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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="tb0005"></elsevierMultimedia></p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Background</span><p id="par0025" class="elsevierStylePara elsevierViewall">In developed countries&#44; malnutrition especially affects hospitalized individuals&#44; with a prevalence that varies &#40;according to the definition of malnutrition employed and the characteristics of each study&#39;s patients<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">1&#44;2</span></a>&#41; between 20&#37; and 50&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">3&#8211;6</span></a> Malnutrition in hospital patients is associated with longer hospital stays&#44; an increased risk of readmission and higher mortality rates&#46;<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">1&#44;7</span></a> It is estimated that hospital costs can be up to 75&#37; higher for malnourished patients&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">8</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Oral nutritional supplements have demonstrated their usefulness in improving the nutritional state in various clinical conditions&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">9&#44;10</span></a> Malnutrition can also be treated using nutritional counseling&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">11</span></a> However&#44; the efficacy of counseling is still a matter of debate&#44; even though a number of studies have indicated that it improves the nutritional state of patients with various chronic diseases&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">12&#8211;15</span></a> Systematic reviews have highlighted the considerable heterogeneity in the results of the nutritional counseling employed&#46;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">16&#44;17</span></a> Although the efficacy of counseling in increasing patients&#8217; dietary intake and weight appears to have been proven&#44; there is no conclusive evidence regarding other circumstances such as mortality&#44; hospital readmissions&#44; length of hospital stay and functional capacity&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">11&#44;16&#44;17</span></a> The method for implementing the intervention and the coordination and continuity of nursing care after hospital discharge appears to improve the results of counseling&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">11&#44;18</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The aim of this study was to assess the effects of a 6-month intervention program on dietary counseling compared with standard treatment on the nutritional state of hospitalized patients with malnutrition secondary to a disease after hospital discharge&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Patients and methods</span><p id="par0040" class="elsevierStylePara elsevierViewall">This was a randomized&#44; open clinical trial with a 6-month follow-up&#44; conducted by case manager nurses from hospital and community care&#44; at Hospital Clinic Virgen de la Victoria of Malaga and from 9 primary care centers of the healthcare district of Malaga-Guadalhorce&#44; between October 1&#44; 2010 and April 30&#44; 2013&#46; The study was approved by the Research Ethics Committee of the Malaga Healthcare District and was conducted in accordance with the Declaration of Helsinki &#40;2008 version&#41;&#44; the current law on the protection of personal data &#40;Law 14&#47;1999&#41; and the law on the protection of patient rights &#40;Law 15&#47;2002&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Screening was conducted to determine patient eligibility during their hospitalization&#44; using the computer program Nutritional Filter &#40;<span class="elsevierStyleItalic">Filtro Nutricional</span>&#44; FILNUT&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">19</span></a> The disease types that motivated these hospitalizations are listed in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; If the presence of a significant risk was detected&#44; we proceeded with the assessment of each patient using the Malnutrition Universal Screening Tool &#40;MUST&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">20</span></a> If a medium&#8211;high risk of malnutrition was detected&#44; the patient was offered the opportunity to join the study provided they were not undergoing treatment with dietary supplements or enteral or parenteral nutrition&#46; The patient was then informed of the study and asked for their informed consent&#46; Once the patient had been included&#44; they were randomized&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">The inclusion criteria were the following&#58; &#40;a&#41; hospitalization&#44; &#40;b&#41; medium&#8211;high risk of malnutrition on the MUST scale&#44; &#40;c&#41; older than 18 years&#44; &#40;d&#41; willingness to participate in the study and signing of the informed consent form &#40;in the event of cognitive impairment&#44; the consent form was signed by the patient&#39;s caregiver&#41; and &#40;e&#41; resident of the geographical area corresponding to the participating health center&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The exclusion criteria consisted of having undergone any of the following during hospitalization&#58; &#40;a&#41; treatment with oral food supplements&#44; enteral or parenteral nutrition&#44; &#40;b&#41; treatment with chemotherapy or radiation therapy and &#40;c&#41; malabsorption syndrome&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The patients assigned to the control group &#40;group C&#41; underwent the standard healthcare procedures&#44; which consisted of delivering a discharge report to the patient for continuity of nursing care and a telephone call by the family nurse to the patient within 72<span class="elsevierStyleHsp" style=""></span>h of the discharge&#46; Control patients were also provided a medical report for the follow-up by their family doctor during the hospital discharge&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">The patients assigned to the intervention group &#40;group I&#41; underwent nutritional counseling by case manager nurses&#44; which began during the hospital stay and lasted 6 months&#46; At the patient&#39;s discharge&#44; the case manager nurses &#40;hospital and community&#41; contacted the caregivers by telephone to notify them of the discharge&#46; A continuity of care report was then issued&#46; Within 48<span class="elsevierStyleHsp" style=""></span>h of the hospital discharge&#44; the case manager nurse from the primary care center contacted the patient and scheduled a home visit or an office consultation&#44; depending on the patient&#39;s condition&#46; The visit was scheduled for the first week after hospital discharge and included a nutritional assessment&#46; The subsequent follow-up and actions depended on the malnutrition risk measured by the MUST scale&#44; conforming to the protocol described by the Malnutrition Action Group of the British Association for Parenteral and Enteral Nutrition&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">20</span></a><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">&#40;a&#41;</span><p id="par0070" class="elsevierStylePara elsevierViewall">For medium risk&#44; specific dietary counseling was provided&#44; the first step of which was to conduct a dietary history aimed at assessing the potential difficulties with properly following the diet&#46; These difficulties included beliefs&#44; trouble chewing and swallowing and diseases&#46; The patient&#39;s nutritional needs were also calculated&#44; and a personalized diet was developed based on the identified problems and underlying diseases&#46; At 15 days&#44; the total dietary intake of the 2 previous days was assessed&#46; If the intake was appropriate or improved&#44; the assessment and dietary counseling were repeated at 1 month and subsequently every 2 months until the final assessment at 6 months of hospital discharge was completed&#46; If the intake was inadequate or worsened&#44; the malnutrition was treated as high risk&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">&#40;b&#41;</span><p id="par0075" class="elsevierStylePara elsevierViewall">For high risk&#44; treatment was starting with specific dietary counseling and strategies to enrich the diet with ordinary food&#46; Patients at high risk were reassessed at 2 weeks&#44; and if there was no improvement in intake and weight gain&#44; they were referred to their family doctor to determine if they should be referred to the Clinical Nutrition and Dietetics Unit&#46; If the intake had improved and weight had increased&#44; the patient was assessed each month&#46; If&#44; according to MUST&#44; the patient transitioned to medium risk during follow-up&#44; the patient was assessed every 2 months until the final assessment was completed 6 months after the discharge&#46;</p></li></ul></p><p id="par0080" class="elsevierStylePara elsevierViewall">The main study endpoint for assessing the nutritional state was the body mass index &#40;BMI&#41;&#46; The secondary endpoints for assessing the nutritional state included the results of the MUST scale&#44; the number of patients who were still at risk of medium&#8211;high malnutrition after completing the study and the following laboratory parameters&#58; total protein&#44; albumin and cholesterol levels and total lymphocyte count&#46; Morbidity was assessed using the number of unscheduled hospital readmissions and length of the hospital stays resulting from these readmissions&#46; The patient-perceived quality of life was assessed using the Short Form 12 Health Survey &#40;SF-12&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">21</span></a> The degree of functional dependence was assessed using the Barthel index&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">22</span></a> Patient satisfaction with the intervention was measured using the Client Satisfaction Questionnaire &#40;CSQ-8&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">23</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">The sample size was calculated by considering BMI the most relevant variable and that BMI presented a distribution with a standard deviation of 3&#46;26 in the adult Spanish population&#46; If we consider a difference of 2&#46;0 points in the BMI as clinically relevant &#40;with an alpha and beta error of 0&#46;05 and 0&#46;20&#44; respectively&#41;&#44; 2 samples of 51 participants would be required&#44; if we chose a 1&#58;1 ratio between the samples&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">A descriptive study of the collected variables was conducted using their mean and standard deviation for continuous variables and frequency and percentages for categorical&#44; ordinal and nominal variables&#46; The goodness of fit to normal was determined based on the Kolmogorov&#8211;Smirnov test&#44; rejecting normality if <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;1&#46; The analysis variables at 6 months of follow-up were the before and after differences in each group&#46; The comparison of means between the groups was performed using Student&#39;s <span class="elsevierStyleItalic">t</span>-test for normal continuous variables&#44; indicating the 95&#37; confidence interval &#40;95&#37; CI&#41;&#46; For non-normal continuous variables&#44; we used the Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span> test&#46; To compare categorical variables&#44; we applied the chi-squared test&#46; To analyze the difference in risk reduction on the MUST scale&#44; we used the comparison of proportions test&#46; The odds ratio &#40;OR&#41; was calculated&#44; with its 95&#37; CI calculated using logistic regression&#46; The SPSS 20&#46;0 and Epidat 3&#46;1 statistical programs were employed&#44; setting statistical significance to <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><p id="par0095" class="elsevierStylePara elsevierViewall">A total of 106 patients were randomized&#44; 54 to group C and 52 to group I&#46; Group C had 1 loss during follow-up due to a change of address&#46; There were also 6 losses due to death in each of the groups&#46; Therefore&#44; the final analysis included a total of 93 patients&#44; 47 in group C and 46 in group I &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; The initial general characteristics demonstrated by the study patients are shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46; The 2 groups were similar&#44; with no significant differences between them&#44; except for the hospital stay of the first hospitalization&#44; which was longer for group I &#40;6&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;2 days&#41;&#46; During the 6-month follow-up&#44; food supplements were prescribed for 2 patients in group C and 1 patient in group I due to a worsening nutritional state &#40;according to the MUST scale&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">The differences found at the end of the study in the variables measured at the start and end of follow-up &#40;6 months later&#41; are shown in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46; BMI was reduced in group C &#40;mean change&#44; &#8722;0&#46;395<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;43<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&#44; while BMI increased in group I &#40;mean change&#44; 1&#46;745<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;06<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&#46; The difference between the groups was 2&#46;14<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;47<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#46; The MUST score was 1&#46;170 &#40;1&#46;67&#41; points higher in group I than in the group C &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46; The MUST score showed a low risk at the end of the study for 19&#47;47 patients in group C &#40;40&#46;4&#37;&#59; 95&#37; CI 25&#46;33&#8211;55&#46;12&#37;&#41; compared with 39&#47;46 patients in group I &#40;84&#46;8&#37;&#59; 95&#37; CI 73&#46;32&#8211;96&#46;25&#37;&#41;&#44; for a difference of 44&#46;4&#37; &#40;95&#37; CI 24&#46;8&#8211;64&#46;0&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46; The satisfaction with the intervention assessed using CSQ-8 was greater in group I than in group C &#40;28&#46;11<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;57 vs&#46; 23&#46;77<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;50&#59; difference&#44; 4&#46;34 points&#59; 95&#37; CI 2&#46;89&#8211;5&#46;80&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;01&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">Group C had 0&#46;62 &#40;1&#46;11&#41; readmissions&#47;patient compared with 0&#46;25 &#40;0&#46;40&#41; in group I &#40;difference&#44; 0&#46;37 readmissions&#47;patient&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;040&#41;&#46; During follow-up&#44; the patients in group C required 8&#46;77 &#40;24&#46;77&#41; days for readmissions&#44; while those in group I required only 2&#46;02 &#40;4&#46;53&#41; days &#40;difference&#44; 6&#46;75 days&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;035&#41;&#46; There were no differences in mortality between the 2 groups&#44; with 6&#47;52 patients &#40;11&#46;54&#37;&#41; in group I versus 6&#47;53 &#40;11&#46;32&#37;&#41; patients in group C &#40;chi-squared&#44; 0&#46;001&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;972&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Discussion</span><p id="par0110" class="elsevierStylePara elsevierViewall">The results of the study indicate that nutritional counseling is more effective than standard practice for improving the nutritional state of malnourished patients after hospitalization&#46; The increase in BMI after nutritional counseling is consistent with the results of studies by other authors&#46;<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">24&#44;25</span></a> However&#44; the differences in the laboratory parameters did not achieve statistical significance&#44; although the results suggest a more favorable outcome for the patients who underwent nutritional counseling&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Moreover&#44; the patients who were given nutritional counseling required fewer readmissions&#44; suggesting that the intervention improved the overall health condition of the patients who followed the program&#46; The patients who followed the nutritional counseling also had a better quality of life and a greater degree of independence&#46; Improved quality of life after nutritional counseling has been previously reported<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">12&#44;26</span></a> but not the improvement in the functional independence index&#46; An earlier study<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">27</span></a> showed a tendency toward improved independence but did not achieve statistical significance&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">However&#44; nutritional counseling had no effect on mortality&#46; There could be numerous reasons for this result&#46; On one hand&#44; the advanced age and the underlying disease could have acted as unchangeable factors of mortality&#46; On the other hand&#44; the length of the intervention and follow-up might not have been sufficient&#46; The majority of studies conducted to date have not reported any effect of nutritional counseling on mortality&#46;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">13&#44;16&#44;17</span></a> However&#44; the study by Ravasco et al&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">12</span></a> showed a reduction in mortality starting the fourth year of follow-up in patients with colorectal cancer who underwent dietary counseling when compared with control patients&#46; Our study&#44; with a 6-month follow-up and 106 patients&#44; might not have sufficient power to detect differences in mortality due to the intervention&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">A significant limitation of our study is the lack of masking of the patients and health professionals&#44; given that it was not possible to standardize a simulated educational intervention&#46; To minimize potential biases&#44; the final assessment and data analysis were performed by professionals other than those who conducted the intervention and follow-up&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Despite the recommendations on this issue&#44;<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">1&#44;3&#44;5</span></a> many hospitals do not systematically conduct nutritional screening&#46; The results of our study suggest that&#44; for malnourished hospital patients&#44; a 6-month interlevel nutritional counseling program &#40;conducted by case manager nurses&#41; is able to improve their nutritional state&#44; quality of life&#44; morbidity&#44; functional independence and satisfaction to a greater degree than standard clinical practice&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Funding</span><p id="par0135" class="elsevierStylePara elsevierViewall">Project funded by a research grant from the Government of Andalusia &#40;project PI-0489&#47;2009&#41;&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflicts of interest</span><p id="par0140" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Malnutrition is associated with an increased risk of mortality and morbidity&#44; longer hospital stays and general loss of quality of life&#46; The aim of this study is to assess the impact of dietary counseling for malnourished hospital patients&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Patients and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Prospective&#44; randomized&#44; open-label study of 106 hospital patients with malnutrition &#40;54 in the control group and 52 in the intervention group&#41;&#46; The intervention group received dietary counseling&#44; and the control group underwent standard treatment&#46; We determined the patients&#8217; nutritional state &#40;body mass index&#44; laboratory parameters&#44; malnutrition universal screening tool&#41;&#44; degree of dependence &#40;Barthel index&#41;&#44; quality of life &#40;SF-12&#41;&#44; degree of satisfaction &#40;CSQ-8&#41;&#44; the number and length of readmissions and mortality&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The patients who underwent the &#8220;intervention&#8221; increased their weight at 6 months&#44; while the controls lost weight &#40;difference in body mass index&#44; 2&#46;14<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46; The intervention group had better results when compared with the control group in the Malnutrition Universal Screening Tool scores &#40;difference&#44; &#8722;1&#46;29&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#44; Barthel index &#40;difference&#44; 7&#46;49&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;025&#41;&#44; SF-12 &#40;difference&#44; 13&#46;72&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41; and CSQ-8 &#40;difference&#44; 4&#46;34&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41; and required fewer readmissions &#40;difference&#44; &#8722;0&#46;37&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;04&#41; and shorter stays for readmissions &#40;difference&#44; &#8722;6&#46;75&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;035&#41;&#46; Mortality and laboratory parameters were similar for the 2 groups&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Nutritional counseling improved the patients&#8217; nutritional state&#44; quality of life and degree of dependence and decreased the number of hospital readmissions&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Patients and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La desnutrici&#243;n se asocia a un mayor riesgo de mortalidad y morbilidad&#44; a estancias hospitalarias m&#225;s largas y a un deterioro general de la calidad de vida&#46; Este estudio se propone evaluar en pacientes desnutridos hospitalizados el impacto del asesoramiento diet&#233;tico&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Pacientes y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio prospectivo&#44; aleatorizado&#44; abierto&#44; en 106 pacientes hospitalizados con desnutrici&#243;n &#40;54 grupo control&#44; 52 en el de &#171;intervenci&#243;n&#187;&#41;&#46; El grupo &#171;intervenci&#243;n&#187; recibi&#243; asesoramiento diet&#233;tico y el grupo control el tratamiento habitual&#46; Se determin&#243; el estado nutricional &#40;&#237;ndice de masa corporal&#44; par&#225;metros anal&#237;ticos&#44; <span class="elsevierStyleItalic">Malnutrition Universal Screening Tool</span>&#41;&#44; el grado de dependencia &#40;&#237;ndice de <span class="elsevierStyleItalic">Barthel</span>&#41;&#44; la calidad de vida &#40;SF-12&#41;&#44; el grado de satisfacci&#243;n de los pacientes &#40;CSQ-8&#41;&#44; el n&#250;mero y d&#237;as de reingresos hospitalarios y la mortalidad&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Los pacientes sometidos a &#171;intervenci&#243;n&#187; aumentaron de peso a los 6 meses&#44; mientras que los controles perdieron peso &#40;diferencia en el IMC de 2&#44;14<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span> &#91;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#93;&#41;&#46; El grupo &#171;intervenci&#243;n&#187; mostr&#243; mejores resultados respecto al grupo control en las puntuaciones obtenidas en el <span class="elsevierStyleItalic">Malnutrition Universal Screening Tool</span> &#40;diferencia &#8722;1&#44;29&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; <span class="elsevierStyleItalic">Barthel</span> &#40;diferencia 7&#44;49&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;025&#41;&#44; SF-12 &#40;diferencia 13&#44;72&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; y CSQ-8 &#40;diferencia 4&#44;34&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; y precisaron de un menor n&#250;mero de reingresos &#40;diferencia &#8722;0&#44;37&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;04&#41; y de d&#237;as de rehospitalizaci&#243;n &#40;diferencia &#8722;6&#44;75&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;035&#41;&#46; La mortalidad y los par&#225;metros anal&#237;ticos fueron similares en grupos&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El asesoramiento nutricional mejor&#243; el estado nutricional&#44; la calidad de vida y el grado de dependencia de los pacientes&#44; adem&#225;s disminuy&#243; el n&#250;mero de reingresos hospitalarios&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Pacientes y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0025">Please cite this article as&#58; Casals C&#44; Garc&#237;a-Agua-Soler N&#44; V&#225;zquez-S&#225;nchez M&#193;&#44; Requena-Toro MV&#44; Padilla-Romero L&#44; Casals-S&#225;nchez JL&#46; Ensayo cl&#237;nico aleatorizado del asesoramiento nutricional en pacientes desnutridos hospitalizados&#46; Rev Clin Esp&#46; 2015&#59;215&#58;308&#8211;314&#46;</p>"
      ]
    ]
    "multimedia" => array:5 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1320
            "Ancho" => 2980
            "Tamanyo" => 191410
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Flow diagram of patients included in the study&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Control group <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>54</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Intervention group <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>52</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total hospitalizations&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Surgical departments&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total hospitalizations&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Surgical departments&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Biliary-pancreatic disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Heart failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Pneumonia and pleural effusion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Other heart diseases&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Inguinal hernia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Femoral neck fracture&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Neoplastic disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Peripheral vascular disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Renal failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Upper gastrointestinal hemorrhage&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Iron-deficiency anemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Cerebrovascular disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Bowel obstruction&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Closed patella fracture&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Anal fistulas and fissures&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Extrapyramidal disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Diagnoses that motivated the hospitalization of patients in the study&#46;</p>"
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      ]
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        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
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        "tabla" => array:3 [
          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Abbreviations</span>&#58; MUST&#44; malnutrition universal screening tool&#59; SF-12&#44; Short Form 12 Health Survey&#46;</p>"
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              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Control group &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>54&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Intervention group &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Age &#40;years&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">73 &#40;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">73 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;640&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Sex &#40;female&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26 &#40;48&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27 &#40;52&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;698&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Weight &#40;kg&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63&#46;4 &#40;11&#46;55&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62&#46;5 &#40;13&#46;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;529&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Body mass index &#40;kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&#46;2 &#40;3&#46;78&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&#46;3 &#40;4&#46;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;277&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Need for surgery</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29 &#40;55&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">37 &#40;71&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;123&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Hospital stay &#40;days&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#46;6 &#40;8&#46;24&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21&#46;0 &#40;17&#46;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;021<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Proteins &#40;g&#47;dL&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;8 &#40;1&#46;04&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;6 &#40;1&#46;00&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;316&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Albumin &#40;g&#47;dL&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;5 &#40;0&#46;76&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;4 &#40;0&#46;44&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;076&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Cholesterol &#40;mg&#47;dL&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">147&#46;3 &#40;38&#46;00&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">143&#46;5 &#40;33&#46;93&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;456&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Lymphocyte &#40;103&#47;&#956;L&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;67 &#40;1&#46;49&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;36 &#40;0&#46;57&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;786&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">MUST</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;4 &#40;1&#46;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;6 &#40;1&#46;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;354&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Barthel index</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62&#46;5 &#40;28&#46;54&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">58&#46;6 &#40;28&#46;84&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;928&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">SF-12</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Overall&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38&#46;7 &#40;13&#46;56&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">37&#46;9 &#40;13&#46;66&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;890&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Physical component&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#46;2 &#40;11&#46;98&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#46;9 &#40;12&#46;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;963&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mental component&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43&#46;3 &#40;15&#46;67&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41&#46;9 &#40;15&#46;65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;616&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0005"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#46;</p>"
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          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Characteristics of patients included in the study &#40;data expressed as mean &#91;standard deviation&#93; or frequency &#91;percentage&#93;&#41;&#46;</p>"
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        "tabla" => array:3 [
          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Abbreviations</span>&#58; MUST&#44; malnutrition universal screening tool&#59; SF-12&#44; Short Form 12 Health Survey&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Control group &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>54&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Intervention group &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Difference&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Weight &#40;kg&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;903 &#40;6&#46;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;750 &#40;5&#46;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">&#42;</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Body mass index &#40;kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;395 &#40;2&#46;43&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;745 &#40;2&#46;06&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">&#42;</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Proteins &#40;g&#47;dL&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;936 &#40;1&#46;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;861 &#40;0&#46;92&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;0&#46;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;749<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Albumin &#40;g&#47;dL&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;691 &#40;0&#46;74&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;983 &#40;0&#46;66&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46; 292&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;061<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Cholesterol &#40;mg&#47;dL&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#46;45 &#40;37&#46;96&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#46;71 &#40;35&#46;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#46;26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;070<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Lymphocyte &#40;103&#47;&#956;L&#41;</span>&nbsp;\t\t\t\t\t\t\n
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          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Changes in the nutritional parameters of the control and intervention groups after 6 months of follow-up&#46; Data are expressed as mean &#40;standard deviation&#41;&#46;</p>"
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          "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">What we know&#63;</span><p id="par0010" class="elsevierStylePara elsevierViewall">Malnutrition affects 20&#8211;50&#37; of hospitalized patients&#46; The condition is associated with longer hospital stays&#44; higher readmission rates and increased mortality&#46; There is insufficient evidence supporting the usefulness of nutritional counseling&#46; In this study&#44; we assess the efficacy of a dietary counseling program on nutritional status and its consequences&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">What this article provides&#63;</span><p id="par0015" class="elsevierStylePara elsevierViewall">The nutritional counseling program&#44; conducted by case manager nurses &#40;hospital and primary care&#41; for 6 months&#44; improved the nutritional state of numerous patients and decreased their morbidity&#44; improved their quality of life and increased their satisfaction with the care received compared with standard clinical practice&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The Editors</p></span></span>"
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    ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Hospital malnutrition&#58; prevalence&#44; identification and impact on patients and the healthcare system"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46;A&#46; Barker"
                            1 => "B&#46;S&#46; Gout"
                            2 => "T&#46;C&#46; Crowe"
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.3390/ijerph8020514"
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                        "tituloSerie" => "Int J Environ Res Public Health"
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                        "volumen" => "8"
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                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21556200"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
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                      "titulo" => "Malnutrition in hospital&#58; the clinical and economic implications"
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                        0 => array:2 [
                          "etal" => false
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                            0 => "C&#46; L&#246;ser"
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                      ]
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                  ]
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                    0 => array:2 [
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                            "web" => "Medline"
                          ]
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Malnutrition in Dutch health care&#58; prevalence&#44; prevention&#44; treatment&#44; and quality indicators"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;M&#46; Meijers"
                            1 => "R&#46;J&#46; Halfens"
                            2 => "M&#46;A&#46; van Bokhorst-de vander Schueren"
                            3 => "T&#46; Dassen"
                            4 => "J&#46;M&#46; Schols"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.nut.2008.11.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nutrition"
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                        "paginaFinal" => "519"
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19135863"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
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                ]
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                    0 => array:2 [
                      "titulo" => "Prognostic indices of poor nutritional status and their impact on prolonged hospital stay in a Greek university hospital"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "G&#46; Tsaousi"
                            1 => "S&#46; Panidis"
                            2 => "G&#46; Stavrou"
                            3 => "J&#46; Tsouskas"
                            4 => "D&#46; Panagiotou"
                            5 => "K&#46; Kotzampassi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1155/2014/924270"
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                        "tituloSerie" => "Biomed Res Int"
                        "fecha" => "2014"
                        "volumen" => "2014"
                        "paginaInicial" => "924270"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24779021"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "How nutritional risk is assessed and managed in European hospitals&#58; a survey of 21&#44;007 patients findings from the 2007&#8211;2008 cross-sectional nutrition Day survey"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46; Schindler"
                            1 => "E&#46; Pernicka"
                            2 => "A&#46; Laviano"
                            3 => "P&#46; Howard"
                            4 => "T&#46; Sch&#252;tz"
                            5 => "P&#46; Bauer"
                          ]
                        ]
                      ]
                    ]
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                    0 => array:2 [
                      "doi" => "10.1016/j.clnu.2010.04.001"
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                        "tituloSerie" => "Clin Nutr"
                        "fecha" => "2010"
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                        "paginaInicial" => "552"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Desnutrici&#243;n hospitalaria&#58; relaci&#243;n con la estancia media y la tasa de reingresos prematuros"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "G&#46; Lobo T&#225;mer"
                            1 => "M&#46;D&#46; Ruiz L&#243;pez"
                            2 => "A&#46;J&#46; P&#233;rez de la Cruz"
                          ]
                        ]
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                    ]
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                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "2009"
                        "volumen" => "132"
                        "paginaInicial" => "377"
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                      ]
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                    0 => array:2 [
                      "titulo" => "Decreased food intake is a risk factor for mortality in hospitalized patients&#58; the Nutrition Day survey 2006"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Hiesmayr"
                            1 => "K&#46; Schindler"
                            2 => "E&#46; Pernicka"
                            3 => "C&#46; Schuh"
                            4 => "A&#46; Schoeniger-Hekele"
                            5 => "P&#46; Bauer"
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.1016/j.clnu.2009.05.013"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Nutr"
                        "fecha" => "2009"
                        "volumen" => "28"
                        "paginaInicial" => "484"
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                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19573957"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
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                ]
              ]
            ]
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              "etiqueta" => "8"
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                    0 => array:2 [
                      "titulo" => "Desnutrici&#243;n en pacientes hospitalizados&#58; prevalencia e impacto econ&#243;mico"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46; P&#233;rez de la Cruz"
                            1 => "G&#46; Lobo T&#225;mer"
                            2 => "R&#46; Ordu&#241;a Espinosa"
                            3 => "C&#46; Mellado Pastor"
                            4 => "E&#46; Aguayo de Hoyos"
                            5 => "M&#46;D&#46; Ru&#237;z L&#243;pez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "2004"
                        "volumen" => "123"
                        "paginaInicial" => "201"
                        "paginaFinal" => "206"
                      ]
                    ]
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              "etiqueta" => "9"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Use of nutritional complete supplements in older adults with dementia&#58; systematic review and meta-analysis of clinical outcomes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "V&#46;J&#46; Allen"
                            1 => "L&#46; Methven"
                            2 => "M&#46;A&#46; Gosney"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.clnu.2013.03.015"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Nutr"
                        "fecha" => "2013"
                        "volumen" => "32"
                        "paginaInicial" => "950"
                        "paginaFinal" => "957"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23591150"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0185"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nutrition prescription to achieve positive outcomes in chronic kidney disease&#58; a systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46; Ash"
                            1 => "K&#46;L&#46; Campbell"
                            2 => "J&#46; Bogard"
                            3 => "A&#46; Millichamp"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/nu6010416"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nutrients"
                        "fecha" => "2014"
                        "volumen" => "6"
                        "paginaInicial" => "416"
                        "paginaFinal" => "451"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24451311"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
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                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dietary counselling with or without oral nutritional supplements in the management of malnourished patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46; Baldwin"
                            1 => "C&#46;E&#46; Weekes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Human Nutr Diet"
                        "fecha" => "2012"
                        "volumen" => "25"
                        "paginaInicial" => "411"
                        "paginaFinal" => "426"
                      ]
                    ]
                  ]
                ]
              ]
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        "texto" => "<p id="par0145" class="elsevierStylePara elsevierViewall">The authors would like to thank the following nursing professionals for their collaboration in the study&#58; Mar&#237;a del Pilar Aguilar Trujillo&#44; Yolanda Carri&#243;n Velasco&#44; Pilar Castro L&#243;pez&#44; Jos&#233; Mar&#237;a Cruz Gir&#225;ldez&#44; Miguel Garc&#237;a Jim&#233;nez&#44; Remedios Madue&#241;o Mel&#233;ndez&#44; Esperanza Mart&#237;n Salvador&#44; Mar&#237;a de los Remedios Reina Campos&#44; Jos&#233; Luis S&#225;nchez del Campo&#44; Carolina S&#225;nchez Zayas&#44; Rosal&#237;a Rioja V&#225;zquez&#44; Inmaculada Valero Cantero&#46; We thank them for participating selflessly in the project and for employing their experience in patient health education&#46;</p>"
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