The prevalence of sarcopenia (loss of muscle strength, mass and function) in individuals with heart failure (HF) stands at a considerable level (approximately 20%), contributing to heightened mortality rates and diminished quality of life. The underlying pathophysiological mechanisms involve the presence of low-grade inflammation and a disturbance of the anabolic–catabolic protein balance. The nutritional assessment of patients with HF is a key aspect, and diverse diagnostic tools are employed based on patient profiles (outpatient, inpatient and nursing home). The Global Leadership Initiative on Malnutrition (GLIM) criteria serves as a consensus for diagnosing malnutrition. Given that edema can impact body mass index (BMI) in patients with HF, alternative body assessment technical methods, such as bioelectrical vector impedance (BiVA), BIA (without vector mode), computer tomography (CT) or clinical ultrasound (US), are useful. Scientific evidence supports the efficacy of both aerobic and resistance physical exercises in ameliorating and preventing muscle wasting associated with HF. Dietary strategies emphasize the importance of protein intake, while certain micronutrients like coenzyme Q10 or intravenous iron may offer benefits. This narrative review aims to present the current understanding of the pathogenesis, diagnosis and treatment of muscle loss in individuals with heart failure and its consequential impact on prognosis.

Primary thyroid malignancy is more frequent than secondary. This case report describes a colon lymphoma with unique thyroid metastasis. When a thyroid lesion appears in an extension study such as Positron emission tomography–computed tomography marked with 18F-2-fluoro-2-deoxy-D-glucose, it is recommended to perform an ultrasound. The correct study with ultrasound and cytology obtained through fine needle aspiration on thyroid lesion allowed to refine the diagnosis and provide the correct treatment.

Introduction: Hyperaldosteronism usually presents with hypertension and hypokalemia; however, there is recent evidence of a relationship with the parathyroid hormone. There are different theories to try to explain this relationship. Hyperaldosteronism treatment is medical or surgical depending upon etiology. We present three cases in which treatment solely for hyperaldosteronism also cured hyperparathyroidism. Materials and methods: We report three patients in whom hyperaldosteronism was diagnosed during 2015 and detected simultaneously hyperparathyroidism. We recorded epidemiological data, pre- and post-surgical phospho-calcium metabolism, as well as hyperaldosteronism. Results: Case 1: A 38 year old male was referred for suspected hyperaldosteronism. A nodule was detected in left adrenal in TC image. Levels of PTH 150 pg/ml were objectified with normal serum and urinary calcium and phosphorus. Levels of vitamin D were 19.9 ng/ml. After left adrenalectomy, PTH levels were normalized. Case 2: A 55 years old woman referred for study of hypokalemia. Her PTH levels were 162 pg/ml with normal serum phosphorus and urinary calcium. Lesion 20 mm in left adrenal was detected in TC image. After adrenalectomy, PTH levels down to 34 pg/ml. Case 3: A 63 years old woman was referred to rule out hyperaldosteronism. She presented PTH levels of 136 pg/ml and normal levels of serum calcium and phosphorus. Vitamin D levels were 24 ng/ml. MRI image showed right adrenal injury that was removed. After surgery, PTH levels diminished. Conclusions: In cases of primary hyperaldosteronism is advisable to assess the phospho-calcium metabolism, especially PTH. The effect of hyperaldosteronism on bone long-term is still unknown. In any case, the calcium/phosphorus levels were not pathological. Sometimes treatment solely of hyperaldosteronism can simultaneously treat hyperparathyroidism.

Introduction: Obesity is one of the most prevalent health problems in our society. The marketing of Liraglutide and the Naltrexone/Bupropion combination has been given the green light. Objectives: To analyze the differences in a series of 19 patients assigned to treatment with Liraglutide or Naltrexone/Bupropion. Material and methods: A descriptive analysis was carried out using Stata. 19 patients were included, 9 were treated with Liraglutide and 10 with Naltrexone/Bupropion. We analyzed the percentage of weight loss and side effects at one month and two months after treatment initiation. Results: Of the 9 patients included in the Liraglutide arm, 2 were male and 7 were female, with a mean age of 56.22 and a mean BMI of 41.35. From the Naltrexone/Bupropion group, 5 male and 5 female participants, with a mean age of 52.90 and an initial BMI of 34.40. After one month of treatment, a % weight loss of 3.81 was observed for the Liraglutide group versus 1.06 for Naltrexone/Bupropion (difference of means 2.75). After two months, a 7.51% weight loss was observed for Liraglutide versus 0.12% for Naltrexone/Bupropion (mean difference 7.40), the latter being statistically significant. 77.8% of patients treated with Liraglutide developed secondary side effects at the first month (28.57% at the second visit), only one patient withdrew from taking the drug. In the Naltrexone/Bupropion group, side effects were observed in 20% with two dropouts for this reason (another 4 abandoned the treatment for other reasons). Regarding the dosage of Liraglutide per month, 11% of Liraglutide 1.2 mg, 33% 1.8 mg, 33% 2.4 mg, 22% 3 mg. At two months, 43.86% 1.8 mg and 57.14% 3 mg. Conclusions: In our clinical practice we observed a greater weight loss % in the Liraglutide group, especially at two months of treatment. The number of negative side effects was greater for Liraglutide, primarily in the first month, with a higher abandonment rate for Naltrexone/Bupropion.