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D de Luis Román

Publications and source records attributed to D de Luis Román.

9 recordsLinked to original sources
PubMed2004

[Enteral nutrition; direct costs in a tertiary care hospital].

INTRODUCTION: The studies in which the direct costs generated by enteral nutrition have been analyzed in hospitals of our country are limited. The objective of our study has been the analysis of costs incurred by this treatment in our center. MATERIAL AND METHODS: A total of 449 consecutive patients who received nutritional support and that were hospitalized in the Hospital Río Ortega (Valladolid) since January 1999 to June 2001 has been studied. In this study only the direct costs were analyzed. RESULTS: The nutritional support was effective in the complete group with an improvement in the serum levels of albumin, prealbumin, and transferrin. In the analysis of direct costs generated by enteral nutrition the total median cost was of 598.4 +/- 761 euros/total treatment/patient, which represents a daily median cost of 36.3 +/- 8.8 euros/day/patient. In the analysis of costs by paragraphs, the expendable equipment constituted 36% of the total, representing the tubes 3%, the lines of nutrition 12%, the containers 21% and the nutritional preparations 64%. A cost analysis was also carried out in relation to the different groups of pathologies, and in this way the patients with hematological tumors and the patients with higher aereodigestive tract tumors showed some greater costs, due to their higher median hospital stay. The patients who received nutrition through a gastrostomy probe showed also higher costs, in addition due to a greater hospital stay. CONCLUSIONS: The costs of the nutritional support were superior in the group of patients with hematological tumors and with higher aereodigestive tract, due to their greatest hospital stay. A greater cost in the patients whose access route was the gastrostomy was also observed.

Direct Service Costs↗
PubMed2004

Iron overload and genotype 3 are associated with liver steatosis in chronic hepatitis C.

OBJECTIVE: To determine epidemiological, biochemical, virological, and histological factors associated with liver steatosis in chronic hepatitis C. SUBJECTS: The medical histories of 53 patients biopsied for chronic hepatitis C diagnosis between June 2000 and December 2002 were retrospectively studied. Epidemiological, biochemical, and virological data were collected. Patients with hepatitis B virus or human immunodeficiency virus coinfection were excluded. Liver biopsy specimens were reviewed and scored by one pathologist. Weight and height were measured at liver biopsy time. The statistic association between qualitative and quantitative variables and the presence of liver steatosis was studied. RESULTS: Steatosis was identified in 52% of biopsies. There was no statistic association with age, sex, method of transmission, duration of infection, alcohol consumption, other diseases, body mass index, glucose, triglycerides, cholesterol, AST, ALT, GGT, alkaline phosphatase, bilirubin, or viral load. Liver steatosis was associated with serum iron, transferrin saturation, and ferritin. Genotype 3 was also associated with steatosis. Piecemeal necrosis, hepatocellular injury, Kupffer cell hyperplasia, liver iron, and portal fibrosis were also associated with steatosis. A multivariate analysis showed that genotype 3, Kupffer cell hyperplasia, and liver iron were associated with the presence of steatosis. CONCLUSIONS: Liver steatosis in chronic hepatitis C associates with genotype 3, Kupffer cell hyperplasia, and iron overload. Hepatic steatosis also associates with greater inflammation and fibrosis, and must be considered to contribute to disease progression.

Adult↗
PubMed2003

[Home enteral nutrition: analysis of efficiency in a Health District].

INTRODUCTION: Studies on the analysis of direct costs generated by household enteral nutrition (HEN) have been scant. The objective of our study was to carry out a direct costs analysis of household enteral nutrition using both the biochemical and nutritional monitoring values of the nutritional state as a point of reference. MATERIAL AND METHODS: Since January 1999 until December 2001, we studied a total sample of 102 consecutive patients with indication of household nutritional support. The following epidemiological data were obtained in all patients: age, sex, and primary condition for which enteral nutrition was prescribed; we carried out an anthropometric assessment and a biochemical nutritional assessment quarterly. We recorded also the number of episodes of diarrhea, vomiting, aspiration pneumonia, and death during the treatment. RESULTS: Average age of the patients was 58.7 13.3 years. The number and proportion of patients according to primary conditions were the following: 71 (69.3%) with head and neck cancer, 14 (13.9%) with a neurological condition with swallowing disturbance (stroke and/or dementia), 6 (5.9%) with tumors in other locations, and 11 (10.9%) with a group of diseases associated with dysphagia or anorexia. HEN was administered by oral route in 81 patients (79.4%), by nasogastric tube (NGT) in 15 patients (14.7%), by PEG in 5 patients (4.9%) and by yeyunostomy in 1 patient (1%). Average duration of HEN was 101 46.9 days. We showed a significant improvement of biochemical and anthropometric parameters in patients with HEN. The economic analysis of direct costs generated by enteral nutrition showed that the total average cost of nutritional formulas and expendable equipment utilized (holders, probes and nutritional tubes) was 300,033 599,203 pesetas/full treatment/patient (1,803 3,601 euros), or a daily average cost of 2,970 5,932 pesetas/day/patient (17.8 35.6 euros). In the analysis of costs acording to different items, the expendable equipment (nutritional tubes, nasogastric tubes and nutritional formula holders) were an average of 1,284 4,571 pesetas/full treatment/patient (7.7 27.4 euros) (5% in total), and the nutritional preparations were an average of 231,313 399,756 pesetas/full treatment/patient (1,390.2 2,402 euros) (95%). The patients with greater resources expenditure were those with tumors of head and neck. In order to analyze the efficiency of this treatment an analysis of costs was carried out for each objective parameter indicating nutritional status improvement; that way, the increase of 1 g/dl of albumin was an average cost of 103,817 2,897 pesetas (623.9 17.4 euros), while the increase of 1 kg of weight was an average cost of 857,237 25,097 pesetas (5,152.1 150.8 euros). CONCLUSIONS. In summary, nutrition enteral household was an effective therapy for nutritional status improvement in different groups of ambulatory patients. The cost of the nutritional support was superior in the group of patients with tumors of the upper aereodigestive system because of the greater duration of the treatment and the complex access route.

Cost-Benefit Analysis↗
PubMed2003

[Hypothyroidism: clinical and economical implications in a health area].

OBJECTIVE: To analyze the clinical, biochemical and epidemiological characteristics in patients with hypothyroidism, substitutive dose and annual direct costs, in a health area. MATERIAL AND METHODS: Seventy five patients attended in a health area were included in the review. Data was divided in epidemiological, biochemical, clinics and economics. RESULTS: A 94.7% were females and 5.3% males, with an average age of 52.07 + 16.5 years. The most frequent disease was Thyroiditis of Hashimoto 48% and atrophic thyroiditis 46.6%. Average value of TSH was 17.57 + 40.8 mUI/ml and TPO 629.3 + 1049 UI/ml and Ac TG 532.1 + 1028 UI/ml. A 58.7% of patients had goiter, only evident 2.6%. The average dose of T4 was 81 + 53.5 mg/day. The average number of visits was 2.67 + 1.08. The highest cost was due to specialists visit 160 + 65 euros with a total average cost of 212.9 + 81.5 euros. Levels of TPO was higher in T. Hashimoto, with a higher number of visits and costs. CONCLUSIONS: The most prevalent disease was autoimmune (T Hashimoto and atrophic thyroiditis) with higher levels of TPO in Hashimoto. Total cost is higher in T. Hashimoto.

Antithyroid Agents↗
PubMedDate not supplied

[Assessment of the compliance of a 1,500 calorie diet in a population of overweight type-2 diabetics].

OBJECTIVE: In patients with diabetes type 2 the individual diet is a main point to reach a good metabolic control. The objective of our study was to evaluate the fulfilment of a 1.500 kcal/day diet in a group of overweight patients with diabetes mellitus type 2. METHODS: A total of 89 diabetic patients were studied in Hospital Universitario del Río Hortega (Valladolid), from March to September of 2000. In all patients the next datas were recorded; age, sex, years of diabetes evolution, with a 24 hours nutritional questionnaire and a frequency questionnaire. All patients had a body mass index higher than 25. RESULTS: Distribution of sex were (36 males y females), mean age 62.92 +/- 9.71 years, weight 75.62 +/- 13.06 kg and body mass index 29.92 +/- 5.97, with an evolution of diabetes (8.3 +/- 2.4 years). Nutritional evaluation showed a calorie intake of 1316 kcal, the recommended calories in the diet were 1522 kcal. Carbohydrates intake were lower than recommended (53.9% vs 43%), this decrease in the carbohidrates intake were compensated a high intake of lipids (23.4% vs 33%), proteins intake were 22%. Frequency questionnaire showed that 96% of population took 3 or more portions of fruit each day and 83% of population 3 or more portions of vegetables. CONCLUSION: Patients with diabetes mellitus type 2 performed a hypocaloric diet. Carbohydrates intake were the most important, with a high percentage of monounsaturated lipids and a good percentage of proteins.

Diabetes Mellitus, Type 2↗
PubMedDate not supplied

[24-hour oral intake in patients with upper aerodigestive tumors].

BACKGROUND: A lot of works have shown, alterations in oral intake of micro and macronutrients, in patients with upper aerodigestive tumors. The main aim of our work was to compare the daily intake in a group of patients with upper aerodigestive tumors versus a control group. METHODS: A group pf 35 patients with upper aerodigestive tumors were studied (8 oral cavity and 27 larynx). A group of 35 subjects were use as control group. In all patients the next parameters were taken; age, sex, smoking and alcohol consumption, type of tumors and a 24 hours oral intake questionnaire. RESULTS: Patients with upper aerodigestive tumors showed a high increase of calories intake (1545.3 +/- 359 cal/day vs 1264.4 +/- 240 cal/day; p < 0.05), carbohydrates intake (177.9 +/- 57.9 g/day vs 135.9 +/- 38.5 g/day; p < 0.05), total fats (58.2 +/- 18.4 g/day vs 45.9 +/- 15.4 g/day; p < 0.05) and saturated fats intake (19.4 +/- 7.7 g/day vs 11.9 +/- 6.1 g/day; p < 0.05). In micronutrients intake differences were detected, a low intake in tumoral patients of vitamin C (59.4 +/- 18.5 mg/day vs 141.5 +/- 83 mg/día; p < 0.05), folic acid (116.5 +/- 56.3 mg/day vs 180.5 +/- 78.5 mg/day; p < 0.05), and vitamin B2 (1.53 +/- 0.5 mg/day vs 23.9 +/- 6.5 g/day; p < 0.05). In minerals intake we detected a low intake in tumoral patients of calcium (702.9 +/- 363 mg/day vs 942.4 +/- 327 mg/day; p < 0.05). CONCLUSIONS: Patients with upper aerodigestive tumors take a high amount of calories, saturated fats and carbohydrates, and a low intake of vitamin C, folic, vitamin B12 and calcium.

Aged↗