bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bacterial Infection
Authors: Wolf Anna , Pohlandt Frank 
Published: January 2024

SUMMARYTo test the hypothesis that bacterial infections are the main cause of acute cholestasis in short‐term intravenously fed newborns, two groups were studied. Group I consisted of 152 newborn infants who were fed intravenously for at least 7 days and in whom severe bacterial infections developed. Group II was formed of 92 newborn infants who were matched to the group I cases with respect to the year of birth, birth weight and gestational age, Apgar scores, and duration of parenteral nutrition but who did not have infections. Bacterial infections were diagnosed on the basis of impaired microcirculation with prolonged capillary filling time, a shift to the left in the white cell differential, and a positive blood culture. Cholestasis was diagnosed when the total serum bilirubin level was >4 mg/dl and the conjugated fraction made up more than 40% of the total. The results were that all 40 cases of cholestasis were found in the first group of infected infants. All of the other factors were distributed equally between both groups and could not be attributed as a major factor in the etiology of idiopathic neonatal cholestasis. The conclusion was that bacterial infections are the main cause of acute cholestasis in intravenously fed newborn infants.
Selective Precipitation of 14 kDa Stone/Thread Proteins by Concentration of Pancreaticobiliary Secretions
Authors: Forstner Gordon G. , Vesely Shirly M. , Durie Peter R. 
Published: January 2024

SUMMARYConcentrated proteins in pancreatic juice could precipitate and plug pancreatic ducts, initiating pancreatic disease. In cystic fibrosis (CF), pancreatic fluid secretion is impaired due to defective anion transport and proteins are hyperconcentrated. To determine whether proteins in pancreatic secretions precipitate selectively or nonspecifically, duodenal secretions were obtained from subjects with and without cystic fibrosis, during pancreatic stimulation with cholecystokinin (CCK) and secretin, dialyzed against phosphate‐buffered saline (PBS), and concentrated in stages by ultrafiltration. Precipitates obtained by centrifugation at 15,600 g for 10 min at 4°C were analyzed by sodium dodecyl sulfate‐polyacrylamide gel electrophoresis. The only protein band regularly enriched in precipitates from 10 CF and 9 non‐CF samples had an Mr of approximately 14,000. Monoclonal antibodies, raised independently in two laboratories against either pancreatic stone protein (PSP) or pancreatic thread protein (PTP), reacted with the Mr 14,000 protein(s). Differential extraction of PTP and PSP by 0.1N HC1 and 10% sodium citrate produced Mr 14,000 products that reacted equally with each monoclonal antibody (MAB). Two‐dimensional gel electrophoresis demonstrated two Mr 14,000 spots in each extract with pI's of 5.8 and 6.0. Each spot reacted equivalently with the MABs for PSP and PTP. PSP/PTP type proteins are sparingly soluble in pancreatic secretions and could contribute to protein plugging in pancreatic disease.
Aneurysmal Dilatation of the Portal Vein
Authors: Lee Hung‐Chang , Yang Yhu‐Chering , Shih Shin‐Lin , Chiang Hsein‐Jar 
Published: January 2024

SUMMARYIn the following study, a case involving an aneurysmal dilatation of the portal vein is reported. The 5‐year‐old boy had a 2 month history of intermittent abdominal pain. A segmental dilatation of the portal vein was noted in the sonographic examination. The portal vein aneurysm diagnosis was later confirmed by superior mesenteric angiography and computed tomography. In our review of the literature, less than 30 cases of portal venous aneurysm have been reported. To our knowledge, this is the youngest case with such an anomaly.
Tannin‐Rich Carob Pod for the Treatment of Acute‐Onset Diarrhea
Authors: Loeb H. , Vandenplas Y. , Würsch P. , Guesry P. 
Published: January 2024

SummaryInfants aged 3–21 months with acute diarrhea of bacterial and viral origin were treated as inpatients with oral rehydration fluid and randomly received for up to 6 days either a tannin‐rich carob pod powder (40% tannins or 21.2% polyphenols and 26.4% dietary fiber), 1.5 g/kg/day (n = 21) to a maximum of 15 g, or an equivalent placebo (n = 20). The duration of the diarrhea from admission was 2.0 ± 0.27 days in the test group and 3.75 ± 0.30 days in the placebo group (p < 0.001). Normalized defecation, body temperature, and weight and cessation of vomiting were reached more quickly by the patients who received the test substance. The test substance was well accepted and tolerated.
Serological Markers and Celiac Disease
Authors: Calabuig M. , Torregosa R. , Polo P. , Tuset L. , Tomás C. , Alvarez V. , Garcia‐Vila A. , Brines J. , Vilar P. , Farré C. , Varea V. 
Published: January 2024

SummaryWe analyze the diagnostic efficacy of two celiac disease serological markers: anti‐gliadin (IgA and IgG class) and anti‐endomysium IgA‐class (EmA‐IgA) antibodies applied to 336 serum samples from celiac patients on both gluten‐challenge and gluten‐free diets, and a control group. The anti‐gliadin and anti‐endomysium antibodies levels were significantly higher among the gluten‐consuming celiac patients than in the other groups. The greatest efficacy in diagnosing celiac disease was achieved in the Ema‐IgA class test. The IgA‐class anti‐gliadin antibodies proved to be more specific, with a higher positive test predictive value than the IgG‐class anti‐gliadin antibodies, whereas the latter proved to be more sensitive, with a higher negative test predictive value than those of the IgA‐class anti‐gliadin antibodies. Our results also demonstrate that the simultaneous assessment of anti‐gliadin IgA‐ and IgG‐class antibodies constitutes a valid test in selecting patients suspected of having celiac disease. In turn the EmA‐IgA antibodies constitute a confirmative test for indication of an intestinal biopsy.
Dermatoglyphic (Fingerprint) Patterns in Celiac Disease
Authors: Weizman Zvi , Vardi Orna , Binsztok Mauricio 
Published: January 2024

SummaryFingerprints were obtained from 46 patients with celiac disease and compared with those of 46 control subjects matched for sex and ethnic origin. Whorls were more frequent and ulnar loops were less frequent, significantly, in celiac patients than in controls. A digital pattern of four or more whorls was present in 69% of celiac patients, but in only 28% of controls (p < 0.001). As a diagnostic test, the fingerprint's sensitivity, specificity, and positive and negative predictive values were 66, 73, 67, and 71%, respectively. Similarly, a pattern of four or less ulnar loops was evident in 44% of celiac patients as opposed to only 19% of controls (p < 0.005). Sensitivity, specificity, and positive and negative predictive values were 46%, 81%, 62%, and 63%, respectively. We conclude that particular dermatoglyphic patterns are significantly more common in patients with celiac disease than in controls. We therefore suggest that this marker be used as a diagnostic clue, indicating the need for further investigation.
Comparison of Total Serum Lipids Measured by Two Methods
Authors: Heubi James E. , Sokol Ronald J. , McGraw Catherine A. 
Published: January 2024

Summaryto accurately assess vitamin E status, the ratio of serum vitamin E to total serum lipids is required. We compared two methods of measuring total serum lipids: (a) the calculated sum of measured cholesterol, triglycerides, and phospholipids, and (b) the colorimetric method. Over the entire range of total lipid concentrations (151–1,728 mg/dl), there was an excellent correlation between methods (r = 0.930; p < 0.001). No significant differences between measurements by these methods were found over the entire range and between 0 and 1,000 mg/dl; however, between 1,000 and 1,728 mg/dl, the measured total lipid concentration was higher (p = 0.023) than the added total lipid measurements. Despite this discrepancy, the methods appear comparable for clinical use in assessing vitamin E/total lipid status; the measured total lipids would be the preferred method because of the low cost and ease of performance of the test.
Nonocclusive Mesenteric Ischemia Associated with Propranolol Overdose
Authors: Pettei Michael J. , Levy Joseph , Abramson Sarah 
Published: January 2024

SummaryWe describe a case of massive propranolol overdose in a healthy 19‐year‐old woman associated with isolated mesenteric ischemia following shock. We postulate that endogenous catecholamine release from shock combined with massive β‐adrenergic blockade led to severe splanchnic vasoconstriction from unopposed α‐adrenergic activity. This case supports current thinking regarding the effect of vasoactive mediators on the gastrointestinal tract in humans and might be relevant to the mechanism of action of propranolol in the prophylaxis of variceal bleeding.
Nodular Gastritis and Helicobacter pylori
Authors: Bujanover Yoram , Konikoff Fred , Baratz Mimi 
Published: January 2024

SummaryNumerous reports have established the association of Helicobacter pylori and peptic ulcer disease in adults. Recently, this association has also been demonstrated in children. We investigated 14 children and adolescents with recurrent abdominal pain. In six patients, endoscopy revealed gastritis and Helicobacter pylori was identified. Giemsa stain was more sensitive than culture or urease testing in identifying the bacteria. In four of the six, a nodular appearance of the antral mucosa was observed. The histological examination suggests lymphoid hyperplasia as the cause of the nodularity. All of the patients became symptomless after combined treatment with amoxicillin and bismuth subsalicylate. We conclude that nodular gastritis is a peculiar type of gastritis in children. It is frequently found in association with Helico‐bacter pylori infection.
Intestinal Giardiasis Associated with Ophthalmologic Changes
Authors: Mantovani M. Pettoello , Giardino I. , Magli A. , di Martino L. , Guandalini S. 
Published: January 2024

Summary:In an ophthalmologic study of 90 children with symptomatic giardiasis, ocular alterations were found in 10. Eight of these subjects presented an extensive “salt and pepper” degeneration of the pigmented epithelium involving 360° of the midperiphery of both eyes. In one of the eight children, the pigmented epithelium showed atrophic areas, and in another there was a small hard exudate in the left eye. Of 2 remaining of the 10 children with ocular alterations, 1 presented with slight decoloration of the temporal half of the optic disc, and the other was affected by chorioretinitis. After single‐dose antiprotozoic therapy (tinidazole 50 mg/kg), parasitologic tests were negative in all subjects and remained so throughout a 1‐year follow‐up. However, the characteristic epithelial lesion remained unalterated in all eight children for the entire follow‐up period, as well as the optic disc decoloration in the only observed case. The child affected by chorioretinitis recovered after 3 weeks of combined treatment with bethametasone plus deflazacort. In two control groups, 1 of 200 healthy children and 1 of 200 children with gastrointestinal symptoms but without giardiasis, no case of “salt and pepper” degeneration of the pigmented epithelium or other significant ocular alterations was found.
Measurement of Gastrointestinal pH and Regional Transit Times in Normal Children
Authors: Fallingborg Jan , Christensen Lisbet A. , Ingeman‐Nielsen Margrethe , Jacobsen Bent A. , Abildgaard Kirsten , Rasmussen Henrik H. , Nørby Rasmussen Sten 
Published: January 2024

Summary:Gastrointestinal pH and regional intestinal transit times of a capsule were measured in twelve healthy children aged 8–14 years using a radiotransmitting pH‐sensitive capsule. The location of the capsule was determined by fluoroscopy. pH in the stomach was 1.5, but rose to 6.4 in the duodenum (mean values). pH gradually rose in the small intestine and reached an alkaline peak value of 7.4 in the distal part. pH dropped to 5.9 in the cecum but rose to 6.5 in the rectum. Median gastric residence time of the capsule was 1.1 h. Small intestinal transit time was 7.5 h, and colonic transit time was 17.2 h. pH profile and intestinal transit times found in the present study are almost identical to values found in studies on healthy adults. It is therefore concluded that the release pattern of pH‐dependent sustained‐release tablets in children is likely to be equal to that of adults.
Enhanced Sodium Absorption by Citrate
Authors: Patra F. C. , Hamidur Rahman A. S. M. , Wahed M. A. , Al‐Mahmud K. A. 
Published: January 2024

SummaryThe effect of citrate on sodium, potassium chloride, and water absorption in the presence of glucose from the whole rat small intestine was studied by an in vivo marker perfusion technique. The perfusion solutions contained glucose and were similar in their electrolyte composition to the currently recommended oral rehydration solution for the treatment and prevention of diarrheal dehydration. Significantly more sodium and water absorption occurred from the citrate‐containing solution than from the one without citrate. It is concluded that citrate enhances net sodium absorption from a glucose electrolyte solution in the rat small intestine independent of glucose‐stimulated absorption.
Diagnostic Value of Serum γ‐Glutamyl Transpeptidase Activity in Liver Diseases in Children
Authors: Maggiore G. , Bernard O. , Hadchouel M. , Lemonnier A. , Alagille D. 
Published: January 2024

SummaryThe clinical usefulness of serum γ‐glutamyl transpeptidase (γGT) assay for the diagnosis of liver disease in children was assessed retrospectively in 398 children investigated from 1981 to 1986, in whom diagnosis was ascertained according to currently accepted criteria including liver histology in each case. Serum γGT activity was within normal limits in 10 controls, in 19 children with portal vein obstruction, and in 10 of 12 children with congenital hepatic fibrosis. Serum γGT was raised in all children with biliary atresia, sclerosing cholangitis, paucity of interlobular bile ducts, and α1‐antitrypsin deficiency with jaundice. Serum γGT was normal in spite of patent clinical signs of cholestasis in 3 patients with benign recurrent intrahepatic cholestasis, 1 infant with posthemolytic neonatal cholestasis, and in 22 of 28 patients with progressive idiopathic cholestasis akin to Byler disease. In the latter group, children with raised serum γGT displayed extensive portal fibrosis and bile duct proliferation on liver histology, while this was not a prominent feature in children with normal serum γGT. These results indicate (a) the value and limits of the assay for serum γGT activity in children with liver disease, (b) that raised serum γGT may be considered a fairly reliable index of bile duct damage, and (c) that serum γGT may prove a useful tool in separating two forms of progressive idiopathic cholestasis, with or without bile duct involvement.
Patient and Procedure Variables Associated with Complications Following Variceal Sclerotherapy in Children
Authors: Proujansky Roy , Orenstein Susan R. , Kocoshis Samuel A. 
Published: January 2024

SummaryVariceal sclerotherapy has been performed in the pediatric population, but techniques and dosages of sclerosant recommended in the literature are largely empirical. Having accumulated much data through experience with sclerotherapy in children, we have identified patient and procedure variables associated with early and late complications. We reviewed our experience with 37 pediatric patients, ages 1–18, who underwent 150 sclerotherapy sessions. Sclerotherapy was associated with 12 early complications in 11 patients. Early complications were bleeding (five), respiratory problems (three), false channel formation (two), and gross hematuria (two). Four patients developed strictures. We identified the following variables associated with complications: for bleeding, platelet count <100,000/mm3; for respiratory complications and false channel formation, weight <12 kg; for false channel formation, dosage of sclerosant/kg/session > 1.75 ml/kg; for gross hematuria, total sclerosant/session >20 ml. A need for more than six sclerotherapy sessions for obliteration of varices was associated with a greater frequency of stricture formation. Sclerotherapy can be performed safely in children. Patients <12 kg or with platelet counts <100,000/mm3 should be monitored carefully for respiratory complications and postprocedure bleeding. Sclerosant dosages >1.75 ml/kg, or 20 ml total sclerosant, should be given with caution.
Cisapride Decreases Prolonged Episodes of Reflux in Infants
Authors: Vandenplas Yvan , de Roy Catherine , Sacre Liliane 
Published: January 2024

SummaryTwenty‐nine infants (2–4 months old), with pathological gastroesophageal reflux assessed by 24‐h esophageal pH monitoring, were studied. Cisapride or placebo was randomly added to positional treatment, prone‐antiTrendelenburg position, which was applied to all infants. The pH monitoring was repeated after 13–16 days of treatment and revealed a significant improvement in both groups for most parameters. But the number of reflux episodes lasting longer than 5 min and the total number of reflux episodes had not decreased significantly in the placebo group. Only in the number of reflux episodes lasting longer than 5 min was improvement during treatment significantly greater in the cisapride group. This suggests cisapride both prevented reflux and improved esophageal clearance. These results suggest that in addition to other therapeutic measurements, such as positional treatment (which was previously demonstrated to be effective in this age group), cisapride might be of benefit in the treatment of gastroesophageal reflux disease.
Intestinal Motility in Symptomatic Children with Fundoplication
Authors: Di Lorenzo Carlo , Flores Alejandro , Hyman Paul E. 
Published: January 2024

Summary.Fundoplication alters the anatomy of the lower esophageal sphincter but should have no direct effects on motility distal to the sphincter. Of 55 children referred for evaluation of symptoms consistent with upper gastrointestinal motor dysfunction, 28 had undergone fundoplication 6 months to 4 years earlier to treat severe gastroesophageal reflux that had failed medical management. All 28 children had symptoms that were unchanged or worsened after fundoplication. In all children, we studied fasting and fed antroduodenal motility, and compared results from groups with and without fundoplication. Abnormalities in antroduodenal motility were found in 25 of 28 of the fundoplication group and in 25 of 27 of unoperated children. We found a wide range of abnormalities, but there were no differences in the types or severity of abnormalities between groups. In summary, in children with severe functional gastrointestinal symptoms, antroduodenal manometry uncovered physiological abnormalities, and fundoplication failed to relieve symptoms. These data suggest that preoperative intestinal manometry could identify children unlikely to benefit from fundoplication.
Human Intestinal Disaccharidase Activities
Authors: Heitlinger Leo A. , Rossi Thomas M. , Lee Ping‐cheung , Lebenthal Emanuel 
Published: January 2024

SummaryThe relationship between intestinal morphology, disaccharidase activity, and disaccharide absorption is controversial. A retrospective study of 798 consecutive biopsies was performed to determine whether disaccharidase activities varied by subject age, biopsy technique, and degree of villus atrophy. Lactase activity was inversely correlated with age in the absence or presence of villus atrophy; sucrase, maltase, and palatinase activities did not correlate with age. Biopsies obtained by capsule or endoscopy had similar disaccharidase activities. In subjects 24 months of age or younger, the degree of mucosal injury was inversely correlated with lactase activity. In subjects older than 24 months, the degree of mucosal injury was inversely correlated with maltase and, to a lesser extent, lactase activities. The data suggest that disaccharidase activities in mucosal biopsies, whether obtained by endoscopy or capsule, are diminished in the presence of mucosal injury and correlate inversely with the degree of injury.
Activities of Lipase and Trypsin in Duodenal Juice of Infants Small for Gestational Age
Authors: Boehm G. , Bierbach U. , Senger H. , Jakobsson I. , Minoli I. , Moro G. , Räihä N. C. R. 
Published: January 2024

SummaryIn 18 low birth weight infants, small for gestational age, with different degrees of intrauterine growth retardation the activities of pancreatic lipase and trypsin and the concentrations of bile acids were measured in preprandially aspirated duodenal juice. The results were compared to those of 24 low birth weight infants, appropriate for gestational age, with comparable birth weights and postnatal ages. The activities of both measured pancreatic enzymes were negatively correlated with the degree of intrauterine growth retardation, expressed as the difference between the individual birth weight and the weight of the 10th percentile of the intrauterine growth curve (lipase: r = −0.697, p < 0.001; trypsin: r = −0.739, p < 0.001). The activity of trypsin in the small for gestational age infants was within the range of that found in the infants appropriate for gestational age. However, the lipase activity was decreased in infants who presented with growth retardation of >400 g/kg birth‐weight. The concentrations of bile acids were similar in both groups (4.60 ± 2.51 and 4.55 ± 2.26 mmol/L, respectively) and sufficient for activating the bile salt stimulated lipase in human milk. The data suggest that in intrauterine growth retarded infants the lipase activity in the duodenal juice can be a limiting factor for optimal fat digestion. This should be considered in the nutritional management of such infants.
A New Direct Pancreatic Function Test in Pediatrics
Authors: Madrazo‐de la Garza J. A. , Gotthold M. , Lu R. B. , Hill I. D. , Lebenthal E. 
Published: January 2024

SummaryTraditional methods for collecting duodenal fluid are time consuming and technically difficult. A simple endoscopic method is proposed in this report as a means of collecting duodenal fluid to perform exocrine pancreatic function tests. Thirty‐five patients between 24 and 36 months of age were studied for pancreatic exocrine function. Twenty‐seven presented with chronic diarrhea and 8 with failure to thrive. In 20 patients (group 1), duodenal fluid was collected by means of a double‐lumen tube and sequential administration of pancreozymin (PZN) and secretin (SEC). The rest (group 2) had duodenal aspiration from the level of the papilla of Vater through a fiberoptic endoscope following administration of SEC only. The procedure took approximately 3 h in group 1 and 45 min in group 2. Secretin administration produced comparable levels of enzymes in both groups. Pancreozymin produced the highest enzyme levels, but this was only significantly higher than SEC‐induced levels in the case of lipase. Endoscopic collection of duodenal fluid following SEC administration is a safe, quick, and reliable method of collecting pancreatic secretion.