RESUMEN
OBJECTIVE: To describe the efforts carried out to strengthen nutrition education in Mexican medical schools. Emphasis was placed on the status previous to the program implementation, the design of a new basic curriculum, and the description of the main program strategies implemented. METHODS: a) Analysis of available medical curricula; b) Application of a questionnaire to the school deans; c) Assessment of knowledge of nutrition of advanced medical students; d) Design of a basic curriculum of clinical nutrition; e) Edition of a textbook; f) Design and implementation of program strategies to strengthen nutrition education. RESULTS: Clinical nutrition was not a topic included in most curricula analyzed and, when present, it was incorporated to related clinical subjects. Usually, emphasis was placed on basic topics of nutrition while clinical and applied subjects were considered less frequently. Lack of a specialized faculty and weakness of teaching infrastructure were some problems identified. A basic curriculum adaptable to different contexts was designed, and a textbook on clinical nutrition was edited and published. Training and formation of nutrition specialists were among the key programs implemented.
Asunto(s)
Ciencias de la Nutrición/educación , Facultades de Medicina , Adulto , Femenino , Humanos , Masculino , México , Estudiantes de Medicina , Encuestas y CuestionariosRESUMEN
BACKGROUND: Reflux Esophagitis is a common complaint from the upper gastrointestinal tract with a figured out prevalence of about 2%. Therapeutic results in this pathology have been unsatisfactory. AIM: To compare lansoprazole and omeprazole therapeutic effects in patients with reflux esophagitis. MATERIALS AND METHODS: A clinical, double-blinded, balanced survey was randomly designed with patients who would daily receive 30 mg lansoprazole (Group A) or 20 mg omeprazole (Group B) during a 4-week period. All patients were submitted to endoscopy and biopsy both at the beginning and at the end of the survey. RESULTS: Ten patients in each group were treated without any significant differences in sex, age, nicotinism, alcoholism, AINES ingestion, development time, pain regurgitations, pyrrosis, hematemesis, dysphagia, melena, nausea or vomiting, and esophagitis degree. A complete cure in 8/10 (omeprazole) and 7/10 (lansoprazole) patients was obtained (p = n.s.). However, the histological results of the biopsy at the end of the four-week period proved to be a failure in 4/10 (omeprazole) and in 5/10 (lansoprazole) patients (p = n.s.). The endoscopy and clinical result at the end of the study were similarly effective; but not so the histological damage to the esophagus, which continues to be important. CONCLUSIONS: The use of bomb inhibitors in esophagitis by reflux is advisable. Future surveys must assess the average time of treatment for the disappearance of the histologic lesion.
Asunto(s)
Antiulcerosos/uso terapéutico , Inhibidores Enzimáticos/uso terapéutico , Esofagitis Péptica/tratamiento farmacológico , Omeprazol/análogos & derivados , Omeprazol/uso terapéutico , 2-Piridinilmetilsulfinilbencimidazoles , Adolescente , Adulto , Anciano , Antiulcerosos/administración & dosificación , Interpretación Estadística de Datos , Método Doble Ciego , Inhibidores Enzimáticos/administración & dosificación , Esofagitis Péptica/complicaciones , Esofagitis Péptica/diagnóstico , Esofagoscopía , Femenino , Humanos , Lansoprazol , Masculino , Persona de Mediana Edad , Omeprazol/administración & dosificación , Factores de TiempoRESUMEN
A prospective randomized double blind study was carried out on 60 patients undergoing elective gastrointestinal endoscopy. Patients in group A were sedated with diazepam (0.15 mg/kg) and those in group B received midazolam (0.10 mg/kg). There were no differences between the groups in age, sex, previous drug intake, level of anxiety prior to the procedure and from the endoscopist point of view the easiness to perform the studies. The group of patients who received midazolam (B) showed a significantly greater sedation, had less pain in the site of injection, their retrograde amnesia was more effective and tolerated much better the overall procedure (p < 0.05). There were no complications in either group. The cost per dosage was 2:1 greater with midazolam. It is concluded that midazolam has some advantages over diazepam used for sedation of patients undergoing gastrointestinal endoscopy. The time for recovery and cost are its disadvantages.