bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dexamethasone Changes the Composition of Insulin‐like Growth Factor Binding Proteins in the Newborn Mouse Ileum
Authors: Gordon Phillip V. , Moats‐Staats Billie M. , Stiles Alan D. , Price Wayne A. 
Published: January 2024

ABSTRACTBackgroundEarly postnatal glucocorticoid exposure accelerates the maturation of the bowel mucosa but results in bowel wall thinning in the newborn mouse ileum and increases the risk of focal ileal perforation in extremely premature infants. We have previously demonstrated a redistribution of insulin‐like growth factor‐I (IGF‐I) from the submucosa in control animals to the distal villi of those treated with early postnatal dexamethasone, implicating IGF‐I as an important mediator of dexamethasone's capacity to alter tissue growth. To investigate the possibility that IGF binding proteins (IGFBPs) might contribute to this process, we characterized the localization and abundance of IGFBP peptides and mRNAs in the same model.MethodsNewborn mice received daily intraperitoneal injections of dexamethasone (l μg/g) or phosphate‐buffered saline and then were euthanized on day 3 of life. Their ileums were harvested and prepared for microscopy. Tissue sections of ileum from both treatment conditions were processed in parallel for immunolocalization of each of the six IGFBP peptides and for in situ hybridization of each of the six IGFBP transcripts.ResultsTranscripts for IGFBP‐1, ‐2, and ‐3 were highly abundant and ubiquitous the ileal mucosa, whereas transcripts for IGFBP‐4, ‐5, and ‐6 were less abundant in epithelial cells. There were no differences in abundance between control and dexamethasone‐treated ileum with regard to mRNA localization or abundance for IGFBP‐1, ‐2, ‐3, and ‐6. In contrast, mRNA transcripts for IGFBP‐4 and ‐5 were modestly increased with dexamethasone treatment (although only IGFBP‐4 was significant). Strikingly different patterns of IGFBP immunolocalization were observed between control and dexamethasone‐treated animals. IGFBP‐1, ‐2, ‐3, and ‐5 were not detected in control ileum, whereas IGFBP‐4 and ‐6 were both present in the mucosa. In contrast, dexamethasone treatment resulted in dramatic mucosal increases in IGFBP‐2, ‐3, ‐4, and ‐5, paralleling the changing distribution of IGF‐I that we previously reported.ConclusionTaken together, these findings further implicate the IGF system as an important participant in dexamethasone‐induced maturation in the newborn mouse ileum.
Disaccharidase Activities in Dyspeptic Children: Biochemical and Molecular Investigations of Maltase‐Glucoamylase Activity
Authors: Karnsakul Wikrom , Luginbuehl Ursula , Hahn Dagmar , Sterchi Erwin , Avery Stephen , Sen Partha , Swallow Dallas , Nichols Buford 
Published: January 2024

ABSTRACTBackgroundMaltase‐glucoamylase enzyme plays an important role in starch digestion. Glucoamylase deficiency is reported to cause chronic diarrhea in infants, but its role in dyspeptic children is unknown.MethodsGlucoamylase and other disaccharidase specific activities were assayed from duodenal biopsy specimens in 44 children aged 0.5–18 years (mean, 10 ± 5 years) undergoing endoscopy to evaluate dyspeptic symptoms. All subjects had normal duodenal histology. Intestinal organ culture was used to evaluate synthesis and processing of maltase‐glucoamylase. Sequencing of the maltase‐glucoamylase coding region was performed in subjects with low activity or variation of isoform in organ culture.ResultsTwenty‐two of the dyspeptic children had one or more disaccharidases with low specific activity. Twelve subjects (28%) had low activity of glucoamylase. Eight subjects had low activities of glucoamylase, sucrase, and lactase. Low glucoamylase activity was not correlated with the isoform phenotype of maltase‐glucoamylase as described by metabolic labeling and sodium dodecyl sulfate electrophoresis. Novel nucleotide changes were not detected in one subject with low glucoamylase activity or in two subjects with variant isoforms of maltase‐glucoamylase peptides.ConclusionTwelve of 44 dyspeptic children had low specific activity of duodenal maltase‐glucoamylase. Eight of these children had low specific activity of all measured disaccharidases.
Antimicrobial Prophylaxis for Gastrointestinal Procedures: Current Practices in North American Academic Pediatric Programs
Authors: Snyder John , Bratton Barbara 
Published: January 2024

ABSTRACTBackgroundGuidelines for the use of antibiotic prophylaxis in children are based on a small number of studies that assess the risk of infection associated with performing endoscopic procedures. The American Heart Association (AHA) and the American Society of Gastroenterological Endoscopy (ASGE) have established guidelines that identify conditions and procedures that place a child at greater risk for infectious complications. Because data on bacteremia and sepsis associated with endoscopy in children are very limited, we reviewed the practices of 15 large academic pediatric gastroenterology services to see if patterns of practice and safety could be determined.MethodsA questionnaire was sent to 15 academic gastroenterology centers in the United States and Canada asking about antibiotic prophylaxis for endoscopic procedures for children with six conditions. These included three conditions related to congenital heart disease based on negligible, moderate, and high risk for endocarditis; immune compromise; the presence of a central venous line; and the presence of a ventriculo‐peritoneal shunt. Six procedures were evaluated, including esophagogastroduodenoscopy with biopsy, flexible sigmoidoscopy or colonoscopy with biopsy, endoscopic retrograde cholangiopancreatography, esophageal sclerotherapy, esophageal dilation, and percutaneous endoscopic gastrostomy (PEG) tube placement.ResultsThe patterns of reported practice generally conform to the AHA and ASGE guidelines. The six conditions and six procedures yielded 36 response categories for the participating centers. The majority of centers reported routine use of antibiotic prophylaxis in about half (17) of the response categories, which represented three distinct situations. These included children with congenital heart disease having moderate or high risk for bacterial endocarditis for almost all procedure categories and children undergoing PEG tube placement regardless of underlying condition. In all other combinations of underlying conditions and procedures, the majority of centers did not use routine prophylaxis. The majority of centers did not use antibiotic prophylaxis for cardiac conditions with a negligible risk of infectious complication or for children with immunocompromise, central venous lines, or ventriculo‐peritoneal shunts for any procedure except PEG placement.ConclusionsThese results indicate that the routine use of antibiotic prophylaxis is limited in pediatric academic centers to a few very specific conditions and procedures. The results also provide indirect evidence that the risk of infectious complications associated with endoscopic procedures appears to be exceedingly low.
Prevalence of Factor V G1691A (Leiden), Prothrombin G20210A, and Methylene Tetrahydrofolate Reductase C677T Thrombophilic Mutations in Children With Inflammatory Bowel Disease
Authors: Kader Howard A. , Berman Wallace F. , Al‐Seraihy Amal S. , Ware Russell E. , Ulshen Martin H. , Treem William R. 
Published: January 2024

ABSTRACTBackgroundPatients with inflammatory bowel disease (IBD) have an increased incidence of thromboembolic events. This risk may be caused by an increased frequency of thrombophilic mutations such as factor V Leiden G1691A (FVL), prothrombin G20210A (PT), or methylene tetrahydrofolate reductase C667T (MTHFR). Prevalence rates of heterozygous mutations in FVL, PT, and MTHFR are reported for whites (1.8%, 1.3%, 26.6%, respectively), blacks (0.8%, 0.3%, and 12.4%, respectively), and Hispanics (1.2%, 2.4%, and 41.5%, respectively). We sought to determine the prevalence of these thrombophilic mutations in a large cohort of children with IBD.MethodsChildren aged 21 years or younger with IBD were genotyped for FVL, PT, and MTHFR mutations by polymerase chain reaction amplification and restriction enzyme digestion. Prevalence rates were compared with established rates in the respective populations.ResultsOf 92 patients enrolled, 89 (62 with Crohn disease, 24 with ulcerative colitis, and 3 with indeterminate colitis) had genotype results available. The mean age was 13.3 ± 4.2 years (range, 2–21 years). Statistical analysis was performed on 89 FVL, PT, and MTHFR allele pairs. Polymerase chain reaction genotyping identified 5 patients with heterozygous FVL mutations, 3 patients heterozygous for the PT mutation, and 36 patients heterozygous and 4 patients homozygous for the MTHFR mutation. The thrombophilic allele mutation frequencies in our sample were not significantly different from predicted weighted average values: FVL, 2.8% versus 1.5%; PT, 1.7% versus 1.1%; and MTHFR, 24.7% versus 24.4%. In 24 patients with a family history of thrombosis, 1 was heterozygous for FVL and for MTHFR, 1 was heterozygous for FVL and homozygous for MTHFR, 2 were heterozygous for PT, and 9 were heterozygous MTHFR. There was no significant correlation between family history of thrombosis and presence of a thrombophilic mutation. The four patients with homozygous mutations for MTHFR, two of whom also were heterozygous for FVL, did not have either a personal history of thrombosis or a family history of thrombotic events. Two patients had thrombotic events without mutations in these genotypes: one had protein S deficiency and the other had no identifiable cause.ConclusionsThe presence of genetic mutations that predispose to hypercoagulable states does not appear to correlate with the prevalence of IBD or to thromboembolic events in patients with IBD. There was no statistical difference between the proportions of the mutated allele frequency in our study patients and the general population.
Slight Decrease in Bone Mineralization in Cow Milk–Sensitive Children
Authors: Hidvégi Edit , Arató András , Cserháti Endre , Horváth Csaba , Szabó András , Szabó Antal 
Published: January 2024

ABSTRACTBackgroundPatients with cow milk allergy (CMA) are potentially at risk for osteopenia because their milk‐free diet usually contains a low calcium content. In our study, different parameters of bone mineralization in children with CMA were investigated.Patients and MethodsTwenty‐seven CMA patients (mean age, 4.3 years; range, 3–8 years) were enrolled in the study. During a mean milk‐free diet period of 11.8 months, children were fed extensively hydrolyzed or soy‐based formulas. After a milk challenge test, 7 patients showed allergic symptoms, and the other 20 children had transient CMA. From the sera of all patients, the levels of sodium, potassium, chloride, calcium, phosphate, and magnesium ions, as well as alkaline phosphatase (AP), parathyroid hormone (PTH), osteocalcin, and beta‐crosslaps, were determined. These values were compared with those of 20 healthy age‐matched controls. Bone mineral density was measured as well.ResultsThe AP and PTH concentrations were higher in CMA patients than in the control group (AP: 610.2 U/L vs. 499.7 U/L, P < 0.01; PTH: 1.56 pmol/L vs. 0.83 pmol/L, P < 0.03), but all values were in the normal range. The osteocalcin concentration was similar in both groups, and the beta‐crosslaps concentration was lower in CMA patients than in controls (0.92 vs. 1.47 ng/mL, P < 0.001). The mean Z score of bone mineral density in patients with CMA was −0.6. In 10 cases, the Z score was less than the −1 SD value. On the basis of the Z score, CMA patients were divided into two groups. The PTH concentration was significantly elevated in the group with lower Z score (2.24 pmol/L vs. 1.16 pmol/L;P < 0.03).ConclusionThe results suggest that, in children with CMA who are on a cow milk–free diet, slight disturbances of bone mineralization can be observed by osteodensitometry.
Helicobacter pylori Seropositivity among Adolescents in Novosibirsk, Russia: Prevalence and Associated Factors
Authors: Reshetnikov Oleg V. , Denisova Diana V. , Zavyalova Larisa G. , Häivä Veli‐Mies , Granberg Christer 
Published: January 2024

ABSTRACTObjectivesWe have reported previously that Helicobacter pylori infection is widespread among adults in Siberia, in whom prevalence rates range from 70% to 90%. The present study was undertaken to determine the seroprevalence of H. pylori infection and its relation to social factors in a community‐based population of adolescents in Novosibirsk, Western Siberia.MethodsAll students in forms 9 to 11 of four randomly selected secondary schools participated. A total of 423 students (180 boys, 243 girls; age, 14–17 years) completed structured questionnaire concerning their lifestyle, and sera were tested for H. pylori using enzyme‐linked immunosorbent assay (Pyloriset®–New EIA‐G; Orion Diagnostica, Finland). Personal information, including parental history, educational level, occupation, and smoking habits, were collected via a questionnaire.ResultsOverall, the seroprevalence of H. pylori infection was 56.3%. Age, sex, smoking, alcohol consumption, number of children and pets in the household, and family history of gastric diseases were not associated with H. pylori positivity. The predictors of infection were dwelling without running hot water supply and sewage (odds ratio [OR] = 2.4; 95% confidence interval [CI], 1.2–4.8), father's occupation as a manual worker (OR = 2.7; 95% CI, 1.5–5.0), mother's occupation as a manual worker (OR = 1.8; 95% CI, 1.0–3.0), father's lower educational attainment (OR = 2.1; 95% CI, 1.2–3.6), and father's smoking (OR = 1.8; 95% CI, 1.1–3.2).ConclusionsThe prevalence of H. pylori seropositivity among adolescents in Russia is higher than in developed countries. The infection is associated with lower socioeconomic status.
Cardiopulmonary Compromise Associated With Milk and Molasses Enema Use in Children
Authors: Walker Melanie , Warner Brad W. , Brilli Richard J. , Jacobs Brian R. 
Published: January 2024

ABSTRACTObjectiveConstipation is a common childhood problem that frequently confronts pediatric practitioners. When enema treatment is indicated to treat constipation, milk and molasses enemas are sometimes used. Side effects and adverse outcomes have been described with many types of enemas, but not with milk and molasses. The purpose of this study is to describe five children who acutely decompensated after receiving milk and molasses enemas.MethodsRetrospective review of the medical records of children with constipation who received milk and molasses enema with subsequent PICU admission at Cincinnati Children's Hospital Medical Center between 1994 and 2000.ResultsFive children developed significant hemodynamic deterioration after receiving milk and molasses enemas. One of these children died and the others recovered after aggressive resuscitation.ConclusionsMilk and molasses enema administration can be associated with significant hemodynamic compromise. These risks appear similar to those risk observed with the use of other enema preparations.
Helicobacter pylori in Children and Adolescents: Increase of Primary Clarithromycin Resistance, 1997–2000
Authors: Crone J. , Granditsch G. , Huber W.‐D. , Binder C. , Innerhofer A. , Amann G. , Hirschl A. M. 
Published: January 2024

ABSTRACTBackgroundThe authors evaluate the prevalence of Helicobacter pylori resistance in 117 children and demonstrate the changes over a 4‐year period.MethodsIn 117 children and adolescents, H. pylori‐positive gastritis was revealed by diagnostic upper endoscopy. Biopsies from the antrum and body of the stomach were tested by histology, urease test, and culture. H. pylori was isolated using standard culture techniques, and susceptibility to amoxicillin, clarithromycin, and metronidazole was tested using the E‐test (AB‐Biodisk, Sweden).ResultsEndoscopy revealed gastric ulcers in 2 of 117 subjects, duodenal ulcers in 6 of 117, and erosive gastritis or duodenitis in 23 of 117. Almost all patients showed antral nodularity. Histology always showed chronic gastritis with different degrees of activity. During the 4‐year study period, the authors noticed an increase of primary clarithromycin‐resistant H. pylori strains, from 14.3% to 27.6% (mean, 20.3%). Metronidazole resistance varied between 5% and 25%. No resistance to amoxicillin was found.ConclusionEradication of H. pylori should take place only after testing of susceptibility. The general use of clarithromycin in children should be restricted to better‐defined indications. Resistance to clarithromycin of H. pylori may also become a future problem for the treatment of adults.
Detection of Small Bolus Volumes Using Multiple Intraluminal Impedance in Preterm Infants
Authors: Peter Corinna S. , Wiechers Cornelia , Bohnhorst Bettina , Silny Jiri , Poets Christian F. 
Published: January 2024

ABSTRACTBackgroundMultiple intraluminal impedance (MII) is a new technique that allows detection of reflux and swallows via changes in impedance caused by a liquid bolus inside the esophagus. The method is independent of pH. The authors studied the ability of this technique to detect the small bolus volumes potentially occurring in young infants.MethodsTen preterm infants (median gestational age at birth, 33 weeks; range, 25–36 weeks; age at study, 9 days; range, 2–39 days) underwent 10 instillations each of 0.1 mL to 0.5 mL saline while MII was recorded via a 2.4‐mm nasogastric catheter. MII signals were analyzed for swallows, defined as a decrease in impedance starting within 1 minute. From the liquid instillation in the most proximal channel and extending downward, impedance changes during these induced swallows were compared with those occurring during spontaneous swallows.ResultsAll 100 liquid instillations resulted in a typical impedance pattern, occurring after a median interval of 4.4 seconds (range, 1.8–8.9 seconds). The decrease in impedance was more pronounced than after spontaneous swallows (30% vs. 24%, P < 0.03) and extended downward more rapidly (12.3 cm/s vs. 5.8 cm/s, P < 0.01).ConclusionBolus transport of small liquid volumes can be detected via MII.
Gastrostomy in Infants With Neonatal Pulmonary Disease
Authors: Guimber D. , Michaud L. , Storme L. , Deschildre A. , Turck D. , Gottrand F. 
Published: January 2024

ABSTRACTObjectiveTo report our experience of enteral feeding via gastrostomy in children with severe chronic neonatal lung disease, failure to thrive, and oral aversive behavior after initial hospitalization.PopulationThirteen patients were studied. All children had chronic lung disease of neonatal onset and were severely malnourished. They received enteral nutrition via a gastrostomy at a median age of 13 months (range: 8–35).ResultsZ‐scores for weight‐for‐height increased significantly, from −3.4 to −1.9 after four months of enteral nutrition. Caloric intake increased significantly from 100% to 140% of the recommended daily allowance for age. Pulmonary status remained stable for all patients and oxygenation was normal. There was an aggravation of oral aversive behavior in 7 of the 13 children, especially those children who were ventilated and hospitalized for a long time (median duration: 195 days). The median follow‐up of patients after gastrostomy was 30 months (range: 8–54) and only six patients could be weaned from enteral nutrition.ConclusionEnteral nutrition via gastrostomy is efficient, and provides the means to improve caloric intake and nutritional status. Gastrostomy is a safe and convenient technique that should be considered early in the course of treatment for infants presenting with malnutrition related to neonatal pulmonary disease.
Prevalence of Celiac Disease and Follow‐up of EMA in Children and Adolescents With Type 1 Diabetes Mellitus
Authors: Crone J. , Rami B. , Huber W. D. , Granditsch G. , Schober E. 
Published: January 2024

ABSTRACTBackground:The prevalence of celiac disease (CD) in children with diabetes mellitus type 1 (DM) is significantly higher than in the nondiabetic population. Most patients with DM and associated CD do not experience typical gastrointestinal symptoms of CD. There is no agreement on the necessity of screening and management of silent CD for patients with DM or on the time scale for screening. Only few data on follow‐up evaluation of children with DM and CD‐related antibodies are available.Methods:One hundred fifty‐seven patients with DM (mean age, 14.8 years; range, 4‐21 years; male, 83) were screened with endomysial antibodies (EMA) between 1993 and 2001. A follow‐up period of at least 3 years, with at least 2 EMA measurements, was possible. Group 1 comprised 37 patients whose first measurement was at the onset of DM. Group 2 comprised 120 patients whose first measurement was during the course of the disease. In patients with positive EMA, small bowel biopsy was performed. Thyroid peroxidase (TPO), thyroglobulin (TgA), glutamate decarboxylase (GAD), antiinsulin (IAA), and islet cell antibodies (IA2) were measured in all patients.Results:EMA was positive in 16 patients, in 5 at onset of DM and in 11 during the course of DM (mean duration, 33.6 months; range, 11‐105 months). Biopsy results showed normal mucosa in seven patients, increased intraepithelial lymphocyte counts in one, and flat mucosa in eight. There was no significant difference between EMA‐positive and EMA‐negative patients regarding height, weight, HbA1c level, frequency of hypoglycemia or hyperglycemia, TPO, TgA, GAD, IAA, or IA2.Conclusion:This study emphasizes the high prevalence of CD in patients with DM. Although several patients already had positive EMA titers at the onset of DM, seroconversion may also occur during the course of the disease. Screening for CD with EMA or tissue transglutaminase should be included in the initial investigation of DM, but should also be repeated over time to detect late seroconversion. JPGN 37:67‐71, 2003.
Increased Levels of Bovine Serum Albumin Antibodies in Patients With Type 1 Diabetes and Celiac Disease‐Related Antibodies
Authors: Rodríguez‐Juan Cristina , Sala‐Silveira Lucía , Pérez‐Blas Mercedes , Valeri Anna P. , Aguilera Noemí , López‐Santalla Mercedes , Fuertes Ana , Martín‐Villa José M. 
Published: January 2024

ABSTRACTObjectivesTo detect the presence of antibodies against bovine serum albumin in a cohort of Spanish patients with type 1 insulin‐dependent diabetes.MethodsAntibodies were measured using an in‐house enzyme‐linked immunosorbent assay test in 80 patients with type 1 diabetes, subdivided according to the presence or absence in their serum of celiac disease‐related antibodies. For comparison, 30 patients with celiac disease (nondiabetic), 13 patients with autoimmune thyroiditis, and 45 healthy volunteers were used.ResultsThirty‐one percent of patients with diabetes yielded a positive result, with a mean value of 26.1 ± 21.8 arbitrary units (AU). If the group was split into those with celiac disease‐related antibodies and those lacking them, the percentages were 53% and 25%, respectively, with a mean value of 39.6 ± 28.4 AU and 22.4 ± 18.3 AU (P = 0.003), respectively. Seventy‐three percent of celiac patients showed bovine serum albumin antibodies with a mean level of 38.8 ± 27.7 AU, comparable to that of patients with diabetes with celiac antibodies, but higher than the group lacking them (P = 0.001). Although 46% of patients with autoimmune thyroiditis had positive results, the level detected (22.1 ± 8.7 AU) was significantly lower than that recorded in patients with type 1 diabetes who had celiac disease antibodies (P = 0.04) and celiac patients (P = 0.04). Healthy volunteers showed no antibodies against bovine serum albumin.ConclusionsThese data suggest that bovine serum albumin antibodies appears in patients with a compromised epithelial permeability, and they reflect a general defect in the process of immunologic tolerance associated with a predisposition to autoimmunity, rather than immunity specific to β cells.