bluuebunny/crossref_metadata_2025_split huggingface dataset:
Continuation of Breast‐Feeding in an Israeli Population
Authors: Birenbaum Emanuel , Vila Yael , Linder Nehama , Reichman Brian 
Published: January 2024

SummaryDemographic and perinatal factors were analyzed in an Israeli urban community to determine the rates of continuation of breast‐feeding and the factors influencing these rates. For the purpose of this study, breast‐feeding was defined as occurring if infants received at least one breast‐feed during a 24‐h period. Among 633 mothers initiating breast‐feeding, 40.3% completed 3 months of breast‐feeding. The factors significantly associated with the continuation of breast‐feeding were maternal religious belief, high education level, high parity, and previous breast‐feeding success. Multivariate analysis by stepwise logistic regression showed that orthodox religious belief was the most significant associated factor. A third interview undertaken after 12 months among the 165 mothers who successfully completed 3 months of breast feeding showed declines of breastfeeding at the second (31.5%), third (53.1%), and fourth (60.4%) trimesters. Only 12.7% of this population completed 12 months of breast‐feeding. Again, the mothers' religious beliefs and education levels were significantly related to the continuation of breast‐feeding. Each specific community must be analyzed to find those groups of mothers at risk for early weaning from breast‐feeding.
Human Leukocyte Antigen Alleles and Haplotypes Associated with Selective Immunoglobulin A Deficiency in Spanish Pediatric Patients
Authors: Clerici Nora , Fernández Miguel , Saiz Isabel , Sainz Teofilo , Polanco Isabel 
Published: January 2024

SummaryClass I and II human leukocyte antigens were determined by a standard microlymphocytotoxity test in a group of 45 pediatric patients with selective immuno‐globulin A deficiency (IgA‐D), 33 of them with frequent respiratory tract infections, allergic diseases, or gastrointestinal disorders (RTIAG), and 12 with celiac disease (CD). The results showed that the DR1 allele, and the A1,B8,Cw7,DR3,DQw2; B35,Cw4,DR1,DQw1; and B14,DR1,DQw1 haplotypes could be involved with IgA‐D susceptibility in RTIAG patients. Among the CD‐IgA‐D group, the B14 allele and A1,B8,Cw7,DR3,DQw2 haplotype were found to confer a high risk of developing IgA‐D. A possible protective role may be postulated for DR2 and DR4 in both types of IgA‐D patients. The present study confirms some of the previous findings in other white populations and describes new possible alleles and haplotypes that could be implicated with IgA‐D susceptibility and resistance.
The Effect of Colitis on Large‐Intestinal Electrolyte Transport in Early Childhood
Authors: Jenkins H. R. , Milla P. J. 
Published: January 2024

SummaryThe large intestine plays an important role in the salvage of electrolytes and water, although little is known of its function in early childhood in health or in disease. Using an in vitro voltage clamp technique, we have measured bidirectional sodium (Na) and chloride (C***l) fluxes (J), electrical potential difference (PD), short circuit current (Isc), and tissue resistance (R) in 10 pairs of healthy human infant left colon and four pairs of inflamed colon. In healthy tissue there was net Na and C***l absorption with JNa net approximating Isc. In contrast, inflamed colon exhibited significant reductions in PD, Isc, and R and increases in net serosa to mucosa flux of Na and Cl (JNasm and JClsm) resulting in net Na and Cl secretion. These results suggest that Na and Cl absorption in left colon is highly efficient in young children and that mucosal inflammation may seriously impair the colon's ability to conserve salt and water.
Saccharomyces boulardii for Clostridium difficile‐Associated Enteropathies in Infants
Authors: Buts Jean‐Paul , Corthier Gérard , Delmee Michel 
Published: January 2024

SummaryBased on experimental evidence in animals showing that the oral administration of Saccharomyces boulardii is effective in reducing morbidity and mortality due to Clostridium difficile‐induced pseudomembranous colitis, we conducted an open trial to examine the effects of the living yeast, given as primary therapy, in a selected group of infants and children with persistent intestinal symptoms related to toxinogenic C. difficile overgrowth. Over a period of 10 consecutive months, we studied 19 eligible patients (median age 8 months) who presented with enteral symptoms lasting for > 15 days and who had solely C. difficile in stools with positive cytotoxin B assay. Serotyping of the strains and determination in vitro of production of toxins A and B were performed subsequently. The patients presented with persistent or protracted diarrhea, malabsorption, and failure to grow (n = 8), or with repeated attacks of colics, emesis, and hypermeteorism without diarrhea (n = 4), or with both entities (n = 7). Patients with chronic protracted diarrhea (n = 3) had‐depressed jejunal disaecharidase activities and ultrastructural changes of enterocytes, including sparce and shortened microvilli. None had evidence of colitis. All the strains of C. difficile tested (n = 17) belonged to pathogenic serotypes (A1, A8, C, F, G, H, and K) and produced in vitro high levels of toxins A (n = 16) and B (n = 17). S. boulardii was given orally in a lyophilized form over 15 days (250 mg two to four times per day according to age). Within 1 week of treatment, enteral symptoms and physical findings resolved in 18 patients (95%) with marked decreases (p < 0.001) in the number of stools, frequency of colic episodes, and total duration of colics per day. Clearing of toxin B was observed within 15 days of therapy in 16 cases (85%), whereas eradication of C. difficile from stools was complete after 1 month in 14 (73%). Also, the ultrastructural changes observed in patients with chronic protracted diarrhea (n = 3) had disappeared after 1 month. A clinical and bacteriological relapse occurred in two patients (11%), which resolved rapidly with a second 15‐day course of S. boulardii. These findings suggest that some toxinogenic strains of C. difficile may cause chronic enteropathies without colitis that may be improved by oral administration of S. boulardii.
Resting Energy Expenditure and Food‐Induced Thermogenesis in Obese Children
Authors: Tounian P. , Girardet J. Ph. , Carlier L. , Frelut M. L. , Veinberg F. , Fontaine J. L. 
Published: January 2024

SummaryNineteen overweight girls 14.54 ± 0.38 years of age were studied. Results were compared with those obtained in eight age‐matched (14.07 ± 0.51 years) and sex‐matched normal weight controls. Energy expenditure (EE) was determined using open‐circuit indirect calorimetry at rest, both after a 12‐h fast and after an oral sucrose load of 3 g/kg ideal body weight. Food‐induced thermogenesis (FIT) was evaluated by computing the area under the curve of the EE response above resting energy expenditure (REE) during the first 3 h after the sucrose load, REE (kcal/day) was higher in the overweight patients (1,818 ± 46 vs. 1,527 ± 67; p = 0.002); REE standardized by fat‐free mass (FFM) (kcal/kg FFM/day) was lower in obese children than in controls (35.2 ± 1.0 vs. 44.9 ± 1.9; p = 0.0001). A linear correlation between REE and FFM was evidenced in both controls and overweight subjects (r = 0.78 and 0.68, respectively; p = 0.05 and p < 0.001, respectively). Actual REE in the obese children was significantly lower than the value predicted by applying the regression equation of REE on FFM in controls to the actual FFM in obese children (paired t test; p = 0.003). FIT was identical in overweight and normal weight subjects, regardless of whether it was expressed in absolute value, as the percentage calorie intake, or standardized by FFM. However, obese children were assigned to two groups according to whether FIT was lower than the value in controls (group 1, <mean −1 SD; n = 9) or at least equal to the value in controls (group 2, mean ‐ 1 SD, n = 10); the only feature that discriminated between these two groups was the presence or absence of a family history for obesity (FHO): FIT was significantly higher in obese children with a negative FHO than in obese children with a positive FHO. Our results support the presence of an energy metabolism disorder in some obese children and suggest that its cause may be constitutional in obese children with a positive FHO.
The Nutritional Value of a Whey Hydrolysate Formula Compared with a Whey‐Predominant Formula in Healthy Infants
Authors: Vandenplas Yvan , Hauser Bruno , Blecker Uwe , Suys Bert , Peeters Stefaan , Keymolen Kathelijn , Loeb Helmuth 
Published: January 2024

SummaryForty‐five healthy infants were included in a double‐blind randomized prospective study comparing the nutritional value of two formulas. One group received a whey‐predominant formula (n = 20); the other group received a whey hydrolysate formula (n = 25). Four infants of the whey hydrolysate group were dropped because they refused the formula. Although the mean daily volume intake was smaller with the whey hydrolysate formula compared with the whey‐predominant formula (p < 0.001), the weight gain in the two groups after 13 weeks was identical (27.2 g/day in both groups; the mean difference in weight gain between the groups after 13 weeks was only 8 g). Length gain at 13 weeks was 10.4 cm in the whey‐predominant formula group and 10.8 cm in the whey hydrolysate formula group (p = NS). After 13 weeks, blood was sampled for hemoglobin, hematocrit, red blood cell count, white blood cell count, lymphocytes, glycemia, proteins, albumin, prealbumin, calcium, phosphorus, urea, creatinine, iron, iron‐binding capacity, zinc, and vitamins A and E. Except for the iron‐binding capacity, zinc, urea (in plasma as well as in urine) (all three were higher in the whey hydrolysate group), no significant differences were found. According to these results, exclusive feeding of the whey hydrolysate formula from birth to 3 months of age to healthy infants appears to result in an adequate nutritional status, as assessed at 3 months of age.
Gastrointestinal Tolerance, Fat Absorption, Plasma Ketone and Urinary Dicarboxylic Acid Levels in Low‐Birth‐Weight Infants Fed Different Amounts of Medium‐Chain Triglycerides in Formula
Authors: Wu Paul Y. K. , Edmond John , Morrow Jack W. , Auestad Nancy , Ponder Debra , Benson John 
Published: January 2024

SummaryThis study was conducted to evaluate the effect of medium‐chain triglycerides (MCT) in a formula for low‐birth‐weight (LBW) infants on gastrointestinal tolerance, fat absorption, plasma ketone levels, and urinary dicarboxylic acid (DCA) excretion. At the start of enteral feedings, 64 LBW infants (≤1500 g) were randomly assigned to one of four experimental formulas. The formulas contained either 0, 17, 34, or 50% of the total fat as MCT oil. The nonfat constituents of all four formulas were the same and identical to Similac Special Care 24 (SCF), Infants were studied from the start of enteral feeding until approximately 7 days after reaching full feeds. Growth and tolerance were assessed in all infants over the entire feeding period. A 48‐h balance study was conducted after enteral intake exceeded 100 kcal/kg/day for 3 days. Stool fat, plasma D‐(—)‐3‐hydroxybutyrate (3HB) and carnitine, serum glucose, and urinary DCA levels were determined. Groups did not differ in growth, formula intake, fat absorption (76–84%), serum glucose, or plasma carnitine levels. Gastrointestinal tolerance was excellent and did not differ among groups. Plasma 3HB was significantly different (p < 0.05) only between the 0 and 50% MCT groups, 50 ± 10 versus 120 ± 20 μM, respectively. The excretion of urinary DCAs increased with increasing amounts of MCT in the formula. In conclusion, fat absorption and gastrointestinal tolerance were not affected by different MCT levels (0 to 50% of the total fat), but higher levels of plasma 3HB and urinary DCAs were associated with higher levels of MCT in the LBW formulas studied.
Newborn Rabbit Gastric Smooth Muscle Cell Culture
Authors: Yuan Qi X. , McRoberts James A. , Lakshmanan J. , Yagi Hideki , Hyman Paul E. 
Published: January 2024

SummaryEpidermal growth factor (EGF) and transforming growth factor‐alpha (TGF‐α) are two in a family of growth‐promoting peptides for many gastrointestinal epithelia. This study was designed to assess their mitogenic effect on cultured gastric myocytes and to characterize specific EGF receptors on these cells. Single myocytes were isolated from newborn rabbit gastric fundus and placed into tissue culture. The composition of the culture at confluence as assessed by immunostaining with smooth muscle actin‐specific monoclonal antibody (CGA7) was >95% myocytes. To assess the effect of putative growth factors, freshly isolated myocytes were incubated in Dulbecco's modified Eagle's (DME) medium containing 1% fetal bovine serum in the presence or absence of growth factors. After 6 days, cells were incubated in serum‐free medium with [3H]thymidine (1 μCi/ml) in the continued presence or absence of growth factors. After 24 h, EGF and TGF‐α but not insulin‐like growth factor I (IGF‐1) induced a dose‐dependent increase in [3H]thymidine incorporation. Ten nanomolar EGF or TGF‐α increased [3H]thymidine incorporation more than sixfold over control. EGF was more potent than was TGF‐α, with apparent median effective dose (ED50) values of 64 ± 14 pM and 166 ± 62 pM (p < 0.05), respectively. EGF bound to cultured myocytes with Kd = 7.6 ± 1.8 nM and Bmax = 27 ± 11 pmol/mg DNA or 440,000 receptors/cell. TGF‐α competed for binding at these receptors. Although IGF‐I did not stimulate thymidine incorporation, specific high‐affinity receptors for IGF‐I were detected on gastric myocytes. These results suggest that the EGF family may play a role in the growth of gastric smooth muscle.
Influence of Prenatal Corticosteroids on Bacterial Colonization in the Newborn Rat
Authors: Schiffrin E. J. , Carter E. A. , Walker W. A. , Frieberg E. , Benjamin J. , Israel E. J. 
Published: January 2024

SummaryThe interactions between bacteria and the host's intestinal barrier appear to be important regulators of bacterial colonization. In this study we investigated the effect of prenatal corticosteroids, known to accelerate the intestinal maturation of newborn rats, on bacterial colonization in the rat pup. Pregnant rats were treated with either cortisone acetate or normal saline on days 18–21 of gestation and were allowed to deliver spontaneously. The pups, after normal delivery, were sacrificed at different times during the first 10 days of life. The entire small intestine was removed, and each lumen was flushed to exclude nonadherent, transient organisms and homogenized. Tenfold dilutions were plated on horse‐blood agar (total bacteria) and MacConkey's medium (gram‐negatives). Quantitation and bacterial typification was determined after 24 h of incubation at 37°C. Total bacteria and gram‐negatives found in association with the mucosa were significantly lower in pups prenatally treated with steroids. These changes were not related to any changes in motility or intraluminal digestion. This suggests that the developmental condition of the host's intestinal barrier may be an important regulator of the bacterial micro‐environment of the newborn small intestinal mucosa
Ultrastructural Changes in the Duodenal Mucosa of HIV‐infected Children
Authors: Fontana M. , Boldorini R. , Zuin G. , Tosoni A. , Costanzi G. , Principi N. 
Published: January 2024

SummaryWe studied the ultrastructure of duodenal biopsy specimens from six HIV‐infected children with chronic gastrointestinal symptoms. A monomorphic pattern of microvillar damage (short and irregular microvilli, joined at their bases) was seen in all cases, even when the mucosa was normal on conventional histology. Among nine HIV antibody negative children, a similar pattern was seen only in three out of four celiac children with severely atrophic mucosa. No viral, bacterial, or protozoan pathogen was found. In HIV‐infected children tu‐buloreticular inclusions were also seen in endothelial cells. These ultrastructural changes could help to account for the gastrointestinal symptoms in HIV‐infected children.
Treatment of Cyclic Vomiting in Childhood with Erythromycin
Authors: Vanderhoof Jon A. , Young Rosemary , Kaufman Stuart S. , Ernst Laura 
Published: January 2024

SummaryCyclic vomiting syndrome is an unusual cause of episodic emesis in children. It manifests as intermittent episodes of severe vomiting, similar in time of onset and duration, with no symptoms during the intervening period. Dehydration necessitating intravenous fluid therapy may occur. Most therapeutic maneuvers have proven unsuccessful. We report the use of erythromycin as a prokinetic agent in the treatment of cyclic vomiting in 20 children (9 boys, 11 girls). Many patients had mild associated abdominal pain with their vomiting. Thirteen patients had previously been given metoclopramide, but none responded. Two patients were mildly developmentally delayed. Twenty patients were given oral erythromycin ethylsuccinate, approximately 20 mg/kg/day, in 2–4 divided doses for 7 days. This dosage was repeated as needed when symptoms reappeared. Thirteen of 20 patients reported total resolution of symptoms when reevaluated at 2 and 6 months. All males responded, 4 of 13 responders were female, and all seven with partial or no response to therapy were female. This uncontrolled trial suggests that erythromycin may be a useful prokinetic agent in the treatment of cyclic vomiting syndrome in childhood. As the study was uncontrolled, placebo effect cannot be excluded. Case‐controlled, double‐blinded prospective trials should be considered to evaluate the effectiveness of erythromycin in cyclic vomiting syndrome.
Contribution of Endoscopy to Early Diagnosis of Hypertrophic Pyloric Stenosis
Authors: De Backer A. , Bové T. , Vandenplas Y. , Peeters S. , Deconinck P. 
Published: January 2024

Summary:The diagnostic accuracy of ultrasonography and gastrointestinal endoscopy was compared in 63 infants who were operated on for infantile hypertrophic pyloric stenosis. Endoscopy was far more accurate than ultrasonography, the diagnosis being made in 97 and 81% of the cases, respectively. The difference between the techniques was even more obvious in the younger patients and in those with a short history of vomiting. The ability to detect coexistent or other causes of vomiting with endoscopy appeared advantageous. The endoscopic procedure is easily done without general anesthesia and was without complications in our series. We recommend endoscopy as an important tool in very young patients with few clinical signs other than vomiting, allowing for appropriate treatment without delay.
Reflux Esophagitis in Infants and Children
Authors: Vandenplas Yvan 
Published: January 2024

SummaryIn this article, the Working Group on Gastro‐Oesophageal Reflux of the European Society of Paediatric Gastroenterology and Nutrition presents and discusses a definition of reflux esophagitis and recommends a diagnostic approach and therapeutic management for this condition. Histologic criteria for reflux esophagitis, modified and adapted to the particular needs of infants and children, are suggested. Upper gastrointestinal en‐doscopy is recommended as the technique of choice in infants and children presenting with symptoms suggestive of reflux esophagitis. Prokinetics, although still a relatively new drug family, have already established a definitive place in the treatment of gastroesophageal reflux disease in infants and children and could also be used in the treatment of nonulcerative esophagitis, as suggested in the literature. If the esophagitis is more severe (ulcerative), treatment should initially consist of H2 blockers and then be continued with prokinetics. New drugs, such as omeprazole, are suggested in cases refractory to H2 blockers. Surgery is indicated in life‐threatening conditions or if the esophagitis is resistant to adequate medical management.
Evaluation of the Effects of Varying Solute Content on the Efficacy of Oral Rehydration Solutions in a Rat Model of Secretory Diarrhoea
Authors: Pillai G. V. , Brueton M. J. , Burston D. , Sandhu B. K. 
Published: January 2024

SummaryA series of in vivo steady‐state perfusion studies in cholera toxin‐induced secreting rat intestine were carried out to investigate net water, sodium, and potassium absorption and water influx and efflux from a range of oral rehydration solutions (ORSs) in which the glucose content had been partially replaced by amino acids or food supplements and the sodium content had been reduced to 60 m M. The reference solution used was the World Health Organization formula. There was a significant correlation between the osmolality of the ORS and the net water absorption (r = −0.911; p < 0.02). The greatest net water absorption occurred using comminuted chicken‐ and tapioca‐supplemented ORS.
Balloon Catheter Dilatation of Peptic Pyloric Stenosis in Children
Authors: Chan K. L. , Saing Htut 
Published: January 2024

SummaryIn the past 3 years, three children (ages 2, 4, and 8 years) suffering from peptic pyloric stenosis and repeated vomiting were treated in our department with balloon dilatation followed by H2‐receptor antagonist therapy. After the dilatation, all three patients could take solid food without vomiting. There were no complications as a result of the procedures. During a mean follow‐up of 17 months (range, 5–30) there was no recurrence of symptoms. The method of dilatation is described, and we recommend it as an option for the initial nonoperative treatment of pediatric peptic pyloric stenosis. The long‐term results of balloon dilatation of peptic pyloric stenosis will, however, require further evaluation.
Localization of the Intestinal Biopsy Capsule in Children by Color‐Coded Duplex Sonography
Authors: Scholbach T. , Künzel R. 
Published: January 2024

SummaryIn 21 children from 3 months to 10 years and 5 months old, the position of the biopsy capsule before suction biopsy of the small intestine was examined by means of x‐ray studies and both conventional and color‐coded duplex sonography. In all cases, the biopsy capsule was correctly positioned under sonographic guidance. The sonographic finding was always confirmed by x‐ray film and the histology of the tissue sample. The main obstacle for imaging the biopsy tube and capsule was intestinal gas due to crying and/or restlessness of infants under examination. However, it was always possible to define the position of the biopsy capsule sufficiently. These promising results allow us to recommend sonographic control of the intestinal tube before intestinal suction biopsy in infants and children. The advantages of this approach include lack of irradiation, which is especially important if the tube is an incorrect position after the first trial, bedside availability of sonographic equipment, lower risk of dislocation of the tube owing to shorter transport time, and continuous contact of medical staff with the infant.