Growth, tolerance and safety outcomes with use of an extensively hydrolyzed casein-based formula in infants with cow's milk protein allergy.

Objective: To evaluate growth, tolerance and safety outcomes with use of an extensively hydrolyzed casein-based formula (eHCF) in infants with cow's milk protein allergy (CMPA). Methods: A total of 226 infants (mean ± SD age: 106.5 ± 39.5 days, 52.7% were girls) with CMPA who received eHCF comprising at least half of the daily dietary intake were included. Data on anthropometrics [weight for age (WFA), length for age (LFA) and weight for length (WFL) z-scores] were recorded at baseline (visit 1), while data on infant feeding and stool records, anthropometrics and Infant Feeding and Stool Patterns and Formula Satisfaction Questionnaires were recorded at visit 2 (on Days 15 ± 5) and visit 3 (on Days 30 ± 5). Results: From baseline to visit 2 and visit 3, WFA z-scores (from -0.60 ± 1.13 to -0.54 ± 1.09 at visit 2, and to -0.44 ± 1.05 at visit 3, p < 0.001) and WFL z-scores (from -0.80 ± 1.30 to -0.71 ± 1.22 at visit 2, and to -0.64 ± 1.13 at visit 3, p = 0.002) were significantly increased. At least half of infants never experienced irritability or feeding refusal (55.7%) and spit-up after feeding (50.2%). The majority of mothers were satisfied with the study formula (93.2%), and wished to continue using it (92.2%). Conclusions: In conclusion, eHCF was well-accepted and tolerated by an intended use population of infants ≤ 6 months of age with CMPA and enabled adequate volume consumption and improved growth indices within 30 days of utilization alongside a favorable gastrointestinal tolerance and a high level of parental satisfaction.

Accuracy Rate of Shear Wave Elastography in Detecting the Liver Fibrosis in Overweight and Obese Children with Hepatosteatosis.

OBJECTIVE: The aim of this study was to compare the accuracy rate of liver stiffness calculated by shear wave elastography with liver biopsy results in obese and overweight children. MATERIALS AND METHODS: Obese and overweight children between 3 and 18 years of age, who had hepatic steatosis and a healthy control group were included in this study. A blood sample was obtained for laboratory tests and shear wave elastography was performed for all subjects. Liver biopsies were performed only in patients with hepatosteatosis, providing permission for biopsy, and for whom the biopsy procedure was not contraindicated. RESULTS: A cohort of 142 children (78 overweight/obese and 64 healthy) was included in this study. Shear wave elastography values were significantly higher in the patient group as com- pared to the control group (34.0 vs. 8.2 kPa; P < .001). Obese children had higher elastog- raphy values compared to non-obese children (50.2 vs. 23.7 kPa, P < .001). No correlation was detected between fibrosis score and elastography values. Elastography increased with increasing weight (correlation coefficient: 0.334, P = .003) and body mass index (correlation coefficient: 0.364, P = .001). CONCLUSION: In obese and overweight patients, elastography values are higher than in healthy subjects as well as patients with liver fibrosis. Disease-specific cut-off, mean, and normal ref- erence range values should be defined with large-scale studies to improve interpretation of elastography values. Our results are contradictory in the determination of liver fibrosis with shear wave elastography in obese and overweight patients, thus further research with a larger patient population is recommended.

The Screening of Celiac Serology in Pediatric Patients Diagnosed with Type 1 Diabetes Mellitus.

BACKGROUND: This study aims to detect the rate of celiac antibody test positivity in pediatric patients diagnosed with type 1 diabetes mellitus (T1DM) and determine the characteristics of the patient groups diagnosed with and without celiac disease (CD). METHODS: This study was conducted retrospectively in Adana City Training and Research Hospital, Pediatric Endocrinology Outpatient Clinic with the patients diagnosed with T1DM between September 17, 2017, and January 1, 2022. The patients were examined by 3 different groups. Group 1: celiac patient group, group 2: serology false positive group, and group 3: serology negative group. RESULTS: The study included 418 patients, 228 (54.5%) males and 190 (45.5%) females. About 6% of the patients (25 patients) were in the celiac patient group, 12.6% (53 patients) in the serology false positive group, and 81.3% (340 patients) in the serology negative group. The age at diagnosis was 10 (7.2-12.9) years in the celiac patient group and 8.8 (6.2-12.00) years in the serology false positive group (P = .559). Among 53 patients in the serology false positive group, spontaneous normalization was observed in 66% (35 patients), and positivity was continued during the test follow-up period in 34% (18 patients). There was no significant difference in terms of sex (P = .101), and HbA1c values at diagnosis (P = .557). Tissue transglutaminase IgA titer was 20× Upper limit of normal (ULN) in the celiac patient group and 2.52× ULN in the serology false positive group. CONCLUSION: T1DM and CD are both autoimmune diseases concurrently seen together. CD antibody positivity may be observed at the first presentation of T1DM. While the majority of these antibodies become negative during the follow-up, we wanted to highlight the false positive antibody titers and emphasize that these patients should be followed by endocrinologists and gastroenterologists together.