ABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Behcet Syndrome/diagnosis , Behcet Syndrome/drug therapy , Colchicine/administration & dosage , Prednisone/administration & dosage , Azathioprine/administration & dosageABSTRACT
No disponible
Subject(s)
Humans , Male , Young Adult , Job Syndrome/diagnosis , Job Syndrome/drug therapy , Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic useSubject(s)
Job Syndrome/diagnosis , Humans , Job Syndrome/genetics , Job Syndrome/pathology , Male , Mutation , Photography , STAT3 Transcription Factor/genetics , Young AdultABSTRACT
Symptoms of hypopituitarism are usually chronic and nonspecific, but rarely the disease can have acute and life threatening manifestations. We report a 53 years old female with a pituitary adenoma that was admitted to our hospital because of syncope. The electrocardiogram showed sinus bradycardia with a prolonged QT interval. Frequent runs of non-sustained polymorphic ventricular tachycardia were noted on telemetry. The patient had a history of severe acute headaches in the previous days and laboratory tests revealed severe secondary hypothyroidism, adrenal insufficiency and a decrease in pituitary hormones. A magnetic resonance imaging of the head showed changes in the size and contrast enhancement of the adenoma. A diagnosis of hypopituitarism secondary to pituitary apoplexy was made and treatment with hydrocortisone and, subsequently, levothyroxine was started. Hormonal disorders such as hypothyroidism, adrenal insufficiency or hypopituitarism should be considered as unusual causes for reversible cardiomyopathy, long QT syndrome and ventricular arrhythmias.
Subject(s)
Adenoma/complications , Hypopituitarism/complications , Long QT Syndrome/etiology , Pituitary Neoplasms/complications , Tachycardia, Ventricular/etiology , Electrocardiography , Female , Humans , Long QT Syndrome/diagnosis , Magnetic Resonance Imaging , Middle Aged , Tachycardia, Ventricular/diagnosisABSTRACT
Symptoms of hypopituitarism are usually chronic and nonspecific, but rarely the disease can have acute and life threatening manifestations. We report a 53 years old female with a pituitary adenoma that was admitted to our hospital because of syncope. The electrocardiogram showed sinus bradycardia with a prolonged QT interval. Frequent runs of non-sustained polymorphic ventricular tachycardia were noted on telemetry. The patient had a history of severe acute headaches in the previous days and laboratory tests revealed severe secondary hypothyroidism, adrenal insufficiency and a decrease in pituitary hormones. A magnetic resonance imaging of the head showed changes in the size and contrast enhancement of the adenoma. A diagnosis of hypopituitarism secondary to pituitary apoplexy was made and treatment with hydrocortisone and, subsequently, levothyroxine was started. Hormonal disorders such as hypothyroidism, adrenal insufficiency or hypopituitarism should be considered as unusual causes for reversible cardiomyopathy, long QT syndrome and ventricular arrhythmias.
Subject(s)
Humans , Female , Middle Aged , Pituitary Neoplasms/complications , Long QT Syndrome/etiology , Adenoma/complications , Tachycardia, Ventricular/etiology , Hypopituitarism/complications , Long QT Syndrome/diagnosis , Magnetic Resonance Imaging , Tachycardia, Ventricular/diagnosis , ElectrocardiographyABSTRACT
No disponible
Subject(s)
Humans , Female , Aged, 80 and over , Bronchography/instrumentation , Bronchography/methods , Incidental Findings , Deglutition Disorders/complications , Deglutition Disorders/prevention & control , Malabsorption Syndromes/complications , Bronchi/pathology , Bronchi , Stroke/complications , Stroke/epidemiology , Quality of LifeSubject(s)
Bronchi/diagnostic imaging , Contrast Media , Deglutition Disorders/complications , Respiratory Aspiration of Gastric Contents/diagnostic imaging , Aged, 80 and over , Cognition Disorders/complications , Female , Frail Elderly , Humans , Infarction, Middle Cerebral Artery/complications , Intestine, Small/diagnostic imaging , Multimorbidity , Respiratory Aspiration of Gastric Contents/etiology , Trachea/diagnostic imagingABSTRACT
OBJETIVOS: Los pacientes con hiperparatiroidismo primario (HPP), incluso asintomático, presentan un mayor riesgo cardiovascular. Sin embargo, los datos sobre la reversibilidad o mejoría de las alteraciones cardiovasculares con la cirugía son controvertidos. Los objetivos de nuestro estudio fueron evaluar la prevalencia de factores de riesgo cardiovascular clásicos en pacientes con HPP asintomático, examinar su relación con los niveles de calcio y PTH y analizar el efecto de la paratiroidectomía sobre los mismos. PACIENTES Y MÉTODOS: Estudio retrospectivo observacional de 2 grupos de pacientes con HPP asintomático: 40 pacientes en observación y 33 pacientes intervenidos. Se recogieron datos clínicos y bioquímicos relacionados con el HPP y de diversos factores de riesgo cardiovascular en todos los pacientes de forma basal, y al año de la cirugía en el grupo de pacientes intervenidos. RESULTADOS: Encontramos una elevada prevalencia de obesidad (59,9%), diabetes mellitus tipo 2 (25%), hipertensión arterial (47,2%) y dislipidemia (44,4%) en la muestra total, sin diferencias entre los grupos de estudio. En el grupo que se mantuvo en observación las concentraciones séricas de calcio y PTH se relacionaron positivamente con el IMC (r = 0,568, p = 0,011 y r = 0,509, p = 0,026 respectivamente). En los pacientes intervenidos, al año de la cirugía no hubo mejoría de los factores de riesgo cardiovascular considerados. Conclusiones Nuestros resultados confirman la elevada prevalencia de obesidad, diabetes mellitus tipo 2, hipertensión arterial y dislipidemia en pacientes con HPP asintomático. Sin embargo, el tratamiento quirúrgico no supuso una mejoría en estos factores de riesgo cardiovascular
OBJECTIVES: Patients with primary hyperparathyroidism (PHP), even asymptomatic, have an increased cardiovascular risk. However, data on reversibility or improvement of cardiovascular disorders with surgery are controversial. Our aims were to assess the prevalence of classic cardiovascular risk factors in patients with asymptomatic PHP, to explore their relationship with calcium and PTH levels, and analyze the effect of parathyroidectomy on those cardiovascular risk factors. PATIENTS AND METHODS: A retrospective, observational study of two groups of patients with asymptomatic PHP: 40 patients on observation and 33 patients who underwent surgery. Clinical and biochemical data related to PHP and various cardiovascular risk factors were collected from all patients at baseline and one year after surgery in the operated patients. RESULTS: A high prevalence of obesity (59.9%), type 2 diabetes mellitus (25%), high blood pressure (47.2%), and dyslipidemia (44.4%) was found in the total sample, with no difference between the study groups. Serum calcium and PTH levels positively correlated with BMI (r = .568, P = .011, and r = .509, P = .026 respectively) in non-operated patients. One year after parathyroidectomy, no improvement occurred in the cardiovascular risk factors considered. CONCLUSIONS: Our results confirm the high prevalence of obesity, type 2 diabetes mellitus, high blood pressure, and dyslipidemia in patients with asymptomatic PHP. However, parathyroidectomy did not improve these cardiovascular risk factors
Subject(s)
Humans , Cardiovascular Diseases/epidemiology , Hyperparathyroidism, Primary/epidemiology , Parathyroidectomy , Risk Factors , Asymptomatic Diseases , Retrospective StudiesABSTRACT
OBJECTIVES: Patients with primary hyperparathyroidism (PHP), even asymptomatic, have an increased cardiovascular risk. However, data on reversibility or improvement of cardiovascular disorders with surgery are controversial. Our aims were to assess the prevalence of classic cardiovascular risk factors in patients with asymptomatic PHP, to explore their relationship with calcium and PTH levels, and analyze the effect of parathyroidectomy on those cardiovascular risk factors. PATIENTS AND METHODS: A retrospective, observational study of two groups of patients with asymptomatic PHP: 40 patients on observation and 33 patients who underwent surgery. Clinical and biochemical data related to PHP and various cardiovascular risk factors were collected from all patients at baseline and one year after surgery in the operated patients. RESULTS: A high prevalence of obesity (59.9%), type 2 diabetes mellitus (25%), high blood pressure (47.2%), and dyslipidemia (44.4%) was found in the total sample, with no difference between the study groups. Serum calcium and PTH levels positively correlated with BMI (r=.568, P=.011, and r=.509, P=.026 respectively) in non-operated patients. One year after parathyroidectomy, no improvement occurred in the cardiovascular risk factors considered. CONCLUSIONS: Our results confirm the high prevalence of obesity, type 2 diabetes mellitus, high blood pressure, and dyslipidemia in patients with asymptomatic PHP. However, parathyroidectomy did not improve these cardiovascular risk factors.
Subject(s)
Cardiovascular Diseases/epidemiology , Hyperparathyroidism, Primary/epidemiology , Adult , Aged , Asymptomatic Diseases , Body Mass Index , Calcium/blood , Comorbidity , Diabetes Mellitus/epidemiology , Dyslipidemias/epidemiology , Female , Follow-Up Studies , Humans , Hyperparathyroidism, Primary/blood , Hyperparathyroidism, Primary/surgery , Hypertension/epidemiology , Male , Middle Aged , Obesity/epidemiology , Parathyroid Hormone/blood , Parathyroidectomy , Phosphorus/blood , Retrospective Studies , Risk FactorsABSTRACT
BACKGROUND: It has been suggested that the changes in hormone levels that occur with menopause and aging are related to loss of muscle mass. However, the role of gonadotropins in this process is unknown. OBJECTIVES: To analyze the relationship between follicle-stimulating hormone (FSH) and luteinizing hormone (LH) and lean mass in a cohort of healthy women. METHODS: This is a cross-sectional study including 91 postmenopausal women (48-65 years old). Serum FSH, LH, and estradiol (E2) were measured. Lean mass was estimated by bioelectrical impedance analysis and expressed as appendicular skeletal muscle mass (AMM) index. RESULTS: AMM index was negatively correlated with FSH levels (r = -0.33, p = 0.001) and LH (r = -0.293, p = 0.005), while there was no association with E2. When muscle mass expressed as AMM index was stratified into tertiles, there were significant differences between the lowest and the highest tertile for both FSH (82.4 ± 30, vs. 67.9 ± 25.8 mIU/mL, p = 0.04) and LH (40.9 ± 15.2 vs. 36.1 ± 12.3 mIU/mL, p = 0.03). In logistic regression analysis adjusted for age and E2 levels, high concentrations of FSH (OR = 1.03, 95% CI = 1.01-1.05, p = 0.008) and LH (OR = 1.06, 95% CI = 1.01-1.1, p = 0.01) were risk factors for having lower lean mass expressed as AMM index. CONCLUSIONS: Menopausal women with high levels of gonadotropins have lower levels of lean mass than those with lower gonadotropins levels.
