Guía Práctica ESPEN: nutrición clínica en las enfermedades del hígado / ESPEN Practical Guideline: clinical nutrition in liver disease

Introducción: la Guía Práctica se basa en la actual guía científica de la ESPEN sobre nutrición clínica en las enfermedades hepáticas. Métodos: se ha reducido y transformado en diagramas de flujo para facilitar su uso en la práctica clínica. La guía está dedicada a todos los profesionales, incluidos médicos, dietistas, Nutriciónistas y enfermeras, que trabajan con pacientes con enfermedad hepática crónica. Resultados: la guía presenta un total de 103 pronunciamientos y recomendaciones con breves comentarios para el manejo Nutricional y metabólico de pacientes con (i) insuficiencia hepática aguda grave, (ii) esteatohepatitis alcohólica, (iii) enfermedad hepática grasa no alcohólica, (iv) cirrosis hepática, y (v) cirugía o trasplante de hígado. Conclusión: las recomendaciones relacionadas con enfermedades están precedidas por recomendaciones generales sobre el diagnóstico del estado Nutricional en los pacientes hepáticos y sobre las complicaciones hepáticas asociadas a la nutrición médica (AU)

Background: the Practical Guideline is based on the current scientific ESPEN guide on Clinical Nutrition in Liver Disease Methods: it has been shortened and transformed into flow charts for easier use in clinical practice. The guideline is dedicated to all professionals including physicians, dieticians, nutritionists and nurses working with patients with chronic liver disease. Results: a total of 103 statements and recommendations are presented with short commentaries for the nutritional and metabolic management of patients with (i) acute liver failure, (ii) alcoholic steatohepatitis, (iii) non-alcoholic fatty liver disease, (iv) liver cirrhosis, and (v) liver surgery/transplantation. Disease-related recommendations are preceded by general recommendations on the diagnosis of nutritional status in liver patients and on liver complications associated with medical nutrition. Conclusion: this Practical Guideline gives guidance to health care providers involved in the management of liver disease on how to offer optimal nutritional care (AU)

Registro del Grupo NADYA-SENPE de Nutrición Enteral Domiciliaria en España: años 2018 y 2019 / The NADYA-SENPE Home Enteral Nutrition Registry in Spain: years 2018 and 2019

Objetivo: exponer los resultados del registro de nutrición enteral domiciliaria (NED) de los años 2018 y 2019 del Grupo NADYA-SENPE. Material y métodos: se recopilaron los pacientes introducidos en el registro desde el 1 de enero al 31 de diciembre de 2018 y en las mismas fechas para 2019, procediendo al análisis descriptivo y analítico de los datos. Resultados: en el año 2018 se registraron 4756 pacientes activos con una tasa de prevalencia de 101,79 pacientes/millón de habitantes; en 2019 fueron 4633 con una tasa de prevalencia de 98,51 pacientes/millón de habitantes. Procedían de 46 hospitales. Fueron el 51,3 % los varones registrados y la edad mediana fue de 71,0 años en ambos periodos. El diagnóstico más frecuente fue el de enfermedad neurológica que cursa con afagia o disfagia severa (58,7 % y 58,2 %), respectivamente. La causa principal de finalización de los episodios fue el fallecimiento. Los pacientes pediátricos registrados fueron 116 en 2018 y 115 en 2019. Las niñas representaron el 57,8 % y 59,1 %, respectivamente, en cada uno de los periodos. La edad mediana de inicio de la NED fue de 5 y 7 meses. El grupo diagnóstico más registrado (42,2 % y 42,6 %) se englobó dentro del grupo de otras patologías, seguido de la enfermedad neurológica que cursa con afagia o disfagia severa de los niños (41,4 % y 41,7 %). Se alimentaban a través de gastrostomía el 46,6 % y 46,1 %, respectivamente, en cada uno de los periodos. Conclusiones: el registro de NED del grupo NADYA-SENPE sigue operativo de forma ininterrumpida desde sus inicios. El número de pacientes registrados y el de hospitales participantes permanece estable en el último bienio analizado (AU)

Aim: to present the results of the Spanish home enteral nutrition (HEN) registry of the NADYA-SENPE group for the years 2018 and 2019. Material and methods: from January 1, 2018 to December 31, 2019 the home enteral nutrition registry was recorded, and afterwards a further descriptive and analytical analysis was done. Results: in 2018, 4756 active patients were registered and the prevalence was 101.79 patients per one million inhabitants; in 2019 there were 4633 patients with a prevalence of 98.51 patients per one million inhabitants. They originated in 46 hospitals: 51.3 % were male, and median age was 71.0 years in both periods. The most frequent diagnosis was a neurological disorder that presents with aphagia or severe dysphagia — 58.7 % and 58.2 %, respectively. The main cause of episode termination was death. A total of 116 pediatric patients were registered in 2018 and 115 in 2019. Females represented 57.8 % and 59.1 %, respectively, in each of the periods. Median age at the beginning of HEN was 5 and 7 months. The most commonly recordered diagnostic group (42.2 % and 42.6 %) was included within the other pathologies group, followed by neurological disorders that present with aphagia or severe dysphagia in 41.4 % and 41.7 % of children. The route of administration was gastrostomy in 46.6 % and 46.1 %, respectively, in each of the periods. Conclusions: the NED registry of the NADYA-SENPE group continues to operate uninterruptedly since its inception. The number of registered patients and the number of participating hospitals remained stable in the last biennium analyzed (AU)

Broad band high resolution rotational spectroscopy for Laboratory Astrophysics.

We present a new experimental setup devoted to the study of gas phase molecules and processes using broad band high spectral resolution rotational spectroscopy. A reactor chamber has been equipped with radio receivers similar to those used by radio astronomers to search for molecular emission in space. The whole Q (31.5-50 GHz) and W bands (72-116.5 GHz) are available for rotational spectroscopy observations. The receivers are equipped with 16×2.5 GHz Fast Fourier Transform spectrometers with a spectral resolution of 38.14 kHz allowing the simultaneous observation of the complete Q band and one third of the W band. The whole W band can be observed in three settings in which the Q band is always observed. Species such as CH3CN, OCS, and SO2 are detected, together with many of their isotopologues and vibrationally excited states, in very short observing times. The system permits automatic overnight observations and integration times as long as 2.4×105 seconds have been reached. The chamber is equipped with a radiofrequency source to produce cold plasmas and with four ultraviolet lamps to study photochemical processes. Plasmas of CH4, N2, CH3CN, NH3, O2, and H2, among other species, have been generated and the molecular products easily identified by their rotational spectrum, and mass spectrometry and optical spectroscopy. Finally, the rotational spectrum of the lowest energy conformer of CH3CH2NHCHO (N-Ethylformamide), a molecule previously characterized in microwave rotational spectroscopy, has been measured up to 116.5 GHz allowing the accurate determination of its rotational and distortion constants and its search in space.

Optofluidic control of the dispersion of nanoscale dumbbells.

Previous research has shown that gold nanoparticles immersed in water in an optical vortex lattice formed by the perpendicular intersection of two standing light waves with a π/2rad phase difference will experience enhanced dispersion that scales with the intensity of the incident laser. We show that flexible nanoscale dumbbells (created by attaching two such gold particles by means of a polymer chain) in the same field display different types of motion depending on the chain length and field intensity. We have not disregarded the secondary optical forces due to light scattering. The dumbbells may disperse, rotate, or remain trapped. For some values of the parameters, the (enhanced) dispersion possesses a displacement distribution with exponential tails, making the motion anomalous, though Brownian.

Stability of CH3NCO in astronomical ices under energetic processing. A laboratory study.

Methyl isocyanate (CH3NCO) was recently found in hot cores and suggested on comet 67P/CG. The incorporation of this molecule into astrochemical networks requires data on its formation and destruction. In this work, ices of pure CH3NCO and of CH3NCO(4-5%)/H2O mixtures deposited at 20 K were irradiated with a UV D2 lamp (120-400 nm) and bombarded by 5 keV electrons to mimic the secondary electrons produced by cosmic rays (CRs). The destruction of CH3NCO was studied using IR spectroscopy. After processing, the νa-NCO band of CH3NCO disappeared and IR bands corresponding to CO, CO2, OCN- and HCN/CN- appeared instead. The products of photon and electron processing were very similar. Destruction cross sections and half-life doses were derived from the measurements. Water ice provides a good shield against UV irradiation (half-life dose of ~ 64 eV molecule-1 for CH3NCO in water-ice), but not so good against high-energy electrons (half-life dose ~ 18 eV molecule-1). It was also found that CH3NCO does not react with H2O over the 20-200 K temperature range. These results indicate that hypothetical CH3NCO in the ices of dense clouds should be stable against UV photons and relatively stable against CRs over the lifetime of a cloud (~ 107 yr), and could sublime in the hot core phase. On the surface of a Kuiper belt object (the original location of comet 67P/CG) the molecule would be swiftly destroyed, both by photons and CRs, but embedded below just 10 µm of water-ice, the molecule could survive for ~ 109 yr.

Plasma generation and processing of interstellar carbonaceous dust analogs.

Interstellar (IS) dust analogs, based on amorphous hydrogenated carbon (a-C:H) were generated by plasma deposition in RF discharges of CH4 + He mixtures. The a-C:H samples were characterized by means of secondary electron microscopy (SEM), infrared (IR) spectroscopy and UV-visible reflectivity. DFT calculations of structure and IR spectra were also carried out. From the experimental data, atomic compositions were estimated. Both IR and reflectivity measurements led to similar high proportions (≈ 50%) of H atoms, but there was a significant discrepancy in the sp2/sp3 hybridization ratios of C atoms (sp2/sp3 = 1.5 from IR and 0.25 from reflectivity). Energetic processing of the samples with 5 keV electrons led to a decay of IR aliphatic bands and to a growth of aromatic bands, which is consistent with a dehydrogenation and graphitization of the samples. The decay of the CH aliphatic stretching band at 3.4 µm upon electron irradiation is relatively slow. Estimates based on the absorbed energy and on models of cosmic ray (CR) flux indicate that CR bombardment is not enough to justify the observed disappearance of this band in dense IS clouds.

Precisely controlled fabrication, manipulation and in-situ analysis of Cu based nanoparticles.

The increasing demand for nanostructured materials is mainly motivated by their key role in a wide variety of technologically relevant fields such as biomedicine, green sustainable energy or catalysis. We have succeeded to scale-up a type of gas aggregation source, called a multiple ion cluster source, for the generation of complex, ultra-pure nanoparticles made of different materials. The high production rates achieved (tens of g/day) for this kind of gas aggregation sources, and the inherent ability to control the structure of the nanoparticles in a controlled environment, make this equipment appealing for industrial purposes, a highly coveted aspect since the introduction of this type of sources. Furthermore, our innovative UHV experimental station also includes in-flight manipulation and processing capabilities by annealing, acceleration, or interaction with background gases along with in-situ characterization of the clusters and nanoparticles fabricated. As an example to demonstrate some of the capabilities of this new equipment, herein we present the fabrication of copper nanoparticles and their processing, including the controlled oxidation (from Cu0 to CuO through Cu2O, and their mixtures) at different stages in the machine.

Using radio astronomical receivers for molecular spectroscopic characterization in astrochemical laboratory simulations: A proof of concept.

We present a proof of concept on the coupling of radio astronomical receivers and spectrometers with chemical reactors and the performances of the resulting setup for spectroscopy and chemical simulations in laboratory astrophysics. Several experiments including cold plasma generation and UV photochemistry were performed in a 40 cm long gas cell placed in the beam path of the Aries 40 m radio telescope receivers operating in the 41-49 GHz frequency range interfaced with fast Fourier transform spectrometers providing 2 GHz bandwidth and 38 kHz resolution. The impedance matching of the cell windows has been studied using different materials. The choice of the material and its thickness was critical to obtain a sensitivity identical to that of standard radio astronomical observations. Spectroscopic signals arising from very low partial pressures of CH3OH, CH3CH2OH, HCOOH, OCS, CS, SO2 (<10-3 mbar) were detected in a few seconds. Fast data acquisition was achieved allowing for kinetic measurements in fragmentation experiments using electron impact or UV irradiation. Time evolution of chemical reactions involving OCS, O2 and CS2 was also observed demonstrating that reactive species, such as CS, can be maintained with high abundance in the gas phase during these experiments.

Formation of nitrile species on Ag nanostructures supported on a-Al2O3: a new corrosion route for silver exposed to the atmosphere.

The aging of supported Ag nanostructures upon storage in ambient conditions (air and room temperature) for 20 months has been studied. The samples are produced on glass substrates by pulsed laser deposition (PLD); first a 15 nm thick buffer layer of amorphous aluminum oxide (a-Al2O3) is deposited, followed by PLD of Ag. The amount of deposited Ag ranges from that leading to a discontinuous layer up to an almost-percolated layer with a thickness of <6 nm. Some regions of the as-grown silver layers are converted, by laser induced dewetting, into round isolated nanoparticles (NPs) with diameters of up to ∼25 nm. The plasmonic, structural and chemical properties of both as-grown and laser exposed regions upon aging have been followed using extinction spectroscopy, scanning electron microscopy and x-ray photoelectron spectroscopy, respectively. The results show that the discontinuous as-grown regions are optically and chemically unstable and that the metal becomes oxidized faster, the smaller the amount of Ag. The corrosion leads to the formation of nitrile species due to the reaction between NO x species from the atmosphere adsorbed at the surface of Ag, and hydrocarbons adsorbed in defects at the surface of the a-Al2O3 layer during the deposition of the Ag nanostructures by PLD that migrate to the surface of the metal with time. The nitrile formation thus results in the main oxidation mechanism and inhibits almost completely the formation of sulphate/sulphide. Finally, the optical changes upon aging offer an easy-to-use tool for following the aging process. They are dominated by an enhanced absorption in the UV side of the spectrum and a blue-shift of the surface plasmon resonance that are, respectively, related to the formation of a dielectric overlayer on the Ag nanostructure and changes in the dimensions/features of the nanostructures, both due to the oxidation process.

Pyridine Based Antitumour Compounds Acting at the Colchicine Site.

Antimitotics binding at the colchicine site of tubulin are important antitumour and vascular disrupting agents. Pyridines and azines are privileged scaffolds in medicinal chemistry and in recent years many colchicine site ligands (CSL) have incorporated them into their structures with the aim of improving their pharmacokinetic and pharmacodynamics properties. CSL have been classified according to their chemical structures and the chemical structures of the pyridine and azine containing antimitotic compounds are described. The designed principles behind the structural modifications and the achieved effect on the biological activity upon inclusion of these heterocycles are also discussed. Lessons from the achievements and failures have been extracted and future perspectives delineated.

Expanding the plasmonic response of bimetallic nanoparticles by laser seeding.

This work explores a cost-effective route to enhance the tuning range of the optical response of metal nanostructures on substrates beyond the ranges that are achievable through the nanostructure dimensions, composition or dewetting processes. The new route (laser seeding) uses single nanosecond laser pulses to induce dewetting in regions of a metal layer deposited on a glass substrate followed by the deposition of a second metal layer, both layers being deposited by pulsed laser deposition. In order to show the possibilities of this new route, we have chosen that the two metals were different, namely Ag and Au. The comparison of the optical response of these regions to those that were laser irradiated after deposition of the second metal layer shows that while nanoalloyed nanoparticles (NPs) are formed in the latter case, the NPs produced in the former case have a heterogeneous structure. The interface between the two metals is either sharp or a narrow region where they have mixed depending on the laser fluence used. While the nanoalloyed NPs exhibit a single, narrow surface plasmon resonance (SPR), the heterogeneous NPs show broader SPRs that peak in the near infrared and depending on conditions exhibit even two clear SPRs. The laser seeding approach in the conditions used in this work allows for the expansion of the tuning range of the color to the blue-green region, i.e. beyond the region that can be achieved through nanoalloyed NPs (yellow-red region). In addition, the results presented foresee the laser seeding route as a means to produce round and almost isolated NPs in an enhanced range of diameters.

Density patterns in metal films produced by laser interference.

Fringed periodic patterns have been produced by laser interference at 193 nm in an almost continuous 9.5 nm-thick Ag film that exhibits a number density of ≈189 µm(-2) holes. Patterns with four periods in the range of 1.8-10.2 µm were produced by changing the projection optics. At high fluences, the film breaks up into nanostructures around the regions exposed to intensity maxima due to laser-induced melting. At low fluences, a new process is observed that is triggered at the initial holes of the film by solid-state dewetting. Once the fluence is high enough to prevent the temperature balance across the pattern, mass transport from cold to hot regions is observed, leading to film densification in regions around intensity maxima sites. The novel patterns are thus formed by fringes of material that is more/less dense than the as-grown film, each of which is located at intensity maxima/minima sites, and have negligible topography. Comparing the present results to earlier reports in the literature shows that the thermal gradient across the pattern is influenced by the initial film microstructure, rather than by the thickness. The existence of a minimum period, which is achievable depending on the thermal continuity of the film, is also discussed.

Period dependence of laser induced patterns in metal films.

Periodic fringed patterns with four periods in the range 1.8-10.2 µm have been produced in continuous Ag films that have thicknesses of 14.6 nm and 19.5 nm by exposing a phase mask to single pulses of an excimer laser operating at 193 nm. The films were patterned either as-grown or after homogeneous exposure to the same laser beam. For fluences above the threshold, the films undergo liquid-state dewetting that, from low to high fluences, leads to their break into holes, fingers or elongated features and finally to isolated nanoparticles irrespective of the period, thickness or fluence. The period determines the range of fluences to achieve the different morphologies since the temperature profile across the pattern depends on the period due to the existence of significant lateral heat flow across the pattern. The maximum temperature achieved at the intensity maxima/minima sites thus decreases/increases as the period decreases, leading to solid-state dewetting at regions around the intensity minima; the shorter the period, the higher this type of dewetting. These regions eventually overcome the melting temperature for the shortest period and intermediate fluence, leading to the complete transformation of the films. Finally, the initial film morphology (discontinuities or holes) rather than thickness plays an essential role in the level of transformation at fluences around the threshold.

Sueño y depresión en una muestra de pacientes con dolor crónico / Sleep and depressive disorder in patients with chronic pain

Introducción: los trastornos del sueño y los trastornos afectivos (trastorno depresivo mayor y trastorno de ansiedad generalizada) son dos de las condiciones comórbidas más frecuentes en los pacientes con dolor crónico. Objetivo: el objetivo principal de este estudio es evaluar la calidad del sueño y la prevalencia del trastorno depresivo mayor y trastorno de ansiedad generalizada en pacientes con dolor crónico osteomuscular. Como objetivos secundarios se señalan: comparar la calidad del sueño y la evaluación del dolor en distintas variables y conocer los predictores de la calidad del sueño. Material y métodos: se diseñó un estudio descriptivo transversal realizado en la Unidad del Dolor del Servicio de Anestesiología y Reanimación del Hospital Son Llàtzer (Palma de Mallorca). Un total de 39 pacientes participaron en el estudio, todos ellos mayores de edad y con diagnóstico de dolor crónico tipo osteomuscular. La inclusión se realizó durante los meses de marzo, abril y mayo de 2013. Se excluyeron aquellos pacientes menores de 18 años, rechazaban participar en el estudio y/o presentaban un trastorno psiquiátrico grave (demencia psicosis, abuso de alcohol/drogas). Se utilizó un cuestionario de elaboración propia para recoger variables sociodemográficas, de estilo de vida y clínicas, una escala visual analógica para evaluar la intensidad del dolor, la entrevista Neuropsiquiátrica Internacional para determinar diagnóstico de trastorno depresivo mayor y trastorno de ansiedad generalizada, el Cuestionario de Pittsburgh para evaluar la calidad del sueño y la Escala de Depresión Montgomery-Asberg para evaluar la gravedad de la sintomatología depresiva. Resultados: la muestra refirió una mala calidad del sueño. El 69,2 % de la muestra presentaba un trastorno depresivo mayor y/o un 65,5 % un trastorno de ansiedad generalizada. No se encontraron diferencias estadísticamente significativas en la calidad del sueño entre los grupos tratados con opioides potentes y tratados con opioides menores/antiinflamatorios. Existen diferencias estadísticamente significativas en determinados ítems del Cuestionario de Pittsburgh: calidad subjetiva del sueño, eficiencia habitual, perturbaciones del sueño, disfunción durante el día y en la puntuación total del cuestionario, así como en la evaluación del dolor en el que los pacientes con depresión presentaban puntuaciones más elevadas respecto a los que no tenían depresión. Los predictores significantes de la calidad del sueño fueron la edad y la gravedad de la depresión. Conclusiones: estos resultados van en la línea de aquellas investigaciones que muestran que los pacientes con dolor crónico presentan pobre calidad de sueño, depresión y ansiedad. Se necesitan futuras investigaciones para evaluar estas variables, conocer la importancia de los factores implicados en esta condición médica y mejorar el manejo clínico y la calidad de vida de estos pacientes (AU)

Introduction: Sleep disturbances and affective disorders major depressive disorder and generalized anxiety disorder) are two comorbidities very frequents in patients with chronic pain. Objective: The main objective is to evaluate sleep quality and the prevalence of major depressive disorder and generalized anxiety disorder in patients with musculoskeletal chronic pain. As secondary objectives: To compare sleep quality and pain severity with different variables and to know the sleep quality predictors. Material and methods: Transversal descriptive study was made in the Pain Unit from Son Llàtzer Hospital (Palma de Mallorca, Spain). A total of 39 patients were included, all of them older than 18 years old and with musculoskeletal chronic pain. Inclusion was during March, April and May 2013. Excluded were patients younger than 18 years old, those who refuse to participate in the study or/and those who diagnosed with severe psychiatric disorder (dementia, psychosis, alcohol/drug abuse). Pain severity was assessed by a visual analogue scale, major depressive disorder and generalized anxiety disorder was assessed by the International Neuropsychiatric Interview, sleep quality was assessed by the Pittsburgh Questionnaire and depressive symptomatology was assessed by the Montgomery-Asberg Questionnaire. Results: Chronic pain patients related poor sleep quality. 69.2 % of patients had major depressive disorder and/or 65.5% had a generalized anxiety disorder. There are not statistical differences in quality of sleep between pharmacological groups (potens opioids vs. minor/antiinflamatories). There are statistical differences in some Pittsburgh Questionnaire items: subjective sleep quality, regular efficiency, dreams perturbances, daily dysfunction and total score, as well as, in pain severity: patients with depression had higher scores than patients without depression. The significant predictors of sleep quality were age and depression severity. Conclusions: These results are in accordance with other studies that show that chronic pain patients suffer poor sleep quality, depression and anxiety. Future researchers are necessary to evaluate these variables, to know the importance of these factors that play a role in this medical condition and to improve clinical management and quality of life of these patients (AU)

Home enteral nutrition in Spain; NADYA registry 2011-2012.

OBJECTIVE: To describe the results of the home enteral nutrition (HEN) registry of the NADYA-SENPE group in 2011 and 2012. MATERIAL AND METHODS: We retrieved the data of the patients recorded from January 1st 2011 to December 31st 2012. RESULTS: There were 3021 patients in the registry during the period from 29 hospitals, which gives 65.39 per million inhabitants. 97.95% were adults, 51.4% male. Mean age was 67.64 ± 19.1, median age was 72 years for adults and 7 months for children. Median duration with HEN was 351 days and for 97.5% was their first event with HEN. Most patients had HEN because of neurological disease (57.8%). Access route was nasogastric tube for 43.5% and gastrostomy for 33.5%. Most patients had limited activity level and, concerning autonomy, 54.8% needed total help. Nutritional formula was supplied from chemist's office to 73.8% of patients and disposables, when necessary, was supplied from hospitals to 53.8% of patients. HEN was finished for 1,031 patients (34.1%) during the period of study, 56.6% due to decease and 22.2% due to recovery of oral intake. CONCLUSIONS: Data from NADYA-SENPE registry must be explained cautiously because it is a non-compulsory registry. In spite of the change in the methodology of the registry in 2010, tendencies regarding HEN have been maintained, other than oral route.

Objetivos: Describir los resultados del registro de nutrición enteral domiciliaria (NED) del grupo NADYASENPE de los años 2011 y 12. Material y métodos: Se recopilaron los datos introducidos en el registro desde el 1 de enero de 2011 al 31 de diciembre de 2012. Resultados: Hubo 3021 pacientes en el registro durante el periodo, procedentes de 29 hospitales, lo que da una prevalencia de 65,39 casos por millón de habitantes. 97.95% fueron adultos, 51,4% varones. La edad media fue 67,64 ± 19,1 años y la mediana 72 años para los adultos y 7 meses para los niños. La duración media de la NED fue 351 días y para el 97,5% fue el primer episodio con NED. La mayoría de pacientes tenían NED por una enfermedad neurológica (57,8%). La vía de acceso fue sonda nasogástrica para el 43,5% y gastrostomía para el 33,5%. La mayoría de pacientes tuvieron un nivel de actividad física limitado y, respecto a la autonomía, 54,8% necesitaba ayuda total. La fórmula de nutrición se suministró desde las oficinas de farmacia para el 73,8% y los fungibles, cuando fueron necesarios, desde los hospitales para el 53,8%. La NED se suspendió en 1.031 pacientes (34,1%) durante el periodo de estudio, 56,6% debido a fallecimiento y 22,2% debido a recuperación de la vía oral. Conclusiones: Los datos del registro NADYA-SENPE deben ser interpretados con precaución ya que se trata de un registro voluntario. A pesar del cambio de metodología del registro en 2010, las tendencias en NED se han mantenido, salvo la importancia cuantitativa de la vía oral.

Home enteral nutrition in Spain; NADYA registry 2011-2012 / Nutrición enteral domiciliaria en España; registro NADYA del año 2011-12

Objective: To describe the results of the home enteral nutrition (HEN) registry of the NADYA-SENPE group in 2011 and 2012. Material and methods: We retrieved the data of the patients recorded from January 1st 2011 to December 31st 2012. Results: There were 3021 patients in the registry during the period from 29 hospitals, which gives 65.39 per million inhabitants. 97.95% were adults, 51.4% male. Mean age was 67.64 ± 19.1, median age was 72 years for adults and 7 months for children. Median duration with HEN was 351 days and for 97.5% was their first event with HEN. Most patients had HEN because of neurological disease (57.8%). Access route was nasogastric tube for 43.5% and gastrostomy for 33.5%. Most patients had limited activity level and, concerning autonomy, 54.8% needed total help. Nutritional formula was supplied from chemist’s office to 73.8% of patients and disposables, when necessary, was supplied from hospitals to 53.8% of patients. HEN was finished for 1,031 patients (34.1%) during the period of study, 56.6% due to decease and 22.2% due to recovery of oral intake. Conclusions: Data from NADYA-SENPE registry must be explained cautiously because it is a non-compulsory registry. In spite of the change in the methodology of the registry in 2010, tendencies regarding HEN have been maintained, other than oral route (AU)

Objetivos: Describir los resultados del registro de nutrición enteral domiciliaria (NED) del grupo NADYASENPE de los años 2011 y 12. Material y métodos: Se recopilaron los datos introducidos en el registro desde el 1 de enero de 2011 al 31 de diciembre de 2012. Resultados: Hubo 3021 pacientes en el registro durante el periodo, procedentes de 29 hospitales, lo que da una prevalencia de 65,39 casos por millón de habitantes. 97.95% fueron adultos, 51,4% varones. La edad media fue 67,64 ± 19,1 años y la mediana 72 años para los adultos y 7 meses para los niños. La duración media de la NED fue 351 días y para el 97,5% fue el primer episodio con NED. La mayoría de pacientes tenían NED por una enfermedad neurológica (57,8%). La vía de acceso fue sonda nasogástrica para el 43,5% y gastrostomía para el 33,5%. La mayoría de pacientes tuvieron un nivel de actividad fí- sica limitado y, respecto a la autonomía, 54,8% necesitaba ayuda total. La fórmula de nutrición se suministró desde las oficinas de farmacia para el 73,8% y los fungibles, cuando fueron necesarios, desde los hospitales para el 53,8%. La NED se suspendió en 1.031 pacientes (34,1%) durante el periodo de estudio, 56,6% debido a fallecimiento y 22,2% debido a recuperación de la vía oral. Conclusiones: Los datos del registro NADYA-SENPE deben ser interpretados con precaución ya que se trata de un registro voluntario. A pesar del cambio de metodología del registro en 2010, las tendencias en NED se han mantenido, salvo la importancia cuantitativa de la vía oral (AU)

Nutrición Parenteral Domiciliaria en España 2011 y 2012; informe del grupo de nutrición artificial domiciliaria y ambulatoria NADYA / Home parenteral nutrition in Spain 2011 and 2012; a report of the home and ambulatory artificial nutrition group NADYA

Objetivo: Comunicar los datos del registro de Nutrición Parenteral Domiciliaria (NPD) del grupo de trabajo NADYA-SENPE de los años 2011 y 2012. Material y métodos: Recopilación de los datos del registro "on-line" introducidos por los colaboradores del grupo NADYA responsables del seguimiento de la NPD desde el 1 de enero de 2011 al 31 de diciembre de 2012 dividido por años naturales. Resultados: Año 2010: Se registraron 184 pacientes, procedentes de 29 hospitales, lo que representa una tasa de 3,98 pacientes/millón habitantes/año 2011, con 186 episodios de NPD. Durante el año 2012 se registraron 203 pacientes, procedentes de 29 hospitales, lo que representa una tasa de 4,39 pacientes/millón habitantes/año 2012, con un total de 211 episodios de NPD. Conclusiones: Se observa un aumento progresivo de los pacientes registrados respecto a años anteriores. El principal grupo patológico sigue siendo oncológico ocupando el primer lugar desde 2003. Aunque el registro NADYA es un registro consolidado y ha sido y es fuente imprescindible de información relevante para el conocimiento de los avances de la Nutrición Artificial Domiciliaria en nuestro país, queda un amplio margen para la mejora. En especial lo que hace referencia al registro de pacientes pediátricos y al registro de las complicaciones (AU)

Objective: To report the data of the Home Parenteral Nutrition (HPN) registry of the NADYA-SENPE working group for the years 2011 and 2012. Methodology: We compiled the data from the on-line registry introduced by reviewers of NADYA group responsible for monitoring of NPD introduced by since January 1, 2011 to december 31, 2012. Included fields were: age, sex, diagnosis and reason for HPN, access path, complications, beginning and end dates, complementary oral or enteral nutrition, activity level, autonomy degree, product and fungible material supply, withdrawal reason and intestinal transplant indication. Results: Year 2010: 184 patients from 29 hospitals, representing a rate of 3.98 patients/million inhabitants/ year 2011, with 186 episodes were recorded NPD. During 2012, 203 patients from 29 hospitals, representing a rate of 4.39 patients/million inhabitants/year 2012, a total of 211 episodes were recorded NPD. Conclusions: We observe an increase in registered patients with respect to previous years. Neoplasia remains as the main pathology since 2003. Although NADYA is consolidated registry and has been indispensable source of information relevant to the understanding of the progress of Home Artificial Nutrition in our country, there is ample room for improvement. Especially that refers to the registration of pediatric patients and the registration of complications (AU)

Absceso paravertebral e intraabdominal secundario a ozonoterapia por lumbalgia / Paravertebral and intra-abdominal abscess due to oxygen-ozone therapy for lower back pain

En la literatura médica se han descrito un número escaso de complicaciones secundarias al tratamiento con ozonoterapia, habiéndose descrito únicamente 2 casos de índole infeccioso tras la terapia percutánea con ozonoterapia. Presentamos el caso de una complicación infecciosa secundaria a ozonoterapia para el tratamiento de una lumbalgia crónica, así como la posterior evolución clínica con tratamiento antibiótico y drenaje de los abscesos. Según la mejoría clínica de la paciente, se deben agotar las posibilidades menos invasivas antes de cualquier cirugía agresiva (AU)

Complications secondary to oxygen-ozone therapy are rare, but they have been described in medical literature. There are only two cases of infectious complications after oxygen-ozone therapy. Our aim is to describe a rare case of purulent complication that was secondary to oxygen-ozone therapy for the treatment of lower back pain. We report the clinical improvement with conservative treatment for a local complication after percutaneous oxygen-ozone treatment. According to the clinical improvement of our patient, conservative treatment should be considered before any aggressive surgery (AU)

[Paravertebral and intra-abdominal abscess due to oxygen-ozone therapy for lower back pain]. / Absceso paravertebral e intraabdominal secundario a ozonoterapia por lumbalgia.

Complications secondary to oxygen-ozone therapy are rare, but they have been described in medical literature. There are only two cases of infectious complications after oxygen-ozone therapy. Our aim is to describe a rare case of purulent complication that was secondary to oxygen-ozone therapy for the treatment of lower back pain. We report the clinical improvement with conservative treatment for a local complication after percutaneous oxygen-ozone treatment. According to the clinical improvement of our patient, conservative treatment should be considered before any aggressive surgery.

Enhanced reactivity and related optical changes of Ag nanoparticles on amorphous Al2O3 supports.

Pairs of samples containing Ag nanoparticles (NPs) of different dimensions have been produced under the same conditions but on different substrates, namely standard glass slides and a thin layer of amorphous aluminum oxide (a-Al2O3) on-glass. Upon storage in ambient conditions (air and room temperature) the color of samples changed and a blue-shift and damping of the surface plasmon resonance was observed. The changes are weaker for the samples on-glass and tend to saturate after 12 months. In contrast, the changes for the samples on a-Al2O3 appear to be still progressing after 25 months. While x-ray photoelectron spectroscopy shows a slight sulfurization and negligible oxidation of the Ag for the on-glass samples upon 25 months aging, it shows that Ag is strongly oxidized for the on a-Al2O3 samples and sulfurization is negligible. Both optical and chemical results are consistent with the production of a shell at the expense of a reduction of the metal core dimensions, the latter being responsible for the blue-shift and related to the small (<10 nm initial diameter) of the NPs. The enhanced reactivity of the Ag NPs on the a-Al2O3 supports goes along with specific morphological changes of the Ag NPs and the observation of nitrogen.