bluuebunny/crossref_metadata_2025_split huggingface dataset:
Carcinoma of the Colon in Children
Authors: Taguchi Tomoaki , Suita Sachiyo , Hirata Yuzo , Ishii Eiichi , Ueda Koji 
Published: January 2024

SummaryWe report a case of sigmoid colon carcinoma in a 14‐year‐old girl. She had been suffering from several nonspecific abdominal symptoms for about 1 year before a definite diagnosis was made. While undergoing an operation, the main tumor was found to be unresectable. She died of Candida‐induced septicemia on the 26th day after the operation. There have been 40 cases of colon carcinoma reported in the Japanese literature in patients 15 years of age or younger. We reviewed the 40 Japanese cases along with our case, and compared these to other children and adult studies. The prognosis is quite unfavorable in children because of the poor histological character and the delayed diagnosis. Serum carcinoembryonic antigen measurement might be one means for early diagnosis.
Breath Methane Excretion in Hong Kong Chinese Children
Authors: Leung D. T. Y. , Robertshaw A. M. , Tadesse K. 
Published: January 2024

SummaryThe factors which determine whether an individual is a methane excretor or a nonexcretor are not clearly understood. Genetic makeup, ethnic origin, diet, environment, or an interaction of all these factors have been implicated. In order to delineate the incidence, the age of onset, and environmental factors that may influence the excretion of methane in our community, we investigated a total of 425 Chinese children in Hong Kong (204 females, 221 males). End‐expiratory breath samples were collected after an overnight fast and measured by gas‐chromatography using a flame ionization detector. Thirty one children (7.3%) excreted at least 1 ppm methane above the ambient level (median = 6.4, range = 1.8–26.0 ppm). There was no difference in methane excretion status and pattern between the sexes or between children who lived at home and those who lived at an institution. There was a general increase in the number of methane excretors with age, but a statistically significant increase was reached only after 14 years of age. The amount of methane excreted was unrelated to age and there were no excretors detected under the age of 5 years. It is concluded that the methane excretion pattern of these children was generally similar to those previously reported from other regions, but the incidence is much lower and the age of onset appears to be more gradual.
Gastroesophageal Reflux with Drifting Onset in Infants
Authors: Sondheimer Judith M. , Hoddes Eric 
Published: January 2024

SummaryWe have characterized the gastroesophageal reflux (GER) episodes which occurred during sleep in 28 infants with pathologic gastroesophageal reflux and 10 symptomatic age‐matched controls without gastroesophageal reflux. We describe three kinds of episodes during the sleeping period‐awake episodes which occur completely during electroencephalogram (EEG)‐defined wakefulness associated with clinical evidence of the waking state (62 episodes), episodes occurring during EEG‐defined sleep which have a rapid drop in pH at their onset (119 episodes), and episodes occurring during EEG‐defined sleep in which the esophageal pH drifts down slowly over a period up to 30 min (113 episodes). Only 9 of the 10 control subjects experienced any reflux episodes during monitoring. The total number of episodes of reflux in controls (34) was less than the total number in reflux subjects (260). Controls did, however, experience all three types of reflux episode. Awake episodes all had a rapid drop in pH at their onset and were characterized by a short acid clearance time (2.0 ± 0.3 min in reflux patients and 1.0 ± 0.2 min in controls). The sleep episodes with rapid onset had longer mean acid clearance time than the awake episodes, significantly so in GER subjects (20.1 ± 6.8 min in reflux subjects and 2.6 +1.3 min in controls). Body movement was noted at the onset of 93.4% of rapid‐onset sleep episodes in reflux subjects and 88.9% in controls. Body movement was also common at the termination of rapid‐onset sleep episodes (77.8% of rapid‐onset episodes in reflux subjects and 80.0% in controls). The drift‐onset sleep episodes in GER subjects were characterized by a low frequency of body movements at their onset (body movement seen in 34.9% of drift‐onset episodes), a higher minimum pH (3.6 ±0.1 versus 2.8 ± 0.2 drift‐onset vs. rapid‐onset episodes), a tendency to start in the deeper EEG sleep stages when compared to rapid‐onset sleep episodes, and a decreased frequency of movement arousal. Mean acid clearance time of drift‐onset sleep episodes was similar to rapid‐onset sleep episodes in GER subjects (15.3 ± 6.1 min). Similar characteristics were noted in the few episodes of drift‐onset reflux observed in the control subjects except that drift episodes had significantly greater mean acid clearance time than rapid‐onset episodes (19.4 ± 9.9 min). We conclude that sleep reflux episodes with drifting onset are a significant part of total reflux occurring during the sleeping period. The similarities between rapid‐ and drift‐onset sleep episodes with respect to acid clearance time, and presence of movement at the termination suggests that the mechanisms of clearance of these two episodes may be similar. The differences in onset characteristics between these two episode types, however, suggests the possibility that they may be initiated by different mechanisms
Gastrointestinal Blood Loss in Older Infants
Authors: Fuchs George , DeWier Marianne , Hutchinson Sharon , Sundeen Mary , Schwartz Samuel , Suskind Robert 
Published: January 2024

SummaryConcerns that consumption of whole cow milk (WCM) by older infants may result in excessive gastrointestinal blood loss and subsequent iron deficiency led us to perform a prospective, randomized study in 104 infants. Infants were assigned to receive WCM beginning at 6 months or one of three formulas beginning at 4‐6 months of age and followed until 12 months of age. Gastrointestinal blood loss was similar for all groups, as determined by both qualitative (Hemoccult II) and quantitative testing (HemoQuant). There was no association between concentration of fecal hemoglobin and volume of WCM consumed or iron status by 12 months of age. Of eight infants (seven WCM, one formula) who became iron‐depleted, none had excessive fecal hemoglobin excretion. When pooled and analyzed regardless of feeding group, fecal hemoglobin increased with age and was greater at 11 and 12 months than at younger ages. We conclude that although infants fed WCM are at increased risk of developing iron depletion, the iron insufficiency is not due to gastrointestinal blood loss. We further conclude, based on our sample of normal infants age 4‐12 months, that fecal hemoglobin concentrations of 0.5‐0.8 mg/g stool correspond to the upper limits of normal, values much lower than in adults.
Helicobacter pylori‐Associated Gastritis in Kuwait
Authors: Radhakrishnan S. , Nakib B. Al , Kalaoui M. , Patric J. 
Published: January 2024

SummaryInformation is limited concerning the prevalence of Helicobacter pylori infection in asymptomatic children. Since January 1989, we have endoscoped 60 children for recurrent abdominal pain or for obtaining small‐intestinal biopsy (their ages were a mean of 6.6 (range 9 months‐13 years); there were 37 boys and 23 girls. Antral biopsies were obtained from all subjects and these were studied for the presence of gastritis and stained for H. pylori using modified Gram's stain. All biopsies were cultured for H. pylori. Children endoscoped for small‐intestinal biopsy (n = 18) were used for comparison. Of the 42 children who had abdominal pain, 24 snowed histological gastritis and 13 had H. pylori on microscopy (31% H. pylori associated gastritis). In the compared group, five showed histological gastritis, and all had H. pylori on microscopy (27.7%). Culture was positive in 15; sensitivity was 85.7%. Six children, three pairs of siblings, had H. pylori gastritis supporting environmental etiology. Two had coinfection with intestinal giardiasis. Seven children were treated with daily oral amoxycillin (50 mg/kg) and tinidazole (20 mg/kg) for 6 weeks. In 3 (42.3%) H. pylori colonization cleared with healing of gastritis and resolution of symptoms. These results indicate that H. pylori gastritis is equally prevalent in symptomatic and asymptomatic children (31 and 27.7%, respectively; p > 0.05) in our population. It seems that the combination of oral amoxycillin and tinidazole is a poor choice in the treatment of H. pylori associated gastritis in Kuwaiti children.
Down's Syndrome and Celiac Disease
Authors: Castro M. , Crinò A. , Papadatou B. , Purpura M. , Giannotti A. , Ferretti F. , Colistro F. , Mottola L. , Digilio M. C. , Lucidi V. , Borrelli P. 
Published: January 2024

SummaryPatients with Down's syndrome (DS) or celiac disease (CD) have altered immune systems. Autoimmune diseases have been described in both conditions; the coexistence of DS and CD has been occasionally reported, but a clear relationship has not been definitely established. In this study we determined IgA antigliadin antibodies (IgA‐AGA) in 155 children with DS, and the results were compared with those of the control groups formed by 320 children affected by upper‐respiratory tract infections and 115 children with gastrointestinal symptoms but with normal jejunal mucosa. High IgA‐AGA levels were found in 26% of DS patients, in 1% of the first control group and in 10% of the second control group. Such differences are statistically significant. Twenty‐one DS patients with high IgA‐AGA levels and gastrointestinal symptoms underwent jejunal biopsy, and total villous atrophy was found in seven of them (33.33%). HLA‐DR and ‐DQ antigens were also determined in 75 DS patients (20 with high and 55 with normal IgA‐AGA levels), and the percentages of the different phenotypes were compared in the two groups and with those of a control group. No statistically significant difference was found, but DR3, DR7, and DQ2 alleles were always present in DS patients with jejunal atrophy. Our study confirms the data reported in the literature about higher levels of IgA‐AGA in DS patients and the relatively high incidence of CD in this group of patients.
HBV Infection in Pediatric Liver Transplantation
Authors: Lykavieris Panayotis , Fabre Monique , Yvart Jeannine , Alvarez Fernando 
Published: January 2024

SummaryWhen hepatitis B virus (HBV) infection precedes orthotopic liver transplantation (OLT), an important issue is to avoid post‐OLT HBV infection of the transplanted liver. When HBV infection is found after OLT, the main objective is to prevent the complication of cirrhosis. A study of HBV infection in 162 liver‐transplanted children followed at Hôpital de Bicêtre is presented here. One hundred forty‐one of these children were completely vaccinated against HBV; 89% of them still disposed of protective titers of serum antibodies to hepatitis B surface antigen (anti‐HBs) (>10 IU/L) 6–60 months after OLT. Four children had a HBV‐associated liver disease that required OLT. In these children a passive immunoprophylaxis maintaining serum anti‐HBs levels >100 IU/L allowed three of them to remain free of serum hepatitis B surface antigen (HBsAg) and HBV‐DNA during follow‐up at 10, 20, and 36 months. Four other children have been found to be HBsAg+ after OLT, but it was not clear whether the source of HBV was a reactivation or a de novo infection. Low doses of cyclosporin and prednisone were administered, in order to avoid the complications of HBV infection. Liver needle biopsies in three of these patients 37, 42, and 46 months after OLT showed a moderate chronic active hepatitis and mild fibrosis. Immunostaining for HBs and hepatitis B core (HBc) antigens indicated active viral replication. In conclusion, this study showed that HBV‐associated liver disease is not a common indication for OLT in children; response to HBV vaccine is good in children with chronic liver disease; postvaccination anti‐HBs titers are not particularly affected by post‐OLT immunosuppression; post‐OLT immunoprophylaxis avoided HBV infection of the transplanted liver in most HBV‐infected children; and low immunosuppressive doses prevented rapid development of cirrhosis in HBV‐infected children.
The Diagnostic and Therapeutic Role of Endoscopic Retrograde Cholangiopancreatography in Children
Authors: Brown Christopher W. , Werlin Steven L. , Geenen Joseph E. , Schmalz Michael 
Published: January 2024

SummaryWe performed 121 endoscopic retrograde cholangiopancreatographies (ERCPs) in 92 patients (60 girls and 32 boys), aged 4 months to 19 years, as part of diagnostic evaluation for suspected pancreatic or biliary tract disease or as therapeutic intervention. ERCP was successful in 116 attempts. The most common indications were recurrent pancreatitis (35 children), nonresolving acute pancreatitis (20), unexplained elevated amylase or lipase (19), postcholecystectomy syndrome (14), and elevated biliary tract enzymes (12). One hundred and one ERCPs were performed for more than one indication. The most common findings included chronic pancreatitis (26 cases), pancreas divisum (14), dilated pancreatic duct (10), gallstones or sludge (8), and abnormal common bile duct (8). Complications were uncommon and usually minor. ERCP is a safe and helpful procedure in the evaluation of suspected pancreatic and biliary tract disease in children and frequently allows for nonoperative treatment of these disorders.
Zinc Supplementation in Very‐Low‐Birth‐Weight Infants
Authors: Friel James K. , Andrews Wayne L. , Matthew J. Derek , Long David R. , Cornel Anna M. , Cox Margaret , McKim Edna , O. Zerbe Gary 
Published: January 2024

SummaryInadequate zinc intake may lead to poor growth and developmental outcome in very‐low‐birth‐weight (VLBW; < 1,500 g) infants. Fifty‐two infants (mean birth weight, 1,117 287 g; mean gestational age, 29 ± 2.9 weeks) were randomly allocated to two groups. SUPP infants received a regular term formula plus zinc supplements (4.4 mg/L; final content, 11 mg/L); PLAC infants received the same formula plus placebo (final content, 6.7 mg/L). Infants started their formula at 1,853 ± 109 g, and consumed the formula for 6 months. All subjects were evaluated at 3, 6, 9, and 12 ± 0.75 months corrected‐for‐gestational‐age. At each evaluation, weight, length, and head circumference were measured, a Griffiths developmental assessment was performed, and a blood sample was taken. Higher plasma zinc levels (p < 0.05) were found in the SUPP group at 1 and 3 months, and improved linear growth velocity was found in the SUPP group over the study period for the whole group as well as for girls alone. Maximum motor development scores were higher (p = 0.018) in the SUPP (98 ± 10) than the PLAC (90 ± 8) group, indicating that increased zinc intake in early infancy may be beneficial to VLBW infants.
Slow‐Release 5‐Aminosalicylic Acid Therapy in Children with Small Intestinal Crohn's Disease
Authors: Griffiths A. , Koletzko S. , Sylvester F. , Marcon M. , Sherman P. 
Published: January 2024

SummaryPharmacologic agents effective in the treatment of Crohn's disease confined to the small intestine are limited. The therapeutic efficacy of oral mesalazine in small bowel inflammation, although theoretically promising, remains unproven. In an open‐labeled initial trial, timed‐release 5‐aminosalicylic acid (5‐ASA), administered al a daily dosage of 30.6 ± 9.0 mg/kg (mean ± SEM) to children with active Crohn's disease involving the small intestine, was associated with improvement on the Harvey index in six of 12 patients treated for 8.1 ± 3.9 weeks. In a subsequent prospective, double‐blind study 14 children, ages 9.3 to 16.1 years, with active Crohn's disease limited radiologically in the small intestine were randomized to receive either timed‐release 5‐ASA [50 mg/kg/day (maximum 3 g/day)] or placebo for 8 weeks. Following a 4‐week washout period, patients crossed over to receive the other study drug for a further 8 weeks. Six children completed the entire 20‐week trial. The van Hees index improved among patients receiving 5‐ASA for 8 weeks (Δ = ‐ 18 ± 6.4) but deteriorated among patients given placebo (Δ = + 14 ± 4.1) (p < 0.05). Mean Crohn's Disease Activity Index (CDAI) decreased marginally after 8 weeks of 5‐ASA treatment (Δ = ‐ 48 ± 38.2) but not with placebo (Δ = ‐ 3.0 ± 7.9) (p = 0.31). Of the eight noncompleters, more patients dropped out of the study because of lack of therapeutic response to placebo (n = 5) than to 5‐ASA (n = 2). No serious adverse clinical effects were observed during either trial, but one adolescent girl reported mild hair loss that was promptly reversed after the drug was discontinued. These results indicate that timed‐release 5‐ASA may be beneficial in the medical therapy of children with active small bowel Crohn's disease.
The Cyclic Vomiting Syndrome
Authors: Fleisher David R. , Matar Maria 
Published: January 2024

SummaryThis study reviews 71 patients who presented between 1968 and 1988 with recurrent, self‐limited episodes of nausea and vomiting separated by symptom‐free intervals and were diagnosed with cyclic vomiting syndrome (CVS). The length and symptomatology of episodes tended to be stereotyped and characteristic for each patient over time. The disorder may persist from months to decades. There is a coincident relationship between CVS, migraine, and irritable bowel syndrome. The differential diagnosis includes many diseases which may mimic CVS. Management involves a responsive, collaborative doctor‐patient relationship, sensitivity to stresses caused by the illness and to feelings and attitudes that may predispose to attacks, use of antiemetic agents to abort or shorten attacks, treatment of complications, and use of prophylactic agents in patients whose episodes are of sufficient frequency and severity to warrant their trial.
Autoimmune Hepatitis Associated with Anti‐Actin Antibodies in Children and Adolescents
Authors: Maggiore Giuseppe , Veber Florence , Bernard Olivier , Hadchouel Michelle , Homberg Jean Claude , Alvarez Fernando , Hadchouel Paul , Alagille Daniel 
Published: January 2024

SummaryThe clinical, biochemical, morphological, and evolutive features of autoimmune hepatitis associated with serum smooth muscle antibodies of anti‐actin specificity were retrospectively analyzed in 31 children and adolescents. Cirrhosis was present at diagnosis in all but six patients, including nine of the 12 diagnosed within 6 months from the onset. In 15 children, one or more associated diseases of an immune‐mediated mechanism were present, including chronic arthritis, sclerosing cholangitis, inflammatory bowel disease, and cutaneous vasculitis. All patients were treated with prednisone and azathioprine with normalization or improvement of liver function tests: 28 children are currently alive after a mean follow‐up of 4 years, 10 months. Treatment was inter rupted in four patients only. Two patients died of liver failure in spite of immunosuppressive therapy before the era of liver transplantation. In spite of prolonged therapy, five other patients ultimately required liver transplantation during adolescence or early adulthood. These results (a) further define a group of autoimmune hepatitis in children characterized by the presence of serum anti‐actin antibodies; (b) indicate that immunosuppressive therapy improves liver function, although in most cases it must be continued for a long period to maintain remission; and (c) suggest that progressive liver failure may occur in early adulthood and may require liver transplantation.
Acute Segmental Obstructing Enteritis in Children
Authors: Lee Hung‐Chang , Huang Fu‐Yuan , Hsu Chyong‐Hsin , Sheu Jin‐Cherng , Shih Shin‐Lin 
Published: January 2024

Summary:We studied a group of 15 children with acute segmental enteritis associated with intestinal obstruction. The disease is characterized by fever, leukocytosis, copious bilious vomiting, and severe abdominal pain with signs of intestinal obstruction. Exploration revealed varying degrees of segmental ischemic change in the small bowel, but surgery seemed to be unnecessary in most cases. Antibiotics were effective in nonoperative cases. The clinical illness lasted 10–14 days. The disease was self‐limited, and no mortality was found in our series. To our knowledge, this is the first report of this disease entity in Chinese children.
Enteroaggregative Escherichia coli
Authors: Chan K. N. , Phillips A. D. , Knutton S. , Smith H. R. , Walker‐Smith J. A. 
Published: January 2024

Summary:Enteroaggregative Escherichia coli (EAggEC) has been found to be associated with acute and persistent diarrhoea in children in developing countries. Its clinical significance in developed countries has not been examined in much detail. In a survey of faecal samples from children with diarrhoea presenting to a children's hospital in East London between August and December 1988, EAggEC strains were isolated in 8 of 297 (2.7%) consecutive stool samples collected from 289 children and in 5 of 34 typed E. coli isolates during 1988. Of the 13 children found to be excreting EAggEC, 8 had acute diarrhoea and 5 had chronic diarrhoea of more than 14 days' duration; 5 children had mixed infections. Compared to other organisms found during the same period, EAggEC were isolated as frequently as many other better‐known pathogens such as enteropathogenic E. coli, Campylobacter, Salmonella, Shigella, Giardia lamblia, and Cryptosporidium. We conclude that EAggEC may be an important pathogen in developed countries.
Fortification of Human Milk
Authors: Moro G. E. , Minoli I. , Ostrom M. , Jacobs J. R. , Picone T. A. , Räihä N. C. R. , Ziegler E. E. 
Published: January 2024

SummaryHuman milk fed to very‐low‐birth‐weight infants must be fortified with protein, minerals, and vitamins. We tested a new fortification regimen in which the amount of fortifier was adjusted on the basis of frequent determinations of serum urea nitrogen (SUN). A newly formulated fortifier based on bovine milk proteins was employed either in the new fashion (regimen ADJ) or in the conventional fixed proportion (regimen FIX). Using the fixed proportion, the study also compared the new fortifier with a fortifier based on human milk protein (regimen HMP). Twelve infants were studied with each of the three regimens; nearly all completed 3 weeks of study. Protein intake was generally higher in ADJ than FIX; the difference was significant (p < 0.01) during week 2. Weight gain was somewhat (but not significantly) greater in regimen ADJ (32.3 g/d or 18.8 g/kg/d) than in regimen FIX (30.0 g/d or 18.3 g/kg/d). SUN was higher in ADJ than in FIX, and several other serum chemical values (calcium, phosphorus, potassium) tended to be higher, probably reflecting higher intakes of these nutrients with ADJ than with FIX. Plasma concentrations of several amino acids were higher in ADJ than FIX, but none, including threonine, were outside the physiological range. In comparing regimen FIX to regimen HMP, infants on FIX received similar intakes of protein and showed slightly but not significantly more rapid weight gain. Concentrations of SUN were lower with FIX, but other serum chemical values, including amino acids, were generally similar to HMP. We conclude that use of the new adjustable fortification regimen is feasible and safe and that it should be studied further. It produced the expected increases in nutrient intakes and growth. The new bovine milk‐based fortifier appears to be equivalent to the human milk‐based fortifier.