BackgroundThe incidence of venous thromboembolic disease (VTED) is estimated to be, on average, 1–2 cases per 1,000 individuals per year worldwide. There are few data concerning the incidence rate (IR) of VTED in the Argentinean population at large.Our aim was to estimate the IR of VTED at the Italian Hospital Medical Care Program (IHMCP) in Buenos Aires, the most populous city in Argentina.MethodsThis prospective cohort study evaluated all consecutive incident cases of pulmonary thromboembolism (PTE) and deep vein thrombosis (DVT) confirmed in patients over the age of 17 who were members of the IHMCP from June 2006 to May 2012. Any patient who had an initial confirmed VTED episode and was a member of the IHMCP at the time of diagnosis was considered an incident case.ResultsThere were 1,138 cases of VTED for 687,871 person-years of follow-up. The crude IR of VTED was 1.65 (95% CI: 1.56 to 1.75) per 1,000 person-years. The highest IR was found in subjects >80 years old (5.92 per 1,000 person years; 95% CI: 5.41 to 6.49).The IRs adjusted to the population of the city of Buenos Aires were 0.90 (95% CI: 0.84 to 0.95) for VTED, 0.71 (95% CI: 0.66 to 0.76) for DVT, and 0.34 (95% CI: 0.31 to 0.37) for PTE.ConclusionsVTED is a common health problem with a high IR in members of the IHMCP, especially the elderly. This is the first paper to report prospectively the cumulative incidence of VTED in Latin America.

The incidence of amyotrophic lateral sclerosis (ALS) ranges from 1.7 to 2.3 per 100,000 persons worldwide. Few epidemiological studies have been published in Latin America. The aim of this study was to estimate the incidence and prevalence of ALS in an HMO (Health Maintenance Organization) of Buenos Aires, capital city of Argentina. The population studied was affiliates of the Italian Hospital Medical Care Program, whose distribution across age and gender strata is similar to the population of Buenos Aires. Cases were detected from 1 January 2003 to 31 December 2010. Incidence density (ID) and prevalence for ALS were estimated for the whole period and at 31 December 2010, respectively. During the seven-year study period, the crude ID estimated was 3.17 per 100,000 person-years (95% CI 2.24-4.48) and the age-adjusted ID for the Buenos Aires population was 2.23 per 100,000 person-years (95% CI 1.45-3.01). Point prevalence at 31 December 2010 was 8.86 per 100,000 persons (95% CI 4.05-13.68). Mean age at diagnosis was 72.29 years (SD 8.5). In conclusion, estimated age-adjusted ID and prevalence of ALS were similar to the incidence and prevalence rates found in other geographical areas.

Nephroblastomatosis is a rare preneoplastic lesion defined as the presence of diffuse or multifocal nephrogenic rests. They are divided into 4 categories: perilobar, intralobar, combined, and universal. The aim of this report is to describe a case of diffuse hyperplastic perilobar nephroblastomatosis. A 1-year-old boy presented with an abdominal mass on the left side. Computed tomography scan showed a homogeneous, isointense enlarged left kidney. A fine needle aspiration cytology was reported as Wilms tumor. After chemotherapy, the left kidney was excised. Nephrectomy specimen presented a thick cortical rim of hyperplastic nephrogenic tissue, well delineated from preserved renal parenchyma without pseudocapsule. Nephroblastomatosis is a rare condition affecting renal parenchyma. Diagnosis is based on imaging studies, such as ultrasound, computed tomography scan, and magnetic resonance imaging. Fine needle aspiration cytology is of limited value. Therapeutic management is controversial. Chemotherapy is used preoperatively, and surgical excision may be an alternative for refractory cases.

Background Two hypotheses attempt to explain the increase of thyroid cancer (TC) incidence: overdetection by excessive diagnostic scrutiny and a true increase in new cases brought about by environmental factors. Changes in the mechanism of detection and the risk of incidentally diagnosed TC could result in an increase of TC incidence. Methods Retrospective cohort study. We identified incident cases of TC from the pathological reports of patients in a HMO and review of clinical records. The results were analyzed in two periods: 2003-2007 and 2008-2012. Incidence rates expressed per 100,000 person-years (with 95% CI) and relative risk of incidence rates of incidental and nonincidental TC were estimated. Results The relative risk of incidentally detecting a thyroid cancer in 2008-2012 compared to 2003-2007 was 6.06 (95%CI 1.84-20.04). Clinical evaluations detected 31 (75.6%) cancers in the period 2003-2007 and 70 (51.8%) cancers in the period 2008-2012 (p<0.007). Although tumor median size was significantly lower in the period 2008-2012 (10 vs. 14 mm, p<0.03), tumors greater than 40 mm (4.3%) were only present in 2008-2012. The female/male ratio decreased between analyzed periods from 8 (3-21) to 4 (3-7). Conclusions Our findings partially support the hypothesis of increased incidence due to overdetection but do not explain the changes in the increase of larger tumors and decrease in the female/male ratio, which could be secondary to the influence of unidentified environmental factors.

<p>Objetivo: Cuantificar la contribución de los factores de riesgo (FR) y de los tratamientos en el descenso de mortalidad por enfermedad coronaria en Argentina entre 1995 y 2010.<br />Métodos: Utilizamos el modelo validado IMPACTCHD integrando datos de efectividad y utilización de tratamientos y cambios en los FR en 1995 y 2010 en mayores de 25 años en Argentina. La diferencia entre las muertes coronarias observadas y esperadas en el 2010 se distribuyó entre los tratamientos y los FR.<br />Resultados: Entre 1995 y 2010 las tasas ajustadas de mortalidad por enfermedad coronaria descendieron 29,8% (8 500 muertes prevenidas o pospuestas - MPP). Las mejoras en los tratamientos explicaron un 49,9%, en su mayoría por prevención secundaria del infarto agudo de miocardio (8,2%); tratamiento antihipertensivo (11,9%) y para insuficiencia cardíaca (13,2%). Las mejoras en los FR explicaron 32,9% de las MPP: presión arterial sistólica 34,6%; colesterol total 12,8%; tabaquismo 6,8%. Se encontró un exceso de muertes debido al aumento de diabetes (9,4%), obesidad (6,9%) y sedentarismo (5%). Un 17,2% de las MPP no fue explicado por el modelo.<br />Conclusiones: Una de cada dos MPP por enfermedad coronaria en Argentina entre 1995 y 2010 se debió a los tratamientos y un tercio a la mejora de los FR. El descenso de la presión arterial, colesterol y tabaquismo fue limitado por aumentos en la prevalencia de obesidad, sedentarismo y diabetes. Este trabajo fue posible gracias al trabajo colaborativo en pos de la epidemiología cardiovascular.</p>

Disability is a public health problem that affects an individual's comprehensive development opportunities. The objective of this study was to estimate the annual incidence and prevalence and the diagnostic categories associated with total disability and age groups based on the application for a Unique Certificate of Disability. This was an analytical cohort study in children aged 0-18 years conducted at a teaching hospital of the Metropolitan Area of Buenos Aires between January 2010 and December 2017. Among 22 750 active members, 726 patients applied for a Unique Certificate of Disability; the prevalence was 3.2 % (95 % confidence interval [CI]: 2.9-3.4). The annual cumulative incidence increased from 2012 (0.22 %, 95 % CI: 0.1-0.19) to 2017 (0.59 %, 95 % CI: 0.5-0.7). Mental disabilities accounted for 80 % (n = 576). This study showed an increase in the incidence of disability and also the mental disability category.

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Antecedentes: Existe limitado conocimiento sobre la incidencia de enfermedad tromboembólica venosa (ETV) durante la hospitalización, dado que la mayoría de los son datos basados en la comunidad. Objetivos: Estimar la tasa de incidencia de ETV incidente durante la hospitalización. Material y métodos: Cohorte restrospectiva de todos los pacientes internados en un hospital de alta complejidad, en Argentina. Los criterios de inclusión fueron definidos como: pacientes adultos consecutivamente admitidos entre Julio 2006 y Agosto 2013, por cualquier causa (clínica o quirúrgica). Se excluyeron los pacientes ingresados por ETV, todos los pacientes al momento de la admisión estaban libres del evento. A cada paciente se lo siguió en tiempo de contribución de riesgo, desde la admisión hasta el evento, el alta o la muerte intrahospitalaria. Los casos incidentes de ETV fueron capturados desde el Registro Institucional de Enfermedad Tromboembólica (ClinicalTrials.gov Identifier NCT01372514). La tasa de incidencia se calculó con intervalos de confianza del 95%. Resultados: La tasa de incidencia (TI) cruda de ETV para los pacientes clínicos fue de 0,49 (IC95% 0,45-0,55) por 1.000 pacientes persona-día, y la TI ajustada para la OMS fue de 0,23 (IC95% 0,19-0,26). La TI cruda de ETV para pacientes quirúrgicos fue de 0,25 (IC95% 0,23-0,27), y la TI ajustada para la OMS fue 0,13 (IC95% 0,10-0,17). La razón de tasas de incidencias muestra que la admisión quirúrgica reduce y la edad aumenta el riesgo de trombosis. Conclusiones: Este estudio sugiere que existe un alto riesgo de ETV en pacientes hospitalizados y sigue siendo un problema frecuente.