Impact of Precision-Guided Dosing on Clinical Decision-Making and Health Care Utilization in Inflammatory Bowel Disease: A Retrospective Pretest/Posttest Real-World Study.

Background: Precision-guided dosing (PGD) is a personalized tool that optimizes clinical decision-making in the treatment of inflammatory bowel disease (IBD) with infliximab (IFX) and its biosimilars. PGD employs nonlinear mixed-effect models using patient-specific pharmacokinetic parameters to predict infliximab trough concentrations without the need to wait until the actual trough measurement. This approach calculates patient-specific clearance (CL) and provides tailored IFX dosing and administration intervals aimed at achieving target trough levels.

Infantile Adenomyomatosis of the Gallbladder in a 3-Month-Old.

Adenomyomatosis of the gallbladder is an acquired condition of the gallbladder with epithelial, mucosal, and muscular hypertrophy. The result is usually gallbladder wall thickening with associated diverticula known as Rokitansky-Aschoff's sinuses. These mucosal invaginations of the gallbladder wall may extend beyond the muscular layer.

Celiac disease and diabetes mellitus diagnosed in a pediatric patient with Hirschsprung disease.

Hirschsprung disease is a disorder of neural crest migration characterized by intestinal aganglionosis along a variable segment of the gastrointestinal tract. It is a complex disorder associated with several syndromes. Celiac disease is an autoimmune enteropathy characterized by dietary intolerance to gluten proteins and can be associated with autoimmune conditions such as diabetes mellitus.

Evaluation of gastroesophageal reflux in pediatric patients with asthma using impedance-pH monitoring.

Objectives: To determine the proportion of acid and nonacid reflux events in children with asthma suspected to have gastroesophageal reflux (GER) using combined impedance-pH monitoring, and to determine the symptom index (SI) for nonacid and acid reflux events.

Study Design: This was a prospective study of children with asthma (age 5 months to 6 years) referred for evaluation of GER. Exclusion criteria were congenital anomalies, cerebral palsy, mental retardation, and cardiac disease.

Evaluation of infantile acid and nonacid gastroesophageal reflux using combined pH monitoring and impedance measurement.

Objective: Characterize the proportion of acid and nonacid esophageal reflux events in young infants with suspected gastroesophageal reflux (GER) using combined pH-multichannel intraluminal impedance (MII) monitoring. Determine the symptom index correlation with nonacid reflux and acid reflux events.

Study Design: Prospective study of children, aged 2 weeks to 1 year, referred to The Children's Hospital of Denver Gastroenterology Clinic for evaluation of GER.

Portopulmonary hypertension in pediatric patients.

Objectives: To investigate the clinical presentation, manifestations, and response to therapy of portopulmonary hypertension (PPHTN) in pediatric patients.

Study Design: This study was a retrospective chart review describing the evaluation and course of 7 patients with PPHTN.

Results: Causes of portal hypertension (HTN) included biliary atresia (3 cases), cavernous transformation of the portal vein (2 cases), and primary sclerosing cholangitis and cryptogenic cirrhosis (1 case each).

Frequency of ASCA seropositivity in children with cystic fibrosis.

Objective: To determine the frequency of anti-Saccharomyces cerevisiae antibodies (ASCA) seropositivity in pediatric patients with cystic fibrosis (CF) and correlate ASCA with clinical features.

Methods: Prospective study of children with CF aged 2 to 21 years enrolled from The Children's Hospital Cystic Fibrosis Center. Exclusion criteria included Crohn disease, immunodeficiency or immunoglobulin A deficiency.

A home infliximab infusion program.

Introduction: Infliximab is a promising advance in the treatment of pediatric inflammatory bowel disease. Infliximab is an effective therapy for selected children with Crohn disease but is both costly and time consuming.

Objectives: To analyze our center's experience with a program of home-based infliximab infusion.

Abnormal intestinal histology in neonates with congenital anomalies of the gastrointestinal tract.

In animal models, when swallowing is experimentally prevented in utero, bowel length and weight are reduced, and villus height, crypt depth, and villus function are retarded. Little is known about the intestinal histology in infants with gastrointestinal (GI) tract anomalies. We examined the histological architecture of the intestine in neonates with GI anomalies in comparison to that of normal fetuses.