bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gluten‐Free Diet Decreases Urinary Peptide Levels in Children with Celiac Disease
Authors: Ek J. , Stensrud M. , Reichelt K. L. 
Published: February 2024

ABSTRACTBackground:Increased urine secretion of peptides has been found in celiac disease, probably resulting from increased intestinal uptake of peptides caused by damage to the small gut mucosa.Methods:High‐performance liquid chromatography of low‐molecular‐weight peptides in the urine was performed over 6 months, before and after a gluten‐free diet was instituted in children who clinically improved while consuming the diet.Results:A significant decrease of peptide levels was observed in children consuming the gluten‐free diet. Certain peptide peaks thought to be gluten related decreased the most after the patients began the diet.Conclusions:Because the peptides decrease in patients consuming a gluten‐free diet, it is reasonable to conclude that such peptide have a mostly dietary origin.
Effect of Sequential Erythromycin and Octreotide on Antroduodenal Manometry
Authors: Di Lorenzo Carlo , Lucanto Cristina , Flores Alejandro F. , Idries Shaheen , Hyman Paul E. 
Published: February 2024

ABSTRACTBackground:In earlier studies, erythromycin stimulated but octreotide inhibited gastric antral contractions, as each drug induced phase 3‐like episodes.Methods:To assess the effect of erythromycin pretreatment on octreotide‐induced changes in antroduodenal motility, 16 patients were studied (mean age, 8.7 ± 1.5 years, 8 male): 6 with severe gastroesophageal reflux, 4 with cyclic vomiting, 3 with gastroparesis, 2 with chronic intestinal pseudo‐obstruction, and 1 with Crohn's disease and unexplained nausea and vomiting. After recording fasting antroduodenal motility for 3 hours, 1 mg/kg intravenous erythromycin was administered over 30 minutes. Sixty minutes after the erythromycin infusion, 0.5 µg/kg subcutaneous octreotide was administered, followed 1 hour later by a meal.Results:Phase 3 occurred spontaneously in 10 patients and after erythromycin in 12 patients. When administered after erythromycin, octreotide immediately induced phase 3s contractions in 15 patients, beginning in the antrum. In 7 children, some of the octreotide‐induced phase 3s did not propagate. After the meal, antral contractions continued in all patients. The fed pattern was replaced in 14 patients by alternating phase 3 and phase 1 activities.Conclusions:Pretreatment with erythromycin prevented octreotide‐induced inhibition of antral contractions. Inhibition of antral contractions by octreotide may be mediated through either a direct or indirect suppression of motilin release, because antral contractions persist after pretreatment with the motilin receptor agonist erythromycin.
Isolated Deficient α6β4 Integrin Expression in the Gut Associated with Intractable Diarrhea
Authors: Lachaux Alain , Bouvier Raymonde , Loras‐Duclaux Irène , Chappuis Jean‐Paul , Meneguzzi Guerino , Ortonne Jean‐Paul 
Published: February 2024

ABSTRACTBackground:An infant born with pyloric atresia had development of intractable diarrhea and was found to have total epithelial detachment of gastric and small and large bowel mucosa. She had no skin abnormalities. Parental consanguinity and pyloric atresia in a sibling who died without autopsy suggest an inherited origin for this disorder. The purpose of this study was to examine defects in intestinal and skin cell adhesion.Methods:Histologic, immunohistochemical, and ultrastructural characteristics of the skin and gut of the patient were compared with that of normal control subjects. Distribution of adhesion molecules was determined.Results:Immunofluorescent analysis of the digestive mucosa showed α6β4 integrin expression deficiency at the epithelial cell‐lamina propria junction. Ultrastructural examination of the digestive mucosa revealed a complete epithelial detachment with a cleavage plane lying between the lamina densa and the basal pole of the enterocytes. Consistent with the absence of skin blistering, integrin α6β4 was expressed at the dermal‐epidermal junction. Electron micrographs of skin biopsy specimens showed the presence of normal hemidesmosomes and the absence of dermal‐epidermal dysadhesion.Conclusion:It was postulated that this patient had protracted diarrhea related to epithelial detachment of the digestive mucosa as a consequence of a deficiency of an integrin α6β4 isoform specific to the gut.
Intussusception in a Tropical Country: Comparison Among Patient Populations in Jakarta, Jogyakarta, and Amsterdam
Authors: van Heek N. Tjarda , Aronson Daniel C. , Halimun Eddy M. , Soewarno Roesman , Molenaar Jan C. , Vos Anton 
Published: February 2024

ABSTRACTBackground:Intussusception is the most common cause of intestinal obstruction in young children, and high mortality rates remain a problem in developing countries. The purpose of this study was to describe and elucidate the differences in outcome become groups of children with intussusception in Indonesia, a developing country, and The Netherlands, a developed country.Methods:In this retrospective review, 176 patients were studied in three types of hospitals. A comparison was made among children treated at a primary care rural hospital in Indonesia, at a secondary care urban hospital in Indonesia, and at a tertiary care urban hospital in The Netherlands.Results:Children in the rural community hospital in Indonesia were more severely ill at arrival and had a significantly longer duration of symptoms, an increased incidence of nonviable bowel, and a mortality rate of 20%, in contrast to a mortality rate of 3% in the urban hospital in Indonesia and no deaths in the Dutch hospital.Conclusions:The mortality of children with intussusception in rural Indonesia is much higher than in urban Indonesia or in The Netherlands, probably because of delayed treatment, which results in more patients undergoing surgery in worse physical condition.
Use of Rifampin for Severe Pruritus in Children with Chronic Cholestasis
Authors: Yerushalmi Baruch , Sokol Ronald J. , Narkewicz Michael R. , Smith Debra , Karrer Frederick M. 
Published: February 2024

ABSTRACTBackground:Rifampin has been proposed to reduce pruritus in children and adults with chronic cholestasis; however, there is a paucity of published data regarding the use of rifampin in children.Methods:In an open trial, 24 children were evaluated during a 6‐year period. Diagnoses included 13 patients with extrahepatic biliary atresia (54%), six with Alagille's syndrome, three with Byler's disease, and one each with primary sclerosing cholangitis and α1‐antitrypsin deficiency. All patients had severe pruritus deficiency. All patients had severe pruritus that had not responded adequately to at least 2 months of therapy with ursodeoxycholic acid, diphenhydramine, or phenobarbital and local skin care measures. Treatment was initiated with rifampin, 10 mg/kg per day in two divided doses for 18 ± 20 months, and the effect on the severity of pruritus was assessed by a clinical scoring system.Results:Ten patients showed a complete response, 12 a partial response, and 2 no response. Complete response was more common in extrahepatic cholestasis (64% vs. 10%), whereas partial response was more common in intrahepatic cholestasis (80% vs. 29%). Treatment was associated with reduction of γ‐glutamyl transpeptidase. No clinical or biochemical toxicity of rifampin was observed.Conclusions:We conclude that for more than 90% of children with chronic cholestasis and severe pruritus unresponsive to other treatments, rifampin appears to be a safe and effective therapy.
Does the Size of Nasogastric Tubes Affect Gastroesophageal Reflux in Children?
Authors: Noviski Natan , Yehuda Yoram Ben , Serour Francis , Gorenstein Arkadi , Mandelberg Avigdor 
Published: February 2024

ABSTRACTBackground:To evaluate the effects of nasogastric tube insertion and different nasogastric tube sizes on gastroesophageal reflux in children.Methods:During a prospective randomized study, 29 patients aged 1 month to 4 years (median, 9 months) underwent 24 hours of continuous esophageal pH monitoring to rule out gastroesophageal reflux as the cause of severe pulmonary problems. Each patient was monitored without nasogastric tube for 16 hours (baseline), and thereafter the first nasogastric tube, small (8‐Fr) or large (10‐Fr or 12‐Fr), was placed. Four hours later, the original nasogastric tube was replaced by a new one of large (instead of small) size or of small (instead of large) size. We selected the times of wakefulness in these study periods and compared the number of reflux episodes (NREs), the number of reflux episodes that lasted more than 5 minutes (NRE > 5), and the percentage of time with esophageal pH less than 4 (PTP < 4).Results:The 12‐Fr group in comparison with the 8‐Fr group and baseline showed significant difference (P < 0.05) in the NRE>5 and PTP<4 parameters. No significant differences were found when comparing 8‐Fr versus 10‐Fr groups and baseline. In children with (n = 20) and without (n = 9) gastroesophageal reflux, comparison of the various reflux parameters between baseline and the different sizes of nasogastric tubes showed the same results.Conclusions:Size of the nasogastric tubes is a significant factor in predisposing the child to gastroesophageal reflux. Large nasogastric tubes interfere with the clearance of the refluxed acid from the esophagus.
A Successful Short‐Bowel Syndrome Model in Neonatal Piglets
Authors: Heemskerk Vincent H. , van Heurn Lodewijk W. E. , Farla Peter , Buurman Wim A. , Piersma Femke , ter Riet Gerben , Heineman Erik 
Published: February 2024

ABSTRACTBackground:With the higher survival rate of premature neonates as a result of improved neonatal intensive care, the incidence of necrotizing enterocolitis, and thus the incidence of short‐bowel syndrome, is increasing. An appropriate animal model resembling the (premature) neonate with short‐bowel syndrome suitable for clinically relevant neonatal bowel adaptation and intervention studies, is not available at present. The purpose of this study was the development of a short‐bowel syndrome model that mimics the clinical state of the affected neonatal patient.Methods:Sixteen 7‐day‐old piglets received either a small bowel transection (group A) or a 75% resection (group B). The piglets were fed 125 kcal/kg body weight per day, including additional electrolytes. The animals were weighed daily and were killed 28 days after surgery. Bowel samples were obtained at both time points.Results:Mortality rates in groups A and B were 0% and 8%, respectively. Body weight gain was significantly higher in group A than in group B (156% vs. 93%; P = 0.01). Jejunal villus length was higher in group B than in group A (74% vs. ‐2%; P = 0.006), and crypt depth was higher in group B in both jejunum (201% vs. 67%; P = 0.001) and ileum, (197% vs. 20%; P = 0.001), than in group A.Conclusions:In 7‐day‐old piglets 75% small bowel resection leads to a clinical short‐bowel syndrome, demonstrated by reduced weight gain and typical changes in bowel adaptation parameters. The excellent survival of the animals provides a possibility for the study of bowel adaptation in a neonatal model as well as in intervention studies.
Cytokine Release of Peripheral Blood Mononuclear Cells in Children With Chronic Hepatitis B Virus Infection
Authors: Hsu Hong‐Yuan , Chang Mei‐Hwei , Ni Yen‐Hsuan , Lee Ping‐Ing 
Published: February 2024

ABSTRACTBackground:Immune response to hepatitis B virus (HBV) antigens or mitogens in Asian children with chronic HBV infection who are mainly perinatally infected has not been studied in connection with the production of various cytokines, although these patients are considered to be less responsive to antiviral therapy.Methods:The production of the cytokines interferon (IFN)‐γ, lymphotoxin, interleukin (IL)‐4, tumor necrosis factor (TNF)‐α, and interleukin (IL)‐1β by peripheral blood mononuclear cells (PBMCs) was studied in 17 hepatitis B surface antigen (HBsAg) carrier children with raised alanine transferase levels (group 1), 17 HBsAg carrier children with normal alanine transferase levels (group 2), and 20 healthy noncarrier control subjects (group 3).Results:Hepatitis B core antigen (HBcAg)‐stimulated IFN‐γ production was significantly higher in group 1 than in groups 2 and 3, serum HBeAg cleared within 1 year in five of eight children in group 1 with stimulation indexes higher than 3, and HBcAg‐induced IL‐4 secretion was minimal in all groups. Interferon‐γ produced by PBMCs stimulated by purified HBsAg did not differ among the three groups. Higher lymphotoxin production by PBMCs stimulated by HBcAg was also noted in groups 1 and 2 than in group 3. Lipopolysaccharide (LPS)‐stimulated TNF‐α production by PBMCs was significantly higher in group 1 than in group 2. There was no association between HBeAg‐anti‐HBe status and production of various cytokines. No differences were seen in the profile of cytokines induced by HBV antigens or LPS in children of carrier mothers compared with children of HBsAg‐negative mothers.Conclusion:Increased IFN‐γ production resulting from HBcAg‐specific T‐helper lymphocyte type 1 response, and increased TNF‐α production may contribute to cell‐mediated antiviral immune response in children with chronic hepatitis B. In HBV carrier children, the ability to produce the studied cytokines is related to whether an endogenous immune attempt to eliminate HBV infection emerges in the patients but is not related to the different modes of acquisition of HBV infection.
Activation of the Gut‐Associated Lymphoid Tissue With Expression of Interleukin‐2 Receptors That Peaks During Weaning in the Rat
Authors: Masjedi Mohsen , Tivey David R. , Thompson Fiona M. , Cummins Adrian G. 
Published: February 2024

ABSTRACTBackground:Weaning exposes the intestinal mucosa to food and bacterial antigens at an age when the immune system is believed to be immature and functionally defective. The purpose of this study was to investigate changes in activation and phenotype of immune cells of the gut‐associated lymphoid tissue during weaning.Methods:Litters of infant rats were studied from pre‐ to postweaned life. The activation status, assessed by interleukin‐2 receptor (IL‐2R) expression, and phenotype of cells in the gut‐associated lymphoid tissue were examined by immunostaining.Results:Interleukin‐2 receptor expression peaked two to fourfold at midweaning (day 21) in mesenteric lymph nodes, jejunal lamina propria, Peyer's patches, and intraepithelial lymphocytes, compared with adult animals (day 70). CD45+ cells expanded in the lamina propria, epithelium, and lymphocyte‐filled villi. With CD45 as the denominator, 10% to 50% of lymphocytes in the lamina propria and epithelium were αβT‐cell receptor (TCR)+, but the remaining cells had a null phenotype, because there were low numbers of γδTCR+ T cells, B cells, and macrophages. Natural killer cells peaked at midweaning in the lamina propria (9%) and epithelium (20%) but were less than 5% of CD45+ cells after weaning.Conclusions:Rather than being immature or functionally inactive, the gut‐associated lymphoid tissue reacts appropriately during weaning with expression of IL‐2R and expansion of αβTCR+ T‐cells.
Antibodies to Gliadin, Endomysium, and Tissue Transglutaminase for the Diagnosis of Celiac Disease
Authors: Vitoria Juan Carlos , Arrieta Arantza , Arranz Cristina , Ayesta Arantza , Sojo Amaia , Maruri Natalia , García‐Masdevall Maria D. 
Published: February 2024

ABSTRACTBackground:Tissue transglutaminase has recently been identified as the main autoantigen recognized by antiendomysial antibodies in celiac disease. Serum immunoglobulin (Ig)A antibodies to tissue transglutaminase (tTG‐ab) determined by an enzyme‐linked immunosorbent assay (ELISA) technique have been reported to correlate closely with IgA antiendomysial antibodies (EMA). The purpose of this study was to assess the sensitivity, specificity, and predictive value of tTG‐ab measured by a commercially available ELISA technique, compared with those of EMA and IgA antigliadin antibodies (AGA) for the diagnosis of celiac disease.Methods:Twenty‐seven serum samples were obtained from patients with untreated celiac disease, 37 from patients who had had gluten withdrawn from their diets for varying time spans, and 34 from control subjects without celiac disease. All were younger than 14 years. Presence of tTG‐ab and AGA was determined by ELISA and of EMA by indirect immunofluorescence.Results:Twenty‐six of 27 serum samples obtained from patients at the time of diagnosis of celiac disease were AGA positive. All 27 (concordance rate 100%) were positive for EMA and tTG‐ab. Of the 34 control subjects, 1 was for AGA and 2 for tTG‐ab. All 34 were negative for EMA. Sensitivity, specificity, positive predictive value, and negative predictive value within this group were, for tTG‐ab: 100%, 94%, 93%, and 100%, respectively; for EMA: all four indexes were 100%; and for AGA: 96%, 97%, 96%, and 97%, respectively. Of the 37 with treated celiac disease, 2 were AGA positive, 9 were EMA positive, and 6 were tTG‐ab positive. The concordance rate between EMA and tTG‐ab was 100% in the group with untreated celiac disease, 94% in the control subjects, and 76% in the group with treated celiac disease.Conclusions:Immunoglobulin A antibodies to tissue transglutaminase are new, highly sensitive, and specific markers of celiac disease. They can be determined easily by an accurate, comparatively cheap technique and thereby may advantageously replace the EMA marker traditionally used.
Potential Uses for Quality‐of‐Life Measures in Childhood Inflammatory Bowel Disease
Authors: Koot Hans M. , Bouman Nico H. 
Published: February 2024

ABSTRACTHealth‐related quality of life (HRQOL) in children with inflammatory bowel disease is clearly reduced in the physical as well as in the psychological and social functioning domains. However, very few studies of these children have been performed from a quality‐of‐life perspective. Multicenter studies on HRQOL are needed to answer questions about the impact of Crohn's disease and ulcerative colitis and their treatment and complications on HRQOL in children and adolescents and their association with outcome. This article describes perspectives from which quality of life studies may be performed, potential uses of HRQOL measures, and issues that should be accounted for in designing multicenter clinical studies on this topic.
Detection of Interferon Regulatory Factor‐1 in Lamina Propria Mononuclear Cells in Crohn's Disease
Authors: Clavell Mariaines , Correa–Gracian Hernan , Liu Zhiyun , Craver Randall , Brown Raynorda , Schmidt–Sommerfeld Eberhard , Udall John , Delgado Alberto , Mannick Elizabeth 
Published: February 2024

ABSTRACTBackground:The transcription factor, interferon regulatory factor (IRF)‐1, is stimulated by interferon‐γ and regulates the expression of several genes implicated in the pathogenesis of inflammatory bowel disease, including interleukin‐6, major histocompatibility complex class II molecules, and inducible nitric oxide synthase. Interferon regulatory factor‐1 also stimulates naive CD4+ T‐cells to differentiate into T‐helper‐1 cells, the T‐cell subset that appears to be upregulated in Crohn's disease. The purpose of this study was to examine the expression of IRF‐1 in the nuclei of lamina propria mononuclear cells in situ in colonoscopic biopsy specimens from pediatric patients with Crohn's disease, in patients with ulcerative colitis, and in control patients with no histopathologic abnormalities.Methods:Archival paraffin‐embedded tissue sections were obtained from 25 pediatric patients with Crohn's disease, 6 patients with ulcerative colitis, and 12 control patients who had undergone colonoscopy. Tissue sections were stained with polyclonal rabbit anti‐human antisera to IRF‐1 and horseradish‐peroxidase–conjugated, biotinylated, goat anti‐rabbit secondary antibody. Slides were scored and scores compared among patient groups using analysis of variance.Results:Patients with Crohn's disease had significantly higher IRF‐1 scores (95% confidence interval [CI], 1.70–2.04) than patients with ulcerative colitis (95% CI, 0.92–1.23) or control subjects (95% CI, 1.11–1.52).Conclusions:Increased expression of IRF‐1 in lamina propria mononuclear cells from patients with Crohn's disease may be relevant to the pathogenesis of Crohn's disease.
Clinical Evaluation of the Addition of Lyophilized, Heat‐Killed Lactobacillus acidophilus LB to Oral Rehydration Therapy in the Treatment of Acute Diarrhea in Children
Authors: Simakachorn Nipat , Pichaipat Vorapun , Rithipornpaisarn Prayungari , Kongkaew Chumnian , Tongpradit Pisamai , Varavithya Wandee 
Published: February 2024

ABSTRACTBackground:Addition of a medication to the World Health Organization protocol for treatment of acute diarrhea in children is controversial. In this trial, the clinical efficacy of a medication (Lactéol Fort sachets; Laboratoire du Lactéol du Docteur Boucard, Houdan France) containing lyophilized heat‐killed Lactobacillus acidophilus LB was assessed as an adjunct to oral rehydration therapy.Methods:Children aged 3 to 24 months with acute diarrhea and mild or moderate dehydration were enrolled in the study. Children received oral rehydration therapy for the first 4 hours. After this first rehydration phase, undiluted milk formula or breast milk was fed alternately with oral rehydration solution. Children were fed rice gruel as tolerated. They received either one sachet containing 10 billion of lyophilized heat‐killed L. acidophilus LB or placebo at admission and at 12‐hour intervals for five doses.Results:Seventy‐three children (37 L. acidophilus LB, 36 placebo) were enrolled, of whom 40 (17 L. acidophilus LB, 23 placebo) received an antibiotic before inclusion. Rotavirus was identified in approximately 50% of the children in each group. After 24 hours of treatment, the number of rotavirus‐positive children with watery stools was significantly lower (p = 0.012) in the L. acidophilus LB group. Mean duration of diarrhea was decreased (p = 0.034) with L. acidophilus LB (43.4 hours) versus placebo (57.0 hours). This decreased duration was particularly marked in children with no antibiotic therapy before inclusion (31.1 hours): 42.9 hours for the L. acidophilus LB group versus 74.0 hours for the placebo group (p = 0.016).Conclusions:Addition of L. acidophilus LB to oral rehydration therapy was effective in the treatment of children with acute diarrhea by decreasing the duration of diarrhea.
Infantile Colic and Food Hypersensitivity
Authors: Hill David J. , Hosking Clifford S. , Simpson Hugh A. , Anderson John A. 
Published: February 2024

ABSTRACTIn this article, some aspects of the phenomenon of infantile colic or fussing and crying behavior in early infancy are reviewed. The major points addressed are as follows: 1) evidence that infants with colic differ significantly in their pattern of distressed behavior from noncolicky infants; 2) the evidence of colic in children with known food allergy; 3) the incidence of food allergy in children with colic; 4) the outcome of trials focusing on the dietary management of colic; 5) the outcome of studies involving behavior modification in colic; 6) the outcome of a preliminary trial of modification of maternal diet in very young infants with colic; and 7) findings of a systematic review of different treatments for colic.