bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expression, Characterization, and Biologic Activity of Recombinant Human Lactoferrin in Rice
Authors: Suzuki Yasushi A. , Kelleher Shannon L. , Yalda Dorice , Wu Liying , Huang Jianmin , Huang Ning , Lönnerdal Bo 
Published: January 2024

ABSTRACTBackgroundLactoferrin has been suggested to have many biologic activities, such as facilitating iron absorption and having antimicrobial and antiinflammatory effects. In humans, several of these activities are likely to only be facilitated by human lactoferrin because they depend on the binding of human lactoferrin to specific receptors. Rice may be a useful vehicle to introduce recombinant human lactoferrin to infant foods because it has low allergenicity and is likely to be safer than using microorganisms or transgenic animals.MethodsRecombinant human lactoferrin was expressed in the rice cell culture system, and its biologic activity was assessed by iron‐binding and ‐releasing properties, antimicrobial activity, and binding and uptake to Caco‐2 cells. The authors also compared the stability of recombinant and native human lactoferrins against heat, low pH, and in vitro digestion.ResultsBiologic activity of rice‐expressed recombinant human lactoferrin was similar to that of native human lactoferrin. Heat‐treated proteins retained their functional activities except with severe treatment at 100°C for 8 seconds, which disturbed the iron‐binding capacity of recombinant human lactoferrin. Both types of proteins retained their functional activities between pH 2 and 7.4. After in vitro digestion, 50% of both proteins were detectable by enzyme linked immunosorbent assay. The remaining native and recombinant lactoferrins retained antimicrobial and Caco‐2 binding and uptake activities.ConclusionsThe results indicate recombinant human lactoferrin has stability similar to native human lactoferrin when exposed to thermal treatment, pH treatment, and in vitro digestion, suggesting it may be active when added to infant formula.
Management of Childhood Pancreatic Disorders: A Multidisciplinary Approach
Authors: Yachha Surender K. , Chetri Kamal , Saraswat Vivek A. , Baijal Sanjay S. , Sikora Sadiq S. , Lal Richa , Srivastava Anshu 
Published: January 2024

ABSTRACTIntroductionData on therapeutic endoscopy and radiologic interventions for the management of childhood pancreatic disorders are relatively limited. This study focuses on the multidisciplinary approach to the management of pancreatitis in children.Patients and MethodsChildren with pancreatic disorders were studied from January 1992 to May 2001. Acute pancreatitis (AP) was diagnosed by clinical evaluation, serum amylase more than three times normal, and morphologic abnormalities of the pancreas on imaging. Children with recurrent abdominal pain, pancreatic calcification or ductal stones on imaging, and pancreatic ductal changes on endoscopic retrograde cholangiopancreatography (ERCP) were diagnosed with chronic pancreatitis (CP). Patients were treated by gastroenterologists, surgeons, and interventional radiologists. Pancreatic exocrine insufficiency was diagnosed in appropriate settings.ResultsFifteen children—6 with AP (posttrauma, 3; gallstone disease, 1; and viral, 1), 7 with CP, and 2 with pancreatic exocrine insufficiency—were diagnosed. Local complications observed in children with AP included pseudocyst in three, and infected acute fluid collection, right‐sided pleural effusion, and ascites in one patient each. Complications of AP were managed with percutaneous catheter drainage (n = 3; pseudocyst, 2; infected fluid collection, 1), additional pancreatic duct stenting (n = 2), surgical drainage (n = 1), and octreotide for pleural effusion (n = 1). Signs of CP included abdominal pain (n = 7), obstructive jaundice resulting from lower common bile duct stricture (n = 2), and bleeding from gastroduodenal artery pseudoaneurysm (n = 1). Pancreatic duct stenting relieved pain in one patient, and steel coil embolization arrested bleeding from the pseudoaneurysm. Common bile duct strictures were managed by surgical bypass (n = 2), one of which required preoperative endoscopic bile duct stenting for management of cholangitis. Two other patients with CP required no intervention.ConclusionA multidisciplinary approach of radiologic and endoscopic interventions and surgery are complimentary to each other in achieving successful outcomes of complicated childhood pancreatitis.
Knowledge, Attitudes, and Practice Styles of North American Pediatric Gastroenterologists:Helicobacter pylori Infection
Authors: Chang Howard Y. , Sharma Virender K. , Howden Colin W. , Gold Benjamin D. 
Published: January 2024

ABSTRACTObjectiveMost Helicobacter pylori infections are acquired during childhood. The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) recently published practice guidelines for managing pediatric H. pylori infection. Before this publication, the authors conducted a survey to assess pediatric gastroenterologists' knowledge and practices regarding H. pylori.MethodsOne hundred nine of 514 NASPGHAN members completed an Internet‐based questionnaire on H. pylori infection.ResultsEighty‐two percent of respondents performed outpatient testing for H. pylori. Of these, only 31% restricted testing to children aged >5 years. Most recommended testing for H. pylori in guideline‐recommended conditions; some would not treat infected patients. Ninety‐seven percent would test for H. pylori in a child with new duodenal ulcer (DU), 79% in a child with a history of DU, and 91% in a child with new gastric ulcer. However, only 86%, 60%, and 91%, respectively, would treat H. pylori infection in those conditions. A proton pump inhibitor (PPI)‐based triple regimen was the first‐choice therapy for 78% of respondents. Correct estimates of rates of resistance to amoxicillin, clarithromycin, metronidazole, and tetracycline were 10%, 17%, 43%, and 12%, respectively. Eighty‐six percent believed there was insufficient research on H. pylori in children.ConclusionsNorth American pediatric gastroenterologists seem well informed about H. pylori infection in children despite the lack of published guidelines at the time of survey. Knowledge about antibiotic resistance rates was deficient. Most offered some outpatient testing for H. pylori and would test children with ulcer disease. However, some would not treat patients based on a positive result.
Nondigestible Carbohydrates in the Diets of Infants and Young Children: A Commentary by the ESPGHAN Committee on Nutrition
Authors: Aggett Peter J. , Agostoni Carlo , Axelsson Irene , Edwards Christine A. , Goulet Olivier , Hernell Olle , Koletzko Berthold , Lafeber Harry N. , Micheli Jean‐Léopold , Michaelsen Kim F. , Rigo Jacques , Szajewska Hania , Weaver Lawrence T. 
Published: January 2024

ABSTRACTThe consumption of nondigestible carbohydrates is perceived as beneficial by health professionals and the general public, but the translation of this information into dietary practice, public health recommendations, and regulatory policy has proved difficult.Nondigestible carbohydrates are a heterogeneous entity, and their definition is problematic. Without a means to characterize the dietary components associated with particular health benefits, specific attributions of these cannot be made. Food labeling for “fiber” constituents can be given only in a general context, and the development of health policy, dietary advice, and education, and informed public understanding of nondigestible carbohydrates are limited.There have, however, been several important developments in our thinking about nondigestible carbohydrates during the past few years. The concept of fiber has expanded to include a range of nondigestible carbohydrates. Their fermentation, fate, and effects in the colon have become a defining characteristic; human milk, hitherto regarded as devoid of nondigestible carbohydrates, is now recognized as a source for infants, and the inclusion of nondigestible carbohydrates in the diet has been promoted for their “prebiotic” effects.Therefore, a review of the importance of nondigestible carbohydrates in the diets of infants and young children is timely. The aims of this commentary are to clarify the current definitions of nondigestible carbohydrates, to review published evidence for their biochemical, physiologic, nutritional, and clinical effects, and to discuss issues involved in defining dietary guidelines for infants and young children.
Low Fecal Elastase: Potentially Related to Transient Small Bowel Damage Resulting from Enteric Pathogens
Authors: Salvatore Silvia , Finazzi Sergio , Barassi Alessandra , Verzelletti Mascia , Tosi Anna , Melzi d'Eril Gian Vico , Nespoli Luigi 
Published: January 2024

ABSTRACTFecal elastase is considered to be a highly sensitive and specific non‐invasive exocrine pancreatic function test. However, enteropathy may theoretically cause decreased exocrine pancreatic enzyme secretion through alteration of enteric hormone release.ObjectiveThe aim of this study was to evaluate the possible influence of transient small bowel damage on pancreatic elastase secretion.MethodsWe studied 166 children (aged 4 months to 14 years, mean 2 years); 114 of these children had acute enteritis and 52 children were control subjects (with gastro‐intestinal symptoms or extra‐intestinal diseases). Feces were collected from each patient 3 days after the onset of diarrhea and then tested for fecal elastase, bacterial pathogens, Rotavirus, and Adenovirus. Liquid fecal samples were not considered eligible for elastase measurement. Pancreatic elastase was measured using an ELISA method (Sche.Bo.Tech, Germany). We classified the results, expressed in μg/g stool, as: severe pancreatic insufficiency (<100 μg/g), moderate pancreatic insufficiency (100 to 200 μg/g), and normal (>200 μg/g).ResultsIn the acute enteritis group we found severe levels in 14 (12%) children, moderate levels in 18 children (16%), and normal levels in 82 children (72%). In contrast, 52 of 52 (100%) control subjects demonstrated normal results. Statistical analysis (Wilcoxon rank test) demonstrated a significant difference between the enteritis and control groups (P < 0.01). Serial measurement of fecal elastase performed in 10 patients with enteritis showed a progressive increase of levels in 6 patients and an early decline with subsequent increases in the other 4 patients.ConclusionsTransient exocrine pancreatic insufficiency may be present in transient small bowel disease, caused by both bacterial and viral infections, possibly related to reduced enteric CCK secretion.
Consensus and Controversy in the Management of Pediatric Crohn Disease: An International Survey
Authors: Levine Arie , Milo Tamir , Buller Hans , Markowitz James 
Published: January 2024

ABSTRACTObjectivesTreatment options for patients with Crohn disease (CD) have expanded, but the use of some of these options in pediatric patients remains controversial. The authors evaluate current trends in treatment and areas of consensus or controversy.MethodsAn international survey of certified pediatric gastroenterologists was conducted using an e‐mail questionnaire in an attempt to evaluate management of active Crohn disease, attitudes toward four types of therapy, and prevalence of testing for osteopenia and 6‐thioguanine levels.ResultsOne hundred sixty‐seven physicians from the United States, Canada, Western Europe, and Israel were included. The majority of North American physicians (71%) prefer to use conventional steroids and azathioprine (AZA) before nutritional therapy or budesonide for patients with mild to moderately active disease, versus 21% of Western Europeans (P < 0.001). Western Europeans prefer nutritional therapy followed by budesonide or steroids for those with mild or moderate disease. Only 4% of North American gastroenterologists use nutritional therapy frequently versus 62% of their Western European colleagues (P < 0.001). Infliximab was thought to be effective for steroid‐unresponsive disease by almost all physicians surveyed, although its efficacy as a maintenance therapy was rated higher by North American physicians than by their Western European and Israeli colleagues (P < 0.01). Bone mineral density is routinely evaluated by about 45% of physicians in Western Europe and North America.ConclusionsAttitudes toward current therapies vary significantly by region, with North Americans strongly favoring corticosteroids followed by immunomodulatory therapy, and Western Europeans favoring nutritional therapy or budesonide and the avoidance of conventional corticosteroids.
Parenteral Fat Emulsions Based on Olive and Soybean Oils: A Randomized Clinical Trial in Preterm Infants
Authors: Göbel Yvonne , Koletzko Berthold , Böhles Hans‐Josef , Engelsberger Ilse , Forget Dominique , Le Brun Alexia , Peters Jochen , Zimmermann Andrea 
Published: January 2024

ABSTRACTObjectiveTo evaluate in premature infants a new parenteral lipid emulsion based on olive and soybean oils (ratio 4:1), with less polyunsaturated fatty acids (PUFA) and more α‐tocopherol than standard soybean oil emulsion.Study designPremature infants (gestational age, 28–<37 weeks) were randomized to receive one of the two emulsions within the first 72 hours of life. The triglyceride dose was increased to 2 g/kg/day within 3 days. Plasma phospholipid fatty acids, α‐tocopherol/lipid ratio, and urinary malondialdehyde (MDA) excretion were determined at baseline and after 7 days.ResultsOf 45 recruited infants, 33 completed the study per protocol (15 soybean oil, 18 olive oil emulsion). At study end, groups did not differ in plasma phospholipid arachidonic acid, total n‐6 and n‐3 metabolites, but the olive oil group showed higher values of the PUFA intermediates C18:3n‐6 (0.19% ± 0.01% vs. 0.13% ± 0.02%, P < 0.05) and C20:3n‐6 (2.92% ± 0.12% vs. 2.21% ± 0.17%, P = 0.005). The plasma α‐tocopherol/total lipd ratio was higher in the olive oil group (2.45 ± 0.27 μmol/mmol vs. 1.90 ± 0.08 μmol/mmol, P = 0.001), whereas urinary MDA excretion did not differ.ConclusionThe lower PUFA supply with the olive/soybean oil emulsion appears to enhance linoleic acid conversion. The reduced PUFA content, combined with a higher antioxidant intake in the olive oil group, results in an improved vitamin E status. The olive oil‐based emulsion is a valuable alternative for parenteral feeding of preterm infants who are often exposed to oxidative stress, while their antioxidative defense is weak.
Gastric Dysrhythmia in Infants with Gastrointestinal Diseases Measured by Epigastric Impedance
Authors: Lange Aksel , Funch‐Jensen Peter , Schiøtz Peter Oluf 
Published: January 2024

ABSTRACTBackgroundGastrointestinal symptoms have been reported in association with myoelectrical dysrhythmia, where different types of gastric electrical activity have been described. These types of gastric myoelectrical activity and dysrhythmia can be measured by electrogastrography using cutaneous electrodes. Epigastric impedance is a non‐invasive method used to study gastric emptying time and gastric phasic activity.At present no study of gastric dysrhythmia, measured with epigastric impedance, has been presented, and the purpose of the present study was to investigate gastric rhythms by means of impedance gastrography in control infants, compared to infants with different gastrointestinal diseases, before and after treatment of their disease.Method21 patients (age 0–2 months) and 40 healthy infants (age 0–2 months) were investigated. The patients suffered from partial or total intestinal obstruction, necrotizing enterocolitis or pyloric stenosis.All infants were fasting and studied during periods of at least one hour. The patients were examined in the acute state and after treatment when possible.ResultsA pathologic result was found in 90% of the patients. A persistent phasic activity pattern was found in 19 of the 21 patients, high frequency phasic activity in 11 of the 21 patients. Short‐term phasic activity was only found in 13 out of 40 of the normal infants (32.5%).ConclusionUsing epigastric impedance we found that infants with partial or total intestinal obstruction had gastric phasic activity, which was not found in the control infants. The origin of the gastric phasic activity patterns is unknown, but they may be related to electrical control activity.
Long‐term Survival Following Kasai Portoenterostomy: Is Chronic Liver Disease Inevitable?
Authors: Hadžić Nedim , Davenport Mark , Tizzard Sarah , Singer Jeanette , Howard Edward R. , Mieli‐Vergani Giorgina 
Published: January 2024

ABSTRACTObjectivesExtrahepatic biliary atresia (EHBA) is the most common indication for liver transplantation in childhood. Most children who do not undergo transplant are reported to have chronic liver disease and its complications. The aim of this single‐center study was to identify children with normal laboratory indices and no clinical evidence of chronic liver disease 10 or more years after Kasai portoenterostomy (KP).MethodsA retrospective analysis of the medical notes of all children surgically treated at the authors' center between 1979 and 1991 was undertaken. Criteria for inclusion were absence of surgical complications, unremarkable clinical examination, and normal bilirubin, aspartate aminotransferase, albumin, international normalized prothrombin ratio, and platelet count.ResultsOf 244 children surgically treated during the observation period, the authors identified 28 (11%) adolescents (14 male) who fulfilled the entry criteria. Their median age was 13.4 years (range, 10.2–22.2 years). Twenty‐six with type 3 EHBA had conventional KP, whereas 2 underwent modified operations. The corrective surgery was performed at a median age of 58 days (range, 20–99 days). Median time of complete clearance of jaundice from the date of KP was 75 days (range, 21–339 days). Twelve (43%) patients had history of cholangitis at a median age of 3.4 years. The liver histologic findings were suggestive of mild to moderate fibrosis in 54.2% and cirrhosis in 40.7% of the patients who underwent biopsy. No child had gastrointestinal bleeding during follow‐up. Thirteen (46%) patients had an elective esophagogastroduodenoscopy, which was normal in all. Twenty‐six (93%) patients were in mainstream education, whereas the remaining two (7%) attended special school because of reasons unrelated to liver disease.ConclusionsA sizable proportion of children with EHBA avoid significant chronic liver disease and its complications 10 years or more after conventional surgical correction and have an excellent quality of life. Their good outcome is not hampered by isolated episodes of ascending cholangitis. Whether or not the residual histologic damage will become symptomatic during their lifetime remains to be established.
Fecal Calprotectin Levels in Healthy Children Studied With an Improved Assay
Authors: Fagerberg Ulrika Lorentzon , Lööf Lars , Merzoug Rumjana Djilali , Hansson Lars‐Olof , Finkel Yigael 
Published: January 2024

ABSTRACTBackgroundCalprotectin is a protein abundant in neutrophils. Fecal calprotectin can be used as a marker of gastrointestinal inflammation, and an improved assay has recently been developed. The aim of this study was to establish reference values for fecal calprotectin in healthy children aged between 4 and 17 years.MethodsFecal samples were obtained from 117 healthy children classified into four age groups: 4 to 6 years, 7 to 10 years, 11 to 14 years, and 15 to 17 years. A health questionnaire was used to ensure that these children fulfilled the inclusion criterion and did not have intercurrent disease, nasal or menstrual bleeding, or nonsteroidal anti‐inflammatory drug medication before the sampling period. Calprotectin was analyzed using a quantitative enzyme‐linked immunosorbent assay (Calprest, Eurospital SpA, Trieste, Italy). Children with fecal calprotectin values >50 μg/g were asked to deliver an additional sample.ResultsThe overall median fecal calprotectin concentration was 13.6 μg/g (95% confidence interval, 9.9–19.5 μg/g) in the 117 children. In the different age groups, 4 to 6 years, 7 to 10 years, 11 to 14 years, and 15 to 17 years, the median calprotectin concentrations were 28.2, 13.5, 9.9, and 14.6 μg/g, respectively. Of these children, 104 (89%) had a concentration <50 μg/g. The remaining 13 children with a calprotectin concentration >50 μg/g delivered one additional fecal sample. All showed a lower concentration in the second sample except for one teenager who later proved to have proctitis.ConclusionsThe suggested cutoff level for adults (<50 μg/g) can be used for children aged from 4 to 17 years regardless of sex. A fecal calprotectin concentration >50 μg/g warrants follow‐up.
The Relationship Between the Concentration of Dextran Sodium Sulfate and the Degree of Induced Experimental Colitis in Weanling Rats
Authors: Shimizu Toshiaki , Suzuki Mitsuyoshi , Fujimura Junya , Hisada Ken , Yoshikazu Ohtsuka , Obinata Kaoru , Yamashiro Yuichiro 
Published: January 2024

ABSTRACTBackgroundAlthough a dextran sodium sulfate (DSS)‐induced colitis is commonly used as an ulcerative colitis (UC) model in adult rodents, there are no studies using this model in young animals. We examined differences in the severity of DSS‐induced colitis as a function of the concentration of DSS administered and sought to establish a DSS‐induced colitis model in young rats.MethodsWe administrated different concentrations of DSS solution (2%, 3%, and 4%) to 4‐week‐old weanling rats and compared their clinical findings, colonic histologic findings, mucosal leukotriene B4 (LTB4) production, and mucosal blood flow with control weanling rats and 8‐week‐old adult rats given 4% DSS for induced colitis.ResultsClinical symptoms, such as diarrhea and rectal bleeding, histologic findings, and disturbance of mucosal microcirculation in weanling rats given 4% DSS were significantly more severe than those in adult rats given the same treatment. Three of 10 rats given 2% DSS had no bloody stool and 2 of 10 rats given 4% DSS died during the experimental periods. Clinical symptoms, hemoglobin levels, histologic damage scores, mucosal LTB4 production, and mucosal blood flow became more severely deranged as the concentration of DSS increased from 2% to 4%.ConclusionThese findings suggest that we can adjust disease severity in UC model for young children by giving different concentrations of DSS to weanling rats.
Efficacy and Safety Measurements of Proton Pump Inhibitors in Infants and Children
Authors: James Laura P. 
Published: January 2024

ABSTRACTThe design of studies to evaluate the efficacy of acid‐lowering drugs in children differs significantly from study designs in adult populations. Efficacy measurements may be less extensive than those used in adult studies because of limitations that exist secondary to concerns for patient safety, parental and institutional review board acceptance of efficacy end points, and existing standards of care within the pediatric gastroenterology community. Study designs involving patients who would routinely receive acid‐lowering therapy have been successfully used to characterize the pharmacokinetics and pharmacodynamics of acid‐lowering therapies (H2 receptor antagonists) and have led to pediatric labeling for these drugs. This approach may likewise be used in the study of newer acid‐lowering agents, such as proton pump inhibitors.