bluuebunny/crossref_metadata_2025_split huggingface dataset:
Randomized, Double‐blind, Placebo‐controlled Trial: Effect of Lactobacillus GG Supplementation on Helicobacter Pylori Eradication Rates and Side Effects During Treatment in Children
Authors: Szajewska Hania , Albrecht Piotr , Topczewska‐Cabanek Agnieszka 
Published: May 2009

ABSTRACTObjective:To determine the effectiveness of Lactobacillus GG (LGG) in children with Helicobacter pylori infection undergoing eradication therapy.Materials and Methods:We conducted a double‐blind, placebo‐controlled, randomized trial comparing a 7‐day, triple eradication regimen consisting of 2 antibiotics (amoxicillin tablets, 25 mg/kg twice per day, and clarithromycin tablets, 10 mg/kg twice per day) plus a proton pump inhibitor (omeprazole capsules, 0.5 mg/kg twice per day) supplemented with LGG (109 colony‐forming units) or placebo in 83 children with H pylori infection confirmed by 2 of 3 tests (13C‐urea breath test, histopathology, rapid urease test). The primary outcome measure was the H pylori eradication rate. The secondary outcome measure was the proportion of patients who experienced therapy‐related adverse effects during anti–H pylori treatment.Results:The groups did not differ with respect to H pylori eradication rates. Of the 34 children in the LGG group, 23 (69%) experienced eradication, compared with 22 of 32 children (68%) in the placebo group (RR 0.98, 95% CI 0.7–1.4). The groups did not differ with respect to adverse effects.Conclusions:In children with H pylori infection, supplementation of standard triple therapy with LGG did not significantly alter the eradication rate or side effects.
AIRE Gene Analysis in Children With Autoimmune Hepatitis Type I or II
Authors: Lankisch Tim O , Mourier Olivia , Sokal Etienne M , Habes Dalila , Lacaille Florence , Bridoux‐Henno Laure , Hermeziu Bogdan , Lenaerts Catherine , Strassburg Christian P , Jacquemin Emmanuel 
Published: May 2009

ABSTRACTThe present report describes AIRE gene analysis in 25 children with autoimmune hepatitis type I or II. The heterozygous transversion c.961C > G (p.Ser278Arg) located in exon 7 was identified in 4 patients with autoimmune hepatitis type I, and mostly in those presenting with a positive family history for autoimmune diseases. In this subgroup of patients, the allelic frequency of this polymorphic variant was at least 3‐fold higher than in healthy controls. These results suggest that heterozygous AIRE gene mutation may represent a genetic predisposition to childhood autoimmune hepatitis type I.
Factors Predictive of Crohn Disease Following Colectomy in Medically Refractory Pediatric Colitis
Authors: Evers Elisa A , Pfefferkorn Marian D , Steiner Steven J 
Published: May 2009

ABSTRACTObjectives:Crohn disease (CD) has been diagnosed following colectomy for ulcerative colitis (UC). This study aims to determine the frequency of this occurrence, and to identify predictive factors leading to a CD diagnosis.Materials and Methods:A retrospective chart review was performed in patients who have undergone colectomy.Results:From 1996 to 2006, colectomy was performed in 212 patients, 37 of whom were diagnosed preoperatively with UC. The mean ages at diagnosis and at colectomy were 10.6 ± 4.3 years and 13.7 ± 3.7 years, respectively. Inflammatory bowel disease serology at diagnosis in 29 patients showed that 26 (90%) were pANCA+. Serology was negative in 3. Ten (27%) had nonspecific inflammation of the upper digestive tract. Radiographs in 25 patients indicated no abnormalities in the small intestine. Before colectomy, patients (n = 35) were treated with corticosteroid (97%), 5‐ASA (69%), immunomodulator (66%), infliximab (29%), and cyclosporin (11%). The mean postoperative follow‐up was 2.6 ± 2 years. Six patients (16%) were found to have CD. All 6 patients were pANCA+ with elevated anti‐OmpC (n = 4), ASCA immunoglobulin A (n = 2), and ASCA immunoglobulin G (n = 1). The CD group had higher mean anti‐OmpC compared with the UC group, 16.9 ± 5.2 and 6.2 ± 3.4, respectively (P < 0.005). Weight z score at time of surgery was lower in the CD group (−1.38 ± 0.79) than in the UC group (0.29 ± 0.24), P < 0.05.Conclusions:The possibility of CD remains in a small fraction of patients who undergo colectomy for medically refractory UC. A lower weight and a higher anti‐OmpC titer may be predictive of CD.
Feasibility and Application of 3‐Dimensional Ultrasound for Measurement of Gastric Volumes in Healthy Adults and Adolescents
Authors: Manini Mhd Louai , Burton Duane D , Meixner Duane D , Eckert Deborah J , Callstrom Matthew , Schmit Grant , El‐Youssef Mounif , Camilleri Michael 
Published: May 2009

ABSTRACTObjectives:Abnormal gastric accommodation to a meal results in dyspepsia. Current methods to measure gastric volume (GV) are invasive or involve ionizing radiation. The aims of this study were to compare fasting and postprandial (PP) GVs measured by 99mTc‐single photon emission computed tomography (SPECT) and 3‐dimensional ultrasound (3D‐US) in adults, to assess the performance characteristics of 3D‐US measurement of GV during fasting and postprandially, and to develop normative data of GVs in 24 healthy adolescents.Patients and Methods:Eleven adults underwent SPECT and 3D‐US simultaneously to measure GV, and a second 3D‐US alone within 1 week of the first study. Twenty‐four adolescents underwent 1 3D‐US measurement. Each study included fasting, a 300‐mL Ensure meal, and 0 to 30‐minute PP GV measurements.Results:3D‐US identifies GV accommodation to 300 mL Ensure. Delta (0–30 minutes average PP fasting) GV was 444 mL (median, interquartile range [IQR] = 422, 534) for 3D‐US and 543 mL (median, IQR = 486, 564) for SPECT (P = 0.15). There were larger interindividual coefficients of variation for GV by 3D‐US (60.3% fasting and 21.3% average PP) compared with 19% fasting and 9.2% PP for SPECT. Intraindividual coefficients of variation for the 2 3D‐US measurements in adults were 84% fasting and 44% average PP. The estimated GVs for the adolescent group (median [25th–75th IQR]) were 33 (18–53) mL fasting, 330 (284–357) mL 30 minutes PP, and 281 (240–324) mL for delta GV.Conclusions:3D‐US is a promising method to measure GV accommodation to a meal. Large coefficients of variation reflect the learning stage in development of this promising technique.
Deuterium Equilibrium Time in Saliva of Newborn Infants
Authors: Traver Luis Ângelo Marti , Martinez Francisco Eulógio , Ferriolli Eduardo , Marchini Júlio Sérgio , Monteiro Jacqueline Pontes , Pfrimer Karina , Sanchez Ana Paula Michelin , de Oliveira Thais , Ducatti Carlos , Camelo José Simon 
Published: May 2009

ABSTRACTThere is an increasing interest about the use of stable isotopes for body composition analysis in pediatrics. To ensure the success of total body water analysis by the deuterium dilution method, it is fundamental to determine the equilibrium time (plateau) of deuterium in the body fluid studied.Objectives:We report here the equilibration time of deuterium oxide in the saliva of newborns after oral intake of the isotope.Methods:Twenty healthy term newborn infants, 10 males and 10 females, were analyzed. Saliva was collected from each newborn before the oral administration of a 100 mg/kg dose of deuterium oxide (baseline sample) and then at 1‐hour intervals for 5 hours after administration. Deuterium enrichment of saliva was determined by isotope ratio mass spectrometry according to the recommendations of the International Atomic Energy Agency.Results:The plateau time of deuterium in saliva occurred 3 hours after oral administration of the stable isotope.Conclusion:These data are essential for further studies on the body composition of newborn infants. To the best of our knowledge, this is the first study regarding the equilibration time of deuterium in the saliva of term newborns.
Neonatal Outcome of Gastroschisis Is Mainly Influenced by Nutritional Management
Authors: Walter‐Nicolet Elizabeth , Rousseau Véronique , Kieffer François , Fusaro Fabio , Bourdaud Nathalie , Oucherif Salima , Benachi Alexandra , Sarnacki Sabine , Mitanchez Delphine 
Published: May 2009

ABSTRACTObjective:The aim of the study was to evaluate early minimal enteral feeding (MEF) and gradual enteral nutrition increment on neonatal outcome of gastroschisis.Patients and Methods:An intervention group was prospectively assessed and compared with an observational historical control group. The prospective study relied on a new protocol of enteral nutrition. According to the new protocol, MEF was initiated 5 days after bowel reintegration and milk amounts were increased 12 mL/kg/day. In the control group, enteral nutrition was delayed until resolution of postoperative ileus, and increment of feeding was not systematized.Results:Twenty‐two patients were included in the MEF group and compared with 51 control patients. Infants in the control group had lower gestational age (36 vs 35 gestational weeks [GW], P = 0.03) and birth weight (2465 vs 2200 g, P = 0.05). Time to first enteral nutrition (5 vs 11.5 days, P = 0.0005) was significantly shorter in the MEF group. All patients in this group were fully enteral fed at day 60, though 30.4% of patients in the control group still needed parenteral nutrition at day 60 (P = 0.004). Incidence of nosocomial infection was reduced (9% of patients vs 40%, P = 0.016) and hospital stay tended to be shorter in the MEF group (40 vs 54.5 days, P = 0.08). In the univariate analysis, factors influencing the length of parenteral nutrition during the 2 periods were the severity of perivisceritis and new nutritional protocol. In the multivariate analysis, only nutritional protocol was significantly associated with the length of parenteral nutrition (P = 0.038).Conclusions:Early MEF and controlled increase of nutritional elements after bowel reintegration significantly improved outcome of gastroschisis in newborns.
Parenteral Nutrition Objectives for Very Low Birth Weight Infants: Results of a National Survey
Authors: Lapillonne Alexandre , Fellous Laure , Mokthari M , Kermorvant‐Duchemin Elsa 
Published: May 2009

ABSTRACTObjectives:The aim of the study was to evaluate parenteral nutrition objectives for very low birth weight (VLBW) infants in neonatal intensive care units (NICUs), and to compare nutritional protocol differences according to levels of care.Materials and Methods:A national survey was conducted in France through a questionnaire sent to 296 French neonatal departments to determine each team leader's nutritional objectives for parenteral nutrition of VLBW infants.Results:A total of 172 of the 296 French neonatal departments responded to the questionnaire. Protein administration was not started during the first day of life in half of the responding units. Furthermore, half of the units initiated protein administration with less than 1 g · kg−1 · day−1. The day of introduction of lipid emulsions varied considerably from one unit to another, but more than half of the units started the lipid emulsions after the third day of life. Twenty percent of the units reported a target energy intake of 100 kcal · kg−1 · day−1, whereas 14% reported a target intake above or equal to 130 kcal · kg−1 · day−1.Conclusions:In comparison with recent guidelines for parenteral nutrition for VLBW infants, the results indicate that the majority of the departments are familiar with target macronutrient and energy intakes, but the time of introduction and the rate of progression of macronutrients, particularly proteins and lipids, are frequently lower than those defined by the guidelines. The large‐scale publication of new nutritional guidelines for the parenteral nutrition of neonates and preterm infants as well as regular, specific training in the parenteral nutrition of preterm infants are needed.
Helicobacter pylori–positive Versus Helicobacter pylori–negative Idiopathic Peptic Ulcers in Children With Their Long‐term Outcomes
Authors: Tam Yuk Him , Lee Kim Hung , To Ka Fai , Chan Kin Wai , Cheung Sing Tak 
Published: May 2009

ABSTRACTObjectives:The aim of this study is to investigate the differences in the characteristics between Helicobacter pylori–positive and H pylori–negative primary ulcers in Chinese children.Patients and Methods:We conducted a retrospective review of children with primary peptic ulcers. Demographic data, clinical presentations, endoscopic features, histological findings, H pylori prevalence, and ulcer recurrences were studied.Results:Forty‐three Chinese children with primary peptic ulcers were diagnosed over 8 years and were reviewed. There were 31 boys and 12 girls (median age 12 years, range 3–16 years). Thirty children (70%) presented with acute gastrointestinal bleeding, whereas only 19 had a history of epigastric pain. Twenty‐three patients (53.5%) were H pylori positive. H pylori–positive ulcers developed in older children (median age 12 vs 10 years, P < 0.05) and affected more males (91.3% vs 50%, P < 0.01) than the H pylori–negative group. The annual ulcer recurrence rates were estimated to be 5.2% (95% CI 4.2–6.3) and 11.4% (95% CI 9.1–13.6) for positive and negative groups, respectively (P < 0.05). Multivariate logistic regression suggested H pylori–negative status and ulcer size >1 cm were independent risk factors for recurrence.Conclusions:Our report suggests that H pylori–negative primary ulcers exist in children with their own distinct features. In contrast to H pylori–positive ulcers, H pylori–negative ulcers develop in younger children, affect both sexes equally, and carry a higher recurrence risk.
A Randomized Controlled Trial on Parenteral Nutrition, Oxidative Stress, and Chronic Lung Diseases in Preterm Infants
Authors: Bassiouny Mohamed R , Almarsafawy Hala , Abdel‐Hady Hesham , Nasef Nehad , Hammad Tarek A , Aly Hany 
Published: May 2009

ABSTRACTObjectives:To evaluate the effect of trace elements (TEs), when added to total parenteral nutrition (TPN) solutions, on peroxides load, and to test the hypothesis that protection of TPN from light can decrease peroxides load and is associated with improvement in oxidant‐related clinical outcomes in preterm infants.Subjects and Methods:A total of 80 preterm infants were randomized to 1 of 4 groups (n = 20 each): group 1 received a mixture of dextrose and amino acids; group 2 received a mixture of dextrose, amino acids, and lipid emulsion; group 3 received dextrose, amino acids, lipid emulsion, and multivitamins (MVP); and group 4 received dextrose, amino acids, lipid emulsion, MVP, and TEs. Each group was subdivided into photo‐protected and photo‐exposed subgroups (n = 10 each). Using ferrous oxidation of xylenol orange technique, we measured the baseline level of excreted urinary peroxides before and 48 hours after starting TPN. We examined the association among light protection, urinary peroxides, and clinical outcomes of these infants.Results:Baseline urinary peroxides ranged between 5.5 and 24.8 μmol/L. A significant increase in urinary peroxides was observed in all groups after receiving TPN. The use of TEs did not affect peroxide production. In regression analysis, the addition of MVP (P < 0.0001) and the exposure to light (P = 0.02) were significantly associated with increased urinary peroxides. In the overall population, light exposure was associated with a significant increase in the incidence of chronic lung disease (adjusted OR 9.26, confidence interval 1.2–73; P = 0.03) but had no effect on mortality, necrotizing enterocolitis, or sepsis.Conclusions:TEs in TPN solutions have no effect on the production of urinary peroxides. Addition of MVP and exposure of TPN to light are the 2 major sources of peroxides in TPN. Protection from ambient light is associated with a decrease in chronic lung disease.
Nutritional Aspects in Inflammatory Bowel Disease
Authors: Shamir Raanan 
Published: May 2009

ABSTRACTNutrition plays a role in inflammatory bowel disease (IBD) primarily in prevention and treatment of malnutrition and growth failure. Furthermore, in Crohn disease (CD), nutrition can induce remission, maintain remission, and prevent relapse. Malnutrition is common in IBD and the mechanisms involved include decreased food intake, malabsorption, increased nutrient loss, increased energy requirements, and drug–nutrient interactions. At the time of diagnosis, up to 85% of pediatric patients with CD and 65% of those with ulcerative colitis (UC) have weight loss. Growth failure occurs in 15% to 40% of children with IBD and is less common in UC compared with CD, both at diagnosis and during follow‐up. In CD, nutritional therapy with enteral formulas induces remission at a rate comparable with that achieved with steroids. In adults with CD, limited information suggests that enteral nutrition (EN) may play a role in maintenance of remission. In children with CD colitis, one study suggested that children without colitis respond better to EN than children with colitis, and another study found no such difference but reported a trend toward earlier relapse in those with isolated colonic involvement. Finally, nutrition may play a role in IBD via the possible protective effect of breastfeeding against UC and CD. In summary, although only CD may benefit from nutrition as primary therapy for remission induction and possibly maintenance of remission, nutrition plays an important role in the prevention and treatment of malnutrition in IBD, and may have a protective role, via the effect of breast‐feeding on disease occurrence.
Unstable taxa in cladistic analysis: identification and the assessment of relevant characters
Authors: Pol Diego , Escapa Ignacio H. 
Published: May 2009

AbstractA common problem in phylogenetic analysis is the presence of unstable taxa that are depicted in multiple positions in optimal topologies. These uncertainties are reflected in strict consensus trees with polytomies that hamper the interpretation of the phylogenetic results. We propose a protocol for detecting unstable branches (either terminal taxa or clades) and identifying particular characters related to their instability in cladistic analysis. This procedure is based on an iterative evaluation of the agreement of triplets among the optimal topologies (i.e. most‐parsimonious trees, MPTs) and examination of character optimizations on these trees. Different types of characters underlying the unstable behaviour of taxa are detected: those with conflicting scorings that support alternative positions of problematic taxa and those with missing data in the unstable taxa that could reduce their instability if they are scored. The entire process is automated through a TNT script that provides a list of characters related to the instability of each unstable taxon. The outcome of this procedure can be used as a guide for further research efforts focused on the revision or addition of (morphological or molecular) phylogenetic data for elucidating the affinities of unstable taxa. © The Willi Hennig Society 2009.
Systematic review: frequency and reasons for consultation for gastro‐oesophageal reflux disease and dyspepsia
Authors: HUNGIN A. P. S. , HILL C. , RAGHUNATH A. 
Published: May 2009

SummaryBackground  Upper gastrointestinal symptoms impose a substantial illness burden and management costs. Understanding perceptions and reasons for seeking healthcare is a prerequisite for meeting patients’ needs effectively.Aim  To review systematically findings on consultation frequencies for gastro‐oesophageal reflux disease (GERD) and dyspepsia and patients’ reasons for consultation.Methods  Systematic literature searches.Results  Reported consultation rates ranged from 5.4% to 56% for GERD and from 26% to 70% for dyspepsia. Consultation for GERD was associated with increased symptom severity and frequency, interference with social activities, sleep disturbance, lack of timetabled work, higher levels of comorbidity, depression, anxiety, phobia, somatization and obsessionality. Some consulted because of fears that their symptoms represented serious disease; others avoided consultation because of this. Inconsistent associations were seen with medication use. Patients were less likely to consult if they felt that their doctor would trivialize their symptoms. Few factors were consistently associated with dyspepsia consultation. However, lower socio‐economic status and Helicobacter pylori infection were associated with increased consultation.Conclusion  Patients’ perceptions of their condition, comorbid factors and external reasons such as work and social factors are related to consultation rates for GERD. Awareness of these factors can guide the clinician towards a more effective strategy than one based on drug therapy alone.
Adiponectin downregulates CD163 whose cellular and soluble forms are elevated in obesity
Authors: Sporrer D. , Weber M. , Wanninger J. , Weigert J. , Neumeier M. , Stögbauer F. , Lieberer E. , Bala M. , Kopp A. , Schäffler A. , Buechler C. 
Published: May 2009

AbstractBackground  CD163 is a monocyte/macrophage specific receptor whose soluble form (sCD163) is elevated in inflammatory diseases. Obesity is associated with chronic inflammation and low adiponectin, an anti‐inflammatory adipokine. Adiponectin, 5‐aminoimidazole‐4‐carboxamide‐1‐4‐ribofuranoside (AICAR) and metformin activate the AMP‐kinase that exerts anti‐inflammatory effects, and the influence of adiponectin and these drugs on monocytic CD163 was analysed, and cellular and sCD163 were determined in obesity and type 2 diabetes.Materials and methods  Monocytes were incubated with adiponectin, AICAR or metformin. Furthermore, monocytes and serum were obtained from type 2 diabetic patients (T2D), overweight (defined as a body mass index ≥ 25 kg m−2) and normal‐weight (NW) controls. CD163 was analysed by immunoblot and sCD163 was measured by enzyme‐linked immunosorbent assay in the supernatants of the monocytes and in serum.Results  In monocytes, adiponectin reduced cellular and surface CD163, whereas sCD163 was not altered in the corresponding supernatants. Further, metformin and AICAR downregulated CD163. Monocytic CD163 was higher in T2D and obesity, whereas sCD163 in the supernatants was not elevated and neither correlated with serum sCD163 nor systemic adiponectin. There was a positive correlation of monocytic sCD163 with serum but not with monocytic IL‐6. In the serum of obese controls and T2D patients, sCD163 was significantly higher compared to NW donors and was positively associated with systemic IL‐6.Conclusions  This study indicates that monocytic CD163 and systemic sCD163 are elevated in T2D and obesity. Adiponectin reduces CD163 in vitro, but additional factors related to obesity like IL‐6 may be more relevant in vivo.
Melatonin – a pleiotropic molecule involved in pathophysiological processes following organ transplantation
Authors: Fildes James E. , Yonan Nizar , Keevil Brian G. 
Published: May 2009

SummaryMammals adjust their physiology in response to seasonal changes to environment (i.e. photoperiod, temperature, food availability). These changes are thought to predominantly occur for the conservation of energy during winter, by pervasive changes such as the inhibition of reproduction. Previous reports have suggested that circannual changes also occur to the immune system. In mammals, this chronological effect may be dependent on photoperiod, and evidence exists to suggest that there is a great deal of immune variation in response to light, or circadian rhythm. This is a clinically relevant, yet under‐reported area of human transplantation. The aim of this review is to discuss immune variation, with specific emphasis on melatonin secretion, in the context of organ rejection, infection, neoplasia formation, and immunosuppression.