bluuebunny/crossref_metadata_2025_split huggingface dataset:
Micronutrient Deficiencies in Patients With Typical and Atypical Celiac Disease
Authors: Botero‐López Jorge E. , Araya Magdalena , Parada Alejandra , Méndez Marco A. , Pizarro Fernando , Espinosa Nelly , Canales Paulina , Alarcón Teresa 
Published: October 2011

ABSTRACTObjective:The extent of the digestive/absorptive involvement in atypical presentation of celiac disease (CD) is not always clear. The aim of the study was to assess nutritional status of iron (Fe), copper (Cu), and zinc (Zn) in patients with typical CD (TCD) and atypical CD (ACD).Patients and Methods:A cross‐sectional study was done in patients with TCD, ACD, and healthy controls (HC). Hemoglobin, serum ferritin, free erythrocyte protoporphyrin, Fe, Cu, ceruloplasmin, Zn, anti‐endomysial antibodies, and anti‐tissue transglutaminase antibodies were measured. Data were analyzed by Kruskal‐Wallis, principal component analysis, and linear discriminant analysis.Results:One hundred nine individuals were studied (54 TCD, 19 ACD, 36 HC); mean age ± standard deviation was 23 ± 15.8 (range 1.6–75.4) years. Median and range of hemoglobin were 12.8 g/dL (8.1–17.6) in TCD, 12.4 g/dL (10.5–14.5) in ACD, and 13.6 g/dL (11.1–16.7) in HC (P < 0.0001); serum ferritin was 17.7 μg/L (2.9–157), 10.8 μg/L (2.7–39.8), and 28.7 μg/L (4.5–127.2), respectively (P < 0.01). Cu was 105 μg/dL (60–185), 97.5 μg/dL (40–130), and 125 μg/dL (80–205), respectively (P < 0.05). Ceruloplasmin was 21.6 mg/dL (14.2–73.2), 22.6 mg/dL (0.9–34.3), and 32.1 mg/dL (5.8–72.6), respectively (P < 0.01). There were no differences in Fe, free erythrocyte protoporphyrin, and Zn. Principal component analysis showed that 58% of observed variability was explained by Fe and Cu indicators. Linear discriminant analysis revealed differences between CD and HC (P < 0.0001), with high values of correct classification for TCD (73%) and HC (72%), but not ACD (16%), which were mostly classified as TCD (79%).Conclusions:Deficiency of micronutrients was found both in typical as well as in atypical cases.
Quality of Life and Level of Anxiety in Youths With Inflammatory Bowel Disease in Ireland
Authors: Kilroy Sarah , Nolan Elizabeth , Sarma Kiran M. 
Published: October 2011

ABSTRACTObjective:Little is known of the psychological well‐being of youths diagnosed as having inflammatory bowel diseases (IBDs). Much of the literature available focuses on adults with IBD and those that focus on youths tend to use generic measures of health‐related quality of life (QOL). The primary aim of this research is to obtain a profile of the IBD‐related QOL and levels of anxiety of youths of ages 9 to 17 years presenting with IBD to a national hospital. It is also intended to examine the clinical utility of the IMPACT‐III questionnaire.Patients and Methods:A questionnaire battery containing the IMPACT‐III questionnaire and the Spence Children's Anxiety Scale (SCAS) was posted to all of the patients on the database of the gastrointestinal clinic between the ages of 9 and 17 years (n = 215), resulting in an achieved sample size of 79 (response rate of 36.7%).Results:It was found that 63% (n = 50) of participants had total IMPACT‐III scores below the cutoff of 143, previously established for remission. In addition, 5 participants reported being unhappy with their lives. Thirty‐nine percent (n = 31) of participants had elevated anxiety symptoms on ≥1 of the SCAS subscales. Anxiety level was found to be a significant predictor of QOL (β = −0.616, P = 0.001). Qualitative feedback highlighted the variability of physical and psychological symptoms participants experience, feelings of anger or embarrassment around the condition, and posed numerous questions, indicating that there is a lack of knowledge among patients around IBD.Conclusions:These findings support the utility of screening patients with IBD for psychological difficulties and estimates of QOL. Further research and group interventions are recommended.
Validation of an Instrument to Measure Quality of Life in British Children With Inflammatory Bowel Disease
Authors: Ogden C.A. , Akobeng A.K. , Abbott J. , Aggett P. , Sood M.R. , Thomas A.G. 
Published: October 2011

ABSTRACTObjective:To validate IMPACT‐III (UK), a health‐related quality of life (HRQoL) instrument, in British children with inflammatory bowel disease (IBD).Patients and Methods:One hundred six children and parents were invited to participate. IMPACT‐III (UK) was validated by inspection by health professionals and children to assess face and content validity, factor analysis to determine optimum domain structure, use of Cronbach alpha coefficients to test internal reliability, ANOVA to assess discriminant validity, correlation with the Child Health Questionnaire to assess concurrent validity, and use of intraclass correlation coefficients to assess test‐retest reliability. The independent samples t test was used to measure differences between sexes and age groups, and between paper and computerised versions of IMPACT‐III (UK).Results:IMPACT‐III (UK) had good face and content validity. The most robust factor solution was a 5‐domain structure: body image, embarrassment, energy, IBD symptoms, and worries/concerns about IBD, all of which demonstrated good internal reliability (α = 0.74–0.88). Discriminant validity was demonstrated by significant (*P < 0.05, **P < 0.01) differences in HRQoL scores between the severe, moderate, and inactive/mild symptom severity groups for the embarrassment scale (63.7* vs 81.0 vs 81.2), IBD symptom scale (45.0** vs 64.2* vs 80.6), and the energy scale (46.4* vs 62.1* vs 77.7). Concurrent validity of IMPACT‐III (UK) with comparable domains of the Child Health Questionnaire was confirmed. Test‐retest reliability was confirmed with good intraclass correlation coefficients of 0.66 to 0.84. Paper and computer versions of IMPACT‐III (UK) collected comparable scores, and there were no differences between the sexes and age groups.Conclusions:IMPACT‐III (UK) appears to be a useful tool to measure HRQoL in British children with IBD.
Late Adolescent Linear Growth Pattern in Pediatric‐onset Inflammatory Bowel Disease
Authors: Hood Helen C. , Cohen Laurie E. , Lee Jessica J. 
Published: October 2011

ABSTRACTThe late adolescent linear growth pattern of pediatric patients with inflammatory bowel disease (IBD) has rarely been studied. We retrospectively reviewed the height measurements of 475 patients with IBD at 16, 18, and 20 years old for girls, and 18 and 20 years old for boys. We also compared Bayley‐Pinneau bone age–predicted and –measured adult heights. Female patients had mean height‐for‐age z scores of −0.25 ± 1.0 at 16 years and −0.23 ± 1.0 at 18 years (P = 0.189); boys had z scores of −0.30 ± 1.1 at 18 years and −0.26 ± 1.0 at 20 years, respectively (P = 0.105). Bayley‐Pinneau height predictions were 1.5 and 2.4 cm greater than measured height for 18‐year‐old girls (P = 0.060) and 20‐year‐old boys (P = 0.017), respectively. Our data indicate that most patients with IBD attain adult height within normal timing for the population. Hence, early identification of growth impairment is critical to appropriate management in IBD.
Impaired Mucosal Barrier Function in the Small Intestine of the Cystic Fibrosis Mouse
Authors: De Lisle Robert C. , Mueller Racquel , Boyd Megan 
Published: October 2011

ABSTRACTObjectives:The intestinal mucosal barrier protects the body from the large numbers of microbes that inhabit the intestines and the molecules they release. Intestinal barrier function is impaired in humans with cystic fibrosis (CF), including reduced activity of the lipopolysaccharide‐detoxifying enzyme intestinal alkaline phosphatase (IAP) and increased permeability. The objective of this study was to determine the suitability of using the CF mouse to investigate intestinal barrier function, and whether interventions that are beneficial for the CF mouse intestinal phenotype (antibiotics or laxative), would improve barrier function. Also tested were the effects of exogenous IAP administration.Materials and Methods:The Cftrtm1UNC mouse was used. IAP expression (encoded by the murine Akp3 gene) was measured by quantitative reverse transcription‐polymerase chain reaction and enzyme activity. Intestinal permeability was assessed by measuring rhodamine‐dextran plasma levels following gavage.Results:CF mice had 40% Akp3 mRNA expression and 30% IAP enzyme activity, as compared with wild‐type mice. Oral antibiotics and laxative treatments normalized Akp3 expression and IAP enzyme activity in the CF intestine. CF mice had a 5‐fold greater transfer of rhodamine‐dextran from gut lumen to blood. Antibiotic and laxative treatments reduced intestinal permeability in CF mice. Administration of exogenous purified IAP to CF mice reduced intestinal permeability to wild‐type levels and reduced small intestinal bacterial overgrowth by >80%.Conclusions:The CF mouse intestine has impaired mucosal barrier function, similar to human CF. Interventions that improve other aspects of the CF intestinal phenotype (antibiotics and laxative) also increase IAP activity and decrease intestinal permeability in CF mice. Exogenous IAP improve permeability and strongly reduce bacterial overgrowth in CF mice, suggesting this may be a useful therapy for CF.
Intestinal Rehabilitation and Bowel Reconstructive Surgery
Authors: Khalil Basem A. , Ba'ath Muhammad E. , Aziz Anuar , Forsythe Lynette , Gozzini Sara , Murphy Fiona , Carlson Gordon , Bianchi Adrian , Morabito Antonino 
Published: October 2011

ABSTRACTBackground and Aim:Short bowel syndrome poses a great challenge to pediatric teams. Several innovative techniques in the management of total parenteral nutrition (TPN) and bowel reconstructive surgery have improved the outcomes of these children. The authors present their experience during the last decade as a specialist unit using improved techniques and multidisciplinary approaches in the management of this condition.Methods:All of the children presenting with short bowel syndrome between 2000 and 2009 were identified. Diagnosis, length of residual gut, age at definitive surgery, length of gut prelengthening, length of gut postlengthening, TPN status, and survival were recorded. Median values were calculated.Results:Twenty‐seven children were identified (14 boys, 13 girls). Overall survival was 92%. Two children died. Nineteen children required bowel lengthening and 8 children had simple bowel reconstruction while on our protocol. Overall median age at definitive surgery was 12 months. Overall median residual gut length for these was 35.5 cm, whereas the median residual gut length for patients undergoing bowel lengthening was 25 cm. Postbowel lengthening, the median gut length was 90 cm. TPN data were unavailable for 2 patients. Overall, excluding the 2 patients who died and the 2 we have no TPN data on, of 23 patients, 21 (91%) are now off TPN.Conclusions:Our series shows improved results not only with survival but also in the number of patients that are off TPN. Multidisciplinary approach consisting of both medical and surgical expertise is necessary in the management of these patients. The authors advocate centralisation of short gut services to experienced centers with multidisciplinary expertise.
Benefits of a New Pediatric Triple‐Chamber Bag for Parenteral Nutrition in Preterm Infants
Authors: Rigo Jacques , Marlowe Monica L. , Bonnot Denis , Senterre Thibault , Lapillonne Alexandre , Kermorvant‐Duchemin Elsa , Hascoet Jean Michel , Desandes Roxane , Malfilâtre Geneviève , Pladys Patrick , Beuchée Alain , Colomb Virginie 
Published: October 2011

ABSTRACTObjectives:The aim of this study was to evaluate the efficacy, safety, flexibility, and ease of handling and use of the Ped3CB‐A 300 mL, the first ready‐to‐use multichamber parenteral nutrition (PN) system, with optional lipid bag activation, specially designed for administration to preterm infants.Materials and Methods:In this prospective, open‐label, multicenter, noncomparative, phase III clinical trial, preterm infants were treated with Ped3CB‐A for 5 to 10 consecutive days.Results:A total of 113 preterm infants were enrolled in the study and 97 (birth weight 1382 ± 520 g; gestational age 31.2 ± 2.5 weeks; postnatal age administration 5.6 ± 6.1 days) were included in the per protocol analysis accounting for 854 perfusion days. Double‐chamber bag activation was used for 32 perfusion days. Macronutrient, electrolyte, and mineral supplements were primarily administered through a Y‐line or directly in the activated bag. In all, 199 additions (mainly sodium, 95%) were made to the Ped3CB‐A bags on 197 infusion days (23.1%) in 43 infants (44.3%). More than 1 of these nutrients was added to the bag on only 1 perfusion day. Mean and maximum parenteral nutrient intakes were 2.8 ± 0.7 and 3.6 ± 0.8 g amino acids per kilogram per day, and 80 ± 20 and 104 ± 22 kcal · kg−1 · day−1. Mean weight gain represented 10.0, 21.5, and 22.6 g · kg−1 · day−1 according to age at inclusion (0–3, 4–7, or >7 days of life). A visual analog scale was completed and produced positive results. No adverse events were attributable to the design of the Ped3CB‐A system.Conclusions:Ped3CB‐A provides easy‐to‐use, well‐balanced, and safe nutritional support. Nutritional intakes and weight gain were within the recent PN recommendations in preterm infants.
Heme Oxygenase‐1 Is Protective Against Nonsteroidal Anti‐inflammatory Drug–induced Gastric Ulcers
Authors: Uc Aliye , Zhu Xiaoyan , Wagner Brett A. , Buettner Garry R. , Berg Daniel J. 
Published: October 2011

ABSTRACTObjectives:Nonsteroidal anti‐inflammatory drugs (NSAIDs) are widely used for the treatment of pain, fever, and inflammation. Long‐term use of these drugs is associated with significant gastric injury. Activated neutrophils and oxidative stress seem to play a significant role in NSAID‐induced gastric mucosal damage. The objective of our study is to examine the protective effects of an antioxidant and anti‐inflammatory enzyme, heme oxygenase‐1 (HO‐1), in NSAID‐induced gastric injury.Methods:Mice were intraperitoneally injected with indomethacin (10 mg/kg) or sham. A specific inducer of HO‐1, cobalt protoporphyrin (5 mg/kg), was given 24 hours before indomethacin to allow for the expression of HO‐1. Controls received sham treatment. Twenty‐four hours after indomethacin injection, gastric tissue damage was examined with histology. HO‐1 expression was measured with immunoblot; cytokine levels were measured with enzyme‐linked immunosorbent assay. Neutrophil infiltration was quantified with myeloperoxidase assay. Using electron paramagnetic resonance and desferrioxamine, we measured the labile iron pool in the mouse stomach as a marker of oxidative stress.Results:Indomethacin caused gastric inflammation and ulcers, neutrophil activation, and increased tissue expression of interleukin‐6 and tumor necrosis factor‐alpha in mice. Inducing HO‐1 with cobalt protoporphyrin reduced gastric inflammation, number of stomach ulcers, tissue neutrophil activation, and proinflammatory cytokine expression caused by indomethacin.Conclusions:These findings suggest that the induction of an anti‐inflammatory and cytoprotective enzyme HO‐1 may be a strategy to overcome the gastrointestinal adverse effects limiting the use of NSAIDs.
Pediatric End‐stage Liver Disease Score in Acute Liver Failure to Assess Poor Prognosis
Authors: Sanchez Maria C. , D'Agostino Daniel E. 
Published: October 2011

ABSTRACTBackground and Aim:Although establishing accurate prognosis in acute liver failure (ALF) is of paramount importance, prognostic scoring systems still fail to achieve success. The pediatric end‐stage liver disease (PELD) score has been used as a predictor of mortality in children with chronic liver disease listed for liver transplantation (LT); however, experience with the PELD score in ALF is limited. The goal of the present study was to investigate the prognostic accuracy of the PELD score in children with ALF.Patients and Methods:PELD score was calculated based on results of blood tests obtained at hospital admission from June 1999 to January 2009, in 40 consecutive patients younger than 18 years who presented with ALF. Poor outcome was defined as LT or death.Results:Mean (±SD) age of patients was 5.3 ± 4.4 years (range 6 months–17 years); 52.5% were girls (n = 21). Etiologies of ALF were hepatitis A in 42.5% (17), indeterminate in 35% (14), autoimmune hepatitis in 17.5% (type 1 12.5% [n5], type 2 5% [n2]), and toxic in 5% (2). Mean PELD score was 34.92 ± 10.48 (range 6–55). PELD scores obtained on admission were significantly higher among nonsurvivors (39.8 ± 9.5) and recipients of an LT (39 ± 7.1) compared with those who survived without LT (31.3 ± 3) (P < 0.001). A cutoff of 33 in PELD score using receiver operating characteristic curves showed 81% specificity and 86% sensitivity for poor outcome (positive predictive value 92% and negative predictive value 69%; area under curve 0.88 95% confidence interval 0.77–1.0; P < 0.0001).Conclusions:PELD score obtained upon admission may be of help to establish the optimal timing for LT evaluation and listing. Further validation in larger and more diverse populations is needed.
Heating‐induced Bacteriological and Biochemical Modifications in Human Donor Milk After Holder Pasteurisation
Authors: de Segura Aránzazu Gómez , Escuder Diana , Montilla Antonia , Bustos Gerardo , Pallás Carmen , Fernández Leonides , Corzo Nieves , Rodríguez Juan M. 
Published: October 2011

ABSTRACTObjectives:The objectives of the present study were to enumerate and characterize the pathogenic potential of the Bacillus population that may survive holder pasteurisation of human milk and to evaluate the nutritional damage of this treatment using the furosine and lactulose indexes.Materials and Methods:Milk samples from 21 donors were heated at 62.5°C for 30 minutes. Bacterial counts, lactose, glucose, myoinositol, lactulose, and furosine were determined before and after the heat treatment. Some B cereus isolates that survived after pasteurisation were evaluated for toxigenic potential.Results:Nonpasteurised milk samples showed bacterial growth in most of the agar media tested. Bacterial survival after pasteurisation was observed in only 3 samples and, in these cases, the microorganisms isolated belonged to the species B cereus. Furosine could not be detected in any of the samples, whereas changes in lactose, glucose, and myoinositol concentrations after holder pasteurisation were not relevant. Lactulose was below the detection limit of the analytical method in nonpasteurised samples, whereas it was found at low levels in 62% of the samples after holder pasteurisation. The lactation period influenced myoinositol content because its concentration was significantly higher in transition milk than in mature or late lactation milk samples.Conclusions:Holder pasteurisation led to the destruction of bacteria present initially in donor milk samples, except for some B cereus that did not display a high virulence potential and did not modify significantly the concentration of the compounds analyzed in the present study.
Safety and performance of TCI pumps in a magnetic resonance imaging environment*
Authors: Adapa R. M. , Axell R. G. , Mangat J. S. , Carpenter T. A. , Absalom A. R. 
Published: October 2011

SummaryTarget controlled infusion (TCI) devices can be associated with significant safety concerns when used during magnetic resonance imaging (MRI). We tested the safety and compatibility of newer TCI systems in a 3‐Tesla MRI environment. Two Asena PK and two Agilia TCI pumps were used to administer TCI propofol (at target blood concentrations of 0.5 and 6.0 μg.ml−1) using the Marsh model under magnetic fields of up to 50 G with a T2‐weighted sequence. We assessed the devices for projectile risk, accuracy of drug delivery, alarm function and effects on MR image quality. Both devices did not demonstrate any significant deflection at the tested field strengths, and performed within acceptable limits (cumulative error in total delivered volume < 3%; maximum 10‐min interval error < 10%). The Asena pump caused minor artefacts on MR images. The TCI pumps tested perform well and safely implement pharmacokinetic software in a high magnetic field.
Evidence for assembly rules: limiting similarity within a saltmarsh
Authors: Wilson J. Bastow , Stubbs Wendy J. 
Published: October 2011

Summary1. We sought evidence for limiting similarity, a basic aspect of community structure, in three zones of a saltmarsh. Sampling was conducted at three spatial scales (grains), from a single point up to the scale of several square metres. Twenty‐three functional traits, related to the structure of the shoot and root systems and to nutrient status, were measured on each species present, separately in each community.2. Patterns of association between plant species were compared with those expected under a null model, to assess whether plants with similar functional traits tended to coexist or to separate, i.e. whether there was environmental filtering or limiting similarity. A patch null model was used, a type that tends to be conservative but that avoids spurious evidence of limiting similarity caused by environmental pseudoreplication. One overall and four univariate test statistics were calculated, to capture possible patterns in trait space whilst minimising the problem of multiple testing.3. In the Shrub community, overall evidence for even spacing of co‐occurring species in functional‐trait space, the pattern expected from the theory of limiting similarity, was seen at the area scale. In univariate tests in that community, there was evidence for even spacing in leaf lobation and leaf succulence, especially at small scales.4. In the Rush community, there was significant evidence for limiting similarity in several traits, especially those related to canopy interactions, but also in some root characteristics. However, clustering in other traits, presumably owing to microenvironmental filtering, reduced overall tests for limiting similarity to ‘marginal significance’ (0.1 > P > 0.05).5. In the species‐poor and salt‐stressed Salt turf, significant departures from the null model were sporadic and not consistent, although chlorophyll characters and leaf nitrogen concentration tended to be clustered.6. Synthesis: There was evidence for niche limitation in two of the communities – Rush and Shrub – apparently based on canopy interactions in both cases and perhaps also root interactions in the latter community. Limiting similarity can be an important force in community assembly. However, in situations when it cannot be demonstrated, we do not know whether trait‐based competition is absent or whether its signal is overwhelmed by other processes.