BACKGROUND: Pancreatitis is uncommon in childhood and there is presently no study among Filipino children.

OBJECTIVE: To determine the clinical features and outcome of pancreatitis among Filipino children.

METHOD: Review of medical records of all patients diagnosed to have pancreatitis based on standard criteria from 2005 to 2009.

RESULTS: A total of 23 children (mean age: 12 years; 13 male, 10 female) were included, 21 with acute and two with chronic pancreatitis. Twenty one (91%) presented with abdominal pain and two with jaundice. Nine had idiopathic pancreatitis. In 14 patients, the etiology was identified: bile duct obstruction (7), trauma (2), drugs (2), infection (2) and hypertriglyceridemia (1). Only four of 20 patients with ultrasound examination showed an enlarged pancreas. Complications were pseudocyst formation (6), pancreatic abscess (4), diabetes mellitus (2) and hypocalcemia (1). Of the 23 patients, eight required surgery: pancreatic debridement (4), choledochal cyst excision (2), cholecystectomy (1) and Whipple's procedure (1). All pseudocyst resolved spontaneously. One patient with pancreatic tumor declined surgery and another with pancreatitis due to choledochal cyst died of sepsis.

CONCLUSIONS: In our study, severe abdominal pain was the most frequent presenting symptom of childhood pancreatitis. Sixty percent had an identifiable cause for pancreatitis. A favorable outcome was observed.

Human ; Male ; Female ; Adolescent ; Child ; Child Preschool ; Pancreatitis, Chronic ; Choledochal Cyst ; Abscess ; Hypocalcemia ; Pancreatic Cyst ; Pancreatic Pseudocyst ; Pancreas ; Abdominal Pain ; Jaundice ; Cholestasis ; Hypertriglyceridemia ; Cholecystectomy ; Diabetes Mellitus

RATIONALE: In the Philippines, 25% of children < 10 years old are underweight. The use of energy-dense ready-to-use therapeutic food (RUTF) augments caloric intake. No local studies have evaluated RUTF.

OBJECTIVE: To determine the efficacy, safety and acceptability of a modified RUTF (mRUTF) to supplement caloric intake.

METHOD: One hundred (100) children 18 months to 10 years old with mild to moderate malnutrition were randomized to either mRUTF or control group. The treatment arm received mRUTF during weekdays for 5 weeks while controls had no supplementation. Anthropometric measurements were taken at baseline, weekly for 5 weeks and 2 weeks post-supplementation.

RESULTS: The two groups were comparable at baseline. At five weekly intervals, there was no significant difference in weight, height and mid upper arm circumference between groups, although the mean percentage weight gain of the mRUTF group was higher compared with controls (8% vs 2.6%, p=0.15). Cessation of supplementation resulted in weight loss in the mRUTF group. [mRUTF: -0.40 (0.33) vs -0.03 (0.35), p=0.00]. The taste of mRUTF was acceptable.

CONCLUSION: Ready-to-use-therapeutic food is an effective, safe and acceptable alternative supplement for children, 18 months to 10 years old, with mild to moderate malnutrition.

Human ; Male ; Female ; Child ; Child Preschool ; Infant ; Thinness ; Philippines ; Weight Gain ; Taste ; Arm ; Weight Loss ; Energy Intake ; Dietary Supplements ; Taste Perception ; Malnutrition

BACKGROUND: Incisional hernia is a common complication following visceral organ transplantation. Transplant patients are at increased risk of primary and recurrent hernias due to chronic immune suppression and large incisions. We conducted a retrospective review of patients with a history of liver or kidney transplantation who underwent hernia repair to analyze outcomes and hernia recurrence. METHODS: This is a single center, retrospective review of 19 patients who received kidney and/or liver transplantation prior to presenting with an incisional hernia from 2011 to 2017. All hernias were repaired with open component separation technique (CST) with biologic mesh underlay. RESULTS: The mean age of patients was 61.0±8.3 years old, with a mean body mass index of 28.4±4.8 kg/m², 15 males (78.9%), and four females (21.1%). There were seven kidney, 11 liver, and one combined liver and kidney transplant patients. The most common comorbidities were hypertension (16 patients, 84.2%), diabetes (9 patients, 47.4%), and tobacco use (8 patients, 42.1%). Complications occurred in six patients (31.6%) including hematoma (1/19), abscess (1/19), seroma (2/19), and hernia recurrence (3/19) at mean follow-up of 28.7±22.8 months. With the exception of two patients with incomplete follow-up, all patients healed at a median time of 27 days. CONCLUSIONS: This small, retrospective series of complex open CST in transplant patients shows acceptable rates of long-term hernia recurrence and healing. By using a multidisciplinary approach for abdominal wall reconstruction, we believe that modified open CST with biologic mesh is a safe and effective technique in the transplant population with complex abdominal hernias.
Abdominal Wall ; Abscess ; Body Mass Index ; Comorbidity ; Female ; Follow-Up Studies ; Hematoma ; Hernia ; Hernia, Abdominal ; Herniorrhaphy ; Humans ; Hypertension ; Immunosuppression ; Incisional Hernia ; Kidney Transplantation ; Kidney ; Liver Transplantation ; Liver ; Male ; Organ Transplantation ; Recurrence ; Retrospective Studies ; Seroma ; Surgical Mesh ; Tobacco Use ; Transplants

Objective: To determine the validity of serum H. pylori IgG in the detection of H. pylori-associated gastroduodenitis in patients with gastrointestinal symptoms. Methods: Cross-sectional study which included consecutive patients 1-18 years old with upper gastrointestinal symptoms who underwent esophagogastroduodenoscopy. H. pylori infection was diagnosed by positive tests for both rapid urease test (RUT) and Giemsa stain of gastric biopsies. H. pylori IgG (ELISA) serology was also performed. Results: Twenty-five patients [Mean (SD) age: 12 (4.5) years, 68% females] were included. Majority presented with epigastric pain (64%) and had endoscopic gastritis (84%). Four patients had ulcers (1 antral, 3 duodenal). Giemsa stain was positive in 16 (64%) patients and RUT in one. Prevalence of H. pylori infection was 4%. Serum H. pylori IgG test was positive in two; borderline in three with a 100% sensitivity, 80% specificity, and a positive and negative likelihood ratio of 10.9 and 0.6. Conclusion The present study showed a low prevalence of H. pylori infection, thus, the validity of the H. pylori serology could not be adequately evaluated. We presently could not recommend the serum IgG in the detection of H. pylori gastroduodenitis in our setting.