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OBJECTIVE: To identify the frequency and factors associated with therapy noncompliance in type-2 diabetes mellitus patients. MATERIAL AND METHODS: A cross-sectional study was carried out in 79 patients with type-2 diabetes mellitus seen in major hospitals of Mexico City. Patients were visited at home, from March 1998 to August 1999, to measure compliance with prescribed therapy. Complying patients were defined as those taking at least 80% of their pills or 80% of their corresponding insulin dose. The degree of compliance with therapy components (diet, amount of exercise, and keeping appointments) was measured. RESULTS: The average age of study subjects was 59 years (SD 11 years); 73% (n=58) were female subjects. The overall frequency of noncompliance was 39%. Noncompliance rates were: 62% for dietary recommendations, 85% for exercise, 17% for intake of oral hypoglycemic medication, 13% for insulin application, and 3% for appointment keeping. Hypertension plus obesity was the only factor significantly associated with noncompliance (OR 4.58, CI 95% 1.0, 22.4, p=0.02). CONCLUSIONS: The frequency of therapy noncompliance was very high, especially for diet and exercise.

OBJETIVO: Determinar el impacto nutricio del consumo de leche entera fortificada con vitaminas y minerales en niños. MATERIAL Y MÉTODOS: Se hizo un estudio prospectivo, longitudinal, en 227 niños de entre 8 a 60 meses de edad. Se ofreció a los menores 500 ml diarios de leche entera fortificada por 90 días. Se registró ingestión, aceptación, peso, talla, hemoglobina (Hb), hierro (Fe), vitamina B12 y folatos séricos. El análisis estadístico se realizó con medidas de tendencia central y dispersión en variables dimensionales utilizando prueba t de Student para comparación de promedios y ji² para variables nominales. RESULTADOS: Al inicio de la suplementación 45 niños estaban desnutridos, y 36, anémicos. Al final de la misma estas cifras disminuyeron: 35 desnutridos (p< 0.21) y 18 niños anémicos (p< 0.01). Al inicio nueve niños tenían desnutrición severa y, al finalizar, sólo eran cinco los que la padecían. La comparación ingreso-egreso en los datos antropométricos fue como sigue (media±desviación estándar): Z peso/talla, -0.35±0.88 vs. -0.14±0.9 (p= 0.01); Hb en g/dl, 11±1.3 vs. 11.9±1.9 (p< 0.001); Fe en mg/dl, 108±44 vs. 115±31 (p= 0.06); vitamina B12 en pg/ml, 649±494 vs. 1 053±854 (p< 0.001). El apego y la aceptación fueron de 100 y 85%, respectivamente. CONCLUSIONES: El consumo de leche entera fortificada durante 90 días mejora significativamente el estado nutricio de los niños, reduce significativamente el número de niños con anemia e incrementa los niveles plasmáticos de Hb, Vitamina B12 y folatos.

Abstract Background The myasthenia gravis is twice as common in women as in men and frequently affects young women in the second and third decades of life, overlapping with the childbearing years. Generally, during pregnancy in one third of patients the disease exacerbates, whereas in two thirds it remains clinically unchanged. Complete remission can occur in some patients. Methods To describe the clinical course, delivery and neonatal outcome of 18 pregnant women with the diagnosis of myasthenia gravis. Retrospective chart review of pregnant patients with myasthenia gravis, followed at the National Institute of Perinatology in Mexico City over an 8-year period. Data was abstracted from the medical records on the clinical course during pregnancy, delivery and neonatal outcome. Results From January 1, 1996 to December 31, 2003 18 patients with myasthenia gravis were identified and included in the study. The mean ± SD maternal age was 27.4 ± 4.0 years. During pregnancy 2 women (11%) had an improvement in the clinical symptoms of myasthenia gravis, 7 women (39%) had clinical worsening of the condition of 9 other patients (50%) remained clinically unchanged. Nine patients delivered vaginally, 8 delivered by cesarean section and 1 pregnancy ended in fetal loss. Seventeen infants were born at mean ± SD gestational age of 37.5 ± 3.0 weeks and a mean birth weight of 2710 ± 73 g. Only one infant presented with transient neonatal myasthenia gravis. No congenital anomalies were identified in any of the newborns. Conclusions The clinical course of myasthenia gravis during pregnancy is variable, with a significant proportion of patients experiencing worsening of the clinical symptoms. However, neonatal transient myasthenia was uncommon in our patient population.