bluuebunny/crossref_metadata_2025_split huggingface dataset:
A New Laboratory Kit for Anti‐gliadin IgA at Diagnosis and Follow‐up of Childhood Celiac Disease
Authors: Ascher H. , Lanner Å. , Kristiansson B. 
Published: January 2024

SummaryA new laboratory kit measuring anti‐gliadin IgA level by enzyme immunoassay has been evaluated to assess the test's potential for screening children with suspected celiac disease for small intestinal biopsy and predicting mucosal relapse after gluten challenge. One hundred thirty children were tested, and the results were related to the histopathologic findings of the intestinal mucosa and the final diagnosis. The sensitivity of the test was 97% and the specificity was 92% in the studied population. Forty‐five children with celiac disease on different diets were observed. All had reduced anti‐gliadin IgA levels on a gluten‐free diet, and 91% had normal levels after 1 year. Two of four patients with increased values had an insufficient diet. During gluten challenge, 38 of 45 children showed increased anti‐gliadin IgA levels. Of the remaining seven, five reacted either with immediate and strong symptoms or had spontaneously reduced gluten intake, or had an acquired IgA deficiency. In two cases, there was no explanation. In five children without relapse on gluten challenge, the anti‐gliadin IgA level remained normal. Provided that IgA deficiency is ruled out and the gluten intake is sufficient, the test is reliable for screening and has a potential to replace the third biopsy.
A Metabolic Bed for Collecting Excreta in Premature Infants
Authors: Kien C. Lawrence 
Published: January 2024

SummaryA mattress and plastic bed for collection of urine and feces in premature infants housed in isolettes is described. The dimensions of the bed are 65.5 x 34.4 x 13.5 cm. A drainage hole is located 18 cm from the foot of the bed and midway (16.5 cm) from either side. The angle of the depression in the bed for the drainage hole is approximately 12.5°. The bed is covered with a plastic‐backed foam rubber mattress. The plastic surface on which the infant lies is impervious to water. The method of excreta collection using the bed does not involve the need for restraints; urine and/or feces are washed off the undiapered infant and the bed into a container beneath the drainage hole. The bed has been well tolerated in over 30 studies of 4 days duration, and laboratory experiments with urine and feces applied to the mattress for 15–60 min have indicated excellent recovery of total nitrogen.
Effect of Vitamin A Deficiency on the Adherence of Fimbriated and Nonfimbriated Salmonella typhimurium to Isolated Small Intestinal Enterocytes
Authors: Gabriel Elizabeth P. , Lindquist Bo L. , Abud Rodney L. , Merrick Joseph M. , Lebenthal Emanuel 
Published: January 2024

SummaryIn vitamin A‐deficient children, increased rates of bacterial infections in the intestine have been observed. The adherence of bacteria is a prerequisite for invasion. Thus, the effect of vitamin A deficiency on the adherence of fimbriated and nonfimbriated Salmonella typhimurium to isolated small intestinal enterocytes was studied. Male weanling rats matched by weight were divided into three groups: one group was fed a vitamin A‐free diet for 8–12 weeks; another was given the same diet supplemented with retinol acetate; a third group matched for age served as controls. The vitamin A‐deficient group showed a significantly lower growth rate and lower serum retinol levels than either the retinol acetate‐supplemented or control groups. In all the groups, S. typhimurium possessing mannose‐sensitive fimbriae adhered to enterocytes in significantly larger numbers than the nonfimbriated strains. The number of fimbriated S. typhimurium bound to enterocytes from the proximal small intestine was significantly higher in the vitamin A‐deficient rats than in the pair‐fed vitamin A‐supplemented group (19.3 ± 14.9 versus 7.8 ± 5.0; p < 0.05) or the control group (19.3 ± 14.9 versus 8.7 ± 3.5, p = 0.01). The specific activities of the enterocytes lactase, sucrase, and maltase and the protein content in the vitamin A‐deficient rats were similar to those in the controls. These results demonstrate that vitamin A deficiency in rats is associated with the increased ability of S. typhimurium to adhere to proximal small intestinal enterocytes. However, the possible changes in the membrane of the entero‐cyte do not include decreases in brush border disaccha‐ridases or protein content.
Cytopathic Effects of Measles Virus on the Human Intestinal Mucosa
Authors: Jirapinyo Pipop , Thakerngpol Kleophant , Chaichanwatanakul Katharee 
Published: January 2024

SummaryWe reported a case of measles with diarrhea in an infant. Capsule biopsy samples of intestinal mucosa taken 14 days after onset of fever was damaged and had low disaccharidase activities. Virus particles were found in the damaged villous cell. Second intestinal mucosa biopsy samples taken 28 days after onset of fever was found to be normal in structure, but lactase and sucrase activities were still low. Mucosal damage by virus particles was the cause of diarrhea in our infant.
Low Fractions of Mono‐ and Diconjugated Bilirubin in Patients with β‐Thalassemia
Authors: Ullrich D. , Sieg A. , Krüger N. , Schröter W. , Bircher J. 
Published: January 2024

SummaryUnconjugated and mono‐ and diconjugated bilirubin was determined by alkaline methanolysis and thin‐layer chromatography in serum from 16 pediatric patients with homozygous β‐thalassemia (aged 1–23 years), in 14 age‐matched controls, and in 26 healthy adults. Total bilirubin amounted to 21 ± 20 μmol/L in patients with thalassemia compared with 7 ± 4 μmol/L in healthy children and 11 ± 3 μmol/L in healthy adults. The fractions of bilirubin conjugates in the various groups were 8 ± 4% (patients with thalassemia), 18 ± 5% (age‐matched controls; p < 0.001), and 16 ± 5% (healthy adults; p < 0.001). The low fraction of bilirubin conjugates in patients with thalassemia showed no correlation to any other physical or laboratory finding. It is concluded that subnormal values of bilirubin conjugates in thalassemia indicate defective bilirubin conjugation.
The Steatocrit Test as a Guide in the Prevention of Cow's‐Milk Enteropathy Following Acute Infectious Enteritis
Authors: lacono Giuseppe , Carroccio Antonio , Alongi Angelo , Montalto Giuseppe , Cavataio Francesca , Comparetto Leonardo , Balsamo Vincenzo , Notarbartolo Alberto 
Published: January 2024

SummaryThis study was designed to evaluate the following in infants with acute enteritis (AE): the influence of different types of milk on the evolution of the acute phase of the diarrhea and whether the degree of steator‐rhea during the acute phase might be a risk factor for developing cow's milk enteropathy (CME). We studied 90 infants with AE, divided into three groups and refed differently after the acute episode: group A was refed using a semielemental formula; group B was refed using a milk containing soy proteins and vegetable oils; and group C was refed using a common cow's‐milk formula. Patients with pathological steatocrit values on hospitalization were randomly assigned to groups A and B; patients with normal steatocrit values were placed in group C. After 4 weeks, the patients included in groups A and B were challenged with cow's milk and their reactions were recorded. During the acute phase of the disease, we noticed a longer persistence of diarrhea in group A than in groups B (p < 0.01) and C (p < 0.0025). In addition, the number of evacuations per day and steatocrit values were higher in group A than in groups B or C, but these differences were not statistically significant. After 4 weeks, the patients in groups A and B were challenged with cow's milk, and eight of 60 patients had positive reactions; intestinal biopsy confirmed the diagnosis of CME. The mean age of these eight patients was 40.3 days. We conclude that the risk of CME development after an AE episode is inversely related to patient age and that severe steatorrhea during AE is an additional risk factor.
The Relationship Between Fecal Fat and Water in Very‐Low‐Birth‐Weight Infants
Authors: De Curtis Mario , Kempson Cara , Ventura Valerie , Carter Nick , McIntosh Neil 
Published: January 2024

SummaryMetabolic balances were carried out in nine preterm very‐low‐birth‐weight (VLBW) infants, five of whom were fed on expressed breast milk and four on a preterm formula. In 39 stool samples from these infants, there was a very close relationship between the fecal fat and the fecal water (r = −0.95; p < 0.001), independent of the type of feed. This relationship was present over a very wide range of fat and water contents. Validation experiments confirmed the reproducibility and reliability of this relationship. The correlation is clinically and experimentally so close that measurement of stool water by freeze‐drying a sample is an accurate indirect measure of fecal fat in VLBW infants when the daily stool weight was known.
Mesenteric Fibromatosis Presenting with Ascites in Childhood
Authors: Mecrow I. K. , Miller V. , Lendon M. , Doig C. M. 
Published: January 2024

SummaryA 7‐year‐old boy presented with acute ascites due to mesenteric fibromatosis. The pathophysiological mechanisms for formation of ascitic fluid and some aspects of the aetiology of intra‐abdominal fibromatosis and its association with Gardener's syndrome are discussed.
Increased Tight Junction Width in Two Children with Ménétrier's Disease
Authors: Oderda Giuseppina , Cinti Saverio , Cangiotti Angela Maria , Forni Marco , Ansaldi Nicoletta 
Published: January 2024

SummaryProtein‐losing enteropathy (PLE) and edema are usually the most prominent clinical features in children with Ménétrier's disease. However, the changes in gastrointestinal mucosa that can cause PLE have not been described yet in children. We studied by electron microscopy the mucosa of the gastric fundus, which is the site where macroscopic changes are most prominent, in two children with Ménétrier's disease. We found that tight junction width was increased to 10.5 ± 0.94 nm (mean ± 1 SD) in one child and to 9.7 ± 0.7 in the other. Tight junction width returned to normal when PLE and edema subsided. These ultrastructural changes were similar to those described in adults with the disease, although the clinical course of Ménétrier's disease is very different in adults and in children. Both patients showed evidence of cytomegalovirus (CMV) infection, as indicated by increasing IgG antibodies against the virus or recovery of the virus in the urine. Although Helicobacter pylori was found in the antral mucosa of one patient, the clinical course of the disease was not related to this microorganism. We conclude that increased tight junction width plays a role in PLE seen in Ménétrier's disease in children and that CMV, rather than Helicobacter pylori, is associated with the disease.
Effect of Vitamin E on Transport Processes in Isolated Rat Hepatocytes
Authors: Sokol Ronald J. , Devereaux Michael W. , Khandwala Rashmi A. , Narkewicz Michael R. , Sondheimer Neal J. 
Published: January 2024

Summary:Vitamin E deficiency is a common consequence of chronic cholestatic liver disorders. Inasmuch as vitamin E content of cellular membranes alters membrane properties such as fluidity and molecular order, we postulated that vitamin E status could affect hepatocyte transport processes dependent on membrane integrity. Hepatocytes were isolated from rats maintained on diets containing deficient, sufficient, or excess vitamin E. Cell viability and oxygen consumption were maintained in all groups of hepatocytes. Hepatocyte uptake of taurocholic acid and ouabain and Na+, K+ ‐ATPase activity estimated by rubidium‐86 influx did not differ with vitamin E status. Vitamin‐E‐deficient hepatocytes had increased generation of lipid peroxide products. We conclude that deficient or excess vitamin E status had little effect on selected transport processes in normal hepatocytes.
The Age‐Related Incidence of Meconium Ileus Equivalent in a Cystic Fibrosis Population
Authors: rbaek Andersen Henrik , Hjelt Karsten , Waever Elisabeth , Overgaard Karsten 
Published: January 2024

SummaryDuring the decade from 1976 to 1986, the age‐related incidence of meconium ileus equivalent (MIE) was calculated on the basis of 240 Danish cystic fibrosis (CF) patients. In the first 5 years, the patients were given enteric‐coated granules of pancreatic enzymes (Pancreatin, Rosco, Denmark), and a low fat diet was recommended. In the last 5 years, the Center recommended supplementation with acid‐resistent, enteric‐coated, encapsulated microspheres (Pancrease, Cilag, Birkerφd, Denmark), and high‐energy intake with a 40% fat content and no dietary restrictions. There was no difference in the incidence of MIE when these two 5‐year periods were compared, and the overall incidence of MIE was low (5.4 MIEs/1.000 patient years). This may, at least in part, be due to the rather high intake of exocrine pancreas enzyme supplementation (EPES) (a mean intake of 0.9 capsules/kg/day). MIE occurred almost exclusively among patients >15 years old and peaked in young adults aged 20–25 years (35.5 MIEs/1.000 patient years). The daily intake of EPES/kg of body weight declined significantly with age, and the patients who developed MIE received even less than average per day. Both of these points strengthen the view that a low enzyme dosage is likely to have an effect on the incidence of MIE.
Discriminant Carbohydrate Components of Human Milk According to Donor Secretor Types
Authors: Viverge Danide , Grimmonprez Louis , Cassanas Geneviève , Bardet Lucette , Solere Maryse 
Published: January 2024

SummaryBecause of the variability of human milk carbohydrate composition, we determined the discriminant carbohydrate components of the milk of 18 mothers according to their ABH and Lewis secretor types during the first week of lactation. Comparative chromatograms revealed that the presence of neuraminyloligosaccharides is linked to the ABH secretor groups, and that the absence of oligosaccharides with Lea or Leb specificity is linked to the Lewis nonsecretor types. The study of carbohydrate composition according to donor secretor types consisted of measuring 16 variables from 69 samples. Analysis of variance showed significant differences between groups: high levels of N‐acetylneuraminic acid and low levels of galactose distinguished ABH secretors from nonsecretors (p < 0.001). In the ABH secretor groups, A and H secretors had higher N‐acetylglucosamine contents than B and AB secretors (p < 0.001) and lower galactose levels (p < 0.001). The Lewis secretor groups were distinguished by significantly higher fucose levels (p < 0.001). The ABH(+)Le(a ‐ b ‐) group had higher lactose contents than the other groups (p < 0.01).
Pediatric HBsAg Chronic Liver Disease and Adult Asymptomatic Carrier Status
Authors: Zancan L. , Chiaramonte M. , Ferrarese N. , Zacchello F. 
Published: January 2024

SummaryUnlike adults (>60% of cases), it is rare to find the chronic hepatitis B virus (HBV) carrier status with normal transaminases among children. The aim of this study was to investigate whether this status would depend on the duration of HBV infection, that is, whether chronic hepatitis in childhood would lead to the asymptomatic carrier status in later life. We reexamined all of our patients with chronic HBV infection of >10 years' duration and with histologically documented chronic hepatitis during childhood. This was a group of 36 adolescents and young adults. All subjects were screened for tumor using α‐fetoprotein assay and hepatic ultrasound. Eight patients with cirrhosis underwent esophageal fiberoptic endoscopy. All patients were in good general condition, with no clinical signs of liver failure. Only two patients had abnormal transaminase levels, both of whom had evidence of delta infection. All but one patient became anti‐HBe positive. Five cases had HBsAg clearance. (Seventy‐one percent of patients were HBeAg positive and 14% anti‐HBe positive at the onset of the disease.) Hepatic ultrasound revealed no tumors in any of the subjects, and fiberoptic endoscopy demonstrated no esophageal varices. This study suggests that (a) chronic hepatitis and asymptomatic carrier status may be subsequent stages of the B virus infection; and (b) chronic hepatitis in childhood is generally benign and may evolve into an asymptomatic carrier status. The main problem with the chronic carrier status is probably the increased risk of hepatocellular carcinoma.
Disaccharidase Activities in Small Intestine of Rotavirus‐Infected Suckling Mice
Authors: Collins J. , Candy D. C. A. , Starkey W. G. , Spencer A. J. , Osborne M. P. , Stephen J. 
Published: January 2024

SummaryA histochemical study of the time course of the appearance and location of lactase and α‐glucosidase (used to detect sucrase and maltase) activities was carried out on control and rotavirus‐infected mice from 7 to 14 days old. The overall pattern of enzyme activity was in agreement with previous quantitative studies on the activities of these enzymes. No evidence was obtained to support the idea that lactase deficiency was the result of repopulation of villi (denuded of lactase‐producing villus cells) with immature lactase‐negative cells. Low lactase activity was more likely to reflect profound changes in metabolically crippled cells, and recovery of lactase activity with recovery of normal metabolic functions. The location of enzyme activity to brush border regions rather than the cytoplasm of villus enterocytes enhances the significance of previous quantitative studies on these enzymes. The timing and duration of diminished lactase activities were such that they were unlikely to cause the induction or perpetuation of diarrhea in murine rotavirus diarrhea. The appearance in infected animals of α‐glucosidase 3 days earlier than normal indicates that, in addition to reversible changes seen with lactase, developmental changes were accelerated that affected both crypt and villus cells.
Neonatal Duodenal Perforation
Authors: Miller Barnett M. , Kumar Ashok 
Published: January 2024

SummaryDuodenal perforation in neonates is uncommon, and has been described rarely in the third part of the duodenum. Gastrointestinal perforations without an obvious cause have been labeled as “spontaneous.” We report a case of perforation in the third part of the duodenum in a premature infant for which there was no obvious cause. In such “spontaneous” perforations, multi‐factorial etiology is likely and possible factors are discussed. The high mortality rate in such patients can be improved by early diagnosis and prompt resuscitation followed by surgery. Peritoneocentesis plays an important diagnostic role. It is also therapeutic in relieving the respiratory distress caused by free intraperitoneal air. The majority of duodenal perforations are amenable to primary closure at surgery and this should be the treatment of choice.
Pulse Oximetry and Upper Intestinal Endoscopy in Infants and Children
Authors: Bendig Donald W. 
Published: January 2024

SummaryInfants and children undergoing upper intestinal endoscopy were monitored by both pulse oximetry and chest EKG. Fifty‐seven patients between the ages of 6 weeks and 36 months underwent 60 flexible upper intestinal endoscopies. All patients received parenteral sedation only. All procedures were successfully performed without significant complications. In 53 of the patients there was only transient mild oxygen desaturation with introduction of the endoscope into the pharynx and upper esophagus. In contrast, in seven patients, oxygen desaturation to less than 90% was noted following sedation but prior to insertion of the endoscope without overt clinical evidence of complications. Oxygen administered by nasal cannula resulted in a return of the oxygen saturation to at least the preprocedural level and allowed for safe completion of the studies. With improved monitoring, the use of smaller, more flexible endoscopes, and more experience, routine general anesthesia in children <3 years of age, as recommended in the past, may not be mandatory. Pulse oximetry may be particularly useful as an early indicator of poor oxygenation and may provide an objective means to assess the need for supplemental oxygen and to determine the degree of postprocedural observation.
Risk Factors for Fatal Diarrhea in Hospitalized Children in India
Authors: Sachdev H. P. S. , Kumar Shiv , Singh K. K. , Satyanarayana L. , Puri R. K. 
Published: January 2024

SummaryThere is scant information on the risk factors for diarrheal deaths in developing countries. A prospective evaluation was therefore conducted on 382 consecutive children (<5 years of age), who were hospitalized with diarrhea. A complete profile, including outcome, was available for 357 patients, 37 of whom died (10.4%). In the univariate analysis, four factors were significantly associated (p < 0.02) with death: associated major infection {pneumonia, septicemia, or meningitis), severe wasting (±50% weight for age), severe stunting (±85% height for age), and protraction of illness (>14 days). In the multivariate analysis, all four factors retained their significance. The adjusted odds ratios (95% confidence interval) were 4.7 (3.9, 5.6), 3.3 (2.7, 4.0), 1.9 (1.6, 2.3), and 1.5 (1.3, 1.8), respectively. In addition, in children <19 months of age (n = 241; 29 deaths) breast‐feeding had a significant (p < 0.001) protective effect (adjusted OR—2.3, 95% CI—1.9–2.8). It is concluded that even in a setting with high diarrheal fatality rates, high‐risk children can be identified and targeted for intensive intervention.
The Development of the Gastrointestinal System in Fetal Sheep in the Absence of Ingested Fluid
Authors: Avila C. G. , Harding R. 
Published: January 2024

SummaryOur aim was to determine the effects of preventing the passage of ingested fluid on the development of the digestive tract in fetal sheep. The esophagus was fistulated and ligated in six fetuses at 90 days of gestation (term = 145 days); vascular catheters were implanted at day 120. Six control fetuses had vascular catheters implanted at day 120. At autopsy (day 135), although fetal body weights were similar in both groups, the abdominal girth and weights of the gastrointestinal tract, liver, and pancreas were reduced in experimental fetuses. In the gastric (abomasal) fundus and antrum, there was evidence of altered mucus composition in epithelial cells, a decrease in thickness of the muscularis externa, and an increase in thickness of the mucosa and its components. In the duodenum, there were significant changes in the thickness of most components of the wall; Brunner's glands were greatly reduced in size or were absent. Glandular cells contained less mucus in comparison to controls. In the proximal small intestine, there were significant reductions in the thickness of most components of the wall, and epithelial cell migration was retarded, resulting in a longer renewal time for villous cells. In the distal small intestine, the diameter of the intestine and submucosal and epithelial cell migration rate were significantly decreased in the experimental group. In summary, the absence of the passage of ingested fluid in fetal sheep restricts the growth and development of the gastrointestinal tract, liver, and pancreas.