bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Powdered Formula and Incidence of Underweight Among Infants of Educated and Uneducated Mothers in Ile‐Ife, Nigeria
Authors: Ojofeitimi E. O. , Elegbe I. A. , Afolabi O. A. 
Published: February 2024

Summary:The duration of usage of a tin of powdered formula and the incidence of underweight among 250 infants 14 days to 12 months old, whose parents were educated and uneducated, are reported. Twenty‐two percent of the educated mothers and 42% of the uneducated mothers started their infants on formula from the 14th day of life. Only 6 % of all the mothers exclusively breastfed for 1 month, and a meager 2% of the uneducated mothers exclusively breastfed for 3 months. There was a significant (p < 0.001) increase in the duration of usage of a tin of powdered formula among the uneducated mothers as compared to the educated ones. Of the 250 infants, 93 (37.2%) ≥ 1 month old were assessed as underweight for age. Most of the underweight infants had uneducated mothers. Practical ways of improving feeding practices and curbing early introduction of supplementary feeds are suggested.
Release of Membrane from Milk Fat Globules by Conjugated Bile Salts
Authors: Patton Stuart , Borgström Bengt , Stemberger Bridget H. , Welsch Ulrich 
Published: February 2024

Summary:We investigated the capacity of conjugated bile salts to remove the membrane, a barrier to lipolysis, from milk fat globules. Cow, goat, and human globules were subjected to varying concentrations of the bile salt taurodeoxycholate at 37°C for 2 min, and the released material was obtained by centrifugation at 2°C and 50,000 g for 1 h. Sedimented pellets were analyzed for phospholipid and protein and were characterized further by sodium dodecylsulfate‐polyacrylamide gel electrophoresis. Pellets were examined in the electron microscope. Measurable amounts of membrane were sedimented from globules incubated at 37°C for 2 min in 0.5 mM taurodeoxycholate. Taurocholate also exhibited this membrane‐releasing ability. However, disintegration of milk fat globule membrane appears to be the principal effect of these salts at 37°C. Our results show that conjugated bile salts within their normal concentration range (2‐6 mM) in digesta of term and preterm infants are capable of removing membrane from milk fat globules.
Forms of Human Milk Folacin and Variation Patterns
Authors: Brown Cecelia M. , Smith Anne M. , Picciano Mary Frances 
Published: February 2024

Summary:The pattern of folacin in 180 human milk samples collected from 16 women was studied before and after pteroylglutamic hydroxylase (conjugase) treatment. The differential response of Lactobacillus casei versus Streptococcus faecalis distinguishes N‐5‐methyltetrahydro‐folate from other forms. Growth of Pediococcus cerevisiae differentiates the reduced monoglutamates, other than the N‐5‐methylated derivative, from oxidized folacins. Mean folacin activity with L. casei was 85.3 ng/ml. Prior to conjugase treatment of samples, mean activity was 46.9 ng/ml with this organism. The responses of S. faecalis and P. cerevisiae were 48% and 7.6%, respectively, of the total L. casei active folacins. The total L. casei active folacins increased from 76.5 ng/ml at 6 weeks of lactation to 97.1 ng/ml at 12 weeks of lactation. Increases were also observed with time of day: from morning (65.7 ng/ml), to afternoon (80.0 ng/ml), and to evening (114.7 ng/ml). Hindmilk had greater total L. casei activity (100.0 ng/ml) than foremilk (73.8 ng/ml). Although folacins active for S. faecalis and P. cerevisiae were not affected by duration of lactation, increases in folacin activity with time of day and from foreto hindmilk were observed using both of these organisms. Values for the folacin content of human milk are therefore dependent on sampling procedures. Pteroylpolyglutamates of ≥ 3 glutamic acid residues and N‐5‐methyltetrahydrofolate are the predominant forms of human milk folacin based on differential growth responses of L. casei, S. faecalis, and P. cerevisiae to these forms.
Chronic Gastroenteritis in a Patient with Histiocytosis‐X
Authors: Sutphen James L. , Fechner Robert E. 
Published: February 2024

Summary:We describe a 5‐year‐old white girl who presented at 18 months of age with an ileal perforation and radiographic evidence of segmental intestinal narrowing. Her initial diagnosis was Crohn's disease; however, on subsequent microscopic review, her lesion consisted of mixed histiocytic and eosinophilic infiltration characteristic of histiocytosis‐X. The case is unique in its clinical similarity to Crohn's disease and its paucity of extraintestinal manifestations in the face of persistent mild chronic intestinal symptoms. She remains well controlled on prednisone therapy.
Subcellular Localization of Class I (A,B,C) and Class II (DR and DQ) MHC Antigens in Jejunal Epithelium of Children with Coeliac Disease
Authors: Sarles J. , Gorvel J. P. , Olive D. , Maroux S. , Mawas C. , Giraud F. 
Published: February 2024

SummaryThin frozen sections of 11 jejunal biopsies from 10 children at different stages of coeliac disease were stained by immunofluorescence technique using a panel of anti‐HLA class I (A, B, C) and anti‐HLA class II (DR and DQ) monoclonal antibodies. On the epithelium of flattened mucosa, in contrast with control sections, the intensity of the labeling on the basolateral membranes with both anti‐class I and class II DR antibodies decreased strongly from the bottom to the upper part of the crypts, and no bright patchy staining was observed on the apical part of enterocytes with anti‐HLA DR antibodies. Numerous cells with large granules expressing class I and class II DR antigens were found in the epithelium of the small intestine. Children with a fully recovered mucosa expressed MHC antigens identical to those previously observed in normal epithelium. On the other hand, children with intermediate mucosal lesions showed the presence of MHC antigens in varying degrees. The results of this report indicate that immunological mechanisms may play a prominent role in coeliac disease.
Portal Vein Measurement by Ultrasonography in Patients with Long‐Standing Cystic Fibrosis
Authors: Kumari‐Subaiya Sheila , Gorvoy Jack , Phillips Gail , Ross Peter , Riddelsberger M. M. 
Published: February 2024

SummaryAdult cystic fibrosis (CF) patients are increasingly diagnosed with hepatic cirrhosis, cholecystitis, and cholelithiasis. A continuing diagnostic problem is the early detection of cirrhosis prior to diffuse liver involvement. Sonography has been used in evaluating the pancreas, gallbladder, liver, and spleen in cystic fibrosis patients. We used a real‐time mechanical sector scanner to study the portal veins in adult CF patients randomly selected from our CF population and correlated the portal vein diameters with liver function studies. A measurement > 12 mm was interpreted as a probable sign of portal hypertension. Of 21 patients studied, 14 had portal veins that measured >12 mm, and 12 patients had (although not necessarily at the time of the exam) elevated serum alkaline phosphatase levels. Three patients had associated splenomegaly and thrombocytopenia, and 10 patients also exhibited cholelithiasis and abnormal gallbladders on sonography. Initial results indicate that portal vein measurement may be a sensitive indicator of early portal hypertension. Sonography may, thus, isolate patients at high risk for possible future complications. Serial sonograms can be performed easily in evaluating the progress of liver disease.
Variance in Fasting Breath Hydrogen Concentrations in Guatemalan Preschool Children
Authors: Barillas‐Mury Carolina , Solomons Noel W. 
Published: February 2024

SummaryThe concentration of hydrogen (H2) in expired air after an overnight fast is receiving interest as a diagnostic indicator in itself. We analyzed 319 fasting samples collected from 90 healthy, well‐nourished preschool children aged 29–72 months in two institutional settings in Guatemala City. The overall range of fasting H2 concentration was 0–40 ppm, with an arithmetic mean of 4.4 ± 5.4 ppm (± SD) and a geometric mean of 3.2 ppm. No differences between boys and girls was found, but there was a progressive increase in the mean levels and an increase in the number of samples with H2 concentrations >10 ppm with decreasing chronological age. One child with three of six samples having H2 concentrations >40 ppm was found to have intestinal multiple parasitism and hence was excluded from the sample. As compared with a previous report from the United States of fasting breath H2 concentrations in older children, the mean and distribution of values for Guatemalan preschoolers is identical. Intraindividual coefficients of variation in 48 children studied on four occasions had a mean of 62 ± 31% (range 0–143%).
Primary Sclerosing Cholangitis in Children
Authors: Classen Martin , Götze Hermann , Richter Hans‐Joachim , Bender Steffen 
Published: February 2024

SummaryPrimary sclerosing cholangitis (PSC) in eight children, five males and three females between the ages of 4 and 13 years, presented with minimal clinical symptoms and few signs of liver disease. Diagnosis was made by a highly characteristic histology in all and additional endoscopic retrograde cholangiography (ERC) in four patients. Six children suffered from concomitant inflammatory bowel disease (IBD). Laboratory abnormalities consisted of mild elevation of transaminases and alkaline phosphatase, with marked elevation of immunoglobulin G in seven and detection of anti‐nuclear antibodies in four of the eight children. In all cases, needle liver biopsy specimens revealed portal tracts considerably expanded by edema and chronic inflammation diagnostic of nonsuppurative cholangitis and nonsuppurative fibrosing pericholangitis. ERC showed decreased arborization in the whole biliary tree. In two patients, changes were confined to the intrahepatic portion of the biliary tract. No specific drug therapy was given to our patients. Those with concomitant IBD were treated with salazosulfapyridine (SASP). The clinical course has been mild in all patients up to now. It is concluded that PSC may be much more frequent in childhood than was considered before, especially in children with IBD.
Different Degree of Antibody Response to Hepatitis B Virus Vaccine in Breast‐and Formula‐Fed Infants Born to HBsAg‐Positive Mothers
Authors: de Martino Maurizio , Resti Massimo , Appendino Claudio , Vierucci Alberto 
Published: February 2024

SummaryAntibody response to hepatitis B virus vaccine was compared in 47 breast‐and 112 formula‐fed infants born to hepatitis B surface antigen‐(HBsAg‐) positive mothers. No difference was observed as to the percentage of infants who seroconverted. However, formula‐fed infants developed transient but significantly higher anti‐HBs antibody levels as compared to breast fed infants. Suppressive factors in human milk or orally induced tolerance may explain this finding. The latter hypothesis may be supported by the presence of HBsAg in more than a half of the milk samples we studied.
Cricopharyngeal Dysfunction in Childhood
Authors: Dinari Gabriel , Danziger Yardena , Mimouni Marc , Rosenbach Yoram , Zahavi Ilan , Grunebaum Michael 
Published: February 2024

SummaryA 3‐year‐old child with Cricopharyngeal dysfunction is reported. Swallowing difficulties, nasal regurgitation, and gagging developed at 2 months of age. Repeated aspirations and over 40 episodes of pneumonia necessitating multiple hospitalizations occurred up to 2 years of age, along with pharyngcal pooling of saliva and inability to swallow solid food. Barium was held up at the Cricopharyngeal level, and a prominent esophageal impression was seen at the same level. Symptoms were completely alleviated after two esophageal dilatations by mercury dilators, and the relief persisted for the 6 months of follow‐up. The diagnosis of Cricopharyngeal dysfunction is discussed, and the necessity for manometric studies, in the face of often misleading radiologic appearance, is emphasized. It is suggested that early use of esophageal dilatations might prevent prolonged morbidity and afford long‐term symptomatic relief.
Gastroesophageal Scintigraphy
Authors: Fernández F. González , Martin F. Argûelles , de Quesada B. Rodriguez , Hachero J. González , Sánchez de Puerta A. Vails , Gentles M. 
Published: February 2024

SummaryNinety children with signs and symptoms of gastroesophageal (GE) reflux were studied. All of them had GE scintigraphy, barium, and endoscopy, and 50, in addition, ultrasound examination. The sensitivity of the GE scintigraphy, in comparison with the other methods, was 92.5%. It is a useful screening test for GE reflux.
Milk Feeding and Changes in Intestinal Permeability and Morphology in the Newborn
Authors: Weaver L. T. , Laker M. F. , Nelson R. , Lucas A. 
Published: February 2024

SummaryThe contrasting effects of natural versus cow's milk formula (CMF) on upper gastrointestinal development in the newborn were studied. The passive intestinal permeability of neonatal human infants and guinea pigs was measured using the nonmetabolisable markers lactulose and mannitol. Mucosal morphology was examined in guinea pigs by light microscopy. Nineteen full‐term human infants and 63 guinea pigs were studied during the 1st week of extrauterine life. The naturally fed infants showed a decline in intestinal permeability to lactulose following the onset of feeding. This was not shared by those fed CMF. The CMF‐fed guinea pigs showed a persistently higher intestinal permeability than the naturally fed animals throughout the 1st week of life. No differences were observed in the villous heights or crypt depths between feeding groups, but both showed an increase in intraepithelial lymphocyte number during the 1st week. Cow's milk formula may cause a persistently higher intestinal permeability, or natural feeding may promote a decline in permeability in the enterally fed newborn.
Lactose Malabsorption and Intolerance in Uruguayan Population by Breath Hydrogen Test (H2)
Authors: Maggi Rodolfo , Sayagues Beatriz , Fernandez Alicia , Romero Beatriz , Barusso Patricia , Hernandez Carmen , Magariños Mabel , Mendez Graciela , Dilascio Cristina , Martell Miguel 
Published: February 2024

SummaryThis study of 200 Uruguayans between 0 and 86 years old was designed to determine the prevalence of lactose malabsorption. Lactose intolerance is defined as a clinical syndrome of abdominal pain, diarrhea, flatulence, and bloating after the ingestion of a standard lactose tolerance test dose (2 g of lactose per kilogram of body weight or 50 g/m2 of body surface area, maximum 50 g in a 20% water solution). Lactose malabsorption refers to the state in which dietary lactose remains unhydrolyzed and subsequently unabsorbed from the gastrointestinal tract; symptoms may or may not result from lactose malabsorption. The technique of breath hydrogen (H2) was used after ingestion of 2 g/kg body weight to a maximum of 50 g in a 20% solution. There was no lactose malabsorption in children younger than 5 years old. The prevalence increases progressively after the age of 5, and in adolescence the percentage of malabsorption is similar to that in adults, who show 65% lactose malabsorption, with 25% asymptomatic and 40% intolerant. In 109 white adults, the prevalence of lactose malabsorption is 63%, with 24% asymptomatic and 39% intolerant. In 11 black adults, lactose malabsorption is 82%, with 27% asymptomatic and 55% intolerant. The difference between white and black adults is statistically significant (p < 0.05). The H2 test is simple, reliable, noninvasive, and appropriate to study large populations.
Comparison of the Macronutrient Intake of Healthy Controls and Children with Cystic Fibrosis on Low Fat or Nonrestricted Fat Diets
Authors: Daniels Lynne , Davidson Geoffrey P. , Martin A. James 
Published: February 2024

SummaryThis study compares the nutrient intake of two cross‐sectional groups of patients attending the CF Clinic at the Adelaide Children's Hospital (A.C.H.). The first group (n = 33) was studied in 1979 while on low fat diets (LF), the second (n = 36) in 1983 on nonrestricted fat diets (NRF). The aim of the study was to assess the degree to which a change in fat intake has been achieved and the effect on nutrient intake and fat absorption. Data from both groups have also been compared with a group of 57 healthy controls. The study showed that when using a NRF rather than LF diet CF patients can achieve significantly improved, although not quite normal, fat intakes. There was a corresponding increase in energy intake such that intakes of CF patients on the NRF diet exceeded those of healthy controls and the RDA. The higher fat intakes appeared to be well tolerated with no evidence of increased steatorrhoea or stool energy loss. Growth improved in the younger group, but further studies on patients who have been established on the NRF diet since birth are needed to confirm that normal fat diets contribute to improved growth.
Relationship Between Breath and Total Body Hydrogen Excretion Rates in Neonates
Authors: Modler Siv , Kerner John A. , Castillo Ricardo O. , Vreman Hendrik J. , Stevenson David K. 
Published: February 2024

Summary:Our study examined the relationship of H2 excreted in breath to total body H2 excreted by neonates. We report simultaneously measured end‐tidal H2 concentrations, plus breath H2 and total body H2 (breath H2 plus flatus H2) excretion rates in 10 neonates. End‐tidal H2 concentrations varied from 2.4 to 192 ppm. Breath H2 excretion rates ranged from 0.20 to 6.5 and total body H2 excretion rates from 0.29 to 15.0 ml/h. The fractional breath H2 excretion in these infants was 48% (range 33–69%), compared with 21% reported in adults. The correlation coefficient for end‐tidal derived H2 excretion and directly measured breath H2 excretion rates was 0.95 (p < 0.001). We conclude that the proportion of total H2 excreted in the breath of neonates is increased compared with adults, suggesting that caution must be exercised when interpreting newborn breath H2 measurements and using adult norms.
Controlled Clinical Trial on the Efficacy of Rice Powder‐Based Oral Rehydration Solution on the Outcome of Acute Diarrhea in Infants
Authors: El‐Mougi Mahmoud , Hegazi Ehab , Galal Osman , Akkad Nayyera El , El‐Abhar Ahmed , Nour Nadia , Emam M. El‐Hadi , Ahmadi Abdel Rahman 
Published: February 2024

Summary:We report a controlled clinical trial of rice powder‐based oral rehydration solution (ORS) versus glucose ORS on the outcome of acute diarrhea in infants. The rice ORS group (n = 30) received ORS containing 50 g rice powder instead of standard WHO solution (20 g glucose, n = 30). Formula‐fed male infants were enrolled to enable calculation of milk intake and excretion of urine. Patient allocation to either group depended on the method of random permuted blocks. Both groups were comparable regarding age (4–18 months), duration of diarrhea, number of bowel movements or vomiting per 24 h, rectal temperature, dehydration score, and nutritional status. Results revealed that the rice ORS group had a shorter duration of diarrhea (28.4 ± 5.1 vs 34.3 ± 2.3 h) and greater mean weight gain in the first 24 h as percentage of recovery weight (5.7 ± 0.5% vs 4.1 ± 0.6%). Furthermore, the mean amount of ORS intake, mean stool output, and mean number of episodes of vomiting were lower in the rice‐ORS group as compared with the glucose ORS group. All differences were statistically significant. Due to its observed superiority and low cost, the widespread use of rice ORS should be considered for treatment of acute diarrhea.
Nutritional Copper Deficiency in Severely Handicapped Patients on a Low Copper Enteral Diet for a Prolonged Period
Authors: Higuchi Shigenori , Higashi Akimasa , Nakamura Toshiro , Matsuda Ichiro 
Published: February 2024

Summary:Six cases of nutritional copper deficiency were identified in a nursery institute for severely handicapped patients. All had been on prolonged enteral feeding of a copper‐deficient diet and all had abnormalities related to the copper deficiency. Two of them had leuko‐penia, with or without macrocytic and normochromic anemia. After the oral administration of copper, the clinical and laboratory observations including neutrophil counts and serum copper and ceruloplasmin levels showed a complete recovery. The dietary copper requirement was estimated to be ∼20 μg/kg/day for these patients, based on the correlation between the dietary copper intake and the levels of copper in the serum.
Decreased Cholestasis with Enteral Instead of Intravenous Protein in the Very Low‐Birth‐Weight Infant
Authors: Brown Marily R. , Thunberg Barbara J. , Golub Leonard , Maniscalco William M. , Cox Christopher , Shapiro Donald L. 
Published: February 2024

Summary:Thirty to 50% of very low‐birth‐weight infants have parenteral nutrition‐associated cholestasis. To test the hypothesis that the incidence of cholestasis would be decreased if parenteral amino acids were avoided and protein given enterally, infants with a gestational age of <30 weeks were randomized to two groups. One group received amino acid‐free parenteral nutrition and whey protein enterally with added premature infant formula. The control group received standard parenteral nutrition with amino acids and enteral premature formula. At the end of 3 weeks of parenteral nutrition, infants who had a direct serum bilirubin level of >3 mg/dl were considered to have significant cholestasis. Twenty‐nine infants required parenteral nutrition for 3 weeks, 17 in the whey group and 12 in the control group. No instances of significant cholestasis were observed in the whey group (0/17), whereas seven of 12 infants (58%) in the amino acid control group had cholestasis (p < 0.001).
Quantitation and Properties of Fecal and Upper Small Intestinal Aerobic Microflora in Infants and Young Children with Persistent Diarrhea
Authors: Bhan M. K. , Raj P. , Khoshoo V. , Bhandari N. , Sazawal S. , Kumar R. , Srivastava R. , Arora N. K. 
Published: February 2024

Summary:The duodenal juice and fecal aerobic microflora was investigated in 54 patients with persistent diarrhea (age ≤2 years). The duodenal aspirates yielded increased aerobic bacteria (>105 organisms/ml) in 28 (51.9%) of the patients. Established enteric pathogens were isolated from the duodenal aspirates of 12 (22.2%) of the 54 patients, viz., enteroadherent Escherichia coli (EAEC) (5), enterotoxigenic E. coli (ETEC) (3), enteropathogenic E. coli (EPEC) (1), nontyphoidal Salmonella (1), and Giardia lamblia (2). The total aerobic bacterial count was >105 in all 12 patients positive for specific pathogens apart from one case in whom E. coli showing diffuse adherence to HEp‐2 cells were identified. Among the remaining 42 specific pathogen‐negative patients, 19 (45.2%) also had >105 aerobic organisms/ml in the small bowel. Eight strains of Klebsiella from four of the patients were negative for enterotoxin production in a rabbit ileal loop assay and for adherence to HEp‐2 cells. In contrast, 28/54 (51.9%) of the same patients had known enteric pathogens in their stools, viz., nontyphoidal Salmonella (8 or 14.8%), Shigella (2 or 3.7%), Campylobacter (1 or 1.9%), ETEC (4 or 7.4%), EPEC (2 or 3.7%), EAEC (7 or 13.0%), and G. lamblia and Entameba histolytica (3 or 5.6%). Further search for potential virulence factors among aerobic bacteria colonizing the upper small intestine in persistent diarrhea is warranted.