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Browsing by Author "Harris, Paul R."

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Análisis comparativo y perfil de publicaciones en la Revista Chilena de Pediatría 2001-2006
(2007) Harris, Paul R.; Liebbe G., J.L.; Sotomayor A., J.; Ugarte P., F.; Cano Sch., F.
Background: The Revista Chilena de Pediatría (Rev Chil Pediatr), official journal of Sociedad Chilena de Pediatría is index in SciELO, but not in the National Library of Medicine (NLM) of USA. Objectives: a) Determine the profile of published and visited articles of Rev Chil Ped, in order to compare them with the Jornal de Pediatria from Brazil (J Ped Br) and the Journal of Pediatrics (J Ped) from USA. b) Evaluate the visibility of Rev Chil Pediatr compared to Revista Medica de Chile (Rev Med Chil). Method: On line issues from the above mentioned journal were evaluated through SciELO database and PubMed database from 2001 - 2006. A random and representative subset of published articles was obtained from each one of the 3 journals during the referred period. The most visited articles from Rev Chil Pediatr were analyzed and classified as originals (clinical and basic research) and non originals (editorial, clinical case, reviews and others). The articles were classified according to thematic content in 25 medical specialties. In addition, the number of annual visits to Rev Chil Pediatr and Rev Med Chil were analyzed, including the most frequent citations given and received in that period of time. Results: Out of 512 articles in Rev Chil Pediatr, 220 were analyzed; 35% were originals and 65% non originals, with a significant lower percentage of original articles compared to J Ped Br and J Ped (p < 0.05). The thematic areas with more articles were respiratory disease, infectious diseases and nutrition with 9.1, 7.7 and 7.7%, respectively. Rev Chil Pediatr published twice as many nutrition articles and five times more public health articles compared to J Ped (p < 0.05). The most visited articles on line were of nutrition, infectious diseases, respiratory diseases and neonatology. Among the 10 most visited articles from Rev Chil Pediatr, 7 were review articles. Since 2005, an explosive growth is detected in the number of visits to articles from Rev Chil Pediatr in SciELO. When the number of visits was adjusted to the number of physicians belonging to the corresponding society, there was a higher number of visits to Rev Chil Pediatr from 2005 compared to Rev Med Chile. Conclusion: The thematic content of Rev Chil Pediatr is similar to regional journals, but different to international ones. There is an appropriate correlation between published and visited articles. SciELO has been an important tool that contributes to the diffusion of research published in Rev Chil Pediatr. © 2007 Sociedad Chilena de Pediatría.
Análisis genético molecular en niños con fibrosis hepática congénita
(2008) Harris, Paul R.; Cavagnaro, F.
Association of metabolic syndrome markers with abnormal alanine aminotransferase levels in healthy children
(SOC MEDICA SANTIAGO, 2012) Arancibia, Gabriel; Garcia, Hernan; Jaime, Francisca; Bancalari, Rodrigo; Harris, Paul R.
Background: There is a high prevalence of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) among pediatric patients. The identification of clinical predictors of these conditions would allow a timely treatment. Aim: To evaluate the relationship between serum alanine aminotransferase levels and parameters of metabolic syndrome in asymptomatic school students without hepatic illness. Subjects and Methods: A randomized sample of 175 children aged between 9 and 14 years (54% females) was selected, from a database of 3010 students living in Santiago, Chile. Weight, height, abdominal circumference, systolic and diastolic blood pressure were measured. A fasting blood sample was obtained to measure glucose, total cholesterol, HDL, LDL-cholesterol, triglycerides, alanine aminotransferase (ALT) and insulin levels. Results: Forty percent of participants were obese, 17% had metabolic syndrome and 13.1% had abnormal ALT levels. Compared with children with normal ALT levels, the latter had significantly higher waist obesity, body mass index, systolic and diastolic blood pressure and triglycerides. However on multivariate analysis, only waist obesity was independently associated with abnormal ALT levels (adjusted odds ratio 3.93, 95% confidence intervals 1.44-10.78, p = 0.008). Conclusions: Only waist obesity was independently associated with abnormal ALT levels in this sample of children. (Rev Med Chile 2012; 140: 896-901).
CagA antibodies as a marker of virulence in Chilean patients with Helicobacter pylori infection
(2003) Harris, Paul R.; Godoy, A.; Arenillas, S.; Riera, F.; Garcia, D.; Einisman, H.; Pena, A.; Rollan, T.; Duarte, I.; Guiraldes, E.; Perez-Perez, G.
Background: The bacterial and host factors that influence the clinical outcomes of the Helicobacter pylori infection have not been fully identified. Cytotoxin-associated gene product (CagA), one of the virulence factors, has been associated with a more aggressive form of infection. The authors studied the relationship between CagA status and clinical outcome in Chilean children and adults with H. pylori infection. Methods: One hundred eighty consecutive patients undergoing upper gastrointestinal endoscopic analysis were enrolled after informed consent was obtained. Rapid urease test and histologic analysis were used to detect H. pylori infection. IgA and IgG antibodies to H. pylori whole cell antigen preparation and IgG antibodies to CagA were measured by enzyme-linked immunosorbent assay (ELISA). Results: H. pylori infection was detected in 42% of the patients by biopsy or urease test and in 38% and 20% of patients by IgG and IgA antibodies, respectively. The prevalence of H. Pylori either by the invasive or the serologic tests was directly related to patient age. Among patients with H. pylori, there was no significant association between age and prevalence of CagA. Nearly 70% of the patients with H. pylori and peptic ulcer disease had CagA-positive strains. In contrast, only 49% of the patients with chronic gastritis alone had CagA-positive strains (P < 0.05). Conclusions: In Chile, patients infected with H. pylori have a proportion of CagA-positive strains similar to that reported in developed countries. CagA prevalence was not significantly different in adults and children infected with H. pylori, suggesting that variations in clinical outcome may be related to host immune or environmental factors.
Characterization of the gastric lesions in Chilean children with sysptomatic Helicobacter pylori associated gastritis
(1999) Guiraldes, E.; Pena, A.; Duarte, I.; Trivino, X.; Schultz, M.; Larrain, F.; Espinosa, M.N.; Harris, Paul R.
Clinical and morphological features of cholelithiasis in children
(2003) Harris, Paul R.; Chateau I, B.; Miquel P, J.F.; Zavala B, A.; Montes C, P.; Herrera V, J.M.; Zúñiga R, S.; Larraín B, F.; Santos M, M.; Contador M, M.
Background: The use of ultrasonography increased the frequency of diagnosis of cholelithiasis in childhood. Aim: To determine the clinical and laboratory features and follow up of children with biliary stones. Patients and methods: Twenty six children (13 male, aged 1 month to 14 years) were prospectively enrolled. Results: Nine children had a past medical history of factors potentially predisposing to stones. A clinical presentation with vomiting (50%), abdominal pain (46%) and jaundice (23%) was the most common indication for surgery. The diagnosis was based on abdominal ultrasound in all children. Cholecystectomy was performed in 15 children (laparoscopy in 13 and open surgery in 2). Children who underwent surgery were older than those who did not undergo surgery (p)
Congenital hepatic fibrosis. Report of five cases.
(2004) Harris, Paul R.; Fodor, D.; Cavagnaro, F.; Di Egidio, M.; Duarte, I.; Fava, M.
Background. Congenital hepatic fibrosis (CHF) is an autosomic dominant disease that has been associated with polycystic kidney disease. Aim: To describe the medical management of 5 children with CHF and to evaluate the presence and extension of the associated renal disease. Patients and methods: Retrospective review of the medical charts of 5 children with CHF, aged 2 to 14 years. Results: Three children presented autosomic recessive polycystic kidney disease, which was diagnosed before the appearance of liver disease manifestations. They presented a more severe liver damage, with a more aggressive clinical course requiring use of transjugular intrahepatic porto-systemic shunts (TIPS) or surgical porto-systemic shunts to control portal hypertension. The other two children, in whom the diagnosed was based on asymptomatic hepatomegaly, had normal renal function and structure with a more benign clinical course. Conclusions: The diagnosis of CHF should be suspected not only in children with polycystic kidney disease but in those children with persistent, hard consistency, left lobe predominance hepatomegaly.
COVID-19 en América Latina: Retos y oportunidades
(2020) Pierre Álvarez, Reinaldo; Harris, Paul R.
COVID-19 (Coronavirus Disease 2019), la enfermedad provocada por el virus SARS-CoV-2, declarada pandemia global por la Organización Mundial de la Salud (OMS) el 11 de Marzo de 20201, comienza a acelerar su propagación en América. Estados Unidos supera ya los 100,000 casos y los 1,500 fallecidos, mientras que en América Latina se reportan hasta el momento más de 10,000 casos confirmados y una tasa creciente de muertes (figura 1). Las experiencias de China, Corea del Sur, el comportamiento actual de la pandemia en Estados Unidos y en algunos países europeos, deben ser analizados y tomados en consideración como señales de alarma frente a lo que podría suceder a corto plazo en nuestra región.
Diagnóstico de la infección por Helicobacter pylori en niños mediante la detección de antígenos en deposiciones
(2007) González, Carmen Gloria; Serrano, Carolina; Harris, Paul R.
Background: During infancy, preventive, diagnostic and therapeutic efforts for Helicobacter pylori infection should be made. Aim: To evaluate non-invasive diagnostic methods such as stool antigen test (HpSA) and serum anti-H pylori antibody detection (IgG e IgA), compared to endoscopy-based invasive methods (histology and urease test) for the diagnosis of Helicobacter pylori infection. Patients and Methods: Thirty nine children (aged 3 to 14 years, 20 males) referred for upper gastrointestinal endoscopy, were studied. The gold standard to diagnose Helicobacter pylori infection was defined as a positive invasive diagnostic test (histology and/or urease test). Sensitivity (S), specificity (E) and positive (PPV) and negative (NPV) predictive values were obtained for HpSA and serum antibodies. Results: Ten children (26%) were infected with H pylori. S, E, PPV and NPV for HpSA were 90, 100, 100 and 97%, respectively. The figures for serum IgG were 81, 97, 89 and 93%, respectively and for IgA, 90, 76, 36 and 96%, respectively. Conclusions: HpSA was sensitive and specific as a clinical and epidemiological tool to evaluate H pylori infection in children. Serology was not as accurate, but IgG had a better performance than IgA. © 2007 Sociedad Médica de Santiago.
Esofagitis eosinofílica en niños: Características clínicas y endoscópicas
(2009) González, Carmen Gloria; Torres, Javiera; Molina, Ricardo; Harris, Paul R.
Evaluación prospectiva de la seguridad y tolerancia de los procedimientos colonoscópicos en pacientes pediátricos
(2006) Gana, Juan Cristobal; Glenz, Constanza; Marchant, Pamela; Vaca, Carina; García, Ximena; Larraín, Francisco; Harris, Paul R.
Background: Colonoscopy is a well established diagnostic and therapeutic procedure in pediatrics. Aim: To evaluate colon preparation alternatives for colonoscopy or sigmoidoscopy, type of sedation, clinical indications and findings. Patients and methods: Prospective study of 123 children referred for colonoscopy. Demographic data, type of colon preparation, sedation, type of endoscope and endoscopic results were obtained. The following day, a phone interview was carried out inquiring about duration, quality and adverse effects of the sedation and procedure. Results: Seventy one boys (58%) and 52 girls (42%) with a mean age of 6.7±4.4 years, were recruited. The main indication was lower gastrointestinal bleeding (71%). The different colon preparations produced elimination of clear liquid stools in 50%, non transparent liquid in 23%, semi liquid in 22% and solid in 6% of the patients. Most common side effects were abdominal distension (20%) and nausea (16.8%). The most commonly used drugs were midazolam (76%) and demerol (43%). The average duration of the procedure was 18.3 minutes (range: 4-50). The most common findings were rectal polyps (18.7%) and hemorrhagic colitis (14.6%). In 77% of cases, the sedation was considered very good or good. Colon visualization was described as very good (51%) or good (36%). Seventy three percent of children had complete amnesia. The most common adverse effect was vomiting (7.5%). Conclusion: Lower endoscopies are feasible procedures to carry out in children, in an ambulatory basis, with intravenous sedation and minimum adverse effects.
Evaluación prospectiva de la seguridad y tolerancia de los procedimientos colonoscópicos en pacientes pediátricos
(2006) Gana A., Juan Cristobal; Glenz A., Constanza; Marchant A., Pamela; Vaca Z., Carina; Garcia R., Ximena; Larrain B., Francisco; Harris, Paul R.
Colonoscopy is a well established diagnostic and therapeutic procedure in pediatrics. Aim: To evaluate colon preparation alternatives for colonoscopy or sigmoidoscopy, type of sedation, clinical indications and findings. Patients and methods: Prospective study of 123 children referred for colonoscopy. Demographic data, type of colon preparation, sedation, type of endoscope and endoscopic results were obtained. The following day, a phone interview was carried out inquiring about duration, quality and adverse effects of the sedation and procedure. Results: Seventy one boys (58%) and 52 girls (42%) with a mean age of 6.7±4.4 years, were recruited. The main indication was lower gastrointestinal bleeding (71%). The different colon preparations produced elimination of clear liquid stools in 50%, non transparent liquid in 23%, semi liquid in 22% and solid in 6% of the patients. Most common side effects were abdominal distension (20%) and nausea (16.8%). The most commonly used drugs were midazolam (76%) and demerol (43%). The average duration of the procedure was 18.3 minutes (range: 4-50). The most common findings were rectal polyps (18.7%) and hemorrhagic colitis (14.6%). In 77% of cases, the sedation was considered very good or good. Colon visualization was described as very good (51%) or good (36%). Seventy three percent of children had complete amnesia. The most common adverse effect was vomiting (7.5%). Conclusion: Lower endoscopies are feasible procedures to carry out in children, in an ambulatory basis, with intravenous sedation and minimum adverse effects.
Fibrosis Hepática congénita: un espectro clínico variable: Casos clínicos
(2004) Harris, Paul R.; Fodor, D.; Cavagnaro, F.; Di Egidio, M.; Fava, M.
Background: Congenital hepalic fibrosis (CHF) is an autosomic dominant disease that has been associated will polycistic kidney disease. Aim. To describe The medical managment of 5 children with CHF and to evaluate the presence and extension of the associated renal disease. Patients and methods. Retrospective review of the medical charts of 5 children with CHF aged 2 to 14 years. Results: Three children presented autosomic recessive polycistic kidney disease, which was diagnosed before the appearance of liver disease manifestations. They presented a more severe liver damage with a more aggressive clinical course requiring use of transjugular intrahepatic porto-systemic shunts (TIPS) or surgical porto-systemic shunts to control portal hypertension. The other two children, in whom the diagnosed was based on asymptomatic hepatomegaly had normal renal function and structure with a more benign clinical course. Conclusions: The diagnosis of CHT should be suspected not only in children with polycystic kidney disease but in those children with persistent, hard consistently, left lobe predominance hepatomegaly.
Gastric cancer is related to early Helicobacter pylori infection in a high-prevalence country
(AMER ASSOC CANCER RESEARCH, 2007) Ferreccio, Catterina; Rollan, Antonio; Harris, Paul R.; Serrano, Carolina; Gederlini, Alessandra; Margozzini, Paula; Gonzalez, Claudia; Aguilera, Ximena; Venegas, Alejandro; Jara, Alejandro
Background and Aims: Chile ranks fifth in the world among countries with the highest incidence of gastric cancer. The aim was to quantify the association between Helicobacter pylori infection and gastric cancer mortality at the county of residence.
Gastroenterología y Nutrición como una sola Especialidad de la pediatría
(2010) Harris, Paul R.; Hodgson B., Maria Isabel; Soriano B., Humberto; Gana A., Juan Cristobal
Helicobacter pylori-associated hypochlorhydria in children relates to the development of iron deficiency
(2010) Harris, Paul R.; Villagran, A.; Serrano, C.; Duarte, I.; Windle, H. J.; Crabtree, J. E.
Introduction Acute H pylori infection is associated with transient hypochlorhydria of variable duration. Hypochlorhydria in H pylori-associated atrophy has a role in iron deficiency (ID) through changes in the physiology of iron absorption. The role of hypochlorhydria in H pylori-associated ID in childhood has not been investigated. The aims were to evaluate the association between H pylori-associated hypochlorhydria and ID in children. Methods A total of 123 children were prospectively enrolled in the study. Any child with peptic ulceration, or who received antacids, PPIs, H2 antagonists, and antibiotics in the previous 4 weeks was excluded. Blood was taken for complete blood count and iron profile. Gastric biopsies were taken for H. pylori determination by histology and rapid urease test. H pylori status was defined as +ve if either test was positive. Gastric juice was obtained at the beginning of the endoscopy avoiding water insufflation. Duodenal biopsies were taken for exclusion of coeliac disease (CD). Stool samples were collected for parasitology/microbiology. Of the 123 children, 2 with CD, 8 with non-specific duodenal inflammation (DI), 5 with lost blood analysis and 9 with parasitic infections (2 with DI) were excluded. Results Of the remaining 101 children 31 were H pylori +ve and 10 were hypochlorhydric (pH>4). There were no differences in demographic characteristics with regard to infection status, or gastric pH. In H pylori +ve children with pH >4 (n=6) serum iron (median (IQR): 60.2 (45–66) μg/dl) and transferrin saturation levels percentage (16.6 (15–19)) were significantly lower (p<0.01) than H pylori positive children (n=25) with pH≤4 (iron 113.2 (91–132); transferrin saturation 32.6 (24–38)). No differences in ferritin or TIBC were observed. In H pylori negative children with pH>4 (n=4) both iron (119 (101–137)), and transferrin saturation (36.4 (31–41)), were not significantly different from children with pH≤4 (n=66) (iron 98.7 (80–122); transferrin saturation 32.2 (25–40)). Conclusion: Low serum iron and transferrin in childhood H pylori infection is associated with hypochlorhydria. In uninfected children, hypochlorhydria was not associated with altered serum iron parameters, indicating a combination of H pylori infection and/or inflammation and hypochlorhydria has a role in the aetiology of iron deficiency. Even though H pylori-associated hypochlorhydria may reflect a transient period during acute gastritis, it alters iron homeostasis with clinical impact in developing countries with a high H pylori prevalence. Funded by EU CONTENT Project (INCO-CT-2006-032136) and CONICYT/BM (RUE #29).
Immunity y Helicobacter pylori
(2011) Harris, Paul R.
Helicobacter pylori a Gram negative bacterium that colonizes gastric mucosa and that has been associated to different disease such as chronic gastritis, duodenal ulcers and gastric cancer. Although the infection by itself is able to produce damage to the gastric mucosa through the expression and interaction of well-known virulence factors, the immune local response is strongly involved in the pathogenesis of H. pylori-associated diseases. The classic dichotomy T helper type 1 vs type 2 response to explain the damage associated to the bacterium, has been reevaluated in a more complex scenario with the recent description of the T regulatory response and the new patterns of T helper response such as Th17. The extremely well balanced equilibrium between virulence and immune infl ammatory response is mainly regulated by the intensity of the T regulatory response; its suppression would allow the expression of different T helper responses that account for the fi nal damage and clinical outcomes.
Inverse correlation between allergy markers and Helicobacter pylori infection in children is associated with elevated levels of TGF-beta
(LIPPINCOTT WILLIAMS & WILKINS, 2011) Serrano, Carolina A.; Talesnik, Eduardo; Pena, Alfredo; Rollan, Antonio; Duarte, Ignacio; Torres, Javiera; Majerson, Daniela; Einisman, Helly; Viviani, Paola; Harris, Paul R.
Objectives We evaluated allergy/hypersensitivity clinical markers and their correlation with Helicobactor pylori infection in children and adults to analyze how early acquisition of H. pylori could modulate allergic disorder expression.
Lack of Diagnostic Utility of Specific Immunoglobulin M in Helicobacter pylori Infection in Children
(LIPPINCOTT WILLIAMS & WILKINS, 2008) Serrano, Carolina A.; Gonzalez, Carmen G.; Rollan, Antonio R.; Duarte, Ignacio; Torres, Javiera; Pena, Alfredo J.; Harris, Paul R.
Background: Helicobacter pylori infection results in ill a systemic immune response characterized by the initial rise of immunoglobulin (Ig) M followed by the elevation of IgG and IgA-specific antibody levels in serum. Age and regional considerations may modify the accuracy of serological tests.
Litiasis biliar pediátrica en una población de alta prevalencia
(2007) Harris, Paul R.; Chateau I., B.; Miquel P., J.F.
Las enfermedades de la vía biliar y los cálculos vesiculares (colelitiasis) han sido consideradas como una causa poco frecuentes de dolor abdominal agudo en niños, a diferencia de lo que ocurre en adultos. Sin embargo, existen diferencias sustanciales con el adulto como son una mayor proporción de casos con causa identificable, mayor incidencia de colecistitis sin cálculos y menor frecuencia de coledocolitiasis. Con la masificación del ultrasonido es posible detectar litiasis biliar en etapa intrauterina, y en pacientes asintomáticos, lo que estaría explicando, en parte, el aumento de su incidencia. La litiasis biliar es más frecuente de lo sugerido clásicamente en la literatura occidental y su diagnóstico está en aumento. La alta prevalencia de colelitiasis en población adulta chilena, posicionan a nuestro país como un escenario ideal para el estudio de genes candidatos asociados a la etiopatogénesis de la litiasis de colesterol. Si bien el diagnóstico de la litiasis es relativamente simple, no hay consenso en la terapia de elección, lo que se explica fundamentalmente por una historia natural desconocida. El rol de la litiasis de colesterol a edades tempranas en la etiopatogénesis de procesos neoplásicos de la vía biliar merece especial atención.

Browsing by Author "Harris, Paul R."

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