To identify the relationship between religiosity and self-rated health among older adults in Colombia.  Data are drawn from the SABE  Colombia Study, a cross-sectional survey conducted in 2015 involving 18,871 community-dwelling adults aged 60 years and older living in urban and rural areas of Colombia. Religiosity was assessed by self-rated religiosity . Self-rated health during previous 30 days was assessed as very good, good, fair, poor or very poor, analyzed as an ordinal variable (1-5) using weighted logistic regression, adjusting for confounders.  Those who were more religious were older, female, had lower socioeconomic status, and were more likely to be married. Multivariate analyses demonstrated that older adults who were more religious had better self-rated health ; however, there was a significant interaction effect between gender and religiosity on self-rated health (p= 0.002), such that the relationship between religiosity and health was stronger in men  but not significant in women.  Older adults in Colombia who consider themselves more religious, especially men, are less likely to perceive their physical health as poor compared to those who are less religious.  Women participants in the Nurses’ Health Study (mean age 58) who attended religious services at least once a week had the lowest risk of developing depression, lower suicide rates, and significantly lower all-cause, cardiovascular and cancer mortality ,et al.et al.et al.et al.et al.et al.Self-rated health (SRH) is an important predictor of morbidity and mortality in older adults et al.In a SABE study, which included participants from seven Latin American cities, Reyes-Ortiz Data were drawn from the 2015 SABE  Colombia Study, a cross-sectional survey of the random sample of older adults, persons age 60 or over, in the country of Colombia. The design of the study and the instrument employed in the SABE Colombia study was derived from the original SABE study conducted in seven Latin American cities A multistage random cluster sampling technique was used with stratification of units as follows. First was the selection of municipalities as primary sampling units (PSUs). Second, area segments  were identified as secondary sampling units (SSU). Third, a complete listing of all housing units (HUs) was physically located. Finally, household units within a sample HU were selected. The SABE Colombia study was integrated within the general framework of the Colombian National Surveys System, which has a similar sampling design inside the national master sample for country population surveys in Colombia. The estimated sample size was 24,553 individuals, and assuming an 80% response, the original target sample was 30,691. Response rates ranged from 62% in urban areas to 77% in rural sites. The final sample size, including 244 municipalities from all states of the country, was 23,694 Participants were included if they were 60+ years of age, were capable of communicating with the research team, and provided written informed consent. Individuals were excluded if they had a total score of less than 13 on the abbreviated version of the Mini-Mental State Examination (AMMSE) The outcomes were self-rated religiosity and self-rated health. Self-rated religiosity was assessed asking participants how religious they were: none (code=1), somewhat (code=2) or very (code=3), and was analyzed as an ordinal variable . Response options for self-rated health during the previous 30 days were very good (code=1), good (code=2), fair (code=3), poor (code=4) or very poor (code=5); self-rated health was analyzed as an ordinal variable . Socio-demographic variables included age , gender , marital status (married or unmarried), socioeconomic status (SES), and education (years). Other variable was medical comorbidity which was assessed including the presence of seven medical conditions: hypertension, diabetes, coronary heart disease, arthritis, stroke, chronic obstructive pulmonary disease, and cancer. Respondents were asked: “Has a doctor or a nurse told you that you have...?” for each of the conditions listed above. Counts of comorbidities were determined (ranging from 0 to 5) and were analyzed as a continuous variable. p <0.05. The Statistical Analysis System (SAS), version 9.4 was used for analysis .To adjust for sampling survey design, data were weighted by using complex survey analyses. Descriptive statistics such as weighted percentages or medians (inter quartile range) were presented, and differences on categorical or ordinal variables were analyzed using the Wald chi-square statistic using the SURVEYFREQ procedure. Graphs were developed describing religiosity across age and gender categories, and self-rated health by gender. Multivariate ordinal logistic regression models examining characteristics associated with religiosity or self-rated health were performed and odds ratios (OR) with confidence intervals (95% CI) were calculated, using the SURVEYLOGISTIC procedure. Relevant interactions terms were tested. Level of statistical significance was set at Of the 18,871 study participants, 23.0% were age ≥75, 55.8% were female, 43.5% rated their health as fair, 7.5% as poor and 0.8% as very poor; 64.7% considered themselves very religious . ). Similarly, those who were older were more likely to indicate that they were very religious compared to those who were younger (p <0.0001). Women tend to have poorer self-rated health than men (p <0.0001). Women were more likely to consider themselves very religious compared to men (p <0.0001) . SimilaMultivariate analyses demonstrated that religiosity was associated with age, female gender and being married . In contp= 0.038) (p= 0.002). We did additional adjusted analyses separated by gender where men tend to have better health when being more religious (p= 0.001) but the association was not significant in women  , Model 1in women , Model 2To our knowledge, this is the first study to examine the relationship between religiosity and self-rated health in older Colombians country-wide. Religiosity was associated with better self-rated health, especially in men. The association was independent of socio-demographic factors, and medical comorbidity. Factors associated with being religious were older age, female gender, being married, and low socioeconomic status. ,,,--Socioeconomic factors and diseases have been considered as the main determinants of self-rated health in the general population as well as in older adults et al.The findings reported here agree with those from other studies that have found religiosity associated with better self-rated health. Koenig ,,Religiosity has also been associated with positive emotions such as greater life satisfaction, psychological and existential well-being, hope, optimism, and meaning and purpose in life, feelings which help to neutralize the negative emotions that underlie poor self-perceptions of health The findings from this study must be interpreted and generalized with caution. First, the cross-sectional nature of the study does not allow us to determine causality or direction of effect in the relationships observed. Poor self-rated health may just as well lead to less religious involvement, as greater religious involvement may lead to better self-rated health. Second, our measures for religiosity were relatively simple, i.e., subjective indicators of religious importance. Nevertheless, the study also has a number of strengths, including the large sample of Colombian older adults who were representative of the urban and rural areas of Colombia; the control for multiple covariates using regression analyses; and as noted earlier, the uniqueness of this study as one of the first to examine religiosity and self-rated health in older Colombians country-wide. If religiosity improves self-rated health among older adults, or improves the perceptions that they have about their health, then they are more likely to feel better about themselves and may be more likely to seek healthcare services in a more appropriate manner  Religious involvement is associated with better self-rated health in older adults, especially men, in the South American country of Colombia. Socioeconomic factors and comorbid illnesses also have a strong influence on self-rated health in older Colombians. Prospective studies are needed to help determine the direction of effect in this relationship, identify mediating factors, and further explore how religiosity may impact self-rated health (and vice-versa).  --La religión se define como tener una fe y creencias religiosas, participar en prácticas religiosas personales  y participar en prácticas religiosas públicas  -,-Otros estudios realizados en poblaciones caucásicas o afroamericanas han demostrado que las actividades religiosas frecuentes, como la asistencia a la iglesia, están asociadas con una mejora en los factores de riesgo cardiovascular o relacionado con el cáncer, como la promoción de una dieta más saludable  y menos comportamientos riesgosos para la salud  --La asociación entre la participación religiosa y la salud también es válida en los adultos mayores que viven en comunidades. Las mujeres participantes en el Estudio de salud de enfermeras (edad promedio de 58 años) que asistieron a los servicios religiosos al menos una vez a la semana tuvieron el riesgo más bajo de desarrollar depresión, menores tasas de suicidio y una mortalidad general, cardiovascular y por cáncer significativamente menor ,et al. et al. et al. et al. et al. El auto reporte de salud (ARS) es un importante predictor de morbilidad y mortalidad en adultos mayores et al. En un estudio de SABE, que incluyó participantes de siete ciudades latinoamericanas, Reyes-Ortiz Los datos se extrajeron del estudio SABE  Colombia 2015, una encuesta transversal de una muestra aleatoria de adultos mayores, personas de 60 años o más, en el país de Colombia. El diseño del estudio y el instrumento empleado en el estudio SABE Colombia se derivaron del estudio original SABE realizado en siete ciudades latinoamericanas Se usó una técnica de muestreo de grupos al azar de múltiples etapas con la estratificación de unidades de la siguiente manera. Primero fue la selección de los municipios como unidades primarias de muestreo (UPM). En segundo lugar, los segmentos de área  se identificaron como unidades secundarias de muestreo (USM). En tercer lugar, se ubicó físicamente una lista completa de todas las unidades de vivienda (UV). Finalmente, se seleccionaron unidades domésticas dentro de una muestra UV. El estudio SABE Colombia se integró en el marco general del Sistema Nacional de Encuestas de Colombia, que tiene un diseño de muestreo similar dentro de la muestra maestra nacional para las encuestas de población en Colombia. El tamaño de muestra estimado fue de 24,553 individuos, y suponiendo una respuesta del 80%, la muestra objetivo original fue de 30,691. Las tasas de respuesta oscilaron entre 62% en áreas urbanas y 77% en sitios rurales. El tamaño final de la muestra, incluyendo 244 municipios de todos los estados del país, fue de 23,694 Los participantes se incluyeron si tenían más de 60 años de edad, eran capaces de comunicarse con el equipo de investigación y dieron su consentimiento informado por escrito. Los individuos se excluyeron si tenían una puntuación total de menos de 13 en la versión abreviada del Mini-Mental State Examination (AMMSE) 33. Para estos individuos  se realizó una entrevista proxy, aunque se excluyeron del presente estudio ya que las preguntas sobre la religiosidad no se hicieron como parte de la entrevista proxy. Por lo tanto, la muestra final para este informe incluyó 18,871 participantes que tenían información completa sobre el ARS y la religiosidad autoevaluada.Las variables dependientes fueron la religiosidad autoevaluada y el ARS. La religiosidad se evaluó preguntando a los participantes qué tan religiosos eran: nada (código = 1), algo (código = 2) o muy (código = 3), y se analizó como una variable ordinal . Las opciones de respuesta para el ARS durante los 30 días anteriores fue muy bueno (código = 1), bueno (código = 2), regular (código = 3), pobre (código = 4) o muy pobre (código = 5); el ARS se analizó como una variable ordinal .Las variables sociodemográficas incluyeron edad , género (masculino o femenino), estado civil (casado o no casado), estado socioeconómico (SES) y educación (años). Otra variable fue la comorbilidad médica que se evaluó con la presencia de siete afecciones médicas: hipertensión, diabetes, enfermedad coronaria, artritis, accidente cerebrovascular, enfermedad pulmonar obstructiva crónica y cáncer. Se preguntó a los encuestados: “¿Un médico o una enfermera le han dicho que usted tiene ...?” Para cada una de las afecciones enumeradas anteriormente. Se determinaron los recuentos de comorbilidades (rango de 0 a 5) y se analizaron como una variable continua.p <0.05. El Sistema de Análisis Estadístico (SAS), versión 9.4 se utilizó para el análisis .Para ajustar el diseño de la encuesta de muestreo, los datos se ponderaron mediante el uso de análisis complejos para encuestas. Se presentaron estadísticas descriptivas, como porcentajes ponderados o medianas (rango inter cuartil), y se analizaron las diferencias en las variables categóricas u ordinales mediante la estadística de Wald Chi-cuadrado mediante el procedimiento SURVEYFREQ. Se desarrollaron gráficos que describían la religiosidad de acuerdo a categorías de edad y género, y el ARS por género. Se realizaron modelos de regresión logística ordinal multivariada que examinaron las características asociadas con la religiosidad o el ARS y se calcularon los odds ratios (OR) con intervalos de confianza (IC 95%), mediante el procedimiento SURVEYLOGISTIC. Las interacciones relevantes fueron exploradas. El nivel de significación estadística se estableció en De los 18,871 participantes del estudio, el 23.0% tenía una edad ≥75, el 55.8% era mujer, el 43.5% calificó su salud regular, el 7.5% como pobre y el 0.8% como muy pobre; el 64,7% se consideraba muy religioso .p <0.0001) (p <0.0001). Las mujeres tienden a tener ARS más pobre que los hombres (p <0.0001).Las mujeres tenían más probabilidades de considerarse muy religiosas en comparación con los hombres (<0.0001) . Del misLos análisis multivariados demostraron que una mayor religiosidad estaba asociada con la edad, el género femenino y el ser casado . En contp= 0.038) (p= 0.002). Hicimos análisis ajustados adicionales separados por género, donde los hombres tienden a tener mejor salud cuando son más religiosos (p= 0.001), pero la asociación no fue significativa en las mujeres .


There are errors in the Funding section. The correct funding information is as follows: This study was sponsored by HAR2016-77789 (Spanish Ministry of Economy and Competitiveness) and 19434/PI/14 . For the fieldwork we had permission from the Andalusian Regional Government's Department of Culture. We also enjoyed the logistical support of the Píñar (Granada) Regional Government. This work was funded by the Andalusian Research Group Board RNM-349. "Proyecto de rehabilitación y conservación del yacimiento arqueológico "Cueva de las Ventanas" , Department of Culture, Andalusian Regional Government (File: BC.01.146/94.) "Análisis polínico y datación para Carbono 14 de huesos y coprolitos de hienas provenientes de la Cueva de las Ventanas depositados en el Museo Arqueológico y Etnológico de Granada , Department of Culture, Andalusian Regional Government. File: BC 03/46/09). We received support from Ministerio de Economía y Competitividad, grant number CGL 2015–68604.


Deep venous thrombosis (DVT) strikes around ten million people worldwide every year and is associated with major complications including pulmonary embolism and post-thrombotic syndrome. Anticoagulation is the standard treatment, with administration of heparins, vitamin K antagonists, fondaparinux, or, more recently, direct oral anticoagulants (DOACs). Anticoagulants reduce thrombus progression and facilitate natural thrombolytic mechanisms, leading to a phenomenon known as recanalization, which can occur in varying degrees and over variable periods of time, under influence from many different factors, including the type of anticoagulation employed.To evaluate the degree of recanalization and the time taken, by analysis of color Doppler ultrasonography (CDU) reports from patients with DVT treated with DOACs or with heparin + warfarin.A retrospective analysis was conducted of demographic data and CDU reports from patients with DVT who had been treated from January 2009 to December 2016. These patients were classified into two groups, according to the treatment given: Group I (heparin + warfarin): 26 patients; or Group II (rivaroxaban): 51 patients. The primary outcomes assessed were degree of recanalization and time taken.Recanalization rates at 30, 90, and 180 days were 10%, 52.5%, and 78.9%, respectively, in Group I, and 55.3%, 83.5%, and 92.4%, respectively, in Group II, with statistically significant difference (p = 0.041).Both treatments led to recanalization. Recanalization occurred earlier among patients treated with rivaroxaban. Deep venous thrombosis (DVT) is characterized by acute formation of blood clots in deep veins and can cause partial or total obstruction of the venous lumen. It is included in the nosological entity venous thromboembolism (VTE), which encompasses both DVT and pulmonary embolism (PE).Venous thromboembolism occurs in two out of every 1,000 individuals each year, with a rate of recurrence of 25%,One controversial element in the natural history of DVT is its progression. After an episode of DVT, an acute inflammatory response occurs in the vein wall and in the thrombus, leading to a dynamic process of thrombus regression by recanalization.Presence of thrombi and the recanalization process can damage venous valves, giving rise to valve incompetence. This condition, or persistent obstruction of the vein by residual thrombus, or even both, can cause chronic venous hypertension, causing post-thrombotic syndrome (PTS).Unfractionated heparin (UFH) was discovered in 1916 and became the first choice treatment for DVT during the 1930s. Soon after, the vitamin K antagonists (VKA) warfarin and phenprocoumon were developed. Low molecular weight heparins (LMWH) emerged during the 1980s.,In the 2000s, direct oral anticoagulants (DOACs) began to be released, offering as primary benefits freedom from laboratory monitoring, oral posology and a wider therapeutic window. Rivaroxaban and apixaban are employed without initial parenteral anticoagulation, in contrast with dabigatran and the more recent edoxaban, which need initial parenteral anticoagulation.,Introduction of DOACs into routine clinical practice was supported by the results of many controlled clinical trials, meta-analyses, and real-life studies with large numbers of patients.,Some reports have demonstrated that DOACs have the capacity to stimulate regression of thrombi, whether in the venous system or in other locations, such as the cardiac chambers.The objective of this study was to assess the degree of recanalization and the time taken for recanalization by analysis of color Doppler ultrasonography (CDU) reports from patients with DVT treated either with rivaroxaban monotherapy or with parenteral heparin followed by oral warfarin.The research on which this article is based was conducted in full compliance with Brazil’s National Health Council  Resolution 466/12 and was submitted to the Research Ethics Committee at the Centro Universitário, Faculdade Assis Gurgacz and approved under certificate number 51793015.0.0000.5219.Reports from serial CDU examinations of 77 DVT patients treated from January 2009 to December 2016 were reviewed. Patients were classified into two groups according to the treatment received: Group I – heparin + warfarin: 26 patients (33.76%); or Group II – rivaroxaban: 51 patients (66.24%). All CDU examinations were performed by the same team of ultrasonographers, who described segments with thrombi using the traditional anatomic nomenclature: common iliac vein, external iliac vein, common femoral vein, deep femoral vein, femoral vein, popliteal vein, anterior and posterior tibial veins, fibular veins, and muscular veins. The baseline study variable was the sum of involved segments. As recanalization progressed, recanalized segments were excluded from the counts, leaving the number of segments still affected by thrombi at the end of the follow-up period. These recanalization data were also stratified in terms of percentage recanalization and time taken for recanalization.The inclusion criteria were all patients with DVT confirmed by CDU for whom at least three follow-up vascular ultrasound examinations were available. From almost 500 CDU examinations performed during the period to evaluate DVT, serial examinations for 77 patients who fulfilled all criteria were selected. The exclusion criteria were patients for whom only two vascular ultrasound reports were available, and patients who had not been treated with either of the two classes of medications assessed in this study.Forty-two (54.55%) of the 77 patients studied were male. Mean age was 59.03±15.98 years. There was no statistically significant difference between the groups in terms of demographic profile (p = 0.42). The mean international normalized ratio (INR) for patients in Group I was 2.71±0.82.At study outset, patients in Group I had a mean of 3.11 segments involved with thrombi. The patients in Group II had a mean of 2.76 involved segments. At the end of treatment, the number of segments still involved  was a mean of 0.38 in Group I and 0.14 in Group II, with no statistically significant difference between groups (p = 0.13).In terms of percentage recanalization, patients in Group II exhibited quicker recanalization during the initial months of treatment and, when partial and total recanalizations were compared, there was a statistically significant difference in favor of patients treated with rivaroxaban (p = 0.041). Analyses of recanalization percentages in each group are shown in In this study, the majority of patients treated up to 2011 were given conventional treatment with UFH + VKA or LMWH + VKA. All of these patients were treated in hospital, with a minimum stay of 4 days. Inclusion of DOACs in clinical practice from 2011 onwards enabled significant changes to the way patients with VTE were treated. Since then, many patients with VTE have been treated with DOAC monotherapy at our service. Electronic patient records have been available at our institution since 2009, so we chose that start date for data collection.Warfarin has been used in day-to-day clinical practice since the 1950s, so there is a wealth of information on its effects and limitations. One negative aspect of warfarin is its slow onset of action, because its effects are the result of interference in cyclic conversion of vitamin K and its 2.3-epóxido, blocking synthesis of the coagulation factors that are dependent on it . Its anticoagulant effects do not therefore occur until factors already present in the circulation have been metabolized, which typically takes 36-72 h.Rivaroxaban is an oral anticoagulant that acts as a reversible and specific factor Xa inhibitor. It has predictable pharmacokinetics and pharmacodynamics, with fewer interactions with foods, medications, and individual characteristics such as age, sex, weight, and ethnicity, in addition to low hepatic toxicity. One very positive factor is the wider therapeutic window than warfarin, which basically enables the same therapeutic result to be achieved despite physiological variations in the drug’s serum concentration. This may help to achieve better and faster recanalization of thrombi, because of reduced external interference in its anticoagulant effects.,It is also necessary to take patient treatment adherence into account, since the simplicity of using a single drug to manage acute DVT from the initial phase with a higher dosage (30 mg) for 3 weeks, followed by a lower dose 20 mg) to maintain standard treatment, can potentially improve the risk/benefit profile of anticoagulation. mg to maHowever, it should not be forgotten that these new drugs also have their limitations, including the fact that they cannot be given to expectant mothers, breastfeeding mothers, patients with chronic advanced stage kidney disease, or patients with severe liver disease; the lack of a widely-available antidote; and the relatively high cost. These limitations create barriers to widespread use of these drugs for prophylaxis and treatment of VTE, particularly in Brazil.The ODIXa-DVT studyThe J-EINSTEIN-DVT/PE randomized study, conducted in Japan, compared oral rivaroxaban in isolation (10 mg or 15 mg – 2x/day for 3 weeks followed by 15 mg/day for up to 12 months) with UFH+VKA in patients with DVT or PE. Imaging exams showed normalization after 22 days of treatment in 27% of the patients who were given rivaroxaban and in 15.8% of patients treated with UFH+VKA. At the end of the treatment, 62% of the patients in the rivaroxaban group and 31.6% in the UFH+VKA group exhibited normalization on examinations.As described above, many patients with DVT develop PTS. The residual thrombi load and the inflammatory process triggered by the thrombotic episode can cause irreversible sequelae. Development of PTS increases the average costs of DVT treatment by 74 to 81%.These factors should be considered in conjunction with the risk-benefit analysis of anticoagulant treatment and its efficacy for earlier regression of thrombi in VTE treatment, since insufficient anticoagulation can increase the risk of PTS and facilitate organization of the thrombus.Residual venous thrombosis has not yet been established as a marker for evaluation of duration of anticoagulation,,Earlier studies using repeated phlebographic examinations considered recanalization to be a later development, occurring over periods varying from 6 months to 1 years after the acute event.Nevertheless, our study has several limitations, such as its single-center nature and the relatively small “n”, in addition to being retrospective. Despite these, the study is relevant because it offers an opportunity for theoretical reflections and analyses and guidance for future studies. More importantly, we must keep a space open for intense debate among health professionals on their experiences with DOACs and, at some point, on new drugs for treatment of VTE.Treatment of DVT with rivaroxaban or warfarin was effective and there was no difference in the number of segments that remained involved after 180 days’ follow-up of both groups. However, patients treated with rivaroxaban exhibited evidence of earlier recanalization than patients treated with warfarin. A trombose venosa profunda (TVP) caracteriza-se pela formação aguda de um coágulo em veias profundas, podendo levar à obstrução parcial ou total do lúmen venoso, e está compreendida dentro da entidade nosológica denominada tromboembolismo venoso (TEV), a qual engloba a TVP e a embolia pulmonar (EP)O TEV pode ocorrer em dois para cada 1.000 indivíduos ao ano, com uma taxa de recorrência de 25%Um dos aspectos controversos na história natural da TVP é a sua evolução. Após um episódio de TVP, uma resposta inflamatória aguda ocorre na parede da veia e no trombo, levando a um processo dinâmico de regressão do trombo por meio da recanalizaçãoA presença do trombo e o processo de recanalização podem levar a danos nas válvulas venosas, originando assim a incompetência valvular. Essa condição, ou a obstrução persistente da veia pelo trombo residual, ou então ambas, causam hipertensão venosa crônica, acarretando a síndrome pós-trombótica (SPT)American College of Chest Physicians Evidence – Based Clinical Practice Guideline (ACCP). De modo geral, o tratamento da TVP se estendia por cerca de 6 meses, conforme a evolução do paciente e a localização do tromboDescoberta em 1916, a heparina não fracionada (HNF) passou a ser a principal escolha para o tratamento da TVP a partir dos anos 30. Logo após, surgiram os antagonistas da vitamina K (AVK), representados pela varfarina e pela femprocumona. Nos anos 80, foi a vez das heparinas de baixo peso molecular (HBPM)direct oral anticoagulants, DOACs), cujos principais benefícios são a não necessidade de monitorização laboratorial, a posologia oral e a janela terapêutica maior. A rivaroxabana e a apixabana são utilizadas sem anticoagulante parenteral inicial, ao contrário da dabigatrana e mais recentemente da edoxabana, que necessitam de anticoagulante parenteral inicial,A partir dos anos 2000, surgiram os anticoagulantes orais diretos  de pacientes com TVP tratados com monoterapia com rivaroxabana ou com heparina parenteral seguida de varfarina oral.A pesquisa que deu origem a este artigo foi realizada em concordância com a Resolução nº 466/12 do Conselho Nacional de Saúde e foi submetida ao Comitê de Ética em Pesquisa (CEP) do Centro Universitário, Faculdade Assis Gurgacz (FAG), com a respectiva aprovação sob CAE Nº 51793015.0.0000.5219.Foram avaliados os laudos de EDC seriados de 77 pacientes portadores de TVP tratados entre janeiro de 2009 a dezembro de 2016. Os pacientes foram divididos em dois grupos de acordo com a terapêutica utilizada: Grupo I – heparina parenteral + varfarina: 26 pacientes ; Grupo II – rivaroxabana: 51 pacientes . Os exames de EDC foram realizados pela mesma equipe de ultrassonografistas, que descreveram os segmentos acometidos pelos trombos seguindo a nomina anatômica tradicional: veia ilíaca comum, veia ilíaca externa, veia femoral comum, veia femoral profunda, veia femoral, veia poplítea, veias tibiais anteriores e posteriores, veias fibulares e veias musculares. A soma dos segmentos acometidos forneceu o dado de entrada no estudo. À medida que a recanalização foi acontecendo, foram excluídas da contagem os segmentos recanalizados, obtendo-se o número de segmentos ainda comprometidos por trombos ao final do período de avaliação. Além disso, os dados de recanalização foram estratificados quanto à porcentagem de recanalização e ao tempo em que ocorreram.Os critérios de inclusão foram todos os pacientes com TVP confirmada por EDC e que possuíam pelo menos três exames de ultrassom vascular no acompanhamento. Dos quase 500 laudos de EDC realizados no período para avaliar TVP, foram selecionados os exames seriados dos 77 pacientes que preencheram todos os critérios. Os critérios de exclusão foram os pacientes com apenas um ou dois laudos de ultrassom vascular, bem como pacientes que não foram tratados com as duas classes de medicamentos avaliadas neste estudo.Dos 77 pacientes estudados, 42  eram do sexo masculino. A média de idade foi de 59,03±15,98 anos. Não houve diferença estatisticamente significativa entre os grupos quanto aos padrões demográficos . A média da razão de normatização internacional (RNI) dos pacientes do Grupo I foi de 2,71±0,82.No início do estudo, os pacientes do Grupo I apresentavam, em média, 3,11 segmentos comprometidos com trombos. Quanto aos pacientes do Grupo II, em média, 2,76 segmentos estavam comprometidos. Ao final do tratamento, a quantidade de segmentos ainda comprometidos  foi, em média, de 0,38 segmentos para o Grupo I e 0,14 segmentos para o Grupo II, não havendo significância estatística na diferença entre os grupos .No que se refere à porcentagem de recanalização, os pacientes do Grupo II apresentaram recanalização mais rápida nos meses iniciais do tratamento e, quando comparadas as recanalizações parciais e totais, houve diferença estatisticamente significativa favorável aos pacientes tratados com rivaroxabana . As avaliações da porcentagem de recanalização em cada grupo estão representadas na Neste trabalho, a maioria dos pacientes tratados até 2011 utilizavam a terapia convencional com HNF + AVK ou HBPM + AVK. Todos os pacientes foram tratados em regime de internação por pelo menos 4 dias. A inclusão dos DOACs na prática clínica a partir de 2011 promoveu mudanças significativas na forma de tratamento dos pacientes com TEV. Desde então, muitos pacientes com TEV têm sido tratados com monoterapia com DOAC em nosso serviço. Devido ao fato dos prontuários eletrônicos estarem disponíveis em nossa instituição a partir de 2009, utilizamos este período como inicial para coleta de dados.A varfarina tem sido utilizada na prática clínica diária desde os anos 1950; portanto, existem informações abundantes sobre seus efeitos e também sobre suas limitações. Um ponto negativo da varfarina é o início de ação demorado, pois produz o seu efeito ao interferir na conversão cíclica da vitamina K e do seu 2,3-epóxido, bloqueando a síntese de fatores de coagulação dela dependentes . Assim, o seu efeito anticoagulante não acontece até que os fatores já presentes na circulação sejam metabolizados, processo que leva tipicamente de 36-72 hA rivaroxabana é um anticoagulante oral que atua como inibidor reversível e específico do fator Xa. Apresenta farmacocinética e farmacodinâmica previsíveis, com menor interação com alimentos, medicamentos e características individuais como idade, sexo, peso e etnia, além de baixa toxicidade hepática. Um fator muito positivo é a janela terapêutica mais larga que a da varfarina, o que permite basicamente o mesmo resultado terapêutico mesmo que ocorram variações fisiológicas da concentração sérica da medicação. Isso pode auxiliar em uma melhor e mais rápida recanalização dos trombos, devido à menor interferência externa em seus efeitos anticoagulantes,É preciso levar em consideração a aderência do paciente ao tratamento, pois a abordagem simples de única droga para o tratamento agudo da TVP desde a fase inicial com dose mais alta (30 mg) por 3 semanas seguida da administração de dose inferior 20 mg) para continuidade de tratamento padrão potencialmente melhora o perfil do risco/benefício da anticoagulação mg para No entanto, não se deve esquecer que essas novas drogas também têm suas limitações, dentre as quais podemos citar a impossibilidade de serem utilizadas em gestantes, lactantes, pacientes renais crônicos em estágio avançado e pacientes com hepatopatia grave; a falta de antídoto amplamente disponível e o custo relativamente alto. Tais limitações impedem que esses novos medicamentos sejam amplamente usados para profilaxia e tratamento de TEV, principalmente no BrasilO estudo ODIXa-DVTO estudo randomizado J-EINSTEIN-DVT/PE, realizado no Japão, compararam a rivaroxabana oral isolada (10 mg ou 15 mg – 2x/dia por 3 semanas seguido de 15 mg/dia por até 12 meses) com HNF+AVK em pacientes com TVP ou EP. Houve normalização dos exames de imagem aos 22 dias de tratamento em 27% dos pacientes que utilizaram rivaroxabana e em 15,8% dos pacientes tratados com HNF+AVK. Ao final do tratamento, 62% e 31,6% dos pacientes dos grupos rivaroxabana e HNF+AVK apresentaram normalização dos exames, respectivamenteversus 8%)versus 0,3%)Conforme descrito anteriormente, muitos pacientes com TVP evoluem para SPT. A carga de trombos residuais e o processo inflamatório gerado pelo episódio trombótico podem causar sequelas irreversíveis. O desenvolvimento da SPT aumenta o custo médio do tratamento da TVP em 74 a 81%Esses fatores devem ser considerados em conjunto com a avaliação risco-benefício da terapia anticoagulante e a eficácia para a regressão de trombos mais precoce no tratamento do TEV, pois a anticoagulação insuficiente pode aumentar o risco de SPT e facilitar a organização do tromboA trombose venosa residual ainda não está estabelecida como um marcador para avaliar a duração da terapia anticoagulante,Os estudos prévios utilizando exames flebográficos repetidos consideravam a recanalização como uma reação tardia, ocorrendo em períodos que variavam de 6 meses até anos após o evento agudoDestarte, o estudo apresenta várias limitações, como concentrar-se em um único centro de tratamento e ter “n” relativamente pequeno, além do fato de ser retrospectivo. Apesar disso, o estudo é relevante, por possibilitar análises e reflexões para aprofundamento teórico e para novas pesquisas. Mais importante que isso, devemos manter aberto o espaço para intenso debate entre profissionais da saúde em relação às experiências com os DOACs e eventualmente com novas drogas para o tratamento do TEV.O tratamento da TVP com rivaroxabana ou varfarina foi efetivo, não havendo diferença na quantidade de segmentos que permaneceram comprometidos ao final de 180 dias de acompanhamento em ambos os grupos. No entanto, os pacientes tratados com rivaroxabana apresentaram evidências de recanalização mais precoce do que os pacientes tratados com varfarina.


Scientific Reports 10.1038/s41598-018-33312-2, published online 05 October 2018Correction to: This Article contains errors.Figure Legends 2 and 3 were published as Figure Legends 3 and 2, the correct Figure Legends appear below:Figure 2:a) Difference between low and high obstacle avoidance; (b) Difference between intermediate and high obstacle avoidance; (c) difference between low and intermediate obstacle. *Difference between people with PD and control group.Group*obstacle variability for horizontal and vertical foot-obstacle distance before and after obstacle avoidance for leading and trailing limb. (Figure 3:Variability of kinects parameters for each group in each condition.Additionally, in the Acknowledgements section:“The author thanks to FAPESP #2014/20549-0 – Fundação de Amparo à Pesquisa do Estado de São Paulo.”should read:“The author thanks to FAPESP #2013/21841-3 – Fundação de Amparo à Pesquisa do Estado de São Paulo.”


The serum paraoxonase-1 (PON1) associated to HDL presents two common polymorphisms in the positions 192 and 55. These polymorphisms are considered determinant of the capacity of HDL to protect LDL from their oxidative modification. In this context, the PON1 genotype has been associated with cardiovascular diseases, including stroke. To determine the allelic and genotypic frequencies of PON1 L55M and Q192R as well as the enzymatic activities of PON1 in subjects with and without atherothrombotic stroke. There were included 28 people with atherothrombotic stroke and 29 without stroke. The genotyping was carried out by PCR-RFLP and the phenotyping by measurement of the activities of paraoxonase and arylesterase in serum.p= 0.843) for the control group and the group with stroke, respectively. While for the polymorphism L55M, the allelic frequencies (L/M) were 0.81/0.19 for the control group, and 0.78/0.22 for the group with stroke (p= 0.610). The activity levels of paraoxonase were not significantly different between the control and stroke groups  While the activity levels of arylesterase were significantly different between the studied groups ; however, upon adjustment by multiple linear regression, it was not longer significant. For the polymorphism Q192R, the allelic frequencies (Q/R) were 0.46/0.54 and 0.48/0.52 ( The polymorphisms Q192R and L55M, and the paraoxonase activity of PON1 are not risk factors for atherothrombotic stroke according to the results of this study. The participants or relatives signed an informed consent and answered a questionnaire  and provided a venous blood sample for biochemical and molecular analysis. The case group were hospitalized subjects between 35 and 85 years of age, with a recent diagnostic of ischemic CVD atherothrombotic type in acute phase. The control group was subjects between 35 and 75 years of age who passed the established tests for blood donation in the same hospital. The study was approved by the INNN Bioethics Committee (No. 67/01).For biochemical assays the Hitachi 912 autoanalyzer  was used. The total serum cholesterol (TC) and triglycerides (TG) determination were carried out with CHOD-PAP, HDL-C with HDL-C plus third generation and LDL-C with LDL-C second generation (Roche Diagnostic).412 continued for 5 min 2 1 mM) and 5 µL of serum. The hydrolysis rate was determined by measuring the product (phenol) at 270 nm wavelength, monitoring it for 3 min and registering the value before and after the incubation was obtained. Absorbance was adjusted based on the molar extinction coefficient 1,310 M cm−1 (Paraoxonase activity was determined in serum by modifying the Eckerson method BspPI restriction enzymes (Fermentas) for PON1-Q192R and Hin1II (Fermentas) for PON1-L55M. The digested fragments were separated by electrophoresis and visualized in polyacrylamide gels at 7.5% and 20% for PON1-L55M (two fragments of 126 and 44 pb) and PON1-Q192R (two fragments of 66 and 33 pb), respectively. The laboratory personnel carried out the samples genotyping in a blind test which included control samples (identified previously by sequencing) and the experimental samples validation. The concordance with the control samples was 100%.To determine PON1-Q192R and PON1-L55M genetic polymorphisms, genomic DNA was extracted from whole blood using a commercial Kit . The identification of PON1 genotypes was carried out by PCR-RFLP p-value of less than or equal to 0.1 were included in a saturated model of multiple linear regression, eliminating those that lost statistical significance. Age and sex were maintained for being potentially confounding. The data were analyzed by using the SPSS® statistical program version 13, with a statistical significance of 0.05.The categorical variables were compared by using Chi square test. The variables with normal distribution were compared by a Students-t or ANOVA. Those non normal variables were analyzed with the U test of Mann-Whitney and were further transformed to logarithmic values to carry out the regression tests. The variables were evaluated in a simple linear regression, those with a  The present study included 28 cases of atherothrombotic cerebral infarction and 29 controls. p= 0.786 and p= 0.282, respectively) between the control and case groups. Subsequently, the allelic distributions of Q/R and L/M for the Q192R and L55M polymorphisms respectively, were compared and no differences were found. The genotypes frequencies of Q192R and L55M polymorphisms of PON1  were notp= 0.093). This was similar to the arylesterase activity of PON1, which was greater in the control group (89.96 IU/mL) than in the case group (69.63 IU/mL), being this difference statistically significant (p= 0.001) (The paraoxonase activity of PON1 was greater in the control group (450.27 UI/mL) than in the case group (348.35 UI/mL), although the difference was not statistically significant (= 0.001) . vs controls). In the multiple regression model, it was demonstrated that age, arylesterase and Q192R polymorphism, were the factors that determined in a significant and independent way paraoxonase activity variation in 78.5%. It was also found that diagnosis , did not influence paraoxonase activity of the subjects. In the simple regression analysis for paraoxonase activity , it was For arylesterase activity , in the In this research, the analysis of the allelic distribution and the corresponding genotypes for Q192R and L55M of the PON1 polymorphisms showed an absence of risk due to these genetic factors for atherothrombotic CVD, similar to the ones found in other populations, even with a larger sample, for risk of coronary heart disease Regarding PON1 activity, this study demostrated that control subjects and the subjects with infarction had no differences in the paraoxonase and arylesterase activities, thus, the level of activity of this enzyme did not represent a risk for the atherothrombotic infarction. The linear regression analysis allowed us to know that age is one of the factors which have influence in the levels of the paraoxonase and arilesterase activities of PON1. While alcohol consumption and cholesterol levels were factors which also had an independent effect regardless of age on the arilesterase activity, suggests to consider such variables in future studies in order to confirm its effect on PON activity.,,The arylesterase activity has been used as a measure of PON1 level Comparing our control group with the reference group in a study carried out in the United Kingdom One of the limitations of this work was the samples size, as well as the fact that it was not possible to assess the effect of other variables such as food habits, drug therapies or comorbid diseases that could influence arilesterase and paraoxonase activities of PON-1.In this study where Mexican subjects were included, Q192R and L55M polymorphisms, paraoxonase and arilesterase activities from PON1 are not risk factors for atherothrombotic cerebral infarction. ,,La enfermedad vascular cerebral (EVC) isquémica o infarto cerebral, es causada por la interrupción del flujo sanguíneo cerebral ocasionada por un trombo promovido por la ateroesclerosis o la cardioembolia ,in vitro a las LDLs de la oxidación.PON1 es una enzima de 355 aminoácidos, sintetizada en el hígado y secretada en la sangre, donde se encuentra unida a las HDL A partir del efecto observado de los polimorfismos comunes de la PON1 sobre la protección por las HDL ante la modificación oxidativa de las LDL, se ha sugerido que los individuos homocigotos para Q y para M de la PON1 podrían ser menos susceptibles a desarrollar enfermedades de origen ateroesclerótico, y que individuos homocigotos para R y para L podrían ser más propensos a desarrollar dichas enfermedades Se realizó un estudio de casos y controles en el Instituto Nacional de Neurología y Neurocirugía (INNN), de la Ciudad de México, durante el año 2005. Los participantes o familiares responsables, firmaron un consentimiento informado, contestaron un cuestionario  y proporcionaron una muestra de sangre venosa para análisis bioquímicos y moleculares. Los casos fueron sujetos hospitalizados de 35 a 85 años de edad con diagnóstico reciente de EVC isquémica de tipo aterotrombótica en fase aguda. Los controles fueron sujetos entre 35 y 75 años que pasaron las pruebas establecidas para la donación de sangre del mismo hospital. El estudio fue aprobado por el Comité de Bioética del INNN (No. 67/01).Para los ensayos bioquímicos se empleó el autoanalizador Hitachi 912 . La determinación de colesterol total sérico (TC) y triglicéridos TG se realizó con CHOD-PAP, HDL-C con HDL-C plus 3ª generación y LDL-C con LDL-C 2ª generación, todas de Roche Diagnostic.−1cm−1  para PON1-Q192R y Hin1II (Fermentas) para PON1-L55M. Los fragmentos digeridos fueron separados por electroforesis y visualizados en geles de poliacrilamida al 7.5% y 20% para PON1-L55M (dos fragmentos de 126 y 44 pb) y PON1-Q192R (dos fragmentos de 66 y 33 pb), respectivamente. El personal de laboratorio llevó a cabo la genotipificación de las muestras en una prueba ciega que incluyó muestras control (identificadas previamente mediante secuenciación) y las muestras experimentales para su validación. La concordancia con las muestras control fue del 100%.Para la determinación de los polimorfismos genéticos de PON1-Q192R y PON1-L55M, el DNA genómico se extrajo a partir de sangre completa mediante un Kit comercial . La identificación de los genotipos de PON1 se realizó por PCR p menor o igual a 0.1, se incluyeron en un modelo saturado de regresión lineal múltiple, eliminando aquellas que perdían significancia estadística, se mantuvieron edad y sexo por ser potenciales confusoras. Los datos fueron analizados con el programa estadístico SPSS® versión 13, con una significancia estadística de 0.05.Las variables categóricas se compararon mediante Chi cuadrado. Las variables con distribución normal se compararon mediante t de Student o ANOVA, aquellas variables no normales se analizaron con la prueba U de Mann-Whitney y posteriormente se transformaron a valores logaritmos para realizar las pruebas de regresión. Se evaluaron las variables en una regresión lineal simple, aquellas con un valor de En el presente trabajo se incluyeron 28 casos de infarto cerebral aterotrombótico y 29 controles. En la p= 0.786 y p= 0.282, respectivamente) entre el grupo control y de casos, posteriormente se compararon las distribuciones alélicas de Q/R para el polimorfismo Q192R y L/M para el polimorfismo L55M las cuales tampoco fueron diferentes entre ambos grupos.Las frecuencias de las tres clases genotípicas correspondientes a los polimorfismos Q192R y L55M de la PON1  no fuerop= 0.093). Situación similar a la actividad arilesterasa de la PON1, que fue mayor en el grupo control (89.96 UI/mL) en relación al grupo de casos (69.63 UI/mL), siendo esta diferencia estadísticamente significativa (p= 0.001) (La actividad paraoxonasa de la PON1 fue mayor en el grupo control (450.27 UI/mL) en relación al grupo de casos (348.35 UI/mL), aunque no fue estadísticamente significativo (= 0.001) .vs controles). En el modelo de regresión múltiple se demostró que la edad, la actividad arilesterasa y el polimorfismo Q192R, fueron los factores que determinaron de manera significativa e independiente en un 78.5% la variación de la actividad paraoxonasa. También se encontró que el diagnóstico , no influyó en la actividad paraoxonasa de los sujetos de este estudio.En el análisis de regresión simple para la actividad paraoxonasa , se obseEn relación a la actividad arilesterasa , en el aEn la presente investigación, el análisis de la distribución alélica y de los genotipos correspondientes a los polimorfismos Q192R y L55M de la PON1 demostró una ausencia de riesgo por estos factores genéticos para la EVC aterotrombótica, similar a lo encontrado en otras poblaciones, aún con una muestra mayor, para el riesgo de enfermedad coronaria Respecto a la actividad de la PON1, en este estudio se demostró que los sujetos control y los sujetos con infarto no tuvieron diferencias en las actividades paraoxonasa y arilesterasa, por lo que el nivel de actividad de esta enzima no representó un riesgo para el infarto aterotrombótico. El análisis de regresión lineal permitió conocer que la edad es uno de los factores que influyen en los niveles de las actividades paraoxonasa y arilesterasa de la PON1. Mientras que el consumo de alcohol y los niveles de colesterol fueron factores que también tuvieron un efecto independiente de la edad sobre la actividad arilesterasa, lo cual sugiere considerar dichas variables en futuros estudios para confirmar su efecto sobre la actividad de PON, así como elucidar el mecanismo por el cual la disminuye.,,La actividad arilesterasa se ha utilizado como una medida del nivel de PON1 Comparando nuestro grupo control con el grupo de referencia de un estudio realizado en el Reino Unido Una de las limitaciones de este trabajo fue el tamaño de muestra, así como también el hecho de que no fue posible evaluar el efecto de otras variables como hábitos alimentación, terapias medicamentosas o enfermedades concomitantes que podrían influir en las actividades arilesterasa y paraoxonasa de la PON-1.Los polimorfismos Q192R y L55M, las actividades paraoxonasa y arilesterasa de PON1 no son factores de riesgo para el infarto cerebral aterotrombótico en este estudio donde se incluyeron sujetos mexicanos.


To describe cancer incidence and mortality during the 2008-2012 period in the District of Barranquilla.Departamento Administrativo Nacional de Estadìsticas (DANE) and mortality from the Sistema de Información de Cáncer en Colombia. The total and specific crude and specific incidence rates and mortality by age and gender were estimated, as well as by-age standardized incidence rates. Statistical analysis were performed with SPSS V24 and Canreg5. Cancer incident cases were collected, analyzed and processed by the Barranquilla Population Cancer Registry during the study period. Population structure was obtained from the  8,182 cases of cancer were identified, excluding non-melanoma skin cancer (62.8% in women). 83.0% of the tumors had histological verification and only 5.2% were DCO. The adjusted incidence rate for all tumors was 116.5 per 100,000 in men and 155.4 per 100,000 in women. The most frequent locations were prostate and trachea-bronchi-lung in men, while in women, breast and cervix occupied the first places. Breast and prostate had the highest mortality rates in women and men, respectively. Specific behavior of cancer incidence and mortality in Barranquilla has important increases for the main types of tumors (breast and prostate) when compared to the country and other population registries. To provide data is key to showing a representative behavior of the Colombian Caribbean. Cancer is a public health problem. In 2012, there were near of 14 million incident cases worldwide, and the expectation is unfavorable since this number is expected to increase to almost 24 million by 2030 In Colombia, cancer is the third cause of mortality Some researchers point out that cancer mortality rates can be taken as an indicator of health care´s quality, due to the disease’s high probability of being prevented or treated in a timely manner Instituto Nacional de Cancerología : Cali, Bucaramanga, Pasto, Manizales and Barranquilla. Every one of the registers represents the cultural, geographical and environmental differences of the zones that each covers; nevertheless, the city of Barranquilla is the only one that does not have direct environmental influences and Andean customs, such as those of the interior of the country, palpable in the other Registries; being a coastal city, with a tropical climate and with characteristic that include genetic, social and cultural elements, a product of the miscegenation marked since the Spanish colonization and having been in previous centuries the recipient of European and Middle Eastern migrants, it is necessary to have a population register of cancer and analyze the behavior of cancer in the city within the national scenario, which gave rise to the Barranquilla Population Cancer Registry (BPCR), the result of a strategic alliance between the INC and the Universidad del Norte to consolidate incidents in the population resident in the District of Barranquilla since January 1st, 2008, and have quality information, which is necessary for cancer control.In Colombia, there are only five Population Base Registries endorsed by the ,Sistema de Información de Cáncer en Colombia (Cancer Information System in Colombia) to obtain valid information to make timely and efficient decisions regarding the comprehensive approach to cancer in the Colombian Caribbean region.The objective of present study is to describe cancer incidence and mortality in Barranquilla for the 2008-2012 period. The BPCR use international standards Descriptive Population base Atlántico, on the western shore of the Magdalena River, 7.5 km from its mouth in the Atlantic Ocean. Its geographical position is: 10º59'16" north latitude, and 74º47'20" west longitude. The urban area is at a maximum height of 98 meters above sea level to the west and 4 meters above sea level to the east. The city limits to the north with the municipality of Puerto Colombia, to the south with the municipality of Soledad, to the east with the department of Magdalena and the Caribbean Sea, and to the west with the municipalities of Galapa, Puerto Colombia and Tubará. The district of Barranquilla is divided into five localities for administrative and political purposes: Riomar, Norte-Centro Histórico, Sur Occidente, Metropolitana, and Sur Oriente These localities are subdivided into 611 manzanas (blocks) and 188 neighborhoods, approximately. Additionally, the District includes the corregimientos  of La Playa and Juan MinaBarranquilla Population Cancer Registry covers the urban and rural population of the District of Barranquilla, located in the northeastern vertex of the department (province) of 2, and the climate is dry tropical, with an average temperature of 27.4° C. According to DANE ) projections for the year 2010, Barranquilla had a total of 1,224,000 inhabitants, with a density of 7,945 inhabitants per km2. The economy is mainly based on the industrial, port and tourism sectors The extension of the city is 154 KmInstituciones Promotoras de Salud) and the public network, made up of 48 health institutions, is managed by a private operator. These institutions have more than 70 oncological services  In 2012, the District of Barranquilla had 1,352 private health service providers  and the "Identification System of Potential Beneficiaries of Social Programs" , among others.The BPCR collects data on malignant tumors  in all topographic locations  and all age groups. The search is active, that is, the BPCR staff periodically visits the sources of information: histopathology laboratories, hospitals and clinics, diagnostic centers, and institutions specialized in oncological care in the city. Likewise, data on mortality, health insurance, and other sociodemographic background is consulted in the official databases of the country, such as the National Registry of the Nation, the "Unique Registry of Affiliates" , one business administrator (coordinator) and 5 technicians (4 information collectors and 1 user) funded by the Universidad del Norte and the INC.Barranquilla Population Cancer Registry actively and passively searches for information regarding new cases of cancer.st of 2008, regardless of the diagnosis method, including cases identified only by death certificate. Skin cases corresponding to squamous and basal cell carcinomas are excluded (ICD code 10).Every malignant tumor located anywhere, including benign neoplasms of the central nervous system that has been diagnosed in permanent residents of the District of Barranquilla, since January 1Primary cancer is understood as one which originates in a location or tissue that does not correspond to the extension, recurrence or metastasis of another primary tumor Registraduría Nacional  website (http://www.registraduria.gov.co/), and the subject that appears with an assigned voting location is considered as a habitual resident of said place; the information is then cross-checked with the official national database of beneficiaries of social programs  and healthcare  which include addresses. Likewise, through specific projects, cases are selected that are analyzed in depth regarding sociodemographic and clinical variables.The main information sources of the registry are: pathology and hematology laboratories, hospital discharges, imaging and early detection centers, oncology centers, medical specialists, and individual death certificates. To confirm if a subject is a resident of Barranquilla, or has a high probability of being a resident, the identification document number is used to validate residence; this is entered on the The cases obtained from hospital discharges on one hand and DCO on the other hand, are determined after a process of review of clinical histories to verify their diagnosis. In the absence of clinical information, cases are labeled as "identified only by DCO".The BPCR collects patient variables  and tumor variables . The coding is carried out by personnel trained in the application of ICD-O-310 guidelines. The information was initially processed in an electronic sheet and was migrated to Canreg5 in 2016. The coding of the cases is carried out following the Third Edition of the International Classification of Oncological Diseases (ICD-O-3) BPCR researchers, supported by the INC and the population registries of Cali, Bucaramanga, Manizales, and Pasto, permanently train the people participating in the RPCB in techniques and standards to collect, process and analyze information, while being aware of the fact that the quality of the data depends on the information obtained from the sources and of the mission processes of the BPCR. In addition, indicators suggested by the IARC are used to evaluate the quality of the BPCR: percentage of cases with microscopic verification, percentage of cases registered only by DCO, percentage of cases with unknown primary location, proportion of cases with unknown age at the time of diagnosis, mortality / incidence ratio, and percentage of cases with unknown diagnosis basis. Regarding confidentiality, the BPCR adopts the standards of the IARC, considering the purpose of collecting, processing and analyzing the information as epidemiological st of 2008 and December 31st of 2012 was considered. The population at risk was calculated using the 1985-2020 projections prepared by DANE. The specific rates were estimated by gender and age (five-year groups) and standardized using the direct method when using the world population (WHO) as a reference. The relative frequencies of incident cases were estimated by specific locations. Incidence and mortality data are presented grouped in ICD-10 codes for comparability purposes, following the methodology used by the IARC Every new case registered in residents of Barranquilla between January 1All deaths occurred during the same period, were included with the ICD-10 codes corresponding to malignant neoplasms, including DCOs and deaths occurred in the observation period. It was based on the information consolidated in the Cancer Information System in Colombia The percentage of histological verification for all locations was of 80.0% in men and of 85.9% in women; the five main locations by gender showed that breast, cervix and thyroid (in women), and leukemia (in men) had percentages higher than 90%. On the other hand, the percentage of registrations by DCO represented 3.9% in women and 6.5% in men and had values lower than 5.0% for prostate and leukemia (men) and breast, cervix and thyroid (women). Regarding the Mortality-Incidence ratio, for men it had a value of 0.5 and for women of 0.7. It is striking that, Leukemia, Lung and Stomach in men, and Lung in women, had values higher than 1. On the other hand, there were no cases without information in the gender and diagnostic basis variables. During the period of study, 8,182 new cases were registered, 62.8% of which corresponded to women. The average age at diagnosis was 56.1 years old for women and 61.9 for men, and 2.3% of cases occurred in the pediatric population (younger than 15 years old). The Age-Standardized Incidence Rate per 100,000 people-year for all primary locations, including melanoma and excluding the rest of skin tumors, was 116.5 in men and 155.4 in women and the female / male incidence ratio was 1.3 . RegardiThe five locations with the highest incidence in men were: prostate 43.0), trachea, bronchus and lung (10.4), colon and rectum (9.6), oral cavity (4.6) and stomach (4.4), corresponding to 61.3% of all the types of cancer. In women, the five most recurrent types of cancer represent 72.0% of all types of cancer, and were: breast (65.7), cervix (26.6), colon and rectum (9.8), thyroid (5.2), and trachea, bronchi and lung (4.8). In terms of mortality, tumors in the lung, breast, prostate, colon and rectum and cervix represent 49.0% of all tumors, and the highest mortality rates standardized by age per 100,000 people / year were: prostate (17.4), lung (14.3), leukemia (6.1) and stomach and lymphomas (5.1 each) in men, and breast (15.7), cervix (9.8), lung (7.1), colon and rectum (6.7), and leukemia (4.4) in women. .0, trachRegarding the quality criteria, the BPCR was found to be compliant with the requirements defined by the IARC With respect to the results of the analysis of the cases registered by the BPCR during the 2008-2012 period, the standardized rate in women  was higher than that of men , as it has occurred in other places, such as Guayaquil, Ecuador, whose Population Registry found rates of 110.0/100,000 and 146.0/100,000 for men and women, respectively, during the 2003-2006 period On the other hand, more than 80% of the cases had pathological confirmation, and the percentages of cases identified only by DCO were 6.5% in men and 3.9% in women, these were values lower than the maximum suggested by the IARC Cervical tumors represented a significant percentage, which can be attributed, to a large extent, to the early detection programs in the country Ministerio de Salud y Protecciòn Social  and the Sociedad Colombiana de Urologìa (Colombian Society of Urology) recommend early detection in men over 50 years of age or under 50 years of age if risk factors are present In the case of men, prostate cancer presented a rate of 43 cases per 100,000 men-years, a value that could be considered as intermediate when compared with Bucaramanga (50.5) and Manizales (32.7). In this regard, it is important to mention that, in Colombia, the Atlántico, where the District of Barranquilla is located, where mortality rates for cancer were higher than the national average Atlántico this indicator had a value of 12.0, only exceeded by Valle del Cauca with 12.3, while for prostate at national level the value was of 10.5 per 100,000 inhabitants, and for the Department it was of 14.6, occupying the second place at the national level Regarding mortality, important differences have been found in some departments of Colombia, such as the case of Análisis de Situación de Salud del Distrito de Barranquilla  This study finds that the rates for breast and prostate cancers are the highest: 15.7 and 17.4 per 100,000 inhabitants in each case, as stated by the Sistema de Información de Cáncer en Colombia to analyze mortality. This tool is available to the general public as of 2017 and is the result of the efforts of the INC and the Cancer Registries of Colombia. Taking this source and not the DCOs of DANE "directly", is an interesting challenge that allows us to glimpse the scope and potential of the information system as an important resource for decision making in the country. Breast cancer was found to be the leading cause of death among women, and in men, cancer mortality was attributed mainly to prostate cancer.It is noteworthy that, this study is the first to take data from the National Information System of Cancer. The epidemiological behavior of cancer in Barranquilla has variations with regards to what was found and reported during the previous years in the country, although the risk of developing cancer or dying due to it is considered intermediate when compared with the figures reported by other registries.The information obtained by the BPCR is reliable, in accordance with the standards required by IARC, and constitutes an important contribution to the The estimates made for the 2008-2012 five-year period will serve as a baseline for the construction of future trends. The information generated by the BPCR provides a valuable contribution to the construction of reliable epidemiological information for the country, specifically in a representative city of the north coast of Colombia, so that its sustainability must be guaranteed and every day its objectives and strategies must be improved for both medium and long term. El cáncer es un problema de salud pública. para el año 2012 hubo alrededor de 14 millones de casos incidentes en todo el mundo, y la expectativa es desfavorable, se espera que esta cifra aumente a casi 24 millones para el año 2030  En Colombia, el cáncer es la tercera causa de mortalidad Algunos investigadores señalan que la mortalidad por cáncer puede ser tomada como un indicador de calidad de atención en salud, por su alta probabilidad de ser prevenible o tratado oportunamente En Colombia solamente existen cinco Registros de cáncer de Base Poblacional avalados por el Instituto Nacional de Cancerología de Colombia (INC): Cali, Bucaramanga, Pasto, Manizales y Barranquilla. Cada uno de los registros representa las diferencias culturales, geográficas y ambientales propias de la zona andina; sin embargo, la ciudad de Barranquilla al ser una ciudad costera, de clima tropical y con elementos genéticos, sociales y culturales característicos, producto del mestizaje marcado desde la colonización española y de haber sido en siglos anteriores receptora de migrantes europeos y de oriente medio, determina un tipo de población diferente, esto hace necesario un registro poblacional de cáncer en esta zona del país para poder analizar el comportamiento del cáncer en la ciudad y dentro del panorama nacional. Esto dio origen al Registro Poblacional de Cáncer de Barranquilla (RPCB), resultado de una alianza estratégica entre el INC y la Universidad del Norte para consolidar casos incidentes en la población residente en el Distrito de Barranquilla a partir del primero de enero de 2008 y contar con información de calidad, necesaria para el control del cáncer.5,6 y la información consolidada por el Sistema de Información de Cáncer en Colombia para obtener información válida que permita tomar decisiones oportunas y eficientes en relación con el abordaje integral del cáncer en la región Caribe colombiana.El objetivo del presente estudio fue describir la incidencia y mortalidad por cáncer en Barranquilla para el período 2008-2012. El RPCB utilizó estándares internacionalesDescriptivo de base poblacional.El RPCB cubre la población urbana y rural del Distrito de Barranquilla, ubicado en el vértice nororiental del departamento del Atlántico, sobre la orilla occidental del río Magdalena, a 7.5 km de su desembocadura en el Océano Atlántico. Su posición geográfica es: latitud 10º59’16” norte, y longitud 74º47’20” occidente. El área urbana se encuentra a una altura máxima sobre el nivel del mar de 98 metros al occidente y 4 metros al oriente. La ciudad limita al norte con el municipio de Puerto Colombia, al sur con el municipio de Soledad, al oriente con el departamento del Magdalena y el Mar Caribe, y al occidente con los municipios de Galapa, Puerto Colombia y Tubará. El distrito de Barranquilla está dividido administrativa y políticamente en cinco localidades: Riomar, Norte-Centro Histórico, Sur Occidente, Metropolitana y Sur Oriente Estas localidades se subdividen en 611 manzanas y 188 barrios, aproximadamente. Adicionalmente, el Distrito comprende los corregimientos de La Playa y Juan Mina 2 y el clima es de tipo tropical seco, con una temperatura promedio de 27.4° C. Según datos de Proyección del DANE, para el año 2010, Barranquilla tenía un total de 1,224,000 habitantes, con una densidad de 7,945 habitantes por Km2. La economía está sustentada principalmente en el sector industrial, portuario y turístico La extensión de la ciudad es de 154 KmEn el año 2012 el Distrito de Barranquilla contaba con 1,352 prestadores de Servicios de Salud privados  y la red pública, conformada por 48 instituciones de salud, es administrada por un operador privado. Estas instituciones poseen más de 70 servicios oncológicos  El RPCB reúne datos sobre tumores malignos  en todas las localizaciones topográficas (en piel solamente melanoma) y de todos los grupos de edad. La búsqueda de casos es activa, es decir, el personal del RPCB visita periódicamente las fuentes de información: laboratorios de histopatología, hospitales y clínicas, centros de diagnóstico e instituciones especializadas en atención oncológica en la ciudad. Así mismo, se consultan datos sobre mortalidad, de aseguramiento en salud, y otros antecedentes sociodemográficos en las bases de datos oficiales del país como la de la Registraduría General de la Nación, la del “Registro Único de Afiliados” (RUAF) y la del “Sistema de Identificación de Potenciales Beneficiarios de Programas Sociales” (SISBEN), entre otras. Inició actividades en el año 2008, recolectando datos sobre los casos de 2007 que se consideraron como prueba piloto adoptando las guías sugeridas por la IARC para registros de base poblacional. el RPCB está constituido por un equipo multidisciplinario de 9 personas: 3 médicos , una administradora de empresas (coordinadora) y 5 técnicos (4 recolectores de información y 1 digitadora) financiado por la Universidad del Norte y el Instituto Nacional de Cancerología de Colombia. El RPCB lleva a cabo búsqueda activa y pasiva de información de casos nuevos de cáncer. Todos los tumores malignos localizados en cualquier sitio, incluyendo neoplasias benignas del sistema nervioso central, que hayan sido diagnosticados en residentes permanentes en el Distrito de Barranquilla, a partir del primero de enero de 2008, independientemente del método de diagnóstico, incluidos los casos identificados únicamente por certificado de defunción. Se excluyen los casos de piel correspondientes a escamocelulares y basocelulares (código CIE 10).Como cáncer primario, se entiende aquel que se origina en un sitio o tejido que no corresponde a la extensión, recurrencia o metástasis de otro tumor primario http://www.registraduria.gov.co/), y se considera como residente habitual aquel sujeto que aparezca con lugar de votación asignado; la información se contrasta con las bases oficiales del país para beneficios  y aseguramiento  en las que se hace mención a residencia. Así mismo, a través de proyectos específicos, se seleccionan casos que son analizados a profundidad con respecto a las variables sociodemográficas y clínicas. Las principales fuentes de información del registro son: laboratorios de patología y hematología, egresos hospitalarios, centros de imagenología y de detección precoz, centros oncológicos, médicos especialistas, y los certificados individuales de defunción. Para confirmar si un sujeto es residente en Barranquilla, o tiene una alta probabilidad de serlo, se emplea el número del documento de identificación para validar residencia; este es ingresado en la página de la Registraduría Nacional  y del tumor . La codificación es llevada a cabo por personal entrenado en la aplicación de las pautas ICD-O-310. La información es procesada inicialmente en una hoja electrónica y en el año 2016 fue migrada a Canreg5. La codificación de los casos se lleva a cabo teniendo en cuenta la Tercera Edición de la Clasificación Internacional de Enfermedades Oncológicas (CIE-O-3) A través de un entrenamiento y capacitaciones permanentes por parte de los investigadores del RPCB y con el apoyo del Instituto Nacional de Cancerología y los registros poblacionales de Cali, Bucaramanga, Manizales y Pasto, las personas que participan del RPCB son formadas en técnicas y normas para recolectar, procesar y analizar la información, conscientes que la calidad de los datos depende de la información obtenida en las fuentes y de los procesos misionales del RPCB. Además, indicadores sugeridos por la IARC, son empleados para evaluar la calidad del RPCB: porcentaje de casos con verificación microscópica, porcentaje de casos registrados solo por DCO, porcentaje de casos con localización primaria desconocida, proporción de casos con edad al momento del diagnóstico desconocida, razón Mortalidad/Incidencia y porcentaje de casos con base diagnóstica desconocida. Con respecto a la confidencialidad de la información, el RPCB adopta los estándares de la International Agency for Cancer Research (IARC), considerando que la finalidad de recolectar, procesar y analizar la información es de tipo epidemiológica Se consideraron todos los casos nuevos ocurridos en personas residentes en Barranquilla entre el 1 de enero de 2008 y el 31 de diciembre de 2012. Como población en riesgo se utilizaron las proyecciones de población de 1985-2020 elaboradas por el DANE sobre la base de conciliaciones censales. Las tasas específicas se estimaron por sexo y edad , y se estandarizaron mediante el método directo al usar la población mundial (OMS) como referencia. Las frecuencias relativas de casos incidentes se estimaron por localizaciones específicas. Los datos de incidencia y mortalidad se presentan agrupados en los códigos de la CIE-10 con fines de comparabilidad, siguiendo la metodología utilizada por la IARC Se incluyeron todas las muertes ocurridas durante el mismo período con los códigos CIE-10 correspondientes a neoplasias malignas, incluyendo los DCO y las muertes ocurridas en el período de observación, a partir de la información consolidada en el Sistema de Información de Cáncer en Colombia El porcentaje de verificación histológica para todas las ubicaciones fue de 80.0% en hombres y 85.9% en mujeres; las cinco principales localizaciones por sexo mostraron que mama, cérvix y tiroides (en mujeres) y leucemia (en hombres), tuvieron porcentajes superiores a 90%. Por su parte, el porcentaje de registros por DCO representó el 3.9% en mujeres y 6.5% en hombres y tuvo valores inferiores a 5.0% en próstata y leucemia (hombres) y mama, cérvix y tiroides (mujeres). En cuanto a la relación Mortalidad-Incidencia, para los hombres fue de 0.5 y para las mujeres 0.7. Llama la atención que, en el caso de los hombres Leucemia, Pulmón y Estómago en hombres, y Pulmón en mujeres, tuvieron valores superiores a 1. Por otro lado, no se registraron casos sin información en las variables sexo y base diagnóstica. En la Durante el período de estudio, se registraron 8,182 casos nuevos, de los cuales el 62.8% correspondió a mujeres. El promedio de edad al momento del diagnóstico fue de 56.1 años para las mujeres y de 61.9 para los hombres, y el 2.3% de los casos ocurrieron en población pediátrica (menores de 15 años de edad). La Tasa de Incidencia Estandarizada por Edad por 100,000 personas-año para todas las localizaciones primarias, incluido el melanoma y exceptuando el resto de tumores en piel, fue de 116.5 en hombres y 155.4 en mujeres y la razón de incidencia mujer/hombre fue de 1.3 . Con resLas cinco localizaciones con mayor incidencia en hombres fueron: próstata (43.0), tráquea, bronquio y pulmón (10.4), colon y recto (9.6), Cavidad oral (4.6) y Estómago (4.4), correspondientes a 61.3% de todos los tipos de cáncer. En las mujeres, los cinco primeros tipos de cáncer representan el 72.0% de todos los tipos de cáncer, y fueron: mama (65.7), cuello uterino (26.6), colon y recto (9.8), Tiroides (5.2), y tráquea, bronquios y pulmón (4.8). En cuanto a mortalidad, los tumores de pulmón, mama, próstata, colon y recto y cuello uterino representan el 49.0% del total de tumores, y las mayores tasas de mortalidad estandarizadas por edad por 100,000 personas/año fueron: próstata (17.4), pulmón (14.3), leucemias (6.1) y estómago y linfomas (5.1 cada uno) en hombres, y Mama (15.7), Cuello uterino (9.8), Pulmón (7.1), Colon y recto (6.7) y Leucemias (4.4) en mujeres. Las Se encontró que, con respecto a los criterios de calidad el RPCB cumple con los requisitos definidos por la IARC ), que igualmente tuvo tasas mayores para mujeres: 124.3/100,000 y 90.8/100,000, durante un período similar al reportado en el presente artículo: 2009-2012.Con respecto a los resultados del análisis de los casos registrados por el RPCB durante el período 2008-2012, la tasa estandarizada en mujeres  fue superior a la de hombres , tal como ha ocurrido en otros lugares, como Guayaquil, Ecuador, cuyo Registro Poblacional encontró tasas de 110.0/100,000 y 146.0/100,000 para hombres y mujeres, respectivamente durante el período 2003-2006 Por otro lado, más del 80% de todos los casos tuvieron confirmación patológica y los porcentajes de casos identificados solo por DCO fue de 6.5% en hombres y 3.9% en mujeres, valores menores al máximo sugerido por la IARC Los tumores de cuello uterino representaron un porcentaje importante, lo cual puede ser atribuido en gran medida a los programas para la detección temprana en el país En el caso de los hombres, el cáncer prostático presentó una tasa de 43 casos por 100,000 hombres-año, valor que podría considerarse como intermedio al comparar con Bucaramanga (50.5) y Manizales (32.7). Al respecto, es importante mencionar que, en Colombia, el Ministerio de Salud y Protección Social y la Sociedad Colombiana de Urología recomiendan la detección temprana en hombres mayores de 50 años o menores de 50 años si se presentan factores de riesgo Con respecto a la mortalidad, en Colombia se han encontrado diferencias importantes en algunos departamentos como es el caso del Atlántico, al cual pertenece el Distrito de Barranquilla, donde las tasas de mortalidad por cáncer fueron superiores al promedio nacional En el presente estudio se encontró que las tasas para mama y próstata son las más altas: 15.7 y 17.4 por 100,000 habitantes en cada caso, tal como lo plantea el Análisis de Situación de Salud del Distrito de Barranquilla Es de destacar que, el presente estudio es el primero que toma datos del Sistema de Información de Cáncer en Colombia para analizar mortalidad. Esta herramienta se encuentra disponible al público en general a partir del año 2017, y es resultado del esfuerzo del Instituto Nacional de Cancerología y los Registros de Cáncer de Colombia. El tomar esta fuente y no los DCO del DANE “directamente”, supone un reto interesante que permite vislumbrar el alcance y potencial del sistema de información como recurso importante para la toma de decisiones en el país. Se encontró que el cáncer de mama fue la primera causa de muerte entre las mujeres, y en los hombres la mortalidad por cáncer se atribuyó principalmente al de próstata.La información obtenida por el RPCB es confiable, de acuerdo con los estándares requeridos por la IARC, y constituye una contribución importante al Sistema Nacional de Información del Cáncer. El comportamiento epidemiológico del cáncer en Barranquilla presenta variaciones con respecto a lo encontrado en el país y reportado en años anteriores, aunque el riesgo de desarrollar cáncer o morir debido se considera intermedio al ser comparado con las cifras reportadas por otros registros. Las estimaciones realizadas para el período quinquenal 2008-2012 servirán como línea de base para la construcción de las tendencias futuras. La información generada por el RPCB provee un valioso aporte a la construcción de información epidemiológica confiable para el país, concretamente en una ciudad representativa de la costa norte colombiana, por lo que se debe garantizar su sostenibilidad y mejorar cada día sus objetivos y estrategias a mediano y largo plazo.


In this special issue dedicated to cancer, Colombia Medica discloses an analysis of the cancer situation in Colombia and Ecuador. The analysis is based on the data collected and analyzed by several Population-based Cancer Registries (PBCR), carried out with an inter-institutional collaborative effort of public and private Colombian universities, Municipal and Provincial Secretaries of Health, and the Ministry of Health and Social Protection through the National Institute of Cancer of Colombia; and of the Fight Cancer Foundation of Ecuador, SOLCA-Core of Quito. This valuable contribution of the academic sector to the control and surveillance of cancer in Colombia needs reciprocity from the Ministry of Health. It is necessary to regulate the participation of RPC in the cancer information system; and to assign permanent resources to guarantee their sustainability.For forty years the Population-based Cancer Registry of Cali  was the only source of valid information on the incidence of cancer in Colombia -In this issue of Colombia Medica, the PBCR-Cali describes the principles and methods used to analyze 50 years of incidence (1962-2012), 30 years of mortality (1984-2014) and 15 years of survival data (1995-2009) -The Population-based Cancer Registries of Cali, Quito and Pasto have at least 15 years of good quality information and present valid results of cancer incidence and mortality trends in their respective populations The PBCR-Cali -Data analysis shows that there is a significant decrease in the incidence and mortality rates of the infectious-related cancers and tobacco-related cancers; and an increase in the incidence rates of cancers related to early detection activities  and new diagnostic techniques (thyroid cancer) ,Barranquilla and Medellín report for the first-time data on the incidence of cancer Medellín, located in the Andean mountains of northwestern Colombia, is the second most populated city in the country, with particular demographic characteristics; it presents the incidence for cancers prioritized by the Ten-Year Plan for Cancer Control in Colombia. It should be noted that nearly 100% of new cases of cancer registered have morphological verification -The NCI-Colombia characterizes the current situation of the supply of oncological services in Colombia To estimate risk measures, PBC-Registries must have a delimited registry area and a clear definition of "case". In this definition, it is critical to include only the new cancer cases diagnosed in the permanent residents of the city and to exclude the cancer cases of patients referred to the city for diagnostic and/or treatment procedures. The data collection must be both passive and active in the different sources of information.PBC-Registries require adequate and sustained resources to be successful. In Colombia, the per capita registration cost varies between US $0.05 to US $0.22. Between 20% and 45% of the total cost is due to activities with a fixed cost. Universities have been the main source of financial resources and of both scientific and technical personnel, which has allowed them to be successful. Another success factor of the PBC-Registries is the social recognition in the city, facilitating the process of data collection.The report of NCI-Colombia Despite this wide range of services, the 5-year global survival of childhood cancer in Cali (51%) is between 26% and 32% below the reported results for affluent countries (77% to 83%). This means that, if around 1,500 to 1,600 children with cancer are treated in Colombia each year, 765 to 816 die within 5 years after diagnosis. Of these, 390 to 512 deaths per year would be avoidable. This survival gap is maintained in all groups of neoplasms, except for Hodgkin's lymphoma (88% vs 95%). In adults, the situation is similar; the 5-year net survival to prostate, cervix and breast cancer is between 20 and 30 points below that observed in North America and Europe. During the period 2000-2004, the 5-year net survival improved for cancers of the breast, cervix, prostate, melanoma and thyroid, although in the period 2005-2009, it was observed a stagnation. In stomach, liver and lung cancer, the 5-year net survival was less than 15% The PBC-Manizales ,,The HBC-Registry of NCI-Colombia In Conclusion, the pioneer effort of the population-based Cancer registry of Cali and of the Universidad del Valle and their collaboration with other academic and public institutions has made possible a precise estimation of the cancer burden in various regions of Colombia and in Quito, Ecuador; this information is basic and essential in the planning of strategies for cancer control. En este número especial dedicado al cáncer, Colombia Médica divulga un análisis de la situación de cáncer en Colombia y Ecuador. El análisis se basa en los datos recolectados y analizados por varios registros de cáncer, realizado con un esfuerzo colaborativo interinstitucional de universidades públicas y privadas colombianas, Secretarias Municipales y Departamentales de Salud y del Ministerio de Salud y la Protección Social a través del Instituto Nacional de Cancerología de Colombia; y de la Sociedad de Lucha contra el Cáncer del Ecuador, SOLCA-Núcleo de Quito. Este valioso aporte del sector académico al control y vigilancia del cáncer en Colombia necesita reciprocidad del Ministerio de Salud. Es necesario reglamentar la participación de los RPCs en el sistema de información de cáncer y asignar recursos permanentes para garantizar su sostenibilidad. Cancer Incidence in Five Continents y los cuatro RPCs colombianos participaron en   el estudio CONCORD Durante cuarenta años el Registro Poblacional de Cáncer de Cali  fue la única fuente de información válida de la incidencia de cáncer en Colombia  y Medellín durante el periodo 2008-2012 -En este número de Colombia Medica, el RPC-Cali describe los principios y métodos utilizados para analizar 50 años de incidencia (1962-2012), 30 años de mortalidad (1984-2014) y 15 años de supervivencia (1995-2009) -Los registros de cáncer de Cali, Quito y Pasto disponen de al menos 15 años de información de buena calidad y presentan resultados válidos de la tendencia de la incidencia y mortalidad por cáncer en sus respectivas poblaciones  y nuevas técnicas diagnósticas (cáncer de tiroides) , . Es importante realizar investigaciones específicas para determinar si estas diferencias son resultado de incluir casos de no-residentes, de duplicidad y/o subregistro de información.Barranquilla y Medellín divulgan por primera vez datos sobre incidencia de cáncer Medellín, segunda ciudad más poblada del país ubicada en las montañas andinas del noroeste colombiano, con características demográficas particulares, presenta la incidencia para los cánceres priorizados por el Plan decenal para el Control del Cáncer en Colombia. Debe destacarse que cerca del 100% de los casos nuevos de cáncer registrados tienen verificación morfológica -) y las cifras oficiales de mortalidad, para hacer estimaciones válidas de la incidencia de cáncer para todo el país y para cada uno de los departamentos de Colombia El INC-Col caracteriza la situación actual de la oferta de servicios oncológicos en Colombia La Para estimar la incidencia de cáncer, los RPC deben tener un área de registro delimitada y una definición clara de “caso”. En esta definición es crítico incluir solo los casos nuevos diagnosticados en los residentes permanentes de la ciudad; y excluir los casos de pacientes remitidos a la ciudad para procedimientos de diagnóstico y/o tratamiento. La recopilación de datos debe ser tanto pasiva como activa en las diferentes fuentes de información.Los RPC requieren recursos adecuados y sostenidos para lograr ser exitosos. En Colombia, el costo del registro por habitante varía entre US $ 0.05 a US $ 0.22. Entre el 20% y el 45% del costo total se debe a actividades con costo fijo. Las universidades han sido la principal fuente de recursos financieros y de personal tanto científico como técnico que les ha permitido ser exitosos. Otro factor de éxito de los RPC es el reconocimiento social en la ciudad facilitando así el proceso de recopilación de datos.En Colombia se ha consolidado una gran oferta de servicios oncológicos. El reporte del INC-ColA pesar de esta amplia oferta de servicios, la supervivencia global a 5 años del cáncer infantil en Cali (51%) está entre 26% y 32% por debajo de los resultados reportados en países afluentes (77% a 83%). Esto significa, que, si en Colombia se tratan alrededor de 1,500 a 1,600 niños con cáncer al año, 765 a 816 mueren en los 5 años posteriores al diagnóstico. De estos, 390 a 512 muertes anuales serían evitables. Esta brecha de supervivencia se mantiene en todos los grupos de neoplasias, excepto en el linfoma de Hodgkin (88% vs 95%). En adultos la situación es similar y la supervivencia neta a 5 años al cáncer de próstata, cuello uterino y mama esta entre 20 y 30 puntos por debajo a la observada en Norteamérica y Europa. Durante el periodo 2000-2004, la supervivencia neta a 5 años mejoró para los cánceres de mama, cuello uterino, próstata, melanoma y tiroides, aunque en el periodo 2005-2009 se observó un estancamiento. En cáncer de estómago, hígado y pulmón, la supervivencia neta a 5 años fue inferior al 15% El RPC-Manizales ,,El registro hospitalario del INC-Colombia En Conclusión, el esfuerzo pionero del Registro Poblacional de Cáncer de Cali y de la Universidad del Valle y su colaboración con otras entidades académicas y públicas han hecho posible una estimación precisa de la carga de cáncer en varias regiones de Colombia y en Quito, Ecuador; esta información es básica y esencial en el planteamiento de estrategias para el control del cáncer.


The name of the institution is spelled incorrectly in the affiliation for authors Francisco Marco-Jiménez and José Salvador Vicente. The affiliation should be: Institute of Science and Animal Technology, Laboratorio de Biotecnología de la Reproducción, Universitat Politècnica de València, 46022 Valencia, Spain.


The affiliations should appear as shown here: David Alaminos1 Department of Finance and Accounting, Universidad de Málaga, Málaga, Spain, 2 PhD Program in Economics and Business, Universidad de Málaga, Málaga, Spain