1,720,957 research outputs found
Non-biopsy Strategy for the Diagnosis of Celiac Disease in Adults: A Narrative Review
No full textCeliac disease (CeD) diagnosis is a complicated process, requiring a multi-step procedure and a high level of clinical knowledge. Some scientific societies, mainly from Europe and North America, have proposed appropriate guidelines for the diagnosis and management of CeD. Since duodenal biopsy is particularly challenging for children, guidelines of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition, presented in 2012 and updated in 2020, have made it possible to avoid the biopsy in symptomatic pediatric patients with high levels of IgA anti-transglutaminase. Several parallel, similar studies in adults support the non-biopsy strategy. However, several pros and cons exist in applying such a strategy. The present narrative review reports the current evidence and the implication of omitting biopsy in the diagnosis of CeD in adults
Associations between Celiac Disease, Extra-Gastrointestinal Manifestations, and Gluten-Free Diet: A Narrative Overview
No full textMillions of children and adults worldwide suffer from undiagnosed and untreated celiac disease (CeD). The clinical picture of CeD is highly heterogeneous and comprises manifestations that can affect almost the whole body. This narrative overview is aimed at characterizing diseases and complaints that are associated with unrecognized CeD and that frequently involve sites other than the gastrointestinal (G.I.) tract, i.e., dental, otorhinolaryngological, and ocular complications; skin and hair abnormalities; afflictions of the bones, joints, and muscles; cardiovascular affectations; kidney diseases; neuro-psychiatric disorders; and gynecological-obstetrical manifestations. The association between CeD and extra-GI manifestations is frequently overlooked, which leads to a delay in diagnosis. Most CeD-mediated disorders can be treated with a strict gluten-free diet (GFD), but some of them are irreversible unless CeD is diagnosed in time. Some manifestations can be classified as risk factors for CeD, and CeD screening tests for affected patients should be selectively considered. Apart from gastroenterologists, specialists in other medical disciplines can play an important role in identifying people with unrecognized CeD and may help prevent its progress and long-term complications. Further comprehensive investigations are necessary to clarify the pathogenesis of extra-GI manifestations and the effect of a GFD
Gastrointestinal and Hepatobiliary Manifestations Associated with Untreated Celiac Disease in Adults and Children: A Narrative Overview
No full textCeliac disease (CeD) is a chronic inflammatory disease of the small intestine, produced by ingesting dietary gluten products in susceptible people. Gluten causes an impairment of the mucosal surface and, consequently, an abnormal absorption of nutrients. Although malabsorption of essential nutrients is a major risk factor for various CeD-associated morbidities, genetic, immunological, and environmental factors also play an important role. The clinical presentation of CeD widely varies and can range from asymptomatic to full-blown symptoms due to the multi-system nature of CeD. The typical gastrointestinal (GI) manifestations of CeD include abdominal pain, diarrhea, bloating, and weight loss, but several hepatobiliary manifestations and a poor nutritional status have also been described. Currently, a gluten-free diet (GFD) is the only current evidence-based treatment that leads to the complete recovery of mucosal damage and the reversibility of its progression. Conversely, undiagnosed CeD might have severe consequences in children as well as in adult patients. This narrative overview aims to characterize the GI and hepatobiliary manifestations, nutritional deficiencies, and delayed pediatric development associated with unrecognized CeD in order to identify it promptly. Moreover, the role of GFD and how it could prevent long-term complications of CeD are described
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Differences in medical care satisfaction of patients with “functional” vs “organic” esophageal diseases, Italian validation of the PPRS SF questionnaire
No full textPatient-physician relationship (PPR) plays a key role in modern healthcare, especially within gastrointestinal medical practice. In 2017 Kurlander et al. developed a Patient-Physician-Relationship-Scale (PPRS), a questionnaire used to assess the patients’ medical care-satisfaction. The PPRS was later simplified by Drossman et al. in 2021 by creating a PPRS-SF (short form). This study aimed to validate the PPRS-SF in Italian and to administer it to patients with “functional” and “organic” esophageal diseases, to highlight the differences in the PPR between the two categories. The process of validation was carried out following a standardized forward-backward procedure and each step was overseen by a Rome foundation independent clinical monitor. The Italian version of the PPRS-SF was then administered to 50 Eosinophilic Esophagitis (EoE), 53 Achalasia, 48 Gastroesophageal Reflux Disease (GERD) and 44 esophageal disorders of gut brain interaction (eDGBI) patients. In eDGBI and GERD, the degree of patients’ satisfaction was significantly lower. Between a score of -36 and + 36, the mean score for patients with EoE was 30.20 (± 9.78), for Achalasia 23.78 (± 19.9); for GERD 20.46 (± 16.03) and for esophageal DGBI 17.91 (± 18.41). Moreover, there was a negative significant correlation between the PPR and age (R=- 0.208). This study validated the Italian version of the PPRS-SF questionnaire and showed that the patients’ diagnosis together with other factors such as their age, can affect the PPR. In particular, patients with DGBI and older patients reported lower scores than the ones with organic diseases and the younger ones, respectively
Fertility in Celiac Disease: The Impact of Gluten on Male and Female Reproductive Health
No full textCeliac disease (CeD) is a chronic immune-mediated disorder of the small intestine triggered by the ingestion of dietary gluten. This narrative review aims to summarize and critically evaluate the recent literature on the association between CeD and infertility, with an emphasis on identifying patterns and inconsistencies. Previous studies have reported conflicting findings: while some demonstrate a higher prevalence of unexplained infertility in patients with CeD, others do not support this association. Overall, untreated CeD may be a contributing factor to infertility, especially unexplained cases, and a gluten-free diet (GFD) might improve fertility outcomes. However, the general prevalence of infertility in CeD patients does not appear to exceed that of the general population. This review includes evidence on both male and female infertility and examines possible pathophysiological mechanisms, including nutritional deficiencies, immune-mediated effects, and sexual dysfunction. Further high-quality prospective studies are needed to determine the true impact of CeD on reproductive health and to inform screening guidelines
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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