RESUMO
RESUMEN El Síndrome de Guillain-Barré es una polineuropatía desmielinizante aguda que se presenta clínicamente con debilidad muscular y trastornos autonómicos de forma típica, mientras que los síntomas sensitivos suelen pasar desapercibidos. Se describe la historia clínica de un paciente masculino con cuadriparesia fláccida aguda y trastornos sensitivos tipo parestesias y alodinia que dificultaron el diagnóstico durante su abordaje inicial. Luego del abordaje diagnóstico completo se confirmó la presencia del Síndrome de Guillain-Barré. Pese a que los síntomas sensitivos dificultaron el diagnóstico durante el ingreso, es importante destacar que el dolor es una manifestación frecuente de este trastorno, siendo subestimado en numerosos pacientes.
ABSTRACT Guillain-Barré syndrome is an acute demyelinating polyneuropathy that presents clinically with muscular weakness and autonomic disorders in its typical form, while the sensory symptoms usually go unnoticed. We describe the clinical history of a male patient with acute flaccid quadriparesis and sensory disorders such as paresthesia and allodynia that hinder diagnosis within the initial approach. Complete diagnostic work up confirmed the presence of Guillain-Barré syndrome. Although the sensory symptoms confused the diagnosis during admission, it is important to highlight that pain is a frequent manifestation of this disorder, being underestimated in many patients.
RESUMO
Background: A growing body of evidence suggests that cigarette smoking can cause the onset of metabolic syndrome prior to cardiovascular diseases. Therefore, the objective of this study was to evaluate the relationship between smoking habit and metabolic syndrome components in an adult population from Maracaibo city, Venezuela. Methods: The Maracaibo City Metabolic Syndrome Prevalence Study is a descriptive, cross-sectional study with random and multi-stage sampling. In this sub-study, 2212 adults from both genders were selected. On the basis of their medical background, they were classified as smokers, non-smokers and former smokers. Metabolic syndrome was defined according to Harmonizing 2009 criteria, using population-specific abdominal circumference cut-off points. The association between risk factors was evaluated using a logistic regression model. Results: In the studied population, 14.8% were smokers, 15.4% were former smokers. In the multivariate analysis, the presence of metabolic syndrome (smokers: OR, 1.54; 95% CI, 1.11-2.14; p=0.010) and its components were related to cigarette smoking, with the exception of hyperglycemia. High blood pressure was inversely associated with current smoking status (smokers: OR, 0.70 (0.51-0.95); p=0.025). Conclusion: Cigarette smoking represents a related factor with metabolic syndrome, being associated with low high-density lipoprotein-cholesterol, increased abdominal circumference and elevated triacylglyceride levels. Former smokers did not present a greater risk for developing this metabolic disease when compared to non-smokers. The effect of avoiding this habit should be evaluated in future studies in our population.
