Impacto de una intervención psicoeducativa en la habilidad para el cuidado, del cuidador principal del paciente en diálisis peritoneal / Impact of a psychoeducational intervention on the caregiving skills of the primary caregiver of a patient on peritoneal dialysis

Introducción: Desarrollar la habilidad para el cuidado por parte del cuidador principal del paciente en diálisis peritoneal requiere de un proceso de adaptación, en el que las intervenciones psicoeducativas son una estrategia importante.Objetivo: Evaluar el impacto de una intervención psicoeducativa en la habilidad para el cuidado del cuidador principal.Material y Método: Estudio cuasi experimental, con un diseño prepost, con un único grupo. La muestra estuvo formada por 40 cuidadores de pacientes en diálisis peritoneal. Se analizaron habilidad del cuidado, de afrontamiento y de adaptación, preintervención y post-intervención, mediante el inventario de Habilidad de Cuidado y la escala de medición de Afrontamiento y Adaptación. La intervención consistió en un programa estructurado sobre estrategias para mejorar el proceso de afrontamiento, adaptación al rol y desarrollo de nuevas habilidades, por parte del cuidador, llevado a cabo por un equipo multidisciplinario. Se estudiaron, además, sexo, edad, estado civil, ocupación, parentesco, tiempo dedicado a recreación y tiempo dedicado al cuidado. Resultados: El cuidador fue principalmente mujer (80%, n=32), con dedicación al hogar 47,5% (n=19), y de estado civil casado, 62,5% (n=25). Encontramos diferencias pre y post intervención en la habilidad general (211,03 + 36,30 vs 230,60 + 16,72, p<0,001), y en la capacidad global de afrontamiento y adaptación (129,32 + 12,55 vs 136,70 + 16,28, p=<0,008).Conclusión: La intervención psicoeductiva aumenta las habilidades generales de cuidados y los mecanismos de afrontamiento y adaptación en los cuidadores de pacientes en diálisis peritoneal.(AU)

Introduction: Developing the caregiver’s ability to care for a patient undergoing peritoneal dialysis requires an adaptation process, in which psychoeducational interventions are important strategies.Objective: To evaluate the impact of a psychoeducational intervention on the caregiver’s ability to care for the patient. Material and Method: This quasi-experimental pre-post design study involved a single group of 40 caregivers of peritoneal dialysis patients. Caregiving, coping, and adaptation abilities were analyzed pre- and post-intervention using the Caregiving Ability Inventory and the Coping and Adaptation Scale. The intervention consisted of a structured program on strategies to improve coping, role adaptation, and the development of new skills by the caregiver, carried out by a multidisciplinary team. Gender, age, marital status, occupation, relationship to the patient, time spent on recreation, and time spent on caregiving were also studied.Results: The caregiver was mainly a woman (80%, n=32), 47,5% (n=19) were dedicated to the home, and 62,5% were married. Differences before and after the intervention in general ability (211,03 + 36,30 vs 230,60 + 16,72, p<0,001), and in the overall coping and adaptation ability (129,32 + 12,55 vs 136,70 + 16,28, p=<0,008) were found.Conclusion: Psychoeducational intervention increases general care skills and coping and adaptation mechanisms in caregivers of patients on peritoneal dialysis.(AU)

Satisfacción laboral del personal de guarderías del IMSS y participativas en Ciudad Juárez, Chihuahua / Job satisfaction of IMSS and participatory nursing staff in Ciudad Juárez, Chihuahua

Introducción: la satisfacción laboral es la sensación positiva de sentirse satisfecho y se encuentra relacionada con la experiencia de trabajo, esto es alcanzado de manera plena cuando el trabajador satisface sus necesidades. El objetivo de la investigación es identificar la satisfacción laboral del personal de guarderías del IMSS y participativas de Ciudad Juárez, Chihuahua. Material y métodos: estudio descriptivo transversal, se aplicó el cuestionario de Meliá y Peiró S21/26 a 270 trabajadores de guarderías de Ciudad Juárez, Chihuahua, México. Resultados: se identificó que los trabajadores declararon nivel de satisfacción alta cuando reportaron antigüedad laboral menor a 1 año. La guardería IMSS reportó satisfacción con un valor de p = 0.05. Conclusión: el grado de satisfacción laboral de los trabajadores de las guarderías, reflejan un mejor ambiente laboral y una mayor calidad en el servicio prestado, lo que de manera positiva impacta en la calidad de los servicios que se ofrecen.

Introduction: Job satisfaction is the positive sensation of feeling satisfied and is related to the work experience, this is fully achieved when the worker satisfies his needs. The objective of the research is to identify the job satisfaction of the staff of IMSS and participatory day care centers in Ciudad Juárez, Chihuahua. Material and methods: A cross-sectional descriptive study, the Meliá and Peiró S21/26 Questionnaire was applied to 270 nursery workers in Ciudad Juárez, Chihuahua, Mexico. Results: It was identified that the workers declared a high level of satisfaction when they reported employment seniority of less than 1 year. The IMSS nursery reported satisfaction with a value of p = 0.05. Conclusion: The degree of job satisfaction of nurseries workers reflects a better work environment and a higher quality of service provided, which positively impacts the quality of services offered.

Percepción de atención obstétrica inadecuada a pacientes de un hospital público de Ciudad Juárez, Chihuahua / Perception of obstetric violence in patients treated in a public hospital in Ciudad Juárez, Chihuahua

Resumen OBJETIVO: Determinar la sensación de maltrato o de acciones contra el natural modo de proceder durante la atención obstétrica e identificar los factores asociados con esa percepción por parte de las pacientes atendidas en un hospital público de Ciudad Juárez, Chihuahua. MATERIALES Y MÉTODOS: Estudio descriptivo, prospectivo, de serie de casos al que se incluyeron todas las pacientes internadas en el área de Ginecología del Hospital 66 del Instituto Mexicano del Seguro Social de Ciudad Juárez, Chihuahua, con diagnóstico de puerperio de parto, cesárea y aborto atendidas entre los meses de junio a diciembre de 2022. RESULTADOS: De 496 pacientes, 13.9% (n = 67) percibieron algún tipo de procederes incorrectos en las dimensiones de: mal trato y abuso 9.9% (n = 49), atención médica no autorizada 2.4% (n = 12). En percepción de acciones contra el natural modo de proceder: 22% (n = 109) de las mujeres entre 14 y 19 años percibieron que el trato recibido no fue el adecuado. De las pacientes atendidas en el turno nocturno 18% percibieron tratos inadecuados. El 17% de las mujeres atendidas por aborto percibieron que el trato recibido no fue adecuado. Riesgo de atención alejada del natural modo de proceder: grupo de edad de 14 a 19 años (RR 1.96; 1.30-3.72), las mujeres que han tenido 1 embarazo tuvieron un RR 1.92 (1.15-3.21) y con escolaridad secundaria RR 1.35 (0.81-2.24). CONCLUSIONES: Las pacientes en mayor riesgo de no recibir una atención obstétrica apegada a las normas de buen trato fueron las adolescentes de entre 14 a 19 años, las mujeres con escolaridad secundaria, las atendidas en el turno nocturno y las primíparas. Esto evidencia que la atención obstétrica no estrictamente apegada al natural modo de proceder sigue siendo una problemática importante en nuestra población de estudio.

Abstract OBJECTIVE: To determine the feeling of mistreatment or actions against the natural way of proceeding during obstetric care and to identify the factors associated with this perception on the part of patients attended in a public hospital in Ciudad Juárez, Chihuahua. MATERIALS AND METHODS: Descriptive, prospective, case series study including all patients admitted to the Gynaecology Department of Hospital 66 of the Instituto Mexicano del Seguro Social in Ciudad Juárez, Chihuahua, with a diagnosis of postpartum labour, caesarean section and abortion attended between June and December 2022. RESULTS: Of 496 patients, 13.9% (n = 67) perceived some type of incorrect procedures in the following dimensions: mistreatment and abuse 9.9% (n = 49), unauthorised medical care 2.4% (n = 12). In perception of actions against the natural way of proceeding: 22% (n = 109) of the women between 14 and 19 years of age perceived that the treatment received was not adequate. Of the patients seen during the night shift, 18% perceived obstetric violence. 17% of the women attended for abortion perceived that the treatment received was inadequate. Risk of care away from the natural way of proceeding: age group 14-19 years (RR 1.96; 1.30-3.72), women who have had 1 pregnancy had a RR 1.92 (1.15-3.21) and with secondary schooling RR 1.35 (0.81-2.24). CONCLUSIONS: Patients at highest risk of not receiving obstetric care adhering to standards of good treatment were adolescents aged 14-19 years, women with secondary schooling, those seen on the night shift and primiparas. This shows that obstetric care that is not strictly adherent to the natural way of proceeding continues to be a major problem in our study population.

Factores de riesgo de complicaciones perinatales en el embarazo de adolescentes / Risk factors for perinatal complications in adolescent pregnancy

Resumen OBJETIVO: Identificar los factores asociados que condicionan complicaciones perinatales en las adolescentes embarazadas. MATERIALES Y MÉTODOS: Estudio de serie de casos, retrospectivo, efectuado en adolescentes embarazadas atendidas en el Hospital General de la Zona 6, Ciudad Juárez, Chihuahua, entre marzo de 2020 y marzo de 2021. Se evaluaron las complicaciones perinatales que se clasificaron en: maternas durante el embarazo, trabajo de parto y puerperio. Y perinatales en el neonato. También se tomaron en cuenta los antecedentes obstétricos (embarazos, partos, cesáreas, abortos y complicaciones). Se utilizó la prueba de χ2 y en las variables estadísticamente significativas se llevó a cabo regresión logística. RESULTADOS: Se evaluaron 287 expedientes clínicos y se encontró asociación estadísticamente significativa entre las complicaciones perinatales y los embarazos sin control prenatal. El 49.8% de las adolescentes tuvieron complicaciones perinatales durante el embarazo, 24.4% en el trabajo de parto y el 0.3% en el puerperio, mientras que el 25.4% no experimentó complicaciones. CONCLUSIONES: Es evidente que la falta total o parcial de control prenatal, aunada al hecho de ser multigesta, soltera, consumir alcohol, vivir con los padres y encontrarse en la adolescencia temprana fueron factores de riesgo de complicaciones perinatales en el embarazo. En esta etapa de la vida el embarazo se asocia con diversos factores sociodemográficos que favorecen las complicaciones perinatales.

Abstract OBJECTIVE: To identify the associated factors that condition perinatal complications in pregnant adolescents. MATERIALS AND METHODS: Retrospective, case series study conducted in pregnant adolescents attended at the Hospital General de la Zona 6, Ciudad Juárez, Chihuahua, between March 2020 and March 2021. Perinatal complications were evaluated and classified as: maternal during pregnancy, labor and puerperium. And perinatal complications in the neonate. Obstetric history (pregnancies, deliveries, cesarean sections, abortions and complications) was also taken into account. The test of 2 was used and logistic regression was performed for statistically significant variables. RESULTS: A total of 287 clinical records were evaluated and a statistically significant association was found between perinatal complications and pregnancies without prenatal control. 49.8% of the adolescents had perinatal complications during pregnancy, 24.4% in labor, and 0.3% in the puerperium, while 25.4% experienced no complications. CONCLUSIONS: It is evident that the total or partial lack of prenatal control, together with the fact of being multigestational, single, consuming alcohol, living with parents and being in early adolescence were risk factors for perinatal complications in pregnancy. At this stage of life, pregnancy is associated with various sociodemographic factors that favor perinatal complications.

"Burnout syndrome and association with work stress in nursing staff in public hospital of the northern border of Mexico".

Currently in Mexico, there is a lack of published research assessing nursing burnout in a consistent manner. The pressure of having to provide quality care to low income patients can be a serious factor triggering work stress in the nursing professional. The aim of this study was to establish the connection between burnout, work stress and both demographic and labor factors in nursing staff. A sample of 424 nurses participated in the descriptive and cross-sectional study. Each of the participants answered a questionnaire with two validated instruments, the Maslach Burnout Inventory-Human Services Survey and the Nursing Stress Scale, both in their Spanish version, as well as a demographic and labor survey of the authors' own creation. A bivariate logistic regression analysis was used to determine any significant association between the variables. We found a prevalence of 65.09% in mid-level burnout syndrome among the female sex. Men, on the other hand, featured a high level of emotional exhaustion and depersonalization, whereas the female sex showed significantly lower levels of depersonalization. Most of the staff showed acute stress levels. Some factors found in the potential development of burnout were work shift, position, department and gender.

Habilidad de cuidado del cuidador principal del adulto mayor con diálisis peritoneal / Caregiver skills of the main caregiver of the older adult with peritoneal dialysis

Introducción: la enfermedad renal crónica tiene consecuencias graves para los adultos mayores. La diálisis peritoneal continua ambulatoria es una alternativa de tratamiento, pero afecta la calidad de vida del paciente, la familia y el cuidador primario, por lo que se requiere un cuidador con habilidades que ofrezca apoyo en algunas actividades elementales y, además, apoye emocional y espiritualmente al paciente. Objetivo: identificar el nivel de la habilidad del cuidador primario del adulto mayor con diálisis peritoneal. Metodología: estudio descriptivo en 80 cuidadores familiares de adultos mayores con diálisis peritoneal continua ambulatoria. Se utilizó el instrumento Habilidad de cuidado del cuidador familiar, que consta de 55 reactivos y se divide en tres dimensiones: relación, 27 reactivos; comprensión, 18 reactivos; y modificación de la vida, 10 reactivos. El instrumento incluye variables sociodemográficas, de parentesco y tiempo dedicado al cuidado. Se elaboró una base de datos y éstos se analizaron mediante estadística descriptiva. Resultados: la habilidad de cuidado fue alta en 65%; la dimensión de relación resultó alta en 38.8% y media en 61.3%, con una comprensión alta en 86.2% y modificación de la vida alta en 68.8%. Los cuidadoras fueron mujeres en 85%; 46.3% cuidó > 37 meses; 50% cuidó > 24 h, y padres y esposa(o) apoyaron en 91.3%. Conclusión: estos hallazgos muestran que las habilidades de los cuidadores primarios fueron en general buenas, con la notoria participación del personal de enfermería en la capacitación y el apoyo recibido.

Introduction: Chronic kidney disease has severe consequences for older adults, and continuous ambulatory peritoneal dialysis is an alternative treatment, but it affects the quality of life of patient, family, and primary caregiver. It requires a caregiver with caregiving skills to provide support in some elemental activities, as well as emotional and spiritual support to the patient. Objective: To identify the level of caregiving skills of the primary caregiver of the older adult on peritoneal dialysis. Methodology: Descriptive study in 80 family caregivers of older adults with continuous ambulatory peritoneal dialysis. It was used the Caregiving skill of the family caregiver instrument, which consists of 55 items, divided into three dimensions: relationship, 27 items; understanding, 18 items; and life modification, 10 items. The instrument includes sociodemographic, relationship and time spent variables. A database was created and it was used descriptive statistics analysis. Results: Caregiving skills were high in 65%; relationship dimension high in 38.8%, and medium in 61.3%; understanding high in 86.2%; life modification high in 68.8%. 85% were female caregivers; 46.3% spent > 37 months providing care, 50% provided care > 24 hours; parents and wife/husband supported in 91.3%. Conclusion: Our findings show that caregiving skills of pri- mary caregivers were generally good with the significant involvement of the nursing staff in the training and support received.

Satisfacción de los usuarios hospitalizados en una unidad del IMSS en Ciudad Juárez, Chihuahua / Satisfaction of hospitalized users in an IMSS hospital in Ciudad Juárez, Chihuahua

Introducción: la Organización Mundial de la Salud es una de las organizaciones interesadas en estudiar los factores que determinan la satisfacción de los usuarios en el sistema de salud, donde mencionan que la satisfacción de la población depende más de factores extrínsecos al sistema de salud. Objetivo: identificar el nivel de satisfacción de la atención integral de los usuarios hospitalizados con atención médica y/o quirúrgica. Metodología: estudio descriptivo, transversal, incluyó a 501 usuarios, se aplicó una encuesta de opinión sobre la calidad de la atención hospitalaria. Resultados: el 88.4% de los participantes fueron pacientes, el 93.1% de los usuarios respondieron sentirse entre muy y bastante satisfechos, la calificación que le brindaron a la enfermera fue alta, de 95.4%, seguida de la del médico (94.4%). El 98.4% de los pacientes egresados recomiendan el hospital. Conclusiones: la satisfacción global fue alta en el 93% de los entrevistados.

Introduction: The World Health Organizaron ¡s one of the organizations ¡nterested ¡n studying the factors that determine user satisfaction in the health system, where they mention that population satisfaction depends more on factors extrinsic to the health system. Objective: To identify the level of satisfaction with comprehensive care for users hospitalized with medical and / or surgical care. Methods: Descriptive, cross-sectional study, included 501 users, an opinión survey on the quality of hospital care was applied. Results: 88.4% of the participants were patients, 93.1% of the users responded feeling very and quite satisfied, the score given to the nurse was high, 95.4%; followed by that of the doctor (94.4%). 98.4% of graduated patients recommend the hospital. Conclusions: Overall satisfaction was high in 93% of the interviewees.

Dimensiones de la relación interpersonal del profesional de enfermería en una unidad de segundo nivel / Dimensions of interpersonal relationship of the nursing professional in a second-level unit

Introducción: las relaciones interpersonales tienen gran variedad de contextos. La familia y el trabajo son la base de los grupos sociales y de la sociedad en su conjunto. Objetivo: describir las dimensiones de la relación interpersonal del profesional de enfermería en una unidad de segundo nivel. Métodos: estudio transversal analítico, en el que se incluyeron 75 profesionales de enfermería. Se elaboró un instrumento validado por ronda de expertos, con alfa de Cronbach de 0.960, el cual estuvo conformado por tres dimensiones (comunicación, trabajo en equipo y manejo de conflictos) y tuvo un total de 53 ítems, elaborados con la técnica de Likert. Se utilizó estadística descriptiva y pruebas no paramétricas. Resultados: las relaciones interpersonales fueron regulares (54.7%). Al hacer las correlaciones de comunicación, trabajo en equipo y manejo de conflictos se encontró una p < 0.005. Conclusiones: el nivel regular de las relaciones interpersonales en el profesional de enfermería ofrece un área de oportunidad para mejorarlas.

Introduction: Interpersonal relationships have a great variety of contexts. Family and work are the bases of social groups and society as a whole. Objective: To describe the dimensions of the interpersonal relationship of the nursing professional in a second level unit. Methods: Analytical cross-sectional study including 75 nursing professional. An instrument validated by an expert round, with Cronbach's alpha of 0.960, was elaborated. This instrument was formed by three dimensions communication, teamwork and conflicto management) with a total of 53 items, made with a Likert scale. Descriptive statistics and nonparametric tests were used. Results: Interpersonal relationships were regular (54.7%). Once the correlations of communication, teamwork and conflict management were made, a significance of p < 0.005 was found. Conclusions: Interpersonal relationships were at a regular level, suggesting windows of opportunity to improve interpersonal relationships in nursing.

Faith, Work, and Reciprocity: Listening to Mexican Men Caregivers of Elderly Family Members.

The purpose of this qualitative study was to examine the role of Mexican men caregivers of older adults. Studies investigating male caregiving practice in Mexico are lacking. Listening events for older adults and family caregivers were held in six cities, obtaining an ethnically and socioeconomically diverse sample of 121 participants-81 older adults and 57 primary caregivers (including 17 older adults). Focus groups discussed end-of-life issues and challenges of care. Discussions were audio recorded and field notes were made. Framework Analysis was used to analyze data. Nationally, 37% of the caregivers were men. In the metropolitan area of Mexico City, 57% of caregivers were men. The men caregivers discussed their roles and experiences. The results were categorized into three themes: (a) reciprocity in family caregiving, (b) a practical work-oriented attitude toward caregiving, and (c) strong religious faith. Caregiving formed an important part of their masculine role. Stereotypes related to gender and care should be reexamined. Further research is needed to explore gender variations in caregiving, evolving gender roles, and needs for support and services.

[Depression in older adults with extreme poverty belonging to Social Program in City Juarez, Chihuahua, Mexico]. / Depresión en adultos mayores (AM) con pobreza extrema pertenecientes a un Programa Social en Ciudad Juárez, Chihuahua, México.

OBJECTIVE: To identify depression in older adults living in extreme poverty beneficiaries of social program in City Juarez, Chihuahua. MATERIAL AND METHODS: Analytical study in 941 adults > 60 years, studied variables: age, sex, marital status, education and work, extreme poverty, place of residence, asylum. Yesavage Geriatric scale was used. STATISTICAL TESTS: X², IC < 95%, p < 0.05. The analysis was performed with SPSS 20.0. RESULTS: Prevalence of depression 45.48%, in women 46.75%. Older adults who do not work, incomplete education, living in asylum, have hypertension and pulmonary diseases increase depression risk (p < 0.05). CONCLUSION: Older Adults program beneficiaries living in extreme poverty depression is greater than that reported in the literature. The support granted by the Mexican Government to social programs that benefit older adults should be planned strategically with aims on improving the long-term health.

[Perceptions of adolescents Jalisco campaign on breast cancer]. / Percepción de los adolescentes jaliscienses de las campañas sobre cáncer de mama.

BACKGROUND: Breast cancer campaigns and awareness strategies with limited evidence of their effectiveness in youth. Behavioral model of perception that shows how individuals choose, organize and interpret information. This study shows the perceptions of youth from Jalisco regarding breast cancer campaigns. METHODS: Cross-sectional qualitative exploratory study based on constructionist and associationist theories of perception. Informed consent interviews with 13 focus groups, 129 men and women between 12 and 19 years old, enrolled students, residents of 6 regions of Jalisco. The sampling consisted in snowball technique. Interviews transcribed and processed with Atlas Ti version 4.1, open coding analysis. RESULTS: 10 campaigns were identified and the perceptions about them showed 3 processes: 1) SELECTION: permeated by the campaign design elements; 2) ORGANIZATION: influenced by pre-structured meanings of the color pink, scope and limitations of the campaigns; and 3) INTERPRETATION: showed judgments about the visibility of breast cancer, accessibility of knowledge and resources, permeability of positive ads and cultural codes and the lack of coverage meeting expectations. CONCLUSIONS: A high awareness of breast cancer among teenagers was evident as well as the extensive need of information and services. We recommend creating strategies for formal education about breast cancer during adolescence.

Introducción: las campañas sobre cáncer de mama (CaMa) y las estrategias de sensibilización tienen limitada evidencia sobre su efectividad en jóvenes. La percepción referente conductual que da cuenta cómo individuos seleccionan, organizan e interpretan información. Este estudio muestra la percepción de adolescentes jaliscienses sobre campañas de CaMa. Métodos: estudio cualitativo, exploratorio, transversal, basado en las teorías construccionista y asociacionista de la percepción. Entrevista con consentimiento informado a 13 grupos focales, 129 hombres y mujeres de 12 a 19 años, escolarizados, residentes de 6 regiones de Jalisco, muestreo: técnica bola de nieve. Entrevistas transcritas y procesadas en Atlas Ti 4.1, análisis por codificación abierta. Resultados: se identificaron 10 campañas, la percepción de ellas mostró 3 procesos: 1) Selección: permeada por elementos del diseño de las campañas; 2) Organización: influenciada por significados pre estructurados sobre el color rosa, alcances y limitaciones de las campañas, y 3) Interpretación: mostró juicios referentes a visibilización del CaMa, accesibilidad al conocimiento y recursos, permeabilización de pautas y códigos culturales positivos y no cobertura a expectativas. Conclusiones: se evidenció alta sensibilización de adolescentes ante el CaMa y amplia necesidad de información y servicios. Recomendamos generar estrategias en educación formal en la adolescencia sobre salud mamaria.

[Pregnancy and obesity: risk of developing gestational diabetes in the northern border area of Mexico]. / Embarazo y obesidad: riesgo para desarrollo de diabetes gestacional en la frontera norte de México.

INTRODUCTION: The United Sates-Mexico border area has the highest prevalence of overweight and obesity in women of reproductive age and family history of T2DM in the world, contributing to the risk of developing GDM. POPULATION AND METHODS: 58 pregnant women with GDM and 174 without GDM. Clinical records, O'Sullivan test and oral glucose tolerance test was used for diagnosis from 24 weeks of gestation. RESULTS: Average BMI 31.78 with GDM, 27.96 without GDM, O'Sullivan (GDM = 192.0 vs. 108.9 mg/dl), confirmatory test OGTT 100 g basal (88.4 vs. 82.5 mg/dl), at one hour (191. vs. 142.76 mg/dl), women with multiple births have 13 times the risk of overweight and obesity and 10.1 times of suffering GDM (p < 0.0001). Morbid obesity contributed 170% on display GDM. CONCLUSIONS: Women with GDM during pregnancy were overweight and obese. Multiparous and with overweight and obesity are at risk for the occurrence of GDM; as BMI increases the greater the occurrence of GDM.

Comparación entre métodos convencionales, ChromAgar Candida® y el método de la PCR para la identificación de especies de Candida en aislamientos clínicos / Comparison between conventional methods, ChromAgar Candida® and PCR method for the identification of Candida species in clinical isolates

El incremento en las últimas dos décadas en la incidencia de fungemias causadas por especies levaduriformes en pacientes inmunodeprimidos susceptibles y la poca sensibilidad del cultivo de sangre convencional hacen necesario el desarrollo de enfoques alternativos para la detección temprana y la identificación de las especies responsables. El objetivo de este trabajo ha sido comparar la utilidad de la prueba molecular de la reacción en cadena de la polimerasa (PCR) y métodos convencionales para identificar aislamientos clínicos de diferentes especies, incluyendo el sistema ATB ID32C (bioMérièux, Francia), el cultivo cromogénico Chromagar Candida® (Chromagar, Francia) y la morfogénesis en agar harina de maíz. Se estudiaron 79 aislamientos clínicos en los cuales la especie más prevalente usando el sistema ATB ID32C y la PCR fue C. albicans, seguida por C. tropicalis, C. glabrata y C. krusei. Los patrones de PCR obtenidos para la identificación de aislamientos clínicos fueron estables y consistentes en los diferentes ensayos independientes y mostraron una buena reproducibilidad. Se concluye que la PCR con los cebadores específicos para cada especie, que amplifican los genes ITS1 e ITS2 del ARNr o del gen de la topoisomerasa II, demostró ser un método sensible y específico para la identificación de los aislamientos de C. glabrata C. krusei, C. albicans y, con menor especificidad, para C. tropicalis(AU)

The increase in the incidence of yeast species causing fungemia in susceptible immunocompromised patients in the last two decades and the low sensitivity of conventional blood culture has led to the need to develop alternative approaches for the early detection and identification of causative species. The aim of this study was to compare the usefulness of molecular testing by the polymerase chain reaction (PCR) and conventional methods to identify clinical isolates of different species, using the ID32C ATB system (bioMérieux, France), chromogenic culture Chromagar Candida® (CHROMagar, France) and morphogenesis in corn meal agar. We studied 79 isolates, in which the most prevalent species using the system ID32C and PCR was C. albicans, followed by C. tropicalis, C. glabrata and C .krusei. PCR patterns obtained for the identification of clinical isolates were stable and consistent in the various independent studies and showed good reproducibility, concluding that PCR with species-specific primers that amplify genes ITS1 and ITS2 for rRNA or topoisomerase II primers is a very specific and sensitive method for the identification of C. glabrata, C. krusei, C. albicans, and with less specificity for C. tropicalis(AU)

[Comparison between conventional methods, ChromAgar Candida® and PCR method for the identification of Candida species in clinical isolates]. / Comparación entre métodos convencionales, ChromAgar Candida(®) y el método de la PCR para la identificación de especies de Candida en aislamientos clínicos.

The increase in the incidence of yeast species causing fungemia in susceptible immunocompromised patients in the last two decades and the low sensitivity of conventional blood culture has led to the need to develop alternative approaches for the early detection and identification of causative species. The aim of this study was to compare the usefulness of molecular testing by the polymerase chain reaction (PCR) and conventional methods to identify clinical isolates of different species, using the ID32C ATB system (bioMérieux, France), chromogenic culture Chromagar Candida® (CHROMagar, France) and morphogenesis in corn meal agar. We studied 79 isolates, in which the most prevalent species using the system ID32C and PCR was C. albicans, followed by C. tropicalis, C. glabrata and C .krusei. PCR patterns obtained for the identification of clinical isolates were stable and consistent in the various independent studies and showed good reproducibility, concluding that PCR with species-specific primers that amplify genes ITS1 and ITS2 for rRNA or topoisomerase II primers is a very specific and sensitive method for the identification of C. glabrata, C. krusei, C. albicans, and with less specificity for C. tropicalis.

Percepción de riesgo de contraer SIDA en adolescentes de Guadalajara Jalisco / Adolescent perceptions about the risk of contracting AIDS

Resumen

Objetivo: identificar la percepción del riesgo de contraer SIDA en adolescentes de Guadalajara, Jalisco.

Metodología: investigación cualitativa y análisis de texto tipo semiótico, con 49 estudiantes de 14 a 19 años. Información obtenida mediante entrevistas con grupos focales; se registró con audio grabación y observación participante; análisis centrado en narrativas desde perspectiva semántica y descripción temática; los ejes abordados son: ITS/SIDA, relaciones sexuales, embarazo, condón y fidelidad.

Resultados: la percepción de riesgo ante el SIDA es mucho menor que para embarazo, porque éste genera cambios inmediatos y hay una clara postura de rechazo familiar y social; ante el contagio de enfermedad no manifiestan preocupación latente, lo ven más como producto del azar o del destino: “si te toca te toca y aunque te cuides”, o enfocado a grupos de riesgo dentro del cual los adolescentes no se incluyen “jotos, drogos”, de aquellos que tienen relaciones con extraños o de gente promiscua. Ante el riesgo se distinguen seis posturas en las que los sujetos se mueven en función a la situación y a su interpretación; no hay una sola razón por la que pasen las cosas, concediéndole a otros la responsabilidad —e incluso— a la suerte.

Conclusiones: los adolescentes consideran al SIDA como un riesgo, pero no para ellos; tienen problemas con la información, comprensión y aceptación del problema. Respecto al uso del condón, las campañas deben ir encaminadas a reiterar las ventajas y utilidad de su uso (placer y protección) y en dar a conocer cómo usarlo. La educación sexual es un derecho y una alternativa de solución.

Summary

Objective: to know the perception of Adquired Immunodeficiecy Sindrome (AIDS) risk by adolescents.

Methodoly: a qualitative study with 49 students of 14 to 19 years old was carried out; a semiotic analysis of text was made. Information was obtained with focal groups recorded interviews. Participanting observation was also carried out; Analysis was centered in narrative since a semantic perspective and thematic description; the approached axes were Sexual Transmitted Diseases (STD) AIDS, sexual relationships, pregnancy, condom using and fidelity.

Results: high school perception of risk concerning AIDS was quite a lot less than students of becoming pregnant. Pregnancy brings immediate changes and there is a clear family and social position of rejection. They perceived it as a product of luck or fate; “If you are going to get it, you get it no matter whether you are careful or not.” Or the perception that it is focused on groups at risk and they do not consider them as part of on (“queers”, “junkies”). Six different stances are distinguished with regard to risk in function of the subjects’ situation and interpretation; there is not just one reason why these things happen and they assign the responsibility and even luck to others.

Conclusions: adolescents perceived AIDS as a risk. They have problems with information, understanding and accepting the problem. Regarding the use of condoms, campaigns should aim at repeating the advantages and usefulness of using them (pleasure and protection) and teach how to use them. Sex education is a right and an alternative solution.

[Risk factors in cesarean section]. / Factores de riesgo en la operación cesárea.

BACKGROUND: Improvement of surgical techniques, innovation, and technological development have increased the frequency of cesarean section. OBJECTIVE: To identify the sociodemographics, obstetrical, attention and medical practice factors of risk most frequently associated to cesarean section. PATIENTS AND METHOD: From January to June 2007, we carried out a study of cases and controls with 222 cases of cesarean section and 358 controls of vaginal childbirth in Hospital General no. 6 of Ciudad Juárez. We compared frequency of sociodemographics, obstetrical, attention, and medical practice variables, by means of chi2 and Fisher exact tests; association among these variables and cesarean section was considered with odds ratio. In all cases chosen confidence interval was 95%. RESULTS: Risk factors associated with cesarean section were: maternal age over 28 years, previous cesarean section, complicated pregnancy, fetal suffering, cephalopelvic disproportion, deficient prenatal care; fetal podalic version, oxytocin administration, abnormal amniotic fluid, double- or triple-circle umbilical cord; patient attended by a gynecologist with more than 16 years of experience and by a resident; and medical care in evening shift. There was no association with age, menarche, beginning of sexual relationships, body mass index, smoking, or addictions. CONCLUSIONS: Risk factors associated with cesarean section were: previous cesarean section and patient attended by a gynecologist with more than 16 years of experience and by a resident.