bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Prevalence of Antibody to CagA in Children Is Not a Marker for Specific Disease
Authors: Mitchell Hazel M. , Hazell Stuart L. , Bohane Timothy D. , Hu Pinjin , Chen Minhu , Yuan Li Yu 
Published: February 2024

ABSTRACTBackground:In adults, a high prevalence of antibody to the cytotoxin‐associated antigen (CagA) of Helicobacter pylori has been linked to the development of more serious gastroduodenal disease. Few investigators have examined this association in children. The purpose of this study was to investigate the seroprevalence of antibody to the CagA antigen as well as other specific H. pylori antigens in children.Methods:By use of an immunoblot analysis kit, the immune response to specific H. pylori antigens in serum collected from 21 H. pylori‐positive symptomatic Australian children, 5 with peptic ulcer disease and 16 with nonulcer dyspepsia, and 33 H. pylori‐positive asymptomatic Chinese children. Sera from 20 H. pylori‐negative symptomatic Australian children were used as control subjects.Results:Antibody responses to the 26.5‐kDa, 30‐kDa, and 116‐kDa (CagA) antigens were found to be the most prevalent, with 81.5%, 79.6%, and 76% of children, respectively, mounting a response. In contrast, antibody responses to the 19.5‐kDa, 35‐kDa, 45‐kDa, 60‐kDa, 89 kDa (VacA), and 180‐kDa antigens occurred in 55.5%, 24%, 16.7%, 63%, 37%, and 7.4% of children, respectively. A higher prevalence of antibody response to CagA was found in the symptomatic Australian children with peptic ulcer disease (100%) compared with prevalence in those with nonulcer dyspepsia (56.3%), but the difference did not reach statistical significance. No significant difference was found between the prevalence of antibody to CagA in the Australian peptic ulcer disease group (100%) and that in the asymptomatic Chinese children (81.8%).Conclusion:These results suggest that in children CagA is not a marker of specific disease development.
Long‐term Follow‐up of Duodenal Ulcer in Children Before and After Eradication of Helicobacter pylori
Authors: Huang Fu‐Chen , Chang Mei‐Hwei , Hsu Hong‐Yuan , Lee Ping‐Ing , Shun Chia‐Tung 
Published: February 2024

ABSTRACTBackground:Helicobacter pylori is a well‐known cause of chronic antral gastritis and plays an important role in the pathogenesis of peptic ulcer disease in adults. However, because the relatively low incidence of duodenal ulcer in childhood, few studies have been directed specifically at the relation between the treatment of H. pylori infection and duodenal ulcer in children. An evaluation in a larger patient population is necessary to draw a conclusion.Methods:Twenty‐six children with duodenal ulcer and H. pylori antral gastritis received triple therapy (amoxicillin, bismuth, and metronidazole) to investigate whether eradication of the organisms can promote healing and prevent relapse of the ulcers in children. Endoscopic examinations were performed before, 2 months, and 12 months after the beginning of treatment.Results:H. pylori infection was eradicated in 25 (96%) of the 26 patients who underwent upper endoscopic follow‐up. Clinical improvement and ulcer healing were achieved in 24 (92%) of 26 children. During a mean follow‐up of nearly 2 years, the annual ulcer relapse rate was estimated to be 9%.Conclusions:Triple therapy is the treatment of choice for endoscopically proven duodenal ulcer and histologically proven H. pylori antral gastritis in children. It strongly supports a causal relation between H. pylori and duodenal ulcer disease in children.
Effect of Milk on Somatostatin Degradation in Suckling Rat Jejunum In Vivo
Authors: Rao Radhakrishna K. , Davis Thomas P. , Williams Catherine , Koldovsky Otakar 
Published: February 2024

ABSTRACTBackground:Somatostatin‐14 is present in breast milk, and intact somatostatin‐14 has been recovered from gastric lumen of infants. Studies have shown that somatostatin‐14 is metabolized in the intestinal luminal contents in vitro, which could be prevented by the presence of breast milk. In this study, the effect of milk on stability of somatostatin‐14 in suckling rat jejunum in vivo was examined.Methods:125I‐Somatostatin‐14[Tyr 11] was administered to the isolated jejunal loops in anesthetized suckling rats in the absence or presence of milk, fractions of milk, or known protease‐peptidase inhibitors. Structural integrity of 125I‐somatostatin‐14[Tyr 11] recovered from tissues at different intervals was analyzed by gel filtration and high‐performance liquid chromatography.Results:Radioactivity rapidly disappeared from the jejunal lumen with a 50% clearance achieved by 1.2 minutes. Gel filtration and high‐performance liquid chromatography analyses showed that 125I‐somatostatin‐14[Tyr 11] was rapidly degraded into smaller fragments. At 1 minute, jejunal luminal radioactivity was eluted in a major peak with retention time of 42.4 minutes, along with other minor peaks (retention time, 5.6, 8.0, 10.4, and 14.4 minutes); only a trace amount of intact 125I‐somatostatin‐14[Tyr 11] (retention time, 44.8 minutes) was present. Coadministration of rat's milk or its soluble fraction increased the level of intact 125I‐somatostatin‐14[Tyr 11] in the jejunal lumen and jejunal tissue. Presence of rat's milk‐casein or peptidase inhibitors (bestatin, phosphoramidon, or Bowman‐Birk inhibitor), however, failed to increase the level of intact 125I‐somatostatin‐15[Tyr 11].Conclusion:These results suggest that somatostatin‐14 is rapidly degraded in the jejunal lumen of suckling rats, and that milk‐borne peptidase inhibitors prevent this somatostatin‐14 degradation.
Evaluation of Enzyme‐Linked Immunosorbent Assay for the Diagnosis of Helicobacter pylori Infection in Children From Different Age Groups With and Without Duodenal Ulcer
Authors: de Oliveira Andreia Maria Rocha , Rocha Gifone Aguiar , Queiroz Dulciene Maria de Magalhães , Mendes Edilberto Nogueira , de Carvalho Anfrisina Sales Teles , Ferrari Teresa Cristina Abreu , Nogueira Ana Margarida Miguel Ferreira 
Published: February 2024

ABSTRACTBackground:Although enzyme‐linked immunosorbent assay (ELISA) is highly sensitive and specific for the diagnosis of Helicobacter pylori infection in adults, their performance in children is still controversial.Methods:A second‐generation ELISA was used to evaluate the IgG response to H. pylori in the serum of 130 consecutive children who underwent upper gastrointestinal endoscopy. The presence of H. pylori was determined in antral biopsy specimens by culture, urease test, and histologic analysis.Results:Sixty‐eight children (all of the 20 who had duodenal ulcer) were H. pylori positive by microbiologic test. Immunoglobulin G antibodies to H. pylori were detected in 79.4% of the infected children and in 8.1% of the noninfected ones. The sensitivity of the test was higher in patients with duodenal ulcer (100%) than in those without (70.8%). When used in children of different ages the test also presented differences in sensitivity: 44.4% in children 2 to 6 years old; 76.7% in children 7 to 11 years old, and 93.1% in children 12 to 16 years old (p = 0.006). The serum immunoglobulin G concentration was significantly higher (p = 0.0003) in children with duodenal ulcer than in those without and was higher in older children than in younger ones without duodenal ulcer (p = 0.05).Conclusions:The accuracy of the test in children with duodenal ulcer and in children more than 12 years old was good; however, in children up to 12 years of age without duodenal ulcer, the sensitivity of the test was too low to be used for screening purposes or to rule out the presence of infection.
Normal Ranges of 24‐Hour pH‐metry Established in Corrected Esophageal Atresia
Authors: Bergmeijer Jan‐Hein L. J. , Bouquet Jan , Hazebroek Frans W. J. 
Published: February 2024

ABSTRACTBackground:This study was undertaken to determine baseline values of 24‐hour pH‐metry in children who had undergone correction for esophageal atresia.Methods:A 24‐hour pH‐metry without medication was conducted in 13 patients with an uncomplicated postoperative course after correction of esophageal atresia. The pH‐metry was performed in the hospital with a flexible glass electrode.Results:The mean reflux index was 4.08%, the mean total number of reflux periods with a pH less than 4 was 21, and the mean number of periods of pH less than 4 lasting longer than 5 minutes was 2.5.Conclusions:Twenty‐four‐hour pH‐metry values in asymptomatic esophageal atresia patients are the same as in children from the same age group with normal anatomy.
Diet and Chronic Constipation in Children: The Role of Fiber
Authors: Roma Eleftheria , Adamidis Dimitris , Nikolara Rodopi , Constantopoulos Andreous , Messaritakis John 
Published: February 2024

ABSTRACTBackground:Chronic constipation is one of the most common disorders in Western countries and despite numerous clinical, pathophysiologic, and epidemiologic studies its cause is still unclear. Several hypotheses have been proposed and according to experimental studies and clinical observation, fiber intake could play a role in its pathogenesis. The purpose of this case‐control study was to examine the possible correlation of idiopathic chronic constipation in children and dietary intake, particularly fiber intake.Methods:A randomized sample of children (291 children with constipation and 1602 controls) aged 2 to 14 years was taken from three of the 52 counties of Greece. Stratification was performed on the basis of urban, rural, or suburban location and socioeconomic status. The nutritional data were obtained from a 3‐day dietary record and a dietary history. Statistical analysis was performed with multivariate tests, multivariate analysis of variance, discriminant analysis, and chi‐square analysis according to the characteristics of the correlated variables.Results:Constipated children had a lower caloric and nutrient intake (p < 0.001), lower body weight/height (p < 0.001), and higher prevalence of reported anorexia (p < 0.001). Discriminant analysis indicated that dietary fiber alone was independently negatively correlated with chronic constipation, despite the age and the age of onset of constipation. Relative risk also had a negative correlation with fiber intake (p < 0.001). Of the main fiber fractions only cellulose and pentose were independently correlated with chronic constipation.Conclusions:Lack of fiber may play an important role in the etiology of chronic idiopathic constipation in children.
Symptomatic Colonic Polyps in Childhood: Not So Benign
Authors: Hoffenberg Edward J. , Sauaia Angela , Maltzman Terese , Knoll Kirsten , Ahnen Dennis J. 
Published: February 2024

ABSTRACTBackground:The clinical spectrum of symptomatic polyps and the frequency of familial polyposis is not well defined in children. In the present study, a series of children with juvenile polyposis coli (JPC) and non‐JPC polyps were studied.Methods:Children with symptomatic colonic polyps and negative family history of polyps were ascertained by review of endoscopic records. Juvenile polyposis coli was defined as 10 or more juvenile polyps or any juvenile polyp in a relative of an index case of JPC. Polyps were tested for Ki‐ras mutations, p53 overexpression, and aneuploidy.Results:Seventy‐eight children (age range, 0.4‐18 years) were identified, all evaluated for lower gastrointestinal bleeding. Nine (12%) had JPC, 66 (84%) had isolated juvenile polyps, and 3 (4%) had other types of polyps. The JPC and non‐JPC groups were similar in age (p = 0.4) and symptom duration (p = 0.3). The JPC group had more polyps (p = 0.0001), and greater likelihood of anemia (p = 0.01), polyps with adenomatous change (p = 0.03), and right‐colon polyps (p = 0.001). In three of eight JPC families, polyps were identified in asymptomatic first‐degree relatives. No abnormalities in Ki‐ras, p53, or aneuploidy were identified.Conclusions:Juvenile polyposis coli is common in children with symptomatic polyps, and is associated with anemia, right‐colon polyps, and adenomas. The risk of polyps and of colorectal cancer in relatives of persons with JPC requires further study.
Findings on Routine Abdominal Ultrasonography in Cystic Fibrosis Patients
Authors: Wilschanski Michael , Fisher Drora , Hadas‐Halperin Irit , Picard Elie , Faber Joseph , Goldberg Shmuel , Branski David , Kerem Eitan 
Published: February 2024

ABSTRACTBackground:Right lower quadrant abdominal pain may pose a diagnostic problem in patients with cystic fibrosis. Abdominal ultrasound examination, used commonly in the diagnostic work‐up, may reveal abnormalities of the appendix. However, interpretation of such findings is problematic, because the appearance of the gastrointestinal system during routine examination has not been documented in patients with cystic fibrosis. The purpose of this study was to investigate the findings during routine abdominal ultrasound scans in our cohort of patients with cystic fibrosis and in control subjects.Methods:Abdominal ultrasound scans were performed prospectively during routine clinic visits in a cohort of patients with cystic fibrosis.Results:Fifty patients aged 10 ± 6 years, (range, 0.5‐28 years) were examined; 45 had pancreatic insufficiency. Four patients (3 with pancreatic insufficiency) reported right lower quadrant pain at the time of the scan. According to standard ultrasound criteria, the appearance of the appendix was abnormal in 8 patients (16%), 6 had a mucoid appendix, and 2 had a pathologically thickened appendiceal wall. Only 1 of these 8 patients mentioned abdominal pain at the time of the study. Other incidental findings included gallstones (3 patients), intussusception (2 patients), and pancreatic cyst (1 patient).Conclusions:Abnormalities can be observed during routine abdominal ultrasonographic studies in cystic fibrosis. These findings may not be associated with abdominal pain; their clinical relevance needs further investigation.
Intestinal Barrier Function and Cow's Milk Sensitization in Guinea Pigs Fed Milk or Fermented Milk
Authors: Terpend Kathleen , Blaton Marie‐Agnès , Candalh Céline , Wal Jean‐Michel , Pochart Philippe , Heyman Martine 
Published: February 2024

ABSTRACTBackground:The respective effect of milk and fermented milks on intestinal barrier capacity and on sensitization to β‐lactoglobulin was studied using a guinea pig model of cow's milk allergy.Methods:Guinea pigs were fed a control diet or the same diet supplemented with milk, fermented milk (Streptococcus thermophilus and Bifidobacterium breve), or dehydrated fermented milk. Intestinal barrier capacity to macromolecules was assessed in an Ussing chamber, and sensitization to cow's milk protein was measured by systemic anti‐β‐lactoglobulin immunoglobulin G1 titers and by intestinal anaphylaxis, the latter assessed by the β‐lactoglobulin‐induced increase in short‐circuit current of jejunal fragments (ΔIscβ‐LG).Results:The electrical resistance of jejunum was similar in the four groups (∼80 Ω/cm2) suggesting the same paracellular permeability. The transport of 14C‐β‐lactoglobulin from mucosa to serosa was significantly decreased in the animals fed dehydrated fermented milk (403 ± 131 ng/hr·cm2) compared with that in control animals or animals fed milk (767 ± 250 ng/hr·cm2 and 749 ± 475 ng/hr·cm2, respectively; p < 0.05). Milk fermentation did not modify native β‐lactoglobulin concentration but anti‐β‐lactoglobulin immunoglobulin G1 titers were higher in fermented milk and dehydrated fermented milk (log10 titer = 2.86 and 2.79, respectively) than in guinea pigs fed milk (log10 titer = 2.5; p < 0.007). However, β‐lactoglobulin‐induced intestinal anaphylaxis remained the same in the three groups (ΔIscβ‐LG, 9.6 ± 4.1 µA/cm2, 8.5 ± 4.3 µA/cm2, and 8.5 ± 3.4 µA/cm2 in milk‐fed, fermented milk‐fed, and dehydrated fermented milk‐fed guinea pigs, respectively).Conclusions:The intestinal barrier capacity to milk proteins seems to be reinforced by dehydrated fermented milk, but milk and fermented milks are equally efficient in inducing cow's milk allergy in guinea pigs.
Disaccharidase Activities in Children: Normal Values and Comparison Based on Symptoms and Histologic Changes
Authors: Gupta Sandeep K. , Chong Sonny K. F. , Fitzgerald Joseph F. 
Published: February 2024

ABSTRACTBackground:The relationship between symptoms, intestinal mucosal histology, and disaccharidase activities is not well defined. An analysis of disaccharidase activities was performed in children grouped by age, symptoms, and intestinal mucosal histology and normal values established.Methods:Disaccharidase activities and histology of 246 endoscopically obtained duodenal biopsies in 232 patients (121 girls; age range, 0.08‐17 years; mean, 5.9 years) in a 3‐year period were reviewed. Patients were divided into two groups based on absence (group 1; n = 142) or presence (group 2; n = 90) of diarrhea and were subdivided by age into, less than 24 months of age and 24 months of age or more. Histologic changes within groups were classified as (A) normal, (B) mild, or (C) moderate to severe based on villus height abnormalities. A questionnaire was sent to 34 patients with hypolactasia to assess the efficacy of lactose avoidance and/or lactase supplementation.Results:All group 1 patients had normal findings in analysis of mucosal specimens, and their disaccharidase activities showed normal values because they had no diarrhea. The geometric means (95% confidence interval) in children aged less than 24 months are (in micromoles of substrate hydrolyzed per minute at 37°C per gram protein) (units [U]) lactase, 36.7 (13.4‐100.4); maltase, 178.5 (88.9‐356.3); palatinase, 12.7 (3.8‐41.5); and sucrase 60.0 (24.0‐148.1). In children 24 months of age or more, the values are 23.2 (3.9‐108.1), 167.6 (78.8‐355.9), 12.7 (4.9‐32.9), and 51.0 (20.5‐126.0), respectively. Only lactase activity decreased with age (p < 0.05). No differences in disaccharidase activities were noted in patients with and without diarrhea if the mucosal histology was normal (group 1A vs. 2A). In patients with diarrhea, values were commensurate with the degree of mucosal injury, especially in the older group. Twenty‐two of 27 patients (81%) who responded to the questionnaire had benefited from lactase supplementation and/or lactose avoidance.Conclusions:We have established normal values for disaccharidase activities in the pediatric population. Although the disaccharidase activities correlate more with degree of intestinal mucosal injury than with symptoms, their activities are difficult to predict accurately based on these criteria. If required, disaccharidase activities should be measured biochemically.
Helicobacter pylori and Type 1 Diabetes Mellitus in Children
Authors: Salardi Silvana , Cacciari Emanuele , Menegatti Marcello , Landi Fabiana , Mazzanti Laura , Stella Felicia A. , Pirazzoli Piero , Vaira Dino 
Published: February 2024

ABSTRACTBackground:Helicobacter pylori is a recognized gastroduodenal pathogen and H. pylori infection is one of the most common bacterial infections, usually acquired during childhood. However, diabetes mellitus is characterized by an increased susceptibility to infections.Methods:We compared the prevalence of H. pylori infection as well as cytotoxin‐associated gene A‐CagA‐and vacuolating cytotoxin gene A‐VacA‐positivity in 103 children and adolescents with type 1 diabetes mellitus and in 236 nondiabetic children. We used a novel Recombinant ImmunoBlot Assay‐Strip (RIBA SIA) with individual band for whole H. pylori lysate and recombinant CagA and VacA.Results:H. pylori‐positive subjects, both diabetics and controls, were significantly older than negative subjects. In the whole group of diabetic patients the prevalence of each of the three reactivities was higher than in control subjects, reaching significance only for lysate. Only diabetic patients over 12 years of age, with a longer disease duration, had a higher prevalence of positive cases, although not significantly so.Conclusion:In the first few years of disease, diabetic children do not differ from the nondiabetic population. Subsequently they show an H. pylori seroprevalence tendentially higher than that of control of the same age. Therefore, H. pylori infection acquired in childhood and lasting several years, could be one of the causes of chronic atrophic gastritis, which is more frequent in longstanding diabetes mellitus.
Increased Expression of Transforming Growth Factor‐β1 and Thrombospondin‐1 in Congenital Hepatic Fibrosis: Possible Role of the Hepatic Stellate Cell
Authors: El‐Youssef Mounif , Mu Yan , Huang Lijun , Stellmach Veronica , Crawford Susan E. 
Published: February 2024

ABSTRACTBackground:Congenital hepatic fibrosis is a rare disease characterized by portal tract fibrosis and biliary duct ectasia. It is associated with autosomal recessive polycystic kidney disease and rarely progresses to cirrhosis. The activated stellate cell has been implicated in the pathogenesis of alcohol‐ or inflammation‐mediated cirrhosis through fibrogenic proteins such as transforming growth factor‐β1; however, the role of the stellate cell in pure, noninflammatory fibrosis is unknown. It has been hypothesized that fibrosis in congenital hepatic fibrosis may be caused by upregulation of transforming growth factor‐β1 and thrombospondin‐1, and that the hepatic stellate cell may be the mediator of these proteins.Methods:Human liver tissue samples from patients with congenital hepatic fibrosis (n = 9) and from normal patients (n = 3) were analyzed. Tissue homogenates from both groups were analyzed for transforming growth factor‐β1 protein and mRNA by Western blot analysis and in situ hybridization, respectively. Immunolocalization studies were performed in fixed tissue sections from both groups. Stellate cells were cultured from livers exhibiting congenital hepatic fibrosis and confirmed by desmin staining. The cells were cultured in serum‐free medium for 48 hours, and media were collected and analyzed by Western blot analysis for thrombospondin‐1 and transforming growth factor‐β1.Results:Congenital hepatic fibrosis liver tissue homogenates had higher levels of thrombospondin‐1 and transforming growth factor‐β1 protein than in normal livers. In congenital hepatic fibrosis tissue, transforming growth factor‐β1 was more highly expressed in the ectatic biliary epithelium and the perisinusoidal space, whereas thrombospondin‐1 localized most intensely to the hepatocytes and spared the bile ducts. Congenital hepatic fibrosis‐derived stellate cells secreted both thrombospondin‐1 and transforming growth factor‐β1 in vitro.Conclusions:Transforming growth factor‐β1 and thrombospondin‐1 may play a role in the pathogenesis of liver fibrosis in patients with congenital hepatic fibrosis. One potential source of these fibrogenic proteins is the hepatic stellate cell.