Nutritional Management and Outcomes in Malnourished Medical Inpatients: Anorexia Nervosa

BACKGROUND: Anorexia Nervosa (AN) is a psychiatric disorder characterised by a physical and psychosocial deterioration due to an altered pattern on the intake and weight control. The severity of the disease is based on the degree of malnutrition. The objective of this article is to review the scientific evidence of the refeeding process of malnourished inpatients with AN; focusing on the clinical outcome. METHODS: We conducted an extensive search in Medline and Cochrane; on April 22; 2019; using different search terms. After screening all abstracts; we identified 19 papers that corresponded to our inclusion criteria. RESULTS: The article focuses on evidence on the characteristics of malnutrition and changes in body composition; energy and protein requirements; nutritional treatment; physical activity programmes; models of organisation of the nutritional treatment and nutritional support related outcomes in AN patients. CONCLUSION: Evidence-based standards for clinical practice with clear outcomes are needed to improve the management of these patients and standardise the healthcare process

Environmental profile of green roof material in different locations in Spain: Life Cycle Assessment and optimization

The building construction industry consumes 40% of the materials entering the global economy and generates 40–50% of the global output of greenhouse gases and agents of acid rain. Thus, energy building consumption minimization became one of the basic principles of the European Environmental Legislation and Strategy. [1] Considering this, the benefits provided by green roofs appear to make them a good option. They reduce thermal fluctuation on the outer roof surface and increase thermal capacity; help to mitigate air pollution; reduce urban heat island effect and noise propagation; reduce runoff peaks of rainfall events; and increase biodiversity. [2-5] The use of green roofs has increased noticeably in recent years in many countries, but relevant up-to-date environmental data is needed to allow the environmental comparison of green roofs with conventional solutions. This will help us to assess their behaviour and analyse if, just because they have vegetation, we can call them “ecological roofs”. There are examples of Life Cycle Assessment (LCA) studies of some construction materials, however no comprehensive Life Cycle Inventory (LCI) data for green roofs is available in the literature. The scope of the study is to deepen the knowledge of green roofs by studying the environmental profile of the materials used to build them, and how their adaptation to climatic conditions affects their environmental impact. To do so, LCA methodology has been used to study the environmental profile of the materials

First Report of Cucurbit chlorotic yellows virus Infecting Cucumber and Zucchini in Algeria

This work was supported by the Spanish Ministerio de Ciencia, Innovacion y Universidades, cofunded with FEDER funds (project nos. AGL2017-85563-C2-1-R and RTA2017-00061-0O3-03 [INIA]) and the programa para grupos de investigacion de excelencia from the Conselleria d'Educacio, Investigacio, Cultura i Esport, (Generalitat Valenciana) (Prometeo Program 2017/078). A. Kheireddine thanks the Erasmus+ Programme of the European Union for her mobility project (KA107 2018-20). C. Saez is a recipient of a predoctoral fellowship from Generalitat Valenciana, cofunded by the Operational Program of the European Social Fund (FSECV 2014-2020) (grant no. ACIF/2016/188). Plant Dis. 104: 1264, 2020; published online as https://doi.org/10.1094/PDIS-10-19-2091PDN.Accepted for publication 19 December 2019.Kheireddine, A.; Sáez-Sánchez, C.; Sifres Cuerda, AG.; Picó Sirvent, MB.; López Del Rincón, C. (2020). First Report of Cucurbit chlorotic yellows virus Infecting Cucumber and Zucchini in Algeria. Plant Disease. 104(4):1264-1264. https://doi.org/10.1094/PDIS-10-19-2091-PDNS12641264104

Development and validation of a specific questionnaire to assess health-related quality of life in patients with home enteral nutrition: NutriQoL® development

Introduction: Home enteral nutrition (HEN) is indicated in patients with a functional gastrointestinal tract but who are unable to meet their nutritional requirements with normally consumed foodstuffs. HEN allows patients to remain in their social and family environment, thus reducing complications and costs associated with hospital admission, while increasing health-related quality of life (HRQoL). HRQoL in patients with HEN is mainly evaluated by generic instruments, which are not sensitive enough to identify certain specific patient-related outcomes of HEN. Objective: To develop a specific instrument to measure HRQoL in patients receiving HEN whose results allow interpretation regardless of the underlying disease and nutritional support administration route: the NutriQoL® questionnaire. Materials and methods: The development of the NutriQoL entailed a literature review, focus groups with experts, semistructured interviews with patients, an assessment of face validity and feasibility, and Rasch analysis conducted on data from a sample of 141 patients and 24 caregivers. Results: Of the 52 items initially proposed on the basis of the literature review, expert focus group, and semi-structured interviews with patients and caregivers, 17 items were finally selected through the development process to make up the final version of the NutriQoL, as well as a visual analog scale for global HRQoL scoring. The selected items were evaluated as adequate for frequency, importance, and clarity. Furthermore, they have been shown to be independent of the underlying condition and HEN administration route. Conclusion: A new instrument for measuring the HRQoL of patients with HEN in Spain has been developed, whose results are independent of the underlying condition and administration route. The next step will be the validation of the questionnaire to ensure that the instrument is valid, reliable, and sensitive to health status changes in patients, to be used periodically in usual clinical practice.The abstract of this paper was presented at the International Society for Pharmacoeconomics and Outcomes Research 17th Annual European Congress (Amsterdam, the Netherlands) on November 2014 as a poster with interim findings. The poster’s abstract was published in “Value in Health” Vol 17, Issue 7, A518 (http://www.valueinhealthjournal.com/article/S1098-3015(14)03541-4/pdf) and A575 (http://www.sciencedirect.com/science/article/pii/S1098301514038650). Nestlé Health Science sponsored the stud

Development and validation of a specific questionnaire to assess health-related quality of life in patients with home enteral nutrition: NutriQoL® development

Introduction: Home enteral nutrition (HEN) is indicated in patients with a functional gastrointestinal tract but who are unable to meet their nutritional requirements with normally consumed foodstuffs. HEN allows patients to remain in their social and family environment, thus reducing complications and costs associated with hospital admission, while increasing health-related quality of life (HRQoL). HRQoL in patients with HEN is mainly evaluated by generic instruments, which are not sensitive enough to identify certain specific patient-related outcomes of HEN. Objective: To develop a specific instrument to measure HRQoL in patients receiving HEN whose results allow interpretation regardless of the underlying disease and nutritional support administration route: the NutriQoL (R) questionnaire. Materials and methods: The development of the NutriQoL entailed a literature review, focus groups with experts, semistructured interviews with patients, an assessment of face validity and feasibility, and Rasch analysis conducted on data from a sample of 141 patients and 24 caregivers. Results: Of the 52 items initially proposed on the basis of the literature review, expert focus group, and semi-structured interviews with patients and caregivers, 17 items were finally selected through the development process to make up the final version of the NutriQoL, as well as a visual analog scale for global HRQoL scoring. The selected items were evaluated as adequate for frequency, importance, and clarity. Furthermore, they have been shown to be independent of the underlying condition and HEN administration route. Conclusion: A new instrument for measuring the HRQoL of patients with HEN in Spain has been developed, whose results are independent of the underlying condition and administration route. The next step will be the validation of the questionnaire to ensure that the instrument is valid, reliable, and sensitive to health status changes in patients, to be used periodically in usual clinical practice

First Report of Tomato leaf curl New Delhi virus infecting Zucchini in Morocco

This work was supported by Projects E_RTA2013-00020-C04-03, and RTA2017-00061-C03-03 from the Spanish Instituto Nacional de Investigaciones Agrarias (INIA) cofunded with FEDER funds and the Prometeo Program 2017/078 from the Generalitat Valenciana. C. Sáez is a recipient of a predoctoral fellowship (ACIF/2016/188) from Generalitat Valenciana.Sifres Cuerda, AG.; Sáez-Sánchez, C.; Ferriol Molina, M.; Selmani, E.; Riado, J.; Picó Sirvent, MB.; López Del Rincón, C. (2018). First Report of Tomato leaf curl New Delhi virus infecting Zucchini in Morocco. Plant Disease. 102(5):1045-1045. https://doi.org/10.1094/PDIS-10-17-1600-PDNS10451045102

Prevalencia de desnutrición en sujetos mayores de 65 años en la Comunidad de Madrid: Estudio DREAM + 65

Introduction: Disease-related malnutrition (DRM) is a frequent community healthcare problem that predominantly affects adults over 65 years of age and increases morbidity and mortality rates, while also decreasing quality of life. Objective: To study the prevalence of DRM in adults over 65 in different community healthcare centres belonging to the Regional Social Welfare Service of the Community of Madrid. Methods: We conducted a cross-sectional study in 33 community healthcare centres in Madrid (6 primary healthcare centres (PC), 9 care centres for the elderly (CE), 9 hospitals (H) and 9 nursing homes (NH)) selected by means of multistage sampling. The variables studied were age, sex, level of dependence according to the Red Cross disability scale, reason for admission and underlying disease, habitat (urban-periurban-rural) and geographical distribution (north-centre-south). The Mini Nutritional Assessment (MNA-screening) was employed as a nutritional screening tool in all the centres. In the case of patients with positive screening (at risk-malnutrition), the MNA-assessment was carried out. Statistical analysis was conducted with the SPSS 21.0 package and included descriptive statistics, Chi-square test and Fisher’s exact test, one-way ANOVA, Kruskal-Wallis test and univariate and multivariate binary logistic regression analysis (LR). Statistical significance was considered to be p < 0.05. Results: A total of 1,103 subjects were recruited (275 PC, 278 CE, 281 H, 269 NH), mean age 79.5 ± 8.4 years (41.2% were males and 58.8% females). The subjects from H and NH had a higher degree of disability (p < 0.001). The overall prevalence of DRM was 10%, 23.3% being at risk of malnutrition, with differences among the 4 types of community healthcare centres (p < 0.001). The univariate LR analysis showed significant differences in the prevalence of malnutrition according to age, sex, degree of dependence, type of community healthcare centre, habitat and geographical zone. Nevertheless, in the multivariate analysis, only the degree of dependence, the type of centre and habitat were statistically significant. Conclusions: The prevalence of DRM in adults over 65 years of age in the Community of Madrid amounts to 10%, with another 23.3% at risk of malnutrition. The variables that were independently related with malnutrition in the multivariate analysis were only the patients’ level of dependence and the type and setting of the community healthcare centreIntroducción: la desnutrición relacionada con la enfermedad (DRE) es un problema sociosanitario frecuente que afecta preferentemente a los mayores de 65 años, que aumenta la morbimortalidad y disminuye la calidad de vida. Objetivo: estudiar la prevalencia de DRE en mayores de 65 años en diferentes centros sociosanitarios del Servicio Regional de Bienestar Social de la Comunidad de Madrid. Métodos: estudio transversal en 33 centros sociosanitarios de Madrid (6 centros de atención primaria [AP], 9 centros de mayores [CM], 9 hospitales [H] y 9 residencias [R]) seleccionados mediante muestreo polietápico. Las variables estudiadas fueron edad, sexo, nivel de dependencia según la escala de incapacidad de la Cruz Roja, motivo de ingreso y enfermedad de base, hábitat (urbano-periurbano-rural) y distribución geográfica (norte-centro-sur). Como herramienta de cribado nutricional se utilizó el Mini Nutritional Assessment (MNA-cribaje) en todos los centros. En los pacientes con cribado positivo (en riesgo-desnutrición) se realizó el MNA-evaluación. El estudio estadístico se realizó con el paquete SSS 21.0 e incluyó estadística descriptiva, test de Chi-cuadrado y prueba exacta de Fisher, ANOVA de un factor, Kruskal-Wallis y análisis de regresión logística (RL) binaria univariante y multivariante. Se consideró significación estadística p < 0,05. Resultados: se reclutaron 1.103 sujetos (275 AP, 278 CM, 281 H, 269 R), edad media de 79,5 ± 8,4 años (41,2% varones, 58,8% mujeres). Los sujetos procedentes de H y R tuvieron un mayor grado de incapacidad (p < 0,001). La prevalencia global de DRE fue del 10%, encontrándose un 23,3% en riesgo de desnutrición, con diferencias entre los cuatro tipos de centros sociosanitarios (p < 0,001). El análisis univariante de RL mostró diferencias significativas en la prevalencia de desnutrición según la edad, sexo, grado de dependencia, tipo de centro sociosanitario, hábitat y zona geográfica. Sin embargo, en el análisis multivariante solo el grado de dependencia, el tipo de centro y el hábitat tuvieron significación estadística. Conclusiones: la prevalencia de DRE en mayores de 65 años en la Comunidad de Madrid es del 10%, encontrándose además un 23,3% en riesgo de desnutrición. Las únicas variables que se relacionaron de forma independiente con la desnutrición en el análisis multivariante fueron el nivel de dependencia de los pacientes y el tipo y hábitat de centro sociosanitari

Vitamin b1 intake in multiple sclerosis patients and its impact on depression presence: a pilot study

Vitamin B1, or thiamine, is one of the most relevant vitamins in obtaining energy for the nervous system. Thiamine deficiency or lack of activity causes neurological manifestations, especially symptoms of depression, intrinsic to multiple sclerosis (MS) and related to its pathogenesis. On this basis, the aim of this study was to determine the possible relationship between the nutritional habits of patients with MS and the presence of depression. Therefore, a cross-sectional and observational descriptive study was conducted. An analysis of dietary habits and vitamin B1 consumption in a Spanish population of 51 MS patients was performed by recording the frequency of food consumption. Results showed a vitamin B1 intake within the established range, mainly provided by the consumption of ultra-processed products such as cold meats or pastries, and a total carbohydrate consumption lower than recommended, which stands out for its high content of simple carbohydrates deriving from processed foods such as dairy desserts, juice, snacks, pastries, chocolate bars, soft drinks and fermented alcohol. In addition, a significant negative correlation between depression and the intake of thiamine and total carbohydrates was observed. These findings could explain the influence of MS patients’ eating habits, and consequently vitamin B1 activity, on depression levels.This research was funded by the Catholic University Foundation San Vicente Mártir, for the research project “The Impact of Triglycerides on Multiple Sclerosis” (promotion code 2018-203-001)Nutrición humana y dietétic

The NADYA-SENPE Home Enteral Nutrition registry in Spain: years 2018 and 2019

Objetivo: exponer los resultados del registro de nutrición enteral domiciliaria (NED) de los años 2018 y 2019 del Grupo NADYA-SENPE. Material y métodos: se recopilaron los pacientes introducidos en el registro desde el 1 de enero al 31 de diciembre de 2018 y en las mismas fechas para 2019, procediendo al análisis descriptivo y analítico de los datos. Resultados: en el año 2018 se registraron 4756 pacientes activos con una tasa de prevalencia de 101,79 pacientes/millón de habitantes; en 2019 fueron 4633 con una tasa de prevalencia de 98,51 pacientes/millón de habitantes. Procedían de 46 hospitales. Fueron el 51,3 % los varones registrados y la edad mediana fue de 71,0 años en ambos periodos. El diagnóstico más frecuente fue el de enfermedad neurológica que cursa con afagia o disfagia severa (58,7 % y 58,2 %), respectivamente. La causa principal de finalización de los episodios fue el fallecimiento. Los pacientes pediátricos registrados fueron 116 en 2018 y 115 en 2019. Las niñas representaron el 57,8 % y 59,1 %, respectivamente, en cada uno de los periodos. La edad mediana de inicio de la NED fue de 5 y 7 meses. El grupo diagnóstico más registrado (42,2 % y 42,6 %) se englobó dentro del grupo de otras patologías, seguido de la enfermedad neurológica que cursa con afagia o disfagia severa de los niños (41,4 % y 41,7 %). Se alimentaban a través de gastrostomía el 46,6 % y 46,1 %, respectivamente, en cada uno de los periodos. Conclusiones: el registro de NED del grupo NADYA-SENPE sigue operativo de forma ininterrumpida desde sus inicios. El número de pacientes registrados y el de hospitales participantes permanece estable en el último bienio analizado.Aim: to present the results of the Spanish home enteral nutrition (HEN) registry of the NADYA-SENPE group for the years 2018 and 2019. Material and methods: from January 1, 2018 to December 31, 2019 the home enteral nutrition registry was recorded, and afterwards a further descriptive and analytical analysis was done. Results: in 2018, 4756 active patients were registered and the prevalence was 101.79 patients per one million inhabitants; in 2019 there were 4633 patients with a prevalence of 98.51 patients per one million inhabitants. They originated in 46 hospitals: 51.3 % were male, and median age was 71.0 years in both periods. The most frequent diagnosis was a neurological disorder that presents with aphagia or severe dysphagia — 58.7 % and 58.2 %, respectively. The main cause of episode termination was death. A total of 116 pediatric patients were registered in 2018 and 115 in 2019. Females represented 57.8 % and 59.1 %, respectively, in each of the periods. Median age at the beginning of HEN was 5 and 7 months. The most commonly recordered diagnostic group (42.2 % and 42.6 %) was included within the other pathologies group, followed by neurological disorders that present with aphagia or severe dysphagia in 41.4 % and 41.7 % of children. The route of administration was gastrostomy in 46.6 % and 46.1 %, respectively, in each of the periods. Conclusions: the NED registry of the NADYA-SENPE group continues to operate uninterruptedly since its inception. The number of registered patients and the number of participating hospitals remained stable in the last biennium analyzed

Nutrición parenteral domiciliaria en los pacientes oncológicos

Objective: to analyze the characteristics of oncology patients with home parenteral nutrition HPD collected from the NADYA registry.Method: cross-sectional study of the data collected from the NADYA’s group registry related to home and outpatient artificial nutrition. Patients with HPD and explicit oncological diagnosis were selected. Data were collected from January 1, 2010 to December 31, 2016.Results: Within the 7 years studied, 1463 patients were collected, of which 599 had a cancer diagnosis (40.94%) with an increase of 43% from the beginning. The mean age was 57 years IIQ [46-64], registering 5 children. The majority of the patients were oncologic palliative (51.3%). There were 3.18 septic catheter-related complications per 1000 days of nutrition, most frequently in the radiation enteritis group (ANOVA p &lt;0.001). The main cause of end of treatment was death 61%, palliative patients in higher proportion than the other diagnoses (x2 = 53,819, p &lt;0.001).Conclusions: palliative represent the majority of cancer patients with HPD. Intestinal obstruction and short bowel syndrome was the main reason for indicating it, almost 80% of cases. Patients with radiation enteritis were the ones with the least metabolic and septic complications not related to the catheter, being the ones with the most septic complications related to the catheter. Quality of life is a parameter that would provide a very valuable information of these patients. It is a limitation of this study not to have data based on this parameter.Objetivo: analizar las características de los pacientes oncológicos con nutrición parenteral domiciliaria (NPD) recogidos en el registro NADYA.Método: estudio transversal de los datos recogidos en el registro del grupo de nutrición artificial domiciliaria y ambulatoria NADYA de pacientes con NPD y diagnóstico oncológico explicito, desde el 1 de enero de 2010 al 31 de diciembre de 2016.Resultados: en los 7 años estudiados se han recogido 1463 pacientes, de los que 599 han tenido un diagnóstico de cáncer (40,94%) con un incremento del 43% desde el inicio. La edad media fue de 57 años IIQ [46 – 64] registrándose 5 niños. La mayoría de los pacientes eran oncológicos paliativos (51,3%). Se registraron 3,18 complicaciones sépticas relacionadas con el catéter por cada 1000 días de nutrición, con mayor frecuencia en el grupo de enteritis rádica (ANOVA p&lt;0,001). La principal causa de finalización fue el fallecimiento 61%, los pacientes paliativos en mayor proporción que los demás diagnósticos (x2 = 53.819; p&lt;0,001).Conclusiones: los paliativos representan la mayoría de los pacientes oncológicos con NPD, siendo la obstrucción intestinal y el síndrome de intestino corto los motivos de indicación de casi el 80% de los casos. Los pacientes con enteritis rádica han sido los que menos complicaciones metabólicas y sépticas no relacionadas con el catéter presentaron, siendo los que más complicaciones sépticas relacionadas con el catéter. La calidad de vida sería un parámetro que proporcionaría una información muy valiosa en estos pacientes, siendo una limitación de este estudio no disponer de datos al respecto