[Albumin-to-creatinine ratio as a diagnostic tool for type 2 diabetic nephropathy]. / Utilidad del cociente albúmina/creatinina en el diagnóstico de la nefropatía en pacientes con diabetes mellitus tipo 2.

BACKGROUND: Given the low effectiveness of 24 hours determination of urinary albumin excretion (UAE) for the diagnosis of diabetic nephropathy in primary care, we aimed at evaluating the albumin: creatinine ratio (ACR) in the first voided morning urine sample as a diagnostic tool in this setting. PATIENTS AND METHOD: 214 patients with type 2 diabetes were studied. ACR and UAE were compared with correlation and lineal regression analyses. A receiver operating characteristic (ROC) curve analysis was performed to determine the discriminatory value for diagnosis of diabetic nephropathy. RESULTS: The correlation coefficient between ACR and UAE was 0.93 (p<0.01) and the ROC curve analysis showed a value of 2.4 g/mol for women and 1.4 g/mol for men. CONCLUSIONS: ROC curve analysis reveals that ACR is a useful method for diagnosing diabetic nephropathy, although the discriminatory value depends on sex.

[One-day prevalence study of catheterized patients at a university general hospital. The SIUMAR project]. / Estudio de prevalencia de un día de pacientes sondados en un hospital general universitario. Proyecto SIUMAR.

OBJECTIVES: This prevalence study analyzed urinary catheter use during a day in the Hospital Universitario del Mar of Barcelona. Furthermore, we investigated the indication and duration of urinary catheterization, the presence of urinary infection and the use of antibiotics. METHODS: All hospitalized patients were included in the study and all pertinent data were obtained from patient clinical history from every department. RESULTS: Overall, 14.75% of the patients were catheterized. The surgical departments showed a higher incidence (18%) than the other departments (14%). The catheter was indwelling for a median of 12.5 days and was frequently indicated for diuresis control (49.1%), 74.5% of the patients were catheterized at the hospital, 20% of these patients were febrile and had a positive urine culture, and only 14.5% had other infectious foci and a negative urine culture. CONCLUSIONS: There was no clear indication for catheterization in a high percentage of catheterized patients, which emphasized the need for continuous evaluation of catheter use. Antibiotics were used in excess in catheterized patients, the quinolones and the last generation of cephalosporins being the most widely utilized. The indiscriminate use of these potent antibiotics can cause undesired effects and increase hospital costs.