Insulin resistance in non-diabetes patients with spondyloarthritis.

Objectives: Insulin resistance (IR) constitutes a major underlying abnormality driving cardiovascular disease in the general population and has been linked to inflammatory diseases. In this study, we aimed to determine the prevalence of IR in patients with spondyloarthritis (SpA) and whether IR can be explained by disease-related features in such cases. Method: The study included 577 subjects: 306 patients diagnosed with SpA according to Assessment of SpondyloArthritis international Society criteria and 271 controls. Insulin and C-peptide serum levels, IR and ß-cell function (%B) indices by homoeostatic model assessment (HOMA2), and lipid profiles were assessed in patients and controls. A multivariable regression analysis was performed to evaluate the differences in IR indices between patients and controls and to determine how IR is associated with disease-related characteristics in SpA patients. Results: HOMA2-%B and HOMA2-IR scores, both calculated with insulin or C-peptide, had significantly higher values in SpA patients compared to controls in multivariable analysis adjusted for age, gender, traditional IR-related factors, and glucocorticoid intake. Disease activity, functional status, and metrological SpA indices were positively related to IR, but only in univariable analysis. Disease duration and positivity for human leucocyte antigen-B27 were independently associated with a higher HOMA2-%B after multivariable analysis. Conclusion: Patients with SpA have an increased IR compared to controls. SpA disease-related data are independently associated with ß-cell dysfunction.

[Well-differentiated basal cell adenocarcinoma of the lacrimal sac: a case report]. / Adenocarcinoma de células basales del saco lacrimal bien diferenciado. A propósito de un caso.

Basal cell adenocarcinoma is a rare tumor first considered to be a separate entity by the WHO in 1991. The mean age of presentation is 48 years and it does not affect one gender more than the other. It normally follows an insidious course with nonspecific signs and symptoms. We present a case of adenocarcinoma of the lacrimal sac diagnosed at histological study. We show the CT, MRI, and histological findings. We discuss the differential diagnosis and treatment for this tumor.

Adenocarcinoma de células basales del saco lacrimal bien diferenciado. A propósito de un caso / Well-differentiated basal cell adenocarcinoma of the lacrimal sac: a case report

El adenocarcinoma de células basales es un tumor raro y descrito por la Organización Mundial de la Salud (OMS) en 1991 como entidad propia1,2. La edad media de presentación es de 48 años y no muestra predominio sexual. El curso es insidioso con signos y síntomas inespecíficos. Presentamos un caso de adenocarcinoma de saco lacrimal, cuyo diagnóstico se realizó por anatomía patológica. Mostramos los hallazgos de tomografía computarizada, resonancia magnética y anatomía patológica. Se comenta el diagnóstico diferencial y el tratamiento

Basal cell adenocarcinoma is a rare tumor first considered to be a separate entity by the WHO in 1991. The mean age of presentation is 48 years and it does not affect one gender more than the other. It normally follows an insidious course with nonspecific signs and symptoms. We present a case of adenocarcinoma of the lacrimal sac diagnosed at histological study. We show the CT, MRI, and histological findings. We discuss the differential diagnosis and treatment for this tumor

Perfil neuroepidemiológico en la zona centro del departamento de Caldas (Colombia), años 2004-2005 / Neuroepidemiology profile center zone of department of Caldas (Colombia), years 2004-2005

Introducción. La enfermedad neurológica (EN) es un reto para la comunidad médica; es la causante en un alto grado de la mortalidad, la discapacidad y el deterioro en la calidad de vida del paciente y su familia. Objetivo. Determinar la prevalencia de EN en la población del departamento de Caldas (Colombia): migraña, enfermedad cerebrovascular, enfermedades extrapiramidales, neuropatía periférica, epilepsia, demencia e insomnio. Este último es innovador pues en los estudios colombianos publicados no se conoce su prevalencia con la metodología de la Organización Mundial de la Salud (OMS). Pacientes y métodos. Estudio poblacional, descriptivo, de corte transversal. Se usó el protocolo neuroepidemiológico desarrollado por la OMS y modificado para Colombia. El neurólogo evaluó los casos sospechosos de padecer EN. La información se procesó en el paquete estadístico Epi Info 6.04d. Resultados. De 787 encuestados, 360 fueron sospechosos de EN con criterios de remisión al neurólogo. Se evaluó como control a 20 sujetos no sospechosos. La prevalencia global de EN para la comunidad estudiada, sin incluir el insomnio, fue del 13,4%, mientras que considerando el insomnio fue del 60,4%. Las enfermedades en orden de prevalencia fueron por 1.000 habitantes: insomnio 468 (IC 95%: 433,4-504,4), migraña 278 (IC 95%: 246,3-310,2), demencias (en mayores de 50 años) 51 (IC 95%: 15,8-87,0), neuropatía periférica 48 (IC: 32,7-63,4), enfermedades extrapiramidales 25 (IC 95%: 13,8-37,0), epilepsia 24 (IC 95%: 12,8-35,5) y enfermedad cerebrovascular 10 (IC 95%: 2,5-17,8). Conclusiones. Estos resultados muestran una alta prevalencia de la migraña en nuestra comunidad. De igual manera, la neuropatía periférica, la enfermedad extrapiramidal y la epilepsia fueron más frecuentes que en investigaciones previas. La demencia y la enfermedad cerebrovascular presentaron una prevalencia similar a la descrita. El insomnio mostró una alta prevalencia, pero por la imposibilidad de comparación con otros estudios locales, queda abierta la necesidad de confirmar estos hallazgos

Introduction. The neurological disease (ND) is a challenge for the medical community, cause of a high degree of morbility, mortality, deterioration in the quality of life of the patient and its family. Aim. To determine the prevalence of ND in the population of the department of Caldas (Colombia): migraine, movement disorders, cerebrovascular diseases, peripheral neuropathy, epilepsy, dementia and insomnia. This last one is innovating aspect in the published Colombian studies has not considered and therefore its prevalence with World Health Organization (WHO) methodology is not known. Patients and methods. This is a population, descriptive study, of cross section. The neuroepidemiological protocol developed by the WHO, modified for Colombia was used. The suspicious cases to suffer ND were evaluated by the neurologist. The information was processed in the statistical package Epi Info 6.04d. Results. Of 787 interviews, 360 were suspicious of ND; additionally 20 non suspicious subjects were evaluated like controls. The global prevalence of ND, excluding insomnia was 13.4%, while including insomnia was 60.4%. The prevalence diseases in sequence (by 1,000 inhabitants) were: insomnia 468 (CI 95%: 433.4-504.4), migraine 278 (CI 95%: 246.3-310.2), dementia (in older 50 years) 51 (CI 95%: 15.8-87), peripheral neuropathy 48 (CI 95%: 32.7-63.4), movement disorders 25 (CI 95%: 13.8-37.0), epilepsy 24 (CI 95%: 12.8-35.5) and cerebrovascular disease 10 (CI 95%: 2.5-17.8). Conclusions. These results show high prevalence of migraine in our community. Also, the peripheral neuropathy, movement disorders and epilepsy were more frequent than in previous investigations. Dementia and stroke presented prevalence similar to the reported one. The insomnia showed very high prevalence, but by the non possibility of comparison with other local studies, it is need conduced others studies to confirm these findings

[Neuroepidemiology profile of the central zone of the department of Caldas (Colombia), years 2004-2005]. / Perfil neuroepidemiológico en la zona centro del departamento de Caldas (Colombia), años 2004-2005.

INTRODUCTION: The neurological disease (ND) is a challenge for the medical community, cause of a high degree of morbility, mortality, deterioration in the quality of life of the patient and its family. AIM. To determine the prevalence of ND in the population of the department of Caldas (Colombia): migraine, movement disorders, cerebrovascular diseases, peripheral neuropathy, epilepsy, dementia and insomnia. This last one is innovating aspect in the published Colombian studies has not considered and therefore its prevalence with World Health Organization (WHO) methodology is not known. PATIENTS AND METHODS: This is a population, descriptive study, of cross section. The neuroepidemiological protocol developed by the WHO, modified for Colombia was used. The suspicious cases to suffer ND were evaluated by the neurologist. The information was processed in the statistical package Epi Info 6.04d. RESULTS: Of 787 interviews, 360 were suspicious of ND; additionally 20 non suspicious subjects were evaluated like controls. The global prevalence of ND, excluding insomnia was 13.4%, while including insomnia was 60.4%. The prevalence diseases in sequence (by 1,000 inhabitants) were: insomnia 468 (CI 95%: 433.4-504.4), migraine 278 (CI 95%: 246.3-310.2), dementia (in older 50 years) 51 (CI 95%: 15.8-87), peripheral neuropathy 48 (CI 95%: 32.7-63.4), movement disorders 25 (CI 95%: 13.8-37.0), epilepsy 24 (CI 95%: 12.8-35.5) and cerebrovascular disease 10 (CI 95%: 2.5-17.8). CONCLUSIONS: These results show high prevalence of migraine in our community. Also, the peripheral neuropathy, movement disorders and epilepsy were more frequent than in previous investigations. Dementia and stroke presented prevalence similar to the reported one. The insomnia showed very high prevalence, but by the non possibility of comparison with other local studies, it is need conduced others studies to confirm these findings.