RESUMEN
Psoriasis and non-alcoholic fatty liver disease (NAFLD) are both inflammatory diseases. The study objective was to estimate the risk of NAFLD, non-alcoholic steatohepatitis, and liver fibrosis (by liver stiffness and liver biopsy) in patients with psoriasis and to determine the epidemiological, clinical, immunological (TNF-α, IL-2, IL-6, IL-12, IL-17, IL-23, and TGF-ß) characteristics, and bacterial translocation. Of the 215 psoriatic patients included, 91 presented NAFLD (prevalence: 42.3%). Compared to patients with psoriasis alone, those with NAFLD were significantly more likely to have metabolic syndrome, diabetes, dyslipidemia, body mass index ≥ 30 kg/m2, homeostatic model assessment of insulin resistance ≥ 2.15, and greater psoriasis area severity index. NAFLD patients also had significantly higher levels of TNF-α (p = 0.002) and TGF-ß (p = 0.007) and a higher prevalence of bacterial translocation (29.7% vs. 13.7%; p = 0.004). Liver stiffness measurement was over 7.8 kPa in 17.2% (15/87) of NAFLD patients; 13 of these underwent liver biopsy, and 5.7% (5/87) had liver fibrosis, while 1.1% (1/87) had advanced fibrosis or non-alcoholic steatohepatitis. In conclusion the prevalence of NAFLD in patients with psoriasis is high and associated with a higher prevalence of metabolic syndrome features, bacterial translocation and a higher pro-inflammatory state. It is worth mentioning that liver fibrosis and non-alcoholic steatohepatitis are not frequent in this population of patients.
Asunto(s)
Traslocación Bacteriana/fisiología , Inflamación/microbiología , Inflamación/patología , Enfermedad del Hígado Graso no Alcohólico/microbiología , Enfermedad del Hígado Graso no Alcohólico/patología , Psoriasis/microbiología , Psoriasis/patología , Adulto , Índice de Masa Corporal , Citocinas/metabolismo , Diabetes Mellitus/metabolismo , Diabetes Mellitus/microbiología , Diabetes Mellitus/patología , Femenino , Humanos , Inflamación/metabolismo , Resistencia a la Insulina/fisiología , Cirrosis Hepática/metabolismo , Cirrosis Hepática/microbiología , Cirrosis Hepática/patología , Masculino , Síndrome Metabólico/metabolismo , Síndrome Metabólico/microbiología , Síndrome Metabólico/patología , Persona de Mediana Edad , Enfermedad del Hígado Graso no Alcohólico/metabolismo , Prevalencia , Psoriasis/metabolismo , Índice de Severidad de la EnfermedadRESUMEN
Objetivos: Revisar nuestra experiencia sobre la utilidad de la mamografía anual del muñón en el seguimiento de las recidivas locales postmastectomía.Material y métodos: Se revisaron retrospectivamente 215 mamografías de seguimiento de muñones postmastectomía de un total de 107 mujeres con edades comprendidas entre los 46 y 79 años, realizadas en nuestro centro desde enero de 2000 a diciembre de 2002. Se recogieron tanto los hallazgos radiológicos como los referidos en la historia clínica y exploración física.Resultados: Se detectaron 5 recidivas locales con la mamografía, todas ellas sospechadas con anterioridad clínicamente, suponiendo una tasa de recidiva local de aproximadamente un 4.67 %.Conclusiones: La realización de mamografías periódicas para el seguimiento de las mastectomías no aporta información suplementaria a la obtenida por medio de la historia clínica y el examen físico de la paciente
Objective: o review our experience about the availability of a yearly mammographic examination of the mastectomy site in the follow-up of local recurrences after mastectomy.Materials y methods: We reviewed retrospectively 215 mammographies of mastectomy site from a total of 107 women aging 46 to 79, performed in our institution from January 2000 to December 2002. We noted not only radiologic features but also those referred in clinical history and physical examination.Results: 5 local recurrences were detected on mammography, all of them clinically suspected previously, establishing a local recurrence rate around 4.67 %.Conclusion: The performance of periodic mamographies for the follow-up of the mastectomy site does not improve any additional information to the clinical history and physical examination of the patient