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1.
Arq Gastroenterol ; 57(1): 107-109, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32294744

RESUMO

BACKGROUND: Celiac disease (CD) is a chronic enteropathy in response to ingestion of gluten. CD was associated with gynecological disorders. OBJECTIVE: In this retrospective study, we aimed to investigate the age of menarche, age of menopause, number of pregnancies and abortions in Brazilian celiac patients. METHODS: We studied 214 women diagnosed with CD and as control group 286 women were investigated. RESULTS: Regarding the mean age of menarche, a significant difference was found (12.6±1.40 in CD and 12.8±1.22 years in healthy group; P=0.04). Regarding abortions, in CD women 38/214 (17.8%) and 28/286 (9.8%) in the control group reported abortion (P=0.0092, OR:1.98; CI95%=1.1- 3.3). There was no significant difference in the mean age of menopause nor number of pregnancies per woman. CONCLUSION: In this study, we found that celiac women had a higher mean age of menarche and higher risk of spontaneous abortions.


Assuntos
Aborto Espontâneo/fisiopatologia , Doença Celíaca/fisiopatologia , Menarca/fisiologia , Menopausa/fisiologia , Paridade/fisiologia , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
2.
Medicina (Kaunas) ; 55(7)2019 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-31311098

RESUMO

Celiac disease (CD) is a systemic autoimmune disease driven by gluten-ingestion in genetically predisposed individuals. Although it primarily affects the small bowel, CD can also involve other organs and manifest as an extraintestinal disease. Among the extraintestinal features of CD, hematologic ones are rather frequent and consist of anemia, thrombocytosis (thrombocytopenia also, but rare), thrombotic or hemorrhagic events, IgA deficiency, hyposplenism, and lymphoma. These hematologic alterations can be the sole manifestation of the disease and should prompt for CD testing in a suggestive clinical scenario. Recognition of these atypical, extraintestinal presentations, including hematologic ones, could represent a great opportunity to increase the diagnostic rate of CD, which is currently one of the most underdiagnosed chronic digestive disorders worldwide. In this review, we summarize recent evidence regarding the hematological manifestations of CD, with focus on practical recommendations for clinicians.


Assuntos
Doença Celíaca/complicações , Doenças Hematológicas/etiologia , Anemia/etiologia , Anemia/fisiopatologia , Doença Celíaca/fisiopatologia , Doenças Hematológicas/fisiopatologia , Humanos , Deficiência de IgA/etiologia , Deficiência de IgA/fisiopatologia , Linfoma/etiologia , Linfoma/fisiopatologia
3.
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
4.
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
5.
Pan Afr Med J ; 32: 25, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31143330

RESUMO

A young emaciated male, known case of celiac disease came with complaints of diarrhea along with 5kgs of weight loss in 3 months' time. He had severe electrolyte abnormalities along with low albumin, low calcium and a high phosphate with deranged liver function test. Ultrasound abdomen had shown fatty liver. Nutrition consult was sought and he was found to have a BMI of 6.8kg/m2. He was started on nutrition support along with supportive therapy, which resulted in weight gain and improvement in his condition.


Assuntos
Doença Celíaca/fisiopatologia , Emaciação/etiologia , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Terapia Nutricional/métodos , Diarreia/etiologia , Emaciação/terapia , Humanos , Masculino , Hepatopatia Gordurosa não Alcoólica/terapia , Perda de Peso , Adulto Jovem
6.
Gastroenterology ; 156(8): 2217-2229, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30836095

RESUMO

BACKGROUND & AIMS: The intestinal microbiota is believed to be involved in the pathogenesis of celiac disease, in addition to genetic variants and dietary gluten. The gut microbiota is strongly influenced by systemic antibiotics-especially in early life. We explored the association between exposure to a systemic antibiotic in the first year of life and risk of diagnosed celiac disease. METHODS: We performed an observational nationwide register-based cohort study. We included all children born in Denmark from 1995 through 2012 or Norway from 2004 through 2012. Children born in Denmark were followed until May 8, 2015 (age at end of follow-up was 2.3-20.3 years) and children born in Norway were followed until December 31, 2013 (age at end of follow-up was 1-10 years). We collected medical information from more than 1.7 million children, including 3346 with a diagnosis of celiac disease. Exposure to systemic antibiotics was defined as a dispensed systemic antibiotic in the first year of life. RESULTS: Exposure to systemic antibiotics in the first year of life was positively associated with diagnosed celiac disease in the Danish and Norwegian cohorts (pooled odds ratio 1.26, 95% confidence interval 1.16-1.36). We found a dose-dependent relation between an increasing number of dispensed antibiotics and the risk of celiac disease (pooled odds ratio for each additional dispensed antibiotic 1.08, 95% confidence interval 1.05-1.11). No specific type of antibiotic or age period within the first year of life was prominent. Adjustment for hospital admissions with an infectious disease in the first year of life did not change the estimates; adjustment for the number of maternally reported infections in the child in 2 large sub-cohorts decreased the association slightly (pooled odds ratio 1.18, 95% confidence interval 0.98-1.39). CONCLUSION: In a nationwide study of children in Denmark and Norway, we found exposure to systemic antibiotics in the first year of life to be associated with a later diagnosis of celiac disease. These findings indicate that childhood exposure to systemic antibiotics could be a risk factor for celiac disease.


Assuntos
Idade de Início , Antibacterianos/efeitos adversos , Doença Celíaca/induzido quimicamente , Doença Celíaca/epidemiologia , Microbioma Gastrointestinal/efeitos dos fármacos , Sistema de Registros , Fatores Etários , Antibacterianos/uso terapêutico , Doença Celíaca/fisiopatologia , Criança , Pré-Escolar , Estudos de Coortes , Dinamarca , Feminino , Humanos , Incidência , Lactente , Masculino , Noruega , Modelos de Riscos Proporcionais , Estudos Prospectivos , Medição de Risco , Índice de Gravidade de Doença
7.
Nutrients ; 11(2)2019 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-30717318

RESUMO

Celiac disease patients may suffer from a number of extra-intestinal diseases related to long-term gluten ingestion. The diagnosis of celiac disease is based on the presence of a manifest small intestinal mucosal lesion. Individuals with a normal biopsy but an increased risk of developing celiac disease are referred to as potential celiac disease patients. However, these patients are not treated. This review highlights that patients with normal biopsies may suffer from the same extra-intestinal gluten-induced complications before the disease manifests at the intestinal level. We discuss diagnostic markers revealing true potential celiac disease. The evidence-based medical literature shows that these potential patients, who are "excluded" for celiac disease would in fact benefit from gluten-free diets. The question is why wait for an end-stage disease to occur when it can be prevented? We utilize research on dermatitis herpetiformis, which is a model disease in which a gluten-induced entity erupts in the skin irrespective of the state of the small intestinal mucosal morphology. Furthermore, gluten ataxia can be categorized as its own entity. The other extra-intestinal manifestations occurring in celiac disease are also found at the latent disease stage. Consequently, patients with celiac traits should be identified and treated.


Assuntos
Doença Celíaca , Glutens , Biópsia , Doença Celíaca/complicações , Doença Celíaca/patologia , Doença Celíaca/fisiopatologia , Dermatite Herpetiforme , Glutens/efeitos adversos , Glutens/imunologia , Humanos , Mucosa Intestinal/patologia , Mucosa Intestinal/fisiopatologia , Intestino Delgado/patologia , Intestino Delgado/fisiopatologia
8.
Cell ; 176(5): 967-981.e19, 2019 02 21.
Artigo em Inglês | MEDLINE | ID: mdl-30739797

RESUMO

Tissue-resident lymphocytes play a key role in immune surveillance, but it remains unclear how these inherently stable cell populations respond to chronic inflammation. In the setting of celiac disease (CeD), where exposure to dietary antigen can be controlled, gluten-induced inflammation triggered a profound depletion of naturally occurring Vγ4+/Vδ1+ intraepithelial lymphocytes (IELs) with innate cytolytic properties and specificity for the butyrophilin-like (BTNL) molecules BTNL3/BTNL8. Creation of a new niche with reduced expression of BTNL8 and loss of Vγ4+/Vδ1+ IELs was accompanied by the expansion of gluten-sensitive, interferon-γ-producing Vδ1+ IELs bearing T cell receptors (TCRs) with a shared non-germline-encoded motif that failed to recognize BTNL3/BTNL8. Exclusion of dietary gluten restored BTNL8 expression but was insufficient to reconstitute the physiological Vγ4+/Vδ1+ subset among TCRγδ+ IELs. Collectively, these data show that chronic inflammation permanently reconfigures the tissue-resident TCRγδ+ IEL compartment in CeD. VIDEO ABSTRACT.


Assuntos
Doença Celíaca/imunologia , Inflamação/imunologia , Receptores de Antígenos de Linfócitos T gama-delta/imunologia , Antígenos , Butirofilinas/metabolismo , Doença Celíaca/fisiopatologia , Doença Crônica , Dieta Livre de Glúten , Glutens/metabolismo , Células HEK293 , Humanos , Inflamação/metabolismo , Mucosa Intestinal/imunologia , Linfócitos Intraepiteliais/imunologia , Linfócitos Intraepiteliais/metabolismo , Receptores de Antígenos de Linfócitos T/imunologia , Receptores de Antígenos de Linfócitos T/metabolismo , Receptores de Antígenos de Linfócitos T gama-delta/metabolismo
9.
Gastroenterol Clin North Am ; 48(1): 19-37, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30711209

RESUMO

The presentation in celiac disease is shifting from the classical malabsorptive presentation to more nonclassical presentations, requiring clinicians to maintain a high level of suspicion for the disease and to be aware of the possible extraintestinal manifestations. The diagnosis of celiac disease is guided by initial screening with serology, followed by confirmation with an upper endoscopy and small intestinal biopsy. In some pediatric cases, biopsy may be avoided.


Assuntos
Biópsia , Doença Celíaca/diagnóstico , Doença Celíaca/fisiopatologia , Testes Sorológicos , Adulto , Doença Celíaca/patologia , Criança , Antígenos HLA-DQ , Humanos , Deficiência de IgA , Intestino Delgado/patologia
10.
Gastroenterol Clin North Am ; 48(1): 53-72, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30711211

RESUMO

Celiac disease (CD) is an autoimmune-related disease causing inflammation in the small intestine triggered by the ingestion of gluten in the diet. The gluten-free diet (GFD) is the only treatment. Nutritional deficiencies of macronutrients and micronutrients are frequently found in untreated or newly diagnosed CD. A registered dietitian nutritionist is uniquely qualified to educate on the GFD and assess and support nutritional status at diagnosis and long term as well as helping patients with nonresponsive CD. Quality of life is important to address in individuals with CD because the GFD affects all aspects of life.


Assuntos
Doença Celíaca/dietoterapia , Doença Celíaca/fisiopatologia , Dieta Livre de Glúten , Fenômenos Fisiológicos da Nutrição , Doença Celíaca/diagnóstico , Doença Celíaca/etiologia , Microbioma Gastrointestinal , Humanos , Intestino Delgado/microbiologia , Desnutrição , Estado Nutricional , Nutricionistas , Educação de Pacientes como Assunto , Papel Profissional , Qualidade de Vida
11.
Gastroenterology ; 156(8): 2266-2280, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30802444

RESUMO

BACKGROUND & AIMS: Wheat-related disorders, a spectrum of conditions induced by the ingestion of gluten-containing cereals, have been increasing in prevalence. Patients with celiac disease have gluten-specific immune responses, but the contribution of non-gluten proteins to symptoms in patients with celiac disease or other wheat-related disorders is controversial. METHODS: C57BL/6 (control), Myd88-/-, Ticam1-/-, and Il15-/- mice were placed on diets that lacked wheat or gluten, with or without wheat amylase trypsin inhibitors (ATIs), for 1 week. Small intestine tissues were collected and intestinal intraepithelial lymphocytes (IELs) were measured; we also investigated gut permeability and intestinal transit. Control mice fed ATIs for 1 week were gavaged daily with Lactobacillus strains that had high or low ATI-degrading capacity. Nonobese diabetic/DQ8 mice were sensitized to gluten and fed an ATI diet, a gluten-containing diet or a diet with ATIs and gluten for 2 weeks. Mice were also treated with Lactobacillus strains that had high or low ATI-degrading capacity. Intestinal tissues were collected and IELs, gene expression, gut permeability and intestinal microbiota profiles were measured. RESULTS: In intestinal tissues from control mice, ATIs induced an innate immune response by activation of Toll-like receptor 4 signaling to MD2 and CD14, and caused barrier dysfunction in the absence of mucosal damage. Administration of ATIs to gluten-sensitized mice expressing HLA-DQ8 increased intestinal inflammation in response to gluten in the diet. We found ATIs to be degraded by Lactobacillus, which reduced the inflammatory effects of ATIs. CONCLUSIONS: ATIs mediate wheat-induced intestinal dysfunction in wild-type mice and exacerbate inflammation to gluten in susceptible mice. Microbiome-modulating strategies, such as administration of bacteria with ATI-degrading capacity, may be effective in patients with wheat-sensitive disorders.


Assuntos
Doença Celíaca/imunologia , Dieta Livre de Glúten/métodos , Gliadina/efeitos adversos , Lactobacillus/imunologia , Triticum/efeitos adversos , Amilases/antagonistas & inibidores , Animais , Doença Celíaca/dietoterapia , Doença Celíaca/fisiopatologia , Modelos Animais de Doenças , Microbioma Gastrointestinal/imunologia , Gliadina/imunologia , Humanos , Imunidade Inata/efeitos dos fármacos , Lactobacillus/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , Distribuição Aleatória , Valores de Referência , Sensibilidade e Especificidade , Triticum/imunologia , Inibidores da Tripsina/imunologia , Inibidores da Tripsina/farmacologia
12.
Nat Rev Dis Primers ; 5(1): 3, 2019 01 10.
Artigo em Inglês | MEDLINE | ID: mdl-30631077

RESUMO

Coeliac disease is an immune-mediated enteropathy against dietary gluten present in wheat, rye and barley and is one of the most common lifelong food-related disorders worldwide. Coeliac disease is also considered to be a systemic disorder characterized by a variable combination of gluten-related signs and symptoms and disease-specific antibodies in addition to enteropathy. The ingestion of gluten leads to the generation of harmful gluten peptides, which, in predisposed individuals, can induce adaptive and innate immune responses. The clinical presentation is extremely variable; patients may have severe gastrointestinal symptoms and malabsorption, extraintestinal symptoms or have no symptoms at all. Owing to the multifaceted clinical presentation, diagnosis remains a challenge and coeliac disease is heavily underdiagnosed. The diagnosis of coeliac disease is achieved by combining coeliac disease serology and small intestinal mucosal histology during a gluten-containing diet. Currently, the only effective treatment for coeliac disease is a lifelong strict gluten-free diet; however, the diet is restrictive and gluten is difficult to avoid. Optimizing diagnosis and care in coeliac disease requires continuous research and education of both patients and health-care professionals.


Assuntos
Doença Celíaca/dietoterapia , Doença Celíaca/diagnóstico , Doença Celíaca/fisiopatologia , Dieta Livre de Glúten/métodos , Humanos , Mucosa Intestinal/anormalidades , Mucosa Intestinal/patologia , Poaceae/efeitos adversos , Qualidade de Vida/psicologia , Fatores de Risco , Triticum/efeitos adversos
13.
Gastroenterol Nurs ; 42(1): 41-48, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30688706

RESUMO

Recent statistics report that 3 million people, or 1% of the population in the United States (U.S.), are affected by celiac disease (CD). In addition, in the U.S., as many as 1 in 80 children is affected with CD. However, CD can be challenging to diagnose and many children are not correctly diagnosed or live without a diagnosis for several years. Symptoms, if present, are often nonspecific and may be common manifestations of many pediatric illnesses. The purpose of this review is to examine the current evidence regarding incidence, pathophysiology, diagnosis, and treatment of a child with CD. Clinical implications for nurses caring for children and families are discussed.


Assuntos
Doença Celíaca/diagnóstico , Doença Celíaca/terapia , Algoritmos , Doença Celíaca/fisiopatologia , Criança , Humanos , Avaliação de Sintomas
14.
J Int Med Res ; 47(2): 815-822, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30477370

RESUMO

OBJECTIVE: Celiac disease (CD) is an autoimmune disorder associated with numerous health problems, including reproductive disorders. This study was performed to analyze the association between CD and the menstrual cycle in a group of patients with CD and compare these patients' characteristics with those of healthy women. METHODS: The study included 145 patients with CD (age, 15-51 years) and 162 healthy women (age, 18-55 years). Age at menarche and characteristics of the menstrual cycle were obtained by an anonymous questionnaire developed for the study. RESULTS: The age at onset of menarche was 12 to 14 years in 72.9% of the patients with CD and 77.3% of the healthy controls. For most patients (74.2%), the length of the menstrual cycle was around 27 to 28 days with 4 to 5 days of bleeding. Furthermore, 8.4% of patients versus 5.9% of controls experienced bleeding between cycles. CONCLUSIONS: Our results suggest that in Slovenia, the age at menarche in patients with CD is 12.7 years, which is comparable with that in healthy women. We conclude that CD (treated or untreated) may not be associated with late menarche.


Assuntos
Doença Celíaca/epidemiologia , Doença Celíaca/fisiopatologia , Menarca , Adolescente , Adulto , Fatores Etários , Idade de Início , Estudos de Casos e Controles , Criança , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Eslovênia/epidemiologia , Adulto Jovem
18.
Minerva Pediatr ; 71(2): 139-143, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27830928

RESUMO

BACKGROUND: Celiac disease (CD) is an immunologically-mediated enteropathy resulting in small-bowel mucosal villous atrophy with crypt hyperplasia. Iron malabsorption is usually observed in CD. Only few studies investigated oral iron absorption in subjects with gastrointestinal diseases and Iron Deficiency Anemia (IDA), using the oral iron absorption test (OIAT). We considered useful to investigate the OIAT, using ferrous bisglycinate chelate (FBC), in patients with CD at diagnosis or on gluten free diet (GFD) from at least 1 year. METHODS: A total of 25 patients with CD (3-18 years old) and iron depletion, at diagnosis of CD (N.=12) or on GFD from at least 12 months (N.=13), were considered. Serum iron was evaluated at baseline (T0) and after 3 hours (T1) from the oral iron ingestion. Statistical analyses were conducted using SPSS 21.0 software for Mac. RESULTS: OIAT was well tolerated by all patients. An important increase of the serum iron at T1, of at least twice the baseline values, occurred in all patients except in one (P value <0.0005). CONCLUSIONS: These results demonstrated good efficacy of the FBC, not only in patients with CD on GFD but also in children with newly diagnosed CD with the characteristic intestinal lesions.


Assuntos
Anemia Ferropriva/etiologia , Doença Celíaca/fisiopatologia , Dieta Livre de Glúten , Compostos Ferrosos/administração & dosagem , Glicina/administração & dosagem , Administração Oral , Adolescente , Doença Celíaca/complicações , Doença Celíaca/dietoterapia , Criança , Pré-Escolar , Feminino , Compostos Ferrosos/farmacocinética , Glicina/farmacocinética , Humanos , Masculino
19.
Med Hypotheses ; 122: 150-156, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30593401

RESUMO

The review aims at providing current state of evidence in the field of medicine with fuzzy logic for diagnosing diseases. Literature reveals that fuzzy logic has been used effectively in medicine. Different types of methodologies have been applied to diagnose the diseases based on symptoms, historical and clinical data of an individual. Increase in the number of recent applications of medicine with fuzzy-logic is an indication of growing popularity of fuzzy systems. Fuzzy intelligent systems developed during 2007-2018 have been studied to explore various techniques applied for disease prediction. In the traditional approach, a physician is required to diagnose disease based on historical and clinical data but the intelligent system will help physicians as well as individuals to detect disease at any location of the world. The studies of various fuzzy logic systems and classified fuzzy logic applications in the field of diabetes, iris, heart, breast cancer, dental, cholera, brain tumor, liver, asthma, viral, parkinson, lung, kidney, huntington and chest diseases have been included in the review. This study indicates all the benefits of the fuzzy logic to the society and direction to tackle the diseases that still need software for their accurate detection. Further, different case studies for celiac disease have been reported earlier. The current review aims at exploring the future direction for fuzzy methodologies and domain on celiac disease.


Assuntos
Doença Celíaca/fisiopatologia , Diabetes Mellitus/fisiopatologia , Lógica Fuzzy , Algoritmos , Biópsia , Doença Crônica , Humanos , Distribuição Normal , Software
20.
Artigo em Inglês | MEDLINE | ID: mdl-30033882

RESUMO

BACKGROUND AND OBJECTIVE: Coeliac disease (CD) is a chronic autoimmune intestinal disorder characterized by intolerance to gluten, a protein contained in certain cereals. The main physiopathological basis of CD is the progressive destruction of intestinal villi caused by gluten ingestion by genetically-susceptible individuals. Patients who receive a diagnosis of CD must make significant changes to their daily habits and this can affect their quality of life. The objective of this review is to summarize the evidence regarding the economic, physical and social limitations which can affect the quality of life in patients with CD. RESULTS: Different factors such as physical changes, psychological effects, interpersonal relationships, emotions and economic difficulties can affect the quality of life of these patients. Observations suggest that, in general, women with CD experience a greater deterioration in their quality of life than men. Lastly, complications in daily life are also associated with the reduced availability of gluten-free products which also usually cost more than standard products. CONCLUSIONS: Continuous health education and care regarding socio-economic issues should be continuously developed and provided to people with CD.


Assuntos
Doença Celíaca/epidemiologia , Doença Celíaca/psicologia , Qualidade de Vida , Doença Celíaca/economia , Doença Celíaca/fisiopatologia , Efeitos Psicossociais da Doença , Dieta Livre de Glúten/economia , Feminino , Humanos , Masculino , Qualidade de Vida/psicologia , Fatores Socioeconômicos
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