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Register a new user24 Hours Esophageal PH Monitoring &Endoscopic Reflux Esophagitis in infants and children
التهاب المري الجزري المثبت تنظيرياً و علاقته مع نتيجة مراقبة باهاء PH المري مدة 24 ساعة عند الأطفال و الرضع
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Added by
Damascus University ورقة بحثية
Publication date
2011
fields
Medicine
and research's language is
العربية
Created by
Shamra Editor
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شخص التهاب المري الجزري عند 50 % من مرضى الجزر المعدي المريئي الحامضي فقط. هدف البحث إلى دراسة علاقة التهاب المري الجزري المثبت بالتنظير عند مجموعة الأطفال مع الجزر المعدي المريئي الحامضي المثبت بنتيجة مراقبة باهاء PH المري مدة 24 ساعة، و لاسيما أن الدراسات الأخيرة بدأت تتحدث عن تأثيرات مؤذيةً للمواد المقلوسة إلى المري سواء كانت حامضة أم قلوية؟
Reflux Esophagitis was diagnosed in 50 % of Acidic Gastro Esophageal Reflux Disease cases only. This study aimed to detect the association between Endoscopic Reflux Esophagitis and acidic Gastroesophageal Reflux disease.
References used
Klein Man et al.EsopHagitis ,GastroEsopHageal Reflux Disease,PH Measurment .Pediatric Gastrointestinal diseases,fourtH ed 2004
Gold BD.Gastroesophageal reflux disease:Am J Med.Sep 6 2004;117 suppl 5 A:23s,29s
RudolpH,colin D et al .Guidelines for Evaluation and Treatment of GastroesopHageal Reflux in Infants and cHildren .Journal of Pediatric Gastroenterology and Nutrition :volume 32 supp 2 January 2001
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Recent studies has proved that high proportion of reflux episodes in Gastro
Esophageal Reflux Disease(GERD) were non acidic ,and could not be detected by classic pH metry alone,
especially less than 2 years, in whom nutrition is mainly depending on
milk .It was too necessarily to improve
a new technique (Multichannel Intraluminal Impedance MII) ,and by this any retrograde flow to
the esophagus can be detected . The aim of this study was to determine whether pH-monitoring alone is
sufficient to diagnose the Gastro Esophageal Reflux Disease (GERD),and how much the diagnosis was
improved after Multichannel Intraluminal Impedance (MII) has been added to the standard pH catheter
in children less than 2 years.
GERD raises respiratory symptoms and the treatment of anti- GERD improve
these symptoms and improve pulmonary function, sometimes GERD silent clinically which makes us
unaware of the role of GERD in pathogenesis of respiratory infections which lead
ing to increased
incidence of respiratory symptoms in patients with GERD and for this reason we must search for GERD
in chronic respiratory infections not responding to treatment.
To determine the prevalence of clinical symptoms associated with GERD in children and to define the role
of treatment of anti-GERD in the management of respiratory symptoms in children.
The study aimed to demonstrate the importance of applying PH- METRY test in the diagnosis of gastroesophageal reflux disease(GERD) of children with recurrent respiratory diseases, to determine the most common digestive and other clinical symptoms(res
piratory) associated with GERD in the study . Thirty children with recurrent respiratory disease aged between two months and 11 years, were included in this study whom applied pH-Metry monitoring. GERD was found in 83.33% of children with recurrent respiratory disease, most patients(63.33%) were less than 3 years with the highest ratio of GERD( 89.4%). The cough was the most common of respiratory symptoms (90%). The prevalence rate of GERD between consenting patients was( 92%) .Night respiratory symptoms were found in (67%) of children. The prevalence rate of GERD between consenting patients was(68%) . Statistically significant relationship found between regurgitated vomiting and the presence of GERD (P = 0,043),and between the night digestive symptoms and GERD(P=0.009)
The research aims to make a statistical approach to the cases of esophageal atresia by
its types and incidence, and to study the surgical treatment outcome and choose the best
method of treatment and follow up.
The study included 27 newborn patien
ts admitted in the Neonatal Intensive Care Unit
at Al-Assad University Hospital and Tishreen University Hospital in Lattakia, due to
diagnosis of esophageal atresia or tracheoesophageal fistula, from the beginning of January
2010 until the end of 2015. 14 of patients were males and 13 were females. Gross
classification of esophageal atresia was used, type (C) was found in 21 cases, type (A) was
found in 4 cases, type (E) was found in 2 cases, while type (B) and (D) were not seen. We
studied The clinical symptoms in newborn patients with this malformation, radial and
laboratory findings and associated malformations. We used esophageal contrast study
insure the diagnosis when needed. With type (C), we did primary anastomosis in 20 cases
and cervical esophagostomy with gastrostomy in only 1 case. With type (A), we did
esophagostomy with gastrostomy in all cases. With type (E), we closed the fistula with
cervical approach in all cases. The survival rate was 70.4%. Spitz classification was used
for risk assessment. The incidence of complications included anastomotic leakage 30% and
anastomotic stricture 69.2%.
Treatment plans were studied for patients with lung and esophageal tumors, patients were imaged using CT-Scan (PHILIP TYPE) and the images were sent to the Treatment Planning System-TPS (ECLIPS type), the system in which the doctor identified the tum
or and at-risk organs. Conventional 3D-Conformal Radiotherapy (3DCRT) and Intensity-Modulated Radiotherapy (IMRT) plans were created for the same patients. Treatment plans were compared according to the Dose Volume Histogram (DVH).It was observed that the radiation dose distribution of radiotherapy plans using IMRT technique better suited to tumor size (CTV) and protecting more organs surrounding the tumor, but it takes longer than 3DCRT technology. Therefore it is necessary to determine which patients should be treated with one technique (3DCRT or IMRT) or another technique depending on the full dose given to CTV and the time it generally takes.
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