[The viewpoint of the patient in hospital practice].
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Biomedical subjects
Publications and source records attributed to M Morera.
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We determined mercury and selenium in 43 eggs (eggshell, albumen, and yolk) which belong to different clutch sizes of Audouin's gull from the Chafarinas Islands. The results were compared with those obtained previously with the same species at the Ebro Delta. Both, the intra- and the interclutch sources of variability have been examined. There is an effect of the female on mercury and selenium concentrations in a clutch, which supports the use of eggs as monitoring tools. The distribution pattern of mercury among albumen, yolk and eggshell, the dynamics of this element during the laying process, as well as data concerning egg formation strategies suggest that the mercury in the albumen corresponds mainly to the mercury acquired by the female while feeding in the breeding area. The mercury and selenium levels of the eggs from the Chafarinas Islands were lower than those of the Ebro Delta, which can be due to differences in both the marine contamination and the diet in the two colonies.
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AIM: In spite of the increasing number of home enteral nutrition (HEN) patients, only few articles had reported the frequency of complications related to this treatment. Our multicentric study analyzes the HEN complications in relation to access device and time of treatment. METHOD: 92 HEN patients from 8 hospitals were randomly selected. Patients were distributed in relation to the time of treatment and access device (nasogastric tube and percutaneous or surgical gastrostomies). After an educational program, they were filled in an initial questionnaire and repeated it the days 15 and 30. They received a mean of 1650 Kcal of enteral solution. A total of 2760 HEN prospective days were analyzed. RESULTS: In prospective study 42% of patients had some complication (112 episodes). The most frequent were gastrointestinal (55%) and mechanical (29%); 0.16 complications of patient-year were registered. The most common complications were: extraction (15%), constipation (13%), vomiting (12%) and diarrhoea (10%). The gastrostomy group had more gastrointestinal complications. In retrospective evaluation, percutaneous gastrostomy group had the lowest ratio of complications and nasogastric tube group required more tube replacements (4 vs 2) and had 1.96 episodes/patient (percutaneous group 1.85 and surgical gastrostomy 3.1 episodes/patient). CONCLUSION: HEN is safe with low incidence of complications. An adequate educational program is very important and we expect, in the future, to establish an proper National Home Care System.