bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determining IgA and IgG Antigliadin, IgA Antitransglutaminase, and Antiendomysial Antibodies in Monkey Esophagus and in Umbilical Cord for Diagnosis of Celiac Disease in Developing Countries
Authors: Bahia Magda , Penna Francisco José , Sampaio Ivan Barbosa Machado , Silva Geraldo Magela Fritz , Andrade Eugênio Marcos Goulart 
Published: March 2009

ABSTRACTObjectives:To assess the efficiency of determining IgA and IgG antigliadin antibodies (IgA‐ and IgG‐AGA, respectively), antitransglutaminase (TgA), and anti‐endomysial antibodies (AEA) in human umbilical cord (CO) and monkey esophagus for diagnosis of celiac disease; to determine the correlation between serological markers and celiac disease.Patients and Methods:A total of 400 patients were divided in 3 groups: group 1 with 37 patients with celiac disease, group 2 with 208 patients with no enteropathies, and group 3 with 155 patients with other enteropathies. IgA‐AGA, IgG‐AGA, and TgA were assessed using enzyme‐linked immunosorbent assay, whereas AEA was evaluated by indirect immunofluorescence.Results:Sensitivity and specificity of IgA‐AGA were 81.1% and 95.2%, of IgG‐AGA 89.2% and 95.2%, of TgA 83.9% and 96.8%, of AEA‐CO 87.9% and 100%, and of AEA of monkey esophagus 88.6% and 100%, respectively. Positive predictive values were 75.0%, 76.7%, 83.9%, and 100%. Negative predictive values were 96.6%, 98.0%, 96.8%, and 97.7% for IgA‐AGA, IgG‐AGA, TgA, and AEA, respectively. Multivariate analysis showed a strong association between AEA‐CO and celiac disease and a good correlation with other markers (TgA, IgA‐AGA, and IgG‐AGA).Conclusions:TgA has been recommended for screening patients with celiac disease. Considering the similar sensitivity and specificity of IgA‐AGA and TgA and their correlations in the multivariate analysis, both are applicable for this purpose. However, because TgA tests are highly costly and celiac disease is associated with IgA deficiency, the determination of IgA‐AGA and IgG‐AGA, followed by AEA‐CO, is suitable for screening in developing countries, provided a cutoff point for these examinations is established. The results of antiendomysial antibodies in umbilical cord overlapped those in monkey esophagus. Therefore, umbilical cord should be used as a substrate instead of specimens from endangered species.
Short‐term Outcome in the First 10 Morbidly Obese Adolescent Patients in the FDA‐approved Trial for Laparoscopic Adjustable Gastric Banding
Authors: Holterman Ai‐Xuan , Browne Allen , Dillard Barney E , Tussing Lisa , Gorodner Veronica , Stahl Christiane , Browne Nancy , Labott Sue , Herdegen James , Guzman Grace , Rink Andy , Nwaffo Ifeoma , Galvani Carlos , Horgan Santiago , Holterman Mark 
Published: March 2009

ABSTRACTBackground:We received the LAP‐BAND Investigational Device Exemption (IDE) from the US Food and Drug Administration in December 2004 to conduct a prospective longitudinal trial examining the safety and efficacy of laparoscopic adjustable gastric banding (LAGB) in morbidly obese adolescents ages 14 to 17 years.Objectives:To report the short‐term results of LAGB in the first 10 adolescents with complete 9 months of follow‐up.Patients and Methods:Baseline characteristics and outcome data were analyzed in 10 patients enrolled between March 2005 and February 2006.Results:All of the patients were girls. Their mean body mass index (±SD) was 50 ± 13 kg/m2, and excess weight was 171 ± 79 pounds. Comorbidities included depression (3 patients), sleep apnea (3), hypertension (6), dyslipidemia (7), insulin resistance (9), metabolic syndrome (9), and steatohepatitis (in 4 of 5 patients with liver biopsy). Operative time was 45 ± 9 minutes, and discharges were within 23 hours of surgery. Band‐related complications were as follows: 2 dehydration, 1 pouch dilation, and 1 port revision. All of the patients lost weight, with a 9‐month excess weight loss of 30% ± 16% (range 14%–57%). Hypertension and the metabolic syndrome were resolved in 100% of patients (P = 0.04) and 80% of the patients (P = 0.01), respectively, along with significant improvement in the Pediatric Quality of Life and Beck Depression Inventory scores and a trend toward improvement in high‐density lipoprotein cholesterol abnormalities (P = 0.08).Conclusions:At short‐term follow‐up, weight loss occurred with minimal complications, leading to early resolution of major obesity‐related comorbidities. Continued evaluation of the long‐term safety and efficacy of LAGB as a surgical adjunct to a comprehensive obesity treatment program is warranted.
Methods of Sedation in Pediatric Endoscopy: A Survey of NASPGHAN Members
Authors: Lightdale Jenifer R , Mahoney Lisa B , Schwarz Steven M , Liacouras Chris A 
Published: March 2009

ABSTRACTThe performance of endoscopy in children generally requires the concomitant administration of sedation to ensure the patient's safety, comfort, and cooperation throughout the procedures. New pharmacological agents, increased procedural volume, variable access to anesthesia support, and improvement in endoscopic technique have contributed to vast differences in sedation regimens for gastrointestinal procedures in patients of all ages. To better understand variation in practice patterns among pediatric gastroenterologists, the NASPGHAN Endoscopy and Procedures Committee surveyed 103 NASPGHAN members during a recent NASPGHAN national meeting. The results of this survey confirm that sedation practices vary widely and reflect continued uncertainty regarding optimal sedation regimens for pediatric endoscopy.
Feeding Experiences and Growth Status in a Rett Syndrome Population
Authors: Oddy Wendy H , Webb Kathryn G , Baikie Gordon , Thompson Susan M , Reilly Sheena , Fyfe Susan D , Young Deidra , Anderson Alison M , Leonard Helen 
Published: March 2009

ABSTRACTObjectives:Feeding difficulties in Rett syndrome are complex and multifactorial. In this study, we describe the feeding experiences in Rett syndrome and examine the factors affecting growth.Materials and Methods:Using questionnaire data related to a population‐based cohort, ages 2 to 29 years (n = 201), we measured the feeding experiences, growth, and factors affecting growth (enteral nutritional support, mutations, mobility, breath‐holding, hyperventiliation) in subjects with Rett syndrome.Results:The mean weight, height, and body mass index z scores in subjects with Rett syndrome were below that of their age group and decreased steadily with age. Twenty percent of subjects had enteral nutrition support, and it was more common in the older age group. Those with truncating mutations had significantly less enteral nutrition support than the other mutation groups. Furthermore, those with low mobility had lower mean body mass index z scores than those with higher mobility, and increased frequency of breath‐holding and hyperventilation also was associated with lower body mass index z scores.Conclusions:Routine monitoring of growth should continue to determine the severity of nutritional problems in Rett syndrome. Active nutritional management is recommended to ensure females affected with Rett syndrome have the best opportunity to reach their growth potential.
Variations in Metabolic Response to TPN Are Influenced More by Sex Than by Light Exposure
Authors: Harrison Adele , Khashu Minesh , Friel James , Lavoie Jean‐Claude , Chessex Philippe 
Published: March 2009

ABSTRACTBackground:Failure to protect total parenteral nutrition (TPN) solutions from ambient light induces the generation of peroxides, which contributes to the oxidation of several amino acids. We hypothesized that photo‐protection improves the metabolic response to TPN.Aim:To study the effects of photo‐protecting TPN on urinary nitrogen and vitamin C excretion and to evaluate in premature infants the influence of sex.Patients and Methods:Premature infants were randomized to receive from birth light‐exposed (LE) or light‐protected (LP) TPN. Upon reaching full TPN, parenteral nutrient intakes were correlated with normalized urinary nitrogen and vitamin C concentrations.Results:No differences were observed between LE and LP. However, sex‐related differences were observed in nitrogen and vitamin C handling. In boys, 50% of the nitrogen loss was explained by parenteral amino acid intake, whereas in girls, no correlation was found. The inverse correlation observed between intake and urinary excretion only in girls suggests a state of greater vitamin C utilization in girls.Conclusions:These results demonstrate that sex‐related differences in nitrogen/protein metabolism reported during enteral nutrition are seen during TPN as well. Sex is an important variable that will need to be taken into account in future studies evaluating the potential clinical effects of photo‐protecting TPN.
Postnatal “Speed of Sound” Decline in Preterm Infants: An Exploratory Study
Authors: Roggero Paola , Giannì Maria Lorella , Orsi Anna , Piemontese Pasqua , Amato Orsola , Mora Stefano , Puricelli Valeria , Mosca Fabio 
Published: March 2009

ABSTRACT“Speed of sound” (SOS), measured by quantitative ultrasound, is a noninvasive method of assessing bone status. At expected term and 1, 2, and 3 months of corrected age, bone status and body fat mass were assessed by quantitative ultrasound and by an air‐displacement system in 53 preterm infants to explore whether longitudinal changes in bone health were influenced by body fat mass. SOS decreased within the first month of corrected age. Body fat mass increased significantly. No correlation between SOS and body fat mass was found. SOS was not influenced by changes in body fat mass. The decline in SOS may be ascribed to bone structure factors.
Effect of Calcium and Vitamin D Supplementation on Bone Mineral Density in Children With Inflammatory Bowel Disease
Authors: Benchimol Eric I , Ward Leanne M , Gallagher JC , Rauch Frank , Barrowman Nick , Warren Jaime , Beedle Susan , Mack David R 
Published: March 2009

ABSTRACTObjectives:The purpose of this study was to evaluate the effect of calcium and vitamin D2 supplementation on bone mineral density (BMD) in children with inflammatory bowel disease (IBD).Patients and Methods:This was an open‐label, prospective study conducted over a 12‐month period. Seventy‐two patients were divided into 2 groups based on lumbar spine areal BMD (L2–4 aBMD). Patients with an L2–4 aBMD z score of −1 or higher were assigned to the control group (n = 33; mean age, 11.0 ± 3.5 years; 20 boys). Patients with an L2–4 aBMD of less than −1 (n = 39; mean age 11.8 ± 2.5 years; 25 boys) were allocated to the intervention group and received 1000 mg of supplemental elemental calcium daily for 12 months (n = 19) or supplemental calcium for 12 months and 50,000 IU of vitamin D2 monthly for 6 months (n = 20).Results:The 2 groups differed in L2–4 aBMD z scores (intervention, −1.9 ± 0.6; control, −0.2 ± 0.6; P < 0.001) and volumetric L2–4 BMD (vBMD; intervention, 0.29 ± 0.04; control, 0.33 ± 0.06; P < 0.001). After 1 year of therapy, the control and intervention groups had similar changes in height z scores, L2–4 aBMD, L2–4 vBMD (z score change, L2–4 aBMD: control 0.2 ± 0.6 [n = 21], intervention 0.4 ± 0.6; P = 0.4 [n = 26]; z score change, L2–4 vBMD: control 0.1 ± 0.4, intervention 0.2 ± 0.6; P = 0.74). The changes in these parameters were similar between patients who had received calcium only or calcium plus vitamin D.Conclusions:These results suggest that, in children with IBD, supplementation of calcium and vitamin D does not accelerate accrual in L2–4 BMD.
Growth Hormone Treatment in Prepubertal Children With Celiac Disease and Growth Hormone Deficiency
Authors: Giovenale Diletta , Meazza Cristina , Cardinale Giuliana M , Farinelli Edorado , Mastrangelo Costanzo , Messini Beatrice , Citro Giuseppe , Del Vecchio Maurizio , Di Maio Salvatore , Possenti Ilaria , Bozzola Mauro 
Published: March 2009

ABSTRACTObjective:To evaluate the growth response to growth hormone (GH) replacement therapy during a gluten‐free diet in patients with celiac disease (CD) associated with GH deficiency (GHD).Patients and Methods:A total of 14 prepubertal children affected by CD and GHD with no catch‐up growth after ≥12 months of gluten‐free diet and a reversion to seronegativity for antiendomysium antibodies and 10 age‐matched prepubertal children with idiopathic GHD (IGHD) entered the study. All of the patients were treated with the same GH dosage (0.25 mg/kg subcutaneously each week). Height, growth rate, and body mass index were measured at the time of diagnosis of CD, at the time of endocrinological evaluation, and after the first, second, and third year of GH replacement therapy.Results:Growth rate strikingly increased (P < 0.005) during the first year of therapy in a similar way in subjects with CD/GHD and IGHD (from a median standard deviation score [SDS] of −2.34 to an SDS of 3.25 and from an SDS of −1.29 to an SDS of 2.79, respectively). During the second and third years of GH treatment, the growth rate tended to decrease but the values at the third year were always positive (CD/GHD, median SDS, 1.10; IGHD, median SDS, 0.11), indicating continued catch‐up growth.Conclusions:In patients with CD with GH deficiency confirmed after ≥12 months of gluten‐free diet, GH replacement therapy should be started to allow complete catch‐up growth in children. In addition, the effect of GH treatment in patients who comply with a gluten‐free diet seems to be comparable to that observed in children with IGHD.
Liver Function Test Results Predict Nutritional Status Evaluated by Arm Anthropometric Indicators
Authors: Hurtado‐López Erika F , Larrosa‐Haro Alfredo , Vásquez‐Garibay Edgar M , Macías‐Rosales Rocío , Troyo‐Sanromán Rogelio , Bojórquez‐Ramos M Carmen 
Published: March 2009

ABSTRACTObjectives:To compare the anthropometric indicators based on weight and height with the anthropometric indicators based on arm measurements and to predict the anthropometric nutritional status with liver function tests (LFTs) in children with chronic liver disease (CLD).Patients and Methods:A cross‐sectional study in a referral pediatric hospital enrolled 79 children with CLD (mean age 72.6 ± 61.8 months, 54% female). An independent variable of LFT was used to determine the outcome variable of nutritional status. Anthropometric indicators of height versus age, weight versus height, head circumference versus age, and arm indicators versus age were analyzed with Pearson correlation, the determination coefficient r2, and multiple regression.Results:A total of 44.3% of patients studied had growth impairment. The anthropomorphic indicator of weight for height identified malnutrition in 11.4%, compared with 43% identified by mid‐ to upper arm circumference (MUAC) and 40.5% identified with total arm area. MUAC (P < 0.001), total arm circumference (P < 0.001), arm muscle area (P = 0.009), and arm fat area (P = 0.023) identified more cases of z score less than −2 SD than weight/height. The presence of ascites misled weight‐for‐height measurements. Conjugated bilirubin and albumin had significant correlations with almost all of the anthropometric indicators. Alkaline phosphatase correlated significantly with all of the arm anthropometric indicators. A regression analysis led to 7 prediction models; the highest prediction of z score less than −2 SD was with triceps skinfold and conjugated bilirubin, albumin, and γ‐glutamyltransferase; height‐for‐age z score less than −2 SD was predicted by measurements of conjugated bilirubin, prothrombin time, and alanine aminotransferase.Conclusions:The data presented underline the correlation between the liver damage severity evaluated by LFT and the nutritional status estimated by anthropometric indicators. In our view these observations reflect the close relationship between liver function and the degree of liver damage to growth and current nutritional status.
Proton Pump Inhibitor Utilization Patterns in Infants
Authors: Barron John J , Tan Hiangkiat , Spalding James , Bakst Alan W , Singer Joseph 
Published: March 2009

ABSTRACTObjective:Practice patterns regarding pediatric gastroesophageal reflux disease include acid suppression for infants meeting certain clinical criteria. This study aimed to examine the use of proton pump inhibitors (PPI) in infants and neonates.Patients and Methods:This retrospective observational study used data from 1999 to 2004 from 4 health care plans in the United States. Infants age <12 months with at least 1 pharmacy claim for a PPI were identified. Demographic information and PPI utilization patterns were assessed. Medical charts were reviewed in a subset of patients to gather dosing information.Results:Identified infants (N = 2469) were 58% male. PPI use rose 4‐fold from 2000 to 2003; lansoprazole and omeprazole were almost exclusively used. Treatment for almost half of the patients was initiated by their fourth month of life. The most common diagnoses identified through medical claims included gastroesophageal reflux (59%), problems feeding (23%), upper respiratory infections (23%), esophagitis (21%), and pain from gas (20%). Preindex H2 blockade was evident in 58% of the patients; preindex metoclopramide was used in 38% of the patients. Longer duration of PPI therapy was associated with patients who had more comorbidities. Through chart review of 388 patients, a subset of 272 patients with dosing information revealed that a median daily dosage in patients receiving lansoprazole was 1.74 mg · kg−1 · day−1 compared with 1.21 mg · kg−1 · day−1 for omeprazole.Conclusions:PPI use in the study population increased steadily from 1999 to 2004. These data offer valuable information on current PPI dosing patterns that may be used to design future clinical trials for assessment of gastroesophageal reflux disease regimens and clinical outcomes in the infant population.
Liver Stiffness Measurement in Children Using FibroScan: Feasibility Study and Comparison With Fibrotest, Aspartate Transaminase to Platelets Ratio Index, and Liver Biopsy
Authors: de Lédinghen Victor , Le Bail Brigitte , Rebouissoux Laurent , Fournier Céline , Foucher Juliette , Miette Véronique , Castéra Laurent , Sandrin Laurent , Merrouche Wassil , Lavrand Frédéric , Lamireau Thierry 
Published: March 2009

ABSTRACTObjective:Transient elastography (FibroScan) is a novel, noninvasive, rapid bedside method to assess liver fibrosis by measuring liver stiffness in adult patients. The usefulness of FibroScan in children with chronic liver diseases is unknown. The aim of this prospective study was to evaluate the feasibility of liver stiffness measurement and to compare FibroScan, Fibrotest, and aspartate transaminase to platelets ratio index (APRI) with liver biopsy for the diagnosis of cirrhosis in children with chronic liver diseases.Patients and Methods:Between February 2004 and October 2005, 116 consecutive children with chronic liver diseases were prospectively included. All except 1 child (58 boys, mean age 10.7 years) could have noninvasive tests for fibrosis: FibroScan, Fibrotest, and APRI, and, when necessary, a liver biopsy (n = 33).Results:FibroScan, Fibrotest, and APRI were correlated with clinical or biological parameters of chronic liver diseases, but the FibroScan marker correlated most with all parameters. By histology, the METAVIR fibrosis category score was F1 in 7 cases, F2 in 8 cases, F3 in 6 cases, and F4 in 12 cases. FibroScan, Fibrotest, and APRI were significantly correlated with the METAVIR fibrosis score. For the diagnosis of cirrhosis, the area under the receiver operating characteristic curve was 0.88, 0.73, and 0.73 for FibroScan, Fibrotest, and APRI, respectively.Conclusions:These results indicate that liver stiffness measurement is feasible in children and is related to liver fibrosis. A specific probe dedicated to children and slender patients has thus been developed and is currently under evaluation. The FibroScan equipped with this specific probe could become a useful tool for the management of chronic liver diseases in children.
Ninety Percent of Celiac Disease Is Being Missed
Authors: Ravikumara M , Nootigattu VKT , Sandhu BK 
Published: March 2009

ABSTRACTSerological screening of 5470 children age 7.5 years from a cohort of 13,971 children in the Avon Longitudinal Study of Parents and Children (ALSPAC) suggested the prevalence of celiac disease (CD) to be at least 1%. ALSPAC is an anonymous study, and hence seropositive children could not be individually identified or undergo biopsy. Inasmuch as all children within ALSPAC suspected of having CD are referred to just 1 center, we aimed to identify children with biopsy‐confirmed CD who were likely to be in this cohort and to estimate the magnitude of discrepancy between serology‐positive cases and biopsy‐confirmed cases. The results suggest that more than 90% of CD in children goes undiagnosed.
Probiotics for Necrotizing Enterocolitis: A Systematic Review
Authors: Barclay Andrew R , Stenson Ben , Simpson Judith H , Weaver Lawrence T , Wilson David C 
Published: March 2009

ABSTRACTBackground:Necrotizing enterocolitis (NEC) is the most commonly acquired neonatal intraabdominal emergency and causes significant morbidity and mortality. A proposed strategy for the prevention of NEC is the administration of oral probiotics. Probiotics have been shown to reduce NEC in experimental rat models and have been used in clinical trials. The authors aimed to review the existing data on the use of oral probiotics for the prevention of NEC in preterm infants (age <33 weeks) and those with very low birth weight (VLBW).Materials and Methods:Systematic review of randomized controlled trials (RCTs) and quasi‐RCTs was performed to find outcome measures of incidence, severity, need for surgery, and mortality in NEC. Electronic searches were performed on Medline and CINAHL databases using key word and subject headings with combinations of the terms “infant, preterm”; “infant, VLBW”; “enterocolitis, necrotizing”; and “probiotics.” In addition, citation searches were performed for all potential studies.Results:Six potential RCTs were identified for inclusion, but there were no systematic or Cochrane database reviews identified. One study was discounted because of the use of historical controls, so 5 studies were selected for analysis. Cumulatively, 640 infants were treated with probiotics and 627 were used as control subjects. All of the studies showed a trend toward less NEC in the treatment group. The heterogeneity of probiotic formulations and the timing and methods of interventions in the identified studies made synthesis and comparison of data inappropriate.Conclusions:The data appear to lend support to the use of oral probiotics for the prevention of NEC in preterm infants and those with VLBW. However, the data are insufficient to comment on their short‐ and long‐term safety. Type of probiotics used, as well as the timing and dosage, are still to be optimized. Further understanding of the pathogenesis of NEC and the mechanisms by which probiotics prevent it may lead to evidence‐based treatment strategies.