Browsing by Author "Guiraldes, Ernesto"

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    A national online survey applied to patients with celiac disease in Chile
    (SOC MEDICA SANTIAGO, 2011) Espino, Alberto; Castillo L, Cecilia; Guiraldes, Ernesto; Santibanez, Helga; Francisco Miquel, Juan
    Background: Celiac disease (CD) is an immune-mediated enteropathy triggered by the ingestion of gluten in genetically susceptible individuals. Its prevalence in Europe and the USA is 0.5 to 1%. Aim: To analyze epidemiological aspect's and degree of compliance with gluten-free diet (GFD) among Chilean individuals with CD. Material and Methods: Subjects with confirmed or suspected CD were invited to answer an online survey published on the web at www.ftmdacionconvivir.cl. The answers were reinforced with a telephone interview. Results: The survey was answered by 1212 subjects (79% females). Median age at diagnosis was 25.8 years (range 1 to 84 years), with a bimodal curve with two peaks at less than 3 years and at 20 to 40 years of age. The diagnosis was made only by serologic markers in 9%, only by intestinal biopsy in 17.5%, and by a combination of both methods in 70%. Conditions associated with CD were reported by 30% of subjects and 20% had relatives with CD. The GFD was strictly adhered to by 70%, occasionally by 27% and never by 3%. Seventy five percent of subjects with a strict adherence to GFD had a favorable clinical response compared with 42% of those with incomplete or lack of adherence (odds ratio 4.0, 95% confidence intervals 2.8-5.7 p < 0.01). Conclusions: In 30% of respondents, the diagnosis of CD was not confirmed according to international guidelines that require serology and duodenal biopsy. One third of subjects recognized a poor compliance with GFD. Those with a strict adherence to it had a more favorable clinical course. However, 25% did not experience a clinical improvement despite a strict GFD, a finding which requires further study (Rev Med Chile 2011; 139: 841-847).
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    Childhood functional gastrointestinal disorders: Child/adolescent
    (2006) Rasquin, Andree; Di Lorenzo, Carlo; Forbes, David; Guiraldes, Ernesto; Hyams, Jeffrey S.; Staiano, Annamaria; Walker, Lynn S.
    The Rome II pediatric criteria for functional gastrointestinal disorders (FGIDs) were defined in 1999 to be used as diagnostic tools and to advance empirical research. In this document, the Rome III Committee aimed to update and revise the pediatric criteria. The decision-making process to define Rome III criteria for children aged 4-18 years consisted of arriving at a consensus based on clinical experience and review of the literature. Whenever possible, changes in the criteria were evidence based. Otherwise, clinical experience was used when deemed necessary. Few publications addressing Rome II criteria were available to guide the committee. The clinical entities addressed include (1) cyclic vomiting syndrome, rumination, and aerophagia; 2) abdominal pain-related FGIDs including functional dyspepsia, irritable bowel syndrome, abdominal migraine, and functional abdominal pain; and (3) functional constipation and non-retentive fecal incontinence. Adolescent rumination and functional constipation are newly defined for this age group, and the previously designated functional fecal retention is now included in functional constipation. Other notable changes from Rome II to Rome III criteria include the decrease from 3 to 2 months in required symptom duration for noncyclic disorders and the modification of the criteria for functional abdominal pain. The Rome III child and adolescent criteria represent an evolution from Rome II and should prove useful for both clinicians and researchers dealing with childhood FGIDs. The future availability of additional evidence-based data will likely continue to modify pediatric criteria for FGIDs.
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    The adverse effect of eating wheat and related grasses for some individuals: coeliac disease and gluten sensitivity
    (TEKNOSCIENZE PUBL, 2007) Silva, Manuela.; Guiraldes, Ernesto; Perdue, Mary H.
    In some individuals dietary gluten can induce an immune-related disorder known as coeliac disease, which is characterized by an enteropathy that may lead to intestinal malabsorption, chronic diarrhea, and nutritional deficiencies. Gluten-related extra-intestinal manifestations have also been described involving, among others, the skin and the central nervous system. In all of these instances dietary exclusion of gluten, a protein present in foods derived from wheat, barley and rye brings improvement of the clinical symptoms and the underlying pathology. In this article we review relevant features of coeliac disease and gluten sensitivity with special emphasis on immune-related mechanisms, the role of intestinal epithelial barrier dysfunction, and the available and potential therapeutic options for celiac disease.