bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modification of the Adult Blakemore Tube for Use in Children with Bleeding Esophageal Varices
Authors: Kline Jeffrey J. 
Published: February 2024

SummaryA modification of the adult‐sized Blakemore tube is described for emergency use in children with bleeding esophageal varices. Inexpensive, readily available, heat‐labile tubing was used to adapt the esophageal balloon for use in small children, keeping possible complications at a minimum.
Esophagitis and Findings of Long‐Term Esophageal pH Recording in Children with Repeated Lower Respiratory Tract Symptoms
Authors: Baer Maija , Mäki Markku , Nurminen Juha , Turjanmaa Väinö , Pukander Juhani , Vesikari Timo 
Published: February 2024

Summary:Esophagoscopy was performed on 116 children with recurrent lower respiratory tract symptoms; esophagitis of various degrees was detected in 45% of the cases. The presence of verified esophagitis correlated with endoscopic findings of bile‐stained gastric contents, suggesting a role of bile reflux in the pathogenesis. Esophageal pH recordings covering an 18‐24‐h period were performed on 22 patients with esophagitis and 19 patients without esophagitis. Gastroesophageal reflux (GER) during the sleeping period was detected in 95% of children with esophagitis, as compared to 42% in children with no esophagitis (p < 0.001). The percentage of time with esophageal pH below 4 of the total registration time was significantly greater (p < 0.05) in children with esophagitis (9.5%) than in those with no esophagitis (4.0%)—the difference being due to a greater share of nocturnal GER of the recording time. These criteria could be applied to a search for clinically significant GER in children with recurrent lower respiratory tract symptoms and to select patients for esophagoscopy.
Comparative Reliability of d‐Xylose Absorption and Serum β‐Carotene Measurements in Small Intestinal Disease
Authors: Amira Ken‐Dror Yehezkel Naveh , Zinder Oren , Berkovich Drora 
Published: February 2024

Summary:Comparative reliability of d‐xylose absorption and serum β‐carotene measurements was studied in 63 healthy and sick children suspected of having proximal small intestinal disease. Group 1 included children with newly diagnosed celiac disease (CD) who were on a normal diet (xylose, n = 46; carotene, n = 43); group 2 included children with CD in remission (xylose, n = 17; carotene, n = 15); group 3 included children with CD in remission, but who were exposed to a gluten‐containing diet for an average of 1.4 years (xylose, n = 19; carotene, n = 17); and group 4 included 17 healthy children, insofar as this study is concerned, in whom serum carotene was examined. The means of serum xylose of groups 1 and 3 were significantly lower than the mean of group 2 (p < 0.001 in both cases). d‐Xylose had a sensitivity of 76.9% and a specificity of 100%. The mean serum carotene concentration for group 2 patients with CD in remission was equal to the mean of group 4, which included healthy children. The means of groups 1 and 3 were significantly lower than the means of groups 2 and 4 (p < 0.001 in all cases). Serum β‐carotene had a sensitivity of 95% and a specificity of 87.5%. The use of these two serum tests in combination would give a specificity of 100% and a sensitivity of 94.1%. Although 1‐h serum xylose was as efficient as serum β‐carotene in newly diagnosed children with CD, carotene was superior to xylose in patients with CD who were challenged with gluten (group 3), and therefore the measurement of carotene, which has the higher sensitivity, may be useful in the detection of children with CD who lack strict adherence to the gluten‐free diet.
Enteropathogens Associated with Acute Diarrhea in Hospitalized Infants
Authors: Figueroa Guillermo , Araya Magdalena , Ibañez Silvia , Clerc Nadine , Brunser Oscar 
Published: February 2024

Summary:Thirty‐five infants of low socioeconomic status who were living in urban Santiago were hospitalized for acute diarrhea were prospectively evaluated for the presence of enteropathogens associated with the episode. Some degree of malnutrition was evident in 20 infants (57.1%); 15 of these (75%) were under 6 months of age. Mean duration of the hospital stay was 11.8 days for well‐nourished patients and 15.7 days for the malnourished patients. One or more enteropathogens were found in 60% of the cases studied: in 17 cases (48.6%) these were bacteria and in four cases (11.4%) it was rotavirus. Parasites were not detected. In three patients, two different pathogens were demonstrated. Among the bacteria, 12 isolates (34.3%) were enteropathogenic E. coli (EPEC) and two (5.7%) were Shigella. Campylobacter jejuni was also isolated from two different cases (5.7%) and Salmonella from one case (2.9%). The recovery of pathogens was independent of the nutritional status. Mean age of detection of EPEC was 3.2 months among well‐nourished infants and 6.2 months among the malnourished (p < 0.001). Half of the EPEC strains isolated were multiresistant to antibiotics. One of these strains transferred some of its resistance in vitro to E. coli K 12. Ampicillin and kanamycin were the antibiotics to which EPEC showed the greatest resistance. The other bacterial pathogens were mostly sensitive to antibiotics. Campylobacter jejuni, together with Shigella, was the second most frequent pathogen isolated during episodes of diarrhea. Campylobacter should be included in the routine study of diarrheal episodes in our setting.
Mineral Homeostasis in Very Low Birth Weight Infants Fed Either Own Mother's Milk or Pooled Pasteurized Preterm Milk
Authors: Pettifor John M. , Stein Harry , Herman Allen , Ross Paddy F. , Blumenfeld Tanya , Moodley Gopal P. 
Published: February 2024

Summary:As part of a randomised controlled study to assess the effect of pasteurization of breast milk on the growth of very‐low‐birth‐weight infants, the longitudinal changes in serum calcium, phosphorus, alkaline phosphatase, 25‐hydroxyvitamin D, and bone‐gla‐protein concentrations were investigated. Infants fed untreated own mother's milk grew more rapidly than those fed pasteurized pooled preterm milk and had higher serum alkaline phosphatase and lower phosphorus values. Serum calcium and 25‐hydroxyvitamin D (25‐OHD) concentrations were similar in the two groups. Despite the provision of 750 IU vitamin D daily from the 2nd week of life, serum 25‐OHD values remained low in a number of infants in both groups, suggesting that either malabsorption of vitamin D or hepatic immaturity might be responsible for the persistently low values. Bone‐gla‐protein rose significantly after birth and was correlated with alkaline phosphatase values, but not with 25‐OHD or phosphorus values. The study supports previous work that indicates that the low phosphorus content of breast milk is probably responsible for biochemical evidence of inadequate bone mineralization and that despite vitamin D supplementation, 25‐OHD values do not rise adequately. Thirty‐six infants were reexamined between 4 and 11 months after birth. The 25‐OHD values had risen significantly in all infants except one who had vitamin D deficiency rickets.
Reliability of a New Technique for the Determination of Vitamin B12 Absorption in Children
Authors: Hjelt Karsten 
Published: February 2024

Summary:The fractional vitamin B12 absorption (FAB12) was determined in 39 patients with various gastrointestinal diseases by a double‐isotope technique, employing a single stool sample test (SSST), as well as a complete stool collection. The age of the patients ranged from 2.5 months to 16.2 years (mean 5.0 years). The test dose was administered orally and consisted of 0.5‐4.5 μg of 57CoB12 (approximately 0.05 μCi), carmine powder, and 2 mg 51CrCl3 (approximately 1.25 μCi) as the inabsorbable tracer. The whole‐body radiation to a 1‐year‐old child averaged only 20 mrad. The stool and napkin was collected and homogenized by addition of 300 ml “chromium sulfuric acid.” A 300‐ml sample of the homogenized stool and napkin, as well as 300 ml chromium sulfuric acid (75% v/v) containing the standards, were counted in a broad‐based well counter. The FAB12 determined by SSST employing the stool with the highest content of 51Cr (which corresponded to the most carmine‐colored stool) correlated closely to the FAB12 based on complete stool collection (r = 0.98, n = 39, p < 0.001). The reproducibility of FAB12 determined by SSST was assessed from double assays in 19 patients. For a mean value of 12%, the SD was 3%, which corresponded to a coefficient of variation (CV) of 25%. The excretion of 57Co and 51Cr in the urine was examined in six patients with moderate to severe mucosal damage and was found to be low. The gut transit time, as determined by the excretion time of ≥ 50% of the orally administered 51Cr, ranged from 4 to 100 h (mean 36 h, n = 39), and it was less than 12 h and 24 h in 7 and 13 patients, respectively. Conclusively, the SSST proved to be a very suitable technique for measurements of B12 absorption, even in children with mucosal damage of the intestine and short gut transit time. Further‐more, the method fulfilled the following requirements; (a) minimal cooperation and control of possible errors, (b) small radiation dose, (c) direct measurement of the B12 absorption, and (d) no need for flushing with B12.
Relapsing Pseudomembranous Colitis
Authors: Holmes Ronald , Byrne William J. 
Published: February 2024

Summary:Pseudomembranous colitis secondary to C. difficile and its toxin(s) is a well‐recognized disease in children and usually responds to treatment with oral vancomycin. There are well‐documented reports of relapse in adults after initial successful treatment with vancomycin. This report documents relapse in a child who developed diarrhea following treatment of pseudomembranous colitis. Stool cultures were negative for C. difficile at the end of the initial course of treatment, but the organism was isolated from the stool when the diarrhea recurred. The symptoms improved following a second course of treatment with vancomycin and have not recurred during 8 months of followup monitoring.
Delayed Gastric Emptying and Chronic Diarrhea in a Patient with Oculodentodigital Dysplasia Syndrome
Authors: Levine Douglas S. 
Published: February 2024

Summary:A patient with oculodentodigital dysplasia (ODDD) syndrome was evaluated because of complaints of intermittent diarrhea of many years duration. Gastrointestinal manifestations have not been routinely described in patients with ODDD, which is a hereditary disorder characterized by abnormal eye findings, defective tooth enamel, various phalangeal aberrations, a distinctive facial appearance, and skeletal dysplasias. Steatorrhea was documented, but the usual methods for investigating this were thwarted ?? motility. A combined endoscopic‐fluoroscopic, guidewire‐directed intubation procedure was performed to permit study of the small bowel. Pancreatic function was normal, and culture of an aspirate from the jejunum revealed a mixed bacterial flora. Treatment for presumed small bowel bacterial overgrowth with antibiotics and a reduced fat diet brought relief of diarrheal symptoms and produced weight gain. The clinical approach to this particular patient and the relationship between the ODDD syndrome and the deseribed gastrointestinal anomalies are disecossed.
Malabsorption of Liposoluble Vitamins in a Child with Bile Acid Deficiency
Authors: Vanderpas Jean B. , Koopman Berend J. , Cadranel Samuel , Vandenbergen Claudine , Rickaert Fabienne , Quenon Marianne , Wolthers Bert G. , Brauherz Georges , Vertongen Françoise , Tondeur Michel 
Published: February 2024

SummaryA male born to first cousins presented at 12 months with hypocalcemic convulsions, rickets, epistaxis due to vitamin K deficiency, and extremely low serum levels of beta‐carotene and vitamin A. Liver function was altered moderately (glutamic‐oxaloacetic transaminase, 55 U/L; glutamic‐pyruvic transaminase, 37 U/L; lactate dehydrogenase, 255 U/L; alkaline phosphatase, 437 U/L). To correct the deficiencies, 8000 IU vitamin D/day, 10,000 IU vitamin A/day, and intramuscular administration of vitamin K1 were required. At 9 years, he presented signs of neuromuscular affection, and the serum vitamin E level (measured for the first time) was extremely low. Classic lipid malabsorption syndromes (abetalipoproteinemia, chronic cholestasis, mucoviscidosis, coeliac disease, Whipple's disease) were excluded by appropriate examinations. Composition of duodenal bile acids was characterized by undetectable levels of cholic acid metabolites, and only chenodeoxycholic acid metabolites were present. Serum total bile acid concentration was normal, with an atypical low cholic acid/chenodeoxycholic acid ratio and abnormal presence of 3β‐OH‐δ5‐cholenic acid and 6‐OH‐bile acids. Urinary bile acid composition was also characterized by elevated 6‐OH‐bile acids. Known enzymopathies of the bile acid synthetic pathway were excluded (cerebrotendinous xanthomatosis, cerebro‐hepato‐renal syndrome of Zellweger, coprostanic acidemia). Bile acid pool sizes were determined by using stable isotopes: cholic acid pool size [2.90 (N, 32 ± 16) μM/kg] and chenodeoxycholic acid pool size [10.8 (N, 32.6 ± 9.9) μM/kg] were extremely low; fractional turnover rates of both bile acids were in a normal range. Treatment with chenodeoxycholic acid markedly improved the absorption of fat soluble substances and normalized hepatic function. A partial enzyme defect in the metabolism of the steroid nucleus is proposed.
Acarboxy Prothrombin (PIVKA‐II) as a Marker of Hepatoblastoma in Infants
Authors: Motohara Kunihiko , Endo Fumio , Matsuda Ichiro , Iwamasa Teruo 
Published: February 2024

SummaryWe evaluated plasma PIVKA‐II (protein induced by vitamin K absence or antagonist‐II, acarboxy prothrombin) levels in three infants with hepatoblastoma as a tumor marker. PIVKA‐II levels were highly elevated in all three patients. Vitamin K administration, performed in two patients, resulted in only moderate reduction of PIVKA‐II levels. Chemotherapy against tumor cells reduced the PIVKA‐II levels without exception. Immunohistochemical study of the liver tissue indicated the presence of PIVKA‐II in the hepatoblastoma cell. These findings suggest that elevated PIVKA‐II in these patients was not due to nutritional vitamin K deficiency, but to excess production of tumor cells. A measurement of plasma PIVKA‐II may be useful as a new marker of hepatoblastoma.
Intestinal Obstruction in Crohn's Disease in Childhood
Authors: Kirchmann Hiltrud M. A. , Bender Steffen W. 
Published: February 2024

SummaryOut of 540 children and adolescents from the Multicenter Pediatric Crohn's Disease Study Group, 42 patients presented with decompensated intestinal obstruction. In 26 patients only one intestinal obstruction occurred, and in 16 children up to five intestinal obstructions occurred. Conservative measures were successful in 37 of 72 episodes of intestinal obstruction (51.4%), while 19 of 42 patients underwent emergency surgery (45.2%) and 16 of 42 (38.1%) were operated on following conservative treatment. From analysis of clinical, intraoperative, and histological findings in surgically treated patients, criteria for emergency surgery and elective surgery of intestinal obstruction in Crohn's disease are derived. One patient with adenocarcinoma of the large bowel, presenting with recurrent obstruction, signals caution in delaying proper diagnosis.
Effect of Somatocrinin and a Somatostatin Antiserum on Liver Growth in the Rat
Authors: Dubreuil P. , Brazeau P. , Morisset J. 
Published: February 2024

SummaryThis study examines the effects of somatocrinin (GRF) and somatostatin antiserum (ASS) alone, and in combination, on liver growth. Twenty‐four‐day‐old rats were injected s.c. twice daily for 14 days with either saline or GRF (4 and 20 μg · kg‐1)‐ASS was given i.p. every 2 days. GRF alone had no effect on liver weight, but produced hyperplasia and increased RNA content. ASS alone had no effect on RNA, DNA, and protein contents. Potentiation of the effects of GRF by ASS was observed on liver weight and DNA content. Indeed, this combined treatment resulted in increased organ weight and hyperpiasia at an intermediary level of GRF. These data indicate that a strong interaction exists between GRF and ASS on the control of liver growth, possibly through the release of growth hormone (GH).
Evaluation of Hexosaminidase Activity as a Potential Biochemical Marker in Serum for Necrotizing Enterocolitis
Authors: Shattuck Karen E. , Richardson C. Joan , Rassin David K. , Lobe Thom E. 
Published: February 2024

SummaryThe presence of increased serum activity of the lysosomal hydrolase hexosaminidase has been suggested to be potentially useful in the diagnosis of neonatal necrotizing enterocolitis (NEC). In the present study, serum activity of hexosaminidase was measured in 19 neonates with NEC and compared to developmental patterns of enzyme activity determined in 61 neonates without NEC. Infants with NEC were studied at intervals starting at the onset of disease and continuing until 6 weeks after diagnosis. In normal infants, serum activity of hexosaminidase increases with increasing gestational and postnatal ages. However, infants with NEC had relatively lower serum hexosaminidase activity than these control infants of similar gestational and postnatal ages. Necrotizing enterocolitis is not associated with increased serum activity of hexosaminidase.
Disaccharidase Activities and Intestinal Absorption in Infants with Congenital Intestinal Obstruction
Authors: Serrano J. , Zetterström R. 
Published: February 2024

SummaryThe results of studies on disaccharidase activities and on intestinal absorption in cases of complete and incomplete congenital small bowel obstruction are presented. Assays of the activities of maltase, isomaltase, sucrase, trehalase, and lactase have been performed on biopsy specimens taken at the time of surgery. In specimens taken from above the site of obstruction, the activities are reduced for all disaccharidases, and are particularly low for trehalase and lactase. There was no difference between the cases with complete and incomplete obstruction. Distal to a complete obstructionrehalase and lactase were reduced, whereas in cases of incomplete obstruction, the activities of all disaccharidases were within what is considered normal in the reference material. Two months after surgery, the disaccharidase activities were found to be normal: One month after surgery, the absorption of glucose and vitamin A was markedly impaired in cases with complete obstruction, whereas that of D‐xylose was not significantly reduced from normal. In cases with incomplete obstruction, the results did not differ from those found in normal infants. The fact that failure to thrive is common during the first months after birth in patients with congenital intestinal atresia, even when surgery is successful, may be explained by deficient intestinal absorption, particularly in patients with complete obstruction.
Serum Calcium and Phosphate Disturbances During Rehydration in Acute Dehydrating Gastroenteritis
Authors: Mohanlal Dhirenda , Pettifor John M. , Moodley Gopal P. 
Published: February 2024

SummaryAlterations in serum ionized and total calcium, magnesium, and phosphate concentrations, during recovery from acute dehydrating gastroenteritis, were studied. Fifteen children with acute dehydrating gastroenteritis had serum concentrations of ionized and total calcium, magnesium, phosphate, sodium, potassium, chloride, urea, creatinine, and albumin, as well as acid‐base status, evaluated during rehydration and up to 72‐h postadmission. The total serum calcium corrected for albumin did not change significantly during rehydration and remained within the normal range. Although serum ionized calcium fell significantly at 24 and 72 h, its concentration was not sufficiently decreased to cause symptomatic hypocalcemia. Serum ionized calcium correlated significantly with pH (r −0.57), bicarbonate (r = −0.63), and albumin (r = +0.65), but not with total serum calcium, magnesium, and phosphate. Serum magnesium remained within the normal range during the study period. Serum phosphate was increased on admission (2.64 ± 0.77 mmol/L), decreased by 12 h (to 0.84 ± 0.32 mmol/L), and then followed by a gradual increase. This study suggests that changes in serum ionized calcium in dehydrating gastroenteritis are not of clinical significance. However, changes in serum phosphate concentration need further evaluation.
Rectosigmoidoscopic Findings During Isolated Rectal Bleeding in the Neonate
Authors: Dupont Christophe , Badoual Jean , Luyer Bernard Le , Bourgeois Corinne Le , Barbet Jacques‐Patrick , Voyer Marcel 
Published: February 2024

SummaryThis study describes a group of 34 infants under 1½ months of age presenting with isolated rectal bleeding not related to hemorrhagic disease of the newborn or to campylobacter infection and with spontaneously favorable evolution. Systematic rectosigmoidoscopy showed the presence of mucosal alterations in the form of either longitudinally stretched ecchymoses lying on a normal mucosa or diffuse ecchymotic patches dispersed on a congestive and friable mucosa, rarely associated to visible micro‐ulcerations. Biopsies showed mucosal hemorrhage, capillary vessel congestion, and epithelial erosions, as well as various grades of inflammation. Clinical data indicate that this hemorrhagic colitis is a heterogeneous group where dietary protein intolerance may account for some cases.
Alpha2 HS‐Glycoprotein Levels in Children with Protein‐Energy Malnutrition and Infections
Authors: Abiodun Ph. O. , Olomu I. N. 
Published: February 2024

SummarySerum alpha2 HS‐glycoprotein levels were studied, using the single‐radial immunodiffusion method, in 39 severely malnourished children (22 kwashiorkor, 17 marasmus) of whom 15 (8 kwashiorkor, 7 marasmus) were infected and 24 (14 kwashiorkor, 10 marasmus) had no signs of infection. Thirty‐two well‐nourished children, 16 of whom were infected, served as controls. The uninfected controls had higher serum alpha2 HS‐glycoprotein levels than the uninfected kwashiorkor (82.0 ± 14.7; 57.0 ± 15.8; p < 0.001) and marasmic children (82.0 ± 14.7; 45.0 ± 13.9; p < 0.001). Infection was associated with a significant decrease in the mean serum alpha2 HS‐glycoprotein levels in the well‐nourished (82.0 ± 14.7; 57.0 ± 7.7; p < 0.001) and kwashiorkor (57.0 ± 15.8; 34.0 ± 20.4; p < 0.02) children, while no such decrease was observed in the marasmic children. While the mean serum glycoprotein level in the infected controls was higher than that in the infected kwashiorkor children (57.0 ± 7.7; 34.0 ± 20.4; p < 0.02), it was comparable to that in the infected marasmic children (57.0 ± 7.7; 50.0 ± 11.6; p > 0.05). Furthermore, the mean alpha2 HS‐glycoprotein level in the infected malnourished children was higher in marasmus than in kwashiorkor (50.0 ± 11.6; 34.0 ± 20.4; p > 0.05); this difference was, however, not statistically significant. It is suggested that the lower level of alpha2‐HS glycoprotein observed in children with kwashiorkor, both in the presence and absence of infection, might be a contributory factor in the impairment of the host defense mechanisms in these children with consequent higher morbidity and mortality from infection as compared to well‐nourished and marasmic children.