Published: 2016-06-30

Historical Article

Biographical Sketch Posthumous Benjamín Torún Rymer (1939 - 2010)

Authors:
Francisco Chew
Pages:
6
Abstract:
The Editorial Committee of the Journal of the College of Physicians and Surgeons of Guatemala, in recognition of the academic career of Dr. Benjamín Torún Rymer, decided to make a posthumous tribute by publishing his biographical sketch.
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Review Articles

Lymph node biopsy: basic considerations

Authors:
Miguel Rivera, Miguel Garcés, María Aguilera, Marco Peñalonzo
Pages:
37-41
Abstract:
Lymph node biopsy is a common surgical procedure. Several aspects of the technique and pathologic analysis will be discussed in this review. In cases of multiple nodes, the biggest lymph node should be selected for the biopsy. Adequate equipment, careful hemostasis, surgical experience and effective communication with the pathologist are key factors to achieve a correct diagnosis. 
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Articles

The scientific production

Authors:
Carlos Chúa, Roberto Orozco
Pages:
7-13
Abstract:
The search and storage of information have been crucial in the world throughout history. These processes are fundamental in science research. With the widespread use of internet and social media, the task of gathering information in websites of free access, has made it easy for researchers, universities, specialized centers, academic authorities, etc., to analyze knowledge generated in any place of the world. Much information is still unavailable (encrypted) to scientific production browsers. In this paper we describe the scientific production, investment in science and technology and browsers of research publications and researchers.
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A glance at the guatemalan production of medical publications

Authors:
Roberto Orozco, Carlos Chúa
Pages:
14-18
Abstract:
Antecedents: Even though it is assumed that Guatemala, as a country, publishes little in medical journals internationally ranked, no studies are known that show actual numbers on the production of medical publications. Objective: To find out Guatemala’s production of medical publications and the contribution of that production to the total production of the world, of Latin America and of Central America. Material y Method: This is a secondary research that analyzes row data available on the free access platform denominated “The SCImago Journal & Country Rank”. Results: The production of medical publications by Guatemala has been about 40 documents per year during the last 24 years.
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Trend of the Cesarean Operation in the Republic of Guatemala: Proposal for intervention, At least let's try it!

Authors:
Edgar Kestler, Vinicio Mora, Vinicio Mora, Andrés Zepeda, Vivian Guzmán
Pages:
19-27
Abstract:
Objective: To determine the trend of caesarean section from 2011 to 2014 in Public hospitals, Private hospitals, and Social Security and APROFAM hospitals in the Guatemala Republic, and suggest a possible intervention to reduce the high rates identified. Material and Methods: Secondary analyses were conducted in the databases provided by the National Registry of Persons (RENAP) for the years 2011 to 2014. These databases contain data for each particular birth occurred in the Republic of Guatemala, for department, type of delivery, and institution attended pregnant women. Results: A total of 665.446 institutional births were analysed during the four years of study, private hospitals had the highest incidence rate of caesarean section with 68%, followed by APROFAM hospitals (55%), Social Security hospitals (42%) and public hospitals (34%). This analysis is related to the number of institutions assisted pregnant women for each department in the country. There is a twofold difference caesarean section among the public system nationwide with a total of 37 health institutions that had a Caesarean section rate of 34% against 198 private institutions who had a Caesarean section rate of 68%. Differences for each department are presented. Finally, the analysis by health regions showed that the rate of caesarean section was higher (47%) for the Metropolitan region and the region with lower rate of caesarean section was the Petén region with 24%. These data are similar to those reported by the National Survey of Maternal and Child Health (ENSMI) 2014-2015. Conclusions: The difference between rates of caesarean section in hospitals that are part of the national health system is disturbing. Private hospitals not only have higher rates than other hospitals, but the trend is still rising. There is no national surveillance and monitoring this situation and these data demonstrate that in the coming years the incidence of caesarean section will be worse given the non surveillance by national health authorities. A proposed classification that allows knowing at hospital level the current situation and to identify the group of patients that contribute to the higher rates of caesarean section, will allowed to implement actions to reduce the high caesarean section rates actually present and reduce this caesarean section rates in a near future.
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Associated psychosocial factors in women with abortion. Roosevelt Hospital, Guatemala, September 2015

Authors:
María Roldán
Pages:
28-32
Abstract:
Medical history: the maternity health is a complex process that has an integrated management detecting biological and psychosocial factors that produce adverse effects during pregnancy and can be preventable if they are detected at time. Goals: identify the psychosocial factors in women with abortion in Roosevelt Hospital of Guatemala. Design: transversal, descriptive study. Material and methods: interview to 61 patients using a structure questionnaire of 29 questions, using as base a PRAMS (Pregnancy Risk Assessment Monitoring System) questionnaire. Results: the average age was of 24.8 years old (IC95%; 22.8-26.8). The epidemiological indicator of risk was found in 47.5% (29); risk of habits 16.4% (10); bad prenatal control 67.2% (41); deficient counseling 36.1% (22); unwanted pregnancy 31.1% (19); perception of insecurity 8.2% (5); family instability 19.7% (14). The cases of spontaneous abortion had the higher age (p=0.0078), wanted pregnancy (p=0.00007), planned pregnancy (p=0.03174) and the ones who had and integrated households (p=0.01052). Conclusions: the deficit in the prenatal control was the most frequent indicator. The patients who had a spontaneous abortion expressed the acceptance of the pregnancy, had integrated households and less risks factors. 
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Prevalence of metabolic syndrome in indigenous women over 45 years

Authors:
Manuel Villalta
Pages:
33-36
Abstract:
Background: the metabolic syndrome is a disorder that results from visceral obesity, hypertension, dyslipidemia, and insulin resistance. After menopause, the incidence is secondary to hypoestrogenism. Cardiovascular disease and metabolic syndrome have an incidence of 35% after menopause and it is estimated that half of cardiovascular diseases could be related to this syndrome. Objective: Determine the prevalence of the metabolic syndrome in native women. Materials and Methods: Transversal study, descriptive with 195 native women of 45 years and older, utilizing NCEPT-ATP II and IDF criteria. Results: According to NCEP-ATP II the prevalence of the metabolic syndrome was 35% (IC 95%, 28% - 42%): 19% (IC 95%, 12% - 26%) in premenopausal and 51% (IC 95%, 42% - 59%) in postmenopausal p < 0.05, OR 4.4 (CI 95%, 2.3 – 8.4). According to IDF the prevalence was 39% (IC 95%, 32% - 46%): 25% (IC 95%, 17% - 33%) vs 53% (IC 95%, 44% - 61%) p<0.05, OR 3.31 (CI 95%, 1.8 – 6.1). The most frequent component was the abdominal circumference (30%) and the less frequent was glycemia (8%). Conclusion: The prevalence of metabolic syndrome was higher in postmenopausal patients. The IDF criteria provides higher prevalence because it uses a minor abdominal circumference.
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Case Report

Gastrointestinal stromal tumors

Authors:
Allan Argueta, Victor Argueta, Diego Hernández, Roberto Orozco
Pages:
42-44
Abstract:
Background: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract (GI), are considered to arise from the Cajal cells. They occur mainly in older adults, 60-65 years. They present in the stomach (50%-70%), small intestine (25%-35%), colon and rectum (5%-10%) and esophagus (<5%). Most GISTs are sporadic and are clinically symptomatic. The definitive diagnosis is made through anatomic pathology study. To determine the prognosis of this type of tumors we use the size, mitotic count and location of the tumor, classified them in: very low risk, low risk, intermediate risk and high risk. Surgery is the main treatment. Objectives: Categorize the prognostic risk of the reported cases of gastrointestinal stromal tumors from 2006 to 2013 years at the San Juan de Dios General Hospital, Guatemala. Materials and Methods: A retrospective study to review all pathology reports and all glass slides to analyze the GISts, and to classify them according to tumor risk based on size, mitotic count and location of tumor. Results: A total of 15 GISTs was obtained, 11 were diagnosed in women and 4 in men; 8 on people over 60 years of age, The most common location site was the small intestine with 7 cases.. Twelve cases were classified as high or intermediate risk. 
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