Subject(s)
Colitis, Ulcerative/genetics , Complement C2/genetics , Complement C4a/genetics , Complement C4b/genetics , Ethnicity/genetics , Genetic Predisposition to Disease/genetics , Major Histocompatibility Complex/genetics , Alleles , Colitis, Ulcerative/immunology , Complement Pathway, Classical/genetics , Gene Frequency/genetics , Genetic Markers/genetics , Genetics, Population , Humans , MexicoABSTRACT
OBJECTIVE: A ten year prolective and multicentre study of cancer of the Digestive Tract aims to evaluate the variations on frequency and to identify risk factors. METHODS: Ten hospitals are participating five in Mexico City and five in other states. Data were obtained through the hospitals files and specially designed questionnaires, the latter mainly diet and habits oriented. RESULTS: Through this ten years in the 4,715 cases studied we can appreciate a decreasing tendency of the carcinoma of the stomach (GC) that has been the most frequent until 1984 in the general group General Hospital and Instituto Nacional de la Nutrición. Since then and up to date, first place in frequency in shared between the stomach and colorectal carcinoma (CRC). CRC has been increasing even in the General Hospital in which GC was very high. Eighth years ago we found that people in those hospitals in which GC was high the diet was poor in proteins, fat A and C vitamin. People in those hospitals with high frequency of CRC had diet high in protein, fat and low in fiber. A new study on diet is ongoing. Gallbladder and biliary tract carcinoma has been increasing in all the hospitals. A high O blood group was found in the Juarez Hospital in which gallbladder carcinoma was the highest. O group is highest in the indian people. Cancer of the gallbladder is very high in Pimas and Navajos indians. A plan to study litogenic index and culture of salmonella is going to be practiced in bile from normal and gallbladder carcinoma. Concerning habits, tobacco and alcohol consumption are most frequent in cancer of the esophagus and pancreas. Also coffee consumption is high in the latter. CONCLUSIONS: Along this 10-year study, the frequency of gastric cancer has been decreasing. Instead, the frequencies of colo rectal and biliary tract cancers have been increasing. Variations in frequencies correlated with the composition of the diet, fiber consumption habits and racial characteristics of the different groups.
Subject(s)
Digestive System Neoplasms/epidemiology , Adult , Hospitals , Humans , Mexico/epidemiology , Prospective Studies , Risk FactorsABSTRACT
Clinical data were collected in 194 cases of jaundiced patients treated at the "Adolfo Lopez Mateos" ISSSTE Hospital in Mexico City from July 1985 to July 1986. A copy of the clinical history of each patient was given to each of four physicians--one recently graduated from medical school, another in his first year of gastroenterology, and two others who were experienced gastroenterologists. The same clinical data were processed by a computer set up to use a modified Danish COMIC algorithm. All physicians and the computer technician were blinded to the "gold standard" pathologic diagnoses, with which their diagnoses were compared. Accuracy rates of the physicians in distinguishing intrahepatic (medical) from extrahepatic (surgical) jaundice were 78%, 86%, 86%, and 91%, and the accuracy of computer-assisted diagnoses was 96%. Chi-squared analysis of the diagnoses of three of the physicians and those of the computer showed significant differences (p between 0.1 and 0.01). For the diagnoses of the remaining physician, however, no significant difference was found after chi-squared continuity correction.
Subject(s)
Algorithms , Cholestasis, Extrahepatic/diagnosis , Cholestasis, Intrahepatic/diagnosis , Diagnosis, Computer-Assisted , Adult , Aged , Aged, 80 and over , Cholestasis, Extrahepatic/etiology , Cholestasis, Extrahepatic/pathology , Cholestasis, Intrahepatic/etiology , Cholestasis, Intrahepatic/pathology , Diagnosis, Differential , Female , Humans , Male , Middle AgedSubject(s)
Decision Making , Philosophy, Medical , Diagnosis , Disease , Expert Systems , Humans , ProbabilitySubject(s)
Gastrointestinal Neoplasms/epidemiology , Aged , Female , Humans , Male , Mexico , Middle AgedSubject(s)
Digestive System Neoplasms/epidemiology , Diet , Digestive System Neoplasms/etiology , Female , Humans , Life Style , Male , Mexico , Retrospective Studies , Smoking , Socioeconomic FactorsABSTRACT
Se estudiaron 290 pacientes con HTDA, en 261 de ellos se practico panendoscopia 100 tenian hipertension porta y/o insuficiencia hepatica, 161 presentaron otras causas de HTDA. El analisis de regresion logistica de los datos clinicos y de laboratorio de rutina permitieron escoger tres datos primarios: ascitis, esplenomegalia y leucopenia. Asi como tambien tres datos secundarios (se requiere la presencia de dos de ellos para dar le valor): alcoholismo, ictericia, hepatomegalia dura, como los mejores discriminantes para establecer la presencia o no de hipertension porta y/o insuficiencia hepatica. La exactitud diagnostica con el uso de estos atributos fue de 91%. Cuando se hizo el estudio de 41 nuevos casos (20 cirroticos y 21 que no lo eran) la exactitud diagnostica fue de 92,6%