RESUMEN
RESUMEN La hipoglucemia por hiperinsulinismo endógeno constituye un reto terapéutico. Se describen las características clínicas, bioquímicas e imagenológicas de pacientes con diagnóstico de hiperinsulinismo endógeno atendidos en el Instituto Nacional de Endocrinología en el periodo 2004-2018(AU)
ABSTRACT Hypoglycemia due to endogenous hyperinsulinism constitutes a therapeutic challenge. The clinical, biochemical and imaging characteristics of patients diagnosed with endogenous hyperinsulinism treated at the National Endocrinology Institute from 2004 to 2018 are described(AU)
Asunto(s)
Humanos , Masculino , Femenino , Recolección de Datos/métodos , Hiperinsulinismo/diagnóstico por imagen , Hipoglucemia/epidemiología , Epidemiología DescriptivaRESUMEN
OBJECTIVE: To measure the vascularization and ovarian volume with three-dimensional sonography in patients diagnosed of polycystic ovary syndrome with stimulated ovulation treatment, and to analyse the differences between the patients treated with clomiphen citrate versus clomiphen citrate and metformin. MATERIAL AND METHOD: Therty patients were studied. Twenty ovulation cycles were obtained with clomiphen citrate and 17 with clomiphen citrate plus merformin (added in case of obesity or hyperglucemy/hyperinsulinemia). Ovarian volumes and vascular indexes were studied with 3D-sonography and results were analysed by treatment. RESULTS: There were no statistical differences of ovarian volume by treatment along the cycles, although bigger volume were found in ovulatory cycles compared to non-ovulatory ones (20,36 versus 13,89 ml, p = 0,026). No statistical differences were also found concerning vascular indexes, neither by treatment nor by the obtention of ovulation in the cycle. CONCLUSIONS: Ovarian volume and vascular indexes measured with three-dimensional sonography in patients diagnosed of polycystic ovary syndrome do not show differents values in patients treated with clomiphen citrate alone versus clomiphen citrate plus metformin.
Asunto(s)
Clomifeno/uso terapéutico , Fármacos para la Fertilidad Femenina/uso terapéutico , Metformina/uso terapéutico , Ovario/efectos de los fármacos , Inducción de la Ovulación , Síndrome del Ovario Poliquístico/tratamiento farmacológico , Adulto , Clomifeno/administración & dosificación , Clomifeno/efectos adversos , Clomifeno/farmacología , Quimioterapia Combinada , Femenino , Fármacos para la Fertilidad Femenina/efectos adversos , Fármacos para la Fertilidad Femenina/farmacología , Humanos , Hiperglucemia/diagnóstico por imagen , Hiperglucemia/tratamiento farmacológico , Hiperglucemia/etiología , Hiperglucemia/patología , Hiperinsulinismo/diagnóstico por imagen , Hiperinsulinismo/tratamiento farmacológico , Hiperinsulinismo/etiología , Hiperinsulinismo/patología , Metformina/administración & dosificación , Metformina/efectos adversos , Metformina/farmacología , Neovascularización Fisiológica/efectos de los fármacos , Obesidad/diagnóstico por imagen , Obesidad/tratamiento farmacológico , Obesidad/etiología , Obesidad/patología , Tamaño de los Órganos/efectos de los fármacos , Ovario/irrigación sanguínea , Ovario/diagnóstico por imagen , Síndrome del Ovario Poliquístico/complicaciones , Síndrome del Ovario Poliquístico/diagnóstico por imagen , Síndrome del Ovario Poliquístico/patología , Estudios Prospectivos , Resultado del Tratamiento , Ultrasonografía Doppler , Adulto JovenRESUMEN
BACKGROUND: In view of the debate on the safety of using ultrasound associated with microbubbles, we investigated the microvascular effects in situations of potential clinical interest. METHODS: Ultrasound, microbubbles, and their association were evaluated on the cheek pouch microcirculation in 96 male hamsters (n = 6 in each group): control; ischemia-reperfusion, 30 minutes total ischemia followed by reperfusion; hyperinsulinemia and hyperglycemia (substitution of the drinking water by 10% fructose solution for 3 months); and endotoxic shock (induced by Escherichia coli lipopolysaccharide). The heart rate, mean arterial pressure, number of rolling and adhered leukocytes, and arteriolar and venular diameters were analyzed. RESULTS: Heart rate and mean arterial pressure were lower in the endotoxic shock group than in the control group. Ultrasound alone or associated with microbubbles decreased the number of rolling and adhered leukocytes in the ischemia-reperfusion and hyperinsulinemia and hyperglycemia groups and increased venular diameter in the ischemia-reperfusion group. CONCLUSION: The use of ultrasound decreases inflammation. Although it has not been established that pseudo-anaphylaxis can be assessed by intravital microscopy, microbubble administration does not increase venular leukocyte adhesion.