RESUMEN
BACKGROUND: Most of the national colleges of general practitioners (GPs) do not have their own dietary/nutritional tools, and GPs and nurses do not have the time, knowledge, or skills to advise their patients about desirable dietary practices. OBJECTIVE: To assess the usefulness of a simple and practical guide on healthy diet to be used by European GPs and nurses. DESIGN: A postal survey was mailed to 171 GPs and nurses from 12 European countries to obtain information about the usefulness of a guide on healthy diet developed by EUROPREV. RESULTS: The perception of health professionals is that the main source of information on healthy diet for the population was the media. In all, 95% of GPs and nurses reported that the guide was useful; 93, 95, and 82% reported that the concepts were concise, easy to understand, and realistic, respectively. Also, 77% reported that the type of counselling recommended was feasible and could be applied, 94% reported that the implementation measures proposed could be effective and 88% reported that the Traditional Mediterranean Diet Pyramid is useful, but some concerns about the content were mentioned. CONCLUSIONS: GPs and nurses from Europe think that a practical guide on healthy diet developed by EUROPREV could be used to advise patients in primary care, although the Traditional Mediterranean Diet Pyramid should be modified.
Asunto(s)
Actitud del Personal de Salud , Dieta/normas , Enfermeras y Enfermeros/psicología , Médicos de Familia/psicología , Atención Primaria de Salud , Adulto , Educación en Enfermería , Europa (Continente) , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Medios de Comunicación de Masas , Persona de Mediana Edad , Educación del Paciente como Asunto , Médicos de Familia/educación , Servicios Postales , Encuestas y CuestionariosRESUMEN
OBJECTIVE: To describe the syndrome of rhabdomyolysis during bacterial sepsis with regard to incidence, blood bacteriology and complications and to examine the association between hyperosmolal state and rhabdomyolysis, evaluating the relationship between plasma osmolality (Posm) and serum creatine phosphokinase (CPK) levels. DESIGN: Prospective study including all patients admitted to the intensive care unit (ICU) for sepsis with positive blood culture and rhabdomyolysis over a 3-year period. SETTING: Seven-bed medical/surgical ICU of a teaching hospital. PATIENTS: 35 patients (group 1) with bacterial sepsis-induced rhabdomyolysis (15 males, 20 females; mean age 71+/-13 years) and 122 (group 2) bacteraemic septic patients without rhabdomyolysis (49 males, 73 females; mean age 68+/-15) were studied. Patients with rhabdomyolysis were divided into gram(+) and gram(-) subgroups according to the blood culture growth. RESULTS: From 491 patients recorded, 35 fulfilled the inclusion criteria for bacterial sepsis-induced rhabdomyolysis (7.1%). Gram-positive bacteria predominated in group 1 (69%), while gram-negative predominated (60%) in group 2. There was a correlation between CPK and Posm levels in the rhabdomyolysis Group (r = 0.52, R2 = 0.27, p = 0.003). There was a stronger correlation between these two variables (r = 0.67, R2 = 0.45, p = 0.001) in the gram(+).subgroup. Acute renal failure (68.5%) and electrolyte disorders such as hyperkalaemia (34%) and hypocalcaemia (48.5%) were the major complications in the rhabdomyolysis group. Sixteen (45.7%) patients in group 1 and 49 (40%) in group 2 died during their stay in the ICU from sepsis and multiple organ failure. Rhabdomyolysis was not considered a contributing factor to their death, as none of our patients died during or immediately after the syndrome. CONCLUSION: Bacterial sepsis-induced rhabdomyolysis results from certain types of microorganisms, mainly gram-positive and to a lesser extent gram-negative. Hyperosmolality is a predisposing mechanism for rhabdomyolysis during bacteraemic sepsis from any type of bacterial microorganism.
Asunto(s)
Infecciones Bacterianas/complicaciones , Rabdomiólisis/microbiología , Sepsis/complicaciones , Lesión Renal Aguda/etiología , Anciano , Femenino , Grecia/epidemiología , Humanos , Incidencia , Unidades de Cuidados Intensivos/estadística & datos numéricos , Masculino , Estudios Prospectivos , Rabdomiólisis/complicaciones , Rabdomiólisis/epidemiología , Rabdomiólisis/fisiopatología , Desequilibrio Hidroelectrolítico/complicacionesRESUMEN
Our recent descriptive report in this journal of "Healthometer", an interactive instrument for self-mediated health counseling, was well received in the medical systems research and development community. Suitable for paper as well as electronic mediation and covering both screening, processing/storage, and advisory tasks in a positively reinforcing and confidential way, it has on the whole been considered to be an interesting model in the advancing "information society technologies" perspective; however, a closer scientific and operative evaluation is warranted. Because the power of the instrument in addition to the hardware is critically dependent upon the wet- and software quality, the present study aims at examining in the same forefront forum some basic aspects of all these modalities, with emphasis on face and content validity, feasibility, and users' attitudes and opinions. It can be summarized, quite briefly, that all of them were satisfactory.