bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Multicomponent Behavioral Program for Oral Aversion in Children Dependent on Gastrostomy Feedings
Authors: Byars Kelly C. , Burklow Kathleen A. , Ferguson Kathleen , O'Flaherty Therese , Santoro Kathy , Kaul Ajay 
Published: January 2024

ABSTRACTObjectivesDescribe outcomes in nine children with Nissen fundoplication and feeding gastrostomy treated in a multicomponent feeding program. The importance of comprehensive evaluation, appetite regulation, and family‐focused intervention within a behavioral feeding program are discussed.MethodsProspective clinical intervention with dependent measures evaluated before treatment, after treatment, and at follow‐up.ResultsNine children (4 girls; mean age, 3.1 ± 1.2 years; range, 1.8–5.5 years) and their mothers were admitted for intensive treatment (mean duration, 11.4 ± 1.7 days; range, 5–16 days). At discharge, 4 of 9 (44%) children were weaned completely from gastrostomy feedings. The mean oral intake of all patients increased 50% from pretreatment to posttreatment assessment. At a mean of 3.1 ± 0.5 months (range, 2.4–3.6 months) after treatment, six of nine children were weaned completely from gastrostomy feedings. The percent of daily nutritional needs consumed orally increased from a pretreatment mean of 14.6% ± 21.2% (range, 0%–67%) to a posttreatment mean of 63.4% ± 18.3% (range, 34%–85%) and a follow‐up mean of 88.1% ± 25.1% (range, 30%–100%). The mean percent ideal body weight for height was not compromised during intensive treatment.ConclusionsShort‐term intensive biobehavioral treatment was successful in improving oral intake and weaning from gastrostomy tube feeding in children with Nissen fundoplication and feeding gastrostomy.
Age and Family History at Presentation of Pediatric Inflammatory Bowel Disease
Authors: Weinstein Toba A. , Levine Mindy , Pettei Michael J. , Gold David M. , Kessler Bradley H. , Levine Jeremiah J. 
Published: January 2024

ABSTRACTObjectivesYoung children are thought to be a unique subset of pediatric patients with inflammatory bowel disease (IBD). The authors' objective was to evaluate the differences in initial clinical presentation of young and older children with IBD and to determine whether a positive family history of IBD is associated with the age of presentation.MethodsThe authors reviewed the records of all patients with new diagnoses of Crohn disease (CD) and ulcerative colitis (UC) who presented between July 1996 and July 1999. Initial evaluation included assessment of growth parameters and laboratory values (hemoglobin concentration, platelet count, erythrocyte sedimentation rate, and serum albumin). Inquiry regarding a family history of IBD was made in every patient.ResultsThere were 153 patients with new diagnoses (82 with CD and 71 with UC), with a mean age of 11.9 years (range, 16 months–18 years). The children with CD had a higher sedimentation rate and platelet count and a lower mean hemoglobin concentration and serum albumin at presentation than did children with UC. Body mass index (BMI) was significantly lower in patients with newly diagnosed CD than in those with UC. The only significant laboratory differences between patients younger than 11 years and those 11 years or older was a higher mean platelet count in patients with CD who were younger than 11 years. Of the younger patients with CD, 41.7% had a positive family history of IBD, which was significantly greater that that found in the older patients with CD.ConclusionsExcept for higher platelet counts, a lower BMI, and a higher frequency of positive family history in young children with CD, there were no significant differences in the presentation of young children with IBD compared with older children.
Impact of Helicobacter pylori Infection on Growth of Children: A Prospective Cohort Study
Authors: Bravo Luis Eduardo , Mera Robertino , Reina Julio Cesar , Pradilla Alberto , Alzate Alberto , Fontham Elizabeth , Correa Pelayo 
Published: January 2024

ABSTRACTObjectiveThe aim of this study was to prospectively follow a cohort of children without Helicobacter pylori infection and to compare growth velocity in the children who become infected during follow‐up with that of children who remained infection‐free.MethodsThree hundred forty‐seven children in general good health, aged 12 to 60 months, who tested negative for H. pylori by the 13C‐urea breath test, from three daycare centers in a lower‐middle class borough of Cali, Colombia, were monitored for 2.5 years. Anthropometric measurements were performed every 2 months and breath tests every 4 months. Linear mixed models were used to analyze growth velocity in relation to onset of H. pylori infection.ResultsOne hundred five (30.3%) children who were uninfected at the start of the study became infected during follow‐up. Growth velocity in infected children was reduced by 0.042 ± 0.014 cm/mo (P = 0.003) (approximately 0.5 cm/yr) after adjusting for age. The rate of deceleration in growth velocity was relatively constant over time.ConclusionsAmong these lower‐middle class children aged 12 to 60 months from a population with high prevalence of H. pylori infection, a new and sustained infection was followed by significant growth retardation.
Outcomes of Pediatric Gastroesophageal Reflux Disease: In the First Year of Life, in Childhood, and in Adults . . . Oh, and Should We Really Leave Helicobacter pylori Alone?
Authors: Gold Benjamin D. 
Published: January 2024

ABSTRACTThe prevalence of gastroesophageal reflux (GER) in childhood varies by age. As in adults, GER can result in a spectrum of disease manifestations. Children with gastroesophageal reflux disease (GERD) may become adults with GERD, as suggested by the frequency of childhood reflux symptoms reported by adults with reflux disease. Some studies suggest a causative association between Helicobacter pylori infection and GERD, whereas others postulate a protective role for H. pylori. To better understand pediatric GERD, age‐appropriate case definitions and multicenter randomized controlled treatment trials are critically needed.
Zinc With Oral Rehydration Therapy Reduces Stool Output and Duration of Diarrhea in Hospitalized Children: A Randomized Controlled Trial
Authors: Bhatnagar Shinjini , Bahl Rajiv , Sharma Punit K. , Kumar Geeta T. , Saxena S. K. , Bhan Maharaj K. 
Published: January 2024

ABSTRACTObjectivesThe authors evaluated the effect of zinc treatment as an adjunct to oral rehydration therapy on stool output and diarrheal duration in children with acute noncholera diarrhea with dehydration.MethodsThis double‐blind, randomized, controlled trial was conducted at two urban hospitals in New Delhi. A total of 287 dehydrated male patients, ages 3 to 36 months, with diarrhea for ≤ 72 hours were enrolled. They were assigned to zinc or placebo by a randomization scheme stratified by age (≤ or >12 months) and weight for height (65%–80% or >80% National Centre for Health Statistics median). Participants in the zinc group received 15 mg (≤12 months) or 30 mg (>12 months) elemental zinc daily in three divided doses for 14 days. The main outcome measures were stool output and diarrheal duration.ResultsZinc treatment reduced total stool output (ratio of geometric means, 0.69; 95% confidence interval [CI]: 0.48, 0.99) and stool output per day of diarrhea (ratio of geometric means, 0.76; 95% CI: 0.59, 0.98). The risk of continued diarrhea was lower (relative hazards, 0.76; 95% CI: 0.59, 0.97) and the proportion of diarrheal episodes lasting ≥ 5 days (odds ratio, 0.49; 95% CI: 0.25, 0.97) or ≥ 7 days was less (odds ratio, 0.09; 95% CI: 0.01, 0.73) in the zinc group.ConclusionsThis study demonstrates a beneficial effect of zinc administered during acute diarrhea on stool output, diarrheal duration, and proportion of episodes lasting more than 7 days. The effects are large enough to merit routine use of zinc during acute diarrhea in developing countries.
Colostomy for Treatment of Functional Constipation in Children: A Preliminary Report
Authors: Woodward Mark N. , Foley Peter , Cusick Eleri L. 
Published: January 2024

ABSTRACTObjectivesSurgery is indicated in very few children with intractable functional constipation. A number of operations have been described with unpredictable outcome and significant morbidity. The authors present a series of 10 children who underwent a Hartmann procedure with end colostomy formation.MethodPreoperative management, in addition to maximum conservative measures, included psychologic referral, rectal biopsy, transit studies, and contrast enemas. A standard Hartmann procedure was performed with on‐table rectal washout, formation of a proximal sigmoid colostomy, limited anterior resection of hypertrophic proximal rectosigmoid, and oversewing of the rectal stump.ResultsThe series includes 10 pediatric patients (4 female, 6 male), in whom constipation was first reported at a median age of 3 years (range, 2 months–7 years) and surgical referral was made at 8 years (range, 1–14 years). Surgery was performed at a median age of 9.5 years (range, 2–15 years), and the median postoperative stay was 5 days (range, 4–9 days). Complications occurred in four patients (transient mild rectal discharge in 2, stomal prolapse in 1, and an unrelated small bowel obstruction in 1 patient with an additional Mitrofanoff stoma). Median postoperative follow‐up was 31 months (range, 9–56 months), and the children and parents were all completely satisfied with the stoma.ConclusionColostomy formation is a potential surgical option for severe functional constipation with low associated morbidity and high patient satisfaction.
Infliximab in Pediatric Ulcerative Colitis: Two‐year Follow‐up
Authors: Mamula Petar , Markowitz Jonathan E. , Cohen Louis J. , von Allmen Daniel , Baldassano Robert N. 
Published: January 2024

ABSTRACTObjectivesThe role of infliximab in treating pediatric ulcerative colitis (UC) is not defined. The authors previously have described their experience with the open label use of infliximab in nine children with moderate to severe UC. The aim of this study was to describe the outcome of these patients after a minimum 2‐year follow‐up and to describe the responses of eight additional patients to this medication.MethodsThe authors reviewed all pediatric patients with UC who received infliximab at The Children's Hospital of Philadelphia from its first use until February 2003. Tolerance of the infusions and adverse events were recorded.ResultsFollow‐up information for a minimum of 2 years was reviewed for the nine initial patients. A total of 73 infliximab infusions were administered to these patients. Seven of nine (78%) patients were considered to be responders to the initial dose of infliximab. Two of these patients became nonresponders within 9 months of the first dose of infliximab and underwent colectomy. Of the remaining five (56%) patients with sustained response, two continue to receive infliximab infusions and three are doing well without infliximab. One patient experienced an infusion reaction, and one experienced herpes zoster infection. We have treated eight additional UC patients with infliximab. Seven (88%) patients were considered responders. One responder experienced relapse within 2 months. Overall, a short‐term improvement was seen in 14 of 17 (82%) patients, and sustained improvement in 10 of 16 (63%) patients followed up for more than 9 months. All five patients with severe or fulminant UC, unresponsive to 2 weeks of intravenous corticosteroid therapy, experienced improvement with infliximab. Infliximab was well tolerated.ConclusionInfliximab is associated with short‐ and long‐term clinical improvement in children and adolescents with moderate to severe UC.
Duodenogastric Bile Reflux Is Common in Cystic Fibrosis
Authors: Hallberg K. , Fändriks L. , Strandvik B. 
Published: January 2024

ABSTRACTBackgroundPatients with cystic fibrosis (CF) have a high incidence of gastroesophageal reflux disease, but few cases of mucosal injury are reported. Duodenogastric reflux has not been studied in CF but has been suggested to have a pathogenic role in producing alkaline injury to the esophageal mucosa. The aim of this study was to analyze the presence of duodenogastric reflux in patients with CF.Patients and MethodsTen patients with CF and 7 healthy volunteers participated in the study. Gastroduodenal manometry and intragastric perfusion were performed in all subjects. Gastric perfusate was analyzed for bilirubin and bile acids. Only patients and controls exhibiting normal migrating motor complexes were evaluated.ResultsEight patients with CF had normal motility recordings and had significantly higher gastric bilirubin levels compared with healthy subjects (P = 0.003). The bilirubin concentration was associated with bile acid regurgitation in five patients with CF. All bile acids were conjugated with a high glycine/taurine ratio and low levels of secondary bile acids. Small amounts of keto bile acids were found in two patients.ConclusionThe patients with CF had an increased incidence of duodenogastric reflux compared with healthy subjects. The bile acid composition was typical for CF with low levels of secondary bile acids. Although high bile acid concentration was found in the duodenogastric reflux in most patients with CF, the less toxic profile of the bile acids might possibly contribute to the low frequency of Barrett's esophagus in CF.
Bone Mineral Density and Bone Acquisition in Children and Young Adults with Cystic Fibrosis: A Follow‐up Study
Authors: Ujhelyi Rita , Treszl András , Vásárhelyi Barna , Holics Klára , Tóth Miklós , Arató András , Tulassay Tivadar , Tulassay Zsolt , Szathmári Miklós 
Published: January 2024

ABSTRACTObjective:To investigate bone mineral density and bone homeostasis in cystic fibrosis (CF) and to assess changes in a 2‐year period.Methods:Thirty‐eight patients with clinically stable CF (11 children, 16 adolescents, 11 young adults) were enrolled. No patient was treated with corticosteroids before or during the study. Weight and height Z scores and bone mineral density (BMD) Z‐score at the femoral neck and the lumbar spine were recorded at the beginning of the study and after 2 years. Osteocalcin and cross‐link excretion, both measurements of bone turnover were also measured. Correlations between BMD, bone turnover parameters, disease severity, pubertal stage, and nutritional state were calculated. The maternal BMD was also determined and related to that of the child.Results:Height and weight Z scores were normal in children and below normal in adolescents. Puberty was delayed in most patients. Bone age was lower than chronological age in adolescents. Lumbar spine and femoral neck BMD Z scores were below normal in each age group. Disease severity determined by Schwachman score correlated with lumbar BMD (r = 0.45, P < 0.02). BMD Z scores did not change during 2 year follow‐up. Maternal and patient lumbar and femoral BMD correlated significantly (r = 0.51, P < 0.01, and r = 0.54, P < 0.01, respectively).Conclusions:Bone deficit is present in patients with CF who have never received steroid treatment. Delay of puberty, chronic inflammation, or genetic susceptibility might be responsible for this phenomenon which was found in patients who had never received steroids and who were in relatively good clinical state.
Effect of Locust Bean Gum in Anti‐regurgitant Milk on the Regurgitation in Uncomplicated Gastroesophageal Reflux
Authors: Miyazawa Reiko , Tomomasa Takeshi , Kaneko Hiroaki , Morikawa Akihiro 
Published: January 2024

ABSTRACTObjectives:To evaluate the efficacy of anti‐regurgitant milk (AR milk) with reduced concentration of locust bean gum (LBG) compared with the usual commercially available concentration of this thickener.Methods:Thirty infants with daily regurgitation but no other medical problems were randomly assigned to one of two groups. Infants in group A (n = 16) were fed either HL‐450, an AR milk thickened with a commonly used concentration of LBG (0.45 g/100 mL) or control milk (HL‐00; no LBG) in a crossover manner for periods of 1 week. The order of milk was randomly chosen for each subject. Infants in group B (n = 14) were fed HL‐350, an AR milk with a reduced LBG concentration (0.35 g/100 mL), or HL‐00 in the same crossover fashion. The number of episodes of regurgitation, feeding time, and body weight gain were recorded. Three infants in group B did not complete the protocol and were excluded.Results:Both AR formulas decreased the number of regurgitation episodes by approximately 50% compared with control. Five mothers who gave their infants HL‐450 and no mothers who fed their children HL‐350 reported that the infants had difficulty sucking the formula through the nipple. Thirteen (81.3%) mothers who used HL‐450 and 9 (81.8%) mothers who used HL‐350 preferred the AR milk to the control milk.Conclusions:An AR milk with reduced LBG was as effective in reducing regurgitation as one with the usually available concentration of LBG.
Helicobacter pylori and Peptic Ulcer: Working Group Report of the Second World Congress of Pediatric Gastroenterology, Hepatology, and Nutrition
Authors: Drumm Brendan , Day Andrew S. , Gold Ben , Gottrand Frederic , Kato Seiichi , Kawakami Elisabete , Madrazo Armando , Snyder John , Thomas Julian 
Published: January 2024

ResearchDetermine the age of acquisition of H. pylori infection in diverse populations and the mode of transmission.InterventionValidate noninvasive methods for determining H. pylori colonisation in childhood.EducationTrain physicians to identify early indicators of long‐term morbidity (i.e., gastric cancer).
Inflammatory Bowel Disease: Working Group Report of the Second World Congress of Pediatric Gastroenterology, Hepatology, and Nutrition
Authors: Murch Simon H. , Baldassano Robert , Buller Hans , Chin Simon , Griffiths Anne M. , Hildebrand Hans , Jasinsky Clara , Kong Tse , Moore David , Orsi Marina 
Published: January 2024

Research
Determine the genotype‐phenotype correlation for different patient groups.
Determine whether mucosal responses in IBD differ between children and adults.
Determine the role of infectious exposures in paediatric IBD.
Intervention
Determine whether early aggressive therapy can alter the natural history of IBD.
Facilitate the rapid assessment of novel agents in paediatric practice by establishing an international paediatric IBD clinical trials bureau.
Determine the factors that improve quality of life.
Education
Determine the global epidemiology of IBD and its environmental triggers.
Establishment of IBD databases for initial presentation and follow‐up data.
Identify the factors that lead to optimal delivery of high‐quality care.
Nutrition Support for Pediatric Patients With Inflammatory Bowel Disease: A Clinical Report of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition
Authors: Kleinman Ronald E. , Baldassano Robert N. , Caplan Arlene , Griffiths Anne M. , Heyman Melvin B. , Issenman Robert M. , Lake Alan M. 
Published: January 2024

AbstractImpairment of growth and malnutrition are significant complications of inflammatory bowel disease (IBD) in pediatric patients. Since this topic was last reviewed in these pages (1), a number of studies have further explored the epidemiology and pathogenesis of these nutritional complications of IBD in an effort to provide more effective interventions to prevent the long‐term consequences of chronic nutrient deficiencies in childhood. In addition, during the past 15 years, the use of selected nutrients and microorganisms (probiotics) as primary or adjunctive therapy for the treatment of IBD has become an emerging area of great interest. The following is a Clinical Report from the Nutrition and Inflammatory Bowel Disease Committees of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition.
Dietary Nucleotides and Intestinal Blood Flow Velocity in Term Infants
Authors: Carver Jane D. , Sosa Roberto , Saste Monisha , Kuchan Matthew 
Published: January 2024

ABSTRACTObjectives:Two previous studies have shown that the addition of nucleotides to single feedings of formula is associated with increased 90‐minute postprandial superior mesenteric artery (SMA) blood flow velocity (BFV). To assess the effect of chronic feeding of nucleotide‐supplemented formula, we measured pre‐ and postprandial SMA BFV in term infants fed formula with or without added nucleotides for 4 weeks.Methods:At 1 week of age, healthy, term infants were randomized to receive formula with added nucleotides (NT+), or formula without added nucleotides (NT−) from age 1 to 5 weeks. When the infants were 5 weeks of age, SMA BFV was measured by Doppler ultrasound 15 minutes before the assigned feeding (baseline) and 30, 60, and 90 minutes after the start of feeding. A reference group of human milk‐fed infants was studied before and after breast feeding.Results:Thirty formula‐fed (NT+ = 17; NT− = 13) and 10 human milk‐fed infants were studied. Baseline BFV was similar among the three groups. BFV increased in each group from baseline to 30 minutes after initiation of feeding and progressively declined from 30 to 90 minutes in infants fed NT− formula or human milk. In infants fed NT+ formula, BFV decreased between 30 and 60 minutes. However, from 60 to 90 minutes, velocity was unchanged or increased. At 90 minutes, mean and peak systolic velocities were significantly greater in the NT+ group than the NT− group (P < 0.001).Conclusions:These data agree with those of previous studies showing increased 90‐minute postprandial SMA BFV after a feeding with nucleotide‐supplemented formula. The clinical significance of these findings is unknown.
Infliximab Therapy in 30 Patients With Refractory Pediatric Crohn Disease With and Without Fistulas in The Netherlands
Authors: de Ridder Lissy , Escher Johanna C. , Bouquet Jan , Schweizer Joachim J. , Rings Edmond H. H. M. , Tolboom Jules J. M. , Houwen Roderick H. J. , Norbruis Obbe F. , Derkx Bert H. F. , Taminiau Jan A. J. M. 
Published: January 2024

ABSTRACTObjective:The purpose of this study was to describe the clinical experience with the anti–tumor necrosis factor chimeric monoclonal antibody, infliximab, in pediatric patients with Crohn disease in The Netherlands.Design:Descriptive.Methods:Clinical response and adverse effects of infliximab were recorded for pediatric patients with Crohn disease treated from October 1992 to January 2003.Results:Thirty patients (aged 7–18 years) with refractory Crohn disease (with or without severe fistulas) were treated with infliximab. Patients were treated with up to 30 infusions. Mean follow‐up was 25.3 months. A total of 212 infusions were administered. Thirteen patients had refractory Crohn disease without fistulas. Six patients showed good long‐term response to infliximab treatment (defined as clinical index ≤10 points). Sixteen patients had refractory Crohn disease with draining fistulas. Nine showed good long‐term response (closure or nonproductiveness of fistulas). One patient with metastatic Crohn disease in the skin had a good long‐term response. Six patients developed an allergic reaction during infusion. In one patient, the allergic reaction occurred after an infliximab‐free interval of 9 years. One patient died of sepsis.Conclusions:Infliximab was an effective therapy in 53% of patients with refractory pediatric Crohn disease, with or without fistulas. Approximately half of the patients become unresponsive to infliximab therapy. Randomized controlled studies are mandatory to assess long‐term efficacy and safety to define the optimal therapeutic strategy of infliximab therapy in children with Crohn disease.