136-138Celiac Gluten Sensitivity

Abstract A new entity was included in the gluten diseases: the non-celiac gluten sensitivity. But the non-celiac gluten sensitivity is not yet clearly defined and its diagnosis is difficult. These lead us to implement a national register for the patients with non-celiac gluten sensitivity

The development and growth of muscular fibers of striated skeletal muscle - Literature review

SUMMARY Based on literature date and on their own experiences, the authors present the morphology, development and growth of the striated muscle, and the role of giant and splitting muscle fibers, and the mechanism of muscle splitting. The muscle develops from the myotom, the myoblasts become coherent myotubules, which then differentiate into muscle fibers. The longitudinal growth of the muscle fibers can take place through the elevation of the number of the sarcomeres or through their prolongation; however the exact mechanism of the morphological and structural changes in the skeletal muscle and myofibrils in the postnatal period is not clearly understood. Recent literature data suggests that postnatal growth of muscle can take place through the splitting of the giant muscle fibers. The presence and splitting of the giant muscle fibers seems to be related to the pathologic metabolism of the muscle, but their presence was detected also in normal muscles. The histological grading system, developed by the authors that provides an opportunity to define the stages (G1–G4) of split muscle fibers may be useful in the future also in the veterinary practice

The importance of determining human leucocyte antigens in preventing intestinal lymphoma in patients with celiac disease

Identification of celiac disease, by determining human leucocyte antigens DQ2/DQ8, is important since recent long-term studies have shown that the mortality of celiac disease is increased, if it is unrecognized and untreated. In this sense, we wanted to see the usefulness of genetic tests in celiac disease diagnosis and screening. Material and methods. During 2010 we determined by PCR, DQ2/DQ8 haplotype, in a group of 27 children with celiac disease and 9 of their brothers, serologically negative for celiac disease. Results. 22 children and 7 of their brothers confirmed the diagnosis of celiac disease, DR3-DQ2 haplotype was predominant in children with celiac disease and DR4-DQ8 to their brothers. Conclusions. Genetic testing to determine human lecocyte antigens remain the most reliable test in the diagnosis of celiac disease but also in identifying family risk for people with celiac disease

IgA Tissue Transglutaminase Antibodies at Different cut-offs in the Evaluation of Possible Celiac Patients

Abstract The celiac disease screening with IgA tissue transglutaminase antibodies depends on the cut-off reaction, therefore many patients with values less but close to the cut-off may be undiagnosed. Material and Method. We conducted the CD screening with IgA tissue transglutaminase antibodies in a group of 1616 children during 2014 at a cut-off of 25 U/ml and at a cut-off of 10 U/ml. We also wanted to compare our results with IgA tissue transglutaminase antibodies prevalence from other countries. Results. We found a IgA tissue transglutaminase antibodies prevalence rate of 3% for values higher 25 U/ml and a IgA tissue transglutaminase antibodies prevalence rate of 1.6% for values between 10-25 U/ml. A prevalence of 13.6% for IgA tissue transglutaminase antibodies was observed in Germany, Finland and Sweden. Conclusions. We observed a 4.6% IgA tissue transglutaminase antibodies prevalence at a cut-off of 10 U/ml. Prevalence of IgA tissue transglutaminase antibodies from Romania is lowered compared with other European countries

EFFICIENCY OF OXYGEN THERAPY BY HEAD BOX FOR ACUTE RESPIRATORY FAILURE IN INFANTS

Oxygen therapy is the main treatment method for acute respiratory failure in children. The method consisting in the administration of oxygen therapy by head box to infants is frequently used in pediatric practice. Objectives. To evaluate the effi ciency of oxygen therapy administered by head box to infants suffering from pneumogenic acute respiratory failure by comparing two methods for measuring hemoglobin oxygen saturation: in arterialized capillary blood and by pulse oximetry. Material and method. 30 infants suffering from pneumogenic acute respiratory failure were studied. We used a clinical appraisal score for acute respiratory failure, which appraises respiratory rate, nasal fl aring, recession, cyanosis, sensorial, before and after oxygen therapy. In arterialized capillary blood we measured partial pressure of oxygen and hemoglobin oxygen saturation, and we used an Automatic Blood Gas System analyzer. We also measured hemoglobin oxygen saturation using a pulse oximeter. Determinations were made before the initiation of oxygen therapy, and 30 minutes and 60 minutes after the initiation of oxygen therapy. Results. As compared to the baseline values, determined before the initiation of oxygen therapy, we recorded a statistically signifi cant improvement in the clinical score both after 30 minutes and 60 minutes from the initiation of oxygen therapy (p<0.001). The improvement was greater after 60 minutes. The increase in the partial pressure of oxygen was statistically signifi cant both at the 30 minute and 60 minute determination (p<0.001). Both methods of SaO2 measurement recorded statistically signifi cant increases (p<0.001) in this variable after 30 and 60 minutes, respectively. Conclusions. Oxygen therapy administered by head box improves acute respiratory failure appraised by clinical score. The administration of oxygen therapy by head box to infants signifi cantly increases the values of partial pressure of oxygen and hemoglobin oxygen saturation measured in capillary blood, as well as the values of hemoglobin oxygen saturation determined by pulse oximeter both after 30 minutes and after 60 minutes. The increases in the three parameters are larger after 60 minutes. There is statistically signifi cant concordance between the values of hemoglobin oxygen saturation determined in capillary blood and by pulse oximetry at all determinations

Endoscopic Grading as a Predictor to Develop Strictures in Corrosive Esophagitis in Children

Introduction. The incidence of corrosive esophagitis, also known as caustic esophagitis in children, is still increasing in developing countries, according to different clinical reports. Acids and alkalis are, in the same manner, involved in the pathogenesis of corrosive esophagitis in children. The aim of our study was to determine the incidence and endoscopic grading of corrosive esophagitis in a cohort of children from a developing country. Materials and methods. We performed a retrospective analysis of all pediatric patients who were admitted for corrosive ingestion at Pediatric Clinic II, Emergency Hospital for Children, Cluj-Napoca, over 10 years. Results. A total of 22 patients consisting of 13 (59.09%) girls and 9 boys (40.91%) were found in the present research. The majority of children lived in rural areas (69.2%). The results of laboratory tests were not well correlated with the degree of the injury. White blood cell counts over 20,000 cells/mm3, an increase in the C-reactive protein level and hypoalbuminemia were noticed only in three patients with strictures. The lesions were associated with increased levels of the pro-inflammatory cytokines, including interleukin (IL)-2, IL-5 and Interferon-gamma. Severe late complications such as strictures have been noticed in children with grade 3A injuries. The endoscopic dilation was done after the six months endoscopy. None of the patients treated with endoscopic dilation required surgical intervention for esophageal or pyloric perforation or dilation failure. The majority of complications (such as malnutrition) were noticed in children with grade 3A injuries. In consequence, prolonged hospitalization has been required. The second endoscopy (done six months after ingestion) revealed stricture as the most common late complication (n = 13, 60.60%: eight patients with grade 2B and five with grade 3A). Conclusion. There is a low incidence of corrosive esophagitis in children in our geographic area. Endoscopic grading is a predictor of late complications such as strictures. Grade 2B and 3A corrosive esophagitis are likely to develop strictures. It is crucial to avoid strictures and to prevent malnutrition