Exploring knowledge and attitudes about emergency contraceptive pills among university students in Jamaica. A qualitative approach

Emergency contraceptive pills (ECPs) are an important option for university students who may be at high risk for unplanned pregnancies. In the Caribbean, little research has been carried out on university student's knowledge and opinions of this method. This study uses qualitative methodology to explore knowledge and opinions on ECPs among university students attending The University of the West Indies (UWI) Mona campus. We conducted eight focus groups (n = 71) with female and male university students at The University of the West Indies, Kingston, Jamaica, in March 2000. The group discussions lasted approximately two hours. We tape-recorded discussions and then transcribed and analyzed them by coding responses according to themes. General knowledge of ECPs was high, but students lacked specific information about the method such as its time frame and its mechanism of action. Most students supported the method, especially after learning correct information. However, several students were concerned about its side effects and the potential for abuse or irresponsible use by young adults. Although the university students in this study lacked detailed information about ECPs, their opinion toward the method was favourable. We suggest further research to investigate the prevalence of misinformation about the method among other groups of Jamaicans

Screening for congenital toxoplasmosis in Brazil.

Toxoplasmosis acquired at the end of the pregnancy can produce ocular and neurological sequelae. The detection of IgM anti-Toxoplasma gondii in dried blood spots of newborns is an important tool for early treatment and prevention. In this study we showed results of a pilot study about the prevalence of congenital toxoplasmosis in Brazil and concluded that this disease should be included in the menu of neonatal screening programs.

Persistent tyrosinemia detected by thin-layer chromatography.

Screening for tyrosinemia is not routinely performed worldwide. Using a low expense thin-layer chromatography (TLC) for amino acids we detected a high frequency of transient tyrosinemia with secondary hyperphenylalaninemia in some newborns. Serum follow up showed the need to introduce adequate therapy in these babies.

Can management strategies alter the course of diabetic nephropathy?

End Stage Renal Disease (ESRD) is a common consequence of diabetic nephropathy (DN). DN is the major cause of death in patients with IDDM, accounting for greater than 40% of deaths with this form of diabetes. There is no clearly documented therapeutic technique that will prevent or reverse progressive renal damage in IDDM. While pancreatic transplantation and "cure" of diabetes in experimental animals may be associated with some histological reversal of renal pathology, this has not been documented in humans. Most studies agree that once diabetic renal disease is present (as documented by proteinuria), progression is inevitable, albeit the rate of progression may be altered by different therapeutic methods. There is considerable hope that "tight metabolic control" will prevent the initial damage that leads to DN and ESRD, but evidence remains inconclusive. There is some evidence that careful monitoring for microalbuminuria will allow for very early detection of damage and alterations in therapy. Our studies have documented a decrease in both morbidity and mortality in IDDM in patients who have been competitive athletes, suggesting that promotion of physical fitness may be a valuable means of delaying progression of renal disease while control of BP delays progression. Early detection and aggressive therapy is recommended. Some studies utilizing diets low in sodium and/or protein appear beneficial but more studies are needed before pediatric application.

Efectos del ayuno y la realimentacion sobre las concentraciones de glucosa, insulina y glucagon en adolescentes obesos. / Effects of fasting and refeeding on concentrations of glucose, insulin and glucagon in obese adolescents

Se estudiaron seis pacientes adolescentes con obesidad grave. Su estancia en el hospital se dividio en cuatro periodos dieteticos de una semana cada uno: dieta normal, ayuno total, realimentacion con 200 calorias y realimentacion con 400 calorias. Se realizo una prueba de tolerancia a la glucosa al principio y otra al final del periodo de hospitalizacion.Al final de cada periodo de variacion dietetica se les practico una prueba de arginina e insulina. Las concentraciones de la glucosa se conservaron sin diferencia en todas las condiciones experimentales cuando se les estimulo con glucosa o con arginina e insulina.Las concentraciones de la insulina plasmatica fueron mayores durante la dieta normal y disminuyeron significativamente durante el periodo de ayuno. La reaccion del glucagon fue mas baja durante la dieta normal que durante el periodo de ayuno. Estas interacciones entre insulina y glucagon permiten conservar la homeostasia de la glucosa. Los cambios observados en estas dos hormonas parecen ser secundarios a las variaciones del estado nutricional