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Introduction: Introduction: we report a patient with transthyretin familial amyloid polyneuropathy (TTR-FAP) and severe hypocupremia. Case report: a 79-year-old male with TTR-FAP and severe malnutrition. Laboratory tests showed low serum copper (Cu) and ceruloplasmin levels, as well as low urinary Cu levels. The patient reported neither digestive symptoms nor previous gastrointestinal surgery. Liver function tests, iron metabolism, hemoglobin, leukocytes and zinc were normal. Discussion: Cu is a trace element. It is part of the cuproenzymes involved in several physiological functions. Hypocupremia can be related to genetic or acquired etiologies, including low intake, bariatric surgery, increased losses, etc. Primary clinical manifestations include hematological (anemia and leukopenia) and neurological (myelopathy, peripheral neuropathy) features. Treatment is empirical. In severe cases it may be initiated with endovenose administration, followed by oral supplementation.

Neuroendocrine tumors (NETs) belong to a heterogeneous family of rare tumors with very broad and complex clinical behavior. Due to their heterogeneity, the lack of specific symptoms and the absence of sensitive methods for early detection, patients are usually diagnosed when the disease is in an advanced state for which curative treatments are scarce. In most cases, these few treatments try to prolong the survival of patients, maintaining the quality of life. The identification of biomarkers could help to improve early diagnosis and to choose the most suitable therapeutic strategy. This paper provides a review of the current histopathological diagnostic approaches for lung NET subtypes, including the predictive and prognostic factors, to help in the early diagnosis of this disease.

Background: Up to 30-40% of the patients starting artificial nutritional support develop hypophosphatemia. In general, patients with mild and moderate hypophosphatemia do not have symptoms, but severe hypophosphatemia is the hallmark of refeeding syndrome., Aim: To determine the incidence of hypophosphatemia in not critically ill patients receiving enteral feeding., Material and Methods: Prospective study. We assessed during seven days 181 not critically ill patients started on enteral artificial nutrition support during seven days., Results: 51.9% of the patients were considered to be at risk of developing refeeding syndrome (United Kingdom National Institute for Health and Clinical Excellence criteria). The incidence of hypophosphatemia was 31.5%, but only 1.1% of the patients developed severe hypophosphatemia. Older age and lower plasma proteins were significantly associated with hypophosphatemia., Conclusion: The incidence of severe hypophosphatemia in our study is low, so we can't offer robust conclusions about the risk of hypophosphatemia in the type of patients receiving enteral nutrition.

Background: Elder people suffer physiological changes and illnes that increase the risk of malnutrition. Nutritional status is a major prognosis factor in older people. This study is aimed at estimating the prevalence of malnutrition among the population of 65 and over inpatients as much at admission as at discharge., Methods: We conducted a transversal observational study. 174 consecutive inpatients were examined using Nutritional Risk Screening 2002 (NRS-2002) and Mini Nutritional Assessment Short Form (MNA-SF) in the first 48 hours from admission. Patient Generated Subjective Global Assessment (PG-SGA) was applied to cancer patients. All patients were submitted the NRS-2002 at discharge., Results: 29.31% of patients were at malnutrition risk according to the results of NRS-2002 at admission. This percentage increased up to 57.89% at discharge. The MNA-SF revealed nutritional alteration in 70.35% (54.65% with malnutrition risk, 15.7% with malnutrition). The NRS-2002 showed that 34.14% of cancer patients presented with nutritional risk; however, according to PG-SGA 56.41% of the cases presented with malnutrition to a certain extent (46.15% with moderate malnutrition and 10.26% with serious malnutrition). There are different groups of patients (older patients, transferred from emergency department, patients with heart failure) who present higher risk of nutritional deterioration while they are hospitalised (p < 0.05)., Conclusions: There is a very high percentage of 65 and over patients at nutritional risk in our centre, as much at admission as at discharge. It is necessary to install a systematic screening of the nutritional status., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)

Background: Malnutrition is a frequent issue in our hospitals, and it is associated with an increase in morbi- mortality and financial costs, together with a decline in the patients' quality of life. This study is aimed at establishing the prevalence of malnutrition in our health centre, as much at admission as at discharge., Methods: Transversal observational study assessing 277 adult patients, who were admitted consecutively, and applying the Nutritional Risk Screening 2002 (NRS-2002) in the first 48 hours from admission and then again at discharge. Cancer patients were also submitted the Patient Generated Subjective Global Assessment (PG-SGA) and the Mini Nutritional Assessment Short Form (MNA-SF) was applied to the population of 65 and over., Results: 32.49% of patients were at malnutrition risk according to the results of NRS-2002 at admission. This percentage increased up to 40.98% at discharge. The NRS-2002 showed that 31.15% of cancer patients presented with nutritional risk; however, according to VGS-GP, 52.54% of the cases presented with nutritional risk to a certain extent (38.98% with moderate malnutrition and 13.56% with serious malnutrition). Among patients aged 65 and over, 29.31% were considered at risk according to the NRS-2002; the MNA-SF revealed nutritional alteration in 70.35% (54.65% with malnutrition risk, 15.7% with malnutrition). There are different groups of patients: 65 years old and over, transferred from the emergency department, multi-medicated, cancer patients and patients with heart failure, who present with a higher risk of nutritional deterioration at admission (p<0.05)., Conclusions: There is a very high percentage of patients at nutritional risk in our centre, as much at admission as at discharge. It is therefore necessary to install a systematic screening of the nutritional status for all inpatients., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)