Helicobacter pylori (H. pylori) is one of the most common chronic bacterial infections in the world, and it is currently estimated that approximately half of the world's population is infected with the bacterium. The correct diagnosis and effective treatment of H. pylori gastric infection are essential in controlling this condition. The available diagnostic methods have advantages and limitations related to factors such as age of patients, technical difficulty level, costs and extensive accessibility in hospitals. The eradication therapy of H. pylori infection is still a challenge for gastroenterologists. One of the main causes of failure in H. pylori eradication is antibiotic resistance. Biopsy cultures are the most widely used methods among the antimicrobial susceptibility tests. In case of a negative culture, H. pylori can be clearly recognised in histological sections. The sensitivity and specificity of histology for the diagnosis depend on clinical settings, density of colonisation and the experience of the histopathologist. A prospective study was performed in order to analyse patients with H. pylori gastric infection with positive histology and positive culture versus positive histology and negative culture.

The current gold standard for the detection of Helicobacter pylori in children remains upper endoscopy plus mucosal biopsies. Endoscopy has the advantage of being able to detect complications of Helicobacter pylori infection and to rule out other upper gastro-intestinal pathologies. An additional advantage of endoscopy with gastric biopsy is that it allows physicians to obtain mucosa for urease testing, histological examination and bacterial culture. In children, there is a high correlation between antral nodularity at endoscopy and the presence of Helicobacter pylori infection. The authors have proposed to investigate the correlations between macroscopic aspects during endoscopy and histological findings, in order to identify those endoscopic and histopathological features that can help the clinician in clinical practice.

Constipation is a common problem in childhood, with a children prevalence varying between 0.7% and 29.6%. Constipation is encountered in all pediatric age groups, with variably severity and duration, from mild and short to severe and chronic forms, with faecal impact and encopresis. This article review the epidemiological, clinical and therapeutically aspects of children constipation, functional in the majority of cases.

Constipaţia este un fenomen comun în practica pediatrică. Prevalenţa sa este în creştere, fiind prezentă, conform diferitelor statistici, la 0,7-29,6% dintre copii. Constipaţia este întâlnită la toate grupele de vârstă, cu severitate şi durată variabile, de la forme uşoare şi de scurtă durată la forme severe şi de lungă durată, cu impactare fecală şi in continenţă fecală. Acest articol revede aspectele epidemiologice, clinice şi terapeutice ale constipaţiei la copil, funcţionale în majoritatea cazurilor.

Background and aimsMultichannel intraluminal impedance (MII) is a pH-independent method of assessing gastroesophageal reflux. We aimed to evaluate the diagnostic accuracy of MII-pH as compared with conventional pH monitoring in detecting reflux events and symptom association.Materials and methodsA retrospective study was performed. For patients suspected of GER, without anti-reflux treatment, examined through MII-pH and with normal pH-metry (differently defined according to age), the following were analysed: the number of weekly acid reflux (WAR) episodes, the number of weekly alkaline reflux (AlkR) episodes, the symptomatic correlation between reflux and symptom by analysing the probability of symptomatic association (SAP), the extension of reflux episodes within the level of proximal oesophagus recorded in percentage.Results35 children (20 male, 15 female), age between 1 month and 11 years (22 infants), were recorded. The reasons for recommending pH-metry associated with electrical impedance were recurrent vomiting and growth failure in 22 cases, recurrent wheezing associated with chronic vomiting in 7 cases and recurrent wheezing or chronic cough in 6 cases. All patients showed in most cases an extension of the reflux episodes at a proximal oesophagus level. WAR was increased in the case of 23 children, 9 positive symptomatic correlation (4 with acid reflux) and 4 increased WAR as well as positive symptomatic correlation. AlkR episodes were absent in all children. The therapeutic recommendations were: hypoallergenic diet in 17 cases, prokinetic agents and/or alginates for 19 patients and histamine 2 receptor antagonists (H2RAs) or proton pump inhibitors (IPPs) in 8 cases.ConclusionThe association of electrical impedance to pH-metry provides new criteria in establishing pathological GER diagnosis, and allows an accurate therapeutic approach in the case of these children.