[A retrospective study of alcoholism at the Hospital Universitario de Granada. II. The reasons for admission and associated pathology in these patients]. / Estudio retrospectivo del etilismo en el Hospital Universitario de Granada. II. Causas de ingreso y patología asociada en estos pacientes.

In a retrospective study conducted from 1985 to 1990, the cause of hospitalization and associated pathology of 221 chronic ethylics were investigated. The most frequent cause of hospitalization was neuropsychiatric, followed by digestive pathology. With respect to the most frequent associated pathology, it was mainly digestive, causing multiple hospitalizations in most of the patients. The respiratory, cardiocirculatory and endocrine-metabolic pathologies followed in the frequency rank in these patients, as well as the traumatisms resulting from the ebrietas condition. We also observed gynecological and neonatal pathologies among the alcoholic women. The association of alcohol, tobacco and analgesics and psychodrugs consumption deserves also to be mentioned.

[A retrospective study of alcoholism at the Hospital Universitario de Granada (1): the sociodemographic and clinical characteristics]. / Estudio retrospectivo del etilismo en el Hospital Universitario de Granada (1): Características sociodemográficas y clínicas.

This work offers the results of a retrospective study carried out on 856 patients diagnosed as suffering from alcoholism and/or other alcohol-related illnesses over 120456 who were admitted at the Granada University Hospital over the period 1985-1990. The patients have been classified in a distribution according to various factors, including age, sex, place of residence, profession and hospital admittance and discharge procedure. We have also taken into account both annual and accumulated incidence, as well as the distribution of those patients in the different hospital services and the evolution of the global average hospital stay. We then offer a study contrasting our results with other national and international studies, taking into account elements such as conceptual diversity and similarities and differences in methodology.

[Dehydroepiandrosterone sulfate and lipids in acute myocardial infarct]. / Dehidroepiandrosterona-sulfato y lípidos en el infarto agudo de miocardio.

To establish the possible relationship between acute myocardial infarction (AMI) and dehydroepiandrosterone-sulfate (DHEA-S) in a group of 15 patients with AMI, blood levels of DHEA-S and certain lipids (total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides) were determined at admission in the hospital and after 10 days. As controls a group of healthy individuals or with minor diseases, and a group of 24 severely ill non-cardioischaemic patients have been studied. DHEA-S and HDL-cholesterol levels have been found significantly lowered both in patients with AMI (at 10th day) as well as in the severely ill non-cardioischaemic patients, in comparison with the healthy volunteers group. We conclude, then, than the lowering in DHEA-S and HDL-cholesterol seems not to be specifically relates with AMI but has a certain relationship with severe disorders in general.

[Derivatives of pro-opiomelanocortin (ACTH and beta-endorphin) in chronic alcoholics]. / Derivados de la pro-opiomelanocortina (ACTH y beta-endorfina) en alcohólicos crónicos.

The plasmatic concentration of beta-endorphins and ACTH were measured in 31 alcoholic patients and in a control group (N = 16), to test the possible relation between chronic alcohol intake and propiomelanocortin production. There were found a decrease of beta-endorphins plasmatic levels in chronic alcoholic group, apart of clinical manifestations or abstinence period (one month maximum). This decrease can be cause by the chronic alcohol intake, and can be mediated by the tetrahydroisoquinolines (TIQs) or otherwise be the cause and not the consequence of alcoholism. The global plasmatic levels of ACTH were decreased but it was significant in the subgroup of alcoholics with liver disfunction, mental illness and those who carry on drinking.

[Evaluation of nutritional status in patients admitted to an internal medicine department. Study of 100 cases]. / Valoración del estado nutricional en pacientes ingresados en un servicio de Medicina Interna. Estudio de 100 casos.

We have confirmed that malnutrition is very frequent in hospitalized patients. There is no agreement about which are the indexes or criteria agreement about which are the indexes or criteria that can be used to define malnutrition, specially in early stages. In the present work, we have studied 100 patients randomly chosen amongst the admissions that occurred in the Internal Medicine Department over a period of one year. The patients were submitted to a protocol which included the following: anthropometric measurements, seric proteins and routine determinations (sugar level, cholesterol, uric acid, etc.) It has been considered as malnourished those patients who presented some marker with a value lower than 90% of the standard value. According to these criteria, 25 of them had a caloric-protein malnutrition, 24 had a proteic malnutrition and 25 of them had mixed malnutrition. The most sensible parameters had been the triceps skin fold and retinal transporting protein.

[Dehydroepiandrosterone sulfate, cortisol and their precursors in severely ill (acute and chronic) patients]. / Dehidroepiandrosterona-sulfato, cortisol y sus precursores en enfermos graves (agudos y crónicos).

This study tries to evaluate the interrelationship amongst certain corticoadrenal hormones (Dehydroepiandrosterones-Sulphate (DHEA-S), progesterone, 17-OH progesterone and cortisol) in male patients with severe organic processes (24 chronic and 22 acutely ill) and comparing them with a control group of 15 healthy male subjects or suffering mild processes. Corticoadrenal hormone behaviour in the presence of a severe disease show marked differences between the androgenic and the glucocorticoid pathways. While DHE-S shows a significant decrease in severe disease, independently of the underlying disease (acute or chronic), the contrary occurs with the glucocorticoid pathway, in which cortisol and specially its precursors, progesterone and 17-OH-progesterone, predominantly present in the acute situation, normal or significantly increased levels. These differences between the two adrenal pathways suggest that apart from ACTH there must be another regulatory mechanism of the androgenic pathway which may facilitate the androgenic adaptation to the situation of severe disease.

[Beta-endorphin in acute focal cerebral infarct]. / Betaendorfina en el infarto cerebral focal agudo.

Experimental studies in animal models suggest that the endorphin system may be implicated in the pathogenetic mechanism of cerebral ischemic lesions. Naloxone has been shown to possess a beneficial effect on the neurologic deficit associated with cerebral ischemia in animal experiments, probably because of its endorphin antagonist properties. By contrast, the results of clinical trials are contradictory. Moreover, the true significance of high plasma levels of beta-endorphin in patients with acute focal cerebral infarct (AFCI) has not yet been elucidated. We have evaluated 23 patients with established AFCI, in whom plasma levels of beta-endorphin and corticotropin (ACTH) were simultaneously measured during the first 48 hours after the onset of the disease. The results were compared with those from a control group. In a subgroup of 9 cases new measurements were made after 7 days. In the patients with AFCI, significantly lower levels of beta-endorphin and ACTH than in the control group were found. One week later, a moderate nonsignificant increase in the plasma level of beta-endorphin was found. The localization and estimated size of the infarct area were not relevant. Probably, the plasma levels of beta-endorphin will need to be considered before naloxone therapy is indicated, and only if it is confirmed that the plasma levels of beta-endorphin reflect changes at the cerebral level, as the pathophysiological role of these opioids in AFCI has not yet been established.