ABSTRACT Foundation: cerebrovascular disease is any alteration of one or more brain areas, whether temporary or permanent, secondary to a cerebral circulation disorder of ischemic or hemorrhagic origin. For many years it has been considered one of the main causes of death worldwide. It is among the main causes of death in Ecuador. Objective: to describe the risk factors for cerebrovascular diseases in adult patients diagnosed with cerebrovascular diseases at the Tulcán Sur Health Center over a period of 1 year. Methods: a descriptive and cross-sectional study was carried out at the Tulcán Sur Health Center, over a period of 1 year, from September 2022 to September 2023. The universe consisted of 130 patients. The sociodemographic variables were analyzed: age and sex; clinical: presence or absence of high blood pressure, smoking, alcoholism, diabetes mellitus, dyslipidemia, atrial fibrillation and sedentary lifestyle. The normality of the data distribution was analyzed using the Kolmogorov-Smirnov test. Categorical variables were expressed in absolute and relative frequencies. Quantitative variables were described using the mean and standard deviation. Results: the mean age of the population was 61.0 ± 16.5. The male sex predominated with 70 patients (53.8 %). High blood pressure, smoking and obesity were the most common cardiovascular risk factors with 73 (56.5 %), 79 (60.7 %), 64 (49.2 %) patients respectively. Conclusions: high blood pressure, smoking and obesity were the most prevalent risk factors.

RESUMEN Fundamento: la enfermedad cerebrovascular es toda alteración de una o varias áreas encefálicas, ya sea de forma transitoria o permanente, secundaria a un trastorno de la circulación cerebral de origen isquémico o hemorrágico. Por muchos años ha sido considerada una de las principales causas de muerte a nivel mundial. Está entre las principales causas de muerte en Ecuador. Objetivo: describir los factores de riesgo de enfermedades cerebrovasculares en pacientes adultos diagnosticados con enfermedades cerebrovasculares en el Centro de Salud Tulcán Sur en un periodo de 1 año. Métodos: se realizó un estudio descriptivo y transversal, en el Centro de Salud Tulcán Sur, en un periodo de 1 año, desde septiembre del 2022 a septiembre del 2023. El universo lo constituyeron 130 pacientes. Se analizaron las variables sociodemográficas: edad y sexo; clínicas: presencia o no de hipertensión arterial, tabaquismo, alcoholismo, diabetes mellitus, dislipidemia, fibrilación auricular y sedentarismo. La normalidad de la distribución de los datos fue analizada utilizando la prueba de Kolmogorov-Smirnov. Las variables categóricas fueron expresadas en frecuencias absoluta y relativa. Las variables cuantitativas se describieron utilizando la media y la desviación típica. Resultados: la media de edad de la población fue de 61,0 ± 16,5. El sexo masculino predominó con 70 pacientes (53,8 %). La hipertensión arterial, el tabaquismo y la obesidad fueron los factores de riesgo cardiovascular más frecuentes con 73 (56,5 %), 79 (60,7 %), 64 (49,2 %) pacientes respectivamente. Conclusiones: la hipertensión arterial, el tabaquismo y la obesidad fueron los factores de riesgo con más prevalencia.

ABSTRACT Objective: To determine the association between diabetes mellitus and chronic depression in adults in the Peruvian population. Materials and methods: A quantitative, observational, cross-sectional and correlational study was carried out, based on the data collected by the 2020 Encuesta Demográfica y de Salud Familiar (ENDES - Demographic and Family Health Survey, 2020). The sample was made up of 14,245 adults; depression was considered as a dependent variable (with depression/without depression), and the independent variables were diabetes mellitus (Yes/No), wealth index (the poorest, poor, middle class, rich, the richest), education (kindergarten-preschool and primary, secondary, non-university higher, university higher and graduate), alcoholism (Yes/No), area of residence (urban/rural). The program used for the statistical analysis was IBM SPSS: Release 23. A univariate data analysis was carried out by determining the frequencies and percentages. Subsequently, in the analytical phase, bivariate and multivariate analyses by logistic regression were used to evaluate the strength of the association between the variables (p < 0.05). Results: A total of 15.7 % of adults between 27 and 59 years of age experienced chronic depression. Furthermore, the bivariate analysis revealed an association between the outcome variable and covariates-diabetes mellitus, level of education and wealth index-(p < 0.05). Depression is more common in lower socioeconomic groups, with higher rates among the poor (16.63 %) and less educated population, especially in those with kindergarten, preschool and primary education (18.88 %). In contrast, the rich and richest classes show lower rates of depression (15.27 % and 12.04 %, respectively). On the other hand, in the multivariate analysis, the risk estimation was carried out, and it was found that having diabetes increased the risk of suffering depression by 1.66 times compared to patients who did not have diabetes. Conclusions: There is an association between chronic depression and diabetes mellitus in the adult population aged 27 to 59 years; in addition, a low wealth index and a lower level of education are risk factors for chronic depressive disorder.

RESUMEN Objetivo: Determinar la asociación entre diabetes mellitus y depresión crónica en adultos en la población peruana. Materiales y métodos: Se realizó un estudio cuantitativo, de tipo observacional, de corte transversal y correlacional, a partir de los datos recogidos por la encuesta demográfica y de salud familiar del 2020 (Endes 2020). La muestra estuvo conformada por 14 245 adultos. La variable dependiente fue la depresión (con depresión/sin depresión); las variables independientes fueron diabetes mellitus (sí/no), índice de riqueza (los más pobres, pobre, medio, rico, más rico), educación (inicial-preescolar y primaria, secundaria, superior no universitaria, superior universitaria y posgrado), alcoholismo (sí/no) y área de residencia (urbano/rural). Para el análisis estadístico, se empleó el programa SPSS, versión 23, donde se realizó un análisis univariado de los datos mediante la determinación de las frecuencias y porcentajes. Posteriormente, en la fase analítica, se utilizó el análisis bivariado y multivariado por regresión logística para evaluar la fuerza de asociación entre las variables (p < 0,05). Resultados: El 15,7 % de adultos entre los 27 y 59 años presentaron depresión crónica; además, en el análisis bivariado se encontró asociación de la variable resultado y las covariables diabetes mellitus, nivel de educación e índice de riqueza (p < 0,05). La depresión es más frecuente en grupos socioeconómicos más bajos, con tasas más altas entre la población pobre (16,63 %) y menos educada, especialmente en aquellos con educación inicial-preescolar y primaria (18,88 %). En contraste, las clases ricas y más ricas muestran tasas menores de depresión (15,27 % y 12,04 %, respectivamente). Por otro lado, en el análisis multivariado se realizó la estimación del riesgo y se encontró que ser diabético aumentó el riesgo 1,66 veces más de padecer depresión en relación con los no diabéticos. Conclusiones: Existe asociación entre depresión crónica y diabetes mellitus en la población adulta de 27 a 59 años, además, el bajo índice de riqueza y tener menor grado de educación son factores de riesgo para el trastorno depresivo crónico.

ABSTRACT Background: Rapid correction of hyponatremia, especially when severe and chronic, can result in osmotic demyelination. The latest guideline for diagnosis and treatment of hyponatremia (2014) recommends a correction limit of 10 mEq/L/day. Our aim was to summarize published cases of osmotic demyelination to assess the adequacy of this recommendation. Method: Systematic review of case reports of osmotic demyelination. We included cases confirmed by imaging or pathology exam, in people over 18 years of age, published between 1997 and 2019, in English or Portuguese. Results: We evaluated 96 cases of osmotic demyelination, 58.3% female, with a mean age of 48.2 ± 12.9 years. Median admission serum sodium was 105 mEq/L and > 90% of patients had severe hyponatremia (<120 mEq/L). Reports of gastrointestinal tract disorders (38.5%), alcoholism (31.3%) and use of diuretics (27%) were common. Correction of hyponatremia was performed mainly with isotonic (46.9%) or hypertonic (33.7%) saline solution. Correction of associated hypokalemia occurred in 18.8%. In 66.6% of cases there was correction of natremia above 10 mEq/L on the first day of hospitalization; the rate was not reported in 22.9% and in only 10.4% was it less than 10 mEq/L/day. Conclusion: The development of osmotic demyelination was predominant in women under 50 years of age, with severe hyponatremia and rapid correction. In 10.4% of cases, there was demyelination even with correction <10 mEq/L/day. These data reinforce the need for conservative targets for high-risk patients, such as 4–6 mEq/L/day, not exceeding the limit of 8 mEq/L/day. Background chronic 2014 (2014 1 mEqLday mEq L mEq/L/day recommendation Method exam 199 2019 Portuguese Results 9 583 58 3 58.3 female 482 48 2 48. 129 12 12. mEqL 90 <120 120 (<12 mEq/L. . mEq/L) 38.5%, 385 38.5% , 38 5 (38.5%) 31.3% 313 31 (31.3% 27% 27 (27% common 46.9% 469 46 (46.9% 33.7% 337 33 7 (33.7% solution 188 18.8% 666 66 6 66.6 hospitalization 229 22 22.9 104 4 10.4 Conclusion <1 highrisk high risk 4– 201 (201 19 58. <12 (<1 38.5 (38.5% 31.3 (31.3 (27 46.9 (46.9 33.7 (33.7 18.8 66. 22. 10. < 20 (20 (< 38. (38.5 31. (31. (2 46. (46. 33. (33. 18. ( (38. (31 (46 (33 (38 (3 (4

RESUMO Antecedentes: A correção rápida da hiponatremia, principalmente quando grave e crônica, pode resultar em desmielinização osmótica. A última diretriz para diagnóstico e tratamento da hiponatremia (2014) recomenda um limite de correção de 10 mEq/L/dia. Nosso objetivo foi sumarizar os casos publicados de desmielinização osmótica para avaliar a adequação dessa recomendação. Método: Revisão sistemática de relatos de caso de desmielinização osmótica. Incluímos casos confirmados por imagem ou anatomia patológica, em maiores de 18 anos, publicados entre 1997 e 2019, nas línguas inglesa ou portuguesa. Resultados: Avaliamos 96 casos de desmielinização osmótica, sendo 58,3% do sexo feminino e com média de idade de 48,2 ± 12,9 anos. A mediana de sódio sérico admissional foi 105 mEq/L e > 90% dos pacientes apresentavam hiponatremia grave (<120 mEq/L). Foram comuns os relatos de distúrbios do trato gastrointestinal (38,5%), etilismo (31,3%) e uso de diuréticos (27%). A correção da hiponatremia foi feita principalmente com solução salina isotônica (46,9%) ou hipertônica (33,7%). Correção de hipocalemia associada ocorreu em 18,8%. Em 66,6% dos casos houve correção da natremia acima de 10 mEq/L no primeiro dia de internamento; a velocidade não foi relatada em 22,9% e em apenas 10,4% foi menor que 10 mEq/L/dia. Conclusão: O desenvolvimento da desmielinização osmótica foi predominante em mulheres, abaixo de 50 anos, com hiponatremia grave e correção rápida. Em 10,4% dos casos, houve desmielinização mesmo com correção <10 mEq/L/dia. Esses dados reforçam a necessidade de alvos conservadores para pacientes de alto risco, como 4–6 mEq/L/dia, não ultrapassando o limite de 8 mEq/L/dia. Antecedentes crônica 2014 (2014 1 mEqLdia mEq L mEq/L/dia recomendação Método patológica anos 199 2019 portuguesa Resultados 9 583 58 3 58,3 482 48 2 48, 129 12 12, mEqL 90 <120 120 (<12 mEq/L. . mEq/L) 38,5%, 385 38,5% , 38 5 (38,5%) 31,3% 313 31 (31,3% 27%. 27 27% (27%) 46,9% 469 46 (46,9% 33,7%. 337 33,7% 33 7 (33,7%) 188 18,8% 666 66 6 66,6 internamento 229 22 22,9 104 4 10,4 Conclusão mulheres <1 risco 4– 201 (201 19 58, <12 (<1 38,5 (38,5% 31,3 (31,3 (27% 46,9 (46,9 33,7 (33,7% 18,8 66, 22, 10, < 20 (20 (< 38, (38,5 31, (31, (27 46, (46, 33, (33,7 18, (2 ( (38, (31 (46 (33, (38 (3 (4 (33

Abstract Autoimmune hepatitis (AIH) is a progressive hepatocellular inflammation. Approximately 550 patients are treated per year in the Hepatology and Alcoholism Unit of the hospital, many of them with a diagnosis of AIH. The objective was to evaluate clinical and epidemiological characteristics and laboratory parameters of patients with AIH from 2012 to 2018; 44 patients were included, 40 with type I AIH and four seronegative patients. Ninety- one per cent were women aged between 13 and 68 years old. The most frequent form of presentation (54.5%) was acute hepatitis. Thirty-two patients required biopsy; 50% showed features of AIH (interphase hepatitis) and 35% had histologic cirrhosis. The study offers an approximate image of the particularities of AIH in the population treated in this hospital. Compared to other populations, this communication shows a higher percentage of female patients, with a high preponderance of acute presentation and associated autoimmune diseases.

Resumen La hepatitis autoinmune (HAI) es una inflamación hepatocelular progresiva. En la Unidad de Hepatología y Alcoholismo del hospital se atienden aproximadamente 550 pacientes anualmente, muchos de ellos con diagnóstico de HAI. El objetivo de este trabajo fue evaluar las características clínicas, epidemiológicas y los parámetros de laboratorio de pacientes con HAI desde 2012 hasta 2018. Se incluyeron 44 pacientes: 40 con HAI tipo I y 4 seronegativos. El 91% fueron mujeres con edades entre 13 y 68 años; la forma de presentación más frecuente fue la hepatitis aguda. Se realizó biopsia en 32 pacientes; 50% mostraban características de HAI (hepatitis de interfase) y 35% presentaban cirrosis en la histología. El estudio ofrece una imagen aproximada de las particularidades de la HAI de la población atendida en este hospital. Respecto a otras poblaciones, esta comunicación muestra un mayor porcentaje de pacientes de sexo femenino, con alta preponderancia de presentación aguda y de las enfermedades autoinmunes asociadas.

Resumo A hepatite autoimune (HAI) é uma inflamação hepatocelular progressiva. Na Unidade de Hepatologia e Alcoolismo do hospital, aproximadamente 550 pacientes são atendidos por ano, muitos deles com diagnóstico de HAI. O objetivo deste trabalho foi avaliar as características clínicas, epidemiológicas e parâmetros laboratoriais de pacientes com HAI de 2012 a 2018. Foram incluídos 44 pacientes, 40 com HAI tipo I e quatro soronegativos. Noventa e um por cento foram mulheres com idades entre 13 e 68 anos; a forma de apresentação mais comum foi a hepatite aguda. Biópsias foram realizadas em 32 pacientes, 50% apresentando características de HAI (hepatite de interface) e 35% com cirrose na histologia. O estudo fornece uma visão aproximada das características da HAI na população atendida neste hospital. Em comparação com outras populações, esta comunicação mostra uma maior proporção de pacientes do sexo feminino, com alta incidência de apresentação aguda e das doenças autoimunes associadas.

ABSTRACT Objetivo: Determinar costos directos del tratamiento en tres grupos de pacientes con tuberculosis pulmonar (TP): ambulatorios-adherentes (AA), hospitalizados adherentes (HA) y hospitalizados no adherentes (HNA). Material y métodos: Se consideraron tres grupos: ambulatorios-adherentes, hospitalizados adherentes y hospitalizados no adherentes. Se determinaron costos directos desde la perspectiva del financiador, según modulación del Gobierno de la Ciudad de Buenos Aires a julio 2022, cotización peso/dólar 140. El costo de las drogas antituberculosis fue provisto por el Programa de Tuberculosis del Gobierno de la Ciudad de Buenos Aires. Resultados: Se incluyeron 10 pacientes ambulatorios adherentes. El tiempo de tratamiento fue de 24 ± 2,52 semanas; la adherencia, el 100 %. El costo directo fue de USD 257,79 por paciente (RIQ = 191,6-328,55). Se incluyeron 20 pacientes hospitalizados no adherentes y 10 hospitalizados adherentes, sin diferencias en edad y género entre ellos. Los primeros tenían mayor carga tabáquica, situación de calle, desnutrición, alcoholismo, adicciones y HIV (todos p < 0,05). El tiempo de primer tratamiento fue para hospitalizados no adherentes 5,5 semanas (RIQ = 3-8) y 24 semanas para hospitalizados adherentes. La duración en hospitalizados no adherentes de siguientes tratamientos fue de 0,5-9 semanas. El costo final alcanzó USD 8165,87 por paciente (RIQ = 4706,45- 12 897,82) en hospitalizados no adherentes y USD 4015,26 (RIQ = 3458,15-4482,6), en hospitalizados adherentes (p < 0,01). Conclusión: El costo directo del tratamiento en ambulatorios adherentes fue USD 257 por paciente. El costo directo del abandono del tratamiento de hospitalizados no adherentes es el doble que en hospitalizados adherentes (USD 8165 vs. USD 4015). El costo de tratar a ambulatorios adherentes es quince veces menor que internarlos. Es el primer estudio de costos directos en nuestro país sobre el tema. Se deben instrumentar programas de mejora de adherencia al tratamiento para evitar un alto costo sanitario, drogorresistencia y aumento de la morbimortalidad.

ABSTRACT Objective: To determine the direct costs of the treatment in three groups of patients with pulmonary tuberculosis (PTB): adherent outpatients (AOs), hospitalized-adherent (HA), and hospitalized non-adherent (HNA). Methods: Three groups were considered: AOs, HA, and HNA patients. Direct costs were determined from the perspective of the funder, based on the cost modules pro-vided by the Government of the City of Buenos Aires (GCBA) as of July 2022, with a peso/dollar exchange rate of 140. The cost of antituberculous drugs was provided by the Tuberculosis Program of the GCBA. Results: Ten AOs were included, with a treatment duration of 24±2.52 weeks and 100 % adherence. The direct cost was US$ 257.79 per patient (IQR [interquartile range]=191.6-328.55). Twenty HNA patients and ten HA patients were included, with no differences between the groups in age and gender. HNA patients showed the following characteristics: higher smoking load, homelessness, malnutrition, alcoholism, addictions, and HIV (all p<0.05). The duration of the first treatment was 5.5 weeks for HNA patients (IQR=3-8), and 24 weeks for HA patients. The duration of subsequent treatments for HNA patients ranged from 0.5 to 9 weeks. The final cost was US$ 8,165.87 per patient (IQR=4,706.45-12,897.82) in the HNA group and US$ 4,015.26 per patient (IQR=3,458.15-4,482.6) in the HA group (p<0.01). Conclusion: The direct cost of treatment in AOs was US$ 257 per patient. The direct cost of treatment withdrawal in HNA patients is twice the cost of HA patients (US$ 8,165 vs. US$ 4,015). The cost of treating AOs is fifteen times lower than the cost of hospitalizing them. This is the first study about direct costs on this topic to be conducted in our country. Programs to improve treatment adherence should be implemented to prevent high healthcare costs, drug resistance, and increased morbidity and mortality.

ABSTRACT Objetivo: Determinar costos directos del tratamiento en tres grupos de pacientes con tuberculosis pulmonar (TP): ambulatorios-adherentes (AA), hospitalizados adherentes (HA) y hospitalizados no adherentes (HNA). Material y métodos: Se consideraron tres grupos: ambulatorios-adherentes, hospitaliza dos adherentes y hospitalizados no adherentes. Se determinaron costos directos desde la perspectiva del financiador, según modulación del Gobierno de la Ciudad de Buenos Aires a julio 2022, cotización peso/dólar 140. El costo de las drogas antituberculosis fue provisto por el Programa de Tuberculosis del Gobierno de la Ciudad de Buenos Aires. Resultados: Se incluyeron 10 pacientes ambulatorios adherentes. El tiempo de trata miento fue de 24 ± 2,52 semanas; la adherencia, el 100 %. El costo directo fue de USD 257,79 por paciente (RIQ = 191,6-328,55). Se incluyeron 20 pacientes hospitalizados no adherentes y 10 hospitalizados adherentes, sin diferencias en edad y género entre ellos. Los primeros tenían mayor carga tabáquica, situación de calle, desnutrición, al coholismo, adicciones y HIV (todos p < 0,05). El tiempo de primer tratamiento fue para hospitalizados no adherentes 5,5 semanas (RIQ = 3-8) y 24 semanas para hospitalizados adherentes. La duración en hospitalizados no adherentes de siguientes tratamientos fue de 0,5-9 semanas. El costo final alcanzó USD 8165,87 por paciente (RIQ = 4706,45- 12 897,82) en hospitalizados no adherentes y USD 4015,26 (RIQ = 3458,15-4482,6), en hospitalizados adherentes (p < 0,01). Conclusión: El costo directo del tratamiento en ambulatorios adherentes fue USD 257 por paciente. El costo directo del abandono del tratamiento de hospitalizados no adherentes es el doble que en hospitalizados adherentes (USD 8165 vs. USD 4015). El costo de tratar a ambulatorios adherentes es quince veces menor que internarlos. Es el primer estudio de costos directos en nuestro país sobre el tema. Se deben instrumentar programas de mejora de adherencia al tratamiento para evitar un alto costo sanitario, drogorresistencia y aumento de la morbimortalidad.

ABSTRACT Objective: To determine the direct costs of the treatment in three groups of patients with pulmonary tuberculosis (PTB): adherent outpatients (AOs), hospitalized-adherent (HA), and hospitalized non-adherent (HNA). Methods: Three groups were considered: AOs, HA, and HNA patients. Direct costs were determined from the perspective of the funder, based on the cost modules pro-vided by the Government of the City of Buenos Aires (GCBA) as of July 2022, with a peso/dollar exchange rate of 140. The cost of antituberculous drugs was provided by the Tuberculosis Program of the GCBA. Results: Ten AOs were included, with a treatment duration of 24±2.52 weeks and 100 % adherence. The direct cost was US$ 257.79 per patient (IQR [inter quartile range]=191.6-328.55). Twenty HNA patients and ten HA patients were included, with no differences between the groups in age and gender. HNA patients showed the following characteristics: higher smoking load, homelessness, malnutrition, alcoholism, addictions, and HIV (all p<0.05). The duration of the first treatment was 5.5 weeks for HNA patients (IQR=3-8), and 24 weeks for HA patients. The duration of subsequent treatments for HNA patients ranged from 0.5 to 9 weeks. The final cost was US$ 8,165.87 per patient (IQR=4,706.45-12,897.82) in the HNA group and US$ 4,015.26 per patient (IQR=3,458.15-4,482.6) in the HA group (p<0.01). Conclusion: The direct cost of treatment in AOs was US$ 257 per patient. The direct cost of treatment withdrawal in HNA patients is twice the cost of HA patients (US$ 8,165 vs. US$ 4,015). The cost of treating AOs is fifteen times lower than the cost of hospitalizing them. This is the first study about direct costs on this topic to be conducted in our country. Programs to improve treatment adherence should be implemented to prevent high healthcare costs, drug resistance, and increased morbidity and mortality.

Abstract Although control of Covid-19 has improved, the virus continues to cause infections, such as tuberculosis, that is still endemic in many countries, representing a scenario of coinfection. To compare Covid-19 clinical manifestations and outcomes between patients with active tuberculosis infection and matched controls. This is a matched case-control study based on data from the Brazilian Covid-19 Registry, in hospitalized patients aged 18 or over with laboratory confirmed Covid-19 from March 1, 2020, to March 31, 2022. Cases were patients with tuberculosis and controls were Covid-19 patients without tuberculosis. From 13,636 Covid-19, 36 also had active tuberculosis (0.0026%). Pulmonary fibrosis (5.6% vs 0.0%), illicit drug abuse (30.6% vs 3.0%), alcoholism (33.3% vs 11.9%) and smoking (50.0% vs 9.7%) were more common among patients with tuberculosis. They also had a higher frequency of nausea and vomiting (25.0% vs 10.4%). There were no significant differences in in-hospital mortality, mechanical ventilation, need for dialysis and ICU stay. Patients with TB infection presented a higher frequency of pulmonary fibrosis, abuse of illicit drugs, alcoholism, current smoking, symptoms of nausea and vomiting. The outcomes were similar between them. Covid19 Covid 19 Covid-1 improved infections countries coinfection casecontrol case Registry 1 2020 31 2022 13636 13 636 13,63 Covid19, 19, 3 0.0026%. 00026 0.0026% . 0 0026 (0.0026%) 5.6% 56 5 6 (5.6 0.0%, 00 0.0% , 0.0%) 30.6% 306 30 (30.6 3.0%, 3.0% 3.0%) 33.3% 333 33 (33.3 11.9% 119 11 9 50.0% 500 50 (50.0 9.7% 97 7 25.0% 250 25 (25.0 10.4%. 104 10.4% 10 4 10.4%) inhospital hospital mortality ventilation stay drugs them Covid1 Covid- 202 1363 63 13,6 0002 0.0026 002 (0.0026% 5.6 (5. 0.0 30.6 (30. 3.0 33.3 (33. 11.9 50.0 (50. 9.7 25.0 2 (25. 10.4 20 136 13, 000 0.002 (0.0026 5. (5 0. 30. (30 3. 33. (33 11. 50. (50 9. 25. (25 10. 0.00 (0.002 ( (3 (2 (0.00 (0.0 (0. (0

ABSTRACT Conditions related to the acquired immune deficiency syndrome (AIDS) are still a significant cause of morbidity and mortality among people living with HIV (PLHIV). Longer survival in this population were reported to increase the risk of developing noncommunicable chronic diseases (NCDs). This study aimed to estimate the survival and causes of death according to age group and sex among PLHIV monitored at two referral centers in the Northeastern Brazil. This is a prospective, retrospective cohort with death records from 2007 to 2018, based on a database that registers causes of death using the International Classification of Disease (ICD-10), which were subsequently coded following the Coding Causes of Death in HIV (CoDe). A total of 2,359 PLHIV participated in the study, with 63.2% being men, with a follow-up period of 13.9 years. Annual mortality rate was 1.46 deaths per 100 PLHIV (95% CI: 1.33 – 1.60) with a frequency of 20.9%. Risk of death for men increased by 49% when compared to women, and the risk of death in PLHIV increased by 51% among those aged 50 years and over at the time of diagnosis. It was observed that 73.5% accounted for AIDS-related deaths, 6.9% for non-AIDS defining cancer, 6.3% for external causes, and 3.2% for cardiovascular diseases. Among the youngest, 97.2% presented an AIDS-related cause of death. Highest frequency of deaths from neoplasms was among women and from external causes among men. There is a need for health services to implement strategies ensuring greater adherence to treatment, especially among men and young people. Moreover, screening for chronic diseases and cancer is essential, including the establishment of easily accessible multidisciplinary care centers that can identify and address habits such as illicit drug use and alcoholism, which are associated with violent deaths. AIDS (AIDS PLHIV. . (PLHIV) NCDs. NCDs (NCDs) Brazil prospective 200 2018 ICD10, ICD10 ICD 10 , (ICD-10) CoDe. CoDe (CoDe) 2359 2 359 2,35 632 63 63.2 followup follow up 139 13 9 13. 146 1 46 1.4 95% 95 (95 CI 133 33 1.3 1.60 160 60 209 20 20.9% 49 51 5 diagnosis 735 73 73.5 AIDSrelated 69 6 6.9 nonAIDS non 3 6.3 32 3.2 youngest 972 97 97.2 treatment Moreover essential alcoholism (PLHIV (NCDs 201 ICD1 (ICD-10 (CoDe 235 35 2,3 63. 14 4 1. (9 1.6 16 20.9 7 73. 6. 3. 97. (ICD-1 23 2, ( 20. (ICD- (ICD

ABSTRACT Maternal and child health remains an enduring global challenge, having occupied a prominent position on international agendas since the dawn of the 21st century. During pregnancy, syphilis emerges as the second most prevalent cause of stillbirth on a global scale, potentially leading to a range of adverse outcomes. This study aimed to describe the clinical and epidemiological profile of cases of gestational and congenital syphilis and the hospital care provided for newborns in Campo Grande municipality, Mato Grosso do Sul State, Brazil, from 2013 to 2018. This is a cross-sectional study based on data from Brazilian Notifiable Diseases Surveillance System (SINAN) and hospital medical records. Chi-square or Fisher’s exact test and logistic regression analysis were used to assess the associations and relationships between the child’s clinical outcome at birth and the mother’s clinical-obstetric and epidemiological characteristics. Cumulative detection rate of gestational syphilis was 174.3 cases per 1,000 live births and cumulative incidence of congenital syphilis was 47.7 cases per 1,000 live births. Alcoholism, prenatal care, number of prenatal visits, maternal treatment regimen, and timing of maternal diagnosis were associated with child’s clinical outcome at birth and considered in the regression model. Prenatal visits showed a protective effect against the signs and symptoms of congenital syphilis (odds ratio = 0.37; 95% confidence interval = 0.17−0.77). Medical assistance was considered inadequate in 62.3% of cases. Prenatal consultations should be encouraged among pregnant women. There is a need for better education of health personnel on the treatment and diagnosis of syphilis. challenge st century pregnancy scale outcomes municipality State Brazil 201 2018 crosssectional cross sectional SINAN (SINAN records Chisquare Chi square Fishers Fisher s childs mothers mother clinicalobstetric obstetric characteristics 1743 174 3 174. 1000 1 000 1,00 477 47 7 47. Alcoholism regimen model odds 0.37 037 0 37 95 0.17−0.77. 017077 0.17−0.77 . 17 77 0.17−0.77) 623 62 62.3 women 20 100 00 1,0 4 0.3 03 9 01707 0.17−0.7 6 62. 2 10 1, 0. 0170 0.17−0. 017 0.17−0 01 0.17− 0.17 0.1

Abstract Objective To determine the prevalence, epidemiological profile, and clinical characteristics of Oral or Oropharyngeal Mucosal Lesions (OOPML) in patients attended at the Otorhinolaryngology Service of the Evandro Chagas National Institute of Infectious Diseases (INI-FIOCRUZ) from 2005 to 2017. Methods Statistical analysis of descriptive data from medical records (gender, age, education level, skin color, origin, smoking, alcoholism, HIV co-infection, time of disease evolution, first symptom, and OOPML location) was performed. Results Of 7551 patients attended at the service, 620 (8.2%) were included in the study. OOPML were classified into developmental anomalies (n = 3), infectious diseases (non-granulomatous n = 220; granulomatous n = 155), autoimmune diseases (n = 24), neoplasms (benign n = 13; malignant, n = 103), and unclassified epithelial/soft tissue diseases (n = 102). OOPML of infectious diseases (60.5%) and neoplasms (18.7%) were the most frequent. The predominant demographics of patients with OOPML were: males (63.5%), white (53.5%), and those in the fifth to sixth decades of life (43.3%). Local pain (18.1%) and odynophagia (15%) were the most reported first symptoms, and the most frequent OOPML sites were the palatine tonsil (28.5%), hard palate (22.7%), and tongue (20.3%). The median evolution time was three months. Conclusions Infectious OOPML were the most frequent, as expected in a reference center for infectious diseases, and thus, they are likely to be less frequent in general care and/or dental services. Underreporting of OOPML is possible, as oral/oropharyngeal examination is often not included in the routine medical examination. Oral cavity/oropharynx examination should be performed by specialists, such as dentists and otorhinolaryngologists, who have the expertise in identifying OOPML, even in incipient/asymptomatic cases. Given the numerous diseases in which OOPML can present, diagnosis could be facilitated by multidisciplinary teams, potentially enabling the early treatment of diseases, and thus, reduce morbidity and improve prognosis. The use of standardized medical records for oral/oropharyngeal systematic examination could provide relevant tools for differential diagnoses and information for new clinical-epidemiological studies. Level of evidence: Level 3. prevalence profile (OOPML INIFIOCRUZ INI FIOCRUZ (INI-FIOCRUZ 200 2017 gender, gender (gender age level color origin smoking alcoholism coinfection, coinfection co infection, infection co-infection symptom location 755 service 62 8.2% 82 8 2 (8.2% study 3, 3 , 3) nongranulomatous non 220 155, 155 155) 24, 24 24) benign 13 malignant 103, 103 103) epithelialsoft epithelial soft 102. 102 . 102) 60.5% 605 60 5 (60.5% 18.7% 187 18 7 (18.7% 63.5%, 635 63.5% 63 (63.5%) 53.5%, 535 53.5% 53 (53.5%) 43.3%. 433 43.3% 43 (43.3%) 18.1% 181 1 (18.1% 15% 15 (15% symptoms 28.5%, 285 28.5% 28 (28.5%) 22.7%, 227 22.7% 22 (22.7%) 20.3%. 203 20.3% 20 (20.3%) months thus andor services possible oraloropharyngeal oral oropharyngeal cavityoropharynx cavity oropharynx specialists otorhinolaryngologists incipientasymptomatic incipient asymptomatic cases present teams prognosis clinicalepidemiological studies evidence 201 75 6 8.2 (8.2 10 60.5 (60.5 18.7 (18.7 63.5 (63.5% 53.5 (53.5% 43.3 4 (43.3% 18.1 (18.1 (15 28.5 (28.5% 22.7 (22.7% 20.3 (20.3% 8. (8. 60. (60. 18. (18. 63. (63.5 53. (53.5 43. (43.3 (1 28. (28.5 22. (22.7 20. (20.3 (8 (60 (18 (63. (53. (43. ( (28. (22. (20. (6 (63 (53 (43 (28 (22 (20 (5 (4 (2

ABSTRACT Objectives: Identify relationships between voiding symptom scores and variables related to transplantation. Methods: Observational, cross-sectional, and analytical study, in which all patients undergoing kidney transplantation in the state of Rondônia, Brazil, were evaluated through interviews and analysis of records, regarding their clinical-demographic profile and signs and symptoms of voiding dysfunction. Chi-square, analysis of variance (ANOVA), and multivariate linear regression were used to establish possible correlations. Results: Eight-one point eighty-seven percent of patients were approached (n = 122). The most common symptoms were increased frequency (68.2%) and nocturia (97.6%). ANOVA demonstrated a relationship between age and International Consultation on Incontinence Questionnaire (ICIQ) (p = 0.014), alcoholism and Overactive Bladder Questionnaire (OAB) (p = 0.001), immunosuppressive regimen and ICIQ (p = 0.04), thymoglobulin and OAB (p = 0.009), use of double J and ICIQ (p = 0.014), citomegalovirus infection and OAB (p = 0.031), and International Prostate Symptom Score (IPSS) (p = 0.008). Of the comorbidities, it was observed heart failure related to OAB (p = 0.009) and ICIQ (p = 0.003) scores. Chi-square showed an association between alcohol use and group 1 of the OAB (p = 0.005). The Pearson test positively correlated graft ischemia time with ICIQ (p = 0.04). Conclusion: The prevalence of lower urinary tract symptoms is higher in kidney transplant recipients than in the general population, and it was possible to determine predictive factors for their occurrence. Objectives Methods Observational crosssectional, crosssectional cross sectional, sectional cross-sectional study Rondônia Brazil records clinicaldemographic clinical demographic dysfunction Chisquare, Chisquare Chi square, square ANOVA, , (ANOVA) correlations Results Eightone Eight one eightyseven eighty seven n 122. 122 . 122) 68.2% 682 68 2 (68.2% 97.6%. 976 97.6% 97 6 (97.6%) (ICIQ p 0.014, 0014 0.014 0 014 0.014) (OAB 0.001, 0001 0.001 001 0.001) 0.04, 004 0.04 04 0.04) 0.009, 0009 0.009 009 0.031, 0031 0.031 031 0.031) IPSS (IPSS 0.008. 0008 0.008 008 0.008) comorbidities 0.003 0003 003 0.005. 0005 0.005 005 0.005) 0.04. Conclusion population occurrence (ANOVA 12 68.2 (68.2 97.6 9 (97.6% 0.01 01 000 0.00 00 0.0 0.03 03 68. (68. 97. (97.6 0. (68 (97. (6 (97 ( (9

RESUMO Objetivos: Identificar relações entre escores de sintomas miccionais e variáveis relacionadas ao transplante. Métodos: Estudo observacional, transversal e analítico no qual o conjunto dos pacientes submetidos a transplante renal no estado de Rondônia, Brasil, foi avaliado por meio de entrevistas e análise de registros quanto a seu perfil clínico-demográfico e aos sinais e sintomas de disfunção miccional. Qui-quadrado, analysis of variance (ANOVA) e regressão linear multivariada foram utilizados para estabelecer possíveis correlações. Resultados: Abordaram-se 81,87% dos pacientes (n = 122). Os sintomas mais frequentes foram aumento da frequência (68,2%) e noctúria (97,6%). O teste ANOVA demonstrou relação entre a idade e o International Consultation on Incontinence Questionnaire (ICIQ) (Questionário Internacional de Consulta sobre Incontinência) (p = 0,014), etilismo e o Overactive Bladder Questionnaire (OAB-V8) (Questionário de Avaliação da Bexiga Hiperativa) (p = 0,001), esquema imunossupressor e ICIQ (p = 0,04), timoglobulina e OAB (p = 0.009), uso de duplo J e ICIQ (p = 0,014), infecção por citomegalovírus e OAB (p = 0,031) e International Prostate Symptom Score (IPSS) (Escore Internacional de Sintomas Prostáticos) (p = 0,008). Das comorbidades, foi observada insuficiência cardíaca relacionada aos escores OAB (p = 0,009) e ICIQ (p = 0,003). Qui-quadrado apontou associação entre uso de álcool e grupo 1 do OAB (p = 0,005). O teste de Pearson correlacionou positivamente tempo de isquemia do enxerto com ICIQ (p = 0,04). Conclusão: A prevalência de sintomas do trato urinário inferior é maior em transplantados renais do que na população geral, e foi possível determinar fatores preditivos para sua ocorrência. Objetivos Métodos observacional Rondônia Brasil clínicodemográfico clínico demográfico miccional Quiquadrado, Quiquadrado Qui quadrado, quadrado (ANOVA correlações Resultados Abordaramse Abordaram se 8187 81 87 81,87 n 122. 122 . 122) 68,2% 682 68 2 (68,2% 97,6%. 976 97,6% 97 6 (97,6%) (ICIQ Questionário Incontinência p 0,014, 0014 0,014 , 0 014 0,014) OABV8 OABV V8 V (OAB-V8 Hiperativa 0,001, 0001 0,001 001 0,001) 0,04, 004 0,04 04 0,04) 0.009, 0009 0.009 009 0.009) 0,031 0031 031 IPSS (IPSS Escore Prostáticos 0,008. 0008 0,008 008 0,008) comorbidades 0,009 0,003. 0003 0,003 003 0,003) 0,005. 0005 0,005 005 0,005) 0,04. Conclusão geral ocorrência 818 8 81,8 12 68,2 (68,2 97,6 9 (97,6% 0,01 01 (OAB-V 000 0,00 00 0,0 0.00 0,03 03 81, 68, (68, 97, (97,6 0, 0.0 (68 (97, 0. (6 (97 ( (9

RESUMO RACIONAL: Apesar da preferência pelo tratamento multimodal para o câncer gástrico, o abandono do tratamento quimioterápico bem como a necessidade de cirurgia “upfront” em pacientes obstruídos traz impactos negativos para o tratamento. A dificuldade de acesso ao tratamento em centros especializados no Sistema Único de Saúde (SUS) é um agravante. OBJETIVOS: Identificar vantagens, fatores prognósticos, complicações e sobrevida de terapias neoadjuvantes e adjuvantes no tratamento do câncer gástrico no cenário do SUS. MÉTODOS: Estudo retrospectivo incluindo 81 pacientes com adenocarcinoma gástrico submetidos a tratamento segundo os protocolos INT0116 (quimiorradioterapia adjuvante), CLASSIC (quimioterapia adjuvante), FLOT4-AIO (quimioterapia perioperatória) e cirurgia com intuito curativo (ressecção R0 e linfadenectomia D2) em um único centro oncológico entre 2015 e 2020. Indivíduos com outros tipos histológicos, coto gástrico, câncer de esôfago, outros protocolos de tratamento e estádio Ia ou IV foram excluídos. RESULTADOS: Os pacientes foram distribuídos em: FLOT4-AIO (26 pacientes), CLASSIC (25 pacientes) e INT0116 (30 pacientes). A média de idade foi 61 anos. Mais de 60% dos pacientes apresentaram estádio III patológico. A taxa de completude do tratamento foi 56%. A taxa de resposta patológica completa do grupo FLOT4-AIO foi 7,7%. Dentre os fatores prognósticos que impactaram a sobrevida global e sobrevida livre de doença tivemos etilismo, complicações pós-operatórias precoces, status anatomopatológico pN2 e pN3. A taxa de sobrevida global em 3 anos foi 64,9% sendo o subgrupo CLASSIC com melhor sobrevida (79,8%). CONCLUSÕES: A estratégia de tratamento do câncer gástrico varia de acordo com a necessidade de cirurgia inicial. O subgrupo CLASSIC apresentou melhor sobrevida global e sobrevida livre de doença. O esquema INT0116 também protegeu contra a mortalidade, mas não com significância estatística. Apesar do FLOT4-AIO ser o tratamento de escolha, a dificuldade na realização da neoadjuvância no âmbito do SUS impactou negativamente nos resultados devido à criticidade da ingesta alimentar e à pior tolerância ao tratamento. RACIONAL upfront “upfront (SUS agravante OBJETIVOS vantagens MÉTODOS 8 INT INT011 quimiorradioterapia adjuvante, adjuvante , adjuvante) quimioterapia FLOT4AIO FLOTAIO FLOT4 AIO FLOT perioperatória ressecção R D2 D 201 2020 histológicos esôfago excluídos RESULTADOS 26 (2 pacientes, 25 30 (3 pacientes. . 6 60 patológico 56 56% 77 7 7,7% etilismo pósoperatórias pós operatórias precoces pN pN3 649 64 9 64,9 79,8%. 798 79,8% 79 (79,8%) CONCLUSÕES inicial mortalidade estatística escolha INT01 20 202 2 ( 5 7,7 64, 79,8 (79,8% INT0 7, 79, (79,8 (79, (79 (7

ABSTRACT BACKGROUND: Despite the preference for multimodal treatment for gastric cancer, abandonment of chemotherapy treatment as well as the need for upfront surgery in obstructed patients brings negative impacts on the treatment. The difficulty of accessing treatment in specialized centers in the Brazilian Unified National Health System (SUS) scenario is an aggravating factor. AIMS: To identify advantages, prognostic factors, complications, and neoadjuvant and adjuvant therapies survival in gastric cancer treatment in SUS setting. METHODS: The retrospective study included 81 patients with gastric adenocarcinoma who underwent treatment according to INT0116 trial (adjuvant chemoradiotherapy), CLASSIC trial (adjuvant chemotherapy), FLOT4-AIO trial (perioperative chemotherapy), and surgery with curative intention (R0 resection and D2 lymphadenectomy) in a single cancer center between 2015 and 2020. Individuals with other histological types, gastric stump, esophageal cancer, other treatment protocols, and stage Ia or IV were excluded. RESULTS: Patients were grouped into FLOT4-AIO (26 patients), CLASSIC (25 patients), and INT0116 (30 patients). The average age was 61 years old. More than 60% of patients had pathological stage III. The treatment completion rate was 56%. The pathological complete response rate of the FLOT4-AIO group was 7.7%. Among the prognostic factors that impacted overall survival and disease-free survival were alcoholism, early postoperative complications, and anatomopathological status pN2 and pN3. The 3-year overall survival rate was 64.9%, with the CLASSIC subgroup having the best survival (79.8%). CONCLUSIONS: The treatment strategy for gastric cancer varies according to the need for initial surgery. The CLASSIC subgroup had better overall survival and disease-free survival. The INT0116 regimen also protected against mortality, but not with statistical significance. Although FLOT4-AIO is the preferred treatment, the difficulty in carrying out neoadjuvant treatment in SUS scenario had a negative impact on the results due to the criticality of food intake and worse treatment tolerance. BACKGROUND (SUS factor AIMS advantages complications setting METHODS 8 INT INT011 chemoradiotherapy, chemoradiotherapy , chemoradiotherapy) chemotherapy, chemotherapy) FLOT4AIO FLOTAIO FLOT4 AIO FLOT perioperative R0 R (R D lymphadenectomy 201 2020 types stump protocols excluded RESULTS 26 (2 patients, patients) 25 30 (3 patients. . 6 old 60 III 56 56% 77 7 7.7% diseasefree disease free alcoholism pN pN3 3year year 3 649 64 9 64.9% 79.8%. 798 79.8% 79 (79.8%) CONCLUSIONS mortality significance tolerance INT01 20 202 2 ( 5 7.7 64.9 79.8 (79.8% INT0 7. 64. 79. (79.8 (79. (79 (7

Abstract OBJECTIVE: To determine the relationship between the extent of alcohol, tobacco and illicit substance use and adverse obstetric outcomes to enable obstetric care providers to assess the risks of substance use. MATERIALS AND METHODS: Retrospective, observational, analytical and cross-sectional study of a case series of postpartum patients who were admitted to the Gynaecology and Obstetrics Service of the General Hospital of Saltillo between March and June 2023 and who reported alcohol, tobacco or drug use during pregnancy. After the obstetric procedure, the ASSIST tool or screening test for alcohol, tobacco and drug use was applied. Pearson&apos;s χ2 test and Fisher´s exact statistic were used to assess their association with adverse outcomes according to the level of use. RESULTS: Of 863 obstetric attendances, 47 patients 5.4% reported active use of different substances during pregnancy; of these, 22 used 2 substances, with a trend between tobacco and cannabis use for adverse obstetric outcomes p = 0.16 and 0.17, respectively. The most common adverse obstetric outcome was low birth weight in 22 of 47 patients. CONCLUSIONS: The substances with the highest tendency for adverse obstetric outcome were tobacco and cannabis, and the most common adverse neonatal outcome was low birthweight.

Resumen OBJETIVO: Establecer la relación entre el grado de consumo de alcohol, tabaco y sustancias ilícitas con los desenlaces obstétricos adversos para que el personal encargado de la atención obstétrica evalúe los riesgos que implica el consumo de esas sustancias. MATERIALES Y MÉTODOS: Estudio retrospectivo, observacional, analítico y transversal de una serie de casos llevado a cabo en pacientes en el puerperio hospitalizadas en el servicio de Ginecología y Obstetricia del Hospital General de Saltillo entre marzo y junio del 2023 y que refirieron consumo de alcohol, tabaco o drogas durante el embarazo. Posterior al procedimiento obstétrico se aplicó la herramienta ASSIST o prueba de detección de consumo alcohol, tabaco y sustancias. Según el grado de consumo, se utilizó la prueba χ2 de Pearson y la prueba exacta de Fisher para evaluar su asociación con los desenlaces adversos. RESULTADOS: De 863 atenciones obstétricas, 47 pacientes 5.4% refirieron un consumo activo de diferentes sustancias durante el embarazo; de ellas, 22 consumían 2 sustancias, con una tendencia entre el consumo de tabaco y cannabis a un desenlace obstétrico adverso p = 0.16 y 0.17, respectivamente. El desenlace obstétrico adverso más frecuente fue el bajo peso al nacer en 22 de 47 pacientes. CONCLUSIONES: Las sustancias con mayor tendencia a un desenlace obstétrico adverso fueron el tabaco y la cannabis, y la consecuencia desfavorable más frecuente en los neonatos fue el bajo peso al nacer.

RESUMEN Fundamento: el alcoholismo es una drogadicción que conduce a la dependencia de otros tipos de drogas peligrosas y dañinas para la salud humana, por lo que es un fenómeno que debe ser comprendido con objetividad para el desarrollo de acciones eficaces en su erradicación. Objetivo: exponer la efectividad de una intervención educativa para incrementar los conocimientos sobre el alcoholismo en adolescentes. Métodos: se realizó un estudio cuasiexperimental de intervención educativa, en el Policlínico Universitario “Ramón López Peñaˮ de Santiago de Cuba, en el período febrero-agosto de 2023. La población de estudio estuvo constituida por 45 adolescentes consumidores de riesgo, que cumplieron los criterios de inclusión, a los que se les aplicó un cuestionario inicial que permitió conocer los conocimientos antes y después de la intervención. Se utilizaron métodos teóricos: histórico-lógico, analítico-sintético e inductivo-deductivo para la recogida de datos y fundamentación de la investigación. Del nivel empírico: el cuestionario y la observación. Resultados: la intervención educativa aplicada en sesiones de trabajo grupal a través de técnicas participativas, favoreció la motivación de los adolescentes. Se modificaron los conocimientos relacionados con tipos de consumo, motivos y consecuencias, conducta a seguir ante el consumo excesivo y prevención del alcoholismo. Conclusiones: fue efectiva al incrementar los conocimientos de los adolescentes sobre el alcoholismo, con acciones para fortalecer la promoción y prevención de esta enfermedad, en el primer nivel de atención de salud.

ABSTRACT Background: Alcoholism is a drug addiction that leads to dependence on other types of drugs that are dangerous and harmful to human health, so it is a phenomenon that must be understood objectively for the development of effective actions to eradicate it. Objective: to present the effectiveness of an educational intervention to increase knowledge about alcoholism in adolescents. Methods: a quasi-experimental educational intervention study was carried out at “Ramón López Peña” University Polyclinic in Santiago de Cuba, from February to August 2023. The study population consisted of 45 adolescent risk consumers, who met the inclusion criteria, to whom an initial questionnaire was applied that allowed to know the knowledge before and after the intervention. Theoretical methods were used: historical-logical, analytical-synthetic and inductive-deductive for data collection and research foundation. From the empirical level: the questionnaire and observation. Results: The educational intervention applied in group work sessions through participatory techniques favored the motivation of adolescents. Knowledge related to types of consumption, reasons and consequences, actions to follow in the face of excessive consumption and prevention of alcoholism were modified. Conclusions: It was effective in increasing adolescents' knowledge about alcoholism, with actions to strengthen the promotion and prevention of this disease, at the first level of health care.

RESUMEN Introducción: Las enfermedades prostáticas, benignas y malignas, presentan una alta prevalencia a nivel mundial. Se estima que el 70 % de los hombres mayores de 50 años padece de síntomas obstructivos urinarios. Objetivo: Describir los factores de riesgos del cáncer prostático en pacientes adultos. Métodos: Se realizó estudio observacional, analítico retrospectivo en el Policlínico Juan Conteras en el período comprendido de enero 2022 a diciembre 2022. La población fue conformada por 212 pacientes masculinos que presentaban riesgo de presentar cáncer de próstata. Se empleó el análisis documental de las historias clínicas individuales y se presentó el odds ratio como medida de asociación con intervalo de confianza del 95 % y valor P. Resultados: Se estudiaron 212 pacientes con factores de riesgos del cáncer prostático: el 46,22 % no presentaron esta enfermedad y el 53,77 %, sí. La disuria OR=0,3306 (IC 95 % 0,1041-1,0496) P=0,0503. El alcoholismo OR=0,0583 (IC 95 % 0,0135-0,2514) P=0,0000. El tabaquismo OR=19,555 (IC 95% 9,7371-39,274) P=0,0000. El APF cáncer próstata OR=0,4605 (IC 95 % 0,2512-0,8442) P=0,0083. El nivel de PSA >10 ng/ml OR= 429,57 (IC 95 % 56,635-3258,2) P=0.0000. Los factores protectores fueron: PSA <4 ng/ml OR=0,0024 (IC 95 % 0,0005-0,0114) P= 0,0000 y el APP HPB OR=0,0065 (IC 95 % 0,0023-0,0184) P=0,0000. Conclusiones: El riesgo de padecer cáncer prostático afecta a pacientes del grupo de edad de 70 o más años, blancos, con APF cáncer de próstata y que consumen alcohol y tabaco. La sintomatología más frecuente fue la disuria. Los factores protectores fueron: el PSA <4 ng/ml y APP HPB.

ABSTRACT Introduction: benign and malignant prostate diseases have a high prevalence worldwide. It is estimated that 70% of men over 50 years of age suffer from urinary obstructive symptoms. Objective: to describe the risk factors for prostate cancer in adult patients. Methods: an observational, retrospective and analytical study was carried out at Juan Conteras Polyclinic from January 2022 to December 2022. The population was made up of 212 male patients who were at risk of developing prostate cancer. Document analysis of individual medical records was used and odds ratio was presented as a measure of association with a 95% confidence interval and P value. Results: a number of 212 patients with risk factors for prostate cancer were studied: 46.22% of them did not have this disease and 53.77% did. Dysuria OR=0.3306 (95% CI, 0.1041-1.0496) P=0.0503. Alcoholism OR=0.0583 (95% CI, 0.0135-0.2514) P=0.0000. Smoking OR=19.555 (95% CI, 9.7371-39.274) P=0.0000. The APF prostate cancer OR=0.4605 (95% CI, 0.2512-0.8442) P=0.0083. The PSA level >10 ng/ml, OR= 429.57 (95% CI, 56.635-3258.2) P=0.0000. The protective factors were PSA <4 ng/ml, OR=0.0024 (95% CI, 0.0005-0.0114) P= 0.0000 and APP HPB OR=0.0065 (95% CI, 0.0023-0.0184) P=0.0000. Conclusions: the risk of suffering from prostate cancer affects white patients aged 70 years or older with APF prostate cancer and alcohol and tobacco consumers. The most frequent symptom was dysuria. PSA <4 ng/ml and APP HPB were the protective factors.