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A Zugasti Murillo

Publications and source records attributed to A Zugasti Murillo.

4 recordsLinked to original sources

[Refeeding syndrome. A review].

Refeeding syndrome is a complex clinical picture that encompass all those alterations that can occur as a consequence of the nutritional support (oral, enteral or parenteral) in malnourished patients. Refeeding syndrome is classically characterized by neurological alterations, respiratory symptoms, cardiac arrhythmias and heart failure few days after beginning of refeeding, with life-threatening outcome. Its pathogenesis includes alterations in the corporal fluids, and in some electrolytes, minerals and vitamins. In this article a review of refeeding syndrome pathogenesis and clinical manifestations is carried out, with a final series of recommendations for lowering the risk of this syndrome and for facilitate the early diagnosis and the treatment.

Humans↗

[Incidental diagnosis of medullary thyroid carcinoma (MTC) after performing 123I-metaiodobenzylguanidine (123I-MIBG) gammagraphy].

UNLABELLED: The objective of this clinical note is to emphasize diagnostic efficiency of 123I-MIBG scintigraphy in the initial diagnosis and follow-up of medullary thyroid carcinoma within MEN2. MATERIALS AND METHODS: We present the case of a patient who, during a scintigraphic study with 123I-MIBG for the diagnosis of pheochromocytoma, was unexpectedly found to suffer from medullary carcinoma of the thyroid. Prior to performing the test, we proceeded to block uptake into the thyroid gland through the administration of Lugol. We carried out the scintigraphic study by intravenously injecting 370 MBq 123I-MIBG. RESULTS: A pathological uptake of the radiopharmaceutical compound over the right suprarenal gland, and unexpectedly, over the thyroid gland was detected, thus confirming the existence of medullary carcinoma of the thyroid in this patient, and obtaining the diagnosis of Type MEN2A polyglandular syndrome. CONCLUSIONS: From our experience, we can manifest the value of scintigraphy using 123I-MIBG in the diagnosis and localization of medullary carcinoma of the thyroid. Furthermore, it is indicated in patients suspected of MEN, since it makes it possible to reach a diagnosis of this kind of syndrome through the performance of just one test.

3-Iodobenzylguanidine↗

[Bariatric surgery: an update].

The indication of bariatric surgery as therapeutic procedure for morbid obese patients requires the application of selection criteria which deal with the degree of obesity, associated complications and previous failure of conventional therapy. Alcohol or drug addiction and concomitant serious disease are contraindications for bariatric surgery. Before operation, a full assessment is needed to identify possible eating behaviour disturbances and associated comorbidity such as cardiovascular disease, sleep apnoea, metabolic and psychiatric alterations which might induce intra and postoperative complications. Surgical techniques can be classified as restrictive, malabsortive and mixed procedures. Gastroplasty and adjustable gastric banding are restrictive techniques, which are indicated in obese patients with body mass index less than 45 kg/m2. Mixed techniques are the most used procedures. They include gastric by-pass which causes a reduction of 60-70% of weight excess, biliopancreatic diversion and duodenal switch which can eliminate a 75% of body weight excess. Following bariatric surgery a dramatic improvement in associated comorbidity can be demonstrated, specially in what refers to diabetes, hypertension, dislipidaemia and apnoea. Postoperative mortality is around 1-2%. Peritonitis and venous thromboembolism are the most serious complications. Postoperative follow-up should be lifelong and requires a progressive nutrition planning and vitamin supplementation.

Aftercare↗