Median nerve compression at elbow level by a proximal cubital artery pseudoaneurysm: a case report

We describe the case of an 82-year-old man who had recently undergone cardiac surgery (quadruple coronary bypass), who consulted due to the appearance of a necrotic eschar on the thumb of the right index finger, together with paraesthesia and hypoaesthesia in the first 3 fingers of the same hand. An ultrasound scan of the right elbow was performed to rule out involvement of the median nerve and an anechoic, thick-walled mass was found, dependent on the wall of the proximal ulnar artery, compatible with a pseudoaneurysm of the same, compressing the nerve. Electromyography showed an acute lesion of the proximal median nerve and angio-CT confirmed the diagnosis of pseudoaneurysm of the proximal ulnar artery. Pseudoaneurysm is a dilatation by rupture of the arterial wall, which does not involve all three layers of the arterial wall and communicates with the vascular lumen. Its development after vascular manipulation is very rare, and it is uncommon for it to act by compressing a nerve structure. In our case, together with vascular surgery, treatment with intralesional thrombin was decided, with good evolution.

Se describe el caso de un varón de 82 arios intervenido recientemente de cirugía cardíaca (cuádruple bypass coronario), que consulta por aparición de una escara necrótica en el pulpejo del dedo índice derecho, junto a parestesias e hipoestesias en los tres primeros dedos de dicha mano. Se realiza una ecografía del codo derecho para descartar afectación del nervio mediano y se objetiva una masa anecoica, de paredes engrosadas, dependientes de la pared de la arteria cubital proximal, compatible con pseudoaneurisma de esta, que comprime dicho nervio. En la electromiografía se evidencia una lesión aguda del nervio mediano a nivel proximal y en el angio-TC se confirma el diagnóstico de pseudoaneurisma de la arteria cubital proximal. El pseudoaneurisma es una dilatación por rotura de la pared arterial, que no implica a las tres capas de esta y se comunica con la luz vascular. Su desarrollo tras una manipulación vascular es muy infrecuente y que actúe comprimiendo una estructura nerviosa es poco común. En nuestro caso, conjuntamente con cirugía vascular se decidió tratamiento con trombina intralesional, con buena evolución.

Dieta de la rana de hojarasca Craugastor rhodopis (Anura: Craugastoridae): una especie abundante en la región montañosa del este de México / Diet of the leaf litter frog Craugastor rhodopis (Anura: Craugastoridae): an abundant species in the mountainous region of the east Mexico

Resumen La composición de la dieta en anfibios puede ser influenciada por diversos factores que causan su variación intraespecífica, como pueden ser la distribución geográfica, ontogenia, estacionalidad, y el sexo de los organismos. El objetivo de este estudio fue analizar la composición de la dieta en adultos de la Craugastor rhodopis (rana hojarasquera común) en la región montañosa del centro de Veracruz, México. Un total de 77 individuos adultos fueron colectados durante la época de lluvias de 2012, de los cuales 66 tuvieron contenido estomacal. Se realizó un análisis de la variación intersexual en la diversidad de la dieta, y el volumen, número de presas, y número de categorías de presa consumidas. La dieta de C. rhodopis estuvo compuesta por 20 categorías, de las cuales predominó Orthoptera en cuanto a número, volumen, frecuencia de ocurrencia e importancia relativa. Los machos consumieron presas de menor tamaño en relación a las hembras. Aunque ambos sexos consumieron similar número de presas, se encontró un efecto significativo de la interacción del sexo y el tamaño de las ranas sobre esta variable de la dieta, en la cual las hembras pequeñas consumen más presas que las grandes, y los machos grandes consumen más presas que los pequeños. El alto consumo de ortópteros (al menos en cuanto a volumen) es un fenómeno común dentro de la familia Craugastoridae y posiblemente está relacionado con el éxito de algunas especies en los ecosistemas donde habitan. A pesar de que la composición de la dieta fue similar entre sexos en C. rhodopis, se sugiere que la competencia intersexual por los recursos tróficos es mínima, dadas las diferencias en el tamaño de presas consumidas por machos y hembras.(AU)

Abstract Dietary composition in amphibians may be influenced by several factors that cause their intraspecific variation, such as geographic distribution, ontogeny, seasonality, and sex of organisms. The objective of this study was to analyze the composition of the diet in adults of the Polymorphic Robber Frog Craugastor rhodopis in the mountainous region of central Veracruz, Mexico. A total of 77 adult individuals were collected during the rainy season of 2012, of which 66 had stomach contents. We performed an analysis of the intersexual variation in diet diversity, volume, number of prey, and number of prey categories consumed. The diet of C. rhodopis was composed by 20 categories. Orthoptera predominated in terms of number, volume, frequency of occurrence, and relative importance. Males consumed smaller prey items relative to females. Although both sexes consumed similar numbers of prey, we found a significant effect of interaction of sex and size of frogs on this variable, with small females consuming more prey than the large ones, whereas in males the opposite occurred. High consumption of orthopterans (at least in volume) is a common phenomenon within Craugastoridae and is possibly related to the success of some species in the ecosystems where they live. Although the composition of the diet was similar between sexes in C. rhodopis, we suggest that intersexual competition for trophic resources is minimal, given differences in prey size consumed by males and females.(AU)

Retrospective analysis of skin complications related to bone-anchored hearing aid implant: association with surgical technique, quality of life, and audiological benefit / Análise retrospectiva de complicações cutâneas relacionadas ao implante de prótese auditiva óssea: associação com técnica cirúrgica, qualidade de vida e benefício audiológico

Abstract Introduction: The bone-anchored hearing aid is an effective form of auditory rehabilitation. Due to the nature of the implant, the most common complications are skin related. A number of alternative surgical implantation techniques have been used to reduce the frequency and severity of skin complications, including the U-shaped graft and the linear incision. Objective: To assess skin complications and their association with surgical technique, quality of life, and audiological benefit in patients with bone-anchored hearing aids. Methods: This was a retrospective study conducted in a tertiary referral center in Bogotá, Colombia. Patients who had been fitted with a bone-anchored hearing aid implant (unilaterally or bilaterally) for at least 6 months were included in the study. The Holgers classification was used to classify skin complications (Grade 0 = none; Grade 1 = erythema; Grade 2 = erythema and discharge; Grade 3 = granulation tissue; and Grade 4 = inflammation/infection resulting in the removal of the abutment). The Glasgow Benefit Inventory questionnaire was used to determine quality of life, and the Abbreviated Profile of Hearing Aid Benefit questionnaire was used to determine the subjective audiological benefit. Results: A total of 37 patients were included in the study (30 with unilateral implants and 7 with bilateral implant). Of the 44 implants evaluated, 31 (70.3%) were associated with skin complications (7 [15.9%] Grade 1; 4 [9.1%] Grade 2; 15 [34.1%] Grade 3, 5 [11.4%] Grade 4). The U-shaped graft was statistically associated with major complications (Grades 3 and 4) compared with the linear incision technique (p = 0.045). No statistically significant differences were found between Abbreviated Profile of Hearing Aid Benefit scores and severity of complications. Similarly, no differences were found between Glasgow Benefit Inventory physical health questions and skin complications. Conclusion: Despite the high frequency, skin complications did not seem to affect quality of life or subjective audiological benefits of patients with bone-anchored hearing aids.

Resumo Introdução: A prótese auditiva óssea (BAHA, do inglês Bone-Anchored Hearing Aid) é uma forma eficaz de reabilitação auditiva. Devido à natureza do implante, as complicações mais comuns são relacionadas à pele. Várias técnicas opcionais de implantação cirúrgica têm sido usadas para reduzir a frequência e a gravidade das complicações cutâneas, inclusive o enxerto em forma de U e a incisão linear. Objetivo: Avaliar as complicações cutâneas e sua associação com a técnica cirúrgica, qualidade de vida e benefício audiológico em pacientes com BAHAs. Método: Estudo retrospectivo feito em um centro terciário de referência em Bogotá, Colômbia. Os pacientes que receberam um implante de BAHA (unilateral ou bilateralmente) durante pelo menos seis meses foram incluídos no estudo. A classificação de Holgers foi usada para classificar as complicações cutâneas (Grau 0 = nenhuma, Grau 1 = eritema, Grau 2 = eritema e secreção, Grau 3 = tecido de granulação e Grau 4 = inflamação/infecção, resultou na remoção da estrutura de apoio). O questionário Glasgow Benefit Inventory (GBI) foi usado para determinar a qualidade de vida e o questionário Abbreviated Profile of Hearing Aid Benefit (APHAB) foi usado para determinar o benefício audiológico subjetivo. Resultados: Foram incluídos 37 pacientes (30 com implantes unilaterais e sete com implantes bilaterais). Dos 44 implantes avaliados, 31 (70,3%) foram associados às complicações cutâneas (sete [15,9%] Grau 1; quatro [9,1%] Grau 2; 15 [34,1%] Grau 3 e cinco [11,4%] Grau 4). O enxerto em forma de U foi estatisticamente associado a complicações maiores (Graus 3 e 4) em comparação com a técnica de incisão linear (p = 0,045). Não foram encontradas diferenças estatisticamente significativas entre os escores APHAB e gravidade das complicações. Do mesmo modo, não foram encontradas diferenças entre as questões de saúde física pelo questionário GBI e complicações cutâneas. Conclusão: Apesar da alta frequência, as complicações cutâneas não parecem afetar a qualidade de vida ou os benefícios audiológicos subjetivos de pacientes com BAHAs.

El abuso psicológico al niño en la familia / The psychological abuse of children in the family

Resumen En muchas familias, los padres o cuidadores de los niños emplean, para controlar el comportamiento de éstos, medidas agresivas que vulneran sus derechos, entre ellas el abuso psicológico (AP). El AP consiste en actos no accidentales, verbales o simbólicos, realizados por un progenitor o cuidador de un niño que provocan o generan una probabilidad razonable de causarle daño psicológico. El AP ha recibido también nombres como maltrato emocional, maltrato psicológico, abuso verbal, entre otros, y generalmente su registro ha sido deficiente. También ha sido difícil determinar su epidemiología por la falta de consenso sobre su definición y porque se ha subestimado su impacto sobre la salud mental de las víctimas. Sin embargo, sus consecuencias psicosociales son tan nocivas o más que las producidas por otras formas de maltrato (físico, sexual, negligencia), a las que habitualmente acompaña. En esta revisión sobre diferentes aspectos del AP, se plantea la necesidad de que todos los clínicos de la salud, y no solamente los dedicados a la salud mental, investiguen las técnicas que padres y cuidadores emplean en la crianza de los menores, traten de modificar aquellas que constituyen ejemplos de AP o de otro tipo y, de ser necesario, refieran a los profesionales de la salud mental los casos que así lo requieran.

Abstract It is still not unusual that the parents or caregivers of children in many families use violent measures to control the behavior of their offspring, even when these measures violate human rights. The psychological abuse involves non-accidental actions, either verbal or symbolic, by a parent or guardian that in all likelihood may cause psychological harm to the child. Other names for psychological abuse are: emotional maltreatment, psychological maltreatment, emotional abuse and verbal abuse. Its epidemiology has been difficult to determine because of the lack of consensus on its definition and because its impact on the mental health of the victims has been underestimated. However, the psychosocial consequences of psychological abuse are as damaging, or even more harmful, that the consequences of other types of abuse (such as physical, sexual or neglect). It is important for physicians and other clinicians to keep an eye on the occurrence of psychological abuse, to teach parents functional rearing technics and refer families to psychological treatment if necessary.

Trastorno por déficit de atención con hiperactividad: un problema de salud pública / Attention deficit hyperactivity disorder: A public health problem

Resumen El trastorno por déficit de atención con hiperactividad (TDAH) es el síndrome neuroconductual más común en la niñez y puede continuar al través de la adolescencia y la edad adulta. Los síntomas incluyen: dificultad para mantener la atención, hiperactividad y dificultad para controlar la conducta. Su prevalencia es de 5% en la niñez y de 2.5% en la edad adulta. Quienes lo padecen suelen llegar a sufrir, más que quienes no lo experimentan, adversidades de diversos tipos en el área de la salud mental: deficientes logros académicos y ocupacionales, abuso de sustancias, problemas legales, lesiones accidentales, pobres elecciones sobre la salud personal, paternidad precoz, problemas de conducta, ansiedad, depresión, divorcio, conducta suicida, etc. Los profesionales mejor capacitados para diagnosticar el TDAH son psiquiatras y neurólogos, sobre todo los especializados en el estudio de los menores. El tratamiento que ha mostrado mayor efectividad en casos de mediana y gran gravedad es el empleo de medicamentos (estimulantes y atomoxetina en primer término), con mejores resultados cuando se combina con medidas psicosociales. Por su elevada prevalencia y su impacto a largo plazo se requiere de un enfoque de salud pública en la identificación y tratamiento del TDAH. Dado el número limitado de profesionales de la salud mental en nuestro país, es conveniente que médicos del primer nivel mejoren sus habilidades para diagnosticar y tratar el TDAH.

Abstract Attention-deficit hyperactivity disorder (ADHD) is the most common neurobehavioral childhood syndrome and it may continue throughout adolescence and adulthood. Symptoms include difficulty to maintain attention, hyperactivity and difficulty to control behavior. Its prevalence is 5% in childhood and 2.5% in adulthood. Affected individuals suffer, more than those not affected, from multiple mental problems like deficient academic and occupational performance, substance abuse, legal problems, accidental injuries, poor health choices, precocious paternity, divorce, behavioral problems, anxiety, depression, suicidal conduct, etc. The medical professionals best qualified to diagnose ADHD are psychiatrists and neurologists, especially those specialized in children. The treatment approach that has shown to be more effective in cases of medium to high severity is drug prescription (stimulants or atomoxetine as a first choice), with best results when this is accompanied by psychosocial treatment. Due to its high prevalence and the long-term impact of having this disorder, the identification and treatment of ADHD requires a public health approach. The limited number of mental health professionals and resources in our country makes it of paramount importance that primary care providers improve their ability to asses and treat ADHD.

Estudio piloto de la prueba de percepción musical camp en implantados y normoyentes / Clinical assesment of the music perception test camp in implant users and normal- hearing subjects: a pilot study

En la búsqueda de una prueba de percepción musical estandarizada y aplicable en español, se evaluó el CAMP test creado en inglés por la Universidad de Washington para implantados y normoyentes. Objetivo: determinar las dificultades de su aplicación cuando el idioma nativo es español. Método: estudio de corte transversal con tres pruebas de percepción musical: umbral de tonos, percepción de melodías y timbre musical. Para correr el programa se tradujeron al español los comandos. Conclusión: la prueba CAMP de percepción musical resulta útil fácil de aplicar en normoyentes y usuarios de implante coclear cuyo idioma nativo sea español, cuando se dispone de cartillas con traducción de los comandos.

The CAMP test, created by the University of Washington for English-speaking implant users and normal-hearing subjects was evaluated in the search to provide a standardized music perception assessment for Spanish-speaking subjects. Objective: to determine administration difficulties when Spanish is the native language. Method: a cross-sectional study developed to examine three aspects of music perception: pitch discrimination threshold, melody recognition responand timbre recognition. Commands were translated into Spanish in order to run the program. Conclusions: The CAMP test for music perception is easily applied in Spanish-speaking normal-hearing individuals and cochlear implant users when instructions translated into Spanish are available.

Imaginarios de investigación. reflexiones en tono al análisis de documentos estratégicos en Colombia. / Research magery.. reflections on strategic analysis documents in Colombia.

Los desarrollos científicos y tecnológicos que se iniciaron durante el siglo XVIII y que continúan hasta nuestros días, le permitieron al hombre someter y explotar la naturaleza para satisfacer sus necesidades biológicas y culturales. Durante este proceso, la ciencia y la investigación han sido vistas como uno de los motores fundamentales del desarrollo. No obstante, los excesos humanos en la utilización de los avances tecnológicos han causado grandes problemas ambientales. Pese a ello, la investigación científica sigue contando con una excelente reputación y es una de las grandes apuestas del hombre para revertir (ahora mitigar) los grandes desequilibrios ambientales que hemos causado. Esta perspectiva ha abierto la posibilidad de investigar en lo ambiental desde una visión holística y sistémica. El presente documento analiza qué tan integrada está la investigación ambiental en las Políticas Nacionales de Investigación. Para ello, toma como referencia la Política Nacional de Ciencia, Tecnología e Innovación (PN-CTI) y el Plan Estratégico Nacional de Investigación Ambiental (PENIA), desarrollados por Colciencias y el Ministerio de Ambiente, Vivienda y Desarrollo Territorial (MAVDT), respectivamente. Producto de ese análisis comparativo, se estableció como principal conclusión la marcada desarticulación conceptual y metodológica que existe entre las Políticas Nacionales de Investigación propuestas por Colciencias y los Planes y Estrategias de Investigación Ambiental propuestos por el MAVDT.

Scientific and technological development which began during the eighteenth century and that continue to this day, allowed man to subdue and exploit nature in order to meet his biological and cultural needs. During this process, science and research have been seen as a fundamental driving foce for development. However human excesses in the use of technological advances have caused huge environmental problems. Nevertheless, scientific research continues to have an excellent reputation and is one of the great commitments man has to reverse (at this point mitigate) the great environmental imbalance we have caused. This approach has opened the possibility to investigate the environmental from a holistic and systemic vision. This paper analyzes how integrated environmental research is in National Research Policies. In order to do this the National Science, Technology and Innovation Policy (NSTIP) and the National Strategic Plan for Environmental Research (NSPER), developed by Colciencias and the Ministry of Environment, Housing and Territorial Development (MEHTD) respectively are taken as reference. As a result of this comparative analysis, an accentuated conceptual and methodological breaking up between National Research Policies proposed by Colciencias and Plans and Environmental Research Strategies proposed by the Ministry of Environment (MEHTD) was established as the main conclusion.

Influencia de la materia orgánica y Azotobacter nigricans en un cultivo de Stevia rebaudiana B / Influência da matéria orgânica e Azotobacter nigricans em uma cultura de Stevia rebaudiana B / Influence of organic matter and Azotobacter nigricans on a Stevia rebaudiana B. plantation

Stevia rebaudiana es una planta que acumula un compuesto edulcorante no calórico conocido como esteviosido. Su cultivo tradicionalmente se fertiliza con compuestos químicos que causan daño al ecosistema, obligando a buscar alternativas orgánicas para mitigar este daño. Objetivo. Evaluar el efecto de la materia orgánica y un biofertilizante con base en Azotobacter nigricans en un cultivo de Stevia rebaudiana ubicado en el departamento de Meta, Colombia. Materiales y métodos. Se establecieron cinco tratamientos: T1 y T2 Incorporando al cultivo compost de residuos domiciliarios en concentraciones de 15 y 30 ton ha-1 respectivamente; T3 y T4 con las mismas concentraciones de compost e inoculando el biofertilizante y T5 solamente con el biofertilizante. El control correspondió a las condiciones normales de cultivo con compost Bokashi. El crecimiento vegetal se evaluó por determinación de biomasa en peso seco, producción y área foliar. El análisis fisicoquímico de suelo incluyó: porcentaje carbono orgánico, humedad y pH. Resultados. La inoculación del biofertilizante produjo un incremento en la velocidad de mineralización del compost, con %CO final de 4,85 entre los 90 y 180 días. Se presentaron diferencias estadísticamente significativas (p< 0,05) entre la producción de biomasa de T2 (1538 kg ha-1) y el control (477 kg ha-1). Respecto al contenido de sólidos solubles T1, T3 y T4 presentaron los más altos valores de °Brix (12,4: 12,35 y 12,15). Conclusiones. La concentración 30 ton ha-1 presentó los mejores rendimientos de biomasa y la aplicación del biofertilizante mostró una correlación positiva con la mineralización del compost y síntesis de glucósidos...

Influence of organic matter and Azotobacter nigricans on a Stevia rebaudiana B. plantation Stevia rebaudiana is a plant that accumulates a non-caloric sweetener compound known as stevioside. This crop is traditionally fertilized with chemicals that are harmful for the ecosystem, forcing to find organic alternatives to mitigate this damage. Objective. To study the effect of organic matter and an Azotobacter nigricans-based bio-fertilizer on a Stevia rebaudiana plantation grown in acidic soil in the Department of Meta, Colombia. Materials and methods. Five treatments were established: T1 and T2 with the application of home organic waste compost at concentrations of 15 and 30 ton ha-1. T3 and T4 with the same compost concentrations and inoculating the A. nigricans bio-fertilizer. T5 contained the bio-fertilizer alone. The control consisted of the application of the Bokashi compost under the usual conditions of cultivation. Plant growth was assessed by biomass increase measured as dry weight, production, and leaf area. The physicochemical analysis of soil included: percentage of organic carbon, water content, and pH. Results. The inoculation of the bio-fertilizer produced an increase in the rate of mineralization of compost, reaching a final 4.85% of OC between 90 and 180 days after inoculation. There were significant (p< 0.05) differences between biomass production with T2 (1,538 kg ha-1) and the control (477 kg ha-1). Regarding the soluble solid content, T1, T3 and T4 showed the highest °Brix values (12.4, 12.35 and 12.15, respectively). Conclusions. The concentration of 30 ton ha-1 produced the highest biomass production and the application of the biofertilizer showed a positive correlation with compost mineralization and glucoside synthesis...

Influência da matéria orgânica e Azotobacter nigricans em uma cultura de Stevia rebaudiana B. Stevia rebaudiana é uma planta que acumula um composto edulcorante não-calórico conhecido como esteviosídeo. Sua cultura é tradicionalmente fertilizada com produtos químicos que danificam o ecossistema, forçando a procura de alternativas orgânicas para reduzir esse dano. Objetivo. Avaliar o efeito da matéria orgânica e um biofertilizante com base em Azotobacter nigricans numa cultura de Stevia rebaudiana localizada no departamento de Meta, na Colômbia. Materiais e métodos. Cinco tratamentos foram estabelecidos: T1 e T2 incorporando ao cultivo composto de lixo doméstico em concentrações de 15 e 30 t ha-1, respectivamente; T3 e T4 com as mesmas concentrações do composto e inoculando o biofertilizante e T5 apenas com o biofertilizante. O controle correspondeu a condições normais de cultivo com composto Bokashi. O crescimento das plantas foi avaliado por estimação da biomassa em peso seco, da produção e da área foliar. A análise físico-química do solo inclui o seguinte: porcentagem de carbono orgânico, umidade e pH. Resultados. A inoculação do biofertilizante produz um aumento na taxa de mineralização do composto, com CO final de 4,85% entre 90 e 180 dias. Diferenças estatisticamente significativa (p <0,05) foram observadas entre a produção de biomassa de T2 (1538 kg ha-1) e o controle (477 kg ha-1). Com relação ao conteúdo de sólidos solúveis T1, T3 e T4 tiveram os maiores valores de °Brix (12,4: 12,35 e 12,15). Conclusões. A concentração de 30 ton ha-1 apresentou o melhor rendimento de biomassa e a aplicação do biofertilizante mostrou uma correlação positiva com a mineralização do composto e a síntese de glicosídeos...

El acoso escolar (bullying) y su asociación con trastornos psiquiátricos en una muestra de escolares en México / Bullying and its association with psychiatric disorders in a Mexican students sample

OBJETIVO: Estudiar la relación entre el tipo de psicopatología y el acoso escolar en una muestra de niños de las escuelas públicas de la Ciudad de México. MATERIAL Y MÉTODOS: Un total de 1 092 escolares identificó por medio del Test Bull-S a un grupo de agresores,víctimas,víctima-agresores y neutros. Los padres contestaron la Lista de Síntomas del Niño (Child Behavior Checklist, CBCL) para determinar el rango clínico de psicopatología. RESULTADOS: El grupo de agresores tuvo asociación con las escalas de ansiedad, síntomas somáticos, oposicionismo y de conducta. El grupo de víctima-agresores presentó asociación con los problemas de atención,oposicionismo y de conducta.En el grupo de víctimas las asociaciones encontradas fueron con los problemas de ansiedad.Estas diferencias fueron significativas frente al grupo control (neutros). CONCLUSIÓN: El acoso escolar se asocia con psicopatología que requiere de atención psiquiátrica oportuna.

OBJECTIVE: To study the relationship between bullying behavior and psychopathology. MATERIALS AND METHODS: A total of 1 092 students identified their peers' bullying status based on the Bull-S questionnaire. Parents completed the Child Behavior Checklist (CBCL) to determine psychopathology levels. RESULTS: The bullying group had associations with anxiety, somatic symptoms, oppositionalism and behavior problems; the bully-victims group had associations with attention, oppositionalism and behavior problems; victims had higher anxiety scores.These differences were significant compared with the control group. CONCLUSIONS: Bullying is associated with psychopathology, which requires timely psychiatric attention.

Características familiares y trastornos de la conducta alimentaria en una muestra de mujeres adolescentes internadas en un hospital psiquiátrico / Family characteristics and eating disorders in a sample of female adolescent inpatients in a psychiatric hospital

Background From the first descriptions of the eating disorders, researchers have found that the families of patients with anorexia nervosa or bulimia nervosa present high levels of family dysfunction. These families tend to differ from the control families, mainly because they present a greater frequency of conflicts and disorganization, less adaptability and cohesion, poor care of the parents towards their children, presence of overprotection, less orientation towards recreational activities and less emotional support. Several authors have suggested that a family adverse environment might represent an important etiologic factor for the development of an eating disorder. Nevertheless, the symptoms more related to degree of dysfunction or to quality of family environment in such patients have not been identified. Objective To describe the frequency of the eating disorders as well as eating disorder not otherwise specified in a sample of inpatient female adolescents; and to establish the relationship that functioning and quality of the family environment hold with the severity and/or characteristics of the eating psychopathology. Subjects and methods The study included a group of 36 female adolescents hospitalized due to any type of psychopathology in the Children's Psychiatric Hospital Dr. Juan N. Navarro. The study sample consisted of all the patients who wanted to be included and who fulfilled the inclusion criteria. A written informed consent was obtained from parents as approved by the Department of Research of the Children's Psychiatric Hospital Dr. Juan N. Navarro. Diagnostic categories in the sample, including eating disorders, were based on the Mini-International Neuropsychiatrie Interview -Kid (MINI-Kid). Those that presented an eating disorder not otherwise specified were diagnosed with a clinical interview based on DSM-IV criteria. In addition, the patients answered a series of self reports: the Eating Disorder Inventory, the General Functioning Subscale of the McMaster Family Assessment Device and the Child Figure Rating Scale. The body dissatisfaction was considered if the patient had negative scores (she wanted to be thinner) in the Child Figure Rating Scale. The score on the Global Family Environment Scale was obtained through a non-structured interview concerning the quality of the family environment (assessed in retrospect) and this information was complemented with that contained in each patient's medical chart. Results From the 36 patients included, 39% presented an eating disorder (17% a specific disorder and 22% an eating disorder not otherwise specified), 42% presented only body dissatisfaction and 19% of the sample was free of eating psychopathology. The average of the body mass index was within the normal range (23.2 kg/m²); nevertheless the average score of the Eating Disorder Inventory (58.22) was higher than what some authors have suggested as cut point score for anorexia nervosa. The average score of the General Functioning Subscale of the McMaster Family Assessment Device (2.16) was in the low normal limit and the Global Family Environment Scale showed an average (62.8) that would correspond to a moderately unsatisfactory family environment. The total sample was divided in two subgroups; the first included the patients who fulfilled the criteria for eating disorder (including an eating disorder not otherwise specified) and the second subgroup included the rest of the patients. There were not significant differences in the type or number of comorbid disorders. The mean scores of the Eating Disorder Inventory were higher in the subgroup with eating disorder with a statistically significant difference (p<0.01). In a similar way, the dissatisfaction with the weight and the current figure as well as the dissatisfaction to future showed statistically significant differences (p<0.01). The score in the scales of functioning and quality of the family environment did not show statistically significant differences. We also divided the whole sample in two subgroups, one with family dysfunction (as determined by the General Functioning Subscale of the McMaster Family Assessment Device ≥2.17), and the other without family dysfunction (scored <2.17). The group with family dysfunction presented a higher frequency of major depressive disorder and social phobia with a statistically significant difference (p<0.05). In a similar fashion, we divided the sample in two subgroups, one with high to moderate quality family environment (score in the Global Family Environment Scale >70) and a second one with low quality family environment (score <70). Nevertheless, these subgroups did not show statistically significant differences concerning psychopathological disorders. We found a positive correlation (r=0.34) among the total score of the Eating Disorder Inventory and the score of the General Functioning Subscale of the McMaster Family Assessment Device (p<0.05). The subscale of the Eating Disorder Inventory that had higher correlation was bulimic symptomatology (r=0.51) followed by ineffectiveness (r=0.43), both statistically significant (p<0.01). On the other hand, the Global Family Environment Scale did not show significant correlations with the Eating Disorder Inventory. Conclusions Eating disorders represent an important cause of morbidity in adolescent female inpatients; likewise, the patients were more frequently diagnosed with an eating disorders not otherwise specified than with anorexia nervosa and bulimia nervosa (in the sample recruited for the present study, we found that the eating disorders not otherwise specified represented 56% of the total of eating disorders), making the early detection necessary for the beginning of treatments directed to avoid the evolution to severe forms. We need to pay attention to «atypical¼ conditions that do not fulfill the full diagnostic criteria for anorexia or bulimia, as they may be in fact associated with important levels of dysfunction and comorbidity. The dissatisfaction with the weight and figure was shown by the majority of the patients who were hospitalized in a psychiatric unit. Adolescence can be accompanied by great dissatisfaction with self appearance; nevertheless, to determine the relevance of this phenomenon as a risk factor for the development of an eating disorder, follow-up studies with bigger samples are needed. Family dysfunction is a variable that relates to the severity of the eating disorders, mainly the bulimic symptoms. From this perspective these findings seem to support the psychodynamic interpretation of bulimia nervosa, where bingeing symbolizes the marked dependence to significant figures, and vomiting the desire to expel an evil introjected object. Nevertheless, given the impossibility to do inferences beyond a simple association among variables, another explanation could be that the aforementioned symptoms were damaging the family functioning, creating in this way a vicious circle. This finding may be important to determine which group of symptoms could be expected to improve after a family intervention directed to treat an eating disorder. The lack of correlations between the Global Family Environment Scale and the Eating Disorder Inventory could be explained by the fact that the Global Family Environment Scale evaluates functioning during the worst year of the patients' life, which could be during their first five years, thus its effect⁄impact on current psychopathology could not be established.

Introducción Desde las primeras descripciones de los trastornos alimentarios, los investigadores han encontrado que las familias de las pacientes con anorexia nerviosa o bulimia nerviosa presentan un alto nivel de disfunción familiar. Sin embargo, aún no se ha establecido qué síntomas se encuentran más relacionados con el grado de disfunción o con la calidad del ambiente familiar en este tipo de pacientes. Objetivo Describir la frecuencia de los trastornos de la conducta alimentaria, incluyendo los trastornos de la conducta alimentaria no especificados, en una muestra de pacientes adolescentes hospitalizadas por diversos tipos de psicopatología; y establecer el tipo de relación existente entre el funcionamiento-calidad del ambiente familiar y la gravedad y características de la psicopatología alimentaria. Material y métodos El estudio incluyó a un grupo de 36 pacientes mujeres adolescentes hospitalizadas debido a cualquier tipo de psicopatología en el Hospital Psiquiátrico Infantil Dr. Juan N. Navarro. Se realizó la entrevista Mini-Kid para determinar las categorías diagnósticas presentes en la muestra (los trastornos de la conducta alimentaria no especificados fueron diagnosticados a través de una entrevista no estructurada basada en los criterios del DSM-IV). Además, se aplicó el Eating Disorder Inventory, la Subescala de Funcionamiento General de la Familia, la Escala del Ambiente Familiar Global y la Escala de Figuras de Niños. Resultados El 39% de la muestra presentó un trastorno alimentario (17% un trastorno específico y 22% un trastorno no especificado), el 42% presentaba únicamente insatisfacción corporal y sólo el 19% de la muestra se encontraba libre de psicopatología alimentaria. El grupo con disfunción familiar (puntuación en la Subescala de Funcionamiento General de la Familia ≥2.17) presentó una mayor tendencia a cursar con episodio depresivo mayor y fobia social en contraste con el grupo sin disfunción familiar, con una diferencia estadísticamente significativa (p<0.05). El grupo de pacientes con alta-moderada calidad del ambiente familiar (puntuación en la Escala del Ambiente Familiar Global ≥70) no mostró diferencias estadísticamente significativas con el grupo de baja calidad del ambiente familiar en cuanto a los trastornos de la conducta alimentaria y el resto de las categorías diagnósticas obtenidas por el Mini-Kid. Se encontró una correlación positiva (r=0.34) entre la puntuación total del Eating Disorder Inventory y la puntuación de la Subescala de Funcionamiento General de la Familia (p<0.05). La subescala del Eating Disorder Inventory que tuvo mayor correlación fue la de sintomatología bulímica (r=0.51), seguida por la de inefectividad y baja autoestima (r=0.43), ambas estadísticamente significativas (p<0.01). Conclusiones Los trastornos de la conducta alimentaria representan una importante causa de morbilidad en las poblaciones clínicas de mujeres adolescentes; asimismo, los trastornos de la conducta alimentaria no especificados superan en prevalencia a la anorexia nerviosa y la bulimia nerviosa. La disfunción familiar es una variable que se relaciona con la gravedad de los trastornos de la conducta alimentaria, principalmente los síntomas bulímicos y la baja autoestima. Este hallazgo resulta relevante ante el hecho de poder determinar qué grupo de síntomas podrían mejorar inicialmente con una intervención familiar encaminada a tratar un trastorno alimentario. Al parecer, la calidad del ambiente familiar medido de forma retrospectiva no tiene un impacto específico en la presencia de un trastorno alimentario, lo que puede quizá solamente propiciar la presencia de variables mediadoras que se relacionen con la generación de psicopatología.

Producción de un biofertilizante a partir de un aislamiento de Azotobacter nigricans obtenido en un cultivo de Stevia rebaudiana Bert / Produção de um bio-fertilizante a partir do isolamento de Azotobacter nigricans obtido num cultivo de Stevia rebaudiana Bert. rato / Bio-fertilizer production from an isolate of Azotobacter nigricans obtained from a plantation of Stevia rebaudiana Bert

Realizar un aislamiento de bacterias fijadoras de nitrógeno para emplearlas en un programa de fertilización bajo un esquema de agricultura orgánica. Materiales y métodos. El aislamiento de bacterias fijadoras de nitrógeno se realizó en medio Ashby-benzoato a partir del suelo de un cultivo de Stevia rebaudiana Bert. Los aislamientos identificados como Azotobacter nigricans fueron evaluados mediante una cinética de crecimiento y la cepa con mayor velocidad se utilizó para la elaboración de un biofertilizante por fermentación discontinua La evaluación preliminar del biofertilizante se realizó mediante su inoculación en 3 eras de un cultivo de S. rebaudiana Bert. y el rendimiento se determinó con base en la producción de biomasa y concentración de glucósidos. Resultados. Dos aislamientos (A5 y A6) fueron identificados como A. nigricans con base en la caracterización fenotípica y genotípica. El aislamiento A5 se seleccionó para la elaboración del biofertilizante debido a que presentó mejor estabilidad, pigmentación, mayor velocidad de crecimiento 0,1405 h-1 fase exponencial de 18 horas y una producción de AIA promedio de 38,4 mg/ml a las 150 horas. El biofertilizante se obtuvo en medio leche con una concentración celular de 4x1012 UFC/ml. Conclusiones. La evaluación preliminar en campo mostró una correlación positiva entre el aumento de la concentración de glucósidos en las hojas de S. rebaudiana y una mayor producción de biomasa en respuesta a la aplicación del biofertilizante...

Bio-fertilizer production from an isolate of Azotobacter nigricans obtained from a plantation of Stevia rebaudiana Bert. Objective.To isolate nitrogen fixing bacteria to be used in a fertilization regime of an organic agriculture program. Materials and methods. The isolation of nitrogen fixing bacteria was done in an Ashby-benzoate medium from soil of a Stevia rebaudiana plantation. Isolates identified as Azotobacter nigricans were evaluated by their growth kinetics and the strain with the fastest growth was used for the production of a biofertilizer by discontinuous fermentation. The preliminary evaluation of the biofertilizer was done by its inoculation into three ridges of a plantation of S. rebaudiana and yield determination was based upon biomass production and glycoside concentration. Results. Two isolates (A5 and A6) were identified as A. nigricans based on their phenotypic and genotypic characterization. Isolate A5 was selected for preparing the biofertilizer because it showed a better stability, pigmentation, a faster growth rate (0.1405 h-1 exponential phase of 18 hours) and an average IAA production of 38.4 mg/ml after 150 hours. The bio-fertilizer was obtained in milk medium with a cell concentration of 4x1012 CFU/ml. Conclusions. The preliminary field evaluation showed a positive correlation between the increase of the glycoside concentration in the leaves of S. rebaudiana and a higher production of biomass in response to the bio-fertilizer application...

Produção de um bio-fertilizante a partir do isolamento de Azotobacter nigricans obtido num cultivo de Stevia rebaudiana Bert.Objetivo: Realizar um isolamento de bactérias fixadoras de nitrogênio para empregá-las num programa de fertilização sob um esquema deagricultura orgânica. Materiais e métodos: O isolamento de bactérias fixadoras de nitrogênio realizou-se no meio Ashby-benzoato a partirdo solo de um cultivo de Stevia rebaudiana Bert. Os isolamentos identificados como Azotobacter nigricans foram avaliados mediante umacinética de crescimento e a cepa com maior velocidade utilizou-se para a elaboração de um bio-fertilizante por fermentação descontínua. Aavaliação preliminar do bio-fertilizante realizou-se mediante sua inoculação em 3 eras de um cultivo de S. rebaudiana Bert., e o rendimento determinou-se com base na produção de biomassa e concentração de glucosideos. Resultados: Dois isolamentos (A5 e A6) foram identificados como A. nigricans com base na caracterização fenotípica e genotípica. O isolamento A5 selecionou-se para a elaboração do bio-fertilizante por apresentar melhor estabilidade, pigmentação, maior velocidade de crescimento (0,1405 h-1 fase exponencial de 18 horas) e uma produção de AIA media de 38,4? mg/ml as 150 horas. O bio-fertilizante obteve-se no meio leite com uma concentração celular de 4x1012 UFC/ml. Conclusões. A avaliação preliminar no campo apresentou uma correlação positiva entre o aumento da concentração deglucosideos nas folhas de S. rebaudiana e uma maior produção de biomassa como resposta à aplicação do bio-fertilizante...

Fístulas aortoentéricas primarias: presentación de dos casos y revisión de la literatura / Aortoenteric primary fistulas: report of two cases and review of literature

Las fístulas aortoentéricas son una entidad clínica infrecuente. Se clasifican en dos tipos: primarias y secundarias. Las primarias, más raras, consisten en una comunicación espontánea de la luz del aneurisma y el tubo digestivo, frecuentemente el duodeno. Las secundarias, más frecuentes, se presentan en pacientes con aneurismas que han sido tratados. El signo clínico de presentación más habitual de las fístulas aortoentéricas es la hemorragia digestiva alta. La sospecha clínica de esta entidad es fundamental para su diagnóstico. La endoscopía y la tomografía computarizada son las técnicas complementarias más usadas para el diagnóstico, aunque en la mayoría de las ocasiones son negativas y el diagnóstico se realiza en la cirugía. El tratamiento de elección es la cirugía, si bien existen casos descritos tratados mediante técnicas endovasculares. Presentamos dos casos de fístulas aortoentéricas primarias y revisamos la literatura publicada al respecto.

El castigo físico en la crianza de los hijos: Un estudio comparativo / Corporal punishment by parents: Comparative study

Introducción. Es común el empleo de castigos físicos en la crianza de los hijos, sin considerar sus posibles efectos psicológicos negativos. Se partió de la hipótesis de que los niños con conductas disruptivas sufren más castigos físicos por parte de los progenitores, y que éstos mantienen creencias más agresivas sobre la disciplina en la crianza. Material y métodos. Se realizó un estudio de escrutinio comparativo, abierto y de corte transversal en 2 grupos de 100 escolares: un grupo clínico con diagnósticos de trastornos disruptivos del comportamiento y un grupo control de una escuela pública. Se aplicaron a los progenitores el Cuestionario de Conners para la evaluación de psicopatología en niños y la Escala de Creencias y Castigos. Los resultados se analizaron mediante la prueba de x2. Resultados. Se observó que 54% de los padres del grupo clínico y 17% del grupo control pensaban que "cuanto más estrictos son los padres, mejores serán los niños también". Tres de los tipos de castigo, ejemplos claros de maltrato, también fueron significativamente más frecuentes en el grupo clínico. Conclusión. En este estudio se encontró asociación entre creencias y prácticas disciplinarias de los padres y comportamientos agresivos de los hijos. Se propone la estrategia de convencer a los padres de lo inapropiado de sus creencias, enseñarles técnicas disciplinarias adecuadas y así evitar el maltrato a los menores.

Introduction. Many parents believe it is legitimate to punish their children to correct improper behavior, and they do it without taking into account its negative psychological consequences. The hypothesis of this clinical study was that children with disruptive behavioral disorders were punished more and their parents held more aggressive beliefs regarding child rearing than children that didn't exhibit disruptive disorders, that served as the comparative group. Material and methods. This is an open, comparative and transverse study of 2 groups of children, 100 with disruptive behavioral disorders and 100 from a public school that were reported as non disruptive. Parents responded the Conners' Parents Rating Scale-long version and the Beliefs and Punishment Scales. Results. More parents in the clinical sample thought that "The stricter the parents are, the better the children turn out", x² 29.89, P =0. Three types of punishment were also more common in the clinical sample, P =0. Conclusion. There is an association between disciplinary beliefs and practices in parents and conduct problems in their children. A strategy is proposed to modify parental beliefs and disciplinary practices in order to avoid abusive parenting.

Violencia autodirigida en la adolescencia: el intento de suicidio / Self-inflicted violence in adolescence: the suicide attempt

Introducción. Objetivo: comparar el grado de depresión con el grado de impulsividad en una muestra clínica de adolescentes con intento de suicidio. Material y métodos. Se estudió a un grupo de adolescentes de 12 a 17 años de edad, hombres y mujeres, llevados en forma consecutiva durante un semestre al Hospital Psiquiátrico Infantil Juan N. Navarro de la Secretaría de Salud por haber realizado un intento de suicidio. Sus diagnósticos clínicos fueron catalogados en 3 grupos: grupo I (conductual), grupo II (afectivo) y grupo III (mixto). Los pacientes también respondieron a escalas que miden depresión y otros tipos de problemas psicológicos. Resultados. De 65 adolescentes (56 mujeres y 9 hombres), con intentos suicidas de primera vez o repetidos, 75% tenían diagnósticos con depresión y 42% tenían diagnósticos con impulsividad. La impulsividad se encontró significativamente más elevada en hombres que en mujeres. En éstas, el medio más empleado fue la sobredosis de medicamentos. Todos los tipos de problemas psicológicos fueron más graves entre los adolescentes que estaban deprimidos. Conclusiones. Hubo mayor frecuencia de depresión que de impulsividad en adolescentes que intentaron el suicidio. Los pacientes deprimidos mostraron más psicopatología de otro tipo que los no deprimidos, y más problemas familiares. Hasta hoy éste es el estudio con más pacientes en población clínica de adolescentes con intento suicida realizado en México.

Introduction. Objective: our aim was to compare degrees of depression and impulsivity in a clinical sample of adolescents with suicide attempts. Material and methods. We studied adolescents of both sexes who attempted suicide and were brought to a psychiatric hospital in Mexico City in a semester. Clinical diagnosis was included in 3 possible groups: group I (behavioral disorders), group II (affective disorders) and group III (mixed disorders). Patients also responded scales in order to measure depression and other types of psychological problems. Results. A total of 65 patients (56 girls and 9 boys), with first or repeated suicide attempts, were evaluated. Depressive type diagnosis was present in 75% and impulsiveness in 42%. Impulsivity was significantly higher in boys than in girls. Overdosing was the most employed method in the suicide attempts of female patients. Psychopathology was more severe among depressed adolescents. Conclusions. There is more depression than impulsivity among adolescents who attempt suicide. Depressed adolescents show more psychopathology and family problems than non-depressed adolescents, with statistical significance. So far, this is the largest study in a clinical sample of Mexican adolescents who attempted suicide.

Estrés ante la venopunción en niños y adolescentes / Venepuncture distress in children and adolescents

Introducción. Es bien conocido el temor de muchos niños (y no pocos adultos) a las agujas, de ahí su resistencia a asistir a la consulta médica por el miedo a ser víctimas de la venopunción. Los objetivos de este estudio fueron: describir la influencia de los factores propios del paciente en el estrés anticipatorio y el real a la venopunción, describir la influencia de la participación de los padres en el estrés anticipatorio y el real, y determinar la relación entre el estrés anticipatorio y el real ante la venopunción. Material y métodos. Se integró una muestra de 178 niños y adolescentes que acudieron a venopunción al laboratorio. Se utilizaron 2 escalas: del dolor y del estrés. Antes de la punción, los niños determinaron qué tanto suponían les iba a doler el procedimiento (dolor predictivo) y 2 observadores estandarizados calificaron el grado de estrés aparente previo a la punción (estrés anticipatorio). La respuesta observada en el paciente fue considerada estrés real. Finalmente, el niño señaló el grado de dolor sufrido efectivamente (dolor estimado). Resultados. Los primeros 4 tuvieron significancia estadística: 1. A mayor grado de estrés anticipatorio mayor fue el estrés real. 2. Los menores que predijeron que el dolor sería intenso obtuvieron mayores calificaciones de estrés real. 3. Los niños de mayor edad obtuvieron menores calificaciones de estrés real. 4. A mayor escolaridad, menor estrés real. 5. Cuando había el antecedente de venopunción reciente, mayor era el estrés real. 6. Los pacientes de sexo masculino mostraron mayor estrés real que los de sexo femenino. 7. La presencia de los padres durante la realización del procedimiento tendía a aumentar el estrés real. 8. Cuando el menor acostumbraba dormir en la cama de sus padres había una tendencia a experimentar mayor estrés real. Conclusión. Estos resultados dan la pauta para promover que padres y clínicos expliquen al niño este procedimiento, así como la aplicación de técnicas ...

Introduction. The fear of many children (and adults) to needles is well known, it explains their resistance to attend medical consultation because they are afraid of venepuncture. Objective. To describe the influence of patient's factors in children's anticipatory and real distress due to venepuncture; to describe the influence of parents in children's anticipatory and real distress and to determine the relationship among anticipatory and real distress due to venepuncture. Material and methods. One hundred and seventy eight children and adolescents ages 7 to 16, who attended a 3rd level pediatric hospital laboratory for blood sampling were studied. Pain and distress scales were used in order to determine predictive pain (children's presumption of pain induced by venepuncture). Two observers rated their anticipatory distress before venepuncture. They also rated their real distress during the painful proceeding. Finally, children themselves rated the real pain they suffered. Results. The first 4 results were statistically significant. 1. Anticipatory distress was directly related to real distress. 2. Those children who predicted higher pain showed higher rates of real distress. 3. Older children had lower rates of real distress. 4. Higher school grades were related to less real distress. 5. Recent venepuncture was related to higher real distress. 6. Boys showed more real distress than girls. 7. Parents presence during blood sampling was related to real distress. 8. When children used to share bed with parents there was a trend to show more real distress. Conclusion. These results support the idea that parents and clinicians should explain this painful proceeding to children in advance, and the possible usefulness of cognitive behavioral techniques in order to diminish venepuncture distress.

Adaptación psicosocial y psicopatología de niños con enuresis y sus hermanos: Un estudio comparativo / Psychosocial adaptation and psychopathology of children with enuresis and their siblings: A comparative study

Introducción. En los niños con enuresis no debida a enfermedad médica es común la presencia de síntomas psicológicos. El objetivo de este estudio fue explorar si existen diferencias en adaptación psicosocial y grado de psicopatología de niños con enuresis en comparación con sus hermanos sin enuresis. Material y métodos. Estudio transversal, comparativo, observacional y abierto de 30 niños enuréticos de 9 a 14 años de edad, referidos al psiquiatra por sus médicos familiares, y sus hermanos no enuréticos. Ellos y sus progenitores respondieron la Escala de Columbia (CIS) que mide adaptación psicosocial y la Escala de Comportamiento de Niños y Adolescentes (CBCL), que mide grado de psicopatología. Los datos fueron analizados mediante coeficiente de correlación de Spearman y x2. Resultados. El tipo de enuresis más frecuente fue el nocturno (25). Los progenitores empleaban medidas punitivas en su corrección, además de dar a sus hijos infusiones y ungüentos. Más de la mitad de los niños enuréticos y ninguno de sus hermanos sanos presentaron psicopatología en grado clínico. Casi todos los niños enuréticos (29) y sólo 2 de los no enuréticos manifestaron mala adaptación psicosocial. Las diferencias fueron significativas. Conclusiones. Los niños con enuresis mostraron más psicopatología, y sobre todo más mala adaptación psicosocial, que sus hermanos no enuréticos, lo cual puede deberse a comorbilidad asociada o resultar del hecho de mojar la cama. Las medidas correctivas empleadas por los progenitores eran inútiles o francamente punitivas. Es necesario que pediatras y médicos familiares ejerzan acciones psicoeducativas para corregir las ideas distorsionadas que, con fuerte influencia cultural, mantienen los progenitores sobre las causas y el tratamiento de la enuresis.

Introduction. Behavioral disorders in children and adolescents with enuresis not due to general medical conditions are common. The objective of this study was to demonstrate differences in psychosocial adaptation between children with enuresis and their nonenuretic siblings. Material and methods. This was a cross sectional, comparative, observational and open study of 30 children 9 to 14 years of age with enuresis, referred to the psychiatrist by their family physicians, and their healthy siblings. Both groups of children and their parents responded the Columbia Impairment Scale, which assesses functional impairment and the parents responded the Child Behavior Checklist to assess their children's psychopathology. Data were analyzed with Spearman's correlation and x2. Results. Primary enuresis was the most common type (25). Parents used to employ punitive measures in an attempt to correct the symptom, besides ointments and herbal infusions. More than half of children with enuresis and none of their healthy siblings had clinical psychopathology scores in CBCL. Almost all children with enuresis (29) and only 2 of their siblings had functional impairment in CIS. Differences between both groups were significant. Conclusions. Children with enuresis showed more psychopathology and functional impairment than their healthy siblings. This may be due either to associated comorbidity or to bed-wetting itself. Corrective measures practiced by parents were useless or even aggressive. It is necessary for pediatricians and family physicians to give psychoeducation to parents of children with enuresis in order to correct culturally influenced distorted ideas on the causes and treatment of enuresis.