Prison infrastructure, the right to health and a suitable environment for the inmates of the Women's Annex in Chorrillos Prison (Peru).

OBJECTIVES: Decide how prison infrastructure guarantees health's right a suitable environment of Establecimiento Penitenciario Anexo de Mujeres de Chorrillos (EPAMCh) prisoners. MATERIAL AND METHOD: For the materials was used an interview guide addressed to 10 specialist and interview guide addressed to 30 prisoners. About the method, it was selected the qualitative approach, the applied type with the phenomenological design. RESULTS: The interview experts said that Establecimiento Penitenciario Anexo de Mujeres de Chorrillos current infrastructure and don´t give minima sanitary services. In the polls, the prisoners unanimously answered that conditions were precarious, but mostly said that they were willing to incorporate to a health education program and bet for a preventive medicine without forget the curative. DISCUSSION: Is Important foment the preventive medicine in order to get a strong health education in jails. To reverse this reality would mean change a guarantee in their health rights and a suitable environment.

Infraestructura penitenciaria, los derechos a la salud y a un ambiente adecuado de las internas del Establecimiento Penitenciario Anexo de Mujeres de Chorrillos (Perú) / Prison infrastructure, the right to health and a suitable environment for the inmates of the Women's Annex in Chorrillos Prison (Peru)

Objetivos: Determinar cómo la infraestructura penitenciaria garantiza los derechos a la salud y a un ambiente adecuado de las internas del Establecimiento Penitenciario Anexo de Mujeres de Chorrillos (EPAMCh). Material y método: En cuanto a los materiales, se empleó una guía de entrevista dirigida a 10 especialistas en la materia y una guía de encuesta destinada a 30 internas. Por lo que se refiere al método, se seleccionó el enfoque cualitativo de tipo aplicado y un diseño fenomenológico. Resultados: Los expertos en la entrevista afirmaron en su mayoría que la infraestructura actual en el Establecimiento Penitenciario Anexo de Mujeres de Chorrillos no permite prestar los servicios sanitarios mínimos. Por otro lado, en la encuesta, de modo unánime, las internas respondieron que las condiciones son precarias, pero mayoritariamente manifestaron su disposición a incorporarse a un programa educativo sanitario y a apostar por la medicina preventiva sin prescindir de la curativa. Discusión: Es importante fomentar la medicina preventiva. Para ello, es necesario nivelar el grado de instrucción de las internas y conseguir una sólida educación sanitaria. Revertir esta realidad significaría un cambio en la garantía de sus derechos a la salud y de sus derechos a un ambiente adecuado

Objective: To determine how the prison infrastructure can guarantee health rights and an adequate environment for inmates at the Women's Annex of Chorrillos Prison (EPAMCh. Material and method: The materials consisted of a guided interview conducted with 10 specialists on the subject and a guided survey completed by 30 inmates. The method consisted of an applied qualitative approach with a phenomenological design. Results: The experts interviewed said that the current infrastructure of the Women's Annex of Chorrillos Prison is in a state of crisis and does not provide even minimal healthcare services. The surveys completed by the prisoners gave the unanimous response that conditions were precarious, but the majority said that they were willing to form part of a health education program and to commit to preventive medicine without forgetting curative methods. Discussion: Preventive medicine must be promoted. To do this, prisoners' educational levels need to be improved and solid health education systems in prisons should be provided. Changes would need to be made in the guarantees of their rights to health and to adequate surroundings to bring about the necessary changes

Analysis of PTPN22, ZFAT and MYO9B polymorphisms in Turner Syndrome and risk of autoimmune disease.

Turner syndrome (TS) is one of the most common sexual chromosome abnormalities and is clearly associated with an increased risk of autoimmune diseases, particularly thyroid disease and coeliac disease (CD). Single-nucleotide polymorphism analyses have been shown to provide correlative evidence that specific genes are associated with autoimmune disease. Our aim was to study the functional polymorphic variants of PTPN22 and ZFAT in relation to thyroid disease and those of MYO9B in relation to CD. A cross-sectional comparative analysis was performed on Mexican mestizo patients with TS and age-matched healthy females. Our data showed that PTPN22 C1858T (considered a risk variant) is not associated with TS (X2  = 3.50, p = .61, and OR = 0.33 [95% CI = 0.10-1.10]). Also, ZFAT was not associated with TS (X2  = 1.2, p = .28, and OR = 1.22 [95% CI = 0.84-1.79]). However, for the first time, rs2305767 MYO9B was revealed to have a strong association with TS (X2  = 58.6, p = .0001, and OR = 10.44 [95% C = 5.51-19.80]), supporting a high level of predisposition to CD among TS patients. This report addresses additional data regarding the polymorphic variants associated with autoimmune disease, one of the most common complications in TS.

Association between nitrous oxide and the incidence of postoperative nausea and vomiting in adults: a systematic review and meta-analysis.

Some, but not all studies have suggested intra-operative use of nitrous oxide is correlated with postoperative nausea and vomiting. We performed a meta-analysis of randomised controlled trials to compare the incidence of nausea and vomiting in adults following general anaesthesia with or without nitrous oxide. We retrieved 30 studies (incorporating 33 separate trials) that investigated a 'nitrous oxide group' (total 2297 patients) vs a 'no-nitrous oxide group' (2301 patients). Omitting nitrous oxide significantly reduced postoperative nausea and vomiting (pooled relative risk 0.80, 95% CI 0.71-0.90, p = 0.0003). However, the absolute incidence of nausea and vomiting was high in both the nitrous oxide and no-nitrous oxide groups (33% vs 27%, respectively). In subgroup analysis, the maximal risk reduction was obtained in female patients (pooled relative risk 0.76, 95% CI 0.60-0.96). When nitrous oxide was used in combination with propofol, the antiemetic effect of the latter appeared to compensate the emetogenic effect of nitrous oxide (pooled relative risk 0.94, 95% CI 0.77-1.15). We conclude that avoiding nitrous oxide does reduce the risk of postoperative nausea and vomiting, especially in women, but the overall impact is modest.

Endometrioid adenocarcinoma of the ovary and endometriosis.

OBJECTIVE: We present a retrospective analysis of 22 cases of endometrioid ovarian carcinoma, reviewed to identify endometriosis and its malignant transformation. STUDY DESIGN: Twenty-two patients with endometrioid ovarian cancer were included in the review. Their clinical and histological data were retrospectively reviewed. The origin of the tumours was considered endometriosis-related when the presence of malignant changes in endometriosis glands leading to endometrioid carcinoma were found. RESULTS: Endometriosis was detected in three cases (3/22=14%). One of them presented a clearly benign to malignant transformation area. In another patient, the transition zone was abrupt and present in both ovaries. In the third, a pre-menopausal woman, ovarian endometriosis with only focal endometrioid carcinoma was observed. The three of them had a clear-cell carcinoma component. The presence of a clear-cell component was significantly greater in patients with endometriosis than in patients without endometriosis Each patient had a different clinical presentation: increase in abdominal perimeter, post-menopausal vaginal haemorrhage and hypermenorrhea. Preoperative CA 125 levels were avalaible in 15 of the patients (15/22=68%). Endometriosis was found in two of these 15 patients, both with the highest CA 125 measured levels, exceeding 1700 U/ml. In the remaining of the patients, CA 125 value did not exceed 35 U/ml. CONCLUSION: Although this association is not very frequent, patients with ovarian endometriosis and a high CA 125 serum level should be managed with special care, regardless of their pre-menopausal or post-menopausal status.

Cáncer de cérvix. Análisis de 72 casos / Cancer of the cervix. Analysis of 72 cases

• Propósito: analizar la casuística y la evolución del cáncer de cérvix en nuestra Area Sanitaria desde laapertura del centro hasta nuestros días.• Material y métodos: es un trabajo retrospectivo. Se revisaron 72 casos de cáncer de cérvix diagnosticadosentre 1988 y 2003 en el Hospital Universitario Príncipe de Asturias de Alcalá de Henares. Se utilizó laclasificación anatomo-clínica FIGO.• Resultados: la edad media fue de 49,28 (16-80 años). El síntoma predominante lo constituyó la metrorragia(71,4%). El método diagnóstico de sospecha principal fue la citología (57,6%), y el de confirmación labiopsia exocervical (64,8%). Más de la mitad de los cánceres se diagnosticaron en estadio I (65,7%). El 77,5%correspondían a tumores epidermoides. El tratamiento primario principal lo constituyó la cirugía (56/72), seguidode la radioterapia (13/72) y de medidas paliativas (3/72). Tras 51,08 meses de seguimiento medio, se encuentranvivas el 68% de las pacientes.• Conclusiones: en el cáncer de cérvix, el screening se ha demostrado eficaz, hecho fundamental para eldiagnóstico precoz. La cirugía se mantiene como tratamiento primario principal y las tasas de supervivencia,en la actualidad, son elevadas

• Purpose: To analyze the casuistics and evolution of cervical cancer in our health center from its openingto nowadays.• Material and methods: A retrospective study of 72 cases of cervical cancer diagnosed between 1988and 2003 at the Príncipe de Asturias University Hospital of Alcalá de Henares is made. The FIGO stageclassification is used.• Results: The average age of the patients was 49.28 years (range 16-80 years). The predominant symptomwas metrorrhagia (71.4%). The main diagnostic method leading to suspect a cancer of the cervix was cervicalcytology (57.6%), using exocervical biopsy for diagnosis confirmation (64.8%). 65.7% of the cases werediagnosed in stage I, and 77.5% were squamous cell carcinomas. The principal primary treatment was surgery(56/72), followed by radiotherapy (13/72), and paliative care (3/72). After a follow-up of 51.08 months, 68%of the patients are alive.• Conclusions: Screening for cervical cancer is an effective prevention procedure of cancer of the cervixleading to an early diagnosis. Surgery is still considered the main primary treatment. Survival rates are high atpresent

Metástasis tiroidea del carcinoma de mama. Descripción de un caso clínico / Thyroid metastases from breast cancer. A case report

Las metástasis tiroideas son raras (3 por ciento) y pueden proceder de cualquier neoplasia que metastatice por vía hemática, como el cáncer de mama.Cualquier nódulo tiroideo en pacientes con tumor primario conocido no tiroideo, se debe estudiar. Lo recomendable es combinar la citología-aspiración con aguja fina y el ultrasonido, que permite diferenciar nódulos únicos o múltiples, unilaterales o bilaterales, y detecta afectación linfática del cuello. El tratamiento suele considerarse paliativo porque es habitual que la masa tiroidea aparezca en el contexto de otras metástasis. El diagnóstico precoz y un tratamiento agresivo con quimioterapia y radioterapia, pueden contribuir a prolongar la supervivencia (AU)

Diagnóstico de la amenaza de parto prematuro / The diagnosis of threatened premature labour

El diagnóstico del parto pretérmino es un tema relevante en la obstetricia actual, ya que éste es la primera causa de mortalidad perinatal en los países desarrollados. Son numerosos los factores que participan en la aparición de un parto prematuro, así como los factores de riesgo para su desarrollo. Se han estudiado marcadores bioquímicos y físicos para identificar a las mujeres con alto riesgo de parir prematuramente y diferenciar, ante una gestante con síntomas, si se trata de un verdadero parto pretérmino o sólo de una "amenaza". Los marcadores bioquímicos son sustancias estudiadas en la secreción cervicovaginal y en el suero materno; otros parámetros estudiados son la longitud del cérvix y la dinámica uterina. De todos los factores, la fibronectina fetal en secreción cervicovaginal y el acortamiento del cérvix son los que han demostrado mayor valor en la predicción de un alto riesgo de parto pretérmino (AU)

Carcinoma de mama bilateralsincrónico / Synchronous bilateral breast carcinoma

El carcinoma de mama bilateral sincrónico se define por la aparición de dos tumores de forma simultánea en ambas mamas. Según otros autores, es aquel que se diagnostica en los primeros 3, 6 o 12 meses tras el descubrimiento del primer tumor. De forma habitual, el cáncer de mama contralateral se diagnostica mediante mamografía, y suele encontrarse en un estadio más temprano que el primero. Presentamos el caso de una mujer de 35 años que, sin antecedentes personales de interés, fue diagnosticada de carcinoma de mama bilateral sincrónico (AU)

Carcinoma epidermoide de pulmón y tuberculosis en paciente con infección por el virus de la inmunodeficiencia humana / Epidermoidal lung carcinoma and tuberculosis in a patient with human immunodeficiency virus

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Effectiveness of reminder systems on appointment adherence rates.

The aim of this study was to determine the impact of reminder systems on appointment nonadherence rates in an low-income inner-city clinic population. A total of 2,304 consenting patients were randomly assigned to one of three groups: (1) automated telephone reminder, (2) postcard reminder, or (3) no reminder. In contrast with research on other populations, the results of this study demonstrated no significant difference in appointment adherence rates among the three groups. To aid in the development of more effective interventions in the future, individuals not attending their scheduled appointments were interviewed by telephone to determine reason for nonadherence.

The impact of depressive symptoms on the functional status of inner-city patients with asthma.

BACKGROUND: Functional deficits are common in patients with asthma. If there is cooccurring depression, these deficits may be more severe and/or more persistent. OBJECTIVE: This study was undertaken to determine 1) the prevalence and severity of depressive symptoms in a sample of inner-city patients being treated for asthma and 2) the impact of these symptoms on functional status. METHODS: Three hundred seventeen enrollees in an inner-city asthma program were evaluated using the health status questionnaire and the Center for Epidemiologic Studies Depression Scale (CES-D) at baseline and at 3- and 6-month follow-ups. Two groups were created based on patients' CES-D baseline scores, using a commonly used cutpoint to define "caseness" for depression. The two groups were compared using ANOVA, chi2, and the general linear model for repeated measures. RESULTS: Of the sample, 55.01% had a CES-D score greater than the cutpoint for depression. The mean was 29.3 +/- 11.95, well above the scores commonly used to indicate the presence of depression. The depressed group had lower scores on many measures of functional capacity at baseline; whereas both depressed and nondepressed patients improved over time on the physical performance measure (the physical performance measure subscale of the health status questionnaire), the mean score for the depressed group was consistently lower. CONCLUSIONS: The prevalence of depressive symptoms was greater than expected. Depression was persistent and had a major impact on functional capacity. Routine depression screening may be especially important in inner-city patients and other groups thought to be at increased risk for poor outcome.

Resistances to turnip mosaic potyvirus in Arabidopsis thaliana.

The responses of a collection of Arabidopsis thaliana ecotypes to mechanical inoculation with turnip mosaic potyvirus were assessed. The virus induced characteristic severe symptoms of infection in systemically infected plants. Resistance was found in four ecotypes: Bay-0, Di-0, Er-0, and Or-0. Enzyme-linked immunosorbent assay results of the resistant ecotypes suggested that ecotypes Di-0, Er-0, and Or-0 actually consist of mixed genotypes with resistances acting at different levels in the virus life cycle. Another form of resistance was found in ecotype Bay-0, for which several lines of evidence indicated an interference with viral cell-to-cell movement in the inoculated leaves.

[Family planning. Regional differences in contraceptive practice]. / Planificacion familiar. Diferencias regionales en la practica anticonceptiva.

PIP: Great efforts have been made to measure contraceptive prevalence in Mexico and to assess various aspects of differential usage. At present, 63.1% of fertile aged women in union are estimated to use a method. State prevalence rates ranged from 77.2% of couples in Baja California Sub to 46.3% in Oaxaca. In general, northern states and Mexico City had the highest prevalence rates and states in the center and south had the lowest. Results of the 1988 Survey of Determinants of Contraceptive Prevalence permit identification of sociocultural variables related to contraceptive usage. The data show that residents of the northwestern states have a considerably higher educational level and proportion urban than do those of the center or southeast. The southeast lagged the center in indicators of household characteristics and services, income, and infant mortality, and also had a higher rate of female labor force participation. The states of the center had a lower rate of contraceptive usage at 54.8% than did those of the southeast at 56.4%. The rate for the northwest states was 71.8%. Knowledge of contraceptive methods in the northwest and center was nearly universal, but almost one-fourth of rural women in the southeast reported not knowing a method. Reasons for not using a method varied in the three regions. Problems of access, lack of knowledge, and fear of side effects were the principal factors in the southeast. Opposition of the woman or spouse or religious beliefs were the main factors in the center. No significant barriers of culture or access were identified in the northwest. The average ideal family size was around 3.5 children in all three regions. The survey results demonstrate that having children was highly valued in all three regions. Children were more highly valued in the southeast for companionship, aid, and economic contribution; in the center as sources of affective relations; and in the northwest for satisfaction or personal fulfillment of the woman.^ieng

[The dynamics of contraceptive use in Mexico]. / Dinamica del uso de metodos anticonceptivos en Mexico.

PIP: The authors identify some variables associated with the adoption and continuation of contraception in Mexico. The focus is on determinants of choice of different methods, as well as the impact of selected socioeconomic and demographic factors and the influence of institutions providing family planning services on choice of method.^ieng

[Family planning. Current levels and trends in contraceptive use]. / Planificacion familiar. Niveles y tendencias recientes del uso de anticonceptivos.

PIP: The general law on population in Mexico has contributed to a noticeable increase in the use of contraceptives. In 1973 only 12% or 900,000 women practiced modern contraception, which increased to 30% by 1976 (with the inclusion of the rhythm and coitus interruptus methods), 47.7% by 1982, and 53% or 7 million couples by 1987. Business provided 70% of contraceptives in 1970, while by 1982 53.4% and by 1987 61.8% was provided by government. The most utilized method until 1982 was female sterilization, 35.5% (18.8% or 2.5 million had tubal ligation by 1987), IUDs 19.8%, pills 18.3%, the rhythm and coitus interruptus, 15.1%, respectively. 1/3 of the 35-39 and 40-44 age groups had tubal ligation and as did 1/4 of the 30-34 age group, as well as 12.6% and 3.3% of the 25-29 and 20-24 age groups, respectively. The surgical method was used by 46.4% of uneducated women and 23.9% with secondary or higher education. This seems to contradict the hypothesis that education is the motivating factor of in the use of contraception, although some kind of contraceptive was used by 70% of women with high school education vs. 23.5% of women with no education. In rural areas inhabited by less than 2500 people, 37.6% of women practiced contraception compared with 59% and 66% in the 3 largest metropolitan areas. The increase of contraceptive use was less in recent years than in the period 1976-1982, but about 20% of women do not want more children. The various methods of regulating fertility need to be evaluated because of increasing integration of segments of population previously excluded by geographical, cultural, and social barriers.^ieng

[Recent levels and trends in the use of anti-contraceptives].

PIP: As a result of the General Population Law, the use of contraceptives has increased greatly in Mexico. In 1972, 900,000 women used contraception, representing 12% of women of reproductive age. In 1987, 7 million women, 53% of those of reproductive age were using contraception. In 1973, 70% of users purchased contraceptives commercially, whereas in 1987, 61.8% obtained them from the government. Until 1982, oral hormonal contraceptives were most widely used, but since than female sterilization has become the most common form of contraception, accounting for 35.5% of users. Sterilization is followed in prevalence by intrauterine devices (19.8%) and oral hormonal contraceptives (18.3%). Female sterilization increases in prevalence with increasing age and parity. 30% of women with 3 or more children are sterilized, versus 7.8% of those with 1 or 2 children. While contraception is more prevalent among women who have completed at least 1 year of secondary education than those with no schooling (70% vs. 23.5%), sterilization is more common among those with lower educational level (46.4% vs. 23.9%). Contraception is more prevalent in urban areas (59%) than rural areas (37.6%). While the prevalence of contraception is expected to continue increasing, it will probably be at a much slower rate.^ieng

The toxicity of the daily intake of nitrite and dimethylamine.

It is known that sodium nitrite and dimethylamine are toxic compounds, which may react to form dimethylnitrosamine in the gastro-intestinal tract, a much more toxic compound and a powerful cancerogen. The aim of the present work is the investigation of toxicity in young rats, caused by daily intake of sodium nitrite, administered together with dimethylamine during 30 days. The indicators examined were: histopathological analysis of the liver and kidney, transaminase in blood serum, variations in body weight and relation of weight liver/body weight. The method of analysis used to determine transaminase was that reported by Reintman and Frankel in 1957. The statistical method employed was the test of multiple comparisons based on the total ranges of Cruskal-Wallis. The results show that either significant differences were found (alpha = 0,05) among the groups (including the control), nor was necrosis observed or forming of tumors in the organs under investigation. Therefore, the doses administered does not seem to be toxic under the conditions of the experiment. Some signs of toxicity found in the group which was severely treated (10 mg of sodium nitrite and 20 mg of dimethylamine) appeared only in a few animals and it is necessary to verify the same in experiments with more animals and over a longer period of treatment.