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Vitamin K in home parenteral nutrition: Is it really necessary? 家庭肠外营养中的维生素K:真的有必要吗?
4区 医学 Q3 Nursing Pub Date : 2026-01-01 DOI: 10.1016/j.endinu.2025.501655
Estrella Diego , María del Carmen Farnández , Beatriz de León , Andoni Monzón , Leire Isasa , Beatriz Sordo , Nuria Valdés

Introduction

Multivitamin preparations with added vitamin K in parenteral nutrition (PN) ensure the coverage of this micronutrient in all adults, as indicated by the latest ESPEN clinical practice guidelines on micronutrients.

Objectives

To monitor vitamin K levels after adding this multivitamin with vitamin K in patients requiring home parenteral nutrition (HPN) at Hospital Universitario Cruces (Bilbao, Basque County, Spain) from 2021 to 2022.

Materials and methods

We analyzed vitamin K levels were collected 6 months into therapy with the multivitamin containing vitamin K in home parenteral nutrition.

Results

At our centre, a total of 8 patients required home parenteral nutrition due to intestinal failure type III, 60% of whom were men, with a mean age of 58 ± 13 years. The cause of intestinal failure was short bowel syndrome (50%), intestinal mucosal disease (38%), and intestinal dysmotility (12%). After adding the multivitamin with vitamin K, 80% (6/8) of patients exhibited elevated vitamin K levels, with a mean of 4.4 μl/L.

Conclusions

After observing vitamin K levels above the upper limit of normal, we reached consensus with the Pharmacy Service to discontinue this multivitamin and restart conventional multivitamin. After this initiative, the vitamin K levels of our patients normalized.
根据最新的ESPEN微量营养素临床实践指南,在肠外营养(PN)中添加维生素K的多种维生素制剂可确保所有成年人都能获得这种微量营养素。目的监测2021年至2022年在西班牙巴斯克县毕尔巴鄂大学医院(Universitario Cruces)需要家庭肠外营养(HPN)的患者添加该复合维生素和维生素K后的维生素K水平。材料与方法采用含维生素K复合维生素的家庭肠外营养治疗6个月后收集患者的维生素K水平。结果本中心共有8例III型肠衰竭患者需要家庭肠外营养,其中60%为男性,平均年龄58±13岁。肠衰竭的原因是短肠综合征(50%)、肠黏膜疾病(38%)和肠蠕动障碍(12%)。加维生素K复合维生素后,80%(6/8)的患者维生素K水平升高,平均为4.4 μl/L。结论在观察到维生素K水平超过正常上限后,我们与药房达成共识,停止使用该复合维生素,重新使用常规复合维生素。这一举措后,我们的病人的维生素K水平恢复正常。
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引用次数: 0
Polimorfismos TLR4 e IL6: potenciales factores de riesgo de obesidad y resistencia a la insulina en individuos venezolanos TLR4和IL6多态性:委内瑞拉人肥胖和胰岛素抵抗的潜在危险因素
4区 医学 Q3 Nursing Pub Date : 2026-01-01 DOI: 10.1016/j.endinu.2025.501657
Stefani Hernández Osorio , María Fátima Garcés , Eva Salazar Alcalá , José Manuel Pestana , Mercedes Fernández Mestre

Objective

This study investigated the association between genetic polymorphisms in the TLR4 (rs4986790 and rs4986791) and IL6 (rs1800795) genes with obesity in a Venezuelan population.

Methods

We conducted a retrospective case-control study with 207 unrelated Venezuelans (137 obese, 70 normal weight). Blood samples were obtained to measure glucose, cholesterol, triglycerides, HDL, insulin, and insulin resistance (HOMA-IR ≥ 2.6) and genotype the TLR4 (rs4986790 and rs4986791) and IL6 (rs1800795) polymorphisms using PCR-SSP. Statistical tests: Student's t-test, Pearson correlation coefficient, chi-square test, odds ratio (OR) with 95%CI were used.

Results

The relationship between obesity and insulin resistance (IR) was confirmed. Heterozygous genotypes A/G (TLR4 rs4986790, P=.012) and C/T (TLR4 rs4986791, P=.005) were more frequent in normal-weight individuals, while homozygous genotypes A/A (TLR4 rs4986790, P=.012) and C/C (TLR4 rs4986791, P=.005) were more frequent in obese individuals. The C allele and CC genotype of IL6 rs1800795 (P=.007) were associated with obesity. The IL6 C/C genotype was associated with higher insulin and HOMA in obese individuals. In obese individuals with IR, the CC genotype (TLR4 rs4986791, P=.03) was more common, as opposted to CT, which was less common (P=.03). The C/C genotype of IL6 rs1800795 was more frequent in obese individuals with IR (P<.0001). Obese individuals with IR and the AA genotype of TLR4 rs4986790 had higher BMI, HOMA-IR, and glucose.

Conclusion

These findings suggest that genetic variations in the TLR4 and IL6 genes may predispose to obesity and its metabolic complications in the Venezuelan population.
目的研究委内瑞拉人群TLR4 (rs4986790和rs4986791)和IL6 (rs1800795)基因多态性与肥胖的关系。方法对207名委内瑞拉人(137名肥胖,70名正常体重)进行回顾性病例对照研究。采集血样,测定血糖、胆固醇、甘油三酯、HDL、胰岛素和胰岛素抵抗(HOMA-IR≥2.6),并利用PCR-SSP对TLR4 (rs4986790和rs4986791)和IL6 (rs1800795)多态性进行基因分型。统计学检验:采用学生t检验、Pearson相关系数、卡方检验、比值比(OR), 95%CI。结果肥胖与胰岛素抵抗(IR)之间的关系得到证实。杂合子基因型A/G (TLR4 rs4986790, P= 0.012)和C/T (TLR4 rs4986791, P= 0.005)在正常体重人群中多见,纯合子基因型A/A (TLR4 rs4986790, P= 0.012)和C/C (TLR4 rs4986791, P= 0.005)在肥胖人群中多见。IL6 rs1800795的C等位基因和CC基因型与肥胖相关(P= 0.007)。在肥胖个体中,IL6 C/C基因型与较高的胰岛素和HOMA相关。在肥胖IR患者中,CC基因型(TLR4 rs4986791, P=.03)更为常见,而CT基因型较少(P=.03)。il - 6 rs1800795的C/C基因型在肥胖IR患者中更为常见(P< 0.0001)。具有IR和TLR4 rs4986790 AA基因型的肥胖个体具有较高的BMI、HOMA-IR和葡萄糖。结论这些发现表明,TLR4和IL6基因的遗传变异可能导致委内瑞拉人群肥胖及其代谢并发症。
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引用次数: 0
¡3, 2, 1! Del análogo de GLP-2 a GLP-1 a lo largo de 10 años 三,二,一!10年从GLP-2到GLP-1
4区 医学 Q3 Nursing Pub Date : 2026-01-01 DOI: 10.1016/j.endinu.2025.501662
María Sara Tapia-Sanchiz, Miguel Antonio Sampedro-Núñez, Sara Jiménez-Blanco, Begoña Molina-Baena
Short bowel syndrome (SBS) represents one of the central conditions in clinical nutrition, with a complex and challenging management. Teduglutide, an analog of human glucagon-like peptide-2 (GLP-2), is the first approved long-term, non-symptomatic treatment for SBS. We present the case of a 62-year-old woman with SBS who required prolonged home parenteral nutrition (HPN). Following clinical stabilization, teduglutide was initiated, leading to significant clinical and nutritional improvement, including spontaneous closure of enterocutaneous fistulas and a 70% reduction in parenteral nutrition requirements. This allowed for a surgical reconstruction, after which she achieved full enteral autonomy, later developing grade 1 obesity. This case highlights the therapeutic potential of teduglutide as a bridging therapy and the remaining uncertainties regarding its long-term management.
短肠综合征(SBS)是临床营养的中心疾病之一,具有复杂和具有挑战性的管理。Teduglutide是一种类似于人胰高血糖素样肽-2 (GLP-2)的药物,是首个被批准用于SBS的长期无症状治疗药物。我们提出的情况下,62岁的妇女SBS谁需要延长家庭肠外营养(HPN)。在临床稳定后,开始使用teduglutide,导致显著的临床和营养改善,包括肠皮瘘的自发闭合和肠外营养需求减少70%。这允许手术重建,之后她实现了完全的肠内自主,后来发展为1级肥胖。该病例突出了特杜卢肽作为桥接疗法的治疗潜力,以及其长期管理的不确定性。
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引用次数: 0
Enhancing levothyroxine dosing accuracy post-total thyroidectomy using body fat percentage 利用体脂率提高甲状腺全切除术后左旋甲状腺素给药准确性
4区 医学 Q3 Nursing Pub Date : 2026-01-01 DOI: 10.1016/j.endinu.2025.501645
Ana M. Díaz Abram , Federico Volpi , Estefanía Chumbiauca , Marta García Goñi , Juan C. Galofré
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引用次数: 0
Implantación de la ecografía cervical y técnicas asociadas en los servicios de endocrinología y nutrición en España. Estudio ECOSEEN 2025 在西班牙的内分泌和营养服务中植入宫颈超声和相关技术。ECOSEEN 2025研究
4区 医学 Q3 Nursing Pub Date : 2026-01-01 DOI: 10.1016/j.endinu.2025.501659
Jordi L. Reverter , Gonzalo Díaz Soto , Tomás Martin , Manuel Gargallo , Marcel Sambo , Iñaki Argüelles , Grupo de Imagen Cervical y Técnicas Asociadas de la Sociedad Española de Endocrinología y Nutrición

Introduction

Before 2014, few endocrinology and nutrition departments nationwide routinely used cervical ultrasound. Following the training activities promoted by the Thyroid Pathology Imaging Group, it is important to evaluate the current level of implementation of ultrasound and ultrasound-guided techniques in clinical practice.

Material and methods

A structured, self-administered survey was designed and sent electronically to hospitals throughout the country.

Results

Responses were received from a total of 101 hospitals. Ninety-three percent of the departments surveyed reported routine use of ultrasound in clinical practice, with specialized consultations in 71% of cases. Sixty percent performed fine-needle aspiration cytology, and 55% performed staging and follow-up of differentiated thyroid cancer. Among minimally invasive techniques (MIT), 42% of centers perform enolization of thyroid cysts and 12% offer thermal ablation techniques, with radiofrequency being the most commonly used modality. Eighty-six% of professionals have received training through the Applied Imaging Techniques for Thyroid Pathology Group of the SEEN (National Institute of Endocrinology and Nutrition). Currently, 56 centers offer specific ultrasound training for medical residents in the specialty.

Conclusion

Over the last decade, ultrasound has been widely implemented in the endocrinology and nutrition departments affiliated with the SEEN, including the incorporation of ultrasound-guided techniques into routine practice. However, the use of MIT such as thermal ablation is still limited, so it is considered necessary to strengthen both specific training and institutional support to promote its maximum implementation.
2014年以前,全国很少有内分泌科和营养科常规使用宫颈超声检查。随着甲状腺病理影像学组的培训活动,评估超声和超声引导技术在临床实践中的实施水平是很重要的。材料和方法设计了一份结构化的、自我管理的调查,并以电子方式发送给全国各地的医院。结果共收到101家医院的回复。93%的受访科室报告在临床实践中常规使用超声,71%的病例进行了专门咨询。60%的患者接受细针穿刺细胞学检查,55%的患者接受分化型甲状腺癌的分期和随访。在微创技术(MIT)中,42%的中心提供甲状腺囊肿烯醇化治疗,12%的中心提供热消融技术,其中射频是最常用的方式。86%的专业人员接受了美国国家内分泌与营养研究所甲状腺病理应用成像技术组的培训。目前,有56个中心为该专业的住院医师提供专门的超声培训。结论近十年来,超声技术在我院内分泌科和营养科得到了广泛的应用,包括超声引导技术在常规诊疗中的应用。然而,热消融等麻省理工技术的应用仍然有限,因此有必要加强具体培训和制度支持,以促进其最大限度地实施。
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引用次数: 0
Continuidad asistencial en la atención clínica de la obesidad 肥胖临床护理的连续性
4区 医学 Q3 Nursing Pub Date : 2026-01-01 DOI: 10.1016/j.endinu.2025.501658
Irene Bretón , José Manuel Fernández García , Nuria Vilarrasa , Violeta Ramírez Arroyo , Ani de Hollanda , Guadalupe Blay Cortés , María D. Ballesteros-Pomar , en representación de SEEN, SEMERGEN, semFYC y SEMG
Obesity is a chronic, multifactorial and relapsing disease with a great impact on public health. Due to its high prevalence and complications, it is essential to coordinate clinical care in different health care settings in order to improve the clinical evaluation and treatment of people with obesity and to optimize the use of health care resources. This document, prepared by experts from the Spanish Society of Endocrinology and Nutrition (SEEN), the Spanish Society of Primary Care Physicians (SEMERGEN), the Spanish Society of Family and Community Medicine (semFYC) and the Spanish Society of General Practitioners (SEMG), proposes a comprehensive clinical approach to obesity, based on effective coordination between Primary Care and Endocrinology and Nutrition Departments.
肥胖是一种慢性、多因素、反复发作的疾病,对公众健康有很大影响。由于其高患病率和并发症,协调不同卫生保健机构的临床护理,以提高对肥胖患者的临床评价和治疗,优化卫生保健资源的利用是必不可少的。该文件由西班牙内分泌与营养学会(SEEN)、西班牙初级保健医师学会(SEMERGEN)、西班牙家庭与社区医学学会(semFYC)和西班牙全科医生学会(SEMG)的专家编写,提出了一种基于初级保健和内分泌与营养部门有效协调的综合临床方法。
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引用次数: 0
Beyond vectorial bioelectrical impedance: Assessing body composition changes with novel electrical parameters in obese osteoarthritis patients on a meal-replacement diet 超越矢量生物电阻抗:用新的电参数评估肥胖骨关节炎患者在代餐饮食中的身体成分变化
4区 医学 Q3 Nursing Pub Date : 2026-01-01 DOI: 10.1016/j.endinu.2025.501644
José-Joaquín Alfaro-Martínez , David Primo-Martín , César Gonzalvo-Díaz , Olatz Izaola-Jauregui , Marina Jara-Vidal , Lourdes García-Blasco , Beatriz Ramos-Bachiller , Diego Bellido-Guerrero , Daniel A. De Luis-Román , Juan José López-Gómez

Background

Rapid weight loss with restricted diets can cause muscle mass decline. The aim of this work is to evaluate a new method for representing the raw electrical values obtained in the bioelectrical impedance analysis (BIA) in patients with obesity and osteoarthritis undergoing a meal-replacement diet.

Methods

We conducted a 1-group intervention study with meal-replacement diet for 3 months in patients with osteoarthritis prior to orthopedic surgery. Anthropometry and BIA was registered at baseline (B) and 3 months (3M) after the intervention. We have calculated traditional estimations of body composition over the raw electrical parameters of BIA parameters and a new bioelectrical impedance vector analysis (BIVA) based method to detect nutrition (NP), hydration (HP) and fat (FP) parameters without estimation.

Results

A total of 272 patients (23.16% men; 76.84% women) were analyzed. There was a correlation between NP and body composition estimates (body cell mass [BCM] standardized by height (BCM/h): men: 0.96; p < 0.01; women: 0.88; p < 0.01). The correlation coefficient between HP and estimated total body water was 0.769 for men and 0.63 for women (p < 0.01 in both cases). The correlation coefficient between FP and estimated fat mass (FM) standardized by height was 0.83 for men and 0.89 for women (p < 0.01). There was a significant decrease in body weight (B: 99.33(15.0) kg; 3M: 92.03(16.0) kg; p < 0.01); and FM (B: 49.93(6.67) kg; 3M: 44.22(9.08) kg). There was no difference in BCM and fat free mass. In new parameters a decrease in NP (B: +0.50(0.31); 3M: +0.42(0.42); p = 0.03) and FP (B: +0.49(0.17) was reported; 3M: +0.38(0.16); p < 0.01), although there was no difference in HP.

Conclusions

The new interpretation of BIVA as NP and HP have a high correlation with the body composition parameters estimated by regression models, and they report changes in body composition after a partial meal-replacement diet such as regression equations.
背景:限制饮食的快速减肥会导致肌肉质量下降。这项工作的目的是评估一种新的方法来表示在进行代餐饮食的肥胖和骨关节炎患者的生物电阻抗分析(BIA)中获得的原始电值。方法对骨科手术前骨关节炎患者进行为期3个月的代餐饮食干预研究。在基线(B)和干预后3个月(3M)记录人体测量和BIA。我们计算了基于BIA参数的原始电参数的传统身体成分估计值,以及一种新的基于生物电阻抗矢量分析(BIVA)的检测营养(NP)、水合(HP)和脂肪(FP)参数的方法。结果共分析272例患者,其中男性23.16%,女性76.84%。NP与身体成分估计值(身高标准化的体细胞质量[BCM] (BCM/h))之间存在相关性:男性:0.96;p < 0.01;女性:0.88;p < 0.01)。HP与估计的总体内水分之间的相关系数男性为0.769,女性为0.63(两种情况的p <; 0.01)。男性的FP与身高标准化的估计脂肪量(FM)的相关系数为0.83,女性为0.89 (p < 0.01)。体重显著下降(B: 99.33(15.0) kg;3M: 92.03(16.0) kg;p < 0.01);FM (B): 49.93(6.67) kg;3米:44.22(9.08)公斤。BCM和无脂质量无显著差异。在新参数下,NP (B)降低:+0.50(0.31);3 m: + 0.42 (0.42);p = 0.03)和FP (B: +0.49(0.17));3 m: + 0.38 (0.16);p < 0.01),但HP无差异。结论BIVA的新解释为NP和HP与回归模型估计的体成分参数具有高度相关性,它们报告了部分代餐饮食后体成分的变化,如回归方程。
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引用次数: 0
Pancreatitis aguda en un lactante, un diagnóstico infrecuente 婴儿急性胰腺炎,罕见的诊断
4区 医学 Q3 Nursing Pub Date : 2026-01-01 DOI: 10.1016/j.endinu.2025.501660
Fátima Pareja Marín, María Pilar Valverde Viu, Sara Vicent Martí, Violeta Martí Enrique
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引用次数: 0
Radioactive iodine-induced esophagitis: A rare complication 放射性碘引起的食管炎:一种罕见的并发症
4区 医学 Q3 Nursing Pub Date : 2026-01-01 DOI: 10.1016/j.endinu.2025.501656
Ignacio Jiménez Hernando , Irene Bretón Lesmes , Arantxa Díaz Gómez , Miguel Sebastián Casallas Cepeda , Santiago Salcedo Cortés
{"title":"Radioactive iodine-induced esophagitis: A rare complication","authors":"Ignacio Jiménez Hernando ,&nbsp;Irene Bretón Lesmes ,&nbsp;Arantxa Díaz Gómez ,&nbsp;Miguel Sebastián Casallas Cepeda ,&nbsp;Santiago Salcedo Cortés","doi":"10.1016/j.endinu.2025.501656","DOIUrl":"10.1016/j.endinu.2025.501656","url":null,"abstract":"","PeriodicalId":37725,"journal":{"name":"Endocrinologia, Diabetes y Nutricion","volume":"73 1","pages":"Article 501656"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145915481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Avances recientes en tumores hipofisarios tras la clasificación OMS 2022 世卫组织2022年分类后垂体肿瘤的最新进展
4区 医学 Q3 Nursing Pub Date : 2026-01-01 DOI: 10.1016/j.endinu.2025.501747
Ignacio Ruz-Caracuel
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引用次数: 0
期刊
Endocrinologia, Diabetes y Nutricion
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