Prevalencia de colecistolitiasis y cáncer de vesícula en una población rural aymara de Chile

Background: The prevalence of cholelithiasis and gallbladder cancer may be different across ethnic groups. Aim: To study the prevalence of cholelithiasis and gallbladder cancer among Aymara individuals. Material and Methods: An abdominal ultrasound was carried out in a sample of 182 Aymara women aged 46 ± 16 years and 76 Aymara men aged 55 ± 16 years. In addition, the histopathological reports of both patients with a history of previous cholecystectomy and those operated after the study were reviewed. Results: Ultrasound was normal in 150 participants (58%), 76 had cholelithiasis (30%) and 32 (12%) had a history of cholecystectomy. Pathological reports of the excised gallbladder were available for 106 cases and showed a chronic cholecystitis in 98% of cases. Gallbladder cancer was not reported. Conclusions: There is a 42% prevalence of cholelithiasis and no gallbladder cancer in this sample of Aymara population.

[Prevalence of cholelithiasis and gallbladder cancer among Aymara individuals]. / Prevalencia de colecistolitiasis y cáncer de vesícula en una población rural aymara de Chile.

BACKGROUND: The prevalence of cholelithiasis and gallbladder cancer may be different across ethnic groups. AIM: To study the prevalence of cholelithiasis and gallbladder cancer among Aymara individuals. MATERIAL AND METHODS: An abdominal ultrasound was carried out in a sample of 182 Aymara women aged 46 ± 16 years and 76 Aymara men aged 55 ± 16 years. In addition, the histopathological reports of both patients with a history of previous cholecystectomy and those operated after the study were reviewed. RESULTS: Ultrasound was normal in 150 participants (58%), 76 had cholelithiasis (30%) and 32 (12%) had a history of cholecystectomy. Pathological reports of the excised gallbladder were available for 106 cases and showed a chronic cholecystitis in 98% of cases. Gallbladder cancer was not reported. CONCLUSIONS: There is a 42% prevalence of cholelithiasis and no gallbladder cancer in this sample of Aymara population.

Factores de riesgo cardiovascular en la población Aymara rural del norte de Chile / Prevalence of cardiovascular risk factors in a rural Aymara population from northern Chile

Background: Some rural non-Caucasian ethnic groups have genetic protective factors for the development of chronic non-communicable diseases. Studies performed in Mapuche and Aymara ethnic groups in Chile, found significantly lower prevalence rates. Aymaras are the second most common ethnic population in Chile. Aim: To determine the prevalence of cardiovascular risk factors in a native Aymara ethnic population. Material and Methods: We studied 276 native Aymara people with a median age of 53 years (63% women), registered in the rural clinics of Camiña and Putre. The frequency of hypertension, Type 2 Diabetes Mellitus (DM2), dyslipidemia, overweight, obesity and smoking were determined. Results: The frequency of overweight and obesity was 38% and 38.4% respectively. The prevalence of hypertension and DM2 were 18.5% and 6.9% respectively. Thirty-five percent had elevated total cholesterol, 21% had high LDL cholesterol, 48% had low HDL cholesterol and 45.7% had high triglyceride levels. Two percent smoked. Conclusions: In this group of Aymara individuals, we found a markedly lower prevalence of hypertension and DM2, despite the high prevalence of obesity and dyslipidemia.

[Prevalence of cardiovascular risk factors in a rural Aymara population from northern Chile]. / Factores de riesgo cardiovascular en la población Aymara rural del norte de Chile.

BACKGROUND: Some rural non-Caucasian ethnic groups have genetic protective factors for the development of chronic non-communicable diseases. Studies performed in Mapuche and Aymara ethnic groups in Chile, found significantly lower prevalence rates. Aymaras are the second most common ethnic population in Chile. AIM: To determine the prevalence of cardiovascular risk factors in a native Aymara ethnic population. MATERIAL AND METHODS: We studied 276 native Aymara people with a median age of 53 years (63% women), registered in the rural clinics of Camiña and Putre. The frequency of hypertension, Type 2 Diabetes Mellitus (DM2), dyslipidemia, overweight, obesity and smoking were determined. RESULTS: The frequency of overweight and obesity was 38% and 38.4% respectively. The prevalence of hypertension and DM2 were 18.5% and 6.9% respectively. Thirty-five percent had elevated total cholesterol, 21% had high LDL cholesterol, 48% had low HDL cholesterol and 45.7% had high triglyceride levels. Two percent smoked. CONCLUSIONS: In this group of Aymara individuals, we found a markedly lower prevalence of hypertension and DM2, despite the high prevalence of obesity and dyslipidemia.

Warfarina versus acenocumarol en alcanzar niveles terapéuticos en una población ambulatoria / Comparison of acenocumarol vs. warfarin in achieving oral anticoagulation therapeutic level in ambulatory patients

Introducción: La anticoagulación constituye una terapia farmacológica habitual en la práctica clínica diaria. En Chile, los ACO disponibles y utilizados son warfarina y acenocumarol, no existiendo mayores experiencias nacionales documentadas sobre el mayor beneficio de un fármaco en particular. Objetivo: Analizar y comparar la eficacia terapéutica de warfarina y acenocumarol en una población ambulatoria. Metodología: Estudio retrospectivo, longitudinal. Se analizó 188 pacientes que estuvieron en tratamiento con acenocumarol durante más de un año, y que luego fueron cambiados a warfarina. Se registró: sexo, edad, efectos adversos, diagnóstico y justificación de inicio de ACO. Se obtuvo el promedio del International Normalizad Ratio (INR) de los últimos 3 meses de tratamiento con acenocumarol. Luego, se sustituyó por warfarina, obteniendo luego de un año de tratamiento, el INR promedio de los últimos 3 meses. Los pacientes se agruparon en tres grupos: Bajo rango terapéutico (INR<2.0), en rango terapéutico (INR=2.0-3.0), sobre rango terapéutico (INR>3.0). Resultados: En los pacientes con acenocumarol, se observó 67 (35,64 por ciento) bajo rango terapéutico; 91 (48,4 por ciento) en rango terapéutico; y 30 (15,96 por ciento) sobre rango terapéutico. Luego del cambio a warfarina, 76 (40,43 por ciento) bajo rango terapéutico; 95 (50,53 por ciento) en rango terapéutico; y 17 (9,04 por ciento) sobre rango terapéutico, diferencias no significativas. Bajo el efecto de ambos fármacos no se registraron hemorragias mayores y no hubo diferencia significativa en hemorragias menores. Discusión: La eficacia terapéutica fue similar con ambos fármacos. A pesar de que con acenocumarol se obtuvo mayor porcentaje de pacientes sobre rango terapéutico, no se observaron complicaciones mayores en el periodo de seguimiento.

Background: oral anticoagulation is frequently needed in clinical practice. Warfarin and acenocumarol are available in Chile for this purpose. Locally there is no evidence favoring one over the other Aim: To compare the efficacy of warfarin and acenocumarol in an ambulatory population. Method: A retrospective study compared data on 188 patients with over 1 year of treatment with acenocumarol, before and after being switched over to treatment with warfarin. Demographic data, adverse effects, diagnosis and indication for oral anticoagulation were record. INRs obtained in the last 3 months of treatment with each agent were compared. Patients were classified in 3 groups: insufficient level (INR < 2.0), adequate level (INR 2.0- 3.0) and high level (INR > 3.0) of anticoagulation. Results: With acenocumarol, low level INR was present in 35.6 percent>, adequate INR in 48.4 percent> and high INR in 15.9 percent> of subjects. After switching to warfarin, corresponding levels in each group were 40.4 percent>, 50.3 percent> and 9 percent> (NS). There were no serious bleeding episodes in either group; minor hemorrhages occurred with similar frequency in both groups. Conclusion: There was similar clinical efficacy of oral anticoagulation with acenocumarol compared to warfarin. The slightly higher percentage of acenocumarol treated patients exhibiting a high IRN level did not result in increased risk of hemorrhage.

Estudio comparativo de los hallazgos electrocardiográficos en colonias india y china en la ciudad de Iquique, Chile / Characteristics of the electrocardiogram in subjects from Indian or Chinese descent living in Iquique, Chile

Introducción: La migración intrínsicamente implica la necesidad de adaptación a nuevos estilos de vida, siendo más radical cuando se trata de países tan lejanos y distintos, como India o China. Las variantes electrocardiográficas en estas culturas están siendo ampliamente estudiadas para entender cuando estos cambios son una anomalía o una adaptación fisiológica normal. Por este motivo se hace imperativo investigar sobre hallazgos electrocardiográficos de una población en constante aumento en nuestra sociedad. Objetivo: Evaluar los hallazgos electrocardiográficos en 2 poblaciones de inmigrantes asiáticos con más de 2 años de residencia en Iquique, Chile. Metodología: Estudio analítico, descriptivo de corte transversal. Análisis de electrocardiograma (ECG) de 12 derivaciones, frecuencia cardíaca, intervalos PR, QTc y conclusiones diagnósticas del trazado. Resultados: El grupo Chino (CHI) de 43 pacientes (37,2 por ciento mujeres), edad de 39,5+13 años. Grupo Indio (IND) de 41 pacientes (48,8 por ciento mujeres) con edad promedio de 38,6+10 años. CHI se encontró un 79,1 por ciento de trazadosalterados con 55,8 por ciento Bloqueo incompleto de Rama Derecha (BIRD), 11,6 por ciento que mostraba signos de Bloqueo completo de Rama Derecha (BCRD), y un 11,6 por ciento presento un QTc alargado. IND el 75,6 por ciento de los pacientes tenía un ECG dentro de los límites normales, los ECG alterados mostraban a un 14,6 por ciento con BIRD y la pesquisa de QTc alargado fue de un 2 por ciento de la población. Conclusión: Existe un alto porcentaje de pacientes chinos con electrocardiogramas alterados y especialmente con bloqueos de rama derecha, lo que hace necesario estudiar las causas y el rol que tendría la occidentalización y las anomalías genéticas en esto.

Background: Immigration implies the adaptation to new life styles and these changes are more complicated when countries are far way as is the case between Chile and both India an China. It is uncertain whether the electrocardiographic differences between these populations reflect adaptation changes or are just differences in normal patterns for each population. Aim: to analyze characteristics of the electrocardiogram in subjects of Indian or Chinese descent living more than 2 years in Iquique, Chile. Method: We analyzed the heart rate (HR), PR interval, and QTc in 12 lead EKGs from subjects of Indian orChinese descent. Results: 43 subjects (37.2 percent women), aged 39.5±13 years were included in the Chinese group (CHI); 41 subjects (48.8 percent women), aged 38.6±10 years were included in the Indian group (IND). 79.1 percent of EKGs in the CHI group were abnormal: incomplete right bundle branch block (RBBB) was present in 55.8 percent 11.6 percent had complete RBBB and 11.6 percent a prolonged QT. On the other hand 75.6 percent of subjects in the IND group had a normal EKG; abnormalities included incomplete RBBB in 14.6 percent and prolonged QT in 2 percent. Conclusion: A high percentage of subjects of Chinese descent living for more than 2 years in Iquique, Chile, exhibit electrocardiographic abnormalities, mainly RBBB. Further study is needed to eucidate whether genetic differences or adaptation to new conditions underlie these characteristics.

Impacto de la occidentalización sobre factores de riesgo cardiovascular en inmigrantes asiáticos residentes en el Norte Grande de Chile / Cardiovascular risk factors in Asian populations migrating to the north of Chile

Antecedentes: Existen pocos estudios clínicos que muestren la relación entre la migración de poblaciones y el aumento en enfermedades cardiovasculares. Objetivo: Comparar factores de riesgo cardiovascular (FRCV) entre colonias chinas (CHI) e indias (IND) residentes en Chile. Metodología: Estudio analítico-descriptivo, transversal. Se analizó a la colonia china (n=43) e india (n=41), incluyendo a los residentes en Chile por más de dos años. Se rnidió: peso, talla, perímetro de cintura (PC), indice de masa corporal (IMC), presión arterial, sedentarismo, hábitos alimentarios, trastornos depresivo y ansiosos, y adicción a! tabaco, además de examen psiquiátrico según DMS-IV Se midieron niveles plasmáticos de triglicéridos, colesterol, hormonas tiroideas, glicemia en ayunas y post-prandial, insulinemia basal y post -sobre carga de glucosa. Análisis Estadístico: T de student, Chi cuadrado. Resultados: Encontramos un peso promedio de 71 +/- 10 en IND v/s 66 +/- 14 kg en CHI, PC 89 +/- 11 v/s 79 +/- 12 cm, IMC 27 +/- 4 v/s 24 4, colesterol total 201 +/- 41 v/s 180 +/-35 mg/dl, colesterol HDL 43 +/- 11 v/s48 +/- 13 mg/dl, Colesterol LDL 125 +/- 33 v/s 107 29 mg/dl, TSH 7.3 +/- 6 v/s 1.8 +/- 1.2 uUl +/-ml, Insulinemia post-prandial 93 +/- 89 v/s 39 +/- 34 Ul/mI, respectivame+/-nte, además de sedentarismo 11 en IND v/s 2 en CHI, hábitos alimentarios sanos 26 v/s 39, beber problema 20 v/s 34, adicción al tabaco 8 v/s 17, Síndrome Metabólico 14 v/s 6, siendo todas estas diferencias significativas. En ambos grupos no se encontraron trastornos depresivos ni ansiosos. Conclusiones: Encontramos un serio impacto del fenómeno migratorio en FRCV de IND, lo que impulse a fomentar cambios en estilos de vida de esa población. Es notable la ausencia de patologías depresivas y ansiosas en ambos grupos.

Background: few clinical studies show a relation between migration and an increase prevalence of cardiovascular diseases. Aim: to study the prevalence of cardiovascular risk factors, including the metabolic syndrome, in Indian and Chinese natives flying in Chile for more than 2 years. Methods: Subjects from either Indian or Chinese origin living in Chile for more than 2 years were evaluated for the presence of cardiovascular risk factors. Wight. height, girth index, body mass index, blood pressure. degree of sedentarism, type of foods and pattern of eating and smoking habits were determined. Plasma lipid, thyroid hormone, fasting and post glucose load (75g) sugar and insulin levels were determined. DSM IV was used to evaluate subjects for the presence of depression or anxiety. Students t test and chi square tests at and alpha level of 5 percent were used to determine statistical significance, as appropriate. Results: Significant differences between the Indian and Chinese groups were, respectively: weight (71.4 vs 66.5, p<0.04); girth index (89.1 vs 79.2, p<0.002); BMI (26.9 vs 23.9 p<0.002); total cholesterol (201.6 vs 180.1 (p<0.05); HOL cholesterol (43.4 vs 47.9, p<0.04); LOL cholesterol (125 vs 107, p<0.004); TSH (7.3 vs 1.8, p<0.036),’ post glucose load insulin level (93.1 vs 39.1, p<0.002). A comparison of the Indian vs the Chinese group also showed relevant differences in presence of sedentarism (11 percent vs 2 percent, p<0.02); healthy eating habits (26 vs 39 percent, p<0.02); excessive alcohol consumption (20 vs 34 percent, p<0.03); tobacco addiction (8 vs 17 percent, p<0. 046) and presence of metabolic syndrome (14 vs 6 percent, p<0. 029). Psycho social problems like presence of depression or anxiety disorders were not detected in any group. Conclusion: The original Indian subjects had a high prevalence of several cardiovascular risk factors, making necessary the promotion of healthy life styles in that population.