[Changes in the nutritional status of the lactating women during exclusive lactation]. / Cambios en el estado nutricional de la nodriza durante lactancia exclusiva.

In order to evaluate the influence of breast feeding upon selected nutritional parameters of lactating women, several anthropometric and biochemical measurements were performed during the interval between 40 and 180 postpartum days in 54 women in full and satisfactory nursing. Only one significant change was detected in measurements done for nutritional assessment: loss of body weight. No changes were detected in hemoglobin levels or in serum protein and albumin. There was high variability in body weight changes with a mean loss of 1.5 kg due especially to a loss in fat body mass and, in a lesser proportion, to loss in lean body mass. The mean food intake did not change during the observation period. The mean caloric intake was 2,771 cal/day at the beginning and 2,737 cal/day in the end of the study. A significant correlation was established between the individual energetic intake and the body weight changes of lactating women. The allowance of 2,750 cal/day suggested by FAO/WHO for lactating women seems adequate for the health of women in a normal nutritional condition, but apparently insufficient to overcome undernutrition in women who initiate lactation with this condition. In spite of the small nutritional impact observed, our results support the need for food supplementation programs destined to lactating women, with special orientation to undernourished women of low socioeconomic level.

[Hypomagnesemia associated with hypokalemia, hyponatremia and metabolic alkalosis. Possible complication of gentamycin therapy]. / Hipomagnesemia asociada con hipokalemia, hiponatremia y alcalosis metabolica. Posible complicacion del uso de gentamicina.

Hypomagnesemia is a serious abnormality with different causes and usually associated to other disorders of electrolyte metabolism. We report a female patient developing hypomagnesemia after administration of gentamycin. This was associated to severe hypokalemia, hyponatremia and metabolic alkalosis. Possible pathogenetic mechanisms and therapeutic measures are discussed.

[Geriatric evaluation of elderly patients at a university hospital]. / Evaluación geriátrica de adultos mayores en un hospital universitario.

The aim of this work was to evaluate general aspects, medical diagnoses, degree of disability, mental status and social support of hospitalized elders using a Geriatric Assessment Scale, devised at the Catholic University. Ninety eight hospitalized subjects (58 female, aged 60 to 74 years old) were surveyed before discharge. Results showed that 34% had serious handicaps in their daily living and required third party help, 14% had a moderate cognitive impairment and that 12% lacked social or family support. We conclude that the scale is useful, easy to use and allows to obtain a thorough diagnosis of hospitalized elders.

[Application of RUG-T18 classification system to elderly patients admitted to a university hospital]. / Resultados al aplicar el sistema de clasificación de pacientes "RUG-T18" en ancianos ingresados a un hospital universitario.

BACKGROUND: Among case mix classifications, the best for hospitalized elders is the Resource Utilization Groups (RUG) system, which allows a better location of patients, resource administration and the design of health care strategies for elderly people. AIM: To report the results of RUG-T18 classification of elderly patients admitted to an university hospital. PATIENTS AND METHODS: RUG-T18 classification was applied to 210 patients aged 75.2 +/- 7.2 years old, 108 male, admitted to the Clinical Hospital of the Catholic University of Chile. RESULTS: The clinical classification of assessed patients was rehabilitation in 50.9% of cases, special care in 10.5%, clinically complex in 37.1% and reduced physical functions in 0.5%. None had behavioral alterations. There were no differences between subjects older or younger than 75 years old. Daily life activities showed that help was required for sphincter control in 46% of patients, for feeding in 44% and for mobilization in 64% (28% of patients required help from two or more people). Geriatric assessment showed that, since 1993, the proportion of elders with greater functional derangement increased from 18 to 28%, and the proportion of those with mental disturbances from 4 to 12%, specially among those over 75 years old. CONCLUSIONS: Most elders admitted to the hospital are classified in the superior categories of the RUG-T18 system and have severe mental and functional limitations. These patients require a multidisciplinary approach with a great emphasis in rehabilitation.