- Browse by Subject
Browsing by Subject "Celiac disease"
Now showing 1 - 4 of 4
Results Per Page
Sort Options
Item Celiac disease hospitalizations: an emerging challenge in the United States(Hellenic Society of Gastroenterology, 2022) Dahiya, Dushyant Singh; Al-Haddad, Mohammad; Perisetti, Abhilash; Singh, Amandeep; Goyal, Hemant; Cheng, Chin-I; Garg, Rajat; Pisipati, Sailaja; Ameyi, Justice; Sanaka, Madhusudhan R.; Inamdar, Sumant; Medicine, School of MedicineBackground: This study aimed to assess the trends and characteristics of celiac disease (CeD) hospitalizations in the United States (US). Methods: The National Inpatient Sample was analyzed from 2007-2017 to identify all adult hospitalizations with a primary discharge diagnosis of CeD. Demographic trends, associations, and other aspects of CeD hospitalizations were analyzed. SAS 9.4 was used for statistical analysis and P-values ≤0.05 were considered statistically significant. Results: From 2007-2017, we noted an increasing trend of CeD hospitalizations from 19,385 in 2007 to 38,395 in 2017 (P-trend <0.001). The mean age was 57.85 years, with a declining trend. Females and patients with a Charlson Comorbidity Index score ≥3 had a rising trend of CeD hospitalizations from 70.68% in 2007 to 73% in 2017 (P-trend <0.001) and from 16.96% in 2007 to 26.59% in 2017 (P-trend <0.001), respectively. Additionally, a White predominance was seen in the study cohort. Furthermore, for CeD hospitalizations, all-cause inpatient mortality increased from 1.30% in 2007 to 1.58% in 2017 (P-trend <0.001) and the mean total hospital charge increased from $26,299 in 2007 to $49,282 in 2017 (P-trend <0.001). However, we noted a decline in the mean length of stay (LOS) from 4.88 days in 2007 to 4.59 days in 2017 (P-trend=0.0015) and rates of esophagogastroduodenoscopy performed from 2.09% in 2007 to 1.89% in 2017 (P-trend <0.001). Conclusion: We noted a rising trend in hospitalizations, inpatient mortality, and hospital costs for CeD hospitalizations in the US; however, inpatient EGDs performed and mean LOS showed a decline.Item Celiac disease in Middle Eastern and North African countries: A new burden?(Baishideng Publishing Group, 2010-03-28) Barada, Kassem; Bitar, Abbas; Mokadem, Mohamad Abdul-Razak; Hashash, Jana Ghazi; Green, Peter; Medicine, School of MedicineCeliac disease (CD) is now recognized as a common disorder among Middle Eastern (ME) and North African (NA) populations. The aim of this review is to assess the available data regarding CD in the ME and NA and to compare this information with that of Western countries. A literature review was performed using the electronic databases PubMed and Medline (1950-2008) as search engines, and “celiac disease” was used as a Mesh term. The search was limited to ME and NA countries. The prevalence of CD in ME and NA countries among low risk populations is similar to that of Western countries, but is higher in high risk populations such as those with type 1 diabetes. It is underestimated because of lack of clinical suspicion and lack of patient awareness. Clinical presentations in term of gastrointestinal, hematologic, skeletal, and liver manifestations are similar between both populations except for a high prevalence of short stature in some ME and NA countries. Few studies have addressed atypical or silent CD. As in the West, diagnosis is initially made by serological tests and is confirmed by small intestinal biopsies. Gluten-free diet is the main mode of treatment with a higher apparent adherence rate than in the West. Most disease complications result from malabsorption. The disease is strongly associated with HLA DQ2 and to a lesser extent with HLA DQ8 alleles. In conclusion, CD prevalence is underestimated, with little data available about its malignant complications. Disease parameters in the ME and NA are otherwise similar to those in Western countries.Item Estimating the Impact of Verification Bias on Celiac Disease Testing(Wolters Kluwer, 2021) Hujoel, Isabel A.; Jansson-Knodell, Claire L.; Hujoel, Philippe P.; Hujoel, Margaux L.A.; Choung, Rok Seon; Murray, Joseph A.; Rubio-Tapia, Alberto; Medicine, School of MedicineGoal: The goal of this study was to estimate the impact of verification bias on the diagnostic accuracy of immunoglobulin A tissue transglutaminase (IgA tTG) in detecting celiac disease as reported by an authoritative meta-analysis, the 2016 Comparative Effectiveness Review (CER). Background: Verification bias is introduced to diagnostic accuracy studies when screening test results impact the decision to verify disease status. Materials and methods: We adjusted the sensitivity and specificity of IgA tTG reported by the 2016 CER with the proportion of IgA tTG positive and negative individuals who are referred for confirmatory small bowel biopsy. We performed a systematic review from January 1, 2007, to July 19, 2017, to determine these referral rates. Results: The systematic review identified 793 articles of which 9 met inclusion criteria (n=36,477). Overall, 3.6% [95% confidence interval (CI): 1.1%-10.9%] of IgA tTG negative and 79.2.2% (95% CI: 65.0%-88.7%) of IgA tTG positive individuals were referred for biopsy. Adjusting for these referral rates the 2016 CER reported sensitivity of IgA tTG dropped from 92.6% (95% CI: 90.2%-94.5%) to 57.1% (95% CI: 35.4%-76.4%) and the specificity increased from 97.6% (95% CI: 96.3%-98.5%) to 99.6% (95% CI: 98.4%-99.9%). Conclusions: The CER may have largely overestimated the sensitivity of IgA tTG due to a failure to account for verification bias. These findings suggest caution in the interpretation of a negative IgA tTG to rule out celiac disease in clinical practice. More broadly, they highlight the impact of verification bias on diagnostic accuracy estimates and suggest that studies at risk for this bias be excluded from systematic reviews.Item Frequency of Celiac Disease in Patients With Chronic Diarrhea(Cureus, 2021-12-17) Panezai, Muhammad S.; Ullah, Asad; Ballur, Kalyani; Gilstrap, Lauren; Khan, Jaffar; Tareen, Bisma; Kakar, Mirwais; Khan, Javeria; Rasheed, Amna; Waheed, Abdul; Ghleilib, Intisar; White, Joseph; Cason, Frederick D.; Pathology and Laboratory Medicine, School of MedicineIntroduction: Celiac disease (CD) is an immune-mediated disease caused by ingesting gluten-containing foods and is characterized mainly by malabsorptive diarrhea. Furthermore, distinguishing between mild disease and asymptomatic individuals is critical and necessitates a high level of clinical suspicion. Short stature, delayed puberty, bone abnormalities, neurological problems, and intestinal cancer can all be consequences of a delayed diagnosis. This study aimed to determine the prevalence of celiac disease among our community's recurrent diarrhea patients. Methods: This was a cross-sectional study aimed at determining the frequency of celiac disease in patients with chronic diarrhea. One hundred eighty-eight patients between the ages of 18 and 60 years who had chronic diarrhea lasting greater than three months were enrolled in this study. Stratification was utilized to control for modifiers. A p-value of ≤ 0.05 was considered significant. Results: A total of 74.5% of patients (n=140) were male, while 25.5% (n=48) were female with a mean age of 38.48±10.85 years. The average duration of celiac disease symptoms was 8.17± 3.75 months. Celiac disease was found in 12.2% (n=23) of the individuals. Also, 21% of individuals with a positive family history of CD devolved CD, compared to those without prior CD family history (p=0.01). Conclusions: In individuals with chronic diarrhea for more than three months, the prevalence of celiac disease was determined to be 12.2% (n=23). There was a statistically significant difference between those with a positive family history of CD and those who did not have the condition.