AIM:To investigate the effects of percutaneous endoscopic gastrostomy(PEG) feeding on gastro-oesophageal reflux(GOR) in a group of these children using combined intraluminal pH and multiple intraluminal impedance(pH/M...AIM:To investigate the effects of percutaneous endoscopic gastrostomy(PEG) feeding on gastro-oesophageal reflux(GOR) in a group of these children using combined intraluminal pH and multiple intraluminal impedance(pH/MII) . METHODS:Ten neurologically impaired children underwent 12 h combined pH/MII procedures at least 1 d before and at least 12 d after PEG placement. METHODS:Prior to PEG placement(pre-PEG) a total of 183 GOR episodes were detected,156(85.2%) were non-acidic.After PEG placement(post-PEG) a total of 355 episodes were detected,182(51.3%) were nonacidic.The total number of distal acid reflux events statistically significantly increased post-PEG placement(prePEG total 27,post-PEG total 173,P=0.028) and themean distal pH decreased by 1.1 units.The distal reflux index therefore also significantly increased post-PEG [pre-PEG 0.25(0-2) ,post-PEG 2.95(0-40) ].Average proximal pH was lower post-PEG but the within subject difference was not statistically significant(P=0.058) . Median number of non-acid GOR,average reflux height,total acid clearance time and total bolus clearance time were all lower pre-PEG,but not statistically significant. CONCLUSION:PEG placement increases GOR episodes in neurologically impaired children.展开更多
AIM： To evaluate the prevalence of autoantibodies in chronic hepatitis C virus （HCV）-infected children focusing on thyroid autoimmunity.METHODS： We investigated the prevalence of autoantibodies in 123 chronic HCV-...AIM： To evaluate the prevalence of autoantibodies in chronic hepatitis C virus （HCV）-infected children focusing on thyroid autoimmunity.METHODS： We investigated the prevalence of autoantibodies in 123 chronic HCV-infected children before, during and after monotherapy with interferon-alpha （IFN-α） or combined treatment with interferon-α or peginterferon-α and ribavirin. Besides antibodies against smooth muscle （SMA）, nuclei （ANA）, and liver/kidney microsomes （1KM）, the incidence of antithyroid peroxidase antibodies as well as thyroid function parameters （TSH, FT3 and FT4） were determined.RESULTS： We found that 8% of children had autoantibodies before treatment. During treatment, 18% of children were found positive for at least one autoantibody; 15.5% of children developed pathologic thyroid values during IFN-α treatment compared to only one child before therapy. Six children had to be substituted while developing laboratory signs of hypothyroidism.CONCLUSION： Our data indicate a strong correlation between interferon-α treatment and autoimmune phenomena, notably the emergence of thyroid antibodies. The fact that some children required hormone replacement underlines the need of close monitoring in particularly those who respond to therapy and have to be treated for more than 6 mo.展开更多
Patients and Results. To determine the prevalence of celiac disease in patients with type 1 diabetes and investigate the clinical symptoms, we screened 183 patients with type 1 diabetes for gliadin antibodies (IgA and...Patients and Results. To determine the prevalence of celiac disease in patients with type 1 diabetes and investigate the clinical symptoms, we screened 183 patients with type 1 diabetes for gliadin antibodies (IgA and IgG) and IgA endomysium antibodies. In 14 (7.7% ), high antibody titers were found and histology confirmed celiac disease in small-bowel biopsies. Classic symptoms were present in 2. These 14 patients (11 girls, 3 boys) were 4.3 years (mean; 1.0- 10.1) old when their diabetes became manifest, 6 having been under 6. Celiac disease was diagnosed at that time or later in all but 1. Three girls also had autoimmune thyroiditis. After 1 year of gluten-free diet BMI-SD increased from 0.01 to 0.36 in 7 prepubertal children. No catch-up growth followed, and no increase in insulin dose per unit of bodyweight or change in frequency of hypoglycemic episodes. Conclusion. We find celiac disease with surprising frequency in patients with type 1 diabetes; girls with early manifestation of diabetes type 1 seem to be at high risk. Clinical symptoms can be absent, making screening essential in such patients. Long-term studies must determine the importance of gluten-free diet in silent forms of celiac disease.展开更多
文摘AIM:To investigate the effects of percutaneous endoscopic gastrostomy(PEG) feeding on gastro-oesophageal reflux(GOR) in a group of these children using combined intraluminal pH and multiple intraluminal impedance(pH/MII) . METHODS:Ten neurologically impaired children underwent 12 h combined pH/MII procedures at least 1 d before and at least 12 d after PEG placement. METHODS:Prior to PEG placement(pre-PEG) a total of 183 GOR episodes were detected,156(85.2%) were non-acidic.After PEG placement(post-PEG) a total of 355 episodes were detected,182(51.3%) were nonacidic.The total number of distal acid reflux events statistically significantly increased post-PEG placement(prePEG total 27,post-PEG total 173,P=0.028) and themean distal pH decreased by 1.1 units.The distal reflux index therefore also significantly increased post-PEG [pre-PEG 0.25(0-2) ,post-PEG 2.95(0-40) ].Average proximal pH was lower post-PEG but the within subject difference was not statistically significant(P=0.058) . Median number of non-acid GOR,average reflux height,total acid clearance time and total bolus clearance time were all lower pre-PEG,but not statistically significant. CONCLUSION:PEG placement increases GOR episodes in neurologically impaired children.
文摘AIM： To evaluate the prevalence of autoantibodies in chronic hepatitis C virus （HCV）-infected children focusing on thyroid autoimmunity.METHODS： We investigated the prevalence of autoantibodies in 123 chronic HCV-infected children before, during and after monotherapy with interferon-alpha （IFN-α） or combined treatment with interferon-α or peginterferon-α and ribavirin. Besides antibodies against smooth muscle （SMA）, nuclei （ANA）, and liver/kidney microsomes （1KM）, the incidence of antithyroid peroxidase antibodies as well as thyroid function parameters （TSH, FT3 and FT4） were determined.RESULTS： We found that 8% of children had autoantibodies before treatment. During treatment, 18% of children were found positive for at least one autoantibody; 15.5% of children developed pathologic thyroid values during IFN-α treatment compared to only one child before therapy. Six children had to be substituted while developing laboratory signs of hypothyroidism.CONCLUSION： Our data indicate a strong correlation between interferon-α treatment and autoimmune phenomena, notably the emergence of thyroid antibodies. The fact that some children required hormone replacement underlines the need of close monitoring in particularly those who respond to therapy and have to be treated for more than 6 mo.
文摘Patients and Results. To determine the prevalence of celiac disease in patients with type 1 diabetes and investigate the clinical symptoms, we screened 183 patients with type 1 diabetes for gliadin antibodies (IgA and IgG) and IgA endomysium antibodies. In 14 (7.7% ), high antibody titers were found and histology confirmed celiac disease in small-bowel biopsies. Classic symptoms were present in 2. These 14 patients (11 girls, 3 boys) were 4.3 years (mean; 1.0- 10.1) old when their diabetes became manifest, 6 having been under 6. Celiac disease was diagnosed at that time or later in all but 1. Three girls also had autoimmune thyroiditis. After 1 year of gluten-free diet BMI-SD increased from 0.01 to 0.36 in 7 prepubertal children. No catch-up growth followed, and no increase in insulin dose per unit of bodyweight or change in frequency of hypoglycemic episodes. Conclusion. We find celiac disease with surprising frequency in patients with type 1 diabetes; girls with early manifestation of diabetes type 1 seem to be at high risk. Clinical symptoms can be absent, making screening essential in such patients. Long-term studies must determine the importance of gluten-free diet in silent forms of celiac disease.
