ABSTRACT
AIMS: Secondary hyperparathyroidism (SHPTH) is a leading cause of renal osteodystrophy, and an independent risk factor for all-cause and cardiovascular mortality. Our aim is to establish differences in prevalence and profile of SHPTH, regarding diabetics or non-diabetics with chronic kidney disease (CKD). METHODS: Cross-sectional multicenter study which included patients with stages 3 to 4 CKD. SHPTH was considered when the intact PTH levels (iPTH) were equal or higher than 70pg/ml. We divided the sample into two groups (diabetics and non-diabetics). We used robust statistical methods. RESULTS: 409 patients (214 diabetics) were studied. HPTH was found in 60.4% of diabetics vs 65% of non-diabetics (P=0.42). Diabetics with HPTH were younger (79.5 vs 82.3 years-old, P=0.005), and had more hypertension (P=0.0014), dyslipidemia (P=0.0001) and comorbidities. In multivariate analysis, we found a significant relationship in case of diabetics, with age (OR: 1.04, 95%CI 1.005-1.09 P=0.02 ), and with statins treatment (OR 2.3, 95%CI 1.17-4.54, P=0.01). DISCUSSION: The prevalence of SHPTH between the groups was similar, however, diabetics had more presence of hypertension and dyslipidemia, and SHPTH in this case was also related with moderate microalbuminuria and lower levels of vitamin D. An association with statins was also found in this group.
Subject(s)
Diabetes Complications/physiopathology , Hyperparathyroidism/epidemiology , Renal Insufficiency, Chronic/complications , Aged , Aged, 80 and over , Cross-Sectional Studies , Diabetes Complications/metabolism , Dyslipidemias/complications , Female , Glomerular Filtration Rate , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Hypertension/complications , Male , Multivariate Analysis , Parathyroid Hormone/blood , Renal Insufficiency, Chronic/metabolism , Spain/epidemiologyABSTRACT
OBJECTIVE: To study the changes occurring in brain lipid composition after the administration of total parenteral nutrition (TPN) by comparing two lipid emulsions, one with long-chain triacylglycerols (LCT) and the other with long-chain and medium-chain triacylglycerols (MCT/LCT 50%/50%). METHODS: We used 21 young New Zealand rabbits divided into three groups of seven animals each. Two groups were subjected to TPN for 7 d, with each group receiving using one of two different lipid emulsions: Intralipid 20% (group LCT) and Lipofundin MCT/LCT 20% (group MCT/LCT). The third control group received an oral diet and underwent the same surgical procedure with the administration of intravenous saline solution. The energy administered in the TPN formulas was non-protein 100 kcal â kg(-1) â d(-1), with 40% corresponding to fats. RESULTS: There were modest increases in plasma cholesterol and triacylglycerols. In the brain tissue, there was a decrease of phosphatidylcholine in animals with TPN, which was greater in group LCT. There were no significant differences in the overall percentage distribution of brain fatty acids among the groups. CONCLUSION: The lipid emulsions administered in TPN, especially those prepared exclusively with LCT, cause changes in the brain lipid polar fractions of young rabbits.
Subject(s)
Brain/metabolism , Fat Emulsions, Intravenous/administration & dosage , Fat Emulsions, Intravenous/chemistry , Lipids/analysis , Parenteral Nutrition, Total/methods , Animals , Brain Chemistry , Cholesterol/blood , Drug Combinations , Emulsions/administration & dosage , Emulsions/chemistry , Lipid Metabolism , Lipids/blood , Phosphatidylcholines/metabolism , Phospholipids/administration & dosage , Phospholipids/chemistry , Rabbits , Sorbitol/administration & dosage , Sorbitol/chemistry , Soybean Oil/administration & dosage , Soybean Oil/chemistry , Triglycerides/bloodABSTRACT
Pneumopericardium is an uncommon but potentially serious condition. It appears in association with invasive diagnostic and therapeutic procedures, although cases have also been reported in association with bronchospasm, esophageal disorders, and other problems. We describe a case of spontaneous pneumopericardium with chest pain in a patient with community-acquired pneumonia.
Subject(s)
Community-Acquired Infections/complications , Pneumonia, Bacterial/complications , Pneumopericardium/etiology , Community-Acquired Infections/diagnostic imaging , Humans , Male , Middle Aged , Pneumonia, Bacterial/diagnostic imaging , Pneumopericardium/diagnostic imaging , Radiography, Thoracic , Tomography, X-Ray ComputedABSTRACT
El neumopericardio es un trastorno infrecuente pero potencialmente muy grave. Aparece asociado a procesos diagnóstico-terapéuticos invasivos, aunque se han descrito casos asociados a broncospasmo, procesos esofágicos, etc. Presentamos un caso de un paciente con una neumonía de la comunidad que presentó dolor torácico por un neumopericardio espontáneo
Pneumopericardium is an uncommon but potentially serious condition. It appears in association with invasive diagnostic and therapeutic procedures, although cases have also been reported in association with bronchospasm, esophageal disorders, and other problems. We describe a case of spontaneous pneumo-pericardium with chest pain in a patient with community-acquired pneumonia
