Effect of Two Meal Replacement strategies on Cardiovascular Risk Parameters in Advanced Age Patients with Obesity and Osteoarthritis

Producción CientíficaBackground and aims: Meal replacement diets consist of replacing one or more meals with an artificial nutritional supplement. The objective of this study was to compare the effect of one against two meal replacement strategies on body composition and cardiovascular risk parameters in patients with obesity. Methods: A randomized clinical trial was designed with a modified hypocaloric diet with an artificial nutritional preparation replacing one or two meals for three months in patients with obesity and osteoarthritis pending orthopedic surgery. An anthropometric evaluation and a measurement of the body composition were done with bioelectrical impedance measurement at the beginning and at three months. Results: A total of 112 patients were recruited. Fifty-two patients (46.4%) were randomized to one replacement and 60 patients (53.6%) to two meal replacements. Eighty-one patients (72.3%) were women, and the average age was 61 (11.03) years. The percentage of weight loss at three months was 8.27 (4.79)% (one meal replacement: 7.98 (5.97)%; two meal replacements: 8.50 (3.48)%; p = 0.56). A decrease in fat mass measured by the fat mass index (FMI) was detected (one meal replacement: −2.15 (1.45) kg/m2 vs. two meal replacements: −2.78 (2.55) kg/m2; p > 0.05), and a relative increase in fat-free mass was observed (one meal replacement: +3.57 (4.61)% vs. two meal replacements: +2.14 (4.45)%; p > 0.05). A decrease in HOMA-IR, systolic blood pressure (SBP), and total cholesterol was observed in both groups without differences between them. Conclusions: The substitution strategies of one or two meal replacements were effective in weight loss and fat mass decrease without differences between the two groups. An improvement in lipid parameters, glycemic control, and systolic blood pressure was observed without differences between strategies

Hiponatremia en nutrición parenteral: etiología, tratamiento y morbilidad asociada. Estudio multicéntrico

La hiponatremia, definida como la disminución de la concentración sérica de sodio o natremia (NaS), es el trastorno iónico más frecuente en la práctica clínica. Su prevalencia se estima en un 15-30% de los pacientes hospitalizados. Además de su elevada frecuencia, esta alteración se asocia con una mayor morbimortalidad, que puede disminuir al administrar un tratamiento eficaz. En general, sólo se logra una respuesta eficaz al tratamiento si éste se pauta en base al tipo y etiología de la hiponatremia (tratamiento adecuado). Por tanto, es importante identificar y realizar un correcto diagnóstico de la hiponatremia. Así pues, el objetivo principal del estudio es conocer el tipo y la etiología de la hiponatremia en pacientes no críticos con nutrición parenteral (NP) de los hospitales españoles. Los objetivos secundarios son identificar los factores de riesgo de desarrollo de hiponatremia, describir el tipo de tratamiento pautado y la eficacia del mismo; y valorar la morbimortalidad asociada a la presencia de hiponatremia.Departamento de Medicina, Dermatología y ToxicologíaDoctorado en Investigación en Ciencias de la Salu

Unresectable Recurrent Multiple Meningioma: A Case Report with Radiological Response to Somatostatin Analogues

Medical treatment of meningiomas is reserved for cases in which surgery and radiotherapy have failed. Given that a high percentage of meningiomas express somatostatin receptors, treatment with somatostatin analogues has been proposed. In addition, these medications have been shown to have an antiproliferative and antiangiogenic effect in vitro. To date, very few cases with clinical response and none with radiological response have been described. The case described here is the first to report a radiological response. A 76-year-old Caucasian male was first diagnosed with unresectable meningioma at age 47. The patient experienced multiple recurrences and underwent three surgeries and radiotherapy over the years from the initial diagnosis. Despite treatment, the disease continued its progression. Based on an Octreoscan positive for tumour uptake, therapy with extended-release somatostatin analogues was started. Although no clinical neurological improvement was observed, magnetic resonance imaging scans revealed a discreet but continuous radiological response over time. After >2 years of continuous administration of lanreotide, the patient remains progression free. In highly selected cases, somatostatin analogue treatment for meningioma may be beneficial. Based on our findings, treatment with somatostatin analogues should be maintained longer than previously described before evaluating treatment response