scholarly journals Nutritional and Gastroenterological Monitoring of Patients With Celiac Disease During COVID-19 Pandemic: The Emerging Role of Telemedicine and Point-of-Care Gluten Detection Tests

2021 ◽  
Vol 8 ◽  
Author(s):  
Andrea Costantino ◽  
Leda Roncoroni ◽  
Daniele Noviello ◽  
Nicoletta Nandi ◽  
Vincenza Lombardo ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Assessment Tool ◽  
Point Of Care ◽  
Phone Call ◽  
Patient Trust ◽  
Telemedicine Service ◽  
Adherence Test ◽  
Nutritional Monitoring

Background and Aims: Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, telemedicine has been supporting many patients with chronic diseases worldwide. However, data on celiac disease (CeD) nutritional and gastroenterological remote monitoring are scanty. The aims of our study were to verify patients' trust in telemedicine and to evaluate the feasibility of telemedicine in nutritional monitoring.Material and Methods: We used telemedicine in place of the scheduled but not provided follow-up visits during the first lockdown of the COVID-19 pandemic. Patients received a phone call, and televisits were conducted for CeD patients with mild or moderate symptoms and/or with blood alterations. The patient's adherence to the gluten-free diet (GFD) was evaluated according to the Celiac Dietary Adherence Test (CDAT). When gluten contamination was suspected, a point-of-care gluten detection test was prescribed. The patient's trust in telemedicine was assessed, through an adapted version of the Patient Trust Assessment Tool (PATAT) questionnaire, as the percentage of patients giving a score of at least 4 out of 5 on a Likert scale for three selected key statements: “I can trust televisit,” “I can trust that possible problems with the telemedicine service will be solved properly,” and “I feel at ease when working with this website.”Results: One hundred and twelve CeD patients were phone called; among symptomatic patients, 39 out of the 42 scheduled (92.9%) televisits were performed. Among the 39 visits, 34 (87.2%) questionnaires were compiled. The patients included in the study obtained a CDAT score from 7 to 13 (11 ± 2). Gluten detection tests were prescribed to 11 patients, resulting positive in 2. Trust in the telemedicine service was achieved in 94.1, 88.2, and 97.1% for the three selected key statements of the PATAT questionnaire.Conclusion: During the COVID-19 pandemic, telemedicine showed to be feasible and the majority of patients trusted the combined gastroenterological and nutritional televisits. Gluten detection tests demonstrated to be useful tools for the patient and for the caregiver to confirm adherence to the GFD remotely.

scholarly journals Current role of ultrasound in hemodialysis access evaluation

2021 ◽  
pp. 112972982110346
Author(s):  
Meola Mario ◽  
Jose Ibeas ◽  
Jan Malik
Keyword(s):  
Turning Point ◽  
Point Of Care ◽  
Low Cost ◽  
Wireless Systems ◽  
Future Perspectives ◽  
Maturation Period ◽  
Surveillance Programs ◽  
Dialysis Nurses

Physical examination (PE) is considered the backbone before vascular access (VA) placement, during maturation period and for follow-up. However, it may be inadequate in identifying suitable vasculature, mainly in comorbid patients, or in detecting complications. This review highlights the advantages of ultrasound imaging to manage VA before placement, during maturation and follow-up. Furthermore, it analyses the future perspectives in evaluating early and late VA complications thank to the availability of multiparametric platforms, point of care of ultrasound, and portable/wireless systems. Technical improvements and low-cost systems should favor the widespread ultrasound-based VA surveillance programs. This significant turning point needs an adequate training of nephrologists and dialysis nurses and the standardization of exams, parameters, and procedures.

scholarly journals TELEMEDICINE IN IBD: GOOD TRUST FROM OUTPATIENTS DURING THE COVID-19 PANDEMIC IN MILAN (LOMBARDY)

2021 ◽  
Vol 27 (Supplement_1) ◽  
pp. S51-S51
Author(s):  
Andrea Costantino ◽  
Daniele Noviello ◽  
Stefano Mazza ◽  
Roberto Berté ◽  
Maurizio Vecchi ◽  
...  
Keyword(s):  
Primary Endpoint ◽  
Assessment Tool ◽  
Healthcare Providers ◽  
Telemedicine Service ◽  
Moderate Disease ◽  
Video Consultation ◽  
K Current ◽  
Remote Assistance ◽  
Video Calling

Abstract Background and Aim During the recent COVID-19 pandemic, telemedicine has enabled many IBD patients worldwide to get access to remote assistance. Some positive reports on the use of telemedicine among patients and healthcare providers have been published1-4, but a patient’s trust perspective is not available yet. The aim of our study was to verify IBD patients’ trust in telemedicine. This study was approved by our local Ethics Committee. Material and Methods At our Gastroenterology Unit in Milan (Italy), 123 video-consultations were delivered to IBD patients with mild or moderate disease, in place of follow-up visits scheduled but not provided during the general lockdown (March-April 2020). Video-calling solutions from Google (Hangouts or Meet) or Microsoft Teams were used according to the patient’s preference. The patients’ trust in telemedicine was assessed through an adapted version of the PAtient Trust Assessment Tool (PATAT) questionnaire.5 The primary endpoint was expressed as a >75% percentage of patients giving a score of at least 4 out of 5 in a Likert Scale for three selected key statements: “I can trust video-consultation”, “I can trust that possible problems with the telemedicine service will be solved properly” and “I feel at ease when working with this website”. The questionnaire was formulated through the EUSurvey platform, widely used for clinical research questionnaires in Europe. Results One-hundred-fifteen (93.4%) video-consultations were performed out of the 123 scheduled. Among the 115 consultations, 100 questionnaires were completed (86.9%). The primary endpoint of trust in the telemedicine service was achieved in 95%, 90% and 84% of patients for the three selected key statements about the trust in the telemedicine service, its capability to solve clinical problems and its ease to use. While clinical outcomes were beyond our intentions, we reported no drugs withdrawal in this cohort nor major events. Conclusion Our results showed that during the COVID-19 pandemic most of our IBD patients accepted to receive a video-consultation in spite of the traditional in-person visit and trusted the video-consultation. References: 1. Bezzio C. et al. Gut 2020;69:1213–1217 2. George L.A., Raymond K. Current Gastroenterology Reports (2020) 22: 12 3. Lees C. W. et al. Gastroenterology 2020; 2020 May 28 4. Allocca M et al. Clin Gastroenterol Hepatol 2020;18:1882–1883 5. Velsen, L. V. et al, H. Int. J. Med. Inform 2017;97:52–58.

Celiac Disease

2021 ◽  
pp. 93-114
Author(s):  
Haalah M. Shaaker
Keyword(s):  
Celiac Disease ◽  
Autoimmune Disorder ◽  
Nutrition Therapy ◽  
Medical Nutrition Therapy ◽  
Nutrient Supplements ◽  
Proximal Small Intestine ◽  
Packaged Foods ◽  
Medical Nutrition

This chapter reveals and discusses a case involving celiac disease (CD). CD is a common, lifelong, genetically-based autoimmune disorder that causes inflammation of the proximal small intestine. This disease is triggered by eating foods containing gluten, which causes intestinal discomfort. Gluten is a protein that is found naturally in wheat, barley, and rye and is common in foods such as bread, pasta, cookies, and cakes. Many pre-packaged foods, lip balms and lipsticks, hair and skin products, toothpaste and vitamin and nutrient supplements contain gluten, although it is rarely found in medicine. The key to living with CD is to follow a gluten-free diet. This case shows the role of medical nutrition therapy in managing and preventing the undesirable symptoms of CD. Moreover, it allows dietetic professionals to assess celiac patients' conditions and provide them with relief from undesirable symptoms, while also establishing an effective follow-up plan with each patient.

scholarly journals Is There a Role of Using a Rapid Finger Prick Antibody Test in Screening for Celiac Disease in Children?

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Kristina Baraba Dekanić ◽  
Ivona Butorac Ahel ◽  
Lucija Ružman ◽  
Jasmina Dolinšek ◽  
Jernej Dolinšek ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Point Of Care ◽  
Tissue Transglutaminase ◽  
Rapid Test ◽  
Antibody Test ◽  
First Grade ◽  
Iga Deficiency ◽  
Iga Antibodies ◽  
Point Of Care Tests

Introduction. Celiac disease (CD) is an autoimmune disease triggered by gluten in genetically predisposed individuals. Despite the increasing prevalence of CD, many patients remain undiagnosed. Standard serology tests are expensive and invasive, so several point-of-care tests (POC) for CD have been developed. We aimed to determine the prevalence of CD in first-grade pupils in Primorje-Gorski Kotar County, Croatia, using a POC test. Methods. A Biocard celiac test that detects IgA antibodies to tissue transglutaminase in whole blood was used to screen for celiac disease in healthy first-grade children born in 2011 and 2012 who consumed gluten without restrictions. Results. 1478 children were tested, and none of them were tested positive with a rapid test. In 10 children (0,6%), IgA deficiency has been suspected; only 4 of them agreed to be tested further for total IgA, anti-tTG, and anti-DGP antibodies. IgA deficiency was confirmed in 3 patients, and in all 4 children, CD has been excluded. Conclusion. Our results have not confirmed the usefulness of the POC test in screening the general population of first-grade schoolchildren. Further research is needed to establish the true epidemiology of CD in Primorje-Gorski Kotar County and to confirm the value of the rapid test in comparison with standard antibody CD testing.

Nanosensors for therapeutic drug monitoring: implications for transplantation

Nanomedicine ◽  
2019 ◽  
Vol 14 (20) ◽  
pp. 2735-2747 ◽  
Author(s):  
Ashkan Shafiee ◽  
Elham Ghadiri ◽  
Jareer Kassis ◽  
Anthony Atala
Keyword(s):  
State Of The Art ◽  
Point Of Care ◽  
Therapeutic Drug ◽  
Organ Rejection ◽  
Number Of Patients ◽  
Deceased Donors ◽  
Transplanted Organs ◽  
Further Development

The number of patients requiring organ transplantations is exponentially increasing. New organs are either provided by healthy or deceased donors, or are grown in laboratories by tissue engineers. Post-surgical follow-up is vital for preventing any complications that can cause organ rejection. Physiological monitoring of a patient who receives newly transplanted organs is crucial. Many efforts are being made to enhance follow-up technologies for monitoring organ recipients, and point-of-care devices are beginning to emerge. Here, we describe the role of biosensors and nanosensors in improving organ transplantation efficiency, managing post-surgical follow-up and reducing overall costs. We provide an overview of the state-of-the-art biosensing technologies and offer some perspectives related to their further development.

scholarly journals A Call for Research on the Prognostic Role of Follow-Up Histology in Celiac Disease: A Systematic Review

2019 ◽  
Vol 10 ◽  
Author(s):  
Zsolt Szakács ◽  
Noémi Gede ◽  
Zoltán Gyöngyi ◽  
Margit Solymár ◽  
Dezső Csupor ◽  
...  
Keyword(s):  
Systematic Review ◽  
Celiac Disease ◽  
Prognostic Role

M2033 Role of Antibodies in the Long Term Follow Up of Patients with Celiac Disease to Predict the Adherence to Gluten-Free Diet

2009 ◽  
Vol 136 (5) ◽  
pp. A-471
Author(s):  
Adriana Mohaidle ◽  
José M. Mella ◽  
Lisandro Pereyra ◽  
Pablo Luna ◽  
Carolina Fischer ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Long Term Follow Up

Abstract W P349: Bridging the Gap: Discharge to Follow-up: A Qualitative Review

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Anh Juntura ◽  
Linda Shields ◽  
Fern Cudlip
Keyword(s):  
Patient Compliance ◽  
Assessment Tool ◽  
Discharge Planning ◽  
Signs And Symptoms ◽  
Well Being ◽  
Qualitative Assessment ◽  
Phone Call ◽  
Discharge Process ◽  
Post Discharge

Background: Discharging patients from the hospital is complex and challenging. The discharge process includes discharge planning, medication reconciliation, discharge summation, and patient instruction. The enormity of information and complexity of the process directly impacts patient compliance and re-admission. Given the extent of this process, efforts toward assuring clarity of knowledge have the potential to improve patient compliance. We sought to identify and address gaps in post discharge patient awareness. Methods: A follow-up phone interview was conducted 1 week post discharge, with 26 stroke patients. All patients had received verbal and written stroke education prior to discharge. The qualitative assessment tool included 10 questions regarding general wellbeing, follow-up appointment compliance, medication utilization, and stroke knowledge. The patient responses were categorized accordingly. A copy of the patient’s discharge instructions was utilized during the interview for verification and clarification of discharge information. Results: Regarding wellbeing, 77% of the patients reported a reasonable sense of well being. The majority (77%) had scheduled follow-up appointments with the remaining 23% requiring clarification. Concerning medication compliance, 92% of the patients were able to obtain and comprehend use of their new medications. Review of stroke type confirmed 54% with understanding, whereas, 44% expressed lack of clarity regarding the subject. The same was true in regards to comprehension of stroke risk factors (56% verbalized understanding and 44% lacked awareness). Lastly, 54% of respondents were unable to identify the signs and symptoms of stroke despite the majority (60%) verbalizing a correct use of the 9-1-1 system Conclusion: Our findings imply that a post discharge phone call practice serves to identify information gaps and provide opportunity to clarify stroke awareness, thus, “bridging the gap” of understanding and compliance regarding stroke management and prevention

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