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The study aims at confirming the adequacy of diets prescribed for dysphagia during hospitalization through a specific questionnaire to identify, give advice, and manage dysphagia. To compare and analyze the diet for dysphagia offered at our Hospital with the recommendations for a dysphagia diet published in recent nutritional literature. From the results obtained, to establish diet improvements (if necessary) and nursing working tools aimed at early detection of swallowing problems and decreasing the risk for Hyponutrition, dehydration and aspiration. Subjects and methods: A cross-sectional study among patients from our hospital with a prescription for a dysphagia diet is performed, assessing the diet usefulness, the characteristics of the 30 patients admitted at the Hospital Complex of Segovia, in several nursing units and with an established diet for dysphagia for two months and with different pathologies. Ages were comprised between 68-85 years. Results: the questionnaire was analyzed and we verified that all patients had a swallowing impairment. The nutritional analysis showed an inadequate adaptation of hospital diet to dysphagia patients with regards to consistency of some dishes and the poor energy intake was significant (x 1339 kcal), poor protein intake (58 g), and a deficiency in some minerals (iron and calcium), and vitamins (vitamin C). Conclusions: Dysphagia is a problem that affects a considerable number of patients in our Hospital (1015%). The diet provided by the Hospital was inadequate before the study. A more adequate diet has been designed with regards to nutritional value and consistency, its indication is broaden, as well as interventional measures and previous patient assessment. The Nutrition Unit has implemented improvements in nutritional content. [ABSTRACT FROM AUTHOR]

Introducción: La nutrición es un pilar fundamental del abordaje de los niños en proceso oncológico siendo, la malnutrición, un indicador pronóstico de disminución de la supervivencia, independiente de mala respuesta al tratamiento; por lo que, la evaluación del estado nutricional, es fundamental. En nuestra Unidad, los niños eligen a demanda la comida, lo que puede propiciar transgresiones nutricionales a tener en consideración. Objetivos: Analizar la adecuación de las peticiones de comida, a las recomendaciones existentes. Material y métodos: Estudio descriptivo de los menús solicitados por los pacientes de la Unidad de hemato-oncología pediátrica en dos meses. Se realiza análisis estadístico descriptivo de las variables registradas (grupos de alimentos), calculando para cada grupo alimentario el porcentaje promedio correspondiente. Resultados: Se analizaron un total de 611 comidas, distribuidas en desayuno, almuerzo, merienda y cena. El desayuno y la merienda se componen mayoritaríamente de un lácteo y un dulce en más del 90% de los casos. La proteína predominante en almuerzo y cena es la carne en más del 88% y las legumbres en un 0,6%. La fruta esta presente en el 51,5% de los almuerzos y 25% de las cenas, y las verduras el 30% de ellas Las distribución de macronutrientes de las peticiones analizadas es la siguiente: 44,55% Proteínas, 38,6% DE H d C y 32,37% de Grasas con un 5,8 de frutas y un 3,4 de verduras. Conclusiones: Las peticiones analizadas, no son equilibradas, se componen de con exceso de dulces, proteínas cárnicas y grasas saturada y son pobre en frutas, verduras, legumbres. Lo que hace necesaria una intervención. [ABSTRACT FROM AUTHOR]

The morbid obesity is a chronic disease with increasing prevalence and that associates an important morbility and mortality. The bariatric surgery is the most effective treatment to secure a weight reduction maintained in the time and a diminution in the rates of complications associated to the obesity. The overweight and the obesity are risk factors for the deficit of several micronutrients like vitamins B1, B6, C, folic acid and D, minerals like the iron and trace elements like zinc, generally by dietetic deficit. In spite of it, at the moment a consensus don't exist about the monitoring of micronutrients in the preoperative one, although it seems reasonable in view of his considerable prevalence. The bariatric surgery can bring about deficit of micronutrients or to intensify previous deficiencies, as much by limitation of the ingestion like by the maldigestión and malabsorption in the malabsortives techniques, being the parallel risk to the ponderal loss. It is precise to monitor of by life the different micronutrients, mainly after the malabsortives surgical techniques. The use of a polivitamínic complex of systematic form is recommended and in the cases in which he is insufficient, it will be precise to use specific suplementación.

Unlabelled: The study aims at confirming the adequacy of diets prescribed for dysphagia during hospitalization through a specific questionnaire to identify, give advice, and manage dysphagia. To compare and analyze the diet for dysphagia offered at our Hospital with the recommendations for a dysphagia diet published in recent nutritional literature. From the results obtained, to establish diet improvements (if necessary) and nursing working tools aimed at early detection of swallowing problems and decreasing the risk for Hyponutrition, dehydration and aspiration., Subjects and Methods: A cross-sectional study among patients from our hospital with a prescription for a dysphagia diet is performed, assessing the diet usefulness, the characteristics of the 30 patients admitted at the Hospital Complex of Segovia, in several nursing units and with an established diet for dysphagia for two months and with different pathologies. Ages were comprised between 68-85 years., Results: The questionnaire was analyzed and we verified that all patients had a swallowing impairment. The nutritional analysis showed an inadequate adaptation of hospital diet to dysphagia patients with regards to consistency of some dishes and the poor energy intake was significant (x 1339 kcal), poor protein intake (58 g), and a deficiency in some minerals (iron and calcium), and vitamins (vitamin C)., Conclusions: Dysphagia is a problem that affects a considerable number of patients in our Hospital (10-15%). The diet provided by the Hospital was inadequate before the study. A more adequate diet has been designed with regards to nutritional value and consistency, its indication is broaden, as well as interventional measures and previous patient assessment. The Nutrition Unit has implemented improvements in nutritional content.

Unlabelled: The prescription and preparation of paediatric parenteral nutrition in Spain are subject to great variability., Aim: To identify how paediatric parenteral nutrition is prescribed and prepared in Spain., Material and Methods: During the first quarter of 2001, a telephone survey was carried out among most of the hospitals in which parenteral nutrition is habitually prepared. The survey included questions on who was in charge of the prescription, the use of different solutions, addition of supplements (carnitine, heparin and glutamine), as well as information on the shelf-life of the mixtures. Subsequently, the results of the survey were compared with the following guidance documents: "Enteral and parenteral nutrition in paediatrics", drafted under the auspices of the Spanish Association for Paediatric Gastroenterology, Hepatology and Nutrition (2000) and the "Guidelines for the use of parenteral and enteral nutrition in adult and paediatric patients"/"Nutrition support practice manual" from the American Society for Parenteral and Enteral Nutrition (1998)., Results: Of the 48 hospitals surveyed, paediatric parenteral nutrition was not prepared in 12 of them. the number of food bags prepared daily correlated directly with the size of the hospital. In all cases, the paediatricians were responsible for prescription. In 87% of the centres, this prescription was customized (i.e. solutions adapted to each individual patient). All of the hospitals used dextrose as the source of carbohydrates and specific amino acid solutions for paediatric medicine. Basically, lipid emulsions with long chain triglycerides were used in 65% of cases and another 19% used physical mixtures of MCT and LCT. Only half of the hospitals routinely used all-in-one mixtures. Inorganic phosphate continued to be used in most cases (78%) versus sodium glycerol phosphate. Vitamins and trace elements were added daily in 65% of the hospitals, with alternate administration in the remainder. In half of the centres, heparin was added to the mixture and carnitine in 27%. For 40% of the centres responding to the survey, the solution had to be used within 24 hours of its preparation; 11% did not indicate the shelf-life., Conclusions: Although parenteral nutrition is prescribed by the paediatricians on all occasions, the preparation protocols differ significantly between hospitals. Standardization is exceptional. It is noteworthy that all-in-one mixtures are only used in half of the hospitals surveyed. We suggest the creation of a multidisciplinary working party (pharmacists, paediatricians, neonatologists) in order to draw up protocols for the preparation of paediatric parenteral nutrition.

Objective: To study compliance with an artificial nutrition protocol at an Intensive Care Unit. During a second stage and after introducing the modifications considered appropriate in the protocol, to verify its implementation and compare both series. REFERENCE POPULATION: All patients with artificial nutrition support were included. Artificial nutrition (AN) was deemed to be the dispensation of commercial preparations for enteral nutrition, formulas with amino acids and glucose and the parenteral provision of fat, including propofol in this case, even where it was the only source of energy. The provision of crystalloid solutions was not considered to be AN. The period of observation was two months in both cases., Intervention: The provision of AN to all such patients was systematically recorded on a daily basis. After analysis of the first series, the members at the unit agreed to increase the nitrogen provision. A second series was recorded, with the data being collected for patients with AN during a similar period., Results: The study of the first series revealed the provisions of energy and nitrogen were below theoretical levels (both in the corrected Harris-Benedict test and at the fixed prescription of 25 kcal/kg). In the second series, there was greater agreement between the theoretical values and the amounts actually received. The deviation in energy and nitrogen was significantly less in the second series. And although the total nitrogen load per patient did not reveal any differences, there were discrepancies in the daily provision per patient. On most days, the diet provided covered over 75% of the energy requirements. With parenteral nutrition on its own or in combination with enteral nutrition, the requirements of energy and nitrogen were exceeded. There were no differences between the two series. The type of provision was enteral on 55% of the days and parenteral on 18%. There was no difference in the type of provision between the two series, although there was a difference in the type of diet administered in that the second series saw a significant increase in the provision of hyperproteic diets, both enterally and through patenteral formulations, rising from 9-13 grammes to 18-20 grammes of nitrogen. Using the enteral route on its own, there was a discreet increase in the energy load in the second series, but this did not occur in the other types of provision. Both series revealed over-nutrition in terms of both calories and nitrogen when enteral and parenteral nutrition were used together, although there was no difference between the series., Conclusions: Early enteral nutrition is possible in critically-ill patients, while artificial nutrition was used most frequently and for longer in our patients. The existence of nutrition protocols allow acceptable levels of nutritional provision. Their controlled use allows the correction of deviations between real and theoretical provisions, customizing the nutrition for each patient. The use of parenteral formulas with high levels of nitrogen requires more accurate adjustment in order to avoid over-nutrition.