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au:SAPUNAR, Jorge

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Clinical and histopathological features of follicular thyroid cancer in Chile
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Díaz, René

; Domínguez, José Miguel

; Tala, Hernán

; Olmos, Roberto

; Pineda, Pedro

; Olivarí, Daniela

; Jiménez, Marcela

; Mimica, Ximena

; Lanas, Alejandra

; Ocares, Gerson

; Sapunar, Jorge

Archives of Endocrinology and Metabolism

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jun 2023, Volume 67 N. 3 Pages 348 - 354

Abstract: En | Text: En | PDF: En

ABSTRACT Objective: Follicular thyroid carcinoma (FTC) is less frequent but has a worse prognosis than papillary carcinoma. The available evidence on pre-operative characteristics of FTC is controversial. Our objective was to characterize the clinical, ultrasound and histopathological presentation of FTC patients treated Chile. Subjects and methods: Retrospective analysis of 97 patients treated for FTC in 6 large centers in Chile. We analyzed their ultrasonographic features and classified the nodules according to ATA risk of malignancy and TI-RADS score, as well as the cytological findings according to the Bethesda system. We described their clinical and histopathological findings at diagnosis and classified their risk of recurrence and mortality according to ATA 2015 recurrence risk category and the eighth edition of the AJCC/UICC staging system, respectively. Results: Median age was 48 years and 73.2% were females. The median diameter was 38.8 mm; only 9.5% of them were microtumors. According to ATA risk of malignancy, 86% of the nodules were low or intermediate suspicious, while 78% were category 3 or 4A nodules according to the TI-RADS. Regarding the Bethesda system, 65.9% had indeterminate cytology (20.6% category III and 45.3% category IV). At histological examination, most were minimally-invasive and angio-invasive tumors with less than 4 foci (54.7% and 28.4% respectively). More than 90% of FTC were unifocal and there was no lymphovascular or extrathyroidal invasion or lymph node involvement. Four patients (4.1%) had distant metastases at diagnosis. Most patients (95%) had stage I or II disease according to the AJCC/UICC staging system, while the risk of recurrence was low at 51.5% when using the ATA risk of recurrence scale. Conclusions: At diagnosis, most FTCs were nodules of low or intermediate suspicion at ultrasound, nearly two thirds had indeterminate cytology according to the Bethesda system, and nearly 50% of them were of low risk of recurrence.

https://doi.org/10.20945/2359-3997000000580

Epidemiología y características anatomoclínicas del melanoma maligno en un instituto oncológico
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Sapunar Z., Jorge

; Pantoja A., Álvaro

; Marín D., Luis

; Ferrer-Rosende, Pedro

Revista médica de Chile

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dec 2022, Volume 150 N. 12 Pages 1585 - 1595

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Background: Malignant melanoma (MM) is the most fatal cutaneous neoplasm. Its incidence is increasing progressively, which cannot be explained only by early diagnosis. Chilean population, due to the geography of the country, has a very varied solar exposure. Aim: To know the incidence of MM in a Chilean population, according to the level of sun exposure and to describe its clinical and histopathological characteristics. Material and Methods: Two hundred seventy-four surgeries for malignant melanoma with histological confirmation, carried out between 2016 and 2018 in an oncological institute were included. Results: The annualized incidence of MM was 13.83 cases per 100,000 people over 15 years of age in the 2016-2018 period. The geographical distribution of the incidence did not have a clear relationship with sun exposure. The most frequent locations of the primary lesions were trunk, head/neck and lower limb. Sixty-one per cent of cases were invasive MM; lesion thickness and presence of ulceration were associated with a higher risk of sentinel node involvement. Conclusions: No association between the level of sun exposure and the incidence of MM was observed in this study.

https://doi.org/10.4067/s0034-98872022001201585

Anthropometric Parameters, Lower Limb Functionality and Quality of Life After High-Intensity Interval Training in Healthy Young People Versus Older Adults
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Artigas-Arias, Macarena

; Olea, María Angélica

; San-Martín-Calísto, Yuri

; Huard, Nolberto

; Durán-Vejar, Fernanda

; Beltrán-Fuentes, Francisca

; Muñoz-Fernández, Aris

; Alegría-Molina, Andrea

; Sapunar, Jorge

; Salazar, Luis A

; Marzuca-Nassr, Gabriel Nasri

International Journal of Morphology

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oct 2021, Volume 39 N. 5 Pages 1337 - 1344

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

SUMMARY: The aim of this study was to determine the effects of High-intensity interval training (HIIT) on the quality of life in healthy young people (YNG) and older adults (OLD)and its correlation with physical health status (anthropometric parameters and lower limb functionality) YNG (21 ? 2 years, BMI 26.37 ? 2.69 n = 12) and OLD (67 ? 5 years, BMI 27.16 ? 3.04 n = 12) groups underwent 12weeks of HIIT. Before and after the HIIT, anthropometric assessments, lower limb functionality tests, and SF-36 quality-of-life questionnaire were performed. There were no significant changes in the SF-36 dimensions (P>0.05). After HIIT, there were improvement percentage changes in Mental Component Summary (MCS) (YNG, +8.51 ? 25.80 % vs. OLD, +2.30 ? 9.05 %) and in Physical Component Summary (PCS) (YNG, +2.66 ? 20.54 % vs. OLD, +4.34 ? 22.71 %). Negative correlations were observed between body mass index (BMI) with PCS (R=-0.570, P=0.009) and with MCS (R=-0.649, P=0.002) in OLD as well as between MCS and waist circumference (R=-0.557, P?0.001) in both groups. Also, correlations were observed between PCS and the sit-to-stand test (R=-0.424, P=0.006) in both groups and gait speed (R=0.458, P=0.042) only in YNG. HIIT promotes positive percentage changes in quality of life, with YNG showing better results in PCS and OLD in MCS. Quality of life and physical health status were correlated in both groups.

RESUMEN: Determinar los efectos del entrenamiento interválico de alta intensidad (HIIT) sobre la calidad de vida en jóvenes sanos (YNG) y personas mayores (OLD) y su correlación con el estado de salud física (parámetros antropométricos y funcionalidad de miembros inferiores). Ambos grupos, YNG (21 ? 2 años, IMC 26,37 ? 2,69 n = 12) y OLD (67 ? 5 años, IMC 27,16 ? 3,04 n = 12) realizaron 12 semanas de HIIT. Antes y después del HIIT, se realizaron evaluaciones antropométricas, pruebas de funcionalidad de miembros inferiores y cuestionario de calidad de vida SF-36. No hubo cambios significativos en las dimensiones del SF-36 (P >0,05). Después del HIIT, hubo cambios porcentuales de mejora en el componente sumario mental (MCS) (YNG, +8.51 ? 25.80 % vs. OLD, +2.30 ? 9.05 %) y el componente sumario física (PCS) (YNG, +2,66 ? 20,54 % vs. OLD, +2,30 ? 9,05 %), correspondientes a la calidad de vida. Se observaron correlaciones negativas entre el índice de masa corporal (IMC) con PCS (R=-0,570; P=0,009) y con MCS (R=0,649; P=0,002) en OLD, así como entre MCS y circunferencia de cintura (R = - 0,557, P?0,001) en ambos grupos. Además, se observaron correlaciones entre PCS y la prueba de sentarse y levantarse (R = -0,424; P = 0,006) en ambos grupos y la velocidad de la marcha (R = 0,458; P = 0,042) solo en YNG. HIIT promueve cambios porcentuales positivos en la calidad de vida, con YNG mostrando mejores resultados en PCS y OLD en MCS. La calidad de vida y el estado de salud física se correlacionaron en ambos grupos.

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Alta prevalencia de dislipidemias y riesgo aterogénico en una población infanto-juvenil
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SAPUNAR, JORGE

; AGUILAR-FARÍAS, NICOLÁS

; NAVARRO, JUAN

; ARANEDA, GUSTAVO

; CHANDÍA-POBLETE, DAMIAN

; MANRÍQUEZ, VÍCTOR

; BRITO, ROBERTO

; CERDA, ÁLVARO

Revista médica de Chile

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dec 2018, Volume 146 N. 10 Pages 1112 - 1122

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Background: Dyslipidemias in childhood increase the risk of cardiovascular events in adult life. Aim: To evaluate the prevalence of dyslipidemia and risk of atherogenicity based in the atherogenic index of plasma (AIP) in a sample of school children and adolescents. Material and Methods: Cross-sectional study of 208 children aged 10.4 ± 1.0 years (107 women). Demographic data were obtained, and a clinical evaluation was conducted, including pubertal development according to Tanner and anthropometric parameters. A fasting blood sample was obtained to measure total cholesterol (CT), HDL cholesterol (cHDL) and triglycerides (TG), glucose and insulin. LDL cholesterol (cLDL), Non-HDL cholesterol and the indices CT/cHDL, cLDL/cHDL and AIP (log[TG/cHDL]) were calculated. Risk categories according to AIP for the pediatric population were also determined (low: AIP < 0.11, intermediate: AIP 0.11-0.21, high: AIP > 0.21). Results: Thirty eight percent of participants had dyslipidemia, without differences by gender and pubertal development. The frequency of dyslipidemia was significantly higher in children with obesity (54%, p < 0.01) and a waist circumference over percentile 90 (61%; p < 0.01). The later conditions had also higher CT/cHDL, cLDL/cHDL and AIP. According to AIP, 54% of children had a high atherogenicity risk along with alterations in anthropometric parameters and insulin resistance. All anthropometric and insulin resistance parameters were significantly correlated with the AIP. Conclusions: There is a high prevalence of dyslipidemia in the studied population, which is associated with an increased cardiometabolic risk. The indices of atherogenicity and particularly AIP are correlated with nutritional status, abdominal obesity and parameters of insulin resistance.

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Rol de la cirugía bariátrica/metabólica en el manejo de la diabetes mellitus 2. Consenso SOCHED/SCCBM
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SAPUNAR, JORGE

; ESCALONA, ALEX

; ARAYA, A. VERÓNICA

; AYLWIN, CARMEN GLORIA

; BASTÍAS, MARÍA JULIANA

; BOZA, CAMILO

; CÁRCAMO, CARLOS

; CSENDES A, ATTILA

; DAVIDOF F, PATRICIO

; FUNKE, RICARDO

; GÓMEZ, PATRICIA

; GONZÁLEZ, MARÍA ISABEL

; LAHSEN, RODOLFO

; LANZARINI, ENRIQUE

; MAÍZ, ALBERTO

; MUJICA, VERÓNICA

; MUÑOZ, RODRIGO

; PÉREZ, GUSTAVO

; RAIMANN, FÉLIX

; SALMAN, PATRICIO

; SEPÚLVEDA, MATÍAS

; SOTO, NÉSTOR

; VILLAGRÁN, RODRIGO

Revista médica de Chile

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dec 2018, Volume 146 N. 10 Pages 1175 - 1183

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Diabetes Mellitus (DM) and obesity are a public health problem in Chile. Bariatric surgery is the most effective treatment alternative to achieve a significant and sustained weight reduction in patients with morbid obesity. The results of controlled clinical trials indicate that, compared to medical treatment, surgery for obese patients with DM2 allows a better control of blood glucose and cardiovascular risk factors, reduces the need for medications and increases the likelihood for remission. Consensus conferences and clinical practice guidelines support bariatric surgery as an option to treat DM2 in Class III Obesity (Body Mass Index (BMI) > 40) regardless of the glycemic control and the complexity of pharmacological treatment and in Class II Obesity (BMI 35-39,9) with inadequate glycemic control despite optimal pharmacological treatment and lifestyle. However, surgical indication for patients with DM2 and BMI between 30-34.9, the most prevalent sub-group, is only suggested. The Chilean Societies of Endocrinology and Diabetes and of Bariatric and Metabolic Surgery decided to generate a consensus regarding the importance of other factors related to DM2 that would allow a better selection of candidates for surgery, particularly when weight does not constitute an indication. Considering the national reality, we also need a statement regarding the selection and characteristics of the surgical procedure as well as the role of the diabetologist in the multidisciplinary team.

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Recomendaciones para el uso correcto de densitometría ósea en la práctica clínica. Consenso de la Sociedad Chilena de Endocrinología y Diabetes
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Barberán M., Marcela

; Campusano M., Claudia

; Trincado M., Patricio

; Oviedo G., Sofía

; Brantes G., Sergio

; Sapunar Z., Jorge

; Canessa, José

; Cid, Pía

; Escobar, Freddy

; Eugenin, Daniela

; Florenzano, Pablo

; Gajardo, Héctor

; González, Gilberto

; Illanes, Francisca

; Jiménez, Beatriz

; Martínez, Carolina

; Miranda, Edith

; Rivera, Sandra

; Salman, Patricio

; Trejo, Pamela

; Velasco, Soledad

Revista médica de Chile

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dec 2018, Volume 146 N. 12 Pages 1471 - 1480

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Osteoporosis is a silent and frequent disease, which increases fracture risk. Approximately half of women and one of five men over 50 years old will suffer an osteoporotic fracture throughout their lives. Dual-energy x-ray absorptiometry (DXA) allows a real bone mineral density (BMD) measurement in different parts of the skeleton and is considered the “gold standard” for quantifying osteoporosis with high accuracy and precision. The Board of the Chilean Society of Endocrinology and Diabetes (SOCHED) required from the Bone Disease Study Group to develop a consensus about the “Correct use of bone densitometry in clinical practice in Chilean population”. Therefore, we elaborated 25 questions which addressed key aspects about the indications for a DXA scan, and the details of how to perform and report this test. Since some of the evidence obtained was of low quality or inconclusive, we decided to create a multidisciplinary group of national experts in osteoporosis to develop a consensus in this subject. The group consisted of 22 physicians including endocrinologists, gynecologists, geriatricians, radiologists, rheumatologists and nuclear medicine specialists. Using the Delphi methodology to analyze previously agreed questions, we elaborated statements that were evaluated by the experts who expressed their degree of agreement. The final report of this consensus was approved by the SOCHED board.

https://doi.org/10.4067/s0034-98872018001201471 22799 downloads

Estrés psicológico y síndrome metabólico
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Ortiz, Manuel S.

; Sapunar, Jorge

Revista médica de Chile

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nov 2018, Volume 146 N. 11 Pages 1278 - 1285

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Background: Psychological stress and depressive symptoms are variables associated with metabolic syndrome (MetS). Aim: To determine the longitudinal association between psychological stress, depressive symptoms and MetS, and whether these variables predict MetS and its component trajectories. Material and Methods: Four hundred and twenty-three participants aged 44 ± 9 years (59% women), free of cardiovascular disease at baseline were enrolled into the Chilean study of psychological stress, obesity and MetS. Participants were followed-up for three years (three waves). Each year, they completed psychological questionnaires, anthropometric variables were measured, and blood samples were obtained. Results: Hierarchical linear regression showed that chronic psychological stress at baseline predicted the total number of MetS components (MetS score) during the third assessment wave (β = 0.147; p < 0.01). Growth curve modeling allowed to determine that participants who scored +1 standard deviation (SD) at baseline over the mean in psychological stress (βchronic stress = 0.903; 95% confidence intervals (CI) = 0.065; 1.741), and depressive symptoms (βdepressive symptoms = 2.482; 95% CI = 0.040; 4.923) had a higher waist circumference trajectory, as compared to those scoring −1 SD above the mean. Conclusions: Chronic psychological stress is longitudinally associated with the MetS score. Further, psychological stress and depressive symptoms at baseline predicted elevated MetS score trajectories, and a highest waist circumference.

5056 downloads

Alta prevalencia de trastornos nutricionales por exceso, resistencia insulínica y síndrome metabólico en escolares de la comuna de Carahue, Región de la Araucanía
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Sapunar, Jorge

; Aguilar-Farías, Nicolás

; Navarro, Juan

; Araneda, Gustavo

; Chandia-Poblete, Damian

; Manríquez, Víctor

; Brito, Roberto

; Cerda, Alvaro

Revista médica de Chile

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sep 2018, Volume 146 N. 9 Pages 978 - 986

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Background: Childhood and adolescent obesity is a major public health problem in Chile. Aim: To characterize cardiometabolic risk factors in a population of schoolchildren from Carahue, Chile. Material and Methods: Cross-sectional assessment of 208 children aged 10.4 ± 1.0 years (106 women). A clinical evaluation was carried out including pubertal development according to Tanner and anthropometric parameters. A fasting blood sample was obtained to measure glucose, insulin and lipid profile. HOMA-IR and Quicki indices were calculated. Insulin resistance (IR) was established according to Burrows criteria and Barja criteria, previously proposed for the Chilean pediatric population. The metabolic syndrome (MetS) was established using the modified Cook criteria. Results: Thirty eight percent of children had overweight and 33.1% obesity. MetS was only observed in obese subjects and the frequency in this subgroup was 38%. The prevalence of IR was 51% according to the Burrows criteria and 19% according to Barja criteria. It was more common in participants who were overweight, obese or had abdominal obesity. Children with insulin resistance according to Barja criteria, had worse anthropometric measures than their counterparts without resistance. When Burrows criteria was used, no differences in anthropometric measures were observed between participants with or without resistance. The frequency of MetS was 26 and 18% in children with insulin resistance according to Barja and Burrows criteria, respectively. Insulin levels and insulin sensitivity indexes were positively correlated with anthropometric parameters. Conclusions: There was a high prevalence of overweight, obesity and MetS in these participants. Our results suggest that the IR criteria according to Barja allows to identify cases with higher metabolic risk.

https://doi.org/10.4067/s0034-98872018000900978 2428 downloads

Análisis crítico del tratamiento de la enfermedad hepática grasa no alcohólica
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Lanuza, Fabian

; Sapunar, Jorge

; Hofmann, Edmundo

Revista médica de Chile

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aug 2018, Volume 146 N. 8 Pages 894 - 901

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Non-alcoholic fatty liver disease (NAFDL) includes fatty liver or simple steatosis, characterized by lipid deposits in hepatocytes and more advanced stages such as steatohepatitis (NASH) and non-alcoholic cirrhosis. Physical inactivity, hypercaloric and unbalanced diet together with aging play a key role in the pathogenesis of NAFLD and are strongly associated with metabolic and physical activity continue to be major components in prevention and first-line treatment to attenuate or reverse NAFLD. Dietary patterns, their composition and weight reduction would be the most relevant nutritional aspects in NAFDL treatment. Physical exercise, moderate to intense, aerobic and resistance type contributes to weight loss, improves metabolic control and body composition. Pharmacological therapy can be useful in clinical circumstances that require it and needs a medical evaluation when there is no adherence and success in non-pharmacological interventions.

https://doi.org/10.4067/s0034-98872018000800894 6672 downloads

10.

Estudio y manejo de nódulos tiroideos por médicos no especialistas. Consenso SOCHED
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Tala, Hernán

; Díaz, René E.

; Domínguez Ruiz-Tagle, José Miguel

; Sapunar Zenteno, Jorge

; Pineda, Pedro

; Arroyo Albala, Patricia

; Barberán, Marcela

; Cabané, Patricio

; Cruz Olivos, Francisco

; Gac, Patricio E.

; Glasinovic Pizarro, Andrea

; González, Hernán E.

; Grob, Francisca

; Hidalgo Valle, Maria Soledad

; Jaimovich, Rodrigo

; Lanas, Alejandra

; Liberman, Claudio

; Lobo Guiñez, Maite

; Madrid, Arturo

; Moreno Seguel, Marcela

; Mosso, Lorena

; Munizaga, Fernando C.

; Ortiz Parada, Eugenia

; Osorio Gonnet, Fernando

; Slater Morales, Jeannie

; Solar, Antonieta

; Stehr, Carlos

; Vásquez Rodríguez, Félix

; Véliz, Jesús

; Villaseca Najarian, Roberto

; Wohllk, Nelson

Revista médica de Chile

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aug 2017, Volume 145 N. 8 Pages 1028 - 1037

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

The thyroid nodule is a frequent cause of primary care consultation. The prevalence of a palpable thyroid nodule is approximately 4-7%, increasing up to 67% by the incidental detection of nodules on ultrasound. The vast majority are benign and asymptomatic, staying stable over time. The clinical importance of studying a thyroid nodule is to exclude thyroid cancer, which occurs in 5 to 10% of the nodules. The Board of SOCHED (Chilean Society of Endocrinology and Diabetes) asked the Thyroid Study Group to develop a consensus regarding the diagnostic management of the thyroid nodule in Chile, aimed at non-specialist physicians and adapted to the national reality. To this end, a multidisciplinary group of 31 experts was established among university academics, active researchers with publications on the subject and prominent members of scientific societies of endocrinology, head and neck surgery, pathology and radiology. A total of 14 questions were developed with key aspects for the diagnosis and subsequent referral of patients with thyroid nodules, which were addressed by the participants. In those areas where the evidence was insufficient or the national reality had to be considered, the consensus opinion of the experts was used through the Delphi methodology. The consensus was approved by the SOCHED board for publication.

https://doi.org/10.4067/s0034-98872017000801028 28478 downloads

11.

II Consenso de la Sociedad Chilena de Endocrinología y Diabetes sobre resistencia a la insulina
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Pollak, Felipe

; Araya, Verónica

; Lanas, Alejandra

; Sapunar, Jorge

; Arrese, Marco

; Aylwin, Carmen Gloria

; Bezanilla, Carmen Gloria

; Carrasco, Elena

; Carrasco, Fernando

; Codner, Ethel

; Díaz, Erik

; Durruty, Pilar

; Galgani, José

; García, Hernán

; Lahsen, Rodolfo

; Liberman, Claudio

; López, Gloria

; Maíz, Alberto

; Mujica, Verónica

; Poniachik, Jaime

; Sir, Teresa

; Soto, Néstor

; Valderas, Juan

; Villaseca, Paulina

; Zavala, Carlos

Revista médica de Chile

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may 2015, Volume 143 N. 5 Pages 627 - 636

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Insulin resistance is a prevalent condition commonly associated with unhealthy lifestyles. It affects several metabolic pathways, increasing risk of abnormalities at different organ levels. Thus, diverse medical specialties should be involved in its diagnosis and treatment. With the purpose of unifying criteria about this condition, a scientific-based consensus was elaborated. A questionnaire including the most important topics such as cardio-metabolic risk, non-alcoholic fatty liver disease and polycystic ovary syndrome, was designed and sent to national experts. When no agreement among them was achieved, the Delphi methodology was applied. The main conclusions reached are that clinical findings are critical for the diagnosis of insulin resistance, not being necessary blood testing. Acquisition of a healthy lifestyle is the most important therapeutic tool. Insulin-sensitizing drugs should be prescribed to individuals at high risk of disease according to clinically validated outcomes. There are specific recommendations for pregnant women, children, adolescents and older people.

40781 downloads

12.

Efecto del estado nutricional neonatal en el riesgo de síndrome metabólico en niños obesos de 2 comunas de la Región del Bío-Bío
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Sapunar, Jorge

; Bustos, Paulina

; Sáez, Katia

; Muñoz, Sergio

; Asenjo, Sylvia

Revista médica de Chile

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dec 2014, Volume 142 N. 12 Pages 1523 - 1529

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Background: Neonatal malnutrition defined by birth weight (BW) is a risk factor for obesity and cardio-metabolic diseases in adults. Neonatal ponderal index (NPI) may have better diagnostic value than BW to establish nutritional status. Aim: To determine the effect of neonatal nutritional status, established by the three NPI curves available in Chile, on the risk of Metabolic Syndrome (MS) in obese school children. Material and Methods: A nested case/control study in a sample of 410 obese school children aged 10 to 16 years (57% males) was performed. The dichotomous response variable was the presence of MS defined as International Diabetes Federation (IDF) or Cook’s criteria. The exposure variable was having NPI < percentile (p) 10. Results: The frequency of MS was 36 and 39% according to the IDF and Cook criteria, respectively. The proportion of children with neonatal malnutrition exceeded 20%. A significantly increased risk for MS was only found when PNI was defined according to Lagos´s Table and MS was defined using IDF criteria. Having a PNI > p90, however, showed a trend towards a reduced risk of MS, which only reached significance using Lagos´s Table and Cook´s Criteria. Conclusions: Neonatal malnutrition defined by NPI is common in obese school children. The condition of neonatal under nutrition defined as PNI < p10 may be a risk factor for developing MS. Instead, having a NPI > p90 could be protective.

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13.

Epidemiología del cáncer de tiroides en Chile: Resultados del estudio INCATIR
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Sapunar Z, Jorge

; Muñoz N, Sergio

; Roa S, Juan Carlos

Revista médica de Chile

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sep 2014, Volume 142 N. 9 Pages 1099 - 1105

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Background: Thyroid cancer (TC) detection is increasing steadily. Aim: To determine the incidence of TC based on pathological reports of thyroidectomies. Material and Methods: Fifty pathology laboratories performing thyroid gland pathological studies were identified. Those that accepted to participate were required to send trimestral reports of all thyroid pathological studies, from March 2011 to February 2012. Results: In the study period, 1309 case of TC were confirmed in 2614 thyroidectomy surgical samples. Considering the susceptible population according to 2012 census, the estimated incidence of TC during 2011 should be higher than 7.86 cases per 100,000 persons/year. Papillary cancer was the most common pathological type in 92% of samples (95% confidence intervals 90-93%). The proportion of microtumors was significantly higher in women than in men and among papillary than in follicular or medullary tumors. Only one fourth of tumors came from thyroidectomies performed in the Ministry of Health network. Conclusions: The incidence and features of TC in Chile are similar to the figures reported abroad.

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14.

Asociación entre malnutrición por exceso con caries temprana de la infancia
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ZAROR S, CARLOS

; SAPUNAR Z, JORGE

; MUÑOZ N, SERGIO

; GONZÁLEZ C, DAMARIS

Revista chilena de pediatría

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jul 2014, Volume 85 N. 4 Pages 455 - 461

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Objective: To determine whether overweight is a risk factor for the development of early childhood caries (ECC) in preschoolers. Patients and Method: An observational retrospective cohort study was performed in 196 children under 2 years of age at Calbuco Hospital, Los Lagos Region, Chile, who were admitted between 2007 and 2009. Patients were grouped based on their nutritional status at admission in the two following categories: eutrophic and overweighed children as a result of excessive intake. Information regarding caries incidence and nutritional status were annually retrieved from records until the age of 5 years, according to medical and dental records. Results: At the beginning of the study, 33.67% were overweight and 16.33% were obese, reaching 40% overweight and 20.56% obese at four years of age. The incidence of early childhood caries in overweighed children was 57.14% compared to 40.82% in normal weight children (p = 0.022), with 1.4 RR (95% CI, 1044-1.88). Conclusions: The increased risk of early childhood decay in overweighed patients makes necessary to create instances of timely mutual referral between the professional that diagnoses overweighed children and the pediatric dentist in order to develop preventive treatments for both diseases.

Objetivo: Determinar si la malnutrición por exceso es un factor de riesgo para el desarrollo de caries temprana de la infancia (CTI) en preescolares. Pacientes y Método: Se realizó un estudio observacional de cohorte retrospectivo en 196 niños de 2 años del Hospital de Calbuco, Región de Los Lagos, Chile, ingresados durante los años 2007 a 2009. Los pacientes fueron agrupados de acuerdo a su estado nutricional al ingreso en niños eutróficos y niños con malnutrición por exceso. La información respecto a incidencia de caries y el estado nutricional fueron recuperados de la ficha anualmente hasta la edad de 5 años, según registro de las fichas médicas y odontológicas. Resultados: El 33,67% estaba en sobrepeso al inicio de la cohorte y el 16,33% obeso, alcanzando 40% sobrepeso y 20,56% obesidad a los cuatro años de edad. La incidencia de caries temprana de la infancia en niños con malnutrición por exceso fue de 57,14% en relación al 40,82% de los niños eutróficos (p = 0,022) con RR de 1,4 (95% IC, 1.044-1,88). Conclusiones: El mayor riesgo asociado a CTI en pacientes con malnutrición por exceso invita a generar las instancias de derivación oportuna desde el profesional que pesquisa a niños con malnutrición por exceso hacia el odontólogo infantil, con el fin de desarrollar intervenciones preventivas para ambas patologías.

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15.

Ejercicio físico interválico de alta intensidad mejora el control glicémico y la capacidad aeróbica en pacientes con intolerancia a la glucosa
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Mancilla, Rodrigo

; Torres, Paola

; Álvarez, Cristian

; Schifferli, Ingrid

; Sapunar, Jorge

; Díaz, Erik

Revista médica de Chile

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jan 2014, Volume 142 N. 1 Pages 34 - 39

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Background: Proper exercise training modifies intra miocellular energy utilization, glucose transport and mitochondrial biogenesis. Aim: To determine the therapeutic effects of a high intensity intermittent training (HIIT) program on glucose homeostasis, physical fitness and body fat in glucose intolerant patients. Patients and Methods: Eighteen patients with overweight or obesity and glucose intolerance were invited to participate in an exercise program consisting in three sessions per week for 3 months. Ten participants aged 35 ± 13 years who attended > 26 of the planned 36 sessions, were considered as adherent to exercise. The other eight participants aged 37 ± 17 years, who attended to a mean of 13 sessions, were considered as non-adherent. Both groups had similar body weight, body mass index, body fat, plasma glucose 2 h after an oral glucose load and maximal oxygen uptake. All these variables were measured at the end of exercise intervention. Each session consisted of 1 min exercise of cycling at maximal intensity until muscle fatigue followed by 2 min rest, repeated 10 times. Results: Among adherent participants, twelve weeks of HIIT improved signifcantly maximal oxygen uptake (6.1 + 3.6 mL/kg/min or 24.6%), reduced 2 h post load blood glucose (-33.7 + 47.9 mg/dL or -12.5%) and body fat (-4.3 + 5.6 kg). No signifcant changes were observed in the non-adherent group. Conclusions: HIIT exercise reduces blood glucose after an oral load in glucose intolerant patients.

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