Incidencia de la hiponatremia y de sus causas en pacientes neurológicos / Incidence of hyponatremia and its causes in neurological patients

Introducción La hiponatremia se considera el trastorno electrolítico más frecuentemente hallado entre pacientes hospitalizados y parece ser un factor pronóstico en dicha hospitalización. Métodos Se realizó un estudio prospectivo observacional en pacientes ingresados de forma consecutiva en el Hospital del Mar de Barcelona, durante un período de 3 meses. Se realizó un ionograma en sangre y orina, así como la osmolalidad en plasma y orina, al ingreso y tras 3–5 días en aquellos que presentaban hiponatremia. Resultados De los 130 pacientes incluidos, 19 (14,6%) presentaron hiponatremia. Las causas de hiponatremia fueron las siguientes: administración de sueros hipotónicos, 4 (21%); medicación antihipertensiva, 4 (21%); síndrome de secreción inadecuada de hormona antidiurética, 4 (21%); síndrome pierde sal cerebral, 2 (10%); estado edematoso causado por hepatopatía, uno (5%), pérdidas digestivas, 2 (10%), cardiopatia hipertensiva, 1 (5%) y 1 paciente sin diagnóstico etiológico (5%). La mortalidad fue de uno (5%) y 0 (0%) entre los pacientes con y sin hiponatremia, respectivamente. Conclusión La hiponatremia es un trastorno común entre pacientes neurológicos hospitalizados, y la falta de diagnóstico podría ser interpretada como un empeoramiento del cuadro neurológico (AU)

Introduction Hyponatremia is considered the most frequent electrolyte disorder found in hospitalized patients and seems to be a prognostic factor during hospitalization. Methods A prospective observational study was carried out in consecutive neurological patients admitted to our hospital over a 3-month period. Blood and urinary ionogram and osmolality were determined at entry and 3–5 days after admission in all patients with hyponatremia. Results Of the 130 patients admitted, 19 (14.6%) had hyponatremia. The causes of hyponatremia were as follows: inappropriate fluid replacement in 4 patients (21%), antihypertensive drugs in 4 (21%), syndrome of inappropriate secretion of antidiuretic hormone in 4 (21%), cerebral salt wasting syndrome in 2 (10%), and edematous status caused by liver disease in one and digestive loss in one (5%) each. Mortality was one (5%) and 0 (0%) among patients with and without hyponatremia, respectively.Conclusion Hyponatremia is common in hospitalized neurological patients and can be misdiagnosed as a worsening of the main illness (AU)

[Incidence of hyponatremia and its causes in neurological patients]. / Incidencia de la hiponatremia y de sus causas en pacientes neurológicos.

INTRODUCTION: Hyponatremia is considered the most frequent electrolyte disorder found in hospitalized patients and seems to be a prognostic factor during hospitalization. METHODS: A prospective observational study was carried out in consecutive neurological patients admitted to our hospital over a 3-month period. Blood and urinary ionogram and osmolality were determined at entry and 3-5 days after admission in all patients with hyponatremia. RESULTS: Of the 130 patients admitted, 19 (14.6%) had hyponatremia. The causes of hyponatremia were as follows: inappropriate fluid replacement in 4 patients (21%), antihypertensive drugs in 4 (21%), syndrome of inappropriate secretion of antidiuretic hormone in 4 (21%), cerebral salt wasting syndrome in 2 (10%), and edematous status caused by liver disease in one and digestive loss in one (5%) each. Mortality was one (5%) and 0 (0%) among patients with and without hyponatremia, respectively. CONCLUSION: Hyponatremia is common in hospitalized neurological patients and can be misdiagnosed as a worsening of the main illness.

Diabetes mellitus tipo 1 y riesgo cardiovascular / Type 1 diabetes mellitus and cardiovascular risk

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[Treatment of diabetes mellitus during Ramadan]. / Tratamiento de la diabetes mellitus durante el Ramadán.

In the treatment of patients with diabetes mellitus it is fundamental that the therapeutic schemes are adapted to each's patient characteristics such as age, associated diseases and diabetes complications. This therapeutic individualization must also include lifestyles and socio-cultural and religious factors as the celebration of Ramadan. Although Muslin diabetics are theoretically free from Ramadan, they commonly wish to fast in practice. It is therefore needed a right approach of the patient during this period. In this Review, we analyze the prevalence of diabetes among different ethnicities, the possible complications of the disease in relation to fasting's pathophysiology, and the studies performed to rightly manage type 1 and 2 diabetic patients during Ramadan. It is necessary to adapt the therapeutic scheme both for patients treated with dietetic measures or oral drugs and for patients receiving insulin. It is also important the involvement of health professionals in the advice, orientation and adaptation of the therapeutic regimen of Muslin people with diabetes.

Tratamiento de la diabetes mellitus durante el Ramadán / Treatment of diabetes mellitus during Ramadan

En el tratamiento de las personas con diabetes es fundamental adaptar los esquemas terapéuticos a las características de cada paciente, como la edad, las enfermedades asociadas y las complicaciones de la enfermedad. Esta individualización del tratamiento debe contemplar también los estilos de vida y condicionantes socioculturales y religiosos, como la celebración del Ramadán. Las personas diabéticas de religión musulmana, aunque en teoría están exentas del Ramadán, en la práctica frecuentemente desean cumplir el ayuno. En consecuencia, es necesario un correcto abordaje del paciente durante este período. En la siguiente revisión se exponen la prevalencia de la diabetes en las diferentes etnias y las posibles complicaciones de la diabetes relacionadas con la fisiopatología del ayuno, así como los estudios realizados para el manejo adecuado del paciente con diabetes tipo 1 y tipo 2 durante el Ramadán. Es necesario adaptar la pauta terapéutica, tanto para los pacientes tratados con dieta o fármacos orales como para los tratados con insulina. Es también importante la implicación de los profesionales sanitarios en el consejo, orientación y adaptación del régimen terapéutico de las personas musulmanas con diabetes

In the treatment of patients with diabetes mellitus it is fundamental that the therapeutic schemes are adapted to each's patient characteristics such as age, associated diseases and diabetes complications. This therapeutic individualization must also include lifestyles and socio-cultural and religious factors as the celebration of Ramadan. Although Muslin diabetics are theoretically free from Ramadan, they commonly wish to fast in practice. It is therefore needed a right approach of the patient during this period. In this Review, we analyze the prevalence of diabetes among different ethnicities, the possible complications of the disease in relation to fasting's pathophysiology, and the studies performed to rightly manage type 1 and 2 diabetic patients during Ramadan. It is necessary to adapt the therapeutic scheme both for patients treated with dietetic measures or oral drugs and for patients receiving insulin. It is also important the involvement of health professionals in the advice, orientation and adaptation of the therapeutic regimen of Muslin people with diabetes