scholarly journals Measures of gluten-related reactivity in children with autism spectrum disorders in the absence of overt gastrointestinal symptoms: a pilot study from the United Arab Emirates

2020 ◽  
Vol 48 (9) ◽  
pp. 030006052095265
Author(s):  
Mohamed Abdel-Maksoud ◽  
Dina Aly El-Gabry ◽  
Tahani Al Kayoumi ◽  
Jamila Alketbi ◽  
Duaa Mohamednour ◽  
...  
Keyword(s):  
United Arab Emirates ◽  
Clinical Symptoms ◽  
Tissue Transglutaminase ◽  
Gastrointestinal Symptoms ◽  
Autism Spectrum ◽  
Immune Reactivity ◽  
Immunological Responses ◽  
Significant Difference ◽  
High Prevalence ◽  
Gliadin Peptide

Objectives The aetiology of autism spectrum disorder (ASD) is multifactorial, sometimes genetic, and may be associated with abnormal immunological responses to peptides from proteins such as gluten. These peptides may cross the blood-brain barrier and affect neurotransmission, resulting in behavioural symptoms consistent with ASD. The aim of this study was to screen for markers of gluten-related immune reactivity in the absence of overt gastrointestinal symptoms in patients with ASD in the United Arab Emirates, a country associated with a high prevalence of ASD but lacking this type of research. Methods Patients diagnosed with ASD (using Diagnostic and Statistical Manual of Mental Disorders-IV-based criteria and Autism Diagnostic Observational Schedules) were compared with controls, regarding anti-tissue transglutaminase (tTG) immunoglobulin (Ig) A and anti-deamidated gliadin peptide (DGP) IgA levels. Results Sixty-six patients with ASD and 101 controls were included. Patients with ASD showed statistically significant lower anti-DGP IgA levels, but no significant difference in anti-tTG IgA levels, versus healthy controls. Correlations between immunological data and clinical symptoms were synergistic, but not statistically significant. Conclusion ASD may be associated with reduced levels of anti-DGP IgA.

scholarly journals Correlation between Clinical Symptoms of Coeliac Disease, Serum IgA Anti TTG and Biopsy in Pediatric Population of Northern India

2020 ◽  
Vol 8 (1) ◽  
pp. 65-68
Author(s):  
Sumit Jeena ◽  
Jaswinder Kaur ◽  
Nishant Wadhwa
Keyword(s):  
Coeliac Disease ◽  
Clinical Symptoms ◽  
Tissue Transglutaminase ◽  
Pediatric Population ◽  
Clinical Manifestations ◽  
North India ◽  
P Value ◽  
Serum Iga ◽  
Significant Difference ◽  
The Mean

Background: Celiac disease is basically an immune-mediated enteropathic condition produced by permanent sensitivity to gluten in genetically susceptible subjects. There is paucity of data in north India regarding clinical symptoms of coeliac disease, Serum IgA Anti TTG and Biopsy in pediatric population. The present study was conducted with the aim to determine the correlation between clinical symptoms of coeliac disease, Serum IgA Anti TTG and Biopsy in pediatric population of northern India.Materials and Methods: The present study was conducted in prospective including 73 pediatric patients at Department of Pediatric Gastroenterology, Institute of Child Health, Sir Gangaram Hospital, New Delhi, India. Esophagogastroduodenoendoscopy and serum anti Ig A tissue transglutaminase were performed. The characteristic scalloping of the folds were looked for in endoscopy followed by four duodenal biopsies performed from second part of duodenum and histological grading was performed as per modified marsh system. Patients with Serum IgA anti tTG>20 U/ml were confirmed to be at risk. Complete histological work up was done including hemoglobin, RBC indices and peripheral blood smear examination. The association of clinical manifestations with disease grade was also established with correlation coefficient. All the data thus obtained was arranged in a tabulated form and analyzed using SPSS software. Probability value of less than 0.05 was regarded as significant.Results: There were 4 males and 16 females with marsh grade 1 and 2 and mean age of 7.3±1.9 years. There were 5 males and 8 females with marsh grade 3a and mean age of 6.8±2.3 years. The mean weight of 18.11±3.89, height of 103.17±8.73 and BMI of 16.26±3.78 was observed amongst subjects with Marsh grade 1 and 2. The mean weight of 15.12±3.17, height of 99.28±9.19 and BMI of 15.02±3.20was observed amongst subjects with Marsh grade 3a. Diarrhoea was maximum amongst subjects with grade 3c and 4(70%) and minimum amongst Grade 1 and 2 (40%). There was a significant difference between the frequency of anemia amongst different grades as the p value was less than 0.05.Conclusion: The most common presenting signs and symptoms were diarrhea and abdominal pain. The study also concluded that the incidence of anemia increases with higher marsh grades.

Cellular immune response studies in bancroftian filariasis

1997 ◽  
Vol 71 (3) ◽  
pp. 265-267 ◽  
Author(s):  
J. Regunathan ◽  
K. Jayaraman ◽  
P. Kaliraj
Keyword(s):  
Immune Response ◽  
Mononuclear Cells ◽  
Genomic Library ◽  
Clinical Symptoms ◽  
Wuchereria Bancrofti ◽  
Proliferative Index ◽  
Peripheral Blood Mononuclear ◽  
Immunological Responses ◽  
Significant Difference ◽  
Cellular Immune

AbstractAn attempt was made to identify the filarial specific antigens that are capable of inducing immune response in human filariasis. Lymphocytes were taken from three clinically defined groups living in an endemic area in Madras, namely microfilaraemic (MF) subjects with microfilariae in their blood smear without any clinical symptoms, chronic pathology (CP) individuals with lymphangitis or lymphadenitis in combination with a history of recurrent filarial fevers or lymphoedema, and endemic normals (EN) subjects without microfilariae nor any clinical symptoms of pathology. Lymphocytes from the three groups responded with no significant difference (P = 0.21) in their proliferative index to PPD and PHA, although lymphocytes from MF individuals showed significantly (P < 0.001) less proliferative index to Brugia malayi antigen (BMA) than the CP and EN subjects. This antigen specific cellular unresponsiveness seen in MF patients was not reversed by the addition of recombinant IL-lα, IL-1β, and IFN-γ, but the addition of sera from EN individuals seemed to restore this unresponsiveness (P < 0.001). The peripheral blood mononuclear cells from MF patients secreted more IL-1 in response to BMA induction than the same from CP and EN individuals. A 58 kDa recombinant protein isolated from a Wuchereria bancrofti genomic library (58 kDa) had mounted a higher proliferative response to lymphocytes from all three groups compared to BMA (P < 0.001) indicating the possible use of recombinant filarial protein to mount immunological responses in filarial patients.

scholarly journals Clinical features and outcome of fecal retention in infancy

2020 ◽  
Author(s):  
Lu Ren ◽  
Lan-Lan Geng ◽  
hong-li Wang ◽  
si-tang Gong ◽  
Jing Xie ◽  
...  
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Clinical Features ◽  
Clinical Symptoms ◽  
Gastrointestinal Symptoms ◽  
Treatment Rate ◽  
Record System ◽  
Significant Difference ◽  
Normal Defecation

Abstract 1) Background: To understand the clinical features and outcome of fecal retention in infancy(FRI), so as to guide the focus and intervention methods of such infants.2) Methods: The electronic medical record system(EMRS)was used to collect and screen out cases diagnosed as fecal retention from June 2018 to June 2019 in outpatient clinic of our hospital. The age, feeding method, frequency and traits of stool, and accompanying symptoms were recorded. The changes of clinical symptoms, medical examinations and drug treatment by the age of 1 year were investigated by means of electronic medical record review and telephone follow-up.3) Results: A total of 286 infants were enrolled, 7 were lost to follow-up, and 279 were effectively followed up. There were 157 males and 129 females, with an age of 3.6 ± 1.5 months. The average stool frequency was 5.9 ± 1.8 days. 63.3% of the infants were breast-fed, 16.8% were formula-fed, and the rest were mixed-fed,all without supplementary food. 9.1% of the infants showed corresponding gastrointestinal symptoms, such as bloating, increased crying, decreased milk intake, and laborious defecation. 87.1% of the infants received medical treatment, including glycerin enema, probiotics, and Chinese herbal preparations, with an effective treatment rate of 7.8%. 38.7% of infants have undergone medical examination, including abdominal ultrasound, X-ray film / barium enema, blood test, etc, the positive rate is 14.8%. The duration of fecal retention in 53% of infants was ≤ 2 months, 22.6% between 2–3 months, 24.4% ≥ 3 months, with an average of 2.6 ± 1.1 months. At the age of followed up to 1 year, 16.8% of infants developed functional constipation(FC). Compared with other infants with normal defecation, there was no significant difference in age, frequency of stool, the proportion of breast milk feeding and receiving treatment, and there was a significant difference in the duration of fecal retention. The duration of FC group was longer than normal defecation group by which was 3.49 ± 0.83 months.4) Conclusions: Infants with fecal retention are more likely to develop FC at age 1 than general population, and may be positively related to the duration of fecal retention.

scholarly journals EXCESS WEIGHT AND GASTROINTESTINAL SYMPTOMS IN A GROUP OF AUTISTIC CHILDREN

2020 ◽  
Vol 38 ◽  
Author(s):  
Dayane Verissimo da Silva ◽  
Poliana Novais Moreira Santos ◽  
Danielle Alice Vieira da Silva
Keyword(s):  
Autism Spectrum Disorder ◽  
Nutritional Status ◽  
Gastrointestinal Symptoms ◽  
Multivariate Logistic Regression Analysis ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
World Health ◽  
Children With Asd ◽  
High Prevalence

ABSTRACT Objective: To evaluate the nutritional status and gastrointestinal changes in children with autism spectrum disorder (ASD). Methods: Cross-sectional, descriptive analysis of 39 children with ASD aged between three and ten years old, registered in the participating association. Nutritional status was evaluated by body mass index/age and weight/age, according to the guidelines from the World Health Organization. In order to investigate whether gastrointestinal alterations occurred, the interviewees answered a questionnaire about the presence of these symptoms within the last 30 days. In order to evaluate food consumption, a 24-hour recall questionnaire was applied and the food reported were grouped as: gluten sources, casein and ultra-processed sources. For the statistical analysis, Epi-Info software version 7.2 was used. Multivariate logistic regression analysis was performed to evaluate the variables associated with gastrointestinal alterations. Results: There was a high prevalence of overweight children with autism spectrum disorder (64.1%). No child was underweight. Thirty-four children (84.2%) had gastrointestinal symptoms. Consumption of gluten was associated with gastrointestinal symptoms (β=0.38; 95%CI 0.07-0.75; p=0.02). Conclusions: The high prevalence of being overweight should be considered during the follow-up visits of children with ASD. The influence of gluten consumption on the presence of gastrointestinal symptoms was observed in this study, and the causes involved in these alterations need to be further investigated.

Utility and Results from a Patient-Reported Online Survey in Myotonic Dystrophies Types 1 and 2

2020 ◽  
Vol 83 (5) ◽  
pp. 523-533
Author(s):  
Stephan Wenninger ◽  
Kristina Stahl ◽  
Federica Montagnese ◽  
Benedikt Schoser
Keyword(s):  
Muscle Weakness ◽  
Online Survey ◽  
Clinical Symptoms ◽  
Age Of Onset ◽  
Neuromuscular Disorders ◽  
Gastrointestinal Symptoms ◽  
Online Surveys ◽  
Cardiac Symptoms ◽  
Significant Difference ◽  
Patient Reported

<b><i>Introduction:</i></b> Myotonic dystrophies (DMs) are the most frequent autosomal dominant neuromuscular disorders in adults. Our objective was to evaluate the utility of an online survey in a rare disease as well as to assess and compare the onset and the progression of clinical symptoms in patients with myotonic dystrophy types 1 (DM1) and 2 (DM2). <b><i>Methods:</i></b> We conducted a patient’s reported online survey assessing demographics, disease-related symptoms (age of onset, first symptom, time of diagnosis, current symptoms, inheritance, and family history) combined with capturing current symptoms by validated questionnaires. The questionnaire consisted of open, closed, single- and multiple-choice questions. Multiple answers were possible in some cases. Patients with genetically confirmed DM1 or DM2 who were registered in the German DM registry or the <i>Deutsche Gesellschaft für Muskelkranke e.V.</i> – Diagnostic Group for DMs were invited to participate in this online survey. We calculated descriptive and exploratory analysis, where applicable. <b><i>Results:</i></b> Out of 677 data sets from respondents, 394 were suitable for final analysis, containing completed questionnaires from 207 DM1 (56% female) and 187 DM2 patients (71% female). The median age of onset was 28 years for DM1 and 35 years for DM2. Muscular symptoms were most frequently reported as the first symptom. The onset of myotonia was earlier than the onset of muscle weakness in both DM1 and DM2. Forty-four percent of patients with DM1 and one-third of patients with DM2 indicated muscle weakness as the first symptom. Patients with DM1 were significantly younger when experiencing muscle weakness as first symptom. Fatigue was only mentioned by a small fraction of patients as a first symptom but increased significantly in the course of the disease. There was no statistically significant difference in the incidence of cataracts, cardiac symptoms, and gastrointestinal symptoms between DM1 and DM2. Falls were reported almost equally in both groups, and most of the patients reported 2–3 falls within the past year. <b><i>Discussion:</i></b> Overall, as our results are consistent with the results of clinical studies and online registries, it can be assumed that this type of systematic gathering of data from patients with rare diseases is useful and provides realistic and appropriate results. Due to the nature of online surveys and the absence of an assessor, some uncertainty remains. Furthermore, survey frauds cannot be completely excluded. An additional clinical assessment could confirm the given information and will improve the utility and validity of reported symptoms participants provide in online surveys. Therefore, we recommend a combination of data collecting by online surveys and clinical assessments.

Radiotherapy-induced Haematological and Intestinal Toxicity in Cervical Cancer

2021 ◽  
Author(s):  
Ruishuang Ma ◽  
Xiaoxian Ye ◽  
Jianliang Zhou ◽  
Pengrong Lou ◽  
Shenchao Guo ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Leukocyte Count ◽  
Gastrointestinal Symptoms ◽  
Monocyte Count ◽  
Intestinal Toxicity ◽  
Lower Baseline ◽  
Conventional Radiation ◽  
Significant Difference ◽  
High Prevalence ◽  
The Relationship

Abstract Chemotherapy-induced myelosuppression is common and threatening, however, the effect of radiation on bone marrow activity especially leukocyte count has been underestimated in cervical cancer. Pelvic radiation-related intestinal toxicity is prevalent, and the relationship between leukopenia and intestinal toxicity is not clear. The clinical data of 59 patients who underwent conventional radiation alone for cervical cancer were retrospectively analyzed. The patients had normal leukocyte count on admission, and the blood cell count, GTV dose, intestinal toxicity were evaluated. During radiotherapy (RT), 47 patients (79.7%) developed into leukopenia with 38.3% mild and 61.7% moderate. The mean time for leucopenia was 9 days. Compared with leucopenia-negative patients, leucopenia-positive ones had lower baseline leukocyte count, while the neutrophil/lymphocyte (NLR) and monocyte/lymphocyte (MLR) showed no significance. Logistic regression analysis indicated that excluding the factors for age, BMI, TNM stage, surgery and GTV dose, baseline leukocyte count was an important independent predictor of leucopenia (OR=0.383). During RT, the significant reduction was found in leukocyte, neutrophil and lymphocyte count at week 2 while monocyte count after 2 weeks. Furthermore, NLR and MLR showed significant and sustained upward trend. About 54.2% patients had gastrointestinal symptoms, however, no significant difference was noted between leukocyte count as well as NLR/MLR and intestinal toxicity. Our results suggest a high prevalence of leucopenia in cervical cancer patients receiving RT, and those with low baseline leukocyte count are more likely for leucopenia, for whom early prevention of infection may be needed during RT.

Disorder-specific alterations of tactile sensitivity in neurodevelopmental disorders

2020 ◽  
Author(s):  
Jason He ◽  
Ericka Wodka ◽  
Mark Tommerdahl ◽  
Richard Edden ◽  
Mark Mikkelsen ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Autism Spectrum ◽  
Typically Developing ◽  
Hyperactivity Disorder ◽  
The Core ◽  
Children With Asd ◽  
Tactile Detection ◽  
Spectrum Disorders ◽  
Sensory Processes ◽  
Core Symptoms

Alterations of tactile processing have long been identified in autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorder (ADHD). However, the extent to which these alterations are disorder-specific, rather than disorder-general, and how they relate to the core symptoms of each disorder, remains unclear. We measured and compared tactile detection, discrimination and order judgment thresholds between a large sample of children with ASD, ADHD, ASD + ADHD combined and typically developing controls. The pattern of results suggested that while difficulties with tactile detection and order judgement were more common in children with ADHD, difficulties with tactile discrimination were more common in children with ASD. Strikingly, subsequent correlation analyses found that the disorder-specific alterations suggested by the group comparisons were also exclusively related to the core symptoms of each respective disorder. These results suggest that disorder-specific alterations of lower-level sensory processes exist and are specifically related to higher-level clinical symptoms of each disorder.

Supporting Youth With Autism Learning Social Competence: A Comparison of Game- and Nongame-Based Activities in 3D Virtual World

2021 ◽  
pp. 073563312110220
Author(s):  
Xianhui Wang ◽  
Wanli Xing
Keyword(s):  
Social Interaction ◽  
Social Competence ◽  
Central Element ◽  
Autism Spectrum ◽  
Virtual Learning Environment ◽  
Learning Activities ◽  
Behavior Patterns ◽  
Interaction Behavior ◽  
Significant Difference ◽  
The Impact

This study explored youth with Autism Spectrum Disorder (ASD) learning social competence in the context of innovative 3D virtual learning environment and the effects of gaming as a central element of the learning experience. The empirical study retrospectively compared the social interactions of 11 adolescents with ASD in game-and nongame-based 3D collaborative learning activities in the same social competence training curriculum. We employed a learning analytics approach - association rule mining to uncover the associative rules of verbal social interaction and nonverbal social interaction contributors from the large dataset of the coded social behaviors. By comparing the rules across the game and nongame activities, we found a significant difference in youth with ASD’s social performance. The results of the group comparison study indicated that the co-occurrence of verbal and nonverbal behaviors is much stronger in the game-based learning activities. The game activities also yielded more diverse social interaction behavior patterns. On the other hand, in the nongame activities, students’ social interaction behavior patterns are much more limited. Furthermore, the impact of game design principles on learning is then discussed in this paper.

scholarly journals Pediatric COVID-19 and the Factors That May Mitigate Its Clinical Course

2020 ◽  
Vol 10 (01) ◽  
pp. e137-e140
Author(s):  
Mosaad Abdel-Aziz ◽  
Nada M. Abdel-Aziz ◽  
Dina M. Abdel-Aziz ◽  
Noha Azab
Keyword(s):  
Clinical Features ◽  
Clinical Symptoms ◽  
Clinical Course ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Angiotensin Converting Enzyme 2 ◽  
Compulsory Vaccination ◽  
Specific Factors ◽  
Novel Coronavirus ◽  
Radiographic Data

AbstractThe clinical manifestations of novel coronavirus disease 2019 (COVID-19) vary from mild flu-like symptoms to severe fatal pneumonia. However, children with COVID-19 may be asymptomatic or may have mild clinical symptoms. The aim of this study was to investigate clinical features of pediatric COVID-19 and to search for the factors that may mitigate the disease course. We reviewed the literature to realize the clinical features, laboratory, and radiographic data that may be diagnostic for COVID-19 among children. Also, we studied the factors that may affect the clinical course of the disease. Fever, dry cough, and fatigue are the main symptoms of pediatric COVID-19, sometimes flu-like symptoms and/or gastrointestinal symptoms may be present. Although some infected children may be asymptomatic, a recent unusual hyperinflammatory reaction with overlapping features of Kawasaki's disease and toxic shock syndrome in pediatric COVID-19 has been occasionally reported. Severe acute respiratory syndrome-coronvirus-2 (SARS-CoV-2) nucleic acid testing is the corner-stone method for the diagnosis of COVID-19. Lymphocyte count and other inflammatory markers are not essentially diagnostic; however, chest computed tomography is highly specific. Factors that may mitigate the severity of pediatric COVID-19 are home confinement with limited children activity, trained immunity caused by compulsory vaccination, the response of the angiotensin-converting enzyme 2 receptors in children is not the same as in adults, and that children are less likely to have comorbidities. As infected children may be asymptomatic or may have only mild respiratory and/or gastrointestinal symptoms that might be missed, all children for families who have a member diagnosed with COVID-19 should be investigated.

Proton pump inhibitor use and appropriateness analysis: a snapshot from a secondary care hospital

2021 ◽  
Author(s):  
Sukaina Salim Damji ◽  
Syed Arman Rabbani ◽  
Padma G M Rao ◽  
Ain-ur Rashid Butt
Keyword(s):  
United Arab Emirates ◽  
Proton Pump ◽  
Secondary Care ◽  
Stress Ulcer ◽  
Risk Category ◽  
Care Hospital ◽  
High Prevalence ◽  
Potential Risks ◽  
Internal Medicine Wards ◽  
Ulcer Prophylaxis

Abstract Objectives Proton pump inhibitors (PPIs) have become one of the most frequently prescribed drugs since their introduction 30 years ago. Effectiveness and safety profile of PPIs has led to their overutilization and has exposed patients to a number of potential risks. The objective of this study was to evaluate the use of PPIs in a secondary care hospital in the United Arab Emirates. Methods This prospective observational drug-utilization study was conducted in patients receiving treatment with PPIs and admitted to internal medicine wards of the study site. Electronic patient case records were reviewed and data on PPI prescribing was collected and analysed. Appropriateness of PPI use was assessed as per international guidelines. Key findings Out of 172 patients enrolled, 53.5% were females with median age of 57 years (34.3, 71.0). Four different PPIs were prescribed to study patients, pantoprazole (86.6%), esomeprazole (5.8%), rabeprazole (4.1%) and omeprazole (3.5%). Ninety-two (53.5%) patients were prescribed intravenous PPI, whereas 80 (46.5%) patients were given PPI in oral form. Overall, 103 (59.9%) patients had inappropriate PPI prescriptions. Of these inappropriate prescriptions, 22 patients had no clear indication for PPI use and for 16 patients; PPIs were indicated for stress ulcer prophylaxis in low-risk category. Corticosteroid use [odds ratio (OR): 4.34, 95% confidence interval (CI): 1.22–15.46; P = 0.023] was significantly associated with greater odds of inappropriate PPI use. Conclusions We report a high prevalence of inappropriate PPI prescribing among the hospitalized patients in our study. Inappropriate PPI prescribing is a concerning issue and collective efforts should be made to check and minimize the same.

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