Objectives: To describe the types of contraception used by women attending Title X-funded clinics... more Objectives: To describe the types of contraception used by women attending Title X-funded clinics and a comparable group of low-income reproductive-age women at risk of unintended pregnancy. Study design: We estimated the percentage of reproductive aged (15-44 years) women using contraception, by method type and level of effectiveness in preventing pregnancy (i.e., most, moderately, and less effective), using Title X Family Planning Annual Report (2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016) and National Survey of Family Growth (2006Growth ( -2015) ) data. We divided most effective methods into permanent (female and male sterilization) and reversible (long-acting reversible contraceptives [LARCs]) methods. Results: Among Title X clients during 2006-2016, use of LARCs increased (3-14%); use of moderately effective methods decreased (64-54%); and use of sterilization (~2%), less effective methods (21-20%), and no method (8-7%) was unchanged. These same trends in contraceptive use were observed in a comparable group of women nationally during 2006-2015, during which LARC use increased (5-19%, pb .001); moderately effective method use decreased (60-48%, pb .001); and use of sterilization (~5%), less effective methods (19%), and no method (11-10%) was unchanged. Conclusions: The contraceptive method mix among Title X clients differs from that of low-income women at risk of unintended pregnancy nationally, but general patterns and trends are similar in the two populations. Research is needed to understand whether method use patterns among low-income women reflect their preferences, access, or the conditions of the supply environment. Implications: This study contributes to our understanding of patterns and trends in contraceptive use among two groups of reproductive-age women -Title X clients and low-income women nationally who are at risk of unintended pregnancy. The findings highlight areas for further research.
Background: Recognizing that quality family planning services should include services to help cli... more Background: Recognizing that quality family planning services should include services to help clients who want to become pregnant, the objective of our analysis was to examine the distribution of services related to achieving pregnancy at publicly funded family planning clinics in the United States. Methods: A nationally representative sample of publicly funded clinics was surveyed in 2013-2014 (n ¼ 1615). Clinic administrators were asked about several clinical services and screenings related to achieving pregnancy: basic infertility services, reproductive life plan assessment, screening for body mass index, screening for sexually transmitted diseases, provision of natural family planning services, infertility treatment, and primary care services. The percentage of clinics offering each of these services was compared by Title X funding status; prevalence ratios (PRs) and 95% confidence intervals (CIs) were estimated after adjusting for clinic characteristics. Results: Compared to non-Title X clinics, Title X clinics were more likely to offer reproductive life plan assessment (adjusted PR [aPR], 1.62; 95% CI, 1.42-1.84), body mass index screening for men (aPR, 1.10; 95% CI, 1.01-1.21), screening for sexually transmitted diseases (aPRs ranged from 1.21 to 1.37), and preconception health care for men (aPR, 1.10; 95% CI, 1.01-1.20). Title X clinics were less likely to offer infertility treatment (aPR, 0.55; 95% CI, 0.40-0.74) and primary care services (aPR, 0.74; 95% CI, 0.68-0.80) and were just as likely to offer basic infertility services, preconception health care services for women, natural family planning, and body mass index screening in women. Conclusions: The availability of selected services related to achieving pregnancy differed by Title X status. A follow-up assessment after publication of national family planning recommendations is underway. Published by Elsevier Inc. on behalf of Jacobs Institute of Women's Health.
Journal of the American Academy of Child & Adolescent Psychiatry, 2019
subjects were young adults aged 24-32 years. ACE scores were computed from Add Health items deriv... more subjects were young adults aged 24-32 years. ACE scores were computed from Add Health items derived from the CDC-Kaiser Permanente Adverse Childhood Experiences study as a template. DSM-5-classified alcohol use disorder (AUD), tobacco use disorder (TUD), and cannabis use disorder (CUD) diagnoses were derived from Add Health items originally based on DSM-IV criteria. Consistent with DSM-5, SUD severity was assessed by symptom counts binned into "mild," "moderate," and "severe" groupings. Analyses were conducted using survey-based logistic regression models adjusted for sociodemographics, and risks are reported as ORs relative to those with no homelessness exposure. Results: Compared with young adults who have never experienced homelessness, those with a history of homelessness had significantly greater odds of developing an AUD (OR ¼ 2.17, p ¼ 0.0002). Mild and moderate AUDs were not associated with homelessness; however, severe AUD was more than 3 times more likely to occur in homeless young adults compared with their peers (OR ¼ 3.96, p < 0.0001). For TUD, young adults who experienced homelessness were at increased risk of TUD (OR ¼ 2.29, p < 0.0001). In terms of TUD severity, subjects who experienced homelessness had a significantly elevated risk of developing severe TUD (OR ¼ 3.93, p < 0.0001). Likewise, young adults who have experienced homelessness had increased risks of CUD (OR ¼ 3.12, p < 0.0001) with the most significant risk peaking at moderate CUD (OR ¼ 4.01, p < 0.0001). Conclusions: We found that young adults who were exposed to homelessness during childhood displayed heighten risk and severity for AUD, TUD, and CUD. Future research is needed to determine whether specific interventions can attenuate the impact of childhood adversity on the subsequent development of SUDs.
Comprehensive Guide to Post-Traumatic Stress Disorder, 2015
Epidemiological studies show that the most frequent pathology in children after a traumatic event... more Epidemiological studies show that the most frequent pathology in children after a traumatic event such as a natural disaster is post-traumatic stress disorder (PTSD), reaching a median rate of 40 % across 27 studies with a range of 6-95 %. The strategies used to cope with these traumatic situations are commonly influenced by several risk factors, including the disaster's magnitude and characteristics, individual and familiar premorbid functioning, and sociocultural conditions. Studies show that female gender and younger age are the most vulnerable subpopulation to develop PTSD symptomatology in children. Also, family
Este articulo muestra resultados de una investigacion cuyo objetivo fue construir un modelo teori... more Este articulo muestra resultados de una investigacion cuyo objetivo fue construir un modelo teorico de formacion docente basado en competencias para el nivel de Educacion Inicial, caso UPEL-IPC, este emergio de la interaccion de los actores involucrados (profesores y egresados). Fue una investigacion cualitativa. Los informantes, docentes que administran los cursos de Practica Profesional y de la Especialidad y docentes en servicio. Las tecnicas utilizadas, entrevista en Profundidad y Analisis de Contenido. Como metodo y tecnica para el analisis e interpretacion de la informacion se utilizaron el Metodo Comparativo Continuo (MCC) de Strauss y Corbin (2002) y Triangulacion. De las categorias y subcategorias que emergieron surgio la construccion del modelo teorico fundamentado en el marco de la transformacion curricular en el Documento Base (2011) y configurado de acuerdo a la intencionalidad pedagogica, emocionalidad, fase maternal desde la preconcepcion, la familia, comunidad y la e...
Post-traumatic stress disorder in children eight months after february 27, 2010 Introduction: The... more Post-traumatic stress disorder in children eight months after february 27, 2010 Introduction: There are several epidemiological studies regarding the incidence of post-traumatic stress di- sorder (PTSD) in children exposed to natural disasters. Objective: To describe the prevalence of PTSD in a school-age population in a coastal town from the Maule Region, 8 months after the earthquake/tsunami in February 2010, and to compare differences among PTSD groups of symptom (re-experiencing, avoidance and activation) according to demographic variables such as age, grade, gender and family type. Methodology: The Child PTSD Symptom Scale (CPSS), validated in Chile in 2009, was used in 89 children between 3rd and 6th grade, corresponding to 94.7% of the children enrolled in the local school in such classes. Data are analyzed by gender, age, grade and type of family. 89 surveys were applied, 59.6% were male and 40.4% female aged 8-13. Results: 40.4% of children had symptoms consistent with PTSD...
Durante muchas decadas, las preguntas de investigacion en salud de ninos y adolescentes fueron re... more Durante muchas decadas, las preguntas de investigacion en salud de ninos y adolescentes fueron respondidas por sus padres. Actualmente, se buscan conocer directamente las percepciones de los ninos y adolescentes, para lo que requiere utilizar instrumentos apropiados. Es por ello que en los procesos de validacion de escalas y cuestionarios se han incorporado las Entrevistas Cognitivas (EC).Las EC son una herramienta de investigacion cualitativa de bajo costo y complejidad, que permite evaluar la comprension de las preguntas, adaptar el lenguaje, identificar los elementos de juicio empleados para responder y aumentar el conocimiento del tema estudiado. En ninos y adolescentes, permite ademas conocer procesos cognitivos, narrativas especificas y diferencias con los adultos.Recientemente, las EC han tomado gran relevancia en el mundo anglosajon, pero a pesar de su demostrada utilidad, han sido menos aplicadas en America Latina, y existe escasa literatura de sus caracteristicas en poblac...
RESUMEN Objetivo: Determinar los tipos de virus papiloma humano mediante la técnica de reacción e... more RESUMEN Objetivo: Determinar los tipos de virus papiloma humano mediante la técnica de reacción en cadena de polimerasa en lesiones preneoplásicas (neoplasia intraepitelial cervical I, II, III) y neoplásica (cáncer in situ), en pacientes que acudieron a la consulta de patología cervical. Métodos: Estudio descriptivo transversal, no experimental y de campo, se evaluaron 102 pacientes de la consulta de patología cervical, de las cuales 42 pacientes se incluyeron en el estudio, se les practicó una entrevista y luego una toma de exfoliado cervical por la técnica de hisopado, que fueron recogidas en un tubo recolector, para ser procesados en el laboratorio clínico e inmunodiagnóstico BRIMED C. A. mediante la técnica de reacción en cadena de polimerasa. Resultados: Mediante reacción en cadena polimerasa para virus papiloma humano dieron positivo en 24 pacientes, mayormente entre las edades de 34 a 39 años con 7 pacientes, el genotipo 6 fue el más común con un total de 12 de pacientes, sie...
El Congreso Internacional de Humanidades es un evento organizado por la Universidad Santo Tomas, ... more El Congreso Internacional de Humanidades es un evento organizado por la Universidad Santo Tomas, el cual convoca a diversos actores nacionales e internacionales para que a traves de la reflexion debatan y socialicen experiencias relacionadas con los retos y desafios del mundo actual, derivados en las sinergias que la tecnologia ha dinamizado en las nuevas generaciones, los ambientes academicos y sociedad en general. En este sentido, la XVI version del Congreso Internacional de Humanidades enfoco su reflexion en las Perspectivas de humanidad en las sociedades digitales, e intento responder a la siguiente pregunta problema ?Como se reconstruye lo humano en la era digital? El dialogo academico se enuncio a partir de la concepcion de la sociedad digital como aquella que articula los avances de la ciencia y la tecnologia como un medio que propicia la emergencia de una inteligencia colectiva y un cerebro social, siendo estos propiciadores de la generacion del conocimiento como riqueza soc...
Entre los textos venezolanos del siglo XVIII hay una obra, Arca de letras y teatro universal (196... more Entre los textos venezolanos del siglo XVIII hay una obra, Arca de letras y teatro universal (1962) de Juan Antonio Navarrete, que demuestra un afan por anotar, describir y recopilar, convirtiendose asi en un registro verbal de la realidad; una especie de pequena enciclopedia que pretende narrar objetivamente los hechos del mundo exterior. Navarrete, como muchos autores que le precedieron en el proceso de representacion del Nuevo Mundo, se afirmaba como un no escritor. Paradojicamente, entre sus anotaciones se asoman discretamente momentos de esencia literaria que figuran por su estilo cuentistico: la alteracion de la secuencia historica, ausencia de opiniones por parte del narrador, imagenes simbolicas y misteriosas y un especial deleite por lo irracional, lo horrible, lo inexplicable de la naturaleza humana. Su obra se percibe como una descarga autonoma que transgrede la noticia, el recuento, la anotacion. En este sentido, no solo estariamos ante un planteamiento estetico sino ant...
Female adolescents with eating disordes: cardiac abnormalities Background: Cardiovascular complic... more Female adolescents with eating disordes: cardiac abnormalities Background: Cardiovascular complications can occur in up to 80% of adolescent patients with eating disorders (ED) and account for 30% of their mortality. Aim: To evaluate cardiovascular complications in adolescents with ED and their evolution after refeeding. Patients and Methods: In adolescents with ED admitted to treatment, we assessed the nutritional status, weight loss prior to consultation, presence of bradycardia (BC, defined as heart rate < 60 bpm), we performed an electrocardiogram (ECG) and an echocardiography and measured thyroid hormones. Results: We studied 53 women aged 16.4 ± 2.3 years. Fifteen had a diagnosis of Anorexia Nervosa (AN), seven of Bulimia (BN), eight a not otherwise specified ED (ED-NOS), four a Binge Eating Disorder (BED), sixteen an Atypical Anorexia (AAN) and three an Atypical Bulimia (ABN). Thirty four percent were malnourished and 3.8% overweight. The most common cardiac problem was BC in 51%. In eight of 26 patients in whom an echocardiogram was done, it was abnormal. Six had a decreased ventricular mass, three a pericardial effusion and three valvular involvement. There was a significant association between bradycardia and malnutrition, weight loss and low free triiodothyronine levels. BC was significantly more common in patients with AN, but it also occurred in half of the patients with AAN and in one of three patients with other types of ED. At follow up, bradycardia significantly improved with refeeding. Conclusions: There is an association between all types of ED and bradycardia, as well as anatomical and functional cardiac anomalies.
Objectives: To describe the types of contraception used by women attending Title X-funded clinics... more Objectives: To describe the types of contraception used by women attending Title X-funded clinics and a comparable group of low-income reproductive-age women at risk of unintended pregnancy. Study design: We estimated the percentage of reproductive aged (15-44 years) women using contraception, by method type and level of effectiveness in preventing pregnancy (i.e., most, moderately, and less effective), using Title X Family Planning Annual Report (2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016) and National Survey of Family Growth (2006Growth ( -2015) ) data. We divided most effective methods into permanent (female and male sterilization) and reversible (long-acting reversible contraceptives [LARCs]) methods. Results: Among Title X clients during 2006-2016, use of LARCs increased (3-14%); use of moderately effective methods decreased (64-54%); and use of sterilization (~2%), less effective methods (21-20%), and no method (8-7%) was unchanged. These same trends in contraceptive use were observed in a comparable group of women nationally during 2006-2015, during which LARC use increased (5-19%, pb .001); moderately effective method use decreased (60-48%, pb .001); and use of sterilization (~5%), less effective methods (19%), and no method (11-10%) was unchanged. Conclusions: The contraceptive method mix among Title X clients differs from that of low-income women at risk of unintended pregnancy nationally, but general patterns and trends are similar in the two populations. Research is needed to understand whether method use patterns among low-income women reflect their preferences, access, or the conditions of the supply environment. Implications: This study contributes to our understanding of patterns and trends in contraceptive use among two groups of reproductive-age women -Title X clients and low-income women nationally who are at risk of unintended pregnancy. The findings highlight areas for further research.
Background: Recognizing that quality family planning services should include services to help cli... more Background: Recognizing that quality family planning services should include services to help clients who want to become pregnant, the objective of our analysis was to examine the distribution of services related to achieving pregnancy at publicly funded family planning clinics in the United States. Methods: A nationally representative sample of publicly funded clinics was surveyed in 2013-2014 (n ¼ 1615). Clinic administrators were asked about several clinical services and screenings related to achieving pregnancy: basic infertility services, reproductive life plan assessment, screening for body mass index, screening for sexually transmitted diseases, provision of natural family planning services, infertility treatment, and primary care services. The percentage of clinics offering each of these services was compared by Title X funding status; prevalence ratios (PRs) and 95% confidence intervals (CIs) were estimated after adjusting for clinic characteristics. Results: Compared to non-Title X clinics, Title X clinics were more likely to offer reproductive life plan assessment (adjusted PR [aPR], 1.62; 95% CI, 1.42-1.84), body mass index screening for men (aPR, 1.10; 95% CI, 1.01-1.21), screening for sexually transmitted diseases (aPRs ranged from 1.21 to 1.37), and preconception health care for men (aPR, 1.10; 95% CI, 1.01-1.20). Title X clinics were less likely to offer infertility treatment (aPR, 0.55; 95% CI, 0.40-0.74) and primary care services (aPR, 0.74; 95% CI, 0.68-0.80) and were just as likely to offer basic infertility services, preconception health care services for women, natural family planning, and body mass index screening in women. Conclusions: The availability of selected services related to achieving pregnancy differed by Title X status. A follow-up assessment after publication of national family planning recommendations is underway. Published by Elsevier Inc. on behalf of Jacobs Institute of Women's Health.
Journal of the American Academy of Child & Adolescent Psychiatry, 2019
subjects were young adults aged 24-32 years. ACE scores were computed from Add Health items deriv... more subjects were young adults aged 24-32 years. ACE scores were computed from Add Health items derived from the CDC-Kaiser Permanente Adverse Childhood Experiences study as a template. DSM-5-classified alcohol use disorder (AUD), tobacco use disorder (TUD), and cannabis use disorder (CUD) diagnoses were derived from Add Health items originally based on DSM-IV criteria. Consistent with DSM-5, SUD severity was assessed by symptom counts binned into "mild," "moderate," and "severe" groupings. Analyses were conducted using survey-based logistic regression models adjusted for sociodemographics, and risks are reported as ORs relative to those with no homelessness exposure. Results: Compared with young adults who have never experienced homelessness, those with a history of homelessness had significantly greater odds of developing an AUD (OR ¼ 2.17, p ¼ 0.0002). Mild and moderate AUDs were not associated with homelessness; however, severe AUD was more than 3 times more likely to occur in homeless young adults compared with their peers (OR ¼ 3.96, p < 0.0001). For TUD, young adults who experienced homelessness were at increased risk of TUD (OR ¼ 2.29, p < 0.0001). In terms of TUD severity, subjects who experienced homelessness had a significantly elevated risk of developing severe TUD (OR ¼ 3.93, p < 0.0001). Likewise, young adults who have experienced homelessness had increased risks of CUD (OR ¼ 3.12, p < 0.0001) with the most significant risk peaking at moderate CUD (OR ¼ 4.01, p < 0.0001). Conclusions: We found that young adults who were exposed to homelessness during childhood displayed heighten risk and severity for AUD, TUD, and CUD. Future research is needed to determine whether specific interventions can attenuate the impact of childhood adversity on the subsequent development of SUDs.
Comprehensive Guide to Post-Traumatic Stress Disorder, 2015
Epidemiological studies show that the most frequent pathology in children after a traumatic event... more Epidemiological studies show that the most frequent pathology in children after a traumatic event such as a natural disaster is post-traumatic stress disorder (PTSD), reaching a median rate of 40 % across 27 studies with a range of 6-95 %. The strategies used to cope with these traumatic situations are commonly influenced by several risk factors, including the disaster's magnitude and characteristics, individual and familiar premorbid functioning, and sociocultural conditions. Studies show that female gender and younger age are the most vulnerable subpopulation to develop PTSD symptomatology in children. Also, family
Este articulo muestra resultados de una investigacion cuyo objetivo fue construir un modelo teori... more Este articulo muestra resultados de una investigacion cuyo objetivo fue construir un modelo teorico de formacion docente basado en competencias para el nivel de Educacion Inicial, caso UPEL-IPC, este emergio de la interaccion de los actores involucrados (profesores y egresados). Fue una investigacion cualitativa. Los informantes, docentes que administran los cursos de Practica Profesional y de la Especialidad y docentes en servicio. Las tecnicas utilizadas, entrevista en Profundidad y Analisis de Contenido. Como metodo y tecnica para el analisis e interpretacion de la informacion se utilizaron el Metodo Comparativo Continuo (MCC) de Strauss y Corbin (2002) y Triangulacion. De las categorias y subcategorias que emergieron surgio la construccion del modelo teorico fundamentado en el marco de la transformacion curricular en el Documento Base (2011) y configurado de acuerdo a la intencionalidad pedagogica, emocionalidad, fase maternal desde la preconcepcion, la familia, comunidad y la e...
Post-traumatic stress disorder in children eight months after february 27, 2010 Introduction: The... more Post-traumatic stress disorder in children eight months after february 27, 2010 Introduction: There are several epidemiological studies regarding the incidence of post-traumatic stress di- sorder (PTSD) in children exposed to natural disasters. Objective: To describe the prevalence of PTSD in a school-age population in a coastal town from the Maule Region, 8 months after the earthquake/tsunami in February 2010, and to compare differences among PTSD groups of symptom (re-experiencing, avoidance and activation) according to demographic variables such as age, grade, gender and family type. Methodology: The Child PTSD Symptom Scale (CPSS), validated in Chile in 2009, was used in 89 children between 3rd and 6th grade, corresponding to 94.7% of the children enrolled in the local school in such classes. Data are analyzed by gender, age, grade and type of family. 89 surveys were applied, 59.6% were male and 40.4% female aged 8-13. Results: 40.4% of children had symptoms consistent with PTSD...
Durante muchas decadas, las preguntas de investigacion en salud de ninos y adolescentes fueron re... more Durante muchas decadas, las preguntas de investigacion en salud de ninos y adolescentes fueron respondidas por sus padres. Actualmente, se buscan conocer directamente las percepciones de los ninos y adolescentes, para lo que requiere utilizar instrumentos apropiados. Es por ello que en los procesos de validacion de escalas y cuestionarios se han incorporado las Entrevistas Cognitivas (EC).Las EC son una herramienta de investigacion cualitativa de bajo costo y complejidad, que permite evaluar la comprension de las preguntas, adaptar el lenguaje, identificar los elementos de juicio empleados para responder y aumentar el conocimiento del tema estudiado. En ninos y adolescentes, permite ademas conocer procesos cognitivos, narrativas especificas y diferencias con los adultos.Recientemente, las EC han tomado gran relevancia en el mundo anglosajon, pero a pesar de su demostrada utilidad, han sido menos aplicadas en America Latina, y existe escasa literatura de sus caracteristicas en poblac...
RESUMEN Objetivo: Determinar los tipos de virus papiloma humano mediante la técnica de reacción e... more RESUMEN Objetivo: Determinar los tipos de virus papiloma humano mediante la técnica de reacción en cadena de polimerasa en lesiones preneoplásicas (neoplasia intraepitelial cervical I, II, III) y neoplásica (cáncer in situ), en pacientes que acudieron a la consulta de patología cervical. Métodos: Estudio descriptivo transversal, no experimental y de campo, se evaluaron 102 pacientes de la consulta de patología cervical, de las cuales 42 pacientes se incluyeron en el estudio, se les practicó una entrevista y luego una toma de exfoliado cervical por la técnica de hisopado, que fueron recogidas en un tubo recolector, para ser procesados en el laboratorio clínico e inmunodiagnóstico BRIMED C. A. mediante la técnica de reacción en cadena de polimerasa. Resultados: Mediante reacción en cadena polimerasa para virus papiloma humano dieron positivo en 24 pacientes, mayormente entre las edades de 34 a 39 años con 7 pacientes, el genotipo 6 fue el más común con un total de 12 de pacientes, sie...
El Congreso Internacional de Humanidades es un evento organizado por la Universidad Santo Tomas, ... more El Congreso Internacional de Humanidades es un evento organizado por la Universidad Santo Tomas, el cual convoca a diversos actores nacionales e internacionales para que a traves de la reflexion debatan y socialicen experiencias relacionadas con los retos y desafios del mundo actual, derivados en las sinergias que la tecnologia ha dinamizado en las nuevas generaciones, los ambientes academicos y sociedad en general. En este sentido, la XVI version del Congreso Internacional de Humanidades enfoco su reflexion en las Perspectivas de humanidad en las sociedades digitales, e intento responder a la siguiente pregunta problema ?Como se reconstruye lo humano en la era digital? El dialogo academico se enuncio a partir de la concepcion de la sociedad digital como aquella que articula los avances de la ciencia y la tecnologia como un medio que propicia la emergencia de una inteligencia colectiva y un cerebro social, siendo estos propiciadores de la generacion del conocimiento como riqueza soc...
Entre los textos venezolanos del siglo XVIII hay una obra, Arca de letras y teatro universal (196... more Entre los textos venezolanos del siglo XVIII hay una obra, Arca de letras y teatro universal (1962) de Juan Antonio Navarrete, que demuestra un afan por anotar, describir y recopilar, convirtiendose asi en un registro verbal de la realidad; una especie de pequena enciclopedia que pretende narrar objetivamente los hechos del mundo exterior. Navarrete, como muchos autores que le precedieron en el proceso de representacion del Nuevo Mundo, se afirmaba como un no escritor. Paradojicamente, entre sus anotaciones se asoman discretamente momentos de esencia literaria que figuran por su estilo cuentistico: la alteracion de la secuencia historica, ausencia de opiniones por parte del narrador, imagenes simbolicas y misteriosas y un especial deleite por lo irracional, lo horrible, lo inexplicable de la naturaleza humana. Su obra se percibe como una descarga autonoma que transgrede la noticia, el recuento, la anotacion. En este sentido, no solo estariamos ante un planteamiento estetico sino ant...
Female adolescents with eating disordes: cardiac abnormalities Background: Cardiovascular complic... more Female adolescents with eating disordes: cardiac abnormalities Background: Cardiovascular complications can occur in up to 80% of adolescent patients with eating disorders (ED) and account for 30% of their mortality. Aim: To evaluate cardiovascular complications in adolescents with ED and their evolution after refeeding. Patients and Methods: In adolescents with ED admitted to treatment, we assessed the nutritional status, weight loss prior to consultation, presence of bradycardia (BC, defined as heart rate < 60 bpm), we performed an electrocardiogram (ECG) and an echocardiography and measured thyroid hormones. Results: We studied 53 women aged 16.4 ± 2.3 years. Fifteen had a diagnosis of Anorexia Nervosa (AN), seven of Bulimia (BN), eight a not otherwise specified ED (ED-NOS), four a Binge Eating Disorder (BED), sixteen an Atypical Anorexia (AAN) and three an Atypical Bulimia (ABN). Thirty four percent were malnourished and 3.8% overweight. The most common cardiac problem was BC in 51%. In eight of 26 patients in whom an echocardiogram was done, it was abnormal. Six had a decreased ventricular mass, three a pericardial effusion and three valvular involvement. There was a significant association between bradycardia and malnutrition, weight loss and low free triiodothyronine levels. BC was significantly more common in patients with AN, but it also occurred in half of the patients with AAN and in one of three patients with other types of ED. At follow up, bradycardia significantly improved with refeeding. Conclusions: There is an association between all types of ED and bradycardia, as well as anatomical and functional cardiac anomalies.
Uploads
Papers by ana briceño