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Biomedical subjects

H Pumarino

Publications and source records attributed to H Pumarino.

At least 19 recordsLinked to original sources
PubMed1998

[Cushing with transition from pituitary to adrenal origin. Study with SPECT scintigraphy of the adrenal cortex with norcholesterol-I 131 in a case].

The case of a 49 yr old alcoholic women with clinical and laboratory findings that suggested a Cushing syndrome is presented. The functional tests showed cortisol suppression greater than 50% of the basal value with 8 mg of dexamethasone and no response in the combined dexamethasone/desmopressin test. Pituitary Nuclear Magnetic Resonance (NMR) was negative, Abdominal Computed Axial Tomography suggested hyperplastic adrenal glands; adrenal nodules were not found in the NMR. Pituitary or hipothalamic Cushing with secondary autonomous micronodular adrenal hyperplasia was suspected. Norcholesterol-I131 SPECT scintigraphy under dexamethasone suppression demonstrated a functional adrenal hyperplasia which was hystologically confirmed.

19-Iodocholesterol↗
PubMed1997

[Twelve-year trends of hip fracture rates in Chile. Is there a relationship between their increase and population aging?].

BACKGROUND: Epidemiology of osteoporosis is assessed measuring bone density or measuring the rates of bone frailty-related fracture rates. Of these, the most important are hip fractures, that markedly increase after 65 years of age. AIM: To measure the incidence of hip fractures in Chile from 1982 to 1993. MATERIAL AND METHODS: All hospital discharges that occurred in Chile from 1982 to 1993 were analyzed, looking for the diagnosis of hip fracture. National censuses in the same period were also analyzed searching for possible changes in the age structure of the population. Fracture rates were analyzed for three age groups, and changes along the years were calculated correlating the rates with the number of the year. RESULTS: In the twelve year period, women aged 55-64 years old had a correlation of 0.32 (NS), women aged 65-74 years old had a correlation of 0.58 (NS) and women aged over 75 years old had a correlation of 0.95 (p < 0.001). This age group corresponded to 2.01% of the whole population in 1982 and to 2.52% in 1993. The mean age of the group increased from 80.7 to 80.9 years in the same lapse. CONCLUSIONS: Fracture rates increased in the 12 years period studied, specially among women older than 75 years old. During the same period the proportion of people over 75 years old also increased, but there was only a slight increase in its mean age. Thus, the increase in fracture rates is disproportionate to population aging and could be related to changes in lifestyles.

Age Factors↗
PubMed1996

[Determination of 25-hydroxyvitamin D serum levels and its seasonal variations in healthy young people].

BACKGROUND: 25-hydroxyvitamin D has a longer half life and its serum levels have less daily variations than calcitriol. Thus, its measurement is a better indicator of vitamin D status. AIM: To measure 25-hydroxyvitamin D levels in normal subjects during summer and winter. PATIENTS AND METHODS: Vitamin D was measured using a competitive protein binding radioassay in 61 subjects (27 male) aged 21 to 57 years old, during July and August (winter) and February and March of the next year (summer). RESULTS: 25-hydroxyvitamin levels were 28.8 +/- 1.5 and 30.9 +/- 2.3 ng/ml during winter and summer respectively. No differences were found between men and women. Ninety five percent confidence levels were between 13 and 50 ng/ml. Levels in one patient with malabsorption were 9.3 ng/ml, in 2 patients with hypophosphatemic osteomalacia were 2.1 and 9.3 ng/ml, in 12 patients with alcoholic cirrhosis were 16.4 +/- 1.3 ng/ml, in 4 patients with primary osteoporosis were 23.3 +/- 0.7 and in three patients receiving vitamin D were 334 +/- 33.2 ng/ml. CONCLUSIONS: Normal levels of 25-hydroxyvitamin D range from 13 to 50 ng/ml in normal adults, there are no differences between men and women and seasonal variations are minimal.

Adult↗
PubMed1996

[Assessment of bone status in intermittent and continuous alcoholics, without evidence of liver damage].

The effect of chronic alcoholism on bone mass and density has been a subject of considerable controversy. The goal of the present study was to evaluate bone mineral content and density in 2 groups of alcoholic men without evidence of liver damage and determine if the modality of alcohol consumption could cause an alcohol-mediated bone loss. We studied 70 alcoholic non cirrhotic men divided into intermittent (n = 38) and continuous (n = 32) drinkers. They were compared to 109 normal men. Dual photon densitometry technique using a Gd 153 source was utilized and bone mineral density (BMD) of lumbar spine, femoral neck, Ward's triangle, trochanter, total body bone density (TBBD) and mineral (TBBM) were measured. Hematologic, serum and urinary tests of mineral metabolism were also carried out. No significant differences were found in lumbar spine BMD between normals and alcoholics regardless of the type of alcohol consumption and duration of alcoholism. In the femoral neck a significant decrease in BMD was found in alcoholics when plotted as regression curves (r = 25; p = 0.02). In this site duration of alcoholism was significantly correlated to decreased BMD in the total group of alcoholics (r = 0.27; p = 0.02) and also in the continuous drinker group (r = 0.39; p = 0.02) but not in the intermittent drinker group. At the whole body level, BMD did not significantly differ between alcoholics and normals (p = 0.08) except in continuous (r = 0.40; p = 0.02) when considered duration of alcohol abuse. Total bone mineral was significantly lower in alcoholics (p < 0.001) and the subgroups compared to normals, and correlated with duration of alcohol abuse (p = 0.01). Chemical values revealed normal calcium, phosphorus, alkaline phosphatases, PTH and Ca/Cr concentration. Only serum magnesium was found diminished in 16.6% of studied subjects. We conclude, that pure alcoholism may affect femoral neck density and total body mineral content, being proportional to the duration of alcohol abuse. Spine density appears unaffected. The type of alcoholic abuse was less important than its duration to cause bone mass abnormalities.

Adult↗
PubMed1996

[Osteoporosis in men under 65 years old presenting as vertebral crushing: idiopathic or secondary? Study of 9 cases].

BACKGROUND: Osteoporosis in young or middle age men is unusual and requires an extensive diagnostic work-up. AIM: To report a retrospective review of nine men with osteoporosis. PATIENTS AND METHODS: The charts of nine men aged 27 to 61 years old (mean 39), that presented with a primary diagnosis of osteoporosis, were reviewed. RESULTS: Subjects were subjected to a diagnostic work up five years after the onset of symptoms. Their body mass index ranged from 21.7 to 26.3 kg/m2, all had vertebral fractures (crush fractures in 8 and a biconcave deformity in one) between T4 and L4 and all had normal serum calcium, phosphate, alkaline phosphatase and creatinine. Four patients had a history of nephrolithiasis and three had hypercalciuria. Bone density, measured in seven patients with a dual photon densitometer, showed a mean Z score of -2.0 in the spine and of -2.2 in the femoral neck. The final diagnoses of these patients were Cushing's disease in two, malabsorption syndrome in one, use of phenobarbital and hydantoin in one, overt renal hypercalciuria with low calcium intake in one and alcoholic liver disease in one. In three patients, osteoporosis was considered idiopathic. Of these, two had moderate absorptive hypercalciuria as a presumable risk factor. CONCLUSIONS: Six of the nine studied male patients with osteoporosis had an underlying cause and in three, this condition was considered idiopathic.

Adult↗
PubMed1996

[Hip fracture: a case-control study in the metropolitan region I].

BACKGROUND: Hip fracture is a preventable cause of disability among elderly people AIM: To study factors associated to hip fractures in Chile. PATIENTS AND METHODS: Patients admitted to seven public hospitals in Chile, with hip fracture not due to major accidents, were considered as cases. To each, at least one age and sex matched hospitalized control, without or neoplastic diseases, was assigned. All patients were subjected to an inquiry, using an instrument devised by the WHO. RESULTS: Two hundred sixty eight cases and 501 controls were studied. Cases and controls has similar educational and labor histories. The right hip was fractures in 47% of cases and the left in the rest. Compared with controls, cases had a higher body mass index, loss of height during life, rate of hysterectomy, incidence of smoking and a lower consumption of diary products. Cases had higher risk of falls inside their homes and controls outside. CONCLUSIONS: The obtained information may contribute to the development of preventive measures and reduce the public health impact of hip fracture.

Aged↗
PubMed1996

[Cytokines, growth factors, and metabolic bone disease].

Cytokines are polypeptides that bind to membrane receptors and may act in an endocrine, paracrine or autocrine way. Several cytokines and growth factors may be produced by bone cells, stored in the matrix or act on them. Osteoclasts derive from the bone marrow stem cell and, as monocytes, belong to the family of tissue macrophages. Their specific function is bone resorption. Interleukin 1, 6 and 11, transforming growth factor and tumor necrosis factor stimulate osteoclast mediated bone resorption. Interleukin 1 is the most potent bone resorption agent and seems to be identical to osteoclast activation factor, identified in multiple myeloma. The role of interleukin 1, 6, 11 and tumor necrosis factors in postmenopausal osteoporosis triggered by the fall in estrogen levels, has not been well defined yet. Cytokines that increase bone formation are insulin like growth factors I and II, transforming growth factor, platelet derived growth factor and bone morphogenic proteins. Probably, tumor necrosis factor and interferon-gamma have a depressor effect on bone formation. Cytokines and growth factors, liberated from bone cells or from the matrix during osteoclastic work, could be the signals responsible for coupling bone formation and resorption.

Bone Diseases, Metabolic↗
PubMed1996

[Bone mass in celiac patients].

Bone mineral content was measured in the whole body, the spine (L2-L4) and hip by Dual Photonic Absorpciometry (densitometer Norland 2600 Gd-153), in seventeen celiac patients, aged 6 to 12 years, with good adherence to the gluten free diet. The diagnosed was made before 30 months of age in 50% of cases. Average treatment duration was 69.8 +/- 36 months. The randomly selected control group was composed of 48 school age children, of the same age and sex of patients. Total bone mass (TBM) and bone mineral density (BMD) were expressed as Z scores on the basis of normal values established by the authors in Chilean children. Celiac patients had lower TBM and BMD of whole body, than controls (-1.11 +/- 0.94 vs 0.00 +/- 0.85 and -0.59 +/- 0.76 vs 0.06 +/- 0.84, respectively) and at the spine (-0.79 +/- 1.04 vs 0.003 +/- 0.92 and -1.49 +/- 0.99 vs 0.06 +/- 0.87 respectively). A lower TBM was founded at the hip (-0.62 +/- 1.28 vs -0.08 +/- 0.82) without differences in BMD. Celiac patients had a lower bone mass than controls despite early diagnosis and good compliance with the gluten-free diet. These differences could not be atributed entirely to the lower height of celiac patients. These results suggest that celiac patients constitute a risk group for development of osteoporosis later in life. This fact should be taken into consideration in the treatment of this condition.

Bone Density↗
PubMed1995

[Thyroid nodule in Basedow-Graves disease and thyroid cancer: experience in 6 patients].

Traditionally, Basedow-Graves disease was considered a protection against thyroid cancer. However, recent reports suggest that cancer occurs with a higher frequency than expected and is more aggressive in this disease. We report six patients with hyperthyroidism due to a Basedow Graves disease that presented a palpable thyroid nodule, which was cold in the scintiscan and solid in the ultrasound examination. Fine needle cytology disclosed cancer in five cases (two with cytological features of greater aggressiveness) and a nodular hyperplasia in one. The diagnosis was confirmed in the surgical piece in all patients. We conclude that Basedow-Graves disease and thyroid cancer, which can have an increased aggressiveness, may coexist.

Adolescent↗
PubMed1995

[Bone mineralization and calcium intake in Chilean school children].

Bone mineralization was evaluated in 36 school age children with calcium intake below 50% of Recommended Dietary Allowances (RDA), and compared with 28 school age children with calcium intake higher than 100% of the RDA. The total group was aged between 86 and 178 months. The calcium intake was evaluated by 24 hours recordatory survey. Height for age and weight for height were evaluated according to WHO tables. Puberal development was evaluated according to Tanner stages. Bone mineral density (BMD) and total bone mass (TBM) of whole body, spine and femoral neck were measured with Norland 2600 densitometer. School age children with intakes below 50% of RDA had lower height for age adequation (97.7 +/- 4.0%), whole body TBM adequation (98.9 +/- 17.9%) and BMD adequation (97.8 +/- 7.9%) than those ingesting more than 100% of the RDA (115.9 +/- 17.4%), (109.7 +/- 18.0%) and (104.7 +/- 11.1%) respectively. In spine, however, there was a clear tendency to be lower, there were no significant differences between both groups. There were no differences in femoral necks BMD adequation, or TBM adequation between both groups. These results show that children with calcium intake below 50% of the recommendation has lower adequation of statural growth and bone mineralization. The role of calcium in the differences found in this study is discussed.

Adolescent↗
PubMed1995

[Bone mineralization in adolescents suffering from postnatal malnutrition].

The bone mineralization of 6 male and 18 female adolescents with a mean age of 12 years and 11 months, who had suffered severe, early, postnatal protein-energy undernutrition, was analyzed. These patients have been followed up at our Institute since their nutritional rehabilitation. Bone mineralization was measured by bone dual isotopic densitometry (Gd 153). These results were compared with those of normal school-age Chilean children of the same age and sex. Weight for height of adolescent who had suffered from undernutrition was similar to the controls, and both were over 100% of the standard. Adequation of height for age was significantly less in those with previous history of undernutrition. Densitometries showed that adolescents with a past history of undernutrition had lower total bone mass in whole body, spine and femoral neck; differences disappeared when expressed per 100 cm of body height. There were no differences in bone mineral density in the different area measurements. It is concluded that the possible alterations that undernutrition produces in bone mineralization probably recover after nutritional rehabilitation, adequate nutritional follow up and health support.

Calcification, Physiologic↗
PubMed1994

[Osteopenia in primary biliary cirrhosis. Study in 20 patients].

We studied 20 female patients, aged 51 +/- 13.6 years old, with the diagnosis of Primary Biliary Cirrhosis (PBC) to assess osteopenia, main involved sites and its relation to menopause, some parameters of mineral metabolism and the degree of histological liver involvement. The diagnosis of PBC was based in histological, clinical and laboratory features. Bone densitometry was measured with a dual-photon densitometer and compared with values of a normal female population from the laboratory. When compared to controls, studied patients had a significantly lower lumbar spine bone density and total bone mineral content and a non significantly lower density in femoral neck and total body. Serum calcium, phosphorus, magnesium, PTH and urinary calcium/creatinine ratio were within normal limits. Lumbar spine density was not significantly lower in patients with more severe liver histological involvement and in postmenopausal women. No correlation was found between the duration of postmenopausal period and the degree of osteopenia. It is concluded that patients with PBC have a clear lumbar spine osteopenia and a lower total mineral content and that these parameters worsen in a non significant fashion in subjects along with liver histological involvement and with the length of post menopausal period.

Adult↗
PubMed1994

[Bone mineralization in Chilean children determined by dual photon bone densitometry].

In 198 school age children, aged 6 to 13 years, the bone mineral density (BMD) and total bone mass (TBM) was measured in total body, lumbar spine and hip, using a double beam photon densitometer with a Gd 153 source. An increase with age of BMD and TBM was found in all the analyzed areas. At 12 years of age, TBM and BMD of total body were higher in girls than in boys. BMD of lumbar spine was significantly higher in girls than in boys at ages between 11 to 13 years. BMD of lumbar spine and femoral neck of 9 years old females were 36% and 18% respectively, lower than values of young adult Chilean females. The importance of normal values of bone mineralization for the diagnosis of bone diseases and for the evaluation of programmes directed to solve this problems is emphasized.

Absorptiometry, Photon↗