ABSTRACT
Pacientes con enfermedad celiaca del adulto de reciente diagnóstico fueron evaluados con los test GSRS y PGWBI con el objetivo de valorar las alteraciones psicológicas que presentan, su relación con la sintomatología gastrointestinal y su evolución después de la instauración de dieta sin gluten. Previo asesoramiento nutricional los pacientes iniciaron dieta sin gluten y 6 meses después fueron reevaluados. Las variables cuantitativas se expresan como medianas y percentil Resultados Se incluyeron 21 pacientes, 17 mujeres y 4 hombres, edad 43 años (31-47). La histología fue compatible con lesión Marsh I en 6 casos, Marsh IIIa en 6 y Marsh IIIb en 9.Basalmente 8 pacientes presentaban distrés psicológico severo, 4 distrés moderado y 9 no presentaban distrés. La puntuación GSRS fue 34 (17-43) y el PGWBI 64 (48-87), objetivando la correlación significativa entre los 2 índices (rho = -0,58, p = 0,006).A los 6 meses 3 pacientes tenían distrés psicológico severo, 5 distrés moderado, 9 no presentaban distrés y 4 presentaban bienestar psicológico, la puntuación GSRS del 6.° mes fue 13 (8-17) y el PGWBI 83 (68-95) (p < 0,05 respecto de los datos basales para los 3 indicadores), constatándose mejoría significativa de los 6 ejes del PGWBI y sin que entonces se objetive correlación entre el GSRS y PGWBI. Conclusiones Los pacientes con enfermedad celiaca presentan alteraciones psicológicas cuya intensidad está relacionada con la sintomatología gastrointestinal, que mejoran después de la instauración de DSG
Patients with recently-diagnosed adult celiac disease were evaluated with the Gastrointestinal Symptom rating Scale (GSRS) and Psychological General Well-Being Index (PGWBI) to evaluate their psychological alterations, the association between any alterations and gastrointestinal symptoms, and their outcome after starting a gluten-free diet. The patients underwent nutritional assessment and then started a gluten-free diet; they were reassessed 6 months later. Quantitative variables are expressed as the median and 25th-75th percentiles. Results: We included 21 patients, 17 women and 4 mena, with a mean age of 43 years (31-47). The results of histological analysis were compatible with Marsh I lesions in 6 patients, Marsh IIIa in 6 and Marsh IIIb in 9. At baseline, 8 patients showed severe psychological distress, 4 showed moderate distress and 9 showed no distress. The GSRS score was 34 (17-43) and the PGWBI was 64 (48-87), with a significant correlation between the 2 indexes (rho = -.58, P = .006). At 6 months, 3 patients had severe psychological distress, 5 had moderate distress, 9 showed no distress and 4 showed psychological well-being. The GSRS score at 6 months was 13 (8-17) and the PGWBI was 83 (68-95) (P < .05 compared with baseline data for the 3 indicators). The 6 axes of the PGWBI showed significant improvement. At 6 months, no correlation was found between the GSRS and PGWBI. Conclusions: Patients with celiac disease have psychological alterations whose intensity is relted to gastrointestinal symptoms. These symptoms improve after the start of a gluten-free diet
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Celiac Disease/complications , Anxiety Disorders/epidemiology , Depressive Disorder/epidemiology , Brief Psychiatric Rating Scale/statistics & numerical data , Gastrointestinal Diseases/complications , Risk FactorsABSTRACT
UNLABELLED: Patients with recently-diagnosed adult celiac disease were evaluated with the Gastrointestinal Symptom rating Scale (GSRS) and Psychological General Well-Being Index (PGWBI) to evaluate their psychological alterations, the association between any alterations and gastrointestinal symptoms, and their outcome after starting a gluten-free diet. The patients underwent nutritional assessment and then started a gluten-free diet; they were reassessed 6 months later. Quantitative variables are expressed as the median and 25th-75th percentiles. RESULTS: We included 21 patients, 17 women and 4 mena, with a mean age of 43 years (31-47). The results of histological analysis were compatible with Marsh I lesions in 6 patients, Marsh IIIa in 6 and Marsh IIIb in 9. At baseline, 8 patients showed severe psychological distress, 4 showed moderate distress and 9 showed no distress. The GSRS score was 34 (17-43) and the PGWBI was 64 (48-87), with a significant correlation between the 2 indexes (rho=-.58, P=.006). At 6 months, 3 patients had severe psychological distress, 5 had moderate distress, 9 showed no distress and 4 showed psychological well-being. The GSRS score at 6 months was 13 (8-17) and the PGWBI was 83 (68-95) (P<.05 compared with baseline data for the 3 indicators). The 6 axes of the PGWBI showed significant improvement. At 6 months, no correlation was found between the GSRS and PGWBI. CONCLUSIONS: Patients with celiac disease have psychological alterations whose intensity is related to gastrointestinal symptoms. These symptoms improve after the start of a gluten-free diet.
Subject(s)
Celiac Disease/psychology , Adult , Celiac Disease/diet therapy , Celiac Disease/pathology , Depression/etiology , Diet, Gluten-Free/psychology , Female , Humans , Male , Middle Aged , Psychological Tests , Quality of Life , Self Concept , Self Efficacy , Severity of Illness Index , Stress, Psychological/etiology , Symptom Assessment , Treatment OutcomeABSTRACT
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Subject(s)
Humans , Celiac Disease/physiopathology , Dyspepsia/etiology , Esophageal Motility Disorders/etiologyABSTRACT
Therapeutic immunization with autologous monocyte-derived dendritic cells (DCs) loaded with heat-inactivated autologous human immunodeficiency virus type 1 (HIV-1) in 12 patients with chronic HIV-1 infection who were receiving highly active antiretroviral therapy (HAART) was feasible, safe, and well tolerated. Virus was obtained during an initial interruption of HAART (hereafter, "stop 1") so that DCs could be pulsed. After immunization and a second interruption of HAART (hereafter, "stop 2"), set-point plasma viral load (PVL; 24 weeks after stop 2) decreased > or =0.5 log(10) copies/mL relative to baseline PVL in 4 of 12 patients. We observed a significant lengthening in mean doubling time of PVL rebound and significant decreases in the area under the curve and the mean peak of PVL rebound after stop 2, compared with those after stop 1. This response was associated with changes in HIV-1-specific CD4(+) lymphoproliferative and CD8(+) T cell responses. These changes were not observed in a group of nonimmunized control patients.
Subject(s)
AIDS Vaccines/therapeutic use , Dendritic Cells/immunology , HIV Infections/therapy , HIV-1/immunology , Antiretroviral Therapy, Highly Active , CD4-Positive T-Lymphocytes/physiology , CD8-Positive T-Lymphocytes/physiology , HIV Infections/drug therapy , Humans , Vaccines, Inactivated/therapeutic use , Viral LoadABSTRACT
In 81 antiretroviral-navie HIV-1 chronic-infected patients, we found a correlation among tonsillar tissue viral load, and virological and immunological measures in blood at baseline. No correlation was observed after 1 year of antiretroviral therapy. A protease inhibitor-containing regimen was the best predictor of good tonsillar tissue virological response.
