Resumen Antecedentes: los pacientes mayores no institucionalizados a los que se les prescribe un suplemento nutricional oral (SNO) suelen tener dificultades con el cumplimiento, lo que origina ...deterioro físico e incrementa el riesgo de desnutrición. Objetivo: evaluar la proporción de pacientes mayores de 60 años que mejoran su categorización de la versión completa del Mini Nutritional Assessment (MNA) desde el inicio hasta la visita final tras la intervención de un nutricionista en el seguimiento de pacientes desnutridos y con indicación de SNO a lo largo de 6 meses. Demostrar que la intervención de un nutricionista aporta mejoras a largo plazo en el estado nutricional de los pacientes desnutridos que están tomando un SNO. Resultados: la intervención nutricional mejoró significativamente el IMC (de 22,9 ± 4,5 a 24,0 ± 4,1; p = 0,001), y la puntuación MNA (de 14,7 ± 4,4 a 20,4 ± 5,8 p < 0,001) de los pacientes, así como su percepción de la salud (medida mediante una EVA). Conclusiones: el consejo nutricional proporcionado por un nutricionista en los pacientes que ewstán tomando un SNO, consiguió una elevada adherencia al tratamiento, lo que produjo una mejora en el estado nutricional de los pacientes.
Background: non-institutionalized elderly patients who are prescribed an oral nutritional supplement (ONS) often have difficulties with compliance, which leads to physical deterioration and increases ...the risk of malnutrition. Objective: to assess improvement in the nutritional status of patients over 60 years of age, using the Mini Nutritional Assessment (MNA) score after the intervention of a nutritionist during a 6-month follow-up of malnourished patients with an indication for ONS. To demonstrate that the intervention of a nutritionist provides long-term improvements in the nutritional status of malnourished patients who are taking an ONS. Results: the nutritional intervention significantly improved BMI (from 22.9 ± 4.5 to 24.0 ± 4.1; p = 0.001) and the MNA score (from 14.7 ± 4.4 to 20.4 ± 5.8; p < 0.001) of the patients, as well as their perception of health (measured by VAS). Conclusions: the nutritional advice provided by a nutritionist to patients who were taking an ONS provided a high rate of adherence to treatment, which resulted in improvement in the nutritional status of patients.
The prevalence of overweight and obesity has increased very significantly in recent decades and is a major public health problem in Spain and in most developed countries. Overweight and obesity ...increase the risk of many other diseases such as cardiovascular disease, insulin resistance, type 2 diabetes, hypertension, dyslipidemia and certain types of cancers. In this context, the increase in life expectancy in our environment, determines that in nursing homes prevalence of diabetes has increased from 16 to 23 percent in the period 1996-2004. In addition there are to take into account that older adults with diabetes suffer from excess morbidity and mortality compared with those without diabetes, which together with its basic characteristics, complicating their management. It is often found in these patients polypharmacy, functional disabilities, as well as geriatric syndromes common as cognitive impairment and risk of falls. Recently it has been marketed lixisenatide (LIX). It is a GLP-1 short-acting. We conducted a study in which we aim to evaluate the effect on glycemic control and other metabolic variables by adding lixisenatide (LIX) a cohort of patients older than 65 years treated with combination therapy of oral agents and basal insulin (BOT).
La prevalencia de sobrepeso y obesidad se ha incrementado de una forma muy notable en las últimas décadas y constituye un gran problema de salud pública tanto en España como en la mayoría de los países desarrollados. El sobrepeso y la obesidad incrementan el riesgo de padecer muchas otras patologías como enfermedades cardiovasculares, insulín-resistencia, diabetes tipo 2, hipertensión, dislipemia y ciertos tipos de cánceres. En este contexto, el aumento de la esperanza de vida en nuestro medio, determina que en residencias de ancianos la prevalencia de diabetes haya aumentado del 16 al 23 por ciento en el periodo de 1996-2004. Además hay que tener en cuenta que los adultos mayores con diabetes sufren un exceso de morbilidad y mortalidad en comparación con aquellos sin diabetes, lo que unido a sus características de base, complica su manejo. Es frecuente encontrar en estos pacientes polifarmacia, discapacidades funcionales, así como síndromes geriátricos comunes como deterioro cognitivo y riesgo de caídas. Recientemente se ha comercializado lixisenatide (LIX). Se trata de un análogo de GLP-1 de acción corta. Hemos realizado un estudio en el que nuestro objetivo es evaluar el efecto sobre el control glucémico y otras variables metabólicas mediante la adición de lixisenatide (LIX) a una cohorte de pacientes mayores de 65 años tratados con la terapia de combinación de agentes orales e insulina basal (BOT).
Carbohydrate: current role in diabetes mellitus and metabolic disease Luna López, Victoria; López Medina, José Antonio; Vázquez Gutiérrez, Mercedes ...
Nutrición hospitalaria : organo oficial de la Sociedad Española de Nutrición Parenteral y Enteral,
2014-Nov-01, 20141101, Volume:
30, Issue:
5
Journal Article
There is a prevalence of diabetes mellitus (DM), unknown DM and stress hyperglycemia among hospital patients, and the nutritional treatment is a key part of care, where carbohydrates (CH) intake is a ...controversial issue. There is also a discussion on the increase of prevalence for DM, obesity and metabolic disease with refined CH or sugar.
This review examines the recommendations from different scientific societies about the percentage of CH in the total calorie intake of the diabetic patient, the CH value in the glycemic index and glycemic load, the new CH included in enteral formulae and the association of refined CH with the high prevalence of DM and metabolic disease.
Systematic review of literature using the electronic scientific databases Pubmed, Science Direct, Scielo, Scopus and Medline.
Scientific societies are flexible about the CH intake in the diet of diabetic patients, suggesting to customize it according to each metabolic profile. Using the glycemic index and glycemic load can provide an extra benefit in the postprandial glycemic control. The new diabetes-specific enteral formulae, with fructooligosaccharides, resistant maltodextrins and fructose-free show efficacy in improving the glycemic control, although more controlled and long-term studies are needed. There is still some controversy about the links between sugar intake and DM, obesity and metabolic disease, although this relationship would be more linked to an increase of the total calorie intake than to a specific nutrient.
Introducción: La diabetes mellitus (DM), la DM no conocida y la hiperglucemia de estrés en pacientes hospitalizados, es prevalente, y el tratamiento nutricional es una parte fundamental de su ...cuidado, siendo el aporte de hidratos de carbono (HC) uno de los aspectos controvertidos. Igualmente está a debate el incremento de la prevalencia de DM, obesidad y enfermedad metabólica con los HC refinados o azúcares. Objetivos: Esta revisión examina las recomendaciones de las distintas Sociedades Científicas en cuanto al porcentaje que los HC tienen que tener en el contenido calórico total de la dieta del diabético, el valor del índice y carga glucémica de los HC, los nuevos HC incluidos en las fórmulas enterales y la relación de los HC refinados con la alta prevalencia de DM y la enfermedad metabólica. Métodos: Revisión sistemática de la literatura usando las bases científicas electrónicas Pubmed, Science Direct, Scielo, Scopus y Medline. Conclusiones: Las Sociedades Científicas flexibilizan el aporte de HC en la dieta del diabético e indican individualizar la misma en función del perfil metabólico. El uso del índice y carga glucémica puede proporcionar un beneficio adicional en el control glucémico postprandial. Las nuevas fórmulas enterales específicas para diabetes, con fructooligosacáridos, maltodextrinas resistentes y sin fructosa son eficaces en mejorar el control glucémico, aunque necesitamos más estudios controlados y a largo plazo. Persiste controversia sobre la relación entre ingesta de azúcares y DM, obesidad y enfermedad metabólica, aunque la asociación estaría más relacionada con un aumento del aporte calórico total que con un nutriente específico.
Introduction: the EuroSCORE model has been used in various countries, including México, to estimate the probability of surgery-associated mortality. Several studies have shown deficiencies in its ...calibration while retaining good discrimination. The model was updated in 2012 and called EuroSCORE II. Objective: to evaluate the calibration and discrimination of the EuroSCORE II model in patients undergoing cardiac surgery in a high specialty hospital in México. Material and methods: an observational, cross-sectional, and retrospective study was performed. Patients ≥ 16 years old years who underwent cardiac surgery between the years 2008-2013 were included. The hospital mortality rate was obtained, and the EuroSCORE II was calculated online. Discrimination of the EuroSCORE II model was evaluated with the area under the curve of a receiver operating characteristics curve (AUC-ROC), and the calibration was assessed using χ2 of Hosmer-Lemeshow (H-L) goodness of fit test and risk-adjusted ratio (RAMR). Results: three hundred thirty-eight patients were included. The mean age of participants was 49.8 ± 16.61 years; 162 were women (47.9%), and 176 (52.1%) were men. Surgery types were valvular 108 (31.9%), coronary revascularization 101 (29.8%), congenital 51 (15.08%), and other 78 (23.07%). The average EuroSCORE II was 4.1 (95% CI, 3.53-4.68). Mortality observed was 10.9%. The AUC-ROC was 0.806 (95% CI, 0.739-0.872), consistent with good discrimination. The χ2 of H-L of 14.2, p = 0.08, compatible with adequate calibration. The RAMR was 2.65, indicating an underestimation of the model. Conclusion: the EuroSCORE II model showed good discrimination. The calibration was adequate according to the χ2 of H-L, but the value of the RAMR suggests that the model underestimates the risk of mortality.
Studies have shown that mesenchymal stem cell-derived exosomes can enhance neural plasticity and improve cognitive impairment. The purpose of this study was to investigate the effects of mesenchymal ...stem cell-derived exosomes on neurogenesis and cognitive capacity in a mouse model of Alzheimer's disease. Alzheimer's disease mouse models were established by injection of beta amyloid 1−42 aggregates into dentate gyrus bilaterally. Morris water maze and novel object recognition tests were performed to evaluate mouse cognitive deficits at 14 and 28 days after administration. Afterwards, neurogenesis in the subventricular zone was determined by immunofluorescence using doublecortin and PSA-NCAM antibodies. Results showed that mesenchymal stem cells-derived exosomes stimulated neurogenesis in the subventricular zone and alleviated beta amyloid 1−42-induced cognitive impairment, and these effects are similar to those shown in the mesenchymal stem cells. These findings provide evidence to validate the possibility of developing cell-free therapeutic strategies for Alzheimer's disease. All procedures and experiments were approved by Institutional Animal Care and Use Committee (CICUAL) (approval No. CICUAL 2016-011) on April 25, 2016.
The pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has quickly spread globally, infecting millions and killing hundreds of thousands of people. Herein, to ...identify potential antiviral agents, 97 natural amide-like compounds known as alkamides and piperamides were tested against SARS-CoV-2 main protease (Mpro) and RNA-dependent RNA polymerase (RdRp), and the human angiotensin-converting enzyme 2 (ACE2) using molecular docking and molecular dynamics simulations. The docking results showed that alkamides and dimeric piperamides from Piper species have a high binding affinity and potential antiviral activity against SARS-CoV-2. The absorption, distribution, metabolism, and excretion (ADME) profile and Lipinski’s rule of five showed that dimeric piperamides have druglikeness potential. The molecular dynamics results showed that pipercyclobutanamide B forms a complex with Mpro at a similar level of stability than N3-I. Our overall results indicate that alkamides and piperamides, and specifically pipercyclobutanamide B, should be further studied as compounds with SARS-CoV-2 antiviral properties.
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