Significado otorgado a la parentalidad durante el transcurso del embarazo por padres adolescentes / Significance given to parenting during the course of pregnancy by adolescent parents

El objetivo de este estudio consiste en comprender el significado que los padres adolescentes otorgan a la parentalidad. Se realizó un estudio cualitativo con una muestra de 10 adolescentes entre 15 y 19 años constituidos como parejas, que se encontraban cursando II o III trimestre de su primera gestación, su participación fue consentida y voluntaria. Se realizaron entrevistas hasta saturar la información, las que fueron transcritas y categorizadas resguardando la rigurosidad científica por medio del proceso de triangulación. Los principales resultados dan cuenta que los adolescentes definen la parentalidad en función de la responsabilidad de cuidar indefinidamente al hijo, como una ruptura del proyecto de vida, sin embargo se sienten invulnerables y gran parte de la muestra volvería a repetir la experiencia, lo cual es un factor de riesgo para un segundo embarazo en la adolescencia

The objective of this qualitative study isunderstand the meaning that parents give to parenting. The sample consisted of 10 adolescents aged between 15 and 19 years, constitutedas couples, were in the II or III trimester of their first gestation, their participation was voluntary and with informed consent voluntary. Interviews were carried out which were transcribed and categorized preserving the scientific rigor by means of the triangulation process. The main results show that adolescents define parenting according to the responsibility of taking care of the child indefinitely, as a break from the project of life, but they feel invulnerable and almost all would repeat the experience, which is a Risk factor for a second pregnancy in adolescence

Análisis bibliométrico y temático de la producción científica existente en la base de datos bibliográfica MEDLINE sobre farmacia comunitaria / Bibliometric and thematic analysis of the scientific literature on community pharmacy services, in the MEDLINE bibliographic database

Objetivo: Analizar y caracterizar, mediante técnica bibliométrica, la documentación científica relacionada con la farmacia comunitaria indizada en la base de datos bibliográfica MEDLINE. Método: Estudio descriptivo transversal. Los datos se obtuvieron de la base de datos MEDLINE interrogando los términos a estudio en los campos de descriptores, título y resumen; fecha de búsqueda diciembre 2017. Se calculó el tamaño muestral mediante estimación de parámetros poblacionales en una población infinita (n=386). El método de muestreo fue el aleatorio simple sin reposición. Resultados: Se analizaron 386 referencias. El número de originales fue de 308 (79,79%), identificando 215 instituciones, con Índice de Cooperación de 3,66 autores/artículo. El idioma predominante fue el inglés con 354 (91,71%) artículos. La obsolescencia, según el Índice de Burton-Kebler fue de 7 años y el Índice de Price del 33,42%. El núcleo de Bradford lo constituyeron 4 revistas. El descriptor más utilizado fue Community Pharmacy Services (n=300; 20,65%) y el área temática más representada Health Care Category, (n=551; 37,92%). Conclusiones: La producción científica sobre farmacia comunitaria, indizada en la base MEDLINE representa un área de conocimiento de plena vigencia que está iniciando la fase de "explosión de la información", con claro hegemonía anglosajona. Existe buen número de artículos de investigación, pero con relación institucional e índice de colaboración bajos. La clasificación temática se corresponde plenamente con la materia investigada

Objective: Analyze and characterize, through bibliometric technique, the scientific documentation related to community pharmacy indexed in the MEDLINE bibliographic database Methods: Cross-sectional descriptive study. The data was obtained from the MEDLINE database by interrogating the study terms in the descriptor, title and summary fields. Search date was December 2017. The sample size was calculated by estimating population parameters in an infinite population (n = 386). Sampling method: simple random sample without replacement. Results: A total of 386 references were analyzed. The number of originals was 308 (79.79%), identifying 215 institutions, with a Cooperation Index of 3.66 authors / article. The predominant language was English with 354 (91.71%) articles. The obsolescence, according to the Burton-Kebler Index, was 7 years and the Price Index was 33.42%. The core of Bradford included 4 journals. The most widely used descriptor was "Community Pharmacy Services" on 300 (20.65%) occasions and the most represented theme area Health Care Category, which was repeated 551 (37.92%) times. Conclusions: The scientific production on community pharmacy, indexed in the MEDLINE database, represents a well-known area of knowledge that is starting the "information explosion" phase, with clear Anglo-Saxon hegemony. There are a good number of research articles, but with both, low institutional relationship and collaboration index. The thematic classification is fully concordant with the researched subject

Barriers to the treatment of childhood tuberculous infection and tuberculosis disease: a qualitative study.

SETTING: In 2012, Peru's National TB Program (NTP) reported approximately 2400 incident cases of tuberculosis (TB) disease in children aged <15 years. Peru's TB burden is concentrated in the Lima metropolitan area, particularly in poor districts such as El Agustino and La Victoria, where this study was conducted. OBJECTIVE: To identify barriers to the treatment of childhood tuberculous infection and TB disease in Lima from the perspective of front-line providers and patients' families. DESIGN: We conducted 10 semi-structured focus groups with 53 purposefully sampled primary care providers, community health workers, and parents/guardians of pediatric TB patients. We also completed nine in-depth interviews with National TB Program administrators and pulmonologists specializing in TB. Two authors performed inductive thematic analysis and identified emerging themes. RESULTS: Four main treatment barriers emerged from the data: 1) dosing errors, 2) time- and labor-intensive preparation and administration of medications, 3) provider concern that isoniazid preventive therapy (IPT) generates isoniazid resistance, and 4) poor adherence to IPT. CONCLUSION: Our findings highlight the urgent need for child-friendly formulations, provider and parent/guardian education about IPT, and strategies to promote adherence to IPT, including support and supervision by health workers and/or regimens with fewer doses.

Neuromielitis óptica y lupus eritematoso sistémico en un hombre: caso clínico / Neuromyelitis optica presenting concomitantly with systemic lupus erythematosus: report of one case

Neuromyelitis optica (NMO) is a severe demyelinating disease of the central nervous system, which preferentially attacks the optic nerve and spinal cord. It is associated with antibodies against aquaporin 4. Morbidity and mortality are higher than in multiple sclerosis and its treatment focuses on immunosuppressive drugs. Immunomodulators are contraindicated. We report a previously healthy 35-year-old man, presenting with NMO concomitantly with systemic lupus erythematosus. His evolution was torpid with three outbreaks in the 10 months after the diagnosis, requiring a first-line therapy with methylprednisolone and cyclophosphamide and then a second-line therapy with rituximab.

[Neuromyelitis optica presenting concomitantly with systemic lupus erythematosus: Report of one case]. / Neuromielitis óptica y lupus eritematoso sistémico en un hombre: Caso clínico.

Neuromyelitis optica (NMO) is a severe demyelinating disease of the central nervous system, which preferentially attacks the optic nerve and spinal cord. It is associated with antibodies against aquaporin 4. Morbidity and mortality are higher than in multiple sclerosis and its treatment focuses on immunosuppressive drugs. Immunomodulators are contraindicated. We report a previously healthy 35-year-old man, presenting with NMO concomitantly with systemic lupus erythematosus. His evolution was torpid with three outbreaks in the 10 months after the diagnosis, requiring a first-line therapy with methylprednisolone and cyclophosphamide and then a second-line therapy with rituximab.

Resultados del tratamiento quirúrgico de las fracturas toracolumbares tipo C de la AO / Results of the surgical treatment of type C AO thoracolumbar fractures

AO Type C Thoracolumbar fractures are the most complex and unstable spine injuries, with a high frecuency of neurological impairment. The goal of this study is to describe the clinical characteristics, management and outcome in worker’s compensation patients with type C AO thoracolumbar fractures that were surgically treated in our hospital between January 1994 and December 2004. We collected 88 patients, 68 of them had work related accidents. Four patients were discarded because of insufficient data. The median follow up was 58 months. Of the 64 patients evaluated (mean age 35.7 years), 94 percent were men. The most common mechanism of injury was height fall (41 percent). Associated injuries occurred in 80 percent of the patients (23 percent had another spine fracture). Neurological impairment was present in 64 percent, 22 percent had incomplete, while 42 percent had complete impairment. The majority of the patients presented a C3 AO thoracolumbar fracture (50 percent). The average preoperative time was 6 days (range 0-64). The mean time of surgery was 224 minutes (range 80-640). Only 9.3 percent of the patients required a complementary anterior approach. The median hospitalization time was 61 days (6-275) and the mean postoperative rest was 9.8 months (1.4-34). We had 11 acute complications and 6 delayed complications. Return to work occurred in 64 percent of the patients, while 59 percent was compensated. Among the patients presenting partial neurological impairment, 50 percent improved at least one degree in the Frankel scale.

Las fracturas tóracolumbares tipo C de la AO corresponden a las lesiones espinales más complejas e inestables, con una alta incidencia de compromiso neurológico. El objetivo del presente estudio es describir las características clínicas, manejo y evolución de los pacientes accidentados del trabajo, con fracturas tóracolumbares tipo C de la AO, operados en nuestro hospital. Revisamos en forma retrospectiva los casos entre enero de 1994 y diciembre de 2004. Recolectamos 88 pacientes, 68 de los cuales correspondían a accidentados del trabajo. Cuatro casos fueron eliminados por información incompleta. La mediana de seguimiento fue de 58 meses. De los 64 pacientes evaluados (edad promedio 35,7 años),el 94 por ciento eran hombres. El mecanismo de lesión más común fue caída de altura (41 por ciento). Un 80 por ciento de los pacientes presentaron lesiones asociadas (23 por ciento con fractura de columna a otro nivel). Un 64 por ciento ingresó con compromiso neurológico, de los cuales, el 22 por ciento fue parcial y 42 por ciento completo. La mayoría de las fracturas fueron tipo C3 de la clasificación AO (50 por ciento). El tiempo promedio preoperatorio fue de 6 días (0-64). La duración promedio de la cirugía fue de 224 minutos (80-640). Un 9,3 por ciento de los pacientes requirió de una vía anterior complementaria. La mediana de hospitalización fue de 61 días (6-275) y el tiempo promedio de reposo post operatorio fue de 9,8 meses (1,4-34 meses). Hubo 11 complicaciones precoces y 6 tardías. Un 64 por ciento retornó al trabajo y un 59 por ciento fue indemnizado. De los pacientes con compromiso neurológico parcial, un 50 por ciento recuperó al menos un grado en la escala de Frankel.

Resultados de la colecistectomía videolaparoscópica en el adulto mayor / Analysis of laparoscopic cholecystectomy in the elderly

Se presenta la experiencia en el tratamiento quirúrgico de la patología vesicular litiásica, mediante videolaparoscopia, en una serie prospectiva de 119 pacientes de 60 o más años de edad, de ambos sexos, operados entre Marzo de 2003 y Marzo de 2004, en el Departamento y Servicio de Cirugía del Hospital Barros Luco Trudeau analizando la patología médica asociada, presente en el 70 por ciento, los hallazgos relevantes del estudio ecotomográfico preoperatorio (99,1 por ciento), las cifras de conversión a cirugía laparotómica (19 por ciento), la morbilidad (8,4 por ciento) y la mortalidad (0 por ciento).

We report our surgical experience in videolaparoscopic cholecystectomy in 119 patients with 60 or more years old, operated between March 2003 and March 2004, at the Barros Luco's Surgical Department and Service. We analized the medical pathology (70 percent of patients); the relevant finding at the preoperative ultrasonic study (99,2 percent of patients); the conversion rate (19 percent) and postoperatory results.

[Leuconostoc infections in patients with short gut syndrome, parenteral nutrition and continuous enteral feeding]. / Infección por Leuconostoc en pacientes con síndrome de intestino corto, nutrición parenteral y alimentación enteral continua.

Leuconostoc is a gram-positive cocci, quite ubiquitous in nature. It is used in wine industry, and for aroma and texture of dairy products. Occasionally it has been isolated from humans in cases of bacteremia, catheter associated infections, sepsis, meningitis, pneumonia, UTI, osteomyelitis and hepatic dysfunction. Short bowel syndrome, patients with CVC and patients with gastrostomy undergoing enteral feeding, are described amongst the factors associated with this infection. The isolation of a gram-positive cocci, that does not hydrolyze arginine and that is resistant to vancomycin leads to this diagnostic possibility. Antibiotic treatment: penicillin or ampicillin.

Infección por Leuconostoc en pacientes con síndrome de intestino corto, nutrición parenteral y alimentación enteral continua / Leuconostoc infcctions in patients with short gut syndrome, parenteral nutrition and continuous enteral feeding

Leuconostoc is a grampositive cocci, quite ubiquitous in nature. It is used in wine industry, and for aroma and texture of dairy products. Occasionally it has been isolated from humans in cases of bacteremia, catheter associated infections, sepsis, meningitis, pneumonia, UTI, osteomyelitis and hepatic dysfunction. Short bowel syndrome, patients with CVC and patients with gastrostomy undergoing enteral feeding, are described amongst the factors associated with this infection. The isolation of a grampositive cocci, that does not hydrolyze arginine and that is resistant to vancomycin leads to this diagnostic possibility. Antibiotic treatment: penicillin or ampicillin.

Leuconostoc es una cocácea grampositiva parecida a los Streptococcus, que se encuentra ampliamente distribuida en la naturaleza; es usada en la industria de vinos, productos lácteos y quesos para la producción de aromas y texturas. Leuconostoc causa ocasionalmente infecciones en humanos, puede producir bacteriemia, infección asociada a catéter, síndrome séptico, meningitis, neumonía, infección del tracto urinario, osteomielitis y compromiso hepático, entre otros. Se describen como factores de riesgo para una infección por este agente: el síndrome de intestino corto, uso de catéter venoso central y la alimentación enteral por gastrostomía. Orientan a la presencia de este agente el aislamiento de una cocácea grampositiva, catalasa negativa, PYR y LAP negativas, resistente a vancomicina. El tratamiento de elección es penicilina o ampicilina.

Prevalencia de colonización por Streptococcus agalactiae (grupo b) durante el embarazo pesquisado en medio de cultivo selectivo

Streptococcus agalactiae es el principal agente bacteriano responsable de la sepsis neonatal. Para evitar la infección perinatal se recomienda su pesquisa en la región vagino-anal durante el tercer trimestre, y tratamiento antibiótico durante el trabajo de parto en las gestantes colonizadas. El objetivo de este estudio es conocer la prevalencia de colonización del Streptococcus agalactie en la población de embarazadas controladas en la maternidad del Hospital Clínico de la Universidad de Chile, en el período comprendido entre el 1 de marzo y el 31 de mayo de 2003. Se tomó cultivo selectivo de Todd Hewitt, entre las 35 y 37 semanas de gestación a 185 embarazadas. Se determinó una prevalencia de colonización vagino-anal de 14,0 por ciento.

[Study of the health education process in liver transplant recipients]. / Estudio del proceso educativo en el paciente con trasplante hepático.

We present the results of a study carried out in Bellvitge University Hospital in Barcelona (Spain) in patients who underwent orthotopic liver transplantation and who are the subject of a health education program. Throughout the years, the structure of this program has undergone several changes. Initially, only verbal information supplied by a nurse on the knowledge required for patient self-care was envisaged. Through continuous evaluation, different forms of written and audiovisual information on patient self-care were introduced. The aim of this study was to evaluate patient knowledge on self-care by comparing compliance with recommendations at discharge among the patients who received verbal information only with that among patients who received verbal as well as written and/or audiovisual information. The study population comprised 434 patients who underwent liver transplantation from February 1984 to December 31, 1998. A retrospective cohort study was designed with two groups of patients. The first group was composed by 117 patients who received verbal, written and audiovisual information. The second group comprised 107 patients who received verbal information only. Data collection was through a telephone survey. Telephone interview was possible with only 98 patients in the first group and 60 in the second.In the overall evaluation of health education level, the score obtained by the first group was 8.3 (SD = 2.2) and that obtained by the second group was 6.8 (SD = 1.8). The possible score was between 0 and 11. The differences between groups were statistically significant (p < 0.001). In general, patients who received verbal information only showed lower compliance with recommendations at discharge than those also received written and/or audiovisual information.

Outcomes assessment of clinical pharmacy services in a psychiatric inpatient setting.

The effects of psychiatric pharmacy services on clinical outcomes of acute care psychiatric inpatients were studied. Patients recruited at a state psychiatric facility during phase 1 (October 1996-March 1997) served as the control group and received only traditional centralized pharmaceutical services and physician-requested psychiatric pharmacotherapy consultations. Patients recruited during phase 2 (May-December 1997) received intensive psychiatric pharmacy services and served as the experimental group. Pharmaceutical services during phase 2 included attending treatment team meetings, performing baseline assessments and weekly reviews, providing pharmacotherapy recommendations, obtaining medication histories, reviewing drug administration records daily, monitoring for adverse drug reactions, conducting medication education classes, and counseling patients before discharge. Outcome variables included clinical response determined with objective rating scales, cost of care, length of stay, adverse events, rate of acceptance of recommendations, patient compliance with the first clinic visit scheduled after discharge, quality of life, and patient satisfaction. Data were analyzed for 48 patients in the control group and 45 patients in the experimental group. There were no significant differences between the two groups with respect to age, sex, duration of illness, number of hospitalizations, and number of months since the last hospitalization. Patients in the experimental group showed significant improvements in clinical response and drug-induced extrapyramidal symptoms compared with the controls and were highly satisfied with the pharmaceutical services they received. Medication costs did not differ significantly, and length of stay was about 29 days for each group. The provision of clinical pharmacy services provided to inpatients in an acute care psychiatric facility was associated with improvements in rating-scale scores for clinical response and for drug-induced extrapyramidal symptoms.

Estudio del proceso educativo en el paciente con trasplante hepático / Study of the health education process in liver transplant recipients

Se presentan los resultados de un estudio realizado en la Ciudad Sanitaria y Universitaria de Bellvitge (Barcelona) en pacientes sometidos a trasplante hepático ortotópico (THO) y que son objeto de un programa de educación sanitaria. El programa ha sufrido diferentes cambios en su estructura a lo largo de los años. Inicialmente el método sólo contemplaba la información verbal suministrada por la enfermera en relación con los conocimientos necesarios para el autocuidado del paciente. Mediante evaluaciones continuadas se introdujeron diferentes sistemas de soporte escrito y audiovisual sobre los cuidados. El objetivo del estudio es evaluar los conocimientos que tiene el paciente sobre su autocuidado comparando el cumplimiento de las recomendaciones al alta entre los pacientes que sólo recibieron información verbal y los que disponían de información con soporte escrito y/o audiovisual. La población estuvo formada por 434 pacientes trasplantados desde febrero de 1984 hasta el 31 de diciembre de 1998. Se diseñó un estudio de cohortes con carácter retrospectivo y con dos grupos de pacientes. El primer grupo corresponde a 117 pacientes que recibieron información verbal, escrita y audiovisual. El segundo grupo a 107, que recibieron sólo información verbal. El método utilizado para la recolección de datos fue una encuesta telefónica. Sólo se pudieron entrevistar a 98 pacientes del primer grupo y a 60 del segundo. En la valoración global del nivel educativo, el primer grupo obtuvo una puntuación de 8,3 (DE = 2,2) y el segundo 6,8 (DE = 1,8) con un rango posible de puntuación de 0-11, apreciándose diferencias significativas entre los pacientes de ambos grupos (p < 0,001). En los pacientes que sólo tenían información verbal se observa en general un menor cumplimiento de las recomendaciones al alta con referencia a los pacientes que además recibieron información con soporte escrito y/o audiovisual (AU)

Anisakiasis gástrica diagnosticada por endoscopia / Gastric anisakiasis diagnosed by endoscopy

La anisakiasis es una parasitosis infrecuente en nuestro país que se adquiere al ingerir pescados infestados con las larvas, crudos o poco cocinados, así como también, pescados ahumados, en vinagre, salados o secos. Puede presentarse bajo diferentes formas clínicas, dependiendo de la zona del tracto gastrointestinal donde se asiente. Se presentan dos casos de anisakiasis gástrica ocurridos en Valladolid. Se trata de dos mujeres que habían ingerido boquerones en vinagre días antes. Las pacientes fueron diagnosticadas mediante endoscopia y el problema se resolvió al extraer el parásito. Los dos casos fueron vistos en un corto intervalo de tiempo quizás como reflejo de una cierta tendencia estacional. Hacemos mención a los hallazgos endoscópicos y se refieren algunas medidas higiénico-dietéticas para evitar este problema de salud (AU)

[Gastric anisakiasis diagnosed with endoscopy]. / Anisakiasis gástrica diagnosticada por endoscopia.

Anisakiasis is a parasitic infestation, infrequent in Spain, due to ingestion of raw or underdone by Anisakis larvae. Also it can appear after consumption of smoked, salted or dried salt fish. The disease can show under different clinical forms, depending on the part of the gastrointestinal tract where the larva settles. We report two cases of anisakiasis diagnosed in Valladolid. Both patients were women that had eaten some days before anchovies marinated with vinegar. The diagnosis was made by endoscopic examination and the problem was solved by extraction of the parasite. It worthy to note that both cases appeared in a short time interval, showing perhaps some seasonal character. Finally some hygienic-dietetic measures are proposed for combating the disease.

[Unwanted children: incidence and characteristics among puerperal women in a hospital of Santiago]. / Hijo no deseado: incidecia y carcterísticas en puérperas de un hospital de Santiago.

A scoring instrument to detect unwanted newborns was applied to 556 living-in women at a Santiago urban hospital in december 1987. Based upon previous research a scoring instrument including 10 items was designed and applied within 24 hours following delivery. According to the total score each newborn was classified as wanted (W), unwanted (U) or doubtful situation: 37.6% of children were born to unwed mothers. In a total of 556 children 4.5% (n = 25) were classified as U, 91.4% as W (n = 508) and 4.1% as doubtful (n = 23). Comparing U and W children the former had mothers with poorer education, higher frequency of bad relationships with their partners as well as higher proportion of three or more previous deliveries and late beginning of prenatal care (significant). On the other hand no significant differences were detected in age distribution of the mothers or their socio-economic level. The applicability of this scoring system and the magnitude and importance of the problem are analyzed and discussed. The need for further research on the natural history of the sequence unwanted pregnancy-unwanted child is stressed.