bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Trial of Home Available, Mixed Diets Versus a Lactose‐Free, Soy‐Protein Formula for the Dietary Management of Acute Childhood Diarrhea
Authors: Alarcon Pedro , Montoya Ramon , Perez Fernando , Dongo Juan W. , Peerson Janet M. , Brown Kenneth H. 
Published: January 2024

SummaryA randomized clinical trial was completed to study the severity, duration, and nutritional outcome of acute diarrhea in 85 Peruvian children between 5 and 24 months of age who received a soy‐protein‐isolate, lactose‐free formula (group SF) or one of two mixtures of home‐available foods, all in amounts up to 110 kcal/kg of body weight/day. The mixed diets contained either wheat flour, pea flour, carrot flour, sucrose, and vegetable oil (group WP) or potato flour, dried whole milk, carrot flour, sucrose, and oil (group PM). The characteristics of the children in each group were generally similar initially. There were no differences in treatment failure rate by diet group. Fecal outputs were similar in all groups during the first day of treatment, averaging 60 to 65 g/kg/day. However, stool outputs were greater for the PM group than for other groups on days 3 and 4, and were less for the SF group than the other groups on days 5 and 6. The estimated median durations of diarrhea in the WP group (52 h) and PM group (53 h) were significantly less than in the SF group (154 h, p = 0.005). Energy intakes, energy absorption, and nitrogen retention (% of intake) were generally similar in all dietary groups, although there were minor differences in the absorption of specific macronutrients. Children in all groups gained weight during hospitalization, and there were no significant differences by diet group in the change in anthropometric status during treatment. We conclude that these locally available, low‐cost staple food mixtures offer a safe and nutritionally adequate alternative to a commercially produced lactose‐free formula for the dietary management of young children with acute diarrhea in this setting.
An Evaluation With Piglets of Bovine Milk, Hydrolyzed Bovine Milk, and Isolated Soybean Proteins Included in Infant Milk Formulas. II. Stomach‐Emptying Rate and the Postprandial Change in Gastric pH and Milk‐Clotting Enzyme Activity
Authors: Moughan Paul J. , Cranwell Peter D. , Smith William C. 
Published: January 2024

SummaryThe piglet was used as a model for the human infant to determine the effect of the protein source of a milk formula on stomach‐emptying rate and the postprandial changes in gastric pH and milk‐clotting enzyme activity. Three liquid milk formulas containing either intact bovine milk protein, hydrolyzed bovine milk protein, or isolated soybean protein as the sole source of dietary protein were given to five 37‐day‐old piglets that had undergone surgery for the preparation of a simple gastric fistula. At set times after commencement of a meal, the stomach contents were removed via a gastric cannula and weighed; then pH and milk‐clotting enzyme activity were determined. The isolated soybean protein‐based formula tended to empty from the stomach more slowly than did the bovine milk‐based formulas. Maximum difference (p < 0.05) was found at 3 h postfeeding, where 30% of the ingested soybean formula dry matter remained in the stomach; comparable values for the intact bovine milk‐based formula and hydrolysate were 22 and 12%, respectively. The type of protein did not significantly (p > 0.05) affect the postprandial change in gastric pH or gastric milk‐clotting enzyme activity. Gastric pH increased sharply after feeding, from pH 1.5 at 0 h to pH 5.2 at 1 h, and then fell gradually over the following 4 h to pH 1.84.
Effects of Different Levels of Intravenous α‐Linolenic Acid and Supplemental Breast Milk on Red Blood Cell Docosahexaenoic Acid in Very Low Birth‐Weight Infants
Authors: Rhodes Philip G. , Reddy N. Sagar , Downing Greg , Carlson Susan E. 
Published: January 2024

SummaryPreterm infants weighing <1,500 g were started on total parenteral nutrition (TPN) if unable to tolerate full enteral feedings. They were randomly assigned to receive intravenous lipids containing either 4.2 or 9.0% α‐linolenic acid to assess the effect on red blood cell (RBC) phospholipid polyenoic fatty acid composition, particularly docosahexaenoic acid (22:6n3) (DHA). DHA ultimately comes from α‐linolenic acid (18:3n3), although there is evidence in human preterm infants that they require preformed DHA. After 1 week of TPN, infants were started on gradually increasing amounts of enteral feeding, breast milk, if elected by mothers, or premature milk formula (Preemie Enfamil). RBC phospholipid fatty acids were measured weekly. Results were evaluated comparing samples from week 1 and week 6. Supplying 9% α‐linolenic acid in intravenous lipids did not prevent a fall in DHA by 6 weeks; however, infants receiving breast‐milk feeding did not have a significant decrease in DHA. Studies are needed to evaluate supplying DHA in intravenous lipids.
Recurrent Pancreatitis in Three Patients with Chronic Idiopathic Intestinal Pseudo‐obstruction
Authors: Heitlinger Leo A. , McClung H. Juhling , Murray Robert D. , Li B. U. K. 
Published: January 2024

SummaryChronic idiopathic intestinal pseudo‐obstruction is a syndrome with substantial morbidity and mortality associated both with the syndrome and with its therapy. Standard therapy has included prokinetic agents and intravenous nutritional support when oral feedings are inadequate to maintain nutriture. We report three children with chronic intestinal pseudo‐obstruction who experienced one or more attacks of pancreatitis. Two patients developed pseudocysts. One patient died. All three patients underwent cholecystectomy; one had stones, one had acalculous cholecystitis, and one had a normal gallbladder. All patients received prokinetic agents and total parenteral nutrition as therapy for their pseudo‐obstruction. Candidate mechanisms to explain the etiology for pancreatitis in chronic intestinal pseudo‐obstruction include biliary dysmotility associated with pseudo‐obstruction and excessive cholinergic stimulation due to therapy with prokinetic agents.
Salmonella typhimurium Appendicitis
Authors: Kazlow Philip G. , Freed Jeffrey , Rosh Joel R. , Reiner Mark , Dische Renata , Benkov Keith , LeLeiko Neal S. 
Published: January 2024

SummaryA child with signs and symptoms of acute gastroenteritis developed localization of her pain to the right lower quadrant. A clinical diagnosis of appendicitis was made and an inflamed appendix was found at surgery. The postoperative period was marked by high spiking fevers and profuse nonbloody diarrhea. Cultures of the appendix and the stool revealed Salmonella typhimurium. Nontyphoidal Salmonella organisms are a rare cause of acute suppurative appendicitis. Intraoperative cultures of the appendix and peritoneal fluid as well as postoperative cultures of the diarrheal fluid were crucial in elucidating the cause of this patient's unusual course.
Endoscopic Removal of Inflammatory Esophagogastric Polyps in Children
Authors: Glassman Mark , Bostwick Howard E. , Godine Louise , Newman Leonard J. 
Published: January 2024

SummaryTwo adolescent patients with inflammatory esophagogastric polyps (IEPs) are presented. In each case, the patients complained of chest pain and dysphagia. In one patient, there was no histological evidence of esophagitis in association with the IEPs. Their clinical course suggests that the presentation of IEPs in adolescents is indistinguishable from and may result in secondary gastroesophageal reflux and esophagitis. In each case, endoscopic polypectomy was utilized effectively as the mode of therapy.
Childhood Protein‐Losing Enteropathy Associated with Helicobacter pylori Infection
Authors: Cohen Herman A. , Shapiro Rivka Preminger , Frydman Moshe , Varsano Itzchak 
Published: January 2024

Helicobacter pyloriwas found in a gastric biopsy specimen of a child with protein‐losing gastropathy. Through erythromycin therapy, clinical and ultrasonographic recovery was associated with the disappearance of the pathogen on repeated biopsy. The association of H. pylori with protein‐losing gastropathy has been reported only once in children, to our knowledge. Although the causative correlation between the pathogen and the disease has not been proven yet, we suggest that future cases of protein‐losing gastropathy be studied for the presence of H. pylori and followed up by ultrasonographic investigation and urea breath test. Appropriate treatment should be given to suspected cases.
Bile Acid Stimulation of Cyclic AMP and Ion Transport in Developing Rabbit Colon
Authors: Potter Gregory D. , Sellin Joseph H. , Burlingame Susan M. 
Published: January 2024

SummaryBile acids elicit Cl secretion and increases in short circuit current (Isc) in rabbit distal colon in vitro in adult but not newborn animals. In this investigation we found that concentrations of taurodeoxycholic acid (TDC) as low as 50 μM significantly increase cyclic AMP (cAMP) in adult but not newborn colon. Further, blocking the increases of cAMP in adult colon with 3,4,5‐trimethoxybenzoate 8‐(N,N‐dimethylamino) octyl ester (TMB‐8), partially inhibited the effect of TDC on Cl secretion. TMB‐8 did not block the effect of increases in cAMP seen with vasoactive intestinal peptide (VIP), the‐ophylline, or forskolin. When newborn colon was exposed to 1 mM TDC, limited Cl secretion was elicited. Increased cAMP is not seen in newborn colon where TDC‐induced secretion is absent. Thus, increases in cAMP may represent one part of the coupling of TDC stimulation to Cl secretion.
Comparison of Glucose/Electrolyte and Maltodextrin/Glycine/Glycyl—Glycine/Electrolyte Oral Rehydration Solutions in Acute Diarrhea in Children
Authors: Khin‐Maung‐U  , Myo‐Khin  , Nyunt‐Nyunt‐Wai  , Mu‐Mu‐Khin  , Mya‐Thi  , Thein‐Thein‐Myint  
Published: January 2024

SummaryMale children (N = 101) 6–35 months of age presenting with acute watery diarrhea for 48 h at home before hospitalization were admitted into a randomized, double‐blind clinical trial. Fifty‐one children were treated with standard oral rehydration solution (ORS) (World Health Organization [WHO] formulation containing citrate) and 50 were treated with an improved ORS formulation (containing, in addition to the standard formula, 20 g maltodextrin instead of glucose, and 4 g glycine and 4 g glycyl‐glycine). None were given antibiotics. No i.v. infusions were given. Rotavirus was detected by enzyme‐linked immunosorbent assay in stools of 43 children. Clinical characteristics of children in the two treatment groups were comparable. Improved ORS did not produce significant reduction in the volume of diarrhea stools. Children given improved ORS had greater weight gain than that observed in children treated with standard ORS, but the differences were not statistically significant except at the end of the first 24 h. Among children with rotavirus diarrhea, no significant differences were observed between the 23 children who received improved ORS and the 20 who received standard ORS.
Occurrence of Acute Diarrhea in Atopic and Nonatopic Infants
Authors: Ruuska Tarja 
Published: January 2024

SummaryA cohort of 336 infants was followed from birth for a total of 717 child‐years for development of atopy and occurrence of acute diarrhea. During follow‐up 94 (28%) of the infants developed atopic eczema or gastrointestinal allergy associated with food allergens, or both. Infants with food allergy had significantly (p = 0.0074) more episodes of acute diarrhea than infants with no atopy, but there was no apparent temporal correlation between the occurrence of acute diarrhea and appearance of gastrointestinal allergy or atopic eczema. Serum IgE levels in children up to 2 years of age who had diarrhea and atopic eczema were lower than those in atopic eczema children with no diarrhea, but infants with gastrointestinal allergy who had acute diarrhea tended to have higher IgE levels than those without diarrhea. Breastfeeding over 6 months of age reduced the incidence of diarrhea in the first year of life in both atopic and nonatopic infants, but had no significant effect on the total incidence of diarrhea during the 2 year follow‐up, as infants breast‐fed longer had more diarrhea in the second year of life. Prolonged breast‐feeding also reduced the severity of diarrhea in atopic infants aged 7–12 months but not for older infants.
Medium Chain Triglyceride in the Therapy of Gastroesophageal Reflux
Authors: Sutphen James L. , Dillard Vivian L. 
Published: January 2024

SummaryCarbohydrate solutions that empty rapidly from the stomach have been shown to produce less gastroesophageal reflux (GER) during the postcibal period than more slowly emptying formulas. These observations have not been extended to complete infant formulas containing fat, carbohydrate, and protein constituents. Medium chain triglyceride has been shown to significantly accelerate gastric emptying compared to long chain triglyceride for preterm infants when investigated in commercial infant formulas. Using a previously reported acidified formula model coupled with esophageal pH probe testing, we have documented in a group of 28 infants that modification of formula by enrichment with medium chain triglyceride produced no improvement in rates of GER during the first 2 h after feeding.
Use of Ass' Milk in Multiple Food Allergy
Authors: Iacono G. , Carroccio A. , Cavataio F. , Montalto G. , Soresi M. , Balsamo V. 
Published: January 2024

SummaryWe report a study of realimentation techniques in 9 unweaned infants with multiple food hypersensitivity. The patients had presented severe symptoms of cow's milk allergy and successive attempts using milk containing soy protein and/or a semielemental formula in their alimentation did not improve their clinical condition, due to the onset of hypersensitivity to these allergens as well. After a short period of parenteral alimentation the infants were refed per os with ass' milk (250 ml/kg/day) + medium chain triglycerides (40 ml/L milk). This food was well tolerated by all patients. No negative clinical reactions were recorded and during hospitalisation average weight increase was 39.8 g/day. The follow‐up of the patients showed that ass' milk was tolerated without any problems up to an age ranging from 15 to 20 months, when cow's milk was reintroduced in some patients.
Antral and Duodenal Motor Responses to Duodenal Feeding in Preterm and Term Infants
Authors: Berseth Carol Lynn , Ittmann Patricia I. 
Published: January 2024

SummaryIn the fasting state, antral motor activity is similar in preterm and term infants, but the antral responses to feeding have not been compared in preterm and term infants. The purpose of this study was to use low‐compliance, continuous perfusion manometry to compare antral and duodenal feeding responses in 13 preterm and nine term infants within the first 14 days of life. Confirming our previous studies, fasting antral motor activity was similar in preterm and term infants, but duodenal activity differed. Individual duodenal cluster activity was of shorter duration in preterm than in term infants (p < 0.01). Motor activity in antrum and duodenum changed in both groups of infants in response to an intraduodenal milk infusion of 4 ml/kg/2 h; however, the nature of the change varied in the two regions. In term infants, the number of antral pressure waves, the duration of antral clusters, and the antral motility index decreased by one third or more during feeding when compared with fasting (all p < 0.05). In contrast to the decrease in antral activity in response to feeding, the duodenal motility index and cluster activity increased significantly during feeding compared with fasting (both p < 0.05). The divergent response of antral and duodenal motor activity in response to feedings was also seen in preterm infants. Antral pressure waves, the duration of antral clusters, and the antral motility index were decreased during feeding (all p < 0.005 or less). Conversely, the preterm duodenal motility index and the duration of cluster activity increased during feeding compared with fasting (p < 0.05 or more). The suppression of antral motor activity in response to feeding is dissimilar to that described in adults fed solids and may be nutrient related. Since these antral responses occurred in response to duodenal feedings, they may have been mediated by hormones or local reflexes that are intact as early as 26 weeks' gestation.
Relationship of Common Laboratory Parameters to the Activity of Crohn's Disease in Children
Authors: Hyams Jeffrey S. , Mandel Francine , Ferry George D. , Gryboski Joyce D. , Kibort Phillip M. , Kirschner Barbara S. , Griffiths Anne M. , Katz Aubrey J. , Boyle John T. 
Published: January 2024

SummaryThe Pediatric Crohn's Disease Activity Index (PCDAI) has been proposed as a simple instrument to aid in the classification of patients by disease severity. The PCDAI includes subjective patient reporting of symptoms, physical examination, nutritional parameters, and several common laboratory tests (hematocrit, erythrocyte sedimentation rate, albumin). In this report we examine the relationship of each of the laboratory parameters to the PCDAI, as well as to a modified Harvey‐Bradshaw Index score and physician global assessment of disease activity. Data were gathered from the clinical and laboratory observations from 133 children and adolescents at 12 pediatric gastroenterology centers in North America. A statistically significant relationship (p < 0.05) was noted between each of the laboratory tests and the PCDAI for patients with either disease limited to the small bowel or in those with colonic in volvement. For patients with disease limited to the small bowel, a statistically significant (p < 0.05) relationship was also noted between the three laboratory parameters and the modified Harvey‐Bradshaw Index and global assessment. For patients with large‐bowel involvement, the erythrocyte sedimentation rate was statistically related to the modified Harvey‐Bradshaw Index and global assessment (p < 0.01), as was hematocrit to global assessment (p < 0.01). Although the laboratory parameters used in the PCDAI appear to generally reflect disease activity in most patients, no single laboratory test is adequate to reflect disease activity in all patients. Future work will need to identify additional laboratory measures to reflect the inflammatory process and serve as important adjuncts in the assessment of disease activity.
Extensive Hepatic Necrosis in a Premature Infant
Authors: Bemtnel L. A. , Hack W. W. M. , Seldenrijk C. A. , Kneepkens C. M. F. 
Published: January 2024

SummaryA fatal case of fulminant hepatic failure that occurred in the neonatal period is reported in a premature infant born after 27‐weeks' gestation. Immediately after birth the infant had severe hypoxia and hypotension resulting from birth asphyxia, hypovolemic shock, and septicemia. At autopsy, histological appearance of the liver showed virtually total hepatocellular necrosis without features of fibrosis. Although the exact cause of hepatocellular injury cannot be fully ascertained, it is assumed that hypoxia and hypotension must have been the predominant factors leading to massive hepatic necrosis.
Comparison of Methods of Assessing 24‐Hour Intraesophageal pH Recordings in Children
Authors: Friesen Craig A. , Hayes Romy , Hodge Charles , Roberts Charles C. 
Published: January 2024

SummaryProlonged intraesophageal pH recording, an important test in the evaluation of children with suspected gastroesophageal reflux (GER) disease, may be performed and evaluated by markedly different methodologies. Twenty‐four‐hour intraesophageal pH recordings from 67 consecutive infants were evaluated by three scoring methods: early postprandial, late postprandial, and total recording. In addition, the scoring methods were evaluated for their ability to identify 20 infants with clinically defined GER‐induced acute life‐threatening events (ALTEs). There were significant positive correlations between each pair of scoring systems (early postprandial with late postprandial, early postprandial with total recording, and late postprandial with total recording). However, our data indicate that the three methods identify different groups of patients. The early and late postprandial methods disagreed in designating “normal” versus “abnormal” in approximately 20% of patients. The total recording method was more likely to label patients as normal than either of the other methods; it yielded normal results in approximately one half of patients abnormal by either the early or the late postprandial methods. Patients with GER‐induced ALTEs were identified by the early postprandial method in 90% of cases, the late postprandial method in 95% of cases, and the total recording method in only 45% of cases. By applying three different scoring methods to the same 24‐h intraesophageal pH recording, we demonstrated less‐than‐perfect correlation among the methods. Long‐term follow‐up is needed to determine if these differences are of clinical significance. We feel that effort should be directed toward standardizing the approach to intraesophageal pH monitoring in infants.
Changes in Fatty Acid Profiles of Red Blood Cell Membranes Mediated by Dietary Nucleotides in Weanling Rats
Authors: Jiménez Jesús , Boza Julio , Suárez María Dolores , Gil Angel 
Published: January 2024

SummaryDietary nucleotides have been described to play multiple physiological roles. We examined the effect of feeding, for 4 weeks, nucleotide‐supplemented diets (N‐50 and N‐250) on red blood cell (RBC) membrane fatty acid composition in weanling rats. Long‐chain polyunsaturated fatty acids (LC‐PUFA) of the n‐6 series, especially arachidonic acid, increased in total RBC phospholipids in N‐50 and N‐250 groups. Concentrations of LC‐PUFA of the n‐3 series were preserved or slightly decreased. Saturates and monoenates also decreased. Phosphatidyleth‐anolamine and sphingomyelin followed the variations observed for total phospholipids. Phosphatidylcholine showed a different response; saturated fatty acids increased while n‐6 LC‐PUFA decreased. Dietary nucleotides seem to affect the conversion of essential fatty acids to their long‐chain derivatives in weanling rats in a similar way to that occurring in newborn infants during early life. These results show that the rat may be a valid model with which to study the biochemical mechanisms by which dietary nucleotides affect fatty acid desaturation.
Veno‐occlusive Disease of the Liver After Combined Adjuvant Chemotherapy for a 1‐Year‐Old Boy with Rhabdomyosarcoma
Authors: Adachi Naoto , Matsuda Ichiro 
Published: January 2024

SummaryA tumor in the left thigh of a 1‐year‐old boy was diagnosed as rhabdomyosarcoma (stage 1). The tumor was excised and vincristine (1.5 mg/m2 given twice), actinomycin D (15 μg/kg given five times), and cyclo‐phosphamide (600 mg/m2 given once) were prescribed. On the 12th day after initiating this chemotherapy, his liver rapidly enlarged and ascites, pleural effusion, and disturbance of consciousness due to hepatic failure successively appeared. Before these clinical signs appeared, laboratory data demonstrated enhanced coagulation and fibrinolysis such as thrombocytopenia refractory to platelet transfusion and a marked increase in fibrinogen and fibrin degradation product (FDP). Hepatic veno‐occlusive disease (VOD) was suspected, and based on the laboratory data indicating enhanced coagulation, anticoagulant (gabexate mesylate; FOY), diuretic, and supportive therapy for hepatic failure was begun. The clinical course was favorable and recovery was complete in 2 months, with no sequelae. We propose that platelet count, coagulation factor levels, and FDP may be useful for the early detection of VOD, and an anticoagulant drug such as FOY is worthy of consideration for the prevention and treatment of VOD.