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Introducción: El síndrome metabólico (SM) agrupa factores de riesgo para enfermedad cardiovascular. Dentro de estos factores se encuentra la obesidad central, evaluada generalmente a través de la circunferencia de la cintura (CC) Objetivo: Analizar el comportamiento de las distintas variables que agrupan el SM (definición ATP III) en relación a los cambios en la CC. Sujetos: Se incluyeron 253 mujeres que concurrieron al Servicio de Endocrinología. Se evaluaron medidas antropométricas y presión arterial, así como glucemia en ayunas y lipidograma. Las pacientes fueron agrupadas por quintilos por CC: Q1 (56-80 cm), Q2 (80.1-89 cm), Q3 (89.1-96 cm), Q4 (96.1-103 cm) y Q5 (103.1-150 cm. Resultados: Existe una correlación positiva entre la CC y el IMC (p < 0,0001, r: 0,87).Asimismo, se observa una correlación positiva entre la CC y los valores de triglicéridos (p <0,0001, r: 0,28), glucemia (p = 0,0001, r: 0,24), presión arterial (PA) sistólica (p < 0,0001, r: 0,27) y diastólica (p < 0,0007, r: 0,21) y una correlación negativa entre la CC y los niveles de HDL (p < 0,0001, r: -0,25). Conclusiones: A medida que aumenta la CC, aumentan los factores de riesgo cardiovasculares (presión arterial diastólica, glucemia, triglicéridos, descenso del HDL).(AU)

Introduction: Metabolic syndrome (MS) is a group of risk factors for cardiovascular disease. These factors include central obesity, usually assessed through waist circumference (WC). Objective: To analyze the behavior of the different MS variables (ATP III definition) in relation to changes in WC. Subjects: We included 253 women who attended the Service of Endocrinology. We performed anthropometric, blood pressure, fasting glucose and lipid profile measurements. Patients were grouped into quintiles by WC: Q1 (56-80 cm), Q2 (80.1-89 cm), Q3 (89.1-96 cm), Q4 (96.1-103 cm) and Q5 (103.1-150 cm. Results: There is a positive correlation between WC and BMI (p < 0.0001, r = 0.87). In addition, there is a positive correlation between WC and triglyceride levels (p < 0.0001, r: 0.28), glucose (p = 0.0001, r = 0.24), systolic blood pressure (BP) (p < 0.0001, r = 0.27) and diastolic BP (p <0.0007, r: 0.21) and a negative correlation between WC and HDL levels (p < 0.0001, r = -0.25). Conclusions: As WC increases, cardiovascular risk factors (diastolic blood pressure, blood glucose, triglycerides, decreased HDL) increase.(AU)

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Introducción: El síndrome metabólico (SM) agrupa factores de riesgo para enfermedad cardiovascular. Dentro de estos factores se encuentra la obesidad central, evaluada generalmente a través de la circunferencia de la cintura (CC) Objetivo: Analizar el comportamiento de las distintas variables que agrupan el SM (definición ATP III) en relación a los cambios en la CC. Sujetos: Se incluyeron 253 mujeres que concurrieron al Servicio de Endocrinología. Se evaluaron medidas antropométricas y presión arterial, así como glucemia en ayunas y lipidograma. Las pacientes fueron agrupadas por quintilos por CC: Q1 (56-80 cm), Q2 (80.1-89 cm), Q3 (89.1-96 cm), Q4 (96.1-103 cm) y Q5 (103.1-150 cm. Resultados: Existe una correlación positiva entre la CC y el IMC (p < 0,0001, r: 0,87).Asimismo, se observa una correlación positiva entre la CC y los valores de triglicéridos (p <0,0001, r: 0,28), glucemia (p = 0,0001, r: 0,24), presión arterial (PA) sistólica (p < 0,0001, r: 0,27) y diastólica (p < 0,0007, r: 0,21) y una correlación negativa entre la CC y los niveles de HDL (p < 0,0001, r: -0,25). Conclusiones: A medida que aumenta la CC, aumentan los factores de riesgo cardiovasculares (presión arterial diastólica, glucemia, triglicéridos, descenso del HDL).

Introduction: Metabolic syndrome (MS) is a group of risk factors for cardiovascular disease. These factors include central obesity, usually assessed through waist circumference (WC). Objective: To analyze the behavior of the different MS variables (ATP III definition) in relation to changes in WC. Subjects: We included 253 women who attended the Service of Endocrinology. We performed anthropometric, blood pressure, fasting glucose and lipid profile measurements. Patients were grouped into quintiles by WC: Q1 (56-80 cm), Q2 (80.1-89 cm), Q3 (89.1-96 cm), Q4 (96.1-103 cm) and Q5 (103.1-150 cm. Results: There is a positive correlation between WC and BMI (p < 0.0001, r = 0.87). In addition, there is a positive correlation between WC and triglyceride levels (p < 0.0001, r: 0.28), glucose (p = 0.0001, r = 0.24), systolic blood pressure (BP) (p < 0.0001, r = 0.27) and diastolic BP (p <0.0007, r: 0.21) and a negative correlation between WC and HDL levels (p < 0.0001, r = -0.25). Conclusions: As WC increases, cardiovascular risk factors (diastolic blood pressure, blood glucose, triglycerides, decreased HDL) increase.

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Whereas ovarian tumors with overt endocrine manifestations account for less than 5% of all ovarian neoplasms, the incidence of virilizing type tumors in postmenopausal women is even lower since the average age of occurrence is 43 years. Steroid cell tumors not otherwise specified (NOS) are even more rare. We report the case of a 56-year-old woman (age of onset of menopause 43 years) who consulted our service due to a hyperandrogenic syndrome: deepening of the voice, temporal balding, hirsutism and cliteromegaly. Laboratory findings indicated hyperandrogenism in male range. The dexamethasone suppression test did not modify basal values, indicating that adrenal origin was unlikely. Transvaginal ultrasound disclosed multiple microcysts in the left ovary. Abdominal tomography was normal. Suspecting an ovarian tumor, bilateral oophorectomy was performed and a pediculate, 3 cm in diameter, was encountered in the left ovary. Histopathological studies determined it to be a virilizing ovarian tumor NOS. Postoperative recovery was fast; normal hormonal values were reached together with visible clinical improvement. This case is reported because this type of tumor is very infrequent in postmenopausal women, and because in this case it was the functional hormonal test that allowed tumor localization.

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Alterations in peripheral nerves are well documented in overt myxedema but not in subclinical hypothyroidism. We performed electrophysiologic studies to investigate such abnormalities in patients with normal serum total T4 and hyperresponsiveness of TSH to TRH, either with normal or high levels of basal circulating TSH. Subjects were divided in three groups: (i) Hypothyroidism Stage I (group () (n = 17, mean age = 39 +/- 34 years), T4 = 9 +/- 0.7 micrograms/dL, TSH = 4.3 +/- 0.4 microU/mL, sTSH post-TRH (peak value) = 37.6 +/- 1.6 microU/mL; (ii) Hypothyroidism Stage II (group II) (n = 10, mean age: 43 +/- 6 years), T4 = 7.7 +/- 0.8 microgram/dL, TSH = 20 +/- 5 microU/mL, TSH post-TRH > 50 microU/mL; (iii) Control Group (n = 20, mean age 41 +/- 5 years), healthy subjects. All patients and controls were women. TRH test consisted in the i.v. injection of 200 micrograms TRH (normal peak value up to 25 microU/mL, normal basal TSH < 5.5 microU/mL. None of the patients had carpal tunnel syndrome or any other neurological or metabolic disturbances. We studied the distal motor latencies, motor and sensory amplitudes, and nerve conduction velocities. The motor parameters were measured in the median and external sciatic popliteal (ESP) nerves, and the sensory parameters in the median and sural nerves. In most cases values were obtained from both right and left nerves. Motor parameters: no differences were found between all groups for conduction velocities (CV).(ABSTRACT TRUNCATED AT 250 WORDS)

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Psychological changes during hyperthyroidism are well known. However, no studies were performed in order to quantify or evaluate them in numerical details. We have studied the personality of 15 women with Graves' disease by means of the 16PF Cattell Test, before and after treatment of hyperthyroidism with surgery or radioactive iodine. The first test was performed when patients relapsed the thyrotoxicosis after a period of euthyroidism, achieved through the treatment with antithyroid drugs during one year. At the time of the second test all patients had 6-12 months of euthyroidism. Hormonal circulating levels were as follow (mean +/- SEM): a) at the first test, T3 = 320 +/- 27 ng/dl, T4 = 19.7 +/- 1.2 micrograms/dl, TSH < 0.2 microU/ml; b) at the second test, T3 = 128 +/- 9 ng/dl, T4 = 8.8 +/- 0.8 micrograms/dl, TSH = 1.9 +/- 0.4 microU/ml. Differences between both tests were expressed for each factor as the mean difference +/- SEM (paired "t" test). After treatment patients were: 1) more relaxed and emotionally trustful and cooperative (factor A + 1.06 +/- 0.39, p < 0.02); 2) better and faster intellectual comprehension (factor B + 0.80 +/- 0.31, p < 0.05); 3) more capable of analysis (factor Q1 + 0.93 +/- 0.41, p < 0.05); 4) lower in lingering anxiety and tension (factor Q4-0.87 +/- 0.36, p < 0.05); 5) more independent, less submissive (factor QIV + 0.88 +/- 0.41, p < 0.05); 6) more relaxed (factor QI-0.69 +/- 0.20, p < 0.01). The other factors remained unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

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La pielonefritis enfisematosa es una infección del parénquima renal asociada con la producción de gas, el que se localiza en el parénquima renal y puede extenderse al espacio perirrenal. Se presenta el caso de una mujer de 61 años con pielonefritis enfisematosa diabética, con obstrucción ureteral, urocultivo y homocultivo positivos para Escherichia coli, comprobándose en la autopsia alteraciones histológicas que corroboran las características clínicas de enfisema renal y perirrenal, resultando este caso, de especial interés por la bilateralidad de las lesiones. Esta enfermedad es poco frecuente y afecta a pacientes con diabetes mellitus y obstrucción ureteral. La producción de gas se debe a la acción de bacterias anaeróbicas facultativas que fermentan la glucosa y producen ácido láctico y dióxido de carbono. El tratamiento se fundamenta en la reposición hidroelectrolítica, control del estado ácido base, corrección de la descomposición diabética y antibiótico-terapia. Se destacan las ventajas del tratamiento quirúrgico precoz, basado en la nefrectomía y/o en el drenaje del espacio perirrenal

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La pielonefritis enfisematosa es una infección del parénquima renal asociada con la producción de gas, el que se localiza en el parénquima renal y puede extenderse al espacio perirrenal. Se presenta el caso de una mujer de 61 años con pielonefritis enfisematosa diabética, con obstrucción ureteral, urocultivo y homocultivo positivos para Escherichia coli, comprobándose en la autopsia alteraciones histológicas que corroboran las características clínicas de enfisema renal y perirrenal, resultando este caso, de especial interés por la bilateralidad de las lesiones. Esta enfermedad es poco frecuente y afecta a pacientes con diabetes mellitus y obstrucción ureteral. La producción de gas se debe a la acción de bacterias anaeróbicas facultativas que fermentan la glucosa y producen ácido láctico y dióxido de carbono. El tratamiento se fundamenta en la reposición hidroelectrolítica, control del estado ácido base, corrección de la descomposición diabética y antibiótico-terapia. Se destacan las ventajas del tratamiento quirúrgico precoz, basado en la nefrectomía y/o en el drenaje del espacio perirrenal (AU)

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