bluuebunny/crossref_metadata_2025_split huggingface dataset:
Virologic Responses to Add‐on Adefovir Dipivoxil Treatment Versus Entecavir Monotherapy in Children With Lamivudine‐resistant Chronic Hepatitis B
Authors: Chu MiAe , Cho Seung Man , Choe Byung‐Ho , Cho Min Hyun , Kwon Soonhak , Lee Won Kee 
Published: November 2012

ABSTRACTPurpose:The aim of the study was to compare the virologic response to adefovir (ADV) add‐on therapy with switching to entecavir (ETV) monotherapy in children and adolescents with chronic hepatitis B (CHB) who have developed lamivudine (LAM) resistance during LAM treatment.Methods:Twenty‐seven consecutive patients with CHB who had developed LAM resistance during LAM treatment were included. Of these 27 patients, 8 patients were treated with the addition of ADV to ongoing LAM and 8 patients were treated by switching to ETV monotherapy and each of these 16 patients were compared with the 11 patients who were treated by switching to ADV alone, as a historical control. Therapeutic responses to treatment were evaluated at 12, 24, 36, and 48 weeks from the initiation of therapy by measuring the decrement of hepatitis B virus (HBV)‐DNA titers.Results:The therapeutic period for HBV‐DNA titer decrement (>2 log10 IU/mL) was significantly shorter in both the LAM+ADV group and the ETV group than in the ADV group (P = 0.008); however, there was no significant difference between the LAM+ADV group and the ETV group. The rate of virologic response, defined as decrement in HBV‐DNA titer to undetectable levels at 24 weeks, was significantly higher in both the LAM+ADV group and the ETV group than in the ADV group (P = 0.029).Conclusions:Both the LAM+ADV combination therapy and ETV monotherapy exhibited significantly more effective virologic responses compared to the ADV monotherapy in children and adolescents with LAM‐resistant CHB, although there was no significant difference between the LAM+ADV group and the ETV group.
Improved Outcomes With Quality Improvement Interventions in Pediatric Inflammatory Bowel Disease
Authors: Samson Charles M. , Morgan Pamela , Williams Elizabeth , Beck Lee , Addie‐Carson RicJunette , McIntire Stacy , Booth Andrea , Mendez Eduardo , Luzader Carolyn , Tomer Gitit , Saeed Shehzad , Donovan Edward , Bucuvalas John , Denson Lee A. 
Published: November 2012

ABSTRACTObjectives:Variations in chronic illness care are common in our health care system and may lead to suboptimal outcomes. Specifically, inconsistent use and suboptimal medication dosing have been demonstrated in the care of patients with inflammatory bowel disease (IBD). Quality improvement (QI) efforts have improved outcomes in conditions such as asthma and diabetes mellitus, but have not been well studied in IBD. We hypothesized that QI efforts would lead to improved outcomes in our pediatric IBD population.Methods:A QI team was formed within our IBD center in 2005. By 2007, we began prospectively capturing physician global assessment (PGA) and patient‐reported global assessment. Significant QI interventions included creating evidence‐based medication guidelines, joining a national QI collaborative, initiation of preclinic planning, and monitoring serum 25‐hydroxyvitamin D.Results:From 2007 to 2010, 505 patients have been followed at our IBD center. During this time, the frequency of patients in clinical remission increased from 59% to 76% (P < 0.05), the frequency of patients who report that their global assessment is >7 increased from 69% to 80% (P < 0.05), and the frequency of patients with a Short Pediatric Crohn's Disease Activity Index (sPCDAI) <15 increased from 60% to 77% (P < 0.05). The frequency of repeat steroid use decreased from 17% to 10% (P < 0.05). We observed an association between the use of a vitamin D supplement (P = 0.02), serum 25‐hydroxyvitamin D (P < 0.05), and quiescent disease activity.Conclusions:Our results show that significant improvements in patient outcomes are associated with QI efforts that do not rely on new medication or therapies.
Intestinal Smooth Muscle Dysfunction Develops Postnatally in Cystic Fibrosis Mice
Authors: De Lisle Robert C. , Meldi Lauren , Mueller Racquel 
Published: November 2012

ABSTRACTObjectives:Intestinal dysmotility is one of the effects of cystic fibrosis (CF), but when and how this develops is not well understood. The goal of the present study was to use the Cftr knockout mouse to determine when in development circular smooth muscle of the small intestine becomes dysfunctional.Methods:Wild‐type (WT) and CF mice were used at postnatal day 5 (P5) through adult. Pieces of small intestine were used to measure contractile activity of the circular muscle. Bacterial overgrowth was measured by quantitative polymerase chain reaction (PCR) of the bacterial 16S gene. Intestinal gene expression was determined by quantitative reverse transcription polymerase chain reaction (RT‐PCR). Prostaglandin E2 (PGE2) and its metabolites were measured by enzyme immunoassay.Results:CF circular muscle response to cholinergic stimulation was similar to WT at P5, became somewhat impaired at P7, and was severely impaired by P14. In the CF intestine, bacterial overgrowth occurred by P4 and was maintained into adulthood. Eicosanoid metabolic gene expression in the CF intestine did not differ from WT shortly after birth. The phospholipase A2 genes, Pla2g4c and Pla2g5 exhibited increased expression in CF mice at P24. Prostaglandin degradative genes, Hpgd and Ptgr1, showed lower expression in CF as compared with WT at P16 and P24, respectively. PGE2 levels were significantly greater in CF mice at most ages from P7 through adulthood.Conclusions:The results clearly demonstrate that lack of CFTR itself does not cause smooth muscle dysfunction, because the circular muscle from P5 CF mice had normal activity and dysfunction developed between P7 and P14.
Effect of the Exposure to TV Food Advertisements on the Consumption of Foods by Mothers and Children
Authors: Díaz‐Ramírez Glenda , Jiménez‐Cruz Arturo , Souto‐Gallardo Maria de las Cruces , Bacardí‐Gascón Montserrat 
Published: November 2012

ABSTRACTFoods advertised were recorded in 2 television (TV) channels. The present article studies the association between products advertised and those consumed by mothers and children. A total of 365 mothers and their children were assessed. A positive correlation was observed between the food advertisements that the mothers recalled and the frequency of TV food advertisements (Rho = 0.44, P = 0.03). A positive correlation was found between the frequency of the foods advertised on TV and the consumption of these by the mothers (r = 0.73, P = 0.0001) and their children (Rho = 0.66, P = 0.0001). These results suggest that TV advertisements influence the food choices of mothers and children.
Milk Temperature Influences Esophageal Motility in the Newborn Lamb
Authors: Djeddi Djamal , Samson Nathalie , Praud Jean‐Paul 
Published: November 2012

ABSTRACTEsophageal dysmotility is common in infants. We aimed to evaluate the influence of milk temperature on esophageal motility using multichannel intraluminal impedance‐pH monitoring (MII‐pH). Five healthy lambs, ages 2 to 3 days, underwent a MII‐pH whereas bottle‐fed randomly with 50 mL of ewe milk at 26°C, 38.5°C, and 41.5°C. Impedance motility parameters were studied on 5 swallows at each temperature. At 38.5°C we noted a higher total propagation velocity and a shorter total bolus transit time (TBTT) (P < 0.05). These unique results suggest a potential role of milk temperature alterations in improving oral feeding in infants with esophageal dysmotility.
TGF‐β Affects Enterocyte Turnover in Correlation With TGF‐β Receptor Expression After Massive Small Bowel Resection
Authors: Sukhotnik Igor , Lulu Shani Ben , Pollak Yulia , Bejar Jacob , Coran Arnold G. , Mogilner Jorge G. 
Published: November 2012

ABSTRACTObjectives:In the present study, we evaluated the effect of transforming growth factor‐beta 2 (TGF‐β2)‐enriched diet on enterocyte turnover and correlated it with TGF‐β2 receptor expression along the villus–crypt axis in a rat model of short bowel syndrome (SBS).Methods:CaCo‐2 cells were incubated with increasing concentrations of TGF‐β2. Alamar Blue reduction test was used for investigation of cell viability and evaluation of cell apoptosis was assessed by flow cytometry. Male rats were divided into 4 groups: Sham rats underwent bowel transection, Sham TGF‐β rats were treated with diet enriched with TGF‐β2, SBS rats underwent a 75% bowel resection, and SBS TGF‐β rats were fed a diet enriched with TGF‐β2 after bowel resection. Parameters of intestinal adaptation, enterocyte proliferation and apoptosis were determined at sacrifice. TGF‐β2r expression in villus tips, lateral villi and crypts was assessed by immunohistochemistry. The effect of TGF‐β2 on enterocyte turnover for each compartment was evaluated in correlation with TGF‐β2r expression.Results:Incubation of CaCo‐2 cells with TGF‐β2 resulted in a significant decrease in cell viability and increased cell apoptosis. TGF‐β2r expression in crypts increased in SBS rats (vs sham) and was accompanied by decreased cell proliferation and increased cell apoptosis following TGF‐β2 administration. A significant decrease in TGF‐β2r expression at villous tips in SBS rats was accompanied by a decreased cell apoptosis in this compartment following exposure to TGF‐β2‐enriched diet.Conclusions:In a rat model of SBS, the inhibiting effect of TGF‐β2 on enterocyte turnover correlates with TGF‐β2 receptor expression along the villus–crypt axis.
Autosomal Dominant Ménétrier‐like Disease
Authors: Strisciuglio Caterina , Corleto Vito D. , Brunetti‐Pierri Nicola , Piccolo Pasquale , Sangermano Riccardo , Rindi Guido , Martini Maurizio , D'Armiento Francesco P. , Staiano Annamaria , Miele Erasmo 
Published: November 2012

ABSTRACTBackground:Familial occurrence of Ménétrier disease is rare and has been reported only in few instances.Methods:Affected patients from a large pedigree were evaluated at the clinical, endoscopic, and pathological levels.Results:Affected members presented with gastropathy of variable severity but without protein loss. Endoscopy and pathology findings were consistent with Ménétrier disease; however, gastric transforming growth factor α (TGF‐α) immunohistochemistry and real‐time polymerase chain reaction showed no increase in TGF‐α expression.Conclusions:We describe a unique, 4‐generation pedigree with autosomal dominant gastropathy exhibiting the typical clinical, endoscopic, and pathological findings of Ménétrier‐like disease, though in the absence of protein loss and with no increase in the levels of gastric TGF‐α. Members of this family may be affected by a novel and previously unrecognised hereditary form of gastric hyperplasia.
Parental Report of Abdominal Pain and Abdominal Pain–related Functional Gastrointestinal Disorders From a Community Survey
Authors: Saps Miguel , Adams Papa , Bonilla Silvana , Chogle Ashish , Nichols‐Vinueza Diana 
Published: November 2012

ABSTRACTBackground and Aims:Functional gastrointestinal disorders (FGIDs) are common in children. Abdominal pain (AP) is the most common gastrointestinal (GI) symptom in children. The severity of AP drives medical consultations and quality of life in adult patients with irritable bowel syndrome (IBS). Thirty‐eight percent of 8‐ to 15‐year‐old schoolchildren report AP weekly with 24% of those children reporting persistence of AP >8 weeks. Despite the high prevalence of AP, only 2% of school children seek medical attention for AP. Lack of parental knowledge on their child's symptoms may constitute one of the factors affecting the low ratio of consultation in children reporting AP. The aim was to assess parental reports of AP symptoms in a population of healthy community children.Methods:Data of 5 studies with identical methodology to assess GI symptoms in children with celiac disease (CD), cow's milk allergy (CMA), pyloric stenosis (PS), Henoch‐Schönlein purpura (HSP), and stem cell transplant (SC) and their healthy siblings were reviewed: a phone questionnaire on GI symptoms and Pediatric Gastrointestinal Symptoms Rome III version questionnaire (QPGS‐RIII). Inclusion criteria were healthy children 4 to 18 years of age with a sibling previously diagnosed with CD, CMA, PS, HSP, or SC.Results:Data on 246 healthy children, mean age (9.8 years, range 3–24, 112 girls) were obtained. Parents reported presence of AP in the last 8 weeks before the telephone contact in 20 (8.1%) children (age range 4–18 years, 11 girls). There was no significant difference in AP prevalence between boys and girls (P = 0.64). Six children (2.4%) met QPGS‐RIII diagnostic criteria for FGIDs: 3 functional abdominal pain (FAP) and 3 IBS.Conclusions:AP was common in community children. FAP was the most common FGID among healthy community children. The prevalence of AP by parental report is lower than the previously published prevalence of AP reported by children. Lack of awareness of children's symptoms may play a role in the low ratio of consultation for AP in symptomatic children. Future prospective studies should confirm our findings and investigate the factors influencing the medical consultation decision including parental awareness of children's symptoms.
Obesity After Pediatric Liver Transplantation
Authors: Sundaram Shikha S. , Alonso Estella M. , Zeitler Phil , Yin Wanron , Anand Ravinder ,   SPLIT Research Group
Published: November 2012

ABSTRACTObjectives:Pediatric obesity has become a significant public health concern. The historical focus in pediatric liver transplant (LT) has been undernutrition, with limited knowledge regarding obesity. Therefore, we sought to determine the prevalence of obesity in pediatric LT, compare it to National Health and Nutrition Examination Surveys (NHANES) data, and identify risk factors for obesity in pediatric LT.Methods:SPLIT, which collects pediatric LT data at 39 centers, was queried for subjects ages 2 to 18 years at follow‐up, LT between 1995 and 2007, and with at least 1 body mass index measured 1 to 5 years after LT.Results:Of 1706 individuals included, 44% had biliary atresia (47% boys, 58% white, mean age at LT 4.6 years). Of these individuals, 19% were obese at 1 year and 18% at 3 years, higher than in the general pediatric population reported by 2003–2004 NHANES, whereas 11% obesity at 5 years after LT was similar to NHANES data. Using logistic regression, Hispanic ethnicity (odds ratio [OR] 1.8, 95% confidence interval [CI] 1.19–2.23), steroid use at follow‐up (OR 1.48, 95% CI 1.23–1.77), overweight (OR 4.34, 95% CI 2.91–6.68), and obesity (OR 10.62, 95% CI 5.9–19.65) at LT independently predicted post‐LT obesity.Conclusions:These findings suggest a need to broaden standard care to include obesity assessment and intervention in routine pre‐ and posttransplant care.
Endoscopic and Histological Gastric Lesions in Children With Celiac Disease
Authors: Nenna Raffaella , Magliocca Fabio Massimo , Tiberti Claudio , Mastrogiorgio Gerarda , Petrarca Laura , Mennini Maurizio , Lucantoni Federica , Luparia Rita Pia Lara , Bonamico Margherita 
Published: November 2012

ABSTRACTObjectives:Lymphocytic gastritis (LG) has been reported in patients with celiac disease (CD). The aim of the present study was to evaluate gastric mucosa involvement in celiac children and gastroenterological controls (GC).Methods:In a retrospective study on 226 patients with CD (82 M; median age: 5.7years) at diagnosis and 154 GC (66 M; median age: 7.4 years), the evaluation of gastric and duodenal mucosa was performed. CD was diagnosed according to the North America Society for Pediatric Gastroenterology, Hepatology, and Nutrition criteria. Gastric lesions were classified according to Updated Sydney System. Anti‐gastric parietal cell antibodies (GPCA) were assayed by enzyme‐linked immunosorbent assay.Results:A total of 21.2% and 7% of patients with CD showed chronic superficial gastritis (CSG) and LG, respectively. Helicobacter pylori (Hp) infection was found in 6 (2.7%) children with CD (66.7% had CSG, 16.7% LG, and 16.7% interstitial gastritis). CSG was present in 21.4% of controls. No control subject showed LG. Hp infection was found in 24 (15.6%) children with GC (91.7% had CSG). Among patients with CSG, Hp infection was more frequent in controls than in celiac children (P < 0.0001). Ten of 90 patients with CD and 1 of 29 controls were positive for GPCA.Conclusions:Gastritis is a common finding in children with CD and adolescents. In celiac subjects, CSG is the most frequently detected. Our data suggest the hypothesis that LG may be related to a longer exposure to gluten. The presence of GPCA may suggest the presence of an underlying autoimmune process.
α‐SMA Overexpression Associated With Increased Liver Fibrosis in Infants With Biliary Atresia
Authors: Dong Rui , Luo Yi , Zheng Shan 
Published: November 2012

ABSTRACTObjective:The mechanisms responsible for increased collagen production and hepatic fibrosis in biliary atresia (BA) remain largely unknown. We evaluated α‐smooth muscle actin (α‐SMA) expression in liver and the porta hepatis in infants with BA.Methods:Immunohistochemical staining for α‐SMA and CD68 in the BA liver and porta hepatis was performed. A semiquantitative 3‐grade staging system was employed to estimate liver fibrosis. The densities of CD68 in BA liver and the levels of direct bilirubin were assessed in relation to α‐SMA expression.Results:α‐SMA was found to be overexpressed in epithelial cells and in periductular collagen fibers. The expression in infants with BA was higher than that in the control group (P < 0.05). The amount of α‐SMA in BA was positively correlated with liver fibrosis scores (r = 0.549, P = 0.022). The levels of α‐SMA in the liver of BA were negatively related with improvements in direct bilirubin levels, 3 months postoperatively (r = −0.653, P = 0.029). The correlation between the α‐SMA and CD‐68 expression was not significantly different (r = 0.444, P = 0.057).Conclusions:The expression of α‐SMA in BA liver is higher than that in contro1 group. α‐SMA expression is negatively correlated with the reduction of direct bilirubin, 3 months postoperatively, probably due to fibrosis or cirrhosis affecting the entire biliary system.
Intestinal Failure in Children
Authors: D'Antiga Lorenzo , Goulet Olivier 
Published: November 2012

ABSTRACTIntestinal failure (IF) is a condition in which severe intestinal malabsorption mandates artificial nutrition through a parenteral route. Causes of severe protracted IF include short bowel syndrome, congenital diseases of enterocyte development, and severe motility disorders (total or subtotal aganglionosis or chronic intestinal pseudo‐obstruction syndrome). IF can result in nutritional failure, defined as the long‐term failure to nourish a child by natural or artificial means. Today, IF‐associated liver disease is the most common cause of parenteral nutrition (PN) failure, but catheter‐related sepsis and extensive vascular thrombosis may also jeopardize the health of those receiving PN. For a child with nutritional failure, intestinal transplantation, often in the form of a composite visceral graft, offers the only chance for long‐term survival. The management of IF requires a multidisciplinary approach. There have been a number of recent advances in both medical and surgical treatments of IF. In particular, new intestinal lengthening techniques and the use of PN formulas rich in fish oil both have resulted in decreased rates of severe complications of IF and its treatments. In addition, better awareness of the risks and benefits of intestinal transplantation have resulted in better patient selection, and ultimately in improved patient survival, hence restricting the indication to transplantation only to patients with nutritional failure and no other chance to survive.
Cow's Milk Elimination
Authors: Kagalwalla Amir F. , Amsden Katie , Shah Ameesh , Ritz Sally , Manuel‐Rubio Maria , Dunne Katherine , Nelson Suzanne P. , Wershil Barry K. , Melin‐Aldana Hector 
Published: November 2012

ABSTRACTObjectives:Cow's‐milk protein is one of the food antigens responsible for causing eosinophilic esophageal inflammation in a majority of children. We describe our experience with treating eosinophilic esophagitis (EoE) in children by eliminating only cow's milk from their diets.Methods:This retrospective study assessed the short‐term clinical and histological response to eliminating cow's‐milk protein from the diet of children with EoE. Only patients undergoing a subsequent upper endoscopy to assess their histological response were included in this analysis.Results:We identified 17 (12 boys and 5 girls) children with EoE who excluded only cow's milk from their diet. Remission was induced in 11 of 17 (65%) patients; within the remission group, 7 (41%) achieved complete histological remission and 4 patients (24%) were in significant histological remission. The mean peak pre‐ and posttreatment counts for those in remission were 76 ± 40 and 2 ± 4 (P < 0.01), respectively.Conclusions:Elimination of cow's milk–induced clinical and histological remission in 65% (95% confidence interval 42%–88%) of children with EoE in whom it was attempted. This approach offers distinct advantages over other dietary treatment approaches for the initial management of children with EoE. The role of eliminating cow's milk alone for the treatment of EoE warrants further prospective study.
Congenital Anomalies and Childhood Celiac Disease in Sweden
Authors: Wingren Carl Johan , Agardh Daniel , Merlo Juan 
Published: November 2012

ABSTRACTPreviously, chromosomal anomalies and, to a lesser extent, other congenital anomalies have been associated with an increased risk of celiac disease (CD). We investigated these associations using a systematic approach. We identified all of the singleton children (792,401) born in Sweden between 1987 and 1993, and obtained cases of CD using the Swedish National Inpatient Registry. We applied Cox regression models as well as sibling designs to study the association between congenital anomalies and childhood CD. We observed that anomalies of face, neck, ear, heart, digestive tract, or chromosomes were associated with CD.
Vitamin and Mineral Status in Patients With Inflammatory Bowel Disease
Authors: Alkhouri Razan H. , Hashmi Humaira , Baker Robert D. , Gelfond Daniel , Baker Susan S. 
Published: November 2012

ABSTRACTObjectives:Patients with inflammatory bowel disease (IBD) are at risk for vitamin and mineral deficiencies because of long‐term inflammation in the gut mucosa and decreased oral intake. The aim of the study is to investigate the prevalence of vitamin and zinc deficiencies in patients with newly diagnosed IBD compared with a control group.Methods:This is a retrospective chart review of all of the patients diagnosed as having IBD from 2006 to 2010, ages 1 to 18 years. Patients who had fat‐ and water‐soluble vitamins (A, E, D 25‐OH, folate, and B12) and zinc levels obtained at time of diagnosis were included in the study. A total of 61 patients with IBD and 61 age‐ and sex‐matched controls were included.Results:None of the 61 patients with IBD had folate or vitamin B12 deficiency. Vitamin D deficiency was found in 62% of the patients, vitamin A deficiency in 16%, vitamin E deficiency in 5%, and zinc deficiency in 40%. The control group had vitamin D and E and zinc deficiency in 75%, 8%, and 19% patients, respectively.Conclusions:We conclude that vitamin B12 and folate deficiencies are rare in children with newly diagnosed IBD in the United States and we question whether routine monitoring is warranted. Vitamin A and zinc deficiency are common in patients with newly diagnosed IBD and levels should be assessed at the time of diagnosis so that enteral repletion can commence. Vitamin D deficiency is common in all of the children in the Buffalo, NY, area, and routine screening for this deficiency is warranted.