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Liver Steatosis and Diarrhea After Liver Transplantation for Progressive Familial Intrahepatic Cholestasis Type 1: Can Biliary Diversion Solve These Problems?
Knisely, A.S.?; Houwen, Roderick H.J.†
doi : 10.1097/MPG.0000000000002990
Journal of Pediatric Gastroenterology and Nutrition: March 2021 - Volume 72 - Issue 3 - p 341-342
Pollutants in Breast Milk: A Public Health Perspective – A Commentary of the Nutrition Committee of the French Society of Pediatrics
Lapillonne, Alexandre?; Bocquet, Alain†; Briend, André‡; Chouraqui, Jean-Pierre§; Darmaun, Dominique||; Feillet, François¶; Frelut, Marie-Laure#; Guimber, Dominique??; Hankard, Régis††; Peretti, Noel‡‡; Roze, Jean-Christophe||; Simeoni, Umberto§; Turck, Dominique??; Dupont, Christophe?; Comité de Nutrition de la Société Française de Pédiatrie (CNSFP)
doi : 10.1097/MPG.0000000000002928
Journal of Pediatric Gastroenterology and Nutrition: March 2021 - Volume 72 - Issue 3 - p 343-346
Pregnant and lactating women are continuously and ubiquitously exposed to numerous environmental pollutants from various sources including air, food, water, and occupational and household environments. The available evidence shows that pollutants are present in human milk and one of the emerging questions is what happens when the nursing infant is involuntarily exposed to contaminants through breastfeeding.
Gut-Brain Axis Exploration: Stabilometric Platform Performances in Children Affected by Functional Gastrointestinal Disorders
Tezza, Giovanna?; Paiola, Giulia?; Zoccante, Leonardo§; Gandolfi, Marialuisa†,‡; Smania, Nicola†,‡; Ciceri, Marco Luigi†,‡; Boner, Attilio?; Piacentini, Giorgio?; Banzato, Claudia?
doi : 10.1097/MPG.0000000000002968
Journal of Pediatric Gastroenterology and Nutrition: March 2021 - Volume 72 - Issue 3 - p 347-353
The pathophysiology of functional gastrointestinal disorders (FGIDs) is associated with dysfunction at various levels of the gut-brain axis. Hypervigilance can result in an increased tendency to report pain. In the present study, we aimed to explore whether hypervigilance can influence attentional processing in postural control in children with FGIDs.
Gastrointestinal Health Questionnaire for Rett Syndrome: Tool Development
Motil, Kathleen J.?,†,‡; Khan, Nabeel†,‡; Coon, Jennifer L.?,‡; Barrish, Judy O.†,‡; Suter, Bernhard†,‡; Pehlivan, Davut†,‡; Schultz, Rebecca J.†,‡,§; Glaze, Daniel G.†,‡
doi : 10.1097/MPG.0000000000002951
Journal of Pediatric Gastroenterology and Nutrition: March 2021 - Volume 72 - Issue 3 - p 354-360
We report the development and validation of a tool to assess gastrointestinal health in Rett syndrome (RTT). We hypothesized that the Gastrointestinal Health Questionnaire (GHQ) is a valid clinical outcomes measure of gastrointestinal health in RTT.
Evaluation of Fecal Incontinence in Pediatric Functional Constipation: Clinical Utility of Anorectal and Colon Manometry
Morera, Claudio?,†; Nurko, Samuel?; Rodriguez, Leonel?
doi : 10.1097/MPG.0000000000002978
Journal of Pediatric Gastroenterology and Nutrition: March 2021 - Volume 72 - Issue 3 - p 361-365
The aim of the study is to evaluate the utility of motility studies in pediatric functional constipation with/without fecal incontinence.
Antibiotic Prophylaxis for Percutaneous Endoscopic Gastrostomy in Children: A Randomised Controlled Trial
Alessandri, Francesco?; Strisciuglio, Caterina†; Borrazzo, Cristian‡; Cozzi, Denis§; Romano, Claudio||; Betalli, Pietro¶; Villa, Maria Pia#; Parisi, Pasquale#; Ziparo, Chiara#; Rocco, Monica??; Evangelisti, Melania#; Pugliese, Francesco?; Di Nardo, Giovanni#
doi : 10.1097/MPG.0000000000002981
Journal of Pediatric Gastroenterology and Nutrition: March 2021 - Volume 72 - Issue 3 - p 366-371
Paediatric studies on the role of antibiotic prophylaxis in the prevention of postoperative infections in children undergoing percutaneous endoscopic gastrostomy (PEG) are lacking. The aim of this study was to assess if a single dose of co-amoxiclav before PEG can decrease the rate of peristomal wound and systemic infection in children.
Overlapping Symptoms of Gastroesophageal Reflux and Aspiration Highlight the Limitations of Validated Questionnaires
Duncan, Daniel R.; DiFilippo, Courtney; Kane, Madeline; Lurie, Margot; McSweeney, Maireade E.; Rosen, Rachel L.
doi : 10.1097/MPG.0000000000002987
Journal of Pediatric Gastroenterology and Nutrition: March 2021 - Volume 72 - Issue 3 - p 372-377
Infants frequently present with feeding difficulties and respiratory symptoms, which are often attributed to gastroesophageal reflux but may be because of oropharyngeal dysphagia with aspiration. The Infant Gastroesophageal Reflux Questionnaire Revised (I-GERQ-R) is a clinical measure of gastroesophageal reflux disease but now there is greater understanding of dysphagia as a reflux mimic. We aimed to determine the degree of overlap between I-GERQ-R and evidence of dysphagia, measured by Pediatric Eating Assessment Tool-10 (Pedi-EAT-10) and videofluoroscopic swallow study (VFSS).
Two-step Testing for Clostridioides Difficile is Inadequate in Differentiating Infection From Colonization in Children
Parnell, Jacob M.?; Fazili, Irtiqa†; Bloch, Sarah C.‡; Lacy, D. Borden‡; Garcia-Lopez, Valeria A.§; Bernard, Rachel||; Skaar, Eric P.§; Edwards, Kathryn M.¶; Nicholson, Maribeth R.||
doi : 10.1097/MPG.0000000000002944
Journal of Pediatric Gastroenterology and Nutrition: March 2021 - Volume 72 - Issue 3 - p 378-383
Recent Infectious Disease Society of America guidelines recommend multistep testing algorithms to diagnose Clostridioides difficile infection (CDI), including a combination of nucleic acid amplification-based testing (NAAT) and toxin enzyme immunoassay (EIA). The use of these algorithms in children, including the ability to differentiate between C. difficile colonization and CDI, however, has not been evaluated.
Esophageal Fibrosis in Eosinophilic Gastrointestinal Diseases
Thaker, Ameet I.?; Melo, Diana Montoya†; Samandi, Layla Z.‡; Huang, Rong§; Park, Jason Y.||; Cheng, Edaire¶
doi : 10.1097/MPG.0000000000002997
Journal of Pediatric Gastroenterology and Nutrition: March 2021 - Volume 72 - Issue 3 - p 392-397
Eosinophilic esophagitis (EoE), the most common eosinophilic gastrointestinal disease (EGID), is associated with lamina propria (LP) fibrosis. The relationship of EoE to other EGIDs is still unclear. We frequently observe cases of concurrent esophageal eosinophilia and extra-esophageal mucosal eosinophilia. The purpose of this study was to compare clinical, endoscopic, and histologic features, as well as the prevalence of esophageal LP fibrosis in children with EGID and concurrent esophageal eosinophilia to children with EoE. We also examine the current practices of pathologists in evaluating fibrosis.
Comorbid Diagnosis of Eosinophilic Esophagitis and Inflammatory Bowel Disease in the Pediatric Population
Moore, Hillary?,†; Wechsler, Joshua‡,§; Frost, Carrie||; Whiteside, Elizabeth¶; Baldassano, Robert?,†; Markowitz, Jonathan¶,#; Muir, Amanda B.?,†
doi : 10.1097/MPG.0000000000003002
Journal of Pediatric Gastroenterology and Nutrition: March 2021 - Volume 72 - Issue 3 - p 398-403
The incidence and prevalence of eosinophilic esophagitis (EoE) and inflammatory bowel disease (IBD) are rising with similar patterns. Co-occurrence of both diseases in the same patient has been increasingly reported. We sought to examine the pediatric population with both EoE and IBD to better understand the epidemiology and clinical implications of this overlap.
Illness Stigma, Worry, Intrusiveness, and Depressive Symptoms in Youth With Inflammatory Bowel Disease
Roberts, Caroline M.?; Baudino, Marissa N.?; Gamwell, Kaitlyn L.?; Edwards, Clayton S.?; Traino, Katherine A.?; Tung, Jeanne†; Grunow, John E.†; Jacobs, Noel J.‡; Mullins, Larry L.?; Chaney, John M.?
doi : 10.1097/MPG.0000000000002939
Journal of Pediatric Gastroenterology and Nutrition: March 2021 - Volume 72 - Issue 3 - p 404-409
Youth who experience IBD-associated stigma may manifest increased worry about aversive symptoms that can intrude on their participation in routine activities (eg, school, social events), potentially resulting in limited opportunities for reinforcement and increased depressive symptoms. The present study examined an IBD stigma ? IBD worry ? illness intrusiveness ? depressive symptoms serial mediation model, in which stigma was hypothesized to confer an indirect effect on youth depressive symptoms through the serial effects of stigma on IBD worry and illness intrusiveness.
Age, Disease Symptoms, and Depression are Associated With Body Image Dissatisfaction in Newly Diagnosed Pediatric Inflammatory Bowel Disease
Cushman, Grace?; Stolz, Mary Gray?; Shih, Sharon†; Listernick, Zoe‡; Talmadge, Clair||; Gold, Benjamin D.||; Reed, Bonney§
doi : 10.1097/MPG.0000000000002943
Journal of Pediatric Gastroenterology and Nutrition: March 2021 - Volume 72 - Issue 3 - p e57-e62
Body image refers to the subjective, mental representation one makes regarding their physical appearance. Children and adolescents with inflammatory bowel disease (IBD) may be prone to experiencing negative self-evaluations regarding their body image given disease-related symptoms and treatment side-effects. In this study, we aimed to examine demographic, medical, and psychosocial variables related to body image dissatisfaction (BID) in pediatric patients diagnosed with IBD and to determine which variables are most predictive of higher dissatisfaction.
Early Inflammatory Markers are Associated With Inadequate Post-Induction Infliximab Trough in Pediatric Crohn's Disease
Constant, Brad D.?; Khushal, Salina?; Jiang, Jiji†; Bost, James E.†; Chaisson, Ellen‡; Conklin, Laurie S.‡
doi : 10.1097/MPG.0000000000002975
Journal of Pediatric Gastroenterology and Nutrition: March 2021 - Volume 72 - Issue 3 - p 410-416
In pediatric Crohn's disease, infliximab trough concentrations after standard weight-based induction therapy are commonly below 7 ?g/mL. Clinical treatment outcomes are associated with post-induction infliximab trough concentration. Markers of inflammation are associated with low infliximab concentrations during maintenance dosing. We sought to determine if early markers of disease activity are associated with inadequate post-induction infliximab trough concentrations in pediatric Crohn's disease.
Clinical Hypnosis in Pediatric Crohn's Disease: A Randomized Controlled Pilot Study
Lee, Amanda?; Moulton, Dedrick†; Mckernan, Lindsey‡; Russell, Alexandra?; Slaughter, James C.§; Acra, Sari?; Walker, Lynn||
doi : 10.1097/MPG.0000000000002980
Journal of Pediatric Gastroenterology and Nutrition: March 2021 - Volume 72 - Issue 3 - p e63-e70
The aim of this study was to implement clinical hypnosis (CH) as an adjunctive therapy for adolescents with Crohn's disease (CD) and to assess the impact of CH on quality of life (QoL), abdominal pain, psychosocial measures, and disease activity compared with standard care.
A Learning Health System for Pediatric Liver Transplant: The Starzl Network for Excellence in Pediatric Transplantation
Perito, Emily R.?; Squires, James E.†; Bray, David‡; Bucuvalas, John§; Krise-Confair, Cassandra†; Eisenberg, Elizabeth‡; Gonzalez-Peralta, Regino P.||; Gupta, Nitika¶; Hsu, Evelyn K.#; Kosmach-Park, Beverly†; Lobritto, Steven??; Logan, Beth†; Mohammad, Saeed††; Ng, Vicky L.‡‡; Pillari, Tony§§; Rasmussen, Sara||||; Shemesh, Eyal§; Soltys, Kyle†; Szolna, Jonathan†; Superina, Riccardo††; Tunno, John‡; Mazariegos, George V.†
doi : 10.1097/MPG.0000000000002974
Journal of Pediatric Gastroenterology and Nutrition: March 2021 - Volume 72 - Issue 3 - p 417-424
Learning health systems (LHS) integrate research, improvement, management, and patient care, such that every child receives “the right care at the right time...every time,” that is, evidence-based, personalized medicine. Here, we report our efforts to establish a sustainable, productive, multicenter LHS focused on pediatric liver transplantation.
Long-term Outcomes of Living-donor Liver Transplantation for Progressive Familial Intrahepatic Cholestasis Type 1
Okamoto, Tatsuya?,†; Sonoda, Mari?,†; Ogawa, Eri?,†; Ito, Shogo‡; Togawa, Takao‡; Hayashi, Hisamitsu§; Okajima, Hideaki?,†,||; Uemoto, Shiji?,†
doi : 10.1097/MPG.0000000000002983
Journal of Pediatric Gastroenterology and Nutrition: March 2021 - Volume 72 - Issue 3 - p 425-429
Progressive familial intrahepatic cholestasis type 1 (PFIC-1), an autosomal recessive disorder, is characterized by cholestasis, jaundice, and refractory pruritus. In some patients with PFIC-1, liver cirrhosis and end-stage liver disease develop and lead to liver transplantation (LT). In this observational study, we sought to clarify the long-term outcomes of LT for PFIC-1 and predictors of favorable outcomes.
Performance Characteristics, Intra- and Inter-operator Agreement of Transient Elastography in Pediatric Nonalcoholic Fatty Liver Disease
Mandelia, Chetan?,‡; Kabbany, Mohammad Nasser?; Worley, Sarah†; Conjeevaram Selvakumar, Praveen Kumar?,§
doi : 10.1097/MPG.0000000000002991
Journal of Pediatric Gastroenterology and Nutrition: March 2021 - Volume 72 - Issue 3 - p 430-435
Transient elastography (TE) is a valuable tool in assessment of hepatic steatosis and fibrosis using liver stiffness measurement (LSM) and controlled attenuation parameter (CAP), respectively. Although widely used in adults, little is known about performance characteristics and reproducibility of TE (using Fibroscan device) in evaluation of pediatric nonalcoholic fatty liver disease (NAFLD).
Development of Methods to Extract RNA From Archived Pediatric Needle Liver Biopsies to Produce Sequencing Data
Shin, Emilia?; Jones-Brando, Lorraine V.†; Florea, Liliana D.‡; Schwarz, Kathleen B.?; Yolken, Robert H.†
doi : 10.1097/MPG.0000000000003012
Journal of Pediatric Gastroenterology and Nutrition: March 2021 - Volume 72 - Issue 3 - p 436-441
Genetic susceptibility has been proposed as etiopathogenic in several pediatric liver diseases including autoimmune hepatitis (AIH). High throughput sequencing (HTPS) has been applied to archived needle liver biopsies obtained from adults but rarely to pediatric biopsies. For conclusive diagnosis of AIH, most subjects have an initial formalin-fixed paraffin embedded (FFPE) needle liver biopsy that is eventually archived and may be stored for decades.
Features of Intestinal Disease Associated With COVID-Related Multisystem Inflammatory Syndrome in Children
Sahn, Benjamin?; Eze, Ogechukwu P.†; Edelman, Morris C.‡; Chougar, Christina E.§; Thomas, Rebecca M.†; Schleien, Charles L.||; Weinstein, Toba¶
doi : 10.1097/MPG.0000000000002953
Journal of Pediatric Gastroenterology and Nutrition: March 2021 - Volume 72 - Issue 3 - p 384-387
Multisystem inflammatory syndrome in children (MIS-C) is a recently identified syndrome that appears to be temporally associated with novel coronavirus 2019 infection. MIS-C presents with fever and evidence of systemic inflammation, which can manifest as cardiovascular, pulmonary, neurologic, and gastrointestinal (GI) system dysfunction. Presenting GI symptoms are seen in the majority, including abdominal pain, diarrhea, and vomiting. Any segment of the GI tract may be affected; however, inflammation in the ileum and colon predominates. Progressive bowel wall thickening can lead to luminal narrowing and obstruction. Most will have resolution of intestinal inflammation with medical therapies; however, in rare instances, surgical resection may be required.
Long-term Outcomes of Children With Pediatric Feeding Disorders Treated in an Inpatient Multidisciplinary Program
Kim, Cindy; Brown, Shonda; Brown, Jessica; Ornelas, Elisa
doi : 10.1097/MPG.0000000000002977
Journal of Pediatric Gastroenterology and Nutrition: March 2021 - Volume 72 - Issue 3 - p 388-391
The purpose of this longitudinal observational study was to evaluate the effectiveness of a multidisciplinary inpatient treatment model for feeding disorders by analyzing long-term nutritional and health outcomes 12 months following discharge. Fifty patients completed the study. Average caloric intake by mouth as a percentage of goal for gastrostomy tube (GT)-dependent patients (n = 31) increased from pre-admit, week 1, and week 2 of the inpatient program (30%, 70%, and 84%, respectively), and was sustained from week 3 to 12-month follow-up (85% and 86%, respectively). Eighty-one percentage were discharged without GT support and 65% remained off GT support at 12 months. Oral supplement dependence for non-GT patients (n = 19) decreased from pre-admit, discharge, and 12-month follow-up (51%, 31%, and 19% of caloric intake, respectively). BMI z-scores improved during and after treatment. The present study demonstrated an effective approach for treatment of pediatric feeding disorders, including decreased reliance on oral supplementation and GT dependence.
Pediatric Feeding Disorder in Children With Short Bowel Syndrome
Christian, Vikram J.?; Van Hoorn, Megan†; Walia, Cassandra L.S.†; Silverman, Alan‡; Goday, Praveen S.‡
doi : 10.1097/MPG.0000000000002961
Journal of Pediatric Gastroenterology and Nutrition: March 2021 - Volume 72 - Issue 3 - p 442-445
We aimed to characterize the prevalence of pediatric feeding disorder (PFD) in short bowel syndrome (SBS) and study factors contributing to the persistence of PFD.
Caregiver Decision-making in Pediatric Intestinal Failure: A Qualitative Study Focused on Iron Deficiency Anemia
Raghu, Vikram Kalathur?; Prathapan, Krishnapriya M.†; Hamm, Megan E.‡; Rudolph, Jeffrey A.?; Norman, Marie K.‡
doi : 10.1097/MPG.0000000000002979
Journal of Pediatric Gastroenterology and Nutrition: March 2021 - Volume 72 - Issue 3 - p 446-450
Caregivers of children with intestinal failure (IF) face difficult decisions without a clear best alternative. Providers assist in decision-making but often lack knowledge of caregiver perspectives. Using decision-making around anemia treatment as a focal point, we explored how caregivers of children with IF prefer to make decisions. Our goal was to offer insight to guide providers as they assist in decision-making.
Relevance of Methane and Carbon Dioxide Evaluation in Breath Tests for Carbohydrate Malabsorption in a Paediatric Cohort
Hammer, Karin?; Hasanagic, Hana†; Memaran, Nima‡; Huber, Wolf-Dietrich§; Hammer, Johann†
doi : 10.1097/MPG.0000000000003004
Journal of Pediatric Gastroenterology and Nutrition: March 2021 - Volume 72 - Issue 3 - p e71-e77
The relevance of methane measurement in breath tests for the detection of carbohydrate malabsorption in children is controversial. The need for correction for poor sample collection is disputed. We evaluated the relevance of methane/CO2 measurements for the diagnosis of paediatric carbohydrate malabsorption.
One-year Experience With Composite Intravenous Lipid Emulsion in Children on Home Parenteral Nutrition
Raphael, Bram P.?; Mitchell, Paul D.†; Carey, Alexandra?; Gura, Kathleen M.?,‡; Puder, Mark§
doi : 10.1097/MPG.0000000000003011
Journal of Pediatric Gastroenterology and Nutrition: March 2021 - Volume 72 - Issue 3 - p 451-455
Composite lipid emulsion (CLE) composed of soybean oil, medium-chain triglycerides, olive oil, and fish oil is approved in the US for parenterally fed adults. For stable children discharged on home parenteral nutrition (HPN) without cholestasis (direct bilirubin > 2.0 mg/dL), CLE has theoretical benefits over soybean-based intravenous lipid emulsion due to reduced phytosterol exposure with higher calorie support to permit reduced glucose infusion rates (GIRs), omega-3 supplementation, and supplemental ?-tocopherol.
Clinical Genomics for the Diagnosis of Monogenic Forms of Inflammatory Bowel Disease: A Position Paper From the Paediatric IBD Porto Group of European Society of Paediatric Gastroenterology, Hepatology and Nutrition
Uhlig, Holm H.?,†,‡; Charbit-Henrion, Fabienne§; Kotlarz, Daniel||; Shouval, Dror S.¶; Schwerd, Tobias||; Strisciuglio, Caterina#; de Ridder, Lissy??; van Limbergen, Johan††; Macchi, Marina?; Snapper, Scott B.‡‡; Ruemmele, Frank M.§§; Wilson, David C.||||; Travis, Simon P.L.?,‡; Griffiths, Anne M.¶¶,##,???; Turner, Dan†††; Klein, Christoph||; Muise, Aleixo M.¶¶,##,???; Russell, Richard K.||||; on behalf of the Paediatric IBD Porto group of ESPGHAN
doi : 10.1097/MPG.0000000000003017
Journal of Pediatric Gastroenterology and Nutrition: March 2021 - Volume 72 - Issue 3 - p 456-473
It is important to identify patients with monogenic IBD as management may differ from classical IBD. In this position statement we formulate recommendations for the use of genomics in evaluating potential monogenic causes of IBD across age groups.
Management of Central Venous Access in Children With Intestinal Failure: A Position Paper From the NASPGHAN Intestinal Rehabilitation Special Interest Group
Wendel, Danielle?; Mezoff, Ethan A.†; Raghu, Vikram K.‡; Kinberg, Sivan§; Soden, Jason||; Avitzur, Yaron¶; Rudolph, Jeffrey A.‡; Gniadek, Michelle†; Cohran, Valeria C.#; Venick, Robert S.??; Cole, Conrad R.††
doi : 10.1097/MPG.0000000000003036
Journal of Pediatric Gastroenterology and Nutrition: March 2021 - Volume 72 - Issue 3 - p 474-486
Intestinal failure requires the placement and maintenance of a long-term central venous catheter for the provision of fluids and/or nutrients. Complications associated with this access contribute to significant morbidity and mortality, while the loss of access is an increasingly common reason for intestinal transplant referral. As more emphasis has been placed on the prevention of central line-associated bloodstream infections and new technologies have developed, care for central lines has improved; however, because care has evolved independently in local centers, care of central venous access varies significantly in this vulnerable population. The present position paper from the Intestinal Failure Special Interest Group of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) reviews current evidence and provides recommendations for central line management in children with intestinal failure.
Our 2 Cents: Corrosion Can Make Pennies Look Like a Button Battery
Saul, Samantha A.?,†; Wenzel, Amanda A.?,†
doi : 10.1097/MPG.0000000000002994
Journal of Pediatric Gastroenterology and Nutrition: March 2021 - Volume 72 - Issue 3 - p e78
An Unusual Cause of Acute Abdominal Pain in a Teenager: Epiploic Appendagitis
Prasad, Durga; Verma, Abhai; Kumar, Alok
doi : 10.1097/MPG.0000000000003014
Journal of Pediatric Gastroenterology and Nutrition: March 2021 - Volume 72 - Issue 3 - p e78
Sustained Virologic Remission in an 8-Month-old Pediatric Patient With Carbamoyl Phosphate Synthetase I Deficiency and Hepatitis C Infection Using Direct-acting Antivirals Prior to Liver Transplant
Huang, Alice C.?; Beadles, Angela†; Romero, Danielle?; Berquist, William?; Bensen, Rachel?; Kwo, Paul‡; Mckenzie, Rebecca B.?
doi : 10.1097/MPG.0000000000002856
Journal of Pediatric Gastroenterology and Nutrition: March 2021 - Volume 72 - Issue 3 - p e79-e80
