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Mucosal pathology of the foregut associated with food allergy and recurrent abdominal pains in children.

https://arctichealth.org/en/permalink/ahliterature32321
Source
Acta Paediatr. 2001 Jan;90(1):16-21
Publication Type
Article
Date
Jan-2001
Author
J. Kokkonen
T. Ruuska
T J Karttunen
A. Niinimäki
Author Affiliation
Department of Pediatrics, University Hospital, Oulu, Finland. jorma.kokkonen@oulu.fi
Source
Acta Paediatr. 2001 Jan;90(1):16-21
Date
Jan-2001
Language
English
Publication Type
Article
Keywords
Abdominal Pain - immunology
Adolescent
Child
Child, Preschool
Endoscopy, Gastrointestinal
Esophagitis - etiology
Female
Food Hypersensitivity
Humans
Infant
Intestinal Mucosa - pathology
Intestines - microbiology
Male
Research Support, Non-U.S. Gov't
Abstract
To determine whether children with recurrent abdominal pain (RAP) include an excess of children with food allergy (FA), this study examined a consecutive series of 84 children (43M, 41F, mean age 7.9 y, range 1.6-15 y) referred during 1 y to 2 university hospitals. In addition to a clinical examination, the patients underwent gastroduodenoscopy with three biopsy specimens, skin-prick and patch tests, and comprehensive laboratory tests for atopic allergy. Based on an open elimination-challenge test, a total of 28 (33%) subjects were diagnosed for FA. In the whole material, specific endoscopic abnormalities were found in 38 (45%) subjects: oesophagitis in 17, gastric erosions in 8, lymphonodular duodenitis in 12 and erosive duodenitis in 5. FA showed a close relationship with duodenal lesions, but no significant association with oesophagitis and gastritis. The histological findings were mild, although some alterations could be observed in up to 66 (79%) subjects, equally often in patients with and without FA. None showed villous atrophy or severe infiltration of eosinophilic or mononuclear cells. Slightly increased densities of eosinophilic cells were significantly associated with endoscopic findings, especially oesophagitis. At least one positive skin-prick test with food allergens was found in 11 subjects and a positive patch test in 21 subjects, but neither showed an association with the endoscopic or histological findings, or even with clinical FA. CONCLUSION: Since the children with FA showed significantly more often concomitant mucosal pathology of the foregut than those without FA, FA may be considered one of the major factors underlying RAP. The report suggests the trial of an elimination diet in cases with RAP if lymphonodular hyperplasia or duodenitis is seen on gastroduodenoscopy.
Notes
Comment In: Acta Paediatr. 2001 Jan;90(1):3-411227329
Comment In: Acta Paediatr. 2001 Sep;90(9):1083-411683203
PubMed ID
11227327 View in PubMed
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The natural course of gastroesophageal reflux disease in children.

https://arctichealth.org/en/permalink/ahliterature189334
Source
Scand J Gastroenterol. 2002 Jun;37(6):638-41
Publication Type
Article
Date
Jun-2002
Author
M. Ashorn
T. Ruuska
R. Karikoski
P. Laippala
Author Affiliation
Dept of Pediatrics, University Hospital of Tampere, School of Public Health, University of Tampere, Finland. lomeas@uta.fi
Source
Scand J Gastroenterol. 2002 Jun;37(6):638-41
Date
Jun-2002
Language
English
Publication Type
Article
Keywords
Adolescent
Age Factors
Child
Child, Preschool
Endoscopy, Digestive System - methods
Esophagoscopy - methods
Female
Finland
Follow-Up Studies
Gastric Acidity Determination
Gastroesophageal Reflux - diagnosis - physiopathology
Gastroscopy - methods
Humans
Hydrogen-Ion Concentration
Male
Monitoring, Physiologic
Probability
Retrospective Studies
Risk assessment
Sensitivity and specificity
Severity of Illness Index
Abstract
The consequences of chronic gastroesophageal reflux disease (GERD) starting in childhood have not been widely studied. Our aim was to evaluate the usefulness of endoscopy in the primary diagnosis of GERD and to investigate the long-term course of this disease in children.
Between 1989 and 1999, 136 children had been endoscoped because of persisting symptoms of GER. After exclusions (neurological impairment, infant GER), 96 subjects were included, and files from 76 were available for the final evaluation. Twenty-four hour pH-monitoring had been performed primarily on 67 children and at follow-up on 28, and endoscopy to 69 subjects and at follow-up to 33, respectively. Medical therapy as well as symptoms prior to the therapy were registered. Clinical outcome was assessed at the end of the follow-up period.
Presenting symptoms were recurrent abdominal pain, heartburn, regurgitation and vomiting. Twenty-two patients had respiratory symptoms in addition to the gastrointestinal complaints. PH-recording was normal in 17/67 subjects, slightly pathological in 33 and severe reflux was diagnosed in 13 patients. Histologically, minimal changes associated with GER were diagnosed in 22 and mild esophagitis in 7. Thirty-six patients had been treated with prokinetic drugs. H2-blockers had been used in 24 children and proton-pump inhibitors in 4. After a mean follow-up period of 28 months, only 24% of patients had become symptom-free. Control endoscopy showed no progression of the esophageal inflammation in any of the subjects.
Pathological reflux in children is associated with no or mild esophageal inflammation, which is unlikely to deteriorate. Therefore endoscopic control could be limited to cases with severe esophagitis.
PubMed ID
12126239 View in PubMed
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A prospective study of acute diarrhoea in Finnish children from birth to 2 1/2 years of age.

https://arctichealth.org/en/permalink/ahliterature226439
Source
Acta Paediatr Scand. 1991 May;80(5):500-7
Publication Type
Article
Date
May-1991
Author
T. Ruuska
T. Vesikari
Author Affiliation
Department of Paediatrics, Tampere University Central Hospital, Finland.
Source
Acta Paediatr Scand. 1991 May;80(5):500-7
Date
May-1991
Language
English
Publication Type
Article
Keywords
Acute Disease
Adenovirus Infections, Human - diagnosis - epidemiology
Bacterial Infections - diagnosis - epidemiology
Child, Preschool
Diarrhea - diagnosis - epidemiology - etiology
Finland - epidemiology
Gastroenteritis - diagnosis - epidemiology - etiology
Humans
Infant
Infant, Newborn
Prospective Studies
Rotavirus Infections - diagnosis - epidemiology
Abstract
To determine the incidence, clinical significance and etiology of acute diarrhoea in early childhood, a cohort of 336 children were followed from birth to the age of 24-32 (mean 26) months. More than half (55%) of the children had no diarrhoea, 26% had one episode and 19% had two or more episodes of diarrhoea during follow-up; altogether 248 episodes of diarrhoea were detected. Rotavirus was by far the most common (26%) identified pathogen; adenoviruses were detected in 4% and bacterial pathogens (EPEC, Salmonellae, Yersiniae) in 4% of the cases. Two thirds of the episodes remained etiologically unresolved. Rotavirus diarrhoea was significantly more severe than diarrhoea due to other causes; 75% of severe episodes of diarrhoea were associated with rotavirus. About two thirds of the infants were breast-fed over 6 months; breast-feeding for less than 6 months was associated with a higher incidence of rotavirus diarrhoea between 7-12 months of age but not thereafter. About three quarters of the children were cared for at home beyond 12 months of age; those at home had a lower rate of rotavirus diarrhoea than those at day-care centers.
PubMed ID
1872172 View in PubMed
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Reverse transcription-polymerase chain reaction in the diagnosis of Helicobacter pylori infection in Finnish children.

https://arctichealth.org/en/permalink/ahliterature202953
Source
J Pediatr Gastroenterol Nutr. 1999 Mar;28(3):252-6
Publication Type
Article
Date
Mar-1999
Author
K. Oksanen
H. Kainulainen
T. Ruuska
M. Mäki
M. Ashorn
Author Affiliation
Institute of Medical Technology, University of Tampere, Finland.
Source
J Pediatr Gastroenterol Nutr. 1999 Mar;28(3):252-6
Date
Mar-1999
Language
English
Publication Type
Article
Keywords
Abdominal Pain
Adolescent
Biopsy
Child
Child, Preschool
Female
Finland
Gastric Mucosa - microbiology - pathology
Gastritis - microbiology - pathology
Helicobacter Infections - diagnosis - microbiology - pathology
Helicobacter pylori - genetics - isolation & purification
Humans
Infant
Male
Pyloric Antrum - microbiology - pathology
RNA, Bacterial - analysis
RNA, Ribosomal, 16S - analysis
Reverse Transcriptase Polymerase Chain Reaction
Sensitivity and specificity
Stomach - microbiology - pathology
Abstract
The purpose of this study was to design a simplified polymerase chain reaction (PCR) technique for the detection of Helicobacter pylori and to compare it with conventional diagnostic methods-culture and histology of gastric biopsy specimens. In addition, the capability of this technique to detect H. pylori in the gastric mucosal biopsies of originally H. pylori-negative children with gastritis or recurrent abdominal pain was investigated.
Reverse transcriptase polymerase chain reaction (RT-PCR) using polymerase from Thermus thermophilus was applied to detect H. pylori 16S rRNA. Twenty-five children H. pylori-positive by culture and/or histology were used as positive control subjects. Sixteen healthy H. pylori-negative children served as negative control subjects. Biopsy specimens from gastric antrum and corpus from 81 children were examined by RT-PCR. Altogether, 30 had histologic gastritis and 51 had nonspecific abdominal pain only, with no disease in histologic specimens. Histology and culture of H. pylori were negative in both patient groups.
Reverse transcription-polymerase chain reaction detected 24 of 25 tissue-positive and 0 of 16 tissue-negative cases, indicating 96% sensitivity and 100% specificity for the test. None of the culturally and histologically H. pylori-negative samples showed H. pylori colonization when analyzed by RT-PCR.
RT-PCR using Thermus thermophilus polymerase is a fast and simple means of detecting H. pylori in gastric biopsy specimens. It is at least as specific and sensitive as conventional methods. In pediatric patients it may be necessary to take more than two biopsy specimens to increase sensitivity in cases of local or patchy colonization.
PubMed ID
10067724 View in PubMed
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Rotavirus disease in Finnish children: use of numerical scores for clinical severity of diarrhoeal episodes.

https://arctichealth.org/en/permalink/ahliterature103371
Source
Scand J Infect Dis. 1990;22(3):259-67
Publication Type
Article
Date
1990
Author
T. Ruuska
T. Vesikari
Author Affiliation
Department of Paediatrics, Tampere University Central Hospital, Finland.
Source
Scand J Infect Dis. 1990;22(3):259-67
Date
1990
Language
English
Publication Type
Article
Keywords
Cohort Studies
Diarrhea, Infantile
Double-Blind Method
Enzyme-Linked Immunosorbent Assay
Feces - microbiology
Finland
Follow-Up Studies
Gastroenteritis
Humans
Infant, Newborn
Longitudinal Studies
Prospective Studies
Rotavirus Infections
Abstract
65 episodes of rotavirus diarrhoea, detected during a longitudinal follow-up of 336 infants from birth to 24-32 months of age, were analyzed for clinical symptoms. Rotavirus gastroenteritis was characterized by watery diarrhoea, vomiting (particularly in older children), fever and dehydration. A 0-20 point numerical score was devised according to the distribution of clinical features in the patients. Using this system, the mean severity score for the 65 episodes of rotavirus diarrhoea was 11.0 +/- 3.7 as compared to 5.6 +/- 3.2 for the 183 episodes of non-rotavirus diarrhoea in the same population (p less than 0.0001, t-test). The 20 point score is proposed for analysis of efficacy studies of candidate rotavirus vaccines.
PubMed ID
2371542 View in PubMed
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Seroepidemiological study of Helicobacter pylori infection in infancy.

https://arctichealth.org/en/permalink/ahliterature212456
Source
Arch Dis Child Fetal Neonatal Ed. 1996 Mar;74(2):F141-2
Publication Type
Article
Date
Mar-1996
Author
M. Ashorn
A. Miettinen
T. Ruuska
P. Laippala
M. Mäki
Author Affiliation
Department of Paediatrics, University Hospital of Tampere, Finland.
Source
Arch Dis Child Fetal Neonatal Ed. 1996 Mar;74(2):F141-2
Date
Mar-1996
Language
English
Publication Type
Article
Keywords
Antibodies, Bacterial - blood
Female
Fetal Blood - immunology
Finland - epidemiology
Helicobacter Infections - blood - epidemiology - immunology
Helicobacter pylori - immunology
Humans
Immunoglobulin G - blood
Incidence
Infant
Infant, Newborn
Maternal-Fetal Exchange
Pregnancy
Abstract
The incidence of Helicobacter pylori infection in very young children was determined, based on the emergence of specific IgG antibodies in sequential serum samples from birth to 2 years of age. The risk of acquiring H pylori infection in infancy as a result of maternal exposure to the organism was also assessed, based on the determination of maternal cord-blood antibodies. Serum IgG class H pylori antibodies were analysed in the cord blood samples of 195 newborns and in their follow up samples until the age of 2 years. Maternal antibodies were detected in the cord-blood samples of 21 children (10.6%). These antibodies disappeared in all but one child before 7 months of age and no new seroconversions occurred in these children. Ten originally cord-blood negative children seroconverted up to the age of 2 years (5.1%). It is concluded that a major proportion of H pylori infections observed in young adults in Finland are acquired during the first two years of life. Maternal seropositivity is not a straightforward risk factor for acquiring H pylori infection in infancy.
Notes
Cites: Scand J Gastroenterol. 1989 Jan;24(1):110-42648556
Cites: N Engl J Med. 1990 Feb 8;322(6):359-632300088
Cites: Arch Dis Child. 1990 Feb;65(2):189-912317065
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Cites: Lancet. 1992 Apr 11;339(8798):896-71348299
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Cites: Lancet. 1993 Aug 7;342(8867):328-318101585
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Cites: J Clin Microbiol. 1994 May;32(5):1193-68051244
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Cites: J Infect Dis. 1993 Jul;168(1):219-218515114
PubMed ID
8777666 View in PubMed
Less detail
Source
Duodecim. 1975;91(2):72-4
Publication Type
Article
Date
1975
Author
T. Ruuska
Source
Duodecim. 1975;91(2):72-4
Date
1975
Language
Finnish
Publication Type
Article
Keywords
Disability Evaluation
Finland
Humans
Rehabilitation, Vocational
PubMed ID
1149653 View in PubMed
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7 records – page 1 of 1.