ABSTRACT
Endocrinology and Clinical Nutrition are branches of Medicine that deal with the study of physiology of body glands and hormones and their disorders, intermediate metabolism of nutrients, enteral and parenteral nutrition, promotion of health by prevention of diet-related diseases, and appropriate use of the diagnostic, therapeutic, and preventive tools related to these disciplines. Development of Endocrinology and Clinical Nutrition support services requires accurate definition and management of a number of complex resources, both human and material, as well as adequate planning of the care provided. It is therefore essential to know the services portfolio of an ideal Department of Endocrinology and Clinical Nutrition because this is a useful, valid and necessary tool to optimize the available resources, to increase efficiency, and to improve the quality of care.
Subject(s)
Endocrinology/organization & administration , Hospital Departments/organization & administration , Nutritional Sciences , Diagnosis-Related Groups , Dietetics/education , Dietetics/organization & administration , Durable Medical Equipment , Endocrine System Diseases/diagnosis , Endocrine System Diseases/nursing , Endocrine System Diseases/therapy , Endocrinology/education , Facility Design and Construction/standards , Food Service, Hospital/organization & administration , Forms and Records Control , Goals , Health Personnel/education , Health Workforce/organization & administration , Hospital Records , Humans , Interprofessional Relations , Malnutrition/diagnosis , Malnutrition/nursing , Malnutrition/therapy , Medicine , Nutritional Sciences/education , Nutritional Support/nursing , Outpatient Clinics, Hospital/organization & administration , Patient Education as Topic/organization & administration , Role , Specialties, NursingABSTRACT
La Endocrinología y Nutrición es la rama de la Medicina que se ocupa del estudio de la fisiología y patología del sistema endocrino, del metabolismo de las sustancias nutritivas, de la nutrición natural y artificial, de la promoción de la salud mediante la prevención de las enfermedades relacionadas con la dieta y de las correspondientes técnicas diagnósticas, terapéuticas y preventivas utilizadas en estas áreas del conocimiento médico. El desarrollo de estas actividades requiere la definición y la gestión de una serie de recursos complejos, tanto humanos como materiales, así como una correcta planificación del trabajo asistencial. Por lo tanto, resulta imprescindible conocer la Cartera de Servicios de un Servicio/Sección o Departamento de Endocrinología y Nutrición, ya que es una herramienta necesaria, válida y útil para optimizar los recursos disponibles, aumentar la eficacia y la rentabilidad de la actuación médica y mejorar la calidad de la asistencia (AU)
Abstract Endocrinology and Clinical Nutrition are branches of Medicine that deal with thestudy of physiology of body glands and hormones and their disorders, intermediate metabolism of nutrients, enteral and parenteral nutrition, promotion of health by prevention of diet-relateddiseases, and appropriate use of the diagnostic, therapeutic, and preventive tools related tothese disciplines. Development of Endocrinology and Clinical Nutrition support services requiresaccurate definition and management of a number of complex resources, both human and material, as well as adequate planning of the care provided. It is therefore essential to know theservices portfolio of an ideal Department of Endocrinology and Clinical Nutrition because thisis a useful, valid and necessary tool to optimize the available resources, to increase efficiency,and to improve the quality of care (AU)
Subject(s)
Humans , Hospital Departments/organization & administration , Endocrinology , Nutritional SciencesABSTRACT
OBJECTIVES: The aim of this study was to validate the Lipochip genetic diagnostic platform by assessing effectiveness, sensitivity, specificity and costs for the identification of patients with familial hypercholesterolemia (FH) in Spain. This platform includes the use of a DNA micro array, the detection of large gene rearrangements and the complete resequencing of the low-density lipoprotein receptor gene. DESIGN AND METHODS: DNA samples of patients with clinically diagnosed FH were analyzed for mutations by application of the Lipochip platform. Results obtained were confirmed by DNA sequencing and MLPA analysis by two other, independent laboratories. RESULTS: Of 808 patients tested, Lipochip detected a mutation in 66% of the cases and of these 78% were detected by the micro array. A specificity of 99.5% at a sensitivity of 99.8% was reached. A positive test result could be reported within 22 days after start of analysis. The total average screening costs of $350 per case were significantly lower compared to other existing screening programs. CONCLUSION: Lipochip provides a reliable, fast and cheap alternative for the genetic testing of patients with clinically diagnosed FH.
Subject(s)
Hyperlipoproteinemia Type II/diagnosis , Hyperlipoproteinemia Type II/genetics , Oligonucleotide Array Sequence Analysis/methods , DNA Mutational Analysis , Humans , Sequence Analysis, DNAABSTRACT
La disfagia orofaríngea es un síntoma que aparece en diferentes patologías, habitualmente infravalorado, y que puede tener repercusiones graves para la salud y la calidad de vida de las personas que la presentan. Es importante conocer su diagnóstico y su gravedad para establecer el plan terapéutico adecuado, cuyo objetivo es que el enfermo esté bien nutrido e hidratado con el mínimo riesgo de aspiración y el máximo bienestar. El tratamiento nutricional (líquidos espesados, dietas con diferentes consistencias y texturas, nutrición enteral por sonda nasogástrica o gastrostomía) depende de la causa, las expectativas vitales, el nivel de conciencia y la calidad de vida del paciente. Aunque es necesario conocer más y unificar criterios acerca de la disfagia, se sabe que los programas multidisciplinarios de evaluación y tratamiento reducen los riesgos y mejoran la calidad de vida de los pacientes
Oropharyngeal dysphagia appears in many diseases and is frequently underdiagnosed. It can have serious effects on health and quality of life. Knowledge of this entity and its severity is important to establish an appropriate treatment plan, the aim of which is to maintain good nutrition and hydration in the patient with a minimum risk of aspiration and maximum comfort. Nutritional treatment can consist of thickened liquids, diets with different consistencies and textures, and enteral nutrition with nasogastric tubes or gastrostomy, depending on the etiology, and the patient's life expectancy, level of consciousness, and quality of life. Although there is a need to gain greater insight into dysphagia and unify criteria, it is already known that multidisciplinary evaluation programs and treatment reduce risks and improve quality of life in patients with this condition
Subject(s)
Humans , Deglutition Disorders/diet therapy , Enteral Nutrition/methods , Nutritional Support/methods , Risk Factors , Quality of Life , Oropharynx/physiopathologyABSTRACT
BACKGROUND: Type 2 diabetic patients may need enteral nutrition support as part of their treatment. The objective was to compare glycemic and lipid control in hospitalized patients with type 2 diabetes requiring feeding via nasogastric tube using enteral feedings with either a highcarbohydrate or a high-monounsaturated-fat content. METHODS: This trial included type 2 diabetes patients admitted to the hospital for neurologic disorders or head and neck cancer surgery who received either a low-carbohydrate-high-mono-unsaturated-fat (Glucerna) or a high-carbohydrate diet (Precitene Diabet). Glycemic and lipid control was determined weekly. Safety and gastrointestinal tolerance were also assessed. RESULTS: A total of 104 patients were randomized and 63 were evaluable according to preestablished protocol criteria. Median duration of therapy was 13 days in both groups. Mean glucose was significantly increased at 7 days of treatment (p = .006) in the Precitene arm, with no significant variations in the Glucerna arm. Mean weekly blood triglycerides levels in the Precitene arm were increased without reaching statistical significance, whereas patients in the Glucerna arm showed a stable trend. Patients in the Precitene arm showed a significantly higher incidence of diarrhea than patients in Glucerna arm (p = .008), whereas the incidence of nausea was smaller in the Precitene arm than in the Glucerna arm (p = .03). CONCLUSIONS: An enteral formula with lower carbohydrate and higher monounsaturated fat (Glucerna) has a neutral effect on glycemic control and lipid metabolism in type 2 diabetic patients compared with a high-carbohydrate and a lower-fat formula (Precitene Diabet).
