35 results on '"Bretón Lesmes, Irene"'
Search Results
2. A survey on the perception of the specialty of Endocrinology and Nutrition among students preparing for the entrance exam for medical specialty training in Spain
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García Blasco, Lourdes, Pinés Corrales, Pedro J., Hanzu, Felicia, Fernández Martínez, Alberto, Bretón Lesmes, Irene, and Escalada San Martín, Javier
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- 2023
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3. Nutritional ultrasound®: Conceptualisation, technical considerations and standardisation
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García-Almeida, José Manuel, García-García, Cristina, Vegas-Aguilar, Isabel María, Ballesteros Pomar, María D., Cornejo-Pareja, Isabel María, Fernández Medina, Beatriz, de Luis Román, Daniel A., Bellido Guerrero, Diego, Bretón Lesmes, Irene, and Tinahones Madueño, Francisco J.
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- 2023
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4. Executive summary of the position paper on the use of enteral nutrition in advanced dementia
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Pita Gutiérrez, Francisco, Álvarez Hernández, Julia, Ballesteros-Pomar, María D., Botella Romero, Francisco, Bretón Lesmes, Irene, Campos del Portillo, Rocío, Hernández Moreno, Ana, Júdez, Javier, and De Montalvo Jaaskelainen, Federico
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- 2022
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5. Continuity of care in disease-related malnutrition and nutritional medical treatment
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Ballesteros-Pomar, María D., Blay Cortés, Guadalupe, Botella Romero, Francisco, Fernández García, José Manuel, Pita Gutiérrez, Francisco, Ramírez Arroyo, Violeta, and Bretón Lesmes, Irene
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- 2022
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6. How the COVID-19 pandemic has affected the training of Endocrinology and Nutrition Residents. Results of a survey by the Spanish Society of Endocrinology and Nutrition
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Zugasti-Murillo, Ana, Tejera-Pérez, Cristina, Rubio-Herrera, Miguel Ángel, Escalada San Martín, Francisco Javier, Ballesteros-Pomar, María D., Bretón-Lesmes, Irene, Dios-Fuentes, Elena, Pinés-Corrales, Pedro J., and Hanzu, Felicia A.
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- 2022
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7. Multidisciplinary consensus on nutritional and metabolic therapy in enhanced recovery after abdominal surgery programs: NutRICA Project
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Ocón Bretón, M. Julia, Tapia Guerrero, M. José, Ramírez Rodriguez, José Manuel, Peteiro Miranda, Carlos, Ballesteros Pomar, María D., Botella Romero, Francisco, Martínez Olmos, Miguel Ángel, Luengo Pérez, Luis Miguel, Cancer Minchot, Emilia, García Malpartida, Katherine, López Gómez, Juan José, Zugasti Murillo, Ana, Álvarez Hernández, Julia, and Bretón Lesmes, Irene
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- 2022
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8. RECALSEEN. Subgroup: Patient care in the clinical nutrition units of the Spanish National Health System
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Cancer Minchot, Emilia, Elola Somoza, Francisco Javier, Fernández Pérez, Cristina, Bernal Sobrino, José Luis, Bretón Lesmes, Irene, and Botella Romero, Francisco
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- 2021
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9. The SEEN comprehensive clinical survey of adult obesity: Executive summary
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Ballesteros Pomar, María D., Vilarrasa García, Nuria, Rubio Herrera, Miguel Ángel, Barahona, María José, Bueno, Marta, Caixàs, Assumpta, Calañas Continente, Alfonso, Ciudin, Andreea, Cordido, Fernando, de Hollanda, Ana, Diaz, María Jesús, Flores, Lilliam, García Luna, Pedro Pablo, García Pérez-Sevillano, Fernando, Goday, Albert, Lecube, Albert, López Gómez, Juan José, Miñambres, Inka, Morales Gorria, María José, Morinigo, Rosa, Nicolau, Joana, Pellitero, Silvia, Salvador, Javier, Valdés, Sergio, and Bretón Lesmes, Irene
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- 2021
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10. Obesity in the COVID era: A global health challenge
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Rubio Herrera, Miguel A. and Bretón Lesmes, Irene
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- 2021
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11. Obesity and SARS-CoV-2: Considerations on bariatric surgery and recommendations for the start of surgical activity
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Sánchez Santos, Raquel, Garcia Ruiz de Gordejuela, Amador, Breton Lesmes, Irene, Lecube Torelló, Albert, Moizé Arcone, Violeta, Arroyo Martin, Juan José, Fernandez Alsina, Enric, Martín Antona, Esteban, Rubio Herrera, Miguel Ángel, Sabench Pereferrer, Fátima, Sánchez Pernaute, Andrés, and Vilallonga Puy, Ramón
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- 2021
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12. Ultrasound Cut-Off Values for Rectus Femoris for Detecting Sarcopenia in Patients with Nutritional Risk.
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de Luis Roman, Daniel, García Almeida, José Manuel, Bellido Guerrero, Diego, Guzmán Rolo, Germán, Martín, Andrea, Primo Martín, David, García-Delgado, Yaiza, Guirado-Peláez, Patricia, Palmas, Fiorella, Tejera Pérez, Cristina, García Olivares, María, Maíz Jiménez, María, Bretón Lesmes, Irene, Alzás Teomiro, Carlos Manuel, Guardia Baena, Juan Manuel, Calles Romero, Laura A., Prior-Sánchez, Inmaculada, García-Luna, Pedro Pablo, González Pacheco, María, and Martínez-Olmos, Miguel Ángel
- Abstract
Background: A nationwide, prospective, multicenter, cohort study (the Disease-Related caloric-protein malnutrition EChOgraphy (DRECO) study) was designed to assess the usefulness of ultrasound of the rectus femoris for detecting sarcopenia in hospitalized patients at risk of malnutrition and to define cut-off values of ultrasound measures. Methods: Patients at risk of malnutrition according to the Malnutrition Universal Screening Tool (MUST) underwent handgrip dynamometry, bioelectrical impedance analysis (BIA), a Timed Up and Go (TUG) test, and rectus femoris ultrasound studies. European Working Group on Sarcopenia in Older People (EWGSOP2) criteria were used to define categories of sarcopenia (at risk, probable, confirmed, severe). Receiver operating characteristic (ROC) and area under the curve (AUC) analyses were used to determine the optimal diagnostic sensitivity, specificity, and predictive values of cut-off points of the ultrasound measures for the detection of risk of sarcopenia and probable, confirmed, and severe sarcopenia. Results: A total of 1000 subjects were included and 991 of them (58.9% men, mean age 58.5 years) were evaluated. Risk of sarcopenia was detected in 9.6% patients, probable sarcopenia in 14%, confirmed sarcopenia in 9.7%, and severe sarcopenia in 3.9%, with significant differences in the distribution of groups between men and women (p < 0.0001). The cross-sectional area (CSA) of the rectus femoris showed a significantly positive correlation with body cell mass of BIA and handgrip strength, and a significant negative correlation with TUG. Cut-off values were similar within each category of sarcopenia, ranging between 2.40 cm
2 and 3.66 cm2 for CSA, 32.57 mm and 40.21 mm for the X-axis, and 7.85 mm and 10.4 mm for the Y-axis. In general, these cut-off values showed high sensitivities, particularly for the categories of confirmed and severe sarcopenia, with male patients also showing better sensitivities than women. Conclusions: Sarcopenia in hospitalized patients at risk of malnutrition was high. Cut-off values for the better sensitivities and specificities of ultrasound measures of the rectus femoris are established. The use of ultrasound of the rectus femoris could be used for the prediction of sarcopenia and be useful to integrate nutritional study into real clinical practice. [ABSTRACT FROM AUTHOR]- Published
- 2024
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13. Protocol for the implementation of a screening tool for the early detection of nutritional risk in a university hospital
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García-Peris, Pilar, Velasco Gimeno, Cristina, Frías Soriano, Laura, Higuera Pulgar, Isabel, Bretón Lesmes, Irene, Camblor Álvarez, Miguel, Motilla de la Cámara, Marta, and Cuerda Compés, Cristina
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- 2019
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14. Evolution of nutritional status and survival in patients with cancer on tyrosine kinase inhibitors treatment
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Higuera-Pulgar, Isabel, Ribed, Almudena, Carrascal-Fabian, M. Luisa, Romero-Jiménez, Rosa M., Velasco-Gimeno, Cristina, Bretón-Lesmes, Irene, Camblor-Álvarez, Miguel, Cuerda-Compes, Cristina, and García-Peris, Pilar
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- 2019
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15. Trends on Diabetes Mellitus's healthcare management in Spain 2007–2015
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Reyes García, Rebeca, Bernal Sobrino, Jose Luis, Fernandez Pérez, Cristina, Morillas Ariño, Carlos, Azriel Mira, Sharona, Elola Somoza, Francisco Javier, Breton Lesmes, Irene, and Botella Romero, Francisco
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- 2019
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16. Patient care in the Endocrinology and Nutrition Units of the National Health System. The RECALSEEN study
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Botella Romero, Francisco, Elola Somoza, Francisco Javier, Navarro González, Elena, Fernández Pérez, Cristina, Bernal Sobrino, José Luis, and Bretón Lesmes, Irene
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- 2019
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17. Training in nutrition for medical residents in endocrinology and nutrition: How have we changed?
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Ballesteros Pomar, María D., Álvarez Hernández, Julia, and Bretón Lesmes, Irene
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- 2019
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18. Terms, concepts and definitions in clinical artificial nutrition. The ConT-SEEN Project
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del Olmo García, María Dolores, Ocón Bretón, Julia, Álvarez Hernández, Julia, Ballesteros Pomar, María Dolores, Botella Romero, Francisco, Bretón Lesmes, Irene, de Luis Román, Daniel, Luengo Pérez, Luis Miguel, Martínez Olmos, Miguel Ángel, and Olveira Fuster, Gabriel
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- 2018
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19. Consensus document on the prevention of methylmercury exposure in Spain: Study group for the prevention of Me-Hg exposure in Spain (GEPREM-Hg)
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González-Estecha, Montserrat, Bodas-Pinedo, Andrés, Guillén-Pérez, José Jesús, Rubio-Herrera, Miguel Ángel, Martínez-Álvarez, Jesús Román, Herráiz-Martínez, Miguel Ángel, Martell-Claros, Nieves, Ordóñez-Iriarte, José Mª, Sáinz-Martín, María, Farré-Rovira, Rosaura, Martínez-Astorquiza, Txantón, García-Donaire, José Antonio, Calvo-Manuel, Elpidio, Bretón-Lesmes, Irene, Prieto-Menchero, Santiago, Llorente-Ballesteros, Mª Teresa, Martínez-García, Mª José, Moreno-Rojas, Rafael, Salas-Salvadó, Jordi, Bermejo-Barrera, Pilar, Cuadrado-Cenzual, Mª Ángeles, Gallardo-Pino, Carmen, Fuentes, María Blanco, Torres-Moreno, Miriam, Trasobares-Iglesias, Elena M., Martín, Bernardino Barceló, Arroyo-Fernández, Manuel, and Calle-Pascual, Alfonso
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- 2015
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20. Expert Consensus on Morphofunctional Assessment in Disease-Related Malnutrition. Grade Review and Delphi Study.
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García-Almeida, José Manuel, García-García, Cristina, Ballesteros-Pomar, María D., Olveira, Gabriel, Lopez-Gomez, Juan J., Bellido, Virginia, Bretón Lesmes, Irene, Burgos, Rosa, Sanz-Paris, Alejandro, Matia-Martin, Pilar, Botella Romero, Francisco, Ocon Breton, Julia, Zugasti Murillo, Ana, and Bellido, Diego
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Disease-related malnutrition (DRM) affects approximately a third of hospitalized patients and is associated with an increased risk of morbimortality. However, DRM is often underdiagnosed and undertreated. Our aim is to evaluate the prognostic value of morphofunctional tools and tests for nutritional assessment in clinical practice. A systematic literature review was conducted to identify studies relating to the morphofunctional assessment of nutritional status and mortality or complications. Evidence was evaluated using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) method. Twelve GRADE recommendations were made and divided into seven topics: food intake and nutrient assimilation, anthropometry, biochemical analysis, hand grip strength, phase angle, muscle imaging, and functional status and quality of life. From these recommendations, 37 statements were developed and scored in a two-survey Delphi method by 183 experts. A consensus was reached on accepting 26/37 statements. Surveys had high internal consistency and high inter-rater reliability. In conclusion, evidence-based recommendations were made on the prognostic value of morphofunctional assessment tools and tests to assess malnutrition, most of which were found to be feasible in routine clinical practice, according to expert opinions. [ABSTRACT FROM AUTHOR]
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- 2023
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21. Clinical Nutrition in times of COVID-19
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Ballesteros Pomar, María D. and Bretón Lesmes, Irene
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- 2020
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22. Short-, Mid- and Long-Term Results of Larrad Biliopancreatic Diversion
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Larrad-Jiménez, Álvaro, Sánchez-Cabezudo Díaz-Guerra, Carlos, de Cuadros Borrajo, Pedro, Bretón Lesmes, Irene, and Moreno Esteban, Basilio
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- 2007
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23. Clinical and economic impact of the taurolidine lock on home parenteral nutrition
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Arnoriaga Rodríguez, María, Pérez de Ciriza Cordeu, Maite, Camblor Álvarez, Miguel, Bretón Lesmes, Irene, Motilla de la Cámara, Marta, Velasco Gimeno, Cristina, Arhip, Loredana, García Peris, Pilar, and Cuerda Compés, Cristina
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Taurolidine ,Infecciones asociadas al catéter (IAC) ,Catheter-related bloodstream infection (CRBSI) ,Home parenteral nutrition (HPN) ,Taurolidina ,Nutrición parenteral domiciliaria (NPD) ,Costes ,Catéter venoso central (CVC) ,Central venous catheter (CVC) ,Costs - Abstract
Introduction: catheter-related bloodstream infections (CRBSI) are one of the most serious concerns in patients on home parenteral nutrition (HPN) which involve high morbidity and cost for the healthcare system. In the last years, taurolidine lock has proven to be beneficial in the prevention of CRBSI; however, the evidence of its efficiency is limited. Objective: to determine if taurolidine lock is a cost-effective intervention in patients on HPN. Materials and methods: retrospective study in patients on HPN with taurolidine lock. We compared the CRBSI rate and cost of its complications before and during taurolidine lock. Results: thirteen patients, six (46%) males and seven (54%) females, with a mean age of 61.08 (SD = 14.18) years received taurolidine lock. The total days of catheterization pre and per-taurolidine were 12,186 and 5,293, respectively. The underlying disease was benign in five patients (38.5%) and malignant in eight (61.5%). The CRBSI rate pre vs per-taurolidine was 3.12 vs 0.76 episodes per 1,000 catheter days (p = 0.0058). When the indication was a high CRBSI rate, this was 9.72 vs 0.39 (p < 0.001) in pre and per-taurolidine period respectively. No differences have been observed in the occlusion rates. None of the patients reported any adverse effects. The total cost of CRBSI in the pre-taurolidine period was 151,264.14 euros vs 24,331.19 euros in the per-taurolidine period. Conclusions: our study shows that taurolidine lock is a cost-effective intervention in patients on HPN with high risk of CRBSI. Resumen Introducción: las infecciones asociadas al catéter (IAC) son una de las complicaciones más serias en pacientes con nutrición parenteral domiciliara (NPD), generando una alta morbilidad y costes sanitarios. En los últimos años, el sellado con taurolidina ha demostrado ser eficaz en su prevención, si bien la evidencia en cuanto a su eficiencia es escasa. Objetivo: determinar si el sellado del catéter con taurolidina es una intervención coste-efectiva en pacientes con NPD. Materiales y métodos: estudio retrospectivo de pacientes con NPD que recibieron sellados con taurolidina. Comparamos la incidencia de IAC antes y durante el tratamiento y los costes asociados. Resultados: el estudio incluyó trece pacientes, seis (46%) varones y siete (54%) mujeres, con edad media de 61,08 (± 14,18) años y un seguimiento de 12.186 y 5.293 días antes y durante el uso de taurolidina. La enfermedad de base era benigna en cinco pacientes (38,5%) y maligna en ocho (61,5%). La tasa de IAC antes y durante el sellado con taurolidina fue de 3,12 vs. 0,76 episodios por 1.000/días de catéter (p = 0,0058). Cuando la indicación fue por alta tasa de IAC, esta fue de 9,72 vs. 0,39 (p < 0,001) episodios por 1.000/días de catéter antes y durante el tratamiento. No hubo diferencias en la tasa de oclusión del catéter en ambos periodos. No se reportaron efectos adversos. El coste total de las IAC antes y durante el uso de taurolidina fue de 151.264,14 euros vs. 24.331,19 euros. Conclusiones: nuestro estudio muestra que los sellados con taurolidina son coste-efectivos en pacientes con NPD con alta tasa de infección.
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- 2019
24. Oral versus intramuscular administration of vitamin B12 for the treatment of patients with vitamin B12 deficiency: a pragmatic, randomised, multicentre, non-inferiority clinical trial undertaken in the primary healthcare setting (Project OB12)
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Sanz-Cuesta Teresa, González-Escobar Paloma, Riesgo-Fuertes Rosario, Garrido-Elustondo Sofía, del Cura-González Isabel, Martín-Fernández Jesús, Escortell-Mayor Esperanza, Rodríguez-Salvanés Francisco, García-Solano Marta, González-González Rocío, Martín-de la Sierra-San Agustín María, Olmedo-Lucerón Carmen, Palmero María Luisa, Mateo-Ruiz Carmen, Medina-Bustillo Beatriz, Valdivia-Pérez Antonio, Blas-González Francisca, Mariño-Suárez José, Rodríguez-Barrientos Ricardo, Ariza-Cardiel Gloria, Cabello-Ballesteros Luisa, Polentinos-Castro Elena, Rico-Blázquez Milagros, Rodríguez-Monje Ma, Soto-Díaz Sonia, Martín-Iglesias Susana, Rodríguez-González Ramón, Bretón-Lesmes Irene, Vicente-Herrero María, Sánchez-Díaz Jesús, Gómez-Gascón Tomás, Drake-Canela Mercedes, and Barco Ángel
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Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background The oral administration of vitamin B12 offers a potentially simpler and cheaper alternative to parenteral administration, but its effectiveness has not been definitively demonstrated. The following protocol was designed to compare the effectiveness of orally and intramuscularly administered vitamin B12 in the treatment of patients ≥65 years of age with vitamin B12 deficiency. Methods/design The proposed study involves a controlled, randomised, multicentre, parallel, non-inferiority clinical trial lasting one year, involving 23 primary healthcare centres in the Madrid region (Spain), and patients ≥65 years of age. The minimum number of patients required for the study was calculated as 320 (160 in each arm). Bearing in mind an estimated 8-10% prevalence of vitamin B12 deficiency among the population of this age group, an initial sample of 3556 patients will need to be recruited. Eligible patients will be randomly assigned to one of the two treatment arms. In the intramuscular treatment arm, vitamin B12 will be administered as follows: 1 mg on alternate days in weeks 1 and 2, 1 mg/week in weeks 3–8,and 1 mg/month in weeks 9–52. In the oral arm, the vitamin will be administered as: 1 mg/day in weeks 1–8 and 1 mg/week in weeks 9–52. The main outcome variable to be monitored in both treatment arms is the normalisation of the serum vitamin B12 concentration at weeks 8, 26 and 52; the secondary outcome variables include the serum concentration of vitamin B12 (in pg/ml), adherence to treatment, quality of life (EuroQoL-5D questionnaire), patient 3satisfaction and patient preferences. All statistical tests will be performed with intention to treat and per protocol. Logistic regression with random effects will be used to adjust for prognostic factors. Confounding factors or factors that might alter the effect recorded will be taken into account in analyses. Discussion The results of this study should help establish, taking quality of life into account, whether the oral administration of vitamin B12 is an effective alternative to its intramuscular administration. If this administration route is effective, it should provide a cheaper means of treating vitamin B12 deficiency while inducing fewer adverse effects. Having such an alternative would also allow patient preferences to be taken into consideration at the time of prescribing treatment. Trial registration This trial has been registered with ClinicalTrials.gov, number NCT 01476007, and under EUDRACT number 2010-024129-20.
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- 2012
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25. Endocrinologic diseases management during breastfeeding
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Serrano Aguayo, Pilar, García de Quirós Muñoz, Juan Manuel, Bretón Lesmes, Irene, and Cózar León, Maria Victoria
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- 2015
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26. Protein malnutrition incidence comparison after gastric bypass versus biliopancreatic diversion
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Suárez Llanos, José Pablo, Fuentes Ferrer, Manuel, Álvarez-Sala-Walther, Luis, García Bray, Bruno, Medina González, Laura, Bretón Lesmes, Irene, and Moreno Esteban, Basilio
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Bariatric surgery ,Malnutrición proteica ,Albúmina sérica ,Protein malnutrition ,Serum albumin ,Obesidad ,Prealbumin ,Obesity ,Prealbúmina ,Cirugía bariátrica - Abstract
Background: bariatric surgery is widely employed nowadays. Nutritional complications following malabsorptive bariatric surgery are common. Objectives: to compare protein malnutrition incidence, the amount of protein intake and the influence of various risk factors in patients undergoing Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion (BPD). Methods: retrospective study comparing the development of hypoalbuminemia in 92 patients undergoing BPD and 121 RYGB, before surgery and 3, 6, 12, 18 and 24 months after it. Protein intake was estimated by serum prealbumin. The influence of prior body mass index (BMI), age and sex was analyzed. Results: hypoprealbuminemia was found in around 40% of patients 3 months after both procedures, decreasing to about 10% after 2 years of surgery. Hypoalbuminemia incidence was close to 20% in the first post-surgery year in BPD, persisting in 10-15% of cases thereafter. After RYGB, hypoalbuminemia incidence was lower (5-9% in all postoperative follow-up measurements). During the first year after surgery, hypoalbuminemia was more frequent after BPD than after RYGB (at the 3rd month (OR:3.9; p=0.006; 95%CI:1.5-10.4), 6th (OR:5.0; p=0.002; 95% CI:1.8-13.8), and at the 12th month (OR:4.4;p=0.007;95%;CI:1.5-12.8)), but not after the first year. A higher preoperative BMI favored it (OR: 1.03; p=0.046; 95% CI:1-1.06), as well as greater age during the first 6 months. Conclusion: Patients with BPD had a higher risk for hypoproteinemia than those undergoing RYGB, especially during the first year post-surgery. Higher preoperative BMI, and age (in the short-term period) could have a significant inverse relation to hypoproteinemia. Introducción: la cirugía bariátrica es muy empleada actualmente y en las malabsortivas, las complicaciones nutricionales son habituales. Objetivos: comparar la incidencia de malnutrición proteica e ingesta estimada de proteínas en pacientes intervenidos de bypass gástrico en Y-de-Roux (BGYR) y derivación biliopancreática (DBP), y la influencia de algunos factores de riesgo. Métodos: estudio restrospectivo comparando el desarrollo de hipoalbuminemia en 92 pacientes intervenidos mediante DBP y 121 de DBP (prequirúrgico, a los 3, 6, 12, 18 y 24 meses postquirúrgicos). La ingesta proteica se estimó mediante prealbúmina. Se evaluó la influencia del índice de masa corporal (IMC) previo, la edad y el sexo. Resultados: se encontró hipoprealbuminemia en torno al 40% de los pacientes a los 3 meses tras ambas técnicas, disminuyendo hasta el 10% a los dos años. La incidencia de hipoalbuminemia fue cercana al 20% durante el primer año tras DBP, persistiendo posteriormente en un 10-15% de los casos. Tras el BGYR, dicha incidencia fue menor (5-9% en todos los momentos). Así, durante el primer año postquirúrgico la hipoalbuminemia fue más frecuente tras DBP [3 meses: (OR:3,9;p = 0,006; 95%CI:1,5- 10,4), 6 meses (OR:5,0; p = 0,002; 95% CI:1,8-13,8), y al año (OR:4,4;p = 0,007;95%;CI:1,5-12,8)], pero no así después. Un mayor IMC prequirúrgico favoreció la inicidencia de hipoalbuminemia (OR:1,03; p = 0,046; 95% CI:1-1,06), así como una mayor edad a los 6 meses postquiúrgicos. Conclusión: los pacientes intervenidos mediante DBP tuvieron mayor riesgo de presentar hipoproteinemia que tras BGYR, especialmente durante el primer año postquirúrgico. Un mayor IMC postquirúrgico y la edad (a los 6 meses) podrían favorecer la aparición de hipoproteinemia.
- Published
- 2015
27. Fish Oil Enriched Intravenous Lipid Emulsions Reduce Triglyceride Levels in Non-Critically Ill Patients with TPN and Type 2 Diabetes. A Post-Hoc Analysis of the INSUPAR Study.
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Abuín-Fernández, Jose, Tapia-Guerrero, María José, López-Urdiales, Rafael, Herranz-Antolín, Sandra, García-Almeida, Jose Manuel, García-Malpartida, Katherine, Ferrer-Gómez, Mercedes, Cancer-Minchot, Emilia, Luengo-Pérez, Luis Miguel, Álvarez-Hernández, Julia, Aragón Valera, Carmen, Ocón-Bretón, Julia, García-Manzanares, Álvaro, Bretón-Lesmes, Irene, Serrano-Aguayo, Pilar, Pérez-Ferre, Natalia, López-Gómez, Juan José, Olivares-Alcolea, Josefina, Arraiza-Irigoyen, Carmen, and Tejera-Pérez, Cristina
- Abstract
There are no studies that have specifically assessed the role of intravenous lipid emulsions (ILE) enriched with fish oil in people with diabetes receiving total parenteral nutrition (TPN). The objective of this study was to assess the metabolic control (glycemic and lipid) and in-hospital complications that occurred in non-critically ill inpatients with TPN and type 2 diabetes with regard to the use of fish oil emulsions compared with other ILEs. We performed a post-hoc analysis of the Insulin in Parenteral Nutrition (INSUPAR) trial that included patients who started with TPN for any cause and that would predictably continue with TPN for at least five days. The study included 161 patients who started with TPN for any cause. There were 80 patients (49.7%) on fish oil enriched ILEs and 81 patients (50.3%) on other ILEs. We found significant decreases in triglyceride levels in the fish oil group compared to the other patients. We did not find any differences in glucose metabolic control: mean capillary glucose, glycemic variability, and insulin dose, except in the number of mild hypoglycemic events that was significantly higher in the fish oil group. We did not observe any differences in other metabolic, liver or infectious complications, in-hospital length of stay or mortality. [ABSTRACT FROM AUTHOR]
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- 2020
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28. Soporte nutricional del paciente con ictus.
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Burgos Peláez, Rosa, Segurola Gurrutxaga, Hegoi, and Bretón Lesmes, Irene
- Abstract
Stroke is a public health problem of the first order. In developed countries is one of the leading causes of death, along with cardiovascular disease and cancer. In addition, stroke is the leading cause of permanent disability in adulthood. Many of the patients who survive do so with significant sequelae that limit them in their activities of daily living. Most strokes (80-85%) are due to ischemia, while the rest are hemorrhagic. We have identified many modifiable risk factors, some with an important relationship with dietary factors or comorbidities in wich the diet has a significant impact. The incidence of malnutrition in stroke patients is not well known, but most likely impacts on patient prognosis. Furthermore, the nutritional status of patients admitted for stroke often deteriorates during hospitalization. It is necessary to perform a nutritional assessment of the patient in the early hours of admission, to determine both the nutritional status and the presence of dysphagia. Dysphagia, through alteration of the safety and efficacy of swallowing, is a complication that has an implication for nutritional support, and must be treated to prevent aspiration pneumonia, which is the leading cause of mortality in the stroke patient. Nutritional support should begin in the early hours. In patients with no or mild dysphagia that can be controlled by modifying the texture of the diet, they will start oral diet and oral nutritional supplementation will be used if the patient does not meet their nutritional requirements. There is no evidence to support the use of nutritional supplements routinely. Patients with severe dysphagia, or decreased level of consciousness will require enteral nutrition. Current evidence indicates that early nutrition should be initiated through a nasogastric tube, with any advantages of early feeding gastrostomy. Gastrostomy will be planned when the enteral nutrition support will be expected for long-term (4 weeks). Much evidence points to the importance of glycemic control during hospitalization for stroke. Hyperglycemia at diagnosis and during the first hours of admission impact on patient prognosis. The goal of glycemic control necessary to modify this bad prognosis without adding risk by iatrogenic hypoglycemia is still matter of debate. [ABSTRACT FROM AUTHOR]
- Published
- 2014
29. Clinical and economic impact of the taurolidine lock on home parenteral nutrition.
- Author
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Arnoriaga Rodríguez, María, de Ciriza Cordeu, Maite Pérez, Camblor Álvarez, Miguel, Bretón Lesmes, Irene, de la Cámara, Marta Motilla, Velasco Gimeno, Cristina, Arhip, Loredana, García Peris, Pilar, Cuerda Compés, Cristina, Pérez de Ciriza Cordeu, Maite, and Motilla de la Cámara, Marta
- Subjects
- *
PARENTERAL feeding , *CENTRAL venous catheterization , *CATHETER-related infections , *MEDICAL care costs , *HOME care services , *ANTI-infective agents , *ALKANES , *NUTRITION , *COST analysis , *SULFUR compounds , *RETROSPECTIVE studies , *IMPACT of Event Scale , *ECONOMICS , *THERAPEUTICS , *INFECTION prevention - Abstract
Introduction: catheter-related bloodstream infections (CRBSI) are one of the most serious concerns in patients on home parenteral nutrition (HPN) which involve high morbidity and cost for the healthcare system. In the last years, taurolidine lock has proven to be beneficial in the prevention of CRBSI; however, the evidence of its efficiency is limited.Objective: to determine if taurolidine lock is a cost-effective intervention in patients on HPN.Materials and Methods: retrospective study in patients on HPN with taurolidine lock. We compared the CRBSI rate and cost of its complications before and during taurolidine lock.Results: thirteen patients, six (46%) males and seven (54%) females, with a mean age of 61.08 (SD = 14.18) years received taurolidine lock. The total days of catheterization pre and per-taurolidine were 12,186 and 5,293, respectively. The underlying disease was benign in five patients (38.5%) and malignant in eight (61.5%). The CRBSI rate pre vs per-taurolidine was 3.12 vs 0.76 episodes per 1,000 catheter days (p = 0.0058). When the indication was a high CRBSI rate, this was 9.72 vs 0.39 (p < 0.001) in pre and per-taurolidine period respectively. No differences have been observed in the occlusion rates. None of the patients reported any adverse effects. The total cost of CRBSI in the pre-taurolidine period was 151,264.14 euros vs 24,331.19 euros in the per-taurolidine period.Conclusions: our study shows that taurolidine lock is a cost-effective intervention in patients on HPN with high risk of CRBSI. [ABSTRACT FROM AUTHOR]- Published
- 2018
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30. Effectiveness and safety of a GLP-1 agonist in obese patients with inflammatory bowel disease.
- Author
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Ramos Belinchón C, Martínez-Lozano H, Serrano Moreno C, Hernández Castillo D, Lois Chicharro P, Ferreira Ocampo P, Marín-Jiménez I, Bretón Lesmes I, and Menchén L
- Subjects
- Humans, Male, Female, Retrospective Studies, Adult, Middle Aged, Glucagon-Like Peptides therapeutic use, Glucagon-Like Peptides adverse effects, Glucagon-Like Peptides analogs & derivatives, Inflammatory Bowel Diseases complications, Inflammatory Bowel Diseases drug therapy, Treatment Outcome, Colitis, Ulcerative drug therapy, Colitis, Ulcerative complications, Crohn Disease complications, Crohn Disease drug therapy, Glucagon-Like Peptide 1 agonists, Aged, Weight Loss drug effects, Liraglutide therapeutic use, Liraglutide adverse effects, Obesity complications, Obesity drug therapy
- Abstract
Background: obesity affects many patients with inflammatory bowel disease (IBD). Glucagon-like peptide (GLP)-1 agonists are a promising therapy for obese patients. However, there is a lack of evidence of the use of these drugs in IBD patients. This study investigated the effectiveness and safety of GLP-1 agonists in a cohort of obese patients with IBD., Methods: a retrospective series of cases of consecutive IBD patients who received GLP-1 agonists indicated to treat obesity between 2019 and 2021 was analyzed. The GLP-1 agonists included were semaglutide 1.0 mg or liraglutide 3.0 mg. The coprimary endpoints were the percentage of change in body weight from baseline to six months and a weight reduction of 5 % or more at six months. In addition, the safety profile of GLP-1 agonist therapy and its impact on the IBD course were reviewed., Results: sixteen obese patients with IBD (nine with Crohn's disease [CD] and seven with ulcerative colitis [UC]) were included in the study. The median body mass index at baseline was 35 (32-37). The percentage of change in body weight was -6.2 % (-3.4-[-8.5]) at six months, and a 5 % or more weight reduction was achieved in 58.3 % (7/12) of patients at six months. The most common side effect was nausea (13.3 %), and one patient withdrew due to diarrhea. IBD activity score did not change significantly during follow-up., Conclusion: our results showed that GLP-1 agonists were effective and had a good safety profile in IBD patients. Most adverse effects were mild, and the IBD activity had no significant changes.
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- 2024
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31. Cross-cultural validation and Spanish translation of the Boston Interview to evaluate severely obese patients seeking metabolic/bariatric surgery.
- Author
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Pelayo Delgado ME, Sogg S, Mori DL, Rodríguez Cano T, Beato Fernández L, Campos Del Portillo R, Royuela Vicente A, de Frutos Guijarro JJ, García-Oria Serrano MJ, Artés Caselles M, Bretón Lesmes I, Carrillo Lozano E, Sánchez Ramos A, Baños Martín I, Torio Palmero I, Alcantara Tadeo A, González Salvador MT, de Arce Cordón MR, and Baca García E
- Abstract
Introduction: obesity is a global health problem. Metabolic/Bariatric surgery (MBS) has proven to be one of the most effective methods for treating the most severe forms. However, a thorough evaluation and preparation of people seeking MBS is necessary. In Spain, there are no standardized interviews to carry out the psychosocial assessment of people seeking MBS. The Boston Interview for MBS (BIBS) is a recognized and flexible tool to evaluate the psychosocial factors., Objective: to present the process of translation into Spanish and cross-cultural adaptation of the BIBS., Materials and Methods: the reverse translation procedure was followed. To validate the translation, a multidisciplinary group of experts was formed. They were asked to rate the clarity of wording and cultural adaptation of the translation items. In addition, the translated interview was used to evaluate 173 patients seeking MBS who rated their satisfaction with the interview experience., Results: the evaluation of the translation by a group of experts was favorable (global mode and median were 3-excellent, IQR of 1). The overall percentage agreement of the adequacy of "cultural adaptation" of the text was 85.8 % (95 % CI, 0.784, 0.932) and of the "clarity of wording" was 84.7 % (95 % CI, 0.7644; 0.9286). Furthermore, it was well accepted by the majority of the patients interviewed (p(50) 10 out of 10)., Conclusions: the Spanish translation of the BIBS is available for the assessment of Spanish-speaking people seeking MBS. It was rated as having good fidelity to the original English version, and was deemed highly satisfactory by patients.
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- 2024
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32. Two pregnancies of an ornithine carbamoyltransferase deficiency disease carrier and review of the literature.
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Arhip L, Agreda J, Serrano-Moreno C, Motilla de la Cámara M, Carrascal Fabián ML, Bielza A, Velasco Gimeno C, Camblor M, Bretón Lesmes I, and Cuerda C
- Subjects
- Humans, Female, Pregnancy, Adult, Pregnancy Complications genetics, Postpartum Period, Heterozygote, Ornithine Carbamoyltransferase Deficiency Disease genetics, Ornithine Carbamoyltransferase Deficiency Disease diagnosis, Ornithine Carbamoyltransferase Deficiency Disease therapy
- Abstract
Introduction: Background: the underlying cause of the deficiency of ornithine carbamoyltransferase (OTCD) is a gene mutation on the X chromosome. In females, the phenotype is highly variable, ranging from asymptomatic to neurologic compromise secondary to hyperammonemia and it can be prompted by numerous triggers, including pregnancy. Objective: the objective of this article is to report a case of two pregnancies of an OTCD-carrier, and to review the literature describing OTCD and pregnancy, parturition and postpartum. Methods: an extensive search in PubMed in December 2021 was conducted using different search terms. After screening all abstracts, 23 papers that corresponded to our inclusion criteria were identified. Results: the article focuses on the management of OTCD during pregnancy, parturition, and the postpartum period in terms of clinical presentation, ammonia levels and treatment. Conclusions: females with OTCD can certainly plan a pregnancy, but they need a careful management during delivery and particularly during the immediate postpartum period. If possible, a multidisciplinary team of physicians, dietitians, obstetrician-gynecologist, neonatologists, pharmacists, etc. with expertise in this field should participate in the care of women with OTCD and their children during this period and in their adult life.
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- 2024
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33. Multidisciplinary consensus on nutritional and metabolic therapy in enhanced recovery after abdominal surgery programs: NutRICA Project.
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Ocón Bretón MJ, Tapia Guerrero MJ, Ramírez Rodriguez JM, Peteiro Miranda C, Ballesteros Pomar MD, Botella Romero F, Martínez Olmos MÁ, Luengo Pérez LM, Cancer Minchot E, García Malpartida K, López Gómez JJ, Zugasti Murillo A, Álvarez Hernández J, and Bretón Lesmes I
- Abstract
Background: The Enhanced Recovery After Surgery (ERAS) care pathways include evidence-based items designed to accelerate recovery after surgery. Interdisciplinarity is one of the key points of ERAS programs., Objective: To prepare a consensus document among the members of the Nutrition Area of the Spanish Society of Endocrinology and Nutrition (SEEN) and the Spanish Group for Multimodal Rehabilitation (GERM), in which the goal is to homogenize the nutritional and metabolic management of patients included in an ERAS program., Methods: 69 specialists in Endocrinology and Nutrition and 85 members of the GERM participated in the project. After a literature review, 79 statements were proposed, divided into 5 sections: 17 of general characteristics, 28 referring to the preoperative period, 4 to the intraoperative, 13 to the perioperative and 17 to the postoperative period. The degree of consensus was determined through a Delphi process of 2 circulations that was ratified by a consistency analysis., Results: Overall, in 61 of the 79 statements there was a consistent agreement, with the degree of consensus being greater among members of the SEEN (64/79) than members of the GERM (59/79). Within the 18 statements where a consistent agreement was not reached, we should highlight some important nutritional strategies such as muscle mass assessment, the start of early oral feeding or pharmaconutrition., Conclusion: Consensus was reached on the vast majority of the nutritional measures and care included in ERAS programs. Due to the lack of agreement on certain key points, it is necessary to continue working closely with both societies to improve the recovery of the surgical patients., (Copyright © 2021 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2021
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34. Portfolio of services in Endocrinology and Nutrition. 2020 update.
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Santamaría Sandi J, Navarro González E, Herrero Ruiz A, Bandrés Nivela O, Ballesteros Pomar M, Escalada San Martín FJ, and Bretón Lesmes I
- Abstract
Endocrinology and Nutrition is a medical specialty covering the study and treatment of diseases of the endocrine system, metabolism and those derived from the nutritional process, including knowledge of diagnostic techniques and dietary and therapeutic measures. In order to develop these activities and plan the management of resources allocated for this purpose, the so-called Portfolio of Services of the specialty has to be defined. A Portfolio of Services is defined as the set of techniques, technologies or procedures through which care services are provided in a healthcare centre, department or institution. It is an essential tool for organization of a hospital Unit or Department by defining the roles and procedures of its healthcare professionals, and also for structuring the resources required to perform the activity. It also allows for defining how to use these resources and identifying the objectives to be achieved, improving the quality of clinical care. Finally, the definition and preparation of the portfolio of services makes it possible to have an inventory of the offer of healthcare services and to detect new healthcare needs., (Copyright © 2021 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2021
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35. PROTEIN MALNUTRITION INCIDENCE COMPARISON AFTER GASTRIC BYPASS VERSUS BILIOPANCREATIC DIVERSION.
- Author
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Suárez Llanos JP, Fuentes Ferrer M, Alvarez-Sala-Walther L, García Bray B, Medina González L, Bretón Lesmes I, and Moreno Esteban B
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- Adult, Anthropometry, Bariatric Surgery adverse effects, Female, Humans, Incidence, Male, Middle Aged, Obesity, Morbid complications, Obesity, Morbid surgery, Retrospective Studies, Time Factors, Weight Loss, Biliopancreatic Diversion adverse effects, Gastric Bypass adverse effects, Hypoalbuminemia epidemiology, Hypoalbuminemia etiology
- Abstract
Background: bariatric surgery is widely employed nowadays. Nutritional complications following malabsorptive bariatric surgery are common., Objectives: to compare protein malnutrition incidence, the amount of protein intake and the influence of various risk factors in patients undergoing Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion (BPD)., Methods: retrospective study comparing the development of hypoalbuminemia in 92 patients undergoing BPD and 121 RYGB, before surgery and 3, 6, 12, 18 and 24 months after it. Protein intake was estimated by serum prealbumin. The influence of prior body mass index (BMI), age and sex was analyzed., Results: hypoprealbuminemia was found in around 40% of patients 3 months after both procedures, decreasing to about 10% after 2 years of surgery. Hypoalbuminemia incidence was close to 20% in the first post-surgery year in BPD, persisting in 10-15% of cases thereafter. After RYGB, hypoalbuminemia incidence was lower (5-9% in all postoperative follow-up measurements). During the first year after surgery, hypoalbuminemia was more frequent after BPD than after RYGB (at the 3rd month (OR:3.9; p=0.006; 95%CI:1.5-10.4), 6th (OR:5.0; p=0.002; 95% CI:1.8-13.8), and at the 12th month (OR:4.4;p=0.007;95%;CI:1.5-12.8)), but not after the first year. A higher preoperative BMI favored it (OR: 1.03; p=0.046; 95% CI:1-1.06), as well as greater age during the first 6 months., Conclusion: Patients with BPD had a higher risk for hypoproteinemia than those undergoing RYGB, especially during the first year post-surgery. Higher preoperative BMI, and age (in the short-term period) could have a significant inverse relation to hypoproteinemia., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)
- Published
- 2015
- Full Text
- View/download PDF
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