The Changing Prevalence of Helicobacter Pylori Infection in Canadian Children: Should Screening Be Performed in High-Risk Children?

While several studies have demonstrated a decline in the overall prevalence of Helicobacter pylori infection in developed countries, there is variability in the burden of infection linked to socioeconomic status and living conditions. Improved socioeconomic status, living conditions and the availability of H pylori-eradication therapy have been associated with a lower prevalence of infection in First World populations, yet immigrants and indigenous people continue to have a high burden of H pylori infection and disease. Although the changing prevalence of H pylori infection in children has been recognized in a few reports, further studies are required to determine the impact of H pylori infection in this population. Moreover, additional studies are required for those populations at risk

Pressure on the Trigger Will Now Fire the Weapon: An Examination of how the Supreme Court, Congress, and Presidents Have Left the Legal Foundation for Executive Detention Akin to the World War II Era Internment of Japanese Americans Largely Intact

Contrary to Chief Justice Robert\u27s dicta, Trump v. Hawaii (2018) did not overrule Korematsu v. United States (1944) which upheld the exclusion of Japanese Americans from the West Coast during World War II. Korematsu and its related cases are still troublingly vital. Their expansive reading of the war powers justifying executive detention has been bolstered by the Court\u27s cases addressing detainees held at Guantanamo Bay. Hamdi v. Rumsfeld (2004), which sanctioned the detention of a U.S. citizen pursuant to the Authorization for the Use of Military Force, exposed a fundamental weakness in the Non-Detention Act, the principal statutory barrier to executive detention. Today, despite the appalling history of the World War II era internment of Japanese Americans, the authority of the President to employ preventive executive detention remains both remarkably intact and remarkably broad. That authority should be restrained by appropriate amendments to the Non-Detention Act

Mucosa-Associated Lymphoid Tissue Lymphoma of the Lacrimal Gland: Sustained Remission after Eradication of Helicobacter Pylori Infection

Mucosa-associated lymphoid tissue (MALT) lymphoma is the third most common non-Hodgkin lymphoma, and it is strongly associated with helicobacter pylori infection of the stomach. MALT lymphoma of the lacrimal gland usually presents as a localized disease process in extranodal tissues. The treatment options of MALT lymphoma of the lacrimal gland chiefly include radiation of the tumor, chemotherapy, surgical removal, or a combination of these strategies. We report a case of localized MALT lymphoma of the lacrimal gland, with prolonged sustained remission after eradication of gastric Helicobacter pylori (H. Pylori) infection. He sustains in remission of lacrimal MALT lymphoma for four years without chemotherapy or radiotherapy

Magnetic Resonance Imaging of the Perineum in Pediatric Patients with Inflammatory Bowel Disease

Magnetic resonance imaging (MRI) has profoundly changed and improved the investigation of abdominal and pelvic inflammatory bowel disease (IBD) in pediatrics. Using an imaging modality without ionizing radiation is of particular advantage because the pediatric IBD population is young and often requires repeat evaluation. MRI of the pelvis has become the imaging gold standard for detecting and monitoring perianal disease while bowel-directed imaging techniques (eg, enterography, enteroclysis and colonography) can accurately evaluate bowel inflammation in IBD. With recent technological innovations leading to faster and higher resolution, the role of MRI in IBD will likely continue to expand. The present article focuses on MRI of the perineum in pediatric IBD

Fasting increases microbiome-based colonization resistance and reduces host inflammatory responses during an enteric bacterial infection.

We thank BC Children’s Hospital Research Institute (BCCHR) animal facility staff as well as the BCCHR histology core for their assistance. We thank Ms. Caixia Ma for assistance with animal handling. We thank Gut4Health for assistance with microbiome analysis and the rest of the Vallance lab for feedback and valuable discussions. We thank Dr. Jose Puente and Ms. Carmen Contreras for generating the luciferase reporter construct and Dr. Leigh Knodler for helpful discussions.Peer reviewe

Allied Health Professional Support in Pediatric Inflammatory Bowel Disease: A Survey from the Canadian Children Inflammatory Bowel Disease Network—A Joint Partnership of CIHR and the CH.I.L.D. Foundation

Objectives. The current number of healthcare providers (HCP) caring for children with inflammatory bowel disease (IBD) across Canadian tertiary-care centres is underinvestigated. The aim of this survey was to assess the number of healthcare providers (HCP) in ambulatory pediatric IBD care across Canadian tertiary-care centres. Methods. Using a self-administered questionnaire, we examined available resources in academic pediatric centres within the Canadian Children IBD Network. The survey evaluated the number of HCP providing ambulatory care for children with IBD. Results. All 12 tertiary pediatric gastroenterology centres participating in the network responded. Median full-time equivalent (FTE) of allied health professionals providing IBD care at each site was 1.0 (interquartile range (IQR) 0.6–1.0) nurse, 0.5 (IQR 0.2–0.8) dietitian, 0.3 (IQR 0.2–0.8) social worker, and 0.1 (IQR 0.02–0.3) clinical psychologists. The ratio of IBD patients to IBD physicians was 114 : 1 (range 31 : 1–537 : 1), patients to nurses/physician assistants 324 : 1 (range 150 : 1–900 : 1), dieticians 670 : 1 (range 250 : 1–4500 : 1), social workers 1558 : 1 (range 250 : 1–16000 : 1), and clinical psychologists 2910 : 1 (range 626 : 1–3200 : 1). Conclusions. There was a wide variation in HCP support among Canadian centres. Future work will examine variation in care including patients’ outcomes and satisfaction across Canadian centres

Diagnostic Delay Is Associated with Complicated Disease and Growth Impairment in Paediatric Crohn\u27s Disease

Background: Paediatric data on the association between diagnostic delay and inflammatory bowel disease [IBD] complications are lacking. We aimed to determine the effect of diagnostic delay on stricturing/fistulising complications, surgery, and growth impairment in a large paediatric cohort, and to identify predictors of diagnostic delay. Methods: We conducted a national, prospective, multicentre IBD inception cohort study including 1399 children. Diagnostic delay was defined as time from symptom onset to diagnosis \u3e75th percentile. Multivariable proportional hazards [PH] regression was used to examine the association between diagnostic delay and stricturing/fistulising complications and surgery, and multivariable linear regression to examine the association between diagnostic delay and growth. Predictors of diagnostic delay were identified using Cox PH regression. Results: Overall (64% Crohn\u27s disease [CD]; 36% ulcerative colitis/IBD unclassified [UC/IBD-U]; 57% male]), median time to diagnosis was 4.2 (interquartile range [IQR] 2.0-9.2) months. For the overall cohort, diagnostic delay was \u3e9.2 months; in CD, \u3e10.8 months and in UC/IBD-U, \u3e6.6 months. In CD, diagnostic delay was associated with a 2.5-fold higher rate of strictures/internal fistulae (hazard ratio [HR] 2.53, 95% confidence interval [CI] 1.41-4.56). Every additional month of diagnostic delay was associated with a decrease in height-for-age z-score of 0.013 standard deviations [95% CI 0.005-0.021]. Associations persisted after adjusting for disease location and therapy. No independent association was observed between diagnostic delay and surgery in CD or UC/IBD-U. Diagnostic delay was more common in CD, particularly small bowel CD. Abdominal pain, including isolated abdominal pain in CD, was associated with diagnostic delay. Conclusions: Diagnostic delay represents a risk factor for stricturing/internal fistulising complications and growth impairment in paediatric CD

A literature review of intimate partner violence and its classifications

Intimate partner violence is an important issue and attempts to distinguish typologies of intimate partner violence are necessary to understand the complexities of intimate partner violence, its various causes, correlates, and consequences. Over the last two decades, much research was aimed at classifying types of violence depending on the similarities and differences in patterns of violence. However, it is difficult to find a single account that provides a succinct and up-to-date overview of these classifications. As a result, considerable effort is required to identify and retrieve relevant papers to understand each typology or classification of intimate partner violence. This article provides a succinct and up-to-date integrative review of various classifications of intimate partner violence. Typologies by form of abuse, type of violence, type of perpetrator (men and women) are critically reviewed in the light of available literature and the strengths and limitations of each are described. Recommendations for further research are also provided