bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of a Long‐Chain Polyunsaturated Fatty Acid Supplemented Formula on Growth, Tolerance, and Plasma Lipids in Preterm Infants up to 48 Weeks Postconceptional Age
Authors: Vanderhoof Jon , Gross Steven , Hegyi Thomas , Clandinin Thomas , Porcelli Peter , DeCristofaro Joseph , Rhodes Torunn , Tsang Reginald , Shattuck Karen , Cowett Richard , Adamkin David , McCarton Cecilia , Heird William , Hook‐Morris Brenda , Pereira Gilberto , Chan Gary , Van Aerde John , Boyle Frances , Pramuk Kathryn , Euler Arthur , Lien Eric L. 
Published: February 2024

ABSTRACTBackground:The last trimester of pregnancy is a period of rapid accretion of long‐chain polyunsaturated fatty acids, both in the central nervous system and the body as a whole. Human milk contains these fatty acids, whereas some preterm infant formulas do not. Infants fed formulas without these fatty acids have lower plasma and erythrocyte concentrations than infants fed human milk. Preclinical and clinical studies have demonstrated that single‐cell sources (algal and fungal) of long‐chain polyunsaturated fatty acids are bioavailable. A balanced addition of fatty acids from these oils to preterm formula results in blood fatty acid concentrations in low birth weight infants comparable to those of infants fed human milk.Methods:In the present study the growth, acceptance (overall incidence of discontinuation, reasons for discontinuation, overall incidence and type of individual adverse events), and plasma fatty acid concentrations were compared in three groups of infants fed a long‐chain polyunsaturated fatty acid‐supplemented preterm infant formula, an unsupplemented control formula, or human milk. The study was prospective, double‐blind (formula groups only), and randomized (formula groups only). Two hundred eighty‐eight infants were enrolled (supplemented formula group, n = 77; control formula group, n = 78; human milk group, n = 133).Results:Anthropometric measurements at enrollment, at first day of full oral feeding, and at both 40 and 48 weeks postconceptional age did not differ between the formula groups, whereas the human milk‐fed group initially grew at a lower rate. The incidence of severe adverse events was rare and not significantly different between formula groups. The groups fed either human milk or supplemented formula had long‐chain polyunsaturated fatty acid concentrations higher than those in the control formula group.Conclusions:The results of this study demonstrate the safety and efficacy of a preterm formula supplemented with long‐chain polyunsaturated fatty acids from single‐cell oils.
Fruit Juice Consumption and the Prevalence of Obesity and Short Stature in German Preschool Children: Results of the DONALD Study
Authors: Alexy Ute , Sichert‐Hellert Wolfgang , Kersting Mathilde , Manz Friedrich , Schöch Gerhard 
Published: February 2024

ABSTRACTBackground:In recent years, a possible association between excessive consumption of fruit juice (≥12 fl oz per day) and short stature and/or obesity has been discussed. The association among the consumption of fruit juice, anthropometric indices, and the overall diet was examined during a 3‐year period in a sample of healthy preschool children participating in the Dortmund Nutritional and Anthropometrical Longitudinally Designed (DONALD) Study.Methods:Two hundred five children were examined annually at the ages of 3, 4, and 5 years. Dietary intake was calculated from 3‐day weighed diet records. Height was measured using a stadiometer. Weight was measured using an electronic scale.Results:Five children consumed excessive fruit juice continually in all three records, 10 children in two records, and 23 children in one record. None of the five children with repeatedly excessive fruit juice consumption was obese or short. Growth velocity, body mass index, and height standard deviation score were not correlated with fruit juice consumption. Consumption of fruit juice was inversely correlated with the consumption of all other beverages and the total consumption of all other food. The intake of protein, fat, and carbohydrates of children consuming excessive fruit juice was closer to the international dietary preventive guidelines than the intake of children consuming low amounts of fruit juice.Conclusions:In the study sample, even repeatedly excessive fruit juice consumption had no influence on anthropometric indices. The results do not justify a general warning or a general promotion regarding high fruit juice consumption in preschool children's diets.
Protein Hydrolysate Formula Maintains Homeostasis of Plasma Amino Acids in Preterm Infants
Authors: Mihatsch Walter A. , Pohlandt Frank 
Published: February 2024

ABSTRACTBackground:Plasma amino acid concentrations were measured in preterm infants who were fed either a new hydrolyzed cow's milk protein formula or a standard preterm infant formula. It was hypothesized that feeding with the hydrolysate results in preprandial amino acid concentrations that are significantly different from the concentrations found when feeding with the standard formula.Methods:Fifteen preterm infants, median gestational age, 29 weeks (range, 24‐32 weeks); birth weight, 1241 g (range, 660‐1900 g); and postnatal age, 18 days (range, 7‐54 days) receiving full enteral feedings (>150 ml/kg·day), were enrolled. The intervention was randomized allocation to the formula with hydrolyzed or natural cow's milk protein (the whey/casein ratio was 60:40 in both formulas). In a crossover design, each formula was fed for 5 days, and plasma amino acids were analyzed on day 4 or 5 of each 5‐day period.Results:In spite of the 12% higher amino acid intake with hydrolysate formula, the median individual plasma amino acid concentrations were virtually identical with both formulas, and they were within the 10th and the 90th percentile of the reference of levels in the umbilical cord artery after elective cesarean delivery or of breast‐fed newborn infants. The median concentrations of lysine and aspartic acid were higher with hydrolyzed formula feeding (p < 0.05; two‐tailed Mann‐Whitney test). With both formulas, single amino acid concentrations were out of the reference values.Conclusion:Virtually identical plasma amino acid concentration patterns were measured with the new hydrolyzed preterm infant formula and the standard preterm infant formula, but longitudinal studies are required before the studied protein hydrolysate can be recommended for preterm feeding in general.
Are Endoscopic Biopsies of Small Bowel as Good as Suction Biopsies for Diagnosis of Enteropathy?
Authors: Thomson Mike , Kitching Paul , Jones Alison , Walker‐Smith John A. , Phillips Alan 
Published: February 2024

ABSTRACTBackground:Endoscopy is increasingly used in paediatric practice for diagnosis of enteropathy, although the quality of grasp forceps‐obtained biopsy specimens required for reliable diagnosis has been questioned in comparison with suction capsule biopsy specimens. This study prospectively compared the diagnostic suitability of grasp forceps biopsy versus suction biopsy in the same patient during the same procedure.Methods:A double‐port paediatric suction biopsy capsule was front‐loaded onto an endoscope and directed to the fourth part duodenum‐proximal jejunum for biopsy sampling. Subsequently, three grasp biopsy specimens were taken from the same region. All biopsies were coded, photographed, and measured for area, using computed morphometry. A single blinded histopathologist assessed sample adequacy for diagnosis. Twenty‐nine patients were enrolled (age range, 8‐185 months).Results:On three occasions the suction capsule failed to fire, and on four occasions only one sample was obtained. Three grasp biopsy specimens were obtained on each occasion by endoscopy, and the first two were used for comparison with suction biopsy samples. Median total area of individual biopsy samples obtained by the two procedures was not different (21.3 vs. 22.5 mm2; P = 0.027). Muscularis mucosae was obtained more commonly with grasp biopsies (P < 0.001), and no difference was observed for the presence of three or more villuscrypt units, degree of haemorrhage, or optimal orientation. Two suction biopsy procedures and one grasp biopsy procedure were inadequate for diagnosis.Conclusions:Endoscopic grasp biopsies are perfectly adequate for the assessment of small intestinal histology. In addition, endoscopy affords advantage in diagnosis of other upper gastrointestinal disease with avoidance of radiologic screening involved with the suction capsule technique.
Colon Involvement in Langerhans' Cell Histiocytosis
Authors: Nanduri Vasanta Rao , Kelly Kara , Malone Marian , Milla Peter , Pritchard Jon 
Published: February 2024

ABSTRACTBackground:Langerhans' cell histiocytosis (LCH), a granulomatous disorder of unknown cause, most often affects the bony skeleton and skin. Obvious gut involvement is uncommon, and colon involvement has been cited in only a small number of case report, probably because most patients who have LCH with diarrhoea and/or failure to thrive are not investigated by colonoscopy and biopsy. The current study was conducted to determine the incidence of symptomatic colon involvement among patients with multisystem LCH treated at a single institution.Method:A retrospective review of cases in hospital records and the literature.Results:Of the 275 children with LCH in the database, 5 were identified as having biopsy‐confirmed colonic involvement. Another 14 cases were identified by a literature review.Conclusion:Colonic involvement in patients with multisystem LCH is probably more common than currently recognised. In addition to the other investigations recommended by the Writing Group of the Histiocyte Society, it is recommended that patients with any symptoms suggestive of gut involvement undergo colonoscopy and biopsy of the colonic mucosa.
The Caffeine Metabolic Ratio as an Index of Xanthine Oxidase Activity in Clinically Active and Silent Celiac Patients
Authors: Boda Márta , Németh Ilona , Boda Domokos 
Published: February 2024

ABSTRACTBackground:The xanthine oxidoreductase system has been identified as one of the main sources of free radicals responsible for various forms of tissue injury. Because the intestinal villi are an important location of this enzyme, it was of interest to study the role of xanthine oxidase in gluten‐sensitive celiac enteropathy, associated with characteristic villous atrophy. Measured by a noninvasive method, the ratio of caffeine metabolites excreted in the urine after a caffeine challenge had previously been shown to be indicative of the total xanthine oxidase activity of the patient.Methods:The study involved 22 children with gluten‐challenged celiac disease, exhibiting subtotal villous atrophy in specimens from the third intestinal biopsy in accordance with ESPGHAN criteria. Ten of the patients displayed overt clinical symptoms (active form), whereas 12 had no symptoms (silent form). Urinary caffeine metabolites were determined by high‐pressure liquid chromatography. The total in vivo xanthine oxidase activity was expressed as the caffeine metabolite index.Results:In patients with active celiac disease the xanthine oxidase activity index was considerably higher, whereas in those with silent disease it was significantly lower than the control value. A significant negative correlation was shown between the index indicative of xanthine oxidase activity and the serum iron level of the patients.Conclusions:Activation of xanthine oxidase may play a role in the pathogenesis of active celiac disease with definite malabsorption, gastrointestinal symptoms, and anemia. The caffeine test reflects the difference in the pathogenetic mechanism leading to the mucosal lesion and clinical symptoms of active and silent forms of celiac disease.
Double‐Blind Randomized Controlled Trial of Glutamine‐Enriched Polymeric Diet in the Treatment of Active Crohn's Disease
Authors: Akobeng Anthony K. , Miller Victor , Stanton John , Elbadri Abubaker M. , Thomas Adrian G. 
Published: February 2024

ABSTRACTBackground:Glutamine is traditionally considered a nonessential amino acid but may be conditionally essential in patients with catabolic conditions. Glutamine‐supplemented foods in these patients have been shown to prevent deterioration of gut permeability, protect against the development of intestinal mucosal atrophy, and improve nitrogen balance. Animal models of inflammatory bowel disease suggest that glutamine‐enriched enteral diets may lead to less severe intestinal damage, less weight loss, improved nitrogen balance, and reduced disease activity. The purpose of the current study was to compare the efficacy of a glutamine‐enriched polymeric diet with a standard low‐glutamine polymeric diet in the treatment of active Crohn's disease.Methods:Eighteen children with active Crohn's disease were randomly assigned to receive a 4‐week course of either a standard polymeric diet with a low glutamine content (4% of amino acid composition; group S) or a glutamine‐enriched polymeric diet (42% of amino acid composition; Group G). The two diets were isocaloric and isonitrogenous with an identical essential amino acid profile. Remission rates were analysed on an intent‐to‐treat basis. Changes in clinical and laboratory parameters of disease activity were also compared after 4 weeks of nutritional treatment.Results:Two of the children, both in group G, were withdrawn from the trial because of nontolerance of the diet. There was no difference between the two groups in proportion of patients achieving remission (intent‐to‐treat basis): 5 (55.5%) of 9 in group S versus 4 (44.4%) of 9 in group G (p = 0.5). Improvement in mean paediatric Crohn's disease activity index (PCDAI) was significantly more in group S (p = 0.002) but changes in orosomucoid level, platelet count, and weight were not different between the groups.Conclusions:The findings suggest that a glutamine‐enriched polymeric diet offers no advantage over a standard low‐glutamine polymeric diet in the treatment of active Crohn's disease. Rather, it appears to be less effective in improving PCDAI. The reported beneficial effects of glutamine seen in many catabolic states must be viewed with caution when extrapolating to the management of Crohn's disease.
Electrogastrography Versus Gastric Emptying Scintigraphy in Children With Symptoms Suggestive of Gastric Motility Disorders
Authors: Barbar Maha , Steffen Rita , Wyllie Robert , Goske Marilyn 
Published: February 2024

ABSTRACTBackground:Cutaneous electrogastrography is a method of recording gastric electrical activity. Abnormalities of the electrogastrogram have been described in a variety of disorders. The purpose of the study was to correlate the electrogastrograms of children with vomiting and dyspepsia with the results of radionucleotide gastric emptying studies.Methods:Nine patients (5–16 years old) with gastrointestinal symptoms of vomiting and/or abdominal pain were studied. The electrogastrogram was recorded using surface electrodes for 30 minutes in the fasting state and for 120 minutes after a radioisotope‐labeled solid meal. Gastric emptying was simultaneously monitored for 120 minutes. The postprandial change in dominant power (power ratio: postprandial/fasting dominant power), percentages of normal slow wave, bradygastria, and tachygastria were recorded and analyzed.Results:The patients were divided into two groups. The first group (four patients; five studies) had normal gastric emptying, whereas the second group (five patients) had delayed emptying (half‐life, >90 minutes). The median power ratio in the first group was 1.69 and in the second group was 2.78; the difference was not statistically significant (P = 0.90). The median difference in slow wave percentages in the fasting and postprandial periods was 0.99 in the first group and 0.73 in the second group; again, the difference was not statistically significant (P = 0.27).Conclusions:Although it is a method of assessing gastric myoelectrical activity and gastric motility disorders, electrogastrogram does not correlate with nuclear scintigraphic gastric emptying studies in children.
Inflammatory Bowel Disease in Children and Adolescents in Sweden, 1984–1995
Authors: Lindberg Eva , Lindquist Bo , Holmquist Lars , Hildebrand Hans 
Published: February 2024

ABSTRACTBackground:A prospective study of inflammatory bowel disease (IBD) in Sweden was performed to investigate whether the incidence and morbidity have changed from 1984 through 1995.Methods:Children 15 years of age or less with IBD were included—i.e., those with a definite diagnosis of ulcerative colitis (UC) and Crohn's disease (CD) and those classified as having indeterminate colitis (IC) and probable Crohn's disease (PCD). The study covered 56.5% of the pediatric population of Sweden.Results:The diagnosis of IBD was made in 639 children, which corresponds to a mean annual incidence of 5.8 per 100,000. The incidence increased from 4.6 per 100,000 per year from 1984 through 1986 to 7.0 from 1993 through 1995. It reflected an increase in UC from 1.4 to 3.2 per 100,000 per year, which is a significant yearly percentage of increase (8%; confidence interval, 2–14%;P < 0.05). In contrast, no change occurred in the incidence of CD (1.2–1.3 per 100,000). The incidence of IC and PCD also remained fairly stable. The percentages of children who underwent surgery decreased from 17.3% in the first 6 years to 4.6% in the last 6 years (P < 0.001). Surgery was performed in 27.7% of CD and 5.3% of UC cases. The median age at diagnosis was 12.2 years for UC, 13.0 years for CD, 11.2 for IC, and 11.2 for PCD. At diagnosis, 48 children (7.5%) were 5 years of age or less, whereas most of the patients were 11 years of age or more (398 children, 62.3%).Conclusions:In Sweden, the incidence of UC has increased, whereas that of CD remains the same. A significant number of children were classified with IC and PCD. In most children, IBD was diagnosed when they were 11 years old or more, but some cases were detected even in those below 6 years of age. A decrease in the frequency of surgery occurred during the study.
Intestinal Colonization Leading to Fecal Urobilinoid Excretion May Play a Role in the Pathogenesis of Neonatal Jaundice
Authors: Vítek Libor , Kotal Petr , Jirsa Milan , Malina Jiří , Černá Marcela , Chmelař Dittmar , Fevery Johan 
Published: February 2024

ABSTRACTBackground:Neonatal hyperbilirubinemia remains of concern because of the potential danger for the central nervous system. Because urobilinogen is a nontoxic derivative of bilirubin, the current study was conducted to examine the fecal excretion of urobilinoids and bilirubin in healthy newborns and infants, as well as their intestinal bacteria capable of reducing bilirubin, to assess a possible relation to serum bilirubin levels during the first weeks of life.Methods:Bilirubin pigments, urobilinoids, and porphyrins were measured in stools of infants during the first week (group A, n = 60) and between the second week and the first 6 months of life (group B, n = 64). Microbiologic analysis of stools was performed in selected cases and bilirubin‐converting activity of isolated bacteria was determined in vitro.Results:Urobilinoids were detectable in stools of 57% of the neonates at day 5, but not before. However, fecal urobilinoid production on that day was only a fraction of that observed in adults (0.07 vs. 0.7–3.6 mg/kg per day), whereas at week 6 it increased significantly to an average of 0.9 mg/kg per day. Microbiologic analysis of neonatal stools revealed two novel bacterial strains of Clostridium perfringens and Clostridium difficile capable of reducing bilirubin to urobilinoids.Conclusions:Urobilinoids can be detected in stools of 57% of newborns at day 5 after delivery. However, the urobilinoid production during the first week of life is quantitatively insufficient to contribute significantly to the removal of bilirubin. Enhancement of the microbial conversion of bilirubin could decrease the intestinal concentration of bilirubin and may decrease the degree or enhance the removal of neonatal hyperbilirubinemia.
Screening by Anti‐Endomysium Antibody for Celiac Disease in Diabetic Children and Adolescents in Austria
Authors: Schober Edith , Bittmann Barbara , Granditsch Gerhard , Huber Wolf‐Dietrich , Hüppe Amelie , Jäger Andrea , Oberhuber Georg , Rami Birgit , Reichel Gerlinde 
Published: February 2024

ABSTRACTBackground:Unrecognized celiac disease (CD) may be found in a substantial proportion of patients with type 1 diabetes mellitus.Methods:A cohort of 403 Austrian children and adolescents with type 1 diabetes mellitus (210 males and 193 females; age range, 1–22 years) was screened for celiac disease using the IgA anti‐endomysium antibody test (EMA) and the immunoglobulin (Ig)G anti‐gliadin (AGA‐IgG) and IgA anti‐gliadin (AGA‐IgA) antibody test.Results:Twelve patients' sera (2.98%) yielded positive EMA results and two patients' sera (0.49%) with IgA deficiency had high AGA‐IgG values. All but one of these patients underwent intestinal biopsy. Six (1.49%) had clear histologic evidence of CD (flat mucosa), whereas three (0.74%) showed minor histologic changes (increase in intraepithelial lymphocytes) and four (0.99%), including the EMA‐negative patients with IgA deficiency, had a normal mucosa. When the cases with silent and potential CD were combined, the overall prevalence in the current cohort was 2.98%. There was no difference in the hemoglobin (Hb)A1c level between antibody‐positive and ‐negative patients, and subsequent gluten‐free diet did not change this metabolic parameter.Conclusion:The prevalence of clinically unrecognized CD, found by EMA screening, is much higher in Austrian children with diabetes than in a comparable population without diabetes. The prevalence of CD in diabetic children in Austria is distinctly lower, however, than in several other countries.
Normal Growth Velocity Before Diagnosis of Celiac Disease
Authors: Lejarraga Horacio , Caíno Silvia , Salvador Alexander , De Rosa Susana 
Published: February 2024

ABSTRACTBackgroundClinical experience leads us to believe there may be patients with celiac disease who have not yet been treated, with a normal physical growth.MethodsTo evaluate height velocity of patients with confirmed celiac disease before their diagnosis and treatment, anthropometric measurements taken by the general pediatricians in charge of the primary care of the patients before they were sent to the authors' hospital were studied. Forty‐two growth periods (available velocities) were measured at varying intervals (ranging from 6 to 27 months) in 23 patients aged 0.1 to 10.66 years were analyzed.ResultsAll patients studied during the first semester of life (n = 5) showed normal growth velocity, and 6 of 10 patients showed normal growth velocity during the second semester of life. Ten of 12 patients between the ages of 1.0 and 1.99 years of age showed normal height velocity, and 7 of 9 patients aged 2.0 to 10.66 years showed normal height velocity. Normal height velocities were found not only during the first year of life, but also in children aged 1 to 8 years.ConclusionsResults should alert pediatricians and those in gastroenterology and growth clinics. In the latter case, norms for studying children who have short stature but are growing at a normal rate should not be a condition for excluding a child from screening for celiac disease.