Control de calidad en nutrición parenteral neonatal, empleando como método validado el análisis bioquímico / Quality control in neonatal parenteral nutrition, using biochemical analysis as a validated method

Objetivos: El objetivo de este estudio es describir el método empleado como control de calidad en las nutriciones parenterales de neonatos en un hospital de tercer nivel, así como realizar un análisis estadístico de los resultados del mismo.Material y métodos: En nuestro centro se realiza un análisis bioquímico de los niveles de glucosa, potasio y calcio de todas las nutriciones parenterales neonatales como método de control de calidad. Dicho análisis se realiza mediante técnicas previamente validadas. Se evaluaron todas las nutriciones parenterales neonatales elaboradas durante el periodo comprendido entre julio de 2018 y noviembre de 2019. Todas las mezclas analizadas contenían lípidos. Para el análisis estadístico de los resultados se consideró un ±10% sobre la concentración teórica como margen de aceptación.Resultados: Se analizaron 950 mezclas y se obtuvieron las rectas de regresión lineal para establecer la correlación entre el valor teórico y real de los componentes analizados.Conclusiones: Destaca la importancia que tiene el establecimiento de un control de calidad de las nutriciones parenterales neonatales, para la detección y prevención de errores durante la preparación de las mismas y previamente a su dispensación. (AU)

Objectives: We aimed to describe the method used as neonatal parenteral nutrition quality control in a third level hospital, as well as to carry on a statistical analysis of its results.Methods: In our center, a biochemical analysis of glucose, potassium and calcium levels of all neonatal parenteral nutrition is performed as a quality control method. This analysis is carried out using previously validated techniques. All neonatal parenteral nutrition prepared during the period between July 2018 and November 2019 were evaluated. All the mixtures analyzed contained lipids. For the statistical analysis of the results, ±10% of the theoretical concentration was considered as the acceptance margin.Results: 950 mixtures were analyzed and linear regression lines were obtained to establish the correlation between the theoretical and real value of the analyzed components.Conclusions: In conclusion, the importance of establishing quality control of neonatal parenteral nutrition is highlighted, for the detection and prevention of errors during their preparation and prior to their dispensing. (AU)

Ergonomic assessment of a new hand tool design for laparoscopic surgery based on surgeons' muscular activity.

Laparoscopic surgery techniques are customarily used in non-invasive procedures. That said traditional surgical instruments and devices used by surgeons suffer from certain ergonomic deficiencies that may lead to physical complaints in upper limbs and back and general discomfort that may, in turn, affect the surgeon's skills during surgery. A novel design of the laparoscopic gripper handle is presented and compared with one of the most used instruments in this field in an attempt to overcome this problem. The assessment of the ergonomic feature of the novel design was performed by using time-frequency analysis of the surface electromyography (sEMG) signal during dynamic activities. Singular Spectrum Analysis (SSA) was used to decompose the sEMG signal and extract the median frequency of each muscle to assess muscle fatigue. The results reveal that using the proposed ergonomic grip reduces the mean values of the muscle activity during each of the proposed tasks. The novel design also improves the ease of use in laparoscopic surgery as it minimises high-pressure contact areas, reduces large amplitude movements and promotes a neutral position of the hand, wrist and forearm. Furthermore, the SSA method for time-frequency analysis provides a powerful tool to analyse a prescribed activity in ergonomic terms. The proposed methodology to assess muscle activity during surgery activities may be useful in the selection of surgical instruments when programming extended procedures, as it provides an additional selection criterion based on the surgeon's biomechanics and the proposed activity.

Resistive Switching and Charge Transport in Laser-Fabricated Graphene Oxide Memristors: A Time Series and Quantum Point Contact Modeling Approach.

This work investigates the sources of resistive switching (RS) in recently reported laser-fabricated graphene oxide memristors by means of two numerical analysis tools linked to the Time Series Statistical Analysis and the use of the Quantum Point Contact Conduction model. The application of both numerical procedures points to the existence of a filament connecting the electrodes that may be interrupted at a precise point within the conductive path, resulting in resistive switching phenomena. These results support the existing model attributing the memristance of laser-fabricated graphene oxide memristors to the modification of a conductive path stoichiometry inside the graphene oxide.

Spinach consumption ameliorates the gut microbiota and dislipaemia in rats with diet-induced non-alcoholic fatty liver disease (NAFLD).

Non-alcoholic fatty liver disease (NAFLD) is defined as the accumulation of fat in liver cells, which causes serious health consequences. Animal and human studies suggest that the gut microbiota plays a role in the pathogenesis of NAFLD. Here, we investigated whether spinach consumption could ameliorate high-fat-diet-induced disturbances in certain intestinal bacterial groups and products derived from their metabolism, such as short-chain fatty acids (SCFAs) and microbial phenolic catabolites. Attention is also paid to blood lipids and glucose. In the study, a rat model of high-fat-diet-induced NAFLD was used. There were six experimental groups: NC (normal diet), NB (normal diet + 2.5% spinach), NA (normal diet + 5% spinach), HC (high-fat diet), HB (high-fat diet + 2.5% spinach) and HA (high-fat diet + 5% spinach). The rats consumed these diets for five weeks, and after that, they were sacrificed and plasma, urine, intestinal content, faeces and liver samples were taken. Biochemical parameters were analyzed in plasma, phenolic catabolites were quantified in the faeces, urine, plasma and liver by UPLC-ESI-MS/MS, and the analysis of the microbiota and SCFAs in the intestinal content was performed by qPCR and GLC. Consumption of a high-fat diet caused NAFLD and dislipaemia and altered the gut microbiota and the pattern of SCFAs and phenolic gut microbial catabolites. Supplementation with spinach partially ameliorated some alterations induced by the high-fat diet, in particular by increasing the Lactobacillus counts, reducing the fasting glucose and total and LDL-cholesterol and preventing excess liver cholesterol accumulation, thereby improving the values of the steatosis biomarkers.

Design of Semirigid Wearable Devices Based on Skin Strain Analysis.

Nowadays, both usability and comfort play a key role in the development of medical and wearable products. When designing any device that is in contact with the human body, the mechanical behavior of the embraced soft tissue must be known. The unavoidable displacement of the soft tissue during motion may lead to discomfort and, thus, the removal of the wearable product. This paper presents a new methodology to design and test a wearable device based on the measurement of the dynamic skin strain field. Furthermore, from this field, the anatomical lines with minimum strain (lines of nonextension (LoNEs)) are calculated to design the structural parts of the wearable device. With this new criterion, the resulting product is not only optimized to reduce the friction in skin-device interface, but fully personalized to the patient's morphology and motion. The methodology is applied to the design of an ankle-foot wearable orthosis for subjects with ankle dorsiflexors muscles weakness due to nervous system disorders. The results confirm that the use of LoNEs may benefit the design of products with a high interaction with the skin.

Cognitive performance of people with traumatic spinal cord injury: a cross-sectional study comparing people with subacute and chronic injuries.

STUDY DESIGN: Cross-sectional study. OBJECTIVES: To assess the impact of spinal cord injury (SCI) on cognitive function in individuals with subacute and chronic SCI. SETTING: National Hospital for SCI patients (Spain). METHODS: The present investigation was designed to determine the nature, pattern, and extent of cognitive deficits in a group of participants with subacute (n = 32) and chronic (n = 34) SCI, using a comprehensive battery of reliable and validated neuropsychological assessments to study a broad range of cognitive functions. Twenty-seven able-bodied subjects matched to the groups with SCI for age and educational level formed the control group. RESULTS: The neuropsychological assessment showed alterations in the domain of attention, processing speed, memory and learning, executive functions, and in recognition in participants with SCI. The prevalence of cognitive dysfunction in the chronic stage was also confirmed at the individual level. The comparison of the neuropsychological assessment between the groups with subacute and chronic SCI showed a worsening of cognitive functions in those with chronic SCI compared to the group with subacute SCI. CONCLUSIONS: In participants with SCI, cognitive dysfunctions are present in the subacute stage and worsen over time. From a clinical point of view, we confirmed the presence of cognitive dysfunction that may interfere with the first stage of rehabilitation which is the most intense and important. Moreover, cognitive dysfunction may be important beyond the end of the first stage of rehabilitation as it can affect an individual's quality of life and possible integration to society.

A study of the prebiotic-like effects of tomato juice consumption in rats with diet-induced non-alcoholic fatty liver disease (NAFLD).

Gut microbiota may play a role in the pathogenesis of NAFLD. We investigated whether tomato juice consumption for 5 weeks could ameliorate high-fat diet-induced alterations in certain intestinal bacterial groups and products arising from their metabolism (short-chain fatty acids and microbial phenolic catabolites). For this, we used a rat model with NAFLD induced by a high-fat diet, involving four experimental groups: NA (standard diet and water), NL (standard diet and tomato juice), HA (high-fat diet and water) and HL (high-fat diet and tomato juice). The onset of NAFLD impacted the gut microbiota profile, reducing the abundance of Bifidobacterium and Lactobacillus and increasing that of Enterobacteriaceae. Also, reduced concentrations of propionate, butyrate and phenolic catabolites and an increased acetate to propionate (Ac : Pr) ratio were observed. Tomato juice intake partially ameliorated high-fat diet-induced disturbances, particularly by increasing Lactobacillus abundance and diminishing the Ac : Pr ratio, suggesting a potential improvement of the metabolic pattern of NAFLD.

Composición corporal en escolares de primaria y su relación con el hábito nutricional y la práctica reglada de actividad deportiva / Composição corporal em estudantes do ensino fundamental e sua relação com o hábito nutricional na prática regular de atividade física / Body composition in elementary school and its relationship with nutritional habits and formal practice sports activity

Objetivos. Presentar las relaciones encontradas en el primer año del estudio longitudinal de 6 años de duración entre la composición corporal, frecuencia de consumo de alimentos, nivel de actividad física y prevalencia de sobrepeso y obesidad en niños y niñas de 6 años. Método. Mensualmente se midió el peso y la talla, se calculó el índice de masa corporal (IMC) y se pasó un cuestionario de frecuencia de consumo de alimentos mediante el test Kidmed de adherencia a la dieta mediterránea y el cuestionario PAQ-C de actividad física. A partir de los datos de IMC se obtuvieron los valores correspondientes a la ecuación de regresión de Cole y los percentiles según las tablas del CDC de Atlanta y de la Fundación Orbegozo. Semestralmente se realizó una bioimpedancia monofrecuencia (BIA), cineantropometría completa y medición del gasto energético durante 2 días consecutivos con un calorímetro ArmBand. Resultados. Los principales hallazgos de este primer año son los siguientes: los datos obtenidos por BIA y por cineantropometría muestran una buena correlación, los datos del cuestionario Kidmed no muestran correlación con los datos antropométricos ni con el IMC, los datos del PAQ-C y la calorimetría muestran un mayor nivel de actividad en niños que en niñas incluso al corregirlo por la masa corporal total. Conclusiones. Las diferencias entre los 3 criterios de diagnóstico de obesidad son patentes, de forma que nuestros datos globales de sobrepeso oscilarían entre el 29 y el 44,9% para los niños o entre el 20,3 y el 32,4% para las niñas, según el criterio utilizado (AU)

Objetivos: Apresentar as relações encontradas no primeiro ano do estudo longitudinal de 6 anos de duração entre a composição corporal, frequência de consumo de alimentos, nível de atividade física e prevalência de sobrepeso e obesidade em meninos e meninas de 6 anos. Método: O peso e a altura foram medidos mensalmente, calculando o índice de massa corporal (IMC) e passou-se um questionário de frequência de consumo de alimentos mediante o teste Kidmed de adesão a dieta mediterrânea e o questionário PAQ-C de atividade física. A partir dos dados de IMC obtiveram-se os valores correspondentes da ação de regressão de Cole e os percentis segundo as tabelas do CDC de Atlanta e da Fundação Orbegozo. Semestralmente foram realizadas biopedância monofrequência (BIA), cineantropometria completa e medição do gasto energético durante 2 dias consecutivos com um calorímetro ArmBand. Resultados: Os principais achados desse primeiro ano foram os seguintes: os dados obtidos por BIA e por cineantropometria mostram uma boa correlação, os dados do questionário Kimed não mostram correlação com os dados antropométricos nem com o IMC, os dados do PAQ-C e da calorimetria mostram um maior nível de atividade em meninos que em meninas, inclusive depois de corrigido pela massa corporal. Conclusões: As diferenças entre os 3 critérios de obesidade são notórias, de forma que nossos dados globais de sobrepeso oscilam entre 29 e 44,9% para meninos e entre 20,3 e 32,4% para as meninas, segundo o critério utilizado

Objectives. To present the results of a longitudinal study of six years with a group of children throughout the primary stage of education based on the relationships between body composition, frequency of food consumption, level of physical activity and the prevalence of overweight and obesity in 6 year-old children. Method. Monthly weight and height were measured, body mass index (BMI) was calculated and two questionnaires were administered: The Kidmed questionnaire of adherence to the Mediterranean diet for the frequency of food consumption, and the PAQ -C questionnaire for physical activity. Data corresponding to the regression equation of Cole and percentiles according to the tables of CDC Atlanta and the Foundation Orbegozo values were obtained from the BMI. Twice a year, a single frequency bioelectrical impedance (BIA) and a full kinanthropometry were assessed and measurement of energy expenditure was conducted over two consecutive days with an ArmBand calorimeter. Results. The main findings of this first year are as follows: Data obtained by BIA and kinanthropometry show a good correlation. The questionnaire data shows that KIDMED does not correlate with anthropometric data or BMI. Data from the PAQ- C and calorimetry show a higher level of activity in boys than in girls even when adjusted to the total body mass. Conclusions. The differences between the three diagnostic criteria of obesity are obvious, so that our global data overweight range between 29 and 44.9% for boys and between 20.3 and 32.4% for girls, depending on the criteria used (AU)

Paresia del vi par como primera manifestación de la DM Tipo 2 / VI cranial nerve palsy as a debut of DM type 2

Caso Clínico. Varón de 56 años sin antecedentes personales de interés, que acude a urgencias por diplopia brusca en la mirada horizontal. A la exploración oftalmológica sólo destaca una restricción a la levoversión en el ojo izquierdo (OI), sin alteraciones en la visión biomicroscopía o fundoscopia. La exploración neurológica y el TAC eran normales. No refería otros síntomas, pero en la analítica observamos una glucemia esporádica de 298 mg/dl y una HbA1c 11,7%, criterio diagnóstico de diabetes (DM) tipo 2, de la que fue tratado. Discusión. La DM es una enfermedad metabólica con alto riesgo cardiovascular, en especial para aquellos enfermos con factores de riesgo asociados. Mientras que la DM tipo 1 presenta sintomatología desde su comienzo diagnóstico, la tipo 2 puede pasar desapercibida. Las complicaciones agudas a destacar para estos enfermos son la cetoacidosis y el estado hiperglucémico hiperosmolar. Sin embargo la neuropatía periférica se trata de un infrecuente síntoma debut (AU)

Case Report. 56 year old male with no relevant past medical history. He came to the emergency department with sudden horizontal dyplopia. Ophthalmological examination only revealed a levoversion restriction in his left eye (OS), with no changes in his vision acuity, slit lamp examination or funduscopy. Neurological examination and CT scan were normal. He had no other symptoms, but the analytical observed glucose levels of 298 mg / dl and HbA1c 11.7%, which is a diagnostic criteria for diabetes (DM) type 2, and so he was treated. Discussion. DM is a metabolic disease with high cardiovascular risk, especially for those patients with associated risk factors. While diabetes type 1 has symptoms just after diagnosis, onset type 2 may go unnoticed. Acute complications are ketoacidosis and hyperosmolar hyperglycemic state, however peripheral neuropathy is an uncommon symptom debut (AU)

Detection of key factors affecting lycopene in vitro accessibility.

On the basis of a Plackett-Burman experimental design for a resolution IV level obtained via a foldover strategy, the effect of 11 factors on lycopene in vitro accessibility was investigated. The selected factors were thermal treatment (X1), olive oil addition (X2), gastric pH (X3), gastric digestion time (X4), pepsin concentration (X5), intestinal pH (X6), pancreatin concentration (X7), bile salts concentration (X8), colipase addition (X9), intestinal digestion time (X10), and intestinal digestion speed (X11). Tomato passata was used as a natural source of lycopene. Samples were collected after gastric and intestinal digestion, and from the micellar phase, to quantify the (all-E)-lycopene and its (Z)-isomers by HPLC. Except for X3, X6, X7, and X11, the other factors studied explained lycopene in vitro accessibility, mainly regarding intestinal digestion, with R(2) values ≥ 0.60. Our results showed that the accessibility of lycopene is influenced by the conditions applied during in vitro intestinal digestion.

Effect of the addition of tomato paste on the nutritional and sensory properties of mortadella.

The aim of this study was to evaluate the effect of the addition of tomato paste (TP) to sausage mortadella in order to improve the nutritional properties and reduce the lipid oxidation associated with the content of lycopene. First, three different mortadellas without colourant were made with 2, 6 and 10% of TP, to optimise technologically the amount of this ingredient. Then, commercial product was compared with 10% of TP mortadella; both products were made with natural colourant. After a proximate analysis only total protein decreased due to the addition of TP. Lycopene content in mortadella and the total antioxidant activity were proportional to the amount of TP added. The presence of TP provided stability during meat grinding, cooking and storage of mortadella by reducing the lipid oxidation. In addition, TP provided yellowness and softness; however, when TP was added together with red colourant, the redness remained constant in the mortadella without effects on the consumer overall acceptance.

Glutaminase isoenzymes as key regulators in metabolic and oxidative stress against cancer.

Cancer cells require a robust supply of reduced nitrogen to produce nucleotides, non-essential amino acids and a high cellular redox activity. Glutamine provides a major substrate for respiration as well as nitrogen for the production of proteins, hexosamines, and macromolecules. Therefore, glutamine is one of key molecules in cancer metabolism during cell proliferation. The notion of targeting glutamine metabolism in cancer, originally rationalized by the number of pathways fed by this nutrient, has been reinforced by more recent studies demonstrating that its metabolism is regulated by oncogenes. Glutamine can exert its effects by modulating redox homeostasis, bioenergetics, nitrogen balance or other functions, including by being a precursor of glutathione, the major nonenzymatic cellular antioxidant. Glutaminase (GA) is the first enzyme that converts glutamine to glutamate, which is in turn converted to alpha-ketoglutarate for further metabolism in the tricarboxylic acid cycle. Different GA isoforms in mammals are encoded by two genes, Gls and Gls2. As each enzymatic form of GA has distinct kinetic and molecular characteristics, it has been speculated that the differential regulation of GA isoforms may reflect distinct functions or requirements in different tissues or cell states. GA encoded by Gls gene (GLS) has been demonstrated to be regulated by oncogenes and to support tumor cell growth. GA encoded by Gls2 gene (GLS2) reduces cellular sensitivity to reactive oxygen species associated apoptosis possibly through glutathione-dependent antioxidant defense, and therefore to behave more like a tumor suppressor. Thus, modulation of GA function may be a new therapeutic target for cancer treatment.

Initial immunosuppression with or without basiliximab: a comparative study.

BACKGROUND: Following liver transplantation, acute kidney injury (AKI) and chronic kidney disease occur in 20%-50% and 30%-90% of patients, respectively. Basiliximab, a chimeric monoclonal antibody, is highly effective to prevent rejection in organ transplant recipients, particularly among patients with renal dysfunction who benefit from delayed introduction of calcineurin inhibitors. OBJECTIVE: The objective of this study was to measure the immunosuppressive effect of basiliximab and its impact on renal failure, lengths of hospital and intensive care unit (ICU) stays and prevalence of infection. METHODS: From January 2010 through December 2011, we performed a controlled, nonrandomized study comparing two different immunosuppressive regimens: Group I, 36 transplantation on 34 patients, tacrolimus and corticosteroids de novo with mycophenolate mofetil in cases of renal failure; and Group II, 33 transplantation in 33 patients, corticosteriods and mycophenolate mofetil de novo with basiliximab on day 0 and day 4, and inception of tacrolimus on day 3. RESULTS: Basiliximab patients (Group II) showed a significantly lower incidence of renal failure requiring replacement therapy (3.03% vs 25%; P = .014). The incidence of acute cellular rejection episodes treated with corticosteriod boluses was also significantly lower (3.03% vs 25%; P = .014). Bacterial, fungal, and cytomegalovirus infection rates were lower in Group II, although the differences were not significant. Similarly, Group II patients had an insignificantly shorter average stay in the hospital (25.9 vs 40.06 days) and the ICU (5.9 vs 8.17 days). CONCLUSIONS: Basiliximab administration with delayed introduction of calcineurin inhibitors may be an effective strategy to reduce post-liver transplantation AKI requiring renal replacement therapy.

[Nutrition acute pancreatitis]. / Nutrición en pancreatitis aguda.

Acute pancreatitis is a common and potentially severe disease where nutritional support does affect its development in a way it may be considered a treatment in severe cases. These include around 20% of patients and present mortality rates of 8%-39%. In mild acute pancreatitis patients are prescribed nil per os at admission and advance diet in a progressive manner the following days. Although early introduction of diet has proven to shorten the length of stay, it is still not clear when and how to introduce diet. Severe disease is a hypercatabolic situation which often appears in already malnourished patients. Early enteral nutrition has shown a significative benefit over parenteral nutrition in terms of infection rates, hyperglycemia and mortality rates. This benefit may be related to a decrease in bacterial intestinal translocation. Nasoyeyunal tube feeding is the preferred site, but there are trials supporting nasogastric tubes, a more feasible election. The following lines offer an up to date review of nutritional management in acute pancreatitis, trying to answer in a clear and practical way to the most frequent problems arising in the day to day management of this disease.