Riesgo alto y muy alto de fracturas osteoporóticas en mujeres chilenas / High and very high risk of osteoporotic fractures in Chilean women

Objetivos: evaluar la aplicación de los umbrales de intervención basados en FRAX en mujeres chilenas. Recategorizar elriesgo de fractura osteoporótica para optimizar la selección de mujeres elegibles para intervención.Métodos: seleccionamos de la Encuesta Nacional de Salud (ENS) 2016-2017 (tercera versión) 1782 mujeres de 50 y másaños. Calculamos la probabilidad de fracturas osteoporóticas mayores y fracturas de cadera utilizando el modelo FRAXchileno. Calculamos la proporción de mujeres elegibles para tratamiento y evaluación de la densidad mineral ósea aplicandoumbrales de intervención específicos por edad de 50 a 90 años y un umbral híbrido que combina umbrales dependientes dela edad hasta los 75 años y, a partir de entonces, un umbral fijo con una única probabilidad de fractura hasta los 90 años.Resultados: veintidós mujeres (1,23 %) tenían una fractura previa y eran elegibles para tratamiento por este motivo.Utilizando umbrales específicos por edad, otras 33 mujeres fueron elegibles para tratamiento porque la probabilidad defractura osteoporótica mayor estaba por encima del umbral superior de evaluación. En 1107 (62,12 %) mujeres, se recomienda medir la densidad mineral ósea para poder recalcular el FRAX con la inclusión de la densidad mineral ósea del cuellofemoral. Con el umbral híbrido, otras 44 (3,69 %) mujeres fueron elegibles para el tratamiento y se recomendó la mediciónde la densidad ósea en 1169 mujeres (65,50 %). Si el tratamiento se asignaba solo con FRAX sin densidad mineral ósea,el número de mujeres elegibles para el tratamiento era de 70 (5,15 %) con un umbral de intervención específico para laedad y de 120 (6,72 %) con el umbral híbrido.Conclusiones: el umbral híbrido identifica más mujeres elegibles para tratamiento que los umbrales específicos poredad. La probabilidad promedio de fractura fue mayor con el umbral híbrido. Sobre esta base, nuestra posición es que serecomiende el umbral híbrido.(AU)

Decreasing incidence rates of osteoporotic hip fractures in Ecuador during the COVID-19 pandemic.

We aimed at comparing the incidence of hip fractures in older adults from Ecuador before and during the COVID-19 pandemic. There was a significant reduction in the number of hip fractures, with no change in the length of hospital stay, mortality, and case-fatality rate, during the period of social isolation. INTRODUCTION: The impact that the COVID-19 pandemic has had on fragility fractures is being recently evaluated in the literature. Despite this, data from Latin America in this regard is scarce. PURPOSE: This study aims to compare the incidence rate of hip fractures before and during the COVID-19 pandemic in older adults who received care in the public and private health system of Ecuador. METHODS: This was a descriptive and retrospective study that analyzed data of individuals aged 60 years and older who had hip fractures before and during the COVID-19 pandemic. The information was obtained from the National Hospital Discharge Yearbook. We calculated the incidence, average length of hospital stay, mortality, and case-fatality rate associated with hip fractures. RESULTS: There was a significant reduction in the incidence of hip fractures in adults 60 or older during the period of social isolation due to COVID-19. Between March and December 2019, there was an incidence of 152 hip fractures per 100,000 inhabitants, whereas during the same period but in 2020 in the incidence was 110 per 100,000 inhabitants (p < 0.0001). The main decrease was observed in women aged 80 or more. The average length of hospital stay did not show significant changes. Mortality displayed a non-significant decrease (p = 0.14), although this decrease was significant among women (p = 0.02). Case-fatality rate showed a non-significant increase for the whole group (p = 0.68) and for men (p = 0.09). CONCLUSION: Hip fracture rates decreased significantly in adults aged 60 and older in 2020 compared to 2019. This decrease of hip fracture incidence rates was mainly due to the reductions observed in older people and women. The average length of hospital stay, mortality, and case-fatality rate associated with hip fractures did not show significant changes during the pandemic.

Thyroid cancer in Ecuador.

BACKGROUND: The incidence of thyroid cancer is increasing worldwide. This is not accompanied by a corresponding increase in mortality. In contrast, in most populations' thyroid cancer mortality has been decreasing in recent decades, although there are some notable exceptions. Relatively few studies focus on mortality and in Latin America we do not find evidence on the temporal trend of mortality. The study of the epidemiology of the thyroid cancer should be approached with a suitable methodology and with data based on the population. Trends should be expressed as an annual percentage of change and/or average annual rate of change. An appropriate method for analyzing trends in thyroid cancer mortality rates is the Joinpoint regression analysis. Previously published findings are described, and the methodology used is compared. SHORT CONCLUSION: At the global level, Ecuador is one of the countries with the highest incidence rate of thyroid cancer. However, mortality data are scarce and not rigorous. It is important to raise awareness of updated and reliable population-based data on the trend of thyroid cancer mortality in Eccuador.

Epidemiología de la acromegalia en Ecuador / Epidemiology of acromegaly in Ecuador

Objetivos: Evaluar la epidemiología de la acromegalia en la ciudad de Guayaquil (Ecuador) y comparar nuestros resultados con los reportados en la literatura. Pacientes, material y métodos: Estudio de recolección de datos retrospectivos y prospectivos de todos los pacientes con acromegalia que acudieron a los consultorios de endocrinología de los 4 principales hospitales de la red pública de salud en la ciudad, desde enero de 2000 hasta diciembre de 2014. Se registró la edad al diagnóstico, tiempo estimado de retraso en el diagnóstico, estudios de imagen de hipófisis, nivel basal de la hormona de crecimiento (GH), GH después de la sobrecarga oral de glucosa (SOG-GH) y concentraciones séricas de factor de crecimiento insulínico 1 (IGF-1). Calculamos la incidencia y prevalencia de la enfermedad utilizando la información del censo de población y vivienda del año 2010. Resultados: Se registraron 48 casos en el periodo de estudio, de los cuales 17 eran hombres (35,4%) y 31 mujeres (64,5%); relación M/H=1,8:1. El promedio global de edad al diagnóstico fue 47,3±16,8 años (rango 18 a 86). El tiempo de retraso en el diagnóstico fue 7,3±6,3 años (rango 1 a 30). En los hombres el promedio de edad al diagnóstico fue de 47,9±18,2 años y en las mujeres de 46,3±15,8 años. El tiempo de retraso en el diagnóstico fue de 10,2±7,9 y de 5,7±3,9 años en hombres y mujeres, respectivamente. La prevalencia de acromegalia es 18,7 casos/millón habitantes y la incidencia es de 1,3 casos/millón personas/año. Conclusiones: Existe predominio de la enfermedad en mujeres, se diagnostica en la cuarta década, con un retraso en el diagnóstico de alrededor de 8 años, que suele ser aún mayor en hombres. La incidencia y prevalencia son más bajas que las descritas en series internacionales. Existe subdiagnóstico y subregistro de la enfermedad en nuestro país (AU)

Objectives: To assess the epidemiology of acromegaly in the city of Guayaquil, Ecuador, and to compare our results to those reported in the literature. Patients, material and methods: An analysis was made of retrospective and prospective data from all patients with acromegaly attending endocrinology clinics at the 4 main hospitals of the public health network of Guayaquil from January 2000 to December 2014. Age at diagnosis, estimated delay in diagnosis, imaging studies of pituitary gland, basal growth hormone (GH) level, GH after an oral glucose tolerance test (OGTT-GH), and serum levels of insulin-like growth factor 1 (IGF-1) were recorded. Incidence and prevalence of the disease were estimated using information from the 2010 census of population and housing. Results: Forty-eight cases were recorded in the study period in 17 males (35.4%) and 31 females (64.5%); M/F ratio=1.8:1. Mean age at diagnosis was 47.3±16.8 years (range 18-86). Delay in diagnosis was 7.3±6.3 years (range 1-30). Mean age at diagnosis was 47.9±18.2 years in males and 46.3±15.8 years in females. Delay in diagnosis was 10.2±7.9 and 5.7±3.9 years in males and females, respectively. Prevalence of acromegaly is 18.7 cases per million inhabitants, and incidence of acromegaly 1.3 cases per million people per year. Conclusions: Acromegaly predominates in females, and is diagnosed in the fourth decade with a delay of approximately 8 years, usually even longer in males. Incidence and prevalence are lower than reported in international series. The disease is underdiagnosed and underreported in Ecuador (AU)

Epidemiology of acromegaly in Ecuador. / Epidemiología de la acromegalia en Ecuador.

OBJECTIVES: To assess the epidemiology of acromegaly in the city of Guayaquil, Ecuador, and to compare our results to those reported in the literature. PATIENTS, MATERIAL AND METHODS: An analysis was made of retrospective and prospective data from all patients with acromegaly attending endocrinology clinics at the 4 main hospitals of the public health network of Guayaquil from January 2000 to December 2014. Age at diagnosis, estimated delay in diagnosis, imaging studies of pituitary gland, basal growth hormone (GH) level, GH after an oral glucose tolerance test (OGTT-GH), and serum levels of insulin-like growth factor 1 (IGF-1) were recorded. Incidence and prevalence of the disease were estimated using information from the 2010 census of population and housing. RESULTS: Forty-eight cases were recorded in the study period in 17 males (35.4%) and 31 females (64.5%); M/F ratio=1.8:1. Mean age at diagnosis was 47.3±16.8 years (range 18-86). Delay in diagnosis was 7.3±6.3 years (range 1-30). Mean age at diagnosis was 47.9±18.2 years in males and 46.3±15.8 years in females. Delay in diagnosis was 10.2±7.9 and 5.7±3.9 years in males and females, respectively. Prevalence of acromegaly is 18.7 cases per million inhabitants, and incidence of acromegaly 1.3 cases per million people per year. CONCLUSIONS: Acromegaly predominates in females, and is diagnosed in the fourth decade with a delay of approximately 8 years, usually even longer in males. Incidence and prevalence are lower than reported in international series. The disease is underdiagnosed and underreported in Ecuador.

Silla turca vacia primaria a propósito de un caso / Primary turkish chair vacia with regard to a case

Analiza que el síndrome de silla turca vacía, es considerado generalmente como un hallazgo radiológico benigno que se presenta en un 20xciento de personas normales, dado que podría ser una variante anatómica normal. Algunos pacientes pueden manifestar signos de hipo o hiperfunción pituitaria, como trastornos visuales, neurológicos, rinorraquia, hipertensión arterial, y tendencia a la obesidad. En nuestro caso los síntomas presentados fueron cefalea y trastornos visuales, además luego de un estudio exhaustivo se obtuvo resultados de una función hipofisiaria normal...