bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immune Status of Infants Fed Soy‐Based Formulas With or Without Added Nucleotides for 1 Year: Part 2: Immune Cell Populations
Authors: Cordle Christopher T. , Winship Timothy R. , Schaller Joseph P. , Thomas Debra J. , Buck Rachael H. , Ostrom Karin M. , Jacobs Joan R. , Blatter Mark M. , Cho Sechin , Gooch Willis M. , Pickering Larry K. 
Published: January 2024

ABSTRACTBackgroundInfants fed a soy protein isolate–based formula have immunization responses similar to breast‐fed infants. However, cellular aspects of the immunologic development of soy‐fed infants have not been studied extensively. Nucleotides added to milk‐based formula benefit infant immune status, but reports of the immunologic effects of adding nucleotides to soy‐based formula are not available. This study examines immune cell populations of infants fed soy protein isolate formulas with and without added nucleotides for 1 year.MethodsNewborn, term infants studied in a masked 12‐month feeding trial were assigned randomly to soy formula groups with and without added nucleotides (n = 94, n = 92). A nonrandomized human milk/formula‐fed cohort (n = 81), was concurrently enrolled. Blood samples were collected at 6, 7, and 12 months. Thirty‐two immune cell populations were characterized using three‐color flow cytometry. Cellular markers were chosen to assess general pediatric immune status, emphasizing maturation and activation of B, T, and NK lymphocytes.ResultsAll cell populations, number and percentages, were within age‐related normal ranges. The only significant difference found between soy formula and human milk/formula‐fed infants was the percentage of CD57+ NK T cells at 12 months (human milk/formula > soy formula, P = 0.034). There were significant differences at some time points between human milk/formula‐fed and nucleotide‐supplemented soy formula–fed infants in populations of lymphocytes, eosinophils, total T, helper T, naive helper, memory/effector helper, CD57−T, and CD11b+CD8+NK cells. None of the cell populations differed between infants fed soy formula versus soy plus nucleotides.ConclusionsInfants fed this commercial soy formula demonstrated immune cell status similar to human milk/formula‐fed infants, consistent with normal immune system development. The addition of nucleotides to soy formula did not significantly change specific individual immune cell populations but tended to increase numbers and percentages of T cells and decreased numbers and percentages of NK cells.
Ganciclovir Treatment in Infants With Cytomegalovirus Infection and Cholestasis
Authors: Fischler Björn , Casswall Thomas H. , Malmborg Petter , Nemeth Antal 
Published: January 2024

ABSTRACTBackgroundThe authors have previously described an association between cytomegalovirus (CMV) infection and intrahepatic and extrahepatic forms of neonatal cholestasis. Pediatric use of the antiviral drug ganciclovir to treat patients with CMV infection has increased. In this study, infants with CMV infection and cholestasis were treated with ganciclovir.MethodsSix infants with cholestasis (age, 3–16 weeks) and with signs of ongoing CMV infection were treated with intravenous ganciclovir for 3 to 7 weeks and observed for 4 to 31 months after treatment. Two patients had biliary atresia, one had suspected septo‐optic dysplasia and three had no obvious cause for intrahepatic cholestasis other than ongoing CMV infection.ResultsFour patients, including one with biliary atresia, responded to the treatment, whereas two patients, including the one with septo‐optic dysplasia did not. The latter patient had episodes of symptomatic hypoglycemia during the treatment, which was subsequently stopped. Liver function at the end of follow‐up was good in four patients, intermediate in one, and poor in one.ConclusionGanciclovir treatment may be beneficial in infants with CMV‐associated intrahepatic cholestasis, but controlled studies are needed. Because of the possible side effect of hypoglycemia, infants with cholestasis who have increased risk for such episodes should not be treated.
Early Constipation and Toilet Training in Children With Encopresis
Authors: Fishman Laurie , Rappaport Leonard , Cousineau Dominique , Nurko Samuel 
Published: January 2024

ABSTRACTObjectiveTo evaluate the frequency of predisposing factors for encopresis before and during toilet training, comparing children with primary and secondary encopresis.MethodsIn this retrospective study, questionnaires from the initial evaluation at an encopresis clinic at a tertiary care pediatric hospital were reviewed for the presence or absence of factors in the first 2 years of life, for toilet training practices, and for disruptive events during the training process. Children younger than 48 months or those with organic defecation disorders were excluded.ResultsIn 411 children with encopresis, the reported frequency of predisposing factors included constipation in 35%, and previous treatment for constipation in 24%. Toilet training was initiated before age 2 years in 26% and after age 3 years in 14%. Interruption of toilet training and punishment were seen more in primary encopresis than in secondary encopresis (50% versus 23%;P < 0.05) and (52% versus 26%;P < 0.05) respectively. Constipation (30% versus 18%;P < 0.05) and abdominal pain (23% versus 9%;P <0.0:5) during toilet training were more common in primary encopresis as was fear of the toilet (47% versus 10%;P < 0.05).ConclusionsIn children with encopresis, early difficult defecation, previous treatment for constipation, and early initiation of toilet training were less common than expected. Children with primary encopresis did not have an increased incidence of early constipation or invasive treatments compared with those with secondary encopresis. However, children with primary encopresis did have more difficult and disruptive toilet training experiences.
Ranitidine and Omeprazole as Adjuvant Therapy to Pancrelipase to Improve Fat Absorption in Patients With Cystic Fibrosis
Authors: Francisco Mary Pat , Wagner Mary H. , Sherman James M. , Theriaque Douglas , Bowser Ellen , Novak Donald A. 
Published: January 2024

ABSTRACTBackgroundInadequate treatment of pancreatic insufficiency in patients with cystic fibrosis (CF) causes malabsorption of nutrients with significant sequelae. The objective of this study was to measure the effect of acid suppressant therapy on fat absorption in patients with CF who received a pH‐sensitive, enteric‐coated microtablet enzyme product.MethodsA double‐blind, placebo‐controlled crossover study of 12 children and 10 adults with pancreatic insufficient CF was performed. All subjects were receiving pancrelipase therapy (Pancrease MT10 and MT16; Ortho‐McNeil, Springhouse, PA, U.S.A.) and for the study also received either placebo or ranitidine (Zantac; Glaxo‐Wellcome, Research Triangle Park, NC U.S.A.) 5 mg/kg or 10 mg/kg daily. The adult subjects also received omeprazole therapy (Prilosec; AstraZeneca/Merck, Wilmington, DE, U.S.A.), 20 mg daily, as adjuvant therapy to pancreatic enzymes. Serial 3‐day fat‐balance studies were performed in the Clinical Research Center. The data were analyzed using individual paired t tests that compared each treatment with placebo and two repeated‐measures, general linear model F tests.ResultsThe linear model for all subjects showed no overall adjuvant drug effect on fat absorption, P = 0.32. A second linear model F test analysis of adult subjects, comparing all four drug treatments (placebo, ranitidine 5 and 10 mg/kg daily and omeprazole), also showed no difference in fat absorption, P = 0.15. Paired t test subgroup analysis of the adults showed an improvement of 4.97% (P = 0.003) in mean fat absorption comparing low‐dose ranitidine to placebo. All other t test analyses showed no significant change in fat absorption between placebo and acid suppressant treatment. There was marked intersubject and intrasubject variability in fat absorption.ConclusionsNo overall significant improvement in fat absorption could be demonstrated with adjuvant therapy. Fat absorption measured by 3‐day fat‐balance studies varied greatly even when comparing the same subject for placebo and baseline treatments, despite identical dietary fat and enzyme intakes. The large variability limited our ability to test for a difference in fat absorption and has significant implication for the use of this test, considered the gold standard, for determining enzyme dosage adequacy.
Plasma Endothelin‐1 Concentrations in Children With Cirrhosis and Their Relationship to Renal Function and the Severity of Portal Hypertension
Authors: Bakr A. M. , Abdalla A. F. , El‐Marsafawy H. , Abu‐Hashem I. , El‐Regal M. Ezz , Amer T. , Abdel‐Khalik M. K. , Mostafa H. , A‐Kader H. H. 
Published: January 2024

ABSTRACTBackgroundPlasma endothelin‐1 (ET‐1) is a potent vasoconstrictor peptide involved in the pathogenesis of several disorders. Endothelin‐1 concentrations are increased in adult patients with cirrhosis. However, little is known about ET‐1 concentrations in children with cirrhosis.MethodsRadioimmune assay was used to measure plasma ET‐1 concentrations in 19 children with cirrhosis (8 patients with ascites, and 11 without ascites), and 11 age‐ and sex‐matched healthy children. The plasma ET‐1 concentrations were correlated with the mean blood pressure, creatinine clearance, and severity of portal hypertension, as measured by portal flow volume and portal flow velocity.ResultsPatients with cirrhosis and ascites had increased plasma ET‐1 concentrations compared with patients who did not have ascites (6.8 pg/mL ± 0.62 pg/mL vs. 4.6 pg/mL ± 0.35 pg/mL; mean ± SEM;P < 0.01) and controls (3.6 pg/mL ± 0.27 pg/mL; mean ± SEM;P < 0.0005). Plasma ET‐1 concentrations were higher in patients with cirrhosis who did not have ascites compared with controls (P < 0.005). No significant differences were observed between concentrations of the patients with cholestasis and those without cholestasis (5.4 pg/mL ± 0.52 pg/mL vs. 5.2 ± 0.32 pg/mL; mean ± SEM;P = 0.1). Plasma ET‐1 concentrations correlated positively with the mean blood pressure (r = 0.58;P < 0.05) and negatively with renal function, as measured by creatinine clearance (r = −0.7;P <0.005). However, no correlation was detected between ET‐1 concentrations and portal flow volume (r = −0.02;P = 0.4) or portal flow velocity (r = −0.16;P = 0.4).ConclusionsPlasma ET‐1 concentrations are increased in children with cirrhosis, with or without ascites, compared with controls. Patients with cirrhosis and ascites have increased ET‐1 concentrations compared with those without ascites. The degree of increase does not relate to the severity of portal hypertension. This increase tends to maintain systemic blood pressure but is associated with a decrease in renal function.
Mechanisms of Vitamin B12 Absorption in Breast‐Fed Infants
Authors: Adkins Yuriko , Lönnerdal Bo 
Published: January 2024

ABSTRACTObjectivesThe mechanisms of vitamin B12 absorption in infants are unknown. We investigated whether haptocorrin (HC), a vitamin B12‐binding protein in human milk, facilitates vitamin B12 absorption during the neonatal period or if it occurs by a process similar to that in adults involving another vitamin B12‐binding protein, intrinsic factor (IF).MethodsTo determine whether HC or IF can deliver vitamin B12 to the enterocyte, binding studies using Caco‐2 intestinal cells in culture and purified human milk HC‐[57Co]vitamin B12 or [125I]IF‐vitamin B12 were performed. Determination of IF secretion by infant stomach was investigated by a competitive ELISA on fecal extracts from breast‐fed infants. Determination of receptors specific for IF‐vitamin B12 or HC‐vitamin B12 in infant intestine was achieved by ligand blot analysis using isolated brush border membrane vesicles (BBMV) from fetal and adult intestine and Caco‐2 cells. PCR was performed to identify the IF receptor gene transcript in Caco‐2 cells and fetal intestine.ResultsLimited binding of both HC and IF to Caco‐2 cells was observed; however, HC displayed affinity to low molecular weight proteins in BBMV from fetal intestine and Caco‐2 cells while IF showed affinity for a 240 kDa protein in BBMV from fetal intestine and Caco‐2 cells. IF receptor gene transcript was identified in fetal intestine and Caco‐2 cells. An increase in IF excretion from breast‐fed infants throughout early life was observed.ConclusionsAn IF‐dependent vitamin B12 absorption mechanism appears to be in place in breast‐fed infants. However, IF levels may be too low in early life to participate in vitamin B12 absorption; therefore, haptocorrin may mediate vitamin B12 absorption until the absorption function can be taken over by a more mature IF system.
Quantitation of Colonic Luminal Synthesis of Butyric Acid in Piglets
Authors: Kien C. Lawrence , Chang J. C. , Cooper James R. 
Published: January 2024

ABSTRACTObjectivesButyric acid, synthesized via bacterial fermentation in colonic lumen, may play an important role in the nutrition of the colonic mucosa. Since disaccharides, especially lactose, are the principal dietary carbohydrates during infancy, it is important to determine if their fermentation is associated with butyric acid synthesis. The objective of this paper is to describe a newly developed stable isotope method for quantifying butyric acid synthesis in the colonic lumen and to demonstrate its application during cecal infusions of lactose and lactulose in piglets.MethodsNine piglets aged 21 to 30 days were studied during acute anesthesia. The 13C enrichment of butyric acid was monitored in the portal vein before and during a 120 minutes cecal infusion of [1–13C]‐butyric acid and either unlabeled lactose (N = 4) or lactulose (N = 5).ResultsThe luminal synthesis of BA (μmol x kg−1 x min−1) (Mean ± S.D.) was respectively 1.5 ± 0.9 and 1.2 ± 0.6 during lactulose and lactose infusion.ConclusionsThis study provides new quantitative data on in vivo butyric acid production in the mammalian colon.
Children and Genetically Engineered Food: Potentials and Problems
Authors: Perr Hilary A. 
Published: January 2024

ABSTRACTChanges in food production and dietary practices are occurring faster than our understanding of their potential impact on children's health. Traditionally, pediatric gastroenterologists have studied food with respect to its nutritive value and digestibility, its influence on metabolism, its growth‐promoting characteristics, and its relationship to risk and severity of disease. Biotechnology is now expanding the science of food to include disease prevention and treatment, as well as the feeding of children on a global scale. Bioengineered (“genetically modified”, or “transgenic”) plants were initially developed to enhance the food supply by increasing crop yields. Such previously developed transgenic plants are now prevalent worldwide and appear in many processed food products. The implementation of the technology of genetic modulation of food plants has led to considerable fear, controversy, and confusion as the understanding of the technology is poor in the general population. This review presents an overview of genetically modified food crops and their potential unique benefits and risks to children's health. Political, economical, and ecological issues related to transgenic crops are not discussed.
Variable Effects of Short Chain Fatty Acids and Lactic Acid in Inducing Intestinal Mucosal Injury in Newborn Rats
Authors: Lin Jing , Nafday Suhas M. , Chauvin Sara N. , Magid Margret S. , Pabbatireddy Sudha , Holzman Ian R. , Babyatsky Mark W. 
Published: January 2024

ABSTRACTBackgroundShort chain fatty acids and lactic acid are colonic bacterial fermentation products.MethodsTo evaluate the effects of these organic acids on the intestinal mucosa, a total of 72 newborn Sprague‐Dawley rats (10 days old) were studied. A 3.5F catheter was inserted per rectum 4.0 cm deep into the proximal colon for organic acid administration at a volume of 0.1 ml/10 g body weight. The pH of organic acid solutions and normal saline was adjusted to 4.0. Group 1 (n = 10) received normal saline as a control. Group 2 (n = 11) received 150 mM acetic acid. Group 3 (n = 11) received 300 mM acetic acid. Group 4 (n = 10) received 150 mM butyric acid. Group 5 (n = 11) received 300 mM butyric acid. Group 6 (n = 7) received 150 mM lactic acid, and group 7 (n = 12) received 300 mM lactic acid. Animals were killed 24 hours after colonic installation of test solutions.ResultsBoth 300 mM acetic acid and 300 mM butyric acid were associated with impaired weight gain, increased colon wet weight, and increased histologic injury scores in the colon and distal ileum (P < 0.05, analysis of variance). Both 150 mM acetic acid and butyric acid at 150 mmol/L induced minimal injury in the colon and distal ileum. Neither 150 mM nor 300 mM lactic acid induced any identifiable gross or microscopic intestinal mucosal injury.ConclusionLuminal short chain fatty acids can induce dose‐dependent intestinal mucosal injury in newborn rats, resembling the pathology seen in neonatal necrotizing enterocolitis. Overproduction/accumulation of short chain fatty acids, but not lactic acid, in the proximal colon and/or distal ileum may play a role in the pathogenesis of necrotizing enterocolitis in premature infants.
Cytomegalovirus‐Associated Manifestations Involving the Digestive Tract in Children With Human Immunodeficiency Virus Infection
Authors: Ukarapol Nuthapong , Chartapisak Wattana , Lertprasertsuk Nirush , Wongsawasdi Lumduan , Kattipattanapong Vinaisak , Singhavejsakul Jesda , Sirisanthana Virat 
Published: January 2024

ABSTRACTObjectiveTo study the clinical manifestations of gastrointestinal cytomegalovirus disease in children with human immunodeficiency virus infection.MethodsReview of clinical records of eight human immunodeficiency virus–infected children and histopathologically confirmed gastrointestinal cytomegalovirus disease from 1995 to 2001.ResultsSix of the eight children were younger than 1 year. The most common clinical presentations were fever and chronic diarrhea. Lower gastrointestinal hemorrhage and bowel perforation were noted in four and three patients, respectively. The colon was the most commonly affected site, followed by the small bowel and esophagus. The diagnosis was established by histopathology, obtained during endoscopy and surgery. Mucosal edema, erythema, and ulcer comprised the most common endoscopic findings. Two patients with fever, chronic diarrhea, and lower gastrointestinal bleeding developed remission after being treated with a 14‐day course of ganciclovir.ConclusionGastrointestinal cytomegalovirus disease can result in serious life‐threatening complications, such as bowel perforation and massive gastrointestinal bleeding. Patients with chronic diarrhea and fever of unidentified cause might benefit from gastrointestinal endoscopy for early diagnosis and treatment. Although ganciclovir does not eradicate the infection and relapses are frequent, this treatment can prevent complications and reduce morbidity.
A Critical Assessment of Items on the Pediatric Crohn's Disease Activity Index
Authors: Loonen H. J. , Griffiths A. M. , Merkus M. P. , Derkx H. H. F. 
Published: January 2024

ABSTRACTObjectivesQuestions have been raised about the discriminative value of the three laboratory items (hematocrit, erythrocyte sedimentation rate, and albumin) and three physical items (height, perirectal disease, and extraintestinal manifestations) included in the Pediatric Crohn's Disease Activity Index (PCDAI). The aim of this study was to analyze the value of these six “criticized” items to the discriminative properties of the PCDAI.MethodsData from 71 children with Crohn's disease visiting an outpatient clinic were analyzed. Physician global assessment of disease activity was used as the gold standard. A “basic index” was calculated by subtracting the score of the six criticized items from the score of the PCDAI calculated in the standard fashion. Multivariate logistic regression procedures identified which items significantly contributed to the “basic index”. Receiver operating characteristic curves were produced comparing the standard PCDAI score to the “basic index” and a new “clinical index” which included only the criticized items truly contributing to the discriminatory ability of the “basic index”.ResultsLogistic regression models identified only perirectal disease as contributing to the discriminative abilities of the basic index. The clinical index therefore consists of the three history items (abdominal pain, number of liquid stools, and general well‐being), three physical examination items (weight loss, abdominal examination, and perirectal disease) and no laboratory tests. The clinical index had an area under the curve not significantly inferior to that of the original PCDAI (0.93 [95% confidence interval, 0.89–0.99] vs. 0.96 [95% confidence interval, 0.92–0.99]).ConclusionsA clinical index consisting of three history items and three physical examination items has an accuracy equal to the standard PCDAI in distinguishing children with disease in remission from those with a relapse.
Limitations of Probiotic Therapy in Acute, Severe Dehydrating Diarrhea
Authors: Costa‐Ribeiro Hugo , Ribeiro Tereza Cristina M. , Mattos Angela P. , Valois Sandra S. , Neri Daniela A. , Almeida Patricia , Cerqueira Celina M. , Ramos Eduardo , Young Rosemary J. , Vanderhoof Jon A. 
Published: January 2024

ABSTRACTBackgroundRecent studies have shown that probiotics, most commonly Lactobacillus GG, may be useful in treating acute gastroenteritis. However, beneficial effects appear to be limited to a modest decrease in the duration of diarrhea. No studies have evaluated this therapy in moderate to severe dehydrating diarrhea in a metabolic facility.MethodsMale children less than 2 years of age were admitted to a metabolic unit of the Department of Pediatrics at the Federal University of Bahia, Brazil, with moderate dehydration and were randomized in a double‐blind, placebo‐controlled fashion. Oral rehydration solution (ORS) was administered per protocol and either placebo or Lactobacillus GG was given in combination with the ORS. Output of urine, stool, and vomitus was recorded along with stool weight, nude body weight, and standard laboratory assessments for hydration.ResultsThere was no significant reduction in diarrhea duration and stool output in the Lactobacillus GG group. However, Kaplan‐Meier survival analysis demonstrated that, even in moderate to severe diarrhea, resolution of the illness occurred so rapidly, that statistically significant benefits of probiotic therapy could not be demonstrated.ConclusionOur data implies that colonization must occur before benefits of probiotics can be realized. Probiotics are, therefore, likely to be of limited benefit in treating diarrheal illnesses of short duration such as viral enteritis. The beneficial effects of probiotics may be limited to prophylactic usage in high‐risk populations.