bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimal Growth and Lower Fat Mass in Preterm Infants Fed a Protein‐enriched Postdischarge Formula
Authors: Amesz Eline M , Schaafsma Anne , Cranendonk Anneke , Lafeber Harrie N 
Published: January 2010

ABSTRACTBackground and Objectives:Postdischarge formulas with extra energy and protein improve short‐term growth but may also influence long‐term body composition in an unwanted manner. Energy‐ and protein‐enriched formulas with an increased protein‐to‐energy ratio improves gain of lean mass. The objective of the study was to investigate whether feeding a nutrient‐enriched formula without extra energy after term, usually 3 to 4 weeks after discharge, would influence growth and body composition in infancy.Methods:In this randomized controlled trial preterm infants were fed fortified human milk or preterm formula until term. At term, 102 infants were randomized to a nutrient‐enriched formula without extra energy or standard formula until 6 months corrected age. Twenty‐six infants received unfortified human milk after term. At term and 6 months corrected age, anthropometry and a dual‐energy x‐ray absorptiometry (DEXA) scan were performed. Lean and fat mass (FM) were corrected for height.Results:There were no differences in growth or body size between the feeding groups. Infants fed the enriched formula gained less FM and had lower FM corrected for body size at 6 months corrected age than infants fed standard formula. Infants fed human milk had lower lean mass and higher FM corrected for body size at 6 months corrected age than formula‐fed infants.Conclusions:Feeding nutrient‐enriched formula without extra energy after term does not change quantity of growth but does influence type of weight gain and body composition of preterm infants. Infants fed the nutrient‐enriched formula had lower FM corrected for body size at 6 months corrected age than infants fed standard formula or human milk.
Whole‐blood–free Choline and Choline Metabolites in Infants Who Require Chronic Parenteral Nutrition Therapy
Authors: Sentongo Timothy A , Kumar Praveen , Karza Kristen , Keys Lisa , Iyer Kishore , Buchman Alan L 
Published: January 2010

ABSTRACTBackground and Aim:Choline deficiency is associated with hepatic dysfunction. Parenteral nutrition (PN) and lipid emulsions contain phosphatidylcholine (PtdCho) but insignificant free choline (FCho). PtdCho is sequentially degraded to glycerolphosphocholine (GPCho), phosphocholine (PCho), and finally to FCho. Biosynthesis of FCho may be insufficient during PN therapy. The aim of the study was to examine the status of FCho and related metabolites in infants on prolonged (≥4 weeks) PN.Methods:Whole blood concentrations of FCho, PtdCho, GPCho, and PCho were measured and compared in infants on PN and infants on enteral feeds (controls).Results:Infants on PN (n = 14) had higher birth weight but same postnatal age as controls (n = 14) (mean ± standard deviation) 8.3 ± 3.9 versus 7.4 ± 3.6 weeks. Parenteral nutrition was associated with increased PtdCho 1761 ± 452 versus 1471 ± 221 nmol/mL,P= 0.04. Mean whole blood FCho, GPCho, and PCho concentrations did not differ significantly in PN versus controls: 40.0 ± 15.4 versus 50.8 ± 49.7, 16.4 ± 14.5 versus 25.2 ± 29.3, and 15.3 ± 13.5 versus 22.0 ± 14.8 nmol/mL, respectively. However, PCho was positively correlated with GPCho in controls (r= 0.91,P< 0.01) but not PN (r= 0.24,P= NS), and infants receiving >90% of daily energy intake from PN (n = 6) had decreased PCho, 5.7 ± 4.1 nmol/mL, compared with those receiving <90% of daily energy intake (n = 8) 22.5 ± 13.7 nmol/mL,P< 0.05, and controls, 22.0 ± 14.8 nmol/mL,P< 0.01.Conclusions:Decreased whole‐blood concentrations of choline suggest possible evidence of choline deficiency as illustrated by decreased whole‐blood PCho. Choline supplementation should be investigated in infants who require prolonged PN, and whole‐blood PCho can be used to monitor response.
Characteristics of Gastroesophageal Reflux and Potential Risk of Gastric Content Aspiration in Children With Cystic Fibrosis
Authors: Blondeau K , Pauwels A , Dupont LJ , Mertens V , Proesmans M , Orel R , Brecelj J , López‐Alonso M , Moya MJ , Malfroot A , De Wachter E , Vandenplas Y , Hauser B , Sifrim D 
Published: January 2010

ABSTRACTObjectives:Increased gastroesophageal reflux (GER) is common in children with cystic fibrosis (CF). We studied the occurrence of acid, weakly acidic (WA), and weakly alkaline (WALK) reflux in children with CF and evaluated a possible surrogate marker for risk of gastric content aspiration.Patients and Methods:Twenty‐four children with CF underwent impedance‐pH monitoring for detection of acid (pH < 4), WA (pH 4‐7), and WALK‐GER (pH ≥ 7). In 11 children, cough was objectively recorded with esophageal manometry and the symptom association probability was calculated to determine the reflux‐cough relation. Presence of bile acids (BA) was measured in the saliva of 65 patients with CF and 23 healthy children, respectively.Results:Sixteen of the 24 children had increased GER (esophageal acid exposure). The majority of reflux events were acidic in nature. WA reflux was less common and WALK reflux was rare. The sequence reflux‐cough was found in 8 of the 11 children and 1 of 11 children had a positive symptom association probability for reflux‐cough. The sequence cough‐reflux was found in only 3 of the 11 children. Only a small fraction of the total esophageal acid and volume exposure was secondary to cough. Twenty‐three of the 65 children with CF had BA in saliva compared with none of the healthy controls.Conclusions:Although WA‐GER is uncommon, acid GER is prevalent in children with CF. It is a primary phenomenon and is not secondary to cough. One third of the children with CF have BA in saliva, which may indicate an increased risk for aspiration. However, the impact of salivary BA and potential aspiration on CF pulmonary disease needs further investigation.
Ascitic Form of Sporadic Acute Viral Hepatitis in Children: A Distinct Entity for Recognition
Authors: Yachha Surender K , Goel Amit , Khanna Vikrant , Poddar Ujjal , Srivastava Anshu , Singh Uttam 
Published: January 2010

ABSTRACTBackground and Objectives:This study looked at the frequency and differences in presentation, laboratory parameters, and outcome between ascitic acute viral hepatitis (AAVH) and nonascitic acute viral hepatitis (NAVH) in children.Methods:Diagnosis of AVH was based on clinical features, >3‐fold elevation of alanine aminotransferase, viral marker positivity (IgM antihepatitis A virus, IgM antihepatitis E virus, hepatitis B surface antigen, and IgM antihepatitis B core antigen) at presentation, absence of history of liver disease, and subsequent normalization within 6 months of clinical features and liver functions including sustained resolution of ascites in AAVH on follow‐up.Results:A total of 139 children (121 children with NAVH and 18 with AAVH, 12.9%) were studied. Children with AAVH in comparison with those with NAVH were younger (median age 4 vs 8 years), had lower frequency of prodrome (22% vs 51%), lower serum albumin (median 2.8 vs 3.7 g/dL), low total serum protein (median 6.5 vs 7.4 g/dL), and prolongation of prothrombin time (median 4.8 vs 1.05 seconds); all P < 0.03. No significant differences were found in sex, height standard deviation scores, duration of symptoms, liver span or consistency, transaminases, alkaline phosphatase, and etiology of NAVH versus AAVH. Among the AAVH group clinically detectable ascites was present in 38.9% (7/18), spontaneous bacterial peritonitis in 11%, and diuretics had to be used in 44% of cases. Ascites resolved in all of the cases in 8 weeks (94.4% cases in <4 weeks) and liver functions normalized in 17%, 50%, and 33% cases in <4, 4 to 8, and >8 weeks duration, respectively.Conclusions:We report AAVH as a distinct entity that affects younger children. This subgroup has compromised biosynthetic liver functions irrespective of viral etiology with total recovery.
Aluminum Content of Parenteral Nutrition in Neonates: Measured Versus Calculated Levels
Authors: Poole Robert L , Schiff Linda , Hintz Susan R , Wong Allison , Mackenzie Nicol , Kerner John A 
Published: January 2010

ABSTRACTBackground and Objective:Aluminum (Al) is associated with significant central nervous system toxicity and bone and liver damage. Because Al is a contaminant of parenteral nutrition (PN) components including calcium and phosphate additives, premature infants are at potentially high risk for toxicity. The US Food and Drug Administration (FDA) has mandated PN component product labeling and recommended maximum Al daily exposure limits. The objective of this article is to determine the actual Al content of neonatal PN solutions, compare these values to the calculated amounts from manufacturers' PN product labels, and ascertain whether the actual Al exposure exceeds the FDA recommended maximum of 5 μg · kg−1 · day−1.Materials and Methods:Samples from 40 neonatal patient PN solutions were selected for sampling and Al content determination. Samples were also taken from 16 manufacturer's component products used in PN formulation. All of the samples were sent to Mayo Laboratories for Al content measurement. The calculated Al concentrations in PN samples were determined from the manufacturer's labeled content.Results:Both measured and calculated Al concentrations exceeded the FDA recommended safe limit of <5 μg · kg−1 · day−1. The actual measured Al content was significantly lower than the calculated Al content in both the patient PN solutions and the component product samples.Conclusions:Al exposure exceeded the FDA recommended maximum limit for all patient samples; however, the actual measured Al content of all the samples was significantly less than the calculated Al content based on manufacturer's labels. These findings suggest that manufacturers label their products with actual Al content at the time of product release rather than at time of expiration. Periodic monitoring of Al levels should be considered with prolonged PN therapy. Changes in manufacturing processes, including the use of better raw materials, are essential to reduce Al contamination to meet FDA mandates.
Increased Expression of Serum‐ and Glucocorticoid‐regulated Kinase‐1 in the Duodenal Mucosa of Children With Coeliac Disease
Authors: Szebeni Beáta , Vannay Ádám , Sziksz Erna , Prókai Ágnes , Cseh Áron , Veres Gábor , Dezsőfi Antal , Győrffy Hajnalka , Szabó IR Korponay , Arató András 
Published: January 2010

ABSTRACTObjectives:Enterocyte apoptosis induced by activated intraepithelial lymphocytes is increased in coeliac disease (CD). Serum‐ and glucocorticoid‐regulated kinase‐1 (SGK1) is a serine/threonine protein kinase that may inhibit apoptosis and compensate for the excessive death of surface epithelial cells. The significance of SGK1 in CD is elusive so far. The aim of this study was to characterise the expression and localisation of SGK1 in duodenal biopsy samples taken from children with untreated CD, children with treated CD, and controls.Patients and Methods:Duodenal biopsy specimens were collected from 16 children with untreated CD, 9 children with treated CD, and 10 controls. The mRNA expression of SGK1 was determined by real‐time reverse transcription‐polymerase chain reaction. SGK1 and phosphorylated (P)‐SGK1 protein levels and their localisation were determined by Western blot and immunfluorescent staining, respectively.Results:We found increased SGK1‐mRNA expression as well as higher SGK1 and P‐SGK1 protein levels in the duodenal mucosa of children with untreated CD compared with controls. In the duodenal mucosa of children with treated CD, SGK1‐mRNA expression was decreased and SGK1 and P‐SGK1 protein levels were lower than in untreated CD. SGK1 and P‐SGK1 staining intensity was stronger in duodenal villous enterocytes of children with untreated CD compared with treated CD.Conclusions:Our results of increased expression of SGK1 in untreated CD may suggest its contribution to the enterocyte survival in this disease.
Derivation of a Clinical Prediction Rule for the Noninvasive Diagnosis of Varices in Children
Authors: Gana Juan C , Turner Dan , Roberts Eve A , Ling Simon C 
Published: January 2010

ABSTRACTBackground and Objectives:Identification of children who are at high risk for having varices using noninvasive tests would enable the selection of children for future studies of primary prophylaxis of variceal hemorrhage, but this has been inadequately studied. The objective of the study was to derive a noninvasive clinical prediction rule that is able to identify children with esophageal varices.Methods:Fifty‐one consecutive children with liver disease or portal hypertension who underwent endoscopy were included in the present retrospective study. At endoscopy, variceal size was graded on a 4‐point Likert scale. Results of physical examination, blood tests, and abdominal ultrasound scan (USS) were recorded. Spleen length on USS was expressed as a standard deviation score (z score). A descriptive univariate analysis was performed on variables that were potentially associated with esophageal varices and multivariate logistic regression was then modeled to derive a clinical prediction rule.Results:Esophageal varices were found in 17 of the 51 children (33%). Variables found to differ significantly between children with and without varices included platelet/spleen‐length z score ratio (P < 0.001), platelet count (P < 0.001), international normalized ratio (P = 0.001), aspartate aminotransferase/alanine aminotransferase ratio (P = 0.002), and albumin (P = 0.003). Using multivariate logistic regression, a model with platelet count, spleen length z score, and albumin as the independent variables had the best fit. Area under the receiver operating characteristic curve for this clinical prediction rule was 0.93 (95% confidence interval 0.85–0.99), sensitivity 94%, specificity 81%, positive predictive value 0.83, negative predictive value 0.94, positive likelihood ratio 5, and negative likelihood ratio 0.06.Conclusions:This clinical prediction rule is a simple noninvasive measure that may identify children at high risk for esophageal varices. A prospective validation study is in progress.
In Situ Expression of cagA and Risk of Gastroduodenal Disease in Helicobacter pylori–infected Children
Authors: Rick James R , Goldman Matthew , Semino‐Mora Cristina , Liu Hui , Olsen Cara , Rueda‐Pedraza Eugenia , Sullivan Carolyn , Dubois Andre 
Published: January 2010

ABSTRACTBackground and Aim:Gastroduodenal disease is more common among adults and children with cagA+ Helicobacter pylori infection, but disease severity varies among those infected with cagA+ strains. We examined whether cagA in situ expression can predict disease manifestations among H pylori–infected children.Patients and Methods:Fifty‐one children were selected from 805 patients with abdominal symptoms who underwent esophagogastroduodenoscopy with gastric biopsies. Endoscopic and histologic gastritis were scored and H pylori colonization was quantified by Genta stain and in situ hybridization expression of 16S rRNA and cagA.Results:Endoscopy was either normal (n = 14) or demonstrated nodularity (n = 18), gastric ulcer (n = 8) or duodenal ulcer (n = 11). H pylori was present in 7, 18, 6, and 10 children, respectively. Expression of 16S rRNA and cagA were significantly higher in children with ulcer compared with normal children. The fraction of H pylori bacteria expressing cagA in situ was higher in children with ulcer compared to those with endoscopic nodularity (P < 0.05).Conclusions:Thus, cagA in situ expression is increased in H pylori–infected children with peptic ulcers and may play a role in the pathogenesis of peptic ulcer disease during childhood. Determination of in situ expression of cagA complements traditional isolation and in vitro testing of single‐colony isolates.
Parenteral Fish Oil as Monotherapy Prevents Essential Fatty Acid Deficiency in Parenteral Nutrition–dependent Patients
Authors: de Meijer Vincent E , Le Hau D , Meisel Jonathan A , Gura Kathleen M , Puder Mark 
Published: January 2010

ABSTRACTObjective:The use of fish oil–based emulsions as the sole source of fat for patients receiving parenteral nutrition (PN) has raised concerns for the development of essential fatty acid deficiency (EFAD), hindering its adoption into clinical practice. The purpose of the present study was to examine fatty acid profiles of patients receiving no enteral energy, while completely dependent on PN and an intravenous fish oil–based lipid emulsion, for onset of EFAD and maintenance of growth.Patients and Methods:Prospectively collected data from 10 patients were reviewed for evidence of EFAD, defined as a triene:tetraene ratio >0.2. Gestational age–adjusted z scores for length, growth, and head circumference at baseline were compared with the corresponding z scores at time of censoring. All of the patients received PN with a fish oil–based lipid emulsion at 1 g · kg−1 · day−1 as the sole source of fat energy for at least 1 month. The fish oil monotherapy was used under a compassionate use protocol.Results:Median gestational age at the time of birth was 35 weeks, and median age at the start of treatment was 3.5 months. After a median time of 3.8 months on exclusive PN and fish oil–based lipid emulsion, none of the patients developed biochemical or clinical evidence of EFAD. z scores were not statistically different, indicating no growth impairment. Median direct bilirubin levels improved in 9 patients from 6.8 to 0.9 mg/dL (P = 0.009).Conclusions:When dosed appropriately, fish oil–based lipid emulsions contain sufficient amounts of essential fatty acids to prevent EFAD and sustain growth in patients who are completely dependent on PN.
Characterization of ATP8B1 Gene Mutations and a Hot‐linked Mutation Found in Chinese Children With Progressive Intrahepatic Cholestasis and Low GGT
Authors: Liu Li‐yan , Wang Xiao‐hong , Wang Zhong‐lin , Zhu Qi‐rong , Wang Jian‐She 
Published: January 2010

ABSTRACTObjectives:The aim of the study was to elucidate the role and characteristics of ATP8B1 gene mutations in mainland Chinese children with progressive intrahepatic cholestasis and low γ‐glutamyltransferase (GGT).Patients and Methods:Twenty‐four children who presented with progressive intrahepatic cholestasis and low GGT were admitted to a tertiary pediatric hospital in eastern China from January 2004 to July 2007. Five children with homozygous or compound heterozygous ABCB11 gene mutations were excluded from the study. All encoding exons and their flanking areas of ATP8B1 gene were sequenced in the remaining 19 patients, in whom only 1 or no mutation of ABCB11 was found. Clinical features and liver histology obtained by reviewing the medical records were compared among patients with different genotypes.Results:Nine mutations of ATP8B1 gene were found in 9 patients. All of them were novel except for mutations I694N and R952X. A linked P209T and IVS6+5G>T mutation was found in 4 of 9 patients, including 2 homozygotes and 2 heterozygotes. Giant cell transformation of hepatocytes was demonstrated in 1 of 6 patients with ATP8B1 mutations and 4 of 5 patients with ABCB11 mutations.Conclusions:ATP8B1 gene mutations play an important role in Chinese patients with progressive intrahepatic cholestasis and low GGT. The linked mutation P209T and IVS6+5G>T is a hot mutation in the Chinese population. Histological examination may be helpful in differentiating familial intrahepatic cholestasis type 1 from bile salt export pump‐related disease.
Chronic Hepatitis C Virus Infection in Children
Authors: Mohan Neelam , González‐Peralta Regino P , Fujisawa Tomoo , Chang Mei‐Hwei , Heller Solange , Jara Paloma , Kelly Deirdre , Mieli‐Vergani Giorgina , Shah Uzma , Murray Karen F 
Published: January 2010

ABSTRACTThe importance of hepatitis C viral infection in the health care of children has grown in recent decades. More is now known about the epidemiology of this infection in children and the progression of disease in the pediatric age group, and the treatment options are increasing. In this review, we update readers on the state of our understanding of hepatitis C infection in children, provide the current recommendations for monitoring and treatment, and discuss emerging therapies.
Characterization of the Rice PHO1 Gene Family Reveals a Key Role for OsPHO1;2 in Phosphate Homeostasis and the Evolution of a Distinct Clade in Dicotyledons
Authors: Secco David , Baumann Arnaud , Poirier Yves 
Published: January 2010

Abstract
Phosphate homeostasis was studied in a monocotyledonous model plant through the characterization of the PHO1 gene family in rice (Oryza sativa). Bioinformatics and phylogenetic analysis showed that the rice genome has three PHO1 homologs, which cluster with the Arabidopsis (Arabidopsis thaliana) AtPHO1 and AtPHO1;H1, the only two genes known to be involved in root-to-shoot transfer of phosphate. In contrast to the Arabidopsis PHO1 gene family, all three rice PHO1 genes have a cis-natural antisense transcript located at the 5 ′ end of the genes. Strand-specific quantitative reverse transcription-PCR analyses revealed distinct patterns of expression for sense and antisense transcripts for all three genes, both at the level of tissue expression and in response to nutrient stress. The most abundantly expressed gene was OsPHO1;2 in the roots, for both sense and antisense transcripts. However, while the OsPHO1;2 sense transcript was relatively stable under various nutrient deficiencies, the antisense transcript was highly induced by inorganic phosphate (Pi) deficiency. Characterization of Ospho1;1 and Ospho1;2 insertion mutants revealed that only Ospho1;2 mutants had defects in Pi homeostasis, namely strong reduction in Pi transfer from root to shoot, which was accompanied by low-shoot and high-root Pi. Our data identify OsPHO1;2 as playing a key role in the transfer of Pi from roots to shoots in rice, and indicate that this gene could be regulated by its cis-natural antisense transcripts. Furthermore, phylogenetic analysis of PHO1 homologs in monocotyledons and dicotyledons revealed the emergence of a distinct clade of PHO1 genes in dicotyledons, which include members having roles other than long-distance Pi transport.
Comparison of Developmental and Stress-Induced Nodule Senescence in Medicago truncatula
Authors: Pérez Guerra Juan Carlos , Coussens Griet , De Keyser Annick , De Rycke Riet , De Bodt Stefanie , Van De Velde Willem , Goormachtig Sofie , Holsters Marcelle 
Published: January 2010

Abstract
Mature indeterminate Medicago truncatula nodules are zonated with an apical meristem, an infection zone, a fixation zone with nitrogen-fixing bacteroids, and a “developmental” senescence zone that follows nodule growth with a conical front originating in the center of the fixation zone. In nitrogen-fixing cells, senescence is initiated coincidently with the expression of a family of conserved cysteine proteases that might be involved in the degradation of symbiotic structures. Environmental stress, such as prolonged dark treatment, interferes with nodule functioning and triggers a fast and global nodule senescence. Developmental and dark stress-induced senescence have several different structural and expression features, suggesting at least partly divergent underlying molecular mechanisms.