Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 32
Filter
1.
Exp Clin Endocrinol Diabetes ; 119(4): 221-4, 2011 Apr.
Article in English | MEDLINE | ID: mdl-21374543

ABSTRACT

UNLABELLED: Hypogonadal males have recently been shown to present prolonged QT interval, an electrocardiographic measure indicative of risk for fatal cardiac arrhythmias. Excess cortisol secretion induces low testosterone levels in male patients with Cushing's disease but no study has yet evaluated if this is accompanied by changes in QT interval duration. We therefore decided to evaluate whether male patients with Cushing's disease present changes in QT interval duration. QT interval was measured in electrocardiographic readings from 19 men and 35 women with Cushing's disease and age- and sex-matched controls were used for comparison. QT interval was corrected for heart rate according to Bazett's formula (QTc) and QTc >440 msec and >460 msec were taken as indicative of increased risk for torsade de pointes in men and women, respectively. Mean QTc was significantly longer in male patients compared with healthy controls (426.9±9.27 vs. 389.7±8.31, p<0.05) and 5 men with Cushing's disease presented prolonged QTc (prevalence 26%). By comparison, none of the women with Cushing's disease presented prolonged QTc. Hypokalemia and low testosterone appeared associated with long QTc. CONCLUSIONS: Male patients with Cushing's disease present prolongation of QT interval which may lead to measurements associated with high risk for ventricular arrhythmias. Both low testosterone levels and hypokalemia appear to contribute to long QT in men with Cushing's disease.


Subject(s)
Electrocardiography , Pituitary ACTH Hypersecretion/physiopathology , Adolescent , Adult , Age Factors , Arrhythmias, Cardiac/etiology , Arrhythmias, Cardiac/physiopathology , Female , Humans , Male , Middle Aged , Pituitary ACTH Hypersecretion/complications , Prevalence , Risk Factors , Sex Characteristics
2.
Horm Metab Res ; 39(12): 908-14, 2007 Dec.
Article in English | MEDLINE | ID: mdl-18046661

ABSTRACT

Hypertension is a major feature of Cushing's disease, with the attendant increase in the rate of cardiovascular events. The circadian blood pressure profile also impacts cardiovascular risk and a few studies have shown that patients with Cushing's syndrome do not present the expected nocturnal blood pressure decrease and, further, that this alteration persists in short-range disease remission. These studies were performed by conventional discontinuous ambulatory pressure monitoring, a technique not devoid of limitations. Aim of our study was the assessment of blood pressure and heart rate profile by beat-to-beat noninvasive monitoring in twelve patients with active Cushing's disease (9 women and 3 men, age 33.3+/-2.36 years) and the assessment of its possible changes at short- (<1 year) and long-term (2-3 years) follow-up after curative surgery. No nocturnal blood pressure dipping (i.e., decrease by 10% of daytime values) was observed in 50% of patients both during active hypercortisolism and within 1 year from surgery. Recovery of blood pressure dipping profile was detected at long-term follow-up in a minority of patients. Daytime heart rate was higher in patients with active Cushing's disease and decreased over time after cure. In conclusion, patients with Cushing's disease present absent nocturnal blood pressure dipping and abnormal heart rate values which do not resolve after short-term remission of hypercortisolism and show only partial improvement in the long run. These findings identify additional cardiovascular risk factors for patients cured of Cushing's disease.


Subject(s)
Blood Pressure/physiology , Circadian Rhythm/physiology , Pituitary ACTH Hypersecretion/physiopathology , Pituitary ACTH Hypersecretion/surgery , Adult , Antihypertensive Agents/therapeutic use , Blood Pressure Monitoring, Ambulatory , Diastole , Female , Heart Rate , Humans , Male , Middle Aged , Pituitary ACTH Hypersecretion/drug therapy , Postoperative Care , Systole , Time Factors
3.
Rev. méd. Panamá ; 24(1): 4-6, Jan.-May 1999.
Article in Spanish | LILACS | ID: lil-409813

ABSTRACT

Reports of Cryptococcus neoformans isolations from patients in Panama have appeared since 1978, but to our knowledge, thIs is the first report of isolation of this organism from soil samples in the Republic. Of 25 soil samples analyzed, two (25%) yielded the organism on birdseed agar medium. Canavanine-glycine-bromthymol blue medium served to identify the isolates as belonging to C. neorformans var neoformans, and not C. Neoformans var. gattii. Initially, isolates did not have capsules, but upon passage through newborn mice, wide capsules developed. This finding has important public health implications, since non-encapsulated environmental organisms, once in the host, can develop capsules, which significantly contribute to virulence


Subject(s)
Cryptococcus neoformans/isolation & purification , Soil Microbiology , Panama
4.
J Clin Endocrinol Metab ; 84(2): 440-8, 1999 Feb.
Article in English | MEDLINE | ID: mdl-10022398

ABSTRACT

The past 45 yr' experience with Cushing's syndrome (CS) has led to the awareness of its complex nature and, by the same token, brought about an increase in the diagnostic and therapeutic dilemmas. We carried out a retrospective multicentre study on the diagnostic work-up and treatment in 426 patients with CS, subdivided as follows: 288 with Cushing's disease (CD), 80 with an adrenal adenoma, 24 with an adrenal carcinoma, 25 with ectopic ACTH and/or CRH secretion, and 9 with ACTH-independent nodular adrenal hyperplasia. Normal urinary free cortisol (UFC) values among multiple collections were recorded in about 10% of patients with CS. In 28% of patients with ACTH-independent CS, basal ACTH concentrations were within the normal range but did not respond to CRH stimulation. Measurement of ACTH levels by immunoradiometric assay, rather than by RIA, offered a greater chance of recognizing patients with ACTH-independent CS or ectopic secretion. A 50% increase in ACTH or cortisol levels after CRH yielded a diagnostic accuracy of 86% and 61%, respectively, in the differential diagnosis of ACTH-dependent CS. An 80% decrease in cortisol levels after 8 mg dexamethasone overnight, or in UFC values after the classical 2-day administration, excluded an ectopic secretion but carried a low negative predictive value given the high number of nonsuppressors among patients with CD. Pituitary imaging identified an adenoma in 61% of patients with CD. At inferior petrosal sinus sampling, an ACTH centre: periphery gradient after CRH less than 3, correctly classified all patients with ectopic secretion but misdiagnosed 15% of 76 patients with CD. Transsphenoidal pituitary surgery, the standard therapy for CD, resulted in complete remission (appearance of clinical signs of adrenal insufficiency associated with low/normal UFC excretion and, when available, low/normal morning plasma ACTH and cortisol levels) in 69% of patients. The overall relapse rate after pituitary surgery was 17%. The probability of relapse-free survival, as assessed by Kaplan-Meier analysis, was 95% at 12 months, 84% at 2 yr, and 80% at 3 yr. Risk of relapse was significantly correlated with postoperative baseline plasma ACTH and cortisol peak after CRH. No relapses were observed among patients who did not respond to CRH. Other therapeutic approaches for CD, such as pituitary irradiation and medical therapy, resulted in normalization of cortisol secretion in about half of treated cases. In summary, an accurate selection of the available diagnostic tools leads to the correct diagnosis in the majority of patients with CS. The therapeutic options for CD, adrenal carcinoma, and ectopic secretion are, as yet, not fully satisfactory. The high incidence of relapse after pituitary surgery calls for a prolonged follow-up.


Subject(s)
Cushing Syndrome/diagnosis , Cushing Syndrome/therapy , Adenoma/complications , Adenoma/surgery , Adolescent , Adrenal Gland Neoplasms/complications , Adrenocorticotropic Hormone/blood , Adult , Aged , Child , Child, Preschool , Corticotropin-Releasing Hormone , Cushing Syndrome/etiology , Diagnosis, Differential , Female , Humans , Hydrocortisone/blood , Hydrocortisone/urine , Infant , Italy , Male , Middle Aged , Pituitary Neoplasms/complications , Pituitary Neoplasms/surgery
5.
Rev Med Panama ; 24(1): 4-6, 1999.
Article in Spanish | MEDLINE | ID: mdl-12436791

ABSTRACT

Reports of Cryptococcus neoformans isolations from patients in Panama have appeared since 1978, but to our knowledge, thIs is the first report of isolation of this organism from soil samples in the Republic. Of 25 soil samples analyzed, two (25%) yielded the organism on birdseed agar medium. Canavanine-glycine-bromthymol blue medium served to identify the isolates as belonging to C. neorformans var neoformans, and not C. Neoformans var. gattii. Initially, isolates did not have capsules, but upon passage through newborn mice, wide capsules developed. This finding has important public health implications, since non-encapsulated environmental organisms, once in the host, can develop capsules, which significantly contribute to virulence.


Subject(s)
Cryptococcus neoformans/isolation & purification , Soil Microbiology , Panama
6.
Metabolism ; 47(2): 143-8, 1998 Feb.
Article in English | MEDLINE | ID: mdl-9472960

ABSTRACT

An overdrive of the hypothalamic-pituitary-adrenal (HPA) axis has been postulated in patients with polycystic ovary syndrome (PCOS). However, little is known concerning the pulsatile modes of corticotropin (ACTH) and cortisol secretion in these patients. To further investigate this issue, spontaneous ACTH and cortisol release were evaluated in 16 normal-weight patients with PCOS and 16 control women. Nine PCOS patients and eight controls were studied between 8 AM and 12 AM (noon), and seven PCOS patients and eight controls between 11 PM and 3 AM. Venous blood samples were taken at 10-minute intervals. Cluster analysis was used to assess ACTH and cortisol pulse frequency and amplitude, deconvolution to calculate mean hormone secretion rates, and approximative entropy (ApEn) to measure the orderliness of ACTH and cortisol time-series data. PCOS patients compared with controls displayed increased ACTH and cortisol release (area under the curve [AUC] and mean plasma concentration) both in the morning and at night. This was not due to increased hormonal secretory burst frequency, but to higher hormonal interpeak valley concentrations and, in the case of ACTH, nighttime pulse amplitudes. Mean ACTH and cortisol secretion rates also were increased in PCOS patients. Further, both controls and PCOS patients exhibited significant (0 to 20 minutes lagged) concordance between individual daytime pulsatile ACTH and cortisol release episodes. As shown by increased ApEn values, PCOS patients had more disorderly daytime cortisol release. In addition, the normal daytime correlation between the amount of pulsatile ACTH and cortisol release as observed in the controls was lost in PCOS patients. Finally, cross-correlation analysis showed a more prominent negative correlation in PCOS patients versus controls between plasma cortisol and 40- to 120-minute delayed ACTH concentrations in the morning, indicating a more sustained negative feedback of cortisol on ACTH release in PCOS at this time. Taken together, these findings demonstrate the existence of multifaceted dysregulation of the HPA axis in PCOS.


Subject(s)
Adrenocorticotropic Hormone/metabolism , Hydrocortisone/metabolism , Polycystic Ovary Syndrome/metabolism , Adolescent , Adult , Female , Humans , Hypothalamo-Hypophyseal System/physiopathology , Pituitary-Adrenal System/physiopathology
7.
Clin Diagn Lab Immunol ; 4(4): 474-7, 1997 Jul.
Article in English | MEDLINE | ID: mdl-9220167

ABSTRACT

Identification of inexpensive and technically simple immunological tests useful in predicting the progression to AIDS in human immunodeficiency virus (HIV)-infected patients would be especially welcome in developing countries, in which 80% of HIV-infected patients reside and health budgets are low. In the current study, we evaluated CD4+ and total lymphocyte counts and the concentrations in serum of beta 2-microglobulin, p24 antigen, and immunoglobulin A (IgA) as predictors of disease progression in 74 Panamanian HIV-positive patients and 50 HIV-negative healthy individuals. Total lymphocyte and CD4(+)-cell counts for AIDS patients (1,451 +/- 811 cells/microliters, P < 0.001, and 238 +/- 392 cells/microliters, P < 0.0001, respectively and asymptomatic patients (2,393 +/- 664 cells/microliters, P > 0.05, and 784 +/- 475 cells/microliters, P < 0.001, respectively) were lower than those observed for healthy subjects (2,596 +/- 631 cells/microliters and 1,120 +/- 296 cells/microliters, respectively). The levels of beta 2-microglobulin and IgA in serum were significantly elevated in patients with AIDS (5.7 +/- 3.6mg/liter, P < 0.001, and 541 +/- 265 mg/dl, P < 0.0002, respectively) and asymptomatic infected subjects (3.4 +/- 2.1 mg/liter, P = 0.001, and 436 +/- 216 mg/dl, P < 0.0001, respectively) compared with the levels in healthy subjects (2.2 +/- 0.7 mg/liter and 204 +/- 113 mg/dl, respectively). Nonstatistically significant differences (P > 0.05) for concentrations of p24 antigen between asymptomatic infected patients (29 +/- 13 pg/ml) and AIDS patients (40 +/- 23 pg/ml) were observed. Total lymphocyte counts of 1,750 cells/microliters or less, CD4 counts of 200 cells/microliters or less, beta 2-microglobulin concentrations in serum of 4 mg/liter or higher, concentrations of IgA in serum of 450 mg/dl or higher, and the presence in serum of p24 antigen were correlated with elevated risks for developing AIDS. Monitoring both total lymphocytes and beta 2-microglobulin identified 91% of the AIDS patients; these assays may allow reductions in the annual number of CD4(+)-cell evaluations and the costs associated with monitoring both total lymphocytes and beta 2-microglobulin identified 91% of the AIDS patients; these assays may allow reductions in the annual number of CD4(+)-cell evaluations and the costs associated with monitoring the immune status of HIV-positive patients.


Subject(s)
Acquired Immunodeficiency Syndrome/blood , Acquired Immunodeficiency Syndrome/immunology , Acquired Immunodeficiency Syndrome/epidemiology , Biomarkers , CD4 Lymphocyte Count , CD4-Positive T-Lymphocytes/cytology , CD4-Positive T-Lymphocytes/immunology , Disease Progression , Female , HIV Core Protein p24/blood , Humans , Immunoglobulin A/blood , Male , Risk Factors , beta 2-Microglobulin/metabolism
8.
Neurology ; 49(1): 126-33, 1997 Jul.
Article in English | MEDLINE | ID: mdl-9222180

ABSTRACT

We used [18F]-2-fluoro-2-deoxy-D-glucose (FDG) and PET to study regional cerebral glucose utilization in seven patients with fatal familial insomnia (FFI), an inherited prion disease with a mutation at codon 178 of the prion protein gene. Four patients were methionine/methionine homozygotes at codon 129 (symptom duration, 8.5 +/- 1 months) and three were methionine/valine (MET/VAL129) heterozygotes (symptom duration, 35 +/- 11 months). A severely reduced glucose utilization of the thalamus and a mild hypometabolism of the cingulate cortex were found in all FFI patients. In six subjects the brain hypometabolism also affected the basal and lateral frontal cortex, the caudate nucleus, and the middle and inferior temporal cortex. Comparison between homozygous or heterozygous patients at codon 129 showed that the hypometabolism was more widespread in the MET/VAL129 group, which had a significantly longer symptom duration at the time of [18F] FDG PET study. Comparison between neuropathologic and [18F] FDG PET findings in six patients showed that areas with neuronal loss were also hypometabolic. However, cerebral hypometabolism was more widespread than the histopathologic changes and significantly correlated with the presence of protease-resistant prion protein (PrPres). Our findings indicate that hypometabolism of the thalamus and cingulate cortex is the hallmark of FFI, while the involvement of other brain regions depends on the duration of symptoms and some unknown factors specific to each patient. The present data also support the notion that PrPres formation is the cause of neuronal dysfunction in prion diseases.


Subject(s)
Cerebral Cortex/diagnostic imaging , Cerebral Cortex/metabolism , PrPC Proteins/metabolism , Prion Diseases/metabolism , Adult , Female , Humans , Male , Middle Aged , Prion Diseases/genetics , Tomography, Emission-Computed
9.
Rev. méd. Panamá ; 20(1/2): 58-64, Jan.-May 1995.
Article in Spanish | LILACS | ID: lil-409939

ABSTRACT

The purpose of this study is to report the results of the authors' investigation to apply the western blot technique (WB UP-LCS) in the diagnosis of human immunodeficiency virus type 1 (HIV-1) infection. To do this, the authors separated the proteins of the HIV-1 virus by electrophoresis, based on their molecular weight, in poliacilamide gel with SDS (SDS-PAGE) during 3 hours at 200 volts. Then they electrotransferred these proteins to nitrocellulose paper during four hours at 200 milliamperes, with the aid of external cooling. The nitrocellulose strips were evaluated considering the incubation time (1 and 16 hours), two conjugates (human anti IgG with Peroxidase and human anti IgG Biotin plus Streptatividine with Peroxidase) and two dilutions of the patients' sera (1/50 and 1/100). Based on their results the Authors conclude that, in the first place, the optimal conditions for the test include a dilution of 1/100 of the patients serum, incubation of the serum for 16 hours and the use of the conjugate of anti human IgG with Biotin and Streptavidine with Peroxidase; secondary, that the immunologic reactivity against proteins p24 and gp 160/120 is the most important diagnostic criterion for the confirmation of infection with HIV-1 and that they obtained a diagnostic correlation of 100% at a cost which was 5 to 7 times less than that of the commercial system


Subject(s)
Humans , HIV-1 , HIV Antibodies/blood , HIV Infections/diagnosis , Blotting, Western/methods , Electrophoresis, Polyacrylamide Gel/methods , Evaluation Study , Time Factors , Blotting, Western/statistics & numerical data
10.
Exp Clin Endocrinol Diabetes ; 103(4): 266-71, 1995.
Article in English | MEDLINE | ID: mdl-7584534

ABSTRACT

The therapeutic efficacy of sustained dopaminergic stimulation in Cushing's disease (CD), was investigated performing a three-month trial with monthly 50-100 mg injections of a bromocriptine depot preparation (Parlodel LAR, Sandoz) in six patients with CD. Dopaminergic treatment did not consistently influence pituitary-adrenal activity, as judged by plasma ACTH, cortisol and urinary free cortisol levels as well as by clinical findings. Interestingly, treatment with bromocriptine was associated with reappearance of menses in the three patients who were amenorrheic. In the five patients submitted to inferior petrosal sinus sampling, a parallelism between ACTH and PRL concentrations could be observed with a PRL rise, ipsilateral to that of ACTH, ensuing in three patients after administration of corticotropin-releasing hormone. In one patient a 55% reduction in the size of the pituitary adenoma was demonstrated by MRI carried out at the end of treatment. Our findings lead to the following conclusions: a) administration of depot injections of bromocriptine to patients with CD appears unable to correct hypercortisolism, although it can induce restoration of menses in amenorrheic patients; b) enhanced PRL concentrations at the pituitary level are probably involved in the amenorrhea often accompanying Cushing's disease.


Subject(s)
Bromocriptine/administration & dosage , Cushing Syndrome/drug therapy , Dopamine Agonists/administration & dosage , Adenoma/drug therapy , Adenoma/pathology , Adolescent , Adrenocorticotropic Hormone/blood , Adult , Amenorrhea/drug therapy , Bromocriptine/therapeutic use , Corticotropin-Releasing Hormone , Cushing Syndrome/blood , Dopamine Agonists/therapeutic use , Female , Humans , Hydrocortisone/blood , Hydrocortisone/urine , Injections, Intramuscular , Male , Middle Aged , Petrosal Sinus Sampling , Pituitary Neoplasms/drug therapy , Pituitary Neoplasms/pathology , Prolactin/blood
11.
Rev Med Panama ; 20(1-2): 58-64, 1995.
Article in Spanish | MEDLINE | ID: mdl-7480906

ABSTRACT

The purpose of this study is to report the results of the authors' investigation to apply the western blot technique (WB UP-LCS) in the diagnosis of human immunodeficiency virus type 1 (HIV-1) infection. To do this, the authors separated the proteins of the HIV-1 virus by electrophoresis, based on their molecular weight, in poliacilamide gel with SDS (SDS-PAGE) during 3 hours at 200 volts. Then they electrotransferred these proteins to nitrocellulose paper during four hours at 200 milliamperes, with the aid of external cooling. The nitrocellulose strips were evaluated considering the incubation time (1 and 16 hours), two conjugates (human anti IgG with Peroxidase and human anti IgG Biotin plus Streptatividine with Peroxidase) and two dilutions of the patients' sera (1/50 and 1/100). Based on their results the Authors conclude that, in the first place, the optimal conditions for the test include a dilution of 1/100 of the patients serum, incubation of the serum for 16 hours and the use of the conjugate of anti human IgG with Biotin and Streptavidine with Peroxidase; secondary, that the immunologic reactivity against proteins p24 and gp 160/120 is the most important diagnostic criterion for the confirmation of infection with HIV-1 and that they obtained a diagnostic correlation of 100% at a cost which was 5 to 7 times less than that of the commercial system.


Subject(s)
Blotting, Western/methods , HIV Antibodies/blood , HIV Infections/diagnosis , HIV-1 , Blotting, Western/statistics & numerical data , Electrophoresis, Polyacrylamide Gel/methods , Evaluation Studies as Topic , Humans , Time Factors
12.
Parasite ; 1(4): 409-11, 1994 Dec.
Article in French | MEDLINE | ID: mdl-9235209

ABSTRACT

A laboratory study was conducted about the duration of developmental stages and the productivity connected with the type of blood meal ingested by the female of Phlebotomus perniciosus. The pre-oviposition and egg incubation periods are not affected whatever the blood ingested by the female. The shorter time required to achieve larval development (rabbit) and pupal development (hamster) governs the generation time, shorter than in the other hosts (dog and man). The productivity is greater when blood is ingested from the rabbit and the dog. This is mainly due to the smaller number of eggs retained in females with these hosts.


Subject(s)
Blood Physiological Phenomena , Phlebotomus/physiology , Animals , Cricetinae , Dogs , Female , Humans , Larva/growth & development , Male , Oviposition , Phlebotomus/growth & development , Pupa/growth & development , Rabbits , Species Specificity
13.
Minerva Med ; 84(4): 171-7, 1993 Apr.
Article in English | MEDLINE | ID: mdl-8506055

ABSTRACT

An impaired plasma Epinephrine (E) and Norepinephrine (NE) response has been described in obese patients during physical exercise. Serum potassium level is influenced either by physical exercise or by the adrenergic system. We studied 12 young obese patients and 12 young controls, all without any cardio-respiratory disorders, who underwent a cycloergometric test with steps of 20 watts every four minutes until exhaustion. During the test we recorded serum potassium levels, E and NE, insulin, glucose and RQ to confirm or not the observation of the reduced adrenergic response in obese patients. During exercise, although both groups reached a not significantly different mean peak value of maximal activity, E and NE increased, more in the controls than in the obese subjects (at peak of exercise 221 +/- 44.1 vs 71 +/- 21.5 pg/ml respectively for E; 2035 +/- 164.8 vs 1141 +/- 313.7 pg/ml respectively for NE). RQ was constantly lower in the obese patients than in the normals both during and after the stress. In both groups potassium increased significantly, but the obese patients had a significantly lower increment at peak of activity when compared to the controls (delta K+: 0.52 +/- 0.11 vs 1.007 +/- 0.17 meq/l respectively, p < 0.05). Insulin and glucose had a behaviour in line with literature in both groups. The behaviour of potassium could be an index of a higher effect of beta-adrenergic system in obese patients than in normals despite the different increases of catecholamines in the two groups. This hypothesis may agree with the preferential metabolic use of fatty acids in our obese patients as indicated by RQ values.


Subject(s)
Obesity/metabolism , Adolescent , Adult , Blood Gas Analysis , Blood Glucose , Epinephrine/blood , Exercise Test , Female , Humans , Insulin/blood , Male , Norepinephrine/blood , Obesity/physiopathology , Potassium/blood
14.
J Endocrinol Invest ; 15(3): 177-84, 1992 Mar.
Article in English | MEDLINE | ID: mdl-1624677

ABSTRACT

The increased survival of patients with thalassemia major, made possible by more adequate therapeutic regimens, has emphasized the importance of the endocrine abnormalities often associated with this disease. In twelve thalassemic patients, we evaluated the hypothalamic-pituitary function by measuring plasma levels of anterior pituitary hormones under basal conditions and in the course of provocative tests. An impairment of growth hormone (GH) secretion was demonstrated in a considerable proportion (7/12) of these patients. In some of them failure of GH response to insulin-hypoglycemia and normal hormone rise after growth hormone-releasing hormone indicate a hypothalamic defect. A defective prolactin secretion was observed in the female hypogonadic but not in the male thalassemic patients. This abnormality appears to be dependent on estrogen deficiency rather than on a hypothalamic-pituitary dysfunction. In our series a high prevalence (8/12) of hypogonadism was also noticed. In these cases, the low gonadotropin levels and their unresponsiveness to gonadotropin-releasing hormone are compatible with a hypothalamic and/or pituitary damage. Lastly, the enhanced ACTH responses to the stimuli associated to a reduced cortisol release suggest the existence, in these patients, of a diminished adrenocortical reserve. On the whole, this study has shown several derangements of the hypothalamic-pituitary function in thalassemia. This emphasizes the need for careful endocrine surveillance in this disease.


Subject(s)
Hypothalamo-Hypophyseal System/physiopathology , Pituitary Gland, Anterior/metabolism , Thalassemia/physiopathology , Adolescent , Adult , Child , Female , Gonadotropins/metabolism , Growth Hormone/metabolism , Humans , Male , Prolactin/metabolism
15.
Parassitologia ; 33 Suppl: 381-6, 1991 Dec.
Article in English | MEDLINE | ID: mdl-1841232

ABSTRACT

Two species belonging to subgenus Larroussius (P.perniciosus and P. ariasi) were collected in Aragón (Northeast of Spain). P.perniciosus was found in all places taken into account in the study, being the most abundant species in the Mediterranean-type vegetation where it is thought it is the principal vector involved in the transmission of Leishmaniasis. On the other hand, P. ariasi was not identified in the Central area, the most dry one, of the Mediterranean zone. It reached its highest density on the Submediterranean-type vegetation where it is considered the main vector.


Subject(s)
Phlebotomus , Animals , Dog Diseases/parasitology , Dog Diseases/transmission , Dogs , Humans , Insect Vectors , Leishmaniasis/epidemiology , Leishmaniasis/transmission , Leishmaniasis/veterinary , Seasons , Spain/epidemiology , Species Specificity
16.
Parassitologia ; 33 Suppl: 89-97, 1991 Dec.
Article in English | MEDLINE | ID: mdl-1841262

ABSTRACT

This paper shows the abundance, density and phenology of Sergentomyia minuta in Aragon (Northeast of Spain). Specimens were collected using sticky traps and sampling was carried out taking vegetation as ecologycal indicator. Differences in density were found among the studied areas related to ecologycal conditions. S. minuta showed its highest density in the coldest and rainiest area of Aragon (Central Pyrenees). These results are discussed with those got from other authors in different parts of the Mediterranean Basin.


Subject(s)
Insect Vectors , Leishmaniasis/transmission , Psychodidae , Animals , Climate , Humans , Leishmania , Leishmaniasis/epidemiology , Seasons , Spain/epidemiology , Species Specificity
17.
Clin Endocrinol (Oxf) ; 35(4): 335-9, 1991 Oct.
Article in English | MEDLINE | ID: mdl-1752061

ABSTRACT

OBJECTIVE: Impairment of linear growth is a common clinical feature in patients with beta-thalassaemia major. Although growth hormone secretion appears to be normal in many short thalassaemic patients, it proves to be deficient in some of them. In these cases, administration of biosynthetic growth hormone seems justified. The aim of this study was to evaluate the effect of such treatment in a group of patients with beta-thalassaemia major presenting with growth failure and impairment of growth hormone secretion. DESIGN: Recombinant human growth hormone, 0.6 U/kg body weight per week, given subcutaneously in three divided doses, was administered for 12 months. PATIENTS: Eight prepubertal patients with beta-thalassaemia major, presenting with severe growth retardation and impaired growth hormone secretion in response to provocative stimuli (insulin-induced hypoglycaemia, L-dopa and growth hormone-releasing hormone), were investigated. MEASUREMENTS: Height and pubertal stage of the patients, as well as plasma levels of insulin-like growth factor I, were determined before, during and after biosynthetic growth hormone treatment. RESULTS: During the first 6 months of therapy, a significant increase of growth velocity was observed, from a mean pretreatment value of 2.1 +/- 0.45 cm/year to a value of 4.8 +/- 0.66 cm/year (P less than 0.002). Mean growth rate at 12 months (4.1 +/- 0.50 cm/year), though slightly decreased in comparison to that recorded at 6 months, was still significantly higher than basal (P less than 0.001). A significant increase in plasma levels of insulin-like growth factor I was recorded during treatment (2.82 +/- 0.47 vs 0.96 +/- 0.22 U/ml, P less than 0.005). No side-effects, adverse reactions or alterations in routine laboratory examinations ensued during or after therapy. CONCLUSIONS: It appears from these data that biosynthetic growth hormone administration is worth serious consideration in patients with beta-thalassaemia major presenting growth retardation and impaired growth hormone secretion.


Subject(s)
Growth Disorders/drug therapy , Growth Hormone/therapeutic use , Thalassemia/complications , Adolescent , Child , Female , Growth Disorders/blood , Growth Disorders/etiology , Growth Hormone/metabolism , Humans , Insulin-Like Growth Factor I/metabolism , Male , Recombinant Proteins/therapeutic use , Thalassemia/blood
18.
J Endocrinol Invest ; 14(8): 685-9, 1991 Sep.
Article in English | MEDLINE | ID: mdl-1663530

ABSTRACT

The case is described of a woman with a Verner-Morrison syndrome of extreme severity, caused by an occult VIPoma. Administration of SMS 201-995 (Sandoz) (SMS) at the dose of 150 and subsequently of 250 micrograms daily, decreased plasma levels of vasoactive intestinal polypeptide (VIP) from about 500 to 100 pg/ml (highest normal limit 60 pg/ml). This was associated with complete regression of the diarrhea and normalization of serum potassium levels and hence with the return of the patient to a fully normal life. After 36 months of clinical remission, watery diarrhea recurred together with elevation of VIP plasma levels and appearance of liver metastases. Laparotomic exploration led to the removal of a pancreatic VIPoma and its liver secondarisms, which was followed by a second remission. Reappearance of the symptoms and development of new liver metastases 8 months later required reinstitution of SMS therapy, which allowed once again to control the clinical picture. Anterior pituitary function, assessed by dynamic testing, was unaffected by chronic SMS administration with the exception of the stimulated growth hormone secretion that was inhibited. Glucose tolerance and insulin secretion remained normal during treatment. Glucose intolerance ensued after pancreatectomy and was not worsened by reintroduction of SMS. Treatment with SMS may allow long-lasting remission of Verner-Morrison syndrome associated to VIPoma, though it does not arrest the progression of the tumor.


Subject(s)
Octreotide/therapeutic use , Pancreatic Neoplasms/drug therapy , Vipoma/drug therapy , Delayed-Action Preparations , Glucose Tolerance Test , Humans , Middle Aged , Pituitary Gland, Anterior/drug effects , Time Factors
19.
Acta Endocrinol (Copenh) ; 125(1): 28-32, 1991 Jul.
Article in English | MEDLINE | ID: mdl-1872121

ABSTRACT

The adrenal participation in the pathogenesis of polycystic ovary syndrome is still under debate. In order to reappraise androgen and glucocorticoid secretion in this disease, we measured serum androstenedione, dehydroepiandrosterone-sulphate, total and free testosterone, sex hormone-binding globulin, LH, FSH, PRL, cortisol, corticosteroid-binding globulin, and urinary free cortisol in 45 women with polycystic ovary syndrome and 27 controls, subdivided in obese and normal-weight subjects. Androstenedione, total and free testosterone were significantly increased, whereas sex hormone-binding globulin tended to be reduced in patients with polycystic ovary syndrome compared with controls, reaching a significant difference between obese patients and matched controls. Free testosterone and sex hormone-binding globulin were significantly increased and reduced, respectively, in obese compared with normal-weight patients. Urinary free cortisol and serum corticosteroid-binding globulin were significantly increased (p less than 0.001) and decreased (p less than 0.005), respectively. Urinary free cortisol exceeded the upper limit of the normal range in 50% of our patients. No appreciable differences were found in PRL and cortisol levels. Besides confirming a hyperandrogenic state, our findings point to an overactivity of the hypothalamic-pituitary-adrenal axis with subsequent diminution of corticosteroid-binding globulin in polycystic ovary syndrome. They also indicate that urinary free cortisol is not a reliable index in differentiating polycystic ovary syndrome from Cushing's disease.


Subject(s)
Hydrocortisone/urine , Polycystic Ovary Syndrome/urine , Transcortin/analysis , Adult , Androgens/blood , Female , Glucocorticoids/blood , Hormones/blood , Humans , Obesity/blood , Osmolar Concentration , Polycystic Ovary Syndrome/blood , Reference Values
20.
Rev Med Panama ; 15(2): 112-8, 1990 May.
Article in Spanish | MEDLINE | ID: mdl-2392574

ABSTRACT

Nosocomial infections increase the morbidity, mortality and cost of hospitalization. The Hospital Infection Committee of the Metropolitan Hospital Complex of the Caja de Seguro Social de Panama studied the problem of nosocomial infections in 1987 and showed that of 29,576 admissions, 820 patients developed 994 nosocomial infections (an annual incidence of 3.69%). This resulted in 5191 additional days of hospitalization, at a conservatively estimated cost of B/ 840,153, and was responsible for 24 deaths. An adequate and efficient program of control of nosocomial infections in recommended.


Subject(s)
Cross Infection/economics , Hospitals, Urban/economics , Hospitals , Hospital Departments/economics , Humans , Panama , Social Security/economics
SELECTION OF CITATIONS
SEARCH DETAIL
...