RESUMO
Esophageal multiple intraluminal impedance baseline is an additional impedance parameter that was recently related to esophageal integrity. The aim of this study was to assess the relationship between mean esophageal impedance value and endoscopic findings in a large group of children. Children with symptoms of gastroesophageal reflux submitted to both endoscopy and impedance were included. Esophagitis was graded according to the Los Angeles classification. Mean impedance value was automatically calculated over 24-hour tracings. Data were adjusted for age through z-score transformation using percentiles normalized by the LMS (Lambda for the skew, Mu for the median, and Sigma for the generalized coefficient of variation) method. Nonparametric Mann-Whitney and Kruskal-Wallis tests, multiple, and stepwise regression were used. P-value <0.05 was considered as statistically significant. A total of 298 impedance tracings were analyzed. Endoscopic and histological esophagitis were detected in 30 and 29% patients, respectively. Median baseline z-score was significantly decreased both in proximal (P = 0.02) and distal (P = 0.01) esophagus in patients with endoscopic (but not histological) esophagitis. Patients with more severe esophagitis showed the lowest z-score. Bolus exposure index and the number of reflux episodes were the variables that were significantly associated with the baseline z-score. Impedance z-score is significantly decreased in infants and children with endoscopic esophagitis. Severity of esophagitis, bolus exposure index, and number of reflux episodes are factors influencing mean esophageal impedance.
Assuntos
Impedância Elétrica , Monitoramento do pH Esofágico/métodos , Refluxo Gastroesofágico , Pré-Escolar , Esofagite Péptica/diagnóstico , Esofagite Péptica/fisiopatologia , Esofagoscopia/métodos , Esôfago/fisiopatologia , Feminino , Refluxo Gastroesofágico/diagnóstico , Refluxo Gastroesofágico/fisiopatologia , Humanos , Concentração de Íons de Hidrogênio , Lactente , Masculino , Reprodutibilidade dos Testes , Estatística como AssuntoRESUMO
Acute acalculous cholecystitis (CAA) is very rare in children and it is usually related to infectious agents. We report 2 paediatric cases of CAA complicating hepatitis type A, with a favourable evolution with conservative treatment.
Assuntos
Colecistite Acalculosa/microbiologia , Colecistite Acalculosa/virologia , Hepatite A/complicações , Infecções por Serratia/complicações , Serratia liquefaciens/isolamento & purificação , Colecistite Acalculosa/diagnóstico por imagem , Colecistite Acalculosa/tratamento farmacológico , Doença Aguda , Adolescente , Antibacterianos/uso terapêutico , Criança , Feminino , Humanos , Masculino , Infecções por Serratia/diagnóstico por imagem , Infecções por Serratia/tratamento farmacológico , Resultado do Tratamento , UltrassonografiaRESUMO
Hepatitis A virus infection is usually asymptomatic in children. Classic symptomatic forms and atypical clinical manifestations are known. We report a paediatric case of hepatitis A with marked cholestasis, treated with steroids, and with an unusual prolonged course.