Prevalence of metabolic syndrome in Galicia (NW Spain) on four alternative definitions and association with insulin resistance.

The present study evaluated the prevalence of the metabolic syndrome (MS) in a representative sample (no.=2860) of adults from the Spanish region of Galicia using the definitions of a) the World Health Organization; b) the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults; c) the European Group for Study of Insulin Resistance; and d) the International Diabetes Federation. In addition, we assess concordance among the different definitions, and the relationships of MS with insulin resistance (IR) as assessed by the homeostatic model assessment (HOMA-IR) index. Our results indicate a high prevalence of MS under all 4 definitions. MS prevalence was higher in men than women on all 4 definitions, and increased significantly with body mass index and age. IR was high among subjects with MS, and the HOMA index was a good discriminator of MS and non-MS on all 4 definitions, suggesting that HOMA index may be a useful predictive tool in clinical practice.

Prevalence, awareness, treatment and control of hypertension in Galicia (Spain) and association with related diseases.

The present study evaluated the prevalence of hypertension (HT) and its possible relationships with various risk factors in a representative sample (n=2884) of the adult population (>18 years old) of Galicia, a region of Spain. Subjects were selected by a two-step cluster sampling procedure from the Galician public health service database, which covers more than 95% of the population (2.7 million inhabitants). The overall prevalence of HT, defined as BP >140/90 mm Hg and/or current treatment with antihypertensive medication, was 25.5%, higher in men (31.1%) than in women (20.7%). Of the hypertensive subjects 50.6% were aware of the HT; of these, 72.0% were receiving treatment and 36.4% were treated and controlled. The prevalence of HT increased with age and was higher in subjects from urban areas than rural areas and higher in subjects with low educational level. Surprisingly, people with low educational level more frequently showed awareness of HT than people with high education level. Increased body mass index was related to increased prevalence of HT and close associations were observed between HT and cardiovascular diseases. Our data also show a linear upward trend in blood pressure from normal glucose metabolism to diabetes mellitus. Surprisingly, the prevalence of HT among people with known diabetes was higher than among people with undetected diabetes, which may indicate poor control of HT in diabetic subjects.

Iodine nutrition in the adult population of Galicia (Spain).

OBJECTIVE: To identify the current state of iodine nutrition in the adult population of Galicia (Spain), which is considered iodine sufficient based on results from studies carried out on schoolchildren. Urinary iodine concentration (UIC) and its relationship with different socio-demographic variables were assessed. DESIGN: A cross-sectional study was carried out on the population aged above 18 years in the Autonomous Community of Galicia (Spain) during 2004. The UICs were determined in an isolated urine sample using Dunn's colorimetric method. Iodine status was based on World Health Organization/International Council for the Control of Iodine Deficiency Disorders (WHO/ICCIDD) UIC. MAIN OUTCOME: A total of 2877 urine samples were taken. Median UIC for the total Galician population was 75.6 microg/L. About 30% of the population showed a UIC below 50 microg/L. Educational level, place of residence (coast vs. inland), and consumption of iodized salt were independent variables associated with the iodine nutrition of the adult population of Galicia. CONCLUSIONS: There is "mild" iodine deficiency (WHO) in the adult population of Galicia, which affects all the groups analyzed and which is particularly significant in the group of women of a fertile age. The data obtained on the state of iodine nutrition in school-age populations cannot be extended to the adult population.

[Incidental diagnosis of lymph node tuberculosis in an 111-indium-octreotide scintigraphy during a study of acromegaly]. / Diagnóstico casual de tuberculosis ganglionar activa en una gammagrafía con octreótido-Indio 111 durante el estudio de una acromegalia.

A patient with clinical suspicion of acromegaly and no radiologic visualization of pituitary adenoma is presented. (111)In-DTPAOC scintigraphy was performed in order to localize an ectopic foci of GH production. Scintigraphy showed uptake in right paratracheal and hiliar lymph nodes that seemed residual in CT. Biopsy through mediastinoscopy showed tuberculous granulomas. After treatment, scintigraphy normalized. This case illustrate that (111)In-DTPAOC can be positive not only in tumoral but in benign pathology and, in specific cases, it can be a marker of inflammatory activity and useful for treatment monitoring.

Diagnóstico casual de tuberculosis ganglionar activa en una gammagrafía con octreótido-Indio 111 durante el estudio de una acromegalia / Causal diagnosis of lymph node tuberculosis in an 111 Indium-octreotide scintigraphy during a study of an acromegaly

Presentamos a un paciente con sospecha de acromegalia y ausencia radiológica de adenoma hipofisario al que se realizó una gammagrafía con 111In-DTPAOC para localizar un posible foco ectópico productor de hormona de crecimiento (GH). La gammagrafía mostró la existencia de adenopatías captantes paratraqueales e hiliares derechas que en la tomografía computarizada (TC) parecían residuales. La biopsia por mediastinoscopia de las adenopatías mostró la existencia de granulomas tuberculosos. Tras tratamiento tuberculostático la gammagrafía se normalizó. Este caso ilustra el hecho de que la gammagrafía con 111In-DTPAOC puede ser positiva no sólo en patología de origen tumoral, sino también en patología benigna y que en ocasiones puede ser un marcador de actividad inflamatoria y útil en la monitorización del tratamiento

A patient with clinical suspicion of acromegaly and no radiologic visualization of pituitary adenoma is presented. 111In-DTPAOC scintigraphy was performed in order to localize an ectopic foci of GH production. Scintigraphy showed uptake in right paratracheal and hiliar lymph nodes that seemed residual in CT. Biopsy through mediastinoscopy showed tuberculous granulomas. After treatment, scintigraphy normalized. This case illustrate that 111In-DTPAOC can be positive not only in tumoral but in benign pathology and, in specific cases, it can be a marker of inflammatory activity and useful for treatment monitoring

Fine-needle aspiration biopsy of thyroid nodules: impact on clinical practice.

UNLABELLED: The aim of the present study was to analyze the changes in our clinical practice due to the use of FNAB in the management of nodular thyroid disease. Patients attended the thyroid unit for thyroid nodules. The study comprises three periods: First, from January 1980 to May 1984, 226 patient. Second, from June 1985 to December 1990, 166 patients. Third, from January 1991 to December 1993, 403 patients. DESIGN: retrospective the 1st period and prospective the 2nd and 3rd periods. During the 1st and 2nd periods, decision for surgery was based on clinical parameters together with results of 99Tc radionucleotide scan and B mode ultrasound studies. In the 3rd period surgical decision was based principally on cytologic results. We comparatively studied the frequency of surgical operation and frequency of malignancy in surgical thyroid specimens between the study periods. Determination of sensitivity, specificity and accuracy of the diagnostic methods was done. We observed a decrease in the frequency of patients requiring surgery, 89.9%, 67.8% and 46.6% for the 1st, 2nd and 3rd study periods, X2 = 114.7, p < 0.0001; and an increase in the frequency of malignancy in the surgical specimens, 14.7%, 24.4% and 32.9% for 1st, 2nd and 3rd periods respectively, X2 = 4.5, p < 0.05. The sensitivity 92.5% and 93.5%, the specificity 50.6% and 61.1%, and the accuracy 60.9% and 71.8% of the FNAB for the second and third periods respectively. The rates of false negative cytological specimens were 1.8% and 2.1% for 2nd and 3rd respectively, p > 0.05. Since the introduction of FNAB in the evaluation of our patients around 70% of these had a definitive preoperative diagnosis of either benign or malignant disease. Simplification in management of patients with nodular thyroid disease is the most important impact for the use of FNAB. Furthermore, a decrease in the number of patients requiring surgical treatment and an increase of malignant nodules in the specimens obtained by surgery were also observed. We think that FNAB is the most direct and accurate method in the management of patients with thyroid nodules.

Linear growth in thalassemic children treated with intensive chelation therapy. A longitudinal study.

The aim of our study was to investigate the effect of a definite schedule of treatment on the growth of children with beta-thalassemia major. Ten children (6 girls, 4 boys) participated in this longitudinal study. They were treated with transfusions to maintain the levels of hemoglobin above 10.5 g/dl from the time of diagnosis and desferrioxamine mesylate 40 mg/kg/day by subcutaneous pump, 5 days a week, during 7 +/- 1.4 years. The patients were followed up from the age at diagnosis (18.9 +/- 9.8 months) until they reached their adult bone age (19.1 +/- 1.6 and 20.8 +/- 0.8 years in girls and boys, respectively). We observed growth retardation before the age of 10 in 3 out of 4 boys and in 1 out of 6 girls. Between the ages of 10 and 15, the growth failure was evident in other children (1 boy and 2 girls), and became more marked in the above mentioned children. After the age of 15, amelioration of the growth failure was observed in relation to sexual maturity. Eight out of 10 patients attain normal stature in accordance with their target height. We had evidence of poor compliance with the chelation therapy in the 2 children of short adult stature. These patients had higher serum ferritin levels than the children with normal height within the study period: 4,461 +/- 1,469 and 1,429 +/- 479 micrograms/l respectively (p = 0.049). Our study reveals a positive effect of intensive chelation therapy on the linear growth in these patients.