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Con el objetivo de diagnosticar las condiciones predisponentes para la primera experiencia de implementación de la modalidad virtual en la Facultad de Ciencias de la Educación del Centro Regional Universitario de Azuero (CRUA), se desarrolló un estudio descriptivo con el que se encuestó en el primer semestre del 2018, a todos los profesores de la facultad, a los estudiantes que cursan la carrera de profesorado en Docencia Media Diversificada y a las autoridades del CRUA y del Campus Virtual de la Universidad de Panamá. Los resultados expresan que los encargados del nivel decisorio aprueban la incorporación de la modalidad educativa virtual, que la institución cuenta con las condiciones aceptables y las facilidades tecnológicas y de infraestructura y que los profesores y estudiantes presentan una actitud favorable hacia el uso de las TIC en el proceso de enseñanza y aprendizaje. Sin embargo, existen algunas debilidades en cuanto a conocimientos y habilidades de uso, las cuales pueden ser subsanadas, oportunamente.

Purpose. This commentary draws on a recent workshop hosted by the Canadian Children's Rehabilitation Research Network that brought together stakeholders to critically examine assumptions embedded in children's rehabilitation in order to advance current debates and suggest areas for further inquiry. Method. Six issues are discussed: (1) the wisdom of dichotomising 'fix' versus 'function'; (2) the ethics of 'it might help and it won't hurt' therapy approaches; (3) the emphasis on early intervention rather than a lifespan approach; (4) the challenges of providing care for new rehabilitation populations; (5) discrepancies between performance outcomes and patient satisfaction; and (6) innovative partnerships to support care transitions of adolescents and their families. Results. Issues identified include: finding the right balance between therapies that focus on 'fixing' children versus enhancing function, judicious design of therapy programs as to not overburden children and families, adopting lifespan approaches to meet the needs of multiple 'paediatric' populations, cautious interpretation of measures and approaches that link well-being with physical performance, and the benefits of including parent and youth facilitators on children's rehabilitation teams. Conclusions. Ongoing debate, discussion and research are needed in each of these areas to ensure that rehabilitation services are enhancing the well-being of children and families. [ABSTRACT FROM AUTHOR]

This article reports on a study conducted for the CANADIAN INTERNATIONAL DEVELOPMENT AGENCY by THE INTERNATIONAL CENTRE FOR DISABILITY AND REHABILITATION at the University of Toronto. We critically examined the broad literature in the area of disability and development and in this article we identify the key issues which emerged. Most of the data were collected from existing literature in the academic and practice settings and from the publications of key NGOs and governments. We first, examine disability in the context of low-income countries, and then discuss key critical issues: disability and poverty, disability and health, disability and education, disability and gender, disability and children/youth, disability and conflict/natural disasters and disability and human rights. In all these areas we find reports of discrimination, stigmatisation and marginalisation. We conclude that, as we address issues of multi-cultural disability services in developed countries, it is important to bear in mind the various issues that many people with disabilities and their families bring with them as the result of immigrating from a developing country. Although we address these issues within our own countries, we must bear in mind the changes that are occurring due to globalisation. [ABSTRACT FROM AUTHOR]

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A 15-year-old girl, a known case of Bartter′s syndrome (BS) for 7 years, developed severe pain in her right knee and right and left ankle. Her older sister had BS and developed end-stage renal disease (ESRD) at the age of 14 years. Her serum uric acid was 12.6 mg/dL, 6 months ago, and 15.4 mg/dL in her recent lab data. Hyperuricemia and gouty arthritis are commonly seen in adults with BS, but to our knowledge there is no report of gouty arthritis in pediatric literature.

Introduction. The pathophysiology of urolithiasis in infancy is not well known. The aim of this study was to investigate whether infants with urolithiasis have higher serum levels of vitamin D, as a possible risk factor for urolithiasis, compared to infants without urinary calculi. Materials and Methods. In this case-control study, 36 infants with urolithiasis (age range, 2.5 to 24 months) were enrolled as well as 36 age- and sex-matched infants without urolithiasis. Random urine samples were tested for calcium, phosphorous, oxalate, citrate, uric acid, sodium, potassium, magnesium, and creatinine levels, and also nitroprusside test was done on the samples. Serum levels of potassium, urea nitrogen, creatinine, 25-hydroxyvitamin D3, parathyroid hormone, calcium, phosphorous, and uric acid were measured in all of the infants with urolithiasis. Serum levels of 25-hydroxyvitamin D3 were also measured in the control group. Results. Serum levels of 25-hydroxyvitamin D3 were significantly higher in the infants with urolithiasis than in the controls (33.85 ± 14.78 ng/mL versus 18.26 ± 7.43 ng/mL, P < .001). Nine infants in the urolithiasis group (25%) were found to have hypercalcemia; 3 of these cases also had hypervitaminosis D. Hypercalciuria was detected in 10 infants with urolithiasis (27.8%), hypocitraturia in 6 (16.7%), hypomagnesiuria in 3 (8.3%), and hyperoxaluria in 1 (2.8%). Nineteen infants with urolithiasis had at least one metabolic disorder. Conclusions. High serum levels of vitamin D may play an important role in the pathogenesis of urolithiasis in infants with hypercalcemia. We recommend evaluation of vitamin D levels in these infants. [ABSTRACT FROM AUTHOR]

Introduction. Urinary tract infection (UTI) is common after pediatric kidney transplantation. The purpose of this study was to evaluate the prevalence of UTI and its risk factors in children and adolescents with kidney transplantation in Shiraz Transplant Center. Materials and Methods. All children with kidney transplantation from 1992 to 2008 who were under regular follow-up were included in this retrospective study. Confirmed episodes of UTI after the 1st month of kidney transplantation were reviewed. Results. Of the 216 patients younger than 19 years at the time of transplantation, 138 were included. The mean age at the time of kidney transplantation was 13.6 ± 3.5 years. Urinary tract infection was documented in 24 patients (15 girls and 9 boys), of whom 12 experienced 1 episode, 4 had 2 episodes, and 8 had more than 2 episodes, during a median follow-up period of 54 months. Of the patients with UTI, 14 (58%) had urinary reflux-obstruction disorders as the primary kidney disease, 6 (25%) had suffered hereditary diseases, 3 (12.5%) had glomerular disease, and 1 (4.5%) had a urinary calculus. Occurrence of UTI was not significantly different among children with different primary kidney disease (P = .22). Despite using prophylactic antibiotics after the 1st month of kidney transplantation in all 5 patients with neurogenic bladder, they all experienced recurrent UTI. Conclusions. Despite discontinuation of antibiotic therapy, UTI was uncommon in children after the first month of transplantation. Two significant risk factors for UTI were female gender and neurogenic bladder in this transplant population. [ABSTRACT FROM AUTHOR]

Regenerative capabilities of the endothelium rely on vessel-resident progenitors termed endothelial colony forming cells (ECFCs). This study aimed to investigate if these progenitors are impacted by conditions (i.e., obesity or atherosclerosis) characterized by increased serum levels of oxidized low-density lipoprotein (oxLDL), a known inducer of Endothelial-to-Mesenchymal Transition (EndMT). Our investigation focused on understanding the effects of EndMT on the self-renewal capabilities of progenitors and the associated molecular alterations. In the presence of oxLDL, ECFCs displayed classical features of EndMT, through reduced endothelial gene and protein expression, function as well as increased mesenchymal genes, contractility, and motility. Additionally, ECFCs displayed a dramatic loss in self-renewal capacity in the presence of oxLDL. RNA-sequencing analysis of ECFCs exposed to oxLDL validated gene expression changes suggesting EndMT and identified SOX9 as one of the highly differentially expressed genes. ATAC sequencing analysis identified SOX9 binding sites associated with regions of dynamic chromosome accessibility resulting from oxLDL exposure, further pointing to its importance. EndMT phenotype and gene expression changes induced by oxLDL in vitro or high fat diet (HFD) in vivo were reversed by the silencing of SOX9 in ECFCs or the endothelial-specific conditional knockout of Sox9 in murine models. Overall, our findings support that EndMT affects vessel-resident endothelial progenitor's self-renewal. SOX9 activation is an early transcriptional event that drives the mesenchymal transition of endothelial progenitor cells. The identification of the molecular network driving EndMT in vessel-resident endothelial progenitors presents a new avenue in understanding and preventing a range of condition where this process is involved., (© 2024. The Author(s).)

It is estimated that 3.75 billion people worldwide lack access to healthcare services. Marginalized populations, such as people with disabilities, are at greater risk of exclusion. People with disabilities not only face the same barriers as people without disabilities, but also experience a range of additional barriers in accessing healthcare due to a variety of discriminatory and inaccessible environments. These extra barriers exist despite their greater need for general healthcare, as well as specialized healthcare related to their impairment. Few studies have focused on healthcare providers and the challenges they face in caring for this group. This paper describes the perspectives of healthcare stakeholders and reported challenges to the provision of quality primary healthcare for people with disabilities. In-depth interviews with 11 healthcare stakeholders were conducted in three regions of Guatemala. Data were analyzed using thematic analysis. Five sub-themes emerged from the above theme: infrastructure and availability of resources, impairment-based challenges, need for special attention and empathy, opportunity to provide services to people with disabilities, and gaps in training. The results could contribute to the development and implementation of strategies that can improve primary care provision and ultimately access to services for people with disabilities in low- and middle-income countries.

Research has demonstrated that persons with disabilities, despite their greater need for healthcare services, often experience greater barriers to accessing healthcare including primary healthcare. Data and interventions on access to primary healthcare for persons with disabilities to date appear to concentrate more on access and quality issues once the person with a disability has initiated the healthcare seeking process, with less emphasis on how healthcare decisions are made at the personal or household level when one identifies a healthcare need. The aim of this study was to investigate how healthcare decisions are made by people with disabilities when they first identify a healthcare need. It is anticipated that gaining a better understanding of how such decisions are made will facilitate the development of interventions and approaches to improve access to primary healthcare services for this group. A qualitative study was undertaken in Guatemala. In-depth interviews were undertaken with twenty-seven adults with disabilities, including men and women with a range of impairment types and ages. Data were analyzed using thematic analysis to identify themes that influence the decision-making processes in accessing primary healthcare services for people with disabilities. Thematic analysis of the interviews along with exploration of three existing access to health frameworks and models, led to identification of four primary themes and development of a new conceptual framework highlighting the complex decision-making process undertaken by people with disabilities about whether to seek primary healthcare services or not when confronted with a healthcare concern. The themes include perceived severity of illness and need for treatment, personal attributes, societal factors, and health system characteristics. Using this new conceptual framework will facilitate the development of more effective policies and interventions to improve access to primary healthcare services for people with disabilities through greater understanding of the complex network of variables and barriers., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Hashemi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The aggressiveness of solid cancers, such as melanoma, relies on their metastatic potential. It has become evident that this key cause of mortality is largely conferred by the tumour-associated stromal cells, especially endothelial cells. In addition to their essential role in the formation of the tumour vasculature, endothelial cells significantly contribute to the establishment of the tumour microenvironment, thus enabling the dissemination of cancer cells. Melanoma tumour vascularization occurs through diverse biological processes. Vasculogenesis is the formation of de novo blood vessels from endothelial progenitor cells (EPCs), and recent research has shown the role of EPCs in melanoma tumour vascularization. A more detailed understanding of the complex role of EPCs and how they contribute to the abnormal vessel structures in tumours is of importance. Moreover, anti-angiogenic drugs have a limited effect on melanoma tumour vascularization, and the role of these drugs on EPCs remains to be clarified. Overall, targeting cancer vasculature remains a challenge, and the role of anti-angiogenic drugs and combination therapies in melanoma, a focus of this review, is an area of extensive exploration.

Methods: Six electronic databases were searched for relevant studies from 2000 to 2019. Forty-one eligible studies were identified., Results: Findings suggest that the people with disabilities' choice to seek healthcare services or not, as well as the quality of intervention provided by primary healthcare providers, are influenced by three types of barriers: cultural beliefs or attitudinal barriers, informational barriers, and practical or logistical barriers., Conclusion: In order to achieve full health coverage at acceptable quality for people with disabilities, it is necessary not only to consider the different barriers, but also their combined effect on people with disabilities and their households. It is only then that more nuanced and effective interventions to improve access to primary healthcare, systematically addressing barriers, can be designed and implemented.IMPLICATIONS FOR REHABILITATIONPeople with disabilities in both high income and low- and middle-income country settings are more likely to experience poorer general health than people without disabilities.Barriers to accessing primary healthcare services for people with disabilities result from a complex and dynamic interacting system between attitudinal and belief system barriers, informational barriers, and practical and logistical barriers.Given primary healthcare is often the initial point of contact for referral to specialty care and rehabilitation services, it is crucial for people with disabilities to access primary healthcare services in order to get appropriate referrals for such services, specifically rehabilitation as appropriate.To achieve full health coverage at acceptable quality for people with disabilities, starting with primary healthcare, it is necessary for healthcare stakeholders, including rehabilitation professionals, to consider the combined and cumulative effects of the various barriers to healthcare on people with disabilities and their families and develop an understanding of how healthcare decisions are made by people with disabilities at the personal and the household level.

The aim of this study was to evaluate the effects of lactoferrin (Lf) on growth and feeding performance, biochemical and immune parameters in Asian sea bass (Lates calcarifer). A basal diet was supplemented with 0 (control), 400 (400 Lf), or 800 (800 Lf) mg Lf kg -1 diet. The results indicate a significant increase in innate immune parameters when the diet was supplemented with 800 mg Lf kg -1 . The highest serum albumin value and the lowest serum glucose concentration were observed in 800 Lf group. The liver catalase activity in the 400 Lf and 800 Lf groups was lower than the control value. Moreover, malondialdehyde concentration in the liver of Asian sea bass was increased with increasing the dietary Lf supplementation. The results of the study suggest that supplementing diet with 800 mg Lf kg -1 stimulates non-specific immune response in Asian sea bass. Nonetheless, selecting an appropriate dose can be difficult, especially since both the higher and the lower dose tested may result in adverse effects., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Endothelial to mesenchymal transition (EndMT) is a leading cause of fibrosis and disease, however its mechanism has yet to be elucidated. The endothelium possesses a profound regenerative capacity to adapt and reorganize that is attributed to a population of vessel-resident endovascular progenitors (EVP) governing an endothelial hierarchy. Here, using fate analysis, we show that two transcription factors SOX9 and RBPJ specifically affect the murine EVP numbers and regulate lineage specification. Conditional knock-out of Sox9 from the vasculature (Sox9 fl/fl /Cdh5-Cre ER RosaYFP) depletes EVP while enhancing Rbpj expression and canonical Notch signalling. Additionally, skin wound analysis from Sox9 conditional knock-out mice demonstrates a significant reduction in pathological EndMT resulting in reduced scar area. The converse is observed with Rbpj conditionally knocked-out from the murine vasculature (Rbpj fl/fl /Cdh5-CreER RosaYFP) or inhibition of Notch signaling in human endothelial colony forming cells, resulting in enhanced Sox9 and EndMT related gene (Snail, Slug, Twist1, Twist2, TGF-β) expression. Similarly, increased endothelial hedgehog signaling (Ptch1 fl/fl /Cdh5-CreER RosaYFP), that upregulates the expression of Sox9 in cells undergoing pathological EndMT, also results in excess fibrosis. Endothelial cells transitioning to a mesenchymal fate express increased Sox9, reduced Rbpj and enhanced EndMT. Importantly, using topical administration of siRNA against Sox9 on skin wounds can substantially reduce scar area by blocking pathological EndMT. Overall, here we report distinct fates of EVPs according to the relative expression of Rbpj or Notch signalling and Sox9, highlighting their potential plasticity and opening exciting avenues for more effective therapies in fibrotic diseases.

Purpose: Dentin hypersensitivity is characterized by short, sharp pain arising from exposed dentin in response to external stimuli. Several modalities have been suggested for treatment of this condition such as low-level laser therapy (LLLT) and application of dentin bonding agents. The aim of this study was to compare the clinical efficacy of diode laser, Nd:YAG laser and dentin bonding agent for treatment of dentin hypersensitivity., Materials and Methods: In this study, 135 teeth of 22 patients diagnosed with dentin hypersensitivity were divided into three groups: In group 1, the teeth were irradiated by diode laser with 810 nm wavelength for 30 seconds and in group 2, the teeth were irradiated by Nd:YAG laser with 1064 nm wavelength for 40 seconds. CLEARFIL SE BOND was applied on teeth in group 3. LLLT was carried out in 3 sessions with 7-day intervals between sessions, during a period of 3 consecutive weeks. Hypersensitivity was assessed by cold test according to the criteria proposed by Uchida at baseline, immediately after treatment and at 1, 3 and 6 months, postoperatively., Results: Reduction of dentin hypersensitivity was observed at 3 and 6 months following the use of Nd:YAG laser (p < 0.001) . Reduction in dentin hypersensitivity was observed immediately after treatment in all groups. Statistically significant differences in level of dentin hypersensitivity were found between groups at 3 and at 6 months (p ≤ 0.001) . The reduction in dentin hypersensitivity by Nd:YAG laser was significantly superior to that in other groups at this time., Conclusion: The efficacy of Nd:YAG laser in reduction of dentin hypersensitivity was significantly superior to that of other modalities at 3 and 6 months.

In this data article, we examined some of those factors such as the effect of fresh, frozen and hot air-dried sample, pH and polarity of solvent by ultrasound-assisted extraction, as a "Green Extraction" technique, to find optimal conditions for increasing the amount of total phenolic and amino acid contents from watermelon rind. Then, we considered the DPPH radical scavenging and anti-tyrosinase activity of the extracts and their association with the amount of the phenolic and amino acid contents in the samples. The obtained data were analyzed one-way ANOVA, Tukey post hoc test and Graph Pad Prism 6 ( P < 0.05). Our findings revealed one of the appropriate pre-extraction and extraction conditions of watermelon white rind to achieve more antioxidant and anti-tyrosinase effects. In addition, our data show the value of watermelon white rind as inexpensive, safe whitening and anti-browning agent, which can be used in pharmaceuticals, cosmetics and food products.

Background: Despite the building evidence on violence against children globally, almost nothing is known about the violence children with disabilities in low and middle-income countries (LMICs) experience. The prevalence of violence against children with disabilities can be expected to be higher in LMICs where there are greater stigmas associated with having a child with a disability, less resources for families who have children with disabilities, and wider acceptance of the use of corporal punishment to discipline children. This study explores violence experienced by children with disabilities based on data collected from four countries in West Africa- Guinea, Niger, Sierra Leone, and Togo., Methods: A qualitative study design guided data generation with a total of 419 children, community members, and disability stakeholders. Participants were selected using purposive sampling. Stakeholders shared their observations of or experiences of violence against children with disabilities in their community in interviews and focus groups. Thematic analysis guided data analysis and identified patterns of meaning among participants' experiences., Results: Results illuminate that children with disabilities experience violence more than non-disabled children, episodes of violence start at birth, and that how children with disabilities participate in their communities contributes to their different experiences of violence., Conclusions: The study recommends policy-oriented actions and prevention programs that include children and their families in strategizing ways to address violence.

Background: Though vedolizumab has received regulatory approval for the treatment of Crohn's disease (CD) and ulcerative colitis (UC) in adults, there is increasing off-label use in children., Aims: To describe the experience with vedolizumab in pediatric inflammatory bowel disease (IBD) patients at 3 tertiary IBD centers and examine predictors of remission., Methods: A retrospective review identified pediatric IBD patients (age < 18 yrs) receiving vedolizumab. Data on demographics, disease behavior, location, activity, and previous treatments/surgeries were collected. Disease activity was assessed using the weighted pediatric CD activity index or pediatric UC activity index. Primary outcome was week 14 remission, defined as pediatric UC activity index <10 or weighted pediatric CD activity index <12.5. Descriptive statistics and univariate analyses were performed to examine associations of clinical characteristics with efficacy., Results: Fifty-two patients, 58% CD and 42% UC, initiated vedolizumab between June 2014 and August 2015. Median age at vedolizumab initiation was 14.9 (range 7-17) years. Ninety percent had failed ≥1 anti-tumor necrosis factor (TNF) agent. Week 14 remission rates for UC and CD were 76% and 42%, respectively (P < 0.05). Eighty percent of anti-TNF-naive patients experienced week 14 remission. At week 22, anti-TNF-naive patients had higher remission rates than TNF-exposed patients (100% versus 45%, P = 0.04). There were no infusion reactions or serious adverse events/infections., Conclusions: Our results suggest that vedolizumab is efficacious and safe in pediatric IBD patients, with UC patients experiencing earlier and higher rates of remission than CD patients. Anti-TNF-naive patients experienced higher remission rates than those with anti-TNF exposure. Controlled clinical trial data are needed to confirm these observations.

Long-term survival after successful renal transplantation is shortened by cardiovascular disease. Cardiovascular disease is a main cause of morbidity and death among children and young adults after renal transplantation. The aim of our study was to measure the carotid intima media thickness (cIMT) and determine its relationship to the risk factors for early arteriopathy in renal transplant recipients. Sixty-six stable renal transplant patients (36 female and 30 male), 7-25 years of age (mean 18.3 +/- 4.5 years) were enrolled in this study. The cIMT was measured by high-resolution B mode ultrasonography in multiple projections. The results were correlated with clinical and paraclinical parameters, including age, gender, body mass index (BMI), blood pressure, glomerular filtration rate (GFR), duration of dialysis, duration of chronic kidney disease (CKD), post-transplantation interval, calcium-phosphate (CaxP) product, cumulative dose of Ca-based P binder and calcitriol, lipid profile, uric acid, and cyclosporine level. The mean post-transplantation follow-up period was 64 +/- 40 months. The mean cIMT standard deviation score (SDS) of the patients and the control group was 0.60 +/- 0.81 mm (range -1.10 mm to 2.75 mm) and -1.25 +/- 0.95 mm (range -3.23 mm to 0.26 mm), respectively. Renal transplant recipients had a significantly greater cIMT than that of the controls (P < 0.001). Among several risk factors, there were positive correlations between cIMT SDS and gender, and cumulative dose of calcitriol (P = 0.02 and P = 0.02, respectively). In conclusion, subclinical atherosclerosis is present in young transplant recipients. Non-invasive monitoring of cIMT in renal transplant patients for the detection of early vascular lesions might be of value in preventing cardiovascular disease. Further studies are needed to see if proper monitoring of vitamin D therapy before and after transplantation could be helpful in the prevention of arteriopathy in renal transplant recipients.

Background: Continuous ambulatory peritoneal dialysis is not a very common modality to treat Iranian children with end-stage renal disease; however, there is sometimes no choice but to offer this therapy to salvage the patient. Obviously, promotion in each program needs re-evaluation to find the pitfalls. Therefore, a nation-wide survey on pediatric continuous ambulatory peritoneal dialysis was conducted to find the cause of death or termination of dialysis., Methods: All children, younger than 14 years old, treated by continuous ambulatory peritoneal dialysis in nine main pediatric nephrology wards in Iran between 1993 and 2006 were included in this historical cohort study. Patient and technique survival rates were determined. Kaplan-Mayer and Cox-regression analysis were used to compare the survival. 2 x 2 table was used to calculate the risk ratio. A P<0.05 was considered significant., Results: One hundred twenty children with a mean age of 47.6 months were on continuous ambulatory peritoneal dialysis. The most frequent cause of renal failure was hereditary-metabolic-cystic disease. One hundred eighty-two peritoneal dialysis catheters were inserted surgically. The median first catheter exchange was 0.74 year (95%CI: 0.5 - 0.98). The most frequent cause of catheter replacement was catheter outflow failure due to displacement, adhesion, and infection (persistent peritonitis or tunnel infection). The mean patient survival was 1.22 years (95%CI: 0.91 - 1.53). The mortality rate was 55% before 1997, and 60% between 1998 and 2001, which declined to 23% after 2002 (P<0.05). Young age (<24 months) was the only independent factor that predicted mortality (P<0.05). The outcome of children was as follows: recovery of renal function (6.7%), renal transplantation (8.3%), switch to hemodialysis (16.7%), still on continuous ambulatory peritoneal dialysis (23.3%), death (43.3%), and lost to follow-up (1.7%)., Conclusion: The mortality is still high among Iranian children on peritoneal dialysis. Young age is the most important factor influencing on survival and mortality.

Introduction: Our aim was to determine the frequency of peptic ulcer and Helicobacter pylori infection by gastrointestinal evaluations in pretransplantation phase in children with end-stage renal disease (ESRD)., Materials and Methods: Twenty-four children with ESRD (13 girls and 11 boys) with a mean age of 14.7 +/- 3.4 years on maintenance hemodialysis were included in this study. Upper gastrointestinal endoscopies were performed and 4 gastric, antral, and duodenal biopsy specimens were obtained for urease test and histological study. Serum gastrin levels were measured in all patients, too. A control group was chosen to compare the rate of H pylori infection between children with ESRD and healthy children., Results: Gastrointestinal symptoms were present in 16 (66.7%) of 24 patients. Seventeen (70.8%) patients had abnormal upper gastrointestinal endoscopic findings. Infection with Helicobacter pylori was detected in 16 patients and 5 healthy children (66.7% versus 20.0%, P < .001). The frequency of dyspeptic symptoms was not different significantly between uremic patients with and without H pylori infection (P = .67). The same results were found regarding the upper gastrointestinal abnormalities found by endoscopy (P = .65). Oral alkalizing supplement was received by 63% of symptomatic and 80% of asymptomatic patients. Serum gastrin levels were significantly higher in infected patients than in noninfected patients with H pylori (P < .001)., Conclusions: We found a significant number of patients with peptic ulcer diseases, H pylori infection, and secondary hypergastrinemia. This study showed that clinical symptoms are not a reliable predictor of gastrointestinal problems and this is more confusing in patients who received alkalizing solutions.