[Wikipedia and wikinutrition: key tools for the global promotion of nutrition]. / Wikipedia y Wikinutrición: herramientas clave para la promoción global de la nutrición.

Wikipedia is an encyclopedia collaboratively edited by volunteers from around the world built on the Web since 2003. Today is the sixth most visited site on the Internet, making it the biggest hit of participatory democracy in the field of information dissemination. The English edition, with more than 3 million items, has become an indispensable part of the Internet and the largest and most popular reference work. In this context, it could be argued that Wikipedia is a valuable tool for the general knowledge of the nutritional sciences terminology. At the same time, it does not only facilitate access to knowledge but also can generate it. It also permits to socialize these spaces for collaboration and development, contributing therefore to disclose science to the society. Consequently, in this article we present and discuss the main features of Wikipedia, emphasizing above all its role in food science and nutrition.

Francis D. Moore. Cirujano, Maestro y Lider / No disponible

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[Careful! Your bibliographic references may be examined]. / Cuidado!, sus referencias bibliográficas pueden ser estudiadas.

Reference to previous work represents a conceptual association of recognized scientific ideas that are beneficial for the citing author. I.e., a reference is an express recognition of an intellectual compromise towards a previous source of information. After all, advancement of science is supported by previous research. At present, the way to know and to measure the importance of a published item comes through its posterior citations, circumstance that obliges scientific journals to control the pertinence and relevance of the cited work. Therefore, when submitting a manuscript for consideration to a scientific journal, it must be beard in mind that the included references will be examined.

¡Cuidado!, sus referencias bibliográficas pueden ser estudiadas / Careful! your blibiographic references may be examined

Las referencias a trabajos previos, simbolizan asociaciones conceptuales de ideas científicas reconocidas como provechosas por el autor que las cita. Es decir, una cita es un reconocimiento expreso de un compromiso intelectual hacia una fuente de información previa. Al fin y al cabo, el avance del conocimiento se apoya en investigaciones anteriores. Actualmente, la forma de conocer y medir la importancia de una publicación se fundamenta en las citas que de la misma se efectúan, circunstancia que motiva que las publicaciones científicas vigilen cada vez más la corrección y relevancia de las mismas. Por tanto, cuando se remite un manuscrito a una revista científica, para su consideración, se debe tener la certeza que las referencias incluidas en la bibliografía del artículo van a ser estudiadas (AU)

Reference to previous work represents a conceptual association of recognized scientific ideas that are beneficial for the citing author. I.e., a reference is an express recognition of an intellectual compromise towards a previous source of information. After all, advancement of science is supported by previous research. At present, the way to know and to measure the importance of a published item comes through its posterior citations, circumstance that obliges scientific journals to control the pertinence and relevance of the cited work. Therefore, when submitting a manuscript for consideration to a scientific journal, it must be beard in mind that the included references will be examined (AU)

[Women and children first?....]. / Las mujeres y los niños primero?....

The goal of the National Health System (SNS in its Spanish acronym) does not consist in distributing to everyone an identical dose of health services but in establishing a balance between those who are ill and those who are healthy in the course of their lives, and concentrating its interventions on those who are worse. In an advanced health care system, there are very few actions by health personnel that can be assessed as "lives saved": more often than not, these actions manage to delay the end and are occasionally limited to improving the quality of the years patients live, without extending their number. It is therefore clearly necessary to find appropriate units of measurement to assess the benefits and utility of all health-related procedures. When effecting a cost-effectiveness study and assessing the results obtained, it is necessary to differentiate between quality of life (personal), utility (personal) and the utility of the procedure or process when applied to our patients. This utility is determined by means of the additional quality and quantity of life, measured in a single unit, QALY, but this cost-effectiveness analysis would be constrained in patients with a shortened life expectancy and/or reduced quality of life due to old age or degenerative disease, thus skewing the distribution of resources in favour of younger population groups. In order to redress this situation, the use of corrective measurements such as EQALY is proposed. We believe that neither age nor illness in themselves limit the application of resources, providing that we can prove a useful result for the patient.

[Evaluation of Hospital Nutrition IV: diffusion and visibility]. / Evaluación de Nutrición Hospitalaria IV: difusión y visibilidad.

To conclude the bibliometric analysis of Nutrición Hospitalaria, we present here the data corresponding to the diffusion and visibility of the publication in the scientific sphere.

[Nutrition in the surgical patient: immunonutrition]. / Nutrición en el paciente quirúrgico: inmunonutrición.

Malnutrition plays an important role in the rate of postoperative complications that interfere with our surgical activity, impairing immune response mechanisms; synthesis and regeneration processes are damaged and the fight against infection is altered. Preoperative and postoperative administration of diets enriched with diverse substances included under the name of "immunonutrients" reduces the rate of complications. Our knowledge about the mechanisms of action of each immunonutrient is increasing as well as the fact that the combined action of these substances improves the immune system and protects the organism against the negative effect of the systemic inflammatory response syndrome.

Soporte nutrometabólico en el paciente quirúrgico crítico / Nutrometabolic support in the critical surgical patient

La agresión provoca una fase aguda de estimulación neuroendocrina, neuropeptídica y de mediadores lipídicos, que puede superarse espontáneamente, o bien perpetuarse y evolucionar hacia situaciones de disfunción y fracaso uni o multiorgánico. El soporte nutrometabólico en el paciente crítico plantea una serie de interrogantes todavía no resueltos: necesidades cuanti y cualitativas. La respuesta hipermetabólica propia del paciente en situación de estrés no se correlaciona con un aumento proporcional del gasto energético. Un aporte excesivo, por sobrestimación, puede añadir un factor de estrés secundario causado por la hipernutrición y la sobrecarga de sustratos. Por otra parte, el aporte de un sustrato considerado adecuado no garantiza necesariamente, en el paciente agredido, una eficaz utilización metabólica, ya que ésta, en la situación de estrés, depende del contexto neuroendocrino, de la acción de los mediadores y del mantenimiento de variables fisiológicas alteradas en el paciente crítico. Consideramos que el soporte nutricional resulta menos eficaz a medida que aumenta la gravedad de la respuesta al estrés. Debe ser instaurado precozmente, y su constitución estará gobernada tanto por la respuesta conseguida como por la condición clínica cambiante del paciente. Nuestra meta es conseguir en este complejo medio un adecuado aporte de hidratos de carbono (glucosa o no glucosa), lípidos, aminoácidos y otros nutrientes esenciales (vitaminas, micronutrientes y elementos traza), sin olvidar las nuevas posibilidades de aporte de sustratos: nucleótidos, péptidos, arginina, glutamina, ácido oleico (w-9) y aceites de pescado (w-3), cuyos efectos terapéuticos en algunos de ellos no han pasado, por el momento, de la fase del "razonamiento fisiopatológico" Parece posible que con un mejor conocimiento de las interacciones entre el hipotálamo, hormonas convencionales, mediadores celulares, moléculas de adhesión y óxido nítrico en la fisiopatología de la enfermedad pueda ser factible desarrollar alternativas terapéuticas basadas tanto en un adecuado soporte nutricional (cuanti, cualitativo y temporal), como hormonal (GH, IGF-1, insulina, esteroides anabólicos), y farmacológico que actúen como moduladores del metabolismo de los sustratos nutrientes durante la compleja fase metabólica de la enfermedad crítica (AU)

[Nutrition and colorectal cancer]. / Alimentación y cáncer colorrectal.

Colorectal cancer is the most common tumor behind lung cancer in men and breast cancer in women. Its prevalence shows a wide geographic variability, which, along with epidemiological and experimental evidence, suggests a considerable participation of environmental factors, mainly dietary in its cause. It is not known which dietary components have an undisputed influence on the risk of colorectal cancer, nor how they condition the different genetic susceptibilities of the individuals. However, we do know of the protective action that consuming vegetables has, and the increased risk associated with saturated fats and red meats, especially when associated with other factors like a hypocaloric diet, obesity, sedentary life, or the use of alcohol. Fiber, however, has not proven the risk reducing properties that were attributed to it by epidemiological studies, possibly because this term encompassed several very different substances. Moreover, it is very difficult to know the effect of an isolated nutrient as these are intimately entwined in the foods. It should be kept in mind that many substances, like plants, as well as the usual nutrients, contain a large number of components with unknown effects and that the manner in which the foods are prepared or eaten, no doubt are of influence. A healthy lifestyle with regard to the risk of colorectal cancer, should no doubt include the consumption of large amounts of vegetables and whole cereals, a limit of the caloric intake with fats not exceeding 30%, to eat fish and chicken rather than red meat, to avoid alcohol, and to regularly partake of physical exercise.

[Magnesium: metabolism and requirements]. / Magnesio: metabolismo y requerimientos.

Magnesium is an important element in health and in disease, it is the organism's second most abundant intracellular cation, after potassium, and it is the main divalent intracellular cation. Its metabolic importance is well known, as it has been identified as a cofactor in more than 300 enzymatic reactions which affect the energetic metabolism, and the synthesis of proteins and nucleic acids, Hypomagnesemia is a frequent finding in hospitalized patients, even more so when the patients are critical (+/-65%). Although low serum levels of magnesium imply the presence of intracellular depletion, normal serum magnesium levels may be present in situations of intracellular magnesium depletion, with important clinical repercussions. Keeping in mind that only 1% of the body's magnesium is in the extracellular fluid, the serum magnesium levels may not adequately reflect the situation, which is why techniques have been proposed which determine the intracellular concentración. The identification of the patients who may potentially present a magnesium depletion, requires a clear knowledge of the risk factors associated with magnesium deficiency: poorly controlled diabetes mellitus, excessive alcohol intake, severe diarrhea, important steatorrhea, and the use of drugs which favor their renal excretion. The present review gives an up date of the most frequent causes of magnesium deficits, giving a series of practical recommendations to prevent this situation, and to undertake a correct replacement therapy. Finally, and although hypermagnesemia appears in a reduced number of circumstances, the presence of kidney failure of diverse etiology, as well as the broadening of the indications of magnesium salts, have increased its incidence, which is why special emphasis is made in this section.

[Amino acid pattern variation in animals after the administration of hypocaloric peripheral parenteral nutrition]. / Variación del patrón de aminoácidos en animales tras la administración de nutrición parenteral periférica hipocalórica.

The pattern of intracellular aminoacids may be reproduced individually and is different for each illness. This study seeks to measure alterations in this pattern in rats after the administration of hypocaloric peripheral parenteral nutrition (HPPN), group B, for five days, by comparing them with rats subjected to conventional fluidtherapy, group A, for the same period. HPPN tolerance was good in all cases. Our results show a higher tendency to glyconeogenesis in group A, measured by a reduction in the glycogenic aminoacids especially alanine. An increase in branched aminoacids was observed in group A due to an increase in proteolisis. The animals in group B showed a lesser reduction in the intracellular aminoacids necessary for glyconeogenesis, especially glycine. HPPN, was found, to alter the aminoacids pattern in fasting rats. The results might be corroborated in humans studies.

[Hepatic metabolism of cholesterol]. / Metabolismo hepático del colesterol.

Cholesterol is an essential component of all tissues, as it is a part of the structure of cell membranes, and it is an immediate precursor of a series of essential substances such as vitamins, steroid hormones, and bile acids. Under physiologic conditions, the intake and output of cholesterol in the organism is coordinated and balanced with the aim of guaranteeing the availability of adequate amounts of cholesterol to satisfy the needs of the different tissues (fig. 1). Under pathological conditions there is an imbalance between these mechanism, which leads to an increase in the circulating levels of cholesterol, leading to pathological processes such as hyperlipemias, atherosclerosis and bile stones. The liver plays a central role in the regulation of the homeostasis of cholesterol. The molecule enters the liver in the form of chylomicrons and low density lipoproteins (LDL), through lipoprotein receptors, and this is also the most important organ for the de novo biosynthesis of cholesterol from acetyl coenzyme A, by means of a cascade enzyme reaction in which the enzyme 3-hydroxy-3 methyl glutaryl CoA reductase (HMG-CoA) is the key of the entire process. Cholesterol is found in the liver in the form of cholesterol esters or as free cholesterol. The two most effective ways of eliminating body cholesterol are found in the liver, with the degradation of the compound to bile acids and the biliary secretion of cholesterol. The conversion to bile acids takes place through a series of enzymatic steps in which the formation of 7-alpha-hydroxycholesterol by the enzyme cholesterol 7-alpha-hydroxylase is the key of the process. The biliary secretion of cholesterol is 600 mg/day. Both the abundance and the universality of cholesterol in living things as its clinical implications emphasize the importance and interest of this compound.

Improvement of the nutritional condition with hypocaloric peripheral parenteral nutrition (HPPN) in the immediate postoperative period of elective abdominal surgery.

Thirty-one patients scheduled for elective surgery for non-malignant abdominal disease were randomized during the first five postoperative days to two different schedules. Group I received water, electrolytes and glucose. Group II received a standard solution containing crystalline amino acids (3.8 g/l), xylitol (25 g/l) and sorbitol (25 g/l), accounting for a total of 900 cal/day. Evaluation was made with clinical, anthropometric and biochemical parameters. Among others, the following significant differences were observed at the end of the study: retinol bound protein: in group I, 4.25 +/- 1.3 and in group II, 5.38 +/- 1.53 (p less than 0.05); prealbumin: in group I, 18.7 +/- 6.24 and in group II, 24.51 +/- 7 (p less than 0.05). The significantly higher values of short-life plasma proteins observed in group II indicate that with HPPN a higher synthesis of visceral protein is promoted. These data demonstrate that HPPN improves the nutritional state during the postoperative period.