Biomedical subjects
Publications and source records attributed to D de Luis.
The aim of this study was to review all published randomized clinical trials evaluating the efficacy of suppressive therapy with levothyroxine for solitary thyroid nodules. No significant differences were observed in reducing the volume of benign solitary cold thyroid nodules between the placebo and levothyroxine groups.
OBJECTIVE: To evaluate the clinical and hormonal responses of adolescent males with hypogonadotropic hypogonadism (HH) in response to gonadotropin replacement with the use of long-term combined hCG and FSH therapy. DESIGN: Prospective clinical study. SETTING: Clinical pediatric department providing tertiary care. PATIENT(S): Seven prepubertal males with isolated HH with a mean (+/-SD) age of 15.44+/-1.97 years and seven prepubertal males with panhypopituitarism-associated HH with a mean (+/-SD) age of 18.1+/-3.24 years were studied. INTERVENTION(S): Human chorionic gonadotropin (1,000-1,500 IU IM) and FSH (75-100 IU SC) were administered every alternate day of the week until the total induction of puberty and spermatogenesis was achieved. MAIN OUTCOME MEASURE(S): Serum testosterone levels, testicular volume, penis length, and sperm count were evaluated after the administration of hCG and FSH. RESULT(S): All patients achieved normal sexual maturation and normal or nearly normal adult male levels of testosterone. The increase in testicular size was significant in both groups. Positive sperm production was assessed in four of five patients with isolated HH and in three of three patients with panhypopituitarism-associated HH. CONCLUSION(S): Long-term combined hCG and FSH therapy is effective in inducing puberty, increasing testicular volume, and stimulating spermatogenesis in adolescent males with isolated HH and panhypopituitarism-associated HH.
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OBJECTIVE: gas exchange abnormalities are frequent in cirrhosis. These abnormalities can be considered an indication or contraindication for liver transplantation. The aim of this study was to investigate the etiology and frequency of these alterations. METHOD: seventy-eight patients with cirrhosis and 20 healthy subjects were selected randomly. Arterial basal blood gases, diffusing capacity of carbon monoxide (DLco), pulmonary function test (PFT) and contrast transthoracic echocardiography (CTTE) with 0. 9% saline were done. RESULTS: patients showed lower DLco (79 +/- 23. 2 vs 96 +/- 20; p < 0.01), lower PaCO2 levels (32.2 +/- 4.5 vs 37.5 +/- 4; p < 0.001) and higher alveolar-arterial oxygen difference (AaPaO2) (22.5 +/- 11.4 vs 12 +/- 7.4; p < 0.001) than controls, but the difference between groups in mean PaO2 levels was not significant. Twenty-three patients (29.5%) had pulmonary vasodilatation (PV) and 28 (36%) altered PFT. Hypocapnia was the most frequently observed alteration in gas exchange (73.4%). Hypoxemia and decreased DLco were more frequent in the presence of altered PFT than in the presence of PV. Both PFT abnormalities and PV were associated with increased AaPaO2. Child stage was higher in patients with PV (7.9 +/- 2.3 vs 9.2 +/- 2; p = 0.01) than in those without PV. CONCLUSIONS: gas exchange abnormalities are frequent in cirrhosis. The most frequent alteration is hypocapnia, which is associated with PV. The main cause of severe hypoxemia in these patients is PFT abnormality. Pulmonary vasodilatation is more frequent and more severe in patients with advanced hepatocellular dysfunction.
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Two cases are reported of spontaneous ascitic fluid Candida albicans peritonitis in two patients with liver cirrhosis secondary to HBV. In non of the two cases was there evidence of findings associated with secondary peritonitis, where ascitic fluid Candida infection has usually been reported.
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OBJECTIVES: The valuation of nutritional state of an individual is necessary to performed a correct diagnostic approach and therapy in each case. This valuation can be performed by biochemical or anthropometric methods. In our country two tables of anthropometric values are used (Alastrue et al. and Frisancho et al.). The aim of our work was to compare the utility of both tables in the nutritional valuation of a urban and rural population of Valladolid. MATERIAL AND METHODS: A total of 110 patients were valued biochemically and anthropometrically, presenting 65.5% pathology tumoral, with a 61.41 +/- 16.73 year old half age. RESULTS: Tricipital pleat classified the patients in a similar way (agreement 76.5%, kappa 0.68), however the muscular circumference of the arm didn't classify the patients in a same way (agreement 23%, kappa 0.02). in the correlation analysis among anthropometrics and biochemical parameters, positive correlations were detected between tricipital pleat and the index of corporal mass with the glucemia and cholesterol values. Positive correlations were also detected between the muscular circumference of the arm and urea and potassium levels. CONCLUSION: The anthropometric parameters are useful for the nutritional valuation of these patients but it is necessary to keep in mind the possible variations that can exist in function of the used tables. For it Would be useful that each geographical area and each group of pathologies even had its own table of percentiles in its normal population's function.