ABSTRACT
BACKGROUND AND OBJECTIVE: Thyroid-associated ophthalmopathy (TAO) is the most common extrathyroidal manifestation of Graves disease, occasionally severe and refractory to treatment, mainly in long-term disease. In these cases, one of the most important infiltrating cytokines in the orbital tissue is interleukin-6 (IL-6). METHODS: This is a case report, the methodology consisted of the application of tocilizumab in a patient with graves disease and the patient's follow-up. RESULTS: We present the case of a 54-year-old male with TAO who responded adequately to treatment with tocilizumab, an antibody directed against the IL-6 receptor. CONCLUSION: Tocilizumab could be an optional treatment in patients with TAO.
Subject(s)
Antibodies, Monoclonal, Humanized/therapeutic use , Graves Ophthalmopathy/drug therapy , Immunosuppressive Agents/therapeutic use , Chronic Disease , Graves Ophthalmopathy/diagnosis , Graves Ophthalmopathy/immunology , Humans , Male , Middle Aged , Remission Induction , Severity of Illness Index , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
OBJECTIVE: To analyze the relationship between rural and urban homicide rates in Colombia between 1992 and 2015 and the fluctuations in these rates. METHODS: Individual records of homicides and population aggregates in men and women aged 15-64 years were used. The adjusted rates of annual homicides were calculated for urban/rural areas and standardized by age. Rate Ratios (RRs) adjusted by region were calculated. A joinpoint analysis was performed to identify inflection points and the Annual Percentage Change (APC). RESULTS: Four joinpoints were identified in rural and urban rates: after peaking in 1992, homicide rates fell until 1997, and then increased until 2002. From this point on there was a continuous reduction until 2015, although this reduction slowed down from 2005 onward. During almost the whole period, the rates of rural homicides were higher than those of urban homicides, although they equalized at the end of the period. CONCLUSIONS: Unlike in other countries, during the study period Colombian homicide rates, which coincided with the dynamics of the armed conflict, were higher in rural than in urban areas. In recent years, a predominance of urban homicides committed by younger men has been identified, which could pose a challenge to postconflict in Colombia.
