DIFFUSION OF CLINICAL NUTRITION THROUGH SCIENTIFIC SOCIETIES AND JOURNALS. A ROUND TABLE AT THE ROYAL ACADEMY OF PHARMACY | Author : Francisco J Sanchez Muniz | Abstract | Full Text | Abstract :This special article defines very briefly some central aspects of Artificial Nutrition as nutritional support in special situations in patients that are not able to maintain a sufficient digestive function to restore or maintain optimal nutritional status or in those malnourished or in the way to be. Subsequently it reviews the round table held in January 2018 at the headquarters of the Royal National Academy of Pharmacy, where this Royal Institution gave a tribute to Dr. Jesus M. Culebras, founder of the journal Nutricion Hospitalaria, and architect of many achievements and initiatives of the Sociedad Española de Nutrition Enteral and Parenteral of great importance in the field of Nutrition and Artificial Nutrition in Spain. Later, directives of the Journal Nutrición Hospitalaria, Farmacia Hospitalaria, Journal of Negative and Non Positive Results and Anales de la Real Academia Nacional de Farmacia participated in a workshop. Emphasis was placed on the convenience of increasing collaboration between the journals and entities that they represent, especially with regard to the framework of Nutrition and also of Artificial feeding, insisting on the need to start a series of meetings in the very near future with the purpose of defining competences and rights, and taking joint positions in publications, consensus agreements that would guarantee the dissemination and visibility of this issue of enormous importance for health. |
| TELEMEDICINE MAY FAIL IF IT IS NOT ADAPTED TO PATIENTS | Author : Ángel Molina Cano, Francisco Javier Callejas González, Francisco Agustín, Josefa María Panisello Royo, Javier Cruz, Pedro J. Tárraga López | Abstract | Full Text | Abstract :Introducción: El asma es una de las patologías crónicas más prevalentes del aparato respiratorio, suponiendo un importante problema de salud en momentos de exacerbación y mal control de la enfermedad.
En la mayoría de los casos diagnosticados, el seguimiento habitual y conocimiento de la enfermedad por parte del paciente ayuda a reducir de forma considerable el número de crisis y la sintomatología asociada. No obstante, diversos factores pueden enmascarar el correcto control del asma, tales como la afectación según estacionalidad, la situación asintomática en periodos Inter- crisis o incluso, patrones de seguimiento médico preestablecidos sin conocer la situación actual del paciente.
La telemedicina es una herramienta que permite interactuar a distancia con los pacientes, brindando posibilidad de objetivar el control de la patología e incluso modificar pautas de tratamiento. Hoy por hoy, donde el desarrollo tecnológico es una realidad, esta posibilidad ha dejado de ser una utopía para convertirse en una opción más para el seguimiento médico.
Objetivo: Comparar el grado de control entre pacientes asmáticos con seguimiento telemático y pacientes sin seguimiento telemático.
Método: Realizamos un estudio prospectivo, aleatorizado, triple ciego, en una población de pacientes asmáticos seguidos habitualmente en las consultas de Neumología del Complejo Hospitalario Universitario de Albacete empleando como metodología una plataforma digital accesible a través de conexión a la red (ordenadores/teléfonos inteligentes), que permiten al paciente ofrecer al médico que lo sigue información básica de forma diaria sobre el control de su enfermedad.
Resultados: Participaron 46 sujetos (25 grupo estudio y 21 grupo control). La cumplimentación farmacológica ha sido superior al 95% en los que han utilizado asiduamente el sistema. El Peak flow de los pacientes del estudio sufre un incremento del 7% respecto de los valores iniciales.
Más del 50% de los pacientes habían aumentado su tratamiento antes de entrar en el estudio, desde su inclusión en el estudio ninguno ha tenido que aumentar tratamiento. Incluso un 25% ha disminuido la dosis de tratamiento. Han mejorado su nivel según el tratamiento base un 32% de los pacientes.A los tres meses únicamente un 26% de los pacientes del grupo estudio y un 10 % del de control cumplían con la introducción de datos incluso tras los avisos que se emitían del portal, por lo que pese a los buenos resultados se decidió suspender el estudio, avisando a los pacientes.
Conclusiones: El seguimiento a medio-largo plazo de los programas mediante telemedicina se constata dificultoso. Tiene que hacerse una adaptación de la telemedicina a los pacientes y a la inversa. |
| IDENTIFICATION OF RISK FACTORS AND PERSPECTIVES OF ADOLESCENTS REGARDING PREGNANCY, SEXUALITY AND CONTRACEPTION | Author : Janette Carrillo Soto, Daniel Manzanero Rodríguez | Abstract | Full Text | Abstract :Aims: Describe the risk factors and perspectives of adolescents regarding pregnancy, sexuality and contraception at the Hospital General de Jerez, Zacatecas.
Material and methods. Transversal, observational and descriptive study. The population consisted of 137 teenagers or young mothers with a history of pregnancy who attended a consultation in the General Hospital of Jerez and who were between 14 and 22 years old.
Results. The average age of the 137 adolescents surveyed was 19.8 ± 1.9 years. 56.2% were single, 68.5% have primary and/or secondary, 75.9% of them depended economically on their father before getting pregnant and currently only 34.3% of them continue with their studies.
Conclusion. The information regarding the risks of pregnancy in adolescents presented in this document is insufficient. It is necessary to reinforce in schools, community health centers, hospitals, neighborhoods and homes, preventive education to avoid pregnancy at an early age and that this brings consequences for the adolescent mother, the child and her family. |
| INTRAVENOUS GLUTAMINE DOES NOT MODIFY LEUCOCYTE COUNT BUT SHORTENS DURATION OF MUCOSITIS AFTER BONE MARROW TRANSPLANT | Author : María Belén Andrade Hernández, Marcela Alejandra Chaug Solórzano, Francisco Xavier Andino Rodríguez, Víctor Hugo Sierra Nieto, Dolores Rodríguez Veintimilla | Abstract | Full Text | Abstract :Rationale: Intravenous administration of Glutamine dipeptides (Gln) has been proposed as treatment of oral mucositis following a bone marrow transplant (BMT).
Objective: To establish the effects of intravenous Gln supplementation upon the severity of oral mucositis after BMT.
Study design: Retrospective, analytical.
Study serie: Records from 25 patients (Males: 56.0%; BMT cause: Leukemia: 64.0%) who developed oral mucositis (Grades III – IV: 48.0%) after BMT (Autologous: 44.0%) at the "Juan Tanca Marengo" Hospital (Guayaquil, Ecuador) between 2009 – 2017.
Glutamine source: Dipeptiven©®: 13 grams of Gln suspended in 100 milliliters of a 20% solution of the alanine-glutamine dipeptide (Fresenius-Kabi©®, Germany).
Materials and Methods: Gln-treated patients received 3(4.0% of the treatment leg), 5 (20.0%); 6 (12.0%); 7 (48.0%); or 10 (16.0%) doses of the dipeptide until resolution of the symptoms. Impact of Gln was estimated from changes observed in the severity and duration of mucositis, white blood cell counts, and body weight regarding 25 non-Gln treated patients (Males: 68.0%; Leukemias: 32.0%; Autologous graft: 68.0%; Grade III – IV mucositis: 48.0%).
Results: Intravenously-administered Gln shortened duration of oral mucositis: Gln-Treated: 12.5 ± 5.1 days vs. Non-Gln Treated: 21.3 ± 17.8 days (p < 0.05). Also, intravenous Gln marginally ameliorated loss of body weight: Gln-Treated -4.5 ± 5.5% vs. Non-Gln Treated: -7.5 ± 5.7% (p = 0.07).
Conclusions: Intravenous Gln administration shortens duration of oral mucositis following BMT. Gln effect might be translated to a lesser weight loss in patients with oral mucositis. |
| CLINICAL RESEARCH FROM A FIRST LEVEL HOSPITAL. 5 YEARS EXPERIENCE (2013-2017) | Author : Julián Solís García del Pozo | Abstract | Full Text | Abstract :One of the products derived from the activity of health services is clinical research. In some studies, quality of healthcare in hospitals is related to clinical research. The first level hospitals have not been taken into account in these matters. They usually lack research management units support and have particular difficulties in this field. The present article describes clinical research of a first level hospital in Castilla-la Mancha from the publications in the last five years in which health personnel of this center participated. There is a reflection on the importance of promoting clinical research in these hospitals as well as maintaining a more significant relationship both with the university and with the larger hospitals and primary care centers in the area they serve. |
| OBESITY AND ITS RELATIONSHIP WITH BLOOD PRESSURE IN CHILDREN | Author : María José Aguilar-Cordero, Ignacio Valverde-Benítez, Raquel Rodríguez-Blanque, Ximena Leon- Ríos, Jessica Pamela Noack-Segovia, Antonio Manuel Sánchez-López | Abstract | Full Text | Abstract :Background: Childhood obesity is one of the most important problems in public health in 21st century. The high level of adiposity is associated with hypertension in early childhood, which could be related to a cardiovascular risk in different periods of life.
Aim: To identify the relationship between obesity and hypertension in children
Materials and methods: A systematic review of the PUDMED, CINAHL and SCOPUS databases have been done. The keywords or search terms used were: obesidad/obesity, presión arterial/blood pressure, hipertensión/hypertension, infancia/childhood, pediátrico/pediatric y niño/children.
Results: For this bibliographic review, 23 specific articles on childhood obesity and their relationship with arterial hypertension have been selected. To describe the relationship between these two pathologies and their impact on adulthood.
Conclusion: The obesogenic epidemic increases in developed and developing countries, which elevate cardiovascular factors. In the medium and long term, they can produce diseases in adult health. It is difficult the clinical management of hypertension in children. Nowadays, there are few actions, in terms of prevention, promotion and treatment of these pathologies. |
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