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  • 1
    In: Diseases of the Colon & Rectum, Ovid Technologies (Wolters Kluwer Health), Vol. 65, No. 8 ( 2022-08), p. 1042-1051
    Abstract: The impact of a stoma on long-term health-related quality of life in people living with ileostomies is not clear. OBJECTIVE: This study aimed to describe important patient-reported outcomes and health-related quality of life in people with ileostomies. DESIGN: This is a population-based, cross-sectional study. Patients were invited to answer questionnaires estimating stoma-specific and generic health-related quality of life (EQ-5D-5L and the Major Depression Inventory). Danish norms were retrieved from reference literature. SETTINGS: This study was conducted at the major stoma clinic at Aarhus University Hospital, Denmark. PATIENTS: We invited all patients with ileostomies who were in contact with the clinic between 2012 and 2017. MAIN OUTCOME MEASURES: The primary outcomes measured were patient-reported outcomes specific to people with ileostomies. RESULTS: Of 621 identified patients (50% women), 412 (67%) responded to the survey. Among the responders, 178 (43%) reported that they still had an ileostomy at the time of the survey and were included in the analysis. Fatigue was frequent; 68% (95% CI 60%–75%) reported being tired and 26% (95% CI 20%–33%) answered that they were “always tired,” whereas 43% (95% CI 36%–51%) lacked energy, 62% (95% CI 54%–69%) reported poor sleep, and 59% (95% CI 52%–66%) needed to rest during the day. Fifty-six percent (95% CI 48%–63%) needed to know the immediate location of the nearest toilet, and 58% (95% CI 51%–66%) felt sexually unattractive because of their ileostomy. Health-related quality of life measured with generic questions indicated 0.124 points lower health-related quality of life than the Danish norm ( p 〈 0.001), and 18% (95% CI 13%–25%) scored above the threshold for depression, which is 2.6 times higher than the background population (7%, 95% CI 6%–9%; p 〈 0.001). LIMITATIONS: This study was limited by potential selection bias, and all participants did not answer all items. CONCLUSIONS: Fatigue and low health-related quality of life is common in people living with ileostomies. Addressing fatigue and stoma-specific challenges in patients with an ileostomy is warranted. See Video Abstract at http://links.lww.com/DCR/B803. DESENLACES INFORMADOS POR PACIENTES Y CALIDAD DE VIDA RELACIONADA CON LA SALUD EN PERSONAS QUE VIVEN CON ILEOSTOMÍAS: UN ESTUDIO TRANSVERSAL POBLACIONAL ANTECEDENTES: El impacto de un estoma en la calidad de vida relacionada con la salud a largo plazo en personas que viven con ileostomías no está claro. OBJETIVO: Describir desenlaces importantes informados por pacientes y la calidad de vida relacionada con la salud en personas con ileostomías. DISEÑO: Estudio transversal poblacional. Se invitó a los pacientes a responder cuestionarios que estiman la calidad de vida relacionada con la salud general y específica del estoma (EQ-5D-5L y el Inventario de depresión mayor). Las normas danesas se recopilaron de la literatura de referencia. AJUSTES: El estudio se llevó a cabo en la clínica principal de estomas del Hospital Universitario de Aarhus, Dinamarca. PACIENTES: Invitamos a todos los pacientes con ileostomías que estuvieron en contacto con la clínica entre 2012 y 2017. PRINCIPALES MEDIDAS DE RESULTADO: Resultados informados por el paciente específicos para personas con ileostomías. RESULTADOS: De 621 pacientes identificados (50% mujeres), 412 (66%) respondieron la encuesta. Entre los que respondieron, 178 (43%) informaron que todavía tenían una ileostomía en el momento de la encuesta y fueron incluidos en el análisis. La fatiga era frecuente; el 68% (intervalo de confianza del 95%: 60–75%) informó estar cansado y el 26% (20–33%) respondió “siempre cansado”, mientras que el 43% (36–51%) carecía de energía, el 62% (54–69%)) refirieron dormir mal y el 59% (52–6%) necesitaba descansar durante el día. El cincuenta y seis por ciento (48–63%) necesitaba saber la ubicación inmediata del baño más cercano y el 58% (51–66%) se sentía sexualmente poco atractivo debido a su ileostomía. La calidad de vida relacionada con la salud medida con preguntas genéricas indicó una calidad de vida relacionada con la salud 0,124 puntos más baja que la norma danesa ( p 〈 0,001), y el 18% (13–25%) puntuó con depresión, que es 2.6 veces más alta que la población de base (7%, 6–9%, p 〈 0,001). LIMITACIONES: Posible sesgo de selección, y no todos los participantes respondieron a todos los ítems. CONCLUSIONES: La fatiga y la baja calidad de vida relacionada con la salud es común en las personas que viven con ileostomías. Se justifica abordar la fatiga y los desafíos específicos del estoma en pacientes con una ileostomía. Consulte Video Resumen en http://links.lww.com/DCR/B803. (Traducción—Juan Carlos Reyes )
    Type of Medium: Online Resource
    ISSN: 0012-3706
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2046914-7
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  • 2
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2022
    In:  Nutrition Reviews Vol. 80, No. 5 ( 2022-04-08), p. 1311-1339
    In: Nutrition Reviews, Oxford University Press (OUP), Vol. 80, No. 5 ( 2022-04-08), p. 1311-1339
    Abstract: Moderate alcohol consumption is associated with decreased risk of cardiovascular disease (CVD) and improvement in cardiovascular risk markers, including lipoproteins and lipoprotein subfractions. Objective To systematically review the relationship between moderate alcohol intake, lipoprotein subfractions, and related mechanisms. Data sources Following PRISMA, all human and ex vivo studies with an alcohol intake up to 60 g/d were included from 8 databases. Data extraction A total of 17 478 studies were screened, and data were extracted from 37 intervention and 77 observational studies. Results Alcohol intake was positively associated with all HDL subfractions. A few studies found lower levels of small LDLs, increased average LDL particle size, and nonlinear relationships to apolipoprotein B–containing lipoproteins. Cholesterol efflux capacity and paraoxonase activity were consistently increased. Several studies had unclear or high risk of bias, and heterogeneous laboratory methods restricted comparability between studies. Conclusions Up to 60 g/d alcohol can cause changes in lipoprotein subfractions and related mechanisms that could influence cardiovascular health. Systematic Review Registration PROSPERO registration no. 98955
    Type of Medium: Online Resource
    ISSN: 0029-6643 , 1753-4887
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2066844-2
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  • 3
    In: European Journal of Preventive Cardiology, Oxford University Press (OUP), Vol. 27, No. 18 ( 2020-12-01), p. 1967-1982
    Abstract: Observational studies have documented lower risks of coronary heart disease and diabetes among moderate alcohol consumers relative to abstainers, but only a randomized clinical trial can provide conclusive evidence for or against these associations. Aim The purpose of this study was to describe the rationale and design of the Moderate Alcohol and Cardiovascular Health Trial, aimed to assess the cardiometabolic effects of one alcoholic drink daily over an average of six years among adults 50 years or older. Methods This multicenter, parallel-arm randomized trial was designed to compare the effects of one standard serving (∼11–15 g) daily of a preferred alcoholic beverage to abstention. The trial aimed to enroll 7800 people at high risk of cardiovascular disease. The primary composite endpoint comprised time to the first occurrence of non-fatal myocardial infarction, non-fatal ischemic stroke, hospitalized angina, coronary/carotid revascularization, or total mortality. The trial was designed to provide & gt;80% power to detect a 15% reduction in the risk of the primary outcome. Secondary outcomes included diabetes. Adverse effects of special interest included injuries, congestive heart failure, alcohol use disorders, and cancer. Results We describe the design, governance, masking issues, and data handling. In three months of field center activity until termination by the funder, the trial randomized 32 participants, successfully screened another 70, and identified ∼400 additional interested individuals. Conclusions We describe a feasible design for a long-term randomized trial of moderate alcohol consumption. Such a study will provide the highest level of evidence for the effects of moderate alcohol consumption on cardiovascular disease and diabetes, and will directly inform clinical and public health guidelines.
    Type of Medium: Online Resource
    ISSN: 2047-4881 , 2047-4873
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2646239-4
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  • 4
    In: Current Problems in Cardiology, Elsevier BV, Vol. 48, No. 1 ( 2023-01), p. 101395-
    Type of Medium: Online Resource
    ISSN: 0146-2806
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
    detail.hit.zdb_id: 2060920-6
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