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Celiac.com 03/02/2015 - Officials at UCLA Ronald Reagan Medical Center have warned 179 people that a fairly routine endoscopy procedure may have left them exposed to a drug-resistant 'super-bug' that infected seven patients, and may have contributed to two deaths. The possible exposures occurred at the UCLA Ronald Reagan Medical Center, between October and January, in patients who underwent a procedure in which a specialized endoscope is inserted down the throat to diagnose and treat pancreatic and bile duct diseases. Officials said in an official statement that hospital staff had been sterilizing the scopes according to the manufacturer's standards, but was now using "a decontamination process that goes above and beyond manufacturer and national standards." Meanwhile, hospitals across the United States have reported exposures from the same type of medical equipment in recent years, and the U.S. Food and Drug Administration (FDA) has said it was working with other government agencies and manufacturers of the scopes to minimize risks to patients. The FDA says recent medical publications and adverse event reports associated multidrug-resistant bacterial infections in patients who have undergone ERCP with reprocessed duodenoscopes, "even when manufacturer reprocessing instructions are followed correctly." The multidrug-resistant bacterial infections include carbapenem-resistant Enterobacteriaceae (CRE) such as Klebsiella species and Escherichia coli. The FDA says that from January 2013 through December 2014, they received 75 medical device reports involving about 135 patients related to possible microbial transmission from reprocessed duodenoscopes. "It is possible that not all cases have been reported to the FDA," the agency says. Given the fact that celiac disease diagnosis and follow up care require the use of endoscopy, this news is particularly disturbing to those in the celiac community. Source: Medscape.com.
Celiac.com 03/23/2012 - Most parents of gluten-free children can attest to the challenges of making certain that the food the kids are eating is, in fact, gluten-free. Many of those parents can also be comforted by the fact that more public schools are recognizing the need for gluten-free lunches for certain children, and are making an effort to provide nutritious gluten-free alternatives for those children. Well, in a development that may interest all parents of gluten-free children, the BBC is reporting that schools in Northamptonshire, UK, have been to ordered to discontinue two particular "gluten-free" meals after the meals were found to contain unacceptable levels of gluten. Gluten from wheat, rye or barley triggers an immune reaction in certain people, requiring them to avoid eating food containing even trace amounts of those grains. Nutritionists overseeing the gluten-free meals discovered gluten in a supplier's shepherd's pie and beef Bolognese. These meals are served to gluten-free children at schools across the county. The BBC report says the county council has about 20 pupils registered with gluten-intolerance or celiac disease, but that no children had shown an adverse reaction. Unacceptably high levels of gluten were detected in a gravy powder used to make the two meals, according to the local authority contacted by the BBC. The report cites Councilor Andrew Grant as saying that nutritionists regularly monitor the ingredients used by companies that supply food to the schools, and that one such check found that food labeled as gluten-free in fact continued gluten. In many gluten-sensitive individuals, even a small amount of gluten can trigger an adverse reaction. So, even if the even if the contamination is slight, Grants notes, it is nevertheless completely unacceptable for a child with allergies to be exposed to this risk. According to the article, county officials wants to make certain that the problem is confined to these two particular products, so it has asked for a full investigation into the cause of the problem. Are problems such as this to be expected as we transition gluten-free food into new areas, such as public schools? Are even these problems a sign that celiac disease and gluten-sensitivity awareness is increasing? Are such issues a sign that more and better gluten-free food options lie just around the corner? Let us know your thoughts.
Recently I have noticed a trend in articles that demonize the gluten-free diet, and imply that there is something unhealthy or even dangerous about it. Here is an example of one that I forwarded to Dr. Ron Hoggan: http://www.post-gazette.com/pg/11017/1118230-114.stm and below is his response to its author: Dear China Millman, Thank you for your interesting article on gluten-free dieting. I was very pleased to read that you include patients with non-celiac gluten sensitivity among those who should follow a gluten free diet. I assume that you have arrived at your estimate of 20 million who are afflicted with wheat allergy, non-celiac and celiac gluten sensitivity using Dr. Fasano’s estimate that 6 to 7 percent of Americans have what you refer to as this “milder form of gluten intolerance”. There are other estimates. For instance, Dr. Kenneth Fine did random blood draws at a shopping center in Dallas, Texas and found an 11% rate of gluten sensitivity. Congruently, Dr. Marios Hadjivassiliou has reported rates as high as 12% in the United Kingdom and Dr. Rodney Ford reports a prevalence estimate of 10% in New Zealand. Each investigator used different methods to arrive at their estimate, and each method is likely to underestimate the true prevalence of non-celiac gluten sensitivity. For instance, they all rely on a single class of antibody reaction against a single sub-group of proteins found in gluten grains. Thus, Dr. Fasano’s estimate may be unduly conservative as it is substantially lower than others have found in similar populations and the testing used to arrive at Dr. Fasano's estimate also carries all of the other limitations mentioned above. As for the notion that non-celiac gluten sensitivity is milder than celiac disease, Anderson et al, in their study titled “Malignancy and mortality in a population-based cohort of patients with coeliac disease or ‘gluten sensitivity’ World J Gastroenterol 2007 January 7; 13(1): 146-151, report a higher rate of malignancy and early mortality among those with non-celiac gluten sensitivity than among those with celiac disease. This finding may be the result of the common recommendation that patients ignore test results that show non-celiac gluten sensitivity, as many physicians believe that such results are “non-specific” and do not warrant a gluten free diet. However, it may also reflect that non-celiac gluten sensitivity is a more serious illness than celiac disease. It may also reflect something entirely different than these two interpretations, but it does make a very good case for the need for more research in this very neglected area. As for the comments by Heather Mangieri and the American Dietetics Association, they might benefit from reading studies such as the one by Dr. Cheng et al titled “Body Mass Index in Celiac Disease Beneficial Effect of a Gluten-free Diet” in the 2009 Journal of Clinical Gastroenterology. They found that, after diagnosis with celiac disease, about half of the overweight and obese patients lost weight. Given the conservative data you report, suggesting that at least 90% of American cases of celiac disease go undiagnosed, there can be little doubt that a large portion of those with undiagnosed celiac disease who are overweight or obese would be likely to lose weight. The number who would lose weight should be greater among those who chose to follow a gluten free diet to lose weight, as some of those who are diagnosed with celiac disease do not comply with the diet. If one accepts the proposition that those with non-celiac gluten sensitivity, IBS, and IBD often have similarly problematic reactions to gluten, the number of Americans who could lose weight and live healthier, and therefore happier, lives (eating a gluten free diet) rises exponentially. On a personal level, my mother lost 66 pounds during her first years on a gluten free diet. Now, some 15 years later, she has lost almost 100 pounds. I doubt that she would still be alive had she not undertaken the gluten free diet purely on the basis of test results suggestive of non-celiac gluten sensitivity. In the current context of excessive under-diagnosis of celiac disease and limited understandings of the dynamics by which a gluten free diet causes weight loss among celiac patients, and an enormously greater number of Americans who have non-celiac gluten sensitivity, it is difficult to understand why anyone would be cautioned against following a gluten free diet with weight loss as their objective. Whether these individuals are undiagnosed celiac patients, have undiagnosed non-celiac gluten sensitivity, or they find that a gluten free diet is helping them to achieve their body mass objectives, there is little legitimate cause to "warn" people away from a gluten free diet. Overall, your article does raise awareness of gluten as a potential health threat, so its overall impact is positive despite the misinformation that a gluten free diet does not help with weight loss. Sincerely, Ron Hoggan, Ed. D. Royal Roads University, Continuing Studies
Proceedings of the National Academy of Sciences 1999;96:11482-11485. (Celiac.com 04/10/2000) Spanish researchers, including Dr. Alicia Armentia Medina from the Hospital Rio Hortega in Valladolid, Spain, warn that people who have cereal allergies should exercise caution when drinking cola or cocoa products as these beverages may contain cereal proteins. These proteins could cause a severe asthmatic reaction in rare instances. Cereal allergies are very common throughout the world, and it is difficult to know the formulation of cola drinks. According to Dr. Medina: It is possible that they contain cereals. In their study, which was presented to the 16th World Congress of Asthma in Spain, Medinas team analyzed the allergic reactions of nine people who suffered severe asthmatic reactions after drinking cola. The researchers linked their allergic reactions to specific alpha-amylase inhibitor molecules that originate from wheat, rye and barley, and were found in their drink. The researchers conclude: My personal opinion is that persons who know that they have a cereal allergy should be careful about consuming foods such as (colas) and cocoa that could contain cereal in their composition.