bluuebunny/crossref_metadata_2025_split huggingface dataset:
Longitudinal Assessment of Growth, Mineral Metabolism, and Bone Mass in Pediatric Crohn's Disease
Authors: Issenman Robert M. , Atkinson Stephanie A. , Radoja Christine , Fraher Laurence 
Published: January 2024

SummaryIn children with inflammatory bowel disease, controversy continues about the use of long‐term alternate day prednisone therapy (ADP) to suppress disease activity and to encourage appetite and growth. One possible side effect of both disease process and prednisone therapy is risk of development of osteoporosis. To evaluate this risk factor, growth, biochemical indices of mineral and vitamin D status, and bone mass were measured in nine adolescents with Crohn's disease (CD) who were treated with ADP (0.3 mg/kg >3 months per year) compared with eight adolescents treated with minimal ADP exposure (<3 months per year). Single photon densitometry was used to measure bone mineral mass at the 1/3 distal radius three times over 2 years. Mean age of the 17 CD boys was 13.9 ± 2.1 years at baseline. CD patients had lower bone BMC/BW mineral content/bone width (BMC/BW) compared with age‐ and height‐matched normal boys at all times. The difference was less when compared to height‐matched normal values as CD patients were shorter than healthy reference boys. Plasma 1,25‐dihydroxyvitamin D, alkaline phosphatase, and parathyroid hormone significantly increased with treatment of disease but there were no differences between treatment groups. CD patients treated with ADP had similar heights and weights at baseline and demonstrated similar linear growth over 2 years (9.1 cm/2 years) to CD patients without ADP (10.3 cm/2 years). In both groups, BMC/BW increased significiantly from year 1 to year 2, but absolute values for bone mass did not differ between the groups. These data suggest that over a 2‐year treatment period male CD patients with chronic low‐dose ADP exposure achieve linear growth rates and maintain bone mineralization at least as well as male CD patients who do not receive ADP.
Comparative In Vitro and In Vivo Studies of Enteric‐Coated Pancrelipase Preparations for Pancreatic Insufficiency
Authors: Thomson M. , Clague A. , Cleghorn G. J. , Shepherd R. W. 
Published: January 2024

SummaryWe evaluated three acid‐resistant pancreatic enzyme preparations by in vitro assays, and by comparing degree of steatorrhea, creatorrhea, fecal wet weight, and stool energy losses in a randomized crossover study of patients with pancreatic insufficient cystic fibrosis. Aims of the study were to assess (a) the most practicable and reliable indicator of malabsorption; (b) the variation in enzyme batch potency; (c) the decline in enzyme batch potency with prolonged shelf life; and (d) the relative bioefficacy of the different preparations. In the in vivo study, absorption of energy, nitrogen, and fat did not differ when comparing the three preparations at roughly pharmaceutically equivalent doses, but when expressed per capsule of pancreatic supplement ingested, absorption reflected relative enzyme content, favoring the higher potency preparations. Although steatorrhea was reasonably controlled by these preparations, stool energy losses varied from 800 to 1,100 kJ per day, suggesting greater attention be paid to overall energy absorption rather than absorption of individual nutrients. In addition, fecal energy loss correlated more closely with fecal wet weight (r = 0.81; p < 0.05) than with steatorrhea (r = 0.40; ns), such that 1 g wet feces = 8.37 kJ (± 0.14). In vitro enzyme potency varied markedly between batches of the same brand, and also a decline of up to 20% in amylase, lipase, and trypsin activity was noted over an 8‐month period for each batch. Both observations have clinical implications at times of represcription. Finally, the higher potency preparations were more effective per capsule and reduced capsule dosage is therefore attainable.
Hypercalciuria in Premature Infants Receiving High Mineral‐Containing Diets
Authors: Abrams Steven A. , Yergey Alfred L. , Schanler Richard J. , Vieira Nancy E. , Welch Thomas R. 
Published: January 2024

Summary:We evaluated urinary calcium excretion in 21 premature infants fed either a formula containing high concentrations of calcium (Ca) and phosphorus (P) or human milk fortified with a commercially available human milk fortifier. Dual‐tracer stable‐isotope Ca absorption studies were performed on all infants. Urinary Ca excretion was not significantly related to Ca or P intake or true Ca absorption. The recovery of the orally administered tracer in the urine was used to evaluate the source of calciuria in study subjects. In almost all subjects, tissue‐derived (Fbu), rather than diet‐derived (Vou), Ca was the principal source of urinary Ca. Hypercalciuric subjects demonstrated greater Vbu and Vou than nonhypercalciuric subjects. Our data demonstrate that moderate hypercalciuria is common in premature infants whose diets are high in mineral content and that hypercalciuria is not related to inadequate mineral intake or Ca absorption but is related, instead, to losses of both tissue and dietary Ca.
Incidence and Duration of Breast‐Feeding of Ill Newborns
Authors: Hunkeler B. , Aebi C. , Minder Ch. E. , Bossi E. 
Published: January 2024

Summary:The many biological advantages of breast milk call for promoting breast‐feeding. The extent to which separation of ill newborns from their mothers negatively influences breast‐feeding is not known. By means of a written inquiry, we investigated the prevalence of exclusive, partial, and no breast‐feeding of 536 newborns hospitalized at a tertiary care neonatal center with no inborn patients. Three hundred twenty‐seven questionnaires were completed correctly. Fifty percent of the mothers eventually succeeded in exclusive breast‐feeding, 25% in partial breast‐feeding, and 25% never breast‐fed. The frequency of breast‐feeding was similar to the Swiss average for the first 4 months of life in healthy newborns and declined more rapidly thereafter. Univariate and multivariate statistical analyses have shown that the following conditions influence breast‐feeding negatively: gestational age ≤33 weeks, maternal age >25 years, and lower professional status of the father. Additionally, multivariate analysis revealed a promoting effect of previous breast‐feeding. Exclusive breast‐feeding has eventually been possible in half of the newborns who had initially been separated from their mothers due to illness. Knowledge of the conditions influencing breast‐feeding in such populations should help to promote breast‐feeding more specifically in tertiary neonatal centers.
Childhood Celiac Disease in Estonia
Authors: Uibo Oivi 
Published: January 2024

Summary:The incidence of celiac disease (CD) and the role of IgA‐class antigliadin antibody (AGA) determination in revealing new CD cases were studied in Estonia. Altogether 36 cases of CD in Estonian children were diagnosed from January 1976 through June 1992 by criteria recommended by the European Society for Paediatric Gastroenterology and Nutrition. A significant increase was observed in the incidence of CD in Estonia (from 1:25,130 live births during 1976–1989 to about 1:2,700 live births during 1990–1992), due mainly to the introduction of IgA‐class AGA determinations in an active search for celiac patients since 1990. A total of 29 IgA‐class AGA‐positive cases was revealed among 1,048 children screened, and 23 of them had CD. Thus, the results show a relatively low incidence of CD in Estonia compared to the figures in neighboring countries. However, the incidence will probably increase if a larger pediatric population can be screened for CD using IgA‐class AGA enzyme‐linked immunosorbent assay.
Influence of the Polyamine, Spermidine, on Intestinal Maturation and Dietary Antigen Uptake in the Neonatal Rat
Authors: Capano G. , Bloch K. J. , Schiffrin E. J. , Dascoli J. A. , Israel E. J. , Harmatz P. R. 
Published: January 2024

SummaryPolyamines appear to have an important role in postnatal growth of the rat intestine. In the present study, we examined the effect of spermidine on the maturation of the intestine and on its ability to exclude macromolecules. Two litters of Sprague‐Dawley rat pups were assigned to one of four experimental groups. These groups received, on Days 7, 8, and 9, either (a) saline by gavage; (b) spermidine, 0.9 mg (6 μmol) by gavage; (c) cortisone acetate, 3.5 mg i.p.; or (d) saline i.p. On Day 10, animals were fed by gavage with a mixture of bovine serum albumin (BSA; 2 mg/g) and the γ‐globulin fraction of mouse antiovalbumin (anti‐OVA) antiserum (1 mg/g) and were bled 4 h later. Intestinal tissues were processed for histologic examination, sucrase determination, and identification of neonatal intestinal Fc receptor (FcRn) by Western blot. Serum immunoreactive BSA (iBSA) and mouse IgG1 and IgG2a anti‐OVA antibodies were estimated by enzyme‐linked immunosorbent assay. Sucrase activity was elevated in cortisone‐ and spermidine‐treated compared to control rats. iBSA and anti‐OVA were significantly reduced in cortisone‐treated compared to control rats but were not diminished significantly in the spermidine‐treated animals. A decrease in the neonatal intestinal Fc receptor was apparent in the spermidine‐fed group; cortisone produced a large reduction in FcRn. Spermidine‐fed animals showed morphologic evidence of maturation, with loss of giant vacuoles in the distal intestine; cortisone did not produce significant changes in morphology. Thus, while spermidine, like cortisone, enhanced the appearance of the disaccharidase sucrase, it did not significantly reduce the uptake of BSA or IgG, which is usually observed in mature compared to immature animals. The reason for this dichotomy is not known.
Safety and Efficacy of a Rice‐Based Oral Rehydration Salt Solution in the Treatment of Diarrhea in Infants Less Than 6 Months of Age
Authors: Maulen‐Radovan Irene , Fernandez‐Varela Hector , Acosta‐Bastidas Mario , Frenk Silvestre 
Published: January 2024

SummaryThe safety and efficacy of a rice‐based oral rehydration salt (ORS) solution for the treatment of acute diarrhea in infants <6 months of age was compared to those of a standard glucose‐based ORS solution. A total of 97 infants aged 1–6 months who had a history of acute diarrhea for 120 h or less and showed signs of mild to moderate dehydration and no complications was recruited. Subjects were assigned to two treatment groups and received either standard glucose‐based ORS solution or rice‐based ORS solution until cessation of diarrhea. There was no significant difference between the two treatment groups with regard to the main outcome variables, including total stool output {84 [95% confidence interval (CI), 56–126] vs. 106 (95% CI, 76–148) g/kg}, total ORS solution intake [171 (95% CI, 149–197) vs. 187 (95% CI, 161–218) ml/kg], or duration of diarrhea (35 ± 31 vs 38 ± 32 h). In addition, the fact that there was no difference between treatment groups in the presence of reducing substances in the stools suggests that rice was digested and absorbed by these infants. The results of our study support the conclusion that for infants <6 months of age, rice‐based ORS solution is safe and as efficacious as standard glucose‐based ORS solution in the treatment of acute diarrhea.
Neonatal Infection Does Not Affect the Immunoreactive Trypsinogen Screening Test for Cystic Fibrosis
Authors: Wilson D. C. , Leslie H. , Edgar J. D. M. , Halliday H. L. , Dodge J. A. 
Published: January 2024

SummaryWe aimed to discover whether neonatal infection affected levels of the immunoreactive trypsin (IRT) assay, which is used as a screening test for cystic fibrosis. Forty babies who had clinical features suggesting infection had blood spot specimens for IRT taken at the same time as blood for culture. Of 27 babies believed clinically to have infection, 19 had positive blood cultures and eight had negative culture. In retrospect, 13 were not thought to have infection. The mean (SD) IRT results in these three groups were 15 (8), 11 (4), and 16 (6) μg/L, respectively. The mean (SD; range) IRT result for all 40 babies was 14 (7; 10–39). Not only did no babies have elevated IRT results at routine neonatal screening, but none have presented with clinical features suggestive of cystic fibrosis since hospital discharge. Neonatal infection does not appear to cause elevated IRT levels and should therefore not cause false‐positive results in mass neonatal screening.
Developmental Regulation of the Porcine Exocrine Pancreas by Glucocorticoids
Authors: Sangild P. T. , Westrom B. R. , Fowden A. L. , Silver M. 
Published: January 2024

SummaryThe possible role of Cortisol in development of the exocrine pancreas was investigated. In the first study, fetal pigs were removed from the uterus by caesarean section (pentobarbitone anesthesia) and the pancreas collected from 51 69 to 109‐day‐old fetuses (term = 114 % 2 days). Of these, 15 88 to 90‐day‐old fetuses had been infused subcutaneously for 6 days with either saline, adrenocorticotropic hormone or Cortisol (osmotic mini‐pumps implanted at 82–84 days). The pancreas was also removed from eight newborn pigs. Quantitative enzyme analysis showed that amylase and trypsin activities per milligram pancreatic protein increased toward term, correlated positively with fetal plasma Cortisol (p < 0.01) and were stimulated by Cortisol infusion (p < 0.05). In the second study, pigs were delivered by caesarean section 2–3 days before term (to circumvent the neonatal Cortisol surge) and injected intramuscularly with saline (n = 11), metyrapone (an inhibitor of Cortisol synthesis, n = 12), adrenocorticotropic hormone (n — 14) or Cortisol acetate (< = 6) during the postnatal period. At 6–7 days of age, adrenocorticotropic hormone‐ and Cortisol acetate‐treated pigs had higher concentrations of amylase and trypsin in pancreas than metyrapone‐treated pigs. The values in saline‐injected pigs were intermediate. By gel electrophoresis and subsequent incubation with enzyme substrates, protease E, chymotrypsin C, and cathodic trypsin were first detected at 6–7 days of age, and the activities (semiquantitative densitometry) appeared lower in metyrapone‐treated pigs than in pigs from other treatment groups. The results indicate that glucocorticoids stimulate the perinatal development of pancreatic enzymes in the pig. In species that have a relatively mature gut at birth (e.g., pig, human), developmental regulation by glucocorticoids may be most important in the period immediately before and after birth.
Low Bone Mineral Content and High Serum Osteocalcin and 1,25‐Dihydroxyvitamin D in Summer‐ Versus Winter‐Born Newborn Infants
Authors: Namgung Ran , Tsang Reginald C. , Specker Bonny L. , Sierra Rosa I. , Ho Mona L. 
Published: January 2024

SummarySeasonal differences in bone mineral indices have not been studied in newborn infants. In adults, indicators of bone metabolism may show seasonal variations. In postneonatal infants and possibly in adults, vitamin D metabolism shows seasonal variations. We hypothesized that in winter‐born infants, the bone mineral content is low and serum osteocalcin is high, related to increased bone turnover and high serum 1,25‐dihydroxyvitamin D [l,25(OH)2D]. We studied 246 healthy, term appropriate‐for‐gestation infants in winter (January through March; 140 children) and summer (July through September; 106 children). The bone mineral content (BMC) of the one‐third distal radius was measured before 3 days of age by photon absorptiometry. Significant seasonal differences were found: summer‐born infants had significantly lower BMC, higher serum osteocalcin and l,25(OH)2D, and lower serum total calcium than winter‐born infants. Seasonal differences in BMC remained significant after adjusting for race and sex. BMC was not correlated with serum biochemical measures. Thus, summer‐born newborn infants have low BMC and high serum osteocalcin and l,25(OH)2D than winter‐born infants; these findings are the opposite of adult findings. We suggest that seasonal effects on fetal bone operate especially in early pregnancy (‐6 months before birth) resulting in a “phase effect” and opposite findings from later life.
A Complex Biochemical Modulation of Intestinal Ion Transport in Rats Fed on High‐Fat Diets
Authors: Cartwright‐Shamoon J. M. , Dodge J. A. , McMaster C. 
Published: January 2024

SummaryThis study investigates the relationship between dietary fat and ion transport in rat intestine. Animals were fed isocaloric diets with high fat content as corn oil, evening primrose oil (Efamol), fish oil, Efamol/ fish oil, olive oil, coconut oil, and butter. A low‐fat (corn oil) diet was used in a control group. Biopsies of the small intestine from these animals were mounted in an Ussing chamber, and the intestinal mucosal to serosal ion transport was measured as short‐circuit current (SCC). The SCC was stimulated in rats fed on diets high in polyunsaturated fatty acids such as corn oil, Efamol, fish oil, and Efamol/fish oil. SCC was also stimulated in rats fed on diets high in monosaturated fatty acids such as olive oil. Animals fed on diets high in saturated fatty acids such as coconut oil and butter, on the other hand, showed an inhibition in the SCC. To determine whether the effect of membrane lipids was mediated by a differential effect on membrane receptor proteins, the response to secretogogue challenge was studied. Biochemical agents and secretogogues including acetylcholine, noradrenaline, dibutyryl‐cAMP, calcium ionophore A2318, and prostaglandin E2 were analysed and compared. These agents were able to influence the SCC, showing responses with marked differences between diet groups.
Fecal Excretion of Leukotriene C4 during Human Disease Due to Shigella dysenteriae
Authors: Cruz Jose R. , Cano Floridalma , Razin Ehud , Acheson David W. K. , Keusch Gerald T. 
Published: January 2024

SummaryFecal excretion of leukotriene C4 was determined in 26 individuals with dysentery and in 19 healthy controls. Of the patients, five were infected with Shigella dysenteriae type 1, 15 were infected with Shigella flexneri, two were infected with Shigella boydii, and four were infected with Shigella sonnei. Three of the healthy controls were infected with non‐dysenteriae Shigellae. All isolates of Shigella dysenteriae type 1 produced Shiga toxin; the other strains were not toxigenic. Patients with dysentery due to Shigella dysenteriae type 1 excreted higher concentrations of leukotriene C4 (median, 3,234 pg/0.05 g of feces) than either ill individuals infected with non‐dysenteriae Shigellae (median, 202 pg/0.05 g) or healthy carriers (median, 145 pg/0.05 g) and uninfected controls (median, 129 pg/0.05 g). We propose that Shiga toxin stimulates intestinal mast cells, which release leukotriene C4, contributing to the inflammatory response in Shigella dysenteriae type 1‐associated dysentery.
Endoscopic Ligation of Esophageal Varices in Children
Authors: Fox Victor L. , Carr‐Locke David L. , Connors Pamela J. , Leichtner Alan M. 
Published: January 2024

SummarySeven consecutive patients presenting acutely with suspected variceal hemorrhage underwent endoscopic variceal ligation (EVL) of esophageal varices. Active bleeding had ceased by the time of the initial EVL session in all patients, although active variceal hemorrhage was controlled by EVL in one patient during a sub‐sequent episode of bleeding. Treatment sessions were repeated at approximately monthly intervals until varices were reduced in size to grade 1 (<4 mm diameter) or eradicated. All patients had portal hypertension secondary to intrahepatic disease. Patient age ranged from 2.4 to 14.5 years (mean, 8.5 years). One patient underwent successful liver transplantation 1 week after the initial treatment session. The remaining six patients required a mean (±SD) of 4.0 ± 1.3 treatment sessions for elimination of varices. One episode of recurrent variceal hemorrhage and one episode of treatment‐related hemorrhage occurred in two separate patients. Transient, mild dysphagia or odynophagia occurred in all patients. No other complications were reported during a mean (±SD) follow‐up period of 13.8 ± 4.6 months (range, 8–20 months). Recurrent varices were seen in three of four (75%) patients returning for follow‐up endoscopy between 5 and 8 months from initial eradication. All underwent repeat EVL without complication. Endoscopic variceal ligation may be a suitable substitute for sclerotherapy in children with bleeding esophageal varices.
Characterization of Symptoms in Children with Recurrent Abdominal Pain
Authors: Hyams Jeffrey S. , Treem William R. , Justinich Christopher J. , Davis Patricia , Shoup Marie , Burke Georgine 
Published: January 2024

SummaryWe sought to prospectively characterize and compare the symptoms of children ≥ 5 years of age with recurrent abdominal pain to previously established criteria for irritable bowel syndrome (IBS) in adults. For all eligible subjects, a detailed questionnaire concerning characteristics of abdominal pain and defecatory pattern was completed at presentation. In addition, a battery of screening tests was performed and additional evaluation was done at the discretion of their physician. In all, 227 subjects fulfilled the entrance criteria, but 56 were sub‐sequently excluded because of diagnoses of inflammatory bowel disease (nine cases), lactose malabsorption (46 cases), or celiac disease (one case). Of the remaining 171 patients, 117 had IBS symptoms. In the IBS subjects, lower abdominal discomfort (p < 0.001), cramping pain (p < 0.0009), and increased flatus (p < 0.0003) were more common, whereas dyspeptic symptoms such as epigastric discomfort (p < 0.003), pain radiating to the chest (p < 0.009), and regurgitation (p < 0.02) were more common in the non‐IBS subjects. Our study not only confirms the clinical heterogeneity of children with recurrent abdominal pain but also concomitantly demonstrates that most children with this disorder have symptoms that fulfill the standardized criteria for IBS in adults. The identification of subgroups of children with recurrent abdominal pain can provide a framework for the diagnosis of functional bowel disease as well as establish the need for invasive and expensive tests.
Magnesium Status, Serum HDL Cholesterol, and Apolipoprotein A‐1 Levels
Authors: Nozue Tomio , Kobayashi Akio , Uemasu Fujio , Takagi Yasuo , Sako Akiko , Endoh Hiroomi 
Published: January 2024

SummaryTo determine the relationship between low magnesium status and lipids, we divided 27 patients with microscopic hematuria and normal renal function into two groups according to magnesium retention, as measured by a magnesium‐loading test, and compared their serum lipid and apolipoproteins. Patients with low magnesium status (n = 7) had significantly lower levels of cholesterol, HDL cholesterol, and apolipoprotein A‐1 than those with normal magnesium status (n = 20); however, there were no significant differences between the groups in serum concentrations of magnesium and apolipoprotein B. These data suggest that magnesium deficiencies are associated with low serum concentration of HDL cholesterol and apolipoprotein A‐1.