5 research outputs found
Cumplimiento de las recomendaciones diarias de nutrientes en personas vegetarianas y veganas pertenecientes al Gran Mendoza
La alimentación basada en plantas es un patrón alimentario que se sustenta
principalmente en el consumo de alimentos de origen vegetal. Si se consumen
exclusivamente alimentos vegetales, es decir, 100% basada en plantas se está
hablando de vegetarianismo estricto o vegano (cuando hay a su vez un
posicionamiento político). Otra opción es cuando se consumen en conjunto
alimentos de origen animal como lácteos, huevos o miel y en ese caso se habla de
alimentación api ovo lacto vegetariana o sus correspondientes variaciones.
Esta investigación tiene como objetivo general determinar el porcentaje de la
población vegetariana y vegana comprendida en el Gran Mendoza, que cumple
con el requerimiento diario de proteínas, ácidos grasos omega 3, vitamina B12,
hierro, calcio y zinc.
Es un estudio cuantitativo y descriptivo que plantea como hipótesis que los
vegetarianos y veganos encuestados, pertenecientes al Gran Mendoza, no cubren
las ingestas diarias recomendadas de proteínas, ácidos grasos omega 3, vitamina
B12, hierro, calcio y zinc. El instrumento de recolección de datos es una encuesta
que incluye un cuestionario de frecuencia de consumo, en el cual hay listados
aproximadamente 180 alimentos, y un recordatorio de 24 horas.
Los principales hallazgos de la investigación reflejan que esta población sí cubre
los requerimientos diarios de proteínas, hierro y zinc, pero tiene un consumo
insuficiente de ácidos grasos omega 3, vitamina B12 y calcio.
A modo de conclusión, la población vegetariana y vegana debe aumentar sus
conocimientos y mejorar sus hábitos alimentarios para lograr cubrir los
requerimientos de todos los nutrientes críticos y, de esta forma, evitar futuras
deficiencias nutricionales y sus consecuentes problemas en la salud
Effectiveness of a strategy that uses educational games to implement clinical practice guidelines among Spanish residents of family and community medicine (e-EDUCAGUIA project):A clinical trial by clusters
This study was funded by the Fondo de Investigaciones Sanitarias FIS Grant Number PI11/0477 ISCIII.-REDISSEC Proyecto RD12/0001/0012 AND FEDER Funding.Background: Clinical practice guidelines (CPGs) have been developed with the aim of helping health professionals, patients, and caregivers make decisions about their health care, using the best available evidence. In many cases, incorporation of these recommendations into clinical practice also implies a need for changes in routine clinical practice. Using educational games as a strategy for implementing recommendations among health professionals has been demonstrated to be effective in some studies; however, evidence is still scarce. The primary objective of this study is to assess the effectiveness of a teaching strategy for the implementation of CPGs using educational games (e-learning EDUCAGUIA) to improve knowledge and skills related to clinical decision-making by residents in family medicine. The primary objective will be evaluated at 1 and 6months after the intervention. The secondary objectives are to identify barriers and facilitators for the use of guidelines by residents of family medicine and to describe the educational strategies used by Spanish teaching units of family and community medicine to encourage implementation of CPGs. Methods/design: We propose a multicenter clinical trial with randomized allocation by clusters of family and community medicine teaching units in Spain. The sample size will be 394 residents (197 in each group), with the teaching units as the randomization unit and the residents comprising the analysis unit. For the intervention, both groups will receive an initial 1-h session on clinical practice guideline use and the usual dissemination strategy by e-mail. The intervention group (e-learning EDUCAGUIA) strategy will consist of educational games with hypothetical clinical scenarios in a virtual environment. The primary outcome will be the score obtained by the residents on evaluation questionnaires for each clinical practice guideline. Other included variables will be the sociodemographic and training variables of the residents and the teaching unit characteristics. The statistical analysis will consist of a descriptive analysis of variables and a baseline comparison of both groups. For the primary outcome analysis, an average score comparison of hypothetical scenario questionnaires between the EDUCAGUIA intervention group and the control group will be performed at 1 and 6months post-intervention, using 95% confidence intervals. A linear multilevel regression will be used to adjust the model. Discussion: The identification of effective teaching strategies will facilitate the incorporation of available knowledge into clinical practice that could eventually improve patient outcomes. The inclusion of information technologies as teaching tools permits greater learning autonomy and allows deeper instructor participation in the monitoring and supervision of residents. The long-term impact of this strategy is unknown; however, because it is aimed at professionals undergoing training and it addresses prevalent health problems, a small effect can be of great relevance. Trial registration: ClinicalTrials.gov: NCT02210442.Publisher PDFPeer reviewe
Practical guideline for Benign paroxismal positional vertigo
Introduction and objective: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vertigo, characterized by brief attacks of rotatory vertigo associated with nystagmus, which are elicited by specific changes in head position relative to gravity. The observation of positional nystagmus is essential for the diagnosis of BPPV. The treatment consists in maneuvers of canalith repositioning procedure to move otoconial debris from the affected semicircular canal to the utricle. These guidelines are intended for all who treat the BPPV in their work, with an intention to assist in the diagnosis and application of an appropriate therapeutic method. Method: The experience and analysis of different national and international consensus on BPPV, has allowed to a large group of ENT specialists of the Communities of Castilla y León, Cantabria and La Rioja (Spain), carry out this guide. Results: The different clinical entities are reviewed. BPPV of the posterior semicircular canal, horizontal canal and anterior canal, BPPV affecting several canals, atypical and central BPPV, subjective BPPV and the characteristics of this process in the elderly. Canalith repositioning procedures have been illustrated with explanatory drawings. Discussion and conclusions: Although the pathophysiology of BPPV is canalolithiasis comprising free-floating otoconial debris within the endolymph of a semicircular canal, or cupulolithiasis comprising otoconial debris adherent to the cupula, there are still many issues to be resolved. We think that the best way to find answers is part of using a common methodology in the diagnosis and treatment of these patients.Introducción y Objetivo: El vértigo periférico más frecuente es el Vértigo Posicional Paroxístico Benigno (VPPB), caracterizado por bruscos ataques de sensación rotatoria, que aparecen como consecuencia de determinados cambios en la posición de la cabeza con relación a la gravedad. La observación del nistagmo posicional es fundamental para el diagnóstico de VPPB. El tratamiento consiste en aplicar maniobras de reposición, para intentar trasladar los restos otoconiales libres, desde el conducto semicircular (CS) afectado hasta el utrículo. Esta guía, está orientada para quienes tratan el VPPB, con la intención práctica de ayudarles en el diagnóstico y tratamiento de esta enfermedad. Método: La experiencia y el análisis de diferentes acuerdos nacionales e internacionales sobre el VPPB, han permitido a un amplio grupo de especialistas ORL de las Comunidades de Castilla y León, Cantabria y La Rioja (España), llevar a cabo esta guía. Resultados: Se revisan las diferentes entidades clínicas. VPPB del conducto semicircular posterior (CSP), horizontal (CSA) y anterior (CSA), incluyéndose también el VPPB multicanal, VPPB atípico y central, VPPB subjetivo y las características de este proceso en el anciano. Las maniobras de reposición se han ilustrado con dibujos explicativos. Discusión y conclusiones: Aunque la fisiopatología del VPPB se explica por la presencia de restos otoconiales libres en la endolinfa de uno o varios conductos semicirculares (canalitiasis) y en algunos casos por su adherencia a la cúpula del CS (cupulolitiasis), aún quedan muchas cuestiones por resolver. Pero creemos que la mejor manera de encontrar respuestas parte de utilizar una metodología común en el diagnóstico y tratamiento de estos pacientes
Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)
This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe
Guía práctica del vértigo posicional paroxístico
Benign paroxysmal positional vertigo (BPPV) is the most common
peripheral vertigo, characterized by brief attacks of rotatory vertigo associated with nystagmus,
which are elicited by specific changes in head position relative to gravity. The observation of
positional nystagmus is essential for the diagnosis of BPPV. The treatment consists in maneuvers
of canalith repositioning procedure to move otoconial debris from the affected semicircular
canal to the utricle. These guidelines are intended for all who treat the BPPV in their work, with
an intention to assist in the diagnosis and application of an appropriate therapeutic method.
Method: The experience and analysis of different national and international consensus on
BPPV, has allowed to a large group of ENT specialists carry out this guide. Results: The different
clinical entities are reviewed. BPPV of the posterior semicircular canal, horizontal canal and
anterior canal, BPPV affecting several canals, atypical and central BPPV, subjective BPPV and
the characteristics of this process in the elderly. Canalith repositioning procedures have been
illustrated with explanatory drawings. Discussion and conclusions: Although the pathophysiology
of BPPV is canalolithiasis comprising free-floating otoconial debris within the endolymph
of a semicircular canal, or cupulolithiasis comprising otoconial debris adherent to the cupula,
there are still many issues to be resolved. We think that the best way to find answers is part of
using a common methodology in the diagnosis and treatment of these patients.El vértigo periférico más frecuente es el Vértigo Posicional Paroxístico
Benigno (VPPB), caracterizado por bruscos ataques de sensación rotatoria, que aparecen
como consecuencia de determinados cambios en la posición de la cabeza con relación a la
gravedad. La observación del nistagmo posicional es fundamental para el diagnóstico de
VPPB. El tratamiento consiste en aplicar maniobras de reposición, para intentar trasladar los
restos otoconiales libres, desde el conducto semicircular (CS) afectado hasta el utrículo. Esta
guía, está orientada para quienes tratan el VPPB, con la intención práctica de ayudarles en el diagnóstico y tratamiento de esta enfermedad. Método: La experiencia y el análisis de diferentes
acuerdos nacionales e internacionales sobre el VPPB, han permitido a un amplio grupo de
especialistas ORL llevar a cabo esta guía. Resultados: Se revisan las diferentes entidades
clínicas. VPPB del conducto semicircular posterior (CSP), horizontal (CSA) y anterior (CSA),
incluyéndose también el VPPB multicanal, VPPB atípico y central, VPPB subjetivo y las características
de este proceso en el anciano. Las maniobras de reposición se han ilustrado con
dibujos explicativos. Discusión y conclusiones: Aunque la fisiopatología del VPPB se explica
por la presencia de restos otoconiales libres en la endolinfa de uno o varios conductos semicirculares
(canalitiasis) y en algunos casos por su adherencia a la cúpula del CS (cupulolitiasis),
aún quedan muchas cuestiones por resolver. Pero creemos que la mejor manera de encontrar
respuestas parte de utilizar una metodología común en el diagnóstico y tratamiento de
estos paciente