Oral fish oil positively influences nutritional-inflammatory risk in patients with haematological malignancies during chemotherapy with an impact on long-term survival: a randomised clinical trial.

BACKGROUND: Studies suggest that the ingestion of fish oil (FO), a source of the omega-3 polyunsaturated fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), can reduce the deleterious side-effects of chemotherapy. The aim of this randomised clinical trial was to evaluate the effect of supplementation with oral FO for 9 weeks on nutritional parameters and inflammatory nutritional risk in patients with haematological malignancies during the beginning of chemotherapy. METHODS: Twenty-two patients with leukaemia or lymphoma were randomised to the unsupplemented group (UG) (n = 13) or supplemented group (SG) (n = 9). SG received 2 g/day of fish oil for 9 weeks. Nutritional status, serum acute-phase proteins and plasma fatty acids were evaluated before (T0) and after (T1) the intervention period. Data were analysed using two models; model 1, comprising data from all patients included in the study, and model 2, comprising data from UG patients with no increase in the proportions of EPA and DHA in plasma and data from SG patients showing an at least 100% increase in plasma EPA and DHA. RESULTS: SG showed an increased plasma proportion of EPA and DHA in both models. In model 2, C-reactive protein (CRP) and CRP/albumin ratio showed larger reductions in the SG. Overall long-term survival in both models (465 days after the start of the chemotherapy) was higher in the group ingesting fish oil (P < 0.05). CONCLUSIONS: These findings indicate an improved nutritional-inflammatory risk and potential effects on long-term survival in patients with haematological malignancies supplemented with FO during the beginning of chemotherapy.

[Giant renal angiomyolipoma]. / Angiomiolipoma renal gigante.

We present a case report of a renal angiomyolipoma with the special feature of its big size at the moment of the diagnosis. It is appreciated an important alteration of the kidney morphology and the repercussion produced in the rest of the abdominal organs. Due to this an exeresis with nefrectomy is performed. We do a bibliographic review and we analyzed the relevant aspects of this tumour.

[Long-term study of gastroduodenal ulcer perforation]. / Estudio a largo plazo de la úlcera gastroduodenal perforada.

One hundred forty-four patients, peptic (129 males and 15 females) treated for peptic ulcer perforation between 1972 and 1988 were reviewed. All were treated surgically, and in 28 the ulcer was also treated. The mean perforation time before treatment was 14 +/- 12.3 hours. The immediate postoperative results and long-term evolution were evaluated on the basis of the medical history, follow-up check-ups and home questionnaires. The were post-operative complications in 33 (23%) of the 137 patients who survived surgery; there was no difference in morbidity between the group in which only Closure and Epiploplasty (group C + E) were performed and group CD, where some type of definitive surgery was added, although the seven deaths belonged to the former. Of the 104 patients who were evaluated on a long-term basis (follow-up period of 55 +/- 44 months), poor results were obtained in 58 of the 82 belonging to group C + E and in four of the 28 in group CD, with a total of 13 re-operations (12 and one, respectively). Only a previous ulcer history dating from over three months had any effect on the appearance of recurrences in group C + E. We recommend performing a VGP within the first six hours as the preferred technique for pyloric or juxtapyloric perforations in patients with a previous ulcer history exceeding three months, since the rate of cure is satisfactory and there are few if any complications.

Biopsia hepatica guiada por ultrasonido. / Hepatic biopsy guided by ultrasound

En un grupo de 100 pacientes se llevo a cabo biopsia hepatica dirigida por ultrasonido, sin empleo de transductores especiales. En 98% se obtuvo material util para el examen histologico; 78% de los enfermos tenian lesiones focales del higado primarias o secundarias y el 22% restantes lesiones difusas, infecciosas u otras.Hubo complicaciones menores en 7% de los enfermos, transitorias y que cedieron con sitomaticos. Se concluye que la ultrasonografia es el metodo de eleccion para llevar a cabo una biopsia del higado