12 results on '"Espinosa-De-Los-Monteros, A."'
Search Results
2. Ectopic ACTH-Secreting Syndrome: A Single Center Experience Report with a High Prevalence of Occult Tumor
- Author
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Hernández, Irma, Espinosa-de-los-Monteros, Ana Laura, Mendoza, Victoria, Cheng, Sonia, Molina, Mario, Sosa, Ernesto, and Mercado, Moisés
- Published
- 2006
- Full Text
- View/download PDF
Catalog
3. Adequate Thyroid-Stimulating Hormone Levels After Levothyroxine Discontinuation in the Follow-Up of Patients with Well-Differentiated Thyroid Carcinoma
- Author
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Sánchez, Reyna, Espinosa-de-los-Monteros, Ana Laura, Mendoza, Victoria, Brea, Eduardo, Hernández, Irma, Sosa, Ernesto, and Mercado, Moisés
- Published
- 2002
- Full Text
- View/download PDF
4. Efficacy and Safety of Radiotherapy in Acromegaly
- Author
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Guadalupe Vargas, Ernesto Sosa, Moisés Mercado, Ana Laura Espinosa-de-los-Monteros, and Baldomero González
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Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Urology ,Hypopituitarism ,Acromegaly ,medicine ,Humans ,Insulin-Like Growth Factor I ,Testosterone ,Aged ,Transsphenoidal surgery ,Human Growth Hormone ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Prolactin ,Surgery ,Radiation therapy ,Pituitary Hormones ,Treatment Outcome ,Somatostatin ,Pituitary Gland ,Female ,Luteinizing hormone ,business - Abstract
Transsphenoidal surgery remains the treatment of choice in acromegaly, yet 40-50% of patients require secondary forms of therapy such as radiation therapy (RT) and somatostatin analogues (SA). We undertook this study to evaluate the efficacy and safety of RT in acromegaly.Forty patients with acromegaly treated with RT (mean dose, 52 Gy) after failed pituitary surgery between 1993 and 2007 were analyzed; all were clinically and biochemically active. Patients were evaluated with yearly hormonal measurements [basal and glucose-suppressed growth hormone (GH), IGF-1, thyroid-stimulating hormone (TSH), free T4, cortisol, luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone or estradiol and prolactin (PRL)] and with magnetic resonance imaging every 2 years.Mean age of patients was 52.9 ± 12.1 years and 85% were female. All subjects had been followed for 1 year, 75% for 3 years, 70% for 5 years and 35% for 10 years. The median basal GH level fell from a baseline of 8.8 ng/mL to 2.27 ng/mL at 5 years (p = 0.001) and to 1.88 ng/mL at 10 years (p = 0.001). A GH1 ng/mL was achieved by 46% and 57% of the patients at 5 and 10 years of follow-up, respectively. The proportion of patients achieving a normal IGF-1 was 36% at 5 years and 43% at 10 years. Before RT, hypothyroidism, hypocortisolism and hypogonadism were present in 44%, 26% and 74% of patients, respectively. After 5 years of follow-up (n = 28), these figures increased to 51%, 41% and 79% and over a third of the group had panhypopituitarism. One patient developed optic neuritis and another patient was diagnosed with a meningioma 10 years after RT. No cerebrovascular events or deaths occurred.RT is an effective, low-cost and reasonably safe means of controlling acromegalic activity, particularly useful in parts of the world where SA are not readily available. more...
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- 2011
- Full Text
- View/download PDF
5. Ectopic ACTH-Secreting Syndrome: A Single Center Experience Report with a High Prevalence of Occult Tumor
- Author
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Moisés Mercado, Ana Laura Espinosa-de-los-Monteros, Victoria Mendoza, Irma Hernández, Ernesto Sosa, Sonia Cheng, and Mario Molina
- Subjects
Adenoma ,Male ,endocrine system ,Pathology ,medicine.medical_specialty ,medicine.medical_treatment ,Neuroendocrine tumors ,Single Center ,Diagnosis, Differential ,Pituitary adenoma ,Ectopic ACTH Secretion Syndrome ,medicine ,Humans ,Cushing Syndrome ,business.industry ,Petrosal Sinus Sampling ,Adrenalectomy ,Inferior petrosal sinus ,General Medicine ,medicine.disease ,Magnetic Resonance Imaging ,Occult ,ACTH Syndrome, Ectopic ,ACTH-Secreting Pituitary Adenoma ,Treatment Outcome ,Female ,Radiology ,Tomography, X-Ray Computed ,business - Abstract
Background Differentiation between the two forms of ACTH-dependent Cushing's syndrome is a challenging task. Although the majority of these cases will be diagnosed as Cushing's disease secondary to an ACTH-secreting pituitary adenoma, 10–15% result from the ectopic ACTH secretion syndrome (EAS), which is usually due to neuroendocrine tumors. In the present study we report our experience with EAS in eight patients evaluated and treated during the past 10 years. Methods Our experience in the evaluation and management of EAS was retrospectively reviewed. The latter included a standard biochemical assessment (urinary free cortisol, low- and high-dose dexamethasone suppression tests), petrosal sinus sampling when indicated and imaging techniques such as pituitary MRI, total body CT and somatostatin receptor scintigraphy. Results The ectopic nature of the ACTH hypersecretion was confirmed with inferior petrosal sinus samplings in all cases. CT scanning localized a putative tumor in 6/8 patients, whereas octreotide scintigraphy was positive in only five. In all cases, the source was traced to the lungs. However, upon performing thoracotomy, a documented ACTH-secreting bronchial carcinoid tumor was found in only four patients. Thus, 4/8 patients with EAS remained “occult.” All of these patients underwent adrenalectomy for hypercortisolism control. Conclusions EAS is a rare cause of ACTH-dependent Cushing's syndrome. Truly “occult” tumors were frequent and these patients need to be under close surveillance for the detection of neuroendocrine tumors. more...
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- 2006
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6. Clinical Outcome of Invasive Infections in Children Caused by Highly Penicillin-Resistant Streptococcus pneumoniae Compared with Infections Caused by Penicillin-Susceptible Strains
- Author
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Romeo S. Rodriguez, Ernesto Calderón-Jaimes, Demóstenes Gómez-Barreto, and Luz Elena Espinosa de los Monteros
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Male ,medicine.medical_specialty ,Heart Diseases ,medicine.drug_class ,Penicillin Resistance ,Antibiotics ,Erythromycin ,Bacteremia ,Comorbidity ,Biology ,medicine.disease_cause ,Pneumococcal Infections ,Microbiology ,Risk Factors ,Neoplasms ,Internal medicine ,Case fatality rate ,Streptococcus pneumoniae ,medicine ,Humans ,Prospective Studies ,Serotyping ,Child ,Mexico ,Cross Infection ,AIDS-Related Opportunistic Infections ,Infant ,General Medicine ,Pneumonia, Pneumococcal ,Hospitals, Pediatric ,medicine.disease ,Drug Resistance, Multiple ,Anti-Bacterial Agents ,Nutrition Disorders ,Community-Acquired Infections ,Penicillin ,Pneumococcal infections ,Treatment Outcome ,Child, Preschool ,Superinfection ,Ceftriaxone ,Vancomycin ,Female ,Disease Susceptibility ,medicine.drug - Abstract
Background In this report based on data from the Institutional Surveillance System during 1994–1998, we document the continuing emergence of drug-resistant Streptococcus pneumoniae strains at the Hospital Infantil de Mexico Federico Gomez in Mexico City. Methods We evaluate the clinical course of 49 invasive pneumococcal infection outside the central nervous system (CNS) by a number of factors including the site, severity, and place where the infection was acquired, the underlying health of the patient, and the adequacy of antimicrobial therapy. Results An underlying illness was present in 21 of 49 (43%) patients, 37 (75%) patients had taken previous antimicrobial therapy, and 25% of the infections were nosocomially acquired. Overall, 25 of 49 (51%) of the pneumococcal strains tested were pencillin-resistant; strains with the highest resistance to penicillin were also resistant to cephalosporins. Twenty-two percent of all strains were considered to be multidrug-resistant. Eleven of 25 penicillin-resistant strains were identified as multidrug-resistant, i.e., to erythromycin, TMP/SMX, and chloramphenicol. Ten serotypes accounted for 88% of the isolates, the most frequent serotypes being 23F, 14, 19V, 6A, and 6B. The overall case-fatality rate was 37% (18 of 49), with most deaths occurring within 3–5 days after antibiotic therapy was initiated. There was no difference in the case fatality rate between children with penicillicin-nonsusceptible and penicillin-susceptible pneumococcal infections; instead; case-fatality rate correlated with severity of illness on admission and presence of underlying disease. Conclusions Characterizing groups at risk for invasive pneumococcal disease could aid in the development of preventive programs and increase the benefits from wide use of future conjugated vaccines. more...
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- 2000
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- View/download PDF
7. Adequate thyroid-stimulating hormone levels after levothyroxine discontinuation in the follow-up of patients with well-differentiated thyroid carcinoma
- Author
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Reyna Sánchez, Moisés Mercado, Victoria Mendoza, Ana Laura Espinosa-de-los-Monteros, Eduardo Brea, Irma Hernández, and Ernesto Sosa
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Adult ,Male ,endocrine system ,medicine.medical_specialty ,Time Factors ,endocrine system diseases ,medicine.medical_treatment ,Urology ,Levothyroxine ,Thyrotropin ,Thyroid carcinoma ,Thyroid-stimulating hormone ,Internal medicine ,medicine ,Humans ,Thyroid Neoplasms ,Radionuclide Imaging ,business.industry ,Incidence (epidemiology) ,Thyroidectomy ,Cell Differentiation ,General Medicine ,Middle Aged ,Discontinuation ,Thyroxine ,Endocrinology ,Triiodothyronine ,Thyroglobulin ,Female ,business ,medicine.drug ,Hormone ,Follow-Up Studies - Abstract
Background In the follow-up of patients with well-differentiated thyroid carcinomas (WTC), a thyroid-stimulating hormone (TSH) ≥30 μU/mL is generally accepted as adequate to perform whole body scans (WBS), determine thyroglobulin (Tg), and administer radioiodine therapeutically. These patients, inevitably rendered hypothyroid, are traditionally switched to T3 for 3–4 weeks prior to withdrawing all thyroid hormones for an additional 2–3 weeks. Neither TSH and Tg elevation dynamics nor WBS characteristics after simply interrupting L-T4 treatment without T3 administration have been evaluated. Methods TSH, total T4 and T3, as well as FT4 were measured weekly after discontinuing L-T4 in 21 subjects (group I) and after thyroidectomy in 10 subjects (group II). WBS and Tg determination was performed upon achievement of TSH ≥30 μU/mL. Results By the second week, 42% of group I patients and 70% of group II patients had TSH ≥30 μU/mL. By the third week, 90% in group I and 100% in group II had achieved this target. Group I patients who needed 4 weeks to increase TSH received a greater cumulative radioiodine dose and had higher Tg levels. Positive WBS were found in eight cases and the incidence of a negative WBS with elevated Tg was significantly higher when evaluation occurred at the second week of L-T4 withdrawal compared to the fourth week. Conclusions L-T4 interruption is a reasonable alternative to temporary T3 in preparation for radioiodine scanning and treatment. more...
- Published
- 2002
8. Opposite effects of breakfast vs. oral glucose on circulating androgen levels in healthy women
- Author
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A, Parra, H, Godoy, J, Ayala, A, Ramírez, I, Coria, and A, Espinosa de los Monteros
- Subjects
Adult ,Glucose ,Food ,Androgens ,Administration, Oral ,Humans ,Female - Abstract
Since certain hormone abnormalities can be food-dependent as in some cases of nodular adrenal hyperplasia, as a first step to study other more frequent endocrine disorders, using a standard meal as means of a more physiologic stimulus, we investigated in healthy women whether or not the changes in serum glucose, insulin, cortisol, and androgens are different following a breakfast than after oral glucose alone. Ten women (group 1) ingested a 725 kilocalories (173 kiloJoules) breakfast and ten women (group 2) ingested a 100-g glucose load at 8:00 A.M. Serum glucose, insulin, cortisol, dehydroepiandrosterone sulfate (DHEAS), free testosterone (free-T), and androstenedione (A) were determined every 30 min for the next 2 h. Serum glucose rose higher in group 2 than in group 1 (por = 0.05), yet insulin increased similarly in both groups. In group 1 free-T and DHEAS increased at 30 min (por = 0.05) while cortisol decreased (por = 0.04); A did not change. On the contrary, in group 2 only a decrease in free-T (por = 0.01) was detected. In these healthy women, serum androgen changed inversely depending on the type and composition of the oral stimulus used. The simultaneous increase of serum insulin, free-T and DHEAS coinciding with a cortisol decrease may enhance insulin anabolic effects following breakfast, but not after oral glucose alone. more...
- Published
- 1995
9. Serum androgen changes during meal-induced hyperinsulinemia and after acute sequential blockade and hyperstimulation of insulin release in women with polycystic ovary syndrome
- Author
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A, Parra, J, Barrón, M, Mota-González, V, Ibarra, and A, Espinosa de los Monteros
- Subjects
Adult ,Food ,Case-Control Studies ,Insulin Secretion ,Androgens ,Humans ,Insulin ,Female ,Secretory Rate ,Polycystic Ovary Syndrome - Abstract
To investigate if acute changes in endogenous insulin release are associated with similar changes in serum androgen, 13 healthy ovulatory women (group 1) and six women with polycystic ovary syndrome (PCOS) and hyperinsulinemia, three with acanthosis nigricans (group 2) were studied. On day 1 all women ingested a 725 kilocalories breakfast between 7:30 and 8:00 A.M. The next day (day 2) only PCOS women had the breakfast and a simultaneous 90-min intravenous infusion of epinephrine (E, 6 micrograms/min) and propranolol (P, 80 micrograms/min). On both days serum glucose, insulin, cortisol, 17 alpha hydroxyprogesterone (17 OHP), dehydroepiandrosterone sulfate (DHEAS), free testosterone (free T), and androstenedione (A) were determined every 30 min for a period of 3 h. In group 1, glucose, insulin, free T, and DHEAS simultaneously rose (por = 0.026) while cortisol and 17 OHP fell (por = 0.020). Group 2 on day 1 had fasting and meal-stimulated hyperinsulinemia but all serum steroids progressively decreased. In only one woman free T rose. On day 2 during the E + P infusion, glucose increased yet fasting insulin remained constant and serum steroids decreased again. During the 90 min post-infusion, insulin sharply increased but no acute elevation in any steroid occurred. In conclusion, in PCOS women no parallel changes in serum androgen concentrations were seen in association with acute truly physiologic endogenous hyperinsulinemia or during the acute pharmacologically induced hypoinsulinemia and subsequent hyperinsulinemia. more...
- Published
- 1995
10. Comparative analysis of plasmids from nosocomial Klebsiella pneumoniae strains isolated from two hospitals
- Author
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L E, Espinosa de los Monteros, V, Ceja, C, Montañéz, and J I, Santos
- Subjects
Cross Infection ,Klebsiella pneumoniae ,Humans ,Hospitals, General ,Hospitals, Pediatric ,Mexico ,Plasmids - Abstract
A total of 46 clinical isolates of Klebsiella pneumoniae were studied. Of these, 33 were from "Hospital Infantil de México" (HIM) and 13 from "Hospital General de México" (HGM). The susceptibility of these strains to five antibiotics, as well as the plasmid DNA profiles, were determined for each group. Antibiotic susceptibility profiles were very similar in strains from both hospitals; however, most of the strains analyzed exhibited heterogeneous plasmid DNA profiles. Results showed that strains isolated in the two hospitals did not differ regarding morphology, biochemical profiles, antibiotic susceptibility or plasmid populations, and these characteristics may not be used as markers to differentiate Klebsiella pneumoniae strains from different hospitals. more...
- Published
- 1994
11. Opposite effects of breakfast vs. oral glucose on circulating androgen levels in healthy women.
- Author
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Parra A, Godoy H, Ayala J, Ramírez A, Coria I, and Espinosa de los Monteros A
- Subjects
- Administration, Oral, Adult, Female, Glucose administration & dosage, Humans, Androgens blood, Food, Glucose pharmacology
- Abstract
Since certain hormone abnormalities can be food-dependent as in some cases of nodular adrenal hyperplasia, as a first step to study other more frequent endocrine disorders, using a standard meal as means of a more physiologic stimulus, we investigated in healthy women whether or not the changes in serum glucose, insulin, cortisol, and androgens are different following a breakfast than after oral glucose alone. Ten women (group 1) ingested a 725 kilocalories (173 kiloJoules) breakfast and ten women (group 2) ingested a 100-g glucose load at 8:00 A.M. Serum glucose, insulin, cortisol, dehydroepiandrosterone sulfate (DHEAS), free testosterone (free-T), and androstenedione (A) were determined every 30 min for the next 2 h. Serum glucose rose higher in group 2 than in group 1 (p < or = 0.05), yet insulin increased similarly in both groups. In group 1 free-T and DHEAS increased at 30 min (p < or = 0.05) while cortisol decreased (p < or = 0.04); A did not change. On the contrary, in group 2 only a decrease in free-T (p < or = 0.01) was detected. In these healthy women, serum androgen changed inversely depending on the type and composition of the oral stimulus used. The simultaneous increase of serum insulin, free-T and DHEAS coinciding with a cortisol decrease may enhance insulin anabolic effects following breakfast, but not after oral glucose alone. more...
- Published
- 1995
12. Serum androgen changes during meal-induced hyperinsulinemia and after acute sequential blockade and hyperstimulation of insulin release in women with polycystic ovary syndrome.
- Author
-
Parra A, Barrón J, Mota-González M, Ibarra V, and Espinosa de los Monteros A
- Subjects
- Adult, Case-Control Studies, Female, Humans, Insulin Secretion, Secretory Rate drug effects, Androgens blood, Food, Insulin metabolism, Polycystic Ovary Syndrome blood
- Abstract
To investigate if acute changes in endogenous insulin release are associated with similar changes in serum androgen, 13 healthy ovulatory women (group 1) and six women with polycystic ovary syndrome (PCOS) and hyperinsulinemia, three with acanthosis nigricans (group 2) were studied. On day 1 all women ingested a 725 kilocalories breakfast between 7:30 and 8:00 A.M. The next day (day 2) only PCOS women had the breakfast and a simultaneous 90-min intravenous infusion of epinephrine (E, 6 micrograms/min) and propranolol (P, 80 micrograms/min). On both days serum glucose, insulin, cortisol, 17 alpha hydroxyprogesterone (17 OHP), dehydroepiandrosterone sulfate (DHEAS), free testosterone (free T), and androstenedione (A) were determined every 30 min for a period of 3 h. In group 1, glucose, insulin, free T, and DHEAS simultaneously rose (p < or = 0.026) while cortisol and 17 OHP fell (p < or = 0.020). Group 2 on day 1 had fasting and meal-stimulated hyperinsulinemia but all serum steroids progressively decreased. In only one woman free T rose. On day 2 during the E + P infusion, glucose increased yet fasting insulin remained constant and serum steroids decreased again. During the 90 min post-infusion, insulin sharply increased but no acute elevation in any steroid occurred. In conclusion, in PCOS women no parallel changes in serum androgen concentrations were seen in association with acute truly physiologic endogenous hyperinsulinemia or during the acute pharmacologically induced hypoinsulinemia and subsequent hyperinsulinemia. more...
- Published
- 1995
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