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At least 991 records · Page 55Linked to original sources
PubMed2005

Is erectile dysfunction really a clinically useful predictor of cardiovascular disease?

OBJECTIVE: To evaluate the possible connection between erectile dysfunction (ED) and cardiovascular disease (CVD) in one of its more severe forms, namely myocardial infarction (MI). MATERIAL AND METHODS: The incidence of ED in men hospitalized due to MI (n=100) was compared with that reported in a questionnaire sent to an age-matched control population (n=129). RESULTS: The incidence of ED before MI (34%) was similar to that in the control population (30%). After MI, 53% reported ED. Smoking was much more common among the men with MI (82%) than among the controls (45%). Smoking was, however, only slightly more common among controls with (50%) than without (40%) ED. None of the men in the study group had consulted a physician due to ED before the MI and only 10/53 (19%) with ED after the MI had consulted a physician for this reason. Among the controls without a history of CVD, 18% reported ED, compared to 34% of the men before the MI but without clinical evidence of CVD and/or diabetes (p=NS). CONCLUSIONS: The well-known association between CVD and ED was confirmed. However, the lack of a sharp rise in the prevalence of ED prior to MI does not support the idea that ED is a clinically useful predictor of MI.

Cardiovascular Diseases↗
PubMed2006

Medical comorbidity in women and men with schizophrenia: a population-based controlled study.

BACKGROUND: Persons with persistent mental illness are at risk for failure to receive medical services. In order to deliver appropriate preventive and primary care for this population, it is important to determine which chronic medical conditions are most common. OBJECTIVE: We examined chronic medical comorbidity in persons with schizophrenia using validated methodologies. DESIGN: Retrospective analysis of longitudinal administrative claims data from Wellmark Blue Cross/Blue Shield of Iowa. PARTICIPANTS: Subjects with schizophrenia or schizoaffective disorder (N=1,074), and controls (N=726,262) who filed at least 1 claim for medical services, 1996 to 2001. MEASUREMENTS: Case subjects had schizophrenia as the most clinically predominant psychotic disorder, based on psychiatric hospitalization, psychiatrist diagnoses, and outpatient care. Controls had no claims for any psychiatric comorbidity. Using a modified version of the Elixhauser Comorbidity Index, inpatient and outpatient claims were used to determine the prevalence of 46 common medical conditions. Odds ratios (ORs) were adjusted for age, gender, residence, and nonmental health care utilization using logistic regression. RESULTS: Subjects with schizophrenia were significantly more likely to have 1 or more chronic conditions compared with controls. Adjusted OR (95% confidence interval [CI]) were 2.62 (2.09 to 3.28) for hypothyroidism, 1.88 (1.51 to 2.32) for chronic obstructive pulmonary disease, 2.11 (1.36 to 3.28) for diabetes with complications, 7.54 (3.55 to 15.99) for hepatitis C, 4.21 (3.25 to 5.44) for fluid/electrolyte disorders, and 2.77 (2.23 to 3.44) for nicotine abuse/dependence. CONCLUSIONS: Schizophrenia is associated with substantial chronic medical burden. Familiarity with conditions affecting persons with schizophrenia may assist programs aimed at providing medical care for the mentally ill.

Adult↗
PubMed2005

Search for disease-specific cardiovascular reactivity patterns: developing the methodology.

Aberrations of CVR (cardiovascular reactivity), an expression of autonomic function, lack specificity for a particular disorder. Recently, a CVR pattern particular to chronic fatigue syndrome has been observed. In the present study, we aimed to develop methodologies for assessing disease-specific CVR patterns. As a prototype, a population of 50 consecutive patients with FMF (familial Mediterranean fever) was studied and compared with control populations. A 10 min supine/30 min head-up tilt test with recording of the heart rate and blood pressure or the pulse transit time was performed. Five studies were conducted applying different methods. In each study, statistical analysis identified independent predictors of CVR in FMF. Based on regression coefficients of these predictors, a linear DS (discriminant score) was computed for every subject. Each study established an equation to assess CVR, calculate DS for FMF and determine the sensitivity and specificity of the DS cut-off. In each of the five studies, abnormal CVR was observed in FMF patients. The best accuracy (88% sensitivity and 90.1% specificity for FMF) was obtained by a method based on beat-to-beat heart rate and pulse transit time recordings. Data was processed by fractal and recurrence quantitative analysis with recordings in FMF patients compared with a mixed control population. Identification of disease-specific CVR patterns was possible with the methodologies described in the present study. In FMF, disease-specific CVR may be explained by the interplay between neuroendocrine loops specific to FMF with cardiovascular homoeostatic mechanisms. Recognition of disease-specific CVR patterns may advance the understanding of homoeostatic mechanisms and have implications in clinical practice.

Adult↗
PubMed1985

A histopathologic evaluation of nevocellular nevi in pregnancy.

A detailed histopathologic study was performed on 128 nevi removed from 86 pregnant white patients. None of the patients had clinical evidence of the dysplastic nevus syndrome, and none of the excised nevi were clinically suspicious for melanoma. One third of patients reported some change in nevi during pregnancy. Nevi from an age-matched male control population (50 patients) had a spectrum of histologic features essentially identical to the pregnant patients, while nevi from a female control population (51 patients) showed slightly less atypia according to our criteria. The differences found between the nevi from pregnant and control women suggest that a mild degree of histopathologic atypia or "activation" is associated with pregnancy. However, in the population studied, these changes were never of sufficient degree to result in diagnostic confusion.

Adult↗
PubMed1992

Radium-226 levels and concentration ratios between water, vegetation, and tissues of ruffed grouse (Bonasa umbellus) from a watershed with uranium tailings near Elliot Lake, Canada.

Radionuclide levels measured in bone, muscle, kidney and liver tissues, gut contents and diet items of 47 grouse from the Serpent River drainage basin, containing uranium (U) tailings at Elliot Lake, and from control areas in Ontario, showed variation by site and tissue. The mean level of 226radium (Ra) in bones of grouse sampled from Elliot Lake (28.5 mBq g(-1)) was higher than that in bones of birds from a distant control site near Sudbury, Ontario (8.0 mBq g(-1)) but similar to the value in a local control population (28.1 mBq g(-1)). Birds from Mid- and Low-Serpent River basin populations (with 17.1 and 17.7 mBw g(-1), respectively) did not differ from local or distant control populations; muscle, liver and kidney had lower 226Ra concentrations, which did not differ significantly among populations. Levels of 226Ra in the crop contents and intestine did not differ significantly by site and were similar to those of food items consumed by the birds. Stomach content values were higher in birds sampled in Elliot Lake and at the local control site than in those taken at the distant control site; birds sampled downstream from Elliot Lake did not differ from distant controls in this regard. Levels of 232thorium (Th) and 230Th were below detection limits (0.1 microg g(-1) and 5.0 mBq g(-1), respectively) in bone, muscle and liver tissue in two grouse with elevated levels of 226Ra. Other radionuclides were measurable in some tissues: 238U in bone at 0.4 microg g(-1), in muscle to 0.2 microg g(-1), in liver to 1.0 gmg g(-1.), 228Th was found only in muscle (8.0 mBq g(-1)), 210poloniuim (Po) was found in bone, muscle and liver (maxima: 24.0, 7.0, 16.0 mBq g(-1)) with the exception of one muscle sample; 210lead (Pb) was detected in only one liver sample (50.0 mBq g(-1)). Environmental levels fell within ranges previously reported at the sites, or at similar locations elsewhere. Leaves of trembling and largetooth aspen growing in the basin had mean 226Ra levels of 14.8 and 52.7 mBq g(-1) (dry weight) respectively, and fungal material carried up to 215.4 mBq g(-1) (air-dried), with some variation by site. River and lake waters sampled near the U tailings had 118.1 mBq litre(-1) of dissolved 226Ra; at the distant control site the value was 12.1 mBq litre(-1). The concentration ratios (CR) between bone of grouse collected at the Elliot Lake sites and trembling and largetooth aspen leaves were 1.38 and 1.09 (fresh weight basis); from other diet items and to other tissues the values were less than unity. Bone tissue: water ratios, based on dissolved 226Ra levels, ranged to 30.89. People eating grouse from the study area are unlikely to consume radionuclides in excess of limits currently established by Canadian regulatory authorities.

Journal Article↗
PubMed1993

Feeding and mating deterrency by sulfhydryl reagents in Triatoma infestans.

Topical application of different sulfhydryl (SH) reagents in acetone solution resulted in a deterrence of the feeding activity of Triatoma infestans nymph V. The ED50 for topical application of N-ethylmaleimide (NEM), the more active compound assayed, was 8.9 micrograms/insect. This effect showed a dose-dependent reversibility. We also observed feeding deterrency when a gauze cloth impregnated with NEM was located between the food source and the nymphs. After topical NEM treatment, mating deterrency was assessed by counting spermatophores dropped and eggs laid. When a population of adult insects, nymphal stages and eggs was reared in a cage containing filter papers treated with 0.4 mg/cm2 of NEM, a significant decrease of population density was seen after 200 days of exposure. Weekly replacement of filter papers impregnated with 0.13 mg/cm2 NEM for a period of one year enabled population control to be maintained. Antifeeding and antimating effects of NEM in Triatoma infestans and the resulting population control could be attributed to a chemoreceptor blockage produced by SH reagents.

Animals↗
PubMed2001

p53 codon 72 polymorphism and human papillomavirus associated skin cancer.

BACKGROUND/AIMS: Non-melanoma skin cancers frequently harbour multiple human papillomavirus (HPV) types. A recent report suggests that a polymorphism of the p53 tumour suppressor gene that results in the substitution of a proline residue with an arginine residue at position 72 of the p53 protein might act as a risk factor in HPV associated malignancies. This study aimed to determine the following: (1) the relation between HPV infection and the development of cutaneous squamous cell carcinoma (SCC), and (2) whether there is a correlation between p53 codon 72 polymorphism and the development of SCC. METHODS: Blood samples were taken from 55 patients with skin cancer (both renal transplant recipients and immunocompetent patients with skin cancer) and 115 ethnically matched volunteers. A polymerase chain reaction based assay was used to determine p53 codon 72 genotypes. In addition, 49 benign and malignant lesions from 34 of the patients with skin cancer and 20 normal human skin samples from 20 of the control volunteers were examined for HPV. RESULTS: The proportions of p53 codon 72 genotypes found were 78% arginine homozygous, 2% proline homozygous, and 20% heterozygous among patients with skin cancer and 79% arginine homozygous, 3.5% proline homozygous, and 17.5% heterozygous among the control population. Statistical analysis showed no significant differences in the distribution of the two p53 isoforms between the patients with skin cancer and the control population. The predominant viral types detected in both the patients and the control group were EV associated HPVs, although the incidence was lower in normal skin samples than in malignant lesions or viral warts. CONCLUSIONS: These results suggest that in a Celtic population there is no correlation between the presence of HPV, the p53 codon 72 arginine polymorphism, and the development of skin cancer.

Carcinoma, Squamous Cell↗
PubMed2006

Inverse association between severe nausea and vomiting in pregnancy and some congenital abnormalities.

The objective of the study was to investigate the possible association between nausea and vomiting in early pregnancy and congenital abnormalities. The prevalence of medically-recorded severe nausea and vomiting in early pregnancy in cases with congenital abnormalities and their available matched population controls without any defect was compared in the population-based large data set of the Hungarian Case-Control Surveillance System of congenital abnormalities, 1980-1996. Of 22,843 cases with as 25 different congenital abnormality groups, 1,713 (7.5%) cases had mothers with medically recorded and treated severe nausea and vomiting during pregnancy. Of 38,151 matched population controls, 3,777 (9.9%) had mothers with severe nausea and vomiting (adjusted prevalence odds ratio (POR) with 95% CI: 0.74, 0.68-0.79). Five congenital abnormality groups: cleft lip with or without cleft palate (0.50, 0.37-0.70), posterior cleft palate (0.53, 0.32-0.89), renal a/dysgenesis (0.23, 0.06-0.96), obstructive defects of urinary tract (0.32, 0.18-0.58), and cardiovascular malformations (0.68, 0.57-0.81) had mothers with a lower prevalence of severe nausea and vomiting in pregnancy (adjusted PORs with 95% CI included in parentheses). Of 25 congenital abnormality groups, 22 had POR lower than 1. Thus in this study the mothers of cases with congenital abnormalities were 26% less likely to have had severe nausea and vomiting in early pregnancy than the mothers of population controls without congenital abnormalities.

Adult↗
PubMed2006

Systemizing empathy: teaching adults with Asperger syndrome or high-functioning autism to recognize complex emotions using interactive multimedia.

This study evaluated Mind Reading, an interactive systematic guide to emotions, for its effectiveness in teaching adults with Asperger syndrome (AS) and high-functioning autism (HFA) to recognize complex emotions in faces and voices. Experiment 1 tested a group of adults diagnosed with AS/HFA (n = 19) who used the software at home for 10-15 weeks. Participants were tested on recognition of faces and voices at three different levels of generalization. A matched control group of adults with AS/HFA (n = 22) were assessed without any intervention. In addition, a third group of general population controls (n = 24) was tested. Experiment 2 repeated the design of Experiment 1 with a group of adults with AS/HFA who used the software at home and met in a group with a tutor on a weekly basis. They were matched to a control group of adults with AS/HFA attending social skills training and to a general population control group (n = 13 for all three groups). In both experiments the intervention group improved significantly more than the control group on close, but not distant, generalization tasks. Verbal IQ had significant effects in Experiment 2. Using Mind Reading for a relatively short period of time allows users to learn to recognize a variety of complex emotions and mental states. However, additional methods are required to enhance generalization.

Adolescent↗
PubMed1996

Marital status and births after losing a baby from sudden infant death.

UNLABELLED: To describe the change in marital status and subsequent live births of mothers who have lost a baby from sudden infant death (SID or cot death), a postal questionnaire was sent to European mothers who had been interviewed approximately 3.7 years (range 2.2-5.2 years) previously as part of a nationwide case-control study. Mothers of 105 (60.3%) cases and 828 (76.9%) controls replied. Changes in marital status between the time of interview and the time of the postal questionnaire did not differ between mothers of cases and that of controls when adjusted for marital status at the time of death/nominated date for controls. Cases were more likely to have further children than controls (P < 0.001) and had them sooner after the death than after the nominated date for control babies (P < 0.001). Case mothers were more likely than controls to have a second child after the death/nominated date, however the interval between the first and second child after the death/nominated date was the same as that for controls. CONCLUSIONS: Although the death of an infant is a major stress on marital relationships, at approximately 3.7 years marital breakdown is no higher than in the control population. After the death of her baby the mother "replaces" the child by having more children than control mothers and having the first one earlier than control mothers. Mothers who lose a baby from SID are more fertile than the control population both before and after the death.

Adult↗
PubMed2006

HFE gene mutations are associated with osteoarthritis in the index or middle finger metacarpophalangeal joints.

OBJECTIVE: . To test the hypothesis that possession of either C282Y or H63D mutations in the HFE gene is associated with primary osteoarthritis (OA) in joints commonly affected in hemochromatotic arthropathy. METHODS: HFE genotyping was performed in 87 patients with radiologically proven OA in 3 joint regions: index or middle finger metacarpophalangeal joints (MCP2,3; n = 52), elbow joints (n = 8), ankle, intertarsal or tarsometatarsal joints (ankle/IT/TMT; n = 27); and in 56 patients with radiologically proven OA in finger interphalangeal (IP) joints, but not MCP2,3 joints (IP OA control group). HFE mutation frequencies in these groups were also compared to those in a similar population (Busselton population control group). RESULTS: A statistically significant association between HFE mutations and OA was observed for the MCP2,3 joints (p = 0.0001) and the ankle/IT/TMT joint group (p = 0.002) as well as for the 3 joint regions collectively (p = 0.0001), but not for the elbow joints (p = 0.062). Comparison with the Busselton population controls showed similar statistically significant associations, except for the elbow and ankle/IT/TMT groups, where similar trends were observed. CONCLUSION: HFE gene mutations are associated with OA in the MCP2,3 joints. These mutations may be markers for a polyarticular OA phenotype.

Adult↗
PubMed2004

Examination of Hardy-Weinberg equilibrium in papers of Kidney International: an underused tool.

BACKGROUND: Population-genetic studies investigating genetic polymorphisms of Mendelian inheritance should always test whether the measured genotype frequencies deviate from the expected one. For this purpose Hardy-Weinberg (HW) criteria are generally used. If genotype distribution of control population misses HW equilibrium, the results should be treated cautiously because the observed genotype distribution in control population does not represent genotype distribution in the overall population. If HW criteria are not fulfilled in the investigated population, this may be further evidence for the correlation between genotype and investigated condition. METHODS: Between September, 1998, and September, 2003, we tested papers published in Kidney International if HW criteria were ordinarily and correctly checked in studies investigating genetic polymorphisms. Seventy-five genotype distributions of the selected 39 articles were reanalyzed. RESULTS: HW calculation was reportedly performed in 25 papers (64%). The observed genotype distribution deviated significantly from the expected one in three control, and in 16 patient populations and in three populations of association studies of 15 papers overall; however, this fact was not mentioned in 12 papers. CONCLUSION: Although the deviation of genotype distribution from the expected one is important information, HW calculations are not performed routinely for each investigated subject groups in these papers investigating genetic polymorphisms.

Alleles↗
PubMed2003

[Serological characteristics of a hepatitis E outbreak].

OBJECTIVE: To look into the serological characteristics of a hepatitis E outbreak. METHODS: Sera from the first five patients with acute icteric hepatitis who developed the disease successively within ten days and the 1,675 employees routinely having their lunch in a dining hall of a department (outbreak population) were examined for anti.HEV IgM and IgG at 26th days after the outbreak, and the 883 employees of a neighboring department not having their lunch in the hall were selected as control (control population). RESULTS: The five patients were all positive for anti-HEV IgM and IgG. The positive rates of anti-HEV IgM and IgG in outbreak population were 8.7% and 38.4% respectively, both significantly higher than those in control population which were only 0.1% and 28.6%. The numbers with abnormal ALT in the 145 individuals with anti-HEV IgM(+) of outbreak population were significantly higher than those in the IgM(-) individuals of the same group as well as in control, while the abnormal ALT ratio in the IgM(-) individuals of the outbreak was not higher than that in control. The results from the four patients' serial sera showed that the anti-HEV IgM titers declined gradually and were undetectable at about 4th month after infection, and the IgG titers increased to peak in about 2-3 months after infection, then declined very slowly. The mean IgG titer of the anti-HEV IgM(+) individuals was significantly higher than that of the IgM(-) but IgG(+) individuals in outbreak population, and the latter was significantly higher than the IgG(+) individuals in control, which suggested that the post-infection individuals' immunities to HEV were boosted during the outbreak. There was no difference between sex or age groups for the anti-HEV IgM(+) ratio, but the abnormal ALT was much more frequent in the anti-HEV IgM(+) male than in the female, and no difference was observed between age groups. CONCLUSION: The pathogen of the outbreak of acute icteric hepatitis was hepatitis E virus and associated with food intake. Anti-HEV IgM and IgG were used not only for diagnosis of hepatitis E but also for surveilance in mass population. The attack risk was not associated with age or sex, but the abnormal ALT was much more frequent fresh infectors in male.

Adult↗
PubMedDate not supplied

Cost-effectiveness of emergency intraarterial intracerebral thrombolysis: a pilot study.

PURPOSE: To assess the clinical efficacy and cost-effectiveness of emergency thrombolysis as a treatment strategy for thromboembolic intracerebral events. METHODS: Thirty-four patients with symptoms suggestive of middle cerebral artery occlusion were included. Eight of these patients were treated with intraarterial urokinase. Effectiveness was determined by comparing the admission National Institutes of Health stroke score to the 24-hour National Institutes of Health stroke score. The cost and length of stay of both populations were derived and used as measures of direct cost. The likelihood of admission to extended care facilities and estimated length cost of admission was used as a measure of indirect cost. RESULTS: The control population became slightly worse, with a change in National Institutes of Health score of -0.5, whereas the treated population improved slightly, with a change in National Institutes of Health score of +5.12. Analysis of the direct costs data between the two populations revealed a slight increased mean for the treated population ($15,202) as compared with the control population ($13,478). The unpaired t test, however, revealed no significant cost difference between the two groups. By reducing the number of completed strokes by one third or by decreasing the severity by the same factor (as shown in our study), the likelihood of admission to an extended nursing facility also is decreased. The cost saving per patient from extended care facilities is approximately $3435. CONCLUSION: The emergency application of intraarterial thrombolysis with urokinase results in a statistically significant positive change in National Institutes of Health score by at least five points. A statistically significant benefit is realized through the use of intraarterial urokinase. A statistically insignificant additional cost is shown by this study. This insignificant cost is more than offset by the saved nursing home costs.

Adult↗
PubMed1998

Neuropsychological performance in low birth weight preschoolers: a population-based, controlled study.

UNLABELLED: The aim was to evaluate neuropsychological performance and its pre-, and perinatal predictors in low birth weight (LBW) preschool children. A population-based sample of 137 5-year-old children with birth weights less than 2000 g and without major handicaps was compared with a random sample of 152 normal birth weight term controls. Main assessment tools were all subscales from the Wechsler Preschool and Primary Scale of Intelligence Revised, subscales from the Illinois Test of Psycholinguistic Abilities and tests of manual dexterity and figure copying. The LBW children showed significantly lower mean scores compared to controls on tests of visuo-spatial and visuo-motor abilities, but were comparable to controls in other areas, confounding parental factors were controlled for. 14 of the LBW children, there were signs of maternal chorio-amnionitis. Twelve of these had premature rupture of membranes lasting more than 24 h. These 14 children had a mean performance IQ of 87 (SD 5) compared to 100 (SD 15) for the LBW children without maternal signs of chorio-amnionitis (P = 0.001). Having a small head circumference at birth was a less powerful, but statistically significant predictor of impaired performance. CONCLUSION: Low birth weight is associated with impaired performance on visuo-spatial and visuo-motor tasks. Signs of maternal chorio-amnionitis and a small head circumference at birth may be risk factors for such impairment.

Case-Control Studies↗
PubMed2006

Impact of functional results on quality of life after rectal cancer surgery.

PURPOSE: Quality of life is an important outcome measure that has to be considered when deciding treatment strategy for rectal cancer. The aim of this study was to find out the impact of surgery-related adverse effects on quality of life. METHODS: The RAND-36 questionnaire and questionnaires assessing urinary, sexual, and bowel dysfunction were administered to 94 patients with no sign of recurrence a minimum of one year after curative surgery. Results were compared with age-matched and gender-matched general population. RESULTS: Eighty-two (87 percent) patients answered the questionnaires. Major bowel dysfunction was as common after high anterior resection as after low anterior resection. Urinary complaints occurred as often after anterior resection as after abdominoperineal resection, but sexual dysfunction was more common after abdominoperineal resection. Overall, the patients reported better general health perception but poorer social functioning than population controls. In particular, elderly patients reported a significantly better quality of life in many dimensions than their population controls. There was no significant difference in quality of life between treatment groups. Major bowel dysfunction after anterior resection impaired social functioning compared with that of patients without such symptoms. Urinary dysfunction impaired social functioning and impotence impaired physical and social functioning. CONCLUSIONS: Quality of life after rectal cancer surgery is not worse than that of the general population. The major adverse impact of bowel and urogenital dysfunction is on social functioning. These adverse effects need to be discussed with the patient and preoperative function needs to be taken into account when choosing between treatment options. Permanent colostomy is not always the factor that disrupts a person's quality of life most.

Adult↗
PubMed2001

Association between endometriosis and N-acetyl transferase 2 polymorphisms in a UK population.

The relationship between endometriosis and polymorphisms in the N-acetyl transferase 2 (NAT 2) gene was investigated in a UK population, as this gene has been previously implicated in the aetiology of the disease. Point mutations in the gene result in the variant alleles NAT 2 *5, *6 and *7 from the wild-type NAT 2 *4 allele. Homozygotes for the NAT 2 *4 wild type allele are fast NAT acetylators, while heterozygotes with one wild-type allele and a variant NAT 2 *5, *6 or *7 allele have reduced enzyme activity, and individuals with two variant alleles are slow acetylators. The NAT 2 *4/*6 genotype was significantly more common among affected women (35.2%) than population controls (8.1%; P = 0.0001) or unaffected women (4.2%; P = 0.02). Significantly more affected women (57.4%) were fast acetylators than were population controls (32.3%; P < 0.01) or unaffected women (33.3%; P < 0.05). These data suggest that altered NAT 2 enzyme activity may be a predisposition factor in endometriosis, or that NAT 2 alleles may be in linkage disequilibrium with a susceptibility allele in the same chromosomal region.

Adult↗
PubMed1999

Allergic esophagitis in children: a clinicopathological entity.

Infiltration of esophageal epithelium by eosinophils is seen in reflux esophagitis and allergic gastroenteritis. This study was performed to identify differences between patients with acid reflux esophagitis and those with non-acid reflux, possibly allergic, esophagitis. Intraepithelial eosinophils were demonstrated in posttherapy esophageal biopsy specimens in 28 children treated for gastroesophageal reflux disease (GERD). These patients were divided into three groups based on their response to treatment and the results of esophageal pH probe monitoring. Eleven patients (Group A) had incomplete clinical response and normal pH probe monitoring results. Ten patients (Group B) had incomplete response but did not have pH probe monitoring. These two groups formed the index population. Seven patients (Group C) had clinical improvement with GERD therapy and abnormal pH probe monitoring characteristic of GERD; they constituted the control population. Clinical, laboratory, and pathologic features were evaluated to detect differences between index and control populations. Dysphagia, food impaction, failure to thrive, peripheral eosinophilia, and abnormal allergen skin test results were detected only in Group A and B patients. Biopsy specimens of the distal 9 cm of the esophagus, after GERD therapy, contained larger numbers of eosinophils in Groups A and B than in Group C as shown on high-power fields (HPF) (A: 31/HPF +/- 19.5; B: 28/HPF +/-23.7; versus C: 5/HPF +/-6.7; p = 0.009). Eosinophil aggregates were identified only in Groups A and B (p = 0.07). Eosinophils located preferentially in the superficial layers of the squamous epithelium were noted only in Groups A and B (p = 0.02). Group A and B patients demonstrated clinical improvement when given antiallergic therapy. The authors identified a group of pediatric patients characterized by an allergic history, lack of adequate response to GERD therapy, normal esophageal pH probe monitoring results, and large numbers of eosinophils in esophageal biopsy specimens obtained after GERD treatment. On the basis of these features, the authors propose that these patients represent examples of allergic esophagitis.

Child↗