Pub Date : 2019-12-01DOI: 10.1097/MPG.0000000000002483
Mei‐Hwei Chang, B. Fischler, B. Blauvelt, M. Ciocca, A. Dhawan, U. Ekong, Y. Ni, G. Porta, A. Sibal, Daniele Dagostino, S. Wirth, Neelam Morhan, K. Schwarz
Mother-to-infant transmission (MIT) is the leading cause of hepatitis B virus (HBV) infections globally. The aim of this international study was to assess the impediments to prevention of (MIT) of HBV. METHODS A cross-sectional survey was developed by the Federation of the International Societies for Pediatric Gastroenterology, Hepatology and Nutrition. (FISPGHAN) The survey was sent to HBV experts of the five member societies of FISPGHAN, and 63/91 countries/regions responded. Main outcome measures include percentage of countries having vaccine programs, timing of the first dose of HBV vaccine, availability of HBV vaccine for out-born neonates, payment of HBV vaccine and HBIG, screening HBV markers during pregnancy, and antivirals to highly infectious pregnant mothers. RESULTS Among the participating countries/regions, 11% did not implement infant HBV immunization programs. The first dose of vaccine was given >24 hours in 36% of the total countries and 100% of African countries. The recommended birth dose was unavailable for out-born neonates in 45% of the total countries, including 92% of African and 50% of Latin American countries/regions. During pregnancy, 44% countries do not screen maternal viral markers, and 46% do not provide third trimester antiviral therapy for highly viremic pregnant mothers. CONCLUSIONS Our study demonstrated multiple obstacles to achieving the goal of preventing MIT of HBV. Comprehensive public health programs to enhance vaccine coverage rate, supply HBV vaccine for out-born neonates, screening maternal HBV markers, treating highly viremic pregnant mothers are proposed to overcome these obstacles and achieve the goal of preventing MIT of HBV.
{"title":"Survey of Impediments to Prevention of Mother-to-Infant Transmission of Hepatitis B Virus by International Societies.","authors":"Mei‐Hwei Chang, B. Fischler, B. Blauvelt, M. Ciocca, A. Dhawan, U. Ekong, Y. Ni, G. Porta, A. Sibal, Daniele Dagostino, S. Wirth, Neelam Morhan, K. Schwarz","doi":"10.1097/MPG.0000000000002483","DOIUrl":"https://doi.org/10.1097/MPG.0000000000002483","url":null,"abstract":"Mother-to-infant transmission (MIT) is the leading cause of hepatitis B virus (HBV) infections globally. The aim of this international study was to assess the impediments to prevention of (MIT) of HBV.\u0000\u0000\u0000METHODS\u0000A cross-sectional survey was developed by the Federation of the International Societies for Pediatric Gastroenterology, Hepatology and Nutrition. (FISPGHAN) The survey was sent to HBV experts of the five member societies of FISPGHAN, and 63/91 countries/regions responded. Main outcome measures include percentage of countries having vaccine programs, timing of the first dose of HBV vaccine, availability of HBV vaccine for out-born neonates, payment of HBV vaccine and HBIG, screening HBV markers during pregnancy, and antivirals to highly infectious pregnant mothers.\u0000\u0000\u0000RESULTS\u0000Among the participating countries/regions, 11% did not implement infant HBV immunization programs. The first dose of vaccine was given >24 hours in 36% of the total countries and 100% of African countries. The recommended birth dose was unavailable for out-born neonates in 45% of the total countries, including 92% of African and 50% of Latin American countries/regions. During pregnancy, 44% countries do not screen maternal viral markers, and 46% do not provide third trimester antiviral therapy for highly viremic pregnant mothers.\u0000\u0000\u0000CONCLUSIONS\u0000Our study demonstrated multiple obstacles to achieving the goal of preventing MIT of HBV. Comprehensive public health programs to enhance vaccine coverage rate, supply HBV vaccine for out-born neonates, screening maternal HBV markers, treating highly viremic pregnant mothers are proposed to overcome these obstacles and achieve the goal of preventing MIT of HBV.","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"88 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74557743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-01DOI: 10.1097/MPG.0000000000002464
Lisa B. Mahoney, E. Liu, R. Rosen
Gastroesophageal reflux disease is common in children with gastrostomy tubes. Clinicians often transition to continuous feedings in an attempt to reduce reflux burden, though there is limited data to support this practice. In this retrospective study, we analyzed 24-hour multichannel intraluminal impedance with pH studies in 18 children with gastrostomy tubes receiving exclusive enteral nutrition with a combination of daytime bolus and overnight continuous feedings. There were no significant differences in the rate of reflux (reflux events per hour) between no feeding, bolus feeding and continuous feeding periods overall or stratified by prior fundoplications (p > 0.40). After adjusting for age, BMI, feeding rate and feeding volume in multivariate analysis, there were no significant differences in the risk of reflux between different feeding periods. These results suggest that continuous feedings may not offer a significant advantage in reducing reflux burden.
{"title":"Continuous Feedings are Not Associated with Lower Rates of Gastroesophageal Reflux When Compared to Bolus Feedings.","authors":"Lisa B. Mahoney, E. Liu, R. Rosen","doi":"10.1097/MPG.0000000000002464","DOIUrl":"https://doi.org/10.1097/MPG.0000000000002464","url":null,"abstract":"Gastroesophageal reflux disease is common in children with gastrostomy tubes. Clinicians often transition to continuous feedings in an attempt to reduce reflux burden, though there is limited data to support this practice. In this retrospective study, we analyzed 24-hour multichannel intraluminal impedance with pH studies in 18 children with gastrostomy tubes receiving exclusive enteral nutrition with a combination of daytime bolus and overnight continuous feedings. There were no significant differences in the rate of reflux (reflux events per hour) between no feeding, bolus feeding and continuous feeding periods overall or stratified by prior fundoplications (p > 0.40). After adjusting for age, BMI, feeding rate and feeding volume in multivariate analysis, there were no significant differences in the risk of reflux between different feeding periods. These results suggest that continuous feedings may not offer a significant advantage in reducing reflux burden.","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":" 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91513231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-01DOI: 10.1097/MPG.0000000000002490
Paula Smith-Brown, M. Morrison, L. Krause, P. Davies
OBJECTIVES This study aimed to explore the associations between food group intake, faecal microbiota profile and body composition during the period of complementary feeding. METHODS Diet was assessed using a quantitative food frequency questionnaire, faecal microbiota profile was assessed using 16S rRNA gene sequencing and body composition was assessed using bioelectrical impedance analysis and dual energy X-ray absorptiometry, in a cohort of 50 infants aged 6 to 24 months of age. RESULTS During this critical period of microbiota development, age was the strongest predictor of microbiota composition with network analysis revealing a cluster of genera positively associated with age. A separate cluster comprised genera associated with Fat Mass Index with Bifidobacterium showing the strongest correlation with Fat Mass Index (rho = 0.55, p = 0.001, FDR = 0.018). Dairy intake was both negatively correlated with Bacteroides (rho = -0.49, p < 0.001, FDR = 0.024) and positively correlated with Lean Mass Index (rho = 0.44, p = 0.007, FDR = 0.024). Antibiotics use in the first month of life had the most striking influence on body composition and was associated with an increase in mean BMI (Body Mass Index) Z score of 1.17 (p = 0.001) and body fat of 3.5% (p = 0.001). CONCLUSIONS Our results suggested that antibiotics use in the first month of life had the most striking influence on body composition in this cohort of infants aged 6 to 24 months while dairy intake interacted with both microbiota and body composition in early life.
{"title":"Microbiota and Body Composition During the Period of Complementary Feeding.","authors":"Paula Smith-Brown, M. Morrison, L. Krause, P. Davies","doi":"10.1097/MPG.0000000000002490","DOIUrl":"https://doi.org/10.1097/MPG.0000000000002490","url":null,"abstract":"OBJECTIVES\u0000This study aimed to explore the associations between food group intake, faecal microbiota profile and body composition during the period of complementary feeding.\u0000\u0000\u0000METHODS\u0000Diet was assessed using a quantitative food frequency questionnaire, faecal microbiota profile was assessed using 16S rRNA gene sequencing and body composition was assessed using bioelectrical impedance analysis and dual energy X-ray absorptiometry, in a cohort of 50 infants aged 6 to 24 months of age.\u0000\u0000\u0000RESULTS\u0000During this critical period of microbiota development, age was the strongest predictor of microbiota composition with network analysis revealing a cluster of genera positively associated with age. A separate cluster comprised genera associated with Fat Mass Index with Bifidobacterium showing the strongest correlation with Fat Mass Index (rho = 0.55, p = 0.001, FDR = 0.018). Dairy intake was both negatively correlated with Bacteroides (rho = -0.49, p < 0.001, FDR = 0.024) and positively correlated with Lean Mass Index (rho = 0.44, p = 0.007, FDR = 0.024). Antibiotics use in the first month of life had the most striking influence on body composition and was associated with an increase in mean BMI (Body Mass Index) Z score of 1.17 (p = 0.001) and body fat of 3.5% (p = 0.001).\u0000\u0000\u0000CONCLUSIONS\u0000Our results suggested that antibiotics use in the first month of life had the most striking influence on body composition in this cohort of infants aged 6 to 24 months while dairy intake interacted with both microbiota and body composition in early life.","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74508735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-01DOI: 10.1097/mpg.0000000000002510
R. Troncone, R. Shamir
{"title":"ESPGHAN Distinguished Service Award 2019 to Professor Stefano Guandalini.","authors":"R. Troncone, R. Shamir","doi":"10.1097/mpg.0000000000002510","DOIUrl":"https://doi.org/10.1097/mpg.0000000000002510","url":null,"abstract":"","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78084035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-01DOI: 10.1097/MPG.0000000000002466
A. M. Wishahy, Hamed M. Seleim, M. Qinawy, Wesam Mohamed, O. Mansour, K. Abdullateef, Reda Elkadi, H. Raslan, A. Arafa, T. Yassin
OBJECTIVES The aim of this study was to investigate the efficacy and safety of endoscopic local infiltration of mitomycin C (MMC) after oesophageal dilation for children suffering from refractory post-corrosive oesophageal stricture (OS). METHODS Children referred to Cairo University Specialized Paediatric Hospital with refractory post-corrosive OS during the period from March 2016 to August 2017 were included in this study. MMC was infiltrated endoscopically at the stricture site by the end of the dilation session. The measured outcomes were dysphagia score (DS) and periodic dilation index (PDI). RESULTS During the inclusion period of the presented study, seventeen children met the inclusion criteria. There were seven males and ten females. During the follow-up period, an average of 3.8 dilation sessions with MMC infiltration per case were performed, using a total dose of 1 mg each session. The median follow-up period was 9.5 months. The median DS improved from DS 3 before application of MMC to DS 0 at the last follow-up (p < 0.001). Additionally, the median PDI declined from 1 to 0.75 after MMC application (p = 0.052). Sixteen cases (94%) became dysphagia free after six months. Seven patients experienced post-dilation minor bleeding that was spontaneously resolved, not triggering blood transfusion. There were no infiltration-related complications in the included series. CONCLUSION Stricture-site MMC endoscopic infiltration by the end of a dilation session proved to be safe and effective in improving the DS and PDI.
{"title":"Short Term Effects of Mitomycin C Infiltration for Caustic Oesophageal Strictures in Children.","authors":"A. M. Wishahy, Hamed M. Seleim, M. Qinawy, Wesam Mohamed, O. Mansour, K. Abdullateef, Reda Elkadi, H. Raslan, A. Arafa, T. Yassin","doi":"10.1097/MPG.0000000000002466","DOIUrl":"https://doi.org/10.1097/MPG.0000000000002466","url":null,"abstract":"OBJECTIVES\u0000The aim of this study was to investigate the efficacy and safety of endoscopic local infiltration of mitomycin C (MMC) after oesophageal dilation for children suffering from refractory post-corrosive oesophageal stricture (OS).\u0000\u0000\u0000METHODS\u0000Children referred to Cairo University Specialized Paediatric Hospital with refractory post-corrosive OS during the period from March 2016 to August 2017 were included in this study. MMC was infiltrated endoscopically at the stricture site by the end of the dilation session. The measured outcomes were dysphagia score (DS) and periodic dilation index (PDI).\u0000\u0000\u0000RESULTS\u0000During the inclusion period of the presented study, seventeen children met the inclusion criteria. There were seven males and ten females. During the follow-up period, an average of 3.8 dilation sessions with MMC infiltration per case were performed, using a total dose of 1 mg each session. The median follow-up period was 9.5 months. The median DS improved from DS 3 before application of MMC to DS 0 at the last follow-up (p < 0.001). Additionally, the median PDI declined from 1 to 0.75 after MMC application (p = 0.052). Sixteen cases (94%) became dysphagia free after six months. Seven patients experienced post-dilation minor bleeding that was spontaneously resolved, not triggering blood transfusion. There were no infiltration-related complications in the included series.\u0000\u0000\u0000CONCLUSION\u0000Stricture-site MMC endoscopic infiltration by the end of a dilation session proved to be safe and effective in improving the DS and PDI.","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"125 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86040973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-01DOI: 10.1097/MPG.0000000000002498
L. Huber, T. Lee, R. LeDrew, M. Dodge, J. Brunton, R. Bertolo
OBJECTIVES The purpose of the current study was to determine if protecting parenteral nutrition solutions from ambient light and supplementing with N-acetylcysteine (NAC) improves mesenteric blood flow, gut morphology, and oxidative status of parenterally fed neonates. METHODS Neonatal Yucatan miniature piglets (n = 23, 7-11 d old) were surgically fitted with central venous catheters and an ultrasonic blood flow probe around the superior mesenteric artery. Piglets were fed continuously for 7 d either light-protected (LP) or light-exposed (LE) complete parenteral nutrition that was enriched with either NAC or alanine (ALA). RESULTS There were no differences in body weight or overall gut morphology among groups after 7 d. Plasma concentrations of NAC were greater and total homocysteine lower in NAC- vs ALA-supplemented pigs on day 7 (N-acetylcysteine: 94 vs. 7 μM; P < 0.001; homocysteine: 14 vs. 21 μM; P < 0.005); plasma total glutathione was not affected. Hepatic lipid peroxidation was reduced by 25% in piglets that received LP parenteral nutrition (P < 0.05). The mesenteric artery blood flow decreased in all pigs between days 2 and 6 (P < 0.001) due to parenteral feeding. Photoprotection alone (LP-ALA) attenuated the decrease in mesenteric blood flow to 66% of baseline on day 6 compared to LE-ALA (37%; P < 0.05) and LP-NAC pigs (43%; P = 0.062); LE-NAC piglets had intermediate reductions in blood flow (55%). CONCLUSIONS Photoprotection of parenteral nutrition solutions is a simple, effective method to attenuate decline in blood flow to the gut and hepatic lipid peroxidation which are both commonly associated with parenteral feeding.
{"title":"Photoprotection But Not N-Acetylcysteine Improves Intestinal Blood Flow and Oxidation Status in Parenterally Fed Piglets.","authors":"L. Huber, T. Lee, R. LeDrew, M. Dodge, J. Brunton, R. Bertolo","doi":"10.1097/MPG.0000000000002498","DOIUrl":"https://doi.org/10.1097/MPG.0000000000002498","url":null,"abstract":"OBJECTIVES\u0000The purpose of the current study was to determine if protecting parenteral nutrition solutions from ambient light and supplementing with N-acetylcysteine (NAC) improves mesenteric blood flow, gut morphology, and oxidative status of parenterally fed neonates.\u0000\u0000\u0000METHODS\u0000Neonatal Yucatan miniature piglets (n = 23, 7-11 d old) were surgically fitted with central venous catheters and an ultrasonic blood flow probe around the superior mesenteric artery. Piglets were fed continuously for 7 d either light-protected (LP) or light-exposed (LE) complete parenteral nutrition that was enriched with either NAC or alanine (ALA).\u0000\u0000\u0000RESULTS\u0000There were no differences in body weight or overall gut morphology among groups after 7 d. Plasma concentrations of NAC were greater and total homocysteine lower in NAC- vs ALA-supplemented pigs on day 7 (N-acetylcysteine: 94 vs. 7 μM; P < 0.001; homocysteine: 14 vs. 21 μM; P < 0.005); plasma total glutathione was not affected. Hepatic lipid peroxidation was reduced by 25% in piglets that received LP parenteral nutrition (P < 0.05). The mesenteric artery blood flow decreased in all pigs between days 2 and 6 (P < 0.001) due to parenteral feeding. Photoprotection alone (LP-ALA) attenuated the decrease in mesenteric blood flow to 66% of baseline on day 6 compared to LE-ALA (37%; P < 0.05) and LP-NAC pigs (43%; P = 0.062); LE-NAC piglets had intermediate reductions in blood flow (55%).\u0000\u0000\u0000CONCLUSIONS\u0000Photoprotection of parenteral nutrition solutions is a simple, effective method to attenuate decline in blood flow to the gut and hepatic lipid peroxidation which are both commonly associated with parenteral feeding.","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88707620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-01DOI: 10.1097/MPG.0000000000002493
B. Joob, V. Wiwanitkit
T o the Editor: We read the publication on ‘‘Performance of Interferon-Gamma Release Assay (IGRA)s for Tuberculosis Screening in Pediatric Inflammatory Bowel Disease’’ with great interest (1). Stevens et al noted that ‘‘IGRA’s are a useful tool to screen for LTBI, both prior to anti-TNF therapy and during treatment (1).’’ The important consideration is on the diagnostic performance of the IGRA. The high false-positive rate might be an important problem that limits the usefulness of IGRA. In addition, the cost of IGRA test should be considered. Indeed, the simple test, such as tuberculin skin test could give the similar diagnostic performance for tuberculosis detection among patient with inflammatory bowel disease (2,3).
{"title":"Interferon-gamma Release Assays for Tuberculosis Screening in Pediatric Inflammatory Bowel Disease.","authors":"B. Joob, V. Wiwanitkit","doi":"10.1097/MPG.0000000000002493","DOIUrl":"https://doi.org/10.1097/MPG.0000000000002493","url":null,"abstract":"T o the Editor: We read the publication on ‘‘Performance of Interferon-Gamma Release Assay (IGRA)s for Tuberculosis Screening in Pediatric Inflammatory Bowel Disease’’ with great interest (1). Stevens et al noted that ‘‘IGRA’s are a useful tool to screen for LTBI, both prior to anti-TNF therapy and during treatment (1).’’ The important consideration is on the diagnostic performance of the IGRA. The high false-positive rate might be an important problem that limits the usefulness of IGRA. In addition, the cost of IGRA test should be considered. Indeed, the simple test, such as tuberculin skin test could give the similar diagnostic performance for tuberculosis detection among patient with inflammatory bowel disease (2,3).","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"212 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87010185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-01DOI: 10.1097/MPG.0000000000002501
J. P. Stevens, Cortney R. Ballengee, Raguraj Chandradevan, Amelia B. Thompson, B. Schoen, S. Kugathasan, Cary G. Sauer
T o the Editor: We read the publication on ‘‘Performance of Interferon-Gamma Release Assay (IGRA)s for Tuberculosis Screening in Pediatric Inflammatory Bowel Disease’’ with great interest (1). Stevens et al noted that ‘‘IGRA’s are a useful tool to screen for LTBI, both prior to anti-TNF therapy and during treatment (1).’’ The important consideration is on the diagnostic performance of the IGRA. The high false-positive rate might be an important problem that limits the usefulness of IGRA. In addition, the cost of IGRA test should be considered. Indeed, the simple test, such as tuberculin skin test could give the similar diagnostic performance for tuberculosis detection among patient with inflammatory bowel disease (2,3).
{"title":"Performance of Interferon-Gamma Release Assays for Tuberculosis Screening in Pediatric Inflammatory Bowel Disease.","authors":"J. P. Stevens, Cortney R. Ballengee, Raguraj Chandradevan, Amelia B. Thompson, B. Schoen, S. Kugathasan, Cary G. Sauer","doi":"10.1097/MPG.0000000000002501","DOIUrl":"https://doi.org/10.1097/MPG.0000000000002501","url":null,"abstract":"T o the Editor: We read the publication on ‘‘Performance of Interferon-Gamma Release Assay (IGRA)s for Tuberculosis Screening in Pediatric Inflammatory Bowel Disease’’ with great interest (1). Stevens et al noted that ‘‘IGRA’s are a useful tool to screen for LTBI, both prior to anti-TNF therapy and during treatment (1).’’ The important consideration is on the diagnostic performance of the IGRA. The high false-positive rate might be an important problem that limits the usefulness of IGRA. In addition, the cost of IGRA test should be considered. Indeed, the simple test, such as tuberculin skin test could give the similar diagnostic performance for tuberculosis detection among patient with inflammatory bowel disease (2,3).","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84437817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-01DOI: 10.1097/MPG.0000000000002438
A. Rosenberg, Jeffery Haynes
JPGN Volume 69, N epends on the mater F tion. Treatment d ial ingested and can include immediate removal or expectant management. Review of Material Safety Data Sheets data is important. One area of concern is the ingestion of items containing lead, due to the uncorrectable effects of lead exposure. We present a case of ingested lead pellets in a child and review the initial evaluation and management of a retained pellet ultimately requiring single site appendectomy.
{"title":"Management of Ingested Lead Pellets with Elevated Blood Lead Levels in a Pediatric Patient.","authors":"A. Rosenberg, Jeffery Haynes","doi":"10.1097/MPG.0000000000002438","DOIUrl":"https://doi.org/10.1097/MPG.0000000000002438","url":null,"abstract":"JPGN Volume 69, N epends on the mater F tion. Treatment d ial ingested and can include immediate removal or expectant management. Review of Material Safety Data Sheets data is important. One area of concern is the ingestion of items containing lead, due to the uncorrectable effects of lead exposure. We present a case of ingested lead pellets in a child and review the initial evaluation and management of a retained pellet ultimately requiring single site appendectomy.","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89220849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-01DOI: 10.1097/MPG.0000000000002492
Sarah A F Henkel, J. Squires
Received August 5, 2019 From the Division of Children’s Hospital Medical Center, Pittsb Address correspondence a Division of Gastroen Hospital of Pittsburgh 4401 Penn Avenue, P (e-mail: James.Squire The authors report no co Copyright # 2019 by E Hepatology, and Nut Gastroenterology, He DOI: 10.1097/MPG.0000 See ‘‘Esophageal Capsule Endoscopy in Children and Young Adults With Portal Hypertension’’ by Pai et al on page 641.
{"title":"New Tools for Screening Children With Portal Hypertension.","authors":"Sarah A F Henkel, J. Squires","doi":"10.1097/MPG.0000000000002492","DOIUrl":"https://doi.org/10.1097/MPG.0000000000002492","url":null,"abstract":"Received August 5, 2019 From the Division of Children’s Hospital Medical Center, Pittsb Address correspondence a Division of Gastroen Hospital of Pittsburgh 4401 Penn Avenue, P (e-mail: James.Squire The authors report no co Copyright # 2019 by E Hepatology, and Nut Gastroenterology, He DOI: 10.1097/MPG.0000 See ‘‘Esophageal Capsule Endoscopy in Children and Young Adults With Portal Hypertension’’ by Pai et al on page 641.","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"102 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77400584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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