Gluten-related disorders (GRDs) are increasing around the world, but their magnitude and relevance remain unknown in most Latin American countries. Thus, an online survey was conducted to estimate the prevalence of GRDs as well as adherence to a gluten-free diet (GFD) in Paraguayan adult population. There were 1058 individuals surveyed using a validated questionnaire (response rate of 93.9%). The self-reported prevalence rates were as follows (95% CI): gluten sensitivity (GS), 10.30% (8.53–12.29); non-celiac GS (NCGS), 5.19% (3.94–6.71); physician-diagnosed celiac disease (PD-CD), 3.11% (2.15–4.35); wheat allergy (WA), 2.07% (1.30–3.13); and adherence to GFD, 15.69% (13.55–18.02). Excluding CD, more women than men met the criteria for GRDs, adverse food reactions, and GFD (p < 0.05). Eight respondents reported the coexistence of NCGS with PD-CD and/or WA. Most cases on a GFD indicated medical/dietitian advice for following the diet (68.07%). Non-self-reported GS individuals indicated weight control (46.4%) and the notion that the GFD is healthier (20.2%) as the main motivations for following the diet. GRDs are not uncommon in Paraguayan adult population. It seems that there is awareness about GRDs and the GFD, but training about the diagnosis of GRDs is desirable because of the informed overlapping diagnoses of CD or WA with NCGS. Future studies involving face-to-face interviews are necessary.

RESUMENLa enfermedad celiaca altera el estado emocional, las relaciones sociales, la autonomía y la percepción de la salud, afectando la calidad de vida relacionada a la salud. Los objetivos de esta investigación fueron determinar la calidad de vida relacionada a la salud en adolescentes y adultos con enfermedad celiaca e investigar las condiciones que la afectan. Se realizó un estudio observacional, prospectivo en adolescentes y adultos de Paraguay portadores de enfermedad celiaca con al menos seis meses en dieta sin gluten. Se aplicó el cuestionario CD-QOL (Celiac Disease Quality of Life Measure). Fueron incluidos 114 sujetos, con edad media 30±10 años, siendo 58% del sexo femenino. La calidad de vida fue buena en 25%, regular en 49% y mala en 26%. Las condiciones asociadas significativamente a mejor calidad de vida fueron el sexo femenino, el grupo etario >30 años y que efectúan actividades fuera del hogar. Se concluye que la calidad de vida de los celiacos adolescentes y adultos es regular en 49% de los encuestados.Palabras clave: Enfermedad celiaca; Calidad de vida; Dieta sin gluten. ABSTRACTCeliac disease alters emotional state, social relations, autonomy and health perception, affecting the health related quality of life. The objectives of this research were to determine the health related quality of life in adolescents and adults with celiac disease and to investigate the factors that affect it. We included 114 subjects. The mean age was 30 ± 10 years and 58% of subjects were female. The quality of life was good in 25% of the cases, regular in 49% and bad in 26%. The factors significantly associated with a better quality of life were the female sex, the age group >30 years and carrying out activities outside home. In conclusion, the quality of life of celiac adolescents and adults is regular in 49% of respondents.

Objectives: The aim of this study was to investigate the psychometric properties of the Spanish version of the Stigma of Occupational Stress Scale for Doctors (SOSS-D) and the factors associated with Physician Burnout in Paraguay. Methods: Participants included 747 Paraguayan healthcare workers, aged 24–77 years old, of both sexes. SOSS-D was translated into Spanish and validated through an exploratory and confirmatory factor analysis. Participants were also scored with the Oldenburg Burnout Inventory (OLBI), the CAGE questionnaire, and the stigma subscale of the Perceived Barriers to Psychological Treatment (PBPT) measure. Results: Three factors had a raw eigenvalue greater than 1, and explained 61.7% of total variance. The confirmatory analysis confirmed that the scale is three-dimensional. The model adjustment was good, according to all fit indices. OLBI results indicate clinically significant disengagement in 85.9% and clinically significant exhaustion in 91.6% of participants. Of the 747 participants, 57.6% reported alcoholic beverage consumption and among those, 19.3% had problematic alcohol consumption according to the CAGE questionnaire. The correlation between SOSS-D and the stigma subscale of the PBPT was statistically significant (r = 0.245, p < 0.001). Conclusions: The Spanish version of the SOSS-D was found to have good psychometric properties and adequately reproduces the three-dimensional model of the original English version.

La enfermedad celiaca (EC) es una afección autoinmune multisistémica inducida por el gluten en personas genéticamente susceptibles. La presentación clínica clásica es con un síndrome diarreico crónico, aunque existen formas atípicas y silentes, lo cual dificulta el diagnóstico. El mismo se basa en la detección de diversos autoanticuerpos, sobre todo la IgA contra la transglutaminasa tisular, aunque la prueba de oro es el estudio anatomopatológico de biopsias duodenales obtenidas por endoscopia digestiva alta. La ausencia del gen HLA es una prueba que se utiliza para descartar la EC. La respuesta a la dieta sin gluten confirma esta afección, que de no diagnosticarse oportunamente y tratarse en forma adecuada puede llevar a complicaciones graves.

Introduction:There are multiple factors that intervene in the lack of control of arterial hypertension such as adherence to antihypertensive treatment. Objectives:To find the frequency of adherence to antihypertensive treatment, to describe the level of knowledge about arterial hypertension and to determine the factors associated with the lack of blood pressure control.Methodology: An observational, prospective, multicenter study was carried out in men and women, of legal age, with arterial hypertension, from the area of influence of three Family Health Units in Paraguay between May-November 2019. Adherence to the antihypertensive treatment was determined with the ARMS-e questionnaire and the level of knowledge about arterial hypertension with the questionnaire by Strelec et al. Ethical standards were respected.Results: 171 subjects entered the study, with a mean age 59 ± 11 years, predominantly female (68%). The most frequent nutritional status was grade 1 obesity (35%). Diabetes mellitus was the predominant comorbidity (18%). The most commonly used drugs were angiotensin 1 inhibitors (56%). Adherence to antihypertensive treatment was detected in 116 cases (68%) and knowledge about arterial hypertension in 141 (82%). Uncontrolled blood pressure was found in 83 subjects (49%) and was significantly associated with lack of adherence to antihypertensive drugs and dependence on a caregiver within the family. Conclusions:The frequency of adherence to antihypertensive treatment in adult patients from 3 Family Health Units in Paraguay in 2019 was 68% and the adequate level of knowledge about arterial hypertension was 82%.