Resultados del mundo real de la ciclofotocoagulación con láser micropulsado en una población latinoamericana y análisis de los factores asociados con la tasa de éxito / Real-world outcomes of micropulse cyclophotocoagulation in a Latin American population and analysis of the factors associated with the success rate

Objetivo Reportar los resultados de la ciclofotocoagulación transescleral con láser micropulsado en una población latinoamericana con glaucoma refractario en un entorno del «mundo real» y evaluar los factores asociados con éxito a un año de seguimiento. Materiales y métodos Estudio multicéntrico, retrospectivo. Se revisaron los expedientes de pacientes sometidos a ciclofotocoagulación transescleral con láser micropulsado entre septiembre de 2017 y octubre de 2018. El éxito del tratamiento se definió como una presión intraocular de 5 a 21mmHg o una reducción de la presión intraocular del 20% de la basal, con o sin tratamiento médico adicional para glaucoma. Resultados Se incluyeron 83 ojos de 83 pacientes, con un seguimiento promedio de 10,1 ±3,1meses. La presión intraocular y el número de medicamentos para glaucoma disminuyeron significativamente en todas las visitas postoperatorias de una media de 21,9 ±7,6mmHg con 3,8 medicamentos a 13,1 ±3,5mmHg con 2,8 medicamentos a 12meses de seguimiento. La presión intraocular media disminuyó un 40,1% de la basal a los 12meses. La tasa de éxito acumulada fue del 54,5% (IC del 95%: 44-67%) a 12meses de seguimiento. Identificamos una presión intraocular basal más alta como predictor independiente significativo del éxito del tratamiento (p=0,03). Las complicaciones tardías incluyeron 1ojo con edema corneal, 1ojo con inflamación prolongada en cámara anterior y edema macular quístico y 9ojos (11%) con pérdida visual de 2líneas de Snellen o más. Conclusiones La ciclofotocoagulación transescleral con láser micropulsado es un tratamiento eficaz y seguro para pacientes latinoamericanos y puede proporcionar reducciones de la presión intraocular y del número de medicamentos con una sola aplicación a un año de seguimiento. La presión intraocular basal alta fue el predictor más significativo del éxito del tratamiento (AU)

Objective To report the outcomes of micropulse cyclophotocoagulation in a Latin American population with refractory glaucoma in a «real-world» setting and to evaluate the factors associated with success after a one-year follow-up. Materials and methods Retrospective, multicenter study. The medical records of patients who underwent micropulse cyclophotocoagulation between September 2017 and October 2018 were reviewed. Treatment success was defined as an intraocular pressure of 5-21mmHg or a 20% intraocular pressure reduction with or without additional glaucoma medical therapy. Results Eighty-three eyes from 83 patients were included, with a mean follow-up of 10.1 ±3.1months. The intraocular pressure and number of glaucoma medications significantly decreased at all postoperative visits from a mean of 21.9 ±7.6mmHg on 3.8 medications to 13.1 ±3.5mmHg on 2.8 medications at the 12-month follow-up. The mean intraocular pressure decreased 40.1% from baseline at 12months. The cumulative success rate was 54.5% (95% CI: 44%-67%) at 12-month follow-up. We identified a higher baseline intraocular pressure as a significant independent predictor of treatment success (P=.03). Late complications included 1eye with corneal edema, 1eye with prolonged anterior chamber inflammation and cystoid macular edema and 9eyes (11%) with visual loss of 2Snellen lines or more. Conclusions Micropulse cyclophotocoagulation is an effective and safe treatment for Latin American patients and can provide intraocular pressure and medication reductions with a single treatment after a one-year follow-up. A high baseline intraocular pressure was the most significant predictor of treatment success (AU)

Real-world outcomes of micropulse cyclophotocoagulation in a Latin American population and analysis of the factors associated with the success rate.

OBJECTIVE: To report the outcomes of micropulse cyclophotocoagulation in a Latin American population with refractory glaucoma in a "real-world" setting and to evaluate the factors associated with success after a one-year follow-up. MATERIALS AND METHODS: Retrospective, multicenter study. The medical records of patients who underwent micropulse cyclophotocoagulation between September 2017 and October 2018 were reviewed. Treatment success was defined as an intraocular pressure of 5 to 21 mmHg or a 20% intraocular pressure reduction with or without additional glaucoma medical therapy. RESULTS: Eighty-three eyes from 83 patients were included, with a mean follow-up of 10.1 ± 3.1 months. The intraocular pressure and number of glaucoma medications significantly decreased at all postoperative visits from a mean of 21.9 ± 7.6 mmHg on 3.8 medications to 13.1 ± 3.5 mmHg on 2.8 medications at the 12-month follow-up. The mean intraocular pressure decreased 40.1% from baseline at 12 months. The cumulative success rate was 54.5% (95% CI, 44-67%) at 12-month follow-up. We identified a higher baseline intraocular pressure as a significant independent predictor of treatment success (p = 0.03). Late complications included 1 eye with corneal edema, 1 eye with prolonged anterior chamber inflammation and cystoid macular edema and 9 eyes (11%) with visual loss of 2 Snellen lines or more. CONCLUSIONS: Micropulse cyclophotocoagulation is an effective and safe treatment for Latin American patients and can provide intraocular pressure and medication reductions with a single treatment after a one-year follow-up. A high baseline intraocular pressure was the most significant predictor of treatment success.

Actuación ante una lesión percutanea contaminada con sangre / Managemetn of blood-contaminated percutaneous injury

Analizamos en este artículo las normas fundamentales para la prevención de las punciones accidentales por parte de los trabajadores sanitarios, así como los pasos a seguir una vez que se ha producido la punción accidental

In the current paper we have assessed the main guidelines for prevention of accidental puntures by helthcare workers as well s the recommended steps to follow once the punture has occurred

Utilidad de la radiofrecuencia pulsada en el dolor postoracotomía / Usefulness of pulsed radiofrequency in thoracotomy pain

No disponible

Evaluación del riesgo nutricional e instauración de soporte nutricional en pacientes oncológicos, según el protocolo del grupo español de Nutrición y Cáncer / Nutricional risk evaluation and establishment of nutricional support in oncology patients according to the protocol of the spanish nutrition and cancer group

Introducción: El cáncer, los tratamientos que lo acompañan y los síntomas consecuentes que a su vez generan, aumentan en los pacientes el riesgo de sufrir malnutrición. La cual produce un gran deterioro del estado de salud, con el consecuente aumento de complicaciones, disminución de la tolerancia al tratamiento oncológico y una disminución de la calidad de vida del paciente. Por este motivo, un grupo de profesionales sanitarios de diferentes puntos de España se reunieron con el objetivo de mejorar la intervención nutricional en pacientes oncológicos, con el apoyo de la Sociedad Española de Nutrición Básica y Aplicada (SENBA). Metodología: Este grupo multidisciplinar de profesionales elaboró un documento de consenso basado en la literatura y en la experiencia personal, creando un protocolo de evaluación y de intervención nutricional en forma de algoritmos. Se clasifican los pacientes en tres pasos: 1. según el tipo de tratamiento oncológico que reciben, ya sea de tipo curativo o paliativo; 2. riesgo nutricional de la terapia antineoplásica (bajo, mediano, o alto riesgo), y 3. de acuerdo a la Valoración Global Subjetiva-Generada por el paciente (VGS-gp), que clasifica a los pacientes en: A. pacientes con adecuado estado nutricional, B. pacientes con malnutrición o a riesgo de malnutrición y C. pacientes con malnutrición severa. Durante un año el protocolo se puso en marcha en 226 pacientes mayores de 18 años de ambos sexos, escogidos al azar en las consultas externas de Radioterapia Oncológica y Oncología Médica. Resultados: Más de la mitad sufren malnutrición (64%), y este valor se incrementa llegando hasta un 81% en pacientes con tratamiento paliativo. La mayoría de los pacientes tienen tratamiento de intención curativa (83%) y reciben tratamiento oncológico de intensidad moderada o de alto riesgo nutricional (69%). Un 68% de los pacientes tienen algún tipo de dificultad en la alimentación. La media en el porcentaje de pérdida de peso es del 6,64% ± 0,87 (min 0, máx 33%). El 32% de la población presenta cifras de albúmina entre 3 y 3,5 g/dl, existiendo una correlación negativa entre ésta y las dificultades con la alimentación p = 0,001. El IMC no mostró ser un parámetro significativo para detectar malnutrición (sólo un 10% se encontraba por debajo de 19,9 kg/m2), pero tiene una tendencia lineal significativa con las dificultades en la alimentación, de forma tal que a medida que disminuye el IMC aumentan las dificultades p = 0,001. Más de la mitad de la población, requirió recomendaciones dietéticas específicas para el control de los síntomas que dificultaban la ingesta y una tercera parte de la población necesitó la indicación de suplementos nutricionales. Tras la intervención nutricional más de la mitad (60%) mantuvo su peso y una sexta parte lo aumentó. Conclusión: La aplicación de este protocolo es útil, sencillo y podría facilitar la detección de malnutrición en los pacientes oncológicos. Seleccionando a los pacientes que realmente se podrían beneficiar de una intervención nutricional específica, pero debería aplicarse al inicio coincidiendo si fuera posible con el diagnóstico de la enfermedad. El soporte nutricional resulta eficaz en la mayoría de los pacientes (AU)

Introduction: Cancer and its oncological treatment cause symptoms which increase the patients risk to suffer from malnutrition. This affects the patients health status negatively by increasing the number of complications, reducing the tolerance to the oncology treatment and a decrease of the patients quality of life. Motivated by this, a group of health professionals from several spanish regions met with the backing of the Sociedad Española de Nutrición Básica y Aplicada (SENBA) to address strategies to improve the quality of nutritional intervention in cancer patients. Methods: This multidisciplinary group developed a protocol describing nutritional assessment and intervention in form of algorithms based on literature and personal experience. The patients are classified in a three step process: 1. type of their oncology treatment (curative or palliative); 2. nutritional risk of the antineoplastic therapy (low, medium or high risk) and 3. depending on the Subjective Global Assessment patient-generated (SGApg). The patients are classified as: A. patients with adequate nutritional state, B. patients with malnutrition or risk of malnutrition and C. patients suffering from severe malnutrition. During one year, the protocol has been used for 226 randomly chosen female and male patients older than 18 years. They were treated by the Medical and Radiotherapy Oncology outpatient clinic. Results: More than a half of the patients were suffering from malnutrition (64%) increasing up to 81% for patients undergoing palliative treatment. Most of them were treated curatively (83%) and received oncology treatment with moderate or high nutritional risk (69%). 68% of patients were affected by some feeding difficulty. The mean percentage of weight loss has been 6.64% ± 0.87 (min 0%, max 33%). Albumin values of 32% of the patients were between 3 and 3.5 g/dl and negatively correlated with feeding difficulties (p = 0.001). The body mass index (BMI) has not found to be a significant parameter for detecting malnutrition (only in 10% of the patients, the value was below 19.9 kg/m2). But a significant linear tendency when compared to feeding problems could be shown, such that in patients with less feeding problems a higher BMI has been found (p = 0.001). More than a half of the patients required nutritional counselling to control symptoms which made food intake difficult. One third of the patients needed oral nutritional supplementation. Following the nutritional intervention the weight of about 60% of the patients could be maintained and of one sixth it could be increased. Conclusion: The application of this protocol is useful, easy and could help detecting malnutrition in oncology patients. It provides the possibility to select those patients who can benefit from a specific nutritional intervention. If possible, the application of the protocol should be started immediatly after cancer is diagnosed. Nutritional support proves efficient for most of the patients (AU)

Autopercepción de los pacientes con cáncer sobre la relación existente entre su estado nutricional, su alimentación y la enfermedad que padecen / Self-perception of cancer patients on the relationship existing between their nutritional status, their feeding status, and their illness

Introducción: Conocer la opinión de los pacientes oncológicos sobre la importancia que dan a su alimentación, a las dificultades para alimentarse, su imagen, su peso, los cambios ponderales, la relación entre su alimentación y su enfermedad, la relación entre la actividad física y el estado de ánimo y su salud, es básico para buscar alternativas terapéuticas nutricionales que nos lleven a mejorar su calidad de vida y en general su sensación de bienestar. Para ello, es imprescindible conocer la opinión de los pacientes respecto a estos temas. Material y métodos: Se elaboró una encuesta a 131 pacientes. Los pacientes fueron reclutados en el Hospital de día de Oncología Médica, consulta de Oncología Radioterápica y el Servicio de Hospitalización de Oncología Médica. En la encuesta se preguntó de manera sencilla sobre la importancia que dan los pacientes a todos estos aspectos. Ha sido una encuesta de 20 preguntas, dividida en 6 partes: 1) Datos de filiación. 2) Percepción de la enfermedad y la relación de ésta con la alimentación. 3) Percepción de la relación de la actividad física y del estado de ánimo con la alimentación. 4) Tratamientos nutricionales indicados al paciente y la percepción de su efecto sobre la evolución de la enfermedad. 5) Dificultades actuales de alimentación. 6) Demanda de atención nutricional. Resultados: Los pacientes presentaban una edad media de 57 ± 13 años. El 45% correspondían a hombres y el resto mujeres. El 81% vive en el área urbana, y solo el 14% en el área rural. El nivel educativo se clasificó en 5 grupos: sin estudios, estudios básicos, EGB, bachiller superior o estudios universitarios. El 28% poseía estudios básicos, el 19% estudios universitarios, y un 8% no tenía ningún estudio. Con respecto a su ocupación también se clasificó en cinco grupos: hogar, estudiante, sin empleo, empleado y jubilado. Un 33% eran empleados, 29% jubilados y un 34% se ocupaba del hogar. La mayoría de los pacientes , un 74% son conscientes de su enfermedad y la perciben como grave o muy grave. La mayoría de estos pacientes están pendientes de su imagen, de su peso y de los cambios ponderales y los relacionan con su alimentación. El 74% de los pacientes encuentran relación entre su estado nutricional y la actividad física que desarrollan y un 73% lo relacionan con su estado de ánimo. Al menos la mitad de los pacientes perciben su estado de ánimo como decaído. Aunque el 47% manifiesta tener alguna dificultad para alimentarse, sólo el 34% ha recibido alguna información sobre su alimentación, el 26% ha consumido suplementos nutricionales y el 81% continúa consumiendo una dieta sin modificaciones. Las dificultades de alimentación más comunes fueron disminución del apetito 38%, saciedad precoz 32% y náuseas 20%. La intervención nutricional más solicitada por los pacientes es la educación nutricional general y específica para paliar los síntomas asociados a los tratamientos oncológicos. Conclusiones: La mayoría de los pacientes son consientes de la gravedad de su enfermedad y están pendientes de su imagen, peso y cambios ponderales, que asocian con su alimentación. La mayoría de los pacientes encontraron una estrecha asociación entre su estado nutricional, la actividad física que desarrollan y su estado de ánimo. Más de la mitad manifestó tener alguna dificultad para alimentarse pero sólo a un tercio de la población se le había hablado de su alimentación en alguna ocasión. Es evidente que el paciente oncológico necesita de diferentes medidas de intervención nutricional efectivas que contribuyan a mejorar su sensación de bienestar (AU)

Introduction: Knowing the opinion of oncologic patients about the importance they give to their feeding, the difficulties they have with feeding, their body image, weight, and ponderal changes, the relationship between their feeding and their illness, the relationship between their physical activity and their mood and health is essential to look for nutritional therapeutic interventions leading to improvement of quality of life and, in general, the feeling of well being. Thus, it is paramount to know the patients' opinion of these issues. Material and methods: We passed a questionnaire to 131 patients. The patients were recruited from the Day-Hospital of the Medical Oncology and Radiotherapeutic Oncology Departments, and from the Hospitalization Department of Medical Oncology. In the questionnaire, we asked in a simple manner about the importance the patients give to all these issues. This is a 20-item questionnaire, divided into six parts: 1. Vital statistics; 2) perception about the disease and its relationship with feeding; 3) Perception of the relationship between physical activity and mood with feeding; 4) Nutritional therapies prescribed to the patients and their perception on its effect on the disease progression; 5) Current difficulties with feeding; 6) Demand of nutritional care. Results: The patients mean age was 57 ± 13 years. 45% were males, and the remaining females. 81% life in an urban area, and only 14% in a rural area. The educational level was categorized in 5 groups: without education, basic education, elementary school, high school, or college studies. 28% had basic education, and 19% college studies, and only 8% had no education at all. Their occupation was also categorized in five groups: home-keeping, student, unemployed, employed, and retired. 33% were employed, 29% retired, and 34% were home-keepers. Most of the patients (74%) are aware of their illness and perceive it as severe or very much severe. Most of these patients worry about their body image, weight, and ponderal changes, and they relate them with their feeding status. 74% find a relationship between their nutritional status and their physical activity, and 73% relate it with their mood. At least half of the patients perceive their mood as being low. Although 47% manifested having some difficulty for feeding, only 34% had received some information about their diet, 26% had consumed nutritional supplements, and 81% still consumed their diet without any change. The most common difficulties for feeding were decreased appetite (38%), early satiety (32%), and nausea (20%). The nutritional intervention most commonly required by the patients was general and specific nutritional education to alleviate the symptoms associated to oncologic therapies. Conclusions: Most of the patients are aware of the severity of their illness and care about their body image, weight, and ponderal changes, which they associate with their nutrition. Most of the patients find a close relationship between their nutritional status, their physical activity and their mood. More than half of the patients manifest having some difficulty feeding, but only one third of the population has received information about their diet some time. It is clearly shown that oncologic patients need different effective nutritional intervention measures contributing to improve their feeling of well being (AU)

[Nutritional risk evaluation and establishment of nutritional support in oncology patients according to the protocol of the Spanish Nutrition and Cancer Group]. / Evaluación del riesgo nutricional e instauración de soporte nutricional en pacientes oncológicos, según el protocolo del grupo Español de Nutrición y Cáncer.

INTRODUCTION: Cancer and its oncological treatment cause symptoms which increase the patients risk to suffer from malnutrition. This affects the patients health status negatively by increasing the number of complications, reducing the tolerance to the oncology treatment and a decrease of the patients quality of life. Motivated by this, a group of health professionals from several spanish regions met with the backing of the Sociedad Española de Nutrición Básica y Aplicada (SENBA) to address strategies to improve the quality of nutritional intervention in cancer patients. METHODS: This multidisciplinary group developed a protocol describing nutritional assessment and intervention in form of algorithms based on literature and personal experience. The patients are classified in a three step process: 1. type of their oncology treatment (curative or palliative); 2. nutritional risk of the antineoplastic therapy (low, medium or high risk) and 3. depending on the Subjective Global Assessment patient-generated (SGA-pg). The patients are classified as: A. patients with adequate nutritional state, B. patients with malnutrition or risk of malnutrition and C. patients suffering from severe malnutrition. During one year, the protocol has been used for 226 randomly chosen female and male patients older than 18 years. They were treated by the Medical and Radiotherapy Oncology outpatient clinic. RESULTS: More than a half of the patients were suffering from malnutrition (64%) increasing up to 81% for patients undergoing palliative treatment. Most of them were treated curatively (83%) and received oncology treatment with moderate or high nutritional risk (69%). 68% of patients were affected by some feeding difficulty. The mean percentage of weight loss has been 6.64% +/- 0.87 (min 0%, max 33%). Albumin values of 32% of the patients were between 3 and 3.5 g/dl and negatively correlated with feeding difficulties (p = 0.001). The body mass index (BMI) has not found to be a significant parameter for detecting malnutrition (only in 10% of the patients, the value was below 19.9 kg/m2). But a significant linear tendency when compared to feeding problems could be shown, such that in patients with less feeding problems a higher BMI has been found (p = 0.001). More than a half of the patients required nutritional counselling to control symptoms which made food intake difficult. One third of the patients needed oral nutritional supplementation. Following the nutritional intervention the weight of about 60% of the patients could be maintained and of one sixth it could be increased. CONCLUSION: The application of this protocol is useful, easy and could help detecting malnutrition in oncology patients. It provides the possibility to select those patients who can benefit from a specific nutritional intervention. If possible, the application of the protocol should be started immediatly after cancer is diagnosed. Nutritional support proves efficient for most of the patients.

[Self-perception of cancer patients on the relationship existing between their nutritional status, their feeding status, and their illness]. / Autopercepción de los pacientes con cáncer sobre la relación existente entre su estado nutricional, su alimentación y la enfermedad que padecen.

INTRODUCTION: Knowing the opinion of oncologic patients about the importance they give to their feeding, the difficulties they have with feeding, their body image, weight, and ponderal changes, the relationship between their feeding and their illness, the relationship between their physical activity and their mood and health is essential to look for nutritional therapeutic interventions leading to improvement of quality of life and, in general, the feeling of well being. Thus, it is paramount to know the patients' opinion of these issues. MATERIAL AND METHODS: We passed a questionnaire to 131 patients. The patients were recruited from the Day-Hospital of the Medical Oncology and Radiotherapeutic Oncology Departments, and from the Hospitalization Department of Medical Oncology. In the questionnaire, we asked in a simple manner about the importance the patients give to all these issues. This is a 20-item questionnaire, divided into six parts: 1. Vital statistics; 2) perception about the disease and its relationship with feeding; 3) Perception of the relationship between physical activity and mood with feeding; 4) Nutritional therapies prescribed to the patients and their perception on its effect on the disease progression; 5) Current difficulties with feeding; 6) Demand of nutritional care. RESULTS: The patients mean age was 57 +/- 13 years. 45% were males, and the remaining females. 81% life in an urban area, and only 14% in a rural area. The educational level was categorized in 5 groups: without education, basic education, elementary school, high school, or college studies. 28% had basic education, and 19% college studies, and only 8% had no education at all. Their occupation was also categorized in five groups: home-keeping, student, unemployed, employed, and retired. 33% were employed, 29% retired, and 34% were home-keepers. Most of the patients (74%) are aware of their illness and perceive it as severe or very much severe. Most of these patients worry about their body image, weight, and ponderal changes, and they relate them with their feeding status. 74% find a relationship between their nutritional status and their physical activity, and 73% relate it with their mood. At least half of the patients perceive their mood as being low. Although 47% manifested having some difficulty for feeding, only 34% had received some information about their diet, 26% had consumed nutritional supplements, and 81% still consumed their diet without any change. The most common difficulties for feeding were decreased appetite (38%), early satiety (32%), and nausea (20%). The nutritional intervention most commonly required by the patients was general and specific nutritional education to alleviate the symptoms associated to oncologic therapies. CONCLUSIONS: Most of the patients are aware of the severity of their illness and care about their body image, weight, and ponderal changes, which they associate with their nutrition. Most of the patients find a close relationship between their nutritional status, their physical activity and their mood. More than half of the patients manifest having some difficulty feeding, but only one third of the population has received information about their diet some time. It is clearly shown that oncologic patients need different effective nutritional intervention measures contributing to improve their feeling of well being.

Evaluación de la utilidad de un Programa de Educación Nutricional en Trastornos de la Conducta Alimentaria / No disponible

Introducción: La Educación Nutricional busca la modificación de la conducta alimentaria hacia patrones más saludables y debe formar parte del tratamiento de los TCA. Objetivo: Determinar el efecto de un programa de EN sobre el estado nutricional y el patrón alimentario de un grupo de pacientes con TCA que siguen con el protocolo habitual de seguimiento en consulta de Nutrición y de Salud Mental. Material y métodos: Se incluyeron 22 parientes (sólo un hombre), que recibieron Educación Nutricional individual con visitas semanales/quincenales por 6 meses, llevadas a cabo por una Dietista. La edad media 24±-725 años. La distribución por diagnóstico fue: Anorexia Nerviosa (AN) 54,5%t Bulimia Nerviosa (BN) 2713%, Trastorno Alimentario No Específico (TANE) 13,6% y Trastorno por Atracón (TA) 4,5%. La media del tiempo de evolución desde el diagnóstico fue de 6±5 años. Los pacientes completaban el cuestionario EAT26 (Eating Altitudes Test-26) en la primera consulta y tras recibir el programa de educación nutricional. Resultados: Tras los 6 meses del programa, disminuyó significativamente el número de vómitos (de 6,51-10 v. s. 1325 1-5,8 /semana p=07002) y atracones en AN purgativa y BOU (315±6 0, 75±2 /semana p= 0.001). Aumentó significativamente el consumo de lácteos 69=0,00), verduras (p=0,021), cereales (p-0,008) y aceite (p=0,063). Inicialmente un 123% consumía por lo menos 3 de los 6 grupos de alimentos dentro del rango recomendado, al final lo hizo el 77% (p=0,002). Al inicio un 70% de las pacientes realizaba menos de 4 comidas, tras la educación este porcentaje se redujo al 30% 69=0,000). Inicialmente un 54% consumió un número incompleto de platos, cifra que se redujo49133% (p= 01001). Aumentaron las !Coal. consumidas (1088 ±-630 v. s. 13231-417, p=0,013) y el porcentaje cubierto por hidratos de carbono (4815 vs. 54%, p=0,023), también aumentó significativamente el consumo de: P2 Jg, Cal K, 1, 01 822 Pirídoxina, vit E y Ácido ;cólico (p<01005). El incremento ponderalmedio fue en ANR: 4,3 kg (41! 7±517 v.s. 46±4, 8), en ANF: BN y TA-NE los valores se mantuvieron estables, tampoco hubo cambios significativos en elpliegue PIcipital y circunferencia muscular del brazo. El valor medio del cuestionario EAT26 fue inicialmente 20±12,9 (Máximo 56, Mínimo 3), tras los 6 meses fue de 271-13,5 (Máximo 50, Mínimo 9), diferencias altamente significativas (p=0,001), lo que evidencia cambios en la sintomatología de los pacientes muy positivos tras la implementación del programa. También hubo diferencias significativas en el análisis del cuestionario por escalas. Conclusiones: Los programas de educación nutricional llevados a cabo por profesionales cualificados y expertos, deben formar parte del tratamiento de los TCA, junto al seguimiento médico y psicológico y dentro del marco de la interdisciplina y el trabajo en equipo (AU)

Introduction: The Eating Disorders-Nutritional Education Program has the purpose to achieve healthier habits, modifying the eating behaviour; and, it should take part of Eating Disorders treatment. Objectives: to determinate the efficacy of a Nutritional Education Program in nutritional status and the eating pattern in a group of patients diagnosed of Eating Disorders. Material and methods: it was included 22 patients (1 man), that received individual Nutritional Education with weekly/fortnightly appointments along 6 months, carried out by a dietician. The mean age of the sample was 24±7.5 years old and their diagnosis were: Anorexia Nervosa (AN) 54.5%, Bulimia Nervosa (B(V) 27.3%, Eating Disorder Not Otherwise Specified (EDNOS) 13.6% and Binge Eating Disorder (BED) 4.5%. The mean evolution time from the diagnosis was 6±5 years. The patients filled up the EAT26 questionnaire (Eating Attitudes Test-26) either in the first appointment and at the end of the Nutritional Education Program. Results: After 6 months there was significantly reduction in the vomiting episodes (from 6.5±10 vs. 1.25 ±5.8 /week, p=0.002) and bin-ge episodes in binge-purging AN and BN (from 3.5±6 v.s. 0.75±2, p= 0.001). There was a significant improvement in: intake of dairy food (p=0.00), vegetables (p=0.021), cereals (p=0.008) and oil (p=0.063). At the be-ginning, 23% consumed at least 3 of the 6 groups within the recommended range, but at the end was 77% (p=0.002) did it. The percentage of subjects that ate fess than 4 meals per day reduced from 70% to 30% after the Education Program (p=0.000). Moreover, before this Program, 54% consumed incomplete number of meal (a three course meal was considered nor-mal), but at the end, this number was reduced to 33% (p= 0.001). The total energy intake and the carbohydrate percentage increased from 1088 ±630 v. s. 1323±417 ( 13=0.013) and from 48.5 to 54% (p.0.023) respectively. Furthermore, the intake of following micronutrients improved significantly: P, Mg, Ca, K, Vii 82, Piridoxina, vit E and Folic Acid (p<0,005). The mean of increased weight was 4.3 kg (41.7±5.7 vs. 46±4.8) in AN pure restricting subtype, while in the AN binge-purging subtype, BN and EDNOS did not change. Neither skin-fold thickness nor mid-arm circumference were significantly different from the beginning. The mean score of EAT26 questionnaire was 20±12.9 (Maximum 56, Minimum 3), when this study started, and after 6 months the score was 27±13.5 (Maximum 50, Minimum 9). Because of this important difference (p=0.001), is possible to believe in a significant improvement of symptoms of this patients after the Program. There were also significantly differences in the evaluation of the questionnaire by scales. Conclusions: The Nutritional Education Pro-gram carried on by qualified and expert professionals must take part of Eating Disorders treatment, along with medical and psychological monitoring and within the interdisciplinary basis of working in a multiprofessional team (AU)