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Gluten-free Products in the UK Retail Environment. Availability, Pricing, Consumer Opinions in a Longitudinal Study 英国零售环境中的无麸质产品。纵向研究中的可用性、定价、消费者意见
Pub Date : 2020-08-02 DOI: 10.12691/IJCD-8-3-5
F. Vriesekoop, E. Wright, S. Swinyard, W. Koning
Gluten free products are essential for people who suffer from coeliac disease or have a more generic gluten intolerance. In both instances people are forced to resort to consuming gluten free (GF) foods. We carried out two online surveys to gauge the sentiments from people purchasing GF produce, and we carried out two retail observation studies. These studies were carried out in 2015 and repeated again 2019. Bread was the most commonly purchased GF product, but also the most complained about GF product, both from a quality and a price point of view. These sentiments did not change much from 2015 to 2019. One clear set of trends was that people purchased less specialty flour and raising agent when comparing 2019 to 2015, and they did less home-baking over the same period. Furthermore, the decrease in home-baking coincided with a relative increase in satisfaction in the quality of GF products. With regards to observations made across 11 supermarkets, we observed an overall increase in the number of GF line items, with the budget supermarkets offering a very small selection of produce labelled as GF in 2019 only. Our research shows that the relative cost of GF items increased from 2015 to 2019, with the average price ratio of GF food to non-GF foods rising from 3.2 to 4.1 across all UK supermarkets. Ultimately, GF produce cost significantly more compared to similar, gluten-containing foods, while many of the GF products, especially GF breads, still underperform when it comes to the perceived quality and value for money.
无麸质产品对于患有乳糜泻或麸质不耐症的人来说是必不可少的。在这两种情况下,人们都被迫食用无麸质(GF)食品。我们进行了两项在线调查,以评估购买无糖食品的人们的情绪,并进行了两项零售观察研究。这些研究于2015年进行,并于2019年再次进行。面包是最常购买的无糖食品,但从质量和价格的角度来看,也是最受抱怨的无糖食品。从2015年到2019年,这些情绪没有太大变化。一个明显的趋势是,与2019年相比,人们购买的特种面粉和发酵剂减少了,同一时期他们在家烘焙的次数也减少了。此外,家庭烘焙的减少与对GF产品质量的满意度相对增加相吻合。根据对11家超市的观察,我们观察到无糖食品的数量总体上有所增加,而廉价超市只在2019年提供了很少一部分标有无糖食品标签的产品。我们的研究表明,从2015年到2019年,GF产品的相对成本有所上升,在所有英国超市中,GF食品与非GF食品的平均价格比从3.2上升到4.1。最终,与同类含谷蛋白食品相比,无谷蛋白产品的成本要高得多,而许多无谷蛋白产品,尤其是无谷蛋白面包,在质量和性价比方面仍然表现不佳。
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引用次数: 6
Celiac Disease Presenting as Celiac Artery Stenosis and Intra Abdominal Venous Thrombosis - An Unheard Entity 乳糜泻表现为腹腔动脉狭窄和腹腔内静脉血栓形成-一个闻所未闻的实体
Pub Date : 2020-08-02 DOI: 10.12691/IJCD-8-3-2
Shravan K. Bohra, Apurva S. Shah
Extra intestinal manifestations of celiac disease are seen in about 20% of patients including venous thrombosis but arterial stenosis is not described in the literature. We describe a first-ever case of celiac disease in 26-year-old lady presenting as severe celiac artery stenosis, managed successfully with arterial stenting. She also had portal and superior mesenteric vein thrombosis. Excellent improvement was seen during follow up after treatment with a gluten-free diet, oral anticoagulation, antiplatelet and celiac arterial stenting. Hypercoagulability and thromboembolic manifestation in celiac disease should be kept in mind especially during active disease or acute exacerbation of celiac disease.
乳糜泻的肠道外表现见于20%的患者,包括静脉血栓形成,但动脉狭窄在文献中未见描述。我们描述了第一例乳糜泻在26岁的女士表现为严重的乳糜泻动脉狭窄,成功地管理动脉支架置入。她也有门静脉和肠系膜上静脉血栓形成。在无麸质饮食、口服抗凝、抗血小板和腹腔动脉支架置入术治疗后的随访中,观察到极好的改善。乳糜泻的高凝和血栓栓塞表现应牢记在心,特别是在活动性疾病或乳糜泻急性加重期间。
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引用次数: 0
Orchestrating the Tumor Microenvironment in Colorectal Cancer 结直肠癌肿瘤微环境的调控
Pub Date : 2020-08-02 DOI: 10.12691/IJCD-8-3-7
Daniel G Sur, A. Irimie
Colorectal cancer (CRC) is one of the most common cancers worldwide. Despite the improvement of treatment options that bettered advanced-stage patient’s overall survival, the clinical outcome is still poor. The tumor microenvironment is thought to be an essential participant in the metastasis process. Liver metastases are the most frequent metastases that occur in CRC patients. It is believed that colorectal cancer has the liver as a preferential site for metastasis, and this is possible due to the multiple interactions that happen in the tumor microenvironment and due to the tumor stem cells input. As a means to investigate this biological process, microRNAs (miRNAs) have established a name for themselves as putative biomarkers in cancer and especially colorectal cancer. In this pilot study, we explored miRNAs expression that by influencing the tumor stem cells can help prevail liver metastasis in advanced-stage CRC patients.
结直肠癌(CRC)是世界上最常见的癌症之一。尽管治疗方案的改善改善了晚期患者的总体生存,但临床结果仍然很差。肿瘤微环境被认为是转移过程的重要参与者。肝转移是CRC患者中最常见的转移。人们认为,结直肠癌以肝脏为转移的优先位点,这可能是由于肿瘤微环境中发生的多种相互作用以及肿瘤干细胞的输入。作为研究这一生物学过程的一种手段,microRNAs (miRNAs)作为癌症,特别是结直肠癌的推定生物标志物已经确立了自己的地位。在这项前期研究中,我们探讨了miRNAs的表达,通过影响肿瘤干细胞来帮助晚期结直肠癌患者战胜肝转移。
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引用次数: 0
Modeling Symptom Severity and Estimated Gluten Ingestion in Celiac Disease Patients on a Gluten-Free Diet 模拟无麸质饮食的乳糜泻患者的症状严重程度和估计的麸质摄入
Pub Date : 2020-08-02 DOI: 10.12691/IJCD-8-3-3
J. Syage, P. Lavin
Introduction: It is common for celiac disease (CD) patients on a gluten-free diet to accidentally consume gluten that can cause symptomatic distress and histologic damage. We present an algorithm to relate the quantity of gluten intake to the severity of episodic symptoms for abdominal pain, bloating and tiredness in CD patients. Methods: This analysis employs a model based on data from the CeliAction study for latiglutenase (ALV003-1221; NCT01917630). A previously estimated average daily quantity of gluten consumed by these trial patients along with the data for frequency and severity of the symptoms for abdominal pain, bloating, and tiredness allowed us to estimate the relationship between episodic inadvertent gluten ingestion and symptom severity. Results: The CD trial patients were previously estimated to consume a mean of 354 mg/day. From the study data, these patients experienced at least one symptom (of six possible) almost every day (6.13/week) and on average experienced 2-3 different symptoms per symptom event. The most common severity (on a 1-5 scale) was 2 for abdominal pain and 3 for bloating and tiredness corresponding to 1.1, 0.9, and 0.7 g gluten consumed per event. The frequency that a severe symptom (4 or 5) occurs during a symptomatic event equates to about 10%, 27%, and 33% for abdominal pain, bloating, and tiredness and correlates to 2.1, 1.2, and 1.0 g gluten consumed per event, respectively. Conclusions: This model suggests that the quantity of ingested gluten varies per event type and likely includes periodic gluten exposures of substantial quantity.
简介:对于无麸质饮食的乳糜泻(CD)患者来说,意外摄入麸质会导致症状窘迫和组织学损伤是很常见的。我们提出了一种算法,将麸质摄入量与乳糜泻患者腹痛、腹胀和疲劳的发作性症状的严重程度联系起来。方法:本分析采用基于CeliAction研究中latiglutenase (ALV003-1221;NCT01917630)。这些试验患者先前估计的平均每日谷蛋白摄入量,以及腹痛、腹胀和疲劳症状的频率和严重程度的数据,使我们能够估计偶发性无意摄入谷蛋白与症状严重程度之间的关系。结果:CD试验患者先前估计平均消耗354毫克/天。从研究数据来看,这些患者几乎每天至少经历一种症状(可能有六种)(6.13/周),平均每个症状事件经历2-3种不同的症状。最常见的严重程度(1-5分)是腹部疼痛为2分,腹胀和疲劳为3分,对应于每次事件摄入1.1、0.9和0.7克麸质。在有症状的事件中,严重症状(4或5)出现的频率相当于腹痛、腹胀和疲劳的10%、27%和33%,每次事件分别消耗2.1、1.2和1.0 g麸质。结论:该模型表明,摄入面筋的数量因事件类型而异,可能包括大量的周期性面筋暴露。
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引用次数: 0
Difficulties Assessing Adherence to Gluten-free Diet in Celiac Patients 评估乳糜泻患者坚持无谷蛋白饮食的困难
Pub Date : 2020-08-02 DOI: 10.12691/IJCD-8-3-4
M. Vespa, Amaya Oyarzún Arancibia, Jimena Ayala Cid, M. A. Quezada
To date the only efficient treatment of celiac disease is a lifelong gluten-free diet (GFD), which involves relevant lifestyle changes. Numerous methods measure adherence to GFD, but none is completely reliable. The aim of the study was to compare three frequently used methods to measure adherence to GFD and study factors that influence adherence to GFD. Eighty-one celiac patients 15 years or older, on GFD were evaluated by dietitian interview, a Celiac Dietary Adherence Test (CDAT) and blood antitransglutaminase antibodies (tTG). Factors influencing adherence were assessed by an ad-hoc questionnaire following WHO criteria. Adherent and non-adherent patients were classified in the same category in 44.4% of cases (n=36), (non-adherent=35.8% and adherent= 8.6%). In general, methods identified better non-adherent than adherent individuals. Among the 5 realms defined by WHO, when tTG (positive/negative) defined adherence, logistic regression identified ten significant variables (information about disease, income, education, cost of gluten-free products, eating in restaurants, time on GFD, symptoms at diagnosis, number of symptoms at time of diagnosis, other chronic diseases present, allergy/food intolerance plus a chronic disease and CD). Using the interview as reference, two variables were significant (self-perception of knowledge of the GFD, and presence of gastrointestinal symptoms when gluten is consumed). Results illustrate the difficulties of measuring both adherence to GFD and the factors that influences it. Further studies should explore new markers able to measure the amount of gluten necessary to activate autoantibodies production and the time they take to stop their production once the patient stops gluten ingestion.
迄今为止,唯一有效的治疗乳糜泻的方法是终生无麸质饮食(GFD),这涉及到相关的生活方式改变。有许多方法衡量GFD的依从性,但没有一个是完全可靠的。该研究的目的是比较三种常用的方法来测量GFD的依从性,并研究影响GFD依从性的因素。通过营养学家访谈、乳糜泻饮食依从性测试(CDAT)和血液抗转谷氨酰胺酶抗体(tTG)对81例15岁及以上接受GFD治疗的乳糜泻患者进行评估。影响依从性的因素按照世卫组织标准通过特别问卷进行评估。有44.4%的病例(36例)将依从性和非依从性患者归为同一类别(非依从性=35.8%,依从性= 8.6%)。一般来说,方法识别非贴壁者比贴壁者更好。在世卫组织定义的5个领域中,当tTG(阳性/阴性)定义依从性时,逻辑回归确定了10个显著变量(有关疾病的信息、收入、教育、无麸质产品的成本、在餐馆用餐、服用GFD的时间、诊断时的症状、诊断时的症状数量、存在的其他慢性病、过敏/食物不耐受加上慢性病和乳糜泻)。以访谈为参照,有两个变量是显著的(GFD知识的自我认知,以及食用谷蛋白时胃肠道症状的存在)。结果说明了测量GFD依从性和影响它的因素的困难。进一步的研究应该探索新的标记物,能够测量激活自身抗体产生所需的谷蛋白量,以及一旦患者停止摄入谷蛋白,它们停止产生所需的时间。
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引用次数: 0
Sjögren’s Syndrome Associated with Celiac Disease 与乳糜泻相关的Sjögren综合征
Pub Date : 2020-08-02 DOI: 10.12691/IJCD-8-3-1
Felipe Freire Silva, A. Lerner, João Carlos Geber Júnior, J. Carvalho, Y. Shoenfeld
Background: Autoimmune diseases tend to run in families and the affected persons are prone to additional autoimmune conditions. This is the case for celiac disease (CD) and Sjogren's syndrome (SS). Objectives: To describe a patient with both diseases and to analyze the clinical, therapeutic and evolutionary characteristics of published patients with SS associated with CD. Methodology: A systematic review of articles published in PubMed, MEDLINE, LILACS and Scielo dating from 1966 to May 2020, was conducted, using the following search words: Sjogren's syndrome, Celiac disease. Only English, German and French publications were considered. Results: Only 16 studies with 31 patients with SS associated CD were depicted. Adding the present case would mount the total to 17 studies, describing 32 patients. There are 6 observational studies and 10 case reports. In relation to demographics, age varied from 10 to 73 years old, with a median of 45 years and the great majority were female (21/32 patients). SS preceded CD manifestations in 7 studies, CD was the first presentation in 6 articles and simultaneous diseases was observed in 4 reports. Time elapsed between the two diseases varied from 2 to 33 years. Autoantibodies related to SS showed that anti-Ro and anti-La were positive in 8/17, while CD-related antibodies were positive in 12/17 studies. Regarding therapy, the majority received a gluten-free diet as CD therapy (13/17 studies). Glucocorticoid was prescribed in 6/17 studies and hydroxychloroquine in 4/17. When described, all studies demonstrated improvement of CD manifestations and 7/17 improved SS symptoms. Conclusion: The present comprehensive review evaluated all published cases of SS and CD of the literature. In the majority, SS precedes CD and all patients had good responses to appropriate therapy. It is hoped that increased awareness of the combination of SS and CD will result in earlier diagnosis and therapy and improved outcome.
背景:自身免疫性疾病倾向于家族遗传,受影响的人容易出现额外的自身免疫性疾病。这就是乳糜泻(CD)和干燥综合征(SS)的情况。目的:描述两种疾病的患者,并分析已发表的SS合并CD患者的临床、治疗和进化特征。方法:系统回顾1966年至2020年5月在PubMed、MEDLINE、LILACS和Scielo上发表的文章,使用以下搜索词:干燥综合征、乳糜泻。只审议了英文、德文和法文出版物。结果:只有16项研究涉及31例SS相关CD患者。加上目前的病例,总共有17项研究,涉及32名患者。有6项观察性研究和10例病例报告。在人口统计学方面,年龄从10岁到73岁不等,中位数为45岁,绝大多数为女性(21/32)。7项研究中SS先于CD表现,6篇文章中首先出现CD, 4篇报道中同时观察到疾病。两种疾病之间的间隔时间从2年到33年不等。与SS相关的自身抗体在8/17的研究中显示抗ro和抗la阳性,而cd相关抗体在12/17的研究中显示阳性。在治疗方面,大多数患者接受无谷蛋白饮食作为乳糜泻治疗(13/17项研究)。在6/17研究中使用糖皮质激素,在4/17研究中使用羟氯喹。当描述时,所有的研究都表明CD的表现得到改善,7/17的SS症状得到改善。结论:本文对所有已发表的SS和CD病例进行了综合评价。大多数情况下,SS先于CD,所有患者对适当的治疗都有良好的反应。希望提高对SS和CD合并的认识将导致早期诊断和治疗并改善预后。
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引用次数: 0
Celiac Disease: Practical Knowledge of Young Doctors at Setif University Hospital, Algeria 乳糜泻:阿尔及利亚塞提夫大学医院年轻医生的实践知识
Pub Date : 2020-08-02 DOI: 10.12691/IJCD-8-3-6
H. Rahmoune, M. Amrane, N. Boutrid
The concept of celiac disease (CD) has greatly evolved during the last decades; ranging from the classical digestive form to the peculiar monosymptomatic and silent forms. Thus, in order to assess the knowledge of interns and residents in pediatrics about CD, a local survey was conducted through a 14-item questionnaire. This work provided a local glimpse of young doctors' awareness about CD. The level of knowledge was globally correct, but vigorous efforts are needed; notably regarding the use of celiac serology and the introduction of the gluten-free diet.
乳糜泻(CD)的概念在过去几十年中有了很大的发展;从经典的消化形式到特殊的单症状和沉默形式。因此,为了评估儿科实习生和住院医师对乳糜泻的了解程度,我们在当地进行了一项14项的问卷调查。这项工作提供了当地年轻医生对乳糜泻认识的一瞥。知识水平在全球范围内是正确的,但需要大力努力;尤其是乳糜泻血清学的使用和无谷蛋白饮食的引入。
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引用次数: 0
Consumers’ Acceptance, Satisfaction in Consuming Gluten-free Bread: A Market Survey Approach 消费者对无麸质面包的接受度、满意度:一项市场调查方法
Pub Date : 2020-06-27 DOI: 10.12691/IJCD-8-2-1
Marcell Tóth, G. Vatai, A. Koris
The market need for good quality gluten-free (GF) bakery products is in focus, due the increasing number of people with Celiac Disease (CD), Non-Celiac Gluten Sensitivity (NCGS) and the growing popularity of following GF diet as a trend. However scientific knowledge of the technically challenging GF bread making is growing, data regarding consumer market needs, opinions, trends and issues are insufficient. The present study was aimed to evaluate the consumer’s acceptance of available GF breads and their satisfaction. The data of the study reveal that approximately half of the people following GF diet have other different food related health problems parallel with CD or NCGS. The present study shows, that 70.8% of the asked consumers are dissatisfied with GF breads due their texture and taste, and for home baking consumers usually mix 2-3 or even more different GF flours, as they are displeased with the quality of the available mixes on their own. Overall, the most relevant problem for the consumers is the particularly higher price of the GF flours and breads.
由于越来越多的人患有乳糜泻(CD),非乳糜泻麸质敏感性(NCGS),以及将无谷蛋白饮食作为一种趋势越来越受欢迎,市场对高质量无谷蛋白烘焙产品的需求受到关注。然而,关于在技术上具有挑战性的GF面包制作的科学知识正在增长,关于消费者市场需求、意见、趋势和问题的数据是不足的。本研究旨在评估消费者对可获得的无谷蛋白面包的接受程度及其满意度。该研究的数据显示,大约有一半遵循无谷蛋白饮食的人患有与乳糜泻或NCGS类似的其他与食物相关的健康问题。目前的研究表明,70.8%的受访消费者对GF面包的质地和味道不满意,而对于家庭烘焙,消费者通常会混合2-3种甚至更多不同的GF面粉,因为他们自己对现有混合物的质量不满意。总的来说,消费者最关心的问题是GF面粉和面包的高价格。
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引用次数: 3
COVID-19 Pandemic an Update for Celiac Community COVID-19大流行:乳糜泻社区的最新情况
Pub Date : 2020-06-25 DOI: 10.12691/IJCD-8-2-8
M. Bordea, G. Klein, Liliana Salanta, Diana Muntean, Florentina Urda, Adrian Dolha, C. Samsudean, Viorica Trifan, Anca Ples, Vera Pop, Lelia Hosu, A. Danyi, Roxana Piscoran, Rareș Rus, P. Rus, Cristian Lutai, Ana Copaciu, Corina Tritean, Carmen Nylas, C. Silaghi, S. Man, C. Aldea, G. Samașca
Nobody believed in a new pandemic this year. COVID19 pandemic is a public health issue. The evolution of the COVID19 pandemic is important to be known by everyone in the medical world. Our goals in this narrative review were to analyze novel coronavirus from all points of view: epidemiology, clinical, and the relationship with Influenza Virus.
没有人相信今年会出现新的大流行。covid - 19大流行是一个公共卫生问题。重要的是,医学界的每个人都应该了解covid - 19大流行的演变。我们在这篇叙述性综述中的目标是从各个角度分析新型冠状病毒:流行病学、临床以及与流感病毒的关系。
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引用次数: 1
The Utility of CCP Antibodies in Autoimmune Diseases CCP抗体在自身免疫性疾病中的应用
Pub Date : 2020-06-25 DOI: 10.12691/IJCD-8-2-5
L. Sur, Remus Gaga, G. Sur, Emanuela Floca
Autoimmune diseases have a constellation of immunological changes that make possible the appearance of clinical manifestations. There are often similarities of clinical manifestations in these autoimmune diseases as possible associations of them during evolution.
自身免疫性疾病有一系列的免疫改变,使临床表现的出现成为可能。这些自身免疫性疾病在进化过程中往往有相似的临床表现。
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引用次数: 1
期刊
International Journal of Celiac Disease
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