BackgroundTo describe the frequency of diabetic retinopathy (DR) and its associated variables in Brazilian Xavante Indians.MethodsA population-based survey carried out in two Xavante Reservations between 2008 and 2012, included 948 Indians aged 20 years or more, identified 246 individuals with type 2 diabetes. A non-probabilistic cluster sample of 140 diabetic individuals were submitted to ophthalmologic examination. Due to operational conditions and to optimize the field work, only the larger Xavante villages were included. Ophthalmologic examinations were performed during one trip to each reservation, in their villages and consisted of measurement visual acuity, anterior segment biomicroscopy, applanation tonometry, and direct and indirect ophthalmoscopy.ResultsThe frequency of DR was 19.3%, distributed as follows: mild non-proliferative retinopathy in nine (33.3%) subjects, moderate in nine (33.3%), severe in six (22.3%), very severe in two (7.4%), and high-risk proliferative DR in one (3.7%). The occurrence of DR was higher among those with a longer duration of diabetes, higher levels of glycated hemoglobin (HbA1c) and fasting glucose, papillary excavation ≥ 0.5, and among individuals in older age group. Using the log-binomial regression model, diabetes duration > 24 months and HbA1c ≥ 6.5% were significantly associated with the occurrence of DR.ConclusionsThe presence of DR (19.3%) in Xavante Indians is an alert for health care providers for this population, since diabetes is a new disease among them. Its association with disease duration, high levels of HbA1c and blood glucose calls attention for the necessity of more actions to improve diabetes control in this recently contacted ethnic group that needs particular attention.
Primary adenocarcinoma of the lacrimal gland with sebaceous differentiation is an extremely rare tumor. Only 11 cases have been reported in the literature, none in children. A 4-year-old girl presented with a rapidly progressing mass in the left lacrimal gland fossa. An incisional biopsy followed by partial orbital exenteration confirmed the diagnosis of adenocarcinoma with sebaceous cell differentiation. Currently, no previous reports of this malignancy in childhood have been published. This case underscores the necessity of expanding the presenting age that adenocarcinomas with sebaceous differentiation of the lacrimal gland can occur.
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