Isidro Huete - Academia.edu (original) (raw)
Papers by Isidro Huete
Revista chilena de radiología, 2003
... En Noviembre de 1948 participó en la organización del Tercer Congreso Interamericano de Radio... more ... En Noviembre de 1948 participó en la organización del Tercer Congreso Interamericano de Radiología celebrado en Santiago y Viña del ... especializado en 1978-1979 en el Centro Hospitalario Universitario de Caen, Normandía con el Dr. Jacques Theron, discípulo también ...
![Research paper thumbnail of [Prognostic value of granular pattern of growth hormone secreting tumors]](https://attachments.academia-assets.com/81709395/thumbnails/1.jpg)
](BACKGROUND Classification of growth hormone (GH) - secreting tumors by the granular pattern might... more BACKGROUND Classification of growth hormone (GH) - secreting tumors by the granular pattern might predict their clinical behavior in acromegalic patients. There are several other prognostic factors. AIM To compare the features at presentation and cure rates of patients with GH secreting tumors according to the granular pattern, and to define independent prognostic factors for surgical treatment in these patients. MATERIAL AND METHODS A retrospective, observational study of 85 active acromegalic patients surgically treated in two medical centers. RESULTS Seventy-four patients (87%) were classified as having densely granulated (DG) and 11 (13%) as sparsely granulated (SG) tumors. The latter were less active biochemically, had a higher rate of macroadenoma and cavernous sinus invasion and had a lower rate of biochemical cure than the DG group. Several characteristics were associated with disease persistence but only age (Odds ratio (OR) = 0.93) and cavernous sinus invasion (OR = 21.7) ...
Journal of Neurology
ObjectivesTo explore risk factors contributing to 30-day and long-term survival in children with ... more ObjectivesTo explore risk factors contributing to 30-day and long-term survival in children with a first episode of arterial ischemic stroke (AIS).Study designSingle center prospective observational study including 119 children aged between 30 days and 18 years, with a first episode of AIS between 2003 and 2015. Diagnosis was confirmed with magnetic resonance images. Outcomes included 30-day mortality and survival up to 8 years of follow-up. Demographic (e.g., gender, age), clinical (e.g., stroke severity measured by the Pediatric National Institute of Health Stroke Scale (NIHSS), clinical presentation, underlying conditions), radiological (e.g., involved circulation, location), and stroke recurrence data, were used to predict outcomes. Data analyses included logistic and Cox regression multivariate models with Firth’s bias correction.Results30-day mortality was 11.7% (n = 14). A total of 23 (19.3%) children died during the follow-up. 30-day mortality was only predicted by stroke severity (OR = 1.11, 95% CI = 1.02–1.26) in children > 2 years. Survival was predicted by stroke severity (HR = 1.05, 95% CI = 1.01–1.09), congenital heart disease (HR = 3.62, 95% CI = 1.33–10.93), prothrombotic states (HR = 3.51, 95% CI = 1.25–9.32), and anterior plus posterior circulation stroke (HR = 2.43, 95% CI = 1.42–4.61, p 0.026). Stroke recurrence (n= 23; 19.3%) was not a significant predictor of follow-up mortality.ConclusionsThis study identified groups with greater acute and long-term mortality after a first episode of AIS in childhood. Specific interventions focused on these risk groups may decrease mortality rates. Further studies need to confirm our findings by adding children from other centers.
![Research paper thumbnail of [Acute Cerebrovascular events associated to hemolytic uremic syndrome: Description of two pediatric cases]](https://attachments.academia-assets.com/81709444/thumbnails/1.jpg)
](Revista chilena de pediatria, 2017
Diarrhea-associated Hemolytic Uremic Syndrome (D+HUS) is a multisystem disorder in which neurolog... more Diarrhea-associated Hemolytic Uremic Syndrome (D+HUS) is a multisystem disorder in which neurological involvement (35 to 50%) is associated to adverse outcome. An important cause of a permanent neurological impairment is the cerebrovascular pathology. To report two pediatric cases of D+HUS with severe neurological involvement due to cerebrovascular disease, and review available literature. Two previously healthy 15- and 21-month-old children debuted with seizures and impairment of consciousness within the first week of a D+HUS. Both presented hypertension, severe acute renal failure, and focal motor deficit. One child showed significant improvement in neurologic status after five sessions of plasmapheresis. Brain magnetic resonance showed in the first child multiple bilateral infarcts of small vessels and lesions of white matter. In the second patient, large bilateral infarcts on both middle cerebral arteries territories were identified. One year after the acute event, both children...
Revista chilena de cardiología
Introducción: La miopatía y fibrosis auricular representan el sustrato protrombótico y proarrítmi... more Introducción: La miopatía y fibrosis auricular representan el sustrato protrombótico y proarrítmico en pacientes con fibrilación auricular (FA). Estudios recientes muestran relación entre el strain auricular izquierdo (SAI), eventos cardiovasculares y recurrencia en pacientes con FA. La asociación entre SAI y biomarcadores cardíacos como predictores de accidente cerebrovascular silente (ACVs) en pacientes con FA de reciente comienzo (FArc) no ha sido estudiada. Objetivo: Determinar si la asociación entre SAI y biomarcadores cardíacos contribuye a la predicción de ACV en pacientes con FArc.
Traumatic brain injury (TBI) is one of the main causes of death and disability in young adults, w... more Traumatic brain injury (TBI) is one of the main causes of death and disability in young adults, with consequences ranging from physical disabilities to long-term cognitive, behavioural, psychological and social defects. Post-traumatic hypopituitarism (PTHP) was recognized more than 80 years ago, but it was thought to be a rare occurrence. Recently, clinical evidence has demonstrated that TBI may frequently cause hypothalamic-pituitary dysfunction, probably contributing to a delayed or hampered recovery from TBI. Changes in pituitary hormone secretion may be observed during the acute phase post-TBI, representing part of the acute adaptive response to the injury. Moreover, diminished pituitary hormone secretion, caused by damage to the pituitary and/or hypothalamus, may occur at any time after TBI. PTHP is observed in about 40% of patients with a history of TBI, presenting as an isolated deficiency in most cases, and more rarely as complete pituitary failure. The most common alterations appear to be gonadotropin and somatotropin deficiency, followed by corticotropin and thyrotropin deficiency. Hyper-or hypoprolactinemia may also be present. Diabetes insipidus may be frequent in the early, acute phase post-TBI, but it is rarely permanent. Severity of TBI seems to be an important risk factor for developing PTHP; however, PTHP can also manifest after mild TBI. Accurate evaluation and long-term follow-up of all TBI patients are necessary in order to detect the occurrence of PTHP, regardless of clinical evidence for pituitary dysfunction. In order to improve outcome and quality of life of TBI patients, an adequate replacement therapy is of paramount importance.
Seminars in Roentgenology, 1977
1. Semin Roentgenol. 1977 Apr;12(2):109-20. Computerized tomography of infratentorial tumors. Gad... more 1. Semin Roentgenol. 1977 Apr;12(2):109-20. Computerized tomography of infratentorial tumors. Gado M, Huete I, Mikhael M. PMID: 300900 [PubMed - indexed for MEDLINE]. MeSH Terms. Astrocytoma/radiography; Brain Neoplasms ...
Seminars in Roentgenology, 1977
1. Semin Roentgenol. 1977 Apr;12(2):109-20. Computerized tomography of infratentorial tumors. Gad... more 1. Semin Roentgenol. 1977 Apr;12(2):109-20. Computerized tomography of infratentorial tumors. Gado M, Huete I, Mikhael M. PMID: 300900 [PubMed - indexed for MEDLINE]. MeSH Terms. Astrocytoma/radiography; Brain Neoplasms ...
Revista médica de Chile, 2005
Stroke is the second cause of mortality and the first cause of morbidity in Chile and worldwide. ... more Stroke is the second cause of mortality and the first cause of morbidity in Chile and worldwide. Nowadays there is a major interest in introducing new therapies applying evidence based medicine for these patients. Aim: To describe the clinical profile of ...
Revista médica de Chile, 2004
... Temporal crescent syndrome. Report of one case. Victoria Mery C a , Patricio Mellado T 1 , Ra... more ... Temporal crescent syndrome. Report of one case. Victoria Mery C a , Patricio Mellado T 1 , RaúlValenzuela M 1 , Cristián Luco F 1 , Isidro Huete L 2 . ... Recibido el 4 de mayo, 2004. Aceptado el 17 de agosto, 2004. © 2011 Sociedad Médica de Santiago Bernarda Morín 488 ...
Rev Chil Cir, Dec 1, 1990
Revista chilena de pediatría
ABSTRACT
Surgical Neurology
Cerebral metastases are the most frequent brain tumors in adults and they may occasionally presen... more Cerebral metastases are the most frequent brain tumors in adults and they may occasionally present as an isolated meningeal mass, suggesting a meningioma. Because of the prognostic relevance in discriminating both tumors, we review the literature and analyze four patients in whom the diagnosis of meningioma was initially made. Four cases of isolated meningeal metastases are presented and in all of them a meningioma was considered as the main preoperative diagnosis. Only one patient had a history of previous cancer. The primary tumors found after pathological testing of the lesions were thyroid carcinoma, prostate adenocarcinoma, breast adenocarcinoma, and hypernephroma. The clinical and neuroimaging features as well as the differential diagnoses are discussed. The literature regarding these forms of meningeal metastases was reviewed. Although they are uncommon, dural metastases can be mistaken for meningiomas. Our experience in these cases has led us to consider ordinary metastases as a differential diagnosis even when a meningioma is suspected. The definitive diagnosis of a meningioma should be established only after the histopathological report has been analyzed.
Revista medica de Chile
We report a 7 year-old girl with mapuche ancestors, diagnosed as a cerebral palsy since infancy a... more We report a 7 year-old girl with mapuche ancestors, diagnosed as a cerebral palsy since infancy and on active rehabilitation. She acquired motor and cognitive skills at 3 years of age. At 5 years of age, a slow neurological deterioration started, associated to visual impairment. Optic atrophy was added to the typical neurological exam of ataxic cerebral palsy and the diagnosis was re-considered. Neuroimaging showed a slow and progressive atrophy of intracerebral structures and ultramicroscopy revealed intracytoplasmatic inclusions in conjunctiva and skin, compatible with mucolipidoses type IV (ML-IV). ML-IV must be included in the differential diagnosis of cerebral palsy associated with loss of acquired skills and progressive visual impairment. Electron microscopy of skin or conjunctiva is a useful diagnostic test. Suspicion of ML-IV must not be restricted to Ashkenazi Jewish population.
Revista médica de Chile, 2004
The temporal crescent syndrome or half-moon syndrome is a rare mono ocular retrochiasmatic visual... more The temporal crescent syndrome or half-moon syndrome is a rare mono ocular retrochiasmatic visual field defect that can be correlated to a lesion along the contralateral parieto-occipital sulcus. This field defect may be missed in automated perimetry. We report a 45 year old man, consulting for sudden loss of the peripheral temporal field in his right eye. The magnetic resonance imaging and the spectroscopy studies confirmed an ischemic lesion on the left anterior occipital cortex. Control imaging studies six months later did not show changes in the lesion.
Surgical neurology
Cerebral metastases are the most frequent brain tumors in adults and they may occasionally presen... more Cerebral metastases are the most frequent brain tumors in adults and they may occasionally present as an isolated meningeal mass, suggesting a meningioma. Because of the prognostic relevance in discriminating both tumors, we review the literature and analyze four patients in whom the diagnosis of meningioma was initially made. Four cases of isolated meningeal metastases are presented and in all of them a meningioma was considered as the main preoperative diagnosis. Only one patient had a history of previous cancer. The primary tumors found after pathological testing of the lesions were thyroid carcinoma, prostate adenocarcinoma, breast adenocarcinoma, and hypernephroma. The clinical and neuroimaging features as well as the differential diagnoses are discussed. The literature regarding these forms of meningeal metastases was reviewed. Although they are uncommon, dural metastases can be mistaken for meningiomas. Our experience in these cases has led us to consider ordinary metastases ...
Rationale and Objectives. Segmented inversion recovery (IR) ratio imaging (SIRRIM) has been estab... more Rationale and Objectives. Segmented inversion recovery (IR) ratio imaging (SIRRIM) has been established as a sensitive tool to assess neurodegeneration of the substantia nigra pars compacta (SNC) in patients with idiopathic Parkinson disease (IPD). The obtained results suggest the possibility of magnetic resonance imaging (MRI) as a biological marker for IPD. The strength and a parsimonious analysis of the technique
Revista chilena de radiología, 2003
... En Noviembre de 1948 participó en la organización del Tercer Congreso Interamericano de Radio... more ... En Noviembre de 1948 participó en la organización del Tercer Congreso Interamericano de Radiología celebrado en Santiago y Viña del ... especializado en 1978-1979 en el Centro Hospitalario Universitario de Caen, Normandía con el Dr. Jacques Theron, discípulo también ...
BACKGROUND Classification of growth hormone (GH) - secreting tumors by the granular pattern might... more BACKGROUND Classification of growth hormone (GH) - secreting tumors by the granular pattern might predict their clinical behavior in acromegalic patients. There are several other prognostic factors. AIM To compare the features at presentation and cure rates of patients with GH secreting tumors according to the granular pattern, and to define independent prognostic factors for surgical treatment in these patients. MATERIAL AND METHODS A retrospective, observational study of 85 active acromegalic patients surgically treated in two medical centers. RESULTS Seventy-four patients (87%) were classified as having densely granulated (DG) and 11 (13%) as sparsely granulated (SG) tumors. The latter were less active biochemically, had a higher rate of macroadenoma and cavernous sinus invasion and had a lower rate of biochemical cure than the DG group. Several characteristics were associated with disease persistence but only age (Odds ratio (OR) = 0.93) and cavernous sinus invasion (OR = 21.7) ...
Journal of Neurology
ObjectivesTo explore risk factors contributing to 30-day and long-term survival in children with ... more ObjectivesTo explore risk factors contributing to 30-day and long-term survival in children with a first episode of arterial ischemic stroke (AIS).Study designSingle center prospective observational study including 119 children aged between 30 days and 18 years, with a first episode of AIS between 2003 and 2015. Diagnosis was confirmed with magnetic resonance images. Outcomes included 30-day mortality and survival up to 8 years of follow-up. Demographic (e.g., gender, age), clinical (e.g., stroke severity measured by the Pediatric National Institute of Health Stroke Scale (NIHSS), clinical presentation, underlying conditions), radiological (e.g., involved circulation, location), and stroke recurrence data, were used to predict outcomes. Data analyses included logistic and Cox regression multivariate models with Firth’s bias correction.Results30-day mortality was 11.7% (n = 14). A total of 23 (19.3%) children died during the follow-up. 30-day mortality was only predicted by stroke severity (OR = 1.11, 95% CI = 1.02–1.26) in children > 2 years. Survival was predicted by stroke severity (HR = 1.05, 95% CI = 1.01–1.09), congenital heart disease (HR = 3.62, 95% CI = 1.33–10.93), prothrombotic states (HR = 3.51, 95% CI = 1.25–9.32), and anterior plus posterior circulation stroke (HR = 2.43, 95% CI = 1.42–4.61, p 0.026). Stroke recurrence (n= 23; 19.3%) was not a significant predictor of follow-up mortality.ConclusionsThis study identified groups with greater acute and long-term mortality after a first episode of AIS in childhood. Specific interventions focused on these risk groups may decrease mortality rates. Further studies need to confirm our findings by adding children from other centers.
Revista chilena de pediatria, 2017
Diarrhea-associated Hemolytic Uremic Syndrome (D+HUS) is a multisystem disorder in which neurolog... more Diarrhea-associated Hemolytic Uremic Syndrome (D+HUS) is a multisystem disorder in which neurological involvement (35 to 50%) is associated to adverse outcome. An important cause of a permanent neurological impairment is the cerebrovascular pathology. To report two pediatric cases of D+HUS with severe neurological involvement due to cerebrovascular disease, and review available literature. Two previously healthy 15- and 21-month-old children debuted with seizures and impairment of consciousness within the first week of a D+HUS. Both presented hypertension, severe acute renal failure, and focal motor deficit. One child showed significant improvement in neurologic status after five sessions of plasmapheresis. Brain magnetic resonance showed in the first child multiple bilateral infarcts of small vessels and lesions of white matter. In the second patient, large bilateral infarcts on both middle cerebral arteries territories were identified. One year after the acute event, both children...
Revista chilena de cardiología
Introducción: La miopatía y fibrosis auricular representan el sustrato protrombótico y proarrítmi... more Introducción: La miopatía y fibrosis auricular representan el sustrato protrombótico y proarrítmico en pacientes con fibrilación auricular (FA). Estudios recientes muestran relación entre el strain auricular izquierdo (SAI), eventos cardiovasculares y recurrencia en pacientes con FA. La asociación entre SAI y biomarcadores cardíacos como predictores de accidente cerebrovascular silente (ACVs) en pacientes con FA de reciente comienzo (FArc) no ha sido estudiada. Objetivo: Determinar si la asociación entre SAI y biomarcadores cardíacos contribuye a la predicción de ACV en pacientes con FArc.
Traumatic brain injury (TBI) is one of the main causes of death and disability in young adults, w... more Traumatic brain injury (TBI) is one of the main causes of death and disability in young adults, with consequences ranging from physical disabilities to long-term cognitive, behavioural, psychological and social defects. Post-traumatic hypopituitarism (PTHP) was recognized more than 80 years ago, but it was thought to be a rare occurrence. Recently, clinical evidence has demonstrated that TBI may frequently cause hypothalamic-pituitary dysfunction, probably contributing to a delayed or hampered recovery from TBI. Changes in pituitary hormone secretion may be observed during the acute phase post-TBI, representing part of the acute adaptive response to the injury. Moreover, diminished pituitary hormone secretion, caused by damage to the pituitary and/or hypothalamus, may occur at any time after TBI. PTHP is observed in about 40% of patients with a history of TBI, presenting as an isolated deficiency in most cases, and more rarely as complete pituitary failure. The most common alterations appear to be gonadotropin and somatotropin deficiency, followed by corticotropin and thyrotropin deficiency. Hyper-or hypoprolactinemia may also be present. Diabetes insipidus may be frequent in the early, acute phase post-TBI, but it is rarely permanent. Severity of TBI seems to be an important risk factor for developing PTHP; however, PTHP can also manifest after mild TBI. Accurate evaluation and long-term follow-up of all TBI patients are necessary in order to detect the occurrence of PTHP, regardless of clinical evidence for pituitary dysfunction. In order to improve outcome and quality of life of TBI patients, an adequate replacement therapy is of paramount importance.
Seminars in Roentgenology, 1977
1. Semin Roentgenol. 1977 Apr;12(2):109-20. Computerized tomography of infratentorial tumors. Gad... more 1. Semin Roentgenol. 1977 Apr;12(2):109-20. Computerized tomography of infratentorial tumors. Gado M, Huete I, Mikhael M. PMID: 300900 [PubMed - indexed for MEDLINE]. MeSH Terms. Astrocytoma/radiography; Brain Neoplasms ...
Seminars in Roentgenology, 1977
1. Semin Roentgenol. 1977 Apr;12(2):109-20. Computerized tomography of infratentorial tumors. Gad... more 1. Semin Roentgenol. 1977 Apr;12(2):109-20. Computerized tomography of infratentorial tumors. Gado M, Huete I, Mikhael M. PMID: 300900 [PubMed - indexed for MEDLINE]. MeSH Terms. Astrocytoma/radiography; Brain Neoplasms ...
Revista médica de Chile, 2005
Stroke is the second cause of mortality and the first cause of morbidity in Chile and worldwide. ... more Stroke is the second cause of mortality and the first cause of morbidity in Chile and worldwide. Nowadays there is a major interest in introducing new therapies applying evidence based medicine for these patients. Aim: To describe the clinical profile of ...
Revista médica de Chile, 2004
... Temporal crescent syndrome. Report of one case. Victoria Mery C a , Patricio Mellado T 1 , Ra... more ... Temporal crescent syndrome. Report of one case. Victoria Mery C a , Patricio Mellado T 1 , RaúlValenzuela M 1 , Cristián Luco F 1 , Isidro Huete L 2 . ... Recibido el 4 de mayo, 2004. Aceptado el 17 de agosto, 2004. © 2011 Sociedad Médica de Santiago Bernarda Morín 488 ...
Rev Chil Cir, Dec 1, 1990
Revista chilena de pediatría
ABSTRACT
Surgical Neurology
Cerebral metastases are the most frequent brain tumors in adults and they may occasionally presen... more Cerebral metastases are the most frequent brain tumors in adults and they may occasionally present as an isolated meningeal mass, suggesting a meningioma. Because of the prognostic relevance in discriminating both tumors, we review the literature and analyze four patients in whom the diagnosis of meningioma was initially made. Four cases of isolated meningeal metastases are presented and in all of them a meningioma was considered as the main preoperative diagnosis. Only one patient had a history of previous cancer. The primary tumors found after pathological testing of the lesions were thyroid carcinoma, prostate adenocarcinoma, breast adenocarcinoma, and hypernephroma. The clinical and neuroimaging features as well as the differential diagnoses are discussed. The literature regarding these forms of meningeal metastases was reviewed. Although they are uncommon, dural metastases can be mistaken for meningiomas. Our experience in these cases has led us to consider ordinary metastases as a differential diagnosis even when a meningioma is suspected. The definitive diagnosis of a meningioma should be established only after the histopathological report has been analyzed.
Revista medica de Chile
We report a 7 year-old girl with mapuche ancestors, diagnosed as a cerebral palsy since infancy a... more We report a 7 year-old girl with mapuche ancestors, diagnosed as a cerebral palsy since infancy and on active rehabilitation. She acquired motor and cognitive skills at 3 years of age. At 5 years of age, a slow neurological deterioration started, associated to visual impairment. Optic atrophy was added to the typical neurological exam of ataxic cerebral palsy and the diagnosis was re-considered. Neuroimaging showed a slow and progressive atrophy of intracerebral structures and ultramicroscopy revealed intracytoplasmatic inclusions in conjunctiva and skin, compatible with mucolipidoses type IV (ML-IV). ML-IV must be included in the differential diagnosis of cerebral palsy associated with loss of acquired skills and progressive visual impairment. Electron microscopy of skin or conjunctiva is a useful diagnostic test. Suspicion of ML-IV must not be restricted to Ashkenazi Jewish population.
Revista médica de Chile, 2004
The temporal crescent syndrome or half-moon syndrome is a rare mono ocular retrochiasmatic visual... more The temporal crescent syndrome or half-moon syndrome is a rare mono ocular retrochiasmatic visual field defect that can be correlated to a lesion along the contralateral parieto-occipital sulcus. This field defect may be missed in automated perimetry. We report a 45 year old man, consulting for sudden loss of the peripheral temporal field in his right eye. The magnetic resonance imaging and the spectroscopy studies confirmed an ischemic lesion on the left anterior occipital cortex. Control imaging studies six months later did not show changes in the lesion.
Surgical neurology
Cerebral metastases are the most frequent brain tumors in adults and they may occasionally presen... more Cerebral metastases are the most frequent brain tumors in adults and they may occasionally present as an isolated meningeal mass, suggesting a meningioma. Because of the prognostic relevance in discriminating both tumors, we review the literature and analyze four patients in whom the diagnosis of meningioma was initially made. Four cases of isolated meningeal metastases are presented and in all of them a meningioma was considered as the main preoperative diagnosis. Only one patient had a history of previous cancer. The primary tumors found after pathological testing of the lesions were thyroid carcinoma, prostate adenocarcinoma, breast adenocarcinoma, and hypernephroma. The clinical and neuroimaging features as well as the differential diagnoses are discussed. The literature regarding these forms of meningeal metastases was reviewed. Although they are uncommon, dural metastases can be mistaken for meningiomas. Our experience in these cases has led us to consider ordinary metastases ...
Rationale and Objectives. Segmented inversion recovery (IR) ratio imaging (SIRRIM) has been estab... more Rationale and Objectives. Segmented inversion recovery (IR) ratio imaging (SIRRIM) has been established as a sensitive tool to assess neurodegeneration of the substantia nigra pars compacta (SNC) in patients with idiopathic Parkinson disease (IPD). The obtained results suggest the possibility of magnetic resonance imaging (MRI) as a biological marker for IPD. The strength and a parsimonious analysis of the technique