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J Sapunar

Publications and source records attributed to J Sapunar.

At least 19 recordsLinked to original sources
PubMed1997

[Validity of routine serum calcium measurements].

BACKGROUND: The frequency of diagnosis of primary hyperparathyroidism increased dramatically with the advent of routine serum calcium measurements. The reliability of colorimetric serum calcium measurements is not well known. AIM: To know the frequency of hyper and hypocalcemia in a population of healthy people and the reliability of serum calcium measurements. SUBJECTS AND METHODS: Serum calcium was measured in 731 subjects participating in a preventive medical examination, using an automated colorimetric method. Serum albumin was also measured. In 31 randomly chosen serum samples, calcium was also measured by atomic absorption spectrometry. Normal serum calcium ranges were established as the mean +/- 1.34 SD of the sample. RESULTS: Mean serum calcium was 9 +/- 0.7 mg/dl, serum albumin was 4.3 +/- 0.5 g/dl and albumin corrected calcium levels were 8.7 +/- 0.7 mg/dl. Excluding lipemic sera, colorimetric calcium measurement had a correlation of 0.6 with atomic absorption spectrometry and a reliability of 17.9%. Using the proposed normal ranges (7.3-10.6 mg/dl), the frequency of hypercalcemia and hypocalcemia was 0.14 and 0.4% respectively. CONCLUSIONS: Most subjects found to have hyper or hypocalcemia in this study were asymptomatic.

Adolescent↗
PubMed1996

[Simple juxtathyroid cyst. Analysis of the possible origin of the lesion].

We report a 34 years old female who presented with a simple juxtathyroid cyst. Its content was translucent with a mPTH concentration 30 higher than in blood. This finding lead to the suspicion of a parathyroid cyst; however there were no laboratory evidence of hyperparathyroidism. Two years later and after repeated needle drainages, a surgical cystectomy was made. The immunohistochemical study of the samples was intensely positive for synaptophysin, a parathyroid tissue marker. Surprisingly, thyroglobulin was also found in some cyst wall cells.

Adult↗
PubMed1993

[3 beta-hydroxysteroid dehydrogenase defect: frequency of presentation in a sample of Chilean hirsute women].

The defect of 3 beta hydroxysteroid dehydrogenase (3 beta HSD) is frequent among hirsute women and clearly dependent on the ethnic composition of the studied population. Our aim was to study the frequency of 3 beta HSD deficit in a group of Chilean hirsute women. Basal and post ACTH concentrations of cortisol, 17 hydroxyprogesterone and 17 hydroxypregnenolone were measured by RIA in 40 hirsute post puberal women and in 15 normal age matched female volunteers. Criteria for considering a 3 beta HDS deficit were 17 hydroxypregnenolone values and 17 hydroxypregnenolone/17 hydroxyprogesterone and 17 hydroxypregnenolone/cortisol ratios after ACTH stimulation over the 95% confidence intervals of normal women. Basal dehydroepiandrosterone sulphate and testosterone levels were also measured in hirsute women. All samples were obtained during the follicular phase of the menstrual cycle. ACTH stimulated hormone values and ratios were diagnostic for 3 beta HDS deficit in 7.5% of hirsute women. Basal testosterone was over 80 ng/dl in 47.5% and dehydroepiandrosterone sulphate over 3.9 micrograms/ml in 52.5% of these women. There was no correlation between dehydroepiandrosterone or testosterone values and ACTH stimulated hormone values. It is concluded that 3 beta HSD is frequent in hirsute women and that its diagnosis requires the determination of ACTH stimulated 17 hydroxypregnenolone values and 17 hydroxypregnenolone/17 hydroxyprogesterone ratio.

17-alpha-Hydroxypregnenolone↗
PubMed1993

[Changes in the clinical presentation of primary hyperparathyroidism. Analysis of 84 cases].

During the last two decades, the clinical presentation of primary hyperparathyroidism (PHP) has changed due to the routine use of multiphasic biochemical screening tests. We assessed 84 patients with PHP treated in our service between 1977 and 1991. The yearly incidence increased from 1.6 to 7.6 patients/year with the introduction of multiphasic biochemical testing in our hospital in 1982; likewise the proportion of asymptomatic patients increased from 12.5 to 40.7%. The most frequent presenting symptoms were bone pain and renal colic. Nineteen percent of patients were over 70 years old and this age group had distinct clinical features. The plasma chlorine/phosphorus ratio was abnormal in 95% of cases; on the contrary only 7 of 18 patients had a urinary calcium excretion over 300 mg/day. Cervical ultrasound, performed in 45 patients had a positive predictive value of 78% to localize the lesion. Bone density was below fracture threshold in 50% of studied patients. The principal surgical finding was the presence of adenoma. Twenty one percent of patients had symptomatic hypocalcemia during the first week after surgery; however, only 2.5% of patients continued to have hypocalcemia one month after surgery. One patient had an inferior laryngeal nerve damage and two a cervical hematoma. It is concluded that the introduction of massive calcium measurements has allowed an early diagnosis of asymptomatic PHP, specially in elderly people.

Adenoma↗
PubMed1992

[Bromocriptine for macroprolactinomas. Discussion of 3 cases treated successfully].

Bromocriptine was used to treat 3 patients with prolactin secreting pituitary adenoma. Diagnosis was based on the presence of a sellar tumor over 1 cm in size at CT scanning and a serum prolactin concentration above 150 ng/ml. All patients were symptomatic from pituitary hypofunction or from tumor compression of neighboring areas. Bromocriptine was given at increasing doses up to 10 mg/day. Prolactin reached normal levels 1 to 7 months later, tumor reduction was confirmed by high resolution scanning. The mechanism of bromocriptine effect on these tumors is discussed.

Adult↗
PubMed1991

[Polycystic ovary syndrome as expression of 3-beta-hydroxysteroid dehydrogenase deficiency].

Late-onset adrenal enzymatic deficiencies are a common cause of hirsutism. They can produce a PCO syndrome-like clinical course, underscoring the multi-causality of this condition. We report a 18 year old woman with secondary amenorrhea and hirsutism, whose serum levels of testosterone and DHEA-S were 175 ng/dl and 7.3 micrograms/ml and the LH/FSH ratio was 5.9. Dexamethasone decreased testosterone and DHEA-S levels, while the ACTH stimulation test increased the 17 hydroxypregnenolone serum concentration and the 17 hydroxypregnenolone/17 hydroxyprogesterone ratio to values considered diagnostic of 3 beta hydroxysteroid dehydrogenase deficiency.

3-Hydroxysteroid Dehydrogenases↗
PubMed1991

[Cushing's syndrome due to bilateral adrenal macronodular hyperplasia. From ACTH-dependent hypercortisolism to ACTH-independent hypercortisolism].

A 35 year old female with Cushing's syndrome and bilateral adrenal macronodular hyperplasia, in whom a change from ACTH dependency to autonomy was observed, is presented. The diagnosis of Cushing's syndrome was based on the failure of suppression of urinary ketogenic steroids (17 KCS) and free cortisol (uF) with the administration of 2 mg of dexamethasone daily for 2 days. CT scan of the abdomen showed adrenal bilateral multinodular hyperplasia and the sellar CT scan was normal. Initially 8 mg for 2 days of dexamethasone suppressed 17 KCS and uF; however, a few months later this effect was lost as well as the effect of endogenous ACTH on cortisol. Bilateral adrenalectomy was carried out, prior to attainment of normal cortisol levels with Ketoconazole. The adrenal glands has multiple nodules and they weighed 10 and 21 grams. Her postoperative plasmatic cortisol levels were imperceptible. Physiopathologic mechanisms involved in bilateral macronodular adrenal hyperplasia are reviewed.

Adrenal Glands↗
PubMed1991

[Validity of laparoscopy in the diagnosis of digestive system diseases].

Laparoscopy, a diagnostic procedure used in Gastroenterology, Surgery and Gynecology is a safe and effective method allowing direct vision of the contents of the abdominal cavity. Since the introduction of different imaging techniques, indications of laparoscopy have decreased. However, it is still useful in the evaluation of peritoneal diseases, liver disease, lymphoma and granulomatosis. The usefulness of laparoscopy is limited in the diagnosis of jaundice, cysts and abdominal masses.

Adolescent↗
PubMed1990

[Tuberculosis in kidney transplant patients].

We studied the incidence of tuberculosis in 37 renal transplant patients. Mean age was 37 years and immune suppression therapy had been used for a mean of 37 months. Tuberculosis-free cases had received prednisone at a mean dose of 10 +/- 4 mg/day and azathioprine, 96 +/- 35 mg/day. 28% of patients had a positive tuberculin test, 24% a healed tuberculous lung lesion and 40% received chemoprophylaxis. Four patients developed tuberculosis, 10 times the incidence expected for the general population. Fever was present in all patients. Two patients had a disseminated form and one a laryngeal location. None of the patients had received chemoprophylaxis and the dose of prednisone was higher (18 +/- 9 mg/day) than that received by non-infected patients. Thus, chemoprophylaxis for tuberculosis appears warranted in all renal transplant recipients, regardless of tuberculin test results or chest X ray findings.

Adult↗
PubMed1989

Effect of industrial pollution on seafood content and dietary intake of total and methylmercury.

The total mercury and methylmercury content of seafood was studied in an area of the Adriatic Sea polluted with inorganic mercury from a local industrial plant. The industrial pollution has affected both the total and the methylmercury content of seafood, but only the difference in the total mercury level was statistically significant when compared with a control area with no local industry. Studies of seafood consumption patterns indicate that, when the subjects examined from both areas were matched by their seafood consumption, both total mercury and methylmercury intake was higher in the industrially polluted area. The percentage of subjects ingesting total mercury above the WHO Provisional Weekly Tolerance Intake (PWTI) of 300 micrograms was also higher in the industrially polluted area. However, the percentage of subjects whose methylmercury intake was above the PWTI of 200 micrograms was higher in the control area, primarily due to the increased number of subjects consuming fish more than 5 times a week.

Animals↗
PubMed1989

[Adenosine deaminase activity in peritoneal tuberculosis].

We performed a prospective study including cytochemical, bacteriologic and pathologic observations in 25 patients with ascites of different causes. Activity of adenosine deaminase in ascitic fluid was higher in tuberculous (103 +/- 61 mu/l) than in neoplastic (16 +/- 8), inflammatory (16 +/- 13) and portal hypertension (15 +/- 6) etiologies (p less than 0.05). Inflammatory cases included patients with lupus and spontaneous peritonitis. Activity of adenosine deaminase was higher in every patient with tuberculosis than in any other patient. Thus, a high sensitivity and specificity of this test in the diagnosis of tuberculous peritonitis is confirmed.

Adenosine Deaminase↗
PubMed1989

[Hepatic cirrhosis with refractory ascitis and changes in renal function: effects of the infusion of fresh plasma and furosemide].

An alteration of renal function may be the main factor responsible for refractoriness of ascites in cirrhotic patients. We treated 10 such patients with intravenous infusion of 600 ml fresh human plasma and 600 mg of furosemide. Two hr after infusion, a significant increase in Na and K urinary excretion, urine volume and osmolality and GFR was observed. Twenty four hr after infusion, these values were decreased but still above pre infusion levels. We conclude that plasma infusion in association to furosemide significantly improves renal function in cirrhotic patients with refractory ascites.

Ascites↗
PubMed1984

Vitamin C status and physical working capacity in adolescents.

The effect of ascorbic acid supplementation on physical working capacity was studied in young adolescent boys in which the concomitant biochemical riboflavin and pyridoxin deficiencies were corrected by medicamentous prophylaxis. After daily administration for two months of 70 mg ascorbic acid, the mean plasma vitamin C in the experimental group (n = 49) rose from 0.33 to 1.49 mg/dl (p less than 0.001) and the prevalence of deficient plasma vitamin C values (less than 0.20 mg/dl) decreased from 52.3 percent to zero. The improvement in vitamin C biochemical status was also accompanied by a statistically significant increase in VO2 max. (p less than 0.01). There were no significant changes neither in the mean plasma vitamin C values nor in the mean VO2 max. in the control group subjects (n = 42). The increase in VO2 max. in the experimental group was primarily the result of an increase of VO2 max. in subjects with initially lower values. When data from both experimental and control groups were pooled together, a positive and significant association was found between VO2 max. and the increase of plasma vitamin C values below 1.0 mg/dl. No further increase in VO2 max. was observed when vitamin C plasma values reached 1.0 mg/dl or more. The two regression lines crossed at X = 0.86 mg/dl. This cut off point of plasma vitamin C level corresponds to a dietary intake of about 80 mg of ascorbic acid per day. The results of this study are in agreement with the suggested optimal ascorbic acid daily intake obtained by kinetic studies with (1-14C) ascorbic acid.

Adolescent↗
PubMed1982

Nutritional status and physical working capacity.

In a population of schoolchildren aged 12-15 years in which biochemical deficiencies of vitamin C, riboflavin and pyridoxine affected 30.0, 33.9 and 17.2 per cent of subjects respectively, a small but statistically significant correlation was found between VO2max and vitamin C, riboflavin, vitamin A, and parameters of iron nutrition status. The administration of tablets containing 70.0 mg ascorbic acid, 2.0 mg riboflavin and 2.0 mg pyridoxine resulted in a statistically significant reduction in prevalence of vitamin deficiency, and in a small but statistically significant increase in VO2max. No such changes were observed in the untreated control groups. When data from both the experimental and control groups were pooled and analysed together, the results showed that the increase in VO2max was associated with an increase in plasma vitamin C level, in erythrocyte riboflavin content and in blood haemoglobin level. On the basis of presented data, it is not possible to conclude whether the increase in VO2max was the result of correction of vitamin deficiency per se or was due to its effect on resorption and utilization of dietary iron.

Adolescent↗