bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stability of Insulin‐Like Growth Factor I in the Gastrointestinal Lumen in Neonatal Pigs
Authors: Shen Wei‐Hua , Xu Ruo‐Jun 
Published: February 2024

ABSTRACTBackground:Insulin‐like growth factor (IGF)‐I is present in the milk of various species. A prerequisite for any biological activity of milk‐borne IGF‐I in the suckling young is to survive the gastrointestinal luminal digestion. In the present study, the stability of IGF‐I was examined in the gastrointestinal lumen in neonatal pigs.Methods:Iodine‐labeled IGF‐I was incubated in the gastrointestinal luminal fluids of 3‐day‐old suckling and 45‐day‐old weaned pigs at 37°C for 20 minutes. Degradation of the peptide was analyzed by trichloroacetic acid (TCA) precipitation, liquid chromatography, and receptor binding assay.Results:IGF‐I remained unchanged in the gastric fluids of suckling and weaned pigs when determined by TCA precipitation. IGF‐I degraded 3%, 18%, and 37% in the luminal fluids of the proximal, mid and distal small intestine in suckling piglets compared with 53%, 62%, and 54% in weaned pigs. The results were supported by the chromatography and receptor binding analysis. Porcine colostrum had a capacity to protect IGF‐I from gastrointestinal luminal digestion in weaned pigs.Conclusion:Milk‐borne IGF‐I is stable in the gastrointestinal lumen in suckling pigs and may play a role in regulating postnatal development in the suckling young.
Assessment of Nutritional Status and Body Composition in Children Using Physical Anthropometry and Bioelectrical Impedance: Influence of Diurnal Variations
Authors: Rodríguez Gerardo , Moreno Luis A. , Sarría Antonio , Fleta Jesús , Bueno Manuel 
Published: February 2024

ABSTRACTBackground:To observe whether there are diurnal variations when assessing children's body composition, using physical anthropometric and bioelectrical impedance (BI) methods.Methods:In 32 children (18 females and 14 males) aged between 7.1 and 14.9 years, weight, height, arm circumference (AC), four skinfolds, and total body impedance (Z) were measured at 8 A.M., 12 noon, 4 P.M., and 8 P.M. on the same day. Body mass index (BMI), skinfolds sum (SS), total body water (TBW), fat‐free mass (FFM), and fat mass (FM) were also calculated at these times.Results:Height at 8 P.M. was 1.156 ± 0.54 cm less than at 8 A.M. (P < 0.001) and BMI increased 0.434 ± 0.29 kg/m2 at 8 P.M. (P < 0.001). Weight, SS and AC underwent no significant changes in the course of the day. Z was 5.83% less at 8 P.M. than at 8 A.M. (P < 0.001), yielding a TBW and FFM increase at 8 P.M. of 0.855 ± 1.061 and 1.173 ± 1.47 kg, respectively (P < 0.001).Conclusions:In children there is a diurnal decrease in height, impedance and FM, and an increase in BMI, TBW, and FFM. These factors must be taken into account when using such methods for assessing nutritional status in childhood.
Risk of Inadequate Bone Mineralization in Diseases Involving Long‐Term Suppression of Dairy Products
Authors: Infante Dámaso , Tormo Ramón 
Published: February 2024

ABSTRACTBackground:Eighty percent of peak bone mass should be achieved from birth through adolescence. An adequate calcium intake is essential, and it is advisable that 60% of the recommended calcium allowance be dairy calcium. This study was conducted to exaine bone mineral content (BMC) in patients with diseases that usually involve long‐term suppression of dairy products.Methods:Thirty patients, aged 2 to 14 years (mean, 7 years), 10 with late‐onset, genetically induced lactose intolerance, 7 with cow's milk protein allergy, 3 with short‐bowel syndrome, and 10 with hypercholesterolemia were involved in the study. They were receiving various dietary regimens for periods longer than 2 years: 14 patients received special formulas for children (lactose‐free cow's milk formula, highly hydrolyzed cow's milk protein formula, soy protein isolate formula), 4 patients received liquid soy beverages, 6 patients received skim milk (1% fat), and 6 patients had exclusion of dairy products. Bone mineral density (BMD) was assessed by dual‐energy x‐ray absorptiometry.Results:Nine patients had osteoporosis, 6 had osteopenia, and 15 had results within normal ranges. Overall, the group had a standard deviation score of −1.3 (osteopenia). The statistical correlation between the BMD value and the percentage intake of recommended daily allowance (RDA) of dairy (or substitute) calcium (in milligrams per day) was highly significant (P < 0.0001, r = 0.89).Conclusions:All patients with diseases involving total or partial withdrawal from milk products for a prolonged period are a group at potential risk of defective bone mineralization and should be monitored through BMD assessment.
Monitoring of 25‐OH Vitamin D Levels in Children With Cystic Fibrosis
Authors: Grey Vijaylaxmi , Lands Larry , Pall Harpreet , Drury Donna 
Published: February 2024

ABSTRACTBackground:Patients with cystic fibrosis are at risk for malabsorption of fat‐soluble vitamins, and those with low 25‐OH vitamin D levels have a higher risk of low bone mineral density and long‐term skeletal complications. It is currently recommended that vitamins A and E be monitored yearly; however, no recommendations exist for 25‐OH vitamin D. Because all three vitamins are fat‐soluble, the hypothesis in the current study was that low levels of vitamins A and E could identify patients at risk for low 25‐OH vitamin D, so that 25‐OH vitamin D measurements could be obtained in only selected circumstances.Methods:Forty (21 girls) patients with CF, age 10.5 ± 3.9 (SD) years, were assessed in a cross‐sectional survey for ideal weight for height (percentage of predicted), spirometry (percentage of predicted FEV1, 33/40 patients), and serum levels of vitamins A, E, 25‐OH vitamin D, and cholesterol (37/40 patients).Results:Nine (22.5%) of 40 patients were malnourished (percentage of predicted ideal weight for height <85%), 7 (21.2%) of 33 had moderate to severe lung disease (FEV1 <60%), 4 (10%) of 40 had low levels of vitamin A, 3 (7.5%) of 40 had low vitamin E levels, 4 (10.8%) of 37 low vitamin E/cholesterol levels, and 4 (10%) of 40 had marginal or low levels of 25‐OH vitamin D (<40 mmol/l). The patients with low 25‐OH vitamin D were older, with no child < 12 years of age having a 25‐OH vitamin D level less than 40 mmol/l. They also had lower vitamin E and vitamin E/cholesterol levels than those with normal 25‐OH vitamin D levels. The groups did not differ in percentage of predicted ideal weight for height, lung function, or vitamin A levels. The best positive predictor for 25‐OH vitamin D less than 40 mmol/l was low vitamin E (66.7%), with a negative predictive value of 94.6%. 25‐OH vitamin D levels correlated with vitamin E/cholesterol levels (r = 0.41, P < 0.01) and weakly with vitamin E levels (r = 0.28, P < 0.08), but not with vitamin A levels.Conclusions:These results suggest that children aged less than 12 years and older children with normal vitamin E levels are especially unlikely to have low 25‐OH vitamin D levels, and this measure can therefore be omitted. In contrast, those children with low vitamin E levels may warrant monitoring.
Liver Disease Does Not Affect Lipolysis as Measured With the 13C‐Mixed Triacylglycerol Breath Test in Children With Cystic Fibrosis
Authors: Ling Simon C. , Amarri Sergio , Slater Christine , Hollman Anne S. , Preston Tom , Weaver Lawrence T. 
Published: February 2024

ABSTRACTBackground:Liver disease associated with cystic fibrosis may not only limit the solubilisation and absorption of the products of fat digestion, but also may depress the activity of pancreatic lipase. The purpose of this study was to measure the effect of liver disease on triacylglycerol lipolysis using the 13C‐mixed triacylglycerol breath test.Methods:Forty children with cystic fibrosis took 13C‐mixed triacylglycerol with a standard breakfast and the child's normal pancreatic enzyme replacement therapy. Breath samples were collected before and every 30 minutes after ingestion for 6 hours. The cumulative percentage dose of 13C recovered at 6 hours was calculated from sequential measurements of 13C enrichment of breath CO2, measured by isotope ratio mass spectrometry. Liver abnormalities and portal hypertension were defined by ultrasound scan and clinical examination.Results:Twenty‐four children had liver abnormalities, including 5 with portal hypertension. No difference was found between cumulative percentage dose of 13C recovered at 6 hours in 16 children with no liver abnormality (mean, 21.4% ± 11.1%), 19 children with liver abnormalities (22.2% ± 10.0%) and 5 children with portal hypertension (20.9% ± 7.1%).Conclusion:Intestinal lipolysis is not reduced in cystic fibrosis liver disease when measured using the 13C mixed triacylglycerol breath test. These findings affirm the test's use as an indirect measure of fat digestion that is not affected by inadequate intraluminal bile salts or liver disease.
Thickening Infant Formula With Digestible and Indigestible Carbohydrate: Availability of Calcium, Iron, and Zinc In Vitro
Authors: Bosscher Douwina , Van Caillie‐Bertrand Micheline , Van Dyck Kristien , Robberecht Harry , Van Cauwenbergh Rudy , Deelstra Hendrik 
Published: February 2024

ABSTRACTBackground:Regurgitation is common in infants and is usually due to gastroesophageal reflux. Often parental reassurance and dietary management by feeding thickened formulas are the only therapeutic steps necessary. Adding fibers may interfere with the absorption of micronutrients.Methods:A continuous‐flow dialysis in vitro method with a preliminary intraluminal digestive phase, modified to simulate the conditions of infants less than 6 months of age and children from 6 months of age on, was used to study the availability of calcium, iron, and zinc from thickened and nonthickened first‐and second‐age infant formulas. Pooled mature human milk was used as the reference standard. The elemental content of the samples and dialysate fractions of calcium, iron, and zinc after digestion was determined by atomic absorption spectrometry.Results:In human milk, calcium, iron, and zinc were highly available for absorptive processes. Availability of calcium, iron, and zinc from nonthickened first‐and second‐age infant formulas tends to be significantly better than in the corresponding products thickened with locust bean gum. Thickening infant formulas with pregelatinized rice starch, however, does not affect the availability of calcium, iron, and zinc.Conclusions:It appears that human milk provides optimal conditions for the availability of calcium, iron, and zinc. Availability of calcium, iron, and zinc seems to lower when infant formulas are thickened with indigestible carbohydrates, whereas it does not by adding digestible carbohydrates.
Complications of Removing Percutaneous Endoscopic Gastrostomy Tubes in Children
Authors: Kobak Gregory E. , McClenathan Daniel T. , Schurman Scott J. 
Published: February 2024

ABSTRACTBackground:Little information has been reported regarding the frequency and type of complications arising from removal of percutaneous endoscopic gastrostomy (PEG) tubes in children.Methods:The records of 397 patients who had PEG tubes placed from 1993 through 1998 were reviewed for complications after removal. Data collected included length of time the tube was in place, age of the patient at insertion, type of tube removed, and patient diagnosis.Results:Fifty‐four children had the PEG tube removed by traction or endoscopy. The only complication was persistent leaking through a gastrocutaneous fistula in 13 patients (24%). Leaking ceased in 6 children coincident with H2‐antagonist therapy and silver nitrate cautery, and surgical closure of the fistula was required in 7 patients. Comparison of these 7 children with those who did not require surgery (n = 47) showed a longer duration of tube placement (mean ± SE of 20.6 ± 3.6 months, range 11–31 months vs. 11.1 ± 1.3 months, range 1–35 months;P < 0.05). Further analysis showed no child with a PEG tube removed before 11 months (n = 23) after insertion required surgery, whereas 7 (23%) of 31 children with a PEG tube removed after 11 or more months required surgery. Age at insertion, type of feeding device removed, and patient diagnoses were not different between the two groups.Conclusions:These data indicate that persistent leaking necessitating surgical closure of a gastrocutaneous fistula does not occur in children with a PEG tube removed within 11 months of insertion. In contrast, 23% of children with a PEG tube removed 11 or more months after insertion require surgery. In patients identified as candidates for tube removal, this time frame may be important in clinical decision making.
Dyspepsia in Children and Adolescents: A Prospective Study
Authors: Hyams Jeffrey S. , Davis Patricia , Sylvester Francisco A. , Zeiter Donna K. , Justinich Christopher J. , Lerer Trudy 
Published: February 2024

ABSTRACTBackground:Dyspepsia is poorly characterized in the pediatric population. The goal of the current study was to describe the clinical constellation and natural history of dyspepsia in children and adolescents seen in a pediatric gastroenterology practice.Methods:A standardized questionnaire was administered by a pediatric gastroenterologist to all subjects 5 or more years of age (and their parents or guardians) treated in a referral pediatric gastroenterology practice for 1 month or more of abdominal pain or discomfort, nausea, or vomiting. Subjects with dyspepsia and dyspepsia subtypes (ulcer‐like, dysmotility‐like) were identified by using previously defined adult criteria. Evaluation and treatment were performed at the discretion of the attending pediatric gastroenterologist.Results:During a 1‐year period, 257 patients were screened with 127 subjects fulfilling criteria for dyspepsia (59% girls, 85% white; median age, 11.7 years; median duration of symptoms, 8 months). Symptoms were ulcer‐like in 26% and dysmotility‐like (nausea predominance) in 15% of subjects. In those with dyspepsia, irritable bowel syndrome and gastroesophageal reflux were noted in 24% and 43%, respectively. Esophagogastroduodenoscopy and biopsy were performed in 56 subjects with 21 (38%) having mucosal inflammation (Helicobacter pylori in 5). The remaining 35 subjects (62%) were considered to have functional dyspepsia. Duration of symptoms less than 1 year and vomiting were risk factors for mucosal inflammation. Follow‐up at 6 months to 2 years revealed 70% of subjects were either asymptomatic or much improved regardless of the cause of dyspepsia.Conclusion:Most children and adolescents with dyspepsia do not have serious disease. In our referral population H. pylori infection was unusual, and no peptic ulceration was found. Most subjects with functional dyspepsia have improvement of symptoms over time.
Portosystemic Shunting in Children During the Era of Endoscopic Therapy: Improved Postoperative Growth Parameters
Authors: Kato Tomoaki , Romero Rene , Koutouby Raghad , Mittal Naveen K. , Thompson John F. , Schleien Charles L. , Tzakis Andreas G. 
Published: February 2024

ABSTRACTBackground:Surgical portosystemic shunting has been performed less frequently in recent years. In this retrospective study, recent outcomes of portosystemic shunting in children are described, to evaluate its role in the era of endoscopic therapy.Methods:Retrospective chart review of children who underwent surgical portosystemic shunt procedures between October 1994 and October 1997.Results:Twelve children (age range, 1–16 years) underwent shunting procedures. The causes of portal hypertension were extrahepatic portal vein thrombosis (n = 6), congenital hepatic fibrosis (n = 2), hepatic cirrhosis (n = 2), and other (n = 2). None of the patients were immediate candidates for liver transplantation. Types of shunt included: distal splenorenal (n = 10), portocaval (n = 1), and other (n = 1). Median follow‐up was 35 months (range, 24–48 months). All patients are currently alive and well with patent shunts. The mean hospital stay was 8 days. Three patients required readmission for further interventions because of shunt stenosis in two and small bowel obstruction in the other. Mild portosystemic encephalopathy was seen in one child with pre‐existing neurobehavioral disturbance. Excluding a patient who underwent placement of a portosystemic shunt for a complication of liver transplantation, mean weight‐for‐age z score in nine prepubertal patients improved from −1.16 SD to +0.15 SD (P = 0.023), and mean height‐for‐age z score from −1.23 SD to 0.00 SD (P = 0.048) by 2 years after surgery.Conclusions:Surgical portosystemic shunting is a safe and effective method for the management of portal hypertension in childhood. Patients show significant improvements in growth parameters after the procedure. Surgical portosystemic shunting should be actively considered in selected children with portal hypertension.
Transmission of Hepatitis C Virus From Infected Mother to Offspring During Subsequent Pregnancies
Authors: Resti Massimo , Bortolotti Flavia , Azzari Chiara , Giacchino Raffaella , Zancan Lucia , Gussetti Nadia , Vierucci Alberto 
Published: February 2024

ABSTRACTBackgroundSeveral studies have demonstrated that hepatitis C virus (HCV) may be transmitted from mother to offspring. To date, however, little is known about the risk of vertical transmission during subsequent pregnancies. The purpose of this study was to evaluate the risk of vertical HCV transmission in offspring in subsequent pregnancies of HCV infected women.MethodsIn a multicenter study, two groups of index cases were selected. Group 1 included 75 children investigated for HCV infection during prospective studies of vertical transmission. Group 2 included children born to HCV‐infected mothers and found to be HCV infected, independent of studies on vertical transmission. All children in the index cases had one or more siblings. Anti‐HCV, HCV‐RNA (determined by polymerase chain reaction), and HCV genotype were evaluated in all the infected children, their mothers, and siblings.ResultsThe results indicate that a mother who has already delivered an HCV‐infected baby is not at greater risk of infecting her second child. Duration of maternal infection does not seem to be a risk factor in offspring infection, because HCV infection is equally distributed among first‐born infants and infants of subsequent births. Because clustering of HCV infection among siblings appeared to be rare in this study, data also indirectly confirm that the risk of horizontal transmission of HCV among siblings is low.ConclusionFor practical purposes, the current observations indicate that mothers who have already delivered an HCV‐infected child can be advised that this event does not increase the probability of infecting the second child.
Contribution of Villous Atrophy to Reduced Intestinal Maltase in Infants With Malnutrition
Authors: Nichols Buford L. , Nichols Veda N. , Putman Margaret , Avery Stephen E. , Fraley J. Kennard , Quaroni Andrea , Shiner Margot , Sterchi Erwin E. , Carrazza Francisco R. 
Published: February 2024

ABSTRACTBackgroundIt has been known for many years that small intestinal maltase activities are reduced in malnourished infants and in other patients with villous atrophy. The recent availability of human maltase‐glucoamylase cDNA provides the opportunity to test the hypothesis that villous atrophy accounts for the reduced maltase enzyme activity in malnourished infants.MethodsMucosal biopsy specimens obtained for clinical evaluation of malnourished infants with poor responses to refeeding were examined by quantitative methods for enzyme activity and mRNA levels.ResultsMaltase activity and maltase‐glucoamylase mRNA were reduced (approximately 45% of normal). When maltase‐glucoamylase message was normalized to villin message, a structural protein expressed only in enterocytes, a preservation of maltase messages in surviving enterocytes was documented. The luminal glucose transporter–villin message was also preserved.ConclusionsThe loss of maltase‐glucoamylase message paralleled the reduction in villin message and degree of villous atrophy. The reduced maltase‐glucoamylase message also paralleled sucrase‐isomaltase message, previously found to be decreased in proportion to villous atrophy of malnourished infants. The data directly demonstrate, for the first time, that the terminal steps of starch 1‐4 starch digestion and sucrase‐isomaltase 1‐6 starch digestion are decreased in malnourished infants, secondary to villous atrophy. These data in prior and present reports suggest that mechanisms underlying the chronic villous atrophy of malnutrition should be a priority for investigations in malnourished infants with slower than expected weight gain during refeeding.
Evaluation of the Use of Botulinum Toxin in Children With Achalasia
Authors: Hurwitz Melissa , Bahar Ron J. , Ament Marvin E. , Tolia Vasundhara , Molleston Jean , Reinstein L. Julio , Walton J. Mark , Erhart Nora , Wasserman Dror , Justinich Christopher , Vargas Jorge 
Published: February 2024

ABSTRACTBackgroundAchalasia is rare in children. Recently, injection of botulinum toxin into the lower esophageal sphincter has been studied as an alternative to esophageal pneumatic dilatation or surgical myotomy as treatment for achalasia. In the current study, the effects of botulinum toxin were investigated in the largest known series of children with achalasia.MethodsTreatment for achalasia was assessed in 23 pediatric patients who received botulinum toxin from June 1995 through November 1998. Those who continued to receive botulinum toxin and did not subsequently undergo pneumatic dilatation or surgery were considered repeat responders. Results were compared with those of published studies evaluating the use of botulinum toxin in adults with achalasia.ResultsNineteen patients initially responded to botulinum toxin. Mean duration of effect was 4.2 months ± 4.0 (SD). At the end of the study period, three were repeat responders, three experienced dysphagia but did not receive pneumatic dilatation or surgery, three underwent pneumatic dilatation, eight underwent surgery, three underwent pneumatic dilatation with subsequent surgery, and three awaited surgery. Meta‐analysis shows that, in the current study group, the data point expressing time of follow‐up evaluation versus percentage of patients needing one injection session without additional procedures (botulinum toxin injection, pneumatic dilatation, or surgery) falls within the curve for those in studies on adult patients receiving botulinum toxin for achalasia.ConclusionsBotulinum toxin effectively initiates the resolution of symptoms associated with achalasia in children. However, one half of patients are expected to need an additional procedure approximately 7 months after one injection session. The authors recommend that botulinum toxin be used only for children with achalasia who are poor candidates for either pneumatic dilatation or surgery.