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Biomedical subjects

P de Juana

Publications and source records attributed to P de Juana.

11 recordsLinked to original sources
PubMed1993

[The stability of antibiotics administered in "and" with a parenteral nutrition mixture enriched with branched-chain amino acids. II. The cephalosporins].

Part I of these stability studies commented on the benefits, in terms of care and therapy, of the Y administration of antibiotics and parenteral nutrition. The aim of this study is to determine the stability of the cephalosporins ceftazidime, ceftriaxone, ceftizosime and cefotaxime in vitro, at therapeutic concentrations, infused together with a parenteral nutrition mixture with polyols, enriched in branched chained amino acids, and without lipids. A microbiological stability analysis was carried out on the antibiotics in the parenteral nutrition, and an HPLC aminogram was done to determine the concentration of amino acids in the infusion together with the antibiotic. As well, pH, osmolarity and colour change were measured in the antibiotics, in the parenteral nutrition used and in the joint infusion mixtures. It is concluded that parenteral nutrition can be jointly infused with cefotaxime and ceftazidime, at the concentrations studied, given the stability results obtained both with HPLC (antibiotics and amino acids) and microbiologically (antibiotics). At the same time, the microbiological analysis of ceftriaxone with the nutrition showed its stability in the study conditions. Its joint infusion with parenteral nutrition, studied by HPLC, confirmed the stability of the amino acids. The ceftizoxime analysed by HPLC remained stable during joint infusion with the parenteral nutrition.

Amino Acids, Branched-Chain↗
PubMed1993

[The stability of antibiotics administered in and with a parenteral nutrition mixture enriched with branched-chain amino acids. I. Amikacin and gentamycin].

The combined infusion of antibiotics and parenteral nutrition makes it possible to maintain plasmatic nutrient concentrations over time, in turn facilitating the administration of the antibiotics in the dilution and infusion time recommended according to their pharmacokinetic parameters. On the other hand, this type of administration has care benefits for the patient, reducing the risk of infections, and adding to comfort. The technique is also cost-effective, reducing the cost of drug administration, saving on administrative personnel and nursing staff time. The stability of amikacin and gentamicin are determined in vitro at therapeutic concentrations jointly infused with a mixture of parenteral nutrition with polyols and enriched in ramified chain amino acids. A microbiological stability analysis was carried out of the antibiotics in the parenteral nutrition, along with an HPLC aminogram, in order to determine the concentration of amino acids in the combined infusion with the antibiotic. pH measurements were also taken, along with osmolarity and colour change. Both of the antibiotics and the parenteral nutrition employed, and of the combined infusion mixtures. Amikacin and Gentamicin are stable at a concentration of 5 mg/ml and 1.6 mg/ml respectively in a parenteral nutrition mixture enriched in ramified chain amino acids.

Amikacin↗
PubMedDate not supplied

[Critical analysis of the evolution of commercial preparations for enteral nutrition during 1988-1996].

Enteral nutrition is a form of nutritional support that is continually growing and expanding, and within this area especially the enteral preparations or formulae. The object of the present is to analyze the evolution of the commercially available nutritionally complete enteral preparations between 1988 and 1997, illustrating the variations that have occurred both from the quantitative and form the qualitative points of view. A progressive increase is seen in the absolute number of available enteral formulae, with the increase in both polymeric formulae with dietary fiber, and that of formulae designed for specific diseases being significant (p < 0.05). The standard polymeric formulae and the oligomeric formulae decrease, but not in a significant manner. There is a special discussion or the characteristic and the usefulness of the polymeric formulae with dietary fiber ad the formulae designed especially for specific diseases. The clinical efficacy of most of these special formulae is controversial, with there not being sufficient objective clinical evidence at present that justifies their routine use.

Dietary Fiber↗
PubMedDate not supplied

[Fiber in enteral nutrition: systematic review of the literature].

UNLABELLED: It has been suggested that adding fibre to enteral nutrition (EN) formulas may achieve a normalization of the gastrointestinal tract's functions by reducing the incidence of diarrhoea and constipation. However, this supposition is based on the demonstrated effect of fibre in natural feeding. There have so far been no firm recommendations on the use, amount or type of fibre that is most advisable in EN. GOAL: To establish the scientific evidence existing on the benefits gained by adding fibre to EN formulas compared with the use of fibre-free formulas. MATERIAL AND METHODS: Bibliographical search on PubMed, on the register of Randomized Prospective Trials (RPT) of the Cochrane Library and manual search. INCLUSION CRITERIA: RPT comparing fibre-free formulas with isocaloric ad isonitrogen formulas containing fibre in total EN. Four independent reviewers revised the references selected. The data were analyzed using the RevMan 4.1 programme from the Cochrane Library. RESULTS: Of 286 references, 25 fulfilled the inclusion criteria. The data were grouped by population and outcome variable. The addition of fermentable fibre to the EN formulas tends to reduce the incidence of diarrhoea in critically-ill and post-surgery patients (OR = 0.66; 95% CI 0.46-0.95; p = 0.19). The use of formulas with insoluble fibre seems to increase the frequency of depositions and reduce the need for laxatives in immobilized patients receiving long-term EN but the data are insufficient. In people with normal gastrointestinal functions, the frequency of depositions is similar when using formulas with and without fibre (DPM = -0.97; 95% CI -0.12-[-0.02]; p < 0.0001). CONCLUSION: There is currently insufficient evidence to recommend the systematic use of formulas containing fibre in total EN. However, in critically-ill and post-surgery patients, the use of formulas with fermentable fibre tends to reduce the incidence of diarrhoea. Although information is still lacking. The formulas with insoluble fibre seem to diminish constipation in chronic EN, whereas in other situations where the digestive system is working appropriately, no benefit has been shown. It is necessary to increase the number and quality of these trials in order to be able to establish firm recommendations on the use of EN formulas containing fibre.

Dietary Fiber↗
PubMedDate not supplied

[Interactions between foodstuffs and statins].

The existence of interactions between different drugs or between drugs and the diet is becoming better and better known. Statins are medicines currently in widespread use for the treatment of hyperlipidaemias. Diet has a great influence on the prevention and/or treatment of these pathologies as the therapeutic strategy used comprises appropriate diet and, if this does not succeed, pharmacological therapy is begun in combination with dietary advice. For this reason it is necessary to be aware of the potential interactions between this kind of medication and foodstuffs in order to avoid alterations in the therapeutic benefits and even the onset of adverse side effects. All of the statins are absorbed orally, so the impact of food intake on administration is extremely important to achieve an appropriate therapeutic effect. Many of the interactions of statins lie in their metabolism through cytochrome P-450 (except for pravastatin), thus making them candidates for interaction with certain foodstuffs or compounds contained in them, such as in the case of grapefruit juice. This paper reviews the drug-nutrient interactions with special attention to the interactions specific to statins and the mechanism of these interactions is described so as to contribute to their avoidance and thus improve this form of treatment in individuals with hyperlipidaemia.

Absorption↗
PubMedDate not supplied

[National Task Force on Home and Ambulatory Artificial Nutrition. NADYA. The NADYA Group].

When a patient needs parenteral or enteral nutrition, be it in a transitory way or as a permanent form, and hospitalization is not strictly required, this treatment should take place in the home of the patient whenever possible. The support with artificial nutrition can be equally efficient, improving the life expectancy ad the quality of life of patients who would otherwise be faced with a much prolonged hospital stay. The Ambulatory and Home Artificial Nutrition group (NADYA) is a multidisciplinary team of health care professionals, from different areas of the national territory, who are dedicated to Clinical Nutrition. With the objective of promoting health and well-being of patients undergoing treatment, and to ease the therapeutic activity of the implicated professionals, this group has developed a series of suggestions for the practice of enteral or parenteral nutrition in the home of the patient. These suggestions include specifications about the technical team, criteria for selection and training of the patients, routes of access, formulas and material needed, follow up characteristics, and associated complications, and the represent a consensus of the regulations necessary for the guarantee of an adequate level of security and efficiency of the at home care of patients who require artificial nutrition support.

Ambulatory Care↗
PubMedDate not supplied

[The participation of hospital pharmacy services in enteral nutrition].

We present the results of a study done in the departments of hospital pharmacy of our country with the aim of knowing their participation in the use and clinical follow up of patients with enteral nutrition. 293 questionnaires were sent out, and 121 were filled out and returned (41.3%). The responses were classified into three groups, according to the number of hospital beds, considering > or = 1000 (large), 500-1000 (medium), and < or = 500 (small). The data were analyzed by means of a statistical program (R-Sigma Horus). 79% (68) of the small hospitals have a unitary dose drug dispensation system, and the Enteral Nutrition was distributed through this system in 53% (50) of them; only 29% (27) of them have a stock of these preparations on the wards. 93% (14) and 65% (54) of the large and small hospitals respectively, prefer the use of enteral nutrition as opposed to parenteral nutrition. 85% (11) of the large hospitals have protocols for the use of enteral nutrition, this being 62% (10) and 59% (47) in medium and small hospitals. The committees for artificial nutrition are present in 75% of the large hospitals, in addition to which, in 66% of these there is a nutritional support team. A pharmacist from the department of pharmacy participates in both multidisciplinary groups. If it is necessary to manipulate the enteral nutrition preparations, in 30% of the departments of pharmacy of the smaller hospitals, this is centralized, being done by personnel of the department itself; in 59% of them (19) there is a specific area for the elaboration, which is not the case in large hospitals. Drugs are mixed with the enteral nutrition in 25% (1), 12% (1), and 9% (4) of the large, medium and small hospitals respectively. There is great, active participation of the hospital pharmacists in the activities of the multidisciplinary nutritional support systems, although at the present time, the involvement of the departments of pharmacy in the centralization of the manipulation of the enteral nutrition is reduced. It is necessary therefore, to implement the development of enteral nutrition programs with a quality guarantee from the departments of pharmacy.

Enteral Nutrition↗