Gonadal cycle, reproductive indices and detection of parasitism in the clam Ameghinomya antiqua in natural beds of importance for fisheries.

The clam Ameghynomia antiqua is a highly important resource for fisheries due to its high catches volume. It is the bivalve mollusc with the highest fisheries landings from natural beds on the Pacific coast of southern South America; however, studies of the reproductive conditions of this species are scarce and date back many years. The object of the present work was to evaluate the reproductive characteristics of the species, analysing its gametogenic and gonadal cycle, and reproductive indices, in fishery locations that present the natural beds with the highest fisheries catches, as well as parasite loads in the species. The gonads of the individuals were sampled monthly over a year and classified into one of three states called: "in development", "ripe" and "spawned". Synchrony between the sexes was observed in the indicators of the Gonadosomatic Index and Condition Index in each of the locations, although no synchrony was observed between locations. In the gametogenic cycle, the "ripe" state was observed in females in spring-summer, followed by rapid recovery to new development of the gonads; in males the "ripe" state was observed throughout the year. It was observed that males entered the "spawned" state one month ahead of females. The presence of digenean parasites in the state of metacercariae was detected in the gonads and mantle. No significant differences were found in the prevalence or intensity of infection when analysed by sex and month. The metacercariae were identified, by sequencing of three DNA regions, as belonging to the clade shared by species of the genus Parvatrema and close to the Gymnophalloides; both these genera belong to the family Gymnophallidae of the superclass Digenea. Infection was observed to reduce the gonadal tissue, in some cases causing castration. This is the first record of the presence of these parasites of A. antiqua, with genetic identification at genus level. These results are relevant for act proper management of this resource, which is important for fishing.

Effect of Ivermectin on Time to Resolution of Symptoms Among Adults With Mild COVID-19: A Randomized Clinical Trial.

Importance: Ivermectin is widely prescribed as a potential treatment for COVID-19 despite uncertainty about its clinical benefit. Objective: To determine whether ivermectin is an efficacious treatment for mild COVID-19. Design, Setting, and Participants: Double-blind, randomized trial conducted at a single site in Cali, Colombia. Potential study participants were identified by simple random sampling from the state's health department electronic database of patients with symptomatic, laboratory-confirmed COVID-19 during the study period. A total of 476 adult patients with mild disease and symptoms for 7 days or fewer (at home or hospitalized) were enrolled between July 15 and November 30, 2020, and followed up through December 21, 2020. Intervention: Patients were randomized to receive ivermectin, 300 µg/kg of body weight per day for 5 days (n = 200) or placebo (n = 200). Main Outcomes and Measures: Primary outcome was time to resolution of symptoms within a 21-day follow-up period. Solicited adverse events and serious adverse events were also collected. Results: Among 400 patients who were randomized in the primary analysis population (median age, 37 years [interquartile range {IQR}, 29-48]; 231 women [58%]), 398 (99.5%) completed the trial. The median time to resolution of symptoms was 10 days (IQR, 9-13) in the ivermectin group compared with 12 days (IQR, 9-13) in the placebo group (hazard ratio for resolution of symptoms, 1.07 [95% CI, 0.87 to 1.32]; P = .53 by log-rank test). By day 21, 82% in the ivermectin group and 79% in the placebo group had resolved symptoms. The most common solicited adverse event was headache, reported by 104 patients (52%) given ivermectin and 111 (56%) who received placebo. The most common serious adverse event was multiorgan failure, occurring in 4 patients (2 in each group). Conclusion and Relevance: Among adults with mild COVID-19, a 5-day course of ivermectin, compared with placebo, did not significantly improve the time to resolution of symptoms. The findings do not support the use of ivermectin for treatment of mild COVID-19, although larger trials may be needed to understand the effects of ivermectin on other clinically relevant outcomes. Trial Registration: ClinicalTrials.gov Identifier: NCT04405843.

Molecular features of premenopausal breast cancers in Latin American women: Pilot results from the PRECAMA study.

BACKGROUND: In Latin America (LA), there is a high incidence rate of breast cancer (BC) in premenopausal women, and the genomic features of these BC remain unknown. Here, we aim to characterize the molecular features of BC in young LA women within the framework of the PRECAMA study, a multicenter population-based case-control study of BC in premenopausal women. METHODS: Pathological tumor tissues were collected from incident cases from four LA countries. Immunohistochemistry (IHC) was performed centrally for ER, PR, HER2, Ki67, EGFR, CK5/6, and p53 protein markers. Targeted deep sequencing was done on genomic DNA extracted from formalin-fixed, paraffin-embedded tumor tissues and their paired blood samples to screen for somatic mutations in eight genes frequently mutated in BC. A subset of samples was analyzed by exome sequencing to identify somatic mutational signatures. RESULTS: The majority of cases were positive for ER or PR (168/233; 72%), and 21% were triple-negative (TN), mainly of basal type. Most tumors were positive for Ki67 (189/233; 81%). In 126 sequenced cases, TP53 and PIK3CA were the most frequently mutated genes (32.5% and 21.4%, respectively), followed by AKT1 (9.5%). TP53 mutations were more frequent in HER2-enriched and TN IHC subtypes, whereas PIK3CA/AKT1 mutations were more frequent in ER-positive tumors, as expected. Interestingly, a higher proportion of G:C>T:A mutations was observed in TP53 in PRECAMA cases compared with TCGA and METABRIC BC series (27% vs 14%). Exome-wide mutational patterns in 10 TN cases revealed alterations in signal transduction pathways and major contributions of mutational signatures caused by altered DNA repair pathways. CONCLUSIONS: These pilot results on PRECAMA tumors give a preview of the molecular features of premenopausal BC in LA. Although the overall mutation burden was as expected from data in other populations, mutational patterns observed in TP53 and exome-wide suggested possible differences in mutagenic processes giving rise to these tumors compared with other populations. Further -omics analyses of a larger number of cases in the near future will enable the investigation of relationships between these molecular features and risk factors.

Mechanosensory system of the lateral line in the subantarctic Patagonian blenny Eleginops maclovinus.

This study describes the cephalic and trunk lateral line systems in Patagonian blenny Eleginops maclovinus juveniles, providing morphological details for pores, canals and neuromasts. Eleginops maclovinus juveniles possess a complete laterodorsal lateral line that extends from the upper apex of the gill opening along the trunk as far as the caudal fin. The lateral line was ramified through pores and canals. The following pores were recorded: four supraorbital pores, with two along the eye border and two on the snout; seven infraorbital pores, with three on the lacrimal bone and four being infraorbital; five postorbital pores, with three along the preopercular border (upper preoperculum branch) and two on the bone curvature (inferior preoperculum branch); and four mandibular pores aligned along the jaw. Furthermore, five narrow-simple and interconnected canals were found (i.e. preopercular, mandibular, supraorbital and infraorbital canals). Histologically, the dorsal lateral line presented thin neuromasts (350 µm) with short hair cells. By contrast, the cranial region presented long, thick neuromasts. Infraorbital and mandibular neuromasts had a major axis length of 260 µm and respective average diameters of 200 and 185 µm. Sensory system variations would be due to a greater concentration of neuromasts in the cranial region, allowing for a greater perception of changes in water pressure. Scarce morphological information is available for the lateral sensory system in Eleginopsidae, particularly compared to Channichthyidae, Bovichthydae, Artedidraconidae and Bathydraconidae. Therefore, the presented results form a fundamental foundation of knowledge for the lateral-line system in juvenile E. maclovinus and provide a basis for future related research in this taxon as well as within the Notothenioidei suborder.

Reproductive factors and molecular subtypes of breast cancer among premenopausal women in Latin America: the PRECAMA study.

Etiological differences among breast cancer (BC) subtypes have not been clearly established, especially among young women in Latin America. This study examined the relationship between reproductive factors and BC subtypes among 288 BC cases (20-45 years) and population-based matched controls in four Latin American countries. Immunohistochemistry was determined centrally. Associations between BC and reproductive factors were determined. Older age at first full-term pregnancy (FFTP) (Odds Ratio (OR) = 1.11; 95% Confidence Interval (CI), 1.04-1.19 per year), longer time between menarche and FFTP (OR = 1.12; 95%CI: 1.04-1.20 per year), and older age at last pregnancy (OR = 1.10; 95%CI, 1.02-1.19 per year) were associated with an increased risk of estrogen receptor positive (ER+) tumors (n = 122). Ever pregnant (OR = 0.35; 95%CI, 0.13-0.96), number of childbirths (OR = 0.64; 95%CI, 0.47-0.87 per child), time since last birth (OR = 0.92; 95%CI, 0.85-0.99 per year), and history of breastfeeding (OR = 0.23; 95%CI, 0.09-0.58) were inversely associated with the risk of ER+ tumor. Older age at menarche (OR = 0.63; 95%CI, 0.45-0.89 per year) and longer duration of breastfeeding (OR = 0.97; 95%CI, 0.94-1.01 per month) were inversely associated with estrogen receptor negative (ER-) tumors (n = 48). Reproductive factors may be differentially associated with BC subtypes in young Latin American women.

Tejido tiroideo y láser infrarrojo: un estudio morfométrico / Thyroid tissue and infrared laser: a morphometric study

La glándula tiroides posee gran importancia debido a la síntesis y secreción de hormonas, las cuales desempeñan funciones fundamentales para la mantención de la fisiología animal. En este contexto, el objetivo del presente trabajo consistió en determinar parámetros morfométricos de estructuras tiroideas sometidas a estimulaciones con láser infrarrojo (LIR). Para ello, 10 ratas Sprague Dawley de 3 meses de vida y peso aproximado de 200 g, fueron divididas en dos grupos de 5 animales cada uno: grupo control y grupo experimental. Estos últimos recibieron estimulaciones infrarrojas en la tiroides con dosis de 16 J/cm2 durante 15 días seguidos. Una vez sacrificadas las ratas, se extrajeron las glándulas tiroides las que fueron procesadas para microscopía óptica obteniéndose placas histológicas y micrografías con aumentos finales de hasta 1000 X. Se efectuaron estudios morfométricos para determinar en 40 placas, variaciones tisulares generadas por las inducciones infrarrojas, con especial énfasis en la disposición coloidal y dimensiones de folículos y células tiroideas. El análisis de las 40 placas histológicas generados por las inducciones del láser infrarrojo comparados con los controles, reveló que existen marcadas diferencias en todos los componentes del tejido tiroideo analizado, lo cual podría otorgar antecedentes de diferentes funcionalidades en el metabolismo de las glándulas.

The thyroid gland is of great importance because of the synthesis and secretion of hormones which play key roles in the maintenance of animal physiology. In this context, the aim of the present study was to determine morphometric parameters of thyroid structures subjected to infrared laser stimulation (ILS) and for this purpose, 10 Sprague Dawley rats, 3 months of age and weighing approximately 200 grams, were divided into two groups of 5 animals each: the control group and the remaining 5 animals constituting the experimental group received infrared stimulation in the thyroid with doses of 16 J/cm2 for 15 consecutive days. After the rats were sacrificed, the respective thyroids were removed and processed for optical microscopy. Histological plates and micrographs were obtained with final increases of up to 1000 X. Morphometric studies were carried out to determine the tissue variations generated by infrared inductions, with special emphasis on the colloidal arrangement and dimensions of follicles and thyroid cells. Our results revealed that there are marked differences in all the components of the analyzed thyroid tissue which could give antecedents of different functionalities in the metabolism of thyroid glands.

Efecto del láser infrarrojo sobre células tiroideas / Infrared laser effect on thyroid cells

Diez ratas Sprague Dawley de 4 meses de vida y peso aproximado de 250 g fueron divididas en dos grupos de 5 animales cada uno, el grupo A se mantuvo como control y los animales del grupo B recibieron estimulaciones con láser infrarrojo en la tiroides con dosis de 16 J/cm2 durante 15 días consecutivos. Posteriormente las ratas fueron sacrificadas, se extrajeron las respectivas tiroides siendo procesadas para microscopía óptica y se obtuvieron placas histológicas y micrografías de tiroides con aumentos finales de hasta 1000X, las cuales fueron sometidas a estudios morfométricos para determinar en 100 células foliculares: número, áreas y perímetro tanto celular como nuclear, además de disposición coloidal y presencia de vasos sanguíneos. El análisis de los resultados entre las 100 células foliculares pertenecientes a tiroides normal y estimulada revela que existen marcadas diferencias en todos los componentes analizados los que se podría traducir en distintas funcionalidades en el metabolismo de las respectivas glándulas.

Ten 4-month-old Sprague Dawley rats weighing approximately 250 g were divided into two groups of 5 animals each. Group A was the control and the animals in group B received thyroid stimulation with infrared laser in a dose of 16 J/cm2 for 15 consecutive days. Subsequently, rats were euthanized and thyroids were removed and processed for optical microscopy. From both cell types thyroid histological slides and micrographs were obtained with final increases of 400 and 1000X. Morphometric analysis determined the number, areas and cell perimeter as well as colloidal dispersion and presence of blood vessels in 100 follicular cells. Analysis of the results among the 100 follicular cells belonging to normal and stimulated thyroids revealed marked differences in all the analyzed components, which could translate into different functionalities in the metabolism of the respective glands.

Clinical characteristics and HPV type in recurrent respiratory papillomatosis in Colombia.

OBJECTIVE: Describe factors associated with aggressive forms of recurrent respiratory papillomatosis (RRP). MATERIALS AND METHODS: One hundred eighty-nine RRP cases diagnosed between 1985 and 2009 were identified in pathological records. HPV was detected by the SPF-10 method with broad spectrum primers, (version 1). RESULTS: 113 patients had only one surgery (less aggressive) and 76, two or more interventions (more aggressive). The likelihood of aggressive lesions decreased with increasing age at diagnosis and HPV-11 was associated with no significant increase in the risk of aggressiveness. CONCLUSIONS: The age at diagnosis was the main determinant of RRP aggressiveness.

Clinical characteristics and HPV type in recurrent respiratory papillomatosis in Colombia / Características clínicas y genotipo de VPH en papilomatosis respiratoria recurrente en Colombia

Objective. Describe factors associated with aggressive forms of recurrent respiratory papillomatosis (RRP). Materials and methods. One hundred eighty-nine RRP cases diagnosed between 1985 and 2009 were identified in pathological records. HPV was detected by the SPF-10 method with broad spectrum primers, (version 1). Results. 113 patients had only one surgery (less aggressive) and 76, two or more interventions (more aggressive). The likelihood of aggressive lesions decreased with increasing age at diagnosis and HPV-11 was associated with no significant increase in the risk of aggressiveness. Conclusions. The age at diagnosis was the main determinant of RRP aggressiveness.

Objetivo. Describir factores asociados con formas agresivas de papilomatosis respiratoria recurrente (PRR). Material y métodos. Se identificaron 189 casos de PRR diagnosticados entre 1985-2009 en registros patológicos. VPH fue detectado por el método SPF-10 con cebadores de amplio espectro, (versión 1). Resultados. 113 casos presentaron una intervención quirúrgica (menos agresivas) y 76, dos o más intervenciones (más agresivas). La probabilidad de lesiones agresivas disminuyó con el aumento de la edad al momento del diagnóstico y el VPH-11 se asoció con aumento no significativo del riesgo de agresividad. Conclusiones. La edad al momento del diagnóstico fue el principal determinante de la agresividad de PRR.

Location and Density of Immune Cells in Precursor Lesions and Cervical Cancer.

Only a small proportion of women infected with Human Papillomavirus (HPV) develop cervical cancer. Host immune response seems to play a role eliminating the viral infection and preventing progression to cancer. Characterization of tumor infiltrating lymphocytes (TILs) in cervical pre-neoplastic lesions and cervical cancer may be helpful to understand the mechanisms that mediate this protection. The aim of this study was to determine if there are differences in the localization and density (cells/mm(2)) of CD8+ T-cells, CD4+ T-cells and Tregs (CD25 + Foxp3+) in cervical pre-neoplastic lesions and cervical cancer. Immunohistochemical analysis of sections of 96 (26 CIN1, 21 CIN2, 25 CIN3, and 24 SCC) samples revealed that regardless of CIN grades, CD8+ T-cells are more abundant than CD4+, CD25+ and Foxp3+ cells in both the stroma and epithelium. There was a higher density of CD8+ cells in the stroma of cervical cancer compared to CIN3 (OR = 4.20, 95% CI 1.2-15), CIN2 (OR = 7.86, 95% CI 1.7-36.4) and CIN1 (OR = 4.25, 95% CI 1.1-17). Studies evaluating whether these cells are recruited before or after cancer progression will be helpful to understand the role of these cells in the natural history of HPV-induced lesions.

Human papillomavirus genotype detection in recurrent respiratory papillomatosis (RRP) in Colombia.

BACKGROUND: Knowledge on human papillomavirus (HPV) genotype distribution in recurrent respiratory papillomatosis (RRP) is essential to assess the impact of HPV vaccine. It is provided information for Colombia. METHODS: In all, 189 RRP primary cases diagnosed between 1985 and 2009 were identified from 5 pathology laboratories of Cali and Medellin, Colombia. HPV DNA testing in 129 cases that fulfilled inclusion criteria (available paraffin blocks, amplifiable DNA, and confirmed histologic diagnosis of RRP) was performed by the SPF-10/LiPA25 assay (version 1). RESULTS: Of all cases 36.1% were juvenile (<12 years old) and a majority of adults were males (p = .09); 95% of cases were HPV positive. HPV 6, 11, and 16 contributed to 69%, 27.1%, and 7.8% of all HPV positive cases. Twelve cases (9.3%) showed multiple infections; 8 of these were HPV 6 or 11 positive. CONCLUSIONS: HPV prophylactic vaccine including HPV 6 and 11 may have a major impact against RRP.

Primary extranodal, extralymphatic hodgkin lymphoma of the mandible.

Primary extranodal, extralymphatic Hodgkin lymphomas (PEEHLs) are a rare occurrence. When they are encountered, they become diagnostic challenges. We are describing the uniqueness of a case of PEEHL affecting the mandible with his early response to the available chemotherapy.

Secondary syphilis in cali, Colombia: new concepts in disease pathogenesis.

Venereal syphilis is a multi-stage, sexually transmitted disease caused by the spirochetal bacterium Treponema pallidum (Tp). Herein we describe a cohort of 57 patients (age 18-68 years) with secondary syphilis (SS) identified through a network of public sector primary health care providers in Cali, Colombia. To be eligible for participation, study subjects were required to have cutaneous lesions consistent with SS, a reactive Rapid Plasma Reagin test (RPR-titer > or = 1 : 4), and a confirmatory treponemal test (Fluorescent Treponemal Antibody Absorption test- FTA-ABS). Most subjects enrolled were women (64.9%), predominantly Afro-Colombian (38.6%) or mestizo (56.1%), and all were of low socio-economic status. Three (5.3%) subjects were newly diagnosed with HIV infection at study entry. The duration of signs and symptoms in most patients (53.6%) was less than 30 days; however, some patients reported being symptomatic for several months (range 5-240 days). The typical palmar and plantar exanthem of SS was the most common dermal manifestation (63%), followed by diffuse hypo- or hyperpigmented macules and papules on the trunk, abdomen and extremities. Three patients had patchy alopecia. Whole blood (WB) samples and punch biopsy material from a subset of SS patients were assayed for the presence of Tp DNA polymerase I gene (polA) target by real-time qualitative and quantitative PCR methods. Twelve (46%) of the 26 WB samples studied had quantifiable Tp DNA (ranging between 194.9 and 1954.2 Tp polA copies/ml blood) and seven (64%) were positive when WB DNA was extracted within 24 hours of collection. Tp DNA was also present in 8/12 (66%) skin biopsies available for testing. Strain typing analysis was attempted in all skin and WB samples with detectable Tp DNA. Using arp repeat size analysis and tpr RFLP patterns four different strain types were identified (14d, 16d, 13d and 22a). None of the WB samples had sufficient DNA for typing. The clinical and microbiologic observations presented herein, together with recent Cali syphilis seroprevalence data, provide additional evidence that venereal syphilis is highly endemic in this region of Colombia, thus underscoring the need for health care providers in the region to be acutely aware of the clinical manifestations of SS. This study also provides, for the first time, quantitative evidence that a significant proportion of untreated SS patients have substantial numbers of circulating spirochetes. How Tp is able to persist in the blood and skin of SS patients, despite the known presence of circulating treponemal opsonizing antibodies and the robust pro-inflammatory cellular immune responses characteristic of this stage of the disease, is not fully understood and requires further study.

Acute and subacute toxicity of Salvia scutellarioides in mice and rats.

The acute and subacute toxicity of the aqueous extract of Salvia scutellarioides (Lamiaceae) was studied in mice and rats. In the acute toxicity test, oral administration of 2g/kg of Salvia scutellarioides produced neither mortality nor changes in behavior or any other physiological activities. In subacute toxicity studies, no mortality was observed when the two doses of 1 or 2g/kgday of aqueous extract of Salvia scutellarioides extract were administered orally for a period of 28 days. In the blood chemistry analysis, no significant changes occurred, including glucose, creatinine, blood urea nitrogen (BUN), aspartate transaminase (AST), alanine transaminase (ALT), potassium, sodium, chloride, calcium, phosphorus, conjugated billirrubin, total billirrubin, total cholesterol, high density lipoprotein (HDL), triglycerides, total protein, albumin, prothrombin time (PT) and thromboplastin partial time (PTT) of both sexes. Hematological analysis showed no differences in any of the parameters examined (WBC count, platelet and hemoglobin estimation) in either the control or treated group of both sexes. The urinalysis was negative for glucose, ketonic bodies, casts, red blood cells, and albumin in the control and treatment groups. There were no significant differences in the body and organ weights between controls and treated animals of both sexes. Pathologically, neither gross abnormalities nor histopathological changes were observed.

FGFR3 and Tp53 mutations in T1G3 transitional bladder carcinomas: independent distribution and lack of association with prognosis.

FGFR3 and Tp53 mutations have been proposed as defining two alternative pathways in the pathogenesis of transitional bladder cancer. FGFR3 mutations are associated with low-grade tumors and a favorable prognosis. Tp53 alterations are associated with advanced tumors and, possibly, with a poor prognosis. We focus here on the subgroup of T1G3 superficial tumors because they are a major clinical challenge. Patients (n = 119) were identified from a prospective study of 1,356 cases. Mutations in FGFR3 (exons 7, 10, and 15) and Tp53 (exons 4-9) were analyzed using PCR and direct sequencing. All cases were followed for recurrence and death. Survival was analyzed using Kaplan-Meier curves and multivariable Cox regression. FGFR3 mutations were detected in 20 (16.8%) tumors; 100 mutations in Tp53 were found in tumors from 78 (65.5%) cases. Multiple alterations in Tp53 were present in 19 tumors (16%). Inactivating mutations were present in 58% of tumors. The combined mutation distribution (FGFR3/Tp53) was: wt/wt (34.5%), mut/wt (7.6%), wt/mut (48.7%), and mut/mut (9.2%), indicating that the presence of either mutation did not depend on the other (P value = 0.767). FGFR3 and Tp53 mutations were not associated with clinicopathologic characteristics of patients and did not predict, alone or in combination, recurrence or survival. Taking the risk of the wt/wt group as reference, the mutation-associated risks of cancer-specific mortality were: mut/wt 1.42 (0.15-13.75), wt/mut 0.67 (0.19-2.31), mut/mut 1.62 (0.27-9.59). These molecular features support the notion that T1G3 tumors are at the crossroads of the two main molecular pathways proposed for bladder cancer development and progression.

Helicobacter pylori: patología y prevalencia en biopsias gástricas en Colombia / Helicobacter pylori: pathology and prevalence in gastric biopsy in Colombia

Estudio comparativo que describe la prevalencia de Helicobacter pylori y las alteraciones asociadas de mucosa gástrica en individuos sintomáticos procedentes de las principales capitales de Colombia.Objetivo. Estimar la prevalencia y describir la patología asociada con la infección por Helicobacter pylori en biopsias endoscópicas de mucosa gástrica. Metodología. En los departamentos de patología de los hospitales regionales localizados en las capitales de 16 departamentos de Colombia se revisaron los resultados de todos los informes histopatológicos practicados durante 1997. Se seleccionaron los estudios solicitados para evaluar las enfermedades gástricas para recolectar la información disponible sobre edad, género, tipo de procedimiento (biopsia o gastrectomía) y diagnóstico histopatológico. Se hizo una descripción de estas características en las diferentes regiones de Colombia. Resultados. En los hospitales regionales de las 16 ciudades participantes se realizaron durante 1997 un total de 86.243 estudios histopatológicos; 10.4/100 correspondieron a muestras de estómago obtenidas en 96.5/100 de los casos mediante biopsia endoscópica y en el restante 3.5/100 mediante gastrectomía. La prevalencia de H. pylori fue 69.1/100. La mucosa gástrica fue normal en 1.4/100 de los casos. El diagnóstico histopatológico más frecuente fue gastritis crónica no atrófica en 36.4/100. La prevalencia de cáncer fue 9.3/100 y de úlcera gástrica 5.1/100; 96.9/100 de los tumores malignos fueron carcinomas y sólo 3.1/100 linfomas. Conclusión. La patología gástrica asociada con la infección por H. pylori es una causa frecuente de morbilidad en Colombia y su distribución muestra variaciones geográficas significativas

Cancer gastrico y lesiones precursoras. Contraste entre regiones de Colombia / Gastric adenocarcinoma and precursor lesions in Colombia

Estudios epidemiológicos muestran variaciones geográficas significativas en la incidencia de adenocarcinoma gástrico y de complejo de lesiones precursoras: atrofia, metaplasia intestinal y displasia. Es importante describir la prevalencia de Helicobacter pylori (HP) y comparar las alteraciones asociadas de mucosa gástrica en las principales capitales de Colombia. Objetivo: comparar las alteraciones histopatológicas en biopsias endoscópicas de mucosa gástrica de pacientes de diferentes regiones de Colombia. Metodología: en los departamentos de patología de los hospitales regionales seleccionados, durante 1997 se practicaron 86.243 estudios histopatológicos. Del total de estudios realizados, el 10.4 por ciento (8.652) correspondieron a muestras de estómago. En 8.357 (96.5 por ciento) de los casos el estudio se hizo mediante biopsia endoscópica y en 304 (3.5 por ciento) mediante gastrectomía. Se hizo muestreo aleatorio del 25 por ciento y se evaluaron histopatológicamente 2.122 casos. Se hizo una descripción de las características encontradas en las diferentes regiones de Colombia. Resultados: el diagnóstico histopatológico más frecuente fue gastritis crónica superficial 49.8 por ciento. La prevalencia de gastritis atrófica multifocal fue de 27.4 por ciento. El 87 por ciento de los casos con atrofia presentaron además metaplasia intestinal. La actividad inflamatoria aguda se asoció a las anteriores lesiones en 87.5 por ciento. En sólo 2. 1 por ciento la mucosa gástrica fue histológicamente normal. Se encontró displasia en /. 4 por ciento. Las prevalencias de cáncer gástrico y úlcera gástrica fueron 11.9 por ciento y 8.5 por ciento respectivamente, significativamente más altas en hombres y en mayores de 50 años. El 97.7 por ciento de los tumores malignos fueron carcinomas y 2.3 por ciento linfomas. La prevalencia de Helicobacter pylori fue del 69.1 por ciento. La prevalencia más alta de Helicobacter pylori se encontró en gastritis antral difusa 90 por ciento; disminuyó en forma significativa en cáncer y displasia 47.3 por ciento y 41.7 por ciento...

Enfoque y manejo del paciente obeso

La obesidad se considera un importante factor de riesgo para varias enfermedades tales como hipertensi'on arterial, diabetes mellitus, enfermedad coronaria, ateroesclerosis, hipertrigliceridemia e hipercolesterolemia. Se estima que en el mundo la prevalencia de obesidad en la población adulta es de 20 a 50 por ciento, según el criterio y la definición empleados. La Asociación colombiana de obesidad y metabolismo (AS-COM), ha desarrollado un trabajo en equipo a lo largo de 1995, encaminado a elaborar recomendaciones generales que sirven como base para un consenso nacional sobre el enfoque y manejo del paciente obeso yno de la obesidad. El principal objetivo del presente trabajo es llevar al médico general y al paciente obeso, un concepto científico sobre la definición, patogenesis, etiología, clasificación y diagnostico de la obesidad, además de proporcionarle una guía práctica sobre su correcto manejo médico.