Biomedical subjects
Publications and source records attributed to L Díez.
The association between neuroblastic tumours and congenital heart disease is widely confirmed in the literature references. The authors describe a case of a patient with congenital heart disease, high blood pressure, renal artery stenosis and high levels in 24 hours urine metanephrines. A MIBG-I-123 scintigraphy was essential for the diagnosis of neuroblastic tumour.
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It is described the case of a patient with Ovarian Cystadenoma in whom a 3.5 cm nodular lesion was accidentally detected in her left suprarenal gland. She had no signs of hypercortisolism or any other suprarenal pathology and was symptomless. Determinations in the urine of 24 hours of Cortisol, Adrenaline and Noradrenaline, 17-ketosteroids and Tetrahydroaldosterone were normal. Daily rhythm and plasmatic determinations of ACTH, cortisol and 11-deoxycortisol were normal. The Dexamethasone suppression test was also normal. In the suprarenal gammagraphy it appeared an intense captation by left suprarenal without visualization of right gland. A left suprarenalectomy was performed and the anatomopathological analysis showed a clear cell corticoadrenal adenoma. Therefore the only data of the function of suprarenal adenoma was the one coming from gammagraphy. We thought that the adenoma was responsible of practically all the corticoadrenal function without reaching pathological levels, meeting the criteria of "pre-Cushing" syndrome or subclinical Cushing, due to the fact that the contralateral gland was not seen in the gammagraphy. Therefore in the characterization of certain tumors which appear clinically and biochemically as non functional, the suprarenal gammagraphy could be a technique of great usefulness for the diagnosis.
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INTRODUCTION: [corrected] There is no "gold standard" for identification of malnutrition. The ASPEN board of directors (2002) suggest the subjective global assessment (SGA) and ESPEN (2002) recommend the nutritional risk screening-2002 (NRS-2002) to detect the prevalence of malnutrition. AIMS: This cross-sectional study aims (1) to assess the prevalence of malnutrition on admission and (2) to know association between two tools used to evaluate nutritional risk. MATERIAL AND METHODS: 135 patients (42.2% women and 58.8% men, 62.1 +/- 14.4 years) are studied at admission. Different parameters are assessed to evaluate nutritional state. Patient's energy requirements (Harris Benedict x Long's factor) and energy intake, calculated as 24 h-recall, are compared. The prevalence of malnutrition is assessed with two screening tools: SGA and NRS-2002. RESULTS: 42.2% of the patients had lost more than 5% body weight and 39.3% had an intake lower than required at admission. The prevalence of malnutrition is 40.7 and 45.1/100 patients admitted at hospital, if SGA or NRS-2002 are used, respectivility. There is strong agreement between results of two nutritional assessment methods (p = 0.000). Serum albumin and protein concentrations and linfocytes count are less in the malnourished patients. CONCLUSIONS: The prevalence of malnutrition is elevated. In clinical practice, both methods could be used to identify patients at nutritional risk, but the NRS-2002 is a less subjective method.
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