[Quality of communication with the caregiver of pediatric patient]. / Calidad de la comunicación con el cuidador del paciente pediátrico.

INTRODUCTION: The deficiencies in the communication between the doctor and the patient have an impact on the care process and its therapeutic outcome. The objective of this study was to determine the perception of the information provided by treating physicians by parents or primary caregivers and the deficits observed in their relationship during the hospitalization of pediatric patients in high, medium and low complexity units. MATERIALS AND METHODS: Descriptive study carried out from January to May 2017 at the Foundation Hospital de la Misericordia, Bogotá (Colombia), through an anonymous, self-filled survey during the hospital stay, consisting of a first part of open questions, and the second by a survey Likert type with qualitative variables. The qualitative variables evaluated through the survey were summarized in frequencies; in addition, the Kaiser-Meyer-Olkin test was performed with principal component analysis under a Varimax rotation. RESULTS: Three hundred and eighty-seven primary caregivers were surveyed, 68.5% belonged to the general stay area, 20.4% to intermediate care and 11.1% to intensive care. Ninety percent of the respondents agreed on the way in which the patient's evolution was explained, expressing satisfaction with the information delivered, the language in which it was expressed and the interest towards their concerns; despite this, 41% indicated uncertainty regarding the medical evolution of their son. CONCLUSIONS: An adequate warning was received regarding the medical information provided, the language used, the treatment of the patient and teaching the main caregiver about the pathology presented by the patient. The uncertainty regarding the evolution of patients is the factor that contributes the most to dissatisfaction with the quality of the information.

Factores psicosociales asociados con suicidalidad, severidad y resultados del tratamiento en el trastorno afectivo bipolar / Psychosocial factors associated with suicidality, severety and outcome in bipolar affective disorder

Introduction: The socio-demographic characteristics, suicidality, severity and treatment outcome is compared of 376 patients with bipolar affective disorder (TB) with 1803 cases with other depressive disorders (TD) and 3131 with other psychopathology (OD). Methodology: The standard information gathered in a large psychiatric unit in a Santiago General hospital collects socio-demographics, ICD 10 diagnoses, as well as changes in scores in Lambert´s Outcome Questionnaire (OQ45).We measured Clinically Significant Change (CCS), as well as an index of reliable change (ICC) of TB compared with TD and OD. Statistical associations of outcome indexes were correlated with the above psychosocial variables, using SPSS 15.5. Results: TB had a lower mean age (41,4 years) than TD (43 years) and OD (39,3 years) (F = 17,07, p=0,0001), 73,8 percent of TB were females vs 79,9 percent of TD and 54,1 percent of OD (X2 2201,2; p = 0,0001). Among TB there were more divorce (23,7 percent) tan among TD (11,5); more TB lived alone or in institutions, (13,1), vs 5,2 among TD and 8,2percent among OD (X2 10 gl: 30,8412 ; p = 0,0006). TB had less stable jobs (15,5 percent) vs 23,5percent among TD and 30,7k percent of OD. (X210 gl: 76,2 ; p = 0,0001). TB had a mean of 12,7 years of schooling, vs 10,8 among TD and 11,3 among OD (student´s t 0,37, p > 0,001). TB presented more suicidal attempts (4,2 percent) and ideation (5 percent) in comparison to TD (3,1 and 3,9) and OD (6,3 any 3,9 percent). (X2; 6 gl: 168,6264, p = 0,0001). Highest global scores in OQ 45 were in TD (101,7), followed by TB (89,6) and OD (88,7). TB presented higher change: ICC (19 vs 16,2) and more CCS tan those with TD (25,9 vs 21,7 percent). Conclusions: Bipolar disorder patients are younger, have less stable jobs and marriages, live alone, but have a higher education. They also present a higher suicidal risk, and change more with therapeutic interventions offered in a general public hospital.

Introducción: Se estudian las características socio-demográficas, suicidalidad, severidad y pronóstico de 376 pacientes con trastorno afectivo bipolar (TB) comparándolas con 1.803 pacientes con trastornos depresivos (TD) y 3.131 con otros diagnósticos (OD). Método: Se aplica rutinariamente base estandarizada con características socio-demográficas, diagnósticos CIE 10 y cambios medidos por el Outcome Questionnaire (OQ45). Se determina Cambio Clínicamente Significativo (CCS), así Índice de Cambio Confiable (ICC) de los TB comparándolas con TD, y con OD. Se correlacionan los cambios con los indicadores psicosociales antes aludidos usando SPSS 15.5. Resultados: Los TB tuvieron un promedio de edad menor (41,4 años) que TD (43 años) y OD (39,3 años) (F = 17,07, p = 0,0001), con un 73,8 por ciento de mujeres vs 79,9 por ciento en TD y 54,1 por ciento de OD (χ2 2201, 2; p = 0,0001). En los TB hubo más separados (23,7 por ciento) que en TD (11,5); más TB vivían solos o en instituciones (13,1), vs (5,2 por ciento) de TD y 8,2 por ciento de OD (χ2 10 gl:30,8412 ; p = 0,0006). Los TB tenían menos trabajo estable (15,5 por ciento) vs 23,5 por ciento de TD y 30,7 por ciento de OD. (χ2 10 gl: 76,2 ; p = 0,0001). Los TB tuvieron un promedio de 12,7 años de educación, vs 10,8 de TD y 11,3 de OD (prueba t 0,37, p > 0,001). Los TB presentaron más intentos suicidas (4,2 por ciento) e ideación suicida (5 por ciento) en comparación a TD (3,1 por ciento y 3,9 por ciento) y a OD (6,3 por ciento y 3,9 por ciento). (χ2; 6 gl: 168,6264, p = 0,0001). Los mayores puntajes globales fueron de TD (101,7), seguidos por TB (89,6) y OD (88,7). Los TB presentaron ICC (19 vs 16,2) y un mayor CCS que aquellos con TD (25,9 por ciento vs 21,7 por ciento). Conclusiones: Los TB tienden a ser de menor edad, más separados y viviendo solos, con menos trabajo estable pero con mejor educación. Tienen más riesgo suicida, y experimentan mayor cambio confiable y clínicamente significativo.

Variations in peroxisomal catalase of neonatal rat hepatocyte subpopulations. Effect of pre- and postnatal exposure to alcohol.

Alcohol consumption during pregnancy is teratogenic and induces severe alterations in hepatocytes. In the hepatocyte peroxisomal system, ethanol is converted in the presence of H2O2 to acetaldehyde and water. Therefore, peroxisomal catalase also acts as an antioxidant defence mechanism by removing H2O2 and preventing the formation of hydroxyl radicals in the cell. Alterations in peroxisomal catalase after pre- and pre+postnatal alcohol exposure were investigated in the rat. The effect of pre- and postnatal exposure to ethanol on hepatocyte subpopulations was analysed in isolated hepatocytes originating from periportal, intermediate and perivenous zones. Analysis of catalase revealed that the total activity and content of this enzyme were higher in 12-day-old cells than in cells from newborns and that this increment was more pronounced in treated cells. In controls, the amount of peroxisomal catalase increased mainly in periportal cells, whereas alcohol exposure induced a significant increase in the catalase of perivenous hepatocytes. We conclude that pre- and postnatal alcohol exposure mainly affects the perivenous hepatocyte peroxisomes and that the increase in peroxisomal catalase could constitute a defence mechanism against free radical generation induced by alcohol exposure during the perinatal period.

[Evaluation of working conditions of municipal employees engaged in manual labor]. / Avaliação das condições de trabalho dos servidores braçais de instituição pública.

The working conditions of municipal employees of Botucatu (State of S. Paulo, Brazil) are described with a view to identifying the most frequent and serious occupational risks. Office workers (clerks) were not included in this study. The morbidities registered in the municipal outpatient service (from July 17 through December 4, 1987) and in the occupational accident register for the period 1984-1987 were evaluated. The activities of the majority of the employees were found to be carried out manually with no technological assistance, likely to generate "occupational accidents" (OA) and related to inadequate (antiergonomic) positions. The coefficient of severity of the OA has increased so rapidly that in 1987 it was 1.85 times higher than in 1984. The analysis of the external sources and the nature of the lesions caused by the OA were closely related to the description of the activities and the risk factors observed. The most frequent ailments registered in the outpatient service were: arterial hypertension, lumbago, the common cold, chronic alcoholism, acute gastroenterecolitis and "personal difficulties". An occupational health program for the municipal workers in Botucatu is proposed.