bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Urinary Excretion of Polyethylene Glycol as a Test for Mucosal Integrity in Children with Celiac Disease
Authors: Lifschitz Carlos H. , Polanco Isabel , Lobb Kelly 
Published: February 2024

Summary:We compared the results of various noninvasive tests with small bowel histology in 61 children with celiac disease. The most sensitive predictors of small bowel histology were serum levels of anti‐gliadin antibodies (AGAs) (90%) and the urinary excretion of polyethylene glycol (PEG) (69%). The sensitivity for the fecal fat analysis was 61% and for the d‐xylose test 34%. The specificity was 96% for both the PEG and the d‐xylose tests, 92% for the fecal fat, and 68% for AGAs. The predictive value of the PEG test was significantly better than that of d‐xylose (p < 0.05). The best combination of tests for the prediction of small bowel histology was the PEG test and the measurement of serum levels of AGAs. Agreement in the results of these two tests helps to time appropriately the second and third small bowel biopsies.
Cyclic Vomiting: The Pattern and Syndrome Paradigm
Authors: Li B U.K. 
Published: February 2024

Summary:Although it remains a mysterious disorder since its description over a century ago, cyclic vomiting syndrome appears to be more prevalent than previously thought. With the goal of improving detection of affected children, two quantitative historical criteria—peak intensity ≥ 4 emeses/h) and a episode frequency ≤ 9/ month—can differentiate those with an explosive, intermittent cyclic pattern from those with a low‐grade, daily chronic pattern. Diagnoses that can cause a cyclic vomiting pattern includes abdominal migraine, chronic sinusitis, intracranial neoplasm, anomalies of and mucosal injury to the gastrointestinal tract, urologic abnormalities, and metabolic and endocrine disorders. Because many organic disorders can mimic cyclic vomiting syndrome, a systematic diagnostic evaluation of potential underlying disorders is recommended. The following terminology is proposed: a cyclic pattern is differentiated from a chronic pattern of vomiting on the basis of a higher peak intensity of emesis and lower frequency of episodes; and of those with a cyclic vomiting pattern, an idiopathic subgroup who is not found to have an underlying disorder on diagnostic testing can be labeled as having cyclic vomiting syndrome.
Differential Diagnosis of Cyclic Vomiting Syndrome
Authors: Forbes David 
Published: February 2024

Summary:Vomiting is a nonspecific symptom and cyclic vomiting is a symptom complex that may result from a disorder of any major organ system. Children with cyclic vomiting syndrome (CVS) need careful review and investigation at their earliest presentations to exclude potentially lethal abnormalities such as intestinal volvulus, metabolic disorders, and neurologic space‐occupying lesions. The range of abnormalities that may present with features consistent with CVS includes gastrointestinal obstructive, inflammatory and motility abnormalities, pancreatic disease, metabolic disease (particularly the amino acidopathies, organic acidurias, fatty acid oxidation defects, and acute intermittent porphyria), renal disease, epilepsy, migraine, and psychiatric disorders. Careful history taking will usually provide clues to these uncommon problems, but all children should undergo baseline assessment of gastrointestinal morphology and screening tests for renal and metabolic disease.
Probiotic Treatment Using Bifidobacterium lactis HN019 Reduces Weanling Diarrhea Associated With Rotavirus and Escherichia coli Infection in a Piglet Model
Authors: Shu Quan , Qu Freeman , Gill Harsharnjit S. 
Published: February 2024

ABSTRACTBackgroundDiarrhea associated with rotavirus and Escherichia coli is one of the major gastrointestinal problems faced by human infants. Using a piglet model, the authors investigated the protective effectiveness of probiotic feeding against naturally acquired diarrhea in weanlings.MethodsSeventeen piglets were allocated into two groups balanced for live weight and litter of origin. The test group was administered Bifidobacterium lactis HN019 (109 colony‐forming units (cfu)/piglet/d) orally until the end of the experiment; the control group did not receive probiotic treatment. After 1 week, animals were penned individually and weaned onto a diet for a weaner. The degree of subsequent diarrheal disease was monitored in both groups of animals, feed intake and live weight gain of the piglets were assessed, and blood and fecal samples were collected to measure concurrent systemic and gastrointestinal tract immunologic activity.ResultsCompared with the controls, piglets that received B. lactis HN019 had a lower severity of weanling diarrhea and maintained a greater feed conversion efficiency during weaning. The protective effect of probiotic feeding was associated with lower concentrations of fecal rotavirus and E. coli, higher blood leukocyte phagocytic and T‐lymphocyte proliferative responses, and higher gastrointestinal tract pathogen‐specific antibody titers.ConclusionsThese results show that dietary treatment using B. lactis HN019 can reduce the severity of weanling diarrhea associated with rotavirus and E. coli, possibly via a mechanism of enhanced immune‐mediated protection. This study suggests that probiotic treatment may be an effective dietary means of preventing or limiting diarrhea in human infants.
The Effect of Cisapride on the Corrected QT Interval and QT Dispersion in Premature Infants
Authors: Cools Filip , Benatar Avram , Bougatef Adel , Vandenplas Yvan 
Published: February 2024

ABSTRACTBackgroundCisapride is used frequently in premature neonates as a gastrointestinal prokinetic drug. Concerns exist, however, about its safety because of its effect on the QT interval. Premature infants could be at higher risk for side effects because of their immaturity. This prospective study investigated the pharmacokinetics of cisapride and its effects on corrected QT interval (QTc) and QT dispersion in premature infants.MethodsElectrocardiogram examination was performed just before and after 72 hours of treatment with cisapride (0.2 mg/kg per dose, four times daily) in 10 premature infants. Trough and anticipated peak plasma level of cisapride and norcisapride were quantified after 72 hours of treatment. Results were compared with a cohort of 41 term infants aged 0 to 3 months receiving cisapride treatment.ResultsThe QTc interval increased significantly from 423 ms to 461 ms after 72 hours of treatment (P = 0.0007). No effect was seen on QT dispersion (44.3 ms vs. 45.9 ms). The change in QTc interval was inversely related to postnatal age (R2 = 0.52;P = 0.02), whereas there was no correlation with gestational age or plasma levels of cisapride or norcisapride. Trough and anticipated peak plasma levels of cisapride and norcisapride were significantly higher in the premature infants compared with the term infants aged 0 to 3 months (P < 0.001).ConclusionsPremature infants less than 1 month of age could be at higher risk for cardiac side effects of cisapride when used in the same dosage as in older infants. The daily dose should be reduced (0.1 mg/kg per dose, maximum four times daily), and the QTc interval should be monitored closely. The benefits and safety of cisapride in premature infants less than 1 month of age should be reconsidered.
Lansoprazole in Adolescents with Gastroesophageal Reflux Disease: Pharmacokinetics, Pharmacodynamics, Symptom Relief Efficacy, and Tolerability
Authors: Gunasekaran Thirumazhisai , Gupta Sandeep , Gremse David , Karol Michael , Pan Wei‐Jian , Chiu Yi‐Lin , Keith Roberta , Fitzgerald Joseph 
Published: February 2024

ABSTRACTObjectives:To evaluate the pharmacokinetics, pharmacodynamics, symptom relief efficacy, and tolerability of lansoprazole in adolescents between 12 and 17 years of age with gastroesophageal reflux disease (GERD).Methods:Adolescents with symptomatic, endoscopically and/or histologically proven GERD were enrolled in this multicenter, double‐blind trial and randomized to lansoprazole 15 mg or 30 mg once daily for 5 days.Results:Sixty‐three adolescents were enrolled in the study. After lansoprazole administration, Tmax occurred at 1.6 hours in those treated with lansoprazole 15 mg and at 1.7 hours in those treated with lansoprazole 30 mg. Dose‐proportional increases in lansoprazole Cmax and AUC were observed in the treatment groups. Age, weight, and gender had no significant effect on Tmax, Cmax, or AUC. Lansoprazole produced significant increases (P ≤ 0.05) in mean 24‐hour intragastric pH and the percentages of time intragastric pH was above 3 and 4. The majority of adolescents treated with lansoprazole 15 mg (69%, 22/32) or lansoprazole 30 mg (74%, 23/31) demonstrated improvement in their reflux symptoms after 5 days of treatment. Adolescents in both dosage groups exhibited reductions from baseline in the percentage of days and nights with heartburn (or other predominant symptom of GERD), the severity of heartburn, the percentage of days antacids were used, and the number of antacid tablets used per day. Pharyngitis and headache were the most commonly reported side effects among adolescents treated with lansoprazole 15 mg and 30 mg, respectively. Five patients experienced adverse events considered to be possibly treatment‐related. One patient with a history of environmental allergies experienced a mild allergic reaction after 3 days of treatment with lansoprazole 15 mg. Among those treated with lansoprazole 30 mg, 4 patients each reported one occurrence of pain (toothache), diarrhea, dizziness, and rash.Conclusion:The pharmacokinetic parameters of lansoprazole observed in this study of adolescents are similar to those observed in studies of healthy adults. Lansoprazole 15 mg or 30 mg once daily for 5 days produces significant increases in intragastric pH, effectively relieves symptoms of reflux disease, and is well tolerated in adolescents with GERD.
Home‐Based Treatment of Malnourished Malawian Children with Locally Produced or Imported Ready‐to‐Use Food
Authors: Sandige Heidi , Ndekha MacDonald J. , Briend André , Ashorn Per , Manary Mark J. 
Published: February 2024

ABSTRACTObjectives:To determine the efficacy of home‐based therapy with ready‐to‐use food (RTUF) in producing catch‐up growth in malnourished children and to compare locally produced RTUF with imported RTUF for this purpose.Methods:After a brief inpatient stabilization, 260 children with severe malnutrition were enrolled and systematically allocated to receive home therapy with either imported, commercially produced RTUF or locally produced RTUF. Each child received 730 kJ/kg/day and was followed up fortnightly. Children completed the study when they reached a weight‐for‐height Z score > −0.5 (WHZ), relapsed, died, or failed to achieve WHZ > −0.5 after 16 weeks. Analyses were stratified by human immunodeficiency virus (HIV) status.Results:78% of all children reached WHZ > −0.5, 95% of those with HIV‐negative status and 59% of those with HIV‐positive status. Eighty percent of those receiving locally produced RTUF and 75% of those receiving imported RTUF reached WHZ > −0.5. The difference between recovery rates was 5% (95% confidence interval [CI], −5–15%). The rate of weight gain was 0.4 g/kg/day (95% CI, −0.6, 1.4) greater among children receiving locally produced RTUF. The prevalence of diarrhea reported by mothers was 3.7% for locally produced RTUF and 4.3% for imported RTUF. After completion of home therapy and resumption of habitual diet for 6 months, 91% of all children maintained a normal WHZ.Conclusions:Home‐based therapy with RTUF was successful in affecting complete catch‐up growth. In this study, locally produced and imported RTUF were similar in efficacy in treating of severe childhood malnutrition.
Portal Hypertension and Duodenal Ulcer in Children
Authors: Hung Pei‐Yin , Ni Yen‐Hsuan , Hsu Hong‐Yuan , Chang Mei‐Hwei 
Published: February 2024

ABSTRACTObjectives:The prevalence of duodenal ulcer (DU) in adult patients with portal hypertension is higher than in patients without portal hypertension. This study investigates the prevalence and characteristics of DU in children with portal hypertension.Patients and Methods:From January 1997 to December 2001, 80 children with portal hypertension who had undergone upper intestinal endoscopic examinations were enrolled. Possible factors contributing to the development of DU including severity of liver disease, portal hypertension, H. pylori, and serum gastrin level were studied. The control group consisted of 80 age‐and sex‐matched children with gastrointestinal symptoms but no liver disease and who underwent endoscopic examination during the same period.Results:The prevalence of DU was significantly higher in children with portal hypertension than in children with digestive symptoms only (22.5%v 8.8%; P =0.017). DU was more common and appeared earlier in children with a history of variceal bleeding. The presence of DU was independent of the severity of liver disease, H. pylori infection and serum gastrin level.Conclusion:DU occurs commonly in children with portal hypertension, especially in those who have had variceal bleeding. It is mandatory to screen a patient with gastrointestinal bleeding for DU even in the presence of esophageal varices. Elevated portal pressure might be a factor contributing to the development of DU.
Glucoamylase Activity in Infants and Children: Normal Values and Relationship to Symptoms and Histological Findings
Authors: Lee P. C. , Werlin Steven , Trost Beth , Struve Mark 
Published: February 2024

ABSTRACTBackground:Starch digestion is dependent on a combination of pancreatic and salivary amylase and the intestinal brush border enzymes glucoamylase and sucrase‐isomaltase. Glucoamylase splits successive glucose molecules from the nonreducing end of starch molecules and is particularly important in infants who are relatively deficient in pancreatic amylase.Methods:The authors measured glucoamylase activity in endoscopic mucosal biopsies submitted for measurement of disaccharidase activity from 214 patients aged 1 month to 20 years. Glucoamylase activity was measured using glucose polymers (polycose) as the substrate. The authors also related enzyme activity to histologic appearance and clinical indication for endoscopy.Results:The most common reasons for biopsy were abdominal pain, gastroesophageal reflux, and vomiting. Disaccharidase activity by age was similar to previous reports. Glucoamylase activity did not differ with age, but was 2 to 3 times the activity reported previously. Glucoamylase activity was significantly depressed in children with the most severe histologic abnormalities. Normal glucoamylase activity (±2 SD) was 80.6 ± 54.8 μmoles of glucose produced per minute per gram of protein.Conclusions:Glucoamylase activity is 2 to 3 times higher when glucose polymers are used as substrate than when glycogen is used. Severe mucosal disease is associated with reduced glucoamylase activity. Quantitation of glucoamylase activity with glucose polymers is more appropriate in evaluating children since these polymers are commonly used as carbohydrate source in the diet.
Esophagitis: Optimizing Diagnostic Yield by Biopsy Orientation
Authors: Brindley Nicola , Sloan J. M. , McCallion W. A. 
Published: February 2024

ABSTRACTObjectives:There is poor correlation between gastroesophageal reflux (GER) symptoms, intraesophageal pH monitoring and endoscopic or histologic appraisal of esophagitis in the pediatric age group. To optimize the diagnosis of childhood esophagitis, histologic evaluation of esophageal pinch and suction biopsies after orientation were compared.Methods:Thirty consecutive children with GER, age range 6 months to 7 years, were prospectively evaluated with upper gastrointestinal endoscopy and biopsy. Three pinch biopsies and one suction biopsy were examined after different methods of biopsy orientation. The suction biopsy orientated with ×10 magnification represented the standard against which the pinch biopsies were compared.Results:After suction biopsy with tissue orientation using ×10 magnification 90% of biopsies were adequate for histologic appraisal. Ninety‐three percent of esophageal pinch biopsies orientated with ×10 magnification were adequate for analysis. After pinch biopsy orientated without magnification 90% of biopsies were suitable for histologic appraisal. Finally, in the pinch biopsy group without formal orientation, only 63% of the biopsies were adequate for histologic analysis and diagnosis of esophagitis.Conclusion:Orientation of esophageal pinch biopsies improves histologic appraisal and hence increases the diagnostic yield of esophagitis in children with GER. The tissue fragments can be easily orientated in the endoscopy room before placement in fixative.
Regulatory Regions in the Rat Lactase‐Phlorizin Hydrolase Gene that Control Cell‐Specific Expression
Authors: Verhave Menno , Krasinski Stephen D. , Christian Sara I. , Van Schaik Sandrijn , van Den Brink Gijs R. , Doting Edwina M. H. , Maas Saskia M. , Wolthers Katja C. , Grand Richard J. , Montgomery Robert K. 
Published: February 2024

ABSTRACTObjectives:Lactase‐phlorizin hydrolase (LPH) is an enterocyte‐specific gene whose expression has been well‐characterized, not only developmentally but also along the crypt‐villus axis and along the length of the small bowel. Previous studies from the authors’ laboratory have demonstrated that 2 kb of the 5′‐flanking region of the rat LPH gene control the correct tissue, cell, and crypt‐villus expression in transgenic animals.Methods:To examine further the regulation conferred by this region, protein‐DNA interactions were studied using DNase I footprint analyses in LPH‐expressing and nonexpressing cell lines. Functional delineation of this 5′‐flanking sequence was performed using deletion analysis in transient transfection assays.Results:Studies revealed a generally positive activity between −74 and −37 bp, a cell‐specific negative region between −210 and −95 bp, and additional elements further toward the 5′ terminus that conferred a highly cell‐specific response in reporter activity. Computer analysis of distal regions encompassing identified footprints revealed potential binding sites for various intestinal transcription factors. Co‐transfection and electromobility shift assay experiments indicated binding of HNF3β at three sites relevant to LPH expression.Conclusions:The data demonstrate that the cell specificity of LPH gene expression depends upon both positive and negative interactions among elements in the first 2 kb of the LPH 5′‐flanking region.
Clinical Usefulness of Culturing H. Pylori from Gastric Juice in Patients with Severe Neurological Impairment
Authors: Yamazaki Tsutomu , Inoue Miyuki , Sasaki Nozomu , Yamada Kazutaka , Minamide Wakio , Matsumoto Takaaki 
Published: February 2024

ABSTRACTObjectives:To clarify the diagnostic usefulness of culturing Helicobacter pylori from gastric juice for the diagnosis of H. pylori infection in patients with neurologic impairment.Methods:Seventy‐five patients (44 males, 31 females) with severe neurologic impairment admitted to Tokyo Children's Rehabilitation Hospital were included in this study. Samples of gastric juice obtained from these patients were put into Helicoporter™, a transport medium for H. pylori. Samples were then centrifuged and sediment was inoculated onto a culture medium. Polymerase chain reaction assays were performed on 41 gastric juice samples for comparison with results of culture. Tests for occult blood in gastric juice and serum anti‐H. pylori immunoglobulin G were tested for all patients.Results:H. pylori was isolated from 33 of 75 gastric juice samples by culture (positive rate, 44%). There was agreement between results of culture and polymerase chain reaction assays in 38 samples (93%). Twenty‐two samples were positive and 16 were negative by both methods. In H. pylori immunoglobulin G‐positive patients, occult blood was more frequently found in the culture‐positive group (92%) than in the culture‐negative group (59%) (P <0.025). The rate of detection of occult blood in immunoglobulin G‐negative patients was similar in the culture‐positive group (44%) and culture‐negative group (50%).Conclusions:The combination of a culture method using gastric juice and a serum H. pylori immunoglobulin G assay was not invasive and clinically useful for evaluating H. pylori infections among handicapped patients.
Depressive Symptoms and Inflammatory Bowel Disease in Children and Adolescents: A Cross‐Sectional Study
Authors: Szigethy Eva , Levy‐Warren Anna , Whitton Sarah , Bousvaros Athos , Gauvreau Kimberlee , Leichtner Alan M. , Beardslee William R. 
Published: February 2024

ABSTRACTObjectives:This study assessed the rates of depressive symptoms in older children and adolescents with inflammatory bowel disease (IBD) and the associations between depressive symptoms and IBD disease characteristics.Methods:One hundred and two youths (aged 11–17 years) with IBD seen consecutively in a gastroenterology clinic were screened for depressive symptoms using the Children's Depression Inventory (CDI). Subjects with CDI scores ≥12 were evaluated for current psychiatric diagnoses using the Schedule for Affective Disorders and Schizophrenia for School‐Age Children—Present and Lifetime Version (K‐SADS‐PL). Disease characteristics examined included IBD type, duration, current severity, course, age at diagnosis and steroid treatment.Results:Of the total sample, 25 (24.5%) had a CDI score ≥12, consistent with clinically significant depressive symptoms. Nineteen of 25 qualified subjects participated in the K‐SADS‐PL semi‐structured interview and 16 of 19 met criteria for major or minor depressive disorder. Mean CDI scores positively correlated with age at IBD diagnosis but not with IBD type, duration or course. Youths with moderate/severe current IBD‐related symptoms had significantly higher mean CDI scores than those with inactive disease activity. Anhedonia, fatigue and decreased appetite were selectively correlated with IBD disease severity. Subjects on steroids were more likely to have CDI scores ≥12, and those with such scores were on higher doses of steroids than subjects without clinically significant depressive symptoms (both P values < 0.05).Conclusions:These findings support the recommendation that adolescents with IBD in outpatient medical care settings, particularly older adolescents and those on steroids, should be screened for depression.