Colecciones abscedadas pelvianas en el Hospital Barros Luco Trudeau: estudio de 5 años / Pelvic abscess colections at Hospital Barros Luco Trudeau: 5 years study

La enfermedad inflamatoria pelviana (EIP) constituye un importante problema de Salud Pública. Una de sus complicaciones más serias es el absceso tubo ovárico. El absceso pelviano es capaz de generar importante morbi-mortalidad. Presentamos experiencia de 5 años (1 de noviembre de 1991 al 31 de octubre de 1996), en el manejo médico-quirúrgico de 98 pacientes con colecciones abscedadas pelvianas, y comparamos nuestros resultados con estudios publicados. Realizamos un estudio retrospectivo de las pacientes que egresaron con diagnóstico de algún tipo de colección abscedada pelviana. Comparamos el grupo de pacientes con tratamiento médico conservador (TMC), con otro que requirió además tratamiento quirúrgico (TQ). Se estudiaron 98 casos de absceso pélvico. Observamos una tendencia a la resolución quirúrgica de ellos entre los años 1996, lo que es estadísticamente significativo. Sólo el 21 por ciento respondió a TMC, casi el 80 por ciento requirió TQ. La causa principal de la cirugía fue la falta de respuesta al TMC. El tipo principal de intervención realizada fue la anexectomía (44 por ciento). El 51 por ciento de los TQ se complicó, casi todos por infección de herida operatoria. La falta de sospecha de EIP, en las pacientes operadas fue de 9 por ciento. Las usuarias de DIU, no presentaron mayor riesgo estadístico de TQ. La fiebre al ingreso resultó un factor protector frente a la TQ. La proteína C, reactiva (PCR) fue el único examen de laboratorio que resultó ser un factor de riesgo de TQ. La extracción de DIU después del ingreso es factor protector frente a la TQ. El riesgo de rehospitalización es menor en las pacientes sometidas a TQ. Conclusión. Un enfoque o manejo agresivo diferido ( a la semana) sería lo más adecuado para estas pacientes, ya que esto, nos ha permitido realizar operaciones menos radicales con conservación de anexo, morbilidad menos grave que la observada en el pasada, y sin mortalidad. El esquema antibiótico triasociado de penicilina, cloramfenicol, gentamicina, clásicamente empleado en nuestros servicios públicos tendría pobre efecto sobre la evolución del absceso pelviano establecido

Anxiety and hostility in written verbal samples of male and female subjects. A content analytic study.

Nonclinical populations of male and female subjects of middle socioeconomic level and different age ranges were assessed by means of the content analysis method developed by Gottschalk and associates. Verbal samples consisted of written productions in response to a standard ambiguous instruction to narrate a dramatic or interesting life experience and were scored for anxiety and hostility. Results show that the method shows no influence of gender under the conditions of this study and can be employed for diagnostic purposes, assuming that personality factors and psychopathological influences might have a more pronounced impact on affect scores.

[Children of parents with mood disorders]. / Hijos de padres con trastorno del ánimo.

In recent years, child and adolescent psychiatry has recognized a high prevalence rate of mental disorders in affective disorders' offsprings. These can vary in their nature and severity. What is important is to bare in mind this risk condition. Many times prevention is possible, or early treatment is available. In an investigation that is actually being carried out in the Department of Psychiatry, University of Chile, that searches for understanding factors that severely deviate child and adolescent development, we found it is not unusual for the parents of the proband group to have affective disorders. In order to illustrate the discussion we describe three clinical histories.

Hijos de padres con trastorno del ánimo / Childrn of parents with mood disorders

En los últimos años, la psiquiatría infanto-juvenil ha reconocido la presencia de una alta tasa de prevalencia de trastornos mentales en los hijos de padres con trastorno del ánimo. Estos pueden ser de variada naturaleza y severidad. Lo importante es tener presente que existe esta condición de riesgo. Muchas veces es posible prevenir los trastornos, o tratarlos precozmente. En una investigación en curso, del Departamento de Psiquiatria de la Universidad de Chile que busca comprender los factores que desvían gravemente el desarrollo infanto-juvenil, encontramos una frecuencia llamativa de trastorno del anímo en los padres del grupo de niños en estudio. Se presentan tres historias clínicas para ilustrar la discusión (AU)

Hijos de padres con trastorno del ánimo / Childrn of parents with mood disorders

En los últimos años, la psiquiatría infanto-juvenil ha reconocido la presencia de una alta tasa de prevalencia de trastornos mentales en los hijos de padres con trastorno del ánimo. Estos pueden ser de variada naturaleza y severidad. Lo importante es tener presente que existe esta condición de riesgo. Muchas veces es posible prevenir los trastornos, o tratarlos precozmente. En una investigación en curso, del Departamento de Psiquiatria de la Universidad de Chile que busca comprender los factores que desvían gravemente el desarrollo infanto-juvenil, encontramos una frecuencia llamativa de trastorno del anímo en los padres del grupo de niños en estudio. Se presentan tres historias clínicas para ilustrar la discusión

Hijos de padres con trastorno del ánimo. / [Children of parents with mood disorders]

In recent years, child and adolescent psychiatry has recognized a high prevalence rate of mental disorders in affective disorders offsprings. These can vary in their nature and severity. What is important is to bare in mind this risk condition. Many times prevention is possible, or early treatment is available. In an investigation that is actually being carried out in the Department of Psychiatry, University of Chile, that searches for understanding factors that severely deviate child and adolescent development, we found it is not unusual for the parents of the proband group to have affective disorders. In order to illustrate the discussion we describe three clinical histories.

[Oral and written affective expression in children of low socioeconomic status]. / Expresión afectiva oral y escrita en niños de nivel economicosocial bajo.

Descriptive data on affective expression of 58 children (33 girls and 25 boys) of low socioeconomic status (Graffar index), with ages between 8 and 12 are presented. Intelligence was assessed by means of Raven Progressive Matrixes Test, all subjects exhibiting mean level. Evaluated were the six forms of anxiety and the four hostility forms defined by the Gottschalk method of verbal content analysis. Hope scores, positive and negative, were also obtained from the same verbal samples. The oral sample consisted in speech produced spontaneously during 5 minutes, in response to a standard instruction, and the written sample consisted in brief stories produced under standardized conditions during 15 minutes. The most frequently expressed form of anxiety was separation anxiety, while the most frequently expressed form of hostility was directed outwards covert hostility. "Positive" hope was expressed more frequently than "negative" hope. Data are discussed in terms of their contribution to the establishment of population norms in Spanish-speaking populations for the psychological constructs explored. It is concluded that the method of content analysis of verbal behavior may represent a useful tool for the study of child psychology in different contexts.

Expresión afectiva oral y escrita en niños de nivel economicosocial bajo. / [Oral and written affective expression in children of low socioeconomic status]

Descriptive data on affective expression of 58 children (33 girls and 25 boys) of low socioeconomic status (Graffar index), with ages between 8 and 12 are presented. Intelligence was assessed by means of Raven Progressive Matrixes Test, all subjects exhibiting mean level. Evaluated were the six forms of anxiety and the four hostility forms defined by the Gottschalk method of verbal content analysis. Hope scores, positive and negative, were also obtained from the same verbal samples. The oral sample consisted in speech produced spontaneously during 5 minutes, in response to a standard instruction, and the written sample consisted in brief stories produced under standardized conditions during 15 minutes. The most frequently expressed form of anxiety was separation anxiety, while the most frequently expressed form of hostility was directed outwards covert hostility. [quot ]Positive[quot ] hope was expressed more frequently than [quot ]negative[quot ] hope. Data are discussed in terms of their contribution to the establishment of population norms in Spanish-speaking populations for the psychological constructs explored. It is concluded that the method of content analysis of verbal behavior may represent a useful tool for the study of child psychology in different contexts.

ARIMA modelling of chronospsychometric self-evaluation of drive and mood.

The expanding study of biological rhythms requires the use of refined methods of time series analysis. We propose the use of ARIMA (Autoregressive Integrated Moving Averages) model, a powerful statistical tool of relatively recent development. A group of 5 patients with Affective Disorders (2 bipolars, 3 unipolars) and 1 patient with Adjustment Disorder self-assessed their AS every 8 hours for about a month. The affective state (AS) was estimated for 4 indicators: the two main constructs (Mood and Drive) of the segmented Visual Scale ESTA III and two bipolar items (Anxiety and Drowsiness). Mood and Drive are continuous variables, while Anxiety and Drowsiness are ordinal ones. Strictly speaking, ARIMA modelling is not valid with ordinal data. However, comparison of models of the two kinds of variables reveals no significant differences. This points out to a certain robustness of the method. Most of the series were non-stationary but could be transformed taking no more than two differences. The models made a very good fit of the data. Statistically significant coefficients on different lags may indicate the presence of circadian and infradian periodicities in the series. Further applications of ARIMA models to biological and psychological rhythmometry may be quite useful.