Recientemente las autoridades de salud de nuestro país decidieron incluir el cáncer diferenciado y medular del tiroides en personas de 15 años o más entre las enfermedades con atención garantizada⁴. Para poder estimar la carga asistencial que esta decisión producirá es necesario actualizar los datos de epidemiología del CT disponibles en Chile^5,6. El CT, parece ser un hallazgo extremadamente frecuente en necropsias. Una revisión sistemática de estudios de necropsias no seleccionadas encontró 7,6% de carcinomas papilares y 0,14% carcinomas medulares, menores de 10 mm y no pesquisados en vida⁷. Contrastando con esta cifra, la incidencia de CT estimada mediante el registro de tumores con confirmación histopatológica SEER en Estados Unidos de Norteamérica fue 17,6 casos por 100.000 el año 2013³. Podemos suponer que esta tasa representa la frecuencia de una enfermedad clínicamente relevante, sin embargo, 28,6% de los tumores medían menos de 10 mm. Tampoco podemos asegurar que se incluyeron todos los casos que debieron ser operados.

Thyroid cancer (TC) detection is increasing steadily. To determine the incidence of TC based on pathological reports of thyroidectomies. Fifty pathology laboratories performing thyroid gland pathological studies were identified. Those that accepted to participate were required to send trimestral reports of all thyroid pathological studies, from March 2011 to February 2012. In the study period, 1309 case of TC were confirmed in 2614 thyroidectomy surgical samples. Considering the susceptible population according to 2012 census, the estimated incidence of TC during 2011 should be higher than 7.86 cases per 100,000 persons/year. Papillary cancer was the most common pathological type in 92% of samples (95% confidence intervals 90-93%). The proportion of microtumors was significantly higher in women than in men and among papillary than in follicular or medullary tumors. Only one fourth of tumors came from thyroidectomies performed in the Ministry of Health network. The incidence and features of TC in Chile are similar to the figures reported abroad.

Diabetes Mellitus (DM) and obesity are a public health problem in Chile. Bariatric surgery is the most effective treatment alternative to achieve a significant and sustained weight reduction in patients with morbid obesity. The results of controlled clinical trials indicate that, compared to medical treatment, surgery for obese patients with DM2 allows a better control of blood glucose and cardiovascular risk factors, reduces the need for medications and increases the likelihood for remission. Consensus conferences and clinical practice guidelines support bariatric surgery as an option to treat DM2 in Class III Obesity (Body Mass Index (BMI) > 40) regardless of the glycemic control and the complexity of pharmacological treatment and in Class II Obesity (BMI 35-39,9) with inadequate glycemic control despite optimal pharmacological treatment and lifestyle. However, surgical indication for patients with DM2 and BMI between 30-34.9, the most prevalent sub-group, is only suggested. The Chilean Societies of Endocrinology and Diabetes and of Bariatric and Metabolic Surgery decided to generate a consensus regarding the importance of other factors related to DM2 that would allow a better selection of candidates for surgery, particularly when weight does not constitute an indication. Considering the national reality, we also need a statement regarding the selection and characteristics of the surgical procedure as well as the role of the diabetologist in the multidisciplinary team.

Background: Previous infection with Adenovirus-36 (HAdv-D36) has been associated with adipogenesis and glycemic regulation in cell culture and animal models. In humans, HAdv-D36 antibodies correlate with increased obesity risk yet paradoxically enhance glycemic control across various demographics. This study assesses the association of HAdv-D36 seropositivity with obesity, lipid, and glycemic profiles among school-aged children. Methods: We evaluated 208 children aged 9–13, categorized by BMI z-scores into normal weight (−1 to +1), overweight (+1 to +2), and obese (>+3). Assessments included anthropometry, Tanner stage for pubertal development, and biochemical tests (relating to lipids, glucose, and insulin), alongside HAdv-D36 seropositivity checked via ELISA. Insulin resistance was gauged using Chilean pediatric criteria. Results: The cohort displayed a high prevalence of overweight/obesity. HAdv-D36 seropositivity was 5.4%, showing no correlation with nutritional status. Additionally, no link between HAdv-D36 seropositivity and lipid levels was observed. Notably, insulin levels and HOMA-RI were significantly lower in HAdv-D36 positive children (p < 0.001). No cases of insulin resistance were reported in the HAdv-D36 (+) group in our population. Conclusions: HAdv-D36 seropositivity appears to decrease insulin secretion and resistance, aligning with earlier findings. However, no association with obesity development was found in the child population of southern Chile.

Neonatal malnutrition defined by birth weight (BW) is a risk factor for obesity and cardio-metabolic diseases in adults. Neonatal ponderal index (NPI) may have better diagnostic value than BW to establish nutritional status.