Jenifer R. Lightdale

Introduction: There are currently no known biomarkers associated with the diagnosis of infant colic, a common early disorder of gut brain interaction (DGBI) that has been found to predict adverse health outcomes, including atopy, migraines and other DGBIs. Infant colic manifests as unsoothable crying and is perceived to be associated with abdominal pain, differentiating it from other crying behaviors. Prior studies have postulated it may involve microbial dysbiosis as well as immunological and neurological dysregulation. The aim of our study was to investigate the associations of cord blood biomarkers at birth with parent reports of colic and excessive crying behaviors at 6 months of age. Methods: We used available data from Project Viva a pre-birth cohort based in the greater Boston, MA area. All infants were born between 1999 and 2002. Results: Among participants with information on infant colic and cord blood biomarkers ( n = 405), we found higher trans fatty acids and an increased abundance of Gammaproteobacteria signature in cord blood from infants with colic and those with excessive crying without colic, compared to those unaffected by colic. The majority of inflammatory and immune system cord blood biomarkers previously measured, including metabolites and cytokine stimulation, showed no association with either colic or excessive crying. Discussion: This exploratory study examined cord blood biomarkers of inflammation or immune dysregulation to support the underlying mechanism of infant colic, and identified trans fatty acid levels and Gammaproteobacteria microbial signatures as possible candidate predictors. On the other hand, we also found a lack of association with most of the cord blood immune and neurological biomarkers that we assessed. In turn, we propose that colic biomarkers may be present closer to its manifestation as a clinical condition of early infancy.

Purpose of Review Defining and measuring the quality of endoscopic care is a key component of performing gastrointestinal endoscopy in children. The purpose of this review is to discuss quality metrics for pediatric gastrointestinal endoscopy and identify where additional research is needed. Recent Findings Pediatric-specific standards and indicators were recently defined by the international Pediatric Endoscopy Quality Improvement Network (PEnQuIN) working group through a rigorous guideline consensus process. Although the aim of these guidelines is to facilitate best practices for safe and high-quality gastrointestinal endoscopy in children, they highlight the pressing need to expand upon the body of evidence supporting these standards and indicators as predictors of clinically relevant outcomes. Summary In this review, we propose and discuss ideas for several high-yield research topics to engage pediatric endoscopists and promote best practices in pediatric endoscopy.

A major aim of the i2b2 (informatics for integrating biology and the bedside) clinical data informatics framework aims to create an efficient structure within which patients can be identified for clinical and translational research projects.