ABSTRACT
BACKGROUND/OBJECTIVES: The home enteral nutrition (HEN) provides nutritional support to children with chronic diseases who are nutritionally compromised and allows them to be discharged more quickly from hospitals. In 2003, a web-based registry (Nutrición Enteral Pediátrica Ambulatoria y Domiciliaria, Pediatric Ambulatory and Home Enteral Nutrition -NEPAD-) was created with the objective of gathering information about pediatric HEN practices in Spain. AIM: The aim of this study was to report the implementation of the NEPAD (Nutrición Enteral Pediátrica Ambulatoria y Domiciliaria, Pediatric Ambulatory and Home Enteral Nutrition) registry of pediatric HEN in Spain and to analyze data evolution trends from 2003 to 2010. SUBJECTS/METHODS: The data from the Spanish NEPAD registry were analyzed according to the following variables: demographic data, diagnosis, indication for HEN, nutritional support regime and administration route. RESULTS: Over the study period, 952 patients (1048 episodes) from 20 Spanish hospitals were included in the NEPAD registry. The most frequent indication for HEN was decreased oral intake (64%), and neurological disease was the most prevalent illness. HEN was delivered via a nasogastric tube in 573 episodes (54.7%), by gastrostomy in 375 episodes (35.8%), oral feeding in 77 episodes (7.3%) and by jejunal access in 23 episodes (2.2%). Significant differences in the mode of administration were observed based on the pathology of the child (χ(2), P<0.0001). The cyclic feeding was the most widely used technique for the administration of HEN. Most of the patients used a pump and a polymeric formula. Transition to oral feeding was the primary reason for discontinuation of this type of support. CONCLUSIONS: Since the NEPAD registry was established in Spain, the number of documented patients has increased more than 25-fold. Many children with chronic illness benefit from HEN, mainly those suffering from neurological diseases.
Subject(s)
Enteral Nutrition/statistics & numerical data , Registries , White People , Child , Child Nutritional Physiological Phenomena , Child, Preschool , Enteral Nutrition/trends , Female , Gastrostomy , Hospitals , Humans , Infant , Internet , Intubation, Gastrointestinal , Male , Nervous System Diseases/diet therapy , Parenteral Nutrition, Home , Patient Discharge , Prospective Studies , SpainABSTRACT
Paraneoplastic limbic encephalitis (PLE) is a disorder characterized by severe cognitive dysfunction and seizures. It is usually associated with small cell lung carcinoma. Diagnosis is difficult because clinical markers are often lacking, and symptoms usually precede the diagnosis of cancer. Serological detection of antineuronal antibodies can be useful. We describe a patient with symptoms of limbic encephalitis, negative for paraneoplastic antibodies, in whom lung cancer was detected.
Subject(s)
Carcinoma, Small Cell/complications , Limbic Encephalitis/complications , Lung Neoplasms/complications , Autoantibodies/analysis , Carcinoma, Small Cell/pathology , Carcinoma, Small Cell/therapy , Fatal Outcome , Humans , Limbic Encephalitis/diagnosis , Limbic Encephalitis/therapy , Lung Neoplasms/pathology , Lung Neoplasms/therapy , Male , Middle Aged , Seizures/diagnosis , Seizures/etiology , Seizures/therapyABSTRACT
La encefalitis límbica paraneoplásica (ELP) es una entidad caracterizada por severos déficits cognitivos y crisis convulsivas. Suele asociarse a carcinoma de células pequeñas de pulmón. El diagnóstico de ELP es difícil, ya que los marcadores clínicos a menudo están ausentes, y los síntomas suelen preceder al diagnóstico del cáncer. La detección de anticuerpos antineuronales puede resultar útil. Presentamos un paciente con síntomas de encefalitis límbica, con anticuerpos paraneoplásicos negativos, en el que se detectó un cancer de pulmón (AU)
