Celiac Disease tTG and Gliadine Rapid Test

Volchansk block is an anticlinal uplift situated in the north-western part of the Azov megablock of the Ukrainian Shield. Characteristic feature of the megablock is the presence of a large number of faults that subdivide it into numerous block structures where linear folds of higher ranks are observed. Of primary importance in the tectonic structure of the region is the system of faults of north-western strike. Horst and graben-like structures are associated with them. The horst-like ("dome") structures are composed of Archean gneisses of the West Azov series and granitoids of the Remiv complex, with graben-like being composed of metasedimentary rocks of the Volchansk thickness. According to geophysical data, the Shevchenko, Fedorivka, Ivanivka and Volchansk synclinal structures were identified in the northern and eastern frames of the Volchansk anticlinorium, which are considered to be the northwest continuation of the Central Azov synclinal structures. They are composed of low metamorphosed sedimentary rocks, which occur unconformable on the highly metamorphosed rocks of the West Azov series and the Volchansk thickness. These metasedimentary rocks are intruded by granitoids of potassium-sodium composition, that form small granite massifs associated with faults. Geochronological studies of porphyritic granites of the January massif, which is located to the west of the Shevchenko and Fedoriv synclinal structures, are made. It has been established that the U-Pb isotopic age of the Janvar porphyry granitoids of the Janvar massif is 2.06 Ga. According to geochemical data, they have crustal origin and are probably produced by melting from Archean tonalite-trondhjemite-granodiorite (TTG) complex. The granitoids of the Janvar massif are comparable, by isotopic age, petrographic and petrochemical characteristics, with the granitoids of the Anadol complex. Their formation is probably associated with the collision phase of the Sarmatian and Volga-Ural microcontinents.

Objectives:Assessment of adherence to gluten-free diet in celiac disease (CD) is generally recommended. Few data are available about consequences of transition from the referral center to the general pediatrician (GP) once remission is achieved.Methods:Adherence was assessed in patients referred to the GP for an annual basis follow-up, called back for re-evaluation. Immunoglobulin A (IgA) antitissue transglutaminase (anti-tTG) antibodies and the Biagi score (BS) were determined at last follow-up at the referral center (V1), and at re-evaluation (V2). Patients were classified as adherent (BS 3-4, IgA anti-tTG <7U/mL) and nonadherent (BS 0-2, IgA anti-tTG 7). Scores of adherence were correlated with personal and clinical data.Results:We evaluated 200 patients. Overall, we found good adherence rates in 94.95% of patients at V1 and 83.5% at V2. IgA anti-tTG were negative in 100% at V1 and 96.97% at V2. BS is 3 to 4 in 94.5% at V1 and 84% at V2. Adherence at V2 was significantly worse than V1 (P<0.001). No significant associations were found between scores of adherence and sex, symptoms and age at diagnosis, family history of CD, comorbidity, and diagnosis by endoscopy. Age 13 years or older represents a risk factor for lack of compliance at V1 (P=0.02) and V2 (P=0.04), and foreign nationality at V2 (P=0.001).Conclusions:The BS, serology, and a clinical interview, integrated, are reliable tools for assessing pediatric adherence to gluten-free diet. We argue that referring patients to the GP after remission of CD is important, but the process must be improved and recommendations are required.