including an esophageal biopsy finding of ≥15 eosinophils/HPF. Patients with GERD were age‐matched one to one with patients with EoE. Clinical, endoscopic, and histologic information at the time of diagnosis was obtained from the medical record and compared between pairs by McNemar test. A conditional logistic regression model was created using 6 distinguishing disease characteristics. This model was used to create a nomogram to differentiate EoE from reflux‐induced esophagitis.Results:Patients with EoE were 75% men and 68% had a history of atopy. Many aspects of EoE were statistically distinct from GERD when controlling for age. Male sex, dysphagia, history of food impaction, absence of pain/heartburn, linear furrowing, and white papules were the distinguishing variables used to create the logistic regression model and scoring system based on odds ratios. The area under the curve of the receiver‐operator characteristic curve for this model was 0.858.Conclusions:EoE can be distinguished from GERD using a scoring system of clinical and endoscopic features. Prospective studies will be needed to validate this model.
Celiac Disease
Authors: Klapp Gabriela , Masip Etna , Bolonio Miguel , Donat Ester , Polo Begoña , Ramos David , Ribes‐Koninckx Carmen 
Published: November 2012

ABSTRACTBackground:The need for an early and accurate diagnosis in celiac disease (CD) has focused attention on new diagnostic approaches, based on the efficiency of serological markers and the high negative predictive value of human leukocyte antigen (HLA) non‐DQ2/8.Methods:We performed a retrospective review of all of the patients suspected of having CD who had undergone a small bowel biopsy in our gastroenterology unit. All symptomatic children with serological marker at time of biopsy (immunoglobulin A‐tissue transglutaminase antibody, endomysial antibody, and HLA genotype) were included. The triple test (TT) was positive if immunoglobulin A‐tissue transglutaminase antibody was 10 times the upper limit of normal, plus positive endomysial antibody plus human leukocyte antigen‐DQ2/DQ8.Results:A total of 150 patients met the inclusion criteria and were enrolled in the study. One hundred sixteen were positive for the TT; 113 of 116 (97.4%) had a Marsh 2/3 histological lesion and had been considered to have CD. Thus, positive predictive value of the TT was 97.4%. The other 3 cases (2.6%) had Marsh 0/1 lesion, so we consider them to be false‐positives for the TT; however, on follow‐up, all 3 children developed histological damage after a gluten challenge. Finally, the positive predictive value of the TT was 100%. Thirty‐four patients were negative for the TT: 22 patients are celiac, 3 are celiac but challenge gluten diet is pending, and the 9 patients left have other gastrointestinal disorder.Conclusions:Our study supports the view that in selected children who are symptomatic and positive for the TT, CD diagnosis could be established independent of histological findings.
Gastroparesis in Children
Authors: Chogle Ashish , Saps Miguel 
Published: November 2012

ABSTRACTBackground and Aim:Scintigraphic gastric emptying study (GES) is the criterion standard for diagnosis of gastroparesis. Adult studies demonstrated that extending GES to 4 hours increases its ability to diagnose delayed gastric emptying. Most pediatric centers assess GES up to 2 hours postmeal. The aim of the present study was to assess the effect of extending GES from 2 to 4 hours in evaluation of children with suspected gastroparesis.Methods:We conducted a chart review of all children who had a 4‐hour GES with standard radiolabeled solid meal in 2009–2010. Results of GES at 1, 2, and 4 hours were compared. Patients were diagnosed as having gastroparesis using adult criteria: if gastric retention of meal was >90%, 60%, and 10% at 1, 2 and 4 hours, respectively. A telephone survey assessed GES time at top 20 pediatric gastroenterology centers in the United States. Cost of evaluation of patients diagnosed as having gastroparesis was estimated. Full‐time equivalents of nuclear medicine technicians and number of nuclear medicine studies done at Ann & Robert H. Lurie Children's Hospital of Chicago from 2007 to 2010 were examined.Results:A total of 71 patients (32 boys, average age 10.8 years) were studied. Sixty‐two percent (n = 44) children had abnormal GES; 23% (8/35) of them who had normal values at 2 hours had abnormal GES at 4 hours (P < 0.0001). Twenty‐eight percent of patients had delayed GES at 1 hour: all persisted to have abnormal GES at 2 and 4 hours. Cost of evaluation of a child for gastroparesis was $9014. Only 5 of the top 20 pediatric gastroenterology centers in the United States conducted 4‐hour GES. Transitioning from 2 hours to 4 hours only required scheduling adjustments and did not result in limitation in the number of scheduled patients.Conclusions:Extending GES to 4 hours results in a considerable increase in diagnosis of gastroparesis.
Immunophenotype Predicts Outcome in Pediatric Acute Liver Failure
Authors: Bucuvalas John , Filipovich Lisa , Yazigi Nada , Narkewicz Michael R. , Ng Vicky , Belle Steven H. , Zhang Song , Squires Robert H. 
Published: November 2012

ABSTRACTObjectives:We sought to determine whether markers of T‐cell immune activation, including soluble interleukin 2 receptor alpha (sIL2Rα) levels predict outcome in pediatric acute liver failure and may target potential candidates for immunomodulatory therapy.Methods:We analyzed markers of immune activation in 77 patients with pediatric acute liver failure enrolled in a multinational, multicenter study. The outcomes were survival with native liver, liver transplantation (LT), and death without transplantation within 21 days after enrollment.Results:Adjusting for multiple comparisons, only normalized serum sIL2Rα level differed significantly among the 3 outcomes, and was significantly higher in patients who died (P = 0.02) or underwent LT (P = 0.01) compared with those who survived with their native liver. The 37 patients with normal sIL2Rα levels all lived, 30 with their native liver. Of the 15 subjects with markedly high sIL2Rα (≥5000 IU/mL), 5 survived with their native liver, 2 died, and 8 underwent LT.Conclusions:Evidence of immune activation is present in some patients who die or undergo LT. Patients with higher sIL2Rα levels were more likely to die or undergo LT within 21 days than those with lower levels. Identifying a subset of patients at risk for poor outcome may form the foundation for targeted clinical trials with immunomodulatory drugs.
Breast Milk Jaundice
Authors: Tuzun Funda , Kumral Abdullah , Duman Nuray , Ozkan Hasan 
Published: November 2012

ABSTRACTObjective:Breast milk is an important source of bacteria in establishing the infantile intestinal microbiota that appear to influence the enterohepatic circulation of bilirubin. The aim of the present study was to evaluate the effect of breast milk's microbiological content on the development of breast milk jaundice (BMJ).Methods:A total number of 60 mother‐infant pairs enrolled to the study. Two groups were defined: BMJ group (n = 30), full‐term otherwise healthy newborns who were considered BMJ; control group (n = 30), full‐term healthy newborns without jaundice. All newborns in the study were exclusively breast‐fed. The breast milk samples and the feces of infants were evaluated for content of selected bacterial populations (Bifidobacterium, Lactobacillus, Clostridium, Staphylococcus, and Streptococcus species) with real‐time polymerase chain reaction.Results:Bifidobacterium bifidum content in the breast milk and B adolescentis, B bifidum, and B longum content in the fecal samples were higher in the control group than in the BMJ group. The milk and fecal concentrations of B bifidum were significantly correlated. The concentrations of breast milk B bifidum and fecal B bifidum, B adolescentis, and B longum were found to be negatively correlated with bilirubin levels.Conclusions:Our results suggest that Bifidobacterium species in breast milk may protect against BMJ.
Effect of Prolonged Refrigeration on the Lipid Profile, Lipase Activity, and Oxidative Status of Human Milk
Authors: Bertino Enrico , Giribaldi Marzia , Baro Cristina , Giancotti Valeria , Pazzi Marco , Peila Chiara , Tonetto Paola , Arslanoglu Sertac , Moro Guido E. , Cavallarin Laura , Gastaldi Daniela 
Published: November 2012

ABSTRACTObjective:The study was aimed at evaluating the effect of prolonged refrigeration of fresh human milk (HM) on its fatty acid profile, free fatty acid content, lipase activities, and oxidative status.Methods:HM from mothers of preterm newborns was collected, pooled, and placed in the neonatal intensive care unit (NICU) refrigerator. Pooled milk was aliquoted and analyzed within 3 hours of collection, and after 24, 48, 72, and 96 hours of storage. The milk samples were analyzed for pH, total and free fatty acid profile, lipase activity at room temperature and at 4°C, lipase activity at room temperature in presence of sodium cholate (bile salt–dependent lipase), total antioxidant capacity, thiobarbituric acid reactive species, malondialdehyde, and conjugated diene concentration. The experiment was replicated in 3 independent trials.Results:Prolonged refrigeration did not affect the fatty acid composition of breast milk, and preserved both its overall oxidative status and the activity of HM lipolytic enzymes. In particular, bile salt–dependent lipase activity, long‐chain polyunsaturated fatty acids, and medium‐chain saturated fatty acid concentrations were unaffected for up to 96 hours of refrigerated storage.Conclusions:Prolonged refrigeration of fresh HM for 96 hours maintained its overall lipid composition. The limited lipolysis during storage should be ascribed to the activity of lipoprotein lipase, responsible for the decrease in pH. Our study demonstrates that infants who receive expressed milk stored for up to 96 hours receive essentially the same supply of fatty acids and active lipases as do infants fed directly at the breast.
Response to Hepatitis A and B Vaccination in Pediatric Patients With Celiac Disease
Authors: Urganci Nafiye , Kalyoncu Derya 
Published: November 2012

ABSTRACTObjectives:The aim of the study was to evaluate the response to hepatitis A and B vaccinations in pediatric patients with celiac disease (CD).Methods:Thirty patients with CD ages 1 to 15 years were compared with 50 healthy age‐, sex‐, and body mass index–matched controls. Screening for hepatitis A and B serology was carried out before vaccination. Susceptible cases received 20 μg of recombinant DNA vaccine for hepatitis B (0,1, and 6 months) and 720 milliELISA units of inactivated hepatitis A virus (HAV) vaccine (0 and 6 months). Postvaccination serologic evaluation was performed 1 month after the last dose of primary vaccination, 1 month after the booster dose, and once every year during follow‐up.Results:Sixteen patients and 35 controls received hepatitis A vaccine; protective anti‐HAV antibodies were developed in 12 (75%) of the patients and all of the controls (75% vs 100%, respectively; 95% confidence interval [CI] 0.47–0.92, P = 0.007). Thirty patients and 50 controls received hepatitis B vaccine, and 70% of the patients vs 90% of the controls achieved seroprotection (anti‐HBs titers ≥10 mIU/mL) 1 month after primary vaccination (95% CI 0.74–0.90, P = 0.03). Four patients were unresponsive to both of the vaccines. The overall seroprotection rates were 96% in controls and 80% in patients after the whole hepatitis B vaccination series (95% CI 0.04–0.18, P = 0.04). No significant reduction was observed in antibody response among patients and controls during follow‐up period.Conclusions:The rate of seroconversion to the hepatitis B virus‐ and HAV vaccine is lower in patients with CD than in healthy controls.
The Celiac Iceberg
Authors: Nenna Raffaella , Tiberti Claudio , Petrarca Laura , Lucantoni Federica , Mennini Maurizio , Luparia Rita Pia Lara , Panimolle Francesca , Mastrogiorgio Gerarda , Pietropaoli Nicoletta , Magliocca Fabio Massimo , Bonamico Margherita 
Published: November 2012

ABSTRACTObjective:Celiac disease (CD) has a prevalence of 0.55% to 1% in Italy. Identifying CD in schoolchildren to characterize CD iceberg and evaluate the effect of diagnosis in screening‐detected children.Methods:A total of 7377 5‐ to 8‐year‐old children were invited to participate. A total of 5733 salivary samples were collected and tested for anti‐transglutaminase antibodies (tTGAb), using a fluid‐phase radioimmunoassay. Salivary tTGAb‐positive children were analyzed for serum antibodies (anti‐endomysium antibodies, radioimmunoassay, and enzyme‐linked immunosorbent assay tTGAb). Positive children underwent endoscopy and then started gluten‐free diet (GFD) and periodical follow‐up.Results:Forty‐six subjects were found salivary tTGAb–positive and 16 border‐line. Forty‐five of 46 and 5 of 15 of them were also serum antibody–positive. Forty‐two children showed duodenal villous atrophy and 1 had only type 1 lesions. Three children started GFD without performing endoscopy. CD prevalence (including 23 previously diagnosed children with CD) was 1.2%. Considering all 65 celiacs in our sample, a silent CD was found in 64%, typical in 28%, atypical in 7%, and potential in 1%. All patients showed strict adherence to GFD, weight and stature increase, and well‐being improvement. Eighty‐five percent and all but 2 screening‐detected children with CD had Italian parents.Conclusions:Our sample size, representative of primary schoolchildren of our region, demonstrated that CD prevalence is growing in Italy, with a modified clinical spectrum and iceberg deepness.
Immunogenecity of Hepatitis A and B Vaccination in Pediatric Patients With Inflammatory Bowel Disease
Authors: Urganci Nafiye , Kalyoncu Derya 
Published: November 2012

ABSTRACTObjectives:Aim of the study was to evaluate the response to hepatitis A and B vaccination in pediatric patients with inflammatory bowel disease (IBD).Methods:A total of 47 patients with IBD (25 ulcerative colitis, 14 Crohn disease, and 8 indeterminate colitis) ages 3 to 17 years were compared with 50 healthy age‐ and sex‐matched controls. Screening for hepatitis A and B serology was carried out before vaccination. Susceptible cases received 20 μg of recombinant DNA vaccine for hepatitis B (0, 1, and 6 months) and 720 milliELISA units of inactivated hepatitis A virus vaccine (HAV) (0 and 6 months). Postvaccination serologic evaluation was performed 1 month after the last dose of primary vaccination, 1 month after the booster dose, and once every year during follow‐up.Results:A total of 23 patients and 35 controls received HAV and protective anti‐HAV antibodies were developed in all of the patients and controls (P = 1.00). Forty‐seven patients and 50 controls received hepatitis B vaccine and 70.2% of the patients versus 90% of the controls achieved seroprotection (anti‐HBs titers ≥10 mIU/mL) 1 month after primary vaccination (95% confidence interval 0.71–0.87, P = 0.02). The overall seroprotection rates were 96% in controls and 85.1% in patients after the whole hepatitis B vaccination series (95% confidence interval 0.83–0.95, P = 0.08). No significant reduction was observed in antibody response among patients and controls during the follow‐up period.Conclusions:The rate of seroconversion to the hepatitis B vaccine was lower in pediatric patients with IBD than in healthy controls and hepatitis A vaccine was highly immunogenic among patients with IBD.
The attitudes of LIS chairs toward the iSchools movement in China
Authors: Chen Chuanfu , Wang Ping , Wu Dan , Liu Yaqi , Wu Gang , Ma Haoqin 
Published: November 2012

PurposeThe goal of this paper is to identify the attitudes of the chairs of library and information science (LIS) programs in Chinese universities toward the iSchools movement.Design/methodology/approachThe authors collected data from 36 deans or other chairs of LIS by using open‐ended questionnaire and utilized grounded theory to analyze the results.FindingsThe result shows that most chairpersons approve the iSchools values of relationship between people, information and technology, nevertheless, they expressed uncertainty regarding the future of iSchools. For the process of adopting the values of iSchools and joining the iSchools movement, the main risks to progress come from within the LIS schools or departments. The consensus among the chairpersons is that the LIS education should reserve its traditional core values, as well as adopt iSchools' values and widely expand in the information profession area.Originality/valueThis study unveiled the attitudes of LIS chairs toward the iSchools movement in China. Its results can help the iSchools movement to develop and promote LIS education innovation globally.
Preparation and anticorrosion properties of polyaniline‐containing coating on Mg‐Li alloy
Authors: Juan Chen Xing , Luo Cheng , Han Zhang Zheng , Zhao Min 
Published: November 2012

PurposeThe purpose of this investigation was to synthesize a doped polyaniline‐containing coating and investigate the anti‐corrosion properties of the coating on Mg‐Li alloy.Design/methodology/approachThe doped polyaniline pigments were prepared by two different methods using ammonium persulphate as oxidant and hydrochloric acid, phosphoric acid, p‐toluene sulfonic acid and sulfosalicylic acid as doping agents. The doped polyaniline was characterized by Fourier transform infrared (FT‐IR) analysis, X‐ray diffraction (XRD) and scanning electron microscopy (SEM). The coatings consisted of polyaniline, epoxy resin and other additives that were formed on Mg‐Li alloy. The anti‐corrosion properties of the polyaniline‐containing coating on the Mg‐Li alloy were investigated in 3.5 wt.% NaCl solution using open circuit potential logging and electrochemical impedance spectroscopy.FindingsThe results of the electrochemical tests indicated that the polyaniline‐containing coatings showed better anti‐corrosion properties, as compared to conventional epoxy coatings on Mg‐Li alloy when exposed in 3.5 wt.% NaCl solution. The coating containing 2 wt.% polyaniline (relative to the mass of epoxy resin) doped with hydrochloric acid had the best anti‐corrosion properties on the Mg‐Li alloy.Originality/valuePrevious reports on the anti‐corrosion properties of polyaniline‐containing coatings focused mainly on the surface of iron, steel, aluminum and magnesium, and there have been few studies on the anti‐corrosion properties as protective coatings for Mg‐Li alloy.