{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T12:12:17Z","timestamp":1788437537965,"version":"build-2803163510"},"reference-count":39,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To evaluate treatment outcomes of pediatric peptic ulcer disease (PUD) and to identify determinants of refractory ulcers, with emphasis on\n                      <jats:italic>Helicobacter pylori<\/jats:italic>\n                      (\n                      <jats:italic>H. pylori<\/jats:italic>\n                      ) status.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this prospective study, 254 children (2\u201317 years) with endoscopically confirmed ulcers were enrolled at a tertiary center in Vietnam (2023\u20132024).\n                      <jats:italic>H. pylori<\/jats:italic>\n                      status and eradication were assessed according to European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN)\/North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) guidelines. Ulcer healing was evaluated at 6 weeks, with repeat endoscopy at 12 weeks for patients with persistent ulcers. Refractory PUD was defined as persistence of active or healing\u2010stage ulcers at 12 weeks. Multivariable logistic regression was used to identify factors associated with refractory disease.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Healing rates were 65.7% at 6 weeks and 76.4% at 12 weeks, and 23.6% of patients had refractory PUD. Healing rates did not differ according to\n                      <jats:italic>H. pylori<\/jats:italic>\n                      status. Eosinophilic gastritis was more frequent in refractory cases, particularly among\n                      <jats:italic>H. pylori<\/jats:italic>\n                      \u2010negative patients. On multivariable analysis, eosinophilic gastritis (adjusted odds ratio [aOR] 6.12; 95% confidence interval [CI] 2.47\u201315.15), persistent\n                      <jats:italic>H. pylori<\/jats:italic>\n                      infection (aOR 4.04; 95% CI 1.67\u20139.76), and poor treatment adherence (aOR 8.12; 95% CI 3.69\u201317.87) were independently associated with refractory ulcers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Nearly one\u2010quarter of children had delayed or incomplete ulcer healing at 12 weeks. Eosinophilic gastritis, persistent\n                      <jats:italic>H. pylori<\/jats:italic>\n                      infection, and poor treatment adherence were independently associated with refractory ulcers, supporting risk stratification and closer follow\u2010up.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jpn3.70494","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T08:43:33Z","timestamp":1782463413000},"page":"422-430","source":"Crossref","is-referenced-by-count":0,"title":["Treatment outcomes and determinants of refractory peptic ulcer disease in children: A prospective study from Vietnam"],"prefix":"10.1002","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-3453-6731","authenticated-orcid":false,"given":"Thi Phuong Mai","family":"Chu","sequence":"first","affiliation":[{"name":"Department of Pediatrics Hanoi Medical University Hanoi Vietnam"},{"name":"Department of Gastroenterology 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