Amenorrea hipotalámica: consideraciones etiológicas y clínicas a raíz de una paciente / Hypothalamic amenorrhea: report of one case

Hypothalamic amenorrhea is secondary to the dysfunction of the hypothalamic pacemaker that regulates the pulsatile secretion of gonadotropin releasing hormone (GnRH). We report a 21 years old female with an isolated and persistent hypogonadotropic hypogonadism probably of congenital origin. The patient had a good olfactory function, did not have anatomical alterations and two GnRH stimulation tests showed a pre puberal pattern. Hormone replacement therapy allowed her to complete her puberal development.

Alta frecuencia de patología tiroidea funcional y autoinmune en mujeres embarazadas chilenas catalogadas como sanas / High frequency of functional and autoimmune thyroid disease in women classified as healthy Chilean pregnant

Background: Untreated functional thyroid diseases are a risk factor for maternal and fetal complications during pregnancy. Aim: To determine the frequency of functional or autoimmune thyroid disease in healthy women during the first trimester of pregnancy. Subjets and Methods: healthy pregnant women attending a routine consult during their first trimester of pregnancy were studied. Thyroid stimulating hormone (TSH), total and free thyroxin (T4) anti-thyroid peroxidase (TPO) antibodies and spot urine iodine levels were measured. The reference ranges provided by the Atlanta Georgia Consensus in 2004 were used as normal values. A urine iodine concentration < 150 ug/L was considered low. Results: One hundred women age 30 +/- 5 years with a mean gestational age of 8,8 +/- 1,9 weeks, were studied. The frequencies of subclinical hypothyroidism, clinical hypothyroidism, isolated low thyroxin lecels, high antiTPO antibodies and low urine iodine levels were 19, 2, 3, 13 and 15 percent, respectively. Women with high TSH levels had lower total and free T4 levels. Conclusions: Twenty one percent of this sample of apparently healthy pregnant women had a clinical or subclinical hypothyroidism.

Timo persistente y su implicancia en el seguimiento del cáncer diferenciado del tiroides / Abnormal mediastinal radioiodine uptake due to persistent thymus: report of one case

We report a 37 years old female operated for a multifocal papillarythyroid carcinoma. During her follow up, mediastinal uptake of radioiodine due to a persistent thymus, was detected. Thisis a situation may cause a false positive uptake of radioiodine that may be interpreted as a tumor relapse or metastasis.

Tumor testicular por restos suprarrenales en un adolescente con hiperplasia suprarrenal congénita clásica: revisión de su fiopatología e implicancias en fertilidad / Testicular adrenal rest tumors in a teenager with classical congenital adrenal hyperplasia: report of one case

Testicular Adrenal Rest Tumors (TART) may play a role in fertility disturbances of patients with Classical Congenital Adrenal Hyperplasia (CAH). We report a 17 years old male with classical CAH, diagnosed in the newborn period due to a salt wasting crisis with dehydration and severe hyponatremia. He was treated with cortisol and fludrocortisone with a low adherence to therapy. He had a precocious puberty and accelerated bone age, and was treated with a luteinizing hormone releasing hormone (LHRH) analog during two years. At the age of 14 years, bilateral testicular masses were detected during the physical examination. Testicular color Doppler ultrasound showed the presence of TART. A new ultrasound at 17 years of age showed the persistence of adrenal rests and an abnormal testicular growth.

Hiperparatiroidismo normocalcémico asociado a hipovitaminosis D, hipercalciuria renal y nódulo paratiroideo: caso clínico / Normocalcemic hyperparathyroidism secondary to vitamin D deficiency and renal hypercalciuria: report of one case

We report a 77 years old woman with osteoporosis in whom a hyperparathyroidism secondary vitaminD deficiency and renal hypercalciuria was diagnosed. Serum calcium was normal. During the diagnostic work up, a parathyroid nodule was discovered and subjected to a fine needle aspiration biopsy, that showed normal parathyroid cells. The patient was treated with calcitriol, cholecalciferol, hydrochlorothiazide and intravenous zolendronic acid. There was a reduction in urinary calcium and serum PTH levels and improvement of serum 25 hydroxy vitamin D levels.

Tratamiento quirúrgico del hiperparatiroidismo secundario a insuficiencia renal crónica / Surgical treatment of secondary hyperparathyroidism in hemodialysis: report of one case

Hyperparathyroidim secondary to chronic renal failure is a common form of presentation of renal osteodystrophy in patients on chronic hemodialysis. Treatment is based on the maintenance of adequate serum calcium and phosphate levels. However, when hyperparathyroid hyperplasia acquires a nodular form, it becomes refractory to medical treatment and total parathyroidectomy is indicated. We report a 37 years old male on hemodialysis, with a progressive secondary hyperparathyroidism that required the excision of the two superior parathyroid glands at the age of 29.Hyperparathyroidsm was not modified, serum PTH remained excessively high and the patient had a non traumatic femoral fracture. Therefore he was subjected to the excision of the two remaining parathyroid glands. During the postoperative period he had a severe hungry bone syndrome, but was discharged in good conditions, 15 days after the operation.

Angioplastia con stents liberadores de rapamicina en diabéticos tipo 2: Experiencia del Hospital DIPRECA / Angioplasty stenting with Sirolimus (Rapamycin) eluting stents in type 2 diabetic patients

Background: Drug-eluting stents have been developed to reduce the rates of restenosis after coronary angioplasty. Several studies have demonstrated that rapamycin eluting stents are reliable and effective. Aim: To report the experience in our Health Centre with rapamycin-eluting stents. Patients and methods: Forty two stents with rapamicine were implanted to 32 diabetic patients, between June 2002 and December 2004. After the procedure, subjects were clinically followed-up for an average period of 19.9+9.9 months, evaluating functional capacity, angina pectoris, dyspnea, need for hospital admission, acute coronary events and cardiac death. In those subjects clinically suspected to have restenosis, a coronary angiography was performed. Results: Twenty-nine subjects (90.6 percent) remained asymptomatic, two subjects (6.3 percent) developed angina pectoris but restenosis was ruled out, and one subject (3.1 percent) died. Conclusions: The use of rapamycin-eluting stents in these patients was safe and successful with no evidence of clinic restenosis. These positive results are similar to those reported in the Diabetes Study.