bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vomiting and Gastric Motility in Infants With Cow's Milk Allergy
Authors: Ravelli Alberto M. , Tobanelli Pamela , Volpi Sonia , Ugazio Alberto G. 
Published: January 2024

ABSTRACTBackgroundRegurgitation and vomiting are common manifestations of cow's milk protein allergy (CMPA) in infants and are usually ascribed to gastroesophageal reflux (GER). Gastric anaphylaxis can induce antral dysmotility in the rat, and therefore the hypothesis for the current study was that cow's milk in sensitized infants may impair antral motility, thereby promoting GER and reflex vomiting.MethodsSeven vomiting infants with CMPA and nine with primary GER underwent a challenge with cow's milk formula. Electrogastrography (EGG) was used to measure the spectral frequency (bradygastria = 1.5—2.4 cycles per minute [cpm], normogastria = 2.5–3.9 cpm, tachygastria = 4.0–9.0 cpm) and the postprandial‐to‐fasting power ratio of gastric electrical activity, whereas gastric half‐emptying time (T½) was measured by electrical impedance tomography (EIT).ResultsIn CMPA and GER, respectively, during fasting, the frequency distribution (mean ± SD) of the EGG was as follows: normogastria 47.9% ± 12.5% versus 52.2% ± 9.8%, bradygastria 24.1% ± 5.7% versus 22.8% ± 8.3%, and tachygastria 28.0% ± 8.5% versus 25.0% ± 8.3%. In contrast, after the cow's milk challenge, the difference between the two groups was statistically significant: normogastria 33.1% ± 8.8% versus 70.6% ± 8.6% (P < 0.0001), bradygastria 38.0% ± 15.5% versus 15.7% ± 5.2% (P = 0.002), and tachygastria 28.9% ± 10.6% versus 13.4% ± 4.6% (P = 0.001. The postprandial/fasting power ratio (mean ± SD) was 3.2 ± 1.9 in CMPA and 8.1 ± 2.1 in GER (P < 0.0001). Gastric T½ (mean ± SD) of the cow's milk meal was 89.0 ± 26.3 minutes versus 54.0 ± 12.6 minutes (P = 0.003). In infants with GER all EGG parameters and gastric T½ were similar to that in 10 healthy control infants.ConclusionsIn sensitized infants, cow's milk induces severe gastric dysrhythmia and delayed gastric emptying, which in turn may exacerbate GER and induce reflex vomiting. Electrogastrography and EIT can be useful in the assessment of vomiting, GER, and CMPA in infants.
Bilirubin‐IXβ Is a Marker of Meconium, Like Zinc Coproporphyrin
Authors: Aziz Sina , Leroy Paul , Servaes Roger , Eggermont Ephrem , Fevery Johan 
Published: January 2024

ABSTRACTBackgroundBecause meconium accumulates continuously in the fetal intestine, analysis of the postnatally excreted material could yield important information of intrauterine metabolism and maturation. Therefore, a study of the bilirubin pigments in meconium and in the first neonatal stools was carried out.MethodsMeconium and stools from 37 neonates of various gestational ages were collected carefully, and stored at −20°C, protected by aluminium foil. Samples were defrosted, vortex mixed with an equal amount of dimethyl sulfoxide, centrifuged, and submitted to analysis by high‐pressure liquid chromatography using newly developed methods to identify and to quantitate the bilirubin‐IXα, ‐IXβ, ‐IXγ, and ‐IXδ isomers. In addition, samples were also submitted to diazo coupling with ethyl anthranilate. Total coproporphyrins and zinc coproporphyrin were assayed for comparison.ResultsUnconjugated bilirubin‐IXα and ‐IXβ were detected in meconium but not the ‐IXγ or the ‐IXδ isomer. Bilirubin‐IXβ was the predominant pigment and comprised 63% to 96% of the unconjugated bilirubins in the first sample of meconium excreted. Its amount decreased rapidly during the first 5 days in full‐term newborns, but this occurred more slowly in preterm neonates, especially in those with a gestational age less than 30 weeks. The decrease of bilirubin‐IXβ over time correlated with that of coproporphyrin.ConclusionsBilirubin‐IXβ is the prevailing bile pigment in the first excreted sample of meconium. It gradually decreases after birth and can be considered a biochemical marker of meconium, like zinc coproporphyrin.
Oroesophageal Motor Disorders in Pierre Robin Syndrome
Authors: Baujat Geneviève , Faure Christophe , Zaouche Abderhaman , Viarme Fabienne , Couly Gérard , Abadie Véronique 
Published: January 2024

ABSTRACTBackgroundFeeding disorders are one of the main clinical features in PRS, which combines a posterior U‐shaped cleft palate, retrognathia, and glossoptosis. The aim of this study was to evaluate the oral and esophageal motor function of children with PRS without additional neurologic symptoms.MethodsAll children hospitalized with Pierre Robin syndrome either isolated (n = 27) or associated with Stickler syndrome (n = 8) were included. Clinical evaluation of their oroesophageal disorders and systematic esophageal manometry were performed.ResultsFeeding disorders were always present, but type of disorder varied from one child to another. Esophageal disorders were frequent and seemed to be resistant to classic gastroesophageal reflux treatment. Eighty‐six percent of the children required nasogastric tube feeding for a mean duration of 8.6 months. Esophageal manometric abnormalities were noted in 50% of the children: lower esophageal sphincter hypertonia, failure of lower esophageal sphincter relaxation at deglutition, and esophageal dyskinesia. These clinical and manometric disorders showed a trend to spontaneous regression after 12 months.ConclusionIn the current Pierre Robin syndrome series, clinical and manometric anomalies of oroesophageal motility were always present. The authors identified an unusual manometric pattern that has also been described in situations of neurovegetative instability. It could reflect dysregulation of the control of the central pattern generators of swallowing in the brain stem.
Nutritional Zinc Balance in Extremely Low‐Birth‐Weight Infants
Authors: Loui Andrea , Raab Andrea , Obladen Michael , Brätter Peter 
Published: January 2024

ABSTRACTBackgroundZinc is important for metabolism, cell growth, immunity, and defense against oxygen radicals. Extremely low‐birth‐weight (< 1000 g) infants have higher nutritional needs, but information on zinc is scarce. The authors performed nutritional balances in 10 infants with birth weights of 500 to 999 g and who were fed with fortified human milk.MethodsThe authors collected infant feces, urine, and blood and human milk samples during 72 hours at 7 and 12 weeks of age. Zinc concentration was measured by inductively coupled plasma–mass spectrophotometry, atomic emission spectro‐photometry, and instrumental neutron activation analysis.ResultsMean (SD) intake via human milk was 379 (± 373) μg · kg−1 · d−1 during both balances. Urinary excretion was high at 7 weeks of age, decreased to half at 12 week, and was negatively correlated (P < 0.01) with weight gain. Mean absorption was slightly positive at 7 weeks of age but zero or negative in most infants at 12 weeks of age. Retention was negative in all infants at both observation periods, except in one infant during the second balance. Clinical zinc deficiency developed in one infant at 12 weeks of age.ConclusionsZinc balances in extremely low‐birth‐weight infants are highly variable and usually negative. Controlled trials are needed to assess need for and benefits and risks of zinc supplementation.
The Effect of Antenatal Vitamin A and β‐Carotene Supplementation on Gut Integrity of Infants of HIV‐Infected South African Women
Authors: Filteau Suzanne M. , Rollins Nigel C. , Coutsoudis Anna , Sullivan Keith R. , Willumsen Juana F. , Tomkins Andrew M. 
Published: January 2024

ABSTRACTBackgroundVitamin A is important for protection against diarrhea, and supplements may benefit gut function of infants of HIV‐infected mothers.MethodsWe studied 238 infants of HIV‐infected South African women participating in a randomized, double‐blind, placebo‐controlled trial of vitamin A during pregnancy (1.5 mg retinyl palmitate and 30 mg β‐carotene daily) plus 60 mg retinyl palmitate at delivery. The placebo group received identical placebo capsules at the same times. When infants were 1, 6, and 14 weeks of age, lactulose/mannitol dual sugar intestinal permeability tests were performed.ResultsMaternal vitamin A supplementation did not significantly affect infant gut permeability in the group as a whole at any time. By multiple regression analysis, HIV infection of the infant by 14 weeks was significantly associated with increased gut permeability at both 6 and 14 weeks. After controlling for birth weight, gestational age, current weight, feeding mode and recent morbidity, there was a trend toward an interaction between vitamin A supplementation and HIV infection (P = 0.086) at 14 weeks. Vitamin A made no difference to gut permeability of uninfected infants (lactulose/mannitol ratio for vitamin A group: 0.11, 95% confidence interval [CI] 0.08, 0.15, n = 73 and for placebo group: 0.09, 95% CI 0.06, 0.12, n = 76), but largely prevented the increase in the ratio of HIV‐infected infants (vitamin A group: 0.17, 95% CI 0.13, 0.23, n = 23; placebo group: 0.50, 95% CI 0.37, 0.68, n = 20). The effects on the lactulose/mannitol ratio were related to changes in lactulose, not mannitol, excretion. Vitamin A supplementation was associated with significantly lower lactulose excretion at 1 and 14 weeks, suggesting the major effect of vitamin A was on maintaining the integrity of gut tight junctions.ConclusionsVitamin A supplementation of HIV‐infected pregnant women may prevent the deterioration in gut integrity in the subgroup of their infants who themselves become infected. Improving vitamin A status of HIV‐infected infants may decrease their gastrointestinal morbidity.
Quality of Life in Inflammatory Bowel Disease: A Cross‐Cultural Comparison of English and Canadian Children
Authors: Richardson Gillian , Griffiths Anne M. , Miller Victor , Thomas Adrian G. 
Published: January 2024

ABSTRACTBackgroundAny disease and its treatment has an important impact on health‐related quality of life for affected individuals. There have been few previous studies on the quality of life for children with inflammatory bowel disease (IBD).MethodsA cross‐cultural comparison was performed to determine whether the concerns of children with IBD in the United Kingdom are ranked similarly to those of children with IBD in Canada. An item reduction questionnaire, developed from interviews with Canadian children with IBD, was scored by 53 British children with IBD for importance and frequency, as a questionnaire had been scored previously by 117 Canadian children.ResultsThere was a significant correlation between the mean scores (r = 0.831, P < 0.001) and ranks (r = 0.801, P < 0.001) for the 96 questions, and 43 of the 50 highest‐ranking concerns corresponded for both populations. Confidence interval analysis showed a significant difference between the mean values for 21 of the 96 items; 20 of these 21 were ranked higher in the United Kingdom than they had been in Canada, suggesting that the frequency and/or degree of concern was greater for the British children with IBD.ConclusionsHealth‐related concerns of British children with Crohn disease and ulcerative colitis correlate closely with those of Canadian children with those diseases. Further studies are needed to determine the sensitivity of individual questions, the most appropriate wording of these questions, and the optimal length for a proposed instrument to assess quality of life in children with IBD.
Familial and Community Environmental Risk Factors for Helicobacter pylori Infection in Children and Adolescents
Authors: Wizla‐Derambure Nathalie , Michaud Laurent , Ategbo Simon , Vincent Pascal , Ganga‐Zandzou Serge , Turck Dominique , Gottrand Frédéric 
Published: January 2024

ABSTRACTBackgroundThe aim of the study was to identify familial and community environmental risk factors associated with Helicobacter pylori infection in a pediatric population.MethodsChildren requiring diagnostic upper endoscopy were included in the study during a 2‐year period. During endoscopy, five gastric biopsies were performed for the histologic or bacteriologic diagnosis, or both, of H. pylori infection. Epidemiologic data collected by a questionnaire were analyzed using the chi‐square test or Fisher test and stepwise logistic regression.ResultsThe authors included 436 patients (242 boys), aged 2 days to 17.9 years (median, 2.7 years). H. pylori prevalence was 7.3%. Univariate analysis found H. pylori was more common in older patients (P < 0.00001), in children who had at least one parent born in a developing country (P < 0.02) or with a low socioeconomic status (P < 0.02), and in those living in crowded conditions (P < 0.02). Children whose mother worked at home were more frequently infected than children whose mother worked outside the home (P < 0.02). Attendance at nursery or school before the age of 6 years was not associated with infection. Logistic regression showed a strong association with H. pylori only for age and number of persons at home.ConclusionsThe source of H. pylori is intrafamilial rather than from a community, such as nursery and school attended at a young age. The number of persons in the home influences the infection status of children but not by the presence of the mother in home. These data suggest that H. pylori infection transmission occurs from siblings or the father rather than from mother.
Serologic Markers of Untreated Celiac Disease in Libyan Children: Antigliadin, Antitransglutaminase, Antiendomysial, and Anticalreticulin Antibodies
Authors: Ashabani Abdelhakim , Errabtea Haneva , Shapan Abdellatif , Tuckova Ludmila , Tlaskalova‐Hogenova Helena 
Published: January 2024

ABSTRACTBackgroundThere are, as yet, no data available about the incidence of celiac disease in Libya. The aim of this study was to test the occurrence of serologic markers in a group of Libyan children with positive clinical and histologic findings indicative of celiac disease diagnosis.MethodsThirty‐nine children with untreated celiac disease and 50 healthy school children, all younger than 14 years, were included in the study. Enzyme‐linked immunosorbent assay for immunoglobulin G and immunoglobulin A (IgA) antigliadin, antitissue transglutaminase, and anticalreticulin antibodies was used to evaluate the serologic markers of the celiac patients. Immunoglobulin A antiendomysial antibodies were detected by indirect immunofluorescence using human umbilical cord tissue.ResultsClinical symptoms at presentation were weight loss (82%), abdominal distension (61.5%), diarrhea or steatorrhea (59%), pallor (41%), abdominal pain (20.5%), constipation (15%), vomiting (10%), and short stature (7.7%). Most of these symptoms disappeared after introduction of a gluten‐free diet. Of 39 patients, only 23 (59%) were endomysium positive and positive also in all other serologic markers. The second group of patients with positive clinical and biopsy findings but antiendomysial antibody‐negative findings was subdivided into two subgroups according to the IgA antigliadin antibody results. Individuals in the IgA gliadin‐negative subgroup also lacked IgA autoantibodies.ConclusionsThe authors’ findings stress the importance of serologic testing not only for screening but also for confirmation of celiac disease.
Laparoscopic‐Assisted Versus Open Ileocolic Resection for Adolescent Crohn Disease
Authors: Diamond Ivan R. , Langer Jacob C. 
Published: January 2024

ABSTRACTBackgroundLaparoscopic‐assisted ileocolic resection for Crohn disease has been reported as an acceptable alternative to the open procedure in adults. We evaluated our experience with this procedure in the adolescent population.MethodsAll adolescents undergoing ileocolic resection for Crohn disease during a 3‐year period were retrospectively reviewed. Intraoperative and early postoperative results were analyzed, comparing those undergoing the laparoscopic‐assisted approach with those having open resection.ResultsEleven patients (mean age, 15.6 years) underwent open and 12 patients (mean age, 16.5 years) underwent laparoscopic‐assisted resection. None had undergone previous resection. The two groups did not differ with respect to time from diagnosis to surgery, indications for surgery, preoperative medical therapy, operative time, or length of intestine resected. One patient in the laparoscopic‐assisted group was converted to an open procedure. There were no intraoperative complications in either group. Although no statistically significant differences were noted for number of days on narcotic, total dosage of narcotic, and time to regular diet, patients undergoing laparoscopic‐assisted resection were discharged 2.2 days earlier (5.4 vs. 7.6;P < 0.05). There was one wound infection and one intraabdominal abscess in the open resection group, and a single patient in the laparoscopic‐assisted group with postoperative fever and a wound infection.ConclusionsLaparoscopic‐assisted ileocolic resection is a safe alternative to open surgery in adolescent patients with Crohn disease.
Vertical Transmission of Hepatitis C Virus in a Cohort of 2,447 HIV‐Seronegative Pregnant Women: A 24‐Month Prospective Study
Authors: Ceci Oronzo , Margiotta Marcella , Marello Fiorino , Francavilla Ruggiero , Loizzi Pasquale , Francavilla Antonio , Mautone Angela , Impedovo Luigi , Ierardi Enzo , Mastroianni Maria , Bettocchi Stefano , Selvaggi Luigi 
Published: January 2024

ABSTRACTBackgroundMother to infant transmission of hepatitis C virus (HCV) has been extensively studied in mothers with human immunodeficiency virus (HIV) infection, whereas fewer data are available on the vertical HCV transmission in HIV‐negative women.MethodsBetween January 1995 and June 1997, 78 consecutive HCV‐positive/HIV‐negative women with their offspring entered this prospective study aimed to define the prevalence of and risk factors for HCV vertical transmission. Risk factors for HCV were carefully sought, and HCV viral load and genotype were determined in all positive mothers. The infants were tested for alanine aminotransferase (ALT) and HCV‐RNA at birth and at 4, 8, 12, 18, and 24 months of age.ResultsEight of 60 (13.3%) infants born to HCV‐RNA positive mothers acquired HCV infection, but only 2 (3,3%) were still infected by the end of follow‐up. Infants' genotypes matched that of the mothers. ALT levels were in the normal range in all study subjects throughout the follow‐up. High maternal viral load (P < 0.05), possession of HCV risk factors (P < 0.004), and history of blood transfusion (P < 0.05) were associated with increased risk of HCV vertical transmission.ConclusionsThis long‐term prospective study shows that, although vertical transmission from HIV‐negative mothers occurs in 13% of cases, there is a high rate of spontaneous viral clearance (75%). High maternal viral load and mothers belonging to HCV risk categories were the only variables predictive of the vertical transmission.
Bacterial Translocation in Neonatal Rats: The Relation Between Intestinal Flora, Translocated Bacteria, and Influence of Milk
Authors: Yajima Masako , Nakayama Makiko , Hatano Seiko , Yamazaki Kumiko , Aoyama Yumi , Yajima Takaji , Kuwata Tamotsu 
Published: January 2024

ABSTRACTBackgroundA high incidence of bacterial translocation in neonates results not only from immaturity of host‐defense functions, but also from the dominant colonization of aerobic bacteria in the intestine. Bacterial colonization develops differently among breast‐fed, formula‐fed, premature, and full‐term infants. The purpose of this study was to examine the incidence of bacterial translocation and to identify the translocated bacterial species, relating these findings to the intestinal microflora and to the type of feeding in neonatal rats.MethodsAnimals were divided into three groups: breast‐fed normal pups (MR group), formula‐fed pups fed via an intragastric cannula implanted esophageally (AR group), and breast‐fed pups after the removal of the cannula (Sham group). Artificial rearing was achieved using a machine feeding system. Culture and identification of the bacteria in the intestine, mesenteric lymph nodes, liver, portal blood, and lungs were made using a simplified version of Mitsuoka's method.ResultsAt 14 days of age, the dominant bacteria in the feces of the MR and Sham Groups were Enterobacteriaceae, Lactobacillus, and Enterococcus, but Enterobacteriaceae and Clostridium were significantly more common in the AR group than in the MR group. The dominant bacteria in the mesenteric lymph nodes were Enterobacteriaceae, Lactobacillus, and Staphylococcus. The extent of systemic bacterial translocation decreased earlier in the Sham group than in the AR group.ConclusionsThe frequency with which species of bacteria were cultured from mesenteric lymph nodes and other peripheral sites did not mirror the composition of the intestinal flora. Among the translocated bacteria, Staphylococcus may be especially hard to recognize and difficult for the host‐defense systems to destroy. Breast‐feeding inhibited systemic bacterial translocation in the suckling period of the rat.
Lymphonodular Hyperplasia on the Mucosa of the Lower Gastrointestinal Tract in Children: An Indication of Enhanced Immune Response?
Authors: Kokkonen Jorma , Karttunen Tuomo J. 
Published: January 2024

ABSTRACTBackgroundTo discover the prevalence and significance of lymphonodular hyperplasia (LNH) of the lower gastrointestinal tract, the authors did a retrospective analysis of a consecutive series of children using colonoscopy to evaluate persistent and severe gastrointestinal symptoms. The authors also sought to discover in more detail how often subjects with LNH of the terminal ileum (TI) or colon show an association with food allergy (FA).MethodsThe analysis included a consecutive series of 140 children evaluated at the Oulu University Hospital using colonoscopy, which extended to the TI in 74 of these children. A total of 102 patients underwent gastroduodenoscopy. The disease category was assessed using endoscopic, histopathologic, and clinical information. To diagnose FA, a masked or an open food challenge was administered to all patients who aroused any suspicion of food‐related exacerbation of symptoms.ResultsOf 140 patients, LNH of the colon was diagnosed in 46 subjects, 9 of 38 patients had colitis, 1 of 8 patients had Crohn disease, and 36 of the remaining 94 subjects did not have colitis. Twelve patients of the 22 with LNH of the colon (55%) showed concomitant LNH on the bulb of the duodenum. Lymphonodular hyperplasia of the TI was diagnosed in 53 of the 74 subjects in whom TI could be visualized. It was seen in most patients without colitis (80%), in one half the subjects with colitis (48%), and in one quarter of those with Crohn disease (25%). Among the whole study group 37 (26%) could be defined as having FA. It was more prevalent in patients with (52%) than in those without (13%) LNH of the colon (P < 0.001). The presence of LNH in the TI also showed some association with FA (P < 0.05), but less than did LNH of the colon.ConclusionWe consider LNH on the mucosa of the colon or TI common but not an innocent bystander. Significantly related to a diagnosis of gastrointestinal FA in this study, it is an expression of mucosal immune response. If detected on the colon, FA should be considered, whereas if present in TI, it may be related to FA but also to a variety of other immunologically active disease states.