Ender Pehlivanoglu - Academia.edu (original) (raw)

Papers by Ender Pehlivanoglu

Research paper thumbnail of Preventive approaches for intrafamilial H. pylori transmission as an efficient target strategy to decrease the prevalence of the infection in developing countries

The Turkish Journal of Gastroenterology, 2013

Research paper thumbnail of What is the diagnostic utility of endoscopic scoring systems in children?

The Turkish Journal of Gastroenterology, 2009

Research paper thumbnail of A rare and often unrecognized cause of hematochezia and tenesmus in childhood: solitary rectal ulcer syndrome

Pediatrics, Dec 1, 2002

http://pediatrics.aappublications.org/content/110/6/e79.full.html located on the World Wide Web at:

Research paper thumbnail of Severe cytomegalovirus infection and immunosuppressive therapy in pediatric liver transplantation

The Turkish journal of pediatrics

Twenty-two post-orthotropic liver transplant (OLT) recipients were studied to investigate the cli... more Twenty-two post-orthotropic liver transplant (OLT) recipients were studied to investigate the clinical, laboratory and histopathological differences between rejection and CMV infection. The mean age at the time of transplantation was five years. Nine of 22 (41%) patients developed positive CMV, CF-IgG and IgM antibody titers and cultures for CMV following surgery, and three (group 1a) developed interstitial pneumonitis. CMV specific inclusion bodies were found in lung and liver biopsies. Two patients in group 1a were treated successfully with DHPG and decreasing immunosuppressive treatment, while the third died. Clinical presentation of rejection episodes were similar in all groups. CMV infected patients (group 1) received more transfusions of blood and blood products than the non-infected patients (group 2). Rejection episodes occurred sooner and more frequently in group 1a than in group 1b (CMV infected-asymptomatic) and group 2 (non-infected). Group 2 received fewer steroid boluses as well as azathioprine and OKT 3. A percutaneous liver biopsy with routine stains helped detect CMV when inclusion bodies were seen. We conclude that culture proven CMV infection is common post-OLT. Severe CMV infection occurred more frequently in those who had received greater doses of immunosuppressive therapy for possible graft rejection. Monitoring CMV infection following OLT is absolutely necessary. After OLT, decreasing the immunosuppressives and using antiviral agents are important in the management of CMV infection.

Research paper thumbnail of Helicobacter pylori infection and peptic ulcer in eastern Turkish children: is it more common than known?

The Turkish journal of pediatrics

Uğraş M, Pehlivanoğlu E. Helicobacter pylori infection and peptic ulcer in eastern Turkish childr... more Uğraş M, Pehlivanoğlu E. Helicobacter pylori infection and peptic ulcer in eastern Turkish children: is it more common than known? Turk J Pediatr 2011; 53: 632-637.

Research paper thumbnail of Sedation for procedures

Research paper thumbnail of High-dose interferon results in high HBsAg seroclearance in children with chronic hepatitis B infection

The Turkish journal of pediatrics

Ertem D, Acar Y, Kotiloðlu Karaa E, Pehlivanoðlu E. High-dose interferon results in high HBsAg se... more Ertem D, Acar Y, Kotiloðlu Karaa E, Pehlivanoðlu E. High-dose interferon results in high HBsAg seroclearance in children with chronic hepatitis B infection. Turk J Pediatr 2003; 45: 123-128. Clinical trials for chronic hepatitis B (HBV) infection in children have shown usefulness of interferon alpha 2b (IFN-α) in eliminating HBV replication and in improving liver histology. Although it is not the ultimate goal of the interferon treatment for chronic HBV infection, it has been suggested in adults that HBsAg clearance decreases the likelihood of development of hepatocellular carcinoma, and prolongs the survival. HBV DNA clearance has been shown to be higher with higher doses of interferon in children, but it was rarely associated with HbsAg clearance. Ten MU/m 2 was tried in 46 children who had biopsy-proven chronic HBV infection. They received IFN-α subcutaneously three times/week for six months. The treatment regimen was completed in 41 children and the second liver hiopsy was carried out one year after the end of the treatment in 30 of 41 patients. With this schedule, 15 (36.6%) children showed persistent loss of HBV DNA 12 months after the cessation of the treatment, 20 (48.7%) lost HBeAg, and eight (19.5%) developed anti-HBs antibody with loss of HBsAg. A significant improvement in liver histology was obtained in children with HBV DNA clearance. Serum ALT levels normalized in all HBeAg seroconverters.

Research paper thumbnail of Can gastro-oesophageal reflux be predicted while advancing the endoscope through the laryngeal area?

Research paper thumbnail of P080 Pediatric Inflammatory Bowel Disease, Review of 22 Cases From Turkey

Journal of Crohn's and Colitis Supplements, 2009

Objective: To define the effect of age & sex on disease location in CD by two statistical approac... more Objective: To define the effect of age & sex on disease location in CD by two statistical approaches in patients aged 0 16 from the CEDATA registry. Age was examined as a continuous variable and grouped. Location was examined grouped (Montreal) and dichotomized (small bowel, large bowel, upper GI only). To examine differences in mean age ANOVA was used. To examine the strength of the association for dichotomized locations by age group logistic regression was applied. Analyses were based on 1064 cases. Mean age (yrs) was as follows: L1 Small bowel, 13.8 (+ upper GI (L4), 13.5); L2 large bowel, 12.2 (+ L4, 12.9); L3 small and large, 12.9 (+ L4 12.6); L 4 upper GI only, 12.3. Differences between L1 and L2 (p < 0.001) and L1 and L3 (p = 0.02) were statistically significant. There was no effect of sex, but centre size contributed significant interaction. The risk for small bowel involvement was very low in young children (age 0 5; OR 0.19, 95% CI 0.06 to 0.63) and increased with age (age 6 10 OR 0.48, 95% CI 0.30 to 0.77; age 11 13 OR 0.58, 95% CI 0.40 to 0.97; reference: age 14 16). In contrast, the OR for large bowel involvement in young children (0 5 yrs) was 1.96 (1.12 to 3.45) and decreased with age. Odds ratios for girls (vs. boys) were strongly decreased for isolated upper GI involvement (OR 0.13, 95% CI 0.03 to 0.54). Conclusion: Small vs. large bowel involvement is dependent on age but not sex, while upper GI location is determined by sex but not age. Future analyses will explore evolution over time.

Research paper thumbnail of Severe gastric outlet obstruction in a child with ectopic pancreas: is there a role for Helicobacter pylori?

Journal of pediatric gastroenterology and nutrition, 2006

Research paper thumbnail of Does endoscopic appearance of esophagus always suffice the diagnosis of esophagitis in patients presenting with otolaryngologic symptoms?

The American journal of gastroenterology, 2005

Research paper thumbnail of A rare and often unrecognized cause of hematochezia and tenesmus in childhood: solitary rectal ulcer syndrome

Pediatrics, 2002

Solitary rectal ulcer syndrome (SRUS) is an unusual disorder of childhood, which usually presents... more Solitary rectal ulcer syndrome (SRUS) is an unusual disorder of childhood, which usually presents with rectal bleeding, mucous discharge, prolonged straining, tenesmus, and localized pain in the perineal area. After the first description by Cruveilhier, Madigan and Morson further detailed the clinical and pathologic features of SRUS in 1969. The pathogenesis of the syndrome is not well-understood. The postulated mechanism responsible for rectal prolapse in most cases seems to be excessive straining efforts during which high intra-abdominal pressure forces the anterior rectal mucosa firmly into the contracting puborectalis muscle. The anterior rectal mucosa is frequently forced into the anal canal and as a consequence becomes strangulated, causing congestion, edema, and ulceration. Histologically, the presence of fibromuscular obliteration of the lamina propria with disorientation of muscle fibers is characteristic, which could be secondary to chronic mechanical and ischemic trauma a...

Research paper thumbnail of Thrombotic and thrombocytopenic complications secondary to hepatitis A infection in children

The American Journal of Gastroenterology, 1999

Research paper thumbnail of Childhood: Solitary Rectal Ulcer Syndrome A Rare and Often Unrecognized Cause of Hematochezia and Tenesmus in

Solitary rectal ulcer syndrome (SRUS) is an unusual disorder of childhood, which usually presents... more Solitary rectal ulcer syndrome (SRUS) is an unusual disorder of childhood, which usually presents with rectal bleeding, mucous discharge, prolonged straining, tenesmus, and localized pain in the perineal area. After the first description by Cruveilhier, Madigan and Morson further detailed the clinical and pathologic features of SRUS in 1969. The pathogenesis of the syndrome is not well-understood. The postulated mechanism responsible for rectal prolapse in most cases seems to be excessive straining efforts during which high intraabdominal pressure forces the anterior rectal mucosa firmly into the contracting puborectalis muscle. The anterior rectal mucosa is frequently forced into the anal canal and as a consequence becomes strangulated, causing congestion, edema, and ulceration.

Research paper thumbnail of Reactive oxygen species and chemokines: Are they elevated in the esophageal mucosa of children with gastroesophageal reflux disease?

World Journal of Gastroenterology, 2008

To determine the role of inflammatory cytokines and reactive oxygen species (ROS) in childhood re... more To determine the role of inflammatory cytokines and reactive oxygen species (ROS) in childhood reflux esophagitis. METHODS: A total of 59 subjects who had complaints suggesting GERD underwent esophagogastroduoden oscopy. Endoscopic and histopathologic diagnosis of reflux esophagitis was established by Savary-Miller and Vandenplas grading systems, respectively. Esophageal biopsy specimens were taken from the esophagus 20% proximal above the esophagogastric junction for conventional histopathological examination and the measurements of ROS and cytokine levels. ROS were measured by chemiluminescence, whereas IL-8 and MCP-1 levels were determined with quantitative immunometric ELISA on esophageal tissue. Esophageal

Research paper thumbnail of Diagnosis and Treatment of Chronic Active Hepatitis (Cah) in Pediatric Patients-Need for Prolonged Therapy

Pediatric Research, 1987

ABSTRACT

Research paper thumbnail of Diagnosis of liver cirrhosis in children based on colour Doppler ultrasonography with histopathological correlation

Pediatric Radiology, 1998

Research paper thumbnail of Autoimmune Complications Associated With Hepatitis a Virus Infection in Children

The Pediatric Infectious Disease Journal, 2001

Hepatitis A virus infection is usually a self-limited disease during childhood. Autoimmune manife... more Hepatitis A virus infection is usually a self-limited disease during childhood. Autoimmune manifestations are rarely reported among patients. We describe two children with acute hepatitis A infection who developed immune thrombocytopenia and hepatic venous thrombosis during the course of acute infection. Antiphospholipid antibodies were increased in both of them during the thrombocytopenic and thrombotic complications and decreased during the resolution of these events.

Research paper thumbnail of Helicobacter pylori Infection in European Children with Gastro-duodenal Ulcers and Erosions

The Pediatric Infectious Disease Journal, 2013

To analyze risk factors associated with gastro-duodenal ulcers and erosions in children. Open, pr... more To analyze risk factors associated with gastro-duodenal ulcers and erosions in children. Open, prospective, multicenter, case-control study carried out in 11 European countries in patients with gastric or duodenal ulcers/erosions and 2 age-matched controls each. Possible risk factors were recorded. Logistic regression models were performed with adjustment for centers and age groups. Seven-hundred thirty-two patients (244 cases, 153 with erosions only and 91 with ulcers, and 488 controls) were recruited. Children receiving antimicrobials or acid suppressive drugs before endoscopy were excluded (202 cases/390 controls remained for risk factor analysis). Helicobacter pylori was detected more frequently in cases than controls but only in 32.0% versus 20.1% in controls (P = 0.001). Independent exposure factors for gastric ulcers were male gender (P = 0.001), chronic neurologic disease (P = 0.015), chronic renal disease (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) and nonsteroidal anti-inflammatory drug consumption (P = 0.035). Exposure factors for duodenal ulcers were H. pylori infection (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) and steroid consumption (P = 0.031). Chronic renal disease was the only independent factor associated with gastric erosions (P = 0.026), those associated with duodenal erosions being H. pylori infection (P = 0.023), active smoking (P = 0.006) and chronic arthritis (P = 0.008). No risk factor was identified in 97/202 (48.0%) cases. H. pylori remains a risk factor for duodenal, but not for gastric lesions in children in countries with low prevalence of infection. No risk factor could be identified in half of the children with gastro-duodenal ulcers/erosions.

Research paper thumbnail of Hepatitis A Virus Infection Presenting With Seizures

The Pediatric Infectious Disease Journal, 2005

Human coronavirus NL63 recently found in the Netherlands has been detected in Japan with a revers... more Human coronavirus NL63 recently found in the Netherlands has been detected in Japan with a reverse transcriptionpolymerase chain reaction technique in clinical specimens from pediatric patients with respiratory symptoms. Of 419 specimens that were negative for common respiratory viruses, 5 were positive for human coronavirus NL63, and these specimens were all collected in the first 3 months of 2003.

Research paper thumbnail of Preventive approaches for intrafamilial H. pylori transmission as an efficient target strategy to decrease the prevalence of the infection in developing countries

The Turkish Journal of Gastroenterology, 2013

Research paper thumbnail of What is the diagnostic utility of endoscopic scoring systems in children?

The Turkish Journal of Gastroenterology, 2009

Research paper thumbnail of A rare and often unrecognized cause of hematochezia and tenesmus in childhood: solitary rectal ulcer syndrome

Pediatrics, Dec 1, 2002

http://pediatrics.aappublications.org/content/110/6/e79.full.html located on the World Wide Web at:

Research paper thumbnail of Severe cytomegalovirus infection and immunosuppressive therapy in pediatric liver transplantation

The Turkish journal of pediatrics

Twenty-two post-orthotropic liver transplant (OLT) recipients were studied to investigate the cli... more Twenty-two post-orthotropic liver transplant (OLT) recipients were studied to investigate the clinical, laboratory and histopathological differences between rejection and CMV infection. The mean age at the time of transplantation was five years. Nine of 22 (41%) patients developed positive CMV, CF-IgG and IgM antibody titers and cultures for CMV following surgery, and three (group 1a) developed interstitial pneumonitis. CMV specific inclusion bodies were found in lung and liver biopsies. Two patients in group 1a were treated successfully with DHPG and decreasing immunosuppressive treatment, while the third died. Clinical presentation of rejection episodes were similar in all groups. CMV infected patients (group 1) received more transfusions of blood and blood products than the non-infected patients (group 2). Rejection episodes occurred sooner and more frequently in group 1a than in group 1b (CMV infected-asymptomatic) and group 2 (non-infected). Group 2 received fewer steroid boluses as well as azathioprine and OKT 3. A percutaneous liver biopsy with routine stains helped detect CMV when inclusion bodies were seen. We conclude that culture proven CMV infection is common post-OLT. Severe CMV infection occurred more frequently in those who had received greater doses of immunosuppressive therapy for possible graft rejection. Monitoring CMV infection following OLT is absolutely necessary. After OLT, decreasing the immunosuppressives and using antiviral agents are important in the management of CMV infection.

Research paper thumbnail of Helicobacter pylori infection and peptic ulcer in eastern Turkish children: is it more common than known?

The Turkish journal of pediatrics

Uğraş M, Pehlivanoğlu E. Helicobacter pylori infection and peptic ulcer in eastern Turkish childr... more Uğraş M, Pehlivanoğlu E. Helicobacter pylori infection and peptic ulcer in eastern Turkish children: is it more common than known? Turk J Pediatr 2011; 53: 632-637.

Research paper thumbnail of Sedation for procedures

Research paper thumbnail of High-dose interferon results in high HBsAg seroclearance in children with chronic hepatitis B infection

The Turkish journal of pediatrics

Ertem D, Acar Y, Kotiloðlu Karaa E, Pehlivanoðlu E. High-dose interferon results in high HBsAg se... more Ertem D, Acar Y, Kotiloðlu Karaa E, Pehlivanoðlu E. High-dose interferon results in high HBsAg seroclearance in children with chronic hepatitis B infection. Turk J Pediatr 2003; 45: 123-128. Clinical trials for chronic hepatitis B (HBV) infection in children have shown usefulness of interferon alpha 2b (IFN-α) in eliminating HBV replication and in improving liver histology. Although it is not the ultimate goal of the interferon treatment for chronic HBV infection, it has been suggested in adults that HBsAg clearance decreases the likelihood of development of hepatocellular carcinoma, and prolongs the survival. HBV DNA clearance has been shown to be higher with higher doses of interferon in children, but it was rarely associated with HbsAg clearance. Ten MU/m 2 was tried in 46 children who had biopsy-proven chronic HBV infection. They received IFN-α subcutaneously three times/week for six months. The treatment regimen was completed in 41 children and the second liver hiopsy was carried out one year after the end of the treatment in 30 of 41 patients. With this schedule, 15 (36.6%) children showed persistent loss of HBV DNA 12 months after the cessation of the treatment, 20 (48.7%) lost HBeAg, and eight (19.5%) developed anti-HBs antibody with loss of HBsAg. A significant improvement in liver histology was obtained in children with HBV DNA clearance. Serum ALT levels normalized in all HBeAg seroconverters.

Research paper thumbnail of Can gastro-oesophageal reflux be predicted while advancing the endoscope through the laryngeal area?

Research paper thumbnail of P080 Pediatric Inflammatory Bowel Disease, Review of 22 Cases From Turkey

Journal of Crohn's and Colitis Supplements, 2009

Objective: To define the effect of age & sex on disease location in CD by two statistical approac... more Objective: To define the effect of age & sex on disease location in CD by two statistical approaches in patients aged 0 16 from the CEDATA registry. Age was examined as a continuous variable and grouped. Location was examined grouped (Montreal) and dichotomized (small bowel, large bowel, upper GI only). To examine differences in mean age ANOVA was used. To examine the strength of the association for dichotomized locations by age group logistic regression was applied. Analyses were based on 1064 cases. Mean age (yrs) was as follows: L1 Small bowel, 13.8 (+ upper GI (L4), 13.5); L2 large bowel, 12.2 (+ L4, 12.9); L3 small and large, 12.9 (+ L4 12.6); L 4 upper GI only, 12.3. Differences between L1 and L2 (p < 0.001) and L1 and L3 (p = 0.02) were statistically significant. There was no effect of sex, but centre size contributed significant interaction. The risk for small bowel involvement was very low in young children (age 0 5; OR 0.19, 95% CI 0.06 to 0.63) and increased with age (age 6 10 OR 0.48, 95% CI 0.30 to 0.77; age 11 13 OR 0.58, 95% CI 0.40 to 0.97; reference: age 14 16). In contrast, the OR for large bowel involvement in young children (0 5 yrs) was 1.96 (1.12 to 3.45) and decreased with age. Odds ratios for girls (vs. boys) were strongly decreased for isolated upper GI involvement (OR 0.13, 95% CI 0.03 to 0.54). Conclusion: Small vs. large bowel involvement is dependent on age but not sex, while upper GI location is determined by sex but not age. Future analyses will explore evolution over time.

Research paper thumbnail of Severe gastric outlet obstruction in a child with ectopic pancreas: is there a role for Helicobacter pylori?

Journal of pediatric gastroenterology and nutrition, 2006

Research paper thumbnail of Does endoscopic appearance of esophagus always suffice the diagnosis of esophagitis in patients presenting with otolaryngologic symptoms?

The American journal of gastroenterology, 2005

Research paper thumbnail of A rare and often unrecognized cause of hematochezia and tenesmus in childhood: solitary rectal ulcer syndrome

Pediatrics, 2002

Solitary rectal ulcer syndrome (SRUS) is an unusual disorder of childhood, which usually presents... more Solitary rectal ulcer syndrome (SRUS) is an unusual disorder of childhood, which usually presents with rectal bleeding, mucous discharge, prolonged straining, tenesmus, and localized pain in the perineal area. After the first description by Cruveilhier, Madigan and Morson further detailed the clinical and pathologic features of SRUS in 1969. The pathogenesis of the syndrome is not well-understood. The postulated mechanism responsible for rectal prolapse in most cases seems to be excessive straining efforts during which high intra-abdominal pressure forces the anterior rectal mucosa firmly into the contracting puborectalis muscle. The anterior rectal mucosa is frequently forced into the anal canal and as a consequence becomes strangulated, causing congestion, edema, and ulceration. Histologically, the presence of fibromuscular obliteration of the lamina propria with disorientation of muscle fibers is characteristic, which could be secondary to chronic mechanical and ischemic trauma a...

Research paper thumbnail of Thrombotic and thrombocytopenic complications secondary to hepatitis A infection in children

The American Journal of Gastroenterology, 1999

Research paper thumbnail of Childhood: Solitary Rectal Ulcer Syndrome A Rare and Often Unrecognized Cause of Hematochezia and Tenesmus in

Solitary rectal ulcer syndrome (SRUS) is an unusual disorder of childhood, which usually presents... more Solitary rectal ulcer syndrome (SRUS) is an unusual disorder of childhood, which usually presents with rectal bleeding, mucous discharge, prolonged straining, tenesmus, and localized pain in the perineal area. After the first description by Cruveilhier, Madigan and Morson further detailed the clinical and pathologic features of SRUS in 1969. The pathogenesis of the syndrome is not well-understood. The postulated mechanism responsible for rectal prolapse in most cases seems to be excessive straining efforts during which high intraabdominal pressure forces the anterior rectal mucosa firmly into the contracting puborectalis muscle. The anterior rectal mucosa is frequently forced into the anal canal and as a consequence becomes strangulated, causing congestion, edema, and ulceration.

Research paper thumbnail of Reactive oxygen species and chemokines: Are they elevated in the esophageal mucosa of children with gastroesophageal reflux disease?

World Journal of Gastroenterology, 2008

To determine the role of inflammatory cytokines and reactive oxygen species (ROS) in childhood re... more To determine the role of inflammatory cytokines and reactive oxygen species (ROS) in childhood reflux esophagitis. METHODS: A total of 59 subjects who had complaints suggesting GERD underwent esophagogastroduoden oscopy. Endoscopic and histopathologic diagnosis of reflux esophagitis was established by Savary-Miller and Vandenplas grading systems, respectively. Esophageal biopsy specimens were taken from the esophagus 20% proximal above the esophagogastric junction for conventional histopathological examination and the measurements of ROS and cytokine levels. ROS were measured by chemiluminescence, whereas IL-8 and MCP-1 levels were determined with quantitative immunometric ELISA on esophageal tissue. Esophageal

Research paper thumbnail of Diagnosis and Treatment of Chronic Active Hepatitis (Cah) in Pediatric Patients-Need for Prolonged Therapy

Pediatric Research, 1987

ABSTRACT

Research paper thumbnail of Diagnosis of liver cirrhosis in children based on colour Doppler ultrasonography with histopathological correlation

Pediatric Radiology, 1998

Research paper thumbnail of Autoimmune Complications Associated With Hepatitis a Virus Infection in Children

The Pediatric Infectious Disease Journal, 2001

Hepatitis A virus infection is usually a self-limited disease during childhood. Autoimmune manife... more Hepatitis A virus infection is usually a self-limited disease during childhood. Autoimmune manifestations are rarely reported among patients. We describe two children with acute hepatitis A infection who developed immune thrombocytopenia and hepatic venous thrombosis during the course of acute infection. Antiphospholipid antibodies were increased in both of them during the thrombocytopenic and thrombotic complications and decreased during the resolution of these events.

Research paper thumbnail of Helicobacter pylori Infection in European Children with Gastro-duodenal Ulcers and Erosions

The Pediatric Infectious Disease Journal, 2013

To analyze risk factors associated with gastro-duodenal ulcers and erosions in children. Open, pr... more To analyze risk factors associated with gastro-duodenal ulcers and erosions in children. Open, prospective, multicenter, case-control study carried out in 11 European countries in patients with gastric or duodenal ulcers/erosions and 2 age-matched controls each. Possible risk factors were recorded. Logistic regression models were performed with adjustment for centers and age groups. Seven-hundred thirty-two patients (244 cases, 153 with erosions only and 91 with ulcers, and 488 controls) were recruited. Children receiving antimicrobials or acid suppressive drugs before endoscopy were excluded (202 cases/390 controls remained for risk factor analysis). Helicobacter pylori was detected more frequently in cases than controls but only in 32.0% versus 20.1% in controls (P = 0.001). Independent exposure factors for gastric ulcers were male gender (P = 0.001), chronic neurologic disease (P = 0.015), chronic renal disease (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) and nonsteroidal anti-inflammatory drug consumption (P = 0.035). Exposure factors for duodenal ulcers were H. pylori infection (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) and steroid consumption (P = 0.031). Chronic renal disease was the only independent factor associated with gastric erosions (P = 0.026), those associated with duodenal erosions being H. pylori infection (P = 0.023), active smoking (P = 0.006) and chronic arthritis (P = 0.008). No risk factor was identified in 97/202 (48.0%) cases. H. pylori remains a risk factor for duodenal, but not for gastric lesions in children in countries with low prevalence of infection. No risk factor could be identified in half of the children with gastro-duodenal ulcers/erosions.

Research paper thumbnail of Hepatitis A Virus Infection Presenting With Seizures

The Pediatric Infectious Disease Journal, 2005

Human coronavirus NL63 recently found in the Netherlands has been detected in Japan with a revers... more Human coronavirus NL63 recently found in the Netherlands has been detected in Japan with a reverse transcriptionpolymerase chain reaction technique in clinical specimens from pediatric patients with respiratory symptoms. Of 419 specimens that were negative for common respiratory viruses, 5 were positive for human coronavirus NL63, and these specimens were all collected in the first 3 months of 2003.