Serological screening for celiac disease in healthy 2.5-year-old children in Sweden

OBJECTIVE: The study was designed to investigate the prevalence of celiac disease (CD) among 2.5-year-old children in a Swedish urban population with a high incidence of CD.MATERIAL AND METHODS: Six hundred ninety apparently healthy children, born in the 12-month period of July 1992 through June 1993, were screened for immunoglobulin A (IgA) antigliadin antibodies and IgA antiendomysium antibodies, and those antibody-positive at repeated testing were further investigated with intestinal biopsy.RESULTS: Of the 690 children, 6 were both IgA antigliadin antibody- and IgA antiendomysium antibody-positive, and 7 were antiendomysium antibody-positive but antigliadin antibody-negative. Jejunal biopsy, performed in 12 cases, manifested partial or total villous atrophy in 8 cases. Thus, together with an additional child whose parents declined the offered biopsy, but whose response to a gluten-free diet confirmed the presence of CD, the prevalence of CD in the study series was 1.3% (9/690; 95% confidence interval:.4-2.2). However, independent of the study, an additional 22 cases of symptomatic, biopsy-verified CD have already been detected in the birth cohort of 3004 children.CONCLUSIONS: The prevalence of CD in our study series was high, at least 1.0%, but may be as high as 2.0% if the frequency of silent CD is as high as we have found in the remaining unscreened cohort. These findings confirm that CD is one of the most common chronic disorders

Predicting the Important Enzymes in Human Breast Milk Digestion

[Image: see text] Human milk is known to contain several proteases, but little is known about whether these enzymes are active, which proteins they cleave, and their relative contribution to milk protein digestion in vivo. This study analyzed the mass spectrometry-identified protein fragments found in pooled human milk by comparing their cleavage sites with the enzyme specificity patterns of an array of enzymes. The results indicate that several enzymes are actively taking part in the digestion of human milk proteins within the mammary gland, including plasmin and/or trypsin, elastase, cathepsin D, pepsin, chymotrypsin, a glutamyl endopeptidase-like enzyme, and proline endopeptidase. Two proteins were most affected by enzyme hydrolysis: β-casein and polymeric immunoglobulin receptor. In contrast, other highly abundant milk proteins such as α-lactalbumin and lactoferrin appear to have undergone no proteolytic cleavage. A peptide sequence containing a known antimicrobial peptide is released in breast milk by elastase and cathepsin D

A critical review of the concept of pathological grief following pregnancy loss

Contains fulltext : 29644.pdf (publisher's version ) (Open Access)It has often been suggested in the literature on pregnancy loss, that parents run a high risk of complicated or pathological grief as a result of the specific characteristics of such loss. What confuses the issue is that pathological grief has been defined in various ways. In the interest of improving professional care, it is important to ascertain how pathological grief manifests itself and which parents are most likely to have problems coping with pregnancy loss and therefore develop pathological grief reactions. Given the lack of clarity regarding the concept of pathological grief following pregnancy loss, this article reviews empirical studies on pathological grief following pregnancy loss according to four subtypes derived from general bereavement literature: chronic grief, delayed grief, masked grief, and exaggerated grief. It can be concluded that in the first six months following pregnancy loss, psychological complaints, behavioral changes, and somatic complaints are fairly common responses. Approximately 10-to-15 percent of the women develop a psychiatric disorder during the first two years following such loss, and less than 10 percent seek specific psychiatric care. Parents often mourn the loss of their baby for more than a year; one in five women is unable to accept pregnancy loss after approximately two years. A delayed grief reaction occurs in about 4 percent of parents and seems to occur most often in men. It is suggested that developing pathological grief following pregnancy loss may be more uncommon than had previously been thought, and the long-held idea that parents run a higher risk of pathological grief following pregnancy loss seems partly to result from flaws in the empirical studies in this field. A large majority of women seem to be able to recover from pregnancy loss in due time, drawing on their own strength