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Significance and Related Factors of Helicobacter pylori Infection in Children with Dyspepsia. 消化不良患儿幽门螺杆菌感染的意义及相关因素分析。
IF 1.3 Q3 PEDIATRICS Pub Date : 2025-01-01 Epub Date: 2025-01-08 DOI: 10.5223/pghn.2025.28.1.38
Hyun Jin Kim

Purpose: Helicobacter pylori is a Gram-negative bacterium that is associated with peptic ulcer disease (PUD) and gastric cancer. However, studies on the endoscopic finding and factors related to H. Pylori infection in children are lacking. This study aimed to evaluate the prevalence and factors associated with H. pylori infection in children with dyspepsia.

Methods: We retrospectively analyzed the medical records of patients aged <18 years who underwent upper endoscopy for dyspepsia between January 2015 and December 2022. H. pylori was diagnosed using a rapid urease test, and the dyspeptic symptoms included postprandial fullness, early satiation, epigastric pain, and nausea.

Results: Among 185 patients, the prevalence of H. pylori infection was 16.2%. Obesity and a family history of H. pylori infection were more frequently observed in patients with H. pylori infection than in those without. Anemia was also more common in patients with H. pylori infection than in those without. H. pylori was detected in six (18.8%) patients with PUD (n=32). All six patients had duodenal ulcers and anemia, and complications such as obstruction and bleeding were significantly more common among patients with PUD who were positive for H. pylori infection than among those without.

Conclusion: We observed a low prevalence of H. pylori infection in children with dyspepsia; however, these children exhibited a more severe clinical course. Therefore, caution should be exercised in detecting H. pylori infection in children, especially, who had obesity or family history of H. pylori infection.

目的:幽门螺杆菌是一种与消化性溃疡病(PUD)和胃癌相关的革兰氏阴性菌。然而,关于儿童幽门螺杆菌感染的内镜发现和相关因素的研究缺乏。本研究旨在评估儿童消化不良患者幽门螺杆菌感染的患病率及相关因素。方法:回顾性分析经快速脲酶试验诊断为幽门螺杆菌的老年患者的病历,其消化不良症状包括餐后饱腹、早期饱足、胃脘痛和恶心。结果:185例患者中幽门螺杆菌感染率为16.2%。有幽门螺杆菌感染的患者比无幽门螺杆菌感染的患者更容易出现肥胖和幽门螺杆菌感染家族史。与未感染幽门螺杆菌的患者相比,感染幽门螺杆菌的患者贫血更为常见。32例PUD患者中检出幽门螺杆菌6例(18.8%)。所有6例患者均有十二指肠溃疡和贫血,幽门螺杆菌感染阳性的PUD患者中梗阻和出血等并发症明显比未感染的患者更常见。结论:我们观察到幽门螺杆菌感染在消化不良患儿中的患病率较低;然而,这些儿童表现出更严重的临床过程。因此,在检测儿童幽门螺杆菌感染时应谨慎,特别是有肥胖或幽门螺杆菌感染家族史的儿童。
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引用次数: 0
Gastrointestinal Health and Immunity of Milk Formula Supplemented with a Prebiotic Mixture of Short-Chain Galacto-oligosaccharides and Long-Chain Fructo-Oligosaccharides (9:1) in Healthy Infants and Toddlers: A Systematic Review with Meta-Analysis. 健康婴幼儿配方奶粉中添加短链半乳糖低聚糖和长链果寡糖(9:1)益生元混合物对胃肠道健康和免疫的影响:一项系统评价和荟萃分析
IF 1.3 Q3 PEDIATRICS Pub Date : 2025-01-01 Epub Date: 2025-01-08 DOI: 10.5223/pghn.2025.28.1.1
Muzal Kadim, Andy Darma, Melissa Stephanie Kartjito, Charisma Dilantika, Ray Wagiu Basrowi, Veli Sungono, Juandy Jo

Prebiotics are substrates selectively utilized by microorganisms to confer health benefits to their hosts. Various prebiotics have been supplemented in standard milk formulas for infants who cannot be exclusively breastfed, aiming to provide benefits similar to those of breast milk. One of the most commonly used prebiotics is a mixture of 90% short-chain galacto-oligosaccharides and 10% long-chain fructo-oligosaccharides (scGOS/lcFOS [9:1]). Systematic review and meta-analysis were conducted to determine the effectiveness of scGOS:lcFOS (9:1) supplementation in standard milk formula for improving gastrointestinal health and immunity among healthy infants and toddlers, using parameters such as stool pH and intestinal colonization with beneficial bacteria. This systematic review was prepared in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Randomized clinical trials comparing scGOS/lcFOS (9:1)-supplemented formula versus placebo- or non-supplemented formula milk were eligible for inclusion. Related studies on gastrointestinal health and immunity among healthy infants up to five years old were searched from the earliest available date until February 29, 2024. Eighteen publications (number of participants=1,675) were selected for the systematic review, of which 11 were subsequently subjected to a meta-analysis. Results showed that the standard formula supplemented with scGOS/lcFOS (9:1) was well tolerated and conferred various gastrointestinal health and immunity to healthy infants and toddlers. These findings support the supplementation of standard milk formula with scGOS/lcFOS (9:1) for healthy infants and toddlers.

益生元是微生物选择性利用的底物,可以给宿主带来健康益处。对于不能纯母乳喂养的婴儿,在标准配方奶粉中添加了各种益生元,旨在提供与母乳相似的益处。最常用的益生元之一是90%短链半乳糖低聚糖和10%长链果寡糖的混合物(scGOS/lcFOS[9:1])。采用粪便pH值和肠道有益菌定植等参数,对标准配方奶粉中添加scGOS:lcFOS(9:1)对改善健康婴幼儿胃肠道健康和免疫力的有效性进行了系统评价和荟萃分析。本系统评价是根据2020年系统评价和荟萃分析指南的首选报告项目编写的。比较scGOS/lcFOS(9:1)添加配方奶与安慰剂或未添加配方奶的随机临床试验符合纳入条件。从最早可获得的日期到2024年2月29日,检索了5岁以下健康婴儿胃肠道健康和免疫的相关研究。18篇出版物(参与者数量=1,675)被选择用于系统评价,其中11篇随后进行meta分析。结果表明,添加scGOS/lcFOS(9:1)的标准配方具有良好的耐受性,并赋予健康婴幼儿多种胃肠道健康和免疫功能。这些发现支持健康婴幼儿在标准配方奶粉中添加scGOS/lcFOS(9:1)。
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引用次数: 0
Association of Helicobacter pylori Infection with Pediatric Asthma in Palestine. 巴勒斯坦幽门螺杆菌感染与儿童哮喘的关系。
IF 1.3 Q3 PEDIATRICS Pub Date : 2025-01-01 Epub Date: 2025-01-08 DOI: 10.5223/pghn.2025.28.1.27
Alaa S Hrizat, Amal A Shahin, Banan M Mafarjeh, Mohammad A Atawneh, Kamel Gharaibeh, Nisreen Rumman, Mutaz Sultan

Purpose: Significant debate exists on the association between Helicobacter pylori infection and childhood asthma. We aimed to explore this association in a cohort of children in Palestine while estimating the prevalence of H. pylori in this population.

Methods: We conducted a prospective case-control study among children aged 6-15 years in Palestine, including 44 asthma cases diagnosed by pediatric pulmonologists and 99 age-matched healthy controls recruited through cluster sampling from schools. H. pylori status was determined using a stool antigen test. Asthma severity was assessed using the International Study of Asthma and Allergies in Childhood questionnaire. Data on recent antibiotic use, which could affect H. pylori status, were collected for both groups. Multiple logistic regression analyzed the association between H. pylori and asthma, adjusting for age and sex. The chi-square test assessed the impact of antibiotic use on H. pylori status.

Results: The prevalence of H. pylori infection in the study population was 45%. Children with asthma had a lower prevalence of H. pylori infection compared to healthy controls (32% vs. 51%, adjusted odds ratios, 0.46; 95% confidence interval, 0.22-0.99; p=0.04). Antibiotic use in the past month or year did not significantly impact H. pylori status. Among children with asthma, H. pylori infection rates did not vary by asthma severity (p=0.05).

Conclusion: H. pylori infection is associated with a reduced risk of asthma in children, suggesting a potential protective role. Further prospective cohort studies are warranted to clarify the mechanisms underlying this association.

目的:关于幽门螺杆菌感染与儿童哮喘之间的关系存在重大争议。我们的目的是在巴勒斯坦的一组儿童中探索这种关联,同时估计该人群中幽门螺杆菌的患病率。方法:我们在巴勒斯坦6-15岁的儿童中进行了一项前瞻性病例对照研究,包括44例由儿科肺科医生诊断的哮喘病例和99例通过学校整群抽样招募的年龄匹配的健康对照。使用粪便抗原试验确定幽门螺杆菌状态。使用儿童哮喘和过敏国际研究问卷评估哮喘严重程度。收集了两组近期抗生素使用情况的数据,这些数据可能会影响幽门螺杆菌的状态。多元逻辑回归分析了幽门螺杆菌与哮喘之间的关系,调整了年龄和性别。卡方检验评估抗生素使用对幽门螺杆菌状态的影响。结果:研究人群幽门螺杆菌感染率为45%。与健康对照组相比,哮喘患儿幽门螺杆菌感染患病率较低(32% vs 51%,校正优势比,0.46;95%置信区间为0.22-0.99;p = 0.04)。过去一个月或一年内使用抗生素对幽门螺杆菌状态没有显著影响。在哮喘患儿中,幽门螺杆菌感染率与哮喘严重程度无关(p=0.05)。结论:幽门螺杆菌感染与儿童哮喘风险降低有关,提示其具有潜在的保护作用。需要进一步的前瞻性队列研究来阐明这种关联的机制。
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引用次数: 0
Impact of a New Preoperative Immune-Nutrition Protocol Using Zinc on Hospital Outcomes of Children with Hirschsprung's Disease: A Novel Randomized Controlled Trial. 一项新的术前使用锌的免疫营养方案对先天性巨结肠患儿医院预后的影响:一项新的随机对照试验
IF 1.3 Q3 PEDIATRICS Pub Date : 2025-01-01 Epub Date: 2025-01-08 DOI: 10.5223/pghn.2025.28.1.54
Hoda Atef Abdelsattar Ibrahim, Sherif Kaddah, Rawan Mohamed El-Hussein Mohamed, Sayed Khedr

Purpose: Research proved the beneficial effect of Zinc on human health and Gastrointestinal tract inflammatory diseases. We propose that zinc would be of value in children with Hirschsprung's disease (HD) undergoing elective pull-through surgery. This study was carried out to determine the influence of preoperative zinc intake on postoperative outcomes, especially the hospital length of stay in patients diagnosed with HD as a primary outcome. Other outcomes include identification of the nutritional and inflammatory status including the nutritional and inflammatory markers in children with HD with possible impacts on hospital outcomes.

Methods: This is a randomized interventional control study that was applied to 50 children diagnosed with HD who underwent elective pull-through surgery. We randomly allocated 25 diagnosed with HD who underwent elective pull-through surgery. We randomly allocated 25 patients to zinc treatment.

Results: The results demonstrated that the interventional group had a lower incidence of complications (20%) when compared to the control group (64%), with a significant p-value of 0.002. In addition, less incidence of Hirschsprung's associated enterocolitis (HAEC) (12% vs. 40%) and skin excoriation (8% vs. 32%) were documented in the interventional group compared to the controls respectively.

Conclusion: Pre-operative zinc supplementation may have a beneficial impact on HD children undergoing elective pull-through surgery as regards outcomes such as HAEC and skin excoriation.

目的:研究证实锌对人体健康和胃肠道炎性疾病的有益作用。我们建议锌对接受选择性拉通手术的先天性巨结肠病(HD)儿童有价值。本研究旨在确定术前锌摄入量对术后结局的影响,特别是将诊断为HD患者的住院时间作为主要结局。其他结果包括确定HD儿童的营养和炎症状况,包括可能影响医院结果的营养和炎症标志物。方法:这是一项随机介入对照研究,应用于50名诊断为HD的儿童,他们接受了选择性拉通手术。我们随机分配了25名诊断为HD的患者,他们接受了选择性拉通手术。我们随机分配25例患者接受锌治疗。结果:结果显示介入组并发症发生率(20%)低于对照组(64%),p值为0.002。此外,与对照组相比,介入组先天性巨结肠相关小肠结肠炎(HAEC)的发生率(12%对40%)和皮肤擦伤(8%对32%)分别较低。结论:术前补充锌可能对接受选择性拉通手术的HD儿童有有益的影响,如HAEC和皮肤擦伤。
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引用次数: 0
Is a Training Program in Pediatric Abdominal Ultrasonography Necessary for Pediatricians? 儿科医生有必要参加小儿腹部超声波检查培训课程吗?
IF 1.3 Q3 PEDIATRICS Pub Date : 2024-11-01 Epub Date: 2024-11-05 DOI: 10.5223/pghn.2024.27.6.333
Soon Chul Kim

Despite being an essential specialty, pediatrics in South Korea faces the threat of collapse. While the declining birth rate is an important contributor to the decrease in the pediatric population, a more critical issue lies in the dysfunctional healthcare system. Primary care pediatricians are troubled by the lack of patients, whereas tertiary care specialists are concerned about the shortage of doctors. Although the absolute number of pediatric specialists is not small, there is a scarcity of doctors willing to specialize in pediatrics. Recently, pediatric abdominal ultrasonography has been conducted in tertiary hospitals. However, there is an argument that this responsibility should be shifted to primary care pediatricians. As someone who has been performing pediatric abdominal ultrasound examinations for years, I am committed to educating pediatric specialists in this field. My aim is to contribute, albeit modestly, to improving the South Korean healthcare system.

尽管儿科是一门重要的专业,但在韩国却面临着崩溃的威胁。虽然出生率下降是导致儿科人口减少的重要原因,但更关键的问题在于医疗保健系统功能失调。初级保健儿科医生为缺乏病人而烦恼,而三级保健专家则为医生短缺而担忧。虽然儿科专家的绝对数量并不少,但愿意专攻儿科的医生却非常稀缺。最近,三级医院开展了小儿腹部超声波检查。然而,有一种观点认为,应将这一职责转移给初级保健儿科医生。作为多年来一直从事小儿腹部超声波检查的人,我致力于教育这一领域的儿科专家。我的目标是为改善南韩的医疗保健系统做出贡献,尽管贡献不大。
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引用次数: 0
Correction: Efficacy and Safety of Long-Term Administration of Esomeprazole in Japanese Pediatric Patients Aged 1-14 Years with Chronic Gastric Acid-Related Disease. 更正:日本 1-14 岁患有慢性胃酸相关疾病的儿科患者长期服用埃索美拉唑的有效性和安全性。
IF 1.3 Q3 PEDIATRICS Pub Date : 2024-11-01 Epub Date: 2024-11-05 DOI: 10.5223/pghn.2024.27.6.383
Masaaki Mori, Yoshiko Nakayama, Shigeo Nishimata, Tadafumi Yokoyama, Ryo Matsuoka, Reiko Hatori, Masaki Shimizu, Katsuhiro Arai, Yuri Etani, Tsuyoshi Sogo, Tomoko Ishizu, Masahiro Nii, Ryosuke Nakashima, Toshiaki Shimizu

[This corrects the article on p. 274 in vol. 27, PMID: 39319279.].

[此处更正了第 27 卷第 274 页的文章,PMID:39319279]。
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引用次数: 0
Prevalence and Factors associated with Bowel Dysfunctions after Pull-Through Surgery in Children Diagnosed with Hirschsprung Disease. 被诊断患有赫氏prung 病的儿童接受拉通手术后肠道功能障碍的发生率和相关因素。
IF 1.3 Q3 PEDIATRICS Pub Date : 2024-11-01 Epub Date: 2024-11-05 DOI: 10.5223/pghn.2024.27.6.372
Maliwan Surasen, Palittiya Sintusek, Nimmita Srisan, Katawaetee Decharun, Paisarn Vejchapipat

Purpose: This study investigated the prevalence of bowel dysfunction and associated factors after pull-through surgery.

Methods: The medical records of children under 18 years old diagnosed with Hirschsprung disease (HD) based on histopathology between 2004 and 2022 were reviewed. Bowel dysfunction after pull-through surgery was categorized into Hirschsprung-associated enterocolitis (HAEC), constipation, and fecal incontinence.

Results: Among 97 children diagnosed with HD, the median age at presentation was 3 (2-15) days (84.54% male). The clinical manifestations included abdominal distension (58.76%), constipation (17.52%), bilious vomiting (17.52%), nonbilious vomiting (14.43%), and enterocolitis (12.37%). HDs were classified by the location of aganglionosis: short segments (74.23%), long segments (8.25%), total colonic (12.37%), and small intestinal (5.15%). Excluding surgical complications, the prevalence of bowel dysfunction was 64.95% during an average follow-up of 8.33 years. HAEC was the most common issue (46.39%), followed by nonretentive incontinence (22.68%), constipation (20.62%), and retentive incontinence (15.46%). Preoperative HAEC was significantly associated with post-surgery HAEC (adjusted odds ratio [aOR] 18.31; 95% confidence interval [CI], 1.30-257.73; p=0.031). The Duhamel operation was associated with constipation and retentive incontinence (aOR 62.15; 95% CI, 1.64-2,349.13; p=0.026). Age under 6 months at pull-through surgery was associated with nonretentive fecal incontinence after 4 years (aOR 8.83; 95% CI, 1.11-70.39; p=0.040).

Conclusion: The prevalence of bowel dysfunction in children with HD remains high despite successful surgical correction. Preoperative HAEC, Duhamel operation, and pull-through surgery before the age of 6 months were found to be independent factors associated with bowel dysfunction after pull-through surgery.

目的:本研究调查了拉通手术后肠道功能障碍的发生率及相关因素:方法:研究人员回顾了 2004 年至 2022 年期间根据组织病理学诊断为赫氏病(HD)的 18 岁以下儿童的病历。拉通手术后肠道功能障碍分为赫氏相关性小肠结肠炎(HAEC)、便秘和大便失禁:在97名确诊为HD的儿童中,发病年龄中位数为3(2-15)天(84.54%为男性)。临床表现包括腹胀(58.76%)、便秘(17.52%)、胆汁性呕吐(17.52%)、非胆汁性呕吐(14.43%)和肠炎(12.37%)。高清病例按结肠病变的部位分类:短节段(74.23%)、长节段(8.25%)、全结肠(12.37%)和小肠(5.15%)。除去手术并发症,在平均 8.33 年的随访期间,肠道功能障碍的发生率为 64.95%。HAEC 是最常见的问题(46.39%),其次是非牵拉性失禁(22.68%)、便秘(20.62%)和牵拉性失禁(15.46%)。术前 HAEC 与术后 HAEC 显著相关(调整赔率 [aOR] 18.31;95% 置信区间 [CI],1.30-257.73;P=0.031)。Duhamel 手术与便秘和牵拉性尿失禁有关(aOR 62.15;95% CI,1.64-2,349.13;p=0.026)。拉通手术时年龄不足6个月与4年后非留置性大便失禁有关(aOR 8.83;95% CI,1.11-70.39;p=0.040):结论:尽管成功进行了手术矫正,但HD患儿肠道功能障碍的发生率仍然很高。研究发现,术前HAEC、Duhamel手术和6个月前的拉通手术是导致拉通手术后肠道功能障碍的独立因素。
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引用次数: 0
Oral Nutrition During Continuous Albuterol for Pediatric Critical Asthma: A Matched Cohort Study. 小儿重症哮喘患者在持续服用阿布特罗期间的口服营养:匹配队列研究
IF 1.3 Q3 PEDIATRICS Pub Date : 2024-11-01 Epub Date: 2024-11-05 DOI: 10.5223/pghn.2024.27.6.364
Maya Antionette Root, Carolyn Maria Ibrahim Pavlich, Anthony Alexander Sochet, Alexa Rae Roberts, Brett Walter Russi

Purpose: The practice of withholding oral nutrition for children hospitalized for critical asthma receiving continuous albuterol is not evidence based. We sought to characterize oral nutrition practices in this population and estimate the frequency of aspiration-related respiratory failure.

Methods: We performed a single-center retrospective, matched cohort study of children 3-17 years of age admitted to a pediatric intensive care unit from Oct 2020 to May 2023 for critical asthma receiving continuous albuterol. Cases provided oral nutrition were matched 1:2 to controls withheld nutrition by age and National Heart Lung and Blood Institute asthma severity classification. The primary outcome was aspiration-related respiratory failure defined as any respiratory support escalation following observed aspiration. Descriptive data included demographics, anthropometrics, pediatric asthma severity scores, adjunct asthma interventions, continuous albuterol duration, mortality, and length of stay.

Results: Of 36 cases and 72 matched controls, the mean age was 9.1±3.9 years and 66.7% had moderate-severe persistent asthma. Cases and controls had comparable anthropometrics and admission pediatric asthma severity scores. No aspiration-related respiratory failure events were observed even among those receiving nutrition concurrent to noninvasive ventilation. Compared to controls, cases experienced a longer continuous albuterol duration (median: 1.1 [interquartile range: 0.7-1.8] versus 0.7 [interquartile range: 0.3-1.3] days, p<0.001). No differences in length of stay, adjunct interventions, endotracheal intubation rates, and mortality were observed between cases and controls.

Conclusion: For children hospitalized for critical asthma, oral nutrition during continuous nebulized albuterol appeared well tolerated. While prospective validation is required, the practice of withholding oral nutrition for continuous albuterol administration may be unwarranted.

目的:对于因重症哮喘住院并持续服用沙丁胺醇的儿童,暂停口服营养的做法并无证据支持。我们试图描述这一人群的口服营养做法,并估计与吸入相关的呼吸衰竭的发生频率:我们对 2020 年 10 月至 2023 年 5 月期间因重症哮喘连续服用沙丁胺醇而入住儿科重症监护病房的 3-17 岁儿童进行了一项单中心回顾性匹配队列研究。提供口服营养的病例与不提供营养的对照组按年龄和美国国家心肺血液研究所哮喘严重程度分类进行了 1:2 匹配。主要结果是吸入相关的呼吸衰竭,定义为观察到吸入后呼吸支持的任何升级。描述性数据包括人口统计学、人体测量学、小儿哮喘严重程度评分、辅助哮喘干预措施、连续使用沙丁胺醇时间、死亡率和住院时间:在 36 例病例和 72 例匹配对照中,平均年龄为(9.1±3.9)岁,66.7% 患有中度-重度持续性哮喘。病例和对照组的人体测量和入院时小儿哮喘严重程度评分相当。即使在接受营养和无创通气的同时,也没有观察到与吸入相关的呼吸衰竭事件。与对照组相比,病例持续服用沙丁胺醇的时间更长(中位数:1.1[四分位数]):1.1天[四分位数间距:0.7-1.8]对0.7天[四分位数间距:0.3-1.3],P 结论:对于因哮喘而住院的危重症儿童来说,持续使用阿布特罗的时间更长:对于因危重哮喘住院的儿童来说,在持续雾化吸入沙丁胺醇期间口服营养似乎耐受性良好。虽然需要进行前瞻性验证,但在连续雾化吸入阿布特罗期间暂停口服营养的做法可能是不正确的。
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引用次数: 0
Prevalence, Management, and Outcomes of Non-Invasive Helicobacter pylori Testing in Children at a Tertiary Paediatric Hospital in Singapore. 新加坡一家三级儿科医院对儿童进行非侵入性幽门螺杆菌检测的患病率、管理和结果。
IF 1.3 Q3 PEDIATRICS Pub Date : 2024-11-01 Epub Date: 2024-11-05 DOI: 10.5223/pghn.2024.27.6.336
Charanya Rajan, Fang Kuan Chiou, Christopher Wen Wei Ho

Purpose: Helicobacter pylori infections differ between children and adults. The Pediatric society practice guidelines recommend against a test-and-treat approach, characterized by the use of non-invasive tests for diagnosis (e.g. urea breath test [UBT] or stool antigen test). However, significant variations exist in clinical practice. This study examined the use of non-invasive testing for the screening and diagnosis of H. pylori infection in children at a tertiary pediatric hospital in Singapore, reviewing both management decisions and patient outcomes.

Methods: A retrospective review was conducted on children between the ages of 0 and 18 years who were tested for H. pylori infection using either a stool antigen test or UBT between January 2018 and June 2020.

Results: Among the 1,397 children tested, 117 (8.4%) had a positive stool H. pylori antigen result, and 5 out of 85 tested (5.9%) had a positive UBT. Abdominal pain was the predominant symptom (n=98; 80.3%). Only 7 treatment-naïve children had biopsy-proven disease. Tissue biopsies for H. pylori culture were sent to 2 children, with 1 negative result. A total of 111 children (91.0%) received treatment, wherein proton pump inhibitor, amoxicillin, and clarithromycin for 14 days was the most common therapeutic regimen. Symptom resolution was observed in 62 children (50.8%).

Conclusion: A test-and-treat strategy was more widely utilized than endoscopy-based testing, showing a low compliance to existing guidelines for the management of H. pylori infections in children at our center and significant false-positive rates.

目的:儿童和成人的幽门螺旋杆菌感染情况不同。儿科学会的实践指南建议不要采取先检测后治疗的方法,其特点是使用非侵入性检测进行诊断(如尿素呼气试验 [UBT] 或粪便抗原检测)。然而,临床实践中存在很大差异。本研究考察了新加坡一家三级儿科医院使用非侵入性检测筛查和诊断儿童幽门螺杆菌感染的情况,并对管理决策和患者预后进行了回顾性分析:方法:对2018年1月至2020年6月期间使用粪便抗原检测法或UBT检测幽门螺杆菌感染的0至18岁儿童进行回顾性研究:在接受检测的 1397 名儿童中,117 人(8.4%)的粪便幽门螺杆菌抗原检测结果呈阳性,85 名接受检测的儿童中有 5 人(5.9%)的 UBT 检测结果呈阳性。腹痛是主要症状(98 人,占 80.3%)。只有 7 名未经治疗的儿童经活检证实患有疾病。2 名儿童接受了组织活检进行幽门螺杆菌培养,其中 1 例结果为阴性。共有 111 名儿童(91.0%)接受了治疗,其中质子泵抑制剂、阿莫西林和克拉霉素治疗 14 天是最常见的治疗方案。62名儿童(50.8%)的症状得到缓解:结论:与基于内镜的检测方法相比,我们更广泛地采用了先检测后治疗的策略,这表明我们中心儿童幽门螺杆菌感染的治疗很少遵循现有指南,而且假阳性率很高。
{"title":"Prevalence, Management, and Outcomes of Non-Invasive <i>Helicobacter pylori</i> Testing in Children at a Tertiary Paediatric Hospital in Singapore.","authors":"Charanya Rajan, Fang Kuan Chiou, Christopher Wen Wei Ho","doi":"10.5223/pghn.2024.27.6.336","DOIUrl":"10.5223/pghn.2024.27.6.336","url":null,"abstract":"<p><strong>Purpose: </strong><i>Helicobacter pylori</i> infections differ between children and adults. The Pediatric society practice guidelines recommend against a test-and-treat approach, characterized by the use of non-invasive tests for diagnosis (e.g. urea breath test [UBT] or stool antigen test). However, significant variations exist in clinical practice. This study examined the use of non-invasive testing for the screening and diagnosis of <i>H. pylori</i> infection in children at a tertiary pediatric hospital in Singapore, reviewing both management decisions and patient outcomes.</p><p><strong>Methods: </strong>A retrospective review was conducted on children between the ages of 0 and 18 years who were tested for <i>H. pylori</i> infection using either a stool antigen test or UBT between January 2018 and June 2020.</p><p><strong>Results: </strong>Among the 1,397 children tested, 117 (8.4%) had a positive stool <i>H. pylori</i> antigen result, and 5 out of 85 tested (5.9%) had a positive UBT. Abdominal pain was the predominant symptom (n=98; 80.3%). Only 7 treatment-naïve children had biopsy-proven disease. Tissue biopsies for <i>H. pylori</i> culture were sent to 2 children, with 1 negative result. A total of 111 children (91.0%) received treatment, wherein proton pump inhibitor, amoxicillin, and clarithromycin for 14 days was the most common therapeutic regimen. Symptom resolution was observed in 62 children (50.8%).</p><p><strong>Conclusion: </strong>A test-and-treat strategy was more widely utilized than endoscopy-based testing, showing a low compliance to existing guidelines for the management of <i>H. pylori</i> infections in children at our center and significant false-positive rates.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"27 6","pages":"336-344"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11570354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Expression of IL-7RαlowCX3CR1+ CD8+ T Cells and α4β7 Integrin Tagged T Cells Related to Mucosal Immunity in Children with Inflammatory Bowel Disease. 炎症性肠病患儿中与粘膜免疫相关的 IL-7RαlowCX3CR1+ CD8+ T 细胞和 α4β7 Integrin 标记 T 细胞的表达。
IF 1.3 Q3 PEDIATRICS Pub Date : 2024-11-01 Epub Date: 2024-11-05 DOI: 10.5223/pghn.2024.27.6.345
Da Hee Yang, Hyo Jin Kim, Duong Thi Thuy Dinh, Jiwon Yang, Chang-Lim Hyun, Youngheun Jee, Naeun Lee, Min Sun Shin, Insoo Kang, Ki Soo Kang

Purpose: The study aimed to investigate the recruiting of T lymphocytes including IL-7Rαlow CX3CR1+ effector memory (EM) CD8+ T cells and α4β7 integrin tagged T cells to inflamed intestinal mucosa.

Methods: Whole blood and mucosal tissues of intestine were collected from 40 children with or without inflammatory bowel disease (IBD). T cell surface staining and immunohistochemistry were done with several antibodies in peripheral blood mononuclear cells (PBMCs) and intestinal mucosa, respectively. Serum levels of cytokines were measured by ELISA.

Results: The frequency of IL-7RαlowCX3CR1+ EM CD8+ T cells in the PBMC was significantly higher in the ulcerative colitis group than in the control group (57.9±17.80% vs. 33.9±15.70%, p=0.021). The frequency of integrin α4β7+ CD4+ T cells in the PBMC was significantly lower in the ulcerative colitis group than in the control group (53.2±27.6% vs. 63.9±13.2%, p=0.022). Serum concentration of TNF-α was higher in the Crohn's disease group than in the control group (26.13±5.01 pg/mL vs. 19.65±6.07 pg/mL, p=0.008). Of the three groups, the ulcerative colitis group had the highest frequency of integrin α4β7+ T cells based on immunohistochemistry analyses for intestinal tissues, followed by the Crohn's disease group and the control group (4.63±1.29 cells vs. 2.0±0.57 cells vs. 0.84±0.52 cells, p<0.001).

Conclusion: Trafficking immune cells with effector memory CD8+ T cells clarified by IL-7RαlowCX3CR1+ and integrin α4β7+ CD4+ T cells might be highly associated with the pathogenesis of ulcerative colitis.

目的:该研究旨在调查T淋巴细胞(包括IL-7Rα-low CX3CR1+效应记忆(EM)CD8+T细胞和α4β7整合素标记T细胞)对炎症肠粘膜的招募情况:方法:收集 40 名患有或未患有炎症性肠病(IBD)的儿童的全血和肠道粘膜组织。用几种抗体分别对外周血单核细胞(PBMCs)和肠粘膜进行了 T 细胞表面染色和免疫组化。用酶联免疫吸附法测定了血清中细胞因子的水平:结果:溃疡性结肠炎组 PBMC 中 IL-7RαlowCX3CR1+ EM CD8+ T 细胞的频率明显高于对照组(57.9±17.80% vs. 33.9±15.70%,P=0.021)。溃疡性结肠炎组 PBMC 中整合素 α4β7+ CD4+ T 细胞的频率明显低于对照组(53.2±27.6% vs. 63.9±13.2%,P=0.022)。克罗恩病组的血清 TNF-α 浓度高于对照组(26.13±5.01 pg/mL vs. 19.65±6.07 pg/mL,P=0.008)。根据肠道组织的免疫组化分析,三组中溃疡性结肠炎组的整合素α4β7+ T细胞频率最高,其次是克罗恩病组和对照组(4.63±1.29 cells vs. 2.0±0.57 cells vs. 0.84±0.52 cells,P=0.008):通过IL-7Rα-lowCX3CR1+和整合素α4β7+ CD4+ T细胞明确的具有效应记忆CD8+ T细胞的交通免疫细胞可能与溃疡性结肠炎的发病机制高度相关。
{"title":"Expression of IL-7Rα<sup>low</sup>CX3CR1<sup>+</sup> CD8<sup>+</sup> T Cells and α4β7 Integrin Tagged T Cells Related to Mucosal Immunity in Children with Inflammatory Bowel Disease.","authors":"Da Hee Yang, Hyo Jin Kim, Duong Thi Thuy Dinh, Jiwon Yang, Chang-Lim Hyun, Youngheun Jee, Naeun Lee, Min Sun Shin, Insoo Kang, Ki Soo Kang","doi":"10.5223/pghn.2024.27.6.345","DOIUrl":"10.5223/pghn.2024.27.6.345","url":null,"abstract":"<p><strong>Purpose: </strong>The study aimed to investigate the recruiting of T lymphocytes including IL-7Rα<sup>low</sup> CX3CR1<sup>+</sup> effector memory (EM) CD8<sup>+</sup> T cells and α4β7 integrin tagged T cells to inflamed intestinal mucosa.</p><p><strong>Methods: </strong>Whole blood and mucosal tissues of intestine were collected from 40 children with or without inflammatory bowel disease (IBD). T cell surface staining and immunohistochemistry were done with several antibodies in peripheral blood mononuclear cells (PBMCs) and intestinal mucosa, respectively. Serum levels of cytokines were measured by ELISA.</p><p><strong>Results: </strong>The frequency of IL-7Rα<sup>low</sup>CX3CR1<sup>+</sup> EM CD8<sup>+</sup> T cells in the PBMC was significantly higher in the ulcerative colitis group than in the control group (57.9±17.80% vs. 33.9±15.70%, <i>p</i>=0.021). The frequency of integrin α4β7<sup>+</sup> CD4<sup>+</sup> T cells in the PBMC was significantly lower in the ulcerative colitis group than in the control group (53.2±27.6% vs. 63.9±13.2%, <i>p</i>=0.022). Serum concentration of TNF-α was higher in the Crohn's disease group than in the control group (26.13±5.01 pg/mL vs. 19.65±6.07 pg/mL, <i>p</i>=0.008). Of the three groups, the ulcerative colitis group had the highest frequency of integrin α4β7<sup>+</sup> T cells based on immunohistochemistry analyses for intestinal tissues, followed by the Crohn's disease group and the control group (4.63±1.29 cells vs. 2.0±0.57 cells vs. 0.84±0.52 cells, <i>p</i><0.001).</p><p><strong>Conclusion: </strong>Trafficking immune cells with effector memory CD8<sup>+</sup> T cells clarified by IL-7Rα<sup>low</sup>CX3CR1<sup>+</sup> and integrin α4β7<sup>+</sup> CD4<sup>+</sup> T cells might be highly associated with the pathogenesis of ulcerative colitis.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"27 6","pages":"345-354"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11570351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Pediatric Gastroenterology, Hepatology & Nutrition
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