[Design and evaluation of an educational course for mothers of pregnant adolescents]. / Diseño y evaluación de un curso educativo dirigido a madres de adolescentes embarazadas.

This article is the continuation of a previous investigation about educational necessities in perinatal health of pregnant adolescent mothers. Now we present the design and evaluation of an Educational Course for that group. The theoretical mark of the Course corresponds to the education of adults, under the focus of the grupal learning. The content included gineco obstetrics topics, prevention of perinatal risks and the analysis of the social and cultural enviroment. As evaluation instrument, a self-applicable questionnaire of thirteen open questions was built on four aspects: family dynamics, utility of the course, utility of the information and behavior of the pregnant adolescents. A sample of 101 mothers of pregnant adolescents participated of the study from January 1999 to May 2000. The results indicate that the family dynamics was modified favorably in 88% of the cases soon after the attendance of mothers like adolescents to their respective courses, although some factors related with the father show a lack of commitment about the family situation. The 100% of the mothers considered important the attendance to the course because it is an educational instrument, so much for pregnant daughters as for themselves. The Course propitiated the exchange of preventive information between them in 87% of the cases. 97% of the mothers informed changes in their daughter's attitudes soon after her attendance to the course.

[Evaluation of an educational course for pregnant adolescents]. / Evaluación de un curso educativo sobre la etapa gestacional exclusivo para adolescentes embarazadas.

The pregnancy among adolescent women in Mexico is close than half million by year, this problem could be attended through health education in the Mexican medical care system. Since 1995 the Instituto Nacional de Perinatologia has a free training program only for adolescents designed to improve the health care medical procedures and reduces some perinatals health risks. This paper shows the structural design, functioning strategies and results of its application. Through a pre codificated 48 item list, were analyzed transversally the clinical records of 234 adolescents engraved themselves to the course. Two groups were formed: the "A" group with the patients attended at least to three sessions (106) and the group "B" with the ones who did not (128). The data analysis was made by contrasting each item between the groups using the appropriate statistical tests. The group "A" had greater average in scholarship, the moreover socioeconomic characteristics and gynecoobstetric background did not show significant differences. Group "B" had a higher proportion of adolescent with aggregated pathology to the pregnancy. We too observed significant differences in the proportions of complications during the pregnancy evolution and in the postpartum period. The acceptance on the pregnancy by the adolescent, her family and by her couple also showed significant differences. The average weight of the newborns were greater statistically in the "A" group. The proportions of family planning methods acceptance was higher in the same group, who has too shorter intra-hospitalary stay. This evaluation shows good fitness with the adolescents education expectatives and performance and favorable associations with some perinatals health risks.

TRH inactivation in the extracellular compartment: role of pyroglutamyl peptidase II.

TRH (pGlu-His-ProNH2) inactivation in the brain and pituitary extracellular fluid is reviewed. While TRH could be eliminated by alternative mechanisms, i.e. uptake or internalization, modification, hydrolysis by broad specificity peptidases such as pyroglutamyl peptidase I and prolyl endopeptidase, evidence accumulates to support a specific neuroectopeptidase as the main mechanism responsible for its extracellular inactivation. Pyroglutamyl peptidase II (PPII; E.C. 3.4.19.6) is a narrow specificity zinc metallopeptidase hydrolyzing the pyroglutamyl-histidyl peptide bond of TRH. PPII is an integral membrane protein with a small intracellular domain, a transmembrane segment and a large extracellular domain that contains the catalytic site. It is therefore idealy situated to degrade TRH present in the extracellular space. PPII is highly enriched in brain, specifically present in neuronal cells. PPII inhibition enhances recovery of TRH released in vitro. In situ hybridization studies demonstrate that PPII mRNA colocalizes with TRH-receptor mRNA in various brain regions. However, the existence of exceptions suggest that alternative inactivation mechanisms for TRH may operate. PPII activity is regulated in various pharmacological or pathophysiological conditions which alter TRH transmission. It is also present in adenohypophysis, preferentially on lactotrophs, where its activity is stringently regulated by hormones and hypothalamic factors. PPII activity regulation may contribute to adjust TRH neural and hormonal transmissions.