bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of a Novel Whole Blood Transglutaminase‐based ELISA With a Whole Blood Rapid Antibody Test and Established Conventional Serological Celiac Disease Assays
Authors: Raivio Tiina , Korponay‐Szabó Ilma R , Paajanen Tuula , Ashorn Merja , Iltanen Sari , Collin Pekka , Laurila Kaija , Nemes Éva , Kovács Judit B , Carrard Géraldine , Saramäki Mika , Mäki Markku , Kaukinen Katri 
Published: October 2008

ABSTRACTObjectives:Serum immunoglobulin A–class tissue transglutaminase (tTG‐ab) and endomysial antibody (EMA) tests play a key role in the diagnostic evaluation of celiac disease. Recently, a novel whole blood rapid test based on self‐tissue transglutaminase (tTG) was developed for celiac disease case finding. Based on the same principle, a whole blood self‐tTG enzyme‐linked immunosorbent assay (ELISA), especially applicable to large‐scale screening of celiac disease, has been produced. We assessed the value of this new test in celiac disease antibody detection.Patients and Methods:The new test uses endogenous tTG found in red blood cells of whole blood in IgA‐class tTG‐ab measurement by detecting tTG–tTG‐ab complexes formed after hemolysis of the whole blood sample. Stored whole blood samples from 150 untreated celiac disease patients and 107 control individuals without celiac disease were evaluated, and the test results were compared with those of the whole blood rapid test, 2 conventional serum‐based tTG‐ab ELISA tests, and 2 EMA tests.Results:A total of 15 whole blood samples were found to be clotted or dried after storage and were excluded from further evaluation. The whole blood ELISA test had a specificity (98%) comparable to that of the conventional serological tests, the sensitivity (91%) being slightly lower. The test was concordant with the whole blood rapid test in 92% of cases, with 2 serological ELISA tests in 91% and 94% of cases and with EMA tests in 94% and 93% of cases.Conclusions:Whole blood self‐tTG–based testing is accurate in celiac antibody detection, also when an ELISA method is applied. The testing requires no serum separation or external tTG.
Long‐Term Outcome in Patients With Short Bowel Syndrome After Longitudinal Intestinal Lengthening and Tailoring
Authors: Reinshagen K , Kabs C , Wirth H , Hable N , Brade J , Zahn K , Hagl C , Jester I , Waag KL 
Published: October 2008

ABSTRACTObjectives:Longitudinal intestinal lengthening and tailoring (LILT) is a well‐established surgical treatment for short bowel syndrome. It has been shown to enhance peristalsis, decrease bacterial overgrowth, and extend mucosal contact time for nutrients. We present the results of a long‐term follow‐up of patients who underwent LILT and define prognostic parameters for the survival of these patients.Patients and Methods:Between 1987 and 2006, 53 patients underwent LILT in our institution. The main diagnoses were gastroschisis, intestinal volvulus, intestinal atresias, and necrotizing enterocolitis. LILT was performed at a mean age of 24 months (range 4−144 months). The follow‐up time was 79.76 months (range 6−234 months).Results:After LILT, 41 of 53 patients survived, and 36 of 41 surviving patients were successfully weaned from parenteral nutrition (PN). In long‐term follow‐up 79% stayed free of PN. The overall survival rate was 77.36%. Weight gain occurred in 58% of the patients after LILT. The quality of life after LILT is on a high level, with most patients having normal physical strength and participating in normal social life and education. Prognostic factors for survival after LILT in short bowel syndrome are length of small intestine (0.06582 + 0.0131 × bowel cm), length of large bowel (P = 0.039), preoperative liver function, and successful weaning from PN within 18 months postoperatively (P = 0.0032).Conclusions:Patients undergoing LILT in short bowel syndrome have a high survival rate, weight gain, and a high quality of life. Autologous gastrointestinal reconstruction remains therefore the first choice in the treatment of patients with short bowel syndrome.
A Dietary Fiber Mixture versus Lactulose in the Treatment of Childhood Constipation: A Double‐blind Randomized Controlled Trial
Authors: Kokke Freddy TM , Scholtens Petra AMJ , Alles Martine S , Decates Tom S , Fiselier Theo JW , Tolboom Jules JM , Kimpen Jan LL , Benninga Marc A 
Published: October 2008

ABSTRACTBackground:Constipation is a common problem in children. As first‐line treatment, increased dietary fiber is often advocated. To our knowledge, however, no large studies evaluating the effect of dietary fibers in childhood constipation have been published.Patients and Methods:A randomized, double‐blind, prospective controlled study was performed. Patients received either a fiber mixture or lactulose in a yogurt drink. After a baseline period of 1 week, patients were treated for 8 weeks followed by 4 weeks of weaning. Polyethylene glycol 3350 was added if no clinical improvement was observed after 3 weeks. Using a standardized bowel diary, parents recorded defecation frequency during the treatment period. In addition, incontinence frequency, stool consistency, presence of abdominal pain and flatulence, necessity for step‐up medication, and dry weight of feces were recorded, as were adverse effects.Results:A total of 147 children were eligible; 12 children wished not to participate. Of the remaining children, 65 were randomized to treatment with fiber mixture and 70 to treatment with lactulose. In all, 97 children completed the study. No difference was found between the groups after the treatment period concerning defecation frequency (P = 0.481) and fecal incontinence frequency (P = 0.084). However, consistency of stools was softer in the lactulose group (P = 0.01). Abdominal pain and flatulence scores were comparable (P = 0.395 and P = 0.739, respectively). The necessity of step‐up medication during the treatment period was comparable (P = 0.996), as were taste scores (P = 0.657). No serious adverse effects were registered.Conclusions:A fluid fiber mixture and lactulose give comparable results in the treatment of childhood constipation.
Ferrous Gluconate and Ferrous Sulfate Added to a Complementary Food Distributed by the Mexican Nutrition Program Oportunidades Have a Comparable Efficacy to Reduce Iron Deficiency in Toddlers
Authors: Shamah‐Levy Teresa , Villalpando Salvador , Rivera‐Dommarco Juan A , Mundo‐Rosas Verónica , Cuevas‐Nasu Lucia , Jiménez‐Aguilar Alejandra 
Published: October 2008

ABSTRACTObjective:To assess the efficacy of ferrous sulfate (FS) and ferrous gluconate (FG) as fortificants for a complementary baby food (Nutrisano) to improve the iron status and to reduce the prevalence of anemia in toddlers.Patients and Methods:Toddlers 12 to 30 months old were randomly assigned to receive either of 3 versions of Nutrisano fortified with FS or FG or not fortified (CG) for 6 months. In final blood samples, the concentrations of hemoglobin, serum ferritin, and soluble transferrin receptors (sTfR) were determined. The effects of treatment on final hemoglobin, ferritin, and sTfR were assessed by multivariate analysis.Results:No significant changes in hemoglobin were observed within or among treatment groups. The prevalence of high sTfR decreased 7.1 percentage points in FG, increased 13.1 percentage points in FS, and increased 0.7 percentage points in CG (P > 0.05). In an interaction between treatment and total intake of Nutrisano on the concentration of ferritin, sTfR, and total iron body stores, adjusted means of serum ferritin in the medium tertiles of intake of Nutrisano for FS (P = 0.05) and in the higher and medium tertiles for FG were higher (P = 0.001), and adjusted means of sTfR were significantly lower (P < 0.001), than the respective lower tertile of intake.Conclusions:Fortification of Nutrisano with FG has an acceptable level of beneficial effect on markers of iron status. The satisfactory efficacy and other sensory data has led to the political decision to substitute hydrogen‐reduced iron, used formerly as a fortificant, with FG. Studies to assess the effectiveness of the reformulated Nutrisano are in order.
The Constipated Child: Is There a Correlation Between Symptoms and Manometric Findings?
Authors: Feinberg Lisa , Mahajan Lori , Steffen Rita 
Published: October 2008

ABSTRACTPurpose:The aim of our study was to evaluate patients referred for care of chronic constipation. We compared results of the anorectal manometry studies with a patient/guardian questionnaire about the patients' constipation.Patients and Methods:From patients seen for constipation in the department of pediatric gastroenterology, 123 were prospectively enrolled and they completed symptom questionnaires. These patients already were treated with stool softeners, either by the referring primary care physician or by the referring gastroenterologist. Anorectal manometry was performed per standard protocol.Results:Of the 123 patients enrolled in the study, 57.7% were male. Patient age ranged from 0.2 to 17.8 years, and the mean age was 7.5 years. The average duration of constipation was 4.84 years. The average number of stools per week was 3.6. Average time spent in the defecation process was 13.3 minutes. The incidence of hematochezia was 30%. Delayed passage of meconium was reported in 45 of 99 patients (45.5%). Significant correlation was found between frequency of soiling and threshold for rectoanal inhibitory reflex (P = 0.029). The volume of first urge also was positively correlated with frequency of soiling (P = 0.034). There was significant correlation of withholding behavior and the maximum volume tolerated (P = 0.020). The presence of blood in stool was inversely correlated with the maximum volume tolerated (P = 0.004). No correlation was found between severity of complaints and the presence of paradoxical puborectalis contraction. Of the patients, 90.5% had paradoxical puborectalis contraction.Conclusions:Significant correlation was found between frequency of soiling and rectoanal inhibitory reflex, as well as soiling and volume of first urge. There was correlation between withholding behaviors and maximum volume tolerated. The presence of blood inversely correlated with maximum volume tolerated. Anorectal manometry continues to provide additional new information and to assist in managing patients with this common chronic pediatric affliction.
Outcomes After Liver Transplantation in Young Infants
Authors: Sundaram Shikha S , Alonso Estella M , Anand Ravinder ,   Study of Pediatric Liver Transplantation Research Group
Published: October 2008

ABSTRACTBackground:Liver transplantation in infants younger than 90 days is increasingly common. These infants typically arrive for transplantation in fragile medical condition. It is commonly assumed that they may experience high complication rates, difficult postoperative courses, and poor graft and patient survival.Objectives:We sought to understand whether graft and patient survival rates in these young infants were lower than in older children, these patients experienced more complications than older children, and health care resource utilization was higher in this population.Patients and Methods:Data queried from the Study of Pediatric Liver Transplantation (SPLIT) database were limited to infants ages 0 to 90 days who had received their primary liver transplant between February 1996 and May 2004. Patients older than 90 days registered in the SPLIT database were used for comparison.Results:Thirty‐eight patients, ages 0 to 90 days, were included in the analysis. Their severity of illness was reflected by a median calculated Pediatric Endstage Liver Disease score of 34.8 at transplant. A majority (89.5%) of infants received cadaveric liver grafts, of which 47% were reduced organs. The infants experienced prolonged hospitalizations, spending an average of 50.9 ± 7.6 days in the hospital after transplant. Long stays in the intensive care unit (average 22.1 ± 1.5 days) and need for mechanical ventilation (average 16.2 ± 2.7 days) also occurred. Length of hospitalization, intensive care, and mechanical ventilation were significantly higher than in older children (P < 0.0001). The reoperation rate (60.5%) was high and significantly greater than in older children (P = 0.007), with 10 patients (26.3%) needing 3 or more early reoperations. Reoperations occurred for bleeding, wound complications, biliary complications, and sepsis. There was no difference in vascular or biliary tract complications compared with older children. Bacterial infections were also common (52.6%) and were seen with greater frequency than in older children (P < 0.04). This infant cohort had an overall graft survival of 76.1% and overall patient survival of 87.8% at 1 year, with median follow‐up of 12.5 months (range 0.6–84.0 months). Graft and patient survival in infants younger than 90 days was similar to that in older infants and children (P = NS).Conclusions:Young infants experience graft and patient survival similar to that in older cohorts of liver transplant recipients. Posttransplant complication rates, including the reoperation rate, were higher in this younger group, and the duration of hospitalization and intensive support were significantly longer. Future studies to better examine the factors, including age, that may contribute to the need for reoperation in children are warranted. Recognition and further analysis of the cost of care in this age group is also needed.
Gluten‐dependent Small Bowel Mucosal Transglutaminase 2–specific IgA Deposits in Overt and Mild Enteropathy Coeliac Disease
Authors: Koskinen Outi , Collin Pekka , Korponay‐Szabo Ilma , Salmi Teea , Iltanen Sari , Haimila Katri , Partanen Jukka , Mäki Markku , Kaukinen Katri 
Published: October 2008

ABSTRACTObjectives:In coeliac disease, immunoglobulin (Ig)A–class autoantibodies against transglutaminase‐2 are produced in the small intestinal mucosa, where they are deposited extracellularly. It remains unclear whether positive intestinal transglutaminase‐2‐targeted IgA deposits in subjects having normal small bowel mucosal morphology are signs of early‐stage coeliac disease. We evaluated the gluten dependency of these deposits in overt and mild enteropathy coeliac disease.Patients and Methods:All together 48 subjects suspected of coeliac disease but having normal small bowel mucosal villi were enrolled; 28 of them had latent coeliac disease. The remaining 20 having positive intestinal IgA deposits adopted a gluten‐free diet before villous atrophy had developed. For comparison, 13 patients with overt coeliac disease and 42 noncoeliac controls were studied. Small bowel mucosal transglutaminase‐2–specific autoantibodies were compared with villous morphology, intraepithelial lymphocyte densities, and serum coeliac autoantibodies.Results:Intestinal IgA deposits were seen in all but 1 of the patients with latent coeliac disease, when the morphology was still intact; the intensity of these deposits increased as villous atrophy developed and decreased again on a gluten‐free diet. In 20 patients with intestinal IgA deposits in normal villi, the intensity of the deposits decreased with the diet similarly to that seen in patients with overt coeliac disease. Mucosal IgA deposits were seen initially only in 5% of noncoeliac controls and in 8% after extended gluten consumption.Conclusions:The response of small bowel mucosal transglutaminase‐2–specific IgA deposits for dietary intervention was similar in overt and mild enteropathy coeliac disease. Detection of such IgA deposits thus offers a good diagnostic tool to uncover early‐stage coeliac disease.
Influence of xanthine oxidase on thiopurine metabolism in Crohn’s disease
Authors: ANSARI A. , ASLAM Z. , DE SICA A. , SMITH M. , GILSHENAN K. , FAIRBANKS L. , MARINAKI A. , SANDERSON J. , DULEY J. 
Published: October 2008

SummaryBackground  The thiopurines, azathioprine (AZA) and mercaptopurine are extensively used in Crohn’s disease (CD). Thiopurine bioactivation can be diverted by either thiopurine methyltransferase (TPMT), or by xanthine oxidase/dehydrogenase (XOD) which forms 6‐thiouric acid (6TU).Aim  To investigate whether chronic inflammation could influence small intestinal XOD activity using urinary excretion of 6TU as a surrogate marker of XOD activity.Methods  6‐Thiouric acid excretion was compared between 32 CD patients and nine dermatology patients (control group), on AZA. Six CD patients were interesting: five with low TPMT activity (one deficient, four intermediate), and one receiving AZA/allopurinol co‐therapy.Results  There was no statistical difference in 6TU excretion between the CD and control group. CD location, severity or surgery did not affect excretion. The TPMT‐deficient patient excreted 89% of daily AZA dose as 6TU, but excretion by TPMT carriers was essentially normal. Concurrent 5‐aminosalicylic acid therapy increased 6TU excretion significantly (median 32.9%), consistent with inhibiting TPMT. 6TU was undetectable in the patient on AZA/allopurinol co‐therapy.Conclusions  The results refuted our hypothesis, but fitted a model where most of an oral thiopurine dose effectively escapes first‐pass metabolism by gut XOD, but is heavily catabolized by TPMT. Bioavailability of thiopurines may be competitively inhibited by dietary purines.
Predictors of subjective fatigue in chronic gastrointestinal disease
Authors: SIMRéN M. , SVEDLUND J. , POSSERUD I. , BJORNSSON E. S. , ABRAHAMSSON H. 
Published: October 2008

SummaryBackground  Fatigue is a common, but poorly understood symptom in patients with chronic gastrointestinal (GI) diseases.Aim  To evaluate factors of importance for fatigue in patients with chronic GI diseases, and to compare it with fatigue in the general population.Methods  In all, 399 patients attending a GI out‐patient clinic completed questionnaires assessing fatigue, sleep disturbances, psychological general well‐being and GI symptom severity. The patients were divided into two diagnostic groups: functional GI disorders (n = 112) and organic GI diseases (n = 287). The severity of fatigue was also evaluated in an age‐ and gender‐matched group of 399 individuals from the general population.Results  Both patient groups had more severe fatigue than controls and patients with functional GI disorders were more fatigued than patients with an organic GI disease. Fatigue was associated with psychological general well‐being, GI symptom severity, gender, employment status and sleep disturbances. In a linear regression analysis, psychological general well‐being (vitality, general health, self‐control), sleep disturbances and employment status were independently associated with the severity of fatigue (adjusted R2 = 55%).Conclusions  Fatigue is a troublesome symptom in a subgroup of patients with chronic GI diseases. These patients have a high symptom burden as regards both GI and psychological symptoms, as well as sleep disturbances.
Predictive factors associated with immunosuppressive agent use in ulcerative colitis: a case–control study
Authors: LAU A. , CHANDE N. , PONICH T. , GREGOR J. C. 
Published: October 2008

SummaryBackground  Some patients with ulcerative colitis (UC) require immunosuppressants as maintenance therapy.Aim  To assess epidemiological, clinical and disease factors at diagnosis that predict immunosuppressant use in UC.Methods  All UC patients diagnosed between 1992 and 2005 and currently managed in the inflammatory bowel disease (IBD) clinic were included. Forty‐three patients who currently or previously received azathioprine (AZA) or mercaptopurine (MP) for UC were compared with 130 controls. Charts were reviewed and logistic regression analyses were applied to identify factors associated with AZA or MP use.Results  In univariate model, seven factors at diagnosis correlated with AZA use: male gender [odds ratio (OR) 2.2]; left‐sided or extensive colitis or pancolitis (OR 8.7–14.1); systemic steroid use within the first 6 months of diagnosis (OR 5.1); more than 10 bowel movements daily (OR 6.4); persistent or mostly blood in stool (OR 2.8); endoscopic proven moderate to severe disease (OR 7.2–12.0) and requirement of hospitalization (OR 2.7) on diagnosis. In multivariate model, the first three factors were shown to be statistically significant.Conclusion  Male gender, initial presentation with severe and extensive disease clinically and endoscopically, requirement of hospitalization on diagnosis or systemic steroids within 6 months of diagnosis are predictive factors for immunosuppressant use in UC.
Assessment of antimicrobial microspheres as a prospective novel treatment targeted towards the repair of perianal fistulae
Authors: BLAKER J. J. , PRATTEN J. , READY D. , KNOWLES J. C. , FORBES A. , DAY R. M. 
Published: October 2008

SummaryBackground  None of the proposed materials tested for the management of perianal fistulae has proven to be a definitive treatment.Aim  To assess a new repair scaffold and drug delivery device conceived to target perianal fistula repair.Methods  Poly(d,l‐lactide‐co‐glycolide) porous microspheres containing either antibacterial silver‐releasing degradable phosphate glass or metronidazole were prepared using thermally induced phase separation.Results  Ion‐ and drug‐release profiling of the microspheres revealed continued release of silver ions from microspheres filled with silver‐doped phosphate glass and high encapsulation efficiency for metronidazole [78% and 82% for microspheres loaded with 2.5% and 1.3% (w/w), respectively]. Microbicidal activity was confirmed by growth inhibition of bacterial species (Staphylococcus aureus, Escherichia coli and Bacteroides fragilis), which characteristically dominate the colonization of perianal fistula tracts. Microspheres containing >3 mol% silver or metronidazole resulted in strong bacterial inhibition/kill against B. fragilis; the presence of one sphere containing >3 mol% silver had a potent inhibitory effect against all the microbes studied. Microspheres became rapidly integrated with host tissue following subcutaneous implantation into a rodent wound model.Conclusion  The study demonstrates a novel scaffold for guided tissue regeneration providing local release of antimicrobial agents sufficient to counter bacterial colonization and warrants further investigation.
Clinical trial: the glucagon‐like peptide‐1 analogue ROSE‐010 for management of acute pain in patients with irritable bowel syndrome: a randomized, placebo‐controlled, double‐blind study
Authors: HELLSTRÖM P. M. , HEIN J. , BYTZER P. , BJÖRNSSÖN E. , KRISTENSEN J. , SCHAMBYE H. 
Published: October 2008

SummaryBackground  There is currently no treatment available to manage acute pain attacks in IBS patients regardless of subtype.Aims  To evaluate efficacy and safety of the GLP‐1 analogue ROSE‐010 in patients with irritable bowel syndrome (IBS) through a randomized, double‐blind, placebo‐controlled study.Methods  Eligible patients (n = 166) meeting Rome II criteria were randomly assigned to receive single subcutaneous injections of ROSE‐010 100 μg, 300 μg and placebo in a cross‐over design. Safety was assessed from spontaneously reported adverse events and measurement of vital signs. Patient‐rated pain relief and intensity were measured on a 100‐mm visual analogue scale. The primary efficacy variable was proportion of patients with >50% maximum total pain relief response from 10 to 60 min after treatment. Secondary endpoints included the maximum summed pain intensity difference, time to meaningful pain relief and patient ratings of satisfaction with treatment.Results  Twice as many patients were responders in the primary efficacy endpoint after both ROSE‐010 injections compared to placebo (24%P = 0.011, 23%P = 0.005, and 12% after 300 μg, 100 μg and placebo injections, respectively). Similar results were obtained for the proportion of patients with total pain intensity response. Times to meaningful and total pain relief were shorter for both doses of ROSE‐010 compared with placebo. Compared with placebo, more patients (P < 0.05) were satisfied with ROSE‐010 and considered ROSE‐010 better than previous IBS medications used.Conclusion  ROSE‐010 was well tolerated and provided fast and effective relief of acute pain attacks on demand in IBS patients.