Situación actual de la nutrición clínica en la red de hospitales públicos de Castilla y León / Nutritional situation in public hospitals of Castilla and Leon

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[Cost-effectiveness of individualized enteral nutrition by a nutrition support team in laryngectomized cancer patients]. / Coste-efectividad de la nutrición enteral individualizada por un equipo de soporte nutricional en pacientes laringectomizados por neoplasia.

The purpose of this study was to evaluate the effectiveness of a Nutritional Support Team (NST) in the control and follow-up of enteral nutrition (EN) in patients subjected to laryngectomy as a result of neoplasia. The study was performed on two groups of patients (A and B) who had been admitted into the Otorhinolaryngological Department, and who required EN by nasogastric tube during the postoperative period. Group A consisted of 20 patients in whom EN was based on standard guidelines, with a daily intake of 11.1 g of Nitrogen and 2.000 kcals. Group B included 23 patients who received EN individually, using NST with a daily intake of Nitrogen of between 8 and 21 g, and energy intake of between 2.000 and 3.000 kcals. The total cost of nutrition was calculated using the following partial costs: diet, administration, laboratory analysis and NST head responsible for follow-up of Group B. Individualized EN was more effective in nutritional terms than a standard diet in all patients. Using this form of treatment, positive Nitrogen balance were achieved, levels of seric albumin were maintained as well as weight, and complications were reduced. The average cost of nutrition per patient in Group B was 46.258 pesetas and in Group A, 43.963 pesetas. However, in the latter Group, there was an average additional weight loss of 4 kg per patient, and an increase in cost effectiveness ratio of 573 pesetas in weight gained in Group B compared to Group A.

[Liver disease in toxic oil syndrome. Clinical and enzymatic course]. / Hépatopathie de la maladie par huile toxique. Evolution clinique et enzymatique.

One-hundred and fifty-nine patients intoxicated with adulterated oil in the province of Salamanca, Spain, were followed-up for 2 years from the onset of the syndrome, in 1981. Four alcoholic patients were excluded from the study. In the remaining 155 patients the liver involvement at the onset took different forms. It was acute in 12 (7%), with jaundice and/or hepatomegaly associated with cytolysis and/or cholestasis; 21 patients (13%) had evidence of cytolysis and/or cholestasis without clinical symptoms, and 29 (18%) only showed a rise in gamma-glutamyltranspeptidase with normal transaminase and alkaline phosphatase levels. Liver enlargement and/or jaundice subsided within 1 month in the 12 patients with clinical symptoms. However, high gamma-glutamyltranspeptidase levels persisted in 4 of them and in 5 of the 21 patients with laboratory abnormalities only. At the end of the study, this enzyme remained elevated in 6 and 7 patients respectively of these two groups and in 5 of the 29 patients with no other abnormality than a rise in gamma-glutamyltranspeptidase.