Browsing by Author "Mosso, Lorena"

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    11 beta-hydroxysteroid dehydrogenase type-2 and type-1 (11 beta-HSD2 and 11 beta-HSD1) and 5 beta-reductase activities in the pathogenia of essential hypertension
    (HUMANA PRESS INC, 2010) Campino, Carmen; Carvajal, Cristian A.; Cornejo, Javiera; San Martin, Betty; Olivieri, Oliviero; Guidi, Giancesare; Faccini, Giovanni; Pasini, Francesco; Sateler, Javiera; Baudrand, Rene; Mosso, Lorena; Owen, Gareth I.; Kalergis, Alexis M.; Padilla, Oslando; Fardella, Carlos E.
    Cortisol availability is modulated by several enzymes: 11 beta-HSD2, which transforms cortisol (F) to cortisone (E) and 11 beta-HSD1 which predominantly converts inactive E to active F. Additionally, the A-ring reductases (5 alpha- and 5 beta-reductase) inactivate cortisol (together with 3 alpha-HSD) to tetrahydrometabolites: 5 alpha THF, 5 beta THF, and THE. The aim was to assess 11 beta-HSD2, 11 beta-HSD1, and 5 beta-reductase activity in hypertensive patients. Free urinary F, E, THF, and THE were measured by HPLC-MS/MS in 102 essential hypertensive patients and 18 normotensive controls. 11 beta-HSD2 enzyme activity was estimated by the F/E ratio, the activity of 11 beta-HSD1 in compare to 11 beta-HSD2 was inferred by the (5 alpha THF + 5 beta THF)/THE ratio and 5 beta-reductase activity assessed using the E/THE ratio. Activity was considered altered when respective ratios exceeded the maximum value observed in the normotensive controls. A 15.7% of patients presented high F/E ratio suggesting a deficit of 11 beta-HSD2 activity. Of the remaining 86 hypertensive patients, two possessed high (5 alpha THF + 5 beta THF)/THE ratios and 12.8% had high E/THE ratios. We observed a high percentage of alterations in cortisol metabolism at pre-receptor level in hypertensive patients, previously misclassified as essential. 11 beta-HSD2 and 5 beta-reductase decreased activity and imbalance of 11 beta-HSDs should be considered in the future management of hypertensive patients.
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    An Ultrasound Model to Discriminate the Risk of Thyroid Carcinoma
    (ELSEVIER SCIENCE INC, 2011) Miguel Dominguez, Jose; Baudrand, Rene; Cerda, Jaime; Campusano, Claudia; Fardella, Carlos; Arteaga, Eugenio; Cruz, Francisco; Solar, Antonieta; Arias, Tatiana; Mosso, Lorena
    Rationale and Objectives: Thyroid nodules are common on ultrasonographic examination and are mostly benign. Ultrasound characteristics may help discriminate thyroid carcinoma (TC) from benign nodules. The aims of this study. were to identify ultrasonographic characteristics associated with IC and to validate a previously proposed model based on the presence of three ultrasonographic characteristics.,
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    Association between maternal thyroid function and risk of gestational hypertension and pre-eclampsia: a systematic review and individual-participant data meta-analysis
    (2022) Toloza, Freddy J. K.; Derakhshan, Arash; Mannisto, Tuija; Bliddal, Sofie; Popova, Polina, V; Carty, David M.; Chen, Liangmiao; Taylor, Peter; Mosso, Lorena; Oken, Emily; Suvanto, Eila; Itoh, Sachiko; Kishi, Reiko; Bassols, Judit; Auvinen, Juha; Lopez-Bermejo, Abel; Brown, Suzanne J.; Boucai, Laura; Hisada, Aya; Yoshinaga, Jun; Shilova, Ekaterina; Grineva, Elena N.; Vrijkotte, Tanja G. M.; Sunyer, Jordi; Jimenez-Zabala, Ana; Riano-Galan, Isolina; Lopez-Espinosa, Maria-Jose; Prokop, Larry J.; Ospina, Naykky Singh; Brito, Juan P.; Rodriguez-Gutierrez, Rene; Alexander, Erik K.; Chaker, Layal; Pearce, Elizabeth N.; Peeters, Robin P.; Feldt-Rasmussen, Ulla; Guxens, Monica; Chatzi, Leda; Delles, Christian; van Lennep, Jeanine E. Roeters; Pop, Victor J. M.; Lu, Xuemian; Walsh, John P.; Nelson, Scott M.; Korevaar, Tim I. M.; Maraka, Spyridoula
    Background Adequate maternal thyroid function is important for an uncomplicated pregnancy. Although multiple observational studies have evaluated the association between thyroid dysfunction and hypertensive disorders of pregnancy, the methods and definitions of abnormalities in thyroid function tests were heterogeneous, and the results were conflicting. We aimed to examine the association between abnormalities in thyroid function tests and risk of gestational hypertension and pre-eclampsia. Methods In this systematic review and meta-analysis of individual-participant data, we searched MEDLINE (Ovid), Embase, Scopus, and the Cochrane Database of Systematic Reviews from date of inception to Dec 27, 2019, for prospective cohort studies with data on maternal concentrations of thyroid-stimulating hormone (TSH), free thyroxine (FT4), thyroid peroxidase (TPO) antibodies, individually or in combination, as well as on gestational hypertension, pre-eclampsia, or both. We issued open invitations to study authors to participate in the Consortium on Thyroid and Pregnancy and to share the individual-participant data. We excluded participants who had pre-existing thyroid disease or multifetal pregnancy, or were taking medications that affect thyroid function. The primary outcomes were documented gestational hypertension and pre-eclampsia. Individual-participant data were analysed using logistic mixed-effects regression models adjusting for maternal age, BMI, smoking, parity, ethnicity, and gestational age at blood sampling. The study protocol was registered with PROSPERO, CRD42019128585. Findings We identified 1539 published studies, of which 33 cohorts met the inclusion criteria and 19 cohorts were included after the authors agreed to participate. Our study population comprised 46 528 pregnant women, of whom 39 826 (85.6%) women had sufficient data (TSH and FT4 concentrations and TPO antibody status) to be classified according to their thyroid function status. Of these women, 1275 (3.2%) had subclinical hypothyroidism, 933 (2.3%) had isolated hypothyroxinaemia, 619 (1.6%) had subclinical hyperthyroidism, and 337 (0.8%) had overt hyperthyroidism. Compared with euthyroidism, subclinical hypothyroidism was associated with a higher risk of pre-eclampsia (2.1% vs 3.6%; OR 1.53 [95% CI 1.09-2.15]). Subclinical hyperthyroidism, isolated hypothyroxinaemia, or TPO antibody positivity were not associated with gestational hypertension or pre-eclampsia. In continuous analyses, both a higher and a lower TSH concentration were associated with a higher risk of pre-eclampsia (p=0.0001). FT4 concentrations were not associated with the outcomes measured. Interpretation Compared with euthyroidism, subclinical hypothyroidism during pregnancy was associated with a higher risk of pre-eclampsia. There was a U-shaped association of TSH with pre-eclampsia. These results quantify the risks of gestational hypertension or pre-eclampsia in women with thyroid function test abnormalities, adding to the total body of evidence on the risk of adverse maternal and fetal outcomes of thyroid dysfunction during pregnancy. These findings have potential implications for defining the optimal treatment target in women treated with levothyroxine during pregnancy, which needs to be assessed in future interventional studies. Copyright (C) 2022 Elsevier Ltd. All righst reserved.
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    Association of maternal thyroid function with birthweight: a systematic review and individual-participant data meta-analysis
    (2020) Derakhshan, Arash; Peeters, Robin P.; Taylor, Peter N.; Bliddal, Sofie; Carty, David M.; Meems, Margreet; Vaidya, Bijay; Chen, Liangmiao; Knight, Bridget A.; Ghafoor, Farkhanda; Popova, Polina V.; Mosso, Lorena; Oken, Emily; Suvanto, Eila; Hisada, Aya; Yoshinaga, Jun; Brown, Suzanne J.; Bassols, Judit; Auvinen, Juha; Bramer, Wichor M.; Lopez-Bermejo, Abel; Dayan, Colin M.; French, Robert; Boucai, Laura; Vafeiadi, Marina; Grineva, Elena N.; Pop, Victor J. M.; Vrijkotte, Tanja G.; Chatzi, Leda; Sunyer, Jordi; Jimenez-Zabala, Ana; Riano, Isolina; Rebagliato, Marisa; Lu, Xuemian; Pirzada, Amna; Mannisto, Tuija; Delles, Christian; Feldt-Rasmussen, Ulla; Alexander, Erik K.; Nelson, Scott M.; Chaker, Layal; Pearce, Elizabeth N.; Guxens, Monica; Steegers, Eric A. P.; Walsh, John P.; Korevaar, Tim I. M.
    Background Adequate transplacental passage of maternal thyroid hormone is important for normal fetal growth and development. Maternal overt hypothyroidism and hyperthyroidism are associated with low birthweight, but important knowledge gaps remain regarding the effect of subclinical thyroid function test abnormalities on birthweight-both in general and during the late second and third trimester of pregnancy. The aim of this study was to examine associations of maternal thyroid function with birthweight.
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    Comparison of confirmatory tests for the diagnosis of primary aldosteronism
    (ENDOCRINE SOC, 2006) Mulatero, Paolo; Milan, Alberto; Fallo, Francesco; Regolisti, Giuseppe; Pizzolo, Francesca; Fardella, Carlos; Mosso, Lorena; Marafetti, Lisa; Veglio, Franco; Maccario, Mauro
    Context: Primary aldosteronism (PA) is the most frequent form of secondary hypertension, accounting for up to 5-10% of all hypertensive patients, and the diagnosis of PA can present an important challenge for the clinician. After a positive screening test, the diagnosis is confirmed by a suppression test, often an iv saline load test (SLT) or a fludrocortisone suppression test (FST). The FST is considered by many to be the most reliable but is more complex and expensive.
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    Study and management of thyroid nodes by non specialist physicians: SOCHED consensus
    (SOC MEDICA SANTIAGO, 2017) Tala, Hernan; Diaz, Rene E.; Dominguez Ruiz Tagle, Jose Miguel; Sapunar Zenteno, Jorge; Pineda, Pedro; Arroyo Albala, Patricia; Barberan, Marcela; Cabane, Patricio; Cruz Olivos, Francisco; Patricio Gac, E.; Glasinovic Pizarro, Andrea; Gonzalez, Hernan E.; Grob, Francisca; Hidalgo Valle, Maria Soledad; Jaimovich, Rodrigo; Lanas, Alejandra; Liberman, Claudio; Lobo Guinez, Maite; Madrid, Arturo; Moreno Seguel, Marcela; Mosso, Lorena; Fernando Munizaga, C.; Ortiz Parada, Eugenia; Osorio Gonnet, Fernando; Slater Morales, Jeannie; Solar, Antonieta; Stehr, Carlos; Vasquez Rodriguez, Felix; Veliz, Jesus; Villaseca Najarian, Roberto; Wohllk, Nelson
    The thyroid nodule is a frequent cause of primary care consultation. The prevalence of a palpable thyroid nodule is approximately 4-7%, increasing up to 67% by the incidental detection of nodules on ultrasound. The vast majority are benign and asymptomatic, staying stable over time. The clinical importance of studying a thyroid nodule is to exclude thyroid cancer, which occurs in 5 to 10% of the nodules. The Board of SOCHED (Chilean Society of Endocrinology and Diabetes) asked the Thyroid Study Group to develop a consensus regarding the diagnostic management of the thyroid nodule in Chile, aimed at non-specialist physicians and adapted to the national reality. To this end, a multidisciplinary group of 31 experts was established among university academics, active researchers with publications on the subject and prominent members of scientific societies of endocrinology, head and neck surgery, pathology and radiology. A total of 14 questions were developed with key aspects for the diagnosis and subsequent referral of patients with thyroid nodules, which were addressed by the participants. In those areas where the evidence was insufficient or the national reality had to be considered, the consensus opinion of the experts was used through the Delphi methodology. The consensus was approved by the SOCHED board for publication.
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    Two Decades of Thyroid Nodule Cytology in Children: Malignancy Risk Assessment at a Tertiary Care Center
    (2024) Pino, Consuelo; Dominguez, Jose Miguel; Solar, Antonieta; Zoroquiain, Pablo; Cruz, Francisco; Garcia, Cristian; De Barbieri, Florencia; Mosso, Lorena; Lustig, Nicole; Gonzalez, Hernan; Leon, Augusto; Goni, Ignacio; Contreras, Andy; Grob, Francisca
    Introduction: Pediatric thyroid nodules exhibit higher malignancy rates compared to adults and are associated with increased incidences of metastases and recurrences. The American Thyroid Association recommends surgery for indeterminate thyroid biopsies in children based on these higher malignancy risks, though this approach may lead to overtreatment. However, there remains a lack of comprehensive pediatric data to inform clinical decisions. This study examines the risk of malignancy (ROM) in pediatric thyroid nodules using the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) and assesses the diagnostic accuracy of fine-needle aspiration (FNA) biopsy compared to histological outcomes. Methods: A retrospective cross-sectional analysis was performed on patients under 19 years with thyroid nodules who underwent FNA and thyroidectomy at a tertiary care center. The sensitivity, specificity, positive predictive value, negative predictive value, and ROM of cytological biopsies were evaluated using TBSRTC criteria, with histology serving as the gold standard. Two analyses were conducted to assess diagnostic accuracy: (a) TBSRTC II as negative and TBSRTC VI as positive and (b) TBSRTC II as negative with TBSRTC V and VI as positive. For neoplasia detection, TBSRTC II was deemed negative, while TBSRTC IV, V, and VI were considered positive. TBSRTC categories III and I were excluded from the performance analysis and evaluated separately. Follicular neoplasm or lesions suspicious for follicular neoplasm (FN/SFN) were treated as positive outcomes, correlated with the presence of adenoma or carcinoma in the surgical specimen. Results: Of 75 nodules from 73 patients, 28 (37.3%) were benign and 47 (62.6%) malignant. No significant differences in gender or age were noted between groups. The ROM in each TBSRTC was Bethesda I 0/2, 0%; II 0/13, 0%; III 2/7, 29%: IV 6/14, 43%; V 10/10, 100%, and VI 29/29, 100%. A sensitivity of 78.38% and specificity of 100% for FNA in detecting malignancy was found, with an even higher sensitivity (100%) for detecting neoplasia in TBSRTC IV. Conclusions: This study reveals that indeterminate thyroid nodules in pediatric patients exhibit a higher rate of malignancy compared to adults, yet align with rates previously reported in the pediatric population. These findings highlight the critical need for guidelines tailored specifically to the management of thyroid nodules and thyroid cancer in children.
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    Urinary free cortisol is not a biochemical marker of hypertension
    (OXFORD UNIV PRESS, 2007) Krall, Paola; Carvajal, Cristian; Ortiz, Eugenia; Munoz, Carlos; Garrido, Lose Luis; Mosso, Lorena; Fardella, Carlos
    Background: Increasing evidence suggests that glucocorticoids might play a role in blood pressure (BP) control. These reports show that cortisol (F) can increase the BP acting on the mineralocorticoid receptor in kidney, brain, heart, and blood vessel. The aim of this study was to evaluate the effects of F in the renal salt and water reabsorption in essential hypertensive patients (EH).