Evidence-based guidelines for growth monitoring

Guidelines for growth monitoring can be established according to two approaches. According to the clinical approach, health workers are expected to base their assessment on the cumulative information from the medical history, physical examination and growth against a background of knowledge about the possible causes. The second approach is that...

Long-term health and quality-of-life consequences of mass screening for childhood celiac disease: A 10-year follow-up study

OBJECTIVE. Mass screening for celiac disease is controversial. The objective of this study was to determine whether detection of childhood celiac disease by mass screening improves long-term health status and health-related quality of life. METHODS.We conducted a prospective 10-year follow-up study of 32 children who were aged 2 to 4 years, had...

Efficient degradation of gluten by a prolyl endoprotease in a gastrointestinal model: Implications for coeliac disease

Background: Coeliac disease is caused by an immune response to gluten. As gluten proteins are proline rich they are resistant to enzymatic digestion in the gastrointestinal tract, a property that probably contributes to the immunogenic nature of gluten. Aims: This study determined the efficiency of gluten degradation by a post-proline cutting...

Microbial transglutaminases generate T cell stimulatory epitopes involved in celiac disease

Celiac disease (CD) is a permanent intolerance to gluten. In CD patients, gluten peptides cause an inflammation in the small intestine leading to tissue damage. Tissue transglutaminase (tTG) is an enzyme involved in the repair of damaged tissue by crosslinking of extracellular matrix proteins. Under certain conditions, tTG can deamidate...

Developing evidence-based guidelines for referral for short stature

Objective: To establish evidence based guidelines for growth monitoring on a population basis. Study design: Several auxological referral criteria were formulated and applied to longitudinal growth data from four different patient groups, as well as three samples from the general population. Results: Almost 30% of pathology can be detected by...

Parental opinions about the expansion of the neonatal screening programme

Background: Advances in genomics will open up opportunities in the fields of genetic testing, early diagnosis and disease treatment. While neonatal screening is the field of application par excellencefor these developments, the debate on its potential benefits and drawbacks is mainly theoretically driven and based on the opinions of...

Screening rules for growth to detect celiac disease: A case-control simulation study

Background: It is generally assumed that most patients with celiac disease (CD) have a slowed growth in terms of length (or height) and weight. However, the effectiveness of slowed growth as a tool for identifying children with CD is unknown. Our aim is to study the diagnostic efficiency of several growth criteria used to detect CD children....

The diagnostic work up of growth failure in secondary health care ; An evaluation of consensus guidelines

Background: As abnormal growth might be the first manifestation of undetected diseases, it is important to have accurate referral criteria and a proper diagnostic work-up. In the present paper we evaluate the diagnostic work-up in secondary health care according to existing consensus guidelines and study the frequency of underlying medical...

Health related quality of life problems of children aged 8-11 years with a chronic disease

In paediatric research, Health-Related Quality-of-Life (HRQoL) has received increasing recognition as an important health outcome. This study aimed to investigate the nature and prevalence of HRQoL problems in children with different chronic diseases. Data were available on 318 children aged 8-11 years with different diseases: congenital heart...

Most probable origin of coeliac disease is low immune globulin A in the intestine caused by malfunction of Peyer's patches

Coeliac disease frequency increases by obscure reasons and affects in some Western countries as much as 1% of the populations. The second one of monozygotic twins does not develop the disease in 100% but only in 20-50%. To unravel these mysteries, literature was searched to determine the disease background and find suggestions for research and...

Coeliac Disease: Background and biochemical aspects

Coeliac Disease has to be considered a main food related affliction, with life long consequences for the people having the disease. Coeliac Disease patients suffer from adverse effects that can be related to specific gluten peptide sequences that trigger a sequence of immune related reactions leading to damage of the intestine and related...

A novel and sensitive method for the detection of T cell stimulatory epitopes of α/β- and γ-gliadin

Background: It is now generally accepted that coeliac disease (CD) is caused by inflammatory T cell responses to gluten peptides bound to HLA-DQ2 or -DQ8 molecules. There is overwhelming evidence that CD patients can mount T cell responses to peptides found in both α-gliadin and γ-gliadin molecules. Assays that would detect the presence or...

Is Candida albicans a trigger in the onset of coeliac disease?

Coeliac disease is a T-cell-mediated autoimmune disease of the small intestine that is induced by ingestion of gluten proteins from wheat, barley, or rye. We postulate that Candida albicans is a trigger in the onset of coeliac disease. The virulence factor of C albicans - hyphal wall protein 1 (HWP1) - contains aminoacid sequences that are...

Optimale zorg voor kinderen met het Down-syndroom en voor hun ouders [Optimal medical care for children with Down's syndrome and their parents]

Children with Down's syndrome have an increased risk of congenital anomalies and additional medical problems. These can be treated but are often seen as part of the syndrome and not as the cause of developmental retardation. Based on the current level of knowledge, specific medical tests and evaluations are recommended. The reasons for these...

Genetic risk factors for autoimmune diseases

In most autoimmune diseases multigenic factors play a significant role in pathogenesis. Progress in identifying these genetic factors, many of which are located outside the major histocompatibility complex, was the subject of a recent meeting. Chemicals/CAS: Interleukin-10, 130068-27-8; Transforming Growth Factor beta; Tumor Necrosis Factor-alpha

Assessment of human exposure to fumonisin B1

Fumonisin B1 is currently regarded as the most significant mycotoxin produced by Fusarium spp. It has carcinogenic properties and may play a role in the etiology of human esophageal cancer. The human population is exposed to fumonisin B1 primarily by intake of fumonisin B1-contaminated maize. Maize consumed in the Netherlands is imported from...

Twintig jaar coeliakie bij kinderen in Nederland: Meer diagnosen en een veranderde verschijningsvorm [Twenty years of childhood coeliac disease in the Netherlands: More diagnoses and changed clinical picture]

Objective. To assess the incidence of childhood coeliac disease in the Netherlands and to study the clinical features. Design. Prospective. Setting. Leiden University Medical Centre, Leiden, the Netherlands. Method. Cases of childhood coeliac disease in the Netherlands in 1993-1995 were identified by means of the Dutch Paediatric Surveillance...

Twenty years of childhood coeliac disease in The Netherlands: A rapidly increasing incidence

Background - The incidence of coeliac disease varies internationally. Aims - To assess the incidence of childhood coeliac disease in The Netherlands and to study the clinical features and the presence of associated disorders. Subjects - Identified cases of childhood coeliac disease in The Netherlands in 1993-4 by means of the Dutch Paediatric...