Thierry Devreker - Academia.edu (original) (raw)

Papers by Thierry Devreker

Résumé Pratiquée principalement en milieu hospitalier universitaire, la gastroscopie pédiatrique... more Résumé Pratiquée principalement en milieu hospitalier universitaire, la gastroscopie pédiatrique est devenue un acte technique de plus en plus fréquent. Un pédiatre général bénéficiant d’une bonne expérience des actes techniques et soumis à une formation continue, est aussi capable de pratiquer des gastroscopies en milieu hospitalier privé. L’hôpital privé présente comme avantage, un environnement plus familial et plus favorable à l’approche

Journal of Pediatric Gastroenterology and Nutrition, 2015

This study was performed to determine normal values for gastric half emptying time (t1/2GE) of li... more This study was performed to determine normal values for gastric half emptying time (t1/2GE) of liquids in healthy children. Gastric emptying (GE) of a standardized test milk-drink measured with Technetium scintigraphy and the C-acetate breath test (C-ABT) were compared in 19 children aged between 4 and 15 years with upper gastrointestinal symptoms. The C-ABT was subsequently used to determine normal values for GE of the same liquid test meal in 133 healthy children aged between 1 and 17 years. In the group of children with upper gastrointestinal symptoms, the results showed a significant correlation (r = 0.604, p = 0.0006) between t1/2GE measured with both techniques. In the group of healthy children, the results of t1/2GE showed that there was no influence of age, gender, weight, height and body mass index on GE. Normal values for GE of a standardized test milk-drink in healthy children were determined with the C-ABT. This technique is considered reliable and is well accepted by the patients.

While the role of microflora is well established in the development of inflammatory bowel disease... more While the role of microflora is well established in the development of inflammatory bowel disease; data is still emerging regarding irritable bowel syndrome as the knowledge on brain---gut interaction grows. For both patient groups multiple efficacious treatments exist, but there are still unmet needs as long term disease control remains an issue. Given the importance of the microbiome on the development of the immune system and the interaction between the microbiome and the host organism, this 'route' is being examined increasingly as a therapeutic possibility in both pathologies with variable results. We here provide a short overview on the existing data, meta---analysis and single studies, on probiotic treatment in both diseases.

Journal of Pediatric Gastroenterology and Nutrition, 1993

Journal of Pediatric Gastroenterology and Nutrition, 1996

Journal of Pediatric Gastroenterology &amp Nutrition, 1998

Journal of Pediatric …, 2011

Acta Endoscopica, 1994

ABSTRACT

The Open Nutrition Journal, 2008

Journal of pediatric gastroenterology and nutrition, Jan 14, 2015

To evaluate the predictive accuracy of screening tools for assessing nutritional risk in hospital... more To evaluate the predictive accuracy of screening tools for assessing nutritional risk in hospitalized children in developed countries. A systematic review of literature (MEDLINE, EMBASE and Cochrane Central databases until 17-01-2014) of studies on the diagnostic performance of pediatric nutritional screening tools. Methodological quality was assessed using a modified QUADAS tool. Sensitivity and specificity were calculated for each screening tool per validation method. A meta-analysis was performed to estimate the risk ratio of different screening result categories of being truly at nutritional risk. Eleven studies were included on one or more of the following screening tools: Pediatric nutritional Risk Score (PNRS), Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP), Paediatric Yorkhill Malnutrition Score (PYMS) and Screening Tool for Risk on Nutritional Status and Growth (STRONGkids). Due to variation in reference standards, a direct comparison of the predic...

Bioscience and microflora, 2011

Western medicine has only recently discovered that the intestinal microbiota is a major determina... more Western medicine has only recently discovered that the intestinal microbiota is a major determinant of the well-being of the host. Although it would be oversimplifying to limit the benefits of breastfeeding compared to cow milk based infant formula to differences in gastrointestinal flora, the impact of the latter has been demonstrated beyond doubt. As a consequence, gastro intestinal flora manipulation with pre- and probiotics added to infant formula or food (mainly milk based products) and/or with food supplements have become a priority area of high quality research. The composition of intestinal microbiota can be manipulated with "biotics": antibiotics, prebiotics and probiotics. Commercialised pre- and probiotic products differ in composition and dose. Major threats to the concept of developing a major role for intestinal microbiota manipulation on health are the commercialisation of products claiming health benefits that have not been validated. Legislation of food su...

Acta gastro-enterologica Belgica, 2013

The pathophysiology of inflammatory bowel disease is still incompletely understood. While the dev... more The pathophysiology of inflammatory bowel disease is still incompletely understood. While the development of the immune system and the establishment of the microflora take place during infancy young patients often have a more severe and extensive disease. The differences in composition and concentration of intestinal microbiota and aberrant immune responses towards the luminal bacteria prompted the concept of an 'ecological' approach to control the disease course. Probiotics, living, non pathogenic micro organisms with a beneficial effect on the host, and prebiotics, oligosaccharides promoting the growth of the beneficial microflora, have been studied to this effect. Results have so far been disappointing for Crohn's disease but encouraging for ulcerative colitis. An overview of studies using probiotics in adults or children and a perspective on specific pediatric issues is provided in this review.

Current infectious disease reports, 2013

Probiotics and prebiotics have a major influence on gastrointestinal flora composition. This revi... more Probiotics and prebiotics have a major influence on gastrointestinal flora composition. This review analyses the relationship between this change in flora composition and health benefits in children. Literature databases were searched for relevant articles. Despite exhaustive research on the subject in different indications, such as prevention and treatment of acute gastroenteritis, antibiotic associated diarrhea (AAD), traveler's diarrhea, inflammatory bowel disease, irritable bowel syndrome, Helicobacter pylori, necrotizing enterocolitis, constipation, allergy and atopic dermatitis, colic and extraintestinal infections, reports of clear benefits for the use of prebiotics and probiotics in pediatric disorders remain scarce. The best evidence has been provided for the use of probiotics in acute gastroenteritis and in prevention of AAD. However, AAD in children is in general mild, and only seldom necessitates additional interventions. Overall, the duration of acute infectious dia...

Journal of pediatric gastroenterology and nutrition, 2011

Jornal de pediatria

To evaluate the impact of probiotics and prebiotics on the health of children. MEDLINE and LILACS... more To evaluate the impact of probiotics and prebiotics on the health of children. MEDLINE and LILACS were searched for relevant English and French-language articles. Human milk is rich in prebiotic oligosaccharides and may contain some probiotics. No data suggest that addition of probiotics to infant formula may be harmful, but evidence of its efficacy is insufficient for its recommendation. Since data suggest that addition of specific prebiotic oligosaccharides may reduce infections and atopy in healthy infants, their addition to infant formula seems reasonable. Long-term health benefits of pro- and prebiotics on the developing immune system remain to be proven. Selected probiotics reduce the duration of infectious diarrhea by 1 day, but evidence in prevention is lacking, except in antibiotic-associated diarrhea. Some specific probiotics prevent necrotizing enterocolitis, and other microorganisms may be beneficial in Helicobacter pylori gastritis and in infantile colic. Evidence is in...

Journal of clinical microbiology, 1996

A prospective study compared fecal isolation rates of Campylobacter concisus for children with di... more A prospective study compared fecal isolation rates of Campylobacter concisus for children with diarrhea and without diarrhea by a filter technique in which media were incubated for 4 days in a microaerobic atmosphere. No statistically significant difference in isolation rates was found (13.2% in patients with diarrhea and 9% in controls). Moreover, 35 of 37 children attending the same day care center harbored different C. concisus strains, as was demonstrated by arbitrary primer PCR DNA fingerprinting. These data suggest a lack of a pathogenic role for C. concisus in enteritis.

Jornal de Pediatria, 2001

Pediatric Neurogastroenterology, 2012

ABSTRACT GER and GERD are frequent conditions in infants, children, and adolescents. Symptoms dif... more ABSTRACT GER and GERD are frequent conditions in infants, children, and adolescents. Symptoms differ with age, although the main pathophysiologic mechanism, transient relaxations of the lower esophageal sphincter, is identical at all ages. Although infant regurgitation is likely to disappear with age, little is known about the natural evolution of pediatric GER and GERD. The majority of reflux episodes are weakly acid, but the majority of “esophageal” symptomatic reflux is likely to be acid related. Regarding “extraesophageal manifestations,” measurement of nonacid reflux may be more relevant. Symptoms of GER are not specific and not sensitive. There is no golden-standard diagnostic technique. Impedance in combination with pH-metry is likely to replace simple pH-metry in the future. Treatment of regurgitation and moderate reflux disease should focus on reassurance and dietary and possibly positional treatment. Medical therapeutic options usually involve inhibition of acid suppression, although not all reflux symptoms and disease are caused by acid reflux. Alginates or antacids are useful when immediate symptom relief is required. No currently available prokinetic drug is indicated in the treatment of childhood GERD. Laparoscopic fundoplication is the recommended surgical procedure in selected cases of particularly severe and chronic GERD.