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Copyright of Diaeta is the property of Asociacion Argentina de Dietistas & Nutricionistas Dietistas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) more...

Copyright of Diaeta is the property of Asociacion Argentina de Dietistas & Nutricionistas Dietistas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) more...

Copyright of Diaeta is the property of Asociacion Argentina de Dietistas & Nutricionistas Dietistas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) more...

Copyright of Diaeta is the property of Asociacion Argentina de Dietistas & Nutricionistas Dietistas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) more...

Cystic fibrosis (CF) is a monogenic disease with different types of mutations that mainly affect the respiratory-digestive system. Calcium (Ca), phosphorus (P), and vitamin D (Vit-D) are essential nutrients for maintaining adequate growth and development, as well as key components in crucial metabolic pathways. Proper diagnosis, treatment, and response are decisive components of precision medicine. Therefore, we conducted a cross-sectional study to evaluate Ca, P, and Vit-D levels along with health and nutritional indicators, regarding their non-skeletal functions, in a series of CF patients. Anthropometric and clinical evaluation, biochemical analysis, dietary survey, and respiratory and pancreatic status were performed. Even though the results showed that all patients had normal dietary and serum Ca levels, 47% of patients had deficient Vit-D intake, 53% of patients had hypovitaminosis D, 35% had insufficient Vit-D levels, 18% had hypophosphatemia, 76% had elevated alkaline phosphate levels, 29% had hypercalciuria, and 65% had hyperphosphaturia. There were no significant differences between homozygous and compound heterozygous patients. Ca, P, and Vit-D levels were associated with body mass index; body composition; physical activity; diet; growth hormones; and the immune, liver, and kidney systems. We suggest a periodically evaluation of Ca and P losses. more...

Magnesium (Mg) is an essential micronutrient that participates in various enzymatic reactions that regulate vital biological functions. The main aim was to assess the Mg status and its association with nutritional indicators in seventeen cystic fibrosis (CF) patients. The serum Mg and calcium (Ca) levels were determined using standardized methods and the dietary Mg intake by prospective 72 h dietary surveys. The mean serum Ca (2.45 mmol/L) and Mg (0.82 mmol/L) had normal levels, and the mean dietary intake of the Ca (127% DRI: Dietary Reference Intake) and Mg (125% DRI) were high. No patients had an abnormal serum Ca. A total of 47% of the subjects had hypomagnesemia and 12% insufficient Mg consumption. One patient had a serum Mg deficiency and inadequate Mg intake. A total of 47 and 82% of our series had a high serum Ca/Mg ratio of >4.70 (mean 4.89) and a low Ca/Mg intake ratio of <1.70 (mean 1.10), respectively. The likelihood of a high Ca/Mg ratio was 49 times higher in patients with a serum Mg deficiency than in normal serum Mg patients. Both Ca/Mg ratios were associated with the risk of developing cardiovascular disease (CVD), type 2 diabetes (T2D), metabolic syndrome (MetS), and even several cancers. Therefore, 53% of the CF patients were at high risk of a Mg deficiency and developing other chronic diseases. more...

Background & Aims: It is not clear how often patients who are on gluten-free diets (GFDs) for treatment of celiac disease still are exposed to gluten. We studied levels of gluten immunogenic peptides (GIP) in fecal and urine samples, collected over 4 weeks, from patients with celiac disease on a long-term GFD., Methods: We performed a prospective study of 53 adults with celiac disease who had been on a GFD for more than 2 years (median duration, 8 y; interquartile range, 5-12 y) in Argentina. At baseline, symptoms were assessed by the celiac symptom index questionnaire. Patients collected stool each Friday and Saturday and urine samples each Sunday for 4 weeks. We used a commercial enzyme-linked immunosorbent assay to measure GIP in stool and point-of-care tests to measure GIP in urine samples., Results: Overall, 159 of 420 stool and urine samples (37.9%) were positive for GIP; 88.7% of patients had at least 1 fecal or urine sample that was positive for GIP (median, 3 excretions). On weekends (urine samples), 69.8% of patients excreted GIP at least once, compared with 62.3% during weekdays (stool). The number of patients with a sample that was positive for GIP increased over the 4-week study period (urine samples in week 1 vs week 4: P < .05). Patients with symptoms had more weeks in which GIP was detected in stool than patients without symptoms (P < .05). The number of samples that were positive for GIP correlated with titers of deamidated gliadin peptide IgA in patients' blood samples, but not with levels of tissue transglutaminase., Conclusions: Patients with celiac disease on a long-term GFD still frequently are exposed to gluten. Assays to detect GIP in stool and urine might be used to assist dietitians in assessment of GFD compliance., (Copyright © 2021 AGA Institute. All rights reserved.) more...

Bifidobacterium infantis NLS super strain ( B. infantis NLS-SS) was previously shown to alleviate gastrointestinal symptoms in newly diagnosed coeliac disease (CD) patients consuming gluten. A high proportion of patients following a gluten-free diet experiences symptoms despite dietary compliance. The role of B. infantis in persistently symptomatic CD patients has not been explored. The aim of the study was to evaluate the effect of B. infantis NLS-SS on persistent gastrointestinal symptoms in patients with CD following a long-term GFD. We conducted a randomised, cross-over, double-blind, placebo-controlled trial in symptomatic adult CD patients on a GFD for at least two years. After one-week run-in, patients were randomised to B. infantis NLS-SS or placebo for 3 weeks with cross-over after a 2-week wash-out period. We estimated changes (Δ) in celiac symptom index (CSI) before and after treatment. Stool samples were collected for faecal microbiota analysis (16S rRNA sequencing). Gluten immunogenic peptide (GIP) excretion in stool and urine samples was measured at each study period. Eighteen patients were enrolled; six patients were excluded due violations in protocol. For patients with the highest clinical burden, CD symptoms were lower in probiotic than in placebo treatment ( P =0.046). B. infantis and placebo treated groups had different microbiota profiles as assessed by beta diversity clustering. In probiotic treated groups, we observed an increase in abundance of B. infantis . Treatment with B. infantis was associated with decreased abundance of Ruminococcus sp. and Bifidobacterium adolescentis . GIP excretion in stools and urine was similar at each treatment period. There were no differences in adverse effects between the two groups. B. infantis NLS-SS improves specific CD symptoms in a subset of highly symptomatic treated patients (GFD). This is associated with a shift in stool microbiota profile. Larger studies are needed to confirm these findings. ClinicalTrials.gov: NCT03271138. more...

Dissemination of enterobacteria that produce extended spectrum β-lactamases (ESBL) throughout the food chain has become an important health concern. This work aimed to evaluate the occurrence of ESBL-producing bacteria in foods of animal origin and to investigate the similarities between food and human isolates. The presence of beta-lactam-resistant Enterobacteriaceae was analyzed in 108 food samples, isolating 10 strains of Escherichia coli , one strain of Citrobacter freundi , and one of Hafnia alvei. E. coli isolates were compared to a group of 15 strains isolated from human patients by antibiotic susceptibility testing, characterization of ESBL genes ( bla TEM , bla CTX ,), multilocus sequence typing (MLST) and pulse-field gel electrophoresis (PFGE). Nineteen (14 clinical and five food) isolates carried bla CTX , 14 (six clinical and eight food) carried bla TEM , and three (one clinical and two food) carried bla SHV gen. MLST analysis revealed the prevalence of ST131 among the clinical strains, which grouped together in a PFGE cluster. Food isolates showed higher diversity and two of them (ST57) grouped with clinical strains, whereas another two belonged to clonal groups with virulence potential (ST59). In conclusion, the results showed that foods of animal origin must be regarded as a reservoir of ESBL-producing bacteria of clinical relevance, which might spread through the food chain. more...

We have recently identified a significant deterioration of bone microarchitecture in premenopausal women with newly diagnosed celiac disease (CD) using high-resolution peripheral quantitative computed tomography (HRpQCT). The aim of this work was to assess changes in bone microarchitecture after 1 year on a gluten-free diet (GFD) in a cohort of premenopausal women. We prospectively enrolled 31 consecutive females at diagnosis of CD; 26 of them were reassessed 1 year after GFD. They all underwent HRpQCT scans of distal radius and tibia, areal BMD by DXA, and biochemical tests (bone-specific parameters and CD serology) at both time points. Secondary, we compared 1-year results with those of a control group of healthy premenopausal women of similar age and BMI in order to assess whether the microarchitectural parameters of treated CD patients had reached the values expected for their age. Compared with baseline, the trabecular compartment in the distal radius and tibia improved significantly (trabecular density, trabecular/bone volume fraction [BV/TV] [p < 0.0001], and trabecular thickness [p = 0.0004]). Trabecular number remained stable in both regions. Cortical density increased only in the tibia (p = 0.0004). Cortical thickness decreased significantly in both sites (radius: p = 0.03; tibia: p = 0.05). DXA increased in all regions (lumbar spine [LS], p = 0.01; femoral neck [FN], p = 0.009; ultradistal [UD] radius, p = 0.001). Most parameters continued to be significantly lower than those of healthy controls. This prospective HRpQCT study showed that most trabecular parameters altered at CD diagnosis improved significantly by specific treatment (GFD) and calcium and vitamin D supplementation. However, there were still significant differences with a control group of women of similar age and BMI. In the prospective follow-up of this group of patients we expect to be able to assess whether bone microarchitecture attains levels expected for their age. © 2016 American Society for Bone and Mineral Research., (© 2016 American Society for Bone and Mineral Research.) more...

Objective: This article is the first investigation into the proportion of unaccompanied refugee minors suffering from psychiatric disorders in Germany. Method: In a retrospective study done between 2013 and 2015, any refugees showing symptoms of a psychiatric disorder during their stay in a residential refugee center were referred to an Outpatient Department of Child and Adolescent Psychiatry for diagnostic assessment. To this end, special consultation hours were arranged. Besides the diagnoses, the number of emergency consultations occurring before and after the implementation of the special consultation hours was recorded., Results: Of the 75 refugee minors (75 %) referred, 56 were suffering from a psychiatric disorder, with posttraumatic stress disorder and depression being the most common diagnoses. Following implementation of the consultation hours, the number of refugee patients initially admitted in the Child and Adolescent Psychiatry on an emergency basis fell., Conclusions: Unaccompanied refugee minors are a highly vulnerable group that poses great challenges to clinical care. The implementation of special consultation hours is a constructive option for meeting these challenges. In particular, this special offer enables improvement of crisis management in the case of emergency consultations. more...

Background: Celiac disease (CD) is mostly recognized among subjects with a Caucasian ethnic ancestry. No studies have explored conditions predisposing Amerindians to CD., Objective: To prospectively assess environmental, genetic and serological conditions associated with CD among members of the Toba native population attending a multidisciplinary sanitary mission., Methods: An expert nutritionist determined daily gluten intake using an established questionnaire. Gene typing for the human leukocyte antigen (HLA) class II alleles was performed on DNA extracted from peripheral blood (HLA DQ2⁄DQ8 haplotype). Serum antibodies were immunoglobulin (Ig) A tissue transglutaminase (tTG) and the composite deamidated gliadin peptides⁄tTG Screen test. Positive cases were tested for IgA endomysial antibodies., Results: A total of 144 subjects (55% female) were screened. The estimated mean gluten consumption was 43 g⁄day (range 3 g⁄day to 185 g⁄day). Genetic typing showed that 73 of 144 (50.7%) subjects had alleles associated with CD; 69 (94.5%) of these subjects had alleles for HLA DQ8 and four had DQ2 (5.5%). Four and six subjects had antibody concentrations above the cut-off established by the authors' laboratory (>3 times the upper limit of normal) for IgA tTG and deamidated gliadin peptides⁄tTG screen, respectively. Four of these had concomitant positivity for both assays and endomysial antibodies were positive in three subjects who also presented a predisposing haplotype., Conclusion: The present study was the first to detect CD in Amerindians. The native Toba ethnic population has very high daily gluten consumption and a predisposing genetic background. We detected subjects with persistent CD autoimmunity and, at least, three of them fulfilled serological criteria for CD diagnosis. more...

Aim: The stroke and aphasia quality of life scale-39 is an interviewer administered questionnaire that has been developed and validated in the United Kingdom to be applied to patients with chronic aphasia as a consequence of a stroke. The objective of this article was to translate the Stroke and Aphasia Quality of Life-39 Scale (SAQOL-39) into Spanish language, and evaluate its acceptability and reliability., Methods: The cross-cultural adaptation of the SAQOL-39 into Spanish was carried out by following the translation and back-translation method. Twenty three patients with long-term aphasia due to stroke were tested. The patients were interviewed twice in a period from 2 to 12 days. The acceptability of the Spanish SAQOL-39 was evaluated by examining the floor/ceiling effects and the missing data. The reliability was assessed by Cronbach's alpha (internal consistence) and intraclass correlation coefficients (test-retest reliability) for the overall scale and its subdomains., Results: There were no difficulties to translate the original version into Spanish. There was good acceptability demonstrated by minimal missing data and floor/ceiling effects. Test-retest reliability for the overall score, and the subscales scores was 0.949 (0.854-0.944). Internal consistency analysis by Cronbach's a was 0.950 (0.851-0.900)., Conclusions: This small scale study provided preliminary evidence for the acceptability and reliability of the Spanish version of the SAQOL-39. Further testing in larger samples is needed to evaluate the validity of the scale, its sensitivity to change and to confirm its reliability. more...

Objective: To study the causes of the disagreement between the general atmosphere of insatisfaction inherent in the assistance offered by the health care system and the favourable evaluation that the public shows in the questionnaires carried out in the field of primary health care. The less satisfactory issues of the health service offert are also identified., Design: A Delphi thecnique has been used as consensus method., Setting: Community setting: Salamanca urban area., Participants: The Delphi group is made up of people working in jobs with a pronounced social character: members of neighbour associations, educators, social workers, etc. Three consecutive questionnaires were distributed among fifty people. Twenty-seven of them completed the three rounds., Measurements and Main Results: The score of the reasons of disagreement perceived as the most important were: the difficulties of access at a specialised level, 8.3 points; the inequality of the services offered by the two organizative models that coexist in the primary health care, 7.1; the lack of discrimination between the primary and the specialized level, 6.8. The highest scores were for the following complaints: excessive waiting lists at the second care level (8.5), delay in solving the problems (7.8) and masification at the consultancy (7.1). The most satisfactory aspects are the possibility of free choice of doctor, 7.9 points; the previous appointement system, 7.6; and a reliable relationship with the doctor, 7.3., Conclusions: To take into account these factors in the future design and interpretation of inquiries will increase their information validity and usefulness. more...

During the last 10 years or so we have witnessed an enormous growth of interest and applications of surfactant-based ordered media in analytical chemistry. However, their use in analytical atomic spectroscopy (AAS) has been rather scarce and often controversial. The utilization of surfactants in this latter field is discussed here along two main lines: one refers to the favourable manipulation of physical properties of the sample solutions (Part A) while the other, demonstrated very recently, refers to the adequate manipulation of chemical reactions and/or interactions of analytes in solution by resorting to surfactants use (Part B). The control of physical properties of sample solutions, e.g. manipulation of the surface tension, allows three main applications of surfactants in atomic methods: possible increases of nebulization/atomization efficiencies in flame-AAS, improvement of aqueous/organic solvent compatibility (emulsification applications) and enhancement of the wettability of graphitic solid surfaces. The facts and controversies existing today on this method of utilization of surfactants to enhance atomic methodologies is critically discussed. The ability of surfactant-based "ordered media" to organize reactants at the molecular level has also been applied to enhance chemical generation of volatile species (e.g. hydride generation or cold Hg vapour generation) used in atomic methods. The analytical potential and usefulness of micelles and vesicles to improve the detection power of hydride generation ICP-AES methodologies are summarized for the determination of arsenic, lead and cadmium by plasma emission. Increases up to two-fold in the sensitivity of As and Pb have been observed by addition of organized media. A volatile Cd species is formed very easily in cationic vesicles with NaBH(4). This Cd species can be used to increase by five times the detectability of Cd by ICP-AES. Moreover, synergic combinations of liquid chromatography separations/atomic detection are possible by resorting to the use of micellar or vesicular mobile phases. The successful application of this principle to the modern problem of toxic arsenic HPLC speciation by using a vesicular solution [as mobile phase for the HPLC separation of As(III), As(V), monomethylarsonic and dimethylarsinic acids] and "on-line" surfactant-enhanced arsine generation is also described in detail and completes the whole picture of the present interface between analytical atomic spectroscopy and surfactant assemblies. more...