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Biomedical subjects

L García Pascual

Publications and source records attributed to L García Pascual.

16 recordsLinked to original sources

[Follicular cancer of the thyroid: atypical presentation].

Follicular thyroid carcinoma usually presents as a thyroid nodule, with rare cases showing metastatic disease at diagnosis. We present a patient with follicular thyroid carcinoma who was diagnosed as a large pelvic metastatic mass with a biochemical profile of subclinical hyperthyroidism. She was treated with local-field radiotherapy, since surgical resection was not possible and radioiodine therapy would be of little benefit due to its large volume. She is currently in continuous remission two years from diagnosis.

Adenocarcinoma, Follicular↗

[Clinical usefulness of adrenal gland computed tomography in the etiologic diagnosis of Addison's disease].

BACKGROUND: The aim of this study was to evaluate adrenal gland morphology by computerized tomography (CT) in the etiologic diagnosis of Addison's disease. METHODS: Twenty-two patients were grouped according to their etiology based on the study of antiadrenal antibodies at diagnosis of the disease: 7 were positive (autoimmune etiology or EAA), 11 were negative (tuberculous etiology or EAT) and in four serologic study was not available (undetermined etiology or EAI). Adrenal gland CT was performed with contiguous sections every 5 mm. In eight cases the examination was carried out upon diagnosis of the disease (initial stage) and in 14 between 2 and 17 years following diagnosis (evolutive stage). RESULTS: In all the patients of the EAA group, examined in either the initial or evolutive stages, the adrenal glands appeared atrophic without calcifications. In the patients of the EAT group adrenal masses of proven tuberculous origin were found in five who were studied in the initial stage and with atrophic glands with calcifications in the remaining patients examined in the evolutive stage, with the exception of two cases with atrophic adrenal glands without calcifications which could serologically be considered as false negatives having autoimmune etiology. The patients in the EAI groups were studied in the evolutive stage with three having atrophic glands with calcifications and one atrophic adrenal glands without calcifications. CONCLUSIONS: Adrenal gland computerized tomography is an useful examination to differentiate between autoimmune or tuberculous origin in Addison's disease. Clinical application may be justified in all patients of recent diagnosis when the study of the antiadrenal antibodies is negative or not possible.

Addison Disease↗

[Platelet hyperactivity in diabetic retinopathy: etiologic factor or epiphenomenon of microangiopathy?].

In order to analyze the etiologic and pathogenic meaning of platelet activity in diabetic retinopathy, Plasmatic Beta-Thromboglobulin (BTG) has been determined in 42 diabetics without retinopathy, 14 diabetics with non proliferative retinopathy and in 29 health controls. BTG showed higher values in diabetic patients with retinopathy in comparison with diabetics with no retinopathy (46.4 +/- 10.7 versus 37.6 +/- 13.4 ng/ml; p < 0.05 and with controls (31 +/- 18.8; p < 0.005). There were no differences between diabetics with no retinopathy and controls. No relation was found between BTG and the glycemic control grade, neither with lipoproteic profile. In resume, platelet hyperactivity found in patients with retinopathy seems to be an epiphenomenon of the microangiopathic lesion and not an etiologic factor, however this not precludes that it can play a role in the progression on retinal lesions.

Adult↗

[Glycemic control and lipoprotein profile in type I diabetes mellitus].

BACKGROUND: To analyze the relation between the degree of glycemic control and the lipoprotein profile in type I diabetes mellitus. METHODS: Seventy-five diabetics were studied in whom the total glycohemoglobin (GHb), total triglycerides (TG), triglycerides of very low density lipoproteins (TG-VLDL), total cholesterol (TC), cholesterol of very low density lipoproteins (C-VLDL), cholesterol of high density lipoproteins (c-HDL), apolipoprotein AI (Apo AI) and apolipoprotein B (Apo B) were determined. Patients were classified according to their GHb: less than 9% (good glycemic control), 9-11% (moderate glycemic control) and greater than 11% (bad glycemic control). There was homogeneity in the 3 groups with regards to other variables which influenced the lipoprotein profile. RESULTS: The concentrations of TG, TG-VLDL, TC, C-VLDL and C-LDL were significantly higher in the groups of greater GHb while those of C-HDL, Apo I and Apo B were independent of the degree of glycemic control. The number of patients whose lipid profiles may be considered as atherogenic risk increases progressively in groups with greater GHb. CONCLUSIONS: In patients with type I diabetes mellitus, bad glycemic control is accompanied by decreases in TG, TC and C-LDL up to a magnitude which frequently reaches risk values for developing vascular disease. However, in these subjects, a less protector effect dependent on C-HDL is not to be expected since their concentrations are similar to those patients with good glycemic control.

Adolescent↗

[A clinically unsuspected pheochromocytoma].

Pheochromocytomas are often unnoticed, and diagnosis is performed on autopsy examination, or more rarely it is noticed during surgery or abdominal exam for a different reason. In many of these patients the lack of hypertension is a characteristic feature. We contribute a singular case of a patient with pheochromocytoma found by chance during an abdominal exam and which in spite of secreting noradrenaline, did not provoke hypertension or other symptoms. We review literature on this stage form of presentation and the different physio-pharmacological hypothesis which could condition the absence of clinical manifestations. We discuss the preoperative management in patients without hypertension.

Adrenal Gland Neoplasms↗

[Addison's disease: a clinico-epidemiologic study of 45 cases].

We present the clinical-epidemiological results obtained in a series of 45 patients diagnosed of Addison disease between 1967 and 1988. The incidence was 0.83 cases/100,000 inhabitants/year and the prevalence was 10 cases/100,000 inhabitants. The etiology was unknown in 44.4% of cases tuberculous in 24.4% and in 31.1% of cases the caused could not be established with the classical clinical and radiological criteria. Amongst the studied variables in each etiological group, we highlight the association with other autoimmune processes and the development of extraadrenal tuberculous infection after Addison disease diagnosis. We discuss the approach to etiological diagnosis and the convenience of tuberculostatic treatment in EAT cases.

Addison Disease↗