Breast/ovarian cancer genetic counseling: Do anxiety, depression, and health care-related fears influence cancer worry and risk perception?

BACKGROUND: The impact of family and personal cancer history and emotional factors, such as depression and anxiety, on disease representation has received limited attention in studies investigating the development of cancer-related worry and risk perception within the context of genetic counseling. The current study endeavors to fill this gap by exploring the extent to which depression and anxiety influence cancer worry and risk perception, and the role of health care-related fear as potential mediator in this relationship. METHODS: A sample of 178 women who underwent their first genetic counseling for breast/ovarian cancer, 52% of whom had previous cancer diagnoses, completed questionnaires assessing sociodemographic and clinical information, emotional distress in terms of anxiety and depression, cancer-related worry, risk perception, and health care-related fears. RESULTS: Results of mediation analyses showed that cancer-related worry and risk perception increased with rising levels of depression and anxiety, with health care-related fears acting as a mediator in the relationship of depression and anxiety with cancer worry and risk perception. Covariate analysis revealed that previous cancer diagnosis increases cancer-related worry but not risk perception, while the number of family members affected by cancer increases both outcomes. CONCLUSION: These findings emphasize the need for a holistic approach in genetic counseling and have implications for the clinical practice.

Oscillatory EEG-TMS Reactivity in Parkinson Disease.

PURPOSE: A dysfunction of beta oscillatory activity is the neurophysiological hallmark of Parkinson disease (PD). How cortical activity reacts to external perturbations may provide insight into pathophysiological mechanisms. This study aims at identifying modifications in EEG rhythms after transcranial magnetic stimulation (TMS) in PD. We hypothesize that single-pulse TMS can modulate brain intrinsic oscillatory properties (e.g., beta excess). METHODS: EEG data were coregistered during single-pulse TMS (100 stimuli over the primary motor cortex [M1, hotspot for Abductor Pollicis Brevis], random intertrial interval from 8 to 13 seconds). We used a time-frequency analysis based on wavelet method to characterize modification of oscillatory rhythms (delta [1-4 Hz], theta [4-7 Hz], alpha [8-12 Hz], and beta [13-30 Hz] in 15 participants with PD compared with 10 healthy controls. RESULTS: An increase in beta power over the sensorimotor areas was recorded at rest in the PD group ( P < 0.05). Brain oscillations in PD transiently reset after TMS: beta power over M1 becomes comparable to that recorded in aged-matched healthy subjects in the 2 seconds following TMS. CONCLUSIONS: Transcranial magnetic stimulation over the dominant motor cortex transiently normalizes cortical oscillations. More user-friendly noninvasive brain stimulation needs to be trialed, based on this proof of concept, to provide practical, portable techniques to treat motor symptoms in PD.

Covid-19 and Mental Health: Could Visual Art Exposure Help?

A worldwidemental health crisis is expected, as millions worldwide fear death and disease while being forced into repeated isolation. Thus, there is a need for new proactive approaches to improve mental resilience and prevent mental health conditions. Since the 1990s, art has emerged as an alternative mental health therapy in the United States and Europe, becoming part of the social care agenda. This article focuses on how visual esthetic experiences can create similar patterns of neuronal activity as those observed when the reward system is activated. The activation of the reward structures could have a stress buffering effect, given the interdependence observed between the reward and stress systems. Therefore, could visual esthetic experiences stimulate mental resilience? And if this were the case, could art-based interventions be offered for mental health in the context of COVID-19 and beyond?

Programa educativo sobre higiene de manos en escolares primarios / Educational program on hand hygiene in elementary school students

La adecuada higiene de manos puede reducir la incidencia de muchas enfermedades infecciosas respiratorias e intestinales, entre otras. Se realizó un estudio cuasiexperimental, con el objetivo de implementar un programa educativo acerca de la higiene de manos en 45 niños de 4to grado de la Escuela Primaria Guerrillero Heróico, Cienfuegos, Cuba, durante los meses de octubre 2018 - diciembre 2019. El diseño de un conjunto de acciones respondió a las necesidades de aprendizaje identificadas, produciéndose un cambio significativo con un valor p<0,05. El 80% de los involucrados tuvo un nivel bajo de conocimientos teóricos sobre higiene de manos antes de la aplicación del programa educativo y solo un 6,6 % resultó calificado como bueno. Entre las razones declaradas por las que no se lavan las manos, los infantes señalaron la falta de recur-sos para eso y la insuficiente percepción del riesgo que conlleva esa conducta. La mayoría decla-ró que recibían información al respecto en el ambiente escolar y a través de la televisión.

Proper hand hygiene can reduce the incidence of many infectious respiratory and intestinal diseases, among others. A quasi-experimental study was carried out to implement an educational program on hand hygiene in 45 students of 4th level of the Guerrillero Heróico Elementary School, Cienfuegos, Cuba, during the months of October 2018 - December 2019. The design of a range of actions responded to the identified learning needs, producing a significant change with a value of p <0.05. In this study, the 80% had a low level of theoretical knowledge about hand hygiene before the application of the educational program and only 6.6% were rated as good. Among the reasons stated for not washing their hands, infants indicated the lack of resour-ces for it and the insufficient perception of the risk that this behavior entails. The majority stated that they had received information on the matter at school and on television.

Cardioprotective effect of a moderate and prolonged exercise training involves sirtuin pathway.

AIM: To investigate the cardioprotective effects of prolonged and moderate exercise training on cellular and molecular events early after myocardial infarction. MATERIALS AND METHODS: Male Wistar rats were divided in sedentary or exercised group; both groups underwent to a myocardial infarction. All the molecular and immunohistochemical analyses on hearts of sedentary and exercised rats were performed 48 h after surgical procedure. SIRT1 and SIRT3 expression were measured and two of the pathways activated by sirtuins, p53-induced apoptosis and Forkhead boxO (FOXO)3a-induced oxidative stress, were investigated. All the experiments were performed also in presence of the SIRT inhibitor, EX527. KEY FINDINGS: Fourty-eight hours post myocardial infarction, exercise training induced the activation of SIRT1 and SIRT3 pathway reducing cardiomyocytes apoptosis and oxidative damage. Molecular data were confirmed by immunohistochemical evaluations. These effects are more evident in border infarcted zone than in the remote myocardium. SIGNIFICANCE: Exercise training is a non-pharmacological prevention strategy in cardiovascular diseases and the sirtuins family seems to be as novel and attractive target in cardioprotection.

Lack of inter-muscular coherence of axial muscles in Pisa syndrome.

BACKGROUND: Pisa syndrome is a lateral deviation of the trunk described in Parkinson's disease (PD). Its etiology is still unknown; advanced muscular signal analysis techniques, such as inter-muscular coherence, could help clarifying its pathophysiology and suggest therapeutic strategies. METHODS: Fourteen idiopathic PD subjects with a lateral deviation of the trunk of at least 10° were included. Electromyographic (EMG) signal was recorded from bilateral thoracic, and lumbar para-spinal and obliqui externi muscles. The synchronization between EMG right and left side signals was quantified using the magnitude-squared coherence function. RESULTS: In our sample, coherence (range 0-1) did not exceed 0.3, which indicates a lack of intra-muscular coherence. CONCLUSION: This finding is suggestive of a defective muscular fine-tuning, which has been associated with bradykinesia. These data support the hypothesis of PS as a clinical sign of bradykinesia, impacting on therapeutic and rehabilitative options.

Role of statins and mevalonate pathway on impaired HDAC2 activity induced by oxidative stress in human airway epithelial cells.

In patients with chronic obstructive pulmonary disease (COPD) the inflammatory response is often steroid-resistant, likely since oxidative stress and cigarette smoking impair histone deacetylase 2 (HDAC2) activity. Since it has been demonstrated that statins may restore the HDAC2 activity in cultured human endothelial cells, the aim of this study was to investigate the effects of statins in reversing the steroid-resistance induced by oxidative stress. We evaluated the effects of simvastatin and dexamethasone on HDAC2 expression and activity, and the role of mevalonate and Rho/ROCK pathways in A549 cells, a human lung type II epithelial cell line stressed with H2O2. Our results documented that H2O2 significantly reduced the HDAC2 expression and activity. In H2O2 treated cells dexamethasone was unable to restore the activity of HDAC2, whereas simvastatin restored both the expression and the activity of this enzyme. Our data also showed that mevalonate reduced the activity of HDAC2 whereas Y27632, a Rho/ROCK inhibitor, had no effect on HDAC2 activity when co-administered with simvastatin. Our data suggest that statins could have the potential to restore corticosteroid sensitivity in A549 cells. The evidences of this study suggest that, although both mevalonate and Rho/ROCK pathways are involved in the detrimental effect elicited by oxidative stress, statins may restore the function and expression of depleted HDAC2 via modulating the mevalonate cascade, at least in A549 cells. In conclusion, the modulation of histone acetyltransferase/deacetylase activity may lead to the development of novel anti-inflammatory approaches to inflammatory lung diseases that are currently difficult to treat.

Avances en el diagnóstico precoz y tratamiento del cáncer de ano / Advances in the early diagnosis and treatment of anal cancer

El cáncer de ano es una neoplasia poco frecuente en la población general, pero, en poblaciones de riesgo, su incidencia sobrepasa al cáncer de cérvix en la era pre-Papanicolaou. El virus del HPV está directamente relacionado con su desarrollo, sumado a factores predisponentes, como infección por HIV, costumbres sexuales, hábito de fumar, inmunosupresión e infección genital por el primer virus. La detección precoz sólo está indicada a determinados grupos, con las muestras de citología anal y anoscopía de alta resolución como principales herramientas para diagnosticar y tratar las lesiones preneoplásicas. Un correcto diagnóstico histológico e imagenológico es indispensable para un tratamiento óptimo cuando estas lesiones progresan a cáncer, con nuevas técnicas radio-quimioterápicas, reservando cirugías de rescate con reconstrucciones perineales en caso de recaídas locales, que se diagnostican con un seguimiento adecuado.

Anal cancer is an unusual neoplasia in the general population, but, in at-risk populations, its incidence surpasses the cervical cancer in the pre-Papanicolaou test era. The HPV virus is directly related to its development, in addition to other predisposing factors such as infection caused by HIV, sexual behavior, smoking habit, immunosuppression and genital infection caused by the first virus. The early detection is only indicated to certain groups, with the anal cytology samples and the high resolution anoscopy being the main tools to diagnose and treat preneoplastic lesions. When these lesions develop into cancer, a proper histological and imaging diagnosis is essential to carry out an ideal treatment with new radiation therapy techniques, reserving salvage surgeries with perineal reconstructions for the cases of local reIapse, which are diagnosed with an appropriate monitoring.

Avances en el diagnóstico precoz y tratamiento del cáncer de ano / Advances in the early diagnosis and treatment of anal cancer

El cáncer de ano es una neoplasia poco frecuente en la población general, pero, en poblaciones de riesgo, su incidencia sobrepasa al cáncer de cérvix en la era pre-Papanicolaou. El virus del HPV está directamente relacionado con su desarrollo, sumado a factores predisponentes, como infección por HIV, costumbres sexuales, hábito de fumar, inmunosupresión e infección genital por el primer virus. La detección precoz sólo está indicada a determinados grupos, con las muestras de citología anal y anoscopía de alta resolución como principales herramientas para diagnosticar y tratar las lesiones preneoplásicas. Un correcto diagnóstico histológico e imagenológico es indispensable para un tratamiento óptimo cuando estas lesiones progresan a cáncer, con nuevas técnicas radio-quimioterápicas, reservando cirugías de rescate con reconstrucciones perineales en caso de recaídas locales, que se diagnostican con un seguimiento adecuado. (AU)

Anal cancer is an unusual neoplasia in the general population, but, in at-risk populations, its incidence surpasses the cervical cancer in the pre-Papanicolaou test era. The HPV virus is directly related to its development, in addition to other predisposing factors such as infection caused by HIV, sexual behavior, smoking habit, immunosuppression and genital infection caused by the first virus. The early detection is only indicated to certain groups, with the anal cytology samples and the high resolution anoscopy being the main tools to diagnose and treat preneoplastic lesions. When these lesions develop into cancer, a proper histological and imaging diagnosis is essential to carry out an ideal treatment with new radiation therapy techniques, reserving salvage surgeries with perineal reconstructions for the cases of local reIapse, which are diagnosed with an appropriate monitoring. (AU)

Inhibitory effect of cannabichromene, a major non-psychotropic cannabinoid extracted from Cannabis sativa, on inflammation-induced hypermotility in mice.

BACKGROUND AND PURPOSE: Cannabichromene (CBC) is a major non-psychotropic phytocannabinoid that inhibits endocannabinoid inactivation and activates the transient receptor potential ankyrin-1 (TRPA1). Both endocannabinoids and TRPA1 may modulate gastrointestinal motility. Here, we investigated the effect of CBC on mouse intestinal motility in physiological and pathological states. EXPERIMENTAL APPROACH: Inflammation was induced in the mouse small intestine by croton oil. Endocannabinoid (anandamide and 2-arachidonoyl glycerol), palmitoylethanolamide and oleoylethanolamide levels were measured by liquid chromatography-mass spectrometry; TRPA1 and cannabinoid receptors were analysed by quantitative RT-PCR; upper gastrointestinal transit, colonic propulsion and whole gut transit were evaluated in vivo; contractility was evaluated in vitro by stimulating the isolated ileum, in an organ bath, with ACh or electrical field stimulation (EFS). KEY RESULTS: Croton oil administration was associated with decreased levels of anandamide (but not 2-arachidonoyl glycerol) and palmitoylethanolamide, up-regulation of TRPA1 and CB1 receptors and down-regulation of CB2 receptors. Ex vivo CBC did not change endocannabinoid levels, but it altered the mRNA expression of TRPA1 and cannabinoid receptors. In vivo, CBC did not affect motility in control mice, but normalized croton oil-induced hypermotility. In vitro, CBC reduced preferentially EFS- versus ACh-induced contractions. Both in vitro and in vivo, the inhibitory effect of CBC was not modified by cannabinoid or TRPA1 receptor antagonists. CONCLUSION AND IMPLICATIONS: CBC selectively reduces inflammation-induced hypermotility in vivo in a manner that is not dependent on cannabinoid receptors or TRPA1.

Chemopreventive effect of the non-psychotropic phytocannabinoid cannabidiol on experimental colon cancer.

Colon cancer affects millions of individuals in Western countries. Cannabidiol, a safe and non-psychotropic ingredient of Cannabis sativa, exerts pharmacological actions (antioxidant and intestinal antinflammatory) and mechanisms (inhibition of endocannabinoid enzymatic degradation) potentially beneficial for colon carcinogenesis. Thus, we investigated its possible chemopreventive effect in the model of colon cancer induced by azoxymethane (AOM) in mice. AOM treatment was associated with aberrant crypt foci (ACF, preneoplastic lesions), polyps, and tumour formation, up-regulation of phospho-Akt, iNOS and COX-2 and down-regulation of caspase-3. Cannabidiol-reduced ACF, polyps and tumours and counteracted AOM-induced phospho-Akt and caspase-3 changes. In colorectal carcinoma cell lines, cannabidiol protected DNA from oxidative damage, increased endocannabinoid levels and reduced cell proliferation in a CB(1)-, TRPV1- and PPARγ-antagonists sensitive manner. It is concluded that cannabidiol exerts chemopreventive effect in vivo and reduces cell proliferation through multiple mechanisms.

Transporte neonatal seguro en la población abierta del estado de Jalisco: impacto del programa S.T.A.B.L.E. en la morbilidad y mortalidad / Safe neonatal transport in Jalisco state: impact of S.T.A.B.L.E. program on morbidity and mortality

Introducción. El transporte neonatal desde las unidades médicas hasta las unidades de tercer nivel en muchos casos es desorganizado y arriesgado, situación que compromete aún más el estado de salud del neonato enfermo. El objetivo del estudio fue analizar el impacto del programa S.T.A.B.L.E. (de las siglas en inglés: Sugar and Safe care, Temperature, Airway, Blood, Lab work, Emotional support) en la morbimortalidad de los neonatos trasladados del interior del estado de Jalisco y de la zona metropolitana de Guadalajara, a la Unidad de Cuidados Intensivos Neonatales Externos (UCIN-EX) del Hospital Civil de Guadalajara. Métodos. Se diseñó un estudio prospectivo de 2005 a 2009. El proceso de intervención se basó en la aplicación del programa S.T.A.B.L.E. a todo neonato que requirió ser trasladado. Esto se logró con la intervención de los médicos reguladores del Sistema de Atención Médica de Urgencias (SAMU) del estado de Jalisco. Se implementó un curso de capacitación para el personal médico y paramédico de los centros de atención que refieren pacientes a nuestra unidad, con el fin darles a conocer el programa S.T.A.B.L.E. y su forma de aplicación. Resultados. Un total de 3,277 neonatos fueron incluidos en el estudio, 384 antes de implementar el programa y 2,893 con la aplicación del programa S.T.A.B.L.E. En el grupo con intervención se observó una frecuencia mayor de pacientes con temperatura corporal normal a su ingreso a la unidad receptora [516 (87%) vs. 227 (59%) p < 0.01 ], así como cifras de glicemia en rangos normales [690 (93%) vs. 173 (45%) p < 0.001]. La mortalidad durante el periodo de hospitalización en la unidad receptora fue menor en el grupo con intervención [405 (14%) vs. 84 (22%) p < 0.05]. Después del proceso de intervención, más pacientes fueron trasladados en incubadora [2,806 (97%) vs. 200 (52%) p < 0.001]; de igual forma, en más pacientes se aplicaron métodos de monitoreo de oximetría de pulso [2,575 (89%) vs. 235 (61 %) p < 0.01 ]. En cuanto al número de transportes neonatales regulados y autorizados por el sistema SAMU, se observó un incremento a favor del grupo con intervención [2,806 (97%) vs. 234(61%) p < 0.001]. La frecuencia de defunciones durante el transporte neonatal no presentó diferencias [30 (1 %) vs. 10 (2.6%) p = NS]. Conclusiones. El traslado de neonatos enfermos al tercer nivel de atención médica en el estado de Jalisco se realizó de forma segura, con una mejoría importante en la morbilidad. El programa S.T.A.B.L.E. fue altamente eficiente y de fácil aplicación. La disminución de la mortalidad de los pacientes con intervención del programa durante el periodo de hospitalización requiere estudios especialmente diseñados para establecer posibles asociaciones.

Background. Transporting newborn infants to third-level units is often disorganized, thus entailing several risks that may further compromise the health of newborn patients. Methods. A prospective study was designed in orderto assess the impact ofthe S.T.A.B.L.E. program (Sugarand Safe Care, Temperature, Airway, Blood, Lab work, Emotional support) from 2005 to 2009 in regard to morbidity and mortality rates of newborn patients who had to be transferred from other regions within Jalisco state or within Guadalajara's metropolitan area to the Neonatal Intensive Care Unit ofthe Civil Hospital in Guadalajara. The intervention process was based on applying the S.T.A.B.L.E. program to all newborns who needed to be transferred and was achieved with the intervention ofthe physicians regulating the Emergency Medical Assistance System (SAMU) of the state of Jalisco. A training course, as well as an educational brochure, was given to medical and paramedical staff from the medical assistance centers referring patients to our unit in orderto provide them with information on the S.T.A.B.L.E. program and its implementation. Results. A total of 3,277 newborn infants were included in the study, 384 before the intervention program and 2,893 once the S.T.A.B.L.E. program was implemented. Within the group transferred after the program's implementation, we observed a greater incidence of patients with normal body temperature upon admission to the receiving unit [516 (87%) vs. 227 (59%); p < 0.01 ] as well as with blood glucose figures within the normal range [690 (93%) vs. 173 (45%); p < 0.001]. Mortality during the hospitalization period in the receiving unit was lower in the group treated after the program's implementation [405 (14%) vs. 84 (22%); p < 0.05]. After the intervention process, more patients were transported in incubators [2,806 (97%) vs. 200 (52%); p < 0.001] and equally, pulse oximetry monitoring methods were applied in a greater number of patients [2,575 (89%) vs. 235 (61 %); p < 0.01 ]. With regard to the number of transfers of newborns that were regulated and authorized by the SAMU system, we also observed an increase in such numbers for the group treated after the intervention program [2,806 (97%) vs. 234 (61 %); p < 0.001]. There was no difference in the incidence of death during the newborns' transport [30 (1%) vs. 10 (2.6%); p = NS]. Conclusions. Transfer of ill newborns to third-level medical care units in the state of Jalisco was safely undertaken with a significant improvement in morbidity rates. The S.T.A.B.L.E. program was highly effective and easy to implement. The decrease in mortality during the hospitalization period of patients treated after the intervention program merits further studies especially designed to establish possible associations.

[Out-of-hospital delivery. Experience of ten years in Jalisco, Mexico]. / Parto fortuito. Experiencia de diez años en Jalisco, México.

BACKGROUND: Birth without medical assistance, or outs hospitals is defined as one that occurs without the optimal medical and health care conditions for mother and son pairing. Frequency of this phenomenon is not known in Mexico. OBJECTIVE: To observe clinical outcomes, morbidity, mortality, epidemiological and geographical patterns. MATERIAL AND METHOD: A retrospective study including newborns of mothers who have had deliveries without medical assistance in accidental conditions, admitted to Unidad de Cuidados Intensivos Neonatales Externos, Hospital Civil de Guadalajara Fray Antonio Alcalde (Mexico). From January 2000 to December 2009. RESULTS: In 4,762 (100%) neonatal records evaluated, 582 (12%) were newborns birth for deliveries out of hospital. 314 (54%) female and 268 (46%) male, first mother's gravidity 195 (33%) and second o more gravidity 387 (68%) were registered. The Hospital stay average was 3-day. Discharge diagnoses: healthy 463 (79%), neonatal sepsis 16 (4%), respiratory distress 35 (6%), jaundice 33 (6%), pneumonia 12 (2%), metabolic disorders 13 (3%), other diagnoses 10 (2%). Place of births: 366 Guadalajara metropolitan area (63%), state of Jalisco, 180 (31%) other states of the Mexican Republic 36 (6%). Lambed at home 117 (20%), 52 bath home (9%), toilet bowl 29 (5%), car 128 (22%), road 58 (10%), hospital admission 104 (18%), Ambulance 42 (7%) Other 52 (9%). CONCLUSION: In our study we observed that 79% of the newborns were healthy. They are the third leading cause of admission to Neonatal Intensive Care Unit External. The most common neonatal complications were solved without consequence. No neonatal mortality cases were founded.

Neuroleptic dose in the management of delirium in patients with advanced cancer.

Neuroleptics are commonly used in the management of delirium. Limited information is available regarding the dosage requirements and efficacy of neuroleptics in the palliative care setting. We determined the type and dose of neuroleptic use by delirium subtype. The medical records of 99 inpatients with advanced cancer were reviewed retrospectively. The doses of different neuroleptics, expressed as haloperidol equivalent daily doses (HEDDs), were correlated with delirium recall, recalled delirium symptom frequency, and associated distress from the patients', family caregivers', nurses' and palliative care specialists' perspectives. Subtypes of delirium included hypoactive in 20 (20%), mixed in 66 (67%), and hyperactive in 13 (13%). The median HEDD was 2.5mg, interquartile range (Q1-Q3) 1-4.7 mg (mean 4.0+/-5.9 mg), and it was significantly higher in agitated and mixed delirium as compared with hypoactive delirium (P=0.008). The neuroleptic dose was low and appeared to be ineffective in preventing patient delirium recall, with 73 (74%) patients remembering their episode of delirium as distressing. HEDD did not correlate with delirium recall, recalled symptom frequency, or distress for patients and family caregivers. However, HEDD increased with nurses' distress related to patients' symptoms (disorientation to place P=0.002, disorientation to time P=0.008, delusions P=0.041, and agitation P<0.001), and palliative care specialists' distress related to patients' hallucinatory symptoms (P=0.006) and agitation (P=0.006). In this study, the administered neuroleptic dose was influenced more by health care professional distress than by delirium symptom frequency. Future studies should examine the efficacy of neuroleptic dose according to individual delirium symptoms.

Hijos de madres adictas con síndrome de abstinencia en Terapia Intensiva Neonatal / Neonatal abstinence syndrome in a Neonatal Intensive Care Unit

Introducción. En años recientes, se ha incrementado el consumo de drogas en mujeres mexicanas durante la gestación, surgiendo como entidad el síndrome del feto adicto y el síndrome de abstinencia en el neonato (SAN). Objetivo: caracterizar una muestra de neonatos, hijos de madres adictas a drogas ilícitas y que desarrollaron síndrome de abstinencia, así como conocer la respuesta terapéutica del fenobarbital en estos pacientes. Métodos. Se aplicó en forma prospectiva un cuestionario estructurado sobre la madre y el producto de todos los hijos de madres consumidoras de drogas ilegales que ingresaron a la Unidad de Cuidados Intensivos Neonatales Externos del Antiguo Hospital Civil de Guadalajara "Fray Antonio Alcalde" entre el 1 de enero de 2003 y el 20 de diciembre de 2007, por presentar SAN. Resultados. Noventa y dos neonatos desarrollaron SAN durante el período evaluado. La media de la edad materna fue de 22 años, con un bajo nivel educacional. La droga más utilizada por las madres fue la cocaína, y 10 de ellas resultaron VIH-positivas. La edad gestacional promedio fue de 37 semanas. El peso al nacer, la talla corporal y el conteo de Apgar promedios fueron de 2 600 g, 47 cm y 9 puntos, respectivamente. El síntoma más frecuente fue la irritabilidad (77% de la muestra), y en todos los casos el tratamiento con fenobarbital resultó adecuado para el control clínico de los síntomas y signos. Conclusiones. El SAN constituyó 3.5% del total de ingresos en nuestra institución durante un período de 4 años. En general, los neonatos mostraron cortejo sintomático similar al reportado previamente en la literatura. Se observó una alta incidencia de infecciones concurrentes -en particular, VIH- y un predominio de la cocaína y la marihuana como las drogas más consumidas por las madres. El tratamiento con fenobarbital resultó exitoso para el control de síntomas y signos en todos los casos. Dada su incidencia e importancia clínica, el uso de drogas durante el embarazo y sus consecuencias sobre el producto merecen un estudio más consistente e intensivo en México.

Introduction. To our knowledge, in spite of the increasing drug-abuse statistics in Mexican pregnant women, there are no published clinical researches approaching this issue in our country. We describe the characteristics of neonatal abstinent infants admitted in the Neonatal Intensive Care Unit (NICU) located at the Hospital Civil of Guadalajara. Objective: To describe the characteristics of a sample of neonatal abstinent children as well as the efficacy of phenobarbital as a pharmacological alternative. Methods. Children from drug dependent mothers who were admitted to NICU from January 1st 2003 to December 20th 2007 and developed the neonatal abstinence syndrome (NAS) were prospectively evaluated with a structured feedback form including parental data. Results. Ninety two NAS cases (3.5% of the total) were recruited in the assessed period. Mother's mean age was about 22 years with a low educational profile. The most common drug consumed by the mothers was cocaine (35%). Ten mothers had HIV-positive results, while the neonatal averaged gestational age was 37 weeks. Birth weight, corporal size and Apgar score mean values were 2 600 g, 47 cm and 9 points, respectively. The most common symptom was irritability in 77% of the patients. All the cases were treated with phenobarbital reaching a successful clinical remission of the symptoms. Conclusions. NAS represented the 3.5% of all the neonate patients admitted in NICU throughout 4 years. Our observations correspond to those previously reported in the literature. High incidence of concomitant infectious conditions was observed -especially HIV- and the predominant used drugs were cocaine and marijuana. Due to its high incidence and clinical relevance, drug-abuse during pregnancy ought to have further study in our country.