bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of Helicobacter pylori Infection Detected by Serology and 13C‐Urea Breath Test in HIV‐1 Perinatally Infected Children
Authors: Lionetti Paolo , Amarri Sergio , Silenzi Francesco , Galli Luisa , Cellini Monica , de Martino Maurizio , Vierucci Alberto 
Published: February 2024

ABSTRACTBackground:Conflicting results have been reported in adults with human immunodeficiency virus (HIV‐1) who were investigated for Helicobacter pylori infection. Most studies indicate a lower prevalence than is found in the general population. The purposes of this study were to evaluate H. pylori prevalence by noninvasive methods in a population of children perinatally infected with HIV‐1 and to correlate H. pylori prevalence with HIV‐1‐related clinical and immunologic status.Methods:H. pylori infection was studied in 45 children perinatally infected with HIV‐1 by performing serologic testing of anti‐H. pylori immunoglobulin G antibodies and the 13C‐urea breath test.Results:Eight children with HIV‐1 (17.7%) were positive by serology, and nine (20%) were positive by 13C‐urea breath test. No significant differences related to age, previous antibiotic treatment, immunoglobulin administration, antiretroviral treatment, abdominal pain, CD4+ cell count, number of HIV‐1 RNA copies, and frequency of severe immunodepression were noted between children with positive 13C‐urea breath test results and those with negative results. Children with positive results were significantly more likely to have severe clinical manifestations.Conclusions:The results show, by both serology and 13C‐urea breath test, a prevalence of H. pylori infection comparable with the prevalence in the normal population of the same age. H. pylori prevalence has probably been underestimated in patients with HIV. Results of serologic and histologic analyses for H. pylori require cautious interpretation, especially in severely immunodeficient patients.
No Evidence of Hepatitis G Virus in Fulminant Hepatic Failure in Children
Authors: Perez Roger G. , Zein Nizar N. , Freese Deborah K. , Perrault Jean J. , Steers Jeffery L. , Sharp Harvey L. , Persing David H. 
Published: February 2024

ABSTRACTBackground:The cause of fulminant hepatic failure in children remains unknown, but a viral origin has been suspected in most cases. The recently discovered blood‐borne virus, hepatitis G, has been suggested as a possible causative agent.Method:Six consecutive children who underwent liver transplantation for fulminant hepatic failure were studied. The children were tested for hepatitis G virus antibodies and hepatitis G virus RNA by polymerase chain reaction after excluding other causes of fulminant hepatic failure.Results:No evidence of hepatitis G virus infection was found in these patients.Conclusion:Hepatitis G virus is unlikely to be a common cause of fulminant hepatic failure in pediatric patients from the upper midwestern United States.
The Role of Cisapride in the Treatment of Pediatric Gastroesophageal Reflux
Authors: Vandenplas Yvan , Belli Dominique C. , Benatar Avram , Cadranel Samy , Cucchiara Salvatore , Dupont Christophe , Gottrand Fréderique , Hassall Eric , Heymans Hugo S. A. , Kearns Gregory , Kneepkens C. M. Frank , Koletzko Sybille , Milla Peter , Polanco Isabel , Staiano Anna‐Maria 
Published: February 2024

ABSTRACTBackground:Cisapride is a gastrointestinal prokinetic agent that is used worldwide in the treatment of gastrointestinal motility‐related disorders in premature infants, full‐term infants, and children. Efficacy data suggest that it is the most effective commercially available prokinetic drug.Methods:Because of recent concerns about safety, a critical and in‐depth analysis of all reported adverse events was performed and resulted in the conclusions and recommendations that follow.Results:Cisapride should only be administered to patients in whom the use of prokinetics is justified according to current medical knowledge. If cisapride is given to pediatric patients who can be considered healthy except for their gastrointestinal motility disorder, and the maximum dose does not exceed 0.8 mg/kg per day in 3 to 4 administrations of 0.2 mg/kg (not exceeding 40 mg/d), no special safety procedures regarding potential cardiac adverse events are recommended. However, if cisapride is prescribed for pateints who are known to be or are suspected of being at increased risk for drug‐associated increases in QTc interval, certain precautions are advisable. Such patients include those:(1) with a previous history of cardiac dysrhythmias, (2) receiving drugs known to inhibit the metabolism of cisapride and/or adversely affect ventricular repolarisation, (3) with immaturity and/or disease causing reduced cytochrome P450 3A4 activity, or (4) with electrolyte disturbances. In such patients, ECG monitoring to quantitate the QTc interval should be used before initiation of therapy and after 3 days of treatment to ascertain whether a cisapride‐induced cardiac adverse effect is present.Conclusions:With rare exceptions, the total daily dose of cisapride should not exceed 0.8 mg/kg divided into 3 or 4 approximately equally spaced doses. If higher doses than this are given, the precautions above are advisable. In any patient in whom a prolonged QTc interval is found, the dose of cisapride should be reduced or the drug discontinued until the ECG normalizes. If the QTc interval returns to normal after withdrawal of cisapride, and the administration of cisapride is considered to be justified because of its efficacy and absence of alternative treatment options, cisapride can be restarted at half dose with control of the QTc interval. Unfortunately, at present, normal ranges of QTc interval in children are unknown. However, a critical analysis of the literature suggests that a duration of less than 450 milliseconds can be considered to be within the normal range and greater than 470 milliseconds as outside it.
Oropharyngeal Dysfunction and Gastroesophageal Dysmotility Are Present in Girls and Women with Rett Syndrome
Authors: Motil Kathleen J. , Schultz Rebecca J. , Browning Kerrie , Trautwein Lynn , Glaze Daniel G. 
Published: February 2024

ABSTRACTBackground:Feeding impairment frequently complicates the course of children with neurologic disorders and places them at risk for malnutrition and growth failure. Although feeding abnormalities have been reported in female patients with Rett syndrome, the mechanisms that account for these findings have not been elucidated fully. This study was designed to characterize the clinical features of oropharyngeal and gastroesophageal dysfunction and their impact on the dietary intake and nutritional status of female subjects with Rett syndrome.Methods:The clinical features of oropharyngeal and gastroesophageal dysfunction in 13 female patients with Rett syndrome, (age range, 3.7 to 25.7 years) were characterized by an oral feeding assessment, swallowing function study, and upper gastrointestinal series. Growth, nutritional status, and body composition were determined by stadiometry and anthropometry. Dietary intakes were determined from 3‐day food records.Results:Oropharyngeal dysfunction and gastroesophageal dysmotility were present in 100% and 69%, respectively, of the study patients with Rett syndrome. The scope and severity of these abnormalities were apparent only by videofluoroscopy. Abnormalities of oropharyngeal function included poor tongue mobility, reduced oropharyngeal clearance, and laryngeal penetration of liquids and solid food during swallowing. Esophageal dysmotility included absent primary or secondary waves, delayed emptying, atony, the presence of tertiary waves, spasm, and gastroesophageal reflux. Gastric dysmotility included diminished peristalsis or atony. Lower dietary energy intakes were associated with persistence of residue in the valleculae and pyriform sinuses and less body fat.Conclusion:The prevalence of oropharyngeal dysfunction and gastroesophageal dysmotility warrants early diagnostic evaluation and intervention strategies to improve the nutritional status of girls and women with RS.
Influence of Jejunal Morphology Changes on Exocrine Pancreatic Function in Celiac Disease
Authors: Nousia‐Arvanitakis Sandra , Karagiozoglou‐Lamboudes Thomais , Aggouridaki Christine , Malaka‐Lambrellis Eva , Galli‐Tsinopoulou Assimina , Xefteri Mary 
Published: February 2024

ABSTRACTBackground:Concurrent exocrine pancreatic dysfunction may be one of the factors implicated in malabsorption in untreated celiac disease, as shown by studies on bicarbonate and pancreatic enzyme secretion. The purpose of this study was to evaluate exocrine pancreatic function in relation to jejunal morphology in celiac disease.Methods:Thirty‐six patients fulfilling the ESPGHAN criteria for celiac disease, aged 3 to 18 years and 36 control subjects matched for age and sex were investigated. The design of the study included measurement of serum pancreatic isoamylase by a chromogenic method after selective inhibition of sialic isoamylase in the untreated phase in patients consuming a gluten‐containing diet and after gluten elimination for a period of 1 year; fecal human elastase activity determined by enzyme‐linked immunosorbent assay in patients consuming a gluten‐free diet and again after gluten challenge for 6 months; correlation of serum pancreatic isoamylase and fecal elastase to the jejunal morphology, classified by criteria described by Marsch; the enzymes in the control group; and ultrasonography of the pancreas in both groups.Results:Enzyme values obtained from celiac disease patients with normal mucosa were significantly higher than those obtained from patients with villous atrophy (p < 0.001) and comparable to those obtained from the control group. Serum pancreatic isoamylase activity increased to normal after gluten elimination, and human elastase activity decreased to values below 200 µg/g of stool after gluten challenge. Enzyme activity was related inversely to the degree of intestinal damage. The echogenicity of the pancreas was normal, regardless of enzyme activity or gut morphology.Conclusions:Exocrine pancreatic function is abnormal in celiac disease when mucosal atrophy is present. Exocrine pancreatic function parameters are associated with the changes of intestinal mucosal morphology in three consecutive phases of the disease.
Evaluation of the Development of Intestinal Function in Rats Reared on Hydrolyzed or Native Protein‐Based Milk Formula
Authors: Kinouchi Toshi , Koizumi Kyoko , Kuwata Tamotsu , Yajima Takaji 
Published: February 2024

ABSTRACTBackground:In recent years, hydrolyzed protein has often been used as a protein source in food products, including infant formula. In the current study, the effects of different protein sources in milk formula on the development of intestinal function in artificially reared rats were examined.Methods:Rat pups were artificially reared on casein‐whey protein‐based, whey protein‐based, or hydrolyzed whey protein‐based milk formula, and the intestinal lactase and maltase activities and the capacity of intestinal immunoglobulin (Ig)G uptake in these rats during the suckling period were determined.Results:There were no significant differences in the activities of disaccharidases among the three groups. In the rats reared on hydrolyzed whey protein milk formula, the plasma and jejunal concentrations of human IgG 2 hours after intragastric administration of human IgG were significantly lower than those of rats reared on milk formulas containing native proteins.Conclusions:The present results suggest that the presence of native protein in milk formula and maternal milk may be important for jejunal IgG uptake in suckling rats an the possibility that the presence or absence of native protein in milk formula can modify some developmental processes of the small intestine in suckling animals.
Fat Mass in Infants and Toddlers: Comparability of Total Body Water, Total Body Potassium, Total Body Electrical Conductivity, and Dual‐Energy X‐ray Absorptiometry
Authors: Butte Nancy , Heinz Carolyn , Hopkinson Judy , Wong William , Shypailo Roman , Ellis Kenneth 
Published: February 2024

ABSTRACTBackground:Accurate assessment of body composition in infants and children is fundamental to understanding normal growth and development. Validation of methods applicable to pediatric populations is needed. In the absence of a gold standard, this study was conducted to compare methods using total body water, total body potassium, total body electrical conductivity, and dual‐energy x‐ray absorptiometry measurements for the estimation of body fat mass in infants and toddlers.Methods:Repeated body composition measurements were performed on 76 healthy term infants at 0.5, 3, 6, 9, 12, 18, and 24 months of age. Total body water was determined by deuterium dilution and converted to fat‐free mass. Total body electrical conductivity was used to measure fat mass. Total body potassium was estimated by whole‐body counting and converted to fat‐free mass. Dual‐energy x‐ray absorptiometry was used to estimate fat mass at 0.5, 12, and 24 months only. Data were analyzed by repeated measures analysis of variance, followed by Bonferroni multiple comparisons at 5%.Results:Significant differences among methods were encountered at each age (p = 0.001‐0.05). The rank order of the methods and the magnitude of the method differences were a function of age, not of gender or infant feeding mode. Wide limits of agreement imply that the methods are not interchangeable for group or individual measurements.Conclusions:Methods using total body water, total body potassium, total body electrical conductivity, and dual‐energy x‐ray absorptiometry to estimate body fat mass in infants and toddlers are not interchangeable and require further development and validation.
Shwachman's Syndrome: Pathomorphosis and Long‐term Outcome
Authors: Cipolli Marco , D'Orazio Ciro , Delmarco Antonella , Marchesini Cristina , Miano Angelo , Mastella Gianni 
Published: February 2024

ABSTRACTBackground:Shwachman's syndrome is the second most common cause of inherited/congenital pancreatic insufficiency after cystic fibrosis. The main associated features are usually cyclic neutropenia, metaphyseal dysostosis, and growth retardation. Other organs or functions may be involved in this syndrome, showing a wide range of abnormalities and symptoms. There are reports of Shwachman's syndrome in childhood, but little is known about the long‐term clinical course of these patients. This article reports on the pathomorphosis and long‐term follow‐up of 13 patients with Shwachman's syndrome diagnosed in infancy focusing, in particular, on modifications of the exocrine pancreatic function over time.Methods:Exocrine pancreatic function was evaluated by duodenal intubation followed by a pancreatic stimulation test. Nutritional, biochemical, hematologic, radiologic, and psychological evaluations were performed at various intervals. Six patients were included in long‐term follow‐up evaluation.Results:At diagnosis, growth retardation was present in all patients, and all subjects showed pancreatic insufficiency. Hematologic features (intermittent neutropenia, anemia and thrombocytopenia), respiratory infection during the first years of life, and skeletal abnormalities were also frequently observed. Other associated features at diagnosis included hepatic involvement and occasional renal dysfunction. In the six patients followed up, a significant growth improvement was observed. In five of them the pancreatic stimulation test showed values of lipase within reference range outputs, whereas fat balance or fecal fat losses were normal in all but one subject. Of seven subjects assessed by psychological evaluation, IQ test results were markedly abnormal in one and bordered on abnormality in the others.Conclusions:The present data on Shwachman's syndrome diagnosed in infancy underline the possibility of improvement or normalization of exocrine pancreatic function with age, suggesting the need for periodic checks on pancreatic activity in these subjects. It also indicates the possibility of diagnosis of this syndrome in the absence of pancreatic insufficiency; decreasing frequency of infections over time; and the usefulness of early neuropsychological evaluation.
Celiac Disease in Relation to Immunologic Serum Markers, Trace Elements, and HLA‐DR and DQ Antigens in Swedish Children with Down Syndrome
Authors: Hansson Tony , Annerén Göran , Sjöberg Olof , Klareskog Lars , Dannæus Anders 
Published: February 2024

ABSTRACTBackground:An association between Down syndrome and celiac disease has been reported. This study was conducted to determine the association between childhood celiac disease and Down syndrome in the county of Uppsala, Sweden.Methods:All 76 children with Down syndrome (1‐18 years) were screened for the occurrence of anti‐gliadin antibodies (AGA) and anti‐endomysium antibodies (EMA). Twelve children with suspected celiac disease were investigated further.Results:Increased levels of both IgA and IgG AGA were found in 26% of the children and of EMA in and 5 of 76. Celiac disease was diagnosed in at least three of the children (3.9%; 95% confidence interval 0%‐8.3%), and it could have been present in as many as eight. Three of the five EMA‐positive children with suspected celiac disease had the HLA phenotype DR3, DQ2.Conclusions:The results show that determination of EMA is more useful as a screening test for celiac disease and for follow‐up than is AGA in children with Down syndrome. The present study also confirms that celiac disease is overrepresented among Swedish children with Down syndrome and that celiac disease should be considered in all persons with Down syndrome.
Testing for Serum IgG Antibodies to Helicobacter pylori Cytotoxin‐Associated Protein Detects Children with Higher Grades of Gastric Inflammation
Authors: Luzza Francesco , Contaldo Antonio , Imeneo Maria , Mancuso Maria , Pensabene Licia , Giancotti Laura , La Vecchia Anna M. , Costa Maria C. , Strisciuglio Pietro , Docimo Corrado , Pallone Francesco , Guandalini Stefano 
Published: February 2024

ABSTRACTBackground:Little information is available about the relationships between Helicobacter pylori cytotoxin‐associated protein (CagA) and clinicopathologic features in children. The purpose of this study was to test whether determining serum IgG antibodies to CagA is a useful tool for detecting more severe disease.Methods:One hundred twenty‐seven consecutive children (age, range, 0.75‐17.8 years; median, 9.4 years) referred for gastroscopy were included in the study. Antral and corpus biopsies were taken for gastric histology and H. pylori detection. Major symptoms and endoscopic findings were recorded. A serum sample was drawn from each child and assayed for IgG antibodies CagA by a commercial enzyme‐linked immunosorbent assay.Results:Sixty‐three (50%) children had no evidence of H. pylori infection, 28 (22%) were H. pylori positive/CagA positive, and 36 (28%) were H. pylori positive/CagA negative. There were no differences in clinical diagnosis and occurrence of any predominant symptom according to H. pylori and CagA status. Findings of antral nodularity were more frequent (p = 0.003) in H. pylori‐positive/CagA‐positive children than in H. pylori‐positive/CagA‐negative children. The gastritis score was significantly higher in H. pylori‐positive/CagA‐positive children than in H. pylori‐positive/CagA‐negative children (5.7 ± 1.9 vs. 3.8 ± 1.6, respectively; p = 0.0003), either in the antral (p = 0.0002) or in the corpus (p = 0.001) mucosa. Inflammation (p = 0.0001) and activity (p = 0.0001) scores were both higher in H. pylori‐positive/CagA‐positive children than in H. pylori‐positive/CagA‐negative children, but the H. pylori density score was not significantly different (p = NS). In no case was normal gastric mucosa found in H. pylori‐positive/CagA‐positive children. Lymphocytic gastritis (p = 0.0008) and lymphoid follicles (p = 0.000003) were a more frequent finding in H. pylori‐positive children than in H. pylori negative children, irrespective of CagA status.Conclusion:Testing for serum IgG to CagA detects higher grades of gastric inflammation among children with H. pylori infection. It may be useful in targeting H. pylori‐positive/CagA‐positive children for antimicrobial therapy while reducing the need for endoscopy and gastric biopsy.
Serum Levels of Hepatitis C Virus RNA in Infants and Children with Chronic Hepatitis C
Authors: Azzari Chiara , Resti Massimo , Bortolotti Flavia , Moriondo Maria , Crivellaro Carlo , Lionetti Paolo , Vierucci Alberto 
Published: February 2024

ABSTRACTBackground:The role of serum hepatitis C virus (HCV) load in infectivity, disease activity, and response to interferon treatment has been investigated in adults, and controversial results have been obtained. Little is known about HCV load in infants and children with HCV infection.Purpose:To investigate the relation between HCV load in serum and features of associated liver disease in infants and children with HCV infection.Methods:Hepatitis C viral load was investigated in serial samples in 43 children with chronic HCV infection, including 32 patients aged 4 to 16 years infected by different routes and 11 vertically infected infants observed prospectively since birth.Results:Overall viremia ranged between 2.7 and 6.9 log copies/ml (median, 5.56 log/ml) and fluctuated slightly during the follow‐up. Median HCV RNA levels did not significantly differ among infants, children, and adolescents. Viral load was also independent of sex, route of infection, clinical manifestation, alanine aminotransferase levels, and liver histology. All 11 perinatally infected children became chronic HCV carriers, whatever their initial viral load; retrospective testing of sera taken in the first day of life in three infants showed high viremia levels.Conclusions:Viremia levels observed in children were similar to those reported in adults, were independent of age, biochemical activity of liver disease, and chronicity of infection. They were also relatively stable, suggesting that serial measurement of viral load is useless in untreated infants and children. The detection of viremia at birth in children in whom chronic hepatitis developed later suggests the possibility of in utero infection.
Linear Growth and Skeletal Maturation in Subjects with Treated Celiac Disease
Authors: Gemme Gerolamo , Vignolo Marina , Naselli Arturo , Garzia Patrizia 
Published: February 2024

ABSTRACTBackground:The aim of this study was to report on the long‐term growth and development in a group of treated patients with celiac disease.Methods:The study includes 26 patients (11 boys and 15 girls) with typical celiac disease who were younger than 2.5 at diagnosis and were followed by means of a growth longitudinal monitoring from the introduction of a gluten‐free diet (mean age, 1.7 ± 0.5 years) until adulthood, over a median period of 15.3 years. Growth indicators used were: height, skeletal age, weight and BMI.Results:At the time of admission, the patients had a general tendency to short stature, underweight and retarded skeletal maturation. They did not catch up completely in height and skeletal age after a dietary treatment period of 3 years. Most of them were seen to be slightly below average height for age during childhood and adolescence with skeletal maturity retardation, even if a fairly large interindividual variation of height profiles was evident.Conclusions:Notwithstanding the early treatment, the careful follow‐up, and the good adhesion to the dietary rules of the patients under study, slight negative effects of the disease on growth were not avoided.