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Article ; Online: Pediatric sarcopenia: An imperfect science in evolution.

Boster, Julia M / Sundaram, Shikha S

Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society

2023 Volume 30, Issue 1, Page(s) 8–9

MeSH term(s)	Child ; Humans ; Sarcopenia/diagnosis ; Sarcopenia/etiology ; Liver Transplantation
Language	English
Publishing date	2023-09-29
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	2006866-9
ISSN	1527-6473 ; 1527-6465
ISSN (online)	1527-6473
ISSN	1527-6465
DOI	10.1097/LVT.0000000000000266
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Article ; Online: Corrigendum to "Primary vs. Salvage Liver Transplantation for Biliary Atresia: A Retrospective Cohort Study" J Pediatr Surg 57 (2022) 407-413.

Yoeli, Dor / Choudhury, Rashikh A / Sundaram, Shikha S / Mack, Cara L / Roach, Jonathan P / Karrer, Frederick M / Wachs, Michael E / Adams, Megan A

Journal of pediatric surgery

2023 Volume 59, Issue 1, Page(s) 165

Language	English
Publishing date	2023-10-12
Publishing country	United States
Document type	Published Erratum
ZDB-ID	80165-3
ISSN	1531-5037 ; 0022-3468
ISSN (online)	1531-5037
ISSN	0022-3468
DOI	10.1016/j.jpedsurg.2023.09.035
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Zs.A 607: Show issues

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Article ; Online: Neonatal Presentation of Congenital Portosystemic Shunt.

Shay, Rebecca L / Goldberg, Alyssa / Sundaram, Shikha S / Browne, Lorna P / Wright, Clyde J / Annam, Aparna

The Journal of pediatrics

2021 Volume 241, Page(s) 261–262

MeSH term(s)	Hepatic Veins/abnormalities ; Humans ; Infant, Newborn ; Male ; Portal Vein/abnormalities ; Vascular Malformations/diagnosis
Language	English
Publishing date	2021-10-21
Publishing country	United States
Document type	Case Reports ; Video-Audio Media
ZDB-ID	3102-1
ISSN	1097-6833 ; 0022-3476
ISSN (online)	1097-6833
ISSN	0022-3476
DOI	10.1016/j.jpeds.2021.10.010
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Um IV Zs.116: Show issues

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Article ; Online: Macronutrient and Micronutrient Intake in Adolescents With Non-alcoholic Fatty Liver Disease: The Association With Disease Severity.

Porto, Ariel / Pan, Zhaoxing / Zhou, Wenru / Sokol, Ronald J / Klaczkiewicz, Kelly / Sundaram, Shikha S

Journal of pediatric gastroenterology and nutrition

2022 Volume 75, Issue 5, Page(s) 666–674

Abstract: Objectives: While dietary changes are recommended to treat pediatric non-alcoholic fatty liver disease (NAFLD), the role of specific nutrients in disease progression is unclear. The objective of this study is to (1) assess the macronutrient and ... ...

Abstract	Objectives: While dietary changes are recommended to treat pediatric non-alcoholic fatty liver disease (NAFLD), the role of specific nutrients in disease progression is unclear. The objective of this study is to (1) assess the macronutrient and micronutrient intake in adolescents with liver biopsy proven NAFLD [with and without non-alcoholic steatohepatitis (NASH)] and lean controls; (2) determine nutritional predictors of disease severity amongst these groups. Methods: Adolescents with biopsy-proven NAFLD and lean controls completed the Harvard Food Frequency Questionnaire. Results: Twenty-eight NAFLD and 15 lean controls were studied. NAFLD with (n = 20) and without NASH (n = 8) had similar total calorie, protein, fat, and carbohydrate intake. Subjects with NASH had higher total sugar (122.3 ± 48.3 vs 83.1 ± 38.8 g), glucose (24.3 ± 9.3 vs 15.2 ± 7.5 g), sucrose (42.3 ± 16.9 vs 28.8 ± 11.7 g), and fructose (29.4 ± 12.5 vs 18.1 ± 8.0 g) intake than those with NAFLD but without NASH ( P < 0.05). Both NAFLD groups had similar micronutrient intake. Alanine aminotransferase (ALT) correlated with total caloric intake ( ρ = 0.4; P = 0.04). Total carbohydrate calories correlated with a higher NAS summary score ( ρ = 0.38; P = 0.04) and lobular inflammation ( ρ = 0.50; P = 0.007). Percent calories from added sugar and glucose correlated with worsening NAS summary score ( ρ = 0.44, P = 0.02; ρ = 0.48, P = 0.009) and lobular inflammation ( ρ = 0.51, P = 0.006; ρ = 0.53, P = 0.004). Percent calories from fructose correlated with lobular inflammation ( ρ = 0.56; P = 0.002). Total daily calories, protein, fat, carbohydrate, and micronutrient intake were similar between NAFLD and lean controls. Conclusions: NASH patients consume similar total calories, protein, and fat as those without NASH, but have significantly higher sugar intake. NAFLD and lean children, however, have similar macro/micronutrient intake. Histologic disease severity correlates with total carbohydrate and added sugar intake, supporting a role for simple sugar intake in NAFLD progression.
MeSH term(s)	Humans ; Adolescent ; Child ; Non-alcoholic Fatty Liver Disease/pathology ; Fructose ; Severity of Illness Index ; Dietary Carbohydrates ; Eating ; Nutrients ; Inflammation/complications ; Glucose ; Liver/pathology
Chemical Substances	Fructose (30237-26-4) ; Dietary Carbohydrates ; Glucose (IY9XDZ35W2)
Language	English
Publishing date	2022-07-28
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	603201-1
ISSN	1536-4801 ; 0277-2116
ISSN (online)	1536-4801
ISSN	0277-2116
DOI	10.1097/MPG.0000000000003578
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Zs.A 1728: Show issues

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Article ; Online: Malnutrition in Biliary Atresia: Assessment, Management, and Outcomes.

Boster, Julia M / Feldman, Amy G / Mack, Cara L / Sokol, Ronald J / Sundaram, Shikha S

Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society

2021 Volume 28, Issue 3, Page(s) 483–492

Abstract: Children with biliary atresia (BA), particularly infants, are at high risk for malnutrition attributed to a multitude of factors, including poor oral intake and intolerance of enteral feeding, fat malabsorption, abnormal nutrient metabolism, and ... ...

Abstract	Children with biliary atresia (BA), particularly infants, are at high risk for malnutrition attributed to a multitude of factors, including poor oral intake and intolerance of enteral feeding, fat malabsorption, abnormal nutrient metabolism, and increased caloric demand. Malnutrition and sarcopenia negatively impact outcomes in BA, leading to higher pretransplant and posttransplant morbidity and mortality. This review summarizes factors contributing to nutritional deficiencies in BA and offers an organized approach to the assessment and management of malnutrition in this vulnerable population.
MeSH term(s)	Biliary Atresia/complications ; Biliary Atresia/diagnosis ; Biliary Atresia/surgery ; Child ; Enteral Nutrition ; Humans ; Infant ; Liver Transplantation/adverse effects ; Malnutrition/complications ; Malnutrition/diagnosis ; Nutritional Status ; Sarcopenia
Language	English
Publishing date	2021-11-10
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Review
ZDB-ID	2006866-9
ISSN	1527-6473 ; 1527-6465
ISSN (online)	1527-6473
ISSN	1527-6465
DOI	10.1002/lt.26339
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Article ; Online: Higher Mortality in Pediatric Liver Transplant Candidates With Sarcopenia.

Boster, Julia M / Browne, Lorna P / Pan, Zhaoxing / Zhou, Wenru / Ehrlich, Peter F / Sundaram, Shikha S

Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society

2021 Volume 27, Issue 6, Page(s) 808–817

Abstract: Little is known about the impact of sarcopenia (reduced muscle mass and function) in pediatric chronic liver disease. We compared psoas muscle surface area (PMSA), measured at the 4th lumbar vertebrae, in children listed for liver transplantation (LT) to ...

Abstract	Little is known about the impact of sarcopenia (reduced muscle mass and function) in pediatric chronic liver disease. We compared psoas muscle surface area (PMSA), measured at the 4th lumbar vertebrae, in children listed for liver transplantation (LT) to that of healthy controls and studied the impact of sarcopenia on transplant-associated outcomes. The effect of PMSA (raw value and z score) on survival was studied using multivariable proportional hazards, whereas the impact of PMSA on other transplant-associated outcomes was assessed by multivariable linear or logistic regression. The correlation of PMSA with anthropometric values and markers of disease severity was studied using Spearman's rank-order correlation. Mean PMSA was significantly lower in LT candidates (n = 57, 699.4 ± 591.9 mm
MeSH term(s)	Child ; End Stage Liver Disease/diagnosis ; End Stage Liver Disease/surgery ; Humans ; Liver Transplantation/adverse effects ; Retrospective Studies ; Sarcopenia/complications ; Sarcopenia/diagnosis ; Severity of Illness Index ; Waiting Lists
Language	English
Publishing date	2021-03-17
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2006866-9
ISSN	1527-6473 ; 1527-6465
ISSN (online)	1527-6473
ISSN	1527-6465
DOI	10.1002/lt.26027
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Article ; Online: Fat Soluble Vitamin Assessment and Supplementation in Cholestasis.

Kamath, Binita M / Alonso, Estella M / Heubi, James E / Karpen, Saul J / Sundaram, Shikha S / Shneider, Benjamin L / Sokol, Ronald J

Clinics in liver disease

2022 Volume 26, Issue 3, Page(s) 537–553

Abstract: Malnutrition in children with chronic cholestasis is a prevalent issue and a major risk factor for adverse outcomes. Fat soluble vitamin (FSV) deficiency is an integral feature of cholestatic disease in children, often occurring within the first months ... ...

Abstract	Malnutrition in children with chronic cholestasis is a prevalent issue and a major risk factor for adverse outcomes. Fat soluble vitamin (FSV) deficiency is an integral feature of cholestatic disease in children, often occurring within the first months of life in those with neonatal cholestasis and malnutrition. This review focuses on FSVs in cholestasis, with particular emphasis on a practical approach to surveillance and supplementation that includes approaches that account for differing local resources. The overarching strategy suggested is to incorporate recognition of FSV deficiencies in cholestatic children in order to develop practical plans for close monitoring and aggressive FSV repletion. Routine attention to FSV assessment and supplementation in cholestatic infants will reduce long periods of inadequate levels and subsequent adverse clinical sequalae.
MeSH term(s)	Child ; Cholestasis/complications ; Dietary Supplements ; Humans ; Infant ; Infant, Newborn ; Liver Diseases/complications ; Vitamins/therapeutic use
Chemical Substances	Vitamins
Language	English
Publishing date	2022-06-25
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1472315-3
ISSN	1557-8224 ; 1089-3261
ISSN (online)	1557-8224
ISSN	1089-3261
DOI	10.1016/j.cld.2022.03.011
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Article ; Online: The effect of sleep on gastrointestinal functioning in common digestive diseases.

Orr, William C / Fass, Ronnie / Sundaram, Shikha S / Scheimann, Ann O

The lancet. Gastroenterology & hepatology

2020 Volume 5, Issue 6, Page(s) 616–624

Abstract: Sleep quality and sleep disorders affect symptom manifestation and the pathogenesis of digestive diseases. Sleep is largely regulated by the light-dark cycle and associated circadian rhythms. These occurrences are closely regulated through several ... ...

Abstract	Sleep quality and sleep disorders affect symptom manifestation and the pathogenesis of digestive diseases. Sleep is largely regulated by the light-dark cycle and associated circadian rhythms. These occurrences are closely regulated through several mechanisms with direct effects on the gastrointestinal tract. Misalignment of the circadian system is a common cause of sleep complaints, which play an important role in the presentation of many gastrointestinal disorders. This Review will focus on sleep disorders and how these alterations in sleep play an important role in many commonly encountered digestive diseases, such as gastro-oesophageal reflux disease, irritable bowel syndrome, inflammatory bowel disease, and non-alcoholic fatty liver disease. Therapeutic interventions focusing on resolving sleep disorders could optimise treatment and improve quality of life in these patients.
MeSH term(s)	Biological Clocks/physiology ; Circadian Rhythm/physiology ; Gastroesophageal Reflux/metabolism ; Gastroesophageal Reflux/physiopathology ; Gastrointestinal Tract/physiology ; Gastrointestinal Tract/physiopathology ; Humans ; Inflammatory Bowel Diseases/metabolism ; Inflammatory Bowel Diseases/physiopathology ; Irritable Bowel Syndrome/metabolism ; Irritable Bowel Syndrome/physiopathology ; Non-alcoholic Fatty Liver Disease/metabolism ; Non-alcoholic Fatty Liver Disease/physiopathology ; Sleep/physiology ; Sleep Apnea, Obstructive/metabolism ; Sleep Apnea, Obstructive/physiopathology ; Sleep Wake Disorders/metabolism ; Sleep Wake Disorders/physiopathology
Language	English
Publishing date	2020-03-29
Publishing country	Netherlands
Document type	Journal Article ; Review
ISSN	2468-1253
ISSN (online)	2468-1253
DOI	10.1016/S2468-1253(19)30412-1
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Article ; Online: Decreased access to pediatric liver transplantation during the COVID-19 pandemic.

Kemme, Sarah / Yoeli, Dor / Sundaram, Shikha S / Adams, Megan A / Feldman, Amy G

Pediatric transplantation

2021 Volume 26, Issue 2, Page(s) e14162

Abstract: Background: The COVID-19 pandemic has affected all aspects of the US healthcare system, including liver transplantation. The objective of this study was to understand national changes to pediatric liver transplantation during COVID-19.: Methods: ... ...

Abstract	Background: The COVID-19 pandemic has affected all aspects of the US healthcare system, including liver transplantation. The objective of this study was to understand national changes to pediatric liver transplantation during COVID-19. Methods: Using SRTR data, we compared waitlist additions, removals, and liver transplantations for pre-COVID-19 (March-November 2016-2019), early COVID-19 (March-May 2020), and late COVID-19 (June-November 2020). Results: Waitlist additions decreased by 25% during early COVID-19 (41.3/month vs. 55.4/month, p < .001) with black candidates most affected (p = .04). Children spent longer on the waitlist during early COVID-19 compared to pre-COVID-19 (140 vs. 96 days, p < .001). There was a 38% decrease in liver transplantations during early COVID-19 (IRR 0.62, 95% CI 0.49-0.78), recovering to pre-pandemic rates during late COVID-19 (IRR 1.03, NS), and no change in percentage of living and deceased donors. White children had a 30% decrease in overall liver transplantation but no change in living donor liver transplantation (IRR 0.7, 95% CI 0.50-0.95; IRR 0.96, NS), while non-white children had a 44% decrease in overall liver transplantation (IRR 0.56, 95% CI 0.40-0.77) and 81% decrease in living donor liver transplantation (IRR 0.19, 95% CI 0.02-0.76). Conclusions: The COVID-19 pandemic decreased access to pediatric liver transplantation, particularly in its early stage. There were no regional differences in liver transplantation during COVID-19 despite the increased national sharing of organs. While pediatric liver transplantation has resumed pre-pandemic levels, ongoing racial disparities must be addressed.
MeSH term(s)	Adolescent ; COVID-19 ; Child ; Child, Preschool ; Female ; Health Services Accessibility/trends ; Healthcare Disparities/ethnology ; Healthcare Disparities/trends ; Humans ; Infant ; Infant, Newborn ; Liver Transplantation/trends ; Living Donors/statistics & numerical data ; Male ; Registries ; Retrospective Studies ; United States ; Waiting Lists/mortality
Language	English
Publishing date	2021-10-11
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	1390284-2
ISSN	1399-3046 ; 1397-3142
ISSN (online)	1399-3046
ISSN	1397-3142
DOI	10.1111/petr.14162
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Zs.A 4947: Show issues

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Article ; Online: Congenital Portosystemic Shunts: Variable Clinical Presentations Requiring a Tailored Endovascular or Surgical Approach.

Robinson, Eduardo Bent / Jordan, Gregory / Katz, Danielle / Sundaram, Shikha S / Boster, Julia / Brigham, Dania / Ladd, Patricia / Chan, Christine M / Shay, Rebecca L / Ochmanek, Emily / Annam, Aparna

JPGN reports

2023 Volume 4, Issue 1, Page(s) e279

Abstract: Congenital portosystemic shunts (CPSS) are rare developmental anomalies resulting in diversion of portal flow to the systemic circulation. These shunts allow intestinal blood to reach the systemic circulation directly, and if persistent or large, may ... ...

Abstract	Congenital portosystemic shunts (CPSS) are rare developmental anomalies resulting in diversion of portal flow to the systemic circulation. These shunts allow intestinal blood to reach the systemic circulation directly, and if persistent or large, may lead to long-term complications. CPSS can have a variety of clinical presentations that depend on the substrate that is bypassing hepatic metabolism or the degree of hypoperfusion of the liver. Many intrahepatic shunts spontaneously close by 1 year of age, but extrahepatic and persistent intrahepatic shunts require intervention by a single session or staged closure with a multidisciplinary approach. Early detection and appropriate management are important for a good prognosis. The aim of this case series is to describe the varied clinical presentations, treatment approaches, and outcomes of 5 children with CPSS at our institution. Management of these patients should involve a multidisciplinary team, including interventional radiology, surgery, hepatology, and other medical services as the patient's clinical presentation warrants. Regardless of clinical presentation, if a CPSS persists past 1-2 years of age, closure is recommended.
Language	English
Publishing date	2023-01-12
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2691-171X
ISSN (online)	2691-171X
DOI	10.1097/PG9.0000000000000279
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