Unusual progression to erythroderma after initiation of dupilumab
October 2019 Update
Stiff Katherine M; Schneider Sarah; Vij Alok
Journal of the American Academy of Dermatology
2019
2019-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.jaad.2019.06.1264" target="_blank" rel="noreferrer noopener">10.1016/j.jaad.2019.06.1264</a>
Topical squaric acid application, an unlikely treatment for mild to moderate mixed type vitiligo
October 2019 Update
Palomo Christina; Esty Tressa; Labrecque Pierre
Journal of the American Academy of Dermatology
2019
2019-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.jaad.2019.06.521" target="_blank" rel="noreferrer noopener">10.1016/j.jaad.2019.06.521</a>
The paradox of melanoma in oculocutaneous albinism: A case report and literature review
October 2019 Update
Ravichandran S; Funchain P; Arbesman J
Journal of Investigative Dermatology
2019
2019-09
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.jid.2019.06.093" target="_blank" rel="noreferrer noopener">10.1016/j.jid.2019.06.093</a>
The Orthopaedic Manifestations of Pseudoachondroplasia
Achondroplasia; Apoptosis; Arthritis; Biomechanics; Bone (axial); Bone dysplasia; Bones; Cartilage; Cartilage (articular); Cartilage oligomeric matrix protein; Chondrocytes; Chromosome 19; Chromosomes; Dwarfism; Dysplasia; Elbow; Elbow (anatomy); Epiphysis; Extremities; Feet; Gait; Hand (anatomy); Hip; Intelligence; Joint diseases; Knee (anatomy); Kyphosis; Medical Sciences--Pediatrics; Mutation; Orthopedics; Plates (structural members); Proteins; Radiographs; Radiography; Skeleton; Thorax; Vertebra; Vertebrae
October 2019 Update
In 1959, Maroteaux and Lamy initially designated pseudoachondroplasia as a distinct dysplasia different from achondroplasia, which is the most common form of skeletal dysplasia associated with dwarfism. Pseudoachondroplasia is the second-most common form of skeletal dysplasia. Pseudoachondroplasia is caused by a mutation in the COMP gene on chromosome 19p13.1-p12 encoding the cartilage oligomeric matrix protein. The mutation causes an accumulation of mutated COMP protein within the rough endoplastic reticulum of chondrocytes leading to premature chondrocyte apoptosis. This cascade of molecular events eventually results in rendering the articular cartilage and growth plate cartilage incapable of withstanding routine biomechanical loads with resultant deformity of the joints, particularly in the lower extremities. A unique opportunity to review charts and radiographs of 141 patients with pseudoachondroplasia allowed the author to assemble the typical findings in pseudoachondroplasia. This cohort, to our knowledge, represents the largest group of patients describing the typical orthopaedic manifestations of pseudoachondroplasia. The intensive review of this cohort yielded the following clinical and radiographic information: Patients with pseudoachondroplasia have a normal craniofacial appearance and are of normal intelligence. Short stature is not present at birth and generally appears by 2 to 4 years of age. The condition is a form of spondyloepiphyseal dysplasia and the long bones are characterized by dysplastic changes in the epiphysis, metaphysis, and vertebral bodies. The hands have short, stubby fingers, short metacarpals, lax wrists, diminished extension of the elbow, and limitation of shoulder motion. Occasionally odontoid dysplasia is seen with kyphosis, scoliosis, and lumbar lordosis, commonly. The gait is characterized by "waddling". The knees show either genu valgum, genu varum, or "windswept" deformity and the feet and ankles are in pronovalgus position with short, wide feet. Radiographically the long bones have altered appearance and structure of the epiphyses with small irregularly formed or fragmented epiphyses or flattening. The metaphyseal regions of the long bones show flaring, widening, or "trumpeting". The cervical vertebrae show platyspondyly. The thoracic and lumbar vertebrae show either platyspondyly, ovoid, "cod-fish" deformity, or anterior "beaking". Most commonly these distortions of the long bones and the axial skeleton, lead to premature arthritis particularly of the hips and often the knees not uncommonly in the 20- to 30-year-old age group. Vertebral "beaking" (Image 1) Epimetaphyseal dysplasia (Image 2)
Guirguis James; Weiner Dennis S
Pediatrics; Evanston
2019
2019-08
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1542/peds.144.2_MeetingAbstract.755" target="_blank" rel="noreferrer noopener">10.1542/peds.144.2_MeetingAbstract.755</a>
Sources of Error in Office Blood Pressure Measurement
bias; Blood Pressure; end-digit preference; global burden; hypertension; Hypertension; mercury; Patient Positioning; Prehypertension; prevalence
October 2019 Update
PURPOSES: To evaluate 2 commonly overlooked sources of error in measuring blood pressure (BP) in the office, improper patient positioning and frequency of terminal digit bias (TDB) using manual and automated (BP) devices. METHODS: BPs recorded by 3 nurses using manual and automated devices were analyzed for TDB. In the next part of the study, 294 patients were recruited and tested with each patient's BP measured twice in the table position and compared with BP measured in the chair position. To eliminate concern for position sequence, a randomized controlled trial was initially conducted. RESULTS: Significant TDB for the digit zero was identified in BPs measured by all nurses using a manual device. No such bias was identified for any nurse when measuring BP with an automated device. For the positional study, the randomized controlled study showed no significant sequencing effect therefore the sequence of table then chair BP measurements was adopted. Significant BP lowering was observed in 128 patients (42.7%) in the chair compared with the table position. Misclassification of prehypertension and hypertension would have occurred in 15.3% and 16% of patients, respectively, when BP was recorded in the table instead of the chair position. CONCLUSIONS: Significant TDB was identified for all nurses when using a manual but not an automated device. Patient positioning on the examination table resulted in elevations of systolic and diastolic BPs.
Morcos Roy N; Carter Kimbroe J; Castro Frank; Koirala Sumira; Sharma Deepti; Syed Haroon
Journal of the American Board of Family Medicine: JABFM
2019
2019-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.3122/jabfm.2019.05.190085" target="_blank" rel="noreferrer noopener">10.3122/jabfm.2019.05.190085</a>
Simulation-based interprofessional conference: a focus on patient handoffs and critical communication
communication; handoff; interprofessional; simulation
October 2019 Update
Gable Brad; Ahmed Rami
Bmj Simulation & Technology Enhanced Learning
2019
2019-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1136/bmjstel-2017-000260" target="_blank" rel="noreferrer noopener">10.1136/bmjstel-2017-000260</a>
Progressive, purpuric nodules on a patient with aplastic anemia and paroxysmal nocturnal hemoglobinuria (PNH)
October 2019 Update
Farid Yostina; Schneider Sarah; Caraway Hetty; Warren Christine; Vij Alok
Journal of the American Academy of Dermatology
2019
2019-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.jaad.2019.06.1141" target="_blank" rel="noreferrer noopener">10.1016/j.jaad.2019.06.1141</a>
Pharmacologic and Nonpharmacologic Management of Atrial Fibrillation
amiodarone; Antiarrhythmic drugs; antiarrhythmic-drugs; Atrial fibrillation; cardioversion; catheter ablation; Catheter ablation; dronedarone; efficacy; heart-failure; maintaining sinus rhythm; mortality; Pharmacologic management; therapy
October 2019 Update
Atrial fibrillation (AF) is the most common arrhythmia and its management may be organized into risk stratification and/or treatment of heart failure, stroke prevention, and symptom control. At the core of symptom control, treatment is tailored to either allow AF continue with controlled heart rates, so-called rate control, versus restoring and maintaining sinus rhythm or rhythm control. Rate control strategies mainly use rate-modulating medications, whereas rhythm control treatment includes therapy aimed at restoring sinus rhythm, including pharmacologic and direct current cardioversion, as well as maintenance of sinus rhythm, including anti-arrhythmic medications and ablation therapy.
Dahya Vishal; Taigen Tyler L
Medical Clinics of North America
2019
2019-09
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<a href="http://doi.org/10.1016/j.mcna.2019.04.004" target="_blank" rel="noreferrer noopener">10.1016/j.mcna.2019.04.004</a>
Learning From the Past and Creating the Future: American Association for Geriatric Psychiatry (AAGP) and Geriatric Mental Healthcare in the United States
October 2019 Update
Tampi Rajesh R
The American Journal of Geriatric Psychiatry: Official Journal of the American Association for Geriatric Psychiatry
2019
2019-08
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.jagp.2019.08.004" target="_blank" rel="noreferrer noopener">10.1016/j.jagp.2019.08.004</a>
Job Selection After Orthopedic Surgery Training: Why Are Our Trainees Failing to Select the Right Job?
future; job attrition; job selection; medical education; orthopedic surgery training; satisfaction; systems-based practice
October 2019 Update
A survey was administered to a random sampling of the American Academy of Orthopaedic Surgeons (AAOS) members to determine the rate at which recently trained orthopedic surgeons switch their first job and to identify factors affecting the job selection process. There were 351 (21%) respondents. Respondents considered practice location (41%), practice type (28%), and family proximity (23%) as most important while research opportunity (54%) and signing bonus (33%) were considered least important in their first job. Half of the respondents (51%) left their first job before the completion of their fifth year; most left for financial reasons (34%) or because the practice was not as advertised (31%). Many (53%) stated they had minimal training in selecting their first job and most (88%) felt inadequately prepared for the business side of orthopedics. Further studies are needed to evaluate the high rate of initial post-training job attrition to decrease the personal and societal costs of this phenomenon.
Laratta Joseph L; Gum Jeffrey L; Shillingford Jamal N; Reddy Hemant; Lehman Ronald A; Crawford Charles H; Glassman Steven D; Carreon Leah
Cureus
2019
2019-08
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.7759/cureus.5539" target="_blank" rel="noreferrer noopener">10.7759/cureus.5539</a>
Internalization of particulate delivery systems by activated microglia influenced the therapeutic efficacy of simvastatin repurposing for neuroinflammation
Brain; Drug delivery; Drug repurposing; PEG-PdLLA; Polymersomes
October 2019 Update
We recently evaluated the suitability of polymersome delivery systems in simvastatin repurposing for treating neuroinflammation. The goal of the current study is to elucidate the therapeutic impact of particulate internalization by activated microglia on the resultant anti-inflammatory properties. Thus, we investigated the endocytic mechanism(s) involved in uptake and transport of simvastatin-loaded polymersomes by BV2 microglia cells coupled with delineation of the intracellular pathway(s) involved in regulating anti-inflammatory effects. Our data indicated that internalization of polymersome delivery systems by activated microglial BV2 cells was important in the suppression of nitric oxide (NO), TNF-α and IL-6 production. Further, we observed that the lipid raft/caveolae pathway had the most influential effect on polymersome internalization by microglia cells while clathrin-mediated endocytosis did not play a major role. Enhancement of anti-inflammatory effects of simvastatin could be attributed to inhibition of ERK1/2, JNK and AKT signaling pathways and internalization of polymersome delivery systems in activated microglia. Taken together, our data provided insights into how the intracellular trafficking of delivery systems by microglial could be a useful tool in modulating the desired anti-inflammatory effects of drugs.
Manickavasagam Dharani; Oyewumi Moses O
International Journal of Pharmaceutics
2019
2019-09
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.ijpharm.2019.118690" target="_blank" rel="noreferrer noopener">10.1016/j.ijpharm.2019.118690</a>
Innovative Moments in Career Construction Counseling: Proposal for an Integrative Model
ambivalence; career construction counseling; career counseling process; CIVILIAN Conservation Corps (U.S.); client change; counseling tasks; COUNSELOR & client; innovative moments; therapy; VOCATIONAL guidance
October 2019 Update
This article advances understanding of career construction counseling (CCC) by viewing it through the lens of the innovative moments model (IMM) of how clients construct change. The IMM conceives clients' narrative transformations as resulting from counselors prompting and clients reflecting on exceptions to a problematic self‐narrative (i.e., innovative moments; IMs) that emerges in counseling dialogues. On the basis of intensive IMM analysis of CCC case studies, the authors propose an integration of the 2 models that describes the sequence of client change in IMs across the 3 phases of CCC. This proposal provides both conceptual and assessment tools that make it possible to describe and analyze the process of client change through life‐designing dialogues. The authors illustrate the integrated framework with vignettes from case studies and conclude by suggesting research to examine the validity and usefulness of the client change sequence and interventions for using this pattern of change to foster client transformation.
Cardoso Paulo; Savickas Mark L; Gonçalves Miguel M
Career Development Quarterly
2019
2019-09
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1002/cdq.12190" target="_blank" rel="noreferrer noopener">10.1002/cdq.12190</a>
HDL Flux is Higher in Patients with Nonalcoholic Fatty Liver Disease
haevy water; HDL; NAFLD; NASH; proteomics
October 2019 Update
Altered lipid metabolism and inflammation are involved in the pathogenesis of both non-alcoholic fatty liver disease (NAFLD) and cardiovascular disease (CVD). Even though high-density lipoprotein (HDL), a CVD protective marker, is decreased, whether HDL metabolism and function are perturbed in NAFLD are currently unknown. We examined the effect of NAFLD and disease severity on HDL metabolism and function in patients with biopsy-proven simple steatosis (SS), nonalcoholic steatohepatitis (NASH), and healthy controls. HDL turnover and HDL proteins dynamics in SS (n=7), NASH patients (n=8), and healthy controls (n=9) were studied in vivo. HDL maturation and remodeling, anti-oxidant, cholesterol efflux properties, and activities of lecithin cholesterol ester acyl transferase (LCAT) and cholesterol ester transfer protein (CETP) were quantified using in vitro assays. All NAFLD patients had increased turnover of both HDL cholesterol (HDLc, 0.16±0.09 vs. 0.34±0.18 day-1, P<0.05) and ApoAI (0.26±0.04 vs. 0.34±0.06 day-1, P<0.005) compared to healthy controls. The fractional catabolic rates (FCR) of other HDL proteins, including ApoAII (and ApoAIV were higher (P<0.05) in NAFLD patients who also had higher CETP activity, ApoAI/HDLc ratio (P<0.05). NAFLD-induced alterations were associated with lower antioxidant (114.2±46.6 vs 220.5±48.2 nml/ml●min) but higher total efflux properties of HDL (23.4±1.3 vs. 25.5±2.3 %) (both P<0.05) which was more pronounced in individuals with NASH. However, no differences were observed in either HDL turnover, antioxidant and cholesterol efflux functions of HDL or HDL proteins' turnover between SS and NASH subjects. Thus, HDL metabolism and function are altered in NAFLD without any significant differences between SS and NASH.
McCullough Arthur; Previs Stephen F; Dasarathy Jaividhya; Lee Kwangwon; Osme Abdullah; Kim Chunki; Ilchenko Serguei; Lorkowski Shuhui W; Smith Jonathan D; Dasarathy Srinivasan; Kasumov Takhar
American Journal of Physiology. Endocrinology and Metabolism
2019
2019-09
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1152/ajpendo.00193.2019" target="_blank" rel="noreferrer noopener">10.1152/ajpendo.00193.2019</a>
Enteral and parenteral nutrition considerations in pediatric patients
compounding; enteral; neonatal; nutrition; parenteral; pediatric; stability
October 2019 Update
PURPOSE: Current clinical practice guidelines on management of enteral nutrition (EN) and parenteral nutrition (PN) in pediatric patients are reviewed. SUMMARY: The provision of EN and PN in pediatric patients poses many unique considerations and challenges. Although indications for use of EN and PN are similar in adult and pediatric populations, recommended EN and PN practices differ for pediatric versus adult patients in areas such as selection of EN and PN formulations, timing of EN and PN initiation, advancement of nutrition support, and EN and PN goals. Additionally, provision of EN and PN to pediatric patients poses unique compounding and medication administration challenges. This article provides a review of current EN and PN best practices and special nutrition considerations for neonates, infants, and other pediatric patients. CONCLUSION: The provision of EN and PN to pediatric patients presents many unique challenges. It is important for pharmacists to keep current with pediatric- and neonatal-specific guidelines on nutritional management of various disease states, as well as strategies to address compounding and medication administration challenges, in order to optimize EN and PN outcomes.
Cober Mary Petrea; Gura Kathleen M
American journal of health-system pharmacy: AJHP: official journal of the American Society of Health-System Pharmacists
2019
2019-09
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1093/ajhp/zxz174" target="_blank" rel="noreferrer noopener">10.1093/ajhp/zxz174</a>
Cutaneous Mycobacterium haemophilum infection in a patient on chronic immunosuppression with MCTD
October 2019 Update
Desai Mansee; Zurfley Frank; Bass Jonathan; Mostow Eliot
Journal of the American Academy of Dermatology
2019
2019-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.jaad.2019.06.184" target="_blank" rel="noreferrer noopener">10.1016/j.jaad.2019.06.184</a>
Ceftolozane/Tazobactam vs Polymyxin or Aminoglycoside-based Regimens for the Treatment of Drug-resistant Pseudomonas Aeruginosa
aminoglycoside; ceftolozane; multidrug resistant; polymyxin; Pseudomonas
October 2019 Update
BACKGROUND: Ceftolozane/tazobactam is a novel cephalosporin/beta-lactamase inhibitor combination that often retains activity against resistant Pseudomonas aeruginosa. The comparative safety and efficacy vs polymyxins or aminoglycosides in this setting remains unknown. METHODS: A retrospective, multicenter, observational cohort study was performed. Patients who received ceftolozane/tazobactam were compared with those treated with either polymyxin or aminoglycoside-based regimens for infections due to drug-resistant P. aeruginosa. Multivariate logistic regression was performed controlling for factors associated with treatment to assess the independent impact of ceftolozane/tazobactam on clinical cure, acute kidney injury (AKI), and in-hospital mortality. RESULTS: A total of 200 patients were included (100 in each treatment arm). The cohort represented an ill population with 69% in the intensive care unit, 63% mechanically ventilated, and 42% in severe sepsis or septic shock at infection onset. The most common infection type was ventilator-associated pneumonia (52%); 7% of patients were bacteremic. Combination therapy was more commonly used in polymyxin/aminoglycoside patients than those who received ceftolozane/tazobactam (72% vs 15%, P < .001). After adjusting for differences between groups, receipt of ceftolozane/tazobactam was independently associated with clinical cure (adjusted odds ratio [aOR], 2.63; 95% confidence interval [CI], 1.31-5.30) and protective against AKI (aOR, 0.08; 95% CI, 0.03-0.22). There was no difference in in-hospital mortality. The number needed to treat for a clinical cure with ceftolozane/tazobactam was 5, and the number needed to harm with AKI with a polymyxin/aminoglycoside was 4. CONCLUSIONS: These data support the preferential use of ceftolozane/tazobactam over polymyxins or aminoglycosides for drug-resistant P. aeruginosa infections.
Pogue Jason M; Kaye Keith S; Veve Michael P; Patel Twisha S; Gerlach Anthony T; Davis Susan L; Puzniak Laura A; File Tom M; Olson Shannon; Dhar Sorabh; Bonomo Robert A; Perez Federico
Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
2019
2019-09
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1093/cid/ciz816" target="_blank" rel="noreferrer noopener">10.1093/cid/ciz816</a>
Antimicrobial resistance in methicillin-resistant Staphylococcus aureus to newer antimicrobial agents
October 2019 Update
Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) result in significant morbidity and mortality for patients in both community and health care settings. This is primarily due to the difficulty in treating MRSA, which is often resistant to multiple classes of antibiotics. Understanding the mechanisms of antimicrobial resistance (AMR) in MRSA provides insight into the optimal use of antimicrobial agents in clinical practice and also underpins critical aspects of antimicrobial stewardship programs. In this review we delineate the mechanisms, prevalence, and clinical importance of resistance to antibiotics licensed in the past 20 years that target MRSA, as well as new drugs in the pipeline which are likely to be licensed soon. Current gaps in scientific knowledge about MRSA resistance mechanisms are discussed, and topics in the epidemiology of AMR in S. aureus that require further investigation are highlighted.
Watkins Richard R; Holubar Marisa; David Michael Z
Antimicrobial Agents and Chemotherapy
2019
2019-09
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1128/AAC.01216-19" target="_blank" rel="noreferrer noopener">10.1128/AAC.01216-19</a>
A Test of the Career Construction Theory Model of Adaptation in Adult Workers With Chiari Malformation
abilities scale; adaptability; Career Adapt-Abilities Scale-Short Form; career adaptability; career construction theory; Chiari malformation; job; life; mediation; need satisfaction; personality; psychometric properties; self-regulation; students
October 2019 Update
The present study examined the career construction theory (CCT) model of adaptation using a sample of working adults diagnosed with Chiari malformation. Specifically, we tested a mediation model in which adaptivity (i.e., proactivity, openness, and conscientiousness) fosters adaptability, which conditions adapting (i.e., competence need satisfaction at work), which leads to adaptation (i.e., work well-being and subjective well-being). Results of structural equation modeling supported all of the hypothesized direct and indirect relations between CCT constructs, thus providing strong support for the applicability of the model of adaptation among workers with Chiari malformation. Prior to testing the model of adaptation, we examined and found support for the hypothesized hierarchical structure of the Career Adapt-Abilities Scale-Short Form, a recently developed operationalization of career adaptability.
Tokar David M; Savickas Mark L; Kaut Kevin P
Journal of Career Assessment
2019
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<a href="http://doi.org/10.1177/1069072719867733" target="_blank" rel="noreferrer noopener">10.1177/1069072719867733</a>
A Single Institution's Experience of Primary Headache in Children With Celiac Disease
celiac disease; children; migraine; primary headache; questionnaire
October 2019 Update
BACKGROUND: Few studies exist examining the frequency of primary headache in children with celiac disease and the impact of a gluten-free diet on primary headache symptomology. This study explores characteristics and frequency of headaches in children with celiac disease and response to gluten-free diet at a single institution. METHODS: Medical records were reviewed for children with celiac disease confirmed by the presence of elevated tissue transglutaminase IgA levels and histologic changes consistent with the diagnosis of celiac disease on small bowel biopsy. Eligible participants were contacted via letter for participation in a phone survey regarding headaches. Phone interviews were conducted 2 weeks after notification and lasted approximately 10 minutes. Headaches were classified according to ICHD-3 criteria. RESULTS: 247 eligible patients or their families were contacted. A total of 132 (53.44%) agreed to participate. One participant was excluded due to insufficient information provided. Overall, 51 of 131 participants had recurrent headache defined as at least 1 episode per month (39%, 95% confidence interval [CI]: 31%-47%) and 33 had migraine with or without aura (25%, 95% CI: 18%-33%). Twenty-eight had frequent tension-type headache (22%, 95% CI: 15%-29%). Thirty-two participants noted headaches before a confirmed diagnosis of celiac disease. Twenty-two of 32 participants (68.75%) noticed decreased headache frequency or intensity, or both, after starting the gluten-free diet. CONCLUSION: This study suggests that at least one-third of children and adolescents with celiac disease have recurrent headaches at the time of diagnosis. A gluten-free diet led to improved headache symptomology in a significant number of these patients.
Hom Grant L; Hom Brian L; Kaplan Barbara; Rothner A David
Journal of Child Neurology
2019
2019-09
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/0883073819873751" target="_blank" rel="noreferrer noopener">10.1177/0883073819873751</a>