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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 Q2 Medicine 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 Q2 Medicine 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。
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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 Q2 Medicine 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
Portal Hypertension in Children: A Tertiary Center Experience in Turkey 儿童门静脉高压症:土耳其三级中心的经验
Q2 Medicine Pub Date : 2023-01-01 DOI: 10.5223/pghn.2023.26.6.301
Emine Nur Sunar Yayla, Sinan Sarı, Neslihan Gürcan Kaya, Ödül Eğrİtaş Gürkan, Hakan Sözen, İbrahim Onur Özen, Aydın Dalgıç, Buket Dalgıç
Purpose Portal hypertension (PH) and its complications have a significant impact on morbidity and mortality. This study aimed to evaluate the etiology; clinical, laboratory, and endoscopic findings; treatment approaches; long-term outcomes; and prognosis of pediatric PH. Methods This retrospective study included 222 pediatric patients diagnosed with PH between 1998 and 2016, and data encompassing clinical, laboratory, and radiological features; treatments; and complications were analyzed. Results The most common causes of PH were portal vein thrombosis (20.3%), progressive familial intrahepatic cholestasis (18.9%), and biliary atresia (12.2%). Among the enrolled patients, 131 (59.0%) were included in the cirrhotic group and 91 (41.0%) in the non-cirrhotic group. Hepatomegaly and increased transaminase levels were more frequent in the cirrhotic group than in the non-cirrhotic group. Additionally, portal gastropathy, esophageal varices, and variceal bleeding were more frequent in the non-cirrhotic group, whereas ascites, hepatopulmonary syndrome and hepatic encephalopathy were more common in the cirrhotic group. The incidence of hepatomegaly was higher in the presinusoidal group than in the prehepatic group (p<0.001). Hyperbilirubinemia was more frequent in the prehepatic group (p=0.046). The frequency of esophageal varices was similar between the prehepatic and presinusoidal groups; however, variceal bleeding was more frequent in the prehepatic group (p=0.002). Conclusion Extrahepatic portal vein obstruction, genetic-metabolic diseases, and biliary atresia were the most prevalent causes of PH in our country. In patients with PH, hepatomegaly, increased transaminase levels, and synthesis dysfunction were suggestive of cirrhotic PH. Notably, PH in patients without cirrhosis might be more severe than that in those with cirrhosis.
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引用次数: 0
Functional Gastrointestinal Disorders and Abdominal Visceral Fat in Children and Adolescents 儿童和青少年的功能性胃肠疾病和腹部内脏脂肪
Q2 Medicine Pub Date : 2023-01-01 DOI: 10.5223/pghn.2023.26.6.338
Chang Yun Kim, Jae Hyuk Hyun, Eell Ryoo
Purpose Few reports have investigated the correlation between functional gastrointestinal disorders (FGIDs) and the degree of obesity in children and adolescents. Thus, this study aimed to examine the relationship between FGIDs and the degree of obesity in children and adolescents. Methods Children and adolescents (<19 years old) who had undergone abdominopelvic computed tomography and had been diagnosed with FGIDs from 2015 to 2016 were included in this retrospective case-control study in a ratio of 1:2. Abdominal visceral fat was measured using an image analysis software. Results The mean age of all 54 FGID patients was 12.9±3.4 years, and the male: female ratio was 1:1.2. We observed no difference in body mass index (BMI) between the FGID and control groups (19.5±4.6 vs. 20.6±4.3 kg/m2, p=0.150). However, the FGID group had less abdominal visceral fat than that of the control group (26.2±20.0 vs. 34.4±26.9 cm2, p=0.048). Boys in the FGID group had lower BMI (18.5±3.5 vs. 20.9±4.3 kg/m2, p=0.019) and less abdominal visceral fat (22.8±15.9 vs. 35.9±31.8 cm2, p=0.020) than those of boys in the control group. However, we found no difference in BMI (20.5±5.3 vs. 20.4±4.2 kg/m2, p=0.960) and abdominal visceral fat (29.0±22.9 vs. 33.1±22.1 cm2, p=0.420) between girls in both groups. Conclusion Our study revealed a difference in the relationship between FGID and the degree of obesity according to sex, which suggests that sex hormones influence the pathogenesis of FGIDs. Multicenter studies with larger cohorts are required to clarify the correlation between FGID subtypes and the degree of obesity.
{"title":"Functional Gastrointestinal Disorders and Abdominal Visceral Fat in Children and Adolescents","authors":"Chang Yun Kim, Jae Hyuk Hyun, Eell Ryoo","doi":"10.5223/pghn.2023.26.6.338","DOIUrl":"https://doi.org/10.5223/pghn.2023.26.6.338","url":null,"abstract":"Purpose Few reports have investigated the correlation between functional gastrointestinal disorders (FGIDs) and the degree of obesity in children and adolescents. Thus, this study aimed to examine the relationship between FGIDs and the degree of obesity in children and adolescents. Methods Children and adolescents (<19 years old) who had undergone abdominopelvic computed tomography and had been diagnosed with FGIDs from 2015 to 2016 were included in this retrospective case-control study in a ratio of 1:2. Abdominal visceral fat was measured using an image analysis software. Results The mean age of all 54 FGID patients was 12.9±3.4 years, and the male: female ratio was 1:1.2. We observed no difference in body mass index (BMI) between the FGID and control groups (19.5±4.6 vs. 20.6±4.3 kg/m2, p=0.150). However, the FGID group had less abdominal visceral fat than that of the control group (26.2±20.0 vs. 34.4±26.9 cm2, p=0.048). Boys in the FGID group had lower BMI (18.5±3.5 vs. 20.9±4.3 kg/m2, p=0.019) and less abdominal visceral fat (22.8±15.9 vs. 35.9±31.8 cm2, p=0.020) than those of boys in the control group. However, we found no difference in BMI (20.5±5.3 vs. 20.4±4.2 kg/m2, p=0.960) and abdominal visceral fat (29.0±22.9 vs. 33.1±22.1 cm2, p=0.420) between girls in both groups. Conclusion Our study revealed a difference in the relationship between FGID and the degree of obesity according to sex, which suggests that sex hormones influence the pathogenesis of FGIDs. Multicenter studies with larger cohorts are required to clarify the correlation between FGID subtypes and the degree of obesity.","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135563779","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
Growth and Nutritional Biomarkers in Brazilian Infants with Cow’s Milk Allergy at Diagnosis and 18-Month Follow-Up: A Prospective Cohort Study 巴西牛奶过敏婴儿在诊断和18个月随访时的生长和营养生物标志物:一项前瞻性队列研究
Q2 Medicine Pub Date : 2023-01-01 DOI: 10.5223/pghn.2023.26.6.355
Anne Jardim-Botelho, Tatiane Graça Martins, Jackeline Motta-Franco, Rosan Meyer, Sarah Cristina Fontes Vieira, Bruna Franca Protásio, Milena Letícia Santos Silva, Rebecca Silveira Pontes, Marcela Barros Barbosa de Oliveira, Ikaro Daniel de Carvalho Barreto, Ricardo Queiroz Gurgel
Purpose This study aimed to describe the growth, body protein status, and micronutrient biomarkers of Brazilian infants with cow’s milk allergy (CMPA) at baseline and at 18 months of follow-up in comparison with their healthy peers. Methods Thirty infants with CMPA younger than six months of age were included in this longitudinal study, and their nutritional status was compared with that of 24 non-allergic age-matched children. Anthropometric measurements were used to assess growth, and blood and urine samples were analyzed for protein and micronutrient status. Mixed linear models adjusted for birth weight, socioeconomic status, infant feeding at baseline, weight-for-age, C-reactive protein, serum albumin, micronutrient dietary supplementation, and salt consumption were employed to evaluate the evolution of nutritional parameters throughout the follow-up period. Results Overall, the mean age of the children at enrolment was 2.9 (standard deviation 1.7) months, and 29 children (53.7%) were male. Infants with CMPA showed a higher prevalence of functional iron depletion (transferrin saturation <20) (p=0.027), lower serum ferritin (p=0.009), and lower urinary iodine (p=0.034) levels than non-allergic children at baseline. Patients with CMPA showed a higher increment in weight-for-age and length-for-age over time than those in the control group (p<0.01). Mixed linear analyses showed a significantly lower increase in serum vitamin B12 (s-B12) (p=0.001) and urinary iodine (p<0.001) concentrations over time compared to the control group. Conclusion Infants with CMPA on a cow’s milk elimination diet had a higher weight and length at 18 months of follow-up but showed signs of inadequate iron, iodine, and B-12 vitamin status.
{"title":"Growth and Nutritional Biomarkers in Brazilian Infants with Cow’s Milk Allergy at Diagnosis and 18-Month Follow-Up: A Prospective Cohort Study","authors":"Anne Jardim-Botelho, Tatiane Graça Martins, Jackeline Motta-Franco, Rosan Meyer, Sarah Cristina Fontes Vieira, Bruna Franca Protásio, Milena Letícia Santos Silva, Rebecca Silveira Pontes, Marcela Barros Barbosa de Oliveira, Ikaro Daniel de Carvalho Barreto, Ricardo Queiroz Gurgel","doi":"10.5223/pghn.2023.26.6.355","DOIUrl":"https://doi.org/10.5223/pghn.2023.26.6.355","url":null,"abstract":"Purpose This study aimed to describe the growth, body protein status, and micronutrient biomarkers of Brazilian infants with cow’s milk allergy (CMPA) at baseline and at 18 months of follow-up in comparison with their healthy peers. Methods Thirty infants with CMPA younger than six months of age were included in this longitudinal study, and their nutritional status was compared with that of 24 non-allergic age-matched children. Anthropometric measurements were used to assess growth, and blood and urine samples were analyzed for protein and micronutrient status. Mixed linear models adjusted for birth weight, socioeconomic status, infant feeding at baseline, weight-for-age, C-reactive protein, serum albumin, micronutrient dietary supplementation, and salt consumption were employed to evaluate the evolution of nutritional parameters throughout the follow-up period. Results Overall, the mean age of the children at enrolment was 2.9 (standard deviation 1.7) months, and 29 children (53.7%) were male. Infants with CMPA showed a higher prevalence of functional iron depletion (transferrin saturation <20) (p=0.027), lower serum ferritin (p=0.009), and lower urinary iodine (p=0.034) levels than non-allergic children at baseline. Patients with CMPA showed a higher increment in weight-for-age and length-for-age over time than those in the control group (p<0.01). Mixed linear analyses showed a significantly lower increase in serum vitamin B12 (s-B12) (p=0.001) and urinary iodine (p<0.001) concentrations over time compared to the control group. Conclusion Infants with CMPA on a cow’s milk elimination diet had a higher weight and length at 18 months of follow-up but showed signs of inadequate iron, iodine, and B-12 vitamin status.","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135563769","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
Impact of the Coronavirus Disease 2019 Pandemic on Pediatric Gastrointestinal Endoscopy: A Questionnaire-based Internet Survey of 162 Institutional Experiences in Asia Pacific 2019冠状病毒病大流行对儿科胃肠内窥镜检查的影响:基于亚太地区162家机构经验的问卷调查
Q2 Medicine Pub Date : 2023-01-01 DOI: 10.5223/pghn.2023.26.6.291
Andy Darma, Katsuhiro Arai, Jia-feng Wu, Nuthapong Ukarapol, Shin-ichiro Hagiwara, Seak Hee Oh, Suporn Treepongkaruna
Purpose The impact of coronavirus 2019 (COVID-19) on gastrointestinal (GI) endoscopy procedures in adults has been reported, with a drastic reduction in the number of procedures. However, there are no sufficient data regarding the impact on pediatric GI endoscopy. Here, we aimed to report that impact in the Asia-Pacific region. Methods A questionnaire-based internet survey was conducted from June to November 2021 among pediatric endoscopy institutions in the Asia-Pacific region, with each institution providing a single response. Overall, 25 questions focused on the impact of the number of procedures conducted, the usage of personal protective equipment (PPE), and endoscopy training programs during the pandemic. Results A total of 162 institutions across 13 countries in the Asia-Pacific region participated in the study, and 133 (82.1%) institutions underwent procedure changes since the emergence of COVID-19. The number of esophagogastroduodenoscopy and ileocolonoscopy procedures decreased in 118/133 (88.7%) and 112/133 (84.2%) institutions, respectively. Endoscopy for patient with positive COVID-19 in an emergency or urgent cases still carried out in 102/162 (62.9%) institutions. Screening of COVID-19 for all patients before endoscopy was done across 110/162 (67.9%) institutions. PPE recommendations varied among institutions. Pediatric gastrointestinal endoscopy training programs were discontinued in 127/162 (78.4%) institutions. Conclusion This study reports the impact of the COVID-19 pandemic on pediatric gastrointestinal endoscopy in the Asia-Pacific region. There has been a significant reduction in the number of endoscopic procedures and relevant training programs.
{"title":"Impact of the Coronavirus Disease 2019 Pandemic on Pediatric Gastrointestinal Endoscopy: A Questionnaire-based Internet Survey of 162 Institutional Experiences in Asia Pacific","authors":"Andy Darma, Katsuhiro Arai, Jia-feng Wu, Nuthapong Ukarapol, Shin-ichiro Hagiwara, Seak Hee Oh, Suporn Treepongkaruna","doi":"10.5223/pghn.2023.26.6.291","DOIUrl":"https://doi.org/10.5223/pghn.2023.26.6.291","url":null,"abstract":"Purpose The impact of coronavirus 2019 (COVID-19) on gastrointestinal (GI) endoscopy procedures in adults has been reported, with a drastic reduction in the number of procedures. However, there are no sufficient data regarding the impact on pediatric GI endoscopy. Here, we aimed to report that impact in the Asia-Pacific region. Methods A questionnaire-based internet survey was conducted from June to November 2021 among pediatric endoscopy institutions in the Asia-Pacific region, with each institution providing a single response. Overall, 25 questions focused on the impact of the number of procedures conducted, the usage of personal protective equipment (PPE), and endoscopy training programs during the pandemic. Results A total of 162 institutions across 13 countries in the Asia-Pacific region participated in the study, and 133 (82.1%) institutions underwent procedure changes since the emergence of COVID-19. The number of esophagogastroduodenoscopy and ileocolonoscopy procedures decreased in 118/133 (88.7%) and 112/133 (84.2%) institutions, respectively. Endoscopy for patient with positive COVID-19 in an emergency or urgent cases still carried out in 102/162 (62.9%) institutions. Screening of COVID-19 for all patients before endoscopy was done across 110/162 (67.9%) institutions. PPE recommendations varied among institutions. Pediatric gastrointestinal endoscopy training programs were discontinued in 127/162 (78.4%) institutions. Conclusion This study reports the impact of the COVID-19 pandemic on pediatric gastrointestinal endoscopy in the Asia-Pacific region. There has been a significant reduction in the number of endoscopic procedures and relevant training programs.","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135563612","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
Significance of Triglyceride-to-High-Density Lipoprotein Cholesterol Ratio in Children with Non-Alcoholic Fatty Liver Disease 甘油三酯与高密度脂蛋白胆固醇比值在非酒精性脂肪肝患儿中的意义
Q2 Medicine Pub Date : 2023-01-01 DOI: 10.5223/pghn.2023.26.6.312
Hyun Jin Kim
Purpose Nonalcoholic fatty liver disease (NAFLD) is associated with obesity and metabolic syndrome. This study evaluated the significance of markers such as the triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio and TG-glucose (TyG) indices in a group of patients with NAFLD. Methods We retrospectively analyzed the data of patients aged 5–18 years diagnosed with NAFLD between January 2014 and January 2021. Results Among the 151 patients with NAFLD, 79.5% were found to be obese, and the mean TG/HDL-C ratio (3.78±2.54 vs. 3.13±2.24) and TyG index (4.69±0.28 vs. 4.56±0.30) were slightly higher in patients with obesity compared to those without obesity. Patients with severe hepatic steatosis had a significantly higher mean TG/HDL-C ratio (4.11±2.16 vs. 3.11±2.30, p=0.035) than those with mild to moderate steatosis. Severe hepatic steatosis grade was defined as an area under the receiver operating characteristic curve of the TG/HDL-C ratio of 0.760 (95% confidence interval, 0.544–0.875), with an optimal cutoff value of 3.37. Conclusion A high TG/HDL-C ratio is associated with severe hepatic steatosis and diabetes mellitus in children with NAFLD. Measurement of this ratio can help clinicians in identifying patients and targeting them for treatment and follow-up.
{"title":"Significance of Triglyceride-to-High-Density Lipoprotein Cholesterol Ratio in Children with Non-Alcoholic Fatty Liver Disease","authors":"Hyun Jin Kim","doi":"10.5223/pghn.2023.26.6.312","DOIUrl":"https://doi.org/10.5223/pghn.2023.26.6.312","url":null,"abstract":"Purpose Nonalcoholic fatty liver disease (NAFLD) is associated with obesity and metabolic syndrome. This study evaluated the significance of markers such as the triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio and TG-glucose (TyG) indices in a group of patients with NAFLD. Methods We retrospectively analyzed the data of patients aged 5–18 years diagnosed with NAFLD between January 2014 and January 2021. Results Among the 151 patients with NAFLD, 79.5% were found to be obese, and the mean TG/HDL-C ratio (3.78±2.54 vs. 3.13±2.24) and TyG index (4.69±0.28 vs. 4.56±0.30) were slightly higher in patients with obesity compared to those without obesity. Patients with severe hepatic steatosis had a significantly higher mean TG/HDL-C ratio (4.11±2.16 vs. 3.11±2.30, p=0.035) than those with mild to moderate steatosis. Severe hepatic steatosis grade was defined as an area under the receiver operating characteristic curve of the TG/HDL-C ratio of 0.760 (95% confidence interval, 0.544–0.875), with an optimal cutoff value of 3.37. Conclusion A high TG/HDL-C ratio is associated with severe hepatic steatosis and diabetes mellitus in children with NAFLD. Measurement of this ratio can help clinicians in identifying patients and targeting them for treatment and follow-up.","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135563661","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
Prevalence and Risk Factors of Functional Gastrointestinal Disorders in Infants in Indonesia. 印度尼西亚婴儿功能性胃肠疾病的患病率和危险因素。
IF 1.9 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.5223/pghn.2023.26.1.58
Lily Arsanti Lestari, Adhyatma Noor Rizal, Wahyu Damayanti, Yulianti Wibowo, Chang Ming, Yvan Vandenplas

Purpose: Information regarding functional gastrointestinal disorders (FGIDs) in infants is currently lacking in Indonesia. This study aimed to describe the prevalence and risk factors of FGIDs in infants aged 6 weeks to 4 months in Indonesia.

Methods: This cross-sectional study of 433 infants was conducted between September 2018 and February 2020. Information on FGIDs was collected using the Infant Gastrointestinal Symptom Questionnaire and the Feeding Practice and Gut Comfort Questionnaire. Adapted Rome IV criteria were used to define the FGIDs.

Results: The prevalence of regurgitation was 26.3%; 16.8% of the infants presented crying-related symptoms and 5.5% exhibited constipation. The statistical analyses revealed that constipation was associated with sex (odds ratio [OR], 2.74; 95% confidence interval [CI], 1.07-7.71; p=0.043), employment of the father (OR, 0.3; 95% CI, 0.12-0.77; p=0.01), and education of the mother (OR, 1.92; 95% CI, 1.07-3.51; p=0.031). Length at birth (OR, 0.74; 95% CI, 0.55-0.99; p=0.042) was associated with constipation. Length at visit (OR, 0.83; 95% CI, 0.76-0.91; p<0.001) was associated with regurgitation, and the weight at visit (OR, 0.58; 95% CI, 0.35-0.96; p=0.038) was associated with crying and/or colic. A history of parental FGIDs was associated with crying-related symptoms (OR, 2.12; 95% CI, 1.23-3.68; p=0.007).

Conclusion: Regurgitation, crying, and constipation are common FGIDs in infants. Some parental and infant characteristics may be predictors for FGIDs. Further investigations are needed to evaluate the clinical relevance of our findings. Understanding the determinants of FGIDs will benefit healthcare professionals and parents to improve infant's quality of life and better manage these condition.

目的:印度尼西亚目前缺乏关于婴儿功能性胃肠疾病(fgid)的信息。本研究旨在描述印度尼西亚6周至4个月婴儿fgid的患病率和危险因素。方法:该横断面研究于2018年9月至2020年2月期间对433名婴儿进行。使用婴儿胃肠道症状问卷和喂养实践与肠道舒适问卷收集fgid信息。采用改编的Rome IV标准来定义fgid。结果:患儿反流发生率为26.3%;16.8%的婴儿出现哭泣相关症状,5.5%出现便秘。统计分析显示,便秘与性别有关(优势比[OR], 2.74;95%置信区间[CI], 1.07-7.71;p=0.043),父亲的就业率(OR, 0.3;95% ci, 0.12-0.77;p=0.01)、母亲的受教育程度(OR, 1.92;95% ci, 1.07-3.51;p = 0.031)。出生时长度(OR, 0.74;95% ci, 0.55-0.99;P =0.042)与便秘有关。访视时长(OR, 0.83;95% ci, 0.76-0.91;Pp =0.038)与哭泣和/或绞痛相关。父母有fgid病史与哭泣相关症状相关(OR, 2.12;95% ci, 1.23-3.68;p = 0.007)。结论:反流、哭闹和便秘是婴儿常见的fgid。一些父母和婴儿的特征可能是fgid的预测因子。需要进一步的研究来评估我们的发现的临床相关性。了解fgid的决定因素将有利于医护人员和家长提高婴儿的生活质量和更好地管理这些情况。
{"title":"Prevalence and Risk Factors of Functional Gastrointestinal Disorders in Infants in Indonesia.","authors":"Lily Arsanti Lestari,&nbsp;Adhyatma Noor Rizal,&nbsp;Wahyu Damayanti,&nbsp;Yulianti Wibowo,&nbsp;Chang Ming,&nbsp;Yvan Vandenplas","doi":"10.5223/pghn.2023.26.1.58","DOIUrl":"https://doi.org/10.5223/pghn.2023.26.1.58","url":null,"abstract":"<p><strong>Purpose: </strong>Information regarding functional gastrointestinal disorders (FGIDs) in infants is currently lacking in Indonesia. This study aimed to describe the prevalence and risk factors of FGIDs in infants aged 6 weeks to 4 months in Indonesia.</p><p><strong>Methods: </strong>This cross-sectional study of 433 infants was conducted between September 2018 and February 2020. Information on FGIDs was collected using the Infant Gastrointestinal Symptom Questionnaire and the Feeding Practice and Gut Comfort Questionnaire. Adapted Rome IV criteria were used to define the FGIDs.</p><p><strong>Results: </strong>The prevalence of regurgitation was 26.3%; 16.8% of the infants presented crying-related symptoms and 5.5% exhibited constipation. The statistical analyses revealed that constipation was associated with sex (odds ratio [OR], 2.74; 95% confidence interval [CI], 1.07-7.71; <i>p</i>=0.043), employment of the father (OR, 0.3; 95% CI, 0.12-0.77; <i>p</i>=0.01), and education of the mother (OR, 1.92; 95% CI, 1.07-3.51; <i>p</i>=0.031). Length at birth (OR, 0.74; 95% CI, 0.55-0.99; <i>p</i>=0.042) was associated with constipation. Length at visit (OR, 0.83; 95% CI, 0.76-0.91; <i>p</i><0.001) was associated with regurgitation, and the weight at visit (OR, 0.58; 95% CI, 0.35-0.96; <i>p</i>=0.038) was associated with crying and/or colic. A history of parental FGIDs was associated with crying-related symptoms (OR, 2.12; 95% CI, 1.23-3.68; <i>p</i>=0.007).</p><p><strong>Conclusion: </strong>Regurgitation, crying, and constipation are common FGIDs in infants. Some parental and infant characteristics may be predictors for FGIDs. Further investigations are needed to evaluate the clinical relevance of our findings. Understanding the determinants of FGIDs will benefit healthcare professionals and parents to improve infant's quality of life and better manage these condition.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":null,"pages":null},"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/d8/3d/pghn-26-58.PMC9911174.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9328830","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: 1
Rising Burden of Psychiatric and Behavioral Disorders and Their Adverse Impact on Health Care Expenditure in Hospitalized Pediatric Patients with Inflammatory Bowel Disease. 儿童炎症性肠病住院患者精神和行为障碍负担的增加及其对医疗保健支出的不利影响
IF 1.9 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.5223/pghn.2023.26.1.23
Aravind Thavamani, Jasmine Khatana, Krishna Kishore Umapathi, Senthilkumar Sankararaman

Purpose: The incidence and prevalence of inflammatory bowel disease (IBD) are increasing along with an increasing number of patients with comorbid conditions like psychiatric and behavioral disorders, which are independent predictors of quality of life.

Methods: Non-overlapping years (2003-2016) of National Inpatient Sample and Kids Inpatient Database were analyzed to include all IBD-related hospitalizations of patients less than 21 years of age. Patients were analyzed for a concomitant diagnosis of psychiatric/behavioral disorders and were compared with IBD patients without psychiatric/behavioral disorder diagnoses for outcome variables: IBD severity, length of stay and inflation-adjusted hospitalization charges.

Results: Total of 161,294 IBD-related hospitalizations were analyzed and the overall prevalence rate of any psychiatric and behavioral disorders was 15.7%. Prevalence rate increased from 11.3% (2003) to 20.6% (2016), p<0.001. Depression, substance use, and anxiety were the predominant psychiatric disorders. Regression analysis showed patients with severe IBD (odds ratio [OR], 1.57; confidence interval [CI], 1.47-1.67; p<0.001) and intermediate IBD (OR, 1.14; CI, 1.10-1.28, p<0.001) had increased risk of associated psychiatric and behavioral disorders than patients with a low severity IBD. Multivariate analysis showed that psychiatric and behavioral disorders had 1.17 (CI, 1.07-1.28; p<0.001) mean additional days of hospitalization and incurred additional $8473 (CI, 7,520-9,425; p<0.001) of mean hospitalization charges, independent of IBD severity.

Conclusion: Prevalence of psychiatric and behavioral disorders in hospitalized pediatric IBD patients has been significantly increasing over the last two decades, and these disorders were independently associated with prolonged hospital stay, and higher total hospitalization charges.

目的:炎症性肠病(IBD)的发病率和患病率正在增加,同时伴有精神和行为障碍等合并症的患者数量也在增加,这些合并症是生活质量的独立预测因素。方法:分析2003-2016年国家住院样本和儿童住院数据库的非重叠年份,包括所有21岁以下的ibd相关住院患者。对伴有精神/行为障碍诊断的患者进行分析,并将结果变量与没有精神/行为障碍诊断的IBD患者进行比较:IBD严重程度、住院时间和经通货膨胀调整的住院费用。结果:共分析了161,294例ibd相关住院病例,其中任何精神和行为障碍的总体患病率为15.7%。患病率从2003年的11.3%上升到2016年的20.6%。结论:在过去20年里,儿科IBD住院患者中精神和行为障碍的患病率显著上升,这些障碍与住院时间延长和住院总费用增加独立相关。
{"title":"Rising Burden of Psychiatric and Behavioral Disorders and Their Adverse Impact on Health Care Expenditure in Hospitalized Pediatric Patients with Inflammatory Bowel Disease.","authors":"Aravind Thavamani,&nbsp;Jasmine Khatana,&nbsp;Krishna Kishore Umapathi,&nbsp;Senthilkumar Sankararaman","doi":"10.5223/pghn.2023.26.1.23","DOIUrl":"https://doi.org/10.5223/pghn.2023.26.1.23","url":null,"abstract":"<p><strong>Purpose: </strong>The incidence and prevalence of inflammatory bowel disease (IBD) are increasing along with an increasing number of patients with comorbid conditions like psychiatric and behavioral disorders, which are independent predictors of quality of life.</p><p><strong>Methods: </strong>Non-overlapping years (2003-2016) of National Inpatient Sample and Kids Inpatient Database were analyzed to include all IBD-related hospitalizations of patients less than 21 years of age. Patients were analyzed for a concomitant diagnosis of psychiatric/behavioral disorders and were compared with IBD patients without psychiatric/behavioral disorder diagnoses for outcome variables: IBD severity, length of stay and inflation-adjusted hospitalization charges.</p><p><strong>Results: </strong>Total of 161,294 IBD-related hospitalizations were analyzed and the overall prevalence rate of any psychiatric and behavioral disorders was 15.7%. Prevalence rate increased from 11.3% (2003) to 20.6% (2016), <i>p</i><0.001. Depression, substance use, and anxiety were the predominant psychiatric disorders. Regression analysis showed patients with severe IBD (odds ratio [OR], 1.57; confidence interval [CI], 1.47-1.67; <i>p</i><0.001) and intermediate IBD (OR, 1.14; CI, 1.10-1.28, <i>p</i><0.001) had increased risk of associated psychiatric and behavioral disorders than patients with a low severity IBD. Multivariate analysis showed that psychiatric and behavioral disorders had 1.17 (CI, 1.07-1.28; <i>p</i><0.001) mean additional days of hospitalization and incurred additional $8473 (CI, 7,520-9,425; <i>p</i><0.001) of mean hospitalization charges, independent of IBD severity.</p><p><strong>Conclusion: </strong>Prevalence of psychiatric and behavioral disorders in hospitalized pediatric IBD patients has been significantly increasing over the last two decades, and these disorders were independently associated with prolonged hospital stay, and higher total hospitalization charges.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":null,"pages":null},"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/06/a1/pghn-26-23.PMC9911177.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10824133","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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