bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dumping in Infancy Diagnosed by Radionuclide Gastric Emptying Technique
Authors: Lavine Joel E. , Hattner Robert S. , Heyman Melvin B. 
Published: February 2024

Summary:Two infants were diagnosed with dumping syndrome by a radionuclide gastric emptying method. Both patients presented with anorexia, weight loss, agitation and diaphoresis following bolus feeding by gastrostomy tube. One had documented hyperglycemia and glycosuria. Symptoms and signs of dumping in one patient were due to a gastrostomy placed in the antrum, whereby bolus tube feedings were inadvertently introduced directly into the duodenum. The second patient developed dumping symptoms after a Waterston colonie interposition was performed to correct a long gap esophageal atresia. Gastric emptying, measured by administering 99mTc‐sulfur colloid‐labeled formula, demonstrated an initial extremely rapid appearance of isotope in the small intestine, with greater than one‐third of the formula leaving the stomach in less than 2 min. The gastric emptying pattern in both patients appeared biphasic; after the initial “dumping” phase, the remaining formula emptied slowly, with monoexponential decay kinetics.
Maternal‐Neonatal Serum Vitamin A Concentrations
Authors: Shirali Girish S. , Oelberg David G. , Mehta Kumud P. 
Published: February 2024

Summary:Prevention of neonatal vitamin A deficiency is related to the adequacy of maternal vitamin A stores. In this study we investigated maternal and cord serum vitamin A and retinol‐binding protein (RBP) values in an Indian population including, for the first time, clinically vitamin A‐deficient mothers. Twenty‐eight maternalneonatal pairs were selected from maternal cohorts of high socioeconomic status without clinical evidence of vitamin A deficiency (group I) and low socioeconomic status with conjunctival xerosis and Bitot's spots (group II). Maternal education, caloric and vitamin A intakes, weight, height, hemoglobin, and birth weight were significantly lower in group II. Serum vitamin A levels were significantly higher in group I mothers and newborns as were RBP levels in group I mothers. However, a significant difference between groups I and II in cord blood RBP was not observed. Upon correlation of maternal vitamin A levels with cord blood vitamin A levels, a logarithmic relationship was revealed, suggesting saturable transplacental transport of vitamin A.
Arthritis as the Initial Manifestation of Inflammatory Bowel Disease in Early Infancy
Authors: Israel David M. , Olson Allan D. , Ilowite Norman T. , Davidson Murray 
Published: February 2024

Summary:We report a 10‐month‐old infant who had arthritis as the initial clinical manifestation of ulcerative colitis. Arthritis is considered to be the most common extraintestinal manifestation of IBD in adults and children. This case emphasizes that arthritis may be the earliest manifestation of IBD even in the very young infant.
Decompensated Cardiomyopathy Mimicking Hepatitis in a 13‐Year‐Old Girl
Authors: Sisto Alfred , Van Doesburg Nicolaas , Deal Cheri , Brochu Pierre , Ki Leung Tack , Roy Claude C. 
Published: February 2024

Summary:The name of a 13‐year‐old girl diagnosed as having idiopathic dilated cardiomyopathy was removed from the cardiac transplant list because a hepatitis‐like picture developed that coincided with evidence of decompensation of her cardiac function. On admission, there was only modest evidence of cytolysis (ALT level, 115 U/L) and of cholestasis (bilirubin level, 3.0 mg/dl), but there was severe prolongation of her prothrombin time (28 s). This was followed by elevation of both her transaminases and bilirubin levels. A liver biopsy sample showed extensive necrosis involving both the central and midlobular zones, while periportal areas revealed dilated sinusoids and steatotic multinucleated hepatocytes. A brief improvement of both her liver and her heart was followed by rapid deterioration of the functions of both. Attention is drawn to the relationship between reduced cardiac output and hepatic dysfunction secondary to massive cytolysis.
Gallbladder Motility in Children With Down Syndrome
Authors: Taşdemir Haydar Ali , Çetinkaya Melih Cevdet , Polat Cafer , Belet Umit , Kalayci Ayhan Gazi , Akbaş Seval 
Published: February 2024

ABSTRACTObjective:The aim of this study was to investigate gallbladder motility in children with Down syndrome by measuring gall‐bladder volume and contraction index.Methods:This study, performed between January 2001 and December 2002 at the Ondokuz Mayis University, School of Medicine, Department of Paediatric Neurology, Samsun, Turkey, included 21 patients with Down syndrome (study group) and 22 healthy children (control group). After an 8‐hour fast, gallbladder diameters in both groups were measured in length, width, and height by ultrasonography before and 30 minutes after a test meal. The volume of gallbladder before and after a test meal was determined, and the contraction index was calculated. Blood triglyceride and cholesterol levels were measured, and 5‐hydroxyindoleacetic acid (5‐HIAA) levels in urine were determined.Results:Mean gallbladder volume before test meal in the study group and controls was 8,412.4 ± 5,174 mm3 and 16,516.8 ± 6,796.1 mm3 (P < 0.001), respectively. The mean contraction index of the study group was 41.2% ± 19.4% and of controls, 75.0% ± 12.3% (P < 0.001). The mean triglyceride level of the study group was significantly higher than controls (P < 0.05). The mean urine 5‐HIAA level of the study group was lower than controls (P < 0.05).Conclusion:CI was lower in patients with Down syndrome, suggesting gallbladder hypomotility. Hypomotility may be a feature associated with the high prevalence of gallstones in Down syndrome.
Serum Transaminases in Children with Wilson's Disease
Authors: Iorio Raffaele , D'Ambrosi Mariangela , Marcellini Matilde , Barbera Cristiana , Maggiore Giuseppe , Zancan Lucia , Giacchino Raffaella , Vajro Pietro , Marazzi Maria Grazia , Francavilla Ruggiero , Michielutti Fabio , Resti Massimo , Frediani Tullio , Pastore Maria , Mazzarella Giuseppina , Fusco Giuseppina , Cirillo Francesco ,   Angela Vegnente on behalf of the Hepatology Committee of Italian Society of Paediatric Gastroenterology Hepatology and Nutrition
Published: February 2024

ABSTRACTObjectives:The response of serum transaminase levels to penicillamine and zinc treatment in Wilson's disease is poorly understood. The aim of this multicenter retrospective study was to evaluate transaminase levels after penicillamine and zinc treatment in children with Wilson's disease.Patients and Methods:One hundred and nine patients with Wilson's disease (median age at diagnosis, 7.2 years; range, 1 to 18 years), treated for at least 12 months and observed in the last 20 years at 11 Paediatric Departments were studied. Clinical, laboratory and histologic features at diagnosis and initial treatment were recorded. Efficacy parameters were normalization of serum transaminase level and improved clinical and/or laboratory signs. One hundred and two patients had clinical or laboratory signs of liver disease.Results:Fifty‐six of 87 patients (64%) given penicillamine normalized serum alanine aminotransferase (ALT) levels within a median of 17 months (range, 2 to 96 months). Of the 29 patients with persistent hyper‐ALT, 17 (59%) switched to zinc; only four of these normalized ALT on zinc within a median period of 38 months (range, 7 to 48 months). Eleven (50%) of the 22 patients given zinc alone normalized ALT within a median period of 6 months (range, 1 to 36 months). Of the 11 patients with persistent hyper‐ALT, five switched to penicillamine. Three of the five normalized ALT within a median period of 6 months (range, 6 to 9 months). Overall, in penicillamine‐treated and zinc‐treated patients with persistent hypertransaminasemia, ALT decreased from a basal median of 236 IU/L (range, 54 to 640 IU/L) to a median of 78 (range, 46 to 960 IU/L) at the end of follow‐up (P = 0.0245). Poor compliance was suspected in only 10% of cases. No predictive factor of persistent hypertransaminasemia was identified. Liver disease did not worsen in any patient during the study.Conclusions:Although the efficacy of penicillamine and zinc is well documented, it is notable that a subset of children with Wilson's disease‐related liver disease (36%) had hypertransaminasemia despite appropriate treatment with penicillamine or zinc.
Goat Milk is Less Immunogenic than Cow Milk in a Murine Model of Atopy
Authors: Lara‐Villoslada Federico , Olivares Mónica , Jiménez Jesús , Boza Julio , Xaus Jordi 
Published: February 2024

ABSTRACTObjectives:Cow milk protein allergy occurs in 2% to 6% of infants population. Goat milk has been used as an alternative to cow milk, but there is probably some cross‐reactivity between the milks. Little is known about the allergenicity of goat milk per se. The aim of this study is to compare cow and goat milk allergenicity in a mouse atopy model.Methods:Balb/C mice were intragastrically sensitized to cow or goat milk by five doses administrated weekly. Six weeks after the first dose mice were killed, sera were collected and spleens removed for analysis.Results:The number of mice with diarrhea was significantly higher in the cow milk‐sensitized group than in the goat milk‐sensitized group. Serum cow milk‐specific immunoglobulin G1 and histamine levels were also significantly higher in cow milk‐sensitized mice. Cytokine production by spleen derived T cells showed a Th2 response with high levels of interleukin‐4 production and low levels of interferon‐γ in cow milk‐sensitized mice. In addition, goat milk induced a lower lymphocyte sensitization as a result of a significant decrease in the specific proliferation ratio of these cells.Conclusion:Goat milk, when used as the first source of protein after a breast‐feeding period, is less allergenic than cow milk in mice. Further studies are needed to clarify if goat milk is suitable as an alternative to cow milk in milk based formulas for infant nutrition.
Meat Consumption is Positively Associated with Psychomotor Outcome in Children up to 24 Months of Age
Authors: Morgan Jane , Taylor Andrew , Fewtrell Mary 
Published: February 2024

ABSTRACTObjective:The impact of specific complementary foods on health outcomes has been poorly studied. We aimed to determine if meat consumption and breastfeeding influence growth and neurocognitive outcome in infants up to 24 months of age.Methods:In a longitudinal cohort study, 144 full‐term infants were recruited at 4 months. Their red and white meat consumption was recorded in sequential 7‐day weighed food intake diaries at 4, 8, 12, 16, 20 and 24 months. Growth data were collected at the same census points as the dietary data. Neurocognitive outcome (psychomotor developmental indices and mental developmental indices) derived from the Bayley Scales of Infant Development II was measured at 22 months.Results:Meat intake from 4‐12 months was positively and significantly related to weight gain (P < 0.05); further analysis suggested this association might be mediated via protein intake but was independent of energy, zinc or iron intake. There was no interaction between meat intake and breastfeeding on growth. Meat intake from 4‐12 and 4‐16 months was positively and significantly related to psychomotor developmental indices (P < 0.02 and 0.013, respectively) but there was no association between breastfeeding and psychomotor developmental indices nor any interaction between meat intake and breastfeeding. Conversely, breastfeeding was positively and significantly related to mental developmental indices (P < 0.01) but there was no association between meat intake and mental developmental indices nor any interaction between breastfeeding and meat intake. These findings remained after adjustment for potential confounding factors.Conclusion:Meat intake, possibly via its effect on protein intake, is associated with increased weight gain in infants up to 12 months of age. Meat intake is also positively associated with psychomotor development at 22 months. These findings highlight the need for further investigation of the role of complementary foods in relation to health outcomes.
Herpes Simplex Virus Esophagitis in Immunocompetent Children
Authors: Rodrigues Fernanda , Brandão Nogueira , Duque Vitor , Ribeiro Catarina , António Armando Mendes 
Published: February 2024

ABSTRACTObjectives:To review clinical, laboratory, endoscopic and histologic features, treatment and outcome of immunocompetent children with Herpes simplex virus esophagitis.Methods:Retrospective analysis of the medical records of six children (five males) referred to our unit between 1997‐2001.Results:The median age at presentation was 4 years. Fever was present in all, odynophagia/dysphagia in five, retrosternal pain in four, vomiting in three, drooling in two and irritability and drowsiness in one. The median time between the onset of symptoms and the diagnosis was 6.5 days. Endoscopy, performed in all, showed friable mucosa and erosive‐ulcerative involvement, with histology showing inflammation and ulcerated esophagitis. Tissue viral culture was performed in five patients and was positive in three, and polymerase chain reaction was positive in two of four tested. Serology was consistent with primary Herpes simplex virus infection in all. All received nasogastric feeding and acyclovir. The outcome was very good.Conclusions:This is an uncommon and under‐recognized condition in the immunocompetent child. The most common symptoms are sometimes not diagnostic, particularly in very young children. The presence of unusual clinical signs may lead to a difficult and delayed diagnosis. Treatment with acyclovir may have hastened the resolution of symptoms, but a controlled clinical study was not performed.
The Effect of Zinc Salts on Serum Bilirubin Levels in Hyperbilirubinemic Rats
Authors: Vítek Libor , Muchová Lucie , Zelenka Jaroslav , Zadinová Marie , Malina Jiří 
Published: February 2024

ABSTRACTObjectives:Intestinal metabolism of bilirubin is implicated in the pathogenesis of neonatal jaundice and Crigler‐Najjar syndrome. In the present study the authors investigated the effect of oral administration of zinc salts on serum bilirubin levels in hyperbilirubinemic rats.Methods:Bilirubin‐binding activities of zinc sulfate and water‐insoluble zinc methacrylate were determined in vitro. Congenitally hyperbilirubinemic Gunn rats and artificially hyperbilirubinemic Wistar rats were used in in vivo studies. Animals were fed a normal diet for 1 week and then a treatment diet of either zinc sulfate or zinc methacrylate for additional 2 weeks. Serum and fecal bile pigments were determined at the end of each phase. Biliary bilirubin secretion rates were determined in hyperbilirubinemic Wistar rats fed zinc methacrylate.Results:Substantial bilirubin‐binding activities of zinc salts were demonstrated in in vitro experiments. Treatment with oral zinc salts significantly decreased serum bilirubin levels in Gunn rats (166 ± 53 versus 123 ± 38 and 206 ± 34 versus 131 ± 31 μmol/L, P < 0.05 for zinc methacrylate and zinc sulfate, respectively). A similar effect of zinc methacrylate was also observed in hyperbilirubinemic Wistar rats (102 ± 10 versus 14 ± 4 μmol/L, P < 0.0001). In accord, biliary bilirubin secretion decreased significantly in these animals (45 ± 11 versus 28 ± 4 nmol/h 100g body weight, P < 0.02). In contrast to zinc sulfate, treatment with zinc methacrylate did not lead to the elevation of serum zinc levels.Conclusions:Oral administration of zinc salts efficiently decreased serum bilirubin levels in hyperbilirubinemic rats, presumably as a result of inhibition of enterohepatic circulation of bilirubin. This approach might be useful in the treatment of severe unconjugated hyperbilirubinemias.
Antiendomysial Antibody Detection in Biopsy Culture Allows Avoidance of Gluten Challenge in Celiac Children
Authors: Bonamico Margherita , Sabbatella Luigi , Di Tola Marco , Vetrano Stefania , Ferri Mirella , Nenna Raffaella , Mariani Paolo , Picarelli Antonio 
Published: February 2024

ABSTRACTObjective:Antiendomysial antibody (EMA) production has been induced in vitro by the small bowel mucosa of celiac disease (CD) patients in clinical remission cultured in the presence of gliadin peptides. The aim of the present study was to use this in vitro system to determine whether it could be used to predict the clinical or histologic relapse to gluten challenge in CD children on a gluten‐free diet (GFD).Methods:Enrolled were 32 CD children and adolescents on GFD (group 1), and 80 controls (group 2) who underwent in vitro gliadin challenge. Subsequently, 24 group 1 CD children underwent in vivo gluten challenge to confirm the diagnosis. Biopsy cultures, with and without gliadin, morphometric analysis, immunoglobulin (Ig)A and IgG1 EMA detection, both in sera and culture supernatants, were performed.Results:Of the 32 group 1 CD patients, 23 were IgA EMA positive in culture supernatants. The other nine were IgG1 EMA positive. All 24 children who had in vivo gluten challenge showed clinical or histologic relapse. All culture supernatants from disease controls belonging to group 2 were both IgA and IgG1 EMA negative, irrespective of gliadin challenge.Conclusions:Organ culture with in vitro gliadin challenge is able to reproduce the results of in vivo challenge. This system could reduce the need for gluten challenge in celiac children.
Diagnostic Utility of the Water Load Test in Children With Chronic Abdominal Pain
Authors: Schurman Jennifer Verrill , Friesen Craig A , Andre Linda , Welchert Elly , Lavenbarg Teri , Danda Caroline Elder , Cocjin Jose T , Hyman Paul E 
Published: February 2024

ABSTRACTObjectives:To compare water load test consumption patterns between children with functional gastrointestinal disorders and healthy control children.Methods:Seventy‐one children with recurrent abdominal pain completed the Behavioral Assessment Scale for Children–Self‐ Report Form and the Questionnaire on Pediatric Gastrointestinal Symptoms during their first visit to a pediatric gastroenterology clinic. Parent‐ and child‐report functional gastrointestinal diagnoses were based on the Questionnaire on Pediatric Gastrointestinal Symptoms scoring criteria, whereas the clinician's diagnosis was based on clinical impression from history and physical examination completed at this visit. Twenty‐six healthy children also participated as controls. Statistical comparisons involved Student t tests, whereas receiver operating characteristic curves estimated sensitivity/specificity of the water load test and linear regression determined the amount of variance accounted for in water volume consumption.Results:Children with recurrent abdominal pain, particularly those with a diagnosis of functional dyspepsia, consumed less water than healthy children on the water load test. The water load test demonstrated good specificity, but poor sensitivity, in identifying patients with functional dyspepsia. Clinician evaluation provided the greatest differentiation between functional gastrointestinal disorders on the water load test.Conclusions:The water load test seems to be a poor diagnostic test for functional dyspepsia because of poor sensitivity. However, future research should examine whether the water load test is identifying a subset of children with functional dyspepsia experiencing a specific mechanosensory dysfunction and whether the water load test can predict clinical response to specific therapeutic interventions.
Esomeprazole for the Treatment of GERD in Infants Ages 1–11 Months
Authors: Winter Harland , Gunasekaran Thirumazhisai , Tolia Vasundhara , Gottrand Frederic , Barker Peter N. , Illueca Marta 
Published: February 2024

ABSTRACTObjectives:Gastroesophageal reflux disease (GERD) is present in pediatric patients when reflux of gastric contents causes troublesome symptoms and/or complications. The present study evaluates the efficacy and safety of esomeprazole in infants ages 1 to 11 months with GERD.Methods:In this multicenter randomized, double‐blind, placebo‐controlled, parallel‐group, treatment‐withdrawal study, infants received open‐label, weight‐adjusted doses of esomeprazole (2.5–10 mg) once daily for 2 weeks. Infants with symptom improvement were randomized to esomeprazole (weight‐adjusted doses [2.5–10 mg]) or placebo for 4 weeks. The primary endpoint was time to discontinuation owing to symptom worsening based on global assessments by the parent/guardian and physician. Adverse events were recorded.Results:Of the 98 patients enrolled, 81 (82.7%) experienced symptom improvement determined by physician global assessment (PGA) during open‐label esomeprazole treatment; 80 entered the double‐blind phase. During this phase, discontinuation rates owing to symptom worsening were 48.8% (20/41) for placebo‐treated versus 38.5% (15/39) for esomeprazole‐treated patients (hazard ratio 0.69; P = 0.28). Posthoc analysis of infants with symptomatic GERD (ie, no diagnostic procedure performed) revealed that time to discontinuation was significantly longer with esomeprazole than placebo (hazard ratio 0.24; P = 0.01); the complementary subgroup difference was not significant (hazard ratio 1.39; P = 0.48). Esomeprazole was well tolerated.Conclusions:The discontinuation rate owing to symptom worsening did not differ significantly between infants receiving esomeprazole versus those receiving placebo. Improved diagnostic criteria in this age group are needed to identify infants with GERD who may benefit from acid suppression therapy.
Effects of flood‐induced financial stress on the viability of a cooperative production system and its farmers: A multilevel study
Authors: Nortes Martínez David , Grelot Frédéric , Brémond Pauline , Farolfi Stefano , Rouchier Juliette 
Published: February 2024

AbstractFloods can severely disrupt agricultural activities. When these activities are part of production chains, domino effects can occur. We use agent‐based modeling to simulate the production dynamics of a French cooperative winery as an example of a production chain, adopting a dual individual‐collective perspective. The cash‐flow analysis shows that there are nonexplicit mechanisms in the cooperative organization that allow the propagation of flood impacts throughout the chain and influence the winegrowers' ability to cope, thus threatening the continuity of the winegrowers' activity and the cooperative winery itself.