As much as 1% of the gluten-consuming world is gluten-intolerant. New screening methods are increasingly identifying gluten intolerance in individuals previously free from health problems. The often-abrupt major change in diet may adversely affect the patient's quality of life. Our aim was to evaluate self-perceived quality of life in a large cohort of adult celiac patients after at least one year of a gluten-free diet. In all 581 members (410 females) of five regional celiac societies were on a gluten-free regimen for at least one year. In this cross-sectional study, a modified version of the Zung Self-Rating Depression Scale was administered to the 581 patients from five Italian regions. Most patients correctly defined celiac disease, and compliance with the gluten-free diet was high, although reporting bias cannot be excluded. Most felt well (83.6% "very well" and "well"); consequently, anxiety and depression scores were low. Happiness also scored low. Most participants did not feel that a gluten-free life differentiated them from the general population. Women and patients diagnosed after 20 years of age had better dietary compliance, but more problems in their social life. Happiness scores were higher in patients diagnosed before 20 years of age. Anxiety and depression were infrequent in this group; however, anxiety was frequently related to feeling different from the general population, and depression to an unsatisfactory sexual life. In conclusion, celiac disease does not appear to be associated to a low level of self-perceived quality of life in members of the Italian Celiac Society.
A participação do sistema nervoso parassimpático na modulação da secreção de insulina manifesta-se claramente durante a fase cefálica que se segue ao estímulo iniciado pelo estímulo sensorial provocado pela presença do alimento na cavidade oral. O objetivo deste trabalho foi avaliar se a vagotomia subdiafragmática seletiva do ramo pancreático poderia modificar a permeabilidade ao Ca2+ da membrana plasmática das células beta. Para avaliar os efeitos da vagotomia usamos o principal secretagogo que é a glicose e o potencializador carbamilcolina. Os estudos de efluxo de 45Ca2+ foram realizados em ilhotas de ratos controle ou desnervados isoladas por digestão com colagenase e perfundidas com KREBS contendo os secretagogos. As ilhotas isoladas de ratos 15 e 30 dias após a vagotomia do ramo pancreático não responderam ao estímulo com 16,7 mM de glicose e também apresentaram alteração na sensibilidade à carbamilcolina (CCh 100μm) adicionada à solução contendo 5,6 mM de glicose. Nossos resultados sugerem que o nervo vago (ramo pancreático) participa da regulação do processo secretório da insulina pelas células beta pancreáticas. Este efeito pode estar associado à modulação da respostas induzidas pela glicose e reguladas pelo neurotransmissor acetilcolina, considerado modulador da secreção de insulina.
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