Self-Reported Nutritional Status and Breakfast Characterization in Latin American University Students.

OBJECTIVE: To associate breakfast consumption frequency with self-reported nutritional status and dietary patterns of Latin American university students by human development. MATERIAL AND METHODS: This was a cross-sectional, multicenter observational study. University students from 11 Latin American countries (Argentina, Chile, Colombia, Costa Rica, Ecuador, Guatemala, Mexico, Peru, Paraguay, Panama and Uruguay) were invited to participate by answering an online self-administered questionnaire on food consumption and sociodemographic indicators, associations were investigated using logistic regression. RESULTS: The logistic regression analysis showed significant associations between breakfast consumption and the crude model, models 2 and 3 in countries with very high and upper-middle/high human development. However, after adjustment in the most comprehensive model, the association is no longer statistically significant. In the fully adjusted model of the variables, a significant relationship was observed between breakfast consumption and both healthy and unhealthy dietary patterns. Specifically, students who typically consume breakfast exhibit greater consumption of oatmeal and fruits, as well as healthier dinner choices. Conversely, they exhibit lower consumption of fast food, sugary drinks, and juices. In particular, in highly developed countries, along with the mentioned foods, consumption of dairy was linked to breakfast consumption in a positive way, while alcohol consumption was negatively associated. CONCLUSION: University students who eat breakfast on a regular basis maintain a healthier diet in comparison to those who do not, irrespective of their country's level of human development.

Factors associated with the consumption of fruits and vegetables in latin american university students

Objective: Explore the association between compliance with recommended consumption (5-a-day) of fruits and vegetables (F&V) with sociodemographic factors of university students of Latin America. Subjects: We conducted an analytical cross-sectional study in which 4,880 university students from 10 Latin American countries completed a self-administered online survey. Methods: F&V consumption and other sociodemographic variables were measured according to a validated survey. Body mass index was self-reported. Ordinal logistic regression models were applied. Results: Regarding the consumption of F&V, 4.7% of men complied with the recommendation, while in women this value reached 7.7%. In the adjusted model, having a normal weight (OR= 0.59; 95% CI 0.44-0.7; p=<0.001), being female (OR= 0.67; 95% CI 0.49-0.89; p=<0.01), being enrolled in a health-related degree program (OR= 0,60; IC95% 0,45-0,78; p<0.001), having professional parents (OR= 0.75; 95% CI 0.60-0.95; p=<0.05) and practicing physical activity (OR= 0.34; 95% CI 0.27-0.42; p=<0.001) were associated with compliance to F&V consumption recommendations. In the analysis by country, physical activity was the variable most associated with F&V consumption. Conclusion: We observed a low consumption of F&V in university students. The variables associated with compliance to the F&V recommendation were being normal weight, female, being enrolled in a health-related degree program, having professional parents, and practicing physical activity, the latter being the most important variable.

Objetivo: Explorar la asociación de la frecuencia de cumplimiento de las recomendaciones de consumo (5 al día) de frutas y verduras (F&V) con factores sociodemográficos de estudiantes universitarios de América Latina. Metodología: Se realizó un estudio transversal analítico con 4.880 estudiantes universitarios de 10 países de América Latina, quienes completaron una encuesta en línea autoadministrada. Se midió el consumo de F&V y otras variables sociodemográficas según una encuesta previamente validada. El índice de masa corporal fue autoinformado. Se aplicaron modelos de regresión logística ordinal. Resultados: En cuanto al consumo de F&V, en los hombres el 4,7% cumple con la recomendación, mientras que en las mujeres este valor alcanza el 7,7%. En el modelo más ajustado, presentar normopeso (OR= 0,59; IC 95% 0,44-0,7; p=<0,001), ser mujer (OR= 0,67; IC 95% 0,49-0,89; p=<0,01), estar matriculado en carrera relacionada con la salud (OR= 0,60; IC95% 0,45-0,78; p<0,001), tener padres profesionales (OR= 0,75; IC 95% 0,60-0,95; p=<0,05) y realizar actividad física (OR= 0,34; IC 95% 0,27-0,42; p=<0,001) fueron las variables asociadas al cumplimiento del consumo de F&V. En el análisis por país, la actividad física fue la variable más asociada al consumo de F&V. Conclusión: Se observa un bajo consumo de F&V en estudiantes universitarios, y entre las variables asociadas al cumplimiento de la recomendación de F&V se encuentran estar normopeso, sexo femenino, estar cursando una carrera relacionada con la salud, tener los padres y la práctica de actividad física, siendo esta última la variable más importante.

Asociación entre sueño insuficiente, cambio en el tamaño de lasporciones, patrones alimentarios y sobrepeso/obesidad enestudiantes latinoamericanos / Association between insufficient sleep, change in portion size, eating patterns and overweight/obesity in latin american students

Fundamentos: El sueño es una función biológica de vital importancia ya que interviene en múltiples procesosbiológicos como la regulación energética, estando asociada una mala calidad y/o cantidad de sueño con elsobrepeso y la obesidad. El objetivo fue identificar la asociación de sueño insuficiente con cambios en el tamaño delas porciones, patrones alimentarios y sobrepeso/obesidad en estudiantes universitarios de América Latina.Métodos: Estudio transversal y multicéntrico. A los estudiantes, utilizando un cuestionario on-line, se les consultósobre su alimentación, horas de sueño, peso y estatura y otras variables sociodemográficas.Resultados: El estudio incluyó a 4.880 estudiantes, mayoritariamente mujeres (73,8%), la regresión no mostróasociaciones entre sueño insuficiente con estado nutricional y aumento del tamaño de las porciones de alimentos.En el modelo 3 (mayor ajuste) se observó que el sueño insuficiente se asoció con el consumo de infrecuente dedesayuno OR:1,22 (IC 95% 1,07-1,40) y frutas OR:1,16 (IC 95% 1,01-1,33), y no realizar actividad física OR:1,18(IC95% 1,03-1,34). Por otro lado, hubo asociaciones protectoras frente al sueño insuficiente como pertenecer alsexo femenino OR: 0,86 (IC 95% 0,74-0,99) y ser estudiantes de carreras de la salud OR:0,64 (IC 95% 0,56-0,73).Conclusiones: El estudio revela que el sueño insuficiente en estudiantes universitarios se asocia con no desayunartodos los días y consumir insuficiente fruta.(AU)

Background: Sleep is a biological function of vital importance since it intervenes in multiple biological processessuch as energy regulation, with poor quality and/or quantity of sleep being associated with overweight and obesity.The objective was to identify the association of insufficient sleep with changes in portion sizes, eating patterns andoverweight/obesity in university students in Latin America.Methods: Cross-sectional, multicenter study. Students, using an online questionnaire, were asked about their diet,hours of sleep, weight and height, and other sociodemographic variables.Results: The study included 4,880 students, mostly women (73.8%). The regression showed no association betweeninsufficient sleep with nutritional status and increased food portion size. In model 3 (higher adjustment), it wasobserved that insufficient sleep was associated with infrequent consumption of breakfast OR:1.22 (95% CI 1.07-1.40) and fruits OR:1.16 (95% CI 1.01-1.33), and no physical activity OR: 1.18 (95% CI 1.03-1.34), on the other handthere were protective associations against insufficient sleep such as belonging to the female sex OR: 0.86 (95% CI0.74-0.99) and being students of health careers OR:0.64 (95% CI 0.56-0.73).Conclusions: The study reveals that insufficient sleep in university students is associated with not eating breakfastevery day and insufficient fruit consumption.(AU)

Ultra-processed food and homemade fried food consumption is associated with overweight/obesity in Latin American university students during COVID-19.

OBJECTIVE: We estimated the association between the consumption of select ultra-processed food (UPF), homemade fried food and overweight/obesity in Latin American university undergraduate students during the COVID-19 pandemic. METHODS: We conducted an analytical cross-sectional study. 4539 university students (73.6% female, mean age 22.5 ± 4.4) from 10 Latin American countries completed a self-administered online survey. UPF eating habits and homemade fried food were measured according to a validated survey. Height and body weight were self-reported. Body mass index (BMI) was calculated. A BMI ≥25 kg/m2 was categorized as overweight/obesity. Ordinal logistic regression models were applied. RESULTS: Snacks (36.2%) and homemade fried food (30.2%) had a higher prevalence of consumption than sugary drinks (22.5%) and fast food (7.2%). The greatest strength of association was found between fast food consumption [odds ratio (OR) = 2.16; 95% confidence interval (CI): 1.63-2.85], sugary drinks [OR = 2.05; CI: 1.63-2.59] and homemade fried food [OR = 1.46; CI: 1.16-1.85] with overweight/obesity. CONCLUSION: Latin American university undergraduates present risky eating behaviors associated with overweight and obesity. Effective policies to promote healthy eating should be incorporated and issued from universities to reduce the consumption of UPF and promote homemade, healthier and more natural food.

Biodisponibilidad de fósforo en alimentos y su efecto en la enfermedad renal crónica / Bioavailability of phosphorus in food and its effect in chronic kidney disease

Resumen Introducción: el objetivo del presente trabajo se centra en reconocer la importancia de las investigaciones que relacionan la biodisponibilidad de fósforo en diferentes grupos de alimentos de origen animal, vegetal e industrial y su efecto en la progresión de la enfermedad renal crónica (ERC). Metodología: la revisión se sustentó en la búsqueda literaria en páginas web como PUBMED, Redalyc, SciELO, SCIHUB y Google Academic. Se seleccionó cada estudio, descartando aquellos que no fueran cuantitativos u originales, estuvieran incompletos, sin metodología clara, realizados en mamíferos o si los resultados no se especificaban en porcentajes. La lectura puso especial énfasis en el índice de biodisponibilidad de fósforo derivado del consumo de distintos productos alimenticios. Se elaboraron tres matrices de acuerdo con el origen del comestible y la biodisponibilidad de fósforo que absorbe el organismo. Resultados: se encontró que los alimentos industrializados y los aditivos muestran una biodisponibilidad de fósforo del 90 % al 100 %, los de origen animal del 40 % al 80 % y los de origen vegetal del 30 %. Conclusiones: los aditivos de los alimentos industrializados promueven la hiperfosfatemia y, con ello, aceleran la progresión de la enfermedad renal crónica, a diferencia de los de origen animal y vegetal, menos perjudiciales para la salud. Esto da pauta a la formación del sector salud para ampliar su conocimiento sobre el tratamiento nutricional del paciente.

Abstract Introduction: to know the importance of the investigations that relate the bioavailability of phosphorus in different groups of foods of animal, vegetable and industrialized origin and its effect on the progression in patients with Chronic Kidney Disease (CKD). Methodology: the review is based on a literary search that was carried out on web pages such as: PUBMED, Redalyc, SciELO, SCIHUB and Google Academic. Each of the studies was selected discarding those that were not quantitative, original, complete, with clear methodology, carried out in mammals, and that in their results specified the bioavailability of phosphorus in percentages. All the studies were read, placing main emphasis and interest on the percentage of phosphorus bioavailability when consuming different food groups. Three matrices were made according to the origin of the food and the bioavailability of phosphorus that is absorbed in the body; grouping them into foods of animal, vegetable and industrialized origin and additives. Results: it was found that industrialized foods and additives show a phosphorus bioavailability of 90-100%, those of animal origin 40-80%, those of plant origin 30%. Conclusions: The additives used in industrialized foods promote hyperphosphatemia and thus accelerate the progression of chronic kidney disease, unlike foods of animal and vegetable origin that are less harmful to health. This guides the training of the health sector, expanding its knowledge in the nutritional treatment of the patient.

Prueba diagnóstica entre la citología, biopsia por congelación e histopatología en el diagnóstico del Nódulo Tiroideo en pacientes atendidos en Solca desde el año 2009 ­2017 / Diagnostic Test between cytology, frozen biopsy and histopathology in the diagnosisof the thyroid nodule in patients treated at Solca from 2009 -2017

Introducción: La citología de nódulos tiroideos es una técnica que, evita procedimientos quirúrgicos innecesarios por lo que se lo ha determinado como primera línea dentro del algoritmo de diagnóstico, el objetivo del estudio fue determinar la sensibilidad y la especificidad de la citología y biopsia por congelación frente al estudio histopatológico en el diagnóstico de nódulos tiroideos en pacientes atendidos en Solca desde el año 2009 -2017. Métodos: Es un estudio de tipo observacional, retrospectivo y de correlación diagnóstica; los datos fueron obtenidos de las historias clínicas de pacientes intervenidos quirúrgicamente por nódulos tiroideos con biopsia por congelación, a quienes se les realizó previamente un estudio citológico en el Departamento de patología de SOLCA de la ciudad de Cuenca, Ecuador. El cálculo del tamaño de la muestra fue de 324 casos. Resultados:324 casos fueron incluidos. El 8.3% correspondió a hombres y el 91.7% a mujeres. La media de la edad fue 51.8 años; la gran mayoría provenían de la provincia Azuay con el 64.8%. En los estudios citológicos el 34.6% (112 casos)corresponden a lesiones inflamatorias benignas; el 11.1% [36 casos]a patologías malignas y 14.2% (46 casos)fueron insatisfactorios. En la biopsia por congelación el mayor porcentaje estuvo concentrado en enfermedades benignas con un 62.6% y 35.5% a lesiones malignas. Hubo 6 casos con el 1.9% en donde fue diferido el criterio diagnóstico. En el histopatológico definitivo el 60.2% (195 casos)fueron patologías benignas y el 39.8% (129 casos)fueron lesiones malignas. La sensibilidad de la PAAF frente a histopatológico es alta con un 91.79%, pero la especificidad es baja con un 51.94%. La sensibilidad y la especificidad de la biopsia por congelación frente a histopatológico es alta con un 98.97% y 90.70% respectivamente lo que le confiere una metodología óptima. Conclusiones: La PAAF de tiroides demuestra ser una metodología útil en el diagnóstico de nódulos, siempre y cuando sea realizada y observada por personal capacitado. La biopsia por congelación constituye una técnica con alta sensibilidad y especificidad que nos permite discriminar lesiones benignas de las malignas. Palabras claves: Nódulo tiroideo, Biopsia con Aguja, Servicio de Patología en Hospital, Oncología Médica, Agencias Voluntarias de Salud, Biología Celular, Biopsia con Aguja Fina

Introduction:Cytology of thyroid nodules is a technique that avoids unnecessary surgical procedures and has therefore been determined as the first line within the diagnostic algorithm.General Objective:To determine the sensitivity and specificity of cytology and freezing biopsy versus histopathological study in the diagnosis of thyroid nodules in patients treated in Solca since 2009 -2017. Methods:This is an observational, retrospective and diagnostic correlation study; the data were obtained from the clinical histories of patients surgically treated by thyroid nodules with freeze biopsy, who underwent a cytological study in the Department of pathology of the city of Cuenca, Ecuador. The calculation of the sample size was 324 cases. Results:8.3% corresponded to men and 91.7% to women. The mean age was 51.8 years; The vast majority came from the province of Azuay with 64.8%. In cytological studies, 34.6% [112 cases]correspond to benign inflammatory lesions; 11.1% [36 cases]to malignant pathologies and 14.2% [46 cases]were unsatisfactory. In the freeze biopsy the greater percentage was concentrated in benign diseases with 62.6% and 35.5% to malignant lesions. There were 6 cases with 1.9% where the diagnostic criterion was deferred. In the definitive histopathological, 60.2% [195 cases]were benign pathologies and 39.8% [129 cases]were malignant lesions. The sensitivity of FNAB to histopathological is high with 91.79%, but the specificity is low with 51.94%. The sensitivity and specificity of freezing versus histopathological biopsy is high with 98.97% and 90.70% respectively, which gives it an optimal methodology. Conclusions: Thyroid PAAF proves to be a useful methodology in the diagnosis of nodules, as long as it is performed and observed by trained personnel. Freezing biopsy is a technique with high sensitivity and specificity that allows us to discriminate benign from malignant lesions. Key words:Thyroid Nodule; Biopsy, Needle;Pathology Department, Hospital; Medical Oncology; Voluntary Health Agencies; Cell Biology; Biopsy, Fine-Needle

Neoplasia Pseudopapilar sólida del Páncreas. A Propósito de un Caso / Solid Pseudopapillary Neoplasia of the Pancreas. Case Report

Introducción: La neoplasia pseudopapilarsólida del páncreas es una patología poco frecuente, que se presenta en mujeres jóvenes y es de comportamiento incierto. La prevalencia es del 1-2% y el tratamiento es quirúrgico. En el presente caso se describe a una paciente de sexo femenino de 10 años de edad que muestra esta patología y su correspondiente manejo. Caso clínico:Paciente de sexo femenino, de 10 años de edad, con antecedentes de una nefrectomía hace 6 años por hidronefrosis, refiere dolor abdominal localizado en egigastrio tipo cólico y pérdida de peso. En los estudio de imagen a nivel peritoneal se observa lesión de aspecto ocupativo de tipo sólido neoplásico con área central de probable necrosis y que desplaza en sentido posterior al páncreas así como al estómago y se asocia con adenomegalias peritoneales y retroperitoneales. Evolución:Lapaciente fue sometido a una espleno-pancreatectomía distal.El estudio anatomo-patológico concluyó en neuplasia pseudopapilar sólida del páncreas.Continúa en valoración por consulta externa. Conclusión:Neoplasia Pseudopapilar sólida del Páncreasdebe ser sospechada en pacientes con una masa sólida o quística pancreática con un estudio de imágenes compatibles. Palabras clave:Neoplasia pseudopapilar sólida del páncreas, prevalencia, inmunohistoquímica, receptores progestágenos,Informe de caso

Introduction:Solid pseudopapillary neoplasia of the pancreas is a rare pathology that occurs in young women and has an uncertain behavior. The prevalence is 1-2% and the treatment is surgical. In the present case, a 10-year-old female patient with this pathology and its corresponding management is described. Clinical case: A 10-year-old femalepatient with a history of nephrectomy 6 years ago due to hydronephrosis, complains of colicky localized abdominal pain in the egigastrium and weight loss. In peritoneal imaging studies, a neoplastic solid type occupational lesion with a central area of probable necrosis is observed, which displaces the pancreas as well as the stomach posteriorly and is associated with peritoneal and retroperitoneal adenomegaly. Evolution: The patient underwent a distal spleno-pancreatectomy. The anatomopathological studyconcluded in solid pseudopapillary neuplasia of the pancreas. He continues to be evaluated by external consultation. Conclusion: Solid Pseudopapillary Neoplasia of the Pancreas should be suspected in patients with a solid or cystic pancreatic mass with a compatible imaging study. Key words:Solid pseudopapillary neoplasm of the pancreas, prevalence, immunohistochemistry, progestin receptors, Case Report.

Total Pancreatectomy for Ampullary Adenocarcinoma in a 74-Year-Old Patient: Case Report and Literature Review.

Primary ampullary neoplasms have origin in the ampulla of Vater, an anatomical structure where the common bile duct and the pancreatic duct join together as a common channel. It represents <0.5% of all gastrointestinal cancers and approximately 7% of all periampullary cancers. The adenocarcinomas arising in this region originate from different epithelial cellular constituents present at the site, the histopathological classification encompass: intestinal type, pancreaticobiliary type, and mixed type. Pancreaticoduodenectomy is the treatment of choice when there is an overt or highly suspicious malignant behaviour. We present here the case of a 74-year-old male patient who presented to our department for further investigation of obstructive jaundice and a pancreatic mass associated with a six-month history of significant weight loss and mild epigastric pain. Eventually, a total splenopancreatectomy was performed given the extension of structural anomalies of the organ secondary to an ampullary adenocarcinoma.

Clinical Taste Perception Test for Patients With End-Stage Kidney Disease on Dialysis.

OBJECTIVE: The aim of this study was to validate a direct taste perception test (TPT) and evaluate its performance in patients on dialysis. METHODS: This cross-sectional study was carried out in a tertiary-care hospital. A TPT was validated on 112 healthy subjects and applied on 43 patients on hemodialysis and 32 patients on peritoneal dialysis. All participants were presented a 10-mL sample to identify and rate intensity of primary tastes: sweet (sucrose 2%), sour (citric acid 0.1%), bitter (caffeine 0.06%), salty (sodium chloride 0.5%), and umami (sodium glutamate 0.25%). The internal consistency and repeatability of TPT was assessed by Cronbach's alpha and intraclass correlation coefficient. Chi-square and Mann-Whitney U tests were used to compare groups. RESULTS: TPT had Cronbach's alpha of 0.77. Intraclass correlation coefficient was 0.74 for sweet, P < .0001; 0.57 for salty, P = .001; 0.62 for sour, P < .0001; 0.78 for bitter, P < .0001; and 0.76 for umami, P < .0001. Compared with controls, patients on peritoneal dialysis were less able to identify sweet and umami tastes (P < .05) and marginally (P = .06) sour taste, whereas patients on hemodialysis were marginally (P = .06) less able to identify sweet and salty tastes. Bitter was not differently identified between groups. According to the visual analog scale (0-10), all patients on dialysis perceived sour taste less intensely than control subjects (P < .05). CONCLUSIONS: This TPT for patients on dialysis had adequate reliability to identify five primary tastes in a clinical setting. Except for bitter taste, perception of all the primary tastes was altered in patients on dialysis compared with control subjects. A broader use of this test would help identify taste alterations and implement strategies for malnutrition.

Pica en enfermedad renal crónica avanzada: revisión de la literatura / Pica in end-stage chronic kidney disease: Literature review

La pica como entidad individual en el paciente con enfermedad renal crónica (ERC) no ha sido ampliamente estudiada, a pesar de que se ha reportado una alta prevalencia en esta población, y de que las complicaciones propias de la pica (anemia, alteración en electrolitos, mala absorción de micro y macronutrientes y desnutrición) podrían verse exacerbadas en la ERC, lo cual limitaría alcanzar una mejor calidad de la terapia de remplazo renal. La ingesta de sustancias no calóricas y no nutricionales podría ser perjudicial por los efectos en la saciedad y en el descontrol metabólico/electrolítico, y por afectar la biocompatibilidad de los micronutrientes, toxinas y patógenos, lo que finalmente puede empeorar el estado de salud. En la práctica diaria es posible que la pica resulte subreportada debido a la vergüenza del paciente a reconocerlo, o el miedo a que dicho comportamiento pueda influir en su tratamiento. Adicionalmente, los clínicos, al no investigar la presencia de pica o sus complicaciones contribuyen a la falta de información acerca de la magnitud y la relevancia de este trastorno de la conducta alimentaria en la ERC

Pica is an individual entity in the patient with chronic kidney disease (CKD), which phenomenon has not been widely studied despite the high reported prevalence. Moreover, pica complications (anemia, altered electrolytes, poor absorption of micro and macronutrients and malnutrition) could be exacerbated in CKD and limit the quality of renal replacement therapy. The intake of non-caloric and non-nutritional substances could be harmful and cause effects on satiety and metabolic / electrolyte imbalance and modify the biocompatibility of micronutrients, toxins and pathogens worsening health status. In daily practice, pica could be under-reported because patient's shame to recognize it, or fear that such behavior influences their treatment. Additionally, clinicians who not investigate the presence of pica or its complications contribute to the lack of information about the magnitude and relevance of this problem in CKD

Pica in end-stage chronic kidney disease: Literature review. / Pica en enfermedad renal crónica avanzada: revisión de la literatura.

Pica is an individual entity in the patient with chronic kidney disease (CKD), which phenomenon has not been widely studied despite the high reported prevalence. Moreover, pica complications (anemia, altered electrolytes, poor absorption of micro and macronutrients and malnutrition) could be exacerbated in CKD and limit the quality of renal replacement therapy. The intake of non-caloric and non-nutritional substances could be harmful and cause effects on satiety and metabolic / electrolyte imbalance and modify the biocompatibility of micronutrients, toxins and pathogens worsening health status. In daily practice, pica could be under-reported because patient's shame to recognize it, or fear that such behavior influences their treatment. Additionally, clinicians who not investigate the presence of pica or its complications contribute to the lack of information about the magnitude and relevance of this problem in CKD.

Inestabilidad de los microsatélites en cáncer colo-rectal y su distribución de acuerdo a factores pronósticos en SOLCA Cuenca 2004-2014 / Instability of microsatellites in colo-rectal cancer and its distribution according to prognostic factors in SOLCA-Cuenca 2004-2014

Mundialmente, el cáncer colo-rectal constituye la tercera neoplasia más común en hombres y la segunda en mujeres. Las vías de tumorogénesis, nos permite subclasificar a los pacientes y protocolizar tratamientos. Lainestabilidad microsatelital constituye una de estas vías; se presenta en un 15% a 20% en el carcinoma colo-rectal y su presencia se asocia a un mejor pronóstico. Objetivo:Determinar la frecuencia de inestabilidad microsatelital y su distribución de acuerdo a los factores pronósticos en biopsias de pacientes con cáncer colo-rectal atendidos en el Instituto del Cáncer SOLCA-Cuenca durante el periodo 2004-2014".Método:Es un estudio de tipo observacional, analítico. Se estudiaron 240 pacientes con cáncer colo-rectal, diagnosticados en Departamento de Patología del Instituto del Cáncer Solca Cuenca y que disponían de su material de biopsias en donde se realizaron las técnicas de inmunohistoquímica con 4 marcadores MLH1, MSH2, MSH6, PMS2. Resultados:El 37.9% correspondió a hombres y el 62.1% a mujeres. La media de edad fue 66.2 años. El 58.75% (n= 141) tuvieron localización en colon. Se observó falta de expresión proteica en un 24.2 % (58 pacientes). En cuanto a que proteínas, el 68.96% (40 casos) fueron MLH1/PMS2; 1.72 % (1 caso) MSH2/MSH6.De los casos que no expresaron las proteínas el 87.93% se localizaron en el colon; 79.3% fueron adenocarcinoma; 58.6% fueron grado moderado y 37.9% fueron etapa II. En el análisis bivariado se estableció asociación estadísticamente significativa entre la inestabilidad microsatelital con localización del tumor (OR 7 . 4 ; IC 3.2-17) y el grado de diferenciación (OR 2.8; IC 1.5- 5.4). Conclusiones: Se recomienda el uso protocolizado dentro del tratamiento del cáncer colo-rectal.

Worldwide, colorectal cancer is the third most common neoplasm in men and the second in women. Tumorigenesis pathways allow us to sub-classify patients and protocolize treatments. The microsatellite instability constitutes one of these pathways; it is present in a 15% to 20% in colorectal carcinoma; its presence is associated with a better prognosis.Objective:To determine the frequency of microsatellite instability and its distribution according to prognostic factors in biopsies of patients with colorectal cancer in the Solca-Cuenca Cancer Institute during the period 2004-2014. Method:It is an observational, analytical study. About 240 patients with colorectal cancer were studied, they were diagnosed in the Pathology Department of the Cuenca Cancer Institute and who had their biopsy material where the immunohistochemical techniques were performed with 4 markers MLH1, MSH2, MSH6, and PMS2.Results:The 37.9% corresponded to men and 62.1% to women. The average age was 66.2 years. The 58.75% (n = 141) had localization in the colon. A lack of protein expression was observed in 24.2% (58 patients). Regarding to proteins, 68.96% (40 cases) were MLH1 / PMS2; 1.72% (1 case) MSH2 / MSH6. About the cases that did not express the proteins, 87.93% were located in the colon; 79.3% were adenocarcinoma; 58.6% were moderate grade and 37.9% were stage II. In the bivariate analysis, a statistically significant association was established between microsatellite instability with tumor location (OR 7 . 4 , CI 3.2-17) and degree of differentiation (OR 2.8, CI 1.5- 5.4). Conclusions:The protocolized use is recommended within the treatment of colorectal cancer.

Collaterals management during pancreatoduodenectomy in patients with celiac axis stenosis: A systematic review of the literature.

BACKGROUND/OBJECTIVES: Celiac axis stenosis (CAS) represents an uncommon and typically innocuous condition. However, when a pancreatic resection is required, a high risk for upper abdominal organs ischemia is observed. In presence of collaterals, such a risk is minimized if their preservation is realized. The aim of the present study is to systematically review the literature with the intent to address the routine management of collateral arteries in the case of CAS patients requiring pancreatoduodenectomy. METHODS: A systematic search was done in accordance with the PRISMA guidelines, using "celiac axis stenosis" AND "pancreatoduodenectomy" as MeSH terms. Seventy-four articles were initially screened: eventually, 30 articles were identified (n = 87). RESULTS: The main cause of CAS was median arcuate ligament (MAL) (n = 31; 35.6%), followed by atherosclerosis (n = 20; 23.0%). CAS was occasionally discovered during the Whipple procedure in 15 (17.2%) cases. Typically, MAL was divided during surgery (n = 24/31; 77.4%). In the great majority of cases (n = 83; 95.4%), vascular abnormalities involved the pancreatoduodenal arteries (i.e., dilatation, arcade, channels, aneurysms). Collateral arteries were typically preserved, being divided or reconstructed in only 14 (16.1%) cases, respectively. Severe ischemic complications were reported in six (6.9%) patients, 20.0% of whom were reported in patients with preoperatively unknown CAS (p-value 0.06). CONCLUSIONS: A correct pre-operative evaluation of anatomical conditions as well as a correct surgical planning represent the paramount targets in CAS patients with arterial collaterals. Vascular flow must be always safeguarded preserving/reconstructing the collaterals or resolving the CAS, with the final intent to avoid dreadful intra- and post-operative complications.