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2.
Medicina (Kaunas) ; 55(9)2019 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-31540157

RESUMO

BACKGROUND: A Spanish version of a questionnaire intended to estimate, at the population level, the prevalence rates of self-reported gluten-related disorders and adherence to gluten-free diets has been applied in four Latin American countries. However, idiom issues have hampered the questionnaire application in the Brazilian population. Thus, the aim of the present study was to carry out a translation, cultural adaptation, and evaluation of a Brazilian Portuguese questionnaire to estimate the self-reported prevalence of gluten-related disorders and adherence to gluten-free diets in a Brazilian population. MATERIALS AND METHODS: Two bilingual Portuguese-Spanish health professionals carried out the translation of the original Spanish version of the questionnaire to Brazilian-Portuguese. Matching between the two translations was evaluated using the WCopyFind.4.1.5 software. Words in conflict were conciliated, and the conciliated version of the Brazilian Portuguese instrument was evaluated to determine its clarity, comprehension, and consistency. A pilot study was carried out using an online platform. RESULTS: The two questionnaires translated into Brazilian Portuguese were highly matched (81.8%-84.1%). The questions of the conciliated questionnaire were clear and comprehensible with a high agreement among the evaluators (n = 64) (average Kendall's W score was 0.875). The participants did not suggest re-wording of questions. The answers to the questions were consistent after two applications of the questionnaire (Cohen's k = 0.869). The pilot online survey yielded low response rates (9.0%) highlighting the need for face-to-face interviews. CONCLUSIONS: The translation and evaluation of a Brazilian Portuguese questionnaire to estimate the self-reported prevalence rates of gluten-related disorders and adherence to gluten-free diets was carried out. The instrument is clear, comprehensible, and generates reproducible results in the target population. Further survey studies involving face-to-face interviews are warranted.


Assuntos
Doença Celíaca/epidemiologia , Dieta Livre de Glúten , Inquéritos e Questionários , Adulto , Brasil/epidemiologia , Doença Celíaca/dietoterapia , Características Culturais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Reprodutibilidade dos Testes , Autorrelato , Traduções , Adulto Jovem
4.
Nutrients ; 11(8)2019 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-31370243

RESUMO

The only treatment currently available to combat celiac disease (CD) is strict adherence to a gluten-free diet (GFD), but there may be various determinants of its adherence, including food neophobia (FN), that is associated with sensory aversions, or fears of negative consequences of eating specific food products, that may be crucial for CD patients following a GFD. The aim of the present study was to analyze food neophobia levels and its determinants in CD patients in comparison with other individuals who follow a GFD based on their own decision. The study was conducted in two independent groups of individuals following a GFD: those diagnosed with CD (n = 101) and those following a GFD based on their own decision (n = 124). Each group was recruited with cooperation from the local CD and GFD societies located in Poland. The FN was assessed using the Food Neophobia Scale (FNS) and compared between groups, as well as the influence of gender, age, body mass index, educational level, place of residence and employment status was assessed. It was stated, that for the individuals following a GFD, CD was the major determinant of FN. The FNS score values were higher (indicating higher food neophobia) for CD individuals (39.4 ± 9.2), than for those following a GFD based on their own decision (33.6 ± 8.7; p < 0.0001) and it was observed both for general group and for sub-groups stratified by assessed variables. Moreover, the indicated variables did not influence the FNS in any of the analyzed groups. The influence of CD with no influence of other variables was confirmed in the regression analysis. It may be concluded that CD is a major contributor to FN, which can be attributed to fear of developing adverse reactions to gluten-contaminated food products, which is more pronounced in CD patients compared to non-CD patients following a GFD based on their own decision.


Assuntos
Doença Celíaca/dietoterapia , Alimentos/classificação , Adulto , Doença Celíaca/psicologia , Dieta Livre de Glúten/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente
5.
Nutrients ; 11(8)2019 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-31434299

RESUMO

Gluten-free diet (GFD) is enjoying increasingly popularity, although gluten-free products are considerably more expensive. GFD is absolutely necessary for patients with celiac disease, as in this case even minor amounts of gluten can lead to the destruction of the intestinal mucosa. In addition, GFD is currently the best therapy to improve clinical symptoms of patients with non-celiac gluten sensitivity (NCGS), although the diet may not be as strict as that for patients with celiac disease. Beside gluten, other wheat components such as oligosaccharides and amylase trypsin inhibitors are discussed as triggers of NCGS in this review. An overlap between gastrointestinal symptoms in NCGS and irritable bowel syndrome (IBS) is described. Patients with NCGS attribute their symptoms to the consumption of gluten, while patients with IBS rarely describe gluten as a trigger. Recently, several studies have demonstrated that the introduction of a low FODMAP (fermentable oligo-, di-, monosaccharides, and polyols) diet reduced gastrointestinal symptoms in patients with IBS and this diet is suggested as the first choice of therapy in IBS. However, a low FODMAP diet also eliminates prebiotica and may negatively influence the gut microbiota. For this reason, the diet should be liberalized after symptom improvement. There is no evidence that a GFD is healthier than the standard diet. In contrast, GFD often is accompanied by nutritional deficiencies, mainly minerals and vitamins. Therefore, GFD and low FODMAP diets are not recommended for healthy subjects. Since wheat contains fructans belonging to FODMAPs), a GFD is not only gluten-free but also has less FODMAPs. Thus, symptom improvement cannot be correctly correlated with the reduction of either one or the other.


Assuntos
Carboidratos , Doença Celíaca/dietoterapia , Dieta Livre de Glúten , Fermentação , Glutens , Polímeros , Dieta com Restrição de Carboidratos , Dieta Livre de Glúten/efeitos adversos , Dieta Livre de Glúten/tendências , Frutanos , Humanos , Síndrome do Intestino Irritável/dietoterapia , Triticum
7.
Nutrients ; 11(9)2019 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-31450806

RESUMO

Every year, the Italian National Health Service (NHS) provides about 200,000 celiac people (based on 2017 data) living in Italy with financial support of about 250 million euro to cover the cost of their specific dietary constrains. The existence of gluten-free products of high quality and affordable price is very important for the quality of life of celiac people and the sustainability of public support. Over the last decade, the market for gluten-free products has experienced a dramatic surge, with an increasing shelf space dedicated to these products in supermarkets, and a large variety of products both in terms of kind of agricultural inputs and processing and packaging methods. This study aimed at assessing the offer of gluten-free (GF) pasta in Italian supermarkets, with respect to its ability to meet the needs of celiac people in terms of variety, prices and safety. A hedonic price analysis was performed. Results indicated that GF pasta is sold only in 44% of the 212 stores of the sample, with a price equal to more than twice that of conventional pasta. A premium price was found for the following attributes: small packages, brands specialized in GF products, content in fiber and the presence of quinoa as ingredient.


Assuntos
Doença Celíaca/dietoterapia , Doença Celíaca/economia , Comércio/economia , Comportamento do Consumidor/economia , Dieta Livre de Glúten/economia , Carboidratos da Dieta/economia , Programas Nacionais de Saúde/economia , Doença Celíaca/diagnóstico , Chenopodium quinoa , Custos e Análise de Custo , Estudos Transversais , Carboidratos da Dieta/administração & dosagem , Fibras na Dieta/administração & dosagem , Fibras na Dieta/economia , Embalagem de Alimentos/economia , Humanos , Itália , Modelos Econômicos , Valor Nutritivo
8.
Nutr. hosp ; 36(4): 912-918, jul.-ago. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-184718

RESUMO

Introducción y objetivos: analizar el perfil alimentario y el valor nutricional de los menús adaptados para celiacos ofertados en los comedores de los centros escolares de Granada capital y área metropolitana. Material y métodos: estudio descriptivo en el que se han analizado los menús adaptados para niños celiacos de 41 centros escolares, cinco con cocina propia y 36 abastecidos por catering. La participación de los centros fue voluntaria, una vez fueron informados de las características y objetivos del estudio. Se recogió información a través de las fichas técnicas de los platos elaborados con la cantidad de cada alimento, además de las marcas de los productos sin gluten utilizados. Se analizaron menús de cuatro semanas en cuanto a distribución de raciones, energía, macro y micronutrientes para el grupo de 10 a 12 años, obteniendo valores medios y desviación estándar de 31 parámetros. Se utilizaron el programa Odimet y la base de datos CeliacBase. Se usó el programa estadístico IBM SPSS 22.0. Resultados: la pasta sin gluten fue la base del primer plato en el 31,7% de los menús analizados. En el segundo plato, la carne fue el constituyente principal. En todos los menús se ofertaba, al menos, una ración diaria de verdura. El 80% de los menús no alcanzaron la ingesta energética recomendada, aunque la distribución de macronutrientes fue adecuada. La cantidad media de fibra y de hidratos de carbono totales fue superior a lo recomendado. La cantidad de calcio y vitamina D no alcanzó la ingesta recomendada. Destaca un elevado consumo de sodio, que duplica la cantidad recomendada para la comida del mediodía. Conclusiones: los menús escolares adaptados para niños celiacos se ajustan a las recomendaciones, aunque deberían limitar la ingesta semanal de carne y presentan exceso de azúcares totales y sal


Introduction and objectives: the alimentary profile and the nutritional value of the menus adapted for coeliacs in the dining halls of the schools of Granada capital and Metropolitan Area. Material and methods: descriptive study in which we analyzed the menus adapted for children from 41 schools, 5 with their own kitchen and 36 supplied by catering. The information is recognized through the technical sheets of the dishes made with the quantity of each food, in addition to the brands of the gluten-free products. The four-week menus will be analyzed in terms of the distribution of rations, energy, macro and micronutrients for the age group of 10 to 12 years, obtaining average values and standard deviation of 31 parameters. The Odimet program and the CeliacBase database are used. The data will be analyzed using the IBM SPSS 22.0 statistical program. Results: gluten-free pasta was the basis of the first course in 31.7% of the menus analyzed. In the second dish, the meat was the main constituent. In all the menus, at least one daily vegetable ration was offered. 80% of the menus did not reach the recommended energy intake, although the distribution of macronutrients was adequate. The average amount of fiber and total carbohydrates was higher than recommended. The amount of calcium and vitamin has not been recommended. It emphasizes a high consumption of sodium, which doubles the amount recommended for the midday meal. Conclusions: school menus adapted for children conform to the recommendations, although they should be limited to intake


Assuntos
Humanos , Masculino , Feminino , Criança , Alimentação Escolar , Doença Celíaca/dietoterapia , Dieta Livre de Glúten/métodos , Dieta Livre de Glúten/tendências , Nutrição do Lactente , Valor Nutritivo , Nutrientes , Micronutrientes , Vitaminas , Minerais
9.
Nutr Hosp ; 36(4): 912-918, 2019 Aug 26.
Artigo em Espanhol | MEDLINE | ID: mdl-31291737

RESUMO

Introduction: Introduction and objectives: the alimentary profile and the nutritional value of the menus adapted for coeliacs in the dining halls of the schools of Granada capital and Metropolitan Area. Material and methods: descriptive study in which we analyzed the menus adapted for children from 41 schools, 5 with their own kitchen and 36 supplied by catering. The information is recognized through the technical sheets of the dishes made with the quantity of each food, in addition to the brands of the gluten-free products. The four-week menus will be analyzed in terms of the distribution of rations, energy, macro and micronutrients for the age group of 10 to 12 years, obtaining average values and standard deviation of 31 parameters. The Odimet program and the CeliacBase database are used. The data will be analyzed using the IBM SPSS 22.0 statistical program. Results: gluten-free pasta was the basis of the first course in 31.7% of the menus analyzed. In the second dish, the meat was the main constituent. In all the menus, at least one daily vegetable ration was offered. 80% of the menus did not reach the recommended energy intake, although the distribution of macronutrients was adequate. The average amount of fiber and total carbohydrates was higher than recommended. The amount of calcium and vitamin has not been recommended. It emphasizes a high consumption of sodium, which doubles the amount recommended for the midday meal. Conclusions: school menus adapted for children conform to the recommendations, although they should be limited to intake.


Assuntos
Doença Celíaca/dietoterapia , Dieta Livre de Glúten/normas , Planejamento de Cardápio/normas , Valor Nutritivo , Instituições Acadêmicas , Animais , Criança , Carboidratos da Dieta , Fibras na Dieta , Ingestão de Energia , Serviços de Alimentação , Humanos , Almoço , Carne , Necessidades Nutricionais , Espanha , Verduras
10.
Medicina (Kaunas) ; 55(7)2019 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-31277328

RESUMO

Background and objective: Often micronutrient deficiencies cannot be detected when patient is already following a long-term gluten-free diet with good compliance (LTGFDWGC). The aim of this narrative review is to evaluate the most recent literature that considers blood micronutrient deficiencies in LTGFDWGC subjects, in order to prepare dietary supplementation advice (DSA). Materials and methods: A research strategy was planned on PubMed by defining the following keywords: celiac disease, vitamin B12, iron, folic acid, and vitamin D. Results: This review included 73 studies. The few studies on micronutrient circulating levels in long-term gluten-free diet (LTGFD) patients over 2 years with good compliance demonstrated that deficiency was detected in up to: 30% of subjects for vitamin B12 (DSA: 1000 mcg/day until level is normal, then 500 mcg), 40% for iron (325 mg/day), 20% for folic acid (1 mg/day for 3 months, followed by 400-800 mcg/day), 25% for vitamin D (1000 UI/day or more-based serum level or 50,000 UI/week if level is <20 ng/mL), 40% for zinc (25-40 mg/day), 3.6% of children for calcium (1000-1500 mg/day), 20% for magnesium (200-300 mg/day); no data is available in adults for magnesium. Conclusions: If integration with diet is not enough, starting with supplements may be the correct way, after evaluating the initial blood level to determine the right dosage of supplementation.


Assuntos
Doença Celíaca/dietoterapia , Dieta Livre de Glúten/efeitos adversos , Micronutrientes/análise , Adolescente , Adulto , Cálcio/análise , Cálcio/sangue , Doença Celíaca/sangue , Doença Celíaca/tratamento farmacológico , Criança , Dieta Livre de Glúten/métodos , Suplementos Nutricionais/normas , Feminino , Ácido Fólico/análise , Ácido Fólico/sangue , Humanos , Ferro/análise , Ferro/sangue , Masculino , Micronutrientes/sangue , Cooperação do Paciente/psicologia , Vitamina B 12/análise , Vitamina B 12/sangue , Vitamina D/análise , Vitamina D/sangue , Zinco/análise , Zinco/sangue
11.
Gastroenterol Hepatol ; 42(7): 449-457, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31262542

RESUMO

Wheat is a common cereal in the Western diet and an important source of protein as well as fiber. However, some individuals develop adverse reactions to a wheat-containing diet. The best characterized is celiac disease which develops after intake of gluten in individuals with genetic predisposition. Other wheat-related conditions are less well defined in terms of diagnosis, specific trigger and underlying pathways. Despite this, the overall prevalence of wheat-related disorders has increased in the last decades and the role of microbial factors has been suggested. Several studies have described an altered intestinal microbiota in celiac patients compared to healthy subjects, but less information is available regarding other wheat-related disorders. Here, we discuss the importance of the intestinal microbiota in the metabolism of wheat proteins and the development of inflammatory or functional conditions. Understanding these interactions will open new directions for therapeutic development using bacteria with optimal wheat protein degrading capacity.


Assuntos
Microbioma Gastrointestinal , Proteínas de Plantas/metabolismo , Triticum , Imunidade Adaptativa , Bactérias/metabolismo , Doença Celíaca/dietoterapia , Doença Celíaca/metabolismo , Doença Celíaca/microbiologia , Dieta Livre de Glúten , Hipersensibilidade Alimentar/dietoterapia , Hipersensibilidade Alimentar/microbiologia , Hipersensibilidade Alimentar/prevenção & controle , Glutens/efeitos adversos , Humanos , Imunidade Inata , Proteínas de Plantas/imunologia , Linfócitos T/imunologia , Triticum/efeitos adversos , Triticum/imunologia , Inibidores da Tripsina/efeitos adversos , Inibidores da Tripsina/metabolismo , Aglutininas do Germe de Trigo/efeitos adversos , Aglutininas do Germe de Trigo/metabolismo
12.
Food Chem ; 299: 125161, 2019 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-31323439

RESUMO

Quinoa (Chenopodium quinoa willd.) is an annual herbaceous flowering plant showing appropriate nutritional and functional properties due to its high quality protein with a wide amino acid spectrum, particularly rich in lysine. The mature quinoa seed predominantly consists of 11S-type globulin called chenopodin, comprising about 37% of the total protein, and also 2S albumin accounting for 35% of the seed protein both stabilized through disulfide bridges. Moreover, quinoa seed contains low concentration of prolamins (0.5-7% of total protein) making it suitable for patients with celiac disease. Different enzymatic, chemical and physical modification methods also can influence the structural and finally nutritional and functional properties of protein isolate. Consequently, considering appropriate nutritional and functional properties of quinoa protein, it can be considered as a good candidate to supply human food products.


Assuntos
Chenopodium quinoa/química , Proteínas de Vegetais Comestíveis/química , Aminoácidos/análise , Doença Celíaca/dietoterapia , Dissulfetos/química , Humanos , Proteínas de Plantas/análise , Proteínas de Vegetais Comestíveis/análise , Prolaminas/análise , Sementes/química
13.
Oxid Med Cell Longev ; 2019: 7384193, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31320984

RESUMO

Neutrophil-to-lymphocyte ratio (NLR) has been proposed as a bone loss index in postmenopausal women and as a marker of inflammation in coeliac patients. The aims of this work were to evaluate the effect of gluten-free diet (GFD) on NLR retrospectively and study the relationship between NLR and Mediterranean diet adherence and selected food groups (fruits, vegetables, red meat, potatoes, and unrefined and refined cereals). Adult individuals (n = 50), who had been on a strict GFD by at least 6 months, were recruited. The degree of adherence to the Mediterranean diet was calculated with two different scores: the Mediterranean Diet Score (MDS-14), assessed through the validated 14-item questionnaire of the PREDIMED study, and the MEDScore (Score-55) proposed by Panagiotakos. The latter includes the consumption of unrefined cereals (UC). High percentages of osteopenia and osteoporosis were found within the recruited subjects, who furnished the reports of bone mineral density (BMD), in particular in postmenopausal (Post-M) women. Recent NLR was higher in subjects with osteoporosis compared to osteopenia and normal BMD. However, retrospective analysis showed both increase and decrease in NLR after GFD, with no significant differences between Marsh grade, anemia, and BMD status. Moreover, premenopausal previous pregnancy (Pre-MPP) and Post-M had higher NLR at diagnosis compared to Men and premenopausal (Pre-M), but higher differences were observed in recent NLR between Pre-MPP and Men only. Chocolate consumption was associated with lower recent NLR, whereas the latter was correlated with Score-55, but not with MDS-14. Moreover, refined cereal consumption was correlated with recent NLR. Although large prospective studies are needed in order to clarify the relationship between UC and NLR in coeliac patients, in this pilot study, we have investigated for the first time the relationship between NLR, dietary habit, and osteoporosis in coeliac disease.


Assuntos
Doença Celíaca/sangue , Doença Celíaca/dietoterapia , Dieta Mediterrânea , Linfócitos/metabolismo , Neutrófilos/metabolismo , Adulto , Doença Celíaca/patologia , Feminino , Humanos , Masculino , Projetos Piloto
14.
Postgrad Med ; 131(7): 496-500, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31359810

RESUMO

Objectives: The commonest types of peripheral neuropathy in the context of Coeliac Disease (CD) and gluten sensitivity (GS) are length-dependent symmetrical sensorimotor neuropathies and sensory ganglionopathies. In patients with such neuropathy, (gluten neuropathy), peripheral neuropathic pain is prevalent suggesting involvement of small fibers. The purpose of this report was to describe the clinical characteristics of patients with CD or GS and pure small fiber neuropathy (SFN). Methods: We reviewed the records of all patients that had been referred to the Gluten-Related Neurological Disorders clinic who had clinical and neurophysiological evidence of SFN. All patients had serological evidence of gluten sensitivity (GS) prior to commencing GFD. All patients were offered a duodenum biopsy. Patients with comorbidities that could cause SFN were excluded. Results: We identified 13 patients (9 males) with SFN and gluten sensitivity. Of 11 patients who underwent duodenal biopsy 10 had evidence of enteropathy (CD). Mean age at onset of pain was 53.5 ± 11.4 years (range 34-72) and mean age of CD/GS diagnosis was 50.8 ± 10.4 years (range 34-68). In 8 patients (61.5%) pain was the presenting feature. Neurophysiological assessment suggested a length-dependent small fiber neuropathy in 11 patients, whereas in 2, a non-length dependent pattern was identifying suggesting that the predominant pathology lies in the dorsal root ganglia. Conclusion: SFN can be a presenting feature of CD and GS and, therefore, screening for CD and GS should be included in the diagnostic workup of patients with idiopathic SFN.


Assuntos
Doença Celíaca/fisiopatologia , Condução Nervosa , Neuralgia/fisiopatologia , Neuropatia de Pequenas Fibras/fisiopatologia , Adulto , Idoso , Anticorpos/imunologia , Autoanticorpos/imunologia , Doença Celíaca/complicações , Doença Celíaca/dietoterapia , Doença Celíaca/imunologia , Dieta Livre de Glúten , Feminino , Proteínas de Ligação ao GTP/imunologia , Gliadina/imunologia , Humanos , Imunoglobulina A/imunologia , Imunoglobulina G/imunologia , Masculino , Pessoa de Meia-Idade , Neuralgia/etiologia , Estudos Retrospectivos , Neuropatia de Pequenas Fibras/etiologia , Transglutaminases/imunologia
15.
Nutrients ; 11(8)2019 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-31349675

RESUMO

The prevalence and associated factors of daily life restrictions due to a gluten-free diet in adult celiac disease patients diagnosed in childhood are poorly known. We investigated these issues by collecting the medical data of 955 pediatric patients and sending questionnaires evaluating various health outcomes to the 559 patients who had reached adulthood. Of the 231 respondents, 46% reported everyday life restrictions caused by dietary treatment. Compared with those without restrictions, they more often had anemia at diagnosis (37% vs. 22%, p = 0.014), but the groups were comparable in other diagnostic features. In adulthood, patients with restrictions reported more overall symptoms (32% vs. 17%, p = 0.006), although the symptoms measured with the Gastrointestinal Symptom Rating Scale questionnaire were comparable. Despite strict dietary adherence in both groups, the experience of restrictions was associated with dietary challenges (34% vs. 9%, p < 0.001), health concerns (22% vs. 13%, p = 0.050), and lower vitality scores in the Psychological General Well-Being questionnaire. The groups did not differ in their current age, socioeconomic status, family history of celiac disease, general health or health-related lifestyle, the presence of co-morbidities, or regular follow up. Our results encourage healthcare professionals to discuss the possible health concerns and dietary challenges with patients to avoid unnecessary daily life restrictions, especially when young patients start to take responsibility for their treatment.


Assuntos
Doença Celíaca/dietoterapia , Dieta Livre de Glúten/efeitos adversos , Atividades Cotidianas , Adolescente , Adulto , Doença Celíaca/diagnóstico , Doença Celíaca/epidemiologia , Doença Celíaca/fisiopatologia , Criança , Feminino , Humanos , Masculino , Estado Nutricional , Valor Nutritivo , Cooperação do Paciente , Fatores de Risco , Resultado do Tratamento , Adulto Jovem
17.
Indian J Gastroenterol ; 38(3): 203-210, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31183842

RESUMO

BACKGROUND: Celiac disease (CD) is a lifelong condition with significant morbidity and requires an accurate diagnosis. Guidelines for pediatric CD were revised by the European and British Societies of Paediatric Gastroenterology Hepatology and Nutrition in 2012 and 2013, respectively. New recommendations introduced non-biopsy pathway (NBP) of diagnosis for a selective group of symptomatic children whose anti-tissue transglutaminase (anti-tTG) antibody titer is greater than ten times upper limit of normal. A clear understanding of the guidelines amongst consultant pediatricians will ensure all children with suspected CD receive a prompt and secure diagnosis. The aim of this study was to establish the interpretation and implementation of the revised guideline for CD amongst consultant general pediatricians in Southwest England (SWE) during the study period. METHODS: Telephone/email survey was conducted amongst consultant general pediatricians (n ≈ 140) working in 12 secondary care hospitals across SWE. The survey included eight questions incorporating three main themes: understanding of diagnostic pathway particularly for non-biopsy diagnosis, awareness of laboratory tests involved, and variations in practice in relation to the revised guidelines. RESULTS: Responses were available from 101/140 (72%). One hundred respondents were aware of the revised guidelines for diagnosing CD. However, only 17 respondents stated all the criteria of the guideline required for diagnosis by NBP, with further 17 seeking immediate advice from a specialist. Forty-four listed both the criteria for HLA-DQ2/DQ8 testing applicable to pediatricians. Forty-nine out of 100 pediatricians would commence gluten-free diet only after all the results were available. Thirty-three pediatricians also considered asymptomatic children with high anti-tTG titer eligible for diagnosis of CD by NBP. CONCLUSIONS: There is a need for improved understanding of revised CD guidelines amongst consultant general pediatricians especially while using the NBP and requesting HLA-DQ2/DQ8 testing.


Assuntos
Doença Celíaca/diagnóstico , Gastroenterologia , Conhecimentos, Atitudes e Prática em Saúde , Pediatria , Padrões de Prática Médica , Autoanticorpos/sangue , Doença Celíaca/dietoterapia , Dieta Livre de Glúten , Inglaterra , Proteínas de Ligação ao GTP/imunologia , Testes Genéticos , Antígenos HLA-DQ/genética , Haplótipos , Humanos , Guias de Prática Clínica como Assunto , Inquéritos e Questionários , Transglutaminases/imunologia
20.
Orv Hetil ; 160(25): 980-986, 2019 Jun.
Artigo em Húngaro | MEDLINE | ID: mdl-31203642

RESUMO

Introduction and aim: With the rising consumer's health awareness, especially towards patients with celiac disease, gluten has become a food ingredient to be avoided by many people expecting various positive health effects. The strict adherence of diet requires serious abandonments and lifestyle changes that affect directly their quality of life. The aim of the present study was to recognise the quality of life of Hungarian and Romanian consumers following a gluten-free diet as well as to explore the negative effects on them. Method: An online questionnaire survey was conducted upon 1155 Hungarian and Romanian respondents. Results: For gluten-free consumers, self-control was relatively easy to overcome, but their lifestyle was negatively affected by social events and dining out. In addition, diet adherence was a burden from both lifestyle and financial point of view. For Hungarian consumers, external factors such as price, choice, taste and availability of products had become a major obstacle, while Romanian ones were more likely to be affected by internal factors (product information, diet knowledge, lifestyle, self-control). Mandatory labelling of substances and products causing allergies and intolerances has achieved its purpose, as it has made it easier for consumers on diet to choose food and increased their confidence. Conclusions: The study points out that dieters' quality of life can be enhanced not only by general actions (improving the preparedness of out-of-home meal services and rationalising the price of products), but also through country-specific community intervention. Orv Hetil. 2019; 160(25): 980-986.


Assuntos
Doença Celíaca/dietoterapia , Dieta Livre de Glúten/psicologia , Qualidade de Vida , Adulto , Doença Celíaca/diagnóstico , Doença Celíaca/epidemiologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Hungria/epidemiologia , Masculino , Romênia/epidemiologia , Inquéritos e Questionários
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