Background/AimsTo evaluate the characteristic properties of laryngopharyngeal reflux (LPR) and gastroesophageal reflux (GER) in children with otitis media with effusion (OME) using 24-hour multichannel intraluminal impedance combined with dual-probe (pharyngeal and esophageal) pH-metry. MethodsChildren aged 7-10 years of age with OME underwent 24-hour multichannel intraluminal impedance pH-metry. The upper pH sensor was situated 1 cm above the upper esophageal sphincter, and the lower pH sensor was placed 3-5 cm above the lower esophageal sphincter. Parents were asked to complete the gastroesophageal reflux assessment of symptoms in a pediatrics questionnaire. ResultsTwenty-eight children were enrolled; LPR was detected in 19 (67.9%) children. The criteria of the LPR diagnosis was the presence of at least one supraesophageal episode with a pH < 5.0 and a change in the pH value measured from the initial level at the upper sensor of > 0.2. In total, 64 episodes were observed. Assessment of all LPR episodes showed the presence of 246 episodes in the entire study. A considerable predominance of weakly acidic episodes (87.8%) was noted; there were 6.5% acidic episodes, and weakly alkaline episodes reached 5.7%. Pathological GER was noted in 10 (35.7%) subjects. Acid GER was detected in 8 children, 2 of whom demonstrated non-acidic reflux. In the LPR-negative patients, no pathological GER was confirmed with the exception of a single case of non-acidic reflux. ConclusionsLPR was frequently noted in the group of children with OME, and it might be an important risk factor in this common disease.

There were no significant differences in the concentrations of interleukins in the various research groups. The results of densitometric analysis showed a positive impact of hormone replacement therapy on the BMD (0.91-0.92 g/cm2) compared with the density in the group not treated with hormone therapy (0.77-0.8 g/cm2). There was no relationship between concentration of interleukins and the level of BMD. CONCLUSIONS. Further research on the level of cytokines in serum and saliva conducted on a broader group of patients is required. Determination of markers of bone turnover can be useful in the assessment of the treatment of metabolic bone changes.

Gallbladder duplication is rare congenital malformation. There is no report of gallbladder duplication or other gastrointestinal tract malformations in patients with Noonan syndrome. We present a child with Noonan syndrome, gallbladder duplication, annular pancreas and duodenal stenosis. The presumptive diagnosis of gallbladder duplication was established on the basis of ultrasonographic examination. Endoscopy revealed the presence of septum in stomach fundus, antrum malformation and duodenal duplication with two separate duodenal papillas. Wide spectrum of diagnostic procedures is needed to establish the diagnosis of gastrointestinal malformations. It is especially important if you plan any surgery.