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R Aller de la Fuente

Publications and source records attributed to R Aller de la Fuente.

At least 19 recordsLinked to original sources

[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↗

[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↗

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↗

[Oral diet in health personnel, fulfillment of daily recommendations].

BACKGROUND: Nutritional education is an essential issue for the proper approach to patients. One of the first issues to have in mind is the appropriate nutritional guidelines in theses professionals in their routine life. The aim of out work was to determine the oral intake pattern in a group of health professionals. MATERIALS AND METHODS: A 24-hours nutritional survey (encuesta) was performed in a group of 51 health professionals (including both medical and nurse personnel) who attended a course in specialized training in nutrition at Hospital Universitario Río Hortega. All participants had their weight, length, age, and profession recorded. Before complying with diet they received an identification session of alimentary rations. RESULTS: The mean age of participants was 25.9 (5.4) years and they were all women (52.9% nurses and 47.1% physicians). Body mass index (BMI) was 21.9 (2.6). The intake of vitamin D was lower than international recommendations (RDA): 2.25 (3.27) g/day. However, the intake of vitamin C, 183.8 (118) mg/day; vitamin B12, 4.73 (3.18) mg/day; folic acid, 262.4 (126) g/day, and iodine, 310.3 (185) g/day were higher than international recommendations. The caloric intake was appropriate for the age of participants and protein intake was 2-fold above normality 1.66 (0.9) g/ kg/day. Differences were observed only between the group of nurses and physicians regarding iodine intake, slightly higher in the former individuals. CONCLUSION: In summary, the caloric intake in these health professionals is appropriate, and there is an excess in the intake of proteins, vitamin C, vitamin B12, folic acid and iodine, with a low intake of vitamin D.

Adult↗

[Atypical presentation and diagnosis of a case of Gitelman syndrome in the adult. How to distinguish between Bartter syndrome?].

We described the case of a patient with 43 year-old, with Gitelman syndrome. The patient presented two epileptic crisis. The cranial computerized axial tomography (CT) was normal. In the seric and urinary analytic we found hypomagnesemia and hypermagnesuria with hypocalciuria. The patient was admitted in our Hospital, and with the administration of magnesium, the seric levels increased and the patient remained asymptomatic. In this article we describe the diagnosis of this infrequent disease, and the differential diagnosis with Bartter syndrome.

Adult↗