bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differences in Distribution and Severity of Helicobacter pylori Gastritis in Children and Adults with Duodenal Ulcer Disease
Authors: Queiroz Dulciene M. M. , Rocha Gifone A. , Mendes Edilberto N. , Carvalho Anfrisina S. T. , Barbosa Alfredo J. A. , Oliveira Celso A. , Lima Geraldo F. 
Published: January 2024

SummaryThe presence of Helicobacter pylori and the gastric mucosa histology were investigated in 15 children and 15 adults with duodenal ulcer. The microorganism was isolated from antral and oxyntic mucosa in 100% of patients, both adults and children. The results of Gram stain and preformed urease test were compared with those of culture and there was no difference in sensitivity among the tests. Antral chronic gastritis was observed in all patients. However, children presented oxyntic gastritis more frequently than adults. It was also observed that the endoscopic aspects were different in the two groups of patients. The results here observed strongly support the idea that, as well as in adults, H. pylori is the causative agent of the gastritis seen in children with duodenal ulceration. On the other hand, the histological findings of oxyntic mucosa of children with duodenal ulcer were different from those of adults.
Routine Measurements of Gluten Antibodies in Children of Short Stature
Authors: Knudtzon Jørgen , Fluge Gjermund , Aksnes Lage 
Published: January 2024

SummarySerum IgA and IgG gluten antibody levels were measured prospectively in 168 children without abdominal symptoms referred to the outpatient clinic for short stature. Elevated (>0.30 units) gluten IgA antibody levels (0.82 ± 0.22 units) were detected in five children (aged 8.5 ± 1.6 years, height standard deviation score −2.14 ± 0.26). They had probable celiac disease based on villus atrophy at duodenal biopsy, in vitro toxicity of wheat gluten, and disappearance of serum gluten antibodies after gluten withdrawal from the diet. Three of these children had elevated IgG antibody levels (>0.25 units). Elevated IgG antibody levels with normal IgA levels were demonstrated in 11 short children who had normal duodenal biopsy results. It is concluded that measurement of gluten antibodies, especially of the IgA type, should be included in the diagnostic evaluation of children with short stature.
Verotoxic Escherichia coli in Human Disease
Authors: Rosensweig Jeffrey N. , Gourley Glenn R. 
Published: January 2024

SummaryVerotoxin‐producing E. coli (most frequently E. coli 0157) have been implicated in the pathogenesis of diarrhea, hemorrhagic colitis, hemolytic uremic syndrome and thrombotic thrombocytopenic purpura. Cattle, meat products, and other sources have been found to harbor these organisms. Isolation of E. coli 0157:H7 on MacConkey‐sorbitol agar is diagnostic, yet the bacteria are difficult to detect after the first week of infection. Enzyme linked immunosorbent assays (ELISAs) can detect verotoxin in fecal filtrates in the absence of viable bacteria. Serologic evidence has also been used to support the diagnosis of verotoxin‐associated infection. Evidence supporting the etiologic role of different verotox‐ins is reviewed. Treatment remains supportive since the use of antibiotics and antimotility agents can lead to poorer outcomes. Recommendations for prevention are presented.
Liver Function in Early Congenital Syphilis
Authors: Venter André , Pettifor John M. , Duursma June , Pudifin Dennis J. , Smyth Amelia , Becker Piet J. 
Published: January 2024

SummaryIn this prospective study, neonates with clinical congenital syphilis were investigated to determine if penicillin therapy caused a deterioration in liver function. The relationship between circulating immune complexes and liver involvement was monitored, and the efficacy of steroid therapy as an adjunct in the treatment of congenital syphilis was investigated. Thirty neonates with clinical congenital syphilis were randomly assigned into two groups: one group received penicillin therapy only, and the other group penicillin and prednisone as an adjunct. Twenty‐one infants who did not have clinical or serological syphilis, born to seropositive mothers, served as a “control” group. Liver function tests, full blood counts, and immunological studies were performed at various intervals up to 3 months of age. Although the symptomatic groups differed significantly from the asymptomatic group in most of the parameters measured, there were no significant differences noted between the two symptomatic groups at any time point. No direct relationship between penicillin therapy and either deteriorating liver function or the presence of circulating immune complexes could be demonstrated. Also, prednisone therapy did not modify any of the parameters studied.
Effect of Calcium/Phosphorus Ratio on Mineral Retention in Parenterally Fed Premature Infants
Authors: Pelegano James F. , Rowe Jonelle C. , Carey Dennis E. , LaBarre Donna J. , Edgren Karl W. , Lazar Ann Marie , Horak Eva 
Published: January 2024

SummaryWe hypothesized that retention of parenterally delivered calcium (Ca) and phosphorus (P) is affected by the ratio of the delivered minerals and that a 1.7:1 ratio would be optimal since this is the ratio of retention of these minerals by the fetus. Forty‐one very low birth weight (VLBW) infants were randomly assigned to one of three total parenteral nutrition (TPN) solutions that were different only in their Ca:P ratios: 2:1 (76 mg/kg/day Ca and 38 mg/kg/day of P), 1.7:1 (76 mg/kg/day Ca and 45 mg/kg/day P), and 1.3:1 (58 mg/kg/day of Ca and 45 mg/ kg/day of P). Serum levels of calcium, phosphorus, and alkaline phosphatase, retentions of calcium and phosphorus and urinary cyclic AMP levels were measured after 48 h on the assigned Ca to P ratio. Calcium retentions were higher with the 2:1 and 1.7:1 ratios and phosphorus retentions were higher with the 1.3:1 and 1.7:1 ratios. The 1.7:1 ratio allowed for the highest absolute retention of both minerals and was the closest to published in utero accretion of calcium and phosphorus. The serum and urine studies demonstrated no abnormalities on any of the three ratios. Cyclic AMPs were not different among groups and were not elevated compared to previous reports suggesting that none resulted in parathyroid hormone (PTH) stimulation. We conclude that the 1.7:1 ratio is better than higher or lower ratios for delivery of calcium and phosphorus in TPN solutions at the quantities studied.
Liver Transplantation for Cholesteryl Ester Storage Disease
Authors: Ferry George D. , Whisennand Hartwell H. , Finegold Milton J. , Alpert Elliot , Glombicki Alan 
Published: January 2024

SummaryThis case describes a patient with cholesteryl ester storage disease who underwent liver transplantation for progressive cirrhosis, portal hypertension, ascites, and uncontrollable gastrointestinal bleeding. Four and one‐half years posttransplant, her growth improved, cholesterol levels have returned to normal, and she is clinically well except for mild hypersplenism and an elevated blood urea nitrogen (BUN) and creatinine. Serum triglycerides remain elevated, but there have been no signs of progressive renal, intestinal, vascular, or pulmonary disease.
Development and Validation of a Pediatric Crohn's Disease Activity Index
Authors: Hyams Jeffrey S. , Ferry George D. , Mandel Francine S. , Gryboski Joyce D. , Kibort Phillip M. , Kirschner Barbara S. , Griffiths Anne M. , Katz Aubrey J. , Grand Richard J. , Boyle John T. , Michener William M. , Levy Joseph S. , Lesser Martin L. 
Published: January 2024

SummaryClinical and laboratory observations of 133 children and adolescents with Crohn's disease were used to validate an index of severity of illness previously developed by a group of senior pediatric gastroenterologists at a research forum in April 1990. This pediatric Crohn's disease activity index (PCDAI) included (a) subjective reporting of the degree of abdominal pain, stool pattern, and general well‐being; (b) presence of extraintestinal manifestations, such as fever, arthritis, rash, and uveitis; (c) physical examination findings; (d) weight and height; and (e) hematocrit, erythrocyte sedimentation rate, and serum albumin. Independent evaluation of each patient by two physician‐observers was performed at the time of a visit, and each physician completed a PCDAI index and a modified Harvey‐Bradshaw index and made a “global assessment” of disease activity as none, mild, moderate, or severe. Excellent interobserver agreement was noted for the PCDAI, modified Harvey‐Bradshaw index, and global assessment. There was a strong correlation between global assessment and both the PCDAI or modified Harvey‐Bradshaw. Increasing PCDAI scores were noted with increasing disease severity, and significant differences in scores were noted between the severity groups. We propose that the PCDAI could be used in multicenter projects to facilitate patient stratification by disease severity and that longitudinal PCDAI scores might provide a numerical measure of response to therapeutic regimens.
Serum Lipids in Celiac Children
Authors: Ciampolini Mario , Bini Stefania 
Published: January 2024

SummaryThe plasma lipid levels were investigated in 45 celiac children under 3 years of age and 49 over this age at diagnosis (untreated groups), after gluten‐free diet and in comparison with irritable bowel syndrome (IBS) groups matched for size, gender, and age. Total and HDL cholesterol levels were significantly lower and triglycerides higher in celiac untreated children than in IBS control children in both age groups. HDL cholesterol significantly increased in both age groups after some months of gluten‐free diet. Total and LDL cholesterol significantly increased and triglycerides decreased in the younger group of subjects after the period of gluten‐free diet. These results may be useful for diagnostic purposes and to motivate a strict gluten‐free diet in celiac children.
Affinity Chromatographic Identification and Quantitation of Blood Group A‐Active Oligosaccharides in Human Milk and Feces of Breast‐Fed Infants
Authors: Sabharwal Hemant , Sjöblad Sture , Lundblad Arne 
Published: January 2024

SummaryThe finding of large quantities of blood group A‐active oligosaccharides in the feces of a blood group A breast‐fed infant motivated a search for the origin of these compounds. Using an affinity chromatographic technique, the nature of A‐active oligosaccharides in human milk is demonstrated. The amounts of A‐active tetrasac‐charide (A‐tetra) and the Lewis b‐active lacto‐N‐difucohexaose I (LND‐I) varied between 19–375 mg/L for A‐tetra and 14–710 mg/L for LND‐I. Using the same technique, the amounts of A‐tetra and LND‐I in milk samples from five women of different blood groups were compared with those in the feces of their breast‐fed infants. The A‐tetra was present only in feces from infants of blood group A or AB mothers and the amount per 24 h corresponded roughly to that in a 1‐L portion of milk. One of the milk samples was also analyzed for the presence of larger A‐active oligosaccharides (A‐pentasaccha‐ride, A‐hexasaccharide, and A‐heptasaccharide). Their amounts were much less as compared to the amounts present in feces. These results indicate that milk is a possible source for the smallest A‐tetrasaccharide found in the feces of breast‐fed infants, while the larger A‐active oligosaccharides might be the result of an intestinal metabolic modification
Comparison of Nonabsorbable Markers Poly R‐478 and [14C]PEG‐4,000 for Use in Developmental Absorption Studies
Authors: Stahl Gary E. , Fayer Jane C. , Ling Saidee C. , Watkins John B. 
Published: January 2024

SummaryTo determine the utility of Poly R‐478, a stable, polymeric dye (MW, 40,000), as a nonabsorbable marker for studies in the developing small intestine, it was validated by comparison to carbon 14‐labeled polyethylene glycol, MW 4,000 ([14C]PEG‐4,000) in rats from 14 to 40 days of age. The recovery and quantification of Poly R‐478 from biological samples is simple and rapid compared to other nonradioactive nonabsorbable markers. In 40‐day‐old rats simultaneously given Poly R‐478 and [14C]PEG, total recoveries were similar, the percentages of the Poly R‐478 dose and the [14C]PEG dose recovered per segment were identical, and taurocholate absorption rates calculated using each marker were comparable. Recovery of Poly R‐478 from flushed intestinal segments, determined by a one‐step extraction, was equivalent to that of [14C]PEG in 40‐day‐old rats (96.5 ± 3.7% versus 102.7 ± 10.1%; NS) but was superior to that of [14C]PEG in 21‐day‐old rats (98.0 ± 6.2% versus 63.4 ± 5.5%; p < 0.001) and 14‐day‐old rats (97.8 ± 6.7% versus 56.7 ± 12.6%; p < 0.001). Within each age group, the distribution of Poly R‐478 within the intestine was similar to that of [14C]PEG. In addition, total taurocholate absorption in the presence of Poly R‐478 was comparable to that in the presence of [14C]PEG. Complete recovery of Poly R‐478 from a suspension of liver particles and from mixtures with two commercial infant formulas was demonstrated in vitro, suggesting that Poly R‐478 may be used when foods are present in the intestine. Poly R‐478 is an effective and easily measured nonabsorbable marker and allows for development absorption studies utilizing two radiolabeled substrates.
Esophageal pH Monitoring Data During Chest Physiotherapy
Authors: Vandenplas Yvan , Diericx Ann , Blecker Uwe , Lanciers Sophie , Deneyer Michel 
Published: January 2024

SummarySixty‐three infants, aged from 1 to 4 months, were examined for gastroesophageal reflux (GER) using esophageal pH monitoring. Thirty were examined because of chronic vomiting, 21 were healthy controls examined for GER as part of a screening program for sudden infant death syndrome, and 12 had an acute respiratory disease (RD). The 24‐h pH monitoring data were within normal ranges in 26 infants (20 controls, 2 babies with emesis, and 4 with RD). Data were abnormal in 37 infants (1 control, 28 infants with emesis, and 8 with RD). All babies were submitted during a fasting awake period to a 30‐min chest physiotherapy session. In the three groups studied, the incidence of GER episodes detected by the pH probe was significantly higher during physiotherapy if compared (a) to the calculated mean incidence during a 30‐min period of the 24‐h investigation or (b) to the incidence during a fasting awake period such as that during which the physiotherapy was given (p < 0.001; Wilcoxon rank‐sum test). We conclude that chest physiotherapy significantly increases GER incidence. We therefore propose restricting chest physiotherapy to fasting periods. These data add to the confusion that already exists regarding the possible causal relationship between (acid) GER and respiratory disease.
The Curious Umbilicus
Authors: Hyman Neil , LeLeiko Neal S. , Dolgin Stephen 
Published: January 2024

SummaryOmphalomesenteric duct derivatives cause an assortment of complications, most notably intestinal hemorrhage and obstruction. Intestinal obstruction is the most lethal complication and usually results from a diverticulum with an attachment to the umbilicus. This cause of intestinal obstruction is not generally recognized pre‐operatively. We report a teenager with episodic abdominal pain, acute small bowel obstruction, and a curious umbilical deformity with an underlying omphalomesenteric duct remnant. We believe that this physical finding suggests the diagnosis in patients with intestinal obstruction who have experienced unexplained episodes of abdominal pain.
Duodenojejunal Intussusception Secondary to Hamartomatous Polyp of Brunner's Glands
Authors: Chuang Jiin‐Haur , Chen Wei‐Jen 
Published: January 2024

SummaryA case of duodenojejunal intussusception secondary to a large hamartomatous polyp of Brunner's glands was reported in a 15‐year‐old girl. Despite a great preponderance of ileocolic intussusception in childhood, this is the first reported case of duodenojejunal intussusception occurring in that age group. The diagnosis was not made by clinical examination; complete duodenal obstruction was shown in upper gastrointestinal series and by endoscopy. The intussusception was reduced manually at laparotomy, and the polyp was excised. Pathological examination revealed a preponderance of normal‐appearing Brunner's glands in the tumor, consistent with the diagnosis of Brunner's gland hamartoma.
Evidence for a Role of Volatile Amines in the Development of Neonatal Hypergastrinemia
Authors: Lichtenberger Lenard M. , Gardner James W. , Barreto José C. , Morrissv Frank H. 
Published: January 2024

SummaryWe investigated the presence of volatile aliphatic amines by fluorescamine and gas chromato‐graphic‐head space analysis in human breast milk and amniotic fluid to assess their role in neonatal hypergastrinemia. These volatile nitrogenous amino acid metabolites have been previously demonstrated to stimulate gas‐trin release in in vivo and in vitro laboratory preparations. In the present study we demonstrated that these gastrin‐stimulatory volatile amines were present in significant concentrations in breast milk during the first several weeks after parturition and in amniotic fluid. The individual amines that were identified in both human milk and amniotic fluid samples were methylamine, dimethylamine, ethylamine, trimethylamine, propylamine, isobutylamine, and butylamine. This study provides indirect evidence to support the possibility that the hypergastrinemia measured in the fetus/neonate during the period immediately before and after birth may be attributable, in part, to the ingestion of fluid containing high concentrations of gastrin‐stimulating amines.
Influence of Breast Versus Formula Milk on Physiological Gastroesophageal Reflux in Healthy, Newborn Infants
Authors: Heacock Helen J. , Jeffery Heather E. , Baker Jennifer L. , Page Megan 
Published: January 2024

SummaryThe effect of milk type on physiological, gastroesophageal reflux (GER) was studied in 37 breast‐fed and 37 formula‐fed, healthy, term neonates aged 2–8 days. The neonates were randomly selected from the public maternity ward and studied for 4 h after their morning milk feed. GER was recorded by a pH microelectrode placed 6 cm above the gastroesophageal junction and analyzed in the third and fourth postprandial hours. Sleep state was accurately defined from the electroencephalogram, electrooculogram, electromyogram, breathing, and behavioral observations. Movement was recorded from a piezo‐electric transducer. In active sleep, the breast‐fed neonates demonstrated GER episodes of significantly shorter duration than the formula‐fed neonates. The means and 95% confidence intervals (CI) were 3.0 (1.6,5.2) compared with 8.3 (5.0,13.3) min/h of active sleep respectively (p < 0.05). This could not be explained by greater milk volume or increased movement before or during reflux in formula‐fed neonates. However, the lower median pH values for GER in breast‐fed neonates, 2.0 versus 2.5, were significantly different (p < 0.05). This difference may reflect more rapid gastric emptying. The lower esophageal pH is more likely to stimulate peristalsis and thus limit the duration of reflux (shorter episodes), in the breast‐fed neonates.
Maillard Reaction Products and Lysinoalanine
Authors: Langhendries J. P. , Hurrell R. F. , Furniss D. E. , Hischenhuber C. , Finot P. A. , Bernard A. , Battisti O. , Bertrand J. M. , Senterre J. 
Published: January 2024

SummaryHeat processing is essential for the preservation of milk‐based infant formulas. Heating, however, induces a number of chemical changes during which lysine in the milk proteins reacts with reducing sugars to form Maillard reaction products (MRPs) and also reacts with the dehydroalanine resulting from cystine degradation to form lysinoalanine (LAL). Both products have been reported to induce histological changes in the straight portion of the proximal tubule in the rat kidney. This pilot study was made to investigate the urinary excretion by healthy preterm babies of MRPs and LAL contained in infant formula and to determine their influence on kidney function. Twelve healthy male preterm babies were first fed for 10 days with pooled human milk and then for 5 days with each of two experimental premature infant formulas in a cross‐over design. The infant formulas were sterilized either by ultra‐high temperature (UHT) treatment or by a conventional retort process to give products with low and high levels of MRPs and LAL, respectively. In total, some 15.6% of the initial lysine had been modified in the in‐can‐sterilized product, compared to 6.2% in the UHT product. Urinary excretion of MRP lactulosyllysine ranged from 1.3 to 3.9% of the ingested amount, whereas that of LAL ranged from 6.2 to 9.3%. The higher level of MRPs and LAL in the formulas compared to breast milk had no influence on creatinine clearance or electrolyte excretion. There was no evidence of tubular damage as determined by the urinary excretion of four kidney‐derived enzymes. Feeding of formula, however, did result in a general increase in urinary microprotein levels. This did not seem to be a reflection of tubular impairment and was probably due to a transient and normal adaptation to the higher protein content of the formulas, although an effect of MRPs and LAL could not be ruled out.
Infantile Refsum Disease
Authors: Mandel Hanna , Meiron Dan , Schutgens Ruud B. H. , Wanders Ronald J. A. , Berant Moshe 
Published: January 2024

SummaryThis article describes two siblings with infantile Refsum disease (IRD) whose initial presentation was that of malabsorption and mimicked a‐β‐ or homozygous hypo‐β‐lipoproteinemia. Failure to recognize IRD in the first‐born child precluded proper genetic counseling and prenatal diagnosis in subsequent pregnancies and also caused considerable delay in diagnosing IRD in the second child. The clinical heterogeneity of peroxisomal disorders constitutes a diagnostic challenge, which demands a high degree of awareness from the part of the clinician. This is particularly the case with IRD, where protracted diarrhea with low serum cholesterol levels appears to be a frequently occurring initial feature during the 1st months of life.
Contribution of Ultrasonography in the Diagnosis of Achalasia
Authors: Bergami G. L. , Fruhwirth R. , Di Mario M. , Fasanelli S. 
Published: January 2024

SummaryWe present a case of achalasia diagnosed with the aid of ultrasonography (US). After having examined the clinical‐radiological characteristics of the disease, and after having noted the diagnostic possibilities of manometry and endoscopy, we emphasize the use of US to clearly show the thickening of the muscular wall and the dilatation of the distal esophagus. In those of pediatric age, particularly, US permits differential diagnosis with the esophageal leiomyoma, which is difficult to obtain with other techniques. We suggest, therefore, including US in the study of patients with stenosis of the third distal section of the esophagus.
Vascular Compromise Prior to Intestinal Manifestations of Crohn's Disease in a 14‐Year‐Old Girl
Authors: Van Elburg R. M. , Henar E. L. , Bijleveld C. M. A. , Prins T. R. , Heymans H. S. A. 
Published: January 2024

SummaryVascular manifestations as extraintestinal symptoms of Crohn's disease are rare and only occasionally reported in children. A 14‐year‐old girl with vascular compromise prior to intestinal manifestations of Crohn's disease is described. The vascular symptoms were due to segmental narrowing of several major arteries as shown by angiography. This kind of vascular involvement in our patient is different from the pattern described in Crohn's disease and resembles Takayasu's disease. Recently, it has been suggested that Crohn's disease could be mediated by multifocal gastrointestinal infarction due to chronic focal mesenteric arteritis at the level of the muscularis propria of the gut. In Takayasu's disease, a granulomatous inflammation of the vasa vasorum of affected vessels is frequently found. An intramural arteritis, granulomatous in nature, could be the common pathway in both Crohn's and Takayasu's diseases. Until the etiologies of both diseases are uncovered, the interrelation between them will remain subject to speculation.