16 research outputs found

    Patient profiles and endoscopic findings according to the gastroesophageal flap valve grades.

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    <p>Fisher exact test or chi-square test was used for categorical data. Continuous non-parametric variables were compared by Mann-Whitney u test.</p>†<p>Los Angeles classification grade.</p>‡<p>The values of pH monitor and Impedance findings were expressed as median (25%–75% range).</p><p>Patient profiles and endoscopic findings according to the gastroesophageal flap valve grades.</p

    Retroflex view of the gastroesophageal flap valve.

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    <p>(a) Grade I. The prominent fold of tissue along the lesser curvature apposed closely to the endoscope. (b) Grade II. The fold was present but less well defined than in grade I, and some periods of opening and rapid closing around the endoscope were found. (c) Grade III. The fold was not prominent and often failed to close around the endoscope, gripping it tightly. (d) Grade IV. There was no fold and the lumen of the esophagus was open. The squamous epithelium of the esophagus could be seen below.</p

    Infantile Hepatitis B in Immunized Children: Risk for Fulminant Hepatitis and Long-Term Outcomes

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    <div><p>Background</p><p>Infantile hepatitis B after neonatal immunoprophylaxis is a rare yet distinct disease. This study aimed to analyze the long-term outcomes and risk factors in immunized infants with hepatitis B.</p><p>Methods</p><p>The clinical parameters and outcomes of 41 infants born after universal immunization, and admitted for HBV-positive hepatitis were studied. All patients were followed for at least 6 months (median  = 4.4 years, range 0.6–18.1 years). Patient survival, changes of HBsAg and HBeAg status, and complications were analyzed.</p><p>Results</p><p>Among the 41 cases (32 males, 9 females), 21 presented with fulminant hepatitis (FH), and 20 with non-fulminant hepatitis (NFH). Ninety-five percent (36/38) of the mothers were positive for hepatitis B surface antigen (HBsAg). Multivariate analyses revealed younger age of onset (age <7 months) and negative maternal hepatitis B e antigen (HBeAg) were associated with FH (p = 0.03 and p = 0.01, respectively). An infantile fulminant hepatitis B risk score using maternal/infant HBeAg positivity and onset age was proposed. Among the FH cases, the rate of mortality, HBsAg clearance, and chronic HBV infection were 47.6%, 38.1%, and 14.3%, respectively. Among the NFH cases, 35% developed chronic infection. Of the 9 chronically infected children received long-term follow-up, 8 had HBeAg seroconversion before 4 years of age. One case of FH developed hepatocellular carcinoma 14 years later.</p><p>Conclusions</p><p>Maternal HBsAg + /HBeAg- and early onset age were risk factors for FH in immunized infants. A significant portion of patients with FH or NFH evolve to chronic HBV infection, with HBeAg seroconversion in young childhood. Close surveillance for hepatocellular carcinoma is warranted in patients surviving infantile hepatitis B.</p></div

    Clinical characteristics of 41 infants with acute or fulminant hepatitis B.

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    <p>FH: fulminant hepatitis, NFH: non-fulminant hepatitis, HBsAg, hepatitis B surface antigen; HBeAg, hepatitis B e antigen, HBV, hepatitis B virus; HBIG, hepatitis B immunoglobulin; ALT, alanine aminotransferase; INR, international normalized ratio.</p><p>Clinical characteristics of 41 infants with acute or fulminant hepatitis B.</p

    Clinical characteristics and outcome of 21 infants with fulminant hepatitis B.

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    <p>HBsAg, hepatitis B surface antigen; HBeAg, hepatitis B e antigen, HBV, hepatitis B virus;</p><p>HBIG, hepatitis B immunoglobulin; ALT, alanine aminotransferase; INR, international normalized ratio.</p><p>Clinical characteristics and outcome of 21 infants with fulminant hepatitis B.</p
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