Laryngopharyngeal Reflux in Children with Chronic Otitis Media with Effusion.

BACKGROUND/AIMS: To evaluate the characteristic properties of laryngopharyngeal reflux (LPR) and gastroesophageal reflux (GER) in children with otitis media with effusion (OME) using 24-hour multichannel intraluminal impedance combined with dual-probe (pharyngeal and esophageal) pH-metry. METHODS: Children aged 7-10 years of age with OME underwent 24-hour multichannel intraluminal impedance pH-metry. The upper pH sensor was situated 1 cm above the upper esophageal sphincter, and the lower pH sensor was placed 3-5 cm above the lower esophageal sphincter. Parents were asked to complete the gastroesophageal reflux assessment of symptoms in a pediatrics questionnaire. RESULTS: Twenty-eight children were enrolled; LPR was detected in 19 (67.9%) children. The criteria of the LPR diagnosis was the presence of at least one supraesophageal episode with a pH < 5.0 and a change in the pH value measured from the initial level at the upper sensor of > 0.2. In total, 64 episodes were observed. Assessment of all LPR episodes showed the presence of 246 episodes in the entire study. A considerable predominance of weakly acidic episodes (87.8%) was noted; there were 6.5% acidic episodes, and weakly alkaline episodes reached 5.7%. Pathological GER was noted in 10 (35.7%) subjects. Acid GER was detected in 8 children, 2 of whom demonstrated non-acidic reflux. In the LPR-negative patients, no pathological GER was confirmed with the exception of a single case of non-acidic reflux. CONCLUSIONS: LPR was frequently noted in the group of children with OME, and it might be an important risk factor in this common disease.

IL-1α and IL-1ß levels in blood serum and saliva of menopausal women.

OBJECTIVE: The aim of this study was to examine the level of IL-1α and IL-1ß in serum and saliva of postmenopausal women. DESIGN: The study was designed to verify the possibility of using the salivary concentration of interleukin 1 as a marker in the diagnosis of osteoporosis. MATERIALS AND METHODS: The study involved a group of 60 women during menopause-30 untreated and 30 treated with hormone replacement therapy. Patients were examined and anamnesis questionnaire was filled. Blood and saliva samples were collected. Densitometry was conducted on the femoral bone in order to compare the bone mineral density (BMD) of different research groups. RESULTS: There were no significant differences in the concentrations of interleukins in the various research groups. The results of densitometric analysis showed a positive impact of hormone replacement therapy on the BMD (0.91-0.92 g/cm2) compared with the density in the group not treated with hormone therapy (0.77-0.8 g/cm2). There was no relationship between concentration of interleukins and the level of BMD. CONCLUSIONS. Further research on the level of cytokines in serum and saliva conducted on a broader group of patients is required. Determination of markers of bone turnover can be useful in the assessment of the treatment of metabolic bone changes.

[Long-term observation of children with gastro-esophageal reflux disease]. / Odlegla obserwacja dzieci z choroba refluksowa przelyku.

INTRODUCTION: Gastroesophageal reflux disease (GERD) is frequent disorder of the gastro-intestinal tract. Although in adults GERD is regarded as a chronic disease, in children it is often considered as a transient disorder. AIM: To assess the natural history of GERD in infants and children. MATERIAL AND METHODS: We enrolled 163 children (44% girls and 56% boys) with GERD diagnosed on the basis of esophageal symptoms and positive result of 24-hour pH-monitoring (fraction time - fT > 4.2%). The mean age at the time of the diagnosis was 4.5 year. After 3.5 years from the diagnosis, the patients or guardians filled in a custom-made questionnaire evaluating GERD symptoms: heartburn, belching, vomiting, regurgitations, feeding problems, dysphagia, epigastric pain. Control pH-monitoring was performed in 71 of the patients. The patients were divided into three age groups: group I--below 1 year of age (38 children), group II--between 1 and 4 years of age (35 children) and group III--above 4 years of age (90 children). RESULTS: GERD symptoms disappeared completely in 45%, 14.3% and 13.4% from group I, II and III, respectively. In 38 (54%) patients the control pH-monitoring revealed pathologic acid reflux, including 4 children without any GERD symptoms. CONCLUSIONS: The study shows that in children aged above 1 year GERD symptoms are unlikely to subside completely. Moreover, acid gastroesophageal reflux may still be present, despite the absence of the clinical symptoms.