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1.
J. coloproctol. (Rio J., Impr.) ; 42(1): 20-24, Jan.-Mar. 2022. tab
Article in English | LILACS | ID: biblio-1375757

ABSTRACT

Background: Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder. Celiac disease (CD), a treatable autoimmune enteropathy, with varied presentations, may simulate clinically symptoms of IBS. The aim of the present study is to screen for CD in patients with IBS diagnosed based on the Rome III criteria. Patients and Methods: A cross-sectional study was conducted at a secondary care gastrointestinal unit in Al-Salam General Hospital in Mosul city, Iraq, from November 2015 to October 2016. All patients fulfilling the Rome III criteria for IBS were screened for CD using antitissue transglutaminase IgA antibodies (anti-tTG). Patients who tested positive were subjected to endoscopic duodenal biopsy to confirm the diagnosis of CD. Results: A total of 100 patients were included in the present study (58 female and 42 male), the mean age of the participants was 40.8 years old (standard deviation [SD]±11.57). Ten patients (10/100, 10%) tested positive for anti-tTG antibodies. Five of the seropositive patients (5/10, 50%) showed positive biopsy results according to the Marsh classification, 3 of whom having diarrhea, and 2 with constipation. Conclusion: Positive serology and biopsy results suggestive of CDare common among patients with IBS. Screening patients with IBS for CD is justified. (AU)


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Celiac Disease/diagnosis , Irritable Bowel Syndrome , Autoantibodies/analysis , Cross-Sectional Studies , Diagnosis, Differential
2.
Repert. med. cir ; 31(2): 123-132, 2022. ilus., tab.
Article in English, Spanish | LILACS, COLNAL | ID: biblio-1381091

ABSTRACT

Introducción: la enfermedad celíaca (EC) es una patología sistémica inmunomediada por el gluten en la dieta en personas genéticamente susceptibles con un amplio rango de manifestaciones clínicas, respuesta serológica específica y un daño variable de la mucosa intestinal. Objetivo: revisar la fisiopatología, manifestaciones clínicas, diagnóstico, tratamiento, seguimiento y pronóstico de la EC, resaltando la importancia de reconocerla y proponer un algoritmo diagnóstico para la población colombiana. Materiales y métodos: revisión crítica de la literatura científica en las bases de datos Medline y buscadores específicos PUBMED, SCIENCE DIRECT, SCIELO, filtrando resultados a revisiones sistemáticas, metaanálisis, ensayos controlados aleatorios y guías de práctica clínica, con un total de 1209 artículos, de los cuales se priorizaron 53. Resultados y discusión: la prevalencia de la EC viene en aumento en países en vía de desarrollo. El diagnóstico tiene tres pilares fundamentales: la identificación de casos de alto riesgo o sospecha por manifestaciones clínicas, un perfil serológico de anticuerpos específicos y hallazgos histológicos característicos. El tratamiento se basa en una dieta sin gluten, en la detección temprana de complicaciones y el manejo de las alteraciones nutricionales. Conclusión: en Colombia no existen protocolos de diagnóstico y tratamiento de la EC, como tampoco una legislación clara con respecto al etiquetado de productos libres de gluten. Hay que establecer estrategias para impactar el curso natural de la enfermedad, las morbilidades asociadas y la calidad de vida de los pacientes.


Introduction: celiac disease (CD) is a systemic diet-gluten-immune-mediated enteropathy occurring in genetically susceptible individuals featuring a broad range of clinical manifestations, a specific serological response and variable intestinal mucosal damage. Objective: to review CD pathophysiology, clinical manifestations, diagnosis, treatment, follow-up and prognosis, highlighting the importance of awareness about this disorder and development of a diagnostic algorithm for Colombian population. Materials and methods: scientific literature critical review in the Medline databases and PUBMED, SCIENCE DIRECT, SCIELO specific search engines, using filters to retrieve systematic reviews, metanalyses, randomized controlled trials and clinical practice guidelines, finding 1209 articles, prioritizing 53. Results and discussion: the prevalence of CD is increasing in developing countries. Diagnosis is based on 3 fundamental pillars: identification of higher-risk populations or suspicion based on clinical manifestations, serological profile of specific antibodies and characteristic histological findings. Treatment is based on a gluten-free diet, early detection of complications and nutritional alterations management. Conclusion: there are no CD diagnosis and treatment protocols, nor clear regulations on labelling gluten-free products, in Colombia. Establishing strategies to impact the natural course of CD, associated morbidities and quality of life, is required


Subject(s)
Celiac Disease , Algorithms , Serologic Tests , Diet , Diet, Gluten-Free , Intestinal Diseases
3.
Article in Spanish | LILACS, BDNPAR | ID: biblio-1337825

ABSTRACT

La enfermedad celíaca (EC) es una enfermedad inflamatoria autoinmune que afecta la mucosa del intestino delgado que lleva a un estado de mal absorción en pacientes genéticamente susceptibles desencadenada por la ingesta de gluten. Tiene síntomas inespecíficos, complicaciones asociadas y no existe a nivel nacional una ley de apoyo económico para las personas con dificultad para seguir una dieta libre de gluten. El objetivo de este estudio observacional, descriptivo, de corte transversal fue describir las características clínicas, demográficas y acceso a productos sin gluten de 237 pacientes con enfermedad celíaca registrados en la Fundación Paraguaya de Celiacos (FUPACEL) en el 2020 y que aceptaron responder una encuesta en línea publicada en la página oficial de la FUPACEL. El 70,4% de los participantes era del sexo femenino, la edad de diagnóstico fue en el 34,5% entre 20-30 años, 48 % tenía algún familiar con EC, el 69,1% presentó distensión abdominal como sintomatología inicial, 16,8% presentó hipotiroidismo como patología asociada, y 42% fue hospitalizado al menos una vez. El 82,7% de los encuestados respondió que la dieta era suficiente como tratamiento, 48% tenía un trabajo y podía solventar los gastos, sin embargo, el 79,3% opinó tener acceso limitado a los productos sin gluten, el 92% que los alimentos sin gluten eran costosos y que se necesitaba una ley de apoyo económico para solventar los gastos. La mayoría reconoció que la dieta sin gluten como tratamiento era suficiente, sin embargo, por su alto costo se necesita una ley de apoyo económico para las personas con enfermedad celiaca


Celiac disease (CD) is an autoimmune inflammatory disease that affects the mucosa of the small intestine that leads to a state of malabsorption in genetically susceptible patients triggered by the ingestion of gluten. It has nonspecific symptoms, associated complications, and there is no national financial support law for people with difficulty following a gluten-free diet. The objective of this observational, descriptive, cross-sectional study was to describe the clinical, demographic characteristics and access to gluten-free products of 237 patients with celiac disease registered in the FUPACEL in 2020 who accepted to answer a online survey published in the official FUPACEL webpage. Seventy-point four percent of the patients were female, their age of diagnosis was between 20-30 years in 34.5%, 48% had relatives with CD, 69.1% presented abdominal distension as initial symptoms, hypothyroidism was present in 16.8% as associated pathology, and 42% were hospitalized at least once. Eighty-two-point seven percent of those surveyed answered that diet was sufficient as a treatment, 48% had a job and could afford expenses, however, 79.3% said they had limited access to gluten-free products, 92% that gluten-free foods were expensive and a financial support law was needed to cover the costs. Most recognized that a gluten-free diet as a treatment was sufficient, however, due to its high cost, a law of financial support is needed for people with celiac disease


Subject(s)
Humans , Male , Female , Adult , Celiac Disease , Public Health , Diet, Gluten-Free , Quality of Life
4.
Arq. gastroenterol ; 58(2): 164-167, Apr.-June 2021. graf
Article in English | LILACS | ID: biblio-1285334

ABSTRACT

ABSTRACT BACKGROUND: Celiac disease (CD) is an immune-mediated systemic disorder elicited by the ingestion of gluten. The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) guidelines published in 2012 suggested a no-biopsy pathway (NBP) for symptomatic children with IgA tissue transglutaminase (TGA-IgA) ≥10x upper limit of normal (ULN). Biopsy confirmation remained mandatory for other cases. OBJECTIVE: This retrospective case note study was aimed at evaluating the adherence to the ESPGHAN 2012 guidelines for diagnosing CD in our unit. METHODS: Forty-three cases with positive TGA-IgA were identified by a laboratory database search from January 2013 to December 2019. 6 of 43 patients were not referred for a confirmation of CD diagnosis. Data was collected on the diagnostic pathways followed, and appropriateness of adherence was compared with the existing ESPGHAN guidelines. RESULTS: A total of 37 cases were included with 35 children diagnosed with CD. 29/35 (83%) were diagnosed via the NBP;15/29 (52%) children did not meet all the criteria required for NBP, but were diagnosed and managed as having CD. 20/35 (57%) children were diagnosed with CD in adherence to the 2012 guidelines. CONCLUSION: The recommended diagnostic guidelines were frequently not implemented; adherence to the guidelines may improve following regular educational sessions. The revised 2020 ESPGHAN guidelines which exclude HLA-DQ2/DQ8 testing would address the issue of diagnosis for the 10/15 NBP cases (with TGA-IgA >10xULN) in our study who did not have HLA testing and were therefore non-adherent to the 2012 diagnostic guidelines. NBP, with the reduced need for endoscopy may be beneficial in resource limited settings.


RESUMO CONTEXTO: A doença celíaca (DC) é uma doença sistêmica imuno-mediada provocada pela ingestão de glúten. As diretrizes da Sociedade Europeia de Gastroenterologia Pediátrica, Hepatologia e Nutrição (ESPGHAN) publicadas em 2012 sugeriram uma via sem biópsia (VSB) para crianças sintomáticas com transglutaminase de tecido IgA (TGA-IgA) ≥10x limite superior do normal (LSN). A confirmação da biópsia permaneceu obrigatória para outros casos. OBJETIVO: Este estudo retrospectivo de dados de caso teve como objetivo avaliar a adesão às diretrizes da ESPGHAN 2012 para o diagnóstico de DC em nossa unidade. MÉTODOS: Quarenta e três casos com TGA-IgA positivo foram identificados por uma pesquisa laboratorial de banco de dados de janeiro de 2013 a dezembro de 2019. Seis de 43 pacientes não foram encaminhados para confirmação do diagnóstico de DC. Os dados foram coletados nas vias diagnósticas seguidas, e a adequação da adesão foi comparada com as diretrizes ESPGHAN existentes. RESULTADOS: Foram incluídos 37 casos com 35 crianças diagnosticadas com DC. Foram diagnosticados 29 (83%) de 35 VSB; 15 (52%) de 29 crianças não atenderam a todos os critérios exigidos para a VSB, mas foram diagnosticadas e gerenciadas como tendo DC. Vinte (57%) em 35 foram diagnosticadas com DC em adesão às diretrizes de 2012. CONCLUSÃO: As diretrizes diagnósticas recomendadas não foram frequentemente implementadas; a adesão às diretrizes pode melhorar após sessões educativas regulares. As diretrizes revisadas ESPGHAN de 2020 que excluem os testes HLA-DQ2/DQ8 abordariam a questão do diagnóstico para 10 em 15 casos VSB (com TGA-IgA >10x LSN) em nosso estudo os quais não fizeram testes de HLA e, portanto, não aderiram às diretrizes de diagnóstico de 2012. A VSB, com a necessidade reduzida de endoscopia, pode ser benéfica em configurações limitadas de recursos.


Subject(s)
Humans , Child , Celiac Disease/diagnosis , Gastroenterology , Autoantibodies , Biopsy , Transglutaminases , Retrospective Studies , Glutens
5.
Arq. gastroenterol ; 58(2): 214-216, Apr.-June 2021. tab
Article in English | LILACS | ID: biblio-1285320

ABSTRACT

ABSTRACT BACKGROUND: Celiac disease (CD) is an autoimmune disease characterized by immune reaction mostly to wheat gluten. The diagnosis is based on clinical, serological and histological findings in patients ingesting gluten. Cases that the clinical profile indicates CD and the autoantibodies are negative bring so a dilemma for the professional, as the risk of missed the diagnosis or a delay at the same. OBJECTIVE: To show the importance of correct diagnosis of cases with seronegative celiac disease (SNCD). METHODS: Ten cases of SNCD Brazilian patients were retrospectively studied (2013 to 2019). Data of clinical complaints, autoantibodies, IgA serum levels, histological findings and HLA-DQ2/DQ-8 were compiled. Dual-X densitometry, delay at diagnosis, previous autoimmune diseases and family history of CD were also checked. RESULTS: All SNCD patients presented clinical symptoms of CD, with confirmed diagnosis by histological findings of the duodenal mucosa and HLA-DQ2 and/or HLA-DQ8 positivity. All patients had normal IgA levels and negative autoantibodies (IgA-anti-transglutaminase and anti-endomysial). Dual-X densitometry detected osteopenia in two women and osteoporosis in two males, all with low levels of vitamin D. Delay diagnostic ranged from 1 to 19 years. Familiar occurrence of CD was reported in 40% of the cases. After one year of gluten-free diet, eight patients refer improve of symptoms, while duodenal biopsies, done in five cases, showed histological improvement. CONCLUSION: Patients who demonstrate the clinical profile of celiac disease with negative serology and normal levels of IgA, especially those who have family members with celiac disease, should be submitted to duodenal biopsies to look for histological findings.


RESUMO CONTEXTO: A doença celíaca (DC) é uma doença autoimune caracterizada por reação imune principalmente ao glúten do trigo. O diagnóstico é baseado em achados clínicos, sorológicos e histológicos em pacientes que ingerem glúten. Casos em que o perfil clínico indica DC e os autoanticorpos são negativos trazem um dilema para o profissional, como o risco de não realizar ou atrasar o diagnóstico da DC. OBJETIVO: Mostrar a importância do diagnóstico correto de casos com doença celíaca soronegativa (DCSN). MÉTODOS: Dez casos de pacientes brasileiros com DCSN foram estudados retrospectivamente (2013 a 2019). Foram compilados dados de queixas clínicas, autoanticorpos, níveis séricos de IgA, achados histológicos e HLA-DQ2 / DQ-8. Densitometria, atraso no diagnóstico, doenças autoimunes prévias e histórico familiar de DC também foram verificados. RESULTADOS: Todos os pacientes com DCSN apresentaram sintomas clínicos de DC, com diagnóstico confirmado por achados histológicos da mucosa duodenal e positividade para HLA-DQ2 e/ou HLA-DQ8. Todos os pacientes apresentavam níveis normais de IgA e autoanticorpos negativos (IgA-anti-transglutaminase e anti-endomisial). A densitometria detectou osteopenia em duas mulheres e osteoporose em dois homens, todos com baixos níveis de vitamina D. O atraso no diagnóstico variou de 1 a 19 anos. A ocorrência familiar de DC foi relatada em 40% dos casos. Após 1 ano de dieta isenta em glúten, oito pacientes referem melhora dos sintomas, enquanto as biópsias duodenais, realizadas em cinco casos, mostraram melhora histológica. CONCLUSÃO: Pacientes que apresentam quadro clínico de doença celíaca com sorologia negativa e níveis normais de IgA, principalmente aqueles que possuem familiares com doença celíaca, devem ser submetidos à biópsia duodenal para pesquisa de achados histológicos.


Subject(s)
Humans , Male , Female , Celiac Disease/diagnosis , Autoantibodies , Transglutaminases , Retrospective Studies , Diet, Gluten-Free , Glutens
6.
Säo Paulo med. j ; 139(3): 201-209, May-June 2021. tab
Article in English | LILACS | ID: biblio-1252242

ABSTRACT

ABSTRACT BACKGROUND: Coronavirus disease 2019 (COVID-19) causes negative life changes brought about through lockdowns, in addition to severe complications and death. Among these changes, asplenism or hyposplenism has been reported in patients with celiac disease. It has been reported that the risk of pneumococcal sepsis is higher in celiac patients with hyposplenism. Moreover, celiac patients present high risk of admission to hospital due to influenza. OBJECTIVE: To determine the degree of awareness of COVID-19 among parents of children with celiac disease and examine the measures that they take. DESIGN AND SETTING: Cross-sectional study at a university hospital in the Middle Anatolian region of Turkey. METHODS: The diagnosis of celiac disease was confirmed through a survey conducted online among 73 parents between May and July 2020. RESULTS: The mean age was 37.57 ± 6.56 years for the mothers, 41.15 ± 5.56 years for the fathers and 11.36 ± 4.36 years for the children. 90.4% of the parents reported that COVID-19 was transmitted through "speaking, coughing, sneezing and infection of the face after contact with virus-infected surfaces". Moreover, 78.1% indicated that they did not have any difficulty in finding gluten-free foods. CONCLUSION: These parents of children with celiac disease believed that their children's risk of developing COVID-19 did not differ from that of healthy children. It was also observed that appetite and states of nervousness were higher among these children with celiac disease during lockdowns and that their sleep patterns were affected.


Subject(s)
Humans , Female , Child , Adult , Celiac Disease , Telemedicine , COVID-19 , Parents , Turkey/epidemiology , Communicable Disease Control , Cross-Sectional Studies , Surveys and Questionnaires , Pandemics , SARS-CoV-2
7.
Gac. méd. boliv ; 44(1): 15-18, jun. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1286593

ABSTRACT

Objetivos: los trastornos motores, hormonales, neuroendocrinos y el estado de inmunodepresión que presenta el paciente celíaco conlleva al desarrollo de alteraciones digestivas, por lo que el presente estudio pretende determinar si la celiaquía se asocia al desarrollo de lesiones preneoplásicas del tubo digestivo superior y comparar dichos resultados con un grupo control (no celíaco). Métodos: se realizó un estudio observacional, analítico de casos y controles, en el Instituto Gastroenterológico Boliviano Japonés, Cochabamba, Bolivia. De forma aleatoria simple se obtuvo una muestra de 297 pacientes, para el grupo caso y control. Se utilizó el programa IMB SPSS v- 20, el análisis estadístico con la prueba de Chi cuadrado (con un valor de p=<0,05; 95% IC) y el análisis epidemiológico con el cálculo el Odds ratio (OR). Resultados: se observó una asociación estadística y epidemiológica significativa para el grupo celíaco con lesiones preneoplásicas en el tubo digestivo alto (p= 0,0001) OR 7,23 (IC 95% 5,387 -9,722) en comparación al grupo control que presenta una asociación estadística (p=0,03); pero con una significancia epidemiológica negativa OR 0,708 (IC 95% 0,639-0,783). Conclusiones: existe mayor prevalencia de pacientes celíacos con lesiones preneoplásicas (metaplasia intestinal esofágica y gástrica, atrofia gástrica, displasias), frente al grupo no celíaco. Esto demuestra la importancia del diagnóstico y pesquisa temprana de esta entidad, evitando el desarrollo de lesiones que podrían considerarse irreversibles en el sistema digestivo.


Objectives: the digestive, hormonal and neuroendocrine disorders and the state of immunosuppression that the celiac patient presents, leads to the development of digestive alterations, the present study aims to determine whether celiac disease is associated with the development of preneoplastic lesions of the upper gastrointestinal tract and compares the results with a control group (non-celiac). Methods: during the period January 2016 to January 2018 at Instituto de Gastroenterología Boliviano Japones - Cochabamba, Bolivia an observational study was conducted, subtype analytical case-control, where 297 samples were obtaining of patients in a simple random way, both for the case and control group. The IMB SPSS v-20 program was used, the statistical analysis was performed using the Chi square test (with p value = <0,05; 95% IC) and the epidemiological analysis with the calculation of the Odds ratio (OR). Results: a statistically and epidemiological significant association was observed for the celiac group with preneoplastic lesions in the upper gastrointestinal tract (p = 0,001) OR 7,23(IC 95% 5,387 -9,722) compared to the control group that presents a statistical association (p = 0,03); but with a negative epidemiological significance OR 0,708 (IC 95% 0,639 -0,783). Conclusions: there is a higher prevalence of celiac patients with preneoplastic lesions (esophageal and gastric intestinal metaplasia, gastric atrophy, dysplasia), compared to the non-celiac group. This demonstrates the importance of early diagnosis and investigation of this entity, avoiding the development of lesions that could be considered irreversible in the digestive system.


Subject(s)
Celiac Disease
8.
Arch. latinoam. nutr ; 71(1): 54-60, mar. 2021. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1283254

ABSTRACT

La enfermedad por coronavirus (COVID-19) es altamente contagiosa y las medidas de confinamiento dinámico han demostrado que reducen significativamente el número de contagios, sin embargo, pueden alterar la disponibilidad de alimentos afectando la adherencia a la dieta libre de gluten (DLG) y la calidad de vida (CV) en la enfermedad celiaca (EC). El objetivo de este estudio fue evaluar los factores que limitan, la adherencia a la dieta libre de gluten y la calidad de vida en personas con enfermedad celiaca en periodo de pandemia por COVID-19. Métodos Se aplicaron encuestas on-line respecto a adherencia a la DLG, CV y acerca de los factores que han generado dificultad para llevar una DLG en este escenario. Resultados Se analizaron 216 encuestas de enfermos celiacos, mayores de 15 años, de los cuales un 91% eran mujeres con un promedio de edad de 36 + 10,7 años y con 5,8 + 6,0 años de enfermedad. El 56,48% tenía una excelente adherencia a la DLG y un 43,52% una buena CV. El costo elevado de los alimentos sin gluten fue la pregunta con mayor porcentaje de respuesta, asociándose con regular y mala adherencia a la DLG (valor p=0,001) y con pobre CV (valor p=0,023). Conclusión En periodo de pandemia por COVID-19, el costo de los alimentos se asocia con adherencia regular y mala a la DLG y con pobre CV(AU)


Coronavirus disease (COVID-19) is highly contagious and dynamic confinement measures have shown to significantly reduce the number of infections, however, they can alter the availability of food, affecting adherence to a gluten-free diet (GFD) and quality of life (QoL) in celiac disease (CD). The objective of this study was to evaluate the limiting factors, adherence to a gluten-free diet and quality of life in people with celiac disease in a COVID-19 pandemic period. Methods. On-line surveys were applied regarding adherence to the GFD, CV, and factors that have generated difficulty in carrying out a GFD in this setting. Results. 216 surveys of celiac patients over 15 years of age were analyzed, of which 91% were women with an average age of 36 + 10.7 years and with 5.8 + 6.0 years of the disease. 56.48% had excellent adherence to the GFD and 43.52% had a good QoL. The high cost of gluten-free foods was the question with the highest response percentage, associated with regular and poor adherence to the GFD (p-value = 0.001) and with poor QoL (p-value = 0.023). Conclusion. In a COVID-19 pandemic period, the cost of food is associated with regular and poor adherence to the GFD and with poor QoL(AU)


Subject(s)
Humans , Male , Female , Adult , Quality of Life , Celiac Disease/diet therapy , Diet, Gluten-Free , Treatment Adherence and Compliance , COVID-19/prevention & control , Celiac Disease/economics , Quarantine , Cross-Sectional Studies , Costs and Cost Analysis , Diet, Gluten-Free/economics , COVID-19/economics
9.
Rev. Assoc. Med. Bras. (1992) ; 67(2): 168-172, Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1287807

ABSTRACT

SUMMARY Refractory celiac disease is an uncommon condition which might be associated to poor prognosis. It is often treated with immunosuppressive medications, with poor results. It is divided in type 1 and type 2, the latter carrying a high risk for lymphoma and mortality. A case of a 41 year old female patient with refractory celiac disease type 2 is reported. She was treated with oral budesonide for six months, achieving histological remission.


Subject(s)
Humans , Male , Female , Celiac Disease/diagnosis , Budesonide
11.
Cad. Saúde Pública (Online) ; 37(2): e00244219, 2021.
Article in Portuguese | LILACS | ID: biblio-1153698

ABSTRACT

As desordens relacionadas ao glúten (DRG) afetam de 1% a 6% da população, com complicações e alto risco de morbimortalidade em curto e longo prazos. Desde 2009, o Brasil possui um Protocolo Clínico de Diretrizes Terapêuticas para a Doença Celíaca, entretanto, são comuns as queixas das pessoas com DRG a respeito da falta de conhecimento dos profissionais de saúde nessa temática e das dificuldades relacionadas ao cuidado em saúde em relação tanto ao diagnóstico quanto ao tratamento. Este estudo objetivou compreender as fragilidades no cuidado em saúde percebidas por pessoas com DRG. Foi realizada uma pesquisa qualitativa virtual no grupo Viva Sem Glúten (VSG), da rede social Facebook, na qual foram consultados os registros armazenados no grupo por 65 meses, que totalizaram 510 postagens e seus respectivos comentários. Os dados foram agrupados em categorias, e foi realizada análise temática de conteúdo, adotando-se os referenciais teóricos sobre o cuidado em saúde. A análise revelou que as buscas por um diagnóstico e por tratamento adequado frequentemente são descritas como uma peregrinação, sendo decorrentes das fragilidades no cuidado em saúde, traduzidas pela falta de conhecimento atualizado dos profissionais sobre as DRG e por problemas na relação profissional-paciente. As fragilidades no cuidado em saúde e os diagnósticos tardios contribuem para aumentar o risco de complicações e óbitos. Nesse contexto, o grupo VSG se destaca em seu papel de grupo de apoio e rede de solidariedade, favorecendo o esclarecimento e o empoderamento de inúmeras pessoas com DRG.


Gluten-related disorders affect 1% to 6% of the population, with complications and high risk of short and long-term morbidity and mortality. Since 2009, Brazil has a Clinical Protocol of Therapeutic Guidelines for Celiac Disease, but there are frequent complaints by persons with gluten-related disorders concerning the lack of healthcare professionals' knowledge of this topic and the difficulties related to healthcare, for both diagnosis and treatment. This study aimed to understand the weaknesses in healthcare perceived by persons with gluten-related disorders. An online qualitative survey was conducted in the Living Without Gluten group on Facebook, consulting the records saved by the group for 65 months, which totaled 510 posts and the respective comments. The data were grouped in categories, and thematic content analysis was performed, adopting the theoretical references on healthcare. The analysis revealed that the searches for diagnosis and adequate treatment were often described as a forced pilgrimage, resulting from shortcomings in healthcare, including lack of up-to-date knowledge on gluten-related disorders among the healthcare professionals and problems in the physician-patient relationship. Weaknesses in patient care and late diagnoses contribute to increasing the risk of complications and deaths. In this context, the Living Without Gluten group plays a leading role as a support group and network of solidarity, favoring increased awareness and empowerment of numerous Brazilians with gluten-related disorders.


Los desórdenes relacionados al gluten afectan de 1% a 6% de la población, con complicaciones y alto riesgo de morbimortalidad en corto y largo plazos. Desde 2009, Brasil posee un Protocolo Clínico de Directrices Terapéuticas para la Enfermedad Celíaca, sin embargo, son comunes las quejas de las personas con desórdenes relacionados al gluten, respecto a la falta de conocimiento de los profesionales de salud en esa temática y las dificultades relacionadas con el cuidado en salud, en relación tanto con el diagnóstico como con el tratamiento. Este estudio se marcó como objetivo comprender las fragilidades en el cuidado en salud percibidas por personas con desórdenes relacionados al gluten. Se realizó una investigación cualitativa virtual en el grupo Vivir Sin Gluten (VSG) de la red social Facebook, en la que se consultaron los registros almacenados en el grupo durante 65 meses, que totalizaron 510 posts y sus respectivos comentarios. Los datos se agruparon en categorías y se realizó un análisis temático de contenido, adoptándose los referenciales teóricos sobre el cuidado en salud. El análisis reveló que las búsquedas de un diagnóstico y tratamiento adecuado frecuentemente se describen como una peregrinación, siendo derivados de las fragilidades en el cuidado en salud, traducidas por la falta de conocimiento actualizado de los profesionales sobre las desórdenes relacionados al gluten y por problemas en la relación profesional-paciente. Las fragilidades en el cuidado en salud y los diagnósticos tardíos contribuyen a aumentar el riesgo de complicaciones y óbitos. En este contexto el grupo VSG se destaca en su papel de grupo de apoyo y red de solidaridad, favoreciendo la información y el empoderamiento de innumerables personas con desórdenes relacionados al gluten.


Subject(s)
Humans , Celiac Disease/diagnosis , Glutens/adverse effects , Brazil/epidemiology , Delivery of Health Care , Diet, Gluten-Free
12.
Rev. Nutr. (Online) ; 34: e200034, 2021. tab
Article in English | LILACS | ID: biblio-1250806

ABSTRACT

ABSTRACT Objective To determine the frequency of Human leukocyte antigen alleles and to verify the association of the presence of these alleles with symptoms and other diseases related to celiac disease in patients with autoimmune thyroid diseases. Methods A questionnaire on the symptoms and diseases associated with celiac disease was applied. Genomic deoxyribonucleic acid was extracted by collecting cells from the oral mucosa. The alleles (DQA1*0501; DQB1*0201; DRB1*04) were identified by means of the polymerase chain reaction. Results A total of 110 patients with autoimmune thyroid diseases participated in this study. It was observed that 66.4% of the individuals carried at least one of the alleles assessed and that 58.2% of the individuals were positive for at least one of the DQ2 alleles (DQA1*0501; DQB1*0201) and out of these 18.2% were positive for both DQ2 alleles (DQA1*0501; DQB1*0201). With regard to DQ8 (DRB1*04), 21.8% of the studied population was positive for this allele and 3.6% was positive for both DQ2 (DQA1*0501; DQB1*0201) and DQ8 (DRB1*04). A significant association was found between the presence of the DRB1*04 allele and gastrointestinal symptoms (p=0.02). A significant association of the DRB1*04 allele with type 1 diabetes mellitus (p=0.02) was observed. Conclusion The genetic profiles most commonly associated with celiac disease, such as DQ2 (DQA1*0501; DQB1*0201) and DQ8 (DRB1*04) were around 20.0% prevalent in the studied population. These are risk haplotypes for celiac disease especially when symptoms and diseases related to celiac disease are present. Therefore, it is important to screen patients to investigate a potential diagnosis for celiac disease.


RESUMO Objetivo Determinar a frequência dos alelos do Human leukocyte antigen e verificar a associação da presença desses alelos com sintomas e outras doenças relacionados à doença celíaca em portadores de doenças autoimunes da tireoide. Métodos Aplicou-se um questionário relacionado aos sintomas e doenças associados à doença celíaca. O ácido desoxirribonucleico genômico foi extraído por meio da coleta das células da mucosa bucal. Os alelos (DQA1*0501; DQB1*0201; DRB1*04) foram identificados por meio da reação em cadeia da polimerase. Resultados Participaram deste estudo 110 portadores de doenças autoimunes da tireoide. Observou-se que 66,4% dos indivíduos carregavam pelo menos um dos alelos estudados e que 58,2% dos indivíduos eram positivos para pelo menos um dos alelos DQ2 (DQA1*0501; DQB1*0201) e destes 18,2% foram positivos para ambos alelos do DQ2(DQA1*0501; DQB1*0201). Com relação ao DQ8 (DRB1*04), 21,8% da população estudada eram positivos para esse alelo e 3,6% eram positivos tanto para o DQ2 (DQA1*0501; DQB1*0201) quanto para o DQ8 (DRB1*04). Foi encontrada associação significativa da presença do alelo DRB1*04 com os sintomas gastrointestinais (p=0,02). Houve associação significativa do alelo DRB1*04 com diabetes mellitus tipo 1 (p=0,02). Conclusão O perfil genético mais fortemente associado à doença celíaca, tais como DQ2 (DQA1*0501; DQB1*0201) e DQ8 (DRB1*04) estavam presentes em torno de 20,0% da população estudada, estes são haplótipos de risco para doença celíaca e principalmente na presença de sintomas e doenças relacionadas à doença celíaca. Sendo assim, é importante realizar o rastreamento para investigar um possível diagnóstico para doença celíaca.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Thyroiditis, Autoimmune , Celiac Disease , HLA Antigens , Alleles
13.
Texto & contexto enferm ; 29: e20180420, Jan.-Dec. 2020.
Article in English | LILACS, BDENF | ID: biblio-1059148

ABSTRACT

ABSTRACT Objectives: to describe the health control habits that influence the daily life of celiac patients and to analyze the practice of actions related to health control and its determinants, from the perspective of the first component of the Pender Health Promotion Model. Method: a cross-sectional study conducted through interviews with instrument with 83 individuals from Ceará and diagnosed with celiac disease. Data was analyzed using the characteristics and individual experiences component of Pender's theoretical model. Results: of the celiac patients, 96.4% did not follow the gluten-free diet; 80.7% had inappropriate behaviors to reduce risk factors; 72.3% made ineffective choices in daily life to achieve health goals and; and 25.3% could not keep the gluten free diet in their daily life. Conclusion: according to the theoretical model, celiac patients did not adhere to the proper diet and presented factors inherent to daily life and social issues, characterized as barriers to an effective health control.


RESUMEN Objetivos: describir los hábitos de control de la salud que influyen sobre la vida diaria de los celíacos y analizar la práctica de acciones relacionados con el control de la salud y sus factores determinantes, bajo la óptica del primer componente del Modelo de Promoción de la Salud de Pender. Método: estudio transversal realizado a través de entrevistas con instrumento con 83 individuos del estado de Ceará diagnosticados con la enfermedad celíaca. Los datos se analizaron mediante el componente de características y experiencias individuales del modelo teórico de Pender. Resultados: de los celíacos, el 96,4% no seguía la dienta sin gluten; el 80,7% presentaba comportamiento inadecuados para reducir factores de riesgo; el 72,3% realizaba elecciones ineficaces en la vida diaria para alcanzar las metas de salud y el 25,3% no lograba mantener la dieta sin gluten en su vida diaria. Conclusión: de acuerdo con el modelo teórico, los celíacos no respetaban la dieta adecuada y presentaron factores inherentes a la vida diaria y a las cuestiones sociales, caracterizados como obstáculos para un control eficaz de la salud.


RESUMO Objetivos: descrever os hábitos de controle de saúde que influenciam no cotidiano dos celíacos e analisar a prática de ações relacionadas ao controle da saúde e seus determinantes, sob o prisma do primeiro componente do Modelo de Promoção da Saúde de Pender. Método: estudo transversal, realizado com 83 indivíduos com diagnóstico de doença celíaca, do Estado do Ceará, através de entrevistas com instrumento. Os dados foram analisados mediante o componente características e experiências individuais do modelo teórico de Pender. Resultados: dos celíacos, 96,4% não seguiam a dieta isenta de glúten; 80,7% possuíam comportamentos inadequados para reduzir fatores de risco; 72,3% faziam escolhas na vida diária ineficazes para atingir as metas de saúde; e 25,3% não conseguiam manter a dieta isenta de glúten na sua vida diária. Conclusão: de acordo com o modelo teórico, os celíacos não aderiam à dieta adequada e apresentaram fatores inerentes ao cotidiano e às questões sociais, caracterizados como barreiras para o controle eficaz da saúde.


Subject(s)
Humans , Adult , Celiac Disease , Chronic Disease , Patient Compliance , Diet, Gluten-Free , Health Promotion
14.
Rev. méd. Maule ; 36(2): 44-49, dic. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1344614

ABSTRACT

This article describes a 19-y-old patient with abdominal pain and signs of malnutrition. She had been treated previously with an antibiotic for chronic diarrhea. Laboratory analyses showed the presence mild hypoalbuminemia, and considerably prolonged prothrombin time. Tests revealed that hemostasis improved after the patient received fresh frozen plasma and vitamin k. A coagulation profile showed a decrease in clotting factors V, VII, IX, and fibrinogen. Positive serology (immunoglobulin A antitissue transglutaminase and immunoglobulin A antiendomysial antibodies) and small bowel mucosal histopathology confirmed the presence of celiac disease (CD). The girl recovered completely after she was put on a gluten-free diet. Vitamin K­deficiency is a rare complication that occurs in celiac disease manifestations. In addition to antibiotic therapy, treatment with other drugs that influence vitamin K resorption and metabolism may increase the risk of bleeding in patients with CD with hypoprothrombinemia.


Subject(s)
Humans , Female , Adult , Blood Coagulation Disorders/complications , Blood Coagulation Disorders/diagnosis , Celiac Disease/complications , Celiac Disease/epidemiology , Vitamin K Deficiency/complications , Blood Coagulation Disorders/epidemiology , Malabsorption Syndromes/diagnosis
15.
Diaeta (B. Aires) ; 38(173): 13-27, dic. 2020. graf
Article in Spanish | LILACS, BINACIS, UNISALUD | ID: biblio-1278979

ABSTRACT

Resumen La dieta libre de gluten (DLG) es el único tratamiento frente a la enfermedad celíaca, la alergia al trigo y la sensibilidad al gluten no celíaca. Se reporta a la DLG como una dieta desbalanceada, escasa en fibra y alta en grasas y carbohidratos. El objetivo del estudio fue evaluar el aporte de energía, de macronutrientes y de fibra de alimentos libres de gluten (bizcochuelos, panes estilo inglés, galletitas dulces y pizzas) elaborados a partir de diferentes premezclas comerciales, disponibles en el mercado local. Además, los resultados fueron comparados con un homólogo comercial elaborado con harina de trigo. Para la determinación de la composición centesimal se aplicó la metodología oficial AOAC 2016. El valor energético se calculó utilizando los factores de Atwater. Los resultados obtenidos para los bizcochuelos fueron: 6,0-8,3 g% de proteína; 9,2-11,3 g% de grasas; 1,5-2,3 g% de fibra dietaria; 40,0-53,1 g% de carbohidratos y 285-339 Kcal% de valor energético. Para los panes: 3,0-6,6 g% de proteína; 3,1-12,7 g% de grasas; 2,7-4,0 g% de fibra dietaria; 36,8-50,1 g% de carbohidratos y 217-290 Kcal% de valor energético. Para las galletitas: 3,5-8,5 g% de proteína; 25,9-31,0 g% de grasas; 0,9-5,9 g% de fibra dietaria; 53,9-60,1 g% de carbohidratos y 483-527 Kcal% de valor energético. Para las pizzas: 7,4-9,3 g% de proteína; 7,3-11,2 g% de grasas; 2,8-8,0 g% de fibra dietaria; 19,1-29,6 g% de carbohidratos y 172-240 Kcal% de valor energético. Los alimentos elaborados con premezclas formuladas únicamente con harina de arroz y féculas contribuyen poco a cubrir el valor diario recomendado de fibra. Los que contienen otras fuentes farináceas (harina de sorgo, trigo sarraceno y teff) reflejan un mayor contenido de fibra. La presencia de harina de arveja, soja y teff refleja un aumento del contenido proteico. Los alimentos estudiados frente a su homólogo comercial con harina de trigo presentan, en general, igual o menor aporte proteico, similar aporte energético y de carbohidratos y un mayor aporte de grasas y fibra dietaria.


Abstract The gluten free diet (GFD) is the only treatment for celiac disease, wheat allergy and non-celiac gluten/wheat sensitivity. GFD is reported as an unbalanced diet, low in fibre and high in fat and carbohydrates. The aim of this study was to evaluate energy, macronutrients and fiber contribution of gluten-free cereal products (pound cake, tin loaf, cookies and pizza) coming from different commercial premixes, available at the local market. Also, the results were compared with a commercial equivalent made with wheat flour. For centesimal composition determination, AOAC Official Method 2016 was applied. The energy was calculated using Atwater factors. The results obtained for pound cake were: 6.0-8.3g% protein; 9.2-11.3g% fat; 1.5-2.3g% dietary fibre; 40.0-53.1g% carbohydrate and 285-339Kcal% energy. For tin loaf: 3.0-6.6g% protein; 3.1-12.7% fat; 2.7-4.0g% dietary fibre; 36.8-50.1g% carbohydrate and 217-290Kcal% energy. For cookies: 3.5-8.5g% protein; 25.9-31.0g% fat; 0.9-5.9g% dietary fibre; 53.9-60.1g% carbohydrate and 483-527Kcal% energy. For pizza: 7.4-9.3g% protein; 7.3-11.2g% fat; 2.8-8.0g% dietary fibre; 19.1-29.6g% carbohydrate and 172-240Kcal% of energy. Products made with premix that only contains rice flour and starches contribute little to meeting recommended daily intake. The ones that contain other farinaceous sources (sorghum flour, buckwheat and teff) show higher dietary fibre content. The presence of pea flour, soybean and teff show an increase of protein content. The analysed products present same or lower protein intake, similar energy and carbohydrate intake and higher fat and dietary fibre intake, compared to their commercial equivalent made with wheat flour.


Subject(s)
Diet, Gluten-Free , Celiac Disease , Wheat Hypersensitivity , Prepared Foods
16.
Medicina (B.Aires) ; 80(6): 718-721, dic. 2020. graf
Article in Spanish | LILACS | ID: biblio-1250301

ABSTRACT

Resumen La enfermedad celíaca tiene una considerable frecuencia en nuestro medio. La mayoría de los pacientes presenta mejoría clínica, serológica y endoscópica al poco tiempo de iniciada la dieta libre de gluten. Un muy bajo porcentaje puede presentar o desarrollar una "enfermedad celíaca complicada", entidad que comprende el esprue refractario, la yeyunitis ulcerativa y el linfoma intestinal, que conllevan pronósticos desfavorables, con requerimiento de tratamientos más radicales. Presentamos aquí el caso de un paciente de 77 años evaluado en nuestro centro, que ingresó para estudio de hemorragia digestiva aguda y se realizó finalmente diagnóstico de enfermedad celiaca complicada, requiriendo inicio de tratamiento con corticoides sistémicos y seguimiento estrecho ambulatorio.


Abstract Celiac disease is considerably frequent in our media. Gluten-free diet shows clinical, serological and endoscopic improvement in most patients shortly after its start. A few patients may present or develop a "complicated celiac disease", an entity that includes refractory sprue, ulcerative jejunitis and intestinal lymphoma, which carry unfavorable prognoses, requiring more radical treatments. We present here the case of a 77-year-old male patient evaluated in our center, who was admitted for study of acute gastrointestinal bleeding. Complicated celiac disease was diagnosed, systemic corticosteroids were started and a close follow-up was carried out.


Subject(s)
Humans , Male , Aged , Celiac Disease/complications , Celiac Disease/drug therapy , Prognosis , Gastrointestinal Hemorrhage/chemically induced
17.
Medicina (B.Aires) ; 80(6): 707-709, dic. 2020. graf
Article in Spanish | LILACS | ID: biblio-1250298

ABSTRACT

Resumen Varón de 33 años con antecedentes de convulsiones febriles y discapacidad intelectual moderada grave, inició a los 2 años convulsiones tanto focales como generalizadas atónicas diarias, que ocasionaron traumas faciales. Debido a la farmacorresistencia se implantó un estimulador del nervio vago, con respuesta parcial al mismo. Durante su seguimiento, se hizo diagnóstico de enfermedad celíaca. Al realizar una tomografía de encéfalo se evidenciaron calcificaciones piriformes occipitales bilaterales, estableciéndose el diagnostico de enfermedad celiaca, epilepsia y calcificaciones cerebrales. Se le indicó dieta libre de gluten y continuar el tratamiento farmacológico, logrando de esta manera una reducción de las crisis.


Abstract A 33-year-old man with a history of febrile seizures and moderate-severe intellectual disability began, at 2 years, both focal and generalized daily atonic seizures, which caused facial trauma. Due to drug resistance, a vagus nerve stimulator was implanted, with partial response to it. During his follow-up, he was diagnosed with celiac disease. When performing a brain tomography, bilateral occipital pyriform calcifications were evidenced, establishing the diagnosis of celiac disease, epilepsy and cerebral calcifications. A gluten-free diet was indicated and pharmacological treatment continued, thus achieving a reduction in seizures.


Subject(s)
Humans , Male , Adult , Brain Diseases , Calcinosis/diagnostic imaging , Celiac Disease/complications , Epilepsy , Electroencephalography
18.
Arq. gastroenterol ; 57(2): 167-171, Apr.-June 2020. tab, graf
Article in English | LILACS | ID: biblio-1131646

ABSTRACT

ABSTRACT BACKGROUND: Molar incisor hypomineralization (MIH) is a developmental enamel defect with multifactorial etiology. Although the relationship between celiac disease (CD) and developmental enamel defect was demonstrated, the association between CD and MIH is uncertain. OBJECTIVE: The objective of this study was to analyze the occurrence of MIH in CD patients. METHODS: Forty CD patients and a control group with 40 healthy individuals were selected. A calibrated examiner (k≥0.889) according to the European Academy of Pediatric Dentistry criteria performed the diagnosis of MIH. Data were analyzed by descriptive statistics and Fischer's exact test (α=0.05). RESULTS: Of the 80 participants, ten presented MIH with eight individuals with CD. Celiac patients presented 4.75 times the chance of occurrence of MIH than the control group (95% CI: 2.22-10.18; P=0.044). In all the evaluated teeth (n=978), 22 had MIH: 20 teeth in individuals with CD and two in those without the disease. All CD participants with MIH presented the classic form of the disease. CD participants showed 17 teeth (85.0%) with demarcated opacities, two (10.0%) post-eruptive collapses and one (5.0%) atypical restoration. The control group presented only demarcated opacities. CONCLUSION: CD increased the chance of MIH and associated with its clinical manifestations can assist in the diagnosis of CD.


RESUMO CONTEXTO: A hipomineralização de molares e incisivos (HMI) é um defeito de desenvolvimento de esmalte com etiologia multifatorial. Embora a relação entre doença celíaca (DC) e defeito de desenvolvimento de esmalte já tenha sido demonstrada, a associação entre DC e HMI ainda é incerta. OBJETIVO: O objetivo deste estudo foi analisar a ocorrência de HMI em pacientes com DC. MÉTODOS: Foram selecionados 40 pacientes com DC e um grupo controle com 40 indivíduos sem a doença. O diagnóstico da HMI foi realizado por examinador calibrado (k≥0,889) segundo critérios da Academia Europeia de Odontopediatria. Dados foram analisados por estatística descritiva e teste exato de Fischer (α=0,05). RESULTADOS: Dos 80 participantes, 10 apresentaram HMI sendo 8 indivíduos com DC. Pacientes celíacos apresentaram 4,75 vezes a chance de ocorrência de HMI que grupo controle (IC 95%: 2,22-10,18; P=0,044). No total dos dentes avaliados (n=978), 22 apresentaram HMI: 20 dentes em indivíduos com DC e 2 entre aqueles sem a doença. Todos os participantes com DC e portadores de HMI apresentavam a forma clássica da doença. Participantes com DC mostraram 17 (85,0%) dentes com opacidades demarcadas, 2 (10,0%) colapsos pós-eruptivos e 1 (5,0%) restauração atípica. Grupo controle apresentou apenas opacidades demarcadas. CONCLUSÃO: DC aumentou a chance de HMI e associada a manifestações clínicas da DC pode auxiliar no diagnóstico da doença.


Subject(s)
Humans , Celiac Disease/epidemiology , Dental Enamel Hypoplasia/epidemiology , Prevalence , Incisor , Molar
19.
Rev. chil. nutr ; 47(3): 372-380, jun. 2020. tab, graf
Article in English | LILACS | ID: biblio-1126134

ABSTRACT

ABSTRACT This study describes the development of mixed flour added of maca for gluten-free bread (GFB) employing a Simplex Centroid Design. Four pseudo-components were evaluated in order to improve the GFB specific volume and texture profile analysis: maca (MC; 0.25 to 0.75), potato starch (PS; 0.25 to 0.75), sweet manioc flour (SEM; 0 to 0.25), and sour manioc flour (SOM; 0 to 0.25). The best GFB formulation - by desirability results - was evaluated regarding physio-chemical, microbiological aspects, and sensory acceptance. The responses specific volume and hardness were adjusted with a special cubic model (R2= 0.973 and 0.913), while cohesiveness, springiness and chewiness was adjusted with a linear model. The significant contribution of maca into GFB dough was evident in the models, and the desirability results indicated an appropriate mixed flour composed by MC (0.25), PS (0.5), and SEM (0.25). The GFB elaborated with this mixed flour generated a product well accepted (acceptability index higher than 73.9%) for attributes of aroma, colour, texture, flavour, and overall acceptance. The values of physio-chemical parameters obtained in the present article was in the range described for GFB in the literature. In addition, the processing method applied allowed for obtaining a GFB that was microbiologically stable.


RESUMEN Este estudio describe el desarrollo de la harina mezclada (MF) agregada de maca para la elaboración de pan sin gluten (GFB) empleando un Diseño Centroide Simplex. Se evaluaron cuatro pseudo-componentes para mejorar el volumen específico y el perfil de textura de GFB: maca (MC; 0,25 a 0,75), almidón de patata (PS; 0,25 a 0,75), harina de yuca dulce (SEM; 0 a 0,25), y harina de yuca agrio (SOM; 0 a 0,25). La mejor formulación de GFB - por la deseabilidad - se evaluó en relación con los aspectos fisicoquímicos, microbiológicos, y sensoriales. El volumen específico y la dureza se ajustaron a un modelo cúbico especial (R2= 0,975 y 0,913). La cohesión, elasticidad y masticabilidad se ajustaron a un modelo lineal. La contribución de la maca a la masa de GFB fue evidente en los modelos, y los resultados indican una MF apropiada compuesta por MC (0,25), PS (0.5) y SEM (0,25). El GFB elaborado con esta MF genera un producto aceptado (índice de aceptabilidad mayor que 73,9%) para aroma, color, textura, sabor y aceptación general. Los parámetros físico-químicos obtenidos estaban en el rango descrito para GFB en la literatura y GFB se mostró microbiológicamente estable.


Subject(s)
Bread/analysis , Celiac Disease , Lepidium , Diet, Gluten-Free , Taste , Solanum tuberosum , Bread/microbiology , Manihot
20.
Acta bioquím. clín. latinoam ; 54(2): 173-182, jun. 2020. ilus, tab
Article in Spanish | LILACS | ID: biblio-1130592

ABSTRACT

Se realizó un estudio sobre treinta pacientes con trastorno del espectro autista (TEA) que asisten para su atención a centros especializados que funcionan en la Ciudad Autónoma de Buenos Aires y en el conurbano bonaerense. A todos ellos se les efectuó un estudio psico-neuro-cognitivo exhaustivo, según la escala IDEA (Inventario del Espectro Autista) que tiene el objetivo de evaluar doce dimensiones características significativas en estos pacientes, con cuatro niveles de puntuación en cada una de las dimensiones estudiadas. Los padres o tutores completaron una encuesta con datos epidemiológicos y se investigaron posibles factores de alergias y/o intolerancias presentes. Esta encuesta también se hizo extensiva a otras familias con niños autistas, para que los datos epidemiológicos fueran representativos de una población mayor. Sobre los treinta pacientes estudiados se dosaron anticuerpos antiendomisio y antitransglutaminasa, ambos asociados con la enfermedad celíaca; IgE total, asociada a procesos de alergia y a parasitosis; homocisteína sérica o urinaria, cortisol sérico o urinario y factor neurotrófico derivado del cerebro (BNDF). Se trataron de establecer posibles asociaciones causales entre los parámetros estudiados y las manifestaciones de los trastornos autistas.


Thirty patients with autism spectrum disorder (ASD) who attend specialized centers in Buenos Aires and its suburbs were carefully studied. All of them underwent a psycho-neuro-cognitive study. The psychologists used the IDEA (Autism Spectrum Inventory) scale which is focused on twelve characteristically significant dimensions with four typical levels in each of those dimensions studied. Their parents or guardians completed a survey with epidemiological data and possible factors of allergies and/or intolerance presence were investigated. This survey was also distributed among other families with children with ASD condition so that the epidemiological results were taken from a larger number of cases. Anti-endomysial and anti-transglutaminase antibodies usually related to celiac disease, total IgE related to allergic processes, homocysteine measures in serum or urine, cortisol measured in serum or urine and brain-derived neurotrophic factor (BNDF) were dosed in all the cases. The aim was to establish possible causal associations between the studied parameters and the manifestations of the autism spectrum disorder.


Foi conduzido um estudo em trinta pacientes com transtorno do espectro autista (TEA) que para serem atendidos frequentam centros especializados que operam na Cidade Autônoma de Buenos Aires e seus arrededores. Todos eles foram submetidos a um exaustivo estudo psico-neurocognitivo, de acordo com a escala IDEA (Inventário do Espectro Autista) que visa avaliar doze características significativas desses pacientes, com quatro níveis de pontuação em cada uma das dimensões estudadas. Os pais ou responsáveis responderam uma pesquisa com dados epidemiológicos e foram pesquisados possíveis fatores de alergias e / ou intolerâncias presentes. Essa pesquisa também foi estendida a outras famílias com crianças autistas, de modo que os dados epidemiológicos fossem representativos de uma população maior. Anticorpos antiendomísio e antitransglutaminase foram dosados nos trinta pacientes estudados, ambos associados à doença celíaca; IgE total associada a processos de alergia e a parasitose; homocisteína sérica ou urinária, cortisol sérico ou urinário e fator neurotrófico derivado do cérebro (BNDF). Tentou-se estabelecer possíveis associações causais entre os parâmetros estudados e as manifestações dos transtornos autistas.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Neurobiology , Biomarkers , Allergy and Immunology , Autism Spectrum Disorder , Autism Spectrum Disorder/complications , Association , Attention , Celiac Disease , Cerebrum
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