bluuebunny/crossref_metadata_2025_split huggingface dataset:
Symptomatic Gastroesophageal Reflux
Authors: Westra Sjirk J. , Derkx Herbert H. F. , Taminiau Jan A. J. M. 
Published: January 2024

SummaryUltrasound is a new test proven to be sensitive in the demonstration of gastroesophageal reflux (GER). Following reflux seen with ultrasound various symptoms can be observed in physiological circumstances, and thereby a causal relationship between reflux and these symptoms can be observed in physiological circumstances, and thereby a causal relationship between reflux and these symptoms can be proven. We performed a study in 220 children suspected of GER to determine the incidence of sonographically demonstrated “symptomatic reflux” in different clinical groups: children with (1) vomiting only, (2) respiratory symptoms, (3) attack‐like symptoms, and (4) pain and irritability. Overall, GER was demonstrated in 78% of all 209 children in whom technically satisfactory studies could be performed. This reflux was associated with symptoms in 32% of the cases. Symptomatic reflux was most frequent in group 3, which included children investigated for near‐miss sudden infant death syndrome. The symptoms that were noted most frequently were vomiting, motor unrest, coughing, and wheezing. Apnea, bradycardia and attacks of unusual posturing could incidentally be related to reflux. Ultrasound is a cheap, simple, noninvasive, and physiological test to show clinically significant reflux.
Effect of a Medium Dose of Ursodeoxycholic Acid with or without Taurine Supplementation on the Nutritional Status of Patients with Cystic Fibrosis
Authors: Merli M. , Bertasi S. , Servi R. , Diamanti S. , Martino F. , De Santis A. , Goffredo F. , Quattrucci S. , Antonelli M. , Angelico M. 
Published: January 2024

SummaryUrsodeoxycholic acid administration has been reported to improve cholestasis and inflammatory activity in primary biliary cirrhosis and, in an uncontrolled study, also in young adults with cystic fibrosis (CF) and chronic cholestasis. As an improvement in nutritional status was also observed in these young adult patients, we investigated whether the administration of a medium dose of ursodeoxycholic acid ameliorates the nutritional status of malnourished young adult CF patients with chronic liver disease. The study included 51 patients (27 male patients and 24 female patients; age range, 8–32 years; median, 14) with body mass percentiles < 90%. Patients were randomly assigned to receive either ursodeoxycholic acid (10–12 mg/kg/day) alone or with taurine (18–22 mg/kg/day). Patients were followed in a crossover fashion within each group; 6 months of treatment was randomly alternated with 6 months of placebo. Nine patients dropped out before concluding the study. Liver function tests, nutritional status, and coefficients of fat absorption were determined at entry and after each 6 months of placebo or treatment. Nutritional status and fat absorption were not significantly modified by either treatment. Liver function tests improved after ursodeoxycholic acid administration only in patients with concomitant chronic liver disease. Our findings indicate that 6 months of therapy with a medium dose of ursodeoxycholic acid, either alone or with taurine, does not improve the nutritional status of young malnourished CF patients. Higher doses given for longer periods might be worth investigating.
Platelet‐Activating Factor Acetylhydrolase in Term and Preterm Human Milk
Authors: Moya Fernando R. , Eguchi Hideshi , Zhao Biren , Furukawa Masayuki , Sfeir SJuan , Osorio Marcial , Ogawa Yunosuke , Johnston John M. 
Published: January 2024

SummaryHuman milk may protect against necrotizing enterocolitis (NEC). Since platelet‐activating factor (PAF) may participate in the pathophysiology of NEC, we measured PAF acetylhydrolase (PAF‐AH), which metabolizes PAF, in term and preterm human milk. The activity of PAF‐AH in term milk collected 2‐A days after delivery (n = 17) was 2.7 |Mp 1.2 nmol x min−1 x ml−1. A higher activity was found in milk collected at similar times from mothers who delivered between 33 and 36 weeks of gestation (n = 6, 5.6 |Mp 2.1 nmol x min−1 x ml−1, p < 0.01). However, milk from mothers who delivered between 26 and 32 weeks of gestation had a PAF‐AH activity similar to that of term milk (n = 6, 3.0 |Mp 0.7 nmol X min−1 x ml−1). With advancing lactational age, PAF‐AH activity in term milk decreased, whereas the activity of this enzyme in preterm milk remained unchanged. In milk samples collected beyond 14 days after delivery from women who gave birth between 33 and 36 weeks or 26 and 32 weeks of gestation, PAF‐AH activity was fivefold higher than that found in milk for women delivering at term (3.7 |Mp 1.3 and 3.6 |Mp 3.6 nmol x min−1 X ml−1 serum 0.7 |Mp 0.4 nmol x min−1 x ml−1, respectively, p < 0.05). We speculate that the presence of PAF‐AH in human milk may protect against NEC in preterm newborns.
The Epidemiology of Rotavirus Infections
Authors: Haffejee Ismail E. 
Published: January 2024

SummaryRotavirus, which is the most common cause of infantile diarrhea worldwide, mainly affects infants between the ages of 6 and 24 months. Most infections in human newborns are mild or asymptomatic, due to the inherently attenuated nature of the “nursery” rotavirus strains. Adults are also sometimes affected, especially those in families with an infected child; the disease also occurs in closed adult communities, HIV‐infected persons, travelers, or as a result of water‐borne epidemics. Nosocomially acquired hospital infections add to morbidity and to the cost of hospitalization. A winter predominance of rotavirus diarrhea has been noted in temperate climates but not in tropical areas. Group A rotavirus infections are generally more common, but human infections with groups B and C have also been documented. The prevalence of scrum antibodies is high during the neonatal period, but it declines sharply between the ages of 3 and 6 months, then rises steeply, peaking at 2 years and remaining high into adulthood. Vaccines against rotavirus are currently under evaluation
The Treatment of Intractable Rejection with Tacrolimus (FK506) in Pediatric Liver Transplant Recipients
Authors: McDiarmid S. V. , Wallace P. , Vargas J. , Ament M. E. , Busuttil R. W. 
Published: January 2024

SummaryWe report our experience in 17 pediatric orthotopic liver transplant (OLT) patients converted from cyclosporine (CsA) to FK506 for intractable acute and chronic rejection. FK506 was initiated orally at a dose of 0.3 mg/kg/day in most patients; the dose was then adjusted to achieve serum levels of 0.5–1.5 ng/ml. Azathio‐prine was discontinued and low‐dose prednisone maintained. The median time between liver transplantation and FK506 conversion was 41 months. Patients have been treated for an average of 14.8 ± 9.6 months. Six patients were converted for acute rejection and 11 for chronic rejection, i.e., vanishing bile duct syndrome (VBDS). After FK506 conversion, the actual patient and graft survival was 88% and 82%, respectively, in the group as a whole. Two patients died, one of chronic active hepatitis C and the other of lymphoma. Three patients, all with VBDS, did not respond to FK506 and therefore required retransplantation. The serum bilirubin is currently normal in 14 patients and the serum transaminases < 100 IU/ml in 12. The mean bilirubin pre‐FK506 of patients successfully converted to FK506 was 4.2 mg/dl compared to 11.8 mg/dl in patients who failed conversion. Major complications included nephrotoxicity, neurotoxicity, and lymphoma. The mean glomerular filtration rate (GFR) of 97 ± 29 mls/min/1.73m2 prior to FK506 conversion dropped to 51 ± 20 mls/min/1.73m2 (p = 0.0001) after a mean of 13.6 months of FK506 therapy. Three patients have developed B‐cell lymphomas; two of them responded to decreased immunosuppression and one died. We conclude that intractable liver graft rejection in children is most successfully reversed if FK506 is instituted before cholestasis becomes pronounced. The high cumulative doses of immunosuppression needed to control intractable rejection places these patients at special risk for developing lymphomas.
The Trophic Action of Human Growth Hormone on Human Duodenal Mucosa Cultured In Vitro
Authors: Challacombe D. N. , Wheeler E. E. 
Published: January 2024

SummaryThe influence of human growth hormone (hGH) on crypt cell proliferation in cultured explants of human duodenal mucosa has been studied, using a stathmokinetic technique with crypt microdissection. The addition of hGH (0.004 μ/ml) to paired duodenal explants from eight patients significantly increased epithelial crypt cell proliferation (p < 0.001), showing that hGH has a trophic action on the human duodenal mucosa in vitro.
Improved Energy Intakes Using Amylase‐Digested Weaning Foods in Tanzanian Children with Acute Diarrhea
Authors: Darling Jonathan C. , Kitundu Jesse A. , Kingamkono Rose R. , Msengi Abel E. , Mduma Benedicta , Sullivan Keith R. , Tomkins Andrew M. 
Published: January 2024

SummaryAmylase from germinating cereal grains enables the preparation of porridge with a higher energy density than conventional weaning foods. This food can be combined with fermentation, which inhibits pathogen growth. These food technologies are inexpensive, can be implemented at the household level, and are therefore particularly appropriate for use in developing countries. In a controlled clinical trial, 75 children aged 6–25 months admitted to hospital with acute diarrhea were rehydrated and then randomly allocated to three corn porridge dietary groups: conventional, amylase‐digested (AMD), and fermented and amylase‐digested (FAD). The study diets were given ad libitum five times daily, and all intakes except breast milk were weighed. Mean daily energy intakes over 4 days in the conventional AMD, and FAD groups, respectively, were 32.4 (95% CI 28.7–36.6), 46.0 (CI 39.6–53.4), and 37.3 (CI 31.8–43.9) kcal/kg/day. The energy intake in the AMD group was 42% higher than the conventional group (p = 0.003). There were no significant differences between the groups for duration of diarrhea, frequency of stooling, or vomiting. Starch digestion using amylase from germination is an effective way of improving energy intake in children with acute diarrhea.
Early Proliferative Events Following Intestinal Resection in the Rat
Authors: Sacks Alan I. , Warwick Ginger J. , Barnard John A. 
Published: January 2024

Summary:Partial resection of the small intestine results in compensatory proliferation and adaptation in the remaining small intestinal mucosa. The molecular mechanisms governing the proliferative response are not known, nor has the timing of events associated with proliferation been adequately defined, particularly during the period just after resection. We designed experiments to characterize early (within 24 h) proliferative events associated with proximal intestinal resection and sought to determine the cell type that first responds to proliferative stimuli. Twenty‐one day old male Sprague‐Dawley rats underwent a 70% proximal intestinal resection or transection (control). Poly(A) RNA was isolated from the distal (ileal) remnants. Northern blots showed a marked induction of the immediate early genes zif‐268, nup‐475, and c‐myc 1–3 h following resection, but not following transection. Immunohistochemical analysis of c‐myc expression in ileal crypt epithelial cells showed a biphasic induction that was most marked 6 h after resection and less prominent 24 h after resection. Immunostaining with 5‐bromodeoxyuridine (5‐BrdU) was restricted to ileal crypt nuclei and was maximal 24 h after resection. All these events were observed in the absence of nutrient intake. Taken together, these data show that a potent nutrient‐independent stimulus for intestinal epithelial cell proliferation occurs within minutes of partial small intestinal resection and that the first targets of this stimulus are crypt epithelial cells in the residual intestine.
Effect of Three Levels of Vitamin D Intake in Preterm Infants Receiving High Mineral‐Containing Milk
Authors: Koo Winston W. K. , Krug‐Wispe Susan , Neylan Michael , Succop Paul , Oestreich Alan E. , Tsang Reginald C. 
Published: January 2024

Summary:Very low‐birth weight (VLBW) infants fed high‐calcium and high‐phosphorus (10.74 and 6.93 mmol/MJ; 180 and 90 mg/100 kcal, respectively) infant formulas were randomized to one of three levels of vitamin D intake to approximate 200, 400, and 800 IU/day. Sixty‐two infants completed the study (24 to 29 days), with actual mean daily vitamin D intakes of 161, 361, and 766 IU, respectively. Outcomes were not different by group: gains in body weight, length and head circumference, serum calcium, magnesium, phosphorus, alkaline phosphatase, osteocalcin, 25‐hydroxyvitamin D, 1,25‐dihydroxyvitamin D, and urine calcium:creatinine and magnesium:creatinine ratios. There were no radiographic fractures and/or rickets. A subset of 19 infants was followed between 173 and 380 days to determine descriptively if there was any delayed effect of earlier manipulation of vitamin D intake. They were fed standard infant formulas with a vitamin D content of 400 to 420 IU/L. No significant differences were present among the three groups, and data were combined. Serum 25‐hydroxyvitamin D increased (p < 0.05), osteocalcin decreased (p < 0.05), and 1,25‐dihydroxyvitamin D decreased (p = 0.06) at follow‐up. Thus, for VLBW infants fed high‐calcium and high‐phosphorus milk, an average daily vitamin D intake as low as 160 IU maintains normal and stable vitamin D status and normal physical growth, biochemical and hormonal indexes of bone mineral metabolism, and skeletal radiographs versus randomized infants receiving about 400 or 800 IU of vitamin D per day. On follow‐up, vitamin D status remained normal for ≥ 6 months while infants received <400 IU of vitamin D per day.
Human Milk K‐Casein and Inhibition of Helicobacter pylori Adhesion to Human Gastric Mucosa
Authors: Strömqvist Mats , Falk Per , Lennart Hansson Sven Bergström , Lönnerdal Bo , Normark Staffan , Hernell Olle 
Published: January 2024

Summary:Readily digested caseins, which account for almost half of the protein content in human milk, are important as nutritional protein for breast‐fed infants. It has also been advocated that part of the antimicrobial activity of human milk resides in the caseins, most likely the glycosylated K‐casein. To explore this possibility, we purified K‐casein from human milk to homogeneity by a two‐step size‐exclusion chromatography procedure. Purified human K‐casein, in contrast to K‐casein purified from bovine milk, effectively inhibited the cell lineage‐specific adhesion of fluoroisothiocyanate‐labeled Helicobacter pylori to human gastric surface mucous cells. The inhibitory activity was abolished by metaperiodate oxidation and considerably reduced by preincubation with α‐L‐ fucosidase but not with α‐N‐acetylneuraminidase or endo‐β‐galactosidase. These results strongly support the view that fucose containing carbohydrate moieties of human K‐casein are important for inhibition of H. pylori adhesion and, thus, infection. They also suggest that breastfeeding may protect from infection by H. pylori during early life and that species‐specific glycosylation patterns, as illustrated by human and bovine K‐casein, partly determine both the narrow host spectrum of this human gastric pathogen and the capacity to resist infection.
ENERGY EXPENDITURE IN CONGENITAL HEART DISEASE
Authors: Taminiau Jan A. J. M. , Broekhoff C. , Houwen R. H. J. , de Meer K. 
Published: January 2024

Summary:Barton et al. studied body composition and energy expenditure in eight infants <6 months of age with severe congenital heart disease. All infants were awaiting surgery because of poor symptom control and failure to thrive despite the best possible medical management. Total daily energy expenditure (TDEE) in these infants was measured with the doubly labeled water method. Barton et al. found that TDEE in the patients with congenital heart disease was similar to TDEE in age‐ and sex‐matched reference children measured with the same technique (Br J Nutr 1989;62:621–9). However, when expressed on a weight basis, TDEE was significantly increased in the cardiac patients versus the reference children (426 ± 12 vs. 280 ± 60 kJ/kg/day or 101 ± 3 vs. 67 ± 14 kcal/kg/day). Although the energy intake calculated from dietary records in these patients seemed reasonable for their body weights (483 kJ/kg/day or 115 kcal/ kg/day), it was only 82% of the estimated average requirement. It was therefore not surprising that the mean weight gain in these patients (14.5 g/day) was considerably lower than expected. The total body fat in the infants was also severely diminished in comparison with controls. It was estimated that a gross energy intake of 600 kJ/kg/day (or 143 kcal/kg/day) is necessary for normal growth in patients with severe congenital heart disease during the first months of life. Barton and co‐workers were able to measure TDEE in four patients after surgery; in these infants, TDEE remained elevated (mean, 381 kJ/kg/day or 91 kcal/ kg/day), but the values in individual patients were not consistent with preoperative measurements.
Absorption of Milk‐Borne Insulin‐Like Growth Factor‐I Into Portal Blood of Suckling Rats
Authors: Philipps Anthony F. , Dvořák Bohuslav , Kling Pamela J. , Grille James G. , Koldovský Otakar 
Published: January 2024

ABSTRACTBackgroundInsulin‐like growth factors (IGFs) are potent mitogens that have been implicated in control of growth and development during the perinatal period. These hormones are also present in biologically significant quantities in mammalian milks. Although one site of action of these IGFs may be at the intestinal level, current information about whether they pass intact into the circulation is conflicting.MethodsTo test the hypothesis that milk‐borne IGFs are absorbed into blood in receptor‐active form, suckling rats were given either recombinant human (rh)125I‐IGF‐I or ‐II (4 × 106 counts per minute [cpm]), and the activity present in portal and cardiac blood was examined at 5, 10, 20, and 30 minutes after ingestion for presence of appropriate molecular weight peptides in these samples. In selected samples, purified radioactive samples were tested for their ability to bind competitively to crude membranes bearing IGF receptors.ResultsThe results of these studies indicate that rh125I‐IGF‐I is absorbed in receptor‐active form into the portal circulation and that maximal amounts are present 20 to 30 minutes after ingestion. Estimation of the presence of intact hormone was made on the basis of the elution profile of samples when run on gel chromatography as well as reversed‐phase high‐performance liquid chromatography. Isolated samples from portal blood also bound competitively to placental membranes bearing IGF receptors. In contrast, rh125I‐IGF‐II could not be demonstrated in receptor‐active form in portal blood. Chromatography showed appropriate sized peaks with greater activity in portal than cardiac samples, but competitive binding was not appreciated.ConclusionsIt is likely that at least milk‐borne IGF‐I is absorbed intact and may exert effects on liver and other peripheral tissues. In addition, this study lends further credence to the possibility of an enterohepatic circulation for IGF‐I.
Vitamin A Supplementation in Acute Diarrhea
Authors: Yurdakök Kadriye , Özmert Elif , Yalçin S. Songül , Laleli Yahya 
Published: January 2024

ABSTRACTBackgroundVitamin A supplementation reduces the severity of subsequent diarrheal episodes. This study was conducted to examine the effect of single oral high‐dose vitamin A supplementation on the duration of acute diarrhea in 6‐to 12‐month‐old infants who are not malnourished.MethodIn this double‐blind, randomized, placebo‐controlled study, infants who were admitted to Hacettepe University Ihsan Dogramaci Children's Hospital Diarrheal Diseases Training and Treatment Unit with acute diarrhea were randomly assigned either to a group receiving a single oral dose of 100,000 IU vitamin A or placebo. There were 60 infants in each group. All infants were followed up until the diarrheal episode ended. Serum vitamin A levels were determined both at admission and 2 weeks later.ResultsNo effect of vitamin A supplementation could be demonstrated on either the total duration of diarrhea (7.4 ± 3.2 days in the treatment group vs. 7.8 ± 3.1 days in the placebo group) or on its duration after intervention (3.8 ± 2.3 days in the treatment group vs. 3.9 ± 1.9 days in the placebo group;P > 0.05 for both comparisons). Serum vitamin A levels were not significantly different at admission (23.5 ± 9.7 μg/dL in the treatment group vs. 24.1 ± 9.7 μg/dL in the placebo group;P > 0.05) nor at the end of a follow‐up period of 2 weeks (treatment: 33.3 ± 13.7 μg/dL, placebo: 35.2 ± 11.2 μg/dL;P > 0.05). However, the increase in serum vitamin A levels at the end of the 2‐week follow‐up interval for infants in both the treatment and placebo groups were found to be significant compared with levels at admission (P < 0.01). The mean weight gain in both groups were similar by the end of the first month (6.9 ± 5.0% in the treatment group vs. 6.3 ± 4.2% in the placebo group;P > 0.05).ConclusionNo effect of oral vitamin A supplementation on serum vitamin A levels, duration of diarrhea, or weight gain during an acute diarrheal episode could be demonstrated in our study group of infants between 6 and 12 months of age who had no malnutrition.
Pressure Pain Threshold in Children With Recurrent Abdominal Pain
Authors: Duarte Marco Antônio , Goulart Eugênio Marcos Andrade , Penna Francisco José 
Published: January 2024

ABSTRACTBackgroundExperimental studies on humans have shown that recurrent pain is associated with altered pain perception. We measured the pressure pain threshold in regions of the body surface in a group of children who had recurrent abdominal pain and in a group of children with chronic or recurrent disease but with no pain.MethodsEach group consisted of 45 boys and 55 girls ranging in age from 5 to 15.8 years. The regions of the body were the trapezius, deltoid, and supraspinous muscles, nine areas on the abdominal wall, and the median part of the tibias. Using an algometer, pressure was applied through a rubber disc with a surface area of 1 cm2 at a rate of 0.5 kg/cm2/s. The pressure values recorded with the algometer when the children communicated that they started to feel pain were considered as pressure pain thresholds.ResultsThe pain thresholds were reduced in all regions investigated in children with recurrent pain. The median thresholds for all regions of the patients with and without pain were 1.60 and 2.2 kg/cm2, respectively. The diseases of children with pain did not influence the pain thresholds.ConclusionThere was an association between recurrent abdominal pain and a lower pressure pain threshold, with no influence of the type of disease, and there was a central nervous system alteration in the perception of pain in these patients.