title: SELENIUM IN DYSPHAGIC PATIENTS WHO UNDERWENT ENDOSCOPIC GASTROSTOMY FOR LONG TERM ENTERAL FEEDING.
abstract: OBJECTIVE
  endoscopic gastrostomy (PEG) patients usually present protein-energy malnutrition, but little is known about selenium deficiency. We aimed to assess serum selenium evolution when patients underwent PEG, after 4 and 12 weeks. We also evaluated the evolution of albumin, transferrin and Body Mass Index and the influence of the nature of the underlying disease.
  
  
  METHODS
  a blood sample was obtained before PEG (T0), after 4 (T1) and 12 (T3) weeks. Selenium was assayed using GFAAS (Furnace Atomic Absorption Spectroscopy). The PEG patients were fed through homemade meals. Patients were studied as a whole and divided into two groups: head and neck cancer (HNC) and neurological dysphagia (ND).
  
  
  RESULTS
  we assessed 146 patients (89 males), between 21-95 years old: HNC-56; ND-90. Normal values of selenium in 79% (n=115); low albumin in 77, low transferrin in 94, low values for both serum proteins in 66. Low BMI in 78. Selenium has slow evolution, with most patients still displaying normal Selenium at T3 (82%). Serum protein levels increase from T0 to T3, most patients reaching normal values. The nature of the underlying disease is associated with serum proteins but not with selenium.
  
  
  CONCLUSIONS
  low serum selenium is uncommon when PEG is performed, after 4 and 12 weeks of enteral feeding and cannot be related with serum proteins levels or dysphagia cause. Enteral nutrition using customized homemade kitchen meals is satisfactory to prevent or correct Selenium deficiency in the majority of PEG patients.
authors.affiliation: GENE - Enteral Feeding Team. Hospital García de Orta, Almada.. carla.adriana.santos@hotmail.com.
authors.forename: Carla Adriana
authors.initials: CA
authors.lastname: Santos
authors.affiliation: GENE - Enteral Feeding Team. Hospital García de Orta, Almada. CiiEM - Center for Interdisciplinary Research Egas Moniz, Almada.. jorgedafonseca@hotmail.com.
authors.forename: Jorge
authors.initials: J
authors.lastname: Fonseca
authors.affiliation: Departamento das Ciências Naturais e Exatas, Área Científica de Matemática. Escola Superior de Tecnologias da Saúde de Lisboa, Instituto Politécnico de Lisboa, Lisboa.. carla.adriana.santos@hotmail.com.
authors.forename: Elisabete
authors.initials: E
authors.lastname: Carolino
authors.affiliation: CEDOC, NOVA Medical School. Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa.. carla.adriana.santos@hotmail.com.
authors.forename: Teresa
authors.initials: T
authors.lastname: Lopes
authors.affiliation: CEDOC, NOVA Medical School. Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa. Unidade Funcional de Med 4. Hospital Santa Marta. Centro Hospitalar de Lisboa Central, Lisboa, Portugal.. carla.adriana.santos@hotmail.com.
authors.forename: António Sousa
authors.initials: AS
authors.lastname: Guerreiro
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy*; D016099:Endoscopy, Gastrointestinal; D004750:Enteral Nutrition; D005260:Female; D005774:Gastrostomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy; D011502:Protein-Energy Malnutrition / Q000209:etiology / Q000628:therapy; D012643:Selenium / Q000097:blood / Q000172:deficiency*; D055815:Young Adult
chemical_list: D012643:Selenium