[Metoclopramide as a risk factor for postprandial hyperglycemia in type 2 diabetes]. / Metoclopramida, factor de riesgo para hiperglucemia postprandial en diabetes tipo 2.

UNLABELLED: Diabetes mellitus is a pathology that has widely spread througout the world in the past decades. Postprandial hyperglycemia plays an important role in the progress of the disease due to the fact that increases the risk for cardiovascular events. This study's aim was to determine if the use of intravenous metoclopramide in patients with Diabetes Mellitus increases the postprandial glycemia. MATERIAL AND METHODS: A cohort of patients hospitalized with type 2 diabetes mellitus. Patients were classified as exposed (metoclopramide 10 mg IV) and not exposed, and glycemia preprandial and postprandial at 30, 60 and 120 minutes was measured. RESULTS: There were 80 patients in each group, and in both groups the general characteristics were homogeneous. The postprandial glycemia in the exposed group was higher at 30, 60, 90 and 120 minutes, being only statistically significant at 120 minutes postprandial (p = < 0,001). CONCLUSIONS: In conclusion, the use of intravenous metoclopramide is a risk factor to develop postprandial hyperglycemia in diabetic patients.

Metoclopramida, factor de riesgo para hiperglucemia postprandial en diabetes tipo 2 / Metoclopramide as a risk factor for postprandial hyperglycemia in type 2 diabetes

La diabetes mellitus (DM) es una patología que ha crecido ampliamente a nivel mundial en las ultimas décadas. La hiperglucemia postprandial (HP) ha tomado importancia en los últimos años, ya que se ha visto se relaciona de manera directa con un aumento en el riesgo de eventos cardiovasculares. A la fecha, no se ha determinado la asociación entre el empleo de metoclopramida y los niveles de glucemia postprandial. Material y métodos: Se realizó un estudio de tipo cohorte, con objeto de determinar si la metoclopramida es factor de riesgo para hiperglucemia postprandial. Se incluyeron pacientes diabéticos tipo 2, se catalogó a los pacientes en expuestos, aquellos manejados con metoclopramida preprandial 10 mg intravenosa (IV) y no expuestos, se determinó glucemia preprandial y 30, 60, 90 y 120 minutos postprandiales. Resultados: 80 pacientes por grupo se incluyeron siendo sus características basales similares. Las glucemia postprandial fue más elevada en aquellos tratados con metoclopramida que sin esta (p = < 0,001)). Conclusiones: La metoclopramida IV es un factor de riesgo para hiperglucemia postprandial en pacientes con diabetes mellitus tipo 2 (AU)

Diabetes mellitus is a pathology that has widely spread througout the world in the past decades. Postprandial hyperglycemia plays an important role in the progress of the disease due to the fact that increases the risk for cardiovascular events. This study's aim was to determine if the use of intravenous metoclopramide in patients with Diabetes Mellitus increases the postprandial glycemia. Material and methods: A cohort of patients hospitalized with type 2 diabetes mellitus. Patients were classified as exposed (metoclopramide 10 mg IV) and not exposed, and glycemia preprandial and postprandial at 30, 60 and 120 minutes was measured. Results: There were 80 patients in each group, and in both groups the general characteristics were homogeneous. The postprandial glycemia in the exposed group was higher at 30, 60, 90 and 120 minutes, being only statistically significant at 120 minutes postprandial (p = < 0,001). Conclusions: In conclusion, the use of intravenous metoclopramide is a risk factor to develop postprandial hyperglycemia in diabetic patients (AU)

[Weight estimation in Mexican elderly outpatients from antropometric measures from the SABE Study]. / Estimación del peso en adultos mayores a partir de medidas antropométricas del Estudio SABE.

INTRODUCTION: The weight is an anthropometric parameter routinely used in ambulatory and hospital settings, and takes its importance, because often there are clinical conditions that impede it´s taking in a traditional scale. There are equations to estimate weight. However, they have not been designed for Mexican ambulatory patients. OBJECTIVE: To develop an equation to estimate weight in Mexican ambulatory patients from the Study of Health, Well Being and Aging, corresponding to Mexico city an surrounded area. MATERIAL AND METHODS: The database of the Study of Health, Well Being and Aging of Mexico City was used, and adults of 60 years and older, who completed the anthropometric measures were included. Two groups of datasets were crated though random numbers, one for the design and the other for the validation of the equation. The equation was obtained from the first database and cross-validated in the second. RESULTS: The equations obtained were: (0.67)* (Knee height)+(0.46)* (Mid-arm circumference)+(0.60)* (waist circumference)+(0.38)* (hip circumference)+(0.53)* (calf circumference)-(0.17)* (Age in years)-80.01 and (0.69)* (Knee height)+(0.61)* (Mid-arm circumference)+(0.17)* (waist circumference)+(0.45)* (hip circumference)+(0.58)* (calf circumference)-(0.24)* (Age in years)-55.9 in men and women respectively. The correlation coefficients were 0.94 y 0.92 (p<0.001 for both). The differences between the real and estimated values were not significant. CONCLUSION: The equations developed in our analysis were confident and can be employed to estimate weight in ambulatory elderly. It is needed to test its validity in clinical scenarios were it is not possible to weight patients directly in the rest of the Mexican republic and adjust to specific populations.

Estimación del peso en adultos mayores a partir de medidas antropométricas del Estudio SABE / Weight estimation in Mexican elderly outpatients from antropometric measures from the SABE Study

Introducción: El peso es un parámetro antropométrico de uso rutinario tanto a nivel ambulatorio como hospitalario y toma su trascendencia, ya que a menudo surgen condiciones clínicas que impiden su obtención en una báscula tradicional. Existen ecuaciones para estimar el peso. Sin embargo, éstas no han sido diseñadas para pacientes mexicanos ambulatorios. Objetivo: Diseñar una ecuación para estimar el peso en población mexicana, a partir de la base de datos del estudio Salud, Bienestar y Envejecimiento (SABE), correspondiente a la ciudad de México y área metropolitana. Material y métodos: Se empleó la base de datos del estudio SABE de la ciudad de México y área metropolitana, en el cual se incluyeron adultos de 60 y más años de la zona metropolitana de la ciudad de México, que completaron en su totalidad la evaluación antropométrica. Se creó un grupo para diseño de la ecuación y otro grupo para su validación. Ambos grupos se seleccionaron al azar a través de números aleatorios. Se estimó la ecuación a partir de medidas antropométricas en un grupo y se validó en el segundo. Resultados: Las ecuaciones obtenidas fueron: (0,67)* (Altura de la Rodilla) + (0,46)* (Circunferencia del Brazo) + (0,60)* (Circunferencia de la cintura) + (0,38)* (Circunferencia de la Cadera) + (0,53)* (Perímetro de la Pantorrilla) - (0,17)* (Edad en años) - 80,01 y (0,69)* (Altura de la Rodilla) + (0,61)* (Circunferencia del Brazo) + (0,17)* (Cintura) + (0,45)* (Cadera) + (0,58)* (Perímetro de la Pantorrilla) - (0,24)* (Edad en años) -55,9 en hombres y mujeres respectivamente. Los coeficientes de correlación correspondientes fueron 0,94 y 0,92 (p menor a 0,001 para ambas). Las diferencias entre los valores reales y estimados no fueron significativas. Conclusión: Las ecuaciones diseñadas en nuestro análisis son confiables y se pueden emplear para estimar el peso a nivel ambulatorio. Es necesario probar su utilidad en la práctica clínica donde no se puede obtener el peso por medición directa en toda la república mexicana y así ajustarlas a cada población en particular (AU)

Introduction: The weight is an anthropometric parameter routinely used in ambulatory and hospital settings, and takes its importance, because often there are clinical conditions that impede it´s taking in a traditional scale. There are equations to estimate weight. However, they have not been designed for Mexican ambulatory patients. Objective: To develop an equation to estimate weight in Mexican ambulatory patients from the Study of Health, Well Being and Aging, corresponding to Mexico city an surrounded area. Material and methods: The database of the Study of Health, Well Being and Aging of Mexico City was used, and adults of 60 years and older, who completed the anthropometric measures were included. Two groups of datasets were crated though random numbers, one for the design and the other for the validation of the equation. The equation was obtained from the first database and cross-validated in the second. Results: The equations obtained were: (0.67)* (Knee height) + (0.46)* (Mid-arm circumference) + (0.60)* (waist circumference) + (0.38)* (hip circumference) + (0.53)* (calf circumference) - (0.17)* (Age in years) - 80.01 and (0.69)* (Knee height) + (0.61)* (Mid-arm circumference) + (0.17)* (waist circumference) + (0.45)* (hip circumference) + (0.58)* (calf circumference) - (0.24)* (Age in years) - 55.9 in men and women respectively. The correlation coefficients were 0.94 y 0.92 (p < 0.001 for both). The differences between the real and estimated values were not significant. Conclusion: The equations developed in our analysis were confident and can be employed to estimate weight in ambulatory elderly. It is needed to test its validity in clinical scenarios were it is not possible to weight patients directly in the rest of the Mexican republic and adjust to specific populations (AU)

Factores de riesgo para las anormalidades de enzimas hepáticas de la nutrición parenteral en un hospital de referencia de México / Risk factors for abnormal liver function tests of parenteral nutrition in a referral hospital in Mexico

Introducción: Las anormalidades en las pruebas de funcionamiento hepático (APFH) y las complicaciones Hepáticas (CH) de la Nutrición Parenteral (NP) son frecuentes y a menudo multifactoriales. Aún no han sido evaluados dichos factores de riesgo en población mexicana adulta. Objetivo: Determinar si la dosis de lípidos prescrita de mayor a 1 g/kg es factor de riesgo para las anormalidades en pruebas de función hepática (APFH) de la NP. Material y métodos: Cohorte que incluyo pacientes mayores de 15 años de edad y excluyó aquellos que fueron manejados en la unidad de cuidados intensivos o con anormalidades en las enzimas hepáticas previo al inicio de NP. Los grupos expuesto (GE) y no expuesto (GNE) fueron aquellos que recibieron más de un gramo y un gramo o menos por kilo de peso de lípidos respectivamente. Las APFH fueron definidas como un incremento mayor al 50% de lo normal de AST, ALT, FA o Bilirubina Total. Resultados: La incidencia de APFH fue de 20 (47,6%) y15 (41,6%), en los GE y GNE respectivamente (RR 1,14IC 95% 0,69-1,88; p = 0,59). El patrón de daño hepático más común fue el colestásico, seguido del mixto y finalmente el hepatocelular. La dosis de lípidos prescrita de más de 1 g/kg, no se asoció con el desarrollo de CH de la APFH. A mayor dosis de proteínas menor frecuencia de APFH Conclusión: La dosis de lípidos prescrita de más de 1g/kg, no se asoció con el desarrollo de APFH de la NP en nuestra población. Estos hallazgos requieren ser confirmados en Ensayos clínicos (AU)

Introduction: the abnormalities in liver function tests (LFTs) and liver complications (LC) from parenteral nutrition (PN) are common and usually multi-factorial. These factors have not yet been assessed in the adult Mexican population. Objective: To determine whether the dose prescribed >1 g/kg is a risk factor for the abnormalities in liver function tests (LFTs) from PN. Material and methods: Cohort study including patients older than 15 years and excluding those managed at the intensive care unit or with abnormalities in liver enzymes before the start of PN. The exposed and non-exposed groups were those receiving > 1 g of lipids per kg of bodyweight or < 1 g/kg, respectively. LFTs were defined as an increase higher than 50% of the normal range for AST,ALT, AF or total bilirrubin. Results: the incidence of LFTs abnormalities was 20(47.6%) and 15 (41.6%) in the exposed and non-exposed groups, respectively (RR 1.14 95% IC: 0.69-1.88; p =0.59). The most frequent liver damage pattern was cholestatic, followed by the mixed pattern and then hepatocellular. The dose of prescribed lipids > 1 g/kg was not associated with the development of LC from LFTs abnormalities. The higher the dose of proteins the lower the frequency of LFTs abnormalities. Conclusion: The dose of lipids prescribed >1 g/kg was not associated with the development of LFTs abnormalities from PN in our sample population. These findings should be confirmed in clinical trials (AU)

Anormalidades significativas en pruebas de función hepática secundariasa nutrición parenteral y su asociación con mortalidad / Significant liver function tests abnormalities related to parenteral nutrition and its association with mortality

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[Risk factors for abnormal liver function tests of parenteral nutrition in a referral hospital in Mexico]. / Factores de riesgo para las anormalidades de enzimas hepáticas de la nutrición parenteral en un hospital de referencia de México.

INTRODUCTION: the abnormalities in liver function tests (LFTs) and liver complications (LC) from parenteral nutrition (PN) are common and usually multifactorial. These factors have not yet been assessed in the adult Mexican population. OBJECTIVE: To determine whether the dose prescribed > 1 g/kg is a risk factor for the abnormalities in liver function tests (LFTs) from PN. MATERIAL AND METHODS: Cohort study including patients older than 15 years and excluding those managed at the intensive car unit or with abnormalities in liver enzymes before the start of PN. The exposed and non-exposed groups were those receiving > 1 g of lipids per kg of body weight or < 1 g/kg, respectively. LFTs were defined as an increase higher than 50% of the normal range for AST, ALT, AF or total bilirrubin. RESULTS: the incidence of LFTs abnormalities was 20 (47.6%) and 15 (41.6%) in the exposed and non-exposed groups, respectively (RR 1.14 95% IC: 0.69-1.88; p = 0.59). The most frequent liver damage pattern was cholestatic, followed by the mixed pattern and then hepatocellular. The dose of prescribed lipids > 1 g/kg was not associated with the development of LC from LFTs abnormalities. The higher the dose of proteins the lower the frequency of LFTs abnormalities. CONCLUSION: The dose of lipids prescribed >1 g/kg was not associated with the development of LFTs abnormalities from PN in our sample population. These findings should be confirmed in clinical trials.