Inflammatory bowel disease in Mexico: Epidemiology, burden of disease, and treatment trends. / Epidemiología, carga de la enfermedad y tendencias de tratamiento de la enfermedad inflamatoria intestinal en México.

INTRODUCTION AND AIMS: There is no systematized information for determining/monitoring the burden of inflammatory bowel disease in Mexico. The aim of the present study was to estimate the annual burden of inflammatory bowel disease on the Mexican National Healthcare System, by number of patients seen, hospitalizations, and specific deaths, stratified into age groups. MATERIALS AND METHODS: Utilizing specific databases of the Mexican National Healthcare System registries coded as ICD-10: K50 and K51, we retrieved and analyzed the data corresponding to the patients seen and hospitalized in 2015, stratified by age group, as well as the specific deaths. Treatment trends among physicians were also examined. RESULTS: In 2015, 5,009 women (8.1) and 4,944 men (8.4) with Crohn's disease received medical attention (prevalence of cases seen) and 35.1% of those patients were ≥50years of age. In that same period, 17,177 women (27.7) and 15,883 men (26.9) with ulcerative colitis were seen and 31.6% of those patients were ≥50years of age. The hospitalized cases (prevalence of hospitalized cases) were 1,097 patients (0.91) with Crohn's disease and 43.7% of those patients were ≥50years of age; and 5,345 patients (4.42) with ulcerative colitis and 47.6% of those patients were ≥50years of age. Deaths (specific mortality rate) were: 32 women (0.52) and 36 men (0.50) due to Crohn's disease, and 267 women (4.31) and 186 men (3.15) due to ulcerative colitis. CONCLUSIONS: Inflammatory bowel disease is a burden on the health of Mexican adults and the Mexican National Healthcare System, and it is expected to increase over the next 15years.

Hepatocellular carcinoma and hepatic cirrhosis in Mexico: a 25 year necroscopy review.

BACKGROUND/AIMS: Hepatocellular carcinoma (HCC) is a common form of cancer which is found throughout the world. In recent years, the rates of HCC seem to have increased in European and North American countries. Herein, a retrospective review of necroscopy records over a 25-year period was undertaken in order to determine the incidence of HCC in a Mexican population. METHODOLOGY: A retrospective review of necroscopy records was performed to determine the incidence of HCC and then to determine the presence or absence of associated cirrhosis in these cases. The tumor/cirrhosis relationship was determined by computing the TC/T and TC/C indexes. RESULTS: Of 12556 autopsies studied, 73 cases of histologically proven HCC were reported, representing a total necropsy carcinoma incidence of 0.59%. Fifty-five cases were associated with cirrhosis (0.43%), and 18 were not (0.14%). HCC was two times more common in males (67%) than in females (33%), with a ratio of 2:1. During this period, the necropsy incidence of HCC rose steadily to twice its original level (1965-69 incidence 0.35%; 1985-89 incidence 0.69%). The necropsy incidence of cirrhosis was 4% (329 males, 185 females). The overall TC/T index was 75% (87% for males and 50% for females). The overall TC/C index was 10.7% (13% for males and 6.4% for females). CONCLUSIONS: There was a two-fold increase in the incidence of HCC in the Mexican population studied over a 25-year period. HCC was associated with cirrhosis in the majority of cases. HCC was two times more common in males than in females in patients with cirrhosis; in patients without cirrhosis, the ratio was 1:1. The incidence of cirrhosis was 4%, which remained unchanged with the passage of time.

[Cystic tumors of the pancreas]. / Tumores quísticos del páncreas.

Cystic tumors of the pancreas are rare, accounting for only 10 to 15% of cystic lesions of the pancreas and 1% of malignant neoplasms. They can be benign or malignant and well circumscribed and localized. Their identification, the differential diagnosis and treatment are difficult and one example is that up to a third of them may be confused with pseudocysts. The most important are serous microcystic cystadenomas, mucinous cystadenomas, mucinous cystadenocarcinomas, mucin-producing adenocarcinomas and adenocarcinomas associated to pseudocyst or to simple cyst. The most useful studies for diagnosis are ultrasound, computed axial tomography, endoscopic retrograde cholangiopancreatography, guided punction of the cyst with study of the fluid, and biopsy. The choice of the type of treatment depends on the variety of the tumor. The localization and extension, the surgical risk, the experience of the surgeon and the institutional resources. The prognosis of these tumors is better than that of ductal adenocarcinoma, even if they are malignant.