GPs think that obesity is not easy to handle in practice. Most GPs have dietary tools in the office and think that nurses play an important role in advising patients.
Background: Most of the national colleges of general practitioners (GPs) do not have their own dietary/nutritional tools, and GPs and nurses do not have the time, knowledge, or skills to advise their patients about desirable dietary practices. Objective: To assess the usefulness of a simple and practical guide on healthy diet to be used by European GPs and nurses. Design: A postal survey was mailed to 171 GPs and nurses from 12 European countries to obtain information about the usefulness of a guide on healthy diet developed by EUROPREV. Results: The perception of health professionals is that the main source of information on healthy diet for the population was the media. In all, 95% of GPs and nurses reported that the guide was useful; 93, 95, and 82% reported that the concepts were concise, easy to understand, and realistic, respectively. Also, 77% reported that the type of counselling recommended was feasible and could be applied, 94% reported that the implementation measures proposed could be effective and 88% reported that the Traditional Mediterranean Diet Pyramid is useful, but some concerns about the content were mentioned. Conclusions: GPs and nurses from Europe think that a practical guide on healthy diet developed by EUROPREV could be used to advise patients in primary care, although the Traditional Mediterranean Diet Pyramid should be modified.
Significant gaps between GP's knowledge and practices persist in the use of evidence-based recommendations for health promotion and disease prevention in primary care. Spanish GPs carried out more frequently evidence-base recommendations for health promotion and disease prevention by age and sex.
Purpose/Objective(s): We aimed to evaluate the feasibility and toxicity of hypofractionated stereotactic body radiation therapy (SBRT) with volumetric modulated arc therapy (VMAT) and flattening filter-free (FFF) beams in low-or intermediate-risk prostate cancer. In addition, we wished to obtain patient self-reported quality of life (QOL) measures and to compare with a normofractionated external beam radiation therapy (EBRT) patient cohort. Materials/Methods: A prospective phase 1-2 study was approved by our institutional review and ethics board. Inclusion criteria were prostate adenocarcinoma, Gleason Score 6e7, clinical stage T1beT2b, prostatespecific antigen (PSA) 20 ng/mL, prostate volume 60 mL, no previous surgery, no malignant tumors in the previous 5 years and International Prostate Symptom Score of 0e7. Neoadjuvant/concomitant hormonal therapy was prescribed according to risk classification. Image guided RT with cone beam CT (with or without fiducial markers) was mandatory. Urinary catheter was needed to maintain stable bladder volume during treatment. SBRT was delivered at a prescribed planning target volume (PTV) dose of 35 Gy in 5 fractions in 5 alternative days using a medical linear accelerator with VMAT, with 6 MV FFF photons. CTCAE v3.0 morbidity scores were used to assess toxicities. Health-related QOL questionnaires, such as EPIC-26 with 5 components (urinary irritative, urinary incontinence, bowel, sexual, and hormonal) and SF-36 with 2 components (physical and mental), were administered centrally by telephone interview before treatment and during follow-up at 3, 6, and 12 months). Comparison means of QLQ values by T test was done between SBRT and a cohort of 206 EBRT patients. Results: Eleven patients have been recruited to date. Mean age was 71.2 years. Pathology centralized Gleason score was 6 in 6 patients and 7 (3+4) in another 6 patients. Mean PSA was 9 ng/mL (range: 0.03e17 ng/mL). According to D'Amico risk classification, 6/11 patients were low risk and 5/11 were intermediate risk. Mean prostate volume was 38.3 mL. All patients completed the treatment as programmed in 2 weeks with good tolerance. No toxicity greater than grade 2 was observed. Acute rectal and GU toxicities were seen in 4/11 (36.4%) and 3/11 (27.3%) patients, respectively. Both rectal and GU late toxicities G 2 were 1/11 (9.1%). For the EBRT cohort (nZ206) SF-36 PCS values were significantly higher (P<.05) pretreatment at 3 months and at 6 months. SF-36 MCS values were also significantly better for EBRT at the base and at 3 months. EPIC Hormonal values were lower in the SBRT Group at 3 and 12 months. Conclusion: Early findings indicate that SBRT with VMAT and FFF beams for loweintermediate-risk prostate cancer delivered in 5 fractions is feasible and well tolerated in selected patients. Although SF-36 and EPIC hormonal QLQ measures are worse than EBRT cohort, EPIC values related to radiation treatment are not different. Long-term follow-up is needed for assessment of late toxicity and outcomes.Purpose/Objective(s): Men di...
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