Pancreatitis aguda: consumo de recursos en un hospital de tercer nivel

INTRODUCCIÓN La pancreatitis aguda es una patología con elevada incidencia y carga sanitaria. Sin embargo, existe una gran disparidad entre regiones, por lo que nuestro objetivo es conocer la incidencia, consumo de recursos y coste sanitario estratificado por gravedad que supone la pancreatitis aguda en nuestro medio para una adecuada planificación de su gestión sanitaria. MATERIAL Y MÉTODOS Planteamos un estudio de cohortes retrospectivo de un centro mediante la revisión de los pacientes que ingresaron con diagnóstico de pancreatitis aguda en el Departamento de Salud de Alicante – Hospital General entre el 1 de enero de 2018 y el 31 de diciembre de 2018. RESULTADOS Un total de 141 pacientes fueron incluidos en el análisis. La incidencia de pancreatitis aguda en nuestro medio fue de 61.7 casos cada 100.000 habitantes por año. Los pacientes fueron distribuidos según gravedad (leve, moderada o grave) con una diferencia significativa en la mediana de días de estancia hospitalaria (mediana 6 (rango intercuartílico [IQR] 4-8) en leves, 13 (IQR 8-18) en moderados y 25 (IQR 4-69) en graves; p < 0.001) y estancia en unidad de cuidados intensivos (mediana 0 (IQR 0-0) en leves y moderados y 7 (IQR 0-24) en graves; p < 0.001). El coste total anual fue 880.110 euros con una diferencia estadísticamente significativa (p < 0.001) en la mediana de coste por paciente de 2.775 euros (IQR 1.999-4.178) en leves, 7.001 euros (IQR 4.609-10.726) en moderados y 38.963 euros (IQR 2.644-52.159) en graves. CONCLUSIONES La pancreatitis aguda tiene una elevada incidencia y supone un alto consumo de recursos y coste sanitario en nuestro medio. Además de nuestro trabajo, son necesarios más estudios regionales que permitan orientar mejor la toma de decisiones y el uso de nuestros recursos.BACKGROUND Acute pancreatitis is a disease with a high incidence and burden. However, there is a great disparity between regions, therefore our objective is to describe the incidence, resource consumption and health care cost stratified by severity of acute pancreatitis in our environment for an adequate planning of its health care management. METHODS We proposed a single-center retrospective cohort study by reviewing patients admitted with a diagnosis of acute pancreatitis in the Alicante Health Department – General Hospital between January 1, 2018 and December 31, 2018. RESULTS A total of 141 patients were included in the analysis. The incidence of acute pancreatitis in our region was 61.7 cases per 100.000 inhabitants per year. Patients were distributed according to severity (mild, moderate or severe) with a significant difference in the median number of days of hospital stay (median 6 (interquartile range [IQR] 4-8) in mild, 13 (IQR 8-18) in moderate and 25 (IQR 4-69) in severe; p < 0.001) and intensive care unit stay (median 0 (IQR 0-0) in mild and moderate and 7 (IQR 0-24) in severe; p < 0.001). The total annual cost was 880.110 euros with a statistically significant difference (p < 0.001) in median cost per patient of 2.775 euros (IQR 1.999-4.178) in mild, 7.001 euros (IQR 4.609-10.726) in moderate and 38.963 euros (IQR 2.644-52.159) in severe. CONCLUSIONS Acute pancreatitis has a high incidence and represents a significant consumption of resources and health care costs in our environment. In addition to our work, more regional studies are needed to better guide decision making and the use of our resource

Actitudes de los estudiantes del Grado de Magisterio y del Máster de Educación Especial hacia la inclusión educativa

El objetivo de este trabajo fue analizar la actitud hacia la inclusión educativa de los futuros docentes. Doscientos setenta y cuatro estudiantes del Grado de Magisterio de Infantil y Primaria y del Máster de Educación Especial de la Universitat de València cumplimentaron una adaptación de la escala ORI (Opinions Relative to Integration of Students with Disabilities Scale). Se analizó la fiabilidad y estructura factorial del cuestionario. Se comparó la puntuación en la escala entre los estudiantes de grado y de máster; entre los estudiantes de Grado de Magisterio de Educación Infantil y el de Educación Primaria; y entre los estudiantes de grado antes y después de cursar la asignatura Necesidades Educativas Especiales. Todos los estudiantes mostraron una actitud favorable hacia la inclusión educativa. La actitud fue mejor en los estudiantes de la titulación de Educación Infantil que en los de Primaria. Existió una mejora significativa en la actitud de los estudiantes de Grado tras cursar la materia ¿Necesidades Educativas Especiales¿. La actitud fue significativamente más favorable en los alumnos de Máster que en los alumnos de Grado. Los veinticinco ítems originales de la escala ORI se redujeron a veintitrés en nuestra adaptación, y los cuatro factores iniciales se incrementaron a cinco

Creencias sobre la educación inclusiva de los futuros maestros y maestras de educación infantil y primaria

En el presente trabajo se analizan las creencias de 111 estudiantes de los grados de magisterio de educación infantil y primaria sobre la educación inclusiva referentes a: qué colectivo de estudiantes les sería más difícil acoger en clase; cuáles son las funciones más importantes que deben desempeñar los maestros/as; qué aspectos son los más relevantes en la educación inclusiva y en la formación de maestros y maestras. Los participantes consideran que es más difícil atender a los estudiantes con autismo, retraso mental y trastornos de la personalidad. Priorizan la enseñanza de actitudes y valores, la creación de un clima agradable de aprendizaje, los aspectos relacionados con la socialización y con los aprendizajes funcionales, la formación y actitudes del profesorado, y la colaboración con las familias

Use of chia seed mucilage as a texturing agent: Effect on instrumental and sensory properties of texture-modified soups

[EN] This work aimed to evaluate colour, texture, flow, and viscoelastic properties of texture-modified chicken and vegetables soups for dysphagic people, as well as their characteristics during simulated oral processing. The use of chia seed mucilage (CSM) as an alternative texturing agent for dysphagia, the influence of temperature, the effect of saliva during the simulated oral processing of samples, and the sensory acceptance of samples were also studied. Modified starch (MS), guar gum (GG), and CSM were used to modify samples texture at two consistency levels: honey-like and pudding-like consistencies. MS and CSM soups presented higher elasticity and resistance to deformation than GG samples, being considered safer to swallow by dysphagic patients. Addition of saliva caused remarkable changes in samples' consistency, adhesiveness, and apparent viscosity. Moreover, the use of CSM did not modify the swallowing properties of samples. These results confirm the feasibility of using CSM as a novel texturing agent for dysphagia management, and represent an advance in developing dysphagia-oriented products by tailoring their textural, rheological, viscoelastic, and sensory characteristics, as well as their properties during the oral processing.The authors gratefully acknowledge the financial support from the Ministerio de Ciencia, Innovacion y Universidades, the Agencia Estatal de Investigacion and Fondo Europeo de Desarrollo Regional (Project RTI2018-098842-B-I00) . Susana Ribes thanks the "Generalitat Valenciana" for her Postdoctoral Fellowship (APOSTD/2020/264) .Ribes-Llop, S.; Grau Meló, R.; Talens Oliag, P. (2022). Use of chia seed mucilage as a texturing agent: Effect on instrumental and sensory properties of texture-modified soups. Food Hydrocolloids. 123:1-12. https://doi.org/10.1016/j.foodhyd.2021.10717111212

Non destructive monitoring of the yoghurt fermentation phase by an image analysis of laser-diffraction patterns: Characterization of cow s, goat s and sheep s milk

[EN] Monitoring yogurt fermentation by the image analysis of diffraction patterns generated by the laser-milk interaction was explored. Cow¿s, goat¿s and sheep¿s milks were tested. Destructive physico-chemical analyses were done after capturing images during the processes to study the relationships between data blocks. Information from images was explored by applying a spectral phasor from which regions of interest were determined in each image channel. The histograms of frequencies from each region were extracted, which showed evolution according to textural modifications. Examining the image data by multivariate analyses allowed us to know that the captured variance from the diffraction patterns affected both milk type and texture changes. When regression studies were performed to model the physico-chemical parameters, satisfactory quantifications were obtained (from R2¿=¿0.82 to 0.99) for each milk type and for a hybrid model that included them all. This proved that the studied patterns had a common fraction of variance during this processing, independently of milk type.Verdú Amat, S.; Barat Baviera, JM.; Grau Meló, R. (2019). Non destructive monitoring of the yoghurt fermentation phase by an image analysis of laser-diffraction patterns: Characterization of cow s, goat s and sheep s milk. Food Chemistry. 274:46-54. https://doi.org/10.1016/j.foodchem.2018.08.091S465427

Laser backscattering imaging as a non-destructive quality control technique for solid food matrices: Modelling the fibre enrichment effects on the physico-chemical and sensory properties of biscuits

[EN] This work focused on modelling the effect of fibre enrichment on the physico-chemical and sensory properties of biscuits by an image analysis of laser backscattering patterns. The study was done on four formulas where, besides the control, three fibre enrichment levels were included (5%, 10% and 20% w/w). The impact on the physico-chemical and sensory properties of biscuits was characterised according to analyses of texture, thickness, area, mass increment, density, flux of solvents (water and milk), colour, taste, mouth texture, etc. Moreover, the image analysis was carried out to collect information from the interaction of a laser with two different biscuit production chain matrices: after the mixing and forming phase (doughs) and after baking (end biscuits). That information was obtained according to the image descriptors generated from the morphology of the observed laser patterns. Both studied matrices offered different, but complementary, information about isolating the variance produced by fibre enrichment for doughs, while the variance generated by heat treatment was also recorded for biscuits. The quantitative prediction of the physico-chemical and sensory properties of biscuits improved when combining both information blocks. The impact of fibre enrichment on biscuits can be modelled by this imaging technique, which could be the basis to develop new non-destructive systems for online inspections made during cookie processing to quickly and non-destructively report physico-chemical and sensory information.This study was supported by the Regional Valencian Ministry of Culture, Education and Sport for Scientific and Technological Politics by Project entitled Use of non-wheat flours, from co-products of the food industry, to produce bread, cakes and snacks (AICO/2015/107) and by the University Polytechnic of Valencia by program Ayudas para la Contratación de Doctores para el Acceso al Sistema Español de Ciencia, Tecnología e Innovación, en Estructuras de Investigación de la UPV (PAID-10-17)Verdú Amat, S.; Barat Baviera, JM.; Grau Meló, R. (2019). Laser backscattering imaging as a non-destructive quality control technique for solid food matrices: Modelling the fibre enrichment effects on the physico-chemical and sensory properties of biscuits. Food Control. 100:278-286. https://doi.org/10.1016/j.foodcont.2019.02.004S27828610

Evaluation of the influence of food intake on the incorporation and excretion kinetics of mesoporous silica particles in C.elegans

[EN] The effect of the presence of food on the incorporation and excretion of silica particles was studied in this work using the biological model Caenorhabditis elegans and image analysis techniques. The experiment was based on two 24-hour phases: exposure and depuration. During exposure, nematodes were maintained for 24 h in liquid medium with silica particles, but some with and others without food. During depuration, nematodes were transferred to medium without particles. Nematodes were analysed by an image analysis in both phases to quantify the properties of particle distributions in nematodes' bodies with time. No differences were found in the proportion of nematodes carrying particles in the exposure phase when food was present. However in the depuration phase, lack of food generated a high proportion of particle carriers. Particle distribution properties were also similar in the exposure phase. Nevertheless, lack of food produced particle accumulation due to decelerated excretion because digestive tube relaxed under these conditions. Thus after the depuration phase, lack of food led particles to persist in digestive tubes. According to these results, intake of silica particles had no retention effects when a food flux was provided, but particles were not easily excreted when the food flux was interrupted.The authors gratefully acknowledge the financial support from the Universitat Polit`ecnica de Valencia by Programme "Ayudas para la Contratacion de Doctores para el Acceso al Sistema Espanol de Ciencia, Tecnologia e Innovacion, en Estructuras de Investigacion de la UPV (PAID-10-17)"and Ministerio de Ciencia, Innovacion y Universidades, the Agencia Estatal de Investigacion and FEDER-EU (Project RTI2018101599-B-C21).Verdú, S.; Ruiz Rico, M.; Barat Baviera, JM.; Grau Meló, R. (2021). Evaluation of the influence of food intake on the incorporation and excretion kinetics of mesoporous silica particles in C.elegans. Chemico-Biological Interactions. 334:1-8. https://doi.org/10.1016/j.cbi.2020.109363S1833

Compositional, structural design and nutritional aspects of texture-modified foods for the elderly

[EN] Background: Texture-modified foods (TMF) are commonly used as a therapeutic strategy for people with chewing or swallowing difficulties such as the elderly, which is the fastest growing segment of the global population. These foods need to be soft, safe and easily swallowed as well as have nutritive properties and attractive sensory attributes in order to help overcome physiological dysfunctions and cover specific nutritional requirements.Scope and approach: This review provides an overview about common and novel ingredients and techniques used to obtain TMF with desired textural characteristics as well as methods or processes aimed to improve nutritional and sensory characteristics. Digestibility aspects of TMF are also presented, specially the influence of food matrix structure and material properties on digestion and bioaccessibility of nutrients.Key findings and conclusions: The design of products with textural, nutritional, and sensory characteristics suitable for the elderly should consider not only compositional and structural aspects during formulation but also the modification of food structure during oral processing and gastrointestinal digestion. Increasing the knowledge in these issues will assist the development of products with enhanced functionalities in order to meet the needs of specific populations such as the elderly.Grant RTI2018-098842-B-I00 funded by MCIN/AEI/10.13039/501100011033 and by ERDF "A way of making Europe" is acknowledged. M.G. also gratefully thanks the postdoctoral grant (PAID-10-19) from the "Universitat Politecnica de Valencia".Gallego Ibáñez, M.; Barat Baviera, JM.; Grau Meló, R.; Talens Oliag, P. (2022). Compositional, structural design and nutritional aspects of texture-modified foods for the elderly. Trends in Food Science & Technology. 119:152-163. https://doi.org/10.1016/j.tifs.2021.12.00815216311

Enrichment of chips with fibre from a tiger-nut (Cyperus esculentus) milk co-product to source of fibre and high fibre content levels: impact on processing, physicochemical and sensory properties

[EN] The impact of integrating a tiger-nut milk co-product into the wheat chip production process for enriching fibre content to meet European recommendations for 'source of fibre foods' and 'high fibre content foods' was studied. Four different flours, based on their composition and particle size, were obtained from the co-product. Wheat flour was substituted at the 5%, 10% and 20% levels with the co-product, and the processing, physico-chemical and sensory properties of chip were studied. In the baking phase, mass loss was more marked for the substituted samples (42%) than the control (34%), but differences diminished after the tempering time (33%) by absorbing moisture from the environment. This effect was related to the increased chips surface (approximate to 43%) in the forming phase because dough retraction decreased. The co-product as a fibre source produced alterations to chip processing and its physico-chemical properties should be taken into account. However, chips positively impacted consumer acceptability.Alava Pincay, C.; Verdú Amat, S.; Barat Baviera, JM.; Grau Meló, R. (2018). Enrichment of chips with fibre from a tiger-nut (Cyperus esculentus) milk co-product to source of fibre and high fibre content levels: impact on processing, physicochemical and sensory properties. International Journal of Food Science & Technology. 54(3):908-915. https://doi.org/10.1111/ijfs.14014S90891554

Effect of tiger-nut (Cyperus esculentus) milk co-product on the surface and diffusional properties of a wheat-based matrix

[EN] The food processing industry generates huge volumes of waste and co-products which still contain valuable compounds. Tiger-nut milk production generates large amounts of a co-product with a high insoluble fibre content, which is interesting as a bioactive component from a nutritional viewpoint. This co-product is formed by two different tissues in composition, particle size and colour terms, so two different flours were obtained from them. Both flours were included in a wheat-based matrix at different substitution levels: 5%, 10% and 20% (d.b). The surface tension of matrices, and the wettability and diffusion of water and oil, were studied. The results showed the matrix s reduced capacity to interact with solvents, principally from the 10% substitution level, with diminished surface tension, and a longer time was needed for both water and oil to wet and diffuse.This study was supported by the Regional Valencian Ministry of Culture, Education and Sport for Scientific and Technological Politics, with the project entitled "Use of non-wheat flours, from co-products of the food industry, to produce bread, cakes and snacks (AICO/2015/107)".Verdú Amat, S.; Barat Baviera, JM.; Alava Pincay, C.; Grau Meló, R. (2017). Effect of tiger-nut (Cyperus esculentus) milk co-product on the surface and diffusional properties of a wheat-based matrix. Food Chemistry. 224:69-77. https://doi.org/10.1016/j.foodchem.2016.12.016S697722