ResumenIntroducción: Obesidad en la adolescencia se asocia con trastornos cardiometabólicos en la edad adulta. Es necesario contar con un índice de obesidad fácilmente aplicable para predecir riesgo cardiometabólico en adolescentes. Objetivo: Comparar la utilidad de los índices radio Cintura/Talla (r-CT), circunferencia de cintura (CC) y el índice de masa corporal (IMC) para determinar obesidad y predecir riesgos cardiometabólicos en adolescentes. Métodos: En este estudio trasversal, bajo criterios de la International Diabetes Federation (IDF) se determinó obesidad mediante tres índices, hipertensión arterial, hiperglicemia, hipertrigliceridemia y bajo HDL en 931 adolescentes mestizos ecuatorianos. La asociación de los índices de obesidad (r-CT, IMC y CC) con los factores de riesgo cardiometabólico se determinaron mediante radios de Odds ajustados y áreas bajo la curva (AUC, siglas en inglés) ROC (Característica Operativa del Receptor, siglas en inglés). Resultados: El r-CT ≥0.5 determinó mayor porcentaje de obesidad (36.6%) respecto a CC (17.4%) e IMC (6.7%). IMC ≥95 percentil se asoció significativamente con los cuatro factores de riesgo cardiometabólico, mientras que CC y r-CT se asociaron con tres de los cuatro factores. Los tres índices de obesidad determinan la concurrencia de tres o más factores de riesgo cardiometabólico con alta sensibilidad y especificidad con un AUC mayor de 0.80. Conclusiones: El IMC ≥ al percentil 95 es mejor predictor de riesgo cardiometabólico, pero no determina bien obesidad. El r-CT parece ser el indicador antropométrico más adecuado para detectar obesidad y predecir riesgo cardiometabólico en adolescentes mestizos debido a su fácil determinación y uso. Palabras clave: Obesidad, síndrome metabólico, predictores, riesgo cardiometabólico Abstract Background: Obesity in adolescence is associated with cardiometabolic problems in adulthood. It is necessary to have an easily applicable obesity index to predict cardiometabolic risk in adolescents. Objective: To compare the usefulness of waist to-height ratio (WHtR), waist circumference (WC), and body mass index (BMI) to determine obesity and predict cardiometabolic risks in adolescents. Methods: In this cross-sectional study, under the criteria of the International Diabetes Federation (IDF), obesity, hypertension, hyperglycemia, hypertriglyceridemia and low HDL rates were determined in 931 Ecuadorian mestizo adolescents. The association of the three obesity indices with the cardiometabolic risk factors was determined by means of adjusted Odds radios and area under the Receiver Operating Characteristic curve (AUC-ROC). Results: WHtR ≥0.5 determined the highest percentage of obesity (36.6%) with respect to WC (17.4%) and BMI (6.7%). BMI ≥95 percentile was significantly associated with the four cardiometabolic risk factors, while WC and WHtR were associated with three out of four factors. The three obesity indices determine the concurrence of three or more cardiometabolic risk factors with high sensitivity and specificity with an AUC great...

Introduction: Episiotomy was considered an obstetric procedure applied routinely to facilitate the expulsive period. Currently, several studies, regulations and protocols indicate that its use should be restricted and its benefits are questioned. Objective: To know the influence of the regulations issued on the selective use of episiotomy in the establishments of the Ministry of Public Health when comparing the year 2007 with 2017. Methods: An analytic epidemiological study of secondary source (medical records of normal delivery) and primary source (surveys to professionals) was carried out. It was carried out in the health units of the MSP-EC: Historic Center Health Center, Enrique Garcés Hospital, and Isidro Ayora Gineco-Obstetric Hospital, medical care centers in which the 0.51 form of the medical records was reviewed and a report was recorded. instrument predesigned for the study. With the compiled information, the database was organized to establish significant differences, the Chi square test was used between the affirmative data of episiotomy action in the two years compared. Results: The application of episiotomy presented a notable change when comparing the year 2007 with 29.2% and 8.7% in 2017. It should be noted that primiparous women were the group in which the highest number of episiotomies was performed. Conclusion: The aspect that most influenced the reduction in the number of episiotomies was the training given to professionals graduated after 2008, included in the MSP-EC regulations for the selective application of episiotomy.