Journal of Pediatric Gastroenterology and Nutrition最新文献

{"title":"Correction to \"Effectiveness and safety of polyethylene-glycol-4000 versus sodium picosulphate plus magnesium oxide and citric acid for bowel cleansing before colonoscopy in children: A systematic review with meta-analysis\".","authors":"","doi":"10.1002/jpn3.70220","DOIUrl":"https://doi.org/10.1002/jpn3.70220","url":null,"abstract":"","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of maternal biliary disease with hepatopancreatobiliary morbidity in offspring.","authors":"Nathalie Auger, Angela Magri, Sarit Kang-Auger, Gabrielle Jutras, Jessica Healy-Profitós, Marianne Bilodeau-Bertrand, Gabriel Côté-Corriveau","doi":"10.1002/jpn3.70219","DOIUrl":"https://doi.org/10.1002/jpn3.70219","url":null,"abstract":"<p><strong>Objectives: </strong>Maternal biliary disease is common, but the link with offspring hepatopancreatobiliary disease has not been studied. We assessed the association between maternal biliary disease and pediatric hepatopancreatobiliary morbidity.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 1,271,864 children born between 2006 and 2022 in Quebec, Canada. The exposure was maternal biliary disease. Offspring outcomes included congenital hepatopancreatobiliary anomalies, inborn errors of metabolism, and hepatopancreatobiliary morbidity between birth and age 17 years. We estimated adjusted risk ratios (RR) and hazard ratios (HR) with 95% confidence intervals (CI) for the association of maternal biliary disease with child outcomes.</p><p><strong>Results: </strong>A total of 95,047 children (7.5%) had mothers with biliary disease. Compared with no exposure, maternal biliary disease was associated with an increased risk of bile duct defects (RR 1.67, 95% CI 1.10-2.52), liver defects (RR 1.47, 95% CI 1.05-2.06), and inborn errors of metabolism (RR 1.41, 95% CI 1.24-1.62) in offspring. Exposed children were more likely to be hospitalized for cholelithiasis, cholecystitis, or cholangitis (HR 2.58, 95% CI 2.14-3.12), acute pancreatitis (HR 1.83, 95% CI 1.38-2.43), and metabolic dysfunction-associated steatotic liver disease (HR 2.71, 95% CI 2.07-3.54).</p><p><strong>Conclusions: </strong>Maternal biliary disease is associated with hepatopancreatobiliary complications in offspring.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective evaluation of the diagnostic yield and tolerance of high-resolution manometry, pH-impedance, and pH-impedance-manometry.","authors":"Carlijn M Mussies, Marinde van Lennep, Jac M Oors, Marc A Benninga, Michiel P van Wijk","doi":"10.1002/jpn3.70217","DOIUrl":"https://doi.org/10.1002/jpn3.70217","url":null,"abstract":"<p><strong>Objectives: </strong>We prospectively evaluated the interpretability, diagnostic yield, and tolerance of high-resolution (impedance-) manometry, 24 h-pH-impedance and pH-MII with manometry (two catheters) in children.</p><p><strong>Methods: </strong>All children who underwent testing were eligible. We assessed whether the results explained the patients' symptoms (interpretability) and recorded the diagnostic yield of each test. A validated questionnaire (DISCOmfort in Research with Children [DISCO-RC]) was additionally used to measure discomfort during the procedures.</p><p><strong>Results: </strong>Forty-nine HR(I)M, 35 pH-MII, and 9 pH-MII + mano were performed in 62 children (median age: 13 [0-18] years). Nine (25%) pH-MII catheters were placed under sedation during another procedure. Seven (7.4%) tests (five h(I)M and two pH-MII) were uninterpretable. All normal tests were considered clinically helpful by the attending physician. Sixty-nine (74.2%) tests in 58 patients (93.5%) led to clinical management that would likely not have occurred without testing. DISCO-RC scores were 7.0 (1-17), 6.0 (01-19), and 14.0 [9-17] in HR(I)M, pH-MII, and pH-MII + mano, respectively. DISCO-RC scores were significantly higher in pH-MII + mano (p = 0.033 and p = 0.005) compared to HR(I)M and pH-MII respectively.</p><p><strong>Conclusion: </strong>HR(I)M, pH-MII, and pH-MII + mano are interpretable and clinically useful in most children. HR(I)M and pH-MII are reasonably well tolerated, whereas adding ambulatory manometry causes more discomfort and should be reserved for cases where the diagnosis of rumination cannot be made without it.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Odevixibat after liver transplant in patients with progressive familial intrahepatic cholestasis type 1: A case series.","authors":"Georg-Friedrich Vogel, Simone Kathemann, Andrea Pietrobattista, Giuseppe Maggiore, Denise Aldrian, Marco Sciveres, Henkjan J Verkade, Etienne Sokal, Giulia Jannone, Magdalena Salcedo, Peter Rauschkolb, Christof Maucksch, Velichka Valcheva, Elke Lainka","doi":"10.1002/jpn3.70227","DOIUrl":"https://doi.org/10.1002/jpn3.70227","url":null,"abstract":"<p><strong>Objectives: </strong>Patients with progressive familial intrahepatic cholestasis type 1 (PFIC1) who have undergone liver transplantation (LT) may have unmet needs and impacts on daily life due to post-LT complications, including diarrhea and hepatic steatosis. Here, we describe the effects of the ileal bile acid transporter inhibitor odevixibat on diarrhea and hepatic steatosis in a cohort of patients with PFIC1 post-LT.</p><p><strong>Methods: </strong>Treating physicians from six centers retrospectively collected data through July 2023 on patients with PFIC1 who received odevixibat post-LT. Data collected included demographics, medical history, and symptom presentation, characteristics of diarrhea, and liver imaging and/or histopathology.</p><p><strong>Results: </strong>Overall, nine male patients with PFIC1 (seven aged <18 years at initial completion of the case report form) were included. In most patients, the primary indication for odevixibat treatment was diarrhea and/or steatosis post-LT. Odevixibat was initiated at a daily dose of 30-120 µg/kg (median exposure: 13 months). All patients had post-LT diarrhea, which was generally associated with negative impacts on daily life (e.g., ability to attend school, needing to wear diapers due to fecal urgency). After odevixibat initiation, most patients had improved diarrhea and positive impacts on daily life. Among five patients with post-LT steatosis and data available before and after odevixibat initiation, steatosis appeared to improve in three and did not change in two.</p><p><strong>Conclusions: </strong>Overall, the majority of patients with PFIC1 post-LT complications in this case series experienced improvements in diarrhea and daily activities with odevixibat. Treatment with odevixibat following LT also appeared to reduce steatosis in some patients. Further studies, particularly those with a prospective design, are needed to confirm these findings.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Duodenal hematoma in pediatric upper endoscopy: A 5-year review and comparison to previous experience.","authors":"Alexander Coe, Phoebe Wood, Lynne Allen Taylor, Michael A Manfredi, Petar Mamula","doi":"10.1002/jpn3.70224","DOIUrl":"https://doi.org/10.1002/jpn3.70224","url":null,"abstract":"","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Numbers matter: How pediatric endoscopy quality varies with annual procedural volume.","authors":"Jeannie S Huang, Lillian Choi, Tom K Lin, Jenifer R Lightdale, Catharine M Walsh","doi":"10.1002/jpn3.70212","DOIUrl":"https://doi.org/10.1002/jpn3.70212","url":null,"abstract":"<p><strong>Objectives: </strong>There is limited data linking pediatric endoscopist experience and procedural quality. We aimed to examine the associations of faculty physicians' years in practice and independent annual procedural volume (APV) with published quality indicators for pediatric endoscopy, including terminal ileal intubation rate (TIIR), cecal intubation rate (CIR), and total procedure time.</p><p><strong>Methods: </strong>We extracted quality indicators, as defined by the Pediatric Endoscopy Quality Improvement Network (PEnQuIN), for ileocolonoscopies performed by faculty endoscopists at a pediatric tertiary-care academic institution from October 2021 to May 2024. Endoscopists were categorized by years' experience and APV. Quality indicators were compared across groups using Kruskal-Wallis analyses. Multivariate modeling was performed to identify variables predicting terminal ileal intubation and TIIR ≥ 85%. Proportional hazards modeling was performed to identify variables predicting shorter procedure duration for combined esophagogastroduodenoscopy and ileocolonoscopy procedures.</p><p><strong>Results: </strong>Nine hundred and eighty-five ileocolonoscopies were performed independently by 20 faculty endoscopists, with varying years' experience (<5 years: N = 7; 5-10 years: N = 3; ≥10 years: N = 10), and a median (interquartile range) APV of 19 (14, 45). Most procedures (71.7%) were scored as demonstrating adequate bowel preparation. Overall TIIR and CIR were 86.3% and 91.6%, respectively. In multivariate modeling, APV ≥ 40 was identified as predictive for TIIR ≥ 85% (p < 0.01) while faculty years' experience (≥10 vs. <10 years) predicted shorter procedure duration (adjusted hazard ratio [confidence interval]: 1.40 [1.23, 1.59]).</p><p><strong>Conclusions: </strong>Our data showed a significant association between pediatric quality indicators and individual endoscopist APV and years of experience. Our findings also suggest that performing ≥40 ileocolonoscopies annually may help ensure high-quality endoscopic procedures in children.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should we all perform colonoscopies?","authors":"Alexander Coe, Petar Mamula","doi":"10.1002/jpn3.70211","DOIUrl":"https://doi.org/10.1002/jpn3.70211","url":null,"abstract":"","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advantages of anti-endomisium evaluation in children with low titers of anti-transglutaminase antibodies: A retrospective study.","authors":"Roberta Mandile, Chiara Esposito, Maria Pia Basile, Mariantonia Maglio, Riccardo Troncone, Renata Auricchio","doi":"10.1002/jpn3.70214","DOIUrl":"https://doi.org/10.1002/jpn3.70214","url":null,"abstract":"<p><p>Diagnosing celiac disease (CD) via esophagogastroduodenoscopy (EGDS) is necessary when anti-transglutaminase (anti-TG) antibody levels are below 10× the upper limit of normal (ULN). This study evaluates patients with low anti-TG titers, particularly when endomysial antibodies (EMA) are negative. In this retrospective study (2022-2024), patients undergoing EGDS for suspected CD were grouped by EMA status: Group 1 (EMA negative) and Group 2 (EMA positive), with similar low anti-TG titers. Group 1 (N = 25) had a mean anti-TG titer of 1.86× ULN and villous atrophy (VA) in only 8% (2/25). Group 2 (N = 100) had VA in 35% (35/100), a 6.16-fold higher risk. Nonatrophic cases showed no significant histological and immunohistochemical differences. In conclusion, low-titer anti-TG with negative EMA indicates a low likelihood of VA. Most asymptomatic patients may not require immediate intervention but should be monitored. EGDS can be reserved to later stages if clinical suspicion persists.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prediction model for genetic cholestatic disease in infancy using the machine learning approach.","authors":"Chi-San Tai, Sung-Chu Ko, Chien-Chang Lee, Hui-Ru Yang, Chia-Ray Lin, Byung-Ho Choe, Suporn Treepongkaruna, Voranush Chongsrisawat, Chau-Chung Wu, Huey-Ling Chen","doi":"10.1002/jpn3.70166","DOIUrl":"10.1002/jpn3.70166","url":null,"abstract":"<p><strong>Objectives: </strong>Cholestasis in infancy poses a complex clinical conundrum for pediatric hepatologists, warranting timely diagnosis, especially for genetic diseases. This study aims to create machine learning (ML)-based prediction models, referred to as Jaundice Diagnosis Easy for Baby (JADE-B), to identify the subjects prone to genetic causes of cholestasis.</p><p><strong>Methods: </strong>We retrieved patient data from the Integrated Medical Database at a university-affiliated tertiary medical center from 2006 to 2018. Patients with cholestatic disease were identified using liver-disease-specific International Classification of Diseases codes. A total of 47 clinical and laboratory parameters were used for ML for predicting a positive genetic disease, defined by a disease-specific genetic diagnosis matched with phenotype. Four distinct classifiers: Logistic regression, XGBoost (XGB), LightGBM (LGBM), and Random Forests were utilized to build the models.</p><p><strong>Results: </strong>From a patient pool of 1845, 1008 infants below 1 year of age diagnosed with cholestatic liver disease were included in the analysis. A comprehensive set of 47 pertinent clinical and laboratory features was incorporated for training the ML models. We built five sets of models (Model 1-5), yielding an area under the receiver operating characteristic curve of 0.869, 0.884, 0.855, 0.852, and 0.836, respectively. A JADE-B model was built using 20 simple and widely accessible clinical parameters at disease onset, up to 1 month, to predict patients with genetic disorders.</p><p><strong>Conclusions: </strong>The machine learning model prioritizes cholestatic infants for the allocation of genetic diagnostic tools and patient referrals, as well as optimizes the utilization of genetic diagnostic resources.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"933-942"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty in children with chronic liver disease: Prevalence and impact on outcomes.","authors":"Deepika Yadav, Vikrant Sood, Bikrant Bihari Lal, Rajeev Khanna, Jaya Benjamin, Rakesh Kumar, Sukriti Baweja, Seema Alam","doi":"10.1002/jpn3.12457","DOIUrl":"10.1002/jpn3.12457","url":null,"abstract":"<p><strong>Objectives: </strong>Frailty is a well-known complication of chronic liver disease and has been recognized as a poor prognostic factor in cirrhotic patients being associated with increased morbidity and mortality. There is limited available pediatric literature in this regard. The current study aimed to estimate the prevalence of frailty and analyze the predictive factors and their association with long-term outcomes in children with liver disease.</p><p><strong>Methods: </strong>Children (6-18 years of age) with cirrhotic liver disease (CLD) and noncirrhotic portal hypertension (NCPH) were prospectively enrolled. Frailty assessment was performed using the five classic Fried Frailty criteria. The children were followed up for 12 months to assess long-term outcomes.</p><p><strong>Results: </strong>The study included 170 children (CLD [n = 149; compensated CLD or CCLD, n = 109; decompensated CLD or DCLD, n = 40) and NCPH [n = 21]). The overall prevalence of frailty was 48% (40% in CCLD, 80% in DCLD group and 33% in NCPH group [p < 0.05]). Among the patients with CLD, 76 (51%) were identified as frail. Frail children had a significantly higher risk of decompensation and poorer hepatic synthetic functions, and their presence at baseline predicted future risk of decompensation, infectious complications, need for readmissions, and poor outcome (death) (p < 0.05).</p><p><strong>Conclusion: </strong>There is a high prevalence of frailty in children with liver disease, which is associated with poorer clinical outcomes, including the risk of mortality. Thus, its presence in children with liver disease highlights the urgent unmet need for additional interventions to improve overall muscle mass and function.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"922-932"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}