Comparison of Patients’ and Doctors’ Reports on Health-related Quality of Life in Celiac Disease
Objective: To investigate whether implementation of a celiac disease (CD)–specific health-related quality of life (HRQOL) questionnaire would add value to CD follow-up visits; we compared patients’ self-reported CD-specific HRQOL with the physician's report provided during a regular CD follow-up visit in children and young adults. Methods: A cross-sectional study in the control group of a study on self-management in CD (CoelKids). Eligible patients had CD for ≥1 year and were 25 years or younger. They completed a CD-specific HRQOL questionnaire (CDDUX) after their regular follow-up visit. Their physicians w...
Source: Journal of Pediatric Gastroenterology and Nutrition - April 26, 2017 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Celiac Disease Source Type: research

Maternal Infections, Antibiotics, and Paracetamol in Pregnancy and Offspring Celiac Disease: A Cohort Study
Conclusions: In this large pregnancy cohort we found no clear association between maternal infections in pregnancy and offspring CD, but considering the marginal significance in some of our results maternal infections cannot be ruled out as a risk factor. Reassuringly for both parents-to-be and clinicians, the use of antibiotics and paracetamol in pregnancy was not a significant risk factor. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - April 26, 2017 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Celiac Disease Source Type: research

Lack of Utility of Anti-tTG IgG to Diagnose Celiac Disease When Anti-tTG IgA Is Negative
Conclusion: In this cohort of patients, the utility of isolated tTG IgG in diagnosing CD was low at 3%. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - April 26, 2017 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Celiac Disease Source Type: research

Perianal Crohn Disease in a Large Multicenter Pediatric Collaborative
Background: Although perianal complications of Crohn disease (CD) are commonly encountered in clinical practice, the epidemiology of perianal CD among populations of children is poorly understood. We sought to characterize the prevalence of perianal disease in a large and diverse population of pediatric patients with CD. Methods: We conducted retrospective analyses from a prospective observational cohort, the ImproveCareNow Network (May 2006–October 2014), a multicenter pediatric inflammatory bowel disease quality improvement collaborative. Clinicians prospectively documented physical examination and phenotype class...
Source: Journal of Pediatric Gastroenterology and Nutrition - April 26, 2017 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Inflammatory Bowel Disease Source Type: research

Tacrolimus Exerts Only a Transient Effectiveness in Refractory Pediatric Crohn Disease: A Case Series
Objectives: Tacrolimus is an immunosuppressive agent that has been proposed in the treatment of severe ulcerative colitis. The present study examined the effectiveness and safety of tacrolimus in treating refractory Crohn disease (CD) colitis in children. Methods: All children treated by oral tacrolimus for CD colitis at a tertiary pediatric center were included in the study. All patients were refractory to steroids and infliximab. Clinical response (decreased pediatric CD activity index [PCDAI]>15 and PCDAI (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - April 26, 2017 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Inflammatory Bowel Disease Source Type: research

Use of Reticulocyte Hemoglobin Content in the Assessment of Iron Deficiency in Children With Inflammatory Bowel Disease
Background: Iron deficiency and anemia affect up to 50% to 75% of patients with inflammatory bowel disease (IBD). Iron deficiency in IBD may be difficult to diagnose because of the effect of inflammation on iron status biomarkers. Thus, there is a need for better methods to accurately determine iron status in IBD. Objective: The aim of the study was to investigate the association of inflammation with hemoglobin content of reticulocytes (CHr) and the utility of CHr in comparison to standard iron biomarkers. Methods: We conducted a cross-sectional study of children with IBD. Iron biomarkers (CHr, ferritin, soluble transfer...
Source: Journal of Pediatric Gastroenterology and Nutrition - April 26, 2017 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Inflammatory Bowel Disease Source Type: research

Analysis of the Duodenal Microbiome in Autistic Individuals: Association With Carbohydrate Digestion
Objectives: There is evidence that symptoms of maldigestion or malabsorption in autistic individuals are related to changes in the indigenous microbiota. Analysis of colonic bacteria has revealed microbial dysbiosis in children with autism; however, characteristics of the duodenal microbiome are not well described. In the present study the microbiome of the duodenal mucosa of subjects with autism was evaluated for dysbiosis, bacteria overgrowth, and microbiota associated with carbohydrate digestion. The relationship between the duodenal microbiome and disaccharidase activity was analyzed in biopsies from 21 autistic subjec...
Source: Journal of Pediatric Gastroenterology and Nutrition - April 26, 2017 Category: Gastroenterology Tags: Original Article: Gastroenterology Source Type: research

Protein Malnutrition During Juvenile Age Increases Ileal and Colonic Permeability in Rats
ABSTRACT: Protein malnutrition can lead to morphological and functional changes in jejunum and ileum, affecting permeability to luminal contents. Regarding the large intestine, data are scarce, especially at juvenile age. We investigated whether low-protein (LP) diet could modify ileal and colonic permeability and epithelial morphology in young rats. Isocaloric diets containing 26% (control diet) or 4% protein were given to male rats between postnatal days 40 and 60. LP-diet animals failed to gain weight and displayed decreased plasma zinc levels (a marker of micronutrient deficiency). In addition, transepithelial electric...
Source: Journal of Pediatric Gastroenterology and Nutrition - April 26, 2017 Category: Gastroenterology Tags: Short Communication: Gastroenterology Source Type: research

Dilation of Pediatric Eosinophilic Esophagitis: Adverse Events and Short-term Outcomes
Conclusions: We conclude that dilation can be performed safely in children with EoE. In the appropriate clinical setting, cautious dilation may be considered in the management of fibrostenotic EoE. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - April 26, 2017 Category: Gastroenterology Tags: Original Article: Gastroenterology Source Type: research

Double Lumen Polyamide Tube-stent for the Treatment of Recurrent Postcorrosive Esophageal Stenosis
This article presents the results of endoscopic treatment for recurrent postcorrosive esophageal stenosis with a tube-stent developed at our institution. The tube-stent was implanted in 5 children with corrosive esophageal injury at the age of 2 to 8.5 years after 7 to 64 dilatation sessions during 5 to 118 months. In total, 13 tube-stents were implanted. One patient had undergone 9 procedures during 2.5 years and the tube-stent remained in place for 14 to 250 days. This patient was tube-stent–dependent due to the lack of any possibility of surgical reconstruction. Two patients had the tube-stent removed after 150 to...
Source: Journal of Pediatric Gastroenterology and Nutrition - April 26, 2017 Category: Gastroenterology Tags: Short Communication: Gastroenterology Source Type: research

Infantile Colic Is Associated With Low-grade Systemic Inflammation
Conclusions: In addition to gut microbiota alterations, colic in infants is associated with low-grade systemic inflammation. Specific bacterial species beyond conventional probiotics may have anti-inflammatory properties that may help to modulate microbiota and alleviate colic-related inflammation. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - April 26, 2017 Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research

Risk Categorization Predicts Disability in Pain-associated Functional Gastrointestinal Disorders After 6 Months
Discussion: A simple approach to risk categorization can identify youth with FGIDs who are most likely to report increased levels of pain-related impairment over time. These findings have important clinical implications that support the utility of a brief screening process during medical care to inform referral for targeted treatment approaches to FGIDs. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - April 26, 2017 Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research

Constipation and Constipation-predominant Irritable Bowel Syndrome: A Comparative Study Using Rome III Criteria
Objective: The aim of the present study is to compare functional constipation (FC) and constipation-predominant irritable bowel syndrome (IBS-C) in adolescents. Methods: A school-based survey was conducted involving adolescents ages 13 to 18 years. A set of validated questionnaires including Rome III questionnaire for functional gastrointestinal disorders in children/adolescents, somatization inventory, quality of life inventory, and childhood traumatic events inventory were used for data collection. FC and IBS-C were defined using Rome III criteria. Results: A total of 1792 adolescents (975 boys [45.4%]) were included i...
Source: Journal of Pediatric Gastroenterology and Nutrition - April 26, 2017 Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research

Outcomes From Pediatric Gastroenterology Maintenance of Certification Using Web-based Modules
Conclusions: Pediatric gastroenterologists and parents reported baseline practice variation, and improvement in care processes and outcomes measured during NASPGHAN-sponsored Web-based MOC QI activities. Subspecialty-oriented Web-based MOC QI activities can reveal targets for reducing unwarranted variation in clinical pediatric practice, and can effectively improve care and patient outcomes. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - April 26, 2017 Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research

Intensive Care Management of Pediatric Acute Liver Failure
ABSTRACT: Pediatric acute liver failure is rare but life-threatening illness that occurs in children without preexisting liver disease. The rarity of the disease, along with its severity and heterogeneity, presents unique clinical challenges to the physicians providing care for pediatric patients with acute liver failure. In this review, practical clinical approaches to the care of critically ill children with acute liver failure are discussed with an organ system-specific approach. The underlying pathophysiological processes, major areas of uncertainty, and approaches to the critical care management of pediatric acute liv...
Source: Journal of Pediatric Gastroenterology and Nutrition - April 26, 2017 Category: Gastroenterology Tags: Invited Review Source Type: research

Creatively Improving Care Delivery
ABSTRACT: The medical community has been challenged to improve upon deficiencies in the delivery of patient care. Quality improvement methods are therefore increasingly used in everyday clinical practice. As demonstrated in this review, creative and impactful improvement projects within pediatric gastroenterology can be successfully achieved as either multicenter projects or single-center efforts. Through our willingness to accept the challenge to improve, practitioners within the pediatric gastroenterology community have become leaders in using quality improvement to change practice and improve clinical outcomes. (Source:...
Source: Journal of Pediatric Gastroenterology and Nutrition - April 26, 2017 Category: Gastroenterology Tags: Topic of the Month Source Type: research

Iodine Status and Growth in Cow's Milk Allergy
No abstract available (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - April 26, 2017 Category: Gastroenterology Tags: Invited Commentaries Source Type: research

Do Maintenance of Certification Activities Promote Positive Changes in Clinical Practice?
No abstract available (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - April 26, 2017 Category: Gastroenterology Tags: Invited Commentaries Source Type: research

Profound Anemia in a Child Secondary to Salmonella Enteritis
No abstract available (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Case Reports Source Type: research

Diagnosis of Muscular Dystrophy in a 6-Week-Old With Jaundice
No abstract available (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Case Reports Source Type: research

Vomiting in a 2-Year-Old With A Twist: Undiagnosed Gastric Volvulus
No abstract available (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Image of the Month Source Type: research

Complementary Feeding: A Position Paper by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) Committee on Nutrition: Erratum
No abstract available (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Erratum Source Type: research

Hepatic Issues and Complications Associated With Inflammatory Bowel Disease: A Clinical Report From the NASPGHAN Inflammatory Bowel Disease and Hepatology Committees
ABSTRACT: Hepatobiliary disorders are common in patients with inflammatory bowel disease (IBD), and persistent abnormal liver function tests are found in approximately 20% to 30% of individuals with IBD. In most cases, the cause of these elevations will fall into 1 of 3 main categories. They can be as a result of extraintestinal manifestations of the disease process, related to medication toxicity, or the result of an underlying primary hepatic disorder unrelated to IBD. This latter possibility is beyond the scope of this review article, but does need to be considered in anyone with elevated liver function tests. This revi...
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Society Statement Source Type: research

Prevalence of Malnutrition and Feeding Difficulties in Children With Esophageal Atresia
Objectives: Growth and feeding problems have been described in children with esophageal atresia (EA). Ongoing gastrointestinal and respiratory complications such as Gastroesophageal reflux disease, esophageal dysmotility, strictures, and respiratory infections may contribute. The aim of the study was to document the prevalence of malnutrition and feeding difficulties and examine predictive factors, which may influence feeding and growth in children attending a multidisciplinary EA clinic in Sydney, Australia. Methods: A retrospective review of 75 children, ages 0 to 16 years, who attended a multidisciplinary EA clinic bet...
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Original Articles: Nutrition Source Type: research

Amino Acid–based Formula in Cow's Milk Allergy: Long-term Effects on Body Growth and Protein Metabolism
Objectives: The long-term effects of amino acid–based formula (AAF) in the treatment of cow's milk allergy (CMA) are largely unexplored. The present study comparatively evaluates body growth and protein metabolism in CMA children treated with AAF or with extensively hydrolyzed whey formula (eHWF), and healthy controls. Methods: A 12-month multicenter randomized control trial was conducted in outpatients with CMA (age 5–12 m) randomized in 2 groups, treated with AAF (group 1) and eHWF (group 2), and compared with healthy controls (group 3) fed with follow-on (if age 12 months). At enrolment (T0), after 3 (T3), ...
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Original Articles: Nutrition Source Type: research

Effects of Infant Formula With Human Milk Oligosaccharides on Growth and Morbidity: A Randomized Multicenter Trial
Conclusions: Infant formula with 2′FL and LNnT is safe, well-tolerated, and supports age-appropriate growth. Secondary outcome findings showing associations between consuming HMO-supplemented formula and lower parent-reported morbidity (particularly bronchitis) and medication use (antipyretics and antibiotics) warrant confirmation in future studies. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Original Articles: Nutrition Source Type: research

Differences in Postprandial Lipid Response to Breast- or Formula-feeding in 8-Week-Old Infants
Objective: Lipids play important roles in infant growth and development. In this exploratory observational single-center study, we investigated postmeal responses of infants to dietary lipids and differences between breast-feeding (BF) and formula-feeding (FF). Methods: Two capillary blood samples were collected from each subject, before and randomly assigned at either 30, 60, 90, 120, 180, or 240 minutes after their respective feeding, followed by measurement of lipid-related plasma parameter concentrations using enzyme-linked immunosorbent assay-based or combined enzymatic and colorimetric methods. Results: The interme...
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Original Articles: Nutrition Source Type: research

Lipid-based Nutrient Supplements Do Not Affect Gut Bifidobacterium Microbiota in Malawian Infants: A Randomized Trial
Objectives: The aim of the study was to assess the effect of nutritional supplementation with lipid-based nutrient supplements (LNS) and corn-soy blend flour on Bifidobacterium and Staphylococcus aureus gut microbiota composition in Malawian infants. In addition, the microbiota changes over time were characterized in the study infants. Methods: Healthy 6-month-old Malawian infants were randomly assigned to 1 of 4 intervention schemes for a 6-month period. Infants in the control group were not provided with any supplementary food. Infants in other 3 groups received either micronutrient-fortified corn-soy blend, micronutrie...
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Original Articles: Nutrition Source Type: research

Levels of Silicon in Maternal, Cord, and Newborn Serum and Their Relation With Those of Zinc and Copper
Background: Evidence of silicon's importance to health has been gradually accumulating. Nevertheless, there are few studies comparing serum silicon levels in newborns with maternal levels. Likewise, little is known concerning the inter-relation between silicon and other trace elements. Objective: The present study evaluated maternal and newborn levels of serum silicon and their relation to those of zinc and copper. Methods: We measured serum silicon, copper, and zinc in 66 pregnant women, in the umbilical cord of their infants, and in 44 newborns, by atomic absorption spectrophotometry. All the samples were from fasted s...
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Original Articles: Nutrition Source Type: research

Complex Relation Between Diet and Phospholipid Fatty Acids in Children With Cystic Fibrosis
Conclusions: The fatty acid composition of plasma PC and PE is altered in CF. Fatty acid differences between children with and without CF are inconsistent between PC and PE and are not explained by dietary fat. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Original Articles: Pancreatology Source Type: research

Endoscopic Ultrasound–guided Drainage of Walled-off Necrosis in Children With Fully Covered Self-expanding Metal Stents
Conclusions: EUS drainage of WON using specially designed FCSEMS is safe and efficacious in children. The utility of FCSEMS in children should be further explored and compared with plastic stents. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Original Articles: Pancreatology Source Type: research

Symptoms and Mucosal Changes Stable During Rapid Increase of Pediatric Celiac Disease in Norway
Objectives: We aimed to study whether the incidence of pediatric celiac disease (CD) in South-Eastern Norway changed from 2000 to 2010. We also examined whether there was a change in symptoms and histopathological morphology in the duodenal biopsies during the same period. Methods: In 3 hospitals in South-Eastern Norway, records from pediatric patients (0–14.9 years) diagnosed with CD during two 3-year periods (2000–2002 and 2008–2010) were reviewed. Only cases with a duodenal biopsy diagnosis of CD classified as Marsh grade 2 and 3a−c were included. Frequencies of symptoms, anthropometric data, an...
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Original Article: Gastroenterology: Celiac Disease Source Type: research

Infliximab Optimization Based on Therapeutic Drug Monitoring in Pediatric Inflammatory Bowel Disease
Background: Infliximab (IFX) is an effective treatment for the management of moderate to severe inflammatory bowel disease (IBD). Low-serum IFX levels are associated with the development of antibodies to IFX (ATI), which subsequently associated with clinical relapse and increased morbidity. The primary purpose of this study is to examine the relation between dose and interval to IFX level. Secondary goal is to evaluate the relation between IFX level and ATI in a pediatric IBD population. Methods: We performed a retrospective chart review of all children diagnosed with IBD and treated with IFX at a tertiary care pediatric ...
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Inflammatory Bowel Disease Source Type: research

Remission in Pediatric Inflammatory Bowel Disease Correlates With Prescription Refill Adherence Rates
Objectives: The aim of the study was to use pharmacy benefit management (PBM) prescription claims data to assess refill adherence in pediatric inflammatory bowel disease (IBD) and correlate adherence with clinical outcomes in pediatric IBD. Methods: We identified 362 pediatric patients with IBD seen at Washington University from 9/1/2012 to 8/31/2013 and matched them within Express Scripts’ member eligibility files for clients allowing use of prescription drug data for research purposes. Maintenance IBD medication possession ratios (MPR) were determined through PBM prescription claims data and chart review. Demograp...
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Inflammatory Bowel Disease Source Type: research

Impact of Environmental and Familial Factors in a Cohort of Pediatric Patients With Inflammatory Bowel Disease
Objectives: The primary role of environment on inflammatory bowel disease (IBD) onset has been recently stressed. We aimed to investigate the effect of environmental factors in an IBD pediatric cohort. Methods: A total of 467 subjects (264 IBD and 203 controls) were enrolled. All patients underwent a questionnaire including 5 different groups of environmental risk factors: family history of IBD and autoimmune diseases, perinatal period, home amenities and domestic hygiene, childhood diseases and vaccinations, and diet. Results: In a multivariate model, mother's degree (odds ratio [OR]: 5.5; 2.5–11.6), duration of b...
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Inflammatory Bowel Disease Source Type: research

Pediatric-onset Chronic Nonspecific Multiple Ulcers of Small Intestine: A Nationwide Survey and Genetic Study in Japan
ABSTRACT: We performed a Japanese nationwide survey of pediatric-onset chronic nonspecific multiple ulcers of the small intestine between January 2000 and July 2013 in 176 institutions of pediatric surgery or pediatric gastroenterology and clarified the clinical features associated with genetic abnormalities in the Solute Carrier Organic Anion Transporter Family, Member 2A1 (SLCO2A1) gene. A total of 4 cases (3 girls and 1 boy) were diagnosed in this series, which had to be differentiated from Crohn disease, Behçet disease, tuberculosis, or drug-induced enteropathy. Clinical symptoms appeared in infants and accurate...
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Short Communication: Gastroenterology Source Type: research

A Procedural and Educational Experience Following Creation of an Advanced Pediatric Endoscopy Service
ABSTRACT: Advanced endoscopic procedures occur infrequently enough in pediatric patients to preclude effective maintenance of competence among all pediatric gastroenterologists. A recent study suggests that fellows are largely unable to achieve the prescribed case volume recommended to achieve competence. We sought to describe the procedural and educational experience following the creation of an advanced pediatric endoscopy service in response to declining confidence among practice members regarding advanced procedures. We found most advanced endoscopy cases (90%) were accomplished during routine business hours with littl...
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research

Using the Objective Structured Clinical Examination to Assess ACGME Competencies in Pediatric Gastroenterology Fellows
Conclusions: To our knowledge, although the OSCE has been validated in other medical fields, this is the first OSCE program developed for PGs fellows. These OSCEs have included Accreditation Council for Graduate Medical Education competencies, serving to assess fellows’ skills in these areas while exposing them to challenging medical and psychosocial cases that they may not frequently encounter. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research

Therapeutic Endoscopy for the Control of Nonvariceal Upper Gastrointestinal Bleeding in Children: A Case Series
Conclusions: NVUGI bleeding requiring therapeutic endoscopic intervention is rare in pediatrics. A high rate (40%) of rebleeding was noted with a large proportion (66%) of patients receiving single modality therapy. Two patients required surgical intervention to control bleeding and both presented with bleeding duodenal ulcers. An insufficient number of therapeutic procedures is available for adequate fellow training requiring supplemental simulator and hands-on animal model, or adult endoscopy unit training. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research

A Clinical and Molecular Genetic Study in 11 Chinese Children With Peutz-Jeghers Syndrome
Conclusions: MLPA plus direct sequencing revealed large genomic deletions of STK11 gene in Chinese children with PJS and increased the detecting rate of STK11 gene mutations in Chinese patients with PJS. MLPA combined with direct sequencing could serve as a better strategy for the genetic diagnosis of PJS in Chinese population. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research

Utility of Routine Colonic Biopsies in Pediatric Colonoscopic Polypectomy for Benign Juvenile Hamartomatous Polyps
Conclusions: In children with benign juvenile hamartomatous polyps, routine colonic biopsies are not required in the absence of mucosal abnormalities. Overuse of pathology services, increased procedural time, risk, and cost can be avoided. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research

Splanchnic Oxygenation at First Enteral Feeding in Preterm Infants: Correlation With Feeding Intolerance
ABSTRACT: Preterm infants are at risk of developing gastrointestinal complications such as feeding intolerance and necrotizing enterocolitis. Near-infrared spectroscopy (NIRS) provides continuous monitoring of abdominal oxygenation (ArSO2) and could help to predict gastrointestinal complications in preterm neonates. In this prospective observational study, ArSO2 patterns at first enteral feed were evaluated by NIRS in 61 clinically stable preterm infants. Splanchnic-cerebral oxygenation ratio, which is a marker of gut hypoxia, was also calculated. ArSO2 and splanchnic-cerebral oxygenation ratio were significantly lower bot...
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research

Propofol Use in Pediatric Patients With Food Allergy and Eosinophilic Esophagitis
ABSTRACT: Propofol is a safe, well-tolerated anesthetic that is labeled as contraindicated in patients with egg or soy allergy. This contraindication has become increasingly problematic given the rising incidence of food allergy and eosinophilic esophagitis (EoE). To address this issue, we studied practice patterns of propofol use for esophagogastroduodenoscopies in children with EoE and food allergies at our institution. A retrospective observational study of 1365 esophagogastroduodenoscopies from January 2013 to June 2014 was performed. Data were analyzed using Student t tests, chi square tests, Fisher exact tests, and m...
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research

Lactulose Breath Test Gas Production in Childhood IBS Is Associated With Intestinal Transit and Bowel Movement Frequency
Objectives: In adults with irritable bowel syndrome (IBS), bacterial gas production (colonic fermentation) is related to both symptom generation and intestinal transit. Whether gas production affects symptom generation, psychosocial distress, or intestinal transit in childhood IBS is unknown. Methods: Children (ages 7–17 years) with pediatric Rome III IBS completed validated psychosocial questionnaires and a 2-week daily diary capturing pain and stooling characteristics. Stool form determined IBS subtype. Subjects then completed a 3-hour lactulose breath test for measurement of total breath hydrogen and methane prod...
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research

Environmental Enteric Dysfunction Is Associated With Altered Bile Acid Metabolism
Objectives: Environmental enteric dysfunction (EED), a clinically asymptomatic condition characterized by inflammation of the small bowel mucosa, villous atrophy, and increased gut permeability, is common among children in developing countries. Because of abnormal gut mucosa and altered gut microbiome, EED could potentially affect the metabolism and enterohepatic circulation of bile acids. Methods: In 313 children, aged 12 to 59 months, EED was assessed by the dual sugar absorption test. Serum bile acids were measured using stable-isotope liquid chromatography-tandem mass spectrometry. Results: In the overall study popul...
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research

Liver Transplantation for Children With Primary Sclerosing Cholangitis and Autoimmune Hepatitis: UNOS Database Analysis
Conclusion: Children with AIH transplanted as status 1 had significantly lower patient survival rates but similar graft survival rates to children with chronic AIH. Children transplanted for AIH versus PSC showed no significant differences in patient or graft survival at both 1 and 5 years. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Original Articles: Hepatology Source Type: research

Serum Acetaminophen Protein Adduct Concentrations in Pediatric Emergency Department Patients
The objective of this study was to describe the serum concentrations of APAP-CYS in pediatric patients with and without reported therapeutic acetaminophen exposure. Methods: A cross-sectional study of children age 1 to (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Original Articles: Hepatology Source Type: research

Family Impact and Infant Emotional Outcomes Following Diagnosis of Serious Liver Disease or Transplantation in Infancy
We examined the effect of the diagnosis of serious liver disease in infants upon parent psychological symptoms and family functioning. We hypothesized that parent psychological symptoms, family functioning, and father engagement will predict infant emotional outcomes. Methods: Parents of infants recently diagnosed with serious liver disease completed validated questionnaires about parent stress, family function, impact of the illness on the family, and father engagement. The measures were repeated after 1 year, with the addition of the Child Behavior Checklist (CBCL). Results: Parents of 37 infants participated. Parent s...
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Original Articles: Hepatology Source Type: research

Survey on Clinical Practice of Primary Prophylaxis in Portal Hypertension in Children
In conclusion, despite the absence of scientific recommendations there is a tacit consensus concerning the need to screen children with clinical signs of portal hypertension, and to provide primary prophylaxis in cases of endoscopic patterns of high-risk varices. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Original Articles: Hepatology Source Type: research

King's Variceal Prediction Score: A Novel Noninvasive Marker of Portal Hypertension in Pediatric Chronic Liver Disease
Conclusions: Our new prediction score may be a useful tool in the selection of children with clinically significant varices eligible for a screening endoscopy. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - March 25, 2017 Category: Gastroenterology Tags: Original Articles: Hepatology Source Type: research