RESUMEN
For many years, osteoporosis has been considered as a women's disease. Data show that the incidence of this bone thinning disease is high in men. Aging is accompanied with changes in circulating hormone levels. Thus, low testosterone levels is associated with osteoporosis in men. Like osteoporosis in females, in men, might be treated with calcium supplements, vitamin D and bisphosphonates. Recent report of treatment for osteoporotic men with bisphosphonate alendronate was successful in improving bone density at several sites in the male skeleton, in reducing the incidence of fractures and in preventing loss of height. The benefits and risks of hormone androgen replacement therapy in men are not fully defined, but the androgens supplementation is also expected to have favorable consequences on bone.
Asunto(s)
Osteoporosis , Factores de Edad , Remodelación Ósea , Fracturas Espontáneas/etiología , Humanos , Masculino , Osteoporosis/complicaciones , Osteoporosis/diagnóstico , Osteoporosis/terapia , Factores de RiesgoRESUMEN
La hiperprolactinemia secudaria a tumor hipotalámo es una patología poco frecuente de gran interés clínico. Se presenta el caso de una mujer de 32 añosde edad con padecimiento de siete meses de evolución manifestado por cefalea intermitente, disminución de la agudeza visual, amenorrea y galactorrea. Posteriormente inicia poliuria, polidipsia, hiperfagia, aumento ponderal y trastornos del sueño. a la exploración física se encontró defecto campimétrico visual, alteración de los pares craneales I, II, III y VII y lesión piramidal. Los estudios hormonales fueron compatibles con diabetes insípida y síndrome hiperprolactinémico. La tomografía computada evidenció la presencia de tumoración hipotalámica hiperémica con componenete quístico. La paciente fue intervenida quirúrgicamente, encontrándose tumor quístico de la línea media de la región hipotalámica, el cual no pudo ser extirpado en su totalidad, reportándose como diagnóstico anatomopatológico definitivo quiste epidermoide de la línea media. La evolución postquirúrgica de la paciente fue mala, fallecido 48 horas después de la cirugía.
Asunto(s)
Humanos , Femenino , Adulto , Amenorrea , Galactorrea , Hipotálamo/patología , Quiste Epidérmico/fisiopatologíaRESUMEN
Five patients with clinical and EEG primary generalized or multifocal uncontrollable seizures underwent stereotaxic implantation of electrodes in both centromedian thalamic nuclei (CM). Each electrode consisted of a semiflexible array of three platinum-iridium wires, isolated except at their tips, which were separated by 4 mm. Bipolar, biphasic rectangular pulses were delivered in trains of 1 min every 5 min, alternating right and left side for sessions 2 h/day. Patients were followed for 3 months with charting of clinical seizures, daily 4-h EEG recordings from scalp and depth for 5 days and weekly thereafter. Baseline and 3-month evaluation of psychological performance through selected Beta R, Wechsler memory scale, visual discrimination, MMPI, and Zung's rated depression scale. Tests were evaluated for significant changes by the parametric student's t test and Mann Whitney nonparametric test. Clinical seizures were significantly reduced by electrical stimulation (ES), as were EEG interictal spikes and EEG slow waves. Psychological performance improved beyond that expected by reduction in seizure activity. ESCM induced a local afterdischarge (AD) that progressively developed in time and intensity, and the beneficial effects outlasted ES for periods of weeks to months, suggesting that a state of hyperexcitability of stimulated tissue, similar to "kindling," was created by chronic ES.