Frecuencia de consumo inadecuado de vitamina B12 y sus niveles séricos en personas con diabetes mellitus tipo 2 tratadas con metformina en centros de salud de la Provincia de Buenos Aires / Frequency of inadequate consumption of vitamin B12 and its serum levels in people with diabetes mellitus type 2 under metformin treatment in health centers of the Province of Buenos Aires

Introducción: el uso prolongado de metformina y la carencia de consumo de vitamina B12 (B12) pueden provocar su déficit en pacientes con diabetes mellitus tipo 2 (DM2). Objetivos: analizar la frecuencia de consumo insuficiente de B12 según: características personales, datos antropométricos, de laboratorio y uso de metformina; asociar niveles séricos de cobalamina con dosis y tiempo de metformina; establecer la relación entre la ingesta de B12 y los niveles séricos. Materiales y métodos: diseño transversal. Mediante encuesta de frecuencia de consumo de alimentos fuente de B12 en 200 pacientes tratados con metformina por más de 18 meses. Se analizaron datos clínicos, antropométricos, de laboratorio, tiempo y dosis de metformina, en dos centros de salud de la Provincia de Buenos Aires. Resultados: el porcentual de consumo deficiente fue del 29%. Se registró un 47,5% de desocupación que alcanzó un déficit de ingesta del 32,6%. Se midió B12 sérica en el 65% de la muestra y un 53,8% de los valores fue anormal (0,8% en niveles deficientes o bajos y 23% en niveles normal-bajo), observándose asociación significativa a dosis de metformina ≥1.500 mg. Las deficiencias de consumos de B12 (<2,4 µg/día) fueron casi cuatro veces mayores en el grupo con menor recuento eritrocítico (76,9 % vs 18,5%; p<0,00 ). El volumen corpuscular medio (VCM) y el recuento de plaquetas arrojaron datos estadísticamente significativos. Conclusiones: si bien el 29% de la muestra exhibió consumo vitamínico deficiente, el 90% de los pacientes con déficit sérico registró ingestas adecuadas de B12. Dado que se trató de un diseño transversal, donde no pudo evaluarse causalidad, en pacientes intervenidos farmacológicamente con metformina se sugiere considerar su impacto en situaciones deficitarias.

Introduction: the prolonged use of metformin and the lack of consumption of vitamin B12 can cause its deficit, in T2D. Objectives: to analyze the frequency of insufficient consumption of vitamin B12 according to: personal characteristics, anthropometric and laboratory data, and use of metformin; associate serum cobalamin levels with metformin dose and time; establish a relationship between B12 intake and serum levels. Materials and methods: cross-sectional design. Through a survey of the frequency of consumption of food sources of B12 in 200 patients treated with metformin for more than 18 months. Clinical, anthropometric, laboratory data, time and dose of metformin were analyzed in 2 health centers in the Province of Buenos Aires. Results: the percentage of deficient consumption was 29%. 47.5% of unemployment was registered, which reached an intake deficit of 32.6%. Serum B12 was measured in 65% of the sample where 53.8% of values were abnormal (0.8% in deficient levels) and 23% at levels normal lower cut-off point, with a significant association being observed at doses of metformin ≥1,500 mg. Deficiencies in B12 intake (<2.4 µg/day) were almost 4 times higher in the group with the lowest erythrocyte count (76.9% vs 18.5%; p<0.00 ). The MCV and platelet count yielded statistically significant data. Conclusions: although 29% of the sample exhibited poor vitamin intake, 90% of patients with serum deficiency had adequate intakes of vitamin B12. Given that it is a cross-sectional design, where causality cannot be evaluated, it is suggested: in patients undergoing pharmacological intervention with metformin, consider the impact of this in deficient situations.

Conocimientos y prácticas actuales sobre cáncer de mama, preservación de la fertilidad y embarazo. Encuesta a los miembros de la Sociedad Argentina de Mastología / Knowledge and current practices on breast cancer, fertility preservation and pregnancy. Survey to the members of the Argentine Society of Mastology

Introducción: debido al retraso de la maternidad, es probable que las mujeres jóvenes con diagnóstico de cáncer de mama (CM) no hayan completado su proyecto de maternidad al momento del diagnóstico y estén interesadas en su fertilidad futura y podrían enfrentarse también a un cáncer de mama asociado al embarazo. El objetivo del trabajo fue analizar la práctica actual, de los miembros de la Sociedad Argentina de Mastología (SAM), sobre preservación de la fertilidad y embarazo. Material y método: se realizó una encuesta por correo electrónico. Respondieron 213 miembros. Resultados: la frecuencia con la que abordan el impacto del tratamiento oncológico en la fertilidad de las pacientes jóvenes y las derivan, fue "siempre" y "casi siempre" en 84,4% y 74,5% respectivamente. El 73,6% afirmó que el embarazo luego del CM no empeora el pronóstico. El 70,1% consideró seguro el uso de radiocoloides para identificar el ganglio centinela durante el embarazo. Encontramos una diferencia significativa en las respuestas de los profesionales pertenecientes a una UM. Conclusiones: el nivel de conocimiento es similar al de otras encuestas. La pertenencia a una unidad de mastología se asoció a un mejor nivel de actualización. Es necesario seguir trabajando en la capacitación de los profesionales.

Introduction: due to delayed motherhood, Young women diagnosed with breast cancer (BC) are likely to have not competed their maternity Project at the time of diagnosis, are interested in future fertility and may also face pregnancy-associated breast cancer. The aim of this study was to analyze the current practice of the Argentine Society of Mastology (SAM) members, on fertility preservation and pregnancy. Material and method: an email survery was conducted 231 members responded. Results: the frequency with which respondentes discuss the impact of cancer treatment of fertility among Young patients and referral was "always" and "almost always", 84.4% and 74.5% respectively. 73.6% considered pregnancy after BC does not worsen the prognosis. 70.1% used radiocoloids to identify sentinel node during pregnancy. We found a significant difference in the responses of professionals belonging to a Breast Unit. Conclusions: the level of knowledge is similar to that of other surverys. Working within a Breast Unit was associated with a better level of knowledge. Further work is needed in the training of professionals.

Prevalence of Hospital infection / 中华医院感染学杂志

OBJECTIVE To investigate the infection condition and associated causative factors in our hospital in order to improve the methods of monitoring,preventing and controlling infection.METHODS All patients admitted in 24 hours were investigated.including record review and patient examination.Participants mainly consisted of the specialized staff,with assistant administrative staff for hospital infection.The investigating table was filled for record review and patient examination respectively.Statistical analysis was performed.RESULTS 119 of the 123 hospitalized patients were investigated(96.8%).The current rate for hospital infection was 6.7%.The most infected site was respiratory tract.Antibiotics was used in 39.5% of the patients.CONCLUSIONS The current method can be used for investigating the present state of hospital infection.Based on the investigation,objective monitoring,intensified specimens detection,and reasonable antibiotics administration can be performed to decrease the incidence of hospital infection.

On the pathophysiological teaching reform from a survey analysis of graduates / 中华医学教育探索杂志

To direct teaching reform of pathophysiology and match the demands of the new situation,a questionnaire survey was performed among graduates from 2002 to 2007.According to the analysis,teaching quality has been examined,and moreover,the deficiency in the process was also found.With the feedback and assessment for knowledge abilities,professional skills,scientific research,mental qualities,humanity qualities,the levels of pathophysiology course and teacher's performance,an important reference has been provided for the further teaching reform.

Surrery about modern medical model of medical staff at the grass-roots hospitals in shanghai / 中国医学伦理学

Medical staff's recognization of medical model will make important influence to the whole medical undertakings. The anthor has survevyed some medical staff who are from two triple hospitals,six second hospitals and eight grass-roos hospitals in Shanghai district, about modern medical model.Through analynzing and discussing,the anthor proposed some positive countermeasures to improve medical staff's conciouness of modern medical medel and adapt to its tranformation.