Complicações metabólicas relacionadas à terapia de nutrição parenteral em pacientes hospitalizados / Metabolic complications related to parenteral nutrition therapy in hospitalized patients

Investigar as complicações metabólicas relacionadas à administração da terapia nutricional parenteral (TNP) e sua relação com o desfecho clínico de pacientes hospitalizados. Métodos: Estudo longitudinal retrospectivo realizado com pacientes internados em hospital público referência no atendimento de urgências e emergências da cidade de Goiânia no período de setembro de 2020 a fevereiro de 2021. A coleta de dados foi realizada por meio de consulta aos prontuários eletrônicos. As informações foram coletadas após o primeiro dia de uso da NP até o desfecho clínico -alta, óbito ou descontinuidade da NP. Resultados: A amostra foi constituída por 28 pacientes em uso de nutrição parenteral no hospital durante a etapa de coleta dedados. Desses pacientes a maioria era do sexo masculino, com média de idade de 46,78 anos. As indicações mais frequentes para o uso da terapia nutricional parenteral foram: repouso,abdome agudo e pós-operatório. As complicações mais prevalentes foram a hipocalemia, hipomagnesemia, uremia e a hiponatremia e o desfecho clínico mais frequente foi o óbito. Encontrou-se relação entre desfecho clínico e presença de hipernatremia (p=0,010), ocorrendo a alta hospitalar exclusivamente naqueles pacientes que não apresentaram hipernatremia. E ainda houve relação marginal (p=0,053) entre desfecho clínico e local da internação, sendo que foi mais frequente o óbito naqueles admitidos na unidade de terapia intensiva. Conclusão: Não houve associação entre a TNP e as complicações metabólicas. Todavia, observou-se relação entre hipernatremia e mortalidade, sendo esta mais prevalente em pacientes internados nas unidades de terapia intensiva (UTIs). Nessa amostra, a complicação metabólica mais observada foi a hipocalemia

To investigate the metabolic complication related to administration of the Parenteral Nutrition Therapy (PNT) and their relation to the clinical outcome of hospitalized patients. Methods: retrospective longitudinal study carried with interned patients at a public hospital of standart in the urgency and emergency care from the Goiânia city during the period from september2020 to february 2021. The data capture was realized through consultation to the electronic record. The information was collected after the first day use of NP to clinical outcome -discharge, death or discontinuation of NP. Results: The sample was composed by 28 patients in use of parenteral nutrition at hospital during the data capture. The majority of these patients were male, with mean age of 46-78 anos. The indications more frequent to the use of parenteral nutrition therapy were: rest, acute abdomen and pos-operative. The complications more prevalent were hypokalemia, hypomagnesemia, uremia and hyponatremia. And the clinical outcome more frequent was death. A relationship between clinical outcome and hypernatremia presence (p=0,010) was found, occurring the hospitalar discharge exclusively in those patients which did not submit to hypernatremia. And there was still a marginal relationship (p=0,053) between clinical outcome and hospitalization, which was more frequent the death in those admitted in intensive care units. Conclusion: There was no association between the PNT and the metabolic complications. However, there was an observed relationship between hypernatremia and mortality, while more prevalent in patients staying in the intensive care unit (ICU). In this sample, the metabolic complication most observed was hypokalemia

Epilepsy and electroencephalographic abnormalities in patients with diagnosis of idiopathic autism spectrum disorder in Medellín.

The objective of the present study was to make a clinical and electroencephalographic characterization of the electrical findings and types of seizures in patients with idiopathic autism. Pediatric patients of any age, with the diagnosis of idiopathic ASD, contained within the database of the research "Genetic in autism" were included. An electroencephalographic recording with epilepsy protocol was performed in all the patients. 20 pediatric patients were included with an age media of 10.5 years, SD 5.48 years. The median age for the diagnosis of ASD was 53 months, and epileptic seizures were documented in 45%. 66.6% of patients with epileptic events had anti-epileptic treatment, and only 33.3% had achieved seizure control with medication. Interictal abnormal EEG records were found in 8 patients (40%), with 6 of them having epileptic seizures. The abnormal EEG activity was multifocal in 62.5%, focal in 25% and generalized in 12.5% of the cases. The most frequently compromised location was the temporal lobe.

El objetivo del presente estudio fue caracterizar desde el punto de vista clínico y electroencefalográfico los hallazgos eléctricos y los tipos de crisis en pacientes con autismo idiopático. Se incluyeron pacientes de cualquier edad, con diagnóstico de TEA idiopático y pertenecientes a la base de datos de la investigación "Genética del Autismo". A todos los pacientes se les realizó electroencefalograma de rutina (EEG) con protocolo de epilepsia. Se recolectaron 20 pacientes en edad pediátrica con edad media de 10.5 años, DE de 5.84 años. Para la edad de diagnóstico del TEA, la media era de 53 meses. Se documentaron crisis epilépticas en 45% de los pacientes. De todos los pacientes con crisis, 66.6% tenían tratamiento con medicamentos antiepilépticos, y solo 33.3% habían logrado control de las crisis con el tratamiento. El EEG interictal fue anormal en 8 pacientes (40%), de los cuales 6 tenían crisis epilépticas. La actividad anormal fue multifocal en 62.5% de los pacientes, focal en 25% y generalizada en 12.5% de los casos. La localización más frecuente de las anomalías fue en el lóbulo temporal.