bluuebunny/crossref_metadata_2025_split huggingface dataset:
Droperidol and Ondansetron-induced QT Interval Prolongation
Authors: Charbit Beny , Alvarez Jean Claude , Dasque Eric , Abe Emuri , Démolis Jean Louis , Funck-Brentano Christian 
Published: March 2009

Background
Droperidol and ondansetron have previously been found to prolong the QT interval in the treatment of postoperative nausea and vomiting. However, this adverse effect has never been confirmed and compared with both drugs under controlled conditions. The objective was to study the effects of droperidol and ondansetron alone or in combination on QT interval duration in healthy subjects.

Methods
Sixteen healthy volunteers, eight males and eight females, were enrolled in this prospective, double-blind, randomized, placebo-controlled study. Subjects received 1 mg droperidol, 4 mg ondansetron, 1 mg droperidol plus 4 mg ondansetron, or a placebo, intravenously in a crossover design. Fridericia-corrected QT interval (QTcF) and plasma concentrations were measured repeatedly during 10 h at each study period. The primary endpoint was the maximal placebo time-matched and baseline-subtracted QTcF prolongation (DeltaDeltaQTcF).

Results
Compared with placebo, both droperidol and ondansetron significantly prolonged the QTcF interval. DeltaDeltaQTcF prolongation was 25 +/- 8 ms after droperidol, significantly greater than the 17 +/- 10-ms prolongation with ondansetron (P = 0.014). The combination of droperidol and ondansetron significantly increased the mean maximal DeltaDeltaQTcF by 28 +/- 10 ms. The combination induced greater QTcF prolongation compared with ondansetron alone (P = 0.001), but not with droperidol alone (P = 0.33). There was no significant pharmacokinetic interaction between droperidol and ondansetron.

Conclusions
Under controlled conditions, both droperidol and ondansetron either alone or in combination induced significant marked QTc interval prolongation. However, the combination of both drugs did not significantly increase QTc prolongation compared with that induced by droperidol alone.
Frequency and Clinical Correlations of Granulomas in Children With Crohn Disease
Authors: De Matos Vera , Russo Pierre A , Cohen Aaron B , Mamula Petar , Baldassano Robert N , Piccoli David A 
Published: March 2009

ABSTRACTBackground:Granulomas are pathognomonic findings of Crohn disease (CD); however, their occurrence and clinical significance are not well characterized. Our aim was to determine the frequency and distribution of granulomas in untreated and treated patients with CD and their relation to age and disease severity.Patients and Methods:Records from patients with CD undergoing colonoscopy with terminal ileum biopsy over 7 years were reviewed. Clinical information and laboratory, pathology, and radiology results were recorded. The frequency and distribution of granulomas were determined.Results:From 376 patients with CD, 75% underwent concurrent esophagogastroduodenoscopy and colonoscopy. Of those, 65% (184/282) were untreated. Granulomas were identified in 48% (136/282) of all patients and in 61% (112/184) of untreated patients and 24.5% (24/98) of treated patients (P < 0.0005). The upper tract and terminal ileum biopsies were essential to the identification of 42% of patients with granulomas. The presence of granulomas at diagnosis was related to anti‐Saccharomyces cerevisiae antibodies, hypoalbuminemia, perianal disease, and gastritis at presentation (P = 0.03, P = 0.008, P = 0.03, and P = 0.001), respectively, and to perianal disease and infliximab treatment at the latest visit (P = 0.02 and P = 0.01), respectively. Granulomas were not related to age, sex, ethnicity, weight and height z scores, hemoglobin, C‐reactive protein, erythrocyte sedimentation rate, CARD15/NOD2 mutations, abdominal surgery, or stricturing or fistulizing disease.Conclusions:Granulomas were identified in 61% of fully investigated pediatric patients with CD at diagnosis, including a substantial proportion of patients in whom colonoscopy to the cecum would have been insufficient for diagnosis. Granulomas were more frequent in untreated patients (P < 0.0005), and their prevalence was not affected by age. The presence of granulomas at diagnosis was associated with perianal disease, gastritis, hypoalbuminemia, anti–Saccharomyces cerevisiae antibodies, and infliximab treatment.
Measuring Quality of Life in Pediatric Patients With Inflammatory Bowel Disease: Psychometric and Clinical Characteristics
Authors: Perrin James M , Kuhlthau Karen , Chughtai Aziz , Romm Diane , Kirschner Barbara S , Ferry George D , Cohen Stanley A , Gold Benjamin D , Heyman Melvin B , Baldassano Robert N , Winter Harland S 
Published: March 2009

ABSTRACTObjective:To extend development of a pediatric inflammatory bowel disease (IBD) health‐related quality of life (HRQoL) measure by determining its factor structure and associations of factors with generic HRQoL measures and clinical variables.Patients and Methods:Cross‐sectional survey of children and adolescents ages 8 years to 18 years and their parents attending any of 6 US IBD centers, recruited from either existing registry of age‐eligible subjects or visits to participating centers. The survey included generic (Pediatric Quality of Life Inventory) and IBD‐specific (Impact Questionnaire) quality of life measures, disease activity, and other clinical indicators. We carried out factor analysis of Impact responses, comparing resulting factors with results on the generic HRQoL and the clinical measures.Results:We included 220 subjects (161 with Crohn disease and 59 with ulcerative colitis). Initial confirmatory factor analysis did not support the 6 proposed Impact domains. Exploratory factor analysis indicated 4 factors with good to excellent reliability for IBD responses: general well‐being and symptoms, emotional functioning, social interactions, and body image. Two items did not load well on any factor. The 4 factors correlated well with the Pediatric Quality of Life Inventory and subscales. Children with higher disease activity scores and other indicators of clinical activity reported lower HRQoL.Conclusions:This study provides further characteristics of a HRQoL measure specific to pediatric IBD and indicates ways to score the measure based on the resulting factor structure. The measure correlates appropriately with generic HRQoL measures and clinical severity indicators.
Gallbladder Motility in Children With Chronic Constipation
Authors: Neto Magno Cardoso Veras , Yamada Roberto Massao , da Costa Pinto Elizete Aparecida Lomazi 
Published: March 2009

ABSTRACTObjective:The aim of this study was to evaluate gallbladder motility in constipated children.Patients and Methods:A cross‐sectional study was conducted on pediatric patients with refractory constipation examined in a pediatric gastroenterology unit of a teaching hospital between January 2005 and August 2006. All of the patients seen during the period were included (age range, 2–16 years). The control group, matched for sex and age, was selected among patients seen at the same basic health units where patients were seen before being referred to pediatric gastroenterologists. A gallbladder contractility index was calculated based on fasting and postprandial gallbladder areas, using an ultrasonographic method. Ultrasonography studies were performed prospectively and blindly by the same physician. Measurements obtained in patients were compared with those obtained in controls.Results:A total of 132 constipated children and the same number of healthy controls were included in the study. Median and mean fasting gallbladder areas were similar in patients and controls. Postprandial gallbladder areas were larger in the patient group, mean ± SD = 594.8 ± 206.4 mm2, median, 562.5 mm2, than in the control group, mean ± SD = 541.1 ± 156.1 mm2, median, 530.5 mm2; P = .031. Logistic regression showed that the risk of a contractility index <25% was 5.2 times greater in patients (odds ratio [OR] 5.2; 95% confidence interval [CI] 2.5–10.81) than in controls. Age was found to be a protective factor (OR 0.79; 95% CI 0.71–0.88).Conclusions:Gallbladder motility disorder was identified in a group of children with severe constipation. This finding may contribute to the understanding of functional constipation in children.
Clinical and Laboratory Predictors of Esophageal Varices in Children and Adolescents With Portal Hypertension Syndrome
Authors: Fagundes Eleonora Druve Tavares , Ferreira Alexandre Rodrigues , Roquete Mariza Leitão Valadares , Penna Francisco José , Goulart Eugênio Marcos Andrade , Filho Paulo Pimenta Figueiredo , Bittencourt Paulo Fernando Souto , Carvalho Simone Diniz , Albuquerque Walton 
Published: March 2009

ABSTRACTObjectives:To determine the clinical and laboratory parameters that may predict the presence of esophageal varices in children and adolescents with portal hypertension.Patients and Methods:Overall, 111 patients with portal hypertension and no previous history of digestive bleeding underwent esophagogastroduodenoscopy for detection of esophageal varices. A univariate analysis initially was carried out, followed by a logistic regression analysis to identify the independent variables associated with the presence of esophageal varices. Sensitivity and specificity rates, positive predictive value, negative predictive value, and the accuracy of the predictive variables identified among cirrhotic patients were calculated with the esophagogastroduodenoscopy as the reference test.Results:Sixty percent of patients had esophageal varices on the first esophagogastroduodenoscopy. Patients with portal vein thrombosis and congenital hepatic fibrosis were 6.15‐fold more likely to have esophageal varices than cirrhotic patients. When we analyzed 85 cirrhotic patients alone, splenomegaly and hypoalbuminemia remained significant indicators of esophageal varices. Only spleen enlargement showed appropriate sensitivity and negative predictive value (97.7% and 91.7%, respectively) to be used as a screening test for esophageal varices among cirrhotic patients.Conclusions:In reference services and research protocols, endoscopic screening should be performed in all patients with portal vein thrombosis and congenital hepatic fibrosis. Among cirrhotic patients, the indication should be conditioned to clinical evidence of splenomegaly or hypoalbuminemia. For clinicians, the recommendation is to emphasize the orientations given to guardians of patients with portal vein thrombosis and congenital hepatic fibrosis as to the risk of digestive bleeding. Cirrhotic patients with hypoalbuminemia and splenomegaly should receive the same orientations.
Body Perception: Do Parents, Their Children, and Their Children's Physicians Perceive Body Image Differently?
Authors: Chaimovitz R , Issenman R , Moffat T , Persad R 
Published: March 2009

ABSTRACTObjectives:To compare children's, parents' and physicians' perceptions of children's body size.Patients and Methods:We administered a structured questionnaire of body size perception using a descriptive Likert scale keyed to body image figures to children ages 12 to 18 years. The same scale was given to parents of children ages 5 to 18 years. The sample consisted of 91 children and their parents being seen in the Pediatric Gastroenterology Clinic for concerns unrelated to overweight. Weight and height of the children were measured, and body mass index (BMI) was calculated. The children's BMI percentiles were categorized as underweight (<15th), normal (15th–85th), overweight (85th–95th), and obese (95th and above). The attending physician independently completed the body image and description scale and indicated the figure that most accurately represented the patient without reference to BMI standards. Accuracy of the patients', parents', and doctors' estimates were statistically compared.Results:The sample population consisted of 6.4% underweight, 70.5% normal weight, 7.7% overweight, and 15.4% obese. Forty‐four percent of parents underestimated children's body size using word descriptions and 47% underestimated using figures. Forty percent of the children underestimated their own body size using descriptions and 43% underestimated using figures. The physicians in this study had a higher percentage of correct estimates; however, they underestimated 33% of the patients using both word descriptions and figures. Some obese children were not recognized, and several average children were perceived as underweight.Conclusions:Many children underestimated their degree of overweight. Their parents and even their attending physicians shared this misperception. This study demonstrates the need to further educate physicians to recognize obesity and overweight so that they can counsel children and their families.
Prevalence of Celiac Disease in Egyptian Children Disputes the East–West Agriculture‐dependent Spread of the Disease
Authors: Abu‐Zekry M , Kryszak D , Diab M , Catassi C , Fasano A 
Published: March 2009

ABSTRACTObjectives:Celiac disease (CD) seems to be a common disorder in north Africa; however, to our knowledge no data are yet available on its prevalence in Egypt. This study was undertaken to investigate the frequency of CD in Egyptian children.Patients and Methods:We investigated a sample of the general pediatric population (1500 individuals, 656 girls and 844 boys, age range 7 months to 18 years, median age 8.0 years) (group A); 150 children (age range 6 months to 13 years, median age 16 months) admitted for diarrhea or failure to thrive (group B); and 250 children and adolescents with type 1 diabetes (group C). The screening test was serum class A anti‐transglutaminase (anti‐tTG) antibody; immunoglobulin A (IgA) antiendomysium, total IgA, and IgG anti‐tTG, and small bowel biopsy was performed for confirmation of diagnosis.Results:In group A, 8 of 1500 children fulfilled the criteria for CD diagnosis; the prevalence of CD was at least 1 in 187 individuals (0.53%; 95% CI 0.17%–0.89%). In group B, 7 of 150 children had CD (4.7%, 95% CI 1.4–7.9). In group C, 16 of 250 sera showed positive results to both the IgA anti‐tTG and the IgA antiendomysium test (6.4%; 95% CI 3.4–9.4).Conclusions:Celiac disease is a frequent disorder among Egyptian children, both in the general population and in at‐risk groups. Therefore, our data do not support the theory of a Middle East–Europe CD prevalence gradient secondary to the pattern of agriculture spreading from the so‐called Fertile Crescent.
Neuromotor Markers of Esophageal Motility in Feeding Intolerant Infants With Gastroschisis
Authors: Jadcherla Sudarshan Rao , Gupta Alankar , Stoner Erin , Fernandez Soledad , Caniano Donna , Rudolph Colin D 
Published: March 2009

ABSTRACTBackground:Feeding problems in neonates with gastroschisis are commonly attributed to foregut dysmotility. However, the dysmotility mechanisms are not well understood.Objective:Our aim was to differentiate the pharyngoesophageal motility characteristics in neonates with gastroschisis compared with the controls. Specifically, the characteristics of swallowing, upper esophageal sphincter (UES), esophageal body, and lower esophageal sphincter (LES) were evaluated during basal state and upon provocation.Patients and Methods:Surgically repaired and recovered study infants with persistent feeding difficulties (n = 8; 36 ± 2 weeks gestational age) and controls (n = 8; 38 ± 2 weeks gestational age) were evaluated at 40 ± 2 weeks and 42 ± 2.5 weeks postmenstrual age, respectively. The basal and adaptive pharyngoesophageal motility characteristics were evaluated using a specially designed esophageal motility catheter with UES and LES sleeves and pneumohydraulic micromanometric water perfusion system at the crib side. Analysis of variance, chi‐square, and t tests were applied; data are shown as mean ± standard deviation, and P < 0.05 was considered significant.Results:Birth weight was less in gastroschisis (P < 0.03, vs controls) and length was less at motility study (P < 0.01, vs controls). The study group (vs controls) needed prolonged respiratory support (21 ± 23 vs 1 ± 2 days; P < 0.001) and prolonged gavage feeding (167 ± 100 vs 9 ± 16 days; P < 0.01). Compared with the controls, the gastroschisis group had lower frequency (P < 0.05) and poor propagation of spontaneous swallows (P < 0.001), UES relaxation time was shorter (P < 0.05), rate of relaxation was faster (P < 0.001), and esophageal peristaltic propagation velocity was slower (P < 0.05). Upon esophageal provocation with air and liquids, frequency occurrence of the esophageal reflexes was low (P < 0.05) with respect to primary peristalsis, secondary peristalsis, UES contractile reflex, and LES relaxation reflex.Conclusions:In gastroschisis feeding milestones and respiratory milestones were delayed, basal pharyngoesophageal peristaltic failure was common, adaptive peristaltic reflexes were less frequent and failed to occur, and frequency occurrences of UES and LES responses were impaired. These neuromotor markers may provide clues to define the esophageal motor function abnormalities in infants with an abnormality thought to be limited to the intestine.
Taurolidine and Catheter‐related Bloodstream Infection: A Systematic Review of the Literature
Authors: Bradshaw Joanne H , Puntis John WL 
Published: March 2009

ABSTRACTBackground:Catheter‐related bloodstream infection remains the most common serious complication associated with long‐term parenteral nutrition. Taurolock (Bio‐Implant HealthCare, Winsen, Germany), which contains taurolidine, is being marketed as a central venous catheter lock solution for decreasing the risk of catheter sepsis.Aim:To review available literature and examine the evidence for efficacy of taurolidine in prevention of central venous catheter–related infection.Materials and Methods:Search of MEDLINE, Embase, and the Internet for all studies involving use of taurolidine to prevent central venous catheter infection.Results:Six in vitro and 11 in vivo studies were assessed. Although in vivo studies suggest a possible useful role for taurolidine, the evidence base from clinical studies is poor, with much of it observational or of poor methodology.Conclusions:The evidence is insufficient to warrant routine use of taurolidine. However, results of in vitro studies are encouraging and further adequately powered and well‐designed randomized trials are required.
Could the Savory Taste of Snacks Be a Further Risk Factor for Overweight in Children?
Authors: Maffeis C , Grezzani A , Perrone L , Del Giudice E Miraglia , Saggese G , Tatò L 
Published: March 2009

ABSTRACTIntroduction:The quantity, type and composition of snack foods may play a role in the development and maintenance of obesity in children. A high consumption of energy‐dense snacks may promote fat gain.Aims:To assess the type and number of snacks consumed weekly by a large sample of 8‐ to 10‐year‐old children, as well as to assess its relationship with body size.Results:The children consumed on average 4 snacks per day. There was no statistical difference in the number of servings per day between obese and nonobese children. However, the mean energy density of the foods consumed was significantly higher for obese and overweight children than for normal weight children [6.8 (0.3) kJ/g, 6.8 (0.16) kJ/g, and 6.3 (0.08) kJ/g, respectively; P < 0.05]. Logistic regression analysis showed that the energy density of the snacks (kJ/g), their savory taste (servings/week), television viewing (hours/day) and sports activity (hours/week) independently contributed to predict obesity in children. However, when the parents' body mass index was included among the independent variables of the regression, only salty foods and sports activity showed an independent association with childhood obesity.Conclusions:Parents' eating habits and lifestyle influence those of their children, as suggested by the association between parents' obesity and their children's energy‐dense food intake at snacktime, the savory taste of snacks and sedentary behavior. However, regardless of parents' body mass index, the preference for savory snacks seems to be associated with overweight in prepubertal children.
Extraction of Diethylhexylphthalate by Home Total Parenteral Nutrition From Polyvinyl Chloride Infusion Lines Commonly Used in the Home
Authors: Loff Steffan , Hannmann Torsten , Subotic Ulrike , Reinecke Franziska‐Maria , Wischmann Hartmut , Brade Joachim 
Published: March 2009

ABSTRACTObjectives:Recently, our group detected that polyvinyl chloride (PVC) perfusion lines leach large amounts of the toxic plasticizer diethylhexylphthalate (DEHP) under conditions typical of intensive care units. In the present study, we investigated the extraction of DEHP from PVC connecting tubes that are commonly used for total parenteral nutrition (TPN) solutions. The aim of the study was to estimate the amount of DEHP to which children receiving home TPN are exposed for months and years.Materials and Methods:1000 mL of TPN, identical in constitution and amount to the home TPN of 1 of our patients, were perfused through 5 different connecting tube systems and collected in hexane‐rinsed glass bottles. The concentration of DEHP in the TPN was analyzed before and after perfusion.Results:Before perfusion of the lines, the solution had a DEHP concentration of 0.05 to 0.69 μg/mL (baseline value). After perfusion of the lines, the load of DEHP in the solution varied between 1.41 and 2.07 μg/mL. This TPN was established for children weighing 20 kg. The daily dosage is between 71 and 104 μg · kg−1· day−1. TPN is administered at home for many months and years. The monthly charge of DEHP is between 42.3 and 62.1 mg. Children weighing 20 kg therefore receive a dosage between 2.1 and 3.1 mg · kg−1· month−1.Conclusions:Diethylhexylphthalate and its metabolite monoethylhexylphthalate have been demonstrated to be carcinogenic, embryotoxic, hepatotoxic, pneumotoxic, and cardiotoxic and are known to disrupt endocrine pathways and liver detoxifying capacity in animals. They are suspected of having multiple effects in humans as well. The doses presented above should therefore be avoided in children receiving home TPN by the use of tubing systems that are completely free of DEHP. Such systems are available.
Anti‐NSP4 Antibody Can Block Rotavirus‐induced Diarrhea in Mice
Authors: Hou Zongliu , Huang Yongkun , Huan Youming , Pang Wei , Meng Mingyao , Wang Ping , Yang Meifen , Jiang Lihong , Cao Xinan , Wu Kenneth K 
Published: March 2009

ABSTRACTBackground:Rotavirus infection is the most common cause of infectious diarrhea and gastroenteritis among children worldwide. The viral proteins (VP), especially VP4‐ and VP7‐induced neutralizing antibodies, were considered to be critical in protective immunity to rotavirus disease. However, whether the antibody to rotavirus nonstructural protein 4 (NSP4) protects against rotavirus‐induced diarrhea directly is not completely clear, especially for the protective time course.Materials and Methods:To obtain direct evidence, 12‐day‐old ICR mice were treated with NSP4 and entire rotavirus to induce diarrhea.Results:Both NSP4 and rotavirus‐treated mice developed diarrhea, which was accompanied by histological changes in the small intestine compared to age‐matched control mice. Anti‐NSP4 antibody demonstrated protection against both entire rotavirus‐induced diarrhea and NSP4‐induced diarrhea. The histological changes in the small intestinal were reversible. These data show that early intervention with anti‐NSP4 antibody can prevent rotavirus‐induced diarrhea in mice; late intervention with anti‐NSP4 antibody could halt diarrhea progression in mice.Conclusions:Our findings demonstrate for the first time that administration of anti‐NSP4 antibody is effective both prior to and during the time course of rotavirus infection. These observations extend our knowledge of rotavirus infection and its therapeutic options.