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Journal: Journal of pediatric gastroenterology and nutrition


To determine the kinetics of true ileal protein digestion and digestible indispensable amino acid score (DIAAS) of a goat milk based infant formula (GIF), a cow milk based infant formula (CIF) and human milk (HM).

Concepts: Acid, Breast milk, Mammal, Metabolism, Amino acid, Protein, Nutrition, Milk


To characterize key clinical manifestations of lysosomal acid lipase deficiency (LAL D) in children and adults.

Concepts: Lysosome, Lysosomal lipase, Lipase


: Gastrointestinal symptoms and signs are rarely the main clinical presentation of Kawasaki disease (KD). In the present study, we report a series of patients with KD in whom a gastroenterology consult was obtained before consideration of the diagnosis of KD.

Concepts: Medical terms, Medicine


BACKGROUND:: Patients with Celiac Disease (CD) have a wide variety of symptoms, from being asymptomatic to having chronic diarrhea, abdominal pain and extra-intestinal symptoms. In the oral cavity, enamel defects and recurrent aphthous stomatitis are the most common symptoms. AIM:: To assess oral health, bacterial colonization and salivary buffering capacity of patients with CD at diagnosis were compared with CD patients on gluten free diet (GFD) and healthy children. METHODS:: Three groups were prospectively investigated: newly diagnosed celiac disease, celiac disease treated with GFD and a control group. All children were examined by pediatric dentists and saliva samples were collected for bacterial and pH analysis. RESULT:: Ninety children were enrolled in the study, thirty in each group. A higher prevalence of enamel hypoplasia (66%) was found in celiac children. Plaque Index was significantly lower in the celiac treated group, which correlated with oral health behavior: teeth brushing and frequency of eating between meals. Children on GFD brushed their teeth and used fluoride significantly more often than other children in the study. No difference between groups was found in snacks consumption, Mutans Streptococci and Lactobacilli counts in saliva, as well as pH and buffer capacity, CONCLUSIONS:: A lower degree of plaque was found in celiac children on GFD. This finding could not be explained by salivary properties or bacteria, but rather by better oral hygiene. The results should raise the awareness of pediatric gastroenterologists to oral health related issues in children with CD.

Concepts: Wheat, Gluten, Aphthous ulcer, Bacteria, Crohn's disease, Gluten-free diet, Buffer solution, Coeliac disease


Enteral feeding through gastrojejunal (GJ) tubes is an established method of nutrition for patients with feeding difficulty who do not tolerate intragastric feedings. Literature about the long-term outcome, safety and complications of different GJ tubes and placement methods remains lacking in children. OBJECTIVES:: Our study aims to provide information about indications, techniques and long-term outcome of GJ tube use in children. METHODS:: Retrospective chart review for GJ tube placement procedures at our center over 10 years (1999 to 2009). Data collected included demographics, placement indications, underlying diagnosis, tube type, placement methods, complications, tube survival and patient outcome. RESULTS:: 33 patients utilizing GJ tubes were identified, with a total of 160 successful procedures documented (overall success rate of 97.6%). At initial placement, the mean age was 6 years (range 0.6-21.6), and mean weight was 19.4 kg (range 6.6-72.2). Patients had a mean of 4.9 tubes placed per patient (range 1-20) over a follow-up of 26.8 months (range 0.4-115.3). The most common indications for replacement included accidental dislodgement, tube obstruction, coiling back into the stomach and broken tube component. At the end of the study, 39% continued using GJ tubes, 30% were transitioned back to gastrostomy or oral feeds and 15% underwent a surgical intervention. CONCLUSIONS:: Long term GJ tube use is possible and safe in children. Various feeding tubes and placement methods can be utilized by pediatric gastroenterologists to provide long term jejunal feeds in children.

Concepts: Feeding tube, Term, Enteral feeding, Percutaneous endoscopic gastrostomy


OBJECTIVES:: To better understand the exocrine pancreatic function of very preterm infants. METHODS:: Pancreas-specific elastase 1 (PSE1) activity was determined in spot stool samples of 69 preterm infants of gestational age <32 weeks and birth weight <1,250 g. Assays were conducted on samples collected at 2 (N = 56), 4 (N = 46), and 6 weeks of age (N = 23). RESULTS:: PSE1 activity increased from week 2 (median [interquartile range] 84 [48-187] μg/g) to week 4 (164 [87-251 μg/g, P < 0.001) but not thereafter (169 [82-298] μg/g at week 6). The maturational increase in PSE1 activity was observed only in infants of gestational age <28 weeks (P < 0.001). At 2 weeks after birth, PSE1 levels were lower in infants of gestational age <28 weeks than in infants of gestational age ≥28 weeks (77 [43-110] vs. 165 [56-300] μg/g, P = 0.019), but this difference was less pronounced at 4 weeks (153 [77-226] vs. 230 [108-503] μg/g, P = 0.070) and had disappeared by 6 weeks (163 [76-258] vs. 175 [85-418] μg/g, P = 0.576).In infants on full enteral feeding regimens 4 weeks after birth, PSE1 levels were associated with weight gain per unit of energy intake (Rs = 0.431, P = 0.005). This measure of weight gain was lower (P = 0.040) in infants with PSE1 levels <200 μg/g (0.110 [0.081-0.139] g/kcal, N = 25) than in those with PSE1 levels ≥200 μg/g (0.139 [0.117-0.157] g/kcal, N = 15). Administration of pancreatic enzymes to infants showing PSE1 excretion levels <200 μg/g did not enhance weight gain. CONCLUSIONS:: Extremely preterm infants have limited exocrine pancreatic function during the first weeks of life, which may contribute to growth failure.

Concepts: Fetus, Small intestine, Exocrine gland, Obstetrics, Digestive enzyme, Enzyme, Exocrine pancreas, Pancreas


The aim was to study the effects of boric acid (BA) and 2-aminoethoxydiphenyl borate (2-APB) on oxidative stress and inflammation in an experimental necrotizing enterocolitis (NEC) rat model.

Concepts: Oxidative phosphorylation, Oxidative stress, Hydrogen, Borax, Borate, Boron, Boric acid, Necrotizing enterocolitis


To determine the strength of evidence for commonly used interventions for colic in breastfed and mixed fed infants younger than 6 months of age.

Concepts: Pregnancy, Baby bottle, Pacifier, Pediatrics, Breastfeeding, Baby colic, Infant


Test the hypothesis that caregiver reported difficulties in infants' behavior and caregivers' distress will significantly improve on lactose free (LF) milk-based or LF soy-based formulas compared to a milk-based, lactose containing formula.

Concepts: Psychology, Lactose intolerance, Infant, Lactose, Milk


With the introduction of smaller probes (S1, S2), the use of transient elastography has been expanded to children. Accordingly, we aimed to address points of consideration in probe choice and interpretation of measured liver stiffness by applying and comparing FibroScan S and M probes in biliary atresia.

Concepts: Space probe, Introduction, Liver