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Parenteral Nutrition for Critically Ill Term and Preterm Neonates: A Commentary on the 2021 European Society for Paediatric Gastroenterology, Hepatology and Nutrition Position Paper
van Goudoever, Johannes B.; van den Akker, Chris H.P.
doi : 10.1097/MPG.0000000000003179
August 2021 - Volume 73 - Issue 2 - p 137-138
Knowledge Translation Action is Needed to Address Problems in Adherance to Pediatric Helicobacter Consensus Guidelines in Clinical Practice
van Zanten, Sander Veldhuyzen?,†
doi : 10.1097/MPG.0000000000003184
August 2021 - Volume 73 - Issue 2 - p 138-139
Identifying the Genetics Underlying Nonalcoholic Fatty Liver Disease: A Quest That is Far From Over
Koot, Bart G.P.?; Jansen, Philip R.†,‡
doi : 10.1097/MPG.0000000000003180
August 2021 - Volume 73 - Issue 2 - p 139-140
Transient Elastography in Pediatric Liver Disease
Banc-Husu, Anna M.?; Bass, Lee M.†
doi : 10.1097/MPG.0000000000003168
August 2021 - Volume 73 - Issue 2 - p 141-144
Transient elastography is an imaging technique utilizing shear wave technology to measure liver stiffness. Recent studies have shown success in utilizing this technique in children. Transient elastography is useful in estimating degree of fibrosis in various pediatric liver diseases, including biliary atresia, alpha-1-antitrypsin deficiency, Alagille syndrome, cystic fibrosis-related liver disease, and non-alcoholic steatohepatitis among others. Confounding factors, however, may affect elastography measurements, such as obesity, severe inflammation, nonfasting state, and hepatic congestion, and should be considered whenever interpreting these measurements. Future studies will correlate liver stiffness on transient elastography and severity of disease.
A Collaborative Effort to Advance Drug Development in Pediatric Constipation and Irritable Bowel Syndrome
Saps, Miguel?; Nurko, Samuel†; Benninga, M.A.‡; Di Lorenzo, Carlo§; Garza, Jose M.||,¶; Thapar, Nikhil¶,#; Richards, Kelly??; Lee, Jessica J.††; Altepeter, Tara††
doi : 10.1097/MPG.0000000000003191
August 2021 - Volume 73 - Issue 2 - p 145-149
Pediatric functional gastrointestinal disorders including irritable bowel syndrome with constipation and functional constipation are common conditions in childhood, but no drugs are U.S. Food and Drug Administration (FDA) approved for chronic use in pediatric patients with these disorders. Despite efforts to better standardize the diagnosis of these conditions in children (including recent modifications to the Rome criteria), conducting pediatric clinical trials to support drug approval remains a challenge. In March 2018, FDA, in collaboration with the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition, American Gastroenterological Association, and American College of Gastroenterology, convened a public workshop to discuss the challenges and opportunities in conducting pediatric clinical trials in functional gastrointestinal conditions. The workshop assembled gastroenterologists, psychologists, patients, patient advocates, regulators, and industry representatives to discuss trial design and conduct including alternative designs, eligibility criteria, instruments for patient- and observer-reported outcomes, and optimal primary endpoints to support regulatory approval. This report summarizes the workshop, key challenges and knowledge gaps identified, and outlines areas where further research efforts are needed to overcome barriers to developing drugs to treat these conditions.
Natural History of Chronic Hepatitis B Infection Among Chinese Children and Young Adults: A Single-Center Experience
Mo, Shirley?,†; Au, Loretta?; Huang, Sherry?; Malik, Preeti‡; Pan, Debra H.?,‡
doi : 10.1097/MPG.0000000000003106
August 2021 - Volume 73 - Issue 2 - p 150-155
There are limited data on the natural history of chronic hepatitis B virus (HBV) infection in Asian American children. The aim of the present study was to describe a single-center experience of chronic HBV infection in Chinese American patients in New York City.
Peginterferon Alfa-2a (40KD) Plus Lamivudine or Entecavir in Children With Immune-Tolerant Chronic Hepatitis B
Mieli-Vergani, Giorgina?,†; Bansal, Sanjay†; Daniel, James F.‡; Kansu, Aydan§; Kelly, Deirdre||; Martin, Carmen¶; Tizzard, Sarah†; Wirth, Stefan#; Zhou, Julian??; Vergani, Diego††
doi : 10.1097/MPG.0000000000003118
August 2021 - Volume 73 - Issue 2 - p 156-160
Treatment guidelines for chronic hepatitis B (CHB) do not recommend antiviral therapy for patients in the immune-tolerant phase of the disease, which generally occurs in children who acquire hepatitis B virus (HBV) vertically and may last for decades. On the basis of promising results of a pilot study, we conducted a randomized, controlled, multicenter study to evaluate the efficacy and safety of antiviral therapy in children and adolescents with immune-tolerant CHB.
Pediatric Non-Alcoholic Fatty Liver Disease Is Affected by Genetic Variants Involved in Lifespan/Healthspan
Crudele, Annalisa?; Dato, Serena†; Re, Oriana Lo‡; Maugeri, Andrea‡,§; Sanna, Paola‡; Giallongo, Sebastiano‡; Oben, Jude||; Panera, Nadia?; De Rango, Francesco†; Mosca, Antonella¶; Rose, Giuseppina†; Passarino, Giuseppe†; Alisi, Anna?; Vinciguerra, Manlio‡,||,#
doi : 10.1097/MPG.0000000000003123
August 2021 - Volume 73 - Issue 2 - p 161-168
Non-alcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease in both adults and children. Along with obesity and metabolic syndrome, genetic predisposition influences the progression of NAFLD. Here, we investigated the effect of lifespan/healthspan-related single nucleotide polymorphisms (SNPs) on metabolically associated fatty liver disease in children.
Mutation Analysis and Disease Features at Presentation in a Multi-Center Cohort of Children With Monogenic Cholestasis
Hertel, Paula M.?; Bull, Laura N.†; Thompson, Richard J.‡; Goodrich, Nathan P.§; Ye, Wen||; Magee, John C.||; Squires, Robert H.¶; Bass, Lee M.#; Heubi, James E.??; Kim, Grace E.†; Ranganathan, Sarangarajan??; Schwarz, Kathleen B.††; Bozic, Molly A.‡‡; Horslen, Simon P.§§; Clifton, Matthew S.||||; Turmelle, Yumirle P.¶¶; Suchy, Frederick J.##; Superina, Riccardo A.#; Wang, Kasper S.???; Loomes, Kathleen M.†††; Kamath, Binita M.‡‡‡; Sokol, Ronald J.##; Shneider, Benjamin L.?; for the Childhood Liver Disease Research Network (ChiLDReN)
doi : 10.1097/MPG.0000000000003153
August 2021 - Volume 73 - Issue 2 - p 169-177
To advance our understanding of monogenic forms of intrahepatic cholestasis.
Low Adherence to Society Guidelines for the Management of Helicobacter Pylori Among Pediatric Gastroenterologists
Bonilla, Silvana?; Mitchell, Paul D.†; Mansuri, Ishrat?
doi : 10.1097/MPG.0000000000002976
August 2021 - Volume 73 - Issue 2 - p 178-183
The revised ESPGHAN/NASPGHAN 2016 guideline on the diagnosis and management of Helicobacter pylori (H pylori) infection discourages a “test and treat” strategy. Instead, upper endoscopy (EGD) is recommended when a valid clinical indication is present. Likewise, new treatment recommendations for first-line therapies strongly encourage obtaining antimicrobial susceptibility before treatment. We conducted this study to assess the effect of revised guidelines on clinical practice at our center.
Esophagitis Dissecans Superficialis in Children
Ebigbo, Nonyelum?,†; Park, Jason Y.‡; Cheng, Edaire?,†; Gurram, Bhaskar?,†
doi : 10.1097/MPG.0000000000003154
August 2021 - Volume 73 - Issue 2 - p e30-e34
Esophagitis dissecans superficialis (EDS) is a desquamative disorder of the superficial esophageal epithelium with variable clinical characteristics. Endoscopically, there is an appearance of superficial peeling of sheets of epithelium. Histologically there is 2-toned epithelium with coagulative necrosis of the superficial epithelium. Currently, there is paucity of data regarding this condition in children.
Electrodermal Activity of Auricular Acupoints in Pediatric Patients With Functional Abdominal Pain Disorders
Borlack, Rachel E.?,†; Shan, Sophie‡; Zong, Amanda M.‡; Khlevner, Julie§; Garbers, Samantha||; Gold, Melanie A.¶
doi : 10.1097/MPG.0000000000003137
August 2021 - Volume 73 - Issue 2 - p 184-191
Functional abdominal pain disorders (FAPD) affect approximately 13.5% of children. Pharmacotherapy is often ineffective, leaving providers, and families seeking adjunctive therapies. Auriculotherapy provides treatment for pain and other symptoms, without a defined protocol for FAPD. A handheld point-finder device measuring transdermal electrical current determines active acupoints, with a higher current indicating a more active acupoint. Our objectives were to determine auricular acupoint (AA) activity in FAPD and to assess participants’ attitudes towards auriculotherapy.
PedsQL™ Gastroparesis Symptoms Module Domain and Item Development: Qualitative Methods
Varni, James W.?; Shulman, Robert J.†; Self, Mariella M.‡; Febo-Rodriguez, Liz§; Charron, Heather†; Williams, Kent||; Nurko, Sam¶; Rosen, Rachel L.¶; Chumpitazi, Bruno P.†; for the Gastroparesis Research Consortium (GpCRC)
doi : 10.1097/MPG.0000000000003146
August 2021 - Volume 73 - Issue 2 - p 192-196
Like adults, children suffer from gastroparesis; however, there are currently no validated instruments to determine the impact of gastroparesis in pediatric patients. The objective of this study was to develop the items and domains to support the content validity of the new Pediatric Quality of Life Inventory (PedsQL™) Gastroparesis Symptoms Module.
Ultrasound Assessment of Gastric Emptying in Premature Infants Treated With Non-Invasive Ventilatory Support
Hlaing, Arkar Ye?; Weinberger, Barry?; Schanler, Richard?; Cerise, Jane†; Kurepa, Dalibor?
doi : 10.1097/MPG.0000000000003157
August 2021 - Volume 73 - Issue 2 - p 197-202
Nasal continuous positive airway pressure (CPAP) introduces positive pressure of air into both the trachea and stomach, which may affect gastric emptying. The rate of gastric emptying can be estimated by ultrasound (US) in neonates by two validated techniques: “antral cross-sectional area” (ACSA, two-dimensional estimate of the surface area at the gastric antrum), and “spheroid gastric volume” (spheroid, three-dimensional estimate of the stomach volume).
Ghrelin, Obestatin and Their Receptors As Well As Metabotropic Glutamate Receptor Assessment in Chronic Functional Constipation in Children
Czkwianianc, Elzbieta?; Kolejwa, Michal?; Bossowski, Artur†; Wawrusiewicz-Kurylonek, Natalia‡; Glowacka, Ewa§; Makosiej, Aleksandra?; Goscik, Joanna||; Socha-Banasiak, Anna?; Makosiej, Ryszard?
doi : 10.1097/MPG.0000000000003124
August 2021 - Volume 73 - Issue 2 - p 203-209
The aim of this study was to examine the role of ghrelin, obestatin, and glutamate and their receptors in the pathogenesis of children functional constipation.
The Modified Bristol Stool Form Scale: A Reliable and Valid Tool to Score Stool Consistency in Dutch (Non)Toilet-trained Toddlers
Wegh, Carrie A.M.?,§; Hermes, Gerben D.A.?; Schoterman, Margriet H.C.†; Vaughan, Elaine E.‡; Smidt, Hauke?; Belzer, Clara?; Benninga, Marc A.§
doi : 10.1097/MPG.0000000000003186
August 2021 - Volume 73 - Issue 2 - p 210-216
The aim of the study was to assess whether the modified Bristol Stool Form Scale (m-BSFS) is reliable, valid and user-friendly to use by parents, grandparents, and day childcare employees to evaluate stool consistency in toilet and nontoilet-trained toddlers in the Netherlands.
Disparities in Telehealth Utilization Within Pediatric Gastroenterology: One Academic Center's Experience
Puthenpura, Vidya?; Du, Nan†; Hauptman, Leora?; Porto, Anthony F.?
doi : 10.1097/MPG.0000000000003167
August 2021 - Volume 73 - Issue 2 - p 217-222
While the use of telemedicine has accelerated significantly with the recent pandemic, it has also magnified disparities in access to telemedicine. This study aims to look at telemedicine utilization patterns within a large pediatric gastroenterology practice.
Pediatric-onset Inflammatory Bowel Disease Has Only a Modest Effect on Final Growth: A Report From the epi-IIRN
Assa, Amit?,†; Assayag, Noa‡; Balicer, Ran D.§; Gabay, Hagit§; Greenfeld, Shira||; Kariv, Revital||,‡‡; Ledderman, Natan¶; Matz, Eran#; Dotan, Iris??,‡‡; Ledder, Oren‡; Yerushalmy-Feler, Anat††,‡‡; Turner, Dan‡; Cohen, Shlomi††,‡‡
doi : 10.1097/MPG.0000000000003072
August 2021 - Volume 73 - Issue 2 - p 223-230
The impact of pediatric-onset inflammatory bowel disease (IBD) on growth is debated. We aimed to investigate the effect of IBD on anthropometric measures at young adulthood.
Bone Health in Pediatric Patients With Crohn Disease
Rozes, Sylvana?; Guilmin-Crepon, Sophie†; Alison, Marianne‡; Thomas, Edouard§; Hugot, Jean-Pierre?,||; Viala, Jerome?; Martinez-Vinson, Christine?
doi : 10.1097/MPG.0000000000003132
August 2021 - Volume 73 - Issue 2 - p 231-235
The aim of our study was to examine longitudinal changes in bone mineral density (BMD) of children and adolescents with Crohn disease (CD), and risk factors related to low BMD.
Monitoring Enables Progress: A Nationwide Quality Improvement Program in Children With Crohn Disease
Yogev, Dotan?,†; Shosberger, Adi?; Nehemia, Chen?; Harel, Sasha?; Yerushalmy-Feler, Anat‡,§; Ledder, Oren?,†; Orlanski-Meyer, Esther?; Assa, Amit||; Slae, Mordechai¶; Kori, Michal#; Elenberg, Yigal??; Shaoul, Ron††,‡‡; Zifman, Eyal§§; Shamaly, Hussein||||; Berkowitz, Drora¶¶; Sarit, Peleg‡‡; Yerushalmi, Baruch##; Broide, Efrat???; On, Avi†††; Elkayam, Orit‡‡‡; Bayan, Hino§§§; Gorodnichenko, Anna||||||; Pinsk, Vered||; Shouval, Dror S.¶¶¶,§; Turner, Dan?,†
doi : 10.1097/MPG.0000000000003133
August 2021 - Volume 73 - Issue 2 - p 236-241
In this quality improvement program, named quality in pediatric inflammatory bowel disease, we constructed a nation-wide platform that prospectively recorded clinically important quality indicators in pediatric inflammatory bowel diseases (PIBD), aiming at improving clinical management across the country.
Is Fecal Calprotectin a Useful Marker for Small Bowel Crohn Disease?
D’Arcangelo, Giulia?; Imondi, Chiara?; Terrin, Gianluca†; Catassi, Giulia?; Aloi, Marina?
doi : 10.1097/MPG.0000000000003151
August 2021 - Volume 73 - Issue 2 - p 242-246
The identification of reliable non-invasive biomarkers of Crohn disease (CD) activity is crucial. Fecal calprotectin (FC) is the most promising one. We aimed to define whether its performance for isolated ileal CD could be as useful as for colonic and ileocolonic disease.
Adolescents With Inflammatory Bowel Disease Have Decreased Rates of Health Maintenance Visits
Moran, Christopher J.?,†; Aryee, Emmanuel‡; Perrin, James M.?,‡
doi : 10.1097/MPG.0000000000003155
August 2021 - Volume 73 - Issue 2 - p 247-250
Inflammatory bowel disease (IBD) commonly presents during adolescence and may affect health care utilization. This study aimed to assess rates of health maintenance examinations (HMEs) in adolescents with IBD with their primary care physicians (PCPs).
Transition Services for Paediatric Inflammatory Bowel Disease: A Multicentre Study of Practice in the United Kingdom
Ashton, James J.?,†; Narula, Priya‡; Kiparissi, Fevronia§; Spray, Christine||; Wilson, David C.¶; Tayler, Rachel#; Howarth, Lucy??; Torrente, Franco††; Deb, Protima‡‡; Cameron, Fiona L.§§; Muhammed, Rafeeq||||; Paul, Thankam¶¶; Epstein, Jenny##; Lawson, Maureen???; Maginnis, Janis†††; Zamvar, Veena‡‡‡; Fagbemi, Andrew§§§; Devadason, David||||||; Bhavsar, Hemant S.¶¶¶; Kammermeier, Jochen###; Beattie, Robert M.?
doi : 10.1097/MPG.0000000000003148
August 2021 - Volume 73 - Issue 2 - p 251-258
Patients with paediatric inflammatory bowel disease (IBD) constitute one of the largest cohorts requiring transition from paediatric to adult services. Standardised transition care improves short and long-term patient outcomes. This study aimed to detail the current state of transition services for IBD in the United Kingdom (UK).
Superior Mesenteric Artery Blood Flow in Parenterally Fed Versus Enterally Fed Preterm Infants
Elgendy, Marwa M.?; El Sharkawy, Hamed M.†; Elrazek, Hussein Abd†; Zayton, Hossam A.‡; Aly, Hany?
doi : 10.1097/MPG.0000000000003139
August 2021 - Volume 73 - Issue 2 - p 259-263
The aim of the study was to compare superior mesenteric artery (SMA) flow in premature infants with parenteral and enteral nutrition.
Supplementary Bovine Colostrum Feedings to Formula-Fed Preterm Pigs Improve Gut Function and Reduce Necrotizing Enterocolitis
Yan, Xudong?,†; Sangild, Per Torp?,‡,§; Peng, Yueming?,†; Li, Yanqi?; Bering, Stine Brandt?; Pan, Xiaoyu?
doi : 10.1097/MPG.0000000000003147
August 2021 - Volume 73 - Issue 2 - p e39-e46
Exclusive feeding with bovine colostrum (BC) protects preterm pigs against necrotizing enterocolitis (NEC) and BC has recently been tested as a supplement to a mother's own milk or formula (FOR) for very preterm infants. Using preterm pigs as a model for infants, we investigated if BC has gut- and NEC-protective effects at different proportions of the daily enteral intake given as BC.
Maternal Obesity Is Associated With Higher Cord Blood Adipokines in Offspring Most Notably in Females
Jaramillo-Ospina, ?ngela?; Casta?o-Moreno, Erika?; Mu?oz-Mu?oz, Estefan?a?; Krause, Bernardo J.†; Uauy, Ricardo†; Casanello, Paola†,‡; Castro-Rodriguez, José A.§
doi : 10.1097/MPG.0000000000003172
August 2021 - Volume 73 - Issue 2 - p 264-270
Deleterious long-term effects in the offspring from women with pregravid obesity have been described; however, the evidence supporting early metabolic and inflammatory markers in the offspring at birth and gender differences are conflicting.
Agreement on Symptoms Between Children With Ulcerative Colitis and Their Caregivers: Towards Developing the TUMMY-UC
Marcovitch, Liron?; Focht, Gili?; Horesh, Anat?; Shosberger, Adi?; Hyams, Jeffrey†; Bousvaros, Athos‡; Hale, Amy E.‡; Baldassano, Robert§; Otley, Anthony||; Mack, David R.¶; Kappelman, Michael D.#; Griffiths, Anne M.??; Turner, Dan?
doi : 10.1097/MPG.0000000000003120
August 2021 - Volume 73 - Issue 2 - p e35-e38
As part of the development of the TUMMY-UC, a patient-reported outcome (PRO) measure for pediatric ulcerative colitis (UC), we aimed to explore agreement on UC symptoms between children and their caregivers. We conducted 44 interviews with children ages 8–12 years, who completed the PRO version of the TUMMY-UC, and their caregivers, who completed the observer-reported outcome (obsRO) version. There was excellent agreement between the total TUMMY-UC PRO and obsRO scores (intra-class correlation coefficient = 0.92 [95% confidence interval 0.74–0.98]). The obsRO scores were always within the same disease-activity category as the corresponding PRO score (ie, remission, mild and moderate-severe disease). There was a strong correlation of the TUMMY-UC PRO and obsRO scores with physician global assessment of disease activity (r = 0.94 and r = 0.90, respectively, P < 0.001) and the pediatric UC activity index (r = 0.95 and r = 0.96; P < 0.001). These data support conceptual equivalence between the PRO and obsRO TUMMY-UC versions, and provide support for their incorporation into one score.
Guidance for Beverages in the Diets of Children Younger Than 2 Years
Baker, Susan S.?; Bodnar, Lisa M.†,‡; Benjamin-Neelon, Sara E.§,||
doi : 10.1097/MPG.0000000000003161
August 2021 - Volume 73 - Issue 2 - p 271-273
Recently the National Academies of Sciences, Engineering, and Medicine reported a summary of recommendations from high-income countries on what and how to feed infants and children from birth to 2 years of age. The report notes generally consistent recommendations against providing sugar-sweetened beverages (SSB), juice, and beverages that contain nonnutritive sweeteners to infants and children younger than 2 years. When counselling parents and other caregivers, pediatricians should feel empowered to advise against offering these beverages.
Nutritional Management of the Critically Ill Neonate: A Position Paper of the ESPGHAN Committee on Nutrition
Moltu, Sissel Jennifer?; Bronsky, Jiri†; Embleton, Nicholas‡; Gerasimidis, Konstantinos§; Indrio, Flavia||; K?glmeier, Jutta¶; de Koning, Barbara#; Lapillonne, Alexandre??; Norsa, Lorenzo††; Verduci, Elvira‡‡; Domell?f, Magnus§§; ESPGHAN Committee on Nutrition
doi : 10.1097/MPG.0000000000003076
August 2021 - Volume 73 - Issue 2 - p 274-289
The nutritional management of critically ill term neonates and preterm infants varies widely, and controversies exist in regard to when to initiate nutrition, mode of feeding, energy requirements, and composition of enteral and parenteral feeds. Recommendations for nutritional support in critical illness are needed.
A Rare Case of Clofazimine-induced Pigmentary Enteropathy
Oberoi, Amarinder; Poojari, Vishrutha; Shah, Ira
doi : 10.1097/MPG.0000000000003112
August 2021 - Volume 73 - Issue 2 - p e47
Cytomegalovirus Colitis in An Immunocompetent Patient
Du, Nan?; Musser, Melissa?; Bern, Elana?; Goldsmith, Jeffrey D.†; Chang, Denis?
doi : 10.1097/MPG.0000000000003113
August 2021 - Volume 73 - Issue 2 - p e47
Seronegative Autoimmune Hepatitis-associated Severe Aplastic Anemia: Looking for the Best Treatment
Maggiore, Giuseppe?; Pietrobattista, Andrea?; Liccardo, Daniela?; Sciveres, Marco†; Nastasio, Silvia‡; Jacquemin, Emmanuel§,||; Bernard, Olivier§
doi : 10.1097/MPG.0000000000003165
August 2021 - Volume 73 - Issue 2 - p e48
Severe Seronegative Hepatitis-associated Aplastic Anemia: Looking for the Best Treatment
Kemme, Sarah; Feldman, Amy G.; Mack, Cara
doi : 10.1097/MPG.0000000000003166
August 2021 - Volume 73 - Issue 2 - p e48
Endoscopic Management of Button Batteries
Ruan, Wenly?,†; Fishman, Douglas S.?,†; Kramer, Robert E.‡; Walker, Thomas‡; Khalaf, Racha T.§,||
doi : 10.1097/MPG.0000000000003169
August 2021 - Volume 73 - Issue 2 - p e48-e49
Reply to “Re: Diagnosis, Management, and Prevention of Button Battery Ingestion in Childhood: an ESPGHAN Position Paper”
de Ridder, Lissy?; Benninga, Marc A.†
doi : 10.1097/MPG.0000000000003170
August 2021 - Volume 73 - Issue 2 - p e49
