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
The occurrence of Gram-negative pathogenic and opportunistic species, was studied for two years on air. soil and leachate from the San Nicolás Landfill. Aguascalientes, Mexico. For soil and leachate four samplings were done, two during the dry season and two during the rainy season. For soil there were 15 sampling points, the leachate samples were taken on the leachate tank. For air, twelve sampling were done in three points of the landfill. Twenty pathogenic and/or opportunistic bacteria were identified from air, twenty from soil and eleven from leachate. Most of them were enteric; however respiratory tract pathogenic bacteria were also identified. Pasteurella haemolytica were isolated in all air samples. Nine species were found in the a half of the soil samples. The most frequent species in leachate were Acinetobacter baumanii, Bordetella sp, Brucella sp. and Escherichia coli var II. The occurrence of pathogenic and opportunistic species points out to the nosocomial and domestic clinical wastes discharged in the landfill as a potential risk for public and occupational health.
