bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dexmedetomidine Reduces Long-term Potentiation in Mouse Hippocampus
Authors: Takamatsu Isao , Iwase Ayano , Ozaki Makoto , Kazama Tomiei , Wada Keiji , Sekiguchi Masayuki 
Published: March 2009

Background
Dexmedetomidine (Precedex; Abbott Laboratories, Abbott Park, IL) is a selective alpha2-adrenergic agonist that also has affinity for imidazoline receptors. In clinical studies, dexmedetomidine has sedative effects and impairs memory, but the action of dexmedetomidine on synaptic plasticity in the brain has yet to be established. In the present study, the authors investigated the effects of dexmedetomidine on two forms of synaptic plasticity-long-term potentiation (LTP) and paired-pulse facilitation-in the CA1 region of mouse hippocampal slices.

Methods
The authors recorded Schaffer collateral-evoked field excitatory postsynaptic potentials from mouse hippocampal slices in CA1 stratum radiatum. The slope of the rising phase of the field excitatory postsynaptic potential was used to estimate the strength of synaptic transmission.

Results
Application of dexmedetomidine for 20 min before "theta burst" stimulation dose-dependently attenuated LTP, and half-inhibitory concentration of dexmedetomidine was 28.6 +/- 5.7 nm. The inhibitory effect of dexmedetomidine on LTP was not abolished by an alpha2-adrenoceptor antagonist (yohimbine), an imidazoline type 1 receptor and alpha2-adrenoceptor antagonist (efaroxan), an alpha1-adrenoceptor antagonist (prazosin), or a gamma-aminobutyric acid type A receptor antagonist (picrotoxin). However, an imidazoline type 2 receptor and alpha2-adrenoceptor antagonist (idazoxan) completely blocked the dexmedetomidine-induced attenuation. Furthermore, 2-benzofuranyl-2-imidaloline, a selective imidazoline type 2 receptor ligand, reduced LTP. 2-(4,5-dihydroimidaz-2-yl)-quinoline, another imidazoline type 2 receptor ligand, abolished the 2-benzofuranyl-2-imidaloline-induced attenuation, but the inhibitory effect of dexmedetomidine on LTP was not abolished by 2-(4,5-dihydroimidaz-2-yl)-quinoline. Dexmedetomidine did not affect paired-pulse facilitation.

Conclusion
Dexmedetomidine impairs LTP in area CA1 of the mouse hippocampus via imidazoline type 2 receptors and alpha2-adrenoceptors.
Long‐term Adverse Outcomes of Low Birth Weight, Increased Somatic Growth Rates, and Alterations of Body Composition in the Premature Infant: Review of the Evidence
Authors: Greer Frank R 
Published: March 2009

ABSTRACTIn appropriate‐for‐gestational‐age preterm infants, data are reviewed to support that both high and low nutrient intakes, as well as fast or slow rates of growth in the neonatal intensive care unit, have long‐term adverse (or even positive) effects on body weight and the metabolic syndrome later in life. Though more studies are needed, it is concluded that it is likely that any such effects will be relatively small compared with other risk factors such as parental weight and various lifestyle factors. At the present time, there is little evidence that negates the goal of maximizing nutritional support for the very low birth weight infant in the neonatal period.
Nutrient Supplies for Optimal Health in Preterm Infants
Authors: Hay William W 
Published: March 2009

ABSTRACTThe most commonly recommended standard for postnatal nutrition of very preterm infants is one that meets the unique nutritional requirements of the growing human fetus and duplicates normal in utero human fetal growth (weight and body composition) and development. Normal fetal nutrition, therefore, may be a useful guide for designing postnatal nutritional strategies in very preterm infants who need to grow and develop outside the uterus. Such information indicates that normal fetal nutrition requires certain nutrients in optimal amounts and certain growth‐promoting hormones in response to nutrient supply that together support optimal fetal growth and development; these include oxygen, glucose, lipids, amino acids, and insulin. Interestingly, nutrient restriction and nutrient excess in the fetus, while leading to different phenotypes, produce a similar phenotype in later life characterized as the “metabolic syndrome,” consisting of obesity, insulin resistance, diabetes, and cardiovascular disease. After birth, preterm infants—who almost universally are not fed as much as normally growing fetuses receive in nutrient supply via the placenta—also end up with a higher incidence of short stature and a predisposition to the metabolic syndrome, whereas those fed excessive amounts of energy and who develop excessive growth primarily of adipose tissue in early life (rapid, positive crossing of weight‐for‐length centiles) also develop a higher incidence of the metabolic syndrome. It is clear, therefore, that just the right amount of the essential nutrients is required to produce optimal outcome; this is as true for the preterm infant as it is for the fetus.
Mother's Own Milk, Donor Human Milk, and Preterm Formulas in the Feeding of Extremely Premature Infants
Authors: Schanler Richard J 
Published: March 2009

ABSTRACTSignificant benefits to infant host defense, sensory‐neural development, gastrointestinal maturation, and some aspects of nutritional status are observed when premature infants are fed their mothers' own milk. A reduction in infection‐related morbidity in human milk‐fed premature infants has been reported in nearly 1 dozen descriptive, and a few quasirandomized, studies in the past 25 years. Studies on neurodevelopmental outcomes have reported significantly positive effects for human milk intake on mental and motor development, intelligence quotient, and visual acuity compared with the feeding of formula. Human milk‐fed infants also have decreased rates of rehospitalization after discharge. It is unclear how much human milk is needed to provide protection or at what postnatal age the protective effects maximize. The data suggest that a specific dose of milk may be needed to confer protection. A detailed composition analysis of milk obtained from women delivering before 30 weeks of gestation is needed to determine if the “immature” milk contains the same functional bioactive factors as more mature milk. Furthermore, lactation strategies should be sought that increase mother's own milk production.
Weaning Preterm Infants: An Open Issue
Authors: Fanaro Silvia , Vigi Vittorio 
Published: March 2009

ABSTRACTSurvival rates for very low birth weight (VLBW) and extremely low birth weight infants have substantially increased during the past few decades. Most of these infants pose new and difficult problems related in particular to neurodevelopmental outcome and growth impairment. In fact, a high percentage of very low birth weight infants fail to achieve their growth potential and experience postnatal growth restriction. Because of this in‐hospital growth failure and nutrient deficits, correct nutritional intervention after hospital discharge must be instituted to avoid postnatal malnutrition and to correct the acquired deficit. Nutrient‐enriched formulas for several months after discharge have shown some benefits, although their clinical value remains unclear. Weaning, which certainly represents a relevant source of nutrients for the preterm infant, has attracted little attention until now. There are no precise guidelines on this topic, and too often weaning practices are left totally to the parents, without considering the specific nutritional needs of the single infant.
Effect of Treatment of Hepatic Histopathology in Children and Adolescents With Autoimmune Hepatitis
Authors: Ferreira Alexandre Rodrigues , Roquete Mariza Leitão Valadares , Toppa Nivaldo H , de Castro Lúcia Porto Fonseca , Fagundes Eleonora Druve Tavares , Penna Francisco José 
Published: March 2009

ABSTRACTObjective:To evaluate the effects of treatment on liver histopathology of children and adolescents diagnosed with autoimmune hepatitis.Patients and Methods:Histopathological evaluation of liver biopsies performed at diagnosis or early during treatment, compared with biopsies after immunosuppressive treatment of 20 children and adolescents diagnosed with autoimmune hepatitis who presented clinical and biochemical remission for at least 24 months. Liver histopathology was assessed by 2 pathologists. Agreement between their interpretations was analyzed with κ statistics.Results:The age at diagnosis of the 20 patients varied from 1.7 years to 11.6 years (median = 6.6 years); 18 were females. The mean duration of clinical and biochemical remission, up to performance of liver biopsy, was 4.1 years. The mean interval between the initial and posttreatment biopsies was 4.6 years (range 2–9.7 years). Assessing the necroinflammatory activity, a mean reduction by 6.3 (observer 1) and 7.3 (observer 2) in the grading score was observed (P = 0.00000). When staging was assessed, a mean reduction by 1.8 (observers 1 and 2) in the score was observed after treatment (P = 0.00008), and there was no progression toward cirrhosis. No regression of cirrhosis was observed.Conclusions:On histopathological evaluation, the immunosuppressive treatment improved the fibrosis scores, with an arrest in its progression and no development into cirrhosis. Fibrosis control is mainly associated with regression of necroinflammatory activity, which is the main treatment component in autoimmune hepatitis.
Very Low Birth Weight Infants as a Model to Study Genetic Influences on Neonatal Weight Gain
Authors: Spiegler Juliane , Kattner Evelyn , Vochem Matthias , Küster Helmuth , Möller Jens , Müller Dirk , Kribs Angela , Segerer Hugo , Wieg Christian , Nikischin Werner , Wense Axel von der , Gebauer Corinna , Herting Egbert , Göpel Wolfgang 
Published: March 2009

ABSTRACTIn a cohort of 829 preterm infants (birth weight below 1500 g) we identified 13 monozygotic, 10 same‐sex dizygotic, and 12 same‐sex matched singleton pairs. The difference in daily weight gain within pairs was significantly lower in monozygotic twins compared with dizygotic twins or matched singleton pairs. Our data support a strong genetic influence on postnatal growth in preterm infants. Therefore, weight gain of preterm infants may be an interesting model to study polymorphic variants of genes regulating neonatal resorption, metabolism, or energy expenditure, and their influence on weight gain in preterm infants.
Back to the Basic Sciences: An Innovative Approach to Teaching Senior Medical Students How Best to Integrate Basic Science and Clinical Medicine
Authors: Spencer Abby L. , Brosenitsch Teresa , Levine Arthur S. , Kanter Steven L. 
Published: March 2009

Abstract

Abraham Flexner persuaded the medical establishment of his time that teaching the sciences, from basic to clinical, should be a critical component of the medical student curriculum, thus giving rise to the “preclinical curriculum.” However, students’ retention of basic science material after the preclinical years is generally poor. The authors believe that revisiting the basic sciences in the fourth year can enhance understanding of clinical medicine and further students’ understanding of how the two fields integrate. With this in mind, a return to the basic sciences during the fourth year of medical school may be highly beneficial. The purpose of this article is to (1) discuss efforts to integrate basic science into the clinical years of medical student education throughout the United States and Canada, and (2) describe the highly developed fourth-year basic science integration program at the University of Pittsburgh School of Medicine. In their critical review of medical school curricula of 126 U.S. and 17 Canadian medical schools, the authors found that only 19% of U.S. medical schools and 24% of Canadian medical schools require basic science courses or experiences during the clinical years, a minor increase compared with 1985. Curricular methods ranged from simple lectures to integrated case studies with hands-on laboratory experience. The authors hope to advance the national discussion about the need to more fully integrate basic science teaching throughout all four years of the medical student curriculum by placing a curricular innovation in the context of similar efforts by other U.S. and Canadian medical schools.
Management of Tracheobronchial Stenoses With Endoprostheses: Experience With 103 Patients and 11 Models
Authors: Merrot Olivier , Buiret Guillaume , Gleizal Arnaud , Poupart Marc , Pignat Jean‐Christian 
Published: March 2009

AbstractObjective: To describe in a retrospective study our experience in endoscopic management of tracheobronchial stenosis with 145 stents (11 different models).Methods: We analyzed the medical records of 103 patients (67 males and 36 females) who underwent the placement of prosthesis for any causes of tracheobronchial stenoses between 1990 and 2005.Results: A total of 145 prostheses were placed. Of these, 96.1% of the patients had a relief of dyspnea, and 73.8% had only one prosthesis. Stent removal and replacement were significantly linked with etiologies (more frequently in patients with an inflammatory component), but not with the type of stent.Conclusion: Endostenting is a safe and effective treatment for tracheobronchial stenoses. Removal and replacements were due to etiologies of the strictures, but not to the type of stent. Stenoses with an inflammatory component were prone to iterative stenting. Only benign diseases that are a contra‐indication to open surgery should be treated by endoscopic stenting.
Evaluation of a Novel Stool Native Catalase Antigen Test for Helicobacter pylori Infection in Asymptomatic North American Children
Authors: Cardenas Victor M , Dominguez Delfina C , Puentes Flor A , Aragaki Corinne C , Goodman Karen J , Graham David Y , Fukuda Yoshihiro 
Published: March 2009

ABSTRACTRapid immunochromatographic tests for Helicobacter pylori infection have been developed to allow “near‐patient” testing. We therefore performed a pilot study to test a rapid immunochromatographic stool antigen test for the diagnosis of H pylori infection in asymptomatic children. We tested stool specimens collected from children participating in a cohort study in the United States and Mexico. H pylori–positive status was defined by positivity on at least 2 tests: a commercial H pylori stool antigen enzyme immunoassay, an immunoglobulin G antibody enzyme immunoassay, and the 13C‐urea breath test. Negative H pylori status was defined by negative findings of all of these tests. Of 52 children (22 girls, 30 boys) 25 were H pylori–positive, 19 H pylori–negative, and 8 uncertain (eg, presumably negative; positive findings on 1 of the 3 noninvasive tests). The sensitivity and specificity of the new stool antigen test for those with definite H pylori status were 100% (exact 95% CI 86.3%–100% and 82.4%–100%, respectively). This rapid stool antigen test may prove useful for point‐of‐care testing and epidemiological field studies. Larger prospective studies are needed in symptomatic and asymptomatic children for more precise estimates.
Looking for a Relation Between Serum Leptin Concentration and Body Composition Parameters in Healthy Term Infants in the First 6 Months of Life
Authors: Savino Francesco , Liguori Stefania Alfonsina , Fissore Maria Francesca , Palumeri Elisabetta , Calabrese Roberto , Oggero Roberto , Silvestro Leandra , Miniero Roberto 
Published: March 2009

ABSTRACTWe carried out a cross‐sectional study of 115 healthy infants, younger than 6 months old, exclusively breast‐fed or formula‐fed, to investigate correlations between circulating leptin concentrations and body composition measurements. Serum leptin was evaluated with radioimmunoassay, and body composition with bioelectrical impedance analysis. Multiple regression analysis showed a relationship between serum leptin and body mass index in the entire study population (P = 0.042). There was a significant negative relationship between serum leptin and phase angle (P = 0.006) in formula‐fed infants. Serum leptin was positively related to subscapular skinfold thickness (P = 0.055) and negatively to reactance (P = 0.057) only in formula‐fed infants, although the differences were just below significance. Serum leptin concentration was higher in breast‐fed infants (P = 0.002), and was not correlated with body composition parameters. This study indicates that there is a relation between leptin and infant body composition in the first months of life, although the link needs to be explored further.
Outcome After Pancreatectomy and Islet Autotransplantation in a Pediatric Population
Authors: Bellin Melena D , Carlson Annelisa M , Kobayashi Takashi , Gruessner Angelika C , Hering Bernhard J , Moran Antoinette , Sutherland David ER 
Published: March 2009

ABSTRACTObjectives:Little is known regarding outcomes after pancreatectomy and islet autotransplantation for chronic pancreatitis in pediatric patients. In this study, we document pain control and metabolic course after this procedure in a pediatric population.Materials and Methods:We reviewed medical records for 24 patients 18 years old or younger who underwent pancreatectomy with islet autotransplantation at the University of Minnesota from July 1989 through June 2006. Patients and/or their parents were invited to participate in a follow‐up telephone survey. Primary outcome measures were narcotics and insulin use at follow‐up. We compared outcomes in patients undergoing surgery as preadolescents (<13 years old) versus adolescents.Results:Follow‐up information was available on 18 of 24 patients. All of the patients required narcotics before surgery. Of the 18, only 7 (39%) were still taking narcotics at the time of the survey. At 1 year posttransplant, 78% of patients had islet graft function with full function (insulin independent) in 56% and partial function (once‐daily insulin use only) in 22%. By Cox regression analysis, important predictors of insulin independence were islet yield >2000 islet equivalents per kilogram and lack of prior pancreatic surgery (P = 0.011). Preadolescents were less likely to require chronic narcotic therapy at follow‐up (P = 0.05) and were more likely to maintain graft function (P = 0.02) compared with adolescents.Conclusions:Pancreatectomy can relieve pain in pediatric patients with chronic pancreatitis and the majority can withdraw from narcotics. Islet autotransplantation can prevent or reduce the severity of diabetes in about three fourths of patients. Outcome goals were reached in a higher proportion of younger than older children.
Fibrin Glue Application in the Management of Refractory Chylous Ascites in Children
Authors: Zeidan S , Delarue A , Rome A , Roquelaure B 
Published: March 2009

ABSTRACTThe purpose of this retrospective review of the charts of 6 children who underwent surgical treatment of chylous ascites refractory to conservative measures between 1993 and 2006 was to evaluate the efficiency of fibrin glue application for control of lymph leakage. Five children had postoperative chylous ascites (neuroblastoma, 4; cystic lymphangioma, 1) and 1 had a congenital malformation. Surgical exploration revealed large areas of diffuse lymphatic leakage in all of the patients. Lymphatic fistula was not identified intraoperatively in any patient. Ingestion of lipophilic dye in a concentrated fatty meal was not helpful in locating a lymph fistula. Absorbable mesh was used in association with glue application in the last 3 patients treated. Control of ascites was achieved immediately in 2 patients and within 3 weeks in 2 patients. Repeat surgery was required in the remaining 2 patients. The mean follow‐up time was 4.3 years. One patient died of tumor recurrence 12 months after surgical treatment without relapse of the ascites. Two mild late recurrences were observed at 6 and 11 months after surgery and were managed conservatively. The findings of this study show that fibrin glue application on absorbable mesh after dissection of the leakage zones is easy, safe, and effective. We recommend that surgery with glue application be repeated until control of ascites is achieved. We suggest fibrin glue application as a preventive measure against postoperative chylous ascites.
Prevalence of Endoscopic Findings of Erosive Esophagitis in Children: A Population‐based Study
Authors: Gilger Mark A , El‐Serag Hashem B , Gold Benjamin D , Dietrich Craig L , Tsou VM , McDuffie Addie , Shub Mitchell D 
Published: March 2009

ABSTRACTPurpose:Symptoms of gastroesophageal reflux disease (GERD) occur in 2% to 7% of children. The manifestations of GERD can be limited to symptoms (eg, heartburn, regurgitation) or can be more complicated, such as erosive esophagitis, esophageal strictures, or Barrett esophagus. The prevalence of such GERD complications in children is unknown. The purpose of this study was to determine the prevalence of endoscopic findings of erosive esophagitis in children.Patients and Methods:All children ages 0 to 17 years, 11 months who underwent upper endoscopy that was recorded in the Pediatric Endoscopic Database System‐Clinical Outcomes Research Initiative between 1999 and 2002 were included. Endoscopic reports that were incomplete or that did not include demographic features, indications for endoscopy, or endoscopic findings were excluded. Erosive esophagitis was defined either descriptively or by the Los Angeles classification. Esophageal biopsy was not evaluated.Results:A total of 7188 children who underwent upper endoscopy fulfilled the inclusion and exclusion criteria. Of those, 888 (12.4%) had erosive esophagitis. The median age of children with erosive esophagitis was 12.7 ± 4.9 years versus 10.0 ± 5.1 years in those without erosive esophagitis (P ≤ 0.0001). Of those with erosive esophagitis, 55.2% (490/888) were male, compared with 48.2% (3040/6300) in those without erosive esophagitis (P = 0.0001). Erosive esophagitis was found in 29 of 531 (5.5%) children ages 0 to 1 years and progressively increased to 106 in 542 individuals (19.6%) by age 17. Hiatal hernia was found in 68 (7.7%) of children with erosive esophagitis, compared with 157 (2.5%) without erosive esophagitis (P ≤ 0.0001. The prevalence of Barrett esophagus, esophageal stricture, ulcer, previous surgery, nodules, foreign body or retained food, and anatomic abnormalities was not significantly different between children with erosive esophagitis and those without.Conclusions:The frequency of erosive esophagitis is slightly higher in male children and increases with age. In contrast to erosive esophagitis in adults, there were no significant variations according to race or ethnicity. Hiatal hernia is the only endoscopic observation that predicts erosive esophagitis.