Blanca Cordero García’s research while affiliated with Marian Regional Medical Center of Santa Maria and other places

Salivary gland tumours, although quite uncommon, may be a reason for primary care consultation. Of all the glands, the parotid gland is where they are most frequently located (80-85 % of cases), with the pleomorphic adenoma being the most common, followed by the Warthin tumour, which makes up between 2 % and 15 % of the total of benign neoplasms. We present the case of a bilateral multifocal Warthin tumour initially detected and diagnosed by ultrasound scan and fine needle puncture-aspiration assessment (PAAF), carried out at the Buenavista health centre, Toledo.

Background and objectiveOur objective was to evaluate the presence of postpartum thyroiditis (PPT) in a group of pregnant euthyroid women.

Our objective was to evaluate the presence of postpartum thyroiditis (PPT) in a group of pregnant euthyroid women. This study was prospective and descriptive in nature and was carried out over the course of three years in an urban Health District in Toledo, Spain. Information recorded included height and weight, tobacco use, previous consumption of oral contraceptives, and numbers of pregnancies and abortions prior to the current gestation. Levels of Thyroid Stimulating Hormone (TSH), free Thyroxin (FT4) and thyroid peroxidase antibodies (TPOAb) were determined during the first trimester and 3 and 6 months postpartum. A urine sample was collected for determination of iodine levels. Thyroid ultrasonography was performed on all pregnant subjects concurrently with analytical sample collection at 3 months of pregnancy and 3 months postpartum. The sample contained 157 pregnant women, of whom 25 (15.9%) developed PPT. Of these, 44.0% were positive for TPO antibodies in the first trimester, compared to 4.5% of the subjects who did not develop PPT (P<.001). At the end of the first year, 5 (20%) were still afflicted with hypothyroidism. The complete study group of pregnant women displayed a median urinary iodine level of 135 microg/L. A minor BMI was found in the PPT subjects when compared with the rest of the study group (21.7 vs 24.5; P=.000). A greater frequency of PPT was found in Rh-negative women (33.3 vs 12.2%; P=.015). The incidence of PPT exceeded that previously reported. We have only found a significant correlation between PPT and BMI and Rh factor. Based on the high incidence rate detected in our Health District, an active search for cases of PPT might be justified.

BACKGROUND AND OBJECTIVES: Thyroid alterations are frequent during pregnancy and can be harmful to the development of the newborn. The objective of this study was to assess the prevalence of thyroid disorders as well as iodine nutritional status in pregnant women in the first trimester of pregnancy. PATIENTS AND METHOD: We performed a descriptive observational survey in a health area of Toledo (Spain). Participants consisted of pregnant women in this area and a control group of non-pregnant women of similar age. Both groups underwent thyroid ultrasonography and urinary iodine concentration test. Thyrotropin, free T4 and anti-thyroid peroxidase antibodies (anti-TPO Ab) levels were also measured in pregnant women. RESULTS: A total of 199 expectant women and a control group of 169 non-pregnant women participated. The median urinary iodine concentration was 135 μg/l (IR, 240-65) in pregnant women and 150μg/l (IR, 200-90) in the control group. The mean values for TSH and free T4 in pregnant women were 1.95±1.62 and 1.03±0.15μU/ml, respectively. The prevalence of hypothyroidism in expectant women was 9.5% (95% CI, 6.0-14.7). Thyroid volume was larger in pregnant women (12.2±5.6mL) than in controls (10.7±4.0mL) (p=0.005). Thyroid nodules were found in 38.5% of the women in the control group and in 33.2% of pregnant women (p = 0.290). CONCLUSIONS: Iodine status was deficient in our group of pregnant women. In agreement with the results of other studies performed in Spain, the prevalence of hypothyroidism was high. Thyroid hormones and anti-TPO Ab tests should be evaluated in the first prenatal visit. The prevalence of nodules was similar in pregnant women in the first trimester of pregnancy and in controls. Thyroid ultrasonography should be performed in pregnant women whenever a goiter and/or thyroid nodules are detected during clinical examination.

Background and objectives Thyroid alterations are frequent during pregnancy and can be harmful to the development of the newborn. The objective of this study was to assess the prevalence of thyroid disorders as well as iodine nutritional status in pregnant women in the first trimester of pregnancy. Patients and method We performed a descriptive observational survey in a health area of Toledo (Spain). Participants consisted of pregnant women in this area and a control group of non-pregnant women of similar age. Both groups underwent thyroid ultrasonography and urinary iodine concentration test. Thyrotropin, free T4 and anti-thyroid peroxidase antibodies (anti-TPO Ab) levels were also measured in pregnant women. Results A total of 199 expectant women and a control group of 169 non-pregnant women participated. The median urinary iodine concentration was 135 μg/l (IR, 240-65) in pregnant women and 150 μg/l (IR, 200-90) in the control group. The mean values for TSH and free T4 in pregnant women were 1.95 ± 1.62 and 1.03 ± 0.15 μU/ml, respectively. The prevalence of hypothyroidism in expectant women was 9.5% (95% CI, 6.0-14.7). Thyroid volume was larger in pregnant women (12.2 ± 5.6 mL) than in controls (10.7 ± 4.0 mL) (p = 0.005). Thyroid nodules were found in 38.5% of the women in the control group and in 33.2% of pregnant women (p = 0.290). Conclusions Iodine status was deficient in our group of pregnant women. In agreement with the results of other studies performed in Spain, the prevalence of hypothyroidism was high. Thyroid hormones and anti-TPO Ab tests should be evaluated in the first prenatal visit. The prevalence of nodules was similar in pregnant women in the first trimester of pregnancy and in controls. Thyroid ultrasonography should be performed in pregnant women whenever a goiter and/or thyroid nodules are detected during clinical examination.

We assessed the clinical and functional changes taking place in patients diagnosed of chronic obstructive pulmonary disease (COPD) who have been treated with ipratropium bromide, three months after this medicament was replaced by the new tiotropium bromide. A prospective intervention survey was carried out in a primary health-care area in patients who suffered from COPD who fulfilled the inclusion criteria. Before changing the treatment and three months after changing it, we carried out the following procedures: spirometry, 6 minutes walking test (6MWT) with pulsioximetry before and after the exercise, St. George Respiratory Questionnaire (SGRQ) and assessment of: patient's chronic dyspnea, degree of patient's compliance, adverse effects and degree of satisfaction with the new drug. 24 patients (22 males and 2 females) with a mean age of 68.54 years participated in the survey. The FVC improved a 4.92% (120 ml) [p = .27] and the FEV1, 14.16% (170 ml) [p < .001]. The degree of compliance arose from 67.54% to 96.73% (p < .001), the degree of dyspnea decreased from 4.63 to 3.89 (p = .141), the 6MWT increased in 23.79 m (p = .027) and the global mark of the SGRQ reduced (improved) in 13.35 points. There were adverse effects in 5 cases (mouth dryness in 4 patients and headache in 1 of them) and 15 patients (62.5%) said the new drug was better. Most analyzed parameters had positive changes three months after changing the treatment. Tiotropium may be a valid alternative in the treatment of patients suffering from COPD in a stable stage.

Background and objective We assessed the clinical and functional changes taking place in patients diagnosed of chronic obstructive pulmonary disease (COPD) who have been treated with ipratropium bromide, three months after this medicament was replaced by the new tiotropium bromide. Patients and method A prospective intervention survey was carried out in a primary health-care area in patients who suffered from COPD who fulfilled the inclusion criteria. Before changing the treatment and three months after changing it, we carried out the following procedures: spirometry, 6 minutes walking test (6MWT) with pulsioximetry before and after the exercise, St. George Respiratory Questionnaire (SGRQ) and assessment of: patient's chronic dyspnea, degree of patient's compliance, adverse effects and degree of satisfaction with the new drug. Results 24 patients (22 males and 2 females) with a mean age of 68.54 years participated in the survey. The FVC improved a 4.92% (120 ml) [p =.27] and the FEV1, 14.16% (170 ml) [p <.001]. The degree of compliance arose from 67.54% to 96.73% (p <.001), the degree of dyspnea decreased from 4.63 to 3.89 (p =.141), the 6MWT increased in 23.79 m (p =.027) and the global mark of the SGRQ reduced (improved) in 13.35 points. There were adverse effects in 5 cases (mouth dryness in 4 patients and headache in 1 of them) and 15 patients (62.5%) said the new drug was better. Conclusions Most analyzed parameters had positive changes three months after changing the treatment. Tiotropium may be a valid alternative in the treatment of patients suffering from COPD in a stable stage.