bluuebunny/crossref_metadata_2025_split huggingface dataset:
Essential Fatty Acids and Their Trans Geometrical Isomers in Powdered and Liquid Infant Formulas Sold in Canada
Authors: Ratnayake W. M. N. , Chardigny J. M. , Wolff R. L. , Bayard C. C. , Sébédio J. L. , Martine L. 
Published: February 2024

BackgroundAnimal and human studies have suggested that trans fatty acids might alter some physiological functions and adversely affect the growth and essential fatty acid balance of infants. In this context it is important to know the fatty acid composition, including the levels of trans isomers of oleic, linoleic and α‐linolenic acids in infant formulas.MethodsTen liquid and fourteen powdered formulas for term infants were purchased from retail stores in Canada. The fatty acid composition of each formula was determined by capillary gas‐liquid chromatography.ResultsAll the formulas met the mimimum content of 500 mg of linoleic acid/100 kcal formula (equivalent to 4.5% of energy) specified under current Canadian regulations. The formulas all met the minimum energy levels of 3% as linoleic acid and 0.7% as α‐linolenic acid recommended recently by an ad hoc committee of Health Canada. However, in nine formulas, the proportion of linoleic acid was more than 20% of total fatty acids, and consequently, in five of them, the ratio of linoleic acid to α‐linolenic acid exceeded the maximum ratio of 16:1 recommended by the ad hoc committee. Trans fatty acids were present in all the samples, and generally the liquid formulas displayed a higher total trans content (mean 1.9%, range 0.9‐3.1%) than powdered formulas (mean 1.4%, range 0.6‐2.5%). The amounts of trans isomers of linoleic and α‐linolenic acids and the degree of isomerization of these fatty acids were also higher in liquid formulas than in powdered formulas.ConclusionsA few of the Canadian infant formulas would provide one‐third of α‐linolenic acid as trans geometric isomers.
Reverse Transcription‐Polymerase Chain Reaction in the Diagnosis of Helicobacter pylori Infection in Finnish Children
Authors: Oksanen Katri , Kainulainen Heikki , Ruuska Tarja , Mäki Markku , Ashorn Merja 
Published: February 2024

ABSTRACTBackground:The purpose of this study was to design a simplified polymerase chain reaction (PCR) technique for the detection of Helicobacter pylori and to compare it with conventional diagnostic methods‐culture and histology of gastric biopsy specimens. In addition, the capability of this technique to detect H. pylori in the gastric mucosal biopsies of originally H. pylori‐negative children with gastritis or recurrent abdominal pain was investigated.Methods:Reverse transcriptase polymerase chain reaction (RT‐PCR) using polymerase from Thermus thermophilus was applied to detect H. pylori 16S rRNA. Twenty‐five children H. pylori‐positive by culture and/or histology were used as positive control subjects. Sixteen healthy H. pylori‐negative children served as negative control subjects. Biopsy specimens from gastric antrum and corpus from 81 children were examined by RT‐PCR. Altogether, 30 had histologic gastritis and 51 had nonspecific abdominal pain only, with no disease in histologic specimens. Histology and culture of H. pylori were negative in both patient groups.Results:Reverse transcription‐polymerase chain reaction detected 24 of 25 tissue‐positive and 0 of 16 tissue‐negative cases, indicating 96% sensitivity and 100% specificity for the test. None of the culturally and histologically H. pylori‐negative samples showed H. pylori colonization when analyzed by RT‐PCR.Conclusions:RT‐PCR using Thermus thermophilus polymerase is a fast and simple means of detecting H. pylori in gastric biopsy specimens. It is at least as specific and sensitive as conventional methods. In pediatric patients it may be necessary to take more than two biopsy specimens to increase sensitivity in cases of local or patchy colonization.
The Effects of Acetylsalicylic Acid, Interferon‐α, and Vitamin E on Prevention of Parenteral Nutrition‐Associated Cholestasis: An Experimental Study
Authors: Demircan Mehmet , Uguralp Sema , Mutus Murat , Gurer E. Inanc , Atik Esin , Turhan Fahri , Gursoy M. Harun 
Published: February 2024

ABSTRACTBackground:Cholestasis is one of the major complications of parenteral nutrition. The purpose of this experimental study was to detect the effects of acetylsalicylic acid (ASA), vitamin E (Vit E), and interferon‐α (IFN‐α) on prevention of parenteral nutrition‐associated cholestasis.Methods:Ten experimental groups, each consisting of 10 4‐week‐old Wistar albino rats, were formed: control 10‐ and 20‐day groups (C10 and C20), parenteral nutrition‐only 10‐ and 20‐day groups (T10 and T20), ASA‐supplemented parenteral nutrition 10‐ and 20‐day groups (TA10 and TA20), Vit E‐supplemented parenteral nutrition 10‐ and 20‐day groups (TE10 and TE20), and IFN‐α‐supplemented 10‐ and 20‐day groups (TF10 and TF20). Acetylsalicylic acid, Vit E, and IFN‐α were administered in the parenteral nutrition solution through an intraperitoneal route. At the end of the study, serum total bile acids, serum aspartate and alanine aminostransferases, and alkaline phosphatase were measured biochemically. In addition, the histopathologic findings of cholestasis were evaluated by using a morphologic portal inflammation index.Results:Although the difference in the serum levels of transferases and alkaline phosphatase was not significant among all groups (p > 0.05), it was significant in total bile acid levels (p < 0.05). There was also a significant correlation between the histopathologic changes of the liver and serum total bile acid concentrations (p < 0.05). Portal inflammation in varying degrees was seen in all experimental groups, but not in the control groups. Serum total bile acid concentrations in parenteral nutrition groups receiving ASA were significantly lower than those in the parenteral nutrition‐only group (p < 0.01). Although Vit E‐supplemented parenteral nutrition was effective in preventing the development of cholestasis in the 10‐day group (p < 0.05), it was not effective in the 20‐day group when compared with incidence of cholestasis in the parenteral nutrition‐only group (p > 0.05). Conversely, IFN‐α‐supplemented parenteral nutrition had no effect on cholestasis in the 10‐day group (p > 0.05) but lowered cholestasis in the 20‐day group when compared with incidence the parenteral nutrition‐only group (p < 0.05).Conclusion:Our results indicate that acetylsalicylic acid may be beneficial in preventing, and α‐interferon in treating, parenteral nutrition‐associated cholestasis.
Severe and Protracted Diarrhea: Results of the 3‐Year SIGEP Multicenter Survey
Authors: Catassi Carlo , Fabiani Elisabetta , Spagnuolo Maria Immacolata , Barera Graziano , Guarino Alfredo ,   the Working Group of the Italian Society of Pediatric Gastroenterology and Hepatology (SIGEP)
Published: February 2024

ABSTRACTBackground:The spectrum of severe and protracted diarrhea (SPD), previously defined as intractable diarrhea, has changed during the past several decades. Despite recent advances in determining the cause of SPD and in treatment, this syndrome still represents a challenge and is becoming a major problem affecting health care resources. This study was conducted to characterize the epidemiology, spectrum of causes, and the outcome of SPD in Italy in recent years.Methods:All the SPD cases seen at the major centers of pediatric gastroenterology in Italy during a 3‐year period (1993‐1996) were recruited in this multicenter, prospective survey.Results:Thirty‐two children (26 boys and 6 girls; median age at the onset of SPD, 40 days) were enrolled in this study by 9 of 26 participating centers. Twelve were newly diagnosed cases, with an estimated SPD incidence rate in Italy of 0.64 to 0.92 × 10‐5 infants per year. The most common causes were autoimmune enteropathy (n = 8) and ultrastructural abnormalities of the enterocyte (n = 7), whereas food intolerance and postenteritis syndrome were less frequent (3 and 2 cases, respectively). Two children with autoimmune enteropathy fulfilled the criteria for the X‐linked variant of this condition. At the end of the study period, 9 of 31 patients had recovered, 15 still had diarrhea, and 7 had died.Conclusions:Severe and protracted diarrhea is a rare but challenging problem in Italy. Because parenteral nutrition or intestinal transplantation are the only options in a subset of cases (e.g., ultrastructural abnormalities of the enterocyte), infants with SPD should be referred to specialized centers where advanced diagnostic and therapeutic facilities are available.
Measurement of Low Dietary Fiber Intake As a Risk Factor for Chronic Constipation in Children
Authors: Morais Mauro B. , Vítolo Márcia R. , Aguirre Andrea N. C. , Fagundes‐Neto Ulysses 
Published: February 2024

ABSTRACTBackground:Scarce information exists regarding dietary fiber intake in children with chronic constipation. The objective of this case‐control study was to evaluate the intake of fiber as a risk factor for chronic constipation.Methods:Fifty‐two children with a mean age of 6.8 ± 3.2 years who had chronic constipation were age and gender matched with 52 children with normal intestinal habits. The fiber content of the diet was evaluated with a 24‐hour dietary recall. Two tables of fiber composition in foods were used: a Brazilian table, and a table based on the method of the Association of Official Agricultural Chemists (AOAC).Results:According to the Brazilian table, the median intake of fiber (in grams per day) by the constipated and the control groups was 13.8 and 17.3, respectively, for total fiber (p = 0.020), 6.8 and 9.7 for insoluble fiber (p = 0.004), and 6.5 and 7.6 for soluble fiber (p = 0.104). According to the AOAC table, the constipation group (9.7 g/day) also had lower (p = 0.0022) intake of total fiber than the control group (12.6 g/day). The coefficient of correlation between the two tables on fiber content of food was +0.82 (p < 0.001) in the constipation group and +0.86 (p < 0.001) in the control group. The intake of fiber was less than the minimum recommendation (age + 5 g) and statistically associated (p = 0.001) with the constipation group (75.0%) in comparison with the controls (42.5%). The odds ratio was 4.1 (95% confidence limits, 1.64‐10.32).Conclusion:Intake of fiber below the minimum recommendation is a risk factor for chronic constipation in children.
The Use of Focus Groups to Define Patient Needs
Authors: Barbour Rosaline S. 
Published: February 2024

ABSTRACTFocus groups are enjoying unprecedented popularity. In this article, the advantages and disadvantages of the method are outlined with cautions against the uncritical adoption of focus groups designed according to the marketing research tradition. It is argued that focus groups require detailed planning, and some advice regarding the running of groups, and analysis of data is provided. Special attention is directed to the practical and ethical issues in using focus groups to define patient needs in the area of childhood inflammatory bowel disease. Finally, some suggestions for maximising the full potential of focus groups are presented. Focus groups, if used appropriately and judiciously, are an inherently flexible method. Ultimately, their use is constrained only by the research question and the imagination of the researcher.
Nonalcoholic Steatohepatitis in Children
Authors: Rashid Mohsin , Roberts Eve A. 
Published: February 2024

ABSTRACTBackground:Nonalcoholic steatohepatitis occurs commonly in adults with obesity or diabetes mellitus. There are only a few reports of this condition in children.Methods:Prospective consecutive clinical series.Results:Between December 1985 and April 1995, 36 children (21 boys, 15 girls) were diagnosed with nonalcoholic steatohepatitis at the Hospital for Sick Children, Toronto. The median age at diagnosis was 12 years (range, 4–16 years). Most patients were referred because of elevated serum aminotransferases or abnormal hepatic sonogram. Thirty patients (83%) were obese. Two patients had diabetes mellitus at diagnosis, and it developed later in two. Fifteen patients had palpable hepatomegaly, and one of these had splenomegaly. None had physical signs of chronic liver disease. Thirteen of 36 patients had acanthosis nigricans. Serum aminotransferases were elevated in all but one patient. Tests for Wilson disease and chronic hepatitis B and C were negative. Serum lipid profiles were abnormal in 18 patients: 7 had hypercholesterolemia, and 11 had hypertriglyceridemia. Twenty‐four of 31 examined had abnormal liver sonograms suggestive of fatty infiltration. Twenty‐four patients underwent percutaneous liver biopsy: all showed large‐droplet fat. Inflammation was present in 88% and fibrosis‐cirrhosis in 75%. One 10‐year‐old patient had established cirrhosis at diagnosis.Conclusions:Nonalcoholic steatohepatitis occurs in children, is clinically diverse, and may not be benign.
Analysis of Intestinal Flora Development in Breast‐Fed and Formula‐Fed Infants by Using Molecular Identification and Detection Methods
Authors: Harmsen Hermie J. M. , Wildeboer–Veloo Alida C. M. , Raangs Gerwin C. , Wagendorp Arjen A. , Klijn Nicolette , Bindels Jacques G. , Welling Gjalt W. 
Published: February 2024

ABSTRACTBackground:An obvious difference between breast‐fed and formula‐fed newborn infants is the development of the intestinal flora, considered to be of importance for protection against harmful micro‐organisms and for the maturation of the intestinal immune system. In this study, novel molecular identification methods were used to verify the data obtained by traditional culture methods and to validate the culture independent fluorescent in situ hybridization (FISH) technique.Methods:From each of six breast‐fed and six formula‐fed newborn infants, six fecal samples were obtained during the first 20 days of life. The microbial compositions of the samples were analyzed by culturing on specific media and by FISH, by using specific 16S rRNA‐targeted oligonucleotide probes. The colonies growing on the media were identified by random amplified polymorphic DNA pattern analysis and by polymerase chain reaction amplification and subsequent analysis of the 16S rRNA gene.Results:Molecular identification of the colonies showed that the selective media are insufficiently selective and unsuitable for quantitative analyses. Qualitative information from the culturing results combined with the data obtained by the FISH technique revealed initial colonization in all infants of a complex (adult‐like) flora. After this initial colonization, a selection of bacterial strains began in all infants, in which Bifidobacterium strains played an important role. In all breast‐fed infants, bifidobacteria become dominant, whereas in most formula‐fed infants similar amounts of Bacteroides and bifidobacteria (∼40%) were found. The minor components of the fecal samples from breast‐fed infants were mainly lactobacilli and streptococci; samples from formula‐fed infants often contained staphylococci, Escherichia coli, and clostridia.Conclusions:This study confirms the differences in development of intestinal flora between breast‐fed and formula‐fed infants. The results obtained from the FISH technique were consistent. Although the repertoire of probes for this study was not yet complete, the FISH technique will probably become the method of reference for future studies designed to develop breast‐fed–like intestinal flora in formula‐fed infants.
Influence of Age on 13C‐Urea Breath Test Results in Children
Authors: Kindermann Angelika , Demmelmair Hans , Koletzko Berthold , Krauss–Etschmann Susanne , Wiebecke Baldur , Koletzko Sibylle 
Published: February 2024

ABSTRACTBackground:The 13C‐urea breath test for diagnosis of Helicobacter pylori infection has not been validated in infants and young children. The influence of age on the test results was studied by conventional validation against invasive methods and by mathematical estimation in a large pediatric population.Methods:The breath test was performed in 1499 children aged 2 months to 18 years. After a fasting period of 4 hours or more, 75 mg 13C‐urea was ingested with cold apple juice, breath samples were taken at baseline and at 15 and 30 minutes. The distribution of the natural logarithms of the Δ‐over baseline (DOB) values were calculated, and the optimal cutoff values between positive and negative test results and gray zones with a risk of misclassification more than 10% were determined for both time points. In a subgroup of 149 children results of the breath test were compared with concordant results of histology and rapid urease test; 53 of them were less than 6 years of age.Results:Logarithmic results of 1499 breath tests revealed two normally distributed subgroups with minimal overlap. The calculated optimal cutoff values were 4.7‰ at 15 minutes and 5.0‰ at 30 minutes. At 30 minutes, only 2.6% of all results were in the calculated gray zone (2.6–6.5‰). Age was negatively correlated to DOB values of both negative (r = −0.223) and positive results (r = −0.291;P < 0.001). Breath test–negative and –positive children 6 or less years of age had significantly higher mean DOB values (P < 0.02) and a larger proportion of results within the gray zone than older children. Compared with biopsy‐based results, the least discrepancies occurred at a cutoff of 5.0‰: 0 of 61 infected (sensitivity 100%) and 6 of 88 noninfected children. Because five of the false‐positive results were obtained in children less than 6 years of age, specificity and positive predictive values were lower in this age group than in older patients (88.1% vs. 97.8% and 68.8% vs. 98.0%, respectively).Conclusions:Under the applied conditions, the 13C‐urea breath test shows an excellent separation between positive and negative results. Because of some overlap and a strong age effect, definition of a gray zone appears more meaningful than a threshold value. Because infants and young children have a high risk for false‐positive breath test results, the values for cutoff and gray zones may have to be adapted. Further validation studies against invasive methods are warranted in this age group.
Antibody Reactivity Against Human and Guinea Pig Tissue Transglutaminase in Children with Celiac Disease
Authors: Hansson Tony , Dahlbom Ingrid , Hall Jeanette , Holtz Anette , Elfman Lena , Dannaeus Anders , Klareskog Lars 
Published: February 2024

ABSTRACTBackground:Highly discriminatory markers for celiac disease are needed to identify children with early mucosal lesions. The purposes of this study were to evaluate the clinical potential of circulating anti‐tissue transglutaminase (tTG) immunoglobulin (Ig)A antibodies in the diagnosis of childhood celiac disease and to investigate the extent of autoreactivity of these antibodies.Methods:Included in this retrospective study were samples from 22 children with biopsy‐verified celiac disease, 23 control subjects with disease, and 22 healthy control subjects without any known gastrointestinal or inflammatory disorders. An enzyme‐linked immunosorbent assay (ELISA) was used to measure the serum levels of IgA antibodies specific for human and guinea pig tTGs. All samples were also analyzed for antibodies to gliadin and endomysium (EMA).Results:The concentrations of IgA specific for human and guinea pig tTGs correlated with the small intestinal villous structure and the serum levels of IgA EMA. The tTG ELISAs exhibited a high specificity and sensitivity for detection of untreated celiac disease. The human erythrocyte IgA tTG ELISA had the highest sensitivity (100%) and a specificity of 98%. The IgA EMA method had a sensitivity of 95% and the highest specificity (100%) of all tests.Conclusions:Our results provide additional support to the concept that anti‐tTG IgA antibodies can be used as a highly discriminatory serologic marker for celiac disease and that measurements of these autoreactive antibodies may in the future be used as an alternative to the EMA test.
Management of Acute Gastroenteritis in Europe and the Impact of the New Recommendations: A Multicenter Study
Authors: Szajewska Hanna , Hoekstra J. Hans , Sandhu Bhupinder ,   The Working Group on Acute Diarrhoea of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition
Published: February 2024

ABSTRACTBackgroundThe European Society for Paediatric Gasteroenterology, Hepatology and Nutrition (ESPGHAN) issued two sets of recommendations for the treatment of infants with acute gastroenteritis (1992, 1997). The purpose of this multicentre study performed in 29 European countries was to determine how closely current treatment compares with the ESPGHAN recommendations.MethodsThe outline of the study was based on a questionnaire that addressed the management of a 6‐month‐old infant with acute gastroenteritis complicated by mild to moderate dehydration. National coordinators circulated the questionnaire to randomly selected primary care physicians and to hospital‐based paediatricians.ResultsA total of 2997 questionnaires were returned, of which 1768 were from Western Europe (WE) and 1229 from Central and Eastern Europe (CEE). Eighty‐four percent of responding physicians said they would follow the ESPGHAN recommendation to use oral rehydration solution (ORS) for rehydration, with 66% using an ORS containing 60 mmol/l sodium ORS. Only 16% (WE 15%, CEE 19%) would follow the guidelines and use rapid oral rehydration over 3 to 4 hours. Forty‐five percent would rehydrate infants in a 3‐to 6‐hour period (WE 35%, CEE 60%), and 17% (WE 23%, CEE 9%) would extend the rehydration period to 12 to 24 hours. ESPGHAN recommendation of rapid reintroduction of normal feeding after 3 to 4 hours of oral rehydration would be followed by only 21% of responding physicians, and only 43% (WE 46%, CEE 38%) would start feeding with full‐strength formula. However, the guideline about continuation of breast‐feeding is widely followed (total 77%; WE 78%, CEE 75%). Thirty‐six percent (WE 45%, CEE 23%) use a lactose‐containing formula after successful oral rehydration. Contrary to the ESPGHAN guideline 35% (WE 30%, CEE 42%) would use a lactose‐free formula and 19% (WE 12%, CEE 28%) a lactose and cow's milk protein–free formula. Only 37% (WE 30%, CEE 46%) of responding physicians would follow the recommendation to use ORS to replace ongoing losses from watery diarrhoea.ConclusionsThe results of the survey suggest that with the exception of recommending ORS for rehydration and continuation of breast‐feeding during diarrhoea, a minority of responding European physicians follow the ESPGHAN guidelines for optimal management of children with acute gastroenteritis.