RESUMEN
Background: Anti thyroglobulin antibodies are present in 25 percent of patients treated for a differentiated thyroid cancer, invalidating thyroglobulin determination. Those patients subjected to total thyroidectomy and free of disease, should reduce the production of these antibodies, due to the lack of antigenic stimulus. Therefore, anti thyroglobulin antibodies could be useful to detect early relapses. Aim: To assess the relationship between anti thyroglobulin antibodies and the evolution of the disease in patients treated for thyroid cancer. Material and methods: Retrospective analysis of 26 patients treated for thyroid cancer with positive anti thyroglobulin antibodies, followed for three years. These were divided in those with or without lymphocytic thyroiditis (19 and 7 respectively). Results: At the first year of follow up, anti thyroglobulin antibody concentration was 401ñ94.9 UI/ml (xñsem) in patients with thyroiditis and 38.9ñ8.9 UI/ml in those without thyroiditis (p < 0.005). During the three years of follow up, no differences in anti thyroglobulin antibodies were observed between patients with or without tumor relapse. Conclusions: Concentration of anti thyroglobulin antibodies was higher in patients with thyroiditis and did not differentiate patients with tumor relapse
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Tiroglobulina , Neoplasias de la Tiroides , Tiroiditis , Tiroiditis Autoinmune , Estudios de Seguimiento , Recurrencia Local de Neoplasia , Formación de Anticuerpos/inmunología , Biomarcadores de Tumor/aislamiento & purificación , Pruebas de Función de la TiroidesRESUMEN
Se realiza un estudio para analizar la frecuencia de patología endometrial en mujeres posmenopáusicas sanas con sangrado uterino anormal bajo terapia de remplazo hormonal (TRH). Se estudiaron 104 mujeres posmenopáusicas que presentaron sangrado uterino anormal (irregular o excesivo) durante THR con estrógenos y progesterona en diferentes esquemas (57 por ciento secuencial continuo; 31 por ciento combinado continuo; 12 por ciento secuencial discontinuo). A todas las pacientes se les realizó una biopsia ambulatoria aspirativa de endometrio. El procedimiento fue bien tolerado y no se observaron complicaciones hemorrágicas o infecciosas. Los resultados histológicos fueron los siguientes: endometrio secretor 38.5 por ciento; endometrio proliferativo 25 por ciento; endometrio atrófico 11.5 por ciento; hierplasia endometrial sin atipias 4.8 por ciento; pólipo endometrial benigno 2.9 por ciento; tejido endometrial benigno, inactivo o fragmentos de epitelio 11.5 por ciento; adenocarcinoma de endometrio 1 por ciento y ausencia de tejido endometrial 4.8 por ciento. La biopsia aspirativa de endometrio permitió conocer la situación endometrial en alrededor del 95 por ciento de las pacientes. Muestra insuficiente para diagnóstico se obtuvo en un 5 por ciento de los casos siguriendo atrofía endometrial o patología focal no diagnosticada por el método. La ausencia de lesiones premalignas y la baja incidencia de patología maligna de endometrio en nuestro estudio confirman su baja incidencia en mujeres que reciben esquemas adecuados de terapia de remplazo hormonal
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Hiperplasia Endometrial , Neoplasias Endometriales , Terapia de Reemplazo de Estrógeno/efectos adversos , Hemorragia Uterina , Biopsia , Hiperplasia Endometrial , Neoplasias Endometriales , Endometrio , Posmenopausia , Hemorragia UterinaRESUMEN
Familial hyperparathyroidism can be a part of a type 1 or 2 multiple endocrine neoplasia syndrome, can be associated to mandibular fibromas or can appear as an isolated disease. We report a family with 11 members affected by a primary hyperparathyroidism, all with a history of kidney stones and without evidences of other endocrine tumors. Not knowing the familial history of the disease, only one adenoma was resected in four cases and in all, the disease recidivated. Two were operated again, performing a total parathyroidectomy and heterologous autotransplantation of parathyroid tissue in the forearm. The presentation form of primary hyperparathyroidism in this family, is similar to other reported cases. It is more aggressive, is diagnosed at a lower age, has a higher incidence of recurrence and multiglandular involvement than the sporadic disease
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Hiperparatiroidismo , Calcitriol , Calcio , Hiperparatiroidismo , Cálculos Urinarios/complicaciones , Neoplasia Endocrina Múltiple/complicacionesAsunto(s)
Humanos , Hipopituitarismo/diagnóstico , Neoplasias Hipofisarias/diagnóstico , Sistema Hipotálamo-Hipofisario/fisiología , Galactorrea/etiología , Hormonas Hipotalámicas/deficiencia , Hormonas Hipotalámicas/farmacología , Hiperprolactinemia/etiología , Hipopituitarismo/clasificación , Hipopituitarismo/etiología , Sistema Hipotálamo-Hipofisario , Hormonas Hipofisarias/farmacología , Neoplasias Hipofisarias/clasificación , Neoplasias Hipofisarias/etiología , Prolactinoma/etiologíaAsunto(s)
Humanos , Enfermedades Óseas Metabólicas/clasificación , Trastornos del Metabolismo del Calcio/clasificación , Calcio/metabolismo , Enfermedades de las Paratiroides/clasificación , Hormona Paratiroidea/metabolismo , Calcitonina/metabolismo , Fósforo/metabolismo , Hipercalcemia , Hiperparatiroidismo , Hipocalcemia , Hipoparatiroidismo , Magnesio/metabolismo , Osteomalacia , Osteoporosis , Cálculos Urinarios , Vitamina D/metabolismoAsunto(s)
Humanos , Femenino , Gonadotropinas/metabolismo , Hormonas Esteroides Gonadales/farmacología , Ovario/fisiología , Moduladores Selectivos de los Receptores de Estrógeno/farmacología , Sistema Hipotálamo-Hipofisario/fisiología , Antagonistas de Andrógenos/uso terapéutico , Neoplasias de la Mama , Climaterio/fisiología , Estrógenos , Estrona , Hormonas Esteroides Gonadales , Terapia de Reemplazo de Hormonas , Trastornos de la Menstruación , Síndrome del Ovario Poliquístico , Progesterona/metabolismoAsunto(s)
Humanos , Masculino , Hormonas Esteroides Gonadales/farmacología , Sistema Hipotálamo-Hipofisario/fisiología , Testículo/fisiología , Andrógenos/deficiencia , Erección Peniana/fisiología , Disfunción Eréctil/tratamiento farmacológico , Disfunción Eréctil/etiología , Ginecomastia/inducido químicamente , Ginecomastia/etiología , Hipogonadismo/tratamiento farmacológico , Hipogonadismo/etiología , Infertilidad Masculina/etiología , Infertilidad Masculina/terapia , Testosterona/farmacologíaAsunto(s)
Humanos , Embarazo , Femenino , Complicaciones del Embarazo , Enfermedades de la Tiroides , Factor F , Fertilidad , Desarrollo Fetal , Ciclo MenstrualRESUMEN
Background: Thyroglobulin measurement is useful for the follow up of patients subjected to total thyroidectomy for differentiated thyroid carcinoma. Thyroglobulin autoantibodies may interfere with its determination. Aim: To measure thyroglobulin autoantibodies and their interference with thyroglobulin determination. Material and methods: The presence of thyroglobulin autoantibodies was investigated in 801 serum samples sent to the laboratory for measurement of thyroglobulin levels. A serum was considered positive for these autoantibodies when radioactivity corresponding to 125I-thyroglobulin bound to thyroglobulin autoantibodies, precipitated with human gamma globulin, exceeded in 1.4 times that of a negative sera pool. In positive sera, thyroglobulin autoantibody concentration was measured and its interference with thyroglobulin radioimmunoassay was assessed through a recuperation test using exogenous thyroglobulin. Results: Thyroglobulin autoantibodies were detected in 149 sera (18.6 percent). Of these, 65 had a recuperation that fluctuated between 1 and 80 percent. Thyroglobulin autoantibody concentration was negatively correlated with recuperation percentages (r= -0.64; p <0.001) but not with thyroglobulin concentrations (r= 0.08). Thyroglobulin was higher in positive sera with a recuperation over 80 percent than in sera with a recuperation of less than 80 percent (12.7 ñ 1.7 and 5.9 ñ 0.6 ng/ml, respectively; p <0.001). Conclusions: Thyroglobulin autoantibodies interfere with thyroglobulin measurement by radioimmunoassay, sequestering variable amounts of thyroglobulin. The presence of these autoantibodies must be investigated prior to thyroglobulin determination
Asunto(s)
Humanos , Autoanticuerpos/inmunología , Tiroglobulina/inmunología , Autoanticuerpos/aislamiento & purificación , Tiroglobulina/sangre , Radioinmunoensayo , Afinidad de AnticuerposRESUMEN
We report a 42 years old male and a 66 years old female with a Cushing syndrome caused by ectopic ACTH secretion secondary to a carcinoid tumor. These patients had both severe hypokalemia, resistant to medical treatment and that subsided with bilateral adrenalectomy and supplementation with dexametasone. Cushing syndrome caused by ectopic ACTH secretion is characterized by a severe and rapidly evolving hypercortisolism. Hypokalemia is present in 90 percent of cases and is probably caused by a defect in 11 ß hydroxysteroid dehydrogenase, that limits the binding of cortisol to aldosterone receptor, metabolizing it to cortisone. Therefore, this alteration will increase the mineralocorticoid action of cortisol
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Anciano , Hormona Adrenocorticotrópica , Hipopotasemia/fisiopatología , Síndrome de Cushing/diagnóstico , Espironolactona/uso terapéutico , Dexametasona/uso terapéutico , Enalapril/uso terapéutico , Neoplasias de la Corteza Suprarrenal/cirugía , Neoplasias de la Corteza Suprarrenal/complicaciones , Síndrome de Cushing/cirugía , Síndrome de Cushing/etiología , Síndrome de Cushing/tratamiento farmacológicoRESUMEN
Se realizó una caracterización clínica, hormonal, de lipoproteínas y de resistencia insulínica en 31 pacientes con síndrome de ovarios poliquísticos sin tratamiento médico. Destaca la importante frecuencia de factores de riesgo cardiovascular en ellas; todas tienen índice de masa corporal aumentando, siendo el 71 por ciento obesas; 6,5 por ciento tienen presión arterial diastólica elevada; 35,5 por ciento de ellas presenta hipercolesterolemia, 13 por ciento tiene hipertrigliceridemia, y 83 por ciento son insulino resistentes. Estos hallazgos justifican la evaluación metabólica en mujeres anovulatorias hiperandrogénicas para indicar las medidas terapéuticas necesarias no sólo desde el punto de vista hormonal y de fertilidad, sino también desde el aspecto metabólico
Asunto(s)
Humanos , Femenino , Adolescente , Adulto , Hiperlipidemias/epidemiología , Resistencia a la Insulina , Síndrome del Ovario Poliquístico/complicaciones , Anovulación/metabolismo , Índice de Masa Corporal , Hipertensión/epidemiología , Hipercolesterolemia/epidemiología , Hipertrigliceridemia/epidemiología , Obesidad/epidemiología , Factores de Riesgo , Síndrome del Ovario Poliquístico/metabolismoRESUMEN
Background: Estradiol (E2) has a potent antioxidant effect on low density lipoproteins (LDL) in vitro and in vivo, which could be important in explaining the cardioprotective effect of hormone replacement therapy (HRT) in post menopausal women. Estriol (E3), on the other hand, is a weak estrogen with low metabolic effects on different tissues, and at present no cardioprotective effect has been attributed to this steroid. Aim: To study the antioxidant effect of E3 on LDL and to compare it with the potent antioxidant action exhibited by E2. Subjects and methods: After LDL was isolated by ultra centrifugation from plasma of 12 healthy untreated post menopausal women, it was divided into aliquots containing 0.5 mg of LDL protein. Estriol and E2 in doses of 0, 1, 5, 15 and 50 µM were incubated with different aliquots of LDL. CuSO4 15 µM was added to each aliquot to induce an oxidative stress. The aliquots were then incubated during 4 hours at 37 C. Malonaldehyde (MDA) was measured as a marker of LDL oxidation, and expressed as nM/mg protein. Results (mean ñ SD): Estriol induced a dose-dependent decrease in MDA concentration (baseline 62.8 ñ 21.7; 1 µM: 61.5 ñ 23.0; 5 µM: 52.9 ñ 20,3; 15 µM 43.5 ñ 20.1 and 50 µM: 31.0 ñ 17.6 nM/mg protein; F= 92.4; p< 0.0001), reaching a mean decrease of 50.7 percent at the highest dose tested. Estradiol has a similar dose-dependent decrease in MDA concentration (F= 60.2; p< 0.0001), revealing a more potent effect than E3 (p< 0.05), with a mean decrease of 67.4 percent at the highest dose tested. Conclusions: Our results demonstrate that estriol shows an important antioxidant action of LDL in vitro, although its effect is less potent than estradiol. These results raise the possibility that estriol could have a cardioprotective effect in post menopausal women, possibility that has not been yet demonstrated
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Posmenopausia/efectos de los fármacos , Estradiol/farmacocinética , Estriol/farmacocinética , Lipoproteínas LDL , Peroxidación de Lípido , Enfermedades Cardiovasculares , Antioxidantes/farmacocinética , Malondialdehído/sangreRESUMEN
Thirty three patients aged 9 to 86 years old, 15 female, with an adrenal macrotumor diagnosed by CAT scan, were analized. Thirty percent of tumors were functioning (70 percent secreted cathecolamines and 30 percent cortisol). Eighty two percent had an adrenal localization and 18 percent were para-adrenal. Thirty four percent were malignant. These tumors were mostly non functioning, 70 percent occured in men and 67 percent were metastatic. Most adrenal macrotumors in this series were non functioning and 36 percent were malignant
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Neoplasias de la Corteza Suprarrenal/diagnóstico , Tomografía Computarizada por Rayos X/métodosRESUMEN
Eighty three postmenopausal women without replacement hormonal therapy, 54 postmenopausal women receiving replacement hormonal therapy and 16 premenopausal women (considered as control group) were studied. Hydroxyproline was measured in an early morning urine sample, after one day of diet without meat or gelatin. Urinary hydroxyproline in premenopausal women was 33.7ñ7.9 mg/g creatinine. The figure for postmenopausal women with hormonal replacement therapy was 33.5ñ7.9 mg/g creatinine. Postmenopausal women without replacement therapy had an urinary hydroxyproline of 47.4ñ8.5 mg/g creatinine, significantly higher than that of premenopausal and supplemented women. In 21 postmenopausal women, hydroxyproline was measured before and after 3 months of replacement therapy; values decreased 35.5ñ11 percent in this period and there was a direct correlation between initial values and the degree of reduction (r=0.69, p<0.001). Postmenopausal women receiving hormone replacement therapy have a urinary hydroxyproline excretion similar to that of premenopausal women
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Estrógenos/farmacocinética , Resorción Ósea/tratamiento farmacológico , Terapia de Reemplazo de Estrógeno/métodos , Estudios de Casos y Controles , Hidroxiprolina/orina , Osteoporosis Posmenopáusica/tratamiento farmacológicoRESUMEN
The correct management of thyroid nodules requires an accurate histological diagnosis to doscard carcinoma. One hundred and forty three thyroid nodules were punctured with a 21 G needle under continous aspiration obtaining a sample for cytological and histological diagnosis. Fifty patients were subjected to a thyroidectomy. The age of studied patients ranged from 12 to 78 years old and 94 percent were female. Mean nodule diameter was 2.7ñ1.4 cm. Two percent of procedures were complicated with local hematomas, that subsided spontaneously. A diagnosis of cancer was reached in 16 percent of all patients and 46 percent of operated patients. Cytology had a 50 percent sensitivity, 87.5 percent specificity, a 89.4 percent positive predictive value and a 87.5 percent negative predictive value. The figures for fine needle aspiration biopsy were 82.6, 100, 100 and 87 percent respectively. Fine needle aspiration biopsy has a better diagnostic accuracy than cytology and is a simple and safe procedure
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Persona de Mediana Edad , Adulto , Biopsia con Aguja , Neoplasias de la Tiroides/patología , Técnicas Citológicas , Nódulo Tiroideo/patologíaRESUMEN
Hydrochloric acid was added to destilled water in increasing amounts to obtain a final pH of 6.9, 3.0, 2.5, 2.0 and 1.5. Eighteen commercial calcium preparations were incubated in these solutions for 60 min and dissolution velocity was measured as the percentage of elemental calcium found in solution after this incubation period. Calcium carbonate preparations had a pH 1.5. Using the solution with pH 1.5 the dissolution velocity of different preparations varied widely from 56 to 100 percent. Calcium acetate, followed by calcium citrate and dicalcic phosphate were the salts in tablets with better dissolution velocities. Among powders and effervescent preparations, those containing calcium lactogluconate and citrate had the better dissolution velocities (95 to 115 percent), that were independent of the solution's pH. A studied preparation with integral bone had a very low dissolution velocity, not surpassing 33 mg of calcium per tablet. The dissolution velocity of different calcium carbonate preparations varies greatly and in conditions of achlorhydria, it is negligible. Calcium lactogluconate and citrate dissolution velocities are independent of the solution's pH