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Search Results: 1 - 10 of 222423 matches for " C.; Acosta Escribano "
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Guidelines for specialized nutritional and metabolic support in the critically-ill patient: Update. Consensus SEMICYUC-SENPE: Severe acute pancreatitis
Bordejé Laguna,L.; Lorencio Cárdenas,C.; Acosta Escribano,J.;
Nutrición Hospitalaria , 2011,
Abstract: severe acute pancreatitis (sap) causes local and systemic complications leading to high catabolic, hypermetabolic and hyperdynamic stress states with marked morbidity and mortality. in the last decade, nutritional support has become a key element in the treatment of sap. thus, specialized nutrition is indicated from admission, with enteral nutrition being preferred to parenteral nutrition. enteral nutrition should be initiated early using infusion through the jejunum beyond the ligament of treitz to minimize pancreatic stress. there are no specific studies that establish the type of diet to be used but experts recommend the use of polymeric diets. parenteral nutrition, without a specific formula, is indicated in patients with sap who are intolerant to enteral nutrition or when the clinical signs of pancreatitis are exacerbated or aggravated by enteral nutrition. even so, a minimal level of enteral infusion should be maintained to preserve the trophic effect of the intestinal mucosa. in the last few years, several studies of the administration of immunomodulatory diets in patients with sap have been carried out to demonstrate their effects on the course of the disease. however, there are few clear recommendations on the prognostic benefits of pharmaconutrient enriched diets in these patients. there is substantial scientific evidence suggesting that the only clear indication for pharmaconutrition in patients with sap is parenteral glutamine administration, which is recommended by all clinical guidelines with distinct grades of evidence.
Guidelines for specialized nutritional and metabolic support in the critically-ill patient: Update. Consensus SEMICYUC-SENPE: Severe acute pancreatitis Recomendaciones para el soporte nutricional y metabólico especializado del paciente crítico: Actualización. Consenso SEMICYUC-SENPE: Pancreatitis aguda grave
L. Bordejé Laguna,C. Lorencio Cárdenas,J. Acosta Escribano
Nutrición Hospitalaria , 2011,
Abstract: Severe acute pancreatitis (SAP) causes local and systemic complications leading to high catabolic, hypermetabolic and hyperdynamic stress states with marked morbidity and mortality. In the last decade, nutritional support has become a key element in the treatment of SAP. Thus, specialized nutrition is indicated from admission, with enteral nutrition being preferred to parenteral nutrition. Enteral nutrition should be initiated early using infusion through the jejunum beyond the ligament of Treitz to minimize pancreatic stress. There are no specific studies that establish the type of diet to be used but experts recommend the use of polymeric diets. Parenteral nutrition, without a specific formula, is indicated in patients with SAP who are intolerant to enteral nutrition or when the clinical signs of pancreatitis are exacerbated or aggravated by enteral nutrition. Even so, a minimal level of enteral infusion should be maintained to preserve the trophic effect of the intestinal mucosa. In the last few years, several studies of the administration of immunomodulatory diets in patients with SAP have been carried out to demonstrate their effects on the course of the disease. However, there are few clear recommendations on the prognostic benefits of pharmaconutrient enriched diets in these patients. There is substantial scientific evidence suggesting that the only clear indication for pharmaconutrition in patients with SAP is parenteral glutamine administration, which is recommended by all clinical guidelines with distinct grades of evidence. La pancreatitis aguda grave es una patología que cursa con complicaciones locales y sistémicas que condicionan una situación de estrés altamente catabólica, hipermetabólica e hiperdinámica con marcada morbimortalidad. En la última década, el soporte nutricional se ha convertido en uno de los puntos clave en el tratamiento de la pancreatitis aguda grave. Así, hay indicación de nutrición especializada desde el ingreso, siendo de elección la nutrición enteral sobre la nutrición parenteral administrada de forma precoz más allá del ligamento de treitz, para provocar el mínimo estímulo pancreático. No hay estudios específicos que nos aclaren cuál es el tipo de dieta a administrar, pero los expertos recomiendan la utilización de dietas poliméricas. La nutrición parenteral, sin una fórmula concreta, quedaría indicada en los pacientes con pancreatitis aguda grave que presentan intolerancia a la nutrición enteral o cuando se agravan los signos clínicos de pancreatitis al administrar la dieta enteral. Aun así, se recomienda mantener
Guidelines for specialized nutritional and metabolic support in the critically-ill patient: Update. Consensus SEMICYUC-SENPE: Introduction and methodology Recomendaciones para el soporte nutricional y metabólico especializado del paciente crítico: Actualización. Consenso SEMICYUC-SENPE: Introducción y metodología
A. Mesejo,C. Vaquerizo Alonso,J. Acosta Escribano,C. Ortiz Leiba
Nutrición Hospitalaria , 2011,
Abstract: The Recommendations for Specialized Nutritional Support in Critically-Ill patients were drafted by the Metabolism and Nutrition Working Group of the Spanish Society of Intensive Care Medicine and Coronary Units (SEMICYUC) in 2005. Given the time elapsed since then, these recommendations have been reviewed and updated as a Consensus Document in collaboration with the Spanish Society of Parenteral and Enteral Nutrition (SENPE). The primary aim of these Recommendations was to evaluate the best available scientific evidence for the indications of specialized nutritional and metabolic support in critically-ill patients. The Recommendations have been formulated by an expert panel with broad experience in nutritional and metabolic support in critically-ill patients and were drafted between October 2009 and March 2011. The studies analyzed encompassed metaanalyses, randomized clinical trials, observational studies, systematic reviews and updates relating to critically-ill adults in MEDLINE from 1966 to 2010, EMBASE reviews from 1991 to 2010 and the Cochrane Database of Systematic Reviews up to 2010. The methodological criteria selected were those established in the Scottish Intercollegiate Guidelines Network and the Agency for Health Care policy and Research, as well as those of the Jadad Quality Scale. Adjustment for the level of evidence and grade of recommendation was performed following the proposal of the GRADE group (Grading of Recommendations Assessment, Development and Evaluation Working Group). Sixteen pathological scenarios were selected and each of them was developed by groups of three experts. A feedback system was established with the five members of the Editorial Committee and with the entire Working Group. All discrepancies were discussed and consensus was reached over several meetings, with special emphasis placed on reviewing the levels of evidence and grades of recommendation. The Editorial Committee made the final adjustments before the document was approved by all the members of the Working Group. Finally, the document was submitted to the Scientific Committees of the two Societies participating in the Consensus for final approval. The present Recommendations aim to serve as a guide for clinicians involved in the management and treatment of critically-ill patients and for any specialists interested in the nutritional treatment of hospitalized patients. El Grupo de trabajo de Metabolismo y Nutrición de la Sociedad Espa ola de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC) elaboró en 2005 unas recomendaciones para el soporte nutri
Guidelines for specialized nutritional and metabolic support in the critically-ill patient: Update. Consensus SEMICYUC-SENPE: Introduction and methodology
Mesejo,A.; Vaquerizo Alonso,C.; Acosta Escribano,J.; Ortiz Leiba,C.; Montejo González,J.C.;
Nutrición Hospitalaria , 2011,
Abstract: the recommendations for specialized nutritional support in critically-ill patients were drafted by the metabolism and nutrition working group of the spanish society of intensive care medicine and coronary units (semicyuc) in 2005. given the time elapsed since then, these recommendations have been reviewed and updated as a consensus document in collaboration with the spanish society of parenteral and enteral nutrition (senpe). the primary aim of these recommendations was to evaluate the best available scientific evidence for the indications of specialized nutritional and metabolic support in critically-ill patients. the recommendations have been formulated by an expert panel with broad experience in nutritional and metabolic support in critically-ill patients and were drafted between october 2009 and march 2011. the studies analyzed encompassed metaanalyses, randomized clinical trials, observational studies, systematic reviews and updates relating to critically-ill adults in medline from 1966 to 2010, embase reviews from 1991 to 2010 and the cochrane database of systematic reviews up to 2010. the methodological criteria selected were those established in the scottish intercollegiate guidelines network and the agency for health care policy and research, as well as those of the jadad quality scale. adjustment for the level of evidence and grade of recommendation was performed following the proposal of the grade group (grading of recommendations assessment, development and evaluation working group). sixteen pathological scenarios were selected and each of them was developed by groups of three experts. a feedback system was established with the five members of the editorial committee and with the entire working group. all discrepancies were discussed and consensus was reached over several meetings, with special emphasis placed on reviewing the levels of evidence and grades of recommendation. the editorial committee made the final adjustments before the document was appro
Importancia clínica de la translocación bacteriana
Acosta Escribano,J.; Rodríguez Montes,J. A.;
Nutrición Hospitalaria , 2007,
Abstract: the gastrointestinal tract is colonized by a huge number of microorganisms that we call intestinal flora. although the bowel provides a functional barrier between these organisms and the host, bacterial translocation is not an infrequent event in healthy people. however, in critically ill patients, carriers of different morbid entities, bacterial translocation may favor infections and increased morbimortality. there are several proposed mechanisms explaining the etiology, genesis, and ways for this entity, and frequently the results from both in vitro and animal experimental investigations are controversial and difficult to apply to humans. many diseases have been linked or are implicated in the translocation phenomenon, although studies with insufficient methodology, reduced populations, and conflicting results still leave open questions and others with no logical answer. this problem is also reflected when studying and assessing different therapeutic strategies used as well as on the methods used to detect translocation.
Recomendaciones para la valoración nutricional y el soporte nutricional especializado de los pacientes críticos
Ortiz Leyba,C.; Montejo Gonzalez,J. C.; Jiménez Jiménez,F. Javier; Lopez Martinez,J.; García de Lorenzo y Mateos,A.; Grau Carmona,T.; Acosta Escribano,J.; Mesejo Arizmendi,A.; Fernandez Ortega,F.; Ordo?ez Gonzalez,F. J.; Bonet Saris,A.; Blesa Malpica,A.; ,;
Nutrición Hospitalaria , 2005,
Abstract: due to the characteristics of critically ill patients, elaborating recommendations on nutritional support for these patients is difficult. usually the time of onset of nutritional support or its features are not well established, so that its application is based on experts' opinion. in the present document, recommendations formulated by the metabolism and nutrition working group of the spanish society of intensive and critical medicine and coronary units (semicyuc) are presented. recommendations are based on the literature analysis and further discussion by the working group members in order to define, consensually, the more relevant issues of metabolic and nutritional support of patients in a critical condition. several clinical situations have been considered which are developed in the following articles of this publication. the present recommendations aim at providing a guideline for the less experienced clinicians when considering the metabolic and nutritional issues of critically ill patients.
Inverses of moment Hermitian matrices
C. Escribano,R. Gonzalo,E. Torrano
Mathematics , 2013,
Abstract: Motivated by [9] we study the existence of the inverse of infinite Hermitian moment matrices associated with measures with support on the complex plane. We relate this problem to the asymptotic behaviour of the smallest eigenvalues of finite sections and we study it from the point of view of infinite transition matrices associated to the orthogonal polynomials. For Toeplitz matrices we introduce the notion of weakly asymptotic Toeplitz matrix and we show that, under certain assumptions, the inverse of a Toeplitz moment matrix is weakly asymptotic Toeplitz. Such inverses are computed in terms of some limits of the coefficients of the associated orthogonal polynomials. We finally show that the asymptotic behaviour of the smallest eigenvalue of a moment Toeplitz matrix only depends on the absolutely part of the associated measure.
Guidelines for specialized nutritional and metabolic support in the critically-ill patient: Update. Consensus SEMICYUC-SENPE: Neurocritical patient
Acosta Escribano,J.; Herrero Meseguer,I.; Conejero García-Quijada,R.;
Nutrición Hospitalaria , 2011,
Abstract: neurocritical patients require specialized nutritional support due to their intense catabolism and prolonged fasting. the preferred route of nutrient administration is the gastrointestinal route, especially the gastric route. alternatives are the transpyloric route or mixed enteralparenteral nutrition if an effective nutritional volume of more than 60% cannot be obtained. total calore intake ranges from 20-30 kcal/kg/day, depending on the period of the clinical course, with protein intake higher than 20% of total calories (hyperproteic diet). nutritional support should be initiated early. the incidence of gastrointestinal complications is generally higher to other critically-ill patients, the most frequent complication being an increase in gastric residual volume. as in other critically-ill patients, glycemia should be closely monitored and maintained below 150 mg/dl.
Nutrición artificial en el paciente politraumatizado
García de Lorenzo y Mateos,A.; Acosta Escribano,J.; Bonet Saris,A.;
Nutrición Hospitalaria , 2005,
Abstract: polytraumatism usually presents in previously healthy patients with a good nutritional status. however, metabolic changes derived from the traumatic injury put these patients in a nutritional risk situation. specialized nutritional support should be started if it is foreseeable that nutritional requirements will not be met p.o. within the 5-10 days period from admission. enteral nutrition should be the first route to consider for nutrients intake. however, the presence of head trauma leads to gastrointestinal motility impairments that hinder tolerance to enteral nutrition. patients with abdominal trauma also present difficulties for the onset and tolerance of enteral diet. the insertion of transpyloric tubes or jejunostomy catheters allows early use of enteral nutrition in these patients.
Valoración del estado nutricional en el paciente grave
Acosta Escribano,J.; Gómez-Tello,V.; Ruiz Santana,S.;
Nutrición Hospitalaria , 2005,
Abstract: there are different parameters aimed at assessing nutritional status. these parameters may be of some help to assess nutritional status prior to patients' admission. however, their application in the critically ill patient is troublesome since results interpretation is interfered by changes originated by the acute disease or treatment measures. this is particularly true in relation to anthropometrical variables that are severely affected by changes in water distribution in the critical patient. biochemical markers (creatinine/height index, serum albumin, etc.) are also interfered as a result of the metabolic changes that modify the synthesis and degradation processes. short half-life proteins (prealbumin, retinol-bound protein) are not indicative of the nutritional status although they do inform about an appropriate response to nutrients intake and concurrence of new conditions of metabolic stress. functional assessment parameters, such as muscular function test, are also difficult to apply in a great number of patients. subjective global assessment, although it requires some degree of expertise, may be an appropriate tool. some theoretically more accurate methods, such as bioelectrical impedance, need further investigation in these patients before being recommended.
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