Differences in Durability, Dislodgement, and Other Complications With Use of Low-Profile Nonballoon Gastrostomy Tubes in Children.

Background: Nonballoon low-profile gastrostomy tubes (GTs) are used for enteral nutrition support in a subset of pediatric patients with feeding difficulties when use of balloon GTs is problematic. Different nonballoon low-profile tube types are available, but comparative studies are lacking.

Materials And Methods: This was a retrospective cohort study comparing complications and outcomes between different low-profile nonballoon GTs at a pediatric tertiary care center over 10 years.

Difficulty Achieving Vitamin D Sufficiency With High-Dose Oral Repletion Therapy in Infants With Cholestasis.

Objectives: Oral high-dose repletion vitamin D therapy, also known as stoss therapy, can be effective in the treatment of nutritional vitamin D deficiency rickets in infants and young children without liver disease and in patients with cystic fibrosis. There is no literature about this approach in infants with new-onset cholestasis.

Methods: This was a retrospective chart review of infants with cholestasis from March 2010 to March 2012 at a pediatric tertiary care center.

Urologic and gastrointestinal symptoms in the dystroglycanopathies.

Objective: To determine the frequency of urologic and gastrointestinal (GI) symptoms in a cohort of individuals with dystroglycanopathy compared with healthy household controls.

Methods: Participants in a North American dystroglycanopathy natural history study (NCT00313677) and other members of their households completed a questionnaire modified from validated instruments and clinical criteria. Urologic and GI symptom frequency, effect on patient life, and medications taken for these symptoms were assessed.

Effects of 70% ethanol locks on rates of central line infection, thrombosis, breakage, and replacement in pediatric intestinal failure.

Objectives: Parenteral nutrition is essential for the growth and nutrition of patients with intestinal failure (IF). Catheter-related bloodstream infections (CRBSI) are a major complication of parenteral nutrition use. Few retrospective studies have shown that 70% ethanol lock (ETL) therapy for central lines can reduce the infection rate.

Challenges in meeting fellowship procedural guidelines in pediatric therapeutic endoscopy and liver biopsy.

Objective: The aims of this study were to assess the opportunities for therapeutic endoscopy, liver biopsies, and percutaneous endoscopic gastrostomy (PEG) placements available to fellows during a 3-year pediatric gastroenterology fellowship, and to evaluate access to ancillary procedural-training opportunities.

Methods: Data were collected from 12 pediatric gastroenterology fellowship programs in the United States. Procedures completed in the years 2009-2011 were queried using CPT codes and endoscopy databases.

Gastrojejunal feeding tube use by gastroenterologists in a pediatric academic center.

Background And Objectives: Enteral feeding through gastrojejunal (GJ) tubes is an established method of nutrition for patients with feeding difficulty who do not tolerate intragastric feedings. The pediatric literature about the long-term outcome, safety, and complications of different GJ tubes and placement methods is lacking. Our study aims to provide information about indications, techniques, and long-term outcome of GJ tube use in children.

Prospective randomized comparative study of low-profile balloon gastrostomy tubes in children.

Background: Supplemental enteral nutrition through gastrostomy tubes is well established in children, but prospective studies comparing different tubes remain lacking in this population. The study aimed at comparing different aspects related to the use of low-profile balloon gastrostomy tubes in children.

Materials And Methods: The authors prospectively studied the use of 2 tube types--tube A (MIC-Key gastrostomy tube; Ballard Medical Products, Draper, UT) and tube B (MINI One gastrostomy tube; Applied Medical Technology, Brecksville, OH)--in a cohort of children in a crossover study design.

Safety techniques for percutaneous endoscopic gastrostomy tube placement in Pierre Robin Sequence.

Pierre Robin Sequence (PRS) is a craniofacial anomaly characterized by a triad of micrognathia, glossoptosis, and cleft palate. Infants with PRS frequently have feeding problems that may require supplemental nutrition through a nasogastric or gastrostomy tube. Very few published studies have illustrated the most appropriate method for securing an enteral feeding route in this patient population.

Identifying small bowel intussusception related to a gastroenteric feeding tube.

Enteral feedings through gastroenteric (GE) tubes are commonly utilised in patients with feeding difficulties and intolerance to gastric feeding. A variety of complications related to GE tubes have been described which rarely include small bowel intussusception. The case of a 23-year-old man with proximal small bowel intussusception related to an endoscopically placed low profile GE tube is described.

Initial clinical experience with allopurinol-thiopurine combination therapy in pediatric inflammatory bowel disease.

Background: Thiopurines are a mainstay of immunomodulator therapy in inflammatory bowel disease (IBD). Despite their efficacy, some patients may have a poor response due to inability to achieve adequate levels of the active metabolite, 6-thioguanine (6-TGN). Others experience hepatotoxicity, which correlates with excessive 6-methylmercaptopurine (6-MMP) levels.

Differential effects of Francisella tularensis lipopolysaccharide on B lymphocytes.

Francisella tularensis, a designated Category A biological agent, can cause severe infection in humans. Previous studies have demonstrated a significant immunoprotective role for B lymphocytes in animal models, but the responses of human B lymphocytes to F. tularensis components are largely unknown.