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Can J Diet Pract Res ; : 1-6, 2020 09 09.
Artigo em Inglês | MEDLINE | ID: mdl-32902303


To determine the food sources of energy and 13 core nutrients, 89 diet recalls were analyzed from an explanatory mixed-methods pilot study with adults following a gluten-free diet (GFD) for any reason. Nonconsecutive dietary recalls were collected through a web-based, Automated Self-Administered 24-Hour (ASA24®-Canada-2016) Tool. Mean nutrient intakes were compared with Dietary Reference Intakes. Food items (excluding supplements) were extracted and categorized according to the Bureau of Nutritional Sciences Food Group Codes. Percentages of total dietary intakes from food sources were ranked. Grain products were the highest ranked contributor of energy (21.4%), carbohydrate (30.3%), fibre (29.1%), and iron (35.3%). Breakfast cereals, hot cereals, yeast breads, and mixed grain dishes (mainly rice or pasta-based) were the most important nutrient contributors for grains, despite most (64.3%) commercial cereals and breads being unenriched. Legumes and seeds were not frequently consumed. Nutrient density in the GFD could be improved with more emphasis on gluten-free (GF) whole grains, legumes, seeds, and enriched breads and cereals. More research is needed on the nutrient composition of GF foods to identify food sources of folate, other B vitamins, zinc and magnesium-nutrients of concern for those requiring a GFD.

Curr Med Res Opin ; 36(11): 1913-1926, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32851882


OBJECTIVES: We conducted a systematic literature review (SLR) of randomized controlled trials and real-world evidence (RWE) studies to determine the humanistic (e.g. health-related/disease-specific quality of life [QOL]) and economic (e.g. direct and indirect costs) burdens of chronic rhinosinusitis with nasal polyposis (CRSwNP). METHODS: The SLR adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Embase, MEDLINE and Evidence-Based Medicine Reviews databases were searched using OVID. Relevant studies involving adult patients with CRSwNP published between 1 January 2008 and 16 February 2019 were included, with relevant conference abstracts from 1 January 2017, onward. RESULTS: Sino-Nasal Outcomes Test (SNOT)-22 was the most frequently used disease-specific health-related QOL/patient-reported outcomes instrument for patients with CRSwNP. Baseline SNOT-22 scores ranged from 25 to 73 for surgical candidates and from 14 to 56 for medically managed patients with CRSwNP. Mean baseline EuroQol-5 Dimensions (EQ-5D) index for patients with CRSwNP ranged from 0.81 to 0.86, and mean baseline Short Form-6 Dimensions (SF-6D) ranged from 0.67 to 0.75. Three months (EQ-5D) and 5 years (SF-6D) post-endoscopic sinus surgery (ESS), rates increased from 0.81 to 0.89 and from 0.69 to 0.80, respectively. One year post-diagnosis, patients with CRSwNP had significantly more systemic prescriptions, underwent significantly more medical procedures, demonstrated greater health care resource utilization and had significantly greater mean health care costs compared with matched controls (all p < .001). Overall, for patients with initial ESS, CRSwNP was associated with higher disease-related expenditures compared with CRS without nasal polyposis (NP), even for patients who did not undergo revision surgery. CONCLUSIONS: This SLR identified substantial humanistic burden among surgery candidates. RWE shows that surgeries were used to treat relatively more severe CRSwNP patients as recommended by guidelines. Patient QOL is improved significantly after surgery; however, there is a lack of evidence on patients with revision surgery. Surgery is also associated with higher costs, and the presence of NP was a predictor of revision surgery. Patients with CRSwNP demonstrate greater health care resource utilization and costs compared to those with CRS without NP. Costs associated with different severity of CRSwNP and revision surgery need to be assessed further.