Standardization of clinical procedures has become a desirable objective in contemporary medical practice. To this effect, the Spanish Society of Parenteral and Enteral Nutrition (SENPE) has ...endeavoured to create clinical practice guidelines and/or documents of consensus as well as quality standards in artificial nutrition. As a result, the SENPE´s Standardization Team has put together the "Document of Consensus in Enteral Access for Paediatric Nutritional Support" supported by the Spanish Society of Pediatric Gastroenterology, Hepatology and Nutrition (SEGHNP), the National Association of Pediatric and Neonatal Intensive Care Nursery (ANECIPN), and the Spanish Society of Pediatric Surgery (SECP). The present publication is a reduced version of our work; the complete document will be published as a monographic issue. It analyzes enteral access options in the pediatric patient, reviews the levels of evidence and provides the team-members' experience. Similarly, it details general and specific indications for pediatric enteral support, current techniques, care guidelines, methods of administration and complications of each enteral access. The data published by the American Society for Parenteral and Enteral Nutrition (ASPEN) and several European Societies has also been incorporated.
Standardization of clinical procedures has become a desirable objective in contemporary medical practice. To this effect, the Spanish Society of Parenteral and Enteral Nutrition (SENPE) has ...endeavoured to create clinical practice guidelines and/or documents of consensus as well as quality standards in artificial nutrition. As a result, the SENPE´s Standardization Team has put together the "Document of Consensus in Enteral Access for Paediatric Nutritional Support" supported by the Spanish Society of Pediatric Gastroenterology, Hepatology and Nutrition (SEGHNP), the National Association of Pediatric and Neonatal Intensive Care Nursery (ANECIPN), and the Spanish Society of Pediatric Surgery (SECP). The present publication is a reduced version of our work; the complete document will be published as a monographic issue. It analyzes enteral access options in the pediatric patient, reviews the levels of evidence and provides the team-members´ experience. Similarly, it details general and specific indications for pediatric enteral support, current techniques, care guidelines, methods of administration and complications of each enteral access. The data published by the American Society for Parenteral and Enteral Nutrition (ASPEN) and several European Societies has also been incorporated.La estandarización de procedimientos clínicos se ha convertido en un objetivo deseable en la práctica médica actual. La Sociedad Española de Nutrición Parenteral y Enteral (SENPE) está haciendo un considerable esfuerzo para desarrollar guías clínicas y/o documentos de consenso así como marcadores de calidad en nutrición artificial. Como fruto de ese esfuerzo el Grupo de Estandarización de SENPE ha elaborado un Documento de Consenso sobre Vías de Acceso en Nutrición Enteral Pediátrica, avalado también por la Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediátrica (SEGHNP), la Asociación Nacional de Enfermería de Cuidados Intensivos Pediátricos y Neonatales (ANECIPN) y la Sociedad Española de Cirugía Pediátrica (SECP). Esta publicación es una síntesis del documento consensuado que ha incluido el estudio en profundidad del acceso enteral pediátrico, la revisión de los niveles de evidencia y la experiencia de los componentes del Grupo. Se han considerado también los datos publicados por la American Society for Parenteral and Enteral Nutrition (ASPEN) y por diversas sociedades europeas. El texto completo se publicará como un número monográfico. En este trabajo se detallan las indicaciones generales y específicas de la nutrición enteral pediátrica, las técnicas, los cuidados generales y específicos, el modo de administración y las complicaciones de las diversas vías de acceso.
Serum levels of cystatin C, an endogenous inhibitor of cysteine proteases, provide an alternative method to creatinine-based criteria for measuring glomerular filtration rate. Preliminary data ...suggested that serum cystatin C levels parallel with the stage of liver fibrosis in chronic liver disorders. Our aim has been to evaluate the possible role of serum cystatin C as a marker of liver fibrosis in hepatitis C virus (HCV)-induced chronic liver disease.
100 consecutive patients (56 men, mean age 51.2 ± 9.5 yrs) with HCV-induced chronic liver disease, scheduled for their first liver biopsy and naïve for antiviral therapy were included. Liver fibrosis was evaluated with the METAVIR score. Serum cystatin C and standard laboratory tests were measured simultaneously. Patients with ethanol abuse (> 50 g/day), HBV or HIV coinfection or plasma creatinine ≥ 1.20 mg/dL were excluded. In addition, a second group of 16 patients fulfilling the same requisites and diagnosed with HCV-induced compensated cirrhosis by clinical evidence of portal hypertension was included.
Serum cystatin C levels significantly increase from F0 to F2 fibrosis stages, remained stable in F3 and F4 stages and increased again in the group of non-biopsied compensated cirrhosis. Serum cystatin C levels were higher in patients with moderate-advanced necroinflammation in the liver biopsy.
Serum cystatin C level may reflect current fibrogenic and necroinflammatory activities in chronic HCV-induced liver disease with normal renal function but can not be considered as a non-invasive marker of liver fibrosis.
There are wide interindividual differences in the risk of developing alcoholic cirrhosis. Transforming growth factor beta(1) (TGF-beta(1)) is the main cytokine involved in liver fibrogenesis. The ...TGF-beta(1) gene is polymorphic at several sites and these polymorphisms are probably related to differences in the rate of TGF-beta(1) synthesis. Our aim has been to analyse the influence of the TGF-beta(1) gene polymorphisms in the predisposition to advanced alcoholic liver disease (ALD) in ethanol abusers.
TGF-beta(1) single nucleotide polymorphisms at positions -509 (C or T), +869 (C or T, codon 10), and +915 (C or G, codon 25) were examined in 165 alcoholics with advanced ALD and in 185 healthy controls.
Among the 94 male patients with oesophageal varices, those carrying the GG genotype at position +915 were diagnosed at an older age than the remaining patients (age 52.1 years, standard deviation (SD) 9.9 vs. 45 SD 13.4, P=0.012). No other statistically significant differences were found in the distribution of the three TGF-beta(1) polymorphisms analysed individually or as combined haplotypes.
The polymorphisms at the TGF-beta(1) gene analysed in this study are probably not related to the risk of advanced ALD.
Background/aims:
There are wide interindividual differences in the risk of developing alcoholic cirrhosis. Transforming growth factor β
1
(TGF‐β
1
) is the main cytokine involved in liver ...fibrogenesis. The
TGF
‐β
1
gene is polymorphic at several sites and these polymorphisms are probably related to differences in the rate of TGF‐β
1
synthesis. Our aim has been to analyse the influence of the
TGF
‐β
1
gene polymorphisms in the predisposition to advanced alcoholic liver disease (ALD) in ethanol abusers.
Methods:
TGF
‐β
1
single nucleotide polymorphisms at positions –509 (C or T), +869 (C or T, codon 10), and +915 (C or G, codon 25) were examined in 165 alcoholics with advanced ALD and in 185 healthy controls.
Results:
Among the 94 male patients with oesophageal varices, those carrying the GG genotype at position +915 were diagnosed at an older age than the remaining patients (age 52.1 years, standard deviation (SD) 9.9 vs. 45 SD 13.4,
P
=0.012). No other statistically significant differences were found in the distribution of the three
TGF
‐β
1
polymorphisms analysed individually or as combined haplotypes.
Conclusions:
The polymorphisms at the
TGF
‐β
1
gene analysed in this study are probably not related to the risk of advanced ALD.
: Background/aims: There are wide interindividual differences in the risk of developing alcoholic cirrhosis. Transforming growth factor β1 (TGF‐β1) is the main cytokine involved in liver ...fibrogenesis. The TGF‐β1 gene is polymorphic at several sites and these polymorphisms are probably related to differences in the rate of TGF‐β1 synthesis. Our aim has been to analyse the influence of the TGF‐β1 gene polymorphisms in the predisposition to advanced alcoholic liver disease (ALD) in ethanol abusers.
Methods: TGF‐β1 single nucleotide polymorphisms at positions –509 (C or T), +869 (C or T, codon 10), and +915 (C or G, codon 25) were examined in 165 alcoholics with advanced ALD and in 185 healthy controls.
Results: Among the 94 male patients with oesophageal varices, those carrying the GG genotype at position +915 were diagnosed at an older age than the remaining patients (age 52.1 years, standard deviation (SD) 9.9 vs. 45 SD 13.4, P=0.012). No other statistically significant differences were found in the distribution of the three TGF‐β1 polymorphisms analysed individually or as combined haplotypes.
Conclusions: The polymorphisms at the TGF‐β1 gene analysed in this study are probably not related to the risk of advanced ALD.
La discectomía cervical anterior con artrodesis intersomática (DCAA) es una técnica quirúrgica ampliamente aceptada en el tratamiento de la enfermedad discal cervical. Recientemente se han ...introducido con esta indicación las cajas de tantalio debido a sus excelentes propiedades mecánicas y biológicas.
Presentamos los resultados iniciales clínicos y radiológicos de un estudio prospectivo de 24 pacientes intervenidos en nuestro servicio tras el empleo de cajas de tantalio en la DCAA. La evaluación clínica pre y postoperatoria se realizó mediante cuestionario que incluía una Escala Visual Analógica de dolor, el Índice de Oswestry, y la Escala de Zung. Los resultados fueron clasificados mediante los criterios de Odom. La evaluación radiológica incluyó radiografías dinámicas en las que se midieron las variaciones del ángulo de Cobb y la distancia interespinosa. Postoperatoriamente los pacientes fueron revisados en el tercer mes y al año de la intervención.
Todos los parámetros clínicos mejoraron de forma estadísticamente significativa. Según con los criterios de Odom, el 75% de los casos fueron considerados como excelentes o buenos. Sólo se confirmó clínica y radiológicamente un caso de pseudoartrosis. No se observaron diferencias significativas en las revisiones al año y a los 3 meses.
Las cajas de tantalio constituyen un implante prometedor y pensamos que útil entre las diversas opciones quirúrgicas para la DCAA, por sus buenos resultados clínicos, por la no necesidad de autoinjerto, y por su excelente compatibilidad con la resonancia nuclear magnética.
Anterior cervical discectomy and interbody fusion (ACDF) is a widely accepted surgical technique in the treatment of cervical disc disease. Tantalum cages have been recently introduced in spine surgery for interbody fusion because of the advantages of their mechanical properties.
We present the results of a prospective clinical and radiological study on 24 consecutive patients who underwent an ACDF with tantalum cages. Clinical evaluation was assessed preoperatively and after surgery by a questionnaire that included a Visual Analogic Scale (VAS) of neck and arm pain, the Oswestry Dissability Index and the Zung Depression Scale. Results were classified by Odom's criteria. Radiological evaluation included flexion-extension X-rays, and changes in distance between spinous processes and Cobb angle were measured. Postoperatively patients were reviewed 3 and 12 months after surgery.
A statisitical significative improvement in all clinical data was reported. According to Odom's criteria in 75% of patients the results were considered like excellent or good. Only one case of radiological and clinical pseudoarthrosis was confirmed. No significative differences were reported 3 and 12 months after surgery.
Tantalum cages are a very promising and usefull alternative among implants available for ACDF. Compatibility with MRI postoperative studies and the unnecessariness of autograft are some of their advantages.
Se presenta una clave de identificación dicotómica de 21 comunidades vegetales pascícolas con interés ganadero, presentes en la provincia de Salamanca, hasta el nivel jerárquico básico de asociación ...fitosociológica, y que figuran en la relación de hábitats de interés comunitario, aprobada por la Comunidad Europea mediante la Directiva Hábitat 92/43. Se hace una breve descripción de cada asociación en la que se mencionan datos ecológicos, florísticos, fitosociológicos, etc. Para elaborar la clave dicotómica se han utilizado caracteres fácilmente apreciables (biotipo, hábitat, humedad y tipo de suelos, especies dominantes, aprovechamiento de el ganado, etc.), que permiten una rápida identificación de cada asociación.
Continuando el estudio de las plantas medicinales espanolas pertenecientes a la familia Labiatae, en este volumen nos ocupamos de la subfamilia Stachyoideae, tribu Saturejeae, subtribu Menthinae, ...representada en Espana por el genero Mentha L.
Spanish medicinal plants, 2: Labiatae Ladero Alvarez, M; Valle Gutierrez, C.J; Santos Bobillo, M.T ...
Studia botánica,
(1987), Letnik:
6
Journal Article
Continuando el estudio de las plantas medicinales espanolas pertenecientes a la familia Labiatae, en este volumen nos ocupamos de la subfamilia Stachyoideae, tribu Saturejeae, subtribu Menthinae, ...representada en Espana por el genero Mentha L.