IVONNE ALEJANDRA MEZA CABRERA - Academia.edu (original) (raw)

Uploads

Papers by IVONNE ALEJANDRA MEZA CABRERA

Toxins, 2021

Among other scorpion species, Colombia has two genera of the Buthidae family Centruroides and Tit... more Among other scorpion species, Colombia has two genera of the Buthidae family Centruroides and Tityus, considered to be dangerous to humans. This research shares scientific knowledge aiming to a better understanding about the pathophysiological effects of such venoms. The venom of the three species: Centruroides margaritarus, Tityus pachyurus, and T. n. sp. aff. metuendus with biomedical interest were studied. An initial pre-glycemic sample was taken from ICR mice. They were later intraperitoneally inoculated with doses of 35% and 70% of LD50 of total venom. Poisoning signs were observed during a 6-h period to determine the level of scorpionism. After observation, a second glycemic sample was taken, and a histopathological evaluation of different organs was performed. This work revealed that all three venoms showed considerably notorious histopathological alterations in main organs such as heart and lungs; and inducing multiple organ failure, in relation to the glycemia values, only ...

Acta Médica Colombiana, 2019

preSentAción de cASoS Resumen El carcinoma de células ecrinas constituye un grupo de neoplasias r... more preSentAción de cASoS Resumen El carcinoma de células ecrinas constituye un grupo de neoplasias raras de la piel, de crecimiento lento pero altamente invasor. Se presenta un caso de lesiones cutáneas múltiples con compromiso multifocal que concluye con la documentación histopatológica de esta condición. (Acta Med Colomb 2019; 44.

Thyroid Research, 2017

Background: Thyroid nodule is a common disorder of the thyroid. Despite their benign nature, they... more Background: Thyroid nodule is a common disorder of the thyroid. Despite their benign nature, they can be associated with multiple pathologic conditions, including thyroid cancer. Methods: This cross-sectional study determined the concordance of Ultrasound (TIRADS criteria) and Fine Needle Aspiration Biopsy (FNA-BETHESDA system) in the assessment of the nontoxic thyroid nodule. A total of 180 subjects 18 years old or older underwent the two diagnostic tests and their results were compared using kappa index. Results: Participants were mostly women, with average age of 57 years. The frequency of BETHESDA II was 65/180 versus 45/180 in TIRADS 2. In contrast, the highest frequency in category 4-IV was 62/180 for TIRADS 4 versus 41/ 180 for BETHESDA IV. The highest concordance was found among the category 2-II classification. The observed agreement was 87.2% with a linear weighted kappa of 0.69 (95% CI: 0.59-0.79). The heterogeneity analysis showed a trend towards a higher weighted kappa value in nodules ≥4 cm in males and individuals aged ≥50 years, with accelerated nodular growth, binding to adjacent structures, vocal folds paralysis, urban origin, and a history of head and neck radiation therapy. Conclusions: The TIRADS criteria has a good concordance with the Bethesda system. The ultrasound findings of benign pathology are aligned with the cytology results. The correct interpretation of the two findings helps the clinician to reduce the risk of unnecessary invasive procedures in patients with a low probability of presenting thyroid cancer, while facilitating the identification of patients at higher risk of cancer.

Revista Medicina, May 17, 2014

RESUMEN Se realizo una revision narrativa rigurosa de la literatura inglesa y en espanol sobre di... more RESUMEN Se realizo una revision narrativa rigurosa de la literatura inglesa y en espanol sobre diferentes aspectos de la Enfermedad de Graves-Basedow e hipertiroidismo. Esta patologia –parte de la llamada “enfermedad tiroidea autoinmune”- se produce como consecuencia de la presencia de anticuerpos circulantes que se unen y activan al receptor de tirotropina, desencadenandose generalmente el hipertiroidismo en asociacion con un estres agudo. En este articulo actualizamos tanto el manejo de hipertiroidismo como el de problemas especiales con el que puede estar asociado. La fisiopatologia y el diagnostico de la Enfermedad de Graves-Basedow son motivo de otra publicacion. Palabras clave: Hipertiroidismo, bocio, TSH, oftalmopatia, dermopatia, yodo radioactivo, tionamidas, tiroides. TREATMENT OF GRAVES-BASEDOW´ S DISEASE ABSTRACT A narrative review with systematic methodology of English and Spanish literature on different aspects concerning Graves-Basedow’s disease was carried out. This is one of the pathologies seen in the socalled “autoimmune thyroid disease”, it is associated with presence of thyrotropin-receptor antibodies and is usually triggered by an acute stressful event. We update in this paper the management of hyperthyroidism and of some special associated problems, while the subject of physiopathology and diagnosis of Graves-Basedow is a matter of discussion in another publication. Key words: Hyperthyroidism, goiter, TSH, ophtalmopathy, dermopathy, radioactive iodine, thyonamides, thyroid.

Thyroid Disorders, 2016

Autoimmune thyroid disease is the most common organ-specific autoimmune disorder affecting 2–5 % ... more Autoimmune thyroid disease is the most common organ-specific autoimmune disorder affecting 2–5 % of the population in Western countries. Graves-Basedow disease is the most frequent form of hyperthyroidism in iodine sufficient countries; while the exact etiology of thyroid autoimmunity is not known, interaction between genetic susceptibility and environmental factors appears to be of fundamental importance to initiate the process of thyroid autoimmunity. The identified autoimmune thyroid disease susceptibility genes include immune-modulating genes, such as the Major Histocompatibility Complex, Cytotoxic T Lymphocyte Antigen-4, CD40 molecule, Protein Tyrosine Phosphatase-22, TSH receptor and Thyroglobulin. The exact nature of the role environmental factors play in Graves-Basedow disease is still not well known, but the involvement of several factors such as: iodine diet, drugs, stress, and infections has been reported. In Graves-Basedow disease the lymphocytic infiltration of the thyroid leads to activation of TSH Receptor (TSHR)-reactive B-cells that secrete TSHR stimulating antibodies causing hyperthyroidism. These antibodies bind to TSH receptors on the surface of thyroid follicular cells, leading to continuous and uncontrolled thyroid stimulation, associated with excess synthesis of the thyroid hormones T4 and T3, and thyroid hypertrophy. Graves-Basedow disease includes thyrotoxicosis, goiter, exophthalmos, and pretibial myxedema when fully expressed, but can occur with one or more of these features.

Thyroid, 2013

Background: Ectopic thyroid tissue is usually found anywhere along the embryonic descent pathway ... more Background: Ectopic thyroid tissue is usually found anywhere along the embryonic descent pathway of the medial thyroid anlage from the tongue to the trachea (Wö lfler area). However, ectopic thyroid tissue in the adrenal gland (ETTAG) is not easy to understand on the basis of thyroid embryology; because it is so rare, the possibility of metastasis should first be considered. Here, we describe two cases of ETTAG with pathogenetic implications and review the associated literature. Patient findings: Two cases of ETTAG presented as incidental cystic adrenal masses in adult females, one having a congenital hernia of Morgagni. The ETTAG was histologically indistinguishable from normal orthotopic thyroid tissue, and its follicular nature was confirmed by immunohistochemical positivity for thyroglobulin, thyroperoxidase, thyroid transcription factor-1 (TTF-1/Titf-1/Nkx2.1), cytokeratin AE1/AE3, cytokeratin 7, pendrin, human sodium iodide symporter, paired box gene 8, and forkhead box E1 (TTF-2), as well as positivity for the messenger RNA of the thyroglobulin gene by in situ hybridization analysis. No C cells (negativity for calcitonin, chromogranin, and synaptophysin) were present. Neither BRAF nor KRAS mutations were detected with real-time polymerase chain reaction analysis. Further work-up did not show evidence of thyroid malignancy. Summary: ETTAG is a rare finding, with only seven cases reported; women are much more frequently affected than men (8:1), and it usually presents in the fifth decade (mean age 54, range 38-67) as a cystic adrenal mass incidentally discovered on abdominal ultrasonography and/or in computed tomography images. ETTAG is composed of normal follicular cells without C cells. The expression of some transcription factors (TTF-1, paired box gene 8, and FOXE1) involved in development and/or migration of the medial thyroid anlage is preserved. Coexistence of a congenital hernia of Morgagni in one patient suggests an overdescent of medial thyroid anlagederived cells in its pathogenesis. Conclusion: Although ETTAG pathogenesis remains unknown, the lack of C cells together with the coexistence of a congenital defect of the anterior diaphragm (hernia of Morgagni) in one of our patients could suggest an overdescent of medial thyroid anlage-derived cells in the origin of this heterotopia.

Revista Medicina, Mar 5, 2013

A strict narrative review of english and spanish literature on different aspects concerning Grave... more A strict narrative review of english and spanish literature on different aspects concerning Graves-Basedow´s Disease-cause of about 80% of cases of hyperthyroidism-was carried out. This is one of the pathologies seen in the so-called "autoimmune thyroid disease", it is associated with presence of thyrotropin-receptor antibodies and is usually triggered by an acute stressful event. We describe the methodology used to structure this State-of-the Art paper of diffuse toxic goiter seen in adult patients, in relation to historical information, physiopathology and diagnosis of Graves-Basedow´s Disease, either physical or by imagenology, pathology and laboratory. Management of hyperthyroidism and of some special associated problems is matter of discussion in another publication.

Toxins, 2021

Among other scorpion species, Colombia has two genera of the Buthidae family Centruroides and Tit... more Among other scorpion species, Colombia has two genera of the Buthidae family Centruroides and Tityus, considered to be dangerous to humans. This research shares scientific knowledge aiming to a better understanding about the pathophysiological effects of such venoms. The venom of the three species: Centruroides margaritarus, Tityus pachyurus, and T. n. sp. aff. metuendus with biomedical interest were studied. An initial pre-glycemic sample was taken from ICR mice. They were later intraperitoneally inoculated with doses of 35% and 70% of LD50 of total venom. Poisoning signs were observed during a 6-h period to determine the level of scorpionism. After observation, a second glycemic sample was taken, and a histopathological evaluation of different organs was performed. This work revealed that all three venoms showed considerably notorious histopathological alterations in main organs such as heart and lungs; and inducing multiple organ failure, in relation to the glycemia values, only ...

Acta Médica Colombiana, 2019

preSentAción de cASoS Resumen El carcinoma de células ecrinas constituye un grupo de neoplasias r... more preSentAción de cASoS Resumen El carcinoma de células ecrinas constituye un grupo de neoplasias raras de la piel, de crecimiento lento pero altamente invasor. Se presenta un caso de lesiones cutáneas múltiples con compromiso multifocal que concluye con la documentación histopatológica de esta condición. (Acta Med Colomb 2019; 44.

Thyroid Research, 2017

Background: Thyroid nodule is a common disorder of the thyroid. Despite their benign nature, they... more Background: Thyroid nodule is a common disorder of the thyroid. Despite their benign nature, they can be associated with multiple pathologic conditions, including thyroid cancer. Methods: This cross-sectional study determined the concordance of Ultrasound (TIRADS criteria) and Fine Needle Aspiration Biopsy (FNA-BETHESDA system) in the assessment of the nontoxic thyroid nodule. A total of 180 subjects 18 years old or older underwent the two diagnostic tests and their results were compared using kappa index. Results: Participants were mostly women, with average age of 57 years. The frequency of BETHESDA II was 65/180 versus 45/180 in TIRADS 2. In contrast, the highest frequency in category 4-IV was 62/180 for TIRADS 4 versus 41/ 180 for BETHESDA IV. The highest concordance was found among the category 2-II classification. The observed agreement was 87.2% with a linear weighted kappa of 0.69 (95% CI: 0.59-0.79). The heterogeneity analysis showed a trend towards a higher weighted kappa value in nodules ≥4 cm in males and individuals aged ≥50 years, with accelerated nodular growth, binding to adjacent structures, vocal folds paralysis, urban origin, and a history of head and neck radiation therapy. Conclusions: The TIRADS criteria has a good concordance with the Bethesda system. The ultrasound findings of benign pathology are aligned with the cytology results. The correct interpretation of the two findings helps the clinician to reduce the risk of unnecessary invasive procedures in patients with a low probability of presenting thyroid cancer, while facilitating the identification of patients at higher risk of cancer.

Revista Medicina, May 17, 2014

RESUMEN Se realizo una revision narrativa rigurosa de la literatura inglesa y en espanol sobre di... more RESUMEN Se realizo una revision narrativa rigurosa de la literatura inglesa y en espanol sobre diferentes aspectos de la Enfermedad de Graves-Basedow e hipertiroidismo. Esta patologia –parte de la llamada “enfermedad tiroidea autoinmune”- se produce como consecuencia de la presencia de anticuerpos circulantes que se unen y activan al receptor de tirotropina, desencadenandose generalmente el hipertiroidismo en asociacion con un estres agudo. En este articulo actualizamos tanto el manejo de hipertiroidismo como el de problemas especiales con el que puede estar asociado. La fisiopatologia y el diagnostico de la Enfermedad de Graves-Basedow son motivo de otra publicacion. Palabras clave: Hipertiroidismo, bocio, TSH, oftalmopatia, dermopatia, yodo radioactivo, tionamidas, tiroides. TREATMENT OF GRAVES-BASEDOW´ S DISEASE ABSTRACT A narrative review with systematic methodology of English and Spanish literature on different aspects concerning Graves-Basedow’s disease was carried out. This is one of the pathologies seen in the socalled “autoimmune thyroid disease”, it is associated with presence of thyrotropin-receptor antibodies and is usually triggered by an acute stressful event. We update in this paper the management of hyperthyroidism and of some special associated problems, while the subject of physiopathology and diagnosis of Graves-Basedow is a matter of discussion in another publication. Key words: Hyperthyroidism, goiter, TSH, ophtalmopathy, dermopathy, radioactive iodine, thyonamides, thyroid.

Thyroid Disorders, 2016

Autoimmune thyroid disease is the most common organ-specific autoimmune disorder affecting 2–5 % ... more Autoimmune thyroid disease is the most common organ-specific autoimmune disorder affecting 2–5 % of the population in Western countries. Graves-Basedow disease is the most frequent form of hyperthyroidism in iodine sufficient countries; while the exact etiology of thyroid autoimmunity is not known, interaction between genetic susceptibility and environmental factors appears to be of fundamental importance to initiate the process of thyroid autoimmunity. The identified autoimmune thyroid disease susceptibility genes include immune-modulating genes, such as the Major Histocompatibility Complex, Cytotoxic T Lymphocyte Antigen-4, CD40 molecule, Protein Tyrosine Phosphatase-22, TSH receptor and Thyroglobulin. The exact nature of the role environmental factors play in Graves-Basedow disease is still not well known, but the involvement of several factors such as: iodine diet, drugs, stress, and infections has been reported. In Graves-Basedow disease the lymphocytic infiltration of the thyroid leads to activation of TSH Receptor (TSHR)-reactive B-cells that secrete TSHR stimulating antibodies causing hyperthyroidism. These antibodies bind to TSH receptors on the surface of thyroid follicular cells, leading to continuous and uncontrolled thyroid stimulation, associated with excess synthesis of the thyroid hormones T4 and T3, and thyroid hypertrophy. Graves-Basedow disease includes thyrotoxicosis, goiter, exophthalmos, and pretibial myxedema when fully expressed, but can occur with one or more of these features.

Thyroid, 2013

Background: Ectopic thyroid tissue is usually found anywhere along the embryonic descent pathway ... more Background: Ectopic thyroid tissue is usually found anywhere along the embryonic descent pathway of the medial thyroid anlage from the tongue to the trachea (Wö lfler area). However, ectopic thyroid tissue in the adrenal gland (ETTAG) is not easy to understand on the basis of thyroid embryology; because it is so rare, the possibility of metastasis should first be considered. Here, we describe two cases of ETTAG with pathogenetic implications and review the associated literature. Patient findings: Two cases of ETTAG presented as incidental cystic adrenal masses in adult females, one having a congenital hernia of Morgagni. The ETTAG was histologically indistinguishable from normal orthotopic thyroid tissue, and its follicular nature was confirmed by immunohistochemical positivity for thyroglobulin, thyroperoxidase, thyroid transcription factor-1 (TTF-1/Titf-1/Nkx2.1), cytokeratin AE1/AE3, cytokeratin 7, pendrin, human sodium iodide symporter, paired box gene 8, and forkhead box E1 (TTF-2), as well as positivity for the messenger RNA of the thyroglobulin gene by in situ hybridization analysis. No C cells (negativity for calcitonin, chromogranin, and synaptophysin) were present. Neither BRAF nor KRAS mutations were detected with real-time polymerase chain reaction analysis. Further work-up did not show evidence of thyroid malignancy. Summary: ETTAG is a rare finding, with only seven cases reported; women are much more frequently affected than men (8:1), and it usually presents in the fifth decade (mean age 54, range 38-67) as a cystic adrenal mass incidentally discovered on abdominal ultrasonography and/or in computed tomography images. ETTAG is composed of normal follicular cells without C cells. The expression of some transcription factors (TTF-1, paired box gene 8, and FOXE1) involved in development and/or migration of the medial thyroid anlage is preserved. Coexistence of a congenital hernia of Morgagni in one patient suggests an overdescent of medial thyroid anlagederived cells in its pathogenesis. Conclusion: Although ETTAG pathogenesis remains unknown, the lack of C cells together with the coexistence of a congenital defect of the anterior diaphragm (hernia of Morgagni) in one of our patients could suggest an overdescent of medial thyroid anlage-derived cells in the origin of this heterotopia.

Revista Medicina, Mar 5, 2013

A strict narrative review of english and spanish literature on different aspects concerning Grave... more A strict narrative review of english and spanish literature on different aspects concerning Graves-Basedow´s Disease-cause of about 80% of cases of hyperthyroidism-was carried out. This is one of the pathologies seen in the so-called "autoimmune thyroid disease", it is associated with presence of thyrotropin-receptor antibodies and is usually triggered by an acute stressful event. We describe the methodology used to structure this State-of-the Art paper of diffuse toxic goiter seen in adult patients, in relation to historical information, physiopathology and diagnosis of Graves-Basedow´s Disease, either physical or by imagenology, pathology and laboratory. Management of hyperthyroidism and of some special associated problems is matter of discussion in another publication.