Intravenous magnesium load test in elderly patients with protein-energy malnutrition.

Forty-two elderly patients were subjected to a nutritional assessment and an intravenous magnesium load (0.5 mmol/kg). After 48 h, patients with protein-calorie malnutrition (PCM) showed magnesium retentions (MgR) above 20 per cent, thus indicating magnesium deficit, and greater (P < 0.001) than those from well-nourished patients. The discriminating cross-point for undernourished patients was at 28 per cent with 95 per cent sensibility and specificity. There were significant correlations between MgR and most nutritional parameters. An increase of the RMg constitutes a PCM indicator which may be useful to quantify it.

[Neck pyomyositis associated with polymicrobial sepsis of sinusal origin]. / Piomiositis cervical asociada a sepsis polimicrobiana de origen sinusal.

Spontaneous pyomyositis (primary pyomyositis) is an infrequent disease in non-tropical countries, caused by bacterial infection of skeletal muscle. Although pyomyositis is associated in many cases to septicemia, the occurrence of that disease as a secondary manifestation of bacteremia is very unusual, requiring a high-grade index of suspicion to diagnose it in the early stages. We present one case of cervical pyomyositis, caused by Fusobacterium necrophorum and group F streptococcus, during the course of a sepsis of sinusal origin, that was treated without surgical therapy. This so uncommon form of presentation of Fusobacterium septicemia, its diagnosis and treatment are discussed.

[Multiple paraganglioma]. / Paranganglioma múltiple.

Paragangliomas are tumors of the chromaffin system producing catecholamines and both the adrenal extra-adrenal type have a common origin at the neural crest, which has been supported by the similarities of the paraganglions both from a histological and functional perspective. Most of the extra-adrenal paragangliomas are bending and non-functional. In addition, they are usually confined to just one site. We present the case of a young patient with benign multiple paraglanglioma in two different locations, juxtahepatic and juxtacarotic (Chemodectoma) and, thus, far away from each other. The extra-abdominal location is very rare, with a frequency lower than 2%. In addition, one of paraganglions was functional and the other one was not. Initially, a surgical intervention was performed on the functional abdominal tumoration and latter, another intervention was performed at the cervical level, both with excellent results. We also highlight the good response to the postoperative therapy with Prazosin.

[Pseudometastatic hepatic lesions and Kikuchi necrotizing lymphadenitis]. / Lesiones hepáticas seudometastásicas y linfadenitis necrotizante de Kikuchi.

Kikuchi's necrotizing lymphadenitis (KNL) is a benign disease of unknown etiology affecting lymphatic nodes and some times extranodal organs. We present a case of KNL with hepatic lesions simulating metastatic liver disease.