We suggest that H. pylori may impair growth significantly only in susceptible children where unfavorable socioeconomic conditions facilitate its action, probably through mechanisms, at least in part, involving growth-related molecules.

Background: Recent investigation of the etiology of Behçet’s disease (BD) has focused on heat shock proteins (HSP) which belong to the HSP 60 family. Both the gastric pathogen Helicobacter pylori (HP) and BD may cause ulcers in the gastrointestinal tract and, HP expresses HSP 60. Objective: Whether HP is linked to the pathogenesis of BD or not, and to investigate the influence of HP eradication on clinical parameters of BD. Methods: Patients with BD were divided into two groups. Group I comprised 49 patients and was investigated for HP seroprevalence and compared with age- and sex-matched controls. Group II comprised 20 patients with BD and HP infection diagnosed by serological and endoscopic examinations as well as the rapid urease test (RUT). A 1-week eradication therapy was administered for HP infection. Patients were examined for the course of BD at monthly intervals. Two months after the eradication therapy, patients underwent an endoscopic examination and RUT for eradication control. Seven patients were excluded because of eradication failure. Thirteen patients were evaluated for the influence of HP eradication on clinical manifestations of BD. The number and size of oral and genital ulcers before the eradication and at the end of the follow-up period were compared statistically. Results: HP seroprevalence between patients with BD and controls did not show significant difference. In 13 patients with BD, the number and size of oral and genital ulcers diminished significantly and various clinical manifestations regressed after the eradication of HP. Conclusion: HP may be involved in the pathogenesis of BD.

We evaluated the effects of hospital stay on nutritional anthropometric data in children of various age groups and investigated the effects of admission undernutrition on nutritional anthropometric data in children who were hospitalized in our university hospital in Turkey. The adverse effect of hospitalization on nutritional status was shown to be most obvious on the 2-6-year age group with undernourished children. We also found reduced anthropometric parameters in all patients with mild malnutrition at admission (p < 0.05). A significant number of pediatric patients in Turkey are at nutritional risk at the time of hospital admission (31.8 per cent). The well-nourished children do not carry nutritional risk due to hospitalization for other medical reasons. Since undernutrition has an adverse effect on morbidity and mortality, careful nutritional evaluation of children on admission is essential. Special attention should be given to patients who had mild malnutrition on admission since this population of patients seem to be at higher risk of adverse effect of hospitalization.

No abstract

Helicobacter pylori is a gastroduodenal pathogen strongly associated with chronic gastritis and duodenal ulceration. It is thought that H. pylori infection might be one of the causes of growth retardation in children. The aim of this study was to evaluate the seroprevalence of H. pylori in children with constitutional delay of growth and puberty (CDGP). H. pylori seropositivity was studied in 24 children with CDGP (22 M, 2 F) and 32 healthy age-matched children with normal pubertal development. Mean age of the children with CDGP was 14.53 +/- 1.12 yr and all of them had been diagnosed as CDGP after physical and laboratory assessment. H. pylori IgG positivity was detected in 16 of the 24 children with CDGP (66.6%) and 12 of 32 controls (37.5%) (p <0.05). This finding is consistent with the hypothesis that H. pylori infection could be one of the environmental factors causing CDGP.

Although the ALT normalization and HBV DNA clearance ratios of IFN plus LAM combination groups were better than the high-dose IFN-alpha monotherapy group, no significant difference was found in the complete response ratios of all three groups.

Cyanotic congenital heart disease in children commonly causes more pronounced growth retardation in comparison with acyanotic congenital heart disease. Chronic hypoxemia has been suggested as the cause of poor growth in these patients, but the relationship between serum IGF-I levels and chronic hypoxemia is unclear. Serum IGF-I concentrations, oxygen saturation and nutritional status were evaluated in 29 patients with cyanotic congenital heart disease, and serum IGF-I levels were compared with a group of 20 well-nourished, age-matched control children to assess the relationship between IGF-I levels and chronic hypoxemia. The nutritional status of each patient was determined by using anthropometric parameters and calorie and protein intake ratios. The patients were divided into malnourished and well-nourished groups (21 and 8 patients, respectively) according to their nutritional status. Serum IGF-I concentrations were measured in the two patient groups and the controls. The malnourished group had the lowest IGF-I levels (48.14 +/- 21.8 ng/ml, p<0.05). However, the well-nourished group's IGF-I levels were significantly lower than the control subjects' despite improved nutritional status (85.5 +/- 30.2 and 107 +/- 19.7 ng/ml, respectively, p<0.05). In addition, we found a positive correlation between serum IGF-I levels and oxygen saturation of the patients (r=0.402, p<0.05). These findings indicate that chronic hypoxemia has a direct or indirect effect to reduce serum IGF-I concentrations and this may be a cause of the increased growth failure in patients with cyanotic congenital heart disease.

Objective-To evaluate the role of vitamin A on renal scarring in recurrent urinary tract infections (UTIs). Design-Twenty three children with UTIs and renal scarring (mean (SD) age 7.3 (3.9) years) and 91 children without renal scarring (6.4 (3.4) years) were studied. All the children had serum vitamin A and -carotene measurements and nutritional evaluation. Renal scarring was assessed by technetium-99m dimercaptosuccinic acid ( The role of vitamin A in recurrent urinary tract infections (UTIs) and urolithiasis has been assessed previously.1 Vitamin A was proposed as eVective in the regeneration of epithelial tissue in the urinary tract 2 ; -carotene has been reported to have antioxidant properties.3 Technetium 99-m dimercaptosuccinic acid ( 99m Tc DMSA) scintigraphy is the gold standard for demonstration of scarring in renal cortical tissue. 4 We hypothesised that the regenerative eVect of vitamin A on epithelial tissue could also be considered to play a part on renal parenchymal epithelium, as in the case of epithelium lining the lower urinary tract. The aim of this study was to evaluate the relation between vitamin A metabolism and scarred and unscarred renal parenchymal tissues and also to evaluate whether vitamin A and -carotene had an eVect on prevention of renal scarring. Subjects and methodsChildren with renal scarring due to recurrent UTIs were enrolled in this study. A control group was composed of children with recurrent UTIs but without renal scarring.Each patient was evaluated twice by 99m Tc DMSA scans performed at least six months apart. Persisting hypodense areas on two consecutive DMSA scans were considered as renal scarring. 4 Patients with normal or nonpersisting DMSA findings were considered as free of scarring. Uptake of each kidney was determined as per cent of total uptake of both kidneys which was considered to be 100%. When the diVerence between uptakes of kidneys exceeds 10% on scanning, renal function was considered to be diminished on the lower uptake side. 4 All the scans were read blindly by two specialists.Nutritional status of patients was evaluated by body mass index and the results were compared with published standards.Vitamin A and -carotene concentrations were measured by the Neeld and Pearson method in venous blood samples obtained during acute UTI episodes. 5 The intrabatch coeYcients of variation for vitamin A and -carotene were 6.5% and 7.8 % respectively in preliminary standardisation.Patients were grouped according to whether they had renal scarring (study group) or not (control group). The groups were compared for serum vitamin A and serum -carotene concentrations and nutritional status. In addition, the extent of kidney scarring was compared with serum concentrations of vitamin A and -carotene, when the diVerence between 99m Tc DMSA uptakes of kidneys was greater than 10%.Results were analysed by unpaired t test and correlation analysis. ResultsThere were 23 children with renal scars (mean (SD) age 7.3 (3.9) years and 91 unscarred children (mean age 6.4 (4.4) ...