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Selecting High-Risk Patients With Pediatric Crohn's Disease for Top-Down Anti-TNF as per the 2021 ECCO-ESPGHAN Guidelines: A 5-Year Nationwide Retrospective Analysis From Scotland (2016-2020).
Inflamm Bowel Dis
December 2024
Department of Paediatric Gastroenterology, Hepatology and Nutrition, Royal Aberdeen Children's Hospital, Aberdeen, UK.
Background: The 2021 ECCO-ESPGHAN guideline on the medical management of pediatric Crohn's disease promotes early risk stratification and top-down anti-TNF for patients deemed high risk of severe disease course.
Aims: We aimed to objectively assess the risk-benefit profile of the guideline's risk stratification policy and guidance on top-down anti-TNF in a nationwide population-based cohort study.
Methods: Using a prospectively identified nationwide cohort of all new pediatric patients (<17 years) diagnosed with Crohn's disease in Scotland between January 1, 2016 and December 31, 2020 and retrospectively applying the current management algorithm, we explored the guideline's ability to accurately risk stratify patients.
Coeliac Disease in Children-A Clinical Review Including Novel Treatment Agents.
Medicina (Kaunas)
October 2024
Department of Gastroenterology, Perth Children's Hospital, Perth, WA 6009, Australia.
Coeliac disease (CD) affects almost of 1% of the population, yet remains undiagnosed in the majority. Though the demonstration of enteropathy in duodenal biopsy was traditionally the essential criterion for the diagnosis of coeliac disease, the guidelines published by the European Society of Paediatric Gastroenterology and Nutrition (ESPGHAN) in 2012, and revised in 2020, paved the way to a no-biopsy approach to diagnosis. In a select group of children meeting certain criteria, a definitive diagnosis of CD can now be made without the need for duodenal biopsies.
View Article and Find Full Text PDFRational application of the ESPGHAN 2022 recommendations for the follow-up of the paediatric coeliac patient: consensus document of scientific societies (SEGHNP, AEPAP, SEPEAP, SEEC, AEG, SEPD, SEMFYC, SEMG and SEMERGEN).
An Pediatr (Engl Ed)
October 2024
Sección de Gastroenterología y Hepatología Pediátrica, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
Coeliac disease is a common condition for which the only current treatment is a gluten-free diet. Adherence to this diet is not always easy and is associated with a reduction in quality of life for the patient and their family. Non-adherence is associated with complications of varying severity.
View Article and Find Full Text PDFFood allergy prevention through the decades: An ounce of humility is worth a pound of cure.
J Food Allergy
July 2024
From the Dartmouth Geisel School of Medicine, Hanover, New Hampshire.
Food allergy prevention has undergone a significant transformation over the past 3 decades. This review provides an overview of the evolution of food allergy prevention, highlighting changes in guidance, cost-effectiveness of prevention, the role of shared decision-making, and the emergence of oral immunotherapy for those in whom primary prevention fails. Changes to food allergy prevention over recent decades can be conceptualized into five epochs, which have followed a general trend of loosening restrictions on the allergen introduction timeline.
View Article and Find Full Text PDFConflict between parents, physicians, and healthcare professionals in medical decision-making: How to address it-A systematic review from the ESPGHAN Ethics Committee.
J Pediatr Gastroenterol Nutr
November 2024
The Hebrew University and Hadassah Medical School, Jerusalem, Israel.
Medical decisions about pediatric gastroenterology pathologies often involve collaboration between the medical team and the family. On occasions, conflict may arise between the individuals involved in decision making (team-family conflict) causing delays in managing a child's health condition. Little is known on the strategies that can be implemented to address such conflicts.
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