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INTRODUCTION: Depression is a highly prevalent mental illness that is associated with high rates of morbidity and functional impairment. At the psychiatric unit of the University Hospital of Strasbourg, France, we have developed an open group that combines psychoeducation and cognitive-behavior therapy (CBT), the information, discovery, exchange and mobilization for depression group (IDEM-depression). IDEM-depression is composed of 17 thematic, structured, and independent sessions, which address different aspects of depression (i.e., rumination, pharmacological treatments). Because of its flexible format, patients with varying degrees of depression severity (from remission up to severe depressive symptoms) and whose depression might be bipolar or unipolar, are able to participate in the group. Thus, the group is well suited to a large number of patients with major depression. In the present study we aimed at describing the IDEM-depression group and presenting results regarding patients' overall satisfaction, assessed via two self-report questionnaires (the Client Satisfaction Questionnaire, the CSQ-8, and the IDEM ad hoc questionnaire), as well as its effect on mood following each session assessed via a visual analog scale (VAS) ranging from 0 up to 100. METHOD: Sixty-five patients participated in 50 sessions of the IDEM-depression group in two hospitals in Alsace. 61% of the patients had bipolar disorder, and 41% of them were inpatients. Sessions took place on a weekly basis, lasted 2hours and were proposed by a CBT-trained clinical psychologist. Patients were asked to fill-out the VAS at the beginning and at the end of each session. Moreover, they were asked to fill-out the CSQ-8 and the IDEM ad hoc questionnaire when they left the group. Other than one session ("yoga and mindfulness"), all the sessions (16 out of 17) were structured on a Powerpoint© presentation. During the first hour information was given regarding the topic (i.e., rumination), and a shared CBT conceptualization of the topic was formulated by the participants and the psychologist. For most sessions, the first hour was therefore communication and information-based, whereas during the second hour participants were asked to participate in in-session behavioral experiments and/or to evaluate specific aspects of their behavior (thoughts, emotions, activity, mindful behavior) during the last few days. The therapist manual and the slides for each session are available via e-mail to the first author. RESULTS: Regarding the results, self-reported mood on the VAS was compared between the onset (225 VAS) and the end (225 VAS) of each session. Overall, results suggest that self-reported mood is significantly improved following the participation in sessions (t=-5. 87, P<0.001). Moreover, mean results on the CSQ-8 suggest that patients are highly satisfied with the group (M=24.46, SD=6.42). Among them, 82% reported a moderate-high satisfaction with the group. On the IDEM ad hoc questionnaire, patients reported an overall high satisfaction level regarding (i) the content of sessions, (ii) the duration of sessions, (iii) the frequency of sessions, (iv) how much they felt they could express themselves during sessions. In the qualitative comments of this questionnaire, patients reported that the group helped them to gain an understanding of the mechanisms involved in depression; to feel less isolated and guilty; and to learn about specific psychotherapeutic tools (i.e., mindfulness) and to try to implement them. CONCLUSION: Our results suggest that an IDEM-depression group is well suited to a wide-array of clinical pictures associated with depression (varying severity, bipolar or unipolar, inpatients and outpatients). This is probably due to its open-group format which is particularly well-adapted to the dynamic symptomatology associated with major depression, and may stimulate decentering in patients who have different levels of severity of symptoms but participate in the same session. Moreover, its impact on mood improvement, and the high satisfaction level reported by patients, seem to be related to its CBT and psychoeducation-based content on the one hand, which has shown its efficacy in depression. On the other hand, IDEM's structured open-group format might have also contributed to the improvement in mood and the overall good satisfaction reported by patients, through the social support provided by the group, improved feeling of self-efficiency, and its effect on stigmatization. Thus, IDEM-depression group is an efficacious, flexible, low-cost, and easy to implement (in different clinical settings) psychotherapeutic option for major depression.
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Terapia Cognitivo-Comportamental/métodos , Transtorno Depressivo/terapia , Educação de Pacientes como Assunto/métodos , Adulto , Idoso , Transtorno Bipolar/psicologia , Transtorno Bipolar/terapia , Terapia Combinada , Feminino , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Atenção Plena/métodos , Pacientes Ambulatoriais , Satisfação do Paciente , Escalas de Graduação Psiquiátrica , Inquéritos e Questionários , Adulto JovemRESUMO
OBJECTIVE: This paper examines whether atypical depression is still a valid entity as a diagnosis subtype in the light of publications with most recent antidepressants. METHOD: First, we present the origins of the diagnosis sub-specification of atypical depression, which is based on a different drug response to tricyclic antidepressants and mono amino oxydase inhibitors. Secondly, we discuss the different definitions that can be found for the terms of atypical depression. We present more specifically the definition of atypical depression as it is described in the DSM-IV, with its most important criterion: mood reactivity. Then we present a review of scientific publications questioning atypical depression validity as a clinical syndrome (based on medline researches). We will see whether this diagnosis is still relevant with the latest drugs used to treat mood disorders. A special focus is made on the link between atypical depression and bipolar disorder, based on Benazzi's work. RESULTS: Most of publications confirm that atypical depression is a valid syndrome regarding first antidepressants clinical trials. Nevertheless, more studies with the latest antidepressants and atypical antipsychotics are needed to confirm this hypothesis. The link between atypical depression and bipolar disorders seems to be quite strong although it requires further investigations. DISCUSSION: There are very few double-blind drug trials focusing on atypical depressions and results need to be confirmed by trials with new drugs. Moreover, we regret that there are no studies including cerebral imagery. More studies are also needed on neurobiology and psychotherapy specificity. CONCLUSION: Atypical depression is still a useful concept, because of its specific clinical presentation, evolution and treatments, even if more studies should be done. Atypical depression could also be useful to diagnose more easily some bipolar disorders and should help clinicians to focus more on suicidal risks and addiction evaluation for these patients, considering the mood reactivity and the link with bipolar disorder. To conclude, we propose that atypical depression should still figure in the future DSM-V for these different reasons.
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Afeto/efeitos dos fármacos , Antidepressivos Tricíclicos/efeitos adversos , Antidepressivos Tricíclicos/uso terapêutico , Antidepressivos/efeitos adversos , Antidepressivos/uso terapêutico , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/tratamento farmacológico , Inibidores da Monoaminoxidase/efeitos adversos , Inibidores da Monoaminoxidase/uso terapêutico , Inibidores Seletivos de Recaptação de Serotonina/efeitos adversos , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico , Transtorno Bipolar/classificação , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/psicologia , Transtorno Depressivo/classificação , Transtorno Depressivo/psicologia , Diagnóstico Diferencial , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Síndrome , Resultado do TratamentoRESUMO
AIM: This study aimed to test the efficacy of mesalazine in maintaining remission in pediatric Crohn's disease (CD) following successful flare-up treatment. METHODS: In this double-blind, randomized, placebo-controlled trial, 122 patients received either mesalazine 50mg/kg per day (n=60) or placebo (n=62) for one year. Treatment allocation was stratified according to flare-up treatment (nutrition or medication alone). Recruitment was carried out over two periods, as the first period's results showed a trend favoring mesalazine. Relapse was defined as a Harvey-Bradshaw score more than or equal to 5. Time to relapse was analyzed using the Cox model. RESULTS: The one-year relapse rate was 57% (n=29) and 63% (n=35) in the mesalazine and placebo groups, respectively. We demonstrated a twofold lower relapse risk (P<0.02) in patients taking mesalazine in the medication stratum (first recruitment period), and a twofold higher risk in patients taking mesalazine in the nutrition stratum (second recruitment period), compared with the other groups. None of the children's characteristics, which differed across the two recruitment periods, accounted for the between-period variation in mesalazine efficacy. One serious adverse event was reported in each treatment group. CONCLUSION: Overall, mesalazine does not appear to be an effective maintenance treatment in pediatric CD.
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Anti-Inflamatórios não Esteroides/uso terapêutico , Doença de Crohn/tratamento farmacológico , Mesalamina/uso terapêutico , Criança , Método Duplo-Cego , Feminino , Humanos , Masculino , Prevenção Secundária , Resultado do TratamentoRESUMO
We report on a child presenting with Anderson's disease. Acanthocytes ("spur cells") were observed on the blood smear, in accordance to the diagnosis. The defect in lipid metabolism lead to changes in erythrocyte's membrane composition. We insist on morphological differences between acanthocytes and echinocytes (both are deformed erythrocytes), regarding separate clinical diagnosis.
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Acantócitos , Glicemia/análise , Transtornos do Metabolismo dos Lipídeos , Fatores Etários , Criança , Quilomícrons/sangue , Eritrócitos Anormais , Feminino , Seguimentos , Humanos , Lactente , Transtornos do Metabolismo dos Lipídeos/sangue , Transtornos do Metabolismo dos Lipídeos/diagnóstico , Transtornos do Metabolismo dos Lipídeos/genética , Transtornos do Metabolismo dos Lipídeos/metabolismo , Mutação , Síndrome , Fatores de TempoRESUMO
UNLABELLED: Hypervitaminosis A is an unusual cause of infant hypercalcemia. The way it occurs can be very surprising, as one can notice from the following case report. CASE REPORTS: A three-year-old boy, presenting important behavioral disorders, was hospitalized because of a deterioration of his general state of health associated with vomiting, cephalgias, fever and cutaneous abnormalities. A 168 mg/L hypercalcemia was found. The only etiology is a deviant consumption of vitamin A within the framework of an "autistic diet": 100000 UI/d during three months, and then 150000 UI/d the three following months. Intoxication was confirmed by the increased vitamin A plasmatic level, and vitamin A/RBP molar ratio and by the presence of plasmatic retinyl palmitate. An emergency treatment by rehydration, biphosphonates and furosemide led to effective calcemia normalization. CONCLUSION: In the case of nonobvious causes of hypercalcemia, a thorough cross-examination must look for vitamin A intoxication. Our observation illustrates the danger of certain diets suggested for autistic children.
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Transtorno Autístico/diagnóstico , Hipercalcemia/etiologia , Hipervitaminose A/diagnóstico , Transtorno Autístico/sangue , Transtorno Autístico/complicações , Pré-Escolar , Humanos , Hipervitaminose A/sangue , Hipervitaminose A/complicações , Masculino , Hormônio Paratireóideo/sangueRESUMO
Ulcerative colitis (UC) is a chronic inflammatory condition. Its incidence is 0.8 per 100,000 children per year and median age at diagnosis is 14.1 years in the pediatric population. Extradigestive manifestations are frequent in inflammatory bowel disease (IBD), but neurologic disorders are rarely associated. We report the case of a 14-year-old boy who was diagnosed with UC and thereafter autoimmune hepatitis with primary sclerosing cholangitis. Two months later, he also developed myasthenia gravis, another autoimmune disease. Physicians should be aware of the possibility of an association between several autoimmune diseases in patients with IBD in order to improve disease outcomes.
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Colite Ulcerativa/complicações , Miastenia Gravis/complicações , Adolescente , Colangite Esclerosante/complicações , Hepatite Autoimune/complicações , Humanos , MasculinoRESUMO
Plasma concentrations and urinary outputs of amino acids were estimated in nineteen patients receiving intravenous hyperalimentation to evaluate the adequacy of dosage and composition of the infusates for the maintenance of normal blood concentrations of essential amino acids. The use of high concentrations of branched chain amino acids seems to be appropriate for valine and isoleucine but not for leucine. The high concentration of cysteine in the infusates used induces a very high urinary excretion of cysteine and cystine and are ineffective to bring the decreased plasma cystine levels back to normal.
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The patient was the first child of first cousin parents. He was born at term after an uneventful pregnancy with normal height, weight and head circumference. Jaundice appeared at 15 days of age. Ventricular septal defects and valvular pulmonary stenosis were diagnosed. An hepatic workup revealed extrahepatic biliary atresia and abdominal situs inversus. Hepatic biopsy showed cirrhosis with intrahepatic cholestasis. Genetic factors are suggested in extrahepatic biliary atresia. Analysis of segregation patterns suggested the existence of two major groups, one with various combinations of anomalies within the laterality sequence and the other with one or two anomalies mostly involving the cardiac, gastrointestinal, and urinary systems. This patient belongs to the first group.
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Ductos Biliares Extra-Hepáticos/patologia , Atresia Biliar/genética , Atresia Biliar/patologia , Atresia Biliar/fisiopatologia , Desenvolvimento Infantil , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Testes de Função Hepática , MasculinoRESUMO
In the present study the pharmacokinetic interactions between digitoxin and the antiarrhythmic drugs amiodarone, mexiletine and propafenone have been examined. Experiments were performed on rabbits in which serum digitoxin concentration was used as indicator to detect drug interactions. The radioimmunoassay "Coat-A-Count" procedure of DPC was used for the quantitative measurement of digitoxin. It was determined that in order to achieve a considerable level of serum digitoxin, it was necessary to administer a multiple dose rather than the one tolerated by humans. It was also observed that serum contained digitalis like immunoreactive factor(s) (DLIF) measured as digitoxin. The mean (+/- SE) digitoxin equivalent value of the DLIF, measured by the "Coat-A-Count" radioimmunoassay in the serum of rabbits (n = 34) was 4.15 +/- 0.059 ng/ml. Each of the three antiarrhythmic drugs increased serum digitoxin levels; its values were almost double in relation to the control group where only digitoxin was administered. This increased digitoxin value was detected one hour after administration of the first dose of the antiarrhythmic drug and remained at a higher level than that of the control group for 6-8 hours. Rabbits given a single high dose of digitoxin and some of the antiarrhythmic drugs and those given a small dose of digitoxin for only four days, presented a retrogressive increase of digitoxin level in serum 5-6 days later. This mechanism needs to be further investigated.
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Antiarrítmicos/farmacologia , Digitoxina/farmacocinética , Amiodarona/farmacologia , Animais , Digitoxina/sangue , Interações Medicamentosas , Feminino , Masculino , Mexiletina/farmacologia , Propafenona/farmacologia , Coelhos , RadioimunoensaioRESUMO
Report of a child with disseminated ganglioneuromatosis of the gut. The complexity of the intestinal nervous system malformation is proved by histochemical, histoenzymological and ultrastructural studies. The malformation is characterized by: hyperplasia and hypertrophy of enteric plexus and nerves bundles in the meso, high acetylcholinesterase activity, aplasia of the sympathetic innervation with the exception of perivascular plexus, qualitative and likely quantitative integrity of the endocrine digestive system. These data are compared with similar observations in the literature.
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Ganglioneuroma/ultraestrutura , Neoplasias Intestinais/ultraestrutura , Acetilcolinesterase/análise , Feminino , Ganglioneuroma/congênito , Ganglioneuroma/enzimologia , Histocitoquímica , Humanos , Lactente , Neoplasias Intestinais/congênito , Neoplasias Intestinais/enzimologia , Intestinos/inervação , Sistema Nervoso Simpático/anormalidadesRESUMO
As main current topics in pediatric nutrition we have considered the results of the continuing research on the long term consequences of fetal malnutrition and intra-uterine growth retardation with the concept of metabolic imprinting leading to chronic disease in adulthood, the progresses of knowledge in the fields of iron metabolism and regulatory mechanisms of satiety, hunger and energetic balance, a better determination of recommended docosahexanoic and arachidonic acids intake in the first months of life for premature and term infants, and the studies on probiotics and prebiotics utilization for preventive and curative purposes. The concerns about vitamin D insufficiency in France have markedly decreased with the generalization ten years ago of cholecalciferol supplementation of infant formula, and more recently the authorization of dairy products supplementation. On the contrary the problem of iron deficiency in young children remains, as well as two major nutritional concerns: the very low percentage of breast-fed infants and the dramatic increase of childhood obesity which affects presently 14% of 10 year old children versus 5% in 1980.
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Fenômenos Fisiológicos da Nutrição Infantil , Adolescente , Fenômenos Fisiológicos da Nutrição do Adolescente , Adulto , Fatores Etários , Anemia Ferropriva/prevenção & controle , Anemia Ferropriva/terapia , Criança , Pré-Escolar , Estudos Transversais , Suplementos Nutricionais , Feminino , Retardo do Crescimento Fetal , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , Masculino , Obesidade/dietoterapia , Obesidade/epidemiologia , Probióticos/uso terapêuticoRESUMO
In recent years, the clinical spectrum of coeliac disease has changed and forms with mild aspecific symptoms are today frequent. Therefore many infants are submitted to jejunal biopsy in order to exclude coeliac disease or to allow an early diagnosis. This has led to a search for a simple and reliable diagnostic test of coeliac disease in order to limit the use of jejunal biopsy. Recent data suggest that the study of serum antigliadin, antireticulin and antiendomysium antibodies may possibly play the role. In this paper the working group on coeliac disease of the Groupe Francophone de Gastroentérologie et Nutrition Pédiatriques expresses its view on the place of the dosages of these antibodies in the diagnosis and follow up procedures of coeliac disease in infants and children. At the present time, although it allows a simplification of the procedures, these dosages are presently not sufficiently reliable to serve as a substitute of jejunal biopsy.
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Autoanticorpos/sangue , Doença Celíaca/diagnóstico , Gliadina/imunologia , Músculo Liso/imunologia , Reticulina/imunologia , Biomarcadores , Biópsia , Doença Celíaca/epidemiologia , Doença Celíaca/imunologia , Doença Celíaca/prevenção & controle , Criança , Seguimentos , Humanos , Jejuno/patologia , Programas de RastreamentoRESUMO
A 4-month old infant developed an immediate and proven systemic allergic reaction to mercurothiolate. The acute accident occurred while an intracaval catheter was being treated with a dry-frozen heparin which excipient contains mercurothiolate. This conservative agent is present in numerous pharmaceutical preparations for topical and systemic use.
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Hipersensibilidade a Drogas/etiologia , Compostos de Etilmercúrio/efeitos adversos , Excipientes/efeitos adversos , Timerosal/efeitos adversos , Cateteres de Demora , Feminino , Heparina/administração & dosagem , Humanos , Lactente , Testes Cutâneos , Veias CavasRESUMO
OBJECTIVE: The study was carried out by the GFHGNP to determine the annual incidence of symptomatic celiac disease in children. PATIENTS AND METHODS: The diagnostic criteria were: symptomatic patients diagnosed under 15 years of age during 1996, villous atrophy and positivity of antigliadin and/or other antibodies. Cases were collected from referral centers, general hospital pediatric departments and private pediatricians with endoscopic practice. RESULTS: The study involved roughly half of the French pediatric population in 41 out of the 95 French districts. In all, 124 patients were collected: 76 girls and 48 boys. By geographical areas, in 30 districts where collection of data was complete which counted 186,285 births, the yearly incidence varied from 1/1731 births to 1/3110. (0.57@1000 to 0.32@1000). On the whole there were 77 cases i.e. an annual incidence of 1/2419 or 0.41@1000 (confidence interval 95%: 0.32 to 0.50@1000). Lower incidences were observed in the district of Paris: 1/4865 (0.21@1000) and Lyon: 1/3310 (0.27@1000). Those lower incidences could be explained by the difficulties of collecting the data in the biggest urban areas. The first signs occurred before one year of age in 73% of the cases, during the second year of life in 20.5% and after 3 in only 6.5%. The diagnosis was made before 2 years of age in 77% of the cases and after 3 in only 13%. In order of frequency symptoms were: failure to thrive (80%), diarrhea (59%), anorexia (59%), abdominal distension (57%), weight under 2 standard deviations (43%), short stature (43%). CONCLUSION: Compared with previous studies in two French districts between 1975 and 1990, the annual incidence of symptomatic celiac disease in children appears to be on the rise. The usual clinical signs continue to be observed.
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Doença Celíaca/epidemiologia , Adolescente , Criança , Pré-Escolar , Coleta de Dados , Feminino , França , Humanos , Incidência , Lactente , Masculino , Estudos ProspectivosRESUMO
Coeliac disease is an intolerance to gluten that classically produces a chronic diarrhoea with a picture of malabsorption and a total villous atrophy. These elements regress completely in a sequential way under a prolonged strict gluten-free diet. The progress registered in the understanding of this affection depends on the individualization of the atypical forms (delayed isolated stature, constipation...) of asymptomatic forms thanks to the study of specific antibodies (anti-gliadin, anti-endomysium, and more recently anti-transglutaminase). The auto-immune nature of coeliac disease is well established. The diagnostic criteria are simplified allowing the commencement of a gluten-free diet which must be perfectly detailed. Finally, allergy to wheat flour merits individualization in the framework of coeliac disease (cf. article).
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Doenças Autoimunes/classificação , Doença Celíaca/classificação , Adolescente , Adulto , Apresentação de Antígeno , Autoanticorpos/imunologia , Doenças Autoimunes/complicações , Doenças Autoimunes/diagnóstico , Doenças Autoimunes/epidemiologia , Doenças Autoimunes/imunologia , Doença Celíaca/complicações , Doença Celíaca/diagnóstico , Doença Celíaca/epidemiologia , Doença Celíaca/imunologia , Criança , Comorbidade , Diarreia/etiologia , Proteínas de Ligação ao GTP/imunologia , Frequência do Gene , Predisposição Genética para Doença , Gliadina/efeitos adversos , Glutens/efeitos adversos , Transtornos do Crescimento/etiologia , Antígenos HLA-DQ/genética , Humanos , Síndromes de Malabsorção/etiologia , Prevalência , Proteína 2 Glutamina gama-Glutamiltransferase , Testes Sorológicos/normas , Transglutaminases/imunologiaRESUMO
The cow-milk weaning sometimes comes with urticaria or others allergic signs, in relation with the anti cow-milk IgE presence, which rate was studied in 30 children at the time of the accident, after the putting back to the breast-feeding or a hydrolyzed proteins milk and after reintroduction of the cow-milk. They disappear in three cases out of four, shortly after the cow-milk suppression. They reappear in one case out of three from the reintroduction. Carried on CGDS or Ketotifen , the cow-milk tolerance was quickly obtained even in the children who conserved anti-cow milk IgE, and after the treatment stop. A spontaneous tolerance after the initial accident is possible. The characteristics of the anti-cow milk IgE response in the breast-fed new-born child are examined.
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Hipersensibilidade Alimentar/imunologia , Imunoglobulina E/imunologia , Leite/efeitos adversos , Animais , Dessensibilização Imunológica , Hipersensibilidade Alimentar/dietoterapia , Humanos , Tolerância Imunológica , Imunoglobulina E/análise , Lactente , Leite/imunologia , DesmameRESUMO
This retrospective study was carried out in the "Medecine Infantile 3 et Genetique" service at Brabois University Hospital in Nancy (France). We collected 14 cases of chronic hepatitis C following perinatal infection via mother to child transmission (group 1: 5 cases) and blood transfusion (group 2: 9 cases). The mean age of patients at the time of first serological screening test was 9.1+/-4.7 years. In 12 cases, the screening test was performed in view of the mother seropositivity or a personal history of perinatal blood transfusion. Only two patients presented with hepatomegaly. ELISA3 test was positive in all patients. With RIBA3 test, antibody to hepatitis C core antigen was absent in one patient while antibody anti-NS3 was present in all of the cases. The mean level of serum transaminase SGPT was 1.9+/-0.9 N in group 1 patients (mother to child transmission) versus 1.4+/-0.7 N in group 2 patients (blood transfusion). In 9 cases out of 14, hepatocytolysis was variable with SGPT levels around 2 N. Total mean Knodell was 3+/-4.1 in the group 1 versus 4.6 + 2.6 in group 2. Using the Metavir score, the mean activity was found to be 0.5+/-0.1 in group 1 versus 1+/-0.6 in group 2, while the mean level of fibrosis in the two groups was 0.3+/-0.5 and 0.7+/-0.1 respectively. On the whole, this study shows that chronic hepatitis C following perinatal infection is commonly asymptomatic, with mild histological changes not relating to the level of hepatocytolysis.
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Hepatite C Crônica/transmissão , Transmissão Vertical de Doenças Infecciosas , Reação Transfusional , Feminino , Hepatite C Crônica/diagnóstico , Humanos , Recém-Nascido , Masculino , Estudos RetrospectivosRESUMO
Gastrointestinal bleeding is not rare in paediatric practice. Always impressive to the surrounding family, they reveal an underlying affection (portal cavernous haemangioma, ulcer) or complicate a progressing disease (oesophagitis, varix). Gastrointestinal endoscopy should be made rapidly in a paediatric setting. The main causes are: before 2 years of age and over 7 years, peptic oesophagitis; from 2 to 7 years, acute lesions of the gastroduodenal mucous membrane and ulcers. Lower tract bleeding (melaena or rectal bleeding) is mainly due to anal fissures, polyps, severe inflammatory colitis and enterocolitis.
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Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/etiologia , Criança , Endoscopia Gastrointestinal , Hemorragia Gastrointestinal/terapia , Humanos , Incidência , Anamnese , Exame Físico , Fatores de RiscoRESUMO
Indications for ileocolonoscopy were defined in 2002 by the Groupe Francophone d'Hépatologie Gastroentérologie et Nutrition. These recommendations were updated with new data and technical innovations appearing over the last decade. Ileocolonoscopy is primarily indicated for digestive bleeding or anemia and for suspected inflammatory bowel disease. It is now indicated in inflammatory bowel disease for control of mucosal healing after medical treatment and relapse after surgical resection. Iterative ileocolonoscopy is primarily indicated for genetic polyposis and well defined for familial adenomatous polyposis. The contraindications were not modified.