bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serial Serum 25‐Hydroxyvitamin D and Mineral Homeostasis in Very Premature Infants Fed Preterm Human Milk
Authors: Hillman Laura S. , Salmons Sharon J. , Slatopolsky Eduardo , McAlister William H. 
Published: January 2024

Summary:Fourteen very low birthweight infants (mean ± SD 1,070 ± 180 g and 29.3 ± 1.9 weeks gestation) fed their own mother's milk were clinically followed until 3–4 months of age with frequent measurements of serum calcium, phosphorus, magnesium, 25‐hydroxyvitamin D (25‐OHD), parathyroid hormone, alkaline phosphatase, and albumin, and urine calcium, phosphorus, and magnesium. These infants were matched for birthweight and gestation with 14 infants (1,075 ± 152 g and 29.0 ± 1.7 weeks) who had been similarly followed during concomitant studies of infants fed standard formula (Similac 20 cal/oz). Urine phosphorus was markedly lower in the breast milkfed group from initiation of feedings, and serum phosphorus became significantly lower at and after 6 weeks of age. The fall in serum phosphorus was accompanied by a marked calciuria. Parathyroid hormone was suppressed in the breast milk‐fed group, although serum calcium was not elevated and did not differ from formula‐fed infants. A high incidence of moderate‐severe hypomineralization on radiographs was seen in both breast milk‐ and formula‐fed groups. Six of 14 breast‐fed infants required phosphorus supplementation at 8–10 weeks of age because of significant hypophosphatemia. hypercalciuria, and hypomineralization. These infants differed from those not requiring phosphorus supplements by being smaller at birth but not of lower gestation, and having persistently low serum 25‐OHD at and after 6 weeks of age.
Effect of Protein Source and Iron Content of Infant Formula on Stool Characteristics
Authors: Malacaman Edgardo E. , Abbousy Fadhil K. , Crooke Donald , Nauyok George 
Published: January 2024

Summary:Formula‐fed, term infants were evaluated in two studies that assessed the influence on stool characteristics of protein source and iron content of the formula. Parental observations of infants' stool characteristics were recorded on standard forms. Green was the primary stool color for infants receiving whey‐predominant formula containing iron at 12 mg/L. A low‐iron (1.5 mg/L), wheypredominant formula produced yellow stools. A caseinpredominant, iron‐fortified (12 mg/L) formula produced primarily yellow or brown stools, although many of the infants fed this formula also had green stools. Soft stools were common in infants fed either whey‐or casein‐predominant formulas. However, more infants receiving whey‐predominant formulas passed watery or slimy stools than did infants receiving casein‐predominant formulas. We conclude that green stools in the absence of signs of disease should be considered a normal variation of stool cofor.
Assessment of Intestinal and Cardiorespiratory Function in Children with Congenital Heart Disease on High‐Caloric Formulas
Authors: Yahav J. , Avigad S. , Frand M. , Shem‐Tov A. , Barzilay Z. , Linn S. , Jonas A. 
Published: January 2024

Summary:Fourteen infants with congenital heart disease were investigated for failure to thrive. Assessment of intestinal function revealed minor absorptive abnormalities (mild steatorrhea in three patients, bile salt loss in four patients), delayed gastric emptying, and abnormal triglyceride loading tests. Low caloric intake (88.3 ± 19.3 kcal/kg/day) seemed the main reason for failure to gain weight. Weight accession and cardiorespiratory rates were monitored daily during voluntary intake, a high‐caloric diet by mouth, and nasogastric tube feeding. Providing 169 ± 29 kcal/kg/day by tube resulted in weight gain with mild and transient elevation of respiratory rate at the end of the meal and increased heart rate 90 min after the meal. This‐regimen is a metabolically inexpensive and efficient method of supporting weight gain in children with congenital heart disease.
Impairment of Lipid Emulsion Metabolism Associated with Carnitine Insufficiency in Premature Infants
Authors: Yeh Yu‐Yan , Cooke Richard J. , Zee Paulus 
Published: January 2024

Summary:Carnitine status and its relation to lipid metabolism were determined in 11 premature infants (<34 weeks of gestation) receiving parenteral nutrition. Intravenous administration of lipid emulsion increased serum concentrations of free fatty acids at 2, 4, and 8 h after infusion. Despite this increase, serum levels of ketone bodies remained low reaching only 40 to 45% of levels in full‐term infants receiving enteral feeds. In premature infants, levels of plasma total and free carnitine were about half those in full‐term infants and were not altered by lipid infusion. The results indicate limited potential for lipid emulsion as a source of energy in premature infants, possibly because carnitine insufficiency restricts fatty acid oxidation.
Solitary Rectal Ulcer Syndrome in a Teenaged Boy
Authors: Sondheimer Judith M. , Slagle Terri A. , Bryke Christine R. , Hill Rolla B. 
Published: January 2024

Summary:Since the original description of solitary rectal ulcer by Cruveilheir in 1830, about 250 cases have been reported (1). The condition most frequently presents in adults between 30 and 50 years of age. There are very few pediatric case reports and none have come from North America. We report here a 13‐year‐old boy with solitary rectal ulcer syndrome and a review of the pediatric experience with this rare condition.
Nephritis Associated with an Infected Peritoneovenous LeVeen Shunt
Authors: Salcedo Jose R. , Sorkin Lawrence 
Published: January 2024

Summary:A patient with chronic active hepatitis and medically unmanageable ascites developed staphylococcal bacttfcaua after insertion of a peritoneovenous LeVeen shunt. The patient developed glomerulonephritis, manifested by moderate proteinuria, microscopic hematuria with red cell casts, azotemia, and evidence of complement activation. The protracted infection, urinary, and renal abnormalities subsided after removal of the LeVeen shunt and a 3‐week course of antibiotics. The clinical course of this patient is typical of the ± mediated glomer ulonephritis that has been previously well described in hydrocephalic patients with chronically infected ventriculoatrial shunts.
Immunoregulatory Functional Abnormalities in Children Affected by HBsAg‐Positive Chronic Active Hepatitis
Authors: Pignata Claudio , Vajro Pietro , Monaco Giuseppe , Fontanella Angiola 
Published: January 2024

SummarySuppressor cell function was evaluated in children affected by HBsAg‐positive chronic active hepatitis. Circulating concanavalin A‐ (ConA) precultured lymphocytes failed to suppress the proliferative response of autologous responder cells to a mitogen. In four of eight patients with a failure of ConA‐induced suppressor activity, indomethacin added during the induction phase of T suppressor cells abolished the defect, indicating that prostaglandin‐producing adherent cells may influence ConA‐induced suppressor activity. An inverse relation ship between suppressor cell activity and the number of suppressor/cytotoxic subsets defined by the OK T8 monoclonal antibody was found. Our findings strongly support the hypothesis that an abnormality in the immunoregulatory system plays a role in the pathogenesis of HBsAg‐related chronic active hepatitis. It is also suggested that non‐T regulatory cells are implicated in the immunological abnormality in chronic active hepatitis.
Evaluation of Microvilli in Gluten‐Sensitive Enteropathy by Means of Scanning and Transmission Electron Microscopy
Authors: Hardoff D. , Levanon D. , Gitay H. , Nir I. 
Published: January 2024

SummaryBiopsies from jejunum of nonceliac patients and patients with active celiac disease were studied and compared by means of transmission (TEM) and scanning (SEM) electron microscopy. Fracturing of dried specimens enabled the visualization of the epithelial microvilli with SEM. Alteration in microvillous appearance in celiac patients, as determined by TEM, could also be clearly detected in SEM images. The SEM preparation is easier to accomplish and less time‐consuming compared to the TEM. This may be an advantage for clinical assessment of jejunal biopsies in syndromes in which early detection of alterations in microvilli in the epithelial mu‐cosa is of diagnostic value.
Childhood Celiac Disease
Authors: Shmerling David H. , Franckx Johan 
Published: January 2024

SummaryThe diagnosis of celiac disease (CD) was uniformly established between 1960 and 1983 in 314 infants and children according to the following criteria: a flat proximal small bowel mucosa in untreated patients and an unequivocal response and remission on a gluten‐free diet (GFD). In 91 patients, one or more interruptions of the GFD (challenges) were documented by repeated intestinal biopsies. Sixty‐eight percent of the challenges were initiated by the patients themselves. Seventy‐one patients (Group A, 81.4%) had a flat mucosa after 0.25–14.67 years off diet. In 11 (Group B, 12%), a successive deterioration of the mucosa occurred during 0.5–6.67 years after interruption of GFD without becoming flat. Six patients (Group C, 6.6%) had a normal intestinal mucosa, after 2.24–6.92 years off diet. Three patients are still under study, being off diet for less than 2 years. Median age at diagnosis was similar in all three groups (1.16, 1.16, and 1.12 years). Median duration of GFD prior to challenge was 4.54 years in Group A, 12.16 years in Group B (p < 0.001), and 6.38 years in Group C. A mucosal relapse within 2 years after the beginning of challenge was observed in 21 of 24 patients (87.5%) studied longitudinally during planned challenges. It is concluded that only a minority (6.6%) of CD patients, when diagnosed as above, will not relapse after an interruption of GFD and that another small group (12%) will deteriorate very slowly. Routine gluten challenges in all CD patients, interrupting established life and dietary habits and including repeated biopsies in the majority of patients who deteriorate and relapse, seem therefore not justifiable.
Retinol‐Binding Protein and Prealbumin
Authors: Helms Richard A. , Dickerson Roland N. , Ebbert Mary Lou , Christensen Michael L. , Herrod Henry G. 
Published: January 2024

SummaryPlasma prealbumin (PA) and retinol‐binding protein (RBP) concentrations were serially measured in 25 critically ill, malnourished infants requiring parenteral nutrition to determine if these visceral protein markers are useful in assessing acute protein repletion. Significant increases in both proteins (p > 0.05) were noted as early as 5 to 7 days after institution of parenteral nutrition and continued significantly above baseline values through 2 weeks of observation. Gestational development (in infants less than 4 weeks old) and mean protein intake influenced visceral protein responses. Appropriate for ges‐tational age neonates had more rapid and quantitatively greater PA responses (p > 0.05) than small for gestational age neonates. Small for gestational age neonates never exceeded baseline RBP responses. Average protein intake of ≥ 2 g/kg/day resulted in PA and RBP concentrations below baseline and significantly lower than infants on higher protein intakes (p > 0.05), at the end of 2 weeks. Average calorie intake of < 100 cal/kg/day had no differential influence on PA or RBP when compared with infants on less calories. Prealbumin values correlated with RBP values observed simultaneously (r = 0.588, p > 0.0001). We conclude that PA and RBP are useful measures of protein repletion in critically ill infants requiring parenteral nutrition.
Mechanisms of Feeding Efficiency in Preterm Infants
Authors: Daniëls H. , Casaer P. , Devlieger H. , Eggermont E. 
Published: January 2024

SummaryNutritive sucking was studied in 18 preterm infants. Differences in feeding efficiency could not be explained by differences in sucking rate. Quick efficient drinking, however, was characterized by long sucking bursts and by a large amount of milk intake during each sucking movement. Slow inefficient drinking was characterized by short sucking bursts and by a small amount of milk intake during each sucking movement.
Lipid Composition of Prepartum Human Mammary Secretion and Postpartum Milk
Authors: Bitman Joel , Freed Lois M. , Neville Margaret C. , Wood D. L. , Hamosh Paul , Hamosh Margit 
Published: January 2024

SummaryChanges in lipid composition of mammary secretions of five women were studied at two prepartum periods and compared with composition of colostrum, transitional, and mature human milk. Fat content was ∼1 g/dl during early (‐42.0 days before parturition) and late (‐9.5 days) prepartum periods and increased to 3–4 g/dl in colostrum (3.0 days post partum), transitional (7.2 days), and mature milk (56.2 days). Most of the lipid present was triglyceride either pre‐ (93%) or post‐ (97%) partum. All fat globule core lipids, with the exception of 1,3‐diglycerides, increased from prepartum concentrations to levels usually found in milk. Prepartum secretions contained higher amounts of the membrane components, phospholipid (3.2 g/dl), cholesterol (2.3 g/dl), and cholesteryl ester (1.1 g/dl), which declined postpartum to 0.65, 0.37, and 0.09 g/dl, respectively. Thus, the content of core lipids exhibited an opposite pattern to the content of membrane lipids pre‐ and postpartum. With regard to synthesis of fatty acids, prepartum secretory mechanisms appeared to be very similar to those occurring postpartum since fatty acid composition of prepartum secretions closely resembled that of postpartum milk.
Inactivation of Bile‐Salt‐Stimulated Human Milk Esterase
Authors: O'Connor Charmian J. , Longbottom John R. , Walde Peter 
Published: January 2024

SummaryThe activity of bile‐salt‐stimulated esterase was monitored in human milk during storage at room temperature, in a refrigerator (4°C), in a freezer (‐ 19°C), and in milk that had been freeze dried and rehydrated after storage of the lypophilized milk at 4°C and ‐ 19°C. In all cases, there was some loss of activity, independent of measurement in the presence or absence of sodium taurocholate, and the loss was highest in milk stored at room temperature, approximating a 50% loss in 1–2 days. Activation and inactivation of solutions of the purified enzyme have been identified by measuring its esterase activity against a variety of 4‐nitrophenylalkanoate esters at pH 7.3 within the temperature range 5–46.5°C. The optimum temperature was 42°C. The presence of bile salt partially serves to maintain the conformation of the bile‐salt‐binding site as the esterolytic binding site becomes inactivated at 50°C. Bile salts thus exert a positive template effect on the enzyme.
Developmental Differences in the Effect of Natural Feeding on Early Enteric Mucosal Growth of Guinea Pigs
Authors: Thompson John F. , Singh Malathy , Wang Yvonne , Zucker Christine , Heird William C. 
Published: January 2024

SummaryIn contrast to observations in other species, neither enteric mucosal weight, protein content, nor DNA content of either the suckled or artificially fed guinea pig changes over the first 24 h following term birth. In guinea pigs delivered 5 days prematurely, however, statistically significant increases in proximal enteric mucosal mass (38%), protein content (51%), and DNA content (35%) occur in suckled animals over the first 24 h of life but not in artificially fed animals. These observations illustrate that the enteric mucosal hyperplasia secondary to natural feeding, quantitatively and temporally, is species‐specific and suggest that this effect is manifested only during a finite period of intestinal development. They raise doubts, therefore, concerning the importance of early enteric mucosal hyperplasia in adaptation of all species to extrauterine life.
Budd‐Chiari Syndrome in a Premature Infant Receiving Total Parenteral Nutrition
Authors: McClead Richard E. , Birken Gary , Wheller John J. , Hansen Nancy B. , Bickers Rex G. , Menke James A. 
Published: January 2024

SummaryA premature infant who developed Budd‐Chiari syndrome as a complication of total parenteral nutrition through an inferior vena cava catheter is presented. A novel approach to the treatment of this otherwise lethal condition is described. This very unusual complication in pediatric patients may be seen with increased frequency as more premature infants are treated with central vein total parenteral nutrition.
Statistical Analysis of Symptoms and Signs in Pediatric Patients with Peptic Ulcer
Authors: Tomomasa T. , Hsu J. Y. , Shigeta M. , Itoh K. , Ohyama H. , Terashima N. , Kambe Y. , Aoki S. , Kuroume T. 
Published: January 2024

SummaryIt is not well known which symptoms or signs related to peptic ulcer are crucial for its diagnosis in children. In order to clarify this problem, we evaluated the sensitivity, specificity, and positive and negative predictability of 13 ulcer‐related symptoms and signs. The data of 160 patients, who were suspected of having peptic ulcer and had undergone endoscopic examinations, were studied. It was significant that five symptoms, i.e., presence of pain in the epigastrium, relationship between the time of pain and that of eating, family history, vomiting, and bleeding, were frequently found in ulcer patients. There was, however, no symptom or sign that predicted by itself precisely the existence of a peptic ulcer. Thus, we computed a discriminant function by combining the data by multivariate analysis. With this score, we could predict the existence of ulcer more precisely. Finally, it was concluded (a) that epigastric pain, food‐related pain, vomiting, bleeding, and family history were crucial factors for the diagnosis of peptic ulcer in childhood and (b) that an overall consideration of symptoms and signs was needed for the evaluation of these factors.
Effect of Metoclopramide on Prolonged Intraesophageal pH Testing in Infants with Gastroesophageal Reflux
Authors: Hyams Jeffrey S. , Leichtner Alan M. , Zamett Lorna O. , Walters J. Ken 
Published: January 2024

SummaryThe effect of metoclopramide (MCP) on prolonged intraesophageal pH testing was evaluated in 42 infants with gastroesophageal reflux (GER). Following a baseline period of intraesophageal pH monitoring, MCP was administered by injection at 0.1 mg/kg/dose (10 patients), 0.2 mg/kg/dose (11 patients), or 0.3 mg/kg/dose (21 patients). The percentage of time of intraesophageal pH less than 4, reflux frequency, and acid clearance time were calculated for each subject before and after MCP for both 5% dextrose and formula feedings. These parameters were further separated into 2‐hour or shorter and more than 2‐hour postprandial periods. No significant differences with either type of feeding were noted at either 0.1 or 0.2 mg/kg/dose. Significant decreases in the percentage of time the intraesophageal pH was less than 4 (30.0 ± 2.9 versus 15.6 ± 3.1, p = 0.001), the reflux frequency (episodes/hour; 6.5 ± 0.9 versus 4.0 ± 0.6, p = 0.004), and the acid clearance time (minutes/episode; 3.8 ± 0.7 versus 2.2 ± 0.3, p = 0.047) were noted in the 2‐hour or shorter period following 5% dextrose feedings but not following the formula feedings in the subjects receiving 0.3 mg/kg/dose. Three of the 42 study patients developed increased irritability, and one developed dystonia following MCP. These data suggest that if a clinical trial of MCP in infants with GER is performed, a larger dose of the medication than previously appreciated might be required.
Duodenal Microflora in Infants with Acute Diarrheal Disease
Authors: Househam K. C. , Mann M. D. , Mitchell J. , Bowie M. D. 
Published: January 2024

SummaryThe duodenal microflora was determined qualitatively and quantitatively in a group of infants early in the course of diarrheal disease. Abnormal bacterial overgrowth in the duodenal aspirate was demonstrated in 70%. Coliforms and bacteroides species were present in significant numbers in 53%. No differences were found in the duodenal microflora distinguishing infants whose diarrhea persisted after 7 days in the hospital from those whose diarrhea resolved earlier.
Effects of Neonatal Undernutrition and Subsequent Nutritional Rehabilitation or Administration of Thyroxine and Hydrocortisone on the Inositol Phosphatase Activities in Rat Intestine
Authors: Rao R. K. , Ramakrishnan C. V. 
Published: January 2024

SummaryUndernutrition during the suckling period imposed by maternal protein deficiency during lactation resulted in elevated inositol triphosphatase activity (units per gram of wet tissue) in the ileum and lower phytase activity in the duodenum and jejunum. Activities of inositol triphosphatase in the duodenum and jejunum and phytase in ileum were unaffected. Postweaning nutritional rehabilitation resulted in elevated specific activities of both enzymes in all segments; however, activities of whole segments were similar to the corresponding control values. Elevation of inositol triphosphatase (ileum) and decline of phytase (duodenum and jejunum) activities due to undernutrition were reversed by the administration of hydrocortisone or thyroxine during undernutrition. These results suggest that maturation of activities of inositol triphosphatase in ileum (by hydrocortisone) and phytase in all segments (by both hydrocortisone and thyroxine) is under hormonal regulation, and the effects of neonatal undernutrition may be partly due to hormonal imbalances.
Hepatic Failure Following Ingestion of Multiple Doses of Acetaminophen in a Young Child
Authors: Smith David W. , Isakson Gordon , Frankel Lorry R. , Kerner John A. 
Published: January 2024

SummaryA 7‐month‐old male developed hepatic failure following the mistaken administration of multiple excessive doses of acetaminophen. Hepatic toxicity following multiple dose ingestion has been reported infrequently.Risk factors for hepatic toxicity following multiple dose ingestion are discussed.
A Single Case of Hypophosphatemic Rickets with Hypercalciuria
Authors: Nishiyama Soroku , Inoue Fumitaka , Matsuda Ichiro 
Published: January 2024

SummaryA single case of hypophosphatemic rickets with hypercalciuria and an elevated level of serum 1,25 dihydroxyvitamin D is reported. The characteristic features (genu valgum, rickets, short stature, increased renal phosphate excretion, decreased serum phosphorus level, elevated serum alkaline phosphatase level, and normal serum calcium level) were comparable to those in hypophosphatemic vitamin D resistant rickets. Massive doses of lα‐hydroxyvitamin D were not effective for the rickets and the biochemical defect in this patient. Long‐term phosphate supplementation on its own resulted in the reversal of all clinical and biochemical abnormalities except for the decreased ratio between the maximum tubular reabsorption rate for phosphorus and the glomerular filtration rate. In this patient, the concentration of serum 1.25 dihydroxyvitamin D seemed to be controlled by the concentration of serum phosphorus rather than by the serum parathyroid hormone level. It is noted that this is the first case of a single hypophosphatemic rickets with hypercalciuria.
Nutritional Regulation of Immunity and Infection
Authors: Chandra Ranjit Kumar 
Published: January 2024

SummaryMalnutrition is the most common cause of acquired immune dysfunction worldwide. Nutritional deficiencies, excesses, and imbalances influence specific components of the immune system. The severity of immunological impairment depends upon the extent and nature of undernutrition, the presence of infection, and the age of onset of nutritional deprivation. Profound immunological changes occur in children with marasmus and kwashiorkor as well as in deficiencies of vitamins A, E, B6, folate, zinc, iron, copper, and selenium. On the other hand, obesity and excessive intake of several vitamins, minerals, cholesterol, and polyunsaturated fatty acids also impair immunocompetence. These epidemiological observations and immunological phenomena are of practical significance in clinical practice.