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Paula Popovici

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Articole semnate de acelasi autor in Revista Romana de Pediatrie:

ATOPIA, FACTOR DE RISC IN APARITIA OTITEI SEROASE LA COPIL

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Revista Romana de PEDIATRIE | Volumul LXV, Nr. 2, An 2016
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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ATOPIA, FACTOR DE RISC IN APARITIA OTITEI SEROASE LA COPIL

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ABSTRACT

Otita medie seroasă cronică, cauză majoră a hipoacuziei în perioada copilăriei, este frecvent asociată cu sensibilizarea alergică. Prevalenţa în continuă creştere a atopiei la această vârstă implică o abordare multidisciplinară a copiilor cu adenoidite, otite recurente şi disfuncţii tubare, în vederea unui management patogenic complex.
Obiectivul studiului a constat în determinarea asocierii otitelor medii cu bolile alergice, şi implicaţiile acestei asocieri în tratamentul şi evoluţia pacienţilor.
Material şi metodă. S-a realizat un studiu retrospectiv care a inclus 92 de copii, cu vârste cuprinse între 6 luni şi 6 ani internaţi în Clinica II Pediatrie, Spitalul Clinic de Copii „Sf. Maria“, Iaşi, cu diagnosticul de otită medie, pe o perioadă de 1 an (ianuarie 2015 – ianuarie 2016).
Rezultate. Majoritatea cazurilor au fost otite supurate (61 de pacienţi), 31 de cazuri au fost otite seroase, dintre care 23 au fost recurente. Asocierea cu bolile alergice a fost mai frecventă la copiii cu otită seroasă (26/31 cazuri). 4 pacienţi cu otită supurată au prezentat reacţii adverse la antibiotice, cu implicaţii majore în evoluţia cazurilor. Asocierea cu refluxul gastroesofagian a fost relativ asemănătoare între cele 2 loturi (11/61 de cazuri şi respectiv 10/31 de cazuri), la 10 pacienţi atopici, obiectivându-se alergia la proteinele laptelui de vacă.
În concluzie, copiii cu otite medii, în special cei cu otite medii seroase recurente ar trebui investigaţi pentru determinarea coexistenţei atopiei şi a refluxului gastroesofagian, eventual cu dozarea markerilor de inflamaţie alergică sau a pepsinei în exsudatul otic, în vederea unui management terapeutic ţintit.

Keywords: otită seroasă, alergie, copii

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ATOPY, RISK FACTOR FOR OTITIS MEDIA WITH EFFUSION

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Revista Romana de PEDIATRIE | Volumul LXV, Nr. 2, An 2016
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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ATOPY, RISK FACTOR FOR OTITIS MEDIA WITH EFFUSION

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ABSTRACT

Chronic otitis, one of the major causes of pediatric hypoacusia is frequent associated with some allergic diseases. The continuous rice of atopic diseases prevalence in childhood, involves a multidisciplinary approach of Eustachian tube dysfunction, adenoid inflammation or recurrent otitis, for a complex pathogenic management.
The objective of this study was to determinate the association between otitis media and the allergic diseases with the implication in the treatment and evolution of this patients.
Methods. Retrospective study on 92 children, between 6 month and 6 years, admitted in II Pediatric Clinic, Clinical Hospital of Children “Sf. Maria” Iasi with diagnosis of acute otitis media, for a period of 1 year.
Results. Majority of cases (61patients) have been suppurate otitis, 31 cases have been otitis media with effusion out of which 23 have been recurrent. Association with allergic diseases has been more frequent in children with serous otitis media (26/31 cases). 4 cases with suppurate otitis media have developed adverse reaction to antibiotics with major implication in the cases evolution. Association with gastroesophageal reflux was relatively similar between cases with serous otitis and the suppurate ones (10/31 cases and 11/61 cases). From the atopic patients with gastroesophageal reflux, 10 presented cow’s milk protein allergy.
In conclusion, the children with otitis media, especially those with recurrent none suppurate form should be investigated for atopy and, eventually, for gastroesophageal reflux, possibly with determination of the allergic markers or of pepsin in the otic exudates, in order to a targeted therapeutic management.

Keywords: otitis, effusion, allergy, children

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OBEZITATEA SI DISLIPIDEMIILE LA COPILUL CU HEPATITA CRONICA

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Revista Romana de PEDIATRIE | Volumul LXV, Nr. 2, An 2016
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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OBEZITATEA SI DISLIPIDEMIILE LA COPILUL CU HEPATITA CRONICA

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REZUMAT

Asocierea hepatitelor cronice cu diverse tipuri de dislipidemii este o realitate nu numai pentru pacientul obez, la care ne aşteptăm să găsim hipercolesterolemii sau/şi hipertrigliceridemii, dar şi pentru copilul normoponderal. Cauzele acestei asocieri sunt multiple, însă trebuie să avem în vedere, în primul rând, predispoziţia familială şi transmiterea genetică a unor forme de dislipidemii. În acelaşi timp, unele dislipidemii sunt secundare hepatopatiilor cronice, astfel că se formează un cerc vicios în care tratamentul de primă intenţie a dezechilibrelor metabolice este de mare importanţă în succesul terapiei antivirale.

Cuvinte cheie: hepatită, dislipidemie, obezitate, copil

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OBESITY AND DYSLIPIDEMIA IN CHILDREN WITH CHRONIC HEPATITIS

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Revista Romana de PEDIATRIE | Volumul LXV, Nr. 2, An 2016
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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OBESITY AND DYSLIPIDEMIA IN CHILDREN WITH CHRONIC HEPATITIS

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ABSTRACT

Chronic hepatitis association with various types of dyslipidemia is a reality not only for the obese pediatric patient, in which we expect to find hypercholesterolemia and / or hypertriglyceridemias, but also for normal weight children with hepatitis. The causes of this association are multiple, but we need to consider first the innate predisposition and transmission of genetic forms of dyslipidemia. Meanwhile, some secondary dyslipidemia are chronic liver disease related. Those considerations are forming a vicious circle in which primary treatment of metabolic imbalances has a great importance for the success of antiviral therapy.

Keywords: hepatitis, dyslipidemia, obesity, children

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Ursodeoxycholic acid benefit in pediatric non-alcoholic fatty liver disease

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Revista Romana de PEDIATRIE | Volumul LXII, Nr. 1, An 2013
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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Ursodeoxycholic acid benefi t in pediatric non-alcoholic fatty liver disease

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REZUMAT

Introduction. Nonalcoholic fatty liver disease (NAFLD), the most common cause of chronic liver disease in children, encompasses a range of disease from simple steatosis to steatohepatitis (NASH). Ursodeoxycholic acid (UDCA) has been used in adult pacients with NASH, demonstrating its efficacy in high doses.

Purpose. The aim of our study was to assess the effect of high-dose ursodeoxycholic acid therapy on liver functions in children with NASH.

Methods. We prospectively studied 18 children with NASH aged 2.5 to 17 years. NASH was operationally defined as diffusely hyperechogenic liver at ultrasonography with persistently elevated (> 35 UI/l) alanine aminotransferase (ALT) or aspartate aminotransferaze (AST) after exclusion of viral, alcohol-induced, druginduced, cholestatic and genetic causes of liver disease. Patients were treated with ursodeoxycolic acid (20 mg/ kg per day) for six month.

Results. Treatment with UDCA significantly decreased hepatic transaminases. ALT levels ranged from 68.5 (50-166) at baseline vs. 47 (29-104) after six month, p <0.001, AST from 43 (29-101) 34 (17-75), p < 0.001, and GGT between 41.5 (11-150) vs. 22 (8-55). At the end of treatment, ALT levels normalized in 4 patients. Moreover, cholesterol levels were significantly reduced after treatment.

Conclusions. Treatment with high-dose ursodeoxycholic acid improves liver function parameters in children with NASH.

Cuvinte cheie: steatoză hepatică, acid ursodeoxicolic, transaminaze hepatice

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BENEFICIUL ACIDULUI URSODEOXICOLIC IN STEATOZA HEPATICA NON-ALCOOLICA LA COPIL

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Revista Romana de PEDIATRIE | Volumul LXII, Nr. 1, An 2013
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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BENEFICIUL ACIDULUI URSODEOXICOLIC IN STEATOZA HEPATICA NON-ALCOOLICA LA COPIL

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REZUMAT

Introducere. Boala ficatului gras non-alcoolic (NAFLD), cea mai frecventă cauză a bolii hepatice cronice la copii, cuprinde un spectru de afecţiuni variind de la steatoză simplă până la steatohepatită (NASH). Acidul ursodeoxicolic (UDCA) a fost utilizat la pacienţi adulţi cu NASH, demonstrându-şi eficacitatea în doze crescute.

Scop. De a evalua efectul tratamentului cu doze crescute de UDCA asupra parametrilor funcţiei hepatice la copii cu NASH.

Metode. Lotul de studiu a fost constituit din 18 copii cu NASH cu vârste cuprinse între 2,5 şi 17 ani. NASH a fost operaţional definit ca ficatul difuz hiperechogenic la ecografie cu valori persistent crescute (> 35 UI/l) ale alanin aminotransferazei (ALAT) sau aspartat aminotransferazei (AST), după excluderea cauzelor virale, drog sau alcool induse, colestatice sau genetice ale bolii hepatice. Pacienţii au fost trataţi cu acid ursodeoxicolic (20 mg/kg/zi), timp de şase luni.

Rezultate. Tratamentul cu UDCA a determinat scăderea semnificativă a valorilor transaminazelor hepatice. Nivelurile ALT au variat între 68,5 (50-166) iniţial vs 47 (29-104) după şase luni, p < 0,001, AST între 43 (29-101) vs 34 (17-75), p < 0,001, şi GGT între 41,5 (11-150) vs. 22 (8-55). La sfârşitul tratamentului, niveluri ALT s-au normalizat la 4 dintre pacienţi. De asemenea, concentraţiile de colesterol au fost semnificativ reduse după tratament.

Concluzii. Tratamentul cu doze crescute de acid ursodeoxicolic imbunătăţeşte parametrii funcţiei hepatice la copii cu NASH.

Cuvinte cheie: steatoză hepatică, acid ursodeoxicolic, transaminaze hepatice

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