[Psychiatric manifestations due to most common endocrine diseases].
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Biomedical subjects
Publications and source records attributed to G Piédrola Maroto.
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BACKGROUND: The clonidine test has been proposed as diagnostic biochemical test for patients with clinical suspicion of pheochromocytoma. METHODS: The clonidine test was used in 80 patients with suspicion of pheochromocytoma (on account of suggestive clinical findings, increased levels of metanephrines, increased plasma or urinary levels of catecholamines, or suggestive images by ultrasonography or CT). RESULTS: Surgery confirmed the diagnosis of pheochromocytoma in 16 patients. The highest sensitivity (62%) and specificity (46%) of the clonidine test corresponded to a brake degree of 5%, with a predictive negative value of 83%. The test was most useful in patients with increased basal plasma values of catecholamines (sensitivity, 62%; specificity, 66%). CONCLUSIONS: The clonidine test can be useful for the diagnosis of pheochromocytoma in patients with increased basal plasma levels of catecholamines and a brake degree lower than 5% at 180 minutes.
BACKGROUND: The demand for sex reassignment in transsexual patients has increased as have the number of treatments. However, these patients run into troubles to be treated in Spanish public hospitals and the patients usually make use of self-therapy, without medical control, by suffering frequent side effects. In this paper, we have analysed these effects. PATIENTS AND METHODS: Cross-sectional and descriptive study of the side effects of cross-gender hormone self-administration in 57 transsexuals, aged (median [SD]) 30(7) years. RESULTS: Combined treatment with estrogen and cyproterone acetate in 31 male-to-female transsexuals was associated with hyperprolactinemia in 24/31 patients (77.4%) and elevation of liver enzymes in 4/31 (12.9%). Androgen treatment in 26 female-to-male transsexuals was associated with hyperprolactinemia in 10/26 patients (38.5%), elevation of liver enzymes in 5/26 (19.2%). The levels of total cholesterol, LDL-cholesterol and triglycerides were higher in female-to-male that in male-to-female transsexuals (197.3 [40.2] vs 160.6 [38.0] mg/dl, p = 0.033; 131.4 [29.4] vs 104.8 [26.4] mg/dl, p = 0.049; and 131.3 [62.7] vs 67.4 [25.6], p = 0.001, respectively). Total cholesterol/HDL-cholesterol and LDL-cholesterol/HDL-cholesterol ratios were higher in female-to-male that in male-to-female transsexuals, too (4.94 [1.20] vs 3.32 [0.71], p = 0.006; and 3.20 [0.87] vs 2.04 [0.63], p = 0.003, respectively). CONCLUSIONS: The alteration of the cardiovascular risk, the presence of hyperprolactinemia and the elevation of liver enzymes must be taken into account in transsexual patients with hormone treatment.
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