Awareness and Self-Reported Knowledge and Training on Nutrition in Older People among Primary Care Practitioners.

OBJECTIVES: To assess the awareness and training of primary care physicians on nutrition in older patients. DESIGN: Observational, real-world data survey. SETTING: Primary Care. PARTICIPANTS: One hundred sixty-two physicians, generalists and specialists, working in primary care. MEASUREMENTS: Participants received an online questionnaire with 18 questions concerning the importance of nutrition, degree of knowledge, needs, and training in nutrition. The results were evaluated using univariate descriptive analysis, with a percentage for each chosen answer. Logistic regression models were used to evaluate if answers were related to training in nutrition and professional experience. RESULTS: 43.2% of participants reported that nutrition is very important in individuals over 65 years old, and 90% were aware of the importance of nutrition in healthy aging. Nutritional problems affect 30 to 50% of patients, according to 44.7% of participants. 89.2% agree about the need for nutritional assessment in older patients; however, the professionals believe they should be better prepared. Two out of three respondents consider the training received in nutrition during their undergraduate course or continuing medical education as deficient. Time of professional practice was mainly associated with conceptual facts, while continuing medical education did with practical issues, mainly the use of screening and diagnostic tools [FRAIL (OR: 3.16; 95%IC: 1.55-6.46), MNA-SF (OR: 6.455; 95%IC: 2.980-13.981) and SARC-F (OR: 3.063; 95%IC: 1.284-7.309)]. CONCLUSION: Although primary care professionals are aware of the importance of nutrition in older patients, there are still gaps in daily practice that could be improved by developing educational strategies.

Estado nutricional de la población mayor de 65 años de edad de la ciudad de Badajoz / Nutritional status of the population over 65 years of age in the city of Badajoz

Introducción. El estado nutricional está muy relacionado con el nivel de salud y la calidad de vida de las personas, y en el caso de los adultos mayores esto es especialmente relevante. Objetivo. Estudiar el estado nutricional en mayores de 65 años no institucionalizados de la ciudad de Badajoz, describiendo parámetros sociodemográficos, bioquímicos, y de valoración funcional. Material y métodos. Diseño poblacional, descriptivo por muestreo aleatorio y estratificado en los centros de salud de la ciudad, obteniéndose un tamaño muestral de 298 pacientes. El estudio sociodemográfico se realizó por género, edad, nivel de estudios, análisis antropométricos por índice de masa corporal y porcentaje de peso graso estimado. Las pruebas estadísticas se llevaron a cabo con el paquete estadístico SPSS v.15. Resultados. La prevalencia de sobrepeso y obesidad medida por peso graso fue del 61,9% (56,1-67,8) y por índice de masa corporal del 65,8% (60,2-71,4). En mujeres fue mayor, siendo por peso graso del 67,3% (64,74-70,03) y por índice de masa corporal del 71,8% (69,16-74,58). El estado nutricional de la población según el cuestionario «Conozca su salud nutricional» fue calificado como «bueno». Conclusión. El problema nutricional más frecuente en la población mayor de 65 años, no institucionalizada de la ciudad de Badajoz, es la obesidad, especialmente en mujeres y en población con bajo nivel educativo. Esta alta prevalencia hace prioritaria la educación para la salud en mejores estilos de vida en esta población (AU)

Introduction. Nutritional status is strongly associated with the level of health and quality of life of the population, and is especially relevant in the case of the elderly. Objective. The aim was to study the nutritional status in a population of non-institutionalised over 65 year-olds in the city of Badajoz, describing the sociodemographic variables, biochemical parameters, and functional assessment. Material and methods. A descriptive study was performed using a design population, which was randomised and stratified in health centres of the city, with a sample size of 298 patients being obtained. The sociodemographic variables included gender, age, educational level, anthropometric analysis with estimated body mass index, and percentage fat weight. Statistical tests were performed using SPSS v.15 statistical package. Results. The prevalence of overweight and obesity as measured by fat weight was 61.9% (56.1-67.8), with a body mass index of 65.8% (60.2-71.4). It was higher in women, with a fat weight of 67.3% (2.56 to 2.73) and a body mass index of 71.8% (2.64 to 2.78). The nutritional status of the population according to the questionnaire «Know your nutritional health» was rated «good». Conclusion. The most common nutritional problem in the non-institutionalised population over 65 years in the city of Badajoz is obesity, especially in women, and in people with low educational level. This high prevalence suggests that health education on a better lifestyle in this population should be a priority (AU)

[Nutritional status of the population over 65 years of age in the city of Badajoz]. / Estado nutricional de la población mayor de 65 años de edad de la ciudad de Badajoz.

INTRODUCTION: Nutritional status is strongly associated with the level of health and quality of life of the population, and is especially relevant in the case of the elderly. OBJECTIVE: The aim was to study the nutritional status in a population of non-institutionalised over 65 year-olds in the city of Badajoz, describing the sociodemographic variables, biochemical parameters, and functional assessment. MATERIAL AND METHODS: A descriptive study was performed using a design population, which was randomised and stratified in health centres of the city, with a sample size of 298 patients being obtained. The sociodemographic variables included gender, age, educational level, anthropometric analysis with estimated body mass index, and percentage fat weight. Statistical tests were performed using SPSS v.15 statistical package. RESULTS: The prevalence of overweight and obesity as measured by fat weight was 61.9% (56.1-67.8), with a body mass index of 65.8% (60.2-71.4). It was higher in women, with a fat weight of 67.3% (2.56 to 2.73) and a body mass index of 71.8% (2.64 to 2.78). The nutritional status of the population according to the questionnaire "Know your nutritional health" was rated "good". CONCLUSION: The most common nutritional problem in the non-institutionalised population over 65 years in the city of Badajoz is obesity, especially in women, and in people with low educational level. This high prevalence suggests that health education on a better lifestyle in this population should be a priority.

El médico de familia en la universidad / The family physician in the university

No disponible

Corea / No disponible

Corea significa danza y se utiliza para designar movimientos rápidos, involuntarios, irregulares, no predecibles, de duración breve, que cambian de una zona corporal a otra sin una secuencia definida, suelen tener una localización distal y baja amplitud y asociarse a hipotonía de los miembros y a reflejos rotulianos pendulares.Suele relacionarse con lesiones o alteraciones del caudado y el putamen.En nuestro caso, los movimientos rápidos e irregulares sedebían a lesiones vasculares, una de las causas de corea. El paciente empezó con la sintomatología hacía quince días. Las exploraciones complementarias realizadas fueron análisis completos con hemograma, bioquímica, coagulación, hormonas tiroideas, serología a lúes, borrelia, brucella, proteína 14-3-3, vitamina E, anticuerpos antineuronales, electrocardiograma,ecocardiograma, ecografía de abdomen, eco-dopplerde troncos supraaórticos, electromiograma/electroneurograma/blink-reflex, resonancia magnética cerebral, metoxisobutil isonitrilo-tomografía computarizada por emisión de fotón único.Tratamiento realizado: médico (clonazepam y toxina botulínica)

Chorea means dance and it is used to designate short duration- fast, involuntary, irregular and unpredictable movements that change from one area of the body to another without a defined sequence. They generally have a distal localization and low amplitude and are usually associated to hypotonia of the limbs and pendular patellar reflexes.This is generally realted to injuries or alterations of the caudate and putamen.In our case, the fast and irregular movements were causedby vascular injuries, one of the causes of Chorea. The patient began with the symptoms 15 days ago. The complementary analyses performed were complete blood count, biochemistry, coagulation, thyroid hormones, serologies for syphilis, borrelia, brucella serology, protein 14-3-3, vitamin and antineuronal antibodies, electrocardiogram, echocardiogram, abdomen ultrasonography, TSA echo-Doppler, EMGENG/blink-reflex, cerebral MRI, MIBI-SPECT.The treatment performed was medical (clonazepam andbotulinic toxin)

Terapéutica en Atención Primaria. La enfermedad tromboembólica en Atención Primaria. Utilización de heparinas de bajo peso molecular / Therapy in Primary Health Care. Thromboembolic disease in Primary Health Care. Use of low molecular weight heparins

INTRODUCCION. La enfermedad tromboembólica venosa (ETV) engloba la trombosis venosa profunda (TVP) y la tromboembolia pulmonar (TEP), es una causa importante de morbimortalidad en la población general y una de las principales enfermedades cardiovasculares, después de la cardiopatía isquémica y el ictus. Estudios poblacionales han registrado una incidencia anual elevada. Los pacientes con patología quirúrgica reciben tromboprofilaxis, pero no se realiza habitualmente en los enfermos con patología médica. ASPECTOS RELEVANTES. Diferentes estudios han demostrado que las heparinas de bajo peso molecular (HBPM) son tan eficaces como las heparinas no fraccionadas (HNF) en el tratamiento de la TVP. Entre los efectos adversos, el más importante es la hemorragia, por lo que es necesario llevar a cabo una valoración de los factores de riesgo hemorrágico y ajustar la dosis en esos pacientes; pueden ser utilizadas con seguridad y con eficacia como anticoagulante alternativo en pacientes que han experimentado complicaciones de sangrado producidos con otros anticoagulantes. El incumplimiento terapéutico por rechazo al pinchazo puede reducirse. Se han descrito diferentes reacciones cutáneas, la más frecuente es el hematoma en el punto de inyección, que puede considerarse como una reacción dentro de la normalidad y no requiere la suspensión del tratamiento. CONCLUSIONES: a) La ETV es un problema de salud de gran magnitud y elevada prevalencia. b) Las HBPM han demostrado ser un tratamiento eficaz y seguro de la ETV, incluyendo a los pacientes con antecedentes de episodios hemorrágicos. c) El incumplimiento terapéutico por rechazo al pinchazo, por poca tolerabilidad en el lugar de la inyección, puede ser minimizado con educación al paciente y seleccionando el tipo y la presentación de la HBPM más adecuado

INTRODUCTION. The venous thromboembolism (VTE) includes deep vein thrombosis (DVT) and acute pulmonary embolism (PE), is important cause of morbidity and mortality rate in the general population and it one of the main cardiovascular diseases, after the isquémica cardiopathy and ictus. Population studies have registered an elevated annual incidence. The patients with surgical pathology receive prevention of venous thromboembolism, but it is not made habitually in them ill with medical pathology. EXCELLENT ASPECTS. Different studies have demonstrated that the low molecular weight heparins (LMWH) are as effective as the unfractionated heparin (UFH) in the treatment of the DTV. Among the adverse effects the most important is the hemorrhagic, being necessary a valuation of the hemorrhagic risks factors, having to fit the dose in those patients; it can be used surely and with effectiveness like alternative anticoagulant in patients who have experienced complications of bled that they have been produced by other anticoagulants. The therapeutic breach by rejection to the prick can be reduced. Different cutaneous reactions have been described, the most frequent is the haematoma in the injection point, it can be considered as a reaction within normality and it does not require the suspension of the treatment. CONCLUSIONS. a) The VTE is a health problem of great magnitude and high prevalence. b) The LMWH have demonstrated to be effective and safe treatment of the VTE, including the patients with antecedents of hemorragics episodes. c) The therapeutic breach by rejection to prick, by few tolerate in the place of the injection, can be minimized by education to the patient and selecting the most suitable type and the presentation of the LMWH

[Study of eating habits in a female population comparing groups with and without food-related diseases]. / Estudio de hábitos alimentarios en población femenina comparando grupos con patología y sin patología alimentaria.

GOAL: To analyze female subjects in the rural setting to detect food-related disorders and factors associated with these. To isolate these factors and prevent the development of food-related disorders in Primary Health Care. Also to assess continuity in the alterations in the general, sub-clinical and bulimic populations. SCOPE AND SUBJECTS: 127 women with absence of dysfunctions: 57 sub-clinical and 63 bulimics, all from south-western Spain. INTERVENTIONS: Those adolescents at risk of dysfunctions would present positive results in pathological personality traits; therefore, their identification in Primary Health Care would avoid the transition to complete forms and would be favour the theory of the continuum. RESULTS: Significant differences were found between sub-clinical and bulimic women for mean age and age of onset of eating-related difficulties. Subjects without eating-related dysfunctions have a lower body mass index (BMI) than sub-clinical ones and the latter have less than bulimic subjects, both now and in the past. The objective and subjective history of excess weight was recorded for all three populations, together with eating-related behaviour and the various symptoms suggesting personality disorders, and data on their consumption of toxic substances. CONCLUSIONS: In our sample, 30% of the population obtained scores above the cut-off value in the two scales used, so they could be considered at risk for having food-related dysfunctions and it is necessary to take action at the level of Primary Health Care, as it is in the transition from childhood to adolescence that diets are begun to be followed because of an excessive assessment of weight and it is in this sphere that early action can be taken.

Estudio de hábitos alimentarios en población femenina comparando grupos con patología y sin patología alimentaria / Study of eating habits in female populations comparing groups with and without food-related pathology

Objetivo: Analizar sujetos femeninos del medio rural, para detectar trastornos alimentarios, y factores relacionados con ellos; aislar dichos factores, y prevenir el desarrollo de trastornos alimentarios en atención primaria, así como valorar la continuidad en las alteraciones en población general, subclínica y bulímica. Ámbito y sujetos: Ciento veintisiete mujeres con disfunciones ausentes; 57 subclínicas, y 63 bulímicas; todas del sudoeste español. Intervenciones: Aquellas adolescentes con riesgo de disfunciones presentarían resultados positivos en rasgos de personalidad patológicos; por lo que la captación en atención primaria, evitaría el paso a formas completas, y estaría a favor de la teoría del continuum. Resultados: Para las edades medias, y de inicio de las dificultades alimentarias, se encontraron diferencias significativas entre subclínicas y bulímicas. Los sujetos sin disfunciones alimentarias tienen IMC (índice de masa corporal) más bajos que los subclínicos, y éstos que los bulímicos, tanto ahora como en el pasado. Se recogen antecedentes, objetivos y subjetivos, de sobrepeso en las tres poblaciones, conductas relacionadas con la alimentación y el peso, así como los diferentes síntomas sugerentes de trastornos de personalidad, y datos referentes al consumo de tóxicos. Conclusiones: En nuestra muestra el 30 por ciento de la población puntuaba por encima del punto de corte de las dos escalas utilizadas, por lo que se pueden considerar de riesgo para tener disfunciones alimentarias, y es necesario intervenir desde atención primaria, ya que es en el paso desde la infancia a la adolescencia donde se empiezan a hacer dietas por sobrevaloración del peso, y es en este ámbito donde se puede actuar precozmente (AU)

Goal: To analyze female subjects in the rural setting to detect food-related disorders and factors associated with these. To isolate these factors and prevent the development of food-related disorders in Primary Health Care. Also to assess continuity in the alterations in the general, sub-clinical and bulimic populations. Scope and subjects: 127 women with absence of dysfunctions: 57 sub-clinical and 63 bulimics, all from south-western Spain. Interventions: Those adolescents at risk of dysfunctions would present positive results in pathological personality traits; therefore, their identification in Primary Health Care would avoid the transition to complete forms and would be favour the theory of the continuum. Results: Significant differences were found between sub-clinical and bulimic women for mean age and age of onset of eating-related difficulties. Subjects without eating-related dysfunctions have a lower body mass index (BMI) than sub-clinical ones and the latter have less than bulimic subjects, both now and in the past. The objective and subjective history of excess weight was recorded for all three populations, together with eating- related behaviour and the various symptoms suggesting personality disorders, and data on their consumption of toxic substances. Conclusions: In our sample, 30% of the population obtained scores above the cut-off value in the two scales used, so they could be considered at risk for having food related dysfunctions and it is necessary to take action at the level of Primary Health Care, as it is in the transition from childhood to adolescence that diets are begun to be followed because of an excessive assessment of weight and it is in this sphere that early action can be taken (AU)

Hábitos alimentarios en población adolescente femenina / Diet among teenage girls

No disponible