[Chronic high levels of CK-MB]. / Elevação crônica da CK-MB.

We presented two cases of falsely elevated CK-MB due to the presence of a type 2 macro CK, showed by isoenzymes electrophoresis. The association of this CK-MB falsely elevated with some digestive diseases are frequent. Quantification of CK isoenzymes by electrophoresis could be indicated in those cases in which the clinical course or ECG changes do not correlate with the CK-MB values.

[Gender identity in adolescents of the lower classes]. / Identidad de genero en adolescentes de sectores populares.

PIP: This reflection on gender identity among lower class adolescent females begins with a discussion of concepts. The specific sociocultural context strongly influences gender identity, which depends largely on social definitions of the female or male. Adolescence is the phase of life from around ten to 18 years during which the individual assumes an adult personality and life plans. The lower class or marginal sector, by whatever term it is called, denotes the group forming the base of the socioeconomic structure. This profoundly heterogeneous group experiences restricted conditions of material and spiritual survival. High proportions are in-migrants from rural areas with little education who earn meager livelihoods in the informal sector. The symbolic configuration of their communities of origin entails a view of submission, dependence, and sacrifice as the dominant characteristics of the female role. Urban residence exposes the population to messages on the value of education, consumption, the modern woman, and family planning, values contradicting traditional female role expectations. Families are large and live in poor and crowded housing with few services. The sexual division of labor places heavy burdens on girls from an early age. Alcoholism, domestic violence, or drug addiction may affect psychoaffective development. The quality of education available to these population sectors is very low. School abandonment is common. Most who continue their studies will be frustrated by a lack of available employment. The less educated will be concentrated in poorly paid jobs in the domestic and personal services, without social security and subject to abuse and exploitation by the employer. Some 50% of the women are in union by age 18. Unmarried motherhood and frequent changes of sexual partners are common. Legal mechanisms to protect the rights of mothers and those of their children are almost completely lacking. Most of the problems suffered by this group result from poverty in the context of crowding and unsatisfied material and spiritual needs. In such a context, the consolidation of a strong self-esteem cannot be expected.^ieng

[Evaluation of alcohol consumption recording in the primary care clinical history]. / Valoración del registro de consumo de alcohol en la historia clínica de atención primaria.

We carried out an internal medical audit to evaluate the recording of alcohol use in the primary care clinical records. 200 records were analyzed out of overall 2250. Of these, 100 belonged to the open (older) model, and 100 to the closed (or current) one. We found that in 56% of open model records there was no mention about alcohol use, against 31% in closed model records. In addition, this latter model permits a quantitative recording of alcohol intake. In both models there was a greater amount of information in males. We conclude that the physician's interest in recording data related to alcohol intake is small. We think that primary care staff should be sensitized to the importance of evaluating and recording alcohol intake.