[Nodular antritis and Helicobacter pylori infection in children]. / Antritis nodular e infección por Helicobacter pylori en el niño.

We have studied 115 patients infected with Helicobacter pylori (HP). Endoscopic nodular antritis and histologic lymphonodular hyperplasia was noted. The frequency of nodular antritis was compared between the 115 HP patients and a HP-negative age-matched control group. Nodular antritis was observed in 70.4% of the HP-positive patients and 11.3% of the HP-negative group (p <0.001). The specificity of nodular antritis was 86.1%. A significant association was found between the existence of nodular antritis and histologic lymphonodular hyperplasia (67.9%; p < 0.001). In conclusion, the endoscopic nodular antritis is a frequent and specific finding in children with HP infection and is associated with histologic lymphonodular hyperplasia.

[Colloidal bismuth subcitrate and amoxicillin in the treatment of Helicobacter pylori infection in children]. / Tratamiento con subcitrato de bismuto coloidal más amoxicilina en la infección por Helicobacter pylori del niño.

We have analyzed the effect of treatment with colloidal bismuth subcitrate (CBS) and amoxicillin in a series of 60 children (age range: 2.9-18 years) infected by Helicobacter pylori (HP). The following results were found: clinical remission 70%; endoscopic normalization 55%; histological normalization 61.6% and HP eradication 53.3%. The improvement of histological activity (100% vs 11.7%) and histological normalization (90.6% vs 28.5%) were significantly more frequent in the HP eradicated group as compared with the persistent HP group (p < 0.001). The present study suggests that combined therapy with CBS and amoxicillin is not the most adequate treatment to eradicate HP in children and supports the role played by HP in the development of antral histologic lesions.

[Inflammatory disease of intestine in the child]. / Enfermedad inflamatoria intestinal en el niño.

We review 28 patients with IBD (14 UC and 14 CD) diagnosed in a period of eight years (1982-1990). The age at the onset of symptoms was similar in both groups (8.1-8.7 years), but the delay in diagnosis was significantly higher in CD (16.2 months). Fever, growth retardation and oral and perianal lesions were more frequent in CD. Articular, mucocutaneous and hepatic were the more usual extraintestinal manifestations. All of them were more frequent in CD. The same comment can be made with respect to the abnormal laboratory test results. Colonoscopy including histological studies was the useful diagnostic method. An increase of the incidence of IBD it has been observed.

[Primary peptic ulcer in infancy and childhood. Personal experience]. / Ulcera péptica primaria en la infancia. Nuestra experiencia.

We report a retrospective review of primary peptic ulcer peptic disease in 61 children. The follow-up period ranged from 1 month to 6 years. All cases were confirmed by endoscopic examination and related with radiological studies result. The number of ulcer peptic disease detected increased as much as the number of endoscopies were performed annually. In the last 20 patients pinch biopsies from antrum were taken looking for Campylobacter pylori, encountering 10 positives. The relation male:female were 2:1. Gastrointestinal bleeding had occurred in children below 6 years and abdominal pain was seen in older children. All of patients who had C. pylory infection had had recurrent abdominal pain. Three peptic ulcer were documented in patients with cystic fibrosis, which had the worse response to medical treatment. Others, had a satisfactory response.

[Results of the treatment of gastroesophageal reflux and peptic esophagitis using cisapride]. / Resultados del tratamiento del reflujo gastroesofágico y la esofagitis péptica con Cisapride.

Cisapride is a new prokinetic agent that acts at gastric emptying, esophagic peristalsis and the pressure of the low esophagic sphincter. In the present study we grave Cisapride for 12 weeks to 34 patients with severe pathologic gastroesophageal reflux and/or peptic esophagitis. The results show an important improvement of the clinic, pH monitoring, endoscopic and histologic alterations.

[Primary saccharose-isomaltose deficit: a 20-year case load]. / Déficit primitivo de sacarasa-isomaltasa: observaciones en veinte años.

In the last twenty years we have diagnosed 9 cases of congenital sucrase-isomaltase deficiency. In all the cases the diagnosis was made before 9 months of age and was confirmed by quantitative determination of sucrase-isomaltase activity in jejunal mucosal homogenates. Malnutrition and dehydration were frequent findings. In 3 cases there was clinical intolerance to dextrinomaltose and to glucose polymers. In the 6 cases in which were performed, abnormal breath H2 test after an oral sucrose load was found. Lactase activity was above the mean in all cases and an important decrease of maltase activity was demonstrated. The enzymatic deficiency persisted even though the clinical tolerance to sucrase improved with age.

[Value of the BUN/creatinine ratio in localizing digestive system hemorrhage in children]. / Valor del cociente BUN/creatinina (BUN/Cr) en la localización de la hemorragia digestiva del niño.

We have evaluated the usefulness of the BUN/Cr ratio in 62 children with gastrointestinal bleeding. For upper gastrointestinal hemorrhage, the calculated BUN/Cr ratios ranged from 10 to 66.6, with a mean value of 30.85. For lower gastrointestinal bleeders, the BUN/Cr ratios ranged from 12.5 to 28, with a mean value of 20.12. 18 patients with upper gastrointestinal hemorrhage had a BUN/Cr ratio greater than 30 and all patients with lower gastrointestinal hemorrhage had a ratio of less than 30. The patients with gastroduodenal peptic ulcer had the highest ratios. We concluded that the BUN/Cr ratio is useful to discriminate upper and lower bleeding sources, especially in patients with gastroduodenal ulcer.

[Experience with the impression cytology test for detecting vitamin A deficiency in children]. / Nuestra experiencia con el test de impresión citológica para detectar deficiencia de vitamina A en niños.

Impression cytology has been suggested as a relatively simple, cheap, practical and non invasive technique for documenting physiologically significant vitamin A deficiency. The vitamin A status of 41 patients was evaluated by serum retinol concentration by high power liquid chromatography (HPLC) and conjunctival impression cytology was performed on each child. All children with normal vitamin A status had normal conjunctival impression cytology. The sensibility of this method was 100%. However, in the 8 vitamin A deficient patients by impression cytology, only 6 of them showed low serum vitamin A levels. Impression cytology appears to detect preclinical vitamin A deficiency that this technique may by of potential usefulness as a screening tool for preclinical vitamin A deficiency populations.

[Disaccharidases: 25 years later]. / Disacaridasas: veinticinco años después.

This report shows, that the major factors involved were histological damage of the mucosa and the etiological diagnosis. Other factors (bacterial overgrowth, malnutrition, etc.), added to the previous referred, increase the oligosaccharidases alteration, yielding statistically significant values referring to healthy subjects. The oligosaccharidases activity were significantly decreased to referring to healthy subjects (p less than 0.001) in the IC1.o and 2.o that have not histological damage, in the DGR, IPLV and coeliac disease with AS of the mucosa and in the SPG that present APM. On the other hand, the analytical methodology with its different biochemical basis could evidence very various values and there is always important to remark the reference normal values in each laboratory.

[Acute gastroenteritis caused by rotavirus (author's transl)]. / Gastroenteritis aguda por rotavirus.

A prospective study of 87 children hospital admitted for acute gastroenteritis [AGE] with ages between 24 days and three years and a control group of 32 children with ages between six months and three years, is presented. In all cases a virological study of stools is made by electron microscopy [E/M]. In 63 percent of the 87 patients with AGE, viruses were isolated, being rotavirus the most common, 45.9 percent, a similar incidence as that found in developed countries. The clinical course and analytical findings within the groups with viral and non-viral AGE do not show significant differences. Special stress is set upon the reliability of the E/M technique on the stools for rotavirus induced AGE diagnosis, due to the good correlation with clinical data, presence of seroconversion and the finding of virus in duodenal juice. Results of intestinal biopsy in a certain group of children are shown.