JPGN reports最新文献

{"title":"Management of pediatric patients admitted for colonic disimpaction: A scoping review protocol","authors":"Alaina C Berg, Dawn Ebach, Nathaniel A. Justice, Andrew Smelser, Riley Samuelson, Zunaira Mahmood, Aamer Imdad","doi":"10.1002/jpr3.12094","DOIUrl":"https://doi.org/10.1002/jpr3.12094","url":null,"abstract":"Chronic constipation is a common condition in pediatric patients worldwide and is associated with decreased quality of life. Inpatient management of constipation is required when outpatient therapy fails and a child becomes obstipated, and unable to pass stool or gas. There is a growing body of evidence regarding different management strategies for pediatric obstipation. This scoping review aims to map the existing literature regarding inpatient management of pediatric obstipation and identify gaps in knowledge.We will follow the methodology described by the Joanna Briggs Institute and outlined in the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for Scoping Reviews guidelines. The search strategy will include Embase, PubMed, CINAHL, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Web of Science, Scopus, and gray literature sources. Two independent reviewers will complete screening for eligible studies in two steps: a scan of the title and abstracts followed by a full‐text review. Studies regarding inpatient management of pediatric obstipation, with experimental or cohort design, and with full text available in English will be included. Systematic reviews will also be included. Two independent reviewers will extract data using a standardized form. Extracted data will be presented in visual and narrative formats, including an evidence map to meet the objectives of this scoping review. This protocol is registered at Open Science Framework.In this scoping review, we will outline the current evidence available regarding the efficacy and safety of various hospital interventions for the treatment of pediatric obstipation.","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"47 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141269884","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}

{"title":"Always check the film: Retained central venous catheter fragment in a patient with intestinal failure.","authors":"Desiree Sierra Velez, Jennifer McClelland, Horacio M Padua, Tom Jaksic, Christopher P Duggan, Alexandra N Carey","doi":"10.1002/jpr3.12086","DOIUrl":"10.1002/jpr3.12086","url":null,"abstract":"","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"5 3","pages":"419-420"},"PeriodicalIF":0.0,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11322037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Celiac disease in North America: What is the current practice of pediatric gastroenterology providers?","authors":"Arunjot Singh, Jocelyn Silvester, Justine Turner, Imad Absah, Brandon A Sparks, Catharine M Walsh, Julia M Bracken, Joanna Stanisz, Temara Hajjat, Vahe Badalyan, Ankur Chugh, Edward J Hoffenberg, Jenna K Dowhaniuk","doi":"10.1002/jpr3.12087","DOIUrl":"10.1002/jpr3.12087","url":null,"abstract":"<p><strong>Objectives: </strong>While guidelines exist for the diagnosis and management of pediatric celiac disease (CeD), current practices in North America are not well-described. This study aimed to explore current practice patterns to identify gaps and direct future clinical, training and research initiatives.</p><p><strong>Methods: </strong>A 23-item survey designed by the Celiac Disease Special Interest Group was distributed electronically to its members. Questions explored four themes: (1) screening and diagnosis pre and post the coronavirus disease (COVID)-19 pandemic, (2) treatment and monitoring, (3) family screening and transition of care, and (4) CeD focused training.</p><p><strong>Results: </strong>The survey response rate was 10.8% (278/2552). Most respondents were from the United States (89.9%, <i>n</i> = 250) and Canada (8.6%, <i>n</i> = 24). While endoscopy remained the gold standard, serology-based diagnosis was accepted by 47.5% (132/278). In response to the COVID-19 pandemic, 37.4% of providers changed their diagnostic practice. Barriers to care included: lack of insurance coverage for dietitians, wait times, and lack of CeD focused training. During fellowship 69.1% (192/278) reported no focused CeD training.</p><p><strong>Conclusion: </strong>Survey results revealed practice variation regarding the diagnosis and management of CeD in North America including a substantial proportion accepting non-biopsy, serology-based diagnosis, which increased during the COVID-19 pandemic. Variations in screening, diagnosis, interval surveillance, and family screening were also identified. Dedicated CeD education in pediatric gastroenterology fellowship may be an opportunity for standardizing practice and advancing research. Future North American guidelines should take current care patterns into consideration and develop new initiatives to improve care of children with CeD.</p>","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"5 3","pages":"276-283"},"PeriodicalIF":0.0,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11322031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing peripubertal growth in a child with short bowel syndrome on full oral feeding with glucagon-like peptide 2 analog.","authors":"Anastasiia Romanchuk, Michela Bravi, Paola Tebaldi, Lorenzo D'Antiga, Lorenzo Norsa","doi":"10.1002/jpr3.12082","DOIUrl":"10.1002/jpr3.12082","url":null,"abstract":"<p><p>Teduglutide is a glucagon-like peptide 2 (GLP-2) analog which acts by increasing intestinal absorption of the remnant bowel for children with short bowel syndrome (SBS) dependent on parenteral nutrition. We present a 13-year-old male patient with type 2 SBS (55 cm of jejunum) from necrotizing enterocolitis on full oral feeding from the age of 12 months. Because of faltering growth from the age of 11 despite oral hyperphagia, he started Teduglutide at the standard dose. Eighteen months after Teduglutide start the young boy gained 10 kg in weight and 13 cm in height with a significant reduction in bowel distension. No adverse events were reported during the treatment. Pubertal spurt might be impaired in children with SBS on full oral feeding if the caloric need is not met by the residual intestinal absorption rate. GLP-2 analog might represent an option to sustain pubertal spurt in SBS children on full oral feeding with hyperphagia.</p>","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"5 3","pages":"407-410"},"PeriodicalIF":0.0,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11322011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Manometric findings in children with eosinophilic esophagitis and persistent post‐remission dysphagia","authors":"D. Yogev, Lev Dorfman, S. Mansi, K. El-Chammas, John Lyles, Vincent Mukkada, Ajay Kaul","doi":"10.1002/jpr3.12083","DOIUrl":"https://doi.org/10.1002/jpr3.12083","url":null,"abstract":"Dysphagia is a frequent symptom of active eosinophilic esophagitis (EoE), but at times it persists despite attaining histologic healing and lack of fibro‐stenotic changes. We aimed to describe the manometric findings in this subset of patients.A retrospective review of charts between 2013 and 2023 at a tertiary pediatric gastroenterology center, treating roughly 1500 EoE patients per year. We included children with EoE referred to high‐resolution impedance manometry (HRIM) for persistent dysphagia despite histologic healing (i.e., <15 Eos/hpf). Data including initial EoE diagnosis, endoscopy reports, esophageal biopsies, treatment regimens, and HRIM were retrospectively collected.The estimated prevalence of post‐remission dysphagia in our cohort was exceedingly rare (<0.05%). Four patients met the eligibility criteria of histologic remission and absence of fibro‐stenotic features on endoscopic evaluation and thus, were included in this case series. Patients achieved remission with steroids, proton‐pump inhibitor, or both within a median time of 5 months from diagnosis. Peak Eosinophil count at remission was ≤5 Eos/hpf in three patients and ≤10 Eos/hpf in one. On HRIM, all four patients had a hypomotile esophagus and abnormal bolus clearance. Lower esophageal sphincter integrated relaxation pressure values were normal in three patients and elevated in one. Two patients were diagnosed with ineffective esophageal motility, one with aperistalsis and one with achalasia type 1.Post‐remission dysphagia is rare in EoE. Esophageal dysmotility with a hypomotile pattern may contribute to the persistent dysphagia in children with EoE. HRIM should be considered in patients with EoE in whom symptoms persist despite histologic remission.","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"43 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141109540","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}

{"title":"Achalasia in Klinefelter syndrome: A suspected pediatric case as well as prevalence analysis suggesting increased risk in this population","authors":"Lacey Miller, Hyung‐Gyo Cho, Charlotte Banayan, Vivian Vega Lemus, Shagun Sharma, Thomas Wallach","doi":"10.1002/jpr3.12084","DOIUrl":"https://doi.org/10.1002/jpr3.12084","url":null,"abstract":"A 4‐year‐old male with Klinefelter syndrome (KS), speech delay, and intermittent history of coughing and choking during meals was referred for evaluation. Prior evaluation with computed tomography showed a dilated esophagus at the gastroesophageal junction. The patient was unable to tolerate a barium swallow. Upper endoscopy was performed, and an intraoperative esophagogram, demonstrated a “birds beak” appearance suggestive of achalasia. There is no documented relationship between achalasia and KS. However, we utilized TriNetX (a large‐scale data clearinghouse) to demonstrate a higher prevalence of achalasia in patients with KS as compared to the general population.","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"48 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141111370","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}

{"title":"Umbilical arterial catheter duration as risk factor for Bell's Stage III necrotizing enterocolitis in preterm neonates","authors":"R. Lalitha, Matthew Hicks, Mosarrat Qureshi, Kumar Kumaran","doi":"10.1002/jpr3.12081","DOIUrl":"https://doi.org/10.1002/jpr3.12081","url":null,"abstract":"To explore risk factors for Stage‐III necrotizing enterocolitis (NEC‐III) in preterm neonates.This was a retrospective case‐control study of neonates born <33 weeks gestational age (GA) who were admitted to a tertiary neonatal intensive care unit, between 2015 and 2018. NEC‐III cases were compared with Stage‐II NEC (NEC‐II) and non‐NEC controls. Two to four non‐NEC controls were matched by GA ± 1 week and date of birth ± 3 months, to one NEC‐III case. Univariate and multivariate analyses were used to examine risk factors for NEC‐III.Of 1360 neonates born <33 weeks, 71 (5.2%) had NEC‐II and above, with 46% being NEC‐III. Mean age of onset of NEC‐III was 13.7 days versus 23.9 days for NEC‐II (p = 0.01). Neonates with NEC‐III were of lower GA (NEC‐III 25.4 weeks, NEC‐II 27.3 weeks, and non‐NEC 26 weeks; p = 0.0008) and had higher Score for Neonatal Acute Physiology Perinatal Extension‐II scores (NEC‐III 47.5, NEC‐II 28.4 and non‐NEC 37, p = 0.003). Multivariate analysis showed duration of umbilical arterial catheter (UAC) >5 days was significantly associated with the development of NEC‐III with adjusted odds ratio (AOR) 3.8; 95% confidence interval (CI) (1.05–13.66) for NEC‐III versus non‐NEC and AOR 5.57; 95% CI (1.65–18.73), p = 0.006 for NEC‐III versus NEC‐II. Rupture of membranes (ROM) >1 week was associated with NEC‐III (AOR 6.93; 95% CI [1.56–30.69] vs. non‐NEC and AOR 11.74; 95% CI [1.14–120.34] vs. NEC‐II).The increased association of NEC‐III with duration of UAC and ROM could be further examined in prospective studies, and an upper limit for UAC duration could be considered in NEC prevention bundles.","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"74 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141121272","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}

{"title":"Autoimmune hepatitis presenting as severe anemia.","authors":"Brandon J Calley, Alexandra Polovneff, Kathryn Henry, Paula North, David C Moe, Cara L Mack","doi":"10.1002/jpr3.12076","DOIUrl":"10.1002/jpr3.12076","url":null,"abstract":"<p><p>Autoimmune hepatitis (AIH) is relatively rare in children. Herein, our case demonstrates a unique presentation of AIH in a previously healthy 18-year-old female presenting with a mild cough, fatigue, and severe anemia (hemoglobin 2.9 g/dL). Initial evaluation revealed jaundice and scleral icterus, prompting transfer of care and further testing, which demonstrated severe microcytic anemia, pancytopenia, elevated liver enzymes, direct hyperbilirubinemia, and marked splenomegaly. Concern for autoimmune hemolytic anemia resulted in a delayed diagnosis. The combination of triple antibody positivity (anti-nuclear antibodies, anti-actin, and anti-liver-kidney microsomal-1) and liver histology findings confirmed the diagnosis of AIH. Intravenous methylprednisolone was initiated to induce remission. Due to pancytopenia and persistently elevated international normalized ratio, tacrolimus was chosen as the maintenance immunosuppression instead of azathioprine. This case highlights several significant considerations for clinicians, including the importance of a timely clinicopathologic diagnosis, the severe anemia presentation secondary to hypersplenism, and the rare finding of triple autoantibody-positive AIH.</p>","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"5 3","pages":"402-406"},"PeriodicalIF":0.0,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11322014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Considerable differences in management of cytomegalovirus infection in patients with biliary atresia.","authors":"Ulrika Liliemark, Afrodite Psaros Einberg, Jan F Svensson, Björn Fischler","doi":"10.1002/jpr3.12068","DOIUrl":"10.1002/jpr3.12068","url":null,"abstract":"<p><strong>Objectives: </strong>Patients with biliary atresia (BA) and ongoing cytomegalovirus (CMV) infection may have poorer outcomes after Kasai portoenterostomy than uninfected patients. Still, there is no consensus on the usefulness of viral testing and antiviral treatment (AVT). This study aims to explore the need for future research on AVT for CMV infection by assessing how CMV infection in BA patients is managed in different centers.</p><p><strong>Methods: </strong>An online questionnaire with 10 questions was offered to participants at an international congress on BA, organized in collaboration with the European Reference Network for rare liver diseases in 2022. Answers to questions were either dichotomic or multiple choices of different numeric intervals. Ongoing CMV infection was defined by detecting cytomegalovirus-immunoglobulin M (CMV-IgM) in serum or cytomegalovirus-deoxyribonucleic acid (CMV-DNA) by polymerase chain reaction in blood or urine.</p><p><strong>Results: </strong>There were 43 respondents from 36 centers in 26 countries. The total number of BA patients per year was between 208 and 380 from centers with 0-5 to >20 BA patients yearly (median 6-10). CMV infection was tested in 27 centers (75%), of which 18 (67%) use AVT. The rate of CMV infection varied between 0%-5% and 40%-50% (median 5%-10%). Willingness to treat the infection did not differ between centers with low and high rates of CMV infection.</p><p><strong>Conclusions: </strong>Most centers test for CMV infection, and a considerable proportion use AVT despite the lack of evidence of its benefits. A future randomized study on treating CMV infection in BA patients is necessary and feasible.</p>","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"5 3","pages":"303-308"},"PeriodicalIF":0.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11322013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visceral leishmaniasis as a rare cause of granulomatous hepatitis","authors":"Dalal Ben Sabbahia, Meriem Atrassi, Halima Msaaf, Imane Chahid, A. Khoaja, Nissrine Bennani, Mehdi Karkouri, Abdelhak Abkari","doi":"10.1002/jpr3.12059","DOIUrl":"https://doi.org/10.1002/jpr3.12059","url":null,"abstract":"Visceral leishmaniasis (VL) is a potentially fatal infection caused by species of Leishmania. It is characterized by fever, weight loss, anemia, and enlargement of the spleen and liver. Hepatitis due to VL is one of the causes of granulomatous hepatitis rarely described in the literature. It poses a problem of differential diagnosis with other causes, notably infectious and autoimmune. Hence the need for a global clinical, biological, and histological evaluation to orientate this entity, especially in endemic countries like ours. In the present case study, a 2‐year 8‐month‐old boy was diagnosed with VL and treated with meglumine antimoniate; the evolution was marked after 2 months by the persistence of a large liver; laboratory results showed elevated liver functions and anemia. A liver biopsy was performed, and the histological findings confirmed the diagnosis of granulomatous hepatitis.","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"80 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140377898","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}