Papers by JUAN BAUTISTA MOLINA SORIA
Journal of Health, Population and Nutrition
Background Home Enteral Nutrition (HEN) is used to prevent or correct malnutrition in outpatients... more Background Home Enteral Nutrition (HEN) is used to prevent or correct malnutrition in outpatients. Due to the complexity of this process, the indication, follow-up, and results of an educational program of HEN patients was evaluated. Methods A prospective, observational, real-life, multicenter study was performed in 21 Spanish Hospital. Patients receiving HEN by nasogastric tube or ostomy were included. The following variables were collected: age, gender, HEN indication, type of formula, nutritional requirements, laboratory variables, complications, and quality standards of the educational program. To calculate the energy and protein requirements, the FAO/WHO/UNU formula was used considering the adjusted weight of the patients. All data were analyzed using SPSS.24. Results 414 patients were included. Most conditions diagnosed were neurodegenerative diseases (64.8%). 100 (25.3%) were diabetic. The mean weight was 59.3 ± 10.4 kg and BMI 22.6 ± 3.2. Moderate protein-calorie malnutritio...
Nutricion hospitalaria, Jan 16, 2018
Non-alcoholic fatty liver disease is characterized by the intrahepatic deposition of fat. It is t... more Non-alcoholic fatty liver disease is characterized by the intrahepatic deposition of fat. It is the most prevalent liver disease in the world, affecting obese children and adolescents. Its pathophysiology is not fully understood, although it is often related to insulin resistance. This in turn would be due to an inflammatory condition common to obesity. Thus, the objective of this study was to describe the behavior of proinflammatory cytokines in obese children and adolescents, with and without non-alcoholic fatty liver disease. A fasting venous blood sample was obtained of consecutive 90 obese individuals aged 8-18 years, of both sexes, for laboratory determinations of glycaemia, basal insulin and homeostasis model assessment insulin-resistance index, and the inflammatory markers tumor necrosis factor-alpha (TNF-α), interleukins 2 and 6 (IL-2 and IL-6), interferon-gamma and high sensitive C-reactive protein. The clinical evaluation included weight, height and waist circumference. W...
Historia De La Educacion, Sep 19, 2013
RESUMEN: La purga de los maestros de escuela primaria, como la de otros grupos profesionales, fue... more RESUMEN: La purga de los maestros de escuela primaria, como la de otros grupos profesionales, fue un instrumento de la represión política organizada y planificada para establecer, conservar y legitimar el «nuevo orden» sociopolítico que se implanta después la victoria militar de Franco. En este artículo planteamos tres cuestiones. La primera realiza un estado de situación sobre la naturaleza de la represión y las condiciones de la España de Franco. La represión adoptada contra el magisterio tiene sus manifestaciones específicas: es más preventiva que punitiva, tratando de disuadir la acción pedagógica de los maestros, grupo profesional que nunca mereció la confianza del nuevo régimen, ni de las fuerzas ideológicas que le sostenían, incluyendo la Iglesia católica. El segundo punto trata de clarificar esta desconfianza, que nos remite a los tiempos de la Segunda República. Tal desconfianza explica las razones de la purga de los maestros de la escuela primaria. La tercera parte explica la purga de los maestros valencianos, y aborda sus rasgos políticos y sociales, concluyendo que un grupo como éste, esencialmente sin compromiso político concreto, es reprimido por acusaciones políticas sobre todo. Mediante acusaciones no justificadas podemos confirmar entonces que la purga tuvo un carácter preventivo para los maestros, grupo que sin embargo necesitaba el régimen de Franco. Los grandes perdedores fueron no sólo los maestros sino la misma sociedad española. Una sociedad que vio cómo la nueva pedagogía del régimen de Franco cercenó y enterró un progreso muy destacado sólo unos años antes.
Nutrients, 2020
In order to develop evidence-based recommendations and expert consensus for nutrition management ... more In order to develop evidence-based recommendations and expert consensus for nutrition management of patients undergoing bariatric surgery and postoperative follow-up, we conducted a systematic literature search using PRISMA methodology plus critical appraisal following the SIGN and AGREE-II procedures. The results were discussed among all members of the GARIN group, and all members answered a Likert scale questionnaire to assess the degree of support for every recommendation. Patients undergoing bariatric surgery should be screened preoperatively for some micronutrient deficiencies and treated accordingly. A VLCD (Very Low-Calorie Diet) should be used for 4–8 weeks prior to surgery. Postoperatively, a liquid diet should be maintained for a month, followed by a semi-solid diet also for one month. Protein requirements (1–1.5 g/kg) should be estimated using adjusted weight. Systematic use of specific multivitamin supplements is encouraged. Calcium citrate and vitamin D supplements shou...
Nutrición Hospitalaria, 2021
In order to develop evidence-based recommendations and expert consensus for the nutritional manag... more In order to develop evidence-based recommendations and expert consensus for the nutritional management of patients with short bowel syndrome (SBS), we conducted a systematic literature search using the PRISMA methodology plus a critical appraisal following the GRADE scale procedures. Pharmacological treatment with antisecretory drugs, antidiarrheal drugs, and somatostatin contributes to reducing intestinal losses. Nutritional support is based on parenteral nutrition; however, oral intake and/or enteral nutrition should be introduced as soon as possible. In the chronic phase, the diet should have as few restrictions as possible, and be adapted to the SBS type. Home parenteral nutrition (HPN) should be individualized. Single-lumen catheters are recommended and taurolidine should be used for locking the catheter. The HPN's lipid content must be greater than 1 g/kg per week but not exceed 1 g/kg per day, and omega-6 fatty acids (ω6 FAs) should be reduced. Trace element vials with low doses of manganese should be used. Patients with chronic SBS who require long-term HPN/fluid therapy despite optimized treatment should be considered for teduglutide treatment. All patients require a multidisciplinary approach and specialized follow-up. These recommendations and suggestions regarding nutritional management in SBS patients have direct clinical applicability.
Nutrición Hospitalaria, 2019
This paper from the ethics Working Group presents a summary of the recommendations of the nutriti... more This paper from the ethics Working Group presents a summary of the recommendations of the nutritional management of patients with advanced dementia.
Nutrición Hospitalaria, 2018
Introducción y objetivos: En el tratamiento dietético de los pacientes con insuficiencia renal ex... more Introducción y objetivos: En el tratamiento dietético de los pacientes con insuficiencia renal existen muchas áreas de incertidumbre. El grupo de trabajo GARIN tiene como objetivo definir su posición en este campo. Material y métodos: Revisión bibliográfica previa y reunión presencial en la que se discutieron y contestaron preguntas específicas sobre el tema. Resultados: La actuación terapéutica debe ser individualizada y atendiendo al grado de insuficiencia renal que presente el paciente y a sus comorbilidades. En cuanto a la terapia médica nutricional nuestro grupo propone tres niveles diferentes de actuación, en los que las recomendaciones de ingesta proteica, fibra, ácidos grasos, fibra o potasio son distintas. Conclusiones: Estas recomendaciones aportan respuestas concretas sobre cuestiones comunes en la asistencia a pacientes con insuficiencia renal.
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Nutrición hospitalaria, 2015
Pharmaconutrient" is a term applicable to those compounds which. in addition to their nutritional... more Pharmaconutrient" is a term applicable to those compounds which. in addition to their nutritional function, play a role as aids in the treatment of patients with severe pathologies, including sepsis, trauma, burns and major surgery, In general, enrichment of enteral an parenteral formulas with pharmaconutrients contribute to positively modulate the inflammatory response, infection and controlling the internal milieu, which in turn can be evaluated through lower mortality, hospital and intensive care units stay, days of mechanical ventilation and other parameters allowing to asses their effects. Arginine, glutamine, nucleotides, omega-3 fatty acids and antioxidant micronutrients, make up the nucleus of pharmaconutrients used with that aim, usually as mixtures of them. In the present review current evidence about the effects, indications, limitations, doses, potential adverse risks and even counter-indications is analysed.
Endocrinología, Diabetes y Nutrición (English ed.)
INTRODUCTION Although current recommendations suggest the use of specific formulas in enteral nut... more INTRODUCTION Although current recommendations suggest the use of specific formulas in enteral nutrition in people with diabetes, there is little evidence of their long-term effectiveness in glycemic control. The main objective of this study is to evaluate the long-term efficacy (24 weeks) of a specific high-protein hypercaloric enteral nutrition formula for people with diabetes in glycemic control and in their improvement in nutritional status. METHODOLOGY This was a multicenter, prospective, observational, real-life study of patients with long-term enteral nutrition prescription through gastrostomy or nasogastric tube who received a high protein hypercaloric formula specific for diabetes. Once the participant's informed consent was obtained and the inclusion and exclusion criteria were verified, data relating to glycemic control, inflammation parameters, biochemical data, nutritional status and gastrointestinal tolerance at 0, 12 and 24 weeks were collected. RESULTS 112 patients were recruited, 44.6% women, age 75.0 (12.0) years and a mean time of evolution of diabetes of 18.1 (9.5) years. The percentage of patients with malnutrition according to VGS decreased throughout the treatment from 78.6% to 29.9% (P<.001). Glycemic and HbA1c levels were significantly reduced at 12 and 24 weeks (Blood glucose 155.9-139.0-133.9mg/dl, P<.001; HbA1c 7.7-7.3-7.1%, P<.001) while no significant changes were observed in cholesterol, triglycerides, creatinine, or glomerular filtration. A significant increase in variables related to nutritional status was observed: weight, the BMI, albumin, prealbumin and transferrin, and CRP levels were significantly reduced and the CRP / Albumin ratio decreased. Gastrointestinal tolerance was good, the number of patients with moderate-severe symptoms was small, and did not change throughout the follow-up. CONCLUSION Our real-life study suggests that the use of a specific hyperprotein hypercaloric formula for diabetes during a 6-month nutritional treatment allows adequate glycemic control and nutritional evolution, with good gastrointestinal tolerance.
PurposeHome Enteral Nutrition (HEN) is used to prevent or correct malnutrition in outpatients. Du... more PurposeHome Enteral Nutrition (HEN) is used to prevent or correct malnutrition in outpatients. Due to the complexity of this process, the indication, follow-up, and results of an educational programme of HEN patients was evaluated.MethodsA prospective, observational, real-life, multicentre study of patients receiving HEN by nasogastric tube or ostomy in 21 hospitals was conducted. The following variables were collected: age, gender, HEN indication, type of formula, nutritional requirements, laboratory variables, complications, and quality standards of the educational programme. All data were analysed using SPSS.24.Results414 patients were included. Most conditions diagnosed were neurodegenerative diseases (64.8%). 100 patients (25.3%) were diabetic. The mean weight was 59.3±10.4kg and BMI 22.6±3.2. Moderate protein-calorie malnutrition was predominant at baseline (46.4%). Improvement in nutritional status at six months was recorded in more than 75% of patients (p<0.05). Tolerance...
INTRODUCCION Y JUSTIFICACION La prevalencia de desnutricion hospitalaria es muy elevada, estimand... more INTRODUCCION Y JUSTIFICACION La prevalencia de desnutricion hospitalaria es muy elevada, estimandose entre el 30-70%, y aumentando a medida que se prolonga la estancia en el hospital. Las consecuencias clinicas pueden ser graves y dan lugar a complicaciones de la propia enfermedad, debil respuesta al tratamiento, disminucion de la inmunocompetencia y aumento de la morbi-mortalidad. Se considera que uno de los componentes esenciales de la calidad asistencial estriba en asumir que, en la evolucion clinica de nuestros pacientes, y para lograr los objetivos terapeuticos en cada caso, es imprescindible la vigilancia, el mantenimiento y el tratamiento del estado nutricional. De esta manera, para conseguir una buena calidad asistencial es necesario perseguir la mayor y mejor seguridad clinica para nuestros pacientes. Una practica clinica segura exige conseguir tres grandes objetivos: Identificar que procedimientos clinicos diagnosticos y terapeuticos son los mas seguros y eficaces, asegura...
Nutrición Hospitalaria, 2017
RESUMENObjetivoNuestro objetivo principal ha sido evaluar y cuantificar la prevalencia de desnutr... more RESUMENObjetivoNuestro objetivo principal ha sido evaluar y cuantificar la prevalencia de desnutrición al ingreso, su grado de severidad y su correlación con parámetros nutricionales en un hospital general básico de primer nivel. MétodosEstudio observacional, transversal y aleatorio sobre 244 pacientes (59,8% hombres y 40,2% mujeres), realizado durante las primeras 24 horas del ingreso hospitalario y con una valoración nutricional que incluyó cribado nutricional (CONUT®), parámetros antropométricos, otros parámetros analíticos, y una cuantificación de la estancia hospitalaria. ResultadosEl 60,7% de la muestra presenta, al ingreso, algún criterio de desnutrición (antropométrico y/o analítico). Cuando se ha considerado, al menos dos parámetros nutricionales alterados (uno de ellos de tipo analítico) la prevalencia ha sido del 29,1%. La prealbúmina y la transferrina se han mostrado especialmente sensibles frente a la desnutrición moderada-grave y leve respectivamente. Conut ha detectad...
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Papers by JUAN BAUTISTA MOLINA SORIA