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Texto completo SciELO Brasil
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Id: biblio-975579
Autor: Teixeira, Liane Sousa; Silva, Isabelle Braz de Oliveira; Sampaio, Andre Luiz Lopes; Oliveira, Carlos Augusto Pires de; Bahamad Júnior, Fayez.
Título: Hearing Loss in Acromegaly - A Review
Fonte: Int. arch. otorhinolaryngol. (Impr.);22(3):313-316, July-Sept. 2018. tab.
Idioma: en.
Resumo: Abstract Introduction Acromegaly is a chronic disease caused by growth hormone (GH) excess due to a GH-secreting pituitary adenoma in most cases. There is reasonable data to presume the possible influence of chronic GH and insulin-like growth factor I (IGF-I) hyperproduction on the anatomical structures involved in normal sound perception, and on its conductive and/or sensorineural part. Objectives To review the literature about acromegaly and hearing loss. Data Synthesis A systematic literature search was performed using the MEDLINE database, including hand-searching reference lists from original articles. The search was performed using the terms hearing loss and acromegaly, and only 5 studies were found. Conclusion The results are not consistent, but led to different conclusions. Therefore, more studies with greater numbers of patients with acromegaly are needed.
Descritores: Acromegalia/complicações
Perda Auditiva/etiologia
-Acromegalia/fisiopatologia
Surdez/etiologia
Surdez/patologia
Perda Auditiva/fisiopatologia
Limites: Humanos
Tipo de Publ: Revisão
Revisão Sistemática
Responsável: BR66.1 - Divisão de Biblioteca e Documentação


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Czepielewski, Mauro Antônio
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Id: biblio-834383
Autor: Costenaro, Fabiola; Rodrigues, Ticiana da Costa; Fedrizzi, Daniela; Oliveira, Marcelle Dietrich; Czepielewski, Mauro Antônio.
Título: Diabetes melito e acromegalia: interações entre hormônio de crescimento e insulina / Diabetes mellitus and acromegaly: interactions between growth hormone and insulin
Fonte: Rev. HCPA & Fac. Med. Univ. Fed. Rio Gd. do Sul;30(4):321-326, 2010. tab.
Idioma: pt.
Resumo: Introdução: o hormônio de crescimento humano (GH) possui um importante papel na fisiologia do metabolismo glicêmico, lipídico e protéico. O excesso deste hormônio, como encontrado na acromegalia, induz a um estado de resistência insulínica que pode estar associado à presença de diabetes melito (DM). Objetivo: descrever a frequência de DM e as características dos indivíduos com acromegalia e DM em acompanhamento no Hospital de Clínicas de Porto Alegre (HCPA). Métodos: estudo transversal avaliando o perfil clínico e laboratorial de uma coorte de pacientes com acromegalia. Os critérios utilizados para cura da doença foram os sugeridos pelo consenso de 2000 e, para considerar-se sob remissão, a presença de IGF-1 normal para sexo e idade em uso de medicação para controle da acromegalia. As dosagens de IGF-1 foram realizadas pelo método imunoradiométrico e as de GH por quimioluminescência. Resultados: cinquenta e nove pacientes com acromegalia foram analisados. Desses, 24% preencheram critérios de cura e 25% estavam em remissão da doença, os restantes apresentavam doença ativa. Trinta e sete por cento dos pacientes apresentavam DM, com HbA1c média de 7,3±2,2%. Entre os pacientes com DM, 86% não preencheram critérios de cura e mais frequentemente eram hipertensos [16/22 (73%) vs. 17/37 (46%), P=0,04] e faziam mais uso de estatina [14/22 (64%) vs. 8/37 (21%), P=0,004] em relação aos pacientes sem DM. Após análise de regressão logística múltipla, a presença de DM foi associada à presença de acromegalia ativa [razão de chances: 17,4 (IC 95%: 1,08-28,0), P=0,04] e essa associação foi independente do ajuste para idade, níveis de IGF-1 ou GH, hipertensão arterial e níveis séricos de triglicerídeos. Conclusões: O DM foi frequente entre os pacientes com acromegalia e significativamente relacionado ao controle da doença.

Background: human growth hormone (GH) plays an important role in the physiology of glucose, lipid and protein metabolism. The excess of this hormone, such as in cases of acromegaly, leads to a state of insulin resistance that can be associated with diabetes. Aim: to describe the frequency of diabetes in the sample of patients with acromegaly followed up at Hospital de Clínicas de Porto Alegre (HCPA). Methods: cross-sectional study assessing the metabolic profile of a cohort of acromegalic patients. The criteria used for cure of the disease were those suggested in the 2000 consensus, and the remission criteria were presence of normal IGF-1 levels for age and gender. IGF-1 was measured using the immunoradiometric assay and GH levels were measured using chemiluminescence. Results: fifty-nine acromegalic patients were analyzed. Only 24% met criteria for cure and 25% were in remission, the remaining had active disease. Thirty-seven percent of patients had diabetes, with a mean HbA1c of 7.3±2.2%. Among patients with diabetes, 86% did not meet criteria for cure and they were more often hypertensive [16/22 (73%) vs. 17/37 (46%), P=0.04] and were on statins [14/22 (64%) vs. 8/37 (21%), P=0.004] compared with patients without diabetes. After the multiple regression analysis, the presence of diabetes was associated with the presence of active acromegaly [odds ratio: 17.4 (95% CI: 1.08-28.0), P=0.04], and this association was independent from adjustment for age, IGF-1 levels or GH levels, hypertension, and triglycerides levels. Conclusions: diabetes was frequent among patients with acromegaly and it was closely related to the control of the underlying disease.
Descritores: Acromegalia/complicações
Diabetes Mellitus/epidemiologia
-Acromegalia/fisiopatologia
Diabetes Mellitus/fisiopatologia
Estudos Transversais
Prevalência
Limites: Humanos
Masculino
Feminino
Adulto
Pessoa de Meia-Idade
Responsável: BR18.1 - Biblioteca FAMED/HCPA


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Texto completo SciELO Cuba
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Id: lil-628234
Autor: Ledón Llanes, Loraine; Agramonte Machado, Adriana; Fabré Redondo, Bárbara; Hernández Rodríguez, José.
Título: Impacto de la acromegalia y el síndrome de Cushing sobre la salud, una perspectiva vivencial / Impact of acromegaly and the Cushing's syndrome, a prospect experience
Fonte: Rev. cuba. endocrinol;22(2):144-166, Mayo.-ago. 2011.
Idioma: es.
Resumo: Objetivo: describir el impacto de la acromegalia y el síndrome de Cushing sobre la salud, desde la perspectiva de personas con estas enfermedades.Métodos: se utilizó un diseño descriptivo, transversal y metodología cualitativa. Participaron 12 mujeres y 8 varones con cambios corporales resultantes de estas enfermedades, atendidos en el Instituto Nacional de Endocrinología, en La Habana, Cuba. Se realizaron entrevistas en profundidad y técnicas psicológicas proyectivas. El material recogido fue transcrito íntegramente, sometido a codificación, interpretación y triangulación. Los aspectos éticos fueron considerados. Resultados: emergieron 5 categorías interconectadas que fundamentaron el impacto de dichas enfermedades sobre la salud: la construcción de sus manifestaciones en términos de síntoma, las trayectorias para acceder a los servicios de salud, la comunicación del diagnóstico, el origen de la enfermedad y su valoración como experiencia de vida.Conclusiones: desde la perspectiva de los sujetos, la acromegalia y el síndrome de Cushing provocaron un impacto significativo de salud como resultado de: sus manifestaciones psíquicas y corporales, las características del proceso de atención y el diagnóstico. El género, las particularidades de la enfermedad y la escasa difusión de información sobre estas enfermedades influyeron sobre las decisiones de salud. El cuerpo se reconstruyó como desvalorizado, y la enfermedad se estructuró como proceso que provocó modificaciones globales en sus vidas(AU)

Objective: to describe the impact of acromegaly and the Cushing's syndrome on health, from the prospective of the persons presenting these diseases. Methods: a descriptive, cross-sectional design and qualitative methodology were used. Twelve women and 8 men with body changes caused by these diseases, seen in the National Institute of Endocrinology in La Habana, Cuba, participated in this study. Interviews in depth were applied as well as psychological projective techniques. The material collected was entirely transcribed, submitted to codification, interpretation and triangulation. Ethical features were taken into account. Results: appeared five interconnected categories supporting the impact of such diseases on health: reproduction of its manifestations in terms of symptom, the paths to accede to health services, the diagnosis's communication, the disease nature and its assessment as a life experience. Conclusions: from the subject's perspective, acromegaly and Cushing's syndrome had a significant impact on health as result of: its psychic and body manifestations, the characteristics of care process and diagnosis. Genre, disease peculiarities and the lack of diffusion of information on these diseases influenced on the health decisions. The meaning of body was devalued and the disease was structured as a process leading to global manifestations in its lives(AU)
Descritores: Acromegalia/psicologia
Imagem Corporal/psicologia
Impactos na Saúde/efeitos adversos
Síndrome de Cushing/diagnóstico
-Estresse Psicológico/etiologia
Processo Saúde-Doença
Epidemiologia Descritiva
Estudos Transversais
Pesquisa Qualitativa
Limites: Humanos
Masculino
Feminino
Adulto
Pessoa de Meia-Idade
Responsável: CU1.1 - Biblioteca Médica Nacional


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Texto completo SciELO Uruguai
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Id: biblio-1009183
Autor: Freundlich, Tomás; Arueste, David; Manríquez, Germán; Díaz, Alejandro.
Título: Comparación cefalométrica entre un paciente acromegálico y su hermano gemelo / Cephalometric comparison between an acromegalic patient and his twin brother
Fonte: Odontoestomatol;21(33):81-88, ene.-jun. 2019.
Idioma: es.
Resumo: La acromegalia es una enfermedad caracterizada por una desfiguración somática de progresión lenta causada por la sobreproducción de hormona de crecimiento (GH) y factor de crecimiento insulinoide tipo 1 (IGF-1), predominantemente asociada con un adenoma hipofisario. La manifestación más evidente a nivel facial es un prognatismo mandibular por exceso de crecimiento de la mandíbula. El propósito del presente trabajo fue realizar una comparación morfológica craneofacial mediante análisis cefalométrico y superposición cefalométrica entre un paciente con diagnóstico de acromegalia y su hermano gemelo que no presenta la enfermedad. Nuestros resultados mostraron que en el hermano con acromegalia existe un significativo aumento del tamaño de la silla turca, un desplazamiento hacia anterior del maxilar y mandíbula, siendo más marcado el desplazamiento mandibular. El cambio morfológico que experimenta la mandíbula en la acromegalia es atribuido principalmente al crecimiento de la rama mandibular por aumento de la unidad condilar.

Acromegaly is characterized by a slowly progressive somatic disfigurement caused by the overproduction of growth hormone (GH) and insulin-like growth factor 1 (IGF 1), mainly associated with a pituitary adenoma. The most evident facial manifestation is mandibular prognathism due to excessive growth of the jaw. This work aimed to perform a craniofacial morphological comparison through cephalometric analysis and cephalometric superimposition of a patient diagnosed with acromegaly and his twin brother without the disease. Our results showed that the acromegalic patient has a significant increase in the size of the sella turcica, an anterior displacement of the maxilla and mandible, the mandibular displacement being more marked. The morphological change of the mandible in acromegaly is mainly attributed to the growth of the mandibular ramus due to an increase in the condylar unit.
Descritores: Acromegalia
Cefalometria
Doenças em Gêmeos
Responsável: UY20.1 - Departamento de Documentación y Biblioteca


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Id: biblio-1006497
Autor: Martínez Montenegro, Irasel; Borges Alonso, Claudia.
Título: Acromegalia y silla turca vacía: una asociación infrecuente: presentación de un caso / Acromegaly and empty sella syndrome: an infrequent association: presentation of a case
Fonte: Rev. chil. endocrinol. diabetes;12(3):162-164, jul. 2019. ilus.
Idioma: es.
Resumo: La acromegalia, originada por un exceso de producción de Hormona de crecimiento (Gh), se caracteriza por crecimiento somático exagerado, alto riesgo cardio-metabólico, así como reducción de la expectativa de vida. Tiene una incidencia de 3-4 casos por millón de habitantes. El diagnóstico se retrasa hasta 10 años aumentando la morbi-mortalidad. Las alternativas terapéuticas incluyen medicamentos y cirugía, que van encaminados a reducir los efectos de masa tumoral, normalizar los parámetros bioquímicos y resolver las manifestaciones clínicas. En casos muy infrecuentes, el tumor hipofisario que la origina se asocia a silla turca vacía.

Acromegaly, caused by an excess production of growth hormone (Gh), it is characterized by exaggerated somatic growth, high cardio-metabolic risk, as well as reduction of life expectancy. It has an incidence of 3-4 cases per million population. The diagnosis is delayed up to 10 years increasing morbidity and mortality. The therapeutic alternatives include medications and surgery, which are aimed at reduce the effects of tumor mass, normalize biochemical parameters and resolve clinical manifestations. In very infrequent cases, the pituitary tumor that originates it is associated with empty sella syndrome. Key words: Acromegaly, Empty sella syndrome, Pituitary tumor.
Descritores: Neoplasias Hipofisárias/complicações
Acromegalia/complicações
Acromegalia/diagnóstico
Síndrome da Sela Vazia/complicações
-Sela Túrcica/patologia
Fator de Crescimento Insulin-Like I/análise
Hormônio do Crescimento/análise
Imagem por Ressonância Magnética
Teste de Tolerância a Glucose
Limites: Humanos
Feminino
Idoso
Tipo de Publ: Relatos de Casos
Responsável: CL1.1 - Biblioteca Central


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Id: lil-292757
Autor: Niño, Antonio; Kattah, William; Ucrós, Antonio.
Título: Asociación de acromegalia y tiroiditis de Hashimoto / Association of acromegaly and chronic lymphocitic thyroiditis
Fonte: Acta méd. colomb;11(2):81-84, mar.-abr. 1986. ilus, tab.
Idioma: es.
Resumo: La tiroiditis de Hashimoto es contrariamente a lo que se aceptaba hace algunos años, una entidad relativamente frecuente en nuestro medio y responsable de un alto porcentaje de bocio e hipotiroidismo, especialmente en mujeres jovenes y de mediana edad. La asociación de esta patología con acromegalia es excepcionalmente rara. Se presenta un caso en el que se desarrolla una tiroiditis linfocítica crónica en una paciente acromegálica. Se discute el proceso diagnóstico y el tratamiento
Descritores: Acromegalia/complicações
Acromegalia/diagnóstico
Acromegalia/epidemiologia
Tireoidite Autoimune/complicações
Tireoidite Autoimune/diagnóstico
Tireoidite Autoimune/epidemiologia
-Oligomenorreia/diagnóstico
Oligomenorreia/etiologia
Hipotireoidismo/etiologia
Testes de Função Tireóidea
Limites: Humanos
Feminino
Adulto
Tipo de Publ: Relatos de Casos
Responsável: CO47.1 - Centro de Documentación


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Texto completo SciELO Saúde Pública
Texto completo
Id: lil-341985
Autor: Anon.
Título: Evaluación de nuevos productos / Evaluation of new products
Fonte: Rev. panam. salud pública = Pan am. j. public health;14(1):53-59, jul. 2003.
Idioma: es.
Descritores: Acromegalia/prevenção & controle
Acromegalia/tratamento farmacológico
-United States Food and Drug Administration/legislação & jurisprudência
Responsável: BR1.1 - BIREME


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Id: lil-641979
Autor: Boero, L; Mallea Gil, M. S; Manavela, M; Stalldecker, G; Danilowicz, K; Guitelman, M; Alfieri, A; Ballarino, M. C; Chervin, A; García Basavilbaso, N; Glerean, M; Loto, M. G; Nahmías, J. A; Rogozinski, A. S; Servidio, M; Vitale, N. M; Katz, D; Fainstein Day, P.
Título: Acromegalia: comparación de los niveles séricos de IGF-I por dos inmunoensayos y su correlación con la prueba de tolerancia oral a la glucosa / Acromegaly: Comparison of serum IGF-1 levels measured by two immunoassays and their correlation with the Oral Glucose Tolerance Test
Fonte: Rev. argent. endocrinol. metab;47(4):18-23, oct.-dic. 2010. graf, tab.
Idioma: es.
Resumo: Introducción: La determinación de IGF-I en suero o plasma es una herramienta esencial en el diagnóstico y seguimiento de la acromegalia. Sin embargo, se deben tener presentes algunos inconvenientes en su medición por diferentes inmunoensayos. Objetivos: Evaluar dos inmunoensayos para la determinación de IGF-I y su correlación con el nadir de GH en el TTOG en pacientes acromegalicos. Materiales y métodos: Se analizaron 37 pacientes acromegálicos, 20 mujeres y 17 hombres. IGF-I fue determinada por Immulite 1000, (IMM) y por IRMA (DSL). Se realizó el TTOG y se determinó glucosa y GH en todos los tiempos (basal, 30, 60, 90 y 120min). Se consideró respuesta normal un nadir de GH <1ng/ml. Nueve pacientes se encontraban bajo tratamiento y 28 sin tratamiento. Análisis estadístico: se utilizaron el test de Wilcoxon, de Bland y Altman y curvas ROC. Se consideró significativa una p<0,05. Resultados: Las concentraciones basales de glucosa fueron 97,86±10,91 mg/dl, de GH 2,8 (1,59-14,4) ng/ml, de IGF-I por IMM 602±318 ng/ml y por DSL 1006±596 ng/ml. IGF-I por IMM y DSL mostró una diferencia significativa con p <0,01 y un bias de - 403,2 ng/ml con valores menores por IMM. IGF-I elevada por IMM y DSL, se encontró en el 84% y en el 97% respectivamente. IGF-I elevada con nadir de GH >1ng/ml se encontró en el 70%, con nadir de GH normal en el 13,5%. IGF-I normal con nadir >1ng/ml en el 2,7% y con nadir de GH normal en el 13,5%. El área bajo las curvas ROC no mostró diferencias significativas. Conclusiones: Los niveles de IGF-I determinados por IMM y DSL fueron significativamente diferentes mostrando un bias negativo para IMM. La mayoría de los valores del nadir de GH fueron consistentes con los niveles de IGF-I observándose una discrepancia en el 30% de los pacientes, estuvieran o no bajo tratamiento.

Introduction: IGF-I determination in serum or plasma is an essential tool in the diagnosis and follow-up of acromegaly. Hepatic production of IGF-I is regulated by GH and circulates bound to several IGF-I binding proteins which extends its half life. IGF-I is not released in a pulsatile pattern and has no significant variability in 24 h. Objective: To evaluate two different methodologies in IGF-I levels determination and their correlation with GH nadir in OGTT in acromegalic patients. Material and methods: We analyzed 37 acromegalic patients, 20 women and 17 men, mean age was 45±12 years. IGF-I levels were assayed by Immulite 1000, DPC (IMM) and DSL-5600 ACTIVE® IGF-I Coated-Tube IRMA (DSL) and OGTTs (at baseline and at 30, 60, 90 and 120 minutes) were performed by measuring plasma glucose and GH assay by immunochemiluminometric assay (Access); we considered a nadir <1ng/ml as normal response. Nine patients were under medical treatment (cabergoline: 4, octeotride: 4, and cabergoline plus octeotrite: 1) and 28 without treatment. Statistical analysis: Wilcoxon and, Bland and Altman tests and ROC curves. Differences were considered significant at p< 0.05. Results: Basal glucose levels were 97.86±10.91 mg/dl and mean GH was 2.8 (1.59-14.4) ng/ml. Mean IGF-I levels performed by IMM were 602±318 ng/ml and 1006±596 ng/ml by DSL. There was a statistically significant difference between both methodologies (p<0.01). Bland and Altman test showed a bias of - 403.2 ng/ml with lower values by IMM. We observed elevated IGF-I levels in 84% by IMM and in 97% by DSL, and only one patient had normal levels with both methodologies. Elevated IGF-I levels and GH nadir >1ng/ml were observed in 70% of the patients, increased IGF-I with normal GH nadir in 13.5%, normal IGF-I with GH nadir >1ng/ml in 2.7% and normal IGF-I with normal GH nadir in 13.5%. Patients under treatment: 3 showed normal GH nadir with elevated IGF-I levels, in 2 of them by both methodologies, and in the other one it was normal by IMM and elevated by DSL; the other 6 showed GH nadir > 1ng/ml, 5 of them presented elevated IGF-I by both methodologies and the other one showed discrepancy in IGF-I levels. The under ROC curve area and confidence interval (CI) of 95% for IGF-I IMM and DSL were 0.96 (0.90-1.00) and 0.91 (0.82-1.00) respectively. Differences between the ROC curves areas were not significant Conclusions: IGF-I levels determined by IMM and DSL were statistically significantly different. IGF-I levels showed a negative bias by IMM. Most of the results of GH nadir were consistent with IGF-I levels but we observed discrepancy in 30% of the patients, regardless of whether they were under treatment or not.
Descritores: Acromegalia/sangue
Fator de Crescimento Insulin-Like I/análise
Teste de Tolerância a Glucose/estatística & dados numéricos
-Imunoensaio/métodos
Interpretação Estatística de Dados
Hormônio do Crescimento Humano/análise
Limites: Humanos
Masculino
Feminino
Criança
Adolescente
Adulto
Pessoa de Meia-Idade
Tipo de Publ: Relatos de Casos
Estudo Comparativo
Ensaio Clínico
Responsável: AR635.1 - FCVyS - Servicio de Información y Documentación


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Id: biblio-957984
Autor: Battistone, María Florencia; Loto, Mónica; Katz, Débora; Agüero, Mónica; Alfieri, Analía; Ballarino, María Carolina; Boero, Laura; Danilowicz, Karina; Sosa, Soledad; Diez, Sabrina; Donoso, Marina; Fainstein Day, Patricia; Furioso, Alejandra; Glerean, Mariela; Mallea Gil, Susana; Martinez, Marcela; Miragaya, Karina; Rogozinski, Amelia; Sabaté, María Isabel; Servidio, Marisa; Slavinsky, Patricia; Stalldecker, Graciela; Tkatch, Julieta; Garcia Basabilbaso, Natalia; Caldo, Ignacio Federico; Lubieniecki, Daniela; Guitelman, Mirtha.
Título: Riesgo aumentado de lesiones colónicas preneoplásicas en acromegalia: estudio multicéntrico caso control. Resultados preliminares / Increased risk of pre-cancerous bowel lesions in acromegaly: Multicentre case-control study. Preliminary results
Fonte: Rev. argent. endocrinol. metab;54(4):169-175, dic. 2017. ilus, tab.
Idioma: es.
Resumo: Introducción: El riesgo de desarrollar neoplasias colónicas en pacientes acromegálicos y su relación directa con los niveles elevados de GH/IGF-1 no están bien establecidos y continúan siendo motivo de controversia en la literatura mundial. El objetivo de este trabajo fue evaluar el riesgo de desarrollar lesiones neoplásicas avanzadas (LNA) (adenomas mayores a 1 cm, componente velloso mayor del 75% y/o displasia de alto grado), en pacientes con acromegalia, comparado con un grupo control. Materiales y métodos: Estudio multicéntrico caso-control retrospectivo. Ciento treinta y siete pacientes con acromegalia que realizaron videocolonoscopia (VCC) fueron incluidos inicialmente, aunque solo 69 cumplieron criterios de inclusión. Sesenta y dos controles fueron obtenidos: por cada caso (paciente con acromegalia) 2 «controles¼ fueron seleccionados aleatorizadamente e igualados por edad y sexo. El riesgo se expresó en odds ratio (OR) y su correspondiente intervalo de confianza (IC) del 95%. La significación estadística fue considerada una p < 0,05. Resultados: De los 69 pacientes con VCC completa y datos adecuados para su análisis, 28 presentaron VCC positiva con hallazgos de pólipos (40%) y 41 VCC negativa o normal (60%). Dentro del grupo con VCC positiva, 14 presentaron LNA (20%) y solo un paciente presentó diagnóstico de cáncer colorrectal. Para el análisis caso-control se incluyó a 31 pacientes frente al grupo control (n = 62) que cumplieron con los criterios de inclusión. La presencia de pólipos colónicos, adenomas y LNA en los pacientes con acromegalia fue de 19/31 (61,9%), 14/31 (45,16%) y 10/31 (32,25%), y en el grupo control de 18/62 (29,03%), 11/62 (17,74%) y 4/62 (6,45%), respectivamente. El riesgo de adenomas y LNA fue mayor en el grupo de acromegalia en comparación con el grupo control, siendo ambos resultados estadísticamente significativos: adenomas OR 2,54 (IC 1,22-5,25) p = 0,005, LNA OR: 7,3 (2,4-25), p = 0,00. Conclusión: La acromegalia se asocia a un mayor riesgo de lesiones colónicas preneoplásicas. Este hallazgo justifica el cribado con VCC al diagnóstico en pacientes con acromegalia.

Background: The risk of developing cancerous lesions in the colon of acromegaly patients and their direct relationship with elevated growth hormone (GH) and insulin-like growth factor-1 (IGF-1) levels is not well established, and is still controversial in the international literature. The objective of this study was to evaluate the risk of developing advanced neoplastic lesions (ALN: greater than 1 cm adenomas, villous component greater than 75% and/or high grade dysplasia) in patients with acromegaly compared to a control group. Materials and methods: A multicentre, retrospective case-control study was conducted initially on 137 patients with acromegaly (cases) who underwent videocolonoscopy (VCC), although only 69 met inclusion criteria. Sixty-two controls were obtained, and for each case two "controls" were randomly selected and matched by age and gender. Risk was expressed as odds ratio (OR) and its corresponding 95% con"dence interval (CI). P values < .05 were considered statistical significantly. Results: Of the 69 acromegaly patients with a completed VCC and adequate data for their analysis, 28 had a positive VCC with findings of polyps (40%), and 41 VCC negative with no lesions (60%). Within the group with positive VCC, 14 were ALN (20%) and one a colorectal cancer. In the case-control analysis, 31 cases were to be analysed against the control group (n = 62). The presence of colonic polyps, adenomas, and ALN in patients with acromegaly was 19/31 (61.9%), 14/31 (45.16%), and 10/31 (32.25%), respectively, and in the control group, it was 18/62 (29.03%), 11/62 (17.74%), and 4/62 (6.45%), respectively. The risk of adenomas and ALN was higher in the acromegaly group compared to the control group: adenomas OR: 2.54 (95% CI 1.22-5.25) P=.005, ALN OR: 7.3 (2.4-25) P=.00. Conclusion: This preliminary case control study showed an increased risk of pre-cancerous colprectal lesions in patients with acromegaly, supporting the VCC screening at diagnosis.
Descritores: Lesões Pré-Cancerosas/complicações
Acromegalia/complicações
-Lesões Pré-Cancerosas/diagnóstico
Neoplasias Colorretais/prevenção & controle
Fatores de Risco
Colonoscopia
Risco Ajustado
Limites: Humanos
Masculino
Feminino
Adulto
Pessoa de Meia-Idade
Idoso
Tipo de Publ: Estudo Comparativo
Estudo Multicêntrico
Ensaio Clínico Controlado
Estudo de Avaliação
Responsável: AR1.2 - Instituto de Investigaciónes Epidemiológicas


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Id: biblio-901007
Autor: Ledón Llanes, Loraine; Fabré Redondo, Bárbara Luz; García Álvarez, Caridad Teresita; Mendoza Trujillo, Madelín; Agramonte Machado, Adriana; Hernández Rodríguez, José.
Título: Sexualidad de personas con acromegalia y síndrome de Cushing; experiencias y aspectos psicosociales relacionados / Sexuality in people with acromegaly and Cushing's syndrome; experiences and related psychosocial aspects
Fonte: Rev. cuba. endocrinol;28(1):1-20, Jan.-Apr. 2017.
Idioma: es.
Resumo: Antecedentes: aunque la literatura documenta que la acromegalia y el síndrome de Cushing pueden producir dificultades sexuales, los estudios sobre el tema son escasos, especialmente desde la perspectiva de los sujetos. Objetivo: describir el impacto de la acromegalia y el síndrome de Cushing sobre la sexualidad y algunos aspectos psicosociales relacionados, desde la perspectiva de personas con estas enfermedades. Métodos: estudio descriptivo, retrospectivo, cualitativo, con 12 mujeres y 8 varones, atendidos en Instituto Nacional de Endocrinología, Cuba. Se utilizaron entrevistas en profundidad y técnicas psicológicas proyectivas. La información fue transcrita, codificada, interpretada y triangulada. Se consideraron los aspectos éticos. Resultados: las manifestaciones clínicas, corporales y psíquicas de la enfermedad impactaron la sexualidad de la mayoría de los sujetos. Los roles de género y la estética corporal jugaron un rol importante, especialmente en mujeres. La pareja se estructuró como apoyo ante las dificultades sexuales, especialmente en varones. Aparecieron tres perfiles de experiencias sexuales: 1) un grupo refirió que la enfermedad impactó negativamente su sexualidad en forma de dificultades con la erección (varones) y el deseo sexual (mujeres), e incidió en la pareja; 2) otro grupo refirió similares cambios sexuales, pero vividos con menor impacto psicoemocional debido al apoyo de la pareja; 3) un tercer grupo no refirió cambios en la sexualidad ni en la pareja. Se discuten factores relacionados. Conclusiones: las experiencias sexuales de los sujetos son diversas, relacionadas con representaciones sobre pareja, sexualidad, cuerpo y enfermedad. Mujeres y varones muestran diferencias en la influencia del impacto estético y psicoemocional de la enfermedad sobre la sexualidad. Las representaciones (genéricas, corporales, sexuales) más flexibles se relacionan con menor impacto sexual de la enfermedad(AU)

Background: although literature documents that acromegaly and Cushing's syndrome may cause sexual difficulties, the number of studies about the topic is low, mainly from the subjects' perspective. Objective: to describe the impact of acromegaly and Cushing's syndrome on the sexuality and some related psychosocial aspects from the perspective of people living with these diseases. Methods: retrospective, descriptive and qualitative study of 12 women and 8 men who were seen at the National Institute of Endocrinology of Cuba. In depth interviews and projective psychological techniques were used. The collected information was transcripted, coded, construed and triangled. Ethical aspects were taken into consideration. Results: the clinical, body and psychical manifestations of the disease had an impact on the sexuality of most of subjects. The gender role and the body image played significant roles mainly in women. The couple was formed as a support to face sexual difficulties, particularly in men. There were three profiles of sexual experiences: 1) a group stated that the disease had a negative impact on their sexuality regarding difficulties in erection (men) and sexual desire (women) and this influenced on the couple; 2) this group mentioned similar sexual changes but experienced lower psychoemotional impact due to the support of the sexual partner; and 3) the third group did not mention any change in sexuality or in the couple. Related factors were also discussed. Conclusions: sexual experiences of the subjects were varied and related to representations about couple, sexuality, body and disease. Women and men showed differences in the effect of the esthetic and psycho-emotional impact of the disease on sexuality. The most flexible representations (generic, body, sexual) were related to lower sexual impact of disease(AU)
Descritores: Acromegalia/psicologia
Técnicas Psicológicas/ética
Sexualidade/estatística & dados numéricos
Síndrome de Cushing/psicologia
-Estudos de Avaliação como Assunto/estatística & dados numéricos
Epidemiologia Descritiva
Estudos Retrospectivos
Limites: Humanos
Masculino
Feminino
Responsável: CU1.1 - Biblioteca Médica Nacional



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