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D A de Luis Román

Publications and source records attributed to D A de Luis Román.

13 recordsLinked to original sources
PubMed2005

[Mini Nutritional Assessment (MNA) test as a tool of nutritional evaluation in hospitalized patients].

OBJECTIVE: The objective of the study was to identified the prevalence of malnutrition in come patients with MNA (Mini Nutritional Assessment) test as a clinical tool. METHODS: A total of 145 patients were studied in Hospital del Río Hortega (Valladolid), from mars of 2000 till may of 2002. In all patients a MNA test, an anthropometric and biochemical evaluation were performed. RESULTS: Mean age was 57.44 +/- 18.06 years, weight 63.5 +/- 13.7 kg and body mass index 23.4 +/- 4.9 kg/m2. The studied population were 48.6% haematological tumours and other tumours, opposite to the rest of the patients who were presenting cerebro-vascular accidents 2.1%, respiratory problems or infections 16.8%, renal failure 3.5% and neurological diseases or processes of dementia in minor proportion 2.9%. Patients were divided in two groups, malnutrition MNA < 17 (n = 99) (group I) and risk of malnutrition MNA = 17 (n = 43) (group II). The malnutrition prevalence was 68.2% (group I) and risk of malnutrition 29.6% (group II) with test MNA. In biochemical evaluation the malnutrition group I had low levels of albumin (2.9 +/- 0.7 g/dl vs 3.41 +/- 2.71 g/dl; p < 0.05), prealbumin (14.9 +/- 6.2 g/dl vs 17.6 +/- 8.1 g/dl; p < 0.05) and transferrin (152.2 +/- 54.9 g/dl vs 189.9 +/- 32.6 g/dl; p < 0.05. Arm muscular circumference and arm circumference had values under average in patients with malnutrition. On having analyzed the different paragraphs of the test MNA between both groups, it was observed since in the group of undernourished patients the punctuation he was below the average in all the paragraphs. CONCLUSIONS: The risk of malnutrition in hospital was frequent, detected by MNA test.

Adult↗
PubMed2005

[Maple syrup disease: a rare entity that we must know. Review of its dietetic management].

Maple syrup disease is secondary to a deficiency of deshydrogenase complex of a cetoacid of branched-chain. This disease has a recessive autosomic inheritance, with an incidence of 1/200,000 newborns, without differences between male and female. Due to clinical presentation and biochemical response to tiamin, these patients can be classified in five clinical entities: classic, intermediate, intermittent, positive response to tiamin and deficiency of dihydrolipoyl deshydrogenase (E3). In these patients, an increase of seric branched-chain aminoacids is detected, it could be detected by (chromatography) during neonatal period. Valine, isoleucine, and aloisoleucine are increased in serum, orine, and cephaloraquideum liquid by ionic changed chromatography, chromatography of high resolution or high voltage electrophoresis. Patients have two phases in this disease (acute phase and maintaining phase). Objectives in acute phase are based in three topics: to eliminate toxic metabolites, nutritional support and to get anabolism. Utilization of hemodialysis/peritoneal dialysis/blood exchange is one of the first treatments. Dietetic support is the second treatment, with a minimum energy intake and controlling blood levels of aminoacids. Modified dietetic formulas is a main device to treat these patients.

Humans↗
PubMed2004

Effects of dietary intake and life style on bone density in patients with diabetes mellitus type 2.

OBJECTIVE: The aim of our study was to investigate the relation among glycemic control, lifestyle and dietary intake with bone mineral density in patients with diabetes mellitus type 2. DESIGN: Cross-sectional study. SETTING: Tertiary care hospital. PARTICIPANTS: A cross-sectional study in a tertiary care hospital was performed. Ninety-two patients attending our diabetes service (56 females/36 males) with diabetes mellitus type 2 were enrolled in a consecutive way. The inclusion criteria were diabetes diagnosed >40 years of age, with type 2 diabetes defined in accordance with the criteria of the American Diabetes Association and no use of dietary supplements. Body mass index, waist-to-hip ratio, glucose level, and HbA1c levels were assessed in all patients. X-ray densitometry of the calcaneal region and a 3-days written food record keeping, and a qualitative questionnaire of lifestyle were also performed. RESULTS: A total of 21.7% of patients had osteoporosis (T score <2.5 SD). Patients were overweight with a high BMI and a medium glucose control. Patients with osteoporosis were older than those without osteoporosis (67.8 +/- 6.9 vs. 62.1 +/- 9.2 years; p < 0.05). Significant differences were detected between patients without and with osteoporosis in calcium intake (1,219.37 +/- 387 vs. 839 +/- 251 mg/day; p < 0.05) and zinc intake (9.23 +/- 3.5 vs. 13.3 +/- 6.9 mg/day; p < 0.05), respectively. No differences were detected in other dietary dairy intakes. In correlation analysis age (r = -0.23; p < 0.05) and BMI (r = 0.48; p < 0.05) was correlated with BMD. In univariate analysis with dicotomic variables, only exercise was positive associated with osteoporotic status (87.5% exercise habit in patients without osteoporosis and 25% exercise habit in patients with osteoporosis; p < 0.05). In a logistic model with the dependent variable (osteoporosis), remained in the final model dietary dairy intake of calcium and zinc, BMI, age and exercise. Exercise, calcium intake and BMI were protective factors. Zinc intake, and age were risk factors. CONCLUSIONS: Exercise, calcium intake, body mass index had a protective role in bone mineral density in patients with diabetes mellitus type 2. Zinc intake and age were risk factors in our population.

Absorptiometry, Photon↗
PubMed2004

[Usefulness of miglitol in patients with diabetes mellitus type 2 and insufficient control of the blood glucose].

OBJECTIVE: Miglitol belongs to the group of the inhibitors of the alpha-glucosidases and in several studies has demonstrated its usefulness in the improvement of the glycemic control in the different types of diabetic patients. The goal of our study was to analyze the usefulness of miglitol in the blood glucose and lipid control in a group of patients with diabetes type 2 treated with sulfonylureas and insulin, with insufficient glycemic control. PATIENTS AND METHODS: A group of 33 patients with diabetes mellitus type 2 treated with sulfonylureas and insulin and with insufficient glycemic control (HbA1c>7.5%) was studied. All patients were treated with miglitol during 3 months with progressive doses: the first week 50 mg twice a day, subsequently and during one month 50 mg three times a day. At the beginning of the study and up to three months the following variables were measured; weight, height, BMI (body mass index), systolic and diastolic blood pressure, HbA1c, number of episodes of peripheral hypoglycemia, basal glucose, albuminuria, total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides, as well as transaminases (GOT, GPT, gamma GT and bilirubin). RESULTS: The median age was 64.1 +/- 12.5 years, and the median length of diabetes mellitus was 9.1 +/- 7 years. The median value of BMI was 27.7 +/- 6.9 kg/cm2. The blood glucose and HbA1c values decreased 4.8% and 5.8%, respectively. A decrease in the number of hypoglycemia episodes (39.4% previous quarter versus 3% quarter wih miglitol) was observed. Also decreased the dose of sulfonylureas needed by the patients (86.2 +/- 24.3 mg/day versus 64.6 +/- 21.9 mg/day; p<0.05) (25%). Total cholesterol, HDL-cholesterol, and LDL-cholesterol levels were not modified, but indeed a reduction of the levels of triglycerides (145.2 +/- 111 mg/dl versus 133.1 +/- 79 mg/dl; p<0.05) (8.3%) was detected. Fifteen percent of patients showed side effects (digestive discomfort) that disappeared two or three weeks after beginning the treatment. CONCLUSIONS: Miglitol is a useful drug in order to improve the glycemic control in diabetic type 2 patients treated previously with other drugs and with insufficient control of the blood glucose. Its side effects are limited and transitory.

1-Deoxynojirimycin↗
PubMed2004

[Colonic polyps: dysplasia predictive factors].

OBJECTIVE: Analyze the presence of dysplasia in colonoscopy visualized colonic polyps, and the predictive factors for high grade dysplasia. MATERIAL AND METHODS: We studied the polyps observed in the colonoscopies carried out during the year 2001. Colonoscopies carried out in 2,144 patients were analyzed, with demonstration of polyps in 326 patients (average age: 67 12,6 years, 63,5% males). 732 polyps were analyzed, with average of 2.27 2 polyps by patient. RESULTS: 72% polyps were located distally to splenic flexure, and sigmoid colon was the most frequent location (34.7%). Most of the polyps (86%) were sessile. Only 3% were > 2 cm, and the majority (88%) was < 1 cm. The most prevalent histological type was tubular adenoma (36%). Dysplasia was observed in 42.2% (low grade in 40% and high grade in 2.2%) Size > 1 cm and location proximal to splenic flexure were the only variables with indendent significant association to high grade dysplasia. CONCLUSIONS: The presence of high grade dysplasia in the colonic polyps was related in our cohort both to the location of the polyps in the colon and to its size, so that greater risk was for proximal polyps and for polyps > 1 cm.

Aged↗
PubMed2003

[Observational study on the efficacy of the application of two classical regimens of triple antiretroviral therapy].

BACKGROUND: To compare the temporal evolution of viral load and CD4 parameters in two cohorts of HIV infected patients enrolled in classical triple antiretroviral regimens. METHODS: Retrospective, observational, descriptive study of the proportions of patients reaching undetectable levels of viral load (VL) as well as the time necessary to get it. The two cohorts were as follows: 91 HIV patients on triple therapy with zidovudine plus lamivudine and indinavir (cohort A) versus 80 HIV patients with Stavudine plus Didanosine and Indinavir (cohort B). RESULTS: The evolution of the patients in terms of percentages who reach undetectable VL was similar in the two therapeutic cohorts (75.8%for cohort A vs 73.8% for cohort B) along the duration of the study (four years). However, the mean time period needed to reach undetectable VL was different, 209 days (IC 95% 175-243 days) for patients in zidovudine plus lamivudine and indinavir and 330 days (IC 95% 263-396 days) for stavudine plus didanosine and indinavir regimen. The immunological status observed in the patients when reaching his first undetectable VL was significantly different. The proportion of patients with CD4 cells counts >200/mm3 in cohort A was 83.1% while for patients from cohort B was 65.4% (p=0.032). CONCLUSIONS: This observational study from clinical settings seems demonstrate similar efficacy to reach undetectable VL with both classical triple antiretroviral therapies evaluated but a shorter delay of time to reach that virological situation for zidovudine plus lamivudine and indinavir regimen is reported.

Anti-HIV Agents↗
PubMed2001

Nutritional treatment for acquired immunodeficiency virus infection using an enterotropic peptide-based formula enriched with n-3 fatty acids: a randomized prospective trial.

OBJECTIVE: Dietary counseling and intervention based on application of conventional criteria have been ineffective in preventing the progressive weight loss associated with HIV infection. The aim of the study was to compare the progression of clinical and nutritional indicators during nutritional supplementation with or without an enterotropic peptide-based formula enriched with n-3 fatty acids. DESIGN: Randomized trial. SETTING: Tertiary care. SUBJECTS: Ninety-one patients were screened for the study. Twenty-three did not meet the inclusion criteria, therefore 74 patients were randomized. Of these, 38 were randomized to group I (standard formula) and 36 were randomized to group II supplementation (enterotropic peptide-based formula enriched with n-3 fatty acids). INTERVENTIONS: Group I received standard enteral formula and group II received a enterotropic peptide-based enteral formula. The volume was the same (3 cans/day, 236 ml per can). In both groups enteral supplementation were recommended in conjunction with a registered dietitian under a dietary counseling program based on standard nutrition principles. Patients received a prospective serial assessment of nutrition status, nutritional intake with 24 h written food records, GI symptoms, immune function, anthropometric status and intercurrent health events including infections and hospitalization. These determinations were performed at baseline and at 3 months. RESULTS: Treatment with both supplements resulted in a significant and sustained increase in weight (3.2% in group I and 3.1% in group II); this increase was mostly due to fat mass (12.8% in group I) and (7.5% in group II). Total body water and fat free-mass remained unchanged. CD4 counts remained stable in group I, while a significant increase was detected in group II (576+/-403 vs 642+/-394 cells/mm(3); P<0.05). After the 3 month period CD4 counts remained higher in group II. Hospitalization events (infections) were also followed during the 3 month period. Group II had fewer hospitalizations than group I, but no statistical differences were found. CONCLUSIONS: Oral nutritional supplements for a 3 month period were well tolerated and resulted in body weight gain in HIV-infected patients. Supplement-enriched formula, with peptides and n-3 fatty acids, increased CD4 count.

Adolescent↗
PubMed1999

[Morbidity in transsexual patients with cross-gender hormone self-treatment].

BACKGROUND: The demand for sex reassignment in transsexual patients has increased as have the number of treatments. However, these patients run into troubles to be treated in Spanish public hospitals and the patients usually make use of self-therapy, without medical control, by suffering frequent side effects. In this paper, we have analysed these effects. PATIENTS AND METHODS: Cross-sectional and descriptive study of the side effects of cross-gender hormone self-administration in 57 transsexuals, aged (median [SD]) 30(7) years. RESULTS: Combined treatment with estrogen and cyproterone acetate in 31 male-to-female transsexuals was associated with hyperprolactinemia in 24/31 patients (77.4%) and elevation of liver enzymes in 4/31 (12.9%). Androgen treatment in 26 female-to-male transsexuals was associated with hyperprolactinemia in 10/26 patients (38.5%), elevation of liver enzymes in 5/26 (19.2%). The levels of total cholesterol, LDL-cholesterol and triglycerides were higher in female-to-male that in male-to-female transsexuals (197.3 [40.2] vs 160.6 [38.0] mg/dl, p = 0.033; 131.4 [29.4] vs 104.8 [26.4] mg/dl, p = 0.049; and 131.3 [62.7] vs 67.4 [25.6], p = 0.001, respectively). Total cholesterol/HDL-cholesterol and LDL-cholesterol/HDL-cholesterol ratios were higher in female-to-male that in male-to-female transsexuals, too (4.94 [1.20] vs 3.32 [0.71], p = 0.006; and 3.20 [0.87] vs 2.04 [0.63], p = 0.003, respectively). CONCLUSIONS: The alteration of the cardiovascular risk, the presence of hyperprolactinemia and the elevation of liver enzymes must be taken into account in transsexual patients with hormone treatment.

Adolescent↗