4 results on '"Werkstetter, K. J."'
Search Results
2. The Knowledge About Celiac Disease Among Healthcare Professionals and Patients in Central Europe
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Martina Klemenak, Ilma Rita Korponay-Szabó, Sibylle Koletzko, Luigina De Leo, Goran Palčevski, Marina Milinović, Tunde Koltai, Jasmina Dolinsek, Judit Gyimesi, Tarcisio Not, Jernej Dolinsek, Tomaz Krencnik, Daniele Sblattero, Katharina Julia Werkstetter, Berthold Koletzko, Petra Riznik, Riznik, P., De Leo, L., Dolinsek, J., Gyimesi, J., Klemenak, M., Koletzko, B., Koletzko, S., Koltai, T., Korponay-Szabo, I. R., Krencnik, T., Milinovic, M., Not, T., Palcevski, G., Sblattero, D., and Werkstetter, K. J.
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Adult ,medicine.medical_specialty ,knowledge ,education ,Slovenia ,MEDLINE ,Disease ,patients ,03 medical and health sciences ,Diet, Gluten-Free ,0302 clinical medicine ,030225 pediatrics ,Internal medicine ,Germany ,Surveys and Questionnaires ,Epidemiology ,Medicine ,Surveys and Questionnaire ,Humans ,In patient ,Patient compliance ,Child ,Health professionals ,business.industry ,Central Europe ,healthcare professional ,Gastroenterology ,Celiac Disease ,Europe ,Italy ,Patient Compliance ,celiac disease ,healthcare professionals ,BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Pedijatrija ,Diet ,celiac disease, Central Europe, healthcare professionals, knowledge, patient ,Pediatrics, Perinatology and Child Health ,BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Pediatrics ,Gluten-Free ,030211 gastroenterology & hepatology ,patient ,business ,Regional differences ,Human - Abstract
OBJECTIVES: Celiac disease (CD) remains undiagnosed for a long time in many adult and pediatric patients. We assessed the knowledge about CD among healthcare professionals (HCPs) and CD patients in Central Europe (CE). METHODS: HCPs and CD patients from 5 CE countries were asked to complete the web-based questionnaire about CD. The questions were divided into subsections on epidemiology, clinical presentation, diagnostics, treatment, and follow-up. Achieved scores of different specialists managing patients with CD were compared and regional differences in patients' knowledge were analyzed. RESULTS: Questionnaire was completed by 1381 HCPs and 2262 CD patients or their caregivers from Croatia, Hungary, Germany, Italy, and Slovenia. Mean score achieved by HCPs was 50.9%, and by CD patients 56.4%. Pediatric gastroenterologists scored the highest (69.4%; P
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- 2021
3. The Use of Biopsy and 'No-Biopsy' Approach for Diagnosing Paediatric Coeliac Disease in the Central European Region
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Daniele Sblattero, Tarcisio Not, Ildikó Guthy, Martina Klemenak, Tomaz Krencnik, Piroska Bodi, István Tokodi, M Balogh, Luigina De Leo, Sibylle Koletzko, Judit Gyimesi, Matej Vogrincic, Éva Pollák, Petra Riznik, Katharina Julia Werkstetter, Ilma Rita Korponay-Szabó, Berthold Koletzko, Ildikó Kis, Jernej Dolinsek, Jasmina Dolinsek, Goran Palčevski, Agnes Horvath, Riznik, P., Balogh, M., Bodi, P., De Leo, L., Dolinsek, J., Guthy, I., Gyimesi, J., Horvath, A., Kis, I., Klemenak, M., Koletzko, B., Koletzko, S., Korponay-Szabo, I. R., Krencnik, T., Not, T., Palcevski, G., Pollak, E., Sblattero, D., Tokodi, I., Vogrincic, M., Werkstetter, K. J., and Rybak, A.
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medicine.medical_specialty ,Pediatrics ,Malabsorption ,Article Subject ,diagnosis ,Biopsy ,intestinal biopsy ,Asymptomatic ,Coeliac disease ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Internal medicine ,medicine ,lcsh:RC799-869 ,Celiac Diseases ,Transglutaminases ,Hepatology ,medicine.diagnostic_test ,business.industry ,Central Europe ,Medical record ,Gastroenterology ,BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Pedijatrija ,medicine.disease ,diagnosi ,Cohort ,celiac disease ,BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Pediatrics ,030211 gastroenterology & hepatology ,lcsh:Diseases of the digestive system. Gastroenterology ,celiac diseases ,transglutaminases ,biopsy ,cohort studies ,medicine.symptom ,business ,Cohort study ,Research Article - Abstract
Objectives. The current European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) guidelines introduced the option to diagnose coeliac disease (CD) in children and adolescents without upper endoscopy if the defined criteria are met. The aim of our study was to evaluate how frequently paediatric gastroenterologists in Central Europe used the “no-biopsy” approach and how often the duodenal biopsy could have been omitted. Methods. Medical records of patients aged<19 years diagnosed with CD in 2016 from five European countries were analysed, focusing on levels of transglutaminase antibodies (TGA) at the time of diagnosis and on whether the diagnosis was confirmed using duodenal biopsy or “no-biopsy” approach. Clinical presentation and delays until final diagnosis were analysed according to diagnostic approach. Results. Data from 653 children (63.9% female, median age: 7 years, range: 7 months-18.5 years) from Croatia, Hungary, Germany, Italy, and Slovenia were analysed. One fifth (n=134) of included children were asymptomatic at diagnosis. Of 519 symptomatic children, 107 (20.6%) were diagnosed by the “no-biopsy” approach. Out of the remaining 412 children who underwent duodenal biopsies, 214 (51.9%) had TGA≥10 times upper level of normal (ULN) and would have been eligible for the “no-biopsy” approach. Signs and symptoms of malabsorption were more frequent in children diagnosed without duodenal biopsies. There were no differences in diagnostic delays with respect to the diagnostic approach. Conclusion. In this cohort, about 60% of symptomatic CD patients could have been diagnosed without duodenal biopsies. The aim of the “no-biopsy” approach was to make the diagnostic procedure less challenging without compromising its reliability. However, this option was applied only in 20%, in spite of fewer burdens to the family and reduced costs. The reasons for this discrepancy are unknown. Physicians should be made more aware about the reliability of CD diagnosis without biopsies when the ESPGHAN guidelines for CD diagnosis are followed.
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- 2019
4. Accuracy in Diagnosis of Celiac Disease Without Biopsies in Clinical Practice
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Sven Seiwerth, Annette M. Müller, Manfred Ratschek, Bożena Cukrowska, Gemma Castillejo, Vanesa Morente, Jorge Amil Dias, Sara Morgenstern, Marco Gasparetto, Nailah Brown, Alexandra Papadopoulou, Gabriele Amann, Kalle Kurppa, Vincenzo Villanacci, Almuthe C. Hauer, Francesc Martínez, Miguel Bolonio, Anikó Nagy, Tine Plato Hansen, Yvan Vandenplas, Sonja Thanner-Lechner, Kaija Laurila, Rita Kőbányai, Søren Thue Lillevang, Zrinjka Mišak, Riccardo Troncone, Pavel Frűhauf, Adina Ene, Jernej Dolinsek, Konstantina Dimakou, Fabio Massimo Magliocca, Annieta Goossens, Vered Nachmias Friedler, Maryam Monajemzadeh, Amir Taher Eftekhar Sadat, Mandana Rafeey, Jan Wyhowski, Rafaella Nenna, Françoise Smets, Hélène Garnier-Lengliné, Marianna Salemme, Martine Vornane, Stine Dydensborg Sander, Hany Banoub, Anne Mourin, Mariantonia Maglio, Stephanie Van Biervliet, Birgit Filipiak, M. L. Mearin, Mehri Najafi, Gauri Batra, Judit Gyimesi, Hubert Kogler, Gabriele Heilig, Raanan Shamir, Laura Petrarca, Katayoun Khatami, Myriam Van Winckel, Susana Corujeira, Hania Szajewska, Ilma Rita Korponay-Szabó, Alina Popp, Stefan Buderus, Sonny K. F. Chong, Elke Janssens, Francesca Penagini, Vincent T.H.B.M. Smit, Judit B. Kovács, Rajko Kavalar, Thomas Kirchner, Carmen Ribes-Koninckx, Renata Auricchio, Ruth Achten, Ester Donat, Catherine Wanty, Nicolas Kalach, Danielle Canioni, Philippe Alliet, Ilona Lellei, Sibylle Koletzko, Yulia Dmitrieva, Fátima Carneiro, Liz Hook, David Fernández Ramos, Roberta Kosova, Dmitry Abramov, Markku Mäki, Helena Skalova, Adrian G. Thomas, Steffen Husby, Steve Sampson, Katharina Julia Werkstetter, Piotr Socha, Andreas Vécsei, Amalia Patereli, Peter Szitanyi, Saskia Vande Velde, Maaike W. Schaart, Pierre Gosset, Growth and Development, Clinical sciences, Werkstetter, K. J, Korponay Szabó, I. R, Popp, A, Villanacci, V, Salemme, M, Heilig, G, Lillevang, S. T, Mearin, M. L, Ribes Koninckx, C, Thomas, A, Troncone, Riccardo, Filipiak, B, Mäki, M, Gyimesi, J, Najafi, M, Dolinšek, J, Dydensborg Sander, S, Auricchio, Renata, Papadopoulou, A, Vécsei, A, Szitanyi, P, Donat, E, Nenna, R, Alliet, Ph, Penagini, F, Garnier Lengliné, H, Castillejo, G, Kurppa, K, Shamir, R, Hauer, A. C, Smets, F, Corujeira, S, van Winckel, M, Buderus, S, Chong, S, Husby, S, Koletzko, S, Socha, Piotr, Bozena Cukrowska, Null, Szajewska, Hania, Wyhowski, Jan, Brown, Nailah, Batra, Gauri, Misak, Zrinjka, Seiwerth, Sven, Dmitrieva, Yulia, Abramov, Dmitry, Vandenplas, Yvan, Goossens, Annieta, Schaart, Maaike W, Smit, V. T. H. B. M, Kalach, Nicola, Gosset, Pierre, Kovács, Judit B, Nagy, Anikó, Lellei, Ilona, Kőbányai, Rita, Khatami, Katayoun, Monajemzadeh, Maryam, Dimakou, Konstantina, Patereli, Amalia, Plato Hansen, Tine, Kavalar, Rajko, Bolonio, Miguel, Kogler, Hubert, Amann, Gabriele, Kosova, Roberta, Maglio, Mariantonia, Janssens, Elke, Achten, Ruth, Frűhauf, Pavel, Skálová, Helena, Kirchner, Thoma, Petrarca, Laura, Magliocca, Fabio Massimo, Martínez, Francesc, Morente, Vanesa, Thanner Lechner, Sonja, Ratschek, Manfred, Gasparetto, Marco, Hook, Liz, Canioni, Danielle, Wanty, Catherine, Mourin, Anne, Laurila, Kaija, Vornane, Martine, Nachmias Friedler, Vered, Morgenstern, Sara L, Amil Dias, Jorge, Carneiro, Fátima, Van Biervliet, Stephanie, Vande Velde, Saskia, Banoub, Hany, Sampson, Steve, Müller, Annette M, Ene, Adina, Rafeey, Mandana, and Eftekhar Sadat, Iran Amir Taher
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Male ,Autoimmunity ,ESPGHAN ,nonbiopsy approach ,ProCeDE study ,adolescent ,autoantibodies ,biomarkers ,biopsy ,celiac disease ,child ,child preschool ,Europe ,female ,GTP-binding proteins ,HLA-DQ antigens ,humans ,immunoglobulin A ,infant ,intestine small ,male ,Middle East ,molecular diagnostic techniques ,predictive value of tests ,prognosis ,prospective studies ,reproducibility of results ,serologic tests ,transglutaminases ,Biopsy ,gastroenterology ,non-biopsy approach ,HLA-DQ Antigens/genetics ,0302 clinical medicine ,Immunoglobulin A/blood ,Intestine, Small ,Nonbiopsy Approach ,Prospective Studies ,Prospective cohort study ,Child ,education.field_of_study ,medicine.diagnostic_test ,Orvostudományok ,Prognosis ,Multicenter Study ,medicine.anatomical_structure ,Molecular Diagnostic Techniques ,Transglutaminases/immunology ,Predictive value of tests ,Child, Preschool ,030211 gastroenterology & hepatology ,Female ,Intestine, Small/immunology ,medicine.medical_specialty ,Child, preschool ,Adolescent ,Anemia ,Population ,Celiac Disease/blood ,Klinikai orvostudományok ,03 medical and health sciences ,autoimmunity ,proCeDE study ,GTP-Binding Proteins ,Predictive Value of Tests ,030225 pediatrics ,Internal medicine ,HLA-DQ Antigens ,medicine ,Journal Article ,Humans ,Protein Glutamine gamma Glutamyltransferase 2 ,Serologic Tests ,Validation Studies ,education ,Pediatric gastroenterology ,GTP-Binding Proteins/immunology ,ProCeDE Study ,Transglutaminases ,business.industry ,Infant ,Reproducibility of Results ,Hepatology ,Endomysium ,medicine.disease ,Surgery ,Immunoglobulin A ,Celiac Disease ,hepatology ,business ,Autoantibodies/blood ,Biomarkers/blood - Abstract
Background & Aims The guidelines of the European Society of Pediatric Gastroenterology, Hepatology, and Nutrition allow for diagnosis of celiac disease without biopsies in children with symptoms and levels of immunoglobulin A against tissue-transglutaminase (TGA-IgA) 10-fold or more the upper limit of normal (ULN), confirmed by detection of endomysium antibodies (EMA) and positivity for HLA-DQ2/DQ8. We performed a large, international prospective study to validate this approach. Methods We collected data from consecutive pediatric patients (18 years or younger) on a gluten-containing diet who tested positive for TGA-IgA from November 2011 through May 2014, seen at 33 pediatric gastroenterology units in 21 countries. Local centers recorded symptoms; measurements of total IgA, TGA, and EMA; and histopathology findings from duodenal biopsies. Children were considered to have malabsorption if they had chronic diarrhea, weight loss (or insufficient gain), growth failure, or anemia. We directly compared central findings from 16 antibody tests (8 for TGA-IgA, 1 for TGA-IgG, 6 for IgG against deamidated gliadin peptides, and 1 for EMA, from 5 different manufacturers), 2 HLA-DQ2/DQ8 tests from 2 manufacturers, and histopathology findings from the reference pathologist. Final diagnoses were based on local and central results. If all local and central results were concordant for celiac disease, cases were classified as proven celiac disease. Patients with only a low level of TGA-IgA (threefold or less the ULN) but no other results indicating celiac disease were classified as no celiac disease. Central histo-morphometry analyses were performed on all other biopsies and cases were carefully reviewed in a blinded manner. Inconclusive cases were regarded as not having celiac disease for calculation of diagnostic accuracy. The primary aim was to determine whether the nonbiopsy approach identifies children with celiac disease with a positive predictive value (PPV) above 99% in clinical practice. Secondary aims included comparing performance of different serological tests and to determine whether the suggested criteria can be simplified. Results Of 803 children recruited for the study, 96 were excluded due to incomplete data, low level of IgA, or poor-quality biopsies. In the remaining 707 children (65.1% girls; median age, 6.2 years), 645 were diagnosed with celiac disease, 46 were found not to have celiac disease, and 16 had inconclusive results. Findings from local laboratories of TGA-IgA 10-fold or more the ULN, a positive result from the test for EMA, and any symptom identified children with celiac disease (n = 399) with a PPV of 99.75 (95% confidence interval [CI], 98.61–99.99); the PPV was 100.00 (95% CI, 98.68–100.00) when only malabsorption symptoms were used instead of any symptom (n = 278). Inclusion of HLA analyses did not increase accuracy. Findings from central laboratories differed greatly for patients with lower levels of antibodies, but when levels of TGA-IgA were 10-fold or more the ULN, PPVs ranged from 99.63 (95% CI, 98.67–99.96) to 100.00 (95% CI, 99.23–100.00). Conclusions Children can be accurately diagnosed with celiac disease without biopsy analysis. Diagnosis based on level of TGA-IgA 10-fold or more the ULN, a positive result from the EMA tests in a second blood sample, and the presence of at least 1 symptom could avoid risks and costs of endoscopy for more than half the children with celiac disease worldwide. HLA analysis is not required for accurate diagnosis. Clinical Trial Registration no: DRKS00003555.
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- 2017
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