UNDERSTANDING THE MULTIPLE FACETS OF HELICOBACTER PYLORI INFECTION IN CHILDREN

Helicobacter pylori (H. pylori) is a bacterium that colonizes the gastric mucosa and which is known for its ability to survive in the acidic environment of the stomach, thanks to its unique spiral shape and the presence of multiple flagella. Thus, H. pylori infection may present under the shape of multiple clinical entities and understanding its various facets is crucial for effective diagnosis and treatment. The importance of H. pylori infection in children lies in its potential to cause significant morbidity and long-term complications. This article aims to provide an overview of the importance of H. pylori infection in children, including its epidemiology, clinical manifestations, and treatment. Through a better understanding of this common infection, healthcare providers can work towards improving the diagnosis and management of H. pylori infection in children, ultimately improving the long-term health outcomes of affected individuals

Thrombosis in Chronic Kidney Disease in Children

Venous thromboembolism (VTE) in children is a rare condition. An increased incidence has been observed in the last few years due to several factors, such as increased survival in chronic conditions, especially chronic kidney disease (CKD), use of catheters, and increased sensitivity of diagnostic tools. VTE includes deep vein thrombosis (DVT) and pulmonary embolism (PE). VTE in children is associated with a two to six times higher mortality risk and a 5–10% prevalence of post-thrombotic syndrome. Overall, 5% of VTE episodes in children are associated with chronic kidney disease. The etiology of VTE in chronic kidney disease covers a wide range of pathologies. Various types of thrombotic complications may occur during long-term use of a chronic dialysis catheter. VTE occurs in 3% of children with nephrotic syndrome (NS). The risks for VTE and arterial thromboembolism (ATE) were particularly high in the first 6 months after the onset of NS. Other causes of VTE are graft rejection due to thrombosis of vascular anastomoses after kidney transplantation (3%) and autoimmune diseases (lupus nephritis, antiphospholipid syndrome). In this state-of-the-art overview, we have reviewed the physiologic and pathologic mechanisms underlying pediatric thrombosis and updated current diagnostic and treatment options, emphasizing personal experience as well