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P García Peris

Publications and source records attributed to P García Peris.

At least 19 recordsLinked to original sources
PubMed2006

[Heart failure, malnutrition and inflammation. Prevalence and relevant aspects in its assessment].

UNLABELLED: Heart failure is associated to alterations in the nutritional status that contributes to a worse prognosis of the disease. OBJECTIVE: To study protein-calorie malnutrition (PEM) prevalence, micronutrient deficits and increase of inflammatory parameters in patients with cardiac failure (CF). MATERIAL AND METHODS: Cross-sectional, observational study in 98 heart failure patients of Internal Medicine Service have been evaluated. We have analyzed biomedical, anthropometric variables (weight, size, BMI, tricipital fold), search of treatments, echocardiogram valuation and determination of albumin, pre-albumin, A and E group vitamins, ESR and C-reactive protein. We have defined protein malnutrition (PN) as albumin values RESULTS: Average age was 76.6 +/- 7.5. A total of 77.7% showed a functional class II-III/IV. Prevalence of PEM was 40%. Low albumin and prealbumin was found in 12.8% and 38.3% respectively (p < 0.05). Using BMI, 5.3% of patients had malnutrition. Nevertheless, if tricipital fold is used, EM was found in the 25.3% of the cases (p < 0.05). Iron iron, vitamin A and C-reactive protein levels were different in heart failure patients with PM (p < 0.05). The percentage of protein malnutrition in patients with LVEF < 45% was 16.4% versus 5.5% in diastolic dysfunction (p = 0.01). Treatment with ACE-inhibitors was 42.2%; in this group the malnutrition for any criterion was 13% vs 26% in the group of patients without ACE-inhibitors (p = 0.08). CONCLUSIONS: There is a high prevalence of nutritional and inflammatory disturbances (low in diastolic dysfunction) in patients with moderate status of heart failure. Treatment with an ACE-inhibitor improves the nutritional parameters.

Aged↗
PubMed2005

[Refeeding syndrome. A review].

Refeeding syndrome is a complex clinical picture that encompass all those alterations that can occur as a consequence of the nutritional support (oral, enteral or parenteral) in malnourished patients. Refeeding syndrome is classically characterized by neurological alterations, respiratory symptoms, cardiac arrhythmias and heart failure few days after beginning of refeeding, with life-threatening outcome. Its pathogenesis includes alterations in the corporal fluids, and in some electrolytes, minerals and vitamins. In this article a review of refeeding syndrome pathogenesis and clinical manifestations is carried out, with a final series of recommendations for lowering the risk of this syndrome and for facilitate the early diagnosis and the treatment.

Humans↗
PubMed2002

[Colonic metabolism of fiber].

Over the last few years, the colon has come to be considered more and more as a central digestive organ. This is where bacterial fermentation takes place to eliminate the substrates, mostly carbohydrates, that have avoided digestion by human enzymes within the small intestine. Of these, fibre plays a prominent role. As a result of this colonic fermentation, short-chain fatty acids are created and these have an important function at the level of the colon (reduction in pH, trophic effect, energy production, etc.) and at the systemic level (lipid metabolism, glycaemic metabolism, etc.) No less important are the effects of this colonic metabolism of fibre on proliferation of bacteria, thus giving fibre probiotic effects.

Colon↗
PubMed2000

[Antioxidant micronutrients and human pathology].

The harmful oxidation by free radicals has been implicated in the pathogenesis of many illnesses, including, as the most significant from the epidemiological standpoint, cardiovascular disease and cancer. This paper reviews the physio-pathological foundations of this relationship and describes the possible usefulness of anti-oxidant therapy in these and other conditions.

Antioxidants↗
PubMed1999

[Dietary fiber: concept, classification and current indications].

Fiber is a concept that refers to or encompasses several carbohydrates and lignine that resist hydrolysis by human digestive enzymes and that are fermented by the microflora of the colon. From a practical point of view, fibers can be divided into soluble and insoluble. There is general acceptance of the concepts soluble fiber, fermentable, viscous and insoluble fiber, and non-viscous and barely fermentable fiber. The physiological effects and therefore the clinical applications of both fibers are different. In general, the insoluble fiber is barely fermentable and has a marked laxative and intestinal regulatory effect. Soluble fiber is fermented to a high degree, showing a powerful trophic effect at the colon level. Soluble fiber is also attributed a positive role in the carbohydrate and lipid metabolism due to the effects that this has at the intestinal and the systemic level on the glucose and the cholesterol metabolism. The goal of this article is to review the current concept of fiber based on the existing bibliography (it is thought that perhaps the current classification should be changed and that fiber should be talked about depending on its degree of polymerization), its physiologic effects and the possible indications that this may have from a clinical point of view, be this at the level of oral or enteral nutrition.

Dietary Fiber↗
PubMed1991

[Proposal for a protein redistribution diet in the control of motor fluctuations in Parkinson's disease: acceptance and efficacy].

Some patients with Parkinson's disease (PD) and fluctuations of motor response to levodopa therapy may benefit by avoiding proteins during daytime meals, while leaving them unrestricted until bedtime. The acceptance and benefits of a protein redistribution diet (PRD) was studied in 26 PD patients whose fluctuations were refractory to current medications. Only 15 patients (57.2%) were still adhered to the diet 3 months later. Non compliance was more often justified on the basis of the changes in alimentary habits, as a too heavy supper (37%), scanty variation of meals (27%) and difficulties in preparing the diet (18%), rather than do to adverse effects of the diet on PD which occurred in 2 patients (exacerbation of the dyskinesias and lack of effectiveness, respectively). The PRD proved beneficial to 67% of those patients able to keep adhered to it, 4 patients shifting to stable responses. Five diet-benefit patients who performed daily "on-off" charts decreased their mean daily "off" time from 13 to 3 % (p less than 0.05), but "on" time quality remained unimproved by the diet. The PRD introduces a heavy change in dietary habits which is not readily accepted by many PD patients. However, the fact that fluctuations disappeared in one fourth of those able to maintain the diet warrants a closely supervised, short-time trial to identify those in whom benefits override the inconveniences of such new changes in the patient's way of life.

Aged↗
PubMedDate not supplied

[Patients at risk for malnutrition in primary care. Social and health study].

GOALS: The worsening nutritional condition of certain population segments is an ever more frequent situation. Malnutrition also has considerable consequences, both in healthy individuals and in patients, leading to an increase in morbidity/mortality among the general population. The purpose of the present study is to learn the opinion of doctors in primary health care about the frequency of patients at risk of malnutrition attending their clinics; the most common forms of diagnostic technique used, the groups of population and situations that show the greatest risk of malnutrition as well as the therapeutic actions undertaken. MATERIALS AND METHODS: The present study effected 1819 opinion polls of primary health care doctors, distributed in proportion to the provincial distribution of doctors throughout Spain. With a margin of error of +/- 2.3% and a confidence interval of 95.5% (K-2). RESULTS: Of the patients seen in primary health care centres, 11% are at risk of malnutrition and approximately 61% of the total are detected at the medical clinic. The situations with the greatest risk are advanced age (71%), marginalized population (drug abusers, alcoholics) (56%), anorexia (50%), patients with mental disorders (42%), oncological pathologies (41%) and prolonged confinement in bed (39%). The therapeutic attitudes considered most appropriate by primary health care practitioners are a greater attention to diets and the use of nutritional supports in cases of established malnutrition. CONCLUSIONS: The present study reflects a high incidence of malnutrition risk among patients attending primary health care clinics (11%); and highlights the importance, from the point of view of preventive medicine, of improving nutritional education among professionals, as well as the availability of simple therapeutic actions and support measures that might help to avoid larger-scale problems with a large social and financial cost.

Humans↗
PubMedDate not supplied

[Parenteral nutrition at home: NADYA register for the year 2000].

AIM: We analyze the registered data of home parenteral nutrition (HPN) in our country during the year 2000. METHOD: The data were collected through a previously designed questionnaire. Apart from epidemiological information, the form includes the disease to prescribe this treatment, the specific nutritional treatment used and its duration, access path, complications and readmission rate in hospital, follow-up of the treatment, and progress. All data were processed and analysed by the co-ordinating team. RESULTS: Fourteen hospitals participated, and 67 patients were enrolled. Middle age was 5 +/- 4 years for patients < 14 years old, and 48 +/- 15 years for those > or = 14 years old. The more prevalent diagnosis were: ischemic bowel (28.4%), neoplasm (16.4%), radiation enteritis (13.4%), motility disorders (7.5%), Crohn's disease (2.9%), and other. The mean time on HPN was 7.5 +/- 4.4 months. Tunelized catheter was the preferential route (77.6%), followed by the implantated one (20.9%). The intermittent method (nocturnal) was preferential (91.0%). Patients receive the formula from hospital pharmacy more frequently than from Nutriservice (71.5% versus 19.4%). The complications related to nutrition (0.32/100 days of HPN) included the infections (0.12 catheter sepsis/100 d of HPN), metabolic (0.06/100 d of HPN), mechanic (0.03/100 d of HPN) and electrolitic disorders (0.03/100 d of HPN). The readmission rate, for nutritional problems, was 0.3 hospitalizations/100 d of HPN. At the end of the year, 61.2% of the patients remained in the HPN program, 37.3% abandoned the treatment (due to death (40%), to progress to oral feeding (48%), and to progress to enteral nutrition (4%); and 1.5% of the patients were not follow up. CONCLUSIONS: This review illustrates that there is an increment in the registration of HPN patients in our country (1997: 0.7 patients/10(6) habitants, 2000: 1.9 patients/10(6) habitants), that vascular pathology is the more frequent diagnoses in HPN patients, and the rate of readmission and complications and the behaviour is similar to other series making this as a safe treatment in our place.

Adolescent↗
PubMedDate not supplied

[Study of energy expenditure in anorexia nervosa: agreement between indirect calorimatry and several equations].

UNLABELLED: Nutritional management is essential in anorexia nervosa (AN), although nutrient replenishment must be done progressively to prevent the occurrence of re-alimentation syndrome. OBJECTIVE: to compare resting enengy expenditure (REE) by means of indirect calorimetry and by different equations in AN female patients. MATERIAL AND METHODS: we studied 21 women admitted for AN (DSM-IV), mean age 17 years (SD 5.9), range 12-34 years. Admission stay was 55.1 +/- 20.7 days (21-91). Initial nutritional assessment included anthropometrics (BMJ, TSF, SSE, MAC, MAMC) and tetrapolar bioimpedance (HoltainBC). Indirect calorimetry (IC) was done after overnight fasting (Deltatrac II MBM-200). In 9 patients, the same study was repeated before hospital discharge. We compared REE (Kcal/24 h) measured by IC with that obtained by several equations [Fleish, Harris- Benedict, FAO, Schofield-HW (SHW), Schebendach] through the intraclass correlation coefficient (ICC) and the Bland-Altman method. RESULTS: Nutritional status significantly improved during hospital admission. Fifty percent of the recovered weight was fat mass. REE significantly increased during admission. The equations overestimated REE as compared to IC (p < 0.05), except for the Schebendach equation that underestimated REE. The agreement between direct measurement of REE by IC and its estimation through equations was poor [Fleish (ICC = 0.21); HB (ICC = 0.21), SHW (ICC = 0.19), Schebendach (ICC = 0.15)]. Through the Bland-Altman method, we observed that there was a variable bias between IC and equations, with a clinically acceptable agreement for REW values of around 1200 Kcal/day. CONCLUSIONS: 1) In our study we obtained a poor agreement between REW values measured by indirect calorimetry and those estimated by equations. 2) Through the Bland-Altman method, we observed that all equations present a variable bias as for IC, the agreement being clinically acceptable for REE values of around 1200 Kcal/day. 3) Thus, indirect calorimetry seems to be a very useful tool to calculate the energy requirements of anorexia nervosa patients.

Adolescent↗
PubMedDate not supplied

[Avascular necrosis of both hips and knees in a patient with ulcerative colitis treated for a long term with high-dose corticosteroids].

INTRODUCTION: Avascular necrosis represents the bone tissue death from vascularization failure, and it is mainly associated with the use of high-dose corticosteroids for a long time. CLINICAL CASE: A 25 years old female patient treated with high-dose corticosteroids for 7 months for ulcerative colitis presents with both knees pain and limited hip and knee motility. In a plain X-ray and in nuclear magnetic resonance imaging (MRI) avascular necrosis was observed at these joints. Bone densitometry showed osteopenia at the femoral head and lumbar osteoporosis. DISCUSSION: We present a striking case for its large involvement of the joints (both knees and hips) with simultaneous osteoporosis and osteopenia in a young patient treated with corticosteroids for ulcerative colitis. It is necessary to recommend the judicious use of glucocorticoids, prescribing the minimal necessary dose and for the least amount of time necessary to control the underlying disease.

Adult↗
PubMedDate not supplied

[Usefulness++ of total parenteral nutrition in radical surgery for bladder cancer].

Thirty patients diagnosed with non-metastatic infiltrating vesical cancer (pT2-3, NoMo) due to receive radical cystectomy and transintestinal urinary by-pass, underwent Pre-operative Nutritional Assessment (PRNA), Cystectomy, post-operative Total Parenteral Nutrition (TPN), and Post-operative Nutritional Assessment (PONA) in day 7. The purposes of this prospective, uncontrolled clinical trial were: to identify, prior to surgery, undernourished patients, to assess the effectiveness of post-operative TPN with regard to a decrease in morbidity and mortality, and to evaluate the influence of a deficient nutritional condition in the occurrence of post-operative complications. It was found the 16.6% patients were undernourished prior to surgery, 80% of which showed complications, while only 28% patients considered to be in a normal state of nutrition had complications (there were no fistulae, intraabdominal abscesses, and abdominal sepsis). 6.6% complications were TPN-related. The conclusions were: the percentage of patients with malnutrition prior to surgery is large enough to justify a routine PRNA; TPN decreases morbidity and mortality in patients with previous good nutritional state but not in those with malnutrition; undernourished patients have a very high rate of complications and surgery should be delayed until a acceptable state of nutrition is achieved.

Cystectomy↗