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Background: Parenteral nutrition (PN) is a costly therapy that can also be associated with serious complications. Therefore, efforts are focusing on reducing rate of complications, and costs related to PN. Objective: The aim was to analyze the effect of the implementation of PN standardization on costs and quality criteria. Secondary aim was to assess the use of individualized PN based on patient's clinical condition. Methods: We compare the use of PN before and after the implementation of PN standardization. Demographic, clinical and PN characteristics were collected. Costs analysis was performed to study the costs associated to the two different periods. Quality criteria included were: 1) PN administration; 2) nutrition assessment (energy intake between 20-35 kcal/kg/day; protein contribution according to nitrogen balance); 3) safety and complications (hyperglycemia, hypertriglyceridemia, hepatic complications, catheter-related infection); 4) global efficacy (as serum albumin increase). Chi-square test was used to compare percentages; logistic regression analysis was performed to evaluate the use of customized PN. Results: 296 patients were included with a total of 3,167 PN compounded. During the first period standardized PN use was 47.5% vs 85.7% within the second period (p < 0.05). No differences were found in the quality criteria tested. Use of individualized PN was related to critical care patients, hypertriglyceridemia, renal damage, and long-term PN. Mean costs of the PN decreased a 19.5%. Annual costs savings would be € 86,700. Conclusions: The use of customized or standard PN has shown to be efficient and flexible to specific demands; however customized PN was significantly more expensive.

Background: Parenteral nutrition (PN) is a costly technology used widely to provide nutrition to patients who have an inaccessible or non-functioning intestine. Two all-in-one systems currently being used are customized formulations and three-compartment bags. Objective: To provide a systematic cost comparison of the two all-in-one PN systems: individualized (made from nutrient solutions) versus commercialized (made from three-compartment bag), both prepared in hospital pharmacies. Setting: This study was conducted in three public Spanish hospitals. Method: We conducted a cost-minimization study to analyze prospectively the total cost of PN bags, accounting for all of the processes involved in preparing and delivering PN bags (cost of manpower, nutrition solutions, medical supplies and quality controls) in three different healthcare settings. To compare therapeutic alternatives of equivalent nutritional value, the study was performed for the most frequently employed formulation and similar to commercial preparations. A univariate sensitivity analysis was performed to evaluate the impact of different rates of use of three-compartment PN bag. Results: 157 routine acts of PN bag preparation (65 customized and 92 three-compartment) were observed and timed over 9 days. Total costs of the 157 PN bags were included in the study. Mean costs of customized bags were higher than three-compartment bags, 51.16 ± 5.63 € versus 39.69 ± 3.00 € respectively (p < 0.01). Manpower costs were responsible for the majority of the differences found (70%). The time to complete an adult bag for the hospital compounded system was a mean of 25.9 minutes longer than the three-compartment system. In scenarios using a three-compartment system for 30%, 70% and 90% of PN provision, a cost savings of 4.3%, 10.1% and 12.9% respectively could be achieved. Greatest rates of changing from customized bags (70% and 90%), in a hospital with 1,800 PN bags/year, might reduce the annual budget by 9306 € and 11,964.8 €, respectively. Meanwhile, in a large facility the savings for 8,000 TPN days would be 64,248 € and 82,605 €, respectively. Conclusions: Since seeking cost-reduction of effective treatments is needed, the use of three-compartment bags for standard adult PN could lead to cost savings. Our data should be helpful for health care providers to calculate their own cost of administer.

Aims: Biogenic amines were determined in 109 wines from two wine-producing areas (Jumilla and Bullas PDOs) situated in the Murcia region (SE Spain). Methods and Results: Biogenic amines (histamine, ethylamine, tyramine, phenylethylamine, putrescine, tryptamine and cadaverine) were analysed by RP-HPLC with o-phthaldialdehyde precolumn derivatization and fluorescence detection. Histamine and putrescine were the most prevalent amines in Jumilla wines (49 and 48%, respectively), whereas tryptamine and putrescine were the most prevalent ones in Bullas wines (19 and 38%, respectively). Multivariate analyses were used to attempt a preliminary classification of wines according to production area. Conclusion: In general, wines from Jumilla PDO had a higher biogenic amine content than wines from Bullas PDO; however, all of them were safe from the health point of view. Significance and impact of the study: This study demonstrates that the Jumilla and Bullas wines studied are safe to drink and that geographical classification based on biogenic amine profiles is not possible with the analysed samples.

Aims: The effects of cluster thinning on yield and extractability parameters of Syrah and Tempranillo grapes, as well as the chromatic characteristics of the wines obtained in three consecutive seasons. Methods and results: Grapes of Vitis vinifera L. var. Tempranillo and Syrah were harvested from a commercial vineyard in Jumilla. Two treatments were evaluated: (a) cluster thinned, where in every shoot all the clusters, except the basal one, were removed just before veraison; (b) unthinned control. Yield, physicochemical and extractability parameters were studied in the grapes. Vinifications were made from these grapes, and chromatic parameters were studied at the end of alcoholic fermentation. Results showed that cluster-thinned vines performed better than control vines during the three consecutive years of the experiment, although the best results were obtained in the driest year (2005). The Syrah variety always provided better results than the Tempranillo variety. The cluster-thinning treatment also influenced the chromatic characteristics of the wines obtained. Conclusions: The results showed that thinning successfully reduced yield and produced an earlier harvest in the two varieties studied. The grape quality improved and, in general, wines made from cluster-thinned vines of both Syrah and Tempranillo had significantly better chromatic characteristics than control wines. Significance and impact of the study: This study demonstrate that the practice of cluster-thinning may be recommended depending on several factors, as the varieties and the climatic conditions play also a role in the extractability parameters of grapes, and therefore its use cannot be generalized.

The results showed that moderately irrigated vines produced berries with a higher anthocyanin content (expressed as mg/100 berries) than non-irrigated vines. These findings suggest that moderate levels of water doses may actually improve the physiological status of vines grown in very dry areas, resulting in higher yields and higher quality grapes. The higher yields were mainly related to larger berry size which led to a lower anthocyanin content when expressed as mg/kg, due to a dilution effect. This fact is also responsible for the lower anthocyanin content of the wines elaborated with grapes from irrigated vines although irrigation per se did not decrease the concentration of anthocyanins in grapes.

This note presents the study of levels of total volatile compounds and monoterpene levels of Italia grapes grafted onto eight rootstocks as well as yield, soluble solids, berry weight and cluster weight, in order to determine if there is any difference in the aromatic composition of the berries. This study has been performed during one year in an Italian vineyard in Murcia (Spain).

El creciente empleo del método de los elementos finitos como herramienta de cálculo estructural requiere la definición de modelos de hormigón capaces de reproducir respuestas más allá del rango eminentemente elástico. En los últimos años ha crecido fuertemente el interés en la caracterización y modelización de materiales cuyo comportamiento mecánico incluye una fase de reblandecimiento en las etapas próximas a la rotura. En muchos casos dicho reblandecimiento está asociado a la interacción entre los componentes microestructurales del material que genera estados de deformación no homogéneos con una localización de las deformaciones en bandas de pequeño espesor. El objeto del presente trabajo es contribuir al análisis por métodos numéricos del fenómeno de localización de deformaciones en materiales cohesivo fricciónales. Se dedica especial atención al hormigón en masa y, de manera particular, a la caracterización y modelización de su comportamiento en compresión uniaxial.