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This paper shows wind speed measurements from the TASEC-Lab experiment in a stratospheric balloon mission. The mission was launched in July 2021 from León (Spain) aerodrome. Measurements of horizontal wind speed in relation to the balloon gondola were successfully carried out with a cup anemometer. According to the available literature, this is the first time a cup anemometer has been used in a stratospheric balloon mission. The results indicate the need to consider the horizontal wind speed from the balloon ascent phase for thermal calculations of the mission.
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Positioning asynchronous architectures based on time measurements are reaching growing importance in Local Positioning Systems (LPS). These architectures have special relevance in precision applications and indoor/outdoor navigation of automatic vehicles such as Automatic Ground Vehicles (AGVs) and Unmanned Aerial Vehicles (UAVs). The positioning error of these systems is conditioned by the algorithms used in the position calculation, the quality of the time measurements, and the sensor deployment of the signal receivers. Once the algorithms have been defined and the method to compute the time measurements has been selected, the only design criteria of the LPS is the distribution of the sensors in the three-dimensional space. This problem has proved to be NP-hard, and therefore a heuristic solution to the problem is recommended. In this paper, a genetic algorithm with the flexibility to be adapted to different scenarios and ground modelings is proposed. This algorithm is used to determine the best node localization in order to reduce the Cramér-Rao Lower Bound (CRLB) with a heteroscedastic noise consideration in each sensor of an Asynchronous Time Difference of Arrival (A-TDOA) architecture. The methodology proposed allows for the optimization of the 3D sensor deployment of a passive A-TDOA architecture, including ground modeling flexibility and heteroscedastic noise consideration with sequential iterations, and reducing the spatial discretization to achieve better results. Results show that optimization with 15% of elitism and a Tournament 3 selection strategy offers the best maximization for the algorithm.
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BACKGROUND: Hyperprolactinemia is a common finding within clinical practice in both endocrinology and general practice fields, amongst other specialties. The general practitioner and other specialists must know the indications and serum prolactin determination parameters in order to, once detected, derive the patient for a correct assessment and begin treatment. OBJECTIVE: Formulate a clinical practice guideline evidence-based for the diagnosis and treatment of hyperprolactinemia. METHOD: It took the participation of eight gynecologists, two pathologists and a pharmacologist in the elaboration of this guideline due their experience and clinical judgement. These recommendations were based upon diagnostic criteria and levels of evidence from treatment guidelines previously established, controlled clinical trials and standardized guides for adolescent and adult population with hyperprolactinemia. RESULTS: During the conformation of this guideline each specialist reviewed and updated a specific topic and established the evidence existent over different topics according their field of best clinical expertise, being enriched by the opinion of other experts. At the end, all the evidence and decisions taken were unified in the document presented here. CONCLUSIONS: It is presented the recommendations established by the panel of experts for diagnosis and treatment of patients with high levels of prolactin; also the level of evidence for the diagnosis of hyperprolactinemia, handling drug-induced hyperprolactinemia and prolactinomas in pregnant and non-pregnant patients.
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Hiperprolactinemia/terapia , Guias de Prática Clínica como Assunto , Prolactinoma/terapia , Adolescente , Adulto , Medicina Baseada em Evidências , Feminino , Humanos , Hiperprolactinemia/diagnóstico , Hiperprolactinemia/fisiopatologia , Neoplasias Hipofisárias/diagnóstico , Neoplasias Hipofisárias/patologia , Neoplasias Hipofisárias/terapia , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/fisiopatologia , Complicações na Gravidez/terapia , Prolactina/metabolismo , Prolactinoma/diagnóstico , Prolactinoma/patologiaRESUMO
Acute pancreatitis during pregnancy is an uncommon complication. The usual cause is biliary tract disease. Cholesterol and triglyceride plasma levels physiologically increase during pregnancy. Pregravidic hypertriglyceridemia (as much primary as secondary) may be exacerbated and occasionally act as the trigger. Early diagnosis and treatment are the keys because related morbidity and mortality are high. We report a case of diabetic ketoacidosis and hypertriglyceridemia-induced gestational pancreatitis (tryglicerid level of 12,100 mg/dL) treated successfully with conservative management. The clinical, biochemical and therapeutic aspects comment in addition of this pathology, as well as its prevention
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Hipertrigliceridemia , Pancreatite , Complicações na Gravidez , Adulto , Feminino , Humanos , Hipertrigliceridemia/diagnóstico , Hipertrigliceridemia/terapia , Pancreatite/diagnóstico , Pancreatite/terapia , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/terapiaRESUMO
Early clinical trials in Mexico with analogs of luteinizing hormone-releasing hormone (LH-RH) also known as gonadotropin releasing hormone (Gn-RH), were reviewed. Extensive clinical studies were carried out at IMSS with agonists of LH-RH, both in men and woman. All subjects responded to LH-RH agonists with a release of LH and FSH, but repeated administration of these analogs, initially aimed at stimulation of fertility (thought to stimulate fertility), was later shown to result in inhibition due to desensitization of pituitary gland and downregulation of LH-RH receptors. Various clinical investigations with LH-RH antagonists were also carried out. This included the first demonstration that LH-RHantagonists can suppress LH and FSH and sex steroid secretion in men and women. Various studies in Mexico with early LH-RH antagonists aimed at the development of new contraceptive methods were reviewed. Modern LH-RH antagonist Cetrorelix was shown to be effective in men and women and useful in treatment of uterine leiomyomas and benign prostatic hyperplasia. Major oncological studies were also carried out with agonist D-Trp6-LH-RH and antagonist Cetrorelix in men with prostate cancer, which demonstrated therapeutic efficacy of both types of analogs. Some endocrine studies with early analogs of somatostatin were also cited and a clinical trial with somatostatin analog vapreotide in patients with relapsed prostate cancer was reviewed. All these studies played a major role in introducing analogs of hypothalamic-releasing hormones into clinical medicine.
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Ensaios Clínicos como Assunto , Hormônio Liberador de Gonadotropina/análogos & derivados , Hormônio Liberador de Gonadotropina/uso terapêutico , Somatostatina/análogos & derivados , Somatostatina/uso terapêutico , Hormônio Liberador de Tireotropina/análogos & derivados , Hormônio Liberador de Tireotropina/uso terapêutico , Feminino , Hormônio Liberador de Gonadotropina/antagonistas & inibidores , Humanos , Masculino , México , Neoplasias da Próstata/tratamento farmacológicoRESUMO
BACKGROUND: Gastrin has a wide variety of functions on the digestive system including the regulation of gastric acid secretion, being a growth factor for the non antral gastric mucosa and the stimulation of mucosal proliferation in the large and small intestines. Animals studies showed that various diseases of the digestive system have better clinical evolution in the presence of estrogens as is the case of peptic ulcers, now little is known in humans about this phenomenon. OBJECTIVE: To evaluate the response of gastrin after an oral calcium load in normal and postmenopausal women without hormone replacement therapy. PATIENTS AND METHODS: We studied 10 healthy women with mean age 25.3 +/- 1.79 yr (range: 23-28 yr) and 7 postmenopausal women without previous treatment and a mean age 56.5 +/- 6.4 yr (range: 50-70 yr). A permeable vein with physiologic solution was obtained in order to maintain a permeable vein in the antecubital fossa to obtain blood samples for the determination of gastrin. Before an oral administration of 1 g of calcium baseline samples were taken at time 0 and thereafter on 30, 60, 90, 120, 150, and 180 minutes. Gastrin levels were determined by RIA using CIS Bio-International commercial kits. RESULTS: Basal gastrin levels were x: 72.54 +/- 15.9 pg/mLK in normal women and x: 61.1 +/- 39.62 in postmenopausal women. Basal gonadotrophins were x: 62.1 +/- 26 and x: 32.9 +/- 7.3 for FSH and LH respectively and estradiol level of x: 13.9 +/- 4.2 pg/mL. Normal volunteers had a peak secretion of x: 173.4 +/- 15 pg/mL at 90 minutes and in postmenopausal women a peak of x: 66.2 +/- 50 at 60 minutes. Comparing the magnitude of the response between the healthy volunteers and the postmenopausal women at 90 and 120 minutes the statistical significance was a (p < 0.005) and (p < 0.001), respectively. CONCLUSIONS: These results demonstrate the lack of response of gastrin levels to the calcium stimulus in postmenopausal women probably due to the lack of hormone replacement therapy. Further studies are needed to best understand the role of sexual hormones on the synthesis and secretion of gastrin in the digestive system especially the role of the estrogens.
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Cálcio/administração & dosagem , Terapia de Reposição de Estrogênios , Gastrinas/sangue , Pós-Menopausa , Administração Oral , Adulto , Idoso , Cálcio/farmacologia , Interpretação Estatística de Dados , Feminino , Gastrinas/metabolismo , Humanos , Pessoa de Meia-Idade , Radioimunoensaio , Fatores de TempoRESUMO
BACKGROUND: Pancreatic cell destruction causing type 1 diabetes is associated to diverse autoantibodies. Antibodies against glutamic acid decarboxylase have been found in type 1 (DM1) and type 2 diabetic patients (DM2). Their presence in siblings is unknown. OBJECTIVE: To determine the presence of anti-GAD65 autoantibodies in diabetic patients and their siblings. PARTICIPANTS AND METHOD: Sixty-eight individuals were included and distributed in four groups: group 1 DM1, group 2 DM2, group 3 and 4 healthy siblings of patients from groups 1 and 2. Anti-GAD65, peptide C, serum glucose, total cholesterol and triglycerides were obtained. Body mass index and hip-waist ratio were measured. RESULTS: Anti-GAD65 antibodies were positive in 23% of DM1, in 14% of DM2, and in 7.7% and 9.5% in siblings of both groups, respectively. Using Mann-Whitney's U the mean of anti-GAD65 in diabetic type 1 and 2 patients was p = 0.022; between DM1 and their siblings and between DM2 and their siblings there was no statistical significance. C peptide was low in cases of positive anti-GAD65 of DM1 and DM2; and it was normal in patients with negative anti-GAD65. CONCLUSIONS: Anti-GAD65 autoantibodies are more frequent in type 1 diabetic patients. There were no meaningful differences regarding the presence of anti-GAD65 in patients and their siblings.
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Autoanticorpos , Irmãos , Adulto , Peptídeo C , Diabetes Mellitus Tipo 1 , Glutamato Descarboxilase , HumanosRESUMO
To assess the prevalence of balance symptoms in type-2 diabetes mellitus (DM2), at the first level of health care. Compared to 101 controls, 101 patients showed a higher frequency of all the symptoms investigated through a standardized questionnaire (p<0.01). In DM2 patients, balance symptoms should be intentionally investigated.
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Diabetes Mellitus Tipo 2/complicações , Tontura/epidemiologia , Transtornos da Audição/epidemiologia , Equilíbrio Postural/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/epidemiologia , Orientação , Valores de Referência , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Dopaminergic agonists are the treatment of choice for prolactinomas with bromocriptine (BCE) being the primary agent used. There is a group of patients who are not responders to such therapy or have severe side effects (resistant or intolerant to BCE, respectively). We undertook this study to evaluate the response to the administration of cabergoline (CBG) in patients intolerant or resistant to BCE. METHODS: Twenty seven patients (25 females and 2 males) were recruited with prolactin-pituitary tumors, obtaining basal serum prolactin (PRL) samples and again each month up to 3 months. We recorded signs associated with hyperprolactinemia and secondary effects of CBG. The initial dose was 0.25 mg twice weekly during the first week, with an increase to 0.5 mg twice weekly from the second week until the conclusion of the study. Statistical analysis included Shapiro-Wilk, Kruskal-Wallis and ANOVA tests. RESULTS: Twenty two patients had microadenomas and five had macroadenomas. In the intolerant group (n= 11), the initial PRL value (61.45 +/- 19.82) decreased by the third month to 4.94 +/- 1.79 (p<0.024). In the resistant group (n= 16), basal PRL values were 119.53 +/- 11.52. In 15 of these patients, the PRL value significantly decreased to 12.95 +/- 3.66 ng/ml (p<0.005) by the third month of treatment. In both groups the signs related to hyperprolactinemia significantly improved, with a low incidence of secondary effects due to CBG. CONCLUSIONS: CBG is useful in most patients considered as intolerant or resistant to BCE.
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Agonistas de Dopamina/uso terapêutico , Ergolinas/uso terapêutico , Hiperprolactinemia/tratamento farmacológico , Neoplasias Hipofisárias/tratamento farmacológico , Prolactinoma/tratamento farmacológico , Adulto , Bromocriptina/efeitos adversos , Bromocriptina/uso terapêutico , Cabergolina , Tolerância a Medicamentos , Feminino , Humanos , Hiperprolactinemia/etiologia , Masculino , Neoplasias Hipofisárias/complicações , Prolactinoma/complicaçõesRESUMO
Introducción: La terapia de elección de los prolactinomas son los agonistas dopaminérgicos, cuyo principal exponente es la bromocriptina, sin embargo, hay pacientes que no responden o presentan severos efectos secundarios (resistentes o intolerantes a bromocriptina, respectivamente). El objetivo en este estudio fue valorar la respuesta al uso de cabergolina en pacientes con prolactinomas, intolerantes o resistentes a bromocriptina Material y métodos: Se estudiaron 27 pacientes (25 mujeres y dos varones) en quienes se realizó determinación basal de prolactina y cada mes hasta completar tres meses, registrando los datos asociados a hiperprolactinemia y los efectos secundarios. La dosis inicial fue de 0.25 mg los lunes y jueves durante la primera semana, y 0.5 mg a partir de la segunda. El análisis estadístico incluyó la prueba de Shapiro-Wilk, Kruskal-Wallis y Anova. Resultados: 22 pacientes presentaron microadenomas y cinco macroadenomas. En los intolerantes (n = 11) el valor inicial de prolactina de 61.45 ± 19.82 disminuyó al tercer mes a 4.94 ± 1.79 (p < 0.024). En los resistentes (n = 16), el valor basal fue 119.53 ± 11.52; 15 pacientes redujeron significativamente a 12.95 ± 3.66 (p < 0.005) al tercer mes de tratamiento. En ambos, los signos atribuibles a la hiperprolactinemia mejoraron significativamente, con poca incidencia de efectos secundarios. Conclusiones: La cabergolina es útil en la mayoría de los pacientes considerados intolerantes o resistentes a la bromocriptina.
BACKGROUND: Dopaminergic agonists are the treatment of choice for prolactinomas with bromocriptine (BCE) being the primary agent used. There is a group of patients who are not responders to such therapy or have severe side effects (resistant or intolerant to BCE, respectively). We undertook this study to evaluate the response to the administration of cabergoline (CBG) in patients intolerant or resistant to BCE. METHODS: Twenty seven patients (25 females and 2 males) were recruited with prolactin-pituitary tumors, obtaining basal serum prolactin (PRL) samples and again each month up to 3 months. We recorded signs associated with hyperprolactinemia and secondary effects of CBG. The initial dose was 0.25 mg twice weekly during the first week, with an increase to 0.5 mg twice weekly from the second week until the conclusion of the study. Statistical analysis included Shapiro-Wilk, Kruskal-Wallis and ANOVA tests. RESULTS: Twenty two patients had microadenomas and five had macroadenomas. In the intolerant group (n= 11), the initial PRL value (61.45 +/- 19.82) decreased by the third month to 4.94 +/- 1.79 (p<0.024). In the resistant group (n= 16), basal PRL values were 119.53 +/- 11.52. In 15 of these patients, the PRL value significantly decreased to 12.95 +/- 3.66 ng/ml (p<0.005) by the third month of treatment. In both groups the signs related to hyperprolactinemia significantly improved, with a low incidence of secondary effects due to CBG. CONCLUSIONS: CBG is useful in most patients considered as intolerant or resistant to BCE.
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Humanos , Masculino , Feminino , Adulto , Agonistas de Dopamina/uso terapêutico , Ergolinas/uso terapêutico , Hiperprolactinemia/tratamento farmacológico , Neoplasias Hipofisárias/tratamento farmacológico , Prolactinoma/tratamento farmacológico , Bromocriptina/efeitos adversos , Bromocriptina/uso terapêutico , Tolerância a Medicamentos , Hiperprolactinemia/etiologia , Neoplasias Hipofisárias/complicações , Prolactinoma/complicaçõesRESUMO
BACKGROUND: The aim of this study was to evaluate the effects of administration of the somatostatin analog RC-160 (vapreotide) at the time of relapse in patients with androgen independent prostate cancer. METHODS: Our study included 13 patients with biopsy-proven prostate cancer, stage D3. Eight patients had been treated with a depot formulation of the agonist D-Trp-6-LH-RH, with a median remission time of 68 (range 48-102 months). Five patients were initially treated by surgical orchiectomy, but relapsed after a median time of 33 months (range 17-91 months). A new remission period with a median duration of 10 months (range 2-29 months) was induced with Ketoconazole in the orchiectomy group. At the relapse time, all the patients received 1 mg of vapreotide t.i.d., by subcutaneous route, in addition to D-Trp-6-LH-RH, or Ketoconazole in the orchiectomy group. RESULTS: Eight of 13 patients demonstrated clinical improvement after 3 months of therapy with vapreotide, six showing a decrease in serum prostate specific antigen (PSA) from 234.5 +/- 308.5 to 68.2 +/- 60.5 ng/ml (mean decline 71 +/- 8%; P < 0.05). Two additional patients presented a fall in serum prostatic acid phosphatase (PAP). Responding patients showed a decrease in the bone pain score from 2.62 +/- 0.48 to 0.37 +/- 0.69 and an increase in the Karnofsky performance status from 72.3 +/- 4.21 to 83.6 +/- 23.2 (P < 0.05). In accord with the ECOG criteria, two patients had a complete response; four had partial response, and two had a stable response. Four patients did not respond and one was not evaluable. Two patients died in remission, one at 16 months due to myocardial infarction and the other at 24 months due to pneumonia. Three patients relapsed at 5, 17, and 19 months respectively. Three patients who have been followed-up for more than 3 years continued in remission (79, 45, and 45 months) respectively. Vapreotide was well tolerated, only three patients having transitory mild diarrhea. CONCLUSIONS: Our results indicate that therapy with the somatostatin analog vapreotide at the time of relapse can induce objective clinical responses in some patients with prostate cancer who are refractory to androgen ablation induced by LH-RH analogs or orchiectomy.
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Antineoplásicos/farmacologia , Recidiva Local de Neoplasia/tratamento farmacológico , Neoplasias da Próstata/tratamento farmacológico , Somatostatina/análogos & derivados , Somatostatina/farmacologia , Adulto , Idoso , Antineoplásicos/administração & dosagem , Antineoplásicos/efeitos adversos , Preparações de Ação Retardada , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Dor , Neoplasias da Próstata/patologia , Neoplasias da Próstata/cirurgia , Somatostatina/administração & dosagem , Somatostatina/efeitos adversos , Análise de Sobrevida , Resultado do TratamentoRESUMO
Las hormonas hipotalámicas son polipéptidos. Al efectuar sustituciones de algunos de sus aminoácidos se obtienen análogos con propiedades especiales, como ser más potentes, de acción prolongada, inhibitorios, selectivos en su función, etc. El desarrollo de estos análogos ha establecido grandes perspectivas terapéuticas. Los análogos agonistas de LH-RH (super potentes de acción prolongada), son los que más impacto clínico han logrado en la actualidad. Estos análogos de LH-RH poseen un efecto doble a nivel hipofisario, dosis pequeñas administradas en forma pulsátil, activan la secreción de las gonadotropinas, mientras que la administración crónica de dosis altas bloquean (inhiben) su liberación induciendo un estado de hipogonadismo. La activación hipofisaria es útil como: prueba diagnóstica de la reserva hipofisaria de LH y FSH, y en el manejo de la pubertad retardada, de la criptorquidia, inducción de espermatogénesis. La inhibición hipofisaria, en el manejo de tumores hormonodependientes, principalmente en el cáncer de próstata, pubertad precoz, endometriosis, y en la inhibición de la espermatogénesis y de la ovulación. Se han obtenido análogos de somatostatina con actividades inhibitorias selectivas, que prometen ser de gran impacto en el tratamiento de la diabetes mellitus y de otros padecimientos como acromegalia, pancreatitis aguuda, úlcera péptica, insulinoma, gastrinoma, etcétera. Diversos análogos de TRH están siendo evaluados sobre su acción en la secreción gástrica, gastrina, pepsinógeno, insulina, TSH, Prolactina, etc., habiéndose identificado algunos con propiedades inhibitorias sobre la secreción gástrica y anorexigénica sin modificar los niveles de la tirotrofina y/o prolactina, lo cual resulta altamente prometedor en el manejo de pacientes con úlcera duodenal y trastornos del apetito
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Humanos , Hipófise/fisiologia , Hormônio Liberador de Gonadotropina/análogos & derivados , Somatostatina/análogos & derivados , Ácido Gástrico/metabolismo , Hormônio Liberador de Gonadotropina/antagonistas & inibidores , Somatostatina/antagonistas & inibidores , Somatostatina/farmacologiaRESUMO
La neurocirugía en la acromegalia continúa siendo el tratamiento más utilizado, obteniéndose resultados variables. Nuestro objetivo fue valorar marcadores que permitan predecir el comportamiento postquirúrgico. Se estudiaron 34 acromegálicos, realizándose pruebas de TRH, de bromocriptina y estudio ultraestructural e inmunohistoquímico del tumor hipofisiario. Se evaluaron por espacio de 14 a 30 meses para conocer su evolución. De los 34 pacientes, 22 incrementaron GH al TRH (TRH+) con niveles elevados de prolactina y disminución de GH postbromocriptina (bromo+) siendo su evolución clínica mejor que los otros 12 pacientes con TRH negativo, sin disminución de GH postbromocriptina (bromo) y niveles de prolactina normales. La ultraestructura mostró predominio de células densamente granuladas en los bromo+ y la inmunohistoquímica positividad para GH, e incluso en 4 de ellos lo fue también para prolactina (mixtos). Conclusiones: Se establecen marcadores para predecir la evolución satisfactoria del paciente acromegálico como: TRH+, hiperprolactinemia y células granulares.
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Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Acromegalia , Acromegalia/cirurgia , Hipófise/cirurgiaRESUMO
Antecedentes. En la actualidad se ha generado gran interés en el papel que juega la disminución de la hormona liberadora de la hormona de crecimiento y la hormona de crecimiento y su repercusión en varias partes del organismo como factores responsables de los cambios observados en la mujer climatérica, en especial en el sistema nervioso central, cardiovascular, genitourinario, digestivo y osteomuscular. Objetivo. Evaluar la influencia de la administración transdérmica de 17-b estradiol sobre la liberación de la hormona de crecimiento en mujeres climatéricas pre y postratamiento mediante la administración de la hormona liberadora de la hormona de crecimiento. Material y método. Se incluyeron cinco pacientes con edad promedio de 51 ñ 4.1 años, con cuadro clínico y bioquímico de climaterio. Tiempo de evolución: 5.4 ñ 4.61 (rango: 1-13 años). Se monitorizó la pulsatilidad de la hormona de crecimiento durante los primeros 120 minutos y tres horas más después de la administración de la hormona liberadora de la hormona de crecimiento (GH-RH-1-29-NH2), I.V. en bolo (50 µg). La obtención del suero para determinar la hormona de crecimiento se realizó cada 15 minutos antes y después del estímulo. Inmediatamente después se inició la sustitución hormonal con el 17-b estradiol transdérmico (parches de 50 µg) dos veces por semana. La evaluación clínica y el estudio mediante la estimulación con GH-RH-1-29 se realizaron al tiempo 0 (basal), 1, 3 y 6 meses de iniciado el tratamiento con las mismas condiciones descritas previamente. Resultados. La pulsatilidad de la hormona de crecimiento antes de iniciada la sustitución estrogénica en los cinco pacientes fue de: X:0.48 ñ 0.22; 0.38 ñ 0.17; 0.45 ñ 0.25 y 0.69 ñ 0.29 (Basal, 1, 3 y 6 meses, respectivamente) y de 2.74 ñ 1.21; 3.48 ñ 1.32 (p > 0.05); 4.91 ñ 1.57 (p < 0.05) y 6.04 ñ 1.69 (p < 0.05) (p en relación con la basal) postestímulo con GH-RH-1-29, Basal, 1, 3 y 6 meses, respectivamente, postestrogenoterapia transdérmica. Los niveles basales de gonadotrofinas descendieron de 54.68 ñ 27 a 33.20 ñ 11.23 y de 40.48 ñ 12 a 28.30 ñ 6.70 (FSH y LH, respectivamente, pre y postratamiento) y los valores basales de estradiol se incrementaron de 1.82 ñ 4.06 a 25.95 ñ 5.96 después de iniciada la estrogenoterapia
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Humanos , Feminino , Pessoa de Meia-Idade , Administração Cutânea , Climatério , Estradiol , Hormônio Liberador de Hormônio do Crescimento , Terapia de Reposição HormonalRESUMO
Los tumores del ovario con repercusión endócrina constituyen 5 por ciento de las neoplasias de este órgano, ocupan el primer término las productoras de estrógenos, las de andrógenos en segundo y son excepcionales las de progesterona, corticosteroides y renina. En la nomenclatura de estos tumores ha existido una serie de sinónimos empleados que indican la confusión acerca de su histogénesis y la dificultad para su manejo en la literatura. Informe del caso. Femenina de 23 años de edad que presentó opsomenorreas de varios años de evolución, amenorrea secundaria, voz grave e hirsutismo rápidamente progresivo. Peso: 98,500 kg, talla: 1.74m. Índice de masa corporal (IMC): 32.61 kg/m2 de supeficie corporal. Vello en cara (barba y bigote), distribución androide en abdomen, antebrazos, muslos y piernas (Ferriman 20), acné e involución mamaria bilateral. Todos los paraclínicos efectuados fueron normales. La cuantificación de gonadotrofina coriónica en orina de 24 horas fue negativa. Imagenología. Ultrasonido de cavidad pélvica y la tomografía axial computada de abdomen demostraron tumoración ovárica derecha. El estudio citogenético fue 46XX. Los estudios endocrinológicos prequirúrgicos fueron: basales hormonales de testosterona libre y total de 14.30 pg/mL y 3.55 ng/mL respectivamente, insulina de 43.3 µU/mL y péptido C de 5.7 ng/mL. La curva de tolerancia oral a la glucosa (CTGO) demostró intolerancia a carbohidratos. Durante el transoperatorio los niveles hormonales de la vena ovárica derecha fueron: testosterona total de 2.70 ng/mL y la libre de 12.70 pg/mL, normalizándose a las 12 horas del postoperatorio. Otras hormonas esteroideas determinadas fueron normales seis meses después del acto quirúrgico la paciente presentaba un puntaje de Ferriman de 10, eumenorreica y con peso: 98,100 kg, CTGO y niveles basles hormonales normales. La ultraestructura mostró datos característicos de tumor productor de esteroides sin cristaloides de Reinke.
Assuntos
Humanos , Feminino , Adulto , Amenorreia , Doenças do Sistema Endócrino/fisiopatologia , Hirsutismo/fisiopatologia , Ovário/patologia , Androgênios/sangue , Testosterona/sangueRESUMO
Objetivo. Explorar el estado audiológico y otoneurológico de pacientes con diabetes. Material y métodos. Se siguieron por tres años a 10 pacientes (6 mujeres) de 20.6 años de edad (DE 5.5 años), con diabetes mellitus insulinodependiente de 9.5 años de evolución (DE 3.7 años). Los pacientes fueron seleccionados por presentar neuropatía periférica en ausencia de retinopatía proliferativa y enfermedad ótica previa o predisponente para la misma. Se les determinó el flujo plasmático renal (543 mL/min DE 113.5) y el filtrado glomerular (149 mL/min, DE 50.3) Resultados. En todos los casos, el estudio audiológico inicial (incluyendo potenciales evocados auditivos del tallo cerebral) se encontró en límites normales; sin embargo, el reflejo vestíbulo-ocular estuvo simétricamente disminuido. Un año después, un paciente presentó vértigo con asimetría del reflejo vestíbulo-ocular e inestabilidad persistente. Al tercer año, otro paciente tuvo manifestaciones similares y uno más mostró hipoacusia sensorial. Conclusión. Estos datos sugieren que los pacientes con diabetes mellitus insulinodependientes pueden tener alteraciones otoneurológicas que requieren de mayor estudio para determinar su incidencia en diabetes
Assuntos
Humanos , Adulto , Diabetes Mellitus Tipo 1/complicações , Neuropatias Diabéticas/fisiopatologia , Reflexo Vestíbulo-Ocular , Transtornos da Audição/etiologia , Doenças Vestibulares/etiologiaRESUMO
La terapia crónica con agonistas de LH-RH, ha demostrado ser una buena alternativa a la castración quirúrgica o la terapia estrogénica en hombres con cáncer de próstata metastásico. La administración crónica produce un bloqueo persistente del eje hipófisis-gónadas en pacientes con carcinoma prostático, ésto condiciona un estado de supresión gonadal denominado "castración farmacológica". Otros tumores hormonodependientes (mama, pâncreas), así como también la miomatosis uterina, la endometriosis y la pubertad precoz, han sido tratados con análogos agonistas de LH-RH. Después de la primera semana de tratamiento con el análogo, se ha observado un incremento importante en el apetito y en el peso corporal. Se seleccionaron 15 pacientes con adenocarcinoma de próstata en estadio D-2, para tratamiento con D-TRP-6-LH-RH. Se realizó una curva de tolerancia a la glucosa (CTG) pretratamiento, y a los 3, 6 y 12 meses durante la terapia. Previo a la terapia, 8 pacientes tuvieron CTG normal y 7 de tipo diabético manteniendose este tipo de respuesta prácticamente sin cambios, durante la terapia con D-TRP-6-LH-RH. En ambos grupos, la administración inicial de D-TRP-6-LH-RH, libró LH y FSH. Al mes y durante la terapéutica, los valores de LH y FSH se mantuvieron en niveles subnormales. Los niveles iniciales séricos de testosterona, estuvieron dentro de límites normales, cayendo a niveles de castración durante el tratamiento
Assuntos
Humanos , Agonistas Adrenérgicos/uso terapêutico , Teste de Tolerância a Glucose , Neoplasias da Próstata/tratamento farmacológicoRESUMO
Se estudió en un grupo de individuos normales la acción de varias dosis de somatostatina y del análogo D5-F-TrP8-D-Cys14-SS sobre la liberación inducida por arginina de insulina, glucagon y hormona de crecimiento (HC). La somatostatina en dosis de 100 g/h suprimió la liberación de insulina, glucagon y HC. El análogo D5-F-TrP8-D-Cys14-SS en dosis de 10 a 20 g/h inhibió a la HC y al glucagon, pero no a la insulina. Estos resultados muestran que es posible obtener análogos de la somatostatina que supriman en forma selectiva a la liberación de insulina, lo que puede ser de gran valor clínico en el manejo de diabetes mellitus, acromegalia, pancreatitis y úlcera péptica
Assuntos
Humanos , Arginina/farmacologia , Glucagon/metabolismo , Insulina/metabolismo , Somatostatina/farmacologia , Hormônio do Crescimento/metabolismoRESUMO
La especialización busca incrementar en los médicos la capacidad creativa y aumentar sus posibilidades de solucionar los problemas que se presentan en un campo definido de la medicina: los cursos de especialización que se imparten en el Instituto Mexicano del Seguro Social se fundamentan en el perfil profesional que requiere la medicina institucional en cada disciplina; ello constituye la fuente más importante para la determinación de los objetivos educacionales y contenido de los programas de especialización. Los cursos tienen duración de dos a cinco años, se imparten en forma de residencia y consisten en actividades académicas, adiestramiento clínico e instrucción clínica complementaria; se organizan en áreas técnico-médica, de enseñanza e investigación y técnico-administrativa. Para los fines descriptivos de este artículo, de las 38 especialidades que se imparten se escogió a la endocrinología a fin de analizar el modelo educativo general y el plan de estudios de esta especialidad en particular, los cuales por su metodología pueden aplicarse a todas las especialidades