<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1561-2953</journal-id>
<journal-title><![CDATA[Revista Cubana de Endocrinología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Cubana Endocrinol]]></abbrev-journal-title>
<issn>1561-2953</issn>
<publisher>
<publisher-name><![CDATA[Editorial Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1561-29532021000100001</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Manifestaciones clínicas predictivas del diagnóstico del hipercortisolismo endógeno]]></article-title>
<article-title xml:lang="en"><![CDATA[Clinical Manifestations Predicting Endogenous Hypercortisolism]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cabrera Gámez]]></surname>
<given-names><![CDATA[Maite]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Domínguez Alonso]]></surname>
<given-names><![CDATA[Emma]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mustelier González]]></surname>
<given-names><![CDATA[Maydelin]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Acosta Cedeño]]></surname>
<given-names><![CDATA[Alina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Turcios Tristá]]></surname>
<given-names><![CDATA[Silvia Elena]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Ciencias Médicas Instituto de Endocrinología ]]></institution>
<addr-line><![CDATA[La Habana ]]></addr-line>
<country>Cuba</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Militar &#8220;Dr. Carlos J Finlay&#8221;  ]]></institution>
<addr-line><![CDATA[La Habana ]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2021</year>
</pub-date>
<volume>32</volume>
<numero>1</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S1561-29532021000100001&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S1561-29532021000100001&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S1561-29532021000100001&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  El diagnóstico clínico del hipercortisolismo endógeno puede ser complejo si las manifestaciones clínicas no son patognomónicas. Es importante conocer cuáles son las distintivas en nuestros pacientes, que permitan diagnosticar la enfermedad de forma precoz.  Objetivo:  Determinar sensibilidad, especificidad y valor predictivo positivo de las manifestaciones clínicas para diagnosticar el hipercortisolismo endógeno.  Métodos:  Estudio descriptivo transversal. Grupo I: 65 pacientes con hipercortisolismo endógeno y grupo II (comparación): 75 con sospecha clínica de hipercortisolismo endógeno a los que se les descartó la enfermedad. Se estudiaron pacientes con diagnóstico de hipercortisolismo endógeno (2004-2017), atendidos en el Instituto de Endocrinología. Se determinaron los valores de sensibilidad, especificidad y valor predictivo positivo para el diagnóstico de hipercortisolismo endógeno de cada síntoma y signo por separado, así como para las combinaciones de tres manifestaciones clínicas; además se realizó una regresión logística binaria para identificar las combinaciones de sintomatologías que mejor predicen la presencia de hipercortisolismo endógeno. Se consideró diferencia estadística significativa con p &#8804; 0,05.  Resultados:  La mayoría de los síntomas presentó una sensibilidad inferior al 45 %. La circunferencia de la cintura fue el único signo que mostró alta sensibilidad (76,9 %), baja especificidad (28,6 %) con valor predictivo positivo de 42,0 %. Cuando se presentan dos o tres de estos signos: rubicundez, cara de &#8220;luna llena&#8221; e hirsutismo la posibilidad de tener hipercortisolismo endógeno es 75,4 %, con valor predictivo positivo de 71 % y, cuando no están presentes la probabilidad de no tenerlo es de 77,5 %.  Conclusiones:  La combinación de sensibilidad, especificidad y valor predictivo positivo de los síntomas y signos de forma aislada no predice el diagnóstico de la enfermedad; sin embargo, la presencia de dos o tres de los síntomas y/o signos tiene una elevada sensibilidad y valor predictivo positivo para el diagnóstico del hipercortisolismo endógeno. Las combinaciones que mejor predicen la posibilidad de tener un hipercortisolismo endógeno son: piel fina, edema y acné; cara de &#8220;luna llena&#8221;, hirsutismo y rubicundez, así como &#8220;giba de búfalo&#8221;, hematomas y estrías.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  The clinical diagnosis of endogenous hypercortisolism can be complex if clinical manifestations are not pathognomonic. It is important to know what are distinctive in our patients, which allows to diagnose the disease early.  Objective:  To determine the sensitivity, specificity and positive predictive value of clinical manifestations for diagnosis. of endogenous hypercortisolism.  Methods:  Descriptive and cross-sectional study. Group I was made up of 65 patients with endogenous hypercortisolism; group II (comparison) was made up of 75 patients with clinical suspicion of endogenous hypercortisolism, finally ruled out. We studied patients diagnosed of endogenous hypercortisolism from 2004 to 2017, treated at the Endocrinology Institute. Sensitivity, specificity and positive predictive values &#8203;&#8203;were determined for the diagnosis of endogenous hypercortisolism for each symptom and sign separately, as well as for the combinations of three clinical manifestations; in addition, binary logistic regression was performed to identify the combinations of symptoms that best predict the presence of endogenous hypercortisolism. A statistically significant difference was considered with p &#8804; 0.05.  Results:  Most of the symptoms presented a sensitivity lower than 45%. Waist circumference was the only sign that showed high sensitivity (76.9%), low specificity (28.6%), and positive predictive value of 42.0%. When two or three of these signs (redness, &#8220;full-moon&#8221; face, and hirsutism) are present, the possibility of having endogenous hypercortisolism is 75.4%, with positive predictive value of 71%; and, when they are not present, the probability of not having it is 77,5%.  Conclusions:  The combination of sensitivity, specificity and positive predictive value of the symptoms and signs in isolation does not predict the diagnosis of the disease; however, the presence of two or three of the symptoms and/or signs has a high sensitivity and positive predictive value for the diagnosis of endogenous hypercortisolism. The combinations that best predict the possibility of having an endogenous hypercortisolism are thin skin, edema and acne; "full-moon" face, hirsutism and redness; as well as "buffalo hump," bruises and stretch marks.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[hipercortisolismo endógeno]]></kwd>
<kwd lng="es"><![CDATA[diagnóstico clínico del hipercortisolismo endógeno]]></kwd>
<kwd lng="es"><![CDATA[manifestaciones clínicas de hipercortisolismo endógeno]]></kwd>
<kwd lng="en"><![CDATA[endogenous hypercortisolism]]></kwd>
<kwd lng="en"><![CDATA[clinical diagnosis of endogenous hypercortisolism]]></kwd>
<kwd lng="en"><![CDATA[clinical manifestations of endogenous hypercortisolism.]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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