bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Factors for Severe Esophageal and Gastric Lesions in Term Neonates: A Case–Control Study
Authors: Benhamou Pierre‐Henri , Francoual Christine , Glangeaud Marie‐Christine , Barette Antoinette , Dupont Christophe , Bréart Gerard ,   Groupe Francophone d'Hépato‐Gastroentérologie et Nutrition Pédiatrique
Published: January 2024

ABSTRACTBackgroundThe purpose of this multicenter case–control study was to search for causes and risk factors related to the severe upper digestive tract lesions often seen in neonates.MethodsCase patients were full‐term neonates with endoscopically confirmed severe bleeding or ulcerative lesions of the esophagus and/or stomach. Matched control subjects were the next infant born in the same maternity unit who met the same criteria and had no clinical abnormality (and, for ethical reasons, no endoscopy). The analysis was based on 137 case–control pairs and considered data showing the mothers' medical and obstetric background, the infants' clinical status and laboratory results, feeding details, and the State and Trait Anxiety Inventory (STAI) questionnaire, which was used to assess the anxiety of the mothers.ResultsCases and controls did not differ in any demographic or social factors. Antacid and anti‐ulcer drugs were used significantly more frequently during the last month of pregnancy by case mothers than by control mothers (28% and 10%, respectively;P < 0.001). Mode of delivery was similar. Case infants more frequently experienced cardiac deceleration during labor and delivery (28% and 12.9%;P = 0.003). Breast‐feeding at birth was less frequent for case infants (36% and 49%;P = 0.05). The mean trait anxiety scores did not differ between the two groups, but the mean state anxiety score was higher in case mothers. Multivariate logistic regression found that three factors were independently and significantly associated with esophageal and gastric lesions: use of antacid and antiulcer treatments (odds ratio [OR], 3.9;P < 0.001), cardiac deceleration (OR, 2.2;P = 0.03), and breast‐feeding (OR, 0.5;P = 0.02).ConclusionsAntacid drug use by mothers during the last month of pregnancy was associated with esophageal and gastric lesions. Breast‐feeding may play a protective role against severe lesions in neonates.
Celiac Disease in a Chilean Population Carrying Amerindian Traits
Authors: Araya Magdalena , Mondragón Alexandra , Pérez‐Bravo Francisco , Roessler Jose Luis , Alarcón Teresa , Ríos Gloria , Bergenfreid Carmen 
Published: January 2024

ABSTRACTBackgroundAlthough clinical manifestations of celiac disease may change throughout life, clinical, histologic, immunologic, and genetic studies show that there are incomplete forms of this condition, making it difficult to define the disease at a given moment. Because there is no information published in the Latin American‐Amerindian population, this study was conducted to assess relations between these parameters in Chileans with celiac disease and their first‐degree relatives.MethodsSixty‐two persons with confirmed celiac disease (mean age, 17.9 ± 5.1 years; 78.3% females) and 126 relatives (mean age, 27.9 ± 17.2 years; 65.1% females) were evaluated. Clinical manifestations, antiendomysial antibodies (EMAs), and human leukocyte antigen (HLA) haplotypes were studied in patients. Additionally, jejunal biopsy specimens were assessed (light microscopy) in EMA‐positive (EMA+) relatives.ResultsOf the patients, 24.1% adhered to a strict gluten‐free diet; 26% were oligosymptomatic, and none were malnourished; 45% were EMA+; 13.8% who ingested gluten were EMA‐negative (EMA−); one patient consuming a strict gluten‐free diet was EMA+. The DQA1*0501 allele was present in the highest frequency (48%, P < 0.0005), whereas combinations of DQ8 were predominant. Of the relatives, 4.8% were EMA+; they had a significantly higher frequency of diarrhea, weight loss, and anorexia (P < 0.03); and all had abnormal histology in biopsy specimens.ConclusionsAfter childhood, celiac disease is oligosymptomatic and is often unrecognized by patients. Disease in 13.8% of patients and in 4.8% relatives appeared as incomplete forms of celiac disease. Predominance of DQ8 HLA haplotypes reflects the genetic Spanish‐Mapuche heritage of this population.
Posttransplantation Lymphoproliferative Disorder: Endoscopic Findings
Authors: O'Connor Judith A. , Cogley Catherine , Burton Mark , Lancaster‐Weiss Kristen , Cordle Richard A. 
Published: January 2024

ABSTRACTBackgroundposttransplantation lymphoproliferative disorder (PTLD) may manifest a variety of nonspecific symptoms and must be suspected in the patient who undergoes solid organ transplantation. Common sites of occurrence include the gastrointestinal tract, the central nervous system, and lymphoid tissue of the oral pharynx, mediastinum, and mesentery. The large incidence of gastrointestinal involvement provides an opportunity for endoscopic diagnosis. This is the description of a characteristic endoscopic finding in patients who have undergone liver transplantation who are under evaluation for suspected PTLD.MethodsDuring a 2‐year period, 27 liver transplantations were performed in 24 pediatric patients. Fourteen patients underwent endoscopic evaluation. Indications for endoscopy included abdominal pain, vomiting, hematemesis, irritability, growth failure, anemia, occult blood loss, and suspected PTLD. Biopsy specimens were obtained from any endoscopically detected abnormality and from the duodenum, gastric antrum, esophagus, terminal ileum, cecum, and rectum. Specimens with suspected PTLD were evaluated with Epstein–Barr virus latent membrane stain.ResultsSix patients were found to have a characteristic lesion, which was raised, rubbery, and erythematous, with a central ulceration. Lesions were singular or multiple and ranged from 5 to 15 mm in diameter. Microscopic evaluation revealed a monotonous proliferation of lymphocytes. All specimens were positive for Epstein–Barr virus latent membrane protein stain. Stains for cytomegalovirus were negative. Biopsy specimens from the eight patients without identified characteristic lesions were negative for PTLD.ConclusionsPanendoscopy is a useful tool for the diagnosis and treatment of gastrointestinal PTLD. Endoscopy is easily accomplished, may provide an instantaneous result if the characteristic lesion is identified, and provides tissue for disease classification. Patients with unexplained gastrointestinal signs or symptoms should undergo panendoscopy for suspected PTLD.
Tissue Transglutaminase Is the Target in Both Rodent and Primate Tissues for Celiac Disease–Specific Autoantibodies
Authors: Korponay–Szabó Ilma R. , Sulkanen Satu , Halttunen Tuula , Maurano Francesco , Rossi Mauro , Mazzarella Giuseppe , Laurila Kaija , Troncone Riccardo , Mäki Markku 
Published: January 2024

ABSTRACTBackgroundEndomysial antibodies have recently been shown to react with tissue transglutaminase. This study was undertaken to investigate whether the tissue distribution of transglutaminase is also compatible with reticulin, jejunal, and fibroblast autoantibody binding patterns.MethodsSera from patients with and without celiac disease, monoclonal tissue transglutaminase antibodies, and sera from mice parenterally immunized against commercially available tissue transglutaminase, transglutaminase complexed with gliadin, or gliadin were used in indirect immunofluorescence and double‐staining studies using both rodent and primate tissues as substrates. Also, antibody competition, affinity chromatography, and potassium thiocyanate extraction studies were undertaken.ResultsTissue transglutaminase antibody binding patterns were identical with the extracellular binding patterns seen with celiac patient sera. Human umbilical cord–derived fibroblasts exhibited both cytoplasmic and extracellular matrix staining. Double staining with patients' sera and tissue transglutaminase antibodies showed complete overlapping. Tissue transglutaminase effectively absorbed reticulin‐endomysial antibodies from celiac sera, and patients' sera blocked the staining of the monoclonal tissue transglutaminase antibodies. Potassium thiocyanate extraction abolished the staining patterns, but they were elicited again after readdition of tissue transglutaminase.ConclusionsReticulin, endomysial, and jejunal antibodies detect transglutaminase in both rodent and primate tissues, indicating that these tissue autoantibodies are identical.
Percutaneous Liver Biopsy in Children: Impact of Ultrasonography and Spring‐Loaded Biopsy Needles
Authors: Scheimann Ann O. , Barrios Jose M. , Al‐Tawil Youhanna S. , Gray Krista M. , Gilger Mark A. 
Published: January 2024

ABSTRACTBackgroundPercutaneous liver biopsy is a valued tool of pediatric hepatology. Recent advances in technology have incorporated spring‐loaded biopsy needles and ultrasonography in percutaneous liver biopsy.MethodsTo determine the frequency of complications after liver biopsy and whether variables such as needle selections (Jamshidi, Monopty, or ASAP) and ultrasound guidance could predict complications, medical records were retrospectively reviewed of all patients who underwent percutaneous liver biopsy during a 7‐year period. Available data were collected from 123 patients who had undergone a total of 249 percutaneous liver biopsies. All patients with evidence of mild clotting abnormalities (8.83%) received platelets, cryoprecipitate, or fresh‐frozen plasma.ResultsThere was a 6.83% incidence of overall complications, and a 2.4% incidence of major complications. The mortality rate was 0.4%. Ultrasound localization did not diminish the risk of bleeding during biopsy. There was no significant difference in the change of hematocrit between the aspiration (Jamshidi) and spring‐loaded (Monopty) needles. However, in patients less than 5 years of age, the change of hematocrit was significantly higher (P < 0.05) with the 15‐or 18‐gauge ASAP needle (Microvasive, Quincy, MA, U.S.A.) than with either the Jamshidi (Allegience Healthcare, Columbia, MD, U.S.A.) or Monopty (Bard Technologies, Covington, GA, U.S.A.) needles.ConclusionPercutaneous liver biopsy is safe, using either aspiration or spring‐loaded needles. Ultrasound guidance may not be helpful except in patients who underwent segmental liver transplantation.
Impact of Early Dietary Intake and Blood Lipid Composition of Long‐Chain Polyunsaturated Fatty Acids on Later Visual Development
Authors: Hoffman Dennis R. , Birch Eileen E. , Birch David G. , Uauy Ricardo , Castañeda Yolanda S. , Lapus Maia G. , Wheaton Dianna H. 
Published: January 2024

ABSTRACTBackgroundIn contrast to human milk, current infant formulas in the United States do not contain ω3 and ω6 long‐chain polyunsaturated fatty acids. This may lead to suboptimal blood lipid fatty acid profiles and to a measurable diminution of visual function in developing term infants. The need for docosahexaenoic acid and arachidonic acid supplementation in the infant diet was evaluated in a double‐blind, randomized clinical trial.MethodsHealthy term infants were randomized to diets of (1) commercial formula, (2) docosahexaenoic acid–enriched formula (0.35% of total fatty acids), or (3) docosahexaenoic acid– (0.36%) and arachidonic acid– (0.72%) enriched formula. Eighty‐seven infants completed the 17‐week nutritional trial, and 58 were observed until 52 weeks of life. A reference group was exclusively breast fed for at least 17 weeks (n = 29). Outcome measures included electroretinographic responses, visual evoked potentials, and blood fatty acid analysis in infants at birth and at 6, 17, and 52 weeks of age.ResultsCommercial formula‐fed infants had 30% to 50% lower content of docosahexaenoic acid in total red blood cell lipids during the 17‐week feeding trial compared with breast‐fed infants. Significant differences persisted at the 1‐year follow‐up. Arachidonic acid content was consistently reduced in the commercial formula group by 15% to 20%. Infants fed long‐chain polyunsaturated fatty acid–enriched formulas had docosahexaenoic acid and arachidonic acid blood lipid profiles resembling those of human milk‐fed infants. Infants receiving this enriched formula had more mature electroretinographic responses than commercial formula‐fed infants at 6 weeks of age. Human milk‐fed and docosahexaenoic acid‐enriched formula‐fed infants had better visual acuity than commercial formula‐fed infants at both 17 and 52 weeks of age. Early (17‐week) fatty acid profiles in blood lipids were correlated with later (52‐week) visual function development in study infants.ConclusionsResults from this clinical trial demonstrate that long‐chain polyunsaturated fatty acid supplementation of formula in term infants produces blood lipid fatty acid profiles that are similar to those observed in breast‐fed infants. This supplementation leads to better visual function later in life (i.e., 1 year of age) than that shown by infants fed commercial formula.
Randomized, Placebo‐Controlled, Clinical Trial of Hyperimmunized Chicken Egg Yolk Immunoglobulin in Children With Rotavirus Diarrhea
Authors: Sarker Shafiqul A. , Casswall Thomas H. , Juneja Lekh R. , Hoq Enamul , Hossain Iqbal , Fuchs George J. , Hammarström Lennart 
Published: January 2024

ABSTRACTBackgroundHyperimmunized bovine colostrum containing antibodies has been shown to be effective in the treatment of rotavirus diarrhea. Antibodies derived from eggs of immunized hens may be a less expensive and more practical alternative. In this study, children with proven rotavirus diarrhea were treated with immunoglobulin extracted from eggs of chicken immunized with human rotavirus strains.MethodsIn a randomized, double‐blind study, 79 children with known rotavirus diarrhea were assigned to receive either 10 g hyperimmune egg yolk (HEY) daily in four equally divided doses for 4 days (HEY group) or a similar preparation obtained from nonimmunized chicken (placebo group). The daily stool frequency and amount, oral rehydration solution (ORS) intake, and presence of rotavirus in the stool were monitored for 4 days.ResultsIn the HEY‐treated group. there was significant reduction in stool output (in grams per kilogram per day; HEY vs. placebo; 87 ± 59 vs. 120 ± 75, P = 0.03), and significant reduction of ORS intake (in milliliters per kilogram per day) (HEY vs. placebo; 84 ± 46 vs. 122 ± 72, P = 0.008) on day 1 and clearance of virus on day 4 (HEY vs. placebo; 73% vs. 46%, P = 0.02). There was, however, no difference in diarrheal duration between the groups.ConclusionsTreatment with HEY against four human rotavirus strains resulted in modest improvement of diarrhea associated with earlier clearance of rotavirus from stools. These results indicate an encouraging role of HEY in the treatment of rotavirus‐induced diarrhea in children. Further studies are needed to optimize the dose and neutralization titer and thus improve the efficacy of egg yolk immunoglobulin IgY derived from immunized hens.
Interferon‐α Treatment of Chronic Hepatitis C in Children with Hemophilia
Authors: Ko Jae Sung , Choe Yon Ho , Kim Eun Joo , Lee Eun Hee , Jang Ja‐June , Seo Jeong Kee 
Published: January 2024

ABSTRACTBackgroundIn children with hemophilia, hepatitis C virus (HCV) is the major cause of chronic liver disease. In this study, long‐term efficacy of interferon‐α was studied to determine the factors that predict a sustained response to interferon therapy in young children with hemophilia who have chronic hepatitis C.MethodsSeventeen Korean children with hemophilia and chronic hepatitis C were treated with 3.7 million units/m2 of interferon‐α2a three times weekly for 6 months. Liver biopsy, pretreatment serum HCV RNA quantitation with competitive reverse transcription assay, and HCV genotyping with reverse hybridization assay were performed.ResultsHepatitis C virus genotypes 1a, 1b, and 2a were found in three (18%), five (29%), and six (35%) patients, respectively. Interferon‐α was well tolerated, and the frequency of bleeding did not increase. Of the 17 patients, 7 (41%) had a sustained response for 3 years after the end of therapy. Patients with a sustained response had lower pretreatment serum HCV RNA levels. One (13%) of eight patients with genotype 1 and five (83%) of six with genotype 2 had a sustained response (P < 0.05).ConclusionsInterferon‐α treatment of chronic hepatitis C in children with hemophilia was safe and effective in producing sustained responses. The pretreatment serum HCV RNA level and viral genotype may be predictive factors for sustained response to interferon therapy.
Clinical Correlations in Infants in the Neonatal Intensive Care Unit With Varying Severity of Gastroesophageal Reflux
Authors: Khalaf M. Nabeel , Porat Rachel , Brodsky Nancy L. , Bhandari Vineet 
Published: January 2024

ABSTRACTBackgroundGastroesophageal reflux (GER) is frequently a benign condition in infancy with spontaneous resolution. In the neonatal intensive care unit (NICU), however, it can add to neonatal morbidity if not adequately diagnosed and treated. The objective of the current study was to analyze factors associated with GER in infants in the NICU and correlate them with the severity of the disease.MethodsAll infants in the NICU (n = 150; born November 1994 through April 1999) who were evaluated by a five‐channel pH study to rule out GER were included in the study. Infants were grouped as normal, with a reflux index (RI) of less than 6 (n = 66); mild, with RI of 6 to 14 (n = 42); and severe, with RI of more than 14 (n = 42). Maternal and neonatal data were obtained. Clinical GER was defined as the presence of feeding problems (significant gastric residue or emesis) and medical improvement with antireflux measures and medications.ResultsThere was no difference in birth weight, gestational age; incidence of patent ductus arteriosus, intraventricular hemorrhage, necrotizing enterocolitis, or chronic lung disease; and treatment with aminophylline or caffeine among the groups. Infants with mild and severe GER (RI 6–14 and >14) had significantly more clinical GER than the normal group (P = 0.0001). Additionally, infants with RI more than 14 had significantly more respiratory distress syndrome, lower hematocrits at the time of study and longer length of stay than those with no or mild GER (P = 0.02).ConclusionInfants with severe GER had lower hematocrits despite receiving more blood transfusions and iron therapy. Infants with severe GER also had prolonged hospital stays. Early diagnosis and aggressive management of GER may decrease neonatal morbidity and result in earlier discharge from the NICU.
Gastrostomy as a Decompression Technique in Children With Chronic Gastrointestinal Obstruction
Authors: Michaud Laurent , Guimber Dominique , Carpentier Bénédicte , Sfeir Rony , Lambilliotte Anne , Mazingue Françoise , Gottrand Frédéric , Turck Dominique 
Published: January 2024

ABSTRACTBackgroundPercutaneous or surgical insertion of gastrostomy tubes for feeding children has been well described. However, there is no report of percutaneous gastrostomy for chronic decompression in children with chronic gastrointestinal obstruction. The objective of this study was to evaluate this technique.MethodsEighteen gastrostomies were performed for gastrointestinal decompression in children. The patients ranged in age from 2 to 125 months (median: 15.5), and all had prolonged hospital stays for severe disease: severe gastroparesis and/or duodenal dysmotility (n = 8), duodenal stenosis (n = 2), chronic intestinal pseudo‐obstruction (n = 4), enterocolitis (n = 2), and metastatic abdominal carcinomatosis (n = 2). The duration of symptoms before gastrostomy placement ranged from 0.5 to 44 months (median: 2), with major symptoms including epigastric pain, early satiety, nausea, vomiting, and bloating.ResultsThe goals of gastric decompression and removal of the nasogastric tube were achieved in all patients, and all had significant relief of both nausea and emesis. Oral intake of liquids and soft foods was possible in 17 of 18 of the children. The tubes were kept in place for a median of 22.5 months (range, 2–73). There was neither long‐term morbidity nor mortality associated with the presence of the tube. Seventeen patients returned home with gastric decompression and cyclic parenteral nutrition, two of them for terminal care. Six patients died. In all patients, gastrostomy was used throughout and did not contribute to the death of the patients. For seven children, tubes were removed because of resolution of small bowel or gastric outlet obstruction.ConclusionsGastrostomy is an efficient and well‐tolerated method of achieving long‐term gastric decompression in children with abdominal obstruction not amenable to surgery and/or resistant to medical treatment.
Efficacy of Long‐Term Treatment With Thalidomide in Children and Young Adults With Crohn Disease: Preliminary Results
Authors: Facchini Sergio , Candusso Manila , Martelossi Stefano , Liubich Mario , Panfili Elisabetta , Ventura Alessandro 
Published: January 2024

ABSTRACTBackgroundSeveral proinflammatory cytokines are involved in the pathogenesis of inflammatory bowel diseases. A significant role has been given to tumor necrosis factor α (TNF‐α) as a guide proinflammatory cytokine. Thalidomide selectively reduces TNF‐α production by inflammatory cells. The aim of the study was to assess the efficacy of thalidomide to induce and maintain remission in refractory Crohn disease.MethodsThe decision to administer thalidomide was made on the basis of patient intolerance or resistance to conventional medical treatment or as the last medical resort before surgical intervention. Only 5 of 96 patients with inflammatory bowel disease satisfied these criteria. All five patients had Crohn disease (male; mean age, 17 years). Thalidomide was administered at night at a dose of 1.5–2 mg/kg/day. The Pediatric Crohn Disease Activity Index, modified Harvey‐Bradshaw scores, and steroids reduction were used to assess clinical response.ResultsDisease activity decreased consistently in four patients with a reduction of mean Pediatric Crohn Disease Activity Index from 36,9 to 2,5 and the mean Harvey‐Bradshaw from 8.5 to 0.75 after 3 months of treatment. Steroid treatment (mean dose, 35 mg/day before treatment) was tapered and then discontinued, in four patients, within 1–3 months. Four patients are in remission after 19–24 months of treatment. The fifth patient discontinued thalidomide after 1 week because of distal paresthesia.ConclusionThalidomide seems to be an effective and safe treatment in patients with refractory Crohn disease. This is the first report of long‐term use of thalidomide in refractory Crohn disease in pediatric patients.
Outcome of Early Hepatic Portoenterostomy for Biliary Atresia
Authors: Volpert Diana , White Fran , Finegold Milton J. , Molleston Jean , DeBaun Michael , Perlmutter David H. 
Published: January 2024

ABSTRACTBackgroundThe outcome of the hepatic portoenterostomy (Kasai) procedure for biliary atresia is improved when it is performed before 90 days of age. However, it is not known whether intervention before 30 days is better than intervention between 30 and 90 days.MethodsThe authors reviewed the records of all patients seen by the Pediatric Gastroenterology Service at St. Louis Children's Hospital from 1984–1999 to ascertain the outcome of patients who underwent Kasai procedure before or after 30 days of age.ResultsOf 92 patients with biliary atresia treated at St. Louis Children's Hospital over 15 years, 9 underwent the Kasai procedure before 30 days of age. Liver transplantation was necessary in 77.8% of these patients at a mean age of 11.0 ± 4.26 months, as compared with 53.4% at 32.14 ± 7.14 months for the remainder of the patients who underwent the procedure after 30 days of age.ConclusionsAlthough these data suggest that outcomes are worse for patients who undergo the procedure before 30 days of age, they may reflect a difference in the pathogenesis of biliary atresia that brings it to clinical attention earlier and may provide further evidence that biliary atresia is a phenotype for a number of distinct underlying disease processes.