Acta Paediatr 2018 Jun 16. Epub 2018 Jun 16.

Department of Neonatology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.

Aim: Cerebral hypoxia has been associated with neurodevelopmental impairment. We studied whether reducing cerebral hypoxia in extremely preterm infants during the first 72 hours of life affected neurological outcomes at two years of corrected age.

Methods: In 2012-2013 the phase II randomised Safeguarding the Brains of our Smallest Children trial compared visible cerebral near infrared spectroscopy (NIRS) monitoring in an intervention group and blinded NIRS monitoring in a control group. Read More

Acta Paediatr 2018 Jul;107(7):1110-1111

Acta Paediatrica, Stockholm, Sweden.

Acta Paediatr 2018 Jun 14. Epub 2018 Jun 14.

Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Acta Paediatr 2018 Jun 14. Epub 2018 Jun 14.

Edith Wolfson Medical Center, Department of Paediatrics, Holon, Israel.

Epstein Barr virus (EBV) infections include a wide spectrum of clinical manifestations, ranging from asymptomatic to multiple organ involvement (1). Several complications have been described and renal involvement is usually nephritic and not nephrotic. Nephritic includes haematuria, proteinuria, renal impairment and salt retention causing hypertension and oedema, while nephrotic is defined as heavy proteinuria, with a protein/creatinine ratio of >200 mg/mmol, hypoalbuminemia of <25 g/L and oedema (2-4). Read More

Acta Paediatr 2018 Jun 14. Epub 2018 Jun 14.

Department of Health Sciences, University of Leicester, Leicester, UK.

Acta Paediatr 2018 Jun 13. Epub 2018 Jun 13.

Dept of Clin Neurophysiology, Inst of Clin and Experimental Medicine, Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden.

Continuous monitoring of electroencephalography (EEG), with a focus on amplitude-integrated EEG (aEEG), has been used in neonatal intensive care for decades. A number of systems have been suggested for describing and quantifying aEEG patterns. Extensive full-montage EEG monitoring is used in specialised intensive care units. Read More

Acta Paediatr 2018 Jun 13. Epub 2018 Jun 13.

Centre for Health and Sport Sciences, School of Education University of Iceland, Reykjavik.

Aim: The associations between body fat levels and physical activity with academic performance are inconclusive and were explored using longitudinal data.

Methods: We enrolled 134/242 adolescents aged 15, who were studied at the age of nine and agreed to be followed up from April to May 2015 for the Health behaviours of Icelandic youth study. Accelerometers measured physical activity, body mass indexes were calculated and dual-energy X-ray absorptiometry scans assessed the participants' body composition at nine and 15. Read More

Acta Paediatr 2018 Jun 11. Epub 2018 Jun 11.

Department of Pediatrics, Institute of Clinical Sciences, University of Umeå, Umeå, Sweden.

Aim: More infants born extremely preterm (EPT) are surviving, but major neonatal morbidities are consistently high. This study examined the impact of bronchopulmonary dysplasia (BPD), brain injuries and severe retinopathy of prematurity (ROP) on adolescents who were born EPT.

Methods: We focused on EPT infants born at 23-25 weeks at the Swedish university hospitals in Uppsala and Umeå from January 1992 to December 1998. Read More

Acta Paediatr 2018 Jun 11. Epub 2018 Jun 11.

Medical Imaging, Hadassah-Hebrew University Medical Center, Jerusalem, 91120.

Aim: We surveyed whether clinicians used the WhatsApp messaging application to view neonatal chest radiographs and asked a sub-sample to compare them with computer screen viewings.

Methods: The study was conducted at three university-affiliated medical centres in Israel from June-December 2016. Questionnaires on using smartphones for professional purposes were completed by 68/71 paediatric residents and 20/28 neonatologists. Read More

Acta Paediatr 2018 Jun 11. Epub 2018 Jun 11.

Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.

Aim: In infants with acute bronchiolitis, the precision of parental disease severity assessment is unclear. We aimed to determine if parental assessment at the time of hospitalisation predicted the use of supportive care, and subsequently determine the likelihood that the infant with acute bronchiolitis would receive supportive care.

Methods: From the Bronchiolitis ALL south-east Norway study, we included all 267, 0-12 month old, infants with acute bronchiolitis whose parents at the time of hospitalisation completed a 3-item visual analogue scale (VAS) concerning Activity, Feeding and Illness. Read More

Acta Paediatr 2018 Jun 11. Epub 2018 Jun 11.

Department of Community Medicine and Rehabilitation, Forensic Medicine, Umeå, Sweden.

Since its publication in 2016, the report by the Swedish Agency for Health Technology Assessment and Assessment of Social Services on the diagnostic accuracy of the triad for determining traumatic shaking (1) has been criticised, mainly by paediatricians. One repeated criticism has been that the report focused on the triad of symptoms, namely subdural haematoma, retinal haemorrhages and encephalopathy, in cases without signs of impact. This focus has been described by some critics as one that has been created by lawyers to use in court cases and the triad itself has been dismissed as irrelevant and of no practical or clinical use (2-3) This article is protected by copyright. Read More

Acta Paediatr 2018 Jun 9. Epub 2018 Jun 9.

Department of Paediatrics, University of Toronto, Toronto, ON, Canada.

Central venous lines (CVLs) are a crucial component of life-sustaining therapy in the neonatal intensive care unit (NICU), providing necessary medication, hydration, and parental nutrition. However, CVLs are not without complications, which commonly include infections, infiltration and thrombosis (1). Effusions are among the rarer, but more dramatic and potentially lethal complications of CVLs. Read More

Acta Paediatr 2018 Jun 9. Epub 2018 Jun 9.

Pediatric Gastroenterology Unit, Soroka University Medical Centre and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Aim: This study investigated the seasonality of birth in children diagnosed with coeliac disease (CD) at a tertiary University hospital in Southern Israel.

Methods: This was a population-based retrospective time series analysis study from January 1988 to December 2014. There were 308,903 live births at Soroka University Medical Centre during the study period and 699 were diagnosed with CD. Read More

Acta Paediatr 2018 Jun 8. Epub 2018 Jun 8.

Professor of Pediatrics & Associate Division Chief of Neonatology, Academics, Divisions of Neonatology, Pediatric Gastroenterology and Nutrition, The Neonatal and Infant Feeding Disorders Program, Innovative Feeding Disorders Research Program, Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.

Acta Paediatr 2018 Jun 6. Epub 2018 Jun 6.

Department of General Pediatrics, Div. Neonatology/Intensive Care Medicine, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.

Performing a frenotomy on tongue-tied infants is controversial, particularly with regard to breastfeeding issues. This paper reviews the literature to bring together clinical experiences and scientific evidence in this field. I found that some tongue-tied babies may exhibit breastfeeding problems, while others may feed perfectly. Read More

Acta Paediatr 2018 Jun 6. Epub 2018 Jun 6.

University of Colorado, Aurora, CO.

This study was a prospective, randomized trial comparing paracetamol to indomethacin and ibuprofen for closing a hemodynamically significant patent ductus arteriosus (hs-PDA) in premature neonates (<28 weeks GA or <1500 grams). Currently available treatments to close the PDA include indomethacin and ibuprofen, but these treatments have been associated with transient reduction in kidney function (1,2), and they are contraindicated in patients with active bleeding or renal dysfunction. Surgical ligation of the PDA has been associated with worse neurodevelopmental outcomes and BPD (3), although there may be no difference in outcomes after correcting for perinatal confounders (4). Read More

Acta Paediatr 2018 Jun 6. Epub 2018 Jun 6.

School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.

Aim: This study aimed to determine whether neonatal intensive care therapies increase the risk of carcinogenesis in childhood.

Methods: This study used population-based data on 1,072,957 infants born in New South Wales, Australia, between 2000-2011 and multivariate logistic regression to examine any associations between therapies used in the neonatal intensive care unit and diagnoses of cancer until mid-2012.

Results: A total of 1,126 of 1,072,957 (0. Read More

Acta Paediatr 2018 Jun 5. Epub 2018 Jun 5.

Division of Computer Engineering, Netaji Subhas Institute of Technology, New Delhi, India.

Children prefer touch screen devices like tablets and smartphone to other media (1) and some use them on a daily basis (2). The interactive nature of smartphones can facilitate informal learning (3) and foster creativity in young children (4), but apps are only useful if they are appropriate. This study estimated the effectiveness of 10 apps that we designed to entertain and educate children aged 2-6 years (Table S1). Read More

Acta Paediatr 2018 Jun 4. Epub 2018 Jun 4.

Karolinska Institutet, Dept of Women's and Children's Health, Child and Adolescent Psychiatric Unit, Astrid Lindgren Children's Hospital, SE-171 76, Stockholm, Sweden.

Aim: Studies of children's early ability to communicate have mainly focused on mother-child dyads. That is why this study analysed the long-term effects of triadic interactions involving both parents.

Method: This prospective pilot-study monitored child-mother-father communication in 19 families from the general population in Sweden using the standardised Lausanne Triologue Play method in a video studio. Read More

Acta Paediatr 2018 Jun 5. Epub 2018 Jun 5.

University of Bristol, Bristol.

Aim: To examine the Sudden Unexpected Death in Infancy (SUDI) disparity between Māori and non-Māori in New Zealand.

Methods: A nationwide prospective case-control study ran from March 2012-February 2015. Exposure to established SUDI risk factors was analysed to investigate the disparity experienced by Māori. Read More

Acta Paediatr 2018 Jun 5. Epub 2018 Jun 5.

Westmead Hospital, Sydney, Australia.

Aim: Cardiorespiratory physiology plays an important role in neonatal care with increasing utility of point of care ultrasound. This review is to bring to light the importance of systemic to pulmonary collaterals (SPCs) in the preterm population without congenital heart disease (CHD) and provide a useful diagnostic tool to the neonatologist performing a cardiac ultrasound.

Methods: Medline, PubMed, EMBASE, and the internet were searched up to November 2017 for papers in English which included SPCs in preterm infants without CHD. Read More

Acta Paediatr 2018 Jun 4. Epub 2018 Jun 4.

Childhood Cancer Research Unit Dept. of Women and Children's Health, Karolinska Institutet, Stockholm.

Aim: This study examined the clinical characteristics of central line associated blood stream infections occurring within 30 days after insertion versus later infections in paediatric cancer patients, and the subsequent risk for premature catheter removal.

Methods: This was a retrospective study of children aged 0-18 years who were diagnosed with cancer from 2013-2014 at the Astrid Lindgren Children Hospital, Sweden. Clinical and microbiology data for each patient was collected for 365 days after the central venous catheter was inserted. Read More

Acta Paediatr 2018 Jun 4. Epub 2018 Jun 4.

Department of Pediatrics, National Hospital Organization, Saga Hospital, Japan.

Aim: The effect that intrauterine or extrauterine growth restriction (EUGR) had on the build of very low birth weight (VLBW) infants was investigated before Japanese children started school.

Method: Between 2005 and 2017 the National Hospital Organization, Saga, Japan, carried out pre-school checks on 322 children born with a VLBW at approximately six years of age. Growth restriction was defined as being born small for gestational age (SGA) or EUGR if they were born at term. Read More

Acta Paediatr 2018 Jun 4. Epub 2018 Jun 4.

Sachs' Children and Youth Hospital, South General Hospital, Stockholm, Sweden.

Aim: We investigated socioeconomic and geographic determinants of hospital care for viral gastroenteritis in young children.

Method: This is a register based study in a national birth cohort of 752,078 children 0-5 years of age in Sweden during 2006-2012. Hazard ratios (HR) of time to first admission and first episode of outpatient emergency department (ED) care with a diagnosis of viral gastroenteritis were estimated with Cox regression. Read More

Acta Paediatr 2018 May 30. Epub 2018 May 30.

Department of Medicine, The Icahn School of Medicine at Mount Sinai, New York, New York.

Aim: We determined the relationship between circulating advanced glycation end products (AGEs), AGE receptors and homeostatic model assessment for insulin resistance (HOMA-IR) in metabolically healthy obese and normal weight adolescents.

Methods: In 2015 we recruited 80 normal weight adolescents and 80 with obesity from schools Leon city, Mexico, and put them into metabolically healthy (HOMA-IR <3.0) and unhealthy (HOMA-IR >3. Read More

Acta Paediatr 2018 May 30. Epub 2018 May 30.

Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy.

In her famous paper Gastric suction in healthy newborn infants - effects on circulation and developing feeding behavior, which was published in Acta Paediatrica Scandinavica in 1987, the Swedish midwife Ann-Marie Widström wrote that healthy newborn infants were able to find the maternal mammary gland by themselves and start nutritive sucking (1). The sequence was illustrated by amazing pictures and Widström et al described how the newborn infants exhibited several behavioural phases during "the first magical golden hour" before the mouth opened over the nipple and breastfeeding began. This paper brought the nutritional climb of a newborn infant towards the nipple to the attention of the scientific world for the first time. Read More

Acta Paediatr 2018 May 28. Epub 2018 May 28.

Small Baby ICU, Nationwide Children's Hospital, Columbus, OH, USA.

Aim: To determine whether a decrease in patent ductus arteriosus (PDA) treatment or ligation in extremely preterm (EP) infants was associated with changes in rates of mortality and/or morbidities.

Methods: Observational study on EP infants admitted from 2008 to 2015. The small baby guidelines do not mandate ligation, however, in late 2010 the guidelines were amended based on new literature suggested that ligation may increase rates of morbidities. Read More

Acta Paediatr 2018 May 26. Epub 2018 May 26.

Consultant Paediatric Nephrologist, Great North Children's Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE1 4LP.

The UK training programme typically takes 8 years full time equivalent to become a paediatric consultant but can be shortened to as little as five years if deemed competent. At minimum trainees complete two six months posts in neonatology, one at level 1 Specialty training (ST 1-3) and another at level 2 training (ST 4-5) during their paediatric training programme. According to the Royal College of Paediatrics and Child Health curriculum (1), by end of ST 5 training year the competent paediatric registrar will 'be able to provide and lead basic and advanced neonatal resuscitation' and 'be able to intubate sick newborn infants without direct supervision. Read More

Acta Paediatr 2018 May 26. Epub 2018 May 26.

Faculty of Medicine, Division of Health Administration and Promotion, Department of Social Medicine, Tottori University, Yonago, Japan.

Aim: This study sought to determine the incidence of annular ligament displacement (ALD), also known as nursemaid's elbow, in the first 3 years of life.

Methods: A questionnaire was sent to 1098 families between August 2014 and July 2015 before their child attended a routine health check at 3 years of age in Izumo, Shimane prefecture, Japan. The questionnaire included a brief description about ALD, the age when ALD occurred and how the condition was managed. Read More

Acta Paediatr 2018 May 26. Epub 2018 May 26.

Centre for Child Health Research, Tampere University and University Hospital, Tampere, Finland.

Aim: Using a high-flow nasal cannula (HFNC) for infant bronchiolitis is increasingly common, but insufficiently studied. In this retrospective study, we examined the outcomes of HFNC and compared infants who did and did not respond to this oxygen delivery method.

Methods: This 2012-2015 study of six Finnish hospitals focused on 88 infants under 12 months who received HFNC: 53 on paediatric wards and 35 in paediatric intensive care units (PICUs). Read More

Acta Paediatr 2018 May 25. Epub 2018 May 25.

Ersta Sköndal Bräcke University College, Stockholm, Sweden.

Acta Paediatr 2018 May 25. Epub 2018 May 25.

Murdoch Children's Research Institute, Parkville, VIC, Australia.

Acta Paediatr 2018 May 24. Epub 2018 May 24.

Center for Rare Diseases, Clinic for Paediatric and Adolescent Medicine, HELIOS Dr. Horst Schmidt Kliniken Wiesbaden, Ludwig-Erhard-Str. 100, 65199, Wiesbaden, Germany.

Aim: The aim of this study was to develop an algorithm to prompt early clinical suspicion of mucopolysaccharidosis type I (MPS I).

Methods: An international working group was established in 2016 that comprised 11 experts in paediatrics, rare diseases and inherited metabolic diseases. They reviewed real-world clinical cases, selected key signs or symptoms based on their prevalence and specificity and reached consensus about the algorithm. Read More

Acta Paediatr 2018 May 24. Epub 2018 May 24.

Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv.

Aim: This study assessed the validity of using established Japanese risk scoring methods to predict intravenous immunoglobulin (IVIG) resistance to Kawasaki disease in Israeli children.

Methods: We reviewed the medical records of 282 patients (70% male) with Kawasaki disease from six Israeli medical centres between 2004-2013. Their mean age was 2. Read More

Acta Paediatr 2018 May 24. Epub 2018 May 24.

Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.

Acta Paediatr 2018 May 24. Epub 2018 May 24.

Department of Physiology and Pharmacology (FYFA), C3, Karolinska Institutet, Stockholm, Sweden.

Aim: This mini review explored the prevalence of white-coat hypertension (WCH), which is very common in children. It results in elevated office blood pressure (BP) but normal ambulatory BP monitoring (ABPM) readings.

Methods: WCH can only be identified by analysing and comparing office BP readings and ABPM, which periodically records BP every 20-30 minutes over 24-hour period. Read More

Acta Paediatr 2018 May 23. Epub 2018 May 23.

Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.

Acta Paediatr 2018 May 23. Epub 2018 May 23.

Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

Aim: This study investigated whether a high birth weight was associated with increased risk factors for cardiovascular disease when Swedish adults reached 34-40.

Methods: We studied 27 subjects born at Uppsala University Hospital in 1975-1979, weighing at least 4500 g, and compared them with 27 controls selected by the Swedish National Board of Welfare with birth weights within ±1 standard deviations scores and similar ages and gender. The study included body mass index (BMI), blood pressure, lipid profile, haemoglobin A1c (HbA1c), C-reactive protein (CRP) and high-frequency ultrasound measurements of intima-media thickness, intima thickness (IT) and intima:media ratio of the carotid and radial arteries. Read More

Acta Paediatr 2018 May 22. Epub 2018 May 22.

Department of Pediatrics, Division of Nephrology, Duke University Medical Center, Durham, NC, USA.

Aim: This study explored any variations in managing childhood nephrotic syndrome between specialist centres in Nigeria and how closely the care reflected the best available evidence.

Methods: In 2016, the heads of Nigerian paediatric nephrology units were asked to complete a study questionnaire that focused on managing nephrotic syndrome.

Results: Of the 31 clinicians we approached, 81% returned the completed questionnaire. Read More

Acta Paediatr 2018 May 22. Epub 2018 May 22.

Princess Amalia Children's Centre, Department of Neonatology, Isala Women and Children's Hospital Zwolle, The Netherlands.

Aim: We explored whether placental histology could help to diagnose early-onset neonatal sepsis (EONS), guide clinical decision-making 48 hours after birth and reduce antibiotic use.

Methods: This study comprised 109 infants born at less than 32 weeks of gestation, who were admitted to the neonatal intensive care unit of Isala, Zwolle, The Netherlands, between January 2013 and December 2013. EONS was defined as clinical symptoms plus raised serial C-reactive protein >10 mg/L and a positive (proven EONS) or a negative (suspected EONS) blood culture. Read More

Acta Paediatr 2018 May 21. Epub 2018 May 21.

Pediatric Gastroenterology Unit, Department of Pediatrics, Skåne University Hospital, SUS, Malmö, Sweden.

Aim: This study compared follow-up protocols for paediatric celiac disease led by either paediatricians or dieticians at Swedish university hospitals.

Methods: We followed 363 celiac disease patients under 18 years at the university hospitals in Malmö (n=140) and Lund (n=79) between 2011-2013 and after they merged to become Skåne (n=144) between 2014-2016. Both Lund and Malmö provided regular paediatrician follow-up visits, while Skåne provided mainly dietitian-led visits. Read More

Acta Paediatr 2018 May 21. Epub 2018 May 21.

Center for Child Health Research, Tampere University and University Hospital, Tampere, Finland.

Aim: This study evaluated children hospitalised for bronchiolitis at less than six months of age to see if they had reduced lung function in early adolescence.

Methods: We have prospectively followed 166 children hospitalised for infant bronchiolitis in 2001-2004 at Tampere University Hospital, Finland. At 10-13 years of age, flow-volume spirometry was measured in 89 cases and 108 controls without infant bronchiolitis from the local population register. Read More

Acta Paediatr 2018 May 21. Epub 2018 May 21.

Department of Paediatrics, Advanced Paediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Aim: This study compared the efficacy of administering intrapleural streptokinase to children with multi-loculated empyema within 14 days or at any time after disease onset.

Methods: We studied children under 12 years with multi-loculated empyema who were admitted to a teaching hospital in Chandigarh, India, from July 2013 to June 2017. They received antibiotics, pleural drainage and intrapleural streptokinase. Read More

Acta Paediatr 2018 Jul 21;107(7):1113-1115. Epub 2018 May 21.

Aschauhof 3, 24340 Eckernförde, Altenhof, Germany.

Acta Paediatr 2018 May 21. Epub 2018 May 21.

The Närhälsan Maternity and Child Health Care Resource Team, Gothenburg, Sweden.

Aim: This study examined medical and psychosocial risk factors in children born to women with addiction problems during pregnancy and the children's needs for extra medical and psychosocial resources.

Methods: Swedish midwives routinely screen pregnant women for drugs and alcohol and refer women with addictions to the Maternity and Child Healthcare Resource Team. We investigated the medical records of 127 children (51% girls) whose mothers were referred to the Resource Team from 2009 to 2015. Read More

Acta Paediatr 2018 May 17. Epub 2018 May 17.

Tampere Center for Child Health Research, Tampere University and University Hospital, Tampere, Finland.

Acta Paediatr 2018 May 13. Epub 2018 May 13.

Department of Paediatric Gastroenterology, University Hospitals Southampton NHS Trust, Southampton, UK.

Aim: We performed this study to examine and understand the evolving demographics and changing outcomes of intestinal failure (IF) and its implications for healthcare delivery.

Method: We conducted a retrospective analysis of outcome data of children on home parenteral nutrition (HPN), over a 15-year period.

Results: A total of 31 patients received HPN: 15 for short bowel syndrome (SBS), eight neuromuscular disease (NMD) and eight for other causes. Read More

Acta Paediatr 2018 May 13. Epub 2018 May 13.

Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.

Aim: To determine how oxygenation, ventilation efficiency and tidal volume requirements changed with the development of pulmonary interstitial emphysema (PIE) and whether in affected patients a composite gas exchange index predicted death or bronchopulmonary dysplasia (BPD).

Methods: Infants who developed PIE from 2010 to 2016 were identified. The oxygenation index (OI), ventilation efficiency index (VEI), ventilation to perfusion ratio and inspiratory tidal volume were calculated before radiological evidence of PIE (pre-PIE) and at the worst PIE radiographic appearance (PIE-worst). Read More

Acta Paediatr 2018 May 12. Epub 2018 May 12.

Department of Pediatric Surgery and Department of Diagnostic and Interventional Radiology, St. Mary's Hospital Herne, St. Elisabeth Group, Ruhr University of Bochum, Herne, Germany.

Acta Paediatr 2018 May 12. Epub 2018 May 12.

Paediatrics Gastroenterology Unit, Ha'Emek Medical Centre, Afula, Israel.

Aim: Elevated levels of anti-tissue transglutaminase (anti-tTG) antibody may spontaneously normalise in children with newly diagnosed type 1 diabetes, even if they eat gluten. The prevalence of this phenomenon and predictors of a subsequent coeliac disease (CD) diagnosis were determined.

Methods: The medical records of children diagnosed with type 1 diabetes at Ha'Emek Medical Centre, Israel, from 2007 to 2015, were retrospectively reviewed for elevated anti-tTG antibody levels. Read More