Preferential habitats prediction in syngnathids using species distribution models.

Syngnathids are considered as flagship species for marine conservation. Seahorses and pipefish are highly vulnerable to anthropogenic and environmental disturbances, but most species are currently considered Data Deficient by IUCN, requiring more biological and ecological research. Although syngnathids are well known for their unusual breeding biology, some aspects on the ecology of this family have rarely received attention. The knowledge on the factors governing syngnathids distribution is limited to some species and geographical regions. The present study is the first approach to predict syngnathid habitat preference in Spanish coasts, particularly in a marine National Park. In this study, Species Distribution Models (SDMs) were implemented to investigate the preferential habitat and distribution of the pipefish Syngnathus acus in Cíes Archipelago (Atlantic Islands of Galicia National Park, PNIA). Occurrence data of the species obtained from 2016 to 2018 surveys in PNIA were modeled as a function of bathymetric (depth, slope), substrate (sediment texture) and oceanographic (waves exposure) variables, using GAM, Random Forest and Maxent algorithms. From those SDMs, prediction models were built and the ensemble map of predictions was performed. The variables that most determined the distribution of the species were depth and wave exposure. The results of this study provide information on (1) habitat preference in the most dominant species in PNIA, the pipefish S. acus, towards sustainable management of this species in the National Park, and (2) predictive statistical tools for proper spatial conservation plans of this syngnathid species.

Administration of the probiotic Lactobacillus rhamnosus IMC 501 as a strategy for the control of Vibrio bacteria in the brine shrimp Artemia.

The present study aimed to address the capability of the probiotic bacterium Lactobacillus rhamnosus IMC 501® to survive in seawater and the ability of Artemia metanauplii to incorporate it, as well as to analyse the potential effect of the probiotic as a control agent for potentially pathogenic Vibrionaceae bacteria in Artemia. The results demonstrate the ability of L. rhamnosus IMC 501® to survive in seawater for up to 30 h. They also advocate their capability to be efficiently incorporated into Artemia metanauplii at concentrations of 104  CFU per Artemia after 30 min of suspension in probiotic solution, thereby promoting a 1-log reduction in Vibrionaceae levels after 3 h. These low levels of Vibrio bacteria were maintained for about 30 min after transfer into clear seawater, a sufficient time for Artemia to be ingested by aquatic organisms. These results contribute to broaden the knowledge on the suitability of probiotics as sustainable alternatives for the prevention/reduction of diseases in aquaculture facilities.

Primary, secondary, and tertiary stress responses of juvenile seahorse Hippocampus reidi exposed to acute acid stress in brackish and seawater.

Seahorse Hippocampus reidi is a vulnerable species, inhabiting estuarine and coastal waters. The safety of acidic environments for fish has been considered in terms of ocean acidification in nature and decreasing pH in intensive aquaculture systems. This study aimed to investigate the effects of acute exposition (96 h) of juvenile seahorses to different pH (5, 6, 7, and 8) in brackish (BW - salinity 11) or seawater (SW - salinity 33). For that, we studied the responses of cortisol, oxidative stress, and survival, thus covering primary, secondary, and tertiary stress responses. In SW, cortisol levels were not altered for fish maintained at pH 5 and 8. However, in BW, cortisol was higher for fish kept at pH 5. Regarding secondary stress responses, only GST activity increased with acidification in SW. However, acidification in BW caused biochemical alterations at enzymatic level (SOD, GST, GPx) and glutathione metabolism, accompanied by reduction of antioxidant capacity (TEAC) and increased lipid peroxidation (TBARS). Survival was always above 90% and it did not differ significantly among pH levels. Our results suggest that H. reidi juveniles are more vulnerable to acidic exposure in BW than in SW.

Delivering aminopyridine ligands into cancer cells through conjugation to the cell-penetrating peptide BP16.

Peptide conjugates incorporating the N-based ligands (Me2)PyTACN or (S,S')-BPBP at the N- or the C-terminus of the cell-penetrating peptide were synthesized (PyTACN-BP16 (), BP16-PyTACN (), BPBP-BP16 (), and BP16-BPBP ()). Metal binding peptides bearing at the N-terminus the ligand, an additional Lys and a ß-Ala were also prepared (PyTACN-ßAK-BP16 () and BPBP-ßAK-BP16 ()). Moreover, taking into account the clathrin-dependent endocytic mechanism of , the enzymatic cleavable tetrapeptide Gly-Phe-Leu-Gly was incorporated between the ligand and the N- or C-terminus of (BPBP-GFLG-BP16 () and BP16-GLFG-BPBP ()). Analysis of the cytotoxicity of all the peptide conjugates showed that: (i) the position of the ligand influenced the IC50 values, (ii) the incorporation of the ßAla-Lys dipeptide rendered non active sequences, (iii) peptide conjugates derived from the (S,S')-BPBP ligand were more active than those bearing (Me2)PyTACN, and (iv) the introduction of the cleavable tetrapeptide significantly enhanced the activity of the BPBP conjugates (IC50 of 4.3 to 11.7 µM ( and ) compared to 26.0 to >50 µM (, and )). The most active peptide was BPBP-GFLG-BP16 () (IC50 of 4.3 to 5.0 µM). This high activity was attributed to its high internalization in MCF-7 cells, as shown by flow cytometry, and to the subsequent release of the ligand by the intracellular cleavage of the enzyme-labile spacer, as observed in cathepsin B enzymatic assays. Therefore, these results pave the way for the design of novel peptide conjugates to be used in pro-oxidant anticancer therapies.

[Validation of the Spanish version of Parent's Postoperative Pain Management pain scale]. / Validación de la versión española de la escala de evaluación del dolor postoperatorio Parent's Postoperative Pain Managament.

INTRODUCTION: Assessment of postoperative pain is a fundamental aspect of post-surgical care. When surgery is performed as an outpatient, the parents are mainly responsible for the assessment of pain, but they may not always correctly evaluate their children's pain. This makes it necessary to have tools that help them to assess postoperative pain reliably. The Parent's Postoperative Pain Measurement (PPPM) is a behavioral measurement tool of post-operative pain developed to help parents to assess their children's post-operative pain. The purpose of this work was to translate this scale into Spanish, and validate the psychometric properties of the Spanish version of the scale. METHOD: Participants were 111 children aged 2 to 12 years, who had undergone surgery, and one of their parents. After the operation, the children's level of pain was assessed, and the parents completed the PPPM scale in Spanish. RESULTS: The PPPM items in Spanish showed good internal consistency (Cronbach alpha between 0.784 and 0.900) and the scale scores were closely related to the global pain assessment (Spearman's rho correlation between 0.626 and 0.431). The score on the scale decreased between the day of the operation and the next day, and discriminated well between children undergoing surgery qualified as low/moderate pain and high pain. CONCLUSIONS: We conclude that the Spanish version of the PPPM scale evaluated in this study, has good psychometric properties to assess postoperative pain by parents at home.

Dynamics of PPARs, fatty acid metabolism genes and lipid classes in eggs and early larvae of a teleost.

Dietary long chain polyunsaturated fatty acids (FA) have been recognized of crucial importance in early development of vertebrates, contributing to the impressive morphological and physiological changes both as building blocks and to energy production. The importance of lipids along development depends on ontogenetic, phylogenetic and environmental parameters. The expression patterns of FA metabolism genes have not been characterized in developing fish embryos nor compared to lipid class profiles. Full lipid metabolism only occurred after hatching, as revealed by alterations in lipid profiles and FA gene expression. Nonetheless, transcriptional changes of some FA genes were already present in embryos at notochord formation. Many genes displayed an expression profile opposed to the decrease of lipids along the development, while others responded solely to starvation. Transcription of most genes involved in FA metabolism had a strong correlation to PPARs' mRNA levels (α1, α2, ß, γ). The comparison of mRNA expression of the genes with the lipid profiles produced new insights into the FA metabolism and regulation during the development of turbot larvae, providing the basis for future studies including comparative approaches with other vertebrate species.

Prevalence of malnutrition and its etiological factors in hospitals.

BACKGROUND: Malnutrition among inpatients is highly prevalent, and has a negative impact on their clinical outcome. The Working Group for the Study of Malnutrition in Hospitals in Catalonia was created to generate consensus guidelines for the prevention and/or treatment of malnutrition in hospitals in Catalonia, Spain. AIMS: The objectives of the study were to determine the prevalence of malnutrition on admission to hospital in Catalonia and to assess relationships between malnutrition, social and demographic data, overall costs, and mortality. METHODS: Prospective and multicenter study conducted with 796 patients from 11 hospitals representative of the hospitalized population in Catalonia. Nutritional status was evaluated using the Nutritional Risk Screening 2002 method. RESULTS: Overall, 28.9% of the patients are malnourished or at nutritional risk. Elderly patients, non-manual workers, those admitted to hospital as emergencies and with higher co-morbidities had higher risk of malnutrition. The type of hospital (second level vs. tertiary or University referral) to which they were admitted was also a factor predisposing to malnutrition. Length of hospital stay was longer in malnourished patients (10.5 vs. 7.7 days, p < 0.0001). The need for a convalescent home on leaving hospital was higher as well as the risk of mortality (8.6% malnourished vs. 1.3% nonmalnourished, p < 0.0001). CONCLUSIONS: The prevalence of malnutrition is high in patients on admission to hospital in our community, resulting in elevated overall costs and higher risk of mortality. Age, social class and characteristics of the Unit and the Hospital are the main factors involved in hospital malnutrition.

Prevalence of malnutrition and its etiological factors in hospitals / Prevalencia de malnutrición y sus factores etiológicos en hospitales

Background: Malnutrition among inpatients is highly prevalent, and has a negative impact on their clinical outcome. The Working Group for the Study of Malnutrition in Hospitals in Catalonia was created to generate consensus guidelines for the prevention and/or treatment of malnutrition in hospitals in Catalonia, Spain. Aims: The objectives of the study were to determine the prevalence of malnutrition on admission to hospital in Catalonia and to assess relationships between malnutrition, social and demographic data, overall costs, and mortality. Methods: Prospective and multicenter study conducted with 796 patients from 11 hospitals representative of the hospitalized population in Catalonia. Nutritional status was evaluated using the Nutritional Risk Screening 2002 method. Results: Overall, 28.9% of the patients are malnourished or at nutritional risk. Elderly patients, non-manual workers, those admitted to hospital as emergencies and with higher co-morbidities had higher risk of malnutrition. The type of hospital (second level vs. tertiary or University referral) to which they were admitted was also a factor predisposing to malnutrition. Length of hospital stay was longer in malnourished patients (10.5 vs. 7.7 days, p < 0.0001). The need for a convalescent home on leaving hospital was higher as well as the risk of mortality (8.6% malnourished vs. 1.3% nonmalnourished, p < 0.0001). Conclusions: The prevalence of malnutrition is high in patients on admission to hospital in our community, resulting in elevated overall costs and higher risk of mortality. Age, social class and characteristics of the Unit and the Hospital are the main factors involved in hospital malnutrition (AU)

Introducción: La desnutrición en los pacientes ingresados en el hospital es altamente prevalente, e impacta negativamente en su evolución clínica. El Grupo de Trabajo para el Estudio de la Desnutrición Hospitalaria en Cataluña se creó para general Guías de consenso para prevenir y/o tratar la desnutrición en los hospitales de Cataluña, España. Objetivos: Los objetivos del estudio fueron determinar la prevalencia de desnutrición al ingreso en los hospitales de Cataluña, y evaluar la relación entre desnutrición, datos sociales y demográficos, coste relacionado con la enfermedad y mortalidad. Métodos: Estudio prospectivo y multicéntrico realizado en 796 pacientes ingresados en 11 hospitales representativos de la población hospitalizada en Cataluña. El estado nutricional se evaluó utilizando la herramienta Nutritional Risk Screening 2002. Resultados: De forma global, 28,9% de los pacientes estaban desnutridos en el momento del ingreso. Los pacientes más ancianos, trabajadores no manuales, ingresados en el hospital procedentes de Urgencias y con más comorbilidades son los que presentaron mayor prevalencia de desnutrición. El tipo de hospital (Segundo nivel versus Tercer Nivel) también fue un factor predisponerte a la desnutrición. La estancia hospitalaria fue mayor en los pacientes desnutridos (10,5 vs 7,7 días, p < 0,0001). La necesidad de centro de convalecencia al alta hospitalaria fue mayor en los pacientes desnutridos, así como la mortalidad (8,6% desnutridos vs 1,3% normonutridos, p < 0,0001). Conclusiones: La prevalencia de desnutrición es elevada en los pacientes ingresados en el hospital en nuestra comunidad, lo que resulta en mayores costes sanitarios y mayor mortalidad. La edad, clase social y características del Servicio y del Hospital son los principales factores involucrados en la presencia de desnutrición hospitalaria (AU)

Recomendaciones para el soporte nutricional y metabólico especializado del paciente crítico. Actualización. Consenso SEMICYUC-SENPE: Paciente oncohematológico / Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): Oncohematological patient

Los pacientes portadores de cáncer, en cualquier fase de su evolución, pueden precisar ingreso en UCI como consecuencia de complicaciones secundarias a su enfermedad de base o de las terapias quirúrgicas o farmacológicas a que se ven sometidos para tratar su enfermedad. La propia enfermedad cancerosa, así como el estado crítico a que pueden derivar como consecuencia de las complicaciones sobreañadidas, con frecuencia condicionan un alto grado de hipermetabolismo y de déficit de ingesta nutricional, lo que conduce en estos enfermos a una alta incidencia de desnutrición. Además, la propia enfermedad cancerosa condiciona una utilización anómala de los sustratos nutritivos, lo que podría condicionar una vía de administración y una proporción y aporte de nutrientes algo diferenciado de los pacientes no tumorales (AU)

Patients with cancer, irrespective of the stage of their disease, can require admission to the intensive care unit as a result of the complications of their underlying processor the surgical or pharmacological treatment provided. The cancer itself, as well as the critical status that can result from the complications of the disease, frequently lead to a high degree of hypermetabolism and inadequate energy intake, causing a high incidence of malnutrition in these patients. Moreover, cancer causes anomalous use of nutritional substrates and therefore the route of administration and proportion and intake of nutrients may differ in these patients from those in non-cancer patients (AU)

Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus SEMICYUC-SENPE: Oncohematological patient / Recomendaciones para el soporte nutricional y metabólico especializado del paciente crítico. Actualización. Consenso SEMICYUC-SENPE: Paciente oncohematológico

Patients with cancer, irrespective of the stage of their disease, can require admission to the intensive care unitas a result of the complications of their underlying process or the surgical or pharmacological treatment provided. The cancer itself, as well as the critical status that can result from the complications of the disease, frequently lead to a high degree of hypermetabolism and inadequate energy intake, causing a high incidence of malnutrition in these patients. Moreover, cancer causes anomalous use of nutritional substrates and therefore the route of administration and proportion and intake of nutrients may differ in these patients from those in non cancer patients (AU)

Los pacientes portadores de cáncer, en cualquier fase de su evolución, pueden precisar ingreso en UCI como consecuencia de complicaciones secundarias a su enfermedad de base o de las terapias quirúrgicas o farmacológicas a que se ven sometidos para tratar su enfermedad. La propia enfermedad cancerosa, así como el estado crítico a que pueden derivar como consecuencia de las complicaciones sobreañadidas, con frecuencia condicionan un alto grado de hipermetabolismo y de déficit de ingesta nutricional, lo que conduce en estos enfermos a una alta incidencia de desnutrición. Además, la propia enfermedad cancerosa condiciona una utilización anómala de los sustratos nutritivos, lo que podría condicionar una vía de administración y una proporción y aporte de nutrientes algo diferenciado de los pacientes no tumorales (AU)

Multidisciplinary consensus on the approach to hospital malnutrition in Spain / Consenso multidisciplinar sobre el abordaje de la desnutrición hospitalaria en España

Rationale: Disease-related malnutrition constitutes a highly prevalent healthcare problem with high costs associated. In Spain, the prevalence of malnutrition in hospitalized patients has been reported from 30% to 50%.Objectives: Main purposes of this consensus document were to establish recommendations that facilitate decision-making and action to prevent and early-diagnosed isease-related hospital malnutrition, on the management of nutritional support methods and actions to evaluate nutritional treatment compliance and efficacy. Methods: A systematic bibliographical search of authors was performed, complemented by updated bibliography by author references up to 2010. From this review, some recommendations were defined, modified and critically evaluated by the representatives of scientific societies in a consensus conference (Dec 2010) following a structured brainstorming technique: the Metaplan® technique. A double validation process was undertaken until final recommendations were obtained. Results: 30 consensus recommendations for the prevention and management of hospital malnutrition are presented in this document. Recommendations cover all clinical care settings as well as prevention, screening, diagnosis, treatment and follow-up of disease-related malnutrition. Conclusions: Nutritional screening is strongly recommended at all clinical settings when nutritional risk factors are identified or there is clinical suspicion of malnutrition. Nutritional assessment should be designed and performed according to centers’ resources, but clearly identified protocols should be available (AU)

La desnutrición relacionada con la enfermedad constituye un problema sanitario de elevada prevalencia y altos costes. En España, la prevalencia de desnutrición de los pacientes hospitalizados se ha estimado entre el 30% y el50%.Objetivos: El objetivo principal de este consenso fue establecer recomendaciones para facilitar la toma de decisiones para la prevención y el diagnostico precoz de la desnutrición hospitalaria, el manejo del soporte nutricional, y las acciones para evaluar el cumplimiento de la intervención nutricional y su eficacia. Métodos: Se realizó una búsqueda sistemática de autor complementada por bibliografía actualizada por referencias de autor hasta el año 2010. A partir de esta revisión, se definieron algunas recomendaciones que fueron criticadas y modificadas por los representantes de las Sociedades Científicas participantes en una conferencia de consenso (Diciembre 2010) siguiendo una técnica de brainstorming estructurado: la técnica Metaplan®. Se realizaron dos vueltas de validación de las recomendaciones hasta obtener las recomendaciones finales. Resultados: Este documento presenta 30 recomendaciones para la prevención y el manejo de la desnutrición hospitalaria. Las mismas cubren todas las áreas de actuación clínica así como la prevención, cribado, diagnóstico, tratamiento y seguimiento de la desnutrición hospitalaria relacionada con la enfermedad. Conclusiones: Se recomienda enérgicamente el cribado nutricional en todas las áreas de actuación clínica cuando se identifiquen factores de riesgo nutricional o sospecha clínica de desnutrición. La valoración del estado nutricional debe diseñarse y realizarse de acuerdo a los recursos disponibles en cada centro, disponiendo de claros protocolos de actuación (AU)

[Importance of water in the hydration of the Spanish population: FESNAD 2010 document]. / Importancia del agua en la hidratación de la población española: documento FESNAD 2010.

For any healthy individual, thirst is an appropriate sign to drink water, except for babies, sportsmen, and most of ill and elderly people. In these instances, it is convenient to schedule appropriate times to drink water since great demands and the physiological mechanisms that determine thirst in these situations may condition water unbalances with important consequences for health and the physical and intellectual performance. The human body has a number of mechanisms that allow keeping constant the water content by adjusting intakes and wastes. Water balance is determined by intake (consumed water, beverages, and water contained in foods) and wastes (urine, stools, the skin, and expired air from the lungs). Failure of these mechanisms and subsequent impairments in water balance may produce severe disarrangements that may threaten somebody's life. In the present document, we analyze the evidences regarding the factors conditioning water needs in the different life stages and physiological situations, as well as the consequences of water unbalance under different situations. A proper hydration may be achieved by feeding and the use of water and other liquids. Although water is the beverage by excellence and represents the ideal way of restoring the losses and get hydrated, we should be aware that, from the very beginning, we have sought other liquid sources with hydration properties. In the last decades we have increased the consumption of different beverages, with a proliferation of sugar-containing beverages. Since excessive sugar consumption has been related to obesity and other chronic conditions, it is evident that the use of these caloric beverages should be rationalized, especially in children. In this document all the considerations regarding hydration are presented and different recommendations are exposed.

Five-year follow-up of patients with chronic C hepatitis and sustained virological response.

OBJECTIVE: to assess persistence of sustained viral response at 5 years of follow-up in patients with chronic viral hepatitis C treated with pegylated interferon and ribavirin. DESIGN: a descriptive study. PATIENTS: from August 2001 to May 2004, all patients treated at our center with pegylated interferon and ribavirin who achieved a sustained viral response were consecutively enrolled (93 patients). Demographic, histological, biochemical, and virological data were collected during treatment and 5 years after achievement of the sustained viral response. Eighty-six percent of patients enrolled (n = 80) attended the control visit at 5 years. RESULTS: mean age of enrolled patients was 41 years (standard deviation = 10 years), and 30.1% (n = 28) were women. Liver biopsy had been performed before treatment in 68.8% of patients (n = 64), showing no or mild fibrosis in 62.3% (F0 and F1) and significant fibrosis and cirrhosis in 37.7% (F ≥ 3). Genotype distribution was: 58.1% genotype 1 (n = 54); 8.6% genotype 2 (n = 8); 24.7% genotype 3 (n = 23); 7.5% genotype 4 (n = 7), and indeterminate in one patient. Only one patient experienced virological recurrence. All other patients had negative HCV RNA levels and, in the absence of other liver diseases, normal ALT levels. CONCLUSION: in patients treated with pegylated interferon and ribavirin with sustained viral response, long-term recurrence rate was very low.

Seguimiento a 5 años de pacientes con hepatitis crónica C y respuesta viral sostenida / No disponible

Objetivo: evaluar la persistencia de respuesta viral sostenida a los 5 años de seguimiento en pacientes con hepatitis crónica por virus C tratados con interferón pegilado y ribavirina. Diseño: estudio descriptivo. Pacientes: desde agosto de 2001 hasta mayo de 2004, se incluyeron de forma consecutiva todos los pacientes de nuestro centro tratados con interferón pegilado y ribavirina que alcanzaron respuesta viral sostenida (93 pacientes). Se recogieron datos demográficos, histológicos, bioquímicos y virológicos durante el tratamiento y a los 5 años de haber obtenido la respuesta viral sostenida. Se presentaron a la visita de control a los 5 años un 86% de los pacientes incluidos (n = 80). Resultados: los pacientes incluidos presentaron una edad media de 41 años (desviación estándar = 10 años); mujeres 30,1% (n = 28). En el 68,8% de los pacientes (n=64) se había realizado biopsia hepática previa al tratamiento, que mostraba ausencia de fibrosis o fibrosis leve en un 62,3% (F0 y F1) y fibrosis significativa o cirrosis en un 37,7% (F≥3). La distribución por genotipos fue: 58,1% genotipo 1 (n = 54); 8,6% genotipo 2 (n = 8); 24,7% genotipo 3 (n = 23); 7,5% genotipo 4 (n = 7) e indeterminado en un caso. Sólo uno de los pacientes presentó recurrencia virológica. El resto de pacientes presentaron niveles de ARN-VHC negativo y, en ausencia de otra hepatopatía, niveles de ALT normales. Conclusión: en pacientes tratados con interferón pegilado y ribavirina con respuesta viral sostenida la tasa de recurrencia a largo plazo es muy baja(AU)

Objective: to assess persistence of sustained viral response at 5 years of follow-up in patients with chronic viral hepatitis C treated with pegylated interferon and ribavirin. Design: a descriptive study. Patients: from August 2001 to May 2004, all patients treated at our center with pegylated interferon and ribavirin who achieved a sustained viral response were consecutively enrolled (93 patients). Demographic, histological, biochemical, and virological data were collected during treatment and 5 years after achievement of the sustained viral response. Eighty-six percent of patients enrolled (n = 80) attended the control visit at 5 years. Results: mean age of enrolled patients was 41 years (standard deviation = 10 years), and 30.1% (n = 28) were women. Liver biopsy had been performed before treatment in 68.8% of patients (n = 64), showing no or mild fibrosis in 62.3% (F0 and F1) and significant fibrosis and cirrhosis in 37.7% (F ≥ 3). Genotype distribution was: 58.1% genotype 1 (n = 54); 8.6% genotype 2 (n = 8); 24.7% genotype 3 (n = 23); 7.5% genotype 4 (n = 7), and indeterminate in one patient. Only one patient experienced virological recurrence. All other patients had negative HCV RNA levels and, in the absence of other liver diseases, normal ALT levels. Conclusion: in patients treated with pegylated interferon and ribavirin with sustained viral response, long-term recurrence rate was very low(AU)

[Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): oncohematological patient]. / Recomendaciones para el soporte nutricional y metabólico especializado del paciente crítico. Actualización. Consenso SEMICYUC-SENPE: paciente oncohematológico.

Patients with cancer, irrespective of the stage of their disease, can require admission to the intensive care unit as a result of the complications of their underlying process or the surgical or pharmacological treatment provided. The cancer itself, as well as the critical status that can result from the complications of the disease, frequently lead to a high degree of hypermetabolism and inadequate energy intake, causing a high incidence of malnutrition in these patients. Moreover, cancer causes anomalous use of nutritional substrates and therefore the route of administration and proportion and intake of nutrients may differ in these patients from those in non-cancer patients.

Multidisciplinary consensus on the approach to hospital malnutrition in Spain.

RATIONALE: Disease-related malnutrition constitutes a highly prevalent healthcare problem with high costs associated. In Spain, the prevalence of malnutrition in hospitalized patients has been reported from 30% to 50%. OBJECTIVES: Main purposes of this consensus document were to establish recommendations that facilitate decision-making and action to prevent and early-diagnose disease-related hospital malnutrition, on the management of nutritional support methods and actions to evaluate nutritional treatment compliance and efficacy. METHODS: A systematic bibliographical search of authors was performed, complemented by updated bibliography by author references up to 2010. From this review, some recommendations were defined, modified and critically evaluated by the representatives of scientific societies in a consensus conference (Dec 2010) following a structured brainstorming technique: the Metaplan(®) technique. A double validation process was undertaken until final recommendations were obtained. RESULTS: 30 consensus recommendations for the prevention and management of hospital malnutrition are presented in this document. Recommendations cover all clinical care settings as well as prevention, screening, diagnosis, treatment and follow-up of disease-related malnutrition. CONCLUSIONS: Nutritional screening is strongly recommended at all clinical settings when nutritional risk factors are identified or there is clinical suspicion of malnutrition. Nutritional assessment should be designed and performed according to centers' resources, but clearly identified protocols should be available.

Guidelines for specialized nutritional and metabolic support in the critically-ill patient: update. Consensus SEMICYUC-SENPE: oncohematological patient.

Patients with cancer, irrespective of the stage of their disease, can require admission to the intensive care unit as a result of the complications of their underlying process or the surgical or pharmacological treatment provided. The cancer itself, as well as the critical status that can result from the complications of the disease, frequently lead to a high degree of hypermetabolism and inadequate energy intake, causing a high incidence of malnutrition in these patients. Moreover, cancer causes anomalous use of nutritional substrates and therefore the route of administration and proportion and intake of nutrients may differ in these patients from those in noncancer patients.

The importance of the coding of hospital malnutrition in the health strategy of the European Union; a Spanish contribution / Importancia de la codificación de la desnutrición hospitalaria en la estrategia de salud de la Unión Europea; una aportación española

Malnutrition related to illness and inadequate nutrition remains a matter of relevant interest in the member countries of the European Union because of its elevated prevalence and high costs. It is estimated to affect 30 million patients and cost 170 billion euros annually. The 2008-2013 strategy 'Together for Health' put forward in the European Parliament urges Member States to develop, together with local and regional authorities, initiatives in the field of education of the population, training, investigation and good clinical practices. SENPE (Spanish Society of Parenteral and Enteral Nutrition) collaborates in different areas in the development of this strategy which aim to put malnutrition related to illness in the focus of the health system. One of its contributions has been the preparation of the Document of Consensus on the Coding of Malnutrition SENPE-SEDOM (Spanish Society of Medical Documentation). The agreements adopted have helped normalize the process of coding this pathology with the assignment of specific codes for specifically defined terms. This document has allowed the optimization of information regarding the types and degrees of malnutrition and the procedures employed for its prevention or treatment in the hospital centres of the National Health System (AU)

La desnutrición relacionada con la enfermedad y una nutrición inadecuada sigue constituyendo un área sanitaria de interés relevante entre los países miembros de la Unión Europea, por su elevada prevalencia y sus altos costes. Se estima que afecta a 30 millones de pacientes y cuesta 170 billones de euros anuales. La Estrategia 2008-2013 'Together for Health' planteada en el Parlamento Europeo insta a los Estados miembros, a que desarrollen, junto con las autoridades regionales y locales, iniciativas en el ámbito de la educación a la población, la formación específica, la investigación y las buenas prácticas clínicas. La SENPE (Sociedad Española de Nutrición Parenteral y Enteral) colabora en distintas áreas de desarrollo de esta estrategia que pretende situar a la desnutrición relacionada con la enfermedad en el foco de atención del sistema sanitario, como estrategias similares han situado a la obesidad. Una de sus contribuciones hasido el desarrollo del Documento de Consenso de Codificaciónde la Desnutrición SENPE-SEDOM (Sociedad Española de Documentación Médica). Los acuerdos adoptados han permitido normalizar el proceso de codificación de esta patología con la asignación de códigos específicos a términos definitorios concretos. Este documento ha permitido optimizarla información sobre la desnutrición tipos y grados, y los procedimientos empleados para prevenirla o tratarla, en los centros hospitalarios de nuestro Sistema Nacional de Salud (AU)