Dr Alex Knisely today in JPGN Journal Club is speaking not only with Kassel’s best, Dr Andreas Jenke, but also with Dr Jake Mann, pride of Birmingham and the Channel Islands – that’s right, double trouble. We say thank you and goodbye to Andreas, thank you and hello to Jake, who is stepping into Andreas’ shoes as primary Journal Club discussant. Andreas leads off with Predicting Insulin Resistance in a Pediatric Population With Obesity, a JPGN article from Portugal, by Daniela Arauj́ o and colleagues, using non-invasive parameters to identify children at increased metabolic-syndrome risk and thereby perhaps opening restricted-prescription gateways for early pharmacologic intervention. Jake is next up at bat, with a non-JPGN entry (Hepatology Communications) from Sagar Mehta et al. at Toronto’s Hospital for Sick Children – Severe Acute Hepatitis of Unknown Etiology in a Large Cohort of Children, a look at the recent purported worldwide spike in numbers of such patients. Was it really

Dr Alex Knisely today is speaking with Dr Jake Mann, of the Children’s Hospital of Birmingham and the University of Birmingham – Dr Mann’s second contribution to these podcasts. At the annual meeting of ESPGHAN in Vienna this May Dr Mann presented information on the potential relevance of genetic variants “of unknown significance”, the sort of thing that often is uncovered in exomic or genomic studies of children with hepatobiliary disease; one can’t pin the hepatobiliary disease on those variants, not exactly, but what is one to do with them ? – to abnormalities in biomarker values assessed in adults. Indeed such variants and such abnormalities co-map, suggesting rôles for the variants as loci minoris resistentiae that may confer adverse prognoses. Worth our attention, although neither easy reading nor easy listening : As Mark Twain famously had Huckleberry Finn say of The Pilgrim’s Progress, “The statements was interesting, but tough.” But who can better explicate Dr Mann’s state

Dr Alex Knisely today in JPGN Journal Club is bantering happily with Dr Andreas Jenke, who for discussion has chosen two articles and a pair of Letters to the Editor, thrust and parry, attack and defence. He believes that correspondence of this sort often affords insight into what is at issue in the matter addressed – and he may well be right. Along with those, we have a contribution from Dr S Bonilla of Boston Children’s Hospital – Helicobacter pylori Antimicrobial Resistance Using Next-Generation Sequencing in Stool Samples in a Pediatric Population – and another from Dr B Özer Bekmez of Ankara City Hospital – Antenatal Neuroprotective Magnesium Sulfate in Very Preterm Infants and Its Association With Feeding Intolerance. Dr Özer Bekmez and her team compared the courses of pre-term infants who received magnesium sulfate (MgSO4) for neuroprotective purposes and pre-term infants who did not receive MgSO4. Findings included “a significant difference in intrauterine growth r

Dr Alex Knisely today is speaking with Prof Marc Benninga and Dr Klaartje de Bruijn, both of Amsterdam’s Academisch Medisch Centrum. Prof Benninga is visiting these podcasts for a second time ; Dr de Bruijn is facing her baptism of fire. Their topic? Shudder and thrill – faecal transplantation. In 2020 their group published a protocol for faecal transplantation in adolescents with refractory irritable-bowel syndrome (PMID : 32864480), midway through the study described. In nuce : Healthy- donor stool or recipient’s own stool, delivered by nasoduodenal sonde immediately after irrigating the bowel clean from above, two doses six weeks apart ; both clinical well-being and stool microbiome assessed ; one-year follow-up. At the annual meeting of ESPGHAN in Vienna this May Dr de Bruijn presented study results : Thirty recipients of healthy-donor stool felt better and experienced shifts in stool microbiome, changes that persisted throughout the year of follow-up. In effect, if this were a

Dr Alex Knisely today is speaking with Dr Andreas Jenke – it’s Journal Club again. Dr Jenke has chosen from the August, 2023, number of JPGN three articles for discussion – from Brisbane (Queensland), Australia, and, in India, Lucknow, Jodhpur, and Rishikesh (a thousand-kilometre span across the centre and north of the subcontinent ! ), Oral Tacrolimus in Steroid-Refractory and - Dependent Pediatric Ulcerative Colitis - a Systematic Review and Meta-Analysis ; from a group in San Diego, California, with contributions from a group at Columbia University in New York City, An Open Label, Randomized, Multicenter Study of Elafibranor in Children with Nonalcoholic Steatohepatitis ; and from Edmonton (Alberta), Canada, Clinical Features of Children with Serology-Negative, Biopsy-Positive Celiac Disease. The Indian / Australian study is a meta-analysis and review rather than primary work ; it concludes that tacrolimus may allow caregivers to temporise, with an initially good response that ra