New laparoscopic assisted percutaneous gastrostomy. Description and comparison with others gastrostomy types.

INTRODUCTION: Gastrostomy feeding tube insertion has become a common procedure as it enables patients who require long term enteral feeding. Conventional surgical gastrostomies were the only way of gaining enteral access in patients in which it is not possible to pass an endoscope or a nasogastric tube required for endoscopic or radiological gastrostomies, and in patients in which certain anatomical abnormalities contraindicate performing these techniques. As conventional surgical gastrostomies are associated with high morbidity, especially gastric leakage around the tube, percutaneous laparoscopic assisted gastrostomy (PLAG) may be a better way to gain enteral access. MATERIAL AND METHODS: Observational study of a prospective cohort of 224 patients on whom a gastrostomy was performed for nutritional support between January 2009 and October 2015 at Virgen del Rocío University Hospital in Seville. The types of gastrostomies carried out were: percutaneous endoscopic gastrostomy (PEG, n = 106), percutaneous radiological gastrostomy (PRG, n = 89), conventional surgical gastrostomy, Open Stamn or Laparoscopic Janeway (SG, n = 9) and percutaneous laparoscopic assisted gastrostomy (PLAG, n = 20), technique that we describe in detail. Short and long term complications are described. RESULTS: Many more complications were seen in the conventional gastrostomy group than in the other three groups, especially leakage of gastric content around the tube, with burning and irritation of the skin (66% compared with 2.83% in PEG and 0% in PLAG and PRG). The group with the highest proportion of patients completely free of complications was PLAG (75%), whilst in the conventional surgical gastrostomy group, no patient was completely free of complications. CONCLUSIONS: We found lower complication rate in PLAG than any other technique. We believe that PLAG could be preferred technique for patients on whom it is not possible to perform PEG or PRG, as it is safe and easy.

[Impact of a brief educational intervention about nutrition and healthy lifestyles to school students given by a healthcare provider]. / Impacto de una intervención educativa breve a escolares sobre nutrición y hábitos saludables impartida por un profesional sanitario.

INTRODUCTION: Obesity is an important health concern worldwide. Spain has one of the highest pediatric obesity rates among European countries, and they are increasing, which mandates the development of innovative strategies aimed at reverting this trend and decreasing the health problems related to obesity and the considerable waste of resources foreseen for the upcoming years. OBJECTIVES: To determine if an educational intervention from a health professional would yield an additional benefit in the acquisition of knowledge on nutrition. A second objective was to determine the prevalence of weight excess as well as the lifestyle habits in a sample of school students. MATERIAL AND METHODS: Analytical, interventional, random, longitudinal, pilot study in a sample of 107 students aged 9-15 years. The weight, height, adherence to the Mediterranean diet, level of physical activity and sedentarism, and knowledge on feeding and healthy lifestyles were estimated through a questionnaire. In an intervention group (54 students) a short educational intervention was carried out by a health professional. Two months later, the knowledge on diet and lifestyle habits was reassessed in all the students. RESULTS: After the educational intervention, the students in the intervention group had better knowledge regarding feeding and healthy lifestyles than the control students, and this difference was statistically significant. CONCLUSIONS: the additional educational activities on healthy lifestyles within the scholar program given by a health professional may represent an additional benefit to the strategies aimed at decreasing pediatric obesity in our setting.

Introducción: La obesidad es un importante problema de salud a nivel mundial. España tiene una de las cifras más altas de obesidad infantil de Europa y están aumentando, lo que obliga a desarrollar estrategias innovadoras que reviertan esta tendencia y disminuyan los problemas de salud asociados a la obesidad y el enorme consumo de recursos que se prevé en los años venideros. Objetivos: Determinar si una intervención educativa por parte de un profesional sanitario aporta un beneficio adicional en la adquisición de conocimientos en materia de nutrición. Secundariamente determinar prevalencia de exceso de peso así como los hábitos de vida en una muestra de escolares. Material y métodos: Estudio piloto longitudinal analítico y de intervención aleatorizado por bloques realizado en una muestra de 107 alumnos de entre 9-15 años. Se estimaron mediante encuesta peso, talla, adherencia a la Dieta Mediterránea, grado de actividad física y sedentarismo, y conocimientos en alimentación y hábitos de vida saludables. Sobre un grupo de intervención (54 alumnos) se realizó una intervención educativa breve por parte de un profesional sanitario. Dos meses después se reevaluaron los conocimientos de alimentación y hábitos de vida saludables en todos los alumnos. Resultados: Después de la intervención educativa los alumnos del grupo de intervención poseen más conocimientos relativos a alimentación y hábitos de vida saludables que los alumnos del grupo control, y esta diferencia es estadísticamente significativa. Conclusiones: Las actividades educativas de apoyo dentro del programa escolar de estilos de vida saludable por parte de profesionales sanitarios pueden suponer un beneficio adicional en las estrategias encaminadas a disminuir la obesidad infantil en nuestro medio.