Publications by authors named "Luis A Ramirez-Stieben"

Background: There are age- and sex-related increases in the prevalence of osteoporosis. Bone densitometry based on dual energy X-ray absorptiometry (DXA) is the gold standard for the assessment of bone mineral density (BMD). Three-dimensional (3D) analysis of the proximal femur (3D-DXA) allows discrimination between cortical and trabecular compartments, and it has shown a good correlation with computed tomography.

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Metastases to the thyroid gland from nonthyroidal malignant tumors are rare but significant. They are often asymptomatic, indicating advanced-stage primary tumors and poor prognosis. Although infrequently, breast cancer (BC) can metastasize to the thyroid gland.

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Primary hyperparathyroidism (PHPT) is characterized by elevated levels of calcium and parathyroid hormone (PTH). However, the interpretation of diagnostic tests, such as serum calcium and PTH levels, is complex in pregnant women. The aim of this report is to present a case of PHTP in a pregnant adolescent, with a special emphasis on an uncommon complication, as well as diagnostic and treatment strategies.

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Article Synopsis
  • A study in La Pampa from 2021-2022 found that 9.6% of newborns had nTSH levels ≥ 5 mIU/L, with higher rates in males and term infants.
  • This prevalence reflects a mild iodine deficiency in La Pampa, which is notably higher than findings from a similar study conducted 20 years ago.
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Objective: Primary hyperparathyroidism (PHPT) and celiac disease (CD) are two distinct medical conditions that can affect bone health. While PHPT leads to excessive calcium levels and bone abnormalities, CD impairs calcium and vitamin D absorption due to small intestine damage.

Case Report: We present a case of a 49-year-old woman diagnosed with osteoporosis who was found to have both PHPT and CD.

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Hyperparathyroidism-induced hypercalcemic crisis (HIHC) is an unusual state of marked progressive primary hyperparathyroidism (PHPT). Patients have severe hypercalcemia and may have severe symptoms such as kidney failure, acute pancreatitis, and mental changes. PHPT is due to the presence of a single gland adenoma/ disease in 80 to 85%; parathyroid carcinoma is reported in <1%.

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Desmoid-type fibromatosis (DF) is a rare monoclonal, fibroblastic proliferation characterized by an unpredictable and variable clinical course. We present the case of a 56-year-old woman who underwent total thyroidectomy for papillary thyroid carcinoma in 2012 and who developed a cervical mass at the left laterocervical level during follow-up, raising the diagnosis of tumor recurrence. Computed tomography of the neck showed solid formations with heterogeneous contrast uptake in the right lateral region of the neck.

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Hypothyroidism can usually be treated effectively with oral levothyroxine (LT-4) supplementation. However, hypothyroidism refractory to treatment with LT-4 is a common clinical condition. Causes include poor compliance, interactions with food or other medications, and gastrointestinal diseases, such as inflammatory bowel disease and short bowel syndromes.

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Background: Home confinement policies during the COVID-19 pandemic limited sun exposure and may have influenced on vitamin D levels.

Objective: To assess changes in 25(OH)D during the COVID-19 pandemic and the impact of Mandatory Preventive Social Isolation (MPSI) on UV radiation recommended dose modified by clouds for the synthesis of vitamin D (UVDVC).

Material And Methods: A retrospective study was carried out on 15,908 patients in whom the level of 25(OH)D was determined between January 2019 and December 2021 in a centralized laboratory in Rosario, Argentina.

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Guidelines suggest a thyrotropin (TSH) stimulation level ≥30 mIU/l for the administration of 131-iodine (I131) in patients with differentiated thyroid carcinoma (DTC). We present a patient with follicular thyroid carcinoma (FTC), with spinal metastasis as the initial manifestation, who after 6 weeks without levothyroxine did not present an elevation of ≥30 mIU/l of TSH. This situation was interpreted as secondary to the presence of functioning metastases and it was decided, regardless of the TSH level, to administer a therapeutic dose of I131, with iodine-uptake lesions in the liver and spine being confirmed.

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Objective. To provide a framework for healthcare professionals managing pediatric patients who are on active glucocorticoid (GC) therapy and to develop recommendations for the prevention and treatment of GC-induced osteoporosis in the pediatric population. Methods.

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Article Synopsis
  • * A working group of experts from Argentina conducted systematic reviews, finding that many clinical trials did not specify BMD thresholds, while patients' T-scores mostly ranged from -1.6 to -2.0.
  • * The expert panel agreed that a T-score of ≤-1.7 is the most suitable threshold for treatment in postmenopausal women and men over 50 on GC therapy, although other fracture risk factors should also be considered.
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Article Synopsis
  • The study aimed to create a framework for healthcare professionals to effectively prevent and treat glucocorticoid-induced osteoporosis (GIO) in postmenopausal women and men aged 50 or older who are undergoing glucocorticoid therapy.
  • The expert panel employed a structured approach (PICO) and used GRADE methodology for a systematic literature review, producing 17 recommendations and 8 general principles for evaluating and treating patients at risk of GIO.
  • The guidelines emphasize the importance of monitoring bone health, managing lifestyle factors, and preventing fragility fractures, with the ultimate goal of maintaining or improving bone mineral density in affected patients.*
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Introduction: Levothyroxine (LT4) has been considered the standard of care for treatment of hypothyroidism. Current recommendations suggest a LT4 dose between 1.6-1.

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Introduction: Diabetic ketoacidosis (DKA) is a life-threatening complication characterized by hyperglycemia, metabolic acidosis, and ketonemia. Although the time to resolution of DKA has been estimated at 12 to 18 hours, the factors that could prolong it have not been fully studied.

Methods: Retrospective study of medical records of adult patients admitted to the general ward with a diagnosis of DKA.

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Introduction: Several studies reported than vitamin D deficiency increases the risk of macrovascular and microvascular disease in patients with type 2 diabetes (T2DM). We investigated the plasma levels of 25OHD in adult patients T2DM, risk factors for 25OHD deficiency and the relationship between 25OHD, glycemic control and chronic complications of T2DM.

Methods: A cross-sectional study was carried out, in which 25OHD levels were evaluated in adult patients (over 18 years) with T2DM.

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Introduction: Although, it is generally held that the levothyroxine (LT4) dose tends to decrease with age, this theory remains controversial. Our objective was to assess whether the LT4 dose required to achieve euthyroid status varies according to age, body weight (BW), sex, menopausal status, or antibody status.

Materials And Methods: A cross-sectional study was performed from the retrospective review of the charts of patients with a previous diagnosis of primary hypothyroidism in treatment with LT4 and in a euthyroid state.

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Introduction: Although, it is generally held that the levothyroxine (LT4) dose tends to decrease with age, this theory remains controversial. Our objective was to assess whether the LT4 dose required to achieve euthyroid status varies according to age, body weight (BW), sex, menopausal status, or antibody status.

Materials And Methods: A cross-sectional study was performed from the retrospective review of the charts of patients with a previous diagnosis of primary hypothyroidism in treatment with LT4 and in a euthyroid state.

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