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    Are Symptoms of Gastroesophageal Reflux in Children Associated with Diagnoses of Endoscopic and/or Histological Esophagitis?
    (ORTADOGU AD PRES & PUBL CO, 2012) Emiroglu, Halil Haldun; Sokucu, Semra; Gulluoglu, Mine; Cantez, Serdar; Camlica, Hakan; Durmaz, Ozlem
    Objective: The purpose of this study was to find out whether symptoms in children suspected to have gastroesophageal reflux disease are correlated with the endoscopic and/or histological diagnoses of esophagitis. Material and Methods: The data of 140 children [mean age 8.9 +/- 4.6 (0.16-18) years] who underwent diagnostic upper endoscopy and biopsy of distal esophagus were collected between January 2002 and December 2004. Endoscopic findings were classified according to the Los Angeles system. Histopathological findings were classified according to Knuff & Leape classification. The relationship between symptoms and the diagnoses of endoscopic or histological esophagitis was examined retrospectively. Results: Twenty nine patients (20.7%) had endoscopic esophagitis and 51(36.4%) had histological reflux esophagitis. Prevalence of erosive reflux disease was 12.1 %, and that of non-erosive reflux disease was 24.3%. The symptoms suggesting gastroesophageal reflux did not have a statistically significant correlation with endoscopic or histological esophagitis. Conclusion: The diagnostic value of symptoms in children suspected to have gastroesophageal reflux disease are low. Regardless of the symptoms of gastroesophageal reflux, collecting biopsy samples from esophagus still seems to be a beneficial approach both in children undergoing diagnostic upper endoscopy when there is no contraindication for obtaining a biopsy.
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    Investigation of Cardiomyopathy in Children With Cirrhotic and Noncirrhotic Portal Hypertension
    (LIPPINCOTT WILLIAMS & WILKINS, 2015) Celtik, Coskun; Durmaz, Ozlem; Oner, Naci; Yavuz, Taner; Gokce, Selim; Aydogan, Aysen; Nisli, Kemal
    Background: Cirrhotic cardiomyopathy (CCMP) is a functional disorder characterized by electrophysiological disturbances, and diastolic and/or systolic dysfunction in patients with liver disease. This disorder is a well-defined entity in adults, but pediatric data are limited. The aim of the study was to determine the incidence, features, and risk factors of CCMP in children with portal hypertension (PHT). Methods: This study included 50 children with cirrhotic PHT (40/50) and noncirrhotic PHT (10/50). Fifty healthy children were also selected for the control group. Electrocardiography and echocardiography were used to evaluate cardiac functions. Corrected QT (QTc) >= 0.45 was accepted as prolonged on electrocardiography. The study group was divided into 3 groups: cirrhotic, noncirrhotic, and control. Then, the CCMP group was created according to the diagnostic criteria. Latent CCMP was diagnosed in the presence of prolonged-QTc along with a minor criterion (tachycardia). Manifest CCMP was diagnosed in the presence of at least 2 major criteria (prolonged-QTc along with abnormal echocardiographic findings). Moreover, in this study, the risk factors for CCMP were investigated. Results: The CCMP group included 10 cases (20%). Nine of these cases had latent CCMP (18%), and the remaining one (2%) had manifest CCMP. All of the cases with CCMP had cirrhosis and ascites. None of the patients with CCMP had severe cardiac symptoms, but they were already using some cardioprotective drugs such as propanolol and spironolactone. As risk factors for CCMP, pediatric end-stage liver disease scores, Child-Pugh scores, and ascites grades were found to be significant for the determination of CCMP. The most important risk factor was ascites severity (P = 0.001, odds ratio 9.4). Conclusions: Approximately 20% of children with PHT have CCMP. A detailed cardiac examination should be carried out periodically in children with cirrhotic PHT, especially in the presence of ascites and high Child-Pugh score.