Gastroenterology/Nutrition Copyright (c) 2013 University of Massachusetts Medical School All rights reserved. http://escholarship.umassmed.edu/peds_gastro Recent documents in Gastroenterology/Nutrition en-us Wed, 13 Feb 2013 17:58:09 PST 3600 Portal Hypertension http://escholarship.umassmed.edu/peds_gastro/11 http://escholarship.umassmed.edu/peds_gastro/11 Tue, 27 Mar 2012 12:50:57 PDT Summary: Provides rapid-access information on the diagnosis, treatment, and follow-up of Portal Hypertension.

]]> Walter M. Kim et al. Hypertension, Portal Hepatic Encephalopathy http://escholarship.umassmed.edu/peds_gastro/10 http://escholarship.umassmed.edu/peds_gastro/10 Tue, 27 Mar 2012 12:50:56 PDT Summary: Provides rapid-access information on the diagnosis, treatment, and follow-up of Hepatic Encephalopathy.

]]> Walter M. Kim et al. Hepatic Encephalopathy Proctitis http://escholarship.umassmed.edu/peds_gastro/9 http://escholarship.umassmed.edu/peds_gastro/9 Tue, 27 Mar 2012 12:50:55 PDT Summary: Provides rapid-access information on the diagnosis, treatment, and follow-up of Proctitis.

]]> Jeffrey Riese et al. Proctitis Encopresis http://escholarship.umassmed.edu/peds_gastro/8 http://escholarship.umassmed.edu/peds_gastro/8 Tue, 27 Mar 2012 12:50:53 PDT Summary: Provides rapid-access information on the diagnosis, treatment, and follow-up of Encopresis.

]]> William T. Garrison et al. Encopresis Splenic pseudoaneurysm in a child with hereditary pancreatitis http://escholarship.umassmed.edu/peds_gastro/7 http://escholarship.umassmed.edu/peds_gastro/7 Tue, 27 Mar 2012 10:44:52 PDT Splenic artery pseudoaneurysm (SAP) formation is an uncommon complication of pancreatitis. It is believed to be the result of vascular erosion by pancreatic enzymes, a process that compromises the integrity of the splenic artery wall. The final result is a weak, expanded vessel wall that may hemorrhage into the peritoneal cavity or retroperitoneal space. There are no known reports of SAP in the pediatric population or in patients with hereditary pancreatitis. We report a case of SAP formation in a 5-year-old child with hereditary pancreatitis that was successfully managed via transcatheter coil embolization of the splenic artery.

]]> Yonathan Fuchs et al. Aneurysm, False Child, Preschool Humans Male Pancreatitis Spleen High sustained virologic response rates in children with chronic hepatitis C receiving peginterferon alfa-2b plus ribavirin http://escholarship.umassmed.edu/peds_gastro/6 http://escholarship.umassmed.edu/peds_gastro/6 Tue, 27 Mar 2012 10:44:50 PDT BACKGROUND and AIMS: Pegylated interferon (PEG-IFN) alfa-2b plus ribavirin (RBV) is the standard of care for adults with chronic hepatitis C but was not approved for the treatment of children at the time of this study. The aim of this study was to evaluate the efficacy and safety of PEG-IFN alfa-2b plus RBV in children.

METHODS: Children and adolescents ages 3-17 years were treated with PEG-IFN alfa-2b (60microg/m(2)/week) plus RBV (15mg/kg/day). The duration of therapy was 24 weeks for genotype (G) 2 and G3 patients with low viral load (<600,000IU/ml) and 48 weeks for G1, G4, and G3 with high viral load (>or=600,000IU/ml). The primary end point was sustained virologic response (SVR), defined as undetectable hepatitis C virus (HCV) RNA 24 weeks after completion of therapy.

RESULTS: SVR was attained by 70 (65%) children. Genotype was the main predictor of response: G1, 53%; G2/3, 93%; G4, 80%. SVRs were similar in younger and older children. Baseline viral load was the main predictor of response in the G1 cohort. No new safety signals were identified, and adverse events (AEs) were generally mild or moderate in severity. Dose was modified because of AEs in 25% of children; 1 child discontinued because of an AE (thrombocytopenia). No serious AEs related to study drugs were reported.

CONCLUSION: Therapy with PEG-IFN alfa-2b plus RBV in children and adolescents with chronic hepatitis C offers favorable efficacy, reduced injection frequency, and an acceptable safety profile.

]]> Stefan Wirth et al. Adolescent Antiviral Agents Body Height Body Weight Child Child Development Child, Preschool Drug Resistance, Viral Drug Therapy, Combination Female Genotype Hepacivirus Hepatitis C, Chronic Humans Interferon Alfa-2b effects Male Polyethylene Glycols effects Ribavirin Treatment Outcome Viral Load Long-term minocycline use for acne in healthy adolescents can cause severe autoimmune hepatitis http://escholarship.umassmed.edu/peds_gastro/5 http://escholarship.umassmed.edu/peds_gastro/5 Tue, 27 Mar 2012 10:44:49 PDT Over the years, a variety of abnormal immune reactions to minocycline have been reported including arthritis, systemic lupus erythematosus, and hepatitis. The current report describes the detailed clinical and pathologic features of 3 patients who presented with chronic/autoimmune hepatitis alone while on minocycline at our hospital over a 2-year period. Minocycline use in these patients was temporally related to onset of severe hepatitis. Adolescents with such a reaction to minocycline have been included in previous reports but have not been well described as a distinct entity. We have compared our cases with similar cases previously reported with a review of the literature and a discussion of the implications for prescribing physicians.

]]> Jyoti P. Ramakrishna et al. Acne Vulgaris Adolescent Anti-Bacterial Agents Drug-Induced Liver Injury, Chronic Female Hepatitis, Autoimmune Humans Male Minocycline Severity of Illness Index Research agenda for pediatric gastroenterology, hepatology and nutrition: acid-peptic diseases. Report of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition for the Children's Digestive Health and Nutrition Foundation http://escholarship.umassmed.edu/peds_gastro/4 http://escholarship.umassmed.edu/peds_gastro/4 Tue, 27 Mar 2012 10:44:49 PDT Identifies and discusses research priorities in acid-peptic diseases in children such as GERD (gastroesophageal reflux disease) and peptic ulcer disease.

]]> Steven Czinn et al. Child Child Nutritional Physiological Phenomena Gastroenterology *Gastroesophageal Reflux *Helicobacter Infections *Helicobacter pylori Humans North America Research Societies, Medical Acylcarnitines in plasma and blood spots of patients with long-chain 3-hydroxyacyl-coenzyme A dehydrogenase defiency http://escholarship.umassmed.edu/peds_gastro/3 http://escholarship.umassmed.edu/peds_gastro/3 Tue, 27 Mar 2012 10:44:48 PDT The acylcarnitines in plasma and blood spots of 23 patients with proven deficiency of long-chain 3-hydroxyacylcoenzyme A dehydrogenase were reviewed. Long-chain 3-hydroxyacylcarnitines of C14:1, C14, C16 and C18:1 chain length, and long-chain acylcarnitines of C12, C14:1, C14, C16, C18:2 and C18:1 chain length were elevated. Acetylcarnitine was decreased. In plasma, elevation of hydroxy-C18:1 acylcarnitine over the 95th centile of controls, in combination with an elevation of two of the three acylcarnitines C14, C14:1 and hydroxy-C16, identified over 85% of patients with high specificity (less than 0.1% false positive rate). High endogenous levels of long-chain acylcarnitines in normal erythrocytes reduced the diagnostic specificity in blood spots compared with plasma samples. The results were also diagnostic in asymptomatic patients, and were not influenced by genotype. Treatment with diet low in fat and high in medium-chain triglyceride decreased all disease-specific acylcarnitines, often to normal, suggesting that this assay is useful in treatment monitoring.

]]> J. L. Van Hove et al. 3-Hydroxyacyl CoA Dehydrogenases Carnitine Erythrocytes False Negative Reactions Female Genotype Heterozygote Homozygote Humans Male Mutation Plasma Sensitivity and Specificity A multidisciplinary interclerkship on hunger and malnutrition http://escholarship.umassmed.edu/peds_gastro/2 http://escholarship.umassmed.edu/peds_gastro/2 Tue, 27 Mar 2012 10:44:47 PDT Objective: In 1997 we developed a third-year "interclerkship" course during which students return to the University of Massachusetts Medical School (UMMS) campus for two days to study childhood hunger and malnutrition. We sought to ( 1) provide knowledge about (a) the extent to which hunger and malnutrition occur, (b) the short· and long-term physical, psychosocial, and cognitive consequences of hunger and malnutrition, (c) practical information on good nutrition, (d) and resources available that help children at risk for hunger or malnutrition; (2) develop skills to use physical signs and screening questions to identify risk and apply nutritional principles and effective patients education; and (3) foster an attitude supportive of the role of nutrition in preventive medicine and of physician advocacy for the nutritional health of children and communities.

]]> Constance A. Cardasis et al. Child *Child Nutrition Disorders Clinical Clerkship Humans Hunger Infant Massachusetts