[Blood pressure and type 2 diabetes mellitus: impact of the insulin therapy]. / Pression arterielle et diabete de type 2: impact de la mise sous insuline.

BACKGROUND: The incidence of arterial hypertension is by 2-3 times with diabetics than with non-diabetics. Etiopathogenesis of arterial hypertension in type 2 diabetes is multifactorial insulin-resistance, obesity, hyperlipoproteinemia, age, smoking and probably method of treatment (insulin therapy). The aim of this retrospective study is to evaluate, over 5 years period, the level of blood pressure and the frequency's progression of arterial hypertension in 35 type 2 diabetes patients treated with insulin METHODS: comparison of 35 type 2 diabetes patients treated with insulin to 35 controls treated with oral hypoglycemic agents. RESULTS: No significant differences were found over 5 years period in mean systolic blood pressure, mean diastolic blood pressure and frequency of arterial hypertension. However, frequency of arterial hypertension was correlated with mean dose of insulin. CONCLUSION: Our study confirms the long-term results found in the literature reading effects of insulin therapy on blood pressure in diabetic patients.

[Chronic gastritis in children]. / Les gastrites chroniques chez l'enfant.

BACKGROUND: Active gastritis, atrophic gastritis (AG) and intestinal metaplasia are lesions associated with Helicobacter pylori (H. pylori) infection in adults. AIM: To assess the prevalence of chronic gastritis, its histological characteristics and clinical features in children. METHODS: 345 children (M/F: 151/194, mean age: 8.6 +/- 3.7 years; range: 1-18 years) were enrolled, referred for upper gastrointestinal endoscopy (UGI endo) with clinical manifestations of gastritis, i.e., recurrent abdominal pain (n = 232, 67.2%), upper gastrointestinal bleeding (n = 59, 17.1%) and miscellaneous (n = 53, 15.3%). Four perendoscopic gastric biopsy specimens (antrum: 2, fundus: 2) were taken. Biopsies were assessed and graded according to the updated Sydney system. H. pylori infection was considered if 2 out 3 tests were positive (culture, histology and rapid urease test), whereas 3 concordant negative results identified H. pylori negative children. RESULTS: H. pylori infection and chronic gastritis were detected in 215/345 (62.3%) (M/F: 104/117, sex ratio M/F = 0.89) and 221/345 (64.05%) children, respectively. Recurrent abdominal pain (n = 149, 67.4%) was the main clinical features of chronic gastritis followed by vomiting (n = 43, 19.5%) and upper gastrointestinal bleeding (n = 41, 18.6%). Any clinical features were however found to be specific. UGI endo showed; nodular gastritis (n = 90, 40.72%), congestive gastritis (n = 84, 38%), gastric ulcer (n = 9), bulbar ulcer (n = 5) and normal (n = 47, 21.2%). Chronic gastritis was active in 115 cases (52%) and was significantly associated with nodular gastritis (p < 0.05). Thirty two chronic gastritis (14.4%) exhibited AG (M/F: 16/16, mean age: 9.4 +/- 3.4 years) and 30/32 (93.7%) were H. pylori positive. AG was significantly associated with H. pylori infection (p < 0.0001) and nodular gastritis (p < 0.005). Active, follicular and AG were significantly associated with H. pylori infection (p < 0.00001). Three patients exhibited intestinal metaplasia. CONCLUSION: Chronic gastritis is frequent in children. Any clinical features were found to be specific. It significantly associated H. pylori infection and nodular gastritis. Atrophic gastritis was found in 14.5% of children.