bluuebunny/crossref_metadata_2025_split huggingface dataset:
High Prevalence of Silent Celiac Disease in Preschool Children Screened with IgA/IgG Antiendomysium Antibodies
Authors: Korponay‐Szabó Ilma R. , Kovács Judit B. , Czinner Antal , Gorácz Gyula , Vámos Adrienn , Szabó Teréz 
Published: February 2024

ABSTRACTBackground:Because of the different sensitivity and specificity of serologic tests, the search for silent celiac disease is usually performed with the combined or sequential use of several tests. Among these, the IgA‐class endomysium antibody test has the highest specificity and positive predictive value, but it may overlook IgA‐deficient patients.Methods:To test a new one‐step screening approach, serum samples from 427 apparently healthy, 3‐ to 6‐year‐old Hungarian children were investigated for IgA‐class and IgG‐class endomysium antibodies using monkey esophagus and human jejunum as substrates.Results:Five new cases with flat mucosa were identified by strong endomysium antibody positivity and subsequent jejunal biopsy, yielding a celiac disease prevalence of 1:85. An additional child may have latent celiac disease (slight histologic changes at present). Two of the screening‐detected celiac patients exhibited only IgG‐class endomysium antibodies due to associated IgA‐deficiency. Despite the young age of the screened population, antigliadin antibodies were positive in only three of the five celiac patients.Conclusions:Prevalence of celiac disease in the study population was much higher than expected on the basis of antigliadin antibody‐based studies. The screening system used detected celiac cases in which there was IgA‐deficiency and those in which there was not and also those negative for antigliadin antibodies. The findings suggest the importance of the primary testing of autoantibodies in future celiac disease screening policies.
Identifying Immunoglobulin‐A‐Deficient Children and Adults Does Not Necessarily Help the Serologic Diagnosis of Coeliac Disease
Authors: Lock Robert J. , Unsworth David J. 
Published: February 2024

ABSTRACTBackground:Immunoglobulin A deficiency is more common in patients with coeliac disease and also in patients with other gastrointestinal diseases than in normal people. There is a concern, therefore, that routine serum immunoglobulin (Ig) A testing of all cases of suspected coeliac disease may lead to unnecessary biopsy.Methods:Four hundred eighty‐two routine consecutive samples from cases of suspected coeliac disease or malabsorption (109 children) were tested for IgA anti‐endomysium and total IgA. Four hundred twenty‐four sera samples also had IgG antigliadin checked for high‐titre antibody. Archived adult sera from 31 patients with coeliac disease and 52 disease control subjects were included in the study.Results:Seven routine cases with serum IgA less than 15% of the mean normal for age and four cases with undetectable IgA were identified. Four patients, including three of four with clear deficiency, underwent small bowel biopsy, and all four had normal histologic findings and normal intraepithelial lymphocyte counts. Only one of the seven had high‐titre IgG antigliadin antibody but that patient had normal histologic findings. One (3%) of 31 adults with established coeliac disease and 1 (2%) of 52 control subjects were IgA deficient.Conclusions:Of patients with IgA deficiency, only those with both IgA deficiency and high‐titre IgG antigliadin antibody should be routinely considered for biopsy.
S‐Fimbriae From Escherichia coli Bind to Soluble Glycoproteins From Human Milk
Authors: Schwertmann Annette , Schroten Horst , Hacker Jörg , Kunz Clemens 
Published: February 2024

ABSTRACTBackground:Escherichia coli (E. coli) strains, expressing S‐fimbriae, belong to the most common gram‐negative pathogens that cause sepsis and meningitis in neonates. The attachment of S‐fimbriae to the cell surface is mediated by membrane glycoconjugates, which often carry N‐acetylneuraminic acid.Methods:Binding studies were performed with glycoproteins from the whey fraction of human milk to investigate whether they exert a potential inhibitory effect on bacterial adhesion. Whey glycoproteins were separated according to their molecular weight by fast protein liquid chromatography gel filtration. After sodium dodecyl sulfate‐polyacrylamide gel electrophoresis, proteins were transferred to nitrocellulose membranes and incubated with isolated S‐fimbriae from recombinant E. coli strain HB (pANN 801‐4).Results:S‐fimbriae recognized four whey proteins with a molecular mass of more than 200 kDa, 170 to 150 kDa, and 80 kDa. Their glycosylation pattern was investigated using the lectins Sambucus nigra, Maackia amurensis, Galanthus nivalis, and Arachis hypogaea. Thus the presence of N‐ and O‐glycans in these proteins was confirmed. The preferential binding to N‐acetylneuraminic acid containing glycoproteins was demonstrated by a complete abolishment of these reactions by incubation with acidic lactose‐derived oligosaccharides. However, the cleavage of N‐acetylneuraminic acid from glycoproteins by mild acid hydrolysis revealed a second binding site for S‐fimbriae on milk proteins of a similar molecular weight range. Terminal galactose in human milk glycoconjugates were thought to react with S‐fimbriae as well.Conclusion:These data further support the opinion that glycoproteins from human milk are potential receptor analogues for certain bacteria that may prevent microbial adhesion to the epithelial cell surface.
Altered Intestinal Permeability to Mannitol in Diabetes Mellitus Type I
Authors: Carratù Romano , Secondulfo Mario , de Magistris Laura , Iafusco Dario , Urio Anna , Carbone Maria Grazia , Pontoni Gabriele , Cartenì Marilena , Prisco Francesco 
Published: February 2024

ABSTRACTBackground:Intestinal permeability has seldom been investigated in diabetes mellitus, even though patients frequently report gastrointestinal symptoms, and it has recently been shown that the prevalence of celiac disease associated with diabetes mellitus is higher than expected.Methods:Intestinal permeability to cellobiose and mannitol was investigated in 31 patients affected by type I uncomplicated diabetes mellitus. Values were compared with those obtained in 32 normal subjects.Results:The percentage of mannitol recovery was far higher than normal in two thirds of the investigated patients and correlated with the length of disease, even though the probes' ratio (cellobiose/mannitol) was in the normal range.Conclusions:A not previously reported increase of intestinal permeability to mannitol, clear‐cut and not associated with that of the larger probe, is found in type I uncomplicated diabetes mellitus. These results may describe a primary feature of type I diabetes mellitus and the initial steps of evolution of celiac disease.
Aluminum Contents of Human Milk, Cow's Milk, and Infant Formulas
Authors: Fernandez‐Lorenzo José R. , Cocho José A. , Rey‐Goldar M. Luz , Couce Mariluz , Fraga José M. 
Published: February 2024

ABSTRACTBackground:Aluminum toxicity is well documented and contamination of milk formulas has been implicated as the source of accumulation in bone and brain tissues. The purpose of the current study was to evaluate the aluminum contents of human milk, cow's milk, and infant formulas.Methods:Aluminum contents were determined by atomic absorption spectrometry in samples of human milk in the colostrum, intermediate, and mature stages; infant formulas from eight manufacturers; and various types and brands of commercially available cow's milk.Results:Mean aluminum concentration was lowest in human milk (23.4 ± 9.6 µg/l), and did not differ significantly between colostrum, intermediate‐stage and mature‐stage milk. Mean aluminum concentration was 70 µg/l in cow's milk, and 226 µg/l in reconstituted infant formulas. Aluminum concentrations in infant formulas differed markedly among manufacturers; concentration in milk from one of the manufacturers was particularly high (mean, 551 µg/l; range, 302‐1149 µg/l). These values are for milk reconstituted with aluminum‐free water under laboratory conditions; formulas prepared with tap water in the University Hospital's infant‐feeding unit had even higher aluminum content. Experiments showed that aluminum concentration in the high‐aluminum milk could be reduced by more than 70% at the manufacturing stage, by using low‐aluminum components.Conclusions:The results of the present study support the recommendations for infant formula manufacturers to strive to reduce aluminum concentration in their products.
Fish Oil Supplementation Does Not Impair the Gut Immune Response to Trichinella Spiralis Infection in Rats
Authors: Olivé Anthony P. , Dudley Mary , Harari Yael , Dudley Alden , Castro Gilbert A. , Lifschitz Carlos H. 
Published: February 2024

ABSTRACTBackground:Fish oil has been recommended as a source of ω‐3 fatty acids for preterm infants and for therapy of some inflammatory diseases.Methods:Because fish oil supplementation could downregulate the host's immune response, we studied the gut inflammatory response to an enteric infection in 72 rats assigned to three dietary groups with differing fatty acid profile: 1) fish oil, rich in eicosapentaenoic and docosahexaenoic acid; 2) olive oil, containing 71% monounsaturated fat; and 3) rat chow, containing 57% saturated fat. One half (n = 36) of the rats were infected with Trichinella spiralis larvae; the other half served as controls. The inflammatory response to initial infection (study 1), and type I hypersensitivity response to a subsequent parasite‐derived antigenic challenge (study 2) were assessed. Jejunal inflammatory cell infiltrate, mean villus height, disaccharidase levels, changes in short‐circuit current in response to glucose absorption, and chloride secretagogues (study 1) were measured 9 days after infection. Short‐circuit current changes induced by chloride secretion were measured when the proximal jejunum was challenged with T. spiralis‐derived antigen 40 days after infection (study 2).Results:In study 1, jejunal tissue from infected animals had more eosinophilic infiltrate, lower disaccharidase levels, and less glucose absorptive and chloride secretory capacity than tissue from noninfected animals. In study 2, the jejunum of infected animals showed an antigen‐induced chloride secretory response, whereas no response was obtained from jejunal tissue from noninfected animals. Type of diet did not affect the response in either study.Conclusion:Under the conditions of this experiment, fish oil supplementation did not interfere with the local intestinal inflammatory response after T. spiralis infection.
The Involvement of the Gastrointestinal Tract in Posttransplant Lymphoproliferative Disease in Pediatric Liver Transplantation
Authors: Younes Bassam S. , Ament Marvin E. , McDiarmid Sue V. , Martin Martin G. , Vargas Jorge H. 
Published: February 2024

ABSTRACTBackground:Posttransplant lymphoproliferative disease (PTLD) is a serious complication associated with the use of immunosuppression after transplantation. In a retrospective study the clinical features of PTLD located primarily in the gastrointestinal tract were analyzed.Methods:Three hundred ninety‐two consecutive pediatric patients who underwent orthotopic liver transplantation (OLT) during a 13‐year period with a survival of more than 6 months were reviewed. Two immunosupression protocols were used: cyclosporin A, or tacrolimus‐based primary therapy. Twenty‐nine randomly selected liver transplant recipients without PTLD were used for comparison of signs and symptoms of gastrointestinal PTLD.Results:Among the 30 patients identified with PTLD, 9 had gastrointestinal PTLD. The overall incidence density of PTLD was 1.8 per 100 patient‐years (30/392). Nine patients (30%) had involvement of the gastrointestinal tract, whereas 7 (23%) had the gastrointestinal tract as the only involved site. When compared with a cohort of liver transplant recipients without PTLD, only gastrointestinal bleeding, weight loss, hypoalbuminemia, and protein‐losing enteropathy were signs most likely associated with gastrointestinal PTLD. Hypoalbuminemia was the most sensitive sign of gastrointestinal PTLD. The lower tract (ileum and colon) was the most common site of involvement.Conclusions:Gastrointestinal involvement is common and occurs in 30% of all patients with PTLD. It may be the only affected organ in a subgroup of patients. Hypoalbuminemia, gastrointestinal bleeding, and weight loss are features that are characteristic of gastrointestinal PTLD. Patients with aggressive gastrointestinal signs and symptoms should undergo upper and lower gastrointestinal tract endoscopy with biopsy, to establish the diagnosis.
Growth Hormone and Insulin‐like Growth Factor‐I Therapy Promote Protein Deposition and Growth in Dexamethasone‐treated Piglets
Authors: Ward Wendy E. , Atkinson Stephanie A. 
Published: February 2024

ABSTRACTBackground:Dexamethasone treatment facilitates the weaning of premature infants from mechanical ventilation but impairs protein homeostasis, lean tissue deposition, and growth. The current study was conducted to investigate whether dexamethasone mediates these effects by reducing protein synthesis or elevating protein breakdown, and whether adjuvant growth hormone ± insulin‐like growth factor‐I therapy can attenuate such effects.Methods:Piglets (n = 24) were randomized to placebo, a tapered course of dexamethasone (0.5, 0.3, 0.2 mg/kg per day for 5, 5 and 4 days each, respectively), dexamethasone + growth hormone 0.1 mg/kg per day, or dexamethasone + growth hormone + insulin‐like growth factor‐I 0.1 mg/kg per day for 14 days. On day 13, 15N‐glycine was administered as a single oral dose, and urine was collected at timed intervals during the subsequent 48 hours.Results:Total urinary N and cumulative 15N excretion were higher in all dexamethasone groups than in control subjects. Protein synthesis was suppressed, whereas protein breakdown was unaltered by dexamethasone. Adjunctive growth hormone ± insulin‐like growth factor‐I therapy enhanced protein synthesis, but only combined therapy improved net protein gain compared with dexamethasone alone. Higher circulating insulin‐like growth factor‐I may have mediated the greater net protein gain. Blood urea nitrogen was elevated in all dexamethasone‐treated groups at days 6 and 11 but was normalized by day 15 with adjunctive growth hormone ± insulin‐like growth factor‐I. From a functional perspective, both adjunctive growth hormone and growth hormone ± insulin‐like growth factor‐I partially attenuated the dexamethasone‐induced reduction in weight and length gain but not in whole body lean and fat mass.Conclusion:Adjunctive growth hormone ± insulin‐like growth factor‐I therapy partially reverses the dexamethasone‐induced reduction in protein synthesis, resulting in improved growth when given concurrently with a low tapering dose of dexamethasone.
Prediction of Survival in Extrahepatic Biliary Atresia by Hepatic Duplex Sonography
Authors: Kardorff Rüdiger , Klotz Michael , Melter Michael , Rodeck Burkhard , Hoyer Peter F. 
Published: February 2024

ABSTRACTBackground:The clinical course of biliary atresia patients is extremely variable. To optimize conservative treatment and correctly schedule liver transplantation, noninvasive investigations that are predictive of individual survival and that can be performed regularly are needed. In this study, the prognostic value of Doppler sonography was investigated in these patients.Methods:Thirty biliary atresia patients (age range, 1 month to 15.2 years; mean, 4.0 years) and 38 control subjects underwent standardized Doppler sonography of liver and spleen. Biochemical tests of liver function and of fibrogenesis were performed in parallel. Individual clinical outcome was registered 1 and 2 years later.Results:In control subjects, maximum portal flow velocity (Vmax) was more than 16 cm/sec, and the hepatic vein flow pattern was triphasic. Among children with biliary atresia, those with diminished portal Vmax, a flattened hepatic vein flow curve, or a hepatic artery resistance index of 0.8 or more had significantly lower indices of hepatic protein synthesis (albumin, cholinesterase), higher bilirubin levels, and higher concentrations of markers of connective tissue turnover (procollagen peptides, laminin P1) than did those with normal Doppler sonography measurements. The rate of survival without transplantation during the following 2 years was significantly lower in children with abnormal Doppler findings. From portal and hepatic vein flow measurements, patient survival 2 years later could be predicted with an accuracy of 93%.Conclusions:In children with extrahepatic biliary atresia, Doppler sonography of the hepatic blood flow is a noninvasive indicator of disease severity. Moreover, it allows a highly accurate prediction of patient survival for the following 2 years.
Ineffectiveness of Breath Methane Excretion as a Diagnostic Test for Lactose Malabsorption
Authors: Myo‐Khin  , Bolin Terry D. , Khin‐Mar‐Oo  , Tin‐Oo  , Kyaw‐Hla S. , Thein‐Myint Thein 
Published: February 2024

ABSTRACTBackground:In clinical and field conditions, breath gas analysis has been widely used in evaluating carbohydrate digestion. A field study was performed to determine the prevalence of lactose malabsorption in Myanmar children and to evaluate the possibility of using breath methane excretion to indicate lactose malabsorption in a field situation.Methods:The study population consisted of 118 children aged 1 to 12 years. A hydrogen breath test after a lactose meal (2 g/kg, maximum 50 g) was used as a standard test.Results:Lactose malabsorption was detected in 16.7% of children aged 1 to 2.9 years, with the prevalence increasing with age from 40.5% of those aged 3 to 5.9 years to 88.5% of those aged 6 to 8.9 years and reaching 91.7% in those aged 9 to 11.9 years. Lactose malabsorption was more prevalent when children were weaned before 4 months of age (87.2 vs. 41.1%; p < 0.01). Compared with lactose‐tolerant children, those with lactose malabsorption had significantly higher concentrations of breath hydrogen excretion 60 minutes after the lactose test meal. Breath methane excretion was also significantly higher in samples at 120 minutes in children with lactose malabsorption. Breath methane excretion of greater than or equal to 2 parts per million at 180 minutes as a diagnostic test for lactose malabsorption had a sensitivity of 61.5% and a specificity of 84.6%.Conclusion:The breath methane test for lactose malabsorption has a lower sensitivity and specificity than the breath hydrogen test and therefore does not replace the lactose breath hydrogen test.
Ultrasound Measurements of Subcutaneous Adipose Tissue in Infants Are Reproducible
Authors: Flygare Annika , Valentin Lil , Karlsland‐Åkeson Pia , Flodmark Carl‐Erik , Ivarsson Sten‐A. , Axelsson Irene 
Published: February 2024

ABSTRACTBackground:The purpose of this study was to evaluate the ultrasound technique for measuring subcutaneous adipose tissue in infants.Methods:Twenty infants were investigated at 3, 6, and 12 months of age. All measurements were made by the same investigator in triplicate on the left side of the body at the triceps and subscapular anatomic landmarks and at the abdomen and thigh. An ultrasound system equipped with a linear 7.0‐MHz transducer was used.Results:The intraclass correlation coefficients were 0.88 to 0.99. Random errors ranged from 0.01 to 0.19 mm. For log‐transformed values, the random error ranged from 2.4% to 5.7%.Conclusions:Measurements of subcutaneous fat in infants using ultrasound are reproducible when performed by the same observer.
Lymphonodular Hyperplasia As a Sign of Food Allergy in Children
Authors: Kokkonen Jorma , Karttunen Tuomo J. , Niinimäki Aila 
Published: February 2024

ABSTRACTBackground:Lymphonodular hyperplasia of the gastrointestinal tract in children is a rare endoscopic finding of uncertain clinical significance. In this study, 12 children with lymphonodular hyperplasia of the duodenum from a series of 63 children were studied for recurrent abdominal pain. Four additional children with lymphonodular hyperplasia of the colon are described. All the patients with lymphonodular hyperplasia were also evaluated for food allergy.Methods:A gastroduodenoscopy was performed in the patients with recurrent abdominal pain and in the four in whom lymphonodular hyperplasia of the colon had been diagnosed by colonoscopy. An open oral elimination and challenge test to diagnose food allergies was scheduled for all subjects with lymphonodular hyperplasia or any suspicion of food allergy. The study design also included skin prick tests with common allergens and determination of serum immunoglobulin A and immunoglobulin E concentrations.Results:Lymphonodular hyperplasia of the duodenal bulb was the main finding in 12 (19%) of the 63 children. The condition was found to be associated with food allergy in nine subjects (75%), which was significantly more often than among the remaining 51, 12 (24%) of whom had food allergy by the same criteria. In an oral challenge, food allergy first manifested gastrointestinal symptoms in the subjects of both groups and, in all except one, on days 2 through 5 after the foodstuffs were administered in minimal doses. In a histologic study, the duodenal specimens revealed significantly more eosinophilic cells in the children with food allergy and lymphonodular hyperplasia than in the children with food allergy but no lymphonodular hyperplasia. The major symptoms in the four patients with lymphonodular hyperplasia of the colon had been anemia and blood in stool in two and abdominal pains with mucous loose stools in the remaining two. Colonoscopic examination showed one to have diffuse and the other three patchy lymphonodular hyperplasia of the colon. In an oral challenge, three reacted to milk and two to cereals.Conclusions:Preliminary observations showed that lymphonodular hyperplasia of the duodenum or the colon is related to the gastrointestinal type of food allergy to basic foodstuffs. Further research is needed to define this finding as a separate entity.
Enteral Insulin‐like Growth Factor‐I Augments Intestinal Disaccharidase Activity in Piglets Receiving Total Parenteral Nutrition
Authors: Park Yoo Kyoung , Monaco Marcia H. , Donovan Sharon M. 
Published: February 2024

ABSTRACTBackground:Partial enteral nutrition is administered to infants on parenteral nutrition to stimulate intestinal function. Herein, the hypothesis that supplementation of partial enteral nutrition with insulin‐like growth factor‐I would augment intestinal development was investigated.Methods:One‐day‐old piglets (n = 29) were randomly assigned to five dietary treatment groups: 100% of energy as enteral formula, 100% of energy as total parenteral nutrition, or 80% parenteral nutrition/20% enteral formula supplemented with either 0, 0.2, or 1 mg/kg insulin‐like growth factor‐I for 7 days. Weight gain, intestinal weight, morphology, protein, and DNA content and disaccharidase activity and mRNA expression were assessed.Results:Parenterally fed piglets had similar whole body weight gain and serum hormone concentrations but reduced intestinal mucosal weight, villus height, and sucrase and lactase activity compared with 100% enterally fed pigs. Partial enteral nutrition alone increased mucosal weight and protein content, villus height, and disaccharidase activity compared with 100% parenterally fed piglets. No effect of the lower dose of insulin‐like growth factor‐I (0.2 mg/kg per day) was observed, but supplementing partial enteral nutrition with 1 mg insulin‐like growth factor‐I/kg further increased villus width and cross‐sectional area and disaccharidase activity compared with partial enteral nutrition alone. Lactase mRNA expression was not affected by insulin‐like growth factor‐I, suggesting that the primary site of regulation of lactase by insulin‐like growth factor‐I occurs after transcription.Conclusions:Enteral insulin‐like growth factor‐I augmented intestinal morphology and disaccharidase activity in parenterally fed piglets over that observed with partial enteral nutrition alone. Thus enteral insulin‐like growth factor‐I may represent an efficacious clinical adjunct to promote intestinal development of parenterally fed neonates.