Papers by Jernej Dolinsek
European Journal of Pediatrics, Nov 24, 2021
Adequate follow-up in celiac disease is important to improve dietary compliance and treat disease... more Adequate follow-up in celiac disease is important to improve dietary compliance and treat disease-related symptoms and possible complications. However, data on the follow-up of celiac children is scarce. We aimed to assess current pediatric celiac follow-up practices across Europe. Pediatricians and pediatric gastroenterologists from 35 countries in Europe, Israel, Turkey, and Russia completed an anonymous survey which comprised a 52-item questionnaire developed by the ESPGHAN Special Interest Group on Celiac Disease. A total of 911 physicians, the majority of whom exclusively worked in pediatric care (83%) and academic institutions (60%), completed the questionnaire. Mean age and mean experience with celiac care were 48.7 years (± 10.6) and 15.7 years ( ± 9.9), respectively. The vast majority (≥ 92%) always assessed anthropometry, dietary adherence, and tissue-transglutaminase IgA-antibodies at every visit, with the first visit being between 3 and 6 months after diagnosis. Other parameters (% always tested) were as follows: complete blood count (60%), iron status (48%), liver enzymes (42%), thyroid function (38%), and vitamin D (26%). Quality of life was never assessed by 35% of the responding physicians. Transition to adult care was mostly completed via a written transition report (37%) or no formal transition at all (27%). Conclusions : Follow-up of celiac children and adolescents in Europe may be improved, especially regarding a more rational use of (laboratory) tests, dietary and QoL assessment, and transition to adult care. Evidence-based advice from international scientific societies is needed. What is Known: • Follow-up in celiac disease is important to treat disease-related symptoms, improve dietary compliance, and prevent possible complications. • There is a lack of consensus about the appropriate follow-up. What is New: • Almost all European physicians assess anthropometry, tissue-transglutaminase IgA-antibodies, and dietary adherence at every visit, but there are large variations in other follow-up aspects. • Follow-up could be improved by a more rational use of (laboratory) tests, increased intention to dietary compliance, and quality of life together with transition programs to adult care.
Journal of Pediatric Gastroenterology and Nutrition, Dec 9, 2020
Objectives: During the past decades, there has been a shift in the clinical presentation of coeli... more Objectives: During the past decades, there has been a shift in the clinical presentation of coeliac disease (CD) to nonclassical, oligosymptomatic, and asymptomatic forms. We assessed clinical presentation of CD in children and adolescents in Central Europe. Methods: Paediatric gastroenterologists in 5 countries retrospectively reported data of their patients diagnosed with CD. Clinical presentation was analyzed and the differences among very young (<3 years) and older children and adolescents were studied. Results: Data from 653 children and adolescents (median age 7 years 2 months; 63.9% girls) from Croatia, Germany, Hungary, Italy, and Slovenia were available for the analysis. One fifth (N ¼ 134) of all children were asymptomatic. In symptomatic children, the most common leading symptom was abdominal pain (33.3%), followed by growth retardation (13.7%) and diarrhoea (13.3%). The majority of symptomatic children (47.6%; N ¼ 247) were polysymptomatic. Abdominal pain was the most common symptom in polysymptomatic (66.4%) as well as in monosymptomatic children (29.7%). Comparing clinical presentation of CD in very young children (younger than 3 years) with older children (3 years or older), we found that symptoms and signs of malabsorption were significantly more common in younger (P < 0.001), whereas abdominal pain and asymptomatic presentation were more common in older children and adolescents (both P < 0.001). Conclusion: In children with CD, abdominal pain has become the most common symptom. However, in younger children, symptoms of malabsorption are still seen frequently. This raises a question about the underlying mechanism of observed change in clinical presentation in favour of nonclassical presentation and asymptomatic disease at certain age.
Journal of Pediatric Gastroenterology & Nutrition
Journal of Pediatric Gastroenterology & Nutrition
Journal of Pediatric Gastroenterology & Nutrition
Journal of Pediatric Gastroenterology & Nutrition
Acta Medico-Biotechnica
Purpose: Purpose: Anemia is the most common systemic complication of inflammatory bowel disease (... more Purpose: Purpose: Anemia is the most common systemic complication of inflammatory bowel disease (IBD). Depending on the diagnostic criteria and patient sub-population, the prevalence of anemia can be as high as 73.7%. Data suggest that the prevalence of anemia is often higher in the pediatric population than adults. The presence of anemia can have a significant impact on the quality of life (QOL) in patients with IBD, which can be as poor as exists in patients with advanced cancer; however, the QOL improves with restoration of the hemoglobin concentration. Because the anemia in patients with IBD is often unrecognized and/or undertreated, this potentially reversible condition is an area of great concern. Methods: We retrospectively collected data for 44 pediatric patients (age range, 10–18 years; mean age, 14.3 years; 25 boys and 19 girls) at the time of diagnosis and after 1 year of IBD treatment and compared the IBD patients to 36 healthy children and adolescents (age range, 10–18 ...
Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature
Journal of Pediatric Gastroenterology and Nutrition, 2004
Journal of Pediatric Gastroenterology & Nutrition
People interested in the research are advised to contact the author for the final version of the ... more People interested in the research are advised to contact the author for the final version of the publication, or visit the DOI to the publisher's website. • The final author version and the galley proof are versions of the publication after peer review. • The final published version features the final layout of the paper including the volume, issue and page numbers. Link to publication General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights. • Users may download and print one copy of any publication from the public portal for the purpose of private study or research. • You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal. If the publication is distributed under the terms of Article 25fa of the Dutch Copyright Act, indicated by the "Taverne" license above, please follow below link for the End User Agreement:
Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature
Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature
Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature
European Journal of Pediatrics, 2021
Adequate follow-up in celiac disease is important to improve dietary compliance and treat disease... more Adequate follow-up in celiac disease is important to improve dietary compliance and treat disease-related symptoms and possible complications. However, data on the follow-up of celiac children is scarce. We aimed to assess current pediatric celiac follow-up practices across Europe. Pediatricians and pediatric gastroenterologists from 35 countries in Europe, Israel, Turkey, and Russia completed an anonymous survey which comprised a 52-item questionnaire developed by the ESPGHAN Special Interest Group on Celiac Disease. A total of 911 physicians, the majority of whom exclusively worked in pediatric care (83%) and academic institutions (60%), completed the questionnaire. Mean age and mean experience with celiac care were 48.7 years (± 10.6) and 15.7 years ( ± 9.9), respectively. The vast majority (≥ 92%) always assessed anthropometry, dietary adherence, and tissue-transglutaminase IgA-antibodies at every visit, with the first visit being between 3 and 6 months after diagnosis. Other parameters (% always tested) were as follows: complete blood count (60%), iron status (48%), liver enzymes (42%), thyroid function (38%), and vitamin D (26%). Quality of life was never assessed by 35% of the responding physicians. Transition to adult care was mostly completed via a written transition report (37%) or no formal transition at all (27%). Conclusions : Follow-up of celiac children and adolescents in Europe may be improved, especially regarding a more rational use of (laboratory) tests, dietary and QoL assessment, and transition to adult care. Evidence-based advice from international scientific societies is needed. What is Known: • Follow-up in celiac disease is important to treat disease-related symptoms, improve dietary compliance, and prevent possible complications. • There is a lack of consensus about the appropriate follow-up. What is New: • Almost all European physicians assess anthropometry, tissue-transglutaminase IgA-antibodies, and dietary adherence at every visit, but there are large variations in other follow-up aspects. • Follow-up could be improved by a more rational use of (laboratory) tests, increased intention to dietary compliance, and quality of life together with transition programs to adult care.
Journal of Pediatric Gastroenterology & Nutrition, 2022
OBJECTIVES To systematically review the current evidence on Helicobacter pylori-negative chronic ... more OBJECTIVES To systematically review the current evidence on Helicobacter pylori-negative chronic gastritis including natural history, available therapies and outcomes. METHODS Articles providing data on the prevalence, treatment or outcomes of Helicobacter pylori-negative gastritis were identified through a systematic search in the MEDLINE and EMBASE databases. All original research articles from human studies until October 31st, 2021, were included. RESULTS A total of 54 studies were included consisted of eosinophilic gastritis (n = 9), autoimmune gastritis (n = 11), collagenous gastritis (n = 16), focally enhanced gastritis (n = 6), lymphocytic gastritis (n = 5) and other causes including idiopathic gastritis and chronic renal failure related (n = 7). Most of the included studies were either cross-sectional or longitudinal cohorts except for collagenous gastritis which mainly included case-reports and case-series. The prevalence of paediatric eosinophilic gastritis ranges between 5-7/100,000 and patients have generally favourable outcome with 50% to 70% clinical and histological response to either corticosteroids or elimination diets. Autoimmune gastritis and collagenous gastritis are extremely rare entities, commonly present with refractory iron deficiency anaemia, while lymphocytic gastritis is relatively common (10%-45%) in children with coeliac disease. Data on treatments and outcomes of autoimmune, collagenous and focally enhanced gastritis are lacking with limited data implying poor response to therapy in the former two diagnoses. CONCLUSIONS Helicobacter pylori-negative gastritis is uncommonly reported, mainly in small cohorts, mixed adult-paediatric cohorts or as sporadic case reports. As common symptoms are not specific, thus not always result in an endoscopic evaluation, the true prevalence of these distinct disorders may be underestimated and thus under reported.
Objective E-learning is a candidate tool for clinical practice guidelines (CPG) implementation du... more Objective E-learning is a candidate tool for clinical practice guidelines (CPG) implementation due to its versatility, universal access and low costs. We aimed to assess the impact of a five-mod-ule e-learning course about CPG for acute gastroenteritis (AGE) on physicians ’ knowledge and clinical practice. Study design This work was conceived as a pre/post single-arm intervention study. Physicians from 11 European countries registered for the online course. Personal data, pre- and post-course questionnaires and clinical data about 3 to 5 children with AGEmanaged by each physician before and after the course were collected. Primary outcomemeasures included the propor-tion of participants fully adherent to CPG and number of patients managed with full adherence.
Zdravniski Vestnik-slovenian Medical Journal, 2006
Izhodisca: Celiakija je imunsko pogojena bolezen tankega crevesa, ki nastane kot posledica uživan... more Izhodisca: Celiakija je imunsko pogojena bolezen tankega crevesa, ki nastane kot posledica uživanja glutena pri genetsko predisponiranih osebah. Bolezen prizadene okoli 1 % prebivalstva in ni le bolezen otroske dobe, saj v razlicnih klinicnih oblikah prizadene ljudi vseh starosti. Diagnostika bolezni temelji na merilih, ki jih je sprejelo in nato revidiralo Evropsko združenje za pediatricno gastroenterologijo, hepatologijo in prehrano (ESPGHAN). Kot zlati standard predvidevajo dokaz reverzibilne okvare sluznice tankega crevesa. Revidirana merila predvidevajo manjse stevilo biopsij za postavitev dokoncne diagnoze, kar je predvsem posledica uporabe seroloskih testov. V diagnostiki celiakije igrajo pomembno vlogo tudi genetske preiskave, predvsem dolocanje prisotnosti zapisa za HLA-DQ2 in HLA-DQ8. Najnovejsi testi, ki omogocajo dolocanje prisotnosti protiteles proti tkivni transglutaminazi v kapilarni krvi ob obisku bolnika v ambulanti, bodo verjetno zelo olajsali diagnostiko bolezni. ...
Slovenian Medical Journal, 2006
Background: Celiac disease, also known as genetic gluten intolerance is a chronic disease that af... more Background: Celiac disease, also known as genetic gluten intolerance is a chronic disease that affects genetically predisposed individuals after the gluten ingestion. It affects about 1 % of population regardless of the age, and can manifest with diverse clinical picture. Diagnosis of celiac disease is based on criteria adopted and later revised by European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN). These criteria consider intestinal biopsy as a gold standard. The number of biopsies has decreased after the introduction of serological tests, which are considered in revised criteria. Genetic tests have also proven to be very valuable in diagnostic procedure, especially HLA-DQ2 and HLA-DQ8 determination. Bedside or point-of-care tests, which enable quick determination of anti tissue transglutaminase antibodies in capillary blood, are a promising new tool. Many reports have shown that adverse immunological response to gluten in genetically predisposed i...
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Papers by Jernej Dolinsek