Screening for celiac disease in patients with irritable bowel syndrome fulfilling Rome III criteria

Background: Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder. Celiac disease (CD), a treatable autoimmune enteropathy, with varied presentations, may simulate clinically symptoms of IBS. The aim of the present study is to screen for CD in patients with IBS diagnosed based on the Rome III criteria. Patients and Methods: A cross-sectional study was conducted at a secondary care gastrointestinal unit in Al-Salam General Hospital in Mosul city, Iraq, from November 2015 to October 2016. All patients fulfilling the Rome III criteria for IBS were screened for CD using antitissue transglutaminase IgA antibodies (anti-tTG). Patients who tested positive were subjected to endoscopic duodenal biopsy to confirm the diagnosis of CD. Results: A total of 100 patients were included in the present study (58 female and 42 male), the mean age of the participants was 40.8 years old (standard deviation [SD]±11.57). Ten patients (10/100, 10%) tested positive for anti-tTG antibodies. Five of the seropositive patients (5/10, 50%) showed positive biopsy results according to the Marsh classification, 3 of whom having diarrhea, and 2 with constipation. Conclusion: Positive serology and biopsy results suggestive of CDare common among patients with IBS. Screening patients with IBS for CD is justified. (AU)

Frecuencia de anticuerpos anti-transglutaminasa y antiendomisio en pacientes con diabetes tipo 1 / Association of type 1 diabetes mellitus with celiac disease

Background: Type 1 diabetes mellitus and celiac disease share common genetic and immunological aspects and celiac disease is more common among type 1 diabetic patients. Aim: To determine the frequency of anti endomysial and anti transglutaminase antibodies among patients with type 1 diabetes. Material and Methods: Anti endomysialantibodies determined by indirect immunofluorescence an anti transglutaminase antibodies determined by ELISA were measured in 410 serum samples of patients with type 1 diabetes. Results: Seventy one samples (17 percent) had positive anti transglutaminase antibodies. Among these, 17 had also positive anti endomysial antibodies. In 11 of these 17 patients, the presence of celiac disease was confirmed. Conclusions: Among patients with type 1 diabetes mellitus, the frequency of celiac disease is three times higher than in the general population.

Determination of amorphous/rubbery states in freeze-dried prebiotic sugars using a combined approach of near-infrared spectroscopy and multivariate analysis.

Galacto-oligosaccharides (GOS) and lactulose are well-recognized prebiotics widely used in functional food and pharmaceutical products, but there is still a lack of knowledge regarding their physical-chemical properties. In this study, a physical-chemical approach on two GOS of different composition (GOS Cup Oligo H-70® and GOS Biotempo) and lactulose was assessed. Mid infrared and Raman spectra of the freeze-dried sugars allowed their structural characterization in the amorphous state, lactulose, showing the main spectral differences. Freeze-dried sugars were then equilibrated at 4°C at relative humidity (RH) ranging from 11% to 80%. Near-infrared reflectance spectra were registered in each condition in the 900- to 1700-nm region. A principal component analysis (PCA) was performed on the three sugars equilibrated at different RH. In all the three sugars, the groups observed explained more than 95% of the variance and were related with the RH of the samples. According to the loading plots of PC1, the main differences related with RH were observed in the 1380- to 1500-nm region. As the amorphous states are very sensitive to changes in temperature and moisture content, and the moisture content is related with the parameter T-Tg (T: storage temperature; Tg: vitreous transition temperature), an effort was made to determine this parameter directly from the NIR spectra. To this aim, a partial least square model (PLS) was defined. Tg values obtained by differential scanning calorimetry (DSC) were used to calculate the T-Tg values of reference. The model was validated with an independent set of data. The mean of predicted values fitted nicely T-Tg obtained from DSC (correlation=0.966; R2=0.934), thus supporting the use of the PLS model to investigate unknown samples. The stability of amorphous sugars in foods and pharmaceuticals is of practical and economical importance because it affects different quality attributes of foods, including texture, aroma retention and shelf life. Therefore, predicting T-Tg, a parameter that is independent on the sugar investigated, directly from their NIR spectra is of utmost importance to determine the shelf life of food and food-related products and up to our knowledge has never been determined hereto.

Low incidence of pathology detection and high cost of screening in the evaluation of asymptomatic short children.

OBJECTIVE: To determine the incidence of pathology during routine screening of healthy short children, testing adherence to a consensus statement on the diagnosis and treatment of children with idiopathic short stature, and the cost per identified diagnosis resulting from comprehensive screening. STUDY DESIGN: Retrospective chart review of 1373 consecutive short stature referrals evaluated at the Cincinnati Children's Hospital Medical Center Pediatric Endocrinology Clinic between 2008 and 2011. We identified 235 patients with a height of <3rd percentile, negative history and review of systems, and normal physical examination. Outcome measures were incidence of pathology detection, diagnostic group characteristics, clinicians' adherence to testing guidelines, and screening costs. ANOVA and χ(2) were used to analyze the data. RESULTS: Nearly 99% of patients were diagnosed as possible variants of normal growth: 23% with familial short stature, 41% with constitutional delay of growth and maturation, and 36% with idiopathic short stature. The incidence of newly diagnosed pathology was 1.3%: 1 patient with biopsy-proved celiac disease, 1 with unconfirmed celiac disease, and 1 with potential insulin-like growth factor I receptor defect. On average, each patient had 64.3% of the recommended tests for age and sex; 2.1% of patients had all of the recommended testing. The total screening tests costs were $315321, yielding $105107 per new diagnosis entertained. CONCLUSIONS: Healthy short children do not warrant nondirected, comprehensive screening. Future guidelines for evaluating short stature should include patient-specific testing.

Petrology of dioritic, tonalitic and trondhjemitic gneisses from Encantadas Complex, Santana da Boa Vista, southernmost Brazil: paleoproterozoic continental-arc magmatism

The Encantadas Complex is a unit composed of dioritic, tonalitic and trondhjemitic gneisses with minor hornblendite. This complex is intruded by granites of Neoproterozoic age. Major and trace element data indicate metaluminous to slightly peraluminous composition related to the medium-K calc-alkaline series. Compositional parameters are consistent with a common evolution from less differentiated magmas, probably through fractional crystallization. The orthogneisses show LaN/YbN ratios from 10 to 50, K2O/Na2O varying from 1.1 to 3.0, Y contents from 3 to 39 ppm, Yb from 0.3 to 3.7, and Lu with contents in the range 0.06 and 0.54 ppm. Such geochemical features are similar to those of Archaean tonalitic rocks and are usually described in rocks formed by partial melting of mafic rocks under high-pressure conditions leaving an eclogitic residue. The presence of diorites and hornblendites, associated to tonalitic and trondhjemitic gneisses suggests, on the other hand, that tonalitic magmas could be formed by hornblende-controlled fractionation of hydrous basaltic magmas. Tonalitic gneisses show U-PbSHRIMP zircon age of 2, 263 ± 6 Ma for igneous crystallization and 2, 045 ± 10 Ma for the metamorphism. The geochemical parameters, tectonic and geochronological features of Encantadas Complex are consistent with magmas derived from mantle metasomatized by subduction-related fluids in a continental-arc.

O Complexo Encantadas é constituído por gnaisses tonalíticos, trondhjemíticos e dioríticos com presença subordinada de hornblenditos. Os elementos maiores e traços indicam uma composição metaluminosa a fracamente peraluminosa relacionada às séries cálcico-alcalinas médio-K. Os parâmetros composicionais são consistentes com uma evolução associada provavelmente a cristalização fracionada a partir de magmas menos diferenciados. Os ortognaisses mostram razões LaN/YbN variando entre 10 até 50, K2O/ Na2O entre 1,1 e 3,0, com conteúdos de Y entre 3 e 39, Yb entre 0,3 e 3,7 e Lu entre 0,06 e 0,54. Estas feições são similares às descritas em tonalitos arqueanos, usualmente atribuídas à fusão parcial de seqüências máficas sob condições de alta pressão deixando um resíduoeclogítico. A presença de dioritos e hornblenditos, associados aos gnaisses tonalíticos e trondhjemíticos sugere, por outro lado, que os mesmos podem representar rochas com uma evolução comum, geradas provavelmente por fracionamento de hornblenda a partir de magmas básicos hidratados. Os tonalitos apresentam idade U-PbSHRIMP em zircão de 2,263±6Ma para a cristalização e 2,045±10Ma para o metamorfismo. Os parâmetros geoquímicos, tectônicos e geocronológicos são consistentes com magmas derivados de manto metassomatizado por fluídos relacionados com subducção oceânica em uma margem continental ativa.