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1.
Appl Opt ; 62(12): 3105-3111, 2023 Apr 20.
Artículo en Inglés | MEDLINE | ID: mdl-37133157

RESUMEN

The generation of series of random numbers is an important and difficult problem. Appropriate measurements on entangled states have been proposed as the definitive solution to produce series of certified randomness, and quantum optical systems play a major role. However, several reports indicate that random number generators based on quantum measurements have a high rate of series rejected by standard tests of randomness. This is believed to be caused by experimental imperfections and is usually solved by using classical algorithms to extract randomness. This is acceptable to generate random numbers in a single place. In quantum key distribution (QKD) instead, if the extractor is known by an eavesdropper (a situation that cannot be ruled out), the key's security may be menaced. We use a not-loophole-free, "toy" all-fiber-optic-based setup, mimicking a QKD one operating in the field, to generate binary series and evaluate their level of randomness according to Ville's principle. The series are tested with a battery of indicators of statistical and algorithmic randomness and nonlinear analysis. The good performance of a simple method to get random series from rejected ones, previously reported by Solis et al. is confirmed and supported with additional arguments. Incidentally, a theoretically predicted relationship between complexity and entropy is verified. Regarding QKD, the level of randomness of series, obtained by applying Toeplitz's extractor to rejected series, is found to be indistinguishable from the level of non-rejected raw ones.

2.
Pituitary ; 24(1): 96-103, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33057946

RESUMEN

PURPOSE: Current international guidelines recommend colonoscopy in patients with acromegaly at the time of diagnosis, even though the risk of developing colorectal neoplasm is still controversial. The main objective of this Argentine multicenter study was to analyze through screening colonoscopy the presence of advanced neoplastic lesions considered as precancerous, in patients with acromegaly compared to a control group. METHODS: This is a case-control retrospective study. Full length colonoscopy of 70 acromegalic patients and 128 control subjects were studied. Polyps were classified into non pre-cancerous lesions and advance neoplastic lesions which included advanced adenomas (preneoplastic) and colorectal carcinomas. RESULTS: Thirty three out of 70 acromegalic patients and 32 out of 128 subjects controls presented polyps in the colonoscopy [47.1% vs 25%, p = 0.002, OR 2.68]. Non precancerous polyps were found in 11 (15.7%) and 23 (17.9%) (p = 0.690), while advanced neoplastic lesions were found in 22 (31.4%) and 9 (7.0%) (p = 0,0001 - OR: 6.06) patients and controls respectively. Advanced adenomas and colorectal carcinomas were found in 18 (27.3%) and 9 (7.0%) (p = 0,0006-OR: 4,57), and 4 (5.7%) and 0 (0.0%) p = 0.0063) of patients and controls respectively. The presence of insulin resistance was the only statistically significant associated factor among acromegalic patients with and without colonic polyps. CONCLUSIONS: Our findings show an increased risk of preneoplastic colonic lesions and colorectal carcinoma in patients with chronic and sustained GH excess compared to a control group. This supports the recommendation to perform screening colonoscopy at diagnosis of acromegaly.


Asunto(s)
Acromegalia/epidemiología , Pólipos/epidemiología , Adulto , Anciano , Estudios de Casos y Controles , Colonoscopía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Multicéntricos como Asunto , Estudios Retrospectivos
3.
Entropy (Basel) ; 23(12)2021 Nov 27.
Artículo en Inglés | MEDLINE | ID: mdl-34945896

RESUMEN

Quantum mechanics predicts correlations between measurements performed in distant regions of a spatially spread entangled state to be higher than allowed by intuitive concepts of Locality and Realism. These high correlations forbid the use of nonlinear operators of evolution (which would be desirable for several reasons), for they may allow faster-than-light signaling. As a way out of this situation, it has been hypothesized that the high quantum correlations develop only after a time longer than L/c has elapsed (where L is the spread of the entangled state and c is the velocity of light). In shorter times, correlations compatible with Locality and Realism would be observed instead. A simple hidden variables model following this hypothesis is described. It is based on a modified Wheeler-Feynman theory of radiation. This hypothesis has not been disproved by any of the experiments performed to date. A test achievable with accessible means is proposed and described. It involves a pulsed source of entangled states and stroboscopic record of particle detection during the pulses. Data recorded in similar but incomplete optical experiments are analyzed, and found consistent with the proposed model. However, it is not claimed, in any sense, that the hypothesis has been validated. On the contrary, it is stressed that a complete, specific test is absolutely needed.

4.
Opt Lett ; 41(13): 3010-2, 2016 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-27367088

RESUMEN

We report observations of extreme events (or dissipative optical rogue waves) in a laser with a modulated parameter (cavity losses). Experimental data supporting the hypothesis that these events are related with multi-stability and external crises is presented. It is also shown that the time separation between a pulse and an extreme event can be predicted more accurately than that between pulses of average intensity, in agreement with the theoretical description and opening the road to the prediction and control of extreme optical events.

5.
Arch Med Res ; 55(3): 102968, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38368779

RESUMEN

BACKGROUND AND AIMS: Vitamin D deficiency is a global health problem. The determinants of this deficiency have not been evaluated in developing countries such as Mexico. Thus, this study aimed to determine vitamin D intake and sun exposure and its relationship with plasma concentrations of 25-hydroxyvitamin D -25(OH)D- in young adults from Mexico City. METHODS: One hundred fifty five urban adult subjects were enrolled during 2017 and 2018. Sociodemographic, anthropometric, and clinical data, vitamin D intake, and sun exposure habits were collected. Plasma concentrations of 25(OH)D were also determined. RESULTS: The proportion of vitamin D deficiency was significantly higher in women than in men (65.7 vs. 43.4%, p = 0.012). The overall median dietary vitamin D intake was 112 IU/d (less than 20% of the recommended daily intake; RDI). 25-hydroxyvitamin D correlated directly with vitamin D intake, sun exposure score, waist-to-hip ratio, and age; an inverse significant association was found with body fat percentage. A multiple regression analysis was performed; simultaneous and significant (p <0.01) effects of sun exposure score, dietary vitamin D, the season of the year (spring-summer vs. fall-winter), and age were observed on 25(OH)D levels. CONCLUSION: High rates of vitamin D deficiency and insufficiency were observed in young adults from Mexico City. According to the RDI of this vitamin, its consumption, assessed by a 24 h multi-step nutritional questionnaire, was significantly low. A linear multiple regression model identified several predictors of plasma 25(OH)D concentrations. This multiple regression model was statistically validated.


Asunto(s)
Luz Solar , Deficiencia de Vitamina D , Femenino , Humanos , Masculino , Adulto Joven , Suplementos Dietéticos , México/epidemiología , Vitamina D , Deficiencia de Vitamina D/epidemiología , Vitaminas
6.
Medicina (B Aires) ; 83(5): 744-752, 2023.
Artículo en Español | MEDLINE | ID: mdl-37870332

RESUMEN

INTRODUCTION: Primary hypophysitis (PH) is a rare disease that represents a challenge among differential diagnosis and management. Our aim was to describe clinical characteristics, diagnostic criteria and different treatment outcomes in patients with PH. Multicentric, retrospective study. Clinical presentation, endocrine function, magnetic resonance imaging findings, visual field defects at diagnosis and treatment outcomes were recorded. METHODS: Twenty-eight patients (23 women), with PH were included. Median age: 37. RESULTS: The most frequent symptoms: headache: 68%, polyuria-polydipsia: 50% and visual disturbances: 48%. At diagnosis, anterior pituitary deficiency was present in 71%, being hypogonadotrophic hypogonadism the most frequent manifestation. The radiological findings: symmetric lesion: 78.5%, homogeneous enhancement: 78.5% and pituitary stalk thickening: 70%. Association with pregnancy or puerperium was found in 4/23 women (17%). Fourteen patients did not receive any treatment ("wait and see" group), 8 underwent surgery for mass reduction or resection and 6 were treated with immunosuppression therapy. Among 15 patients with histopathological diagnosis, 9 were lymphocytic hypophysitis, 5 IgG4 related hypophysitis and 1 xanthomatous hypophysitis. Thirteen were diagnosed by established clinical criteria. Mass reduction was observed in 43% of "wait and see group" patients, 62.5% of operated patients and 50% with immunosuppression therapy. Compressive symptoms showed improvement in the 3 groups, with modest effect on anterior pituitary function, diabetes insipidus did not resolve in any patients. DISCUSSION: In patients without severe compressive symptoms, we adopted a "wait and see" approach. In patients with uncertain diagnosis of PH or severe compressive symptoms, transsphenoidal surgery was the best option.


Introducción: La hipofisitis es una enfermedad infrecuente que plantea un desafío en el diagnóstico y tratamiento. El objetivo de este estudio multicéntrico y retrospectivo fue describir: a) características de pacientes con hipofisitis primaria (HP), b) métodos diagnósticos, y c) tratamientos realizados. Además, evaluar: a) presentación clínica, b) bioquímica, c) radiológica, d) oftalmológica al diagnóstico y evolución según el tratamiento recibido. Métodos: Estudio retrospectivo donde se estudiaron 28 pacientes (23 mujeres/5 varones) con HP, edad promedio de 38±11.1 años. Resultados. Los síntomas fueron: cefalea: 68%, poliuria- polidipsia: 50% y alteraciones visuales: 48%. El examen de laboratorio inicial informó disfunción adenohipofisaria en 71% de los pacientes, siendo el eje gonadal el más afectado. Los hallazgos radiológicos más frecuentes fueron: lesión simétrica:78.5%, aumento homogéneo post contraste: 78.5% y engrosamiento de tallo:70%. En 4/23 mujeres (17%) se relacionó con embarazos o puerperio La conducta inicial fue expectante (CE) en 14 pacientes, cirugía de resección/descompresión en 8 y tratamiento con inmunosupresores en 6. Quince pacientes tuvieron confirmación histológica, 9 resultaron hipofisitis linfocitaria, 5 hipofisitis por IgG4 y una xantomatosa. Trece fueron diagnosticados por criterios clínicos establecidos. El tamaño de la lesión disminuyó en 43% de pacientes con CE, 62.5% con cirugía y 50% con inmunosupresores. Los síntomas compresivos mejoraron en los 3 grupos, con escaso efecto sobre la función adenohipofisaria, sin resolución de la diabetes insípida. Discusión: En pacientes sin síntomas compresivos adoptamos CE. En aquellos pacientes sin certeza diagnóstica o con síntomas compresivos graves, se optó por cirugía transesfenoidal.


Asunto(s)
Hipofisitis Autoinmune , Hipofisitis , Hipopituitarismo , Embarazo , Humanos , Femenino , Adulto , Estudios Retrospectivos , Hipofisitis/diagnóstico , Hipofisitis/terapia , Hipofisitis/patología , Hipófisis/patología , Hipopituitarismo/diagnóstico , Hipofisitis Autoinmune/diagnóstico , Hipofisitis Autoinmune/terapia , Hipofisitis Autoinmune/patología , Imagen por Resonancia Magnética
7.
Arch Med Res ; 53(4): 416-422, 2022 06.
Artículo en Inglés | MEDLINE | ID: mdl-35501225

RESUMEN

BACKGROUND: FokI (rs2228570 T>C) and BsmI (rs1544410 A>G) polymorphisms of the vitamin D receptor (VDR) have been associated to abnormal glucose metabolism and could be inversely associated with ß-cell function (BCF) and vitamin D status. There is a lack of information about this topic in the Mexican population. AIM OF THE STUDY: To evaluate the relationship between VDR gene polymorphisms FokI and BsmI with BCF and vitamin D status in a population of non-obese Mexican adults. METHODS: A sample of 192 participants were enrolled during 2016-2018. Blood samples were collected to determine fasting concentrations of glucose, insulin, and vitamin D. Genomic DNA was isolated from leucocytes and the polymorphic variants of FokI and BsmI were analyzed. The Homeostasis Model Assessment Calculator was used to estimate the BCF (HOMA2-B). RESULTS: FokI polymorphism showed a frequency of 20.1% for homozygous TT carriers and 7.8% for the BsmI GG. The recessive model of FokI (TT genotype) showed a lower mean value of BCF compared to the combination of CC + CT (99.2 vs. 109.6%, p = 0.045). Likewise, significantly lower mean values of HOMA2-B and insulin were observed for BsmI (GG genotype, p = 0.016 and p = 0.039, respectively). After covariates adjustment, only FokI polymorphism remained as an independent predictor of BCF. CONCLUSIONS: the TT and GG variants of the FokI and BsmI polymorphisms are related to a decrease in FCB. In the case of FokI, this decrement was independent of insulin sensitivity, vitamin D levels, percentage of body fat, gender, and age.


Asunto(s)
Insulinas , Receptores de Calcitriol/genética , Adulto , Estudios de Casos y Controles , Predisposición Genética a la Enfermedad , Genotipo , Humanos , Polimorfismo Genético , Polimorfismo de Nucleótido Simple , Vitamina D
8.
J Clin Res Pediatr Endocrinol ; 10(2): 139-146, 2018 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-29082896

RESUMEN

OBJECTIVE: The aim of this study was to determine optimal cut-off points for fasting and post-glucose stimulus surrogates of insulin resistance to predict metabolic syndrome in adolescents according to several definitions. METHODS: One hundred fifty-five adolescents living in Mexico City were enrolled during 2011 and 2012. Waist circumference and blood pressure were recorded. Subjects received an oral glucose load of 1.75 g per kg up to a maximum dose of 75 g. Blood samples were drawn at baseline and 120 minutes. Concentrations of plasma glucose, triglycerides, high-density lipoprotein cholesterol and insulin were determined. RESULTS: The frequency of metabolic syndrome showed a large variability when using a variety of published definitions; in contrast, the optimal cut-off points for fasting insulin, homeostatic model assessment of insulin resistance and two-hour oral glucose tolerance test insulin were very similar in almost all the definitions considered and had adequate diagnostic performance: area under the curve >0.869, sensitivity >0.835 and specificity >0.755. Insulin resistance surrogates had substantial agreements with Ford, Cook and Salas definitions (Kappa~0.62; agreement~82%); moderate agreement was observed for International Diabetes Federation, Cruz and Ferranti definitions (Kappa~0.41­0.59; agreement~77%). CONCLUSION: Insulin resistance surrogates may be a better approach for metabolic syndrome assessment in an adolescent population because of reduced variability and a higher predictive value.


Asunto(s)
Glucemia/análisis , Homeostasis/fisiología , Resistencia a la Insulina/fisiología , Insulina/sangre , Lipoproteínas/sangre , Síndrome Metabólico/sangre , Triglicéridos/sangre , Adolescente , Niño , Estudios Transversales , Femenino , Prueba de Tolerancia a la Glucosa , Humanos , Masculino , Valor Predictivo de las Pruebas , Pronóstico , Valores de Referencia
9.
Medicina (B.Aires) ; 83(5): 744-752, dic. 2023. graf
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1534878

RESUMEN

Resumen Introducción : La hipofisitis es una enfermedad in frecuente que plantea un desafío en el diagnóstico y tratamiento. El objetivo de este estudio multicéntrico y retrospectivo fue describir: a) características de pa cientes con hipofisitis primaria (HP), b) métodos diag nósticos, y c) tratamientos realizados. Además, evaluar: a) presentación clínica, b) bioquímica, c) radiológica, d) oftalmológica al diagnóstico y evolución según el tratamiento recibido. Métodos : Estudio retrospectivo donde se estudiaron 28 pacientes (23 mujeres/5 varones) con HP, edad pro medio de 38±11.1 años. Resultados . Los síntomas fueron: cefalea: 68%, po liuria-polidipsia: 50% y alteraciones visuales: 48%. El examen de laboratorio inicial informó disfunción ade nohipofisaria en 71% de los pacientes, siendo el eje gonadal el más afectado. Los hallazgos radiológicos más frecuentes fueron: lesión simétrica:78.5%, aumento homogéneo post contraste: 78.5% y engrosamiento de tallo:70%. En 4/23 mujeres (17%) se relacionó con em barazos o puerperio La conducta inicial fue expectante (CE) en 14 pacientes, cirugía de resección/descompresión en 8 y tratamiento con inmunosupresores en 6. Quince pacientes tuvieron confirmación histológica, 9 resulta ron hipofisitis linfocitaria, 5 hipofisitis por IgG4 y una xantomatosa. Trece fueron diagnosticados por criterios clínicos establecidos. El tamaño de la lesión disminuyó en 43% de pacientes con CE, 62.5% con cirugía y 50% con inmunosupresores. Los síntomas compresivos mejora ron en los 3 grupos, con escaso efecto sobre la función adenohipofisaria, sin resolución de la diabetes insípida. Discusión : En pacientes sin síntomas compresivos adoptamos CE. En aquellos pacientes sin certeza diag nóstica o con síntomas compresivos graves, se optó por cirugía transesfenoidal.


Abstract Introduction : Primary hypophysitis (PH) is a rare disease that represents a challenge among differential diagnosis and management. Our aim was to describe clinical characteristics, diagnostic criteria and different treatment outcomes in patients with PH. Multicentric, retrospective study. Clinical presentation, endocrine function, magnetic resonance imaging findings, visual field defects at diagnosis and treatment outcomes were recorded. Methods : Twenty-eight patients (23 women), with PH were included. Median age: 37. Results : The most frequent symptoms: headache: 68%, polyuria-polydipsia: 50% and visual disturbances: 48%. At diagnosis, anterior pituitary deficiency was present in 71%, being hypogonadotrophic hypogonad ism the most frequent manifestation. The radiological findings: symmetric lesion: 78.5%, homogeneous en hancement: 78.5% and pituitary stalk thickening: 70%. Association with pregnancy or puerperium was found in 4/23 women (17%). Fourteen patients did not receive any treatment ("wait and see" group), 8 underwent surgery for mass reduction or resection and 6 were treated with immunosuppression therapy. Among 15 patients with histopathological diagnosis, 9 were lymphocytic hypophysitis, 5 IgG4 related hypophysitis and 1 xanthomatous hypophysitis. Thirteen were di agnosed by established clinical criteria. Mass reduction was observed in 43% of "wait and see group" patients, 62.5% of operated patients and 50% with immuno suppression therapy. Compressive symptoms showed improvement in the 3 groups, with modest effect on anterior pituitary function, diabetes insipidus did not resolve in any patients. Discussion : In patients without severe compressive symptoms, we adopted a "wait and see" approach. In patients with uncertain diagnosis of PH or severe com pressive symptoms, transsphenoidal surgery was the best option.

10.
Can J Gastroenterol Hepatol ; 2017: 3689375, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28634575

RESUMEN

OBJECTIVE: To assess the association between plasma ceramides and hepatic steatosis (HS) in adolescents, independently of obesity. MATERIALS AND METHODS: Ninety-four adolescents from two previous studies conducted and published by our crew were included. Study subjects were stratified in three groups: normal weight (n = 18), obesity (n = 34), and obesity + HS (n = 42). The presence of HS was defined when ALT/AST ratio was <1. Ceramides subspecies (C14:0, C16:0, C18:0, C24:0, and C24:1) were determined by LC/MS. RESULTS: All ceramides correlated directly with ALT levels and inversely with ALT/AST ratio; the strongest correlation was observed among C14:0 ceramide (r = 0.41 and r = -0.54, resp.; P < 0.001). Furthermore, significant correlations were observed between cholesterol and all ceramides except for C24:1 ceramide. Interestingly ceramides C14:0, C18:0, and C24:1 correlated directly with both fasting insulin and HOMA-IR index. For assessing HS, a cut-off point of 10.3 nmol/L for C14:0 ceramide reported a sensitivity of 92.7% and a specificity of 73.5% when normal weight and obesity groups (n = 52) were compared against obesity + HS group (n = 42). Positive and negative predictive values were 77.5% and 90.2%, respectively. CONCLUSIONS: Plasma ceramides are closely associated with hepatic steatosis in adolescents. C14:0 ceramide could be a novel biomarker of HS independently of obesity.


Asunto(s)
Alanina Transaminasa/sangre , Aspartato Aminotransferasas/sangre , Ceramidas/sangre , Hígado Graso/sangre , Adolescente , Biomarcadores/sangre , Ayuno/sangre , Hígado Graso/etiología , Femenino , Humanos , Insulina/sangre , Masculino , Obesidad Infantil/sangre , Obesidad Infantil/complicaciones , Valor Predictivo de las Pruebas , Sensibilidad y Especificidad
11.
J Clin Res Pediatr Endocrinol ; 8(4): 419-424, 2016 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-27354200

RESUMEN

OBJECTIVE: To evaluate the use of the 13C-glucose breath test (13C-GBT) for insulin resistance (IR) detection in adolescents through comparison with fasting and post-glucose stimulus surrogates. METHODS: One hundred thirty-three adolescents aged between 10 and 16 years received an oral glucose load of 1.75 g per kg of body weight dissolved in 150 mL of water followed by an oral dose of 1.5 mg/kg of U-13C-Glucose, without a specific maximum dose. Blood samples were drawn at baseline and 120 minutes, while breath samples were obtained at baseline and at 30, 60, 90, 120, 150, and 180 minutes. The 13C-GBT was compared to homeostasis model assessment (HOMA) IR (≥p95 adjusted by gender and age), fasting plasma insulin (≥p90 adjusted by gender and Tanner stage), results of 2-h oral glucose tolerance test (OGTT), insulin levels (≥65 µU/mL) in order to determine the optimal cut-off point for IR diagnosis. RESULTS: 13C-GBT data, expressed as adjusted cumulative percentage of oxidized dose (A% OD), correlated inversely with fasting and post-load IR surrogates. Sexual development alters A% OD results, therefore individuals were stratified into pubescent and post-pubescent. The optimal cut-off point for the 13C-GBT in pubescent individuals was 16.3% (sensitivity=82.8% & specificity=60.6%) and 13.0% in post-pubescents (sensitivity=87.5% & specificity=63.6%), when compared to fasting plasma insulin. Similar results were observed against HOMA and 2-h OGTT insulin. CONCLUSION: The 13C-GBT is a practical and non-invasive method to screen for IR in adolescents with reasonable sensitivity and specificity.


Asunto(s)
Pruebas Respiratorias/métodos , Prueba de Tolerancia a la Glucosa/métodos , Glucosa/administración & dosificación , Resistencia a la Insulina , Adolescente , Biomarcadores/sangre , Glucemia/análisis , Índice de Masa Corporal , Isótopos de Carbono/metabolismo , Niño , Estudios Transversales , Ayuno/sangre , Femenino , Glucosa/metabolismo , Homeostasis , Humanos , Insulina/sangre , Modelos Lineales , Masculino , Reproducibilidad de los Resultados
12.
Rev. argent. endocrinol. metab ; 54(4): 169-175, dic. 2017. ilus, tab
Artículo en Español | LILACS | ID: biblio-957984

RESUMEN

Introducción: El riesgo de desarrollar neoplasias colónicas en pacientes acromegálicos y su relación directa con los niveles elevados de GH/IGF-1 no están bien establecidos y continúan siendo motivo de controversia en la literatura mundial. El objetivo de este trabajo fue evaluar el riesgo de desarrollar lesiones neoplásicas avanzadas (LNA) (adenomas mayores a 1 cm, componente velloso mayor del 75% y/o displasia de alto grado), en pacientes con acromegalia, comparado con un grupo control. Materiales y métodos: Estudio multicéntrico caso-control retrospectivo. Ciento treinta y siete pacientes con acromegalia que realizaron videocolonoscopia (VCC) fueron incluidos inicialmente, aunque solo 69 cumplieron criterios de inclusión. Sesenta y dos controles fueron obtenidos: por cada caso (paciente con acromegalia) 2 «controles¼ fueron seleccionados aleatorizadamente e igualados por edad y sexo. El riesgo se expresó en odds ratio (OR) y su correspondiente intervalo de confianza (IC) del 95%. La significación estadística fue considerada una p < 0,05. Resultados: De los 69 pacientes con VCC completa y datos adecuados para su análisis, 28 presentaron VCC positiva con hallazgos de pólipos (40%) y 41 VCC negativa o normal (60%). Dentro del grupo con VCC positiva, 14 presentaron LNA (20%) y solo un paciente presentó diagnóstico de cáncer colorrectal. Para el análisis caso-control se incluyó a 31 pacientes frente al grupo control (n = 62) que cumplieron con los criterios de inclusión. La presencia de pólipos colónicos, adenomas y LNA en los pacientes con acromegalia fue de 19/31 (61,9%), 14/31 (45,16%) y 10/31 (32,25%), y en el grupo control de 18/62 (29,03%), 11/62 (17,74%) y 4/62 (6,45%), respectivamente. El riesgo de adenomas y LNA fue mayor en el grupo de acromegalia en comparación con el grupo control, siendo ambos resultados estadísticamente significativos: adenomas OR 2,54 (IC 1,22-5,25) p = 0,005, LNA OR: 7,3 (2,4-25), p = 0,00. Conclusión: La acromegalia se asocia a un mayor riesgo de lesiones colónicas preneoplásicas. Este hallazgo justifica el cribado con VCC al diagnóstico en pacientes con acromegalia.


Background: The risk of developing cancerous lesions in the colon of acromegaly patients and their direct relationship with elevated growth hormone (GH) and insulin-like growth factor-1 (IGF-1) levels is not well established, and is still controversial in the international literature. The objective of this study was to evaluate the risk of developing advanced neoplastic lesions (ALN: greater than 1 cm adenomas, villous component greater than 75% and/or high grade dysplasia) in patients with acromegaly compared to a control group. Materials and methods: A multicentre, retrospective case-control study was conducted initially on 137 patients with acromegaly (cases) who underwent videocolonoscopy (VCC), although only 69 met inclusion criteria. Sixty-two controls were obtained, and for each case two "controls" were randomly selected and matched by age and gender. Risk was expressed as odds ratio (OR) and its corresponding 95% con"dence interval (CI). P values < .05 were considered statistical significantly. Results: Of the 69 acromegaly patients with a completed VCC and adequate data for their analysis, 28 had a positive VCC with findings of polyps (40%), and 41 VCC negative with no lesions (60%). Within the group with positive VCC, 14 were ALN (20%) and one a colorectal cancer. In the case-control analysis, 31 cases were to be analysed against the control group (n = 62). The presence of colonic polyps, adenomas, and ALN in patients with acromegaly was 19/31 (61.9%), 14/31 (45.16%), and 10/31 (32.25%), respectively, and in the control group, it was 18/62 (29.03%), 11/62 (17.74%), and 4/62 (6.45%), respectively. The risk of adenomas and ALN was higher in the acromegaly group compared to the control group: adenomas OR: 2.54 (95% CI 1.22-5.25) P=.005, ALN OR: 7.3 (2.4-25) P=.00. Conclusion: This preliminary case control study showed an increased risk of pre-cancerous colprectal lesions in patients with acromegaly, supporting the VCC screening at diagnosis.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Lesiones Precancerosas/complicaciones , Acromegalia/complicaciones , Lesiones Precancerosas/diagnóstico , Neoplasias Colorrectales/prevención & control , Factores de Riesgo , Colonoscopía , Ajuste de Riesgo
13.
Medicina (B.Aires) ; 58(5,pt.1): 469-73, 1998. graf, tab
Artículo en Español | LILACS | ID: lil-224398

RESUMEN

Las enfermedades de transmisión sexual (ETS) conforman el grupo más frecuente de enfermedades infecciosas de declaración obligatoria. La identificación de nuevos patógenos y una distribución más amplia, ha hecho que sean consideradas uno de los problemas de salud pública más importantes. El objetivo de este trabajo fue conocer el estado actual de las ETS y comparar métodos diagnósticos para diferentes infecciones en la población estudiada. Se procesaron muestras de flujos vaginales, materiales endocervicales y exudados uretrales de 1060 pacientes, durante 3 años, de las que 583 fueron positivas para uno o más microorganismos, correspondiendo a 493 mujeres y 90 hombres. Los microorganismos hallados en mujeres fueron: Gardnerella vaginalis (39.3 por ciento), Candida albicans (21.1 por ciento), Trichomonas vaginalis (17.3 per ciento), Chlamydia trachomatis (11.3 por ciento); Neisseria gonorrhoeae (3.2 por ciento); Mycoplasma hominis; Ureaplasma urealyticum (6.5 por ciento) y Treponema pallidum (1.4 por ciento). Las asociaciones fueron, Gardnerella vaginalis con Trichomona vaginalis (5.5 por ciento); Gardnerella vaginalis con Candida albicans (4.9 por ciento); Trichomonas vaginalis con Neisseira gonorrhoeae (2.2 por ciento) y Gardnerella vaginalis con Chlamydia trachomatis (1.9 por ciento). En hombres la uretritis gonocócicas (UG) representó en 37.7 por ciento, las uretritis no gonocócica (UNG) 55.6 por ciento y Treponema pallidum 6.7 por ciento. Se observó disminución de sífilis, UG y cervicitis gonocócica, aumentando la prevalencia de las uretritis y cervicitis no gonocócicas. De este trabajo se desprende la necesidad de dar mayor énfasis en la búsqueda de Chlamydia trachomatis, por el riesgo de transmisión vertical en el embarazo. A pesar de ciertas fluctuaciones la incidencia de las ETS en nuestro medio, sigue siendo elevada.


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Enfermedades de Transmisión Sexual/epidemiología , Argentina , Prevalencia , Enfermedades de Transmisión Sexual/diagnóstico
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