RESUMEN
El objetivo de esta investigación fue determinar la utilidad diagnóstica de la evaluación antropométrica Este estudio prospectivo, transversal de 30 pacientes, distribuidos en 3 grupos de 10 pacientes. Grupo A (GA)= con cirrosis alcohólica. Grupo B (GB): con cirrosis no alcohólica y el grupo C (GC) (control) = sujetos sanos. La evaluación antropométrica incluyó peso, talla, circunferencia del brazo, pliegues. ¸ndice de masa corporal, el área grasa y el área magra. El análisis estadístico (programa SPSS versión 10), aplicándose t de student (p<0,05). En la evaluación antropométrica en GA hubo 30% desnutridos, 30% sobrepeso y 30% obesos; en GB hubo 20% desnutridos y 40 % con sobrepeso. El 30% del GA presentó reservas proteicas muy bajas y 20% bajas. El GB 10% presentó reservas musculares bajas y 10% bajas. Se concluye que la antropometría permitió determinar que la malnutrición constituye un problema para los pacientes con cirrosis hepática de origen alcohólica, y que es un instrumento útil para el diagnóstico temprano de riesgo nutricional en enfermedad hepática crónica.
The objective of this research was to determine the diagnostic utility of anthropometric assessment. This prospective, cross 30 patients divided into 3 groups of 10 patients. Group A (GA) = with alcoholic cirrhosis, Group B (GB) with non-alcoholic cirrhosis, and group C (GC) (control) = healthy. The anthropometric assessment included weight, height, arm circumference, skinfold, body mass index, fat area and lean area. Statistical analysis (SPSS program version 10), using t-student (p <0.05). In Anthropometric assessment was 30% in GA malnourished, 30% overweight and obese 30%, 20% in the UK were malnourished and 40% overweight. 30% of GA reservations very low protein and 20% low. The GB 10% had low muscle reserves and 10% low. It is concluded that anthropometry revealed that malnutrition is a problem for patients with liver cirrhosis of alcoholic origin and is a useful tool for early diagnosis of nutritional risk in chronic liver disease.
RESUMEN
Los perfiles de mortalidad orientan sobre las prioridades necesarias en la prevención de enfermedades. En Venezuela se publican Anuarios de Mortalidad oficiales basados en Certificados de Defunción (distribuidos por Direcciones Regionales de Epidemiología/DVE/DEAE/MSDS) que contienen causas de muerte codificadas, siguiendo lineamientos internacionales CIE-10 de la OMS. Aún cuando estas cifras están a disposición del público, consideramos importante en este trabajo descriptivo-retrospectivo extraer, reunir y analizar, la data oficial Hepatobiliar del primer quinquenio del nuevo siglo. RESULTADOS: Un promedio de 3.621 venezolanos (3,20% del total de muertes anuales registradas) murieron por esta patología, con amplia variación por entidad federal. Trujillo reporta el mayor porcentaje de mortalidad debido a enfermedades del hígado (3%), seguido de cerca por Vargas; tercer lugar compartido, D.Federal y Táchira (2,8%) Las mayores cifras de mortalidad por cirrosis y fibrosis están en Táchira (2.35%), Trujillo y Vargas (2,1%) Aragua y Nueva Esparta (2%) Las muertes por causas hepáticas en Zulia, Portuguesa, Cojedes, Guárico, Delta Amacuro, Bolívar, Apure y Amazonas, no se registran entre las 10 primeras causas de muerte. Los perfiles de mortalidad orientan sobre las prioridades necesarias en la prevención de enfermedades. Consideramos importante, como médicos, conocer la data oficial de morbimortalidad de nuestro país, divulgar su nomenclatura y colaborar con su registro, recodando que el CIE es un sistema que "permite la producción de estadísticas sobre mortalidad comparables en el tiempo, entre regiones de un país, y entre países" y, por tanto, las consecuencias del subregistro son internacionales.
Mortality profiles state priorities in health care with emphasis in disease prevention. Mortality Year Books are published in Venezuela by the regional Epidemiology Bureau/DVE/DEAE/MDS, based in death certificates which follow international guidelines from CIE-10 (World Health Organization). Although statistics are of public knowledge, we considered important in this study to extract the data related to hepatobiliary diseases during the first five years of the new century. RESULTS: According with official data, a mean of 3.621 Venezuelans died, each year, from hepatobiliary pathology (3.2% of the total registered annual deaths) There are many regional variation of this pathology. Trujillo has the highest mortality rate from liver diseases (3%), followed by Vargas, Distrito Federal and Táchira. Mortality from fibrosis and cirrhosis is higher in Tachira (2.35%), Trujillo and Vargas (2,1%), Aragua and Nueva Esparta (2%)Mortality from hepatobiliary diseases in Zulia, Portuguesa, Cojedes, Guárico, Delta Amacuro, Bolívar, Apure y Amazonas, are not reported among the first 10 causes of death. Mortality profiles lead priorities in disease prevention. CIE-10 is for international purposes and incomplete data brings international consequences. As medical doctors, and as gastroenterologists, we have to know the official terms in order to be accurate. At the time, we have to design a strategic plan to spread its terms and to colaborate with data registration.
RESUMEN
Once the elaboration of CIE-10 Gastroenterology we used two indicators (Health and Management) as quantifiable measurements that reflect the critical success factors in the specialty. HEALTH INDICATORS: MORBIDITY: 13,21% of main medical complains in primary care concern to Gastroenterology. Four of them rank among the first 25 ("Diarrhea", "Abdominal pain", "Helmintiasis" and "Other Esophagus, Stomach and Bowel diseases"). At the specialty care, Acid-peptic disease ranked as the first main complain according with 56-73.3% of the gastroenterologist consulted (Public and Private care) followed by Gastrointestinal reflux, Irritable bowel, Constipation, Lithiasis, Diverticular disease, Hemorrhages, Jaundice, Cirrhosis, Amibiasis, Pancreatitis, Colon cancer, Polyps, Hepatitis and Colopathy. MORTALITY: 11,4% of the total deaths among Venezuelans are by gastrointestinal causes and five of them count among the first 25, with wide regional variability. Trujillo reports major mortality by liver disease (3%) followed by Vargas, District Federal, Tachira (2.8%). Cirrhosis and Fibrosis are more frequent in Táchira (2.3%) Trujillo, Vargas (2,1%) Some regions report mainly infections and diarrheas. Major cancer mortality is in Táchira (6,73% of deaths in the State) followed by Merida and Trujillo. MANAGEMENT INDICATORS: Services Demand. 2,86 consult/habitant/year in internal medicine and 0.77 en specialties. Services Offer. 793 Gastroenterologists (3.4/10.000 habitants). 44.5% concentrated in D.Federal, followed by Táchira (3.9%) Carabobo, Zulia y Mérida. Human Resources Formation. 16 Post-graduated Programs graduate 70 gastroenterologists annually. The Gastroenterology Education Agreement 2006 unified the Venezuelan Gastroenterologist profile and the graduation requirements. The Venezuelan Gastroenterology Society, age 60, has extraordinary national and international projection through its scientific publication (GEN Magazine). This analysis of the present of Gastroenterology in Venezuela allows us the strategically planning of its future, in order to satisfy the population needs in the specialty in a rational and effective way.