bluuebunny/crossref_metadata_2025_split huggingface dataset:
Energy Supplements Rich in Linoleic Acid Improve Body Weight and Essential Fatty Acid Status of Cystic Fibrosis Patients
Authors: Steinkamp Gratiana , Demmelmair Hans , Rühl‐Bagheri Ina , von der Hardt Horst , Koletzko Berthold 
Published: January 2024

ABSTRACTBackgroundPatients with cystic fibrosis who have steatorrhea frequently are underweight and have essential fatty acid (EFA) depletion, which is associated with a poor clinical course. It has been stated that poor EFA status is difficult to correct in patients with cystic fibrosis, and an impaired EFA metabolism with reduced synthesis of long‐chain polyunsaturated fatty acids has been proposed. In this study, the effects of an oral energy supplement rich in linoleic acid were investigated in patients with cystic fibrosis who had a body weight below 95% of normal for height.MethodsThirty‐six patients (16 girls) more than 4 years of age were randomized either to a control group (n = 20, age 13.3 ± 3.8 years, mean ± SD) receiving intensive dietary counseling only, or an intervention group (n = 16, age, 10.4 ± 4.3 years) treated for 3 months with dietary counseling plus 628 ± 254 mL (=kcal) per day of an energy supplement rich in fat (31% of energy) and linoleic acid (16% of energy).ResultsIn contrast to the control group, the patients with supplemented diets achieved significant increases of energy intake (2189 ± 731 kcal/day vs. 2733 ± 762 kcal/day), weight for height (82.8% ± 8.6% vs. 84.8% ± 9.6% of normal), and body fat (5.1 ± 1.7 kg vs. 5.8 ± 2.2 kg) as well as the initially low values of plasma phospholipid linoleic acid (11.8% ± 1.1% vs. 17.6% ± 1.6% of total phospholipid fatty acids) and its main metabolite arachidonic acid (4.4% ± 0.4% vs. 5.9% ± 0.3%).ConclusionsPatients with cystic fibrosis with low body weight and poor EFA status benefit from EFA‐rich energy supplements and can synthesize arachidonic acid from the precursor linoleic acid.
Influence of a β‐Glucan–Enriched Bedtime Snack on Nocturnal Blood Glucose Levels in Diabetic Children
Authors: Rami Birgit , Zidek Thomas , Schober Edith 
Published: January 2024

ABSTRACTBackgroundThe high prevalence of low nocturnal blood glucose levels is a major problem in the treatment of children with diabetes.MethodsThe effect of a β‐glucan–enriched bedtime snack on nocturnal blood glucose levels was examined in comparison with an equicaloric conventional snack in 38 children with diabetes during a 12‐night study period.ResultsA significant influence of the type of bedtime snack on the blood glucose course until 2 AM could be observed (P < 0.05). However, there was no difference in the prevalence of nocturnal hypoglycemic blood glucose levels, which was 27% at 2 AM.ConclusionSilent nocturnal hypoglycemia is common in children with diabetes. The introduction of a fiber‐enriched bedtime snack may flatten the blood glucose curve before midnight but cannot prevent low 2 AM blood glucose. Other therapeutic strategies that reduce the risk of asymptomatic and symptomatic nocturnal hypoglycemia would be beneficial to many children with diabetes.
Smectite in the Treatment of Acute Diarrhea: A Nationwide Randomized Controlled Study of the Italian Society of Pediatric Gastroenterology and Hepatology (SIGEP) in Collaboration With Primary Care Pediatricians
Authors: Guarino Alfredo , Bisceglia Massimo , Castellucci Giuseppe , Iacono Giuseppe , Casali Luigi Gobio , Bruzzese Eugenia , Musetta Antonella , Greco Luigi ,   SIGEP Study Group for Smectite in Acute Diarrhea.
Published: January 2024

ABSTRACTBackgroundChildhood gastroenteritis is associated with considerable health costs. The natural clay dioctahedral smectite increases intestinal barrier function and is effective against infectious diarrhea in children in developing countries. The purpose of this work was to investigate the efficacy of smectite in Italian children with acute diarrhea of mild to moderate severity.MethodsA national, prospective, randomized, case‐controlled study was performed in collaboration with primary care pediatricians. Children seen by pediatricians for acute gastroenteritis were treated with oral rehydration solution (ORS) alone or ORS with smectite. Parents returned a form in which total duration of diarrhea, incidence of vomiting and fever, persistence of diarrhea for more than 7 days and hospital admissions were recorded.ResultsEight hundred four children with acute diarrhea were randomly assigned to treated or control groups. Administration of smectite was associated with significant reduction of the duration of diarrhea, as judged by stool frequency and consistency. The incidence and duration of vomiting and fever were not different. Diarrhea lasted more than 7 days in 10% of treated and in 18% of control children (P < 0.01). Hospital admission was necessary in seven treated and six control children. No side effects were observed.ConclusionsSmectite reduces the duration of diarrhea and prevents a prolonged course. It may therefore consistently reduce the costs of gastroenteritis.
An Infant Formula Free of Glycomacropeptide Prevents Hyperthreoninemia in Formula‐Fed Preterm Infants
Authors: Rigo Jacques , Boehm Günther , Georgi Gilda , Jelinek Jürgen , Nyambugabo Kindja , Sawatzki Günther , Studzinski Fréderic 
Published: January 2024

ABSTRACTBackgroundHyperthreoninemia is a well‐known phenomenon in infants fed a whey protein‐predominant formula. Sweet whey is commonly used for the production of these whey‐predominant infant milk formulas. Sweet whey contains not only whey proteins but also the threonine‐rich glycomacropeptide (GMP). In the current study, an experimental formula based on acid whey without GMP and a formula based on sweet whey with GMP (threonine content 17.2 % higher than in the experimental formula) but otherwise with identical composition were tested with particular respect to threonine metabolism.MethodsFourteen preterm infants appropriate for gestational age were enrolled in this randomized cross‐over study. After a feeding period of at least 7 days, the nutrition of each infant was switched to the other formula for the second feeding period. At the end of each feeding period, the concentrations of creatinine and amino acids in the plasma and in the urine were measured.ResultsIn the plasma, the threonine concentration was significantly lower in the group fed the experimental GMP‐free formula than in the group fed the sweet whey formula (P < 0.001). Renal excretion of all essential amino acids was generally very low and less than 2% of the intake, indicating that the kidneys had no marked homeostatic function with respect to plasma amino acid. The plasma concentrations of the threonine metabolites glycine and serine, and that of urea were not influenced by diet.ConclusionFeeding a whey protein‐predominant bovine milk produced from acid whey protein reduces significantly the hyperthreoninemia commonly found in formula‐fed preterm infants. Thus, acid whey formulas should be recommended for feeding preterm infants.
Effect of Preterm Formula With and Without Long‐Chain Polyunsaturated Fatty Acids on the Urinary Excretion of F2‐Isoprostanes and 8‐Epi‐Prostaglandin F2α
Authors: Stier Christian , Schweer Horst , Jelinek Jürgen , Watzer Bernhard , Seyberth Hannsjörg W. , Leonhardt Andreas 
Published: January 2024

ABSTRACTBackgroundThe objective of this study was to evaluate the effect of conventional and long‐chain polyunsaturated fatty acids (LCP)‐enriched preterm formula on the endogenous formation of F2‐isoprostanes and 8‐epi‐prostaglandin (PG) F2α as possible markers of lipid peroxidation in preterm infants during their first weeks of life.MethodsIn a prospective, randomized, double‐blind study, infants received either formula enriched with LCP (n = 8), standard preterm formula (n = 7), or (expressed) breast milk (n = 8). Urine was sampled at study entry and after the study period of 3 weeks. The formation of F2‐isoprostanes and 8‐epi‐PGF2α was evaluated by measuring the urinary excretion by gas chromatography–mass spectrometry.ResultsNo differences in the urinary excretion of F2‐isoprostanes and 8‐epi‐PGF2α were observed at the end of the study period.ConclusionsThis result suggests that supplementation of a preterm formula with LCP for a period of 3 weeks does not stimulate lipid peroxidation in preterm infants.
Technetium‐99m HMPAO‐Labeled Leukocyte Imaging Compared with Endoscopy, Ultrasonography, and Contrast Radiology in Children with Inflammatory Bowel Disease
Authors: Alberini Jean–Louis , Badran Abdul , Freneaux Eric , Hadji Said , Kalifa Gabriel , Devaux Jean–Yves , Dupont Christophe 
Published: January 2024

ABSTRACTBackgroundThe purpose of this study was to evaluate retrospectively the value of leukocyte‐labeled scintigraphy, ultrasonography, and contrast radiography compared with endoscopy in children suspected of having inflammatory bowel disease (IBD).MethodsTwenty‐eight children (17 boys; mean age, 10.2 years) with IBD based on standard colonoscopic, histologic, and radiologic criteria (16 with Crohn's disease, 5 with ulcerative colitis, 5 with nonspecific colitis, 1 with granulomatous disease, and 1 with Behçet's disease) were included. Endoscopic, ultrasonographic, and contrast radiologic examinations were realized for 28, 23, and 19 children respectively.ResultsSensitivity and specificity were 75% and 92% for leukocyte‐labeled scintigraphy, 39% and 90% for ultrasonography, and 58% and 83% for contrast radiography. The authors noted discontinuous uptake for 14 of 15 true‐positive results for patients with Crohn's disease and continuous uptake for 4 of 4 true‐positive results for patients with ulcerative colitis. A negative correlation between scan activity index and Lloyd–Still clinical score was found for 11 patients with Crohn's disease (r = −0.77).ConclusionsLeukocyte‐labeled scintigraphy, a noninvasive and reproducible technique, is a useful tool in the diagnosis and therapeutic strategy of IBD, and provides information on the presence, the intensity, and the extent of the disease, particularly in the terminal ileum. Leukocyte‐labeled scintigraphy may not replace colonoscopy with biopsies for diagnosis confirmation. Its reliability seems higher than that of ultrasonography.
Duodenal Tube Test in the Diagnosis of Biliary Atresia
Authors: Larrosa–Haro Alfredo , Caro–López Angélica María , Coello–Ramírez Pedro , Zavala–Ocampo Jesús , Vázquez–Camacho Gonzalo 
Published: January 2024

ABSTRACTBackgroundBiliary atresia (BA) is the main cause of severe liver damage in infants. Successful surgical treatment is related directly to an early and rapid diagnosis. The aim of this study was to determine specificity, sensitivity, and predictive value of the duodenal tube test (DTT) in the diagnosis of BA in a series of infants with cholestatic jaundice.MethodsThis was a descriptive study of a series of infants with cholestatic jaundice created to validate the sensitivity, specificity, and predictive value of the DTT in the diagnosis of BA. A total of 254 patients were identified from 1988 to 1998. The study cohort included 137 male infants (53.9%), and the mean age on admission was 8.3 weeks ± 2.47 weeks (standard deviation). Study protocol included liver function tests, liver ultrasound, metabolic screening and serology for viral hepatitis, and toxoplasma, rubella, cytomegalovirus, herpes, and others. A nasoduodenal tube was placed at the distal duodenum and the fluid was collected for 24 hours. DTT was considered bile positive when yellow biliary fluid was observed; the test was concluded at this time. When no yellow biliary duodenal fluid was observed, the collection was continued for 24 hours and, if negative, was reported as bile negative. The patients with a bile‐positive DTT were not explored surgically, and the cholestasis workup was completed. Laparotomy and a surgical cholangiogram were indicated in patients with bile‐negative DTT. If BA was verified, portoenterostomy was performed. The gold standard for BA diagnosis was the following: obstruction of the biliary tract confirmed by laparotomy and a surgical cholangiogram, and clinical outcome in patients without laparotomy (followed for a minimum of 18 months).ResultsThe results are as follows. BA: bile‐positive DTT, n = 3; bile‐negative DTT, n = 108. No BA: bile‐positive DTT, n = 134; bile‐negative DTT, n = 9. The following values were also determined: sensitivity, 97.3%; specificity, 93.7%; positive predictive value, 92.3%; and negative predictive value, 98.5%. The final diagnoses were as follows: BA, n = 111 (43.7%); neonatal hepatitis syndrome, n =103 (40.6%); cholestasis associated with inspissated bile syndrome, n = 13 (5.1%); choledochal cyst, n = 11 (4.3%); galactosemia, n = 9 (3.5%); cirrhosis of unknown etiology, n = 5 (2%), and Alagille syndrome, n = 2 (0.8%).ConclusionsThe data obtained from this series validate the DTT as a useful clinical tool for the differential diagnosis of the infant with cholestasis, particularly for indicating laparotomy and cholangiogram to substantiate BA. This diagnostic test is quick and simple, and offers the clinician valuable information with which to determine whether surgical intervention is necessary.
Relation Between Serum Insulinlike Growth Factor‐1, Insulinlike Growth Factor Binding Protein‐2, and Insulinlike Growth Factor Binding Protein‐3 and Nutritional Intake in Premature Infants With Bronchopulmonary Dysplasia
Authors: Price Wayne A. , Lee Edward , Maynor Angela , Stiles Alan D. , Clemmons David R. 
Published: January 2024

ABSTRACTBackgroundThe usefulness of serum insulinlike growth factor (IGF)‐system–peptide measurement to assess the adequacy of nutritional intake in premature infants with chronic lung disease bronchopulmonary dysplasia (BPD) was assessed.MethodsTwenty‐nine premature infants had serial measurements taken of their serum IGF‐1, insulinlike growth factor binding protein (IGFBP)‐2, and IGFBP‐3 concentrations between 2 and 6 weeks of age. Regression analyses were used to examine the relation between nutritional parameters and IGF‐1, IGFBP‐2, and IGFBP‐3 concentrations in premature infants with and without BPD.ResultsThe group of infants with BPD (n = 12) did not differ from infants without BPD (n = 17) in gestational age or weight at entry, but gained less weight during the study period. In infants without BPD, IGF‐1 correlated positively with protein intake (r = 0.50) and caloric intake (r = 0.41) over the 3 days before sample collection and with weight change over the previous week (r = 0.46). In contrast, infants with BPD showed a significant correlation between IGF‐1 and weight change (r = 0.54) only. There was a significant negative correlation between IGFBP‐2 and protein intake in infants without BPD (r = −0.50) and in infants with BPD (r = −0.41). Negative correlations between IGFBP‐2 and both weight change (r = −0.64) and caloric intake (r = −0.43) over the previous week were found only in the group of infants without BPD. IGFBP‐3 correlated positively with weight changes and protein intake in both groups but correlated with caloric intake only in the group without BPD. Multiple regression analyses were used to determine significant independent variables associated with IGF‐1, IGFBP‐2, and IGFBP‐3. In infants without BPD, significant independent predictors of IGFBP‐2 were 7‐day weight change and 2‐day protein intake; 3‐day caloric intake was the only significant independent predictor for IGFBP‐3. For infants with BPD, 3‐day weight gain was the only independent variable associated with serum IGF‐1. Protein intake in the week before sample collection was an independent predictor of IGFBP‐2 and 3‐day weight change and 2‐day protein intake were independent predictors of IGFBP‐3.ConclusionsThese results confirm that changes in serum IGF‐1, IGFBP‐2, and IGFBP‐3 reflect the nutritional status of premature infants and demonstrate that the relation between these proteins and nutritional intake differs in premature infants with and without BPD. Refinement of these observations by future studies may permit a more accurate determination of the protein and caloric intake sufficient for growth and repair after injury in premature infants with lung disease.
Nutritional Efficacy of Preterm Formula With a Partially Hydrolyzed Protein Source: A Randomized Pilot Study
Authors: Picaud Jean‐Charles , Rigo Jacques , Normand Sylvie , Lapillonne Alexandre , Reygrobellet Bernadette , Claris Olivier , Salle Bernard L. 
Published: January 2024

ABSTRACTBackgroundDecreased nitrogen levels, calcium intestinal absorption rates, and plasma amino acid imbalances were reported for preterm infants who were fed partially hydrolyzed preterm formulas. In this pilot study, we evaluated a new formula with modified nitrogen and calcium sources.MethodsDuring their second week of life, 16 preterm infants were randomly assigned to one of two groups: 9 were fed the new partially hydrolyzed formula and 7 were fed a conventional formula. Nutrient balance was performed at the end of the first month of life. Amino acid concentrations and anthropometric parameters were measured at theoretical term.ResultsBirth weight and gestational age (mean ± SD) were similar in the two groups (28.9 ± 7.0 weeks and 1183 ± 242 g vs. 27.7 ± 1.0 weeks and 1139 ± 162 g). Median nitrogen absorption rates (85% vs. 89%;P = 0.03) and biological values (59% vs. 69%;P = 0.13) were lower for infants who were fed the new formula than for those fed the conventional formula. After correction for difference in nitrogen intake, there was no significant difference in nitrogen retained between the two groups (P = 0.11). Plasma amino acid concentrations were also similar in the two groups. Median calcium absorption tended to be higher in the new‐formula group than in the conventional‐formula group (54% vs. 45%, P = 0.19). At theoretical term, infants fed the conventional formula were heavier than infants fed the new formula (3559 ± 362 g vs. 3193 ± 384 g, P = 0.04).ConclusionsBecause nitrogen content is 10% higher in hydrolyzed‐protein formula than in entire‐protein formula, appropriate nitrogen retention, plasma amino acid profile, and mineral use can be achieved with the new partially hydrolyzed formula. Further studies with larger groups are needed to evaluate the effect on growth.
An Epidemiological Survey of Hepatitis C Virus Infection in Italian Children in the Decade 1990–1999
Authors: Bortolotti Flavia , Iorio Raffaele , Resti Massimo , Verucchi Gabriella , Giacchino Raffaella , Vegnente Angela , Vajro Pietro , Marazzi Maria Grazia , Marcellini Matilde , Barbera Cristiana , Zuin Giovanna , Zancan Lucia , Maggiore Giuseppe ,   Italian Observatory for the Epidemiology of Hepatitis C Virus Infection
Published: January 2024

ABSTRACTBackgroundA retrospective–prospective survey of Italian children with hepatitis C virus (HCV) infection was planned in 1998 to explore the epidemiologic features of infection during the past decade.MethodsAnti‐HCV–positive patients (or HCV RNA–positive infants) aged 1 month to 16 years, consecutively observed in 20 pediatric Institutions, were considered. An anonymous epidemiologic questionnaire based on clinical records was used.ResultsFrom 1990 through March 1999, 606 patients were observed (296 boys, average age 5.8 years). Maternal infection (46% of cases) and blood transfusions (34%) were the most frequent risk factors. Of 279 infected mothers, 61% did not recall a putative source of infection (by history, many could possibly have had exposure through routes such as therapeutic injections with nondisposable material), whereas 94 (34%) admitted drug abuse, including 49 (17%) coinfected with human immunodeficiency virus (HIV). Only 157 (26%) children were born after 1991: 90% of their mothers were infected (11% were HIV coinfected vs. 25% mothers of older children, P < 0.01).ConclusionsMaternal infection is a prominent source of pediatric HCV infection in Italy. The fact that most mothers had a history of covert exposure to HCV, probably through percutaneous routes that are no longer operating, and that the number of those with HIV coinfection has decreased suggests that the frequency of pediatric infection could decrease in the future.
Extremely Short Small Bowel Induces Focal Tubulointerstitial Fibrosis
Authors: Hebiguchi Tatsuzo , Kato Tetsuo , Yoshino Hiroaki , Mizuno Masaru , Wakui Hideki , Komatsuda Atsushi , Imai Hirokazu 
Published: January 2024

ABSTRACTBackgroundArginine becomes an essential amino acid after massive resection of the small bowel as a result of decreased biosynthesis of citrulline in the remaining small bowel. It is also reported that nitric oxide (NO) is synthesized from l ‐arginine by NO synthase (NOS), and NO is involved in the regulation of blood flow in the kidney. The authors observed a patient with an extremely short small bowel, showing focal tubulointerstitial fibrosis. The experiment was designed to clarify whether massive small bowel resection (SBR) produces focal tubulointerstitial fibrosis in the kidney.MethodsAn experimental study was performed using 4‐week‐old rats with 90% proximal SBR either with or without arginine supplementation for 6 weeks after surgery.ResultsIn rats without arginine supplementation, low plasma levels of citrulline and arginine increased urinary excretion of orotate, and focal tubulointerstitial fibrosis was observed 6 weeks after 90% SBR. The data from plasma amino acid chromatography and increased excretion of urinary orotate suggested the presence of arginine deficiency. The kidney pathology was similar to that of our patient. Rats with arginine supplementation after 90% SBR and pair‐fed control rats without 90% SBR showed almost normal glomeruli and tubulointerstitium.ConclusionsExperimental study strongly suggests that arginine deficiency causes focal tubulointerstitial fibrosis in the kidney after massive SBR.
Phenotypic and Genetic Analysis of Diarrhea‐Associated Escherichia coli Isolated From Children in the United Kingdom
Authors: Knutton Stuart , Shaw Robert , Phillips Alan D. , Smith Henry R. , Willshaw Geraldine A. , Watson Peter , Price Elizabeth 
Published: January 2024

ABSTRACTBackgroundA hospital‐based study was performed to (1) compare phenotypic and genotypic diagnostic tests for enteropathogenic Escherichia coli, enteroaggregative E. coli, and diffuse‐adhering E. coli (collectively termed adherent E. coli) and (2) to assess the importance of these different classes of adherent E. coli as causes of infant diarrhea in the United Kingdom in comparison with other enteropathogens.MethodsE. coli isolated from 1,496 infants with diarrheal disease and from 546 age‐related controls were screened for enteropathogenic E. coli, enteroaggregative E. coli, and diffuse‐adhering E. coli using HEp‐2 cell adherence assays and DNA probes.ResultsMarked discrepancies between the phenotype and genotype of isolates indicate significant heterogeneity among enteroaggregative E. coli and diffuse‐adhering E. coli strains. Depending on the assay used, adherent E. coli were isolated as the only putative pathogen in 23% to 27% of diarrhea cases, a significantly higher incidence than in the control group. Individually, enteroaggregative E. coli (8.5–8.6% of cases) and diffuse‐adhering E. coli (10.4–11.3% of cases), but not enteropathogenic E. coli (4.5–7.5% of cases), were significantly associated with diarrhea.ConclusionsThese studies indicate that adherent E. coli may be an important cause of diarrhea in infants in the United Kingdom; they also emphasize the need for more specific virulence‐based tests for these putative classes of “diarrheagenic” (diarrhea causing) E. coli.