Neuroendocrine Tumors: An Analysis of Prevalence, Incidence, and Survival in a Hospital-Based Study in Ecuador.

Neuroendocrine tumors (NETs) represent a heterogeneous malignancy group of neoplasms, with a limited amount of data from Latin America. Thus, this observational study aimed to provide data about the prevalence, incidence, and survival rates for NET in Ecuadorian hospitals. The study was conducted using data from the Society for the Fight Against Cancer (SOLCA). We evaluated patients with NETs (2000−2020) using the HJ-Biplot method and Cox proportional hazards. Annual age-adjusted incidence and limited-duration prevalence in multivariable analyses as well as hazard ratios (HRs) for mortality and survival were obtained. In the years 2000−2020, the age-adjusted incidence rate increased by 9-fold in the stomach and by 7-fold in the breast. The incidence rates were 1.38 per 100,000 persons in the lung and at 1.79 per 100,000 persons in gastroenteropancreatic sites (rectum, stomach, and pancreas). The prevalence increased from 0.0027% in 2000 to 0.0736% in 2019 and 0.0245% in 2020. Overall survival was worse for metastatic NETs (HR, 4.061; 95% CI, 1.932−8.540; p < 0.001) and advanced local NETs (HR, 2.348; 95% CI, 1.007−5.475 p < 0.048) than for localized NETs. In conclusion, the NET incidence increased in the last 20 years and survival decreased over time, especially for metastatic tumors in the pancreas and the nostril.

Parámetros bioquímicos y biometría hemática de pacientes con COVID-19 moderado y grave en terapia intensiva de un hospital básico de Ecuador / Biochemical parameters and blood count of patients with moderate and severe COVID-19 in intensive care at a basic hospital in Ecuador

La infección por COVID-19 se presenta principalmente de forma leve y grave, ésta última hace necesaria la hospitalización y soporte respiratorio por complicaciones como el síndrome respiratorio agudo severo (SARS), cuyo curso clínico ha sido ampliamente descrito; sin embargo, la alteración de los perfiles de laboratorio no ha sido establecida de manera precisa. Se realizó un estudio retrospectivo para determinar parámetros bioquímicos y biometría hemática en 32 pacientes con COVID-19 moderado y grave, recluidos en el Hospital Básico "Raúl Maldonado Mejía" de Cayambe, Ecuador y evaluar su utilidad como indicadores de gravedad. Se revisaron las historias clínicas, obteniendo datos clínicos, bioquímicos y hematimétricos. Se observó mayor proporción de casos COVID moderado y grave en hombres, y de la forma grave en ambos géneros, con un promedio de edad entre 45-73 años. Las comorbilidades más frecuentes fueron: hipertensión arterial (HTA), diabetes mellitus tipo 2 (DM2), insuficiencia cardíaca congestiva (ICC) y obesidad. Los parámetros bioquímicos y hematimétricos con peor pronóstico para gravedad fueron: elevación de la actividad de lactato deshidrogenasa (LDH), alanina aminotranferasa (ALT), aspartato aminotranferasa (AST), niveles de proteina C reactiva (PCR), prolongación del tiempo de protrombina (TP), contaje total de leucocitos, índice neutrófilo/linfocito (INL) y disminución de linfocitos. Los parámetros bioquímicos (LDH, PCR, ALT, AST), de coagulación (TP) y hematimétricos (recuento de leucocitos, linfocitos e INL), pueden ser útiles indicadores de gravedad en pacientes con COVID-19, permitiendo identificar precozmente pacientes con enfermedad moderada y evitar el desarrollo de la forma más severa de la enfermedad y sus complicaciones(AU)

COVID-19 infection occurs mainly in mild and severe forms, the latter requiring hospitalization and respiratory support due to complications such as severe acute respiratory syndrome (SARS), the clinical course of which has been widely described; however, the alteration of laboratory profiles has not been precisely established. A retrospective study was carried out to determine biochemical parameters and blood counts in 32 patients with moderate and severe COVID-19, confined at the "Raúl Maldonado Mejía" Basic Hospital in Cayambe, Ecuador, and to evaluate their usefulness as indicators of severity. Medical records were reviewed. , obtaining clinical, biochemical and hematometric data. A higher proportion of moderate and severe COVID cases was observed in men, and the severe form in both genders, with an average age between 45-73 years. The most frequent comorbidities were: arterial hypertension (HTA), type 2 diabetes mellitus (DM2), congestive heart failure (CHF) and obesity. The biochemical and blood count parameters with the worst prognosis for severity were: elevation of lactate dehydrogenase (LDH) activity, alanine aminotransferase (ALT), aspartate aminotransferase (AST), C-reactive protein (CRP) levels, prothrombin time (PT) prolonged, total leukocyte count, ne index utrophil/lymphocyte (INL) and decreased lymphocytes. Biochemical parameters (LDH, CRP, ALT, AST), coagulation (PT) and blood counts (leukocyte count, lymphocytes and INL) can be useful indicators of severity in patients with COVID-19, allowing early identification of patients with moderate disease and avoid the development of the most severe form of the disease and its complications(AU)

Estrés ocupacional en docentes universitarios expuestos a riesgos biológicos / Occupational stress in university teachers exposed to biological risks

El estrés laboral ha sido un factor determinante en la aparición de enfermedades en los docentes universitarios, lo cual ha generado absentismo, errores y accidentes en los ambientes de trabajo. El objetivo de esta investigación fue caracterizar el estrés laboral en personal docente universitario del área de la salud, con riesgo biológico. Se realizó una investigación descriptiva, transversal, de campo y prospectiva, con diseño no experimental, en 53 docentes de la Facultad de Ciencias de la Salud, de la Universidad Técnica de Manabí, Ecuador, desde junio de 2018 a junio de 2021, aplicándose el Instrumento de Estrés Laboral OIT-OMS y la estimación índice numérico de riesgo biológico para entornos académicos. Prevalecieron las mujeres (73,6%), mayores de cincuenta años (52,8%) con estrés nivel bajo. Todas las dimensiones del estrés en general mostraron niveles bajos (2,25 ± 1,05), no obstante, al discriminar según el cargo académico, los pocos casos de niveles altos fueron los Auxiliares Titulares, específicamente en las dimensiones: tecnología, clima organizacional y respaldo de grupo, el riesgo biológico ocurre en el 7,5% de los casos y 64,2% similar a la población en general. Se determinó que existen docentes con niveles de estrés que pudieran afectar su homeostasis psico-biológica, por lo cual se recomienda su intervención, independientemente de su escalafón académico o dedicación laboral(AU)

Work stress has been a determining factor in the appearance of illnesses in university teachers, which has generated absenteeism, errors and accidents in work environments. The objective of this research was to characterize work stress in university teaching staff in the health area, with biological risk. A descriptive, cross-sectional, field and prospective research was carried out, with a non-experimental design, in 53 teachers of the Faculty of Health Sciences, of the Technical University of Manabí, Ecuador, from June 2018 to June 2021, applying the ILO-WHO Occupational Stress Instrument and the estimation of the numerical index of biological risk for academic environments. Women (73.6%), older than fifty years (52.8%) with low level stress prevailed. All the stress dimensions in general showed low levels (2.25 ± 1.05), however, when discriminating according to the academic position, the few cases with high levels were the Titular Assistants, specifically in the dimensions: technology, organizational climate and group support, biological risk occurs in 7.5% of cases and 64.2% similar to the general population. It was determined that there are teachers with stress levels that could affect their psycho-biological homeostasis, for which their intervention is recommended, regardless of their academic rank or work dedication(AU)