1,721,024 research outputs found
Helicobacter pylori infection in childhood
No full textThe incidence of H. pylori infection in children of western countries is low: in England and Italy it is about 7 %, but in developing countries it is more common. Primary gastritis and peptic ulcer are growing problems in pediatrics. H pylori is found in gastric antrum of 32 % to 62 % of children with recurrent abdominal pain. Studies on families of infected children show a 73 to 78 % infection rate in parents and siblings. The intrafamilial clustering of the infection suggests that person-to-person transmission, and reinfection after eradication is likely in children. Serum Pepsinogen I levels are related to severity of antral inflammation and decrease after eradication. Antral nodularity is a peculiar endoscopic picture in children. At histology gastritis is usually superficial and chronic without mucosal atrophy, it is « active » in one third of children and seems to be an early stage of the disease. The most common symptom is recurrent abdominal pain, frequently associated with recurrent vomiting or diarrhea, mimicking gastro-esophageal reflux, or irritable bowel syndrome. Symptoms are less severe in older children. Monotherapy with a single antimicrobial drug or H2 antagonists are ineffective to eradicate the infection or to prevent peptic ulcer relapse, whereas eradication rates after double therapy are higher than in adults. © 1991 Springer-Verlag
Eosinophilic oesophagitis in children: responders and non-responders to swallowed fluticasone
No full textEosinophilic Oesophagitis (EO) is characterised by large numbers of eosinophils in oesophageal mucosa in response to food or inhaled antigens. Treatment with elimination diet or corticosteroids lead to improvement in some children, but their efficacy is not optimal.
AIM:
of this study is to identify clinical, endoscopic and/or histological features associated with response to treatment with swallowed fluticasone propionate.
PATIENTS AND METHODS:
In the last 12 years 34 children (M/F 25/9) with EO were treated with fluticasone propionate spray 250 μg/puff by inhaler without spacer, three puffs three times a day for 6 weeks, and returned for a follow-up endoscopy. At histology 25 of them were found to be responders to therapy (73.5%) and 9 were non-responders. Anthropometric characteristics, symptoms at presentation, endoscopic and histological data at baseline between responders and non-responders were compared.
RESULTS:
Age, sex, height, duration and type of main symptom at presentation, type of allergy and number of allergens, peripheral eosinophil counts an serum IgE were similar in responders and non-responders. At baseline histology findings responders had a more severe inflammation: median peak eosinophils/high power field was higher (76 vs 44 in non responders p=0.04), eosinophilic microabscesses were present in a significantly higher number of responders (p=0.04) and peak mast cells/ high power field was significantly higher (p=0.001).
CONCLUSIONS:
Clinical characteristics of children with EO at baseline were similar in responders and non-responders, but a more severe inflammation in oesophageal mucosa was associated with a higher response rate to fluticasone treatment
Age-related increase of Helicobacter pylori frequency in symptom-free and in dyspeptic children
No full textAge-related increase of Helicobacter pylori frequency in symptom-free and in dyspeptic childre
Diagnostic tests for childhood Helicobacter pylori infection: invasive, noninvasive or both?
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Delayed-release oral suspension of omeprazole for the treatment of erosive esophagitis and gastroesophageal reflux disease in pediatric patients: a review
No full textAlice Monzani, Giuseppina Oderda1Department of Pediatrics, Università del Piemonte Orientale, Novara, ItalyAbstract: Omeprazole is a proton-pump inhibitor indicated for gastroesophageal reflux disease and erosive esophagitis treatment in children. The aim of this review was to evaluate the efficacy of delayed-release oral suspension of omeprazole in childhood esophagitis, in terms of symptom relief, reduction in reflux index and/or intragastric acidity, and endoscopic and/or histological healing. We systematically searched PubMed, Cochrane and EMBASE (1990 to 2009) and identified 59 potentially relevant articles, but only 12 articles were suitable to be included in our analysis. All the studies evaluated symptom relief and reported a median relief rate of 80.4% (range 35%–100%). Five studies reported a significant reduction of the esophageal reflux index within normal limits (<7%) in all children, and 4 studies a significant reduction of intra-gastric acidity. The endoscopic healing rate, reported by 9 studies, was 84% after 8-week treatment and 95% after 12-week treatment, the latter being significantly higher than the histological healing rate (49%). In conclusion, omeprazole given at a dose ranging from 0.3 to 3.5 mg/kg once daily (median 1 mg/kg once daily) for at least 12 weeks is highly effective in childhood esophagitis.Keywords: proton pump inhibitors, children, ranitidine, H2-blocker
Saliva antibodies to Helicobacter pylori antigens measured by western-blotting children before and after treatment.
No full textHelicobacter pylori: its role in gastric disease
No full textHelicobacter pylori: its role in gastric diseas
Short stature and Helicobacter pylori infection in Italian children: prospective multicentre hospital based case-control study.
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