Browsing by Author "Soto, Nestor"

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    Case report: psoriasis relapse following adrenalectomy for cushing syndrome
    (2011) Achurra Tirado, Pablo; Eugenin Soto, María Ignacia; Orlandini Sánchez, Elisa Javiera; Soto, Nestor; García-huidobro Munita, Diego Nicolás
    The relapse of autoimmune diseases following resolution of Cushing syndrome (CS) has been established with frequency, especially for thyroid disease. We present the case of a 39-year-old woman with a history of psoriasis vulgaris, with no other comorbidities. She presented a one-year of weight gain, high blood pressure, hypermenorrhea, pre-diabetes and dyslipidemia. During this period of time, the complete remission of psoriatic lesions was confirmed. The laboratory analysis demonstrated elevated free urinary cortisol in two opportunities, and a confirmatory low-dose dexamethasone test. Low ACTH levels were established (12,3pg/ml), and the abdominal images where compatible with a right adrenal adenoma of 3,0 x 2,3 cm, so the patient underwent a laparoscopic right adrenalectomy with no complications. Her blood pressure, glucose and cholesterol levels improved following surgery. One month after surgery the patient developed new, generalized psoriatic plaques. The excess of glucocorticoids produced by the adrenal tumor could have controlled the immunopathogeny of psoriasis. By removing the tumor, with the consequent reduction of cortisol levels, a more severe relapse of her cutaneous disease occurred.
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    Second Consensus of the Chilean Society of Endocrinology and Diabetes about insulin resistance
    (SOC MEDICA SANTIAGO, 2015) Pollak, Felipe; Araya, Veronica; Lanas, Alejandra; Sapunar, Jorge; Arrese, Marco; Gloria Aylwin, Carmen; Gloria Bezanilla, Carmen; Carrasco, Elena; Carrasco, Fernando; Codner, Ethel; Diaz, Erik; Durruty, Pilar; Galgani, Jose; Garcia, Hernan; Lahsen, Rodolfo; Liberman, Claudio; Lopez, Gloria; Maiz, Alberto; Mujica, Veronica; Poniachik, Jaime; Sir, Teresa; Soto, Nestor; Valderas, Juan; Villaseca, Paulina; Zavala, Carlos
    Insulin resistance is a prevalent condition commonly associated with unhealthy lifestyles. It affects several metabolic pathways, increasing risk of abnormalities at different organ levels. Thus, diverse medical specialties should be involved in its diagnosis and treatment. With the purpose of unifying criteria about this condition, a scientific-based consensus was elaborated. A questionnaire including the most important topics such as cardio-metabolic risk, non-alcoholic fatty liver disease and polycystic ovary syndrome, was designed and sent to national experts. When no agreement among them was achieved, the Delphi methodology was applied. The main conclusions reached are that clinical findings are critical for the diagnosis of insulin resistance, not being necessary blood testing. Acquisition of a healthy lifestyle is the most important therapeutic tool. Insulin-sensitizing drugs should be prescribed to individuals at high risk of disease according to clinically validated outcomes. There are specific recommendations for pregnant women, children, adolescents and older people.