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1.
Artigo em Inglês | MEDLINE | ID: mdl-32740538

RESUMO

OBJECTIVES: Crohn disease (CD) can affect patient's quality of life (QOL) with physical, social, and psychological impacts. This study aimed to investigate the QOL of children with CD and its relationship with patient and disease characteristics. METHODS: Children ages from 10 to 17 years with diagnosed CD for more than 6 months were eligible to this cross-sectional study conducted in 35 French pediatric centers. QOL was assessed by the IMPACT-III questionnaire. Patient and disease characteristics were collected. RESULTS: A total of 218 children (42% of girls) were included at a median age of 14 years (interquartile range [IQR]: 13--16). Median duration of CD was 3.2 years (IQR: 1.7-5.1) and 63% of children were in clinical remission assessed by wPCDAI. Total IMPACT-III score was 62.8 (±11.0). The lowest score was in "emotional functioning" subdomain (mean: 42.8 ±â€Š11.2). Clinical remission was the main independent factor associated with QOL of children with CD (5.74 points higher compared with those "with active disease", 95% confidence interval [CI] 2.77--8.70, P < 0.001). Age of patient at the evaluation was found negatively correlated with QOL (-0.76 per year, 95% CI: -1.47 to -0.06, P = 0.009). Presence of psychological disorders was associated with a lower QOL (-9.6 points lower to those without, 95% CI: -13.34 to -5.86, P < 0.0001). Total IMPACT-III and its subdomains scores were not related to sex, disease duration, or treatments. CONCLUSIONS: These results not only confirm that clinical remission is a major issue for the QOL of patients, but also highlights the importance of psychological care.

2.
Clin Nutr ; 39(6): 1793-1798, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31427183

RESUMO

BACKGROUND & AIMS: Bone health is an important concern in patients with inflammatory bowel disease (IBD). Low bone mineral density (BMD) is a powerful predictor of fracture risk in IBD patients. Physical activity (PA) plays an important role in bone health. However, PA data for children and adolescents with IBD are scarce. The primary aim is to evaluate the relationship between PA and BMD in children with IBD. The secondary aim was to assess the relationship between PA and quality of life. METHODS: Eighty-four IBD paediatric patients (45 boys) aged 14.3 ± 2.7 years were included (disease activity: (i) remission, n = 62; (ii) mild, n = 18; (iii) severe disease, n = 1). BMD was measured using dual-energy X-ray absorptiometry and expressed as age- and sex-based Z-scores. Each patient wore a triaxial accelerometer for seven consecutive days for objective PA quantification. Quality of life was assessed using the PedsQL™ and energy intake was assessed prospectively for three days using a dietary diary. RESULTS: BMD Z-score was -0.96 ± 1.11. Only five patients (6%) fulfilled the recommendation of 60 min of daily moderate-to-vigorous PA (MVPA). The proportion of children with osteopenia and osteoporosis was 51% and 4%, respectively. After adjustment for confounders (pubertal status and body mass index), total PA and time in MVPA were positively associated with BMD (regression coefficient per one standard deviation increase in PA parameters = 0.26; P < 0.05). There was no association between time spent in MVPA and total PA, and total quality of life score. CONCLUSIONS: PA likely is associated with improved bone health in IBD children. Intervention studies investigating a causal relationship between PA and BMD in paediatric patients with IBD are warranted.

3.
Dig Liver Dis ; 51(4): 496-502, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30611597

RESUMO

BACKGROUND: Pediatric-onset Crohn's disease (CD) may represent a more severe form of disease. The aim of this study was to describe long-term outcome and identify associated risk factors of complicated behavior in a large population-based pediatric-onset CD cohort. PATIENTS AND METHODS: Cases included all patients recorded in the EPIMAD registry diagnosed with definite or probable CD between January 1988 and December 2004, under the age of 17 years at the time of diagnosis, with at least two years of follow-up. RESULTS: Five hundred and thirty-five patients were included. Median follow-up was 11.1 years [IQR, 7.3-15.0]. At the end of follow-up, 8% (n = 44) of patients had pure ileal disease (L1), 8% (n = 44) had pure colonic disease (L2), and 83% (n = 439) had ileocolonic disease (L3). L4 disease and perianal disease were observed in 42% (n = 227) and 16% (n = 85) of patients, respectively. At the end of follow-up, 58% (n = 308) of patients presented complicated disease behavior (B2, 39% and B3, 19%), and 42% (n = 163) of patients with inflammatory behavior at diagnosis had evolved to complicated behavior. During follow-up, 86% of patients (n = 466) received at least one course of corticosteroids, 67% (n = 357) of patients had been exposed to immunosuppressants and 35% (n = 187) of patients received at least one anti-TNF agent. Forty-three percent (n = 230) of patients underwent at least one intestinal resection. The overall mortality rate was 0.93% and the SMR was 1.6 [0.5-3.8] (p = 0.20). Five cancers were reported with a crude cancer incidence rate of 1.1% and an SIR of 3.3 [1.2-7.0] (p = 0.01). In a multivariate Cox model, ileal (HR, 1.87 [1.09-3.21], p = 0.022) or ileocolonic (HR, 1.54 [1.01-2.34], p = 0.042) and perianal lesions at diagnosis (HR, 1.81 [1.13- 2.89], p = 0.013) were significantly associated with complicated behavior. CONCLUSION: About 80% of patients with pediatric-onset CD presented extensive ileocolonic disease during follow-up. The majority of patients evolved to complicated behavior. Surgery, cancer and mortality were observed in 43%, 0.9% and 0.9% of patients, respectively.


Assuntos
Doença de Crohn/diagnóstico , Doença de Crohn/mortalidade , Adolescente , Corticosteroides/uso terapêutico , Idade de Início , Criança , Doença de Crohn/terapia , Progressão da Doença , Feminino , Seguimentos , França/epidemiologia , Humanos , Imunossupressores/uso terapêutico , Masculino , Análise Multivariada , Neoplasias/complicações , Modelos de Riscos Proporcionais , Sistema de Registros , Fatores de Risco , Índice de Gravidade de Doença
4.
Ann Biol Clin (Paris) ; 76(6): 681-685, 2018 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-30543193

RESUMO

The Waldmann's disease is a primitive intestinal lymphangectasia. This exsudative enteropathy initiates a protein leakage by the digestive tract. Clinically, this syndrome is characterised by oedemas and biologically by hypoprotidemia and loss of lymphocytes T CD4+, which increases a risk for infections. Here, we describe a patient's case for whom the protein loss was aggravated by a nephrotic syndrome.


Assuntos
Edema/diagnóstico , Edema/etiologia , Linfangiectasia Intestinal/complicações , Linfangiectasia Intestinal/diagnóstico , Linfedema/complicações , Linfedema/diagnóstico , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Lactente
5.
Am J Gastroenterol ; 113(2): 265-272, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28809388

RESUMO

OBJECTIVES: Few data are available to describe the changes in incidence of pediatric-onset inflammatory bowel disease (IBD). The aim of this study was to describe changes in incidence and phenotypic presentation of pediatric-onset IBD in northern France during a 24-year period. METHODS: Pediatric-onset IBD (<17 years) was issued from a population-based IBD study in France between 1988 and 2011. Age groups and digestive location were defined according to the Paris classification. RESULTS: 1,350 incident cases were recorded (8.3% of all IBD) including 990 Crohn's disease (CD), 326 ulcerative colitis (UC) and 34 IBD unclassified (IBDU). Median age at diagnosis was similar in CD (14.4 years (Q1=11.8-Q3=16.0)) and UC (14.0 years (11.0-16.0)) and did not change over time. There were significantly more males with CD (females/males=0.82) than UC (females/males=1.25) (P=0.0042). Median time between onset of symptoms and IBD diagnosis was consistently 3 months (1-6). Mean incidence was 4.4/105 for IBD overall (3.2 for CD, 1.1 for UC and 0.1 for IBDU). From 1988-1990 to 2009-2011, a dramatic increase in incidences of both CD and UC were observed in adolescents (10-16 years): for CD from 4.2 to 9.5/105 (+126%; P<0.001) and for UC, from 1.6 to 4.1/105 (+156%; P<0.001). No modification in age or location at diagnosis was observed in either CD or UC. CONCLUSIONS: In this population-based study, CD and UC incidences increased dramatically in adolescents across a 24-year span, suggesting that one or more strong environmental factors may predispose this population to IBD.


Assuntos
Colite Ulcerativa/epidemiologia , Doença de Crohn/epidemiologia , Adolescente , Criança , Feminino , França/epidemiologia , Humanos , Incidência , Doenças Inflamatórias Intestinais/epidemiologia , Masculino
6.
Acta Paediatr ; 106(12): 2025-2030, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28667775

RESUMO

AIM: This French study assessed a quick, noninvasive, immuno-chromatographic, Helicobacter pylori (H. pylori) stool antigen test for detecting infections in children. METHODS: We enrolled 158 children, with a median age of 8.5 years (range eight months to 17 years), with digestive symptoms suggesting upper gastrointestinal tract disease. Upper digestive endoscopy was performed with gastric biopsy specimens for histology, a rapid urease test, culture test and quantitative real-time polymerase chain reaction. The H. pylori stool antigen test was performed twice for each child and the results were compared to the reference method. RESULTS: The reference methods showed that 23 (14.6%) of the 158 children tested were H. pylori positive. The H. pylori stool antigen test showed 91.3% sensitivity, with a 95% confidence interval (95% CI) of 86.9-95.6 and 97% specificity (95% CI 94.3-99.6), 30.84 positive likelihood ratio and 0.09 negative likelihood ratio. The test accuracy was 96.2% (95% CI 93.2-99.1). The two blinded independent observers produced identical H. pylori stool antigen test results and the Kappa coefficient for the H. pylori stool antigen test was one. CONCLUSION: The H. pylori stool antigen test was found to be a consistent, reliable, quick and specific test for detecting the H. pylori infection in children.


Assuntos
Antígenos de Bactérias/análise , Cromatografia de Afinidade/métodos , Fezes/química , Infecções por Helicobacter/diagnóstico , Helicobacter pylori/imunologia , Helicobacter pylori/isolamento & purificação , Adolescente , Criança , Pré-Escolar , Feminino , Infecções por Helicobacter/imunologia , Infecções por Helicobacter/microbiologia , Humanos , Lactente , Masculino , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Fatores de Tempo
7.
J Pediatr Gastroenterol Nutr ; 60(6): 744-8, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26000887

RESUMO

OBJECTIVES: The objective of the present study was to evaluate the effectiveness and safety of adalimumab (ADA) in children with Crohn disease (CD) who experienced infliximab (IFX) failure at the population level. METHODS: The present retrospective study included all of the children with CD from a pediatric-onset population-based cohort who received ADA before 18 years because of IFX failure or intolerance. Efficacy of ADA was evaluated using the physician's global assessment score, C-reactive protein and orosomucoid, and nutritional and growth indicators. RESULTS: A total of 27 children with CD received ADA. Median age at CD diagnosis and at ADA initiation was 11 years (Q1 = 9; Q3 = 12) and 15 years (12; 15), respectively. After a median follow-up of 16 (8; 26) months after ADA initiation, ADA had clinical benefit as measured by the physical global assessment score in 19 patients (70%). Cumulative probability of failure to ADA treatment was 38% at 6 months and 55% at 1 year. Eight patients had a primary failure (30%) and 5 of 19 (26%) a secondary failure to ADA. Furthermore, 11 patients (40%) experienced a total of 19 adverse effects. No serious adverse effects were observed and none resulted in ADA discontinuation. There was no significant change in growth and nutritional patterns during the study period, but we found a significant decrease in median C-reactive protein (15 mg/L [4; 44] vs 9 mg/L [3; 19]; P = 0.05) and orosomucoid (1.6 g/L [1.5; 2.6] vs 1.1 g/L [0.8; 1.9]; P = 0.001) from ADA initiation to maximal follow-up in patients responding to ADA. CONCLUSIONS: In the present population-based cohort of pediatric-onset CD with IFX failure, treatment with ADA was safe and effective in two-thirds of patients.


Assuntos
Adalimumab/uso terapêutico , Doença de Crohn/tratamento farmacológico , Doença de Crohn/fisiopatologia , Infliximab/administração & dosagem , Adalimumab/administração & dosagem , Adalimumab/efeitos adversos , Adolescente , Anticorpos Monoclonais/administração & dosagem , Anticorpos Monoclonais/efeitos adversos , Anticorpos Monoclonais/uso terapêutico , Proteína C-Reativa/análise , Criança , Desenvolvimento Infantil/efeitos dos fármacos , Doença de Crohn/sangue , Esquema de Medicação , Feminino , Seguimentos , Humanos , Infliximab/uso terapêutico , Masculino , Estado Nutricional/efeitos dos fármacos , Orosomucoide/análise , Indução de Remissão/métodos , Estudos Retrospectivos , Fatores de Tempo , Falha de Tratamento , Resultado do Tratamento
8.
J Pediatr Gastroenterol Nutr ; 61(3): 307-12, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25793904

RESUMO

OBJECTIVES: The aim of the study was to assess the usefulness of gastric biopsy-based quantitative real-time polymerase chain reaction (qPCR) for the detection of Helicobacter pylori infection and the identification of clarithromycin-resistant strains in children. METHODS: A gastric biopsy-based qPCR for the detection of H pylori infection and the identification of clarithromycin-resistant strains in children was evaluated in 62 children with infection and 341 children without infection. H pylori infection was considered by the "reference method" when culture was positive for both histology and rapid urease test (RUT). Results were compared with those obtained using the qPCR. RESULTS: The reference method versus H pylori qPCR positivity showed 95% confidence interval sensitivity 100% versus 100%, specificity 93.2% (86.9-99.4) versus 100%, positive predictive value 59.7% (47.4-71.9) versus 100%, negative predictive value 100% versus 100%, and, finally, test accuracy of 59.6% (47.3-71.8) versus 100%. Sixty-two children were found to be H pylori positive, based on the qPCR results. Among those, 31 children had both positive qPCR and culture with concordant antimicrobial susceptibility testing results, whereas 31 children had negative culture and positive qPCR. The qPCR showed a bacterial load ≥10 copies per milliliter when culture, histology, and RUT were all positive (29/31 children) versus <10 copies per milliliter when culture, histology, and RUT were all negative (25/31 children). Grades 2 and 3 histological gastritis were associated with a bacterial load ≥10 copies per milliliter for 28/35 of children versus 27/27 of grade 0 to 1 <10 copies per milliliter. CONCLUSIONS: H pylori qPCR positivity is a more precise test than the routine culture, histology, RUT alone and allows detecting low bacterial loads.


Assuntos
Carga Bacteriana/métodos , Mucosa Gástrica/microbiologia , Infecções por Helicobacter/diagnóstico , Helicobacter pylori/isolamento & purificação , Reação em Cadeia da Polimerase em Tempo Real/métodos , Adolescente , Carga Bacteriana/estatística & dados numéricos , Biópsia , Criança , Pré-Escolar , DNA Bacteriano/análise , Feminino , Mucosa Gástrica/patologia , Gastrite/microbiologia , Infecções por Helicobacter/microbiologia , Helicobacter pylori/efeitos dos fármacos , Helicobacter pylori/fisiologia , Humanos , Lactente , Masculino , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Urease/análise
9.
Am J Gastroenterol ; 108(10): 1647-53, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23939626

RESUMO

OBJECTIVES: Although the incidence of pediatric inflammatory bowel disease (IBD) continues to rise in Northern France, the risks of death and cancer in this population have not been characterized. METHODS: All patients <17 years, recorded in EPIMAD registry, and diagnosed between 1988 and 2004 with Crohn's disease (CD) or ulcerative colitis (UC) were included. The observed incidences of death and cancer were compared with those expected in the regional general population obtained by French Statistical Institute (INSEE) and the cancer Registry from Lille. Comparisons were performed using Fisher's exact test and were expressed using the standardized mortality ratios (SMRs) and standardized incidence ratios. RESULTS: A total of 698 patients (538 with CD and 160 with UC) were identified; 360 (52%) were men, the median age at IBD diagnosis was 14 years (12-16) and the median follow-up time was 11.5 years (7-15). During follow-up, the mortality rate was 0.84% (6/698) and did not differ from that in the reference population (SMR=1.4 (0.5-3.0); P=0.27). After a median follow-up of 15 years (10-17), 1.3% of patients (9/698) had a cancer: colon (n=2), biliary tract (cholangiocarcinoma; n=1), uterine cervix (n=1), prepuce (n=1), skin (basal cell carcinoma (n=2), hematological (acute leukemia; n=1), and small bowel carcinoid (n=1). There was a significantly increased risk of cancer regardless of gender and age (standardized incidence ratio=3.0 (1.3-5.9); P<0.02). Four out of nine patients who developed a cancer had received immunosuppressants or anti-tumor necrosis factor-α therapy (including combination therapy in three patients). CONCLUSIONS: In this large pediatric population-based IBD cohort, mortality did not differ from that of the general population but there was a significant threefold increased risk of neoplasia.


Assuntos
Colite Ulcerativa/mortalidade , Doença de Crohn/mortalidade , Neoplasias/epidemiologia , Sistema de Registros , Adolescente , Neoplasias do Sistema Biliar/epidemiologia , Tumor Carcinoide/epidemiologia , Carcinoma Basocelular/epidemiologia , Causas de Morte , Criança , Pré-Escolar , Colangiocarcinoma/epidemiologia , Neoplasias do Colo/epidemiologia , Feminino , Seguimentos , França/epidemiologia , Humanos , Incidência , Neoplasias Intestinais/epidemiologia , Leucemia/epidemiologia , Masculino , Neoplasias Penianas/epidemiologia , Fatores de Risco , Neoplasias Cutâneas/epidemiologia , Neoplasias do Colo do Útero/epidemiologia
10.
J Pediatr Gastroenterol Nutr ; 53(3): 271-4, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21865973

RESUMO

OBJECTIVE: The association of adrenocorticotropic hormone (ACTH) insensitivity with achalasia and alacrimia (Allgrove syndrome, 3A) constitutes a rare multisystem disorder. Its evolution is not well known. The aim of this study was to describe clinical and esophageal manometric characteristics and outcomes in Allgrove syndrome. PATIENTS AND METHODS: This multicenter retrospective study compared clinical and manometric characteristics at diagnosis and on follow-up of 9 children presenting with 3A (mean age at diagnosis 7.1 years) with those of 9 children with idiopathic achalasia (IA) (mean age at diagnosis 8.3 years). RESULTS: At the time of diagnosis, 3 children with 3A presented with no digestive or respiratory signs because they were identified during a family screening; 1 remained asymptomatic 8 years later. ACTH levels were high in patients with 3A. All of the patients with IA were symptomatic at diagnosis. No significant difference was observed when comparing any of the manometric parameters of the first esophageal manometry of 3A with those of IA. Seven children with 3A were operated on using the Heller procedure, completed by pneumatic esophageal dilation in 2 of these 7. One patient with 3A was treated only by nifedipine. Failure of treatment was observed in 3 children with 3A and 1 child with IA, partial success in 4 with 3A and 1 with IA, and total success in 2 with 3A and 7 with IA (P < 0.03). Control manometry showed that in the 3A group, partial success after surgery was always associated with abnormally low or normal lower esophageal sphincter (LES) pressure, whereas failure after surgery was associated with high LES pressure. CONCLUSIONS: Our data showed that 3A presented a more severe course than IA despite presymptomatic diagnosis in cases of family screening. The high LES pressure noted in some patients with 3A is suggestive of a peculiar pattern in 3A affecting the LES and the lower part of the esophagus.


Assuntos
Insuficiência Adrenal/fisiopatologia , Acalasia Esofágica/fisiopatologia , Manometria/métodos , Criança , Pré-Escolar , Esfíncter Esofágico Inferior/fisiopatologia , Feminino , Seguimentos , Humanos , Masculino , Estudos Retrospectivos
11.
J Pediatr Gastroenterol Nutr ; 53(3): 296-302, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21865978

RESUMO

OBJECTIVE: To retrospectively assess, in a pediatric multicenter cohort, guidelines for the management of familial adenomatous polyposis (FAP). METHODS: Ten centers from the French-speaking Pediatric Gastroenterology Hepatology and Nutrition Group provided follow-up data on patients up to 18 years of age. Clinical records, genetic test results, endoscopy with histopathology examination, and therapeutic modalities were reviewed. RESULTS: A total of 70 children from 47 families were included. When initial consultation resulted from a surveillance program because of an affected family member, 12 of 59 children were already symptomatic. Among 11 patients whose initial consultation was based only on symptoms, families were unaware at the time of a familial FAP history for 7 children, whereas only 4 cases were sporadic. A panel of 27 different pathogenic adenomatous polyposis coli (APC) germ-line mutations and large genomic deletions were identified in 43 families. Extracolonic manifestations were found in half of the patients. As part of the standard practice for initial screening, the entire cohort underwent colonoscopy, which revealed adenoma above an intact rectosigmoid in 8 cases. Prophylactic colectomy was performed in 42 cases; high-grade dysplastic adenoma and 1 invasive carcinoma were detected in 6 children. For timing of surgery, indications were in accordance with recent international guidelines. CONCLUSIONS: Defining optimal screening and therapeutic modalities in pediatric FAP cohorts is a challenge. Specific advice for genetic screening, endoscopy surveillance, and type of surgery based on recent guidelines is recommended.


Assuntos
Polipose Adenomatosa do Colo/genética , Polipose Adenomatosa do Colo/patologia , Polipose Adenomatosa do Colo/cirurgia , Criança , Colectomia , Colonoscopia , Estudos de Avaliação como Assunto , Feminino , Seguimentos , Genes APC , Estudos de Associação Genética , Mutação em Linhagem Germinativa , Humanos , Masculino , Guias de Prática Clínica como Assunto , Estudos Retrospectivos , Inquéritos e Questionários
12.
Diagn Microbiol Infect Dis ; 59(2): 217-22, 2007 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17662555

RESUMO

The yearly prevalence between 1994 and 2005 of primary resistance to amoxicillin, metronidazole, and clarithromycin of 377 Helicobacter pylori strains isolated from children was studied. All the H. pylori strains were susceptible to amoxicillin, 138/377 (36.7%) were resistant to metronidazole, 86/377 (22.8%) to clarithromycin, and 30/377 (7.9%) to both metronidazole and clarithromycin. Over the entire period, resistance to clarithromycin did not change, whereas metronidazole resistance decreased significantly from 43.3% (1994-1998) to 32% (1999-2005), P = 0.001.


Assuntos
Amoxicilina/farmacologia , Antibacterianos/farmacologia , Claritromicina/farmacologia , Farmacorresistência Bacteriana , Helicobacter pylori/efeitos dos fármacos , Metronidazol/farmacologia , Adolescente , Criança , Pré-Escolar , Feminino , França/epidemiologia , Infecções por Helicobacter/epidemiologia , Infecções por Helicobacter/microbiologia , Helicobacter pylori/genética , Humanos , Masculino , Testes de Sensibilidade Microbiana , Fatores de Tempo
13.
Presse Med ; 34(5): 373-7, 2005 Mar 12.
Artigo em Francês | MEDLINE | ID: mdl-15859573

RESUMO

INTRODUCTION: A rare genetic disease (with around a hundred cases in France), fibrodysplasia ossificans progressiva is characterized by heterotopic ossification and congenital malformation of the bones. It is worsened by physical trauma, progresses in successive flares and slowly results in total confinement of the children because of the calcification of the muscles and ankylosis of all the joints. OBSERVATIONS: We report the case of two children exhibiting fibrodysplasia ossificans progressiva in whom diagnosis was delayed at the age of 4 and 18 months respectively. DISCUSSION: Fibrodysplasia ossificans progressiva must be diagnosed during the neonate period. Early treatment will help to avoid the factors of aggravation, slow the progression of the disease and provide the children with improved quality of life. Unfortunately, there is no efficient treatment, bisphosphonates and corticosteroids are only beneficial during the flares. Hope for the future relies on gene therapy.


Assuntos
Miosite Ossificante/complicações , Miosite Ossificante/diagnóstico , Acidentes por Quedas , Anti-Inflamatórios/uso terapêutico , Pré-Escolar , Diagnóstico Precoce , Feminino , Humanos , Metilprednisolona/uso terapêutico , Miosite Ossificante/terapia , Modalidades de Fisioterapia , Qualidade de Vida
14.
Pediatrics ; 115(1): 17-21, 2005 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-15629976

RESUMO

OBJECTIVES: To assess symptoms associated with Helicobacter pylori infection in children presenting with nonulcer dyspepsia (NUD). STUDY DESIGN: A prospective double-blind study was conducted between March 2001 and April 2002 in children at least 6 years old with NUD who had been referred for upper gastrointestinal endoscopy for epigastric pain. A standardized questionnaire was administered blindly by a pediatric gastroenterologist. This questionnaire characterized epigastric pain and associated factors. Infection was confirmed by positive culture and histologic examination of the gastric mucosa. RESULTS: From 100 children enrolled, 26 proved infected (12 female, 14 male; mean age: 11.4 +/- 2.6 years), and 74 were noninfected (44 female, 30 male; mean age: 10.4 +/- 3.1 years). There were no differences in age or symptom characteristics between groups except for epigastric pain during meals that was more frequent in noninfected than in infected children (25.6% vs 3.8%). CONCLUSION: There were no specific characteristics of symptoms in nonulcer-dyspeptic H pylori-infected children as compared with noninfected children.


Assuntos
Dispepsia/complicações , Dispepsia/microbiologia , Infecções por Helicobacter/complicações , Helicobacter pylori , Dor/etiologia , Adolescente , Criança , Método Duplo-Cego , Esofagite/etiologia , Feminino , Infecções por Helicobacter/etnologia , Infecções por Helicobacter/patologia , Humanos , Masculino , Medição da Dor , Estudos Prospectivos , Fatores Socioeconômicos , Inquéritos e Questionários
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