Dissertations / Theses: 'Celiaki'

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Alriksson, Martina. "Jämförelse mellan olika serologiska markörer för diagnostik av celiaki." Thesis, Linnéuniversitetet, Institutionen för naturvetenskap, NV, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-8329.

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Celiaki är en kronisk autoimmun överkänslighetssjukdom mot proteinet gluten. Gluten förekommer i vete, korn, råg och havre. Sädesslagen innehåller olika prolaminer, vilka gemensamt benämns för gliadin. Autoantigenet utgörs av enzymet vävnadstransglutaminas (tTG). Genom deamidering medför enzymet att gliadinets immunogenitet ökar. Det är av största vikt att tidigt ställa korrekt diagnos och inleda glutenfri diet, eftersom celiakin i sig inte bara kan orsaka lidande utan även frambringa en rad följdsjukdomar. Symptomen vid celiaki kan vara väldigt varierande. Därför är behovet av säkra analysmetoder mycket stort. Idag sker diagnostiken vanligen med den serologiska markören immunoglobulin A (IgA) tTG. Analysprincipen bygger på en antigen-antikroppsreaktion mellan bundet antigen och eventuella antikroppar hos patienten, riktade mot antigenet. En sekundär antikropp konjugerad med enzym tillsätts och binder in till komplexet. Vid efterföljande enzymreaktion uppstår en mätbar produkt, vilken är direkt proportionell mot halten av de sökta antikropparna. Syftet med denna studie var att undersöka korrelationen mellan analysinstrumenten, Immulite® 2500 och Phadia® 250, med avseende på markören IgA tTG. Dessutom undersöka sambandet mellan markörerna IgA gliadin (Agl) samt deamiderat gliadin IgA (Agp) respektive deamiderat gliadin immunoglobulin G (Ggp). Korrelationen mellan analysinstrumenten beräknades till 0,85. Korrelationen var något lägre än förväntat, men trots det resulterade 80 % av analysresultaten i samma kliniska bedömning. Korrelationen mellan gliadinmarkörerna var följande: 0,79 mellan Agl och Agp, 0,57 mellan Agl och Ggp samt 0,67 mellan Agp och Ggp. Resultaten visade att 64 % av analysresultaten gav samma kliniska bedömning. Fortsatta studier med referensmaterial krävs för att bedöma markörernas sensitivitet och specificitet.

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Rosenqvist, Louisa, and Sara Thundal. "Kostfiberintag hos Vuxna mde Celiaki : Dagsintag, källor och uppfattningar." Thesis, Uppsala universitet, Institutionen för kostvetenskap, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-216570.

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SAMMANFATTNING Introduktion: Studier har visat att kostfibrer har många hälsofördelar. Vete, råg och korn är fiberrika cerealier som måste undvikas i en glutenfri kost. Tidigare undersökningar har visat att personer med celiaki har haft ett lågt fiberintag, men det saknas aktuella svenska studier inom detta område. Dessutom finns i författarnas kännedom inga studier som behandlar uppfattningar om fibrer hos personer med celiaki. Syfte: Att undersöka fiberintag hos personer med celiaki i Sverige, de huvudsakliga fiberkällorna i deras kost samt deras uppfattning om fiberintag i en glutenfri kost. Metod: Tre dagars kostregistrering (39 deltagare) samt en kompletterande enkät (37 deltagare). Deltagarna i undersökningen var personer mellan 18-80 år med diagnostiserad celiaki, men utan andra matrelaterade intoleranser eller allergier. Resultat: Deltagarnas kostfiberintag var 19,0 gram per dag på gruppnivå, vilket var i nivå med en nationell svensk kostundersökning från 2010-11. Detta resultat var signifikant högre än i en svensk studie från 2001, men fortfarande under den nordiska näringsrekommendationen. De huvudsakliga fiberkällorna i undersökningen var frukt, bär och juice (24 %), bröd (16 %), grönsaker och grönsaksrätter (14 %) samt flingor, müsli och gröt (12 %). Majoriteten av deltagarna ansåg att de hade kunskap om fiberrika livsmedel, och hälften ansågs intresserade av sitt fiberintag. Fiberintaget var inte högre hos de deltagare som fokuserade på sitt fiberintag eller hos de som hade träffat dietist. Slutsats: Undersökningen visade att personer med celiaki hade ett liknande fiberintag som resten av den svenska befolkningen. Dock var medelintaget lägre än den nordiska näringsrekommendationen, även när deltagarna fokuserade på sitt fiberintag. Därför behövs riktade åtgärder för att öka fiberintaget hos personer med celiaki.

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Byström, Ing-Marie. "Celiaki i barn och ungdomsåren : Livskvalitet ur barn- och föräldraperspektiv." Thesis, Linköpings universitet, Institutionen för medicin och hälsa, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-68931.

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Introduction: More and more children and young people get the diagnosis celiac disease established. Celiac is a life-long disease, which means that the child during the rest of its life has to be on a strictly gluten-free diet. There are few studies so far, which have examined how children having a life-long disease with food treatment and increasing prevalence really experience their health related quality of life (HRQoL). Purpose: The purpose of the study was to examine how children (8 – 18 years old) suffering from celiac valued their HRQoL and to illustrate as well whether the age of the child and its extent of disease when it was taken ill affected the child’s evaluation of HRQoL later in life. The purpose was also to compare whether the children’s parents valued the HRQoL of their children to the same extent as the children did. Method: 160 children, 54 boys and 102 girls were included in the study. Answers from 149 children/parents are being worked up in the result. DISABKIDS Chronic generic measure – DCGM – 12 in a short version for both children and parents is used to measure HRQoL during the last four weeks. Results: There was no difference between how boys and girls of different age experienced their total HRQoL during the latest four weeks. Nor were there any visible dissimilarities in the individual domains (mental, social and psychic health). The children who were diagnosed before the age of four being much affected by their disease at the time of the diagnosis valued their HRQoL higher than the children who were diagnosed after the age of four. The children who had been suffering from their disease during a longer period (>8, 7 years) showed a higher degree of HRQoL. The parental evaluation of their children’s HRQoL was lower than that of their own children, in the evaluation of the total HRQoL as well as in the individual domains (mental, social and psychic health). Conclusion: The test “DISABKIDS” shows that the majority of children suffering from celiac disease judged their HRQoL as very good during the last four weeks. Children suffering from celiac showed in this study a higher HRQoL than all the other groups of diagnosis having used DISABKIDS.

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Olofsson, Malin, and Malin Thelander. "En kartläggning av dietistkontakten hos personer med celiaki i Sverige." Thesis, Umeå universitet, Institutionen för kostvetenskap, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-60861.

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Bakgrund Celiaki är en autoimmun sjukdom som påverkar tunntarmen. Prevalensen i Sverige uppskattas till 1 %. Mycket forskning har gjorts kring celiaki men gällande den faktiska dietistkontakten, vilka som får träffa dietist, hur ofta och i vilken form kontakten sker, har lite forskning av relevans hittats. Därför kan en kartläggning vara viktig för att få en överblick på hur det ser ut i Sverige idag. Uppsatsen skrevs på uppdrag av Svenska Celiakiförbundet. Syfte Syftet med studien var att kartlägga dietistkontakten och se hur den överensstämmer med upplevda behov hos vuxna med celiaki i Sverige. Metod En enkätstudie genomfördes där 348 personer med celiaki, varav 273 kvinnor och 75 män, besvarade webbenkäten som skickades ut via Svenska Celiakiförbundets nyhetsbrev. Data bearbetades och analyserades i statistiska program och signifikansnivån sattes till p < 0.05. Resultatet sammanställdes i form av deskriptiv statistik. Resultat Åttiotvå procent av respondenterna hade varit i kontakt med dietist angående sin celiaki och vanligast var individuellt mottagningsbesök (88 %). Majoriteten ansåg att tiden från diagnostillfälle till första dietistkontakt var lagom. Männen var mer nöjda med antalet dietistkontakter jämfört med kvinnorna och signifikanta skillnader kunde ses mellan åldersgrupperna där den yngre gruppen önskade fler dietistkontakter. Sextiofem procent ansåg att informationen från dietist hjälpt dem till att äta glutenfritt. Angående informationsinnehållet var 51 % nöjda med helheten, medan 50 % menade att de inte fått tillräcklig information om att hantera sin celiaki i sociala sammanhang. Slutsats Majoriteten fick dietistkontakt inom en månad efter diagnos i form av individuellt mottagningsbesök, däremot var täta uppföljningsbesök ovanliga. Många var nöjda med antalet dietistkontakter, informationen som getts under dessa samt ansåg att dietistkontakten hjälpt dem att äta glutenfritt. Däremot fanns en betydande andel som uttryckte motsatsen. Männen var mer nöjda än kvinnorna gällande antalet dietistkontakter och den äldre gruppen var mest nöjd i sin helhet.
Background Celiac disease is autoimmune and affecting the small intestine. Prevalence in Sweden counts to 1 %. Research regarding celiac disease has been done but patients’ experiences of dietary provision are a quite unexplored area. A mapping is therefore important to get a general view over the situation in Sweden today. This essay was assigned by The Swedish Society for Coeliacs. Objective The aim was to make a general view over appointments with clinical dietitians and investigate how they correspond with experience of needs in adults with celiac disease in Sweden. Method A web-based questionnaire was conducted where 348 individuals, 273 women and 75 men participated. The questionnaire was distributed in the newsletter of The Swedish Society for Coeliacs. Data was analyzed in statistical programs. Results were presented in descriptive statistics, p-value <0.05. Results Eighty-two percent had been in contact with clinical dietitians concerning their celiac disease, most common type of contact was individual appointments (88 %). The majority found the duration between diagnosis and first dietitian contact satisfying. Men were more satisfied with number of appointments compared to women. The youngest age group wanted significantly more contact. Fifty-one percent were satisfied with the content of the information, 50 % claimed a lack of information on how to manage the gluten free diet in social contexts. Sixty-five percent considered the information had helped them follow the gluten free diet. Conclusion Individual dietitian contact within a month after diagnosis was common, but frequent follow-ups were unusual. Respondents were satisfied with dietetic provision regarding number of appointments, general information and considered it had helped them follow the gluten free diet. But there were a considerable amount who expressed opposite opinion. Men were more satisfied compared to women concerning number of appointments and in general persons > 60 years were most satisfied.

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Apell, Amandine, and Viktoria Burman. "Hur upplevs och hanteras familjens vardag av mödrar till barn med celiaki? : en kvalitativ intervjustudie." Thesis, Umeå universitet, Institutionen för kostvetenskap, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-128826.

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SAMMANFATTNING Bakgrund: Celiaki är en autoimmun sjukdom med en prevalens på 2/100 i Sverige. Enda behandlingen är att äta en kost fri från gluten. Gluten förekommer i spannmålen vete, råg, korn och att diagnostiseras med celiaki innebär ofta att en förändring av matvanor blir nödvändig. Att leva tillsammans med någon med celiaki har visat sig kunna vara problematiskt då familjelivet kan påverkas negativt och föräldrar till barn med celiaki upplever ofta oro och ängslan för sitt barn. Syfte: Syftet med studien var att undersöka hur mödrar till barn med celiaki upplever och hanterar familjens vardag i relation till barnets specialkost. Metod: Ett målinriktat urval användes och kvalitativa, semi-strukturerade intervjuer genomfördes med nio mödrar till barn med celiaki. Materialet spelades in och transkriberades ordagrant för att sedan analyseras med kvalitativ innehållsanalys. Resultat: Samtliga mödrar upplevde att vardagen hade anpassats efter barnet med celiaki och det fanns olika sätt att hantera den glutenfria kosten. Vissa valde att ha helt glutenfritt hemma för att undvika stress över rädslan att ge barnet fel mat. Andra valde att ha både gluteninnehållande och glutenfria livsmedel hemma p.g.a. ekonomiska skäl samt preferenser från övriga familjemedlemmar. Kunskapsnivån kring celiaki i samhället ansågs låg, vilket upplevdes försvåra vardagen för mödrar till ett barn med celiaki. Majoriteten av mödrarna uttryckte att bästa stödet fanns att tillgå via internet och sociala medier. Slutsats: Enligt mödrar till barn med celiaki innebar sjukdomen en del dilemman och vardagen upplevdes stundvis som orofylld, vilket kan påverka livskvaliteten. Internet och sociala medier sågs som ett bra stöd i vardagen. Ökad kunskap samt större förståelse från omgivningen skulle kunna förbättra familjernas vardag.
ABSTRACT Background: Celiac disease (CD) is an autoimmune disorder with a prevalence of 2/100 in Sweden. The only treatment is a diet free from gluten. Gluten occurs in grains of wheat, rye, barley and being diagnosed with CD often means that a change in eating habits is necessary. Living together with someone with CD has been shown to be problematic. Family life may be negatively affected and parents of children with CD experience worry and anxiety for their child. Objective: The aim of the study was to examine how mothers of children with CD experienced and handled everyday life in relation to their child's gluten-free diet (GFD). Method: A targeted selection was used and qualitative, semi-structured interviews were conducted with nine mothers of children with CD. The interviews were recorded and transcribed verbatim and then analyzed with qualitative content analysis. Results: All participants felt that everyday life had been adapted to the child with CD and there were different ways to deal with the GFD. Some chose to have the home as a gluten-free zone to avoid the stress of risking to give the child wrong food. Others chose to have both gluten-containing and gluten-free foods at home because of economic aspects and preferences from other family members. The level of knowledge about CD in the community was considered low, which was perceived to complicate everyday life for mothers of a child with CD. The majority of participants expressed that best support was found through Internet and social media. Conclusion: According to mothers of children with CD, the disease involved some dilemmas and daily life was at times perceived as worrisome, which can affect quality of life. Internet and social media were considered as good support in everyday life. Increased knowledge in society and greater understanding from the environment could improve families everyday life.

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Lidgren, Erika. "Följsamhet till glutenfri kost hos tonåringar med celiaki : en kvantitativ studie om tonåringars förhållande till och kunskap om glutenfri kost." Thesis, Umeå universitet, Institutionen för kostvetenskap, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-107219.

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Bakgrund: Oupptäckt eller obehandlad celiaki kan leda till flertalet komplikationer. Det är svårt att följa en glutenfri kost och följsamheten till den glutenfria kosten varierar mycket. Tonåringar har visat sig ha lägre följsamhet än andra grupper. Syfte: Att analysera följsamhet till glutenfri kost, symtom vid glutenintag, tillväxt, kontakt med sjukvården samt upplevelse och kunskap om glutenfri kost hos ungdomar med celiaki. Metod: Data samlades in via enkät, blodprov och mätning av längd och vikt. Datainsamlingen skedde på Astrid Lindgrens barnsjukhus under våren 2011 och våren 2012. Data analyserades med Minitab 17. Resultat: 16 ungdomar i åldern 16-18 år deltog i studien. Deltagarna hade en hög följsamhet till den glutenfria kosten, tolv var följsamma enligt självrapportering, 14/15 hade normala serologiska värden och 2/15 hade inte nått förväntad target height. Deltagarna upplevde att det främst var utanför hemmet och skolan som det var besvärligt att äta glutenfri kost och i de fall där gluten ingick i kosten var det främst då det skedde. Alla som fick i sig gluten av misstag eller medvetet fick symtom, de som åt gluten medvetet hade en lägre frekvens av symptom. Fyra deltagare angav att de vid något tillfälle träffat dietist på grund av sin celiaki. Slutsats: Ungdomarna i studien hade en hög följsamhet till den glutenfria kosten. Åtta deltagare tyckte det var jobbigt att ha celiaki. Detta i kombination med kunskapsluckor om den glutenfria kosten hos ungdomarna gör att dietister inom sjukvården har en viktig roll i att ge stöd och förmedla kunskap om den glutenfria kosten och förhoppningsvis genom detta minska bördan av en celiakidiagnos. För att öka kunskapen om sjukdomen bör sjukvården ha som mål att alla celiakipatienter bör känna till vad celiaki är och vad följden kan bli om de inte följder den glutenfria kosten.

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Linnér, Christian, and Axel Zuber. "Den Glutenfria Dieten : En studie om att undvika gluten utan diagnosticerad celiaki." Thesis, Uppsala universitet, Institutionen för kostvetenskap, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-305867.

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Bakgrund: Den glutenfria dieten har ökat i popularitet under de senaste åren och verkar ha väckt ett stort intresse för ämnet. Dock verkar det ibland råda oenighet mellan vad vetenskapen har visat och hur allmänheten uppfattar hälsoeffekter av en glutenfri diet. Syfte: Att undersöka varför konsumenter utan diagnosen celiaki väljer att undvika/utesluta gluten. Utöver detta är syftet även att undersöka kunskap kring och uppfattning om gluten i kosten. Metod och Material: En kvantitativ studie med en webbaserad enkät som verktyg för datainsamling. Resultaten presenteras med beskrivande statistik. Chi 2 -test genomfördes som hypotesprövning för att kunna säkerställa statistiska resultat. 476 deltog i enkäten, varav 454 inkluderades. Resultat: Av de respondenter som undviker/utesluter gluten gör mer än två tredjedelar detta då de upplever att de mår bättre av det, trots att celiaki inte föreligger. Drygt en tredjedel av det totala antalet respondenter uppfattar gluten som mycket dåligt för hälsan respektive dåligt för hälsan. Respondenter som av författarna definierats som hälsomedvetna undviker/utes luter gluten i signifikant större utsträckning än icke hälsomedvetna (p = 0,023). Slutsats: Resultaten pekar på att de flesta respondenter som undviker/utesluter gluten gör detta för att de upplever ett faktiskt förbättrat välmående. Kännedomen om gluten hos de svarande varierar men ungefär hälften visste inte vad gluten är. Nästan hälften av respondenterna svarade rätt på samtliga frågor om förekomst av gluten i livsmedel. Majoriteten av deltagarna ansåg att gluten är dåligt för hälsan.

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Wänersjö, Maria. "Föräldrars upplevelse av att leva med ett barn med celiaki : -en intervjustudie." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-49604.

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Ising, Emma, and Eva Jönsson. "VARDAGSPUSSEL! En litteraturstudie om att som vuxen leva med celiaki i vardagen." Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-24831.

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Syftet med denna studien var att undersöka huruvida den glutenfria dieten förceliakipatienter påverkar det dagliga livet. Frågeställningen är: Hur är det att somvuxen leva med celiaki i vardagen? Hur påverkar kostomläggningen ochtillgänglighet av glutenfri kost det dagliga livet och den privata ekonomin? Elvavetenskapliga artiklar granskades och resultaten i dem tematiserades i fem olikateman. Dessa teman var måltider i hemmet, måltider utanför hemmet, vardagslivetoch sociala aktiviteter, copingstrategier samt ekonomi och tillgänglighet.Resultaten diskuteras med Carnevalis omvårdnadsmodell som teoretiskreferensram. Celiakipatienters inre och yttre resurser balanseras mot kraven somfinns för att klara det dagliga livet. Det visade sig att celiakin och den glutenfriadieten påverkade flera situationer i det dagliga livet. Det upplevdes som svårt attfölja en diet och samtidigt ha ett problemfritt socialt liv, mycket spontanitetförsvann och mycket planering krävdes. Dessutom fann författarna enkönsskillnad i upplevelsen av vad den glutenfria dieten innebar och inkräktade på.I diskussionen berörs framtida värden där sjuksköterskans behov av kunskap tasupp. Slutsatsen baseras på resultaten från de vetenskapliga artiklar som används istudien.
The aim in this study was to make research into whether the gluten-free diet forceliac patients influences their daily life. The issue is: How is it to live with celiacdisease in everyday life as an adult? How does the change in diet and availabilityof gluten-free products influence the everyday life and the private economy?Eleven scientific articles were studied and the results in them is presented in fivedifferent themes. These themes were meal times at home, meal times outside thehome, the everyday life and social activities, coping strategies and economy andavailability. The results are discussed with Carnevali´s model of nursing astheoretical frame of reference. Celiac patients inside and outside resources isbalanced against the requirements necessary to handle daily life. The resultsshowed that the gluten-free diet itself influenced the daily life in severalsituations. The celiac patients experienced difficulties in following the diet and atthe same time having a social life without any trouble A lot of spontaneity wasreplaced by a lot of planning. Moreover, the authors found a sex difference in theexperience of the influence of the gluten-free diet meant and trespassed on. In thediscussion, the future value of nurses knowledge of celiac disease is mentioned.The conclusion is based on the results from the scientific articles that are used inthe study.

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Andersson, Anna. "Att leva med glutenintolerans - en intervjustudie." Thesis, Halmstad University, School of Social and Health Sciences (HOS), 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-518.

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Syftet med föreliggande studie var att ur ett folkhälsoperspektiv beskriva hur individer med celiaki upplever sin livssituation. Intervjuer genomfördes med 14 individer med celiaki och analyserades med hjälp av en kvalitativ innehållsanalys. Tre kategorier som beskrev människor med celiaki och deras syn på sin livssituation framkom: Oförstående omgivning, att övervinna hinder och begränsad tillgänglighet. Dessa utgör tillsammans två subteman: Anpassning till sjukdom och begränsande omgivning. De två subteman bildar i sin tur det övergripande huvudtemat: Tillvarons sociala betydelse i ett kontinuerligt samspel mellan individ och omgivning. Hur informanterna upplevde sin livssituation berodde i stor utsträckning på hur individen hanterade sociala situationer, tillgänglighet av glutenfria produkter på marknaden, samt de begränsningar som uppstod i situationer utanför hemmet. Hur människor i omgivningen visade på förståelse, kunskap och respekt ansågs också inverka, men också hur individen själv kunde acceptera och hantera sin sjukdom. En konklusion av studien är att det måste göras tillräckliga insatser för att alla som lider av celiaki ska få möjlighet att delta socialt utan att uppleva svårigheter. Det kan också vara en anledning till att syna det merarbete och de merkostnader som föreligger glutenfri kost. För att detta ska bli möjligt krävs utbildning och information till allmänheten, men framförallt till personal inom livsmedels- och restaurangbranschen.

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Norlin, Helena, and Irene Persson. "Påverkan av glutenfri mat i det dagliga livet : - en litteraturstudie." Thesis, Karlstad University, Division for Health and Caring Sciences, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-143.

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Inom vården möter sjuksköterskan många olika människor med dolda sjukdomar. En av dem är celiaki, även kallad glutenintolerans, som är en kronisk, inflammatorisk tarmsjukdom. Celiaki kan drabba både barn och vuxna. Sjukdomen är genetiskt betingad och beror på överkänslighet mot proteinet gluten som finns i sädesslag, men orsaken till sjukdomen är ännu okänd. Idag finns inget läkemedel som botar sjukdomen, utan det är maten som är medicinen. Syftet var att belysa faktorer som vuxna personer med celiaki upplever i det dagliga livet relaterat till den glutenfria maten. Metoden som användes var en litteraturstudie. Databassökningen gjordes i två databaser: CINAHL och Medline mellan åren 1998 – 2005. Studiens resultat bygger på tio vetenskapliga artiklar, som har kvalitetsgranskats. Efter bearbetning av materialet framkom tre huvudkategorier med tillhörande subkategorier: Sociala faktorer – måltidssituation, resor och möte med sjukvården. Psykiska faktorer – känslor och depression. Fysiska faktorer – mag – tarmbesvär och fatigue. I resultatet framkom att celiaki hade inverkan på den sociala funktionen relaterat till den glutenfria maten. Depression är vanligt förekommande vid celiaki och studier har visat att psykolog hjälp är till stor nytta. Förekomsten av mag – tarmbesvär är vanlig trots att en glutenfri diet följs. Celiaki upplevs olika mellan män och kvinnor.

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Ingman, Fanny. "Hur påverkar celiaki vardagen? : En enkätstudie med fokus på måltider utanför hemmet och den glutenfria trenden." Thesis, Umeå universitet, Institutionen för kost- och måltidsvetenskap, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-173094.

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Bakgrund Antalet personer som är diagnostiserade med celiaki har inte förändrats de senaste åren men trots det har antalet personer som följer en glutenfri kost tredubblats, en förändring som talat för att glutenfri kost blivit en trend. Vuxna med celiaki undviker att äta på café eller restaurang och bidragande orsaker till det är kontaminationsrisk, dålig kommunikation med personalen och restaurangpersonalens otillräckliga kunskap om sjukdomen. Syfte Syftet med studien var att undersöka på vilket sätt celiaki påverkar vardagen, med fokus på måltider utanför hemmet och den glutenfria trenden. Metod Kvantitativ metod i form av en webbaserad enkät valdes som metod. Inklusionskriterierna för att få delta i studien var att personerna måste vara diagnostiserade med celiaki och vara minst 18 år gamla. Enkätsvaren analyserades i SPSS. Chi-2 test, Mann Whitney u test och deskriptiv data användes för analys. Resultat Totalt valde 188 personer att svara på enkäten, 1,1% av respondenterna kände sig alltid trygga att äta utanför hemmet. Yngre kände sig tryggare än de äldre att äta på café/restaurang. Kontaminationsrisk var den faktorn som flest upplevde som orsak till minskad trygghet med att äta måltider utanför hemmet. Den mest framträdande positiva konsekvensen av den glutenfria trenden var ett ökat utbud av glutenfria produkter och den mest framträdande negativa konsekvensen var minskad noggrannhet kring kontaminationsrisk. Slutsats Undersökningen visade att endast ett fåtal deltagare alltid kände sig trygga att äta ute på café/restaurang samt hemma hos andra, vilket kan påverka hur ofta personer med celiaki väljer att äta utanför hemmet. Den glutenfria trenden hade enligt deltagarna medfört både positiva och negativa konsekvenser men resultatet talar för att de positiva konsekvenserna övervägde.
Background The number of people diagnosed with celiac disease has been stable during the recent years, even though the number of people preferring gluten-free food has tripled, this may suggest that gluten-free food has become a trend. The majority of adults with celiac disease avoid eating at café’s or restaurants and the main reason for this are the risk of contamination, poor communication and the lack of restaurant staff's knowledge about celiac disease. Objective The aim of the study was to investigate how celiac disease affects everyday life, focusing on meals outside the home and the gluten-free trend. Method For this study, a quantitative method in the form of web-based questionnaires was used. The inclusion criteria for participating in the study were that people must be diagnosed with celiac disease and be at least 18 years old. The responses from the questionnaire were analyzed in SPSS, Chi -2, Mann Whitney U test and descriptive data were used for analysis. Results In total, 188 chosed to answer the questionnaire. 1,1% of the respondents always felt safe eating outside the home. Younger people felt safer than the elderly did when eating at a café or restaurant. Risk of contamination was the factor that caused least security when eating outside the home. The most significant positive consequence due to the gluten-free trend was increased variety of gluten-free products and the most significant negative consequence was decreased accuracy in contamination risk. Conclusion The study showed that only a few people always felt safe eating at a café or restaurant and at home with others, which can affect how often people with celiac disease choose to eat outside the home. According to the respondents the gluten-free trend had both positive and negative consequences, but the results indicate that the positive consequences were considered.

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Halvarsson, Frida. "Kemokiner och ”tight junction”-proteiner hos celiakipatienter : Lokal immunaktivitet i tunntarmens slemhinna, framförallt i epitelet hos barn med celiaki." Thesis, Umeå universitet, Biomedicinsk laboratorievetenskap, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-79344.

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Aspholme, Carita, Evelina Persson, and Nina Svensson. ""Har ni något överhuvudtaget som jag kan äta?" : Att ha ett barn med dubbeldiagnosen celiaki-diabetes: föräldrars upplevelser av kosten." Thesis, Umeå universitet, Institutionen för kostvetenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-49425.

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Bakgrund Prevalensen hos barn med diabetes typ I och den samtidiga förekomsten av celiaki varierar i studier mellan 2,4-16,4 %. Celiaki och diabetes typ I kräver båda en noggrant kontrollerad kost. Det tycks finnas få studier som undersöker hur kombinationen av de två olika kosterna fungerar i praktiken. Syfte Att utforska hur föräldrar till barn med dubbeldiagnosen celiaki-diabetes upplever att kosten fungerar. Metod En kvalitativ metod användes i form av skrivna berättelser, insamlade via ett webbaserat formulär. Informanterna var 26 föräldrar till barn i åldrarna 3- 16 år med dubbeldiagnosen celiaki-diabetes. Berättelserna analyserades med kvalitativ innehållsanalys. Resultat Informanterna upplevde att det var svårare att få maten att fungera då de hade båda sjukdomarna att ta hänsyn till och att dubbeldiagnosen krävde ständig planering av måltider. Föräldrarna upplevde bristande kunskap i omgivningen, exempelvis hos personal inom skola och restaurang. Det fanns små möjligheter att spara tid och pengar och matutbudet var ofta begränsat, särskilt vad gäller produkter med lågt glykemiskt index. Upplevelser av att vara till besvär och ett bristande bemötande från omgivningen kunde förstärka känslan av att inte vara som alla andra. Slutsats Svårigheterna att lita på omgivningens kunskaper kring de två kostbehandlingarna försvårade följsamheten till kosten och begränsade barnens sociala liv. Upplevelserna av bristande bemötande och förståelse i omgivningen kunde förstärka känslan av att inte vara som alla andra och att vara till besvär. Därför finns ett behov av utbildning riktad till skol- och restaurangpersonal för ökad kunskap och förståelse. Mer material rörande matlagning anpassat till dubbeldiagnosen skulle också underlätta, både för barnens familjer och omgivningen. Den ständiga planeringen begränsade vardagen och föräldrarollen påverkades till att bli mer kontrollerande vilket skulle kunna försvåra för föräldrarna i att lotsa barnet till mer självständighet. Utbudet av glutenfria specialprodukter med lågt glykemiskt index var begränsat, framförallt vad gäller bröd. Därmed finns ett behov av en vidare produktutveckling.
Background The prevalence of both coeliac disease and diabetes type I in the pediatric population varies between 2.4-16.4 %. Both diseases demand a strictly controlled diet A limited number of studies are investigating the practical implementation of the two diets. Objective To investigate parent’s experiences of the diet, when having a child with both coeliac disease and diabetes type I. Method A qualitative method was used in form of narratives, collected through a web based form. The informants consisted of 26 parents, having a child of age 3-16 years, diagnosed with both coeliac disease and diabetes type I. Qualitative content analysis was used to analyze the narratives. Result Difficulties were experienced by the informants considering the practical implementation of the two diets. The double diagnosis demanded frequent planning. Lack of knowledge in the surroundings was experienced, for example in staff at school and restaurants. The possibilities of saving time and money were limited and there were limitations also in the food supply, especially gluten-free products with low glycemic index. Due to experience of inconvenience and negative treatment from their surroundings, the feelings of being different were enhanced. Conclusion Difficulties in trusting others knowledge regarding the diet lead to compliance issues and put restraint to the children’s social life. Perceptions of lack of treatment and understanding in the surroundings could enhance the feeling of not being like everyone else and being a nuisance. A need for education aimed at staff in schools and restaurants exists to increase knowledge and understanding. More materials regarding cooking with the double-diagnosis are desirable. Constant planning lead to limitations in the daily life and the parenting role became more controlling, which could create difficulties when guiding the child into independence. Also the supply of gluten-free products with low glycemic index is limited and need further development.

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Guldstrand, Maria, and Andreas Rydström. "Fördröjningen till celiakidiagnos : En kvantitativ studie om sjukskrivning, vårdkonsumtion och social situation hos vuxna med celiaki före och efter diagnos." Thesis, Umeå universitet, Institutionen för kostvetenskap, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-64203.

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Bakgrund Celiaki är en autoimmun sjukdom som ger inflammation i tunntarmsslemhinnan vid intag av gluten. Symtom hos vuxna kan vara diffusa och därför svåra att koppla till celiaki. I Sverige är genomsnittstiden från första symtom till celiakidiagnos ungefär 10 år och det finns luckor i kunskapen om vilka konsekvenser fördröjningen till diagnos ger. Syfte Studiens syfte är att överblicka hur fördröjd diagnos av celiaki hos vuxna påverkar samhällets resurser, hur dessa individer upplever att symptomen påverkat deras sociala liv före och efter diagnos, samt om diagnostiken behöver effektiviseras. Metod I Sverige, september 2012, skickades en Internetbaserad enkät ut till 4337 medlemmar i Svenska Celiakiförbundet varav 611 kvarstod efter bortfall. Enkätens fokus var främst sjukfrånvaro, vårdkontakter och social påverkan p.g.a. symtom av celiaki. Enkäterna analyserades i SPSS (v.20.0) med p<0,05. Resultat Efter diagnos sjönk både sjukfrånvaro och vårdkontakter. Deltagarna undvek också sociala aktiviteter i mindre utsträckning och majoriteten upplevde förbättrad livskvalité. En stor del (39 %, n=238) uppgav att de fått diagnos först 10 år eller mer efter symtomdebut, varav majoriteten var äldre. Det var framför allt de som uppgav en fördröjning på fyra år eller mer från första symtom till diagnos som upplevde att deras livskvalité förbättrades av diagnosen. Slutsats Det är viktigt att celiakidiagnos ställs tidigt för att bespara kostnader som annars kommer av sjukfrånvaro och vårdkonsumtion, samt minska den negativa påverkan av symtom på det sociala livet och livskvalitén. Då mer än hälften av deltagarna i studien haft symtom i minst 5 år innan diagnos anser vi att åtgärder måste sättas in. Tidigare diagnos kräver antingen screening av befolkningen eller nya vårdplaner där diffusa symtom av celiaki uppmärksammas mer. Mer studier behövs för att avgöra vilken åtgärd som är mest hållbar.
Background Coeliac disease is an autoimmune disease where gluten causes inflammation in the mucosa of the small intestine. Symptoms in adults may be vague and therefore difficult to associate with coeliac disease. In Sweden, the average delay from first symptom to diagnosis is about 10 years. There are gaps in the knowledge of the consequences of a delayed diagnose. Objective The purpose of this study is to review the effect of the delay of coeliac diagnosis among adults on society’s resources, how the symptoms may have affected these individuals social life and the need of improved diagnosis. Method In Sweden, September 2012, an online questionnaire was distributed to 4,337 members of the Swedish Coeliac Society of which 611 was included in the study. The survey focus was mainly sick leave, health care contacts and social impacts due to symptoms of coeliac disease. The questionnaires were analyzed in SPSS (v.20.0) with p<0,05. Results Both sick leave and health care contacts decreased after diagnosis. The participants also avoided social activities to a lower extent and the majority experienced an improved quality of life. A large proportion (39%, n=238) reported that diagnosis delayed at least 10 years from the onset of symptoms, the majority of whom were older than the average. It was mainly those who reported a long delay from first symptom to diagnosis who experienced an improvement in quality of life due to diagnosis. Conclusion Early diagnosis is important in order to reduce costs that would otherwise derive from health care consumption and sick leave. Early diagnosis would also reduce the negative impact of symptoms on social life and quality of life. Since the majority of the participants reported a delay of at least 5 years from onset of symptoms to diagnosis, we believe that it is necessary to take action. In order to diagnose individuals with coeliac disease at an earlier stage it is necessary to apply effective methods such as screening or new care plans with more attention on vague symptoms. To determine which method is most sustainable, more studies needs to be done.

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Hollén, Elisabet. "Coeliac Disease in Childhood : On the Intestinal Mucosa and the Use of Oats." Doctoral thesis, Linköpings universitet, Medicinsk mikrobiologi, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-7690.

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Celiaki, eller glutenintolerans, är en av våra vanligaste kroniska sjukdomar i barnaåren. Sjukdomen orsakar en kraftig inflammation i tunntarmens slemhinna efter intag av glutenhaltig föda hos personer med ärftlig benägenhet att utveckla celiaki. En frisk tarm är kraftigt veckad för att öka ytan för upptag av näringsämnen. Ytan består dessutom av åtskilliga fingerliknande utskott, s.k. villi, och mellan villi finns kryptorna där celldelning och celldifferentiering sker. Villi och kryptor kantas av epitelceller, enterocyter, vilkas uppgift är att ta upp näring från tarminnehållet samt att utgöra en selektiv barriär mellan den yttre och inre miljön i tarmen. Den typiska tarmskadan vid celiaki karakteriseras av avsaknad av villi och kraftigt förlängda kryptor, och både näringsupptaget och barriärfunktionen är dessutom störda. Den enda behandling som finns att tillgå vid celiaki är en livslång glutenfri diet. De skadliga proteinerna i vetegluten kallas gliadin, och det finns liknande proteiner i råg, korn, och havre. I havre kallas proteinet avenin. Möjligheten att använda havre vid celiaki har diskuterats flitigt, men numera anses det riskfritt för majoriteten av både barn och vuxna att använda havre i den glutenfria dieten. Målet med den här avhandlingen var att undersöka hur barn med celiaki reagerar på havre i kosten. Detta studerades med avseende på antikroppar mot avenin samt med en metod som mäter halten av kväveoxid- (NO-) produkter i urinen. Ett andra mål var att studera tunntarmens struktur vid olika stadier av celiaki. I den första studien undersökte vi om celiakibarn har antikroppar i serum mot avenin. Vi fann att så var fallet och att nivåerna var signifikant högre än hos friska kontrollbarn. När barnen sattes på glutenfri kost sjönk antikroppsnivåerna, för att öka igen när gluten återinfördes i kosten. Blodproverna till den här studien togs innan debatten om havre kom igång, vilket gör att vi tror att de olika dieterna även speglar ett sant intag av havre. Studien visade också att det inte var någon korsreaktion mellan antikroppar mot avenin och gliadin. Vi använde sedan vår metod för att mäta antikroppar mot avenin i en randomiserad studie där havre gavs till barn med nydiagnostiserad celiaki. Barnen fick antingen en vanlig glutenfri diet eller en med tillsats av specialhavre. Antikroppsnivåerna sjönk markant redan efter tre månader i båda grupperna, och vid studietidens slut, efter ca ett år, hade alla utom ett par patienter återfått normala nivåer. Samma barn studerades även med avseende på NO-produkter i urinen. NO är en kortlivad molekyl som fungerar som budbärare i och mellan celler, och produktionen av den ökar markant vid en inflammation. Tidigare studier har visat att barn med obehandlad celiaki har extremt höga halter av NO-produkter i urinen. I vår studie sjönk även dessa värden signifikant efter tre månader, och det var ingen skillnad mellan grupperna. Efter ett år hade dock fyra barn i havregruppen och ett barn i den grupp som fick vanlig glutenfri kost, fortfarande extremt höga nivåer av NO-produkter. Dessa båda studier styrker den kliniska uppfattningen att de flesta barn med celiaki kan tåla havre, men de visar också att man bör följa upp de celiakibarn som kompletterar sin glutenfria kost med havre eftersom vissa barn verkar ha kvarstående tecken på inflammation i tarmen. I tarmbiopsier från barn med olika stadier av celiaki studerades förekomst och lokalisering av occludin och claudiner, proteiner som är viktiga för att upprätthålla barriärfunktionen i tarmen. Vi fann ett ökat uttryck av occludin vid obehandlad celiaki, vilket vi tror speglar den ökade celldelning och de förändrade barriäregenskaper som man ser vid aktiv celiaki. Resultaten tyder även på att uttrycket av claudin 1-5 inte tycks påverkas av kosten hos barn med celiaki.
Coeliac disease (CD) is one of our most common chronic diseases in childhood. The disease causes an intense inflammation in the small intestinal mucosa after ingestion of gluten-containing cereals in genetically predisposed individuals. The mucosal lesion in CD is characterised by villous atrophy and crypt hyperplasia, and both the absorptive and the barrier functions of the enterocytes are disturbed. The treatment of CD is a life-long adherence to a gluten-free diet (GFD). The toxic fraction of wheat gluten is gliadin, and there are similar proteins in rye, barley and oats. In oats this protein is called avenin, and it is proposed to be less toxic than the others. The use of oats in CD has been debated, but it is now considered safe for the majority of both children and adults with CD. The aims of this thesis were to investigate the humoral and inflammatory reactions to oats in children with CD, and also to study the intestinal mucosa at different stages of the disease. In a retrospective study we found that children with CD had antibodies to oats avenin, and that the levels were significantly higher than in controls. The levels attenuated during GFD, and we also showed that there was no crossreactivity between antibodies to oats and gliadin. We then used our method for measuring antibodies to avenin in a randomised, double-blind trial of oats given to children with newly diagnosed CD. The children were given either a traditional GFD or a GFD supplemented with oats. There was a rapid decrease in antibody levels in both groups already after three months on diet, and at the end of the study period all but a few had normalised their levels. The same children were also studied using urinary nitric oxide (NO) products as markers for intestinal inflammation. Likewise, these values decreased significantly after three months. At the end of the study four children in the GFD-oats group and one in the standard GFD group still had extremely high concentrations of urinary NO metabolites. Taken together, these studies strengthen the clinical impression that oats can be tolerated by the majority of children with CD, but they also warrant a caution, since there seem to be children that do not tolerate oats in their diet. The structure and distribution of occludin and claudins 1-5, tight junction proteins known to play a crucial role in maintaining the barrier function, was studied in biopsy specimens from children at different stages of CD. There was an increased expression of occludin in untreated CD, which reflects the characteristics of crypt cell hyperplasia and altered barrier properties seen in active CD. The findings also indicate that gluten intake does not significantly influence the expression and distribution of claudins 1-5 in coeliac children.

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Nilsson, Bia, and Wiklund Erika Holmlund. "Glutenfri mat på restauranger och caféer i Umeå : En kartläggning av utbud och personalens kunskap." Thesis, Umeå universitet, Institutionen för kostvetenskap, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-57838.

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Bakgrund Restaurang- och cafébesöken ökar, liksom antalet människor med födoämnesöverkänslighet. Utbudet av glutenfri mat upplevs dåligt av de med celiaki, vilket också innebär svårigheter att äta utanför hemmet. Detta kan medföra en negativ social påverkan av rädsla för att äta mat som kan vara kontaminerad med gluten. Tidigare studier har visat brist av kunskap om födoämnesallergener bland restaurangpersonal. Syfte Syftet med studien var att kartlägga restaurangers och caféers utbud av och kunskap om glutenfri mat, samt att undersöka om intresse fanns för mer information kring glutenfri mat. Metod En anonym enkätstudie genomfördes bland restauranger och caféer inom Umeå tätort, under perioden april till juni 2012. Enkäten bestod av 18 frågor, inklusive ett kunskapstest. Totalt tillfrågades 115 verksamheter varav 102 deltog. Materialet sammanställdes i SPSS 18.0 med signifikansnivån p<0,05. Resultat Glutenfri mat på menyn fanns hos 81 av 102 besökta verksamheter. Av dessa bedömdes 55 ha ett bra utbud, med fyra glutenfria alternativ eller fler. Majoriteten (n=92) kunde också ordna glutenfri mat vid förfrågan. Kunskapstestets resultat gav ett medelvärde på sju rätt av tolv möjliga. God kunskap hade 29 %, medelgod kunskap 36 % och dålig kunskap hade 35 %. Av de respondenter som angett att de kände till glutenintolerans mycket väl, klarade färre än hälften kunskapstestet med goda resultat. Mer information om glutenintolerans önskades av 43 respondenter (n=98). Slutsats Trots att de flesta caféer och restauranger i Umeå erbjuder glutenfri mat, och överlag upplever att efterfrågan är relativt stor, så motsvarar detta inte kunskapsnivån bland respondenterna. Det kan ha förekommit respondenter som övervärderat sin kunskap. Detta skulle kunna innebära en risk att äta mat som sägs vara glutenfri, men som kan vara kontaminerad med gluten. Något de med celiaki bör vara medvetna om. Dessa faktorer pekar mot vikten av att genomföra utbildningsinsatser bland personal inom branschen.

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Kuncířová, Sabina. "Stravovací zařízení pro turisty celiaky v regionu Hl. města Prahy." Master's thesis, Vysoká škola ekonomická v Praze, 2015. http://www.nusl.cz/ntk/nusl-203778.

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The main aim of this thesis is to analyse restaurants in Prague which offer special dishes for people who suffer from celiac disease. Theoretical part consists of definition and history of celiac disease, symptoms of celiac disease etc. One of the aims of the practical part is to create a free city map with marked restaurants suitable for people who suffer from celiac disease. The author conducted a survey among tourists whether they would appreciate this kind of map.

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Nykvist, Fanny. "SPECIALKOST VID MÅLTIDSSERVICE : En kvalitativ intervjustudie." Thesis, Umeå universitet, Enheten för restauranghögskolan, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-161198.

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Hos barn förekommer allergier, överkänsligheter och intoleranser mot födoämnen allt oftare. För dessa tillstånd krävs näringsrik specialkost. Celiaki är ett sådant exempel som kräver en strikt kosthållning helt fri från gluten för ett gott välmående. Syftet med arbete är att undersöka hur måltidsservice på några av de olika produktionsköken i Umeå kommun arbetar med specialkost på förskolor. Studien baseras på sju stycken kvalitativa semistrukturerade intervjuer. Det insamlade materialet analyserades med hjälp av innehållsanalys. Resultatet visade på att produktionsköken har strikta rutiner angående specialkost och en god kommunikation ger trygghet för både kökspersonalen och föräldrarna. Resultatet pekade på att barn vid kommunens förskolor har intyg och arbetet med specialkost uppfattas som tidskrävande. Utbildning angående specialkost på produktionsköken var bra medan det framkom variation bland förskolepersonalens utbildning och utbudet av utbildning. Strikta rutiner följs i produktionsköken för att garantera en icke kontaminerad måltid för barnen som behöver följa en specialkost.
Allergies, oversensitivity, and intolerances towards food are more becoming more common found amongst children. For these kinds of diseases, a nutritious special diet is required. Same thing is necessary for children with coeliac disease, that due to the certain condition requires a strict gluten free diet for a good wellbeing. The purpose of this thesis was to investigate how the food service in Umeå county is working with special diets for preschools in the different production kitchens. Seven qualitative interviews that were semi structured where collected. This data was thereafter analyzed with content analysis. The result showed that the production kitchens had strict routines regarding special diets, and a good communication is a vital part for the safety between kitchen staff and the children's parents. Further on, the result indicates that the children need to have a certain certificate and that special diets are perceived as a time consuming. Education about special diets were seen as good in the production kitchens, whereas at the preschools the educational level and possibility to educate themselves were more varied. Strict routines are followed to guarantee a non-contaminated meal for the children that are required to follow a special diet.

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Valkus, Martin. "Způsoby stanovení a léčení celiakie." Master's thesis, Vysoké učení technické v Brně. Fakulta chemická, 2015. http://www.nusl.cz/ntk/nusl-217168.

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This diploma thesis deals with methods of determining and treatment of coeliac disease. In the theoretical part of the work sums up informations about coeliac disease - history, prevalence, etiopathogenesis, immunopathogenesis, possibilities of diagnosis, discusses about gluten-free diet, mentions legislation of the Czech Republic and the European Union and compares expensiveness of gluten-free diet and normal diet. The experimental part of this thesis compares PCR, ELISA and indirect immunofluorescence methods for assesment of determination of genetic predisposition and antibodies in coeliac disease (greatest emphasis was placed on the comparison of antibodies against gliadin and deamidated gliadin antibodies in IgA and IgG).

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Porubiaková, Otília. "Sledování změn obsahu proteinů lepku v průběhu technologie výroby piva." Master's thesis, Vysoké učení technické v Brně. Fakulta chemická, 2018. http://www.nusl.cz/ntk/nusl-376783.

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The aim of thesis was monitoring of changes in the content of gluten proteins in the biotechnological process of beer production. During the production process of wheat and barley beer, the samples were collected and analysed using the electrophoresis and immunoassay method. The results of the analyses were compared with commercial Czech beers. The theoretical part contains description and composition of gluten proteins, malt and beer technology, the changes that occur in this process, and methods of gluten proteins analysis. The experimental part contains procedures for laboratory production of barley and wheat beer and analyses of gluten proteins. To identify the individual gluteal protein fraction acid and SDS electrophoresis methods were used. For quantification, enzyme immunoassay was used and evaluated spectrophotometrically. The identification of the gluten‘s fractions by electrophoretic methods has been shown to be less specific for samples with lower content of gluten proteins and for barley specimens. A decrease in the concentration of gliadins and glutenins in the beer production process was demonstrated. A significant change was found during wort production with 98% decrease of gluten content compared to the feedstock and during the fermentation, when the gluten concentration dropped below 10 mg/kg. This value is acceptable from the legislation for products labelled „gluten-free“.

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Gruberová, Anna. "Segmentace trhu bezlepkových protravin." Master's thesis, Vysoká škola ekonomická v Praze, 2013. http://www.nusl.cz/ntk/nusl-198447.

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This thesis contains information about gluten free food market. It describes all main actors and also different types of business which can sell or manufacture gluten free food. Great emphasis is placed on understanding needs of "gluten free" customers identifying behavior which differentiate them inside this segment and also between regular customers. It also discovers opportunities and challenges on this market. Based on collected information it predicts possible future development.

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Alencar, Natália Manzatti Machado 1988. "Direcionadores de preferência e perfil sensorial de pães isentos de glúten e sacarose." [s.n.], 2014. http://repositorio.unicamp.br/jspui/handle/REPOSIP/254258.

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Orientador: Helena Maria André Bolini
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia de Alimentos
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Resumo: Na atualidade a doença celíaca atinge aproximadamente 1% da população do mundo, e cerca de 3,1% dos pacientes com diabetes mellitus tipo I. A doença celíaca é caracterizada pela atrofia da mucosa intestinal na parte proximal e pela permanente intolerância ao glúten. Seu tratamento consiste em uma dieta isenta de glúten. Novas estratégias tem sido utilizadas para a fabricação de produtos de panificação isentos de glúten e sacarose, que se referem à utilização de pseudocereais, tais como amaranto e quinoa e edulcorantes, como por exemplo, sucralose e estévia. Diante disso, o objetivo desse estudo foi analisar a incorporação de farinha de amaranto e quinoa e edulcorantes (sucralose, estévia, acessulfame-k) no estudo do perfil sensorial e físico-químico em 6 amostras de pães isento de glúten e de sacarose. Os pães foram formulados contendo 20% farinha de amaranto e quinoa como substituto parcial da composição de amidos, sucralose, estévia e sucralose/acessulfame-K como edulcorantes substitutos da sacarose. Para compor o estudo de análise sensorial foram realizados Análise Descritiva Quantitativa (ADQ), teste de aceitação e análise tempo-intensidade para os estímulos gosto doce e amargo. O perfil físico-químico foi determinado por meio de volume específico do pão, cor, firmeza, atividade de água, composição centesimal, energia bruta e análise de imagem dos alvéolos. A análise estatística foi composta por Análise de Variância (ANOVA), teste de médias de Tukey ao nível de 5% de significância. Foi realizada uma correlação com os resultados da ADQ e impressão global do teste de aceitação por meio da análise de mínimos quadrados parciais (PLS). A ADQ foi realizada por 12 assessores, que geraram 24 termos descritores. Os pães com amaranto e quinoa foram percebidos com aroma e sabor característico desses pseudocereais, coloração marrom da casca do pão e maciez. No teste de consumidor verificou-se que a amostra com farinha de amaranto com sucralose foi a que obteve maior aceitação pelos consumidores. As análises-físico-químicas mostraram que os edulcorantes e as farinhas de amaranto e quinoa resultaram em bons substitutos para sacarose e amidos, respectivamente. A análise tempo-intensidade identificou um comportamento similar para a percepção do gosto doce entre as amostras. Quanto à percepção do gosto amargo, os pães de quinoa com edulcorantes sucralose e sucralose/acessulfame-K apresentaram maior intensidade máxima para esse estímulo. A correlação por PLS revelou que os atributos aroma e sabor de amaranto foram direcionadores de preferência positivos. Por meio desses resultados observa-se que a incorporação de farinha de quinoa e amaranto e edulcorantes em pães sem glúten e sacarose foi eficiente no desenvolvimento dos pães. Assim a pesquisa possibilitou o desenvolvimento de pães para uma população específica, ou seja, os celíacos, diabéticos ou ambos
Abstract: Nowadays the celiac disease reaches nearly 1% of the world population, and almost 3,1% of the patients that have mellitus type I diabetes are affected by this disease. It is characterized by the atrophy of intestinal mucosa in the proximal part and permanent gluten intolerance. The treatment is a gluten free diet. Recent studies have shown new strategies for the gluten free or/and sugar free baked products, with pseudocereals amaranth; quinoa and sweeteners as sucralose and stevia. The objective of this study was analyze the partial replacement of amaranth and quinoa flour incorporation and sucrose replacement with sweeteners (sucralose, stevia and acesulfame-K) in gluten and sucrose free bread in the sensorial and physicochemical profile in 6 samples. Different types of breads where produced with either 20% amaranth or quinoa flour replacing wheat flour and sucralose, stevia and a blend of sucralose/acesulfame-K as sucrose replacers. The sensory evaluations were performed by means of Quantitative Descriptive Analysis (QDA), acceptance test, time intensity analysis for the sweet and bitter stimuli. Physicochemical analyses were performed by specific volume, colour, firmness, water activity, proximate composition, gross energy and image analysis of the alveoli. Statistical data were statistically analised by Analysis of Variance (ANOVA) and Tukey¿s test average (in p<0.05 of significance level). Sensory profile by QDA and overall impression were correlated obtained in the partial least square analysis (PLS) correlations technique. The QDA comprised which 12 panelists and created 24 descriptive terms. The bread samples with amaranth and quinoa were identified with characteristic¿s pseudocereals aroma and taste, brown bread skin color and soft. In the acceptance test, samples with amaranth and sucralose were preferred (p<0,05). The physicochemical analyses showed the sweeteners and the amaranth and quinoa flour were good replacers for sucrose and starch respectively. Time-intensity analysis identified a substitute similar behavior concerning to the sweet taste perception among the samples, while the perception of bitterness in the quinoa with sweeteners sucralose and sucralose/acesulfame-K presented maximum intensity for that stimuli. The correlations by PLS analysis revealed that the aroma and taste amaranth attributes detected the positive preference. From these results it is possible to conclude that the incorporation of quinoa and amaranth flour and sweeteners in breads without gluten and sucrose was efficient in the development the bread for a specific population, in other words, celiac and diabetics
Mestrado
Consumo e Qualidade de Alimentos
Mestra em Alimentos e Nutrição

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Bělušová, Kristýna. "Podnikatelský záměr - vybudování kavárny pro osoby trpící celiakií." Master's thesis, Vysoké učení technické v Brně. Fakulta podnikatelská, 2017. http://www.nusl.cz/ntk/nusl-318302.

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This thesis decribes the setting up of a business plan for coffee shop, which besides quality coffee, targets customers suffering from celiac disease (gluten-free assortment). The aim of this thesis is to create a real business plan. For this purpose, the data for the creation of financial plan were based on real datas. In the end of this thesis the success of the established business plan is evaluated.

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Pechová, Gabriela. "Poskytování služeb v oblasti pohostinství se zaměřením na celiaky." Master's thesis, Česká zemědělská univerzita v Praze, 2017. http://www.nusl.cz/ntk/nusl-257591.

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The master´s thesis is focusing on temporary characteristics of restaurant services from the view of customers who have the illness called coeliac disease, which means they have certain dietary restrictions. Firstly, the theoretical part sets the topic into the wider context. The theoretical background is divided into three larger parts dealing with coeliac disease, the specifics of gluten-free diet and with a characteristics of hospitality industry with focus on this group. In the practical part statistical tests analyse the information, obtained by survey aimed at the target group. For this purpose the practical part is divide into four parts dealing with demographic characteristics of coeliacs and their influence on frequency of visiting restaurants, suitable characteristics of restaurants, their promotion and with coeliacs' interset in specialized restaurants. The outcomes of the thesis are a summary of coeliacs' consumer behaviour in the field of restaurant industry and recommendations for restaurants, how the offered services could be improved and fitted to the target group. Finally the thesis deal with the question of working of a restaurant which would be partly or entirely focused on serving a specially prepared gluten-free meals.

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Escouto, Luiz Fernando Santos [UNESP]. "Elaboração e avaliação sensorial de pré-mistura de massa para pão sem glúten a partir de derivados energéticos de mandioca." Universidade Estadual Paulista (UNESP), 2004. http://hdl.handle.net/11449/101720.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Universidade Estadual Paulista (UNESP)
Em pesquisa anterior, foi desenvolvida uma formulação para pão sem glúten, baseada em derivados de mandioca. O pão sem glúten visa os celíacos, para os quais a ingestão de alimentos contendo glúten danifica a superfície da mucosa do intestino delgado. Essa formulação exigia uma fase de escaldamento dos ingredientes, o que acarretava maior consumo de energia. O ponto mais importante, entretanto, é que o pão tem curta vida de prateleira e por isso é adequado à dispersão do mercado, uma característica dos consumidores celíacos. Para contornar essas limitações foi desenvolvida e avaliada uma pré-mistura de pão sem glúten baseada na formulação anterior, mas com ajustes dos ingredientes farinha de mandioca, amido pré-gelificado e lecitina. O uso de pré-mistura é uma tendência da panificação atual e permite a comercialização dispersa e por maior período. Para os testes de ajuste da formulação foi usada a análise estatística univariada com 3 ensaios e 3 tratamentos cada para dois ingredientes amido pré-gelificado e farinha de mandioca crua. Foram selecionados como fatores importantes na escolha da formulação: a cor da crosta, miolo e na escolha da pré-mistura, avaliação energética e econômica, índice de aceitabilidade, calorimetria, avaliação sensorial. Além desses foram usados indicadores de volume, como o volume específico, densidade, indicador de conversão, perda por evaporação, pontuação da qualidade. Essa análise permitiu a seleção de uma formulação de pré-mistura a qual foi caracterizada para cor, calorimetria, conteúdo energético, custo da matéria prima e preparo. Como forma de confirmar a aceitabilidade foram preparados pães com a formulação selecionada, que por sua vez foram avaliados por degustadores selecionados entre os prováveis consumidores do público celíaco, sócios da Associação dos Celíacos do Brasil - ACELBRA, de São Paulo.
In a previou research it was develop a formulation for bread without gluten, using energetic cassava derivatives. This bread aims the celiac persons, for whom the ingestion of food with gluten causes damages the mucosa surface of small bowl. In a specific phase of this formulation the ingredients had to be scalded, which spent more energy. The point important is that the bread has short shelf life and is for these adequated the market dispersion characteristic of the celiac consumers. In order to solve these limitations was developed and evaluated a premixture of bread without gluten based in the previous formulation, but adjusted for ingredients cassava flour, pregelatinized starch and lecithin. Nowadays the use of the premixture is a tendency of the modern bakery. In the adjust of these formulation it were used statistical analysis univariable with 3 essays and 3 treatment for each two ingredients pregelatinized starch and cassava flour. It was selected some factors that influence the formulation: selected crust color, crumb and into select of the premixture, energetic and economical evaluation, acceptability index, calorimetry, sensory evaluation. Besides was volume indicators as specific volume, density, conversion indicator, evaporation rate, quality punctuation, volume and losses after cooking. This analysis allowed the selection of a premixture formulation that was characterized in color, calorimetric, energetic content, costs and of preparation. In order to confirm the bread acceptability it was made breads using these selected formulation, which were tasted and evaluated by celiac consumers and members of the São Paulo section for Brazilian Association of Celiac ACELBRA of the São Paulo. It was also stablished the organoleptic characteristics of the bread made with a premixture: crust color, symmetry and shape, crust characteristics, color, porousness and texture of the crumb, flavor and taste.

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Sjöberg, Veronika, Olof Sandström, Maria Hedberg, Sten Hammarström, Olle Hernell, and Marie-Louise Hammarström. "Intestinal T-cell responses in celiac disease : impact of celiac disease associated bacteria." Umeå universitet, Immunologi/immunkemi, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-64525.

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A hallmark of active celiac disease (CD), an inflammatory small-bowel enteropathy caused by permanent intolerance to gluten, is cytokine production by intestinal T lymphocytes. Prerequisites for contracting CD are that the individual carries the MHC class II alleles HLA-DQ2 and/or HLA-DQ8 and is exposed to gluten in the diet. Dysbiosis in the resident microbiota has been suggested to be another risk factor for CD. In fact, rod shaped bacteria adhering to the small intestinal mucosa were frequently seen in patients with CD during the "Swedish CD epidemic" and bacterial candidates could later be isolated from patients born during the epidemic suggesting long-lasting changes in the gut microbiota. Interleukin-17A (IL-17A) plays a role in both inflammation and anti-bacterial responses. In active CD IL-17A was produced by both CD8(+) T cells (Tc17) and CD4(+) T cells (Th17), with intraepithelial Tc17 cells being the dominant producers. Gluten peptides as well as CD associated bacteria induced IL-17A responses in ex vivo challenged biopsies from patients with inactive CD. The IL-17A response was suppressed in patients born during the epidemic when a mixture of CD associated bacteria was added to gluten, while the reverse was the case in patients born after the epidemic. Under these conditions Th17 cells were the dominant producers. Thus Tc17 and Th17 responses to gluten and bacteria seem to pave the way for the chronic disease with interferon-γ-production by intraepithelial Tc1 cells and lamina propria Th1 cells. The CD associated bacteria and the dysbiosis they might cause in the resident microbiota may be a risk factor for CD either by directly influencing the immune responses in the mucosa or by enhancing inflammatory responses to gluten.

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Donat, Aliaga Ester. "Análisis genético de la enfermedad celiaca." Doctoral thesis, Universitat de València, 2010. http://hdl.handle.net/10803/52125.

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La Enfermedad Celiaca (EC) es de origen multifactorial (gluten y otros factores ambientales no bien definidos) y poligénico. La predisposición genética viene dada por la tasa de concordancia entre familiares de primer grado (10%) y la tasa de concordancia entre gemelos monocigotos de hasta un 70%. Los genes del sistema HLA (antígeno Humano de Histocompatibilidad) case II han sido identificados como factores de riego genético claves en la susceptibilidad de la EC otorgándoles un 40% del riesgo genético global. En nuestra población española (Comunidad Valenciana) se analizó la asociación entre los genes HLA clase II y EC. En nuestra muestra se han estudiado a un total de 185 pacientes (que cumplían los criterios ESPGAN 1990 para el diagnóstico de la EC) y a sus familiares en primer grado. En nuestra población hemos encontrado asociación individual entre la EC y los antígenos de sistema HLA DRB1*03, DRB1*07, DRB3*, DQB1*02:01, DQB1*02:02 y DQA1*05:01, sin embargo, no encontramos asociación con los alelos DRB1*04, DQB1*03:02 ni DQA1*03:01-03, que codificarían para la molécula heterodímera DQ8. El 92.9% de los sujetos son portadores de DQ2 y el 69.7% de los pacientes presentan el haplotipo DRB1*03:01-DQB1*02:01-DQA1*05:01 (DR3-DQ2), existiendo un número importante de pacientes con el haplotipo DRB1*07:01-DQB1*02:02-DQA1*02:01/ DRB1*11-DQB1*03:01-DQA1*05:05 (DR7-DQ2/DR5-DQ7) que codificarían para la molécula heterodímera DQ2 en trans (18.9%). El 3.7% son positivos para DQ8 y negativos para DQ2. Únicamente 1.6% de todos los pacientes no porta alguno de haplotipos asociados clásicamente a la EC. Las combinaciones de los haplotipos DR3–DQ2 con DR7–DQ2, y DR7–DQ2 con DR5–DQ7, presenta 2 veces el riesgo comparado con cada haplotipo en homocigosis. En el test de independencia para el haplotipo DR3-DQ2 mostró que la susceptibilidad para la EC no se asocia de forma primaria con ninguno de los loci estudiados sino con el haplotipo completo. Por el contrario en el caso del haplotipo DR7-DQ2 la asociación con DRB1*07 es secundaria a DQB1/DQA1. El tipaje de los alelos HLA en la EC nos reporta un alto valor predictivo negativo siendo útil como guía para el despistaje de la EC en familiares y grupos de riesgo o en aquellos casos con dudas diagnósticas. No encontramos relación entre las diversas combinaciones de haplotipos y las manifestaciones clínicas de la enfermedad, grado de lesión o momento de debut. Si realizamos el estudio HLA en los familiares como despistaje de EC en un 22,7% se excluiría la enfermedad no precisando seguimiento clínico ni serológico. En el estudio del locus CTLA-4, existe una transmisión estadísticamente significativa mayor del alelo A frente al alelo G a los individuos afectos de enfermedad celíaca en el caso del marcador +49*A/G.
Coeliac Disease (CD) is a polygenic (multiple gene) and multifactorial (gluten and other still unidentified environmental factors) disease. Genetic predisposition to CD is illustrated by a high prevalence rate among first-degree relatives (10%) and a concordance rate of approximately 70% in monozygotic twins. Human leukocyte antigen (HLA) genes encoding class II molecules have been firmly identified as key genetic risk factors in CD, this region by its own is believed to confer up to 40% of the increased risk of CD. The association between HLA class II antigens and CD was analyzed in a Spanish population (Valencian Community). In our CD population (185 patients who fulfil ESPGAN criteria) we found iassociation between CD and the HLA alleles DRB1*03, DRB1*07, DRB3*, DQB1*02:01, DQB1*02:02 and DQA1*05:01 but no association with DRB1*04 and DQB1*0302 was noted. The 92.9% of the subjects were DQ2 being the main associated haplotype in a 69.7% of the cases DRB1*03–DQB1*0201–DQA1*0501(DR3–DQ2), followed by DRB1*07– DQB1*0202–DQA1*0201 (DR7–DQ2) haplotype, which is associated with DRB1*11–DQB1*0301–DQA1*0505 (DR5–DQ7) in an 18.9%. The combinations of DR3–DQ2 with DR7–DQ2, and DR7–DQ2 with DR5–DQ7, present a twofold risk compared with each haplotype in homozygosis. An independence test in DR3-DQ2 haplotype found that association with CD was attributable to the whole haplotype, but for DR7-DQ2 was secondary to DQB1/DQA1. There is no need of a double gene dosage to increase the risk. CD-associated alleles typing demonstrate a very high negative predictive value to exclude CD in risk groups. No relation between clinical manifestations, age of onset or mucosal damage degree could be related with any kind of haplotype combination. If HLA typing was performed among first degree relatives following up of 22, 5% of them could be excluded as they do not share the risks HLA haplotypes. In the evaluation of the CTLA 4 locus in our population we found a small but significant association with the SNP +49*A/G.

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Kolkowski, Edgardo Carlos. "Linfocitos intraepiteliales en la enfermedad celiaca." Doctoral thesis, Universitat Autònoma de Barcelona, 2004. http://hdl.handle.net/10803/3760.

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Elfström, Peter. "Associated disorders in celiac disease." Doctoral thesis, Örebro universitet, Hälsoakademin, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-5223.

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Background: Celiac disease (CD) is an autoimmune disorder that affects genetically susceptible individuals and is induced by dietary gluten. Treatment consists of a lifelong gluten-free diet. CD is common and affects about 1% of the general population. The classic symptoms include diarrhea and malabsorption, but many patients have only mild symptoms or no symptoms at all. The proportion of individuals presenting with atypical symptoms or discovered only when investigating an associated condition of CD is increasing. Aims: The aim of this thesis was to investigate the risk of possible associated disorders through Swedish population-based registers. The objective was to gain more information on the consequences of having CD and to identify high risk groups where screening may be considered. Materials and methods: We used the Swedish hospital discharge register to examine the risk of liver disease, autoimmune heart disease, Addison’s disease and thyroid disorders in a cohort of about 14,000 individuals with CD and an age and sex matched reference population of 70,000 individuals. In the last study we used all regional pathology registers and the cancer registry to examine the risk of hematopoietic cancer, including lymphoma in three different cohorts: I) 28,810 individuals with CD; II) 12,681 individuals with small intestinal mucosal inflammation but without villous atrophy; and III) 3552 individuals with latent CD (a positive serology test for CD with a normal small intestinal biopsy). Results: CD is statistically significantly associated with an increased risk of liver disease, Addison’s disease, thyroid disease and lymphoma. We also found an increased risk of lymphoma in individuals with small intestinal mucosal inflammation. There was no statistically significant association between autoimmune heart disease or leukemia and CD. Latent CD was not associated with any hematopoietic cancers. Conclusion: This thesis found a positive association between CD and a number of autoimmune and inflammatory disorders. Clinicians need to have a high awareness of this association and to test for these conditions when symptoms appear.

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Arévalo, F., E. Roe, Castillo J. Arias-Stella, J. Cárdenas, P. Montes, and E. Monge. "Baja frecuencia de positividad serológica en pacientes con biopsias histológicamente compatibles con enfermedad celiaca en Perú." Sociedad Española de Patología Digestiva, 2014. http://hdl.handle.net/10757/314580.

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Objetivo: estudiar la frecuencia de positividad de las pruebas serológicas en pacientes con biopsias compatible con enfermedad celiaca. Material y métodos: estudio transversal. Se incluyeron pacientes con biopsia duodenal histológicamente compatible con enfermedad celiaca y determinación de anticuerpos antigliadina, antiendomisio y antitransglutaminasa IgA. Definimos como caso de enfermedad celiaca a quienes tuvieran biopsia positiva y anticuerpos antiendomisio y/o antitransglutaminasa positivos. Resultados: 31 pacientes fueron incluidos de los cuales 6 fueron antiendomisio positivo, 5 fueron antitransglutaminasa positivo y antigliadina fue positivo en 14. Por lo tanto de 31 pacientes con cambios histológicos compatibles con enfermedad celiaca sólo 10 tuvieron serología diagnóstica. Sólo uno de los pacientes tuvo positividad tanto para antitransglutaminasa como para antiendomisio. Conclusiones: a) encontramos que la mayoría de biopsias de duodeno con un cuadro histológico sugerente de enfermedad celiaca no se corresponden con serología diagnóstica de esta enfermedad; b) encontramos baja coincidencia en la positividad serológica entre antiendomisio y antitransglutaminasa.
Objective: to study the frequency of positive serology for celiac disease (CD) in patients with duodenal biopsies suggestive of this disease. Material and methods: cross sectional study. We included patients with duodenal biopsies histologically compatible with CD and antigliadin, antiendomysial and IgA antitransglutaminase antibodies. We defined a “case” of CD if there was a positive biopsy and either antiendomisial or antitransglutaminase positive antibodies. Results: thirty one patients were included in our study. Six were antiendomysial positive and 5 antitransglutaminase positive while the antigliadin was positive in 14 cases. Therefore, out of 31 patients only 10 had a serology compatible with CD and only one had positive both antibodies, antiendomysial and antitransglutaminase. Conclusions: a) we have found that most of the duodenal biopsies compatible with CD are not diagnosed with positive serology; and b) we found a low correlation between serological diagnostic tests.

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Jagdell, Mari. "Celia betyder himmel." Thesis, Linnéuniversitetet, Institutionen för film och litteratur (IFL), 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-95293.

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Abstrakt Min text är tänkt att ingå som en del av en roman som jag påbörjade förra läsåret. Detta är en fortsättning på det jag påbörjade då. Texten handlar om Celia som växer upp som enda barnet i ett hem med alkoholmissbruk och ovanpå det, sexuella övergrepp. Hennes mamma vet inte vad hennes dotter utsätts för och har så fullt upp med sitt eget, att frågan är om hon hade märkt det även om Celia hade sagt något. Celia har också en vän sedan småskolan, Sanna. Hon har en helt annorlunda familjesituation än Celia och hon försöker att övertala Celia att berätta för någon vuxen. Celia vägrar och får Sanna att lova att ingenting säga. Ett löfte som Sanna håller. I början av högstadiet har Celia lärt känna Kina som också bor i huset där Celia och hennes familj bor. Kina har ungefär samma situation hemma, med en styvpappa som dricker. Celia låter sig övertalas av Kina att följa med på en fest. Där blir hon bjuden på sprit och i fyllan hamnar hon i säng med en kille. Mot sin vilja ställer Celia upp och har sex med Uffe, som han heter. Efteråt pratar inte Kina med henne och i hemkunskapen börjar Uffes kompisar att trakassera Celia, genom att kalla henne lättfotad och annat. Till slut brister det för Celia och all ilska, maktlöshet och frustration tar sig uttryck i ett anfall mot Uffes kompisar. Som tillhygge har hon en kökskniv. Ingen kommer dock till skada och förtvivlad över vad hon varit på väg att göra flyr Celia hem till sitt rum och till maten som hon upptäckt har en lugnande effekt. När Celia inte kommer tillbaka till skolan blir Sanna ledsen och förtvivlad. Det dåliga samvetet som hon känner för att hon inte berättat, gör att hon har svårt att släppa Celias öde och detta följer henne även upp i vuxen ålder. Som vuxen är Sanna gift med Stefan, som hon även har en dotter, Emelie, med. De åker med jämna mellanrum hem till Sannas barndomshem och Celia dyker upp som ett spöke mellan Sanna och Stefan. Något som Stefan tröttnar på. När de ett jullov är hemma hos Sannas föräldrar, stöter de av en händelse på Celia på en buss och Celia bjuder hem Sanna på fika. Sanna märker att Celia har problem bland annat för att hon verkar gömma mat. Hon är gravt överviktig och hennes man, Uffe, verkar vara allt annat än trevlig. Min text startar när Sanna, efter fikan, sitter i sin bil för att åter köra hem till sina föräldrars hus, Uffe och Emilia.

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Gass, Jonathan David. "Oral enzyme therapies for celiac sprue /." May be available electronically:, 2007. http://proquest.umi.com/login?COPT=REJTPTU1MTUmSU5UPTAmVkVSPTI=&clientId=12498.

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Peters, Ulrike. "Epidemiologische Studien zur Zöliakie Inzidenz in Norddeutschland 1985 bis 1994, sowie eine, Fall-Kontroll Studie zum Einfluss der Säuglingsernährung auf die Entstehung der Zöliake und zum Auftreten assoziierter Erkrankungen /." Kiel : Selbstverlag des Instituts für Humanernägrung und Lebensmittelkunde der Christian-Albrechts-Universität Kiel, 1998. http://catalog.hathitrust.org/api/volumes/oclc/41956146.html.

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Whitacker, Fatima Cristina de Freitas. "Prevalencia e aspectos clinicos da associação entre diabetes mellitus tipo 1 e doença celiaca." [s.n.], 2008. http://repositorio.unicamp.br/jspui/handle/REPOSIP/309455.

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Orientadores: Gil Guerra Junior, Gabriel Hessel
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: Justificativa: Há quatro décadas é conhecida a associação entre Diabetes mellitus tipo 1 (DM1) e doença celíaca. Entretanto, a manifestação predominantemente atípica desta doença em diabéticos, dificulta seu diagnóstico e o reconhecimento de possíveis efeitos desta associação no controle do diabetes. Objetivos: Estimar a prevalência da associação entre DM1 e doença celíaca e verificar a presença de sintomas da doença celíaca, a ocorrência de outras doenças auto-imunes entre os pacientes e seus parentes de primeiro grau e as possíveis influências da doença celíaca no controle do diabetes. Casuística e métodos: Estudo transversal com 195 pacientes com DM1, que responderam um questionário sobre a presença de sintomas gastrintestinais e a ocorrência de doenças auto-imunes em familiares. Foi dosada a IgA e pesquisado o anticorpo anti-endomísio (EMA). Os pacientes com EMA positivo foram submetidos à biópsia intestinal. Aqueles com doença celíaca confirmada por biópsia (grupo casos) foram pareados com pacientes apenas diabéticos (grupo controle) segundo idade no momento da triagem, tempo de duração do diabetes e gênero. Resultados: O EMA foi positivo em nove pacientes. Em sete a biópsia confirmou DC (prevalência de 4%). No pareamento de casos (DM1 e doença celíaca) e controles (somente DM1), os sintomas gastrintestinais foram significativamente mais freqüentes no grupo casos, porém não houve diferença entre os grupos quanto ao controle do diabetes. Conclusões: A prevalência de doença celíaca neste grupo de pacientes com DM1 foi de 4%. A amostra de pacientes celíacos apresentou predomínio de sintomas gastrintestinais e a presença de doença celíaca não interferiu no controle do diabetes
Abstract: Justify: There were four decades that the association between Diabetes Mellitus type 1 (DM1) and celiac disease is known. However, the manifestation of celiac disease in diabetic patients is predominantly atypical, what difficult its diagnosis and the recognition of possible effect of this association in the control of diabetes. Objectives: To estimate the prevalence of DM1 and celiac disease association and to verify the existence of celiac disease symptoms, the occurrence of other autoimmune diseases among the patients and their first-degree relatives and the possible influences of celiac disease in diabetes control. Patients and methods: It was done a cross-sectional study with 195 patients that ansewered a questionnaire about gastrintestinal symptoms and the occurrence of autoimmune diseases in theirs first-degree relatives. IgA was measured and antiendomysial antibody (EMA) screened. The patients with positive EMA were submitted to intestinal biopsy. Those with celiac disease confirmed by biopsy (case group) were paired with DM1 patients without celiac disease (control group) according to age at the screening, time of diabetes duration and gender. Results: EMA was positive in nine patients. In seven of them the biopsy confirmed celiac disease (4.0%). Comparing the cases with controls, the gastrointestinal symptoms were significantly more frequent in the first group and there was no difference between the groups regarding to the control of diabetes. Conclusions: The prevalence found was 4.0%. This sample of celiac patients showed a predominance of gastrointestinal symptoms and the celiac disease did not influence the diabetes control
Mestrado
Pediatria
Mestre em Saude da Criança e do Adolescente

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Pietz, Grzegorz. "Innate immunity of human intestinal epithelium in childhood celiac disease : influences from celiac disease associated bacteria and dietary oats." Doctoral thesis, Umeå universitet, Institutionen för molekylärbiologi (Medicinska fakulteten), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-140691.

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Background & Aims: Celiac disease (CD) is a chronic inflammatory small-bowel enteropathy caused by permanent intolerance to gliadin in wheat gluten, and related proteins in ray and barley. It is disputed whether CD patients tolerate oats. The only treatment of CD is lifelong gluten-free diet (GFD). Only individuals that carry the HLA-DQ2 and/or DQ8 alleles, and eat gluten can develop CD. Dysbiosis in the gut microbiota is a suggested risk factor for CD. T cells in small intestinal mucosa, including intraepithelial lymphocytes (IELs), are known to be important in the pathogenesis of CD. In contrast, the role of intestinal epithelial cells (IECs) is poorly understood. In this thesis we investigated the role of IECs in the immune pathology of CD from duodenal mucosa of children with CD, clinical controls and treated CD. We also investigated the role of CD associated bacteria and oats supplemented GFD on the mucosal immune system. Results: A new CD-associated bacterium, Prevotella jejuni, was isolated and characterized. It is a saccharolytic and proteolytic anaerobe. More than 25 defense-related genes, including IRF1, SPINK4, ITLN1, OAS2, CIITA, HLA-DMB, HLA-DOB, PSMB9, TAP1, BTN3A1, and CX3CL1, were upregulated in IECs in active CD. In two in vitro models for intestinal epithelium, small intestine enteroids and T84 polarized tight monolayers, we showed that 70% of these genes were upregulated by interferon (IFN)-γ via the IRF1 pathway. IRF1 was also upregulated by the CD-associated bacteria P. jejuni and Actinomyces gravenitzii. IECs expressed the NLRP6/8 inflammasome yielding CASP1 and biologically active interleukin (IL)-18, which induces IFN-γ in IELs. P. jejuni bound the intestinal epithelial cell lines T84, Caco2, HT29, and INT407, while Lachnoanaerobaculum umeaense preferentially bound Caco2. P. jejuni caused decreased transepithelial resistance over tight monolayers, while L. umeaense caused an increase. P. jejuni upregulated mRNAs for the detoxification molecules CYP1A1, CYP1A2, CYP1B1, and TIPARP, the chemokines CX3CL1, CXCL1, and CXCL10, the sialyltranserase ST3GAL4, and the inflammation promoting protein S100A3 in tight monolayers. L. umeaense upregulated the chemokines CCL20 and CXCL10, and down-regulated TLR2. In a randomized, double-blinded intervention trial comparing two study-groups, standard GFD and oat-containing GFD, we found that mRNAs for several immune effector molecules and tight junction proteins were only reduced in patients receiving GFD, but not in a substantial fraction of patients on GFD with oats. The down-regulatory cytokines IL-10 and TGF-β1, the cytotoxicity-activating NK-receptors NKG2C and NKG2E, and the tight junction protein claudin-4 remained elevated in the study group on GFD with oats. Conclusions: IECs are far from inactive in CD. A key factor in the epithelial reaction in CD appears to be over-expression of IRF1 in IECs. Dual activation of IRF1 and IRF1-regulated genes, both directly by P. jejuni and indirectly by IFN-γ via the IL-18-inflammasome, would drastically enhance the inflammatory response and lead to the pathological situation seen in active CD. P. jejuni harms the intestinal epithelium, i.e., it is a likely risk factor for CD, while L. umeaense strengthen barrier function and local immunity, possibly acting as a protective. A fraction of CD patients should avoid oats in the diet.
Doctoral thesis

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Forsberg, Göte. "Innate and adaptive immunity in childhood celiac disease." Doctoral thesis, Umeå universitet, Immunologi/immunkemi, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-874.

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Celiac disease (CD) is an inflammatory small-bowel enteropathy caused by a permanent intolerance to wheat gluten and related proteins in rye and barley. Even though the disease originate from the small intestine the clinical symptoms varies in affected individuals and are often different in small children compared to adolescents and adults. Susceptibility to develop the disease is strongly associated with certain genetic factors i.e. HLADQ2/DQ8 but it is undoubtedly that additional inherited and environmental factors are involved. As specific T lymphocyte reactions are central in the pathogenesis of CD, six key cytokine messenger RNA levels in intestinal intraepithelial and lamina propria T lymphocytes (IEL, LPL), retrieved from small intestinal biopsies, were determined by using quantitative real-time reverse transcription polymerase chain reaction (RTPCR). Levels of cytokines, small secreted proteins which mediate and regulate immunity, in children with active disease were compared with that of treated children and controls. Interferon (IFN)-γ and interleukin (IL)-10 were also determined at the protein level by immunohistochemistry. Active celiac disease was characterized by distortions in cytokine expression, with highly significant increases of IFN-γ and IL-10 but no concomitant increases in tumor necrosis factor α (TNF-α), transforming growth factor β1 (TGFβ1), or IL-2 and no induction of IL-4. A marked shift of IFN-γ and IL-10 production from LPLs to IELs was characteristic of active celiac disease, and as many as one fourth of the IELs expressed IFN-γ. IELs in treated, symptom-free celiac patients still had increased IFN-γ levels compared with controls. In CD, gluten intake seems to cause an overreaction in IELs, with uncontrolled production of IFN-γ and IL-10 which may cause both recruitment of more IELs and a leaky epithelium, leading to a vicious circle with amplified immune activity and establishment of the intestinal lesion. In order to determine different IEL subsets contribution of the produced cytokines, γδIELs, CD4+αβIELs, and CD8+αβIELs as well as CD94+CD8+αβIELs and CD94CD8+αβIELs of children with active CD and children with no food-intolerance were analyzed for cytokine mRNA expression levels by RT-PCR. In active CD, CD8+αβIELs had the highest expression levels of IFN-γ- and IL-10 mRNA and constituted the cellular source for almost all IFN-γ and a large fraction of the IL-10. Expression levels of these two cytokines correlated and were higher in CD94-CD8+αβIELs than CD94+CD8+αβIELs CD4+αβIELs had the highest expression levels of TNF-α and despite the small number of this cell subset they contributed with half of the small amounts of this cytokine. Interestingly, TNF-α levels correlated with IL-10 in CD4+αβIELs. γδIELs had the lowest expression levels of IFN-γ, TNF-α, IL-10, and TGF-β1. Essentially no IL-2 mRNA was detected in the three IEL subpopulations. “Classical” CD8+CD94-αβT cells in the epithelial compartment are responsible for most of the excessive production of proinflammatory IFN-γ. The question whether an impaired extrathymic T cell maturation and/or capacity for secondary T cell receptor (TCR) gene recombination in iIELs is a contributing factor to CD was addressed. Expression levels of recombination activating gene-1 (RAG1) and the pre T α-chain (preTα) mRNAs were determined in IEL T cell lineage subsets of children with CD and controls. In controls, RAG1 was expressed in both mature (TCRγδ+ and TCRαβ+) and immature (CD2+CD7+TCR-) IELs while preTα was expressed preferentially in immature IELs. The RAG1 splice form selectively expressed outside thymus (RAG1 1A/2) as well as preTα were significantly decreased in CD patients both in active and inactive disease suggesting a deteriorated capacity of de novo TCR gene rearrangement in local T cell development and / or of secondary TCR gene rearrangement during editing or antigen-driven revision. This may lead to an imbalance between thymus- and gut derived T lymphocytes in the intestinal mucosa with consequent inefficient regulation of T cell responses against food antigens. Innate or nonspecific immunity is the first line, immediate defense against pathogens mediated by the epithelial cells in the intestine (IECs). As certain adaptive immune reaction in CD mimics that of intestinal infections, aberrant innate immune reaction could be a contributing factor to CD. Therefore jejunal biopsies were screened for bacteria and the innate immune status of the epithelium was investigated. Bacteria were freqently (40%) associated with the mucosa of children with active but also treated disease (20%) compared to controls (2%). Lack of antimicrobial factors such as mucins, proteins forming protective biofilm on the IECs, defensins and lysozym, peptides and enzymes with antibacterial effects, could not explain the presence of bacteria. If anything, mucin-2 (MUC2), α-defensins, HD-5, HD-6, and lysozyme mRNA levels were increased in epithelial cells in active CD, returning to normal levels in treated CD. Their expression levels correlated to the IFN-γ mRNA levels in IELs. Analysis of beta defensins, hBD-1 and hBD-2 as well as carcinoembryonic antigen (CEA) cell adhesion molecule 1a (CECAM1a), glycoproteins in the glycocalyx with ability to bind micro organisms, were not affected by the disease. Lectin staining by histochemistry revealed that goblet cells were stained by UEA1 in CD both active and treated but not in controls. The opposite pattern was seen for the lectin PNA where staining was seen in controls in the glycocalyx layer but not in CD. Thus altered glycocalyx/mucous layer may promote bacterial adhesion in CD.

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Forsberg, Göte. "Innate and adaptive immunity in childhood celiac disease /." Umeå : Umeå universitet, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-874.

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Laurin, Pia. "Clinical and epidemiological aspects of childhood celiac disease /." Linköping : Univ, 2002.

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Nagel, Joan Lynn. "Survey of Registered Dietitians' Proficiency of Celiac Disease and Use of Twitter, Facebook, Smart Phone App, and Internet for Celiac Disease Management." Thesis, North Dakota State University, 2014. https://hdl.handle.net/10365/27379.

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The Registered Dietitian (RD) plays an integral role in helping patients manage their celiac disease (CD). This study explored how proficient RDs are with CD management in addition to determining how RDs use technology to educate themselves and CD patients. RDs (N=405) participated in this 35 item internet-based survey to measure self-reported CD proficiency, CD knowledge, preferences for CD resources for self-education and patient education, and use of Twitter, Facebook, smart phone apps, and internet for CD management. RDs reported either moderate or high levels of proficiency for all seven of the seven self-reported proficiency topics. Professional and academic publications were the most commonly used resources by the RD for self-education whereas handouts were the most commonly used resource by the RD for patient education. RD's reported using Twitter the least for self-education and the Internet the most for patient education.

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Stauble, Taylor M. "Celiac Disease: a Gluten Free Diet and Diet Quality." UKnowledge, 2013. http://uknowledge.uky.edu/foodsci_etds/13.

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The media has highlighted a proposed link between a gluten free diet (GFD) and weight loss. However, research related to weight gain and a GFD for persons with celiac disease (CD) has shown the opposite effect. A GFD is the only known treatment for persons with CD. If a patient with CD consumes a diet high in GF processed foods, weight management may be difficult to achieve. Participants with self-reported CD completed a modified GF food frequency questionnaire (FFQ) to assess typical dietary consumption of whole grains, sweets, fruits, vegetables and regular soda. Additionally, body mass index (BMI) and exercise were assessed. The results of this study found that whole grain, fruit and vegetable intakes were low among celiac patients. Additionally, BMI was on the high end of the normal weight range. The results of this study indicate that a greater emphasis should be placed on nutritional quality when counseling patients with CD. Registered dietitians should focus their diet counseling sessions with CD patients on a nutritious naturally GF diet in order to better manage weight.

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Holopainen, Päivi. "Genetic susceptibility to celiac disease : HLA-unlinked candidate genes." Helsinki : University of Helsinki, 2002. http://ethesis.helsinki.fi/julkaisut/mat/bioti/vk/holopainen/.

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Bethune, Michael Thomas. "Detection and destruction of gluten peptides in celiac sprue /." May be available electronically:, 2009. http://proquest.umi.com/login?COPT=REJTPTU1MTUmSU5UPTAmVkVSPTI=&clientId=12498.

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Tapsas, Dimitrios. "Demographics, clinical features and treatment of pediatric celiac disease." Doctoral thesis, Linköpings universitet, Avdelningen för mikrobiologi och molekylär medicin, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-122371.

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Celiac disease (CD) is a chronic small intestinal immune-mediated enteropathy triggered by ingestion of gluten-containing food in genetically predisposed subjects. The enteropathy is presented with a wide variety of clinical manifestations, which can occur even outside the gastrointestinal tract. In the majority of cases, the diagnosis of CD is based on a small intestinal biopsy showing mucosal alterations, i.e. intraepithelial lymphocytosis, crypt hyperplasia, and villous atrophy. The treatment, gluten-free diet (GFD), has recently been revised with the addition of gluten-free oats. Oats give a more diversified nutrition and increase the fibre content. The use of oats in CD is though still debated in some reports. A strict life-long adherence to the GFD can be problematic, especially for pediatric CD patients. Sweden reported of one of the highest observed CD prevalences worldwide, i.e. 3%, among 12-year-olds born during what has been described as “the Swedish celiac epidemic”, 1984−1996. The aims of this thesis were to elucidate how pediatric CD has changed during a 41-year period in Sweden, i.e. 1973−2013, in terms of clinical presentation, disease severity, incidence, and demographics. We also wanted to adress the compliance to the GFD, the use of oats in the GFD and the safety of oats inclusion in the diet by measuring urinary nitric oxide (NO) metabolites. Filed information provided data about 2856 pediatric patients investigated for suspected CD between 1973 and 2013; of which 1030 patients were diagnosed with CD. After the data analyses the mean age of CD patients was shown to increase after the celiac epidemic period. Currently, CD shows a less severe picture in terms of symptoms and intestinal pathology. Younger children suffer primarily from gastrointestinal symptoms and growth failure, whereas extra-intestinal manifestations are more often displayed among adolescents. We also reported an unusually high pediatric CD incidence rate and cumulative incidence, likely the highest reported worldwide. We hypothesised that the introduction of new antibody tests would affect the diagnostic activity and accuracy in performing small intestinal biopsies for CD investigation. However, the outcome of diagnostic activity and accuracy could not clearly be attributed to the use of antibody tests due to changes occurring in parallel during the 41-year study period, e.g. a different pattern of symptoms at presentation and improved knowledge of the disease among parents and health professionals. In a questionnaire-based study our patient group reported a high compliance to the GFD. Long duration of the GFD may, however, influence compliance negatively. Oats have been included to the GFD of our study population in most of the cases without reporting major complications related to their well-being. The urinary measurements of NO metabolites revealed two patient groups, one with high and one with low levels. The two populations did not differ regarding sex, age, compliance to the GFD or oats consumption. Factors such as nitrate-rich foods, asthma or urinary tract infections did not affect the results. The high levels could possibly be attributed to poor adherence to the GFD, sensitivity to oats, or some unknown factor(s). The elevated levels of NO metabolites might indicate mucosal inflammation and pinpoint the need of careful follow-up of children on oats-containing GFD as not all of them might tolerate oats.

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Borsuk, Alexandra M. "Social and Behavioral Characteristics of Individuals with Celiac Disease." The Ohio State University, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=osu1366232495.

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Vaezghasemi, Masoud. "Nutrient intake of adolescents with celiac disease and their non-celiac counterparts : A comparative study of Swedish 14-year-old boys and girls on gluten-free diet with a non-celiac, gender- and age-matched control group." Thesis, Umeå universitet, Institutionen för kostvetenskap, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-101629.

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Abstract Introduction: Following a strict gluten-free diet means exclusion of many staple foods such as traditionally made bread, flour, pasta, and whole grain products that are largely included in the Swedish daily diet. Such exclusions of vital resources could have harmful consequences on nutritional status and cause nutritional hazard, if they are not substituted with appropriate alternatives. Aim: To compare the nutrient and energy intakes of 14-year-old boys and girls on gluten free diet with their non-celiac counterparts as well as the estimated average requirement. Method: All 14-year-old adolescents with suspected and previously diagnosed Celiac disease from the ETICS study (Exploring the Iceberg of Celiac in Sweden) as well as a randomized gender- and age-matched non-celiac controls were invited to a dietary sub-study; ETICS-diet. A four-week food frequency questionnaire was used to assess the dietary intakes of 129 celiac cases (63 boys and 66 girls) with 428 non-celiac controls (boys 188 and girls 240). Basal Metabolic Rate was used to evaluate the validity of the reported food intakes in the present study through comparison with individually calculated energy requirements. Results: There were no significant differences between Celiac disease cases and controls regarding their food and energy intakes nor physical activity level. In general, the nutrient intakes were significantly lower among cases compared to controls, particularly in fiber, but similar patterns were observed among both cases and controls when we assessed whether they were within the recommended range of nutrient intake or not. Conclusion: The current study, in sum, informs public health intervention programs to promote healthy eating habits for all children by endorsing foods highest in Folate, Vitamin C, Iron, and fiber.

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Hartsook, Elaine Iris. "Dietary intake and use of dietary supplements in persons with celiac sprue compared with persons of similar race, age, and sex in the general United States population : prerequisite for nutrition education /." Thesis, Connect to this title online; UW restricted, 1985. http://hdl.handle.net/1773/7721.

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Caio, Giacomo Pietro Ismaele <1986&gt. "Caratteristiche cliniche, istologiche ed immunologiche dell'adenocarcinoma dell'intestino tenue associato alla malattia celiaca." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2016. http://amsdottorato.unibo.it/7701/.

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L’adenocarcinoma dell’intestino tenue (SBA) è una neoplasia estremamente rara nella popolazione generale. La letteratura suggerisce che la malattia celiaca (MC) sia associata ad un aumentato rischio di sviluppare un SBA, ma non ci siano dati sulle caratteristiche di questa variante associata a MC. Lo scopo dello studio è consistito nel chiarire la prevalenza del SBA in una coorte soggetti con MC, definendo le loro caratteristiche cliniche, istologiche ed immunologiche. Sono stati studiati retrospettivamente (1995-2014) tutti i casi di SBA trovati in associazione a MC. Le biopsie dei casi identificati sono state valutate attraverso indagini immunoistochimiche impiegando anticorpi monoclonali che riconoscono markers epiteliali intestinali (e.g. MUC2, CDX2 e CD10) e gastrici (e.g. MUC5AC e MUC6). Sono inoltre state ricercate eventuali mutazioni di KRAS, NRAS e BRAF. Sono stati identificati 5 SBA su 779 pazienti con MC (0,65%), tutte di sesso femminile età media 53. La tipizzazione dell'HLA ha mostrato un DQ2+ in tutti i casi. Al momento della diagnosi di SBA il quadro clinico di questi pazienti era caratterizzato da diarrea in 3 casi e da episodi subocclusivi negli altri due casi. La più frequente localizzazione anatomica dell’SBA era il digiuno. In nessuno dei 5 casi lo SBA è stato preceduto da una malattia celiaca refrattaria. L’esame istologico eseguito mostrava la presenza in tre casi di un carcinoma di alto grado, scarsamente differenziato (grado III-IV). La sopravvivenza a 5 anni è risultata molto migliore rispetto al SBA sporadico. KRAS è stato trovato mutato in 2/5 casi. L’ SBA associato a MC sembra avere caratteristiche cliniche, istologiche e fenotipiche differenti rispetto al SBA sporadico. In particolare: a) il più frequente coinvolgimento del sesso femminile; b) l’età di esordio più giovane; c) la localizzazione digiunale; d) una migliore prognosi associata a positività per CDX2; e) presenza di neoplasie con KRAS mutato.
The small bowel adenocarcinoma (SBA) is a very rare neoplasia in the general population. Previous studies suggest that celiac disease (CD) is associated with an increased risk in developing a SBA. Unfortunatly, there are no information about the features of this cancer when associated with CD. The aims of the present study were to shed light on the prevalence of SBA in a CD patients cohort and to define its clinical, histological and immunological features. We retrospectively investigated all the cases of SBAs in a cohort of CD patients during a 19 years period (1995-2014). Biopsies from selected cases were analyzed by immunohistochemestry, looking for intestinal and gastric markers, using monoclonal antibodies against MUC2, CDX2, CD10, MUC5AC, MUC6. Moreover, we checked the presence of KRAS, NRAS and BRAF mutations. We identified 5 cases of SBA in a population of 779 CD patients (0,65%). All the SBA found were in female patients with a mean age of 53 years. The HLA genotyping revealed a positivity for the DQ2+ in all cases. At onset SBA showed a clinical picture characterized by diarrhoea in 3 cases and subocclusion in 2 cases. Refractory CD never preceded the onset of a SBA. Th histologica evaluation revealed a high grade, poorly differentiated neoplasia in 3 cases (G3-G4). Overall survival at 5 years was extremely better than that of the sporadic SBA. A mutation of KRAS was found in 2/5 cases. In conclusion, the SBA associated with CD showed different features in comparison to the sporadic one, in particular: a) a female gender predominace, b) a lower median age at diagnosis, c) a preferred jejunal localization, d) a better prognosis (in particular when associated witha CDX2 positivity) and e) for the finding of KRAS mutations.

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Siegel, Matthew John. "Biological evaluation of novel therapeutics for treatment of celiac sprue /." May be available electronically:, 2007. http://proquest.umi.com/login?COPT=REJTPTU1MTUmSU5UPTAmVkVSPTI=&clientId=12498.

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Judy, Kennedy. "An analysis of the dietary iron intakes in celiac patients." Online version, 2008. http://www.uwstout.edu/lib/thesis/2008/2008kennedyj.pdf.

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Dissertations / Theses on the topic 'Celiaki'

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