Diagnostic reasoning in internal medicine: a practical reappraisal.

The practice of clinical medicine needs to be a very flexible discipline which can adapt promptly to continuously changing surrounding events. Despite the huge advances and progress made in recent decades, clinical reasoning to achieve an accurate diagnosis still seems to be the most appropriate and distinctive feature of clinical medicine. This is particularly evident in internal medicine where diagnostic boundaries are often blurred.

Recent advances in coeliac disease.

Purpose Of Review: Worldwide awareness of coeliac disease in all ages continues to grow. This article aims to summarize critically the recent research advances in coeliac disease.

Recent Findings: Large multicentre studies have provided further evidence of the role of environmental and nonhuman leucocyte antigen genetic factors in coeliac disease.

Evidence for the involvement of NOD2 in regulating colonic epithelial cell growth and survival.

Aim: To investigate the function of NOD2 in colonic epithelial cells (CEC).

Methods: A combination of in vivo and in vitro analyses of epithelial cell turnover in the presence and absence of a functional NOD2 protein and, in response to enteric Salmonella typhimurium infection, were used. shRNA interference was also used to investigate the consequences of knocking down NOD2 gene expression on the growth and survival of colorectal carcinoma cell lines.

Newly identified genetic risk variants for celiac disease related to the immune response.

Our genome-wide association study of celiac disease previously identified risk variants in the IL2-IL21 region. To identify additional risk variants, we genotyped 1,020 of the most strongly associated non-HLA markers in an additional 1,643 cases and 3,406 controls. Through joint analysis including the genome-wide association study data (767 cases, 1,422 controls), we identified seven previously unknown risk regions (P < 5 x 10(-7)).

Advances in coeliac disease.

Purpose Of Review: The number of people diagnosed with coeliac disease continues to rise, and this article critically summarizes recent research into the condition.

Recent Findings: Much work has been focused on clarifying the molecular pathways involving cytokines in coeliac disease. Such work will yield improved understanding of the complex pathogenesis of coeliac disease and novel therapeutic targets.

Advances in celiac disease.

Purpose Of Review: Increasing numbers of atypical or asymptomatic cases of celiac disease are being diagnosed. This review aims to summarize recent critical research in celiac disease.

Recent Findings: Alternative candidate genes outside of the human leukocyte antigen complex continue to be identified, whilst innate and adaptive immune responses to key gliadin epitopes are now both recognized to be important in celiac disease pathogenesis.

Gliadin, glutenin or both? The search for the Holy Grail in coeliac disease.

Wheat gluten was traditionally classified into gliadin and glutenin based upon solubility in aqueous alcohol. Gliadins were thought to be responsible for precipitating coeliac disease; glutenins were thought probably to be nontoxic. More recent classification, according to primary amino acid structure, reveals not only great heterogeneity but also similarities between different gliadin and glutenin proteins.

Advances in celiac disease.

Purpose Of Review: This article primarily aims to review critically research in all aspects of celiac disease over the last year. As always, there has been a wealth of relevant papers.

Recent Findings: The role of genetics in disease susceptibility is slowly becoming more clearly defined and a more detailed understanding of the disease processes at the molecular level is paving the way towards the development of specific targeted therapies.

New developments in celiac disease.

Celiac disease remains a challenge to the clinician and scientist. It is clearly more prevalent than was previously suspected. Much interest is seen in identifying the genetic factors, which predispose to disease and the environmental agents that can trigger it.

Cognitive dysfunction and health-related quality of life in long-term liver transplant survivors.

Although several studies have investigated short-term effects of liver transplantation on cognitive function and health-related quality of life, there have been no studies looking at long-term effects. Patients who received a single liver transplant at St James's University Hospital (Leeds, UK) before October 1, 1991, were invited to participate in this cross-sectional study. Cognitive function was assessed using the Mini-Mental State Examination, the Rey Auditory Verbal Learning Test, trail-making tests, the Stroop test, and the Benton Visual Retention Test.

Celiac disease.

Celiac disease is more prevalent than it was previously thought to be, and screening of selected population groups may reveal many new cases. Tissue transglutaminase appears to have a significant role in the degradation of gliadin and antigen production. Specific gliadin epitopes have been defined using T-cell responses.