Papers by MARIA HONOLINA S GOMEZ
Analytical and Bioanalytical Chemistry, 2021
The current gold standard in cancer diagnosis—the microscopic examination of hematoxylin and eosi... more The current gold standard in cancer diagnosis—the microscopic examination of hematoxylin and eosin (H&E)–stained biopsies—is prone to bias since it greatly relies on visual examination. Hence, there is a need to develop a more sensitive and specific method for diagnosing cancer. Here, Fourier transform infrared (FTIR) spectroscopy of thyroid tumors (n = 164; 76 malignant, 88 benign) was performed and five (5) neural network (NN) models were designed to discriminate the obtained spectral data. PCA-LDA was used as classical benchmark for comparison. Each NN model was evaluated using a stratified 10-fold cross-validation method to avoid overfitting, and the performance metrics—accuracy, area under the curve (AUC), positive predictive value (PPV), negative predictive value (NPV), specificity rate (SR), and recall rate (RR)—were averaged for comparison. All NN models were able to perform excellently as classifiers, and all were able to surpass the LDA model in terms of accuracy. Among the NN models, the RNN model performed best, having an AUC of 95.29% ± 6.08%, an accuracy of 98.06% ± 2.87%, a PPV of 98.57% ± 4.52%, a NPV of 93.18% ± 7.93%, a SR value of 98.89% ± 3.51%, and a RR value of 91.25% ± 10.29%. The RNN model outperformed the LDA model for all metrics except for the AUC, NPV, and RR. In conclusion, NN-based tools were able to predict thyroid cancer based on infrared spectroscopy of tissues with a high level of diagnostic performance in comparison to the gold standard.
Endocrine Practice, 2021
There is currently no published data on the use of mifepristone (Korlym®, Corcept Therapeutics) i... more There is currently no published data on the use of mifepristone (Korlym®, Corcept Therapeutics) in patients with End Stage Renal Disease (ESRD) on hemodialysis diagnosed with hypercortisolism. We present a patient case with ESRD demonstrating the safe and efficacious long-term use of mifepristone. Case Description: A 67-year-old woman presented with ESRD on hemodialysis due to HIV-associated nephropathy and multiple comorbidities (T2DM, hypertension, hyperlipidemia, obesity, hypothyroidism, HSV, anemia, depression, tertiary hyperparathyroidism). She has a history of bilateral adrenal adenomas (2.0 cm left, 1.8 cm right) discovered incidentally in 2008 during a hospital stay. ACTH-independent hypercortisolism was confirmed with 1mg ODST, late-night salivary cortisol, and ACTH. Anuria prevented the collection of the 24-hour UFC. Due to the patient's poor surgical candidacy, she was conservatively managed for 7 years. In 2015, she was started on mifepristone 300 mg QD. At 2 months, mifepristone was titrated to 600 mg QD which is the maximum dose for patients with renal impairment. No adjustments to the mifepristone dose were required to accommodate the 3 days a week hemodialysis schedule. Mifepristone was dosed daily in the evenings of both the hemodialysis and nonhemodialysis days. Over 55 months, her HbA1c improved from 7.2 to 4.8 % with discontinuation of all insulin; blood pressure normalized with discontinuation of antihypertensive medications; weight decreased from 198 to 155 lbs with a BMI improvement of 36.2 to 28 kg/m 2 . Hypokalemia was treated with KCl supplementation. HIV remained undetectable. Discussion: This is the first published case of a complex patient with ESRD on hemodialysis using mifepristone to control hypercortisolism. The long-term use of mifepristone in this patient resulted in clinically meaningful improvements in hyperglycemia, hypertension, and weight loss while offering an acceptable safety profile.
Journal of the Endocrine Society, 2020
Primary hyperparathyroidism is a common endocrine disorder of metabolism usually due to a parathy... more Primary hyperparathyroidism is a common endocrine disorder of metabolism usually due to a parathyroid adenoma. Although, the clinical presentation of primary hyperparathyroidism has changed from Albright’s description of a disease of bones and stones, the central target organs affected by this disorder continue to be the skeleton and kidneys. With the advent of routine biochemical screening, the typical diagnosis of primary hyperparathyroidism is no longer accompanied by overt skeletal and renal involvement. Majority of the cases of primary hyperparathyroidism are due to parathyroid adenomas. Giant glands were defined as greater than the 95th percentile, characterized as glands weighing > 3.5 grams. This present case in a 54-year old female is a rare case of primary hyperparathyroidism secondary to a giant parathyroid adenoma measuring 10.7 x 8.0 x 40.0 cm and weighing 145 grams, the largest giant parathyroid adenoma reported to date, with co-existent silent thymoma, multinodular...
CVD Prevention and Control, 2009
CVD Prevention and Control, 2009
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Papers by MARIA HONOLINA S GOMEZ