Psicopatología del adolescente con intento suicida y diferencias de g¨¦nero / No disponible

Presentamos una evaluaci¨®n de la psicopatolog¨ªa deladolescente con intento suicida y sus diferencias porg¨¦nero. Se evalu¨® dimensionalmente la psicopatolog¨ªaen 723 adolescentes, escala de Likert (¦Á = 0,88). Adem¨¢s,antecedentes de intento suicida, tratamientos psicol¨®gicos,consumo de medicamento para los nervios.Se emple¨® el OR para determinar asociaci¨®n significativa.El antecedente de intento suicida fue 9,96%. Ellasmuestran ratios significativos en depresi¨®n y sus equivalentes(OR = 3,35; IC 1,62-7,07); patrones neur¨®ticosde comportamiento (OR 5,62; IC 3,13-10,21); historiade consumo de medicamentos para nervios (OR = 3,08;IC 1,70-5,65); historia de tratamientos psiqui¨¢tricos/psicol¨®gicos(OR = 3,39; IC 1,04-12,19); el consumo dealcohol mostr¨® comportamiento inverso en cuanto alriesgo (OR 0,38; IC 0,25-0,60). Las manifestacionespsicopatol¨®gicas muestran un patr¨®n diferenciado yhablan de un riesgo espec¨ªfico para ellas, predominanlos trastornos depresivos y sus equivalentes, los patronesneur¨®ticos de comportamiento y el intento suicida(AU)

We present an evaluation of the psychopathology ofadolescent with suicide attempt and its gender differences.The psychopathology of 723 teenagers was evaluateddimensionally, Lickert¡¯s scale (¦Á = 0.88): andalso antecedents of suicidal attempts, psychologicaltreatment and consumption of medication for thenerves. OR was used to determine significant association.The antecedent of suicidal attempt was 9.96%.Significant ratios were shown for: depression and itsequivalents (OR = 3.35; IC 1.62-7.07); neurotic behaviorpatterns (OR 5.62; IC 3.13-10.21); history of consumptionof medication for the nerves (OR = 3.08; IC1.70-5.65); history of psychiatric/psychological treatments(OR = 3.39; IC 1.04-12.19); the alcohol consumptionshowed an inverse behavior concerning risk(OR 0.38; IC 0.25-0.60). The psychopathologic manifestationsshow a differenced pattern and speak of a riskspecific to them. The predominant variables were:depressive disorders and their equivalents, neuroticbehavior patterns and suicide attempt(AU)

[Predictors of use of ante-natal care]. / Predictores de utilización de la atención prenatal.

OBJECTIVE: To establish the association and possible interactions between emotional and cognitive factors in pregnant women and their use of institutional antenatal care. It was assumed that the knowledge and attitude of a pregnant woman determines her approach to demanding antenatal care. DESIGN: Analytic study. SETTING: Hospitals in the Health Area of Jalisco, Mexico. PARTICIPANTS: 2955 women leaving hospital early who had had at least 2 antenatal consultations. MAIN MEASUREMENTS: Personal and reproductive characteristics of the women, opportunity and continuity of antenatal care, knowledge of pregnancy and the antenatal care programme, attitudes towards institutional medical care of pregnancy. RESULTS: In the logistical regression model, 6 associations or interactions between unsatisfactory antenatal care and the variables analysed were found. The strong association of positive attitudes and sufficient knowledge in achieving satisfactory antenatal care was notable, and was even placed above the question of receiving, or otherwise, free medical provision from the health service. CONCLUSIONS: Undoubtedly, women's educational background plays a major role. This obliges the health services to strengthen their educational programmes by adjusting them to women's culture.

Predictores de utilización de la atención prenatal / Predictors of use of ant-natal care

Objetivo. Establecer la asociación y las posibles interacciones entre los aspectos cognitivos y emocionales de la mujer gestante y la utilización de la atención prenatal institucional. Se partió del supuesto de que el conocimiento y la actitud de la mujer gestante orienta el comportamiento hacia la demanda de atención prenatal. Diseño. Estudio analítico. Emplazamiento. Hospitales del Sector Salud de Jalisco,México. Participantes. Participaron en el estudio 2.955 mujeres con un alta hospitalaria temprana que hubieran tenido un mínimo de 2 consultas prenatales. Mediciones principales. Características personales y reproductivas de las mujeres, oportunidad y continuidad de la atención prenatal, conocimiento sobre embarazo y el programa de atención prenatal, actitudes hacia la atención médica institucional del embarazo. Resultados. En el modelo de regresión logística obtenido se observan 6 asociaciones e interacciones entre una atención prenatal no satisfactoria (APNS) y las variables analizadas. Destacan por su fuerte asociación para el logro de una atención prenatal satisfactoria las actitudes positivas y los conocimientos adecuados, aun ante la posibilidad de contar o no con servicios médicos de la seguridad social. Conclusiones. Es indudable que el referente educacional de la mujer desempeña un papel importante, situación que obliga a los servicios de salud a fortalecer los programas educativos de acuerdo con la cultura de la mujer

Objective. To establish the association and possible interactions between emotional and cognitive factors in pregnant women and their use of institutional antenatal care. It was assumed that the knowledge and attitude of a pregnant woman determines her approach to demanding antenatal care. Design. Analytic study. Setting. Hospitals in the Health Area of Jalisco,Mexico. Participants. 2955 women leaving hospital early who had had at least 2 antenatal consultations. Main measurements. Personal and reproductive characteristics of the women, opportunity and continuity of antenatal care, knowledge of pregnancy and the antenatal care programme, attitudes towards institutional medical care of pregnancy. Results. In the logistical regression model, 6 associations or interactions between unsatisfactory antenatal care and the variables analysed were found. The strong association of positive attitudes and sufficient knowledge in achieving satisfactory antenatal care was notable, and was even placed above the question of receiving, or otherwise, free medical provision from the health service. Conclusions. Undoubtedly, women’s educational background plays a major role. This obliges the health services to strengthen their educational programmes by adjusting them to women’s culture

Prevalencia de depresion en adultos mayores en poblacion urbana / Depression prevalence in older adults in an urban population

INTRODUCCION: El objetivo del presente estudio fue establecer la prevalencia de depresión en una población constituida por los ancianos que viven en su propio domicilio en la zona metropolitana de la ciudad de Guadalajara, Jalisco, México. MATERIAL Y MÉTODOS: Se utilizó como prueba de despistaje la 'Escala de Depresión Geriátrica' (EDG) de Brink aplicada a una muestra representativa de 246 sujetos. RESULTADOS: La prevalencia encontrada fue de 36,2 por ciento de los sujetos estudiados, 43,2 por ciento de las mujeres y 27,1 por ciento de los hombres. Aparecieron como factor de riesgo la actividad (OR 4,21 a los desempleados, el estado civil (OR 3,16 los viudos/as y 2,32 los solteros/as) y la edad (OR 2,90 para el rango de 80 a 84 años). Cinco de los 30 reactivos de la EDG resultaron positivos en más del 50 por ciento de los sujetos estudiados. DISCUSION: La tasa de 36,2 por ciento de depresión encontrada en nuestra población de estudio no es muy común, pero tampoco resultan frecuentes los estudios en población abierta y domiciliar. En la condición de hábitat urbano, donde se desarrolla nuestra investigación, el aspecto laboral sigue siendo relevante, aunque no en los jubilados sino en los desocupados. La falta de empleo y la viudez representaron altos valores como factores de riesgo; no podemos dejar de considerar que estos dos factores representan pérdidas y que la pérdida es uno de los principales elementos en la etiología de la mayoría de las depresiones (AU)

[An experience with public education in nutritional health in 2 communities in Jalisco, Mexico]. / Una experiencia de educación popular en salud nutricional en dos comunidades del Estado de Jalisco, México.

This study describes a popular educational process conducted in two communities in Jalisco, Mexico. The purpose was to add an alfalfa concentrate to the population's diet as an alternative, locally available food source. Previous studies had shown that alfalfa contains high protein, vitamin, and essential amino acid levels and can be useful to supplement and improve child nutrition. This resource had not been used previously due to lack of knowledge concerning its properties and harvesting and processing procedures and because it had traditionally been used as livestock feed. The current study included four steps: 1) community knowledge, 2) a community survey using interviews, home visits, and child nutrition evaluation, 3) formation of work groups in a community meeting, and 4) an educational program, working with a self-diagnostic tool taking child nutritional status into account. Our work focused on two areas simultaneously: family nutrition and the alfalfa concentrate as a way to improve it. Although this process was lengthy, it resulted in the acceptance and inclusion of alfalfa concentrate. In addition, the community groups formed in the process remain as an ongoing organizational resource.

[Trying vaginal delivery in 1000 patients with previous cesarean section in the Antiguo Hospital Civil de Guadalajara]. / Intento de parto vaginal en 1000 pacientes con antecedente de una cesárea previa en el Antiguo Hospital Civil de Guadalajara.

Because of the main justification for practicing a cesarean section is due to a previous cesarean and the rasing rates frequency of this operation, we concluded a descriptive and prospective investigation in order to analize the factibility and security of vaginal delivery after one cesarean section. We include 1000 patients with a past history of one previous cesarean section and with the following main characteristics: normal evaluation of the actual pregnancy and a gestational age of at least 36 weeks of pregnancy, no pelvis stenosis and a normal fetal status. The management were expectant and or with the use of oxitocin, prostaglandin PGEJ, uterionhibition and or amnioinfusion according to medical indication, 679 (67.9%) patients had a vaginal delivery; one ruterine rupture (0.001 x 1000) happened (the place of the rupture were not in the scar of the previous cesarean); two uterine dehicence (0.002 x 1000) of the previous uterine scar; one of this require laparotomy and sture of the dehiscence scar and the other one only require observation. We had two intrapartum fetal dead (0.002 x 1000) on due to the uterine rupture and the other one because of a taquisitolia not corrected by betamimetics. The factibility and security of vaginal delivery after one previous cesarean section is a logical and reasonable strategy in order to decrease the actual high rates of cesarean section. Whenever we try a viginal delivery in a patients with one previous cesarean is imperative to keep in mind that if something is not going well during the attempts we must repeat another cesarean.

[Reduction of the number of cesarean sections from 28% to 13%: does it reduce or increase perinatal maternal mortality: the great doubt?]. / La reducción de cesáreas de 28 a 13% incrementa o no la mortalidad materna y perinatal; la gran duda?

According to the new trends related to decrease the cesarean section rates, we conducted our retrospective investigation in order to investigate if the decrease of the cesarean section from 28 to 13%, affect the perinatal mortality (before labor and during labor) and maternal mortality. The years included in this paper were 1990 and 1995. We justified our investigation because some professional in health, believe that the decrease of the cesarean section produce an increase of the maternal and perinatal mortality. In 1990 and 1995 this were our obstetric activity respectively: 1954 and 1504 cesarean section, 4899 and 9176 vaginal deliveries, 6893 and 10730 alive newborns, 172 and 199 perinatal deaths, and finally 9 and 11 maternal deaths. The comparative statistical analysis is as following: for perinatal mortality CHi2 8.00, p 0.004 and OR 1.33 (1.09-1.66) and for maternal mortality Chi2 0.34, P 0.56 and OR 1.30 (0.50-3.36). The risk of perinatal deaths increased in 1990. In relation to the maternal deaths, the risk of mortality didn't increase in 1995.

[Polydactyly in 26,670 consecutive births. The clinical characteristics, prevalence and risk factors]. / Polidactilia en 26,670 nacimientos consecutivos. Características clínicas, prevalencia y factores de riesgo.

OBJECTIVE: The purpose of the study is to determine the prevalence of polydactyly, its clinical characteristic and its association with some risk factors. MATERIAL AND METHODS: A retrospective, case-control study, of 45 newborn with polydactyly and their controls, in 26,670 consecutive births in the Nuevo Hospital Civil de Guadalajara, with 20 weeks or more of gestational age, and birth weight greater than 500 g, since November of 1988 to October of 1992. The information were obtained from the database of the Congenital External Malformation Register, carried out by the University of Guadalajara. The prevalence of polydactyly was obtained and clinical characteristic were documented. Continuous variables were compared using t Student test. For discrete variables, analysis were carried out using X2 test and the odds ratio. RESULTS: The prevalence of polydactyly was of 1.73 x 1,000 alive newborn. The polydactyly of the hands in 26 newborn; preaxial in five and 21 was postaxial. The polydactyly in the foot was present in 19 newborn. The only statistics differences with control group were: low length and the antecedent of other malformation in the family. CONCLUSION: The found prevalence is different to the one informed in the literature. The association with antecedent of another malformation in the family, support the role of hereditary factors in etiology.

[Family influence in the metabolic control of the type-2 diabetic]. / Influencia de la familia en el control metabólico del paciente diabético tipo II.

This paper presents the results of the identification and association of certain family characteristics of type II diabetes patients in relation with its metabolic control in 121 families of tw o health centers of Guadalajara, Jalisco, Mexico in 1989. The attitude an d information about of the sickness, and the complications and therapeutics were evaluated through psychosocial evaluations. The majority of the family members showed a negative attitude and a profound understanding of the disease process. Only a 16.5 per cent of the patients were under control, and found a strong association between lack of control and nuclear family involved in the last cycles of this type of unit: independence and retirement.

[The prevalence and risk factors of cleft lip and cleft palate in 2 hospitals in the city of Guadalajara, Jalisco, Mexico]. / Prevalencia y factores de riesgo de labio y paladar hendido en dos hospitales, en la Ciudad de Guadalajara, Jalisco, México.

OBJECTIVE: The purpose of this article is to determine the prevalence of the cleft lip and palate and its association with some risking factors. MATERIAL AND METHODS: A retrospective, observational and analytic study, of 44 newborn infants with cleft lip and palate and their controls, in 33,461 consecutive births, with 20 weeks or more, and birth weight more than 500 g, since November of 1988 to June of 1991. The information were obtained from the database of the Congenital External Malformation Register, done by the University of Guadalajara, in four hospitals. The prevalence of the cleft lip and palate was calculated. Of the variables studied their association was searched with congenital malformation in 2 x 2 tables, calculating, its chi square, confidence interval, and old ratio. RESULTS: The prevalence of the cleft lip and palate was of 13.2 x 10,000 births. By categories: cleft lip 2.7 x 10,000, cleft lip and palate 7.8 x 10,000 and cleft palate 2.7 x 10,000. The only statistics differences with control group were the association with antecedent of other malformation in the family and methrorrague during pregnancy. CONCLUSIONS: The found prevalence is similar to the one informed in the literature, with some differences by categories. The association with antecedent of another malformation in the family, support the role of the hereditary role in the multifactorial etiology.