Consensus Statement on Metabolic Dysfunction-Associated Steatotic Liver Disease in Children and Adolescents From the Joint TASL-TSPGHAN Expert Committee.

Background And Objective: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver condition in children and adolescents, driven by the global rise in pediatric obesity. In this consensus statement by the Taiwan Association for the Study of the Liver (TASL) and the Taiwan Society of Pediatric Gastroenterology, Hepatology, and Nutrition (TSPGHAN), we highlight the unique clinical challenges in diagnosing and managing this condition in Asian children.

Methods: This consensus was developed by expert members of TASL and TSPGHAN through a comprehensive review of current literature and clinical practice.

Perception of obesity and weight-loss attitudes among adolescents living with obesity, caregivers, and healthcare professionals in Taiwan: Data from the ACTION Teens survey study.

Background: The ACTION Teens study (NCT05013359) surveyed adolescents living with obesity (ALwO), caregivers (CGs) of ALwO, and healthcare professionals (HCPs) of ALwO, to identify behaviors, perceptions, attitudes, and barriers to effective obesity care. The goal was to generate insights to help improve obesity management for ALwO, both globally and locally. Here, we discuss insufficient management of adolescent obesity in Taiwan.

Prenatal Exposure to Air Pollution and Pediatric Biliary Atresia: A Nationwide Population-Based Cohort Study.

Introduction: Biliary atresia (BA) is a serious pediatric liver disease and the leading cause of liver transplants in children. Although its cause is unknown, prior research suggests air pollution may influence childhood diseases. This study examines the potential association between prenatal air pollution exposure and BA incidence.

Clinical application and feasibility of capsule endoscopy in children at a medical center in central Taiwan.

Background Purpose: Capsule endoscopy (CE) is a noninvasive examination for excellent visualization of small bowel mucosal lesions. We aimed to evaluate the clinical efficacy and safety of CE in pediatric patients.

Methods: From April 2014 to December 2022, CE procedures performed in children younger than 18 years of age at Taichung Veteran General Hospital were analyzed retrospectively.

Influence of Helicobacter pylori infection on risk of rheumatoid arthritis: a nationwide population-based study.

The relationship between Helicobacter pylori infection and rheumatoid arthritis has been investigated, but the results remain controversial. This study aims to determine the association between the two diseases via a 17-year retrospective cohort study. Using the National Health Insurance Research Database, a nationwide population based in Taiwan, we identified 97,533 individuals with H.

Number of cholangitis episodes as a prognostic marker to predict timing of liver transplantation in biliary atresia patients after Kasai portoenterostomy.

Background: Cholangitis may affect liver failure of biliary atresia (BA) patients after Kasai portoenterostomy (KP). We examined whether the number of cholangitis episodes could be a prognostic marker for liver transplant (LT) in children with BA after Kasai portoenterostomy (KP).

Methods: Data for BA patients born after 1998 and undergoing KP were obtained from National Health Insurance Research Database (NHIRD), Taiwan.

Effectiveness of the IMFeD tool for the Identification and Management of Feeding Difficulties in Taiwanese children.

Background: The Identification and Management of Feeding Difficulties (IMFeD™) tool was introduced in 2011 for management of children with feeding difficulties and has been used in various countries around the world. This study aimed to assess its acceptance and effectiveness in clinical practice in Taiwan.

Methods: This was a prospective, observational, multicenter study where subjects were followed over 3 months.

Factors Determining Bone Mineral Density in Patients with Biliary Atresia after a Successful Kasai Operation.

Background: Hepatic osteodystrophy is a common complication in patients with chronic liver disease, however, bone mineral status in patients with biliary atresia has rarely been investigated.

Methods: Twenty-nine children with biliary atresia were enrolled in our study and their demographic data, bone mineral density (BMD) of lumbar spine and bilateral femoral neck, and biochemical parameters were measured and analyzed.

Results: The majority of our patients had osteopenia or osteoporosis over at least one part of the skeleton although none had jaundice.

Family impact of Rotavirus Gastroenteritis in Taiwan and Vietnam: an Ethnographic Study.

Background: Prior to the introduction of rotavirus vaccines, rotavirus was the leading cause of severe gastroenteritis in infants and young children, and it continues to be the leading cause in countries without vaccination programs. Rotavirus gastroenteritis results in substantial economic burden and has a pronounced effect on the family of those who are ill. Both in Taiwan and in Vietnam, rotavirus illness is viewed as a priority disease.

The correlation between plasma cytokine levels in jaundice-free children with biliary atresia.

Background: T helper (Th) cell cytokines modulate inflammation and play a role in biliary atresia (BA). The aim of the study is a cross-sectional assessment of the levels of Th cytokines in the jaundice-free post Kasai procedure patients.

Methods: There were 40 jaundice-free patients with BA and 28 normal controls enrolled.

Decreasing rate of biliary atresia in Taiwan: a survey, 2004-2009.

Objectives: The pathogenesis of biliary atresia (BA) is unclear, but epidemiological studies may help to elucidate possible causes. The goals of this study were to identify BA incidence changes in Taiwan in 2004-2009 and to survey the factors that might influence incidence changes to elucidate the possible causes of BA.

Methods: A Taiwan national registry system for BA has been established since 2004.

Effects of the infant stool color card screening program on 5-year outcome of biliary atresia in Taiwan.

Unlabelled: In Taiwan, a screening system using an infant stool color card to promote the early diagnosis of biliary atresia (BA) was established in 2002. This study aimed to investigate the 5-year outcome of BA before and after using the screening program. BA patients were divided into three cohorts according to their birth dates.

Clinical features and therapeutic response in Taiwanese children with Wilson's disease: 12 years of experience in a single center.

Background: Wilson's disease (WD) is an autosomal recessive defect of cellular copper export. Early diagnosis in children is difficult due to its obscure clinical presentations. The efficacy of zinc salts is well documented, although there are limited data concerning zinc use in pediatric patients with WD.

Universal screening for biliary atresia using an infant stool color card in Taiwan.

Unlabelled: Biliary atresia is the most common cause of death from liver disease in children. Although the Kasai operation before 60 days of age can significantly improve prognosis, delay in referral and surgery remains a formidable problem worldwide because of difficulties in differentiating it from benign prolonged neonatal jaundice. We established a universal screening system using an infant stool color card to promote the early diagnosis and treatment of biliary atresia.

Transcatheter therapy of Budd-Chiari syndrome in a child after liver transplantation: report of one case.

Budd-Chiari syndrome is a rare, heterogenous and potentially lethal condition due to hepatic venous outflow obstruction. Classic triads include hepatomegaly, ascites and abdominal pain. Most cases are caused by abnormal coagulopathy, infection, inflammation or tumor invasion.

Subacute nonsuppurative cholangitis (cholangitis lenta) in pediatric liver transplant patients.

Background: Subacute nonsuppurative cholangitis (cholangitis lenta) is an uncommon yet important histological finding in liver biopsies from pediatric liver transplant recipients. The histopathological features include proliferation of bile ductules at the edges of portal tracts, inspissated bile within dilated bile ductules, absence of acute inflammation within ducts or ductules, and normal structure of interlobular bile ducts.

Objective: To describe the histopathology and clinical outcomes of pediatric liver transplant recipients with subacute nonsuppurative cholangitis.

Pediatric liver tumors: initial presentation, image finding and outcome.

Background: Few reports have been carried out on the characteristics of pediatric liver tumors.

Methods: A retrospective study of 57 patients diagnosed with liver tumors from 1989 through 2004 was conducted. They were classified into groups; 10 benign, 33 primary malignant and 14 metastatic liver tumors.

Screening for biliary atresia by infant stool color card in Taiwan.

Objective: We aimed to detect biliary atresia (BA) in early infancy to prevent additional liver damage because of the delay of referral and surgical treatment and to investigate the incidence rate of BA in Taiwan.

Methods: A pilot study to screen the stool color in infants for the early diagnosis of BA was undertaken from March 2002 to December 2003. We had designed an "infant stool color card" with 7 numbers of different color pictures and attached it to the child health booklet.

[Nursing care for children undergoing percutaneous endoscopic gastrostomy].

Ever since percutaneous endoscopic gastronomy (PEG) was used for the first time in 1980 by Gauderer, Ponsky, Izant et al., It has been widely used in patients incapable of oral feeding. It is a safe and effective technique for long-term nutritional support in children, and easy to perform, as only local anesthesia or heavy sedation is required PEG can prevent children from suffering from nasopharyngeal and esophageal erosions due to repeated insertion of nasogastric tubes and the complication of aspiration pneumonia.