RESUMO
Background : Escherichia coli is the main bacterium associated with urinary tract infections (UTIs), including cystitis and pyelonephritis. Uropathogenic E. coli (UPEC) harbors numerous genes that encode diverse virulence factors contributing to its pathogenicity. The treatment of UTIs has become complicated due to the natural selection of E. coli strains that are multiresistant to several groups of antibiotics regularly used in clinical settings such as hospitals. Genomic reports of the global composition and distribution of the antibiotic resistance and virulence genes of these pathogenic strains are lacking in the Mexican population. Purpose and methods : The aim of this study was to globally characterize the genomes of a group of UPEC strains by massive parallel sequencing to determine the prevalence and distribution of virulence and antibiotic resistance genes associated with different serotypes and phylogenetic groups. Results: The strains exhibited 138-197 virulence genes and 29 antibiotic resistance genes related to antibiotics that are commonly used in clinical practice. Conclusions: These findings are relevant to the definition of new strategies for treating urinary tract infections in public hospitals and private practice. To further define the epidemiological distribution and composition of these virulence and antibiotic resistance genes, larger studies are needed.
RESUMO
Introducción: El embarazo no deseado, lleva a la mujer a practicarse un aborto. De acuerdo a International Projects Assistance Services (IPAS) en México, el aborto y sus complicaciones son la 5ª causa de muerte materna. En el D.F. la despenalización de la interrupción del embarazo antes de las 12 semanas de gestación es una ley, lo que ha significado derecho a elegir voluntaria y libremente sobre la maternidad y por lo tanto a decidir la interrupción de un embarazo. Objetivo: Caracterizar a la población que acude al programa de Interrupción Legal del Embarazo (ILE) en un hospital del sector salud del D.F. Metodología: Estudio cuantitativo, descriptivo y transversal, encuestando a 61 mujeres, que deseaban ingresar al programa ILE y aceptaron participar en el estudio. Se realizó y aplicó un instrumento de valoración con 27 ítems. Resultados: Mujeres asistentes al ILE de entre 16 y 42 años; el 46% se dedican al hogar; 50% solteras y el resto en unión libre o casadas; el 23% reportó no emplear ningún método para control de la natalidad. Principales razones para acudir al programa ILE: problemas económicos (36%), embarazo no deseado (20%), paridad satisfecha (20%). Principal sentimiento que despierta el ingreso al programa ILE: tranquilidad (82%). El 100% de las mujeres sometidas a ILE aseguran haber sido tratadas con ética y dignidad. Discusión: Se concuerda con Gutmacher que la legalización de la interrupción del embarazo coincide con el incremento en solicitudes de la mujer a este procedimiento. Respecto a las razones tales como embarazo no deseado y los problemas económicos, ello corresponde con los resultados de la encuesta IPSOS- Bimsa para Population Council en la población Mexicana. Conclusiones. Debe ser creciente la calidad de atención a la salud reproductiva, se debe priorizar en la prevención de embarazos no deseados, orientando y educando a la población y ofreciendo métodos de planificación a hombres y mujeres con vida sexual activa.
Introduction: Unwanted pregnancy leads women to undergo abortion. According to the International Projects Assistance Services (IPAS), abortion and its complications are the 5th cause of maternal death in Mexico. However, in Mexico's Federal District (D.F.), it is legal to interrupt pregnancy before the 12th week of gestation, a situation which gives women the right to freely and voluntarily decide about their maternity. Objective: To characterize the people who enroll a Legal Pregnancy Interruption Program in a D.F. health sector's hospital. Methodology: Basic and descriptive study involving 61 women who were willing to enroll the program and be part of this study. We used a 27-item instrument. Results: Out of all participants (16 to 42 years old), 46% had home activities; 50% were single; 50% were married (or de-facto); and 23% said they were not using pregnancy-prevention methods. Among the main reasons to enroll the Legal Pregnancy Interruption Program were: economical problems (36%); unwanted pregnancy (20%); and being satisfied with the number of sons (20%). 82% reported a feeling of tranquility after having enrolled the program, and all of them reported having been treated with ethics and dignity. Discussion: In agreement with Gutmacher, pregnancy interruption legalization is in parallel with the increment in women's application to pregnancy interruption procedures. Findings on economical problems and unwanted pregnancy reasons were similar to those found in the Population Council's IPSOS-Bimsa survey on the Mexican population. Conclusions: Reproductive health attention must be enhanced, emphasizing unwanted pregnancy prevention programs and thus, orienting and offering people family planning methods.
Assuntos
Humanos , Feminino , Gravidez , Aborto Legal , Anticoncepcionais , GravidezRESUMO
In four ongoing cases treated with psychoanalytic psychotherapy, the reactions presented before and after a Christmas break and the place of such reactions in the transference are examined. Separation-anxiety was evident and expressed clearly in typical reactions. However, during the reunion, the reactions took diverse forms: failure to recognise the therapist; use of maniac defenses, use of body language and self injury; verbal and motor inhibition, use of symbolic angry material and concern for a fantasied baby.