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Biomedical subjects

Y Vandenplas

Publications and source records attributed to Y Vandenplas.

At least 73 records · Page 4Linked to original sources
PubMed1998

Management of ingested foreign bodies in childhood: our experience and review of the literature.

The management of foreign bodies in the gastrointestinal tract is not standardized. Retrospectively, we analysed the management of 174 cases of accidental ingestion of foreign bodies in children. No child had ingested more than one foreign object. The ingested foreign bodies were: coins, toy parts, jewels, batteries, 'sharp' materials such as needles and pins, fish and chicken bone, and 'large' amounts of food. Of the patients 51% had transient symptoms at the moment of ingestion, such as retrosternal pain, cyanosis and dysphasia. Attempts to extract the foreign body either by a magnet tube, endoscopy or McGill forceps was performed in 83 patients. The majority of the extracted foreign bodies were batteries and sharp materials. The outcome of all the patients was excellent. No complications were observed.

Adolescent↗
PubMed1997

The relation between gastro-oesophageal reflux, sleeping-position and sudden infant death and its impact on positional therapy.

UNLABELLED: Many infants do regurgitate. The recommended therapeutic approach starts with postural and dietary measures, followed by antacids and prokinetics. However, the recent findings regarding the increased risk for sudden infant death (SID) in the prone sleeping position challenge the current recommendations. Management of regurgitation should in the first place aim at reducing parental anxiety. Postural treatment favouring the prone-elevated (30 degrees) position is no longer recommended as a first line treatment of regurgitation, despite its efficacy, because of the unexplained association of SID with the flat prone sleeping position. Favouring the prone elevated position would result in an increased parental anxiousness. CONCLUSION: Positional treatment can only be recommended in children beyond the age of SID risk, or as an adjuvant therapy in cases resistant to reassurance, thickeners and prokinetics and in whom other diagnostic possibilities (infection, etc.) are considered rejected.

Gastroesophageal Reflux↗
PubMed1997

A critical appraisal of current management practices for infant regurgitation--recommendations of a working party.

Regurgitation is a common manifestation in infants below the age of 1 year and a frequent reason of counselling of general practitioners and paediatricians. Current management starts with postural and dietary measures, followed by antacids and prokinetics. Recent issues such as an increased risk of sudden infant death in the prone sleeping position and persistent occult gastro-oesophageal reflux in a subset of infants receiving milk thickeners or thickened "anti-regurgitation formula" challenge the established approach. Therefore, the clinical practices for management of infant regurgitation have been critically evaluated with respect to their efficacy, safety and practical implications. The updated recommendations reached by the working party on the management of infant regurgitation contain five phases: (1 A) parental reassurance; (1 B) milk-thickening agents; (2) prokinetics; (3) positional therapy as an adjuvant therapy; (4 A) H2-blockers; (4 B) proton pump inhibitors; (5) surgery.

Antacids↗
PubMed1997

Role of hydrolyzed formulas in nutritional allergy prevention in infants.

BACKGROUND: In recent years, more and more discussions have arisen with regard to the role of (partially) hydrolyzed formulas as standard feedings for infants with a high risk to have allergy. METHODS: This review is based on an extensive overview of the literature dealing with the subjects of allergy prevention and hydrolyzed formulas. RESULTS: Although breast-feeding should receive absolute priority in the nutrition of infants, the existence of artificial milk formulas as an addition to or replacement of breast milk is a necessity. In high-risk infants with a family history of allergy, we might consider a hypoallergenic formula instead of the classical start formulas to reduce the risk of allergy. From a nutritional point of view, these formulas should only be hydrolyzed as much as necessary. On the other hand, for the treatment of food allergies, the peptides of the semi-elementary infant formulas should be as short as possible. This can, however, have an impact on the nutritional value of the formula. Therefore, a difference is made between partial and complete hydrolysates. CONCLUSION: While a firm recommendation is not yet possible, physicians might consider partial hydrolysate formulas in high-risk infants if parents can afford the higher-cost option.

Dietary Proteins↗
PubMed1997

Myths and facts about breastfeeding: does it prevent later atopic disease?

Exclusive human milk feeding during the first 6 months of life, with delayed introduction of solids, is the recommended feeding for human infants. Human milk reduces the incidence and morbidity related to infection and allergy to cow's milk proteins. Dietary maternal restrictions during (late) pregnancy or lactation cannot be recommended, but may be advised in special cases. A maternal elimination diet seems more effective if associated with environmental hypoallergenic intervention(s). Milk from mothers consuming cow's milk proteins contains small amounts of beta-lactoglobulin, which appear to introduce in the majority of infants both atopic and non-atopic tolerance rather than sensitization. However, it is uncertain whether breastfeeding also reduces the incidence of later atopic disease, since its aetiology is multifactorial.

Animals↗
PubMed1996

Peroxisome proliferation associated with fibrinogen storage in the liver.

We report a patient with fibrinogen storage disease in which there was proliferation of normal-sized peroxisomes in the hepatocytes. this phenomenon has previously been described in several acquired liver diseases. We believe that this is an adaptation response due to decreased microsomal isoenzyme activity as a result of the excess accumulation of fibrinogen in the endoplasmic reticulum.

Child↗
PubMed1996

The prevalence of Helicobacter pylori positivity in asymptomatic children of different ethnic backgrounds living in the same country.

OBJECTIVE: To measure the prevalence of Helicobacter pylori seropositivity in a population of apparently healthy children of different ethnic backgrounds, matched for age and socioeconomic background, who were born and continue to reside in the same country. DESIGN: The presence of Helicobacter pylori specific IgG antibodies was determined during pre-surgery blood analysis in 883 symptom-free children, aged from 1 months to 17 years, who belong to different ethnic populations and were admitted for elective minor surgery. The different groups were matched for age and socioeconomic background. RESULTS: Seventy-two children (8.2%) had a positive titer for Helicobacter pylori. We observed a significant difference in the prevalence of Helicobacter pylori positivity between symptom-free Caucasian and non-Caucasian children (p < 0.001). However, no difference could be observed between the non-Caucasian groups (p > 0.8). CONCLUSION: We conclude that significant differences exist in the prevalence of Helicobacter pylori infection between asymptomatic children of different ethnic backgrounds, despite the fact that all investigated subjects were born in Belgium and have been living in this country ever since. Whether this difference is caused by an unknown environmental factor or an, until now, unrecognized genetic predisposition still needs to be evaluated.

Adolescent↗
PubMed1996

Current concepts and issues in the management of regurgitation of infants: a reappraisal. Management guidelines from a working party.

Regurgitation in infants is a common problem. Recent issues, such as the increased risk of sudden infant death in the prone sleeping position, the finding of persisting occult gastro-oesophageal reflux with feed thickeners, and the increasing awareness of the cost-benefit ratio of medications may challenge the currently recommended management approach. A round table was organized to elaborate on the impact of (i) the pro supine sleeping campaigns in relation to sudden infant death and (ii) advancement in medical treatment on therapeutic strategies in regurgitating infants. The participants were opinion leaders from Europe and North America (Belgium, Canada, France, UK, Italy, Switzerland and The Netherlands). The importance of parental reassurance is stressed. As a consequence of the supine sleeping campaigns aiming to decrease the incidence of sudden infant death syndrome, the "prone elevated sleeping position" is no longer advised as a first-line therapeutic approach, although it is still recommended in "complicated reflux". It is emphasized that milk thickeners are an adequate therapeutic tool for regurgitation, but not in reflux disease. According to the literature, the efficacy of (alginate )antacids, although very popular in some countries, is questionable. These recommendations will be of interest to first-line paediatricians, since about 40% of their patients, according to the literature, present because of regurgitation.

Anti-Ulcer Agents↗
PubMed1996

Symptomatology of Helicobacter pylori infection in children.

In a retrospective evaluation we reviewed the symptomatology of 143 children (age 2-15 years, mean 8.9 years) who were referred to us for upper gastrointestinal endoscopy because of recurrent abdominal pain with a duration of 6 weeks or longer. Helicobacter pylori infection was diagnosed in 36 out of 143 patients (25.2%). No statistically significant differences could be detected between the symptoms experienced by the 36 H. pylori-infected children and those experienced by the remaining 107 H. pylori-negative pediatric patients (p = 0.18-0.60). We conclude that no specific symptoms are associated with H. pylori gastritis in children. Our observations suggest that the recurrent abdominal complaints found in children with H. pylori infection seem to be caused by the secondary gastroduodenal pathology, rather than by H. pylori infection itself.

Abdominal Pain↗
PubMed1996

Isolation of Campylobacter concisus from feces of children with and without diarrhea.

A prospective study compared fecal isolation rates of Campylobacter concisus for children with diarrhea and without diarrhea by a filter technique in which media were incubated for 4 days in a microaerobic atmosphere. No statistically significant difference in isolation rates was found (13.2% in patients with diarrhea and 9% in controls). Moreover, 35 of 37 children attending the same day care center harbored different C. concisus strains, as was demonstrated by arbitrary primer PCR DNA fingerprinting. These data suggest a lack of a pathogenic role for C. concisus in enteritis.

Campylobacter↗
PubMed1996

[Food allergy].

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Child, Preschool↗