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Agreement Level of Inflammatory Bowel Disease Symptom Reports between Children and Their Parents. 儿童与父母炎症性肠病症状报告的一致性水平
IF 1.9 Q3 PEDIATRICS Pub Date : 2023-03-01 Epub Date: 2023-03-07 DOI: 10.5223/pghn.2023.26.2.88
Angharad Vernon-Roberts, Emma Rouse, Nerissa L Bowcock, Daniel A Lemberg, Andrew S Day

Purpose: Children with inflammatory bowel disease (IBD) frequently undergo clinical assessments, involving triadic communication between clinician, parent, and child. During such encounters parents are traditionally the main communicator of information on their child's IBD, including subjective symptom reports. The level of agreement between children and their parents for IBD symptoms is poorly understood, and this study aimed to examine this factor.

Methods: This was a cross-sectional study among children with IBD, and one parent. A validated paediatric IBD symptom report tool (IBDnow) enabled children and their parent to rate seven pain, well-being, and stool metrics, with dyads completing the tool concurrently. Results were assessed using: Individual agreement: proportion of identical symptom reports by each dyad (ideal score >0.7); Category agreement: percentage of identical reports for IBDnow metrics for the cohort; Inter-rater reliability: Gwet's AC1 coefficient with higher scores indicating better reliability (maximum=1).

Results: Seventy-four parent/child dyads participated; child's mean age 12.2 years (standard deviation [SD] 2.9, range 6-16), mean time since diagnosis 2.8 years (SD 3), 54% female, 73% had Crohn's Disease. Mean individual agreement level was 0.6, with 27% of dyads agreeing on ≥6/7 IBDnow metrics. Category agreement was reported by 61% of dyads, 20% of parents overestimated, and 19% underestimated, their child's symptoms. Inter-rater reliability ranged from fair to good.

Conclusion: These results should improve clinician awareness of how IBD symptom reports from parents may introduce bias. Children should be considered the most important source of symptom reports, and tools such as IBDnow utilised to enhance communication.

目的:患有炎症性肠病(IBD)的儿童经常接受临床评估,包括临床医生、父母和儿童之间的三阶段沟通。在这种遭遇中,父母传统上是孩子IBD信息的主要沟通者,包括主观症状报告。儿童及其父母对IBD症状的一致程度尚不清楚,本研究旨在检验这一因素。方法:这是一项针对IBD儿童和父母一方的横断面研究。一个经过验证的儿科IBD症状报告工具(IBDnow)使儿童及其父母能够对七项疼痛、健康和粪便指标进行评分,两人同时完成该工具。结果评估采用:个体一致性:每个二人组相同症状报告的比例(理想得分>0.7);类别一致性:队列IBDnow指标的相同报告百分比;评分者间信度:Gwet的AC1系数得分越高,表示信度越好(最大值=1);儿童平均年龄12.2岁(标准差[SD]2.9,范围6-16),诊断后平均时间2.8年(标准差3),54%为女性,73%患有克罗恩病。平均个体一致性水平为0.6,27%的二人组同意≥6/7 IBDnow指标。61%的二人组报告了类别一致性,20%的父母高估了孩子的症状,19%的父母低估了他们的症状。评分者间的可靠性从一般到良好不等。结论:这些结果应该提高临床医生对父母IBD症状报告可能引入偏见的认识。儿童应被视为症状报告的最重要来源,IBDnow等工具可用于加强沟通。
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引用次数: 0
A Nationwide Survey on Gastrointestinal Endoscopy Practice Patterns among Pediatric Endoscopists in South Korea. 韩国儿科内镜医师胃肠内镜检查实践模式的全国性调查。
IF 1.9 Q3 PEDIATRICS Pub Date : 2023-03-01 DOI: 10.5223/pghn.2023.26.2.79
Yoo Min Lee, Yoon Lee, So Yoon Choi, Hyun Jin Kim, Suk Jin Hong, Yunkoo Kang, Eun Hye Lee, Kyung Jae Lee, Youjin Choi, Dae Yong Yi, Seung Kim, Ben Kang

Purpose: Gastrointestinal (GI) endoscopy is an important tool for diagnosing and treating GI diseases in children. This study aimed to analyze the current GI endoscopy practice patterns among South Korean pediatric endoscopists.

Methods: Twelve members of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition developed a questionnaire. The questionnaire was emailed to pediatric gastroenterologists attending general and tertiary hospitals in South Korea.

Results: The response rate was 86.7% (52/60), and 49 of the respondents (94.2%) were currently performing endoscopy. All respondents were performing esophagogastroduodenoscopy, and 43 (87.8%) were performing colonoscopy. Relatively rare procedures for children, such as double-balloon enteroscopy (DBE) (4.1%), endoscopic retrograde cholangiopancreatography (ERCP) (2.0%), and endoscopic ultrasound (EUS) (2.0%), were only performed by pediatric gastroenterologists at very few centers, but were performed by adult endoscopists in most of the centers; of all the respondents, 83.7% (41/49) performed emergency endoscopy. In most centers, the majority of the endoscopies were performed under sedation, with midazolam (100.0%) and ketamine (67.3%) as the most frequently used sedatives.

Conclusion: While most pediatric GI endoscopists perform common GI endoscopic procedures, rare procedures, such as DBE, ERCP, and EUS, are only performed by pediatric gastroenterologists at very few centers, and by adult GI endoscopists at most of the centers. For such rare procedures, close communication and cooperation with adult GI endoscopists are required.

目的:胃肠内镜是诊断和治疗儿童胃肠疾病的重要工具。本研究旨在分析目前韩国儿科内镜医师的胃肠道内镜实践模式。方法:韩国儿科胃肠病学、肝病学和营养学学会的12名成员制作了一份问卷。问卷通过电子邮件发送给韩国综合医院和三级医院的儿科胃肠病学家。结果:有效率为86.7%(52/60),其中49例(94.2%)正在进行内镜检查。所有受访者均行食管胃十二指肠镜检查,43例(87.8%)行结肠镜检查。相对罕见的儿童手术,如双球囊肠镜检查(DBE)(4.1%)、内窥镜逆行胆管造影(ERCP)(2.0%)和内窥镜超声检查(EUS)(2.0%),仅在极少数中心由儿科胃肠科医生进行,但在大多数中心由成人内窥镜医生进行;在所有应答者中,83.7%(41/49)进行了急诊内镜检查。在大多数中心,大多数内窥镜检查是在镇静下进行的,咪达唑仑(100.0%)和氯胺酮(67.3%)是最常用的镇静剂。结论:虽然大多数儿童胃肠道内窥镜医师都进行常见的胃肠道内窥镜手术,但罕见的手术,如DBE、ERCP和EUS,仅在极少数中心由儿童胃肠病学家进行,而在大多数中心由成人胃肠道内窥镜医师进行。对于这种罕见的手术,需要与成人胃肠道内窥镜医师密切沟通和合作。
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引用次数: 0
Treatment of Symptomatic Focal Hepatic Hemangioma with Propranolol in Neonates: Is It Efficient? 心得安治疗新生儿症状性局灶性肝血管瘤是否有效?
IF 1.9 Q3 PEDIATRICS Pub Date : 2023-01-01 DOI: 10.5223/pghn.2023.26.1.70
Jana Lozar Krivec, Nina Lah, Mojca Glušič, Orjana Velikonja, Darja Paro-Panjan

Hepatic hemangiomas (HH) - classified into congenital hepatic hemangiomas (CHH) or infantile hepatic hemangiomas (IHH) - are benign vascular tumors that are mainly asymptomatic, but may cause clinical problems that require treatment. While focal, multifocal, and diffuse IHH are responsive to propranolol treatment, CHH is mainly focal and thought to be resistant to treatment with propranolol. The clinical and imaging distinctions between CHH and IHH in cases of focal lesions can be challenging, while histopathological distinction is mostly lacking in the clinical setting. We report 4 neonatal symptomatic cases of focal HH treated with propranolol, with partial or complete resolution of the tumor, and the positive hemodynamic effect of propranolol in one case. We believe that although clear differentiation cannot be achieved between CHH and IHH without histopathological examination in cases of focal HH in neonates, propranolol treatment should be attempted in symptomatic cases since its benefits outweigh the possible small risk of side effects of propranolol.

肝血管瘤(HH) -分为先天性肝血管瘤(CHH)或婴儿肝血管瘤(IHH) -是一种良性血管肿瘤,主要无症状,但可能引起临床问题,需要治疗。虽然局灶性、多灶性和弥漫性IHH对心得安治疗有反应,但CHH主要是局灶性的,被认为对心得安治疗有耐药性。局灶性病变中CHH和IHH的临床和影像学区分可能具有挑战性,而临床环境中大多缺乏组织病理学区分。我们报告了4例新生儿局灶性HH的症状性病例,用心得安治疗后肿瘤部分或完全消退,其中一例心得安对血流动力学有积极影响。我们认为,虽然在新生儿局灶性HH病例中,如果没有组织病理学检查,无法明确区分CHH和IHH,但在有症状的病例中,应尝试心得安治疗,因为其益处超过心得安可能产生的小副作用风险。
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引用次数: 2
Fecal Calprotectin and Cow's Milk-Related-Symptoms Score in Children with Cow's Milk Protein Allergy. 牛奶蛋白过敏儿童粪便钙保护蛋白与牛奶相关症状评分
IF 1.9 Q3 PEDIATRICS Pub Date : 2023-01-01 DOI: 10.5223/pghn.2023.26.1.43
Sahar Zain-Alabedeen, Noha Kamel, Mona Amin, Angharad Vernon-Roberts, Andrew S Day, Abdelmoneim Khashana

Purpose: The cow's milk-related-symptom-score (CoMiSS) tool was developed as an awareness tool for the assessment of cow's milk-related symptoms in infants or children. Fecal calprotectin (FC) is a noninvasive biomarker of gut inflammation that can be measured in serum and stool. This study aimed to investigate the relationship between FC levels and CoMiSS scores in infants with cow's milk protein allergy.

Methods: Infants (aged 6-12 months) who were allergic to cow's milk protein were enrolled prospectively. Following completion of the CoMiSS scoring, the infants were divided into group 1 (positive CoMiSS scores ≥12) and group 2 (negative CoMiSS scores <12). FC was measured using immunoassay.

Results: Of the 120 infants enrolled in this study, 60 (50.0%) had positive CoMiSS scores (group 1), while 60 (50.0%) had negative scores (group 2). The mean FC level was higher in the infants in group 1 than those in group 2 (2,934.57 µg/g vs. 955.13 µg/g; p<0.001). In addition, there was a positive correlation between FC and CoMiSS scores (R=0.168, p<0.0001). A FC level of 1,700 µg/g provided a sensitivity of 98.3%, specificity of 93.3%, and accuracy of 95.8% for the diagnosis of cow's milk protein allergy (CMPA).

Conclusion: FC measurement may have a role in the assessing infants with CMPA.

目的:开发牛奶相关症状评分(CoMiSS)工具,作为评估婴儿或儿童牛奶相关症状的意识工具。粪钙保护蛋白(FC)是一种无创的肠道炎症生物标志物,可以在血清和粪便中测量。本研究旨在探讨牛奶蛋白过敏婴儿FC水平与CoMiSS评分之间的关系。方法:前瞻性招募对牛奶蛋白过敏的婴儿(6-12个月)。CoMiSS评分完成后,将婴儿分为1组(CoMiSS阳性评分≥12)和2组(CoMiSS阴性评分)结果:本研究纳入的120例婴儿中,60例(50.0%)为CoMiSS阳性评分(1组),60例(50.0%)为CoMiSS阴性评分(2组)。1组婴儿的平均FC水平高于2组(2934.57µg/g vs 955.13µg/g;结论:FC测量对CMPA患儿有一定的评价价值。
{"title":"Fecal Calprotectin and Cow's Milk-Related-Symptoms Score in Children with Cow's Milk Protein Allergy.","authors":"Sahar Zain-Alabedeen,&nbsp;Noha Kamel,&nbsp;Mona Amin,&nbsp;Angharad Vernon-Roberts,&nbsp;Andrew S Day,&nbsp;Abdelmoneim Khashana","doi":"10.5223/pghn.2023.26.1.43","DOIUrl":"https://doi.org/10.5223/pghn.2023.26.1.43","url":null,"abstract":"<p><strong>Purpose: </strong>The cow's milk-related-symptom-score (CoMiSS) tool was developed as an awareness tool for the assessment of cow's milk-related symptoms in infants or children. Fecal calprotectin (FC) is a noninvasive biomarker of gut inflammation that can be measured in serum and stool. This study aimed to investigate the relationship between FC levels and CoMiSS scores in infants with cow's milk protein allergy.</p><p><strong>Methods: </strong>Infants (aged 6-12 months) who were allergic to cow's milk protein were enrolled prospectively. Following completion of the CoMiSS scoring, the infants were divided into group 1 (positive CoMiSS scores ≥12) and group 2 (negative CoMiSS scores <12). FC was measured using immunoassay.</p><p><strong>Results: </strong>Of the 120 infants enrolled in this study, 60 (50.0%) had positive CoMiSS scores (group 1), while 60 (50.0%) had negative scores (group 2). The mean FC level was higher in the infants in group 1 than those in group 2 (2,934.57 µg/g vs. 955.13 µg/g; <i>p</i><0.001). In addition, there was a positive correlation between FC and CoMiSS scores (R=0.168, <i>p</i><0.0001). A FC level of 1,700 µg/g provided a sensitivity of 98.3%, specificity of 93.3%, and accuracy of 95.8% for the diagnosis of cow's milk protein allergy (CMPA).</p><p><strong>Conclusion: </strong>FC measurement may have a role in the assessing infants with CMPA.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"26 1","pages":"43-49"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/09/21/pghn-26-43.PMC9911171.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9314492","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: 2
Management of Gastrointestinal Foreign Bodies with Brief Review of the Guidelines. 胃肠道异物的处理与指南的简要回顾。
IF 1.9 Q3 PEDIATRICS Pub Date : 2023-01-01 DOI: 10.5223/pghn.2023.26.1.1
Kaan Demiroren

Foreign body (FB) ingestion is a common health problem that affects children more than adults. According to gastroenterologists' guidelines, the management of FB ingestion differs slightly between adult and children. This review aimed to compile adult and children guidelines and establish an understandable association to reveal the requirements and timing of the endoscopic procedure, which is the most effective and least complicated technique for gastrointestinal FBs. Coins, pins, and chicken and fish bones have been the most commonly ingested FBs. However, with their increasing use in recent years, large batteries with lithium-ion conversion, stronger magnets composed of rare earth metals, such as neodymium, and superabsorbent objects have become the most morbid and mortal, necessitating new management strategies. Although the approach to gastrointestinal FBs is controversial, with different treatment options available in different disciplines, many studies have demonstrated the efficacy and safety of endoscopic procedures. Many factors influence the timing of endoscopy, including the nature, size, and location of the ingested object and the patient's clinical condition.

异物(FB)摄入是一种常见的健康问题,对儿童的影响大于成人。根据胃肠病学家的指南,成人和儿童对FB摄入的处理略有不同。本综述旨在编制成人和儿童指南,并建立一个可理解的联系,以揭示内镜手术的要求和时机,这是胃肠道FBs最有效和最简单的技术。硬币、别针、鸡骨和鱼骨是最常被摄入的FBs。然而,随着近年来锂离子转换的大型电池、由稀土金属(如钕)组成的更强磁铁和高吸收率物体的使用越来越多,它们已经成为最病态和致命的,需要新的管理策略。虽然胃肠道FBs的治疗方法存在争议,不同学科有不同的治疗方案,但许多研究已经证明了内镜手术的有效性和安全性。许多因素影响内窥镜检查的时机,包括摄取物体的性质、大小和位置以及患者的临床状况。
{"title":"Management of Gastrointestinal Foreign Bodies with Brief Review of the Guidelines.","authors":"Kaan Demiroren","doi":"10.5223/pghn.2023.26.1.1","DOIUrl":"https://doi.org/10.5223/pghn.2023.26.1.1","url":null,"abstract":"<p><p>Foreign body (FB) ingestion is a common health problem that affects children more than adults. According to gastroenterologists' guidelines, the management of FB ingestion differs slightly between adult and children. This review aimed to compile adult and children guidelines and establish an understandable association to reveal the requirements and timing of the endoscopic procedure, which is the most effective and least complicated technique for gastrointestinal FBs. Coins, pins, and chicken and fish bones have been the most commonly ingested FBs. However, with their increasing use in recent years, large batteries with lithium-ion conversion, stronger magnets composed of rare earth metals, such as neodymium, and superabsorbent objects have become the most morbid and mortal, necessitating new management strategies. Although the approach to gastrointestinal FBs is controversial, with different treatment options available in different disciplines, many studies have demonstrated the efficacy and safety of endoscopic procedures. Many factors influence the timing of endoscopy, including the nature, size, and location of the ingested object and the patient's clinical condition.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"26 1","pages":"1-14"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bb/6f/pghn-26-1.PMC9911172.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9328829","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: 3
APPSPGHAN 2023 APPSPGHAN 2023
Q3 PEDIATRICS Pub Date : 2023-01-01 DOI: 10.5223/appspghan2023
{"title":"APPSPGHAN 2023","authors":"","doi":"10.5223/appspghan2023","DOIUrl":"https://doi.org/10.5223/appspghan2023","url":null,"abstract":"","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"157 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135448619","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}
引用次数: 0
Developing the Mansoura Early Feeding Skills Assessment Scale for Preterm Infants Mansoura早产儿早期喂养技能评估量表的编制
Q3 PEDIATRICS Pub Date : 2023-01-01 DOI: 10.5223/pghn.2023.26.6.320
Omnia El-Kassas, Ayman Amer, Hesham Abdel-Hady, Tamer Abou-Elsaad
Purpose This study aimed to develop a new bedside scoring system scale that assesses preterm infants’ oral feeding skills (OFS) in the neonatal intensive care unit (NICU). Methods A literature review and critical appraisal of available oral feeding assessment tools/scores were performed. Subsequently, we developed the “Mansoura Early Feeding Skills Assessment” (MEFSA) scale, an 85-item observational measure of oral feeding skills with three main sections. Forty-one preterm infants who did not receive oral feeding but were clinically stable enough to initiate oral feeding were included in the study. Next, we applied and interpreted the MEFSA to describe and score their feeding skills. Results Applying the MEFSA resulted in a smooth feeding transition, early start of oral feeding, full oral feeding, and discharge with a shorter period of tube feeding in preterm infants. Conclusion The MEFSA is a successful bedside scoring system that assesses the OFS of preterm infants in the NICU.
{"title":"Developing the Mansoura Early Feeding Skills Assessment Scale for Preterm Infants","authors":"Omnia El-Kassas, Ayman Amer, Hesham Abdel-Hady, Tamer Abou-Elsaad","doi":"10.5223/pghn.2023.26.6.320","DOIUrl":"https://doi.org/10.5223/pghn.2023.26.6.320","url":null,"abstract":"Purpose This study aimed to develop a new bedside scoring system scale that assesses preterm infants’ oral feeding skills (OFS) in the neonatal intensive care unit (NICU). Methods A literature review and critical appraisal of available oral feeding assessment tools/scores were performed. Subsequently, we developed the “Mansoura Early Feeding Skills Assessment” (MEFSA) scale, an 85-item observational measure of oral feeding skills with three main sections. Forty-one preterm infants who did not receive oral feeding but were clinically stable enough to initiate oral feeding were included in the study. Next, we applied and interpreted the MEFSA to describe and score their feeding skills. Results Applying the MEFSA resulted in a smooth feeding transition, early start of oral feeding, full oral feeding, and discharge with a shorter period of tube feeding in preterm infants. Conclusion The MEFSA is a successful bedside scoring system that assesses the OFS of preterm infants in the NICU.","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135563616","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}
引用次数: 0
Human Leukocyte Antigen-DQ Genotyping in Pediatric Celiac Disease. 儿童乳糜泻的人白细胞抗原- dq基因分型
IF 1.9 Q3 PEDIATRICS Pub Date : 2023-01-01 DOI: 10.5223/pghn.2023.26.1.50
Stuti Pareek, Raj Kumar Gupta, Abhinav Sharma, Sandhya Gulati

Purpose: The purpose of this study was to determine the pattern of human leukocyte antigen (HLA)-DQ genotype in children diagnosed with celiac disease (CD) (biopsy proven), and to compare this with a control group; and secondarily, to correlate HLA genotypes with clinical profiles of CD.

Methods: This cross-sectional comparative observational study included 26 controls and 52 patients diagnosed with CD who presented at Sir Padampat Mother and Child Health Institute, Jaipur, from May, 2017 to October, 2018. HLA DQ genotype was assessed for each patients and correlated with clinical profiles.

Results: HLA DQ2/DQ8 genotypes were significantly more common in CD (present in 100.0% cases) than in controls (23.1%) in Northern India (Rajasthan). When HLA DQ2.5 and DQ8 were present together, individuals had significantly more atypical presentations and severe findings on duodenal biopsy. Similarly, patients with the HLA DQ 2.5 genotype were also predisposed to more severe endoscopic findings, while HLA DQ2.2 predisposed them to less severe biopsy findings. HLA DQ8 was significantly associated with later age at diagnosis (>5 years) and shorter stature. The highest HLA DQ relative risk (RR) for CD development was associated with HLA DQ2.5 and DQ2.2 in combination, followed by HLA DQ2.5 and DQ8 in combination, while HLA DQx.5 and HLA DQ2.2 together had the lowest risk.

Conclusion: HLA DQ2/DQ8 genotypes are strongly associated with pediatric CD patients in northern India. These genotypes and their combinations may be associated with different clinical presentations of CD, and may help predict severity of CD.

目的:本研究的目的是确定诊断为乳糜泻(CD)(活检证实)的儿童中人类白细胞抗原(HLA)-DQ基因型的模式,并将其与对照组进行比较;方法:本横断面比较观察研究包括2017年5月至2018年10月在斋浦尔Sir Padampat母婴健康研究所就诊的26名对照组和52名诊断为CD的患者。评估每位患者的HLA DQ基因型,并与临床资料相关联。结果:HLA DQ2/DQ8基因型在印度北部(拉贾斯坦邦)的CD患者中(100.0%)比对照组(23.1%)明显更常见。当HLA DQ2.5和DQ8同时存在时,个体在十二指肠活检中有明显更多的不典型表现和严重的结果。同样,HLA dq2.5基因型患者也易出现更严重的内窥镜检查结果,而HLA DQ2.2基因型患者易出现较轻的活检结果。HLA DQ8与诊断年龄较晚(>5岁)和身材较矮显著相关。发生CD的最高HLA DQ相对风险(RR)与HLA DQ2.5和DQ2.2联合相关,其次是HLA DQ2.5和DQ8联合,而HLA DQx。HLA 5和HLA DQ2.2的风险最低。结论:HLA DQ2/DQ8基因型与印度北部儿童CD患者密切相关。这些基因型及其组合可能与乳糜泻的不同临床表现有关,并可能有助于预测乳糜泻的严重程度。
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引用次数: 0
Fecal Calprotectin Levels Significantly Correlate with Polyp Size in Children and Adolescents with Juvenile Colorectal Polyps. 儿童和青少年幼年性结直肠息肉患者粪便钙保护蛋白水平与息肉大小显著相关。
IF 1.9 Q3 PEDIATRICS Pub Date : 2023-01-01 DOI: 10.5223/pghn.2023.26.1.34
Yu Bin Kim, Ju Young Kim, Sujin Choi, Yoo Min Lee, So Yoon Choi, Soon Chul Kim, Hyo-Jeong Jang, Yoon Lee, In Sook Jeong, Dae Yong Yi, Yunkoo Kang, Kyung Jae Lee, Byung-Ho Choe, Ben Kang

Purpose: We aimed to investigate factors that correlate with fecal calprotectin (FC) levels in children and adolescents with colorectal polyps.

Methods: Pediatric patients aged <19 years who underwent colonoscopic polypectomy for a juvenile polyps (JPs) and FC tests were simultaneously conducted in a multicenter, retrospective study. Baseline demographics, colonoscopic and histological findings, and laboratory tests, including FC levels, were investigated. Correlations between the factors were investigated, and linear regression analysis revealed factors that correlated with FC levels. FC levels measured after polypectomies were investigated and the FC levels pre- and post-polypectomies were compared.

Results: A total of 33 patients were included in the study. According to Pearson correlation analysis, the polyp size was the only factor that showed a statistically significant correlation with FC levels (r=0.75, p<0.001). Furthermore, according to the multivariate linear regression analysis, polyp size was the only factor that showed a statistically significant correlation with FC levels (adjusted R2 =0.5718, β=73.62, p<0.001). The median FC level was 400 mg/kg (interquartile range [IQR], 141.6-1,000 mg/kg), and the median polyp size was 14 mm (IQR, 9-20 mm). Nineteen patients underwent post-polypectomy FC tests. FC levels showed a significant decrease after polypectomy from a median of 445.2 mg/kg (IQR, 225-1,000) to 26.5 mg/kg (11.5-51) (p<0.001).

Conclusion: FC levels significantly correlated with polyp size in children and adolescents with JPs.

目的:我们旨在研究儿童和青少年结肠直肠息肉患者粪便钙保护蛋白(FC)水平的相关因素。方法:年龄较大的儿科患者。结果:共纳入33例患者。Pearson相关分析显示,息肉大小是唯一与FC水平有统计学意义相关的因素(r=0.75, pR2 =0.5718, β=73.62, ppp)。结论:FC水平与儿童青少年jp患者息肉大小有显著相关性。
{"title":"Fecal Calprotectin Levels Significantly Correlate with Polyp Size in Children and Adolescents with Juvenile Colorectal Polyps.","authors":"Yu Bin Kim,&nbsp;Ju Young Kim,&nbsp;Sujin Choi,&nbsp;Yoo Min Lee,&nbsp;So Yoon Choi,&nbsp;Soon Chul Kim,&nbsp;Hyo-Jeong Jang,&nbsp;Yoon Lee,&nbsp;In Sook Jeong,&nbsp;Dae Yong Yi,&nbsp;Yunkoo Kang,&nbsp;Kyung Jae Lee,&nbsp;Byung-Ho Choe,&nbsp;Ben Kang","doi":"10.5223/pghn.2023.26.1.34","DOIUrl":"https://doi.org/10.5223/pghn.2023.26.1.34","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to investigate factors that correlate with fecal calprotectin (FC) levels in children and adolescents with colorectal polyps.</p><p><strong>Methods: </strong>Pediatric patients aged <19 years who underwent colonoscopic polypectomy for a juvenile polyps (JPs) and FC tests were simultaneously conducted in a multicenter, retrospective study. Baseline demographics, colonoscopic and histological findings, and laboratory tests, including FC levels, were investigated. Correlations between the factors were investigated, and linear regression analysis revealed factors that correlated with FC levels. FC levels measured after polypectomies were investigated and the FC levels pre- and post-polypectomies were compared.</p><p><strong>Results: </strong>A total of 33 patients were included in the study. According to Pearson correlation analysis, the polyp size was the only factor that showed a statistically significant correlation with FC levels (<i>r=</i>0.75, <i>p</i><0.001). Furthermore, according to the multivariate linear regression analysis, polyp size was the only factor that showed a statistically significant correlation with FC levels (adjusted <i>R<sup>2</sup></i> =0.5718, β<i>=</i>73.62, <i>p</i><0.001). The median FC level was 400 mg/kg (interquartile range [IQR], 141.6-1,000 mg/kg), and the median polyp size was 14 mm (IQR, 9-20 mm). Nineteen patients underwent post-polypectomy FC tests. FC levels showed a significant decrease after polypectomy from a median of 445.2 mg/kg (IQR, 225-1,000) to 26.5 mg/kg (11.5-51) (<i>p</i><0.001).</p><p><strong>Conclusion: </strong>FC levels significantly correlated with polyp size in children and adolescents with JPs.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"26 1","pages":"34-42"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/45/aa/pghn-26-34.PMC9911176.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9314491","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
Practice Patterns of Colorectal Polypectomy in Pediatric Endoscopic Specialists in South Korea: A Nationwide Survey Study. 韩国儿童内镜专家结肠息肉切除术的实践模式:一项全国性调查研究。
IF 1.9 Q3 PEDIATRICS Pub Date : 2023-01-01 DOI: 10.5223/pghn.2023.26.1.15
Yoon Lee, Sujin Choi, Ben Kang

Purpose: Total colonoscopy is recommended if colorectal polyps are clinically suspected. This study aimed to investigate the performance status of pediatric colonoscopic polypectomy in Korea.

Methods: We surveyed pediatric endoscopic specialists who perform colonoscopic polypectomy in Korea using a questionnaire of 13 questions on pediatric colonoscopic polypectomy performance status.

Results: The survey was conducted at 45 institutions, and 32 specialists (71.1%) responded. Among the respondents, 31.2% (10/32) said colonoscopy was performed in all age groups, while 12.5% (4/32) said sigmoidoscopy was performed in all age groups. Meanwhile, 56.2% (18/32) said that sigmoidoscopy was performed in young children, while colonoscopy was performed in older children. Among them, 38.9% (7/18) believe that 4-6 years were young, and 44.5% (8/18) believe that 7-9 years were young. Regarding surveillance examinations, 21.9% (7/32) said they would perform a surveillance colonoscopy or sigmoidoscopy in the future if less than five juvenile polyps were found in the colon. Meanwhile, if less than five adenomatous polyps were found in the colon, 93.8% (30/32) said they would perform surveillance colonoscopy or sigmoidoscopy in the future.

Conclusion: More than half of the pediatric endoscopic specialists in Korea choose between a colonoscopy and sigmoidoscopy depending on the patient's age, contrary to the generally accepted recommendation of total colonoscopy if colorectal polyps are suspected in children and adolescents. In this survey, most pediatric endoscopists used the age range of 4-9 years as the reference age.

目的:临床怀疑结直肠息肉时,建议行全结肠镜检查。本研究旨在调查韩国儿童结肠镜息肉切除术的执行状况。方法:我们对韩国进行结肠镜息肉切除术的儿科内镜专家进行了调查,使用了一份关于儿童结肠镜息肉切除术表现状况的13个问题的问卷。结果:45家机构参与调查,32名专家参与调查,占71.1%。31.2%(10/32)的受访者表示所有年龄组都进行了结肠镜检查,12.5%(4/32)的受访者表示所有年龄组都进行了乙状结肠镜检查。同时,56.2%(18/32)的患者表示幼儿行乙状结肠镜检查,而年龄较大的儿童则行结肠镜检查。其中,38.9%(7/18)的人认为4-6岁较年轻,44.5%(8/18)的人认为7-9岁较年轻。在监察检查方面,21.9%(7/32)表示,如果在结肠内发现少于5个幼年息肉,他们会在日后进行监察结肠镜或乙状结肠镜检查。同时,如果在结肠内发现少于5个腺瘤性息肉,93.8%(30/32)的人表示将来会进行监测结肠镜或乙状结肠镜检查。结论:韩国超过一半的儿科内镜专家根据患者的年龄选择结肠镜检查和乙状结肠镜检查,这与普遍接受的建议相反,如果怀疑儿童和青少年患有结肠直肠息肉,则应进行全结肠镜检查。在本次调查中,大多数儿科内窥镜医师使用4-9岁作为参考年龄。
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引用次数: 0
期刊
Pediatric Gastroenterology, Hepatology & Nutrition
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