Helicobacter pylori infection and gastroesophageal reflux in children.

Some studies suggest that Helicobacter pylori (H. pylori) infection would be a protective factor for the gastroesophageal reflux. The aim of this study was to explore this fact. A group of 72 children, admitted in a pediatric gastroenterology regional center in Northeast Romania, diagnosed with gastroesophageal reflux by 24-hour continuous esophageal pH monitoring (results were interpreted using the Boix-Ochoa score), underwent upper endoscopy with gastric biopsy to detect the presence of H. pylori by the rapid urease testing and for bacteriological and histologic examination. 19 children (26.39%) had H. pylori infection, while 53 (73.61%) did not. The grade of esophagitis was classified according to the Los Angeles classification system. Out of 47 children with esophagitis A, 16 (34.04%) had H. pylori infection, while out of the 25 children with esophagitis B, only 3 (12%) had H. pylori infection, with statistic significance (χ2 = 54.69, P << 0.05, 95% confidence interval [CI]). Regarding the value of the Boix-Ochoa score, it appears that the presence of the H. pylori determines lower pH-metry scores (F = 8.13, P = 0.0015, 95% CI). The presence of the H. pylori was not an important factor in the gastroesophageal reflux. On the other hand its relationship with esophagitis appears to be inverse ratio. The fact that the H. pylori presence is statistically greater in the grade A esophagitis could confirm the hypothesis that the bacteria would slow down the development of the esophagitis.

[Arachnoid cyst associated with pyloric stenosis in a young boy]. / Chist arahnoidian asociat cu stenoza pilorica la un copil de vârsta mica.

An unusual association between an arachnoid cyst and a decompensated pyloric stenosis in a three years-old boy is presented. The little patient was admitted into hospital with haematemesis, melena, influenced generally condition and acute posthemorrhagic anaemia following aspirin intake for hypertermia. Specific intensive care was successful and the little patient was discharged but without an upper digestive endoscopy(parents refusal, technical reasons). After one week he returned with progressive worsening vomitings and an intracranial hypertension was suspected. CT documented an arachnoid cyst in the right middle cranial fossa and the patient is directed to the Neurosurgical Clinic where a cyst fenestration was done. Subsequent to operation the vomitings reinstaled with severe dehydration and an upper GI series showed a decompensated pyloric stenosis. He was operated on underwenting an antrectomy. Finally the child recovered with good short and long-term evolution. The coincidental presence of an intracranial congenital mass and a complicated aspirin-induced peptic ulcer in this young patient, misleaded us and in the lack of an early endoscopy an intempestive neurosurgical operation was initially done.

[Neurocutaneous syndromes and epilepsy. Report of 23 cases and review of the literature]. / Sindroamele neurocutanate si epilepsia. Raportarea a 23 de cazuri si revederea literaturii.

The neurocutaneous syndromes are characterized by congenital dysplastic abnormalities involving the skin and nervous system. We included in the study 23 children diagnosed with different types of neurocutaneous syndrome (10 patients with tuberous sclerosis, 5 with Sturge-Weber syndrome and 8 with neurofibromatosis type 1 and epilepsy'. The factors studied included: age at onset of seizures, seizure types and frequency, seizure response of treatment, EEG, CT/MRI, neurologic, neuro-ophthalmologic and psychological examination. In 39.13% of cases the epilepsy onset preceded the clinical diagnosis of neurocutaneous disorders. The age of seizure onset ranged from 4 month to 5 years. The most common type of seizure appear to be complex partial. 21.73% of patients associated mental retardation. Therapeutical efficacy was variable depending on type of seizure and type of neurocutaneous syndromes.

The prevalence of pathological gambling in Romanian teenagers.

BACKGROUND: The liberalization of teenagers' way of life strikingly increased in Romania after 1989; this includes gambling. The goal of our study is to analyze the different aspects of gambling in some teenager communities in Romania. METHODS: The study included 500 school-teenagers from 3 different Romanian districts (Cluj, Salaj and Bacau). Of these 217 (43.40%) were males and 283 (56.60%) females. Median age was 16 years old (range 14-19). A structural questionnaire was applied to the teenagers consisting in "The 20 questions of the American Anonymous Gambling Association". Other 20 questions about their age, gender, family, income, school, toxic abuse, gambling preferences, the frequency and the amount of money they use in gambling were also proposed. RESULTS: The results of the study were as it follows: 34 (6.8%) of the tested teenagers were pathological gamblers, 28 (82.36%) males and 6 (17.64%) females, with a ratio F:M of 1:4.6. The average age of starting gambling was 13.25 1.51 years old. The majority (82.35%) prefers group gambling and only 17.64% prefer individual gambling. Of these, 47.5% of them gamble very often (almost every day) and 38.2% gamble often (once a week). The most frequent gambling was: pool (55.88%), poker (35.29%), bingo (32.35%), and basketball on a bet (5.88%), black-jack, roulette and craps (2.94% each). Gambling was the reason for school absenteeism and modest results at school in 64.70% and 52.94% of all the teenagers respectively. CONCLUSIONS: The results of the study revealed very concerning aspects of the increased incidence of gambling among Romanian teenagers, compared to the UK (6% of them are gambling).

Single-channel properties of inositol (1,4,5)-trisphosphate receptor heterologously expressed in HEK-293 cells.

The inositol (1,4,5)-trisphosphate receptor (InsP3R) mediates Ca2+ release from intracellular stores in response to generation of second messenger InsP3. InsP3R was biochemically purified and cloned, and functional properties of native InsP3-gated Ca2+ channels were extensively studied. However, further studies of InsP3R are obstructed by the lack of a convenient functional assay of expressed InsP3R activity. To establish a functional assay of recombinant InsP3R activity, transient heterologous expression of neuronal rat InsP3R cDNA (InsP3R-I, SI- SII+ splice variant) in HEK-293 cells was combined with the planar lipid bilayer reconstitution experiments. Recombinant InsP3R retained specific InsP3 binding properties (Kd = 60 nM InsP3) and were specifically recognized by anti-InsP3R-I rabbit polyclonal antibody. Density of expressed InsP3R-I was at least 20-fold above endogenous InsP3R background and only 2-3-fold lower than InsP3R density in rat cerebellar microsomes. When incorporated into planar lipid bilayers, the recombinant InsP3R formed a functional InsP3-gated Ca2+ channel with 80 pS conductance using 50 mM Ba2+ as a current carrier. Mean open time of recombinant InsP3-gated channels was 3.0 ms; closed dwell time distribution was double exponential and characterized by short (18 ms) and long (130 ms) time constants. Overall, gating and conductance properties of recombinant neuronal rat InsP3R-I were very similar to properties of native rat cerebellar InsP3R recorded in identical experimental conditions. Recombinant InsP3R also retained bell-shaped dependence on cytosolic Ca2+ concentration and allosteric modulation by ATP, similar to native cerebellar InsP3R. The following conclusions are drawn from these results. (a) Rat neuronal InsP3R-I cDNA encodes a protein that is either sufficient to produce InsP3-gated channel with functional properties identical to the properties of native rat cerebellar InsP3R, or it is able to form a functional InsP3-gated channel by forming a complex with proteins endogenously expressed in HEK-293 cells. (b) Successful functional expression of InsP3R in a heterologous expression system provides an opportunity for future detailed structure-function characterization of this vital protein.

Functional coupling of phosphatidylinositol 4,5-bisphosphate to inositol 1,4,5-trisphosphate receptor.

The inositol 1,4,5-trisphosphate receptor (InsP3R) plays a key role in intracellular Ca2+ signaling. InsP3R is activated by InsP3 produced from phosphatidylinositol 4,5-bisphosphate (PIP2) by phospholipase C cleavage. Using planar lipid bilayer reconstitution technique, we demonstrate here that rat cerebellar InsP3R forms a stable inhibitory complex with endogenous PIP2. Disruption of InsP3R-PIP2 interaction by specific anti-PIP2 monoclonal antibody resulted in 3-4-fold increase in InsP3R activity and 10-fold shift in apparent affinity for InsP3. Exogenously added PIP2 blocks InsP3 binding to InsP3R and inhibits InsP3R activity. Similar results were obtained with a newly synthesized water soluble analog of PIP2, dioctanoyl-(4,5)PIP2, indicating that insertion of PIP2 into membrane is not required to exert its inhibitory effects on the InsP3R. We hypothesize that the functional link between InsP3R and PIP2 described in the present report provides a basis for a local, rapid, and efficient coupling between phospholipase C activation, PIP2 hydrolysis, and intracellular Ca2+ wave initiation in neuronal and non-neuronal cells.

Effect of magnesium sulfate on learning, emotivity and spontaneous motility in rats.

The study was performed on three groups, each including 10 male Wistar rats, weighing 110-130 g: group 1, the control group; group 2, animals treated with magnesium sulfate in a dose of 100 mg/kg body/day i.m.; group 3, animals treated with double dose of magnesium sulfate (200 mg/kg body/day i.m.). All animals were tested for emotivity and spontaneous motility in the open field, as well as for their capacity of acquiring active avoidance conditioned reflexes in the shuttle-box, for 9 days. Magnesium sulfate decreased significantly the learning ability, decreased emotivity scores regardless of the administered dose, and increased significantly spontaneous motility scores only in the double dose treated group.

The effect of reduced glutathione (TAD-600) on the behavior of rats neonatally intoxicated with ethanol.

The study was performed on three groups of male rats of the Wistar strain at the age of three months: group 1 (n = 10), the control group; group 2 (n = 10), consisting of animals treated neonatally (from day 4 through day 10) with ethanol 20%, administered by gavage to the mothers, at the dose of 5 g/kg body/day; group 3 (n = 10) of animals exposed to ethanol under similar conditions, but whose mothers have been injected a reduced glutathione (TAD-600) solution in a dose of 2 mg/100 g body weight of the mother. All the animals were weight ed before the test of behavior. The neonatal administration of ethanol caused ponderal weight retardation, which was not influenced by TAD-600 administrations. Also, a decrease in the scores of emotivity and spontaneous motility in the open field was noticed, as well as difficulties in the acquisition of active avoidance conditioned reflexes in the shuttle-box. Concomitant glutathione administration during the neonatal period significantly improves the learning ability at the age of three months, as well as the score of emotivity, without improving the spontaneous motility score.

[Lipid metabolism in severely acute diarrheic disease in infants]. / Aspecte ale metabolismului lipidic în boala diareica acuta grava a sugarului.

In a group of 34 infants with serious acute diarrheic disease, the authors study the total lipids, total and esterified cholesterol, triglycerides and lipidogram, in the acute phase of the disease and at a 10-day-interval from the first determination. Triglycerides have constantly increased values both at admittance and at the second determination, as a consequence of lipid mobilization in acute stage. This process continues due to the hypolipidic and hypocaloric diet. Esterified fraction of cholesterol has initially important decreases, tending to become normal in the interval studies, more evident in the healthy infant. Total lipids are increased in 10.5% of the cases and the lipidogram shows an increase of alpha-lipoproteins and prebeta-lipoproteins in 10.5% and 17.5% respectively of the cases in the first determination.

[Jaundice with indirect bilirubinemia via the mother's milk]. / Icter cu bilirubinemie indirecta prin lapte matern.

Among the clinical entities included in the differential diagnosis of the prolonged jaundice at the end of neonatal period and in the small infant is the jaundice due to mother's milk, whose incidence is of 0.5-2% in the naturally fed infants. The authors present two cases in which the diagnosis was reached by exclusion and confirmed by the therapeutically positive test. Physiopathologic considerations are made on the basis of the literature data, and the nosologic background of the affection is presented. This clinical entity, considered to have an excellent prognosis, presented a special evolution in one of the cases.

[A severe dystonic reaction in acute Torecan poisoning]. / Reactie distonica severa în intoxicatia acuta cu Torecan.

Phenothiazines are a widely used group of drugs for medical practice. Some of them, including Torecan, may induce dystonic reactions of severe aspect which may lead to errors of diagnosis. Although in the paediatric practice this drug is but seldom used the possibility of intoxications exists when it is used without a medical prescription. The authors present two cases where neurological manifestations occurred, as severe, dystonic phenomena, that had a favourable evolution, under adequate therapy.

[Enzymatic aspects of severely acute diarrheal disease in infants]. / Aspectele enzimatice în boala diareica acuta grava a sugarului.

Acute dehydration of diarrhoea of the breast-fed child is a type of hypovolemic shock which, by its severity and frequency is one of the major emergencies of pediatrics. The liver, as the site of many metabolic processes is mainly affected in the frame of the multiple-tissue involvement which is characteristic for this condition. The authors carried out a study of several enzymes (total LDH and the thermally-labile fraction, gluthamatdehydrogenase, gammaglutamyltranspeptidase, acid and alkaline phosphatase) in 27 breast-fed children. Determination of the enzymes was done on hospitalization, and 10 days later. The study showed that all the enzymes that were evaluated had moderate increases in 40.7-71% of all cases. The increases were significant (p less than 0.001). After 10 days the enzyme titers showed a tendency to become normal again, and slightly higher values were found in only 15-12% of all cases. Minimal hepatopathy can be considered, associated to the clinico-biological evolution of this severe conditions of the breast-fed child pathology.