Efficacy of a new immunonutrition formula with extra virgin olive oil in the reduction of complications in surgeries of upper digestive tract tumors.

Background: To demonstrate whether a nutritional supplement enriched with arginine, nucleotides, omega-3 fatty acids, and extra virgin olive oil reduces postoperative complications in patients with tumors in the upper digestive tract. Methods: A randomized, controlled, double-blind, multicenter clinical trial, in which a new immunomodulatory formula with extra virgin olive oil was compared with a standard isoprotein and isoenergetic formula. Patients with gastric, esophageal or biliopancreatic tumors were recruited to receive two units of immunomodulatory formula or control, 5 days before the surgical intervention. Results: A total of 119 patients were recruited. There was a significant reduction in the number of reinterventions (7.7 vs. 20.4%; p = 0.044) in the intervention group. There was a significant reduction in the development of fistulas in patients with phase angles >5.7°. Also, there were fewer readmissions after biliopancreatic surgeries (0.0 vs. 100%; p = 0.014). The length of hospital stay was similar between groups; however, with the immunomodulatory formula, the patients exhibited greater phase angle at the end of follow-up. Conclusion: The immunomodulatory formula with extra virgin olive oil administered 5 days before surgery for stomach, esophageal and biliopancreatic tumors improved cellular health and reduced postoperative complications.Clinical trial registration: [https://clinicaltrials.gov/], identifier [NCT04027088].

Should we suspect primary aldosteronism in patients with hypokalaemic rhabdomyolysis? A systematic review.

Severe hypokalaemia causing rhabdomyolysis (RML) in primary aldosteronism (PA) is a rare entity, and only a few cases have been reported over the last four decades. This systematic review and case report aims to gather all published data regarding a hypokalaemic RML as presentation of PA in order to contribute to the early diagnosis of this extremely rare presentation. With the use of PubMed Central, EMBASE, and Google Scholar, a thorough internet-based search of the literature was conducted to identify articles and cases with RML secondary to hypokalaemia due to PA between June 1976 and July 2023. The case study concerns a 68-year-old male patient with hypokalaemic RML at presentation of PA. In the systematic review of the literature, 37 cases of RML secondary to hypokalaemia due to PA have been reported to date. In summary, the median age was 47.5 years, the male/female ratio was 17/21, all patients presented symptoms (weakness and/or myalgia), all the patients were hypertensive, and only four patients had complications with acute kidney injury (AKI). Although PA rarely presents with RML, it should be suspected when marked hypokalaemia and hypertension are also present. Early detection and management are essential to reduce the frequency of manifestations such as AKI.

Factores predictores de formas graves de COVID-19 que requieren hospitalización en pacientes con diabetes mellitus / Predictor factors of severe forms of COVID-19 requiring hospitalisation in patients with diabetes mellitus

Aims: To identify possible risk factors of hospitalisation in patients with diabetes (DM) and 2019 novel coronavirus disease (COVID-19), to establish the prevalence of DM among infected patients and that of DM in patients requiring hospitalisation. Research design and methods: Between March-May 2020, 1202 consecutive subjects in the healthcare area of Santiago de Compostela and Barbanza (Galicia, Spain) were diagnosed with COVID- 19, among whom 136 patients with DM were identified. Demographic data, DM characteristics and complications during hospitalisation were collected and analysed. Results: The prevalence of DM among COVID-19 infected subjects was 11.3%. This ascended to 21.7% in inpatients, while only 8.1% of outpatients had DM (p<0.0001). Higher levels of glycated haemoglobin significantly increased the risk of hospitalisation (OR: 1.57; 95% CI: 1.03-2.41, p=0.037), with small differences making the difference between inpatients and outpatients (7.3 ± 1.3% vs 6.8 ± 0.9% [56 ± 14 vs 51 ± 10 mmol/mol], respectively, p=0.009). Obesity (BMI ≥ 30 kg/m2) was the only comorbidity associated to hospitalization (OR: 2.94; 95% CI: 1.17-7.30, p=0.021). There were no differences in the type and duration of DM, the type of glucose-lowering drugs, or in the presence of micro/macrovascular complications. Conclusion: DM does not increase the risk of suffering from COVID-19, but it can worsen the outcome, raising the hospitalisation rate. Thus, obesity and worse chronic glycaemic control, even with small variations, are independent and determining factors for severe forms which require hospitalisation. (AU)