Crisis adrenal neonatal secundaria a hipoplasia hipofisaria / Neonatal Adrenal Crisis Secondary to Pituitary Hypoplasia

Introducción: La insuficiencia adrenal hipotálamo hipofisaria usualmente se manifiesta secundaria a tumores y, cuando resulta congénita se asocia, con frecuencia, con otras deficiencias hormonales. La crisis adrenal suele presentarse en su debut y puede resultar potencialmente mortal. Objetivo: Examinar el caso de una paciente con insuficiencia adrenal central que debutó con una crisis adrenal congénita. Presentación del caso: Recién nacida a término, padres no consanguíneos, hospitalizada a los 9 días de vida por clínica de una semana con múltiples episodios eméticos y apnea. Ingresó con deshidratación severa, hipotensa y estuporosa. Además, se encontró acidosis metabólica severa, hipoglucemia persistente, hiponatremia e insuficiencia prerrenal. Ante la no mejoría de su estado hemodinámico, a pesar del uso de cristaloides y vasopresores, finalmente mejoró con la administración de dosis altas de hidrocortisona. El diagnóstico de deficiencia de cortisol de origen central se realizó con un test dinámico de insulina y la resonancia magnética nuclear hipofisaria. Conclusiones: La crisis adrenal se debe tener presente como diagnóstico diferencial en episodios agudos con inestabilidad hemodinámica persistente e hipoglucemia de difícil manejo. Adicionalmente, hay que considerar que existen otras causas menos comunes de insuficiencia adrenal en neonatos como la hipoplasia hipofisaria(AU)

Introduction: Hypothalamic-pituitary adrenal insufficiency usually manifests secondary to tumors and, when congenital, is often associated with other hormonal deficiencies. Adrenal crisis usually occurs at its onset and can be life threatening. Objective: To review the case of a patient with central adrenal insufficiency who had an onset with a congenital adrenal crisis. Case presentation: Term newborn, non-consanguineous parents, hospitalized at 9 days of life for a week-long clinical presentation with multiple emetic episodes and apnea. She was admitted with severe dehydration, hypotensive and stuporous. In addition, severe metabolic acidosis, persistent hypoglycemia, hyponatremia and prerenal failure were found. Given the lack of improvement of her hemodynamic status, despite the use of crystalloids and vasopressors, she finally improved with the administration of high doses of hydrocortisone. The diagnosis of cortisol deficiency of central origin was made with a dynamic insulin test and pituitary nuclear magnetic resonance imaging. Conclusions: Adrenal crisis should be kept in mind as a differential diagnosis in acute episodes with persistent hemodynamic instability and difficult-to-manage hypoglycemia. Additionally, other less common causes of adrenal insufficiency in neonates, such as pituitary hypoplasia, should be considered(AU)

Association of vitamin d with mild cognitive impairment and alzheimer's dementia in older mexican adults

ABSTRACT Background It has been proposed that Vitamin D helps reduce the accumulation of cerebral β-amyloid-42 by innate immune stimulation and phagocytosis activation. An association between low Vitamin D levels and Alzheimer’s dementia (AD) has been established. We determined the association between Vitamin D, mild cognitive impairment (MCI), and AD in older Mexican adults (> 65 years) Methods Cross-sectional study conducted at the memory clinic in a tertiary-level hospital in Mexico City. We evaluated subjects with MCI, AD, and normal cognition (NC) with available serum Vitamin D [25(OH)D] levels (past 6 months). Three categories were assigned according to 25(OH)D levels: sufficiency (> 30 ng/mL), insufficiency (21-29 ng/mL), and deficiency (≤ 20 ng/mL). Descriptive statistics, means and standard deviations were used. Logistic regression analyses adjusted by age, sex, and educational level were performed Results We evaluated 208 patients. Mean age was 79 ± 1 year, 65% (n = 136) were female; and mean educational level was 6.7 ± 2.3 years. Thirty-one subjects (14%) had NC; 42% (n = 88) had MCI; and 43% (n = 89) had AD. Prevalence of Vitamin D deficiency was 54%, more frequent in the AD group (64%) followed by the MCI (59%) and NC (13%) (p < 0.001) groups. In the multivariate logistic regression analysis, Vitamin D deficiency was associated with MCI (HR 25.02 [confidence interval 95% 4.48-139]; p < 0.001) and AD (HR 41.7 [5.76-301]; p < 0.001) after adjusting for confounders Conclusions Serum Vitamin D deficiency was associated with MCI and dementia; low levels produced a greater effect over executive functions.

Comunicação de notícias difíceis no contexto do cuidado em oncologia: revisão integrativa de literatura / Giving bad news in the context of cancer care: integrative literature review / La comunicación de malas noticias en el contexto del cuidado en oncología: revisión integrativa de la literatura

Objetivo: discutir os achados de publicações, abordando repercussões da comunicação de notícias difíceis aos clientes por enfermeiros atuantes em atenção oncológica. Método: revisão integrativa de literatura analisando publicações indexadas em bancos de dados, no período de 2011 a 2015, abordando as repercussões da comunicação de noticias difíceis aos clientes por enfermeiros atuantes na atenção oncológica. A busca foi realizada no período de maio a setembro de 2015 nas bases LILACS, MEDLINE e BDENF. Foram encontrados 182 artigos, sendo excluídos 156 que não atenderam aos critérios estabelecidos. A amostra final foi composta por 26 artigos. Resultados: após a análise e síntese dos dados registrados, obteve-se as categorias: Dificuldades na comunicação de notícias difíceis; Desenvolvimento de habilidades dessas comunicações; Repercussões dessas notícias; Formação Profissional; Relação enfermeiro-cliente. Conclusão: há necessidade do desenvolvimento de habilidades sociais por parte dos profissionais de saúde para a comunicação de situações difíceis no percurso da doença oncológica.

Objective: to discuss the findings of publications addressing the repercussions of difficult news given to clients by nurses working in cancer care. Method: integrative literature review analyzing publications addressing the repercussions of difficult news given to clients by nurses working in cancer care indexed in databases from 2011 to 2015. The search was performed from May to September 2015 in the LILACS, MEDLINE and BDENF databases. Of the 182 articles found, 156 which did not meet the criteria established were excluded. The final sample consisted of 26 articles. Results: analysis and synthesis of the recorded data obtained the categories: Difficulties in giving difficult news; Developing skills in giving difficult news; Professional training; and Nurse-client relations. Conclusion: there is a need for health personnel to develop social skills for giving news of difficult situations in the course of cancer diseases.

Objetivo: discutir los hallazgos de publicaciones que tratan sobre las repercusiones de comunicación de malas noticias a los clientes por parte de enfermeros que trabajan en atención oncológica. Método: una revisión integrativa de literatura que analiza las publicaciones indexadas en bases de datos, en el período comprendido entre 2011 a 2015, abordando el impacto de la comunicación de malas noticias a los clientes por parte de enfermeros que trabajan en la atención oncológica. La búsqueda se realizó en el período comprendido entre mayo y septiembre de 2015 en las bases LILACS, MEDLINE y BDENF. Se han encontrado 182 artículos, 156 fueron excluidos puesto que no cumplían con los criterios establecidos. La muestra final estuvo compuesta por 26 artículos. Resultados: tras el análisis y síntesis de los datos registrados, se obtuvieron las categorías: dificultades en la comunicación de malas noticias; desarrollo de habilidades en la comunicación de malas noticias; Desarrollo de habilidades para hacer esas comunicaciones; Repercusiones de esas malas noticias; Formación profesional; Relación enfermero-cliente. Conclusión: existe la necesidad de desarrollar habilidades sociales por parte de profesionales de salud para la comunicación de situaciones difíciles en el curso de las enfermedades oncológicas.

The Use of Long Acting Reversible Contraceptives and the Relationship between Discontinuation Rates due to Menopause and to Female and Male Sterilizations / Uso de contraceptivos reversíveis de longa duração e a relação entre taxas de descontinuidade devido à menopausa e à esterilização de homens e mulheres

Abstract Introduction Women require effective contraception until they reach menopause. The long acting reversible contraceptives (LARC) and the depot-medroxyprogesterone acetate (DMPA, Depo-Provera(r), Pfizer, Puurs, Belgium) are great options and can replace possible sterilizations. Purpose To assess the relationship between the use of LARCs and DMPA and terminations ascribed to menopause and sterilizations in a Brazilian clinic. Methods We reviewed the records of women between 12 and 50 years of age attending the clinic that chose to use a LARC method or DMPA. Cumulative termination rates due to sterilization or because the woman had reached menopause were computed using single decrement life-table analysis over 32 years. We also examined all records of surgical sterilization at our hospital between the years 1980-2012. Results Three hundred thirty-two women had continuously used the same contraceptive until menopause, and 555 women had discontinued the method because they or their partners underwent sterilization. From year 20 to year 30 of use, levonorgestrel intrauterine-releasing system (LNG-IUS - Mirena(r), Bayer Oy, Turku, Finland; available since 1980), copper intrauterine device (IUD - available since 1980) and DMPA users showed a trend of cumulative higher discontinuation rates due to menopause when compared with the discontinuation rates due to sterilization. Over the study period, a steep decline in the use of sterilization occurred. Conclusion Over the past 15 years of research we have observed a trend: women usually preferred to continue using LARC methods or DMPA until menopause rather than decide for sterilization, be it their own, or their partners'. The annual number of sterilizations dropped in the same period. The use of LARC methods and DMPA until menopause is an important option to avoid sterilization, which requires a surgical procedure with potential complications.

Resumo Introdução Mulheres necessitam de contracepção até atingirem a menopausa. Os contraceptivos reversíveis de longa duração e o acetato de medroxiprogesterona de depósito (AMPD) são ótimas opções para substituir possíveis esterilizações. Objetivo Avaliar a relação entre o uso de contraceptivos reversíveis de longa duração (LARCs) e AMPD com terminações atribuídas à menopausa e a esterilizações em uma clínica brasileira. Métodos Revisamos os registros de mulheres entre 12 e 50 anos de idade atendidas em clínica e que escolheram usar LARC ou AMPD. Índices de terminação acumulada devido à esterilização ou à menopausa foram computados usando análise de tabela de vida durante 32 anos. Também examinamos todos os registros de cirurgias de esterilização em nosso hospital no período de 1980 a 2012. Resultados Trezentas e trinta e duas mulheres usaram continuamente o mesmo contraceptivo até a menopausa, e 555 mulheres não deram continuidade ao método pelo fato de elas ou seus parceiros terem se submetido à esterilização. De 20 a 30 anos de uso, usuários de sistema intrauterino de levonorgestrel, dispositivo intrauterino de cobre e AMPD apresentaram tendência de maiores índices de descontinuidade devido à menopausa quando comparados a índices de descontinuidade devido à esterilização. No período de estudo, ocorreu um declínio acentuado no uso de esterilização. Conclusão Nos últimos 15 anos do estudo, foi observada uma tendência na qual mulheres optaram mais por continuar usando LARC ou AMPD até a menopausa do que pela esterilização própria ou de seus parceiros. O número anual de esterilizações caiu no mesmo período. O uso de LARC e AMPD até a menopausa é uma opção importante para evitar a esterilização, que exige um procedimento cirúrgico com potenciais complicações.

Pobreza e suas relações com a Psicologia Comunitária na 5a Conferência Internacional de Psicologia Comunitária

O problema da pobreza tem influências psicossociais na vida humana. A Psicologia Comunitária trabalha com esses problemas psicossociais. Então, busca-se com este artigo analisar a presença da temática da pobreza nos trabalhos apresentados na 5ª Conferência Internacional de Psicologia Comunitária (CIPC), que foi realizada em setembro de 2014 em Fortaleza (Ceará/Brasil). O tema da 5ª CIPC foi "Psicologia Comunitária no mundo atual: desafios, limites e práticas" com 1553 inscritos e 726 trabalhos aprovados. A metodologia consiste em analisar a temática da pobreza nos trabalhos aprovados nos cincos eixos temáticos: Políticas Públicas, Acadêmico/Formação, Profissão, Movimentos Sociais e Ética na dimensão planetária e em defesa da vida. As dimensões analisadas foram: concepções de pobreza, dimensõespsicossociais utilizadas e relação da Psicologia Comunitária com a pobreza. Analisa-se que os eixos com mais produções relacionadas à pobreza são Acadêmico/Formação e Políticas Públicas. Entretanto, a maioria dos resumos não apresenta uma definição específica da pobreza. Há também produções com enfoques monetários e multidimensionais. Sobre as dimensões da pobreza, as mais utilizadas foram o apoio social, as potencialidades, o fatalismo, a conscientização, a vergonha, a humilhação e a exclusão social. Sobre as relações da Psicologia Comunitária com a pobreza, grande parte dos resumos utilizam a pobreza somente como caracterização de um contexto, porém também há produções que atuam contra as práticas de opressão relacionadas à pobreza e em uma perspectiva crítica.

The problem of poverty has psychosocial influences on human life. Community Psychology works with psychosocial problems that occur in the lives of people in situations of social vulnerability. Then, this article analyzes the presence of the theme of poverty in the papers presented at the 5th International Conference on Community Psychology (ICCP), held in September 2014 in Fortaleza (Ceará/ Brazil). The theme of the 5th CIPC was "Community Psychology in the current world: Challenges, limits and practices" with 1553 enrolled participants and 726 papers approved. The methodology consists of analyzing the theme of poverty approved in the five themes of the 5th CIPC works: Public Policies, Academic / Training, Occupation, Social Movements and Ethics in planetary dimension and in defense of life. The analyzed dimensions were:poverty concepts, psychosocial dimensions and relationship between Community Psychology and poverty. It is analyzed that the axes with more productions related to poverty are Academic / Training and Public Policy. However, the majority of abstracts do not have a specific definition of poverty. There are also productions with monetary and multidimensional approaches. On poverty dimensions, there were used social support, the potential, the fatalism, the conscientization, the shame, the humiliation and the social exclusion. On the relations between Community Psychology and poverty, the majority of abstracts used poverty only as characterizing a context, but there are also productions that act against oppression practices related to poverty and a critical perspective.

Frecuencia de grupos sanguíneos ABO y Rh en donantes del banco de sangre del Hospital Pablo Tobón Uribe, entre 2000 y 2009, 50 años después del primer trabajo realizado en Medellín / Frequency of ABO and Rh blood group in blood bank donors of Hospital Pablo Tobon Uribe between 2000 and 2009, 50 years after the first report in Medellin

En 1964 se publicó en la revista Antioquia Médica el primer trabajo original sobre la frecuencia de grupos sanguíneos en Medellín, dirigido por el Dr. Alberto Restrepo Mesa, uno de los pioneros de la Hematología en Colombia; posteriormente se realizaron dos importantes trabajos en los años 1999 y 2006, sin embargo, no se cuenta con reportes actuales. Objetivo: Establecer la frecuencia de los grupos sanguíneos en Medellín y el Valle de Aburrá, después de 50 años de publicada la primera investigación. Metodología: Se realizó un estudio observacional descriptivo con una muestra de 87.000 personas adultas, de ambos sexos, sin discriminación racial, que donaron hemoderivados en el banco de sangre del Hospital Pablo Tobón Uribe de la ciudad de Medellín (Colombia), entre 2000 y 2009, y se calculó la frecuencia de los grupos sanguíneos ABO y Rh...

At 1964, Antioquia Medica journal published the first original work of blood type frequencies in Medellin led by Dr. Alberto Restrepo Mesa, one of Hematology pioneers in Colombia; later there have been two important investigations in 1999 and 2006, however, there are not current reports. Objective: Establish the blood type frequencies in Medellin and the Valle de Aburrá after 50 years of the first published investigation. Methods: An observational descriptive study was made, with a sample of 87.000 adult people of both sexes, without racial discrimination, who donated blood at the Hospital Pablo Tobón Uribe blood bank of Medellin (Colombia) between 2000 and 2009; and frequency of ABO and Rh blood groups was calculated...

Brote de fiebre de Oropuche en dos localidades de la región Cajamarca, Perú, 2011 / Oropuche fever outbreak in two villages of the region Cajamarca, Peru, 2011

La fiebre de Oropuche es una arbovirosis transmitida por especies de Culicoides, tiene un ciclo selvático y otro urbano, comparte las mismas características clínicas con el dengue, pero con escaso compromiso cutáneo y mayor tendencia a la recurrencia. Desde su primer aislamiento en humanos hasta el año 2011 se han reportado más de 30 brotes epidémicos y por lo menos 500 000 personas infectadas. Objetivo: Describir un brote de fiebre de Oropuche en la región Cajamarca en el año 2011. Métodos: Estudio transversal. El ámbito geográfico del brote es eminentemente rural, su población muestra un fluido intercambio migratorio con zonas endémicas de dengue. La investigación se inició luego de detectar el incremento de pacientes febriles a través de la vigilancia sindrómica, se realizaron búsquedas activas institucional y comunitaria mediante las definiciones de caso sospechoso y probable de la directiva sanitaria de dengue. Resultados: Se investigaron un total de 33 pacientes que cumplieron la definición de caso probable de dengue, todos con evolución favorable, 31 casos fueron autóctonos. El laboratorio del Instituto Nacional de Salud (INS) confirmó, por primera vez en la provincia de Cutervo de la región Cajamarca, la presencia de anticuerpos para el virus de Oropuche en 17 muestras de las 26 enviadas. El manejo inicial del brote fue orientado según el contexto clínico y epidemiológico para dengue, lo cual generó demoras en el periodo de confirmación diagnóstica y por ende en la implementación de las medidas de intervención. Conclusiones: La fiebre de Oropuche es uno de los diagnósticos diferenciales de dengue, en tal sentido, los sistemas de vigilancia y la red de laboratorios del país deben ser fortalecidos en su detección temprana y control.

Oropuche fever is an arbovirus transmitted by Culicoides species. It has a jungle and an urban cycle, and shares the same clinical features with dengue, but with limited cutaneous involvement and a greater tendency to recur. Since its first isolation in humans until 2011, more than 30 outbreaks have been reported and at least 500 000 people infected. Objective: To describe an outbreak of Oropuche fever in Cajamarca region in 2011. Methods: Cross-sectional study. The geographical scope of the outbreak was largely rural. The population shows a fluid migration exchanges with dengue endemic areas. The investigation began after detecting an increase of febrile patients by syndromic surveillance. An institutional and community active search of suspect and probable cases of dengue according to health directives was performed. Results:We investigated a total of 33 patients who met the definition for a probable case of dengue, all with favorable course, 31 cases were autochthonous. The laboratory of the National Institute of Health (NIH) confirmed for the first time in the province of Cutervo, Cajamarca region, the presence of antibodies to the virus Oropuche in 17 of 26 samples. Initial management of the outbreak was oriented along the clinical and epidemiological context for dengue, which caused delays in the diagnostic confirmation period and therefore in the implementation of intervention measures. Conclusions: Oropuche fever is one of the differential diagnosis of dengue, as such, surveillance systems and laboratory network in the country should be strengthened in early detection and control.

Incremento de la temperatura ambiental y su posible asociación al suicidio en Baja California Sur (BCS) 1985-2008 / Environmental temperature increase and its possible association with suicide in the population of Baja California Sur (BCS) 1985-2008

Introduction During the last decade we have observed important climate changes, especially in environmental temperatures. There is considerable information linking the increase in hot weather and human health. For example, hot weather is associated with an increased risk of suicide in different countries around the world. Objective To evaluate the relationship between suicide rates and the environmental temperature in Baja California Sur, Mexico, from 1985 to 2008. Method Suicide mortality data for Baja California Sur (BCS) were obtained for the years 1985-2008 from the Instituto Nacional de Estadística, Geografía e Informática (INEGI). The selected codes were: E950-E959 (ICD-9) and X60-X84, Y87.0 (ICD-10) for BCS. The BCS weather data used was the maximum temperature from 1985 to 2008, obtained from the Extractor Rápido de Información Climatológica (ERIC III). Lineal and quadratic models were used to assess the annual rate changes of suicide and generalized lineal models (GLM) to assess the effect of the climatological variables to the suicide rate. The p≤0.05 was considered significant. Results In BCS, 582 suicide deaths were reported from 1985 to 2008. The 9% (53) of the total reported were women with a yearly average rate 1.6/100 000; 91% (529) were men with a yearly average rate 16.3/100 000. Lineal and quadratic models explained the tendency of the annual increment observed in the number of suicides in both seasons. The quadratic model better explained such increment during the warmer months (R²=0.64 p<0.01). The temperature was positively correlated with the rate of suicides in both seasons (p<0.01). Two predictive GLMs were created by season. Discussion These results suggest a potential link between an increase in environmental temperature and the rates of suicide during 24 years in BCS. This relationship is clear during the hot season; however, a positive trend was found during the cold season, perhaps due to the result of warmer winters.

Introducción Durante las últimas décadas se ha podido apreciar un cambio en las variables climáticas, en especial en la temperatura ambiental. Hay evidencias que asocian el aumento de la temperatura ambiental con el incremento en las tasas de mortalidad por suicidio. Objetivo Evaluar la relación entre la tasa de suicidio y la temperatura ambiental en Baja California Sur (BCS) durante los años 1985-2008. Método Los datos de suicidio fueron obtenidos de las bases de Mortalidad del INEGI de 1985-2008. Se tabularon los registros con códigos: E950-E959 CIE-9 y X60-X84, Y87.0 CIE-10 para BCS. En el análisis climático se usaron las temperaturas máximas de 1985 al 2008 para BCS del Extractor Rápido de Información Climatológica (ERIC III). Para evaluar la tendencia, se utilizaron modelos de regresión lineal y cuadráticos. Los modelos lineales generalizados (GLM) se utilizaron para evaluar el efecto de las variables ambientales sobre la tasa de suicidios, con una significancia de p≤0.05. Resultados Un total de 582 suicidios ocurrieron en BCS de 1985 a 2008. Las mujeres representaron el 9% (53), con tasa anual promedio de 1.6/100 000. Los hombres 91% (529), con tasa promedio anual de 16.3/100 000. La tendencia de incremento anual se explicó con modelos lineales simples y cuadráticos en ambas temporadas. En los meses cálidos el modelo cuadrático explicó mejor dicho incremento (R²=0.64 p<0.01). La temperatura se correlacionó positivamente con la tasa en ambas temporadas (p<0.01). Se generaron dos modelos GLM predictivos por temporada. Discusión En este trabajo se observó una posible relación entre el incremento de la temperatura ambiental y el número de suicidios registrados durante 24 años en BCS. Esta relación se encuentra bien definida en los meses cálidos, pero con una tendencia en aumento para los meses fríos.

Tele-asistencia y tele-alarma para adultos mayores: experiencias preliminares en Mexico / Tele-care and tele-alarms for the elderly: preliminary experiences in Mexico

OBJETIVO Analizar el efecto de un programa piloto de tele-asistencia y tele-alarma en la autopercepción del estado de salud de los adultos mayores y conocer la satisfacción y aceptación del programa. METODOS Estudio transversal que incluyó entrevistas a 378 adultos mayores, 294 cuidadores/familiares y 53 profesionales de la salud, realizado en la Ciudad de México en 2010. Variables sociodemográficas, de autopercepción del estado de salud, satisfacción y aceptación del programa se obtuvieron por medio de cuestionario estandarizado. Se realizó análisis descriptivo y se utilizaron pruebas no paramétricas. RESULTADOS Se observaron efectos significativos en la autopercepción del estado de salud, 6,17 (DE 17,9 p < 0,05) puntos por encima de la media. El programa tuvo una buena aceptación por parte de los adultos mayores, de sus cuidadores familiares y de los profesionales de la salud. CONCLUSIONES El programa contribuye a mantener o mejorar la calidad de vida, permite la atención preventiva y es un medio ideal para dar apoyo psicosocial a los adultos mayores. .

OBJECTIVE : To analyze the effect of a pilot program of tele-assistance and tele-alarms on the elderly’s self-perception of health status and to identify the satisfaction with and acceptance of the program. METHODS : Cross-sectional study that included interviews with 378 elderly individuals, 294 caretakers/relatives and 53 health care professionals. The program was run in Mexico City in 2010. The variables were socio-demographic characteristics, self-rated health, satisfaction and acceptance of the program. The information was gathered through a standardized questionnaire. The statistical analysis included descriptive analysis and nonparametric tests. RESULTS : Significant effects on self-perception of health were observed, 6.17 (SD 17.9 p < 0.05) points above the average. The program was well received and accepted by the elderly, family caregivers and health professionals. CONCLUSIONS : The program helps to maintain or improve quality of life, allows preventive care and is an ideal means of providing psychosocial support to the elderly. .

Necesidades de atención social a la salud de los niños y adolescentes con VIH-SIDA: perspectivas del Hospital Infantil de México Federico Gómez / Social care needs to the health of child and adolescents with HIV-AIDS: perspectives of the Hospital Infantil de Mexico Federico Gomez

Introducción. Objetivo: analizar las necesidades de atención social a la salud de pacientes atendidos en la Clínica para niños con Inmunodeficiencias/VIH-SIDA del Hospital Infantil de México Federico Gómez. Métodos. En el año 2008 se condujo un estudio transversal con niños y adolescentes usuarios de la clínica para niños con inmunodeficiencias. Se analizó la información demográfica, familiar y económica contenida en los expedientes sociales. Resultados. Se analizaron 177 pacientes: 25% menores de 5 años de edad, 48% tenían entre 5 y 10 años, 13% de 10 a 15 años y 13% mayores de 15 años; 53% recibía cuidado parental, 28% por familiares cercanos y 17.5% estaba en albergues. La escolaridad se observó por debajo del promedio esperado; 70% de los padres (madre, padre o ambos) tenía VIH-SIDA. El ingreso promedio mensual de 87.8% de las familias fue de $2 644.00 MN; del cual, 62% se destinaba para gastos de alimentación y 9% para servicios médicos. Los ingresos provenían del mercado informal. Todos los pacientes recibían los medicamentos gratuitamente a través del Sistema de Protección Social en Salud (Seguro Popular). Conclusión. Los pacientes y sus familias tenían severas condiciones de vulnerabilidad social y escasa posibilidad para desarrollar competencias educativas y laborales. Por lo que es indispensable incrementar la capacidad institucional de la Clínica de Inmunodeficiencia/VIH-SIDA para otorgar atención social.

Introduction. We undertook this study in order to analyze the social care needs of users of the Immunodeficiency/HIV clinic of Hospital Infantil de Mexico Federico Gomez in Mexico City. Methods. A cross-sectional study was conducted with chil-dren and adolescents attending the clinic. Demographic, family and economic information were analyzed from the clinical files. Results. Included in the study were 177 patients: 25% were <5 years of age, 48% between 5 and 10 years, 13% between 10 and 15 years and 13% >15 years. Their educational level was below the expected average. Of these children, 53% are cared for by their parents, 28% by close relatives and 17% reside in shelters; 70% of parents suffer from HIV-AIDS and 87% of families have a monthly average income of MXN$2 644.00, from which 62% is allocated for food and 9% for medical care. Most of the "breadwinners" are marginally employed. All patients receive free medication covered by the Sistema de Protección Social en Salud. Conclusion. Children and adolescents with AIDS and their families have severe conditions of social vulnerability and little possibility for developing their educational and occupational capabilities. Expanding the capacity of the Immunodeficiency/ HIV clinic to provide social care will fulfill an unmet need.

Percepcao de mudancas fisicas e psiquicas durante o ciclo menstrual em relacao ao dia ovulatorio / Perception of physical and psychological changes during the menstrual cycle in relation to the ovulatory day

Ha uma importante parcela da populacao que opta pela abstinencia periodica para evitar a gravidez. Muitos outros casais gostariam de usar este metodo se pudessem identificar com maior certeza o periodo infertil. Com o objetivo de pesquisar que sinais e sintomas poderiam estar influenciados pelas mudancas fisiologicas que acometem durante o ciclo menstrual, foram estudadas 35 mulheres durante tres ciclos consecutivos, tentando relacionar as mudancas fisicas ou psicologicas que experimentaram durante esse periodo com pico de LH...