bluuebunny/crossref_metadata_2025_split huggingface dataset:
Energy and Respiratory Metabolism in Cystic Fibrosis
Authors: Kane Robert E. , Hobbs Patricia 
Published: January 2024

SummaryThe basal energy expenditure (BEE) in a group of adolescent and young adult patients with cystic fibrosis (CF) with mild lung disease was 97 ± 6% of that predicted by the Harris‐Benedict equation (which estimates BEE by age, sex, height, and weight). The BEE of a group with more severe lung disease was 117 ± 5% of that predicted by the Harris‐Benedict equation, due primarily to a 14% greater oxygen consumption (Vo2) and 24% greater CO2 production (Vco2) compared with milder lung disease (p < 0.05). The measured BEE in the patients with mild lung disease correlated well with the predicted BEE, but variably underestimated that of patients with more advanced lung disease. The influence of low carbohydrate (Pulmocare) and higher carbohydrate (Instant Breakfast) nutritional supplements on the energy and pulmonary metabolism was compared in 10 malnourished CF patients with moderate to severe lung disease. Their BEE before ingesting the supplements was 120% of that predicted by the Harris‐Benedict equation. Their Vco2 increased 9–19% for the 3 h after ingesting 500 kcal/M2 of Pulmocare, and 25–30% after ingesting Instant Breakfast (p < 0.05). The respiratory quotient (RQ) was significantly greater for Instant Breakfast than Pulmocare. The minute ventilation (VE) rose 10–13% for the 3 h after ingesting Pulmocare, versus 27–31% after ingesting Instant Breakfast, but the difference was not significant. The metabolic expenditure rose 13–16% for the 3 h after ingesting both formulas. We concluded that CF patients have increasing difficulty maintaining their nutrition as their pulmonary disease progresses, in part because of a 17–20% increase in their BEE. Pulmocare resulted in a lower Vco2 and RQ than Instant Breakfast, suggesting it is a reasonable nutritional supplement in CF patients with moderate to severe pulmonary disease.
Tumor Necrosis Factor‐α Is Not Elevated in Children with Inflammatory Bowel Disease
Authors: Hyams Jeffrey S. , Treem William R. , Eddy Evangeline , Wyzga Nancy , Moore Robert E. 
Published: January 2024

SummaryChronic undernutrition and high‐dose daily corticosteroid therapy are well‐accepted causes of growth failure in children with inflammatory bowel disease. Occasionally, children are seen with minimal gastrointestinal symptoms but in whom severe anorexia and profound growth impairment are evident. Recent observations that elevated serum levels of tumor necrosis factor‐α (TNF) in cachexia associated with a number of disease states have suggested a similar possible role in inflammatory bowel disease. Accordingly, we determined TNF levels in 45 children and adolescents with inflammatory bowel disease (18 ulcerative colitis, 27 Crohn's disease) at varying times during their clinical course and compared them to values obtained from a group of 25 children with functional bowel disease. No differences were noted in serum TNF levels between the children with inflammatory bowel disease and the control population. Values were generally within the range of the lower limit of detection of the assay. In the children with inflammatory bowel disease, there was no significant correlation between TNF levels and disease activity or growth parameters. Our observations suggest that elevated TNF levels are not associated with inflammatory bowel disease in children.
The Developmental Accumulation of γ‐Glutamyl Transferase in the Pancreas of the Rat
Authors: Chin Richard J. , Callaghan James W. , Githens Sherwood 
Published: January 2024

SummaryThe developmental accumulation of pancreatic exocrine secretory enzymes is well defined, but little is known of the development of other enzymes in the pancreas. This report focuses on the developmental accumulation of γ‐glutamyl transferase (GGT), a membrane‐bound ectoenzyme whose specific activity in the pancreas is the second largest among rat organs. GGT activity is large in organs with active glutathione metabolism. Pancreatic GGT specific activity increased 100‐fold from prenatal day 14 to birth, decreased 3‐fold until about postnatal week 2, and then increased until the adult value was reached 4 weeks after birth. There was a 500‐fold increase in specific activity from prenatal day 14 to the adult. The developmental accumulation pattern of GGT was very similar to that of the exocrine secretory enzyme amylase, which increased 1,300‐fold from prenatal day 14 to birth, decreased 8‐fold by postnatal week 1, and then increased to the adult level soon after week 4. The overall increase in amylase specific activity was 1,100‐fold. The similar developmental accumulation patterns of GGT and amylase suggested that their accumulation might be regulated in a similar fashion. Although the thymidine analogue 5‐bromodeoxyuridine inhibited the prenatal accumulation of amylase, as previously reported, it did not inhibit prenatal GGT accumulation. Therefore, the prenatal accumulation of GGT appears to be regulated differently than amylase. On the other hand, the postnatal levels of GGT appear to be controlled by glucocorticoids in a fashion similar to the previously reported control of amylase levels, since both enzymes could be induced to rise prematurely to adult levels by a series of three injections of the glucocorticoid dexamethasone beginning on days 7, 8, 9, 10, 11, or 12. A dose of 0.1 mg/kg of body weight was optimal. The specific activities of GGT and amylase were stimulated 7.5‐fold and 6.3‐fold, respectively, compared to saline‐injected controls, prematurely achieving values equal to and greater than the adult specific activities of these enzymes, respectively.
Gastroesophageal Reflux in Infants with a History of Near‐Miss Sudden Infant Death
Authors: Veereman‐Wauters Genevieve , Bochner Andre , Van Caillie‐Bertrand Micheline 
Published: January 2024

SummaryFrom January 1984 through August 1986, 130 infants were referred to our department with a history of apnea, hypotonia, and cyanosis or pallor, suggesting near‐miss sudden infant death syndrome. Protocol consisted of medical history, clinical examination, overnight polygraphic recording, and cardiologic, gastrointestinal, metabolic, neurologic, and toxicologic workups. In 49 of these infants who needed vigorous stimulation or mouth to mouth resuscitation, the event occurred shortly after feeding. Combined, continuous esophageal pH monitoring and polygraphic recording in these 49 infants showed pathologic gastroesophageal reflux (GER) in 34 patients. An abnormal overnight polygraphic recording was observed in 8 of 34 infants with pathologic GER. Other investigations led to etiologic diagnoses in 42 of the remaining infants. Severe GER was frequently found in children with apnea after feeding but clearly is not the only mechanism involved. Infants with a history of apnea after a feeding should be investigated for GER and appropriately treated.
Measurement of Calbindin‐D9K in Small Intestinal Biopsy Specimens of Children
Authors: Staun Michael , Pærregaard Anders , Krasilnikoff Peter A. 
Published: January 2024

SummaryThe vitamin D dependent intestinal calcium‐binding protein (calbindin‐D9K) was measured by an enzyme‐linked immunoadsorbent assay in small intestinal biopsy specimens from 10 children (aged 15–126 months). The aim was to study the relationship between calcium‐binding protein and age, bone age, and height. The patients were examined due to complaints of chronic diarrhea, but no evidence of malabsorption was found. The amount of calbindin‐D9K per mg of soluble protein in the small intestinal biopsy specimens was higher than previously studied in normal adults. Calbindin‐D9K correlated inversely with chronological age, bone age, and height of the children (p = −0.87, p = −0.66, and p = – 0.66; p < 0.05). A direct correlation was found between calbindin‐D9K and intestinal alkaline phosphatase activity (p = 0.60; p < 0.05). The decline in calbindin‐D9K may indicate that the active vitamin D dependent intestinal calcium absorption decreases during childhood.
Stable Isotopic Measurement of Endogenous Fecal Calcium Excretion in Children
Authors: Abrams Steven A. , Sidbury James B. , Muenzer Joseph , Esteban Nora V. , Vieira Nancy E. , Yergey Alfred L. 
Published: January 2024

SummaryUsing a stable isotopic technique in which 42Ca was administered via a bolus injection, we measured endogenous fecal calcium excretion, Vf, in five healthy children, aged 3–14 years. The Vf averaged 1.4 ± 0.4 mg/kg/day, and was lower than urinary Ca excretion (Vu) in four of the five children. These results for Vf are consistent with previously reported results for Vf in healthy adults and much lower than those reported in premature infants. These results may be useful in understanding developmental changes in Ca metabolism and in interpreting dual tracer Ca isotope studies in children.
Sialylated Oligosaccharides in Human Milk and Feces of Preterm, Full‐Term, and Weaning Infants
Authors: Sabharwal Hemant , Sjöblad Sture , Lundblad Arne 
Published: January 2024

SummaryThe amount of free and glycosidically bound sialic acid was quantitated in the oligosaccharide fraction of breast milk from nine women in the 2nd‐3rd week of lactation. These amounts showed a certain individual variation but the amount of bound sialic acid was higher than the free sialic acid in each sample. A similar study on the feces from preterm and full‐term breast‐fed infants revealed that the amount of free sialic acid increased while the bound sialic acid decreased during maturation, which could possibly be a result of increasing activity of an intestinal sialidase in the newborn child. The fecal oligosaccharide patterns in one blood group A secretor breast‐fed infant were studied every 2 months during weaning until the age of 1 year. It was seen that the fecal oligosaccharide pattern disappears, along with the blood group A‐active compounds, with a corresponding decrease in the amount of breast milk in the diet.
Early Liver Transplantation Is Indicated for Tyrosinemia Type I
Authors: Freese Deborah K. , Tuchman Mendel , Schwarzenberg Sarah J. , Sharp Harvey L. , Rank Jeffrey M. , Bloomer Joseph R. , Ascher Nancy L. , Payne William D. 
Published: January 2024

SummaryLiver transplantation is now accepted as the treatment of choice for tyrosinemia type I (hereditary tyrosinemia). In an effort to determine whether any factors in these patients would aid in predicting optimal timing of the transplant procedure, we evaluated several clinical, biochemical, and radiographic parameters in five successive patients undergoing liver transplant for tyrosinemia type I at the University of Minnesota. All five patients evidenced prolonged periods of clinical and metabolic stability with dietary therapy and four of five remained stable at the time of evaluation for transplantation. Nevertheless, all five suffered significant and unexpected complications of tyrosinemia prior to the time of liver transplant. Four developed renal stones, two were in liver failure, and one developed a neurologic crisis that left him completely paralyzed. Hepatocellular carcinoma was found in one of the five at transplant. We could identify no clinical, biochemical, or radiographic study that was predictive of the likelihood of significant complications of the disorder. Survival from the transplant procedure itself was 100%. The inability to predict or prevent significant complications of tyrosinemia and the favorable outcome from transplantation lead us to recommend liver transplant for all patients with tyrosinemia type I by 12 months of age.
Gastroesophageal Reflux in Children with Chronic Recurrent Bronchopulmonary Infection
Authors: Chen Pei‐Huai , Chang Mei‐Hwei , Hsu Shun‐Chien 
Published: January 2024

SummaryTo evaluate the role of gastroesophageal reflux (GER) as a possible cause of recurrent bronchopulmonary infection in Chinese children, 23 patients were studied prospectively with 24‐h pH monitoring. Their ages ranged from 3 to 25 months. The patients studied were chosen by the criterion of repeated, radiographically documented bronchopulmonary infection with a frequency of two or more episodes in the most recent 6 months, or a single episode with a protracted course longer than 3 months. Twenty‐one of the 23 showed abnormal GER on 24‐h pH monitoring. Twenty children received medical therapy, 17 of whom were followed regularly for 14–29 months. Eleven had subsidence or improvement of symptoms at follow‐up. Follow‐up pH monitoring was performed in 5 of the 11 patients, and showed improvement. Six failed to show improvement with medical therapy. Follow‐up pH monitoring revealed increased reflux in two of them. Three of the six received fundoplication and had marked improvement of reflux and symptoms postoperatively. Clinical resolution corresponded well to 24‐h pH monitoring. GER may be considered one of the possible contributing factors in any child with chronic recurrent bronchopulmonary infection, and antireflux therapy might be beneficial. Twenty‐four hour pH monitoring was the best single test for diagnosing GER and determining the severity of the disease.
The Role of the Exocrine Pancreas in Early‐Onset Vitamin B12 Malabsorption in Gluten‐Challenged Celiac Children
Authors: Hjelt Karsten 
Published: January 2024

SummaryThe fractional absorption of vitamin B12 (FAB12) was measured by a double‐isotope technique specially adapted for children. In six celiac children on a strict gluten‐free diet and with a normal small intestinal biopsy, the FAB12 performed in the fasting patient averaged 30% (23–40%). After gluten challenge for a mean of 2 months (range 1–4), when mucosal damage was demonstrated by biopsy, the average fasting FAB12 in these patients decreased to 10% (0–17%) (p < 0.05). However, when the FAB12 test was repeated by means of stimulation by a B12‐free meal 1–3 weeks later, while the patients were still on a diet containing gluten, a significant increase was observed (mean 21%, range 14–27%) (p < 0.05). In four of the six patients the B12 absorption was further evaluated by repeating the FAB12 test by means of intravenous cholecystokinin (CCK) stimulation (n = 3) or by administration of exocrine pancreas enzyme supplementation (EPES) (n = 2) or cobinamide (n = 1). These tests all showed FAB12 values within the range of the meal‐stimulated FAB12. Moreover, in eight gluten‐free celiac children with normal biopsies, no difference was found between fasting and meal‐stimulated FAB12 values. Therefore, it is likely that the early‐onset B12 malabsorption observed in the gluten‐challenged celiac child with upper‐small‐intestinal mucosal damage is in part due to an insufficient stimulation of the exocrine pancreas when using the standard fasting B12 absorption test. These results indicate that a B12 absorption test with meal stimulation is preferable to the standard fasting test in children with small‐intestinal mucosal damage.
The Effect of Glucocorticosteroids on Serum, Liver, and Lung Vitamin A and Retinyl Ester Concentrations
Authors: Georgieff Michael K. , Radmer William J. , Sowell Anne L. , Yeager Pat R. , Blaner William S. , Gunter Elaine W. , Johnson Dana E. 
Published: January 2024

SummaryVitamin A and its active metabolites are important factors in promoting normal respiratory epithelial differentiation and growth. Glucocorticoids, often used to treat chronic lung diseases in infancy and childhood, are known to increase serum retinol concentrations. To determine the effects of exogenous steroids on serum retinol and retinal‐binding protein concentrations (as well as on liver and lung total vitamin A, retinol, and retinyl ester concentrations), 32 weanling Sprague‐Dawley rats were divided into four equal experimental groups. Eight animals were vitamin A sufficient and received 7 days of intraperitoneal dexamethasone at 0.5 mg/kg/day (group SD), 8 were vitamin A sufficient and received placebo (group SP), 8 were made vitamin A deficient and subsequently received dexamethasone (group DD), and 8 were vitamin A deficient and received placebo (group DP). Dexamethasone increased serum retinol concentrations in the SD group (2.27 ± 0.20 μmol/L) when compared with control (SP, 1.64 ± 0.46 n,mol/L, p < 0.001) as well as with pretreatment baseline values (1.21 ± 0.23 μmol/L, p < 0.001). Lung total vitamin A, retinol, and individual retinyl esters were depleted by 56 ± 19% in the SD group, whereas liver values were depleted by 36 ± 23%. In the vitamin A‐sufficient groups the relative percentages of four major retinyl esters (palmitate, stearate, oleate, and linoleate) did not change in either tissue after steroid exposure. The vitamin A‐deficient groups had no detectable tissue vitamin A, and dexamethasone did not increase serum retinol concentrations in the DD group. Serum retinol‐binding protein concentrations were significantly higher in both steroid‐treated groups when compared with control. Dexamethasone increases serum retinol and retinol‐binding protein concentrations in vitamin A sufficient rats, apparently at the expense of both lung and liver total vitamin A, retinol, and retinyl ester concentrations. We speculate that the liver and lungs are two sources for the increase in serum retinol reported with glucocorticosteroids.
Infectious Gastroenteritis Does Not Act as a Triggering Mechanism for the Synthesis of Serum IgG Antibody to β‐Lactoglobulin
Authors: Brüssow Harald , Sidoti Josette , Rahim Hassan , Dirren Henri , Freire Wilma 
Published: January 2024

Summaryβ‐Lactoglobulin (BLG)‐specific serum IgG antibody was measured by enzyme‐linked immunosorbent assay in 1,392 serum samples from newborn to 5‐year‐old Ecuadorian children enrolled into a representative nutrition and health survey. At a 1:100 serum dilution, 62% of the children showed specific antibody (blank‐corrected optical density ≥ 0.1). This prevalence did not change with increasing age. More specifically, we did not observe a prevalence or titer increase of BLG‐specific antibody in age groups where the majority of these Ecuadorian children experienced infection with rotavirus (8–24‐month age groups) and enterotoxigenic Escherichiacoli (8–12‐month age group). In addition, BLG‐specific antibody did not differ between children who did or did not experience an episode of diarrhea 15 days before blood sampling. We observed a small but statistically significant difference in BLG‐specific antibody between subsamples of Ecuadorian children regularly or only occasionally ingesting milk. Titers were higher in the group consuming more milk.
Persistent Diarrhea
Authors: Roy S. K. , Akramuzzaman S. M. , Akbar M. S. 
Published: January 2024

SummaryThe study was undertaken to better understand the role of total gut transit time (TGTT) on the absorption of nutrients in patients with persistent diarrhea. Twenty‐six boys aged 3–18 months with persistent diarrhea and 25 age‐matched healthy controls were studied. Their TGTT was measured with charcoal markers during their treatment with a diet made up with rice powder, soya oil, glucose, and egg white. Coefficients of absorption of nutrients were estimated in a 72‐h balance study. The median TGTTs in patients and controls were 5 and 11.6 h, respectively. Among the patients, the TGTT correlated significantly with absorption of total energy (p < 0.01), absorption of fat (p < 0.01), stool frequency (p < 0.01), and stool weight during the 1st 24 h (p < 0.01). Coefficients of absorption of energy, fat, and carbohydrate were significantly different among the patients above or below the median transit time (5 h). None of these relationships was present among the healthy controls. The TGTT was negatively associated with the duration of clinical recovery. The results of this study suggested that intestinal transit time is an important factor for absorption of nutrients that may influence clinical recovery in patients with persistent diarrhea.
Effect of Iron Deficiency on Small Intestinal Permeability in Infants and Young Children
Authors: Berant Moshe , Khourie Marwan , Menzies Ian S. 
Published: January 2024

SummarySmall intestinal absorptive function can be disturbed in iron deficiency. We examined the permeability behavior of the small intestinal mucosa toward lactulose and rhamnose in 26 otherwise healthy children with iron deficiency. Their (mean ± SD) age was 21 ± 8.6 months; hemoglobin 7.9 ±0.9 g/dl, mean corpuscular volume (MCV) 60.1 ± 3.4 fl, serum iron 2.72 ± 0.66 μmol/L, serum ferritin 7.3 ± 1.6 μg/L. After an isotonic oral load of both sugars, their 5‐h urinary excretion was measured by gas‐liquid chromatography/mass spectrometry. The ratio of the percentage of urinary recovery of the sugars [lactulose/rhamnose(%)] was determined as the permeability index. The tests were repeated in the same subjects after 3 months of iron supplementation, and achievement of an iron sufficient state. In the iron‐deficient state, the permeability index was significantly higher than the standard normal value (0.15 ± 0.05 versus <0.07; p < 0.01), but was not different from normal when the children had attained a normal iron status. The major factor for the alteration of the permeability index in the children with iron deficiency was a significantly lower urinary recovery of rhamnose (which passes the small intestinal epithelium by a transcellular route); the recovery of lactulose (which passes through a paracellular route) was not affected by iron deficiency. Our study indicates that iron deficiency in infants and young children can alter permeability characteristics of the small intestinal mucosa. Iron status should therefore be considered when interpreting permeability tests in the young.
Iron Absorption and Iron Deficiency in Infants and Children with Gastrointestinal Diseases
Authors: de Vizia Basilio , Poggi Vincenzo , Conenna Rodolfo , Fiorillo Amedeo , Scippa Luigi 
Published: January 2024

SummaryIron status, iron absorption, and intestinal blood loss were studied in 199 children undergoing diagnostic evaluation for suspected malabsorption. Evaluation of iron status included hematological indices, serum ferritin, and transferrin saturation. Iron absorption was assessed by the increment of serum iron after an oral iron load. Iron deficiency was common among patients affected by malabsorptive states, such as celiac disease (84%), cow's milk intolerance (76%), Crohn's disease (72%), and giardiasis (64%), whereas it was less common among patients with postinfectious enteritis (41%) and chronic nonspecific diarrhea (11%). Intestinal blood loss was seen only in patients with Crohn's disease and cow's milk intolerance, irrespective of iron nutritional status. On the other hand, iron malabsorption was very common, affecting 85–95% of the iron‐deficient patients in all diagnostic groups, except in chronic nonspecific diarrhea. Iron malabsorption was less common among patients with adequate iron nutritional status than in those with iron deficiency. Iron malabsorption appears to play a major role in the pathogenesis of iron deficiency in patients with malabsorption. The iron absorption test shows greater sensitivity as a screening test for upper intestinal malabsorption than the D‐xylose absorption test.