RESUMO
AIM: Protein-energy malnutrition as well as systemic inflammation and metabolic disorders are common in patients with chronic kidney failure, who require renal replacement therapy (haemodialysis). Such malnutrition is a factor that significantly contributes to their morbidity and mortality. This study evaluated the nutritional status of haemodialysis patients by assessing biochemical and anthropometric parameters in order to determine whether these patients suffered disorders reflecting nutritional deterioration directly related to time on haemodialysis. SUBJECTS AND METHOD: This research comprised 90 patients of both genders with chronic kidney failure, who regularly received haemodialysis at our unit over a period of ten years. The patients' blood was tested quarterly for plasma albumin, total cholesterol and total proteins, and tested monthly for transferrin. The patients' weight, height and body mass index (BMI) were monitored. Body mass index was calculated using the formula: weight (kg)/height (m2 ) and classified in one of the following categories defined in the World Health Organization (WHO) Global Database on Body Mass Index: (i) underweight [BMI < 18.50], (ii) normal [BMI 18.50 - 24.99], (iii) overweight [BMI 25 - 29.99], (iv) obese [BMI > 30]. RESULTS: In the ten-year period of the study, the patients experienced a substantial decline in their biochemical parameters. Nevertheless, their BMI did not show any significant changes despite the patients' state of malnutrition. CONCLUSIONS: The prevalence of malnutrition in haemodialysis patients was evident. Nevertheless, the BMI of the subjects did not correspond to the biochemical parameters measured. Consequently, the results showed that the nutritional deterioration of these patients was mainly reflected in their biochemical parameters rather than in their anthropometric measurements.
RESUMO
OBJECTIVES: Study the percentage of clinical successes which have been confirmed by percutaneous hepatic biopsy guided by echography (PHBE) in those diseases which can affect the liver in an Internal Medicine service. PATIENTS AND METHODS: 78 patients were chosen for this study. All of them were admitted to hospital during the last eight years. Each patient had had a PHBE made regarding clinical, analytical and echographic criteria that were necessary to conclude their diagnostic studies. They were distributed into different groups. RESULTS: Patients could be distributed into five different groups. There was a higher percentage of clinical successes on those who suffered from chronic hepatopathy derived from alcohol-addiction and on those with carcinomatous hepatopathies. When corroborating the diagnosis of clinical suspect, the diagnostic profitability of the biopsy proved to get down in the others groups, depending on it was the group of miscellaneous, dissociate cholestasis and, in the last place, unknownly originated fever. CONCLUSIONS: The diversity of diseases which can affect the liver in an Internal Medicine service gives PHBE a particular diagnostic character. The diagnosis of clinical suspect was confirmed in 78.2% of the total of cases that made up the different groups. Therefore, PHBE plays a main role in a large amount of hepatic repercussive diseases that are treated in Internal Medicine services where, despite the clinical suspect, a diagnostic corroboration is often required for a right treatment.
Assuntos
Biópsia por Agulha , Hepatopatias/patologia , Fígado/patologia , Humanos , Neoplasias Hepáticas/patologia , Ultrassonografia de IntervençãoRESUMO
Intracerebral hemorrhages represent about 10% of the whole of vascular cerebral accidents. According to different authors, the incidence of cerebral amyloid angiopathy varies between 5-10% and up to 20-30% of all primary non-traumatic intracerebral hemorrhages. This incidence was analyzed in our environment. A retrospective study was carried out on 403 patients, 203 of them were analyzed between 1990-91 and the other 200 between 1992-3. Age, arterial tension, relapses and localization were taken as criteria for a diagnosis. For the statistical analysis, Student's T-test was used for quantitative variables, while square Chi with Yates' correction was used for qualitative variables. Ischemic cerebral accidents (90.5% of the total) are more frequent than hemorrhagic cerebral accidents, which represent 5.7%. 3.7% were not registered. Therefore, it was suspected cerebral amyloid angiopathy in 1.4% of all vascular cerebral accidents. This represents 26.1% of the total of hemorrhagic patients. Different variables from groups of hemorrhagic vascular cerebral accidents were compared to those caused by amyloid cerebral angiopathy and significant statistics were found with respect to localization in the cerebral hemispheres (p < 0.01). Neither age, nor arterial tension or relapses were significant. Amyloid cerebral angiopathy as a cause of hemorrhagic cerebrovascular accident is and entity to be considered in the diagnosis of these patients. By using clinical criteria and others of localization through complementary explorations, a diagnosis for guessing such a process can be determined.