bluuebunny/crossref_metadata_2025_split huggingface dataset:
Helicobacter pylori Infection and Chronic Gastritis
Authors: De Giacomo C. , Fiocca R. , Villani L. , Lisato L. , Licardi G. , Diegoli N. , Donadini A. , Maggiore G. 
Published: January 2024

SummaryTwenty‐three children with Helicobacter (Campylobacter) pylori‐associated chronic gastritis are reported. Family history of peptic disease, previous digestive procedures, and nonspecific epigastric pain were the most frequently encountered clinical features. Antral nodularity at endoscopy and histologic evidence of follicular gastritis were characteristic morphological aspects. Rapid urease tests suggested the diagnosis in 90% of patients. Significant increases of serum IgG and IgA against Helicobacter pylori allowed the identification of infected children with 95% cumulative sensitivity. Treatment with amoxicillin and bismuth subcitrate eradicated the infection and improved gastritis in 13 of 19 children. These findings provide further evidence for the etiologic role of Helicobacter pylori in chronic antral gastritis in children.
Epidemiologic, Clinical, and Laboratory Characteristics of Acute vs. Persistent Diarrhea in Periurban Lima, Peru
Authors: Lanata Claudio F. , Black Robert E. , Gilman Robert H. , Lazo Francisco , Del Aguila Roberto 
Published: January 2024

SummaryLongitudinal studies of acute and persistent diarrhea in 677 children less than 3 years old were conducted for 27 months in an underprivileged, periurban community near Lima, Peru. Incidence rates and accurate durations of diarrhea were obtained by twice‐weekly community‐based surveillance and clinical and laboratory features of diarrheal episodes were documented. Study children had an overall incidence of diarrhea of 8.1 episodes per child‐year and an incidence of persistent (>14 days) diarrhea of 0.25 episodes per child‐year. Episodes of longer duration were associated with young age (0–5 months) and more severe illness (±6 diarrheal stools per day) in the first week. None of the laboratory tests performed in the first week of illness (fecal leukocytes, blood, reducing substances, pH, or fat) proved of value to identify episodes that would become persistent. Although steatorrhea was commonly present in the acute phase of the illness, it became less frequent by the third or subsequent week of illness in the persistent diarrheas. These results suggest that there are no clinical or laboratory features of acute diarrhea that are strongly predictive of the subset of diarrheas that persist. Thus, it is important that all diarrheal episodes should have appropriate fluid and dietary management and follow‐up to detect the persistent diarrheas that may need special intervention.
Accuracy and Reproducibility of 12‐h Esophageal pH Monitoring
Authors: Friesen Craig A. , Hodge Charles , Roberts Charles C. 
Published: January 2024

SummarySeventy‐five consecutive 24‐h intraesophageal pH recordings performed according to the methods of Jolley et al. were evaluated. Total scores and the mean duration of sleep reflux (ZMD) were calculated for the first and the last 12 h, respectively, and compared to each other, as well as to the full 24‐h recording. The accuracy of the first and last 12 h in predicting whether the 24‐h study was abnormal was 85% and 87%, respectively. The accuracy in predicting whether the ZMD for the 24‐h study was abnormal was 73% and 83%, respectively, with an overall 39% false‐negative rate. The 12‐h study reproducibility was 72% for the total score and 56% for the ZMD. Since the original standards were determined from 18− to 24‐h recordings, the test was restandardized based on 12‐h recordings from patients with normal 24‐h studies. Restandardization did not improve the accuracy or reproducibility. The high false‐negative rate for the ZMD and the poor reproducibility cast serious doubt on the utility of 12‐h pH recordings, especially in patients with respiratory symptoms.
Intestinal Neuronal Dysplasia
Authors: Schofield Deborah E. , Yunis Eduardo J. 
Published: January 2024

SummaryFour hundred ninety‐eight acetylcholinesterase‐stained suction rectal biopsies from 456 children were examined to assess the occurrence of “isolated” or “primary” intestinal neuronal dysplasia at Children's Hospital of Pittsburgh. Cases of proven Hirschsprung's disease were excluded. In 38 biopsies from 38 patients, we found a mild to moderate increase in mucosal acetyl‐cholinesterase staining and abundant submucosal ganglion cells (large, irregular ganglia or at least five ganglia per HPF). This group was clinically heterogeneous with a frequent history of prematurity and small left colon/meconium plug syndrome, protein/formula intolerance, or obstructive anatomic gastrointestinal abnormalities. We feel that isolated “intestinal neuronal dysplasia,” as diagnosed by suction rectal biopsy and the above criteria, is a descriptive biopsy appearance. Rather than characterizing a unique disease entity, it is encountered in a variety of clinical situations. Based on our observations and review of the literature, we therefore conclude that “intestinal neuronal dysplasia” not associated with Hirschsprung's disease, neurofibromatosis, or multiple endocrine neoplasia syndrome has yet to be well defined in clinical and histopathologic terms. The histologic diagnosis, at this time, should be reserved for those rare, florid cases of parasympathetic hyperganglionosis that are documented by adequate tissue sampling.
Clostridium difficile in Inflammatory Bowel Disease Relapse
Authors: Gryboski Joyce D. 
Published: January 2024

SummaryStools of 65 patients with exacerbation of symptoms of inflammatory bowel disease were examined for the presence of enteric pathogens and Clostridium difficile. Ten (16%) had C. difficile toxin. Symptoms in all patients cleared after therapy, with improvement correlating with elimination of toxin from the stool.
Kinetics of Viral Replication in Experimental Rotavirus Infection
Authors: Sagher F. A. , Dodge J. A. , Simpson D. H. , Evans P. 
Published: January 2024

SummaryEpidemiological studies suggest that dietary fat can affect the frequency and severity of diarrhoeal illnesses in childhood. To study the effects of dietary fat on the kinetics of rotavirus antigen, 3‐week‐old mice of rotavirus‐seronegative mothers were fed isocaloric diets with 40% of the total calories as fat [either butter (high saturated fat), olive oil (high monounsaturated fat), or corn oil (high polyunsaturated fat)] with one group on low fat (10% of calories) standard diet as controls. Seven‐day‐old mice from the first litter were killed and their stomach contents (milk) analyzed for total fatty acids. Seven‐day‐old mice from the second litter were inoculated with EDIM rotavirus, and some were killed at 48 h and others at 120 h postinoculation. The stool was removed from the distal colon of each mouse and examined for evidence of diarrhoea. The small intestine was removed, the contents washed, and the intestine divided into equal thirds. All stool and tissue samples were made to 10% (wt/vol), homogenised, and tested for rotavirus antigen by ELISA. We found that (a) dietary fat markedly altered the fatty acid profile of milk, (b) high saturated dietary fat (butter) delayed the onset of diarrhoea, reduced the excretion of rotavirus antigen in stool, and reduced mucosal antigen in the lower third of the small intestine at 120 h compared to 48 h postinoculation, (c) high polyunsaturated dietary fat initially increased the frequency of diarrhoea and viral antigen in the middle and lower segment at 120 h, followed by a reduction in rotavirus excretion in stool. We conclude that dietary saturated fat reduces the incidence and severity of rotavirus infection in mice. These observations may have implications for infant diarrhoeal illnesses.
Changes in Hepatic Vitamin K1 Levels After Prophylactic Administration to the Newborn
Authors: Guillaumont M. , Sann L. , Leclercq M. , Dostalova L. , Vignal B. , Frederich A. 
Published: January 2024

SummaryWe undertook a study of hepatic concentrations of vitamin K (vitamin K1 or phylloquinone, vitamin K1‐epoxide, and menaquinones) in 18 infants, ages 1‐8 days, with or without vitamin K1 supplementation. The infants who had no supplementation had a total hepatic storage ranging between 0.1 and 0.9 μg. Also, hepatic storage of phylloquinone was poor (< 1 μg) when compared with daily requirements. Moreover, we did not detect any menaquinone in the livers of these infants in our study. The prophylaxis applied to the other infants was very efficient. Hepatic vitamin K1 concentrations, obtained <24 h after administration, were very high (62.8‐93.5 μg/g). Vitamin K1‐epoxide concentrations were high, which proved the efficiency of the vitamin K cycle. In contrast, the decrease in vitamin K1 concentrations was also very rapid, since the median value after 48 h was 8.4 μg/g and only 2.9 μg/g 5 days after administration. However, hepatic total storage after 5 days in one infant with vitamin K1 supplementation was much higher (112 μg) than in infants who had not received supplementation. In conclusion, hepatic phylloquinone storage at birth was poor (<1 μg). The newborn infant might be in a situation of potential deficiency. After prophylactic oral administration of phylloquinone, uptake by the liver was quite satisfactory, but concentrations dropped quickly. However, phylloquinone hepatic storage remained elevated (112 μg) after 5 days.
Apple Juice Malabsorption
Authors: Hoekstra J. H. , van Kempen A. A. M. W. , Kneepkens C. M. F. 
Published: January 2024

SummaryCarbohydrate malabsorption after apple juice ingestion may produce abdominal symptoms and diarrhea, especially in children. The carbohydrates suggested to play roles in this process are fructose, as it is present in excess of glucose, and sorbitol. Absorption of the carbohydrates in apple juice was investigated in 17 children and 12 adults by means of the hydrogen breath test. Apple juice was given at a dose of 15 ml/kg body weight, with a maximum of 375 ml. Fructose (0.6 g/kg) and sorbitol (0.06 g/kg), alone and in combination, were administered in amounts similar to their contents in apple juice (fructose as excess over glucose content). Apple juice malabsorption, as judged by a peak breath H2 excretion of ≥20 ppm, was found in 11 children (65%) and 4 adults (33%). Of those malabsorbing apple juice, 7 of 11 children malabsorbed fructose, 1 of 11 sorbitol, and 4 of 11 the combination; the four adults absorbed all test solutions completely. We could not find an additive effect of sorbitol on breath H2 excretion after fructose ingestion. Peak breath H2 concentrations after apple juice ingestion (mean ± SEM: 43 ± 7 ppm) were higher than those with fructose (23 ± 5 ppm; p < 0.05) or the fructose‐sorbitol combination (20 ± 5 ppm; p < 0.05). Fructose, and not sorbitol, is the sugar responsible for the increase in breath H2 after apple juice consumption and therefore for the diarrhea accompanying excessive apple juice consumption in toddlers.
Characterisation of the Local Inflammatory Response in Appendicitis
Authors: Tsuji M. , Puri P. , Reen D. J. 
Published: January 2024

SummaryIn this study we have characterised the local inflammatory response in acute suppurative appendicitis (S), focal appendicitis (F), and normal appendices (C). Enumeration of lymphocyte subpopulations, cells expressing IL‐2 receptor, natural killer (NK) cells, monocytes and plasma cell isotypes and subclasses infiltrating the lamina propria was carried out on all specimens using immunoperoxidase staining procedures. Total T cells were significantly increased in both acute suppurative appendicitis and focal appendicitis compared with controls (p < 0.001). Cells infiltrating the lamina propria expressed IL‐2 receptor in all appendiceal specimens but were significantly increased in both acute and focal appendicitis (p < 0.01). IgG and IgA plasma cell isotypes were significantly increased in all S and F appendiceal specimens (p < 0.001). Monocyte and NK cell numbers, however, were only increased in acute suppurative appendiceal specimens. The increased lymphocyte and plasma cell isotypes seen in focal appendicitis occurred throughout the entire organ even though the inflammatory focus was confined to only three to seven serial sections. These results clearly show a differential pattern of cellular infiltration in focal appendicitis from that seen in acute suppurative appendicitis. The selective lymphocyte and plasma cell nature of the cellular infiltrate in the lamina propria of focal appendicitis may reflect the presence of a specific immune response to an as yet unidentified luminal antigen as a possible cause of appendicitis.
Efficacy of Diazepam and Meperidine in Ambulatory Pediatric Patients Undergoing Endoscopy
Authors: Bahal‐O'Mara Neeta , Nahata Milap C. , Murray Robert D. , Linscheid Thomas R. , Williams Todd , Heitlinger Leo A. , K. Li B. Ulysses , McClung H. Juhling , Lininger Barbara 
Published: January 2024

SummaryMedications are routinely administered to children prior to upper gastrointestinal endoscopy procedures. We evaluated the efficacy and safety of four dosage regimens: meperidine 2 mg/kg (M); low‐dose meperdine 1 mg/kg and diazepam 0.1 mg/kg (M low + D); high‐dose meperidine 2 mg/kg and diazepam 0.1 mg/kg (M high + D); and, diazepam 0.1 mg/kg (D) in a randomized, double‐blind trial in 71 pediatric patients (ages 1 to 19 years). Cooperation, emotional state, and sedation were rated. The frequency of negative behavior demonstration (i.e., crying, gagging, flailing, nervous behavior) indicating ineffective or inadequate sedation was recorded before, during, and after the procedure. Vital signs and oxygen saturation were noted. Significant differences were observed in the efficacy of the various sedation regimens. Overall, the physicians and nurses rated M most effective in children <11 years. In these children, M high + D and D were rated least effective by the nurses, whereas physicians felt that D was least effective. In the older children, M, M low + D, and M high + D were rated similarly effective by physicians and nurses, and D was rated least effective. In both age groups, the lowest incidence of negative behaviors during the endoscopy procedure occurred in patients who received M. Combinations of D and M + D resulted in an increased incidence of negative behaviors; thus, M may be the preferred sedation regimen in children undergoing endoscopy. The addition of diazepam to meperidine may be detrimental in terms of eliciting negative behaviors.
Olsalazine Versus Sulfasalazine in Mild to Moderate Childhood Ulcerative Colitis
Authors: Ferry George D. , Kirschner Barbara S. , Grand Richard J. , Issenman Robert M. , Griffiths Anne M. , Vanderhoof John A. , Fiedorek Stephen C. , Winter Harland S. , Hassall Eric G. , Watkins John B. , Gryboski Joyce , Ulshen Martin H. , Daum Frederic , Perman Jay A. , Thomas Daniel W. , Heubi James E. , Byrne William J. , Jones Bobbette 
Published: January 2024

SummaryThe safety and efficacy of olsalazine sodium was compared to sulfasalazine over 3 months in a multi‐center, randomized, double‐blind study of 56 children with mild to moderate ulcerative colitis. Twenty‐eight children received 30mg/kg/day of olsalazine (maximum, 2 g/day) and 28 received 60 mg/kg/day of sulfasalazine (maximum, 4 g/day). Side effects were frequent in both groups. Eleven of 28 patients (39%) on olsalazine reported headache, nausea, vomiting, rash, pruritus, increased diarrhea, and/or fever. Thirteen of 28 on sulfasalazine (46%) reported similar side effects and/or neutropenia, and four patients had the drug stopped because of an adverse reaction. After 3 months, 11 of 28 (39%) on olsalazine were asymptomatic or clinically improved, compared to 22 of 28 (79%) on sulfasalazine (p = 0.006). In addition, 10 of 28 patients on olsalazine versus one on sulfasalazine required prednisone because of lack of response or worsening of colitis (p = 0.005). The dose of olsalazine used in this clinical trial was thought to be equivalent to a standard dose of sulfasalazine, but fewer patients on olsalazine improved and a greater number had progression of symptoms when compared to sulfasalazine. Although side effects were slightly less frequent for olsalazine, the number of patients was too small to detect a clinically significant difference.
Sonographic Findings in Celiac Disease
Authors: Riccabona M. , Rossipal E. 
Published: January 2024

SummaryIn 43 children who had been admitted to our department due to symptoms of malabsorption, sonography of the small bowel was performed before biopsy. Seventeen of the patients were shown to have celiac disease. Twenty‐six patients had gastroenteritis, postenteritis syndrome, and enteropathic cow's milk allergy, and one patient had sarcoidosis. At the time of diagnosis, 16 children with celiac disease showed a sonographically abnormal appearance of the small‐bowel wall structure. In addition to hyperperistalsis, slight ascites, pericardial fluid, or liver tissue texture changes could be found in some of the patients. Relating the findings of abnormal small‐bowel wall structures to the data of the small‐bowel biopsy, we found a sensitivity of 94% and a specificity of 88% for sonographic detection of changes related to celiac disease. Our findings indicate that sonographic data can be of great help in exploring children with signs of malabsorption. These data provide a further argument for the decision to perform a biopsy of the small bowel.
Presence of Multiple Forms of Peptidase Inhibitors in Rat Milk
Authors: Rao R. K. , Lam K. , Philipps A. F. , Williams C. , Lake M. , Koldovský O. 
Published: January 2024

SummaryPeptides such as somatostatin (SS14), epidermal growth factor (EGF), transforming growth factor‐α (TGFα), and insulin‐like growth factors (IGF‐I and IGF‐II) are present in breast milk from various species, and their significance in the developing gastrointestinal tract has been suggested. Our recent studies have indicated that rat milk soluble fraction (RMSF) protects SS14 in the gastrointestinal lumen by inhibiting in vitro the luminal peptidolysis. In the present studies, we have shown that RMSF inhibited in vitro degradation by midjejunal luminal flushings of suckling rats of 125I‐labeled somatostatin 14[Tyr11], EGF, TGFα, IGF‐I and IGF‐II, as well as trypsin activity in vitro against benzoyl‐L‐arginyl‐p‐nitroanilide. The inhibitory factors present in the RMSF were further fractionated by gel filtration on Sephadex G100, ion‐exchange chromatography on DEAE‐Sephadex, and fast protein liquid chromatography (FPLC). Gel filtration of Sephadex G100 separated RMSF into three peaks of proteins: G1, G2, and G3; peptidase inhibitor activities were present exclusively in G1. Ion‐exchange chromatography on DEAE‐Sephadex column resolved peptidase inhibitory activity (G1) into three different peaks, D1, D2, and D3, eluted at sodium chloride concentrations of 0.05 M, 0.1 M, and 0.2 M, respectively. Further purification of D2 by FPLC resulted in a fraction rich in peptidase inhibitory activity, which was essentially free of trypsin inhibitory activity. Results indicate the presence of at least three peptidase inhibitors in rat milk, which may play a role in the protection of milk‐borne peptides in the gastrointestinal lumen.
Peripheral γδ T Cell Receptor‐Bearing Lymphocytes Are Increased in Children with Celiac Disease
Authors: Klemola T. , Tarkkanen J. , ürmälä T. , Saxen H. , Savilahti E. 
Published: January 2024

SummaryThe percentages of γδ T cell receptor‐bearing (TCR+) cells in the peripheral blood and jejunal mucosa of patients with celiac disease were measured before treatment, during a gluten free‐diet, and after a gluten challenge. The percentages of the different cell types were evaluated by flow cytometry, and immunohistochemical staining of the jejunal specimen was used to identify lymphocyte surface markers. Nineteen blood samples and intestinal specimens from 13 children with celiac disease (eight samples taken before treatment, six during gluten‐free diet, and five after gluten challenge) and samples from nine controls were studied. The proportion of γδ TCR+ lymphocytes was significantly higher both in the peripheral blood and the jejunal mucosa of the patients with celiac disease. A significant correlation was found between the percentage of peripheral γδ TCR+ cells and the density of γδ TCR+ cells in the lamina propria.
Is a Low‐Osmolarity ORS Solution More Efficacious Than Standard WHO ORS Solution?
Authors: El‐Mougi M. , El‐Akkad N. , Hendawi A. , Hassan M. , Amer A. , Fontaine O. , Pierce N. F. 
Published: January 2024

SummaryThe clinical efficacy of a diluted oral rehydration salts (ORS) solution was compared in a pilot study with that of intravenous (i.v.) therapy and of standard World Health Organization (WHO)/United Nations Childrens Fund (UNICEF) ORS solution in children with acute diarrhea. Sixty‐one boys aged 3 to 24 months, admitted to hospital with acute diarrhea and signs of dehydration, were randomly assigned to groups receiving standard ORS solution, diluted ORS solution, or i.v. therapy. In children treated with standard ORS solution and small amounts of plain water, the total fluid intake was 25–39% greater, the stool output was 58–77% greater (p < 0.01), and the duration of diarrhea was 30–55% greater than in the other treatment groups. Intake of plain water, taken separately or added to the ORS solution, was greater in children given diluted ORS solution (73 ± 23 ml/kg) than in those given standard ORS solution (21 ± 32 ml/kg) (p < 0.001). The mean serum sodium concentration increased by 2.2 mEq/L in children given standard ORS solution, whereas it decreased by 2.9 mEq/L in those given diluted ORS solution. This study shows that some children develop worsening diarrhea and increasing serum sodium concentrations when treated with standard ORS solution and given only small amounts of plain water. This is probably caused by the slight hypertonicity of standard ORS solution combined with transient partial glucose malabsorption. This can be avoided if water, breast milk, or another low‐solute drink is given liberally during maintenance therapy with ORS solution, as recommended by the WHO.
The Oligosaccharide Composition of Human Milk
Authors: Miller Janette Brand , Bull Stefan , Miller John , McVeagh Patricia 
Published: January 2024

SummaryOligosaccharides are an important component of human milk, but little is known about variations in their composition. The aim of this study was to determine the temporal and inter‐individual variations in carbohydrate composition of human milk during the first 3 months of lactation. Serial milk samples of 10 mothers (eight full‐term and two preterm births) were analyzed to determine the concentration of lactose and three monosaccharide components derived from the non‐lactose carbohydrate: sialic acid, N‐acetylglucosamine, and fucose. In full‐term milk, sialic acid and N‐acetylglucosamine were found to decrease significantly (p < 0.05) from weeks 1 to 13 postnatally. On average (mean ± SD), sialic acid decreased by 71% (from 879 ± 157 to 256 ± 82 mg/L; p < 0.05) and N‐acetylglucosamine by 56% (from 1,459 ± 282 to 646 ± 214 mg/L; p < 0.05), while fucose decreased by only 35% (from 660 ± 192 to 432 ± 180 mg/L; p > 0.05). On average, lactose concentration increased by 17% over the same period, from 55.4 ± 4.2 g/L in week 1 to 64.9 ± 2.3 g/L at 3 months. Preterm milk contained higher concentrations of each component, but temporal changes were similar to those seen in full‐term milk. Apart from temporal changes, there were large inter‐individual differences in oligosaccharide composition: fucose varied fourfold, sialic acid threefold, and N‐acetylglucosamine twofold among women at the same stage of lactation. The changes observed may simply reflect the aging of the cells responsible for milk secretion, but they are also consistent with a programmed adaptation of the milk composition to the needs of the infant.