PubMed Health⌕ Search

Biomedical subjects

S Oviedo

Publications and source records attributed to S Oviedo.

14 recordsLinked to original sources
PubMed2000

[Hungry bone syndrome: clinical experience in its diagnosis and treatment].

Hungry bone syndrome is a unusual complication of the postoperative period of primary hyperparathyroidism. This syndrome is characterized by hypocalcemia, hypophosphatemia and hypomagnesemia, due to an excessive bone remineralization. We report the clinical features, laboratory and therapy in four females (aged 39 to 73 years old) with a long standing hyperparathyroidism, elevated alkaline phosphatases and decreased bone mineralization in two. The mean size of the adenoma was 2.9 +/- 1.1 cm. Hypocalcemia appeared between days 1 and 6 of the postoperative period. All were treated with calcium, calcitriol and magnesium at different timing and dosages. The mean hospitalization period was 19.8 +/- 2.1 days. As reported previously, low bone mineralization and a large adenoma are risk factors for the syndrome. Serial monitoring of serum calcium and magnesium and an early supplementation of these minerals could prevent hypocalcemia and decrease the hospitalization time.

Adenoma↗
PubMed2000

[Treatment of hyperthyroidism with radioiodine: effects of administered dose on complications and thyroid function].

BACKGROUND: Radio-iodine is a definite therapy for Graves disease hyperthyroidism. However, the optimal dosage is still debatable. AIM: To assess the effects of different radioiodine doses on thyroid function and complications in patients with hyperthyroidism. MATERIAL AND METHODS: A retrospective analysis of 139 patients with hyperthyroidism, treated with ratio-iodine between 1988 and 1998. Radio iodine dose used was classified as low (< 10 mCi), intermediate (10-14.9 mCi) or high (> or = 15 mCi). RESULTS: Thirty-five patients were treated with low doses, 33 with intermediate doses and 71 with high doses. There were no differences between these patients in age, disease severity, frequency of post treatment euthyroidism or complications. Patients treated with low doses had a higher frequency of persistent hyperthyroidism than patients treated with high doses (25.7 and 4.2% respectively, p < 0.001). Likewise, the frequency of subsequent hypothyroidism was 60% in patients treated with low doses and 84.5% of those with high doses, in whom it also appeared earlier. Associated complications were clinically irrelevant. In seven patients, Graves ophthalmopathy progressed after treatment, but this progression was not associated with the dose used. CONCLUSIONS: Radio iodine in high doses is useful, safe and effective for the treatment of Graves hyperthyroidism.

Adolescent↗
PubMed1998

An institutional experience with cervical vagus nerve trunk stimulation for medically refractory epilepsy: rationale, technique, and outcome.

OBJECTIVE: Intermittent stimulation of the left cervical vagus nerve trunk is emerging as a novel adjunct in the treatment of medically refractory seizures. We sought to evaluate theoretical and practical issues attendant to this concept. We review the anatomic and physiological background arguing for clinical application of vagus nerve stimulation, discuss salient aspects of patient selection and the nuances of surgical technique, and present our observations of and results from application of the method. METHODS: Each of 18 patients with medically refractory epilepsy and at least six complex partial or secondarily generalized seizures per month underwent placement of a NeuroCybernetic Prosthesis pulse generator (Cyberonics, Webster, TX) in the chest, connected to helical platinum leads applied to the left cervical vagus nerve trunk. The patients were then randomized in a double-blinded fashion to receive either high (presumably therapeutic) or low (presumably less therapeutic) levels of vagus nerve stimulation. Reduction in seizure frequency, global assessments of quality of life, physiological measurements, and adverse events were recorded during a 3-month period. Patients in the low group were then crossed over to high-stimulation paradigms during a 15-month extension trial. RESULTS: All operations were successful, uneventful, and without adverse postoperative sequelae. One patient was excluded from analysis because of inadequate seizure calendars. Of the seven patients initially assigned to high stimulation, the mean reduction in seizure frequency was 71% at 3 months and 81% at 18 months. Five (72%) of these patients had a greater than 75% reduction in seizure frequency, and one (14%) remained seizure-free after more than 1.5 years of follow-up. The mean reduction in seizure frequency among the low-stimulation group was only 6% at 3 months. No serious complications, device failures, or physiological perturbations occurred. CONCLUSION: In our experience, vagus nerve stimulation has proven to be a safe, feasible, and potentially effective method of reducing seizures in select patient populations. However, the elements of strict definition for the application of the method require further study.

Adult↗
PubMed1998

[Partial remission of hypercortisolism in Cushing disease after pituitary apoplexy. A case report].

ACTH secreting macroadenomas and pituitary apoplexy are unusual in Cushing disease. In the few cases reported in the literature, they have been found in long term hypercortisolism. We communicate a 43 yr old woman with a 4 year evolution Cushing syndrome, who developed sudden cephalea and oftalmoplejia. A Computed Tomography of the pituitary fossa disclosed a macroadenoma with intracapsular hemorrhage and suprasellar expansion. In the functional tests, serum cortisol was suppressed with dexamethasone in a dose of 1 and 8 mg and responded to the desmopressin stimulus. Nevertheless, cortisol levels were lower than those observed in Cushing syndrome of similar magnitude. The tumor was resected by transphenoidal surgery and immunohistochemistry to ACTH was positive. In this case, the laboratory results suggest a partial remission of the hypercortisolism after pituitary apoplexy.

Adenoma↗
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↗
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↗
PubMed1993

[Bone density and mineral content in normal men. Measurement by dual photon densitometry].

The aim of this study was to measure whole body, L2 to L4 vertebral bodies and femoral neck bone density and mineral content, using a dual photon densitometer with a 153Gd source, in normal male subjects. One hundred twenty five males, aged 20 to 85 years, were studied. Subjects were separated, according to age in 5 year groups, with at least 10 subjects per group. Height did not show secular changes until 70 years of age, but a 9 kg increase in weight and a 3.8 kg/m2 increase in body mass index was observed. Lumbar spine bone density was 1.066 g/cm2 between 20 and 29 years and did not change with increasing age. In the same age group, femoral neck density was 1.034 g/cm2 and it decreased steadily after the age of 40 (slope = -0.003) with an annual loss of 0.23%. Total mineral content decreased from 2.477 g in the first age group to 2.316 g in subjects 70 years old or older. This represents a net loss of 6.5% in this period. Compared with normal females from a previous study, young men have similar spine and femoral neck densities than young women until the age of 50. In women over this age, there is a steady decline in lumbar spine density and the decrease in femoral neck density is more marked than in men. Also, total mineral content is higher in young men and its 6.5% loss with age is much lesser than the 31.6% loss observed in women.

Absorptiometry, Photon↗
PubMed1992

[Osteopenia in anorexia nervosa evaluated by dual photon-densitometry. Role of malnutrition and hypogonadism].

30 female patients with anorexia nervosa (AN) were studied and compared with 45 age-matched normal controls. All the patients had severe weight loss and nutritional involvement. Mean and SE body mass index, BMI (kg/m2) were 15.8 +/- 1.8 in anorectics compared to 21.7 +/- 4.7 in normals (p < 0.0001). All the patients presented amenorrhea lasting between 3 and 120 months (mean 24.8 +/- 25.3). A nutritional survey and a dual photon bone densitometry, including spine, hip, total body and total mineral content were performed. The mean values +/- SE in patients and controls were: spine densities (L2-L4) in g/cm2: AN 0.84 +/- 0.1, controls 1.03 +/- 0.1 (p < 0.002). Total mineral content (g): AN mean 1733 +/- 261, controls 2045 +/- 276 (p < 0.0001). In anorectic patients the correlations between bone density and BMI for spine were r: 0.52 (p = 0.002), for hip r: 0.37 (p = 0.04), and total mineral content vs BMI gave r: 0.64 (p = 0.0001). Mean calcium intake in 23 studied patients was lesser than the classic recommended dietary allowance in the whole group, it was less in the pure restricters as compared to vomiters. The relation between duration of amenorrhea and bone density showed than a decrease in the later was evident when the absence of menses was longer than 24 months. In conclusion, in patients with AN there is a real decrease in bone density which is strongly related to low weight and in lesser proportion to the duration of amenorrhea, particularly when it was longer than 24 month.

Absorptiometry, Photon↗
PubMed1991

[Density and bone mineral content and their relation to anthropometric parameters in a normal Chilean population. A study with women].

We studied 227 normal women from 20 to 89 years of age. Bone density and mineral content was measured in vertebral bodies L2 to L4, both femurs and whole body, using a double beam photon densitometer with a 153Gd source. Body height remained between 156 and 158 cm up to age 64, then decreased gradually to 152 cm. Weight increased from age 35 to 69 (mean 9 kg) and then decreased. Mean bone density of the lumbar spine was 1.07 g/cm3 up to age 50. A marked decrease in density was observed for 10 years after that age, gradually slowing in later years. Mean density of the femoral neck was 0.931 g/cm3 up to age 50. A steady decline is observed in later ages down to 0.763. The density ratio of spine to femoral neck remains under 1.2 up to age 60, then increases progressively. Total mineral content, absolute or relative to body weight, was a less sensitive index. Total content decreased from above 2000 gm to about 1550 gm after age 70. The greater proportion of mineral contents is found in the lower extremities (30%). With increasing age a greater mineral loss was observed in the trunk, including spine and hips, compared to other segments. Our findings reveal bone densities somewhat lower than those reported from USA and higher than those reported from Denmark.

Absorptiometry, Photon↗
PubMed1991

[Nutritional study of alcoholics with specific reference to calcium and phosphorus].

We performed a nutritional study of 80 alcoholic males at least 15 days after an acute episode of alcoholic intake. 43 patients were intermittent drinkers with mean age 37.9 years and 37 patients were continuous drinkers with mean age 440.30 healthy subjects were studied as controls. Body mass index was 23.7 (range 19.2-37.9) in intermittent drinkers compared to 23.1 (range 18.1-29.8) in continuous drinkers (NS). Wine was the main alcoholic beverage in 70% and 89%, respectively. Mean daily alcohol intake was 170 g for 17 years and 358 g for 23 years, respectively. Mean caloric intake and % of calories from alcohol were 3387 and 42% for intermittent compared to 4271 and 66% for continuous drinkers, respectively. Daily calcium intake was 757 g and 774 g in each group. Alcoholic beverages supplied 16% and 34% of calcium intake, respectively. The intake of phosphorus was adequate. Alcoholic subjects did not manifest anemia or hypoalbuminemia, compared to controls. The present study fails to disclose significant caloric and protein undernutrition in alcoholic subjects. However, the intake of calcium is inadequate and a high percentage of it is provided by alcoholic beverages. This deficiency in conjunction with alcoholic damage to intestinal mucosa may lead to osteopenia in alcoholic patients.

Adult↗
PubMed1991

[Active acromegaly and gigantism: some clinical characteristics of 50 patients].

50 patients with autonomous growth hormone excess (48 with adult acromegaly and 2 with gigantism) were studied between 1966 to 1986 (2.38 pts/year). Characteristic clinical presentation, an increase in growth hormone (GH) uninhibited by glucose, and/or hyperphosphemia and hyperhydroxiprolinuria were present in all patients. No cases of hypercalcemia were recorded. Phosphemia was increased in 55.8%, alkaline phosphatases in 61.7%, calciuria in 26.9% and hydroxyprolinuria in 74.2% of the patients. Basal GH was over 5 ng/ml (89.9 DS +/- 170.9) in 42 pts, and in 37 was not suppressed after glucose administration, 38% had an increased (paradoxical response) and 62% a flat response (less than 50% change of basal values). TRH test was performed in 14 patients, 8 presented an increase in GH titer. Hyperprolactinemia was seen in 4 of 12 patients in whom this hormone was measured. The size of the sella turcica was increased in 93%, and although the larger sellar size correlated to higher levels of GH, correlation was not significant. 20% of the pts had rheumatological disease, 14% goiter, 12% cardiac disease, 26.5% had diastolic hypertension and 4% renal lithiasis (hypercalciuric pts). 38% had hyperglycemia with a diabetic glucose tolerance test and 18% had non-diabetic abnormal glucose tolerance test.

Acromegaly↗