Pancreatic ductal adenocarcinoma: Eleven years of experience at a tertiary care hospital center. / Adenocarcinoma ductal de páncreas. Experiencia de 11 años en un centro de tercer nivel.

INTRODUCTION AND AIM: Pancreatic cancer is considered one of the most aggressive solid tumors. In Mexico, it is the twelfth cause of cancer, with 4,489 cases diagnosed annually, and accounts for 4.9% of oncologic deaths. The aim of our study was to describe the clinical and epidemiologic characteristics of the patients diagnosed with pancreatic cancer spanning an 11-year period at the Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán". METHODS: A retrospective, cross-sectional study was conducted that included 479 patients diagnosed with pancreatic cancer, within the time frame of 2003-2013. The documented findings were summarized through descriptive statistics. RESULTS: Of the patients with pancreatic ductal adenocarcinoma, 50.9% were women, and the mean patient age at diagnosis was 61.5 years. A total of 48.4% of the cases were diagnosed at clinical stage IV, 12.9% presented with clinical stage III, and 25.0% had localized disease. Surgery was performed on 37.5% of the patients, the most frequent of which was pancreatoduodenectomy. The surgical mortality rate was 5.5%. CONCLUSION: The clinical characteristics in our study group were similar to those described in the literature. However, the number of candidates for surgical treatment was higher than that reported in other hospitals and the percentage of borderline tumors was lower. Those differences, respectively, are possibly associated with the nature of our referral center and the prolonged intervals between diagnosis and treatment that result in the loss of potential surgical patients.

[Neuroepidemiology in the eastern region of Colombia]. / Neuroepidemiologia en el Oriente colombiano.

OBJECTIVE: To determine the presence of eight neurological disorders (migraine, cerebrovascular disease, disorders of movement, peripheral neuropathy, mental retardation, epilepsy, dementia and the sequelas of head injuries) in the eastern region of Colombia. PATIENTS AND METHODS: Using the neuro epidemiological protocol of the World Health Organization (WHO), modified by our group, together with a questionnaire to determine the sequelas of head injuries and the abbreviated mental test (Mini mental), we interviewed people in the municipalities of Bucaramanga, Piedecuesta and Aratoca. The persons suspected of having neurological disorders, who were over 12 years old, were evaluated by neurologists and those under 12 years old by a neuropaediatrician. RESULTS: In the eastern region, 1,454 persons altogether were interviewed. Neurological conditions were suspected in 454 of these (31.2%), and confirmed in 437 (30.1%). The specific results for these neurological disorders and their respective confidence intervals (in brackets) were: migraine 198.8 (178.7 220.4); peripheral neuropathy: 26.8 (19.4 36.9); epilepsy: 22.7 (15.9 32.1); dementia: 17.9 (11.9 26.5); cerebrovascular disease: 17.2 (11.4 25.7); mental retardation and delayed nervous system development: 15.1 (9.7 23.2); extrapyramidal disorders: 8.3 (4.5 14.8); sequelas of head injuries: 6.9 (3.5 13.1). RESULTS: These results, obtained using a modified version of a WHO protocol, together with dementia and the sequelas of head injuries, will permit the development of health policies and programmes for the control and treatment of neurological disorders prevalent in this region of Colombia