Irina Lazarevich

THE RELATIONSHIP BETWEEN SARCOPENIA,UNDERNUTRITION, PHYSICAL MOBILITY AND BASIC ACTIVITIES OF DAILY LIVING IN A GROUP OF ELDERLY WOMEN OF MEXICO CITY

BACKGROUNDnSarcopenia is a geriatric syndrome, which affects the functional status and mobility of individuals.nnnOBJECTIVEnTo identify the prevalence of sarcopenia and undernutrition, and to assess the association between sarcopenia and mobility, and sarcopenia and basic activities of daily living (ADL) in a group of elderly women.nnnSUBJECTS AND METHODSnA cross-sectional study was performed in patients attending a geriatric service at a government hospital in Mexico City. Sarcopenia was identified applying Baumgartners equation by obtaining skeletal muscle mass index (SMI) and undernutrition was diagnosed using mini-nutritional assessment instrument (MNA). The SENECA questionnaire and Katz index were used to evaluate mobility and ADL, respectively.nnnSTATISTICAL ANALYSISnlineal regression models were constructed fitting SMI as a dependent variable and SENECA, and ADL scores as independent variables, adjusted for age.nnnRESULTSn90 women with a mean age of 78.2 (± 6.8) were studied. Undernutrition was identified in 15.5% of the patients. The prevalence of sarcopenia was 41.1%. Patients with sarcopenia presented a high prevalence of undernutrition (p < 0.001). Sarcopenia was associated with difficulty in climbing stairs (OR = 2.63, p = 0.03), adjusted for age. The mobility score was associated with sarcopenia, in the group without sarcopenia the mean score was 16.3, and with sarcopenia it was 18.3, (p = 0.04). Regarding ADL, 64.9% of the patients with intermediate independence and dependence had sarcopenia, while 35.1% with total independence presented sarcopenia (p < 0.001).nnnCONCLUSIONSnThe elder women with sarcopenia had a higher prevalence of undernutrition. Sarcopenia was associated with difficulties in mobility, particularly difficulties in climbing stairs.

Obesity, eating behaviour and mental health among university students in Mexico city

Objective: To investigate the prevalence of trematode Aspidogastrea in the freshwater mussels in the Yangtze River basin within Anhui province, China. Methods: We initially harvested the freshwater mussels living in the Yangtze River running through Anhui area, and labeled them with corresponding number. Then the samples were dissected for isolating the flukes, which were identified by conventional staining. Results: Infection rate of trematode Aspidogastrea in freshwater mussels in the Yangtze River basin within the territory of Anhui province was 30.38℅(103/339)in general, and a total of 912 flukes of Aspidogastrea were detected in the 103 mussels, with average infection rate of 8.85 for each mussel. Conclusion: Trematode Aspdogastrea is prevalent in the freshwater bivalves living in the Yangtze River basin running through Anhui area, and the treamatode was identified as Aspidogaster sp. belong to Aspidogaste under Aspidogastridae of Aspidogastrea.Objective: to assess the use of oral nutritional supplements analyzing the reason for prescription and its implication in caloric-protein intake. Setting: study performed at a university hospital of 350 beds with medical and surgical specialties. Subjects, patients: Patients inclusion was done by selecting all starting oral nutritional supplement prescription. Exclusion criteria were being younger than 18 years, being admitted to the Intensive Care Unit, having cognition or communication impairments, being on concomitant parenteral nutrition or requiring complete enteral diet, and/or using nasogastric tube for feeding. We also excluded special enteral diets, specifically designed for certain conditions. Interventions: One-year long prospective study on prescription of oral nutritional supplements. Through clinical chart review and personal interview, we recorded demographic data, nutritional parameters, characteristics of the diet and supplement, and caloricprotein intake prescribed and ingested. The data were introduced in an Access97 database and processed by means of SPSS software for Windows®. We performed a descriptive study of quantitative and qualitative variables, a χ2 analysis between qualitative variables, and a comparative analysis between means of all paired data by means of the student’s t test, and variance analysis between quantitative variables. The significance level was set at p < 0.05. Results: we were only able to analyze 77 out of 130 prescriptions for nutritional supplements since we could not adequately interview the remaining patients, mainly due to neurological impairments. Mean age was 74.8 years (SD = 12) and 50.6% were women. The departments prescribing the highest number of supplements were hematology (22.1%) and internal medicine (20.8%). GI neoplasm was the most frequent diagnosis at admission (27.3%). The most frequent indication was kwashiorkor (45.5%), with 15.6% of patients being well nourished. Mean therapy duration was 11 days (SD = 11.1), and the main reason for termination was hospital discharge (70.1%). The supplement was concomitantly prescribed with the meals in 70.6% of the cases, and more than halfMaterial y metodos: Estudio retrospectivo de 55 pacientes de 65,4 ± 14,7 anos, 35,7% mujeres y 64,3% varones con un IMC 27,87 ± 5,56 kg/m (0% con IMC 30 kg/m ) en tratamiento con NPT con una duracion de 28 ± 5 dias (mas de 20 dias en el 75% de los casos). El 16,1% presentaba Diabetes Mellitus previa al inicio de NPT. En el 64,3% de los pacientes, la fistula ocurria tras cirugia reciente: en un 38.8% tras reseccion de colon, 16,6% de intestino delgado y 13,9% de estomago. La NPT se planificaba para aportar diariamente 1,5 × Gasto Energetico Basal, 1,5 g/kg/dia de proteinas, 6 mg de vitamina B 12 y 414 μg de acido folico. Ninguna solucion contenia hierro.Objective. To assess the impact of weight loss in clinical nprogression of the comorbidities in a group of morbid nobese patients submitted to surgical treatment with the nduodenal switch technique. nStudy setting. Between 2001-2006, we have operated by nthe duodenal crossing technique a total of 118 morbid nobese patients (97 women and 21 men), mean age 42.6 nyears. Average pre-surgical BMI was 49.7, with average noverweight of 69.1 kg. nAfter surgical intervention, we have prospectively nassessed the progression of the main comorbidities (arterial nhypertension, diabetes, OSAS, osteoarticular pathology, ndyslipidemia), according to the subscale of the nBAROS scoring system. Postsurgical controls are done at nmonths 3, 6, 12, 18, and 24 and annually thereafter. We nhave followed-up 110 patients, of whom 90 presented ncomorbidities, being the ones studied. nResults. At 3 months post-surgery, we observed a decrease nin the mean value of %WL to 31%, and a mean BMI nvalue of 41.3, the percentage of lost BMI being 40.3%. nMost of the weight loss occurred within 2 years, with %WL nof 74.8% and a percentage of lost BMI of 97.7%. nIn 68 patients (75.5%) there was resolution of their ncomorbidities, 14.4% having improvement, and 10% nwith no improvement in spite of the surgery. Of patients nachieving complete resolution, almost all of them achieved nit within two years after surgery. nCure rates correlate with weight loss, so that at 3 nmonths, with a mean weight loss of 25 kg (BMI decrease nof 8.4 points) the comorbidity resolution rate is 45.5%. At n12 months, with a mean decrease in BMI of 16.4 points, n%WL of 61.6% and % of lost BMI of 70.4%, the comorbidity nresolution rate is 89.7%. nAt two years, by the time most of the main comorbidities nresolved (68 patients), the BMI decreased by 22.4 npoints, the %WL 74.8% and the % of lost BMI 97.9%. nConclusion. The aim of bariatric surgery is weight loss nand overweight-associated comorbidities improvement. nIn our study, most of the comorbidities improvement nstarted at the third month, with the highest improvement nrate occurring within two years, verifying that there is a ndirect relationship between post-surgical weight loss ncomorbidities improvement and resolution in most of the ncases.Objective: To investigate the breeding rate and breeding density of Carpoglyphus lactis in stored Fructus Jujubae in Anhui, China in order to provide a scientific basis for prevention of Carpoglyphus lactis(C. lactis) from spoiling the dried fruit of such category. Methods： By the breeding nature of C. lactis, we collected samples of Fructus Jujubae, which were kept over 6 months in general, from the dried fruit shop and (or) Chinese herbal medicine warehouse, and isolated C. lactis from those samples. The mite specimens were prepared, and microscopically and morphologically identified. Species classification was done in accordance with Hughes (1976). Result:C. lactis was identified in 19 of the 300 samples, with breeding density and breeding rate of 6.52 heads/g and 6.33%. Constitute ratio at distinct developmental phase was associated with adult (including nymph, 85.71%), larva(12.27%), hypopus (0.56%) and egg(1.45%), respectively. The richness index, diversity index and evenness index was1.644, 1.644 and 0.923, respectively. Conclusion： Carpoglyphus lactis appears infesting in large quantity in the Fructus Jujubae stored in the above places in Anhui province, and the density is higher. Therefore, it is urgent to take effective measures to prevent C. lactis from spreading over other dried products stored in the same room and potential human intestinal acariasis as a result of the biological contamination.Objective: To determine possible associations between nthe risk of breast cancer in Brazilian women and demographic, nsocial and economical variables, and past dietary nintake. nMethods: A case-control study was conducted in Joinville, nSanta Catarina, Brazil, between june and november n2003 involving a group of 33 women recently diagnosed nwith breast cancer and a control group of 33 healthy nwomen volunteers. Personal details, health history and npast dietary intake were obtained via questionnaires and ninterviews. Data between groups were compared using χ2, nFisher, and Student’s t test, whilst associations were evaluated nusing a non-conditional logistic regression method nand odds ratio (OR). nResults: Statistically significant differences between the ntwo groups were revealed with respect to age distribution n(P = 0.007), family income level (P = 0.02), educational level n(P 45 years), low family income n(<

Relationship among obesity, depression, and emotional eating in young adults.

520/month), poor educational level (primary school nlevel or lower) and past regular consumption of pork fat nand fatty meat may be factors associated with an increased nrisk of breast cancer.A case of peritoneal mucinous carcinomatosis in a patient nwho suffered a Hirschsprung disease 30 year before nis presented. TH present condition caused an irreversible nintestinal obstruction and the patients received home nparenteral nutrition without unremarkable complications nlonger than two years.Introduction: Clinical nutrition is an activity realized in most of Health Centres of France, Canada, Great Britain and USA. The aim of our work was to determine activity and resources of Nutrition Units of Hospitals in the Community of Castilla y Leon. Material and methods: A questionnaire was send to all Hospitals of Castilla y Leon (SACYL); Hospital UniMaterial y método: Se estudió una población de pacientes postquirúrgicos (n = 22; 12 hombres y 10 mujeres) de 72,9 años de promedio (DE = 13,5) que fueron apareados en razón de edad y además un 40% de ellos por sexo, en dos grupos: A) con gastrectomía total (73%) o parcial (23%) por neoplasia y B) control, presencia de íleo paralítico postquirúrgico de causa no neoplásica. La duración media de la NPT fue de 14 días (DE = 2) y 13 días (DE = 2) respectivamente siendo la composición estándar de 12 g/N2, 100 kcal no proteicas/g N2, carbohidratos/lípidos: 63/38; volumen: 1.550-2.250 mL. Se realizaron controles basales habituales antes de la cirugía y al final de la NPT. Se analizaron los niveles de: Hb, Hto, contaje de linfocitos, contaje de neutrófilos y bioquímicos: glucosa, urea, creatinina, proteínas y albúmina. Análisis estadístico: test no paramétrico U de Mann Whitney y correlación de Pearson.El Órgano Oficial de SENPE, Nutrición Hospitalaria, no ha parado de crecer y prosperar a lo largo de sus 26 años de existencia. La revista se ha ido haciendo un hueco merecido en las bases de datos electrónicas y repositorios, alcanzando a los lectores interesados en su temática, no solo en España e Iberoamérica, sino también en países de ámbito sajón y en otros muy lejanos. El éxito ha traído parejo un incremento de originales, que en 2006 permitió alcanzar la cifra de 1.000 páginas publicadas. La creciente exigencia de los revisores, rechazando un treinta por ciento de los artículos recibidos, no ha sido impedimento para esta progresión, de lo que nos congratulamos. Otro de los éxitos positivos de este éxito editorial ha sido el aumento de números suplementarios de NUTR HOSP, documentos monográficos relativos a congresos, cursos, eventos o conclusiones de grupos de trabajo. La proliferación de los suplementos, muy halagüeña al comienzo, empezó a preocuparnos por las posibles desviaciones de la esencia de la revista. Vaya por delante que todos los suplementos han cumplido siempre las pautas éticas exigibles por la revista y por la SENPE, pero lo que escapaba al ámbito del comité editorial era la garantía de originalidad de todas las contribuciones, la homogeneidad en su estructura de acuerdo con las normas de publicación de la revista y, lo que es más importante, la falta de revisión por pares de sus contenidos. Esto último contradice formalmente la esencia de una revista científica. Por ello, Nutrición Hospitalaria y su comité editorial se encontraron ante un dilema: si se renuncia a la edición de suplementos que apoyan acciones especiales de la SENPE, se deja de prestar un servicio muy importante a la sociedad. Si se continua, incumplimos la normativa de revisión por pares. Hemos consultado los entornos científicos internacionales y rápidamente encontramos la solución, que colegas como Clin Nutr vienen aplicando desde hace uno o dos años: los suplementos deben aparecer bajo la cobertura de un ISSN diferente, llevando su propia paginación correlativa, en volúmenes independientes. Esta solución, que nos ha parecido la idónea, ha sido refrendada por el Comité Científico y la Junta Directiva de la Sociedad, y empezará a implementarse a partir de mayo de 2008. Así, el lector recibirá, a lo largo de los próximos meses, suplementos de Nutr Hosp ligeramente distintos. Los contenidos científicos de esta nueva línea editorial vendrán avalados por el Comité Científico Educacional y la Junta Directiva de SENPE. Creemos que con esta nueva fórmula que, como decimos, está ampliamente implantada en otras revistas científicas, se propiciará la multiplicación de los suplementos científicos de diversa índole que, en definitiva, redundará en beneficio de los miembros de SENPE y de nuestros lectores en general, sin menoscabo de las características referentes a originalidad y control que se exigen a los artículos que se publiquen en Nutrición Hospitalaria.OBJECTIVES: To analyze the complications related to enteral nutritional support in patients with lateral amyotrophic sclerosis included in our home-based mechanical ventilation program (HMVP), with a special emphasis on gastrointestinal complications. METHOD: Retrospective, descriptive study of the patients included in our HMVP directed by intensive care physicians, by means of systematic review of the medical records (included in a Microsoft Access database) during the period 2004-2011. RESULTS: In the period 2004-2011, 73 patients with a diagnosis of lateral amyotrophic sclerosis were followed: 34 (46.6%) refused nutritional support through gastrostomy or nasogastric tube, whereas 39 (53.4%) accepted. Twenty (51.3%) of the 39 patients with (home-based nutritional support) were females. The mean age of the patients was 60.6 + 13.4 years (95% CI 56.4-64.8). Diagnoses at the time of inclusion in the HMVP were: LAS, 21 cases (53.8%), and LAS with bulbar impairment 18 (43.1%). 34 patients (87.2%) were fed through percutaneous endoscopic gastrostomy (PEG), 3 (7.7%) through surgical gastrostomy, and 3 (7.7%). PEG was performed at the time of inclusion of the patients in the program, with a mean duration of 222.7 + 356.6 days (95% CI: 110.8-334.7). In patients with LAS, the mean duration was 271.4 + 449.5 days (95% CI: 130.3-412.1), and with LAS and bulbar impairment of 126.4 + 131.3 days (95% CI: 90-172.6). The mean duration of the nasogastric tube was 7.3 + 4.8 months (95% CI: 4-10.6). The mean duration of enteral nutrition was 578.6 + 872.9 days (95% CI: 304.7-852.6). There were complications in 35 patients (89.7%), and no complications occurred in only 4 patients (10.3%) (See table 2). Constipation occurred after initiating EN in 30 patients (76.9%); however, it was already present in 18 of them (60%). The remaining gastrointestinal complications observed were: abdominal bloating (9 patients; 23.1%); abdominal pain (6; 15,.4%); nausea and vomiting (5; 12.8%); diarrhea (3; 7.7%). CONCLUSIONS: Gastrointestinal complications are the most common ones; constipation stands out as the main problem in patients with LAS and HEN. However it may not be considered as a complication exclusively due to nutritional support since it is also a manifestation in the disease course. The occurrence of granulomas is also common.Obesity combined with breast cancer is a public health problem, given the high incidence and prevalence of both diseases. The aim of this review is to determine the current status of research on the relationship between the body weight of breast cancer patients and their prognosis. Overweight and obesity at the time of diagnosis are associated with a worse prognosis in breast cancer survivors. Observational studies show that breast cancer mortality is 33% higher in obese than in non-obese survivors. Furthermore, weight gain after diagnosis is common in these patients and is even greater in those receiving chemotherapy. Weight gains of 2-8 kg are observed in 68% of patients 3 years after diagnosis. Each 5 kg increase in body weight is associated with a 13% increase in breast cancer specific mortality. The mechanisms that cause this weight gain are not totally known. A higher weight gain is also associated with higher the risk of co-morbid cardiometabolic diseases, which worsen the quality of life and shorten overall survival. On the other hand, excess adipose tissue is an indirect promoter of tumor cell proliferation and releases circulating estrogens. Hence, preventing excess weight is important in these patients. An important limitation is the small number of randomised controlled trials investigating the type of diet that could be recommended specifically to breast cancer survivors. The evidence from current studies suggests that a healthy diet, low in fat and simple sugars and with a high proportion of fruit, vegetables and wholegrain products, has the potential to reduce morbidity and the risk of recurrence significantly, thus improving prognosis and quality of life in the long term.OBJECTIVEnTo compare measured resting energy expenditure (REE) with that predicted by formulas derived from populations with normal weight or obesity and from women with severe and morbid obesity.nnnMATERIAL AND METHODSn66 women (aged 35.6 +/- 10.3 y and BMI of 44.7 +/- 4.9 kg/m2) were evaluated by indirect calorimetry with a metabolic monitor Deltatrac (Datex Inst., Finland), before undergoing gastric bypass. REE was calculated with the following equations: Harris-Benedicts with both actual and adjusted weight, Ireton-Jones, Mifflins, and Carrascos Fast Estimation, which corresponds to 16.2 kcal x kg actual weight.nnnRESULTSn(mean +/- sd). Measured REE was 1797 +/- 239 kcal/day. All formulas, except Harris-Benedicts with adjusted weight, overestimated REE. The Ireton-Jones equation presented the greater overestimation (689 +/- 329 kcal/day), whereas Mifflins equation overestimated REE only by 6 +/- 202 kcal/day. No significant differences were detected between measured and calculated REE by Mifflins and Carrascos Fast Estimation. Accuracy (defined as difference between calculated and measured REE within +/- 10%) was greater with Mifflins equation (68%), followed by Harris-Benedicts with actual weight (64%) and Carrascos Fast Estimation (61%). By using the Bland-Altman analysis, significant correlations were observed between calculated-measured REE and mean REE (calculated + measured/2) with all equations except Carrascos Fast Estimation. This means that all but one formula underestimate or overestimate REE depending on the level of measured REE.nnnCONCLUSIONnIn severe and morbid obese women, Mifflins and Carrascos Fast Estimation equations provided the best performance to estimate REE. Before recommending an equation in an a subset of individuals it is necessary to make previous validation studies to determine that equation with the best predictive power for this particular group of patients.Objective To investigate the species and breeding density of acaroid mites in the stored rhizomatic traditional Chinese medicinal materials in Anhui province, China, in order to supply evidences for control and prevention of such species. Methods The stored traditional Chinese medicinal materials of root-stock origins were collected in 30 herb stores and warehouses in 17 cities across Anhui province. Mites were collected by using Tullgren funnel and directicopy, and identified under microscopy. Results 22 species of acaroid mites, belonging to 15 genera under 5 families, were identified from the total 47 stored samples, in which Tyrophagus putrescentiae，Acarus farinae, Carpoglyphus lactis, and Cologlyplus berlesei were predominant. Conclusion Breeding density of acaroid mites was high in the stored rhizomatic traditional Chinese medicinal materials in Anhui province. This indicates that the traditional Chinese medicinal herbs of root-stock origins in storage are seriously contaminated by the acaroid mites, and such infestation should be positively controlled to reduce the potential harm to public health.INTRODUCTIONnFor critically patients, enteral immunonutrition results in notable reductions in infections and in length of stay in hospital, but not on mortality, raising the question as to whether this relate to the heterogeneous nature of critically ill patients or to the absence of the altered absorption of specific nutrients within the immunonutrient mix (e.g. iron). Immune-associated functional iron deficiency (FID) is not only one of the many causes or anaemia in the critically ill, but also a cause of inappropriate immune response, leading to a longer duration of episodes of systemic inflammatory response syndrome and poor outcome.nnnOBJECTIVEnThis prospective cross-sectional study was undertaken to assess the prevalence of FID in critically ill patients during their stay in intensive care (ICU) in order to find the more appropriate population of patients that can benefit from iron therapy.nnnMETHODnFull blood cell counts, including reticulocytes (RETIC), serum iron (SI), transferring levels (TRF) and saturation (satTRF), serum TFR receptor (sTfR), ferritin (FRT) and C-reactive protein (CRP) were measured in venous blood samples from 131 random patients admitted to the ICU for at least 24 h (Length of ICU stay, LIS; min: 1 day; max: 38 days).nnnRESULTSnAnaemia (Hb < 12 g/dL) was present in 76% of the patients (Hb < 10 g/dL in 33%), hypoferremia (SI < 45 microg/dl) in 69%; satTRF < 20% in 53%; FRT < 100 ng/mL in 23%; sTfR > 2.3 mg/dL in 13%; and CRP > 0.5 mg/dL in 88%. Statistically significant correlations (r of Pearson; *p < 0.05, **p < 0.01) were obtained for serum CRP levels and WBC**, Hb*, TRF**, satTRF*, and FRT**. There was also a strong correlation between TRF and FRT (-0.650**), but not between FRT and satTRF or SI. LIS correlated with Hb*, CRP**, TRF*, satTRF* and FRT**.nnnCONCLUSIONSnA large proportion of critically ill patients admitted to the ICU presented the typical functional iron deficiency (FID) of acute inflammation-related anaemia (AIRA). This FID correlates with the inflammatory status and the length of stay at the ICU. However, 21% of the ICU patients with AIRA had an associated real iron deficiency (satTRF < 20; FRT < 100 and sTfR > 2.3). Since oral supplementation of iron seems to be ineffective, all these patients might benefit of iv iron therapy for correction of real or functional iron deficiency, which in turn might help to ameliorate their inflammatory status.In August 1976, a young man named LeRoy fell from a ledge, fracturing his femur. Major internal bleeding was nsuspected. During a laparotomy, the trauma team ensured that all internal organs were intact and the orthopedic nteam set his fracture. Thirty days later, LeRoy died. He had eaten little; each day he only received three liters of nglucose, the equivalent of 510 calories, intravenously. The glucose was insufficient to meet his nutritional needs, nand he lost over 20% of his body weight during his hospital stay. The cause of death was due to “physicianinduced” nmalnutrition. Meanwhile, a paper around the same time documented that the prevalence of malnutrition nin Boston hospitals was 44% and that malnutrition itself was a predictor of higher complication and death rates. nAs a result, like-minded physicians formed a society that created training programs and encouraged formation of nhospital nutrition teams. Industry produced nutrition formulas and catheters. Complications in sick hospitalized npatients plummeted while survival rates rose, and California passed legislation to mandate nutritional support. nThough the health care industry recognized the importance of nutrition in patient care, Congress failed to pass nfiscal support for nutrition teams. As a result, hospitals disbanded their newly created nutrition teams, nutrition neducation and skills declined, and hospital complications and death rates have risen again.Some bioethicists consider older age as a limiting factor nfor receiving special medical care. Older adults comprise nthe majority of home enteral nutrition patients n(neoplams of the head, neck, and upper gastrointestinal ntract neuromuscular swallowing disorders, dementia, netc) On the contrary, there are very few data on Home nParenteral Nutrition (HPN) in the elderly. We report nthese of a 75 years old man affected from a severe short nbowel syndrome due to mesenteric thrombosis. After a nhospital stay of two months he was sent home on HPN. nHis current caregiver was her wife, a 72 year old woman nsuffering from incipient Parkinson’s disease. nHPN lasted for 11 years and was stopped because of clinical ndeterioration. During this time he presented 5 catheter- nrelated infections (1.3 episodes/1,000 days). 5 catheters nwere used (average length 788 days). He was nhospitalized four times because of HPN complications. nFunctional status was maintained along almost all the nlength of HPN. nConclusions: The rate of complications in this patient nwas similar to other groups of age receiving HPN. The ntechnique was not burdensome for the family. Older age ncannot be consider, by itself a limiting factor when receiving nlong term nutritional support.Patients submitted to hematopoietic stem cells transplantation (HSCT) have an increased risk for having hyponutrition, both in the phase prior to transplantation and after this one. The indication of specialized nutritional support is common in allogenic HSCT, whereas patients submitted to auto-HSCT need it in the presence of complications that compromise an adequate nutrients intake. Enteral nutrition through a nasogastric tube has difficulties in these patients; the presence of mucositis delays the indication for enteral nutrition, which usually is poorly tolerated. Thus, frequently parenteral nutrition needs to be used as the route for nutritional support. The use of specific substrates, such as glutamine, is a controversial issue.La edad media fue 4,29 anos (0,1-14,4); el 48% de los ninos tenian menos de 3,5 anos. En el 70% de los casos, el motivo de la indicacion fue la disminucion de la ingesta. La duracion media fue 116,16 dias (4-1.165), manteniendose durante menos de 100 dias en el 79% de los pacientes. El porcentaje calorico medio administrado fue del 68%, precisando el 48% de la serie un aporte < 50%. El tipo de acceso inicial fue la sonda nasogastrica en el 92% de los ninos, la gastrostomia en el 5% y la sonda nasoyeyunal en el 3%. El modo de alimentacion mas frecuentemente utilizado fue la administracion exclusivamente nocturna en el 39% de los casos. El soporte de modo continuo se realizo en el 32%. La dieta polimerica pediatrica se empleo en el 70% de los pacientes. Los datos antropometricos, a excepcion de la talla, mejoraron de forma significativa tras la aplicacion del soporte. El 33% de los pacientes mostraban un indice de Waterlow inicial ≥ 90%.Metodo: Se realizo una busqueda de GPC disponibles en Internet en New Zeland Guidelines Group, Nacional Institute for Clinical Excellence, Scottish Intercollegiate Guidelines Network, Canadian Medical Association Infobase, Health Services/Technology Assesment, Fisterra y Medline. Se incluyeron ademas las direcciones de la ASPEN y la SENPE. Se recuperaron todas aquellas guias editadas o actualizadas en los ultimos cinco anos, en idioma ingles o castellano.Resumen es: Las enfermedades cardiovasculares representan la primera causa de muerte en Venezuela desde el ano 1967. Existen evidencias que demuestran que la lesion ...Material y metodo: Estudio retrospectivo. Cuando existe indicacion de administrar nutricion enteral en intestino, las enfermeras de nuestra Unidad colocan este tipo de sonda en la misma habitacion del enfermo, segun tecnica descrita por el fabricante. Despues de 24 horas de su colocacion, y sin fijarla en el ala de la nariz durante este tiempo, se realiza una radiografia de abdomen en decubito supino para valorar la situacion de la punta de la sonda (gastrica vs intestinal). Si no progresa a intestino, se reajusta la longitud introducida de la sonda y se repite la radiografia en las siguientes 24 horas. Ninguno de los pacientes tenian ventilacion asistida o sedo-relajacion. El exito en la colocacion se expresa como porcentaje de paso a traves del piloro.Introduction: Significant malnutrition exists in a high percentage of patients with head and neck cancer. Malnutrition is associated with defects in immune function that may impair the host response to malignancy. Malnutrition and immunosupression make patients highly susceptible to postoperative infections and complications. Objectives: Compare two immunoenhanced enteral nutritions with a control diet, and evaluate the effect in postoperative infections, length of stay and inflammatory markers. nPatients: A population of 44 patients with oral and laryngeal cancer was enrolled in a randomized trial. At surgery, patients were randomly allocated to three groups: (group I); patients receiving an arginine-enhanced formula (group II); patients receiving a standard polymeric formula, and (group III) patients receiving an arginine, RNA and omega-3 fatty acids enhanced formula, in an isonitrogenous way. nResults: The duration of enteral nutrition in the three groups was similar with an average duration of 14,5 ± 8 days. The length of postoperative stay was similar, with an average of 19,8 ± 8,5 days. Wound infections and general infections were more frequent in the control group. Fistula rates were not improved in the enhanced diet groups. No significant intergroup differences in the trend of the two plasma proteins (albumin, transferrin), lymphocytes, weight, IL-6, CPR and TNFα were detected. The control group showed the highest levels of TNFα at the fourteenth postoperative day. Gastrointestinal tolerance and diarrhoea rate were similar in all the patients. Conclusions: Immunoenhanced enteral nutrition formulas nimproved the infection rate in the postoperative of nhead and neck cancer patients. In the fistula rates, we nobserved that technical problems and nutritional status nmight have played an equally important role, and therefore nthe positive effect of immunonutrition in this parameter nmight have been overestimated.Introduction: Due to the high prevalence of overweight and obesity, new strategies are needed for its prevention and treatment. Nutritional Coaching (NC) has been shown to be effective in weight reduction, even though the innovation of this concept, it’s not always used properly. nObjective: To verify if NC, added to dietary assessment, is an effective approach for weight loss in overweight or obese population, compared with only technical dietary assessment. nMethodology: We performed a search for papers related to NC to establish quality parameters for this intervention. A systematic review was conducted, including randomized controlled trials that apply CN according to the selected parameters and comparing it with technical dietary assessment. nResults: Eight high quality studies were included in the analysis. Among these, six revealed statistical differences on behalf of the group that received NC. nConclusion: Nutritional Coaching is an effective approach for weight reduction. Future nutritional coaching intervention research would benefit from clear definitions of this new model.Introducción: El control de calidad es fundamental en cualquier intervención de enfermería clínico-asistencial y más aun en el paciente crítico. El protocolo de Enfermería de Nutrición Parenteral Total (NPT), que incluye el cambio de bolsa de nutrición, equipo de perfusión y cuidado del catéter venoso central (CVC) define unas actividades básicas. Fundamentamos el seguimiento en dos aspectos principales: 1. El paciente tiene un potencial de complicaciones relacionadas con la inserción del CVC y su manipulación, y 2. las repetidas manipulaciones de la conexión del CVC al equipo durante el tratamiento puede incidir en las infecciones del mismo.Material y metodo: Se estudiaron 27 pacientes (16 hombres y 11 mujeres) con carcinoma de colon y una edad media de 62,1 anos ? 11,2 (M?DE), de los cuales un 59% estaban en un estadio III de la enfermedad. De los pacientes incluidos, 11 habian recibido tratamiento quimioterapico previo y 16 no. El protocolo de Oncologia supuso la administracion aislada de 5fluoracilo en el 80% de los pacientes combinado con Oxaliplatino en un 17%. En todos los casos se registraron parametros antropometricos y analiticos (hemograma completo, glucosa, creatinina, bilirrubina, ALAT, ASAT, fosfatasa alcalina, albumina y marcadores tumorales) determinados antes de la cirugia y al final de la nutricion parenteral. Para evaluar la posible influencia del soporte nutricional los pacientes fueron divididos en dos grupos, en funcion de si habian o no recibido tratamiento citostatico previo a la intervencion. El analisis estadistico se realizo con el test ?2 y el de Wilcoxon (SPSS 10.0), aceptandose un nivel de significacion estadistica para p < 0,05.

Comparison of the prevalence of sarcopenia using skeletal muscle mass index and calf circumference applying the European consensus definition in elderly Mexican women

Depressive symptoms are often associated with obesity, and emotional eating may play a considerable role in weight gain. This study aimed to examine the association among depression symptoms, emotional eating, and body mass index (BMI) in Mexican college students; and to assess emotional eating as mediator between depressive symptoms and BMI. A total of 1453 students at a public university in Mexico City completed the scale Self-Efficacy in Emotion- and Stress- Related Eating of the Eating and Appraisal Due to Emotions and Stress Questionnaire (EADES) to assess emotional eating, and the scale created by the Center for Epidemiologic Studies (CES-D) to identify depressive symptoms. Weight and height were measured to calculate BMI. Structural equation models (SEM) were used to assess emotional eating as mediator between depressive symptoms and BMI by sex. Depressive symptoms were associated with emotional eating in both men (Betaxa0=xa0-0.33, pxa0<xa00.001) and women (Betaxa0=xa0-0.46, pxa0<xa00.001). Emotional eating, in turn, was associated with BMI in men (Betaxa0=xa0-0.08, pxa0<xa00.001) as well as in women (Betaxa0=xa0-0.09, pxa0<xa00.001). Emotional eating was a mediator between depression and BMI, adjusted for age in both sexes. This finding suggests that emotion management should be taken into consideration in obesity prevention and treatment strategies applied to young adults.

Violencia en el noviazgo y salud mental en estudiantes universitarios mexicanos

To compare the prevalence of sarcopenia using two indicators: skeletal muscle mass index (SMI) and calf circumference (CC) used in the algorithm proposed by the European Working Group on Sarcopenia in Mexican elderly women.

Psychometric characteristics of the Eating and Appraisal Due to Emotions and Stress Questionnaire and obesity in Mexican university students

Antecedentes: En las últimas dos décadas, ha aumentado el interés por la promoción de la salud en el sector educativo superior, a través del programa “Universidades Saludables” promovido por la Organización Mundial de la Salud (OMS). Es importante reconocer las necesidades relacionadas con la salud de los integrantes de la comunidad universitaria, así como reflexionar sobre las acciones dirigidas a cubrirlas. Uno de los problemas prioritarios respecto a la salud mental de los jóvenes universitarios es la violencia en el noviazgo. Considerando lo anterior, los objetivos del presente estudio fueron: evaluar la violencia en el noviazgo, la sintomatología depresiva y la autoestima en estudiantes universitarios; estudiar la relación entre la violencia, la depresión y la autoestima; y promover la implementación de programas preventivos entre la comunidad universitaria. Métodos: Se realizó un estudio transversal y descriptivo con las respuestas de 729 estudiantes universitarios, aplicando el “Conflict in Adolescent Dating Relationship Inventory,” el Inventario de Depresión de Beck y el Inventario de Coopersmith para evaluar la autoestima. Resultados: Los resultados mostraron una elevada prevalencia de violencia en los jóvenes universitarios, particularmente verbal-emocional (75%). Las agresiones fueron de carácter bidireccional, tanto hombres como mujeres cometieron y sufrieron la violencia. La conducta violenta se asoció con la baja autoestima en las mujeres y con síntomas depresivos en ambos sexos. Conclusiones: Desde el enfoque del programa “Universidades Saludables,” es importante que las instituciones de educación superior sean promotoras de la salud mediante la creación y difusión del conocimiento, la formación de recursos humanos y la promoción de la organización comunitaria. Los resultados del estudio indican la necesidad de desarrollar programas educativos orientados a la prevención de la violencia, al manejo de emociones y a la resolución de conflictos.

Depression and food consumption in Mexican college students

INTRODUCTIONnEmotional eating has been defined as eating in a response to negative emotions and it is associated with weight gain. The English version of Eating Appraisal Due to Emotions and Stress Questionnaire (EADES) was developed to assess how individuals use food in order to cope with stress and emotions.nnnOBJECTIVEnTo analyze psychometric characteristics of Spanish version of EADES and to identify whether the constructs of EADES were associated with obesity in university students.nnnMETHODSnThe EADES (Spanish version) was administered to 232 Mexican university students from 18 to 29 years old. Body Mass Index (BMI) was calculated. A test-retest evaluation was conducted with 75 participants.nnnRESULTSnCronbachs alpha of EADES was 0.92; the interclass correlation coefficient was 0.88. Regarding BMI and EADES results, the subscale Emotion and Stress Related Eating was significantly associated with obesity (p = 0.026). Through factor analysis of the instrument, three factors were extracted and items that showed factor loading < 0.40 were eliminated. 40 items remained in the questionnaire. With regard to obesity and the 40-items version of the instrument, a statistically significance association was found for the total score (OR = 0.973, p = 0.020) and for the factor Self-confidence related to Emotional Eating component (OR = 0.940, p = 0.026).nnnCONCLUSIONSnA good internal consistency and temporal stability of the Spanish version of the instrument were found; the 40-item EADES version was positively associated with obesity. This instrument could be useful in assessing emotional eating.

Indicadores psicosociales de riesgo suicida en los estudiantes universitarios

INTRODUCTIONndepression is frequently accompanied by overeating and a preference for certain foods that may consequently lead to weight gain.nnnOBJECTIVESna) to determine the prevalence of depression and the consumption of unhealthy food in first-year college students; and b) to analyze the association between depression score and food consumption frequency.nnnMETHODSna cross-sectional study was carried out in 1,104 freshman students, 40.3% men and 59.7% women, at a public university in Mexico City. The 20-item depression scale (CES-D) and Food Frequency Questionnaire were applied to measure depressive symptoms and food consumption. Logistic regression analysis was carried out for food consumption frequency and CES-D depression score grouped in quartiles.nnnRESULTSnthe prevalence of depression symptoms was 18.2% in men and 27.5% in women (p < 0.001). A considerable proportion of the students reported poor eating habits: consumption of fried food (30.3%), sweetened drinks (49.0%) and sugary food (51.8%) 2-7 times/week; and less than half the students practiced vigorous physical activity (39.7%). In women, a higher depression score was associated with a higher frequency of consumption of fast food (OR = 2.08, p = 0.018), fried food (OR = 1.92, p = 0.01) and sugary food (OR = 2.16, p = 0.001), and a lower frequency of physical exercise (< 75 min/week; OR = 1.80, p = 0.017). In men, no association was observed between depression score and food consumption variables. An association was observed between depression and low exercise frequency (OR = 2.22, p = 0.006).nnnCONCLUSIONSnwomen vulnerable to depression may use food to cope with negative mood states. Therefore, institutional health promotion and nutritional education programs should include adequate emotion and stress management.