bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects in Premature Infants of Normalizing Breath H2 Concentrations with CO2
Authors: Kien C. Lawrence , Liechty Edward A. , Myerberg David Z. , Mullett Martha D. 
Published: February 2024

SummaryInterval sampling of expired breath samples from the anterior nares is a feasible and noninvasive method for detecting elevated breath H2 and thus colonic carbohydrate fermentation, especially in nontherapeutic research studies of healthy premature infants. However, there may be a risk of falsely low breath H2 concentration and an unacceptable experimental error due to contamination with room air as well as with dead space air. We studied ten premature infants (28–32 week gestational age and 2–4 weeks postnatal age) who were receiving either a proprietary formula containing equal proportions of lactose and glucose polymer, or a similar formula in which lactose was the sole carbohydrate. In 70 breath samples (obtained 30–180 min after feeding) we assessed the coefficient of variation in breath hydrogen concentration among three aliquots obtained over a 3–5 min interval. Breath was collected from the anterior nares. The interaliquot coefficient of variation averaged 11% when expressed as parts per million per 5% CO2, compared to 19% when expressed as parts per million (Wilcoxon, p < 0.001). Mean breath hydrogen concentration at each time period using the former method (parts per million per 5% CO2) was about 100% higher than when using the latter method. Although ventilation rate can alter alveolar CO2, normalizing for CO2 concentration reduces a major source of experimental error.
Recovery of Exogenous Heme as Carbon Monoxide and Biliary Heme in Adult Rats After Tin Protoporphyrin Treatment
Authors: Hintz Susan R. , Kwong Linda K. , Vreman Hendrik J. , Stevenson David K. 
Published: February 2024

SummaryWe studied the effect of tin protoporphyrin (TP) on bilirubin production in adult Wistar rats by quantifying in vivo carbon monoxide (CO) excretion and the simultaneous excretion of biliary heme after common bile duct cannulation. A known amount of heme was injected intravenously as red blood cells (RBC) damaged with a sulfhydryl inhibitor, N‐ethylmaleimide. The recovery of heme as CO or biliary heme in the cannulated animals was calculated as the molar percent of heme recovered over heme injected. For cannulated controls (n = 4), the recovery was 89 ± 6% SD, and no heme appeared in bile. Cannulated rats treated with TP (n = 4) had 64 ± 11% recovered as CO and 30 ± 11% as heme in bile. Our findings suggest that TP is an effective in vivo inhibitor of exogenous heme catabolism and bilirubin production in adult rats. Furthermore, this inhibition results in increased excretion of heme into the bile proportional to the degree of inhibition.
Gastrointestinal Peptide Profile in Children with Celiac Disease
Authors: Hernanz Angel , Polanco Isabel , Codoceo Rosa , Lama Rosa , Vazquez Carlos 
Published: February 2024

SummaryIn order to investigate if a plasma profile of gastrointestinal peptides reflects changes in jejunal mucosa in celiac disease, we studied basal and postprandial plasma levels of gastrin, secretin, somatostatin, vasoactive intestinal polypeptide (VIP), and neurotensin in children with untreated and treated celiac disease and in a control group of children. Basal and 30‐min postprandial secretin concentrations were statistically significantly lower in untreated celiac children compared to both treated celiac (p < 0.01 and p < 0.05, respectively) and control children (p < 0.001). Plasma secretin levels 30 min after a breakfast meal were also statistically significantly lower (p < 0.001) in treated celiac children with respect to the control group. In both untreated and treated celiac groups, basal and postprandial plasma levels of somatostatin and VIP were statistically significantly decreased (p < 0.001) compared to control children. Moreover, there was a significant rise in postprandial levels of neurotensin after a breakfast meal in untreated celiac children. On the contrary, there was no rise of neurotensin in healthy children. These findings seem to indicate that determination of plasma profile of gastrointestinal peptides in children with celiac disease may be useful in monitoring the development of this disease and, thus, the number of jejunal biopsies could be decreased.
In Vitro Solubility of Calcium Glycerophosphate Versus Conventional Mineral Salts in Pediatric Parenteral Nutrition Solutions
Authors: Hanning R. M. , Mitchell M. K. , Atkinson S. A. 
Published: February 2024

Summary:Low‐birth‐weight infants requiring total parenteral nutrition receive inadequate intakes of calcium (Ca) and phosphorus (P) due to poor solubility of available mineral salts. To optimize Ca/P delivery, we tested the effects on in vitro solubility of mineral salt:calcium glycerophosphate (CaGP) versus calcium gluconate and K2HPO4 (CG + P); Ca:P ratios of 1:1 (at 12.5 and 25 mmol/L of Ca and P) and 2:1 (25:12.5 mmol/L): amino acid (AA) formulation: Aminosyn (A), Aminosyn‐PF (A‐PF), TrophAmine (T) or Vaminolac (V); and AA concentration (25 versus 8.3 g/L). Parenteral nutrition solutions contained 10% dextrose and vitamins and minerals typical of a neonatal prescription. Solutions were sampled at preparation, after 24 h in the neonatal unit (25°C), and from before and after a 0.22‐μm filter in extension tubing through which solutions were pumped at 5 ml/h within an incubator at 37°C. Samples were analyzed for Ca and pH, and precipitation by spectrophotometry at 600 nm and light microscopy at × 100 magnification. The Ca concentration was unaffected by filtration. While spectrophotometry detected only gross precipitation, with light microscopy crystal formation was evident with 25 mmol/L of Ca and P as CG + P in A and T at 25 g of AA/L and in A, V, T, and A‐PF at 8.3 g of AA/L. Precipitation did not occur with CaGP or CG + P at 12.5 mmol/L of Ca and P. Under in vitro conditions mimicking the neonatal unit, CaGP versus CG + P resulted in greater mineral solubility even at low AA concentrations.
Chronic Pancreatitis and Pancreas Divisum in an Infant
Authors: Yaffe Michael R. , Gutenberger James E. 
Published: February 2024

Summary:We describe an infant with pancreas divisum diagnosed by endoscopic retrograde cholangiopancre‐atography. This infant had chronic and unremitting pancreatitis that only became amenable to surgery following the use of somatostatin analog after the usual and customary treatment for pancreatitis was ineffective.
Hepatic Disease Associated with Intrauterine Parvovirus B19 Infection in a Newborn Premature Infant
Authors: Metzman Ross , Anand Aditi , DeGiulio Patricia A. , Knisely A. S. 
Published: February 2024

Summary:A hydropic premature infant with intrauterine growth retardation died at 4 days of age and was found at necropsy to have advanced liver disease. Clinical and serologic findings in mother and infant were consistent with recent parvovirus B19 infection. Parvovirus can cause fetal liver disease in animals, and some instances of congenital hepatic dysfunction in man may be due to intrauterine parvovirus B19 infection.
Gastric Bezoar After Hepatic Transplantation
Authors: Schwarzenberg Sarah Jane , Freese Deborah K. , Payne William D. , Ascher Nancy L. , Sharp Harvey L. 
Published: February 2024

Summary:A gastric bezoar complicated the postoperative course of three children following successful hepatic transplantation. Two patients had evidence of extremely erratic absorption of the cyclosporine (CSA) used for immunosuppression. Gastric bezoars usually occur in patients with gastric dysmotility and/or patients ingesting poorly digestible material. Although several factors may contribute to bezoar formation after hepatic transplantation, a major predisposing factor may be the administration of the large quantities of olive oil required for solubilization of CSA.
Neurologic Investigations of Childhood Abdominal Migraine: A Combined Electrophysiologic Approach to Diagnosis
Authors: Good Peter A. 
Published: February 2024

Summary:Neurologic studies of childhood migraine, including imaging techniques and electrophysiology, have identified a number of abnormalities, but none of high specificity. Therefore, a diagnostic marker for childhood migraine and its equivalents remains elusive. In this study a combined electrophysiologic approach is assessed, using measurements of visually provoked β‐activity, highfrequency photic following responses, and visually stimulated event‐related potentials. Eighteen children younger than 10 years of age with abdominal migraine and/or cyclic vomiting syndrome were investigated with these techniques. They were compared with the responses from a number of control groups, including a group diagnosed as childhood migraine with or without aura. Individually, each investigation yielded high sensitivities but low specificities (<50%). However, when these techniques were used in combination the specificity for migraine rose to >90%. There was no significant difference between abdominal migraineurs and those with migraine with or without aura in any of the parameters studied. This combined approach is potentially useful in the diagnosis of abdominal migraine and supports the view that abdominal migraine can be classed as a true childhood migraine equivalent.
Randomized, Multicenter Trial of Two Different Formulas for Very Early Enteral Feeding Advancement in Extremely‐Low‐Birth‐Weight Infants
Authors: Mihatsch Walter Alexander , von Schoenaich Patrik , Fahnenstich Hubert , Dehne Norma , Ebbecke Hartmut , Plath Christian , von Stockhausen Hans‐Burkhardt , Gaus Wilhelm , Pohlandt Frank 
Published: February 2024

ABSTRACTBackgroundIn extremely‐low‐birth‐weight (ELBW) infants, formula feeding is required if human milk is not available. The tolerance of a new `high' lactose (55 g/L), low protein, low phosphate, hydrolyzed protein formula (HLF) for early enteral feeding advancement of ELBW infants was compared with that of a low lactose (1 g/L) hydrolyzed protein formula (LLF).MethodsIn a randomized multicenter trial, 99 ELBW infants were fed according to a standardized protocol beginning at 48 hours of age with 12 ml/kg daily increments. Primary outcome was the cumulative milk feeding volume (CFV) from days 3 to 14. The authors hypothesized that feeding HLF as a supplement to human milk would increase the CFV at least by 20% in at least 60% of matched pairs compared with LLF. A secondary issue was to investigate whether human milk would increase the CFV compared with formula.ResultsThe CFV was 720 mL/kg (range, 0–962 mL/kg) with HLF and 613 mL/kg (range, 3–1,283 mL/kg) with LLF feeding. There was no 20% difference. On day 14, the median feeding volume was 103 mL/kg. The CFV was 533 mL/kg (range, 0–962 mL/kg) in infants who received less than 10% of human milk and 832 mL/kg (range, 74–1,283 mL/kg) in infants who received more than 10%. Necrotizing enterocolitis (Bell stage ≥2) occurred only with LLF feeding (n = 5;P < 0.05).ConclusionsThe study failed to find the hypothesized 20% advantage of the new HLF. The observed advantage of human milk supports the hypothesis that it should be the first diet in ELBW infants; however, this hypothesis still must be confirmed in a controlled, randomized trial.
Chronic Subcutaneous Octreotide Decreases Gastrointestinal Blood Loss in Blue Rubber–Bleb Nevus Syndrome
Authors: Gonzalez Daniela , Elizondo Ben J. , Haslag Sara , Buchanan George , Burdick J. Steven , Guzzetta Philip C. , Hicks Barry A. , Andersen John M. 
Published: February 2024

ABSTRACTBackgroundA patient affected by blue rubber–bleb nevus syndrome had chronic gastrointestinal bleeding requiring weekly blood transfusions. Despite multiple surgical and endoscopic procedures to treat the venous malformations, the patient continued to bleed primarily from lesions in the small bowel. Therefore, this patient was treated with octreotide, a somatostatin analog known to decrease splanchnic blood flow and that is used for acute and chronic gastrointestinal bleeding.MethodsOctreotide therapy, 5.7 μg/kg subcutaneously twice daily, was initiated, and the patient was followed up clinically. Complete blood counts, blood glucose concentration, pancreatic enzyme concentration, liver function tests, and growth hormone concentration were monitored during treatments.ResultsDuring the 4 weeks after initiation of octreotide therapy, hemoglobin concentration was maintained without the need for transfusions. Octreotide decreased the patient's monthly need for blood transfusion from 52 ± 7 mL · kg−1 · mo−1 of packed red blood cells to 23 ± 7 mL · kg−1 · mo−1. She had no detectable side effects or growth inhibition. Other medical interventions including ‐εaminocaproic acid, nadolol, and total parenteral nutrition with bowel rest were not as effective as octreotide alone.ConclusionOctreotide decreased the patient's need for blood transfusions. Possible mechanisms include altering blood flow to the gastrointestinal tract and direct effects on the venous malformations.
Intestinal Protein and LPH Synthesis in Parenterally Fed Piglets Receiving Partial Enteral Nutrition and Enteral Insulinlike Growth Factor 1
Authors: Park Yoo Kyoung , Dudley Mary A. , Burrin Douglas G. , Donovan Sharon M. 
Published: February 2024

ABSTRACTBackgroundProviding partial enteral nutrition (PEN) supplemented with insulinlike growth factor‐1 (IGF‐1) to parenterally fed piglets increases lactase–phlorizin hydrolase (LPH) activity, but not LPH mRNA. The current aim was to investigate potential mechanisms by which IGF‐1 up‐regulates LPH activity.MethodsNewborn piglets (n = 15) received 100% parenteral nutrition (TPN), 80% parenteral nutrition + 20% parenteral nutrition (PEN), or PEN + IGF‐1 (1.0 mg · kg−1 · d−1) for 7 days. On day 7, [2H3]‐leucine was intravenously administered to measure mucosal protein and brush border LPH (BB LPH) synthesis.ResultsWeight gain, nutrient intake, and jejunal weight and length were similar among the treatment groups. Partial enteral nutrition alone increased mucosal weight, villus width and cross‐sectional area, LPH activity, mRNA expression, and high mannose LPH precursor (proLPHh) abundance compared with TPN (P <0.05). Insulinlike growth factor‐1 further increased mucosal weight, LPH activity, and LPH activity per unit BB LPH approximately twofold over PEN alone (P < 0.05) but did not affect LPH mRNA or the abundance of proLPHh (one of the LPH isoforms) or mature LPH. Isotopic enrichment of [2H3]‐leucine in plasma, mucosal protein, and LPH precursors, and the fractional and absolute synthesis rates of mucosal protein and LPH were similar among the treatment groups. Insulinlike growth factor‐1 treatment increased total mucosal protein synthesis (60%, P < 0.05) but not LPH synthesis compared with the other two groups.ConclusionsBecause IGF‐1 did not affect the fractional synthesis rate of either mucosal protein or LPH, the authors suggest that enteral IGF‐1 increases mucosal protein mass and LPH activity by suppressing mucosal proteolytic degradation.
Guideline for the Evaluation of Cholestatic Jaundice in Infants: Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition
Authors: Moyer Virginia , Freese Deborah K. , Whitington Peter F. , Olson Alan D. , Brewer Fred , Colletti Richard B. , Heyman Melvin B. 
Published: February 2024

AbstractFor the primary care provider, cholestatic jaundice in infancy, defined as jaundice caused by an elevated conjugated bilirubin, is an uncommon but potentially serious problem that indicates hepatobiliary dysfunction. Early detection of cholestatic jaundice by the primary care physician and timely, accurate diagnosis by the pediatric gastroenterologist are important for successful treatment and a favorable prognosis. The Cholestasis Guideline Committee of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition has formulated a clinical practice guideline for the diagnostic evaluation of cholestatic jaundice in the infant. The Cholestasis Guideline Committee, consisting of a primary care pediatrician, a clinical epidemiologist (who also practices primary care pediatrics), and five pediatric gastroenterologists, based its recommendations on a comprehensive and systematic review of the medical literature integrated with expert opinion. Consensus was achieved through the Nominal Group Technique, a structured quantitative method.The Committee examined the value of diagnostic tests commonly used for the evaluation of cholestatic jaundice and how those interventions can be applied to clinical situations in the infant. The guideline provides recommendations for management by the primary care provider, indications for consultation by a pediatric gastroenterologist, and recommendations for management by the pediatric gastroenterologist.The Cholestasis Guideline Committee recommends that any infant noted to be jaundiced at 2 weeks of age be evaluated for cholestasis with measurement of total and direct serum bilirubin. However, breast‐fed infants who can be reliably monitored and who have an otherwise normal history (no dark urine or light stools) and physical examination may be asked to return at 3 weeks of age and, if jaundice persists, have measurement of total and direct serum bilirubin at that time.This document represents the official recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition on the evaluation of cholestatic jaundice in infants. The American Academy of Pediatrics has also endorsed these recommendations. These recommendations are a general guideline and are not intended as a substitute for clinical judgment or as a protocol for the care of all patients with this problem.
Treatment of Functional Abdominal Pain in Childhood With Cognitive Behavioral Strategies
Authors: Youssef Nader N. , Rosh Joel R. , Loughran Mary , Schuckalo Stephanie G. , Cotter Ann N. , Verga Barbara G. , Mones Richard L. 
Published: February 2024

ABSTRACTObjective:The aim of this study was to assess the efficacy of a cognitive‐behavioral approach to the treatment of recurrent abdominal pain caused by childhood functional gastrointestinal disorders (FGIDs).Methods:From September 2001 to December 2002, 18 patients (12 male; mean age, 12.1 ± 4.9 years) with chronic abdominal pain (mean duration, 11.8 ± 13.3 months) caused by FGIDs were referred to our facility's mind‐body institute (MBI). Treatment included guided imagery and progressive relaxation techniques. The mean number of sessions per patient was 4.3 ± 3.4. Outcomes included change in abdominal pain and quality of life, evaluated by the Pediatric Quality of Life Scale (PedsQL®). Follow‐up was 10.6 ± 2.3 months after the last MBI session.Results:Abdominal pain improved in 89% of patients; weekly pain episodes decreased from 5.5 ± 0.9 to 2.0 ± 2.7 (P < 0.05); pain intensity (0 to 3 scale) decreased from 2.7 ± 0.6 to 0.6 ± 0.7 (P < 0.04); missed school days/month decreased from 4.6 ± 1.7 to 1.4 ± 3.2 (P < 0.05); social activities/week increased from 0.3 ± 0.6 to 1.3 ± 0.6 (P < 0.05); physician office contacts/year decreased from 24 ± 10.2 to 8.7 ± 13.1 (P = 0.07). PedsQL® scores (0 to 100 scale) improved from 55.3 ± 11.9 to 80.0 ± 10.7 (P < 0.03).Conclusions:Guided imagery and progressive relaxation can safely and effectively reduce chronic abdominal pain in children with FGIDs. This treatment also improved social functioning and school attendance.
Gastric Emptying of Solids in Children with H. pylori‐Positive and H. pylori‐Negative Non‐Ulcer Dyspepsia
Authors: Sýkora Josef , Malán Alexander , Záhlava Jan , Varvars̆ká Jana , Stozĭcký František , Siala Konrad , Schwarz Jan 
Published: February 2024

ABSTRACTObjective:There is currently no data available in children on possible relationships among Helicobacter pylori, gastric motility and gastric inflammation. This is a prospective study of gastric emptying (GE) in symptomatic children with and without H. pylori who met symptom‐based criteria for non‐ulcer dyspepsia (NUD).Methods:47 consecutive dyspeptic patients (23 males; age range, 7 to 18 years) were enrolled. All patients had extensive negative diagnostic investigations. Scintigraphic solid‐phase gastric emptying was assessed.Results:21 H. pylori‐positive and 26 H. pylori‐negative patients were identified with non‐ulcer dyspepsia. The groups were not different in clinical symptoms except that pain related to feeding was more frequent in infected children (P < 0.03). Nodular antral gastritis was found more frequently in the H. pylori positive group (P < 0.0001). The gastritis score was more severe in H. pylori infected than H. pylori negative patients in both fundic and body mucosa (P < 0.001). Within the H. pylori‐positive NUD group, the mean half‐time GE of a solid meal was significantly accelerated compared to the non‐infected group (P < 0.05). There was no difference in the intragastric food distribution and curves of gastric emptying of both groups. A significant relationship was found between the degree of gastric body inflammation gastric emptying, but not antral inflammation. Gastric emptying rate did not differ by sex or age of the subjects in either group.Conclusions:In dyspeptic children with H. pylori, gastric emptying of a solid was significantly accelerated compared with symptomatic H. pylori uninfected patients. This suggests that H. pylori is able to induce gastric emptying acceleration. Our findings add more information on H. pylori infection and gastroduodenal disease.
Intestinal Imaging of Children with Acute Rotavirus Gastroenteritis
Authors: Bass Dorsey , Cordoba Eileen , Dekker Cornelia , Schuind Anne , Cassady Christopher 
Published: February 2024

ABSTRACTObjective:To examine the morphology and motility of the distal small bowel of infants with rotavirus gastroenteritis using non‐invasive/non‐ionizing imaging technology.Methods:Prospective, non‐randomized observational study of five infants with symptomatic rotavirus infection. Infants were imaged by real‐time magnetic resonance imaging (MRI) and ultrasound within 5 days of onset of gastroenteritis symptoms. Imaging studies were repeated in the convalescent period 5 to 9 weeks later.Results:Three of five infants had a significant increase in the ileal wall thickness visualized by ultrasound during acute rotavirus infection compared with convalescence. The number and size of mesenteric lymph nodes visualized by ultrasound appeared similar in the acute and convalescent phases, as did peristaltic activity assessed by MRI.Conclusion:Abdominal ultrasound can detect changes in ileal wall thickness in infants with rotavirus infection. These changes may reflect ileal inflammation elicited by viral infection. Such studies may prove useful in evaluating morphologic response to attenuated rotavirus vaccines.