Acute pancreatitis in children. An Italian multicentre study

AIM: To evaluate the clinical, morphological and aetiological aspects of acute pancreatitis in children in Italy. PATIENTS: The hospital records of 50 consecutive patients with acute pancreatitis observed in 5 Italian Pediatric Departments were reviewed. RESULTS: A total of 25 males and 25 females (median age 10.5 years, range 2-17) were studied. Of these patients, 48 (96%) had abdominal pain. The pancreatitis was associated with biliary disease in 10 patients (20%); it was due to viral infection in 6 patients (12%), pancreatic duct abnormalities in 4 (8%, familial chronic pancreatitis in 3 (6%), trauma in 5 (10%) and other causes in 5 (10%); the pancreatitis was of unknown origin in 17 patients (34%). Previous attacks of the disease had occurred in 14 patients. A diagnosis of mild pancreatitis was made in 41 patients (82%) and of severe disease in 9 (18%). One patient with severe pancreatitis died from multiorgan failure. Patients with severe pancreatitis had significantly higher serum concentrations of C-reactive protein than patients with mild pancreatitis. Hospital stay was similar for patients with the mild form and those with the severe form of the disease. CONCLUSIONS: In Italian children, acute pancreatitis is of unknown origin in about one-third of the children and is recurrent in 28% of the cases. The disease is severe in 18% of the case

Diagnostic accuracy of fecal calprotectin assay in distinguishing organic causes of chronic diarrhea from irritable bowel syndrome: a prospective study in adults and children

Fecal calprotectin (FC) has been proposed as a marker of inflammatory bowel disease (IBD), but few studies have evaluated its usefulness in patients with chronic diarrhea of various causes. We evaluated the diagnostic accuracy of a FC assay in identifying "organic" causes of chronic diarrhea in consecutive adults and children

La agricultura ecológica a largo plazo en plantaciones de cítricos permite la recuperación del carbono orgánico del suelo

[ES] Se ha demostrado que el manejo del suelo bajo agricultura ecológica puede aumentar el contenido de carbono orgánico en el suelo moderando el incremento de los gases de efecto invernadero, pero hasta la fecha las evaluaciones cuantitativas basadas en mediciones a largo plazo han sido escasas, especialmente bajo condiciones mediterráneas. En esta investigación se examinaron los cambios en el contenido de carbono orgánico como respuesta a la agricultura ecológica con cobertura vegetal en una plantación de cítricos en el área mediterránea, utilizando una base de datos de 21 años. El incremento de contenido de carbono orgánico en el suelo fue más evidente tras cinco años desde el cambio del manejo del suelo, sugiriendo que, para plantaciones de cítricos en ambientes mediterráneos, los estudios deberían tener una duración superior a cinco años. La sata de secuestro de carbono orgánico no cambió significativamente durante los 21 años de observaciones, con valores que oscilaron entre -1.10 Mg C ha-1 a-1 y 1.89 Mg C ha-1 a-1. Tras 21 años, un total de 61 t CO2 ha-1 fueron secuestradas en las áreas de acumulación de carbono en el suelo. Estos resultados demuestran que la agricultura ecológica es una estrategia efectiva para restaurar o incrementar los niveles de carbono orgánico en el suelo en los sistemas de cítricos mediterráneos.[EN] It has been shown that soil management under organic farming can enhance soil organic carbon, thereby mitigating atmospheric greenhouse gas increases, but until now quantitative evaluations based on long term experiments are scarce, especially under Mediterranean conditions. Changes in soil organic carbon (SOC) content were examined in response to organic management with cover crops in a Mediterranean citrus plantation using 21 years of survey data. Soil organic carbon increase was more apparent 5 years after a land management change suggesting that, for citrus plantations on Mediterranean conditions, studies should be longer than five years in duration. Soil organic carbon sequestration rate did not significantly change during the 21 years of observation, with values ranging from -1.10 Mg C ha(-1) y(-1) to 1.89 Mg C ha(-1) y(-1). After 21 years, 61 Mg CO2 ha(-1) were sequestered in long-lived soil C pools. These findings demonstrate that organic management is an effective strategy to restore or increase SOC content in Mediterranean citrus systems.This research was funded by the European Union Seventh Framework Program (FP7/2007-2013) under grant no. 603498 (RECARE Project) and the research projects GL2008-02879/BTE and LEDDRA 243857.Novara, A.; Pulido, M.; Rodrigo-Comino, J.; Di Prima, S.; Smith, P.; Gristina, L.; Giménez Morera, A.... (2019). Long-term organic farming on a citrus plantation results in soil organic carbon recovery. Cuadernos de Investigación Geográfica. 45(1):271-286. https://doi.org/10.18172/cig.3794S27128645

Comparison of anti-transglutaminase ELISAs and an anti-endomysial antibody assay in the diagnosis of celiac disease: A prospective study

Background: Most studies of anti-transglutaminase (anti-tTG) assays have considered preselected groups of patients. This study compared the sensitivity, specificity, and predictive value of an immunofluorescence method for anti-endomysial antibodies (EmAs) and two anti-tTG ELISAs, one using guinea pig tTG (gp-tTG) and the other human tTG (h-tTG) as antigen, in consecutive patients investigated for suspected celiac disease (CD). Methods: We studied 207 consecutive patients (99 men, 108 women; age range, 17-84 years) who underwent intestinal biopsy for suspected CD. Patients presented with one or more of the following: weight loss, anemia, chronic diarrhea, abdominal pain, dyspepsia, alternating bowel habits, constipation, pain in the joints, and dermatitis. At entry to the study, an intestinal biopsy was performed and a serum sample was taken for IgA EmAs, anti-gp-tTG, and anti-h-tTG. Results: Intestinal histology showed that 24 patients had partial or total villous atrophy; in these patients the diagnosis of CD was confirmed by follow-up. The remaining 183 patients had villous/crypt ratios that were within our laboratory's reference values and were considered controls. Serum EmAs, anti-gp-tTG, and anti-h-tTG were positive in all 24 CD patients; in the control group, none were positive for serum EmAs, but 15 of 183 (8.2%) were positive for anti-gp-tTG, and 6 of 183 (3.3%) were positive for anti-h-tTG. Sensitivity was 100% for all assays, whereas specificity was 100% for the EmA, 92% for the anti-gp-tTG, and 97% for the anti-h-tTG assay. The negative predictive value was 100% for all assays; the positive predictive value was 100% for the EmA, 80% [95% confidence interval (CI), 65-95%] for the anti-h-tTG (P = 0.03 vs EmA) and 60% (95% CI, 44-76%) for the anti-gp-tTG assay (P = 0.0002 vs EmA). Areas (95% CIs) under the ROC curves were 0.987 (0.97-1.0) for anti-h-tTG and 0.965 (0.94-0.99) for anti-gp-tTG. Most of the patients testing false positive for anti-tTG had Crohn disease or chronic liver disease. Conclusions: Although both anti-tTG ELISAs showed optimum sensitivity, their lack of specificity yielded positive predictive values significantly lower than those for the EmA assay. © 2002 American Association for Clinical Chemistry

Usefulness of the organ culture system in the in vitro diagnosis of coeliac disease: A multicentre study

Objective. Diagnosis of coeliac disease is based on the presence of villous atrophy which recovers following a gluten-free diet. The presence of circulating antiendomysial antibodies as well as their disappearance after a gluten-free diet supports the diagnosis. It has also been demonstrated that antiendomysial antibodies are detectable in supernatants of cultured intestinal biopsies from patients with coeliac disease. The objective of this study was to compare the histology and antiendomysial antibodies in culture supernatants of intestinal biopsies to validate the in vitro organ culture system as a future diagnostic tool for coeliac disease. Material and methods. Seventy-five antiendomysial serum-positive patients on a gluten-containing diet were evaluated. Patients underwent endoscopy with 5 biopsy fragments: 3 for histology, 1 cultured with and the other without gliadin-peptide activator. Antiendomysial antibodies were evaluated in all culture supernatants. Results. Sixty-eight patients had evidence of villous atrophy, while 73 out of 75 were positive to the organ culture system. The agreement rate between organ culture and histology results was 94%. Conclusions. As all the centres participating in the study obtained good agreement between organ culture and histology results, the new system could be considered a reliable tool for the diagnosis of coeliac disease. Nevertheless, it is possible to highlight cases with an organ culture-positive and -negative histology. This feature could be of considerable interest because, as the sensitivity of organ culture seems to be greater than the initial histology, the new system might be useful in uncertain cases where the risk of missing the diagnosis of coeliac disease is high