[Proposals of a quality model in health care].
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Biomedical subjects
Publications and source records attributed to J Varo.
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Total parenteral nutrition (TPN) is indicated in a number of clinical situations involving obstructive disorders of the gastrointestinal tract or when total bowel rest is required. However, little is known of its effects upon the physiology of gastric storage and emptying. A study of the effects of lipid nutrient content of TPN on the gastric emptying of a non-energy liquid test meal in male and female conscious rats (250-280 g) was undertaken. Five experimental groups were set up according to the percentage of total non-protein energy administered in the form of different lipids: A (lipid-free: 100% of non-protein energy as glucose); B (5% long-chain triglycerides (LCT), 95% glucose); C (40% LCT, 60% glucose); D (5% LCT and medium-chain triglycerides (MCT) in 1:1 proportion, 95% glucose); and E (40% LCT and medium-chain triglycerides (MCT) in 1:1 proportion, 60% glucose). Animals were maintained on TPN for 24 h and for 3 and 4 days, after which gastric emptying was measured by the phenol red method. 40% lipid TPN was found to accelerate gastric emptying as infusion was prolonged, although the type of lipid had no effect.
At the present time, research into Eating Disorders is being carried out in very different areas: clinical and diagnostic, epidemiological, comorbidity, aetiopathogeny, treatment and forms of care. This paper reviews this type of pathology, and aims to update the most important data in the different fields. The epidemiological studies of recent decades would indicate a considerable increase in the rates of incidence and prevalence of both Nervous Anorexia and Nervous Bulimia. On the other hand, there is increasing confirmation of an early appearance of these disorders. Similarly, the discovery of certain physiopathological appetite markers and/or regulators opens a new path for understanding this phenomenon. Research into these problems has reached a certain consensus in aspects such as: a multidimensional consideration of the ethiopathogeny, increasingly purified diagnostic criteria, care and therapeutic procedures and resources to be used in treatment.
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Gastrointestinal motility is altered in several clinical situations in which Total Parenteral Nutrition (TPN) is indicated. Nevertheless, the effects of TPN on motility are not well known. In this study, Wistar rats (250-280 g) were divided into two groups were defined according to the route of administration of the nutrients: Group A (with TPN: 100% of the total non-protein calories administered as glucose), and Group B (solid enteral nutrition, but with the infusion of normal saline under the same conditions as in the previous group). Each group was subjected to three different infusion times: 24 hours, 3 days, and 5 days post-intervention, after which the gastric emptying was measured by means of the phenol red test. TPN delayed emptying in all the times with respect to group B, although significant differences were only found after 3 days of infusion.