Résumé
OBJECTIVE: To identify the beliefs and knowledge of a group of rural physicians on the dietary management of children under five years of age, with acute diarrhea. Physicians' dietary management was compared with that recommended by the World Health Organization. MATERIAL AND METHODS: A cognitive anthropology study was carried out from July to December 1998, on ten physicians that care for the infant population ascribed to Hospital Rural IMSS-Solidaridad of San Juanito Bocoyna, Chihuahua, Mexico. Data were collected through focus groups, case vignettes, free listing, pile sorting, and a semi-structured questionnaire, and then cross-referred. RESULTS: The physicians recognized the negative impact of diarrhea on the nutritional state of the child, but not all of them evaluated this state. Prevailing interventions were antibiotic therapy, fluid management, and feeding recommendations. Among the latter, the most consistent were breastfeeding, delayed feeding, and gradual feeding. CONCLUSIONS: The obtained information is in conflict with WHO's recommendations, specially with that of sustained feeding.
Sujets)
Adulte , Enfant d'âge préscolaire , Humains , Nourrisson , Adulte d'âge moyen , Diarrhée , Médecins/psychologie , Allaitement naturel , Études cas-témoins , Savoir , Culture (sociologie) , Diarrhée du nourrisson , Régime alimentaire , Aliment du nourrisson au cours de la première année , Troubles nutritionnels , Prise en charge personnalisée du patient , Déshydratation/prévention et contrôle , Guides de bonnes pratiques cliniques comme sujet , Maladie aigüe , Traitement par apport liquidien , Organisation mondiale de la santéRésumé
Background. The association between gallstone disease (gallstones or cholecystectomy) and plasma lipids was evaluated in 2,089 subject who attended a private health care facility in Mexico city from august 1991 to August 1992. Methods. All participants provided data on their sociodemographic status, non-insulin dependent diabetes mellitus diagnoses, alcohol consumption, and smoking habits; women also gave data regarding their obstetric-gynecologic histories. Ultrasounds of the liver and biliary tract were performed. Cholesterol levels, high-density lipoproteins cholesterol, and triglyceride plasma concentration were determined. Results. This study shows a strong inverse association between gallstone disease and plasma cholesterol concentration, with OR = 0.61 (95 percent CI = 0.42-0.89) in the category of 181-239 mg/dL, and OR = 0.49 (95 percent CI 0.32-0.77) in the group of 240 mg/dL or more, when compared to 180 mg/dL or less, after adjusting for the following risk factors; gender, age, and body mass index. Conclusions. These results suggest an increment in the catabolic pool of cholesterol, reflected in lower levels of plasm cholesterol in subjects with gallstone disease