Results of a survey on peri-operative nutritional support in pancreatic and biliary surgery in Spain

Introduction: a survey on peri-operative nutritional support in pancreatic and biliary surgery among Spanish hospitals in 2007 showed that few surgical groups followed the 2006 ESPEN guidelines. Ten years later we sent a questionnaire to check the current situation. Methods: a questionnaire with 21 items sent to 38 centers, related to fasting time before and after surgery, nutritional screening use and type, time and type of peri-operative nutritional support, and number of procedures. Results: thirty-four institutions responded. The median number of pancreatic resections (head/total) was 29.5 (95 % CI: 23.0-35; range, 5-68) (total, 1002); of surgeries for biliary malignancies (non-pancreatic), 9.8 (95 % CI: 7.3-12.4; range, 2-30); and of main biliary resections for benign conditions, 10.4 (95 % CI: 7.6-13.3; range, 2-33). Before surgery, only 41.2 % of the sites used nutritional support (< 50 % used any nutritional screening procedure). The mean duration of preoperative fasting for solid foods was 9.3 h (range, 6-24 h); it was 6.6 h for liquids (range, 2-12). Following pancreatic surgery, 29.4 % tried to use early oral feeding, but 88.2 % of the surveyed teams used some nutritional support; 26.5 % of respondents used TPN in 100 % of cases. Different percentages of TPN and EN were used in the other centers. In malignant biliary surgery, 22.6 % used TPN always, and EN in 19.3 % of cases. Conclusions: TPN is the commonest nutrition approach after pancreatic head surgery. Only 29.4 % of the units used early oral feeding, and 32.3 % used EN; 22.6 % used TPN regularly after surgery for malignant biliary tumours. The 2006 ESPEN guideline recommendations are not regularly followed 12 years after their publication in our country

Resultados de una encuesta sobre el soporte nutricional perioperatorio en la cirugía pancreática y biliar en España

Introduction: a survey on peri-operative nutritional support in pancreatic and biliary surgery among Spanish hospitals in 2007 showed that few surgical groups followed the 2006 ESPEN guidelines. Ten years later we sent a questionnaire to check the current situation. Methods: a questionnaire with 21 items sent to 38 centers, related to fasting time before and after surgery, nutritional screening use and type, time and type of peri-operative nutritional support, and number of procedures. Results: thirty-four institutions responded. The median number of pancreatic resections (head/total) was 29.5 (95% CI: 23.0-35; range, 5-68) (total, 1002); of surgeries for biliary malignancies (non-pancreatic), 9.8 (95% CI: 7.3-12.4; range, 2-30); and of main biliary resections for benign conditions, 10.4 (95% CI: 7.6-13.3; range, 2-33). Before surgery, only 41.2% of the sites used nutritional support (&lt; 50% used any nutritional screening procedure). The mean duration of preoperative fasting for solid foods was 9.3 h (range, 6-24 h); it was 6.6 h for liquids (range, 2-12). Following pancreatic surgery, 29.4% tried to use early oral feeding, but 88.2% of the surveyed teams used some nutritional support; 26.5% of respondents used TPN in 100% of cases. Different percentages of TPN and EN were used in the other centers. In malignant biliary surgery, 22.6% used TPN always, and EN in 19.3% of cases. Conclusions: TPN is the commonest nutrition approach after pancreatic head surgery. Only 29.4% of the units used early oral feeding, and 32.3% used EN; 22.6% used TPN regularly after surgery for malignant biliary tumours. The 2006 ESPEN guideline recommendations are not regularly followed 12 years after their publication in our country.Introducción: realizamos una encuesta sobre soporte nutricional perioperatorio en cirugía pancreática y biliar en hospitales españoles en 2007, que mostró que pocos grupos quirúrgicos seguían las guías de ESPEN 2006. Diez años después enviamos un cuestionario para comprobar la situación actual. Métodos: treinta y ocho centros recibieron un cuestionario con 21 preguntas sobre tiempo de ayunas antes y después de la cirugía, cribado nutricional, duración y tipo de soporte nutricional perioperatorio, y número de procedimientos. Resultados: respondieron 34 grupos. La mediana de pancreatectomías (cabeza/total) fue de 29,5 (IC 95 %: 23,0-35; rango, 5-68) (total, 1002), la de cirugías biliares malignas de 9,8 (IC 95 %: 7,3-12,4; rango, 2-30) y la de resecciones biliares por patología benigna de 10,4 (IC 95 %: 7,6-13,3; rango, 2-33). Solo el 41,2 % de los grupos utilizaban soporte nutricional antes de la cirugía (< 50 % habian efectuado un cribado nutricional). El tiempo medio de ayuno preoperatorio para sólidos fue de 9,3 h (rango, 6-24 h), y de 6,6 h para líquidos (rango, 2-12). Tras la pancreatectomía, el 29,4 % habían intentado administrar una dieta oral precoz, pero el 88,2 % de los grupos usaron algún tipo de soporte nutricional y el 26,5 % usaron NP en el 100 % de los casos. Los demás grupos usaron diferentes porcentajes de NP y NE en sus casos. En la cirugía biliar maligna, el 22,6 % utilizaron NP siempre y NE en el 19,3 % de los casos. Conclusiones: la NP es el soporte nutricional más utilizado tras la cirugía de cabeza pancreática. Solo el 29,4 % de las unidades usan nutrición oral precoz y el 32,3 % emplean la NE tras este tipo de cirugía. El 22,6 % de las instituciones usan NP habitualmente tras la cirugía de tumores biliares malignos. Las guías ESPEN 2006 no se siguen de forma habitual en nuestro país tras más de 10 años desde su publicación

Natació especial : l'aigua un estímul educatiu

Albiol, Francesc (guió i realització) ; Martínez Pardo, Maite (realització)Fou gravat a la Piscina Municipal de Can CaralleuLa data de publicació no és exactaAvantatges que comporta la pràctica de la natació en tot infant disminuït. - Plans: (DP) Infants i joves disminuïts nadant a la piscina, (PM) Diversos disminuïts tirant-se a la piscina. Entrenador ajudant a diferents infants disminuïts a tirar-se a l'aigua. Entrevista realitzada al Sr. Jordi Ponces (director del Centre de rehabilització de paralítics cerebrals "Arcángel San Gabriel"), (PP) Jove disminuït fent peus de crol, a la piscina, (PM) Jove disminuït ajudat a tirar-se a l'aigua des d'un trampolí. Nena disminuïda rebent instruccions del seu entrenador. Diversos infants disminuïts fent exercicis de peus de crol. Mare d'una nena disminuïda exposant els beneficis de la natació en la seva filla. Jove, disminuït psíquic, entrevistat sobre la seva activitat a la piscina. Diverses nenes sordes, tirant-se a l'aigua, (TRAV) Joves, paralítics cerebrals, ajudats pel seu entrenador, fan esquenaDigitalitzat pel SEDA

Seleccions de barri

Albiol, Francesc (guió); Albiol, Francesc (realització); Martínez Pardo, Maite (realització)La data de publicació no és exactaAmb motiu del foment de l'esport als barris es realitzen partits de futbol. - Plans: (DP) Nois jugant a fútbol, (PM) Narcís Serra (Alcalde de Barcelona), Enric Trunyo (Regidor de l'Ajuntament de Barcelona), Antoni Guasch (President F.C.F), (DP) Repartició de premisDigitalitzat pel SEDA

Multivariate data analysis for the detection of human alpha-acid glycoprotein aberrant glycosylation in pancreatic ductal adenocarcinoma

Relative quantification of human alpha-acid glycoprotein (hAGP) glycan isomers using [12C6]/[13C6]-aniline in combination with multivariate data analysis is proposed as an efficient method for the identification of pancreatic ductal adenocarcinoma (PDAC) glycan biomarkers in serum samples. Intact and desialylated glycans from hAGP, purified from serum samples of patients with PDAC and chronic pancreatitis (ChrP), were labeled with aniline and analyzed by μZIC-HILIC-MS. Afterwards, partial least squares discriminant analysis (PLS-DA) was applied to the relative areas obtained for all glycan isomers in the different samples: pathological (ChrP or PDAC) versus healthy samples. Seven intact glycan isomers with α2-6 linked sialic acids, five of them also fucosylated, were the most meaningful to distinguish between PDAC and ChrP patients. The desialylated glycan isomers also identified by PLS-DA as potential biomarker candidates confirmed that antenna but also core fucosylation could be involved in PDAC. The analysis of intact and desialylated glycan isomers in combination with the multivariate data analysis revealed that the triantennary glycan with two fucoses of hAGP could have in the future a relevant role in the differentiation of patients with PDAC from those with ChrP

Extra-Glissonian approach in liver resection

AbstractBackgroundIn this study we analyzed our most recent experience in the use of the extraglissonian approach to the hilar structures in two circumstances: pedicle transection during major liver resections, and selective clamping in minor hepatectomies.MethodsThe major liver resections study group consisted of 89 cases. Extraglissonian approach and stapler transection of hilar structures was used in 61 (69%). The study group of minor liver resections consisted of 103 cases. Extraglissonian approach and selective clamping was used in 27 cases (26%).ResultsIn major hepatectomies pedicle stapling and hilar dissection demonstrated a similar operative time (240 vs. 260 min; P=0.230); no differences were observed in the amount of haemorrhage (800ml vs. 730ml; P=0.699), number of patients transfused (16 vs. 6; P=0.418) and volume of blood transfused (4 PRC vs. 4 PRC; P=0.521). Duration of vascular pedicle occlusion was 35 vs. 30 min respectively (P=0.293). Major complications (grade ≥3a) occurred in 18 (20%) patients and mortality rates (4.9% vs. 3.5%; P=0.882) were similar for both group. In minor liver resections there were no differences between Pringle and selective clamping in operative time (240 vs. 240 min; P=0.321), haemorrhage (435ml vs. 310ml; P=0.575), number of patients transfused (18 vs. 7; P=0.505) and volume blood transfused (4 PRC vs. 3 PRC; P=0.423). Major complications (grade ≥3a) occurred in 14 (14%) patients, and mortality (2.6% vs. 3.7%; P=0.719) were similar for both groups. However, the duration of pedicle clamping was significantly longer in the selective clamping group (26±21 minutes vs. 44±18 minutes) (P=0.001).ConclusionsThe extraglissonian approach can be extremely useful in liver surgery. Selective clamping with extraglissonian approach avoids ischemia to the other hemiliver. Selective clamping it is also important from the homodynamic point of view because there is no splanchnic stasis and low fluid replacement

cDf International Congress : proceedings : actes, actas : actes, Barcelona Jun. 2013

El Congrés Internacional coupDefouet Barcelona 2013 ha estat una iniciativa de l'Art Nouveau European Route – Ruta Europea del Modernisme, organitzada per l'Institut del Paisatge Urbà de l'Ajuntament de Barcelona i el grup de recerca GRACMON de la Universitat de BarcelonaCoordinació: Lluís Bosch, Mireia Freixa.[eng] In 2013 the magazine coupDefouet reached its first decade of existence. As a way of celebrating this, the Art Nouveau European Route – the association of cities and other local institutions for the promotion and diffusion of Art Nouveau heritage that created the magazine – organised a magnificent international congress as a framework for scientific exchange and raising public awareness. The first coupDefouet International Congress on Art Nouveau was held in Barcelona, the city from which coupDefouet is published and one of the undisputable world capitals of Art Nouveau. This volume of the Singularitats series comprises the proceedings of that event.[cat] L’any 2013 va fer deu anys de l’aparició de coupDefouet, la revista de la Ruta Europea del Modernisme, una associació de municipis i altres entitats locals per a la promoció i la difusió del patrimoni modernista o Art Nouveau. Per commemorar-ho, s’organitzà un congrés internacional amb l’objectiu de contribuir al coneixement científic i la difusió d’aquest moviment artístic. El primer Congrés Internacional coupDefouet se celebrà a Barcelona, la ciutat en què s’edita coupDefouet i una de les capitals indiscutibles de l’Art Nouveau. En aquest volum de Singularitats s’apleguen les actes d’aquell esdeveniment