ObjectiveEmergency interim guidance from the British Society for Gastroenterology (BSG) states that a no-biopsy strategy is possible to diagnose coeliac disease (CD) in adults with elevated transglutaminase IgA antibody (TGA-IgA) levels. We aimed to determine if the suggested TGA-IgA ≥10× ULN is safe and robust in making the diagnosis in adult patients in Scotland. We also aimed to establish if any important co-diagnoses would be missed if no biopsy was performed.MethodAll positive coeliac serology results for patients aged >15 years in Scotland in 2016 (Grampian 2019) were accessed. Data were collected on demographics, TGA-IgA titres, D1 sampling, histology and macroscopic findings at upper and lower gastrointestinal (GI) endoscopy.Results1037/1429 patients with positive serology proceeded to biopsy, of which 796/1037 (76.8%) were diagnosed as CD. A total of 320/322 (99.37%) patients with TGA-IgA ≥10× ULN were diagnosed as CD giving the cut-off a positive predictive value of 99.38%. No significant co-pathology was found at endoscopy in these patients.ConclusionOur results show that a no-biopsy strategy using a cut-off of TGA-IgA ≥10× ULN is safe to diagnose CD and that no important pathology would be missed. The European Society for Paediatric Gastroenterology, Hepatology and Nutrition 2020 and BSG COVID-19 interim guidelines are applicable to adult patients in Scotland.
This article gives a brief overview of Flipgrid and Seesaw, two free platforms that allow for video responses to prompts provided by the teacher. Flipgrid allows students to see other students’ submissions and allows students to provide feedback to their classmates. Seesaw defaults to private submission of assigned activities in a variety of formats. Potential assessment implications are also discussed.
Educators are consistently asked to show their students’ literacy levels; however, the traditional definition of literacy is typically limited to a strict interpretation of reading and writing using text rather than notation. Disciplinary literacy expands the definition of literacy, allowing music educators to teach disciplinary-specific symbology. This article describes how the Kodály concept helps students process sound into symbol, which provides students with specific literacy strategies to convert sound into developmentally appropriate visual representations.
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