4 research outputs found
High Prevalence of Silent Celiac Disease in Preschool Children Screened with IgA/IgG Antiendomysium Antibodies
Background: Because of the different sensitivity and specificity of serologic tests, the search for silent celiac disease is usually performed with the combined or sequential use of several tests. Among these, the IgA-class endomysium antibody test has the highest specificity and positive predictive value, but it may overlook IgA-deficient patients.
Methods: To test a new one-step screening approach, serum samples from 427 apparently healthy, 3- to 6-year-old Hungarian children were investigated for IEA-class and IgG-class endomysium antibodies using monkey esophagus and human jejunum as substrates.
Results: Five new cases with flat mucosa were identified by strong endomysium antibody positivity and subsequent jejunal biopsy, yielding a celiac disease prevalence of 1:85. An additional child may have latent celiac disease (slight histologic changes at present). Two of the screening-detected celiac patients exhibited only IgG-class endomysium antibodies due to associated IgA-deficiency. Despite the young age of the screened population, antigliadin antibodies were positive in only three of the five celiac patients.
Conclusions: Prevalence of celiac disease in the study population was much higher than expected on the basis of antigliadin antibody-based studies. The screening system used detected celiac cases in which there was IgA-deficiency and those in which there was not and also those negative for antigliadin antibodies. The findings suggest the importance of the primary testing of autoantibodies in future celiac disease screening policies
A gyermekkori asztma prevalenciájának növekedése Budapesten 1995 és 2003 között a (változatlan) légszennyezettségi és pollen adatok tükrében = Increase in prevalence of childhood asthma in Budapest between 1995 and 2003: is there a connection with the air pollution data or the total pollen count?
BevezetĂ©s: A magyarországi asztma prevalencia a legutĂłbbi 15 Ă©vben egyenletesen nĹ‘tt, az Országos Korányi TBC Ă©s PulmonolĂłgiai IntĂ©zet nyilvántartása szerint 2004-ben elĂ©rte az 1,8%-ot. A gyermekkori asztma hazai gyakoriságára vonatkozĂłan csak szĂłrványos felmĂ©rĂ©sekbĹ‘l származĂł adatok vannak. CĂ©lok: SzerzĹ‘k cĂ©lul tűztĂ©k ki a terĂĽletet ellátĂł gyermekorvosoktĂłl nyert adatok segĂtsĂ©gĂ©vel a budapesti gyermekek asztma prevalenciájának a felmĂ©rĂ©sĂ©t 1995-ben, 1999-ben Ă©s 2003-ban. MegkĂsĂ©reltĂ©k az esetleges változás okát is felderĂteni. MĂłdszerek: Ennek Ă©rdekĂ©ben kĂ©rdĹ‘Ăveket kĂĽldtek a 23 kerĂĽleti szakfelĂĽgyelĹ‘ gyermekgyĂłgyász fĹ‘orvosnak, melyet Ĺ‘k a terĂĽletet ellátĂł kollĂ©gáknak továbbĂtottak. Ebben csupán azt kĂ©rdeztĂ©k, hány gyermek tartozik a körzetĂĽkbe Ă©s közĂĽlĂĽk hányrĂłl tudják biztosan, hogy asztmában szenved. Emellett Budapest 8 pontján folyamatosan mĂ©rtĂ©k a levegĹ‘ CO, NO2, SO2, O3 Ă©s szállĂł por koncentráciĂłját, valamint kĂĽlön Pesten Ă©s Budán a pollenszámot. EredmĂ©nyek: 1995-ben 11 kerĂĽletbĹ‘l 108 gyermekorvos válaszolt. Az általuk kezelt 104.060 gyermek közĂĽl 1962-rĹ‘l tudták, hogy asztmában szenved, ami 1,88±0,87%-os prevalenciát jelent. 1999-ben 22 kerĂĽletbĹ‘l, 153 kollĂ©gátĂłl kaptak választ. A gondozásuk alatt állĂł 142.679 (0–18 Ă©v közötti) gyermek 2,26±0,94%-át asztmáskĂ©nt tartották nyilván (összesen 3228-at). 2003-ban már mind a 23 budapesti kerĂĽletbĹ‘l sikerĂĽlt válaszhoz jutniuk. A 204 kollĂ©ga által ellátott 176.049 gyermek között minden eddiginĂ©l több (4712) az asztmában szenvedĹ‘, ami a prevalencia 2,68±1,31%-ra törtĂ©nĹ‘ emelkedĂ©sĂ©t jelenti. A növekedĂ©s ĂĽteme mind 1995 Ă©s 1999, mind 1999 Ă©s 2003 között szignifikáns (p < 0.0001). Ez a szignifikáns növekedĂ©s akkor is igazolhatĂł, ha csak azt a 11 kerĂĽletet hasonlĂtjuk össze a vizsgált Ă©vekben, amelyekbĹ‘l már 1995-ben is Ă©rkezett válasz. A mĂ©rt lĂ©gszennyezĹ‘ anyagok koncentráciĂłja nem nĹ‘tt a vizsgált Ă©vek alatt Ă©s a leginkább allergizálĂł növĂ©nyek pollenszáma sem emelkedett. KövetkeztetĂ©sek: JĂłval több mint 100 ezer gyermek vizsgálati adata alapján megállapĂthatĂł, hogy 1995 Ă©s 2003 között az asztmás gyermekek aránya másfĂ©lszeresĂ©re nĹ‘tt Budapesten, miközben a lĂ©gszennyezettsĂ©g nem romlott Ă©s a pollenszám sem emelkedett.
Introduction: According to the data of the Hungarian pulmonological network, the prevalence of asthma in the last 15 years has increased (almost linearly) in Hungary. In 2004 it was 1.8%. There are only a few data about the prevalence of childhood asthma. Aims: The aim of the authors was to measure the prevalence of bronchial asthma in childhood in Budapest in 1995, 1999 and 2003, using questionnaires directed to district pediatricians. Methods: There were only two questions in these questionnaires: how many children are in their districts, and how many are suffering from asthma? Besides of this survey the dust, CO, NO2
and SO2 concentrations in the air were measured on-line at 8 points in Budapest, while ozone level measurements were also made at 2 stations. The counts of pollen and of fungal elements in the air were calculated separately for Buda and for Pest. Results:
In 1995, replies were received from 118 pediatricians in 11 districts, who were responsible for the supervision of 104 060 children, out of these 1.88±0.87% had been diagnosed as having asthma. In 1999 replies were sent by 153 physicians in 22 of the 23 districts, who had a total of 142 679 children under their care. These included 3228 asthmatics, i.e. a prevalence of 2.26±0.95%. In 2003 the authors received answers from all of the 23 districts of Budapest. The 204 pediatricians were responsible for the supervision of 176 049 children. The number of patients with the diagnosis of asthma was 4712 (corresponding for a prevalence of 2.68±1.3%). The increase between 1995 and 1999, and between 1999 and 2003 was highly significant (p < 0.0001). This significant increase was valid even when the authors analysed only those 11 districts, which answered already in 1995. The level of air pollution in Budapest did not deteriorate in the period in question, and the concentration of pollen grains of plants causing allergy did not increase compared to previous years. Conclusions: On the basis of the results of more than 100 thousand children, the authors conclude that between 1995 and 2003 the proportion of asthmatic children increased by 50% in Budapest, while the air pollution did not deteriorate and the pollen concentration from sensitizing plants did not increase