Impact of gluten-free diet on quality of life in celiac patients.

BACKGROUND AND AIM: Celiac disease (CD) is a common gluten-related disorder, whose only treatment is a gluten-free diet (GFD). Since a unique view on psychological consequences of a GFD still lacks, our aim was to assess the quality of life (QoL) and the depression state in symptomatic CD patients after GFD. Socio-demographic features were considered. PATIENTS AND METHODS: 210 adult CD patients were recruited and divided into 3 groups : 70 newly diagnosed patients (​Group A​),70 patients who have been on GFD for 6-12 months (​Group B​), and 70 patients who have been on GFD for more than 12 months (​Group C​). We recruited 210 healthy controls (​Group D). Psychological General Well-Being Index (PGWBI) and Beck Depression Inventory (BDI) questionnaires were administered. Each group was evaluated according to age, gender and school ranking. RESULTS: Groups A ​and B showed lower PGWBI scores compared with both Group C ​and D (p <0.001 for each comparison). Moreover, Groups A and B showed higher BDI scores compared with both ​Group C ​and D (p <0.001 for each comparison).Women, the elderly and the poorly educated seemed to suffer more psychological stress. CONCLUSION: GFD induces an improvement of well-being and a decrease of depression state after 12 months of strict GFD. Negative psychological implications were observed only in specific risk categories. (Acta gastroenterol. belg., 2016, 79, 447-453).

First clinical case of effective medical treatment of the vitreoretinal traction with recovery of the visual acuity.

This case-report evaluates the effectiveness of the medical treatment on vitreomacular traction through the use of palmitoylethanolamide (PEA), orally administered. Our 69 year-old patient reported a significant eyesight reduction, metamorphopsia and photopsia. He underwent the following investigations, before and after medical treatment: visual acuity evaluation, dilated fundus examination, OCT. The treatment consisted of the administration of two tablets of PEA per day over 7 days. We observed that, while the visual acuity in the right eye was 2/10 compared to the initial 11/10, the dilated fundus examination highlighted a foveal hole. Moreover, the OCT confirmed the presence of a vitreomacular traction due to the incomplete posterior vitreous detachment. At the end of the treatment with PEA, the visual acuity was equal to 8/10 and the OCT showed a disappearance of the hyperreflective streak with recovery of the physiological retinal and foveal profile. The therapy was eventually carried on for 10 more days with a final visual acuity of 10/10. In conclusion, PEA orally administered, beyond a rare possibility of a spontaneous resolution of the vitreomacular traction, probably contributed, by anti inflammatory action, to the vitreolysis and thus to the disappearance of the vitreomacular traction and foveal hole with a subsequent recovery of the eyesight and of the metamorphopsia.