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Dominique Ryan, Fiona Pelly, Elizabeth Purcell
BACKGROUND: Extending the scope of practice of allied health professionals has been a strategy adopted in the United Kingdom to address issues within the health system. Australia's health system is currently undermined by similar issues, heightening government interest in adopting the extended scope health care model. The aim of the current study was to describe the activities and outcomes of a dietitian-led gastroenterology clinic which operated under an extended scope of practice model in an outpatient gastroenterology department at a tertiary hospital in regional Queensland, Australia, and to assess patient satisfaction with the initiative...
October 21, 2016: BMC Health Services Research
Jacqui Wise
No abstract text is available yet for this article.
October 20, 2016: BMJ: British Medical Journal
R Perlstein, S McCoombe, C Shaw, C Nowson
OBJECTIVES: The objective of this study was to examine the perceived importance, knowledge and confidence in nutritional management in a sample of Australian medical students undertaking a 4-year postgraduate medical degree. STUDY DESIGN/METHODS: In 2015, students in years 1-4 were anonymously surveyed to assess students' perceived importance of nutrition, and knowledge and confidence in nutritional management. RESULTS: A total of 131 first and second year (preclinical/yr 1-2) medical students (46% response rate) and 66 third and fourth year (clinical/yr 3-4) students (24% response rate) completed the questionnaire...
October 13, 2016: Public Health
A Raut, Bajrang K, U Sundar, S Honrao, N Inamdar
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
Goyal S, Bhardwaj Bl, Kumar A, Jaura S, Bhardwaj Hs
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
Michelle Shui Yee Lau, Peter D Mooney, William L White, Victoria Appleby, Sulleman Moreea, Ismail Haythem, Joshua E Elias, Kiran Bundhoo, Gareth D Corbett, Liam Wong, Her Hsin Tsai, Simon S Cross, John M Hebden, Sami Hoque, David S Sanders
No abstract text is available yet for this article.
October 5, 2016: BMC Gastroenterology
Tom Hughes, Nikolaos A Chatzizacharias, James Richards, Simon Harper
INTRODUCTION: Inferior pancreatico-duodenal artery (IPDA) aneurysms are very rare and commonly associated with coeliac axis stenosis or occlusion due to atherosclerosis, thrombosis or median arcuate ligament syndrome. We present a case of a surgical repair of an IPDA aneurysm with the use of a supra-coeliac aorto-hepatic bypass with a polytetrafluoroethylene (PTFE) graft, following a failed initial attempt at an endovascular repair. PRESENTATION: A 75 year old female, who was under investigation for night sweats, was referred to our team with an incidental finding of a 19mm fusiform IPDA aneurysm...
September 26, 2016: International Journal of Surgery Case Reports
Joni Leppänen, Olli Helminen, Heikki Huhta, Joonas H Kauppila, Ilkka Miinalainen, Veli-Pekka Ronkainen, Juha Saarnio, Petri P Lehenkari, Tuomo J Karttunen
Doublecortin-like kinase 1 (DCLK1) is a microtubule-associated kinase. In murine intestine, DCLK1 marks tuft cells with characteristic microvilli, features of neuroendocrine cells and also quiescent stem cell-like properties. The occurrence and pathological role of DCLK1-positive cells in human intestinal mucosa is unknown. We analysed DCLK1 expression in healthy duodenal, jejunal and colorectal mucosa samples (n = 35), and in duodenal specimens from patients with coeliac disease (n = 20). The samples were immunohistochemically double-stained with DCLK1, and synaptophysin, chromogranin A and Ki-67...
November 2016: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
Daniela Carnevale, Marialuisa Perrotta, Fabio Pallante, Valentina Fardella, Roberta Iacobucci, Stefania Fardella, Lorenzo Carnevale, Raimondo Carnevale, Massimiliano De Lucia, Giuseppe Cifelli, Giuseppe Lembo
The crucial role of the immune system in hypertension is now widely recognized. We previously reported that hypertensive challenges couple the nervous drive with immune system activation, but the physiological and molecular mechanisms of this connection are unknown. Here, we show that hypertensive challenges activate splenic sympathetic nerve discharge to prime immune response. More specifically, a vagus-splenic nerve drive, mediated by nicotinic cholinergic receptors, links the brain and spleen. The sympathetic discharge induced by hypertensive stimuli was absent in both coeliac vagotomized mice and in mice lacking α7nAChR, a receptor typically expressed by peripheral ganglionic neurons...
2016: Nature Communications
Michael W J Davie, Sally F Evans, Christopher A Sharp
Aims. To investigate regional lower limb bone density and associations with weight, PTH, and bone breakdown in coeliac men. Methods. From whole body DXA scans bone mineral density (BMD) was measured in 28 coeliac men, in the lower limb (subdivided into 6 regions, 3 being metaphyseal (mainly trabecular) and 2 diaphyseal (mainly cortical)). BMD at femoral neck (FN) and lumbar spine L2-4, body weight, height, serum calcium, alkaline phosphatase, parathyroid hormone (PTH), and urinary calcium and NTx/Cr, a measure of bone breakdown, were also measured...
2016: Journal of Osteoporosis
Amit Assa, Yael Frenkel-Nir, Ya'ara Leibovici-Weissman, Dorit Tzur, Arnon Afek, Lior H Katz, Zohar Levi, Raanan Shamir
OBJECTIVES: To investigate the impact of coeliac disease (CD) diagnosis on anthropometric measures at late adolescence and to assess trends in the prevalence of diagnosed CD over time. DESIGN: A population based study. PATIENTS: Prior to enlistment, at the age of 17 years, most of the Israeli Jewish population undergoes a general health examination. Subjects' medical diagnoses are entered into a structured database. INTERVENTIONS: The enlistment database was thoroughly searched for CD cases between the years 1988 and 2015...
September 26, 2016: Archives of Disease in Childhood
Prashant Singh, John J Garber
BACKGROUND: There are no studies evaluating the implementation of American Gastroenterological Association (AGA) guidelines on osteoporosis screening in coeliac disease. AIMS: To investigate implementation of osteoporosis screening guidelines in coeliac disease patients and determine how often bone mineral density (BMD) assessment leads to therapeutic intervention. METHODS: We screened all patients with biopsy-proven coeliac disease at our center from 2003 to 2013 and collected data on indication and results of dual energy X-ray absorptiometry scanning (DXA) and therapeutic interventions...
September 5, 2016: Digestive and Liver Disease
Widya A Wahab, Tanja Šuligoj, Julia Ellis, Beatriz Côrtez-Real, Paul J Ciclitira
Coeliac disease (CD) is an inflammatory disorder of the small intestine. It includes aberrant adaptive immunity with presentation of CD toxic gluten peptides by HLA-DQ2 or DQ8 molecules to gluten-sensitive T cells. A ω-gliadin/C-hordein peptide (QPFPQPEQPFPW) and a rye-derived secalin peptide (QPFPQPQQPIPQ) were proposed to be toxic in CD, as they yielded positive responses when assessed with peripheral blood T-cell clones derived from individuals with CD. We sought to assess the immunogenicity of the candidate peptides using gluten-sensitive T-cell lines obtained from CD small intestinal biopsies...
August 2016: International Journal of Experimental Pathology
Nicholas J Fordham, Richa Ajitsaria, Leena Karnik, Subarna Chakravorty
BACKGROUND: This is the first documented case of a patient with hemophagocytic lymphohistiocytosis in association with coeliac disease. There was complete clinical and biochemical remission of hemophagocytic lymphohistiocytosis following the introduction of a gluten-free diet. CASE PRESENTATION: A 7-year-old white girl presented with fevers and maculopapular rash with a recent history of tonsillitis. Blood tests revealed thrombocytopenia (64×10(9)/L), anemia (80 g/L), hypofibrinogenemia (1 g/L), and hyperferritinemia (71,378 μg/L)...
2016: Journal of Medical Case Reports
Hilal Özakıncı, Ayça Kırmızı, Berna Savaş, Çağdaş Kalkan, İrfan Soykan, Hülya Çetinkaya, Zarife Kuloğlu, Aydan Kansu, Ödül Eğritaş Gürkan, Buket Dalgıç, Zeynep Şentürk, Arzu Ensari
The spectrum of mucosal pathology in coeliac disease (CD), initially defined by Marsh in 1992 has been subjected to several modifications in the following years by Oberhuber, then by Corazza and Villanaci, and finally by Ensari. The present study, aimed to end the ongoing confusion regarding the classification of mucosal pathology in CD by applying all the classifications proposed so far on a large series of cases. A total of 270 duodenal biopsies taken from the distal duodenum of patients with a diagnosis of CD were included in the study...
September 3, 2016: Pathology, Research and Practice
Daisy Khera, Baldev Sharma, Kuldeep Singh
We report a 17 year-old male patient, who presented with chronic diarrhoea, progressive pallor, short stature, anaemia (haemoglobin of 4.9 g/dL) and neutropenia and was diagnosed as coeliac disease. His neutropenia did not respond to 8 months of gluten-free diet, iron, folic acid and vitamin B12 therapy. So we suspected copper deficiency and his serum copper levels were tested, which was low. His neutrophil counts normalised after 2 months of copper supplementation. Hence we concluded that the cause of neutropenia in our case was copper deficiency...
2016: BMJ Case Reports
Antonio Bevilacqua, Adele Costabile, Triana Bergillos-Meca, Isidro Gonzalez, Loretta Landriscina, Emanuela Ciuffreda, Paola D'Agnello, Maria Rosaria Corbo, Milena Sinigaglia, Carmela Lamacchia
The main aim of this paper was to assess the in vitro response of healthy and coeliac human faecal microbiota to gluten-friendly bread (GFB). Thus, GFB and control bread (CB) were fermented with faecal microbiota in pH-controlled batch cultures. The effects on the major groups of microbiota were monitored over 48 h incubations by fluorescence in situ hybridisation. Short-chain fatty acids (SCFAs) were measured by high-performance liquid chromatography (HPLC). Furthermore, the death kinetics of Lactobacillus acidophilus, Bifidobacterium animalis subsp...
2016: PloS One
Priscila Farage, Yanna Karla de Medeiros Nóbrega, Riccardo Pratesi, Lenora Gandolfi, Pedro Assunção, Renata Puppin Zandonadi
OBJECTIVE: The present study aimed to assess the safety of gluten-free bakery products for consumption by coeliac patients. Design/setting In the current exploratory cross-sectional quantitative study, a total of 130 samples were collected from twenty-five bakeries in Brasilia (Brazil). For the quantification of gluten, an ELISA was used. The threshold of 20 ppm gluten was considered as the safe upper limit for gluten-free food, as proposed in the Codex Alimentarius. RESULTS: The results revealed a total of 21·5 % of contamination among the bakery products sampled...
September 15, 2016: Public Health Nutrition
Michelle Shui Yee Lau, Peter Mooney, William White, Victoria Appleby, Sulleman Moreea, Ismail Haythem, Joshua Elias, Kiran Bundhoo, Gareth Corbett, Liam Wong, Her Hsin Tsai, Simon Cross, John Hebden, Sami Hoque, David Sanders
BACKGROUND: International guidelines recommend coeliac serology in iron deficiency anaemia, and duodenal biopsy for those tested positive to detect coeliac disease. However, pre-endoscopy serology is often unavailable, thus committing endoscopists to take routine duodenal biopsies. Some endoscopists consider duodenal biopsy mandatory in anaemia to exclude other pathologies. We hypothesise that using a point of care test at endoscopy could fill this gap, by providing rapid results to target anaemic patients who require biopsies, and save costs by biopsy avoidance...
September 15, 2016: BMC Gastroenterology
Julián Rodríguez Almagro, Antonio Hernández Martínez, María Carmen Solano Ruiz, José Siles González
AIMS: To research the quality of life of Spanish women with coeliac disease BACKGROUND: Coeliac women express lower quality of life than male coeliacs. DESIGN: Explanatory sequential approach using mixed methods and with a gender perspective. METHODS: The research was carried out between May and July 2015. In its quantitative stage it aims to determine the health-related quality of life (HRQoL) in a representative sample (n=1097) of Spanish adult women with coeliac disease using a specific questionnaire named CD-QOL...
September 14, 2016: Journal of Clinical Nursing
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