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Smaranda Diaconescu

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Articole semnate de acelasi autor in Revista Romana de Pediatrie:

Eradication of Helicobacter Pylori infection in children: current matters and perspectives

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Revista Romana de PEDIATRIE | Volumul LX, Nr. 2, An 2011
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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Eradication of Helicobacter Pylori infection in children: current matters and perspectives

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ABSTRACT

The strategies used to treat Helicobacter pylori infection in children derives mostly from recommendations based on clear consents in adult patients. The triple therapy that associates proton pump inhibitors (PPI), clarithromycin and amoxicillin is used on a large extent all over the world; beside this, other associations came out based either on PPI or bismuth salts. Nowadays, new drugs were introduced in anti-bacterial schemes, alongside esomeprazole, pantoprazole or lansoprazole being azithromicine and fluoroquinolones (in older children). At the same time, second line therapies were suggested in order to treat relapse or bacterial reinfection and these are quadruple associations based on bismuth salts or regimens including fluoroquinolones; the introduction of sequential therapy in children also represents a promising alternative. Concerning prophylaxy, the oral or intramuscular vaccine (the latter being in an advance clinical trial), should be able to contribute in the future to decrease the incidence of H.pylori infection, gastritis, ulcer and gastric cancer.

Key words: H.pylori, quadruple schemes, fluoroquinolones, sequential therapy, vaccine

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ERADICAREA INFECTIEI CU HELICOBACTER PYLORI LA COPIL: ACTUALITATI SI PERSPECTIVE

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Revista Romana de PEDIATRIE | Volumul LX, Nr. 2, An 2011
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

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ERADICAREA INFECTIEI CU HELICOBACTER PYLORI LA COPIL: ACTUALITATI SI PERSPECTIVE

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REZUMAT

Strategiile utilizate în tratamentul infecţiei cu Helicobacter pylori la copii derivă în mare parte din schemele de tratament stabilite de consensuri clare la pacienţii adulţi. Tripla terapie ce asociază inhibitori de pompă protonică (IPP), claritromicina şi amoxicilina este utilizată pe scară largă în întreaga lume; alături de aceasta s-au impus şi alte asocieri bazate fie pe IPP, fie pe săruri de bismut. La ora actuală au fost introduse noi preparate în schemele antibacteriene, alături de esomeprazol, pantoprazol sau lansoprazol aflându-se azitromicina şi fluorochinolonele (la copiii mari). În acelasi timp au fost propuse terapii de linia a doua, rezervate cazurilor de recădere sau reinfecţie bacteriană, acestea fiind reprezentate de asocieri cvadruple bazate pe săruri de bismut sau de regimuri ce includ fluorochinolone; nu în ultimul rând, introducerea terapiei secvenţiale la copii reprezintă o alternativă promiţătoare. Pe plan profilactic, vaccinarea orală sau intramusculară, aceasta din urmă aflată în faze avansate de testare clinică, va putea contribui în viitor la scăderea incidenţei infecţiei cu H.pylori, a gastritei, ulcerului şi cancerului gastric.

Cuvinte cheie: H.pylori, scheme cvadruple, fluorochinolone, terapie secvenţială, vaccin

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Upper digestive tract manifestations inCRF patients on dialysis

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Revista Romana de PEDIATRIE | Volumul LXI, Nr. 2, An 2012
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

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Upper digestive tract manifestations inCRF patients on dialysis

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REZUMAT

Background: CRF patients are prone to a wide range of complications: gastroesophageal reflux disease, esophagitis, gastropathy, gastritis and duodenitis, gastric and duodenal ulcer, angiodysplasia.

Objectives: the study’s aim was to highlight the gastro-duodenal symptoms, the frequency of pathological modifi cations of eso-gastro-duodenal mucous membrane and the presence of H.pylori in CRF children receiving dialysis.

Material and methods: the study included 55 children admitted to the IVth Pediatric Nephrology Clinic of the Emergency Clinical Hospital “Sf Maria” Iasi, all receiving dialysis, to which was applied a systematized protocol: objective and subjective symptoms and the results of upper gastrointestinal endoscopy. The study included patients with mucosal changes detected endoscopically.

Conclusions: Pathological modifications of the upper digestive tract mucous membrane in children on chronic dialysis are inconstant, suggesting the need for endoscopy in each case. H.pylori was found in 24/55 (43.63%) biopsies and points out the relatively frequent association between gastro-duodenal lesions and H.pylori in chronic dialysis patient.

Key words: esophagitis, gastritis, H.pylori, dialysis

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MANIFESTARILE TUBULUI DIGESTIV SUPERIOR LA PACIENTUL CU IRC DIALIZAT

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Revista Romana de PEDIATRIE | Volumul LXI, Nr. 2, An 2012
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

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Promoting Global Health

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MANIFESTARILE TUBULUI DIGESTIV SUPERIOR LA PACIENTUL CU IRC DIALIZAT

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REZUMAT

Introducere: bolnavii cu IRC sunt susceptibili la o gamă largă de complicaţii: reflux gastro-esofagian, esofagită, gastropatie, gastrită şi duodenită, ulcer gastric şi duodenal, angiodisplazie. Obiective: studiul a constat în evidenţierea simptomelor gastro-duodenale, a frecvenţei modificărilor patologice ale mucoasei eso-gastro-duodenale şi a prezenţei H.pylori la copiii cu IRC aflaţi în program de dializă. Material şi metodă: lotul de studiu a fost format din 55 de copii internaţi în Clinica a IV-a Nefrologie, aflaţi în program de substituţie renală cronică, la care s-a aplicat un protocol ce a sistematizat: simptomele obiective şi subiective şi rezultatele endoscopiei digestive superioare. Lotul cuprinde bolnavii cu modificări ale mucoasei depistate endoscopic. Concluzii: modificările patologice ale mucoasei eso-gastro-duodenale la copilul dializat cronic se reflectă clinic inconstant, ceea ce sugerează necesitatea endoscopiei pentru fiecare caz. Prezenţa H.pylori la 24/55 (43,63%) cazuri biopsiate evidenţiază asocierea relativ frecventă între leziunile gastro-duodenale şi H.pylori la pacienţii dializaţi cronic.

Cuvinte cheie: esofagită, gastrită, H.pylori, dializǎ

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Digestive hemorrhage in pediatric pathology

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Revista Romana de PEDIATRIE | Volumul LXI, Nr. 3, An 2012
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

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Digestive hemorrhage in pediatric pathology

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ABSTRACT

Digestive hemorrhage in children can evolve from the occult form up to major manifestations with vital risk. The etiology comprises extra-digestive (acute pathology of the nervous system, coagulopathies, portal hypertension, etc.) or digestive (infectious, malformative, inflammatory etc.) diseases with a frequency which depends on the age. The medical history encumbered by multiple error possibilities is supplemented with a synthesized exploration, which approaches: the seriousness of the blood loss, its reflection on the function of the vital organs, depicting a medical cause or a preexisting (malformative) or acquired surgical cause. The treatment depends on the seriousness of the blood loss, on the necessary drugs with ethiopathogenetic impact. Besides its important role as diagnostic method, the digestive endoscopy sometimes represents a therapeutic method.

Key words: child, hemorrhage, digestive, endoscopy

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HEMORAGIA DIGESTIVA IN PATOLOGIA PEDIATRICA

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Revista Romana de PEDIATRIE | Volumul LXI, Nr. 3, An 2012
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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HEMORAGIA DIGESTIVA IN PATOLOGIA PEDIATRICA

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REZUMAT

Hemoragia digestivă la copil poate evolua de la forma ocultă până la manifestări majore cu risc vital. Etiologia cuprinde boli extradigestive (patologia acută a sistemului nervos, coagulopatii, hipertensiune portală etc.) sau digestive (infecţioase, malformative, inflamatorii etc.) cu o frecvenţă nuanţată de vârstă. Anamneza grevată de numeroase posibilităţi de eroare se completează cu o explorare sistematizată abordându-se: gravitatea pierderii de sânge, reflectarea acesteia asupra funcţiei organelor vitale, depistarea unei cauze medicale sau a unei cauze chirurgicale preexistente (malformativă) sau dobândite. Tratamentul este nuanţat de severitatea pierderii de sânge, de necesarul de medicamente cu impact etiopatogenetic. Endoscopia digestivă, pe lângă rolul ei important ca metodă de diagnostic, reprezintă uneori şi o metodă terapeutică.

Cuvinte cheie: copil, hemoragie, digestiv, endoscopie

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Psychosomatic approaches to digestive diseases in children

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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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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.

Psychosomatic approaches to digestive diseases in children

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ABSTRACT

Psychosomatic diseases refer to those medical affections whose appearance and/or evolution is significantly influenced by psychological factors. The main digestive disorders in which the psychosomatic factor is prevalent are: gastroduodenal affections, corrosive esophagitis, constipation, encopresis, emotional diarrhoea, irritable bowel syndrome, ulcerative rectocolitis and Crohn’s disease. The management is based on collaboration between the psychologist and the pediatric gastroenterologist. Supportive psychotherapy is necessary for completing medication. Child should receive emotional support and be helped to understand their feelings about the situation of the disease. The doctor must create a relationship based on trust, develop an attitude that shows empathy, honesty and openness towards children.

Key words: psychosomatic, gastroenterology, child

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ABORDAREA PSIHOSOMATICA A BOLILOR DIGESTIVE 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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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.

ABORDAREA PSIHOSOMATICA A BOLILOR DIGESTIVE LA COPIL

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REZUMAT

Bolile psihosomatice sunt acele afecţiuni medicale a căror apariţie şi/sau evoluţie este determinată, în mod semnificativ, de factori psihologici. Principalele tulburări digestive în care factorul psihosomatic este prevalent sunt: afecţiunile gastroduodenale, esofagitele corozive, constipaţia, encompresis, diareea emoţională, sindromul colonului iritabil, rectocolita ulceroasă şi boala Crohn. Conduita terapeutică se bazează pe strânsa colaborare dintre psiholog şi pediatrul gastroenterolog. Psihoterapia de susţinere este necesară pentru completarea medicaţiei. Copilul trebuie să primească suport emoţional şi ajutat să îşi înţeleagă sentimentele faţă de situaţia de boală traversată. Medicul trebuie să realizeze o relaţie de încredere, să dezvolte o atitudine empatică, onestă şi deschisă în relaţiile cu copiii.

Cuvinte cheie: psihosomatic, gastroenterologie, copil

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The Roviralta syndrome – case report

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Revista Romana de PEDIATRIE | Volumul LXII, Nr. 2, An 2013
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

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The Roviralta syndrome – case report

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ABSTRACT

The Roviralta syndrome represents the association of hypertrophic pyloric stenosis and hiatal hernia. The authors present the case of a 2 month old male child hospitalized at the 5th Pediatric Clinic of “St. Maria” Emergency Hospital for Children in Iasi with postprandial vomiting and progressing weight loss. The barium esogastroduodenal transit pointed out hiatal hernia, narrowed pyloric channel and inconstant gastroesophageal reflux. The ultrasound confirmed the hypertrophy of pyloric oliva, pH-metry and the gastroesophageal reflux. The medical treatment with antispastics, rehydration, protons and prokinetic pump inhibitors was successful and the child’s evolution was good.

Key words: Roviralta syndrome, hypertrophic pyloric stenosis, hiatal hernia

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SINDROMUL ROVIRALTA – PREZENTARE DE CAZ

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Revista Romana de PEDIATRIE | Volumul LXII, Nr. 2, An 2013
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.

SINDROMUL ROVIRALTA – PREZENTARE DE CAZ

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REZUMAT

Sindromul Roviralta reprezintă asocierea dintre stenoza hipertrofică de pilor şi hernia hiatală. Autorii prezintă cazul unui copil de sex masculin în vârstă de 2 luni internat în Clinica a V-a de Pediatrie a Spitalului de Urgenţă pentru Copii „Sfânta Maria“, Iaşi pentru vărsături postprandiale şi pierderea progresivă în greutate. Tranzitul esogastroduodenal baritat relevă hernie hiatală, canal piloric îngustat şi reflux gastroesofagian prezent inconstant. Ecografia a confirmat hipertofia olivei pilorice şi pH-metria, refluxul gastroesofagian. Tratamentul medical cu antispastice, rehidratarea, inhibitori de pompă de protoni şi prokinetice a avut succes, iar evoluţia a fost bună.

Cuvinte cheie: sindrom Roviralta, stenoză hipertrofică de pilor, hernie hiatală

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