bluuebunny/crossref_metadata_2025_split huggingface dataset:
Five‐Year Follow‐Up of High‐Risk Infants with Family History of Allergy Who Were Exclusively Breast‐Fed or Fed Partial Whey Hydrolysate, Soy, and Conventional Cow's Milk Formulas
Authors: Chandra Ranjit Kumar 
Published: February 2024

Background:Allergy is a common cause of illness. The effect of feeding different infant formulas on the incidence of atopic disease and food allergy was assessed in a prospective randomized double‐blind study of high‐risk infants with a family history of atopy.Methods:216 high‐risk infants whose mothers had elected not to breast‐feed were randomized to receive exclusively a partial whey hydrolysate formula or a conventional cow's milk formula or a soy formula until 6 months of age. Seventy‐two high risk infants breast‐fed for ≥ 4 months were also studied.Results:Follow‐up until 5 years of age showed a significant lowering in the cumulative incidence of atopic disease in the breast‐fed (odds ratio 0.422 [0.200‐0.891]) and the whey hydrolysate (odds ratio 0.322 [0.159‐0.653) groups, compared with the conventional cow's milk group. Soy formula was not effective (odds ratio 0.759 [0.384‐1.501]). The occurrence of both eczema and asthma was lowest in the breast‐fed and whey hydrolysate groups and was comparable in the cow's milk and soy groups. Similar significant differences were noted in the 18‐60 month period prevalence of eczema and asthma. Eczema was less severe in the whey hydrolysate group compared with the other groups. Double‐blind placebo‐controlled food challenges showed a lower prevalence of food allergy in the whey hydrolysate group compared with the other formula groups.Conclusions:Exclusive breast‐feeding or feeding with a partial whey hydrolysate formula is associated with lower incidence of atopic disease and food allergy. This is a cost‐effective approach to the prevention of allergic disease in children.
Lactobacillus reuteri as a Therapeutic Agent in Acute Diarrhea in Young Children
Authors: Shornikova Aino‐Vieno , Casas Ivan A. , Isolauri Erika , Mykkänen Hannu , Vesikari Timo 
Published: February 2024

Background:Certain strains of lactobacilli may promote recovery from acute diarrhea. Lactobacillus reuteri is of human origin and is a natural colonizer of gastrointestinal tract. In this trial, exogenously administered L. reuteri was studied as a therapeutic agent in acute diarrhea.Methods:Forty patients between 6 and 36 months of age hospitalized with acute diarrhea (75% rotavirus) were studied. After parental consent, the patients were randomized to one of two treatment groups to receive either 1010 to 1011 colony‐forming units of L. reuteri or a matching placebo daily for the length of hospitalization or up to 5 days. The clinical outcome of diarrhea and colonization of L. reuteri were evaluated.Results:The mean (SD) duration of watery diarrhea after treatment was 1.7 (1.6) days in the L. reuteri group and 2.9 (2.3) days in the placebo group (p = 0.07). On the second day of treatment only 26% of patients receiving L. reuteri had watery diarrhea, compared with 81% of those receving placebo (p = 0.0005). Cultures of lactobacilli from stool samples demonstrated that administration of L. reuteri resulted in colonization of the gastrointestinal tract. Lactobacillus reuteri accounted for >75% of the total lactobacilli found in children fed with this product.Conclusions:Lactobacillus reuteri is effective as a therapeutic agent in acute rotavirus diarrhea in children. Further studies are warranted to confirm the present finding and to explore the full therapeutic potential of L. reuteri in acute viral diarrhea.
The Estimated Incidence of Cystic Fibrosis in Japan
Authors: Yamashiro Y. , Shimizu T. , Oguchi S. , Shioya T. , Nagata S. , Ohtsuka Y. 
Published: February 2024

Background:It is believed that the incidence of cystic fibrosis (CF) among Asiatic races, including the Japanese, is very rare. This epidemiological study was carried out to investigate the incidence of CF in Japan.Methods:We collected literature describing CF cases among pure Japanese and found 124 cases reported as CF during the 43 years from 1951, when the first case was reported, to 1993. Only 104 cases (57 male and 47 female patients) of 124 cases met our diagnostic criteria.Results:A simple calculation based on the number of reported CF cases and of live births after 1980 suggested that the incidence of CF is about 1 in 350,000 in the Japanese population. Twenty‐nine (27.9% of the total) of 30 patients diagnosed in the neonatal period presented symptoms of meconium ileus, an incidence higher than that reported for the white population.Conclusions:Our study results suggest that the incidence of CF in the Japanese population is even rarer than had been estimated before and that there is a genetic difference between northern European and Japanese populations.
Gastric Emptying Time is Faster in Cystic Fibrosis
Authors: Collins Clare E. , Francis J. Lynn , Thomas P. , Henry Richard L. , O'Loughlin Edward V. 
Published: February 2024

Background:The high energy requirements in cystic fibrosis (CF) increase the likelihood of malnutrition. Delayed mouth‐to‐cecum transit times have been reported and raise the possibility that abnormalities of gastric function in CF contribute to reduced food intake. The aims of this project were to document solid‐phase gastric emptying times in young people with CF and age‐ and sex‐matched healthy controls, and to investigate whether delayed gastric emptying contributes to suboptimal energy intakes.Methods:Nineteen subjects with CF, mean age 12.6 years (11 girls and 8 boys), and 17 control subjects, mean age 12.8 years (9 girls and 8 boys), were studied. Energy intake was assessed by means of a 4‐day weighed food record. Fecal fat excretion was determined from a 3‐day stool collection. Gastric emptying was assessed with a standard test meal of pancakes labeled with 99mTc‐macroalbumin aggregates. The half emptying time of solids from the stomach was recorded.Results:The mean solid‐phase gastric emptying time was significantly faster in the CF subjects compared with normal, healthy, age‐ and sex‐matched control subjects (53 min vs. 72.2 min, p<0.05). Energy intakes, measured as the percentage of the recommended energy intake for age and sex, were greater in the CF subjects than in the control subjects (115% vs. 89%, p<0.01), whereas the mean% FFE for the CF subjects was 9.9%. CF subjects with longer gastric emptying times also had lower relative energy intakes (r = ‐0.50, p<0.05).Conclusion:Gastric emptying time in healthy subjects with CF is rapid. Faster solid‐phase gastric emptying times may be secondary to high‐fat, high‐energy intakes and may represent a survival advantage.
Nonsyndromic Paucity of Interlobular Bile Ducts: Clinical and Laboratory Findings of 10 Cases
Authors: Koçak Nurten , Gürakan Figen , Yüce Aysel , Çağlar Melda , Kale Gülsev , Göğüş Safiye 
Published: February 2024

Background:Reports concerning nonsyndromic paucity of the interlobular bile ducts are not common.Methods:The clinical, biochemical, and histological features of ten such children were described.Results:All presented with jaundice, starting in the first month in seven and in the fourth, seventeenth, and thirtieth month in the others. Acholic stools were present intermittently in seven and persistently in three patients. Pruritus was a prominent symptom in five. Liver function tests were abnormal in all but one. Liver biopsies were performed at ages of 20 days to 3 years (median 5 months). In addition to a paucity of interlobular bile ducts, histology revealed intracellular cholestasis in all, portal fibrosis in four, and regenerative nodules in two patients. Complications of fat‐soluble vitamin deficiency occurred in seven. Therapy consisted of supplementation of those vitamins and administration of cholestyramine, phenobarbital, prednisolone, or ursodeoxycholic acid. While one child had a successful orthotopic liver transplantation, three died. Consanguinity rate was 80% among the parents, and five of the patients had siblings with similar symptoms.Conclusions:Prognosis of these patients is variable. Differentiation from other forms of cholestasis is important especially to avoid surgery.
Endoscopic Sclerotherapy for Esophageal Varices in Children with Extrahepatic Portal Venous Obstruction: A Follow‐Up Study
Authors: Yachha S. K. , Sharma B. C. , Kumar M. , Khanduri A. 
Published: February 2024

Background:Results of treatment with endoscopic sclerotherapy for esophageal varices in children extrahepatic portal venous obstruction are limited.Methods:A prospective study was undertaken of fifty children (mean age, 7.4 ± 3.8 years; range, 4 months to 14 years) with esophageal variceal bleeding caused by extrahepatic portal venous obstruction (EHPVO) treated by repeated intravariceal endoscopic sclerotherapy (EST) at intervals of 2‐3 weeks until eradication (no varices on endoscopy).Results:Eradication of varices was achieved in 44 children (88%) with a mean of eight sessions per child. In six other cases, variceal grade decreased by 50% from the initial grades. Bleeding episodes at presentation were controlled in all of the children with first ET>. Over a mean follow‐up period of 19 months (range, 12‐36 months), a total of 15 episodes of rebleeding occurred in 13 children (26%) before the third session of EST and all were controlled with EST. Risk of rebleeding in children with eradicated varices (n = 44) significantly decreased from 0.2 episodes per month to nil after eradication. None of the children without eradicated varices had rebleeding. Thus, EST was successful in controlling rebleeding in all of the cases. Recurrence of varices was observed in five children (10%). None of our children either required surgery for EST failure or died.Conclusions:EST is a safe and effective nonsurgical mode of therapy in controlling esophageal variceal bleeding in children with EHPVO. Significant variceal bleeding did not occur during the relatively short follow‐up in this series.
Colonoscopy or Sigmoidoscopy as the Initial Evaluation of Pediatric Patients with Colitis: A Survey of Physician Behavior and a Cost Analysis
Authors: Deutsch David E. , Olson Allan D. 
Published: February 2024

Background:Pediatric patients presenting with colitis, suggestive of inflammatory bowel disease, undergo evaluation with either flexible sigmoidoscopy or colonoscopy. Our objectives were to assess current practice behavior in the evaluation of pediatric patients with colitis and to determine whether flexible sigmoidoscopy or colonoscopy was more cost‐effective as the initial evaluation.Methods:Practice behavior and procedure charges were assessed using a nationwide survey, and costs for diagnostic strategies were compared using a decision analysis program.Results:The vast majority of survey respondents would proceed with colonoscopy if colitis suggestive of Crohn's disease was noted in the rectosigmoid area (81%) or if ulcerative colitis extended proximal to the rectosigmoid area (70%). If colonoscopy would follow if flexible sigmoidoscopy suggested either ulcerative colitis or Crohn's disease (67%), then colonoscopy would result in a savings of 23%. If the evaluation was predetermined to be limited to flexible sigmoidoscopy (16%), then flexible sigmoidoscopy was the cost‐effective strategy with savings of 29%. If colonoscopy would follow flexible sigmoidoscopy for Crohn's colitis only (13%), there was no clear cost advantage.Conclusions:The most cost‐effective strategy depends on the physician's need to know the disease location. Our survey results indicate that most physicians chose to establish the extent of disease in both ulcerative colitis and in Crohn's disease; thus initial colonoscopy would be the more cost‐effective strategy. When knowledge of disease distribution is not essential for patient care, flexible sigmoidoscopy can lead to substantial cost savings.
NADPH‐Diaphorase in Antral Gastritis of Childhood
Authors: Sbarbati Andrea , Bertini Marina , Peng Ze‐Chun , Tonolli Elisabetta , Osculati Francesco 
Published: February 2024

Background:Nitric oxide has an important role in the pathophysiology of the gastric mucosa. However, to date, it is not clear if nitric oxide plays a cytoprotective or cytotoxic role in the pathogenesis of mucosal lesion.Methods:We have used the NADPH‐diaphorase histochemistry that selectively stains cells containing nitric oxide synthase, the enzyme that catalyzes the production of nitric oxide on the antral gastric mucosa of children with antral gastritis.Results:In the lamina propria of the mucosa, the presence of the enzymatic activity was found in perivascular round cells and nerve fibers. In the epithelium, focal positivity to NADPH‐diaphorase was found in superficial cells, mainly located in the extrusive zones. The epithelial cells in the pits and glands were negative, in the mucous layer, Helicobacter pylori were also stained by NADPH‐diaphorase. A single H. pylori‐infected child who was also examined after eradication of the H. pylori showed during the control examination absence of microorganisms and reduction of the NADPH‐diaphorase‐positive cells in the mucosa.Conclusions:Our results demonstrate that, in gastric mucosa, endogenous and exogenous structures express a NADPH‐diaphorase activity.
Small Bowel and Fecal Microbiology in Children Suffering from Persistent Diarrhea in Bangladesh
Authors: Bardhan Pradip K. , Albert M. John , Alam Nur H. , Faruque Shah M. , Neogi Prodyot K. B. , Mahalanabis Dilip 
Published: February 2024

ABSTRACTBackground:The etiology of persistent diarrhea in children is multifactorial. The objective of the current study was to ascertain the role of microorganisms in the etiology and pathogenesis of persistent diarrhea in a group of children in Bangladesh.Methods:Enteric pathogens and total aerobic microflora were studied in the duodenal aspirates of 100 children with persistent diarrhea and compared with those in aspirates of 30 children with acute diarrhea, and those in aspirates of 15 healthy control children. The enteric pathogens in the stools of these children and in stools of an additional 38 patients with persistent diarrhea and 12 with acute diarrhea were also studied.Results:Approximately two thirds of the patients with acute diarrhea and persistent diarrhea, and half of the control subjects had more than 105 organisms per milliliter of duodenal fluid. Significantly, more patients with persistent diarrhea had a greater variety of flora than did patients with acute diarrhea and control subjects. The predominant organisms in patients with acute diarrhea and in those with persistent diarrhea were Gram‐negative rods, whereas those in control subjects were Gram‐positive cocci. Significantly more acute diarrhea patients and persistent diarrhea patients had enteric pathogens isolated from stool than did control subjects. DiarrheagenicEscherichia coli, as a whole, were present in significantly more persistent diarrhea patients than in acute diarrhea patients and control subjects. Among diarrheagenic E. coli, enteroaggregative E. coli were significantly associated only with persistent diarrhea. Other organisms significantly associated with persistent diarrhea wereAeromonas spp. and Klebsiella spp. Some patients in the acute diarrhea and the persistent diarrhea groups had the same pathogens isolated from both the duodenal fluid and stool.Conclusions:In accordance with results of other studies, an association between enteroaggregative E. coli and persistent diarrhea was found in the present study. This suggests that therapy directed against enteroaggregativeE. coli can be evaluated for management of some cases of persistent diarrhea.
Dientamoeba fragilis Masquerading as Allergic Colitis
Authors: Cuffari Carmello , Oligny Luc , Seidman Ernest G. 
Published: February 2024

ABSTRACTBackground:Dientamoeba fragilis is a rare cause of chronic infectious diarrhea and colitis in children.Methods:Review of the clinical manifestations, diagnostic methods, and clinical course of D. fragilis infection in our hospital.Results:Eleven pediatric patients are discussed, seven of whom had a history of recent travel. Clinical manifestations of infectious diarrhea included anorexia, intermittent vomiting, abdominal pain, and diarrhea, ranging from 1 to 100 weeks in duration. Peripheral eosinophilia was present in seven patients. One patient with well‐documented bovine protein allergy had intermittent episodes of diarrhea and abdominal pain, despite an appropriate elimination diet. Eosinophilic colitis documented by colonoscopy, was due toD. fragilis. Metronidazole was effective in treating five patients, and iodoquinol was effective in treating four others.Conclusions:D. fragilis should be included in the differential diagnosis of chronic diarrhea and eosinophilic colitis. The identification of this pathogen requires clinical awareness of epidemiologic risk factors and presenting complaints, as well as the laboratory staining procedures essential to its proper identification.
Addition of Rice Cereal to Formula Does Not Impair Mineral Bioavailability
Authors: Lifschitz Carlos H. , Abrams Steven A. 
Published: February 2024

ABSTRACTBackground:The effect of adding rice cereal to formula on calcium and iron bioavailability was studied.Methods:Fourteen healthy infants were studied at 2‐week intervals to assess the absorption of calcium and iron from formula or formula mixed with rice cereal. Infants were randomly assigned to initiate the study either on a lactose‐containing formula (F) or the same formula mixed with 6.5 g/dl of rice cereal (F + R). Calcium and iron absorption were determined using a multiple tracer approach in which calcium and iron isotopes were given orally mixed with either F or F + R and a different tracer of calcium given intravenously. Nine infants underwent calcium and iron studies and five underwent calcium studies only. A tracer amount of 46Ca was administered intravenously. Calcium absorption was determined as the ratio of the recovered oral versus intravenous tracer in the urine during the 24 hr after tracer administration. Iron incorporation into red blood cells (RBCs) was determined from the enrichment of the iron isotopes in the RBCs at 14 days after dosing.Results:Mean (±SD) percent absorption of calcium from F was 58% (±13) and from F + R 57% (±18). Absorption of iron from F was 5.8%(±7) and from F + R 6.3% (±4) (p = 0.06). Analyses of variance for repeated measures indicated no significant correlation between amount of calories, calcium, or iron ingested, and calcium or iron absorbed.Conclusions:Adding rice cereal to formula does not impair bioavailability of calcium or iron from infant formulas. Because of the increased total calcium and iron in the mixture of formula and cereal, the overall amount of minerals absorbed from F + R may be greater than from formula alone.
Pediatric Duodenal Biopsies: Mucosal Morphology and Glycohydrolase Expression Do Not Change Along the Duodenum
Authors: Van Berrs Erik H. , Einerhand Alexandra W. C. , Taminiau Jan A. J. M. , Heymans Hugo S. A. , Dekker Jan , Büller Hans A. 
Published: February 2024

ABSTRACTBackground:Duodenal mucosal biopsies are routinely taken for diagnosis in children with complaints of the upper gastrointestinal tract. Surprisingly, little is known about the usefulness of proximal duodenal versus distal duodenal biopsies for routine diagnostic purposes. This study evaluated the comparability of proximal and distal duodenal biopsies with respect to mucosal morphology as well as glycohydrolase expression as an indicator of intestinal epithelial function.Methods:Specimens obtained in duodenal endoscopic biopsies from 64 children, ranging in age from 3 months to 18 years with normal or affected mucosa, were studied. Biopsies were performed in anatomically defined regions in the bulbus duodeni (the very proximal part of the duodenum) and distally of the papilla of Vater (distal of the pancreatic duct). Biopsy specimens were paraformaldehyde‐fixed for histologic examination and immunohistochemical evaluation or were homogenized to isolate RNA. Crypt/villus morphology was assessed as is routinely determined by pathologists. In addition, several aspects of lactase and sucrase‐isomaltase expression as paradigms of intestinal brush border enzymes were assessed: localization at the cellular level, semiquantitative immunohistochemistry, and quantitative measurement of the messenger RNA levels of the respective brush border glycohydrolases.Results:As anticipated, there was a wide interpatient variation in mucosal morphology and expression of lactase and sucrase‐isomaltase. Nonetheless, the consistent finding was that in each patient, measurements of morphology and lactase and sucrase‐isomaltase gene expression were very similar between samples obtained in the proximal and distal biopsies.Conclusions:Biopsies performed in either location in the duodenum are equally suitable for diagnostic workup of patients suspected of mucosal abnormalities affecting morphology or small intestinal brush border glycohydrolase activities.
Discrepancies Between Males and Females with Cystic Fibrosis in Dietary Intake and Pancreatic Enzyme Use
Authors: Collins Clare E. , O'Loughlin Edward V. , Henry Richard 
Published: February 2024

ABSTRACTBackground:Length of survival of females with cystic fibrosis is worse than it is in males. Results of current research have shown an important correlation among dietary intake, nutritional status, lung function, and survival. The purpose of this study was to explore gender differences in dietary intake and pancreatic enzyme replacement therapy in males and females with cystic fibrosis.Methods:The study was a cross‐sectional measurement of clinical characteristics, energy, and fat intakes in males and females attending the cystic fibrosis outpatients clinics of the John Hunter Hospital, Newcastle, Australia. Twenty‐nine subjects, (17 females and 12 males), completed 4‐day weighed food records to measure total energy intake and the contribution of macronutrients and to document use of pancreatic enzyme replacement therapy. Energy intake was assessed as the percentage of the recommended energy intake for age and sex.Results:Females with cystic fibrosis had significantly lower energy and fat intakes than males, whereas the females used significantly more pancreatic enzyme replacement therapy. There were no significant differences in clinical characteristics between groups.Conclusion:The results support the possibility that gender differences in the energy and fat intakes of older patients may contribute to differential median survival time of males and females with cystic fibrosis.