Investigación en sarcopenia: importancia de la metodología / Sarcopenia research: relevance of methodology

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[Myopathy and polyneuropathy caused by colchicine]. / Miopatía y polineuropatía por colquicina.

A forty-six year old man with chronic renal failure and a toxic chronic liver disease developed progressive muscle weakness after a long trial with colchicine. Physical exam revealed muscle weakness and proximal muscle atrophy with hyporeflexia. Serum levels of creatine kinase were high and signs of myopathy and axonal and demyelinating polyneuropathy was evidenced in electrophysiological studies. Muscle biopsy disclosed a vacuolar myopathy, disruption of myofibers and dilatation of sarcoplasmic reticulum. The clinical pictures was attributed to a toxic myopathy and polyneuropathy due to colchicine, thus this treatment was discontinued. Four week later, the patient was symptom free, the levels of seric creatine kinase were normal and a new muscle biopsy was normal, with disappearance of previous histological findings.

[Evolution of the emergency consultations in patients with human immunodeficiency virus infection in various levels of medical care in an urban area of Barcelona]. / Evolución de las consultas urgentes realizadas por pacientes con infección por virus de la inmunodeficiencia humana en distintos niveles de la atención médica en un área urbana de Barcelona.

Medical emergencies involving patients with Human Immunodeficiency Virus (HIV) infection comprise an increasing number of the total hospitalary consults and contribute to their overflow. In order to evaluate possible alternative solutions to this problem, we performed a retrospective study of urgent medical consults by HIV patients at three different levels of medical care (primary assistance, extrahospitalary and hospitalary emergencies centers) all included in the same urban area of Barcelona. We demonstrated a growing excess in hospitalary emergencies, with high requirements of complementary explorations and hospitalary admittances. In the extrahospitalary emergency center, we can observe a progressive increasing of emergency consults, but still reasonable in number and adequate to the real possibilities of the center. At primary care level, HIV patients consulted because of less severe reasons. We conclude that a possible solution in order to decrease the assistance requirements in the hospitalary emergencies level could be to try to attend these patients in emergency extrahospitalary centers. These centers should be technically provided and with a close relationship both with the primary assistance care level and with the reference hospital.

[Thyrotoxic hypokalemic periodic paralysis]. / Parálisis periódica tireotóxica normocaliémica.

A case of palsy without family history associated to hyperthyroidism, is described. This is an rare entity in our environment (only two cases have been previously described) and may develop with hypo, normo or hyperkalemia. Its potential pathogenicity is discussed, which finally results in a disorder of the ionic interchange at the level of the muscle membrane. The need to identify these secondary forms of recurrent palsy is stressed, given that it may benefit from an adequate treatment. In the case presented here, the normalization of the thyroid function was followed by the sustained elimination of the muscle symptomatology.