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1.
Endocrinol. diabetes nutr. (Ed. impr.) ; 66(9): 555-562, nov. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-184378

RESUMO

Introducción: La prevalencia de la desnutrición relacionada con la enfermedad en el hospital varía del 20 al 50%. La utilización de herramientas de cribado debe ser el primer paso en la prevención y el tratamiento de los pacientes en riesgo de desnutrición o desnutridos. Objetivos: Implantar un método de cribado nutricional al ingreso en el ámbito de un hospital terciario. Métodos: La Unidad de Nutrición elaboró un protocolo de detección precoz del riesgo nutricional y eligió el NRS 2002 como herramienta de cribado. El protocolo fue aprobado por la Comisión de Protocolos y Procedimientos del hospital y difundido en la intranet. El NRS 2002 se incluyó en el programa de prescripción de dietas para su realización por parte del personal de enfermería de las unidades de hospitalización y como sistema de comunicación directo con la Unidad de Nutrición. Se diseñaron 3 fases para la implantación: fase de pilotaje, fase de implantación y fase de consolidación. Resultados: En la fase de pilotaje se implantó el NRS 2002 en 2 unidades de hospitalización para monitorizar el software. La fase de implantación se realizó en las mismas unidades y se verificaron todos los protocolos de actuación relacionados con el mismo. La fase de consolidación consistió en ir ampliando sucesivamente las unidades de hospitalización con el protocolo implantado. Conclusiones: La implantación de un cribado nutricional al ingreso hospitalario es un proceso largo y complejo, con la implicación de muchos estamentos. El programa informático ha posibilitado que la realización del mismo sea rápido, sencillo y automatizado, y que el resultado del cribado llegue inmediatamente al personal de enfermería de la unidad de Nutrición y se activen los protocolos de actuación de la misma


Introduction: Prevalence of disease-related malnutrition in hospitals ranges from 20%-50%. Use of nutritional screening tools should be the first step in the prevention and treatment of patients at risk of malnutrition and/or undernourished. Aims: To implement a nutritional screening tool at admission to a tertiary hospital. Methods: The nutrition unit prepared a protocol for early detection of nutritional risk and selected the NRS 2002 as screening tool. The protocol was approved by the hospital committee of protocols and procedures and disseminated through the intranet. NRS 2002 was included in the diet prescription software to be implemented by the nursing staff of the hospital wards and as a direct communication system with the nutrition unit. Three phases were designed: pilot phase, implementation phase, and consolidation phase. Results: The pilot phase, NRS 2002 was implemented in 2 hospital units to monitor software. The implementation phase was carried out in the same units, and all action protocols related to it were verified. The consolidation phase consisted of sequential extension of the protocol to the other hospital units. Conclusions: Implementation of nutritional screening at hospital admission is a long and complex process that requires involvement of many stakeholders. Computer software has allowed for a rapid, simple, and automatic process, so that the results of the screening are immediately available to the nursing staff of the nutrition unit and activate the nutritional protocols when required


Assuntos
Humanos , Idoso , Desnutrição/prevenção & controle , Desnutrição/terapia , Diagnóstico Precoce , Hospitais Universitários , Desnutrição/diagnóstico , Programas de Triagem Diagnóstica/normas , Indicadores de Morbimortalidade , Tempo de Internação
2.
Endocrinol. diabetes nutr. (Ed. impr.) ; 66(8): 472-479, oct. 2019.
Artigo em Espanhol | IBECS | ID: ibc-184140

RESUMO

Antecedentes y objetivo: El tratamiento con antineoplásicos orales tipo inhibidores de tirosina quinasa (ITK) es novedoso, y por ello se conoce poco sobre cómo afectan al estado nutricional (EN), la ingesta dietética, la calidad de vida, y su influencia sobre la supervivencia. Este estudio pretende aportar información sobre estos componentes, para dirigir las recomendaciones nutricionales futuras. Pacientes y método: Estudio prospectivo y observacional en adultos que inician ITK, donde se valoró el EN mediante el cuestionario de valoración subjetiva global generada por el paciente (VSG-GP), medidas antropométricas, parámetros bioquímicos e ingesta dietética (Recuerdo de 24 h). La calidad de vida se estudió con EORTC QLQ-C30. El análisis estadístico empleó pruebas no paramétricas y la supervivencia se analizó mediante curvas de Kaplan-Meier y log-rank. Resultados: El 21,7% de la muestra presentó desnutrición moderada según VSG-GP; el 74,2% mostró pérdida de peso moderada a los 6 meses, aunque ningún paciente tuvo un IMC < 18,5 kg/m2. Los pacientes moderadamente desnutridos presentaron menor supervivencia a los 4 años del diagnóstico (log-rank = 0,015). El 44,4% realizó una ingesta energética inferior a las recomendaciones ESPEN 2017 y ningún paciente cubrió requerimientos proteicos (1,5 g proteína/kg peso) durante el seguimiento. Una peor puntuación en la escala global de salud del EORTC QLQ-C30 se relacionó con peor EN. Conclusiones: El tratamiento con ITK no parece afectar de manera importante el EN y la calidad de vida a los 6 meses de seguimiento. Se debe prevenir la desnutrición, mediante un consejo nutricional individualizado, pues se relaciona con menor supervivencia


Background and objective: Treatment with oral antineoplastic agents known as tyrosine kinase inhibitors (TKIs) is new and, thus, little is known about their impact on nutritional status (NS), dietary intake, quality of life, and survival. The aim of this study was to provide information on these components in order to guide future nutritional recommendations. Patients and method: A prospective, observational study in adults who start treatment with TKIs, in whom NS was assessed using the Patient-Generated Subjective Global Assessment (PG-SGA), anthropometric measures, biochemical parameters, and dietary intake (24-hour dietary recall). The EORTC QLQ-C30 was used to assess quality of life. Nonparametric tests were used in statistical analysis, and survival was analyzed using Kaplan-Meier and log-rank curves. Results: Of the overall sample, 21.7% had moderate malnutrition according to PG-SGA, and 74.2% moderate weight loss at 6 months, but no patient had BMI < 18.5 kg/m2. Patients with moderate malnutrition had lower survival at four years of diagnosis (log-rank = 0.015). Energy intake was lower than recommended by the ESPEN 2017 congress, and no patient covered the protein requirements (1.5 g protein/kg weight) during follow-up. A worse score on the global health scale of the EORTC QLQ-C30 was related to worse NS. Conclusions: Treatment with TKIs does not appear to have a significant impact on NS and quality of life after 6 months of follow-up. Malnutrition should be prevented through individualized nutritional advice because it is related to shorter survival


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Sobrevivência , Neoplasias/epidemiologia , Estado Nutricional , Proteínas Tirosina Quinases/antagonistas & inibidores , Qualidade de Vida , Neoplasias/dietoterapia , Estudos Prospectivos , Inquéritos e Questionários , Antropometria , Dietoterapia , Dietética
3.
Endocrinol. diabetes nutr. (Ed. impr.) ; 66(7): 425-433, ago.-sept. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-182862

RESUMO

Objetivos: Elaborar un registro de situación de los Servicios y Unidades de Endocrinología y Nutrición (S°EyN) del Sistema Nacional de Salud (SNS) y valorar sus recursos asistenciales para desarrollar, a partir de los resultados obtenidos, propuestas de políticas de mejora en los S°EyN. Material y métodos: Estudio descriptivo transversal de los pacientes atendidos en los S°EyN en hospitales generales de agudos del SNS en 2016. Se utilizaron datos obtenidos mediante RECALSEEN 2017, una encuesta «ad hoc» diseñada específicamente para este fin y de las altas dadas por los S°EyN registradas en el CMBD del SNS (2015). Resultados: De un total de 125 hospitales generales de agudos de más de 200 camas instaladas del SNS español, se han obtenido 88 respuestas de los S°EyN, que representan el 70%. El 47% de los S°EyN que respondieron eran servicios y el 31% secciones. El promedio de endocrinólogos por S°EyN era de 7,4±4,4, siendo la tasa media de endocrinólogos por cada 100.000 habitantes de 2,3±1. Las actividades asistenciales más relevantes eran la consulta (promedio de 12,3 primeras consultas por mil habitantes y año), hospital de día (mediana de 2.000 sesiones/año) e interconsulta hospitalaria (mediana de 900 interconsultas/año). El 83% de los S°EyN incorporaban una Unidad de Nutrición Clínica. La dotación de dietistas, técnicos en nutrición y bromatólogos en las Unidades de Nutrición Clínica era baja. En relación con la gestión de la calidad se detectó un amplio margen de mejora; solamente un 35% de los S°EyN tenían responsable de calidad y el 38% había implantado una gestión por procesos para aquellos más frecuentemente atendidos por la unidad. Existen notables diferencias en estructura, recursos y actividad de los S°EyN entre Comunidades Autónomas. Conclusiones: La encuesta RECALSEEN 2017 es útil para el análisis de los S°EyN. La notable variabilidad hallada en los indicadores de estructura, actividad y gestión probablemente indica relevantes diferencias y, por tanto, un amplio margen de mejora


Objectives: To elaborate a diagnosis of the situation regarding the assistance in the Services and Units of Endocrinology and Nutrition (S°EyN) of the National Health System of Spain (SNHS) and to develop, based on the results obtained, proposals for improvement policies in the S°EyN. Material and methods: Cross-sectional descriptive study of the patients treated in the S°EyN departments of acute general hospitals of the SNHS in 2016. Data were obtained through RECALSEEN 2017, an "ad hoc" survey designed specifically for this purpose, and the Minimum Basic Data Set of discharges given by the S°EN of the SNHS (2015). Results: 88 responses of S°EyN have been obtained forma total of 125 acute general hospitals of more than 200 beds installed in the SNHS (70% answers). 47% of the S°EyN respondents were services and 31% sections. The average of endocrinologists by S°EyN was 7.4±4.4, and the average rate of endocrinologists per 100,000 inhabitants was 2.3±1. The most relevant care activities were the consultation (average of 12.3 first consultations per thousand inhabitants and year), day hospital (median of 2,000 sessions/year) and in-hospital consultations (median of 900 in-hospital consultations/year). 83% of S°EyNhad a Clinical Nutrition Unit. The number of dietitians, nutrition technicians and nutritionists in the Clinical Nutrition Unit was low. In relation to quality management, a large margin for improvement was detected; only 35% of S°EyN had a responsible of quality and 38% had implemented process management for those most frequent processes in the unit. There were notable differences in structure, resources and activity of S°EyN between Autonomous Communities. Conclusions: RECALSEEN 2017 survey is a useful tool for the analysis of S°EyN. The remarkable variability found in the structure, activity and management indicators probably indicates significant differences and, therefore, a wide margin for improvement


Assuntos
Humanos , Unidades Hospitalares , Assistência ao Paciente/estatística & dados numéricos , Sistemas Nacionais de Saúde/organização & administração , Sistema de Registros/normas , Endocrinologistas/estatística & dados numéricos , Política de Saúde , Estudos Transversais , Gestão da Qualidade , Análise Estatística , Serviço Hospitalar de Nutrição/organização & administração , Serviço Hospitalar de Nutrição/normas , Endocrinologistas/organização & administração , Endocrinologistas/provisão & distribução
4.
Diabetes Res Clin Pract ; 156: 107824, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31446112

RESUMO

AIMS: To analyze the trends on diabetes mellitus (DM) healthcare management in Spain. METHODS: Retrospective observational study between January 1st 2007 and 31th December 2015 with DM as the principal diagnosis. The main clinical outcome measures were all-cause, in-hospital mortality and 30-day readmissions. We also analyze three Prevention Quality Indicators (PQI) for DM. RESULTS: The number of hospitalization episodes decreased significantly as well as the frequentation rate and average length of stay (Incidence Rate Ratio [IRR] = 0.963, p < 0.001; 0.91, p < 0.001 and 0.986, p < 0.001, respectively). Crude in-hospital mortality and readmissions rates and risk-standardized in-hospital mortality rates (RSMR), however, remained stable (IRR = 0.988, p = 0.073; IRR = 1.003, p = 0.334 and IRR = 0.997, p = 0.116, respectively). A relevant variability in RSMR, both at hospital (Median Odds Ratio 1.49) and regional level, was found. High volume hospitals (≥105 DM discharges at year) showed better outcomes. High variability was also found in PQI indicators al regional level. CONCLUSION: The present analysis shows an improvement in hospitalizations related to DM in Spain in the period 2007-2015. There was also a decrease in the frequentation rate and in the average length of stay. These findings are probably explained by quality improvements in the healthcare management of the DM at the ambulatory level. However, there were important differences in the management of diabetic inpatients both at the hospital and the regional level.

7.
Endocrinol. diabetes nutr. (Ed. impr.) ; 66(6): 346-352, jun.-jul. 2019. mapas, graf, tab
Artigo em Espanhol | IBECS | ID: ibc-182850

RESUMO

Objetivo: El objetivo de este trabajo es evaluar los cambios en la formación en nutrición clínica y dietética de los residentes de endocrinología y nutrición en los últimos 10 años. Metodología: En el Curso Anual de Actualización en Nutrición Clínica y Dietética que organiza la SEEN se realiza una encuesta de formación a los residentes desde 2006. Se recogen los datos descriptivos de los 10 últimos años. Resultados: Todos los hospitales con docencia acreditada en endocrinología y nutrición disponen de una unidad de nutrición, con dependencia en el 94,5% de los servicios de endocrinología y nutrición. Mientras que en 2006 un 13,3% de residentes necesitaban hacer su rotación en nutrición en otro hospital, en 2018 todos tenían en su hospital recursos suficientes para su formación. Un 62,6% comienzan su formación en nutrición en su tercer año de residencia. La duración de la rotación se ha ido incrementando y está en 6 meses para el 66% de los residentes. Un 41,9% de los residentes considera que su rotación en nutrición debe ser superior a 6 meses. La formación en dietética es la que más consideran que necesitan ampliar. Un 72,5% de los residentes participan en protocolos de estudios o publicaciones, frente a solo un 27,9% en 2009. Existe aún un porcentaje de residentes entre el 10,1 y el 19% que califican como insuficiente su formación global en nutrición. Conclusión: Los residentes consideran que la formación global en nutrición ha mejorado en estos 10 años, aunque aún existen posibilidades de optimización en áreas como dietética


Objective: Our aim is to assess the changes in clinical nutrition and dietetics education of the residents in endocrinology and nutrition for the last 10 years. Methods: During the yearly update course in Clinical Nutrition and Dietetics held by SEEN, a survey about medical training is conducted since 2006. Descriptive data for the last 10 years are reported. Results: Every hospital accredited for medical training in endocrinology and nutrition has a unit of nutrition, depending on endocrinology and nutrition departments in 94.5%. While 13.3% of the residents required a different hospital for training in nutrition in 2006, all of them had enough resources in their own hospital in 2018. The training started in their third year of residency in 62.6%. The rotation has been increasing its length and now it lasts 6 months for 66% of the residents. 41.9% of the residents think it should be longer than 6 months. Education in dietetics should be extended the most. The residents take part in study protocols or publications in 72.5%, against only 27.9% in 2009. There is still a percentage of 10.1% to 19% of the residents grading their training in nutrition as insufficient. Conclusion: The residents consider their global training in nutrition has improved in these last 10 years, although there is still a chance for optimization in areas such as dietetics


Assuntos
Humanos , Internato e Residência , Nutrição em Saúde Pública/educação , Endocrinologia/educação , Dietética/educação
8.
Endocrinol Diabetes Nutr ; 66(8): 472-479, 2019 Oct.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31171456

RESUMO

BACKGROUND AND OBJECTIVE: Treatment with oral antineoplastic agents known as tyrosine kinase inhibitors (TKIs) is new and, thus, little is known about their impact on nutritional status (NS), dietary intake, quality of life, and survival. The aim of this study was to provide information on these components in order to guide future nutritional recommendations. PATIENTS AND METHOD: A prospective, observational study in adults who start treatment with TKIs, in whom NS was assessed using the Patient-Generated Subjective Global Assessment (PG-SGA), anthropometric measures, biochemical parameters, and dietary intake (24-hour dietary recall). The EORTC QLQ-C30 was used to assess quality of life. Nonparametric tests were used in statistical analysis, and survival was analyzed using Kaplan-Meier and log-rank curves. RESULTS: Of the overall sample, 21.7% had moderate malnutrition according to PG-SGA, and 74.2% moderate weight loss at 6 months, but no patient had BMI<18.5kg/m2. Patients with moderate malnutrition had lower survival at four years of diagnosis (log-rank=0.015). Energy intake was lower than recommended by the ESPEN 2017 congress, and no patient covered the protein requirements (1.5g protein/kg weight) during follow-up. A worse score on the global health scale of the EORTC QLQ-C30 was related to worse NS. CONCLUSIONS: Treatment with TKIs does not appear to have a significant impact on NS and quality of life after 6 months of follow-up. Malnutrition should be prevented through individualized nutritional advice because it is related to shorter survival.

9.
Endocrinol Diabetes Nutr ; 66(9): 555-562, 2019 Nov.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31085072

RESUMO

INTRODUCTION: Prevalence of disease-related malnutrition in hospitals ranges from 20%-50%. Use of nutritional screening tools should be the first step in the prevention and treatment of patients at risk of malnutrition and/or undernourished. AIMS: To implement a nutritional screening tool at admission to a tertiary hospital. METHODS: The nutrition unit prepared a protocol for early detection of nutritional risk and selected the NRS 2002 as screening tool. The protocol was approved by the hospital committee of protocols and procedures and disseminated through the intranet. NRS 2002 was included in the diet prescription software to be implemented by the nursing staff of the hospital wards and as a direct communication system with the nutrition unit. Three phases were designed: pilot phase, implementation phase, and consolidation phase. RESULTS: The pilot phase, NRS 2002 was implemented in 2hospital units to monitor software. The implementation phase was carried out in the same units, and all action protocols related to it were verified. The consolidation phase consisted of sequential extension of the protocol to the other hospital units. CONCLUSIONS: Implementation of nutritional screening at hospital admission is a long and complex process that requires involvement of many stakeholders. Computer software has allowed for a rapid, simple, and automatic process, so that the results of the screening are immediately available to the nursing staff of the nutrition unit and activate the nutritional protocols when required.

10.
Endocrinol Diabetes Nutr ; 66(6): 346-352, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30954443

RESUMO

OBJECTIVE: Our aim is to assess the changes in clinical nutrition and dietetics education of the residents in endocrinology and nutrition for the last 10 years. METHODS: During the yearly update course in Clinical Nutrition and Dietetics held by SEEN, a survey about medical training is conducted since 2006. Descriptive data for the last 10 years are reported. RESULTS: Every hospital accredited for medical training in endocrinology and nutrition has a unit of nutrition, depending on endocrinology and nutrition departments in 94.5%. While 13.3% of the residents required a different hospital for training in nutrition in 2006, all of them had enough resources in their own hospital in 2018. The training started in their third year of residency in 62.6%. The rotation has been increasing its length and now it lasts 6 months for 66% of the residents. 41.9% of the residents think it should be longer than 6 months. Education in dietetics should be extended the most. The residents take part in study protocols or publications in 72.5%, against only 27.9% in 2009. There is still a percentage of 10.1% to 19% of the residents grading their training in nutrition as insufficient. CONCLUSION: The residents consider their global training in nutrition has improved in these last 10 years, although there is still a chance for optimization in areas such as dietetics.


Assuntos
Endocrinologia/educação , Internato e Residência , Ciências da Nutrição/educação , Espanha
13.
Nutr Hosp ; 35(4): 761-766, 2018 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-30070861

RESUMO

INTRODUCTION: catheter-related bloodstream infections (CRBSI) are one of the most serious concerns in patients on home parenteral nutrition (HPN) which involve high morbidity and cost for the healthcare system. In the last years, taurolidine lock has proven to be beneficial in the prevention of CRBSI; however, the evidence of its efficiency is limited. OBJECTIVE: to determine if taurolidine lock is a cost-effective intervention in patients on HPN. MATERIALS AND METHODS: retrospective study in patients on HPN with taurolidine lock. We compared the CRBSI rate and cost of its complications before and during taurolidine lock. RESULTS: thirteen patients, six (46%) males and seven (54%) females, with a mean age of 61.08 (SD = 14.18) years received taurolidine lock. The total days of catheterization pre and per-taurolidine were 12,186 and 5,293, respectively. The underlying disease was benign in five patients (38.5%) and malignant in eight (61.5%). The CRBSI rate pre vs per-taurolidine was 3.12 vs 0.76 episodes per 1,000 catheter days (p = 0.0058). When the indication was a high CRBSI rate, this was 9.72 vs 0.39 (p < 0.001) in pre and per-taurolidine period respectively. No differences have been observed in the occlusion rates. None of the patients reported any adverse effects. The total cost of CRBSI in the pre-taurolidine period was 151,264.14 euros vs 24,331.19 euros in the per-taurolidine period. CONCLUSIONS: our study shows that taurolidine lock is a cost-effective intervention in patients on HPN with high risk of CRBSI.


Assuntos
Anti-Infecciosos/economia , Anti-Infecciosos/uso terapêutico , Infecções Relacionadas a Cateter/economia , Infecções Relacionadas a Cateter/prevenção & controle , Nutrição Parenteral no Domicílio/economia , Nutrição Parenteral no Domicílio/métodos , Taurina/análogos & derivados , Tiadiazinas/economia , Tiadiazinas/uso terapêutico , Adulto , Idoso , Anti-Infecciosos/efeitos adversos , Custos e Análise de Custo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Taurina/efeitos adversos , Taurina/economia , Taurina/uso terapêutico , Tiadiazinas/efeitos adversos
14.
Nutr. hosp ; 35(4): 761-766, jul.-ago. 2018. tab, graf
Artigo em Inglês | IBECS | ID: ibc-179865

RESUMO

Introduction: catheter-related bloodstream infections (CRBSI) are one of the most serious concerns in patients on home parenteral nutrition (HPN) which involve high morbidity and cost for the healthcare system. In the last years, taurolidine lock has proven to be beneficial in the prevention of CRBSI; however, the evidence of its efficiency is limited. Objective: to determine if taurolidine lock is a cost-effective intervention in patients on HPN. Materials and methods: retrospective study in patients on HPN with taurolidine lock. We compared the CRBSI rate and cost of its complications before and during taurolidine lock. Results: thirteen patients, six (46%) males and seven (54%) females, with a mean age of 61.08 (SD = 14.18) years received taurolidine lock. The total days of catheterization pre and per-taurolidine were 12,186 and 5,293, respectively. The underlying disease was benign in five patients (38.5%) and malignant in eight (61.5%). The CRBSI rate pre vs per-taurolidine was 3.12 vs 0.76 episodes per 1,000 catheter days (p = 0.0058). When the indication was a high CRBSI rate, this was 9.72 vs 0.39 (p < 0.001) in pre and per-taurolidine period respectively. No differences have been observed in the occlusion rates. None of the patients reported any adverse effects. The total cost of CRBSI in the pre-taurolidine period was 151,264.14 euros vs 24,331.19 euros in the per-taurolidine period. Conclusions: our study shows that taurolidine lock is a cost-effective intervention in patients on HPN with high risk of CRBSI


Introducción: las infecciones asociadas al catéter (IAC) son una de las complicaciones más serias en pacientes con nutrición parenteral domiciliara (NPD), generando una alta morbilidad y costes sanitarios. En los últimos años, el sellado con taurolidina ha demostrado ser eficaz en su prevención, si bien la evidencia en cuanto a su eficiencia es escasa. Objetivo: determinar si el sellado del catéter con taurolidina es una intervención coste-efectiva en pacientes con NPD. Materiales y métodos: estudio retrospectivo de pacientes con NPD que recibieron sellados con taurolidina. Comparamos la incidencia de IAC antes y durante el tratamiento y los costes asociados. Resultados: el estudio incluyó trece pacientes, seis (46%) varones y siete (54%) mujeres, con edad media de 61,08 (± 14,18) años y un seguimiento de 12.186 y 5.293 días antes y durante el uso de taurolidina. La enfermedad de base era benigna en cinco pacientes (38,5%) y maligna en ocho (61,5%). La tasa de IAC antes y durante el sellado con taurolidina fue de 3,12 vs. 0,76 episodios por 1.000/días de catéter (p = 0,0058). Cuando la indicación fue por alta tasa de IAC, esta fue de 9,72 vs. 0,39 (p < 0,001) episodios por 1.000/días de catéter antes y durante el tratamiento. No hubo diferencias en la tasa de oclusión del catéter en ambos periodos. No se reportaron efectos adversos. El coste total de las IAC antes y durante el uso de taurolidina fue de 151.264,14 euros vs. 24.331,19 euros


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Anti-Infecciosos/economia , Anti-Infecciosos/uso terapêutico , Infecções Relacionadas a Cateter/economia , Infecções Relacionadas a Cateter/prevenção & controle , Nutrição Parenteral no Domicílio/economia , Nutrição Parenteral no Domicílio/métodos , Taurina/análogos & derivados , Tiadiazinas/economia , Tiadiazinas/uso terapêutico , Anti-Infecciosos/efeitos adversos , Custos e Análise de Custo , Estudos Retrospectivos , Taurina/efeitos adversos , Taurina/economia , Taurina/uso terapêutico , Tiadiazinas/efeitos adversos
15.
Endocrinol. diabetes nutr. (Ed. impr.) ; 65(1): 5-16, ene. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-171909

RESUMO

Antecedentes: La imprecisión en la terminología dentro de la nutrición clínica puede acarrear malas interpretaciones entre los distintos profesionales. Objetivo: Por esta razón, la Sociedad Española de Endocrinología y Nutrición (SEEN) ha promovido la realización del presente trabajo, el primero sobre terminología y definiciones en nutrición artificial clínica (enteral y parenteral) publicado en castellano. Métodos: Un total de 47 especialistas en Endocrinología y Nutrición expertos en la materia, miembros del Área de Nutrición de la SEEN, han participado entre los meses de abril y septiembre de 2016. Tras una revisión bibliográfica sistematizada fueron propuestos 52 conceptos, ampliándose a 54 por las coordinadoras y finalmente a 57 por el grupo de trabajo: 13 de carácter general, 30 referidos a la nutrición enteral y 14 a la parenteral. En una fase posterior se determinó el grado de acuerdo mediante un proceso Delphi de 2 circulaciones. Finalmente fue ratificado mediante un análisis de consistencia y concordancia. Resultados: En 54 de los 57 términos hubo un acuerdo muy consistente y resultaban concordantes. Solo 3 no presentaron concordancia, de los que 2 eran muy consistentes y uno inconsistente. En conclusión, queda consensuada la definición de 54 términos básicos en la práctica de la nutrición clínica (AU)


Background: Imprecision in terms used in the field of clinical nutrition may lead to misinterpretations among professionals. Objective: For this reason, the Spanish Society of Endocrinology and Nutrition (SEEN) promoted this document on the terms and definitions used in clinical artificial nutrition (enteral and parenteral), establishing an agreement between Spanish experts of this specialty. Methods: Forty-seven specialists in endocrinology and nutrition, members of the Nutrition Area of the SEEN, participated between April and September 2016. After a systematic literature review, 52 concepts were proposed. The coordinators included two additional concepts, and 57were finally selected by the working group: 13 of a general nature, 30 referring to enteral nutrition and 14 to parenteral nutrition. The degree of agreement was subsequently determined using a two-round Delphi process. It was finally ratified by consistency and concordance analysis. Results: Fifty-four of the 57 terms had a very consistent agreement and were concordant. Only three showed no concordance, of whom two were very consistent and one inconsistent. In conclusion, there was consensus in the definition of 54 basic terms in the practice of clinical nutrition (AU)


Assuntos
Humanos , Masculino , Feminino , Terminologia como Assunto , Ciências da Nutrição/métodos , Endocrinologia/métodos , Nutrição Enteral/métodos , Nutrição Parenteral/métodos , Sociedades Médicas/normas , Técnica Delfos
16.
Endocrinol Diabetes Nutr ; 65(1): 5-16, 2018 Jan.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29233514

RESUMO

BACKGROUND: Imprecision in terms used in the field of clinical nutrition may lead to misinterpretations among professionals. OBJECTIVE: For this reason, the Spanish Society of Endocrinology and Nutrition (SEEN) promoted this document on the terms and definitions used in clinical artificial nutrition (enteral and parenteral), establishing an agreement between Spanish experts of this specialty. METHODS: Forty-seven specialists in endocrinology and nutrition, members of the Nutrition Area of the SEEN, participated between April and September 2016. After a systematic literature review, 52 concepts were proposed. The coordinators included two additional concepts, and 57were finally selected by the working group: 13 of a general nature, 30 referring to enteral nutrition and 14 to parenteral nutrition. The degree of agreement was subsequently determined using a two-round Delphi process. It was finally ratified by consistency and concordance analysis. RESULTS: Fifty-four of the 57 terms had a very consistent agreement and were concordant. Only three showed no concordance, of whom two were very consistent and one inconsistent. In conclusion, there was consensus in the definition of 54 basic terms in the practice of clinical nutrition.


Assuntos
Ciências da Nutrição , Apoio Nutricional/métodos , Terminologia como Assunto , Técnica Delfos , Suplementos Nutricionais/classificação , Endocrinologia/organização & administração , Alimentos Formulados/classificação , Humanos , Linguagem , Necessidades Nutricionais , Ciências da Nutrição/organização & administração , Apoio Nutricional/classificação , Sociedades Médicas , Sociedades Científicas , Espanha
17.
An. R. Acad. Farm ; 82(n.extr): 195-205, oct. 2016. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-157625

RESUMO

La obesidad es una enfermedad metabólica crónica cuyo tratamiento requiere unos cambios favorables en la alimentación y en el estilo de vida, mantenidos en el tiempo. La elevada prevalencia de esta enfermedad y la dificultad que entraña su tratamiento contribuye a la proliferación de dietas ‘mágicas’ y otros procedimientos, de eficacia no comprobada, que prometen una pérdida de peso rápida y sin esfuerzo. En este artículo haremos una revisión crítica de estos tratamientos heterodoxos para la obesidad (AU)


Obesity is a chronic metabolic disease whose treatment requires favorable changes in diet and lifestyle, that have to be maintained over time. The high prevalence of this disease and the difficulty of treatment contributes to the proliferation of ‘fad diets’ and other procedures, mostly unproven, that promise quick weight loss without making any effort. In this article we will make a critical review of these heterodox treatments for obesity (AU)


Assuntos
Humanos , Dietas da Moda/efeitos adversos , Obesidade/dietoterapia , Nutrientes , Análise de Alimentos , Necessidades Nutricionais , Dieta com Restrição de Carboidratos
18.
Nutr Hosp ; 33(4): 387, 2016 Jul 19.
Artigo em Espanhol | MEDLINE | ID: mdl-27571662

RESUMO

Introducción: la esofagitis eosinofílica (EEo) es una enfermedad inmunoalérgica crónica emergente en adultos. Surge como respuesta disfuncional frente a los antígenos de los alimentos y se caracteriza por síntomas recurrentes de disfunción esofágica e inflamación. El tratamiento farmacológico y dietético se basa en su patogénesis y debe ser individualizado. Uno de los posibles abordajes dietéticos se basa en la eliminación empírica de alimentos que con mayor frecuencia causan EEo.Objetivo: evaluar la ingesta dietética de los pacientes con EEo que siguen la dieta de exclusión de los seis grupos de alimentos (DESGA) y conocer sus posibles carencias nutricionales.Métodos: estudio transversal descriptivo en un grupo de pacientes con EEo que inició tratamiento con DESGA durante el periodo de marzo de 2013 hasta marzo de 2015. Se evaluó la ingesta mediante registro de 72 horas. Se compararon los resultados con las referencias para población adulta sana española (23). Para el análisis estadístico se usaron los test de Mann-Whitney, Krhuskall-Wallis y Chi-cuadrado. Significación p < 0,05.Resultados: se incluyeron en el estudio 14 pacientes. En algunos de ellos, la ingesta dietética siguiendo DESGA fue deficitaria en energía, proteínas y fibra. Tampoco consiguieron cubrir las ingestas de micronutrientes de calcio, zinc, magnesio, ácido fólico, niacina y vitaminas B2 y D, teniendo en cuenta edad y sexo, el 60% de la muestra.Conclusiones: el abordaje terapéutico mediante DESGA, teniendo en cuenta las características de la dieta, debe acompañarse de una evaluación periódica del estado nutricional, que incluya micronutrientes y una pauta de suplementación específica.


Assuntos
Esofagite Eosinofílica/dietoterapia , Adulto , Estudos Transversais , Dieta , Ingestão de Alimentos , Ingestão de Energia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Padrões de Referência
19.
Nutr Hosp ; 33(4): 404, 2016 Jul 19.
Artigo em Espanhol | MEDLINE | ID: mdl-27571679

RESUMO

La deficiencia de vitamina A es infrecuente en los países desarrollados. La cirugía bariátrica constituye un factor de riesgo de deficiencia de esta vitamina. Se han descrito varios casos en pacientes sometidos a técnicas con un importante componente malabsortivo, como la derivación biliopancreática. En este artículo se describe un caso de deficiencia clínica de vitamina A con manifestaciones oculares y cutáneas tras bypass gástrico y se revisan las publicaciones sobre este tema y las recomendaciones para la prevención de esta importante complicación.


Assuntos
Derivação Gástrica/efeitos adversos , Complicações Pós-Operatórias/terapia , Deficiência de Vitamina A/etiologia , Deficiência de Vitamina A/terapia , Adulto , Cegueira/etiologia , Cegueira/terapia , Humanos , Masculino , Dermatopatias/etiologia , Dermatopatias/terapia
20.
Nutr. hosp ; 33(4): 879-886, jul.-ago. 2016. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-154914

RESUMO

Introducción: la esofagitis eosinofílica (EEo) es una enfermedad inmunoalérgica crónica emergente en adultos. Surge como respuesta disfuncional frente a los antígenos de los alimentos y se caracteriza por síntomas recurrentes de disfunción esofágica e inflamación. El tratamiento farmacológico y dietético se basa en su patogénesis y debe ser individualizado. Uno de los posibles abordajes dietéticos se basa en la eliminación empírica de alimentos que con mayor frecuencia causan EEo. Objetivo: evaluar la ingesta dietética de los pacientes con EEo que siguen la dieta de exclusión de los seis grupos de alimentos (DESGA) y conocer sus posibles carencias nutricionales. Métodos: estudio transversal descriptivo en un grupo de pacientes con EEo que inició tratamiento con DESGA durante el periodo de marzo del 2013 hasta marzo del 2015. Se evaluó la ingesta mediante registro de 72 h. Se compararon los resultados con las referencias para población adulta sana española Moreiras, 2013. Para el análisis estadístico se usaron los test de Mann-Whitney, Krhuskall-Wallis y chi cuadrado. Signifi cación p < 0,05. Resultados: se incluyeron en el estudio 14 pacientes. En algunos de ellos, la ingesta dietética siguiendo DESGA fue deficitaria en energía, proteínas y fibra. Tampoco consiguieron cubrir las ingestas de micronutrientes de calcio, zinc, magnesio, ácido fólico, niacina y vitaminas B2 y D, teniendo en cuenta edad y sexo, el 60% de la muestra. Conclusiones: el abordaje terapéutico mediante DESGA, teniendo en cuenta las características de la dieta, debe acompañarse de una evaluación periódica del estado nutricional, que incluya micronutrientes y una pauta de suplementación específica (AU)


Introduction: Eosinophilic esophagitis (EoE) is an emerging chronic immune/antigen mediated inflammatory disease in adults. It develops as a dysfunctional response to food antigens and is characterized by recurrent symptoms of esophageal dysfunction and inflammation. Drug and dietary treatment are based on its pathogenesis and should be individualized. One of the possible dietary approaches is based on empirical elimination of foods which most commonly cause EoE. Objective: To evaluate dietary intake of patients who follow the diet consisting of the exclusion of six food groups (DESGA) and to know its potential nutritional deficiencies. Methods: Cross-sectional study of patients who started treatment with DESGA diet between March 2013 and March 2015. A 72 h dietary record was completed. The results were compared with the references for the Spanish healthy adult population Moreiras, 2013. Statistical analysis included Mann-Whitney, Kruskal-Wallis and Chi-square tests. Significance was set at p < 0.05. Results: The study included 14 patients. For some of them, the DESGA diet was defi cient inenergy, protein and fiber. Taking into account age and sex, sixty percent of the sample did not get adequate amount of calcium, zinc, magnesium, folic acid, niacin, vitamin B2 and vitamin D. Conclusions: Considering the characteristics of the DESGA diet, this therapeutic approach must be accompanied by a periodic assessment of nutritional status, including micronutrients and a pattern of specific supplementation (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Dietética/métodos , Dietética/normas , Recomendações Nutricionais/tendências , Esofagite Eosinofílica/complicações , Esofagite Eosinofílica/dietoterapia , Estado Nutricional/fisiologia , Dieta/classificação , Dieta , Alimentos/classificação , Alimentos , Micronutrientes/uso terapêutico , Estudos Transversais/métodos , Estudos Transversais , Índice de Massa Corporal
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