Policondritis recidivante / Relapsing polychondritis

La policondritis recidivante, es una infrecuente enfermedad inflamatoria del tejido conjuntivo, de etiología desconocida. Se caracteriza por inflamación episódica y progresiva de tejido cartilaginoso, principalmente del pabellón auricular, nariz y árbol traqueo-bronquial. Se presenta el caso de una paciente femenina de 58 años, que consulta por enrojecimiento y dolor en pabellón auricular derecho, con episodios previos similares en ambos oídos y nariz, además de estudio por poliartritis simétrica. Al examen físico destaca: eritema, edema y dolor local en pabellón auricular, respetando lóbulo. Con exámenes complementarios normales y presencia de tres criterios característicos de McAdam, se diagnostica policondritis recividante, iniciando prednisona oral, con respuesta favorable. Pese a ser una enfermedad poco frecuente, es importante considerarla en casos recurrentes de eritema y dolor local en regiones cartilaginosas, principalmente en pabellón auricular y nariz, de tal forma de lograr un diagnóstico precoz, para suprimir las crisis y mejorar el pronóstico de estos pacientes.

Relapsing Polychondritis (RP) is a rare inflammatory connective tissue disease of unknown etiology. It is characterized by episodic and progressive inflammation of cartilage tissue, especially ear, nose and tracheobronchial tree. We report the case of 58 year old Chilean female patient, who consulted for redness and pain in the right ear, with similar previous episodes in both ears and nose; along with symmetric polyarthritis study it is presented. Physical examination highlighted erythema, edema and local pain in ear, respecting lobe. With normal complementary examinations and presence of three diagnostic criteria of McAdam y col. relapsing polychondritis diagnosed, initiating oral prednisone, with favorable response. Despite being a rare disease, it is important to consider in recurrent cases of erythema and local pain in cartilaginous regions, mainly in ear and nose, so to achieve early diagnosis, to suppress the crisis and improve the prognosis of these patients.

Iodine nutrition in elementary state schools of Queretaro, Mexico: correlations between urinary iodine concentration with global nutrition status and social gap index / Consumo de iodo em escolas de ensino fundamental de Querétaro, México: correlação entre a concentração urinária de iodo, o estado nutricional geral e o índice de desigualdade social

OBJECTIVE AND METHODS: To estimate median urinary iodine concentration (UIC), and to correlate it with global nutrition indicators and social gap index (SGI) in 50 elementary state schools from 10 municipalities in the State of Queretaro, Mexico. RESULTS: 1,544 students were enrolled and an above of requirements of iodine intake was found (median UIC of 297 µg/L). Iodine status was found as deficient, adequate, more than adequate and excessive in 2, 4, 19 and 25 schools, respectively. Seventy seven percent of table salt samples showed adequate iodine content (20-40 ppm), while 9.6% of the samples had low iodine content (< 15 ppm). Medians of UIC per school were positively correlated with medians of body mass index (BMI) by using the standard deviation score (SDS) (r = 0.47; p < 0.005), height SDS (r = 0.41; p < 0.05), and overweight and obesity prevalence (r = 0.41; p < 0.05). Medians of UIC per school were negatively correlated with stunting prevalence (r = -0.39; p = 005) and social gap index (r = -0.36; p < 0.05). Best multiple regression models showed that BMI SDS and height were significantly related with UIC (p < 0.05). CONCLUSIONS: There is coexistence between the two extremes of iodine intake (insufficient and excessive). To our knowledge, the observed positive correlation between UIC and overweight and obesity has not been described before, and could be explained by the availability and consumption of snack food rich in energy and iodized salt.

OBJETIVO E MÉTODOS: Estimar a concentração de iodo urinário (CIU) mediana e correlacioná-la com os indicadores de nutrição geral e com o índice de desigualdade social (IDS) de 50 escolas estaduais de ensino fundamental de 10 municípios do estado de Querétaro, no México. RESULTADOS: Utilizou-se um total de 1.544 crianças e encontrou-se uma ingestão acima das necessidades de iodo (CIU mediana de 297 µg/L). O nível de iodo determinado foi deficiente, adequado, mais do que adequado e excessivo em 2, 4, 19 e 25 escolas, respectivamente. Setenta e sete por cento de amostras de sal de mesa mostraram uma quantidade de iodo adequada (20-40 ppm), enquanto 9,6% das amostras tinham um teor de iodo baixo (< 15 ppm). As medianas de CIU por escola foram correlacionadas positivamente com as medianas do índice de massa corporal (IMC) usando o desvio-padrão da contagem (DP) (r = 0,47; p < 0.005), o DP da altura (r = 0,41; p < 0.05) e a prevalência de sobrepeso e de obesidade (r = 0,41; p < 0,05). As medianas de CUI por escola foram correlacionadas negativamente com a prevalência de desnutrição (r = -0.39; p = 005) e com o índice de desigualdade social (r = -0.36; p < 0,05). Os melhores modelos de regressão múltipla mostraram que a DP do IMC e a altura foram relacionados significativamente com a CIU (p < 0,05). CONCLUSÃO: Existe uma convivência entre os dois extremos de ingestão de iodo (insuficiente e excessiva). Em nosso conhecimento, a correlação positiva entre a CIU, o excesso de peso e a obesidade não foi descrita anteriormente e poderia ser explicada pela disponibilidade e consumo de alimentos ou refeições ricos(as) em energia e sal iodado.

Importance of iodine in pregnancy

Iodine is an essential constituent of thyroid hormones (TH). TH actively take part in critical periods of brain development during embryonic, fetal and postnatal stages. Therefore the absence of TH or iodine in these critical periods produces an irreversible brain damage. In fact, it is known that iodine deficiency is the leading cause of preventable brain damage worldwide. Because of the physiological adjustments during pregnancy iodine requirements increase significantly from 150 μg per day in non-pregnant adult women to 250 μg per day. Moreover, recent epidemiological studies around the world show that iodine intake during pregnancy is insufficient in many countries, even in developed countries like Australia, Spain and Italy. In the present work an overview of the importance of iodine nutrition during pregnancy is given.

Importancia del yodo en la gestación. El yodo es un nutrimento constituyente indispensable de las hormonas tiroideas (HT). Las HT participan activamente en periodos críticos del desarrollo cerebral durante las etapas embrionaria, fetal y posnatal. Por lo tanto la ausencia o deficiencia de las HT o de yodo en estas etapas del desarrollo produce un daño cerebral irreversible. De hecho, se sabe que la deficiencia de yodo es la principal causa de daño cerebral prevenible en el mundo. Debido a los ajustes fisiológicos propios de la gestación los requerimientos de yodo se incrementan notablemente, pasando de 150 μg al día en la mujer adulta no gestante a 250 μg al día durante el embarazo. Por otra parte, estudios epidemiológicos recientes hechos en todo el mundo muestran que el consumo de yodo durante la gestación es insuficiente en varios países; incluso en países desarrollados como Australia y España e Italia. En la presente revisión se da un panorama general de la importancia del consumo adecuado de yodo durante la gestación.

Sintomatología respiratoria y enfermedad pulmonar obstructiva crónica y su asociación a contaminación intradomiciliaria en el área metropolitana de Santiago: estudio platino / Association between indoor pollution, respiratory symptoms and COPD in Santiago, Chile: platino study

The aim of this study is to report the association between indoor pollution (IP), chronic respiratory symptoms (CRS) and chronic obstructive pulmonary disease (COPD). Data provided from PLATINO study considering a sample of 1.208 subjects 40 and over years old population in Santiago, Chile. Analyses regarding indoor air pollution variables, smoking, environmental tobacco smoke (ETS) and lifetime exposure to occupational dust and CRS and COPD as main outcomes was performed. Crude and adjusted prevalence odds ratios (POR) were calculated using logistic regression, adjusting for potential confounders. Variables explaining higher COPD risk were age > 60 years (POR 3.94, CI95 percent 2.87-5.41, p < 0.01) and males (POR 2.08, CI95 percent 1.53-2.83, p < 0.01). Exposure to coal IP was associated with CRS (POR 1.41, CI95 percent 1.05-1.89; p = 0.024), as well as exposure to firewood IP (POR 1.42, CI95 percent 1.04-1.93; p = 0.029) and ETS (POR 2.15, CI95 percent 1.24-3.73, p = 0.006). Exposure to coal, firewood and ETS are independent risk factors for CRS. Association between exposure to IP and COPD was not observed.

El objetivo de la comunicación fue evaluar la asociación entre contaminación intradomiciliaria (CID) y la presencia de síntomas respiratorios crónicos (SRC) y Enfermedad Pulmonar Obstructiva Crónica (EPOC). Se analizó información del estudio de prevalencia Platino en base a una muestra de población general de 1.208 sujetos de 40 y más años de Santiago, Chile. Se analizó la CID derivada del uso de combustibles sólidos, exposición a humo ambiental (EHAT) y el reporte de exposición previa a polvo de origen ocupacional calculando Odds Ratio de Prevalencia (ORP) crudos y ajustados por potenciales variables confundentes. Las variables que determinan mayor riesgo de EPOC fueron edad mayor 60 años (ORP 3,9; IC95 por ciento 2,9-5,4; p < 0,01) y sexo masculino (OR 2,08; IC95 por ciento 1,5-2,8; p < 0,01). La CID derivada de carbón se asoció con síntomas respiratorios crónicos (ORP 1,4; IC95 por ciento 1,05-1,89; p = 0,024), al igual que el antecedente de exposición a humo de leña (ORP 1,4, IC95 por ciento 1,04-1,9; p = 0,029) y EHAT (ORP 2,1, IC95 por ciento 1,2-3,7; p = 0,006). La exposición a carbón, leña y EHAT constituyen factores de riesgo independientes para presentar SRC. No se encontró asociación entre CID y EPOC.