bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feeding Behavior Problems in Children With Cystic Fibrosis in the UK: Prevalence and Comparison With Healthy Controls
Authors: Duff Alistair James Aitken , Wolfe Susan Pamela , Dickson Corrine , Conway Steven Phillip , Brownlee Keith Graham 
Published: January 2024

ABSTRACTBackgroundFeeding behavior problems contribute to inadequate dietary intake for many patients with cystic fibrosis (CF). However, to establish effective intervention programs, more needs to be known about the occurrence and distribution of these difficulties. The aims of this study were to establish the prevalence and range of disruptive child behaviors (DCB) in patients with CF and the inappropriate parental responses (IPR) during mealtimes and to compare the results with those of healthy children.MethodsIn study A, parents of 108 patients (aged 1–7 years) completed a Behavioural Paediatric Feeding Assessment Scale comprising two domains: DCBs and IPRs during mealtimes. Parents rated the frequency of the behaviors and responses and identified those they considered problematic. In study B, data from the CF group (n = 69, aged 1–12 years) were compared with 69 age‐ and sex‐matched control subjects.ResultsParents of children with CF aged 5 to 8 years recorded significantly more DCBs than those in all other age ranges. These parents also reported significantly more IPRs than did parents of children aged 9 to 12 years and 13 to 17 years. Parents of children with CF reported significantly more DCBs and IPRs than did those of the control subjects. There were significantly more problematic DCBs and IPRs in the CF group than in the control group for children aged 5 to 8 years and 9 to 12 years but not for those aged 1 to 4 years.ConclusionsParents of children with CF report more feeding behavior problems than do those of healthy control subjects. The high prevalence of feeding behavior problems in older children suggests that preventative and reactive interventions must continue throughout childhood and vary according to the child's developmental abilities.
Culturing Helicobacter pylori from Clinical Specimens: Review of Microbiologic Methods
Authors: Ndip Roland N. , MacKay William G. , Farthing Michael J. G. , Weaver Lawrence T. 
Published: January 2024

ABSTRACTHelicobacter pylori is probably the most common chronic bacterial infection of humankind, and is usually acquired first in childhood. Microbiologic culture of H. pylori is the “gold standard” for diagnosis in a patient with suspected infection. Although not currently recommended for routine use, culture allows testing for susceptibility to antimicrobials, especially in populations with a high prevalence of drug resistance. Gastric biopsies are the specimens most commonly used to culture H. pylori, but stool, vomitus, saliva, and dental plaque offer opportunities. This review examines the current methods used to culture H. pylori from biologic specimens and suggests useful hints to enhance its recovery rate.
Low Plasma Cholecystokinin Levels in Colicky Infants
Authors: Huhtala Virpi , Lehtonen Liisa , Uvnäs‐Moberg Kerstin , Korvenranta Heikki 
Published: January 2024

ABSTRACTObjectives:Cholecystokinin (CCK) plays an important role in postprandial gallbladder contraction and may also have pacifying behavioral effects, such as inducing satiety and calming in infants. The authors hypothesized that colicky infants have impaired CCK secretion, which contributes to their gallbladder hypocontractility (reported earlier) and excessive crying.Methods:Cholecystokinin levels of 40 colicky and 37 control infants were evaluated at a mean of age 5 weeks. Plasma CCK levels were drawn before, immediately after, and 1 hour after a regular milk feeding and analyzed using radioimmunoassay (RIA). The contraction of the gallbladder was calculated using ultrasound measurements before and 1 hour after the feeding. The two‐tail t test for independent samples was used to test continuous data.Results:The preprandial and 1‐hour postprandial plasma levels of CCK were lower in the colicky infants than in the control subjects (P < 0.05). The immediate postprandial CCK levels were also lower in the colicky infants, although this difference did not reach a statistical significance. The proportion of gallbladder contractions did not differ between the study groups.Conclusions:The authors conclude that low CCK levels in colicky infants may predispose them to excessive crying in the absence of the calming effect of CCK.
Correlation Between Helicobacter pylori Infection and Vitamin C Levels in Whole Blood, Plasma, and Gastric Juice, and the pH of Gastric Juice in Korean Children
Authors: Park Jae H. , Kim Su Y. , Kim Dong W. , Lee Woo G. , Rhee Kwang H. , Youn Hee S. 
Published: January 2024

ABSTRACTBackground:It is well known that chronic gastritis induced by Helicobacter pylori may be associated with hypochlorhydria and may also be accompanied by low levels of vitamin C in plasma and gastric juice in adults. This study investigates the relationship between H. pylori infection and vitamin C levels in the blood, plasma and gastric juice and the gastric juice pH of Korean children.Methods:During a 5‐year period, multiple gastric antral biopsies were taken from 452 children who underwent gastroduo‐denoscopy. The biopsy specimen was inoculated into phenol red buffered urea broth and incubated for 48 hours to detect color changes. The histopathologic findings were evaluated using the Sydney System. Concentrations of vitamin C in whole blood, plasma, and gastric juice aspirate were measured using the 2,4‐dinitrophenylhydrazine method.Results:Four hundred fifty‐two patients (228 boys, 224 girls) aged 1 to 15 years were enrolled in this study. H. pylori was detected in 112 patients (24.8%) using histology, whereas it was found in 204 patients (45.1%) using the urease test. One hundred seven patients (23.7%) had active gastritis, and 421 patients (93.1%) had chronic gastritis. Vitamin C levels in whole blood, plasma, and gastric juice exhibited significant negative correlation with the age of patients, the histologic density of H. pylori, the degree of active and chronic gastritis, and the severity of H. pylori infection (based on urease positivity and histologic density of H. pylori). Gastric juice pH was correlated with the degree of chronic gastritis and was significantly higher in urease‐positive patients.Conclusions:The data demonstrate that vitamin C levels in whole blood, plasma, and gastric juice and the gastric juice pH in Korean children are closely related to the severity of H. pylori infection and the histologic changes in the stomach. These data suggest that vitamin C may play a role in determining infection and progression, and vitamin C supplementation may be an important axis for the management of H. pylori infection in children. JPGN 37:53‐62, 2003.
Intestinal Protein Loss and Hypoalbuminemia in Children with Pneumonia
Authors: Klar Aharon , Shoseyov David , Berkun Yaakov , Brand Abraham , Braun Jacques , Shazberg Gila , Jonathan Moise , Gross‐Kieselstein Eva , Revel‐Vilk Shoshana , Hurvitz Haggit 
Published: January 2024

ABSTRACTBackgroundIntestinal protein loss has been reported mainly in diseases affecting the gastrointestinal tract. Intestinal protein loss during pneumonia with effusion has not been reported to date. The authors attempted to assess the associations between pneumonia with effusion and intestinal protein loss and hypoalbuminemia in children.MethodsThis was a prospective consecutive case series study of in children hospitalized with pneumonia and effusion during a period of 4½ years. Serum albumin, C‐reactive protein (CRP), and fecal α‐1 antitrypsin (α‐1‐AT) were measured in the first 72 hours of hospitalization. Two control groups were studied: one consisted of 50 febrile children hospitalized because of viral or mild bacterial infections, and the other consisted of 20 afebrile children hospitalized because of convulsive disorders.ResultsSixty‐seven children ages 4 months to 14 years hospitalized with pneumonia and effusion were enrolled in the study. Fifty‐nine percent (40 children) were found to have elevated fecal α‐1‐AT excretion (range, 2–10 mg/g) compared with none in the two control groups (P < 0.000).Fifty‐two percent (35 children) of the children with pneumonia and effusion had mild to moderate hypoalbuminemia (range, 22–34 g/L). Only one child (2%) in the febrile control group had a low albumin of 34 g/L; none were found in the afebrile control group. The level of fecal α‐1‐AT was inversely correlated with serum albumin level.ConclusionsPneumonia with effusion in children is often associated with an intestinal protein loss that can be monitored by measuring gastrointestinal loss of protein, namely fecal α‐1‐AT. In most cases the development of hypoalbuminemia correlates with the development of intestinal protein loss.
No Association of CTLA4 Gene With Celiac Disease in the Basque Population
Authors: Martín‐Pagola Ainhoa , de Nanclares Guiomar Pérez , Vitoria Juan C. , Bilbao J. Ramón , Ortiz Lourdes , Zubillaga Paul , Castaño Luis 
Published: January 2024

ABSTRACTBackgroundCeliac disease (CD) is an autoimmune disorder caused by intolerance to ingested gluten that develops in genetically susceptible individuals. The contribution of human leukocyte antigen (HLA) genes to the genetic risk to CD has been known for a long time; however, non‐HLA genetic factors are likely to be required for the development of the disease. Several studies have associated the CD28/CTLA4 region on chromosome 2q33 with the disease in different populations. The CTLA4 gene encodes a receptor involved in the control of T‐cell proliferation and mediates T‐cell apoptosis.AimTo determine the contribution of two polymorphisms of the CTLA4 to the disease: the A/G dimorphism at position +49 in exon 1 and the (AT)n microsatellite in the 3´ untranslated region.PatientsForty‐one celiac families of Basque origin (43 patients with CD and 80 first‐degree relatives).MethodsRestriction enzyme digestion of polymerase chain reaction amplified genomic DNA for the A/G dimorphism and polymerase chain reaction followed by high‐resolution electrophoresis for the (AT)n microsatellite. For disease association studies, the Affected Family Based Controls approach was used.ResultsThe frequency of the A allele of 49 A/G polymorphism was 67.47% in the celiac allele group compared with 70.13% in the Affected Family Based Controls group. These differences were not significant. Analysis of the (AT)n polymorphism identified 17 different alleles, ranging from 262 to 312 bp in length, but no allele was significantly associated with the disease.ConclusionsOur results did not show any evidence of association of any of the CTLA4 gene polymorphisms with the disease. This may result from population‐specific differences in genetics and environmental susceptibility to CD.
A Human Flora‐Associated Rat Model of the Breast‐Fed Infant Gut
Authors: Edwards Christine A. , Rumney C. , Davies M. , Parrett A. M. , Dore J. , Martin F. , Schmitt J. , Stahl B. , Norin E. , Midtvedt T. , Rowland I. R. , Heavey P. , Köhler H. , Stocks B. , Schroten H. 
Published: January 2024

ABSTRACTObjectivesBacterial colonization of the infant gut may have important influences on the development of gastrointestinal, respiratory, and allergic disease. Early diet is a major determinant of the gut microflora. It is very difficult to carry out studies in human infants that can investigate the interaction of diet, flora, and mucosa. In this study we have developed an infant human flora‐associated (IHFA) rat model to allow such investigation.MethodsGerm‐free infant rats were infected with fecal bacteria from exclusively breast‐fed infants and were maintained on a modified infant formula for 8 weeks. The fecal and cecal contents were collected and compared with feces of breast‐fed infants for bacterial populations, bacterial metabolites, and enzymes and for the ability to inhibit adhesion of pathogenic bacteria to human mucosal cells.ResultsThe IHFA cecum and feces were dominated by lactic acid bacteria, Bifidobacterium, and lactobacilli, which were representative of the infant feces. The fecal short‐chain fatty acid profile was dominated by acetic and lactic acid in a similar manner to human infant feces. Other bacterial metabolites were similar to those of the human infant. Rat intestinal samples were able to inhibit the adhesion of pathogens to mucosal cells, but to a lesser extent than the human samples.ConclusionsThis IHFA infant model of the intestinal flora of the breast‐fed infant is considered valid for studying the effect of diet on bacterial colonization and metabolism.
Sweat Test Results in Children with Primary Protein Energy Malnutrition
Authors: Yiğit Hakan , Selimoğlu Mukadder Ayşe , Altinkaynak Sevin 
Published: January 2024

ABSTRACTObjectivesIn underdeveloped and developing countries where protein energy malnutrition (PEM) is common, it is sometimes difficult to exclude the diagnosis of cystic fibrosis (CF) in malnourished children because both primary PEM and CF share similar symptoms, signs, and laboratory findings, such as elevated sweat chloride value. This study was performed to investigate sweat test results and determine percentile values in children with primary PEM.MethodsA total of 90 children with PEM and 30 healthy children were included. PEM was classified according to criteria defined by Gomez, Waterlow, and McLaren. Sweat tests were performed using the Macroduct conductivity system.ResultsPatient age and gender did not affect the test results (P > 0.05). The mean sweat conductivity (equivalent NaCl mMol/L) of patients with PEM was higher than that of controls (P < 0.001) and increased with the degree of malnutrition (P < 0.001). Inverse correlations between sweat conductivity and weight for age, height for age, and weight for height were detected (P < 0.001). The highest value was found in children with wasting and stunting, followed by those with stunting (P < 0.05) and those with marasmic kwashiorkor (P < 0.01). Of all children with PEM, 6.7% had elevated sweat test results that normalized after nutritional management; of children with third degree PEM, the figure was 20%. Ninety‐fifth percentile values of first, second, and third degree malnutrition were 47 mMol/L, 49 mMol/L, and 69 mMol/L, respectively.ConclusionElevated sweat test result is not an important problem, especially in first and second degree PEM, but borderline values can be detected in as many as 20% of cases of third degree malnutrition. Sweat conductivity may increase to 69 mMol/L in children with stunting, those with wasting and stunting, and in those with third degree PEM.
The Effect of Early Treatment in Children with Chronic Hepatitis
Authors: Hartman Corina , Berkowitz Drora , Rimon Nurit , Shamir Raanan 
Published: January 2024

ABSTRACTBackgroundThe aim of this study was to compare the efficacy of interferon alpha (IFN) or IFN and ribavirin (IFN+RIB) combination therapy in children with chronic hepatitis C (CHC). Most children were infected during treatment for pediatric malignancies.Patients and MethodsWe reviewed the charts of 20 patients (11 boys and 9 girls) aged 10.6 ± 3.7 years with CHC who were treated between 1995 and 2001. Seven patients diagnosed with CHC before 1998 were treated with 3 million units of IFN three times weekly for 6 to 12 months. Thirteen children diagnosed after 1998 were treated with 3 million units of IFN three times weekly plus 15 mg/kg of ribavirin daily for 6 months (IFN+RIB).ResultsDemographic and clinical characteristics were not different between the two treatment groups. A sustained complete response defined as serum alanine aminotransferase normalization and hepatitis C virus RNA clearance at 6 and 12 months after termination of treatment occurred in three of seven children (43%) treated with IFN monotherapy compared with 7 of 12 children (54%) in the group treated with IFN+RIB combination therapy (not significant). The only difference between responders and nonresponders was the duration of infection before the initiation of therapy, which was significantly shorter in responders (1 ± 0.3 vs. 5.6 ± 2.2; P = 0.001).ConclusionsIn this small cohort of children with CHC, early initiation of antiviral treatment was associated with a sustained response rate independent of treatment type. Regular follow‐up of children at risk of acquiring hepatitis C virus infection should assist in the early diagnosis. Early initiation of antiviral treatment may improve the rate of sustained response.
Immunogenicity and Safety of Hepatitis A Vaccine in Children With Chronic Liver Disease
Authors: Ferreira Cristina Targa , da Silveira Themis Reverbel , Vieira Sandra Maria , Taniguchi Adriano , Pereira‐Lima Jorge 
Published: January 2024

ABSTRACTBackgroundAcute hepatitis A superimposed on chronic liver disease has been associated with a more severe course of disease and development of fulminant hepatitis. The aim of this study was to evaluate the immunogenicity and safety of an inactivated hepatitis A virus vaccine in children with chronic liver disease.Patients and MethodsThis was an open, prospective, and controlled trial with 89 anti‐HAV negative children between 1 and 16 years of age studied at a pediatric liver disease and transplantation referral center. Inactivated HAV vaccine (Havrix), from GlaxoSmithKline Biologicals containing 720 Elisa units of alum‐adsorbed hepatitis A antigen per 0.5 ml dose was used. Thirty‐four pediatric patients with chronic liver disease (mean age: 7.0 ± 4.86 years) and 55 healthy controls (mean age: 4.8 ± 2.7 years) received two doses of Havrix vaccine in months zero and six. Seroconversion and anti‐HAV titers expressed as geometric mean titers (GMT) in mIU/ml were measured at months one and seven, by a modified Hepatitis A virus andibodies (HAVAB) assay.ResultsSeroconversion rates at four weeks after primary immunization were 76% and 94% and the GMT 107.77 and 160.77 mIU/ml in the patient and control groups, respectively. One month after second dose the seroconversion rates were 97% and 100% in the groups with GMT of 812.40 and 2344.90 mIU/ml. Both doses were well tolerated with no significant adverse events observed. Local injection‐site symptoms were the most common reactions reported in both groups.ConclusionAlthough GMTs were significantly lower in children with chronic liver disease compared to healthy controls, the overall seroconversion rates were not different. Hepatitis A virus vaccine was safe, well‐tolerated, and immunogenic in children with chronic liver disease.
Recombinant Factor VIIa Improves Coagulopathy Caused by Liver Failure
Authors: Brown Jeffrey B. , Emerick Karan M. , Brown Deborah L. , Whitington Peter F. , Alonso Estella M. 
Published: January 2024

ABSTRACTObjectiveCoagulopathy is an important cause of morbidity and mortality in patients with liver failure. The benefit of traditional therapies to correct coagulation is often limited and short‐lived. Our aim is to identify indications for rFVIIa use and the outcome of treatment in children with liver failure.MethodsA retrospective review from July 2000 to December 2001 was performed to identify consecutive patients with acute or chronic liver failure who received rFVIIa. Prothrombin times (PT) before and after therapy were compared by paired t test.ResultsFifteen patients were treated with rFVIIa for coagulopathy caused by liver failure. All were receiving fresh frozen plasma (mean infusion rate, 39.7 mL/kg/day) when rFVIIa therapy was started. The mean PT before rFVIIa was 32.0 ± 7.0 seconds. One hour after infusion, the PT normalized to 13.7 ± 2.4 seconds (P < 0.0001) and remained significantly reduced at 6 hours (19.8 ± 5.3 seconds; P < 0.0001). A sustained improvement was maintained during the subsequent 3 days. Five of seven patients with bleeding complications improved clinically after rFVIIa treatment. Two of the bleeding patients also benefited from improved fluid balance as fresh frozen plasma support was reduced. No thrombotic events were attributed to rFVIIa therapy.ConclusionsIn patients with liver failure, rFVIIa therapy quickly normalizes the PT and maintains improved hemostasis, even when coagulopathy has been refractory to fresh frozen plasma. Therapy subjectively reduces clinical bleeding and can improve fluid balance, without complications.
Cytokines, Chemokine Receptors, and Homing Molecule Distribution in the Rectum and Stomach of Pediatric Patients with Ulcerative Colitis
Authors: Berrebi D. , Languepin J. , Ferkdadji L. , Foussat A. , De Lagausie P. , Paris R. , Emilie D. , Mougenot J. F. , Cezard J. P. , Navarro J. , Peuchmaur M. 
Published: January 2024

ABSTRACTBackgroundCytokines appear to play a significant role in the pathogenesis of inflammatory bowel disease (IBD) with a predominant Th2 pattern in colonic mucosa of patients with ulcerative colitis (UC). Chemokines and their receptors also regulate the migration of Th1 or Th2 lymphocytes to inflammatory tissues during the immune response. Although adult UC is usually confined to the colon, pediatric UC not uncommonly affects the stomach.AimsThe aim of this study was to compare expression of cytokines, chemokine receptors, and homing molecules in the rectal and the histologically characterized gastric mucosa of pediatric patients with UC.SubjectsSixteen patients (11 girls and 5 boys; median age, 9 years) having all the features of UC were included in the study.MethodsRectal and gastric mucosa obtained from UC cases were immunostained with antibodies against L‐selectin, β7 integrin, CXCR3, CCR3, and CCR5. IL‐4 and IL‐12 p40 transcript expression was studied by in situ hybridization.ResultsChronic gastritis was found in 93.7% of cases and Helicobacter pylori (Hp) was found in 2 (13.3%) cases. In the rectal and gastric mucosa, CXCR3 was found in perivascular lymphocytes and CCR5 in a subset of CXCR3+ cells in the lamina propria. CCR3+ lymphocytes and IL‐4–positive cells were always found, but there was no evidence of IL‐12 production. Most of the lymphocytes infiltrating the gastric mucosa expressed β7 but not CD62L. In contrast, β7‐positive cells were randomly dispersed in the rectal lamina propria, and the fraction of CD3+β7+ was low.ConclusionsThe authors conclude that gastritis is common in pediatric UC. The presence of CCR3+ lymphocytes, IL‐4 transcript expression, without IL‐12 p40 production in the stomach and in the rectum suggests a Th2 immune response. The presence of CCR3+, CD62L‐ activated Th2 cells may suggest that these gastric cells are recruited from colorectal primary lesions.
Internal Anal Sphincter Achalasia in Children: Clinical Characteristics and Treatment with Clostridium botulinum Toxin
Authors: Ciamarra Paola , Nurko Samuel , Barksdale Edward , Fishman Steven , Di Lorenzo Carlo 
Published: January 2024

ABSTRACTObjectivesTo describe the clinical characteristics of children with internal anal sphincter (IAS) achalasia and to evaluate the benefit of intrasphincteric injection of Clostridium botulinum toxin.MethodsRetrospective review of the medical records of 20 patients (8 male, mean 5.8 ± 4.2 years) with severe chronic constipation and IAS achalasia. Each patient received four‐quadrant, intrasphincteric injections of botulinum toxin at a dose of 15–25U per quadrant. Patients were reassessed 4 weeks‐18 months after injection. We compared the clinical characteristics of these patients to 20 consecutive children (14 male, mean age 8.1 + 4.6 y) with functional constipation (control group).ResultsThe children with IAS achalasia had earlier onset of symptoms, less fecal soiling, and less withholding behavior than the control children. Response to botulinum injection was rated excellent by the parents in 60% and by the physician in 35% of children. There was wide individual variability in the frequency of defecation after therapy. Duration of response ranged from 1 week to 18 months.ConclusionsChildren with IAS achalasia have clinical characteristics differentiating them from children with functional constipation. Intra‐anal injection of botulinum toxin is a safe and effective short‐term treatment for these children.