Diagnostic delay in adult coeliac disease: An Italian multicentre study.

BACKGROUND: There are few data regarding the diagnostic delay and its predisposing factors in coeliac disease (CD). AIMS: To investigate the overall, the patient-dependant, and the physician-dependant diagnostic delays in CD. METHODS: CD adult patients were retrospectively enroled at 19 Italian CD outpatient clinics (2011-2021). Overall, patient-dependant, and physician-dependant diagnostic delays were assessed. Extreme diagnostic, i.e., lying above the third quartile of our population, was also analysed. Multivariable regression models for factors affecting the delay were fitted. RESULTS: Overall, 2362 CD patients (median age at diagnosis 38 years, IQR 27-46; M:F ratio=1:3) were included. The median overall diagnostic delay was 8 months (IQR 5-14), while patient- and physician-dependant delays were 3 (IQR 2-6) and 4 (IQR 2-6) months, respectively. Previous misdiagnosis was associated with greater physician-dependant (1.076, p = 0.005) and overall (0.659, p = 0.001) diagnostic delays. Neurological symptoms (odds ratio 2.311, p = 0.005) and a previous misdiagnosis (coefficient 9.807, p = 0.000) were associated with a greater extreme physician-dependant delay. Gastrointestinal symptoms (OR 1.880, p = 0.004), neurological symptoms (OR 2.313, p = 0.042), and previous misdiagnosis (OR 4.265, p = 0.000) were associated with increased extreme overall diagnostic delay. CONCLUSION: We identified some factors that hamper CD diagnosis. A proper screening strategy for CD should be implemented.

A new approach for the quantitative evaluation of drawings in children with learning disabilities.

A new method for a quantitative and objective description of drawing and for the quantification of drawing ability in children with learning disabilities (LD) is hereby presented. Twenty-four normally developing children (N) (age 10.6 ± 0.5) and 18 children with learning disabilities (LD) (age 10.3 ± 2.4) took part to the study. The drawing tasks were chosen among those already used in clinical daily experience (Denver Developmental Screening Test). Some parameters were defined in order to quantitatively describe the features of the children's drawings, introducing new objective measurements beside the subjective standard clinical evaluation. The experimental set-up revealed to be valid for clinical application with LD children. The parameters highlighted the presence of differences in the drawing features of N and LD children. This paper suggests the applicability of this protocol to other fields of motor and cognitive valuation, as well as the possibility to study the upper limbs position and muscle activation during drawing.