Epidemiología del cáncer de estómago en un centro de referencia del Ecuador / Epidemiology of gastric cancer in a referral center in Ecuador

El cáncer gástrico es el tumor maligno más frecuente del Ecuador. A pesar de los avances en los métodos de diagnóstico y de las terapias oncológicas, la mayoría de los casos se diagnostican en etapas avanzadas de la enfermedad con pobre pronóstico y alta mortalidad. El objetivo de este estudio fue determinar las características epidemiológicas en pacientes atendidos con cáncer gástrico en un centro de referencia del Ecuador. Pacientes y métodos Fue un estudio retrospectivo transversal, fueron elegibles para participar del estudio pacientes atendidos en el Servicio de Oncología del Hospital de Especialidades Eugenio Espejo (HEEE) entre marzo del 2012 y marzo del 2017. Los datos epidemiológicos, clínicos y relacionados con el CG, se recopilaron de las historias clínicas. Resultados Durante el período de estudio se evaluaron 159 pacientes, la mediana de edad fue 61 años y el 52,80 % fueron del sexo masculino. El síntoma más frecuente al diagnóstico fue el dolor abdominal en 59% de los casos. El estadio de la enfermedad en 72% de los pacientes fue loco regionalmente avanzado y diseminado. Aquellos pacientes que se sometieron a cirugía; presentaron mayor sobrevida. Conclusión El 50% de los casos fueron diagnosticados en etapas avanzadas de la enfermedad y se asociaron a pobre pronóstico y alta mortalidad. Las características clínicas y epidemiológicas de este primer estudio realizado en el HEEE permitirán establecer medidas que permitan mejorar el screening y diagnóstico precoz de los pacientes.

Gastric cancer is the most common malignant tumor in Ecuador. Despite advances in diagnostic methods and cancer therapies, most cases are diagnosed in advanced stages of the disease with poor prognosis and high mortality. The objective of this study was to determine epidemiological characteristics in patients treated with gastric cancer at a reference center in Ecuador. Patients and methods It was a cross-sectional retrospective study, patients were eligible in the Oncology Service of the Hospital de Especialidades Eugenio Espejo (HEEE) between March 2012 and March 2017. data were collected from medical records. Results during the study period 159 patients were evaluated, the median age was 61 years and 52.80% were male. The most common symptom of diagnosis was abdominal pain in 59% of cases. The stage of the disease in 72% of patients was regionally advanced and widespread. Those patients who underwent surgery; presented more survival. Conclusions 50% of cases were diagnosed in advanced stages of the disease and were associated with poor prognosis and high mortality. The clinical and epidemiological characteristics of this first study carried out in the HEEE, will allow to establish measures to improve the screening and early diagnosis of patients.

Inverse Associations between a Locally Validated Mediterranean Diet Index, Overweight/Obesity, and Metabolic Syndrome in Chilean Adults.

Obesity and metabolic syndrome (MetS) are key risk factors for chronic disease. Dietary patterns are critical in the incidence and persistence of obesity and MetS, yet there is few data linking diet to obesity and MetS in Chile. Our objective was to use a locally validated diet index to evaluate adherence to a Mediterranean dietary pattern and its correlations with overweight/obesity (OW/O) and MetS prevalence in Chilean adults. We conducted a nationwide, cross-sectional online survey of Chilean adults with complete self-reported diet and body mass index data (n = 24,882). A subsample of 4348 users (17.5%) had valid MetS data. An inverse association was observed between adherence to Mediterranean diet and OW/O and MetS prevalence. As diet quality decreased from healthy, to moderately-healthy, to unhealthy, prevalence increased from 44.8, 51.1, to 60.9% for OW/O and from 13.4, 18.5, to 28.9% for MetS (p-values < 0.001). Adjusted odds ratios for OW/O and MetS were significantly higher in moderately-healthy (OR = 1.58 and 1.54) and unhealthy (OR = 2.20 and 2.49, respectively) diet groups in comparison to the healthy diet group. This study represents the first report on the relationship between Mediterranean diet and chronic disease risk in Chile. It suggests that the Mediterranean diet may be applied to manage chronic disease risk beyond the Mediterranean basin.

Wine grape pomace flour improves blood pressure, fasting glucose and protein damage in humans: a randomized controlled trial.

BACKGROUND: The Mediterranean diet is a healthy diet with positive scientific evidence of preventing chronic diseases. Bioactive components support the healthy properties of the Mediterranean diet. Antioxidants and fiber, two components of the Mediterranean diet, are key functional nutrients for healthy eating and nutrition. Wine grape pomace is a rich source of these dietary constituents and may be beneficial for human health. Our hypothesis was that the intake of red wine grape pomace flour (WGPF) prepared from red wine grapes (Cabernet Sauvignon variety) reduced the metabolic syndrome in humans. To evaluate the effect of WGPF on components of metabolic syndrome we design a 16-week longitudinal intervention study. Thirty-eight males, 30-65 years of age, with at least one component of metabolic syndrome, were randomly assigned to either the intervention group (n = 25) or the control group (n = 13). At lunch, the intervention group was given 20 g of WGPF per day, which contained 10 g of dietary fiber, 822 mg of polyphenols and an antioxidant capacity of 7258 ORAC units. Both groups were asked to maintain their regular eating habits and lifestyles. Clinical evaluation, anthropometric measurements and biochemical blood analyses were done at the beginning and the end of the study. RESULTS: WGPF intake significantly decreased systolic and diastolic blood pressure as well as fasting glucose levels. Plasma γ-tocopherol and δ-tocopherol increased and carbonyl group in plasma protein decreased in WGPT group, significantly. No significant effect was observed for waist circumference, HDL cholesterol, triglycerides, total antioxidant capacity and vitamin C in and between groups. The group-dependent magnitude of the differences between the baseline and final postprandial insulin values and γ-tocopherol concentrations was statistically significant. CONCLUSIONS: The consumption of WGPF-rich in fiber and polyphenol antioxidants, as a food supplement in a regular diet improves blood pressure, glycaemia and postprandial insulin. In addition, increased antioxidant defenses and decreased oxidative protein damage indicating attenuation of oxidative stress. WGPF might be a useful food ingredient for health promotion and chronic disease prevention.

Wine grape pomace flour improves blood pressure, fasting glucose and protein damage in humans: a randomized controlled trial

BACKGROUND: The Mediterranean diet is a healthy diet with positive scientific evidence of preventing chronic diseases. Bioactive components support the healthy properties of the Mediterranean diet. Antioxidants and fiber, two components of the Mediterranean diet, are key functional nutrients for healthy eating and nutrition. Wine grape pomace is a rich source of these dietary constituents and may be beneficial for human health. Our hypothesis was that the intake of red wine grape pomace flour (WGPF) prepared from red wine grapes (Cabernet Sauvignon variety) reduced the metabolic syndrome in humans. To evaluate the effect of WGPF on components of metabolic syndrome we design a 16-week longitudinal intervention study. Thirty-eight males, 30-65 years of age, with at least one component of metabolic syndrome, were randomly assigned to either the intervention group (n = 25) or the control group (n = 13). At lunch, the intervention group was given 20 g of WGPF per day, which contained 10 g of dietary fiber, 822 mg of polyphenols and an antioxidant capacity of 7258 ORAC units. Both groups were asked to maintain their regular eating habits and lifestyles. Clinical evaluation, anthropometric measurements and biochemical blood analyses were done at the beginning and the end of the study. RESULTS: WGPF intake significantly decreased systolic and diastolic blood pressure as well as fasting glucose levels. Plasma γ-tocopherol and δ-tocopherol increased and carbonyl group in plasma protein decreased in WGPT group, significantly. No significant effect was observed for waist circumference, HDL cholesterol, triglycerides, total antioxidant capacity and vitamin C in and between groups. The group-dependent magnitude of the differences between the baseline and final postprandial insulin values and γ-tocopherol concentrations was statistically significant. CONCLUSIONS: The consumption of WGPF-rich in fiber and polyphenol antioxidants, as a food supplement in a regular diet improves blood pressure, glycaemia and postprandial insulin. In addition, increased antioxidant defenses and decreased oxidative protein damage indicating attenuation of oxidative stress. WGPF might be a useful food ingredient for health promotion and chronic disease prevention.

[Early enteral nutrition in cancer patients subjected to a total gastrectomy]. / Nutrición enteral precoz en pacientes con gastrectomía total por cáncer.

BACKGROUND: Total parenteral nutrition has a high cost and frequency of complications. Enteral feeding is a feasible alternative that can be started early in the postoperative period. AIM: To assess digestive tolerance to early enteral feeding in cancer patients undergoing total gastrectomy and to compare early enteral feeding (EEF) with total parenteral nutrition plus enteral feeding (TPN + EF), initiated after overcoming postoperative ileus. PATIENTS AND METHODS: Subjects with a resectable gastric cancer were considered eligible for the study. During surgery a nasoenteral tube was placed and patients were prospectively randomized to EEF or TPN + EF. Digestive tolerance, effectiveness, complications and costs between both modalities of nutritional support were compared. RESULTS: Twenty eight patients (15 male, aged 63 +/- 14 years old) were studied. Fourteen patients were randomized to EEF and 14 to TPN + EF. Diarrhea occurred in 14 and 29% of EEF and TPN + EF patients respectively, (p: NS). Patients with TPN + EF received an average of 28 Cal/kg/day and 1.1 g/kg/day proteins. Patients with EEF received an average of 29 Cal/kg/day and 0.8 g/kg/day proteins. At the eighth postoperative day, serum albumin was 3.9 +/- 0.7 and 3.2 +/- 0.5 g/dl in EEF and TPN + EF patients respectively (p < 0.05), serum prealbumin was 16.9 +/- 5 and 12.3 +/- 4.3 mg/dl in EEF and TPN + EF patients respectively (p < 0.05) and nitrogen balance was +2.4 +/- 1.5 and -1.6 +/- 0.6 g/24 h in EEF and TPN + EF patients respectively (p < 0.05). Postoperative hyperglycemia was observed with a lower frequency and nutritional support costs and length of hospital stay were significantly lower in the EEF group. CONCLUSIONS: After total gastrectomy EEF is well tolerated, safe and effective, even during the early postoperative ileus. This therapeutic modality could be the first choice for nutritional support in these patients.