Browsing by Author "Sapunar, Jorge"

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    Clinical and histopathological features of follicular thyroid cancer in Chile
    (2023) Diaz, Rene; Dominguez, Jose Miguel; Tala, Hernan; Olmos, Roberto; Pineda, Pedro; Olivari, Daniela; Jimenez, Marcela; Mimica, Ximena; Lanas, Alejandra; Ocares, Gerson; Sapunar, Jorge
    Objective: Follicular thyroid carcinoma (FTC) is less frequent but has a worse prognosis than papillary carcinoma. The available evidence on pre-operative characteristics of FTC is controversial. Our objective was to characterize the clinical, ultrasound and histopathological presentation of FTC patients treated Chile. Subjects and methods: Retrospective analysis of 97 patients treated for FTC in 6 large centers in Chile. We analyzed their ultrasonographic features and classified the nodules according to ATA risk of malignancy and TI-RADS score, as well as the cytological findings according to the Bethesda system. We described their clinical and histopathological findings at diagnosis and classified their risk of recurrence and mortality according to ATA 2015 recurrence risk category and the eighth edition of the AJCC/UICC staging system, respectively. Results: Median age was 48 years and 73.2% were females. The median diameter was 38.8 mm; only 9.5% of them were microtumors. According to ATA risk of malignancy, 86% of the nodules were low or intermediate suspicious, while 78% were category 3 or 4A nodules according to the TI-RADS. Regarding the Bethesda system, 65.9% had indeterminate cytology (20.6% category III and 45.3% category IV). At histological examination, most were minimally-invasive and angio-invasive tumors with less than 4 foci (54.7% and 28.4% respectively). More than 90% of FTC were unifocal and there was no lymphovascular or extrathyroidal invasion or lymph node involvement. Four patients (4.1%) had distant metastases at diagnosis. Most patients (95%) had stage I or II disease according to the AJCC/UICC staging system, while the risk of recurrence was low at 51.5% when using the ATA risk of recurrence scale. Conclusions: At diagnosis, most FTCs were nodules of low or intermediate suspicion at ultrasound, nearly two thirds had indeterminate cytology according to the Bethesda system, and nearly 50% of them were of low risk of recurrence.
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    Rol de la cirugía bariátrica/metabólica en el manejo de la diabetes mellitus 2. Consenso SOCHED/SCCBM
    (2018) Sapunar, Jorge; Escalona, Alex; Veronica Araya, A.; Gloria Aylwin, Carmen; Juliana Bastias, Maria
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    Second Consensus of the Chilean Society of Endocrinology and Diabetes about insulin resistance
    (SOC MEDICA SANTIAGO, 2015) Pollak, Felipe; Araya, Veronica; Lanas, Alejandra; Sapunar, Jorge; Arrese, Marco; Gloria Aylwin, Carmen; Gloria Bezanilla, Carmen; Carrasco, Elena; Carrasco, Fernando; Codner, Ethel; Diaz, Erik; Durruty, Pilar; Galgani, Jose; Garcia, Hernan; Lahsen, Rodolfo; Liberman, Claudio; Lopez, Gloria; Maiz, Alberto; Mujica, Veronica; Poniachik, Jaime; Sir, Teresa; Soto, Nestor; Valderas, Juan; Villaseca, Paulina; Zavala, Carlos
    Insulin resistance is a prevalent condition commonly associated with unhealthy lifestyles. It affects several metabolic pathways, increasing risk of abnormalities at different organ levels. Thus, diverse medical specialties should be involved in its diagnosis and treatment. With the purpose of unifying criteria about this condition, a scientific-based consensus was elaborated. A questionnaire including the most important topics such as cardio-metabolic risk, non-alcoholic fatty liver disease and polycystic ovary syndrome, was designed and sent to national experts. When no agreement among them was achieved, the Delphi methodology was applied. The main conclusions reached are that clinical findings are critical for the diagnosis of insulin resistance, not being necessary blood testing. Acquisition of a healthy lifestyle is the most important therapeutic tool. Insulin-sensitizing drugs should be prescribed to individuals at high risk of disease according to clinically validated outcomes. There are specific recommendations for pregnant women, children, adolescents and older people.