Sipple's syndrome presenting acutely as severe heart failure.

We describe the case of a 56-year-old man who developed acute hypertension leading to cardiac insufficiency, arrhythmia, severe heart failure and death. The autopsy revealed Sipple's syndrome (multiple endocrine neoplasia syndrome type IIa) and catecholamine-induced cardiomyopathy. This man had received a false diagnosis of primary hypertension 1 year before. The prime objective of this report is to call attention to the necessity of an in depth diagnosis of labile and paroxysmal hypertension. The clinical diagnostic features of phaeochromocytoma as well as the main therapeutic approaches suggested in the literature are commented on.

[Evolution of the nutritional status of patients with HIV-AIDS. Effects of socioeconomic situation and dietetic counseling]. / Evolución del estado nutricional de pacientes VIH-SIDA. Efecto de su situación socio-económica y del consejo dietético.

OBJECTIVES: To know HIV-AIDS patient's nutritional status in different infection's condition and their relation with the socioeconomic situation and, in that case, the nutritional condition improvement through the dietetic advice appropriated for each patient. METHODS: Prospective study of 79 patients with HIV-AIDS diagnostic in any illness's condition and recopilation of anthropometrics and biochemical variables. At the beginning of the study we got data about socioeconomic situation of patient with a scale of 1 to 5 points each variable and an score top of 35. In the survivors we checked, after dietetic advice, the variables at 6 and 12 months by sanitary personal (physician and nurse) who weren't implicated in direct assistance. The study was analyzed by Student "T" for matched data and the simple correlation test. RESULTS: We have objectivated a lost of initial weight over their habitual's with a progressive impairment in different stage of evolution that weren't modified by dietetic advice. We didn't observed significant variations in the biochemical variables included in advances states and in parameters which are usually affected in malnutrition. In the analysis of relation between nutritional condition and socioeconomic factors, it was estimated a lesser score, that was statistically significative, in patients who had a work, family situation and an affective upset positive. CONCLUSIONS: The results obtained induce to think that the nutritional advices appropriated for each patient are not related, in our series, with progressive deterioration of anthropometrics variables, neither biochemical parameters fluctuations at 6, 12 months of follow-up. The patient's socioeconomic situation is not influenced by nutritional condition except for the work, affectivity and family environment.