A146 TRENDS IN THE CLINICAL PRESENTATION OF CELIAC DISEASE AT DIAGNOSIS IN CHILDREN IN QUEBEC
Notice bibliographique
Résumé
Celiac disease (CD) is an immune-mediated condition that affects the intestinal mucosa of children at any age. Digestive symptoms include abdominal pain, diarrhea, vomiting and bloating. However, extra-digestive manifestations appear more common nowadays and may be associated with a delay in diagnosis. To describe the current presentation of CD in children in a tertiary hospital in Quebec and compare it to data from a historical Canadian cohort. We identified all cases of CD seen in the gastroenterology unit between January 2015 and September 2017. Data collection was performed using patient medical records. A database was created with Filemaker pro software to collect the age at diagnosis, anthropometric data, clinical symptoms at diagnosis, associated diseases and intestinal biopsy results. A diagnosis of CD was established when the duodenal biopsies displayed a Marsh classification ≥2 {Oberhuber and al. 1999}. Statistical analyzes were carried out with SAS software. A total of 323 patients with CD were included (203 girls (63%)). The median age (Interquartile range(IQR)) at diagnosis was 9 (5.60, 12.10) years. The median (IQR) BMI was 16.30 (15.10, 18.20) and the median (IQR) BMI Z score was -0.31 (-1.00, 0.34). The proportion of undernutrition, normal weight, overweight and obesity at diagnosis were respectively : 27 (8%), 264 (82%), 27 (8%) and 5 (2%). A total of 62% of patients had at least one digestive symptom: 204 (63%) had abdominal pain, 87 (27%) had bloating, 91 (28%) had diarrhea, 83 (26%) had constipation, 34 (11%) had anorexia and 35 (11%) had vomiting. At least one isolated extraintestinal manifestation was present in 96 (30%) children: 72 (22%) with fatigue, 43 (13%) with anemia and 25 (8%) with arthralgia. A total of 26 (8%) children had no symptoms. Associated diseases such as diabetes and Down syndrome were present in 11% of the cohort. Although abdominal pain remains the most prevalent symptom at diagnosis, its frequency seems lower than historical studies (90% of children had abdominal pain in a 2005 Canadian study) {Rashid and al. Pediatrics 2005}. Diarrhea and constipation were equally found in ¼ of the cohort as compared to 65% and 30% in the 2005 study {Rashid and al. Pediatrics 2005}. The median age at diagnosis in our cohort was higher than in the past study (3 years). Non-digestive symptoms were present in one-third of patients. Hence, primary caregiver must be aware of these trends in clinical presentation. Early recognition could be associated with early diagnosis and overall wellbeing. None
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,002 | 0,003 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».