Undernutrition measured by the Mini Nutritional Assessment (MNA) test and related risk factors in older adults under hospital emergency care.

OBJECTIVES: In developed countries, undernutrition affects mostly older adults, worsens with hospitalization, and affects immune response, with higher rates of infection and delayed wound healing-which leads to an increase in hospital stay and health costs. The aim of this study was to assess the prevalence of undernutrition and related risk factors in a sample of older adults who presented at the emergency room (ER) of a university hospital in Spain. METHODS: This was a cross-sectional study of 288 patients ≥70 y of age who were seen at the emergency department at the University Hospital of Valladolid. Variables of nutritional evaluation, including a Mini Nutritional Assessment Test, sociodemographic factors, comorbidities, chronic treatments, frequency of visits to the ER, and destination after hospital discharge were collected. RESULTS: The percentage of undernutrition was 14.9% and the risk for undernutrition was 54.5%. Most patients were able to independently conduct basic activities of daily living (BADLs), lived at home, resided in an urban environment, and had autonomous mobility. The mean body mass index (BMI) was 26.14 ± 4.52 kg/m2. Patients who were dependent on others for BADLs; institutionalized or bedridden; and with hematologic disease, chronic depressive syndrome, polymedication, low hemoglobin or low hematocrit, and hypochromia were associated with a higher prevalence of undernutrition. In the multivariate analysis, for each unit of increase in BMI, patients had 12% lower risk for developing undernutrition, and for each unit of increase in the frequency of ER visits, patients had a 41% higher risk for developing undernutrition. CONCLUSIONS: Older adults who presented to the ER had a high percentage of undernutrition, which is related to sociodemographic factors, comorbidities, polymedication, and biochemical factors. We also found a direct association between the frequency of ER visits and undernutrition, in addition to an inverse relationship with BMI. Detecting undernutrition in an ER may improve health and reduce related complications in older adults.

Características nutricionales y estilo de vida en universitarios / Nutritional characteristics and lifestyle in university students

La obesidad y el estilo de vida característico de nuestra sociedad llevan a los jóvenes a situaciones de potencial riesgo cardiovascular. El objetivo de este estudio fue valorarla situación antropométrica y estilo de vida de una muestra de universitarios. Se realizó una valoración antropométrica completa, incluyendo un análisis por impedancia bioeléctrica (AIB), a 111 estudiantes de último curso de Nutrición Humana y Dietética, así como una encuesta sobre su estilo de vida (actividad física, tabaquismo y consumo de alcohol). Se encontró un dimorfismo sexual en la distribución del peso según la clasificación propuesta por la SEEDO: un 6,4% de mujeres presentaron un peso inferior al saludable (ningún hombre se encontraba en este grupo), mientras que un 27,8% hombres y un 6,5% mujeres estaban en rango de sobrepeso. Un 15,3% de casos presentó un perímetro de cintura excesivo. La masa grasa, hallada por AIB, fue superior en las mujeres. Por otro lado, un 67% de universitarios declararon realizar ejercicio físico habitualmente, un 16,7% se declararon fumadores, y un 55,6% declararon consumo de alcohol de alta graduación. En conclusión, nos encontramos ante una población de sujetos jóvenes y sanos donde, sin embargo, aparece un significativo porcentaje de mujeres en peso inferior al saludable, personas con sobrepeso, fumadores bebedores de alcohol de alta graduación de manera habitual. Estos datos deben poner en aviso de que el grupo de población universitaria está en riesgo de sufrir patologías cardiovasculares en un futuro si no se actúa, y no deben estar olvidados en los planes de promoción de la salud (AU)

Obesity and the lifestyle characteristic of our society lead young people to conditions of potential cardiovascular risk. The aim of this study was to assess the anthropometrical situation and the lifestyle in a sample of university students. A full anthropometrical evaluation was undertaken, including bioelectric impedance analysis(BIA), in 111 students in the last year of Human Nutrition and Dietetics, as well as a lifestyle questionnaire (physical activity, alcohol and cigarette consumption). A sexual dimorphism was found in weight distribution according to the classification proposed by SEEDO: 6.4% of women presented a weight lower than the health recommendations (there no men in this group) where as 27.8% of men and 6.5% of women were in the overweight range. 15.3% of the cases had excessive waist circumference. Fat mass by BIA was higher among women. On the other hand,67% of university students stated to perform regular physical activity, 16.7% stated being cigarette smokers, and 55.6% stated to consume high-grade alcohol. To conclude, we studied a sample population of young and healthy subjects with, however, a significant percentage of women with body weight lower than the healthy standards, over weighed people, and smokers usually taking high-grade alcohol. These data should elicit an alert of the potential cardiovascular risk in the university population if action is not taken. This population should be included in the health promotion plans (AU)

[Nutritional characteristics and lifestyle in university students]. / Características nutricionales y estilo de vida en universitarios.

Obesity and the lifestyle characteristic of our society lead young people to conditions of potential cardiovascular risk. The aim of this study was to assess the anthropometrical situation and the lifestyle in a sample of university students. A full anthropometrical evaluation was undertaken, including bioelectric impedance analysis (BIA), in 111 students in the last year of Human Nutrition and Dietetics, as well as a lifestyle questionnaire (physical activity, alcohol and cigarette consumption). A sexual dimorphism was found in weight distribution according to the classification proposed by SEEDO: 6.4% of women presented a weight lower than the health recommendations (there no men in this group) whereas 27.8% of men and 6.5% of women were in the overweight range. 15.3% of the cases had excessive waist circumference. Fat mass by BIA was higher among women. On the other hand, 67% of university students stated to perform regular physical activity, 16.7% stated being cigarette smokers, and 55.6% stated to consume high-grade alcohol. To conclude, we studied a sample population of young and healthy subjects with, however, a significant percentage of women with body weight lower than the healthy standards, overweighed people, and smokers usually taking high-grade alcohol. These data should elicit an alert of the potential cardiovascular risk in the university population if action is not taken. This population should be included in the health promotion plans.

Tumor submucoso en el fondo del ciego / No disponible

No disponible

[Gastrointestinal stromal tumors (GISTs): clinical aspects]. / Tumores de la estroma gastroinestinal (GIST): aspectos clínicos.

INTRODUCTION: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors in the gastrointestinal tract. One of their features is the expression of the c-KIT/CD117 receptor. AIMS AND METHODS: We will focus on describing the symptoms, clinical studies prior to diagnosis, histologic and immunohistochemical characteristics, as well as the progression of disease in a group of patients. RESULTS: Seventeen cases were diagnosed between December 1999 and April 2005. Mean age of patients was 64.5 (+/-11.9); 47% were women. Tumor location was as follows: 52.9% in the jejunum or ileum, 29.4% were gastric, 11.7% were in the duodenum, and 5.8% were located in the mesentery. Tumor size was 6.0 cm on average (+/-5.0); 47% were asymptomatic, and to a lesser degree caused abdominal pain or digestive bleeding; 94.1% of tumors expressed CD117. Most of them were discovered while performing a laparotomy or ultrasound scan; 94.1% of tumors were removed; 35.2% (6 out of 17) of patients suffering from GIST met consensus criteria for aggressive behavior. Over 25.6 months (+/-22.5) metastasis or tumor relapse occurred in 23.5% (4 out of 17) of patients--those with more frequent high-risk criteria, symptomatic and bigger tumors, and tumors not expressing CD117. The three patients with tumor relapse were prescribed imatinib mesylate. Three patients died because of the tumor, and four from other causes unrelated to GIST. CONCLUSIONS: GIST was diagnosed in around 12 cases per million a year. Its diagnosis was usually an incidental finding during a medical evaluation, and tumors were malignant in nearly one fourth of cases. We can predict its outcome depending on different aspects.

Tumores de la estroma gastrointestinal (GIST): aspectos clínicos / Gastrointestinal stromal tumors (GISTs): Clinical aspects

Introducción: los tumores GIST son los tumores mesenquimales más frecuentes del tubo digestivo. Se caracterizan por la expresión del receptor c-KIT/CD 117. Objetivos y métodos: pretendemos describir las manifestaciones clínicas, las exploraciones que llevan al diagnóstico, los aspectos histológicos e inmunohistoquímicos, la evolución y factores predictores de esta a partir de una serie de pacientes. Resultados: se han diagnosticado 17 casos de GIST entre diciembre de 1999 y abril de 2005. La edad media de los pacientes fue 64,5 años (± 11,9). El 47% eran mujeres. La localización de los tumores por paciente fue: yeyuno-íleon en el 52,9%, gástrica en el 29,4%, duodenal en el 11,7% y mesentérica en el 5,8%. Los tumores medían 6,0 cm (± 5,0). El 47% eran tumores asintomáticos, menos frecuentemente produjeron dolor abdominal o hemorragia digestiva. El 94,1% de los tumores expresaba CD 117. Se diagnosticaron principalmente durante una laparotomía o con ecografía. Se extirparon el 94,1% de los tumores. En el 35,2% (6/17) de los pacientes había criterios de alto riesgo de malignidad según el consenso establecido. A lo largo de 25,6 meses (± 22,5) las metástasis o la recidiva tumoral se dieron en el 23,5% (4/17) de los pacientes y en estos fueron más frecuentes: los criterios de alto riesgo, los tumores sintomáticos, los de mayor tamaño y los que no expresan CD 117. Los tres pacientes con recidiva recibieron imatinib mesilato. Tres pacientes fallecieron por causa del tumor. Otros 4 pacientes fallecieron por otras causas no relacionadas con el GIST. Conclusiones: se diagnosticaron aproximadamente 12 casos por millón de habitantes y año. Su diagnóstico con frecuencia es casual. Son malignos en cerca de la cuarta parte de los casos. Existe la posibilidad de predecir la evolución en función de diferentes aspectos

Introduction: gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors in the gastrointestinal tract. One of their features is the expression of the c-KIT / CD117 receptor. Aims and methods: we will focus on describing the symptoms, clinical studies prior to diagnosis, histologic and immunohistochemical characteristics, as well as the progression of disease in a group of patients. Results: seventeen cases were diagnosed between December 1999 and April 2005. Mean age of patients was 64.5 (± 11.9); 47% were women. Tumor location was as follows: 52.9% in the jejunum or ileum, 29.4% were gastric, 11.7% were in the duodenum, and 5.8% were located in the mesentery. Tumor size was 6.0 cm on average (± 5.0); 47% were asymptomatic, and to a lesser degree caused abdominal pain or digestive bleeding; 94.1% of tumors expressed CD117. Most of them were discovered while performing a laparotomy or ultrasound scan; 94.1% of tumors were removed; 35.2% (6 out of 17) of patients suffering from GIST met consensus criteria for aggressive behavior. Over 25.6 months (± 22.5) metastasis or tumor relapse occurred in 23.5% (4 out of 17) of patients – those with more frequent high-risk criteria, symptomatic and bigger tumors, and tumors not expressing CD117. The three patients with tumor relapse were prescribed imatinib mesylate. Three patients died because of the tumor, and four from other causes unrelated to GIST. Conclusions: GIST was diagnosed in around 12 cases per million a year. Its diagnosis was usually an incidental finding during a medical evaluation, and tumors were malignant in nearly one fourth of cases. We can predict its outcome depending on different aspects

Colitis ulcerosa y anemia hemolítica autoinmunitaria / Ulcerative colitis and autoimmune hemolytic anemia

No disponible

[Study of gastronitestinal transit times with capsule endoscopy]. / Estudio de los tiempos de tránsito gastrointestinal con cápsula endoscópica.

INTRODUCTION: Until the introduction of capsule endoscopy (CE), studies of gastrointestinal transit times were based on indirect data or data obtained with radiographic techniques. We analyzed gastric and intestinal transit times through the images obtained with EC and evaluated the influence of age, sex, body mass index (BMI) and abdominal perimeter on these times. PATIENTS AND METHOD: Of the total number of procedures performed over one year, we reviewed 89 in which CE reached the blind gut. Transit times through the pylorus and the ileocecal valve, as well as a series of clinical and epidemiological characteristics of the patients, were recorded. RESULTS: The mean age of the patients was 59.2 years with a mean BMI of 25.5. Gastric transit times ranged from 0.7 to 171 min (mean 22.6) while small intestine transit times ranged from 91 to 416 min (mean 283.3). No significant associations were found between gastric and intestinal transit times with age, sex, BMI, or abdominal perimeter. A significant negative correlation (p < 0.05) was found between transit time of CE through the stomach with respect to the time taken between the pylorus and the cecal pole. CONCLUSION: CE is a good method to study gastrointestinal transit times directly and could lead to greater knowledge of the pathogenesis of various gastrointestinal entities. Age, sex and nutritional status do not seem to influence intestinal kinetics. In contrast, longer or shorter gastric emptying times have an inverse effect on the transit of CE through the small intestine.

Estudio de los tiempos de tránsito gastrointestinal con cápsula endoscópica / Study of gastronitestinal transit times with capsule endoscopy

Introducción: Hasta la llegada de la cápsula endoscópica (CE), los estudios sobre tiempos de tránsito gastrointestinal se basaban en datos indirectos u obtenidos con técnicas irradiantes. Hemos analizado la duración de los tránsitos gástricos e intestinales a través de las imágenes obtenidas con la CE y valorado la influencia que sobre ellos tienen la edad, el sexo, el índice de masa corporal (IMC) y el perímetro abdominal. Pacientes y método: Revisamos las 89 exploraciones en las que la CE llegó al ciego del total de pruebas realizadas durante un año. Se recogieron los tiempos de paso por el píloro y la válvula ileocecal, así como una serie de características clinicoepidemiológicas de los pacientes. Resultados: La edad media de los pacientes fue de 59,2 años, con un IMC medio de 25,5. Los períodos de vaciamiento gástrico variaron de 0,7 a 171 min (media de 22,6), situándose los del intestino delgado entre 91 y 416 min (media de 283,3). No había relación significativa entre ninguno de ambos tiempos con la edad, el sexo, el IMC ni la cintura. Se evidenció interrelación negativa significativa (p < 0,05) entre la duración del tránsito de la CE por el estómago respecto a lo que tardó en recorrer la distancia entre el píloro y polo cecal. Conclusión: La CE puede constituir un buen método para el estudio de los tiempos de tránsito gastrointestinal de una manera directa. Su conocimiento podría suponer avances en el campo de la etiopatogenia de diversas entidades digestivas. La edad, el sexo o el estado nutricional no parecen influir en la cinética intestinal. Por otra parte, la mayor o menor duración del vaciamiento gástrico sí determina de forma inversa el recorrido de la CE por el intestino delgado

Introduction: Until the introduction of capsule endoscopy (CE), studies of gastrointestinal transit times were based on indirect data or data obtained with radiographic techniques. We analyzed gastric and intestinal transit times through the images obtained with EC and evaluated the influence of age, sex, body mass index (BMI) and abdominal perimeter on these times. Patients and method: Of the total number of procedures performed over one year, we reviewed 89 in which CE reached the blind gut. Transit times through the pylorus and the ileocecal valve, as well as a series of clinical and epidemiological characteristics of the patients, were recorded. Results: The mean age of the patients was 59.2 years with a mean BMI of 25.5. Gastric transit times ranged from 0.7 to 171 min (mean 22.6) while small intestine transit times ranged from 91 to 416 min (mean 283.3). No significant associations were found between gastric and intestinal transit times with age, sex, BMI, or abdominal perimeter. A significant negative correlation (p < 0.05) was found between transit time of CE through the stomach with respect to the time taken between the pylorus and the cecal pole. Conclusion: CE is a good method to study gastrointestinal transit times directly and could lead to greater knowledge of the pathogenesis of various gastrointestinal entities. Age, sex and nutritional status do not seem to influence intestinal kinetics. In contrast, longer or shorter gastric emptying times have an inverse effect on the transit of CE through the small intestine