[Efficient prevention of overweight and obesity in the experience of family practitioners and "nutrition units" of the public health system in Lombardy]. / La prevenzione efficace del sovrappeso e dell'obesità sul territorio, esperienza in Lombardia fra u.o. nutrizione del SIAN e medici di famiglia.

General practitioners (GP's) presence is homogeneously distributed in the Lombardy territory. GP's are easy accessible by people so they could play a key role in the prevention of overweight and obesity. In this study GP's included in everyday medical activity a primary prevention strategy regarding nutrition and lifestyle. The goal was to maintain a constant BMI for one and a half year for at least 50% of the patients (stable means without progression within BMI's range). During the same time another endpoint was to decrease from 1 to 3 units the BMI in overweight patients in half of the observed population. Subjects were randomly recruited during routinely ambulatory activity, without a specific BMI based selection. Diet quality was assessed with a food frequency questionnaire regarding "protective foods" as vegetables, fruits and legumes. Some "basic" information about nutrition and lifestyle where then provided through explanation of issues printed on A4 page brochure. Percentage BMI's range variation before and after the intervention show a stability in the observed population, with an increase 0,3% for normal weight males and 0,9% for females. BMI was constant in 72,2% of the subjects considering a 1 unit variation and in 92,2% considering 3 units variation. Within subjects who varied 1 unit (27,7%) more subjects decreased rather than gained weight (16% vs 11,7%); within subjects who varied 3 units (7.8%), 4,5% decreased and 3,3 increased their BMI. GP's demonstrate to have an efficient role in weight gain control with a simple and regular prevention strategy towards healthy lifestyles and simple nutritional tips. It is important for patients to comprehend the importance the doctor give to the overweight and obesity problem, apart from the medical issue considered during the visit. GP's have a key role for healthy life-style change programs among their patients. These results provide new arguments about the opportunity to invest public resources towards population (managed in collaboration with GP's coordinated by a public health department such as NU), rather than towards a single patient. The project management was supervised by the Nutrition Unit (NU) of the public heath system SIAN (ASL di Brescia).

[New techniques in nutritional surveys and food educational programs: volumetric dietetics for portion size assessment]. / Tecniche innovative per la sorveglianza nutrizionale e l'educazione alimentare: la dietetica per volumi.

Data in literature show that body weight in adults and children seems to be related to portion sizes more than to food choices and people are more reluctant to give up favourite foods than to reduce portions. So several scientific societies in USA have recently emphastzied the need to select appropriate portion sizes. At the same time, studies on cognitive strategies show that the best method to help people to remember how much they eat is visualisation/comparison to tridimensional visual aids. So a new technique for evaluating portion sizes, based on comparison of portions to volume of usual objects (baseball, dice, deck of cards) appeared in the last years, in nutritional surveys and food educational projects. Our team, since 1990, appointed a volumetric assessment based on comparison of foods to the fist, palm, fingers of the examined subject; this system has been experienced with success for a long time both in individual dietetics and in food educational projects or surveys. Since the interest for this new technique is rising, the aim of this review is to introduce the method and to delineate the applications in nutritional surveys or educational projects in national and international literature. This method, simple practical and intelligible, seems to be addressed to a wide development in the future.

Bran diet for an earlier resolution of post-operative ileus.

The effect of a pre-operative high fibre diet on the resolution of ileus following cholecystectomy has been evaluated. The time needed to restore canalization of the gastro-intestinal tract has been compared in two random groups of patients (a total of thirty-eight) one treated with wheat bran and the other as control without the diet supplementation. The average persistence of ileus was 24 hours in the treated group and 54 hours in the control group. These results suggest that a bran-enriched diet could be an inexpensive and simple treatment to shorten the duration of ileus after abdominal surgery.

[Althesin in urologic surgery]. / L'althesin in chirurgia urologica.

Results obtained with Althesin as anaesthetic in 100 patient subjected to urological surgery are presented. The continuous perfusion of Althesin gave a level of stable and flexible anaesthesia that, like the return to consciousness, was particularly appreciated by aged patients. Stress is laid on the fact that the harm caused by volatile anaesthetics is avoided.