bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intra‐ and Interexaminer Reliability of Anthropometric Measurements of Term Infants
Authors: Johnson Teresa S. , Engstrom Janet L. , Gelhar Debra K. 
Published: February 2024

Background:The reliability of anthropometric measurements of term infants has not been studied sufficiently to determine if these measurements are reliable enough to be used in clinical practice and research. This study described the intra‐ and interexaminer reliability of the following anthropometric measurements: weight (WT), head circumference (HC), chest circumference (CC), abdominal circumference (AC), mid‐arm circumference (MAC), and length.Methods:A convenience sample of 50 clinically stable term infants was studied. Two examiners obtained the six measurements twice using blank tape measures. The order of examiners was randomized and the examiners were masked to their own and the other examiners' measurements.Results:The intraexaminer mean absolute differences were as follows: WT = 1.88, 3.28 g; HC = 0.29, 0.29 cm; CC = 0.50, 0.78 cm; AC = 0.71, 0.77 cm; MAC = 0.36, 0.39 cm; length = 0.92, 1.18 cm. The interexaminer mean absolute differences were as follows: WT = 1.94, 1.66 g; HC = 0.37, 0.36 cm; CC = 0.59, 0.72 cm; AC = 0.99, 0.77 cm; MAC = 0.41, 0.57 cm; length = 1.57, 1.47 cm.Conclusions:These findings indicate that intraexaminer differences tended to be smaller than interexaminer differences for all measures except weight, which remained stable for intra‐ and interexaminer comparisons. These findings also suggest that weight and head circumference were the most reliable measures, whereas length and mid‐arm circumference were the least reliable measures.
Digestion of Proteins in Human Milk, Human Milk Fortifier, and Preterm Formula in Infant Rhesus Monkeys
Authors: Lindberg Tor , Engberg Staffan , Jakobsson Irene , Lönnerdal Bo 
Published: February 2024

Background:There is limited information in the literature on the capacity of the preterm infant to digest human and bovine milk proteins. We therefore studied in vivo the luminal phase of the hydrolysis of proteins in human milk, human milk fortifier, and preterm formula in preterm rhesus monkeys and in infant rhesus monkeys at 6 weeks and 7 months of age.Methods:Protein hydrolysis was followed by polyacrylamide gradient gel electrophoresis and electroimmunoassay. The serum level of absorbed unhydrolyzed human α‐lactalbumin was measured by a radioimmunoassay method. Trypsin and elastase activities in duodenal contents were measured before and after the meal.Results:In 6‐week‐old monkeys, the enzyme activities decreased by 50% postprandially, whereas they increased in 7‐month‐old monkeys. In preterm and in 6‐week‐old monkeys, hydrolysis of human and bovine whey proteins was slow, and in 6‐week‐old monkeys, 30‐50% of the proteins could still be detected immunochemically in duodenal contents after 60 min. At these ages, serum levels of absorbed α‐lactalbumin were high. At 7 months of age, no or small (lactoferrin and bovine serum albumin) amounts of the proteins could be detected in duodenal contents after 15 min. At this age α‐lactalbumin was not measurable in serum.Conclusion:The low capacity to digest whey proteins in suckling monkeys may depend upon an immaturity of the exocrine pancreas to respond to secretogogues.
Experimental Colitis Impairs Linear Bone Growth Independent of Nutritional Factors
Authors: Koniaris Soula G. , Fisher Stanley E. , Rubin Clinton T. , Chawla Anupama 
Published: February 2024

BackgroundPoor linear growth frequently complicates chronic inflammatory bowel disease in children. Circulating inflammatory mediators may play a role in this growth delay. We evaluated the effect of experimental colitis on bone growth in a nutritionally controlled rat model.MethodsExperimental colitis was induced in male Sprague‐Dawley rats (125‐150 g) by enema with trinitrobenzene sulfonic acid in 50% ethanol on day 1 and 11 of a 14‐day protocol. Control animals were pair‐fed and all animals received a liquid rat diet (1 kcal/ml). Twenty‐four‐hour urine, collected on days 2 and 12 and serum samples, collected at death, were analyzed for calcium, zinc, and magnesium. Serum samples from a separate set of animals were studied for serial interleukin‐6 levels. Right proximal tibias were processed for growth‐plate histo‐morphometry, in which linear growth is proportional to the heights of the proliferative zone, and terminal hypertrophic chondrocyte, but inversely proportional to the height of the resting zone.ResultsHistology confirmed active inflammation in the animals given trinitrobenzene sulfonic acid. Weight gain and both urinary excretion and serum levels of zinc, calcium, and magnesium did not differ between treatment and nontreatment groups. Histologically, there was impaired linear bone growth. The resting zone was greater in the colitis group (94.5 ± 32.6 μm versus 3.9 ± 5.4 μm; p < 0.05); the proliferative zone was smaller in the colitis group (123.7 ± 18.2 μm versus 78.9 ± 11.2; p < 0.05 μm); the terminal hypertrophic chondrocyte was reduced in the colitis group (19.5 ± 1.4 μm versus 28.8 ± 3.6 μm; p < 0.05). At 6 and 24 hours after induction, the level of interleukin‐6 was elevated in the colitis group.ConclusionsExperimental colitis results in a decreased linear bone growth, independent of nutritional intake. Circulating cytokines derived from intestinal inflammation may contribute to the suppression of bone growth.
Casein Phosphopeptides Improve Zinc and Calcium Absorption from Rice‐Based but not from Whole‐Grain Infant Cereal
Authors: Hansen Marianne , Sandström Brittmarie , Jensen Mikael , Sørensen Sven S. 
Published: February 2024

Background:Casein phosphopeptides (CPP) are phosphorus‐rich peptide fragments of casein, assumed to contribute to the high bioavailability of calcium from milk.Methods:The effect of casein phosphopeptides on calcium and zinc absorption from infant foods was investigated. Twenty‐two men and women were given single test meals extrinsically labeled with Ca and Zn. Absorption was calculated from measurements on whole‐body retention of the radioisotopes. Each subject was given either rice‐based cereal (n = 11) or whole‐grain cereal (n = 11) on three occasions together with 250 ml water and added 0, 1, and 2 g CPP in random order. One serving of rice‐based cereal contained 481 mg Ca and 1.29 mg Zn: whole‐grain cereal contained 541 mg Ca and 1.77 mg Zn. One and 2 g of CPP contributed with additional 69 and 138 mg Ca, respectively.Results:From rice‐based cereal, fractional calcium absorption was not affected by CPP addition (mean ± SD): 16.0 ± 4.0% (no CPP), 17.6 ± 4.5% (1 g CPP), and 15.8 ± 4.3% (2 g CPP), while the total quantity of calcium absorbed was significantly improved: 7 ± 19 mg, 97 ± 25 mg, and 98 ± 26 mg, respectively (p = 0.0004). Fractional zinc absorption as well as total quantity of zinc absorbed were increased with addition of CPP: 19.4 ± 9.0% (0.25 ± 0.12 mg), 25.2 ± 7.5% (0.33 ± 0.10 mg) and 23.9 ± 5.4% (0.31 ± 0.07 mg) at the three CPP levels (p = 0.04). From whole‐grain cereal, CPP had no effect on the percentage or actual quantity of calcium absorbed: 17.0 ± 3.2% (92 ± 18 mg), 17.2 ± 4.5% (105 ± 27 mg), and 15.0 ± 4.6% (102 ± 31 mg), respectively. Zinc absorption was also not influenced by CPP: 16.0 ± 5.1% (0.28 ± 0.09 mg), 15.3 ± 3.1% (0.27 ± 0.06 mg) and 18.1 ± 4.4% (0.32 ± 0.08 mg), respectively.Conclusions:CPP addition improved calcium and zinc absorption from rice‐based cereal, while no effect was seen from whole‐grain cereal.
Neonatal Hemochromatosis: Outcomes of Pharmacologic and Surgical Therapies
Authors: Sigurdsson Luther , Reyes Jorge , Kocoshis Samuel A. , Hansen Thor W. R. , Rosh Joel , Knisely A. S. 
Published: February 2024

ABSTRACTBackground:Neonatal hemochromatosis (NH), also known as perinatal hemochromatosis or neonatal iron storage disease, is a disorder in fetuses and newborn infants. A retrospective study was conducted to report management of patients with NH.Methods:Retrospective analysis was conducted by chart review and by review of histologic material from patients with NH.Results:Neonatal hemochromatosis was diagnosed in 14 patients between 1985 and 1995. All were considered for orthotopic liver transplantation (OLTX). From 1993 onward, all patients were treated with an antioxidant‐chelation“cocktail,” consisting of deferoxamine, vitamin E,N‐acetylcysteine, selenium, and prostaglandin‐El. Of 6 patients with NH diagnosed before 1993, 4 underwent OLTX; only 1 is still alive. Of 8 patients with NH diagnosed after 1993 and treated with the cocktail, 7 expired before OLTX. One stabilized on therapy, but having never recovered full synthetic liver function, underwent OLTX and is now alive and well.Conclusion:Neonatal hemochromatosis carries a grim prognosis; however, successful OLTX is curative. The use of an antioxidant‐chelation cocktail did not improve outcome in the patients studied. Earlier (perinatal) diagnosis may be required for optimal results. Further study of other interventions, including antenatal diagnosis and earlier institution or modification of cocktail therapy appears warranted.
Aluminum in Total Parenteral Nutrition Solutions Produces Portal Inflammation in Rats
Authors: Demircan Mehmet , Ergün Orkan , Çoker Canan , Yilmaz Funda , Avanoglu Sibel , Özok Geylani 
Published: February 2024

ABSTRACTBackground:Aluminum contaminates parenteral nutrition solutions and accumulates in bone and liver of patients receiving total parenteral nutrition therapy. Although previous reports have shown that parenteral administration of aluminum in pharmacologic doses to rats results in the production of elevated total serum bile acid concentrations alone or in combination with decreased bile flow, they have failed to demonstrate any abnormalities in the histologic appearance of liver tissue. The effects of aluminum in total parenteral nutrition and of aluminum chloride on total serum bile acid concentrations, aluminum contents of the liver, and histopathologic changes in the liver were studied in rats.Methods:The aluminum concentrations in the aluminum chloride solution and total parenteral nutrition formula were equal (300 μg/l). They were given intraperitoneally as follows: control group, 0.9% saline for 14 days; T7 group, total parenteral nutrition for 7 days; A7 group, aluminum chloride for 7 days; A14 group, aluminum chloride for 14 days; T7A7 group, total parenteral nutrition for 7 days and aluminum chloride for the next 7 days; and T7O7 group, total parenteral nutrition for 7 days and 0.9% saline for the next 7 days. Volumes of 0.9% saline, aluminum chloride, and total parenteral nutrition given to rats were equal. During the experiment, rats were maintained on rat chow and water ad libitum. Serum glutamic oxaloacetic transaminase, serum glutamic pyruvic transaminase, alkaline phosphatase, and bile acid concentrations and aluminum content of the liver were measured. The liver was evaluated histopathologically by light microscope, and a morphologic portal inflammation index was calculated.Results:Portal inflammation was present in all groups except the control group. The morphologic portal inflammation correlated with hepatic aluminum accumulation in all groups and was the highest in the T7A7 group. Levels of serum glutamic oxaloacetic transaminase, serum glutamic pyruvic transaminase, and alkaline phosphatase did not correlate with the histopathologic findings, but serum bile acid concentrations correlated with morphologic portal inflammation and hepatic aluminum accumulation in all groups. Hepatic aluminum accumulation also correlated with the duration of exposure to total parenteral nutrition and aluminum chloride concentration.Conclusion:Aluminum in contaminating doses, not in pharmacologic doses, accumulates in the liver and can produce hepatobiliary dysfunction characterized by portal inflammation detectable in histologic examination of liver tissue.
Primary Eosinophilic Esophagitis in Children: Successful Treatment with Oral Corticosteroids
Authors: Liacouras Chris A. , Wenner William J. , Brown Kurt , Ruchelli Eduardo 
Published: February 2024

ABSTRACTBackground:The histologic appearance of esophageal eosinophils has been correlated with esophagitis and gastroesophageal reflux disease in children. Esophageal eosinophilia that persists despite traditional antireflux therapy may not represent treatment failure, but instead may portray early eosinophilic gastroenteritis or allergic esophagitis. In this study, a series of pediatric patients with severe esophageal eosinophilia who were unresponsive to aggressive antireflux therapy were examined and their clinical and histologic response to oral corticosteroid therapy assessed.Methods:Of 1809 patients evaluated prospectively over 2.5 years for symptoms of gastroesophageal reflux, 20 had persistent symptoms and esophageal eosinophilia, despite aggressive therapy with omeprazole and cisapride. These patients were treated with 1.5 mg/kg oral methylprednisolone per day, divided into twice‐daily doses for 4 weeks. All patients underwent clinical, laboratory, and histologic evaluation before and after treatment.Results:Histologic findings in examination of specimens obtained in pretreatment esophageal biopsies in children with primary eosinophilic esophagitis indicated significantly greater eosinophilia (34.2 ± 9.6 eosinophils/high‐power field [HPF]) compared with that in children with gastroesophageal reflux disease who responded to medical therapy (2.26± 1.16 eosinophils/HPF; p < 0.001). After corticosteroid therapy, all but one patient with primary eosinophilic esophagitis had dramatic clinical improvement, supported by histologic examination (1.5± 0.9 eosinophils/HPF, p < 0.0001).Conclusions:Pediatric patients in a series with marked esophageal eosinophilia and chronic symptoms of gastroesophageal reflux disease unresponsive to aggressive medical antire‐flux therapy had both clinical and histologic improvement after oral corticosteroid therapy.
Serum Leptin in Children and Young Adults with Inflammatory Bowel Disease
Authors: Hoppin Alison G. , Kaplan Lee M. , Zurakowski David , Leichtner Alan M. , Bousvaros Athos 
Published: February 2024

ABSTRACTBackground:Pediatric inflammatory bowel disease is often associated with growth failure and inadequate energy intake. Although several circulating cytokines are known to be elevated in inflammatory bowel disease, the mechanism for the related anorexia has not been described. Leptin is a newly recognized circulating protein that is an important regulator of appetite and energy metabolism; leptin levels are elevated in several animal models of inflammation. This study was conducted to determine whether serum leptin levels are elevated in young patients with inflammatory bowel disease.Methods:One hundred twelve children and young adults with Crohn's disease or ulcerative colitis were studied prospectively. Forty‐two patients with other gastrointestinal illnesses were used as control subjects. Height, weight, erythrocyte sedimentation rate, serum albumin concentration, and clinical information were collected prospectively, and leptin was measured by radioimmunoassay of stored serum.Results:No significant differences in leptin levels were found among disease groups or control subjects. Body mass index and gender were the only independent predictors of serum leptin in all groups examined. Disease activity varied inversely with serum leptin in patients with Crohn's disease, but these differences were explained entirely by variations in body mass index.Conclusions:The determinants of serum leptin were the same in young patients with inflammatory bowel disease as in normal populations, indicating that alterations in leptin levels are unlikely to mediate the anorexia and growth failure associated with this disease.
Treatment Strategies for Small Bowel Bacterial Overgrowth in Short Bowel Syndrome
Authors: Vanderhoof Jon A. , Young Rosemary J. , Murray Nancy , Kaufman Stuart S. 
Published: February 2024

ABSTRACTBackground:Small bowel bacterial overgrowth is a common complication of short bowel syndrome, and although it is often controlled with antimicrobial therapy, alternative strategies may occasionally be needed.Methods:Six patients with bacterial overgrowth are described, who did not respond to antimicrobial therapy and required additional medical or surgical measures to control the overgrowth.Results:Recalcitrant bacterial overgrowth was successfully treated with periodic small bowel irrigation with a balanced hypertonic electrolyte solution, colonic flushes, encouraging frequent stooling, intestinal lengthening procedure, or probiotic therapy with Lactobacillus plantarum 299V and Lactobacillus GG.Conclusions:Small bowel bacterial overgrowth should be aggressively evaluated in patients with short bowel syndrome who are not progressing in a normal manner. Inadequate or incomplete response to antibiotic therapy is common, and several additional treatment possibilities are available.
Human Colostrum Contains IgA Antibodies Reactive to EnteropathogenicEscherichia coli Virulence‐Associated Proteins: Intimin, BfpA, EspA, and EspB
Authors: Loureiro Ivana , Frankel Gad , Adu‐Bobie Jeannette , Dougan Gordon , Trabulsi Luiz R. , Carneiro‐Sampaio Magda M. S. 
Published: February 2024

ABSTRACTBackground:In Brazil, enteropathogenic Escherichia coli diarrhoea is endemic among infants born into low economic levels, and it is one of the main causes of morbidity and mortality in this group. Binding of enteropathogenic E. coli to the brush border mucosa triggers a cascade of transmembrane and intracellular signals, causing cytoskeletal reorganization and formation of a specific lesion, termed the attaching and effacing lesion. Several enteropathogenic E. coli gene products have been implicated in formation of attaching and effacing lesions. Evaluation of pathogen‐specific protective factors shows that breast feeding is effective against enteropathogenic E. coli infection. To investigate the nature of the protection, defatted colostrum and secretory immunoglobulin A obtained from mothers living in Sao Paulo were investigated for the ability to recognise selected enteropathogenic E. coli‐associated virulence factors.Methods:Western blot analysis was used to investigate the IgA repertoire in pooled colostrum that is reactive with specific enteropathogenic E. coli proteins. Whole enteropathogenic E. coli bacterial cell extracts, nonpathogenic E. coli strains over‐expressing specific virulence factors, and purified polypeptides were used as antigen sources in this study.Results:Reaction of the colostrum samples in Western blots of whole bacterial cell extracts and selected purified enteropathogenic E. coli proteins showed that they contained a secretory immunoglobulin A reactive with all the virulence‐associated proteins studied.Conclusion:These results suggest that maternal antibodies may protect infants from enteropathogenic E. coli infection by interfering with adherence processes (anti‐intimin and anti‐bundle‐forming pili antibodies) and cell signaling (anti‐enteropathogenic Escherichia coli‐secreted protein A and B antibodies).
Bacterial Wall Lipopolysaccharide as a Cause of Intussusception in Mice
Authors: Lin Zhong , Cohen Patrizia , Nissan Aviram , Allweis Tanir M. , Freund Herbert R. , Hanani Menachem 
Published: February 2024

ABSTRACTBackground:There is evidence that intussusception is associated with bacterial infection. It was hypothesized that a component of the bacterial wall may induce the intussusception. This study was intended to determine whether lipopolysaccharide from Escherichia coli or Salmonella can initiate intussusception in mice.Methods:Lipopolysaccharide was injected intraperitoneally in mice, and the animals were examined for the presence of intussusception from 2 to 192 hours after injection. Gastrointestinal transit was assessed by measuring the passage of charcoal in the small intestine. Transit index was defined as the ratio between the distance traveled by charcoal and the total length of the small intestine.Results:Intussusceptions were found in as much as 25.9% of lipopolysaccharide‐injected animals, whereas in control animals, the incidence was zero. The threshold for the lipopolysaccharide effect was at 4 mg/kg and incidence reached a plateau at 8 mg/kg to 16 mg/kg. The incidence of intussusception peaked 6 hours after injection of lipopolysaccharide and declined to zero after 15 hours. To test the possibility that lipopolysaccharide induces intussusception by altering motility, its effect on transit index was measured. A dose of 12 mg/kg lipopolysaccharide reduced the transit index from 56.2 ± 1.4% to 37.7 ± 2.1% (p< 0.05). No microscopic histologic changes were found in the bowels with intussusception.Conclusions:Intraperitoneal bacterial wall lipopolysaccharide causes intussusception in mice by disturbing gastrointestinal motility.
Effects of Human Milk Pasteurization and Sterilization on Available Fat Content and Fatty Acid Composition
Authors: Fidler Nataša , Sauerwald Thorsten U. , Koletzko Berthold , Demmelmair Hans 
Published: February 2024

ABSTRACTBackground:Human milk is frequently heat treated in hospitals to reduce bacterial contamination, particularly in banked milk fed to preterm infants. Pasteurization and sterilization may induce oxidative losses of unsaturated lipids and vitamins and may inactivate enzymes and immunologic factors. This study was designed to examine the effects of pasteurization and sterilization on milk fat content available to the recipient infant and on fatty acid composition.Methods:In fresh, pasteurized (62.5°C for 30 minutes), and sterilized(120°C for 30 minutes) milk samples (5 ml) of 12 mothers (days 5‐35 of lactation), fat content was determined gravimetrically and the contribution of 30 fatty acids was determined by gas‐liquid chromatography.Results:The coefficients of variation for measurements of milk fat content were 0.7% and of fatty acids accounting for more than 0.09% of weight, 0.1‐3.0%. Available fat content was 3.1 ± 1.4 g/dl (mean ± SD) in fresh human milk and 3.1 ± 1.4 g/dl (not significant) in pasteurized human milk. Fat content declined to 2.7 ± 1.1 g/dl (p < 0.001 vs. fresh) in sterilized human milk, because of increased fat adherence to the container surface after sterilization. The percentage composition of saturated, monounsaturated, and polyunsaturated fatty acids of the n‐6(C18:3, C20:2, C20:3, and C22:4) and the n‐3 series (C18:3 C20:5, C22:5, and C22:6) was not affected by thermal treatment. Milk sterilization caused a slight decrease of linoleic (‐0.7% vs. fresh milk; p = 0,006) and arachidonic (‐2,6%; p = 0.045) acids.Conclusions:Pasteurization of human milk does not influence fat content and composition, but sterilization may reduce available fat content by more than 10%, whereas there are only slight changes in fatty acid composition.