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Background: Studies indicate that 40–50% of hospitalized patients show malnutrition, a variable that is associated with length of stay and morbidity. The aim of our study was to detect nutritional parameters, which could have an influence on length of stay in hospitalized patients. Material and Methods: All patients with a nutritional evaluation at hospital admission were elegible for inclusion. A total of 1,088 patients were studied from January 1999 to December 2003. Length of stay (LOS) data was obtained from the patient hospital record after the patient was discharged. All patients received instruction in 24-hour written food record keeping. Albumin, prealbumin, transferrin, glucose levels and total lymphocytes, were measured in all patients. Weight, body mass index, tricipital skinfold, midarm muscle circumference and midarm muscle area were assessed in a standard way. Weight loss in the previous 3 months was recorded. Results: A total of 1,088 patients were enrolled, mean age 61.8 ± 17 years, weight 64.2 ± 15 kg and BMI 23.9 ± 4.6, with a weight loss 4.15 ± 9.6 kg. The sex distribution of patients was 65.2% male and 34.8% females. Distribution of diagnosis showed leukemia and lymphoma (11.5%), solid cancer (37.4%), infections (3.5%), neurological disease (13.6%), respiratory tract disease (8.8%), and miscellaneous group (25.3%). Length of stay was 29.45 ± 25.13 days. In whole group, the correlation analysis among length of stay (days) and predictive parameters showed a positive association between albumin and length of stay (r = –0.2; p < 0.05). In the multivariant analysis with a dependent variable (length of stay (days)) and independent variables with an association in univariant analysis adjusted by age and sex, only albumin remained as an independent predictor in the model (F = 8.8; p < 0.05), with an increase of 6.2 days (95% CI: 3.5–8.9) with each decrease of 1 g/dl of albumin. Conclusion: The serum albumin levels are a good marker of LOS, a decrease in admission levels produces an increase in LOS.

Objective: The wide spread use of long-term enteral nutrition and the substantive costs dictate a need to study outcome, clinical and epidemiological characteristics of these patients. The aim of our study was to analyze incidence and characteristics of a cohort of patients on HEN during 6 years, after our previous pilot study of 3 years. Design: Prospective observational study. Setting: Tertiary care. Subjects: Between January 1999 and December 2004, all adult patients living in Valladolid West area who were discharged from the hospital on HEN were prospectively studied and followed up. Interventions: Information for each patient was prospectively recorded by the dietitian of the team, and include age, sex, body mass index, tricipital skinfold, midarm circumference, underlying disease, exitus, dates of initiation and discontinuation of HEN, nutrient formula, mode of administration and complications of HEN. During HEN, physicians supervised the home patients and the patients themselves or their close relative, were asked to contact our nutrition team if any problem occurred. Finally the yearly incidence of HEN was calculated each year on the basis of the estimated population in our area of recruitment, assuming almost all HEN patients were reported.

Background: The wide spread use of long-term enteral nutrition and the substantive costs dictate a need to study the outcome, as well as the clinical and epidemiological characteristics, of these patients. The present study aimed to analyse the incidence and characteristics of a cohort of patients on home enteral nutrition (HEN) over 12 years. Materials and methods: A prospective observational study was performed between January 1999 and December 2010. All adult patients living in Valladolid West area who were discharged from the hospital on HEN were prospectively studied and followed up. Results: The incidence of HEN ranged between 9.52 per 100 000 inhabitants in 2001 to 30.0 per 100 000 inhabitants in 2009. HEN was administered orally in 472 patients (68.28%) (group 1), and through a nasogastric tube in 168 patients (24.30%), a percutaneous enteral gastrostomy tube in 47 patients (6.80%) and a jejunostomy in four patients (0.60%) (group 2; 219 patients). During the course of HEN, 31 patients had diarrhoea (4.5%), 17 patients had constipation and 12 patients had nausea. The mean (SD) duration of HEN was 159.9 (97) days. In multivariable analysis, an independent factor associated with death was age (hazard ratio = 1.03; 95% confidence interval -1.01-1.05), adjusted by sex, route and diagnosis. Conclusions: HEN has a high incidence in our area and it is a valid and safe technique for nutrition support.

Background: The phase angle of the impedance vector was lower because of a decreased Xc component in hemodialysis patients with poorer prognosis, patients with hemodynamic instability, and in critically ill patients. The phase angle is easy to obtain. The aim of our study was to investigate in a case-control study the utility of phase angle and other impedance parameters in a population of male patients with head and neck cancer. Material and Methods: A case-control study was designed. A population of 67 ambulatory post-surgical male patients was enrolled with the following inclusion criteria: oral and/or laryngeal cancer confirmed by biopsy, without a recent loss weight (<5% during previous 3 months) and signed informed consent. As reference group, we selected 70 male subjects from the same geographic region and matched by age, which were selected from a database of healthy people of our hospital. Basal blood sampling was performed for determinations of blood chemistry. Weight, height, body mass index and tetrapolar body electrical bioimpedance were performed in both groups. Results: A total of 67 head and neck cancer male patients were enrolled, mean age was 58.49 ± 14.54 years, weight 73.32 ± 11.4 kg and BMI 28.53 ± 3.5. A total of 70 controls subjects were studied, mean age was 62.33 ± 12.4 years. Weight 64.31 ± 8.38 kg and BMI 24.33 ± 3.2 were significantly lower than in cancer patients (p < 0.05). Renal function and blood sodium levels were similar in both groups. Anthropometric evaluation in cancer patients showed a mean fat mass lower than control patients (13.9 ± 6.1 vs. 12.1 ± 6.1 kg; p < 0.05). In control patients, fat-free mass was higher than in cancer patients (58.7 ± 8.2 vs. 51.23 ± 8.4 kg; p < 0.05). In cancer patients, reactance (62.3 ± 17.2 vs. 56.6 ± 15.1 ohm; p < 0.05) and phase angle (8.02 ± 1.3 vs. 6.9 ± 1.5°; p < 0.05) were lower than in control patients. Conclusion: Impedance in male head and neck cancer patients were characterized by a reduced reactance and phase angle. These early altered tissue electric properties appeared with a normal weight and body mass index.

Inhaled dopamine was able to induce bronchodilatation when the bronchial tone was already increased by acute asthma attack, but it did not modify the resting bronchial tone in normals or in asthmatics without acute bronchospasm. DA2 blockade with metoclopramide did not modify resting bronchial tone either. We suggest that dopamine exerts a modulatory effect on bronchial tone of human airways depending on the degree of existing basal tone.

BPD showed early effectiveness in weight loss and co-morbidity improvement. Calorie, protein, oligoelement and vitamin dietary intakes were below recommendations, so that strict multidisciplinary follow-up and supplementation to prevent or treat nutritional deficiencies are mandatory.