A Sanz Paris | PubMed Health

PubMed1996

[Pseudo-idiopathic hypoparathyroidism].

Hypoparathyroidism can exist due to one or more of the following pathogenic mechanisms: 1) Parathyroid Hormone (PTH) deficit, b) biologically inactive PTH, c) PTH antagonists and d) target tissues defects. Biologically inactive PTH secretion, also named pseudo-idiopathic hypoparathyroidism, is an exceptional cause of hypoparathyroidism. We report a case of a patient with this illness. A 71-year-old male with a past history of cataracts since he was 48 was admitted to our hospital. Laboratory data showed a total calcium of 4.82 mg/dl, ionized calcium of 2.72 mg/dl, serum phosphate 5.30 mg/dl, intact PTH 83 pg/ml (N 15-60), osteocalcin 2,4 ng/ml (N 9-30), tubular resorption of phosphate 96% and 1.25 di-hydroxycholecalciferol 7 pg/ml (N 18-78); creatinine and magnesium values were between normal limits. The Ellsworth-Howard test showed a normal response of both urinary c-AMP excretion and phosphaturia to PTH. We review the diagnostic clues of hypoparathyroidism and the value of the Ellsworth-Howard test in order to enable distinction between the several variants of the syndrome.

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[Nutritional support in patients with thoracic trauma. Usefulness of an enteral diet with a high fat content].

The purpose of this study is to evaluate the effects and clinical tolerance of an enteral diet containing 55% "AET" in the form of fat and only 28% in the form of H. C. in a group of 17 polytraumatized patients admitted to the Intensive Care Unit with assisted ventilation as a result of thoracic traumatism. The average age of the patients was 36.6 +/- 17 years, and they remained in Intensive Care for more than 10 days. Energetic requirements were estimated at 1,800 +/- 180 Kcal per day. Enteral intake commenced on day 4.5 +/- 1.2 and 90% of the estimated requirements was achieved at 8.5 +/- 2.9 days. Average duration of the Enteral Nutrition was 15 +/- 3.7 days, Tolerance of the diet was considered good and problems due to intolerance leading to suspension of the diet were mainly related to worsening of the clinical condition. The volumen per minute expired per Kg of weight descended gradually and assisted ventilation was removed at 16 +/- 5.4 days, 5 patients died, mainly due to septic problems. There was a significant improvement in surviving patients with regard to levels of transferrin (p less than 0.01), prealbumin (p less than 0.001) and RBP (p less than 0.05), and no improvement was observed in the patients who had died. The nitrogenated balance was positive from the ninth day onwards in surviving patients, and remained negative in the patients who had died. In conclusion, this enteral diet with a high intake of fats, showed good tolerance and is beneficial in patients with thoracic traumas which require assisted ventilation.

Adult↗