Navegando por Palavras-chave "Celiac disease"
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- ItemAcesso aberto (Open Access)Anti-tissue transglutaminase antibodies (IgA and IgG) in both Crohn's disease and autoimmune diabetes(Aran Ediciones, S A, 2011-09-01) Cabral, Virginia Lucia Ribeiro [UNIFESP]; Patricio, Francy Reis da Silva [UNIFESP]; Ambrogini-Junior, Orlando [UNIFESP]; Miszputen, Sender Jankiel [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: a strong association has been observed between celiac disease, generally its silent clinical form, and autoimmune disorders. A potential correlation with inflammatory bowel disease has also been suggested. Anti-tissue transglutaminase antibodies have been detected in Crohn's disease. We investigated the prevalence of celiac disease in patients with autoimmune diabetes and in Crohn's disease patients and also evaluated the correlation between anti-transglutaminase antibody positivity and the clinical status of these diseases.Methods: anti-tissue transglutaminase and anti-endomysium antibodies were assessed by enzyme-linked immunosorbent assay and indirect immunofluorescence, respectively. Upper digestive endoscopy and duodenal biopsy were indicated for cases with positive serology.Results: anti-transglutaminase antibodies were detected in five diabetic patients (prevalence of 11.1%). only one serum sample was positive for IgG isotypes. Nine of thirty-three patients with Crohn's disease had low positive levels for IgA anti-transglutaminase. Anti-endomysium antibodies were detected only in celiac patients. Celiac disease was confirmed in all diabetic patients submitted to duodenal biopsies who presented both anti-transglutaminase and anti-endomisyum antibodies positivity. In Crohn's disease, its clinical status and the diagnosis of celiac disease were not associated with positive anti-transglutaminase result.Conclusions: the prevalence of celiac disease was high in diabetic patients. Anti-tissue transglutaminase antibodies were sensitive and specific markers of celiac disease in this diabetic group, while these antibodies were of limited value for celiac disease screening in patients with Crohn's disease.
- ItemSomente MetadadadosArtificial intelligence techniques applied to the development of a decision-support system for diagnosing celiac disease(Elsevier B.V., 2011-11-01) Tenorio, Josceli Maria [UNIFESP]; Hummel, Anderson Diniz; Cohrs, Frederico Molina [UNIFESP]; Sdepanian, Vera Lucia [UNIFESP]; Pisa, Ivan Torres; Marine, Heimar de Fatima; Universidade Federal de São Paulo (UNIFESP)Background: Celiac disease (CD) is a difficult-to-diagnose condition because of its multiple clinical presentations and symptoms shared with other diseases. Gold-standard diagnostic confirmation of suspected CD is achieved by biopsying the small intestine.Objective: To develop a clinical decision-support system (CDSS) integrated with an automated classifier to recognize CD cases, by selecting from experimental models developed using intelligence artificial techniques.Methods: A web-based system was designed for constructing a retrospective database that included 178 clinical cases for training. Tests were run on 270 automated classifiers available in Weka 3.6.1 using five artificial intelligence techniques, namely decision trees, Bayesian inference, k-nearest neighbor algorithm, support vector machines and artificial neural networks. the parameters evaluated were accuracy, sensitivity, specificity and area under the ROC curve (AUC). AUC was used as a criterion for selecting the CDSS algorithm. A testing database was constructed including 38 clinical CD cases for CDSS evaluation. the diagnoses suggested by CDSS were compared with those made by physicians during patient consultations.Results: the most accurate method during the training phase was the averaged one-dependence estimator (AODE) algorithm (a Bayesian classifier), which showed accuracy 80.0%, sensitivity 0.78, specificity 0.80 and AUC 0.84. This classifier was integrated into the web-based decision-support system. the gold-standard validation of CDSS achieved accuracy of 84.2% and k = 0.68 (p < 0.0001) with good agreement. the same accuracy was achieved in the comparison between the physician's diagnostic impression and the gold standard k = 0. 64 (p < 0.0001). There was moderate agreement between the physician's diagnostic impression and CDSS k = 0.46 (p = 0.0008).Conclusions: the study results suggest that CDSS could be used to help in diagnosing CD, since the algorithm tested achieved excellent accuracy in differentiating possible positive from negative CD diagnoses. This study may contribute towards developing of a computer-assisted environment to support CD diagnosis. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
- ItemAcesso aberto (Open Access)Avaliação nutricional e consumo alimentar de pacientes com doença celíaca com e sem transgressão alimentar(Pontifícia Universidade Católica de Campinas, 2013-06-01) Andreoli, Cristiana Santos; Cortez, Ana Paula Bidutte; Sdepanian, Vera Lucia [UNIFESP]; Morais, Mauro Batista de [UNIFESP]; Instituto Federal de Ouro Preto; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: This study evaluated the nutritional status and intakes of energy and macronutrients of celiac disease patients compliant or not with a gluten-free diet. METHODS: We studied 63 patients with celiac disease, 34 children and 29 adolescents. Noncompliance with a gluten-free diet was characterized by detection of antibodies to tissue transglutaminase in serum by recombinant human tissue transglutaminase antigen. Nutritional status was classified according to the weight-for-age, height-for-age, and body mass index Z-scores. Dietary intake was assessed by a 24-hour recall. RESULTS: The percentages of children and adolescents noncompliant with a gluten-free diet were 41.2% and 34.5%, respectively. Noncompliant children had a lower mean height-for-age Z-score than compliant children (p=0.024). However, noncompliant children had higher mean body mass index Z-score than compliant children (p=0.021). On the other hand, compliant adolescents had higher BMI than noncompliant adolescents (p=0.037). The food intake between the groups did not differ, but the energy intakes of 70.0% of the children and adolescents exceeded 120.0% of their requirements. CONCLUSION: Children who do not comply with a gluten-free diet have lower height-for-age Z-scores and higher body mass index Z-scores than children who comply. Compliant adolescents have a higher mean body mass index than noncompliant adolescents. High energy intake was observed in both children and adolescents.
- ItemAcesso aberto (Open Access)Doença celíaca: avaliação da obediência à dieta isenta de glúten e do conhecimento da doença pelos pacientes cadastrados na Associação dos Celíacos do Brasil (ACELBRA)(Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED, 2001-10-01) Sdepanian, Vera Lucia [UNIFESP]; Morais, Mauro Batista de [UNIFESP]; Fagundes-neto, Ulysses [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Background The compliance to a gluten-free diet may prevent the development of both non-malignant and malignant complications. Aim - To evaluate compliance to a gluten-free diet and knowledge of the disease in celiac patients registered at the Brazilian Celiac Association (BCA). Methods - A structured questionnaire was designed to assess compliance to a gluten-free diet as well as knowledge of the celiac disease. It was mailed to 584 members of BCA. Results - Five hundred and twenty nine (90.6%) of a total of 534 (91.4%) answered questionnaires were analyzed; 69.4% were classified as compliant patients whereas 29.5% were classified as noncompliant. The proportion of patients age 21 or older who consume gluten frequently or without any restriction is larger (17.7%) than those who were younger than 21 years (9.9%). Frequency of dietary compliance was higher when the diagnosis had taken less than 5 years to be established; 82% of the patients replied that the small intestine was the part of the body affected by the disease. The most common symptoms of the disease according to the answers were diarrhea (96.6%), weight loss (93.4%), protuberant abdomen (90.4%), anemia (68.1%) and vomiting (59.6%). Only 59.0% agreed with the existence of genetic predisposition; 90.4% answered that the disease is permanent and 96.2% stated that the diet should exclude gluten absolutely; 67.1% answered that the gluten is a protein and according to 92.1% questionnaires this protein is present in wheat, rye, barley and oat. Greater compliance was observed when there was an understanding of the disease and diet. The small intestine biopsy was considered necessary for just 67.5% of the patients, and greater compliance was observed in patients who had undergone at least one small intestine biopsy. Conclusion - Our findings indicate that the more the patients know and understand about the disease, the better able they are to comply with the diet.
- ItemAcesso aberto (Open Access)Frequência de sensibilização ao trigo, centeio, cevada e malte em crianças e adolescentes com doença celíaca de um ambulatório de referência(Universidade Federal de São Paulo (UNIFESP), 2016-03-10) Lanzarin, Camila Marques de Valois [UNIFESP]; Sdepanian, Vera Lucia [UNIFESP]; http://lattes.cnpq.br/8273324982105660; http://lattes.cnpq.br/0326962491983147; Universidade Federal de São Paulo (UNIFESP)Objective: Evaluate the frequency of sensitization to wheat, rye, barley, malt and milk by specific IgE dosage in children and adolescents with celiac disease. Methods: Mensured specific IgE serum levels to wheat, rye, barley, malt and milk. (sensitization IgE?0.35 kUA/L) in patients with celiac disease from specialized center and verified, through medical records, history of atopy, characteristic of small intestinal biopsy at the diagnosis and history of transgressions to the gluten-free diet and symptoms and general characteristics. Results: Evaluated 74 patients with celiac disease, 55.4% were female, median age at diagnosis of 8.6 years (5.0-12.8) and 3.6 years (1.6-7.0), respectively The median of gluten-free diet time was 3.5 years (1.4-5.8). History of asthma was present in 17.3%, allergic rhinitis in 13.5%, atopic dermatitis in 5.4% and food allergy in 8,1%. Frequency of sensitization was 4.0% wheat, 10.8% rye, 5.4% barley, 2.7% malt and 20.3% milk. There was no statistically significant difference in the sensitization proportion of wheat, rye, barley and malt compared between each other. There was no association between the sensitization to wheat and the age at diagnosis, age at blood sample, time of gluten free diet, characteristic of small intestinal biopsy at diagnosis, short stature (and thinness at the diagnosis and at blood sample, history of atopy and transgression to the diet. The transgression of the diet was present in 60.8% of the sample. There was no relationship between sensitization to wheat and the occurrence of immediate symptoms when transgression of the gluten-free diet. Conclusion: The frequency of sensitization to wheat was low - 4% - similar to general population. The frequency of sensitization to rye, barley, malt and milw was 10.8%, 5.4%, 2.7% and 20.3% milk, retrospectively.
- ItemAcesso aberto (Open Access)Massas alimentícias sem glúten: uma análise multivariada de informações nutricionais, ingredientes e aditivos expressos nos rótulos(Universidade Federal de São Paulo, 2023-01-06) Manfré, Daniela Leandro [UNIFESP]; Sinnecker, Patrícia [UNIFESP]; Meza, Silvia Letícia Rivero; http://lattes.cnpq.br/6047376992510357; http://lattes.cnpq.br/2985373783444597A doença celíaca é um tipo de intolerância alimentar permanente ao glúten em indivíduos geneticamente susceptíveis, caracterizada por atrofia total ou parcial das microvilosidades do intestino delgado provocando má absorção dos nutrientes da dieta. A substituição de ingredientes em produtos alimentícios sem glúten, principalmente em massas, produtos de panificação, cereais matinais e outros, requer o uso de aditivos para manter as propriedades tecnológicas de textura, viscosidade, consistência, elasticidade, gomosidade, estabilidade. Massas alimentícias sem glúten tem sido um segmento de significativo crescimento e diversidade de produtos para essa parcela de consumidores que muitas vezes não têm muita opção de produtos sem glúten com qualidade nutricional e sensorial aceitável. O objetivo deste trabalho foi fazer uma análise comparativa de massas alimentícias sem glúten (MSG) disponíveis no mercado, através de uma análise estatística multivariada das informações contidas nos rótulos sobre as informações nutricionais, ingredientes e aditivos. A análise mostrou uma ampla diversidade de possibilidades de substitutos de glúten em massas alimentícias, tais como arroz, milho, mandioca, batata, grão de bico, amaranto, feijão, lentilha, isolados ou combinados, assim como uso de cenoura, espinafre, cúrcuma, urucum, beterraba, ovo e o uso de aditivos, como agentes de textura com propriedades hidrocoloides, tais como as gomas. A busca por misturas de ingredientes e aditivos na substituição do glúten pode resultar em MSG com qualidade tecnológica e sensoriais aceitáveis e ainda melhorar significativamente a qualidade nutricional, elevando o teor de proteínas, fibras, vitaminas, minerais e ainda aportando compostos bioativos naturais com efeitos benéficos à saúde. A diversificação de MSG traz inúmeros produtos com qualidade sensorial, mas é muito importante a comparação e compreensão dos rótulos para orientar escolhas mais saudáveis de alimentação, principalmente para consumidores portadores de doença celíaca, cuja dieta já é normalmente pobre em nutrientes.
- ItemSomente MetadadadosNovel Approaches in Gluten-Free Breadmaking: Interface between Food Science, Nutrition, and Health(Wiley-Blackwell, 2014-09-01) Capriles, Vanessa Dias [UNIFESP]; Arêas, José Alfredo Gomes; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)The evidence that celiac disease is one of the commonest food intolerances in the world is driving an increasing demand for gluten-free foods. However, gluten is a structure-building protein essential for formulating leavened baked goods. Therefore, obtaining high-quality gluten-free bread (GFB) is a technological challenge. This review focuses on contemporary approaches in gluten-free baking that allow improvements at the structure, texture, acceptability, nutritive value, and shelf life of GFB. Gluten-free breadmaking is a relatively new, emerging research topic that is attracting worldwide attention in order to develop different kinds of GFB, including regional varieties. Several approaches have been used to understand and improve GFB systems by evaluating different flours and starch sources, ingredients added for nutritional purposes, additives, and technologies or a combination of these elements. Some studies aimed to assess or improve GFB's technological or nutritional properties, while others had multiple objectives. Several studies used food science tools in order to improve technological and sensory quality of GFB, together with nutritional value. Some GFBs are vehicles of nutrients and bioactive compounds. Furthermore, extensive research on interfacing food science, nutrition, and health is needed so that a GFB with both good technological and nutritional properties can be prepared and made more available to those with celiac disease, which will help them adhere to a strict gluten-free diet, increase social inclusion, and improve their quality of life.
- ItemAcesso aberto (Open Access)Pesquisa de gliadina em medicamentos: informação relevante para a orientação de pacientes com doença celíaca(Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED, 2001-09-01) Sdepanian, Vera Lucia [UNIFESP]; Scaletsky, Isabel Cristina Affonso [UNIFESP]; Morais, Mauro Batista de [UNIFESP]; Fagundes-neto, Ulysses [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Background Some drugs might contain gliadin which can be dangerous for celiac disease patients. Objective - Detect gliadin in pharmaceutical products commonly used in Brazil. Methods - We analyzed 78 pharmaceutical products selected aleatory from a list of 180 products most frequently sold at Brazilian community pharmacies. The analyzed samples were analgesics (n = 9), anthelmintics (n = 3), antiacids (n = 8), antibiotics (n = 13), anticolesterolemics (n = 1), anticonvulsants (n = 2), antidepressants (n = 2), antiemetics (n = 3), antihipertensives (n = 3), antihistaminics (n = 3), anti-inflamatories (n = 7), antipyretics (n = 2), bronchodilatadors (n = 1), laxatives (n = 1), oral contraceptives (n = 5) and vitamins (n = 10). The samples were analyzed by enzyme immunoassay based on monoclonal antibodies omega-gliadins, the elected technique according to the Codex Alimentarius Commission WHO/FAO. All samples were analyzed in duplicate. The sensitivity of this test is 4 mg of gliadin/100 g of product. Results - Only one (1.3%) out of 78 pharmaceutical products contained detectable amounts of gliadin (5,5 mg/100 g). The active ingredient of this drug is ranitidine. According to the Codex Alimentarius Commission WHO/FAO the intake of 10 mg of gliadin/day should not be exceeded by celiac disease patients. Considering the amount of gliadin in each capsule of ranitidine, the ingested quantity would be lower than the maximum allowed for celiac patients. Conclusions - In this study gliadin was not detected in pharmaceutical products in harmful amount for celiac disease patients.
- ItemSomente MetadadadosUtilização da farinha de chia (salvia hispânica l) Na elaboração de pães sem glúten: otimização das propriedades tecnológicas e sensoriais(Universidade Federal de São Paulo (UNIFESP), 2014-03-26) Sandri, Luciana Teodoro Braz [UNIFESP]; Capriles, Vanessa Dias [UNIFESP]; http://lattes.cnpq.br/2781360640415360; http://lattes.cnpq.br/4258935175070745; Universidade Federal de São Paulo (UNIFESP)The objective of this study was to develop and optimize the technological and sensory properties of gluten-free breads formulations (GFB) containing chia flour (Salvia hispanica L.). Two types of experimental designs were used to identify the proportions of chia flour and other key ingredients that would allow maximizing physical properties and acceptability of GFB. The experimental design for mixing three components was used to evaluate the effects of rice flour (RF), potato starch (PS) and whole chia flour (WCF), as well as their interactions, in the physical properties of GFB. The proportions of components varied from 0 to 100% (flour basis - fb). The rotational central composite design for two factors (DCCR 22) was used to evaluate the effects of the defatted chia flour dosages (DCF) (range from 0 to 28% fb) and water (range from 100 to 200% fb) as well as their interactions, in the physical properties and acceptability of GFB. Data were analyzed using response surface methodology. The experimental mixture design results showed that the WCF has interactions with the RF, resulting in increased loaf volume and decreased crumb firmness [R2(adj)=72-94%, p=0.00]. This suggests that formulations prepared from the mixture of RF with WCF have good physical properties. Three GFB formulations were optimized for physical properties (1: 95% RF + 5% WCF, 2: 90% RF + 10% WCF, 3: 86% RF + 14% WCF), and were accepted regarding appearance, color, flavor, texture, taste and overall appearance, with an acceptability average from 7.3 to 8.7, in a hybrid hedonic scale of 10 cm. However, the water content (100% fb) and the other ingredients were fixed for all formulations, which may have limited the amount of WCF in the formulation. Therefore, in continuity, the DCCR 22 was used. The models showed that the higher the concentration of DCF and water, the lower the acceptability of GFB [R2(aj)=69-95%, p<0,01]. And no significant effects were observed from the interactions between these factors on the GFB characteristics. However, increasing the water content of the DCF formulations improved physical properties and acceptability of GFB. Three optimum formulations were obtained (1 ? 0% DCF, 135,5% water; 2 ? 9,8% DCF, 135,5% water; 3 ? 17,2% DCF and 139,7% water) showing acceptability scores ranging from 7.0 to 9.0 for all measured attributes. The results of this study show that it is possible to incorporate up to 17.2% of chia flour in GFB formulation. This research cooperates with the technology of gluten-free baking, indicating the use of a new raw material in products with a high acceptability and may contribute to the development and diversification of this market, increasing the offer of good quality of GFB, regarding technological, sensory and nutritional characteristics, making them more accessible to people with celiac disease, which will help these people regarding adherence and diversification in the gluten-free diet.