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Biomedical subjects

E Montaña

Publications and source records attributed to E Montaña.

At least 37 records · Page 2Linked to original sources
PubMed1992

Salivary testosterone as an index of antiandrogen therapy in hirsutism.

The purpose of this study is to examine whether salivary testosterone (ST) in hirsute women treated with antiandrogen therapy can be considered a good parameter for the evaluation of clinical response. Twenty-three hirsute women, four with polycystic ovarian disease and 19 with idiopathic hirsutism were treated with cyproterone acetate and ethynyl-oestradiol with levonorgestrel in a reverse sequential regime for three months. Basal ST from hirsute women was 0.18 +/- 0.11 nmol/L (normal values 0.03-0.17) and a decrease to 0.11 +/- 0.06 was observed in the first month of treatment, to 0.1 +/- 0.059 after two months and to 0.11 +/- 0.06 after three months, all of them significantly different from basal values (p < 0.05). We found a relationship between ST decrease and the clinical response to antiandrogen therapy. On the basis of these results we suggest that ST values could be a good index for the follow-up of antiandrogen therapy in hirsute women.

Adolescent↗
PubMed1991

[Pituitary apoplexy: analysis of endocrine function in 17 cases].

BACKGROUND: From a neurological standpoint, pituitary apoplexy (PA) is a well defined syndrome. There are few systematic studies addressing pituitary hormone secretion after a PA episode. The aim of the present study was to assess the frequency and degree of endocrine dysfunction due to PA. METHODS: In 17 consecutive patients, the secretion of growth hormone (GH), the pituitary-adrenal axis status, thyrotropin (TSH), prolactin and gonadotropins (LH, FSH) were evaluated after the administration of insulin, thyrotropin releasing hormone (TRH) and gonadotropin-releasing hormone (LHRH) after an episode of PA. 20-90 days after surgery the measurements were repeated. Antidiuretic hormone (ADH) was measured by plasma/urine osmolality after water deprivation and, in some cases, by administration of hypertonic saline. RESULTS: The most commonly found deficiency was that of GH (84%), which in two cases resulted in cure of acromegaly, followed by that of LH (78%). Pituitary-adrenal dysfunction was improved in two patients after surgery. In all cases except one there was a reduced secretion of at least two hormones. If serum prolactin was reduced, the rest of pituitary function was usually impaired. In one case, permanent diabetes insipidus developed after PA. The prevalence of PA in pituitary adenomas was 9%. CONCLUSIONS: Pituitary hormone secretion after a PA episode is almost invariably impaired. This impairment may be reversed after surgery. Hypoprolactinemia is an indicator of pituitary hypofunction.

Adenoma↗
PubMed1991

[Limitations of joint mobility in patients with type 1 diabetes mellitus].

BACKGROUND: To assess limitation of joint mobility in patients with type I diabetes mellitus and to evaluate its relation with retinopathy, joint mobility was prospectively assessed in 96 diabetic patients and 68 healthy controls. METHODS: Joint mobility was explored with the praying maneuver and the measurement in mobility degrees of the third and fifth metacarpophalangeal joints, wrists and elbows. The degree of metabolic control was assessed with the mean glycosylated hemoglobin in the last two years. Retinopathy was investigated with direct funduscopy. The results were statistically evaluated with chi-square and Student's t tests and the linear coefficient. RESULTS: A reduced joint mobility was found in 41 diabetics and 5 controls (p less than 0.0001). The reduction in joint mobility was related with the patients' age but not with the degree of metabolic control. 85% of diabetics with joint involvement had retinopathy of some degree. CONCLUSIONS: A limited joint mobility is a common complication of type I diabetes mellitus. The demonstration of this abnormality in diabetic patients might represent a first and simple marker of microangiopathy.

Adolescent↗
PubMed1991

[Thyroid dysfunction induced by amiodarone in Catalonia. Prevalence and characteristics].

The purpose of this study was to review the epidemiological aspects and the characteristics of the thyroid disfunction produced by amiodarone in Catalonia, an area with type I endemic goiter. For this purpose, three groups of patients have been studied: 1) 102 patients with prolonged amiodarone treatment, out of whom 6 (5.9%) presented hyperthyroidism, and 2 (1.9%) hypothyroidism. 2) 909 patients with hyperthyroidism of any origin out of which 42 (4.6%) were produced by amiodarone. 3) 203 patients presenting primary hypothyroidism of any origin out of which 11 (3.8%) were induced by amiodarone. Out of the 48 patients with amiodarone induced hyperthyroidism, 16 presented multinodular goiter, 2 toxic thyroid goiter and 7 Graves Basedow disease. Thyroid uptake of 131I was studied in 10 cases being normal or increased in six of them, all with a underlaying thyroid pathology. Out of the 13 patients with amiodarone induced hypothyroidism, 3 presented diffuse goiter; thyroid uptake of 131I was studied in 5 patients, being normal or increased in 4 cases, 2 of which with thyroid pathology. Amiodarone administration very often produces thyroid disfunction, specially hyperthyroidism. These patients with hyperfunctional thyroids usually present underlying thyroid pathologies in which thyroid uptake of 131I are frequently not suppressed as well as in those patients in whide amiodarone induced hypothyroidism.

Adolescent↗
PubMed1989

[Study of thyroid function parameters and thyrotropin in general non-thyroid diseases].

The changes in the parameters of thyroid function and thyrotropin (TSH) have been evaluated in 5 groups of patients with general non-thyroid disease (GNTD): acute severe bacterial infection (16 patients), acute myocardial infarction (22 patients), diabetic ketoacidosis (24 patients), non-ketotic hyperosmolar decompensation (8 patients), protein-calorie undernutrition (12 patients), without associated conditions or drug therapies that might have modified the thyroid hormones. These patients were evaluated at the beginning of their GNTD and after recovery. Thyroxine (T4), triiodothyronine (T3) and reverse T3 (rT3) were measured by radioimmunoassay (RIA), the TBC index by competitive analysis, the free T4 by a labeled T4 analogue and T4 by immunoradiometric analysis (IRMA). In all patients similar changes in thyroid hormones and in IRMA were found, and they returned to normal after recovery; the changes were most marked in diabetic ketoacidosis, followed by hyperosmolar decompensation and by undernutrition. When the 5 groups were evaluated together, T3 was the most commonly low value (57.3%), followed by T4 and TBC index (26.8%), free T4 (20.7%) and the free T4 index (10.9%). The level of rT3 was increased in 39% of cases. Baseline TSH was, initially, 1.05 +/- 1.05 microU/ml, and 1.36 +/- 0.85 microU/ml after recovery (p less than 0.001). It was only found to be suppressed in one patient (a female with diabetes mellitus and Graves disease); in 17 cases it had borderline values between 0.1 and 0.4 microU/ml, and in the remaining patients it was normal. GNTD induces profound changes in the thyroid functional parameters, with reductions below their normal range, including the analogue measured T4 and low TSH.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1989

Transient hypothyroidism after iodine-131 treatment of Graves' disease.

One hundred twenty six patients with Graves' disease, 26 with toxic multinodular goiter, and 18 with toxic adenoma were treated with 131I (3-15 mCi), and followed at monthly intervals for six months. Transient hypothyroidism occurred at two months in 22 patients with Graves' disease. In this state TSH levels became elevated in seven patients, but were normal or suppressed in seven. In 17 patients T4 and T3 levels returned to normal without T4 replacement. Five patients developed recurrent thyrotoxicosis, and required repeated doses of 131I. The possibility of transient hypothyroidism in the early months after 131I therapy in Graves' disease should be borne in mind.

Adult↗
PubMed1989

[Thyroid function parameters and TSH in patients treated with anticonvulsant drugs].

Several antiepileptic drugs change the serum levels of thyroid hormones by different mechanisms, of these diphenylhydantoin being the most known. This study was carried out on 96 patients in order to analyse the effects of long-term treatment with phenobarbital (N = 29), carbamazepine (N = 21), sodium valproate (N = 11), diphenylhydantoin (N = 6) and a combination of them all at therapeutic doses. We observed a decrease of T4 seric levels and free T4 index (in 25 and 14 patients respectively, under normal levels) free T4 normal, T3 normal, decreased rT3, and normal TSH in all groups being more noticeable in patients treated with diphenylhydantoin, carbamazepine, phenobarbital and lastly, sodium valproate. It is a different situation from a general non-thyroid disease, where there is a decrease of T3 and where the antiepileptic drugs of different chemical structure induce changes in seric levels of thyroid hormones. The basal TSH is the best measurement to reflect the euthyroidism of these patients.

Adolescent↗
PubMed1989

Islet-cell antibodies: markers of a more severe insulin-dependent diabetes mellitus?

The aim of the present study was to analyze if an association exists between metabolic condition, C-peptide secretion and islet-cell antibody (ICA) presence in insulin-dependent diabetes mellitus (IDDM) at the clinical onset of the disease. Two hundred and nine IDDM patients were studied at diagnosis. 89% of the subjects showed residual C-peptide secretion that correlated inversely with blood glucose and glycosylated hemoglobin at diagnosis and with insulin requirement at discharge. Islet-cell antibodies were detected in 68.6% of the patients, complement-fixing ICA in 30% and insulin autoantibodies in 17.3%. Islet-cell antibody positive patients had a lower glucagon stimulated C-peptide than ICA negative subjects (0.41 +/- 0.22 versus 0.54 +/- 0.25 nmol/l, p = 0.005). However patients with high titers of ICA expressed in JDF units (JDF greater than 20) showed similar C-peptide secretion than ICA positive patients with a low level of JDF (JDF less than 20). When acid-base condition was analyzed patients on ketoacidosis at diagnosis had significant higher insulin requirement, lower C-peptide secretion and higher prevalence of ICA compared to patients that were not ketotic at diagnosis. Our findings suggest that residual beta-cell secretion plays a role on metabolic condition at diagnosis of IDDM and that ICA may be the markers of a more severe form of IDDM.

Adolescent↗