bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dietary Management of Acute Diarrhoea in Children: Effect of Fermented and Amylase‐Digested Weaning Foods on Intestinal Permeability
Authors: Willumsen Juana F. , Darling Jonathan C. , Kitundu Jesse A. , Kingamkono Rose R. , Msengi Abel E. , Mduma Benedicta , Sullivan Keith R. , Tomkins Andrew M. 
Published: February 2024

Background:There is a strong relationship between diarrhoea, malnutrition, and intestinal integrity. To investigate the effect of different dietary treatment on intestinal permeability during acute diarrhoea, 87 Tanzanian children aged 6‐25 months were recruited to this study when admitted to hospital.Methods:Children with acute diarrhoea were rehydrated and then randomly assigned to one of three dietary treatment groups: a conventional low‐energy density porridge, a high‐energy density amylase digested porridge (AMD), or a high‐energy density amylase digested and then fermented porridge (FAD). Lactulose/mannitol permeability tests were performed on admission, at 3 days, and at follow‐up 2 and 4 weeks after discharge. The lactulose/mannitol (L/M) ratios were compared between dietary treatment groups and to a group of age‐matched, healthy control subjects.Results:Children with diarrhoea had higher L/M ratios (geometric mean 0.85, 95% CI 0.68‐1.05) compared with control subjects (0.14, 0.12‐0.17) on admission. There was a significant difference in the change in L/M ratio between admission and 3 days between dietary treatment groups in favour of the FAD group (p < 0.05).Conclusions:Dietary treatment and intestinal damage at admission explain 13.5% of the variation in L/M ratio, but when age at admission and age at weaning are included as covariants, 21.9% is explained. FAD porridge seems to be more effective in the treatment of intestinal permeability than AMD or conventional porridge. Urinary lactose concentrations in spot urine samples taken prior to the permeability test were also measured. There was a significant correlation with the L/M ratio (correlation coefficient = 0.62, p < 0.001).
Hepatocellular Adenomas in Glycogen Storage Disease Type I and III: A Series of 43 Patients and Review of the Literature
Authors: Labrune Philippe , Trioche Pascale , Duvaltier Isabelle , Chevalier Paquita , Odièvre Michel 
Published: February 2024

Background:Hepatocellular adenomas may develop in patients with glycogen storage disease types I and III, and the malignant degeneration of adenomas in hepatocellular carcinoma has been reported in ten cases. The aim of this work was to study the characteristics of hepatic adenomas in a large series of 43 patients with glycogen storage disease types I and III and to determine the optimal means of follow‐up.Methods:The charts of 43 patients with glycogen storage disease type I and III were studied. In all these patients, abdominal ultrasonography and the determination of serum α‐fetoprotein had been performed yearly and serum concentrations of several proteins were determined once.Results:51.8% of patients with type I and 25% of patients with type III glycogen storage disease had hepatic adenomas at the time of the study. The male to female ratio was 2 to 1 in type I, and no female had adenomas in type III. No evidence of malignant transformation was observed during the follow‐up period. Serum concentrations of several proteins were significantly higher in patients with hepatic adenomas than in patients without such lesions.Conclusions:In patients with glycogen storage disease type I and III, the determination of α‐fetoprotein serum concentration has to be combined with yearly hepatic ultrasound examinations. Other investigations such as CT scan should be considered when the size of any adenoma increases. The malignant transformation of hepatocellular adenoma into hepatocellular carcinoma remains a rare event.
Nutritional Factors and Helicobacter pylori Infection in Colombian Children
Authors: Goodman Karen J. , Correa Pelayo , Tenganá Aux Heraldo J. , DeLany James P. , Collazos Tito 
Published: February 2024

Background:Helicobacter pylori infection occurs most frequently in impoverished populations; however, little is known about specific determinants of susceptibility. This report describes the relationship between H. pylori infection and nutritional indicators among children from a rural village in the Colombian Andes, where a prevalence of 69% was observed in children from 2 to 9 years old.Methods:In a cross‐sectional study of 684 children, comprising 92% of the 2‐ to 9‐year‐old population of Aldana, Colombia, information was obtained on dietary factors by questionnaire, height and weight by direct measurement, and H. pylori status using the carbon‐13 urea breath test. Multivariate logistic regression was used to estimate relative risks for nutritional indicators.Results:The infection was least frequent among children who ate several servings of fruits and vegetables daily, drank two or more cups of milk daily, and were in the upper quintile of height for their age. The odds of infection increased 19‐fold (95% confidence interval, 4.0‐91.9) among children who consumed less than two daily servings of fruits and vegetables compared with the modal intake of three to five daily servings. Children whose daily vitamin C intake from fruits and vegetables was less than 40 mg had greatly increased odds of infection (odds ratio, 7.2; 95% confidence interval, 1.5‐34.1) compared to the modal intake of 80‐119 mg; for beta‐carotene, the odds ratio was 3.1 (95% confidence interval, 1.2‐7.9) for intakes of less than 300 IU per day, compared with the modal daily intake of 900 IU or more.Conclusions:The results of this population‐based study suggest that nutritional factors may play a role in determining susceptibility to H. pylori infection.
Measurement of the Rate of Entry of Intact Colon‐Derived Lactose into the Circulation: A Model for Assessing Gut Uptake of Molecules Not Endogenously Synthesized
Authors: Kien C. Lawrence , Murray Robert D. , Ailabouni Anton H. , Habash Diane L. , Powers Priscilla A. 
Published: February 2024

Background:Results of in vitro studies have documented colonic absorption of lactose in the newborn. A stable isotope model was developed for assessing the entry rate of intact lactose into the portal circulation in newborn piglets.Methods:In experiment 1, unlabeled and [D‐1‐13‐C]‐lactose were infused into two separate mesenteric veins, and in experiment 2, labeled lactose was infused into a mesenteric vein and unlabeled lactose was infused into the colon. The 13C‐enrichment of plasma lactose was assessed by high performance liquid chromatography gas chromatography combined with mass spectrometry.Results:The isotopic estimate of the mesenteric venous infusion rate of lactose was 91% of the theoretical. In the second experiment 13% of the unlabeled lactose infused into the colon reached the portal circulation.Conclusions:The current study provides the first, direct, in vivo confirmation of colon absorption of intact lactose. The tracer model could be used to evaluate intestinal or colonic absorption of other organic compounds not endogenously synthesized, including vitamins or drugs.
Vomiting and Gastroesophageal Motor Activity in Children with Disorders of the Central Nervous System
Authors: Ravelli Alberto M. , Milla Peter J. 
Published: February 2024

ABSTRACTBackground:Vomiting is common in children with disorders of the central nervous system(CNS) and is usually ascribed to gastroesophageal reflux (GER). However, recent acquisitions on the pathophysiology of vomiting suggest that the dysmotility of the foregut may be more widespread.Methods:Fifty‐five children with CNS disorders, 50 of whom suffered from retching and/or vomiting (18 following fundoplication) were studied. We assessed GER by 24 hour pH monitoring and endoscopy, gastric electrical activity by electrogastrography, and gastric half‐emptying time (T½) of a milk meal be electrical impedance tomography.Results:Of the 50 vomiting patients, 29 had GER (reflux index of 5.7%‐87.4%; controls: <5%), and 31 had gastric dysrhythmias (12 tachyarrhythmia at 5.5‐11.2 cpm, 4 bradyarrhythmia at 1.7‐1.9 cpm, 15 unstable electrical activity; controls: 2.2‐4.0 cpm). Sixteen patients had GER and gastric dysrhythmias. Eleven of 18 patients with fundoplication had gastric dysrhythmias. Gastric T½ was delayed in 12 of 13 patients with gastric dysrhythmia (6 with GER), versus 2 of 5 with GER alone. No abnormalities were detected in the 5 patients who did not suffer from vomiting.Conclusions:Children with CNS disorders who vomit have abnormal gastric motility as often as GER. Following fundoplication, many patients continue to have symptoms possibly related to gastric dysrhythmias, the effects of which may be unmasked by fundoplication. Foregut dysmotility may be related to abnormal modulation of the enteric nervous system by the CNS or to involvement of the enteric nervous system by the same process affecting the brain.
Pudendal Nerve Function in Normal and Encopretic Children
Authors: Sentovich Stephen M. , Kaufman Stuart S. , Cali Rebecca L. , Falk Peter M. , Blatchford Garnet J. , Antonson Dean L. , Thorson Alan G. , Christensen Mark A. 
Published: February 2024

ABSTRACTBackground:Abnormal pudendal nerve function contributes to fecal retention and incontinence in adults. To determine the role of pudendal neuropathy in childhood, we prospectively evaluated pudendal nerve function in normal and encopretic children.Methods:We studied pudendal nerve terminal motor latency in 23 encopretic children and in an equal number of similarly aged, normal children. Anal manometry and electromyography were also obtained in all children.Results:Pudendal nerve latency in the encopretic children equaled 1.58 ± 0.33 msec, which was the same as that in control children. Of the 75 pudendal nerves tested, latency was prolonged in only one encopretic child. In contrast, anal electromyography demonstrated nonrelaxation of the external anal sphincter in 75% of the encopretic children but in only 13% of the normal children (p < 0.001). Anorectal manometry demonstrated, on average, lower anal sphincter pressures at rest and with squeezing in the encopretic children (p < 0.01), but only 17% had sphincter pressures more than two standard deviations below normal.Conclusions:Other than poor relaxation response of the external anal sphincter during evacuation, these data reveal a paucity of functionally important abnormalities in encopretic children. In particular, we find no evidence that abnormal pudendal nerve function is important in the etiology or pathogenesis of encopresis in children.
Pancreatic Enzyme Supplementation in Cystic Fibrosis Patients Before and After Fibrosing Colonopathy
Authors: Stevens John C. , Maguiness Karen M. , Hollingsworth Judy , Heilman Douglas K. , Chong Sonny K. F. 
Published: February 2024

ABSTRACTBackground:In 1994 we cared for nine cystic fibrosis patients with fibrosing colonopathy. To evaluate the relationship between fibrosing colonopathy and supplemental pancreatic enzymes we reviewed our dosing of enzymes prior to fibrosing colonopathy development and then evaluated the subsequent effect of drastically reducing pancreatic enzyme dose.Methods:We retrospectively reviewed pancreatic enzyme dosing for 267 cystic fibrosis patients with pancreatic insufficiency. The supplemental enzyme history of nine patients with fibrosing colonopathy was contrasted with the history of 258 nonaffected patients. The pancreatic enzyme doses of 75 patients taking at least 6,000 U lipase/kg/meal were systematically reduced to approximately 2,000 lipase units/kg/meal. We evaluated the effect of this dose reduction on change in height and weight z scores one year after achievement of stable enzyme dose.Results:In the year prior to diagnosis patients with fibrosing colonopathy took a significantly larger pancreatic enzyme dose, whether assessed by highest dose or cumulative dose, than did nonaffected patients. Similar results were observed after controlling for sex and age. All 75 patients on at least 6,000 U lipase/kg/meal were able to tolerate a significant reduction in dose while achieving clinically acceptable nutrient absorption, with no change over one year in height and weight z scores.Conclusions:Our data demonstrate a strong relationship between very high doses of pancreatic enzyme supplementation and formation of fibrosing colonopathy. These very high doses do not appear to be needed for adequate nutrient absorption and growth.
Reducing Parenteral Requirement in Children with Short Bowel Syndrome: Impact of an Amino Acid‐Based Complete Infant Formula
Authors: Bines Julie , Francis Dorothy , Hill David 
Published: February 2024

ABSTRACTBackground:The aim of this study was to assess the impact of an amino acid‐based complete infant formula on enteral feeding tolerance and parenteral nutrition requirement in children with severe short bowel syndrome.Methods:Four children (23 months‐4.75 years) with short bowel syndrome who required long‐term parenteral nutrition due to persistent feeding intolerance while receiving an extensively hydrolyzed formula were assessed before and after the commencement of an amino acid‐based complete infant formula for a mean follow‐up period of 48 months (range 39‐51 months). Assessment included clinical monitoring of feeding tolerance and nutritional status, biochemistry, stool analysis, skin‐prick testing to common food antigens, esophagogastroduodenoscopy and colonoscopy or jejunoscopy with biopsies, and measurement of disaccharidase levels and intestinal permeability.Results:All patients ceased parenteral nutrition within 15 months as a result of decreased stool output and resolution of vomiting. Patients had a reduction in hospitalization (mean: 198 versus 98 days/patient/year), episodes of proven(mean: 4.3 versus 3.3/patient/year) and suspected (mean: 6.5 versus 4.0/patient/year) bacterial sepsis and central line insertions (mean: 2.5 versus 1.5/patient/year). Intestinal permeability to lactulose fell markedly(mean: 69% versus 2.7%). Disaccharidase levels increased in all three patients undergoing repeat studies.Conclusions:An amino acid‐based complete infant formula improved feeding tolerance and eliminated the need for parenteral nutrition in four children with short bowel syndrome who had previously required long‐term parenteral nutrition. The clinical improvement was mirrored by improvement in measurements of intestinal function.
Vitamins A and E Serum Levels in Children and Young Adults with Inflammatory Bowel Disease: Effect of Disease Activity
Authors: Bousvaros Athos , Zurakowski David , Duggan Christopher , Law Terry , Rifai Nader , Goldberg Nancy E. , Leichtner Alan M. 
Published: February 2024

ABSTRACTBackground:Hypovitaminosis and fat‐soluble vitamin deficiency have been reported in adults with inflammatory bowel disease (IBD). A prospective study was undertaken to determine the prevalence of low serum levels of vitamins A and E in children and young adults with IBD.Methods:Clinical information and serum for vitamin levels was gathered prospectively from 61 patients with Crohn's disease, 36 patients with ulcerative colitis, and 23 control subjects. Disease activity and disease location were determined for IBD patients. Serum retinol and alpha‐tocopherol levels were determined by high‐performance liquid chromatography.Results:The prevalence of hypovitaminosis A (defined as serum vitamin A <20μg/dl) or hypovitaminosis E (defined as serum vitamin E <5 mg/l) was 16% in the pediatric IBD population studied. Low vitamin A levels were more common than low vitamin E levels. Serum retinol levels correlated significantly with alpha‐tocopherol levels. Hypovitaminosis was significantly more prevalent in the Crohn's disease patients who had active disease, an erythrocyte sedimentation rate of more than 25 mm/hour, or a serum albumin level less than 3 mg/dl.Conclusions:Children and young adults with active IBD frequently have low serum levels of vitamin A or vitamin E. The severity of disease activity is a better predictor of risk for hypovitaminosis than is nutritional status. Further work is necessary to determine whether the hypovitaminosis seen in children with IBD reflects true deficiency.
Gastric Lipase and Pepsin Activities in the Developing Ferret: Nonparallel Development of the Two Gastric Digestive Enzymes
Authors: Hamosh Margit , Henderson Theresa R. , Hamosh Paul 
Published: February 2024

ABSTRACTBackground:Gastric lipase has an important compensatory function in neonatal fat digestion. The activity level of pepsin and its role in protein digestion is less well understood. We have, therefore, studied the ontogeny of lipase and pepsin in the ferret, a species with a neonatal fat digestion pattern similar to that of humans.Methods:Gastric lipase and pepsin activities were quantified from the late fetal period throughout lactation, and were compared with those of the adult.Results:The data show earlier ontogeny and much more rapid rise of lipase activity than of pepsin. Lipase activity was present during the last week of fetal development, whereas pepsin was detected only postnatally. Lipase activity was 72.8% ± 14.2% and 153% ± 9.95% and pepsin activity was 11.6%± 1.3% and 30.1% ± 1.3% of the adult level at 2 and 4 wk of age, respectively.Conclusions:We conclude that lipase activity develops early and exceeds adult activity during the suckling period, when fat intake is very high. The low pepsin activity and high postprandial pH probably limit gastric proteolysis, thereby contributing to the structural and functional stability of milk proteins, many with protective or bioactive function in the gastrointestinal tract of the newborn.
The 13 Urea Breath Test for the Noninvasive Detection ofHelicobacter pylori in Children: Comparison with Culture and Determination of Minimum Analysis Requirements
Authors: Kalach Nicolas , Briet Françoise , Raymond Josette , Benhamou Pierre‐Henri , Barbet Patrik , Bergeret Michel , Senouci Lahouari , Maurel Michèl , Flourié Bernard , Dupont Christophe 
Published: February 2024

ABSTRACTBackground:The purpose of the study was to determine the accuracy of the labelled13 carbon urea breath test for the diagnosis of Helicobacter pylori in children and to simplify the 13carbon urea breath test in identifying the most discriminating sampling time.Methods:H. pylori was searched for in 100 children aged 10.5 ± 4.5 years by histology, bacteriological counts, and culture on antral biopsies together with serology and 13carbon urea breath test. Breath samples were obtained before ingestion (T0) of 75 mg urea‐13C and every 10 minutes after until T60. 13CO2 excess ratio was measured by isotope ratio mass spectrometry, and values expressed as delta per mil over baseline enrichment (δ 13CO2). The arithmetic mean(Mδ 13CO2) of T20 to T60 values was calculated and the test considered positive with Mδ 13CO2 higher than Mδ 13CO2 + 3 SD as determined in noninfected children.Results:Mδ 13CO2 of noninfected children as assessed by culture was 1.4 ± 0.6 per mil, determining a positive cut‐off value of 3.44 per mil. Mδ 13CO2 was correlated in 11 children with biopsy bacteriological counts. Both culture and 13carbon urea breath test were positive in 38 of 100 children, without any discordance. Plotting13 carbon urea breath test results at each sampling time versus Mδ13 CO2 showed weaker correlations at T20, T30, T50, and T60, than at T40. The two‐sample method at T0 and T30, T40, T50, had high sensitivity and specificity. Single‐sample analysis obtained at T40 gave a comparable sensitivity and a slightly reduced specificity.Conclusion:13carbon urea breath test is sensitive and specific in children. Two samples collected at T0 and T40 provide the most discriminating procedure.
The Viral Association of Neonatal Cholestasis in Sweden: A Possible Link Between Cytomegalovirus Infection and Extrahepatic Biliary Atresia
Authors: Fischler Björn , Ehrnst Anneka , Forsgren Marianne , Örvell Claes , Nemeth Antal 
Published: February 2024

ABSTRACTBackground:In addition to earlier reports on the association between viral infections and intrahepatic neonatal cholestasis, in recent studies, investigators have suggested a similar link to extrahepatic biliary atresia.Methods:Fifty‐nine cholestatic infants (mean age 8 weeks) were investigated for signs of infection with a large spectrum of viruses. Twenty‐one infants had extrahepatic biliary atresia, 38 had intrahepatic cholestasis. The virologic methods included serologic investigation in 59 infants and 54 mothers, virus isolation from stools (49 infants), urine (58 infants) and liver biopsies (40 infants). Polymerase chain reaction was used to detect cytomegalovirus DNA in 25 of the liver biopsy specimens. Two control groups, one with 35 noncholestatic infants and one with 111 healthy, pregnant women were checked for serologic signs of cytomegalovirus.Results:Nineteen of 59 (32%) cholestatic infants, including 8 of 21 (38%) with extrahepatic biliary atresia, compared with 2 of 35 (6%) control infants had cytomegalovirus‐immunoglobulin (Ig) M detected in serum (p < 0.01). Fifty‐one of 54 (94%) tested mothers of cholestatic infants were sero‐positive for cytomegalovirus, compared with 83 of 111 (75%) control mothers (p < 0.01). Cytomegalovirus DNA in liver specimens was detected by polymerase chain reaction in 9 of 18 (50%) analyzed patients with biliary atresia and in specimens from 3 of 7 patients with intrahepatic cholestasis.Conclusions:Cytomegalovirus infection may play a role, not only in intrahepatic neonatal cholestasis, as was suggested earlier, but also in extrahepatic biliary atresia. The pathogenetic mechanism for this link remains to be established
Fat Distribution in Obese and Nonobese Children and Adolescents
Authors: Moreno Luis A. , Fleta Jesús , Mur Lilianne , Sarría Antonio , Bueno Manuel 
Published: February 2024

ABSTRACTBackground:It is not known whether fat deposition in obese children and adolescents occurs in the body's central or peripheral regions.Methods:A representative sample of children was drawn from the schools of Zaragoza, Spain. The population selected comprised 1728 children ranging in ages from 6 to 14.9 years. Of the original sample, 368 children (21.29%) were excluded because of chronic diseases or refusal to participate. The waist‐to‐hip circumference ratio and the triceps‐to‐subscapular skin‐fold thickness ratio were calculated and served as indexes of body fat distribution. The children were divided into tertiles according to standard deviation score of body mass index.Results:Both in boys and in girls, waist‐to‐hip circumference ratio was higher in tertile 3 than in the other two tertiles, and triceps‐to‐subscapular skinfold thickness ratio was lower in tertile 3 than in the other two tertiles. Waist‐to‐hip circumference ratio was higher and triceps‐to‐subscapular skinfold thickness ratio was lower in obese than in nonobese children and adolescents of both sexes.Conclusions:Increased adiposity may be accompanied by an increase of fat depot in the abdominal region. In obese children and adolescents, fat deposition seems to occur in the body's central regions.