End of Life in Patients With Advanced Non-curable Cancer: Patient Considerations Around the Moment of Death.

There is limited knowledge regarding Colombian patients with advanced cancer preferences regarding their final moments, place of death, and post-death wishes. To better understand these preferences, we conducted 23 in-depth interviews with patients between the ages of 28 and 78 receiving treatment at two academic hospitals and the National Cancer Institute. While many participants desired a peaceful death, few were comfortable discussing the topic of death directly. Some younger participants expressed an interest in euthanasia but had not received any guidance or support. While several participants preferred a home death, some expressed a desire to die in a hospital due to better symptom control. Additionally, when discussing post-death wishes, some participants expressed frustration about being unable to have these conversations with their loved ones and their preferences for funeral arrangements. Socioeconomic and geographical factors significantly impacted the wishes and preferences expressed, with many individuals hesitant to initiate difficult conversations.

Disfunción eréctil en personas con VIH ­ Revisión de alcance / Erectile Dysfunction in People with HIV ­ A Scoping Review

Objetivo Exponer los factores que han sido asociados al desarrollo de disfunción eréctil (DE) en las personas con virus de la inmunodeficiencia humana (VIH) y cuál es la prevalencia de la disfunción eréctil en esta población. Métodos Se realizó una revisión de alcance utilizando las siguientes bases de datos: MEDLINE, CENTRAL, Embase, Scopus, Lilacs, y Psycinfo. Los artículos incluidos debían tener cualquier información relacionada con la DE en personas con VIH, su prevalencia, y posibles factores asociados. Se filtraron un total de 2.726 artículos por título y resumen, y, de estos, se seleccionaron 22 referencias para revisión de texto completo y análisis. Resultados Se encontró que las personas con VIH tienen una mayor probabilidad de presentar DE en comparación con las personas sin VIH. Algunos estudios han establecido una asociación entre la DE y trastornos psicológicos o factores orgánicos, como la lipodistrofia, la hipertensión arterial, la hipercolesterolemia, la diabetes mellitus, la depresión, la ansiedad, y el hipogonadismo. La ingesta de terapia antirretroviral (TARV), más específicamente los inhibidores de la proteasa, sigue siendo cuestionada como causante de DE en pacientes con VIH. Conclusiones Ante un paciente con diagnóstico de VIH, se debe ahondar sobre DE con el fin de recomendar e iniciar conductas terapéuticas que aseguren un mejoramiento en su calidad de vida.

Aim To present factors that have been associated with the development of erectile dysfunction (ED) in people with human immunodeficiency virus (HIV) and the frequency of erectile dysfunction among this population. Methods We performed a scoping review on the following databases: MEDLINE, CENTRAL, Embase, Scopus, Lilacs, and Psycinfo. The articles included information related to ED in people with HIV, its frequency, and possible associated factors. A total of 2,726 articles were filtered by title and abstract, and, from these, 22 references were selected for full-text review and analysis. Results People with HIV were found to be more likely to have ED compared to people without HIV. Some studies have established an association between ED and psychological disorders or organic factors, such as lipodystrophy, high blood pressure, hypercholesterolemia, diabetes mellitus, depression, anxiety, and hypogonadism. The intake of antiretroviral therapy (ART), more specifically protease inhibitors, continues to be questioned as a cause of ED in patients with HIV. Conclusions In HIV-positive men, we recommend to actively seek ED in order to initiate therapeutic conducts that can ensure an improvement in their quality of life.

Microlitiasis testicular como factor de riesgo de Cáncer testicular - Estudio de casos y controles / Testicular Microlithiasis: A Risk Factor for Testicular Cancer ­ A Case Control Study

Introducción Con una prevalencia entre el 1,5% y el 5,6%, la microlitiasis testicular es un hallazgo incidental. Aunque se ha propuesto una posible asociación entre la microlitiasis testicular y el cáncer testicular dicha relación no ha sido comprobada. Objetivos Establecer la relación entre microlitiasis testicular y cáncer testicular. Métodos Se realizó un estudio de casos y controles con la base de datos de un hospital de la ciudad de Bogotá de pacientes atendidos entre 2007 y 2017. Tanto casos como controles debían tener entre 5 y 35 años de edad, sin otros antecedentes que aumentaran el riesgo de cáncer testicular (criptorquidia, antecedente de cáncer testicular contralateral). Los casos debían tener reporte ecográfico y patológico del cáncer testicular así como una historia clínica completa de valoración por Urología. Los controles fueron pacientes que consultaron por otros cuadros de molestia testicular a quienes se les descartó ecográficamente la presencia de cáncer. Resultados Se identificaron 24 casos y 96 controles. Al momento de calcular los riesgos relativos indirectos, se obtuvieron un OR crudo de 7,86 (95% CI 2,3 - 26,86) y un OR ajustado por tabaquismo de 10,66 (95% IC 3,29 - 34,55). Al ajustar por edad, historia de cáncer familiar y antecedente de varicocele, no se encontraron diferencias. Conclusión Existe una aparente asociación entre microlitiasis testicular y cáncer testicular. A pesar de eso, estudios con tamaños de muestra más grande serían beneficiosos. Así mismo, al no poder determinar la existencia de una asociación temporal que permita hablar de causalidad entre las dos condiciones, esos resultados deben tomarse con cautela.

Introduction Testicular microliathiasis is an incidental finding with a prevalence that varies between 1,5% and 5,6%. Although a possible association between testicular microlithiasis and testicular cancer has been proposed, this relationship has not been proven. Objective To establish the association between testicular microlithiasis and testis cancer. Methods A case-control study was conducted with the database of a hospital in the city of Bogotà, Colombia, of patients treated between 2007 and 2017. Both cases and controls should be between 5 and 35 years of age, with no other history that would increase the risk of testicular cancer (cryptorchidism, antecedent of contralateral testicular cancer). The cases had to have an ecographic and pathological report of testicular cancer as well as a complete clinical history of assessment by Urology. Likewise, the control group were patients who attended during the same period, with other testicular problems, such as: hydrocele, varicocele or inguinal hernia and with ultrasound findings that ruled out testicular cancer. Results We identified 24 cases and 96 controls. We found a crude OR of 7.86 (95% CI 2.3­26.86) and an OR adjusted for smoking of 10.66 (95% CI 3.29­34, 55). When adjusting for age, family cancer history and varicocele history, no differences were found. Conclusion There is an apparent association between testicular microlithiasis and testicular cancer. Despite this, studies with larger sample sizes would be beneficial. Likewise, since it cannot determine the existence of a temporary association that allows to speak of causality between the two conditions, these results must be taken with caution.

Epidemiología del cáncer de vejiga con énfasis en Colombia - revisión de la literatura / Epidemiology of Bladder Cancer with Emphasis in Colombia - Review of the Literature

Introducción El cáncer de vejiga es el noveno cáncer más frecuente para ambos sexos con una incidencia en ascenso. Habiendo una aparente relación entre el desarrollo de los países y la epidemiología del cáncer; el objetivo de este artículo es observar la epidemiología del cáncer de vejiga en nuestro medio respecto a otros países y describir los posibles factores asociados. Métodos Se realizó una revisión de la literatura en cuatro bases de datos: Medline, Embase, Cochrane database y Lilacs. Se incluyeron estudios de incidencia, prevalencia, mortalidad, sobrevida y carga de enfermedad, publicados en los últimos 5 años. Resultados Se encontraron 7806 referencias que fueron discriminadas por título y resumen, incluyendo al final 44 referencias en texto completo. Se observaron tasas de incidencia y mortalidad diferentes, siendo las más altas las encontradas en Europa principalmente en la República Checa seguido de Norte América. En Colombia, la incidencia general es de 6,8/100.000 en hombres y 2,1/100.000 en mujeres entre 2003 y 2007, encontrando cifras bajas en departamentos como la Guajira. Conclusiones Se ha observado un ascenso en la incidencia y mortalidad del cáncer de vejiga a nivel global. Parece haber una asociación con el tabaquismo y la dieta, así como con el Índice de Desarrollo Humano. Existe una escasa información en Latino América. En Colombia, observando los datos de algunos departamentos y la distribución de especialistas por regiones, se puede suponer un sub-registro haciendo necesario mejorar los sistemas de vigilancia, así como las políticas de salud para el diagnóstico e intervención temprana del cáncer.

Introduction Bladder cancer is the ninth most common cancer for both sexes with an increasing incidence. There is an apparent relationship between the development of countries and the epidemiology of cancer; the objective of this article is to observe the epidemiology of bladder cancer in our environment respect to other countries and to describe the possible associated factors. Methods A review of the literature was performed in four databases: Medline, Embase, Cochrane database and Lilacs. Studies about Incidence, prevalence, mortality, survival and burden of disease, published in the past 5 years, were included. Results 7806 references were found that were discriminated by title and abstract, 44 references in full text were included at the end. Different incidence and mortality rates were observed, the highest being found in Europe mainly in the Czech Republic followed by North America. In Colombia, the general incidence was 6.8 / 100,000 in men and 2.1 / 100,000 in women between 2003 and 2007, finding low numbers in departments such as Guajira. Conclusions There has been an increase in the incidence and mortality of bladder cancer worldwide. There seems to be an association with smoking and diet, as well as with the Human Development Index. There is little information in Latin America; in Colombia, observing the data of some departments and the distribution of specialists in the different regions a sub-register can be consider, making necessary to improve surveillance systems, as well as health policies for the diagnosis and early intervention of cancer.

Sexualidad en el adulto mayor, conductas y retos ­ revisión de la literatura / Sexuality in the Elderly, Behaviors and Challenges - Review of the Literature

Introducción Pese a que se ha descrito la presencia de actividad sexual en el adulto mayor, ella tiende a menospreciarse. Al no contar con personas con quienes puedan hablar de sus dificultades o les facilite información, los adultos mayores pueden tener problemas para tener una vida sexual activa, así como mayor probabilidad de presentar conductas de riesgo. Objetivo Identificar las actividades sexuales y los problemas en ese campo más frecuentes en el adulto mayor. Métodos Se realizó una revisión en las bases de datos: Medline, Embase, Lilacs y Scielo. Se incluyeron estudios que brindaron información sobre la sexualidad en el adulto mayor al respecto de: Conductas sexuales más frecuentes, condiciones asociadas a una mejor o peor satisfacción sexual, y comunicación con el adulto mayor. Resultados Se revisaron 2.342 artículos por título y el resumen. En total se seleccionaron 27 referencias para revisión en texto completo. Se identificó la importancia de la sexualidad en el adulto mayor en la calidad de vida y cómo ella se ve afectada por la presencia de condiciones como: cáncer, diabetes y depresión; además de falta de deseo, disfunción eréctil en el hombre y la menopausia en la mujer. Dentro de las conductas sexuales más frecuentes se describen: los besos, el coito genital, el sexo oral y la masturbación. Conclusiones Es importante conocer las condiciones que afectan la sexualidad del adulto mayor y entender la forma en que ellos desean vivir su sexualidad para facilitar la comunicación en la consulta y ayudarlos a tener una vida sexual satisfactoria.

Introduction Although the presence of sexual activity in the elderly has been described, it tends to be underestimated. By not having people with whom they can talk about their difficulties or providing them with information, older adults may have problems to have an active sex life, as well as a greater probability of having risky behaviors. Aim To identify the most frequent sexual activities and problems in this field in the elderly. Methods A review was performed in the databases: Medline, Embase, Lilacs and Scielo. We included studies that provided information about sexuality in the older adult regarding: More frequent sexual behaviors, conditions associated with better or worse sexual satisfaction, and communication with the elderly. Results 2,342 articles were reviewed by title and abstract. In total, 27 references were selected for full-text review. The importance of sexuality in the elderly was identified in the quality of life and how it is affected by the presence of conditions such as: cancer, diabetes and depression; In addition to lack of desire, erectile dysfunction in men and menopause in women. Among the most frequent sexual behaviors are described: kissing, genital intercourse, oral sex and masturbation. Conclusions It is important to know the conditions that affect the sexuality of the older adult and to understand the way in which they want to live their sexuality, to facilitate the communication in the consultation and to help them to have a satisfactory sexual life

Mental health in displaced children by armed conflict - National Mental Health Survey Colombia 2015.

INTRODUCTION: The armed conflict in Colombia is considered one of the most violent in Latin America. Children as a vulnerable population are most affected, increasing their risk of developing mental problems such as anxiety disorder and post-traumatic stress disorder. OBJECTIVES: To determine the prevalence of the most frequent mental problems in the Colombian children affected by armed conflict. METHODOLOGY: A cross-sectional study, using data from the National Mental Health Survey 2015. With children aged 7 to 11 years, in whom the RQC, PCL and DISC-IV-P (3.0.1) were applied. RESULTS: We described information on 100 displaced children between 7 and 11 years old due to armed conflict, being a representative sample at national level. It was found that 98.7% of this population is at school, as well as 17.8% in poverty. Mental illnesses were asked according to their appearance in the last 12 months, these were: anxiety disorder 6.5% (CI 95% 2.7-14.7) in displaced population, compared to 1.8% (CI 95% 1.1-3.1) in non-displaced; High score for post-traumatic stress was 13.2% (CI 95% 3.9-36.4) in displaced persons and 6.6% (CI 95% 4.0-10.7) in nondisplaced persons. CONCLUSIONS: Children affected by armed conflict have greater risk of presenting some mental illnesses such as anxiety disorder and post-traumatic stress, evidencing the situation of vulnerability in which they are.

Salud mental en niños desplazados por conflicto armado - Encuesta Nacional de Salud Mental Colombia 2015 / Mental health in displaced children by armed conflict - National Mental Health Survey Colombia 2015

Introducción. El conflicto armado en Colombia es considerado uno de los más violentos de América Latina. Los niños como población vulnerable son los más afectados, aumentándoles el riesgo de desarrollar problemas mentales como trastorno de ansiedad y estrés postraumático. Objetivos. Determinar la prevalencia de los problemas mentales más frecuentes en la población infantil colombiana afectada por el conflicto armado. Metodología. Estudio transversal, con datos de la Encuesta Nacional de Salud Mental 2015. Con niños entre 7 y 11 años, a quienes se les aplicó RQC, PCL, DICS-IV-P (3.0.1). Resultados. Se describió información de 100 niños desplazados ente 7 y 11 años por conflicto armado siendo una muestra representativa a nivel nacional. Se encontró que el 98,7% de esta población se encuentra escolarizada, y el 17,8% en estado de pobreza. Para enfermedades mentales en los últimos 12 meses, se obtuvo: trastorno de ansiedad 6,5% (IC 95% 2,7-14,7) en población desplazada, respecto 1,8% (IC 95% 1,1-3,1) en no desplazados; puntaje alto para estrés post traumático 13,2% (IC 95% 3,9-36,4) en desplazados y 6,6% (IC 95% 4,0-10,7) en no desplazados. Conclusiones: La población infantil afectada por conflicto armado presenta aparentemente mayor riesgo de presentar algunas enfermedades mentales como trastorno de ansiedad y estrés postraumático, evidenciando la situación de vulnerabilidad en la que se encuentran

Introduction. The armed conflict in Colombia is considered one of the most violent in Latin America. Children as a vulnerable population are most affected, increasing their risk of developing mental problems such as anxiety disorder and post-traumatic stress disorder. Objectives. To determine the prevalence of the most frequent mental problems in the Colombian children affected by armed conflict. Methodology. A cross-sectional study, using data from the National Mental Health Survey 2015. With children aged 7 to 11 years, in whom the RQC, PCL and DISC-IV-P (3.0.1) were applied. Results. We described information on 100 displaced children between 7 and 11 years old due to armed conflict, being a representative sample at national level. It was found that 98.7% of this population is at school, as well as 17.8% in poverty. Mental illnesses were asked according to their appearance in the last 12 months, these were: anxiety disorder 6.5% (CI 95% 2.7-14.7) in displaced population, compared to 1.8% (CI 95% 1.1-3.1) in non-displaced; High score for post-traumatic stress was 13.2% (CI 95% 3.9-36.4) in displaced persons and 6.6% (CI 95% 4.0-10.7) in nondisplaced persons. Conclusions. Children affected by armed conflict have greater risk of presenting some mental illnesses such as anxiety disorder and post-traumatic stress, evidencing the situation of vulnerability in which they are

[Chronic diseases in the population affected by the armed conflict in Colombia, 2015]. / Enfermedades crónicas en población afectada por el conflicto armado en Colombia, 2015.

OBJECTIVE: The purpose of this study was to identify the most frequent non-mental chronic illnesses in the Colombian population affected by the armed conflict. METHODOLOGY: A cross-sectional study using data from the National Mental Health Survey 2015. The study population was stratified by sex and age and other general data were extracted, including education and poverty level, measured by the Multidimensional Poverty Index. Data analysis was based on information from people who reported having been victims of the Colombian armed conflict at some time in their lives; the frequency of presentation of non-mental chronic illnesses was reported as a measure of indirect relative risk. RESULTS: Information on 10,764 people over 18 years of age was described, this being a representative sample at the national level. It was found that 10.4% of subjects affected by the armed conflict have a high educational level (technical school or university), and that 43.6% are living in conditions of poverty or vulnerability. The non-mental chronic illnesses identified were: hypertension 20.4% (CI95%: 15.7-26.1); diabetes 6.7% (CI95%: 4.4-10.3); rheumatologic diseases 10.4% (CI95%: 7.1-14.9); gastrointestinal diseases 19.1% (CI95%: 14.5-24.7); and chronic pain 6.9% (CI95%: 4.2-11). CONCLUSIONS: The population affected by the armed conflict is apparently at greater risk of presenting non-mental chronic illnesses such as hypertension and diabetes, which shows the vulnerability of these communities.

Epidemiology of renal cancer in developing countries: Review of the literature.

INTRODUCTION: Renal cell carcinoma (RCC) is the ninth most common cancer in men, and the 14th most common cancer in women. It has been reported that the incidence of RCC is rising. These changes are more common in developed countries because of better screening programs and disease registry. The aim of this article is to review the epidemiology of RCC around the world. METHODS: A literature review of four databases was performed: PubMed, Embase, Lilacs, and Scielo. Studies of incidence, prevalence, mortality, and survival of RCC were taken from different countries. Studies included were published in the last 10 years. Two reviewers independently selected the studies. RESULTS: A total of 5275 references were reviewed by title and abstract. In the end, 42 references were selected for full-text review. The global incidence and prevalence of cancer vary. The highest incidence was described in North America and Northern Europe. In Canada, by 2007 the incidence was 17.9/100 000 and 10.3/100 000 in males and females, respectively. Developing countries like Colombia have fewer incidence rates, with less information in poor-income areas. CONCLUSIONS: We have seen a rise in the incidence and mortality of RCC globally. There is an association between RCC and smoking, obesity, hypertension, and socioeconomic status. Seeing the epidemiological data from some regions in developing countries and the lack of specialists in those places, it can be deduced there is underreporting of the disease that reveals the need to improve both surveillance and disease registration programs, especially in these countries.

Descripción de factores clínicos asociados a la torsión testicular / Description of Clinical Factors Associated with Testicular Torsion

El escroto agudo es una de las pocas condiciones urológicas que requiere intervención inmediata.1 La principal causa de escroto agudo es la torsión testicular y afecta a 4,5 de cada 100.000 hombres menores de 25 años.2 Se presenta por una predisposición dada por un defecto congénito de la inserción del testículo al escroto mediante un gubernaculum testis largo y/o con una implantación posterior que le permite al testículo girar libremente sobre su propio eje

The acute scrotum is one of the few urological conditions requiring immediate intervention.1 The main cause of acute scrotum is testicular torsion and affects 4.5 out of every 100,000 men under the age of 25.2 It arises from a predisposition given by a congenital defect of insertion of the testicle into the scrotum by means of a long gubernaculum testis and/or with a subsequent implantation that allows the testicle to rotate freely on its own axis.

Enfermedades crónicas en población afectada por el conflicto armado en Colombia, 2015

Objetivo. El propósito de este estudio fue identificar las enfermedades crónicas no mentales, más frecuentes en la población colombiana afectada por el conflicto armado. Metodología. Este es un estudio transversal, que usa datos de la Encuesta Nacional de Salud Mental 2015. La población estudiada se estratificó por sexo y edad y se extrajeron otros datos generales como: nivel educativo y grado de pobreza, medido por el Índice Multidimensional de Pobreza. Se analizaron datos de personas que reportaron haber sido víctimas del conflicto armado colombiano en algún momento de la vida la vida y se reportó como medida de riesgo relativo indirecto la frecuencia de presentación de enfermedades crónicas no mentales. Resultados. Se describió información de 10 764 personas mayores de 18 años siendo una muestra representativa a nivel nacional. Se encontró que 10,4 % de los sujetos afectados por el conflicto armado tienen un nivel educativo superior (técnico o universitario), así como 43,6 % se encuentran en estado de pobreza o en estado de vulnerabilidad. Las enfermedades crónicas no mentales identificadas fueron: hipertensión arterial 20,4 % (IC95% 15,7–26,1), diabetes 6,7 % (IC95% 4,4–10,3), enfermedades reumatológicas 10,4 % (IC95% 7,1–14,9), enfermedades gastrointestinales 19,1 % (IC95% 14,5–24,7), y dolor crónico 6,9 % (IC95% 4,2–11) Conclusiones. La población afectada por el conflicto armado tiene aparentemente mayor riesgo de presentar enfermedades crónicas no mentales, tales como hipertensión arterial y diabetes, lo que evidencia la situación de vulnerabilidad de estas comunidades.

Objetivo. Identificar as doenças crônicas não relacionadas à saúde mental mais comuns na população oriunda de áreas de conflito armado. Metodologia. Estudo transversal conduzido com dados da Pesquisa Nacional de Saúde Mental realizada na Colômbia em 2015. A população estudada foi estratificada por sexo e idade. Foram também coletadas informações gerais como nível de escolaridade e nível de pobreza, avaliado pelo Índice Multidimensional de Pobreza. Foram analisados dados de pessoas que se declararam vítimas do conflito armado em algum momento da vida e a frequência de ocorrência de doenças crónicas não relacionadas à saúde mental foi usada como medida de risco relativo indireto. Resultados. Foram obtidas informações de 10.764 pessoas acima de 18 anos de idade, constituindo uma amostra representativa ao nível nacional. Verificou-se que 10,4% das pessoas oriundas de áreas de conflito armado têm nível de escolaridade superior (técnico ou universitário) e 43,6% vivem em situação de pobreza ou vulnerabilidade. As doenças crônicas não relacionadas à saúde mental identificadas foram: hipertensão arterial (20,4%, IC95% 15,7–26,1), diabetes (6,7%, IC95% 4,4–10,3), doenças reumatológicas (10,4%, IC95% 7,1–14,9), doenças gastrointestinais (19,1%, IC95% 14,5– 24,7) e dor crônica (6,9%, IC95% 4,2–11). Conclusões. A população oriunda de áreas de conflito armado aparentemente tem maior risco de apresentar doenças crônicas não relacionadas à saúde mental, como hipertensão arterial e diabetes, o que evidencia a situação de vulnerabilidade em que vivem estas comunidades.

Objective. The purpose of this study was to identify the most frequent non-mental chronic illnesses in the Colombian population affected by the armed conflict. Methodology. A cross-sectional study using data from the National Mental Health Survey 2015. The study population was stratified by sex and age and other general data were extracted, including education and poverty level, measured by the Multidimensional Poverty Index. Data analysis was based on information from people who reported having been victims of the Colombian armed conflict at some time in their lives; the frequency of presentation of non-mental chronic illnesses was reported as a measure of indirect relative risk. Results. Information on 10,764 people over 18 years of age was described, this being a representative sample at the national level. It was found that 10.4% of subjects affected by the armed conflict have a high educational level (technical school or university), and that 43.6% are living in conditions of poverty or vulnerability. The non-mental chronic illnesses identified were: hypertension 20.4% (CI95%: 15.7-26.1); diabetes 6.7% (CI95%: 4.4-10.3); rheumatologic diseases 10.4% (CI95%: 7.1-14.9); gastrointestinal diseases 19.1% (CI95%: 14.5-24.7); and chronic pain 6.9% (CI95%: 4.2-11) Conclusions. The population affected by the armed conflict is apparently at greater risk of presenting non-mental chronic illnesses such as hypertension and diabetes, which shows the vulnerability of these communities.

[Testicular Cancer Epidemiology in Developing Countries. Review of the literature.] / Epidemiología del cáncer testicular en países en desarrollo. Revisión de la literatura.

OBJECTIVE: Testicular cancer (TC) is the most common cancer in men between 15 and 44 years. It has been reported that the incidence of TC is rising. The aim of this article is to determine the epidemiology of TC in Colombia. METHODS: A literature review on four databases was performed PubMed, Embase, Lilacs and Scielo. Studies of incidence, prevalence, mortality and survival of TC were taken from different countries. Studies included were published in the last 10 years. RESULTS: 2308 references were reviewed by title and abstract. In search of local references in non-indexed journals 5 references were extracted. In total 139 references for review in full text were selected. The global incidence and prevalence of cancer varies. In the Northern Europe region, the highest incidence is evident, mainly in Denmark, Croatia and Norway. Followed by Western Europe and South America with Chile. In Colombia the general age incidence is 2,2/100.000, finding a zero incidence in departments such as Chocó and Guajira. CONCLUSIONS: A rise in the incidence of TC has been seen globally, this trend mainly in developing countries. In Colombia most studies are crossectional studies. By seeing the epidemiological data from some departments and the lack of specialists in those regions, it can be deduced the existence of an underreport of the disease that reveals the need to improve both surveillance systems and information registration, such as policies to achieve early diagnosis of TC.

Epidemiología del cáncer testicular en países en desarrollo. Revisión de la literatura / Testicular Cancer Epidemiology in Developing Countries. Review of the literature

OBJETIVO: El cáncer testicular (CT) es el cáncer más frecuente en hombres entre los 15 y 44 años. Se ha reportado que la incidencia del CT viene en ascenso. El objetivo de este artículo es determinar la epidemiología del CT en Colombia. MÉTODOS: Se realizó una revisión de la literatura en las bases de datos de Medline, Embase, Lilacs y Scielo. Se incluyeron estudios de incidencia, prevalencia, mortalidad y sobrevida del CT a nivel mundial, publicados en los últimos 10 años. RESULTADOS: Se revisaron 2308 referencias por título y abstract. En la búsqueda de referencias locales en revistas no indexadas se extrajeron 5 referencias. En total se seleccionaron 139 referencias para revisión en texto completo. A nivel global las tasas de incidencia y prevalencia del cáncer varían. En la región de Europa del Norte se evidencia la mayor incidencia, principalmente en Dinamarca, Croacia y Noruega. Seguida de Europa Occidental y Suramérica con Chile. En Colombia la incidencia general por edad es 2,2/100.000, encontrando una incidencia nula en departamentos como Chocó y Guajira. CONCLUSIONES: Se ha visto un ascenso en la incidencia de CT a nivel global, dicha tendencia principalmente en países en desarrollo. En Colombia la mayoría de estudios son transversales, al observar los datos epidemiológicos de algunos departamentos y la falta de especialistas en la región se puede deducir la existencia de un subregistro de la enfermedad que revela la necesidad de mejorar, tanto los sistemas de vigilancia y registro de información, como las políticas para lograr un diagnóstico temprano del CT

OBJECTIVE: Testicular cancer (TC) is the most common cancer in men between 15 and 44 years. It has been reported that the incidence of TC is rising. The aim of this article is to determine the epidemiology of TC in Colombia. METHODS: A literature review on four databases was performed PubMed, Embase, Lilacs and Scielo. Studies of incidence, prevalence, mortality and survival of TC were taken from different countries. Studies included were published in the last 10 years. RESULTS: 2308 references were reviewed by title and abstract. In search of local references in non-indexed journals 5 references were extracted. In total 139 references for review in full text were selected. The global incidence and prevalence of cancer varies. In the Northern Europe region, the highest incidence is evident, mainly in Denmark, Croatia and Norway. Followed by Western Europe and South America with Chile. In Colombia the general age incidence is 2,2/100.000, finding a zero incidence in departments such as Chocó and Guajira. CONCLUSIONS: A rise in the incidence of TC has been seen globally, this trend mainly in developing countries. In Colombia most studies are crossectional studies. By seeing the epidemiological data from some departments and the lack of specialists in those regions, it can be deduced the existence of an underreport of the disease that reveals the need to improve both surveillance systems and information registration, such as policies to achieve early diagnosis of TC

Enfermedades crónicas en población afectada por el conflicto armado en Colombia, 2015 / Chronic diseases in the population affected by the armed conflict in Colombia, 2015 / Doenças crônicas em população oriunda de áreas de conflito armado na Colômbia, 2015

RESUMEN Objetivo El propósito de este estudio fue identificar las enfermedades crónicas no mentales, más frecuentes en la población colombiana afectada por el conflicto armado. Metodología Este es un estudio transversal, que usa datos de la Encuesta Nacional de Salud Mental 2015. La población estudiada se estratificó por sexo y edad y se extrajeron otros datos generales como: nivel educativo y grado de pobreza, medido por el Índice Multidimensional de Pobreza. Se analizaron datos de personas que reportaron haber sido víctimas del conflicto armado colombiano en algún momento de la vida la vida y se reportó como medida de riesgo relativo indirecto la frecuencia de presentación de enfermedades crónicas no mentales. Resultados Se describió información de 10 764 personas mayores de 18 años siendo una muestra representativa a nivel nacional. Se encontró que 10,4 % de los sujetos afectados por el conflicto armado tienen un nivel educativo superior (técnico o universitario), así como 43,6 % se encuentran en estado de pobreza o en estado de vulnerabilidad. Las enfermedades crónicas no mentales identificadas fueron: hipertensión arterial 20,4 % (IC95% 15,7-26,1), diabetes 6,7 % (IC95% 4,4-10,3), enfermedades reumatológicas 10,4 % (IC95% 7,1-14,9), enfermedades gastrointestinales 19,1 % (IC95% 14,5-24,7), y dolor crónico 6,9 % (IC95% 4,2-11) Conclusiones La población afectada por el conflicto armado tiene aparentemente mayor riesgo de presentar enfermedades crónicas no mentales, tales como hipertensión arterial y diabetes, lo que evidencia la situación de vulnerabilidad de estas comunidades.

ABSTRACT Objective The purpose of this study was to identify the most frequent non-mental chronic illnesses in the Colombian population affected by the armed conflict. Methodology A cross-sectional study using data from the National Mental Health Survey 2015. The study population was stratified by sex and age and other general data were extracted, including education and poverty level, measured by the Multidimensional Poverty Index. Data analysis was based on information from people who reported having been victims of the Colombian armed conflict at some time in their lives; the frequency of presentation of non-mental chronic illnesses was reported as a measure of indirect relative risk. Results Information on 10,764 people over 18 years of age was described, this being a representative sample at the national level. It was found that 10.4% of subjects affected by the armed conflict have a high educational level (technical school or university), and that 43.6% are living in conditions of poverty or vulnerability. The non-mental chronic illnesses identified were: hypertension 20.4% (CI95%: 15.7-26.1); diabetes 6.7% (CI95%: 4.4-10.3); rheumatologic diseases 10.4% (CI95%: 7.1-14.9); gastrointestinal diseases 19.1% (CI95%: 14.5-24.7); and chronic pain 6.9% (CI95%: 4.2-11) Conclusions The population affected by the armed conflict is apparently at greater risk of presenting non-mental chronic illnesses such as hypertension and diabetes, which shows the vulnerability of these communities.

RESUMO Objetivo Identificar as doenças crônicas não relacionadas à saúde mental mais comuns na população oriunda de áreas de conflito armado. Metodologia Estudo transversal conduzido com dados da Pesquisa Nacional de Saúde Mental realizada na Colômbia em 2015. A população estudada foi estratificada por sexo e idade. Foram também coletadas informações gerais como nível de escolaridade e nível de pobreza, avaliado pelo Índice Multidimensional de Pobreza. Foram analisados dados de pessoas que se declararam vítimas do conflito armado em algum momento da vida e a frequência de ocorrência de doenças crónicas não relacionadas à saúde mental foi usada como medida de risco relativo indireto. Resultados Foram obtidas informações de 10.764 pessoas acima de 18 anos de idade, constituindo uma amostra representativa ao nível nacional. Verificou-se que 10,4% das pessoas oriundas de áreas de conflito armado têm nível de escolaridade superior (técnico ou universitário) e 43,6% vivem em situação de pobreza ou vulnerabilidade. As doenças crônicas não relacionadas à saúde mental identificadas foram: hipertensão arterial (20,4%, IC95% 15,7-26,1), diabetes (6,7%, IC95% 4,4-10,3), doenças reumatológicas (10,4%, IC95% 7,1-14,9), doenças gastrointestinais (19,1%, IC95% 14,5-24,7) e dor crônica (6,9%, IC95% 4,2-11). Conclusões A população oriunda de áreas de conflito armado aparentemente tem maior risco de apresentar doenças crônicas não relacionadas à saúde mental, como hipertensão arterial e diabetes, o que evidencia a situação de vulnerabilidade em que vivem estas comunidades.

[Depression and Anxiety Disorders and Associated Factors in the Adolescent Colombian Population, 2015 National Mental Health Survey]. / Trastornos depresivos y de ansiedad y factores asociados en la población de adolescentes colombianos, Encuesta Nacional de Salud Mental 2015.

INTRODUCTION: There was a prevalence of mental disorders of 17% in adolescents in the past year. These tended to be chronic and their appearance at this age is associated with a worse prognosis than those in adulthood. OBJECTIVES: To determine the prevalence and mental factors associated with major depression and anxiety disorders. METHODS: Data were obtained from the IV National Mental Health Survey representing 5 regions. A structured computerised survey was conducted using the Computer Assisted Personal Interview-Composite International Diagnostic Interview-Adolescent Version (CAPI-CIDI-A), focused on the most common depression and anxiety disorders. It included a sample of 1754 adolescents between 12 and 17 years old. RESULTS: The prevalence of any disorder at some point in life was 7.2% (95%CI, 5.8-8.9). The most common disorder corresponded to social phobia manifested sometime in life in 4.8% (95%CI, 3.7-6.2). Less frequent were panic disorder in girls (0.2%; 95% CI, 0.1-1.0) and other bipolar disorders in boys (0.2%; 95%CI, 0.1-0.7). Among the associated factors of suffering from any disorder were, being female (OR=2.1), having little family support (OR=2.0), having witnessed at least one traumatic event (OR=2.6), and having had a previous suicide attempt (OR=3.4). Participation in at least one group was a protective factor (OR=0.5). CONCLUSIONS: Mental disorders of anxiety and depression represent a major burden of disease for Colombia.

[Depression and Anxiety Disorders and Associated Factors in the Adult Colombian Population, 2015 National Mental Health Survey]. / Trastornos depresivos y de ansiedad y factores asociados en la población adulta colombiana, Encuesta Nacional de Salud Mental 2015.

INTRODUCTION: Mental disorders are the first causes of disability adjusted life years (DALY), contributing with the 7.4%. This value increases as the DALYs of the transmittable diseases decrease. OBJECTIVES: To determine the prevalence and associated factors of the major depressive and anxious disorders. METHODS: Data obtained from the IV Mental Health Survey with representation from 5 regions. A computerised interview was conducted, focusing on the most frequent anxiety and depressive disorders, using the CIDI CAPI 3.0. A sample of 10,870 adults over 18 years old was obtained. RESULTS: The lifetime prevalence of any of these disorders is 10.1% (95% CI: 8.8-11.5) in the population between 18 and 44 years, and of 7.7% (95% CI: 6.5-9.1) in those older than 45 years. The prevalence in the last 12 months was 5.1% (95% CI: 4.3-6.0) in the younger group, and 2.3% (95% CI: 1.8-3.0) in the older group. Of the people with evaluated mental disorders, 17.6% (95% CI: 13.1-23.4) had 2 or more disorders, a comorbidity that is more common in the female population (20.4%, 95% CI: 14.2-28.3) than in males (13.5%, 95% CI: 7.9-22.0). Major depressive disorder is the most prevalent of the disorders, with a lifetime prevalence of 4.3% (95% CI: 3.7-5.0). After adjusting in a multivariate model, being divorced or widowed (OR=1.3), previous suicide attempt (OR=3.3), and having 6 or more features of border-line personality, were associated with an increased risk of presenting with any of the studied disorders. CONCLUSIONS: Anxiety and depressive mental disorders are an important health burden in Colombia.

Trastornos depresivos y de ansiedad y factores asociados en la población adulta colombiana, Encuesta Nacional de Salud Mental 2015 / Depression and Anxiety Disorders and Associated Factors in the Adult Colombian Population, 2015 National Mental Health Survey

Resumen Introducción: Las enfermedades mentales son la primera causa de años vividos con discapacidad, contribuyen al 7,4% de los años de vida ajustados por discapacidad y esto aumenta en la medida en que disminuyen los producidos por enfermedades transmisibles. Objetivos: Determinar la prevalencia y los factores asociados a los principales trastornos mentales depresivos y ansiosos. Métodos: Datos obtenidos de la IVEncuesta Nacional de Salud Mental con representatividad de cinco regiones. Se realiza una encuesta estructurada computarizada con el CIDI-CAPI 3.0, centrada en los más frecuentes trastornos depresivos y ansiosos. Se tomó una muestra de 10.870 adultos mayores de 18 años. Resultados: La prevalencia de cualquiera de estos trastornos alguna vez en la vida es del 10,1%, (intervalo de confianza del 95% [IC95%], 8,8%-11,5%) de las personas de 18-44 años y el 7,7% (IC95%, 6,5%-9,1%) de los mayores de 45 años. En los últimos 12 meses, el 5,1% (IC95%, 4,3%-6,0%) del grupo más joven y el 2,3% (IC95%, 1,8%-3,0%) del de más edad. De las personas con alguno de los trastornos mentales medidos, el 17,6% (IC95%, 13,1%-23,4%) presentan dos o más trastornos; es más frecuente la comorbilidad en mujeres (20,4%; IC95%, 14,2%-28,3%) que en varones (13,5%; IC95%, 7,9%-22,0%). El trastorno depresivo mayor es el más prevalente de los trastornos, con una prevalencia de vida del 4,3% (IC95%, 3,7%-5,0%). Entre los factores asociados a cualquier trastorno, se encontró en el modelo multivariable que estar separado, viudo o divorciado (odds ratio [OR] = 1,3), el intento de suicidio previo (OR = 3,3) y tener seis o más rasgos de personalidad limítrofe (OR = 2,7) incrementan el riesgo de sufrirlos. Conclusiones: Los trastornos mentales de ansiedad y depresión suponen una importante carga de enfermedad para Colombia.

Abstract Introduction: Mental disorders are the first causes of disability adjusted life years (DALY), contributing with the 7.4%. This value increases as the DALYs of the transmittable diseases decrease. Objectives: To determine the prevalence and associated factors of the major depressive and anxious disorders. Methods: Data obtained from the IV Mental Health Survey with representation from 5 regions. A computerised interview was conducted, focusing on the most frequent anxiety and depressive disorders, using the CIDI CAPI 3.0. A sample of 10,870 adults over 18 years old was obtained. Results: The lifetime prevalence of any of these disorders is 10.1% (95% CI: 8.8-11.5) in the population between 18 and 44 years, and of 7.7% (95% CI: 6.5-9.1) in those older than 45 years. The prevalence in the last 12 months was 5.1% (95% CI: 4.3-6.0) in the younger group, and 2.3% (95% CI: 1.8-3.0) in the older group. Of the people with evaluated mental disorders, 17.6% (95% CI: 13.1-23.4) had 2 or more disorders, a comorbidity that is more common in the female population (20.4%, 95% CI: 14.2-28.3) than in males (13.5%, 95% CI: 7.9-22.0). Major depressive disorder is the most prevalent of the disorders, with a lifetime prevalence of 4.3% (95% CI: 3.7-5.0). After adjusting in a multivariate model, being divorced or widowed (OR = 1.3), previous suicide attempt (OR = 3.3), and having 6 or more features of border-line personality, were associated with an increased risk of presenting with any of the studied disorders. Conclusions: Anxiety and depressive mental disorders are an important health burden in Colombia.

Trastornos depresivos y de ansiedad y factores asociados en la población de adolescentes colombianos, Encuesta Nacional de Salud Mental 2015 / Depression and Anxiety Disorders and Associated Factors in the Adolescent Colombian Population, 2015 National Mental Health Survey

Resumen Introducción: La prevalencia de trastornos mentales entre los adolescentes es del 17% en el último año. Dichos trastornos tienden a ser crónicos y su aparición a esta edad se asocia a un peor pronóstico que las que aparecen en la edad adulta. Objetivos: Determinar la prevalencia y los factores asociados a los principales trastornos mentales depresivos y ansiosos de los adolescentes. Métodos: Datos obtenidos de la Encuesta Nacional de Salud Mental 2015 con representatividad de 5 regiones. Se realiza una encuesta estructurada computarizada con el CIDI-CAPI adolescentes, centrada en los más frecuentes trastornos depresivos y ansiosos. Se tomó una muestra de 1.754 adolescentes entre 12 y 17 años. Resultados: La prevalencia de cualquier trastorno alguna vez en la vida es del 7,2%, (intervalo de confianza del 95% [IC95%], 5,8-8,9). El trastorno más frecuente fue la fobia social, que se manifestó alguna vez en la vida en un 4,8% (IC95%, 3,7-6,2); los menos frecuentes fueron el trastorno de pánico en las mujeres (0,2%; IC95%, 0,1-1,0) y otros trastornos bipolares en los varones (0,2%; IC95%, 0,1-0,7). De los factores asociados a sufrir cualquier trastorno, se encontró: ser mujer (odds ratio [OR] = 2,1), tener poco apoyo familiar (OR = 2,0), haber presenciado al menos un evento traumático (OR = 2,6) y haber hecho un intento de suicidio (OR = 3,4). Como factor protector, se encontró la participación en por lo menos un grupo (OR = 0,5). Conclusiones: Los trastornos mentales de ansiedad y depresión representan una importante carga de enfermedad para Colombia.

Abstract Introduction: There was a prevalence of mental disorders of 17% in adolescents in the past year. These tended to be chronic and their appearance at this age is associated with a worse prognosis than those in adulthood. Objectives: To determine the prevalence and mental factors associated with major depression and anxiety disorders. Methods: Data were obtained from the IV National Mental Health Survey representing 5 regions. A structured computerised survey was conducted using the Computer Assisted Personal Interview-Composite International Diagnostic Interview-Adolescent Version (CAPI-CIDI-A), focused on the most common depression and anxiety disorders. It included a sample of 1754 adolescents between 12 and 17 years old. Results: The prevalence of any disorder at some point in life was 7.2% (95%CI, 5.8-8.9). The most common disorder corresponded to social phobia manifested sometime in life in 4.8% (95%CI, 3.7-6.2). Less frequent were panic disorder in girls (0.2%; 95% CI, 0.1-1.0) and other bipolar disorders in boys (0.2%; 95%CI, 0.1-0.7). Among the associated factors of suffering fromany disorderwere, being female (OR = 2.1), having little family support (OR = 2.0), having witnessed at least one traumatic event (OR = 2.6), and having had a previous suicide attempt (OR = 3.4). Participation in at least one group was a protective factor (OR = 0.5). Conclusions: Mental disorders of anxiety and depression represent a major burden of disease for Colombia.