Intended for Special Medical Purposes

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intended for special medical purposes BRANCHED TENEX POT OF 2 Kg PROTEIN CONCENTRATED 100 SACHETS OF 20 g PROTEIN CONCENTRATED 6 CANS OF 500 g THICKENER WALLAX 100 SACHETS OF 9 g THICKENER WALLAX 6 AND 12 CANS OF 227 g ESSENTIAL TENEX POT OF 454 g FIB TENEX 24 BOTTLES OF 250 ml (DIABETICS) HEPATO TENEX 12 SACHETS OF 97.7 g KID TENEX 6 POTS OF 500 g MCT TENEX BOTTLE OF 500 ml NEFRONUTRIL 6 SACHETS OF 91 g NUT TENEX 24 BOTTLES OF 250 ml NUT TENEX HP BOTTLES OF 250 ml PEP TENEX 87 - 10 SACHETS OF 87 g CONCENTRATED PROTEINS POT OF 2 Kg SUP TENEX 15 SACHETS OF 32 g SUP TENEX 100 SACHETS OF 32 g UNO TENEX 12 SACHETS OF 98 g Garbí, 43 NUT TENEX SIX - FIB TENEX SIX - NUT HP SIX 08397 - PINEDA DE MAR (Barcelona) Tel, 937 625 981 - 937 629 837 Fax. 937 621 091 E-mail: [email protected] www.wallax.es PRODUCTOS SANITARIOS Y DIETÉTICOS farma, S.l. Amino acid module for metabolic disorders Branched Tenex and for the preparation of modular diets in For metabolic disorders home enteral nutrition

COMPOSITION PER 100 g L-leucine 25.00 g L-isoleucine 12.90 g L-valine 12.10 g Proteins 96.00 g Carbohydrates 1.00 g Fats 0.00 g Vitamin B6 14.00 mg

PRODUCTOS SANITARIOS Y DIETÉTICOS farma, S.l.

Indications: for preparation of diets to patients with a tendency to hepatic encephalopathy. To maintain a good condition nutritious in diseases acute and chronic liver cursen with tendency to encephalopathy.

It must be used to complement a diet that is administered by orally.

IMPORTANT NOTICE: This food must be used under medical supervision. This product is not suitable to be consumed as unique Net weight: 454 g food source. It must not be administered parenterally. BRANCHED AMINO ACIDS

Branched amino acids (also called branched-chain amino acids in English) are called Branched-Chain Amino Acids BCAA) refers to a type of amino acid that has a Aliphatic compound that are non-linear (their name comes from this branched feature). Among them are leucine, isoleucine and valine (These are the most hydrophobic amino acids) Ingest through a proper diet. The combination of these three essential amino acids makes up almost the third part of the skeletal muscles in the human body and play a very important role in the synthesis of proteins. Branched chain amino acids are frequently used in treatment of patients who have suffered burns, as well as in the dietary supplements of the athletes who practice muscle building.

FUNCTION

One of the main functions of this type of amino acids is protein synthesis. The oxidation of BCAA has the function of providing metabolic energy to the muscles as well as to other organs applicants for it, as well as being precursors of the synthesis of amino acids being a facilitator of the synthesis of alanine and glutamine in catabolic states. Catabolism wears out muscle skeletal generating a negative nitrogen balance in the tissues. BCAAs stop proteolysis both in live subjects and in laboratory samples. This type of amino acids is captured with 'avidity' by the muscle causing certain ergogenic effects, mainly stopping the catabolic effect and favoring protein synthesis. The content of branched chain amino acids grows during first phases of the exercise and then decrease. The reason or rate of decrease depends directly on the intensity of the exercise. They usually increase serotonin levels when the Brain receives elevated levels of tryptophan (an amino acid precursor of serotonin).

The intake of amino acids, including BCAAs, is absorbed by the small intestine via the cells epithelial cells through specific amino acid transporters and are transported to the liver by the blood flow of the portal vein. BCAAs are used in the body as regulators of synthesis and protein degradation (proteolysis) and are key precursors in the synthesis of glutamine and alanine. In addition, the oxidation of BCAAs generates anaerobic energy in the muscles. Oxidation of BCAAs is controlled in the short term by the products synthesized in the leucine transamination and in the long term by many physiological and pathological conditions such as diabetes, cancer, sepsis and infection.

APPLICATIONS It is usually eaten as a dietary supplement (often as a bodybuilding supplement) with the object of avoiding the so-called overtraining in the athletes of weight lifting and bodybuilding. his effect on the decrease of sports fatigue is a source of debate at present and there are studies scientists with contradictory results. It is applied as a dietary supplement in patients who have had a surgical operation or suffering from cancer due to protein catabolysis processes that can suffer their organisms. It has been used as therapy in patients suffering from dyskinesia. It has been employed in the meat industry as a food supplement for certain animals and to obtain meat quality.

DIETETIC USE The use as a supplement in anaerobic sports is usually done in shots with two-shot protocols, usually half an hour before and after the exercise. Some authors mention two shots, but average hour before and 'during the exercise'. Others have investigated the effect of intakes in periods before the night rest being able to check that there are no effects on muscle growth. The amino acids of Branched chain are distributed in many ways, in pills, in powder, etc. And there is a great variety of dosages ranging from one to forty grams per day. The compounds marketed are usually have a ratio of 2: 1: 1 (leucine: valine: isoleucine). Some recommendations mention a dose of 1,500- 6,000 mg / day of leucine and 800-3,000 mg / day of both isoleucine and valine. It is advised to take the amino acids Branched together with protein supplements or with lean meat, as well as with multiple vitamins (inside of group B) and minerals. About 5-20 grams per day (in the form of tablets / capsules) in divided doses during the day (some of them during the exercise) or after the exercise in the form of liquid (from 1 to 7 grams of BCAA per liter of sports drink).

SIDE EFFECTS The relationship of l-leucine l-valine l-isoleucine with the appearance of varicocele in sportsmen and women is being investigated other unwanted effects. Consuming large amounts of BCAA during exercise can make decrease the absorption of water in the intestine which can induce gastrointestinal problems. HE recommends taking large amounts of water during the day, from 2 to 3 liters to avoid such problems. It has been proven in exhaustive studies of human behavior observation (in FOREST TOWN) a slight change in the behavior of the individual especially during working hours (called effect Paul).

BIOSYNTHESIS OF BRANCHED AMINO ACIDS The human being can not produce valine, leucine and isoleucine, for which they are considered amino acids essentials that must be ingested from food. Other organisms can produce amino acids branched, for example lactic acid bacteria. In this case the biosynthesis path starts from pyruvate and first step is catalyzed by the enzyme acetohydroxy acid synthase. DIETARY FOOD FOR SPECIAL MEDICAL USES A whole Instructions: protein For dietetic treatment in PROTEIN module for patients who need extra proteic metabolic intake, to increase diet protein CONCENTRATED disorders content in those cases in which treatment the increase cannot be WALLAX and the obtained by ordinary food preparation intake. It recovers, keep of modular Post operations, crusts and W sloughs, cicatrisation, or increases the diets in home undernourishment, malnutrition body protein content. enteral and convalescences. nutrition. Nitrogen: 14,13 g% Proteins: 90,45 g%

FINANCIADO Content: 100 sachets SNS x 20 g

C.N. 504444.6

It is advisable to be administered with pineapple NEUTRAL juice because it contains an enzyme, the FLAVOR bromulin, which helps metabolize proteins.

Ingredients: Milk proteins (casein, lactoalbumine, Instructions for use: sodium caseinate, calcium caseinate), L-cystine, Adminster orally or via feeding tube. Dose: 1-2 g/Kg of body weight emulsiﬁer, soy lecithin. Important warning: NUTRITIONAL INFORMATION: per 100 g per 20 g This food must be used under medical Energetic value Kcal/kJ 381/1615 76/323 supervision. Proteins g 90.45 18.09 This product cannot be taken as the Fats g 1.70 0.34 only source of food. Carbohydrates g 0.85 0.17 IDo not give this product to breast- fedbabies and children under 3 years COMPOSITION old. Casein g 50.00 10.00 Lactalbumin g 16.13 3.23 Sodium caseinate g 16.13 3.23 Calcium caseinate g 16.13 3.23 L-cystine g 1.10 0.22 Lecithin g 0.50 0.10 PRODUCTOS SANITARIOS Y DIETÉTICOS farma, S.l. Special product for dietetic services and hospital pharmacy. Concentrated proteins WALLAX COMPOSITION PER 100 g It recovers, keeps or increases Micellar casein 50.00 g Lactalbumin 16.13 g Sodium caseinate 16.13 g the body protein content Calcium caseinate 16.13 g L-cystine 1.10 g FINANCIADO Soy lecithin 0.50 g SNS NUTRITIONAL INFORMATION PER 100 g

Energetic value 401/1,675 Kcal/kJ Proteins 90.45 g Carbohydrates 1.00 g Lipids 1.00 g Humidity 5.94 g Ash 4.72 g Presentation: 6 pots of 500g

PRODUCTOS SANITARIOS Y DIETÉTICOS farma, S.l. C.N. 504445.3 COMPOSITION PER 500 g

Micellar casein 250.00 g Proteins: 84,21 g % DOSE: Lactalbumin 80.65 g Net weight: 500 g Sodium caseinate 80.65 g Calcium caseinate 80.65 g 1-2 g/Kg of weight L-cystine 5.50 g g per day. Soy lecithin 2.50 Neutral flavor. NUTRITIONAL INFORMATION PER 500 g Highly recommended for otorhinolaryngology, in laryngectomy and dysphagia.

Energetic value 1 920/7,725 Kcal/kJ PROTEIC CONTRIBUTION FOR: Proteins 421.05 g Making up enteral nutrition diets. Carbohydrates 5.00 g Add to oral food by means of infusions, soups, purée, desserts, etc. Lipids 5.00 g It recovers the muscular mass integrity in CPR, commas, burned people, Humidity 29.70 g post operations, crusts and sloughs, cicatrisation, malnutrition, undernourishment Ash 23.60 g and convalescences. It is advisable to be administered with pineapple juice because it contains an enzyme, the bromulin, which helps metabolize proteins. Food thickening agent Facilitates swallowing Adaptable consistency to patient's necessities. of liquids and purees. It does not change food ﬂavor. Thickener SACHETS

neutral 100 FINANCIADO PRODUCTOS SANITARIOS Y DIETÉTICOS farma, S.l. flavor SNS C.N. 504286.2 High quality and inflatable food modified starch, designed for easy dispersion in cold and hot liquids. Wallax thickener is suitable for the dietetic treatment of dysphagia. Ingredients: Modified corn starch.

Product description: This product is specially designed for the treatment of swallowing diﬃculty patients.

Dose: It depends on the desired thickness and the liquid volume.

Important: Use under medical supervision. This product can not be used as the sole source of power. COMPOSITION per 100 g per 9 g Energetic value 1513 kJ 136 kJ 356 Kcal 32 Kcal Carbohydrates 89 g 8 g -Of which sugars 0 g 0 g Sodium 0.22 g 0.02 g Proteins 0 g 0 g Dose: Consistency per 200 ml liquid Lipids 0 g 0 g 1 sachet (9 g) Nectar Dietary ﬁber 0 g 0 g 1 1/2 sachets (13,5 g) Honey Minerals 0 g 0 g 2 sachets (18 g) Pudding

Net weight: 900 g Dietary food for special medical uses. 100 sachets of 9 g Food thickening agent Facilitates swallowing Adaptable consistency to patient's necessities. of liquids and purees. It does not change food ﬂavor. Thickener POTS PRODUCTOS SANITARIOS Y DIETÉTICOS farma, S.l. neutral FINANCIADO ﬂavor SNS

High quality and inflatable food modified starch, designed for easy dispersion in cold and hot liquids. Wallax thickener is suitable for the dietetic treatment of dysphagia. Ingredients: Modified corn starch.

Product description: This product is specially designed for the treatment of swallowing diﬃculty patients.

Instructions for use: Add thickener to hot or cold liquids and purees and stir briskly until the powder is completely dissolved. In case of using a blender, dissolve at slow speed for 5-10 seconds. The thickener reaches the appropiate consistency after 15 seconds and remains stable over time. Net weight: Do not mix too much. 227 g Dose: COMPOSITION per 100 g per 4,5 g It depends on the desired thickness and the liquid volume. Energetic value 1513 Kj 68 kJ 356 Kcal 16 Kcal Carbohydrates 89 g 4 g Box of: -Of which sugars 0 g 0 g Sodium 0,22 g 0,01 g 6 tins of 227 g Proteins 0 g 0 g IT INCLUDES Lipids 0 g 0 g C.N. 504176.6 Dietary ﬁber 0 g 0 g DOSER Minerals 0 g 0 g Box of: * 1 doser 12 tins of 227 g Important: C.N. 504177.3 Use under medical supervision. This product can not be used as the sole source of power.

Nectar: 1 doser Honey: 1,5 dosers Pudding: 2 dosers Dietary food for special medical uses. (1 doser = 4,5 g) Amino acid module for metabolic disorders and for the preparation Essential Tenex of modular diets in home enteral For metabolic disorders nutrition

COMPOSITION PER 100 g L-valine 18.33 g L-leucine 12.22 g L-methionine 12.22 g L-lysine hydrochloride 11.08 g L-tyrosine 10.18 g L-phenylalanine 9.51 g L-threonine 8.83 g L-Isoleucine 8.14 g L-histidine base 6.10 g L-tryptophan 3.39 g

Nutritional information per 100 g Energetic value 300 Kcal (1275kJ) Proteins 75 g Carbohydrates < 0.05 g Fats < 0.05 g

PRODUCTOS SANITARIOS Y DIETÉTICOS farma, S.l.

It should be used to supplement a diet that is administered orally. Net weight: 454 g

Dosage: 40 g of this product correspond approximately to 5 g of nitrogen, average dose to add to a diet hypoproteic and hypercaloric. IMPORTANT NOTICE: This food must be used under medical supervision. This product is not suitable to be For the dietetic treatment of patients with nephropathies. consumed as only food source. Maintains a positive nitrogen balance, to prevent protein deﬁcit, Do not administer to infants or to improve uraemic symptoms, maintain complement factors and children under 3 years old. reduce the risk of infection in kidney diseases. ESSENTIAL AMINO ACIDS

INDICATED IN For the dietary treatment of patients with renal disease. It maintains a positive nitrogen balance. To prevent protein deficiency, improve uremic symptoms, maintain the complement factors and reduce the risk of infection in renal diseases.

DESCRIPTION Of all the existing amino acids, essential amino acids are those that we ingest through diet because our body cannot synthesize them. By contrast, the amino acid that metabolism can produce are called non-essential amino acids and their presence in the diet is not as important as essential ones.

In fact, the content of essential amino acids in a protein defines its Biological Value. A high Biological Value means a greater presence of EEAA, which is to say that protein "gives us more nutritional benefit." Essential amino acids are 8: L-Leucine, L-Isoleucine, L-Phenylalanine, L-Methionine, L-Lysine, L-Threonine, L-Tryptophan and L-Valine. Of these, 3 are known as "branched amino acids" (BCAA, in English named as Branched Chain Amino Acids):

• The branched amino acids (L-Leucine, L-Isoleucine and L-Valine) represent a very important percentage in the chain of amino acids from muscle protein. Not only are they so representative in the muscles, but also stimulate protein synthesis processes. Therefore they are essential in the process of muscle tissue regeneration.

On the other hand, L-Phenylalanine, L-Methionine, L-Lysine, L-Threonine and L-Tryptophan also have important functions in metabolism: L-Fenilalanina: it stimulates brain function and the production of neutransmitters.

• L-Methionine: sulfur amino acid that promotes growth and is involved in the synthesis of many metabolites in the body.

• L-Lysine: it stimulates the immune system and cell regeneration. It is an important presence in muscle tissue.

• L-Threonine: it contributes to the proper liver functioning and together with the L- Methionine, they act as liver protectors.

• L-Tryptophan: immediate precursor of serotonin, a neurotransmitter that acts on mood and behavior of the person. R

FIBTENEX PRODUCTOS SANITARIOS Y DIETÉTICOS farma, S.l. It is used in the diabetes dietary Complete diet, with fiber and balanced. treatment when patients are affected by moderate or serious malnutrition Dietary food for special medical uses. symptoms. It is especially designed for patients This product is appropriate to treat who require extra fibre intake. patients with diarrhoea or bowel/colon mucus dysfunctions and also in moderate or serious ingestion, It is suitable for diabetics too. assimilation or malnutrition problems. Fibtenex must be used under medical supervision. special This product can be taken as the only source of food . It can be administered orally or via feeding tube. FIBER FIBTENEX contains fructose and sweeteners. FINANCIADO Do not give this food to children under 12 years old. SNS Unsuitable for galactosemic patients. DOSE: If considered as the only source of food, administer approximately 30 ml/kg of body weight per day in adults.

FEEDING VIA TUBE: Follow the instructions given by your doctor. Theflow, volume and dilution parameters will depend on the patient's physiological state and its tolerance. INSTRUCTIONS FOR USE: Shake it briskly before using. Keep a strict metabolic control when impaired glucose tolerance chocolate flavor vanilla flavor is diagnosed. C.N. 504099.8 C.N. 504253.4 Presentation in boxes of: 24 x 250 ml bottle. INGREDIENTS: water, hydrolysed corn starch, fructose, milk serum protein, medium-chain triglyceride (MCT), vegetable oil, sodium caseinate, calcium caseinate. FIBRE: wheat dextrin and oligofructose, fat-free cocoa. MINERAL SALTS: sodium citrate, potassium phosphate, magnesium chloride, calcium chloride, potassium citrate, iron lactate, zinc sulfate, manganese sulfate, cupric gluconate, sodium molybdate, potassium iodine, sodium fluoride, chromium chloride, sodium selenite. EMULSIFIER: E472, soy lecithin, choline citrate, inositol. POLIVITAMIN CONCENTRATE: vitamin C, niacin, vitamin E, calcium pantothenate, vitamin B1 , vitamin B2 , vitamin B6 , vitamin A, folic acid, biotin, vitamin K1 , vitamin D3 , vitamin B12 , aroma. STABILIZERS: carrageenan, xanthan gum. SWEETENERS: sodium cyclamate, sodium saccharin. NUTRITIONAL INFORMATION: in 100 ml in 250 ml (% RDA) Energetic value Kcal/kJ 99/414 247/1.035 Carbohydrates g 10,40 26,00 of which: - sugars g 2,50 6,25 Fats g 4,20 10,50 of which: - saturates g 2,80 7,00 Proteins g 4,10 10,25 Fiber g 1,50 3,75 MINERALS Chloride mg 113,00 282,50 Potassium mg 102,90 257,25 Sodium mg 100,00 250,00 Calcium mg 59,20 148,00 (37%) Phosphorus mg 40,80 102,00 (25%) Magnesium mg 18,00 45,00 (30%) Iron mg 1,20 3,00 (43%) Zinc mg 0,80 2,00 (25%) Manganese mg 0,20 0,50 Copper μg 89,90 224,75 Molybdenum μg 10,00 25,00 Iodide μg 7,40 18,50 (25%) Fluoride μg 3,00 8,00 Selenium μg 2,50 6,25 Chromium μg 1,25 3,13 Product manufactured in Spain VITAMINS Vitamin C mg 6,00 15,00 (50%) Vitamin B3 (Niacin) mg 1,80 4,50 (50%) Vitamin E mg 1,00 2,50 (50%) Pantothenic acid mg 0,60 1,50 (50%) Vitamin B6 mg 0,20 0,50 (50%) Vitamin B2 mg 0,16 0,40 (50%) Vitamin B1 mg 0,14 0,35 (50%) Vitamin A μg 80,00 200,00 (50%) Vitamin B9 (Folic acid) μg 20,00 50,00 (50%) Biotin μg 6,00 15,00 (23%) TENEX Vitamin K1 μg 5,50 13,75 Vitamin D3 μg 0,50 1,25 (50%) Vitamin B12 μg 0,10 0,25 (50%) Inositol mg 20,00 50,00 Choline citrate mg 20,00 50,00 RDA: Recommended Dietary Allowances 365 mOsm/l In a more colloquial language, FIB TENEX KEEPS THE PATIENT WITH A CORRECT GLYCEMIC INDEX FOR A LONGER PERIOD OF TIME since carbohydrates that compose it are of low glycemic index, such as maltodextrin and wheat dextrin. Its unsaturated fats such as medium chain triglycerides have better cardiovascular risk parameters and the inclusion of MCT in the diet increases the use of long chain fat (fat deposits in the body) as an energy source, promoting the loss of body fat. Therefore, they are used in enteral and parenteral nutrition because of its good absorption. FIB FIB TENEX ENTERAL-ORAL NUTRITION IN DIABETIC PATIENTS

Both diabetes mellitus type 1 and 2 diabetes is a common condition in both the general population and in the hospital. Nutritional support is no different from a diabetic to one that is not patient. The goal of metabolic control in diabetic patients receiving enteral nutrition should be reach adequate nutritional requirements, but keeping an optimal glycemic and lipid profile. Proper formulation of FIB TENEX influencesimproving metabolic control of diabetic patients (glycemic and lipid).

In people with diabetes or stress hyperglycemia, as in the usual diet, the use of FIB TENEX with a moderate content of medium chain triglycerides have a favorable effect on metabolic control in the short and medium term (reducing the risk of diseases heart, raising your HDL, lowering triglyceride and LDL levels) these fats provide a more stable supply of energy during the day that carbohydrates, which can cause fluctuations in blood sugar. Addition of soluble fiber as wheat dextrin , type of carbohydrates, oligofructose, low glycemic index are contributing factors in the decrease of postprandial glucose response, while maintaining adequate levels of glucose in blood .

In our country the prescription of home enteral nutrition (HEN) is gradually increasing. The most used route by far is oral, followed by nasogastric tubes, and greater distance, ostomy. The main indications for the use of the NED in Spain are neurological disorders that prevent swallowing and cancer, whichare more common disorders in elderly life. This implies that the prevalence of diabetes in patients who are prescribed home enteral nutrition is very high.

The nutritional requirements of people with diabetes who receive artificial enteral nutritional support (oral or tube) are similar to those of people without diabetes. On the one hand, it is necessary to provide individualized nutritional requirements depending on their clinical status , body composition , age and sex , this implies not provide excessive calories in a population with very often obesity. Generally one can estimate the energy intake between 25 and 35 kcal / kg body weight per day, depending on the estimated degree of patient stress. Also estimated in the absence of kidney or liver disease that limits, protein intake will depend on the degree of metabolic stress present patient, generally between 1 g / kg / day in patients with stress and 1.5 g / kg / day. Less than 20% of the total caloric content as protein, less than 5 % saturated fat, dividing the remaining 60 to 70 % from carbohydrates (oligofructose and wheat dextrin). The Nutrition Group of the Spanish Diabetes Society recommends no change dietary habits of patients in the percentage of fat with the clear exception of reducing the content of saturated fats below 10%.

Regarding the type of carbohydrate ingested in the medical literature has proposed the concept of glycemic index (GI) to classify foods containing carbohydrates based on their potential to raise blood glucose levels after ingestion. The GI is defined as the area under the curve of increased glycemic response of a portion of 50 g of carbohydrate foods test, expressed as a percentage response to the same amount of HC from a standard food (normally, white bread, glucose). Foodswith a low GI are digested and absorbed more slowly than foods with a High GI. FIB TENEX with oligofructose and wheat dextrin as HC and the latter as soluble fiber are a clear example of low GI HC and a total low glycemic load (GL).

Epidemiological studies in the general population, it has been suggested that long-term consumption of a diet with high glycemic load would be an independent risk factor for developing type 2 diabetes and cardiovascular disease. Likewise, a low GI diet may protect against development of obesity and even some cancers (such as breast or colon). Also, a recent analysis of several randomized controlled trials indicates that choosing low GI foods in people with diabetes (both type 1 and 2) have a clinically useful effect on medium-term glycemic control. The added benefit is similar to that obtained with pharmacological agents directed to treat postprandial hyperglycemia (approximately a decrease of between 0.2 and 0.4% in glycated hemoglobin).

The European Association for the strudy of Diabetes (EASD) also recommends choosing foods that cause a lower glycemic response after ingestion. Finally, the ADA recommends for people with diabetes who regularly consume a diet with soluble fiber. A high intake of dietary fiber appears to improve glycemic discreetly and lipid metabolic control in diabetes between 20 and 30 g per day.

FIB TENEX formula addition to diabetes fiber added with a ( " soluble " ) high proportion of fermentable which preferably is associated with improved glucose and lipidprofile production of short chain fatty acids in the colon (after fermentation). FIB TENEX is normocaloric, with a caloric density and normoproteic kcal/100ml 0.96 with less than 20 % of the total caloric value. FIB TENEX is cataloged by the Ministry of Health as "complete diet", so it is funded by the Spanish National Health System.

CLINICAL EXPERIENCES WITH SPECIAL DIETS FOR DIABETES: A SHORT TERM STUDY. These studies compared in people with diabetes, the postprandial glycemic response to breakfast makingtest (or test meals) of different enteral formulas. Some also study other aspects, such as the lipid response or production of ketone bodies. When we compared the intake of high enteral formulas in HC (specific to diabetes) compared to diets high in monounsaturated fat, has proven significantly lower glycemic response in the past. It has also been observed that the increase in blood glucose is lower when a diet for diabetes is discussed moderately rich in fat ( 38% of total caloric value ) fatty acids suchas medium chain triglycerides , compared to standard formulations and standard fiber . It is possible that the synergy of several factors in this type of diet (HC content against lipid and starch type, fructose, adding fiber , and even protein source ) causes the beneficial effect on blood sugar. When this type of diet (for diabetes with moderate fat intake) compared (after a test shot) with other specific diabetes diet high in fat (49% of total caloric value) glycemic response is slightly lower in the last (although not statistically significant).

It seems therefore that , when ingested formula low in HC and high in monounsaturated fat, the postprandial glycemic response depends primarily on the total content of HC contributed , and has little HC source (starch, fructose ) or even the content and fiber type. As the content of the formulas HC increases, especially if compared with diets high in carbohydrates, these factors may play a greater role to the attenuation of the glycemic response. In all cases when used diets with moderate or high in monounsaturated fats has not been modified or lipid profile were caused ketosis.

CONCLUSIONS Of the above papers several conclusions can be drawn: 1. In people with diabetes or stress hyperglycemia, as in the usual diet, the use of enteral formulas with a low content of saturated fat has a favorable effect on metabolic control in the short and medium term. The addition of fiber (preferably fermentable as wheat dextrin HC type, oligofructose, are contributing factors in reducing the glycemic response. Two. The 2 models of diabetic diets that have been studied in the medium term to date (high in fat and higher in HC) are generally well tolerated and safe. Although there is a tendency to improve the metabolic profile (glycemic and lipid) in the group fed the high-fat diet, these formulations may be useful in patients with diabetes if properly estimated calorie requirements. Three. Are needed work with more patients, with lower rates of dropout protocol, longer duration, randomized, preferably double-blind, in different clinical situations, where its effectiveness and efficiency (cost / effectiveness) is assessed on metabolic effect and morbidity to offerevidence- based recommendations. R

HEPATO TENEX PRODUCTOS SANITARIOS Y DIETÉTICOS farma, S.l. It is a residue-free product.

Hepatotenex contains all the necessary nutrients. A balanced synthetic diet.

It is a branced-chain amino A dietetic treatment for patients with acids enriched diet with poor aromatic amino acids content. any hepatic insuﬃciency.

The ﬁrst 2 days of treatment do not give a complete diet to avoid any possible This product is complications. DOSAGE: suitable to be A complete diet equals from 6 to 8 sachets of this product. consumed as In case of chronic hepatic insuﬃciency, the dose will be 2 the only source daily sachets together with an appropiate diet. of food.

INSTRUCTIONS FOR USE: Add 1 sachet content to 350-400 ml of FINANCIADO water and stir until its complete dilution. When it is dissolved, it must be immediately consumed. SNS PRESENTATION: box with 12 sachets. CONTINUED NEED OF HEPATOTENEX: In circumstances in which the liver failure is mild but chronic, caused by residual It can be administered orally or via cirrhosis originated by several causes C.N. 504951.9 C.N. 504952.6 nasogastric feeding tube. (chronic alcoholism, continued drug treatment, acute hepatitis C phases, age, VANILLA COFFEE etc.), the use of a diet which complements NUTRITIONAL INFORMATION: PER SACHET PER 100 g MINERALS sachet 100 g R.D.A. the liver function is recommended . Energetic value Kcal/kJ 411/1,737 421/1,778 Its function is from complementing to Potassium mg 330.35 338.13 Carbohydrates g 73.57 75.30 Calcium mg 145.08 148.50 (19%) substituting nutritional intake. of which: - sugars g 35.56 36.40 Phosphorus mg 124.47 127.40 (16%) Proteins g 12.90 13.20 Chlorine mg 124.28 127.21 Fats g 7.23 7.40 Sodium mg 123.58 126.49 of which: - saturated g 5.76 5.90 INGREDIENTS: Magnesium mg 30.97 31.70 maltodextrin, sucrose. CARBOHYDRATES: Iron mg 4.87 4.98 (36%) Polysaccharides g 38.01 38.90 Zinc mg 3.27 3.35 (22%) Amino acid complex: Disaccharides g 19.25 19.70 Manganese mg 1.03 1.05 (L-leucine, L-ornithine, L-aspartate, Monosaccharides g 16.30 16.70 Copper μg 360.02 368.50 L-isoleucine, L-valine, L-lysine acetate, L- Molybdenum μg 41.73 42.71 arginine base, L-serine, PROTEINS: Di and oligopeptides g 3.25 3.33 Iodine μg 30.03 30.74 (20%) L-alanine, L-proline, L-threonine, L-leucine g 1.58 1.62 Fluorine μg 12.24 12.52 L-glutamic acid, L-glycine, L-isoleucine g 1.49 1.52 Selenium μg 10.41 10.65 L-histidine base, L-methionine, L-valine g 1.41 1.44 Chromium μg 5.27 5.39 L-phenylalanine, L-cysteine, L-ornithine L-aspartate g 1.19 1.22 L-tryptophan) L-lysine acetate g 1.15 1.18 VITAMINS Dextrose, fructose, medium-chain Vitamin C mg 26.55 27.17 (45%) L-arginine base g 0.91 0.93 Vitamin B3 (Niacin) mg 5.32 5.45 (30%) triglycerides (MCT), lactalbumin L-serine g 0.51 0.52 Vitamin E mg 3.98 4.07 (41%) hydrolysate, vegetable oil. L-alanine g 0.39 0.40 Pantothenic acid mg 2.31 2.36 (39%) Mineral complex: L-threonine g 0.22 0.23 Vitamin B6 mg 0.53 0.54 (27%) (potassium citrate, calcium phosphate, L-proline g 0.22 0.23 Vitamin B2 mg 0.48 0.49 (31%) calcium citrate, sodium citrate, potassium L-glutamic acid g 0.18 0.18 Vitamin B1 mg 0.41 0.42 (30%) chloride, magnesium carbonate, zinc Glycine g 0.13 0.13 Vitamin A μg 229.98 235.39 (29%) sulfate, copper gluconate, manganese L-histidine base g 0.11 0.11 Vitamin B9 (Folic acid) μg 105.98 108.48 (54%) L-methionine g 0.09 0.09 Vitamin K1 μg 25.26 25.85 sulfate, potassium iodide). L-phenylalanine g 0.05 0.05 Vanilla scent. Biotin μg 10.60 10.85 L-cysteine g 0.03 0.03 Vitamin D3 μg 2.10 2.15 (43%) Vitamin complex: L-tryptophan g 0.02 0.02 choline citrate, inositol, vitamin C, niacin, Vitamin B12 μg 0.97 0.99 (99%) Choline citratre mg 129.62 132.67 vitamin E, pantothenic acid, vitamin B 6 , FATS: Inositol mg 87.49 89.55 vitamin B2 , vitamin B1 , vitamin A, folic Medium-chain triglycerides g 5.52 5.65 acid, biotin, vitamin K1 , vitamin D3 , Essential fatty acids g 1.55 1.59 *RDA: Recommended Dietary Allowances vitamin B12 ). Soy lecithin g 0.03 0.03 799 mOsm/l in 1 Kcal/ml solution Soy lecithin and E-102 food colour. product manufactured in Spain HEPATOTENEX

HEPATOTENEX AND HEPATIC FUNCTION, INFORMATIVE SUMMARY Comment: These notes are intended to give a basic information of the product and the approach to its use.

HEPATOTENEX, a specific diet for liver failure or liver failure.

LIVER FUNCTION The liver performs four specific functions. 1. Synthesis, that is, formation of the elements or compounds for metabolism, such as proteins, antibodies, coagulation factors, etc ... 2. Cell lysis or dissociation, fragments molecules derived from the functioning or activity of metabolism. 3. Ionic balance, together with the kidney maintain the adequate levels of ions, necessary for cellular activity. 4. Detoxification, deriving or eliminating by intestinal route all the waste or unnecessary substances of the organism that are not soluble in water, since these will be discarded by the urine from the kidneys. In summary, if this organ fails below about 20%, the patient enters a clinical picture of various consequences, such as deficit or loss of essential elements for a quality of life and survival. The patient will lose muscle mass and vitality, in turn will increase the ease of bleeding, infections, dehydration and toxic state, among other things.

HEPATIC FAILURE We could list more than 50 different causes, statistically alcohol and hepatitis C are the most cirrhosis produce, but as acute symptoms are also all toxicities (food, pharmacological, professional, etc ...), so the field of applications of HEPATOTENEX is not only in the hepatology or in the digestive, it extends to oncology, geriatrics, etc ... If the liver fails almost in its entirety there is no substitute therapy, only the transplant works. During these stages of insufficiency, the patient must be provided with the elements that he himself can not form through adequate nutrition, depending on their low levels, detected by laboratory analysis, such as albumin, amino acids, minerals, vitamins, etc …

THERAPY AND / OR SUBSTITUTE DIET If the patient presents a picture of infection, an antibiogram will be done and the appropriate drugs will be given. If you have a hemorrhage, you will be transfused or infused with platelet factors. Albumin is also a plasma element, which below some level is necessary to replenish. In short terms, to each element or lack, it is administered, but this pathological level is not necessary to recommend or administer supplementary diet, since through it and a minimum of liver function, the patient will have its own resources to generate them and wait for the evolution of the acute picture. HEPATOTENEX is a complete diet that provides the necessary amino acids and in adequate proportion for each intake, as needed, in addition to vitamins, minerals, trace elements and carbohydrates. The amount of each dose is determined by the doctor, being this in proportion to their level of deficiency, weight or body mass.

CONTINUED NEED FOR HEPATOTENEX In circumstances where the liver failure is mild but chronic, caused by residual cirrhosis of diverse causes, (chronic alcoholism, continued treatments for drugs, acute phases in hepatitis C, age, etc ...), the use of a diet that complements liver function is recommended. Its function consists of complementing and replacing the nutritional intake.

FUNCTION OF A DIET LIKE HEPATOTENEX The liver through the blood circulation takes the proteins from the intestine and partly transforms them into amino acids, retains vitamins, minerals, etc ..., i.e all substances that will then transfer back into circulation, so that it spreads throughout the organism. Inside each sachet of HEPATOTENEX are the base elements already formed, the liver does not have to manufacture them and these go directly to the cells and tissues, but being a dose to maintain an adequate amount, it is necessary to schedule intakes or sachets per day, like any drug, thus ensuring the level of nutrients per day. It provides 100% of the PRODUCTOS SANITARIOS Y DIETÉTICOS farma, S.l. recommended daily Garbí, 43 - 08370 Pineda de Mar Tel. 937 625 981 - Fax 937 621 091 intake of vitamins. www.wallax.es - [email protected]

DIETARY SUPPLEMENT

Box with 40 capsules of 500 mg 157847.1 Vitamine K and lactose free can be simultaneous with anticoagulants

MULTIVITAMIN MULTIMINERAL Capsules DOSE: 1 capsule per day Rich in PRODUCTOS SANITARIOS Y DIETÉTICOS farma, S.l. Garbí, 43 - 08370 Pineda de Mar Tel. 937 625 981 - Fax 937 621 091 VITAMINS AND MINERALS www.wallax.es - [email protected]

NUTRITIONAL INFORMATION: Average analysis per 100 g Energetic value 209.8 Kcal/876.96 kJ Carbohydrates 41.0 mg It provides 100% of the Proteins 11.0 mg Lipids 0.2 mg recommended daily

COMPOSITION PER CAPSULE: intake of vitamins. MINERALS % RDA* Calcium 37.0 mg Phosphorus 37.0 mg Potassium 21.0 mg Magnesium 13.0 mg Zinc 7.5 mg (50%) Iron 7.0 mg (50%) The recommended daily dose should Manganese 1.0 mg Copper 500.0 μg not be exceeded. Iodine 75.0 μg (50%) Selenium 18.0 μg INGREDIENTS: Molybdenum 10.0 μg Calcium phosphate, gelatin capsule, vitamin C, Chromium 10.0 μg ferrous gluconate, magnesium carbonate, potassium phosphate, vitamin E, zinc sulfate, VITAMINS niacin, maltodextrin, glazing agent, Vitamin C 60,00 mg (100%) magnesium stearate, calcium pantothenate, Vitamin B3 (Niacin) 18.00 mg (100%) vitamin A, manganese sulfate, vitamin B , Vitamin E 10.00 mg (100%) 6 vitamin D3 , copper sulfate, vitamin B2 , Pantothenic acid 6.00 mg (100%) vitamin B1 , folic acid, biotin, potassium iodide, Vitamin B6 2.00 mg (100%) chromium chloride, sodium selenite, sodium Vitamin B2 1.60 mg (100%) molybdate, vitamin B12. Vitamin B1 1.40 mg (100%) Vitamin A 800.00 μg (100%) Folic acid 200.00 μg (100%) Biotin 150.00 μg (100%) Vitamine K and lactose free. Vitamin D 5.00 μg (100%) can be simultaneous with anticoagulants Vitamin B12 1.00 μg (100%)

* %RDA: Recommended Dietary Allowances It can contain soy Product manufactured in Spain NefroNutril R DIETARY FOOD FOR SPECIAL MEDICAL USES

FINANCIADO SNS

box with 6 sachets of 91 g

BISCUIT FLAVOR

C.N. 371385.6

COFFEE FLAVOR

C.N. 371393.1 PRODUCTOS SANITARIOS Y DIETÉTICOS farma, S.l.

It has little protein, it is indicated at the beginning of the disease, in pre-dialysis or the beginning of dialysis. It is so because when the patient is in an advanced dialysis with great loss of nutrients, the nephrologist prefers administering more protein though they damage the kidney. 2,316 Kcal (8.4 g of nitrogen)

Basic enteral diet for patients with chronic or acute kidney failure NefroNutril R DIETARY FOOD FOR SPECIAL MEDICAL USES BALANCED FORMULA FOR ENTERAL HOME NUTRITION SPECIAL FOR DIETARY TREATMENT IN PATIENTS WITH MALNUTRITION-RELATED PROBLEMS.

FINANCIADO ELEMENTAL DIET FOR KIDNEY PATIENTS 2,316 Kcal (8.4 g of nitrogen) 6 sachets with 91 g of net content SNS

* MONO- DI- AND POLYSACCHARIDES. * ESSENTIAL BALANCED AMINO ACIDS C.N. 371385.6 BISCUIT WITH THE APPROPRIATE C.N. 371393.1 COFFEE OLIGOPEPTIDES RATIO. FLAVORS * ESSENTIAL FATTY ACIDS. NUTRITIONAL INFORMATION: PER SACHET PER 100 g Energetic value Kcal/kJ 384/1,622 422/1,783 * VITAMINS. Carbohydrates g 71.32 78.38 of which: - sugars g 37.04 40.70 * A QUICK FULL ABSORPTION OF THE Proteins g 8.83 9.70 GrasaFats g 7.02 7.71 COMPOUNDS IS ACHIEVED IN A SHORT of which: - saturated g 5.75 6.32 Sodium g 0.12 0.13 GUT TRACT SECTION. THE DIGESTION Dietary ﬁbre g <0.05 <0.05

IS INDEPENDENT OF DIGESTIVE PROTEINS: Di- and oligopeptides g 4.88 5.36 ENZYMES. L-valine g 1.21 1.33 L-leucine g 0.81 0.89 * MINIMUM OR RESIDUE-FREE FOOD. L-methionine g 0.81 0.89 L-lysine HCI g 0.73 0.80 L-tyrosine g 0.67 0.74 * IT IS SUITABLE FOR ALL PATIENTS L-phenylalanine g 0.63 0.69 L-threonine g 0.58 0.64 WITH ACUTE OR CHRONIC KIDNEY L-isoleucine g 0.54 0.59 L-histine g 0.40 0.44 FAILURE. L-tryptophan g 0.22 0.25

FATS: Medium chain triglycerides g 5.43 5.97 Essential fatty acids g 1.59 1.75 INGREDIENTS: Dosage: sugar, maltodextrin, Nefronutril amino 6 sachets constitute a daily MINERALS 100 g sachet acids complex (L-valine, L-leucine, L- diet if it is taken as the only Potassium mg 340.00 309.40 methionine, L-lysine L-tyrosine, L- source of nutrition. Calcium mg 147.70 134.41 phenylalanine, L-threonine, L-isoleucine, When abnormal metabolic Sodium mg 130.00 118.30 Chloride mg 130.00 118.30 L-histidine, L-tryptophan) medium-chain activity is demonstrated, it triglycerides (MCT), hydrolyzed milk- Phosphorus mg 130.00 118.30 must be considered in each Magnesium mg 33.00 30.03 serum protein, sunflower oil, mineral Iron mg 2.10 1.92 complex (potassium citrate,calcium case if it is necessary to Zinc mg 2.10 1.92 phosphate, potassium chloride, sodium increase the amount of Manganese mg 0.20 0.19 dairyproduct intake. Fluorine mg 0.20 0.19 phosphate, sodium citrate, calcium Copper μg 255.00 232.05 citrate, magnesium carbonate, ferrous Iodine μg 29.00 26.39 sulfate, zinc sulfate, manganese sulfate, ESSENTIAL AMINO Molybdenum μg 14.80 13.44 copper sulfate, sodium fluoride, Selenium μg 10.60 9.60 ACIDS PER DIET Chromium μg 5.30 4.80 chromium chloride, sodium molybdate, potassium iodide and sodium selenite), L-Valine 7.206 g VITAMINS coffee or biscuit scent, vitamin complex, L-Leucine 4.812 g Vitamin C mg 92.84 84.48 L-Methionine 4.812 g Vitamin B3 (Niacin) mg-EN 12.66 11.52 (L- ascorbic, calcium D-pantothenate, L-Tyrosine 4.002 g Pantothenic acid mg 4.22 3.84 nicotinamide, DI-alpha-tocopheryl L-Phenylalanine 3.736 g Vitamin E mg-ET 3.17 2.88 acetate, pyridoxine hydrocloride, Vitamin B12 μg 2.95 2.69 L-Lysine HCI 3.468 g Vitamin B mg 2.11 1.92 riboflavin, thiamin hydrocloride, retinyl 1 L-Threonine 3.468 g Vitamin B2 mg 2.11 1.92 acetate, pteroilnomoglutamic acid, L-Isoleucine 3.204 g Vitamin B6 mg 2.11 1.92 cholecalciferol, phylloquinone, Vitamin B9 (Folic acid) μg 211.00 192.01 cyanocobalamin, D-biotin), emulsifier: Vitamin A μg-ER 147.70 134.41 L-Histidine 2.400 g Vitamin K μg 14.77 13.44 soy lecithin and food colour (E-102). L-Tryptophan 1.332 g Biotin μg 3.23 2.93 Vitamin D μg 2.11 1.92

Osmolarity: 590 mOsm/l. This diet can be used as the main nitrogen source to maximize urea recycling. If it used as a complement This is a hypertonic diet if it is prepared according to the instructions given. it adds essential amino acids, hystidine, tyrosine Therefore subsequent dilutions may be requiered in some patients in order and calories to other diets, without increasing to avoid diarrhoea episodes. significantly the electolytes intake. It is necessary to arrange periodic blood test to detect K, P and Mg When the patient responds to this special diet, deﬁciencies. which is electrolyte-free, it can be necessary to give The serum bicarbonate or its CO2 content must be controlled frequently. extra electrolytes supplements in order to avoid hypophosphatemia and hypopotassemia. These side It allows to check the absence of a primary metabolic acidosis. effects are frequently detected when this treatment If tap water is used to prepare this food, you must consider that a signiﬁcant is followed. amount of electrolytes can be added in the process. NEFRONUTRIL

Coffee and biscuit flavors (6 sachets of 91 g)

NEFRONUTRIL INFORMATION

Food supplement for kidney patients. Patients with kidney problems can not take too many proteins, that's why our product which has few proteins, is indicated at the beginning of the disease in pre-dialysis or at the beginning of dialysis, because when the patient is in an advanced dialysis with great loss of nutrients, the nephrologist is interested in administering more proteins although they damage the kidney.

Therefore NEFRONUTRIL must be promoted in pre-dialysis or at the beginning of the dialysis, with our great advantage we have: the TASTE.

Clinicians comment that the fact that it contains little sodium is relevant at the level of hypertension, where there is no malnutrition. The group that has malnutrition is the one that is in therapy substitution and especially in dialysis, where what they are concerned is about phosphorus, since the level of sodium is controlled by the technique. To avoid osmolarity excess it is always advisable to start with a lower dose and go increasing the amount.

For example: - Half sachet (175 ml) on the first day. - Two half sachets (175 ml) on the second day and third day (morning and afternoon) if you like you can store the product in the fridge. - One full sachet (350 ml) on the fourth and fifth days.

Subsequently maintain the doses at the decision of the physician. You can stored this product 12 hours in the refrigerator.

Note. Due to this product contains sugars, you should be very careful with patients with diabetics. R A complete balanced, low residue TENEX and gluten and lactose-free diet. Dietary food for special medical uses Each bottle of NUTTENEX 250 ml provides: 250 Kcal 10 g fats 30 g carbohydrates 200 g water 370 mOsm/litre 10 g milk proteins

very PRODUCTOS SANITARIOS Y DIETÉTICOS farma, S.l. nice ﬂavor ﬂavors:

Chocolate Strawberry Vanilla

FINANCIADO SNS

C.N.504157.5 C.N.502088.4 C.N.502062.4 CHOCOLATE STRAWBERRY VANILLA This product can be taken as the only Presentation in source of food or as a bottles of: nutritional supplement. 250 ml x 24

GLASS CONTAINER DOES NOT CONTAIN BISPHENOL-A IMPORTANT WARNING: This food must be used under medical supervision. Do not give this product to children under 12 years old. Product made in Spain FLAVORS: NEUTRAL, VANILLA, BANANA, STRAWBERRY, CHOCOLATE AND CAPPUCCINO. INGREDIENTS: water, maltodextrin, sucrose, lactalbumin, medium-chain triglycerides (MCT), vegetable oil, sodium caseinate, calcium caseinate. MINERAL SALTS: sodium citrate, potassium phosphate, magnesium chloride, calcium chloride, potassium citrate, ferrous lactate, zinc sulfate, manganese sulfate, copper gluconate, sodium molybdate, potassium iodide, sodium ﬂuoride, chromium chloride, sodium selenite. EMULSIFIERS: E472 and soy lecithin. POLYVITAMIN CONCENTRATE: choline citrate, inositol, vitamin C, niacin, vitamin E, pantothenic acid, vitamin B1, vitamin B2, vitamin B6, vitamin A, folic acid, biotin, vitamin K1, vitamin D3, vitamin B12. carrageenan (E-407), strawberry ﬂavour, food colour (E-120). SWEETENERS: sodium cyclamate (E-952), sodium saccharin (E-954).

NUTRITIONAL INFORMATION: in 100 ml in 250 ml (% RDA) Energetic value Kcal/kJ 100/420 250/1050 It is not suitable for Carbohydrates g 12.0 30.0 galactosaemic of which: - sugars g 5.2 13.2 Proteins g 4.1 10.2 or diabetics. Fats g 4.0 10.0 of which: - saturated g 2.7 6.7 MINERALS Administer Chlorine mg 113.00 282.50 orally or via Potassium mg 102.90 257.20 tube feeding. Sodium mg 100.00 250.00 Calcium mg 59.20 148.00 (19%) Unsuitable for Phosphorus mg 40.80 102.10 galactosemic Magnesium mg 18.00 45.00 (15%) Iron mg 1.20 3.00 (22%) or diabetic Zinc mg 0.80 2.00 patients. Manganese mg 0.20 0.60 Cooper μg 89.90 224.90 Unsuitable for Molybdenum μg 10.00 25.00 parenteral Iodine μg 7.40 18.40 administration. Fluorine μg 3.00 7.50 Selenium μg 2.60 6.50 Chromium μg 1.30 3.10 DOSE: as the only source VITAMINS of food administer Vitamin C mg 6.00 15.00 (25%) approximately Vitamin B3 (Niacin) mg 1.80 4.50 (25%) Vitamin E mg 1.00 2.50 (25%) in adults: Pantothenic Acid mg 0.60 1.50 (25%) 30 ml/Kg of body Vitamin B6 mg 0.20 0.50 (25%) weight per day. Vitamin B2 mg 0.20 0.40 (25%) Vitamin B1 mg 0.10 0.20 (25%) Vitamin A μg 80.00 200.00 (25%) Vitamin B9 (Folic acid) μg 20.00 50.00 (25%) Biotin μg 7.50 18.70 PRESENTATION: Vitamin K1 μg 5.50 13.75 Each box contains: Vitamin D3 μg 0.50 1.20 (25%) 24 x 250 ml bottle Vitamin B12 μg 0.10 0.20 (25%) Inositol mg 20.00 50.00 Choline citrate mg 20.00 50.00 RDA: Recommended Dietary Allowances 370 mOsm/l Preferably formulated for: elderly people because the wearing out and degeneration of their digestive tract cause a lower benefit of their diet, the consequences of which are very adverse for their body. Obese people: it contributes in hypocaloric diets. Anorectics, convalescents: For a faster recovery. Difficulty swallowing or mastication, insufficient food intake, gastrointestinal tract surgery, gastric resections, diverticulitis, colostomy, inflammatory bowel diseases treatment (Chron's and ulcerative colitis). Orthopedic surgery: For a faster recovery after a prosthesis replacement. Competitive sport: Rehydration after exercise. Cancer treatments, sports nutrition and extreme underweight children and adults. R DIETARY FOOD FOR SPECIAL MEDICAL USES TENEX WITH SUGARS AND SWEETENERS HIPER For dietary treatment of patients with PROTEICA disorders associated to malnutrition It is not suitable for parenteral nutrition

PRODUCTOS SANITARIOS Y DIETÉTICOS farma, S.l.

FINANCIADO FINANCIADO FINANCIADO SNS SNS SNS

VANILLA STRAWBERRY CHOCOLATE 250 ml 250 ml 250 ml C.N.504155.1 C.N.504426.2 C.N.504430.9

STERILIZED PRODUCT MPORTANT WARNING: his food must be PRESENTATION: boxes with 24 bottles of 250 ml. used under medical supervision. If there is glucose tolerance impairment, it is INSTRUCTIONS FOR USE: shake briskly before opening. necessary a strict metabolic control. Administer at room temperature. This drug should not be given together with DOSE: as the only source of food, in adults administer antacid drugs. approximately 30 ml / kg of body weight per day. This product is suitable for being taken as the only source of food. VIA TUBE FEEDING: follow your doctor's instructions. The Administer orally or via feeding tube. ﬂow, volume and dilution depend on the patient's tolerance Do not give this product to breast-fed babies and and conditions. children under 12 years old. It is not suitable for diabetic and galactosemic HOW TO STORE: Store in a cool, dry place, away from heat patients. and light. Once opened, store it in the fridge for 24 hours maximum. Product made in Spain R DIETARY FOOD FOR SPECIAL MEDICAL USES TENEX WITH SUGARS AND SWEETENERS HIPER It is for the dietetic treatment in patients with PROTEICA pathologies related to malnutrition disorders.

For the dietary management of patients with diseases related to malnutrition and have some increased protein requirements. In surgery, pressure ulcers, trauma, oncology, etc. INGREDIENTS: water, maltodextrin, sugar, milk serum proteins, medium-chain triglycerides (MCT), vegetable oil. MINERAL SALTS: sodium citrate, potassium phosphate, magnesium chloride, calcium chloride, potassium citrate, ferrous lactate, zinc sulfate, manganese sulfate, copper gluconate, sodium molybdate, potassium iodide, sodium fluoride, chromium chloride, sodium selenite. EMULSIFIERS: E-472c, soy lecithin, choline citrate, inositol. VITAMIN COMPLEX: L- ascorbic, nicotinamide, DL-alpha-tocopheryl acetate, calcium pantothenate, thiamin hydrochloride, riboflavin, pyridoxine hydrochloride, retinyl acetate, pteroilmonoglutamic acid, D-biotin, phylloquinone, cholecalciferol, cyanocobalamin, vanilla scent. STABILIZERS: carrageenan, xanthan gum. SWEETENERS: sodium cyclamate, sodium saccharin, food colorant E-102. NUTRITIONAL INFORMATION: in 100 ml in 250 ml Energetic value Kcal/kJ 108/455 271/1.137 Carbohydrates g 12.00 30.00 of which: - sugars g 5.20 13.00 Proteins g 6.00 15.00 Fats g 4.00 10.00 of which: - saturated g 2.70 6.75 Dietary fiber g 0.10 0.25

MINERALS RDA Chlorine mg 113.00 282.50 Potassium mg 102.90 257.25 Sodium mg 100.00 250.00 Calcium mg 60.80 152.00 (19%) Phosphorus mg 41.60 104.00 (13%) Magnesium mg 18.00 45.00 (15%) Iron mg 1.20 3.00 (22%) Zinc mg 0.80 2.00 (13%) Manganese mg 0.20 0.50 Copper μg 89.90 224.75 Molybdenum μg 10.00 25.00 Iodine μg 7.80 19.50 (13%) Fluorine μg 3.00 7.50 Selenium μg 2.70 6.75 Chromium μg 1.35 3.38

VITAMINS Vitamin C mg 6.00 15.00 (25%) Vitamin B3 (Niacin) mg 1.80 4.50 (25%) Vitamin E mg 1.00 2.50 (25%) Pantothenic acid mg 0.60 1.50 (25%) Vitamin B6 mg 0.20 0.50 (25%) Vitamin B2 mg 0.16 0.40 (25%) Vitamin B1 mg 0.14 0.35 (25%) Vitamin A μg 80.00 200.00 (25%) Vitamin B9 (Folic acid) μg 20.00 50.00 (25%) Biotin μg 7.50 18.75 (13%) Vitamin K1 μg 5.50 13.75 Vitamin D3 μg 0.54 1.35 (30%) Vitamin B12 μg 0.10 0.25 (25%) *RDA (Recommended Dietary Allowances) OSMOLARITY: 424 mOsm/l R DIETARY FOOD FOR SPECIAL MEDICAL USES TENEX WITH SUGARS AND SWEETENERS HIPER For dietary treatment of patients with PROTEICA disorders associated to malnutrition It is not suitable for parenteral nutrition PRODUCTOS SANITARIOS Y DIETÉTICOS farma, S.l.

FINANCIADO FINANCIADO FINANCIADO SNS SNS SNS

VANILLA STRAWBERRY CHOCOLATE 250 ml 250 ml 250 ml C.N.504155.1 C.N.504426.2 C.N.504430.9 STERILIZED PRODUCT IMPORTANT WARNING: This food must be used PRESENTATION: boxes with 24 bottles of 250 ml. under medical supervision. If there is glucose tolerance impairment, it is necessary a strict metabolic control. This drug should not be given together with antacid NutTenex hiperprotéica MULTI FLAVOR drugs. This product is suitable for being taken as the only (8 bottles of each ﬂavor) C.N.504871.0 source of food. Administer orally or via feeding tube. Do not give this product to breast-fed babies and children under 12 years old. It is not suitable for diabetic and galactosemic patients. FINANCIADO

INSTRUCTIONS FOR USE: shake briskly before SNS opening. Administer at room temperature. DOSE: as the only source of food, in adults administer approximately 30 ml / kg of body weight per day.

VIA TUBE FEEDING: follow your doctor's instructions. The ﬂow, volume and dilution depend on the patient's tolerance and conditions.

HOW TO STORE: Store in a cool, dry place, away from heat and light. Once opened, store it in the fridge for 24 hours maximum. CHOCOLATE STRAWBERRY VANILLA Product manufactured in Spain R For patients who are being treated with radiation therapy and PEPTENEX chemotherapy, who often reject lactic diets (smoothies, yoghurt, etc.), but have a good tolerance to It is a FINANCIADO presentations made of pineapple complete and orange. FINANCIADO SNS balanced diet, synthetic, hydrolysed Flavors: orange and NEW and nitrogen- pineapple enriched. MONO-, DI- AND POLYSACCHARIDES, R OLIGOPEPTIDES, PEP TENEX MINERALS SALTS, MEDIUM-CHAIN TRIGLYCERIDES AND 87 ESSENTIAL FATTY ACIDS, VITAMINS AND OLIGOELEMENTS. A QUICK FULL ABSORPTION OF THE COMPOUNDS IS ACHIEVED IN A SHORT GUT TRACT SECTION. THE DIGESTION IS INDEPENDENT OF DIGESTIVE ENZYMES. C.N. 504244.2 C.N. 504245.9 MINIMUM OR RESIDUE- FREE. IT IS SUITABLE FOR PATIENTS AFFECTED BY HYPERCATABOLISM box with 10 sachets Dietary food for PROTEIN. of 87 g special medical uses, with sugar and sweeteners. PRODUCTOS SANITARIOS Y DIETÉTICOS farma, S.l. special for HYPERCATABOLICS PEPTID DIET INGREDIENTS: Hydrolyzed milk-serum proteins, Instruction for use: maltodextrin, sugar, medium-chain triglycerides It is appropriate for the dietetic treatment of patients with manutrition- (MCT), sunflower oil, pineapple or orange scent, related symptoms, pre and post operations, gastrointestinal surgery, X- acidity regulator: citric acid, L-lysine hydrochloride, ray exams of the digestive tract, radiation and cytostatic therapies. As well in the transition from parenteral to enteral nutrition, digestive mineral complex, (potassium citrate, sodium system fistulas and certain hypermetabolic conditions such as phosphate, calcium citrate, sodium chloride, traumatisms, serious burns, multiple fractures and sepsis, maldigestion magnesium carbonate, ferrous sulfate, zinc sulfate, and malabsorption, short bowel syndrome and inflammatory bowel manganese sulfate, copper sulfate, sodium fluoride, diseases including Crohn's disease and pancreatic insufficiency. chromium chloride, sodium molybdate, potassium iodide, sodium selenite) L-cystine, vitamin complex Dose: (L-ascorbic, DL-alpha-tocopheryl acetate, 6 daily sachets must be given in case of being used as the only nutrition source. At this dosage, nutritional deficiencies have not been nicotinamide, retinyl acetate, calcium D-pantothenate, detected, even for long term dietetic treatments. 6 sachets provide cholecalciferol, pyridoxine hydrochloride, 2,300 kcal and 15 g of high biological value of nitrogen. riboflavin,thiammin hydrochloride, pteroilmonoglutamic Therefore, it covers the daily adult nutrition requirements. acid,D-biotin, phylloquinone, cyanocobalamin), For the total dose, the hypercatabolic states must be taken into emulsifier:soy lecithin, sweeteners: sodium cyclamate account. andsodium saccharin, food colour (E-102).

PEP TENEX R NUTRITIONAL INFORMATION Per 100 g Per sachet Energetic value Kcal/kJ 438/1.840 381/1.601 Carbohydrates g 50.57 44.00 PRODUCTOS SANITARIOS Y DIETÉTICOS farma, S.l. 87 Of which: - sugars g 26.00 22.62 Proteins g 23.23 20.21 Fats g 15.90 13.83 Of which: - saturated g 13.00 11.31 Dietary ﬁber g 0.00 0.00 MODO DE USO: CARBOHYDRATES El contenido de un sobre Disaccharides g 26.21 22.80 debe disolverse en 375-425 Polysaccharides g 24.11 20.98 Monosaccharides g 0.25 0.22 ml de agua, agitando hasta PROTEINS conseguir una perfecta Di and oligopeptides g 21.64 18.83 homogeneización. L-lysine HCI g 1.35 1.17 L-cystine g 0.41 0.36 Se administrará FATS preferentemente por sonda y Medium chain triglycerides g 11.92 10.37 a ritmo continuo, también Essential fatty acids g 3.73 3.25 Soy lecithin g 0.08 0.07 podrá ingerirse por vía oral. Si el paciente experimenta PER PER MINERALS 100 g R.D.A. sobre R.D.A. sed, deberá completarse el Potassium mg 524.30 456.14 tratamiento con agua. Sodium mg 507.50 441.53 Una vez disuelto debe Phosphorus mg 266.62 (33%) 231.96 (29%) Calcium mg 243.46 (30%) 211.81 (26%) consumirse en el acto. Chloride mg 230.40 200.45 Consérvese en lugar fresco y Magnesium mg 87.55 (29%) 76.17 (25%) Zinc mg 3.35 (22%) 2.91 (19%) seco. Iron mg 3.08 (21%) 2.68 (18%) Manganese mg 0.90 0.78 Copper μg 340.00 300.00 Aviso importante: Fluoride mg 0.22 0.19 Este alimento debe ser Iodide μg 35.00 (23%) 30.45 (20%) Chrome μg 21.80 18.97 utilizado bajo supervisión Molybdenum μg 21.80 18.97 médica. Selenium μg 11.50 10.00 Este producto es adecuado VITAMINS para ser consumido como Vitamin C mg 24.00 (40%) 20.88 (35%) Vitamin E mg-αET 5.25 (52%) 4.57 (45%) única fuente de alimento. Vitamin B3 (Niacin) mg-EN 4.80 (27%) 4.18 (23%) Administrar por sonda o vía Pantothenic acid mg 0.90 0.78 oral. Vitamin B6 mg 0.48 (24%) 0.42 (21%) Vitamin B2 mg 0.43 (27%) 0.37 (23%) No administrar a lactantes ni Vitamin B1 mg 0.36 (26%) 0.31 (22%) Vitamin A μg-ER 360.00 (45%) 313.20 (39%) a niños menores de 3 años. Vitamin B9 (Folic acid) μg 96.55 (48%) 84.00 (42%) No apto para diabéticos, ni Biotin μg 30.00 (20%) 26.10 (17%) Vitamin K μg 28.74 25.00 para personas intolerantes a Vitamin D μg 2.50 (50%) 2.18 (44%) la leche y a la soja. Vitamin B12 μg 1.15 (115%) 1.00 (100%)

*C.D.R. (cantidad diaria recomendada) Osmolaridad: 550 mOsm/l Special product for dietary Protein concentrate services and hospital It recovers, keeps and increases pharmacy. COMPOSITION PER 100 g the body protein content Casein 50.00 g Lactalbumin 16.13 g Sodium Caseinate 16.13 g Calcium Caseinate 16.13 g FINANCIADO L-cystine 1.10 g Lecithin 0.50 g

SNS AVERAGE ANALYSIS PER 100 g Proteins 90.45 g Nitrogen 14.13 g Lipids 1.70 g Carbohydrates 0.85 g

ELECTROLYTES: Sodium 353.8 mg 15.4 mEq Calcium 288.5 mg 14.4 mEq Phosphorus 160.0 mg Potassium 66.4 mg 1.7 mEq

Humidity 4 g Ashes 3 g

PRODUCTOS SANITARIOS Y DIETÉTICOS farma, S.l.

COMPOSITION PER 2000 g Casein 1.000,0 g Lactalbumin 322,6 g C.N. 371252.1 Sodium Caseinate 322,6 g Proteins: 90.45 g % Calcium Caseinate 322,6 g L-cystine 22,0 g Nitrogen: 14.3 g % DOSE: Lecithin 10,0 g

1-2 g/Kg of AVERAGE ANALYSIS PER 2000 g Net weight: 2,000 g Proteins 1.809.0 g weight per day. Nitrogen 282.6 g PROTEIN CONTRIBUTION FOR: Lipids 34.0 g The preparation of enteral nutrition diets. Carbohydrates 17.0 g Add to oral feeding in infusions, soups, purées, desserts, etc. ELECTROLYTES: It recovers the muscular mass integrity in CPR, commas, burned people, Sodium 7.076 mg 308 mEq post operations, crusts and sloughs, cicatrisation, malnutrition, Calcium 5.770 mg 288 mEq undernourishment and convalescences. Phosphorus 3.200 mg Potassium 1.328 mg 34 mEq It is advisable to be administered with pineapple juice because it contains Humidity 80 g an enzyme, the bromulina, which helps metabolize proteins. Ashes 60 g

R It is a nutritional supplement enriched with high biological value proteins, carbohydrates, vitamins and minerals SUPTENEX whichare essential in a balanced diet. PROTEIN, VITAMIN AND MINERAL CONCENTRATE Dietary food for special medical uses. Flavors: Sucrose and gluten free. chocolate and vanilla.

PRODUCTOS SANITARIOS Y DIETÉTICOS farma, S.l. PRESENTATION: Boxes with 15 sachets. C.N. 154858.0 C.N. 154857.3 INGREDIENTS: Maltodextrin, powdered skimmed milk, milk proteins, cocoa defatted powder, NUTRITIONAL INFORMATION: in 100 g in 32 g scent, sodium chloride, emulsifier Energetic value Kcal/kJ 379/1.605 121/514 Carbohydrates g 62.0 20.0 (soy lecithin), mineral complex (iron gluconate, Proteins g 25.0 8.0 zinc gluconate, copper gluconate, manganous Fats g 3.2 1.02 sulfate, sodium fluoride, potassium iodide, Salt g 1.2 0.38 Dietary fiber g 1.0 0.32 sodium molybdate, sodium selenite, chrome chloride), vitamins (L-ascorbic acid, DL-alpha-tocopheryl acetate, nicotinamide, MINERALS Potassium mg 840.00 268.80 retinyl acetate, D-calcium pantothenate, Chloride mg 450.00 144.00 colecalciferol, pyridoxine hydrochloride, Sodium mg 420.00 134.40 riboflavin, thiamine hydrochloride, Calcium mg 400.00 128.00 pteroylmonoglutamic acid, D-biotin, Phosphorus mg 250.00 80.00 phylloquinone, cyanocobalamin), Magnesium mg 75.00 24.00 Iron mg 5.00 1.60 sweeteners (aspartame and acesulfame Zinc mg 4.60 1.47 potassium). Copper µg 840.00 268.80 * With sweeteners. It contains a source of Manganese mg 0.70 0.22 phenylalanine. Fluoride mg 0.30 0.10 * It contains lactose and soy derivatives. Iodide μg 60.00 19.20 Selenium μg 25.00 8.00 Dose: 1 to 3 sachets per day Molybdenum μg 20.00 6.40 depending on the patient's needs. Chrome μg 8.00 2.56 Important warning: VITAMINS This product must be used under medical Vitamin C mg 30.00 9.60 supervision. It is not suitable for being taken Vitamin B3 mg-NE 10.00 3.20 Vitamin E mg-TE 5.50 1.76 as the only source of food. Pantothenic acid mg 3.00 0.96 Administer it orally or via tube feeding. Vitamin B2 mg 1.30 0.42 This product is addressed to youngsters, Vitamin B6 mg 1.00 0.32 adults, and elderly people. Vitamin B1 mg 0.70 0.22 Vitamin A µg-RE 380.00 121.60 It is for the dietetic treatment in situations Folic acid μg 110.00 35.20 that require an extra nutritional contribution. Vitamin K1 μg 30.00 9.60 in high physical activity, when there is lack Biotin μg 15.00 4.80 of appetite, unbalanced or insufficient food, Vitamin D3 μg 2.70 0.86 convalescences, weakness or stress. Vitamin B12 μg 1.70 0.54

Product manufactured in Spain R It is a nutritional supplement enriched with high biological value proteins, carbohydrates, vitamins and minerals SUPTENEX VEGETAL which are essential in a balanced diet. Suitable for diabetics. Flavor: C.N. 166583.6 Vegetables cream PRESENTATION: Boxes with 15 sachets of 32 g PROTEIN, INGREDIENTS: VITAMIN AND Maltodextrin, vegetable protein MINERAL concentrate (peas protein, soy isolated CONCENTRATE protein (29%)), mineral complex (potassium gluconate, calcium chloride, potassium choride, calcium phosphate, sodium chloride, Dietary food for magnesium carbonate, ferrous gluconate, zinc special medical gluconate, copper gluconate, manganese purposes. sulfate, sodium fluoride, potassium iodide, sodium selenite, sodium molybdate, chromiun chloride), carrot flakes (carrot, thickener (pectin), antioxidant (E304), 15 sachets of 32 g flavorings (it contains celery), leek white Sucrose and gluten free. powder, leek green powder, emulsifier (soy lecithin), yeast extract, vitamins NUTRITIONAL INFORMATION: in 100 g in 32 g (cellulose, L-ascorbic, DL-alpha-tocopheryl Energetic value Kcal/kJ 381/1,615 122/517 acetate, nicotinamide, retinyl acetate, Carbohydrates g 63 20 calcium patothenate, cholecalciferol, Proteins g 26 8.3 Fats g 2.6 0.83 pyridoxine hydrochloride, riboflavin, thiamin Salt g 1.75 0.56 hydrochloride, pteroilmonoglutamic acid, Dietary fiber g 0.70 0.22 D-biotin, phylloquinone, cyanocobalamin). MINERALS It contains celery and soy derivatives. Sodium mg 700 224 Potassium mg 650 208 Dose: 1 to 3 sachets per day Calcium mg 420 134 depending on the patient's needs. Phosphorus mg 400 128 Dissolve a sachet into 125 ml hot Chloride mg 150 48 water preferably. Magnesium mg 50 16 Zinc mg 4.1 1.3 Important warning: Iron mg 4.0 1.3 This product must be used under Copper mg 0.55 0.18 medical supervision. It is not suitable for Manganese mg 0.50 0.16 Fluoride mg 0.30 0.10 being taken as the only source of food. Iodide μg 60 19 Administer it orally or via tube feeding. Selenium μg 25 8.0 This product is addressed to youngsters, Molybdenum μg 20.0 6.4 adults and elderly people. Chrome μg 8.0 2.6 It is for the dietetic treatment in situations that require an extra nutritional contribution, VITAMINS Vitamin C mg 30 9.6 or high physical activity, when there is lack of appetite, unbalanced or insufficient food, Vitamin B3 mg-NE 10 3.2 Vitamin E mg-TE 5.5 1.8 convalescence, weakness or stress. Pantothenic acid mg 3.0 0.96 Vitamin B2 mg 1.30 0.42 Vitamin B6 mg 1.0 0.32 Vitamin B1 mg 0.70 0.22 Vitamin A µg-RE 380 122 Folic acid μg 110 35 Vitamin K1 μg 30 9.6 Biotin μg 15 4.8 Vitamin D3 μg 2.7 0.86 PRODUCTOS SANITARIOS Y DIETÉTICOS farma, S. Vitamin B12 μg 1.70 0.54

LACTOSE FREE Product manufactured in Spain MANUFACTURED IN SPAIN

PROTEIN, VITAMIN AND MINERAL CONCENTRATE Dietary food for special medical uses. Sucrose and gluten free.

15 sachets of 32 g Chocolate 154858 Vanilla 154857

PRODUCTOS SANITARIOS Y DIETÉTICOS farma, S.l.

C.N. 166584 CHOCOLATE

C.N. 166586 VANILLA EXCELLENT TASTE Important warning: This product must be used under medical supervision, It is not suitable for being taken as the only source of food. Administer it orally or via tube feeding. This product is addressed to youngsters, adults, and elderly people. It is for the dietetic treatment in situations that require an extra nutritional contribution, in high physical activity, when there is lack of appetite, unbalanced or insufficient food, convalescences, weakness or stress. A balanced formula for home enteral nutrition. It is appropriate INGREDIENTS: maltodextrin, milk proteins (casein, lactalbumin, for the dietetic treatment of sodium caseinate, calcium caseinate), sunflower patients with malnutrition-related oil, L-arginine base, L-glutamine, fish oil (omega 3), symptoms. medium- chain triglycerides (MCT), mineral complex (sodium phosphate, potassium citrate, R calcium phosphate, magnesium carbonate, potassium chloride, ferrous sulfate, zinc sulfate, manganese sulfate, copper sulfate, sodium TENEX selenite, chromium chloride, potassium iodide, sodium fluoride, sodium molybdate), strawberry or uno biscuit scent, choline citrate, inositol, vitamin Dietary food for complex (ascorbic acid, DL-alpha-tocopheryl special medical acetate, nicotinamide, retinyl acetate, calcium D-pantothenate, cholecalciferol, pyridoxine uses, with hydrochloride, riboflavin, thiamin hydrochloride, pteroilmonoglutamic acid, D-biotin, sweeteners phylloquinone,cyanocobalamin), N-acetyl L- cysteine, emulsifier(soy lecithin), sweeteners (sodium cyclamate andsodium saccharin), food colour (*E-124 strawberry),(E-150d biscuit).

Enriched with: L-arginine, L-glutamine Fish oil (rich in EPA and DHA) Ribonucheic acid (yeast RNA) Zinc, Vitamins E and C

NUTRITIONAL INFORMATION: per 100 g sachet 98 g Energetic value Kcal/kJ 423/1,785 415/1,749 Carbohydrates g 61.90 60.66 Of which: - sugars g 2.80 2.74 Proteins g 22.40 21.95 Fats g 9.50 9.31 Of which: - saturated g 2.60 2.55 Salt g 1.00 0.98 Dietary ﬁber g 0.00 0.00 PROTEINS: FINANCIADO Casein g 7.40 7.25 L-arginine g 3.80 3.72 Lactalbumin g 2.30 2.25 Content: Calcium Caseinate g 2.30 2.25 12 sachets Sodium Caseinate g 2.30 2.25 SNS L-glutamine g 1.70 1.67 of N-acetyl L-cysteine g 0.20 0.20

98 g FATS: Essential fatty acids g 5.80 5.68 strawberry and C.N. 504523.8 C.N. 504491.0 Medium-chain triglycerides g 1.70 1.67 Fish oil (omega 3) g 1.60 1.57 biscuit ﬂavor BISCUIT STRAWBERRY Soy lecithin g 0.05 0.05 MINERALS 100 g %RDA sachet %RDA

INSTRUCTIONS FOR USE: Sodium mg 378.80 371.00 If it is used as the only source Potassium mg 340.00 333.20 Phosphorus mg 280.20 (35%) 274.60 (34%) of food, take 6 sachets per day. mg 227.00 (28%) 222.46 (27%) Calcium PRODUCTOS SANITARIOS Y DIETÉTICOS farma, S.l. In case of using it as a Chlorine mg 130.00 127.40 supplement, the dose Magnesium mg 62.90 (21%) 61.64 (21%) Zinc mg 3.20 (21%) 3.14 (21%) It is recommended in cases depends on the other Iron mg 2.80 (21%) 2.74 (21%) nutrients that are being Manganese mg 0.79 0.77 Copper μg 400.00 392.00 of sepsis, aids, cancer, burns taken. Therefore, the average Selenium μg 39.00 38.22 dose that will be Iodine μg 30.00 (23%) 29.40 (23%) and other pathologies that administered is 3 daily Chromium μg 16.90 16.56 Molybdenum μg 16.00 15.68 sachets. Fluorine μg 10.00 9.90 aﬀects the inmune system. To avoid hyperosmolarity complications, the daily diet VITAMINS IMPORTANT WARNING: Vitamin C mg 90.00 (133%) 88.20 (130%) dose must be increased Vitamin E mg-αET 10.00 (100%) 9.80 (98%) mg-EN 6.73 (37%) 6.60 (36%) gradually until reaching the 6 Vitamin B3 (Niacin) This food must be used under Pantothenic acid mg 3.06 (50%) 3.00 (49%) daily sachets on the fourth Vitamin B mg 0.70 (35%) 0.69 (34%) medical supervision. 6 mg or ﬁfth day. Vitamin B2 0.64 (37%) 0.63 (36%) mg 0.54 (36%) 0.53 (35%) Do not give this product to The optimum result of the Vitamin B1 Vitamin A μg-ER 303.47 (38%) 297.40 (37%) breast- fed babies and children diet is achieved taking 6 μg 135.00 (68%) 132.30 (67%) Vitamin B9 (Folic acid) under 12years old. daily sachets. Vitamin K μg 34.39 33.70 Biotin μg 29.00 (17%) 28.42 (17%) Vitamin D μg 2.30 (46%) 2.25 (45%) This product can be taken as a the μg 1.40 (140%) 1.37 (137%) Vitamin B12 only source of food. * RDA = Recommended dietary allowances THE ENTERAL DIET THAT PROTECTS AND STIMULATES THE SYSTEM IMMUNOLOGICAL

UnoTenex® constitutes the specific nutritional support to reinforce the immunological system against different pathologies related to immunosuppression.

The combination of carbohydrates of different chain lengths, among which small amounts of free glucose are included and being mainly chains of medium size, optimizes the rapidity of hydrolysis and consequent rapid absorption intestinal. Thanks to this glucidic calories are obtained without precipitating a remarkable diffusion of water in the intestinal lumen. In turn, the protein material consists exclusively of one mixture of proteins of dairy origin of high biological value. The lipid content of UnoTenex® is rich in omega-3 polyunsaturated fatty acids, which have demonstrated its intervention in the immune system (1), and MCT (Chain Triglycerides Medium) that have the characteristic of absorbing more quickly and not needing the presence of bile for its absorption.

UnoTenex® presents a specific formulation to boost the immune system of the patient:

L-ARGININE reduces catabolism and stimulates lymphocyte activity compared to occurrence of carcinogens as well as in affected patients by trauma and surgical interventions. (1, 2 and 5). The administration of NUCLEOTIDES (RNA) is vital for the maintenance of the immunity, since its lack opens the doors of the organism to the infectious processes (1 and 5).

L-GLUTAMINE is fundamental in protein synthesis. Avoid atrophy of the tract gastrointestinal and increases the defense capacity of the same, avoiding the aggressions exogenous and endogenous bacteria (3 and 4). Both lymphocytes and macrophages use significant amounts of L-Glutamine. It is essential that it be administered in this way and not as glutamic acid.

The administration of NUCLEOTIDES (RNA) is vital for the maintenance of the immunity, since its lack opens the doors of the organism to the infectious processes (1 and 5).

N-ACETYL-L-CISTEINE has antioxidant and hepato-protective activity. Increase the glutathione levels in the immunocompromised patient (6).

VITAMINS C and E have shown a great antioxidant power and, therefore, their ability to reduce the degenerative activity of free radicals in the body (7). Vitamin C also increases the activity of lymphocytes (8).

UnoTenex® is indicated in cases of SEPSIS, AIDS, CANCER, BURNS and other pathologies that affect the immune system. UnoTenex® acts against immunosuppression and against states of malnutrition so typical in patients suffering from this type of disease.

REFERENCES:

1) Daly, J.M. et al.; Enteral nutrition with supplemental arginine, RNA and omega-3 fatty acid in patients after operation: Inmunologic, metabolic and clinical outcome; Surgery (1992) 112:57-67.

2) Barbul, A. et al.; Arginine enhaces wound healing and lymphocyte immune responses in human; Surgery (1990) 108:331-336, discussion 336-337.

3) Ackerson, A.; Nutritional management of intestinal permeability defects; J. of Advancement in Medicine (1997) vol.10 no4.

4) Chun, H. et al.; Effect of enteral glutamine on intestinal permeability and bacterial translocation after abdominal radiation injury in rats; J. Gastroenterol. (1997) 32:189-195. 5) O’Flaherty, L. et al.; Immunonutrition and surgical practice; Proceedings of the Nut. Soc. (1999) 58:831- 837

6) Vargas, O. et al.; N-Acetylcisteine decreases lactate signal intensities in liver tissue and improves liver function in septic shock patients, as shown by magnetic resonance spectroscopy: extended case report; Critical Care (2004) 8:R66-R71.

7) Zandi, P.P. et al.; Reduced Risk of Alzheimer Disease in Users of Antioxidant Vitamin Supplements; Arch. Neurol. (2004) 61(1):82-88.

8) Lenton, K.J. et al.; Vitamin C augments lymphocyte glutathione in subjects with ascorbate deficiency; Am. J. Clin. Nutr. (2003) 87:189-195. DIETARY FOOD FOR SPECIAL MEDICAL PURPOSES PRODUCTOS SANITARIOS Y DIETÉTICOS farma, S.l.

EXCELLENT TASTE R IT IS NOT SUITABLE IN ALL FOR PARENTERAL USE PRESENTATIONS NUT TENEX SIX - 6 BOTTLES OF 250 ml Complete diet, balanced, without gluten and of low residue.

Chocolate Strawberry Vanilla Product manufactured in Spain

DIETARY FOOD FOR SPECIAL

R MEDICAL PURPOSES PRODUCTOS SANITARIOS Y DIETÉTICOS farma, S.l. FIB SUITABLE FOR DIABETICS EXCELLENT TASTE especial IT IS NOT SUITABLE IN ALL FOR PARENTERAL USE PRESENTATIONS FIBRA FIB TENEX SIX - 6 BOTTLES OF 250 ml Complete diet, balanced, without gluten and of low residue.

Chocolate Vanilla Product manufactured in Spain

DIETARY FOOD FOR SPECIAL MEDICAL PURPOSES PRODUCTOS SANITARIOS Y DIETÉTICOS farma, S.l.

R EXCELLENT TASTE IT IS NOT SUITABLE IN ALL FOR PARENTERAL USE PRESENTATIONS HIPERPROTÉICA HIPERPROTÉICA SIX - 6 BOTTLES OF 250 ml Complete diet, balanced, without gluten and of low residue.

Chocolate Strawberry Vanilla Product manufactured in Spain Ingredients: Water, maltodextrin, saccharose, whey proteins, medium chain Minerals 100 ml 250 ml Vitamins 100 ml 250 ml triglycerides (MCT), vegetable oil, sodium caseinate, calcium caseinate, Chloride mg 113.00 282.50 Vitamin C mg 6.00 15.00 mineral complex (sodium citrate, potassium phosphate, magnesium chloride, Potassium mg 102.87 257.18 Vitamin B3 mg-NE 1.80 4.50 calcium chloride, potassium citrate, ferrous lactate, zinc sulfate, manganese Sodium mg 100.00 250.00 Vitamin E mg α-TE 1.00 2.50 sulphate, cupric gluconate, sodium molybdate, potassium iodide, sodium Calcium mg 59.20 148.00 Pantothenic acid mg 0.60 1.50 fluoride, chrome chloride and sodium selenite), emulsifiers (E-472c and soy Phosphorus mg 40.80 102.00 Vitamin B6 mg 0.20 0.50 lecithin), choline citrate, Inositol, vitamin complex (L-ascorbic acid, Magnesium mg 18.00 45.00 Vitamin B2 mg 0.16 0.40 DL-alpha-tocopherol acetate, nicotinamide, retinyl acetate, D-calcium Iron mg 1.20 3.00 Vitamin B1 mg 0.10 0.25 pantothenate, colecalciferol, pyridoxine hydrochloride, riboflavin, thiamine Zinc mg 0.80 2.00 Vitamin A μg RE 80.00 200.00 hydrochloride, phylloquinone, pteroylmonoglutamic acid, D-biotin and Manganese mg 0.25 0.63 Folic acid μg 20.00 50.00 cyanocobalamin), scent, stabilizers (carrageenan and xanthan gum), Copper μg 89.90 224.75 Biotin μg 7.50 18.75 sweeteners (sodium cyclamate and sodium sacharine) and colorant (E-102). Molybdenum μg 10.00 25.00 Vitamin K1 μg 5.50 13.75 *Contains lactose and soy derivatives. With sugars and sweeteners. Iodide μg 7.35 18.38 Vitamin D3 μg 0.50 1.25 *Contains E-102 : It can have an adverse effect on the activity and attention Fluoride μg 3.00 7.50 Vitamin B12 μg 0.10 0.25 of children. Selenium μg 2.60 6.50 Inositol mg 20.00 50.00 Chrome μg 1.25 3.13 Choline citrate mg 20.00 50.00 Nutritional information per 100 ml per 250 ml Energetic value (Kcal) 100 251 Energetic value (kJ) 422 1,054 Carbohydrates (g) 12.00 30.00 R of which: sugars (g) 5.20 13.00 Proteins (g) 4.10 10.25 Fats (g) 4.00 10.00 of which: saturates (g) 2.70 6.75

Ingredients: Water, hydrolyzed corn starch, fructose, whey proteins, medium Minerals 100 ml 250 ml Vitamins 100 ml 250 ml chain triglycerides (MCT), vegetable oil, sodium caseinate, calcium caseinate, Chloride mg 113.00 282.50 Vitamin C mg 6.00 15.00 fiber (wheat dextrin and oligofructose), defatted cocoa powder, mineral Potassium mg 102.90 257.25 Vitamin B3 mg-NE 1.80 4.50 complex (sodium citrate, potassium phosphate, magnesium chloride, calcium Sodium mg 100.00 250.00 Vitamin E mg α-TE 1.00 2.50 chloride, potassium citrate, ferrous lactate, zinc sulfate, manganese sulphate, Calcium mg 59.20 148.00 Pantothenic acid mg 0.60 1.50 cupric gluconate, sodium molybdate, potassium iodide, sodium fluoride, Phosphorus mg 40.80 102.00 Vitamin B6 mg 0.20 0.50 chromium chloride and sodium selenite), emulsifiers (E-472c and soy lecithin), Magnesium mg 18.00 45.00 Vitamin B2 mg 0.16 0.40 choline citrate, inositol, vitamin complex (L-ascorbic acid, nicotinamide, Iron mg 1.20 3.00 Vitamin B1 mg 0.14 0.35 DL-alpha-tocopherol acetate, D-calcium pantothenate, colecalciferol, Zinc mg 0.80 2.00 Vitamin A μg RE 80.00 200.00 pyridoxine hydrochloride, thiamine hydrochloride, riboflavin, retinyl acetate, Manganese mg 0.20 0.50 Folic acid μg 20.00 50.00 pteroylmonoglutamic acid, D-biotin, phylloquinone, colecalciferol, Copper μg 89.90 224.75 Biotin μg 6.00 15.00 cyanocobalamin), scent, stabilizers (carrageenan and xanthan gum), Molybdenum μg 10.00 25.00 Vitamin K1 μg 5.50 13.75 sweeteners (sodium cyclamate and sodium sacharine). Iodide μg 7.40 18.50 Vitamin D3 μg 0.50 1.25 *Contains lactose and soy derivatives. With sugars and sweeteners. Fluoride μg 3.00 8.00 Vitamin B12 μg 0.10 0.25 Selenium μg 2.50 6.25 Inositol mg 20.00 50.00 Nutritional information per 100 ml per 250 ml Chrome μg 1.25 3.13 Choline citrate mg 20.00 50.00 Energetic value (Kcal) 99 247 Energetic value (kJ) 414 1035

Carbohydrates (g) 10.40 26.00 R of which: sugars (g) 2.50 6.25 FIB Fats (g) 4.20 10.50 especial of which: saturates (g) 2.80 7.00 FIBRA Proteins (g) 4.10 10.25 Fiber (g) 1.50 3.75 Salt (g) 0.25 0.63

Ingrediente: water, whey proteins (lactalbumin, calcium caseinate and sodium Minerals 100 ml 250 ml Vitamins 100 ml 250 ml caseinate), maltodextrin, sugar, medium chain triglycerides (MCT), vegetable Chloride mg 113.00 282.50 Vitamin C mg 6.00 15.00 oil, mineral complex (potassium phosphate, sodium citrate, magnesium chloride, Potassium mg 102.90 257.25 Vitamin B3 mg-NE 1.80 4.50 potassium citrate, calcium chloride, ferrous lactate, zinc sulfate, manganese Sodium mg 100.00 250.00 Vitamin E mg α-TE 1.00 2.50 sulphate, copper gluconate, sodium molybdate, potassium iodide, sodium Calcium mg 60.80 152.00 Pantothenic acid mg 0.60 1.50 fluoride, chrome chloride and sodium selenite), emulsifiers (E-472c and soy Phosphorus mg 41.60 104.00 Vitamin B6 mg 0.20 0.50 lecithin), choline citrate, inositol, vitamin complex (L-ascorbic acid, nicotinamide, Magnesium mg 18.00 45.00 Vitamin B2 mg 0.16 0.40 DL-alpha-tocopherol acetate, D-calcium pantothenate, pyridoxine hydrochloride, Iron mg 1.20 3.00 Vitamin B1 mg 0.14 0.35 riboflavin, thiamine hydrochloride, retinyl acetate, pteroylmonoglutamic acid, Zinc mg 0.80 2.00 Vitamin A μg RE 80.00 200.00 D-biotin, phylloquinone, colecalciferol, cyanocobalamin), scent, stabilizers Manganese mg 0.20 0.50 Folic acid μg 20.00 50.00 (carrageenan and xanthan gum), Copper μg 89.90 224.75 Biotin μg 7.50 18.75 sweeteners (sodium cyclamate and sodium sacharine) and colorant (E-102). Molybdenum μg 10.00 25.00 Vitamin K1 μg 5.50 13.75 *It contains E-102 : It can have adverse effects on activity and attention of Iodide μg 7.80 19.50 Vitamin D3 μg 0.54 1.35 the kids. Fluoride mg 0.003 0.008 Vitamin B12 μg 0.10 0.25 **Contains lactose and soy derivatives. With sugars and sweeteners. Selenium μg 2.70 6.75 Inositol mg 20.00 50.00 Nutritional information per 100 ml per 250 ml Chrome μg 1.35 3.38 Choline citrate mg 20.00 50.00 Energetic value (Kcal) 108 270 Energetic value (kJ) 454 1.136 Carbohydrates (g) 12.00 30.00 of which: sugars (g) 5.20 13.00 R Proteins (g) 6.00 15.00 Fats (g) 4.00 10.00 HIPERPROTÉICA of which: saturated (g) 2.70 6.75 Salt (g) 0.25 0.63 Dietary fiber (g) 0.05 0.13 BASIC VOCABULARY IN NUTRITION

Intestinal absorption: Set of mechanisms that ensure passage through the intestinal membrane of a nutrient until its discharge into the lymph, (circulatory system responsible for the transport of nutrients to capillaries)

Fatty acids: They are molecules composed of carbon, hydrogen and oxygen, which combine with glycerol to form triglycerides, fundamental components of lipids or fats. Usually constituted by a long chain that may or may not have double bonds, being called then unsaturated or saturated.

Food: Matter of agricultural or industrial origin that serves to cover the nutritional needs. The need for food begins with the beginning of life, because food has to provide the chemical elements essential for life and development.

Aromatic amino acids: The three aromatic amino acids are essential, phenylalanine and tryptophan strictly, that is, in no case can they be synthesized, while tyrosine can be obtained from the diet or synthesize it from phenylalanine. In addition to being part of the proteins, they are precursors of other biological compounds. In proteins, they are responsible for their absorption in the next UV. He Tryptophan is relatively unstable, while phenylalanine and tyrosine are stable.

Branched Amino Acids: Branched chain amino acids are essential nutrients that the body it gets from proteins found in food, especially meat, dairy products and vegetables. These include leucine, isoleucine, and valine. "The branched chain" refers to the structure chemistry of these amino acids. Some people use branched chain amino acids to avoid fatigue and improve concentration. Athletes use branched-chain amino acids to improve the exercise and performance, in addition to reducing muscle degradation during intense exercise. The branched-chain amino acids stimulate the building of proteins in the muscle and reduce the muscle degradation, likewise prevent the transmission of the message of failure in the brain cells of people with advanced liver disease. When we eat a meal rich in proteins and carbohydrates, the increase in blood glucose caused by carbohydrates, generates an increase in insulin that contributes to the anabolic effect of the ingested proteins. The problem is time, since the Hepatic control over all these levels forces a slow process.

Anabolism: Set of metabolic reactions that lead to the synthesis of the necessary compounds for the growth, development and maintenance of the structures of an organism.

Arginine: It is an essential amino acid, stimulates the immune function by increasing the number of leukocytes. Arginine is involved in the synthesis of creatine, polyamines and DNA. It can lower cholesterol to improve the capacity of the circulatory system. Reduces catabolism or loss of muscle mass, as well It also helps the recovery of patients affected by trauma and surgical interventions.

ATP: (Adenosine triphosphate) substance that plays a key role in cellular metabolism thanks to its high energy potential. It is the energy reserve in which the cell supports to carry out the synthesis of the body's constituents and cover their energy expenses.

Digestion: Mechanical, chemical and enzymatic process, performed by the digestive system, which aims to convert the ingested food into simple nutrients so that they can be absorbed by the Intestinal mucosa.

Calorie: Unit of measurement in nutrition that refers to the amount of heat necessary for the temperature of one liter of water rises one degree at normal pressure. 1kcal = 4,484 kjoules.

Carbohydrates = Glucides = Sugars: They constitute the main source of energy in the animal kingdom. All carbohydrates contain carbon, hydrogen and oxygen, in the proportion of 2 hydrogens per 1 oxygen (same ratio as in water, hence its name of carbohydrate or carbohydrate). Compounds with a carbohydrate molecule are designated as polysaccharides (ex .: monosaccharides: glucose, fructose and galactose); polysaccharides that can contain up to 2000 molecules simple carbohydrates arranged in long chains, eg: starch, glycogen, cellulose).

Catabolism: Catabolism occurs when the body itself, not receiving food, ends up nourish itself of its own tissues consuming in this way the muscle and finishing little by little with ourmuscle mass A process that can be carried out in cases in which we subject our body to hard workouts or do not feed it properly to grow; or when we follow a diet of thinning.

Dietetics: Science that consists of applying to the individual the fundamental knowledge of nutrition, especially the establishment of a diet in accordance with a physiological state and its metabolic consumption. Dietetics should be considered as a preventive weapon whose first mission is to to maintain the individual in an optimal physiological state of health and secondly, to contribute to the restoration of the subject with disorders of nutritional origin.

Energetics: Food constituents whose main function is to supply energy; the carbohydrates and lipids are the energetic compounds of the diet. Generally 1 gram of carbohydrates provides 16 kJ or 4 Kcal. metabolizable, 1 gram of lipids 37.5 kJ or 9 Kcal. metabolizable and 1 gram of proteins 16 kJ or 4 Kcal. Metabolizable.

EPA & DHA: Omega 3 is a type of polyunsaturated fatty acid that the body needs but not It can generate by itself. That is why we need to obtain them through food. There are three omega-3 main fatty acids. One, alpha-linolenic acid, is found in some seeds and oils of some plants such as flaxseed. The other two are EPA and DHA, and these appear almost exclusively in the fish and crustaceans. EPA and DHA are known as "long-chain" omega-3s because their structure is longer than alpha-linolenic acid. The body has a very strong preference for long chain omega-3.

Carbohydrates: They are our main source of energy, they are classified into several groups, two of the most important; monosaccharides, (glucose, fructose and galactose). Polysaccharides, (starch, glycogen and cellulose).

Hypercaloric: Diets with high calorie content. Apply the same definition for normoproteic e hyperprotéico.

Hypocaloric: The hypocaloric diet is that dietary regime that bases its application in the daily caloric restriction, or reduction in food intake (which provide calories). It is the most usual of the diets that doctors use and diagnose in cases of weight loss. L-glutamine: Helps to repair and build muscle, since it is linked to the improvement of the synthesis of proteins and metabolism, also has anti-catabolic capacity preventing the loss of muscle mass. It helps increase the levels of growth hormone. L-glutamine also contributes to improving the immune system because it is one of the most important elements when elaborating one of the Our body's most powerful antioxidants, glutathione. Prevents atrophy and stress of the intestinal tract improving the digestive system.

Lipids: They are molecular formations that serve as a reserve of energy and are the basis of structures biotic Functions: They are the main energy reserve of the organism. Structural function They form the lipid bilayers of the membranes. Biocatalyst function. In this role, lipids favor or facilitate the chemical reactions that occur in living beings. This function is fulfilled by lipid vitamins, steroid hormones and prostaglandins. Conveyor function The transport of lipids from the intestine to its place of destination is made by its emulsion thanks to bile acids and proteolipids. Within the lipids you can find the saturated and trans and unsaturated fatty acids (Omega 3-6-9). Soluble fiber retains water and becomes gel during digestion and also slows digestion and the absorption of nutrients from the stomach and intestine. The insoluble accelerates the passage of food to through the stomach and intestines and adds volume to the stool.

Micro and macronutrients: The macronutrients are: carbohydrates or carbohydrates, proteins, lipids and soluble fiber. The micronutrients are: vitamins, minerals, insoluble fiber, water. Minerals: A mineral is a natural substance that differs from the rest by its inorganic origin, its homogeneity, pre-established chemical composition and that currently has a crystal structure. Its main functions include being a decisive and fundamental component for the conservation and health of living beings, since their presence is a determining factor for the activity of different cells.

Normocaloric: The normocaloric diet is achieved when an amount of energy similar to the that the individual consumes. The energy balance is maintained. Therefore, you have to know what the expense is energetic of the individual. Energy expenditure comes as a result of three items. One is the basal metabolism (which is called resting energy expenditure), which is a fixed item that depends on factors such as age, sex, height or weight; and that is the largest game, around 60 percent. Another is a small item that corresponds to the thermal effect of the food. And finally, physical activity, which It depends on the vital option of each individual.

Peptide: Link. The binding between amino acids to form peptides or proteins is carried out by the amino group of one amino acid and the carboxyl group of the other amino acid, eliminating one molecule of Water.

Peptide: Sequence of amino acids bound by peptide bond. The number of amino acids present in a peptide molecule is extremely variable, being called dipeptide when the union is two amino acids, tripeptide when the union is three, re-peptide when it is four, and in general oligopeptides with the chains cut off, while if they are longer they are called polypeptides.

Proteins: Proteins are macromolecules formed by linear chains of amino acids, which, they are part of the fundamental matter of cells and substances, both plant and animal. The proteins turn out to be of vital importance in all matter that lives and extremely indispensable for the growth of them. Among other issues they play a substantial role when it comes to regeneration of cells, forming some new ones and transporting oxygen; are the most biomolecules versatile and diverse that are found in living beings. The most outstanding functions that they practice are structural, transportation, regulation, defensive, enzymatic and contractile. Within the proteins is find amino acids, which are the constituent elements of proteins, there are approximately 21 types of amino acids, 8 of them are essential and must be supplied in the food, the rest is synthesized by our body.

Proteolysis: The hydrolysis of the protein chains can be carried out chemically or enzymatically. The Proteolysis can be partial (peptide formation) or total (amino acid release).

RNA: A polymeric constituent of all living cells and many viruses, consisting of one, so general long single chain chain of ribose phosphate units and alternating with adenine bases, guanine, cytosine, uracil and attached to ribose. RNA molecules are involved in the synthesis of proteins and sometimes in the transmission of genetic information. It is also called ribonucleic acid.

Vitamins: Vitamins are a group of substances essential for cellular functioning, the growth and development. Vitamins A, C, D, K, B1, B2, B3, B6, B12, panthenic acid, biotin, folic acid. Fat-soluble vitamins that are stored in the fatty tissue of the body. Water-soluble vitamins that the You have to use them immediately. Any excess water-soluble vitamin leaves the body through urine. Vitamin B12 is the only water-soluble vitamin that can be stored in the liver for many years. Functions of vitamins: Each vitamin has specific functions. The lacks Vitamins cause health problems.

Vitamin A helps the formation and maintenance of teeth, bone and soft tissues, membranes mucous membranes and healthy skin.

Vitamin B6 It is also called pyridoxine. The more protein you consume, the more vitamin B6 you it will require to help the body use that protein. Vitamin B6 helps, among other things, the formation of red blood cells and the maintenance of brain function. Vitamin B12 Like the other B vitamins, it is important for metabolism and it also helps the formation of red blood cells and the maintenance of the central nervous system.

Vitamin C also called ascorbic acid, is an antioxidant that promotes teeth and gums healthy This vitamin helps the body absorb iron and maintain healthy tissue and also favors the healing of wounds.

Vitamin D It is also known as "the sun's vitamin" because the body produces it after the exposure to sunlight. 10 to 15 minutes of sun exposure three times a week are enough to produce the body's requirements of this vitamin. However, many people who live in climates sunbathers still do not produce enough vitamin D and need to get more from their diet or supplements. This vitamin helps the body absorb calcium, which is necessary for normal development and maintenance of healthy teeth and bones. It also helps maintain appropriate blood levels of calcium and phosphorus.

Vitamin E It is an antioxidant, also known as tocopherol. Play an important role in the formation of red blood cells and helps the body to use vitamin K.

Vitamin K It does not appear on the list of essential vitamins, but without it the blood would not coagulate. Some studies suggest that it helps promote strong bones in the elderly.

Biotin is essential for the metabolism of proteins and carbohydrates, as in the production of hormones and cholesterol.

Niacin is a vitamin B complex that helps keep skin and nerves healthy and equally It has hypocholesterolemic effects.

Folate acts with vitamin B12 to help in the formation of red blood cells and is necessary for the DNA production, which controls tissue growth and cell function. Any pregnant woman you must ensure that you consume adequate amounts of folate, as low levels of this vitamin they are associated with congenital defects such as spina bifida. Many foods come now enriched with folic acid.

Pantothenic acid is essential for the metabolism of food and also plays a role in the production of hormones and cholesterol.

Riboflavin (B2) works in conjunction with the other B vitamins and is important for the body growth and the production of red blood cells.

Thiamine (B1) helps body cells convert carbohydrates into energy. It is essential for the heart functioning and maintenance of healthy neurons. ADVERTISING / PROFESSIONALS

As you well know, it is important to do good research on our clients with respect to our dietetic products. In other words, consultants may check what other medicines can prescribe in a specific situation or purchase our products.

To give more information about it, this leaflet gathers the knowledge collected from our experience, although it is not always applicable because it depends on patient autonomy.

Dietician/Nutritionist: It is logically the most important group: Not only for the possible introduction of our dietary therapies in centres in which they provide services but also for their prescriptions in outpatient visits. Multitenex may be prescribed to treat the vitamin deficiencies originated from the treatment of obesities, putting somebody on a diet and in hypocaloric diets.

Oncologist / Palliative care: Unotenex and Esencial Nutril are the most suitable for the types of pathologies they treat. However, Peptenex is used in the great majority of diets, including those established in chemotherapy, and when cytostatics are prescribed.

Radiotherapist: They radiate patients, in larynx and in other parts of the body. Consequently, these patients can not ingest solids for several months. Therefore, Nut Tenex, Fib Tenex etc, can be prescribed.

ENT specialist: They treat vocal cords cancer and total or partial laryngetomized patients. They usually prescribe thickeners, Nut Tenex hiperproteica, protein concentrate (100 sachets), protein concentrate (6 x 500 g bottle) and thickened water.

Maxillofacial Surgery: When cerclage wire is used to stitch the mouth and in traumas, thickeners, thickened water, Sup Tenex (supplements) and Nut Tenex (enteral) can be prescribed.

Traumatologist: In elderly people, in patients who have suffered a hip replacement and in other pathologies to achieve a faster recovery. For example, thickeners are used for trauma and Pep Tenex is used in multiple fractures, accidents and other traumas.

Digestive system: Specialists often prescribe diets because they treat inflammatory bowel diseases, Crohn disease, etc. Hepato Tenex and Pep Tenex are suitable in cirrhosis and liver failure.

Digestive Surgery: Nut Tenex, Hepato Tenex and Pep Tenex are indicated for digestive system fistulas and general gastrointestinal surgery. Diets are also indicated in bariatric and other kinds or surgical treatments for obesity.

In old people's homes and geriatricians, in centres for physical and psychic disabled people, in phychiatric hospitals, in dialysis centres (Nefronutril), in prisons (Sup Tenex, Hepato Tenex, Uno Tenex and Esencial Nutril), in palliative care (diets and protein concentrate sachets) and diets, thickeners and thickened water are used in clinics, in pneumology (cystic fibrosis), Fib Tenex and Pep Tenex.

In old people homes, the elderly usually lose weight and muscle mass, which causes protein loss, more infections, more health diseases, more bedsore, etc. I.C.U. : In burned victims, Unotenex - Essecial Nutril are used.

Endocrine: Standard diets and Fib Tenex fibre are preferably used in diabetics. Fib Tenex is also suitable for anorexia, bulimia, etc

Neurologist / Neuropsychiatrist / Psychiatrist: They use diets, thickeners and thickened water to treat Alzheimer, trigeminal neuralgia, stroke, facial paralysis, (They often use Nut Tenex orally or by tube, in certain hospitals there are special units for ICTUS, these are patients who easily ulcerate because of their lack of movement, they also lack appetite), in encephalic trauma, Parkinson, multiple sclerosis and amyotrophic lateral sclerosis.

Respiratory system: Patients with chronic obstructive pulmonary disease (COPD), shortness of breath and people with cystic fibrosis.

Radiotherapist: Nut Tenex is used in X-Ray exams of the digestive track and Pep Tenex is used for radiation therapies.

Rehabilitators: Thickeners are used in dysphagia. Representative:

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