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Prevalence, Management, and Outcomes of Non-Invasive Helicobacter pylori Testing in Children at a Tertiary Paediatric Hospital in Singapore. 新加坡一家三级儿科医院对儿童进行非侵入性幽门螺杆菌检测的患病率、管理和结果。
IF 1.3 Q3 PEDIATRICS Pub Date : 2024-11-01 Epub Date: 2024-11-05 DOI: 10.5223/pghn.2024.27.6.336
Charanya Rajan, Fang Kuan Chiou, Christopher Wen Wei Ho

Purpose: Helicobacter pylori infections differ between children and adults. The Pediatric society practice guidelines recommend against a test-and-treat approach, characterized by the use of non-invasive tests for diagnosis (e.g. urea breath test [UBT] or stool antigen test). However, significant variations exist in clinical practice. This study examined the use of non-invasive testing for the screening and diagnosis of H. pylori infection in children at a tertiary pediatric hospital in Singapore, reviewing both management decisions and patient outcomes.

Methods: A retrospective review was conducted on children between the ages of 0 and 18 years who were tested for H. pylori infection using either a stool antigen test or UBT between January 2018 and June 2020.

Results: Among the 1,397 children tested, 117 (8.4%) had a positive stool H. pylori antigen result, and 5 out of 85 tested (5.9%) had a positive UBT. Abdominal pain was the predominant symptom (n=98; 80.3%). Only 7 treatment-naïve children had biopsy-proven disease. Tissue biopsies for H. pylori culture were sent to 2 children, with 1 negative result. A total of 111 children (91.0%) received treatment, wherein proton pump inhibitor, amoxicillin, and clarithromycin for 14 days was the most common therapeutic regimen. Symptom resolution was observed in 62 children (50.8%).

Conclusion: A test-and-treat strategy was more widely utilized than endoscopy-based testing, showing a low compliance to existing guidelines for the management of H. pylori infections in children at our center and significant false-positive rates.

目的:儿童和成人的幽门螺旋杆菌感染情况不同。儿科学会的实践指南建议不要采取先检测后治疗的方法,其特点是使用非侵入性检测进行诊断(如尿素呼气试验 [UBT] 或粪便抗原检测)。然而,临床实践中存在很大差异。本研究考察了新加坡一家三级儿科医院使用非侵入性检测筛查和诊断儿童幽门螺杆菌感染的情况,并对管理决策和患者预后进行了回顾性分析:方法:对2018年1月至2020年6月期间使用粪便抗原检测法或UBT检测幽门螺杆菌感染的0至18岁儿童进行回顾性研究:在接受检测的 1397 名儿童中,117 人(8.4%)的粪便幽门螺杆菌抗原检测结果呈阳性,85 名接受检测的儿童中有 5 人(5.9%)的 UBT 检测结果呈阳性。腹痛是主要症状(98 人,占 80.3%)。只有 7 名未经治疗的儿童经活检证实患有疾病。2 名儿童接受了组织活检进行幽门螺杆菌培养,其中 1 例结果为阴性。共有 111 名儿童(91.0%)接受了治疗,其中质子泵抑制剂、阿莫西林和克拉霉素治疗 14 天是最常见的治疗方案。62名儿童(50.8%)的症状得到缓解:结论:与基于内镜的检测方法相比,我们更广泛地采用了先检测后治疗的策略,这表明我们中心儿童幽门螺杆菌感染的治疗很少遵循现有指南,而且假阳性率很高。
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引用次数: 0
Expression of IL-7RαlowCX3CR1+ CD8+ T Cells and α4β7 Integrin Tagged T Cells Related to Mucosal Immunity in Children with Inflammatory Bowel Disease. 炎症性肠病患儿中与粘膜免疫相关的 IL-7RαlowCX3CR1+ CD8+ T 细胞和 α4β7 Integrin 标记 T 细胞的表达。
IF 1.3 Q3 PEDIATRICS Pub Date : 2024-11-01 Epub Date: 2024-11-05 DOI: 10.5223/pghn.2024.27.6.345
Da Hee Yang, Hyo Jin Kim, Duong Thi Thuy Dinh, Jiwon Yang, Chang-Lim Hyun, Youngheun Jee, Naeun Lee, Min Sun Shin, Insoo Kang, Ki Soo Kang

Purpose: The study aimed to investigate the recruiting of T lymphocytes including IL-7Rαlow CX3CR1+ effector memory (EM) CD8+ T cells and α4β7 integrin tagged T cells to inflamed intestinal mucosa.

Methods: Whole blood and mucosal tissues of intestine were collected from 40 children with or without inflammatory bowel disease (IBD). T cell surface staining and immunohistochemistry were done with several antibodies in peripheral blood mononuclear cells (PBMCs) and intestinal mucosa, respectively. Serum levels of cytokines were measured by ELISA.

Results: The frequency of IL-7RαlowCX3CR1+ EM CD8+ T cells in the PBMC was significantly higher in the ulcerative colitis group than in the control group (57.9±17.80% vs. 33.9±15.70%, p=0.021). The frequency of integrin α4β7+ CD4+ T cells in the PBMC was significantly lower in the ulcerative colitis group than in the control group (53.2±27.6% vs. 63.9±13.2%, p=0.022). Serum concentration of TNF-α was higher in the Crohn's disease group than in the control group (26.13±5.01 pg/mL vs. 19.65±6.07 pg/mL, p=0.008). Of the three groups, the ulcerative colitis group had the highest frequency of integrin α4β7+ T cells based on immunohistochemistry analyses for intestinal tissues, followed by the Crohn's disease group and the control group (4.63±1.29 cells vs. 2.0±0.57 cells vs. 0.84±0.52 cells, p<0.001).

Conclusion: Trafficking immune cells with effector memory CD8+ T cells clarified by IL-7RαlowCX3CR1+ and integrin α4β7+ CD4+ T cells might be highly associated with the pathogenesis of ulcerative colitis.

目的:该研究旨在调查T淋巴细胞(包括IL-7Rα-low CX3CR1+效应记忆(EM)CD8+T细胞和α4β7整合素标记T细胞)对炎症肠粘膜的招募情况:方法:收集 40 名患有或未患有炎症性肠病(IBD)的儿童的全血和肠道粘膜组织。用几种抗体分别对外周血单核细胞(PBMCs)和肠粘膜进行了 T 细胞表面染色和免疫组化。用酶联免疫吸附法测定了血清中细胞因子的水平:结果:溃疡性结肠炎组 PBMC 中 IL-7RαlowCX3CR1+ EM CD8+ T 细胞的频率明显高于对照组(57.9±17.80% vs. 33.9±15.70%,P=0.021)。溃疡性结肠炎组 PBMC 中整合素 α4β7+ CD4+ T 细胞的频率明显低于对照组(53.2±27.6% vs. 63.9±13.2%,P=0.022)。克罗恩病组的血清 TNF-α 浓度高于对照组(26.13±5.01 pg/mL vs. 19.65±6.07 pg/mL,P=0.008)。根据肠道组织的免疫组化分析,三组中溃疡性结肠炎组的整合素α4β7+ T细胞频率最高,其次是克罗恩病组和对照组(4.63±1.29 cells vs. 2.0±0.57 cells vs. 0.84±0.52 cells,P=0.008):通过IL-7Rα-lowCX3CR1+和整合素α4β7+ CD4+ T细胞明确的具有效应记忆CD8+ T细胞的交通免疫细胞可能与溃疡性结肠炎的发病机制高度相关。
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引用次数: 0
Establishment and Characterization of Patient-Derived Intestinal Organoids from Pediatric Crohn's Disease Patients. 从小儿克罗恩病患者中建立患者衍生肠组织细胞并确定其特征
IF 1.3 Q3 PEDIATRICS Pub Date : 2024-11-01 Epub Date: 2024-11-05 DOI: 10.5223/pghn.2024.27.6.355
Sunghyun An, Homin Huh, Jae Sung Ko, Jin Soo Moon, Ky Young Cho

Purpose: This study aimed to establish and characterize patient-derived intestinal organoids (PDOs) from children with Crohn's disease (CD).

Methods: To generate PDOs, endoscopic biopsy specimens were obtained from non-inflamed duodenal bulbs of normal controls and CD patients. To verify the presence of PDOs, histological staining and quantitative reverse transcription polymerase chain reaction (RT-qPCR) analyses were performed.

Results: PDOs were successfully established in normal controls (n=2) and CD patients (n=2). Hematoxylin and eosin staining of formalin-fixed, paraffin-embedded PDO sections revealed crypt and villus structures, whereas immunofluorescence staining with EpCAM and DAPI confirmed the epithelial-specific architecture of the PDOs. RT-qPCR results revealed a significant increase in Lgr5, Si, and Chga gene expression and a decrease in Olfm4 and Muc2 expression in CD patients compared to normal controls, suggesting altered stem cell activity and mucosal barrier function (p<0.05).

Conclusion: We successfully established and characterized PDOs in children with CD, providing a valuable tool for understanding the pathophysiology of the disease and evaluating potential therapeutic approaches. The differential gene expression of PDOs in CD patients might be caused by the complex interplay between epithelial adaptation and inflammation in the intestinal epithelium.

目的:本研究旨在建立克罗恩病(CD)儿童患者来源的肠器官组织(PDOs)并确定其特征:为生成 PDOs,从正常对照组和 CD 患者的无炎症十二指肠球部获取内窥镜活检标本。为了验证 PDO 的存在,进行了组织学染色和定量反转录聚合酶链反应(RT-qPCR)分析:结果:正常对照组(2 例)和 CD 患者(2 例)均成功建立了 PDO。福尔马林固定、石蜡包埋的 PDO 切片经苏木精和伊红染色后显示出隐窝和绒毛结构,而 EpCAM 和 DAPI 的免疫荧光染色证实了 PDO 的上皮特异性结构。RT-qPCR结果显示,与正常对照组相比,CD患者的Lgr5、Si和Chga基因表达量显著增加,而Olfm4和Muc2表达量减少,这表明干细胞活性和粘膜屏障功能发生了改变(P结论:我们成功地在 CD 儿童中建立了 PDOs 并对其进行了表征,为了解该疾病的病理生理学和评估潜在的治疗方法提供了宝贵的工具。CD 患者 PDOs 基因表达的差异可能是肠上皮适应性和炎症之间复杂的相互作用造成的。
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引用次数: 0
Clinical Dilemmas for the Diagnosis and Treatment of Helicobacter pylori Infection in Children: From Guideline to Practice. 诊断和治疗儿童幽门螺旋杆菌感染的临床难题:从指南到实践。
IF 1.3 Q3 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2024-09-09 DOI: 10.5223/pghn.2024.27.5.267
Susanne Jenneke Van Veen, Elvira Ingrid Levy, Koen Huysentruyt, Yvan Vandenplas

Helicobacter pylori infection is often acquired in early childhood. While most infected children remain asymptomatic, H. pylori can cause chronic gastritis, gastric ulceration, and, in the long term, gastric cancer. This article aimed to review different diagnostic and treatment options and discuss the challenges associated with applying the current guidelines in the real world. Relevant articles published from 2015 to August 2023 in the English language in PubMed and Medline electronic databases were extracted using subject headings and keywords of interest to the topic. References of interest in the selected articles were also considered. Invasive and noninvasive diagnostic tests have advantages but also disadvantages and limitations according to the clinical setting and age of the child. Guidelines recommend not performing diagnostic testing in children with long-lasting or recurrent abdominal complaints or cases of a family history of severe disease caused by H. pylori. However, parents regularly consult with the explicit demand to test for H. pylori because of them or a close family member experiencing severe gastric disease caused by H. pylori. In some situations, it may be challenging for the healthcare professional to stick to evidence-based guidelines and not consider "patient-centered care," with the risk of putting a trustful relationship in danger. Physicians may find it challenging not to perform diagnostic tests for H. pylori and prescribe eradication treatment in specific clinical settings when maintaining a trusting patient-physician relationship by applying this "patient-centered care" method when evidence-based guidelines recommend differently.

幽门螺杆菌感染通常发生在儿童早期。虽然大多数受感染的儿童仍无症状,但幽门螺杆菌可导致慢性胃炎、胃溃疡,长期可引发胃癌。本文旨在回顾不同的诊断和治疗方案,并讨论在现实世界中应用现行指南所面临的挑战。使用主题标题和与主题相关的关键词提取了2015年至2023年8月在PubMed和Medline电子数据库中发表的相关英文文章。同时还考虑了所选文章中的相关参考文献。根据临床环境和儿童年龄的不同,侵入性和非侵入性诊断测试各有利弊和局限性。指南建议,对于长期或反复腹部不适或有幽门螺杆菌引起严重疾病家族史的儿童,不要进行诊断检测。然而,经常有家长咨询,明确要求检测幽门螺杆菌,因为他们或他们的近亲属经历过由幽门螺杆菌引起的严重胃病。在某些情况下,医护人员可能很难坚持循证指南,而不考虑 "以患者为中心的护理",这有可能会危及彼此间的信任关系。医生可能会发现,在特定的临床环境中,当循证医学指南提出不同建议时,如果采用这种 "以患者为中心的护理 "方法来维护医患之间的信任关系,而不进行幽门螺杆菌诊断检测和开具根除治疗处方,可能会很有挑战性。
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引用次数: 0
Efficacy and Safety of Valganciclovir in Congenital Cytomegalovirus Infection with Isolated Intrahepatic Cholestasis: A Randomized Controlled Trial. 缬更昔洛韦治疗先天性巨细胞病毒感染伴孤立性肝内胆汁淤积症的有效性和安全性:随机对照试验
IF 1.3 Q3 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2024-09-09 DOI: 10.5223/pghn.2024.27.5.298
Salahuddin Mahmud, Tanzila Farhana, Ataul Mustufa Anik, Fayaza Ahmed, Mashud Parvez, Madhabi Baidya, Rafia Rashid, Farhana Tasneem, Ahmed Rashidul Hasan, Mohammad Jahangir Alam, Shafi Ahmed Muaz

Purpose: Cytomegalovirus (CMV) infection affects the hepatic, neurologic, hematopoietic, respiratory, gastrointestinal, and other organs, resulting in a high mortality rate and long-term sequelae. It may cause acute or chronic hepatitis, or even lead to hepatic cirrhosis. Valganciclovir (VGCV) is an effective, safe, and well-tolerated treatment for congenital CMV infection, without any serious adverse effects. This study was conducted to evaluate the clinical, biochemical, and virological profiles of infants with CMV with intrahepatic cholestasis and to determine the outcomes with or without treatment with VGCV.

Methods: Twenty infants aged <6 months diagnosed with congenital CMV infection with evidence of intrahepatic cholestasis were included in this study. Randomization was used to divide the study participants into 2 groups. The control group (n=10) was treated with only supportive management, and the intervention group (n=10) was treated with oral VGCV at 16 mg/kg/dose 12 hours a day for 6 weeks plus supportive treatments. Physical examinations and biochemical, serological, and virological tests were performed at the time of diagnosis and at the end of 6 weeks and 6 months.

Results: The control and intervention groups were compared in terms of clinical and laboratory parameters such as jaundice, dark urine, pale stool, hepatomegaly, total bilirubin, aminotransferases, gamma-glutamyl transferase, alkaline phosphatase, and CMV polymerase chain reaction load, which showed a significant reduction after treatment in the intervention group (p<0.05) with oral VGCV, with very few side effects, whereas the control group showed no significant changes.

Conclusion: Oral VGCV can be used to effectively treat CMV infection with intrahepatic cholestasis without notable side effects.

目的:巨细胞病毒(CMV)感染会影响肝脏、神经系统、造血系统、呼吸系统、胃肠道和其他器官,导致高死亡率和长期后遗症。它可能引起急性或慢性肝炎,甚至导致肝硬化。缬更昔洛韦(VGCV)是治疗先天性巨细胞病毒感染的有效、安全、耐受性良好的药物,且无任何严重不良反应。本研究旨在评估患有 CMV 并伴有肝内胆汁淤积症的婴儿的临床、生化和病毒学特征,并确定使用或不使用 VGCV 治疗的结果:方法:20 名年龄为 6 个月的婴儿:对照组和干预组在黄疸、深色尿液、苍白粪便、肝肿大、总胆红素、转氨酶、γ-谷氨酰转移酶、碱性磷酸酶和CMV聚合酶链反应载量等临床和实验室指标方面进行了比较,结果显示干预组治疗后CMV载量显著降低(p):口服 VGCV 可有效治疗 CMV 感染合并肝内胆汁淤积症,且无明显副作用。
{"title":"Efficacy and Safety of Valganciclovir in Congenital Cytomegalovirus Infection with Isolated Intrahepatic Cholestasis: A Randomized Controlled Trial.","authors":"Salahuddin Mahmud, Tanzila Farhana, Ataul Mustufa Anik, Fayaza Ahmed, Mashud Parvez, Madhabi Baidya, Rafia Rashid, Farhana Tasneem, Ahmed Rashidul Hasan, Mohammad Jahangir Alam, Shafi Ahmed Muaz","doi":"10.5223/pghn.2024.27.5.298","DOIUrl":"https://doi.org/10.5223/pghn.2024.27.5.298","url":null,"abstract":"<p><strong>Purpose: </strong>Cytomegalovirus (CMV) infection affects the hepatic, neurologic, hematopoietic, respiratory, gastrointestinal, and other organs, resulting in a high mortality rate and long-term sequelae. It may cause acute or chronic hepatitis, or even lead to hepatic cirrhosis. Valganciclovir (VGCV) is an effective, safe, and well-tolerated treatment for congenital CMV infection, without any serious adverse effects. This study was conducted to evaluate the clinical, biochemical, and virological profiles of infants with CMV with intrahepatic cholestasis and to determine the outcomes with or without treatment with VGCV.</p><p><strong>Methods: </strong>Twenty infants aged <6 months diagnosed with congenital CMV infection with evidence of intrahepatic cholestasis were included in this study. Randomization was used to divide the study participants into 2 groups. The control group (n=10) was treated with only supportive management, and the intervention group (n=10) was treated with oral VGCV at 16 mg/kg/dose 12 hours a day for 6 weeks plus supportive treatments. Physical examinations and biochemical, serological, and virological tests were performed at the time of diagnosis and at the end of 6 weeks and 6 months.</p><p><strong>Results: </strong>The control and intervention groups were compared in terms of clinical and laboratory parameters such as jaundice, dark urine, pale stool, hepatomegaly, total bilirubin, aminotransferases, gamma-glutamyl transferase, alkaline phosphatase, and CMV polymerase chain reaction load, which showed a significant reduction after treatment in the intervention group (<i>p</i><0.05) with oral VGCV, with very few side effects, whereas the control group showed no significant changes.</p><p><strong>Conclusion: </strong>Oral VGCV can be used to effectively treat CMV infection with intrahepatic cholestasis without notable side effects.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"27 5","pages":"298-312"},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11419786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy and Safety of Long-Term Administration of Esomeprazole in Japanese Pediatric Patients Aged 1-14 Years with Chronic Gastric Acid-Related Disease. 日本 1-14 岁患有慢性胃酸相关疾病的儿科患者长期服用埃索美拉唑的有效性和安全性
IF 1.3 Q3 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2024-09-09 DOI: 10.5223/pghn.2024.27.5.274
Masaaki Mori, Yoshiko Nakayama, Shigeo Nishimata, Tadafumi Yokoyama, Ryo Matsuoka, Reiko Hatori, Masaki Shimizu, Katsuhiro Arai, Yuri Etani, Tsuyoshi Sogo, Tomoko Ishizu, Masahiro Nii, Ryosuke Nakashima, Toshiaki Shimizu

Purpose: To evaluate prolonged esomeprazole use in Japanese pediatric patients for reflux esophagitis (RE) maintenance therapy and prevention of gastric (GU) and/or duodenal ulcers (DU) while using non-steroidal anti-inflammatory drugs (NSAIDs) or low-dose aspirin (LDA).

Methods: This multicenter, open-label, parallel-group, phase III study (NCT03553563) included patients who were administered esomeprazole according to body weight (10 mg/day [Groups 1 and 3] and up to 20 mg/day [Groups 2 and 4] for patients weighing 10-20 kg and ≥20 kg, respectively). Efficacy outcomes for Groups 1 and 2 (maintenance therapy for healed RE) and Groups 3 and 4 (prevention of long-term NSAID/LDA use-associated GU/DU) were the presence/absence of RE relapse and GU/DU recurrence, respectively.

Results: Esomeprazole as maintenance therapy was associated with a low RE recurrence rate, independent of body weight or dosage. Recurrence rates of RE were 0.0% and 5.3% for Groups 1 and 2, respectively. In patients previously diagnosed with GU and/or DU due to long-term NSAID/LDA use, the recurrence rates of GU/DU during weeks 0-32 were 11.1% and 0.0% in Groups 3 and 4, respectively.

Conclusion: Long-term use of 10- or 20-mg, once-daily esomeprazole demonstrated a favorable benefit-risk balance in preventing RE and suppressing recurrence of GU and/or DU secondary to NSAID or LDA therapy in Japanese pediatric patients. No new safety concerns were identified. Esomeprazole may be a viable option for managing RE and preventing GU and DU in Japanese pediatric patients.

目的:评估日本儿科患者在使用非甾体抗炎药(NSAID)或小剂量阿司匹林(LDA)的同时,长期使用埃索美拉唑进行反流性食管炎(RE)维持治疗和预防胃溃疡(GU)和/或十二指肠溃疡(DU)的情况:这项多中心、开放标签、平行分组的III期研究(NCT03553563)纳入了根据体重给药的埃索美拉唑患者(体重为10-20公斤和≥20公斤的患者分别为10毫克/天[第1组和第3组]和最多20毫克/天[第2组和第4组])。第1组和第2组(痊愈RE的维持治疗)以及第3组和第4组(预防长期使用非甾体抗炎药/LDA引起的GU/DU)的疗效结果分别为有无RE复发和GU/DU复发:结果:埃索美拉唑作为维持疗法,RE复发率较低,与体重或剂量无关。第一组和第二组的RE复发率分别为0.0%和5.3%。对于曾因长期使用非甾体抗炎药/LDA而被诊断为GU和/或DU的患者,第3组和第4组在0-32周期间的GU/DU复发率分别为11.1%和0.0%:结论:在日本儿童患者中,长期使用10或20毫克、每日一次的埃索美拉唑在预防RE和抑制继发于非甾体抗炎药或LDA治疗的GU和/或DU复发方面显示出良好的效益-风险平衡。未发现新的安全性问题。埃索美拉唑可能是日本儿科患者控制RE、预防GU和DU的可行选择。
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引用次数: 0
Evaluating the Association between Anemia and the Severity of Liver Disease in Children with Cirrhosis: A Cross-Sectional Study from 2015 to 2020. 评估肝硬化儿童贫血与肝病严重程度之间的关系:2015年至2020年横断面研究。
IF 1.3 Q3 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2024-09-09 DOI: 10.5223/pghn.2024.27.5.286
Seyed Mohsen Dehghani, Iraj Shahramian, Hamideh Salehi, Leila Kasraian, Maryam Ataollahi, Masoud Tahani

Purpose: Liver cirrhosis is a major cause of hospital admission and mortality among children. Understanding the factors that influence disease severity is essential for preventing and reducing mortality. This study explored the association between hemoglobin levels and liver disease severity in children with cirrhosis.

Methods: This cross-sectional study included 326 children with cirrhosis admitted to Namazi Teaching Hospital between 2015 and 2020. Clinical data, Child-Turcotte-Pugh (CTP) scores, and pediatric end-stage liver disease/model for end-stage liver disease (PELD/MELD) scores were collected to assess disease severity. Anemia was defined based on age, sex, and hemoglobin levels.

Results: Among the children with cirrhosis, 275 (84.4%) were anemic, with a mean age of 5.4±4.8 years. The overall mean hemoglobin level was 9.2±2.1 g/dL. A significant inverse correlation was observed between hemoglobin levels and CTP and PELD/MELD scores in children with anemia (p<0.001). Moreover, lower hemoglobin levels were associated with more higher CTP classes (p<0.001).

Conclusion: According to the data analysis, a significant correlation was observed between hemoglobin level and the severity of liver disease, and hemoglobin level decreased with increasing severity of liver disease. According to CTP class, the mean hemoglobin level decreased progressively as the disease progressed. A comparison of the mean CTP scores between children with and those without anemia revealed that those with anemia had more severe disease than those without anemia.

目的:肝硬化是儿童入院和死亡的主要原因。了解影响疾病严重程度的因素对于预防和降低死亡率至关重要。本研究探讨了肝硬化儿童血红蛋白水平与肝病严重程度之间的关系:这项横断面研究纳入了2015年至2020年期间在纳马齐教学医院住院的326名肝硬化患儿。收集了临床数据、Child-Turcotte-Pugh(CTP)评分和儿科终末期肝病/终末期肝病模型(PELD/MELD)评分,以评估疾病严重程度。贫血的定义基于年龄、性别和血红蛋白水平:结果:在肝硬化患儿中,275 人(84.4%)贫血,平均年龄为(5.4±4.8)岁。总体平均血红蛋白水平为 9.2±2.1 g/dL。贫血患儿的血红蛋白水平与 CTP 和 PELD/MELD 评分之间存在明显的反相关性(ppConclusion:数据分析显示,血红蛋白水平与肝病严重程度之间存在明显相关性,血红蛋白水平随着肝病严重程度的增加而降低。根据 CTP 分级,随着病情的发展,平均血红蛋白水平逐渐下降。对有贫血和无贫血儿童的 CTP 平均得分进行比较后发现,有贫血的儿童比无贫血的儿童病情更严重。
{"title":"Evaluating the Association between Anemia and the Severity of Liver Disease in Children with Cirrhosis: A Cross-Sectional Study from 2015 to 2020.","authors":"Seyed Mohsen Dehghani, Iraj Shahramian, Hamideh Salehi, Leila Kasraian, Maryam Ataollahi, Masoud Tahani","doi":"10.5223/pghn.2024.27.5.286","DOIUrl":"https://doi.org/10.5223/pghn.2024.27.5.286","url":null,"abstract":"<p><strong>Purpose: </strong>Liver cirrhosis is a major cause of hospital admission and mortality among children. Understanding the factors that influence disease severity is essential for preventing and reducing mortality. This study explored the association between hemoglobin levels and liver disease severity in children with cirrhosis.</p><p><strong>Methods: </strong>This cross-sectional study included 326 children with cirrhosis admitted to Namazi Teaching Hospital between 2015 and 2020. Clinical data, Child-Turcotte-Pugh (CTP) scores, and pediatric end-stage liver disease/model for end-stage liver disease (PELD/MELD) scores were collected to assess disease severity. Anemia was defined based on age, sex, and hemoglobin levels.</p><p><strong>Results: </strong>Among the children with cirrhosis, 275 (84.4%) were anemic, with a mean age of 5.4±4.8 years. The overall mean hemoglobin level was 9.2±2.1 g/dL. A significant inverse correlation was observed between hemoglobin levels and CTP and PELD/MELD scores in children with anemia (<i>p</i><0.001). Moreover, lower hemoglobin levels were associated with more higher CTP classes (<i>p</i><0.001).</p><p><strong>Conclusion: </strong>According to the data analysis, a significant correlation was observed between hemoglobin level and the severity of liver disease, and hemoglobin level decreased with increasing severity of liver disease. According to CTP class, the mean hemoglobin level decreased progressively as the disease progressed. A comparison of the mean CTP scores between children with and those without anemia revealed that those with anemia had more severe disease than those without anemia.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"27 5","pages":"286-297"},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11419789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Relationship of MicroRNA according to Immune Components of Breast Milk in Korean Lactating Mothers. 韩国哺乳期母亲母乳中的微RNA与免疫成分的关系
IF 1.3 Q3 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2024-09-09 DOI: 10.5223/pghn.2024.27.5.322
You Jin Choi, Da Hye Lee, Jeonglyn Song, Ki-Uk Kim, Hyeyoung Min, Sung-Hoon Chung, Tae Hyeong Kim, Chae-Young Kim, Insoo Kang, Na Mi Lee, Dae Yong Yi

Purpose: Human breast milk (HBM) contains immune components that produced and delivered from the mother along with nutrients necessary for the baby. MicroRNA (miRNA) is a small noncoding RNA molecule, that is used as an ideal biomarker for diagnosis and prognosis of various diseases and are more abundant in HBM. We analyzed and compared the immune components and miRNAs of HBM.

Methods: HBM were collected from 20 healthy breastfeeding mothers. We measured the amount of lactoferrin, lysozyme, and immunoglobulin A (IgA) and extracted the miRNAs from each breast milk samples. Next, the top 5 and bottom 5 expressed miRNAs were compared and analyzed based on the amounts of the 3 immune components.

Results: The mean levels and ranges of lactoferrin, lysozyme, and IgA were 6.33 (2.24-14.77)×106 ng/mL, 9.90 (1.42-17.59)×107 pg/mL, and 6.64 (0.48-20.01)×105 ng/mL, respectively. The miRNAs concentration per 1 mL of skim milk was 40.54 (14.95-110.01) ng/μL. Comparing the bottom 5 and top 5 groups of each immune component, 19 miRNAs were significantly upregulated (6, 9, and 4 targeting lactoferrin, lysozyme, and IgA, respectively) and 21 were significantly downregulated (4, 9, and 8 targeting lactoferrin, lysozyme, and IgA, respectively). There were no miRNAs that were expressed significantly higher or lower in common to all 3 components. However, 2 and 3 miRNAs were commonly overexpressed and underexpressed, in the top 5 groups of lysozyme and IgA concentrations.

Conclusion: We identified the immune components and miRNAs in breast milk and found that each individual has different ingredients.

目的:母乳(HBM)中含有由母亲产生和输送的免疫成分以及婴儿所需的营养物质。微RNA(miRNA)是一种非编码RNA小分子,可作为诊断和预后各种疾病的理想生物标志物,在HBM中含量较高。我们分析并比较了 HBM 中的免疫成分和 miRNA。我们测量了乳铁蛋白、溶菌酶和免疫球蛋白 A(IgA)的含量,并从每个母乳样本中提取了 miRNA。然后,根据这三种免疫成分的含量,对表达量最高的 5 个和最低的 5 个 miRNA 进行比较和分析:结果:乳铁蛋白、溶菌酶和 IgA 的平均水平和范围分别为 6.33 (2.24-14.77)×106 ng/mL、9.90 (1.42-17.59)×107 pg/mL 和 6.64 (0.48-20.01)×105 ng/mL。每 1 毫升脱脂牛奶中的 miRNAs 浓度为 40.54 (14.95-110.01) 纳克/微升。比较每种免疫成分的后 5 组和前 5 组,19 个 miRNAs 显著上调(分别有 6、9 和 4 个以乳铁蛋白、溶菌酶和 IgA 为靶标),21 个显著下调(分别有 4、9 和 8 个以乳铁蛋白、溶菌酶和 IgA 为靶标)。没有任何 miRNA 在所有 3 种成分中都有明显的高表达或低表达。然而,在溶菌酶和 IgA 浓度最高的 5 个组别中,有 2 个和 3 个 miRNAs 普遍表达过高或过低:我们确定了母乳中的免疫成分和 miRNA,并发现每个人的免疫成分各不相同。
{"title":"Relationship of MicroRNA according to Immune Components of Breast Milk in Korean Lactating Mothers.","authors":"You Jin Choi, Da Hye Lee, Jeonglyn Song, Ki-Uk Kim, Hyeyoung Min, Sung-Hoon Chung, Tae Hyeong Kim, Chae-Young Kim, Insoo Kang, Na Mi Lee, Dae Yong Yi","doi":"10.5223/pghn.2024.27.5.322","DOIUrl":"https://doi.org/10.5223/pghn.2024.27.5.322","url":null,"abstract":"<p><strong>Purpose: </strong>Human breast milk (HBM) contains immune components that produced and delivered from the mother along with nutrients necessary for the baby. MicroRNA (miRNA) is a small noncoding RNA molecule, that is used as an ideal biomarker for diagnosis and prognosis of various diseases and are more abundant in HBM. We analyzed and compared the immune components and miRNAs of HBM.</p><p><strong>Methods: </strong>HBM were collected from 20 healthy breastfeeding mothers. We measured the amount of lactoferrin, lysozyme, and immunoglobulin A (IgA) and extracted the miRNAs from each breast milk samples. Next, the top 5 and bottom 5 expressed miRNAs were compared and analyzed based on the amounts of the 3 immune components.</p><p><strong>Results: </strong>The mean levels and ranges of lactoferrin, lysozyme, and IgA were 6.33 (2.24-14.77)×10<sup>6</sup> ng/mL, 9.90 (1.42-17.59)×10<sup>7</sup> pg/mL, and 6.64 (0.48-20.01)×10<sup>5</sup> ng/mL, respectively. The miRNAs concentration per 1 mL of skim milk was 40.54 (14.95-110.01) ng/μL. Comparing the bottom 5 and top 5 groups of each immune component, 19 miRNAs were significantly upregulated (6, 9, and 4 targeting lactoferrin, lysozyme, and IgA, respectively) and 21 were significantly downregulated (4, 9, and 8 targeting lactoferrin, lysozyme, and IgA, respectively). There were no miRNAs that were expressed significantly higher or lower in common to all 3 components. However, 2 and 3 miRNAs were commonly overexpressed and underexpressed, in the top 5 groups of lysozyme and IgA concentrations.</p><p><strong>Conclusion: </strong>We identified the immune components and miRNAs in breast milk and found that each individual has different ingredients.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"27 5","pages":"322-331"},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11419785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Nutrition Supply and Growth Post Nutrition Support Team Activity in Neonatal Intensive Care Unit. 新生儿重症监护室营养支持小组活动后的营养供应与成长。
IF 1.3 Q3 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2024-09-09 DOI: 10.5223/pghn.2024.27.5.313
Hye Min Ha, Yu Jin Jung, Yoo Rha Hong, So Yoon Choi

Purpose: For neonates admitted to the neonatal intensive care unit (NICU), appropriate nutritional assessment and intervention are important for adequate growth. In this study, we aimed to determine whether there were changes in the nutritional supply and growth status of premature infants hospitalized in the NICU after the introduction of the Nutrition support team (NST).

Methods: This study retrospectively analyzed premature infants admitted to the NICU for over 14 days. The average daily calorie, protein, and fat supply at 1 and 2 weeks after birth were compared before and after NST, and growth was evaluated by changes in length, weight, and head circumference z-scores at birth and 28 days after birth.

Results: A total of 79 neonates were included in the present study, with 32 in the pre-NST group and 47 in the post-NST group. The average daily energy supply during the first (p=0.001) and second (p=0.029) weeks postnatal was significantly higher in the post-NST group than in the pre-NST group. Lipid supply for the first week was significantly higher in the post-NST group than in the pre-NST group (p=0.010). The change in the z-score for length was significantly higher in the post-NST group than in the pre-NST group (p=0.049).

Conclusion: Nutrient supply and length z-score change increased significantly at 28 days after birth in the post-NST group. These results suggest that calorie calculators and NST activity can promote adequate growth and development in neonates.

目的:对于入住新生儿重症监护室(NICU)的新生儿而言,适当的营养评估和干预对其充分生长非常重要。本研究旨在确定在引入营养支持小组(NST)后,在新生儿重症监护室住院的早产儿的营养供应和生长状况是否发生了变化:本研究对在新生儿重症监护室住院超过 14 天的早产儿进行了回顾性分析。比较了 NST 启用前后出生后 1 周和 2 周的日均热量、蛋白质和脂肪供应量,并通过出生时和出生后 28 天的身长、体重和头围 Z 值的变化评估了生长情况:本研究共纳入了 79 名新生儿,其中 NST 前组 32 名,NST 后组 47 名。新生儿出生后第一周(p=0.001)和第二周(p=0.029)的平均每日能量供应量,NST后组明显高于NST前组。NST 后组第一周的脂质供应量明显高于 NST 前组(p=0.010)。NST后组的身长Z值变化明显高于NST前组(P=0.049):结论:NST后组的营养供应量和身长Z值变化在出生后28天明显增加。这些结果表明,卡路里计算器和 NST 活动可促进新生儿的充分生长和发育。
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引用次数: 0
Prevalence of Inflammatory Bowel Disease Unclassified, as Estimated Using the Revised Porto Criteria, among Korean Pediatric Patients with Inflammatory Bowel Disease. 韩国儿科炎症性肠病患者未分类的炎症性肠病患病率(根据修订后的波尔图标准估算)。
IF 1.3 Q3 PEDIATRICS Pub Date : 2024-07-01 Epub Date: 2024-07-08 DOI: 10.5223/pghn.2024.27.4.206
Sung Hee Lee, Minsoo Shin, Seo Hee Kim, Seong Pyo Kim, Hyung-Jin Yoon, Yangsoon Park, Jaemoon Koh, Seak Hee Oh, Jae Sung Ko, Jin Soo Moon, Kyung Mo Kim

Purpose: Few studies have reported the prevalence of inflammatory bowel disease unclassified (IBDU) among Korean pediatric IBD (PIBD) population. To address this gap, we used two tertiary centers and nationwide population-based healthcare administrative data to estimate the prevalence of Korean pediatric IBDU at the time of diagnosis.

Methods: We identified 136 patients aged 2-17 years with newly diagnosed IBD (94 Crohn's disease [CD] and 42 ulcerative colitis [UC]) from two tertiary centers in Korea between 2005 and 2017. We reclassified these 136 patients using the revised Porto criteria. To estimate the population-based prevalence, we analyzed Korean administrative healthcare data between 2005 and 2016, which revealed 3,650 IBD patients, including 2,538 CD and 1,112 UC. By extrapolating the reclassified results to a population-based dataset, we estimated the prevalence of PIBD subtypes.

Results: Among the 94 CD, the original diagnosis remained unchanged in 93 (98.9%), while the diagnosis of one (1.1%) patient was changed to IBDU. Among the 42 UC, the original diagnosis remained unchanged in 13 (31.0%), while the diagnoses in 11 (26.2%), 17 (40.5%), and one (2.4%) patient changed to atypical UC, IBDU, and CD, respectively. The estimated prevalences of CD, UC, atypical UC, and IBDU in the Korean population were 69.5%, 9.4%, 8.0%, and 13.1%, respectively.

Conclusion: This study is the first in Korea to estimate the prevalence of pediatric IBDU. This prevalence (13.1%) aligns with findings from Western studies. Large-scale prospective multicenter studies on PIBDU are required to examine the clinical features and outcomes of this condition.

研究目的很少有研究报道韩国儿科IBD(PIBD)人群中未分类炎症性肠病(IBDU)的患病率。为了填补这一空白,我们利用两家三级医疗中心和全国范围内基于人口的医疗保健管理数据来估算韩国儿科 IBDU 在诊断时的患病率:2005年至2017年期间,我们从韩国两家三级医疗中心确定了136名2-17岁新诊断为IBD的患者(94名克罗恩病[CD]患者和42名溃疡性结肠炎[UC]患者)。我们采用修订后的波尔图标准对这 136 名患者进行了重新分类。为了估算基于人群的患病率,我们分析了 2005 年至 2016 年间韩国的行政医疗数据,结果显示有 3,650 名 IBD 患者,其中包括 2,538 名 CD 患者和 1,112 名 UC 患者。通过将重新分类的结果推断到基于人群的数据集,我们估算出了PIBD亚型的患病率:结果:在 94 名 CD 患者中,93 人(98.9%)的原始诊断保持不变,1 人(1.1%)的诊断改为 IBDU。在 42 例 UC 患者中,13 例(31.0%)的原始诊断保持不变,而 11 例(26.2%)、17 例(40.5%)和 1 例(2.4%)患者的诊断分别变更为非典型 UC、IBDU 和 CD。据估计,CD、UC、非典型 UC 和 IBDU 在韩国人群中的患病率分别为 69.5%、9.4%、8.0% 和 13.1%:这项研究是韩国首次估算小儿 IBDU 患病率。结论:这项研究是韩国首次估算小儿 IBDU 患病率,其患病率(13.1%)与西方研究结果一致。需要对 PIBDU 进行大规模的前瞻性多中心研究,以了解这种疾病的临床特征和预后。
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引用次数: 0
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Pediatric Gastroenterology, Hepatology & Nutrition
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