bluuebunny/crossref_metadata_2025_split huggingface dataset:
Results of Extremely‐low‐birth‐weight Infants Randomized to Receive Extra Enteral Calcium Supply
Authors: Carroll William F. , Fabres Jorge , Nagy Tim R. , Frazier Marcela , Roane Claire , Pohlandt Frank , Carlo Waldemar A. , Thome Ulrich H. 
Published: October 2011

ABSTRACTBackground and Objective:Bone mineral deficiency continues to occur in extremely‐low‐birth‐weight (ELBW) infants despite formulas enriched in calcium (Ca) and phosphorus (P). This study tested whether extra enteral Ca supplementation increases bone mineral content (BMC) and prevents dolichocephalic head flattening and myopia in ELBW infants.Study Design:Infants 401 to 1000 birth weight receiving enteral feeds were randomized to receive feeds supplemented with Ca‐gluconate powder or pure standard feeds. The main outcome measures were the excretion of Ca and P by weekly spot urine measurements, the degree of dolichocephalic deformation (fronto‐occipital diameter to biparietal diameter ratio, FOD/BPD) at 36 weeks postmenstrual age, and the BMC (by dual‐energy x‐ray absorptiometry) at discharge. Cycloplegic refraction was measured at 18 to 22 months corrected age.Patients and Results:Ninety‐nine ELBW infants with a gestational age of 26 weeks (23–31) (median [minimum‐maximum]) were randomized at a postnatal age of 12 days (5–23) weighing 790 g (440–1700). Urinary Ca excretion increased and P excretion decreased in the Ca‐supplemented group. Total BMC was 89.9 ± 2.4 g (mean ± SE) in the supplemented group and 85.2 ± 2.6 g in the control group (P = 0.19). The FOD/BPD was 1.50 (1.13–1.69, mean ± SD [standard deviation]) and 1.47 (1.18–1.64) in the supplemented and control groups, and the refraction 0.98 ± 1.23 and 1.40 ± 1.33 dpt (P = 0.68), respectively in 64 ELBW infants (79% of survivors) at 2‐year follow‐up.Conclusions:Extra enteral Ca supplementation did not change BMC, head shape, or refraction. The decreased P excretion may reflect P deficiency in infants receiving extra Ca, preventing improved bone mineral accretion.
Molecular Fingerprints of the Human Fecal Microbiota From 9 to 18 Months Old and the Effect of Fish Oil Supplementation
Authors: Andersen Anders Daniel , Mølbak Lars , Michaelsen Kim Fleischer , Lauritzen Lotte 
Published: October 2011

ABSTRACTObjectives:The aim of this study was to monitor changes in the fecal microbiota from 9 to 18 months and to investigate the effect of increasing dietary n‐3 polyunsaturated fatty acids on the fecal microbiota.Patients and Methods:In a double‐blind controlled trial with random allocation to daily supplementation with 5 mL of fish oil (FO) or sunflower oil (SO) from 9 to 18 months of age, stool samples were collected from 132 healthy Danish infants. Molecular fingerprints of the bacterial DNA were obtained by terminal restriction fragment length polymorphism (T‐RFLP).Results:The T‐RFLP profiles indicated that a few T‐RFs became dominant with age (bp100 and 102, both presumed to be Bacteroidetes) concomitantly with an overall increase in the microbial diversity (P = 0.04). Breast‐feeding influenced both the T‐RFLP profiles at 9 months and the changes from 9 to 18 months, and breast‐feeding cessation during the trial modified the response to the dietary oils. In the FO group, the increase in bp102 was significantly reduced among children weaned before compared with those weaned during the trial (P = 0.027), whereas the increase in bp100 was reduced in the preweaned children of the SO group relative to those weaned during the trial (P = 0.004). This was supported by intervention group differences in the changes in bp102 and bp100 among the earlier weaned children (P = 0.06 and P = 0.09, respectively).Conclusions:Cessation of breast‐feeding played a dominant role relative to developmental changes in the fecal microbiota from 9 to 18 months. FO compared with SO supplementation affected changes in large bacterial groups, but only among children who had stopped breast‐feeding before 9 months of age.
Zinc Monotherapy From Time of Diagnosis for Young Pediatric Patients With Presymptomatic Wilson Disease
Authors: Mizuochi Tatsuki , Kimura Akihiko , Shimizu Norikazu , Nishiura Hiroshi , Matsushita Masami , Yoshino Makoto 
Published: October 2011

ABSTRACTIn 4 young pediatric patients with presymptomatic Wilson disease, we found zinc monotherapy beginning at time of diagnosis to be safe and highly effective for follow‐up intervals between 1 and 2 years. Such maintenance therapy with zinc can maintain urinary copper excretion between 1 and 3 μg · kg−1 · day−1.
Septic Shock and Hypofibrinogenemia Predict a Fatal Outcome in Childhood Acute Acalculous Cholecystitis
Authors: Huang Shu‐Ching , Yang Yao‐Jong 
Published: October 2011

ABSTRACTObjectives:The aim of the study was to investigate the etiology, clinical presentation, and risk factors for poor prognosis of acute acalculous cholecystitis (AAC) in children.Patients and Methods:Children younger than 18 years diagnosed as having AAC were analyzed retrospectively from 2000 to 2009. The demographic and clinical characteristics, etiology, and outcomes were recorded. AAC was defined as a gallbladder wall thickness of >3.5 mm in sonogram with a duration of symptoms <1 month. The severity of sonographic findings was scored, with 1 point each given for wall thickness >3.5 mm, gallbladder distention, sludge, and pericholecystic fluid.Results:A total of 109 children (boys:girls 1:2, median age 4.9 years) were diagnosed. The most common clinical presentation was fever (88%), followed by hepatomegaly (72%). The rates of elevated alanine aminotransferase and thrombocytopenia were 72% and 65%, respectively. The most common causative etiology was infectious diseases (74%). All of the patients were treated nonoperatively. Sixteen (15%) patients died. Children with mortality had a significantly higher rate of septic shock (P < 0.001), anemia (P = 0.01), thrombocytopenia (P = 0.04), hypofibrinogenemia (P = 0.002), the presence of pericholecystic fluid (P = 0.04), and higher sonographic scores (P = 0.04) than those with survival. Multiple logistic regression analysis confirmed that the presence of septic shock (P = 0.004) and hypofibrinogenemia (P = 0.014) were independent risk factors that predict mortality.Conclusions:Childhood AAC is usually secondary to a variety of etiologies, especially during the course of infectious diseases. The presence of septic shock and a low value of fibrinogen determine a fatal outcome in childhood AAC.
Liprotamase Long‐term Safety and Support of Nutritional Status in Pancreatic‐insufficient Cystic Fibrosis
Authors: Borowitz Drucy , Stevens Christopher , Brettman Lee R. , Campion Marilyn , Wilschanski Michael , Thompson Henry ,   Liprotamase 767 Study Group
Published: October 2011

ABSTRACTObjectives:Patients with cystic fibrosis (CF) who have exocrine pancreatic insufficiency (EPI) require treatment with pancreatic enzyme replacement therapy (PERT) to maintain adequate nutrition and age‐appropriate growth and weight gain. Liprotamase, a nonporcine, highly purified biotechnology‐derived PERT, has demonstrated significant efficacy in fat and protein malabsorption in patients with EPI compared to placebo. This study of liprotamase is the first ever long‐term trial of a PERT to evaluate safety and nutritional parameters.Methods:This phase III 12‐month open‐label trial assessed the safety, tolerability, and long‐term nutritional effects of liprotamase treatment in patients with CF and EPI 7 years and older. All of the patients were required to discontinue their long‐term use of porcine PERTs at the time of enrollment. Dosing started at 1 capsule of liprotamase (32,500 US Pharmacopoeia (USP) units crystallized cross‐linked lipase, 25,000 USP units crystallized protease, and 3,750 USP units amorphous amylase) per meal or snack; dose could be increased based on protocol‐defined parameters.Results:A total of 215 subjects were enrolled and 214 received at least 1 dose of liprotamase (mean 5.5 capsules per day). During the study period, height, weight, and body mass index z scores and lung function as measured by forced expiratory volume in 1 second were stable. There were no clinically meaningful changes in laboratory tests, including levels of fat‐soluble vitamins. Liprotamase was well tolerated without any significant safety concerns. Adverse events, primarily gastrointestinal, led to treatment discontinuation for 36 subjects (16.8%), most within the first 3 months.Conclusions:Treatment with a mean of 5.5 capsules of liprotamase per day, during meals and snacks, for up to 12 months was safe, well tolerated, and associated with age‐appropriate growth and weight gain or weight maintenance in subjects with CF‐related EPI.
Infant Stunting Is Associated With Short Maternal Stature
Authors: Hambidge K. Michael , Mazariegos Manolo , Kindem Mark , Wright Linda L. , Cristobal‐Perez Christina , Juárez‐García Lucrecia , Westcott Jamie E. , Goco Norman , Krebs Nancy F. 
Published: October 2011

ABSTRACTThe objectives were to determine the range of maternal height associated with growth velocity of older infants and the magnitude of this association in an indigent population. Maternal height and infant length‐for‐age z scores (LAZ) were positively correlated at both 6 (n = 412, r = 0.324) and 12 (n = 388, r = 0.335) months (P < 0.0001) and for maternal heights from 131 to 164 cm. Maternal height is independently associated with infant LAZ and stunting (LAZ <−2) at both 6 and 12 months (P < 0.001) and with linear growth velocity from 6 to 12 months (P = 0.0023).
Human Milk Probiotic Lactobacillus fermentum CECT5716 Reduces the Incidence of Gastrointestinal and Upper Respiratory Tract Infections in Infants
Authors: Maldonado José , Cañabate Francisco , Sempere Luis , Vela Francisco , Sánchez Ana R. , Narbona Eduardo , López‐Huertas Eduardo , Geerlings Arjan , Valero Antonio D. , Olivares Mónica , Lara‐Villoslada Federico 
Published: October 2011

ABSTRACTObjectives:The aim of the study was to examine the effects of a follow‐on formula containing Lactobacillus fermentum CECT5716 (L fermentum) on the incidence of infections in infants between the ages of 6 and 12 months.Patients and Methods:A randomized double‐blinded controlled study including infants at the age of 6 months was conducted. Infants were assigned randomly to either follow‐on formula supplemented with L fermentum plus galactooligosaccharide (experimental group, EG), or the same formula supplemented with only galactooligosaccharide (control group, CG). The main outcome was the incidence of infections for the 6‐month duration of the study.Results:The EG showed a significant 46% reduction in the incidence rate (IR) of gastrointestinal infections (EG: 0.196 ± 0.51, CG: 0.363 ± 0.53, IR ratio 0.54, 95% confidence interval [CI] 0.307–0.950, P = 0.032), 27% reduction in the incidence of upper respiratory tract infections (EG: 0.969 ± 0.96, CG: 1.330 ± 1.23, IR ratio 0.729, 95% CI 0.46–1.38, P = 0.026), and 30% reduction in the total number of infections (EG: 1.464 ± 1.15, CG: 2.077 ± 1.59, IR ratio 0.70, 95% CI 0.46–1.38, P = 0.003), at the end of the study period compared with CG.Conclusions:Administration of a follow‐on formula with L fermentum CECT5716 may be useful for the prevention of community‐acquired gastrointestinal and upper respiratory infections.
Prevalence and Outcome of Hepatobiliary Dysfunction in Neonatal Septicaemia
Authors: Khalil Sumaira , Shah Dheeraj , Faridi M.M.A. , Kumar Ashwani , Mishra Kiran 
Published: October 2011

ABSTRACTBackground:Cholestatic jaundice and liver enzyme abnormalities have been reported in neonatal septicaemia; the course, pattern, and outcome of such hepatobiliary dysfunction have not been described.Methods:One hundred fifty‐three neonates with blood culture–positive sepsis were recruited from the neonatal intensive care unit of an urban hospital. Liver function tests were done on day 3 and day 10 in all of the cases. In babies with abnormal results (direct bilirubin >20% of total with a minimum level of 2 mg/dL or alanine aminotransferase [ALT] >50 U/L), tests were repeated weekly for 1 month and then fortnightly for 3 months or until normalization of values. Anthropometry was recorded at all of these visits.Results:Klebsiella pneumoniaewas the commonest organism, isolated in 95.4% of subjects. Eighty‐three (54.2%) subjects had hepatobiliary dysfunction in the form of either cholestatic jaundice (n = 65 [42.5%]) or derangement in ALT (n = 57 [37.3%]). The onset of cholestasis was seen by day 3 of sepsis in 80% (n = 52), with maximum value of direct bilirubin seen by the 10th day in 90% (n = 58). Only 15% (n = 10) continued to have cholestatic jaundice beyond 30 days of onset of sepsis, and it resolved by 60 days. Hepatic enzyme abnormalities followed a more protracted course: onset by day 10 in 95%, peak value by day 38 in 90%, and normalisation by 60 days in 82% of subjects. The prevalence of any hepatobiliary dysfunction was found less frequently in babies who died as compared with survivors (43.4% vs 56.7%;P< 0.01). The weight, length, and head circumference during follow‐up visits were comparable between neonates with or without hepatobiliary dysfunction.Conclusions:Hepatobiliary dysfunction is common in Gram‐negative neonatal septicaemia. The onset of abnormalities is early in most cases but ultimately resolve within 2 to 3 months after sepsis. The presence of conjugated hyperbilirubinemia in neonatal sepsis may carry a better prognosis in terms of survival and has no significant effect on growth during early infancy.
Is Cow's Milk Harmful to a Child's Health?
Authors: Agostoni Carlo , Turck Dominique 
Published: October 2011

ABSTRACTDiscussions and debates have recently emerged on the potential positive and negative effects of cow's milk in the paediatric community, also under the pressure of public opinion. The negative effects of cow's‐milk consumption seem to be limited to iron status up to 9 to 12 months; then no negative effects are observed, provided that cow's milk, up to a maximum daily intake of 500 mL, is adequately complemented with iron‐enriched foods. Lactose intolerance can be easily managed and up to 250 mL/day of milk can be consumed. Allergy to cow's‐milk proteins is usually transient. Atopic children may independently be at risk for poor growth, and the contribution of dairy nutrients to their diet should be considered. The connection of cow's milk to autistic spectrum disorders is lacking, and even a cause–effect relation with type 1 diabetes mellitus has not been established because many factors may concur. Although it is true that cow's milk stimulates insulin‐like growth factor‐1 and may affect linear growth, association with chronic degenerative, noncommunicable diseases has not been established. Finally, fat‐reduced milk, if needed, should be considered after 24 to 36 months. Cow's milk represents a major source of high nutritional quality protein as well as of calcium. Moreover, it has growth‐promoting effects independent of specific compounds. Its protein and fat composition, together with the micronutrient content, is suggestive of a functional food, whose positive effects are emphasised by regular consumption, particularly under conditions of diets poor in some limiting nutrients, although in industrialised countries cow's milk's optimal daily intake should be around 500 mL, adequately complemented with other relevant nutrients.
Serum and Tissue CD23, IL‐15, and FasL in Cow's‐Milk Protein–sensitive Enteropathy and in Coeliac Disease
Authors: Kokkonen Tuomo S. , Augustin Merja T. , Kokkonen Jorma , Karttunen Riitta , Karttunen Tuomo J. 
Published: October 2011

ABSTRACTObjectives:The aim of the study was to explore pathogenesis and find new serum markers for cow's‐milk–sensitive enteropathy (CMSE) and coeliac disease (CD). We assessed the intestinal expression and serum concentration of CD23, IL‐15, and FasL. We hypothesised that the serum levels of CD23, a protein expressed in the lymphoid follicles, would be associated with lymphonodular hyperplasia (LNH), a feature characteristic of CMSE. We also presumed that interleukin (IL)‐15 and FasL, functionally connected with proliferation and apoptosis of the intraepithelial lymphocytes (IELs), would relate with the increased numbers of IELs present in both CMSE and CD.Methods:Twenty‐three children with CMSE, 20 with untreated CD, and 14 controls were studied for CD3, α/β‐ and γ/δ‐expressing IELs, and for duodenal and ileal expression of CD23, FasL, and IL‐15 by immunohistochemistry, and for serum concentration of sCD23, sFasL, and sIL‐15 by enzyme‐linked immunosorbent assay.Results:There was a trend for increase in sCD23 serum levels in untreated CMSE and in CD (P = 0.074; P = 0.077). CD23 was expressed in the mucosal germinal centres, but sCD23 was not related to presence of LNH. In CMSE, there was a trend for increase in serum sFasL (P = 0.07) and high levels associated with LNH (P = 0.025) and correlated with the IEL numbers (P < 0.05). Mucosal high endothelial venules adjacent to lymphoid follicles showed an intensive FasL expression.Conclusions:Serum sCD23 shows a trend of increment in CMSE and CD, and in the latter, sCD23 level may provide information about the severity of villous atrophy. In CMSE, high serum sFasL indicates both LNH and an increase of IELs, suggesting importance of FasL‐mediated mechanisms in the pathogenesis of these features characteristic of CMSE. Further studies are necessary to evaluate whether intensive FasL expression in mucosal high endothelial venules presents a regulatory element in mucosal immunity.
Lactose Malabsorption, Calcium Intake, and Bone Mass in Children and Adolescents
Authors: Medeiros Lilian C. da Silva , Lederman Henrique M. , de Morais Mauro B. 
Published: October 2011

ABSTRACTObjectives:The objective of the present study was to evaluate the calcium intake and bone mass in children and early adolescents in accordance with their absorption capacity to lactose.Patients and Methods:A transversal study was conducted on a sample composed of 76 individuals. Lactose malabsorption status was determined with hydrogen breath test. The hydrogen breath test was applied using 2 g of lactose per kilogram of weight up to a maximum of 50 g. A hydrogen increment ≥20 ppm in relation to fasting was used to characterize lactose malabsorption. Two 24‐hour recalls were applied for the evaluation of food consumption. Bone mineral content and bone mineral density were evaluated in the lumbar spine by dual‐energy x‐ray absorptiometry.Results:The prevalence of lactose malabsorption was 61.8%. The participants were divided into 2 groups: lactose malabsorbers (n = 47) and lactose absorbers (n = 29). There was no statistically significant difference (P > 0.05) between the groups with respect to the intake of total calcium, milk calcium, milk, cheese, yogurt, ice cream, and calcium density of the diet. Additionally, there was no difference with respect to the bone mineral content and the bone mineral density of the lumbar spine. Independent from lactose absorption capacity, it was observed that the majority of the children and early adolescents showed calcium intake lower than the recommended value.Conclusions:There was no relation among lactose malabsorption and bone densities, bone mineral content, or calcium intake within the present study.
Proton Pump Inhibitor Use in Infants
Authors: Chen Ii‐Lun , Gao Wen‐Yi , Johnson Aisha P. , Niak Ali , Troiani John , Korvick Joyce , Snow Nancy , Estes Kristina , Taylor Amy , Griebel Donna 
Published: October 2011

ABSTRACTThe Food and Drug Administration has completed its review of 4 clinical trials evaluating the use of proton pump inhibitors (PPIs) in infants (ages 1 month to <12 months) for the treatment of gastroesophageal reflux disease (GERD). An Advisory Committee meeting was held in November 2010 to discuss the potential reasons why PPI use in these trials failed to show a benefit in infants with GERD, and directions for future study. The present review summarizes the findings from the clinical trials. Potential mechanisms for the failed clinical trials are discussed. The safety of long‐term use is also discussed. As a result of our analysis and review, the authors agree with the Advisory Committee members that PPIs should not be administered to treat the symptoms of GERD in the otherwise healthy infant without the evidence of acid‐induced disease.
Quality of life and psychological status of patients with pemphigus vulgaris using Dermatology Life Quality Index and General Health Questionnaires
Authors: GHODSI S. Zahra , CHAMS‐DAVATCHI Cheyda , DANESHPAZHOOH Maryam , VALIKHANI Mahin , ESMAILI Nafiseh 
Published: October 2011

AbstractPemphigus vulgaris with painful chronic blisters and/or erosions on skin and mucosa can impair quality of life (QOL). Therapeutic modalities in the long run can have additional negative impact. There are few studies that have focused on QOL of such patients except in treated cases. The aim of this study was to describe the effect of the disease per se on QOL before receiving treatment and evaluation of psychological status of the patients and its effect on their QOL. A total of 61 patients with newly diagnosed non‐treated pemphigus vulgaris participated in the study. The Persian version of the Dermatology Life Quality Index (DLQI) questionnaire was used to evaluate their QOL and the 28‐item General Health Questionnaire (GHQ‐28) for their psychological status. In this study, the mean DLQI score was 10.9 ± 6.9. QOL was worse in patients with nasal and pharynx involvement, with positive Nikolsky sign, patients with severe skin involvement and those who showed the symptom of itching. There was a negative correlation between DLQI score and duration of the disease. More than 77% of patients experienced anxiety and depression with more impaired QOL. In conclusion, pemphigus vulgaris is responsible for great alteration in QOL, especially in its severe form. The disease in its initial stage may have greater impact on the QOL. The high probability of anxiety and depression in these patients and its negative effect on QOL should be taken into account in the management of these patients right from the start of the treatment.
miR‐155 modulates microglia‐mediated immune response by down‐regulating SOCS‐1 and promoting cytokine and nitric oxide production
Authors: Cardoso Ana L. , Guedes Joana R. , Pereira de Almeida Luís , Pedroso de Lima Maria C. 
Published: October 2011

SummaryInnate immunity constitutes the first line of defence against both external and endogenous threats in the brain, and microglia cells are considered key mediators of this process. Recent studies have shown that microRNAs (miRNAs) may play a determinant role in the regulation of gene expression during innate immune responses. The major goal of this work was to investigate the contribution of a specific miRNA – miR‐155 – to the modulation of the microglia‐mediated immune response. For this purpose, in vitro studies were performed in N9 microglia cells to evaluate changes in the levels of this miRNA following microglia activation. A strong up‐regulation of miR‐155 expression was observed following microglia exposure to lipopolysaccharide, which was consistent with a decrease in the levels of the suppressor of cytokine signalling 1 (SOCS‐1) protein, a key inhibitor of the inflammatory process and a predicted target of miR‐155. The miR‐155 knockdown by anti‐miRNA oligonucleotides up‐regulated SOCS‐1 mRNA and protein levels and significantly decreased the production of nitric oxide and the expression of inflammatory cytokines and inducible nitric oxide synthase. Finally, treatment of neuronal primary cultures with conditioned medium obtained from microglia cells, in which miR‐155 was inhibited before cell activation, decreased inflammatory‐mediated neuronal cell death. Overall, our results show that miR‐155 has a pro‐inflammatory role in microglia and is necessary for the progression of the immune response through the modulation of SOCS‐1, suggesting that, in a chronic inflammatory context, miR‐155 inhibition can have a neuroprotective effect.