bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gut Permeability to Human α‐Lactalbumin, β‐Lactoglobulin, Mannitol, and Lactulose in Celiac Disease
Authors: Kuitunen Mikael , Savilahti Erkki 
Published: February 2024

SummaryOur objective was to examine the permeability of the gut to protein macromolecules and sugar probes and their possible association in celiac disease patients. We studied the permeability to human α‐lactalbumin, β‐lactoglobulin, mannitol, and lactulose on 46 occasions in 33 celiac disease patients in various phases of the disease; in addition, mannitol and lactulose permeability was studied in 18 healthy controls. Lactalbumin absorption was detected in 19 of 42 patients tested, more often in celiac disease patients with villous atrophy than in those with normal jejunal biopsy (p = 0.01). Higher absorption of lactalbumin was found in patients with subtotal villous atrophy than in those with normal biopsy (p = 0.02). β‐lactoglobulin was found in four of 42 patients tested. Less mannitol was absorbed by patients with either subtotal or partial villous atrophy than by those with normal histology (p = 0.001 and 0.006, respectively). Lactulose recovery was higher in newly diagnosed patients and patients with subtotal villous atrophy than in controls (p = 0.007 and 0.03, respectively). The lactulose/mannitol ratio was higher in newly diagnosed patients and patients with villous atrophy than in controls (p = 0.002 and 0.002, respectively). The correlation between permeability to lactalbumin and mannitol and lactulose was poor. We conclude that permeability to proteins and sugar molecules is abnormal in celiac disease patients with mucosal damage and that they probably reflect different mechanisms of penetration.
Endoscopic Assessment of the Colonic Response to Corticosteroids in Children with Ulcerative Colitis
Authors: Beattie R. M. , Nicholls S. W. , Domizio P. , Williams C. B. , Walker‐Smith J. A. 
Published: February 2024

SummaryTwenty children with active ulcerative colitis were assessed before and after 8 weeks of medical therapy with 5‐aminosalicylic acid (5‐ASA) derivatives and corticosteroids. Local therapy was given for distal disease (seven cases); other disease was terated with oral prednisolone (1‐2 mg/kg/day, maximum 40 mg). Eighteen of the children showed a clinical improvement on therapy, and complete remission of clinical disease activity by 8 weeks was seen in 17 (85%). C‐reactive protein was elevated initially in 10 of 20 children and returned to normal posttreatment in all but one. Reassessment of the colon after treatment showed an improved endoscopic appearance in 15 and complete remission in eight (40%). Histological improvement was seen in 13, with full remission in only three (15%). In conclusion, remission of clinical disease activity by corticosteroid therapy in ulcerative colitis may not be accompanied by endoscopic remission and uncommonly by mucosal healing. This finding may be important prognostically because of the risk of dysplasia in long‐standing persistent mucosal inflammation.
Structural Position and Amount of Palmitic Acid in Infant Formulas: Effects on Fat, Fatty Acid, and Mineral Balance
Authors: Carnielli Virgilio P. , Luijendijk Ingrid H. T. , Van Goudoever Johannes B. , Sulkers Eric J. , Boerlage Anneke A. , Degenhart Herman J. , Sauer Pieter J. J. 
Published: February 2024

SummaryThe structure of the triglycerides (TG) in human milk (HM) differs from those of vegetable oils used in infant formulas. In HM, palmitic acid is predominantly esterified to the center or β‐position of the TG, in vegetable oil, it is mainly at the external or α‐positions. These differences in configuration affect intestinal fat absorption. Fat and mineral balances were investigated in three groups of 9 healthy term infants aged 5 weeks. Infants were randomly assigned to receive one of the three study formulas from birth: (a) formula beta, resembling the structure of HM fat most closely (24% palmitic acid, 66% esterified to β‐position), (b) formula intermediate (24% palmitic acid, 39% esterified to the β‐position), and (c) regular formula (20% palmitic acid; 13% esterified to the β‐position). Fat absorption was highest in infants fed the beta formula (97.6 ± 0.9%), intermediate in those fed with the intermediate formula (93.0 ± 1.8%), and lowest in infants receiving the regular formula (90.4 ± 4.6%). Fecal calcium excretion was significantly lower in the beta group than in the other two groups (43.3 ± 18.1 vs. 59.9 ± 15.1 vs. 68.4 ± 22.3 mg · kg‐1 · day‐1 for beta, intermediate, and regular respectively). Dietary TG containing palmitic acid predominantly at the β‐position, as in HM, have significant beneficial effects on the intestinal absorption of fat and calcium in healthy term infants.
Simplified Preparation of a Refined Milk Formula Comparable to Rat's Milk: Influence of the Formula on Development of the Gut and Brain in Artificially Reared Rat Pups
Authors: Kanno Takahiro , Koyanagi Namiko , Katoku Youli , Yonekubo Akie , Yajima Takaji , Kuwata Tamotsu , Kitagawa Hiroshi , Harada Etsumori 
Published: February 2024

Background:Milk formulas for artificially reared (AR) rat pups are mostly based on complex cow's milk products, prepared by laborious and time‐consuming processes. The aim of this study was to develop a simplified procedure for preparing a refined formula and to examine its influences on gut and brain development.Methods:The formula comprised a combination of purified cow's casein and whey proteins, five kinds of edible oil, minerals, and vitamins. Detailed analyses showed that the composition of macro‐ and micro‐nutrients, osmolarity, and pH of the new formula closely resembled those of rat's milk. Rat pups, each with an intragastric cannula implanted at age 5 days, were artificially reared for the following 10‐15 days.Results:The body weight gain of AR pups matched that of mother‐reared (MR) pups. Histoplanimetrical analyses showed that the small intestine in AR pups was more developed in relation to area of a transverse section, number and length of villi, and thickness of tunica muscularis than that of MR pups. Fat components in the formula influenced the fatty acid composition and the cholesterol‐to‐phospholipid ratio in the small intestinal microvillus membrane (MVM) of AR pups, but not the MVM fluidity. Brain weight was not significantly different between the two groups at age 15‐20 days.Conclusion:This formula is useful for artificial rearing of rats and for identifying dietary components contributing to metabolic adaptation during the suckling period.
Effect of Prenatal Exposure to Ethanol on Intestinal Development of Rat Fetuses
Authors: Camps L. , Kédinger M. , Simon‐Assmann P. M. , López‐Tejero D. 
Published: February 2024

Background:Chronic alcoholism in pregnant animals and humans lead to general growth impairment in their offspring, which show multiple birth defects and delayed grown (fetal alcohol syndrome). Here we study the maturation of the intestine under the effect of chronic exposure to ethanol in utero together with associated malnutrition.Methods:Lactase, acid β‐galactosidase, maltase, and alkaline phosphatase activity profiles were monitored in 18‐, 19‐, 20‐, and 21‐day‐old fetuses from rats kept under three nutritional treatments before and during gestation: alcohol‐treated (25% ethanol in drinking water), fiber‐treated (50% cellulose‐diluted diet) as a control of the malnutrition associated with chronic alcoholism, and control or normal diet. Serum corticosterone determination and lactase immunolocalization were carried out. To detect possible direct effects of ethanol during the period of mucosa development, intestinal explants from 18‐, 19‐, and 20‐day‐old control fetuses were cultured either in the basal medium alone or in a medium containing 25 mM ethanol for 72, 48, and 24 h of incubation, respectively.Results:Following chronic ethanol exposure in utero, intestinal weight and brush‐border protein content and the specific activities of lactase, acid β‐galactosidase, maltase, and alkaline phosphatase were significantly lower than those of nutritional controls. Organ culture results, under the assay conditions stated, did not show a direct effect of ethanol 25 mM on prenatal mucosal functionality.Conclusions:All these results suggest that maternal malnutrition is not primarily responsible for the impaired intestinal maturation in rat fetuses from alcohol‐treated mothers; indirect effects of ethanol and/or its derivatives throughout embryo‐fetal development could be necessary to promote this intestinal delay.
Effect of Vitamin K1 Supplementation on Vitamin K Status in Cystic Fibrosis Patients
Authors: Beker Leila T. , Ahrens Richard A. , Fink Robert J. , O'Brien Maureen E. , Davidson Kenneth W. , Sokoll Lori J. , Sadowski James A. 
Published: February 2024

Background:Patients with cystic fibrosis are at risk for impaired vitamin K status due to fat malabsorption from pancreatic insufficiency. This study was designed to assess vitamin K status and measure the effect of vitamin K1 supplementation in cystic fibrosis patients.Methods:Eighteen outpatients participated in a crossover study to determine the effect of vitamin K1 (phylloquinone) supplementation. After obtaining initial data, each subject was randomly assigned to either a 4‐week study treatment of 5 mg oral vitamin K1 supplementation per week, or no supplementation and then crossed over to the other treatment for a second 4 week period. Plasma, serum and urine samples were collected and analyzed pre‐study and at the end of each study period.Results:The mean concentration of plasma vitamin K1 for the supplemented group was significantly higher than the unsupplemented group, [0.34 nmol/L and 0.21 nmol/L, respectively (p < 0.05)]. The percent of undercarboxylated osteocalcin increased on supplementation from 17% to 31%, (p < 0.005). Prothrombin induced in vitamin K absence (PIVKA‐II) increased on supplementation from 5 ng/mL to 22 ng/mL, (p < 0.005). The ratio of urinary gammacarboxyglutamic acid/creatinine was similar for both study periods.Conclusions:In contrast to other studies in cystic fibrosis, this study demonstrated a need for vitamin K1 supplementation. The carboxylation state of osteocalcin and PIVKA‐II were the most sensitive indices of changes in vitamin K1 status. Although the 5 mg vitamin K1/week dose improved these vitamin K parameters, normal levels were not achieved.
Oral Bacterial Therapy Reduces the Duration of Symptoms and of Viral Excretion in Children with Mild Diarrhea
Authors: Guarino Alfredo , Canani Roberto Berni , Spagnuolo Maria Immacolata , Albano Fabio , Di Benedetto Linda 
Published: February 2024

Background:Oral administration of live Lactobacillus casei strain GG is associated with the reduction of duration of diarrhea in children admitted to the hospital because of diarrhea. The purposes of this work were to investigate the clinical efficacy of oral administration of Lactobacillus in children with mild diarrhea who were observed as outpatients, and to see whether Lactobacillus GG can reduce the duration of rotavirus excretion.Methods:Duration of diarrhea was recorded in 100 children seen by family pediatricians and randomly assigned to receive oral rehydration or oral rehydration followed by the administration of lyophilized Lactobacillus casei, strain GG. Rotavirus was looked for in the stools of all children and, in those in whom results were positive, stools were examined again 6 days after the onset of diarrhea.Results:In 61 children results were positive for rotavirus and in 39 results were negative. Duration of diarrhea was reduced from 6 to 3 days in children receiving Lactobacillus GG, with a similar pattern in rotavirus‐positive and ‐negative children. Six days after the onset of diarrhea, stools in only 4 out of 31 children that received Lactobacillus GG were positive for rotavirus compared with positive findings in 25 out of 30 control subjects.Conclusions:Oral administration of Lactobacillus GG is effective in rotavirus‐positive and rotavirus‐negative ambulatory children with diarrhea. Furthermore, it reduces the duration of rotavirus excretion.
Extrahepatic Portal Vein Obstruction in Children: Anthropometry, Growth Hormone, and Insulin‐Like Growth Factor I
Authors: Mehrotra Rabindera N. , Bhatia Vijayalakshmi , Dabadghao Preeti , Yachha Surender K. 
Published: February 2024

Background:Extrahepatic portal vein obstruction has been shown to cause growth retardation in children, though literature is scant. No information is available regarding the cause of growth retardation in these patients.Methods:To document the presence of growth retardation in this disease, we studied growth and nutrition in 33 consecutive prepubertal patients. Anthropometry, fasting growth hormone, and insulin‐like growth factor I levels were compared in 22 well‐nourished patients from this group with 35 age‐matched well‐nourished controls.Results:Mean ± SD height standard deviation score of well‐nourished patients (‐1.88 ± 1.33) was significantly below that of the controls (‐1.06 ± 0.64, p < 0.01). Patients also had significantly lower midarm muscle circumference z scores (‐2.65 ± 1.09) than controls (‐1.17 ± 1.09, p < 0.0001), though triceps skinfold thickness z scores were comparable in the two groups (‐1.60 ± 0.68 vs ‐1.24 ± 0.79, p = NS). Insulin‐like growth factor I z scores were significantly lower in patients (‐1.48 ± 0.88) than in controls (‐0.49 ± 1.09, p < 0.001), whereas basal growth hormone was significantly higher in patients (4.60 ± 3.70 mIU/L) compared with controls (2.66 ± 0.82, p < 0.01).Conclusion:Extrahepatic portal vein obstruction in children leads to growth retardation. Anthropometric and preliminary hormonal evaluation suggest resistance to the action of growth hormone as a possible mechanism.
An Evaluation of the Role of Suction Rectal Biopsy in the Diagnosis of Intestinal Neuronal Dysplasia
Authors: Cord‐Udy C. L. , Smith V. V. , Ahmed S. , Risdon R. A. , Milla P. J. 
Published: February 2024

Background:German pathologists have developed a consensus for histological features of intestinal neuronal dysplasia.Methods:A blind reevaluation of ganglionic suction rectal biopsies from infants and children who initially presented with symptoms of intestinal dysmotility was made.Results:84 of 411 specimens had sufficient depth of submucosa for adequate assessment. Questionnaires or clinical interviews were employed 3‐5 years after biopsy in these 84 patients to assess the relationship between histological changes and persistent symptomology. Eighteen children were lost to follow‐up, 4 others had Hirschsprung's disease the study biopsy specimen having been taken from the pulled‐through bowel after surgical resection of the aganglionic segment. The remaining 62 patients were divided into three groups. There were six patients in group A (both obligatory criteria) and 28 in group B (nonessential, or just one of the obligatory criteria), and 28 in group C (normal appearances). On follow‐up, two of the 28 (7%) in group B, and six of the 28 (21%) in group C had persistent dysmotility symptoms.Conclusions:Histological criteria of the consensus of German Pathologists for intestinal neuronal dysplasia was unhelpful in predicting the clinical outcome and therefore, should not influence clinical management. As one of the obligatory criteria, hyperplasia of the submucosal plexus was significantly more common in neonates (<4 weeks), it is concluded that this is an age‐related variation.
Recurrence of Autoimmune Hepatitis in Children After Liver Transplantation
Authors: Birnbaum Audrey H. , Benkov Keith J. , Pittman Nanci S. , McFarlane‐Ferreira Yvonne , Rosh Joel R. , LeLeiko Neal S. 
Published: February 2024

Background:Liver transplantation is recognized as the appropriate treatment for end‐stage liver disease due to chronic active autoimmune hepatitis. While it was initially thought that the disease did not recur after transplant, it is now generally accepted that adult patients may develop recurrent disease, with studies reporting a recurrence rate of ≤25%. We have noted a higher incidence of recurrent autoimmune hepatitis in our pediatric patients undergoing liver transplant, with a high incidence of associated morbidity.Methods:We reviewed the records of six children followed up for autoimmune hepatitis who underwent orthotopic liver transplant for complications of end‐stage liver disease.Results:Of the six, five developed recurrent autoimmune hepatitis at a mean time of 11.4 months after transplant. The disease was aggressive, leading to cirrhosis and retransplant in three patients, within 1 year of recurrence. A second recurrence of disease occurred in all three retransplanted patients. One patient has received a third liver transplant, one has died, and one patient is asymptomatic on medical therapy. Autoimmune hepatitis recurred in all four patients receiving tacrolimus.Conclusion:We conclude that liver transplant for autoimmune hepatitis is likely to be palliative for most pediatric patients. Potent immunosuppressives such as tacrolimus do not protect against the development of recurrent autoimmune hepatitis.
A Position Paper of the North American Society for Pediatric Gastroenterology and Nutrition
Authors: Colletti Richard B. , Winter Harland S. , Sokol Ronald J. , Suchy Frederick J. , Klish William J. , Durie Peter R. 
Published: February 2024

ABSTRACTBackground:The North American Society for Pediatric Gastroenterology and Nutrition(NASPGN) performed a Workforce Survey to determine the current number and distribution of pediatric gastroenterologists in the United States and Canada and to estimate the supply and demand in the future in the United States.Methods:The response rate was more than 90%. There were 624 pediatric gastroenterologists in the United States, and 48 in Canada.Results:There were 2.4 pediatric gastroenterologists per million population in the United States, ranging from 3.1 per million in the Northeast to 1.9 per million in the West, and 1.6 per million in Canada. In the United States, fewer than 5 pediatric gastroenterologists retire each year, but more than 40 fellows per year complete training. In the United States, 30% of pediatric gastroenterologists believe there is already an excess supply; only 12% believe there is a shortage (p < 0.001).Conclusions:If the number of fellows who complete training each year remains unchanged, in 10 years there will be more than 950 pediatric gastroenterologists in the United States (3.3 per million population). At the same time, if the demand for pediatric gastroenterologists remains 2.4 per million population, there will be a demand for only 675.If these assumptions are correct, it is necessary to reduce the number of fellows to be trained. Although it is difficult to predict future workforce needs reliably, we recommend that the number of fellowship positions in training programs in the United States be reduced by 50% to 75%. Changes in health care in the coming years will be challenging, and effective planning is necessary for pediatric gastroenterologists to achieve their clinical, research, and educational missions.
Protein and Amino Acid Metabolism in Three‐ to Twelve‐Month‐Old Infants Fed Human Milk or Formulas with Varying Protein Concentrations
Authors: KarlslandÅkeson Pia M. , Axelsson Irene E. M. , Räihä Niels C. R. 
Published: February 2024

ABSTRACTBackground:The metabolic response to different protein intakes from breast milk and/or formulas varying in protein concentrations, in combination with supplementary foods, has not been studied in infants who are in the second half of infancy.Methods:Healthy infants, exclusively breast‐fed until 3 months old, were randomly assigned to one of three groups, F13, F15, or F18, and were given formulas with 13, 15, or 18 g/l of protein, respectively. Infants breast‐fed (B) and mixedfed (M) (breast milk and formula) at months formed the fourth and fifth groups. All infants received the same supplementary foods and were studied from ages 3 to 12 months.Results:The concentrations of albumin, prealbumin, and transferrin were similar in all groups. At 6 months, serum and urine urea concentrations were lower in B and M, compared with urea levels in the formula‐fed groups of infants. At 12 months, urine urea was lower in B + M than it was in F18. At 6 months, plasma concentrations of phenylalanine, tyrosine, and methionine were higher in all formula‐fed groups; and those of valine, isoleucine, and threonine were higher in F18 and F15 than they were in B and M. Plasma concentrations of methionine, valine, and threonine were higher in F18 than in F13. At 12 months, plasma levels of tyrosine, methionine, valine, isoleucine, and leucine were higher in F18 than they were in B + M.Conclusion:Many indexes of protein metabolism were similar in groups F13, B, and M, particularly at 6 months. In contrast, the provision of a formula with 18 g/l of protein resulted in a different metabolic pattern, which could indicate unnecessarily high protein intakes.
Alpha‐1 Antichymotrypsin Levels Are Actively Increased in Normal Colostrum
Authors: Urueña C. , Tellería J. J. , Blanco‐Quirós A. , Arranz E. , Gomez‐Carrasco J. A. 
Published: February 2024

ABSTRACTBackground:It is well known that human colostrum has important antinflammatory functions. The purpose of the current study was to determine antiprotease levels in colostrum and serum and to assess the importance of local synthesis and the electrophoretic differences in both locations.Methods:Five protease inhibitors were determined by radical immunodiffusion in colostrum and serum samples taken simultaneously from 50 healthy women, 36 to 72 hours after delivery.Results:Antithrombin III, inter‐α trypsin inhibitor, and α‐2 macroglobulin levels were undetectable in colostrum. Mean antitrypsin levels in colostrum were 6% of serum levels, but colostrum α‐1 antichymotrypsin was higher than expected (0.39 ± 0.34 g/l) in relation according to the albumin passive transport, and their mean value was 41% of serum levels. Colostrum antichymotrypsin levels did not correlate with serum antichymotrypsin levels or with colostrum albumin levels. The antichymotrypsin molecule in colostrum had a slower electrophoretic mobility when compared with that of serum antichymotrypsin, and it showed a different pattern in Western blot analysis, with a predominating 80‐kDa molecule.Conclusions:Although the origin of colostral antichymotrypsin is unclear, local production in breast epithelial cells is likely. Antichymotrypsin is increased in colostrum, and its molecule has some characteristic differences, suggesting that it has an important and specific role in infant nutrition during breast milk feeding.