Journal of Pediatric Gastroenterology & Nutrition最新文献_第3页

Corticosteroids for Caustic Esophageal Burns. 糖皮质激素治疗食管烧灼性烧伤。

Journal of Pediatric Gastroenterology & Nutrition Pub Date : 2019-12-01 DOI: 10.1097/MPG.0000000000002508

R. Hoffman, M. Burns, S. Gosselin

引用次数: 0

A Pilot Study of the pedsPCF Item Bank as a Screening Tool for Pediatric Minimal Hepatic Encephalopathy. pespcf题库作为儿童轻度肝性脑病筛查工具的初步研究。

Journal of Pediatric Gastroenterology & Nutrition Pub Date : 2019-12-01 DOI: 10.1097/MPG.0000000000002488

Daniella Ohnemus, K. Neighbors, Lisa G. Sorensen, J. Lai, E. Alonso

{"title":"A Pilot Study of the pedsPCF Item Bank as a Screening Tool for Pediatric Minimal Hepatic Encephalopathy.","authors":"Daniella Ohnemus, K. Neighbors, Lisa G. Sorensen, J. Lai, E. Alonso","doi":"10.1097/MPG.0000000000002488","DOIUrl":"https://doi.org/10.1097/MPG.0000000000002488","url":null,"abstract":"OBJECTIVES\u0000Despite the need for monitoring cognition for minimal hepatic encephalopathy (MHE) in children with portal hypertension, few screening methods exist. The Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Cognitive Function (PedsPCF) item bank, a 43-item parent- and self-report questionnaire, could be a useful screening tool. This study aimed to evaluate the PedsPCF item bank as a screening tool and explore its correlation with other neurocognitive measures and clinical indicators of portal hypertension.\u0000\u0000\u0000METHODS\u0000Pediatric patients with portal hypertension were recruited at Lurie Children's Liver Clinic. A short battery of neuropsychological tests tapping attention, executive functioning, and fine motor speed was administered along with surveys of cognitive functioning (PedsPCF, Behavior Rating Inventory of Executive Function; BRIEF) and quality of life (PROMIS Pediatric-25 Profile).\u0000\u0000\u0000RESULTS\u000018 patients participated (ages 8 to 17). The PedsPCF correlated well with the BRIEF but did not correlate with neurocognitive testing. Qualitative heatmap analysis of the relationship between z-scores and clinical signs of portal hypertension suggests the PedsPCF is less sensitive than the BRIEF. The fine motor task (Grooved Pegboard) appears to offer the highest sensitivity of the tests administered and is also relatively quick and easy to administer.\u0000\u0000\u0000CONCLUSIONS\u0000Elements of the battery show promise in this small pilot sample. The BRIEF and the Grooved Pegboard may hold the most potential for screening in the clinical setting. Further study is necessary to examine this question in a larger multi-center sample.","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83716597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Response to Letter: Corticosteroids for Oesophageal Caustic Injuries. 对信函的回应:糖皮质激素治疗食道腐蚀性损伤。

Journal of Pediatric Gastroenterology & Nutrition Pub Date : 2019-12-01 DOI: 10.1097/MPG.0000000000002509

A. Akobeng, I. Abdelgadir

引用次数: 0

Enhancing the Patient Experience for Individuals Undergoing Endoscopic Procedures Using Virtual Reality. 使用虚拟现实增强个体内窥镜手术的患者体验。

Journal of Pediatric Gastroenterology & Nutrition Pub Date : 2019-11-26 DOI: 10.1097/MPG.0000000000002577

A. Palanica, M. Leier, Andrew Lee, Yan Fossat, Michael Docktor

{"title":"Enhancing the Patient Experience for Individuals Undergoing Endoscopic Procedures Using Virtual Reality.","authors":"A. Palanica, M. Leier, Andrew Lee, Yan Fossat, Michael Docktor","doi":"10.1097/MPG.0000000000002577","DOIUrl":"https://doi.org/10.1097/MPG.0000000000002577","url":null,"abstract":"The results of medical procedures can often be difficult to translate into comprehensible and engaging information for patients. This randomized controlled trial evaluated the satisfaction and perceived value of a technology, called HealthVoyager, which creates a personalized virtual reality (VR) experience of a patient's endoscopy or colonoscopy findings in comparison to the standard practice (i.e., reviewing printed reports). The platform allows gastroenterologists to create a customized VR patient report to help translate medical knowledge and procedural information to the patient. Forty-one patients (17 HealthVoyager [test]; 24 standard practice [control]) completed a self-report survey assessing their experience for receiving medical information. Results demonstrated that patients were significantly more satisfied in learning about their gastrointestinal condition and procedural results using HealthVoyager rather than with the standard of care. These results have implications for improving the knowledge translation of medical findings between healthcare providers and patients in various disease states and patient populations.","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"113 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80601619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

The Impact of Celiac Disease on Caregivers' Well-Being: An Integrative Review. 乳糜泻对照顾者幸福感的影响:一项综合综述

Journal of Pediatric Gastroenterology & Nutrition Pub Date : 2019-11-26 DOI: 10.1097/MPG.0000000000002572

R. Satherley, S. Coburn, Monique M. Germone

{"title":"The Impact of Celiac Disease on Caregivers' Well-Being: An Integrative Review.","authors":"R. Satherley, S. Coburn, Monique M. Germone","doi":"10.1097/MPG.0000000000002572","DOIUrl":"https://doi.org/10.1097/MPG.0000000000002572","url":null,"abstract":"OBJECTIVES\u0000A diagnosis of celiac disease (CD) requires individuals to adopt a strict gluten-free diet (GFD). As children with CD must rely on their caregivers for guidance and support with managing the GFD, CD may challenge the caregiver's emotional and social well-being. The primary objective of this mixed-methods systematic review was to synthesize of research investigating the impact of CD on caregiver's well-being.\u0000\u0000\u0000METHODS\u0000Five databases were systematically searched from 1990-2018 to identify all empirical studies that assessed well-being in caregivers of children (0-18 years) with CD. Qualitative and quantitative data were extracted separately before being integrated to explore key themes across the studies.\u0000\u0000\u0000RESULTS\u000012 studies were identified that explored the well-being of caregivers of children with CD (3 qualitative, 9 quantitative), reporting on 665 caregivers. The quality of evidence was limited across studies. Synthesis of results revealed three themes (Caregiver Responsibility, Caregiver Well-Being and Concern for Child's Health, Implications for the Family) describing the impact of a child with CD on caregiver well-being.\u0000\u0000\u0000CONCLUSIONS\u0000Caregivers of children with CD may experience difficulties that impact their well-being; specific difficulties identified included the impact of caregivers' social activities, finances and anxiety. The findings detailed in this review point towards factors that may guide health care personnel to provide support for the caregivers of children with CD.","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80245118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6

Trough Measurements of Infliximab: The Earlier the Better? 英夫利昔单抗:越早越好?

Journal of Pediatric Gastroenterology & Nutrition Pub Date : 2019-11-26 DOI: 10.1097/MPG.0000000000002576

R. Harris, R. Jackson, R. Russell

引用次数: 0

Intralesional Steroid Injection Therapy for Esophageal Anastomotic Stricture Following Esophageal Atresia Repair. 食道闭锁修复后食管吻合口狭窄局内类固醇注射治疗。

Journal of Pediatric Gastroenterology & Nutrition Pub Date : 2019-11-19 DOI: 10.1097/MPG.0000000000002562

P. Ngo, Ali Kamran, Susannah J. Clark, R. Jennings, Thomas E. Hamilton, C. Smithers, B. Zendejas, Jessica L Yasuda, D. Zurakowski, M. Manfredi

{"title":"Intralesional Steroid Injection Therapy for Esophageal Anastomotic Stricture Following Esophageal Atresia Repair.","authors":"P. Ngo, Ali Kamran, Susannah J. Clark, R. Jennings, Thomas E. Hamilton, C. Smithers, B. Zendejas, Jessica L Yasuda, D. Zurakowski, M. Manfredi","doi":"10.1097/MPG.0000000000002562","DOIUrl":"https://doi.org/10.1097/MPG.0000000000002562","url":null,"abstract":"OBJECTIVES\u0000The role of intralesional steroid injection (ISI) in the treatment of anastomotic stricture in esophageal atresia (EA) patients remains unclear. The aim of this study was to evaluate the efficacy and safety of ISI.\u0000\u0000\u0000METHODS\u0000158 EA patients with at least one ISI for the treatment of esophageal anastomotic stricture between 2010 and 2017 were identified. The change in stricture diameter (ΔD) was compared between procedures with dilation alone (ISI-) and dilation with steroid injection (ISI+).\u0000\u0000\u0000RESULTS\u0000A total of 1055 balloon dilations were performed (452 ISI+). The median ΔD was significantly greater in the ISI+ group: 1 mm (IQR 0, 3) vs. 0 mm (IQR -1, 1.5) (P < 0.0001). The ISI+ group had greater percentage of improved diameter (P < 0.0001) and lesser percentages of unchanged and decreased diameters at subsequent endoscopy (P = 0.0009, P = 0.003). Multivariable logistic regression confirmed the significance of ISI on increasing the likelihood of improved stricture diameter with an adjusted odds ratio of 3.24 (95% CI: 2.15-4.88) (P < 0.001). The ΔD for the first 3 ISI+ procedures was greater than the ΔD for subsequent ISI+ procedures: 1 mm (IQR 0, 3) vs. 0.5 mm (IQR -1.25, 2) (P = 0.001). There was no difference in perforation incidence between ISI+ and ISI- groups (P = 0.82).\u0000\u0000\u0000CONCLUSIONS\u0000ISI with dilation was well tolerated and improved anastomotic stricture diameter more than dilation alone. The benefit of ISI over dilation alone was limited to the first 3 ISI procedures.","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"117 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75761530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 16

Clinical Value of Serum Interleukin-33 Biomarker in Infants with Neonatal Cholestasis. 血清白细胞介素-33生物标志物在新生儿胆汁淤积症中的临床价值

Journal of Pediatric Gastroenterology & Nutrition Pub Date : 2019-11-19 DOI: 10.1097/MPG.0000000000002565

O. Behairy, A. Elsadek, E. Behiry, Ibrahim A. Elhenawy, N. Shalan, Kamal R Sayied

{"title":"Clinical Value of Serum Interleukin-33 Biomarker in Infants with Neonatal Cholestasis.","authors":"O. Behairy, A. Elsadek, E. Behiry, Ibrahim A. Elhenawy, N. Shalan, Kamal R Sayied","doi":"10.1097/MPG.0000000000002565","DOIUrl":"https://doi.org/10.1097/MPG.0000000000002565","url":null,"abstract":"OBJECTIVES\u0000This study aimed to estimate the value of serum IL-33 levels in infants with cholestasis, correlate serum IL-33 levels with the clinicopathological profile of infants with cholestasis and compare its level with that of healthy infants who served as control METHODS:: sixty infants with cholestasis were enrolled in this study and divided into biliary atresia group and non-biliary atresia group, in addition to thirty healthy infants as a control group. All infants were analyzed for their clinical, biochemical features, histopathological profile and serum level of IL- 33 by ELISA.\u0000\u0000\u0000RESULTS\u0000serum level of IL -33 in BA group (median 48.0, IQR: 28.9-106.2) was significantly higher than the non-BA group (median 17.3, IQR: 13.7-18.8 pg/ml) and both were higher than the control group. There was a positive correlation between serum IL-33 and AST, ALT, bilirubin (total and direct) levels and fibrosis stage among the BA group. Serum IL-33 at a cut-off value of 20.8 pg/ml can detect biliary atresia with a specificity of 95% and a sensitivity of 96.7%.\u0000\u0000\u0000CONCLUSION\u0000The significantly higher production of IL -33 in patients with BA compared to non-BA suggests a potential role of IL -33 for initiation and progression of the disease process. also, IL -33 may have a diagnostic role in infants with BA.","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81242604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 11

Anti-TNF Exposure Impacts Vedolizumab Mucosal Healing Rates in Pediatric Inflammatory Bowel Disease. 抗肿瘤坏死因子暴露影响儿童炎症性肠病Vedolizumab粘膜愈合率

Journal of Pediatric Gastroenterology & Nutrition Pub Date : 2019-11-14 DOI: 10.1097/MPG.0000000000002556

J. Jossen, B. Kiernan, N. Pittman, M. Dubinsky

{"title":"Anti-TNF Exposure Impacts Vedolizumab Mucosal Healing Rates in Pediatric Inflammatory Bowel Disease.","authors":"J. Jossen, B. Kiernan, N. Pittman, M. Dubinsky","doi":"10.1097/MPG.0000000000002556","DOIUrl":"https://doi.org/10.1097/MPG.0000000000002556","url":null,"abstract":"BACKGROUND\u0000Vedolizumab (VDZ) is effective for treating both adult and pediatric onset IBD. Clinical outcomes, however, have been reported to be superior in patients naïve to anti-TNF. With the growing interest in endoscopic endpoints, we aimed to describe rates of mucosal healing in pediatric patients being treated with VDZ and examine the influence of anti-TNF on outcomes.\u0000\u0000\u0000METHODS\u0000We conducted a retrospective review of all IBD patients ≤21 years of age who initiated VDZ and underwent endoscopy. Primary outcome was mucosal healing (composite of endoscopic (SES-CD and Mayo score UC) and histological remission (Nancy index-UC and CD histologic activity). Descriptive statistics summarized the data. Comparisons were made for endpoints based on anti-TNF exposure using univariate testing.\u0000\u0000\u0000RESULTS\u0000Sixty-eight patients were included in the final analysis; 35 with UC and 33 with CD. Thirty-two patients (22 UC and 10 CD) were anti-TNF naïve and 36 patients (13 UC and 23 CD) were anti-TNF exposed. The median duration on VDZ prior to endoscopic assessment was 49 (IQR 32-73) weeks. A total of 38% (25/66) of patients met the primary outcome of mucosal healing and did not differ between anti-TNF naïve or exposed. Endoscopic remission was achieved by 51% with significantly more anti-TNF naïve patients reaching this endpoint (66% v. 40%, p = 0.03). Histologic remission was achieved by 42% of patients with a non-significant trend towards improved histologic remission rates in anti-TNF naïve patients (52% v. 33%, p = 0.13).\u0000\u0000\u0000CONCLUSION\u0000VDZ is associated with mucosal healing in pediatric IBD. Anti-TNF exposure significantly impacted endoscopic remission, but not histologic remission in children on VDZ.","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82711840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 10

Normal Gamma Glutamyl Transferase Levels at Presentation Predict Poor Outcome in Biliary Atresia. 出现时正常的谷氨酰转移酶水平可预测胆道闭锁的不良预后。

Journal of Pediatric Gastroenterology & Nutrition Pub Date : 2019-11-14 DOI: 10.1097/MPG.0000000000002563

S. Shankar, R. Bolia, H. Foo, C. D'Arcy, N. Hardikar, Martin Wensing, W. Hardikar

{"title":"Normal Gamma Glutamyl Transferase Levels at Presentation Predict Poor Outcome in Biliary Atresia.","authors":"S. Shankar, R. Bolia, H. Foo, C. D'Arcy, N. Hardikar, Martin Wensing, W. Hardikar","doi":"10.1097/MPG.0000000000002563","DOIUrl":"https://doi.org/10.1097/MPG.0000000000002563","url":null,"abstract":"OBJECTIVES\u0000Gamma-glutamyl transferase levels (GGT) are typically elevated in biliary atresia (BA), but normal GGT levels have been observed. This cohort of 'normal GGT' BA has not been described nor has the prognostic value of GGT level on outcomes in BA. We aimed to 1) describe outcomes of a single-centre Australian cohort of infants with biliary atresia and 2) assess the impact of GGT level at presentation on outcomes in BA.\u0000\u0000\u0000METHODS\u0000Infants diagnosed with BA between 1991 - 2017 were retrospectively analysed. Outcomes were defined as survival with native liver, liver transplantation (LT) and death. Patients were categorised into normal (<200IU/L) or high GGT groups based on a mean of three consecutive GGT values done prior to Kasai portoenterostomy (KPE). Baseline parameters, age at surgery, clearance of jaundice and outcomes were compared between the two groups.\u0000\u0000\u0000RESULTS\u0000113 infants underwent KPE at median 61 (30-149) days. At a median follow-up of 14.2 (0.9-26.3) years, 35% (39/113) patients were surviving with native liver, 55% (62/113) underwent LT and 11% (12/113) died pre-transplant. 12.3% (14/113) patients had normal GGT. Age at KPE and time to clearance of jaundice were similar between normal and high GGT groups. Normal GGT group had shorter time from KPE to LT (11 vs 18months, p = 0.02), underwent LT at a younger age (14 vs 20months, p = 0.04) and had poorer transplant-free survival (p = 0.04) than high GGT group.\u0000\u0000\u0000CONCLUSION\u000012.3% of infants with BA had normal GGT levels at diagnosis. Low GGT levels at presentation in biliary atresia was associated with a poorer outcome.","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75052734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 11