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Biomedical subjects

H Bodánszky

Publications and source records attributed to H Bodánszky.

At least 19 recordsLinked to original sources

Short-term omeprazole treatment does not influence biochemical parameters of bone turnover in children.

Gastric proton pump inhibitors are widely used in the treatment of dyspeptic problems and for the eradication of H. pylori infection. Data are not available on whether omeprazole, a representative of proton pump inhibitors, influences the function of osteoclastic H+-pump in children. We studied the impact of short-term omeprazole administration on the biochemical parameters of bone turnover in pediatric patients. Urinary calcium excretion, serum total alkaline phosphatase activity, collagen type 1 crosslinked C-telopeptide, and osteocalcin levels were determined in 34 children [20 girls (9 prepubertal) and 14 boys (6 prepubertal)] before and after 2 weeks of omeprazole treatment at a dose of 20 mg/day. The measured parameters were within the healthy reference range in each patient. None of them altered during the study in any age or in any gender. We conclude that omeprazole, at a dose of 20 mg/day, does not significantly influence the investigated biochemical parameters of osteoclast and osteoblast function in pediatric patients.

Adolescent↗

[Treatment of infants with acute diarrhea in Hungary].

In the treatment of infants with acute diarrhoea complicated by mild to moderate dehydration, there is a great importance of rapid rehydration over 3-4 hours with oral rehydration solution containing 60 mmol/l sodium and then the rapid reintroduction of normal diet or breast feeding which should be continued all the time if possible. The pharmacological treatment of diarrhoea is not justified. In the present study which was part of a European multicentre survey using questionnaires the authors analysed how the recommendation of European Society of Pediatric Gastroenterology, Hepatology and Nutrition are followed in Hungary. It was evaluated 131 returned questionnaires, 80 of primary care and 51 of hospital-based pediatricians. The overwhelming majority of pediatricians (92%) recommended the oral rehydration at the beginning of treatment. The four fifth of them use the ORS with recommended composition. Only 31% of them use rapid oral rehydration over 3-4 hours. Merely 10% of them suggest the early reintroduction of normal feeding after the oral rehydration, while more than half of the respondent pediatricians (52%) think that temporarily the use of lactose free formula is justified. It is a very favourable fact that 84% of doctors recommend the continuation of breast feeding. Some kind of drugs for the treatment of diarrhoea is suggested by 15% of repliers. On the base of results it is obvious that the guidelines for the treatment of acute diarrhoea in infancy is complied only partially in Hungary and the reintroduction of normal feeding is delayed.

Acute Disease↗

Bone mineral content and density in asymptomatic children with coeliac disease on a gluten-free diet.

OBJECTIVES: Osteoporosis is a complication of coeliac disease. A gluten-free diet improves but does not normalize bone mineral density in adult patients. Only limited data are available regarding the influence of the disease and diet on bone mineralization in children. The aim of this study was to evaluate the radial bone mineral content and density in children and adolescents who are asymptomatic on a gluten-free diet. SUBJECTS AND METHODS: The bone mineral content (BMC) and density (BMD) values of the non-dominant radius midshaft in 91 children (53 girls, 38 boys, mean age 11.7 years, mean duration of disease 8.7 years) were determined by single-photon absorptiometry. At the diagnosis and at least three years after commencement of a gluten-free diet, serum calcium, phosphorus, albumin concentrations and alkaline phosphatase activities were measured in all patients, and intact parathormone concentrations in 16 patients. RESULTS: The mean BMC Z-score value in the female adolescent group only was significantly lower than normal (mean Z-score -1.04, P < 0.01). In contrast, the mean BMD Z-score was significantly higher compared to a healthy population both in girls (mean Z-score +1.36, P < 0.001) and in boys (mean Z-score +0.53, P < 0.02), as well as in the total patient group (mean Z-score +1.01, P < 0.001). The radial diameter was significantly smaller than normal in both pre-pubertal and adolescent groups. Serum laboratory parameters of asymptomatic patients were in the normal range. The parathormone mean value was significantly lower after at least three years of gluten-free diet than at diagnosis (mean +/- SD 3.77 +/- 1.07 versus 7.89 +/- 2.54 pmol/l, P < 0.01), but significantly higher compared to controls (2.89 +/- 0.90 pmol/l, P < 0.05). CONCLUSIONS: These data indicate that treated, asymptomatic coeliac children and adolescents have normal or even higher radius mineral density values than controls, but the bone size remains reduced. Although there is no direct evidence of calcium malabsorption in this cohort of coeliac patients, the slightly higher parathormone levels, together with some other factors, particularly delayed puberty, may result in reduced bone size.

Absorptiometry, Photon↗

[Helicobacter infection in children].

Consensus was achieved on the following issues: in children H. pylori infection causes chronic gastritis, but rarely gastric and duodenal ulcer disease. Eradication of H. pylori leads to healing of these conditions. To-date, there is no evidence demonstrating a link between H. pylori gastritis and abdominal pain except in those children where a gastric or duodenal ulcer is present. Children should be investigated for H. pylori infection only if their symptoms are suggestive of organic disease rather than functional abdominal pain. Endoscopy with biopsies is the optimal method to investigate a child with upper gastrointestinal symptoms suggestive of organic disease but this should only be carried out when a diagnostic work up using non-invasive methods has excluded other causes such as lactose maldigestion, constipation, coeliac disease, liver or biliary tact disease. If H. pylori is identified through investigations carried out during endoscopy the infection should be treated. Treatment should be monitored with a reliable non-invasive test and the 13C-urea breath test is the preferred method. H. pylori eradication in such children will cure gastritis but there is no data to support a relationship between a cure of H. pylori gastritis and symptom relief except in patients with ulcer disease. Further studies are needed to establish whether there are any specific symptoms associated with H. pylori gastritis alone and whether infected children without ulcer disease benefit from anti-H. pylori therapy regarding their symptoms. This consensus meeting did not deal with the optimal therapy for H. pylori infection as there are insufficient studies concerned the best treatment in children.

Algorithms↗

[Mineral content in bones of children with symptomless celiac disease and gluten-free diet].

Osteoporosis is a complication of adult celiac disease. The gluten-free diet improves but does not normalize bone mineral density. Only few and conflicting data are known about the influence of the disease and diet on bone mineralization in children. The aim of this study was to evaluate the radial bone mineral content (BMC) and density (BMD) in children and adolescents who are asymptomatic on gluten-free diet. The BMD and BMC values of non-dominant radius midshaft in ninety-one children (53 girls and 38 boys, mean age: 11.7 years, mean duration of disease: 8.7 years) were determined by single photon absorptiometry. At the diagnosis and at least three years after gluten-free diet, serum calcium, phosphorous and albumin concentrations and alkaline phosphatase activities were determined in all, and additionally intact parathormone concentrations in 16 patients. The mean BMC Z-score value in the entire study population did not differ from the value of normal age-matched population (mean Z-score: -0.27), but in female adolescent group was significantly lower than the normal value (mean Z-score: -1.04, p < 0.01). In contrast, the mean BMC Z-score value was significantly higher than in normal value in girls (mean Z-score: +1.36, p < 0.001), in boys (mean Z-score: +0.53, p < 0.02) as well as in the total patients group (mean Z-score: +1.01, p < 0.001). The diameter of radius midshaft was significantly smaller in all age group than the normal mean value. Serum laboratory parameters of asymptomatic patients were in the normal range. The serum parathormone value in treated patients was significantly lower than in untreated celiac children (mean +/- SD: 3.77 +/- 1.07 versus 7.89 +/- 2.54, p < 0.01), but significantly higher compared to controls (2.89 +/- 0.9, p < 0.05). The data indicate that the gluten-free diet alone is not able to normalize bone mineralization in children. The significant increase of serum parathormone level in treated asymptomatic patients may be explained by the lower calcium content of gluten-free diet. The authors suppose that low calcium supply in children similarly to adult patients can lead to increased parathormone secretion, which can cause the retardation of bone growth even in treated patients with celiac disease.

Adolescent↗

[Neonatal neuroblastoma detected by ultrasonic screening].

It was found a solid tumour of 24 x 28 x 31 mm size above the right kidney with ultrasound screening in a three days old newborn. After three days appeared cystic areas inside the tumour, so it was thought to adrenal haemorrhage. The tumour didn't decrease during two months and metastases developed in the liver. The urinary VMA level was normal, the HVA elevated. The MIBG scintigraphy was first negative, after a month pathognostic. The primer tumour and metastases disappeared after cyclophosphamid and Adriablastin treatment. The adrenal neuroblastoma can imitate the adrenal apoplexy, so it's important to control all neonatal adrenal haemorrhage until their disappearance.

Age Factors↗

Use of Cosilat food preparation in paediatric practice.

Cosilat is the sole Hungarian therapeutic food preparation which may be successfully used in several clinical conditions due to it's hydrolyzed protein and MCT fat content and the absence of lactose. In infancy it may be given orally, in older children in form of tube feeding. The authors have reported on their observations in healthy and diseased children. The required weight gain could be obtained with Cosilat in all examined groups. Side-effects were not observed. They recommend the use of the formula for the treatment of premature infants and in postoperative and malabsorption cases as well. All clinical conditions in which the use of Cosilat may be justified because of it's composition are described in the report.

Humans↗

[Chronic recurrent abdominal pain and lactose malabsorption in childhood].

The Authors examined 515 children with abdominal pain in the outpatient clinics for a period of two years. The pain was frequently periumbilical or mid epigastric with a history of more than two months. Persistent lactose malabsorption was found in 252 children (48,9%), which justifies the use of Breath Hydrogen Test as a first diagnostic procedure for assessing recurrent abdominal pain. Putative pathogens were identified in the stool specimens of 21 patients. Oesophagitis was diagnosed in 18 children and duodenal ulcer in one. 91 patients (less than 6 years old) improved after successful treatment of the chronic upper respiratory inflammations. The authors did not find any causes in 18.1 per cent of the children examined and they think that the abdominal pain in these children may be psychogenic. The use of high-fiber diet is proposed for the later group.

Abdominal Pain↗

[Leukocyte migration inhibition test in celiac disease].

The leukocyte migration inhibition test is a method used to assess the cell-mediated immune function. The authors examined 251 samples for a period of 3 years; 169 samples from celiac patients and 82 were control. The sensitivity of this test was 34/35 (97%) in proved gluten sensitive patients, but this was found after repeating the test at different periods of time. According to these results the authors conclude that the efficacy of this test is less sensitive in the newly diagnosed celiac patients, which means that it is not suitable for screening purpose, but useful for detecting gliadin sensitivity during the diagnostic period of celiac disease (e. i. the 3 biopsies). LMT may be used to indicate the proper time for the 2nd and/or 3rd biopsy, and can also be used to reveal the gluten-free diet defaults. The authors agree with those who believe that this test cannot substitute the performance of the small intestinal biopsy.

Adolescent↗

[The value of the d-xylose loading test in the diagnosis of malabsorption syndromes].

The test of d-xylose concentration in blood has been used for approximately two decades for the examination of the absorption. The authors compared in 261 cases the total d-xylose blood level with the histological picture of the small intestine. Good correlation was observed between the 2 examinations. The d-xylose loading was found to select with favorable efficacy the new cases of celiac disease, of 63 fresh diagnosed subtotal and total villus atrophy cases the blood level of 61 was under the 1,64 mmol/l limit. At the 3rd stage of partial villus atrophy the blood level was pathological in 17 new patients. The sensitivity of the examination was 92.2% in selection of the new cases. Significant differences were found between the new cases and patients with excess gliadin (0.929 +/- 0.44 mmol/l and 1383 +/- 0.052 mmol/l) with identical rate of duodenal tissue impairments. On this basis the significant decrease of d-xylose level (0.5-1 mmol/l) must be regarded as the sign of relapse in patients with excess gliadin. Giardia lamblia and slight villus impairment was found in the biopsy material of further 28 children. The d-xylose level was pathological in 14 of them. D-xylose absorption was pathological before treatment in each of the 13 patients with contaminated (Gram-negative aerobic bacteria) small intestinal syndrome. D-xylose test is a useful method in the diagnostics of conditions associated with malabsorption and completed with other techniques it provides means for the separation of conditions associated with the diffuse impairment of the small intestine.

Celiac Disease↗

[Contaminated small bowel syndrome in infants caused by gram-negative bacteria and yeasts].

The upper small intestine is usually "sterile" in a healthy individuals, but due to some reasons the number of microorganisms may reach or increase above 10(4)/ml, leading to the contamination of the small intestine, which may cause severe malabsorption. The authors have diagnosed this syndrome in 50 children, aged between 1 month and 3 years, using breath hydrogen test and duodenal juice culture. Most of these children had growth retardation. According to their experience the authors found that the oral antibiotic is the effective treatment of this syndrome.

Anti-Bacterial Agents↗

[Incidence of lactose malabsorption in the population 6-18 years of age].

Breath test was performed in 664 school-aged children in order to measure lactose malabsorption. The first screening showed that 23.4% of the children evidenced malabsorption of milk sugar. In these children further stool examination for Giardia lamblia infection, and saccharose breath test was performed to identify more complex absorption problems. The remaining 146 children were tested again after a period of 3-9 month and 45.8% of this population showed lactose malabsorption. In conclusion the authors determined that 10.1% of school aged children were permanently hypo- or alactasic. During the examination, they measured the approximate consumption of milk considering the quantity of milk intake showed that the consumption of milk and lactose malabsorption were not closely related normal and abnormal absorption among children who would not normally consume milk.

Adolescent↗

Intestinal mast cells and neutrophil chemotactic activity of serum following a single challenge with gluten in celiac children on a gluten-free diet.

The number of one subtype of mast cells (formalin fixation, toluidine blue staining), cells of the lamina propria, and intraepithelial lymphocytes were counted in the intestinal biopsy specimens of 14 children with treated celiac disease following a single challenge with gluten. The serum neutrophil chemotactic activity was measured at 0, 1, 3, 5, and 24 h after challenge. There was no significant change in the number of intraepithelial lymphocytes, but the biopsy samples obtained at 5 h showed a marked increase in the inflammatory cells of the lamina propria and a significant decrease in the number of mast cells. A pronounced decrease was present at 3-5 h in the number of eosinophil cells in the blood. The neutrophil chemotactic activity of sera showed a significant increment in 10 of 14 patients. The intestinal permeability of patients became abnormal, as detected by the increased absorption of lactulose. These findings suggest that degranulation of mast cells may be involved in the pathogenesis of the small intestinal mucosal injury in children with celiac disease.

Adolescent↗

Hydrogen breath test in small intestinal malabsorption.

Jejunal biopsy and hydrogen breath test were performed in 57 children, 34 having coeliac disease and 23 with other forms of malabsorption. In children affected by coeliac disease there was a gradually increasing incidence of positive findings with the H2 breath test as villous damage progressed. In the group of subtotal villous atrophy age dependence was also observed, the majority of positive results occurring below three years of age. In the non-coeliac group the most frequent cause of the positive finding was Giardia lamblia infestation. Among 27 cases with lactose malabsorption confirmed by a positive hydrogen breath test only 11 had diarrhoea. The test proved to be useful in differentiating between the contaminated intestine syndrome and malabsorption due to reduced absorptive surface.

Adolescent↗