[Poisoning by delayed-release verapamil in renal insufficiency patients].
Explore the source record for details and available documents.
Aged↗
Biomedical subjects
A Alfaro Olea
Publications and source records attributed to A Alfaro Olea.
[Liver dysfunction associated with total parenteral nutrition].
An evaluation is made of liver malfunctions in patients receiving TPN over a period of > or = 15 days between 1989 and 1991. Use was made of the monitoring records on patients undergoing TPN and, subsequently, of clinical records, with analysis of diagnoses and type of intervention, the biochemical parameters (SGOT, SGPT, GGT, FA, LDH, and total and direct bilirubin), and the type and degree of malnutrition, nutritional backup, associated medication, etc. A group of patients was excluded from the study on the basis of the following criteria: liver-biliary disease, cardiac insufficiency, liver metastasis, sepsis, kidney insufficiency and hepatotoxic drugs. Of 237 patients, 75 (31.64%) had liver alterations: following application of the exclusion criteria, 24 patients (10.12%) were taken with liver alterations attributable to the TPN. Macro- and micronutrients were included in the TPN. We found no relation between the kcal/kg of weight, nor with the quantity of glucose and fats nor of nitrogen, calculated according to individual requirements: they remained within the limits established. No serious case of cholestatic jaundice was encountered. Moderate to severe malnutrition was found in 50% of patients, so that this must be treated as a risk factor. GGT is the first enzyme to alter; this occurred in the largest proportion of patients (91.66%), followed by SGPT. FA and GOT are altered in the same percentage of patients. Biochemical parameter monitoring is essential in patients undergoing TPN, not only for appraisal of the nutritional state but also to prevent or correct potential serious metabolic complications.
Adult↗
[The protocolization and follow-up of enteral nutrition. 2 years of experience].
The Artificial Nutrition Unit was set up in 1980 in the Pharmacy Service, with the objective of preparing parenteral nutritional units. Different protocols were prepared, approved by the Commission of Pharmacy and Therapeutics. From 1986 onwards, follow-up was commenced and since March 1988, nutritional evaluation of the patients on enteral nutrition has been performed. Encouraged by the results obtained, a proposal for protocolizing enteral nutrition was put to the Commission of Pharmacy and Therapeutics, which was approved in December 1988. The main objective was to select the enteral diets which would be used as a formula for existing hospital diets and, after establishing this formula, protocolize the indications that would assists in selecting from among the diets available, the ones that would best adapt to the individual needs of each patient. As a secondary objective, the Artificial Nutrition Unit took on the responsibility of processing the medical instructions and dispensing enteral diets using the dosage/patient/day distribution system. It also provides information to medical and nursing staff on existing diets, as well as on rules for administration and storage in nursing units, providing when necessary the most suitable containers, equipment and pumps for administering the diets. It also carries out a nutritional evaluation of patients exclusively on enteral nutrition, as well as follow-up of these. Finally, it prepares the monthly actual cost figures generated by each nursing unit, since diets not administered after twenty-four hours are returned to the Nutrition Unit. One problem existing is the non-administration of products or patients who refuse to take their diets.(ABSTRACT TRUNCATED AT 250 WORDS)
Clinical Protocols↗