bluuebunny/crossref_metadata_2025_split huggingface dataset:
Colonic Structural and Ion Transport Abnormalities in Suckling Rabbits Infected with Escherichia coli K12
Authors: O'Loughlin Edward V. , Zhe Li , Buret Andre , Bell Cameron , Robins‐Browne Roy M. , Elliott Elizabeth J. 
Published: February 2024

BackgroundEscherichia coli K12 is a laboratory strain considered nonpathogenic. The purpose of this study was to examine the effect of E. coli K12 infection on colonic structure and function.MethodsSuckling rabbits were infected at 10 days of age with 6 × 109 CFU E. coli by intragastric inoculation and were examined 4 to 5 days later. Segments of ileum and proximal and distal colon were removed for light and electron microscopy, and NaCl transport was examined in vitro under short‐circuited conditions in Ussing chambers.ResultsInfection did not cause weight loss or diarrhea. Colonic mucosa was inflamed with infiltration by polymorpho‐nuclear neutrophils mainly in the lamina propria. The proximal and distal colon exhibited reduced Na+ absorption. The proximal colon also showed increased Cl‐ secretion; the ileum was unaffected.ConclusionsInfection with E. coli K12 disrupts the epithelium and alters ion transport in the colon, probably as a result of mucosal inflammation. The changes indicate that nonpathogenic E. coli have the potential to cause intestinal disease.
Abnormal Expression of Brush‐Border Membrane Transporters in the Duodenal Mucosa of Two Patients with Microvillus Inclusion Disease
Authors: Michail Sonia , Collins James F. , Xu Hua , Kaufman Stuart , Vanderhoof Jon , Ghishan Fayez K. 
Published: February 2024

ABSTRACTBackground:Microvillus inclusion disease is a congenital disorder characterized by secretory diarrhea. Patients demonstrate villus atrophy, loss of microvilli, and internalized inclusions of microvilli within the cytoplasm of small intestinal enterocytes. The exact molecular defect in these patients is not known. Two infants are described in this report with microvillus inclusion disease. Case 1 was a 3‐month‐old boy who developed secretory diarrhea shortly after birth. Case 2 was a 9‐month‐old boy who had abrupt onset diarrhea at 2 weeks of age resulting in weight loss and dehydration. Light microscopy revealed total villus atrophy with minimal crypt hyperplasia, and electron microscopic examination revealed variably shortened microvilli and cytoplasmic microvillus inclusions in both patients.Methods:Poly (A)+ RNA was purified from duodenal biopsies and RT‐PCR reactions were performed. Normal human intestinal RNA was used as a positive control. Primers specific for human NHE‐1, NHE‐2, NHE‐3 (2 sets), sodium‐glucose transporter (SGLT1), and β‐actin were used.Results:Results showed that NHE‐1 and β‐actin cDNAs amplified to similar levels in both patient and control samples. However, the expression of NHE‐2 and SGLT1 was much higher in the control sample than in the patient samples. Additionally, NHE‐3 mRNA was not detected in the patient samples using two sets of NHE‐3 specific primers.Conclusions:The patients with microvillus inclusion disease have defects in apical but not basolateral membrane transport systems, and these defects are related to the pathogenesis of the disease.
Evaluation of Serology, 13C‐Urea Breath Test, and Polymerase Chain Reaction of Stool Samples to Detect Helicobacter pylori in Bangladeshi Children
Authors: Casswall Thomas H. , Nilsson Hans‐Olof , Bergström Mats , Aleljung Pär , Wadström Torkel , Dahlström Anders K. , Albert M. John , Sarker Shafiqul A. 
Published: February 2024

ABSTRACTBackground:Serologic methods to detect Helicobacter pylori in infants, especially in developing countries, may be limited because of decreased immune response caused by malnutrition. The true prevalence may therefore be underestimated in this age group. Urea breath test is considered to be a good screening method in children but is expensive and therefore is not suitable for screening in developing countries. Simple, inexpensive, and accurate noninvasive methods to detect H. pylori in infants and young children are needed.Methods:Enzyme immunoassay (EIA) and immunoblot (IB) serologic analyses, 13C‐urea breath test (UBT), and immunomagnetic separation‐polymerase chain reaction (IMS‐PCR) were performed on stool specimens, to detect H. pylori in 68 children between 4 and 24 months of age (mean, 11.5 months) in an endemic area in Bangladesh and the results compared.Results:The occurrence of H. pylori was 57% (n = 39) using only UBT, 60% (n = 41) using only IMS‐PCR, and 78% (n = 53) using UBT and IMS‐PCR together. The concordance between UBT and IMS‐PCR results was 62%. Immunoblot was positive in only 9% (n = 6). Results in all 68 children were negative using EIA.Discussion:The prevalence of H. pylori infection in this peri‐urban community and age group was high. Only serologic methods seem to be unsatisfactory for screening of H. pylori infection in infants and may not reflect the true prevalence. Immunomagnetic separation‐PCR is a simple and rapid method for detection of H. pylori in stool and is an attractive method for analysis of colonization in infants. However, it may reflect a different stage of disease than UBT. Further studies are needed to clarify this.
Dietary Lipid Composition Modifies Intestinal Morphology and Nutrient Transport in Young Rats
Authors: Perin Nilza , Jarocka‐Cyrta Elizabeth , Keelan Monika , Clandinin Tom , Thomson Alan 
Published: February 2024

ABSTRACTBackground:Varying lipid content of the diet of pregnant and nursing dams results in alterations in sugar and lipid uptake into the intestine of their suckling offspring. In this study, we wished to determine whether the same alterations in dietary lipid result in adaptation of intestinal transport in postweaning rats.Methods:During nursing, the dams were fed the same diet that their offspring were fed for 3 more weeks after weaning. These semipurified diets contained: 1) 15.8% of total fatty acids (w/w) as 18:2n‐6 and an n6/n3 ratio of 7.3:1; 2) a diet with 17.6% of total fatty acids as 18:2n‐6 and an n6/n3 ratio of 4:1; 3) a diet with 16.2% of total fatty acids as 18:2n‐6 and 1.2% arachidonic acid (AA); 4) a diet with 16.8% of total fatty acids at 18:2n‐6, 1.2% AA and 0.7% docosahexaenoic acid (DHA); and 5) a diet with 16.0% of total fatty acids as 18:2n‐6 and 0.7% as DHA. The in vitro uptake of D‐glucose, D‐fructose, medium‐ or long‐chain fatty acids and cholesterol was assessed in 6‐week‐old rats.Results:Feeding AA increased the Vmax for jejunal and ileal uptake of glucose, compared with the high n6/n3 diet. This effect was prevented by adding DHA to the AA diet. The low n6/n3 fatty acid ratio diet decreased uptake of fructose as compared with the high n6/n3 diet, and the increased uptake of fructose with DHA was prevented by adding AA. The incremental change in free energy associated with uptake of medium chain‐length fatty acids was lower in the jejunum of animals fed AA plus DHA as compared with the other diet groups. Jejunal uptake of 18:0 was lower for animals fed DHA or AA plus DHA, as compared with AA alone; ileal rate of uptake of long‐chain fatty acids was unaffected by diet.Conclusions:The intestine of young rats modifies its intestinal morphology and adapts its nutrient transport in response to variations in dietary lipids. In postweaning rats, the potentially undesirable effect of one fatty acid on nutrient uptake may be countered by adding a select second fatty acid to the diet.
Lymphocyte Subset Profile of Young Healthy Children Residing in a Rural Area: Possible Role of Recurrent Gastrointestinal Infections
Authors: Granot Esther , Rabinowitz Ruth , Schlesinger Michael 
Published: February 2024

ABSTRACTBackground:Lymphocyte subsets in healthy children are currently characterized by age‐related standards. Because antigenic stimuli play a role in maturation of the immune system after birth, there is a question of whether cellular immune development differs in infants whose living conditions entail extensive antigenic exposure and infants growing up in a more protected environment.Methods:Peripheral blood lymphocyte subsets were studied in two populations of children of similar age and nutritional status; children belonging to a rural population residing in proximity with farm animals and children from an economically privileged urban population. In each population, children studied included a group with an acute diarrheal episode and a healthy control group.Results:Among rural population children, 65% had experienced at least one episode of gastroenteritis within the previous 3‐month‐period, compared with less than 10% of urban population children. In the rural population group 15% had experienced two or more episodes of gastroenteritis. The proportion of helper T cells was similar in rural population and urban population children. Among helper T cells, the proportion of CD29+ “memory” cells of the total CD4+ helper T cells was more than two times higher than those in rural population children. The proportion of CD8 cells was higher in rural population children than in urban population children, and the proportion of natural killer cells, CD56+ and CD57+, was two to three times higher in rural population children. Within each population, peripheral blood lymphocyte subsets did not differ between the healthy control group and those with acute diarrhea.Conclusions:In young children exposure to environmental pathogens and specifically to gastrointestinal antigenic stimuli is a major factor affecting development of the cellular immune response. Young children who have experienced enhanced infectious exposure have a peripheral blood lymphocyte profile similar to that of adults.
Epidemiology of Altered Intestinal Permeability to Lactulose and Mannitol in Guatemalan Infants
Authors: Goto Keiko , Chew Francisco , Torún Benjamin , Peerson Janet M. , Brown Kenneth H. 
Published: February 2024

ABSTRACTBackground:Subclinical alterations of small intestinal function have been reported frequently in tropical countries. Studies of small intestinal permeability to lactulose and mannitol were therefore completed in Guatemalan infants from a low‐income, periurban community to assess the prevalence of altered intestinal function and the factors associated with this condition.Methods:Two hundred studies were successfully completed in 158 infants who had been free of diarrhea for at least 1 week before the day of study. Urinary concentrations of lactulose and mannitol during the 5‐hour period after ingestion of 400 mg/kg body weight of lactulose and 100 mg/kg body weight of mannitol were measured by gas‐liquid chromatography and compared by age group, feeding practices, anthropometric indexes, and serum iron and zinc concentrations.Results:The overall prevalence of altered intestinal permeability (defined as a ratio of urinary recovery of lactulose to mannitol [L/M] ≥0.07) was 30%. The urinary L/M recovery ratio was positively associated with age; low weight for age; and, in infants less than 6 months of age, non‐breast‐feeding. Children with serum iron concentrations less than 7.16 µM/l (40 µg/dl) had higher median L/M ratios (L/M = 0.068; 95% confidence interval [CI], 0.054, 0.085) than those with iron levels higher than this cutoff (L/M = 0.052; CI = 0.046, 0.058; p = 0.038). The median urinary L/M recovery ratio in 10 currently asymptomatic infants who had diarrhea during the week before testing (0.087; CI = 0.49, 0.154) was higher than that in children who had been free from diarrhea for at least 1 week (0.052; CI = 0.048, 0.056; p = 0.01).Conclusion:Age, feeding practices, low weight‐for‐age, low serum iron concentration, and recent diarrhea were all associated with altered intestinal function in this group of Guatemalan infants.
Helicobacter pylori and Nonulcer Dyspepsia in Childhood: Clinical Pattern, Diagnostic Techniques, and Bacterial Strains
Authors: Rutigliano Vincenzo , Ierardi Enzo , Francavilla Ruggiero , Castellaneta Stefania , Margiotta Marcella , Amoruso Annacinzia , Marrazza Elisa , Traversa Andrea , Panella Carmine , Rigillo Nicola , Francavilla Antonio 
Published: February 2024

ABSTRACTBackground:This is a report of the results of a multicenter study performed in children with dyspepsia from five pediatric centers in Puglia, a region in southern Italy. In the study, clinical features of Helicobacter pylori infection, the reliability of diagnostic techniques, and the involvement of bacterial strains were examined.Methods:Fifty‐three outpatients with dyspepsia enrolled in our study and compiled a diary recording clinical symptoms in patients before they underwent the following diagnostic techniques: endoscopy, biopsy for histologic analysis, rapid urease test, 13C urea breath test, serology specific for immunoglobulin (Ig) G and anti‐CagA and VacA.Results:H. pylori showed a prevalence of 30.2% (n = 16). Histologic positivity was seen in all patients at the antral level (H. pylori‐associated chronic gastritis). In the gastric body, bacterial chronic active gastritis was present only in six patients (H. pylori‐associated chronic pangastritis). Clinical evaluation showed a significant difference in favor of subjects positive for H. pylori only for epigastric burning and/or pain (p < 0.001). The comparison of results of diagnostic tests, using histology as the gold standard, showed sensitivity and specificity of more than 93% for 13C urea breath test and more than 85% for rapid urease test and serology. Anti‐CagA antibodies were found in 64.3% and anti‐VacA antibodies in 42.8% of H. pylori‐positive patients.Conclusions:H. pylori prevalence in children with dyspepsia from the geographic area studied in comparable with that found in other developed countries. Approximately 50% of the studied patients were infected by cytotoxic strains. The urea breath test was the most reliable noninvasive diagnostic tool and is suitable for routine use, although endoscopy with histologic assessment remains the definitive investigation and is particularly important in patients with positive serology for CagA and VacA. Finally, the frequency of aggressive strains in our region seems to affect the clinical pattern; this emphasizes the importance of definitive diagnosis in children and offers a new role for serology.
Growth Hormone Stimulates, Through Tyrosine Kinase, Ion Transport and Proliferation in Human Intestinal Cells
Authors: Canani Roberto Berni , Bisceglia Massimo , Bruzzese Eugenia , Mallardo Giuseppe , Guarino Alfredo 
Published: February 2024

ABSTRACTBackground:Growth hormone (GH) stimulates intestinal growth and differentiation and promotes water and ion absorption in the rat intestine. Epidermal growth factor has similar effects, which involve tyrosine kinase activity. The effects of growth hormone on ion transport and cell growth and the role of tyrosine kinase in these effects were examined in a human‐derived intestinal cell line (Caco‐2).Methods:For transport study, electrical parameters were measured in human intestinal Caco‐2 cell monolayers mounted in Ussing chambers. Cell growth was monitored by counting and 3H‐thymidine incorporation in the presence and absence of growth hormone. The role of tyrosine kinase was investigated by using its specific inhibitor genistein.Results:The addition of growth hormone induced a rapid, Cl‐‐dependent, decrease in short‐circuit current without affecting tissue conductance, which is consistent with an anion‐absorptive effect. Incubation with growth hormone increased cell count by 85% and 3H‐thymidine incorporation by 64% versus the count in control specimens. The absorptive and trophic effects of growth hormone were dose‐dependent, and the maximum effective concentration was identical for each effect. Genistein blocked and growth effect on ion transport and cell growth.Conclusions:Growth hormone stimulates ion absorption and cell growth in human enterocytes. Both effects result from a direct growth hormone‐enterocyte interaction, and both require tyrosine kinase activity. Growth hormone may have therapeutic potential in intestinal diseases characterized by epithelial atrophy and loss of water and electrolytes.
Gastroesophageal Reflux and Respiratory Phenomena in Infants: Status of the Intraluminal Impedance Technique
Authors: Wenzl Tobias G. , Silny Jiri , Schenke Simone , Peschgens Thomas , Heimann Gerhard , Skopnik Heino 
Published: February 2024

ABSTRACTBackground:The coincidence of recurrent respiratory symptoms and gastroesophageal reflux (GER) is a well‐known phenomenon in infants. Twenty‐four‐hour pH metry is the presumed gold standard of diagnostic tools for this symptom complex, but with this method, only acid (pH <4) and alkaline (pH >7) GER can be detected. Gastroesophageal reflux with an esophageal pH in the physiological range (pH 5‐6.8) may represent many cases of clinically relevant GER unrecognized by pH metry. In this study the intraluminal multiple electrical impedance (IMP) procedure for complete registration of GER was compared with pH metry for its diagnostic value in the presence of respiratory symptoms.Methods:Twenty‐two infants with recurrent regurgitation or pulmonary problems were investigated simultaneously with IMP, pH metry, and polygraphy during two feeding periods. Heart rate, oxygen saturation, sleep states, and oronasal flow were recorded, among other parameters.Results:Three hundred sixty‐four occurrences of GER were detected by IMP; only 11.4% had a pH less than 4 and were therefore recognized by pH metry. Three hundred twelve (84.8%) occurrences were associated with breathing abnormalities, and 11.9% of these were detected by pH metry. Nineteen instances were accompanied by a decrease of oxygen saturation of more than 10% of the initial value. Only three (15.8%) of these had a pH less than 4. The remaining 16 reflux episodes were recognized by IMP only. After software‐aided preselection, 165 instances of apnea were visually validated, 49 of which were accompanied by GER. Thirty‐eight (77.6%) of these were exclusively recorded by IMP.Conclusions:The use of pH metry alone cannot detect most GER incidents accompanied by respiratory symptoms and therefore does not appear to be suitable for this approach. The pH‐independent IMP technique promises to be a reliable tool for presumably GER‐associated respiratory symptoms.
Nonspecific Esophageal Motility Disorders in Children Without Gastroesophageal Reflux
Authors: Rosario Jorge A. , Medow Marvin S. , Halata Michael S. , Bostwick Howard E. , Newman Leonard J. , Schwarz Steven M. , Berezin Stuart H. 
Published: February 2024

ABSTRACTBackground:Nonspecific esophageal motility disorders (NEMDs) have been identified in up to 50% of adults with noncardiac chest pain or dysphagia. This study sought to determine the incidence of NEMDs in children with upper gastrointestinal tract symptoms and to evaluate the clinical course of pediatric patients with these manometric abnormalities.Methods:The study involved 154 children aged 4 to 18 years (mean age, 11.6 ± 2.6 years [SE]) who had upper gastrointestinal, swallowing‐related symptoms. The children were evaluated by 24‐hour intraesophageal pH monitoring, esophageal manometry, and esophagogastroduodenoscopy.Results:Gastroesophageal reflux (GER) was diagnosed by pH study in 109 (71%) of 154 patients, and examination of biopsy specimens demonstrated esophagitis in 70 children with GER. Results of esophageal manometry were abnormal in 30 (67%) of 45 children without GER. A variety of motility disorders were diagnosed in 17 of the patients without GER, whereas NEMDs were diagnosed in the remaining 13 children (mean age, 10.6 ± 2.7 years; 10 boys, 3 girls). Patients with GER showed normal esophageal wave propagation; however, mean lower esophageal sphincter pressure was significantly lower in patients with GER than in children with NEMDs. The children with NEMDs exhibited a diverse array of symptoms, including esophageal food impaction in 4 of the 13 patients. During a 36.2 ± 4.3‐month follow‐up period, no correlation was found between therapeutic intervention and clinical course in the 13 patients with NEMDs. Symptomatic improvement occurred in 6 of 13 patients, including 3 children for whom no pharmacologic therapy was prescribed.Conclusions:These data indicate that NEMDs represent a common group of esophageal manometric abnormalities in children with upper gastrointestinal tract symptoms and without GER. Food impaction appears to be a relatively frequent complication, and NEMDs should be considered in children who have this finding.
Propranolol in Prevention of Portal Hypertensive Hemorrhage in Children: A Pilot Study
Authors: Shashidhar Harohalli , Langhans Nancy , Grand Richard J. 
Published: February 2024

ABSTRACTBackground:Data regarding the use of propranolol in the prevention of portal hypertensive hemorrhage in pediatric patients are limited despite its widespread use in adults with cirrhosis. The purpose of this study was to evaluate safety and efficacy of propranolol in the management of portal hypertension in the pediatric population.Methods:Medical information was retrieved from the records of 21 children with portal hypertension who received propranolol either before or after an episode of gastrointestinal bleeding. Data collected included diagnosis, type of portal hypertension, age at initiation of therapy, bleeding episodes before and during propranolol therapy, degree of reduction of heart rate, adherence, and adverse effects.Results:Fourteen of 21 patients did not experience portal hypertensive bleeding while receiving propranolol. Of the seven patients who had bleeding episodes, two had failed to adhere to the medication regimen, and four were receiving doses of less than 1 mg/kg per day. Only one of the four patients who experienced bleeding before initiation of therapy also bled while receiving propranolol, and two of the three patients who had a heart rate reduction of less than 25% each experienced a bleeding episode. Side effects were minimal and did not necessitate discontinuation of therapy in any patient.Conclusions:Propranolol was well tolerated with minimal side effects in our patients with portal hypertension. Adherence and adequacy of dosage (>1 mg/kg per day, more than twice daily dose frequency) are important determinants of efficacy. A reduction in heart rate of less than 25% may be associated with suboptimal efficacy.
Percutaneous Endoscopic Gastrostomy for Continuous Feeding in Children with Chronic Cholestasis
Authors: Duché Mathieu , Habès Dalila , Lababidi Abdullraman , Chardot Christophe , Wenz Joelle , Bernard Olivier 
Published: February 2024

ABSTRACTBackground:Malnutrition associated with chronic cholestasis in children often requires continuous enteral feeding through a nasogastric tube, which may be poorly tolerated.Method:Percutaneous endoscopic gastrostomy was performed in five children (age range, 20 months to 13 years) with severe cholestasis (Alagille syndrome in four; biliary atresia in one) and severe malnutrition (mean weight, ‐2.6 standard deviations; mean height, ‐2.7 standard deviations) who were awaiting liver transplantation. The pull‐through technique was used in patients under general anesthesia, and the button was set within 2 months.Results:Minor wound infection required antibiotic therapy in one patient. In the four children with Alagille syndrome, enteral feeding by means of percutaneous endoscopic gastrostomy was used until liver transplantation for a mean period of 14 months with a mean weight gain of 350 g/mo and a mean height gain of 0.53 cm/mo. Seventeen months to 3 years, 3 months after liver transplantation, all four children were alive and in good clinical condition with normal readings in liver function tests. The technique had to be discontinued in the child with biliary atresia because of secondary occurrence of ascites, gastric intolerance, and refractory wound infection.Conclusion:Percutaneous endoscopic gastrostomy may be a valuable alternative to nasogastric tube for nutritional support in children with cholestasis and mild portal hypertension.