Nutrition in medical education in Latin America: Results of a cross-sectional survey.

RATIONALE: The gap between the nutrition education provided to medical students and the nutrition competences and attitudes needed for doctors to provide effective nutrition care is a global concern. The goal of this study was to investigate the curricular content on nutrition education in Latin American medical schools and to evaluate the self-perceived knowledge, attitudes, and barriers to nutrition practice of final-year medical students. METHODS: Eighty-five public and private medical schools from 17 Latin American countries were invited to participate in the study. Two close-ended online questionnaires consisting of 25 and 43 questions were sent to medical school directors. Quantitative variables were expressed as frequencies, percentages, mean ± standard deviation, medians, and ranges. RESULTS: A total of 22 (26%) medical school directors responded, of which 11 schools (50%) offered stand-alone mandatory nutrition courses in preclinical and 8 (36%) in clinical years. The mean hours dedicated to nutrition education was 47 (range: 0-150). A total of 1530 of 1630 (94%) students from 12 countries responded. Students' average age was 25 ± 3 years, and 59% were female. Most students agreed that improving patients' health through nutrition (91%) is important and that nutrition counseling and assessment should be part of routine care provided by all physicians (89%), but they lack the level of education and training required to address nutrition-related issues. CONCLUSIONS: Positive attitude and interest in nutrition among final-year medical students is high, but nutrition education is not perceived as sufficient to adequately prepare doctors in the field of nutrition.

[Efficacy of stool antigen and serologic tests in the diagnosis of Helicobacter pylori in Ecuadorian population]. / Eficacia de las pruebas de antigenos en heces y serológica para el diagnóstico de helicobacter pylori en la población ecuatoriana.

OBJECTIVE: To assess the effectiveness in the Ecuadorian population of 2 non-invasive methods for the detection of the Helicobacter pylori: the stool antigens immunoassay (HpSAg) and the determination IgG serum of'antibodies. MATERIALS AND METHODS: Eighty six dyspeptic patients were evaluated. In each, Helicobacter pylori presence was investigated with three methods: histology, HpSAg and serology. Sensibility and specificity values were obtained, as well as the positive and negative predictive values. RESULTS: The prevalence of Helicobacter pylori with the 3 tests was 89.53%. The sensibility, specificity, positive predictive value, and negative predictive value were: 42.5%, 69.2%, 88.6% and 17.6% with histology; 69.2%, 42.9%, 78.9% and 31% with HpSAg; 64.2%, 47.7%, 81.1% and 27.3% with serology. CONCLUSIONS: In the highly prevalent Ecuadorian setting, HpSAg and serology have relative low sensibility and specificity values. Based on our results, it is necessary to assess for conditions that could alter their results, and strategies to increase the sensibility of these tests, including the histology.

Repair of bile duct injuries with Gore-Tex vascular grafts: experimental study in dogs.

Bile duct injury is the most feared complication related to biliary tract operations. The goal of this investigation was to offer an alternative treatment that might prevent this complication. Twelve mongrel dogs, thin-walled FEP-ringed Gore-Tex vascular grafts, and Gore-Tex sutures were used in this study. The dogs were randomized into three groups of four according to the length of time of graft implantation: group 1 = 1 month; group 2 = 2 months; and group 3 = 3 months. During the first part of the study, a biliary injury was induced by ligating the middle choledocus after performing a conventional cholecystectomy. During the second part of the study, biliodigestive and biliobiliary anastomosis were performed using Gore-Tex vascular grafts prior to resection of the stenotic area. Initially, an increase in serum bilirubin and alkaline phosphatase levels was noted. Two weeks later, after implantation of the grafts, these values returned to normal. Thin-walled FEP-ringed Gore-Tex vascular grafts were found to be useful in the repair of bile duct injuries, especially in complete transections of the common bile duct. The ductility and flexibility of the material allows any type of anastomosis to be performed, especially when bile duct-gut anastomosis is technically difficult.

[Percutaneous endoscopic gastrotomy (GEP): designed reusable (NAGEP) for one time endoscopic technique. Experimental study in dogs]. / Gastrostomía endoscópica percutánea (GEP): dispositivo diseñado reutilizable (NAGEP) en técnica endoscópica de un tiempo. Estudio experimental en perros.

INTRODUCTION: This aim of our experimental study was to demonstrate the versatility of our designed reusable device for PEG and its future application in humans. MATERIALS AND METHODS: 20 mongrel dogs received enteral nutrition by a Foley tube placed by a single endoscopic technique using a reusable stainless steel designed device, three reusable stainless steel designed device, three reusable stainless steel dilators, an Olympus XQ20 video gastrointestinal endoscope, basic surgical equipment and surgical material. RESULTS: The procedure was successfully performed in all dogs under general anaesthesia. The duration of the whole procedure ranged from 10 to 18 min. The complications regardless by the PEG procedure were minimal. The Foley tube was retained by 15 days. CONCLUSIONS: The application of the stainless steel reusable designed device for the PEG is safe, and presents several advantages. This technique for PEG placement could be used in the future due the characteristics of the designed device: durable and reusable for unlimited number of procedures.

Gastrostomía endoscópica percutánea (GEP): dispositivo diseñado reutilizable (NAGEP) en técnica endoscópica de un tiempo. Estudio experimental en perros. / [Percutaneous endoscopic gastrotomy (GEP): designed reusable (NAGEP) for one time endoscopic technique. Experimental study in dogs]

INTRODUCTION: This aim of our experimental study was to demonstrate the versatility of our designed reusable device for PEG and its future application in humans. MATERIALS AND METHODS: 20 mongrel dogs received enteral nutrition by a Foley tube placed by a single endoscopic technique using a reusable stainless steel designed device, three reusable stainless steel designed device, three reusable stainless steel dilators, an Olympus XQ20 video gastrointestinal endoscope, basic surgical equipment and surgical material. RESULTS: The procedure was successfully performed in all dogs under general anaesthesia. The duration of the whole procedure ranged from 10 to 18 min. The complications regardless by the PEG procedure were minimal. The Foley tube was retained by 15 days. CONCLUSIONS: The application of the stainless steel reusable designed device for the PEG is safe, and presents several advantages. This technique for PEG placement could be used in the future due the characteristics of the designed device: durable and reusable for unlimited number of procedures.

Gastrostomía endoscópica percutánea (GEP): Dispositivo diseñado reutilizable (NAGEP) en técnica endoscópica de un tiempo. Estudio experimental en perros / Percutaneous endoscopic gastrostomy (GEP): designed reusable device (NAGEP) for one time endoscopic technique. Experimental study in dogs

INTRODUCTION: This aim of our experimental study was to demonstrate the versatility of our designed reusable decive for PEG and its future application in humans. MATERIALS AND METHODS: 20 mongrel dogs received enteral nutrition by a Foley tube placed by a single endoscopic technique using a reusable stainless steel designed decive, three reusable stainless steel designed decive, three reusable stainless steel dilators, an Olympus XQ20 video gastrointestinal endoscope, basic surgical equipment and surgical material. RESULTS: The procedure was successfully performed in all dogs under general anaesthesia. The duration of the whole procedure ranged from 10 to 18 min. The complications regardless by the PEG procedure were minimal. The Foley tube was retained by 15 days. CONCLUSIONS: The application of the stainless steel reusable designed decive for the PEG is safe, and presents several advantages. This technique for PEG placement could be used in the future due the characteristics of the designed device: durable and reusable for unlimited number of procedures. (Au)

Gastrostomía endoscópica percutánea (GEP): Dispositivo diseñado reutilizable (NAGEP) en técnica endoscópica de un tiempo. Estudio experimental en perros / Percutaneous endoscopic gastrostomy (GEP): designed reusable device (NAGEP) for one time endoscopic technique. Experimental study in dogs

INTRODUCTION: This aim of our experimental study was to demonstrate the versatility of our designed reusable decive for PEG and its future application in humans. MATERIALS AND METHODS: 20 mongrel dogs received enteral nutrition by a Foley tube placed by a single endoscopic technique using a reusable stainless steel designed decive, three reusable stainless steel designed decive, three reusable stainless steel dilators, an Olympus XQ20 video gastrointestinal endoscope, basic surgical equipment and surgical material. RESULTS: The procedure was successfully performed in all dogs under general anaesthesia. The duration of the whole procedure ranged from 10 to 18 min. The complications regardless by the PEG procedure were minimal. The Foley tube was retained by 15 days. CONCLUSIONS: The application of the stainless steel reusable designed decive for the PEG is safe, and presents several advantages. This technique for PEG placement could be used in the future due the characteristics of the designed device: durable and reusable for unlimited number of procedures.