GERD is a frequent problem in children with FC. Treatment of the constipation can improve the reflux symptoms and abnormal acid reflux in these cases. Physicians should bear in mind the co-occurrence of these two prevalent problems for better disease management.
The objective of this prospective cross-sectional study was to compare a Mycobacterium tuberculosis-specific interferon gamma (IFN-γ) enzyme linked immunosorbent assay [QuantiFERON-TB Gold In-Tube (QFT-GIT)] test with tuberculin skin test (TST) for detection of latent tuberculosis infection (LTBI) in patients with juvenile idiopathic arthritis (JIA). To our knowledge, this is the first study evaluating the performance of QFT-GIT in comparison with TST in JIA. A cross-sectional study of 39 children with JIA and 40 healthy controls was conducted in İzmir, Turkey. Blood was for drawn for the QFT-GIT assay prior to administration of the TST using 5 tubercullin units (TU) of purified protein derivative (PPD-S). A positive TST was defined as ≥10 mm for JIA and ≥15 mm for controls. Statistical analysis was performed using SPSS version 16.0 for Windows. There were no significant differences between JIA patients and controls for age, sex, and Bacillus Calmette-Guérin (BCG) vaccination. Of patients, 70% had active JIA disease. The median TST induration was 5.8 mm (±5.7 mm) for JIA and 10.7 mm (±4.5 mm) for the control group, which was statistically significant (p = 0.000). The rate of patients who showed no reaction to TST was 38%, of which 93% had active disease. There were two patients who had positive IFN-γ results but negative TST, who had systemic and polyarticular type JIA, respectively. Overall agreement between TST and QFT-GIT was low both in JIA and control group (κ value =0.06 and 0.10, respectively). TST may be inadequate to diagnose LTBI in JIA patients. The IFN-γ assay may be useful to identify false negative TST response in cases with latent M. tuberculosis infection. The combination of IF QFT-GIT method with TST would provide successful diagnostic screening for LTBI in JIA, particularly prior to anti-tumor necrosis factor treatment. Long-term prospective studies are still necessary to appreciate the advantages and the applicability of these tests in pediatrics.
Introduction: To compare the bioelectric impedance analysis (BIA) with indirect measurement methods in the evaluation of obese children. To determine the diagnostic value of BIA in the fatty liver and metabolic syndrome (MS) in obese children. Population and methods: One hundred thirty-four obese children whom ≥10 years of age were prospectively assessment. All patients were evaluated by foot to foot BIA and indirect measurement methods. Blood biochemical parameters such as glucose, lipids and insulin levels were studied and oral glucose tolerance test was performed. Fatty liver was assessed by ultrasonography. Compared BIA records and indirect measurements findings according to fatty liver and MS. Results: The study included females/males: 77/57, mean age of 13.3 ± 2.2 years. Fatty liver was detected in 94 patients, MS was diagnosed in 58 cases. There were no gender difference in terms of fatty liver and MS. Fatty liver was seen more frequently in patients with metabolic syndrome than in those without metabolic syndrome (p < 0.001). Fat Mass (FM) of ≥ 97th percentile was observed in 63% of the 94 patients with fatty liver versus 37.5% of 40 patients without fatty liver. A FM of ≥97th percentile was observed in 72% (n=42) of the 58 patients with metabolic syndrome, 42% (n=33) of 76 patients without MS. Body mass index, upper mid-arm circumference, waist circumference (WC), and hip circumference values were significantly increased in patients with fatty liver. There was a better correlation was determined between FM and FM Index with fatty liver compared to indirect measurement methods. BIA records were found moderately correlated with indirect measurements. Conclusion: Our results revealed that FM and FMI have a better correlated in obese children with fatty liver and metabolic syndrome than indirect measurement methods. The measurement of body FM by BIA can be used together with the indirect measurement methods to detect the fatty liver. FMI may be an alternative diagnostic criterion instead of WC for diagnosis of MS in children.
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