[Quality control of general diets served in a county hospital]. / Control de calidad de las dietas generales servidas en un hospital comarcal.

INTRODUCTION: The general diet of a hospital, given to patients who do not require therapeutic modifications, must meet their nutritional demands. MATERIAL AND METHODS: During a 42 consecutive days period, the complete menu of a patient was randomly selected. Using a computer program based on the food composition tables, we verified whether or not the foods the patient received, met the requirements of the theoretical menus of the hospital, designed according to the international recommendations. RESULTS: The provided menus supplied 2,410 kilocalories, of which 900 (37.3%) corresponded to carbohydrates, 1,071 (44.4%) corresponded to lipids, and 439 (18.3%) corresponded to proteins. The level of cholesterol was 422 mg, and the fiber content was 20 g. These values differ significantly from the theoretical values noted previously: 2,200 kilocalories, 55% carbohydrates, 30% lipids, 15% proteins, cholesterol less than 300 mg, and 40 g of fiber (p < 0.001). Within the fats, the monounsaturated fats were the most abundant (45%). With regard to vitamins and minerals, vitamin D was the only deficient vitamin when compared to the international recommendations. CONCLUSION: We have detected that our general menus provide an excess of fats and cholesterol, as well as a deficient supply of carbohydrates, fiber, and vitamin D. We believe it necessary to carry out periodic quality controls to correct the defects that arise on translating the theoretical menus into daily practice.

[An evaluation of the SMAST questionnaire for the diagnosis of alcoholism in primary care. The Self-Administered Short Michigan Alcoholism Screening Test]. / Validación del cuestionario SMAST para el diagnóstico del alcoholismo en atención primaria.

OBJECTIVE: To validate a self-administrable version of the SMAST questionnaire for diagnosing alcoholism at the primary care level. DESIGN: A descriptive study of a crossover type. SETTING: An urban health centre. PATIENTS AND OTHER PARTICIPANTS: 497 patients over 15, selected at random from the log-book of daily demand, answered the questionnaire. 46 patients with 2 or more positive replies concerning alcoholism (SMAST positive) were invited to a subsequent appointment, as were 40 with a lower score (SMAST negative). 30 from each group attended. MEASUREMENTS AND MAIN RESULTS: The presence of alcoholism was examined by looking at the compliance with the diagnostic criteria of the DSM-III-R and/or the existence of alcohol consumption equal to or above 30 grams a day in women and 60 in men, in those patients who attended the subsequent appointment. 20 SMAST++ positives and two negatives were diagnosed as alcoholics. There was good correlation between daily alcohol consumption in grams and SMAST scoring (r = 0.60; CI's 95%: 0.41-0.74). SMAST showed 50.48% sensitivity, 96.48% specificity and positive and negative predictive values of 66.67% and 93.33%, respectively. By means of a logistical regression analysis, it was clearly shown that the SMAST questions which best forecast the existence of alcoholism were the first two. CONCLUSIONS: The SMAST questionnaire is a very specific test for diagnosing alcoholism within primary care, although its only moderate sensitivity does not recommend it for screening purposes.