[Sclerotic inflammation of the orbit and multifocal fibrosclerosis syndrome]. / Esclerosis inflamatoria orbitaria y síndrome de fibrosis multifocal.

CLINICAL CASE: A fifty-two-year-old woman consulted our department because of a bilateral proptosis. The appearance of acute symptoms suggestive of a digestive disorder during her admission to hospital for the study of the proptosis, led to a diagnosis of multifocal fibrosclerosis with simultaneous affliction of orbital tissue, mesenteric fat and the brain stem. DISCUSSION: Idiopathic Sclerotic Inflammation of the orbit is a rare pathological entity, with similar clinical and radiological characteristics to orbital pseudo-tumour. The differential diagnosis is important because both these conditions differ in treatment and prognosis.

Esclerosis inflamatoria orbitaria y síndrome de fibrosis multifocal / Sclerotic inflammation on the orbit and multifocal fibrosclerosis syndrome

Caso clínico: Mujer de 52 años que consulta en nuestro Servicio por proptosis bilateral. La aparición de sintomatología aguda digestiva durante el ingreso para el estudio de la proptosis, condujo al diagnóstico de un cuadro de fibroesclerosis multifocal, con afectación simultánea de los tejidos orbitarios, grasa mesentérica y tronco de encéfalo. Discusión: El pseudotumor esclerosante orbitario es una rara entidad clinicopatológica, cuyas características en la clínica y en las pruebas de imagen pueden ser similares a las del pseudotumor inflamatorio idiopático. El diagnóstico diferencial es importante porque ambos difieren tanto en su tratamiento como en su pronóstico

Clinical case: A fifty-two-year-old woman consulted our department because of a bilateral proptosis. The appearance of acute symptoms suggestive of a digestive disorder during her admission to hospital for the study of the proptosis, led to a diagnosis of multifocal fibrosclerosis with simultaneous affliction of orbital tissue, mesenteric fat and the brain stem. Discussion: Idiopathic Sclerotic Inflammation of the orbit is a rare pathological entity, with similar clinical and radiological characteristics to orbital pseudo-tumour. The differential diagnosis is important because both these conditions differ in treatment and prognosis (Arch Soc Esp Oftalmol 2008; 83: 263-266)

[Risk factors for cryptorchidism]. / Factores de riesgo de criptorquidia.

OBJECTIVES: To identify the main risk factors for cryptorchidism in southeast Spain, and their possible association with environmental factors. METHODS: In this retrospective case-control study, the target population consisted of babies born in the University of Granada Hospital (UGH) in Granada, Spain, between 1 January 1992 and 31 December 1999, both inclusive. All boys from the target population aged 1 year or more diagnosed at the Pediatric Urology or Endocrinology Services of the UGH as having cryptorchidism (n = 70) were included, and a random sample of 144 baby boys born without cryptorchidism or any other related genitourinary abnormality or disease formed the control group. The mother's hospital record in the obstetrics clinic was checked to record information on potential risk factors, such as residence (specific health care district), parents' occupation, obstetric antecedents, diseases during pregnancy, gestational age at birth, birth weight and type of delivery. To search for associations between cryptorchidism and each of the variables we calculated crude and adjusted odds ratios with unconditional logistic regression analysis. RESULTS: Low gestational age at birth (37 weeks) and cesarian section were significantly associated with cryptorchidism. We also found an association with residence of the mother in the Costa-Alpujarra health care district, but its magnitude decreased when the association was adjusted for the father's occupation in agriculture. This last factor was also associated with cryptorchidism, although the association was not statistically significant. CONCLUSIONS: Our findings are consistent with those of other studies, except for the absence of association between low birth weight and cryptorchidism. Geographic variations in our study population suggested that environmental factors possibly related with farm work are involved in cryptorchidism.

Factores de riesgo de criptorquidia / Risk factors for cryptorchidism

Objetivos: Identificar los principales factores de riesgo de criptorquidia en nuestro ámbito geográfico y la posible asociación de ésta con factores ambientales. Métodos: Se realizó un estudio retrospectivo de casos y controles. La población diana estuvo constituida por los varones nacidos en el Hospital Universitario San Cecilio de Granada entre el 1 de enero de 1992 y el 31 de diciembre de 1999.Se seleccionaron todos los casos (n = 70) diagnosticados decriptorquidia a partir del primer año de vida en las historias clínicas de urología y endocrinología pediátrica del hospital, así como una muestra de 144 controles sin esta enfermedad, ni ninguna otra genitourinaria relacionada. A partir de la historia obstétrica materna se recogió información sobre los potenciales factores de riesgo considerados: factores previos al embarazo (p. ej., lugar de residencia, profesión de los padres);factores del embarazo (p.ej., enfermedades y tratamiento hormonal durante la gestación); y factores del parto y neonatales(p. ej., tipo de parto, edad gestacional y peso del neonato).Para cada uno de ellos se calculó su odds ratio cruda (ORc) y ajustada (ORa) mediante regresión logística no condicionada. Resultados: La baja edad gestacional 37 (..) (AU)

Objectives: To identify the main risk factors for cryptorchidism in southeast Spain, and their possible association with environmental factors. Methods: In this retrospective case-control study, the target population consisted of babies born in the University of Granada Hospital (UGH) in Granada, Spain, between 1 January1992 and 31 December 1999, both inclusive. All boys from the target population aged 1 year or more diagnosed at the Pediatric Urology or Endocrinology Services of the UGH as having cryptorchidism (n = 70) were included, and a random sample of 144 baby boys born without cryptorchidism or any other related genitourinary abnormality or disease formed the control group. The mother’s hospital record in the obstetrics clinic was checked to record information on potential risk factors, such as residence (specific health care district), parents’ occupation, obstetric antecedents, diseases during pregnancy, gestational age at birth, birth weight and type of delivery. To (..) (AU)

[Effects of chronic diseases on the use of primary care by the aged]. / Influencia de la patología crónica sobre la utilización de atención primaria en la tercera edad.

OBJECTIVE: To analyse how often elderly people attend Primary Care (PC) consulting rooms and how attendance is affected by the number and kind of chronic pathologies those elderly people suffer. SETTING: A medical list from each of three Health Centres in the city of Granada was chosen. PATIENTS: All those over 65 registered on these lists from 1990 to 1994 inclusive, 711 people in total, were included. The number of attendances and chronic illnesses were obtained from the Clinical Records. The outcome variable "Mean Annual Consultations" (MAC) over the study period was analysed by ANOVA and multiple linear regression. RESULTS: MAC was 5.79 (SD 4.20), with a range from 0 to 27 consultations. MACs were significantly higher among the elderly registered at the Doctors' Health Centre (p < 0.001), among women (p < 0.05) and for the presence of any of the pathologies under consideration (p < 0.01) except dementia. A relationship was found between the number of comorbidities and MAC (p < 0.001). In the scaled multiple regression analysis, the number of comorbidities, the first variable introduced into the model, explained 33% of variability in use. CONCLUSIONS: The number of chronic pathologies strongly determines elderly people's attendance at PC consulting rooms, independently of the kind of illness they suffer from.