Warthin Tumor of the Caruncle: A Rare Case Report and Review of the Literature.

The authors describe a case of Warthin tumor arising in the caruncle of a 76-year-old man. Clinical examination identified a left medial canthus swelling that was treated by complete local excision. Pathologic examination revealed a benign epithelial tumor with diagnostic features of Warthin tumor. Clinical and histologic features, along with review of the literature, are discussed.

THE RELATIONSHIP BETWEEN DEPRESSION, ANXIETY DISORDER AND LOW SELF-ESTEEM IN REGARD TO GLYCEMIC VARIABILITY IN DIABETIC PATIENTS.

Objective: We analyzed the possible correlation between glycemic variability and psychological disorders such as depression, anxiety disorder, and low self-esteem, in diabetic patients. These correlations are relevant, as they consume a large number of resources. Their better understanding can increase the effectiveness of incident reduction techniques and could provide better management and cost reduction of care. Methods: We compared the relationships between the glycemic variability (for a period of 10 days prior to completing the depression questionnaire) and the results of two standardized questionnaires: Hamilton anxiety scale - HRSA (group 1: 500 patients), Rosenberg self-esteem test (group 2: 490 patients) and Beck depression inventory (both groups). Results: A statistically significant correlation was identified between the glycemic oscillation and depression as well as both anxiety and low self-esteem. The present data justify further research. Our results could be developed into a preliminary intervention protocol, using the daily glycemic values measurements, collected by patients. In conclusion, psychometric tests could be an important instrument in the management of diabetic patients.

Association of serum adiponectin and insulin-like growth factor I levels with parameters of cardiac remodeling in severely obese patients.

BACKGROUND: Obesity is associated with various changes in cardiac geometry and this process involves both hemodynamic and non-hemodynamic factors, among which adipocitokines and growth factors may play an important role. The aim of this study was to identify the extent and pattern of cardiac remodeling in a group of severely obese patients and analyze the relationship between adiponectin, IGFI and cardiac parameters reflecting obesity-associated structural changes. SUBJECTS AND METHODS: Our study included 344 patients (104 men) with severe obesity [mean body mass index (BMI)= 45.7 ± 8.5 kg/m(2)], extensively evaluated clinically and biologically (complete metabolic tests, serum adiponectin, and IGF-I measurements). Left ventricular (LV) mass index (LVMI), left atrium (LA) size, and LV geometry were determined by means of cardiac ultrasound. RESULTS: The most prevalent pattern of LV geometry was eccentric hypertrophy (28.7% of patients). In a gender-, age-, BMI-, diabetes- and hypertension-adjusted general linear model, patients with concentric or eccentric hypertrophy had significantly lower values of adiponectin than those with normal geometry (6.75 ± 0.41, 6.96 ± 0.53, vs 9.04 ± 0.42 mg/l, p<0.05). In multivariate analysis, independent determinants for LVMI were BMI (ß=0.364, p<0.001), systolic blood pressure (BP) (ß=0.187, p=0.004), age (ß=0.246, p<0.001), adiponectin (ß=-0.151, p=0.012), and IGF-I z-score (ß=0.134, p=0.025) while factors independently related to LA size were systolic BP (ß=0.218, p<0.001), BMI (ß=0.194, p<0.001), age (ß=0.273, p<0.001), gender (ß=-0.195, p<0.001), and adiponectin (ß=-0.180, p=0.005). CONCLUSIONS: In patients with severe obesity, IGF-I z score and adiponectin correlate with parameters of cardiac remodeling independently of anthropometric, hemodynamic or metabolic factors.