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Biomedical subjects

U Blecker

Publications and source records attributed to U Blecker.

At least 37 records · Page 2Linked to original sources
PubMed1998

Helicobacter pylori infection in children.

Helicobacter pylori colonizes the human stomach, especially during childhood. However, a variety of H. pylori strains exists, with major differences in virulence characteristics which probably account for different clinical symptoms, and the majority of infected subjects remains asymptomatic. Helicobacter pylori infection is correlated with socioeconomic conditions and hygienic circumstances, resulting in an extremely high prevalence in children in developing countries. Commercial screening tests are not capable of separating the more virulent strains (type I with vacuolating toxin VacA and CagA protein) from the less virulent strains (type II, VacA and CagA negative). Type I strains, but not type II, are associated with an increased risk for duodenal ulcer and gastric cancer. Therefore, future screening tests and vaccinations should focus on the type I strains.

Child↗
PubMed1998

Escherichia coli and the hemolytic-uremic syndrome.

BACKGROUND: The hemolytic-uremic syndrome (HUS) comprises hemolytic anemia, acute renal failure, and thrombocytopenia. It is the most frequent cause of acute renal failure in children. METHODS: This review is based on an extensive overview of the literature dealing with the HUS in children. RESULTS: HUS is the most common cause of acute renal failure in infants and young children and follows a diarrheal prodrome approximately 90% of the time. Nearly all postdiarrheal cases are caused by enterohemorrhagic E coli infections, in particular serotype O157:H7. Mortality is around 5%, and approximately 50% of survivors manifest some types of sequelae. CONCLUSION: Surveillance and contact investigation are important to control outbreaks, as well as early and aggressive treatment of symptomatic subjects to prevent mortality and severe complications, such as chronic renal disease.

Child↗
PubMed1998

Chronic diarrhea in infancy and childhood.

Important inroads are being made into understanding the pathophysiology of acute diarrhea. Clear understanding of key mechanisms should suggest new approaches to combat disease. Exciting developments are occurring in terms of super-ORS solutions, particularly with the promise of short-chained glucose polymers and glutamine. Perhaps the most important development is the prospect of a good rotavirus vaccine being available before the end of the decade. Chronic diarrhea seems to be on the increase globally, probably because of the success of ORS. The mechanisms that lead to mucosal injury are elusive and therapy is still largely supportive and empiric. Celiac disease continues to be a puzzle, not least because of the uncomfortable feeling that a majority of cases may be being missed because of atypical presentations. The successful use of long-term parenteral nutrition has allowed survival and better characterization of cases that otherwise would have perished as "lethal protracted diarrhea". Microvillus inclusion disease may be the most common congenital secretory diarrhea. The role of the recently reported high prevalence of glucoamylase deficiency may be important. Lastly attention to micronutrients, particularly low vitamin A and probably zinc, may prove to be important in prevention and amelioration of diarrhea and growth failure.

Child, Preschool↗
PubMed1997

Role of hydrolyzed formulas in nutritional allergy prevention in infants.

BACKGROUND: In recent years, more and more discussions have arisen with regard to the role of (partially) hydrolyzed formulas as standard feedings for infants with a high risk to have allergy. METHODS: This review is based on an extensive overview of the literature dealing with the subjects of allergy prevention and hydrolyzed formulas. RESULTS: Although breast-feeding should receive absolute priority in the nutrition of infants, the existence of artificial milk formulas as an addition to or replacement of breast milk is a necessity. In high-risk infants with a family history of allergy, we might consider a hypoallergenic formula instead of the classical start formulas to reduce the risk of allergy. From a nutritional point of view, these formulas should only be hydrolyzed as much as necessary. On the other hand, for the treatment of food allergies, the peptides of the semi-elementary infant formulas should be as short as possible. This can, however, have an impact on the nutritional value of the formula. Therefore, a difference is made between partial and complete hydrolysates. CONCLUSION: While a firm recommendation is not yet possible, physicians might consider partial hydrolysate formulas in high-risk infants if parents can afford the higher-cost option.

Dietary Proteins↗
PubMed1997

The role of modified food starches in baby food.

Modified food starches were developed as a stabilizer, suspending the food particles and providing a desirable consistency, texture, and storage ability. They are used primarily in strained and junior foods and to a minor extent in infant formulas. This review discusses modified food starches because of four principal concerns. The first relates to the bioavailability of the starch itself. The second is the potential that indigestible starch may have for producing diarrheal symptoms, malabsorption, and changes in gastrointestinal flora. The third is the possibility that modified food starches might be implicated in gastrointestinal disease like Crohn's ileocolitis. The fourth is the toxicological effect of the chemicals used to modify the starch and their possible mutagenic and carcinogenic properties.

Age Factors↗
PubMed1997

Helicobacter pylori-associated gastroduodenal disease in childhood.

Helicobacter pylori is responsible for one of the most frequently encountered infectious diseases worldwide. Infection due to H pylori can lead to the development of gastritis and peptic ulcer disease. The presence of H pylori in the human stomach also represents an increased risk for gastric cancer and gastric lymphoma. Recent epidemiologic data obtained in adults suggest that the actual colonization with H pylori is in fact determined by childhood factors. Therefore, the pediatric age group represents the ideal target population for studies concerning the pathogenesis and epidemiology of H pylori infection. This review addresses the spectrum of H pylori-associated gastroduodenal disease in childhood.

Adult↗
PubMed1996

The prevalence of Helicobacter pylori positivity in asymptomatic children of different ethnic backgrounds living in the same country.

OBJECTIVE: To measure the prevalence of Helicobacter pylori seropositivity in a population of apparently healthy children of different ethnic backgrounds, matched for age and socioeconomic background, who were born and continue to reside in the same country. DESIGN: The presence of Helicobacter pylori specific IgG antibodies was determined during pre-surgery blood analysis in 883 symptom-free children, aged from 1 months to 17 years, who belong to different ethnic populations and were admitted for elective minor surgery. The different groups were matched for age and socioeconomic background. RESULTS: Seventy-two children (8.2%) had a positive titer for Helicobacter pylori. We observed a significant difference in the prevalence of Helicobacter pylori positivity between symptom-free Caucasian and non-Caucasian children (p < 0.001). However, no difference could be observed between the non-Caucasian groups (p > 0.8). CONCLUSION: We conclude that significant differences exist in the prevalence of Helicobacter pylori infection between asymptomatic children of different ethnic backgrounds, despite the fact that all investigated subjects were born in Belgium and have been living in this country ever since. Whether this difference is caused by an unknown environmental factor or an, until now, unrecognized genetic predisposition still needs to be evaluated.

Adolescent↗
PubMed1996

Symptomatology of Helicobacter pylori infection in children.

In a retrospective evaluation we reviewed the symptomatology of 143 children (age 2-15 years, mean 8.9 years) who were referred to us for upper gastrointestinal endoscopy because of recurrent abdominal pain with a duration of 6 weeks or longer. Helicobacter pylori infection was diagnosed in 36 out of 143 patients (25.2%). No statistically significant differences could be detected between the symptoms experienced by the 36 H. pylori-infected children and those experienced by the remaining 107 H. pylori-negative pediatric patients (p = 0.18-0.60). We conclude that no specific symptoms are associated with H. pylori gastritis in children. Our observations suggest that the recurrent abdominal complaints found in children with H. pylori infection seem to be caused by the secondary gastroduodenal pathology, rather than by H. pylori infection itself.

Abdominal Pain↗
PubMed1996

Helicobacter pylori disease in childhood.

Helicobacter pylori (H. pylori) is responsible for one of the most frequently encountered infectious diseases worldwide. H. pylori infection can lead to the development of gastritis and peptic ulcer disease. The presence of H. pylori in the human stomach also represents an increased risk for gastric cancer and gastric lymphoma. Epidemiologic data obtained in adults suggest that the actual colonization with H. pylori is in fact determined by childhood factors. Therefore, the pediatric age group represents the ideal target population for studies concerning the pathogenesis and epidemiology of H. pylori infection.

Age Factors↗
PubMed1995

Resolution of Helicobacter pylori-associated gastric lymphoproliferative disease in a child.

A possible causative association between Helicobacter pylori infection and gastric lymphoproliferative disorders has recently been recognized. The case of a 14-year-old girl who was diagnosed with H. pylori gastritis and associated gastric lymphoproliferative disease of the low-grade mucosa-associated lymphoid tissue type is reported. The patient was treated only for the H. pylori infection (amoxicillin, bismuth, and metronidazole) without any adjuvant chemotherapy or surgery for her lymphoproliferative disorder. This treatment not only resulted in the eradication of the microorganism but also complete resolution of her lymphoproliferative disease. The patient was subsequently followed up for a period of 7 years. There has been no histological recurrence of H. pylori gastritis or gastric lymphoproliferative disease. It is believed that this is the first report to describe a long-term follow-up of an H. pylori-associated gastric lymphoproliferative disorder in a pediatric patient who was exclusively treated for H. pylori infection. The observations in this report suggest that H. pylori-associated low-grade gastric lymphoproliferative disease can be completely cured by eradicating the organism. Therefore, this therapeutic approach, combined with close follow-up, should be the treatment of choice in children with this associated condition before attempting more aggressive treatments, thus potentially avoiding chemotherapy and/or (partial) gastrectomy.

Adolescent↗
PubMed1995

The contribution of specific immunoglobulin M antibodies to the diagnosis of Helicobacter pylori infection in children.

OBJECTIVE: To evaluate the diagnostic value of specific immunoglobulins G and M in the detection of Helicobacter pylori infection. METHODS: Sera from 68 H. pylori-infected children and 35 H. pylori-negative children (aged 1-15 years) were examined using recent-generation serum enzyme-linked immunosorbent assay (ELISA) tests (Malakit Helicobacter pylori series; Biolab, Limal, Belgium). RESULTS: All of the investigated children had positive values for immunoglobulin G antibodies. However, anti-H. pylori-specific immunoglobulin M could be detected only in 19 (27.9%) of the 68 children. When compared with the 13C-urea breath test, these findings represent sensitivity, specificity and positive and negative predictive values of 27.9, 100, 100 and 41.7%, respectively, for the serum ELISA test for the detection of H. pylori-specific immunoglobulin M compared with 100.0, 97.2, 98.5 and 100.0%, respectively, for the Malakit for the detection of specific immunoglobulin G antibodies. CONCLUSION: Although H. pylori-specific immunoglobulin G has been established as a reliable indicator of active H. pylori infection, using the Malakit for the detection of H. pylori-specific immunoglobulin M does not seem to be of major value in the diagnosis of H. pylori infection in children.

Adolescent↗