Journal of Pediatric Gastroenterology and Nutrition最新文献

{"title":"Isolated intestinal lymphatic anomaly: Underwater endoscopic identification and therapeutic intervention.","authors":"Ashley Polachek, Geoffrey Daves, Sheena Pimpalwar, Bhaskar Gurram, Suren Reddy, Christian Wysocki, David Troendle","doi":"10.1002/jpn3.70074","DOIUrl":"https://doi.org/10.1002/jpn3.70074","url":null,"abstract":"","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026454","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":"Effect of glycerin on colonic motility in children.","authors":"Julia M J van der Zande, Anna E Leone, Shruthi Srinivas, Richard J Wood, Marc A Benninga, Raul E Sanchez, Neetu Bali Puri, Karla Vaz, Desale Yacob, Carlo Di Lorenzo, Peter L Lu","doi":"10.1002/jpn3.70057","DOIUrl":"https://doi.org/10.1002/jpn3.70057","url":null,"abstract":"<p><strong>Objective: </strong>Colonic manometry (CM) involves measurement of colonic neuromuscular activity and administration of a stimulant laxative, most commonly bisacodyl, which is part of the study protocol. Glycerin is another laxative used in the treatment of constipation. Our objective was to evaluate the effect of glycerin on colonic motility and compare the response to glycerin with each patient's response to bisacodyl.</p><p><strong>Methods: </strong>We performed a retrospective review of all CM studies performed between May 2015 and May 2022. All studies with glycerin administration were included. Patient demographics, medical and surgical history, and results of each CM, including name, number, and dose of stimulant laxatives administered, colonic motor response after each stimulant, and final interpretation, were recorded.</p><p><strong>Results: </strong>We included 131 CM studies in 125 patients (53% female, median age at CM 10 years, interquartile range 7-14 years). Compared to bisacodyl, glycerin more commonly triggered fully propagated high-amplitude propagating contractions (HAPCs; 35% vs. 13%, p < 0.001) and led to a greater extent of propagation (propagation to sigmoid vs. to descending colon, p < 0.001). In 36% of studies, glycerin led to an improved response (stimulation of HAPCs when they were absent after bisacodyl, or HAPCs propagating through a greater extent of colon) compared to bisacodyl. In studies with an improved response, the median dose of glycerin in mL/kg was not significantly different compared to studies with the same/worse response.</p><p><strong>Conclusion: </strong>Glycerin can trigger HAPCs in patients in whom bisacodyl was not able to do so. Incorporation of glycerin into standard CM protocols should be considered.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023442","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":"Parental education in pediatric dysphagia: A comparative analysis of three large language models.","authors":"Bülent Alyanak, Burak Tayyip Dede, Fatih Bağcıer, Mazlum Serdar Akaltun","doi":"10.1002/jpn3.70069","DOIUrl":"https://doi.org/10.1002/jpn3.70069","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluates the effectiveness of three widely used large language models (LLMs)-ChatGPT-4, Copilot, and Gemini-in providing accurate, reliable, and understandable answers to frequently asked questions about pediatric dysphagia.</p><p><strong>Methods: </strong>Twenty-five questions, selected based on Google Trends data, were presented to ChatGPT-4, Copilot, and Gemini, and the responses were evaluated using a 5-point Likert scale for accuracy, the Ensuring Quality Information for Patients (EQIP) and DISCERN scales for information quality and reliability, and the Flesch-Kincaid Grade Level (FKGL) and Flesch Reading Ease (FRE) scores for readability. The performance of ChatGPT-4, Copilot, and Gemini was assessed by presenting the same set of questions at three different time points: August, September, and October 2024. Statistical analyses included analysis of variance, Kruskal-Wallis tests, and post hoc comparisons, with p values below 0.05 considered significant.</p><p><strong>Results: </strong>ChatGPT-4 achieved the highest mean accuracy score (4.1 ± 0.7) compared to Copilot (3.1 ± 0.7) and Gemini (3.8 ± 0.8), with significant differences observed in quality ratings (p < 0.001 and p < 0.05, respectively). EQIP and DISCERN scores further confirmed the superior performance of ChatGPT-4. In terms of readability, Gemini achieved the highest scores (FRE = 48.7 ± 9.9 and FKGL = 10.1 ± 1.6).</p><p><strong>Conclusions: </strong>While ChatGPT-4 generally provided more accurate and reliable information, Gemini produced more readable content. However, variability in overall information quality indicates that, although LLMs hold potential as tools for pediatric dysphagia education, further improvements are necessary to ensure consistent delivery of reliable and accessible information.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026431","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":"Hydrostatic low-volume enemas in infants with birth weight ≤1000 g or gestational age ≤28 weeks: A controlled interventional study.","authors":"Tabea Stock, Anne-Marie Kamp, Markus Waitz, Teresa Riedl-Seifert, Andreas C Jenke","doi":"10.1002/jpn3.70055","DOIUrl":"https://doi.org/10.1002/jpn3.70055","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated the safety and efficacy of standardized minimally invasive hydrostatic low-volume saline enemas in infants with a birth weight ≤1000 g or gestational age ≤28 weeks and delayed meconium passage.</p><p><strong>Methods: </strong>Conducted at the Neonatology Department of Klinikum Kassel, Germany, this monocentric controlled interventional study included a historic control group and a prospective intervention group. Infants born between January 2019 and October 2022 were included. The control group received manual enemas using varied techniques, while the intervention group underwent standardized hydrostatic low-volume saline enemas at predefined intervals. Key outcomes assessed included gastrointestinal complications (necrotizing enterocolitis [NEC], focal intestinal perforation [FIP], and meconium plug syndrome [MPS]), morbidity, mortality, stool and feeding parameters, and staff evaluations.</p><p><strong>Results: </strong>A total of 42 infants were included in the control group and 74 in the intervention group. NEC incidence was lower in the intervention group (4.1%) compared to the control group (9.5%), as was the rate of FIP (2.7% vs. 7.1%). Morbidity showed a decreasing trend in the intervention group (6.8% vs. 16.7%), and the combined morbidity and mortality rate was significantly lower (6.8% vs. 19.1%). Despite reduced stool frequency, enteral feeding tolerance improved in the intervention group.</p><p><strong>Conclusion: </strong>An unstandardized approach to rectal interventions may increase the need for surgical interventions, whereas standardized hydrostatic low-volume saline enemas are a safe and effective alternative to conventional rectal interventions, offering improved comfort and potentially reducing intestinal morbidity in infants with a birth weight ≤1000 g or gestational age ≤28 weeks.</p><p><strong>Trial identification number: </strong>DRKS00024191 (https://drks.de/search/de/trial/DRKS00024191).</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018869","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":"Assessment of growth status and nutritional management of prematurely born infants after hospital discharge: A position paper of the ESPGHAN Nutrition Committee.","authors":"Nadja Haiden, Veronica Luque, Magnus Domellöf, Susan Hill, Laura Kivelä, Barbara de Koning, Jutta Kӧglmeier, Sissel J Moltu, Lorenzo Norsa, Miguel Saenz De Pipaon, Francesco Savino, Elvira Verduci, Jiri Bronsky","doi":"10.1002/jpn3.70054","DOIUrl":"https://doi.org/10.1002/jpn3.70054","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of the manuscript is to provide evidence-based or expert consensus-based recommendations for growth assessment and nutritional management of preterm-born infants during the post-discharge period.</p><p><strong>Methods: </strong>The search was conducted in Pubmed, MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews using the MESH terms: infant, preterm infant, low birth weight, infant food, nutritional status, nutrients, breast feeding, infant formula, human milk, dietary supplements, vitamins, iron, vitamin D, minerals, energy intake, weaning, and baby led. Overall, 402 papers were identified and screened, from which 101 publications were included in the present position paper. In the absence of evidence, recommendations reflect the authors' combined expert opinion. Final consensus was obtained through multiple e-mail exchanges and meetings with the Committee of Nutrition of the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition.</p><p><strong>Results: </strong>Continuous growth monitoring through measurements of weight, length, and HC post-discharge is recommended to identify growth faltering (GF) or undernutrition. To prevent disproportionate growth, weight-for-length z-scores should be included in the assessment when term equivalent age is reached. Infants discharged with a significant drop in weight and length, exceeding a -2 standard deviation loss, require tailored nutritional support to address long-term growth challenges and to support recovery to normal growth rates. Breastfeeding is highly recommended for all infants when feasible. Infants needing to catch up in growth should be given supplements, such as HMF For those fed with formula, an adequate protein: energy ratio, minerals, and trace elements should be supplied to facilitate catch-up growth. The start of solid foods should coincide with the infant's neurological developmental milestones, rather than adhering strictly to a set age. Vitamin D and iron supplementation (with regular ferritin monitoring) is recommended through at least 12 months CA.</p><p><strong>Conclusion: </strong>For preterm infants, close monitoring of growth after discharge and nutritional assessment is essential to identify those at high risk for GF or undernutrition and to provide individualized nutritional support when needed. These patients should either be referred to a specialized center for pediatric nutritional care or, alternatively, their general pediatrician should receive appropriate training on the subject.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015437","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":"The effects of liquid bleach ingestion on children's esophageal and gastric mucosa.","authors":"Paolo Quitadamo, Angelamaria di Lauri, Rossana Albano, Valentina Laudadio, Piergiorgio Gragnaniello, Maria G Puoti, Cristina Bucci, Sara Isoldi, Francesco Cirillo, Rossella Turco, Ludovica Carangelo, Mariano Caldore","doi":"10.1002/jpn3.70063","DOIUrl":"https://doi.org/10.1002/jpn3.70063","url":null,"abstract":"<p><strong>Objectives: </strong>The ingestion of caustic substances is currently a significant health concern in pediatric age, being bleach products among the most commonly ingested. The management of children having ingested bleach is currently controversial since scientific data on their degree of toxicity toward the esophageal and gastric mucosa are currently very poor. Therefore, our study aims at comprehensively analyzing the effects of bleach ingestion in children as well as at evaluating patterns of ingestions, clinical symptom development, and endoscopic findings.</p><p><strong>Methods: </strong>This prospective observational study was carried out between January 2017 and December 2023 at the Pediatric Department of Santobono Children's Hospital in Naples. Children aged 0-18 years admitted for bleach ingestion were enrolled.</p><p><strong>Results: </strong>One hundred children with a mean age of 58.7 months were included in the study. Eighty-nine/100 (89%) children had ingested household bleaches (both chlorine- or peroxidase-based) while 11/100 (11%) had ingested homemade or industrial bleaches. The latter were significantly more likely to develop esophagogastric lesions, while children having ingested commercially available household bleaches did not report significant mucosal lesions.</p><p><strong>Conclusions: </strong>Our data suggest that the toxicity of commercially available household bleaches on the gastrointestinal tract is very low. Therefore, digestive endoscopy is generally unnecessary in case of household bleach ingestion. Conversely, a timely endoscopic evaluation and close follow-up should be performed in children who ingest homemade or industrial bleaches.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988213","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":"Sleep tracking and sleep hygiene counseling improve fatigue in pediatric patients with inflammatory bowel disease.","authors":"Sydney Kuzoian, Bradley Jerson, Michael Brimacombe, Lynelle Schneeberg, Jeffrey S Hyams","doi":"10.1002/jpn3.70066","DOIUrl":"https://doi.org/10.1002/jpn3.70066","url":null,"abstract":"<p><strong>Objectives: </strong>While the presence of fatigue and inadequate sleep are well-described in children with inflammatory bowel disease (IBD), little data exist on potential sleep improvement interventions. We aimed to determine if sleep tracking and sleep hygiene counseling can result in sleep behavior change and reduced fatigue in children/adolescents with IBD.</p><p><strong>Methods: </strong>This was a single-center, prospective, randomized controlled trial. Patients 12-20 years old with IBD, in clinical remission, completed validated Pediatric Quality of Life-Multidimensional Fatigue Scales (PedsQL-MDFS). Those who were found to have impaired sleep/rest fatigue (score <60) were randomized 1:1 into two intervention groups (A and B). Both groups were asked to track their sleep for 2 weeks using a standardized sleep log. Group B also had in-person sleep hygiene counseling. Outcomes were assessed 2 weeks after intervention implementation through repeat PedsQL-MDFS, self-reported behavior change surveys, and analysis of 2-week sleep logs.</p><p><strong>Results: </strong>Sixty-six patients were enrolled. The mean age was 16.5 years, 53% male, 71% Crohn's disease, and 25% ulcerative colitis. Forty-three patients met criteria for randomization into the intervention groups. There was a significant improvement in the PedsQL-MDFS Sleep/Rest Fatigue score in both intervention groups. Sleep hygiene counseling for Group B resulted in a significant increase in patients putting their electronic screens away 30 min before bedtime.</p><p><strong>Conclusion: </strong>Sleep tracking and in-person sleep counseling positively impact sleep/rest fatigue scores and sleep behavior change. These simple interventions hold the promise of improving sleep and fatigue in children and adolescents with IBD.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998443","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":"Analysis of multichannel intraluminal impedance and pH monitoring values in children with cerebral palsy: A comparative multicenter study.","authors":"Cristina Lorenzo, Cecilia Zubiri, Anabella Zosi, Sandro Miculan, Daniela Neder, Ana Rocca, Judith Cohen Sabban, Roman Bigliardi, Maria Florencia Biasoli, Manuela Manterola, Maria de Los Angeles Savia, Luis Orlando Perez, Carlos Ruiz Hernández, Renata Weinschelbaum, Ana Cristina Fontenele Soares, Soraia Tahan, Veronica Plante, Christian Boggio, Soledad Arcucci, Erick Toro Monjaraz, Maria Alejandra Mortarini, Samantha Arrizabalo, Miguel Saps","doi":"10.1002/jpn3.70058","DOIUrl":"https://doi.org/10.1002/jpn3.70058","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the features of multichannel intraluminal impedance and pH monitoring (MII-pH) tracings in children with cerebral palsy (CP) and children without CP.</p><p><strong>Methods: </strong>Multicenter, retrospective, analytical study. We examined tracings of children aged 1 to 15 years old, evaluated from May 2017 to January 2024. Population included two groups: Group 1 consisted of children with CP, while control group comprised children without CP who had extra-digestive symptoms suggestive of gastroesophageal reflux disease (GERD) but normal MII-pH results. Quantitative data were analyzed using analysis of variance and t tests. Qualitative data were analyzed using contingency tables and chi-square tests.</p><p><strong>Results: </strong>We studied 245 children. CP group included 110 children with a mean age of 5.71 years (standard deviation [SD] ± 4.24), while control group included 135 children with a mean age of 5.73 years (SD ± 3.39). The CP group had fewer reflux episodes (p = 0.0015), slower mean acid clearance time (p = 0.04), lower mean baseline impedance and mean nocturnal baseline impedance (p = 1.82e-07 and p = 7.50e-07).</p><p><strong>Conclusion: </strong>Children with CP have fewer reflux episodes and longer acid clearance times compared with children without CP. Prospective studies including esophagogastroduodenoscopy findings are needed to establish MII-pH reference values in children with CP.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972495","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":"Letter to the Editor Re: Sirolimus to treat chronic and steroid-resistant allograft rejection-related fibrosis in pediatric liver transplantation.","authors":"Dana Cerminara, Krupa R Mysore","doi":"10.1002/jpn3.70059","DOIUrl":"https://doi.org/10.1002/jpn3.70059","url":null,"abstract":"","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031075","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":"Response to the Letter to the Editor: Sirolimus for treating chronic and steroid-resistant allograft rejection-related fibrosis in pediatric liver transplantation.","authors":"Jesús Quintero-Bernabeu, Javier J Goñi, Maria Mercadal-Hally, Mauricio Larrate-King","doi":"10.1002/jpn3.70060","DOIUrl":"https://doi.org/10.1002/jpn3.70060","url":null,"abstract":"","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031078","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}