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Differentiated thyroid cancer (DTC) is the most common endocrine malignancy, with a high 5-year survival rate of approximately 98%. Despite advances in diagnosis and treatment, up to 20% of patients experience recurrence, adversely affecting their quality of life. Predictive models have been developed to assess recurrence risk and guide clinical decision-making, but these models often face limitations such as retrospective design, lack of diversity in study populations and absence of external validation. The primary aim is to externally validate existing predictive models for DTC recurrence using prospective data from a diverse Latin American cohort. The secondary aim is to explore opportunities for model recalibration to improve their performance in our population.
The CaTaLiNA study is a multicentre prospective observational study conducted across 10 hospitals in five Latin American countries, including Ecuador, Peru, Uruguay and Mexico. Patients aged 18 years or older receiving treatment for DTC, such as the first thyroid surgery, active surveillance or radiofrequency ablation will be included. Recruitment will occur from November 2023 to June 2025, with follow-up extending until June 2028. Data collection will include baseline clinical, surgical and histological characteristics, treatment details and follow-up outcomes. Statistical analysis will follow the Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis guidelines, using imputation strategies for missing data and evaluating calibration and discrimination of the prediction models. Calibration measures include the ratio of expected and observed events, calibration slope and calibration plot, while discrimination will be assessed using the C-index and area under the receiver operating characteristic curve.
This study protocol was approved by Comité de Ética de Investigación en Seres Humanos de la Universidad San Francisco de Quito USFQ ‘CEISH-USFQ’ APO-010–2023-CEIHS-USFQ Oficio No. 161-2023-CA-23030M-CEISH-USFQ. Results will be disseminated via peer-reviewed publications.
Objetivo: Identificar las complicaciones maternas en el embarazo adolescente desde el contexto mundial. Método. Se siguió el protocolo de las guías (PRISMA ScR) y los manuales (JBI), utilizando los Descriptores en Ciencias de la Salud y el ordenador booleano AND: Complicaciones del embarazo AND adolescentes y palabras de texto libre, mismas que fueron insertadas en las bases de datos Dialnet, Pubmed, LILACS y SciELO, considerando los estudios primarios de textos completos que hayan investigado las complicaciones maternas en el embarazo adolescente, cuya metodología empleada haya sido de tipo descriptivo (transversal), incluyendo investigaciones retrospectivas o prospectivas, con una antigüedad no mayor a 10 años y adaptadas al idioma español, inglés o portugués. Resultados. Se encontró un total de 548 estudios primarios, los cuales fueron seleccionados de acuerdo a los criterios de elegibilidad, además de excluir los estudios duplicados en las bases de datos. El total de artículos primarios seleccionados para la revisión fue de 11 estudios en donde se identificaron como principales complicaciones maternas: trastornos hipertensivos, anemia, infecciones del tracto urinario, aborto, ruptura prematura de membranas, y hemorragias ante parto o postparto. Conclusión. La gestación en la adolescencia predispone al desarrollo de complicaciones maternas y en mayor proporción a la aparición de trastornos hipertensivos aumentando el riesgo de morbi-mortalidad materna y neonatal.
ABSTRACT
Objective. To identify maternal complications in adolescent pregnancy from the global context. Methodology. The protocol of the guidelines (PRISMA ScR) and manuals (JBI) was followed, using the Descriptors in Health Sciences and the Boolean computer AND: Complications of pregnancy AND adolescents and free text words, which were inserted in the Dialnet, Pubmed, LILACS and SciELO databases, considering the primary studies of full texts that have investigated maternal complications in adolescent pregnancy, whose methodology used was descriptive (cross-sectional), including retrospective or prospective research, no older than 10 years and adapted to Spanish, English or Portuguese language.Results. A total of 548 primary studies were found, which were selected according to the eligibility criteria, in addition to excluding duplicate studies in the databases. The total number of primary articles selected for the review was 11 studies where the main maternal complications were identified as: hypertensive disorders, anemia, urinary tract infections, abortion, premature rupture of membranes, and antepartum or postpartum hemorrhage. Disicussion. Adolescent gestation predisposes to the development of maternal complications and, to a greater extent, to the appearance of hypertensive disorders, increasing the risk of maternal and neonatal morbidity and mortality.
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