bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Prevalence and Clinical Characteristics of Celiac Disease in Juvenile Diabetes in Wisconsin
Authors: Aktay Atiye N. , Lee P. C. , Kumar Vijay , Parton Elaine , Wyatt David T. , Werlin Steven L. 
Published: January 2024

ABSTRACTBackgroundThe relationship between celiac disease and juvenile diabetes has long been known. Only a single study in the United States, from Buffalo, New York, has reported the prevalence of celiac disease in a pediatric diabetic population. This study was conducted to determine the prevalence and clinical presentation of celiac disease in children and adolescents with juvenile diabetes in Wisconsin, U.S.A., using serum antiendomysial antibody as a screening test.MethodsTwo hundred eighteen patients with diabetes (113 males; age range, 4–21 years) and 117 age‐and gender‐matched control participants were tested for immunoglobulin A endomysial antibody. Patients with positive results were offered a small bowel biopsy. A questionnaire regarding abdominal pain, diarrhea, and growth failure was completed by the parents.ResultsSeventeen of 218 diabetic patients (7.7%) had positive endomysial antibody. All control participants had negative results for the endomysial antibody. Small bowel biopsy was performed in 14 patients. Ten patients had villous atrophy. In one patient without villous atrophy, a repeat biopsy 2 years later showed villous atrophy, and two patients had increased intraepithelial lymphocytes without villous atrophy. Seventy percent of the patients with celiac disease were asymptomatic. The reported symptoms were abdominal pain and diarrhea (n = 1) and growth failure (n = 2). Two patients with celiac disease had Down syndrome.ConclusionsThe prevalence of celiac disease in children with juvenile diabetes in Wisconsin is at least 4.6%, which is comparable with European and Canadian studies. Because patients without villous atrophy may have latent celiac disease, the prevalence may be even higher. All children with juvenile diabetes should be screened for celiac disease.
Antiendomysial Antibody Test Reliability in Children With Frequent Diarrhea and Malnutrition: Is It Celiac Disease?
Authors: Gandolfi Lenora , Catassi Carlo , Garcia Steven , Modelli Ines Cristina , Campos Dioclecio , Pratesi Riccardo 
Published: January 2024

ABSTRACTBackgroundThe aim of this study was to evaluate the specificity of the immunoglobulin A (IgA) antiendomysial antibody test in the diagnosis of celiac disease in a group of malnourished children with acute diarrhea, chronic diarrhea, or parasitosis, because the reliability of this test has been questioned when applied to this specific group of patients.MethodsSerum IgA level, IgA antiendomysial antibody (EMA) test, and stool examination were performed in 315 children, ranging in age 6 months to 13 years (range, 41 ± 2.9 months), affected by malnutrition, isolated or in association with diarrhea or parasitosis. Independent of results, 33 children with a strong suspicion of celiac disease, also underwent IgA antitransglutaminase antibody test and jejunal biopsy.ResultsThe EMA test was negative in 313 children, including the 43 with parasitosis, being positive in two patients in whom biopsy disclosed typical celiac mucosal abnormalities (1:157). The 31 children with negative EMA test who underwent biopsy also showed negative antitransglutaminase antibody results. Their biopsies disclosed normal mucosa in 1 patient, variable degree of jejunal atrophy (grade 1 and 2) in 27 patients, and grade 3 abnormalities in 3 patients. One of these three children, showing severe jejunal atrophy, died. The diagnosis of celiac disease was apparently not confirmed by a protracted gluten challenge in the other two children.ConclusionsThe specificity of the EMA test seems to be high also in children with chronic malnutrition and diarrhea. However, the possibility of false‐negative tests among immunologically compromised children cannot be excluded. In doubtful cases, the gluten challenge is required in malnourished children with clinical picture, biopsy finding, and evolution suggestive of celiac disease.
Late‐Onset Complications of Percutaneous Endoscopic Gastrostomy in Children
Authors: Ségal Delphine , Michaud Laurent , Guimber Dominique , Ganga‐Zandzou Patrice S. , Turck Dominique , Gottrand Frédéric 
Published: January 2024

ABSTRACTPurposeThe aim of this study was to report the late morbidity of percutaneous endoscopic gastrostomy (PEG) in a pediatric population and to identify possible risk factors for complications developing after PEG insertion.MethodsA PEG was placed in 110 children between 1 May 1990 and 1 January 1997 using the pull technique. A retrospective study of late‐onset complications was performed, with a follow‐up period ranging from 1 to 8 years. All the complications occurring more than 6 days after PEG insertion were recorded, except for gastrostomy tube obstruction and accidental tube dislodgement.ResultsThe prevalence of late‐onset complications related to PEG in our patients varied from 3.8 to 4.4 per 10 5 days. The overall rate of late‐onset complications was 44% (48 complications observed in 29 patients [26%]). Seventy‐five percent of the complications appeared during the first 2 years after PEG insertion. Nine different types of complication have been identified: intragastric buried or extruded gastrostomy (n = 24), gastric metaplasia granulation tissue around the site of gastrostomy (n = 8), intragastric pseudotumoral proliferative gastric mucosa (n = 4), intragastric mucosal ulceration (n = 3), cutaneous necrosis (n = 3), cologastric fistula (n = 2), gastrostomy closure delay after tube removal (n = 2), subcostal neuralgia (n = 1), and peritonitis (n = 1). Wilcoxon and chi‐square tests were used to compare the clinical characteristics of the patients and the type of material used in the two populations, with and without complications. No clinical risk factor for the development of complications could be identified. Intragastric buried or extruded gastrostomy appeared more frequently with the use of one type of button than with the use of tubes.ConclusionsThe authors' experience suggests that PEG is associated with significant late morbidity, which is mainly observed within the first 2 years after PEG insertion. However, no risk factor for the development of such complications could be identified.
Even Small Amounts of Gluten Cause Relapse in Children With Celiac Disease
Authors: Laurin Pia , Wolving Mats , Fälth‐Magnusson Karin 
Published: January 2024

ABSTRACTBackgroundPreviously, a gluten challenge was customary to establish the diagnosis of celiac disease in children. There are no clear recommendations on how to perform this challenge or what markers to rely on for timing the biopsy after the challenge. The authors' aim was to monitor gluten intake, clinical symptoms, and antibody kinetics to evaluate the influence of gluten exposure during the challenge.MethodsTwenty‐five children under investigation for suspected celiac disease were challenged. One child was excluded because blood samples, food records, or biopsy was lacking. Median age at the postchallenge biopsy was 3.8 (2.7–8.8) years. The families kept daily records of the children's gluten intake and of symptoms that occurred. Blood samples were taken monthly for analysis of antigliadin and endomysium antibodies and total immunoglobulin A (IgA). A third biopsy was performed when clinical symptoms suggested a relapse.ResultsAll 24 children showed deterioration of the mucosa or elevated antibodies during gluten challenge. Median duration of the challenge was 13 (5–51) weeks, and mean gluten intake was 1.7 (0.2–4.3) g/d and 0.1 (0.02–0.26) g/kg daily.ConclusionsGluten intake during the challenge varied widely, and the parents were unable to give their children the recommended amount. Despite the small amounts given, all children showed signs of relapse at a clinical, laboratory, or histologic level. Much smaller amounts of gluten than previously suggested seem sufficient to cause relapse during gluten challenge in children.
Antitissue Transglutaminase Antibodies Outside Celiac Disease
Authors: Clemente Maria Grazia , Musu Maria Paola , Frau Fulvia , Lucia Cicotto , De Virgiliis Stefano 
Published: January 2024

ABSTRACTBackgroundTissue transglutaminase enzyme‐linked immunosorbent assay (tTG‐ELISA) has recently been proposed as a simple and fast screening test for celiac disease (CD). The rate of false‐positive and false‐negative tests with tTG‐ELISA, however, has not been definitively established. Therefore, the aim of our study was to investigate anti‐tTG antibodies (TGA) not only in untreated patients with CD and in healthy controls, but also in a large group of patients with other autoimmune diseases.MethodsThe presence of TGA was investigated in sera from 111 patients with untreated CD, 96 patients with other autoimmune conditions (28 with autoimmune liver disease, 46 with insulin‐dependent diabetes mellitus, 10 with inflammatory bowel syndrome, 12 with type 1 polyglandular syndrome) and from 100 healthy controls using guinea pig tTG‐ELISA (gp‐TG/ELISA) and highly purified recombinant human tTG‐ELISA (h‐TG/ELISA). Western blotting with guinea pig tTG was also performed.ResultsNinety‐four patients with CD who tested positive for antiendomysial antibodies (AEA) and one who tested negative for AEA showed antibodies against the gp‐TG. Among the controls, 50% of patients with autoimmune liver disease and 6.5% of patients with insulin‐dependent diabetes mellitus tested positive with gp‐TG/ELISA. Western blotting experiments revealed that the high rate of positive tests observed using ELISA among the control group sera is attributable to impurities in the gp‐TG preparation. However, h‐TG/ELISA tests were positive for the sera from all patients who tested positive for AEA and from one control who tested negative for AEA, whereas h‐TG/ELISA tests were negative for all CD patients who tested negative for AEA and for other controls who tested negative for AEA.ConclusionsThe frequency of false‐negative and false‐positive tests represents the major limit to the use of gp‐tTG/ELISA. However, because h‐TG/ELISA is both simple and fast, it could be used in large screening programs for CD.
Prevalence and Natural Course of Gastroesophageal Reflux Symptoms: A 1‐Year Cohort Study in Thai Infants
Authors: Osatakul Seksit , Sriplung Hutcha , Puetpaiboon Areeruk , Junjana Cha‐on , Chamnongpakdi Suthaporn 
Published: January 2024

ABSTRACTBackgroundEpidemiologic studies in adults suggest that the nature of gastroesophageal reflux may differ among various ethnic groups. Until recently, there has been limited information concerning the epidemiology of gastroesophageal reflux in non‐Western children. The objectives of this cohort study were to investigate the prevalence of symptoms related to gastroesophageal reflux in Thai infants and to describe the clinical course of reflux regurgitation during the first year of life.MethodsA cohort study was performed in 216 healthy neonates who attended the well‐baby clinic of Songklanagarind Hospital between March and June 1998. All neonates were followed up, at regular well‐baby clinic visits, for 1 year for reflux symptoms and clinical progress. Information concerning gastroesophageal reflux symptoms was obtained by interviewing the parents and from their diary records. An infant who regurgitated at least 1 day per week was considered to have reflux regurgitation.ResultsNo infant with clinical features of pathologic gastroesophageal reflux or other reflux symptoms apart from regurgitation were seen during this study period. Of 145 infants in a 1‐year cohort, the prevalence of reflux regurgitation peaked at 2 months at 86.9% and significantly decreased to 69.7% at 4 months, 45.5% at 6 months, and 22.8% at 8 months. At 1 year of age, only 7.6% of infants still had reflux regurgitation. Most Thai infants with gastroesophageal reflux had mild symptoms: 90% of them regurgitated only one to three times per day, and daily regurgitation was reported in a low percentage. Comparing infants with reflux regurgitation and those without, the standard deviation scores of body weight for age were similar. There was no significant difference in prevalence of reflux regurgitation between breast‐fed and bottle‐fed infants.ConclusionsThe nature of gastroesophageal reflux in Thai infants differs from that in Western infants. The prevalence of reflux regurgitation in Thai infants was very high at 1 to 2 months of age; however, many infants became symptom‐free by 6 months. The type of feeding (breast milk vs. bottle milk) had no influence on the prevalence of reflux regurgitation.
Does Ileal Reverse Segment in Rats With Short Bowel Syndrome Change Intestinal Morphology?
Authors: Şencan Aydin , Akçora Bülent , Mir Erol , Şencan Arzu , Günşar Cüneyt , Arslan Oğuz , Özer Erdener 
Published: January 2024

ABSTRACTBackgroundThe primary goal of surgical therapy for short bowel syndrome is to increase intestinal absorptive capacity. Many surgical procedures have been described for this purpose. One of these is ileal reverse‐segment procedure. This procedure after massive small‐bowel resection is an alternative way to treat short bowel syndrome, but how it affects intestinal morphology in short bowel syndrome has not been investigated. The aim of this study is to investigate macroscopic and microscopic effects of reverse‐segment procedure on the short bowel.MethodsTwenty rats underwent resection of 80% of the small bowel. The rats were separated into two groups (n = 10). In the first group (reverse group), a reverse segment was formed by twisting a 2‐cm ileal segment 180°, without damaging its vascularity. In the second group (control group), a 2‐cm ileal segment was resected, preserving its mesentery, and end‐to‐end anastomosis was performed to maintain the intestinal passage. The segment was not twisted 180°. The 2‐cm proximal (jejunal) and distal (ileal) segments of the resected bowel were reserved for histologic investigation. Two months later, the rats were killed and the jejunal and ileal segments were evaluated morphologically.ResultsIn the reverse group, body weight and total intestinal length significantly increased (14% more than in the control group). The diameter of both proximal (jejunal) and distal (ileal) segments in the reverse group also increased 53.8% and 22.8%, respectively (P < 0.05). Histologically, crypt depth and villus height of the ileal segment in the reverse group increased 15.2% and 18.2% more than in the control group (P < 0.05). No histologic change was observed at the jejunal level except for intestinal muscle thickness.ConclusionsIleal reverse‐segment procedure in rats with short bowel syndrome 1) does not cause intestinal obstruction, 2) increases total bowel length and body weight, 3) increases the diameter of both jejunal and ileal segments, and 4) increases villus height and crypt depth only at the ileal level. For this reason, reverse‐segment procedure positively affects intestinal adaptation.
Does Interferon and Ribavirin Combination Therapy Increase the Rate of Treatment Response in Children With Hepatitis C?
Authors: Süoğlu Özlem D. , Elkabes Berna , Sökücü Semra , Saner Günay 
Published: January 2024

ABSTRACTBackgroundInterferon‐α was the first accepted treatment of chronic hepatitis C. In recent years, adding ribavirin has produced better response rates in adult patients than monotherapy with interferon‐α. Whether adding ribavirin also improves treatment results in pediatric patients remains unclear.MethodsTwelve patients were given 3 million U/m2 subcutaneous interferon‐α three times weekly and 15 mg/kg oral ribavirin daily, and 10 patients were given only 3 million U/m2 subcutaneous interferon‐α three times weekly for a total of 12 months.ResultsThe dropout rate was 22.8% (25% for patients receiving combination treatment versus 20% for those receiving monotherapy). At the end of treatment, viral clearance was achieved in 50% of the patients who received combination treatment versus 30% of those who received monotherapy. After 12 months of posttreatment follow‐up, sustained response rates were 30% and 41.7%, respectively. Of those who responded to treatment, 66.7% had received ribavirin whereas 37.5% of nonresponders had received ribavirin therapy.ConclusionAdding ribavirin to interferon treatment improved end‐of‐treatment response rates in children with chronic hepatitis C. Tolerance of treatment was similar to tolerance of monotherapy. However, studies of greater numbers of pediatric patients with longer follow‐up periods are necessary to determine prolonged sustained response.
Prolonged Esophageal pH Monitoring in the Evaluation of Gastroesophageal Reflux in Children With Chronic Tubotympanal Disorders
Authors: Rožmanic Vojko , Velepic Mitja , Ahel Vladimir , Bonifacic David , Velepic Marko 
Published: January 2024

ABSTRACTBackgroundChildren with ear, nose and throat disorders are believed to have a high incidence of pathologic gastroesophageal reflux (GER). This study was designed to establish the frequency and ratio of pathologic GER in the development of chronic tubotympanal disorders.MethodsTwenty‐seven children with chronic tubotympanal disorders (mean age, 2 to13 years; average age, 6.8 years) underwent 24‐hour continuous pH monitoring. Fourteen of the examined patients had secretory otitis, whereas 13 patients had recurrent otitis. From each 24‐hour pH monitoring, 12‐hour daytime and nighttime periods were selected. Eleven patients were tested using simultaneous dual pH monitoring (distal and proximal pH monitoring).ResultsFifteen (55.6%) of 27 patients had pathologic GER. The authors did not find a relation between pathologic GER and different types of ear disorders. Daytime pH monitoring yielded significantly more episodes of reflux than did nighttime monitoring. The reflux index was substantially higher during the day. In the current study, distal pH monitoring showed that 6 of 11 patients had pathologic GER, whereas proximal pH monitoring showed that only only 3 of 11 patients had pathologic GER.ConclusionsThe authors recommend that a pH study be performed in children with chronic tubotympanal disorders when standard treatment is ineffective. The method of choice for the diagnosis of pathologic GER in patients with chronic tubotympanal disorders should be pH monitoring of the esophagus and throat.
Treatment of Helicobacter pylori Gastritis Improves Dyspeptic Symptoms in Children
Authors: Uc Aliye , Chong Sonny K. F. 
Published: January 2024

ABSTRACTBackgroundIn adults, the treatment of Helicobacter pylori infection is only recommended for patients with active gastric or duodenal ulcers. It is not known whether similar guidelines can be applied to children because the prevalence of peptic ulcer disease in childhood is estimated to be much lower than in adults. The purpose of this study was to determine whether treatment of H. pylori gastritis would improve symptoms of dyspepsia in children.MethodsSixteen patients (5 boys, 11 girls) aged 14 ± 1.2 years who had symptoms of dyspepsia were evaluated using upper gastrointestinal endoscopy with biopsies to establish the diagnosis of H. pylori gastritis. They were treated for 2 weeks with clarithromycin, amoxicillin, and a proton pump inhibitor. Dyspepsia symptoms were evaluated by a questionnaire before and after treatment of the infection. The effect of H. pylori treatment on the total symptom score was analyzed with use of the Student t test. Values are presented as mean ± SEM.ResultsAll patients had antral nodularity and chronic active gastritis with spiral‐shaped organisms but no evidence of peptic ulcer disease. Mean total symptom score decreased significantly at 2 to 4 weeks after treatment (12.6 ± 0.9 vs. 2.1 ± 0.5 P < 0.001), and it remained low (2.9 ± 0.7) at follow‐up 9.7 ± 1.4 months (range, 2–24 months later).ConclusionThese results suggest that the treatment of H. pylori gastritis can improve dyspeptic symptoms in children.
Effect of Renutrition on Natural and Cell‐Mediated Immune Response in Infants With Severe Malnutrition
Authors: Vásquez‐Garibay Edgar , Campollo‐Rivas Octavio , Romero‐Velarde Enrique , Méndez‐Estrada Concepción , García‐Iglesias Trinidad , Alvizo‐Mora José Guadalupe , Vizmanos‐Lamotte Barbara 
Published: January 2024

ABSTRACTBackgroundThe purpose of this study was to evaluate whether a 4‐week nutritional recovery period with a starting infant formula and 3.35 kJ/mL energy density would favorably affect the natural and cell‐mediated immune response in infants with severe and primary protein‐energy malnutrition.MethodologyThe study included 12 severely malnourished infants, 3 to 18 months of age. For 2 weeks, infants were fed a starting infant formula, with energy density increased to 0.8 kcal/mL, through a nasogastric tube. Infants were fed “ad libitum” for 2 more weeks. On the fifth day, 837 kJ/kg and 4 g/kg protein were given daily. At the beginning and at the end of the 4‐week period, weight, length, phagocytosis, microbicidal activity, chemotaxis, and cell proliferation indices were measured. Null hypothesis was rejected with a paired t test and a P value less than 0.05.ResultsAfter the 4‐week period of nutritional recovery, the weight and length indicators and the four immunologic assays showed significant increase (P < 0.005).ConclusionThe study demonstrated that a 4‐week nutritional recovery period with a starting infant formula and 0.8 kcal/mL energy density favorably affected the natural and cell‐mediated immune response in infants with severe protein‐energy malnutrition.
Increased Rectal Nitric Oxide in Children With Active Inflammatory Bowel Disease
Authors: Ljung Tryggve , Beijer Eva , Herulf Max , Weitzberg Eddie , Lundberg Jon O. N. , Finkel Yigael , Hellström Per M. 
Published: January 2024

ABSTRACTBackgroundLuminal nitric oxide increases in ulcerative colitis and Crohn disease. The authors have previously used a minimally invasive method to demonstrate increased luminal nitric oxide in ulcerative colitis and Crohn disease of the colon. The aim of the current study was to determine whether this method could be applied to identify inflammatory activity in ulcerative colitis and Crohn disease in children.MethodsThirty‐six children (18 of whom had active disease) with inflammatory bowel disease localized to the colon were studied. The control group comprised 12 healthy children. To measure nitric oxide, a silicon catheter with an inflatable balloon was inserted into the rectum and inflated with 10 mL of nitric oxide–free air. After a 10‐minute incubation time, the air was withdrawn and nitric oxide concentrations were immediately analyzed using a chemiluminescence technique.ResultsChildren with active ulcerative colitis and Crohn disease of the colon had greatly increased luminal nitric oxide concentrations in the rectum (8,840 ± 5,120 and 15,170 ± 4,757 parts per billion [ppb], respectively) compared with controls (77 ± 17 ppb) (P < 0.001). Children with nonactive ulcerative colitis or Crohn disease displayed low concentrations of rectal nitric oxide (356 ± 110 and 188 ± 55 ppb, respectively), which was not different from that of healthy controls.ConclusionRectal nitric oxide measurement is a feasible and useful method for monitoring disease activity in inflammatory bowel disease, especially in children.