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Injury to the thoracic duct, leading to chyle leak, occurs in 1-2,5% of patients who undergo neck dissection. Associated complications include malnutrition, immune compromise, fistula formation and carotid blowout. No definitive treatment algorithm can be deduced from the current literature, but on last reviews, there is an agreement on the conservative management. Medical management is based on that decreasing chyle flow will allow for spontaneous closure of the chyle leak. Conservative treatment includes: closed vacuum drainage, bed-rest, nutrition modification and synthetic somatostatin analog. Nutrition modification involves a low-fat diet supplemented with medium-chain triglycerides (MCT), enteral nutrition with high percentage of MCT or parenteral nutrition. [ABSTRACT FROM AUTHOR]

Injury to the thoracic duct, leading to chyle leak, occurs in 1-2,5% of patients who undergo neck dissection. Associated complications include malnutrition, immune compromise, fistula formation and carotid blowout. No definitive treatment algorithm can be deduced from the current literature, but based on recent reviews, there is agreement on conservative management. Medical management is based on decreasing chyle flow, which will allow for spontaneous closure of the chyle leak. Conservative treatment includes: closed vacuum drainage, bed-rest, nutrition modification and synthetic somatostatin analog. Nutrition modification involves a low-fat diet supplemented with medium-chain triglycerides (MCT), enteral nutrition with a high percentage of MCT or parenteral nutrition. [ABSTRACT FROM AUTHOR]

Aim: To assess the degree of compliance with the European ESC/EAS 2016 and 2019 dyslipidaemia guidelines in patients with type 2 diabetes mellitus (T2DM)., Methods: Multicentre retrospective cross-sectional study, conducted in 380 adults with T2DM and dyslipidaemia in 7 Spanish health areas., Inclusion Criteria: minimum follow-up of one year in Endocrinology Units, at least one visit in 2020 and a lipid profile measurement in the last 3 months., Exclusion Criteria: familial hypercholesterolaemia, recent hospitalisation, active oncological pathology and dialysis., Results: According to the 2016 and 2019 guidelines the majority of patients were classified as being at very high cardiovascular risk (86.8% vs. 72.1%, respectively). LDL-c compliance was adequate in 62.1% of patients according to the 2016 guidelines and 39.7% according to the 2019 guidelines (p<0.001). Clinical conditions such as history of cardiovascular disease and therapy-related aspects (use of statins, especially high-potency statins, combination therapies and good adherence) were significantly associated with greater achievement of lipid targets., Conclusion: There is a discrepancy between dyslipidaemia guideline recommendations and the reality of lipid control in patients with T2DM, despite most of these patients being at very high cardiovascular risk. Strategies to optimise lipid-lowering treatments need to be implemented., (Copyright © 2022 SEEN and SED. Published by Elsevier España, S.L.U. All rights reserved.)

Ectopic ACTH production occurs in about 10% of all cases of Cushing's syndrome, and about 25% of cases of ACTH-dependent Cushing's syndrome. Diverse tumor types are able to produce ACTH ectopically, including small cell lung carcinoma. Ectopic ACTH secretion by malignant neoplasm has been reported to have earlier and more aggressive metabolic effects. We report a 59-year-old male patient with severe hypertension, metabolic alkalosis and hypokalemia as the first clinical manifestations of an ACTH-secreting small cell lung carcinoma, although the typical phenotypic features of Cushing's syndrome were not present. Ectopic Cushing's syndrome should always be ruled out in patients with severe hypertension and hypokalemia.

Adrenal incidentalomas are adrenal masses detected during radiologic examination performed for an indication otherthan evaluation of adrenal disease. Diagnosis of these masses has increased due to the widespread use of ultrasonography, computed tomography (CT) and magnetic resonance imaging. We report the case of a 69-year-old woman with a left adrenal incidentaloma simulating a non-functioning adenoma and right adrenal atrophy. The results of contrast-enhanced CT and subsequent histopathological study confirmed the diagnosis of adrenal tuberculosis. Hormonal study revealed partial adrenal insufficiency as a result of bilateral involvement of the adrenal tuberculosis., (Copyright © 2008 Sociedad Española de Endocrinología y Nutrición. Published by Elsevier Espana. All rights reserved.)