Glycemic status and health-related quality of life (HRQOL) in populations at risk of diabetes in two Latin American cities.

PURPOSE: To estimate the health-related quality of life (HRQOL) according to glycemic status, and its relationship with sociodemographic and clinical factors in a population at risk of developing type 2 diabetes (T2D). METHODS: Cross-sectional study, using cluster sampling. Data were collected from 1135 participants over 30 years of age, at risk of developing T2D from the PREDICOL project. Participants' glycemic status was defined using an oral glucose tolerance test (OGTT). Participants were divided into normoglycemic subjects (NGT), prediabetes and diabetics do not know they have diabetes (UT2D). HRQOL was assessed using the EQ-5D-3L questionnaire of the EuroQol group. Logistic regression and Tobit models were used to examine factors associated with EQ-5D scores for each glycemic group. RESULTS: The mean age of participants was 55.6 ± 12.1 years, 76.4% were female, and one in four participants had prediabetes or unknown diabetes. Participants reported problems most frequently on the dimensions of Pain/Discomfort and Anxiety/Depression in the different glycemic groups. The mean EQ-5D score in NGT was 0.80 (95% CI 0.79-0.81), in prediabetes, 0.81 (95% CI 0.79-0.83), and in participants with UT2D of 0.79 (95% CI 0.76-0.82), respectively. Female sex, older age, city of residence, lower education, receiving treatment for hypertension, and marital status were significantly associated with lower levels of HRQOL in the Tobit regression analysis. CONCLUSIONS: HRQOL of NGT, prediabetes, and UT2D participants was statistically similar. However, factors such as gender, age. and place of residence were found to be significant predictors of HRQOL for each glycemic group.

Risk of violence from a current or former partner: Associated factors and classification in a nationwide study in Colombia.

Intimate partner violence (IPV) includes assaults that risk a woman's bodily integrity. Intimate partners commit IPV, people with whom the victim shares (or shared) a close personal or sexual relationship. This phenomenon has a great global and national impact. Thus, it is necessary to establish trends of the risk of physical violence to women by their current or former partner in each department of Colombia and its relationship with sociodemographic and health characteristics. This study uses an ecological approach at the departmental level, with victims of intimate partner violence treated at the National Institute of Legal Medicine and Forensic Sciences (INMLyCF). Potential factors were identified through Bayesian factor analysis and were included in the model to estimate risk. The findings show that the Casanare department had the highest risk of producing victims (SMR: 2.545). In departments where the educational level of women is at or below primary school, there is a high-risk ß = 0.343 (0.285, 0.397) of them being assaulted. For the departments in which the employment of women is in sales and services or office workers, the associated factor presents a higher risk ß = 0.361 (0.201, 0.485), as in the risk related to affiliation with the social security system ß = 0.338 (0.246, 0.498), as well as sexual and reproductive life ß = 0.143 (0.003, 0.322). The following categories were associated with physical gender violence: no education and low participation in making purchases at home ß = 0.106 (0.049, 0.199), low participation in decisions about their health, and visits to family and friends ß = 0.240 (0.170, 0.299). Therefore, public health programs should strengthen women's empowerment in household decisions and increase their educational level to reduce this incidence.

Neumotórax espontáneo bilateral en primigestante adolescente, reporte de un caso / Spontaneous bilateral pneumothorax in a primigestant adolescent, a case report

El neumotórax espontáneo es una patología extremadamente rara durante la gestación. Se define como la presencia de aire dentro de la cavidad pleural que puede generar principalmente dolor torácico y disnea. Esta patología tiene unas bajas incidencia y prevalencia en el embarazo, pero es relevante por una alta tasa de recurrencia, con un buen pronóstico para la madre y el feto si es tempranamente diagnosticada y oportunamente manejada. Se relaciona con factores de riesgo como las maniobras de Valsalva efectuadas durante el trabajo de parto, además de con comorbilidad como el tabaquismo, y con el biotipo longilíneo, entre otros, por lo que son muy importantes una adecuada anamnesis y la evaluación de la exploración física. El obstetra debe sospecharlo ante la clínica de dolor torácico asociado a disnea en gestantes en el trabajo de parto y el parto, y tenerlo en cuenta como diagnóstico diferencial. Es de vital importancia tener un manejo multidisciplinario compuesto por ginecoobstetra, internista, neumólogo y neonatólogo, incluido el apoyo por una unidad de cuidado intensivo para evitar complicaciones materno-perinatales que se puedan asociar al neumotórax espontáneo.

Spontaneous pneumothorax is an extremely rare pathology during pregnancy. It is defined as the presence of air inside the pleural cavity that can mainly generate chest pain and dyspnea. This pathology has a low incidence and prevalence in pregnancy, but a high rate of recurrence with a good prognosis for the mother and the fetus if it is diagnosed early and managed early. It is related to risk factors such as Valsalva maneuvers performed during labor, in addition to comorbidities such as smoking, longilinear biotype, among others, so it is very important to have an adequate history and evaluation of the physical examination. The obstetrician must be attentive to chest pain symptoms associated with dyspnea in pregnant women during labor and delivery, suspect this pathology and take it into account as a differential diagnosis. It is vitally important to have a multidisciplinary management composed of the gynecologist-obstetrician, internist, pulmonologist, neonatologist, including the support of an intensive care unit to avoid maternal-perinatal complications that may be associated with spontaneous pneumothorax.

Health-related quality of life (HRQoL) in a population at risk of type 2 diabetes: a cross-sectional study in two Latin American cities.

PURPOSE: The purpose of this study was to describe the health-related quality of life (HRQoL) characteristics in a population at risk of developing type 2 diabetes in Barranquilla and Bogotá, Colombia. METHODS: A cross-sectional study with 1135 participants older than 30 years-of-age recruited in Bogotá D.C., and Barranquilla by cluster sampling in 2018 to 2019. The Finnish Diabetes Risk Score (FINDRISC) was used to detect participants at risk of developing type 2 diabetes (T2D). HRQoL was assessed using the EQ-5D-3L questionnaire. Unadjusted and adjusted logistic regression models were used to calculate odds ratios (OR) and their corresponding 95% confidence intervals CI). RESULTS: Moderate or extreme problems appeared more frequently in the dimensions of Pain/Discomfort (60.8%) and Anxiety/Depression (30.8%). The mean score of the EQ-VAS was 74.3 (± 17.3), significantly larger in the state of complete health (11111) compared with those with problems in more than one of the quality-of-life dimensions. Being female and living in Bogota D.C., were associated with greater odds of reporting problems in the Pain (OR 1.6; 95% CI 1.2-2.2) and Discomfort dimensions (OR 1.6; 95% CI 1.2-2.0) respectively and Anxiety/Depression (OR 1.9; 95% CI 1.3-2.7), (OR 9.1; 95% CI 6.6-12.4), respectively. CONCLUSIONS: As living place and sex were associated with dimensions of Pain/Discomfort and Anxiety/Depression in the HRQoL in people at risk of T2D, greater attention should be paid to these determinants of HRQoL to design and reorient strategies with a territorial and gender perspective to achieve better health outcomes. Diabetes is one of the four non-communicable diseases with increasing prevalence in the world, which has made it a serious public health problem. In Colombia, in 2019 diabetes affected 8.4% of the Colombian adult population and more than one million Colombian adults of this age group have hidden or undetected diabetes. This disease is not only characterized by increased premature mortality, loss of productivity, and economic impact, but it also involves a deterioration in the quality of life of people with diabetes with their respective families. However, very Little is known about health-related quality of life (HRQoL) in a population at risk or with prediabetes. This study has evaluated the quality of life in patients at risk of diabetes and their behavior with some variables as sociodemographic, lifestyle, history, and established their difference in two territories of the Colombian Caribbean. The results of this study indicate that the HRQoL of people at risk of type 2 diabetes is affected by factors such as gender, city, dysglycemia, medication for hypertension and education level. Therefore, greater attention should be paid to these determinants of HRQL to design and implement strategies that reduce this risk of developing type 2 diabetes, prevent prediabetes and improve the quality of life in prediabetic or diabetic patients.

Repeated Suicide Attempts Among Service Users of An Emergency Service in Northern Colombia: Characteristics, Associated Factors, And Management / Intento de Suicidio Repetido en Usuarios de un Servicio de Emergencias En Colombia Del Norte: Características, Factores Asociados y Manejo

Abstract Suicide has increased close to 60% in the last four decades worldwide. In Colombia, during the year 2019, 10,9% of violent deaths were due to suicide. This study aimed to identify risk factors predicting repeated suicide attempts. It also aimed to describe the management of suicidal behaviour within an emergency department of Northern Colombia. Dataset comprised 336 medical records of individuals seeking medical assistance for intentional self-harm between 2008-2019; 136 medical records were associated with previously reported suicide attempts. Results from a multivariate logistic regression showed that suicide ideation and having a history of psychiatric disorders significantly predicted repeated suicide attempts. Furthermore, repeated attempts were more likely in underaged individuals and young adults. Management of patients engaging in suicidal behaviour involved hospitalization and outpatient mental health services. However, a few patients were sent home with recommendations or were non-compliant. Findings from this study highlight the importance to develop evidence-based screening and monitoring protocols that prevent repeated suicide attempts.

Resumen El suicidio ha aumentado en cerca de un 60% en los últimos cuarenta años. En Colombia, para el año 2019, el 10.9% de las muertes violentas se presentaron por suicidio. Este estudio busca identificar los factores de riesgo asociados con los intentos repetidos de suicidio y además realiza un análisis descriptivo del manejo dado a estos pacientes. Esta investigación utiliza la base de datos de la unidad de emergencias en un hospital del norte de Colombia, y se centra en los pacientes que acudieron al hospital por intento de suicidio entre enero de 2008 y junio de 2019. La base de datos presenta 336 casos de los cuales el 81% corresponden a intentos suicidas y 19% a gestos. Resultados de un análisis de regresión logística multivariada mostraron que la ideación suicida y la historia de desorden psiquiátrico predecían significativamente los intentos suicidas repetidos y que los intentos repetidos eran más probables en el grupo de individuos menores de edad y en adultez temprana. El tratamiento administrado a los pacientes fue hospitalización y servicios ambulatorios; un porcentaje fue enviado a casa con recomendaciones. Los hallazgos de este estudio destacan la importancia del desarrollo de protocolos estandarizados basados en evidencia para prevenir los intentos repetidos.

Consecuencias y complicaciones de la amniocentesis. Experiencia de dos centros latinoamericanos de medicina materno fetal / Results and complications of amniocentesis. Experience of two centers of Latin American fetal maternal medicine

Resumen Objetivo Describir las indicaciones, complicaciones y repercusiones de la amniocentesis. Materiales y métodos Estudio descriptivo, observacional y transversal de las amniocentesis efectuadas de 2009 a 2015 en dos unidades de medicina materno fetal de Bogotá, Colombia. Se evaluaron las características de las pacientes, indicación de los procedimientos y las complicaciones. Además, los hallazgos se compararon con reportes de diferentes estudios de la bibliografía internacional. Resultados Se incluyeron 748 amniocentesis. La mediana de edad de las pacientes fue de 29 años (límites 23 y 37). La indicación más común fue el estudio genético en 508 casos (67.9%). Se reportaron 89 (17.5%) casos de cromosomopatías, y de éstas la de mayor frecuencia fue la trisomía 21 en 41 pacientes (46%). La mayor parte de las complicaciones se registró en embarazos que superaron las 20 semanas. La pérdida del embarazo y la amenaza de parto pretérmino atribuibles a la amniocentesis fueron de 0.9 y 2.5%, respectivamente. Conclusión Las características de la amniocentesis permitieron conocer sus repercusiones, complicaciones, tasa de pérdida real o factores asociados, con miras a explorar los factores maternos y fe tales en embarazos únicos y múltiples en dos unidades de Medicina Materno Fetal latinoamericanas.

Abstract Objective The purpose of this paper is to describe the indications, complications and results of amniocentesis performed in two fetal maternal medicine units in Bogota Colombia between 2009 and 2015. Materials and methods Cross-sectional observational descriptive study; 770 amniocentesis performed during 6 years (2009 - 2015) with evaluation of the characteristics of the patients, procedures and complications observed were evaluated. In addition, the findings were compared with reports from different studies of the world literature. Results 748 amniocentesis data were included, statistically analyzing the clinical characteristics of the patients and the results, indications and complications of the procedure. The median age was 29 years (RIQ: 23-37). The most common indication was genetic in 508 cases (67.9%). 89 (17.5%) cases of chromosomopathies were reported, with trisomy 21 being more frequently observed in 41 patients (46%). The loss of pregnancy and the threat of preterm labor attributable to amniocentesis were 0.94% and 2.54%, respectively. Conclusion The characteristics of amniocentesis allow us to know statistics of outcomes, complications, actual loss rate or associated factors, with a view to exploring both maternal and fetal factors in single and multiple pregnancies in two units of Latin American Fetal Maternal Medicine.

Stroke Hospital Characteristics in the Florida-Puerto Rico Collaboration to Reduce Stroke Disparities Study.

OBJECTIVES: Although disparities in stroke care and outcomes have been well documented nationally, state-based registries to monitor acute stroke care in Florida (FL) and Puerto Rico (PR) have not been established. The FL-PR Collaboration to Reduce Stroke Disparities (CReSD) was developed to evaluate race-ethnicity and regional disparities in stroke care performance. The objective of this study was to assess and compare hospital characteristics within a large quality improvement registry to identify characteristics associated with better outcomes for acute ischemic stroke care. METHODS: Trained personnel from 78 FL-PR CReSD hospitals (69 FL, 9 PR) completed a 50-item survey assessing institutional characteristics across seven domains: acute stroke care resource availability, emergency medical services integration, stroke center certification, data collection and use, quality improvement processes, FL-PR CReSD recruitment incentives, and hospital infrastructure. RESULTS: The rate of survey completion was 100%. Differences were observed both within FL and between FL and PR. Years participating in Get With The Guidelines-Stroke (8.9 ± 2.6 years FL vs 4.8 ± 2.4 years PR, P < 0.0001) and proportion of hospitals with any stroke center certification (94.2% FL vs 11.1% PR, P < 0.0001) showed the largest variations. Smaller hospital size, fewer years in Get With The Guidelines-Stroke, and lack of stroke center designation and acute stroke care practice implementation may contribute to poorer outcomes. CONCLUSIONS: Results from our survey indicated variability in hospital- and system-level characteristics in stroke care across hospitals in Florida and Puerto Rico. Identification of these variations, which may explain potential disparities, can help clinicians understand gaps in stroke care and outcomes and targeted interventions to reduce identified disparities can be implemented.

Salud y Medio Ambiente: estrategias metodológicas para valorar el impacto de los daños ambientales sobre la salud / Health and Environment: Methodological Strategies to Assess the Impact of Environmental Damage on Health

Este artículo presenta distintas metodologías utilizadas para valorar los impactos que la contaminación ambiental tiene sobre la salud de la población y algunos resultados de los estudios más destacados en el tema. Estos impactos, denominados desde la economía como externalidades, cobran importancia, dado que cuando se toman las decisiones de inversión −como el tipo de tecnología utilizada en un proceso de producción o la ubicación de una planta eléctrica- es evidente que a la sociedad le interesará saber los impactos que se generarán sobre el ambiente y la salud, por tanto, al final se deberán incluir esos efectos externos en el proceso de toma de decisiones. No obstante, la estimación de los efectos de la contaminación sobre la salud trae consigo un alto grado de incertidumbre. Una parte importante de esa incertidumbre no es de carácter científico sino de los resultados de elecciones éticas y por el desconocimiento del futuro. Todo esto implica un análisis de sistemas multidisciplinarios, con aportes de los ingenieros, salubristas, epidemiólogos, ecólogos y economistas.

This paper aims to present different methodologies used to assess the impact of environmental pollution on the health of the population, and some results that have been addressed by the most important studies on the subject. These impacts, known as externalities in economics, become important because when investment decisions are taken, such as the type of technology used in a production process or the location of an electrically plant, it is clear that the society will be interested to know the impacts generated on the environment and health, thus eventually these external effects must be included on the decision-making process. However, the estimation of the effects of pollution on health has a high degree of uncertainty. An important part of that uncertainty is not scientific, but derives from the results of ethical choices and lack of awareness of the future. All this implies a multidisciplinary systems analysis, with input from engineers, public health professionals, epidemiologists, ecologists and economists.

Relationship of ghrelin, acid uric and proinflammatory adipocytokines in different degrees of obesity or diabetes.

We compared and examined factors associated with ghrelin and uric acid in obese subjects (OB), obese plus type 2 diabetes mellitus (OBDM) and healthy controls (C). Methods. We analyzed blood count, renal function, liver enzymes, lipids, resistin, leptin, IL-6, uric acid and ghrelin in OB, OBDM and C. We included 76 subjects with different body mass index (BMI): 36 C (24 ± 3), 11 OB<40 (30-39.9), 20 OB>40 (40-60), and 9 OBDM (45.9 ± 9). Results. Metabolic profile was as follows: HOMA-IR 4.7 ± 3 and 5 ± 3 vs 2 ± 1 (p < 0.01), resistin 8.7 ± 2 and 9.4 ± 2 vs 5.4 ± 2 ng/mL (p < 0.001), leptin 6.2 ± 3.9 and 5.3 ± 2 vs 3.6 ± 1.8 ng/mL (p = 0.001) and IL-6 197.5 ± 78.9 and 223.6 ± 115 vs 7.4 ± 8.3 pg/mL (p = 0.001) in OB and OBDM vs C, respectively. Ghrelin was higher in OB<40 compared to C (1780 ± 197 vs 1465 ± 12 pg/mL, p < 0.05), and lower in OBDM (987.4 ± 114 pg/mL, p < 0.05). BMI showed a positive correlation with resistin (p < 0.001); leptin (p = 0.004), IL-6 (p = 0.001), uric acid (p = 0.0005) and negative with ghrelin (r = -0.431, p = 0.028). Resistin was directly correlated with leptin (p < 0.001) and inversely correlated with renal function (p = 0.03). Conclusion. Severe obesity and obesity-associated diabetes affected ghrelin and uric acid levels. This may well be associated with proinflammatory adipocytokines, insulin resistance, liver enzymes or renal function.

Conocimiento métodos anticonceptivos en estudiantes de pregrado / Contraceptive method knowledge in undergraduate students

La investigación que se presenta en el siguiente artículo se realizó bajo un estudio de naturaleza cuantitativa, descriptivo de corte transversal, en donde se pretende determinar los conocimientos de los métodos anticonceptivos en los estudiantes de un programa de salud en pregrado. El colectivo en estudio correspondió a 72 estudiantes de enfermería del primer al octavo semestre del primer periodo académico del año en curso, de ambos sexos y en edades comprendidas desde los 16 años hasta 30 años de edad. Los resultados obtenidos correspondieron a un 58% de conocimientos que tienen los estudiantes en formación sobre métodos naturales, 42% métodos hormonales, 65,30% métodos de barrera, 40,30% métodos quirúrgicos, con predominio de nociones en el octavo semestre. Finalmente, se determina que los métodos anticonceptivos del cual tienen más conocimientos los estudiantes resultaron ser: los preservativos, coito interrumpido y los anticonceptivos hormonales y el dispositivo intrauterino

The research presented in the following article was conducted under a quantitative study, cross sectional, where it is intended to determine the knowledge of contraceptive methods among students in an undergraduate health program. The group under study corresponded to 72 nursing students from first to eighth semester of the first academic term of the current year, they were both men and women and aged between 16 years old to 30 years old . The results corresponded to 58% of knowledge among students in training , about natural methods, 42% hormonal methods, barrier methods, 65.30%, 40.30% surgical methods, prevailing notions in the 8th semester Finally, it is determined that contraceptive methods which are more known for students were: condoms, coitus interruptus and hormonal contraceptives and intrauterine devices.

Evolución del estado mental del paciente sometido a la contención mecánica / Evolution of the mental state of the patient submitted to the mechanical containment

La investigación es de naturaleza cuantitativa, descriptivo de corte prospectivo, en donde se pretende caracterizar el tiempo de reversión que se manifiesta en la contención mecánica de pacientes psiquiátricos. El colectivo en estudio correspondió a 30 pacientes con edades comprendidas entre los 15 a los 65 años, del de ambos sexos que manifestaron como características comunes: agitación psicomotriz, con variables alternas comprendidas en, etiología orgánica y número de contenciones implementadas en cada caso. Para realizar la aplicación de los instrumentos de recolección de información se creó un formato de valoración individual de la contención mecánica, el cual fue revisado y ajustado. Los resultados obtenidos indican que el 60% de la muestra es de género masculino, el cual el 30% comprenden edades entre los 35 a 44 años, en donde se evidencian alteraciones en la normalidad de signos vitales y componentes de las esferas mentales. Aunque los síntomas se revierten en un tiempo de 2 a 3 horas por lo cual se da retiro de la contención Servicio de Observación Constante (SOC) en la ESE Hospital Mental Rudesindo Soto (HMRS) durante el segundo semestre del 2009, mecánica, el paciente continúa confuso, finalmente, se observa que la reversión de la contención mecánica en la mayoría de la muestra se presenta en tiempos de +/- 1.1 a 2 horas.

The investigation is of quantitative nature, descriptively of pilot cut, where one tries to characterize the time of reversion that is evident in the mechanical containment of psychiatric patients. The group in study corresponded(fitted) to 30 patients with ages understood(comprised) between the 15 at the age of 65, of the Service of Constant Observation (SOC) in THIS Mental Hospital Rudesindo Soto (HMRS) during the second semester of 2009, of both sexes that they showed like common characteristics: agitation psicomotriz, with alternate variables understood(comprised) in, organic etiology and number of containments implemented in every case. To realize the application of the instruments of compilation of information there was created a format of individual evaluation of the mechanical containment, which was checked and fitted. Them turned out obtained they indicate that 60 % of the sample is of masculine(male) genre, which 30 % understands ages between the 35 to 44 years, where alterations are demonstrated in the normality of vital signs and components of the mental spheres. Although the symptoms are re-spilled in a time from 2 until 3 hours by which gives itself retirement of the mechanical containment, the patient continues that confused, finally, it is observed that the reversion of the mechanical containment in most of the sample presents in times of +/-1.1 to itself at 2 hours.

Actividad antibacteriana de extractos de Phenax rugosus y Tabebuia chrysantha / Antibacterial activity of Phenax rugosus and Tabebuia chrysantha extracts

Se evaluó la actividad antibacteriana de extractos metanólicos, clorofórmicos y de éter de petróleo de las hojas de Phenax rugosus y Tabebuia chrysantha frente a Staphylococcus aureus, Streptococcus pneumoniae, Escherichia coli, Proteus vulgaris y Pseudomona aeruginosa; en los resultados obtenidos se observa muy leve actividad antibacteriana con los extractos metanólicos de ambas plantas; los extractos clorofórmicos y los etéreos no presentaron actividad antimicrobiana. Estos hallazgos indican que posiblemente el uso empírico de estas plantas no se deba a un efecto antibacteriano, pues las concentraciones de los extractos que inhiben el crecimiento bacteriano son demasiado altas para considerarlas antibacterianas.

¿Son alcanzables los Objetivos de Desarrollo del Milenio? / Can we achieve the Millenium Objetives?

Colombia, along with 188 countries, committed itself to achieve the so-called Millennium Development Goals. This depends on the performance of the Colombian “departamentos” (provinces) with respect to the basic indicators. Though the central government and local administrations have agreed to pursue these objectives, it is not clear that they will be successful. This paper focuses on the case of the Departamento of Atlántico. The analysis of the basic indicators for this section of the country shows that it is likely that five of the eight objectives pursued will not be reached. There is no information system with which to develop indicators to gauge the effectiveness of government action. Finally, it was found that there is no clear overall policy for the attainment of the declared goals.

Al igual que otros 188 países, Colombia se comprometió con los denominados Objetivos de Desarrollo del Milenio. El logro del compromiso nacional dependerá del desempeño que los departamentos tengan en los indicadores básicos. Aunque se han firmado acuerdos entre el orden central y los gobiernos locales, no se observa un camino claro para alcanzar estos objetivos. Este trabajo se enfoca en el caso del departamento del Atlántico. El análisis de la información disponible muestra que existe un alto riesgo de no lograr por lo menos cinco de los ocho objetivos planteados. Además, no se cuenta con un sistema de información clara para la construcción a futuro de los indicadores necesarios. Finalmente, no existe una política global clara para redireccionar el camino.

Dilatación quística de la vía biliar en adultos: experiencia del Hospital de La Samaritana 1985-2000 / Cystic dilatation of the bibliary tree in adults: experience of the Hospital de La Samaritana 1985-2000

En el servicio de Cirugia General del Hospital Universitario de La Samaritana se revisaron 16 años de casuistica quirúrgica (1985-2000), analizando de forma descriptiva la presentación y tratamiento de la dilatación quística de la vía biliar; se encontraron un total de 21 casos; el 47.6/100 de la población fue menor de 25 años, con límites entre 16 y 46 años. La variedad anatómica mas frecuente fue la dilatación tipo IV A de la clasificación Todani en ocho pacientes. Los síntomas predominantes fueron dolor abdominal asociado a ictericia; en ninguno se observó la triada de dolor abdominal, masa e ictericia. La ecografía hepatobiliar fue el método diagnóstico mas utilizado y en todos los casos se realizó el tratamiento quirúrgico.

Variaciones del status de hierro en hombres y mujeres adultos antes y después de una prueba de suplementación con sulfato ferroso y ácido fólico

Se evaluó el status de hierro en un grupo de 79 estudiantes universitarios voluntarios, que se encontraban aparentemente sanos, que vivían en Quito (2820 m.s.n.m). Se realizaron determinaciones de hemoglobina (HB), hematocrito (HCT), protorfitina eritrocitaria (EPP), saturación de transferrina (TS), hierro sérico (SI) y la capacidad total de fijación del hierro (TIBC). La deficiencia del hierro fue definida como el hallazgo de dos valores anormales en los indicadores independientes del status de hierro usados (EPP y TS). En el DO ocho mujeres tuvieron anemia (HB<13.4) y un hombre y tres mujeres se les encontro con deficiencia de hierro en el estado II. Una de las mujeres anémicas tubo HB bajo 12g/dl. Doce personas tuvieron niveles se SI bajo 50g/dl, trece tuvieron TS de menos de 16 por ciento, cuatro tuvieron EPP sobre g/G de Hb, siete tuvieron valores de TIBC sobre los 420 g/ml. Nadie tuvo valores de HCT anormales. Luego de 30 días de suplementación de hierro los valores de Hb media se elevaron de 15.43 a 15.59 (p>0.05), el Hct de 46.67 a 47.18 (p>0.05), SI de 89.37 a 137.54 (p>0.05), TS de 25.87 a 37.15 (p>0.05), TIBC de 351.94 a 378,59 (p>0.05) y EPP bajó de 1.66 a 1.47 (p>0.05). Nuestros resultados revelan que este grupo si tenía una deficiencia en su hierro de reserva, pero no en su hierro funcional, así que podemos afirmar que la población a la cual pertenece no es de riesgo.

Variaciones del status de hierro en hombres y mujeres adultos antes y después de una prueba de suplementación con sulfato ferroso y ácido fólico

Se evaluó el estatus de hierro en un grupo de 79 estudiantes universitarios voluntarios, que se encontraban aparentemente sanos, que vivían en Quito. Se realizaron determinaciones de hemoglobina (Hb), hematócrito (Hct), protoporfirina eritrocitaria (EPP), saturación de transferrina (TS), hierro sérico (SI), hierro sérico (SI) y la capacidad total de fijación del hierro (TIBC). La deficiencia de hierro fue definida como el hallazgo de dos valores anormales en los indicadores independientes del status de hierro usados (EPP y TS). En el DO ocho mujeres tuvieron anemia (Hb>13,4) y un hombre y tres mujeres se les encontró con deficiencia de hierro en el estadio II. Una de las mujeres anémicas tuvo HB bajo 12 g/dl. Doce personas tuvieron niveles de SI bajo 50...