Are the dietary habits of treated individuals with celiac disease adherent to a Mediterranean diet?

BACKGROUND AND AIMS: The only treatment for celiac disease (CD) is strict, lifelong adherence to a gluten-free (GF) diet. To date, there are contrasting data concerning the nutritional adequacy of GF products and diet. There have been no studies that have assessed the adherence of individuals with CD to a Mediterranean diet (MD), a protective dietary regimen against major non-communicable diseases (NCDs). Therefore, we examined the adherence to an MD of a group of Italian individuals with CD and compared it with that of a healthy control group. METHODS AND RESULTS: In a cross-sectional study, a sample of individuals with CD and a group of healthy subjects were included. The dietary habits of all participants were recorded using a validated food frequency questionnaire, and the adherence to an MD was determined using the Italian Mediterranean Index. Typical Mediterranean food consumption was not significantly different between individuals with CD and the healthy participants, except for fruits (P = 0.017). However, individuals with CD consumed significantly higher amounts of potatoes (P = 0.003) and red and processed meat (P = 0.005) than healthy participants. The resulting mean Italian Mediterranean Index was significantly higher in healthy participants than in individuals with CD (P < 0.001). CONCLUSION: The results raise questions concerning the food choices of individuals with CD, suggesting the need of encouraging them to make better food choices more in line with an MD, which would improve their nutritional status and better protect them from NCDs at long term. PROTOCOL REGISTRATION: ClinicalTrials.gov (ID NCT01975155) on November 4 2013.

Snakebite in pregnancy: a preliminary study

Worldwide occurrence of envenomation by snakebite in pregnancy is rare according to the medical literature. The objective of the present study was to evaluate the frequency of snakebite envenomation cases as well as their obstetrical consequences. Thus, we conducted this study based on the medical records of 157 patients, aged from 13 to 54 years old who had been attended at the "Joao de Barros Barreto" University Hospital from January 1989 to May 1994. These patients presented epidemiological and clinical diagnosis of snakebite envenomation. Of the 157 patients, 8 (5 per cent) were pregnant, 6 of them (75 per cent) were in the first trimester of pregnancy and 2 (25 per cent) in the 2nd trimester. Most of the victims were usually over 18 years old (7 cases, 87.5 per cent). Concerning the severity of the envenomation cases, 5 of them were considered mild accidents. Obstetrical consequences occurred in 3 (37.5 per cent) patients, 2 patients (25 per cent) with moderate manifestations, while 1 (12.5 per cent) presented severe manifestations. Patients developed vaginal bleeding in 3 cases (100 per cent), and uterine contraction, threatened abortion, decreased fetal movements, absence of fetal heartbeat and fetal death in one case (33.35 per cent). Snakebite is not common among pregnant women, since in most cases, these women are homebound. However, the obstetrical consequences are severe and related to severity of the envenomation.