bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of Helicobacter pylori in Neonates and Young Infants Undergoing ERCP for Diagnosis of Neonatal Cholestasis
Authors: Guelrud Moises , Mujica Cesar , Jaen Domingo , Machuca Jensi , Essenfeld Harold 
Published: January 2024

SummaryThis study was carried out to determine the prevalence of Helicobacter pylori infection in 20 neonates and young infants from lower socioeconomic background undergoing endoscopic retrograde cholangiopancreatography (ERCP) examination for diagnosis of neonatal cholestasis. One young asymptomatic infant (5%) who was breast‐feeding with complementary formula had H. pylori infection. Endoscopy showed a normal appearing mucosa and histology demonstrated mild superficial acute gastritis. A follow‐up gastroscopy performed 14 months after the initial study showed normal histology without evidence of H. pylori suggesting that the infection was transient. Nineteen (95%) of the 20 mothers had H. pylori infection, including the mother with the infant positive for H. pylori. All mothers had gastritis on biopsy specimens. Despite the high prevalence of H. pylori in the mothers, infection in neonates and young infants was uncommon.
Metabolites of Lactose Synthesis in Milk from Diabetic and Nondiabetic Women During Lactogenesis II
Authors: Arthur Peter G. , Kent Jacqueline C. , Hartmann Peter E. 
Published: January 2024

SummaryThe concentrations of lactose, glucose, glucose 6‐phosphate (G6P), glucose 1‐phosphate (G1P), UDPglucose (UDPglc), UDPgalactose (UDPgal), and inorganic phosphate (Pi) (metabolites in the lactose synthesis pathway) were measured in mammary secretion from nondiabetic (ND) and insulin‐dependent diabetic (IDD) mothers during the first 10 days postpartum to determine their relationship with the amount of lactose synthesized and their association with the delay in lactose synthesis in IDD mothers. For all mothers the concentrations of all metabolites were low initially, and in ND mothers the first increases occurred as follows: lactose day 2; glucose, G6P and Pi—day 3; G1P and UDPglc—day 4; and UDPgal—day 6. The first increases for IDD mothers occurred 1–4 days later than for ND mothers. The concentrations of glucose, G6P, G1P, UDPglc, and Pi were related to the amount of lactose synthesized. Since the rate of lactose synthesis and concentrations of other metabolites were less than half‐maximal while the concentration of glucose was low, and since there was a delay in the increase in mammary gland concentrations of glucose in IDD mothers, it is concluded that glucose availability has the potential to play a role in the regulation of the rate of lactose synthesis at lactogenesis II.
Bradycardia and Gastroesophageal Reflux in Term and Preterm Infants
Authors: Suys Bert , De Wolf Danial , Hauser Bruno , Blecker Uwe , Vandenplas Yvan 
Published: January 2024

SummaryConflicting data are published regarding the influence of acid gastroesophageal reflux on the heart rate. In this study, heart rate was monitored simultaneously with esophageal pH in 50 infants with symptoms suggestive of gastroesophageal reflux disease (frequent vomiting and regurgitations). The data of 25 preterm infants (born at 28–366/7 weeks) were compared to those of 25 term infants (born after 37 weeks of gestation). However, both groups were investigated at identical postconceptional age of 47–49 weeks. Not one significant bradycardia (heart rate %80/min during 3%10 s) was recorded, although 71 “relative bradycardia episodes” (heart rate %s80/min during s%5 beats) were detected, none lasting for >5 s. Although the number of infants with relative bradycardia episodes did not differ between groups, the relative bradycardia episodes occurred more frequently in some preterm infants (53 episodes in preterm infants vs. 18 in term babies). Acid gastroesophageal reflux episodes were observed in 46 infants (92%). Neither the number of reflux episodes nor their duration was different in both groups. Simultaneous relative bradycardia episodes and acid reflux episodes were observed in three of 23 preterm and two of 23 term infants (NS). It is concluded that in a population of preterm and term infants with symptoms suggestive of a moderate gastroesophageal reflux pathology, investigated at comparable postconceptional age, most reflux episodes are not time‐related to changes in heart rate.
Potential Aluminium Toxicity in Infants Fed Special Infant Formula
Authors: Hawkins Nicole M. , Coffey Susan , Lawson Margaret S. 
Published: January 2024

SummaryAluminium was measured in samples of plasma and samples of feed obtained from 74 infants with normal renal function established on various feeds (breast, whey‐based, fortified whey‐based, preterm, soy, and casein hydrolysate). All infants were bolus fed, and blood samples were collected midway between feeds. Aluminium was measured using electrothermal atomization and atomic absorption spectrometry. Mean aluminium concentrations in milks were as follows: breast, 9.2 (xg/L [95% confidence interval (CI), 5.6–12.7]; whey‐based, 165 μLg/L (95% CI, 151–180); fortified, 161 μg/L (95% CI, 143–180); preterm, 300 μg/L (95% CI, 272–328); soy, 534 (μg/L (95% CI, 470–598); casein hydrolysate, 773 μg/L (95% CI, 632–914). Mean plasma aluminium concentrations in infants receiving different milks were as follows: breast, 8.6 μg/L (95% CI, 5.6–10.6); whey‐based, 9.2 μg/L (95% CI, 7.4–11.0); fortified, 10.3 μ,g/L (95% CI, 8.3–12.3); preterm, 9.7 μg/L (95% CI, 5.3–17.1); soy, 12.5 μg/L (95% CI, 5.0–20.0); casein hydrolysate, 15.2 μg/L (95% CI, 10.7–19.8). Mean plasma aluminium concentration was significantly different in infants fed casein hydrolysate formulae than in those fed breast milk (difference, 6.7 μg/L; 95% CI, 2.8–10.5; p = 0.028). We conclude that infants may be at risk from aluminium toxicity when consuming formula containing >300 μg/L–in particular, casein hydrolysate formulae. We speculate that the aluminium compounds found in breast milk are more bioavailable than those found in other milks and that some constituents of infant formula affect aluminium absorption from the gut lumen.
Insulin‐Like Growth Factor‐I in Celiac Disease
Authors: Weile Birgitte , Krasilnikoff Peter A. , Giwercman Aleksander , Skakkebæk Niels E. 
Published: January 2024

SummaryTo contribute to the description of the physiopathological mechanisms of celiac disease, changes in insulin‐like growth factor I (IGF‐I) were folio wed‐up in 21 children suspected of suffering from celiac disease. Thirteen children were suffering from celiac disease according to the original criteria of the European Society of Paediatric Gastroenterology and Nutrition. Ten celiac children changing from a gluten‐containing to a gluten‐free diet presented a significant rise in IGF‐I (+1.54 mM per month). In a group of eight celiac children challenged with gluten, seven had a significant decrease in IGF‐I (‐1.11 mM per month), and five celiac children returning to the gluten‐free diet after challenge with gluten had a marked but not significant increase in IGF‐I (+1.7 mM per month). Eight children not suffering from celiac disease, but challenged with gluten, had a significant increase in IGF‐I (+ 0.29 mM per month), corresponding to the expected age‐dependent increase. The significant changes in IGF‐I described under the diagnostic dietetic phases of celiac disease reflect the extent of growth retardation caused by the disease. IGF‐I may be a supplementary aid in the diagnosis of celiac disease in describing individual changes under the dietetic phases.
Catch‐up Growth in 60 Children with Celiac Disease
Authors: Damen G. M. , Boersma B. , Wit J. M. , Heymans H. S. A. 
Published: January 2024

SummaryThe growth pattern of 28 girls and 32 boys with celiac disease was analyzed up to the ages of 10 and 12 years, respectively. Fifty‐four patients (90%) were diagnosed before 4 years of age and six patients (10%) between 5 and 9 years of age. At diagnosis, 18 of 60 patients (30%) had a height SD score below ‐ 2.0, and 45 of 59 patients (76%) had a weight‐for‐height below the median. The mean height SD score showed increasing growth retardation in the year before diagnosis, relatively quick catch‐up growth in the year after diagnosis, and complete catch‐up in 2–3 years. Mean weight‐for‐height showed a progressive decrease 12–18 months before diagnosis, increased to a maximum at the end of the first year of therapy, and returned to normal 15 months after dietary treatment. Independent of age at diagnosis, initial degree of wasting, diagnostic delay, and strictness of gluten‐free diet, catch‐up growth was complete in this group of patients who were diagnosed before 9 years of age.
The Prevalence of Helicobacter pylori Positivity in Human Immunodeficiency Virus‐Infected Children
Authors: Blecker Uwe , Keymolen Kathelijn , Lanciers Sophie , Bahwere Paluku , Souayah Hicham , Levy Jack , Vandenplas Yvan 
Published: January 2024

SummaryTo investigate the prevalence of Helicobacter pylori infection in pediatric patients infected with the human immunodeficiency virus, we sought to detect the presence of antibodies against this organism in 23 human immunodeficiency virus‐infected children of central African ethnic origin by means of a second‐generation enzyme‐linked immunoassay (ELISA) test for the detection of immunoglobulin G (IgG) antibodies to Helicobacter pylori (Malakit Helicobacter pylori, Biolab, Limal, Belgium). They were compared to an asymptomatic control population matched for age and ethnic origin. Blood samples were taken during routine blood analysis before the monthly administration of intravenous γ‐globulins in the human immunodeficiency virus‐infected patients and during preoperative blood analysis in the control population. Despite the fact that most human immunodeficiency virus‐infected patients had IgG antibodies against other frequently encountered pathogens, none of them had a positive serology for Helicobacter pylori, compared to 10 of 52 patients (19.2%) in the control population. This difference is statistically significant (p = 0.01)
The Renin‐Angiotensin‐Aldosterone System and Vasopressin in Early‐Stage Liver Cirrhosis after HBV Infection in Children
Authors: Winnicki Cezary , Warnawin Krzysztof , Januszewicz Pawel , Socha Jerzy 
Published: January 2024

SummaryWe evaluated the dynamic response of renin, aldosterone, and vasopressin to intravenous water loading (20 ml 5% glucose/kg b.w.) in 12 children (aged 7–18 years) with postinflammatory liver cirrhosis after hepatitis B virus (HBV) infection. All of the patients had early‐stage liver cirrhosis; according to Child's classification, nine patients had group A; three, group B cirrhosis. A group of 17 children with chronic persistent hepatitis served as the control. The diagnoses were confirmed in all of the patients by liver biopsy. The patients followed a diet containing 3 mmol NaCl/kg/day, maximum 100 mmol per day for 6 days. Water loading was performed in recumbency over ± 45 min. Renin, aldosterone, and vasopressin, assayed by radioimmunoassay (RIA), were determined before, 1 h, and 5 h after starting the water load. Prestudy hormone levels were within normal range in both groups. Renin and aldosterone concentration change patterns were similar in both groups and characterized by suppression of hormone activity caused by central volume expansion and recovery to prestudy levels after 5 h. However, the pattern of change of vasopressin concentrations differed in the control and study groups. In contrast to that of the controls, volume expansion did not suppress vasopressin in the group with liver cirrhosis. We conclude that failure to suppress vasopressin activity after central volume expansion may be one of the early mechanisms responsible for water‐electrolyte imbalance in liver cirrhosis in children.
Quantitative Analysis and Immunohistochemical Studies on Small Intestinal Mucosa of Food‐Sensitive Enteropathy
Authors: Nagata S. , Yamashiro Y. , Ohtsuka Y. , Shioya T. , Oguchi S. , Shimizu T. , Maeda M. 
Published: January 2024

SummaryQuantitative analysis and immunohistochemical studies of small intestinal mucosa were performed to investigate the mechanism of mucosal damage in 10 patients with food‐sensitive enteropathy. Jejunal biopsy specimens were taken before and after treatment and after clinical relapse following a challenge test. The low villous height of untreated patients normalized after introduction of an elimination diet but declined again to subnormal level after a challenge test. Several other types of cells were significantly increased in the untreated patients in comparison to controls. These included HLA‐DR+ (DR + ) CD4+ cells in the lamina propria and intraepithelial CD8+ cells. Moreover, those cell patterns, such as increased DR+ CD4+ cells and CD8+ cells, normalized with treatment but regressed to pretreatment levels when the patients were challenged. These findings suggest that activated CD4+ cells in the lamina propria of the small intestinal mucosa, probably by releasing cytokines, may play an important role in contributing to mucosal damage in patients with food‐sensitive enteropathy.
Lack of Neuronal Nitric Oxide Synthase in Nerve Fibers of Aganglionic Intestine
Authors: Larsson L. T. , Shen Z. , Ekblad E. , Sundler F. , Aim P. , Andersson K. E. 
Published: January 2024

SummaryThe lack of nonadrenergic, noncholinergic (NANC) inhibitory innervation in aganglionic intestine is typical of Hirschsprung's disease. Several neuropeptides participating in the intestinal NANC innervation are greatly reduced in aganglionic intestine. However, these findings do not fully explain the pathophysiology of the disease. Recently, nitric oxide (NO) has been presented as a potent smooth muscle relaxant, and the enzyme responsible for its formation, nitric oxide synthase (NOS) has been demonstrated in neuronal elements in both the central and peripheral nervous system. In our study, nicotinamide adenine dinucleotide phosphate (NADPH)‐diaphorase staining, a marker for NOS, and NOS immu‐nohistochemistry revealed a dense innervation of the smooth muscle layers and the myenteric ganglia in ganglionic non afflicted intestine from patients with Hirschsprung's disease. By contrast, there was an almost complete lack of NOS‐immunoreactive and NADPH‐diaphorase‐positive nerve fibers in the afflicted aganglionic bowel. NOS and vasoactive intestinal peptide were found to be partially colocalized in nerve fibers and neuronal cell bodies in the ganglionic but not in the aganglionic intestine. The lack of NO‐producing nerve fibers in the aganglionic intestine probably contributes to the inability of the smooth muscle to relax, thereby causing lack of peristalsis in Hirschsprung's disease.
Absence of NADPH‐Diaphorase Activity in Internal Anal Sphincter (IAS) Achalasia
Authors: Hirakawa Hitoshi , Kobayashi Hiroyuki , O'Briain D. Sean , Puri Prem 
Published: January 2024

SummaryWe studied the internal anal sphincter (IAS) muscle from 10 patients with achalasia and five normal controls using histochemical staining for NADPH‐diaphorase and acetylcholinesterase (AChE). Normal control IAS muscle contained occasional AChE‐positive nerve fibers, whereas IAS achalasia specimens demonstrated prominent AChE‐positive nerve fibers in muscle layers. NADPH‐diaphorase activity was strongly expressed in nerves in the normal IAS muscle but was absent or scanty in the muscle of patients with IAS achalasia. Our findings of increased AChE‐positive nerves and the absence of NADPH‐diaphorase activity taken in conjunction with reports of abnormal peptidergic innervation indicate that complex neural abnormalities occur in IAS achalasia. The primary event remains obscure, but it is possible that a single defect, such as nitrergic nerve depletion, may lead to compensatory changes in the other nerve fibers.
Applied Potential Tomography in the Measurement of Gastric Emptying in Infants
Authors: Nour S. , Mangnall Y. F. , Dickson J. A. S. , Johnson A. G. , Pearse R. G. 
Published: January 2024

SummaryThe aim of this study was to investigate the feasibility of using applied potential tomography (APT), a noninvasive and nonradioactive method, to measure the rate of gastric emptying in preterm babies and infants <3 months old. APT, a form of electrical impedance tomography, creates tomographic images of tissue resistivity to a small electrical current and has been used to study gastric emptying in adults. The rate of gastric emptying of 53 preterm infants and 29 term infants was measured. The test feed was either milk (formula milk or expressed breast milk) or Dioralyte (a commercial rehydration solution). When a nasogastric tube was present, the results obtained by APT were validated by comparing the volume of feed estimated to be present with the volume that could be aspirated. All infants completed the investigation without any problems. APT demonstrated a slower rate of emptying of milk feeds than Dioralyte and showed that milk and Dioralyte feeds in preterm babies emptied at a similar rate to feeds in term infants. In validation studies, gastric emptying has been observed in 44 of 47 studies, and this finding was confirmed by aspiration of the nasogastric tube. Applied potential tomography is a safe, noninvasive method for measuring gastric emptying in small infants.
Differentiation and Polarity Alter the Binding of IGF‐I to Human Intestinal Epithelial (Caco‐2) Cells
Authors: Oguchi S. , Walker W. A. , Sanderson I. R. 
Published: January 2024

SummaryThis study examined whether insulin‐like growth factor‐I (IGF‐I) bound to specific functioning IGF receptors on the surface of Caco‐2 cells and how this binding was affected by the differentiation and polarity of these cells. IGF‐I, which increased cell proliferation in a dose‐dependent manner, bound to a specific receptor on the surface of Caco‐2 cells. Affinity cross‐linking with labeled IGF‐I followed by reducing sodium dodecylsul‐fate‐polyacrylamide gel electrophoresis (SDS‐PAGE) showed Mrs at 135,000, 270,000 and 355,000 bands, which was inhibited by unlabeled IGF‐I. A Scatchard analysis of radioligand‐receptor binding showed the presence of a single class of receptors with high affinity for IGF‐I. This class of receptors was specific for IGF‐I, the affinity of IGF‐I to the receptor being four and 150 times greater than IGF‐II and insulin, respectively. There was no difference in the affinity of IGF‐I to type 1 IGF receptors between less‐differentiated [dissociation constant (Kd) = 3.81 nM] and well‐differentiated cells (Kd = 3.78 nM); however, well‐differentiated cells showed a 2.4‐fold higher maximum number of binding sites (Bmax) than less‐differentiated cells (3.45 vs. 1.44 x 104 sites/cell), indicating an increase in the density of IGF‐I receptors with differentiation. Furthermore, the number of type 1 IGF receptors on the basolateral surface of well‐differentiated cells was 2.4 times greater than that seen on the apical surface. In summary, IGF‐I binds to a single class of specific Caco‐2 cell‐surface receptors, which increase in number with differentiation and are found on both aspects of the epithelium.
Etiology and Risk Factors of Severe and Protracted Diarrhea
Authors: Guarino Alfredo , Spagnuolo Maria Immacolata , Russo Stefania , Albano Fabio , Guandalini Stefano , Capano Guglielmo , Cucchiara Salvatore , Vairano Paola , Liguori Roberto , Casola Antonella , Rubino Armido 
Published: January 2024

SummarySevere and protracted diarrhea (SPD) is the most severe form of diarrhea in infancy and has also been defined as intractable diarrhea. Its etiology is poorly defined. We have retrospectively evaluated the etiology, the outcome, and the risk factors of 38 children, admitted with protracted diarrhea and need for total parenteral nutrition (TPN) from 1977 to 1993. Children with anatomic abnormalities and/or primary immunodeficiency were excluded. There was an inverse relationship between the number of patients and the age of diarrheal onset (mean age, 2.9 ± 3.5 months). Etiology of SPD was an enteric infection in 18 cases (eight Salmonella, three Staphylococcus, five rotavirus, one adenovirus, one Cryptosporidium), multiple alimentary intolerance (eight cases), familial microvillous atrophy (two), autoimmune enteropathy (two), celiac disease, lymphangectasia, eosinophilic enteropathy, intestinal pseudoobstruction, and intestinal neurodysplasia (1 case each). Etiology was not detected in three cases. Overall, 12 children died, five are presently being treated, and 21 had full remission. Comparative evaluation of risk factors between children with SPD and a control population of children with diarrhea but without the need for TPN showed that low birth weight, no breast feeding, history of fatal diarrhea in a relative, and early onset of diarrhea had a significantly higher incidence in the former. Social background was similar in the two populations. We conclude that a specific etiology can be identified in the majority of cases of SPD. The etiologic spectrum of SPD is broad, but an enteric infection is the most common cause of SPD. The severity of this condition is related, at least in part, to established risk factors.
The Prognostic Significance of Caffeine Half‐Life in Saliva in Children with Chronic Liver Disease
Authors: Baker A. , Girling A. , Worthington D. , Ballantine N. , Smith S. , Tarlow M. , Kelly D. 
Published: January 2024

SummaryTo evaluate its clinical value, the half‐life of caffeine (1,3,7‐trimethylxanthine) in saliva (SCT) after 3 mg/kg‐1 oral caffeine was measured in 53 children with chronic liver disease (mean age, 4.41 years) and 48 control children (mean age, 6.26 years) in five samples over 24 h and compared with parameters of liver function and outcome. Sensitivity was 60.3% and specificity 97% of SCT for diagnosis of chronic liver disease. The correlation of SCT with serum albumin (ALB) was −0.52 (p < 0.001), total bilirubin (SBR) was 0.585 (p < 0.001), prolonged prothrombin time (PT) was 0.387 (p = 0.004), and aspartate aminotransferase (AST) was 0.538 (p = 0.001). The correlation of SCT with a clinical score of liver dysfunction calculated from the presence of features of hepatic decompensation was 0.627 (p < 0.001) and with Malatack's paediatric prognostic score was 0.505 (p < 0.001). Serial SCT and liver function tests were performed on 53 patients on 127 occasions during a mean follow‐up of 361 days (range, 4–709). Of this group, 18 were listed for liver transplantation. Predictive values of outcome by analysis of variance expressed as ratio of mean squares were SBR, 34.1 (p < 0.001); log10 SCT, 20.6 (p < 0.001); ALB, 5.2 (p < 0.05); PT, 1.2 (NS). SCT correlated with clinical and biochemical parameters of severity of liver disease, but SBR was a better predictor of listing for liver transplantation in this group of paediatric patients.
Grasp Biopsy, Suction Biopsy, and Clinical History in the Evaluation of Esophagitis in Infants 0–6 Months of Age
Authors: Friesen Craig A. , Zwick David L. , Streed Cindy J. , Zalles Carola , Roberts Charles C. 
Published: January 2024

SummaryFifty‐three infants 0–6 months of age with abnormal 24‐h intraesophageal pH monitoring were evaluated by esophageal suction biopsies and endoscopic grasp biopsies. Histologic esophagitis was present in 30% of the infants. Of the infants with esophagitis, 88% were accurately identified by suction biopsy, and 75% were accurately identified by endoscopic grasp biopsy. Suction biopsy alone was not significantly different from combined grasp and suction biopsy, while differences between grasp biopsy and combined biopsy approached significance (p = 0.051). Twelve clinical symptoms and 21 intraesophageal pH monitoring parameters were evaluated for their ability to predict esophagitis, and none were found to be useful. We conclude that endoscopic esophageal biopsy, while more costly, offers no advantage over suction biopsy for the detection of esophagitis in young infants.