Summary
Some studies suggest that Helicobacter pylori (H. pylori) infection would be a protective factor for the gastroesophageal reflux. The aim of this study was to explore this fact. A group of 72 ...children, admitted in a pediatric gastroenterology regional center in Northeast Romania, diagnosed with gastroesophageal reflux by 24‐hour continuous esophageal pH monitoring (results were interpreted using the Boix‐Ochoa score), underwent upper endoscopy with gastric biopsy to detect the presence of H. pylori by the rapid urease testing and for bacteriological and histologic examination. 19 children (26.39%) had H. pylori infection, while 53 (73.61%) did not. The grade of esophagitis was classified according to the Los Angeles classification system. Out of 47 children with esophagitis A, 16 (34.04%) had H. pylori infection, while out of the 25 children with esophagitis B, only 3 (12%) had H. pylori infection, with statistic significance (χ2 = 54.69, P << 0.05, 95% confidence interval CI). Regarding the value of the Boix‐Ochoa score, it appears that the presence of the H. pylori determines lower pH‐metry scores (F = 8.13, P = 0.0015, 95% CI). The presence of the H. pylori was not an important factor in the gastroesophageal reflux. On the other hand its relationship with esophagitis appears to be inverse ratio. The fact that the H. pylori presence is statistically greater in the grade A esophagitis could confirm the hypothesis that the bacteria would slow down the development of the esophagitis.
Celiac disease with neurologic manifestations in children Diaconu, Georgeta; Burlea, M; Grigore, Ioana ...
Revista medico-chirurgicala a Societatii de Medici si Naturalisti din Iasi,
2013 Jan-Mar, Letnik:
117, Številka:
1
Journal Article
Recenzirano
Celiac disease (CD) is an immune-mediated enteropathy triggered by the ingestion of gluten in genetically susceptible individuals and neurologic manifestations may be one of the presentations form. ...The aim of this study was to report the incidence of neurologic manifestations in children with CD.
Between 2000-2010, 48 children aged 2-18 years diagnosed with CD have been monitored. The diagnosis of CD was made by serological tests and intestinal biopsy. The study protocol included: measurement of weight and height, biological and immunological tests, histological examination, questionnaires filled out by parents about their child motor development and some neurologic signs, psychological exam, electroencephalogram, and brain CT-scan.
16 of the 48 children presented one or more neurologic symptoms as the onset manifestation of CD. The neurologic signs in order of frequency were: headache/migraine, attention-deficit/hyperactivity disorder, epileptic seizures, mental retardation, cerebellar ataxia and behavior disorders. Brain CT-scan showed cerebral calcifications in 3 patients with epilepsy, and atrophy in 2 cases with cerebellar ataxia. All children received gluten free diet, but a favorable course was noticed only in the children with migraine and epilepsy, in the other patients this diet having no influence on neurologic symptoms.
This study proved the variety of neurologic symptoms that can be included in the clinical signs of celiac disease in pediatric patients. That is why in the presence of different neurologic symptoms of unknown etiology and resistant to treatment, celiac disease must be taken into account and laboratory investigations have to include intestinal biopsy and immunological test.
Hepato-pulmonary syndrome Bozomitu, Laura; Moraru, Evelina; Stana, B ...
Revista medico-chirurgicala a Societatii de Medici si Naturalisti din Iasi,
2010 Jul-Sep, Letnik:
114, Številka:
3
Journal Article
Recenzirano
The hepato-pulmonary syndrome (HPS) is a rare complication of liver cirrhosis, with poor outcome; the term includes liver disease, increased alveolo-arterial gradient and intrapulmonary vascular ...dilations, described by Fluckiger, Kennedy and Knudson. HPS impairs survival in cirrhotic patients and the posttransplant outcome is altered in correlation with severity of HPS. Combined determination of SaO2 in clino- and orthostatic position by a pulsoximeter is a simple test for HPS identification in patients with chronic liver disease or non-cirrhotic portal hypertension.
Arachnoid cyst associated with pyloric stenosis in a young boy Diaconescu, Smaranda; Păduraru, Gabriela; Bărbuţă, O ...
Revista medico-chirurgicala a Societatii de Medici si Naturalisti din Iasi,
2010 Oct-Dec, Letnik:
114, Številka:
4
Journal Article
Recenzirano
An unusual association between an arachnoid cyst and a decompensated pyloric stenosis in a three years-old boy is presented. The little patient was admitted into hospital with haematemesis, melena, ...influenced generally condition and acute posthemorrhagic anaemia following aspirin intake for hypertermia. Specific intensive care was successful and the little patient was discharged but without an upper digestive endoscopy(parents refusal, technical reasons). After one week he returned with progressive worsening vomitings and an intracranial hypertension was suspected. CT documented an arachnoid cyst in the right middle cranial fossa and the patient is directed to the Neurosurgical Clinic where a cyst fenestration was done. Subsequent to operation the vomitings reinstaled with severe dehydration and an upper GI series showed a decompensated pyloric stenosis. He was operated on underwenting an antrectomy. Finally the child recovered with good short and long-term evolution. The coincidental presence of an intracranial congenital mass and a complicated aspirin-induced peptic ulcer in this young patient, misleaded us and in the lack of an early endoscopy an intempestive neurosurgical operation was initially done.
Authors present a case of Munchausen syndrome, a factitious disease of unknown etiology in a teenager girl aged 17. The patient has been diagnosed with Helicobacter pylori associated gastritis ...successfully treated in our clinic, with normal endoscopic aspect and negative CLO-test and microscopy at two month check-up. She has two suicide attempts, a voluntary ethylic alcohol intoxication, followed by multiple admissions into different services from our hospital (gastroenterology, cardiology, nephrology, surgery) and in other hospitals (Infectious Diseases, Neuropsychiatry). She frequently addressed to the hospital, with various complaints usually worsening after standard therapy (peregrination). The total number of hospitalizations was 34 (166 days) in 3 years. Another characteristic of the disease, „pseudologia fantastica‖, was also present; the girl told different stories about her family, about one of her friend’s death and about a rape that she was victim of. Psychological and psychiatric examination showed medium IQ, sadness, low level of self-esteem, anxiety and depression. Risk factors for the disease were identified: separation from the mother in early childhood, emotional neglect, physical and possibly sexual abuse. Psychological counseling and anti-depressive therapy were initiated, but medication has to be stopped because the girl left home and the treatment can’t be continued without an adult surveillance. The patient is lost from our evidence because she changed her residence (another behavioural pattern of the disease), but she will probably be found in the next years in the records of various adult clinical services.
The aim of this study is to evaluate the frequency of photosensitivity at patients of paediatric age diagnosed with different types of generalized idiophatic epilepsies.
We used a group of 68 ...children aged 3-18 years diagnosed: 39 patients with childhood absence epilepsy (CAE), 11 with juvenile absence epilepsy (JAE), 10 with epilepsy with grand mal on awakening (EGMA), 8 with juvenile myoclonic epilepsy (JME). EEG was recording without and with stimulation (hyperventilation, intermittent photic stimulation -IPS) after sleep deprivation. For all children with CAE absences and anormal EEG was provoked by hyperventilation and in 12 cases seizures was provoked by IPS.
At 4 patients with JAE, EEG show photosensitivity. 5 children with JME have photosensitivity and for one child opening eyes provoked polyspike-wave discharges without clinical correspondent. The EEG of patients with EGMA showed photosensitivity at 6 children. The photosensitivity is frequently associated with generalized idiophatic epilepsies (32.35%) and it is most often seen at girls (54.54%) of puberty age.
Boala de reflux gastro-esofagian (BRGE), „boala mileniului 3“, este mult mai frecvent întâlnită în practica pediatrică decât s-a crezut până în prezent. Autorii fac o incursiune scurtă în ...embriologia, anatomia, fi ziologia esofagului şi în istoria naturală a bolii pentru a explora, identifi ca şi explica mecanismele patogenice care stau la baza dezvoltării BRGE. Sunt descrise cele 3 verigi patogenice: disfuncţia sfi ncterului esofagian inferior, disfuncţia esofagiană şi disfuncţia gastrică, la care se adaugă hernia hiatală care are o relaţie patogenică specială cu BRGE.
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