Pub Date : 2019-10-01DOI: 10.1097/MPG.0000000000002453
C. Tersigni, L. Galli
{"title":"Response - Letter to Editor About the Article: Should Pediatricians be Aware of Cystic Echinococcosis? A Literature Review.","authors":"C. Tersigni, L. Galli","doi":"10.1097/MPG.0000000000002453","DOIUrl":"https://doi.org/10.1097/MPG.0000000000002453","url":null,"abstract":"","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72862865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-01DOI: 10.1097/MPG.0000000000002452
Dongmei Huang, Yin Zhou
T o the Editor: We have read a recent report by Tersigni et al (1) with great interest. This review demonstrated that serological tests and different radiological findings are diagnostic tools in cystic echinococcosis (CE) in European children. Meanwhile, watch-andwait, pharmacological treatment, percutaneous treatment, and surgery are 4 available therapy approaches of CE. However, recently more study claimed that endoscopic retrograde cholangiopancreatography (ERCP) and ERCP-associated techniques play a crucial role in diagnosis and treatment biliary tree CE (2–6). ERCP is an important diagnostic and therapeutic tool for biliary disease in child (7,8). Firstly, ERCP can be used to identify the cystobiliary relations if noninvasive tools to explore the biliary tract are unavailable, which attributes to determinate next treatment means (7,9). Secondly, ERCP is another nonsurgical way to treat cystobiliary communications diseases, especially alleviating jaundice and cholangitis of biliary tree obstruction, as a therapeutic alternative to percutaneous transhepatic biliary drainage (PTDC). ERCP is regarded as an interesting alternative to palliative surgery combined with drug treatment, and never impairs further surgical operation (2). Thirdly, ERCP and ERCP-associated techniques are effective ways to detect and treat the postoperative complications after surgery for biliary hydatid diseases, such as biliary fistulas and biliary obstruction by endoscopic nasobiliary drainage and endoscopic sphincterotomy. It avoids surgical reintervention and decreases hospitalazitation time (2,4). Hence, we suggest emphasizing the ERCP role in diagnosis and treatment of CE in European child. It is absolutely benefited to effectively and safely diagnosis and treatment CE in an early stage.
{"title":"Letter to editor about the article: Should Pediatricians be aware of cystic Echinococcosis? A literature review.","authors":"Dongmei Huang, Yin Zhou","doi":"10.1097/MPG.0000000000002452","DOIUrl":"https://doi.org/10.1097/MPG.0000000000002452","url":null,"abstract":"T o the Editor: We have read a recent report by Tersigni et al (1) with great interest. This review demonstrated that serological tests and different radiological findings are diagnostic tools in cystic echinococcosis (CE) in European children. Meanwhile, watch-andwait, pharmacological treatment, percutaneous treatment, and surgery are 4 available therapy approaches of CE. However, recently more study claimed that endoscopic retrograde cholangiopancreatography (ERCP) and ERCP-associated techniques play a crucial role in diagnosis and treatment biliary tree CE (2–6). ERCP is an important diagnostic and therapeutic tool for biliary disease in child (7,8). Firstly, ERCP can be used to identify the cystobiliary relations if noninvasive tools to explore the biliary tract are unavailable, which attributes to determinate next treatment means (7,9). Secondly, ERCP is another nonsurgical way to treat cystobiliary communications diseases, especially alleviating jaundice and cholangitis of biliary tree obstruction, as a therapeutic alternative to percutaneous transhepatic biliary drainage (PTDC). ERCP is regarded as an interesting alternative to palliative surgery combined with drug treatment, and never impairs further surgical operation (2). Thirdly, ERCP and ERCP-associated techniques are effective ways to detect and treat the postoperative complications after surgery for biliary hydatid diseases, such as biliary fistulas and biliary obstruction by endoscopic nasobiliary drainage and endoscopic sphincterotomy. It avoids surgical reintervention and decreases hospitalazitation time (2,4). Hence, we suggest emphasizing the ERCP role in diagnosis and treatment of CE in European child. It is absolutely benefited to effectively and safely diagnosis and treatment CE in an early stage.","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83564643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-01DOI: 10.1097/MPG.0000000000002441
M. Narkewicz
need to have ‘‘personal equipoise,’’ not favoring a positive outcome over a negative one (13). Studies need to be adequately powered and designed, so that a negative study is as scientifically sound as a positive one. Medical journals need to embrace negative or neutral studies just as much as the positive ones (14). Some progress on this topic has been made, for example with the American Journal of Gastroenterology recently dedicating an entire issue to studies that had no statistically significant superiority of one outcome over another (15). Finally, penalties probably need to be imposed to pharmaceutical companies who keep the less favorable results from being reported in medical journals.
{"title":"Integrating Clinical Ultrasound into Screening for Cystic Fibrosis Liver Disease: Approach with Caution and Optimism.","authors":"M. Narkewicz","doi":"10.1097/MPG.0000000000002441","DOIUrl":"https://doi.org/10.1097/MPG.0000000000002441","url":null,"abstract":"need to have ‘‘personal equipoise,’’ not favoring a positive outcome over a negative one (13). Studies need to be adequately powered and designed, so that a negative study is as scientifically sound as a positive one. Medical journals need to embrace negative or neutral studies just as much as the positive ones (14). Some progress on this topic has been made, for example with the American Journal of Gastroenterology recently dedicating an entire issue to studies that had no statistically significant superiority of one outcome over another (15). Finally, penalties probably need to be imposed to pharmaceutical companies who keep the less favorable results from being reported in medical journals.","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88239154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-01DOI: 10.1097/MPG.0000000000002447
C. De Carlo, M. Bramuzzo, C. Canaletti, C. Udina, G. Cozzi, P. M. Pavanello, Stefania Rampado, S. Martelossi, F. Giudici, G. Di leo, E. Barbi
OBJECTIVES Inflammatory bowel disease (IBD) can be particularly challenging during the pediatric age with a relevant impact on patient's health-related quality of life (HRQoL). Disease activity accounts for only a small part of the variability in HRQoL, and psychological factors can play a significant role. We aimed to evaluate the impact of patient's distress and pain catastrophizing on children and adolescents with IBD. METHODS We prospectively recruited children aged 8-18 with IBD and recorded demographic and disease characteristics. Patients answered questionnaires on HRQoL (IMPACT III), distress (Distress Thermometer, DT), and pain catastrophizing (Pain Catastrophizing Scale - Children, PCS-C). Univariate and multivariate regression models analysis were used to evaluate correlations between patients's characteristics, disease activity, distress, pain catastrophizing and HRQoL. RESULTS Seventy-one patients were enrolled (median age 13.6, 49.3% Crohn's disease, 50.7% ulcerative colitis). Median HRQoL, DT and PCS-C scores were 78.6 (IQR 68.0-87.1), 3.0 (1.0-5.0), and 12.0 (4.0-23.0) respectively. Patient's distress and pain catastrophizing levels significantly correlated with HRQoL. Pain catastrophizing had the strongest impact on HRQoL (Spearman correlation coefficient, ρ 0.73), followed by distress (ρ 0.67), and ulcerative colitis severity (ρ 0.67). The DT and the PCS-C scores were significantly associated (ρ 0.46). CONCLUSIONS Distress and pain catastrophizing have a significative impact on HRQoL in young patients with IBD. Physicians should recognise the role of these psychological factors and consider cognitive-behavioural therapy to optimise the patient's health.
{"title":"The role of distress and pain catastrophizing on the health-related quality of life of children with inflammatory bowel disease.","authors":"C. De Carlo, M. Bramuzzo, C. Canaletti, C. Udina, G. Cozzi, P. M. Pavanello, Stefania Rampado, S. Martelossi, F. Giudici, G. Di leo, E. Barbi","doi":"10.1097/MPG.0000000000002447","DOIUrl":"https://doi.org/10.1097/MPG.0000000000002447","url":null,"abstract":"OBJECTIVES\u0000Inflammatory bowel disease (IBD) can be particularly challenging during the pediatric age with a relevant impact on patient's health-related quality of life (HRQoL). Disease activity accounts for only a small part of the variability in HRQoL, and psychological factors can play a significant role. We aimed to evaluate the impact of patient's distress and pain catastrophizing on children and adolescents with IBD.\u0000\u0000\u0000METHODS\u0000We prospectively recruited children aged 8-18 with IBD and recorded demographic and disease characteristics. Patients answered questionnaires on HRQoL (IMPACT III), distress (Distress Thermometer, DT), and pain catastrophizing (Pain Catastrophizing Scale - Children, PCS-C). Univariate and multivariate regression models analysis were used to evaluate correlations between patients's characteristics, disease activity, distress, pain catastrophizing and HRQoL.\u0000\u0000\u0000RESULTS\u0000Seventy-one patients were enrolled (median age 13.6, 49.3% Crohn's disease, 50.7% ulcerative colitis). Median HRQoL, DT and PCS-C scores were 78.6 (IQR 68.0-87.1), 3.0 (1.0-5.0), and 12.0 (4.0-23.0) respectively. Patient's distress and pain catastrophizing levels significantly correlated with HRQoL. Pain catastrophizing had the strongest impact on HRQoL (Spearman correlation coefficient, ρ 0.73), followed by distress (ρ 0.67), and ulcerative colitis severity (ρ 0.67). The DT and the PCS-C scores were significantly associated (ρ 0.46).\u0000\u0000\u0000CONCLUSIONS\u0000Distress and pain catastrophizing have a significative impact on HRQoL in young patients with IBD. Physicians should recognise the role of these psychological factors and consider cognitive-behavioural therapy to optimise the patient's health.","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85434756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-01DOI: 10.1097/MPG.0000000000002430
P. Sintusek, Nipaporn Siriporn, D. Punpanich, V. Chongsrisawat, Y. Poovorawan
OBJECTIVES To determine the accuracy of non-invasive parameters such as liver (LS) and spleen stiffness (SS) to detect esophageal varices (EV) in children with biliary atresia (BA). METHODS Children with BA between 2000 and 2015 were recruited. All underwent esophagogastroduodenoscopy and transient elastography. Demographic data, laboratory investigations, alanine transferase-to-platelet ratio index (APRI), and Varices Prediction Rule (VPR) score were collected. RESULTS A total of 51 children (mean age 10.63 years, standard deviation [SD]=6.08 years; 53% males) were enrolled. There were differences in onset and outcome of portoenterostomy, spleen palpablility, platelet count, albumin, LS, SS, and VPR between the varice and varice-free groups (P < 0.05). In the varice group, the median LS was 18.12 [interquartile ratio, IQR 13.15-19.12] and the median SS was 46.85 [IQR 25.95-54.55] kPa. In the varice-free group, the median LS was 7.85 [IQR 5.88-16.75] and the median SS was 16.54 [IQR 11.75-21.75] kPa. Both LS and SS were higher in the varice than the varice-free group (P < 0001). The area under the receiver operating characteristic curve of LS, SS, spleen palpability, platelet count, APRI and VPR were 0.734, 0.870, 0.817, 0.810, 0.751 and 0.794, respectively. Using a cut-off value of 12.5 kPa for LS, the sensitivity and specificity were 80% and 70% respectively. Using a cut-off value of 28.9 kPa for SS, the sensitivity and specificity were 75% and 87% respectively. Combination of LS and SS to diagnose varices increased the specificity to 93%. CONCLUSIONS SS as a single marker had the best diagnostic value to predict esophageal varices in children with BA. The combination of SS and LS furthermore increased the diagnostic yield.
{"title":"Spleen and Liver Stiffness to Detect Esophageal Varices in Children with Biliary Atresia.","authors":"P. Sintusek, Nipaporn Siriporn, D. Punpanich, V. Chongsrisawat, Y. Poovorawan","doi":"10.1097/MPG.0000000000002430","DOIUrl":"https://doi.org/10.1097/MPG.0000000000002430","url":null,"abstract":"OBJECTIVES\u0000To determine the accuracy of non-invasive parameters such as liver (LS) and spleen stiffness (SS) to detect esophageal varices (EV) in children with biliary atresia (BA).\u0000\u0000\u0000METHODS\u0000Children with BA between 2000 and 2015 were recruited. All underwent esophagogastroduodenoscopy and transient elastography. Demographic data, laboratory investigations, alanine transferase-to-platelet ratio index (APRI), and Varices Prediction Rule (VPR) score were collected.\u0000\u0000\u0000RESULTS\u0000A total of 51 children (mean age 10.63 years, standard deviation [SD]=6.08 years; 53% males) were enrolled. There were differences in onset and outcome of portoenterostomy, spleen palpablility, platelet count, albumin, LS, SS, and VPR between the varice and varice-free groups (P < 0.05). In the varice group, the median LS was 18.12 [interquartile ratio, IQR 13.15-19.12] and the median SS was 46.85 [IQR 25.95-54.55] kPa. In the varice-free group, the median LS was 7.85 [IQR 5.88-16.75] and the median SS was 16.54 [IQR 11.75-21.75] kPa. Both LS and SS were higher in the varice than the varice-free group (P < 0001). The area under the receiver operating characteristic curve of LS, SS, spleen palpability, platelet count, APRI and VPR were 0.734, 0.870, 0.817, 0.810, 0.751 and 0.794, respectively. Using a cut-off value of 12.5 kPa for LS, the sensitivity and specificity were 80% and 70% respectively. Using a cut-off value of 28.9 kPa for SS, the sensitivity and specificity were 75% and 87% respectively. Combination of LS and SS to diagnose varices increased the specificity to 93%.\u0000\u0000\u0000CONCLUSIONS\u0000SS as a single marker had the best diagnostic value to predict esophageal varices in children with BA. The combination of SS and LS furthermore increased the diagnostic yield.","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88737810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-13DOI: 10.1097/MPG.0000000000002496
I. Broekaert, C. Tzivinikos, P. Narula, H. Antunes, J. Dias, H. V. D. van der Doef, S. Isoldi, L. Norsa, C. Romano, I. Scheers, A. Silbermintz, M. Tavares, F. Torroni, A. Urs, M. Thomson
Received March 8, 2019; From the University Ch University of Cologn Specialty Hospital, D dren’s Hospital, Sheffi terology, Hepatology of Medicine; Univer Hospitalar S. João, P Gastroenterology Hep Groningen, University #Pediatric Gastroente Rome, the Paediatr Giovanni XXIII, Be Department of Huma Barresi’, University o enterology Unit, Clini de Louvain, Brussels Nutrition, and Liver of Israel, Petach Tik Pediatrica, Centro ma Digestive Endosco Hospital-IRCCS, Rom Address correspondence University Children’s versity of Cologne, C (e-mail: ibroekaert@g Disclaimer: ‘‘ESPGHAN and provides guideline only. Diagnosis and t J.A.D. received grants/res for lectures from Nest ings from Danone an lectures from Abbvie; from Nestle; C.T. rece vie, Merck, Sanofi; A Health Science and p Johnson Nutrition. H.A and F.T. report no con Copyright # 2019 by E Hepatology, and Nut Gastroenterology, He DOI: 10.1097/MPG.0000
{"title":"European Society for Paediatric Gastroenterology, Hepatology and Nutrition Position Paper on Training in Paediatric Endoscopy.","authors":"I. Broekaert, C. Tzivinikos, P. Narula, H. Antunes, J. Dias, H. V. D. van der Doef, S. Isoldi, L. Norsa, C. Romano, I. Scheers, A. Silbermintz, M. Tavares, F. Torroni, A. Urs, M. Thomson","doi":"10.1097/MPG.0000000000002496","DOIUrl":"https://doi.org/10.1097/MPG.0000000000002496","url":null,"abstract":"Received March 8, 2019; From the University Ch University of Cologn Specialty Hospital, D dren’s Hospital, Sheffi terology, Hepatology of Medicine; Univer Hospitalar S. João, P Gastroenterology Hep Groningen, University #Pediatric Gastroente Rome, the Paediatr Giovanni XXIII, Be Department of Huma Barresi’, University o enterology Unit, Clini de Louvain, Brussels Nutrition, and Liver of Israel, Petach Tik Pediatrica, Centro ma Digestive Endosco Hospital-IRCCS, Rom Address correspondence University Children’s versity of Cologne, C (e-mail: ibroekaert@g Disclaimer: ‘‘ESPGHAN and provides guideline only. Diagnosis and t J.A.D. received grants/res for lectures from Nest ings from Danone an lectures from Abbvie; from Nestle; C.T. rece vie, Merck, Sanofi; A Health Science and p Johnson Nutrition. H.A and F.T. report no con Copyright # 2019 by E Hepatology, and Nut Gastroenterology, He DOI: 10.1097/MPG.0000","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78797922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-11DOI: 10.1097/MPG.0000000000002484
Ineke de Kruijff, Vandhana Choenni, Jasja T Groeneweg, A. Vlieger, M. Benninga, R. Kok, A. Kamperman, M. L. D. Berg
OBJECTIVES Gastroesophageal reflux (GER), excessive crying, and constipation are common gastrointestinal symptoms in infancy of multifactorial origin in which psychosocial stress factors play an important role. The aims of this observational study were to investigate the presence of gastrointestinal symptoms in infants of mothers with or without a history of a psychiatric disorder, their association with maternal depressive symptoms, and the possible mediating role of bonding. METHODS 101 mothers with a history of a psychiatric disorder ("PD mothers") and 60 control mothers were included. Infant gastrointestinal symptoms, maternal depressive symptoms, and mother-infant bonding were assessed using validated questionnaires and diagnostic criteria at 1.5 month postpartum. RESULTS The mean total score on the Infant Gastroesophageal Reflux Questionnaire Revised (I-GERQ-R) reported in infants of PD mothers (13.4 SD 5.4) was significantly higher than in infants of control mothers (10.8 SD 5.4; P = .003). No significant differences were found in the presence of excessive crying (modified Wessel's criteria and subjective experience) and constipation (ROME IV criteria) between both groups. Infant GER was associated with maternal depressive symptoms (P = 0.027) and bonding problems (P = <0.001). Constipation was related to maternal depressive symptoms (P = 0.045), and excessive crying (Wessel and subjective criteria) was associated with bonding problems (respectively P = 0.022 and P = 0.002). The effect of maternal depressive symptomatology on infant GER symptoms and excessive crying was mediated by bonding problems. CONCLUSION Maternal psychiatric history is associated with infant gastrointestinal symptoms, in which mother-infant bonding is a mediating factor.
{"title":"Gastrointestinal Symptoms in Infants of Mothers with a Psychiatric History and the Role of Depression and Bonding.","authors":"Ineke de Kruijff, Vandhana Choenni, Jasja T Groeneweg, A. Vlieger, M. Benninga, R. Kok, A. Kamperman, M. L. D. Berg","doi":"10.1097/MPG.0000000000002484","DOIUrl":"https://doi.org/10.1097/MPG.0000000000002484","url":null,"abstract":"OBJECTIVES\u0000Gastroesophageal reflux (GER), excessive crying, and constipation are common gastrointestinal symptoms in infancy of multifactorial origin in which psychosocial stress factors play an important role. The aims of this observational study were to investigate the presence of gastrointestinal symptoms in infants of mothers with or without a history of a psychiatric disorder, their association with maternal depressive symptoms, and the possible mediating role of bonding.\u0000\u0000\u0000METHODS\u0000101 mothers with a history of a psychiatric disorder (\"PD mothers\") and 60 control mothers were included. Infant gastrointestinal symptoms, maternal depressive symptoms, and mother-infant bonding were assessed using validated questionnaires and diagnostic criteria at 1.5 month postpartum.\u0000\u0000\u0000RESULTS\u0000The mean total score on the Infant Gastroesophageal Reflux Questionnaire Revised (I-GERQ-R) reported in infants of PD mothers (13.4 SD 5.4) was significantly higher than in infants of control mothers (10.8 SD 5.4; P = .003). No significant differences were found in the presence of excessive crying (modified Wessel's criteria and subjective experience) and constipation (ROME IV criteria) between both groups. Infant GER was associated with maternal depressive symptoms (P = 0.027) and bonding problems (P = <0.001). Constipation was related to maternal depressive symptoms (P = 0.045), and excessive crying (Wessel and subjective criteria) was associated with bonding problems (respectively P = 0.022 and P = 0.002). The effect of maternal depressive symptomatology on infant GER symptoms and excessive crying was mediated by bonding problems.\u0000\u0000\u0000CONCLUSION\u0000Maternal psychiatric history is associated with infant gastrointestinal symptoms, in which mother-infant bonding is a mediating factor.","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82630087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-01DOI: 10.1097/MPG.0000000000002499
L. Mackner, Brandi N. Whitaker, Michele H. Maddux, S. Thompson, Cheyenne L. Hughes-Reid, Megan Drovetta, B. Reed‐Knight
Rates of youth depression are increasing, and approximately 75% of adolescents with depression go unrecognized. Research in pediatric IBD documents increased depression risk, with rates up to 25%, as well as worse adherence and treatment outcomes associated with depressive symptoms. Evidence-based psychological interventions improve the physical and emotional health of these patients, highlighting the importance of detection and treatment. Psychosocial screening has been shown to increase the accurate identification of psychosocial problems and facilitate timely psychosocial intervention. The objective of this article is to establish clinical guidelines for depression screening in youth diagnosed with IBD and to provide resources for implementation. The psychosocial screening task force group comprised of psychologists and social workers in the ImproveCareNow (ICN) learning health system reviewed research and clinical guidelines in other fields, and consulted with physicians, nurses, other psychosocial professionals, patients with IBD, and parents of children with IBD in ICN. It is recommended that adolescents with IBD ages 12 and older be screened for depression annually. Additional practical recommendations for implementation, triage, and treatment within the pediatric gastroenterology clinic are also provided.
{"title":"Depression Screening in Pediatric IBD Clinics: Recommendations and a Toolkit for Implementation.","authors":"L. Mackner, Brandi N. Whitaker, Michele H. Maddux, S. Thompson, Cheyenne L. Hughes-Reid, Megan Drovetta, B. Reed‐Knight","doi":"10.1097/MPG.0000000000002499","DOIUrl":"https://doi.org/10.1097/MPG.0000000000002499","url":null,"abstract":"Rates of youth depression are increasing, and approximately 75% of adolescents with depression go unrecognized. Research in pediatric IBD documents increased depression risk, with rates up to 25%, as well as worse adherence and treatment outcomes associated with depressive symptoms. Evidence-based psychological interventions improve the physical and emotional health of these patients, highlighting the importance of detection and treatment. Psychosocial screening has been shown to increase the accurate identification of psychosocial problems and facilitate timely psychosocial intervention. The objective of this article is to establish clinical guidelines for depression screening in youth diagnosed with IBD and to provide resources for implementation. The psychosocial screening task force group comprised of psychologists and social workers in the ImproveCareNow (ICN) learning health system reviewed research and clinical guidelines in other fields, and consulted with physicians, nurses, other psychosocial professionals, patients with IBD, and parents of children with IBD in ICN. It is recommended that adolescents with IBD ages 12 and older be screened for depression annually. Additional practical recommendations for implementation, triage, and treatment within the pediatric gastroenterology clinic are also provided.","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"80 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86939416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-01DOI: 10.1097/MPG.0000000000002240
Amit A Shah, A. Kastl, Bridget C. Godwin, P. Mamula, Kristin N. Fiorino
Upper gastrointestinal series with small bowel follow-through, upper endoscopy, and colonoscopy were normal. Magnetic resonance enterography showed proximal jejunal thickening. Capsule endoscopy and push enteroscopy exhibited proximal jejunal edema and ulceration; jejunal biopsies showed normal mucosa intermixed with gastric epithelium (Fig. 1). Meckel’s scan revealed ectopic gastric mucosa throughout midabdomen (Fig. 2). Laparotomy with intraoperative push enteroscopy resulted in 25 cm of jejunal resection 20 cm distal to the ligament of Treitz (Fig. 3). Pathology illustrated multifocal polypoid gastric heterotopia with reactive gastropathy and focal hemorrhage.
{"title":"Obscure GI Bleeding Secondary to Diffuse Gastric Heterotopia in the Proximal Jejunum.","authors":"Amit A Shah, A. Kastl, Bridget C. Godwin, P. Mamula, Kristin N. Fiorino","doi":"10.1097/MPG.0000000000002240","DOIUrl":"https://doi.org/10.1097/MPG.0000000000002240","url":null,"abstract":"Upper gastrointestinal series with small bowel follow-through, upper endoscopy, and colonoscopy were normal. Magnetic resonance enterography showed proximal jejunal thickening. Capsule endoscopy and push enteroscopy exhibited proximal jejunal edema and ulceration; jejunal biopsies showed normal mucosa intermixed with gastric epithelium (Fig. 1). Meckel’s scan revealed ectopic gastric mucosa throughout midabdomen (Fig. 2). Laparotomy with intraoperative push enteroscopy resulted in 25 cm of jejunal resection 20 cm distal to the ligament of Treitz (Fig. 3). Pathology illustrated multifocal polypoid gastric heterotopia with reactive gastropathy and focal hemorrhage.","PeriodicalId":16725,"journal":{"name":"Journal of Pediatric Gastroenterology & Nutrition","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83258257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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