1,721,162 research outputs found
La Mesalazina: cosa c’è di nuovo. Il punto di vista del pediatra e del gastroenterologo dell’adulto.
No full textUpdate on peptic ulcers in the pediatric age.
Full text linkBackground. Peptic ulcer disease (PUD) in children is reported worldwide, although it is relatively rare as compared with adults.
Helicobacter pylori (HP) infection is a common cause of PUD in the pediatric age. Other risk factors include the use of nonsteroidal
anti-inflammatory agents (NSAIDs), steroids, immunosuppressive drugs, and stressful events. Aim. To critically review the
evidence on epidemiology, diagnostic management, and available treatments for PUD in the pediatric age. Methods.AMEDLINE
search was performed indicating keywords as “Peptic Ulcer Disease,” “Epidemiology,” “Pediatric,” “Helicobacter pylori,” “Gastric
ulcer,” “Bulbar Ulcer,” and “Upper Gastrointestinal Bleeding.” A selection of clinical trials, systematic reviews, and meta-analyses
within the time period 2002–2012 was performed. Results. PUD in children is reported worldwide with an estimated frequency
of 8.1% in Europe and of 17.4% in the US. When the underlying cause of PUD is addressed, the prognosis is excellent. Standard
triple therapy, bismuth-based quadruple therapy, and the sequential therapy represent the current recommended treatments for
HP related ulcers. NSAIDs related ulcers are treated by stopping the causative medications and by administration of proton-pump
inhibitors or antisecretory drugs. Conclusions. PUD still represents a major concern in the paediatric age. A careful differential
diagnosis and an adequate treatment constitute an excellent prognosis
Focal nodular hyperplasia of the liver associated with portal vein agenesis: a morphological and immunohistochemical study of one case and review of the literature
No full textIperfosfatasemia alcalina transitoria in bambini sottoposti a trapianto epatico. Esperienza di due casi.
No full textThe importance of acoustic impedance measurements in middle ear pathology during acute viral respiratory illness in the first year of life.
No full text
Helicobacter pylori eradication therapy: current availabilities.
Full text linkAbstract
Background. Though Helicobacter pylori (HP) infections have progressively declined throughout most of the industrialized countries, a gradual increase in failure of HP eradication treatments is observed. Aim. To critically review evidence on the efficacy of the therapeutic availabilities for HP eradication, as yet. Methods. A selection of Clinical Trials, Systematic Reviews and Meta-analyses within the time period 2010-2012, was performed through a Medline search. Previous references were included when basically supporting the first selection. Results. An increasing rise in HP resistance rates for antimicrobial agents is currently observed. Further causes of HP treatment failure include polymorphisms of the CYP 2C19, an increased body mass index (BMI), smoking, poor compliance and re-infections. Alternative recent approaches to standard triple therapy have been attempted to increase the eradication rate, including bismuth-containing quadruple therapy, non-bismuth containing quadruple therapy, sequential therapy and levofloxacin-containing regimens. Conclusions. The main current aims should be the maintenance of a high eradication rate (>85%) of HP and the prevention of any increase in antimicrobial resistance. In the next future, the perspective of a tailored therapy could optimize eradication regimens within the different countries
The multidisciplinary health care team in the management of stenosis in Crohn's disease.
Full text linkBackground: Stricture formation is a common complication of Crohn’s disease (CD), occurring in approximately one-third of all patients with this condition. Our aim was to summarize the available epidemiology data on strictures in patients with CD, to outline the principal evidence on diagnostic imaging, and to provide an overview of the current knowledge on treatment strategies, including surgical and endoscopic options. Overall, the unifying theme of this narrative review is the multidisciplinary approach in the clinical management of patients with stricturing CD.
Methods: A Medline search was performed, using “Inflammatory Bowel Disease”, “stricture”, “Crohn’s Disease”, “Ulcerative Colitis”, “endoscopic balloon dilatation” and “strictureplasty” as keywords. A selection of clinical cohort studies and systematic reviews were reviewed.
Results: Strictures in CD are described as either inflammatory or fibrotic. They can occur de novo, at sites of bowel anastomosis or in the ileal pouch. CD-related strictures generally show a poor response to medical therapies, and surgical bowel resection or surgical strictureplasty are often required. Over the last three decades, the potential role of endoscopic balloon dilatation has grown in importance, and nowadays this technique is a valid option, complementary to surgery.
Conclusion: Patients with stricturing CD require complex clinical management, which benefits from a multidisciplinary approach: gastroenterologists, pediatricians, radiologists, surgeons, specialist nurses, and dieticians are among the health care providers involved in supporting these patients throughout diagnosis, prevention of complications, and treatment
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