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  • 1
    Online Resource
    Online Resource
    Twenty-first Century Trends in the Global Epidemiology of Pediatric-Onset Inflammatory Bowel Disease: Systematic Review
    Elsevier BV ; 2022
    In:  Gastroenterology Vol. 162, No. 4 ( 2022-04), p. 1147-1159.e4
    Details
    In: Gastroenterology, Elsevier BV, Vol. 162, No. 4 ( 2022-04), p. 1147-1159.e4
    Type of Medium: Online Resource
    ISSN: 0016-5085
    URL: Article
    DOI: 10.1053/j.gastro.2021.12.282
    RVK:
    XA 44500
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
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  • 2
    Online Resource
    Online Resource
    Food Intake Adequacy in Children and Adolescents With Inflammatory Bowel Disease
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  Journal of Pediatric Gastroenterology & Nutrition Vol. 63, No. 4 ( 2016-10), p. 437-444
    Details
    In: Journal of Pediatric Gastroenterology & Nutrition, Ovid Technologies (Wolters Kluwer Health), Vol. 63, No. 4 ( 2016-10), p. 437-444
    Abstract: Diet assessment is essential in the care of patients with inflammatory bowel disease (IBD). We aimed to study food intake in children with IBD and evaluated the relation of dietary intake with disease activity and nutritional status in these children. Methods: This cross-sectional study investigated 68 children and adolescents with IBD (57 Crohn disease, 11 ulcerative colitis). Evaluation included clinical, laboratory, and nutritional assessment including 3 days diet record. Results: Compared with recommended daily allowance, the intake of patients with IBD was significantly poor for carbohydrates (75%, P  = 0.016), calcium (49%, P   〈  0.05), magnesium (76%, P   〈  0.05), vitamin A (72%, P   〈  0.05), vitamin E (57%, P   〈  0.05), and fiber (44%, P   〈  0.05) and higher for protein (175%, P   〈  0.05), iron (112%, P   〈  0.05), and water-soluble vitamins (118%–189% P   〈  0.05). Compared with the intakes of healthy children from National Nutritional Survey, the intake of IBD group was lower for calories (78%, P  = 0.012), carbohydrates (61% P   〈  0.05), magnesium (67% P   〈  0.05), vitamin C (34%, P   〈  0.05), and fiber (54%, P   〈  0.05) and high for B12 (141%, P   〈  0.05). Fifty subjects ate ordinary diets, 7 of 68 children were on exclusive enteral nutrition and 11 of 68 consumed regular food with different polymeric formulas supplements. Compared with children without supplements, children on exclusive enteral nutrition and nutritional supplements (18/68) had significantly better intakes of energy (1870 ± 755 vs 2267 ± 432, P   〈  0.05), carbohydrates (223 ± 97 vs 292 ± 99, P   〈  0.05), and all minerals ( P   〈  0.05) and micronutrients ( P   〈  0.05). Dietary intake was not different by disease status (remission or relapse). Conclusions: In the absence of nutritional supplements, food intake is inadequate for many nutrients in many children with IBD.
    Type of Medium: Online Resource
    ISSN: 0277-2116 , 1536-4801
    URL: Article
    DOI: 10.1097/MPG.0000000000001170
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 2078835-6
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  • 3
    Online Resource
    Online Resource
    Children with Intestinal Failure Maintain Their Renal Function on Long-Term Parenteral Nutrition
    MDPI AG ; 2021
    In:  Nutrients Vol. 13, No. 10 ( 2021-10-18), p. 3647-
    Details
    In: Nutrients, MDPI AG, Vol. 13, No. 10 ( 2021-10-18), p. 3647-
    Abstract: Background: Long-term parenteral nutrition (PN) has been associated with renal complications, including hypercalciuria, nephrocalcinosis, proteinuria and reduced glomerular filtration rate (GFR). Pediatric data are scarce and mostly short-term. Our study aimed to evaluate renal complications in children with intestinal failure (IF) receiving long-term PN. Methods: A cross-sectional study was performed in a tertiary pediatric IF clinic of patients receiving home-PN treatment for more than 1 year. Data regarding medical background, anthropometrics, laboratory investigations and abdominal sonography were retrieved. Results: Complete data were available for 15 children (67% males), with a median age of 6 (range 1.5–15) years and a median (IQR) PN duration of 4 (1.5–6) years. Low-grade proteinuria was identified in 61% and microalbuminuria in 30% of the cohort. Hypercalciuria and hyperoxaluria were present in 50% and 46%, respectively. One patient had nephrocalcinosis. The estimated GFR was normal in all but one patient who had pre-existing kidney disease. Conclusions: Pediatric IF patients can present with preserved kidney function after years of PN treatment. Despite the high prevalence of hypercalciuria, nephrocalcinosis was not common. Base line and long-term monitoring of various aspects of renal function would be essential to characterize the effects of prolonged PN on kidney functions in pediatric patients.
    Type of Medium: Online Resource
    ISSN: 2072-6643
    URL: Article
    DOI: 10.3390/nu13103647
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2518386-2
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  • 4
    Online Resource
    Online Resource
    A randomized trial evaluating the utility of non-targeted biopsies for colorectal neoplasia detection in adults with inflammatory bowel disease: a pilot study protocol
    Springer Science and Business Media LLC ; 2024
    In:  Pilot and Feasibility Studies Vol. 10, No. 1 ( 2024-02-01)
    Details
    In: Pilot and Feasibility Studies, Springer Science and Business Media LLC, Vol. 10, No. 1 ( 2024-02-01)
    Abstract: Persons with inflammatory bowel diseases are at increased risk of developing colorectal cancer and require frequent colonoscopy surveillance. Guidelines recommend taking 30 to 40 non-targeted biopsies throughout the colorectum to detect “invisible” neoplasia in this setting, despite a lack of evidence supporting this practice. We sought to assess the utility of this practice through a randomized controlled trial. We first propose an internal pilot study to assess recruitment potential, protocol adherence and data capture to guide the full trial. Methods We have designed a multi-centre, parallel-group, non-inferiority randomized controlled trial to test the utility of non-targeted biopsies as an adjunct to colonoscopy surveillance for neoplasia detection in persons with inflammatory bowel disease involving the colorectum in routine clinical practice. Participants are randomized 1:1, stratified by study site, to either standard of care high-definition white-light colonoscopy with 32 to 40 non-targeted biopsies of non-neoplastic-appearing mucosa along with a sampling of abnormal-appearing mucosa (control group) or modified colonoscopy with targeted sampling alone (intervention group). The primary outcome for the full trial will be the proportion of persons with ≥ 1 neoplastic focus detected during colonoscopy. For the pilot phase, we will assess the feasibility of recruiting a minimum of 15% of the estimated sample size within 1 year, under identical conditions as the full trial, while maintaining ≥ 90–95% rate of protocol adherence and data capture. These participants will contribute data to the full trial. The trial is being conducted at 12 centres across Canada, with a total sample size of 1952 persons. Discussions The trial protocol has been approved by the ethics committees of all participating sites, and the pilot study has received funding through the Canadian Institutes of Health Research (PJT 159607). If feasibility metrics are met during the pilot phase, we will complete the full trial. The trial outcomes will contribute to update the practice guidelines in this area. Trial registration ClinicalTrials.gov, NCT04067778.
    Type of Medium: Online Resource
    ISSN: 2055-5784
    URL: Article
    DOI: 10.1186/s40814-023-01434-8
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2024
    detail.hit.zdb_id: 2809935-7
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  • 5
    Online Resource
    Online Resource
    Validation and impact of paediatric malnutrition screening tool in hospitalised children on awareness of medical staff and health‐related outcomes
    Wiley ; 2019
    In:  Nutrition & Dietetics Vol. 76, No. 5 ( 2019-11), p. 574-579
    Details
    In: Nutrition & Dietetics, Wiley, Vol. 76, No. 5 ( 2019-11), p. 574-579
    Abstract: This study aimed to evaluate the use of the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) among children admitted in a paediatric hospital, and assess its impact on the nutritional status awareness among the medical staff and on health outcomes at discharge. Methods STAMP performed by nurses on admission was compared with full nutritional assessment performed by a dietitian. Area under the receiving operating characteristic (AUROC) curve was used to evaluate validity of the tool. To assess how the tool affected awareness among the staff, information on nutritional status was compared prior to and following the intervention period. Therewith, health outcomes at discharge were compared for the children who had been screened by STAMP and the children who had not. Results The analysis was performed for a total of 60 children (38 boys, 63%). The mean age was 7.8 ± 4.7 years. Malnutrition was found in 16% of patients, segregating equally between acute and chronic malnutrition. Sensitivity, specificity, positive predictive value and negative predictive value were 95.7% (95% confidence interval, CI = 85.75–98.83%), 76.9% (95% CI = 49.74–91.82%), 93.7 and 83.3, respectively. AUROC was 0.863 (95% CI = 0.72–1). There was no difference either in malnutrition awareness among the medical staff before and after the intervention period or in health outcomes at discharge. Conclusions STAMP is a valid tool for malnutrition screening in hospitalised children; however, its use does not influence admitted patients’ nutritional status awareness among the medical staff nor their outcomes at discharge.
    Type of Medium: Online Resource
    ISSN: 1446-6368 , 1747-0080
    URL: Issue
    URL: Article
    DOI: 10.1111/ndi.v76.5
    DOI: 10.1111/1747-0080.12529
    Language: English
    Publisher: Wiley
    Publication Date: 2019
    detail.hit.zdb_id: 2117208-0
    SSG: 21
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  • 6
    Online Resource
    Online Resource
    Pediatric Eosinophilic Esophagitis: Results of the European Retrospective Pediatric Eosinophilic Esophagitis Registry (RetroPEER)
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Journal of Pediatric Gastroenterology & Nutrition Vol. 68, No. 4 ( 2019-04), p. 552-558
    Details
    In: Journal of Pediatric Gastroenterology & Nutrition, Ovid Technologies (Wolters Kluwer Health), Vol. 68, No. 4 ( 2019-04), p. 552-558
    Abstract: Recommendations for diagnosing and treating eosinophilic esophagitis (EoE) are evolving; however, information on real world clinical practice is lacking. To assess the practices of pediatric gastroenterologists diagnosing and treating EoE and to identify the triggering allergens in European children. Methods: Retrospective anonymized data were collected from 26 European pediatric gastroenterology centers in 13 countries. Inclusion criteria were: Patients diagnosis with EoE, completed investigations prescribed by the treating physician, and were on stable medical or dietary interventions. Results: In total, 410 patients diagnosed between December 1999 and June 2016 were analyzed, 76.3% boys. The time from symptoms to diagnosis was 12 ± 33.5 months and age at diagnosis was 8.9 ± 4.75 years. The most frequent indications for endoscopy were: dysphagia (38%), gastroesophageal reflux (31.2%), bolus impaction (24.4%), and failure to thrive (10.5%). Approximately 70.3% had failed proton pump inhibitor treatment. The foods found to be causative of EoE by elimination and rechallenge were milk (42%), egg (21.5%), wheat/gluten (10.9%), and peanut (9.9%). Elimination diets were used exclusively in 154 of 410 (37.5%), topical steroids without elimination diets in 52 of 410 (12.6%), both diet and steroids in 183 of 410 (44.6%), systemic steroids in 22 of 410 (5.3%), and esophageal dilation in 7 of 410 (1.7%). Patient refusal, shortage of endoscopy time, and reluctance to perform multiple endoscopies per patient were noted as factors justifying deviation from guidelines. Conclusions: In this “real world” pediatric European cohort, milk and egg were the most common allergens triggering EoE. Although high-dose proton pump inhibitor trials have increased, attempted PPI treatment is not universal.
    Type of Medium: Online Resource
    ISSN: 0277-2116 , 1536-4801
    URL: Article
    DOI: 10.1097/MPG.0000000000002215
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2078835-6
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  • 7
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    Online Resource
    Can We Rely on Resting Metabolic Rate Equations? Large Variance in Crohn Disease Pediatric Patients
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Journal of Pediatric Gastroenterology & Nutrition Vol. 77, No. 3 ( 2023-09), p. 389-392
    Details
    In: Journal of Pediatric Gastroenterology & Nutrition, Ovid Technologies (Wolters Kluwer Health), Vol. 77, No. 3 ( 2023-09), p. 389-392
    Abstract: Inadequate caloric intake is common in Crohn disease (CD) and nutrition support plays an important role in remission induction and in meeting nutritional needs. For nutritional planning, determining resting metabolic rate (RMR) is essential in pediatric patients with CD. Study Aim: To measure RMR in CD pediatric patients using indirect calorimetry, and compare it with estimated RMR (eRMR) calculated by Schofield equation. Methods: Children with CD treated in a tertiary pediatric inflammatory bowel disease center in Israel participated in the cross-sectional study. At study visits, weight, height, clinical and laboratory assessments, bioelectrical impedance, and RMR measured by indirect calorimetry were done. Additionally, disease severity was determined by the Pediatric Crohn Disease Activity Index and eRMR was calculated using the Schofield equation. The ratio of the measured RMR to eRMR was performed in addition to the Spearman correlation test. Results: The study group included 73 children (49 boys) with mean age of 13.9 ± 2.3 years. Children with moderate or severe disease had lower weight for age z score, lower BMI- z , and lower RMR compared to children with mild disease. However, when RMR was adjusted for fat free mass (n = 50), the association between RMR and disease severity disappeared. Variance in RMR was high between subjects. Conclusions: Our data suggest that the Schofield equation is inadequate for determining RMR in pediatric CD and that RMR should be measured to guarantee the most appropriate nutritional intervention.
    Type of Medium: Online Resource
    ISSN: 0277-2116
    URL: Article
    DOI: 10.1097/MPG.0000000000003878
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2078835-6
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  • 8
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    Online Resource
    Age-Dependent Trends in the Celiac Disease: A Tertiary Center Experience
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Journal of Pediatric Gastroenterology & Nutrition Vol. 72, No. 6 ( 2021-06), p. 894-899
    Details
    In: Journal of Pediatric Gastroenterology & Nutrition, Ovid Technologies (Wolters Kluwer Health), Vol. 72, No. 6 ( 2021-06), p. 894-899
    Abstract: Celiac disease (CD) is a common intestinal autoimmune disorder with diverse presenting features. We aimed to determine age-dependent patterns in CD presentation, diagnosis and management at a large tertiary referral center. Methods: A retrospective review of electronic medical records of pediatric patients diagnosed with CD between January 1999 and December 2018 at Schneider Children's Medical Center of Israel. We compared demographics, clinical and laboratory parameters between four age groups at CD presentation. Results: A cohort of 932 children was divided into four groups by age (in years) at diagnosis: 0–3 (17.9%), 3–6 (31.8%), 6–12 (34.5%), 12–18 (15.8%). The youngest age group presented more frequently with diarrhea, weight loss, abdominal distention, vomiting and lower weight z scores, P   〈  0.01. Hypoalbuminemia and zinc deficiency were also more frequent in this age group, compared to older patients ( P   〈  0.05, each). Rates of anemia were higher in younger age groups (0–3 and 3–6 years), compared to older age groups, P   〈  0.05. Patients in the younger age groups (0–3 and 3–6 years) presented more frequently with tissue transglutaminase (TTG) levels above 10 times the upper limit of normal (ULN; P   〈  0.05), and more often normalized their CD serologies by 24 months of gluten-free diets (GFD) compared to older age groups ( P   〈  0.05). Conclusion: There is an age-dependent variation in CD presentation during childhood. Younger patients present more often with malabsorptive features, and higher TTG levels, yet normalize TTG while on GFD more rapidly than older patients. Clinicians should be aware of the diversity in CD presentation and course at the various presentation age.
    Type of Medium: Online Resource
    ISSN: 0277-2116 , 1536-4801
    URL: Article
    DOI: 10.1097/MPG.0000000000003130
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 2078835-6
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  • 9
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    Online Resource
    Body composition correlates with laboratory parameters and disease severity in infants with biliary atresia
    Wiley ; 2022
    In:  Pediatric Transplantation Vol. 26, No. 3 ( 2022-05)
    Details
    In: Pediatric Transplantation, Wiley, Vol. 26, No. 3 ( 2022-05)
    Abstract: Infants with biliary atresia (BA) generally have chronic malnutrition. However, the best anthropometric measure to assess malnutrition and its correlation with disease severity is unknown. We aimed to assess correlations of various anthropometric measurements, including air displacement plethysmography (ADP), with laboratory parameters and with the pediatric end‐stage liver disease (PELD) score in infants with BA. Methods Infants with BA were followed at a pediatric liver transplantation center during 2014–2018. Follow‐up comprised laboratory tests and nutritional assessment by a dietitian including dietary intake, weight, height, mid‐upper arm circumference (MUAC), and skin‐fold thickness. Fat‐free mass (FFM) and fat mass (FM) were measured by ADP. Results Forty‐three nutritional evaluations were performed in 28 infants with BA (13 boys, 44.4%). The median age was 20.7 weeks (IQR: 13–25.9). Based on the various anthropometry modalities, infants with BA were found to be malnourished on most of the visits; 63% had a MUAC‐Z score lower than −2 standard deviations. High serum bilirubin level predicted lower weight for age, length for age, and MUAC‐Z. Lower MUAC‐Z was associated with a higher PELD score. Neither FM mass nor FFM correlated with PELD or with serum bilirubin level. However, FM correlated with skin‐fold thickness‐Z and was low in most patients. Conclusions The majority of BA infants suffer from malnutrition as assessed by most anthropometrics modalities; low MUAC correlated best with disease severity and serum bilirubin level. Further studies are warranted to determine the contribution of FM measurement by ADP to the anthropometric assessment of infants with BA.
    Type of Medium: Online Resource
    ISSN: 1397-3142 , 1399-3046
    URL: Issue
    URL: Article
    DOI: 10.1111/petr.v26.3
    DOI: 10.1111/petr.14208
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2008614-3
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  • 10
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    Online Resource
    Sustained Remission of Eosinophilic Esophagitis Following Discontinuation of Dietary Elimination in Children
    Elsevier BV ; 2020
    In:  Clinical Gastroenterology and Hepatology Vol. 18, No. 1 ( 2020-01), p. 249-251.e1
    Details
    In: Clinical Gastroenterology and Hepatology, Elsevier BV, Vol. 18, No. 1 ( 2020-01), p. 249-251.e1
    Type of Medium: Online Resource
    ISSN: 1542-3565
    URL: Article
    DOI: 10.1016/j.cgh.2019.03.008
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2020
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