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Original article


Clinical characteristics of Iranian pediatric patients with inflammatory bowel disease


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Abstract Background : Inflammatory bowel disease (IBD) is a group of disorders, including Crohn’s disease (CD), ulcerative colitis (UC) and indeterminate colitis (IC). Small intestine and colon are primarily affected in this group of disorders. Purpose : This single center study was performed to define demographic features and clinical characteristics of Iranian pediatric patients with IBD. Method : Fifty nine patients with IBD, who have been referred to Children’s Medical Center Hospital during a 10-year period, were investigated in this study. The data was gathered by interviewing the patients and their families, as well as reviewing their medical records. Results : Among 59 patients with IBD, 23 cases had UC and 19 cases had CD, while the remaining 17 cases had IC. Patients with UC were significantly younger at the time of diagnosis in comparison with patients with CD. The most common symptoms were abdominal pain, diarrhea, fever and growth failure. Hepatobiliary abnormalities and arthritis were common extra intestinal manifestations. The median Pediatric Crohn’s Disease Activity Index was 42.5 (range 20-60), whereas the median Pediatric Ulcerative Colitis Activity Index was 40 (range 20-70). Seven of 23 UC (30.4%) had proctatis, while 16 (69.6%) had extensive colitis. In CD, 11 of 19 (57.9%) had involvement of terminal ileum and colon, while inflammation was limited to the colon in 8 cases (42.1%). The colonoscopic findings in the IC group were heterogeneous. Conclusion : This study provides epidemiological data on pediatric patients with IBD, which could be useful for health care workers in prompt diagnosis and appropriate treatment of early onset IBD. (Acta gastro enterol. belg., 2009, 72, 230-234). [Product Details...]


Effect of addition of vitamin C to clarithromycin-amoxicillin-omeprazol triple regimen on Helicobacter pylori eradication


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Abstract Background : The use of vitamin C as a supplement with the common regimen for eradication of Helicobacter pylori infection is the subject of ongoing controversy. We conducted a prospective controlled study with the aim of testing whether the vitamin C supplement to the therapy includes lower dosage of clarithromycin could have an acceptable influence on Helicobacter pylori eradication in comparison with routine anti-Helicobacter pylori regimen. Materials and methods : Two hundred and fourteen consecutive patients with the verification of Helicobacter pylori infection via positive Rapid Urease Test (RUT) and histology results were included and divided into two therapy groups : 1) a group without vitamin C (n = 100) that were administered 20 mg omeprazol, 1 g amoxicillin, and 500 mg clarithromycin twice daily for 2 weeks and 2) a triple-plus-vitamin C group (n = 114) that was administered 20 mg omeprazol, 1 g amoxicillin, 250 mg clarithromycin plus 250 mg vitamin C twice daily for 2 weeks. Four weeks after the completion of therapy, each patient was scheduled for urea breath test to assess the success of Helicobacter pylori eradication. Results : Similar eradication of Helicobacter pylori was found between the triple-only group with 500 mg of clarithromycin and the triple with 250 mg of clarithromycin-plus vitamin C group (89% versus 86.8%, P = 0.623). Conclusions : Adding vitamin C might reduce the needed dosage of clarithromycin for eradication of Helicobacter pylori. (Acta gastro enterol. belg., 2009, 72, 222-224). [Product Details...]


Quantitative endoscopic and histologic activity assessment of ulcerative colitis


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Abstract Background : Correct assessment of the severity and activity of ulcerative colitis (UC) is necessary for determining effective treatment and predicting prognosis. The correlation between histologic activity and endoscopic activity, however, has not yet been determined by using a quantitative scoring system. Study aims : To compare the endoscopic activity index (EAI), detected during colonoscopy, with the histologic activity index (HAI) detected in biopsy samples taken from the same colon segments of UC patients in order to determine the degree of agreement between both assessments. Patients and methods : Ninety-six UC patients participated in this prospective study. EAIs and HAIs were obtained by summing the scores given for each mucosal/histological change to produce a total score between 1 and 12. The correlation between EAI and HAI was calculated. Results : There was a positive correlation between HAI and EAI (r = 0.78 ; p [Product Details...]


Tumor necrosis factor–alpha gene promoter polymorphisms in Chinese patients with nonalcoholic fatty liver diseases


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Abstract Background : Nonalcoholic Fatty Liver Disease (NAFLD) encompasses a histopathological spectrum of clinical conditions such as simple fatty liver (steatosis), nonalcoholic steatohepatitis (NASH), and a variant that has degrees of fibrosis. Tumor Necrosis Factor–alpha (TNF-a) is considered essential for NAFLD. Therefore, we investigated the correlation between TNF-a gene promoter polymorphism and NAFLD in this human study. Patients and methods : The TNF-a gene polymorphisms at position -238 and -308 were analyzed in 189 Chinese patients with NAFLD and 138 healthy controls by using polymerase chain reaction and restriction fragment length polymorphism assay. The serum levels of TNF-a in both patient and control groups were measured by ELISA. The associations of TNF-a polymorphism and serum TNF-a, and/or insulin resistance, and/or clinical features were analyzed. Results : The carrier frequencies of TNF-a gene polymorphism with G/A mutation at -238 were significantly higher in the patients with NAFLD than those in the control subjects (p 0.05). In addition, the serum level of TNF-a was markedly higher in the patients with NAFLD than in the control subjects (p nsulin resistance, as well as increased body mass index in the NAFLD patients. Conclusions : The results indicate that the TNF-a gene polymorphism at position -238 is associated with susceptibility of nonalcoholic Fatty Liver Disease in a Chinese population. (Acta gastro - enterol. belg., 2009, 72, 215-221). [Product Details...]


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