Browsing by Author "Carrasco, Carmen"
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Item Caracterización de tumores secretores de hormona de crecimiento de acuerdo al patrón granular y su rol en el pronóstico(2019) Valenzuela, Felipe; Villanueva, Pablo; Rojas, David; Gejman, Roger; Huete, Isidro; Zunino, Romina; Díaz, René; Wohllk, Nelson; Tissera, Claudia; Carrasco, CarmenBackground: Classification of growth hormone (GH) - secreting tumors by the granular pattern might predict their clinical behavior in acromegalic patients. There are several other prognostic factors. Aim: To compare the features at presentation and cure rates of patients with GH secreting tumors according to the granular pattern, and to define independent prognostic factors for surgical treatment in these patients. Material and Methods: A retrospective, observational study of 85 active acromegalic patients surgically treated in two medical centers. Results: Seventy-four patients (87%) were classified as having densely granulated (DG) and 11 (13%) as sparsely granulated (SG) tumors. The latter were less active biochemically, had a higher rate of macroadenoma and cavernous sinus invasion and had a lower rate of biochemical cure than the DG group. Several characteristics were associated with disease persistence but only age (Odds ratio (OR) = 0.93) and cavernous sinus invasion (OR = 21.7) were independently associated in the logistic regression model. Conclusions: The sparsely granulated pattern is associated with a more aggressive behavior, but the main determinants of prognosis are age and cavernous sinus invasion.Item Depressive symptoms are associated with higher morning plasma cortisol in primary care subjects(2018) Capponi, Valentina; Carrasco, Carmen; Macchiavello, Stefano; Undurraga, Juan; Campino, Carmen; Carvajal, Cristian; Gómez, Teresita; Weiss, Cristian; Aedo, Igor; Vecchiola, Andrea; Allende, Fidel; Solari, Sandra; Fardella, Carlos; Baudrand, RenéBACKGROUND: Cortisol dysregulation has a potential role in depression. AIM AND METHODS: We evaluated depressive symptoms using the Hamilton Rat- ing Scale for Depression in 48 primary care subjects without history of previous or current depression and its association with cortisol dysregulation (morning plasma cortisol, 24-hour urinary free cortisol and cortisol metabolites). Presence of metabolic syndrome and inflammatory parameters were also assessed. RESULTS: Hamilton Rating Scale for Depression correlated significantly with morning cortisol, but not with urinary free cortisol or metabolites. A significant increase in morning cortisol by Hamilton groups (asymptomatic ≤8; mild to moderate: 9–18; moderate to severe: ≥19) was observed even when adjusted by age/gender. We observed no association of depressive symptoms with metabolic or inflammatory parameters. CONCLUSIONS: Depressive symptoms in primary care subjects not consulting for their mood are associated with higher morning plasma cortisol, but not urinary cortisol or its metabolites. These observations suggest that systemic hypercorti- solism and related metabolic disorders are not observed in mild/initial states of depressive disorders.Item Thyroid Microcalcifications in the Absence of Identifiable Nodules and Their Association With Thyroid Cancer(2019) Whittle, Carolina; García, Marisol; Horvath, Eleonora; Slater, Jeannie; Carrasco, CarmenObjectives: To determine ultrasound (US) and clinical findings of thyroid microcalcifications in the absence of a nodule and their association with the risk of malignancy. Methods: The Institutional Review Board approved a 5-year retrospective study. Twenty-one patients with clustered or scattered thyroid microcalcifications in the absence of nodules on US images who underwent fine-needle aspiration biopsies (FNABs) were included. Demographic and clinical data, US findings, and pathologic results were registered. Patients with a suspicion of malignancy or papillary thyroid carcinoma (PTC) on FNAB underwent thyroidectomy. Patients with benign results on FNAB underwent clinical and US surveillance. Results: The mean age of the 21 patients was 33.2 years (29.5 years in patients with PTC patients and 39.4 years in those with benign findings; P = .034). Eleven of 21 patients had clustered microcalcifications (9 had cancer), and 10 of 21 patients had scattered microcalcifications (4 of 10 had cancer; P = 0.063). Sixty-two percent of the patients had FNAB findings that were suspicious for cancer or had a diagnosis of cancer. Eleven of 13 patients had surgical thyroidectomy performed in our institution; in all cases, Hashimoto thyroiditis was confirmed. Univariate and multivariate analysis showed that only age was significant (odds ratio, 0.9; P < .05). Conclusions: Our study suggests that the presence of thyroid microcalcifications without a nodule is suspicious for PTC. We found that both patterns were suspicious for PTC, particularly in young patients. Special concern arises for those clustered microcalcifications on a background of Hashimoto thyroiditis.