ABSTRACT
BACKGROUND AND STUDY AIMS: The aim of this prospective survey was to determine and compare the knowledge of children with inflammatory bowel disease (IBD) and their parents about their disease. Furthermore, patients and parents were ask to provide the main source for disease related information and to give opinion for possible improvement. PATIENTS AND METHODS: This was a prospective survey which included children with IBD with ≥ 12 years of age and their parents. Only ambulatory patients treated in tertiary medical center were included. RESULTS: 38 child/parent pairs (79% mothers) were enrolled. Major differences between parents and children were in a) internet search where majority of parents (n = 28â¯; 73.7%) and only 17 (44.7%) children gathered disease related information over the internet (p = 0.01)â¯; b) need for participation in patients' organization (97.4% parents comparing 55.3% children would like to participateâ¯; p<0.001) and c) clinical practice with time reserved for child/adolescent to be with his/her physician alone (78.9% of parents encourage this practice comparing to 2.6% of childrenâ¯; p <0.001). CONCLUSION: This study shows significant difference between children/adolescents with IBD and their parents in several aspects that should be acknowledged before initiating changes into the clinical practice.
Subject(s)
Attitude to Health , Inflammatory Bowel Diseases/psychology , Information Seeking Behavior , Parents/psychology , Adolescent , Adult , Child , Croatia , Female , Health Knowledge, Attitudes, Practice , Humans , Information Literacy , Information Storage and Retrieval , Male , Patient Education as Topic/methodsABSTRACT
BACKGROUND: The aim of this study was to determine the role of multichannel intraluminal impedance-pH (pH-MII) monitoring in the diagnosis of gastro-esophageal reflux disease (GERD) in children who presented with gastrointestinal (GI) symptoms in comparison with the results of pH-metry alone and endoscopy. METHODS: All children who underwent pH-MII monitoring due to GI symptoms, suggestive of GERD, from October 2013 to October 2015 in Children's Hospital Zagreb, were retrospectively enrolled in the study. The cohort was divided into three groups according to age - group 1: children <1 year of age; group 2: 1-9 years of age; and group 3: ≥9 years of age. KEY RESULTS: One hundred thirty-three patients met our inclusion criteria (73 female/60 male; mean age 9.2 years [0.19-18.0]). Gastro-esophageal reflux disease was determined in 44 of 133 patients (33.1%) by pH-MII and only in 21 of 133 patients (15.8%) by pH-metry alone. Endoscopy was performed in 77 (57.9%) children and esophagitis was found in 32/77 (41.6%). The finding of esophagitis significantly correlated with the number of total reflux episodes (coef. 0.42, p < 0.001), acidic (coef. 0.26, p = 0.02), weakly acidic (coef. 0.3, p = 0.008) and non-acidic (coef. 0.26, p = 0.02) reflux episodes detected by pH-MII; but, no correlation was found to reflux episodes detected by pH-metry alone (coef. 0.21, p = 0.07). CONCLUSIONS & INFERENCES: Compared with pH-metry alone, pH-MII performed significantly better in the detection of GERD in all age groups. On the basis of our data, pH-MII had a strong correlation with endoscopically confirmed esophagitis.
Subject(s)
Electric Impedance , Esophageal pH Monitoring/methods , Esophagitis/physiopathology , Gastroesophageal Reflux/physiopathology , Monitoring, Ambulatory/methods , Adolescent , Child , Child, Preschool , Esophagitis/diagnosis , Female , Gastroesophageal Reflux/diagnosis , Gastrointestinal Diseases/diagnosis , Gastrointestinal Diseases/physiopathology , Humans , Infant , Male , Retrospective StudiesABSTRACT
Refeeding syndrome (RFS) is a well-described state of the series of metabolic and biochemical changes that can occur during the feeding of malnourished persons. The shifts in fluids and electrolytes can lead to complications during artificial feeding, which if not recognised and untreated can lead to death. Although the physiology and pathophysiology of RFS is well known, the circumstances under which the RFS appears, clinical manifestations and management of these patients are less clear. There are few published studies describing the occurrence of RFS in children. We describe two cases of RFS in children. The first case is a boy with unrecognised coeliac disease and second case is a girl with cerebral palsy. In both cases, the RFS has developed without clinical symptoms and it was shown only through laboratory findings. Electrolyte disturbances have been successfully corrected and treatment of the underlying disease continued.
