Factores que intervienen en la decisión de abortar en adolescentes, Instituto Nacional Materno Perinatal, enero 2015 - marzo 2016 / Factors that intervene in the decision of abortion in adolescents, National Institute Maternal Perinatal, January 2015-March 2016

Objetivo: Determinar los factores personales, familiares y relacionados a la pareja que intervienen en la decisión de abortar en adolescentes, Instituto Nacional Materno Perinatal, enero 2015 - marzo 2016. Metodología: Estudio de casos y controles. El grupo de casos estuvo comprendido por 75 adolescentes que manifestaron haber tenido un aborto inducido y que se atendieron en el Instituto Nacional Materno Perinatal durante el período comprendido entre enero 2015 y marzo 2016 y el grupo de controles por 75 gestantes adolescentes sin antecedente de aborto del Instituto Nacional Materno Perinatal durante el período comprendido entre enero 2015 y marzo 2016. Resultados: Los factores personales que intervienen en la decisión de abortar son: el bajo grado de instrucción tiene un riesgo significativo con un OR de 2.688 (IC 95 por ciento 1.385-5.217), la ocupación tiene un riesgo significativo con un OR de 2.984 (IC 95 por ciento 1.535-5.798), el embarazo planificado tiene una protección significativa con un OR de 0.059 (IC 95 por ciento 0.008-0.461), el número de parejas sexuales tiene una protección significativa con un OR de 0.343 (IC 95 por ciento 0.154-0.764), el uso de métodos anticonceptivos tiene una protección significativa con un OR de 0.325 (IC 95 por ciento 0.172-0.651). Los factores familiares que intervienen en la decisión de abortar son: el estado civil de la madre tiene un riesgo significativo con un OR de 2.538 (IC 95 por ciento 1.281-5.028), el grado de instrucción de la madre tiene un riesgo significativo con un OR de 3.558 (IC 95 por ciento 1.821-6.958), el estado civil del padre tiene un riesgo significativo con un OR de 2.818 (IC 95 por ciento 1.359-5.841), la violencia familiar tiene un riesgo significativo con un OR de 7.250 (IC 95 por ciento 2.790-18.839), el ingreso familiar tiene un riesgo significativo con un OR de 2.705 (IC 95 por ciento 1.018-7.186), los hábitos nocivos familiares tienen un riesgo significativo con un OR de 3.567...

Objective: To determine the personal, family and related to the couple factors involved in the abortion decision in adolescents, National Maternal Perinatal Institute, January 2015 - March 2016. Methodology: Gases and control s study. The case group was comprised of 75 adolescents who indicate that they have had an induced abortion and that were addressed by the National Maternal Perinatal Institute during the period between January 2015 and March 2016 and the control group were 75 pregnant teenagers who have not had abortion history of National Maternal Perinatal Institute during the period between January 2015 and March 2016. Results: Personal factors involved in the decision to abort are the low level of education has a significant risk with an OR of 2.688 (95 per cent CI 1.385-5.217), the occupation has a significant risk with an OR of 2.984 (95 per cent CI 1.535 5798), the planned pregnancy has significant protection with an OR of 0.059 (95 per cent CI 0008-0461), the number of sexual partners has significant protection with an OR of 0.343 (95 per cent CI 0.154 to 0.764), use contraceptive methods has significant protection with an OR of 0.325 (95 per cent CI 0.172-0651). Family factors involved in the decision to abort are the marital status of the mother has a significant risk with an OR of 2.538 (95 per cent CI 1.281-5.028), the level of education of the mother has a significant risk with an OR of 3.558 (95 per cent CI 1.821-6.958), parent marital status has a significant risk with an OR of 2.818 (95 per cent CI 1.359-5.841), family violence is a significant risk with an OR of 7.250 (CI 95 per cent 2.790-18.839), household income has a significant risk with an OR of 2.705 (95 per cent CI 1.018-7.186), harmful habits relatives have a significant risk with an OR of 3.567 (95 per cent CI 1.818-6.999), the type of family is a protective factor with OR of 0.244 (95 per cent CI 0.111-0.536) and family support has significant protection with an OR of 0.061...

Artritis piógena por Streptococcus agalactiae. Aportación de cuatro casos y revisión de la literatura / Pyogenic arthritis caused by Streptococcus agalactiae: report of four cases and a review of the literature

En su mayoría, las infecciones por estreptococos del grupo B de la clasificación de Lancefield (Streptococcus agalactiae) afectan a mujeres gestantes o durante el puerperio, así como a neonatos. Durante las tres últimas décadas, se han comunicado cada vez más infecciones invasivas en adultos sin relación con la gestación, aunque las artritis y osteomielitis siguen siendo muy poco frecuentes. En este artículo, describimos 4 nuevos pacientes adultos con artritis séptica por S. agalactiae (2 mujeres posmenopáusicas y 2 varones), dos de ellos con afectación esternoclavicular, y realizamos una revisión de la literatura (AU)

Most infections by group B streptococcus of the Lancefield classification (Streptococcus agalactiae), were reported in pregnant women or during the puerperal period, as well as in neonates. During the past three decades there have been reports of increasingly invasive infections in adults unrelated to pregnancy, although arthritis and osteomyelitis are still very rare. In this article, we describe four new adult patients with arthritis by S. agalactiae (two postmenopausal women and two men), two of them with affection of the sternoclavicular joint. We also review the medical literatura (AU)

[Pyogenic arthritis caused by Streptococcus agalactiae: report of four cases and a review of the literature]. / Artritis piógena por Streptococcus agalactiae. Aportación de cuatro casos y revisión de la literatura.

Most infections by group B streptococcus of the Lancefield classification (Streptococcus agalactiae), were reported in pregnant women or during the puerperal period, as well as in neonates. During the past three decades there have been reports of increasingly invasive infections in adults unrelated to pregnancy, although arthritis and osteomyelitis are still very rare. In this article, we describe four new adult patients with arthritis by S. agalactiae (two postmenopausal women and two men), two of them with affection of the sternoclavicular joint. We also review the medical literature.

[Primary hepatic lymphoma: an infrequent cause of focal hepatic lesion]. / Linfoma hepático primario: causa infrecuente de lesión focal hepática.

Primary hepatic lymphoma (PHL) is confined to the liver with no evidence of extrahepatic lymphomatosis. Histopathologically, the PHL belongs to the group of non-Hodgkin's lymphomas and the most common subtype is the diffise large B-cell lymphoma. We present a 72-year-old woman, with no relevant antecedents and the following symptoms: early satiety, abdominal discomfort and rapid weight loss. Liver function tests are normal, erythrocyte sedimentation rate is accelerated and LDH progressively increases during the hospitalization. Imaging studies (ultrasound, CT scan, nuclear magnetic resonance) show a multilobued mass of around 12 cm of diameter in the right hepatic lobe. Tumoral and virological markers are negative. The pathology of an echo-guided biopsy informs a massive infiltration by a diffuse large B-cell lymphoma. The immunohistochemical study shows CD20+, CD45+ and negative CD3, CKAE1, AE3, Hepatocyte and HMB45. The citology of pleural liquid is negative for atypia, peripheral blood smear shows no signs of leukemia, bone marrow biopsy is negative for lymphomatous infiltration, and gallium scintigraphy and body CT scan do not reveal extrahepatic lesions. The patient starts chemotherapy with cyclophosphamide and methylprednisolone but worsens and dies two weeks after beginning treatment. We conclude that our patient had a rare disease with an unresectable lesion, poor prognostic factors and high recurrence risk. Chemotherapy is the treatment of choice in these cases.

Customized biofeedback therapy improves results in fecal incontinence.

BACKGROUND AND AIMS: Biofeedback therapy has been extensively used and accepted in fecal incontinence, but reports of its efficiency vary. We evaluated feedback therapy efficiency when (a) selecting the patient's subject of the therapy, and (b) customizing the therapy protocol used for each patient. PATIENTS AND METHODS: Fifty-three patients with fecal incontinence were selected for biofeedback training. The treatment program was customized for each patient depending on the underlying dysfunction, the patient's cooperative and learning attitude, and the patient's progress. Biofeedback efficiency was measured using clinical scores, subjective satisfaction of the patient, and manometry. RESULTS: Incontinent scores showed improvement in 66% of patients and good improvement in 11% and 15%, respectively, indicating an overall excellent effect of the therapy. Subjective satisfaction was strongly correlated with the previous incontinent scores. Comparison of manometry parameters before and after biofeedback therapy, including maximum anal resting, maximum anal squeeze pressure, and maximum duration of the squeeze, all showed significant differences. In addition, the sensory threshold significantly decreased after biofeedback therapy. Clinical improvements were maintained during the following 12 months. CONCLUSION: Biofeedback improves objective and subjective parameters of anorectal function. Selection of patients and customization of the therapy program increased biofeedback efficiency for the treatment of fecal incontinence.