Introduction The COVID-19 pandemic resulted in the need for antibody testing to determine the impact of the disease. This study quantifies the COVID-19 infection risk of healthcare workers (HCW) compared to other community essential workers (CEW) through positive COVID-19 antibody rates. Methods This prospective observational study was conducted September through December 2020 in Charleston, West Virginia. A total of 1,081 essential workers were recruited. Blood samples were tested for SARS-CoV-2 IgG antibodies and questionnaires were obtained describing symptom history, exposure, prior testing, and employment. Results COVID-19 antibodies were found in 7.8% of participants. There were no significant differences in terms of gender, living alone or with children, month of lab collection, or working on a COVID-19 unit. Risk factors included having a known exposure (p<0.001), living with someone with COVID-19 (p<0.001), being previously tested (p<0.001), and positive polymerase chain reaction tests (p<0.001). Additional risks were county of residence (p=0.02) and working in healthcare (p=0.004). Discussion Essential workers had a nearly 60% increased risk of COVID-19 compared with the public. HCW had a higher risk than other CEW with rates 1.8 times that of CEW. Living in Kanawha County was a risk factor, but the difference was driven by the HCW population with 12.1% positivity. HCW in a COVID-19 unit had similar positive rates versus non-COVID-19 units. Conclusion This study confirms that healthcare workers had a much higher risk of contracting COVID-19 near Charleston, WV. With these findings, despite the use of safety guidelines and use of personal protective equipment, healthcare workers in Kanawha County had higher positivity rates for SARS-CoV-2 IgG antibodies. Further evaluation of PPE compliance, hand hygiene habits, sharing work cultures, and roles within hospital would be of value.
{"title":"COVID-19: West Virginia Essential Workers and the Risks They Face","authors":"Rayan Ihle, MD, Syed Kashif Mahmood, MD","doi":"10.21885/wvmj.2023.08","DOIUrl":"https://doi.org/10.21885/wvmj.2023.08","url":null,"abstract":"Introduction The COVID-19 pandemic resulted in the need for antibody testing to determine the impact of the disease. This study quantifies the COVID-19 infection risk of healthcare workers (HCW) compared to other community essential workers (CEW) through positive COVID-19 antibody rates. Methods This prospective observational study was conducted September through December 2020 in Charleston, West Virginia. A total of 1,081 essential workers were recruited. Blood samples were tested for SARS-CoV-2 IgG antibodies and questionnaires were obtained describing symptom history, exposure, prior testing, and employment. Results COVID-19 antibodies were found in 7.8% of participants. There were no significant differences in terms of gender, living alone or with children, month of lab collection, or working on a COVID-19 unit. Risk factors included having a known exposure (p<0.001), living with someone with COVID-19 (p<0.001), being previously tested (p<0.001), and positive polymerase chain reaction tests (p<0.001). Additional risks were county of residence (p=0.02) and working in healthcare (p=0.004). Discussion Essential workers had a nearly 60% increased risk of COVID-19 compared with the public. HCW had a higher risk than other CEW with rates 1.8 times that of CEW. Living in Kanawha County was a risk factor, but the difference was driven by the HCW population with 12.1% positivity. HCW in a COVID-19 unit had similar positive rates versus non-COVID-19 units. Conclusion This study confirms that healthcare workers had a much higher risk of contracting COVID-19 near Charleston, WV. With these findings, despite the use of safety guidelines and use of personal protective equipment, healthcare workers in Kanawha County had higher positivity rates for SARS-CoV-2 IgG antibodies. Further evaluation of PPE compliance, hand hygiene habits, sharing work cultures, and roles within hospital would be of value.","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87024811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Santiago Lopez, BS, Cristhian Perez Torrico, BS, Connie DeLa'O, MD
Introduction With the onset of the COVID-19 pandemic, elective surgeries were decreased and associated with worsened outcomes. Trauma outcomes have been varied, and rural traumas have not been solely analyzed. This study investigated outcomes related to COVID-19 infection at a rural Level I trauma center in West Virginia (WV). Methods A retrospective analysis of trauma outcomes of patients aged 18 years and older from March 30, 2020, until December 21, 2021, presenting to a Level I trauma center in WV was conducted. Data was collected from the John Michael Moore Trauma Center trauma registry. Mortality, complications, injury characteristics, comorbidities, and demographics were examined. Results Out of 2,118 patients tested for the novel coronavirus, 61 (1.7%) were positive (COV+). There was no significant increase in mortality regarding COVID-19 infection. COV+ patients had an increased length of stay (median 5.2 vs. 3.6, p=0.015) and intubation rates (21.3% vs. 12.5%, p=0.070), but fewer days on a ventilator (median, 2 vs. 3, p=0.012). COV+ patients were more likely to be discharged to rehabilitation centers, skilled nursing facilities, or long-term acute care hospitals (44.3% vs 34.5%), and less often routine or home measures (42.6% vs. 58.7%) (p=0.015). Conclusion This single retrospective study found increased rates of length of stay and intubation rates with no increased rates of mortality or complications in COV+ trauma patients compared to non-COV+ trauma patients. Further research is needed to validate and characterize the impact of COVID-19 for the entirety of the state.
随着COVID-19大流行的发生，选择性手术减少并与预后恶化相关。创伤的结果是多种多样的，农村创伤并没有被单独分析。本研究调查了西弗吉尼亚州农村一级创伤中心与COVID-19感染相关的结果。方法回顾性分析2020年3月30日至2021年12月21日在武汉市某创伤一级中心就诊的18岁及以上患者的创伤结局。数据收集自约翰·迈克尔·摩尔创伤中心创伤登记处。检查死亡率、并发症、损伤特征、合并症和人口统计学。结果在2118例新型冠状病毒检测中，61例(1.7%)呈阳性。COVID-19感染的死亡率没有显著增加。COV+患者的住院时间(中位数5.2 vs. 3.6, p=0.015)和插管率(21.3% vs. 12.5%， p=0.070)增加，但使用呼吸机的天数减少(中位数，2 vs. 3, p=0.012)。COV+患者更有可能出院到康复中心、专业护理机构或长期急症护理医院(44.3%对34.5%)，而常规或家庭措施的频率更低(42.6%对58.7%)(p=0.015)。结论该单一回顾性研究发现，与非COV+创伤患者相比，COV+创伤患者的住院时间和插管率增加，但死亡率或并发症发生率未增加。需要进一步的研究来验证和描述COVID-19对整个国家的影响。
{"title":"The Impact of COVID-19 Infection on Concurrent Traumatic Insults: An Analysis from the West Virginia Trauma System","authors":"Santiago Lopez, BS, Cristhian Perez Torrico, BS, Connie DeLa'O, MD","doi":"10.21885/wvmj.2023.10","DOIUrl":"https://doi.org/10.21885/wvmj.2023.10","url":null,"abstract":"Introduction With the onset of the COVID-19 pandemic, elective surgeries were decreased and associated with worsened outcomes. Trauma outcomes have been varied, and rural traumas have not been solely analyzed. This study investigated outcomes related to COVID-19 infection at a rural Level I trauma center in West Virginia (WV). Methods A retrospective analysis of trauma outcomes of patients aged 18 years and older from March 30, 2020, until December 21, 2021, presenting to a Level I trauma center in WV was conducted. Data was collected from the John Michael Moore Trauma Center trauma registry. Mortality, complications, injury characteristics, comorbidities, and demographics were examined. Results Out of 2,118 patients tested for the novel coronavirus, 61 (1.7%) were positive (COV+). There was no significant increase in mortality regarding COVID-19 infection. COV+ patients had an increased length of stay (median 5.2 vs. 3.6, p=0.015) and intubation rates (21.3% vs. 12.5%, p=0.070), but fewer days on a ventilator (median, 2 vs. 3, p=0.012). COV+ patients were more likely to be discharged to rehabilitation centers, skilled nursing facilities, or long-term acute care hospitals (44.3% vs 34.5%), and less often routine or home measures (42.6% vs. 58.7%) (p=0.015). Conclusion This single retrospective study found increased rates of length of stay and intubation rates with no increased rates of mortality or complications in COV+ trauma patients compared to non-COV+ trauma patients. Further research is needed to validate and characterize the impact of COVID-19 for the entirety of the state.","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88866078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ryan Demkowicz, MD, P. R. LaSala, MD, Peter Stoilov, PhD, James Denvir, PhD, Jonathan Moddle, Peter Perrotta, MD
Introduction The COVID-19 pandemic began in West Virginia (WV) in March 2020 at the end of the seasonal increase in influenza virus infections. Diagnostic and surveillance testing for influenza continued throughout the pandemic because these viruses cause similar diseases and the effects of SARS-CoV-2 on seasonal influenza patterns were unpredictable. Methods Positivity rates for SARS-CoV-2 and influenza viruses were studied using test results obtained from samples collected across an academic health system from July 2018 through June 2022. Trends in COVID-19 variants were assessed using data obtained from national and local databases. Data were analyzed to detect differences in and correlations between SARS-CoV-2 and influenza positivity rates. Results Test positivity rates were higher for the 602,109 SARS-CoV-2 tests than the 186,563 influenza tests performed during the study period (13.7% vs. 3.5%, p<0.0001). SARS-CoV-2 test positivity rose and fell with the emergence of SARS-CoV-2 variants of differing infectivity, being highest when the omicron variant predominated. Significant negative correlations between the number of SARS-CoV-2 and influenza positive tests were seen throughout stages of the pandemic. The normally expected influenza season did not occur during winter 2020 through spring 2021, and there were essentially no influenza cases during the delta surge. A more typical pattern of seasonal influenza was observed in late 2021 to early 2022 during the omicron surge. Conclusion There was an inverse correlation between SARS-CoV-2 and influenza test positivity rates observed throughout several COVID-19 surges in WV. The reasons for these correlations are unclear.
2019冠状病毒病大流行于2020年3月流感病毒感染季节性增加结束时在西弗吉尼亚州开始。在整个大流行期间，流感诊断和监测检测一直在继续，因为这些病毒引起类似的疾病，而且SARS-CoV-2对季节性流感模式的影响是不可预测的。方法利用2018年7月至2022年6月在一个学术卫生系统采集的样本的检测结果，研究SARS-CoV-2和流感病毒的阳性率。使用从国家和地方数据库获得的数据评估了COVID-19变体的趋势。分析数据以检测SARS-CoV-2和流感阳性率之间的差异和相关性。结果研究期间602109例SARS-CoV-2检测阳性率高于186563例流感检测阳性率(13.7% vs. 3.5%， p<0.0001)。SARS-CoV-2检测阳性率随传染性不同的SARS-CoV-2变异体的出现而有升有降，以组粒变异体为主时阳性率最高。在大流行的各个阶段，SARS-CoV-2的数量与流感阳性检测之间存在显著的负相关。通常预期的流感季节在2020年冬季至2021年春季期间没有出现，在三角洲激增期间基本上没有流感病例。在2021年底至2022年初的流感爆发期间，观察到一种更典型的季节性流感模式。结论SARS-CoV-2与流感检测阳性率呈负相关。这些相关性的原因尚不清楚。
{"title":"COVID-19 Pandemic Effects on Seasonal Influenza Patterns in West Virginia","authors":"Ryan Demkowicz, MD, P. R. LaSala, MD, Peter Stoilov, PhD, James Denvir, PhD, Jonathan Moddle, Peter Perrotta, MD","doi":"10.21885/wvmj.2023.09","DOIUrl":"https://doi.org/10.21885/wvmj.2023.09","url":null,"abstract":"Introduction The COVID-19 pandemic began in West Virginia (WV) in March 2020 at the end of the seasonal increase in influenza virus infections. Diagnostic and surveillance testing for influenza continued throughout the pandemic because these viruses cause similar diseases and the effects of SARS-CoV-2 on seasonal influenza patterns were unpredictable. Methods Positivity rates for SARS-CoV-2 and influenza viruses were studied using test results obtained from samples collected across an academic health system from July 2018 through June 2022. Trends in COVID-19 variants were assessed using data obtained from national and local databases. Data were analyzed to detect differences in and correlations between SARS-CoV-2 and influenza positivity rates. Results Test positivity rates were higher for the 602,109 SARS-CoV-2 tests than the 186,563 influenza tests performed during the study period (13.7% vs. 3.5%, p<0.0001). SARS-CoV-2 test positivity rose and fell with the emergence of SARS-CoV-2 variants of differing infectivity, being highest when the omicron variant predominated. Significant negative correlations between the number of SARS-CoV-2 and influenza positive tests were seen throughout stages of the pandemic. The normally expected influenza season did not occur during winter 2020 through spring 2021, and there were essentially no influenza cases during the delta surge. A more typical pattern of seasonal influenza was observed in late 2021 to early 2022 during the omicron surge. Conclusion There was an inverse correlation between SARS-CoV-2 and influenza test positivity rates observed throughout several COVID-19 surges in WV. The reasons for these correlations are unclear.","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73850907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Histoplasmosis is a fungal infection caused by a histoplasma species known to be endemic to the Ohio River valley region. Commonly encountered as a solitary pulmonary nodule, histoplasmosis has both acute and chronic forms. We present a case of a 36-year-old woman with multiple episodes of pneumothorax who was ultimately diagnosed with pulmonary histoplasmosis, demonstrating a complication of chronic pulmonary histoplasmosis, which has not been reported in the medical literature.
{"title":"Recurrent Pneumothorax and a Solitary Pulmonary Nodule: A Case Report of a Rare Sequelae of Histoplasmosis","authors":"L. Hamrick, B. Balakrishnan","doi":"10.21885/wvmj.2022.24","DOIUrl":"https://doi.org/10.21885/wvmj.2022.24","url":null,"abstract":"Histoplasmosis is a fungal infection caused by a histoplasma species known to be endemic to the Ohio River valley region. Commonly encountered as a solitary pulmonary nodule, histoplasmosis has both acute and chronic forms. We present a case of a 36-year-old woman with multiple episodes of pneumothorax who was ultimately diagnosed with pulmonary histoplasmosis, demonstrating a complication of chronic pulmonary histoplasmosis, which has not been reported in the medical literature.","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"108 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77629866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Editor's Letter: When Race is Included in Medical Manuscripts","authors":"Linda Nield, MD","doi":"10.21885/wvmj.2022.19","DOIUrl":"https://doi.org/10.21885/wvmj.2022.19","url":null,"abstract":"","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"93 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85684876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Microcephaly After Multiple Fetal Exposures","authors":"Lesley Cottrell, PhD, Alicia Moise, MD, Carrie Moore, MD, Mark Polak, MD","doi":"10.21885/wvmj.2022.23","DOIUrl":"https://doi.org/10.21885/wvmj.2022.23","url":null,"abstract":"","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88580471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Message from the President: Engagement, Leadership, Education","authors":"Lisa Costello, MD, MPH, FAAP","doi":"10.21885/wvmj.2022.20","DOIUrl":"https://doi.org/10.21885/wvmj.2022.20","url":null,"abstract":"","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91525936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
It is well-known that West Virginia (WV) is one of the states most affected by the opioid epidemic. Recently, WV has implemented a program to expand buprenorphine use as part of a multi-prong approach to treat opioid use disorder accompanied by positive outcomes. However, buprenorphine can be diverted and obtained outside of a medical provider's guidance. Given the prevalence of buprenorphine use in WV, we aim to present original clinical data prompting clinicians to recognize buprenorphine as a potential cause of toxic leukoencephalopathy. We describe the case of a 28-year-old female who presented with catatonia believed to be secondary to buprenorphine, and we discuss the diagnostic challenges and therapeutic management of buprenorphine-induced toxic leukoencephalopathy.
{"title":"Catatonia Associated with Buprenorphine-Induced Toxic Leukoencephalopathy","authors":"Danielle DeCicco, MD, PhD, Jessica Thayer, MD, Ziad Dimachkie, MD","doi":"10.21885/wvmj.2022.22","DOIUrl":"https://doi.org/10.21885/wvmj.2022.22","url":null,"abstract":"It is well-known that West Virginia (WV) is one of the states most affected by the opioid epidemic. Recently, WV has implemented a program to expand buprenorphine use as part of a multi-prong approach to treat opioid use disorder accompanied by positive outcomes. However, buprenorphine can be diverted and obtained outside of a medical provider's guidance. Given the prevalence of buprenorphine use in WV, we aim to present original clinical data prompting clinicians to recognize buprenorphine as a potential cause of toxic leukoencephalopathy. We describe the case of a 28-year-old female who presented with catatonia believed to be secondary to buprenorphine, and we discuss the diagnostic challenges and therapeutic management of buprenorphine-induced toxic leukoencephalopathy.","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75847549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose Celiac disease (CD) is a disorder in which gluten ingestion triggers an autoimmune response causing inflammation and damage to the small intestine. With improved awareness and screening availability, prevalence and variation in clinical presentation have subsequently increased. Thus, our study identified the disease characteristics and presentation patterns of pediatric CD in southern West Virginia. Methods We retrospectively reviewed charts for pediatric patients (age <18 years) diagnosed with CD during a 10-year period at a tertiary care hospital. Results A total of 59 patients met inclusion criteria. The mean age of diagnosis was 10.0+4.6 years, with 61% of patients being female. One-third of cases were asymptomatic and diagnosed from screenings of patients with hypothyroidism or type 1 diabetes mellitus. In symptomatic patients (n=40), abdominal pain was the most common presenting symptoms (78%), followed by constipation (30%). Classical symptoms of diarrhea and failure to thrive/unexplained weight loss were less common (n=9). At diagnosis, anti-tissue transglutaminase (tTG) IgA antibodies and deamidated gliadin peptide IgG antibodies were both positive in 88% of cases, and endomysial antibodies were positive in 70% cases. One-year post-diagnosis clinic follow-up rate was 63%. A gluten-free diet improved symptoms and tTG IgA serology levels in all patients with follow-up. Conclusion Our data fills in the gap of the paucity of information available about CD in children from Appalachia. A high index of suspicion is required to screen and diagnose CD as many patients are either asymptomatic or lack classical findings. A gluten-free diet is a highly effective treatment, although follow-up after initial diagnosis remains a challenge.
{"title":"Characteristics of Pediatric Celiac Disease in Southern West Virginia","authors":"Rahiya Rehman, MD, Anam Bashir, MD, Stephanie Thompson, PhD, Pratikkumar Patel, MD, MPH, FAAP","doi":"10.21885/wvmj.2022.21","DOIUrl":"https://doi.org/10.21885/wvmj.2022.21","url":null,"abstract":"Purpose Celiac disease (CD) is a disorder in which gluten ingestion triggers an autoimmune response causing inflammation and damage to the small intestine. With improved awareness and screening availability, prevalence and variation in clinical presentation have subsequently increased. Thus, our study identified the disease characteristics and presentation patterns of pediatric CD in southern West Virginia. Methods We retrospectively reviewed charts for pediatric patients (age <18 years) diagnosed with CD during a 10-year period at a tertiary care hospital. Results A total of 59 patients met inclusion criteria. The mean age of diagnosis was 10.0+4.6 years, with 61% of patients being female. One-third of cases were asymptomatic and diagnosed from screenings of patients with hypothyroidism or type 1 diabetes mellitus. In symptomatic patients (n=40), abdominal pain was the most common presenting symptoms (78%), followed by constipation (30%). Classical symptoms of diarrhea and failure to thrive/unexplained weight loss were less common (n=9). At diagnosis, anti-tissue transglutaminase (tTG) IgA antibodies and deamidated gliadin peptide IgG antibodies were both positive in 88% of cases, and endomysial antibodies were positive in 70% cases. One-year post-diagnosis clinic follow-up rate was 63%. A gluten-free diet improved symptoms and tTG IgA serology levels in all patients with follow-up. Conclusion Our data fills in the gap of the paucity of information available about CD in children from Appalachia. A high index of suspicion is required to screen and diagnose CD as many patients are either asymptomatic or lack classical findings. A gluten-free diet is a highly effective treatment, although follow-up after initial diagnosis remains a challenge.","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85574949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Message from the President - Physician Leadership and Advocacy","authors":"Lisa M. Costello, MD, MPH, FAAP","doi":"10.21885/wvmj.2022.14","DOIUrl":"https://doi.org/10.21885/wvmj.2022.14","url":null,"abstract":"","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"153 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77505688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：