bluuebunny/crossref_metadata_2025_split huggingface dataset:
Are Bilirubin and Plasma Lipid Profiles of Premature Infants Dependent on the Lipid Emulsion Infused?
Authors: Rubin Moshe , Naor Nora , Sirota Lea , Moser Asher , Pakula Ronit , Harell Daniella , Sulkes Jacqueline , Davidson Shmuel , Lichtenberg Dov 
Published: January 2024

SummaryThe effect of a lipid emulsion containing longchain triglycerides (LCT) and supplemented with L‐carnitine on plasma lipids and bilirubin in premature neonates on total parenteral nutrition was compared to that of lipid emulsions containing either LCT or a mixture of LCT and medium‐chain triglycerides (MCT). In a double‐blind randomized study 49 premature neonates received one of the three fat emulsions, given intravenously, over 16–20 h daily for 6 days. Plasma carnitine levels increased significantly in the supplemented group only; the addition of carnitine did not seem to affect any of the parameters studied. Mean plasma triglycerides rose by 193 and 199% in the carnitine‐supplemented and the LCT groups, respectively, and by 314% in the MCT/LCT group. On the sixth day of the study free fatty acids were significantly higher in the MCT/LCT group than in the other two groups. Plasma phospholipids and free cholesterol increased (p < 0.05) progressively in all groups and were correlated (r = 0.74, p < 0.001). At the end of the 6‐day study all groups showed a similar decline in free and total bilirubin levels despite the significant increase in plasma lipids and free fatty acids resulting from the stepwise increase in lipid load. No correlation was found between free fatty acids and free bilirubin. Since hyperbilirubinemia and hypertriglyceridemia appear to be clinically independent factors, the infusion of lipids should not be withheld from jaundiced infants on total parenteral nutrition.
Reliability of Short‐term Esophageal pH Monitoring Versus 24‐Hour Study
Authors: Costantini A. Barabino M. , Ciccone M. O. , Pesce F. , Parodi B. , Gatti R. 
Published: January 2024

SummaryThe child's discomfort and the cost of overnight hospitalization are clear disadvantages of prolonged esophageal pH monitoring. The aim of this study was to verify the reliability of short recording versus 24‐h testing in a pediatric series with symptoms suggestive of gastro‐esophageal reflux (GER) disease. A 24‐h pH monitoring performed on 160 patients with either gastroenterological symptoms (n = 61), respiratory problems (n = 58), or emesis plus respiratory problems (n = 41) was reviewed. Regardless of clinical presentation, children were also classified according to age: <12 months (n = 39), 12–71 months (n = 81), and 72–168 months (n = 40). A diurnal fraction of 6 h, including at least 2 h after a meal, was compared to the entire 24‐h recording in all groups with respect to the reflux index (RI) (sum of the periods with pH <3.9 expressed as percentage of time) and reflux/h. RIs of > 10% were considered positive in patients < 1 year of age, whereas RIs of >5% were considered positive in other age groups. Negative predictive values of the short recording RI ranged from 71 to 90%. Positive predictive values ranged from 50 to 83%; it was unreliable for children <12 mos (50%) and patients with emesis plus respiratory problems (64%), who were, significantly, the youngest. Reflux/h values were not in agreement for the same groups. Absence of agreement was found if the absolute value of RI was considered. In conclusion, our data show that short‐term recordings may be used as an ambulatory screening test for GER in selected children, being unreliable for patients <1 year of age and for those presenting with both gastroenterological and respiratory symptoms.
Effectiveness of Nasogastric Rehydration in Hospitalized Children with Acute Diarrhea
Authors: Gremse David A. 
Published: January 2024

Summary:The American Academy of Pediatrics recommends oral rehydration and early refeeding for management of infants with diarrhea and mild to moderate dehydration. However, intravenous rehydration is still widely used for treatment of infants hospitalized for dehydration. The administration of oral rehydration solution via continuous infusion through a nasogastric tube facilitates its delivery in hospitalized children. The purpose of this study is to compare intravenous and nasogastric rehydration in children hospitalized for mild to moderate dehydration. Infants who failed attempts at oral rehydration and were hospitalized for dehydration due to acute diarrheal illness were randomized to receive intravenous or nasogastric rehydration. Following rehydration, infants received soy formula and a maintenance oral electrolyte solution to replace ongoing stool losses, as directed by the attending physician. Patients were discharged from the hospital once oral feeding was tolerated, and the vomiting and diarrhea resolved. Twenty‐four patients, from 2 to 19 months of age, were enrolled in the study. Rehydration was successful in 11 of 12 patients in the nasogastric rehydration group and in all 12 patients who received intravenous rehydration. The degree of dehydration, severity of vomiting and diarrhea, and duration of rehydration were similar in both groups. The duration and cost of hospitalization were less for patients receiving nasogastric rehydration compared to those who were rehydrated intravenously. Rehydration by infusion of oral rehydration solution via a nasogastric tube is a safe and effective treatment for infants with mild to moderate dehydration. Rehydration with infusion of oral rehydration solution through a nasogastric tube should be considered for in‐patient management of infants with diarrhea.
Effect of Early Dietary Deficiency in Polyunsaturated Fatty Acids on Two Lectin Binding Sites in the Small Intestine of Postweanling Rats
Authors: Alessandri J‐M , Joannic J‐L , Delpal S. , Durand G. 
Published: January 2024

Summary:This study was designed to determine whether dietary lipids influence the development of intestinal cell glycosylation, in relationship to diet‐induced changes in phospholipid fatty acid composition. The ability of two different lectins, wheat germ agglutinin (WGA) and Maackia amurensis agglutinin (MAA), to combine specifically with particular carbohydrate residues was used to investigate the surface characteristics of epithelial cells of rats fed different dietary lipids from birth to 6 weeks of age. Diets contained 5% (weight) peanut oil (PO), rich in n‐6 fatty acids; salmon oil (SO), rich in n‐3 fatty acids; hydrogenated palm oil (HPO), deficient in both n‐6 and n‐3 fatty acids or a PO and rapeseed oil (RO) mixture (PRO), the control diet. Pieces of jejunal and ileal villi were excised from postweanling rats and prepared for lectin histochemical study. Concurrently, epithelial cells were removed from jejunal and ileal segments for determining their phospholipid fatty acid compositions. Polyunsaturated fatty acid (PUFA) deficiency was evidenced in the HPO group by the appearance of eicosatrienoic acid (20:3n‐9) in both jejunal and ileal phospholipids, which paralleled the decrease in arachidonic acid content. Accretion of 18: ln‐9 and 20:3n‐9 in cell phospholipids of group HPO was not sufficient to match the unsaturation level in rats fed nonhydrogenated vegetable oils (PRO, PO) or fish oil (SO). The lectin histochemical study showed that WGA strongly labelled the brush border membrane microvilli whereas binding of MAA was specific to goblet cells and mucus. Regardless of the type of diet, WGA binding was weaker in the ileum than in the jejunum. In comparison to all other groups, WGA‐labelling of villi was less intense in the jejunum and disappeared almost completely in the ileum of HPO‐fed rats. Although SO‐ and PO‐fed rats had, respectively, very low and high ratios of n‐6 to n‐3 in their intestinal phospholipids, binding of WGA in both groups was not markedly different from that in the control (PRO). MAA‐labelling was very intense in jejunal and ileal villi of n‐3‐fed (SO) rats, whereas it was strongly attenuated in the n‐3− and n‐6 deficient (HPO) group. These results suggest that intestinal glycosyltransferase activities involved in cell differentiation were altered relative to the overall unsaturation index of dietary fatty acids. Alterations of epithelial glycosylation mainly resulted from a drop in total n‐6 and n‐3 fatty acids, although it may be speculated that there is a specific effect of n‐3 fatty acids.
Normal Ranges of Continuous pH Monitoring in the Proximal Esophagus
Authors: Bagucka Beatrise , Badriul Hegar , Vandemaele Kris , Troch Elie , Vandenplas Yvan 
Published: January 2024

ABSTRACTBackgroundTo determine normal ranges of gastroesophageal reflux (GER) in the proximal esophagus, measured with continuous pH monitoring. Normal ranges in the distal esophagus have been published. Because esophageal pH monitoring is frequently performed in children with atypical manifestations such as chronic respiratory disease, and because one of the possible pathophysiologic mechanisms may be (micro‐)aspiration, it may be relevant to establish normal ranges in the proximal esophagus.MethodsTwenty‐four‐hour pH monitoring was performed in 200 children with suspected GER disease. The mean age of the patients was 4.5 months (range, 0.5–17.0 months). After initial analysis, patients were divided into three groups according to the reflux index (RI) in the distal esophagus, because it could be speculated that the amount of reflux reaching the proximal esophagus depends on the amount of reflux in the distal esophagus: Group I (n:120) children had a distal RI of less than 5% and were considered normal, group II (n:50) had a distal RI of 5% to 10% and was considered to have intermediate disease, and group III (n:30) had a distal RI of more than 10% and was regarded as pathologic. The following parameters are calculated: the RI, the total number of reflux episodes, the number of reflux episodes lasting more than 5 minutes, the duration of the longest reflux episode, and the acid clearance time (ACT).ResultsThe median RI in the distal esophagus was 3.8 ± 0.34 (standard error of the mean [SEM]), and in the proximal esophagus, the RI was 1.2 ± 0.23. In group I patients, the RI in the proximal esophagus was 0.5% ± 0.09%, in group II the RI increased significantly to 2.75% ± 0.34% (P [group I compared with group II] < 0.01), and in group III the RI was 6.15% ± 0.96% (P [II‐III] < 0.01). The number of acid reflux episodes in group I was 17.0 ± 2.27, in group II the number increased to 62.5 ± 8.18 (P [I‐II] < 0.01), and in group III it reached 102.0 ± 23.9 (P [II‐III] < 0.05). Also the duration of the longest reflux episodes and the number of reflux episodes lasting more than 5 minutes increased from group I to group II, and from group II to group III. The ACT was shorter in the proximal esophagus (group I 0.3 ± 0.06 minutes; group II 0.48 ± 0.07 minutes, P [I‐II] = not significant [NS]; group III 0.56 ± 0.17 minutes P [II‐III] = NS) than in the distal esophagus (group I 0.49 ± 0.03 minutes, P [proximal ACT compared with distal ACT] < 0.05; Group II 0.76 ± 0.05 minutes, P [proximal‐distal] < 0.01; Group III 0.89 ± 0.09 minutes, P [proximal‐distal] = NS) suggesting more effective esophageal clearance in the proximal esophagus.ConclusionsProtection of the proximal esophagus from acid reflux is significantly related to the incidence and duration of reflux measured in the distal esophagus. These normal ranges in the upper esophagus will be helpful in the interpretation of upper esophageal pH monitoring data.
Effect of a Water‐Soluble Fiber (Galactomannans)‐Enriched Formula on Gastric Emptying Time of Regurgitating Infants Evaluated Using an Ultrasound Technique
Authors: Fabiani Elisabetta , Bolli Valeria , Pieroni Giovanni , Corrado Giovanni , Carlucci Antonio , De Giacomo Costantino , Catassi Carlo 
Published: January 2024

ABSTRACTBackgroundMilk formulas enriched with water‐soluble fibers are a first‐line measure for infants with gastroesophageal reflux. However, it has been reported that these compounds could affect gastric emptying. The aim of this study was to evaluate the effects of these thickeners on gastric emptying time in infants with frequent regurgitation or vomiting.MethodsForty‐seven infants, aged 1 to 12 months, with uncomplicated gastroesophageal reflux underwent two ultrasound evaluations of gastric emptying time after receiving either a standard formula or a formula enriched with 0.4 g galactomannan per 100 ml diluted milk. Gastric emptying time was calculated by measuring the antrum area at baseline and at defined intervals over the next 3 hours.ResultsThe gastric emptying time (mean ± SD) for the standard and the thickened formula was 136 ± 33 and 133 ± 34 minutes, respectively. There was no significant difference in the gastric emptying patterns of the two formulas. Gastric emptying time was longer after the standard formula in 15 of the 47 subjects, shorter in 15 of the 47, and the same in 17 of the 47.ConclusionsThe ingestion of a water‐soluble fiber‐enriched formula does not have any significant influence on the gastric emptying time of infants with frequent regurgitation or vomiting.
Evoked Potentials for the Evaluation of Latent Hepatic Encephalopathy in Pediatric Liver Transplant Candidates
Authors: Nora Daniel B. , Amaral Olavo B. , Busnello João V. , Quevedo João , Vieira Sandra , da Silveira Themis R. , Kapczinski Flávio 
Published: January 2024

ABSTRACTBackgroundVisual evoked potentials (VEPs) and brain stem auditory evoked potentials (BAEPs) have been proposed as tools in the diagnosis of subclinical hepatic encephalopathy (HE). However, little information exists to determine their usefulness in pediatric patients. This study was undertaken to evaluate both methods in the detection of subclinical HE in pediatric liver transplant candidates.MethodsVEPs and BAEPs were recorded in 15 pediatric liver transplant candidates with no clinical signs of HE. The wave latencies found in these examinations were then compared with those in 16 healthy controls of similar age. Laboratory data on liver function and electroencephalographic data from the patients were also recorded to examine their correlation with the evoked potentials results.ResultsNo differences were found in the BAEP results between patients and controls. However, in the VEPs, the liver transplant candidates had significantly prolonged N1 (N75) latencies when compared with controls; no significant delay was found in the other waves. In contrast, among the children with liver disease, higher BAEP peak latencies correlated positively with electroencephalographic abnormalities, but this correlation was not observed in VEPs.ConclusionsEvoked potentials might be of use in detecting alterations related to HE in children. However, further studies are necessary to determine their sensitivity and specificity in this situation.
Helicobacter pylori Infection in Children of Texas
Authors: Opekun Antone R. , Gilger Mark A. , Denyes Susan M. , Nirken Milton H. , Philip Soman P. , Osato Michael S. , Malaty Hoda M. , Hicks John , Graham David Y. 
Published: January 2024

ABSTRACTBackgroundAcquisition of the Helicobacter pylori infection usually occurs in childhood. The prevalence of infection differs among ethnic groups and in adults is inversely related to the socioeconomic status of the individual's family during childhood. This study investigates the seroprevalence of H. pylori infection in children of different ethnic groups in relation to socioeconomic class and investigates the prevalence of acute H. pylori infection among children who have had recent onset of abdominal pain.MethodsSerum samples were collected from 797 children, aged 6 months to 18 years, of various socioeconomic and ethnic backgrounds, at a large urban children's hospital. H. pylori status was determined by an anti‐H. pylori immunoglobulin (Ig)G enzyme‐linked immunosorbent assay (ELISA) validated for pediatric use. To determine the prevalence of acute H. pylori infection, children brought to the emergency center with abdominal symptoms without diarrhea and overt signs of acute abdomen were evaluated with both serology and the 13C‐urea breath test. Acute H. pylori was defined as a positive 13C‐urea breath test result and negative IgG serology for H. pylori.ResultsThe overall seroprevalence of H. pylori was 12.2% and increased with age (e.g., 8.3% at 6–11.9 months and 17.9% at 13 years). The prevalence was inversely related to socioeconomic status (6.6%, moderate to high vs. 15%, low socioeconomic status). The difference in seroprevalence among blacks (16.8%), Hispanics (13.3%), and whites (8.3%;P < 0.01) could be accounted for by differences in socioeconomic status. Eighteen percent of children who were evaluated at the emergency center for recent‐onset abdominal pain had acute H. pylori infections.ConclusionsSocioeconomic status, not ethnic group, is the more important risk factor for acquisition of H. pylori infection during childhood. Acute H. pylori infection was a relatively common cause of recent‐onset, nonsurgical abdominal pain.
Celiac Disease in Children and Adolescents with Type I Diabetes: Importance of Hypoglycemia
Authors: Mohn Angelika , Cerruto Marina , Iafusco Dario , Prisco Francesco , Tumini Stefano , Stoppoloni Ornella , Chiarelli Francesco 
Published: January 2024

ABSTRACTBackgroundSymptomatic hypoglycemia is an unavoidable problem in the treatment of type I diabetes. Celiac disease is associated with malabsorption and may therefore represent an important risk factor.MethodsThe frequency of symptomatic hypoglycemia in patients with type I diabetes and celiac disease (cases) was compared with those of patients who had diabetes without celiac disease (controls). For this purpose, each case was matched for age, sex, and duration of disease with one to two control patients. Indices of metabolic control (hemoglobin [Hb]A1c, frequency of hypoglycemia, and total insulin requirement) were retrieved for the 18 months before and after diagnosis of celiac disease.ResultsEighteen patients (6 males and 12 females) had diagnosed celiac disease and were matched with 26 control patients (10 males and 16 females). There was no difference in age (11.0 years; range, 1.8–21.9 vs. 13.1 years; range, 2.3–22;P = 0.3) and duration of disease (8.4 years; range, 1.2–19.3 vs. 8.3 years; range, 1.1–18.7;P = 0.3) between the two groups. During the 6 months before and after diagnosis of celiac disease the cases had significantly more hypoglycemic episodes than the controls (means ± SD; 4.5 ± 4 vs. 2.0 ± 2.2 episodes/months, P = 0.01). This was reflected by a progressive reduction in insulin requirement over the 12 months before diagnosis reaching a nadir at time 0 (0.6 ± 0.2 vs. 0.9 ± 0.3, P = 0.05).ConclusionThese data suggest that underlying celiac disease is associated with an increased risk of symptomatic hypoglycemia and that the introduction of a gluten‐free diet with normalization of the intestinal mucosa may reduce its frequency.
Assessment of Gliadin in Supposedly Gluten‐Free Foods Prepared and Purchased by Celiac Patients
Authors: Sdepanian Vera Lucia , Scaletsky Isabel Cristina Affonso , Fagundes‐Neto Ulysses , de Morais Mauro Batista 
Published: January 2024

ABSTRACTBackgroundThe present study was designed to evaluate the presence of gliadin in homemade foods prepared by patients with celiac disease and/or their relatives, as well as in processed products consumed by such patients in São Paulo, Brazil, by enzyme immunoassay (EIA) and Western blot (WB) analysis.MethodsOne hundred ninety samples were analyzed: 108 homemade foods prepared in homes of patients with celiac disease, 81 processed products, and 1 positive control of homemade food. All samples were analyzed by EIA based on monoclonal antibodies to heat stable ω‐gliadins and related prolamins from wheat, rye, and barley. Samples were also analyzed using the WB technique.ResultsOnly one (0.9%) of 108 homemade foods contained detectable amounts of gliadin, as determined by EIA. Twelve of 81 processed products contained gliadin by EIA, as follows: 5 of 61 without gluten listed in the ingredients, 2 of 11 malt extracts, 1 of 2 wheat starches, 1 of 2 types of beer, and all 3 positive control products. Gliadin content of these products was between 4 and 10 mg of gliadin/100 g of product, except for the wheat starch sample (28 mg of gliadin/100 g) and all 3 samples with gluten (>4000 mg of gliadin/100 g). The positive control of homemade food contained 152 mg of gliadin/100 g. One hundred three of 190 samples were analyzed by WB, and 21 of these were gliadin positive. A comparison of results obtained by EIA and WB showed no statistical differences between the methods.ConclusionsThe greater part of the foods prepared in homes of patients with celiac disease and most processed products supposed to be gluten‐free did not contain gliadin. Therefore, celiac patients adequately prepare gluten‐free homemade food and have the expertise to purchase processed gluten‐free food in São Paulo, Brazil.
Insulin‐Like Growth Factors and Leucine Kinetics During Exercise Training in Children With Cystic Fibrosis
Authors: Gulmans Vincent , van der Laag Johannes , Wattimena Darcos , van Doorn Jaap , Oostveen Dorothe , Berger Ruud , de Meer Kees 
Published: January 2024

ABSTRACTBackgroundLittle is known about the metabolic effects of exercise training in children with cystic fibrosis. The hypothesis for the current study was that in patients with declining clinical status, exercise increases circulating insulin‐like growth factors (IGFs) and improves protein kinetics.MethodsThis was a prospective intervention study in 10 children with cystic fibrosis who participated in a structured isoenergetic exercise (cycling) training program for 3 months. Measurements of IGFs, protein kinetics (using intravenous [13C]‐1‐leucine tracer infusions) and nutritional balance studies were conducted at baseline and after 3 months.ResultsStandard deviation scores of plasma IGF‐I, IGF‐II, and IGF binding protein (BP)‐3 were all decreased at baseline (mean ± SE: −2.0 ± 0.2, −2.0 ± 0.2, −0.6 ± 0.2, respectively). IGF‐I and IGF‐II concentrations were significantly higher after exercise training (standard deviation scores −1.4 ± 0.3 and −1.3 ± 0.1, respectively; compared with baseline: one‐tailed t‐test P = 0.03 and 0.002). The standard deviation score of the IGF‐I/IGF BP‐3 ratio, an indicator of free IGF‐I in the circulation, normalized during exercise training (0.0 ± 0.6 vs. −1.3 ± 0.2 SD units at baseline, one‐tailed t‐test P = 0.04). There was no significant difference in protein intake and fasting protein breakdown, oxidation, and protein synthesis or in energy balance and fat absorption.ConclusionsThese results show that isoenergetic exercise training can be safely recommended to patients with cystic fibrosis. It provides a positive anabolic stimulus to IGF status but is not sufficient to adequately augment protein accretion in patients with diminished nutritional status.