Metabolic osteopathy in celiac disease: importance of a gluten-free diet

Reduced bone mineral density (BMD) is frequently found in individuals with untreated celiac disease (CD), possibly due to calcium and vitamin D malabsorption, release of pro-inflammatory cytokines, and misbalanced bone remodeling. A gluten-free diet (GFD) promotes a rapid increase in BMD that leads to complete recovery of bone mineralization in children. Children may attain normal peak bone mass if the diagnosis is made and treatment is given before puberty, thereby preventing osteoporosis in later life. A GFD improves, but rarely normalizes, BMD in patients diagnosed with CD in adulthood. In some cases, nutritional supplementation may be necessary. More information on therapeutic alternatives is needed

Uveitis in celiac disease with an excellent response to gluten-free diet: third case described

To describe the case of a patient with celiac disease who achieved a complete response to a gluten-free diet. A 28-year-old woman presented with diarrhea, oral ulcers, and refractory uveitis of 2.5-years duration. She was treated with prednisone, mydriatic drops, and infliximab with no response. She was referred to our hospital at which point her previous diagnosis of uveitis was confirmed; she was also diagnosed with right-sided sacro-iliitis. The patient did not have arthritis or any skin conditions. Three tests for fecal parasites and a fecal leukocyte were negative. Endoscopy revealed atrophic appearance of the duodenal mucosa. Biopsy showed atrophy of the duodenal villi with intra-epithelial lymphocytes, hyperplasia of the crypts, and chronic inflammatory infiltrate. The search for antiendomysial antibody was > 1/1,280. The patient was started on a gluten-free diet and after 3 months demonstrated significant improvement of gastrointestinal symptoms and uveitis, as well as a reduction of antiendomysial antibodies (1/80). After 6 months, there was complete remission of gastrointestinal symptoms and total control of uveitis. The antiendomysial antibody was negative at that time. Clinical uveitis as a manifestation of celiac disease has been described in only two cases in the literature. This case study is the third to demonstrate that uveitis is a clinical symptom that can be addressed in patients with celiac disease.

Apparent digestibility coefficients of selected feed ingredients for dourado Salminus brasiliensis

The excellence of its flesh and fast growth makes the dourado, Salminus brasiliensis, a carnivorous fish native to the Prata basin, a potential candidate for intensive fish farming. This study evaluated the apparent digestibility coefficients (ADC) of energy and nutrients of animal and plant protein sources for the carnivorous Characin dourado S. brasiliensis. Fish (19.5 +/- 5.0 g) were stocked in plastic cages (80-L) and fed pelleted test diets containing 30% of the test ingredient [fish meal (FM), poultry by-product meal (PBM), soybean meal (SBM), and corn gluten meal (CGM) plus 70% of a reference diet (481.4 g kg(-1) of crude protein and 18.63 kJ of gross energy per gram]. After the last daily meal, cages were transferred to cylindrical, conical-bottomed aquarium (200-L) where faeces were collected by sedimentation in a refrigerated container. Except for ADC of protein and energy, all other ADC of nutrients showed significant differences (P < 0.01). ADC values were: 94.3%, 91.3%, 93.1%, and 93.5% for crude protein; 91.0%, 90.3%, 87.8%, and 88.8% for gross energy; 92.1%, 84.5%, 80.6%, and 79.3% for ash; 83.9%, 80.3%, 84.3%, and 84.6% for dry matter; 97.4%, 96.7%, 93.3%, and 91.5% for lipid for FM, PBM, SBM, and CGM, respectively. The average amino acid ADC was: 93.6%, 90.0%, 92.1%, and 92.5% of FM, PBM, SBM, and CGM, respectively. All test ingredients were efficiently used and can partially replace FM in diets for carnivorous dourado.

Behcet`s disease associated with celiac disease: a very rare association

There are common findings between Beh double dagger et`s disease (BD) and celiac disease (CD); however, association in the same patient is a rarity. We relate the third case in the literature of this overlap in a 40-year-old woman with history of obstipation since her childhood. She also presented asymmetric polyarthralgia, loss of weight, anemia, oral recurrent aphthas (> 3/year) and genital ulcerations, inflammatory lower back pain, bowel bleeding and abdominal colic. Afterwards, she presented episodes of erythema nodosum, superficial thrombophlebitis, pseudofolliculitis and aseptic meningitis, thus fulfilling criteria for BD. Due to persistence of the digestive complaints, a gastrointestinal endoscopy was performed. The biopsy showed chronic duodenitis with intraepithelial lymphocytosis, crypt hyperplasia, and villous atrophy. Endomysial antibody was positive. She fulfilled the diagnosis criteria for CD; a gluten-free diet was applied with clinical improvement. Ascertaining whether pathogenic mechanisms are common in these two conditions requires further investigation.

Performance of Two Commercial ELISAs for Detecting IgA Anti-Human and Anti-Guinea Pig Tissue Transglutaminase Antibodies

Background: Sensitivity and specificity of anti-human tissue transglutaminase antibodies (anti-htTGA) seem to be superior to those of anti-tissue transglutaminase of guinea pig (anti-gptTGA) for screening patients with celiac disease (CD), but there are still controversies. The aim of this study was to evaluate the performance of two INOVA ELISA kits to detect IgA anti-htTGA and anti-gptTGA in patients with and without CD. Methods: The study groups were comprised of 49 anti-endomysial antibody (EMA)-positive untreated-CD, and 123 controls (EMA-negative treated CD, EMA-negative chronic diarrhea, autoimmune hepatitis, inflammatory bowel disease and healthy people). Results: The agreement between the two ELISAs was statistically significant in all study groups and there was no significant difference between them (92.7% agreement; kappa=0.70; kappa p=0.001; McNemar p=1). All patients with serum reactivity of more than 100 units had histologic diagnosis of CD. In seven of 10 patients with treated-CD who had control biopsies, villous atrophy was still present in four who tested positive by both kits. Two of three celiacs with histologic remission tested positive for both anti-tTGA. Conclusions: the anti-gptTGA and anti-htTGA determination were equally efficient in identifying patients with untreated-CD with high titers of EMA. Whatever the anti-tTGA ELISA used, the reactivity above 100 units was always related to active CD diagnosed by histologic alterations in intestinal biopsies. The anti-tTGA reactivity by both kits was not only similar in determining histologic activity in the follow-up of CD after a gluten free diet, but also in identifying positive sera from the control groups, regardless if CD has been confirmed by duodenal biopsies. (Clin. Lab. 2010;56:29-35)

Amaranth bars enriched with fructans: acceptability and nutritional value

Amaranth bars enriched with fructans: acceptability and nutritional value. There is an increasing appeal for convenience foods with potential health benefits to the consumer. Raw materials with high nutritional value and functional properties must be used on the development of these food products. Amaranth is a gluten-free grain with high nutrition value. Inulin and oligofructose are prebiotic ingredients presenting effects as the enhancement of calcium absorption. Amaranth bars enriched with inulin and oligofructose were developed in the flavors: banana, Brazilian nuts and dried grape, coconut, peach, strawberry and wall nut. The proximate composition were determined and compared to commercial cereal bars, available in traditional (n=59), light (n=60), diet (n=8), with soy (n=10) and quinoa (n=1) categories. Amaranth bars present mean global acceptance values from 6.3 to 7.6 on a 9-point hedonic scale, nutritional advantages as compared to commercial cereal bars (caloric reduction and higher levels of dietary fiber). Although amaranth is an unknown raw material in Brazil, it shows good potential to be used in the manufacturing of ready-to-eat products. As they are gluten free, these amaranth bars are also an alternative product for celiacs, also contributing to the enhancement of calcium absorption, a problem frequently observed in these patients.

Effect of surfactants on the functional properties of gelatin-based edible films

The aim of this research was to evaluate the plasticizing effect of natural surfactants lecithin or yucca extract from Yucca schidigera on gelatin-based films Films containing yucca extract showed higher tensile strength values (similar to 90-40 MPa) and moisture contents (similar to 15%) and less elongation (similar to 5%) and water vapor permeability values (similar to 0 22-009 g mm m(-2) h(-1) kPa(-1)) compared to films containing lecithin Soluble films (similar to 20-50%) were obtained when yucca extract was used while lecithin produced low soluble films (<10%) The opacity of the films (similar to 14 5-16 2%) was similar for both surfactants and the film surface morphologies were continuous and homogeneous X-ray diffraction indicated that the addition of surfactants produced amorphous films compared to gelatin-based films and FT-Infrared spectroscopy showed no evidence of association between the surfactants and the gelatin The plasticizing effect was not obtained after surfactants addition and casting technique (C) 2010 Elsevier Ltd All rights reserved

Optimization of amaranth flour films plasticized with glycerol and sorbitol by multi-response analysis

The optimal formulation for the preparation of amaranth flour films plasticized with glycerol and sorbitol was obtained by a multi-response analysis. The optimization aimed to achieve films with higher resistance to break, moderate elongation and lower solubility in water. The influence of plasticizer concentration (Cg, glycerol or Cs, sorbitol) and process temperature (Tp) on the mechanical properties and solubility of the amaranth flour films was initially studied by response surface methodology (RSM). The optimized conditions obtained were Cg 20.02 g glycerol/100 g flour and Tp 75 degrees C, and Cs 29.6 g sorbitol/100 g flour and Tp 75 degrees C. Characterization of the films prepared with these formulations revealed that the optimization methodology employed in this work was satisfactory. Sorbitol was the most suitable plasticizer. It furnished amaranth flour films that were more resistant to break and less permeable to oxygen, due to its greater miscibility with the biopolymers present in the flour and its lower affinity for water. (C) 2011 Elsevier Ltd. All rights reserved.