Transición del paciente adolescente con mielomeningocele en su paso al hospital de adultos / Transition of the adolescent patient with myelomeningocele to adult hospital care

El acceso a una salud integral de calidad a lo largo de la vida es un derecho de todos los adolescentes y jóvenes; pero sobre todo resulta relevante en aquellos pacientes con enfermedades complejas crónicas como el mielomeningocele pues de no realizarse tiene repercusión notoria sobre su estado de salud con mayor riesgo de morbimortalidad. En este artículo se comenta la experiencia sobre transición de pacientes con mielomeningocele que se realizó en forma organizada entre los servicios de Consultorio de Mielomeningocele y Hospital de día Polivalente del Hospital Garrahan y el Servicio de Adolescencia del Hospital Ramos Mejía. Se trata de un nuevo modelo asistencial de trabajo interdisciplinario y colaborativo teniendo como eje una fluida comunicación interinstitucional. Este acuerdo formal entre ambos hospitales contó con el recurso humano especializado y la estructura física adecuada para el abordaje integral de esta compleja enfermedad crónica. Este programa propició un entorno al paciente que aseguró el seguimiento por equipos interdisciplinarios. Esta es la mejor opción para brindar un cuidado integral, equitativo, coordinado y accesible mejorando la calidad de vida de los pacientes con mielomeningocele a largo plazo (AU)

Access to quality comprehensive health throughout life is a right of all adolescents and young people; but above all it is relevant in those patients with complex chronic diseases such as myelomeningocele because if it is not performed it has a notable impact on their health status with a greater risk of morbidity and mortality. This article discusses the transition experience of patients with myelomeningocele that was carried out in an organized manner between the Myelomeningocele Clinic and Multipurpose Day Hospital services of the Garrahan Hospital and the Adolescence Service of the Ramos Mejía Hospital. It is a new care model of interdisciplinary and collaborative work with fluid inter-institutional communication as its axis. This formal agreement between both hospitals had specialized human resources and the appropriate physical structure for the comprehensive approach to this complex chronic disease. This program provided an environment for the patient that ensured follow-up by interdisciplinary teams. This is the best option to provide comprehensive, equitable, coordinated and accessible care, improving the quality of life of patients with myelomeningocele in the long term (AU)

Cutis verticis gyrata primario esencial: comunicación de dos casos / Essential primary cutis verticis gyrata: report of two cases

Se presentan dos pacientes de 21 y 26 años de edad con cutis verticis gyrata. No se encontraron en ellos enfermedades subyacentes y el examen histopatológico no mostró alteraciones relevantes. Por lo tanto los incluimos en el tipo de cutis verticis gyrata primario esencial.(AU)

Acute effects of three natural corticosteroids on the acid-base and electrolyte composition of urine in adrenalectomized rats

In acute experiments, aldosterone (aldo), 18-hydroxycorticosterone (18 OH B) or corticosterone (B) were administered to adrenalectomized rats and parameters related to acid-base balance measured in urine samples collected for 3.5 hours after injection. Aldo reduced sodium excretion but did not affect pH nor the outputs of K, NH4+, CO3H-, phosphates nor titratable acidity. 18 OH B increased the excretion of titratable acidity and reduced drastically that of CO3H-. The lowest effective dose (3 micrograms) promoted Na excretion while the highest dose employed (6 micrograms) reduced pH and Na excretion. B increased the excretions of phosphates and ammonium, the former drastically. Potassium output either increased or did not change, and pH augmented marginally. It is postulated that a) 18 OH B is a naturally occurring steroid eliciting urine-acidification not necessarily accompanied by sodium retention; and b) at least B and 18 OH B in the rat, possess hormonal roles according to which the latter promotes the presence of protons, and the former, that of acute proton-acceptors in the lumen of tubuli.

Acute effects of three natural corticosteroids on the acid-base and electrolyte composition of urine in adrenalectomized rats.

In acute experiments, aldosterone (aldo), 18-hydroxycorticosterone (18 OH B) or corticosterone (B) were administered to adrenalectomized rats and parameters related to acid-base balance measured in urine samples collected for 3.5 hours after injection. Aldo reduced sodium excretion but did not affect pH nor the outputs of K, NH4+, CO3H-, phosphates nor titratable acidity. 18 OH B increased the excretion of titratable acidity and reduced drastically that of CO3H-. The lowest effective dose (3 micrograms) promoted Na excretion while the highest dose employed (6 micrograms) reduced pH and Na excretion. B increased the excretions of phosphates and ammonium, the former drastically. Potassium output either increased or did not change, and pH augmented marginally. It is postulated that a) 18 OH B is a naturally occurring steroid eliciting urine-acidification not necessarily accompanied by sodium retention; and b) at least B and 18 OH B in the rat, possess hormonal roles according to which the latter promotes the presence of protons, and the former, that of acute proton-acceptors in the lumen of tubuli.

Cálculos vesiculares: contenido de colesterol y su correlación radiológica / [Gallbladder calculi: cholesterol concentration and its radiologic correlates]

Cholesterol concentration in the gallstones of 84 patients obtained by surgery is studied and radiologic correlation of the stones (lucency and opaqueness) is established with relation to cholesterol concentration. We conclude that 70

of gallstones in our population, contain greater than or equal to 80

of cholesterol and the radiographic appearance of stones in functioning gallbladder is a good method to predict cholesterol content in gallstones.

Composición lipídica biliar de pacientes colecistectomizados en ayunas y en períodos post-ingesta / [Bile lipid composition of cholecystectomized patients during fasting and in postprandial periods]

Fasting state, 1 and 3 hours postprandial biliary lipid periods are studied in 19 cholecystectomized gallstone patients. Methodological items togeher with the characteristics of the kind of diet: normocaloric; lipids, 15

; and carbohydrates, 60

are established. It is concluded that biliary lipids are not quantitatively modified in the subjects on established diet respect fasting, 1 and 3 hours postprandial periods, particularly pointing out that the biliary cholesterol saturation rate remains unchanged--supersaturated--for fasting state, as well as for postprandial periods. We believe that the lack of observable changes may be in relation with the characteristics of the employed diet, which is usually suggested to people suffering from cholecystopathies in Argentina.

Los lípidos biliares y el índice de saturación del colesterol en relación con al administración de lecitina por vía oral / [Biliary lipids and the cholesterol saturation rate in relation to lecithin administration by oral route]

Lecithin is, at present, a contradictory drug to increase the solubility degree of bile cholesterol. Our main purpose in this work was to study the lipidic bile composition of gallstone patients under lecithin treatment, in order to value its action on biliary lipids and cholesterol saturation rate. Men and women with gallstones and radiologically functioning gallbladder were included. They were divided into 2 groups: [quot ]A[quot ], including 12 patients and [quot ]B[quot ], 13. In both groups, percentage values of cholesterol, phospholipids, total bile acids and cholesterol saturation rate were determined, before and after the administration of lecithin, everyday during a period of 30 years, 8 grams on group [quot ]A[quot ] and 2 grams placebo, on group [quot ]B[quot ]. No significant differences were found in the studied samples. Before and after the administration of 8 grams of lecithin orally. Total bile acids: 67--78 +/- 4,42, 72,07 +/- 4,61 p greater than 0,05; cholesterol; 15,88 +/- 2,29, 1689 +/- 2,87 p greater than 0,05; phospholipids 16,25 +/- 3,10, 12,04 +/- 2,29 p greater than 0,05; cholesterol saturation rate; 1,70 +/- 0,24, 2,10 +/- 0,36 p greater than 0,05. It is concluded that lecithin orally administered on patients with the established characteristics and diet and the used methodology results in a useless treatment to increase the solubility of bile cholesterol.

Cálculos vesiculares: contenido de colesterol y su correlación radiológica. / [Gallbladder calculi: cholesterol concentration and its radiologic correlates]

Cholesterol concentration in the gallstones of 84 patients obtained by surgery is studied and radiologic correlation of the stones (lucency and opaqueness) is established with relation to cholesterol concentration. We conclude that 70

of gallstones in our population, contain greater than or equal to 80

of cholesterol and the radiographic appearance of stones in functioning gallbladder is a good method to predict cholesterol content in gallstones.

Composición lipídica biliar de pacientes colecistectomizados en ayunas y en períodos post-ingesta. / [Bile lipid composition of cholecystectomized patients during fasting and in postprandial periods]

Fasting state, 1 and 3 hours postprandial biliary lipid periods are studied in 19 cholecystectomized gallstone patients. Methodological items togeher with the characteristics of the kind of diet: normocaloric; lipids, 15

(50

of which are obtained from animals); proteins, 25

; and carbohydrates, 60

are established. It is concluded that biliary lipids are not quantitatively modified in the subjects on established diet respect fasting, 1 and 3 hours postprandial periods, particularly pointing out that the biliary cholesterol saturation rate remains unchanged--supersaturated--for fasting state, as well as for postprandial periods. We believe that the lack of observable changes may be in relation with the characteristics of the employed diet, which is usually suggested to people suffering from cholecystopathies in Argentina.

Los lípidos biliares y el índice de saturación del colesterol en relación con al administración de lecitina por vía oral. / [Biliary lipids and the cholesterol saturation rate in relation to lecithin administration by oral route]

Lecithin is, at present, a contradictory drug to increase the solubility degree of bile cholesterol. Our main purpose in this work was to study the lipidic bile composition of gallstone patients under lecithin treatment, in order to value its action on biliary lipids and cholesterol saturation rate. Men and women with gallstones and radiologically functioning gallbladder were included. They were divided into 2 groups: [quot ]A[quot ], including 12 patients and [quot ]B[quot ], 13. In both groups, percentage values of cholesterol, phospholipids, total bile acids and cholesterol saturation rate were determined, before and after the administration of lecithin, everyday during a period of 30 years, 8 grams on group [quot ]A[quot ] and 2 grams placebo, on group [quot ]B[quot ]. No significant differences were found in the studied samples. Before and after the administration of 8 grams of lecithin orally. Total bile acids: 67--78 +/- 4,42, 72,07 +/- 4,61 p greater than 0,05; cholesterol; 15,88 +/- 2,29, 1689 +/- 2,87 p greater than 0,05; phospholipids 16,25 +/- 3,10, 12,04 +/- 2,29 p greater than 0,05; cholesterol saturation rate; 1,70 +/- 0,24, 2,10 +/- 0,36 p greater than 0,05. It is concluded that lecithin orally administered on patients with the established characteristics and diet and the used methodology results in a useless treatment to increase the solubility of bile cholesterol.

Contenidos audiovisuales de educación y promoción de la salud: identificación de áreas de vacancia respecto de las necesidades prioritarias / Health promotion and education audiovisual contents: identification of vacancy areas on priority health needs

INTRODUCCIÓN Organismos gubernamentales de Nación y Provincia de Buenos Aires (PBA) producen contenidos audiovisuales (CAV) de salud. OBJETIVOS Analizar CAV producidos en 2010-2014 por TV abierta e Internet, evaluando su adecuación a lo establecido en planes y programas de salud y la perspectiva de usuarios, efectores y gestores. MÉTODOS Diseño exploratorio-descriptivo cualicuantitativo, con triangulación de análisis de contenidos, revisión de programas, cuestionarios y auditorías. La muestra estuvo constituida por 144 CAV y 79 documentos (planes y programas) del Ministerio de Salud de la Nación y de la PBA, con 410 encuestados (51% usuarios, 40% efectores, 9% gestores) y 2 auditorías. RESULTADOS De los CAV analizados, sólo el 28% apela a la función poética del lenguaje. El 44,9% refiere enfermedades transmisibles; 22,9% salud sexual y reproductiva (SSR); 22% prevención/promoción; 18,6% vacunación; 16,1% derechos/equidad; 12,7% enfermedades no transmisibles, etc. El 45% se dirige a la población general. Los destinatarios particulares son madres 15,3%, mujeres en edad fértil 14,4%, embarazadas 11,9%, etc. Menos del 40% se dirigen a destinatarios contextuados; el 60%, a uno abstracto y universal; el 90%, a un sujeto de aprendizaje sin saberes previos; el 96% supone incorporación mecánica del contenido del mensaje. No se observan cuidadores, a excepción de bebés/niños acompañados. El propósito es de prevención (55,9%), promoción (32,2%) y asistencia (11,9%). No hay diversidad regional; un 4,2% menciona grupos minoritarios. Los contenidos identificados como prioritarios por los usuarios son prevención/promoción 53,9%, SSR 44,7%, adicciones 31,8%, alimentación 28,4%, etc. DISCUSIÓN Las concepciones de los CAV se sustentan en el modelo hegemónico. Los planes y programas priorizan contenidos de promoción de la salud. Las auditorías señalan las diferencias más importantes entre demanda y tratamiento en temas de enfermedades no transmisibles, alimentación e higiene, agua y medio ambiente.