Biomedical subjects

U Blecker

Publications and source records attributed to U Blecker.

85 records · Page 5Linked to original sources

PubMed1992

Contribution of the 13C-urea breath test to the detection of Helicobacter pylori gastritis in children.

Serology, 13C-urea breath test, histology, Campylobacter-like organism testing, and culture were performed in 95 consecutive children to evaluate the contribution of these tests to the detection of Helicobacter pylori infection. In analyses considering any combination of three positive tests as "gold standard" for diagnosing H pylori infection, 26 children were Helicobacter positive (27%), which is only one patient more than the number of children with only a positive culture. The accuracy of culture was excellent when "any combination of three positive tests" was used as the gold standard (sensitivity 96%, specificity 100%, positive predictive value 100% [false positivity 0%], negative predictive value 99% [false-negative results 1%]). The results of invasive and noninvasive tests were comparable. When culture was considered as "gold standard," the sensitivity of serology and 13C-urea breath test was 96%; the specificity was 96% and 93%, respectively; the positive predictive value was 89% and 83% (false-positive results in 11% and 17%); and the negative predictive value for both was 99% (false-negative results in 1%). It is concluded that culture can be used as gold standard, but that non-invasive tests such as serology and/or 13C-urea breath test can be used to diagnose H pylori infection in children, since each has at least 95% sensitivity and 92% specificity.

Adolescent↗

PubMed1992

[Helicobacter pylori infections in children].

In our patient population with chronic aspecific abdominal complaints Helicobacter pylori gastritis is no rarity. This entity has been diagnosed in 10 children out of 48 (mean age: 8 years 11 months) who underwent an endoscopy of the upper gastrointestinal tract. After treatment with amoxicillin and colloidal bismuth subcitrate during a period of 2 weeks the complaints disappeared and an eradication was obtained in 7. Histology of the antral mucosa demonstrated a type B chronic active gastritis in all patients. A Helicobacter pylori specific serology was positive in all 10 patients. This test was also positive in 17 out of 35 asymptomatic first degree family members; this is an illustration for the high family prevalence of Helicobacter pylori.

Adolescent↗

PubMed1991

Syncopes leading to the diagnosis of a Helicobacter pylori positive chronic active haemorrhagic gastritis.

A 15-year-old girl was admitted after 1 week of increasing fatigue and pallor. She had no gastro-intestinal complaints. The patient had suffered from four episodes of syncope during the last 3 days prior to admission. Besides pallor and a discrete cardiac murmur, the physical examination was normal. A further thorough investigation revealed an iron deficiency anaemia related to a Helicobacter pylori positive chronic active haemorrhagic gastritis. Treatment consisted of amoxycillin and colloidal bismuth subcitrate (500 mg and 120 mg orally respectively, 3 times daily) during a period of 6 weeks. Iron supplements were not administered. Together with the clearance of H. pylori and healing of the haemorrhagic gastritis, as demonstrated by histology, haemoglobin values returned to normal and the symptoms disappeared. An eradication of the micro-organism was obtained. She has since had no further similar complaints.

Adolescent↗

PubMed1991

Esophageal pH monitoring data during chest physiotherapy.

Sixty-three infants, aged from 1 to 4 months, were examined for gastroesophageal reflux (GER) using esophageal pH monitoring. Thirty were examined because of chronic vomiting, 21 were healthy controls examined for GER as part of a screening program for sudden infant death syndrome, and 12 had an acute respiratory disease (RD). The 24-h pH monitoring data were within normal ranges in 26 infants (20 controls, 2 babies with emesis, and 4 with RD). Data were abnormal in 37 infants (1 control, 28 infants with emesis, and 8 with RD). All babies were submitted during a fasting awake period to a 30-min chest physiotherapy session. In the three groups studied, the incidence of GER episodes detected by the pH probe was significantly higher during physiotherapy if compared (a) to the calculated mean incidence during a 30-min period of the 24-h investigation or (b) to the incidence during a fasting awake period such as that during which the physiotherapy was given (p less than 0.001; Wilcoxon rank-sum test). We conclude that chest physiotherapy significantly increases GER incidence. We therefore propose restricting chest physiotherapy to fasting periods. These data add to the confusion that already exists regarding the possible causal relationship between (acid) GER and respiratory disease.

Drainage, Postural↗

PubMedDate not supplied

Diagnosis of Helicobacter pylori.

In view of its potential risk for the development of gastrointestinal disease or even gastric cancer at a later age, the study of Helicobacter pylori infection in childhood is gaining increasing importance and H. pylori infection is being considered a major issue of public health. H. pylori infection can be detected by a variety of methods. Because of its easy use, affordability, and overall availability, serology is the preferred diagnostic test, especially for large epidemiological studies. Based on our results, one might consider treating a child with recurrent abdominal pain and positive serology for H. pylori without further work-up, and only perform additional investigations when an anti-H. pylori therapy fails to resolve the complaints. According to this proposition, endoscopy of the upper gastrointestinal tract remains indicated in children if the noninvasive tests for Helicobacter pylori are negative in the absence of a diagnosis, or if symptomatology persists despite treatment.

Breath Tests↗

PubMedDate not supplied

Pediatric gastritis and peptic ulcer disease.

Inflammation of the gastric and duodenal mucosa is the end result of an imbalance between mucosal defensive and aggressive factors. The degree of inflammation and imbalance between defensive and aggressive factors can then result in varying degrees of gastritis and/or mucosal ulceration. Gastritis and ulcers of the duodenum or stomach can be classified as primary or secondary. The majority of children with chronic gastritis and ulcers in the stomach or duodenum have secondary inflammation or mucosal ulceration. These secondary ulcers generally occur due to a systemic condition like head trauma or overwhelming sepsis, or as sequelae to drug ingestion (i.e. non-steroidal anti-inflammatory agents), but secondary gastroduodenal ulcers can also occur in specific disease conditions such as Zollinger-Ellison syndrome or Crohn's disease. In almost all children with primary duodenal or gastric ulcers mucosal inflammation and, less frequently, ulceration is caused by a spiral shaped, gram-negative, microaerobic rod Helicobacter pylori. Recent epidemiological evidence has linked chronic H. pylori infection with the development of gastric carcinomas.

Child↗

PubMedDate not supplied

Modified food starches in baby foods.

Modified food starches were developed as a stabilizer, providing desirable consistency, texture, and storage ability. They are used primarily in strained and junior foods and, to a minor extent, in infant formulas. However, despite the fact that there is an increasing tendency to introduce solid foods to infants at a very early age, there is few long-term studies to delineate the effect of starch feeding on the growth of young infants. Modified food starches used by the food industry for infants and young children are of concern and there is an urgent need for additional data regarding their bioavailability, effect on nutrient absorption, intestinal changes, and toxic, mutagenic, and carcinogenic effects. Therefore, the inclusion of modified food starches should be used prudently and sparingly.

Animals↗

PubMedDate not supplied

Presentation and management of Helicobacter pylori infection in childhood.

Helicobacter pylori is responsible for one of the most frequently encountered infectious diseases worldwide. Helicobacter pylori infection can lead to the development of gastritis and peptic ulcer disease. The presence of Helicobacter pylori in the human stomach also represents an increased risk of gastric cancer and gastric lymphoma. Epidemiological data obtained in adults suggest that the actual colonization with Helicobacter 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 Helicobacter pylori infection. The present work reflects our experience with regard to the diagnosis, epidemiology and pathogenesis of Helicobacter pylori infection in childhood.

Adolescent↗

PubMedDate not supplied

Chronic diarrhea: causes, presentation, and management.

Important inroads are being made into understanding the pathophysiology of 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 still largely supportive and empiric. Celiac disease continues to be a puzzle, because of the uncomfortable feeling that a majority of cases may be 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 commonest congenital secretory diarrhea. The role of the recently reported high prevalence of glucoamlase 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↗

PubMedDate not supplied

Plasma amino acid concentrations in term-born infants fed a whey predominant or a whey hydrolysate formula.

BACKGROUND: Hydrolysates are used in the treatment and prevention of cows milk protein allergy. Hydrolysis might alter the plasma level of amino acids. METHODS: Forty-five infants were included in a double-blind prospective study and were randomized in two groups: one receiving a whey predominant formula (n = 20) and the second group receiving a whey hydrolysate formula (n = 25). Weight and length gain was evaluated up to the age of 13 weeks, when blood was sampled for determination of fasting plasma amino acids. RESULTS: Four infants of the hydrolysate group dropped out because refusal to ingest the formula. Weight and length gain at 13 weeks of age were extremely comparable. Significant differences in plasma concentrations were observed for a number of nonessential and essential amino acids (p = .035 to .0001). Threonine and lysine were both higher in the hydrolysate group, and aspartic acid, cystine, methionine, tyrosine, phenylalanine, histidine, and arginine were lower in the hydrolysate group. CONCLUSIONS: These differences in plasma amino acid levels have to be regarded with care because all concentrations were within normal ranges, with the exception of threonine. Weight and length gain of the hydrolysate and the whey predominant formula were identical.

Amino Acids↗

PubMedDate not supplied

Helicobacter pylori positivity in Belgium.

Epidemiological data about the prevalence of Helicobacter pylori positivity are presented in a large population of symptom-free paediatric and adult patients in Belgium (n: 1180, age range: 1 to 40 years). The investigated patients belonged to different ethnic backgrounds and are representative for the general population of Brussels. The overall prevalence of Helicobacter pylori positivity was 18.0%. We observed a significant increase in the number of positive patients with advancing age, ranging from 6.4% in the youngest age group (1 to 5 years) to 36.4% in the age group from 36 to 40. Furthermore, a significantly higher prevalence was observed in non-Caucasian patients when compared to caucasian subjects, even if both groups were born in Belgium and have been living in the same area ever since (p < 0.001). We conclude that the overall prevalence of Helicobacter pylori positivity in asymptomatic subjects in Belgium should not be underestimated. Their number increases with age and there are significant ethnic differences. The meaning of these "asymptomatic carriers" still needs to be elucidated, but their prevalence should be considered in future studies about the role of Helicobacter pylori in upper gastro-intestinal pathology.

Adolescent↗

PubMedDate not supplied

Validation of a new serologic test for the detection of Helicobacter pylori.

In order to determine normal ranges for positive and negative titres using a new commercially available second generation serologic ELISA test for the detection of Helicobacter pylori IgG antibodies (Malakit by Biolab, Limal, Belgium) we investigated 560 asymptomatic pregnant women aged 20 to 44. 128 patients (22.9%) had a positive titre for Helicobacter pylori. Although we were able to observe an increase of the number of seropositive subjects with advancing age, a significant increase in titre with age, both for positive and negative titres, could not be demonstrated. Although there was a much higher prevalence of Helicobacter pylori seropositivity in patients with a non-caucasian ethnic background, we did not observe a significant difference in cut-off limit between the different ethnic populations. In all seropositive patients a control serology and 13C-urea breath test were performed 4 to 6 months later. In 124 patients (96.9%) both control examinations were positive. The positivity of the 13C-urea breath test suggests an existent Helicobacter pylori infection in these (symptom-free) women. 13C-urea breath tests were also performed in 100 randomly selected seronegative women and were all negative, as well. Since 13C-urea breath tests were positive in seropositive subjects and negative in seronegative women, we validated the manufacturer's previously established cut-off values, based on only 37 adult patients, in a much larger population.

Adult↗

PubMedDate not supplied

The role of "occult" gastroesophageal reflux in chronic pulmonary disease in children.

It has repeatedly been demonstrated that a correlation exists between gastroesophageal reflux and the presence of various "atypical" complaints, such as recurrent chest pain, apneic attacks in infants, and recurrent or chronic respiratory symptoms. Very recently it has been shown that gastroesophageal reflux is frequently associated with non-controlled asthma in children and that medical treatment for reflux can improve the further course of respiratory disease. The aim of the present study was to investigate a possible cause-relationship between recurrent respiratory symptoms in children and the presence of gastroesophageal reflux disease, and to investigate the value of continuous 24-hour esophageal pH-monitoring in the diagnosis and management of these complaints in 62 children with chronic respiratory disease. Continuous 24-hour pH-monitoring was abnormal in 39/62 patients (62.9%). However, no statistically significant correlation could be detected between the presence of gastroesophageal reflux and various anamnestic parameters (parental smoking, pet in household, sibling with gastroesophageal reflux disease), or concomitant atopy. All children that were found positive for gastroesophageal reflux (n = 39) were started on an antireflux therapy (cisapride 0.2 mg/kg q.i.d.). This treatment resulted in an improvement of the symptoms in 84.6%. We conclude that gastroesophageal reflux is an important (causative) factor in chronic recurrent respiratory disease. This entity is often resistant to "classical" respiratory treatment, but can be treated with an anti-reflux therapy. We, therefore, suggest to perform continuous 24-hour esophageal pH-monitorings as a standard procedure in all patients with recurrent respiratory complaints, independent of the severity of their symptoms.

Adolescent↗