Nutrición y anemias en pacientes graves

INTRODUCTION: We made a clinical study, about nutrition in seriously ill patients, which includes a typical heterogeneous group of critical ill patients, with/without anaemia's, that have been admitted to Intensive Care Unit, ICU. It is difficult to individualize and to generalize the relative importance of all the factors that can contribute to these anaemia's in the admission to the Unit, including nutritional deficiencies, inflammatory alterations, the immune response to aggressions, inmunitary modifications and the complex relations existing between these clinic processes. OBJECTIVE: Indirect valuation of the nutritional situation and anaemia's, in a typical heterogeneous group of critical ill patients. METHOD/RESULTS: We studied 202 patients admitted to ICU, of varied and heterogeneous origin, classifying them in 3 groups: control, post surgery and septic group's, becoming the indirect valuation of the nutritional situation on the basis of: Global Subjective Valuation, (VGS) and the nutritional analytical determinations of total lymphocytes, albumin, and transferrin. Also we made hemogram and determinations of sideremia and ferritinemia to all of them. In 57% of the patients, we observed levels haemoglobin < 12.5 g/dl, basically in the post surgery groups, 68 patients and septic group's, 10 patients. And with levels haemoglobin < 10 g/dl, in 25 patient's (12.3%). There were 87 patients, 23 of them in the control group's, 58 in the post surgery and 5 septic group's, with levels haemoglobin > 12.5 g/dl. Regarding the nutritional prognoses indicators, (VGS + nutritional profile), in the control group's, they did not present anaemia nor analytical clinical under nourishment, in the post surgery group's, anaemia and slight under nourishment and in the septic group's, anaemia and moderate under nourishment. There were significant differences between the surgery and septic group and control group's, in values of haemoglobin, iron, total lymphocytes, transferrin and albumin. A statistical correlation between sideremia and albumin was significative. (Spearman's Rho 0,277). CONCLUSIONS: The evaluation of the anaemia and nutritional valuation. and the ferroterapic treatment, as immune-nutrient, can be beneficial for the integrity of the immune system and its defense's abilities against the aggressions in critically ills.

Calidad de vida en los pacientes obesos y su cambio tras cirugía bariátrica a medio y largo plazo.

INTRODUCTION: Morbid obesity has grown enormously in recent decades, representing a serious public health problem. It is characterized by the accumulation of body fat and the presence of diseases associated with it, which affects the physical, psychological and social level. It has been considered bariatric ciguría as the most effective treatment for weight loss, getting the welfare of the obese person in the above-described drawings. OBJECTIVE: To evaluate the impact on the quality of life of obese people before and after bariatric surgery be tapped using the technique of laparoscopic gastrectomy (GVL) in a follow short, medium and long term. METHOD: The study population are all people with morbid obesity and are candidates for surgery, presenting at Torrecárdenas Bariatric Surgery Hospital (Almería). The design is a descriptive, longitudinal study, prospective. RESULTS: After evaluation of the obese patients a year, two years and five years after surgery, there has been decrease in weight, therefore decrease in BMI and the degree of obesity, improvement or disappearance of comorbidities and increased CV variables. DISCUSSION: The GVL gets reduce excess weight and therefore BMI and the degree of obesity, as well as the number of obesity-associated diseases, thus increasing the CV.