The prevalence and demographic associations of headache in the adult population of Peru: a national cross-sectional population-based study.

BACKGROUND: The Global Campaign against Headache is conducting a series of population-based studies to fill the large geographical gaps in knowledge of headache prevalence and attributable burden. One major region not until now included is South America. Here we present a study from Peru, a country of 32.4 million inhabitants located at the west coast of South America, notable for its high Andes mountains. METHODS: The study was conducted in accordance with the standardized methodology used by the Global Campaign. It was a cross-sectional survey using cluster randomised sampling in five regions to derive a nationally representative sample, visiting households unannounced, and interviewing one randomly selected adult member (aged 18-65 years) of each using the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire translated into South American Spanish. The neutral screening question ("Have you had headache in the last year?") was followed by diagnostic questions based on ICHD-3 and demographic enquiry. RESULTS: The study included 2,149 participants from 2,385 eligible households (participating proportion 90.1%): 1,065 males and 1,084 females, mean age 42.0 ± 13.7 years. The observed 1-year prevalence of all headache was 64.6% [95% CI: 62.5-66.6], with age-, gender- and habitation-adjusted prevalences of 22.8% [21.0-24.6] for migraine (definite + probable), 38.9% [36.8-41.0] for tension-type headache (TTH: also definite + probable), 1.2% [0.8-1.8] for probable medication-overuse headache (pMOH) and 2.7% [2.1-3.5] for other headache on ≥ 15 days/month (H15+). One-day prevalence of headache (reported headache yesterday) was 12.1%. Migraine was almost twice as prevalent among females (28.2%) as males (16.4%; aOR = 2.1; p < 0.001), and strongly associated with living at very high altitude (aOR = 2.5 for > 3,500 versus < 350 m). CONCLUSION: The Global Campaign's first population-based study in South America found headache disorders to be common in Peru, with prevalence estimates for both migraine and TTH substantially exceeding global estimates. H15 + was also common, but with fewer than one third of cases diagnosed as pMOH. The association between migraine and altitude was confirmed, and found to be strengthened at very high altitude. This association demands further study.

Características anatomopatológicas, clínicas y ecográficas del cáncer de ovario / Pathological, clinical and ultrasonographic ovarian cancer

Objetivo: Determinar las principales características anatomopatológicas, clínicas y ecográficas del cáncer de ovario y determinar si existe relación entre la ecografía y los hallazgos anatomopatológicos, en el Hospital Nacional Hipólito Unanue en el periodo comprendido del 01 de Enero al 31 de Diciembre del 2012. Materiales y métodos: Se realizó un estudio descriptivo, retrospectivo en 62 pacientes con diagnóstico de cáncer de ovario, atendidas en el Hospital Nacional Hipólito Unanue en el periodo que comprendió al estudio. Resultados: El 80,65% tuvieron estudio ecográfico de alto riesgo y el 19,35% tuvieron estudio ecográfico de bajo riesgo. En el 51,61% de los casos el tamaño fue mayor de 10 cm, el 24,19% tuvo presencia de septos o tabiques de 1 a 3mm; el 46,77% tuvo densidad ecográfica mixta; el 95,16% no tiene bilateralidad de tumoración y de estos 57,62% es izquierda y el 36,23% es derecha. El 75,80% no tuvo presencia de ascitis. La presencia ecográfica de ascitis fue mayor en el estadio clínico IIIC en el 53,3% de los casos. Se encontró masas menores de 5 cm en el 12,9% de casos con estadio IIA y 6,45 % en IIC. El 24,19% de pacientes tuvieron Adenocarcinoma seroso, el 14,52% tuvo carcinoma Seroso Bordeline, seguidos por Adenocarcinoma mucinoso y endometroide en el 11,29 y 8,05% respectivamente. El 67,74% tuvieron diagnóstico patológico de origen epitelial; y el 19,35% tuvieron tumor estromal y cordón sexual. Conclusiones: Existe relación significativa entre la anatomía patológica y el estudio ecográfico en la detección del cáncer de ovario, además este último presenta una alta sensibilidad y especificidad. (AU)

Objective:To determine the main pathological, clinical and ultrasonographic ovarian cancer and to determine the correlation between ultrasound and pathologic findings at the National Hospital Hipólito Unanue in the period from January 1 to December 31 2012. Materials Methods: A retrospective descriptive studywas conducted on 62 patients diagnosed with ovarian cancer treated at the National Hospital Hipólito Unanue in the period that included the study. Results:80.65% had high risk ultrasonography and ultrasound study 19.35% had low risk. 51.61% in the cases size was greater than 10 cm, the presence of 24.19%was septa or walls 1 to 3mm; 46.77% had mixed the ultrasound density; the 95.16% do not have bilateral nature of these tumor and 57.62% is left and the right is 36.23%. The 75.80% had no ascites. Ultrasound presence of ascites was higher in clinical stage IIIC in 53.3% of cases. Under 5 cm mass was found in 12.9% of cases with stage IIA and 6.45% in IIC. 24.19% of patients had serous adenocarcinoma, the carcinoma was14.52% Serous Borderline, followed by mucinous and endometrioid adenocarcinoma in 11.29 and 8.05% respectively. 67.74% had a pathologic diagnosis of epithelial origin; and 19.35% had sex cord stromal tumor. Conclusions: There is significant relationship between pathology and sonography in detection of ovarian cancer, the latter also has a high sensitivity and specificity. (AU)