Browsing by Author "Mosso, G. L."

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    Carcinoma familiar del tiroides no medular (CFTNM): características de presentación en 17 casos
    (2007) Mosso, G. L.; Velasco, S.; Cardona, B.; Fardella, C.; González, G.; López, J.M.; Rodríguez, J.A.; Arteaga, E.; Salazar, I.; Solar, A.; González, H.; Cruz, F.; NCD Risk Factor Collaboration (NCD-RisC)
    Background: Papillary thyroid carcinoma can have familial aggregation. Aim: To compare retrospectively familial non medullary thyroid carcinoma (FNMTC) with sporadic papillary thyroid carcinoma (PTC). Material and methods: Retrospective analysis of medical records of patients with thyroid carcinoma. An index case was defined as a subject with the diagnosis of differentiated thyroid carcinoma with one or more first degree relatives with the same type of cancer. Seventeen such patients were identified and were compared with 352 subjects with PTC. Results: The most common affected relatives were sisters. Patients with FNMTC were younger than those with PTC. No differences were observed in gender, single or multiple foci, thyroid capsule involvement, surgical border involvement, number of affected lymph nodes and coexistence of follicular hyperplasia. Patients with FNMTC had smaller tumors and had a nine times more common association with lymphocytic thyroiditis. Five patients with FNMTC had local recurrence during 4.8 years of follow up. Conclusions: Patients with FNMTC commonly have an associated chronic thyroiditis, are younger and have smaller tumors than patients with PTC.
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    El enfermo terminal
    (2000) Bravo, L. M.; Goic, G. A.; Kottow, B. M.; Rosselot, J. E.; Echeverría, B. C.; Rojas, O. A.; Lavados, M. M.; Mosso, G. L.; Quintana, V. C.; Taboada, R. P.; Pérez, F. M.; Serani, M. A.; Trejo, M. C.; NCD Risk Factor Collaboration (NCD-RisC)
    The classification of a patient as terminally ill is based on an expert diagnosis of a severe and irreversible disease and the absence of an effective available treatment, according to present medical knowledge. Terminal diseases must not be confused with severe ones, since the latter may be reversible with an adequate and timely treatment. The physician assumes a great responsibility at the moment of diagnosing a patient as terminally ill. The professional must assume his care until the moment of death. This care must be oriented to the alleviation of symptoms and to provide the best possible quality of life. Also, help must be provided to deal with personal, legal and religious issues that may concern the patient.
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    Elevación del cortisol urinario en hipertensos esenciales hiporreninémicos
    (2004) Mosso, G. L.; Fardella, B. C.; Krall, O. P.; Carvajal, M. C.; Rojas, O. A.; NCD Risk Factor Collaboration (NCD-RisC)
    Background: Glucocorticoids play a key role in blood pressure (BP) control and are associated with hypertension in patients with Cushing's syndrome. A number of reports indicate that cortisol (F) may be involved in etiology of essential hypertension (EH). F can bind to the mineralocorticoid receptor, triggering both sodium and water reabsorption in kidney, increase BP and cause renin suppression. Aim: To evaluate urinary free cortisol (UFF) excretion as a potential intermediate phenotype of essential hypertension and correlate F level with plasma renin activity (PRA) and serum aldosterone (SA). Patients and Methods: We recruited 132 EH patients and 16 normotensive healthy controls. Blood samples and 24 hours urine were collected for PRA, SA and UFF analysis. Differences in UFF excretion between sexes were normalized by urinary creatinine (Creat) excretion. The upper limit of UFF/Creat was determined in normotensives considering the mean value plus 2 standard deviations. According to this value, subjects were classified as having high or normal UFF. Results: In EH patients and in normotensives, the UFF/Creat was 36.9±17.0 μg/gr and 30.9±8.8 μg/gr, respectively. The upper limit was set at 48.5 μg/gr. A high UFF/Creat was found in 20/132 EH (15%) patients and 0/16 normotensive subjects. EH patients with high UFF showed lower PRA levels than patients with normal cortisol levels (0.78±0.47 vs. 1.13±0.66 ng/ml*h, respectively, p=0.027) and lower SA values (4.52±1.65 vs 6.34±3.37 ng/dl, respectively, p=0.018). There was a negative correlation between UFF and PRA (r=-0.176, p=0.044) and between UFF and SA (r=-0.183, p=0.036). Conclusions: We have identified a subgroup of EH patients with increased UFF excretion. Patients with the highest UFF showed lower renin and aldosterone levels. These data suggest a potential influence of cortisol in the genesis of hypertension.