Anemia in inflammatory bowel disease.

Anemia is a frequent extraenteric complication of inflammatory bowel disease (IBD, Crohn's disease and ulcerative colitis). A systematic review of the literature shows that the overall prevalence of anemia ranges from 8.8% to 73.7% but differs whether in a setting of Crohn's disease or ulcerative colitis. A disabling complication of IBD, anemia worsens the patient's general condition and quality of life, and increases hospitalization rates. Different factors, including vitamin B12 and folic acid deficiency, bone marrow suppression secondary to drug therapy, autoimmune hemolytic anemia and the coexistence of myelodysplastic syndromes are involved in the pathogenesis of anemia in IBD. The main types of anemia in IBD are iron deficiency anemia and anemia accompanying chronic diseases. Correct diagnostic definition of anemia is a fundamental step in guiding the choice of therapeutic options, since the co-presence of different pathogenetic factors may sometimes require a more complex treatment plan. A review of anemia in IBD, its pathogenetic features, epidemiology, diagnosis and therapy based on evidence from recent studies is the focus of this article.

[Diabetic food competition. Another way of teaching]. / Concurso de comida para diabéticos. Otra forma de educar.

OBJECTIVE: To employ a different and appetizing method of food education. DESIGN: A descriptive, crossover, observational study. SETTING: Las Fuentes Norte Health Centre, Zaragoza, jointly with a civic centre in the neighbourhood. PARTICIPANTS: 54 people out of a population of 492,521 (over 15). One was excluded and 21 dishes were chosen. INTERVENTION: Composing posters with a day's complete menu, including one of the dishes chosen in each menu. Choice of the three best dishes presented. RESULTS: 18.8% of the dishes selected were proposed by diabetics (with a mean of 387.22 +/- 150.72 calories, SD 171.95, with 30.74% proteins, 25.59% lipids and 43.65% CH). 24.5% were proposed by carers (mean of 378.1 +/- 103.86 calories, SD 118.65, with 30.89% proteins, 31.11% lipids and 37.99% CH). 30% were proposed by members of diabetics' families (mean of 197.43 mame 149.33 calories, SD 152.38, with 36.3% proteins, 20.07% lipids and 43.61% CH). 26.5% of dishes bore no relationship to this disease (mean of 422.15 +/- 148.09 calories, SD 199.91 and 31.15% proteins, 34.23% lipids and 34.6% CH), with no statistical significance between the different groups. Using the data of the means calculated as a basis, we obtained a meal of 1,141.3 calories with 29.3% proteins, 29.6% lipids and 41.1% CH. CONCLUSIONS: Combining the results in one meal would not only give a high amount of calories, but a high proportion of proteins, mainly at the expense of CH.