bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assay of Tracheal Pepsin as a Marker of Reflux Aspiration
Authors: Krishnan Usha , Mitchell John D. , Messina Isabella , Day Andrew S. , Bohane Timothy D. 
Published: January 2024

ABSTRACTObjectivesAspiration of gastric contents is a relatively common cause of acute and chronic pulmonary disease. However, a reliable method of diagnosing recurrent aspiration is currently lacking. The aim of this study was to determine whether the presence of gastric pepsin in tracheal aspirates of infants and children might be used as a reliable marker of the microaspiration of refluxed gastric contents.MethodsNinety‐eight children undergoing general anesthesia and tracheal intubation participated in the study. Sixty‐four of 98 children underwent endoscopy for clinically significant gastroesophageal reflux. Thirty‐four children from routine operative lists were nonreflux controls. These two groups were further subdivided based on the presence or absence of associated respiratory symptoms. After endotracheal intubation, tracheal aspirates were obtained and subsequently assayed for gastric pepsin using a fluoroscein isothiocyanate casein.ResultsPepsin was detected in 7 of 27 children with reflux symptoms alone and in 7 of 8 of those with chronic respiratory symptoms. In addition, pepsin was present in 31 of 37 children with a history of both reflux and chronic respiratory symptoms. Tracheal pepsin was not detected in any of the 26 children without gastroesophageal reflux or respiratory symptoms. Tracheal pepsin was found significantly more frequently in children with reflux symptoms than in those without, particularly in children with both reflux and respiratory problems.ConclusionTracheal pepsin assay as a reliable marker of gastroesophageal reflux aspiration.
Terminal Ileum Intubation in Pediatric Colonoscopy and Diagnostic Value of Conventional Small Bowel Contrast Radiography in Pediatric Inflammatory Bowel Disease
Authors: Batres L. Arturo , Maller Eric S. , Ruchelli Eduardo , Mahboubi Soroosh , Baldassano Robert N. 
Published: January 2024

ABSTRACTBackgroundSmall bowel contrast radiography is often suggested as the first diagnostic tool in evaluating pediatric inflammatory bowel disease. The purpose of this study was to determine the sensitivity and specificity of small bowel radiography compared with terminal ileal biopsies in diagnosing pediatric inflammatory bowel disease, and to determine the success rate and safety of terminal ileum intubation during pediatric colonoscopy.MethodsWe retrospectively reviewed the records of 164 subjects who had colonoscopies with terminal ileal biopsies between 1994 and 1996. Small bowel contrast radiography was performed in 84 subjects within two weeks of the colonoscopy. We also reviewed all the colonoscopy reports from the years 1994 to 1996 and 1999 to 2000 to determine the percentage of terminal ileal intubation.ResultsEighty‐four subjects with small bowel contrast radiography and terminal ileal biopsies were reviewed. Using small bowel radiography as a screening test for the diagnosis of terminal ileum inflammatory bowel disease resulted in a sensitivity of 45% (17/37) and a specificity of 96% (17/19). Between the years 1994 and 1996 the percentage of pediatric colonoscopies that resulted in terminal ileal intubation was 21.5%; between the years 1999 and 2000 the percentage increased to 65.6%.ConclusionsA normal small bowel radiography alone should not be used to rule out pediatric inflammatory bowel disease when the symptoms suggest it. Colonoscopy with terminal ileal intubation is feasible and safe; it should be attempted in all children with symptoms consistent with inflammatory bowel disease.
Fibrosing Colonopathy Revealing Cystic Fibrosis In A Neonate Before Any Pancreatic Enzyme Supplementation
Authors: Serban Daniela Elena , Florescu Petre , Miu Nicolae 
Published: January 2024

ABSTRACTAlthough its pathogenesis remains still unknown, fibrosing colonopathy (FCP) is considered to be the result of prolonged treatment by high doses of pancreatic enzyme preparations, in a small proportion of patients who present with cystic fibrosis (CF). We present the case of a newborn with meconium ileus (treated by conservative measures), in which, at the age of 3 weeks, the features of intestinal obstruction made necessary the removal of 15 cm of the proximal large intestine. Macroscopical and especially microscopical appearances typical for FCP were found, despite the absence of any enzymatic treatment. These findings raised the suspicion of CF, which was confirmed 4 weeks later at necropsy by the presence of characteristic pancreatic lesions. This case and another similar report in the literature suggest that the mechanism of FCP must be linked with the disease itself, at least in some patients. Thus, for us, FCP is not a “closed subject” and we sustain the importance of continuing studies, which will shed light on its etiopathogenesis.
Acute Gastric Perforation after Acid Ingestion
Authors: Gün Feryal , Abbasoğlu Latif , Çelik Alaaddin 
Published: January 2024

ABSTRACTGastric outlet obstruction is a common late result after acid ingestion; early complications, such as gastric necrosis or perforations are unusual. This is a report of a patient with the history of strong acid ingestion who underwent total gastrectomy due to perforation and extensive necrosis of the stomach.
Drug Reaction To Ursodeoxycholic Acid: Lichenoid Drug Eruption In An Infant Using Ursodeoxycholic Acid For Neonatal Hepatitis
Authors: Büyükgebiz Benal , Arslan Nur , Oztürk Yeşim , Soyal Cüneyt , Lebe Banu 
Published: January 2024

ABSTRACTLichenoid drug eruptions are skin reactions associated with a number of drugs and chemicals. They are rare in infants. We report here an infant who presented with neonatal hepatitis and who was being treated with ursodeoxycholic acid. The infant developed lichenoid skin eruptions in the third week of the therapy. The lesions have resolved two months after the discontinuation of the drug. To our knowledge, this is the first infant case of lichenoid drug eruption associated with ursodeoxycholic acid.
Predictors of Cobalamin Deficiency in Guatemalan School Children: Diet, Helicobacter pylori, or Bacterial Overgrowth?
Authors: Rogers Lisa M. , Boy Erick , Miller Joshua W. , Green Ralph , Rodriguez Monica , Chew Francisco , Allen Lindsay H. 
Published: January 2024

ABSTRACTObjectivesThe authors investigated whether low vitamin B12 intake, impaired gastric function, Helicobacter pylori infection, and bacterial overgrowth were risk factors for the high prevalence of cobalamin deficiency observed in Guatemalan children.MethodsThe plasma cobalamin concentration of 556 school children was measured and classified as low, marginal, or adequate. In 60 children from each of these three groups, concentrations of serum methylmalonic acid (MMA), plasma homocysteine, and plasma holotranscobalamin II were measured, and usual dietary B12 intake was estimated. Serum gastrin and pepsinogen I concentrations were measured, and H. pylori and bacterial overgrowth were diagnosed using 13C‐urea and 13C‐xylose breath tests, respectively.ResultsH. pylori infection was present in 83% (144 of 174) of children, and bacterial overgrowth was found in 25% (28 of 113). Children with H. pylori infection had higher serum gastrin and pepsinogen I. There were no significant differences among the plasma cobalamin groups in the prevalence of H. pylori infection, bacterial overgrowth, serum gastrin, or pepsinogen I concentrations. However, there was a significant positive correlation between serum MMA and gastrin concentrations. The average daily consumption of dietary B12 was 5.5 ± 5.2 μg/day, but intakes for 23% of children were <1.8 μg/day. B12 intake from fortified snacks added an additional 0.3 ± 0.2 μg/day. B12 intake was not significantly different among the plasma cobalamin groups, but it was significantly correlated with plasma cobalamin.ConclusionsThe specific cause of cobalamin deficiency in this population remains unclear, but these results suggest that low dietary B12 intake is a risk factor and alterations in gastric secretions may also play a role.
Effect of Nucleotides on Diarrhea and Immune Responses in Healthy Term Infants in Taiwan
Authors: Yau Kuo‐Inn Tsou , Huang Chung‐Bin , Chen Walter , Chen Shu‐Jen , Chou Yi‐Hong , Huang Fu‐Yuan , Kua Ka Em , Chen Nancy , McCue Maggie , Alarcon Pedro A. , Tressler Randy L. , Comer Gail M. , Baggs Geraldine , Merritt Russell J. , Masor Marc L. 
Published: January 2024

ABSTRACTObjectivesThe aim of this study was to compare the effects of an infant formula fortified with nucleotides (NF) with those of a control formula (CF) on the incidence of diarrhea, respiratory tract infections (RTIs), and immune responses in healthy term infants.MethodsThis 12‐month, double‐blind study was conducted on 1‐ to 7‐day‐old infants randomized to receive NF or CF exclusively until 12 weeks of age, and fed the assigned formula with solid food until 12 months. NF was supplemented with 72 mg/L of nucleotides, based on the total potentially available nucleotide content of human milk. Subjects were evaluated within 1 week of birth, at 4 weeks, and every 4 weeks thereafter until 48 weeks of age. The primary outcome variable was the incidence of diarrhea. Secondary variables included RTIs, serum immunoglobulin concentrations, and response to hepatitis B vaccine.ResultsCompared with subjects fed CF (n = 170), those fed NF (n = 166) had a trend toward reduced risk of diarrhea from 8 to 48 weeks of age and a significantly lower risk of 25.4% (P = 0.05) between 8 and 28 weeks. NF subjects had significantly higher serum immunoglobulin A concentrations (P < 0.05) throughout the 48‐week study. The NF group had an increased risk of upper RTIs, the same incidence of lower RTIs, and the same antibody response to hepatitis B vaccination as the CF group, based on one‐sided tests. Growth was normal in both groups, and no adverse events were considered to be formula‐related.ConclusionsHealthy term infants from 8 to 28 weeks of life are less likely to experience diarrhea and have higher serum immunoglobulin A concentrations with NF compared with formula without added nucleotides.
Breath Test Using A Single 50‐mg Dose of 13C‐Urea to Detect Helicobacter pylori Infection in Children
Authors: Canete Alfonso , Abunají Yamil , Alvarez‐Calatayud Guillermo , DeVicente Mercedes , González‐Holguera José A. , Leralta María , Pajares José M. , Gisbert Javier P. 
Published: January 2024

ABSTRACTBackgroundThe 13C‐urea breath test is an accurate, noninvasive method for the diagnosis of Helicobacter pylori in adults. A dose of 75 to 100 mg of urea is generally used, especially in adults, but the optimal dose in children is still unknown. Our aim was to determine whether urea breath test performed with a single 50‐mg dose of 13C‐urea was sufficient and accurate for diagnosing H. pylori infection in children.MethodsConsecutive children 4 to 14 years of age undergoing upper intestinal endoscopy to evaluate symptoms of recurrent abdominal pain were prospectively included. Exclusion criteria included use of antibiotics or proton pump inhibitors during the last month, gastric surgery, and previous H. pylori eradication therapy. Reference criteria for diagnosis of infection were based on histology, culture, and serology. Urea breath test (TAU‐KIT; Isomed, S.L., Madrid, Spain) was performed as follows: citric acid (Citral pylori) dissolved in 100 mL of water was initially given. Ten minutes later, a baseline exhaled breath sample was collected, and thereafter 50 mg of 13C‐urea dissolved in 50 mL of water was given. A second breath sample was obtained 30 minutes later. Breath samples were analyzed by isotope ratio mass spectrometry. The endoscopist, the pathologist, the microbiologist, and the person responsible for reading the serology and the urea breath test were all unaware of H. pylori status by the other diagnostic methods.ResultsOne hundred children were included (40% males; mean age, 9.2 ± 2 years; mean weight, 33.9 ± 12 kg). Based on the reference criteria, 45% were infected, 37% were not infected, and 18% were indeterminate. Sensitivity, specificity, positive predictive value, and negative predictive value were, respectively, 91% (95% confidence interval [CI], 79%–96%), 97% (95% CI, 86%–99%), 98% (95% CI, 87%–91%), and 90% (95% CI, 76%–96%). Positive and negative likelihood ratios were of 33 and 0.09. Any cutoff point between 2 and 14 δ units had the same high diagnostic accuracy. The area under the receiver operating characteristic curve was 0.94. No adverse effects were reported.ConclusionUrea breath test using 50 mg of urea is sufficient and accurate for the diagnosis of H. pylori infection in children. Use of a small test dose significantly lowers the cost of the test.
A Comparison of Budesonide and Prednisone for the Treatment of Active Pediatric Crohn Disease
Authors: Levine Arie , Weizman Zvi , Broide Efrat , Shamir Raanan , Shaoul Ron , Pacht Avi , Dinari Gabriel , On Avi , Weiss Batya , Bujanover Yoram ,   Members of the Israeli Pediatric Gastroenterology Association Budesonide Study Group
Published: January 2024

ABSTRACTObjectivesBudesonide has been found effective in patients with mild and moderate Crohn disease and has been found to cause fewer side effects than prednisone. The use of oral budesonide has not been prospectively evaluated in children with Crohn disease. Therefore, the authors initiated a trial to compare remission and tolerance to budesonide and prednisone in children with mild or moderately active Crohn disease.MethodsA prospective randomized open controlled 12‐week trial was carried out comparing pH modified release budesonide, 9 mg, versus prednisone, 40 mg, in children with active mild to moderate pediatric Crohn disease.ResultsThirty‐three patients (20 boys and 13 girls; mean age, 14.3 years) enrolled and completed the study. The groups treated with budesonide and prednisone did not differ by age, onset of disease, location of disease, or disease activity. The remission rate at 12 weeks was 47% in the budesonide treatment group and 50% in the prednisone treatment group. Side effects occurred in 32% and 71% of patients treated with budesonide and prednisone, respectively (P < 0.05). Severity of cosmetic side effects was significantly lower in patients treated with budesonide (P < 0.01).ConclusionsRemission rates for Crohn disease with budesonide and prednisone treatment in this study were similar. Pediatric patients treated with budesonide had significantly fewer side effects than patients treated with prednisone. Budesonide should be considered an alternative to prednisone in pediatric patients with mild to moderate disease activity.
Efficacy and Safety of Oral Pantoprazole 20 mg Given Once Daily for Reflux Esophagitis in Children
Authors: Madrazo‐de la Garza Armando , Dibildox Miguel , Vargas Antonio , Delgado Juan , Gonzalez Jorge , Yañez Patricia 
Published: January 2024

ABSTRACTObjectivesTo investigate the efficacy and safety of oral pantoprazole, 20 mg (0.5 to 1.0 mg/kg/day) once daily for 28 days, in pediatric patients with reflux esophagitis.MethodsPatients in this study (n = 15; 6 to 13 years old, 9 boys) had reflux esophagitis grade Ic or II (Vandenplas classification). The efficacy of pantoprazole to reduce esophageal acid exposure time (pH < 4), reduce the number and duration of reflux episodes, and to increase the percentage of time with gastric pH > 3 was assessed by continuous 24‐hour pH monitoring. The intensity of 5 common symptoms of esophagitis was scored before and after treatment on a 4‐point scale. Esophagitis was assessed at baseline and after treatment by visual inspection and by the histology of biopsies from the distal third of the esophagus.ResultsBefore treatment, the median percentage of time with intra‐esophageal pH <4 was 9.3%. After 28 days of therapy with pantoprazole, this value decreased to 2.7% (P = 0.0006). The median percentage of time with intragastric pH > 3 increased from 21% at baseline to 39% on day 28 of therapy (P = 0.005). After 28 days of treatment, all patients experienced at least partial relief from reflux symptoms. Endoscopically confirmed healing of esophagitis was seen in 47% of children (Savary‐Miller classification). Histologic evidence of healing was not observed. Median serum gastrin levels were slightly elevated over baseline levels (from 74 pg/ml to 93 pg/ml). In one patient there was a transient elevation of serum GOT and GPT during treatment.ConclusionsOral pantoprazole 20 mg daily provided gastric acid control in 15 pediatric patients with reflux esophagitis with partial clinical improvement of symptoms after 28 days of treatment. Pantoprazole was safe and well tolerated.
Complementary Food Supplements to Achieve Micronutrient Adequacy for Infants and Young Children
Authors: Nestel P. , Briend A. , de Benoist B. , Decker E. , Ferguson E. , Fontaine O. , Micardi A. , Nalubola R. 
Published: January 2024

ABSTRACTMany children in developing countries survive on a nutritionally inadequate diet. Dietary inadequacies during the complementary feeding period can be prevented by using complementary food supplements (CFSs) such as water dispersible or crushable micronutrient tablets, micronutrient sprinkles added to food just before feeding, or fortified spreads added to food just before feeding or fed as a snacks. A meeting was convened to discuss technical and operational issues related to the development of these new approaches and to identify knowledge gaps. The technical issues covered: what micronutrients to include, tolerable upper intake limits, bioavailability, micronutrient and macronutrient stability, package systems and amounts, encapsulation technologies, methods to limit or eliminate allergens, bacterial and chemical contamination, interactions between CFSs and complementary foods, and flavoring agents. Operational issues included: identifying the market positioning of CFSs, cost positioning of CFSs, regulatory requirements, CFS production and technology transfer, quality assurance, and public‐private sector partnership and coordination. Intervention trials are needed to determine the efficacy of CFSs in preventing micronutrient deficiencies. Other important knowledge gaps relate to technical and operational issues. Sprinkles and tablets are produced using well‐known technologies, but further research is needed to modify them for use as CFSs. Spread development is not as advanced as sprinkle and tablet development, and further research is needed to improve the technology. Although none of the products is ready for widespread use, enough information is available to set research priorities and accelerate product development and implementation.
Randomized Double‐Blind Study of the Nutritional Efficacy and Bifidogenicity of a New Infant Formula Containing Partially Hydrolyzed Protein, a High β‐Palmitic Acid Level, and Nondigestible Oligosaccharides
Authors: Schmelzle Hansjörg , Wirth Stefan , Skopnik Heino , Radke Michael , Knol Jan , Böckler Heinz‐Michael , Brönstrup Anja , Wells John , Fusch Christoph 
Published: January 2024

ABSTRACTObjectivesThe aim of this study was to evaluate the nutritional efficacy and bifidogenic characteristics of a new infant formula containing partially hydrolyzed whey protein, modified vegetable oil with a high β‐palmitic acid content, prebiotic oligosaccharides, and starch.MethodsIn a double‐blind study, healthy formula‐fed term infants aged younger than 2 weeks were randomized to receive either the new infant formula (NF) or a standard formula (SF) until the age of 12 weeks. Anthropometric measurements were taken at enrollment, 6 weeks, and 12 weeks. In a subsample of infants, blood samples were taken at 6 weeks and stool samples were taken at enrollment and 6 weeks. Blood samples were analyzed for biochemical measures of protein status and amino acids, and stools were analyzed for total bacteria and bifidobacteria. Mothers completed a feeding diary and questionnaire at 6 and 10 weeks.ResultsOne hundred fifty‐four infants were enrolled in the study; 102 completed the trial. The growth of infants in both formula groups was in line with published growth curves. During the first 6 weeks, NF girls gained more weight and head circumference than the SF girls. These velocity differences were not maintained throughout the 12‐week study period. The NF stools had a higher proportion of bifidobacteria at 6 weeks compared with the SF stools, and they were softer. There were no clinically significant differences in the blood biochemical and amino acid values between groups. Both formulas were well tolerated by the infants.ConclusionsWhen compared with a standard infant formula, the new formula supported satisfactory growth, led to higher counts of bifidobacteria in the feces, produced blood bio‐chemical values typical of formula‐fed infants, and was well tolerated.
Helicobacter pylori Antigens in Stool Specimens of Gastritis Children Before and After Treatment
Authors: Gościniak Grażyna , Przondo‐Mordarska Anna , Iwańczak Barbara , Blitek Aleksander 
Published: January 2024

ABSTRACTBackgroundVarious testing methods are successfully applied to the diagnosis of Helicobacter pylori infection, but noninvasive techniques are still needed for therapeutic monitoring, especially in children. In the search for new noninvasive techniques for the diagnosis of H. pylori infection, the authors evaluated an enzyme immunoassay for the detection of H. pylori antigen in stool (HpSA).MethodsThe authors studied 62 H. pylori–positive children with chronic gastritis and 45 control subjects. H. pylori infection was diagnosed using cultures and histology of gastric biopsy specimens and a stool antigen test before treatment (clarithromycin, amoxicillin, omeprazole for 7 days) and 4 weeks to 6 weeks after treatment.ResultsBefore therapy, antigen in stool was detected in 55 of 62 H. pylori–positive patients, which indicates that the sensitivity of the HpSA test was 88.7%. Of the 45 control subjects (with negative culture and histology results), 43 had negative results for H. pylori in the stool test (specificity, 95.5%). After completion of therapy, eradication was obtained (and confirmed by culture and histology) in 53 of the 62 H. pylori–positive children (85.5%). Four weeks to 6 weeks after eradication therapy, the sensitivity, specificity, positive predictive value, and negative predictive value of the stool antigen (HpSA) test were 88.9%, 96.2%, 80%, and 98%, respectively.ConclusionsThe accuracy of the HpSA test for the detection of H. pylori in human stool 4 weeks to 6 weeks after treatment is comparable with the accuracy of the culture results. The stool antigen (HpSA) test was found to be a useful method for posttreatment eradication testing of H. pylori infection in children.