bluuebunny/crossref_metadata_2025_split huggingface dataset:
Total Parenteral Nutrition with Intralipid in Pr Infants Receiving TPN with Heparin
Authors: Berkow S. E. , Spear M. L. , Stahl G. E. , Gutman A. , Polin R. A. , Pereira G. R. , Olivecrona T. , Hamosh P. , Hamosh M. 
Published: January 2024

SummaryPlasma lipolytic activity (lipoprotcin lipase and hepatic lipase). free fatty acids (FFA). triglyceridcs. cholesterol, and glucose levels were measured in 21 premature infants [gestational age 26–37 weeks (mean ± SEM 30.4 ± 0.63 weeks), aged 1–8 days (mean ± SEM 3.00 ± 0.35 days)]. All infants were maintained on total parenteral nutrition with heparin (1 U/ml) and were given Intralipid, 1. 2, and 3 g/kg/day. over 15 h on days 1, 2, and 3. respectively. Blood samples were drawn before and at the end of Intralipid administration. Baseline plasma lipolytic activity, before the start of lipid infusion, was 1.54 ± 0.24 U/ml (1 U = I μmol [3H]oleic acid released from tri[3H]olein/h). Lipolytic activity increased after lipid infusion to 4.04 ± 0.96, 4.32 ± 0.63. and 6.09 ± 1.00 U/ml on days 1, 2, and 3 of the study. Hepatic lipase amounted to 38–47% of total lipolytic activity. During the 3 days of lipid infusion, there were dose‐dependent increases in plasma FFA, triglyceride, and cholesterol. Whereas FFA and triglyceride concentrations returned to prelipid infusion levels 9 h after stopping the infusion of Intralipid, 1, 2, or 3 g/kg, there was a cumulative increase in plasma cholesterol and glucose concentrations. The close correlation between FFA concentrations and plasma lipolytic activity (r = 0.655, p < 0.001) suggests considerable in‐travascular lipolysis. The positive correlation between plasma FFA and triglycerides (r = 0.632, p < 0.001) and FFA and cholesterol (r = 0.582. p < 0.001) indicate, however, that intravascular lipolysis does not prevent the lipemia associated with Intralipid infusion to low birth weight infants. This study suggests that the infusion of a mixture of small amounts of heparin and Intralipid leads to detachment of lipoprotcin lipase and hepatic lipase from the capillary endothelium of low birth weight infants. The resulting intravascular lipolysis probably exceeds the FFA disposal capacity of premature infants. The rise in plasma FFA concentration to 2.0 μmol/ml warrants caution in the combined use of Intralipid (at rates exceeding 2 g/kg/day) and low levels of heparin for the clinical management of premature infants maintained on total parenteral nutrition.
Cornstarch Therapy in a Patient with Type III Glycogen Storage Disease
Authors: Borowitz Stephen M. , Greene Harry L. 
Published: January 2024

SummaryA child with type III glycogen storage disease is described. The patient presented with growth failure and hepatic dysfunction, and no clinical or biochemical evidence of myopathy. Institution of high protein nocturnal intragastric feedings was associated with improved growth and less hepatic dysfunction. Compliance with tube feedings was sporadic necessitating another approach to the patient's management. The use of oral cornstarch supplements enabled the child to maintain normoglycemia and was associated with clinical and biochemical improvement. Our experience with this child suggests cornstarch therapy may be useful in those patients with type III glycogen storage disease who suffer primarily from hepatic dysfunction and growth failure.
Growth and Adiposity of Term Infants Fed Whey‐Predominant or Casein‐Predominant Formulas or Human Milk
Authors: Harrison Gail G. , Graver Ellen J. , Vargas Margaret , Churella Helen R. , Paule Charles L. 
Published: January 2024

SummaryGrowth, estimated composition of weight gained, and stool patterns of term infants who were fed either a whey‐predominant formula or a casein‐predominant formula in a random design and of breast‐fed infants were compared. All infants (N = 111) were healthy, singleton products of uncomplicated pregnancies. Birth weights and other anthropometric measures in the first few days of life were not different among the three feeding groups. Formula or breast milk was the infants' principal source of energy from birth to age 16 weeks. Average energy intakes of formula‐fed infants and change of intakes with age were similar in both groups at all ages. Feeding groups were not significantly different at any age in weight, length, weight or length gain, head circumference, skinfold measurements, upper arm fat area and muscle area, or estimated total body fat. Stools of infants on the whey‐predominant formula differed from both the breast‐fed and casein‐predominant formula groups.
Differences in Fatty Acid Composition of Human Milk in Vegetarian and Nonvegetarian Women
Authors: Specker Bonny L. , Wey Howard E. , Miller Donald 
Published: January 2024

SummaryThe purpose of the current study was to determine whether there were differences in the fatty acid composition of milk from vegetarian mothers compared to nonvegetarian mothers and whether fatty acid composition was related to length of time on a vegetarian diet. Median time on a vegetarian diet was 81 months (range 36–132 months). Milk fat and fatty acids produced de novo in the mammary gland did not differ between diet groups. Milk from vegetarian women (n = 12) contained higher percentages of the precursors of arachidonic acid compared to nonvegetarian women (n = 7). Although there was no difference between diet group in the amount of arachidonic acid present (percent of total), a lower percentage was observed in women the longer they were on a vegetarian diet (r = −0.724, p = 0.008), with a corresponding higher percentage of the sum of precursors of arachidonic acid (r = 0.563, p = 0.056). The percentage of docosahexenoic acid was similar in the milk of vegetarian women compared to nonvegetarian women. The length of time on a vegetarian diet had no effect on these two fatty acids. In summary, differences in fatty acid content were apparent between the two dietary groups and changes with time on a vegetarian diet suggest that not only does current maternal diet affect fatty acid milk composition, but long‐term dietary habits may as well.
Antibodies to 90 Kilodalton Glycoprotein in Childhood and Adolescent Celiac Disease
Authors: Teppo A. ‐M. , Mäki M. , Háullström O. , Maury C. P. J. 
Published: January 2024

SummaryAntibodies to 90 kilodalton (kDa) glycoprotein, a mannose‐rich protein of skin and intestinal mucosa, were determined in 31 children or adolescents with untreated cehac disease, in 30 of these patients during gluten withdrawal, and in 17 patients on gluten challenge. Highly elevated antibody levels to 90 kDa glycoprotein were found in patients with untreated cehac disease. Close, positive correlation (r 0.74, p 0.0005) was found between the age of these patients and the level of 90 kDa glycoprotein antibodies. The antibodies to 90 kDa glycoprotein behaved, compared with the reticulin antibodies, in a different manner kinetically. During gluten challenge antibodies to 90 kDa glycoprotein increased on an average 2.6 months later than the antibodies to reticulin. On the other hand, in patients undergoing gluten withdrawal the antibodies to reticulin markedly decreased or disappeared during the first 3 months on the diet, whereas the level of 90 kDa glycoprotein antibodies did not decrease until the 5th to 11th months on the diet. These results suggest that the antibodies reacting with the 90 kDa glycoprotein differ from those reacting with reticulin and that in celiac patients undergoing gluten challenge the synthesis of reticulin antibodies is an earlier event than the production of 90 kDa glycoprotein antibodies. The level of 90 kDa glycoprotein antibodies may reflect the extent of tissue damage.
Factors Responsible for Persistence of Childhood Constipation
Authors: Loening‐Baucke Vera A. 
Published: January 2024

SummaryIn this study 56% of children with chronic constipation and encopresis were unable to defecate rectal balloons. Most of them had an abnormal contraction of the external anal sphincter during defecation trials. Eighty‐six percent were still unable to defecate balloons 1 year later after having complied with a conventional treatment program. Only 14% of patients unable to defecate balloons had recovered by 1 year, whereas 64% of patients able to had recovered (p ‐ 0.02). Only 13% of patients unable to relax the external sphincter had recovered by 1 year, whereas 70% of those able to do so had recovered (p ‐ 0.01). In addition, none of the patients with an abdominal fecal mass present during the initial examination independent of ability or inability to defecate balloons had recovered (p ‐ 0.001). This study shows that abnormal defecation dynamics and the severity of constipation are predictors for persistence of chronic constipation and encopresis.
Lowered Serum Ca, Blood Ionized Ca, and Unresponsive Serum Parathyroid Hormone with Oral Glucose Ingestion in Infants of Diabetic Mothers
Authors: Venkataraman Pankaja S. , Blick Kenneth H. , Dasharathy Gayathri , Parker Michael K. 
Published: January 2024

SummaryOral glucose ingestion may lower serum Ca in infants of diabetic mothers (IDMs). Six metabolically stable IDMs were studied following ingestion of 1.7 0.1 g/kg (mean ± SE) of glucose over 20 min and serum Ca. Mg. P. blood iCa, serum PTH, and CT were measured at 0. 1/2, 1, and 2 h. Data obtained in IDMs were compared with previously reported findings in 10 normal neonates. In IDMs as in normal neonates. serum Ca. Mg. P declined significantly after oral glucose ingestion. Blood Ca2+ was significantly lower at 1 1/2 h in IDMs versus normal neonates, and by analysis of covariance, trends in blood Ca2+ were significantly different in IDMs versus normal neonates (p < 0.05). Serum PTH concentrations were unaltered in IDMs versus a significant rise in serum PTH noted in normal neonates. The difference between the two groups was significant statistically (p < 0.05). Baseline serum CT was elevated in both groups and did not change. Thus, in IDMs responses to oral glucose ingestion differs from that seen in normal neonates as follows: blood Ca2+ is lowered in IDMs versus normal neonates, and serum parathyroid hormone (PTH) does not respond to a decline in blood Ca2+ in IDMs, whereas in normal neonates serum PTH rises and blood Ca2+ is maintained. We speculate that relative parathyroid gland unresponsiveness occurs in IDMs, which may result in lowered blood Ca2+ after oral glucose ingestion in these infants.
Effects of Berberine on Basal and Secretagogue‐Modified Ion Transport in the Rabbit Ileum in Vitro
Authors: Guandalini Stefano , Fasano Alessio , Migliavacca Maurizio , Marchesano Giuseppe , Ferola Anna , Rubino Armido 
Published: January 2024

Summary:The antisecretory effect of berberine sulfate (BS) was determined in the rabbit ileal mucosa in vitro mounted in Ussing chambers. When present in the luminal side, the drug had no effect on potential difference (PD) or on the short‐circuit current (Isc) changes induced by theophylline or prostaglandin E2(PGE2). When present in the serosal medium at a concentration of 2 mM, however, berberine reduced PD and Isc and abolished residual ion flux (bicarbonate secretion) but had no significant affect on basal net Na and CI transepithelial transport. BS effect on basal PD was not affected by the absence of Ca2+ in the medium: neither was it inhibited by the α‐adrenergic blocker yohimbine. Serosally added BS effectively antagonized the secretory effect on Isc of agents that increase each of the known intracellular mediators of ion secretion: cyclic 3′, 5′‐adenosine monophosphate (cAMP), cyclic 3′, 5′‐guanosine monophosphate (cGMP), and Ca2+: it also inhibited the ion transport modifications evoked by PGE2. The drug had no effect on the concentration of cyclic nucleotides either under basal condition or in the presence of some secretagogues. Finally, BS did not impair the PD rise due to luminal addition of glucose.
Short‐Term Malnutrpition in Neonatal Rabbits. I. Brush Border Enzymes
Authors: Baker Susan S. , Suthutvoravut Umaporn , Walker W. Allan 
Published: January 2024

SummarySeventy‐two hour starvation in neonatal rabbits was studied. Fasted animals received no feeds, only water every 8 h for 72 h. Fed animals were suekled by the dam. I here was no difference in birth weight, serum albumin, blood urea nitrogen, electrolytes, or urine specific gravity between led and fasted animals. Weight at 72 hr was less in lasted (p < 0.01) than fed rabbits. Serum cortisol (p < 0.05) and corticosterone (p < 0.01) levels were higher in the fasted group. Proximal and distal small bowel homogenates had less DNA and protein (p < 0.01) in the lasted group, but the protein DNA ratio was the same in the proximal and distal small bowel homogenates from both groups. Sucrase (E.C.3.2.1.26) specific activity was significantly increased in proximal small bowel homogenates from the fasted group (p < 0.01) but was the same in distal small bowel homogenates from both groups. Sucrase total activity per proximal segment was the same in fed and fasted animals but was significantly less per segment in distal small bowel homogenates from fasted animals. Alkaline phosphatase (E.C.3.1.3) total and specific activity was decreased in proximal (p < 0.01 ) and distal (p < 0.05) small bowel homogenates from the lasted group. Lactase (E.C.3.2.1.23) total activity was decreased in proximal and distal (p < 0.01) small bowel homogenates from the lasted group but lactase specific activity was unchanged. Thus, a brief period of malnutrition in neonatal animals can result in a variety of regional functional changes in the gastrointestinal mucosa.
Renal Abnormalities in Paucity of Interlobular Bile Ducts
Authors: Tolia Vasundhara , Dubois Reuben S. , Watts Frederick B. , Perrin Eugene 
Published: January 2024

SummaryPaucity of interlobular bile ducts is a common histologic characteristic in persistent conjugated hyperbilirubinemia of infancy. It occurs in two forms: the syndromatic and the nonsyndromatic types. The syndromatic form is also called arteriohepatic dysplasia. The nonsyndromatic type of paucity of interlobular bile ducts occurs less frequently and is usually associated with more severe disease and a less favorable prognosis. We present two unusual renal anomalies in association with paucity of interlobular bile duels. In the first case, juvenile nephronophthisis was diagnosed in a 4‐week‐old infant with arteriohepatic dysplasia: the patient died from severe renal disease by 2 months of age. The second case presented with severe bilateral hydronephrosis and hydroureter secondary to posterior urethral valves associated with the nonsyndromatic form of paucity of interlobular bile duels. He, however, improved after corrective surgery of the urethral valves. Other renal abnormalities previously reported in the literature in association with chronic liver disease are also reviewed.
Successful Management of an Acquired Gastric Outlet Obstruction with Endoscopy Guided Balloon Dilatation
Authors: Treem William R. , Long William R. , Friedman David , Watkins John B. 
Published: January 2024

SummaryAntral‐pyloric strictures and gastric outlet obstruction are known complications of caustic ingestions. These lesions can develop even in the absence of overt signs of potentially serious upper gastrointestinal tract pathology of abdominal pain at the time of ingestion. The development of radial balloon catheters, which can be endoscopically guided into narrow strictures and inflated, offers an alternative therapy to surgical resection if obstructing lesions. We report the successful management of a pyloric stricture secondary to a caustic ingestion by sequential endoscopically guided balloon dilatations and offer guidelines for the use of this procedure.
Clinical and Laboratory Correlates of Esophagitis in Young Children
Authors: Hyams Jeffrey S. , Ricci Andrew , Leichtner Alan M. 
Published: January 2024

SummaryTo develop clinical and laboratory criteria to identify young children with gastroesophageal reflux (GER) who are at particular risk for esophagitis and then to monitor their clinical course we have prospectively studied 40 subjects (ages 2–22 months, mean 8 months) with persistent symptoms of GER with 18 h intraesophageal pH monitoring, endoscopy, and grasp and suction esophageal biopsies. Esophagitis was found in 16 of 20 patients under 7 months, 12 of 14 between 7 and 12 months, and five of six between 12 and 24 months. Esophagitis was equally frequent in those patients with or without poor weight gain, wheezing, or irritability. Only 15% of patients with esophagitis had occult blood in their stool. No parameter of intraesophageal pH monitoring was both sensitive and specific in identifying patients who were ultimately found to have either mild or severe esophagitis. Follow‐up data (37 patients) revealed that fundoplication was eventually required in four of eight patients with severe esophagitis, three of 22 with mild esophagitis, and none of seven without esophagitis. Currently used clinical and laboratory assessments of GER have limited value in identifying those children with either normal esophageal mucosa or at risk for varying degrees of esophagitis. Preliminary observations suggest that the presence of severe histologic esophagitis at the time of initial evaluation may have prognostic value in identifying those patients most likely to fail medical therapy and require fundoplication.
Comparison of Nitrogen Utilization of Two Elemental Diets in Patients with Crohn's Disease
Authors: Vaisman Nachum , Griffiths Anne , Pencharz Paul B. 
Published: January 2024

SummaryEnergy, nitrogen absorption, and nitrogen utilization of two commercial elemental diets, Vivonex and Vital, were compared in 10 teenage boys and girls with Crohn's disease. The diets were given in random order as overnight feedings and were the sole source of nutrients for two consecutive periods of 3 weeks each. Urine and stools were collected for 48 h at the end of each 3‐week period. Energy absorption was slightly better on Vivonex (p < 0.05), although 95–100% of energy was absorbed with both formulas. Nitrogen absorption was not different for the two formulas, but nitrogen utilization was significantly better on Vital (28.6 ± 12.9% versus 9.7 ± 17.7%, p < 0.01). This difference may be attributable to the different concentrations of sulfur‐containing and aromatic amino acids in the two formulas.
Spontaneous Perforation of Common Bile Duct
Authors: Shun A. , Middleton A. W. , Kamath K. R. , Brewster D. 
Published: January 2024

SummaryA 2‐week‐old Micronesian infant presented with spontaneous perforation of the common bile duct. Mild jaundice, acnolic stools, and heavily bile‐stained ascites were the main clinical features. The presentation of this rare disorder is characteristic enough to permit early diagnosis. Surgery is the treatment of choice.
Comparison of Glucose/Electrolyte and Glucose/Glycine/Electrolyte Oral Rehydration Solutions in Hospitalized Children with Diarrhea in Costa Rica
Authors: Pizarro Daniel , Levine Myron M. , Posada Gloria , Sandi Leyla 
Published: January 2024

SummaryThe experience of Nalin et al. and Palra et al. with a “super oral rehydration solution (ORS)” containing glucose plus glycinc to enhance the intestinal absorption of sodium and water prompted us to investigate a similar ORS containing the standard World Health Organization (WHO/ORS) plus either 55 or 110 mmol/L glycine in infants and small children with noncholera diarrhea. We did not find a statistically significant difference between the glycine‐fortified ORS and the standard WHO/ORS with respect to the clinical outcome and composition of serum electrolytes.
Oral Rehydration Therapy for Low Birth Weight Neonates Suffering from Diarrhea in the Intensive Care Unit
Authors: Helmy Nabil , Abdalla Safia , Essaily Medhat El , Nassert Shafika , Hirschhorn Norbert 
Published: January 2024

SummaryA total of 62 low birth weight (LBW) neonates (29 boys and 33 girls) suffering from diarrhea in our neonatal intensive care unit were included in this period of intense observation. The mean age was 13.89 ± 13.22 days and average body weight was 1,500.49 ± 281.45 g. Severity of dehydration was assessed by the Fortin‐Parent score. When the score was <8 (mild to moderate hypovolemia), oral rehydration therapy (ORT) was administered by feeding bottle or nasogastric tube hourly. Severely hypovolemic neonates needed intravenous rehydration; 52 neonates received ORT only using the World Health Organisation (WHO) formula; 58 neonates received either cow's milk‐based or soy‐based formula within 12 h after ORT began, and the rest within 24 h. Diarrhea lasted <1 day in 92% of cases. The regimen corrected hyponatremia and hypernatremia. Only two neonates developed mild asymptomatic hypernatremia. No child became edematous. Using the WHO solution, ORT was safely given to LBW neonates, sparing painful and potentially hazardous invasive techniques, and resulted in excellent outcomes.
Acute Appendicitis in Childhood in the Negev Region
Authors: Freud E. , Pilpel D. , Mares A. J. 
Published: January 2024

SummaryIn an attempt to explore the possible variation over time of acute appendicitis (AA) 406 medical files comprising all children aged 0–14 years operated on during an 11‐year period (1973–1983) at the Soroka Medical Center were reviewed. Only patients that were histopathologically confirmed were included in the study. Soroka Medical Center is the only general hosptal providing services to the entire population of the region. Hence, a reasonable coverage of all AA patients is expected. As a result, comparison of incidence rates among different subgroups is plausible. The annual rate of AA was 3.75 operations/10.000 children. The rates were somewhat higher for boys (5.20 versus 2.31, p. < 0.05). They were also higher for Jewish versus Bedouin children (4.44 versus 1.14, p. < 0.05). The highest rate of AA was among children in the 10‐to 14‐year‐old age group (7.79). A gradual increase in the rates of AA during the study period was noticed, over and above the increase in the region's populat in. However, the ratio of change over time was higher for the Bedouins. Although this cannot be proven, the caques of AA have been hypothesized to be multifactorial. Diet is considered to have an important role in the etiology of AA. Some seasonal trends could be observed. paralleling changes in humidity. viral and bacterial infeetions, suggesting the involvement of these factors in the etiology of AA.
Ascites Complicating Ventriculoperitoneal Shunts
Authors: Goodman Gary M. , Gourley Glenn R. 
Published: January 2024

SummaryVentriculoperitoneal shunts are currently a standard therapy for obstructive hydrocephalus. These shunts are associated with a variety of abdominal complications, one of which is the development of ascites. We report an 11‐year‐old girl with a ventriculoperioneal shunt in whom a low‐grade peritoneal infection presented with ascites. This case demonstrates the importance of diagnostic paracenteses, appropriate antibiotic therapy and the potential need to establish an alternative rout for cerebrospinal fluid diversion in patients with ventriculoperitoneal shunts and ascites.
Detection of Anti‐Endoplasmic Reticulum Antibody‐Positive Autoimmune Hepatitis in Children, Using an ELISA Technique
Authors: Paradis Khazal , Dib Amale , Homberg Jean‐Claude , Bernard Olivier , Alagille Daniel , Alvarez Fernando 
Published: January 2024

SummaryAnti‐endoplasmic reticulum antibody positive autoimmune hepatitis in children is characterized by the recognition of a single 50,000 MW protein of the endoplasmic reticulum in liver microsomal fractions by their sera. We have developed an enzyme‐linked immunosorbent assay technique with rat liver microsomal preparations as the antigen to be used for detection of this disease, liters obtained may be useful in following the course of the disease and as an aid in determining when therapy can be discontinued. The technique is rapid, sensitive, reproducible, and simple to perform and is easier to manipulate than immunofluorescence or radioimmunoassay techniques.