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Register a new userThe sensitivity and specificity of duodenal endoscopic findings in the diagnosis of celiac disease in children
حساسية ونوعية الموجودات التنظيرية للعفج في تشخيص الداء الزلاقي عند الأطفال
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تم تعيين عدة مظاهر عيانية أثناء تنظير العفج عند مرضى الداء الزلاقي، أجريت هذه الدراسة من أجل تحديد القيمة التشخيصية لبعض العلامات التنظيرية المشاهدة عند مرضى الزلاقي بهدف استخدامها في التشخيص السريري للمرض كمشعر إضافي يدعم التشخيص. شملت الدراسة 504 أطفال راجعوا بأعراض مختلفة (فشل نمو، إسهال أو إمساك مزمن، فقر دم غير مفسر، نقص وزن)، وخضعوا لإجراء تنظير هضمي علوي. تم تقييم أربع علامات تنظيرية في القطعتين الثانية والثالثة للعفج هي: التحرشف، قلة الانثناءات، المظهر العقيدي، والالتهاب المزمن (البقع البيضاء). شُخص الداء الزلاقي بناء على نتيجة التشريح المرضي للخزعة المأخوذة أثناء التنظير عند 123 مريضاً، تراوحت أعمار المرضى من 6 أشهر إلى 15 سنة. وكانت علامة التحرشف الأعلى حساسية ونوعية 89%، 96% على التوالي. القيم التشخيصية لهذه العلامات بشكل عام (الحساسية91%، النوعية 76%، القيمة التنبئية الإيجابية 56%، والقيمة التنبئية السلبية 97%). لاحظنا أن وجود الداء الزلاقي وكذلك الدرجة النسيجية حسب تصنيف Marsh يتعلق بوجود العلامات التنظيرية
Several appearances were assigned in duodenum during endoscopy in patients with celiac disease, this study was conducted to determine the diagnostic value of some endoscopic markers in celiac patients in order to be used in the clinical diagnosis of the disease an additional factor supporting the diagnosis. The study included 504 children reviewed the different symptoms (failure to thrive, chronic diarrhea or constipation, unexplained anemia, weight loss), and underwent an upper gastrointestinal endoscopy. Four markers were evaluated in the second and third part of the duodenum are: scalloping, reduction of duodenal folds, nodular mucosal pattern, and chronic inflammation (punctate whitish spots) . Celiac disease was diagnosed at 123 patients, which was based on the result of the pathology biopsy taken during endoscopy, the patients ranged in age from 6 months to 15 years. Scalloping was the highest sensitivity and specificity marker of 89% ,96 % respectively. Diagnostic values for these signs in general ( 91% sensitivity, 76% specific, positive predictive value 56 %, and negative predictive value 97% ). We observed that the presence of celiac disease, as well as histological grade rating by Marsh classification respect to the existence of endoscopic markers.
Artificial intelligence review:
Research summary
تهدف هذه الدراسة إلى تقييم حساسية ونوعية العلامات التنظيرية للعفج في تشخيص الداء الزلاقي عند الأطفال. شملت الدراسة 504 أطفال يعانون من أعراض متنوعة مثل فشل النمو، الإسهال أو الإمساك المزمن، فقر الدم غير المفسر، ونقص الوزن. تم تقييم أربع علامات تنظيرية في القطعين الثانية والثالثة للعفج وهي: التحرشف، قلة الانتناءات، المظهر العقيدي، والالتهاب المزمن (البقع البيضاء). تم تشخيص الداء الزلاقي بناءً على نتيجة التشريح المرضي للخزعة المأخوذة أثناء التنظير عند 123 مريضاً. كانت علامة التحرشف الأعلى حساسية ونوعية بنسبة 89% و96% على التوالي. القيم التشخيصية لهذه العلامات بشكل عام كانت: الحساسية 91%، النوعية 76%، القيمة التنبؤية الإيجابية 56%، والقيمة التنبؤية السلبية 97%. لاحظت الدراسة وجود علاقة بين وجود الداء الزلاقي والدرجة النسيجية حسب تصنيف Marsh مع وجود العلامات التنظيرية.
Critical review
دراسة نقدية: تقدم هذه الدراسة إسهاماً مهماً في تشخيص الداء الزلاقي عند الأطفال باستخدام العلامات التنظيرية. ومع ذلك، هناك بعض النقاط التي يمكن تحسينها. أولاً، كان من الأفضل توسيع العينة لتشمل فئات عمرية مختلفة وأعراض متنوعة أكثر لتعميم النتائج بشكل أفضل. ثانياً، يجب أن تكون هناك مقارنة مع تقنيات تشخيصية أخرى مثل الاختبارات المصلية لتحديد مدى فعالية العلامات التنظيرية مقارنةً بها. أخيراً، كان من الممكن تقديم تحليل أكثر تفصيلاً للعوامل التي قد تؤثر على دقة التشخيص مثل الخبرة الفنية للمنظرين.
Questions related to the research
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ما هي العلامة التنظيرية الأكثر حساسية ونوعية في تشخيص الداء الزلاقي عند الأطفال؟
علامة التحرشف كانت الأكثر حساسية ونوعية بنسبة 89% و96% على التوالي.
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ما هي الأعراض الأكثر شيوعاً التي دفعت الأطفال لإجراء التنظير الهضمي العلوي في هذه الدراسة؟
الأعراض الأكثر شيوعاً كانت فشل النمو وفقر الدم غير المفسر.
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ما هو الهدف الأساسي من هذه الدراسة؟
الهدف الأساسي هو تحديد حساسية ونوعية بعض العلامات العيانية أثناء تنظير العفج في تشخيص الداء الزلاقي.
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ما هي العلاقة بين العلامات التنظيرية والدرجة النسيجية حسب تصنيف Marsh؟
لاحظت الدراسة وجود علاقة مهمة بين العلامات التنظيرية وتقدم الدرجة النسيجية حسب تصنيف Marsh.
References used
[Guandalini S, Setty M. Celiac disease. Curr Opin Gastroenterol. Nov 2008;24(6):707-12. [Medline
[Husby S, Koletzko S, et al. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease. J Pediatr Gastroenterol Nutr. Jan 2012;54(1):136-60. [Medline
Guandalini S, ed. Celiac Disease. In. Textbook of Pediatric Gastroenterology and Nutrition. London: Taylor & Francis;. 2004: 435-50
[Baydoun A, Maakaron JE, Halawi H, Abou Rahal J, Taher AT. Hematological manifestations of celiac disease. Scand J Gastroenterol. Dec 2012;47(12):140111. [Medlin
[Riddle MS, Murray JA, Porter CK. The incidence and risk of celiac disease in a healthy US adult population. Am J Gastroenterol. Aug 2012;107(8):1248-55. [Medline
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This study included 502 children between 0,5-15 years old. They were all subjected to duodenal biobsy for several reasons, and underwent investigations; Hb, MCV, MCH, MCHC and RDW.
The prevalence of celiac disease among anemic children was higher
than nonanemic patients (36,04% vs 12,14%). The mean duration of compliance was higher in both anemic children and celiac patients than in comparing groups .The mean levels of Hb,MCV,MCH and MCHC were lower in celiac group, while RDW was higher. Anemia was the most common presentation of celiac disease and it was seen in 77% among celiac children, while failure to thrive was detected in 43% of celiac group. Clinicians should consider celiac disease as a possible cause of anemia in all subjects with unexplained or refractory anemia
This study was performed in children’s hospital of Damascus University which
included all cases of hydatid cysts admitted to the hospital between 1/1/1994 and
1/9/1996.
The number of cases totaled 47 which accounted for 1.4 to 2.4 per 1000
admission in different years.
As the prevalence of obesity has been increasing rapidly worldwide in recent times where
became of the most important diseases of age and the most influential public health, where a
second reason stainless prevention after smoking and leading to de
adly diseases, where it proved its
relationship with many cancers, especially cancers women such as cancer of the endometrine of the
uterus and breast cancer, where one study showed that obesity increases the progression of a range
of cancers also increase the proportion of morbidity and mortality resulting scientifically it is useful
to highlight the impact of obesity on the cellular changes and cervical colposcopy.
Research aim and justifications:To draw attention to the importance of obesity as a potential
factor to cause cellular alterations in the cervix due to it being a factor can be prevented and thus
emphasize the need to include obese within the league scanning programs.
The absence of a similar earlier study in Assad University Hospital.
Research methods and materials:Study 100 included sick of reviews the department of obstetrics
and gynecology at the Assad University Hospital in Lattakia during the period between 01/01/2012
and 01/01/2014, where they were questioning the patients and record information on Bmhar body
mass (weight, height) and did not study included patients smokers or users of oral contraceptives or
devices within the uterus (IUDs) or pregnant women or women with frequent infections.
Results :
- The existence of consensus between the results of endoscopic magnifier of the cervix and
cytological tests observed any that theory has not ignored any abnormal condition, with some cases
of false positive and this goes back to that colposcopy is a diagnostic test depends on the evaluation
of endoscopy specialist and his expertise in the interpretation of laparoscopic assets.
- Also found consensus among the results of smear and cellular screening with the presence
also some cases of false positive and this is due to not taking the biopsy directed properly, as is the
smear relatively test depends on the estimation of anatomy specialist patients and the presence of
abnormalities cell or to the extent this anomaly or for the possibility of error contained in the way
sampling or sample installed.
Conclusion:It turns out the study and depending on the value of the P value of a relationship
between obesity and assets laparoscopic and cellular cervix and thus conclude that all of Stain and
theorizing magnifier of the cervix and Sillete survey competently and are necessary can rely on
them in the initial survey for cancerous lesions and pre-cancer of the cervix in women obese.
Recent studies has proved that high proportion of reflux episodes in Gastro
Esophageal Reflux Disease(GERD) were non acidic ,and could not be detected by classic pH metry alone,
especially less than 2 years, in whom nutrition is mainly depending on
milk .It was too necessarily to improve
a new technique (Multichannel Intraluminal Impedance MII) ,and by this any retrograde flow to
the esophagus can be detected . The aim of this study was to determine whether pH-monitoring alone is
sufficient to diagnose the Gastro Esophageal Reflux Disease (GERD),and how much the diagnosis was
improved after Multichannel Intraluminal Impedance (MII) has been added to the standard pH catheter
in children less than 2 years.
Aim of study: Evaluating the oral health status of children with congenital heart
disease in comparison with the healthy children in Lattakia city.
Materials and Methods: A total of 100 children aged between 5 and 12 years
attending the pediatric
clinic of AL-Assad Hospital-Lattakia were included. The study
group was consisted of 50 children diagnosed with heart disease. The control group was
consisted of 50 healthy children of the same age and gender. Dental caries, plaque,
gingivitis and developmental enamel defects were assessed for each child in the two
groups.
Results: Mean dmft, gingivitis and plaque were significantly higher in the cardiac
group as compared to the control group. Statistically, no significant differences were found
in the comparison between the prevalence of developmental enamel defects and mean
DMFT for the two groups.
Conclusion: Children with congenital heart disease had a poor oral health compared
to the healthy children, which increased the risk of susceptibility to bacteremia and
development of infective endocarditis. Therefore, dental care for children with heart
disease must be seriously considered at an early age when the first tooth erupts.
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