ABSTRACT
Background/Aims@#Combined multichannel intraluminal impedance and pH monitoring (MII/pH) is considered the most accurate test to detect gastroesophageal reflux (GER), however lacking reference values. We aim to determine reference values for the pediatric population and to correlate these values with age and postprandial/fasting period. @*Methods@#We evaluated MII/pH traces from patients (newborns, infants, and children) admitted to 3 Italian hospitals and who underwent MII/ pH for suspected GER disease. Patients with MII/pH traces that showed significant symptom-reflux associations and/or a pathological reflux index (> 6% for newborns and infants, > 3% for children) were excluded. Traces were analysed in their entirety, and in the postprandial period (first hour after a meal) and the fasting period (the following hours before the next meal) separately. @*Results@#A total of 195 patients (46 newborns, 83 infants, and 66 children) were included. Age positively correlated with frequency of acidic GER events (r = 0.37, P < 0.05) and negatively associated with weakly acidic GER events (r = 0.46, P < 0.05). @*Conclusions@#This study describes the distribution of MII/pH values in a pediatric population with normally acidic GER exposure and no significant association between GER events and symptoms. These MII/pH values may be used as reference values in clinical practice for a corrected GER disease diagnosis in the pediatric population.
ABSTRACT
Interferon [IFN] monotherapy significantly reduces the chronicity rate of acute hepatitis C [AHC] but optimal regimen and treatment timing remain undefined. The aim of this study was to assess the efficacy of a 6-month course of pegylated IFN [PEG-IFN] alpha-2b monotherapy in AHC patients and to investigate if IFN treatment initiated after 12 weeks from clinical presentation, still achieved a high response rate. Sixteen AHC patients still viremic after 12 weeks from the onset were treated with PEG-IFN a-2h [1.5 mcg/kg once weekly] for 6 months and followed for at least 12 months. Response to therapy was defined as normal ALT values and undetectable HCV RNA [<50 IU/ml] at the end of therapy, after 6 [sustained response] and 12 months follow-up [long-term response]. At the end of treatment, HCV RNA was undetectable in 15/16 patients while ALT normalized in 14/16 patients. After 6 and 12 months follow-up, 15/16 patients [94%] showed virological and biochemical response. A 6-month course of PEG-IFN alpha-2b is effective in inducing resolution of AHC in 94% of patients. Our results provide a rationale for delaying treatment for 12 weeks, targeting only patients who fail to clear the virus spontaneously and truly requiring therapy without loss of efficacy