bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence of late recurrence and second primary cancers 5–10 years after non‐metastatic colorectal cancer
Authors: Nors Jesper , Gotschalck Kåre Andersson , Erichsen Rune , Andersen Claus Lindbjerg 
Published: February 2024

AbstractThe fraction of patients who are cancer‐free survivors 5 years after curative‐intended surgery for colorectal cancer (CRC) is increasing, suggesting that extending surveillance beyond 5 years may be indicated. Here we estimate the incidence of late recurrence, metachronous CRC, and second primary cancers 5–10 years postoperative. All patients resected for UICC stage I–III CRC in Denmark through 2004–2013 were identified. Through individual‐level linkage of nationwide health registry data, recurrence status was determined using a validated algorithm. Cancer‐free survivors 5 years after surgery, were included. Cumulative incidence functions (CIF) of late recurrence, metachronous CRC, and second primary cancer 5–10 years postoperative were constructed. Subdistribution hazards ratios (sHR) were computed using Fine‐Gray regression. Among 8883 patients, 370 developed late recurrence (5–10‐year CIF = 4.1%, 95%CI: 3.7%–4.6%), 270 metachronous CRC (5–10‐year CIF = 3.0%, 95%CI: 2.7%–3.4%), and 635 a second primary cancer (5–10‐year CIF = 7.2%, 95%CI: 6.7%–7.7%). The risk of late recurrence was reduced for patients operated in 2009–2013 compared to 2004–2008 (2.9% vs. 5.6%, sHR = 0.52, 95% CI: 0.42–0.65). The risk of metachronous CRC was likewise reduced from 4.1% to 2.1% (sHR = 0.50, 95%CI: 0.39–0.65). While the risk of second primary cancer did not change between 2009–2013 and 2004–2008 (7.1% vs. 7.1%, sHR = 0.98, 95% CI: 0.84–1.15). Using nation‐wide 10‐year follow‐up data, we document that the incidences of late recurrence and metachronous CRC are low and decreasing from 2004 to 2013. Thus, despite increasing numbers of long‐term cancer survivors, the data do not advocate for extending CRC‐specific surveillance beyond 5 years.
Malabsorption in Giardiasis
Authors: Poley J. Rainer , Rosenfield Sheila 
Published: February 2024

SummaryInvestigations of the small bowel mucosa by scanning and transmission electron microscopy are reported in two coetaneous children with giardiasis. Serum immunoglobulins and mucosal architecture by light microscopy were normal in both, as well as activities of lactase, sucrase, and maltase. One of the children had suggestive evidence of malabsorption. Scanning and transmission electron microscopic examination of biopsied mucosa of the child with malabsorption suggested the following: increased secretory activity in crypts and increased cell damage, producing excess mucus containing extruded cytoplasm. It is hypothesized that the physicochemical properties of the mucoid material permitted ready interaction with the mucosal surface, the biochemical qualities of which could have been altered by the presence of the parasites. Close adherence of this mucoid layer to the surface gave it the aspect of a pseudomembrane which, by covering wide areas of the mucosal surface, probably functioned as an effective luminal barrier for nutrients. This pseudomembrane was not seen by light microscopy. Excessive secretion of mucus, its physicochemical and immunologic properties, and mueus‐mucosal surface interaction could have been engendered by genetic and environmental factors, which need further study. Although some mucus was present in the mucosa of the other child, it was confined to the base of the villi, and did not cover the mucosal surface. The presence of a luminal barrier (mucoid pseudomembrane) may be added to the list of mechanisms implicated in causing malabsorption in giardiasis.
Milk and Nutrient Intake of Breast‐Fed Infants from 1 to 6 Months
Authors: Dewey Kathryn G. , Lönnerdal Bo 
Published: February 2024

Summary:Dietary intake, milk composition, growth, and activity were monitored monthly for 20 breast‐fed infants from 1 to 6 months. Breast milk intake (of infants receiving no more than 50 kcal from other foods) ranged from 341 to 1,096 ml/day, with mean intake increasing from 673 to 896 ml/day from 1 to 6 months. Energy intake per kilogram body weight averaged 113 kcal/kg/day at 1 month, decreasing to 85‐89 kcal/kg/day at 5‐6 months—considerably lower than the recommended 115 kcal/kg/day. At 6 months, all infants except one were above the 10th percentile of weight‐for‐age. Nutrient content of milk samples was similar to previously reported values. Protein, iron, zinc, copper, sodium, and potassium levels declined during the first 6 months. Intakes of iron, zinc, calcium, and magnesium were lower than recommended allowances for infants. Weight‐for‐length and weight gain were significantly correlated with total energy intake, but not with activity level, during the first 6 months.
Parietal Cell Function of Full‐Term and Premature Infants
Authors: Marino Lucyndia R. , Bacon Bruce R. , Hines John D. , Halpin Thomas C. 
Published: February 2024

SummaryA 1‐h basal collection of gastric secretions was taken from 14 healthy full‐term infants (group I) and 10 premature infants (group II). Simultaneously, acid and intrinsic factor (IF) secretion was measured. In an additional group of 19 full‐term infants (group III), 16 had IF detectable in their gastric secretions immediately at birth. Volumes of gastric juice (ml/kg/h) and IF secretion (ng/ kg/h) were similar for group I and group II infants. Acid secretion (mEq/kg/h) was significantly less in group II (p < 0.01). There was a linear correlation between acid secretion (mEq/kg/h) and IF secretion (ng/kg/h) for group I (r = 0.85, p < 0.001). There was no correlation between the values for the premature infants in group II. The study documents that the parietal cell of the premature infant has the same capacity to secrete IF as the cell of the more mature infant. It also demonstrates the presence at birth of IF in gastric secretions, which suggests in utero secretion and independence from enteral feeding for stimulation.
Glycogen Storage Disease
Authors: Yudkoff Marc , Nissim Itzhak , Stanley Charles , Baker Lester , Segal Stanton 
Published: February 2024

SummaryThe effects of intragastric glucose infusions on [15N]glycine kinetics and whole body protein turnover were investigated in four children with type I and two children with type III glycogen storage disease. Either fasting or the administration of insufficient glucose was associated with a diminution in the glycine pool size relative to values observed when patients received adequate glucose. The cause of the smaller pool size was an increased fractional glycine turnover. Simultaneous determination of whole body protein turnover, using a stochastic model based on [15N]urea excretion, showed higher rates of protein synthesis, nitrogen flux, net tissue protein retention, and reutilization of amino acid nitrogen derived from protein catabolism, in patients receiving sufficient exogenous glucose. Depletion of amino acid pools, presumably because of intensive utilization of these gluconeogenic precursors when inadequate glucose is administered, was associated with a lower rate of whole body protein synthesis.
Cholestasis Associated with Total Parenteral Nutrition
Authors: Merritt Russell J. 
Published: February 2024

SummaryIt appears that neonates, especially those with very low birthweights, may be at especially high risk of developing cholestasis associated with total parenteral nutrition (TPN). Within 2 weeks of starting intravenous alimentation, it would appear highly desirable to be able to start at least small enteral feedings to interrupt the physiology of fasting. Such feedings may not have to be of much nutritional benefit to improve cholestasis. Calorie and amino acid intake should be limited to the requirements of the infant being treated. Whether protection of the TPN infusate from light is of benefit remains to be determined. Drug therapies for TPN‐associated cholestasis of infancy have not been proven safe or effective. Additional investigations to further clarify the pathogenesis of this syndrome, and clinical studies of prophylaxis and therapy, are needed to enhance our ability to provide nutritionally effective and metabolically safe parenteral nutrition.
Bloody Diarrhea—A Possible Complication of Sulfasalazine Transferred Through Human Breast Milk
Authors: Branski David , Kerem Eitan , Gross‐Kieselstein Eva , Hurvitz Haggit , Litt Ruth , Abrahamov Abraham 
Published: February 2024

Summary:Sulfasalazine very rarely causes bloody diarrhea. A 3‐month‐old infant had bloody diarrhea that could be related to sulfasalazine that had been taken by his mother and was transferred through his mother's breast milk. The patient was exclusively breast fed, and no other known etiological factors could be detected for the infant's bloody diarrhea.
Parenteral Nutrition for Infants
Authors: Koo Winston W. K. , Tsang Reginald C. , Steichen Jean J. , Succop Paul , Babcock Diane , Oestreich Alan E. , Noseworthy John , Horn Jack , Farrell Michael K. 
Published: February 2024

SummaryCalcium (Ca) and phosphorus (P) homeostasis were determined in 18 infants (birth weight, 2,810 ± 135 g; gestational age, 37.4 ± 0.5 weeks; mean ± SEM) who received high or low Ca and P content (Ca, P) parenteral nutrition (PN) with a fixed, low dose of vitamin D (25 IU/dl). Nine infants were randomized into low (standard) Ca, P (20 mg Ca and 15.5 mg P/dl) and nine into high Ca, P (60–80 mg Ca and 46.5–62 mg P/dl) PN, and then were studied for up to 6 weeks. The high Ca, P group had stable serum 1,25 dihydroxyvitamin D [1,25(OH)2D], which consistently remained within the normal range (<116 pg/ml). Tubular reabsorption of phosphorus (TRP) also was stable and remained consistently <90%. The low Ca, P group had elevated and higher 1,25(OH)2D (p = 0.03) than the high Ca, P group. The mean serum 1,25(OH)2D concentration rose from 32 to 112, 115, and 133 pg/ml over a period of 6 weeks. TRP also was higher (p = 0.02) and remained consistently >90%. There were no significant differences between groups in serum parathyroid hormone, calcitonin, Ca, Mg, P, alkaline phosphatase, vitamin D binding protein, and 25 hydroxyvitamin D concentrations; urine Ca/creatinine and Mg/creatinine ratios, and fractional excretion of sodium (Na). Thus, a “high” Ca (60 mg/dl) and P (46.5 mg/dl) content in PN solutions can result in stable serum 1,25(OH)2D and TRP, presumably reflecting minimal stress to Ca and P homeostatic mechanisms without further increase in urinary Ca excretion.
Meconium Ileus and Its Equivalent as a Risk Factor for the Development of Cirrhosis
Authors: Maurage Chantal , Lenaerts Catherine , Weber Andrée , Brochu Pierre , Yousef Ibrahim , Roy Claude C. 
Published: February 2024

Summary:Although dehydrated obstructing mucus is thought to account for the obstructive pathology involving the lungs, the pancreas, the reproductive system, and the intestinal tract, its relationship with CF‐associated liver disease remains largely hypothetical and little is known about possible risk factors. Complete clinical and autopsy records were available in 38 of 73 deaths occurring over a 10‐year period. The liver was normal in only five cases, and they were all infants. Steatosis was the only lesion present in 9, hypoxic liver disease was documented in 8, and biliary cirrhosis in 16 (focal in 10 and multilobular in 6). There was no relationship between the presence of cirrhosis, gallbladder abnormalities, age at death, and clinical status recorded during the year precoding their demise. Mucus plugs characterized by amorphous eosinophilic material within proliferated bile ductules were present in 75% of children with focal or multilobular biliary cirrhosis as opposed to 14% in those without (p = 0.015). A history of meconium ileus or its equivalent was recorded more frequently (p = 0.038) in those with cirrhosis. Finally, biliary cirrhosis was invariably present when there was a history of meconium ileus or its equivalent and when mucus plugs were noted. These findings suggest that patients with intestinal obstruction are at greater risk for the development of cirrhosis and that strategies should be developed to increase the detergent capacity of bile and its flow in order to decrease the viscosity of mucus in the biliary tree.
Infliximab Is Effective in Acute but not Chronic Childhood Ulcerative Colitis
Authors: Russell George H. , Katz Aubrey J. 
Published: February 2024

ABSTRACTPurpose:The authors report their experience with infliximab in pediatric patients with ulcerative colitis (UC).Methods:Fourteen patients were reviewed. Group 1 included five patients with newly diagnosed, fulminant colitis refractory to 7 to 10 days of intravenous steroids. Group 2 included four patients with ulcerative colitis in remission off steroid therapy who experienced relapse and were hospitalized with fulminant colitis refractory to intravenous steroids for 7 to 10 days. Group 3 included five patients chronically dependent on steroids with colitis refractory to medical management. All patients were treated on an open‐label basis with infliximab infusions of 5 mg/kg/dose at 0, 2, and 6 weeks and every 6 to 8 weeks thereafter. Follow‐up was maintained for at least 6 weeks. Clinical status was scored with the Lichtiger Colitis Activity Index (LCAI) at each visit. LCAI ≥10 was considered treatment failure. We defined success as LCAI ≤2, a score consistent with UC remission. Response was categorized for each group.Results:All patients began the study with LCAI ≥11 before infliximab treatment. All group 1 patients experienced response to infliximab. All but one (75%) patient in group 2 had a response. Only one (20%) group 3 patient had a response to infliximab.Conclusion:Infliximab was an effective agent in the treatment of acute UC in our patients. Long‐term steroid use and emergency colectomy were avoided. Infliximab was less effective in patients who were dependent on steroids.
Safety of Infliximab Treatment in Pediatric Patients with Inflammatory Bowel Disease
Authors: Friesen Craig A. , Calabro Cheryl , Christenson Kathy , Carpenter Ellen , Welchert Eleanor , Daniel James F. , Haslag Sara , Roberts Charles C. 
Published: February 2024

ABSTRACTBackground:Infliximab appears to be efficacious in the treatment of pediatric Crohn disease (CD). There are few large‐scale pediatric studies on the complications of infliximab therapy.Methods:A retrospective review of all infliximab infusions administered to IBD patients at a tertiary children's hospital was undertaken. Data was obtained from an infliximab infusion database maintained in the section of Pediatric Gastroenterology, pharmacy records and patient charts.Results:594 infusions were administered to 111 IBD patients (88 CD and 23 UC; 55 male and 56 female; ages 4 to 20 years; mean age, 13.4 years). The number of infusions ranged from 1 to 24 with a mean of 5.4/patient. Infusion reactions occurred in 8.1% of patients (seven early and two delayed) and in 1.5% of all infusions. Reactions occurred more frequently in female patients (14% versus 2%; P = 0.03). All reactions were mild and responded rapidly to treatment. Four patients had infections deemed unusual, including three cutaneous tinea infections and one case of shingles.Conclusion:Infliximab is safe in pediatric IBD patients with a low incidence of generally mild reactions that respond rapidly to intervention. Infusion reactions are more common in female patients. Our patients had no serious infectious complications, although cutaneous tinea infection may represent a newly reported associated complication.
Immunogenicity and Safety of an Inactivated Hepatitis A Vaccine in Children With Down Syndrome
Authors: Ferreira Cristina Targa , Leite Júlio César , Taniguchi Adriano , Vieira Sandra Maria , Pereira‐Lima Jorge , Silveira Themis Reverbel da 
Published: February 2024

ABSTRACTObjectives:Hepatitis A vaccine has not been investigated in children with Down syndrome. The aim of this study was to evaluate immunogenicity and safety of an inactivated hepatitis A vaccine in noninstitutionalized children with Down syndrome and compare their responses to those of healthy control children.Methods:An open, prospective, controlled trial of 127 children ages 1 to 12 years, 63 with Down syndrome and 64 healthy control subjects, was conducted at a single hospital. Inactivated hepatitis A virus (HAV) vaccine containing 720 enzyme‐linked immunosorbent assay units of alum‐adsorbed HAV was administered intramuscularly in a two‐dose schedule at 0 and 6 months. Seroconversion and anti‐HAV titers were measured at months 1 and 7.Results:Seroconversion rates at month 1 were 92% and 94% and geometric mean titers (GMT) were 164.02 and 160.77 mIU/mL in the Down syndrome (DS) and control groups, respectively. At month 7, seroconversion rates were 100% in both groups, with GMT of 1,719.86 and 2,344.90 mIU/mL in the DS and control groups, respectively (P = 0.117). Both doses were well tolerated and no significant adverse events observed. Local reaction at the injection site was the most common adverse event reported in both groups (15% in DS and 11% in controls).Conclusions:The authors’ data demonstrate a good response to HAV vaccination in children with DS living at home, with GMT not statistically different from that of healthy control children. HAV vaccine is well tolerated and highly immunogenic in children with DS.
Prebiotic Oligosaccharides in Dietetic Products for Infants: A Commentary by the ESPGHAN Committee on Nutrition
Authors: Agostoni Carlo , Axelsson Irene , Goulet Olivier , Koletzko Berthold , Michaelsen Kim F. , Puntis John W. L. , Rigo Jacques , Shamir Raanan , Szajewska Hania , Turck Dominique ,   ESPGHAN Committee on Nutrition
Published: February 2024

ABSTRACTThis article by the ESPGHAN Committee on Nutrition summarizes available information on the effects of adding prebiotic oligosaccharides to infant and follow‐on formulae. Currently there are only limited studies evaluating prebiotic substances in dietetic products for infants. Although administration of prebiotic oligosaccharides has the potential to increase the total number of bifidobacteria in feces and may also soften stools, there is no published evidence of clinical benefits of adding prebiotic oligosaccharides to dietetic products for infants. Data on oligosaccharide mixtures in infant formulae do not demonstrate adverse effects, but further evaluation is recommended. Combinations and dosages in addition to those so far studied need to be fully evaluated with respect to both safety and efficacy before their use in commercial infant food products. Well‐designed and carefully conducted randomized controlled trials with relevant inclusion/exclusion criteria, adequate sample sizes and validated clinical outcome measures are needed both in preterm and term infants. Future trials should define optimal quantity and types of oligosaccharides with prebiotic function, optimal dosages and duration of intake, short and long term benefits and safety. At the present time, therefore, the Committee takes the view that no general recommendation on the use of oligosaccharide supplementation in infancy as a prophylactic or therapeutic measure can be made.
Colostrum Protein Concentrate Enhances Intestinal Adaptation After Massive Small Bowel Resection in Juvenile Pigs
Authors: Nagy Èva S. , Paris Monique C. J. , Taylor Russell G. , Fuller Peter J. , Sourial Magdy , Justice Fran , Bines Julie E. 
Published: February 2024

ABSTRACTObjectives:Short bowel syndrome (SBS) usually results from the surgical removal of a large segment of small intestine. Patient outcome depends on the extent of intestinal resection and adaptation of the remaining intestine. We evaluated the impact of colostrum protein concentrate (CPC) on intestinal adaptation after massive small bowel resection in a porcine model of infant SBS.Methods:Four‐week‐old piglets underwent an approximate 75% small bowel resection (R, n = 23) or a control transection operation (C, n = 14). Postoperatively, animals from both groups received either pig chow (R = 6, C = 5), polymeric infant formula (R = 6, C = 3) or polymeric infant formula supplemented with CPC (R = 11, C = 6) for 8 weeks until sacrifice. Clinical outcome measures included weight gain and stool consistency. Morphologic measures were intestinal villus height and crypt depth. Functional outcome measure was mucosal disaccharidase activity.Results:Resected animals fed polymeric infant formula alone had reduced weight gain compared with controls fed the same diet (P < 0.005). Despite massive small bowel resection, animals fed pig chow or polymeric infant formula supplemented with CPC grew at an equivalent rate to controls fed polymeric infant formula alone. Resected animals supplemented with CPC had increased villus length and crypt depth in the jejunum (P < 0.001) and ileum (P < 0.001) compared with resected animals fed either pig chow or polymeric infant formula alone.Conclusion:In an animal model of SBS, CPC supplementation of polymeric infant formula resulted in normal weight gain and features of enhanced morphologic adaptation.
Bone Quantitative Ultrasound and Bone Mineral Density in Children with Celiac Disease
Authors: Hartman Corina , Hino Bayan , Lerner Aaron , Eshach‐Adiv Orly , Berkowitz Drora , Shaoul Ron , Pacht Avi , Rozenthal Eldad , Tamir Ada , Shamaly Hussein , Shamir Raanan 
Published: February 2024

ABSTRACTObjectives:Osteoporosis is the most common manifestation of untreated celiac disease (CD). Bone quantitative ultrasound (QUS) has recently emerged as a new modality for bone status assessment. We evaluated bone status in children with CD using dual‐energy x‐ray absorptiometry and quantitative ultrasound.Methods:This cross‐sectional study included 41 children (13 girls, 28 boys) aged 11.2 ± 3.6 years with CD. All children had been diagnosed with CD for at least 1 year (mean, 5.7 ± 4.3 years). The results of lumbar spine bone mineral density assessed by dual‐energy x‐ray absorptiometry and the measurements of the velocity of ultrasound wave (at distal radius and midshaft tibia sites), expressed as speed of sound in m/s, were compared between children adherent to gluten‐free diet (GFD) and non‐compliant children.Results:Speed of sound z‐scores at tibia were below −2 SD in 20 of 41 children (49%), whereas lumbar spine bone mineral density z‐scores were below −2 SD in 4 of 41 (10%) children with CD (P = 0.0002). Only 19 of 41 children were strictly compliant to GFD. The prevalence of tibia speed of sound z‐scores <−2 SD was significantly higher in non‐compliant children (15 of 22, 68%) compared with children on GFD (5 of 19, 26%), (P = 0.01). Children non‐compliant with GFD had significantly worse tibia speed of sound z‐scores (−2.3 ± 1.8, mean ± SD) compared with children on GFD (−1.2 ± 1.5, mean ± SD) (P = 0.04).Conclusions:Children with CD on a gluten‐containing diet had higher prevalence of abnormal tibia bone SOS and lower z‐scores compared with children on a GFD. These differences were not detected by spinal dual‐energy x‐ray absorptiometry or radius speed of sound. The value of quantitative ultrasound for screening and follow‐up of children with CD should be further evaluated.