bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Oral Administration of Bifidobacterium breve on Fecal Lactic Acid and Short‐chain Fatty Acids in Low Birth Weight Infants
Authors: Wang Chongxin , Shoji Hiromichi , Sato Hiroaki , Nagata Satoru , Ohtsuka Yoshikazu , Shimizu Toshiaki , Yamashiro Yuichiro 
Published: January 2007

ABSTRACTObjectives:Short‐chain fatty acids (SCFAs) are known to provide energy to colonocytes, whereas overproduction of SCFAs can cause mucosal injury in premature infants. Our objective was to investigate the effects of the oral administration of Bifidobacterium breve M‐16V (B breve) on fecal lactic acid and SCFAs in low birth weight (LBW) infants.Patients and Methods:Fecal lactic, acetic, propionic, and butyric acids from 66 premature infants were analyzed by high‐performance liquid chromatography at 0, 2, and 4 weeks after birth. The subjects included 22 extremely LBW (ELBW, <1000 g), 22 very LBW (VLBW, <1500 g), and 22 LBW (<2500 g) infants. The infants were divided into two groups: those with and those without B. breve supplementation.Results:In the control groups, fecal acetic acid and total SCFA concentrations were significantly increased at 2 weeks in the VLBW and LBW infants (P < 0.05) and at 4 weeks in the ELBW, VLBW, and LBW infants (P < 0.01 for each) compared with those at week 0. Fecal lactic acid concentrations showed a similar pattern during follow‐up, but the differences were not significant. Four weeks after B breve administration, the fecal butyric acid concentrations were significantly decreased in the ELBW and VLBW infants (P < 0.05 each), and the ratio of the acetic acid concentrations to the total SCFAs was significantly increased compared with those of the control groups in the ELBW (P < 0.05), VLBW (P < 0.05), and LBW infants (P < 0.01).Conclusions:Oral administration of B breve reduces the production of butyric acid, which may be helpful in protecting LBW infants from digestive diseases such as necrotizing enterocolitis.
At What Age Is a Suction Rectal Biopsy Less Likely to Provide Adequate Tissue for Identification of Ganglion Cells?
Authors: Croffie Joseph M , Davis Mary M , Faught Philip R , Corkins Mark R , Gupta Sandeep K , Pfefferkorn Marian D , Molleston Jean P , Fitzgerald Joseph F 
Published: January 2007

ABSTRACTObjective:The objective of this study was to determine at what age suction rectal biopsy is less likely to provide adequate tissue to detect submucosal ganglion cells in a child being evaluated for Hirschsprung disease.Patients and Methods:Children ≥1 year of age undergoing a rectal biopsy at a single children's hospital had 1 biopsy each obtained simultaneously with a suction biopsy device and a grasp biopsy forceps. The biopsies were examined by 2 pathologists for adequacy of the submucosa (none, scant, adequate, or ample) and the presence of ganglion cells. The 2 specimens were compared with each other.Results:One hundred fifty‐two children 1 to 17 years of age were included. Fifty‐three were female. Subjects were grouped into 4 age categories: 1 to 3 years (group A), 4 to 6 years (group B), 7 to 9 years (group C), and ≥10 years (group D). Similar numbers of patients were recruited for each group. Ganglion cells were identified in 73% and 90% by the suction and grasp devices, respectively, in group A. In groups B through D, ganglion cells were identified in 50% to 53% vs 92% to 97% of the suction and grasp biopsies, respectively (P < 0.001). Submucosa was present in 88% (suction) vs 98% (grasp) in group A, 70% vs 95% in group B, 69% vs 94% in group C, and 45% vs 92% in group D.Conclusion:The suction rectal biopsy is less likely to provide adequate submucosa for identification of ganglion cells after 3 years of age.
Natalizumab Therapy for Moderate to Severe Crohn Disease in Adolescents
Authors: Hyams Jeffrey S , Wilson David C , Thomas Adrian , Heuschkel Robert , Mitton Sally , Mitchell Brent , Daniels Regina , Libonati Michele A , Zanker Susan , Kugathasan Subra ,   International Natalizumab CD305 Trial Group
Published: January 2007

ABSTRACTObjectives:This study evaluated the safety, tolerability, and efficacy of natalizumab, a humanized monoclonal immunoglobulin‐G4 antibody to α4 integrin, in adolescent patients with moderately to severely active Crohn disease (CD).Patients and Methods:In a single‐arm study, 38 adolescent patients (ages 12–17 y) with active CD (Pediatric Crohn Disease Activity Index [PCDAI] >30) received 3 intravenous infusions of natalizumab (3 mg/kg) at 0, 4 and 8 weeks. The primary analysis was safety, assessed by adverse events, laboratory results, and vital signs. Pharmacokinetic and pharmacodynamic measurements and formation of anti‐natalizumab antibodies also were analyzed. Efficacy outcomes were assessed by changes in PCDAI, quality of life (IMPACT III), and levels of C‐reactive protein and serum albumin.Results:Thirty‐one patients (82%) received 3 natalizumab infusions. The most common adverse events were headache (26%), pyrexia (21%) and CD exacerbation (24%). Clinical response (≥15‐point decrease from baseline PCDAI) and remission (PCDAI ≤10) rates were greatest at week 10 (55% and 29%, respectively). Three patients (8%) tested positive for anti‐natalizumab antibodies. The peak level (61.0 and 66.3 μg/mL) and half‐life (92.3 and 96.3 h) of natalizumab were comparable after the first and third infusions. Mean α4 integrin receptor saturation was 93% at 2 hours and <40% at 4 weeks after the first and third infusions. Increase from baseline in circulating lymphocytes ranged from 106% to 122% at 2 weeks and 45% to 65% at 4 weeks after each infusion.Conclusion:Natalizumab (3 mg/kg) was well tolerated in these adolescent patients with active CD, with a safety and efficacy profile similar to that of adult natalizumab‐treated CD patients. Future studies should evaluate long‐term safety and efficacy.
Influence of Different Intravenous Lipid Emulsions on Hepatobiliary Dysfunction in a Rabbit Model
Authors: Kohl Martina , Wedel Thilo , Entenmann Andreas , Stuttmann Julia , Bendiks Meike , Loff Steffan , Köster Stefan , Ortfeld Stefan , Bos Inge 
Published: January 2007

ABSTRACTObjectives:Long‐term total parenteral nutrition (TPN) in children is often complicated by the development of cholestasis, liver fibrosis, and liver failure. High doses of intravenous lipids may be involved in the pathogenesis of hepatobiliary dysfunction. The purpose of this study was to determine whether the use of 2 newly developed lipid emulsions could reduce liver damage.Materials and Methods:Three groups of prepubescent rabbits received TPN including a lipid emulsion either based on soybean oil, olive oil, or soybean oil with n‐3 fatty acids added. Enterally fed animals served as controls. After 21 d the animals were killed. Serum samples were obtained at the beginning and end of the study period. Specimens were processed for histological evaluation using a specific score to assess the severity of liver damage.Results:Biochemical parameters did not predict the extent of liver damage. Hydropic degeneration as an indicator of toxic liver injury was the predominant histological alteration regardless of the type of lipids infused. The extent of fibrosis did not significantly differ among treatment groups except for animals infused with n‐3 fatty acids exhibiting increased fibrotic transformation as compared with controls.Conclusion:In our animal model, the use of a lipid emulsion with a reduced amount of polyunsaturated fatty acids was not superior to a lipid emulsion based on soybean oil. Long‐term application of n‐3 fatty acids was associated with more extensive fibrosis. Therefore, intravenous n‐3 fatty acids containing lipid preparations (fish oil) should not be used in patients for long‐term TPN.
Colorectal Carcinoma in Childhood: A Retrospective Multicenter Study
Authors: Kravarusic Dragan , Feigin Elad , Dlugy Elena , Steinberg Ran , Baazov Arthur , Erez Ilan , Lazar Ludvig , Kapuller Vadim , Grunspan Moshe , Ash Shifra , Freud Enrique 
Published: January 2007

ABSTRACTObjectives:Colorectal carcinoma, a common adult malignancy, has an estimated childhood incidence of 0.3 to 1.5/million in Western countries and 0.2/million in Israel. Diagnosis is difficult because adult screening measures are unfeasible in children. The tumor is frequently associated with predisposing genetic factors, aggressive biological behavior, and poor prognosis. The aim of this multicenter study was to document the clinical profile, treatment and prognosis of colorectal carcinoma in children in Israel.Patients and Methods:The clinical, laboratory, therapeutic, and prognostic parameters of all 7 children from 4 medical centers in Israel who were diagnosed with colorectal carcinoma over a 25‐y period were reviewed.Results:Patients presented with rectal bleeding (4 of 7), abdominal pain (2 of 7), and abdominal distension (2 of 7). Average time to diagnosis was 6 months. Six patients underwent surgery (1 refused), and 5 received chemotherapy. Histopathological studies showed poorly differentiated mucinous adenocarcinoma, signet‐ring type, in 4 cases, moderately differentiated adenocarcinoma in 2, and well‐differentiated carcinoma in 1. Three patients died of the disease, 2 shortly after diagnosis. One patient with recurrent metastatic disease was lost to follow‐up.Conclusion:Colorectal carcinoma in children is characterized by aggressive tumor behavior and delayed diagnosis, resulting in a worse prognosis than in adults. Heightened physician awareness of the possibility of this disease in children, with special attention to adolescents with predisposing factors and rectal bleeding, could help to improve outcome.
Wireless Capsule Endoscopy in Children: A Study to Assess Diagnostic Yield in Small Bowel Disease in Paediatric Patients
Authors: Thomson Mike , Fritscher‐Ravens Annette , Mylonaki Maria , Swain Paul , Eltumi Muftah , Heuschkel Robert , Murch Simon , McAlindon Mark , Furman Mark 
Published: January 2007

ABSTRACTBackground and Aim:Small bowel disease in the paediatric population is varied and to date has relied on indirect l modalities such as small bowel follow‐through with attendant radiation exposure. Wireless capsule endoscopy (WCE) has the potential to provide a safer and more effective means of investigating the paediatric small bowel. The aim of our study was to prospectively assess the diagnostic yield of WCE compared with standard investigation in children with suspected small bowel disease.Methods:Twenty‐eight consecutive patients, median age 12.5 y (range, 9.4–15.9) with suspected small bowel disease were investigated with WCE. This included 16 patients with suspected small bowel Crohn disease (CD) (10 newly diagnosed; 6 known cases), 6 with obscure or occult gastrointestinal bleeding (GIB), 3 with Peutz‐Jegher polyposis (PJP), 2 with protein‐losing enteropathy and 1 with recurrent abdominal pain. All of the patients had preceding upper gastrointestinal endoscopy (OGD) and ileocolonoscopy, and 24 had a barium meal and follow‐through (BMFT). Images were downloaded and analysed and results compared with the endoscopic and radiological findings.Results:Three patients were unable to swallow the capsule (1 CD, 1 PJP and 1 GIB). Two of these patients (1 GIB, 1 PJP) had the capsule placed in the stomach endoscopically and completed the WCE uneventfully thereafter. In 3 patients (CD group) the capsule remained in the stomach and/or proximal duodenum and no small bowel images were obtained. Hence, 24 patients had successful completion of the WCE through the small bowel, 23 of whom had clinically relevant findings identified. In all patients with CD who had successful WCE studies (12/16), small bowel disease was identified (11/12 active disease, 1/12 chronic disease). A possible small bowel bleeding source was identified in all 6 patients with GIB. Two patients with GIB also underwent push enteroscopy and 1 of these had a bleeding source identified. The 2 patients with protein‐losing enteropathy had extensive patchy lymphangiectasia of the jejunum and ileum, not detected at OGD. The patient with abdominal pain had an intussusception of the upper jejunum. The 2 PJP patients had small bowel polyps identified, which were not detected at BMFT. WCE was more sensitive for small bowel pathology than both BMFT (19 vs 5; 26% sensitivity compared with WCE) and endoscopic investigations (23 vs 10; 43.4% sensitivity compared with WCE). Two patients with CD had delayed capsule transit.Conclusions:WCE led to a positive alteration in management in 18/24 (75%) of patients whose small bowel was examined by WCE and in 18/28 (64.3%) who were admitted to the study. WCE was safe, well tolerated, and more sensitive than radiological and standard endoscopic modalities in the detection of small bowel CD distribution, GIB source, and presence of polyps in children.
Risk Factors for Small Bowel Bacterial Overgrowth in Cystic Fibrosis
Authors: Fridge Jacqueline L , Conrad Carol , Gerson Lauren , Castillo Ricardo O , Cox Kenneth 
Published: January 2007

ABSTRACTObjectives:The purpose of this study was to determine the prevalence of small bowel bacterial overgrowth in patients with pancreatic‐insufficient cystic fibrosis (CF) compared with age‐matched controls and to identify potential risk factors for small bowel bacterial overgrowth.Patients and Methods:Fifty patients, 25 pancreatic‐insufficient CF study patients (mean age, 17 y) and 25 gastrointestinal clinic control patients (mean age, 15 y), completed a glucose‐hydrogen breath test after an overnight fast. Study patients completed a quality‐of‐life questionnaire modified from the Cystic Fibrosis Questionnaire. The medical history of each patient was compared with breath test results. A positive breath test was defined as a fasting hydrogen ≥15 ppm or a rise of ≥10 ppm hydrogen over baseline during the test.Results:The prevalence of positive breath tests was higher in the CF study group (56%) than in the control group (20%) (P = 0.02). The mean fasting hydrogen levels of patients in the study and control groups were 22 and 5 ppm (P = 0.0001). The mean questionnaire scores were not significantly different between breath test–positive and –negative study patients. The use of azithromycin was associated with an increased risk of a positive breath test. Use of laxatives and inhaled ipratropium was associated with a decreased risk of a positive breath test.Conclusions:Patients with CF were more likely to have elevated fasting hydrogen levels compared with controls. This suggests a high prevalence of small bowel bacterial overgrowth in CF patients. Medications commonly used by CF patients may influence intestinal health.
Efficacy of Rice‐based Oral Rehydration Solution Containing Recombinant Human Lactoferrin and Lysozyme in Peruvian Children With Acute Diarrhea
Authors: Zavaleta Nelly , Figueroa Dante , Rivera Juan , Sánchez Julia , Alfaro Segundo , Lönnerdal Bo 
Published: January 2007

ABSTRACTObjective:To compare glucose and rice‐based oral rehydration solution with rice‐based oral rehydration solution containing recombinant human lactoferrin and recombinant human lysozyme in diarrhea outcomes.Patients and Methods:We conducted a randomized, double‐blind controlled trial in children with acute diarrhea and dehydration. One hundred and forty children 5 to 33 months old were block randomized to receive low osmolarity WHO‐ORS (G‐ORS), rice‐based ORS (R‐ORS), or rice‐based ORS plus lactoferrin and lysozyme (Lf/Lz‐R‐ORS). Intake and output were monitored for 48 h in the ORU, with continued monitoring through home and clinic follow‐up for 14 d.Results:The G‐ORS and R‐ORS groups did not show any differences in diarrhea outcomes and were therefore combined as the control group. Intent‐to‐treat analysis showed a significant decrease in duration of diarrhea (3.67 d vs 5.21 d, P = 0.05) in the Lf/Lz‐R‐ORS group as compared with the control group and a significant increase in the number of children who achieved 48 h with solid stool, 85% vs 69% (P < 0.05). There were also decreases in volume of diarrhea and the percentage of children who had a new diarrhea episode after achieving the endpoint.Conclusions:Addition of recombinant human lactoferrin and lysozyme to a rice‐based oral rehydration solution had beneficial effects on children with acute diarrhea.
Comparison of Monoclonal and Polyclonal ELISAs for Fecal Elastase in Patients With Cystic Fibrosis and Pancreatic Insufficiency
Authors: Borowitz Drucy , Lin Rong , Baker Susan S 
Published: January 2007

ABSTRACTObjectives:Two enzyme‐linked immunosorbent assay methodologies are used to detect pancreatic insufficiency: monoclonal and polyclonal. We sought to compare these assays in patients with cystic fibrosis and to correlate these with the coefficient of fat absorption (CFA).Study Design:As part of a larger study, subjects had stool elastase measured by both methods while taking exogenous enzymes. Subjects subsequently stopped enzymes and had a fecal fat balance study performed; the CFA was then calculated.Results:One hundred twenty‐four subjects participated in this substudy. The median values for the monoclonal and polyclonal assays were 0.3 and 22.75 μg/g, respectively. The correlation coefficient between the 2 tests was 0.86 (P < 0.0001). The correlation coefficients between CFA and the monoclonal and polyclonal assays were 0.24 (P = 0.006) and 0.10 (P = 0.27), respectively. If the criterion standard definition of pancreatic insufficiency was set at a CFA < 90% and the test definition of pancreatic insufficiency was set at <100 μg/g, then the monoclonal and polyclonal assay positive predictive values were 97.6% (120 of 123) and 97.4% (111 of 114), respectively.Conclusions:The positive predictive value of both monoclonal and polyclonal fecal elastase in patients with cystic fibrosis is extremely good; however, correlation of either test with CFA was poor. The median value for the polyclonal elastase assay is higher than for the monoclonal assay, which could potentially lead to lower sensitivity of the polyclonal assay at lower cutpoints for the monoclonal assay is used.
Polymorphisms of Tumor Necrosis Factor‐α but Not MDR1 Influence Response to Medical Therapy in Pediatric‐Onset Inflammatory Bowel Disease
Authors: Cucchiara Salvatore , Latiano Anna , Palmieri Orazio , Canani Roberto Berni , D'Incà Renata , Guariso Graziella , Vieni Giuseppe , De Venuto Domenica , Riegler Gabriele , de'Angelis Gian Luigi , Guagnozzi Danila , Bascietto Cinzia , Miele Erasmo , Valvano Maria Rosa , Bossa Fabrizio , Annese Vito ,   Italian Society of Pediatric Gastroenterology and Nutrition
Published: January 2007

ABSTRACTAim:We investigated the contribution of variants of tumour necrosis factor (TNF)‐α and MDR1 genes in the predisposition and response to medical therapy in a large pediatric cohort of patients with Crohn disease (CD) and ulcerative colitis (UC).Patients and Methods:In this study, 200 patients with CD, 186 patients with UC, 434 parents (217 trios), and 347 healthy unrelated controls were investigated. Single‐nucleotide polymorphisms −G308A and −C857T of the TNF‐α gene and C3435T of the MDR1 gene were investigated and correlated with clinical subphenotypes and efficacy of medical therapy.Results:The frequency of the −308A allele of the TNF‐α gene was significantly increased in both patients with CD (15%; odds ratio [OR] = 2.79; P < 0.01) and patients with UC (11%; OR = 1.96; P < 0.003) compared with controls (6%). Carriers of this allele were 27% in CD (OR = 2.94; P < 0.01) and 19% in UC (OR = 1.86; P = 0.015) compared with 11% in healthy controls. No significant difference was found for both the −C857T and C3435T single‐nucleotide polymorphisms. With the genotype/phenotype analysis, no correlation in patients with UC with the MDR1 gene was found. CD carriers of the −308A allele had a higher frequency of surgical resection (35% vs 20%; OR = 2.1; P = 0.035) and more frequent resistance to steroids (22% vs 8%; OR = 0.29; P = 0.032) compared with noncarriers. These findings were confirmed by stepwise logistic regression.Conclusions:In our pediatric cohort, the promoter −308A polymorphism of TNF‐α but not the MDR1 gene is significantly involved in the predisposition to both CD and UC. This polymorphism carries a significant reduction in response to steroid therapy, probably leading to a more frequent need for surgical resection.
Small Volume Enemas Do Not Accelerate Meconium Evacuation in Very Low Birth Weight Infants
Authors: Haiden Nadja , Jilma Bernd , Gerhold Bernadette , Klebermass Katrin , Prusa Andrea R , Kuhle Stefan , Rohrmeister Klaudia , Kohlhauser‐Vollmuth Christina , Pollak Arnold 
Published: January 2007

ABSTRACTWe hypothesized that small volume enemas accelerate meconium evacuation in very low birth weight (VLBW) infants. In a randomized controlled trial, VLBW infants (n = 81) received either repeated daily small volume enemas if complete spontaneous meconium passage failed within 24 h or no intervention. Small volume enemas did not accelerate complete meconium evacuation, which occurred after 6.0 to 9.6 (95% CI) d in the intervention group and after 7.7 to 11.0 (95% CI) d in the control group. No adverse events were observed. Daily administration of small volume enemas had no effect on total meconium evacuation defined by the time of last meconium passage.
Hepatitis B “By Proxy”: An Emerging Presentation of Chronic Hepatitis B in Children
Authors: Sciveres Marco , Maggiore Giuseppe 
Published: January 2007

ABSTRACTWe report on 6 adopted asymptomatic children in whom chronic HBV infection was identified through the occurrence of an acute hepatitis B in a family member. All of the children had serum HBV‐DNA >2000 pg/mL. Acute hepatitis B in a family should alert the physician regarding the possibility of existing chronic HBV infection in other members of the family, especially newly adopted children, leading to a quick evaluation of their HBV status and to an efficacious protection of susceptible family members.