[Nutritional assessment of patients candidates for waiting list simultaneous kidney pancreas transplantation]. / Evaluación nutricional de pacientes candidatos a lista de espera de trasplante renopancreático.

BACKGROUND: Simultaneous Kidney Pancreas transplantation is currently the treatment of choice for patients with type 1 diabetes ERD advanced. Scientific studies on the therapeutic benefits of this guarantee acceptance of it as the most suitable for patients. The independence of dialysis and insulin therapy after the transplant represents a significant increase in the quality of life for these patients. In recent years, the importance of nutritional assessment in patients with chronic diseases has increased. There is increasing evidence that malnutrition is associated with an increased risk of morbidity and mortality after surgery. Given the therapeutic choice for these patients and the importance of nutritional status as an independent risk factor for post-transplant complications objective of our work is to describe the nutritional status of patients who are candidates for transplant through objective and subjective parameters of evaluation nutritional. MATERIALS AND METHODS: We included 45 patients with type 1 diabetes ERD interned in the Hospital Italiano of Buenos Aires for assessing pre Transplantation during the period June 2007-June 2008. They collected data through a sheet produced by themselves. As parameter anthropometric was calculated body mass index (BMI) by the formula Quetelet (post dialysis Weight (kg) / height 2 (m)) and was ranked as the ranges proposed by the committee of experts from WHO. As a subjective argument took place the Subjective Global Valuation (VGS), which ranked patients in well-nourished (A), mild malnourished (B), moderately malnourished (C) and severely malnourished (D). As biochemical parameters of the data was recorded serum albumin (g/dl) to hospitalizations and this data was obtained from the patient's medical history. RESULTS: The value of the average BMI of the total population was 21.83+/-2.65. According to the sex values were: 21.83+/-2.39 and 21.82+/-2.95 for male and female respectively. The nutritional status according to this indicator was anthropometric Normal in 89% of cases. The 6.66% of the cases submitted 13.33% pre malnutrition and obesity. We found no cases with obesity. Taking into account the albumin 47.45% of patients presented moderate risk of morbidity and mortality. According to GSV 62.22% were classified as well-nourished (Class A). It was the equitable proportion of women and men 33.33% were classified as mild malnourished (Class B). Only 2 cases (8.88%) had moderate malnutrition (Class C). None presented malnutrition Graves (Class C). CONCLUSION: In our study we can see that patients are candidates for waiting list while normal BMI have presented evidence of nutritional risk when one takes into account the VGS and the average value of albumin.

Profile of HIV disease in an American border city.

A previous study on patterns of migration of HIV-infected persons suggested that most patients in a rural setting in eastern Tennessee acquired their disease in an urban area, typically during a period of prolonged residence. Disease and disability were the most common reasons for returning to their hometown. We studied our urban, border-city HIV clinic population to see whether similar patterns of migration were discernible. Fifty-one of the 103 patients studied lived outside the El Paso/Juarez area when they contracted HIV infection. The major reason cited for returning home was a desire to return to family (25%). Those who returned and those who had never left showed no statistically significant difference in age, race, or risk factors. This study suggests that migration of HIV-infected patients back to their hometown does not appear to be an exclusively rural phenomenon.

Cerebrospinal fluid values for monoamine metabolites, gamma-aminobutyric acid, and other amino compounds in Rett syndrome.

We measured concentrations of 3-methoxy-4-hydroxy-phenylglycol, 3,4-dihydroxyphenylacetic acid, homovanillic acid, and 5-hydroxyindoleacetic acid--the metabolites of noradrenaline, dopamine, and serotonin used as central neurotransmitters--in the cerebrospinal fluid (CSF) specimens of five girls with Rett syndrome. These patients met the clinical criteria for both inclusion and exclusion of the diagnosis of Rett syndrome. In contrast to previous reports, cerebral monoamine metabolites were present in normal concentrations in CSF. In addition, concentrations of gamma-aminobutyric acid and of a large number of other amino acids and related compounds were normal in the CSF of patients with the syndrome. We doubt that an underlying biochemical cause for this disorder has yet been discovered.

Blood serotonin concentrations and fenfluramine therapy in autistic children.

Whole-blood serotonin concentrations of 31 autistic children, aged 2 1/2 to 16 years, 10 non-autistic retarded children, and 18 children with Down syndrome were measured by a fluorometric method and compared with those of normal children of similar age range. No significant difference in the serotonin concentration per milliliter of whole blood or per 1000 platelets was found between groups for autistic, retarded, or normal children, but the values for those with Down syndrome were significantly lower. A double-blind cross-over study on the effect of fenfluramine versus placebo in seven autistic boys over a period of 8 months demonstrated a significant decrease in blood serotonin levels during the fenfluramine phase in all subjects. Slight improvements were found in short-term auditory memory and some measures of receptive language skills, particularly in children functioning at a high level. There was no significant change in global psychometric measurements of general intelligence during therapy. No adverse clinical effect was observed other than weight loss of 6% in one child. We conclude that fenfluramine may have some selective favorable effects on increasing attention in high-functioning autistic children. Blood serotonin concentration may be followed as an indication of drug compliance during fenfluramine therapy, but does not appear to reflect clinical efficacy.