2,379 research outputs found
The Spanish society of Parenteral and Enteral Nutrition (SENPE) and its relation with healthcare authorities
Está muy bien documentado en la literatura médica
que la desnutrición es un problema común en todos los
niveles de atención sanitaria, desde atención primaria a
especializada y en centros de atención geriátrica. Este
problema no se limita a países con pocos recursos económicos
o con limitado desarrollo social y económico. También
es un problema universal en Europa. La desnutrición
aumenta las cifras de morbilidad, mortalidad,
ingresos hospitalarios y duración de la estancia. Estas
cifras más elevadas suponen lógicamente un aumento del
uso de recursos sanitarios. A pesar de esto, el problema de
la desnutrición a menudo puede pasar desapercibido y el
paciente no recibir el tratamiento necesario. Este problema
requiere la cooperación de múltiples agentes tales
como los Gobiernos de los Estados, los profesionales de la
salud y los mismos ciudadanos. El VIII Foro de Debate
concluye con la necesidad de establecer un claro plan de
actuación (a semejanza de la European Alliance for
Health Nutrition) y la creación de una plataforma (coalición)
que reúna las voces de asociaciones de profesionales
sanitarios, instituciones, colegios profesionales, asociaciones
de pacientes, industria y entidades aseguradoras. Los
fines de esta plataforma consistirán en informar de la
extensión del problema, identificar y potenciar líderes
que transmitan los fines de esta iniciativa ante las autoridades
autonómicas y nacionales, propuesta de soluciones
y colaboración en su puesta en marcha y finalmente, evaluación/
control de las acciones desarrolladasIt has been well documented in medical literature that
hyponutrition is a common issue at all healthcare levels,
from primary to specialized health care, as well as geria -
tric healthcare facilities. This problem is not limited to
countries with scarce economic resources or limited social
development; it is also a universal issue in Europe.
Hyponutrition increases the rates of morbidity, mortality,
hospital admissions, and hospital stay. These higher
figures also represent a higher use of healthcare
resources. In spite of this, hyponutrition may often go
undetected and the patient may not receive the necessary
treatment. This problem requires the cooperation of multiple
agents such as the Governments, the healthcare professionals,
and the citizens themselves. The VIII Discussion
Forum concludes on the need to establish a clear-cut
plant for action (similar to the European Alliance for
Health Nutrition) and the creation of a platform (coalition)
encompassing the voices of healthcare professionals
associations, institutions, professional colleges, patients
associations, the pharmaceutical companies, and insurance
companies. The goals of this platform will be to
inform about the extent of this issue, to identity and promote
leaders that will convey the aims of this initiative to
regional and national healthcare authorities, to present
solutions and to collaborate in their implementation, and
finally to assess/control the actions take
Assessment of nutritional status and bone health in neurologically impaired children: a challenge in pediatric clinical practice
NTRODUCTION: neurologically impaired children frequently experience nutritional disorders and bone health complications. Our aim was firstly to analyze a method to interpret bone mineral density (BMD) accurately in neurologically impaired children. Secondly, to determine its relationship with the nutritional status and micronutrient levels in order to identify which factors are associated with low BMD. METHODS: a observational multicenter study was conducted in children with moderate-to-severe neurological impairment. Data collected included: medical records, anthropometric measures, hematologic and biochemical evaluation. BMD was measured with Dual-energy X-ray absorptiometry and z-scores were calculated adjusting for sex and chronological age. Secondly, BMD z-scores were calculated applying height age (age at which the child's height would be in 2nd percentile) instead of chronological age. RESULTS: fifty-two children were included (aged 4-16 years). Seventeen patients (32.7%) received feeding by gastrostomy tube. Height and BMI z-score were below 2SD in 64% and 31% of patients respectively, with normal mid upper arm circumference and skinfold thickness measurements. Low vitamin-D levels were found in 42% of cases. 50% of patients evidenced low BMD when calculated for chronological age, whereas only 34.5% showed BMD z-score <-2 when calculated for height age. No correlation was observed between BMD and vitamin-D levels, weight and height z-scores or age when BMD was calculated applying height age. CONCLUSIONS: the prevalence of low BMD is high in neurologically impaired children, and it is probably multifactorial. In these children, we suggest adjusting BMD for height age, in order not to over diagnose low BMD
Chagas disease in Latin American migrants: a Spanish challenge
AbstractChagas’ disease affects millions in Latin America and is the leading cause of cardiomyopathy and death due to cardiovascular disease in patients aged 30–50 years. As a consequence of immigration it has settled in several European countries, where besides imported cases, autochthonous infections arise through vertical transmission and blood/organ donation. All Latin American immigrants who attended our Unit were screened for T. cruzi infection (ELISA and IFAT ± PCR). An ECG and echocardiogram were requested for all positive patients, and oesophageal manometry, barium swallow and barium enema were requested according to patient symptoms. All patients under 50 years without severe cardiac involvement and who had not received correct treatment previously were treated with benznidazole 5 mg/kg/day for 60 days. Patients were followed-up with serology and PCR 1 month after treatment ended and every 6 months thereafter. A total of 1146 Latin Americans were screened for T. cruzi (357 positive serology results). The typical patient profile was a Bolivian female, of rural origin, in her fourth decade of life, without evidence of visceral involvement. Treatment tolerance was poor, with 29.7% discontinuing treatment due to adverse reactions. Among those with adverse reactions (52%), the most frequent were cutaneous hypersensitivity (68.7%), gastrointestinal upset (20%) and nervous system disturbances (16.2%). T. cruzi infection is no longer limited to Latin America. Poor treatment tolerance can limit current treatment options. More epidemiological data are necessary to estimate the magnitude of a problem of great relevance for public health and health resource planning
Produzione, mercato e consumi della cerasicoltura spagnola
La crisi di sovrapproduzione di alcune specie tradizionali sta favorendo la crescita del ciliegio, che mostra
un costante incremento delle superfici, favorito dal rinnovamento varietale, dall’aumento dei consumi, dal
miglioramento delle tecnologie di produzione e dalla precocità di maturazione. Tutti fattori che
garantiscono alla Spagna elevata competitività nelle esportazioni verso i Paesi dell’Ue.Colaboración en el blog: Rivista di frutticoltura e di ortofloricoltura. Disponible: http://www.rivistafrutticoltura.it
Compliance with current dietary recommendations and geographical variability of diet in women participating in 7 screening programs for breast cancer in Spain
Introducción: Una dieta saludable es especialmente
importante durante la menopausia, periodo en el que
aumenta el riesgo de varios problemas de salud. Analizamos
la dieta de mujeres peri y postmenopáusicas españolas
y el grado de cumplimiento de las recomendaciones
actuales.
Material y métodos: Estudio transversal en 3.574 mujeres
de 45-68 años que acuden al cribado de cáncer de
mama en 7 centros (A Coruña, Barcelona, Burgos, Palma
de Mallorca, Pamplona, Valencia y Zaragoza). Se recogió
la dieta mediante un cuestionario de frecuencia de alimentos
validado para población española. Para la valoración
del cumplimiento de las recomendaciones actuales se
utilizaron los rangos recomendados por la Sociedad
Española de Nutrición Comunitaria para ingesta de grupos
de alimentos y las Ingestas Diarias Recomendadas
(IDR) para energía, vitaminas y minerales de la Federación
Española de Nutrición, Alimentación y Dietética.
Resultados: El 29% de las mujeres eran obesas y un
42% tenía sobrepeso. El aporte calórico medio fue de
2.053 kcal (DE: 480). El perfil calórico general fue de:
43% de la energía aportada por lo carbohidratos, 36%
por las grasas, 20% por las proteínas. Se evidenció una
ingesta deficiente de vitamina D en todos los nodos del
estudio, con una ingesta media general de 2,14 μg/día. Se
detectó a su vez una ingesta deficitaria de vitamina E en A
Coruña y Burgos. Todos los centros presentaron una
ingesta elevada de productos lácteos y de legumbres. El
consumo de frutas y verduras fue muy heterogéneo
siendo especialmente elevada su ingesta en Mallorca y
Valencia mientras que fue baja para ambos grupos de alimentos
en A Coruña. La ingesta de aceite de oliva fue elevada
en todos los centros exceptuando Burgos con un
74,3% de las mujeres estudiadas por debajo de las 3
raciones al día recomendadas.
Conclusiones: Una dieta con menos grasas y proteínas
y más rica en vegetales, frutos secos y alimentos ricos en
hidratos de carbono equilibraría el balance energético y
mejoraría la calidad de la dieta corrigiendo las bajas
ingestas de vitaminas D y E. Estas recomendaciones son
especialmente importantes en las ciudades más alejadas
de la costa mediterránea donde se han detectado mayores
incumplimientos de las recomendaciones vigentes y una
dieta más alejada de la dieta mediterránea.Introduction: A healthy diet is especially important
during menopause, a period which increases the risk of
various health problems. We analyzed the diet of periand
postmenopausal Spanish women and the degree of
compliance with current recommendations.
Material and methods: We studied 3574 women 45-68
years old who attended breast cancer screening programmes
in 7 centres (A Coruña, Barcelona, Burgos,
Palma de Mallorca, Pamplona, Valencia and Zaragoza).
Diet information was collected using a food frequency
questionnaire validated for the Spanish population. For
the assessment of compliance with current guidelines we
used the recommendations by the Spanish Society of
Community Nutrition for food groups intake and by the
Spanish Federation of Nutrition, Food and Dietetics for
energy, vitamins and minerals intake.
Results: The 29% of women were obese and 42% overweight.
The average caloric intake was 2.053 kcal (SD
480). The general energy profile was: 43% of the energy
from the carbohydrates, 36% from fats, and 20% from
proteins. There was a low vitamin D intake in all centres
of the study, with an overall mean intake of 2.14 mg/day.
A deficit of vitamin E intake in A Coruña and Burgos was
also detected. Intake of dairy products and vegetables
was high in all the study centers. The consumption of
fruits and vegetables was very heterogeneous, with high
intakes observed in Mallorca and Valencia and low for
both food groups in A Coruña. The olive oil intake was
high in all centers except Burgos with 74.3% of the
women studied below the recommended 3 servings per
day.
Conclusions: A diet with less fat and protein and a
higher consumption of vegetables, nuts and foods rich in
carbohydrate might balance the energy intake and
improve the quality of the diet correcting the low intakes
of vitamins D and E. These recommendations are especially
important in cities far from the Mediterranean
coast where more breaches have been detected over the
current recommendations with a lower adherence to the
Mediterranean diet.Este estudio ha recibido financiación del Fondo de
Investigación Sanitaria (proyecto PI060386) y de
Astra-Zéneca (convenio de colaboración entre Astra-
Zeneca y el Instituto de salud Carlos III 1306-1306
EPY
A placebo-controlled trial of tinted lenses in adolescents with good and poor academic performance: reading accuracy and speed
Postprint (author's final draft
Anticoagulant therapy for splanchnic vein thrombosis: an individual patient data meta-analysis
Robust evidence on the optimal management of splanchnic vein thrombosis (SVT) is lacking. We conducted an individual-patient meta-analysis to evaluate the effectiveness and safety of anticoagulation for SVT. Medline, Embase, and clincaltrials.gov were searched up to June 2021 for prospective cohorts or randomized clinical trials including patients with SVT. Data from individual datasets were merged, and any discrepancy with published data was resolved by contacting study authors. Three studies of a total of 1635 patients were included. Eighty-five percent of patients received anticoagulation for a median duration of 316 days (range, 1-730 days). Overall, incidence rates for recurrent venous thromboembolism (VTE), major bleeding, and mortality were 5.3 per 100 patient-years (p-y; 95% confidence interval [CI], 5.1-5.5), 4.4 per 100 p-y (95% CI, 4.2-4.6), and 13.0 per 100 p-y (95% CI, 12.4-13.6), respectively. The incidence rates of all outcomes were lower during anticoagulation and higher after treatment discontinuation or when anticoagulation was not administered. In multivariable analysis, anticoagulant treatment appeared to be associated with a lower risk of recurrent VTE (hazard ratio [HR], 0.42; 95% CI, 0.27-0.64), major bleeding (HR, 0.47; 95% CI, 0.30-0.74), and mortality (HR, 0.23; 95% CI, 0.17-0.31). Results were consistent in patients with cirrhosis, solid cancers, myeloproliferative neoplasms, unprovoked SVT, and SVT associated with transient or persistent nonmalignant risk factors. In patients with SVT, the risk of recurrent VTE and major bleeding is substantial. Anticoagulant treatment is associated with reduced risk of both outcomes. © 2022 by The American Society of Hematology
DNA sequences within glioma-derived extracellular vesicles can cross the intact blood-brain barrier and be detected in peripheral blood of patients
Tumor-cell-secreted extracellular vesicles (EVs) can cross the disrupted bloodbrain
barrier (BBB) into the bloodstream. However, in certain gliomas, the BBB
remains intact, which might limit EVs release. To evaluate the ability of tumor-derived
EVs to cross the BBB, we used an orthotopic xenotransplant mouse model of human
glioma-cancer stem cells featuring an intact BBB. We demonstrated that all types of
tumor cells-derived EVs−apoptotic bodies, shedding microvesicles and exosomes−
cross the intact BBB and can be detected in the peripheral blood, which provides a
minimally invasive method for their detection compared to liquid biopsies obtained
from cerebrospinal fluid (CSF). Furthermore, these EVs can be readily distinguished
from total murine EVs, since they carry human-specific DNA sequences relevant
for GBM biology. In a small cohort of glioma patients, we finally demonstrated
that peripheral blood EVs cargo can be successfully used to detect the presence of
IDH1G395A, an essential biomarker in the current management of human gliomaWe are grateful for the financial support from the ‘Fondo de Investigaciones Sanitarias’ (FIS) (PI10/01069 and PI14/00077) and the ‘Miguel Servet Program’ (CP11/00147) from the ‘Instituto de Salud Carlos III’ (AAS), RTC-2015-3846-1 from Ministerio de Economía
y Competitividad and FEDER fund
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