Safety of Adding Oats to a Gluten-free Diet for Patients with Celiac Disease: Systematic Review and Meta-analysis of Clinical and Observational Studies

Background & Aims: Patients with celiac disease should maintain a gluten-free diet (GFD), excluding wheat, rye, and barley. Oats might increase the nutritional value of a GFD, but their inclusion is controversial. We performed a systematic review and meta-analysis to evaluate the safety of oats as part of a GFD in patients with celiac disease. Methods: We searched the Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE databases for clinical trials and observational studies of the effects of including oats in GFD of patients with celiac disease. The studies reported patients’ symptoms, results from serology tests, and findings from histologic analyses. We used the GRADE approach to assess the quality of evidence. Results: We identified 433 studies; 28 were eligible for analysis. Of these, 6 were randomized and 2 were not randomized controlled trials comprising a total of 661 patients—the remaining studies were observational. All randomized controlled trials used pure/uncontaminated oats. Oat consumption for 12 months did not affect symptoms (standardized mean difference: reduction in symptom scores in patients who did and did not consume oats, −0.22; 95% CI, −0.56 to 0.13; P = .22), histologic scores (relative risk for histologic findings in patients who consumed oats, 0.24; 95% CI, 0.01–4.8; P = .35), intraepithelial lymphocyte counts (standardized mean difference, 0.21; 95% CI, reduction of 1.44 to increase in 1.86), or results from serologic tests. Subgroup analyses of adults vs children did not reveal differences. The overall quality of evidence was low. Conclusions: In a systematic review and meta-analysis, we found no evidence that addition of oats to a GFD affects symptoms, histology, immunity, or serologic features of patients with celiac disease. However, there were few studies for many endpoints, as well as limited geographic distribution and low quality of evidence. Rigorous double-blind, placebo-controlled, randomized controlled trials, using commonly available oats sourced from different regions, are needed

Animais gordos e a dissolução da fronteira entre as espécies

Animais de estimação gordos costumavam ser, para muitas pessoas, engraçados e adoráveis; para algumas, os animaizinhos gordos (especialmente gatos) ainda o são: os quadrinhos de Garfield, sobre um gato acima do peso e preguiçoso, venderam bem; há sites e livros dedicados a exaltar a beleza e o encanto dos gatos gordos; e crianças anglófonas são socializadas por meio de livros de leitura fonológicos com títulos como Fat cat on a mat, associando o prazer de ler à fofura de animais de estimação rechonchudos. Tudo isto, no entanto, está mudando. Testemunhamos a transformação da obesidade de animais de estimação de fenômeno trivial ou preferência estética idiossincrática em problema social. Este vem mobilizando os meios de comunicação de massa, a opinião pública e ampla variedade de especialistas, além da intervenção de aparatos de Estado, como os tribunais e a polícia. Este artigo discute as maneiras pelas quais a obesidade ultrapassou a fronteira das espécies. Revisa as provas divulgadas para justificar as cada vez mais comuns - e cada vez mais estridentes - alegações de que estamos em meio a uma "epidemia" de obesidade de animais de estimação (algumas das quais afirmando que os animais de estimação acima do peso chegam a 60% do total), discute a fonte e avalia a credibilidade desta informação. Examina como a obesidade animal é apresentada na mídia por organizações de caridade, como Pet Club UK ou a RSPCA. E oferece reflexões sobre o que a preocupação corrente em relação à obesidade dos animais de estimação pode nos dizer a respeito das dimensões sociais, culturais, médicas, históricas, econômicas, emocionais e subjetivas da obesidade de maneira geral.<br>For many people, fat pets used to be cute, funny and adorable, and for some people fat pets (especially fat cats) still are: the Garfield comics, about an overweight, lazy cat, sell well, there are websites and books devoted to extolling the beauty and allure of fat cats, and children are socialized, through phonics readers with titles like Fat Cat on a Mat, to associate the pleasure of reading with the cuteness of round pets. All of this, however, is changing. We are witnessing the transformation of pet obesity from a trivial phenomenon or an idiosyncratic aesthetic preference into a social problem - one that increasingly mobilizes the mass media, public opinion and a wide variety of experts, and the intervention of state apparatuses like the courts and the police. This article discusses the ways in which obesity has crossed the species boundary. It reviews the evidence circulated to justify the increasingly common - and increasingly shrill - claims that we are in the midst of an "epidemic" of pet obesity (some claims assert that as many as 60% of all pets are overweight or obese) and it discusses the source and assesses the reliability of that evidence. It examines how pet obesity is presented in the mass media and by charitable organizations like Pet Club UK or the RSPCA. It also offers some thoughts about what current concerns about pet obesity can tell us about the social, cultural, medical, historical, economic, emotional and subjective dimensions of obesity more generally

Prophylaxis of postoperative endophthalmitis following cataract surgery: Results of the ESCRS multicenter study and identification of risk factors

Purpose: To identify risk factors and describe the effects of antibiotic prophylaxis on the incidence of postoperative endophthalmitis after cataract surgery based on analysis of the findings of the European Society of Cataract & Refractive Surgeons (ESCRS) multicenter study. Setting: Twenty-four ophthalmology units in Austria, Belgium, Germany, Italy, Poland, Portugal, Spain, Turkey, and the United Kingdom. Methods: A prospective randomized partially masked multicenter cataract surgery study recruited 16 603 patients. The study was based on a 2 × 2 factorial design, with intracameral cefuroxime and topical perioperative levofloxacin factors resulting in 4 treatment groups. The comparison of case and non-case data was performed using multivariable logistic regression analyses. Odds ratios (ORs) associated with treatment effects and other risk factors were estimated. Results: Twenty-nine patients presented with endophthalmitis, of whom 20 were classified as having proven infective endophthalmitis. The absence of an intracameral cefuroxime prophylactic regimen at 1 mg in 0.1 mL normal saline was associated with a 4.92-fold increase (95% confidence interval [CI], 1.87-12.9) in the risk for total postoperative endophthalmitis. In addition, the use of clear corneal incisions (CCIs) compared to scleral tunnels was associated with a 5.88-fold increase (95% CI, 1.34-25.9) in risk and the use of silicone intraocular lens (IOL) optic material compared to acrylic with a 3.13-fold increase (95% CI, 1.47-6.67). The presence of surgical complications increased the risk for total endophthalmitis 4.95-fold (95% CI, 1.68-14.6), and more experienced surgeons were more likely to be associated with endophthalmitis cases. When considering only proven infective endophthalmitis cases, the absence of cefuroxime and the use of silicone IOL optic material were significantly associated with an increased risk, and there was evidence that men were more predisposed to infection (OR, 2.70; 95% CI, 1.07-6.8). Conclusions: Use of intracameral cefuroxime at the end of surgery reduced the occurrence of postoperative endophthalmitis. Additional risk factors associated with endophthalmitis after cataract surgery included CCIs and the use of silicone IOLs. © 2007 ASCRS and ESCRS