bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of Oral Inoculation With Plasmid‐Free Human Escherichia coli on the Frequency of Diarrhea During the First Year of Life in Human Newborns
Authors: Figueiredo Paulo Pimenta , Vieira Enio Cardillo , Nicoli Jacques Robert , Nardi Regina Drummond , Raibaud Pierre , Duval‐Iflah Yvonne , Penna Francisco José 
Published: January 2024

ABSTRACTBackgroundThis study was carried out to determine whether early inoculation of the plasmid‐free human Escherichia coli into human newborns would reduce the frequency of acute diarrhea during a 1‐year period. The plasmid‐free E. coli strain isolated from the fecal microbiota of a healthy adult was nontoxigenic in vivo and in vitro and sensitive to all usual antibiotics.MethodsIn the experimental group, 51 healthy newborns were inoculated orally with 10 6 viable cells of the bacteria within 2 hours after birth. In the control group, the same number of newborns received the heat‐killed bacteria. The clinical trial was double blind, and the newborns were randomly assigned to the experimental and control groups.ResultsSix months and 1 year after bacterial inoculation, infants in the experimental group showed a higher mean body weight (7.59 ± 1.15 kg and 9.88 ± 1.31 kg, respectively;P < 0.05) when compared with the control group (7.03 ± 1.09 kg and 8.92 ± 1.38 kg, respectively). At the end of the clinical trial, 48% (23/48) of the infants in the experimental group had shown at least one diarrhea episode during the 1‐year period, as opposed to 71% (34/48) in the control group. These values were significantly different (P = 0.037), showing a 32.3% protective effect of inoculation.ConclusionsThe present study shows that protection against diarrhea was obtained by oral inoculation with a single dose of plasmid‐free human E. coli soon after birth.
Hepatobiliary and Pancreatic Complications of Ascariasis in Children: A Study of Seven Cases
Authors: Bahú Maria da Graça Soares , Baldisseroto Matteo , Custodio Carolina Moraes , Gralha Clarissa Zavagna , Mangili Alexandre Rampinelli 
Published: January 2024

ABSTRACTObjectivesThis study presents seven cases of severe hepatobiliary and pancreatic complications of ascariasis in children. The authors describe the clinical, laboratory, and imaging findings, as well as the patients’ clinical evolution.MethodsThese cases were studied within a period of approximately 1 year and included children younger than 11 years (mean age, 4.4 years). The authors reviewed their medical history and evaluated the results of their main diagnostic examinations.ResultsAll of the patients had vomiting, abdominal pain, pallor, and abdominal distension at presentation. Passage of Ascaris lumbricoides in stool occurred in five cases, emesis with worms in three, fever in three, and hepatomegaly in two. Five patients had pancreatitis, of which two were necrohemorrhagic and one had pseudocyst of the pancreas. In three patients, A. lumbricoides was present in the pancreatic duct. Two patients had hepatic abscess (28.6%), and one of them also had cholangitis. One of the patients with pancreatitis also had signs of cholecystitis at presentation.ConclusionsUltrasonography was the imaging diagnostic method of choice and demonstrated the presence of A. lumbricoides in the biliary and the pancreatic ducts, as well as signs of pancreatitis, cholecystitis, and hepatic abscess. Endoscopic retrograde cholangiopancreatography, used to confirm the diagnosis, was a fundamental procedure in the treatment, allowing the removal of worms from the biliary duct in four of seven patients.
Pediatric “PSC‐IBD”: A Descriptive Report of Associated Inflammatory Bowel Disease Among Pediatric Patients With PSC
Authors: Faubion W. A. , Loftus E. V. , Sandborn W. J. , Freese D. K. , Perrault J. 
Published: January 2024

ABSTRACTBackgroundInflammatory bowel disease (IBD) in adults with primary sclerosing cholangitis (PSC) is characterized by pancolonic involvement, a high frequency of rectal sparing, and an increased risk of pouchitis and colorectal neoplasia. The clinical features of IBD in pediatric patients with PSC have not been well described. The aim of this study was to characterize the frequency, clinical features, and natural history of IBD in pediatric patients diagnosed with PSC.MethodsA retrospective chart review was performed for all patients 18 years of age or younger diagnosed with PSC seen at the Mayo Clinic between 1975 and 1999. Endoscopic and histologic features and surgical and postsurgical outcomes were recorded.ResultsFifty‐two children with PSC were identified. Forty‐three patients (84%) were also diagnosed with IBD. In 36 of 43 cases, there was a sufficient diagnostic evaluation to allow a detailed review. Thirty‐two of 36 patients (89%) had ulcerative colitis and 4 of 36 patients (11%) had Crohn’s disease. In 4 of 36 patients (11%), IBD was asymptomatic. Although the most frequent endoscopic presentation of IBD was universal colitis, endoscopic rectal sparing was frequently noted (27% of colonoscopic studies). Of the four patients diagnosed with Crohn disease, in none did perianal, fistulizing, or stricturing disease develop. Proctocolectomy was performed in six patients (17%); three operations were performed for dysplasia. Pouchitis complicated four of the five ileal pouch–anal anastomoses procedures.ConclusionsAmong pediatric patients (1) PSC without IBD is uncommon; (2) asymptomatic IBD may be associated with PSC; (3) because the time to dysplasia may be accelerated, once the diagnosis of IBD is made in the setting of PSC, heightened endoscopic surveillance may be indicated; (4) pouchitis occurs frequently in these patients.
Laparoscopic and Thoracoscopic Esophagomyotomy for Children With Achalasia
Authors: Mehra M. , Bahar R. J. , Ament M. E. , Waldhausen J. , Gershman G. , Georgeson K. , Fox V. , Fishman S. , Werlin S. , Sato T. , Hill I. , Tolia V. , Atkinson J. 
Published: January 2024

ABSTRACTBackgroundMinimally invasive esophagomyotomy, consisting of a laparoscopic or thoracoscopic approach, has become a preferred surgical treatment for adults with achalasia. This multicenter study reports on the clinical status of children who have undergone minimally invasive esophagomyotomy for achalasia.MethodsSymptomatology for achalasia was assessed in 22 pediatric patients who underwent minimally invasive esophagomyotomy for achalasia between 1995 and 2000. All patients were evaluated for duration of hospitalization, postoperative resumption of feeds, postoperative complications, and symptomatic relief. Participants were assigned pre‐and postoperative symptom severity scores ranging from 0 (no symptoms) to 3 (severe).ResultsThe median age of the 10 females and 12 males at time of surgery was 11.3 years ± 3.4 (standard deviation). Transabdominal laparoscopic esophagomyotomy with fundoplication was performed in 18 patients, and thoracoscopic esophagomyotomy without fundoplication was performed in 4. Two patients required conversion from transabdominal laparoscopic esophagomyotomy to open esophagomyotomy because of intraoperative esophageal perforation. The mean duration of postsurgical follow‐up was 17 ± 16 (standard deviation) months (range, 1–54 months). Mean duration of hospitalization (days ± standard error or mean) was less for transabdominal laparoscopic esophagomyotomy than for converted open esophagomyotomy (2.7 ± 0.3 vs. 9.0 ± 3.0 days;P < 0.05) or for thoracoscopic esophagomyotomy (4.8 ± 1.7 days;P = not significant). Mean time to resumption of soft feedings (days ± standard error or mean) occurred sooner after transabdominal laparoscopic esophagomyotomy than after converted open esophagomyotomy (2.0 ± 0.2 vs. 5.5 ± 0.5 days;P < 0.001) or after thoracoscopic esophagomyotomy (4.0 ± 1.3 days;P = not significant). Patients experienced significant pre‐to postoperative improvement in mean severity score with regard to dysphagia (2.6 vs. 0.4;P < 0.001) and regurgitation (1.7 vs. 0.2;P < 0.001).ConclusionsMinimally invasive esophagomyotomy can provide excellent symptomatic relief from dysphagia and regurgitation for children with achalasia.
Hiatal Hernia in Pediatric Gastroesophageal Reflux
Authors: Gorenstein Arkadi , Cohen Amram J. , Cordova Zohar , Witzling Michaela , Krutman Boris , Serour Francis 
Published: January 2024

ABSTRACTBackgroundThis study compares esophageal pH‐monitoring parameters of children with gastroesophageal reflux (GER) with or without hiatal hernia (HH) and determines the outcome of those with GER and HH.MethodsAmong 718 children with GER, 45 children (6%) with associated HH were retrospectively studied. They were divided into those with neurologically normal development (NN, n = 35) and those with neurologic disorders (ND, n = 10). The pH‐monitoring parameters of 27 of these (60%) were compared with pH‐monitoring parameters of 27 control children who had GER without HH.ResultsEsophageal clearance was longer in patients with HH compared with those without HH (P < 0.05). All 35 NN patients underwent a trial of conservative treatment, which failed in 9 patients (25.7%). Surgery was the initial treatment in 8 ND patients. Follow‐up was available in 20 NN and 10 ND patients. Nine of 11 conservatively treated NN patients improved. All NN (n = 9) and ND (n = 8) patients who underwent surgery improved. Conservative treatment failed in 2 NN and in 2 ND patients.ConclusionsPresence of HH in children with GER is associated with prolonged exposure of the esophagus to acid and a high failure rate of nonoperative treatment. However, medical treatment should be tried in NN children despite the significant failure rate.
Renal Excretion of Calcium and Phosphorus in Premature Infants With Incipient Late Metabolic Acidosis
Authors: Kalhoff H. , Diekmann L. , Rudloff S. , Manz F. 
Published: January 2024

ABSTRACTBackgroundPremature infants receiving alimentation with cow milk–based formulas run a considerably high risk of incipient late metabolic acidosis, an early stage developing of manifest late metabolic acidosis. Is bone metabolism involved in pathophysiologic mechanisms characterizing this early stage of retention acidosis?MethodsUrinary ionography was performed in 10 premature infants with spontaneous development of incipient late metabolic acidosis (indicated by urine pH < 5.4 on 2 consecutive days) and 10 pair‐matched premature infants with normal values of urine pH; both groups were receiving full oral nutrition with the same standard formula. Moreover, in 37 premature infants with incipient late metabolic acidosis who were randomly allocated to oral therapy with 2 mmol · kg −1 · d −1 of either NaHCO 3 or NaCl over a period of 7 days, urinary excretion of calcium and phosphorus was assessed on day 1 and day 7.ResultsIncipient late metabolic acidosis was accompanied by increased phosphaturia in premature infants receiving full oral nutrition. Seventeen premature infants receiving NaCl therapy (19 treatment periods) showed increased calciuria from day 1 to day 7, whereas, in 20 premature infants receiving NaHCO 3 therapy (23 treatment periods), calcium or phosphorus excretion in urine did not increase.ConclusionsThe data of urinary calcium and phosphorus excretion in premature infants support the hypothesis that bone mineralization may already be impaired in the early stage of incipient late metabolic acidosis.
Prevalence of TT Virus in Healthy Children and Thalassemic Pediatric and Young Adult Patients
Authors: Kondili Loreta A. , Pisani Giulio , Beneduce Francesca , Morace Graziella , Gentili Giuliano , Ballati Guiduccio , Rapicetta Maria 
Published: January 2024

ABSTRACTBackgroundThe recently discovered TT virus (TTV) has been shown to be highly prevalent in patients with cryptogenetic chronic liver disease and fulminant hepatitis. To study the frequency of TTV and to evaluate the possible association with liver disease, 37 pediatric and young adult patients with thalassemia, and 36 healthy children were included in the study. The sera of 100 blood donors selected randomly in the same period were also tested for TTV DNA.MethodsThe TTV amplification by polymerase chain reaction (PCR) was performed using a first set of primers that recognize an internal sequence into N22 and a second set of primers amplifying a sequence within 5´NCR (5´ noncoding region).ResultsThe first set of primers revealed TTV DNA in 73% of thalassemic patients, in 8% of healthy children, and in 5% of healthy blood donors. With the second set of primers, the prevalence of TTV DNA was, respectively, 100% in thalassemic patients, 44.5% in healthy pediatric patients, and 87% in healthy blood donors. All individuals who tested positive for TTV by the first set of primers were also positive by the second primer set. The TTV infection seemed not to be the cause of altered transaminase levels. Sequencing of TTV clones from thalassemic patients showed the presence of different TTV variants in the same serum.ConclusionThe prevalence of TTV in polytransfused children is similar to that detected in blood donors. Moreover, TTV can be detected in healthy children of all ages. The presence of TTV seems to have no clinical significance.
Niemann‐Pick Disease Type C in Neonatal Cholestasis at a North American Center
Authors: Yerushalmi Baruch , Sokol Ronald J. , Narkewicz Michael R. , Smith Debra , Ashmead Josephine W. , Wenger David A. 
Published: January 2024

ABSTRACTObjectiveTo determine the frequency of Niemann‐Pick disease type C (NPC) among children being evaluated for neonatal cholestasis during a 2‐year period.MethodsMedical records were reviewed from all infants with cholestasis and all patients with NPC evaluated at our center from January 1997 through December 1998.ResultsForty neonates with cholestasis were evaluated, including three patients diagnosed with NPC (age at diagnosis, 5–21 months) who were originally labeled as having idiopathic neonatal cholestasis (INH). Two adolescents (ages 14 and 16 years) were also diagnosed with NPC during this period, one who originally had neonatal hepatitis and cirrhosis, and the other who had hepatosplenomegaly throughout childhood. Three of the patients with NPC were Hispanic. At time of NPC diagnosis, infants had mildly delayed motor development and persistent splenomegaly with or without hepatomegaly, and the adolescents had ataxia, dysarthria, hepatosplenomegaly, and paresis of vertical gaze. The diagnosis of NPC was established by demonstrating defective cellular cholesterol esterification in cultured skin fibroblasts in three patients and a specific genetic mutation in three patients. Niemann‐Pick disease type C was found in 27% of infants initially diagnosed with INH and 8% of all infants evaluated for cholestasis.ConclusionNiemann‐Pick disease type C should be considered in all infants with cholestasis, particularly those with splenomegaly or who are of Hispanic descent. Electron microscopy and lipid analysis of liver biopsy specimens obtained during the evaluation of neonatal cholestasis may suggest this diagnosis.
Influence of Dietary Cholesterol on Vitamin D Metabolism in Formula‐Fed Preterm Neonates
Authors: Picaud Jean‐Charles , Boucher Philippe , Lapillonne Alexandre , Berthouze Magali , Delvin Edgar , Boehm Günther , Claris Oliver , Laborie Sophie , Reygrobellet Bernadette , Lapillonne Helene , Glorieux Francis H. , Salle Bernard L. 
Published: January 2024

ABSTRACTObjectivesSupplementation of preterm formulas with cholesterol could help to mimic the fat composition of human milk. However, this could possibly influence vitamin D 25‐hydroxylation because this reaction is catalyzed in part by the mitochondrial cytochrome P‐450, the enzyme responsible for the 27‐hydroxylation of cholesterol. The purpose of this study was to verify whether the addition of cholesterol to preterm formulas could interfere with vitamin D metabolism in preterm neonates.MethodsIn a prospective study, 30 preterm neonates were randomly assigned to a low (< 0.03 g/L), medium (0.15 g/L), or high (0.30 g/L) cholesterol‐content preterm formula until theoretical term (i.e., 40 weeks post‐conceptional age). Anthropometric data and serum hydroxy‐vitamin D and 1,25 dihydroxy‐vitamin D concentrations were measured at study entry and theoretical term. In a subgroup of 14 subjects, serum cholesterol and lymphocyte 3‐hydroxy‐3‐methylglutaryl coenzyme A reductase mRNA were also assessed.Results(median [25th, 75 th centiles]): At theoretical term, there were no significant differences in serum hydroxy‐vitamin D concentrations among the three groups, even after adjustment for confounding variables (65 [50, 78] nmol/L, 79 [59, 86] nmol/L, and 67 [43, 103] nmol/L, respectively, P = 0.65) or 1,25 dihydroxy‐vitamin D (P = 0.88). Furthermore, there were no significant differences in 3‐hydroxy‐3‐methylglutaryl coenzyme A reductase mRNA copy numbers.ConclusionsIn preterm neonates fed formulas with a cholesterol content similar to or higher than that of human milk, we did not observe deleterious effects on vitamin D metabolism. However, long‐term effects of cholesterol supplementation require further studies.
Effects of Intrauterine Growth Restriction and Intraamniotic Insulin‐like Growth Factor‐I Treatment on Blood and Amniotic Fluid Concentrations and on Fetal Gut Uptake of Amino Acids in Late‐Gestation Ovine Fetuses
Authors: Bloomfield Frank H. , van Zijl Pierre L. , Bauer Michael K. , Harding Jane E. 
Published: January 2024

ABSTRACTObjectivesTo investigate, in the late‐gestation ovine fetus: 1) amino acid concentrations in blood and amniotic fluid, 2) the effects of intrauterine growth restriction (IUGR) induced by placental embolization on these concentrations, 3) fetal gut uptake of glutamine in healthy and IUGR fetuses, and 4) the effects of intraamniotic insulin‐like growth factor‐I (IGF‐1) treatment on these parameters.MethodsFetuses were randomly assigned to control (n = 9), IUGR + saline (n = 9), or IUGR + IGF‐1 (n = 11) groups. IUGR was induced by uteroplacental embolization from 114 to 119 days (term = 145 days). IUGR fetuses received daily intraamniotic injections of saline or IGF‐1 (20 μg/d) from 120 to 130 days.ResultsBaseline amino acid concentration was higher in fetal blood than amniotic fluid for all essential amino acids except lysine and histidine, but was lower for serine, alanine, and methylhistidine. Embolization reduced total amino acid concentration in blood and amniotic fluid by approximately 15%. Concentrations were reduced for serine, glutamine, and methylhistidine in blood and for serine in amniotic fluid, but were increased for glycine, alanine, and asparagine in blood and for alanine in amniotic fluid. Glutamine was taken up by the fetal gut (glutamine:oxygen quotient of 0.65) and citrulline was released by the gut. IGF‐1 treatment did not alter amino acid concentration in blood or amniotic fluid, but reduced gut uptake of glutamine from blood and the gut glutamine:oxygen quotient by 15%. Citrulline release was unchanged.ConclusionsThese data suggest that amniotic fluid amino acids are not simply filtered from fetal blood and may provide an important pool of nutrients for the fetus. They demonstrate for the first time that glutamine is taken up by the fetal gut. IGF‐1 treatment may promote gut utilization of amino acids from the amniotic fluid pool.
Routine Handling of Milk Fed to Preterm Infants Can Significantly Increase Osmolality
Authors: Fenton Tanis R. , Belik Jaques 
Published: January 2024

ABSTRACTBackgroundThe purpose of these studies was to evaluate the changes in osmolality which occur in human breast milk or formula after two modifications; these changes are sometimes used in preparing these milks for consumption by premature infants, namely, the addition of fortifiers and the addition of exogenous lactase enzyme.MethodsThe osmolality of expressed, previously frozen human breast milk, breast milk fortified with commercial fortifiers, liquid formulas, powdered formulas, or glucose polymers was measured. Osmolality was measured before and after warming (15 minutes at 37°C) or after refrigeration at 4°C for 12 hours with subsequent warming. In a second group of experiments, the osmolality of expressed breast milk and three lactose‐containing formulas was measured before and after incubation with lactase (Lactaid ®) at 4°C for 2, 6, and 24 hours.ResultsWarming of breast milk mixed with some of the additives was associated with a significant increase in osmolality. The additives which increased osmolality included liquid glucose polymers, two commercially available powdered human milk fortifiers, and three formulas which contain glucose polymers (a protein hydrolysate infant formula powder, powdered lactose free formula, and a powdered preterm formula). Maximum increase in osmolality of breast milk occurred with the addition of 20 ml/100ml liquid glucose polymers (Polycose, Ross Laboratories) which resulted in a 21% increase in osmolality after refrigeration and warming. The addition of liquid glucose polymers and of powdered preterm formulas containing glucose polymers (Enfacare, Mead Johnson, 9.5 g/100ml and Nutramigen, Mead Johnson, 6 g/100ml) resulted in a final osmolality of over 425 mOsmol/L. The addition of lactase and subsequent incubation under refrigeration resulted in significant increases in osmolality that ranged from 25 to 66% in fortified breast milks and lactose‐containing formulas. Incubation of these milks at 37° for 15 minutes produced about 50% greater increase in osmolality than observed after 2 hours of incubation under refrigeration.ConclusionsRoutine warming of breast milk with glucose polymer containing additives, or the addition of lactase enzyme to lactose containing feedings, can increase osmolality to levels that exceed current guidelines for premature infant feedings.
Serum Soluble Interleukin‐2 Receptor, Interleukin‐6, and Tumor Necrosis Factor‐α Levels in Children with Celiac Disease: Response to Treatment
Authors: Romaldini Ceres C. , Barbieri Dorina , Okay Thelma S. , Raiz Roberto , Cançado Eduardo L. R. 
Published: January 2024

ABSTRACTObjectivesT‐cell mediated immune response to dietary gluten and cytokines release are important for the enteropathy seen in celiac disease. We investigated the serum levels of soluble interleukin‐2 receptor, interleukin‐6, and tumor necrosis factor‐α in celiac children before and after gluten exclusion.MethodsCytokine levels were determined using enzyme immunoassay in serum from 12 untreated celiac patients, 16 treated celiac patients on a gluten‐free diet for at least two years, and from 26 control children. Eight of 12 untreated patients were also investigated at 6 and 12 months after gluten exclusion. Serum IgA antiendomysium antibodies were also assayed by indirect immunofluorescence.ResultsSoluble interleukin‐2 receptor and interleukin‐6 levels were significantly increased in untreated celiac patients compared with treated and control children. There was no difference in the tumor necrosis factor‐α levels between the groups. Soluble interleukin‐2 receptor levels were the only ones significantly decreased at 12 months after gluten exclusion. However, soluble interleukin‐2 receptor and interleukin‐6 levels at 12 months were significantly higher compared with controls. Antiendomysium antibodies had a diagnostic sensitivity of 100% and the titers decreased significantly after 12 months of gluten exclusion. A significant positive correlation was found between antiendomysium antibody titers with both soluble interleukin‐2 receptor and interleukin‐6 values.ConclusionsThe serum soluble interleukin‐2 receptor and interleukin‐6 levels may be used as a noninvasive measure of celiac disease activity and response to treatment.