bluuebunny/crossref_metadata_2025_split huggingface dataset:
Niacin Nutritional Status in HIV Type 1–Positive Children: Preliminary Data
Authors: Tremeschin Marina Hjertquist , Cervi Maria Célia , Júnior José Simon Camelo , de Moura Negrini Bento Vidal , Martinez Francisco Eulógio , Motta Fabrízio , de Souza Meirelles Mônica Silva , Vanucchhi Helio , Monteiro Jacqueline Pontes 
Published: April 2007

ABSTRACTObjective:HIV infection induces a state of pellagra in cell culture models. This study compared the nutritional status and the 24‐hour urine excretion of N1‐methylnicotinamide between HIV‐positive children and HIV‐negative children who were or were not born of mothers with HIV‐1 infection.Patients and Methods:Forty patients were included in the study: HIV‐positive children (group 1; n = 20), HIV‐negative children born to infected mothers (group 2; n = 10), and HIV‐negative control children (group 3; n = 10). Usual dietary intake was assessed by a semiquantitative food‐frequency questionnaire. Weight and height were assessed and compared with the reference data of the U.S. National Center for Health Statistics/Centers for Disease Control and Prevention. For the estimation of fat‐free mass and total body water, bioelectrical impedance technique was used. N1‐methylnicotinamide was measured by a modified method of high‐performance liquid chromatography.Results:Groups were matched in relation to age, sex, percentage of malnutrition, anthropometric measures, and body composition. Daily niacin intake did not differ statistically across groups (group 1 = 18.0 ± 11.4 mg/day; group 2 = 18.9 ± 8.0 mg/day; group 3 = 14.2 ± 5.2 mg/day), nor did intake of tryptophan, vitamin B6, and zinc. The values of urinary niacin per gram of creatinine were similar and adequate across the groups (group 1 = 4.68 [0.75–14.9]; group 2 = 3.74 [1.13–5.69]; group 3 = 3.85 [1.80–8.19]).Conclusions:HIV‐positive children excreted the same amount of N1‐methylnicotinamide in urine as did the control children. These findings may be attributed to similarities in nutritional status, adequate intestinal absorption (no children experienced diarrhea) and stable clinical condition.
Transpyloric Feeding in the Pediatric Intensive Care Unit
Authors: Babbitt Christopher 
Published: April 2007

ABSTRACTThe approach to achieving and maintaining nutritional support in pediatric intensive care unit patients continues to evolve with newer techniques such as transpyloric feeding. We reviewed our transpylorically fed patients over a 4‐year period and found that we achieved adequate nutritional support in 96% of them. We did find an increase in necrotizing enterocolitis in cyanotic patients and recommend that these patients be fed with caution when transpyloric feeding is used.
Amplification of Bacterial DNA Does Not Distinguish Patients with Ascitic Fluid Infection From Those Colonized by Bacteria
Authors: Vieira Sandra MG , da Silveira Themis R , Matte Ursula , Kieling Carlos O , Ferreira Cristina T , Taniguchi Adriano , dos Santos Oliveira Fernanda , Barth Afonso L 
Published: April 2007

ABSTRACTObjective:To evaluate 16S ribosomal RNA (rRNA) gene amplification to diagnose spontaneous bacterial peritonitis (SBP).Patients and Methods:According to a retrospective protocol, 31 patients with portal hypertensive ascites (serum to ascites albumin gradient ≥1.1 g/dL) were studied. Ascitic fluid was analyzed as follows: Gram stain, aerobic and anaerobic cultures, polymorphonuclear cell count, and biochemical tests. Bacterial DNA was detected by polymerase chain reaction.Results:There were 8 episodes of SBP and 4 episodes of bacterascites (BA). Culture was positive in 4 of 8 cases of SBP and bacterial DNA was positive in 7 of 8 cases of SBP. Bacterial DNA was positive in 3 of 4 cases of BA and in 8 of 28 cases of culture‐negative non‐neutrocytic ascites (CNNNA). The PELD score, serum to albumin ascites gradient, and mortality showed no statistical difference between patients with CNNNA and the result of the bacterial DNA analysis.Conclusions:Although the 16S rRNA gene amplification was better than culture to diagnose SBP, bacterial DNA does not seem to allow a distinction between ascites infection and ascites colonization.
Minimally Invasive Surgery for Achalasia: Combined Experience of Two European Centers
Authors: Garzi Alfredo , Valla Jean Stephan , Molinaro Francesco , Amato Giovanna , Messina Mario 
Published: April 2007

ABSTRACTBackground:The present report summarizes 12 cases with achalasia treated with laparoscopic Heller myotomy and anterior fundoplication according to the method of Thal and Dor.Patients and Methods:From 1997 to 2005 at 2 institutions in Europe, 12 patients (7 male and 5 female, ages ranging from 3.5 to 7 years) were treated for esophageal achalasia (EA) with laparoscopic Heller myotomy and anterior fundoplication according to Thal and Dor. In 1 case a perforation of the esophageal mucosa occurred, which was promptly treated during surgery. Follow‐up ranged from 18 to 60 months and included clinical examination and barium radiography of the upper digestive tract.Results:Postoperatively, 10 patients showed a normal weight curve and complete resolution of symptoms. All patients showed complete regression of digestive and respiratory symptoms from the first examination, with a normal oral meal intake and an improvement of weight and height parameters. One case required repeat intervention after 2 years because of persisting pain; in this case surgery revealed an insufficient myotomy.Conclusions:Modified extramucosal Heller cardiomyotomy associated with 180° anterior antireflux plastic surgery (according to Thal and Dor's procedures) is a useful and safe procedure in the treatment of EA in pediatric patients. Our data, which are supported by long‐term follow‐up, also stress the relevance of anterior fundoplication in preventing postoperative gastroesophageal reflux.
Disease Presentation and Clinical Course in Black and White Children With Inflammatory Bowel Disease
Authors: Eidelwein Alexandra P , Thompson Richard , Fiorino Kristin , Abadom Vivian , Oliva‐Hemker Maria 
Published: April 2007

ABSTRACTObjectives:To compare the disease presentation, disease phenotype, and clinical course between black and white children with inflammatory bowel disease (IBD).Patients and Methods:A 10‐year retrospective review was undertaken of the medical records of 245 pediatric patients with IBD studied at a tertiary care center.Results:In this patient population 24% were black and 76% were white. There were no differences between black and white patients in terms of anatomic distribution of IBD, symptom presentation, and extraintestinal manifestations. A family history of IBD (36.4% vs 17.5%; P = 0.006) was more common in white children. Mean erythrocyte sedimentation rate of black patients with Crohn disease was higher at diagnosis compared with whites (P < 0.001) and a greater proportion of African Americans presented with a body mass index z‐score less than −2 (P < 0.009). At 12 months following diagnosis 22.5% of African American children had a hemoglobin level lower than 10 g/dL compared with 4.3% of whites (P = 0.001). African Americans had evidence of more complicating stricturing and penetrating Crohn disease behavior (51.3% vs 27.4%; P = 0.006). African Americans received significantly more corticosteroids and infliximab to treat their IBD compared with whites (P < 0.04).Conclusions:This study suggests that for pediatric IBD, there may be racial differences in prevalence of family history and in disease phenotype.
Effectiveness and Safety of Lactobacillus LB in the Treatment of Mild Acute Diarrhea in Children
Authors: Salazar‐Lindo Eduardo , Figueroa‐Quintanilla Dante , Caciano Maria Isabel , Reto‐Valiente Victoria , Chauviere Gilles , Colin Patrick ,   Lacteol Study Group
Published: April 2007

ABSTRACTBackground:Acute diarrhea is an important cause of morbidity and mortality in children. Oral rehydration salts (ORS) have lowered mortality without having an effect on the duration or severity of diarrhea. Some studies have reported that heat‐killed Lactobacillus bacteria have a beneficial effect in the treatment of acute diarrhea. In this placebo‐controlled study the duration of diarrhea was compared for 2 types of treatment: Lactobacillus LB (Lacteol) in association with oral rehydration and oral rehydration alone.Patients and Methods:A total of 80 nondehydrated children between the ages of 3 months and 4 years with acute watery diarrhea were randomly assigned to be treated with Lactobacillus LB or placebo plus ORS. The primary endpoint was the duration of diarrhea; intake of ORS and change in body weight between the time of randomization and the last assessment were also measured.Results:In 71 of the 80 patients, diarrhea was resolved: 36 in the Lactobacillus LB group and 35 in the placebo group. Several clinical characteristics of the 2 treatment groups were comparable at baseline. Median duration of diarrhea was 16.6 hours in the placebo group compared with 10.0 hours in the Lactobacillus LB group (P = 0.275). In the subgroup with a duration of diarrhea of more than 24 hours at inclusion, duration of diarrhea measured from that point was shorter for the Lactobacillus LB group (30.4 h vs 8.2 h; P = 0.044). ORS intake was similar for both groups. Lactobacillus LB was well tolerated, with only one patient experiencing an adverse effect.Conclusions:Lactobacillus LB is an effective and safe treatment for children with well‐established diarrhea (>24 h).
Functional Consequences of NOD2/CARD15 Mutations in Crohn Disease
Authors: Quaglietta Lucia , te Velde Anje , Staiano Annamaria , Troncone Riccardo , Hommes Daan W 
Published: April 2007

ABSTRACTCrohn disease (CD) is a chronic, relapsing inflammatory disorder of the gastrointestinal tract. Its etiology remained obscure until recently, when, through an overwhelming body of research, the main theme of its origin became clear. CD develops in individuals who carry risk alleles for the disease that can cause a loss of physiological tolerance to commensal bacteria. As a consequence, immune responses develop that activate a whole range of immunocompetent cells, resulting in the secretion of proinflammatory mediators that ultimately cause mucosal breaks and the formation of ulceration, edema, and loss of proper function.
Effects of the Probiotic Formulation VSL#3 on Colitis in Weanling Rats
Authors: Fitzpatrick Leo R , Hertzog Kristy L , Quatse Angela L , Koltun Walter A , Small Jeffrey S , Vrana Kent 
Published: April 2007

ABSTRACTBackground:Only a few studies have used models of inflammatory bowel disease (IBD) with weanling animals. Previously, the effects of probiotics have not been assessed in such IBD models. The objectives of our study were 2‐fold: to establish a suitable model of dextran sulfate sodium (DSS)–induced colitis in weanling rats and to determine the effects of the probiotic formulation VSL#3 on DSS‐induced colitis in weanling animals.Materials and Methods:Rats were weaned on postnatal day 21 and administered 2%, 2.5%, or 3% (wt/vol) DSS in drinking water. In subsequent experiments, newly weaned animals were administered vehicle or VSL#3 (0.06, 0.6, or 6 mg) by orogastric gavage. These treatments were given to animals maintained on water (postnatal days 21–28) and then on DSS (postnatal days 28–35). Disease activity indices were determined on a routine basis. On day 35, rats were euthanized. The total colon length was determined. Other parameters of colitis were measured from the distal colon. These parameters included myeloperoxidase (MPO), interleukin (IL)–1β, inhibitory κB‐α (IκB‐α), and histological assessment of crypt damage and inflammation.Results:DSS 2% was optimal for inducing colitis in weanling rats without significant morbidity. VSL#3 treatments improved various parameters of 2% DSS–induced colitis in weanling rats. The 0.6‐ and 6‐mg doses of VSL#3 were most effective for attenuating this colitis.Conclusions:The probiotic formulation VSL#3 improved DSS‐induced colitis in weanling rats. This improvement of colitis involved changes in colonic IκB‐α, IL‐1β, and MPO, which are suggestive of immune modulation by VSL#3.
Usefulness of Ultrasonography in Acute Appendicitis in Early Childhood
Authors: Chang Yi‐Jung , Kong Man‐Shan , Hsia Shao‐Hsuan , Wu Chang‐Teng , Lai Ming‐Wei , Yan Dah‐Chin , Chao Hsun‐Chin , Chen Chien‐Chang , Chen Shih‐Yann 
Published: April 2007

ABSTRACTObjective:Acute appendicitis is an uncommon diagnosis in early childhood. It is frequently complicated by delays in diagnosis, perforation, and prolonged hospital stay. The aim of this study was to evaluate the usefulness of ultrasonography (US) in the management of suspected appendicitis in children younger than 3 years of age.Patients and Methods:Seventy‐one children under age 3 with acute abdomen and possible acute appendicitis, but with atypical findings, were included. All of the children underwent a US scan to rule out appendicitis.Results:There were 41 positive US results for appendicitis. Three children had false‐positive scan results and 2 children had false‐negative results. Twenty‐eight patients had ruptured appendicitis with tumor formation on US. Eighteen of the 28 patients received emergency appendectomy and the other 10 patients received initial conservative treatment with interval appendectomy. Compared with those who received emergency appendectomy, patients who received initial conservative treatment had a significantly smoother postoperative course, including shorter postoperative hospital stay and earlier postoperative oral intake. The overall sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of abdominal US to diagnose acute appendicitis in cases of atypical findings in early childhood are 95.0%, 90.3%, 92.9%, 92.6%, and 93.3%, respectively.Conclusions:US is a useful and highly accurate tool to assess acute appendicitis in early childhood. US has the potential to aid in diagnosis of early childhood appendicitis to avoid the frequent rupture with tumor formation seen at this age. Initial conservative treatment for ruptured appendicitis with tumor formation is safe and is associated with a smoother postoperative course in early childhood.
Impact of Diet on the Intestinal Microbiota in 10‐month‐old Infants
Authors: Nielsen Susanne , Nielsen Dennis S , Lauritzen Lotte , Jakobsen Mogens , Michaelsen Kim Fleischer 
Published: April 2007

ABSTRACTObjective:To investigate whether diet influences the composition of the intestinal microbiota in 10‐month‐old infants.Patients and Methods:Fecal samples were collected from sixty‐five 10‐month‐old infants participating in a randomized 2 × 2 intervention study comparing cow's milk (CM) with infant formula (IF) with or without fish oil (FO) supplement. Infants randomized to CM received a daily iron supplement. Bacterial DNA was extracted from the feces. Polymerase chain reaction was performed with primers targeting the V3 and V6–8 region of the 16S rRNA gene and analyzed by denaturing gradient gel electrophoresis (DGGE). Cluster analysis of the DGGE gels was performed by use of the Pearson correlation coefficient.Results:Samples from infants receiving CM clustered differently than did those from the IF group in the V3‐based DGGE gels (P < 0.001) and showed a different distribution with or without FO in the CM group (P = 0.001) but not in the IF group (P = 0.39). Repeat analysis with the V6–8‐based DGGE gels showed the same pattern, although the V3 gels had 2.5 times as many bands as the V6–8 gels.Conclusions:Consumption of CM or IF has a decisive influence on the composition of the intestinal microbiota. Supplementation with FO showed an effect on the microbiota only in the CM group. We speculate that these differences could be influenced by the intake of iron and n‐3 polyunsaturated fatty acids, respectively.
Fasting Glucagon‐like Peptide‐1 and Its Relation to Insulin in Obese Children Before and After Weight Loss
Authors: Reinehr Thomas , de Sousa Gideon , Roth Christian L 
Published: April 2007

ABSTRACTObjective:To study the relationships between glucagon‐like peptide‐1 (GLP‐1), weight status, insulin, and insulin resistance in the fasting state.Patients and Methods:Fasting GLP‐1, glucose and insulin concentrations, insulin resistance index as homeostasis model assessment (HOMA), body mass index (BMI), and percentage body fat based on skinfold thickness measurements were determined in 42 obese (median age 11 years) and in 16 lean children of the same age. The HOMA model was used to calculate degree of insulin resistance. Furthermore, the changes in GLP‐1, glucose, insulin, and HOMA in the course of 1 year were analyzed in the 42 obese children participating in an obesity intervention.Results:GLP‐1 concentrations did not differ significantly between obese and lean children. In multiple linear regression analyses, GLP‐1 was significantly related to insulin (P = 0.028) and HOMA (P = 0.019) but not to glucose, age, sex, pubertal stage, BMI, or percentage body fat. The 15 obese children with substantial weight reduction demonstrated significantly (P < 0.05) decreased GLP‐1, insulin, and HOMA levels, whereas these parameters did not change in 27 obese children without substantial weight loss. Changes in GLP‐1 correlated significantly with changes in insulin (r = 0.46, P = 0.001) and HOMA (r = 0.28, P = 0.036) but not with changes in glucose, BMI, or percentage of body fat.Conclusions:In children, fasting GLP‐1 concentrations are independent of age, sex, and pubertal stage. Although GLP‐1 did not differ between lean and obese children, weight loss was associated with decreasing GLP‐1. Inasmuch as GLP‐1 levels were related to insulin concentrations in both cross‐sectional and longitudinal analyses, we hypothesize a relationship between GLP‐1 and insulin in the fasting state.
Conditions of Bifidobacterial Colonization in Preterm Infants: A Prospective Analysis
Authors: Butel Marie‐José , Suau Antonia , Campeotto Florence , Magne Fabien , Aires Julio , Ferraris Laurent , Kalach Nicolas , Leroux Bernard , Dupont Christophe 
Published: April 2007

ABSTRACTBackground:Premature birth results in a delayed and abnormal qualitative pattern of gut colonization. This abnormal pattern is thought to affect intestinal development and contribute to a higher risk of gastrointestinal infectious diseases such as neonatal necrotizing enterocolitis (NEC). In particular, bifidobacteria are thought to play a major role. We therefore studied bifidobacterial colonization in preterm infants during the first month of life.Patients and Methods:Fecal samples were prospectively analyzed in 52 infants born at a gestational age ranging from 30 to 35 weeks fed with a preterm formula alone and, in 18, with their mother's milk. Fecal samples were collected twice per week during the hospital stay. Bifidobacterial colonization was analyzed with culture and a molecular method.Results:Bifidobacterial colonization occurred in 18 infants at a median age of 11 days, always greater than the corrected mean gestational age of 35.4 weeks (SD, 0.9) and greater than 34 weeks for 16 of 18. Colonization by bifidobacteria was affected by neither birthweight nor mode of delivery nor antibiotics given to the mother or infant. In contrast, birth gestational age had a significant impact on colonization by bifidobacteria (P < 0.05), which always occurred in children born at a birth gestational age greater than 32.9 weeks (P < 0.05).Conclusions:Birth gestational age seems to act as a major determinant of bifidobacterial colonization in the premature infant, suggesting the role of gut maturation, a finding that should probably be taken into account in manipulations of the gut flora aimed at reducing NEC.
Wilson Disease in Children: Serum Aminotransferases and Urinary Copper on Triethylene Tetramine Dihydrochloride (Trientine) Treatment
Authors: Arnon Ronen , Calderon Judith Flores , Schilsky Michael , Emre Sukru , Shneider Benjamin L 
Published: April 2007

ABSTRACTObjectives:To evaluate the efficacy of and adherence to trientine and/or zinc therapy in children with Wilson disease (WD).Materials and Methods:We retrospectively reviewed the clinical records of all children with WD in the pediatric liver/liver transplant program at our institution between 1998 and 2006.Results:A total of 22 children with WD were evaluated and treated. Seven with fulminant disease required liver transplantation and 15 were treated with trientine and/or zinc. Ten of those 15 had follow‐up for 12 to 60 months and 6 of the latter 10 were followed for 12 to 18 months. All 10 patients were started on a trientine treatment regimen. Mean alanine aminotransferase (ALT) levels decreased from 183 ± 103 IU at presentation (n = 10) to 80 ± 46 IU at 12 months (n = 10) and 66 ± 40 IU at 18 months (n = 7). Mean 24‐hour urinary copper levels increased from 156 μg at presentation to 494 μg at 1 to 2 months, then decreased to 71 μg after 21 to 24 months of treatment. Three of 10 patients had normalized ALT levels and 1 patient with cirrhosis continued with normal ALT levels since presentation. Four of 10 patients were documented to be nonadherent, as manifested by increased ALT levels (99 ± 31 IU); 1 patient had previously normalized ALT levels. In 3 of 10 patients, ALT level decreased but remained at an abnormal level (93 ± 53 IU).Conclusions:Trientine and/or zinc therapy is effective for children with WD. Nonadherence is a common cause of increased aminotransferase levels in patients with WD.
Public forum mediation: a training exercise for conflict facilitation skills
Authors: Hartman Rosanne L. , Crume Alice L. 
Published: April 2007

PurposeThe purpose of this paper is to describe the use of public forum mediation as a model for training in and improvement of conflict facilitation skills.Design/methodology/approachThe training strategy integrates continuous involvement of all the trainees through the use of a reflective team. The team and trainees focus on recognizing communication patterns used by individuals engaged in conflict.FindingsIdentifying communication patterns and strategies strengthens the trainees' ability to alter language use and nonverbal behavior during the facilitation process.Originality/valueThe use of public forum mediation strategies within the training context offers new and different ways for examining communication in the process of conflict facilitation.
Information behaviour of primary health care providers in rural Uganda
Authors: Musoke Maria G.N. 
Published: April 2007

PurposeThe purpose of this paper is to investigate the accessibility and use of health information among primary health care providers. The study focused on women and health workers' experiences with information in rural Uganda.Design/methodology/approachFace‐to‐face interviews (82) were conducted using an interview schedule that consisted of open questions and one relating to health information critical incidents. A holistic inductive paradigm was used with a grounded theory analysis. An “Interaction‐value model” emerged from the study. The model was driven by the value and impact of information, unlike previous information models which have been driven by information needs.FindingsThe findings have a number of implications for improving information provision, and further research.Originality/valueThis study has demonstrated that, although an information need could trigger off an information activity, the subsequent information processes could only be sustained by the value of information. The study has also shown that health workers were generally active information seekers, whereas women were mainly passive.