bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is Gluten Challenge Really Necessary for the Diagnosis of Coeliac Disease in Children Younger Than Age 2 Years?
Authors: Wolters Victorien M , van de Nadort Cissy , Gerritsen Susan AM , Kneepkens CM Frank , Ten Kate Fiebo JW , Gijsbers Caroline FM , Schweizer Joachim J , Nikkels Peter GJ , Benninga Marc A , Houwen Roderick HJ 
Published: May 2009

ABSTRACTObjective:In the diagnosis of coeliac disease (CD), gluten challenge is recommended for children under the age of 2 years at initial biopsy. The aim of the study was to investigate the diagnostic yield of gluten challenge in this group of children.Patients and Methods:We included children aged 2 years or younger who were analysed for possible CD and who had villous atrophy at initial small bowel biopsy in the period 1993–2004. We subsequently identified all patients who underwent a complete gluten challenge.Results:We identified 333 children with possible CD. In 100 children (30%), a gluten challenge was performed, with the diagnosis being confirmed in 97. Retrospectively, in 2 of the 3 children without mucosal relapse, data available before gluten challenge did not justify the initial diagnosis of CD. In the third patient, transient gluten intolerance could not be excluded. At first biopsy, the 2 children without mucosal relapse had negative serological parameters, whereas the third patient had IgA anti‐gliadin antibodies, but no IgA anti‐endomysium antibodies (EMA). Indeed, all of the patients with EMA at diagnosis had a relapse at gluten challenge.Conclusions:Routine gluten challenge in children younger than 2 years at initial diagnosis of CD has an extremely low diagnostic yield. We suggest that routine gluten challenge in this group of patients is not necessary when patients have villous atrophy in combination with EMA. Therefore, a revision of the current diagnostic criteria has to be considered.
Does the Enteral Feeding Advancement Affect Short‐term Outcomes in Very Low Birth Weight Infants?
Authors: Härtel Christoph , Haase Berit , Browning‐Carmo Kathryn , Gebauer Corinna , Kattner Evelyn , Kribs Angela , Segerer Hugo , Teig Norbert , Wense Axel von der , Wieg Christian , Herting Egbert , Göpel Wolfgang 
Published: May 2009

ABSTRACTBackground and Objectives:Controversy exists regarding the optimal enteral feeding regimen of very low birth weight infants (VLBW). Rapid advancement of enteral feeding has been associated with an increased rate of necrotizing enterocolitis. In contrast, delaying enteral feeding may have unfavorable effects on nutrition, growth, and neurodevelopment. The aim is to compare the short‐term outcomes of VLBW infants in tertiary care centers according to their enteral feeding advancement.Patients and Methods:We prospectively studied the influence of center‐specific enteral feeding advancement in 1430 VLBW infants recruited from 13 tertiary neonatal intensive care units in Germany on short‐term outcome parameters. The centers were post hoc stratified to “rapid advancement to full enteral feeds” (median duration of advancement to full enteral feeds ≤12.5 days; 6 centers), that is, rapid advancement (RA), or “slow advancement to full enteral feeds” (median duration of advancement to full enteral feeds >12.5 days; 7 centers), that is, slow advancement (SA).Results:VLBW infants born in centers with SA (n = 713) had a significantly higher rate of sepsis compared with VLBW infants born in centers with RA (n = 717), which was particularly evident for late‐onset sepsis (14.0% vs 20.4%; P = 0.002). Furthermore, more central venous lines (48.6% vs 31.1%, P < 0.001) and antibiotics (92.4% vs 77.7%, P < 0.001) were used in centers with SA.Conclusions:Center differences in enteral feeding advancement occur and may have a significant impact on short‐term outcomes such as nosocomial sepsis. Large, multicenter, prospective trials are required to further elucidate the optimal feeding strategy for VLBW infants.
Peptide YY Induces Intestinal Proliferation in Peptide YY Knockout Mice With Total Enteral Nutrition After Massive Small Bowel Resection
Authors: Zhu Weiming , Zhang Wei , Gong Jianfeng , Huang Qian , Shi Yichao , Li Qiurong , Li Ning , Li Jieshou 
Published: May 2009

ABSTRACTObjective:In previous research, peptide YY (PYY) administered in supraphysiological doses did not induce significant proliferative effects in rats that were allowed to feed ad libitum after massive small bowel resection (SBR). The main reason may well have been the interference of endogenous PYY released from L cells in the distal bowel in response to the presence of augmented unabsorbed intraluminal nutrients. The purpose of the present study was to explore the effect of PYY on intestinal proliferation with total enteral nutrition (TEN) in a SBR model of PYY knockout (Pyy−/−) mice, which do not produce endogenous PYY.Materials and Methods:Pyy−/− mice were assigned into 3 experimental groups: sham mice (sham group) underwent bowel transection and reanastomosis, and received TEN; SBR mice (SBR group) underwent a 50% small bowel resection, and received TEN; and SBR‐PYY mice (SBR‐PYY group) underwent a 50% small bowel resection, received TEN, and were treated with PYY1–36 subcutaneously from day 2 postoperatively. Parameters of enterocyte proliferation and apoptosis were determined on day 8 following operation.Results:SBR‐PYY mice demonstrated a significant increase in (vs SBR) bowel and mucosal weights, mucosal DNA and protein, villus height, and crypt depth in jejunum and ileum. SBR‐PYY mice also showed an increased crypt cell proliferation index in jejunum and ileum and decreased villus cell apoptotic index in ileum compared with SBR animals.Conclusions:In an SBR model of Pyy−/− mice, PYY induces proliferation of residual intestine with TEN.
Bone Health in Children With Inflammatory Bowel Disease: Adjusting for Bone Age
Authors: Hill Rebecca J , Brookes Denise SK , Lewindon Peter J , Withers Geoffrey D , Ee Looi C , Connor Frances L , Cleghorn Geoffrey J , Davies Peter SW 
Published: May 2009

ABSTRACTObjectives:Clinical results of bone mineral density for children with inflammatory bowel disease are commonly reported using reference data for chronological age. It is known that these children, particularly those with Crohn disease, experience delayed growth and maturation. Therefore, it is more appropriate to compare clinical results with bone age rather than chronological age.Materials and Methods:Areal bone mineral density (aBMD) was measured using dual energy x‐ray absorptiometry, and bone age was assessed using the Tanner‐Whitehouse 3 method from a standard hand/wrist radiograph. Results were available for 44 children ages 7.99 to 16.89 years. Areal bone mineral density measurements were converted to z scores using both chronological and bone ages for each subject.Results:Areal bone mineral density z scores calculated using bone age, as opposed to chronological age, were significantly improved for both the total body and lumbar spine regions of interest. When subjects were grouped according to diagnosis, bone age generated z scores remained significantly improved for those with Crohn disease but not for those diagnosed with ulcerative colitis. Grouping of children with Crohn disease into younger and older ages produced significantly higher z scores using bone age compared with chronological for the older age group, but not the younger age group.Conclusions:Our findings, in accordance with those presented in the literature, suggest that aBMD results in children with Crohn disease should include the consideration of bone age, rather than merely chronological age. Bone size, although not as easily available, would also be an important consideration for interpreting results in paediatric populations.
Methotrexate Treatment in Pediatric Crohn Disease Patients Intolerant or Resistant to Purine Analogues
Authors: Weiss B , Lerner A , Shapiro R , Broide E , Levine A , Fradkin A , Bujanover Y 
Published: May 2009

ABSTRACTBackground:Immunomodulatory drugs play a major role in maintaining remission and steroid sparing in children with Crohn disease. Although thiopurine agents are commonly used, unresponsiveness or intolerance to these drugs is common. The efficacy of methotrexate in maintenance of remission has been shown in adult Crohn disease; however, pediatric data are limited. Our goal was to evaluate the efficacy and safety of methotrexate in induction and maintenance of clinical remission in children with active Crohn disease who failed thiopurine treatment.Patients and Methods:In a retrospective multicenter study, efficacy of methotrexate in inducing and maintaining remission or response was assessed by Harvey‐Bradshaw activity index, paediatric Crohn disease activity index and steroid use, in 25 children with Crohn disease, refractory or intolerant to thiopurine analogues.Results:Crohn disease was diagnosed at a mean age of 11.1 ± 3.1 years and methotrexate was initiated at age 14.5 ± 3.1 years. The median methotrexate dose was 12.5 mg/m2. Remission was achieved in 16 patients (64%), and response in 6 patients (24%). Out of 18 patients treated for longer than 6 months, 83% were in remission or response after 12 months of treatment. The mean duration of remission and response was 10.8 ± 8.8 months. Steroid withdrawal was possible in 12/16 patients (75%) receiving steroids at methotrexate introduction. Adverse effects were observed in 6 patients (24%) including nausea and vomiting in 3, elevation of liver enzymes in 2 and pancreatitis in 1 patient.Conclusions:Methotrexate is beneficial in maintaining remission and steroid‐sparing treatment in children with Crohn disease following failure of thiopurine therapy.
Management of Chronic Hepatitis B in Children
Authors: Shah Uzma , Kelly Deirdre , Chang Mei‐Hwei , Fujisawa Tomoo , Heller Solange , González‐Peralta Regino P , Jara Paloma , Mieli‐Vergani Giorgina , Mohan Neelam , Murray Karen F 
Published: May 2009

ABSTRACTHepatitis B virus (HBV) infection is a worldwide problem and can cause acute liver failure, acute hepatitis, chronic hepatitis, liver cirrhosis, and liver cancer. In areas of high prevalence such as in Asia, Africa, southern Europe, and Latin America, the hepatitis B surface antigen positive rate ranges from 2% to 20%.In endemic areas, HBV infection occurs mainly during infancy and early childhood. Mother‐to‐infant transmission accounts for approximately half of the chronic HBV infections. In contrast to infection in adults, HBV infection during early childhood results in a much higher rate of persistent infection and long‐term serious complications such as liver cirrhosis and HCC.Three phases of chronic hepatitis B have been identified: the immune‐tolerant phase, the immune‐active phase, and the inactive hepatitis B phase. These phases of infection are characterized by variations in viral replication, hepatic inflammation, spontaneous clearance, and response to antiviral therapy.The optimal goal of antiviral therapy for chronic HBV infection is to eradicate HBV and to prevent its related liver complications. However, due to the limited effect of available therapies in viral eradication, the goal of treatment is to reduce viral replication, to minimize liver injury, and to reduce infectivity. In this review the current recommendations for monitoring and treating chronic HBV infection in children are reviewed.
Advances in Understanding Colonic Function
Authors: Milla Peter J 
Published: May 2009

ABSTRACTThe colon is an organ of conservation that salvages water, electrolytes, and energy. The organization of colonic function is determined by the roles played by the luminal flora, the function of the different mucosal epithelial cell types, immunocompetent cells, and the neuromusculature. These different components of the colon interact with one another and with the colonic flora, and different areas of the colon serve different functions. In the normal adult during the course of a day the colon absorbs approximately 1.5 L of fluid, but under the influence of aldosterone increases up to 5 to 6 L. Diarrhoea occurs when secretion exceeds absorptive processes by either small intestinal secretion overwhelming colonic salvage or salvage being impaired by reduced colonic absorption or increased colonic secretion.
Role of the Colon in Short Bowel Syndrome and Intestinal Transplantation
Authors: Goulet Olivier , Colomb‐Jung Virginie , Joly Francisca 
Published: May 2009

ABSTRACTColon is a crucial partner for small intestinal adaptation and function in patients who underwent extensive small intestinal resection or transplantation. This short review deals with the different properties and roles of the colon in these settings, involving fluid and electrolytes absorption, absorption of medium‐chain triglycerides, and production of short‐chain fatty acids for malabsorbed energy salvage. The colon may adapt after small intestinal resection, whereas it hosts the most important part of the intestinal microbiota, which plays a crucial role in intestinal function and health. Also, colon may be responsible for D‐lactic acidosis as well, as it can be injured by noninfectious colitis. Finally, the relevance of a simultaneous colon grafting is discussed as it is occasionally considered in specific patients requiring intestinal transplantation.
Nutritional Challenge in Pseudo‐obstruction: The Bridge Between Motility and Nutrition
Authors: Cucchiara Salvatore , Borrelli Osvaldo 
Published: May 2009

ABSTRACTChronic intestinal pseudo‐obstruction is a severe syndrome characterized by a profound derangement of the intestinal propulsive motility that resembles mechanical obstruction, in the absence of any mechanical obstruction. This syndrome represents one of the main causes of intestinal failure and is characterized by impairment of physical growth and development as well as by a high rate of morbidity and mortality. It may be idiopathic or secondary to a variety of diseases. Most cases are sporadic, even though familial forms with either dominant or recessive autosomal inheritance have been described. Based on histological features intestinal pseudo‐obstruction is classified into 3 main groups: neuropathies, mesenchymopathies, and myopathies, according to the predominant involvement of enteric neurones, interstitial cells of Cajal, and smooth muscle cells, respectively. Treatment of intestinal pseudo‐obstruction involves nutritional, pharmacological, and surgical therapies, but it is often frustrating and does not change the natural course in the majority of cases. The nutritional management has a crucial importance in pediatric age and involves the administration of special formulae, the enteral delivery of nutrients, by a nasogastric tube, percutaneous gastrostomy, or jejunostomy. In the most severe cases, parenteral nutrition becomes mandatory in order to satisfy nutritional requirements and manage appropriately obstructive episodes.
Postinfectious Irritable Bowel Syndrome
Authors: Barbara Giovanni , Cremon Cesare , Pallotti Francesca , De Giorgio Roberto , Stanghellini Vincenzo , Corinaldesi Roberto 
Published: May 2009

ABSTRACTIrritable bowel syndrome (IBS) is a gastrointestinal disorder characterized by abdominal pain and changes in bowel habits, not sustained by structural changes. There is now consistent evidence indicating that IBS may be the adverse outcome of an acute episode of infectious gastroenteritis, the so‐called postinfectious (PI) IBS. The infectious agents involved in the development of PI‐IBS include pathogenic bacteria, parasites, and viruses. Abdominal pain and diarrhea are the most common symptoms of PI‐IBS. Several studies identified a number of risk factors increasing the susceptibility for PI‐IBS development. These include the virulence of the pathogen, the severity, and duration of the acute enteritis, younger age, female sex, and psychological disturbances. Several mucosal abnormalities in the colon or ileum of patients who develop PI‐IBS have been described. These changes include increased mucosal permeability, an increased amount of intraepithelial lymphocytes, lamina propria T cells, and mast cells, as well as serotonin‐containing enteroendocrine cells. The mediators released by these activated cells may evoke enteric nervous system responses, excite sensory afferent pathways, and induce visceral hyperalgesia. Little is known about the prognosis of PI‐IBS, although it is likely better than that of nonspecific IBS. There is little evidence about a specific treatment for PI‐IBS. Although probiotics and antibiotics may be promising in the prevention of PI‐IBS, the efficacy of these treatments should be assessed in an ad hoc designed study.
Functional Nonretentive Fecal Incontinence in Children: A Frustrating and Long‐lasting Clinical Entity
Authors: Burgers Rosa , Benninga Marc A 
Published: May 2009

ABSTRACTFecal incontinence is defined as the passage of stools in an inappropriate place at least once per month, for a minimum period of 2 months. This frustrating symptom is a source of considerable distress and embarrassment for the child and the family. According to the Rome III criteria fecal incontinence can be subdivided into constipation‐associated fecal incontinence and functional nonretentive fecal incontinence. This short review mainly addresses functional nonretentive fecal incontinence in children. Definition, prevalence, pathophysiology, and recent updates on treatment and long‐term follow‐up of fecal incontinence are discussed.
Probiotics and Functional Gastrointestinal Disorders in Children
Authors: Vandenplas Yvan , Benninga Marc 
Published: May 2009

ABSTRACTChronic constipation is one of the most frequent complaints in childhood. Although there is evidence that gastrointestinal flora is important in gut motility, there is little evidence that gut flora is abnormal in constipation. Lactobacilli and bifidobacteria increase stool frequency and decrease consistency in normal individuals. But, according to several reviews, the evidence of probiotics for efficacy in constipation is limited. Fiber supplements, lactose‐free diets, and lactobacillus supplementation are effective in the management of children with recurrent abdominal pain and irritable bowel syndrome. Several studies with Lactobacillus GG in children showed negative results in children with chronic constipation. Because Bifidobacterium animalis DN‐173 010 has been shown to be effective in adults with constipation‐predominant irritable bowel syndrome this study should also be performed in a well‐designed large placebo‐controlled trial in children with constipation.
The Tryptophan Conjugates of Jasmonic and Indole-3-Acetic Acids Are Endogenous Auxin Inhibitors
Authors: Staswick Paul E. 
Published: May 2009

AbstractMost conjugates of plant hormones are inactive, and some function to reduce the active hormone pool. This study characterized the activity of the tryptophan (Trp) conjugate of jasmonic acid (JA-Trp) in Arabidopsis (Arabidopsis thaliana). Unexpectedly, JA-Trp caused agravitropic root growth in seedlings, unlike JA or nine other JA-amino acid conjugates. The response was dose dependent from 1 to100 μm, was independent of the COI1 jasmonate signaling locus, and unlike the jasmonate signal JA-isoleucine, JA-Trp minimally inhibited root growth. The Trp conjugate with indole-3-acetic acid (IAA-Trp) produced a similar response, while Trp alone and conjugates with benzoic and cinnamic acids did not. JA-Trp and IAA-Trp at 25 μm nearly eliminated seedling root inhibition caused by 2 μm IAA. The TIR1 auxin receptor is required for activity because roots of tir1-1 grew only approximately 60% of wild-type length on IAA plus JA-Trp, even though tir1-1 is auxin resistant. However, neither JA-Trp nor IAA-Trp interfered with IAA-dependent interaction between TIR1 and Aux/IAA7 in cell-free assays. Trp conjugates inhibited IAA-stimulated lateral root production and DR5-β-glucuronidase gene expression. JA-deficient mutants were hypersensitive to IAA and a Trp-overaccumulating mutant was less sensitive, suggesting endogenous conjugates affect auxin sensitivity. Conjugates were present at 5.8 pmol g−1 fresh weight or less in roots, seedlings, leaves, and flowers, and the values increased approximately 10-fold in roots incubated in 25 μm Trp and IAA or JA at 2 μm. These results show that JA-Trp and IAA-Trp constitute a previously unrecognized mechanism to regulate auxin action.
CDKB1;1 Forms a Functional Complex with CYCA2;3 to Suppress Endocycle Onset
Authors: Boudolf Véronique , Lammens Tim , Boruc Joanna , Van Leene Jelle , Van Den Daele Hilde , Maes Sara , Van Isterdael Gert , Russinova Eugenia , Kondorosi Eva , Witters Erwin , De Jaeger Geert , Inzé Dirk , De Veylder Lieven 
Published: May 2009

AbstractThe mitosis-to-endocycle transition requires the controlled inactivation of M phase-associated cyclin-dependent kinase (CDK) activity. Previously, the B-type CDKB1;1 was identified as an important negative regulator of endocycle onset. Here, we demonstrate that CDKB1;1 copurifies and associates with the A2-type cyclin CYCA2;3. Coexpression of CYCA2;3 with CDKB1;1 triggered ectopic cell divisions and inhibited endoreduplication. Moreover, the enhanced endoreduplication phenotype observed after overexpression of a dominant-negative allele of CDKB1;1 could be partially complemented by CYCA2;3 co-overexpression, illustrating that both subunits unite in vivo to form a functional complex. CYCA2;3 protein stability was found to be controlled by CCS52A1, an activator of the anaphase-promoting complex. We conclude that CCS52A1 participates in endocycle onset by down-regulating CDKB1;1 activity through the destruction of CYCA2;3.
Phylogenetic relationships and generic delimitation in Inuleae subtribe Inulinae (Asteraceae) based on ITS and cpDNA sequence data
Authors: Englund Markus , Pornpongrungrueng Pimwadee , Gustafsson Mats H. G. , Anderberg Arne A. 
Published: May 2009

AbstractPhylogenetic relationships in Inuleae subtribe Inulinae (Asteraceae) were investigated. DNA sequence data from three chloroplast regions (ndhF, trnL–F and psbA–trnH) and the nuclear ribosomal internal transcribed spacer (ITS) region were analysed separately and in combination using parsimony and Bayesian inference. A total of 163 ingroup taxa were included, of which 60 were sampled for all four markers. Conflicts between chloroplast and nuclear data were assessed using partitioned Bremer support (PBS). Rather than averaging PBS over several trees from constrained searches, individual trees were considered by evaluating PBS ranges. Criteria to be used in the detection of a significant conflict between data partitions are proposed. Three nodes in the total data tree were found to encompass significant conflict that could result from ancient hybridization. Neither of the large, heterogeneous and widespread genera Inula and Pulicaria is monophyletic. A monophyletic group (“the Inula complex”) that comprises all species of Inula includes also Telekia, Carpesium, Chrysophthalmum, Rhanteriopsis, Amblyocarpum, and Pentanema sensu stricto. Two species of Pentanema were found to be closer to Blumea (including Blumeopsis and Merrittia) and Caesulia. The monophyletic “Pulicaria complex” includes all taxa with heteromorphic pappus. Within this group, Francoeuria is distinct from Pulicaria and merits recognition as a separate genus. © The Willi Hennig Society 2009.
Hennig’s enkaptic system
Authors: Rieppel Olivier 
Published: May 2009

AbstractHennig’s phylogenetic system is characterized by an asymmetry between (sexually reproducing) species that form tokogenetic systems, versus monophyletic taxa that form a phylogenetic system. This was claimed to reflect a conflict between two hierarchies, i.e. the hierarchy of species‐lineages splitting and splitting again as opposed to the phylogenetic hierarchy of groups within groups. Some cladists have sought the unification of the phylogenetic system by abandoning the species concept. In contrast, contemporary commentators (Klaus Günther, Walter Zimmermann) characterized Hennig’s system as an enkaptic hierarchy. This paper explores the concept of enkapsis, and the way Hennig used it as a basis for the unification of his phylogenetic system. © The Willi Hennig Society 2009.