scholarly journals Physical development in children with celiac disease in St. Petersburg

Author(s):  
N. S. Shapovalova ◽  
V. P. Novikova ◽  
K. A. Klikunova

Aim: to compare physical development in children with celiac disease (CD), depending on adherence to a gluten-free diet (GFD), and in children without CD.Materials and methods: 176 children with gastrointestinal disease were examined. Group 1 consisted of 58 children with newly diagnosed CD and chronic gastritis (CG), before the appointment of a gluten-free diet (GFD), group 2–49 children with CD and CG, adhered of GFD for 1 year, the comparison group consisted of 69 children with CG and duodenitis and excluded CD. The assessment of anthropometric data was carried out using the WHO AnthroPlus software (2009), with the determination of BMI and Z-score values: WAZ, SD; WHZ, SD; HAZ, SD; BAZ, SD.Results: The groups of participants in the study were homogeneous in terms of gender and age. BMI (16,57±3,29; 1,96 ± 3,96; 18,17±,22; t1,2=0,573; t1,3=0,007; t2,3=0,009). Weight deficiency was more often observed in patients in group 1 (56,8%, 4,1%, 23,2%; P1,2=0,00; P1,3=0,00; P2,3=0,02). Obesity was detected in the groups equally (1,7%, 4,1%, 4,3%; P1,2=0,00; P1,3=0,01; P2,3=0,04). Normal body weight was most common in groups 2 (39,7%, 91,8%, 7205%; P1,2=0,00; P1,3=0,01; P2,3=0,04). HAZ, SD statistically differed in all groups (–0,3928±1,13; 0,0133±1,06; 0,4664±1,15; t1,2=0,008, t1,3=0,004, t2,3=0,031).Conclusion: normal body weight was most typical for children on GFD. HAZ, SD in children with CD increased in comparison with children with newly diagnosed CD, but it was less, than in group 3. After a one year of GFD, the improvement of weight has a more pronounced dynamics than growth.

Author(s):  
Д.С. Шилин ◽  
К.Г. Шаповалов

Актуальность: ожирение является одной из самых распространенных в мире причин развития сопутствующих заболеваний. у человека. В настоящий момент проблема СOVID-19 приводит к развитию и обострению сердечно-сосудистой патологии, сопровождающейся изменениями гемодинамики. Цель исследования - оценка зависимости изменений гемодинамики у пациентов с COVID-19 от алиментарно-конституционального ожирения. Методика. Исследование выполнено у 73 пациентов обоего пола с внебольничной полисегментарной вирусно-бактериальной пневмонией на фоне СOVID-19. Пациенты были разделены на 3 группы по индексу массы тела. В 1-ю группу вошли пациенты без избытка массы тела, 2-ю составили пациенты с избыточной массой тела, 3-ю - с ожирением 1 степени. Использован комплекс аппаратно-программного неинвазивного исследования центральной гемодинамики методом объемной компрессионной осциллометрии «КАП ЦГ осм- «Глобус» (Россия). Результаты. У пациентов с СOVID-19, страдающих ожирением I степени (30,0 - 34,9 кг/м2). выявлено статистически значимое снижение сердечного индекса относительно лиц с нормальной массой тела (на 10,8%, p=0,010). Пациенты с избытком массы тела имели более высокое диастолическое давление (на 10,5%, p=0,011) Показатель периферического сосудистого сопротивления у пациентов с СOVID-19 без избыточной массы тела был на 16.5% ниже, чем у пациентов с ожирением 1 степени. Удельное периферическое сопротивление сосудов у пациентов 1-й группы было на 10.3% меньше, чем у пациентов с избыточной массой тела. Податливость сосудистой стенки у пациентов 1-й группы была ниже на 22.5%, чем у пациентов с СOVID-19 и ожирением 1 степени. Заключение. У пациентов с внебольничной полисегментарной вирусно-бактериальной пневмонией на фоне СOVID-19 при ожирении 1 степени и избыточной массе тела выявляются значимые изменения гемодинамики относительно больных с нормальной массой тела. Background: Obesity is one of the most common causes of comorbidities worldwide. During the COVID-19 pandemic, development and increasing severity of cardiovascular disorders associated with hemodynamic changes has become increasingly relevant. Aims: The study aimed to evaluate the hemodynamic changes in COVID-19 patients depending on the severity of their exogenous constitutional obesity. Methods. 73 male and female patients with community-acquired polysegmental pneumonia of viral and bacterial origin associated with COVID-19 were enrolled in the study. The patients were allocated to three groups depending on the value of their body mass index (BMI). Group 1 included patients with normal body weight; Group 2 included overweight patients, and Group 3 included patients with grade 1 obesity (BMI 30.0-34.9 kg/m2). The measurements were performed using a technique of volumetric compression oscillometry on a non-invasive hemodynamic monitoring system KAP CG osm (Globus, Russia). Results. COVID-19 patients with grade 1 obesity (BMI 30.0-34.9 kg/m2) demonstrated a statistically significant 10.8% decrease in the cardiac index compared to patients with normal body weight (p=0.010). Overweight patients had 10.5% higher diastolic blood pressure (p=0.011). Peripheral vascular resistance (PVR) in COVID-19 patients with normal body weight was 16.5% lower than in patients with grade 1 obesity. PVR adjusted for body surface area in patients with normal body weight was 10.3% lower than in overweight patients. The compliance of the vascular wall in Group 1 patients was 22.5% lower than in COVID-19 patients with grade 1 obesity. Conclusion. COVID-19 patients with community-acquired, polysegmental pneumonia of viral and bacterial origin demonstrate significant hemodynamic changes compared to patients with normal body weights.


2019 ◽  
Vol 68 (5) ◽  
pp. 684-688 ◽  
Author(s):  
Eyal Zifman ◽  
Orith Waisbourd-Zinman ◽  
Luba Marderfeld ◽  
Noam Zevit ◽  
Anat Guz-Mark ◽  
...  

2018 ◽  
Vol 1 (suppl_2) ◽  
pp. 258-258
Author(s):  
M Rashid ◽  
J Haskett ◽  
L Parkinson-McGraw ◽  
A Noble ◽  
J Van Limbergen ◽  
...  

2016 ◽  
Vol 23 (07) ◽  
pp. 807-811
Author(s):  
Nagina Shahzadi ◽  
Muhammad Almas Hashmi ◽  
Sadida Bahawal

Objectives: Probiotics are alive organisms which confer health benefit whentaken at an appropriate dosage. This study was done to determine the efficacy of probiotics indecreasing the frequency of diarrhea in children with celiac disease. Study Design: Randomizedcontrolled trial. Setting: Department of Pediatrics/DHQ Allied Hospital, Faisalabad. Period:November 2011 to October 2012. Methods: Newly diagnosed patients with CD having diarrheawere included by consecutive non-probability sampling. Patients were randomized in twogroups using computer generated numbers. One group was given probiotic along with glutenfree diet while other was only prescribed gluten free diet. Reduction in frequency of diarrhea intwo groups was compared after a period of 28 days. Results: A total of 116 cases (58 in eachgroup) were enrolled. Mean age was 9.11 years. The groups were similar in age and gender ofpatients. Comparison of efficacy of probiotics in children with CD was done with control groupwhich revealed reduction in stools frequency to less than half in 86.21% (n=50) in probioticgroup but only 62.07% (n=36) in control group. P-value was 0.00015 which shows a highlysignificant difference in both groups. Conclusion: Probiotics in addition to gluten free diet arehighly effective in reducing the frequency of diarrhea in newly diagnosed patients with CD, incomparison with gluten free diet alone.


2018 ◽  
Vol 20 (6) ◽  
pp. 913-920
Author(s):  
M. V. Antonyuk ◽  
T. A. Gvozdenko ◽  
T. P. Novgorodtseva ◽  
T. I. Vitkina ◽  
B. I. Geltser ◽  
...  

Combination of bronchial asthma (BA) and obesity is a difficult-to-control phenotype. Studies of inflammatory process with respect to severity of the disease are important for understanding the potential influence of obesity on the BA clinical course. The objective of this study was to determine cytokine profile in patients with mild BA combined with obesity. The study involved fifty-three patients with partially controlled mild BA. The patients were recruited as volunteers and signed an informed consent. The first observation group consisted of 27 asthma patients with normal body weight, the second observation group consisted of 26 patients with BA combined with obesity. A control group included 25 healthy volunteers. All the patients underwent clinical and laboratory examination in accordance with clinical standards for BA and obesity. The levels of TNFα, IL-2, IL-4, IL-6, IL-10 were evaluated in blood serum by means of flow cytometry. The ratios of proand anti-inflammatory cytokines (TNFα/IL-4, TNFα/IL-10, IL-6/IL-4, IL-6/IL-10) were calculated. Asthma patients with obesity (the 2nd group) had elevated levels of IL-2 over control group and group 1, by 38% and 44% respectively(p < 0.05). The concentration of proinflammatory cytokines TNFα and IL-6 was significanty increased in the both patient groups. Mean TNFα level was increased 2.5 times (p < 0.05), and IL-6 levels were increased by 30% (p < 0.05) in the 1st group as compared to the controls. TNFα and IL-6 concentrations showed a 3-fold increase over control values (p < 0.05) in the 2nd group. The level of antiinflammatory cytokine IL-4 was increased in patients with BA, independently of body mass. It should be noted that the concentration of this cytokine in obese patients was higher by 29% than in patients with normal body weight. IL-10 levels in patients from the 2nd group were reduced more than 2 times than in the 1st group. The patients of the 1st group showed a decrease in the IL-6/IL-10 index, in comparison with control parameters, thus indicative of an imbalance due to the elevation of the anti-inflammatory IL-10 cytokine. Among BA patients with obesity (group 2) the TNFα/IL-10 and IL-6/IL-10 indexes were higher than those of the control group (2.3- and 5.5-fold, respectively) and the group 1 (2.6- and 2.5-fold, respectively). Dynamics of these indexes confirms the systemic nature of inflammation and a predominance of non-atopic  inflammation in asthma patients with obesity. Thus, features of the cytokine profile in BA with obesity consist of a significant increase in pro-inflammatory IL-2, IL-6, TNFα cytokines, and a relative decrease in anti-inflammatory IL- 10 cytokine. The development of BA with obesity, even in mild-severity BA, is accompanied by development of a cytokine disbalance, which is typical for a mixed-type inflammation, with a prevalence of neutrophil inflammation. 


2014 ◽  
Vol 306 (6) ◽  
pp. G526-G534 ◽  
Author(s):  
Tobias L. Freitag ◽  
Jussi Loponen ◽  
Marcel Messing ◽  
Victor Zevallos ◽  
Leif C. Andersson ◽  
...  

The current treatment for celiac disease is strict gluten-free diet. Technical processing may render gluten-containing foods safe for consumption by celiac patients, but so far in vivo safety testing can only be performed on patients. We modified a celiac disease mouse model to test antigenicity and inflammatory effects of germinated rye sourdough, a food product characterized by extensive prolamin hydrolysis. Lymphopenic Rag1−/− or nude mice were injected with splenic CD4+CD62L−CD44high-memory T cells from gliadin- or secalin-immunized wild-type donor mice. We found that: 1) Rag1−/− recipients challenged with wheat or rye gluten lost more body weight and developed more severe histological duodenitis than mice on gluten-free diet. This correlated with increased secretion of IFNγ, IL-2, and IL-17 by secalin-restimulated splenocytes. 2) In vitro gluten testing using competitive R5 ELISA demonstrated extensive degradation of the gluten R5 epitope in germinated rye sourdough. 3) However, in nude recipients challenged with germinated rye sourdough (vs. native rye sourdough), serum anti-secalin IgG/CD4+ T helper 1-associated IgG2c titers were only reduced, but not eliminated. In addition, there were no reductions in body weight loss, histological duodenitis, or T cell cytokine secretion in Rag1−/− recipients challenged accordingly. In conclusion: 1) prolamin-primed CD4+CD62L−CD44high-memory T cells induce gluten-sensitive enteropathy in Rag1−/− mice. 2) Hydrolysis of secalins in germinated rye sourdough remains incomplete. Secalin peptides retain B and T cell stimulatory capacity and remain harmful to the intestinal mucosa in this celiac disease model. 3) Current antibody-based prolamin detection methods may fail to detect antigenic gluten fragments in processed cereal food products.


2021 ◽  
Vol 11 (22) ◽  
pp. 10960
Author(s):  
Alejandro Martínez-Rodríguez ◽  
Daniela Alejandra Loaiza-Martínez ◽  
Javier Sánchez-Sánchez ◽  
Jacobo A. Rubio-Arias ◽  
Fernando Alacid ◽  
...  

Celiac disease (CD) is an autoimmune disease characterized by gluten-induced intestinal inflammation. Dietary restrictions and symptoms may have a significant impact on the patient’s quality of life, body composition (BC), and strength. This study was designed to assess the impact of an isocaloric gluten free diet and resistance exercise in women. A total of 28 Spanish women, aged 40 years old or more, took part in a randomized controlled trial. Each group received a different intervention: group 1, gluten-free nutrition plan + exercise (GFD + E); group 2, gluten-free nutrition plan (GFD); group 3, celiac controls (NO-GFD); and group 4, non-celiac controls (CONTROL). The variables studied were quality of life, BC and isometric hand strength. After 12 weeks of intervention, celiac women that followed a gluten-free diet and exercise showed higher scores on the psychological health scale than celiac women without intervention. The women in group 1 were the only ones who presented improvements in BC variables; fat mass, BMI, and fat-free mass. Negative correlations were found between the perception of quality of life and age, however a positive correlation between quality of life and isometric strength test results was found. In addition to a gluten-free diet, resistance training is essential to improve BC, strength, and gastrointestinal symptoms.


2019 ◽  
Vol 6 (3) ◽  
pp. 1090
Author(s):  
Mahendra Meena ◽  
Pradeep Meena ◽  
R. L. Suman ◽  
Suresh Goyal

Background: Diagnosis of celiac disease in children suffering from severe acute malnutrition without duodenal biopsy or HLA typing is a dilemma. The objective of this study was to study the response to gluten free diet in sero-positive Celiac Disease children suffering from severe acute malnutrition in age group 1-5 years.Methods: This prospective, observational, hospital-based study was conducted at MTC of tertiary care medical college hospital of southern Rajasthan from Dec. 2017 to Nov. 2018. Total 110 children with SAM were enrolled and screened for celiac disease on the basis of tissue tTg-IgA/IgG serology. Seropositive cases were kept on gluten free diet for short period of time and observed for the resolution of symptoms and improvement in growth, monitored by anthropometry on discharge and follow up visit.Results: Mean weight gain (gm/kg/day) on follow up was 3.87±3.49 in seropositive and 1.88±3.79 in seronegative cases (P-value<0.05). Mean weight gain was 6.43±3.28gm/kg/day in only tTg-IgA positive and 3.04±2.95 gm/kg/day in only tTg-IgG positive cases (P-value-<0.05). The mean weight gain in strictly gluten free adherent sero-positive cases was 4.89±2.97 gm/kg/day while in gluten free non-adherent patients it was -0.49±1.70 (P-value <0.001). Mean weight gain in probable (tTg-Ig-A <10 times ULN) and presumptive (tTg-IgA >10 times ULN) Celiac disease were 3.44±3.73 and 5.44±3.78, respectively without statically significant difference (P-value >0.05).Conclusions: In situations where facility of duodenal biopsy and or HLA DQ2/DQ8 typing is not available, resolution of symptoms and improvement in growth on gluten free diet confirms the diagnosis of celiac disease.


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