Endocrine Abstracts

Aims: The dual burden of tuberculosis (TBC) and diabetes (DM) has attracted much attention in the past decade. Patients with type 2 diabetes have a higher risk of developing pulmonary tuberculosis; moreover, DM co-morbidity in pulmonary TB is associated with poor treatment outcomes. Patients admitted to Internal Medicine (IM) Departments are an ideal setting to analyze the prognostic roll of DM on TBC clinical course.Material and method: The Minimum Basi...

Introduction: Hyponatremia is the most frequent electrolyte disorder in hospitalised patients. Our aim was to determine the incidence, mean hospital stay, readmission rate and mortality rate among patients with acute heart failure (HF) and hyponatremia.Methods: Retrospective analysis of data collected from the minimum data set (MDS) of Spanish National health System during 2005–2012 from discharged patients of Internal Medicine with HF and hyponatre...

Introduction: The prevalence of hyperthyroidism in patients admitted in Internal Medicine at Spanish hospitals is 0.8%. Proper diagnosis and management of HTD in these patients is still a challenge and therefore, the analyses of the factors involved in the prognosis and survival is of interest.Methods: Data from the minimum-data-set (MDS) of Spanish National health System were collected during 2005–2012 from discharged patients of Internal Medicine ...

Introduction: Hypoaldosteronism (HA), a cause of hypovolemic hyponatremia (HN) with urinary(U) sodium(Na) loss, is often underdiagnosed. We studied 28 patients with an episode of HA-induced moderate/severe hyponatremia.Methods: Retrospective 2012–2015. In all patients, Nadir(N) serum(S) Na <130 mmol/l (corrected for total proteins and glycemia), low internal yugular venous pressure, low ocular pressure. Addison’s Disease ruled (ACTH, cortis...

Context: Fluid restriction (FR) is recommended as first line therapy for SIAD by both the European1 and the American guidelines2 for management of SIAD. Not all patients respond to FR however, and the American guidelines have identified clinical predictors of failure to respond to FR. These include 1.Urine osmolality (UOsm) >500 mOsm/Kg 2. Furst formula (ratio UNa+UK/pNa) > 1, and 3. 24 hour-urine volume<1500 mlObjective...

Introduction: ESE guidelines state a risk for overcorrection of serum sodium levels (SNa) with vaptans. We present the results of our protocol for initiation of tolvaptan(TV) therapy in SIADH.Methods: Retrospective (2011–15). 86 patients with SIADH-induced mild/moderate hyponatremia received TV:7.5 mg day 1, ad-libitum liquids, no other Na-raising therapies. Conventional hospitalization (CH):66/86, day hospital (DH):20/86. Glycemia-corrected SNa det...

Introduction: Some authors consider aldosteronism to be a spectrum, ranging from aldosterone-associated (or low-renin) hypertension (AAH) to primary hyperaldosteronism (PHA) due to bilateral adrenal hyperplasia. Thus, blood pressure (BP) response to mineralocorticoid-receptor blockade (MRB) could be similar.Methods: Retrospective analysis of 60 patients. Screening per Endocrine Society guidelines, positive screening: aldosterone (pg/ml) to direct-renin (...

Introduction: Hypothyroidism (hT) is a very common disease that can affect inpatients prognosis. We analysed the clinical profile of patients with hT admitted to Internal Medicine using a large clinical-administrative database.Methods: A descriptive analysis based on the minimum-data-set database of the Spanish National health System of patients who were discharged from the services of Internal Medicine with the diagnoses of hT during 2005–2012 was ...

Introduction: Furosemide can be used in the treatment of SIADH. However, to be effective, renal medulla osmolality (OsmRM) as reflected in urinary osmolality (UOSM) must be high. Sodium is the most important contributor to OsmRM, which increases following the administration of oral salt. We analyze the use of an oral salt load followed by furosemide for the acute/short-term treatment of euvolemic SIADH hyponatremia.Method...

Introduction: Chronic tolvaptan (TV) therapy has been found to be safe and effective in the treatment of chronic SIADH. However, experience with modification of doses over time is limited.Methods: We conducted a retrospective analysis of weekly TV doses (mg) in 41 patients with chronic SIADH treated for a minimum of 3 months, seen a week following discharge and monthly thereafter. Serum sodium (SNa) goal was 137–140 mmol/l, with 50% TV dose reductio...