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PubMed1991

Iron deficiency anemia in the elderly: the diagnostic process.

OBJECTIVE: To determine the effectiveness of physician probability estimates calculated on the basis of findings from history-taking and physical examination in the diagnosis of iron deficiency anemia in elderly patients. DESIGN: Prospective study. SETTING: Two community hospitals offering secondary and tertiary care. PATIENTS: A total of 259 patients over 65 years of age found to have previously undiagnosed anemia. MEASURES: Physician estimates of the likelihood of iron deficiency before (pretest probability) and after (post-test probability) the laboratory test results were available. The hemogram was available to the physicians when they made their pretest probability estimates. Because the serum ferritin level proved to be the most powerful of the laboratory test results studied, the likelihood ratios associated with the post-test estimates were compared with the ratios associated with the serum ferritin level. MAIN RESULTS: The post-test probability estimates were influenced by the serum ferritin level and the pretest estimates. The post-test estimates derived from the findings obtained through history-taking and physical examination and the laboratory test results (including the serum ferritin level) were slightly less accurate in predicting iron deficiency than the serum ferritin level alone. Nevertheless, a model in which the pretest estimates were used in addition to the serum ferritin level to predict iron deficiency proved to be more powerful than the serum ferritin level alone (p = 0.006). This indicated that the limitations of the post-test estimates were due to a misinterpretation of the serum ferritin level and that the findings from history-taking and physical examination added important diagnostic information. CONCLUSIONS: Physicians must be aware of test properties to provide optimal care to their patients. If test results are properly interpreted, pretest probabilities derived from findings obtained through history-taking and physical examination can add useful information that will lead to more accurate diagnoses.

Aged↗
PubMed1991

Program to improve nurses' knowledge of pediatric emergency medications.

The effects of an educational program designed to improve nurses' knowledge of the use of emergency medications in the pediatric intensive-care unit (PICU) are reported. The clinical pharmacist for a six-bed PICU and a clinical nurse educator developed a program to assess and extend PICU nurses' knowledge of emergency medications with respect to calculations of bolus and continuous infusions, pharmacology, and proper dosage and administration route. The program consisted of a pretest, a pharmacology lecture, calculation problems, a hands-on practicum, and a posttest. Drugs covered were atropine sulfate, sodium bicarbonate, calcium gluconate, calcium chloride, dopamine hydrochloride, dobutamine hydrochloride, epinephrine hydrochloride, isoproterenol hydrochloride, lidocaine hydrochloride, sodium nitroprusside, and norepinephrine bitartrate. A retest was given 13 months after the pretest. The program was completed by 21 nurses over seven months. There was a significant difference between the mean pretest score, 69.5%, and the mean posttest score, 87.3%, due to improvements in scores for the calculation questions. There was no significant difference in the mean time required to complete the pretest and the posttest. A significant correlation was observed between pretest score and months spent practicing in the PICU. Time to take the retest was significantly shorter than the posttest time, and scores continued to improve. An educational program developed cooperatively by pharmacy and nursing improved specific measures of PICU nurses' knowledge of emergency drugs.

Chicago↗
PubMedDate not supplied

Effectiveness of medication calculation enhancement methods with nurses.

Medication calculation errors occur in all settings and can cause serious disruption in treatment protocols. This experimental study used a pretest-posttest, control group design. Sixty-seven RNs from three healthcare agencies completed all phases of the study. All nurses completed a 20-item medication calculation test, used both as the pretest and the posttest, and completed a short questionnaire that contained demographic and attitudinal items. After taking the pretest, nurses were assigned randomly to one of three experimental groups or a control group. Intervention times for the experimental groups totaled 3 hours, followed by a posttest 4 to 5 months after the pretest. Scores on the pretest ranged from 25% to 100% (mean = 75.5%, standard deviation = 15.13) and from 30% to 100% on the posttest (mean = 80%, standard deviation = 14.72). Scores improved for all groups except the self-study workbook group. No significant difference was found between the experimental groups or the control group for posttest medication calculation test scores. The classroom intervention was most costly, and the workbook intervention was least costly. The nurses identified the workbook intervention as the most satisfying method and computer-assisted instruction (CAI) as least satisfying. A strong positive correlation existed between the nurses' self-assessment of comfort and skill levels with medication calculation test scores. Questions necessitating multiple calculations and those necessitating a conversion not provided were the most difficult to answer correctly. Staff development educators need to address their role in improving the effectiveness of medication calculation.

Clinical Competence↗
PubMed1998

Economic outcomes of antipsychotic agents in a Medicaid population: traditional agents vs. risperidone.

Clinical trials reveal that the newer atypical antipsychotic agents are more effective and have fewer side effects than traditional agents. However, these newer agents have a higher acquisition cost than traditional agents. This study assessed the differential impact of risperidone and traditional agents on the total schizophrenia-related cost of care for Medicaid patients suffering from schizophrenia. This was a retrospective longitudinal pretest-posttest analysis of Medicaid claims data covering January 1992 to August 1996. Continuously eligible patients (n = 150) with a documented diagnosis of schizophrenia were evaluated. Medical claims were analyzed for patients treated with traditional antipsychotics for at least 12 months and then switched to risperidone and followed for at least 12 months. Patients who failed on at least one traditional agent and who remained on other traditional agents throughout the study timeframe served as a control group. Monthly costs per patient were estimated using mixed model linear regression with age and gender serving as covariates. The total monthly costs per patient for the risperidone and traditional cohorts were similar ($1,050.52 and $946.24, respectively; p = .5438) during the pretest phase of the study. For patients treated with risperidone, drug costs were $177.35 higher (CL0.95 +/- $7.64; p = .0001) per patient per month in the posttest period compared with the pretest period. However inpatient hospital costs were $312.04 lower (CL0.95 +/- $146.76; p = .001) per patient per month in the posttest period compared with the pretest period. In addition, physician costs were $9.55 lower (CL0.95 +/- $5.31; p = .0004) per patient per month in the posttest period. The difference from the pretest to posttest period for outpatient mental health clinic costs was statistically similar. For those in the risperidone cohort, total estimated costs decreased by $204.87 per patient per month during treatment with risperidone (CL0.95 +/- $161.01; p = .0127). Over the same time-frame, total costs increased $160.68 per patient per month (CL0.95 +/- $196.04; n.s.; p = .1082) in the control cohort. While the mean monthly drug cost was significantly higher during treatment with risperidone, this increase was offset by cost reductions elsewhere in the system.

Adult↗
PubMed2000

An evaluation of a safety education program for kindergarten and elementary school children.

OBJECTIVE: To determine the effectiveness of a safety education program, Safety City, that is designed to teach kindergarten and first grade children how to cross the street, call 911 in an emergency, and avoid strangers. PARTICIPANTS/SETTING: Kindergarten students at 10 urban elementary schools. DESIGN: Each school was randomized to either the intervention or control group. An evaluation tool was administered to all participants as a pretest. The Safety City program was then presented to the intervention schools. Afterward, the same evaluation tool was used as a post-test. The posttest was administered to the intervention group 6 months after the Safety City program was presented. The control group took the posttest 6 months after the pretest. MAIN OUTCOME MEASURE: Change in individual test scores. RESULTS: One hundred eighty-one children completed the pretest and posttest evaluations. There was no statistical difference in the change between pretest and posttest scores of children who participated in the Safety City program and those in the control group (crossing the street, P = .29; calling 911, P = .41; stranger avoidance, P = .57). CONCLUSIONS: Exposure to the Safety City program did not achieve the desired changes in safety knowledge among participants. This is most likely owing to the fact that Safety City attempts to convey a large amount of relatively complex information to young children in a brief period. We conclude that programs such as Safety City are not sufficient to teach children these behaviors. This report also emphasizes the importance of building an evaluation component into educational programs.

Child↗
PubMed1996

Effects of feeding on conditioned avoidance responses in rats.

Possible effects of feeding on learning were studied by comparing learned avoidance rates among three groups of Wistar rats that were given a diet at 1 h (1-h pretest group) and 5 h (5-h pretest group) before and immediately after (post-test group) the conditioned avoidance test. Learned avoidance rates during eight test sessions were higher in the order of the 1-h pretest, post-test, and 5-h pretest groups. This suggests that both pre- and post-test (training) feeding facilitates acquisition of conditioned avoidance learning presumably based on neurohumoral processes influenced by available glucose concentrations.

Animals↗
PubMed1998

The heart rate-corrected QT interval of conscious beagle dogs: a formula based on analysis of covariance.

Three frequently used and cited formulas used to rate correct the QT interval (Bazett's, Fridericia's, and Van de Water's) were compared and ranked using a large population-based cohort of beagle dogs (99 males and 99 females). In addition, analysis of covariance was used to derive a flexible method to rate correct the QT.interval for heart rate. The method is flexible in that it utilizes pretest or control data to determine the degree of correction. In addition, it can also be used to evaluate whether treatment alters the association between heart rate and QT. Specifically, pretest QT (unadjusted) and heart rate data were used to estimate coefficients in the linear regression log(QT) = alpha + beta log(HR). The estimated slope (beta) from the pretest data was used to heart rate correct the QT interval in the formula log(QT)ca = log(QT) - beta *[log(HR - log(HRm)]. The term "log(HRm)" is included to standardize QTca to a reference value, either a fixed value or an average heart rate for the data set being analyzed. These formulas were retrospectively compared under a typical toxicity study paradigm with a class III antiarrhythmic agent (L-768,673) that selectively prolongs the QT interval by blocking the slow activating component of the delayed rectifying potassium channel (lks). Based on their ability to dissociate the effects of heart rate on the QT interval, the formulas received the following ranking: Covariate Adjustment (preferred) = Van De Water's > Fridericia's > Bazett's (not recommended). Analysis of covariance based on pretest or control data is preferred for moderate to large studies where there are adequate data for estimation of the slope parameter beta, the investigator does not have sufficient control over HR, or treatment alters the association between HR and the QT interval. Conversely, for smaller studies a fixed rate adjustment formula from the literature (such as Van de Water's or Fridericia's equations) may be preferable since the bias from using a fixed formula is likely to be smaller than the variance resulting from estimating beta from a small sample.

Acetamides↗
PubMed1996

Racial and gender effects on the relaxation response: implications for the development of hypertension.

This study was designed to explore the effect of race and gender on the forehead muscle tension and finger temperature response to biofeedback-assisted relaxation training in individuals with normal blood pressure. Forty-five subjects-18 Black and 27 White, 25 males and 20 females-participated in eight sessions of autogenic relaxation training and thermal biofeedback. Multivariate analysis of variance of the variables measured at baseline (systolic BP diastolic BP sodium excretion, anxiety) was significant for gender Univariate analysis showed males different from females in DBP Na(+) excretion, and trait anxiety. Pretest values of muscle tension were similar by gender, but pretest temperatures were lower in males than females. Repeated measures ANOVA for muscle tension showed a significant effect of period. For temperature a significant effect of period, gender and gender x period was observed. Males increased temperature more than females. There was no effect of history of hypertension on the relaxation response. Multiple regression performed on change in muscle tension and change in temperature showed that pretest muscle tension predicted change in muscle tension. Four variables contributed to the variance in change in temperature: pretest temperature, sodium excretion, and state and trait anxiety.

Adult↗
PubMed1996

How well can the chest radiograph diagnose left ventricular dysfunction?

OBJECTIVES: To review the diagnostic utility of the chest radiograph for left ventricular dysfunction. DATA SOURCES: Structured MEDLINE searches, citation reviews of relevant primary research, review articles, and textbooks, personal files, and data from experts. STUDY SELECTION: Studies of patients without valvular disease that allowed calculation of the sensitivity and specificity of selected radiographic signs compared with a criterion standard of increased left ventricular preload or reduced ejection fraction. DATA EXTRACTION: Two independent readers reviewed 29 studies. Studies were pooled after stratification by radiographic finding, criterion standard, and clinical setting. MAIN RESULTS: Redistribution best diagnosed increased preload with a sensitivity of 65% (95% confidence interval [CI] 55%, 75%) and specificity 67% (95% CI 53%, 79%). Cardiomegaly best diagnosed decreased ejection fraction with a sensitivity of of 51% (95% CI 43%, 60%) and specificity of 79% (95% CI 71%, 85%). Interrater reliability was fair to moderate for redistribution and moderate for cardiomegaly. The clinical setting affected results by decreasing the specificity of cardiomegaly to 8% in detecting increased preload in patients with severe systolic dysfunction. The absence of redistribution could only exclude increased preload in situations in which the suspicion (pretest probability) of disease was less than 9%, whereas redistribution could confirm increased preload when the pretest probability was greater than 91%. The absence of cardiomegaly could only exclude a reduced ejection fraction if the pretest probability was less than 8%, whereas cardiomegaly could confirm a reduced ejection fraction if the pretest probability was greater than 87%. CONCLUSIONS: Redistribution and cardiomegaly are the best chest radiographic findings for diagnosing increased preload and reduced ejection fraction, respectively. Unfortunately, neither finding alone can adequately exclude or confirm left ventricular dysfunction in usual clinical settings. Redistribution is not always reliably interpreted.

Confidence Intervals↗
PubMed2006

Inhibition of neuronal nitric oxide synthase in the rat hippocampus induces antidepressant-like effects.

RATIONALE: Systemic inhibition of neuronal nitric oxide synthase (nNOS) induces antidepressant-like effects in rodents. The mechanisms and brain regions mediating this effect are still unknown. The hippocampus is a brain region proposed to mediate adaptation to stress and antidepressant behavioral effects. Therefore, it could be involved in the antidepressant effects of NOS inhibitors. OBJECTIVES: To test the hypothesis that nNOS inhibition in the dorsal hippocampus will induce antidepressant-like effects in the forced swimming test (FST) in rats. METHODS: Rats implanted with cannulas aimed at the dorsal hippocampus were submitted to 15 min of forced swimming (pretest). Immediately before or after pretest they received bilateral microinjections of the nNOS inhibitor 7-nitroindazole (7-NI; 50, 100, or 200 nmol/0.5 microl) or vehicle, alone or combined with L-arginine. Additional groups received SIN-1 (125 or 250 nmol/0.5 microl), a NO donor, either before or after the pretest. Twenty-four hours later, immobility time was registered for 5 min in the FST. RESULTS: 7-NI (100 nmol) significantly decreased immobility time when administered either before or after pretest. Pretreatment with L-arginine (100 nmol/0.5 microl) prevented these effects but produced no significant effects per se. SIN-1 did not induce any significant effect. CONCLUSION: These data suggest that the reduction of NO levels within the hippocampus can induce antidepressant-like effects; thus implicating endogenous hippocampal NO in the neurobiology of stress and depression.

Animals↗
PubMed1985

Exercise testing in suspected coronary artery disease.

The interpretation and selection of exercise tests depends on the pretest probability of CAD. Imperfect tests (like exercise tests) provide probability estimates, not definite statements (such as "the patient has CAD" or "the patient does not have CAD"). In patients with a low pretest probability of CAD (asymptomatic persons or men and women with nonanginal chest pain), abnormal exercise test results provide probability estimates that are much too low to conclude that the patient has CAD. In patients with anginal pain and normal exercise tests, the probability of CAD is too high to conclude that the patient has a normal coronary circulation. Exercise tests are not useful for trying to rule out CAD in patients with anginal pain. In patients with an intermediate pretest probability of CAD (men and women with atypical angina and women with typical angina), abnormal exercise tests (particularly the myocardial scintiscan) provide probability estimates that are high enough to justify starting treatment for CAD. Exercise tests are most useful in this group, a conclusion that has been reached by other methods of analysis. The myocardial scintiscan is much more useful than the exercise ECG in women. When CAD is strongly suspected, exercise tests have relatively little diagnostic value but may be useful for prognosis. However, clinical evidence of poor ventricular function may alone suffice to select patients with angina pectoris for coronary arteriography. Conversely, when clinical indicators of congestive heart failure are absent, the prognosis in chronic stable angina is so favorable that any further testing may be unnecessary. Screening asymptomatic persons for CAD is a very low yield practice. Patients who have no cardiac risk factors (hypercholesterolemia, family history of CAD, cigarette smoking, and hypertension) are at especially low risk of a primary cardiac event. Older men with stable typical angina are particularly likely to have left main coronary artery stenosis or three-vessel disease with poor ventricular function. The exercise ECG can identify groups of older men with a relatively high risk of having left main coronary artery stenosis. Physicians should be cautious when applying these recommendations to a primary care practice. The foregoing analysis is based on data obtained from patients who had been selected for coronary arteriography. There are two principal effects of biased selection of study patients: The pretest probability of CAD in clinical subgroups is probably lower than as shown here.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1992

Antidepressant and anxiolytic effects of alprazolam versus the conventional antidepressant desipramine and the anxiolytic diazepam in the forced swim test in rats.

The antidepressant and anxiolytic effects of alprazolam were compared to those of desipramine, diazepam and buspirone in the forced swim test. Subchronic alprazolam induced a reduction in immobility similar to that of desipramine in 'non-pretested' and 'pretested' rats. In 'non-pretested' rats, the anti-immobility effect of desipramine was potentiated by diazepam and alprazolam, given before subchronic desipramine, while the anti-immobility effect of subchronic alprazolam was counteracted by diazepam. Diazepam, administered before the pretest session, counteracted, 24 h later, the anti-immobility effect of subchronic desipramine and alprazolam; alprazolam counteracted the anti-immobility effect of alprazolam but not of desipramine, buspirone at the highest doses tested potentiated the anti-immobility effect of subchronic desipramine but not of alprazolam. These data provide further support for the hypothesis that the GABA/benzodiazepine/Cl complex is directly implicated in the action of antidepressants and that systems other than the GABA system are involved in the antidepressant and anxiolytic effects of alprazolam.

Alprazolam↗
PubMed1991

Reversal of retrieval impairment caused by retroactive interference on a two-way active avoidance task in rats.

Rats were exposed to an open field with flashing light (OFL; 60-W lamp, 30 Hz, for 7 min) 2 h after training and/or 2 h before testing in a two-way active avoidance task (30 trials, 0.5-mA footshock). Post-training OFL presentation caused retroactive interference, i.e., a retrieval impairment/amnesia for the avoidance task. Pretest OFL exposure reversed the post-training OFL-induced retrieval deficit. Diazepam (2.0 mg/kg), atropine (2.0 mg/kg), and methylatropine (0.1 mg/kg) administered before post-training OFL presentation blocked the OFL amnesic effect. However, these drugs did not counteract the pretest OFL-induced recovery of retrieval. Atropine and methylatropine administered 2 h before testing to rats receiving only post-training OFL presentation canceled the OFL-interfering effect. These results suggest: (1) that the amnesic effect of post-training OFL is due to failure of retrieval of the avoidance task, (2) that the reversal of this retrieval impairment by pretest OFL exposure may involve either priming or state-dependent mechanisms, and (3) that there are different modulatory mechanisms involved in post-training and pretest OFL effects.

Animals↗
PubMed1988

Increasing patients' knowledge of radiation therapy.

Scripts for a set of patient education programs were developed by a multidisciplinary team of health care professionals to provide information to cancer patients receiving a 4-7 week course of external beam radiation therapy. The programs were designed to be presented sequentially at three critical points during a course of treatment: Pretreatment, Treatment Week 2, and Final Treatment Week. A total of 72 patients, 24 per program, with cancers of the lung, breast, or prostate, were assessed for their level of knowledge after hearing the audiotape appropriate to their treatment phase (posttest). Half of the patients, on a random basis, were also assessed prior to hearing their tape (pretest). This split design allowed the differentiation of true learning effects from effects of multiple assessments. Knowledge test items were developed from learning objectives for each program. Posttest results indicate a very high level of patient learning for all three programs, significantly exceeding the target of 75% correct. For patients tested twice, posttest scores were significantly higher than pretest scores. No testing effects were found for the Pretreatment and Treatment Week 2 programs. Final Treatment Week subjects who were pretested scored slightly higher on the posttest than their controls who were not pretested; however, additional analysis demonstrated true learning effects for this group as well. The results indicate that the programs are effective for increasing patients' knowledge regarding their treatment program, its side effects, and strategies to manage those side effects. Further research and intervention programs are discussed.

Audiovisual Aids↗
PubMed2005

Implementation and evaluation of a genetics curriculum to improve obstetrician-gynecologist residents' knowledge and skills in genetic diagnosis and counseling.

OBJECTIVE: This study was undertaken to develop, implement, and evaluate a genetics curriculum for obstetrician-gynecologist residents. STUDY DESIGN: We prospectively evaluated the effect of a genetics curriculum on obstetrician-gynecologist residents' knowledge and skills. Residents completed a needs assessment and pretest. Educational intervention included 2 3-hour didactic sessions with 1 hour of lecture followed by case discussion and 1 3-hour session of experiential learning using standardized patients who evaluated residents' knowledge and skills in taking family history, drawing genetic pedigrees, and counseling patients. Posttest scores were compared with pretest scores. RESULTS: Needs assessment was completed by all 40 obstetrics and gynecology residents and identified limited and variable genetics education in medical school. Twenty-eight of 40 residents attended the entire educational intervention and completed the pretest and posttest, and 25 of 28 showed improved test scores. Residents stated that they were more confident in their ability to take a family history, record a 3-generation pedigree, and counsel patients about genetic conditions after completion of the genetics curriculum. CONCLUSION: This multifaceted genetics curriculum improved residents' knowledge of genetics as well as their confidence in applying genetic concepts as assessed by the pretest and posttest and by their comments in the debrief session.

Clinical Competence↗
PubMed2005

Trauma evaluation and management: who benefits among medical students?

BACKGROUND: This study examines whether or not the ACS ATLS Subcommittee's Trauma Evaluation and Management (TEAM) course is more appropriate for third (Y3) or fourth year (Y4) medical students. MATERIALS AND METHODS: Y3 and Y4 students were divided into control (CTL: 41 Y3, 17 Y4) and experimental (EXP: 39 Y3, 17 Y4) groups. The EXP groups had a 20-item, multiple-choice question exam before, and a similar exam after TEAM. The control CTL group took both exams prior to TEAM. Repeated measures analysis of variance was used for statistical comparison with group and year as between subject factors and with P < 0.05 being considered statistically significant. RESULTS: For the Y4 CTL, pretest was 58.8 +/- 10.5% and posttest was 54.4 +/- 11.2%. For the Y3 CTL, pretest was 53.0 +/- 11.8% and posttest was 47.6% +/- 11.4%. For the Y4 EXP, pretest was 59.4% +/- 11.5% and posttest was 69.1 +/- 8.3%. For the Y3 EXP, pretest was 49.2 +/- 11.4% and posttest was 55.0 +/- 10.9%. The difference between experimental and control groups was statistically significant (P = 0.042). The scores for Y4 were higher than Y3 in all groups (P < 0.001). The distribution of scores of Y4 control was nearly identical to Y3 experimental, suggesting that the improvement with TEAM in Y3 was equivalent to the improvement following the traditional curriculum in Y4 without TEAM. CONCLUSIONS: Y3 and Y4 students improved their performance following TEAM, but Y4 students had greater improvement. Y4 students without TEAM achieved scores similar to or greater than students who completed TEAM in Y3. TEAM appears to be more effectively directed to Y4 medical students.

Analysis of Variance↗
PubMed2004

Dominance status predicts response to nonsocial forced movement stress in the green anole lizard (Anolis carolinensis).

We used changes in body color and eyespot formation, two somatic indices of stress controlled mainly by catecholamine activity, to compare the reactions of dominant and subordinate male green anole lizards (Anolis carolinensis) to a nonsocial stressor, forced movement. Individual males were pretested by subjecting them to 10 min of forced movement induced by chasing them around their home cage with a slender wooden stick. Stress responses were assayed via changes in body color (progressive darkening from green to brown indicating increasing stress) and expression of a black postorbital eyespot (which appears with increasing catecholaminergic stress responses). Lizards were paired and allowed to form stable dominant/subordinate relationships for 2 weeks. After that period of stable social status, dominants and subordinates were separated and subjected to the same forced-movement stress. There was no difference between experimental groups in the pretest. After assuming positions in the dominance hierarchy, however, dominant males showed reduced somatic indicators of stress and were quicker to recover from the stress. The data suggest that animals that assumed the dominant position decreased their stress response relative to the pretest, while animals that assumed the subordinate position increased their stress response relative to the pretest. The results indicate that dominant social status may have advantages beyond the realm of social interactions by enhancing an individual's ability to tolerate other, nonsocial stressful events.

Adaptation, Psychological↗
PubMed2004

Effectiveness of diet in hyperlipidemia in renal transplant patients.

In renal transplant patients dietary therapy alone does not always provide satisfactory results to control hyperlipidemia. To assess the effectiveness of diet, 151 renal transplant patients were selected for a prospective clinical study using pre- and posttest groups. During 8 weeks these patients received a diet with 25% energy intake from lipids, less than 10% from saturated fats, and less than 500 mg of cholesterol per day. Total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides were measured (pre- versus postdiet). The degree of compliance with the diet was measured by a 24-hour food recall record. Patients who had 90% compatibility between the questionnaire and the prescribed diet were considered compliant. The diet was considered effective in the patients who achieved a reduction of cholesterolemia to less than 200 mg/dL after 8 weeks of treatment. Ultimately 108 patients completed the study, with a significant reduction in total serum cholesterol from 262.37 mg/dL pretest to 252.85 mg/dL posttest (P =.010); LDL cholesterol from 174.29 mg/dL pretest to 166.60 mg/dL posttest (P =.036), of body weight from 68.98 kg pretest to 67.78 kg posttest (P =.01) and of body mass index from 25.86 kg/m(2) pretest to 25.41 kg/m(2) posttest (P =.01). Cholesterol variation was 3.63% as compared to prediet levels. Only 22 patients (20.4%) achieved cholesterol levels below 200 mg/dL. In conclusion, although diets decrease cholesterolemia, they alone are not effective to control hyperlipidemia in most renal transplant patients.

Adult↗