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Marin Burlea

Presedintele Societatii Romane de Pediatrie

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Articole semnate de acelasi autor in Revista Romana de Pediatrie:

DIAGNOSTIC SI TRATAMENT IN BOALA DE REFLUX GASTROESOFAGIAN – POSIBILITATI SI LIMITE

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Revista Romana de PEDIATRIE | Volumul LXV, Nr. 3, An 2016
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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DIAGNOSTIC SI TRATAMENT IN BOALA DE REFLUX GASTROESOFAGIAN – POSIBILITATI SI LIMITE

, , , , , and

REZUMAT

Departajarea refluxului gastro-esofagian (RGE) fiziologic (cel mai frecvent) de boala de reflux gastro-esofagian (BRGE) în primul an de viaţă este obligatorie pentru a evita farmacoterapia agresivă. La toate vârstele
copilăriei se aplică criterii moderne de evaluare clinică, sumând simptome digestive şi/sau extradigestive şi rezultatele unor investigaţii moderne. Tratamentul igieno-dietetic (suficient in RGE fiziologic), obligatoriu în toate cazurile, şi inhibitorii de pompă protonică dupa vârsta de un an induc remisiune în majoritatea cazurilor de RGE. Evoluţia cronică/recidivantă şi rezistenţa la tratamentul comun impun intervenţia chirurgicală, domeniu îmbogaţit recent la copil cu miotomia perorală endoscopică (POEM).

Cuvinte cheie: boală de reflux gastroesofagian, inhibitori de pompă de protoni, miotomia perorală endoscopică

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DIAGNOSIS AND TREATMENT IN GASTROESOPHAGEAL REFLUX DISEASE – POSSIBILITIES AND LIMITATIONS

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Revista Romana de PEDIATRIE | Volumul LXV, Nr. 3, An 2016
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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HIGHLIGHTS

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

DIAGNOSIS AND TREATMENT IN GASTROESOPHAGEAL REFLUX DISEASE – POSSIBILITIES AND LIMITATIONS

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ABSTRACT

In children’s first year of life it is mandatory to make a difference between physiological gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD), in order to avoid an aggressive pharmacologic therapy. All ages of childhood benefit from modern criteria of clinical evaluation, by corroborating the digestive or extradigestive symptoms with the results of modern investigations. The dietary measures (sufficient in GER but mandatory in all cases) together with proton pump inhibitors administration after one year of age induce remission in majority of GER cases. The chronic and recurrent evolution of the disease or failure of the common treatment require surgical intervention, recently enriched in children with peroral endoscopic myotomy (POEM).

Keywords: gastroesophageal reflux disease, proton pump inhibitors, Peroral Endoscopic Myotomy

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REFLUXUL GASTROESOFAGIAN LA NOU-NASCUT SI SUGAR (II)

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Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 4, An 2015
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

REFLUXUL GASTROESOFAGIAN LA NOU-NASCUT SI SUGAR (II)

, , , and

REZUMAT

Refluxul gastroesofagian la nou-născut şi sugar se particularizează prin patogenie, încadrare diagnostică şi abordare terapeutică, imaturitatea funcţională a aparatului digestiv, imaturitatea anatomică a sfincterului esofagian inferior Hiss şi aciditatea gastrică mai mică. În cazul sugarilor se ţine cont şi de complianţa redusă la procedurile laborioase cum sunt pH-metria, impedanţ-pH-metria şi endoscopia degestivă. Graniţa dintre regurgitaţii, reflux gastroesofagian fiziologic şi boală de reflux este uneori dificil de trasat. Modificarea stilului de viaţă la sugari (alimentaţia şi modificările poziţionale), prin obţinerea aderenţei mamei la recomandările medicale reprezintă un prim pas în tratamentul RGE, fiind urmat în cazurile non-responsive de terapia farmacologică şi intervenţia chirurgicală.

Cuvinte cheie: reflux gastroesofagian, nou-născut, sugar

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GASTROESOPHAGEAL REFLUX IN NEWBORNS AND INFANTS (II)

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Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 4, An 2015
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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HIGHLIGHTS

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

GASTROESOPHAGEAL REFLUX IN NEWBORNS AND INFANTS (II)

, , , and

ABSTRACT

Gastroesophageal reflux in newborns and infants is particularized by pathogeny, diagnosis and therapeutical approach, functional immaturity of the digestive tract, the anatomic immaturity of the Hiss lower esophageal sphincter and lower gastric acidity. In infants, the low compliance with the laborious procedures such as pHmetry, impedance – pH-metry and digestive endoscopy is also considered. The border between regurgitations, physiological gastroesophageal reflux and the reflux disease is sometimes hard to establish. Changing the lifestyle of infants (feeding and position changes) based on the mother’s compliance with the medical recommendations is a first step in the treatment of GER, followed in non-responsive cases by pharmacological therapy and surgery.

Keywords: gastroesophageal reflux, newborn, infant

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ULCERUL GASTRIC DUPA ADMINISTRAREA PE TERMEN SCURT DE ANTIINFLAMATOARE NESTEROIDIENE LA UN COPIL MIC – PREZENTARE DE CAZ

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Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 4, An 2015
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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HIGHLIGHTS

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

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ULCERUL GASTRIC DUPA ADMINISTRAREA PE TERMEN SCURT DE ANTIINFLAMATOARE NESTEROIDIENE LA UN COPIL MIC – PREZENTARE DE CAZ

, , , , and

REZUMAT

Agenţii antiinflamatori nesteroidieni (AINS) produc leziuni gastrice prin intermediul a două mecanisme: iritaţia locală şi acţiunea sistemică. Un copil în vârstă de 2 ani şi 10 luni, sex feminin, a primit AINS timp de 2 zile pentru o infecţie acută a tractului respirator superior şi a prezentat vărsături în „zaţ de cafea“ o zi mai târziu. Endoscopia digestivă superioară a evidenţiat o leziune de ulcer gastric. Biopsia gastrică a fost negativă pentru infecţia cu H. pylori, iar pacienta a fost diagnosticată cu ulcer gastric acut indus de consumul de AINS în absenţa altor cauze de ulcer gastric. Ulcerele gastrice se dezvoltă foarte rar după o administrare pe termen scurt de AINS, fapt ce a determinat raportarea acestui caz. Luând în considerare atât riscurile cât şi beneficiile terapiei cu AINS, este indicat ca în cazul fiecărui pacient care trebuie să urmeze un tratament cronic cu medicamente antiinflamatorii să fie căutaţi posibilii factori de risc asociaţi.

Cuvinte cheie: medicamente antiinflamatoare nesteroidiene (AINS), ulcer gastric, copil

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GASTRIC ULCER AFTER SHORT-TERM NONSTEROIDAL ANTI-INFLAMMATORY DRUGS ADMINISTRATION IN A SMALL CHILD – CASE REPORT

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Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 4, An 2015
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

GASTRIC ULCER AFTER SHORT-TERM NONSTEROIDAL ANTI-INFLAMMATORY DRUGS ADMINISTRATION IN A SMALL CHILD – CASE REPORT

, , , , and

ABSTRACT

Nonsteroidal anti-inflammatory agents (NSAIDs) produce gastric lesions through two mechanisms: local irritation and systemic action. A 2 year and 10 months old female received NSAID for acute upper respiratory infection for 2 days and she developed coffee ground vomitus one day later. Upper gastrointestinal endoscopy revealed a gastric ulcer. She was negative for H. pylori infection, and she was diagnosed with NSAID – induced acute gastric ulcer in the absence of other causes of gastric ulcer. Gastric ulcers develop very rarely after a short-term administration of NSAIDs, which prompted us to report this case. Balancing the risk and the benefit of eradication therapy, it is indicated, for every patient who must follow a chronic treatment with anti-inflammatory drugs, to look for possible associated risk factors.

Keywords: anti-inflammatory drugs (NSAIDs), gastric ulcer, child

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REFLUXUL GASTROESOFAGIAN LA NOU-NASCUT SI SUGAR (I)

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Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 4, An 2015
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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HIGHLIGHTS

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

REFLUXUL GASTROESOFAGIAN LA NOU-NASCUT SI SUGAR (I)

, , and

REZUMAT

Refluxul gastro-esofagian (RGE) la nou-născut şi sugar se particularizează prin patogenie, încadrare diagnostică şi abordare terapeutică. La aceştia situaţia este mai complexă dacă avem în vedere imaturitatea funcţională a aparatului digestiv, imaturitatea anatomică a sfincterului esofagian inferior Hiss şi aciditatea gastrică mai mică. În cazul sugarilor se ţine cont şi de complianţa redusă la procedurile laborioase cum sunt pH-metria, impedanţ-pH-metria şi endoscopia digestivă. Graniţa dintre regurgitaţii, reflux gastro-esofagian fiziologic şi boală de reflux este uneori dificil de trasat. Modificarea stilului de viaţă la sugari (alimentaţia şi modificările poziţionale), prin obţinerea aderenţei mamei la recomandările medicale, reprezintă un prim pas în tratamentul RGE, fiind urmat în cazurile non-responsive de terapia farmacologică şi intervenţia chirurgicală.

Cuvinte cheie: reflux gastroesofagian, nou-născut, sugar

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GASTROESOPHAGEAL REFLUX IN NEWBORNS AND INFANTS (I)

SELECT ISSUE

Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 4, An 2015
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

Indexed

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HIGHLIGHTS

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

GASTROESOPHAGEAL REFLUX IN NEWBORNS AND INFANTS (I)

, , and

ABSTRACT

Gastroesophageal reflux in newborns and infants is particularized by pathogeny, diagnosis and therapeutical approach. The situation is much more complex for them due to the functional immaturity of the digestive tract, to the anatomic immaturity of the Hiss lower esophageal sphincter and to the lower gastric acidity. In infants, the low compliance with the laborious procedures such as pH-metry, impedance – pH-metry and digestive endoscopy is also considered. The border between regurgitations, physiological gastroesophageal reflux and the reflux disease is sometimes hard to establish. Changing the life style of infants (feeding and position changes) based on the mother’s compliance with the medical recommendations is a first step in the treatment of GER, followed in non-responsive cases by pharmacological therapy and surgery.

Keywords: gastroesophageal reflux, newborn, infant

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GASTRITELE SI HELICOBACTER PYLORI LA COPIL – DIAGNOSTICUL ENDOSCOPIC PRIMAR SI SECUNDAR

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Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 3, An 2015
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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HIGHLIGHTS

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

GASTRITELE SI HELICOBACTER PYLORI LA COPIL – DIAGNOSTICUL ENDOSCOPIC PRIMAR SI SECUNDAR

, , , , , , , , and

REZUMAT

Infecţia cu Helicobacter pylori (H. pylori) este o problemă comună şi semnificativă de sănătate publică.
Obiectiv. Determinarea prevalenţei infecţiei cu H. pylori la copiii cu simptomatologie sugestivă şi conturarea cazurilor în funcţie de tipul şi felul gastritei prin efectuarea de endoscopii digestive superioare.
Material şi metodă. Studiu retrospectiv realizat pe o perioadă de 5 ani pe 1.269 de copii cu simptomatologie gastrică, la care s-au efectuat endoscopii cu biopsie, stabilindu-se rata de infecţie cu H. pylori prin examen direct sau testul ureazei.
Rezultate. Frecvenţa H. pylori în cazul gastritei acute a fost semnificativ mai mică (34,78%) comparativ cu frecvenţa acesteia în cazul gastritei cronice (54,94%). În cadrul celor 10 tipuri de gastrită, cele mai frecvente sunt formele purpurice (43,66%), nodular purpurică (25,93%) şi nodular antrală (15,84%), la polul opus situându-se gastrita atrofică şi hipertrofică. Asocierile cele mai frecvente decelate endoscopic sunt cu esofagita gr I în 51,6%, duodenita în 45,07% şi forma purpurică în 24,74%.
Concluzii. Infecţia cu H. pylori este cel mai frecvent asociată gastritei cronice (54,94%). Identificarea precoce a infecţiei este esenţială pentru eradicarea bacteriei şi prevenirea apariţiei diferitelor tipuri de gastrită identificate endoscopic.

Cuvinte cheie: gastrită, H. pylori, endoscopie, copil

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GASTRITIS AND HELICOBACTER PYLORI IN CHILDREN – PRIMARY AND SECONDARY ENDOSCOPIC DIAGNOSIS

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Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 3, An 2015
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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HIGHLIGHTS

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

GASTRITIS AND HELICOBACTER PYLORI IN CHILDREN – PRIMARY AND SECONDARY ENDOSCOPIC DIAGNOSIS

, , , , , , , , and

ABSTRACT

The infection with Helicobacter pylori (H pylori) represents an important issue of public health.
Aim. Establishing the prevalence of H. pylori infection in children and presenting the cases according to the gastritis type by performing upper digestive endoscopies.
Material and method. The retrospective study referred to a period of 5 years and included 1269 children evaluated by upper endoscopy to establish the H. pylori infection rate.
Results. The frequency of H. pylori in the case of acute gastritis was significantly more reduced (34.78%) than in the case of chronic gastritis (54.94%). Referring to the 10 types of gastritis, the most frequent ones are purpuric (43.66%), nodular purpuric (25.93%) and nodular antral (15.84%). At the other end, atrophic and hypertrophic gastritis were positioned. The most frequent associations pointed out endoscopically are those with 1st degree esophagitis - 51.6%, duodenitis – 45.07% and purpuric duodenitis – 24.74%.
Conclusions. The H. pylori infection is the most frequent etiologic factor for chronic gastritis (54.94%). The early identification of the infection is essential to destroy the bacteria and to prevent the development of various types of gastritis that are later on endoscopically identified.

Keywords: gastritis, H. pylori, upper endoscopy, child

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