ABSTRACT
El crecimiento unilateral de una de las amígdalas palatinas o asimetría amigdalina se asocia de manera generalizada con malignidad y es objeto de amigdalectomías sistematizadas. Existen ciertas características clínicas que aumentan el grado de sospecha de malignidad. Objetivo: Determinar los indicadores de malignidad en pacientes con asimetría amigdalina de la consulta otorrinolaringológica del Hospital Militar de Maracaibo y del Hospital Manuel Noriega Trigo entre enero de 2012 a enero de 2013. Diseño: Estudio de corte transversal. Materiales y Métodos: Se evaluaron 587 pacientes que acudieron a la consulta otorrinolaringológica; 74 casos correspondieron a asimetría amigdalina (12,6%), teniendo en cuenta edad, sexo, antecedentes, síntomas, hallazgos físicos y resultado anatomopatológico, en el período comprendido entre enero de 2012 a enero de 2013. El análisis estadístico incluyo la construcción de un modelo de regresión logística. Resultados: Los resultados histopatológicos de los casos con asimetría amigdalina fueron: 63 (85%) patología benigna y 11 (15%) neoplasia. La patología maligna estuvo representada por carcinoma epidermoide y linfoma no Hodgkin. Los factores que mostraron relación con malignidad fueron: edad >40 años, hábito tabáquico, pérdida de peso, adenopatías cervicales y hallazgos sospechosos de las tonsilas palatinas. Conclusiones: La indicación de amigdalectomía en pacientes con crecimiento amigdalino unilateral, debe ser clara y fundamentarse en la valoración clínica exhaustiva, basada en la identificación de factores indicadores de malignidad en ésta entidad. Se puede plantear la posibilidad de llevar a cabo un control y seguimiento estricto en los casos de asimetría amigdalina sin evidencia de factores de riesgo...
The unilateral growth of the tonsils or tonsillar asymmetry is widely associated with malignancy and is the subject of tonsillectomies systematized. There are certain clinical features that increase the level of suspicion for malignancy. Objective: To determine the indicators of malignancy in patients with tonsillar asymmetry of otolaryngology consultation from Military Hospital of Maracaibo and Manuel Noriega Trigo Hospital during January 2012 to January 2013. Design: Crosssectional study. Materials and Methods: 587 patients attending the otolaryngology consultation were evaluated; 74 cases were tonsillar asymmetry (12.6%), taking into account age, sex, history, symptoms, physical findings, histopathology, during the period from January 2012 to January 2013. The statistical analysis included the construction of logistic regression model. Results: Histopathological findings of cases with tonsillar asymmetry were: 63 (85%) benign and 11 (15%) neoplastic disease. The malignancy was represented by squamous cell carcinoma and non- Hodgkin lymphoma. Factors related to malignancy showed were: age > 40 years, smoking, weight loss, cervical lymphadenopathy and suspicious findings of the palatine tonsils. Conclusions: The indication for tonsillectomy in patients with unilateral tonsillar growth should be clear and substantiated by thorough clinical assessment, based on the identification of indicators of malignancy factors in this entity. It may be the possibility of carrying out strict control and monitoring in cases of tonsillar asymmetry without evidence of risk factors...
Subject(s)
Humans , Carcinoma , Neoplasms , Otolaryngology , HealthABSTRACT
Type 2 diabetes mellitus and obesity are the most frequent endocrine-metabolic diseases in the world and their pathogenic basis are characterized by insulin resistance and insulin secretion defects that can be demonstrated through several alterations in carbohydrates, lipids, and protein metabolism. The peroxisome proliferator-activated receptors have been identified as key regulators of glucose and lipid metabolism, because they act as transcription factors that stimulate protein synthesis in a wide variety of processes (energetic metabolism, proliferation, and cellular differentiation), of which have been identified 3 types (alpha, beta/delta, gamma). The thiazolidenediones are compounds that act as agonists of the peroxisome proliferator-activated receptor-gamma increasing the tissues sensibility (muscle, adiposity tissue, and liver) to the insulin action; that is why they are used nowadays in treatment of type 2 diabetes mellitus. These drugs produce several of adverse effects, such as weight increased, edema, anemia, pulmonary edema, and congestive cardiac failure. Even their use have been related for some studies to an increased in the myocardium infarct risk; this correlation has not been a strong determinant to remove them from the market.
