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Testing for secretory IgA antibodies against gliadin and human tissue transglutaminase in stools is not a satisfactory way of screening for coeliac disease. In Munich (BMJ 2006; 332: 213-4) 20 children with proved coeliac disease and 64 controls were tested. A test for faecal antibodies against human tissue transglutaminase proved 10% sensitive and 98% specific. Testing for antibodies against gliadin was 6% sensitive and 97% specific. The sensitivity could be increased to 82% by adjusting cut-off limits and using the results of both tests but specificity then fell to 58%.
A systematic review of the effects of antiviral drugs in the prophylaxis and treatment of influenza in adults (Lancet 2006; 367: 303-13) has led to the conclusion that the M2 ion channel blockers (amantadine and rimantadine) should not be used. The neuraminidase inhibitors (oral oseltamivir and inhaled zanamivir) should be used only in a serious epidemic or a pandemic and alongside public health measures. There is no good evidence about the effects of neuraminidase inhibitors on avian influenza and the authors of this review discourage excessive reliance on the effectiveness of drugs in a pandemic.
Counting eosinophils in oesophageal biopsies from children with severe gastro-oesophageal reflux disease (GERD) does not help to identify those with cows’ milk hypersensitivity. In Odense, Denmark (J Clin Pathol 2006; 59: 89-94) cows’ milk hypersensitivity was identified by cows’ milk withdrawal and challenge in 10 of 17 children (median age 7.8 years, range 2 months to 14 years 10 …