Browsing by Author "Lopez, JM"

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    Bone turnover and density in healthy women during breastfeeding and after meaning
    (1996) Lopez, JM; Gonzalez, G; Reyes, V; Campino, C; Diaz, S
    To investigate the changes in maternal bone density and turnover associated with lactation we ran a longitudinal study in fully breastfeeding women (age 26.3+/-4.1 years, mean+/-SD) at the first (stage I, n = 30) and sixth (stage II, n = 25) months postpartum and 6 months after weaning (stage III, n = 20), and in a contemporary control group of non-nursing women. At each time point bone density, serum calcium, phosphorus, alkaline phosphatases, parathyroid hormone (PTH), osteocalcin, follicle stimulating hormone (FSH), estradiol (E(2)), prolactin (PRL) urinary hydroxyproline and creatinine (OH-P/Cr) were measured in both groups. The daily calcium intake of nursing women (1479 +/- 590 mg/day at stage I) was higher than in non-nursing women (536 +/- 231 mg/day at stage I). Biochemical markers of bone turnover were higher (p<0.05) in nursing than in non-nursing women at stages I and II, while in stage III only OH-P/Cr was elevated. The lumbar spine (L2-4) bone mineral density was similar in the two groups at the beginning of the study (1.148 +/- 0.111 g/cm(2) in nursing women vs 1.211 +/- 0.102 g/cm(2) in non-nursing women; p = 0.56), but it was lower in nursing women at stage II (1.144 +/- 0.110 g/cm(2) vs 1.216 +/- 0.095 g/cm(2) respectively; p<0.05). Right cm femoral neck bone density decreased by 3% between stages I and II in nursing women but did not differ from values in non-nursing women (0.947 +/- 0.110 vs 0.973 +/- 0.108 in stage I and 0.918 +/- 0.114 vs 0.975 +/- 0.098 in stage II respectively; p<0.05, ANOVA). After weaning, lumbar spine and femoral neck bone density increased by 6% and 8% respectively (p<0.05, ANOVA). No correlation was found between changes in bone turnover markers or bone density and parity, frequency and duration of nursing episodes, body weight, body mass index, and plasma PRL, E(2) and PTH levels. We conclude that in nursing women with a daily calcium intake at the recommended dietary allowance (>1200 mg/day), full breastfeeding extending over 6 months is characterized by increased maternal bone turnover and a transient bone loss which normalizes after weaning.
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    Bone turnover in lactating teenagers: Assessment at the end of pregnancy, during and after the breast feeding period
    (2000) Cattani, A; Zubarew, T; Maddaleno, M; Mosso, L; Lopez, JM; NCD Risk Factor Collaboration (NCD-RisC)
    Background: There is paucity of information about bone metabolism during pregnancy or breast feeding in teenagers. Aim: To study bone turnover at the end of pregnancy and during breast feeding in teenagers and correlate it with environmental, hormonal or nutritional variables. Subjects and methods: Thirty teenagers during their breast feeding period after a first pregnancy and 30 nulliparous girls matched for age, age of menarche and body mass index were assessed three weeks after delivery (period 1), at six months of breast feeding (period 2) and one year after the lactating period (period 3). Calcium intake and plasma calcium, phosphorus, alkaline phosphatases, parathormone, estradiol and prolactin were measured. Calcium, creatinine and hydroxypyroline were also measured in a morning urine samples. Results: Lactating and control girls were aged 16.3+/-0.8 and 16.1+/-0.7 years old respectively. Calcium intake in lactating and control girls was 798+/-421 and 640+/-346 g/day respectively in period 1, 612+/-352 and 592+/-309 mg/day in period 2 and 495+/-180 and 456+/-157 g/day in period 3. During periods 1 and 2, lactating girls had higher alkaline phosphatases (161+/-37 compared to 119+/-28 U/l and 149+/-37 compared to 106+/-23 U/l), parathormone (4.3+/-2.6 compared to 2/8+/-0.8 ng/dl and 3.6+/-1.6 compared to 3.0+/-0.9 ng/dl) and urinary hydroxyproline (95+/-16 compared to 63+/-15 mg/g creatinine and 84+/-19 compared to 59+/-15 mg/g creatinine). No differences were observed in period 3. No correlation between bone turnover variables, body mass index or hormonal parameters, was observed. Conclusions: In teenagers, there is an increase in bone turnover at the end of pregnancy, that persists during the lactating period. These changes are not relaxed to nutritional or hormonal variables.
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    Functioning and non functioning parathyroid cysts. Report of two cases
    (1997) Mosso, L; Lopez, JM; Trincado, P; Olea, E; Talesnik, E; Verdugo, C
    We report two women presenting with parathyroid cysts. A 20 years old woman presented with goiter and a cystic lesion in the left thyroid lobe was identified on ultrasound examination and CAT scan. The patient had hypercalcemia and elevated PTH levels. The content of the cyst, obtained by needle aspiration, had an extremely high PTH concentration. The patient was operated, removing the cyst and a remaining thymus. Pathological study confirmed the diagnosis of a parathyroid cyst. An 11 years old girl presented with a mass in the left thyroid lobe. An ultrasound examination disclosed the presence of a cystic nodule. The patient was otherwise asymptomatic and laboratory work up was normal. The patient was operated and pathological examination of the surgical piece revealed a parathyroid cyst.
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    Hyperthyroxinemia and clinical euthyroidism. Report of one case
    (1999) Lopez, JM; Mosso, L; Campino, C
    The association of hyperthyroxinemia and euthyroidism is frequent and characterized by high plasma thyroxin concentrations, normal TSH values and absence of clinical signs of hyperthyroidism. We report an asymptomatic 28 years old male presenting with a serum total plasma thyroxin of 18.5 mu g.gl (N 6.1-12.5), a free thyroxin of 2.9 ng/dl (N 0.8-1.4) a TSH of 3.4 mu IU/ml (N 0.5-5), and a triiodothyronine of 128 ng/dl (N 80-180). Laboratory assessment did not find high thyroxin binding globulin, albumin or prealbumin concentrations or antithyroxin antibodies. The thyroxin binding capacity of albumin was elevated to 58.2 mu g/dl (N 11.5-34.1). TSH responded normally to TRH stimulus and was suppressed with exogenous triiodothyronine, which caused an hyperthyroid syndrome. We concluded that this patient had a familial dysalbuminemia.
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    Mixed medullary and follicular carcinoma of the thyroid. Report of three cases
    (1997) Trincado, P; Lopez, JM; Mosso, L; Ciani, S; Olea, E
    Mixed medullary and follicular carcinoma of the thyroid shares secretory and immunohistochemical features of both follicular and parafollicular thyroidal cells. we report three women aged 34, 63 and 63 old with this type of tumor. Ifs diagnosis must be bore in mind in patients with thyroidal tumors and a histological appearance of a medullary or undifferentiated carcinoma. An early diagnosis of a mixed medullary and follicular carcinoma of the thyroid is important, considering its special treatment and negative prognosis.
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    Pathological characteristics of thyroid microcarcinoma. A review of 402 biopsies
    (2005) Fardella, C; Jimenez, M; Gonzalez, H; Leon, A; Goni, I; Cruz, F; Solar, A; Torres, J; Mosso, L; Gonzalez, G; Rodriguez, JA; Campusano, C; Lopez, JM; Arteaga, E
    Background: Thyroid microcarcinoma is a tumor of 10 mm or less. that should have a low risk of mortality. However a subgroup of these carcinomas is as aggressive as bigger tumors. Aim To describe the pathological presentation of these tumors.. and compare them with larger tumors. Material and methods. All Pathological samples of thyroid carcinoma that were obtained between 1992 and 2003, were studied. In all biopsies, the pathological type, tumor size. the focal or multifocal character the presence of lymph node involvement and the presence of lymphocytic thyroiditis or thyroid hyperplasia, were recorded. Results: One hundred eighteen microcarcinomas and 284 larger tumors were studied. The mean age of patients with microcarcinoma and larger tumors was 42.7 +/- 14 and 49.3 +/- 16 years respectively (p < 0,00.1) and 83% were female. without gender differences between tumor types. klean size of microcarcinomas was 8.6 mm and 116 (98%) were papillary carcinomas. Of these. 109 (94% were well differentiated and seven (6%) were moderatly differentiated. Thirty six(31%) were multifocal and in 10 (8,6%), there was lymph node involvement. The mean size of larger tumors was 23.8 mm and 241 (85%) were papillary carcinomas. Of these, 200 (83%) were well differentiated, and 41 (17%) were moderately differentiated.Eighty five (35%) were multifocal and in 44 (18%) there was lymph node involvement. The prevalence of thyroiditis and hyperplasia was significantly higher among microcardinomas than in larger tumors (15 and 2.5%, respectively, p < 0.001, for the former; 32.4 and 1.7%, respectively, p < 0.001, for the latter. Conclusions. In this series. one third of microcarcinomas were multifocal and 10% had lymph node involvement. Therefore, aggresiveness of these tumors is higher than what is reported in the literature and they should be treated with total thyroidectomy.
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    Post-suckling prolactin:oestradiol ratio - a potential index to predict the duration of lactational amenorrhoea in women
    (1997) Campino, C; Ampuero, S; Diaz, S; Lopez, JM; SeronFerre, M
    To assess whether the duration of lactational amenorrhoea can be predicted in individual women, we studied the pre-and post-suckling concentrations of immune prolactin (IR-PRL) and of bioactive prolactin (BIO-PRL) and basal concentrations of oestradiol in ten amenorrhoeic fully nursing women at 3 months post-partum. The women were of similar age, weight and had infants of similar growth rate, Five of these women were to experience long amenorrhoea (>180 days) and the others short amenorrhoea (<180 days), Blood samples were drawn 30 min after a suckling episode initiated at 0800 h, 1600 h and 2400 h. BIO-PRL distinguished between groups of women at 0030 h but not at other times, while there was considerable overlap between values for IR-PRL and oestradiol at all times studied, At 1630 h, the ratios post-suckling BIO-PRL: oestradiol and post-suckling IR-PRL:oestradiol were above 2000 in the women that were to experience long amenorrhoea and below this threshold in the other women, The ratio post-suckling BIO-PRL:oestradiol provided more information since the difference between the lowest ratio in the long amenorrhoea and the highest ratio in the short was 699, while it was 520 for the IR-PRL:oestradiol ratio, The determination of these ratios may help to predict the duration of lactational amenorrhoea in individual fully nursing women.