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Introduction. Anxiety can have negative effects on the course of inflammatory bowel diseases such as nonspecific chronic ulcerative colitis (NCUC) since a mechanism has been proposed, relating psychological factors and inflammatory bowel disease. Objective. To identify the relationship between anxiety levels in patients with acute NCUC at the Hospital General de Zona con Medicina Familiar No. 1, La Paz, Baja California Sur, Mexico. Material and methods. Prospective, longitudinal and analytical study. It was performed at 36 patients with a diagnosis of NCUC from this unit. The Hamilton Anxiety Questionnaire was applied with prior authorization from the ethics committee, research and informed consent from the patients. A statistical analysis of frequencies and percentages was performed for qualitative variables; of central tendency and dispersion in quantitative variables, with determination of Chi 2 in the bivariate analysis Results. Of the 36 with NCUC patients to whom the Hamilton Questionnaire was applied, the ages were 54.2 (SD 14.2) years. Obesity was observed in 44.4%, marital status married in 58.3%, primary education 41.7%, occupation of employees and pensioners 30.6%. NCUC exacerbation table occurred in 61.1%, with moderate to severe anxiety levels of 72.2% without significant association (p=0.141). Conclusion. No significant association was found between anxiety and NCUC, and it could not be corroborated among our population that disease being associated with the presence of exacerbation of the NCUC.

espanolIntroduccion: La violencia en contra de la pareja intima se ha documentado en todos los paises del mundo. La OMS estima que mundialmente alrededor de una de cada tres mujeres ha sufrido violencia, ya sea de tipo fisica y/o sexual por su pareja intima o por terceras personas en algun momento de su vida, por lo que es importante saber detectarlas y sobre todo hacerlo en actividades del sector salud. Objetivo: Identificar la capacidad de los medicos para detectar violencia contra la mujer en la consulta externa. Material y metodos: Estudio observacional, transversal, descriptivo. Previa autorizacion de los comites de investigacion, etica y firma del consentimiento informado se realizo la encuesta PREMIS a medicos especialistas que otorgan consulta de diferentes especialidades, se realizo estadistica descriptiva. Se respeto la autonomia de cada participante, en apego a las normas nacionales e internacionales en materia de investigacion, principios de Belmont, declaracion de Helsinki y Ley General de Salud en Mexico. Resultados: De un total de 58 medicos se evaluaron 30 (51.7%) medicos familiares y 28 (48.3%) medicos de otras especialidades. Predomino el sexo masculino 32 (55.2%), 41 (80.7%) medicos no tienen ninguna formacion previa en violencia contra la mujer, 39 (67.2%) se sienten minimamente preparados para detectarla. Conclusion: La capacidad de los medicos familiares y no familiares para detectar la violencia contra la mujer es menor a 50% en la poblacion de profesionales de la salud encuestados. EnglishIntroduction: Violence against intimate partners has been documented in all countries of the world. WHO estimates that worldwide around 1 in 3 women have suffered physical and/or sexual violence by their intimate partner or by third parties at some point in their life, so it is important to know how to detect them and above all to do so in health sector. Objective: To identify the capacity of doctors to detect violence against women in the outpatient clinic. Material and methods: Observational, crosssectional, descriptive study. With prior authorization from the research and ethics committees and the signing of the informed consent, the PREMIS survey was conducted with specialist physicians who provide consultations from different specialties, descriptive statistics were performed. The autonomy of each participant was respected, in adherence to national and international regulations on research, Belmont principles, the declaration of Helsinki and the general health law in Mexico. Results: Of a total of 58 doctors, 30 (51.7%) family doctors and 28 (48.3%) doctors from other specialties were evaluated. male sex predominated 32 (55.2%). 41 (80.7%) doctors do not have any previous training in violence against women, 39 (67.2%) feel minimally prepared to detect it. Conclusion: The capacity of family and non-family doctors to detect violence against women is less than 50% in the population of health professionals surveyed.

espanolIntroduccion. El estres es uno de los factores a que se encuentra expuesto un individuo al ser hospitalizado, bajo perspectivas de riesgo de muerte, soledad, abandono, cambios animicos, incapacidad temporal o definitiva, entre otros. Objetivo. Conocer el nivel de ansiedad, depresion y estres en pacientes hospitalizados en Medicina Interna en comparacion con los de cirugia. Material y metodos. Estudio observacional, descriptivo, para conocer el nivel de estres en los pacientes hospitalizados en los servicios de Medicina Interna y Cirugia. Se analizaron variables demograficas y medicion del cuestionario DASS 21. Se realizo estadistica descriptiva para variables demograficas y chi2. Todos los participantes firmaron consentimiento informado por escrito. Este estudio fue autorizado por los comites de etica e investigacion de la unidad hospitalaria. Resultados. La media de edad fue de 49,2 ± 18 anos, 51 % hombres, 120 (58,3 %) del Servicio de Cirugia, 86 (41,7 %) en medicina interna. 150 (72,8 %) estuvieron 1-7 dias de estancia. 72,8 % de los casos refirio dolor. No se encontro asociacion estadisticamente significativa entre el servicio y los niveles de depresion (p= 0,86; IC95 %: 0,78-0,88), ansiedad (p= 0,17; IC95 %: 0,13-0,24) y estres (p= 0,52; IC95 %: 0,52-0,65). Conclusion. En el presente estudio se observo que no existe una diferencia significativa en el nivel de estres de los pacientes hospitalizados en los Servicios de Medicina Interna y Cirugia. Predomino el estres leve, con una prevalencia similar en cuanto al sexo de los pacientes. EnglishIntroduction. Stress is a conditioning factor to which an individual is exposed when hospitalized, under the risk of death, loneliness, abandonment, and mood swings, temporary or permanent disability among others. Objective. To know the level of anxiety, depression and stress in hospitalized patients in internal medicine vs. surgery. Material and methods. Observational, descriptive study, to know the level of stress in hospitalized patients in the Internal Medicine and Surgery departments, demographic variables and measurement of the DASS 21 questionnaire were analyzed. Descriptive statistics were performed for demographic variables and chi2. All participants signed informed written consent. This study was authorized by the ethics and research committees of the hospital unit. Results: The mean age was 49.2 ± 18 years, 51% men. 120 (58.3%) of the surgery department, 86 (41.7%) in internal medicine. 150 (72.8%) presented 1-7 days of stay. 72.8% of cases reported pain. No statistically significant association was found between the service and the levels of depression p = 0.86 (95% CI 0.78-0.88), anxiety p = 0.17 (95% CI 0.13-0.24) and stress p = 0.52 (95% CI 0.52-0.65). Conclusion. In the present study it was observed that there is no significant difference in the level of stress of hospitalized patients in the internal medicine and surgery services. Mild stress prevailed, with a similar prevalence in terms of patient sex.

espanolAntecedentes. La percepcion de los grupos de apoyo por parte de los pacientes con enfermedad renal cronica (ERC) terminal son de gran ayuda en las estrategias terapeuticas de la enfermedad y contribuyen a mantener un mejor control de su padecimiento. Objetivo. Determinar cual es la percepcion de las redes de apoyo del paciente con ERC en terapia sustitutiva con dialisis peritoneal. Metodos. Se realizo un estudio descriptivo, transversal en 40 Pacientes con ERC en terapia sustitutiva con dialisis peritoneal, mediante encuesta de percepcion de las redes de apoyo a los pacientes seleccionados. Se realizo estadistica descriptiva para variables demograficas y x2. Se obtuvo consentimiento informado de cada paciente y se tomaron en cuenta los Principios de Belmont, la Declaracion de Helsinki y la Ley General de Salud. Fue autorizado por el Comite de Investigacion y Etica. Resultados. De los 40 encuestados el 67,5 % son hombres con una edad de 57,18 (DE 11,604) anos; 97,5 % tienen una buena percepcion de su red de apoyo; no hay asociacion estadisticamente significativa entre la percepcion de su red de apoyo y el sexo del paciente (p= 0,325; IC95 % 0,789-1,080). Conclusion. La percepcion de las redes de apoyo del paciente con ERC en terapia sustitutiva mediante dialisis peritoneal es buena en la poblacion de estudio. EnglishScientific background. The perception of support groups by patients with terminal chronic kidney disease (CKD), contribute a great help in the therapeutic strategies of the disease and to maintain a better control of their condition. Objective. To determine the perception of the patient with chronic kidney disease in replacement therapy with peritoneal dialysis of their support networks. Methods. A descriptive, cross-sectional work was carried out in 40 patients with CKD in replacement therapy using peritoneal dialysis, a perception survey of the support networks for the selected patients was carried out. Descriptive statistics were performed for demographic variables and x2 with informed consent and the principles of Belmont, Helsinki Declaration and General Health Law will be taken into account. It was authorized by the research and ethics committee R-2019-301-008. Results. Of the 40 respondents, 67.5% are men with an age of 57.18 ± 11,604 years, 97.5% have a good perception of their support network, the association between the perception of their support network and the patient’s gender, without significant association p = 0.325 (95% CI 0.789 -1.080). Conclusion. The perception of the support networks of the patient with chronic kidney disease in replacement therapy by peritoneal dialysis is good in the study population.

espanolAntecedentes. La diabetes mellitus tipo 2 (DM 2) es una enfermedad metabolica que se manifiesta por niveles de glucosa en sangre superiores a los limites normales. Las malas condiciones sociales y economicas son algunos de los principales factores de riesgo de la mala adherencia al tratamiento. Objetivo. Describir la relacion entre nivel socioeconomico y el apego al tratamiento farmacologico en pacientes con DM2. Metodos. Estudio observacional, transversal y descriptivo en 130 pacientes, utilizando la encuesta Haynes-Sackett, Morisky- Green y medicion del nivel socioeconomico (AMAI NSE). Se realizo previa aprobacion del Comite Local de Etica e Investigacion y firma del consentimiento informado. Resultados. La edad promedio fue de 56 (DE 10,66) anos; 74 % correspondian al sexo femenino, 75 % referian ser casados, 61,5 % reportaba tener algun tipo de trabajo. El 29 % tenia un nivel socioeconomico medio bajo, 18 % nivel bajo alto. La relacion entre nivel socioeconomico y el apego al tratamiento, es estadisticamente significativa (p= 0,031; IC95 % 0,001-0,060). Conclusion. Se encontro asociacion estadisticamente significativa entre el nivel socioeconomico de los pacientes y el mal apego al tratamiento; predomino el nivel medio alto en pacientes con apego al tratamiento. EnglishBackground. Type 2 diabetes mellitus (DM2), is a metabolic disease that is manifested by blood glucose levels above normal limits, the impact of social and economic inequalities is considered as one of the main risk factors for poor adherence to treatment. Objective. Describe the relationship between socioeconomic status and adherence to drug treatment in patients with DM2. Methods. Observational, cross-sectional and descriptive study in 130 patients, using the Haynes-Sackett, Morisky-Green survey and measurement of socioeconomic status (AMAI NSE). It was carried out with the prior approval of the Local Ethics and Research Committee and signed informed consent. Results. The average age was 56 (SD 10.66) years, 74% corresponded to the female gender, 75% reported being married, 61.5% reported having some type of work. The socioeconomic level was 29% with medium low level, 18% with high low level. The relationship between socioeconomic status and adherence to treatment is significant (p= 0.031; 95% CI 0.001-0.060). Conclusion. An association of the socioeconomic level of the patients and the poor attachment to the treatment were found, the medium high level prevailed in those patients with adherence to the treatment.

espanolObjetivo general. Identificar el porcentaje de apego a la Guia de Practica Clinica (GPC) en el tratamiento de neumonias. Introduccion. La diabetes mellitus 2 (DM2) es la enfermedad con mas prevalencia en Mexico. Para evitar las complicaciones de esta es necesario conseguir un buen control glucemico. Para ello la participacion de la familia es de suma importancia, en especial el subsistema conyugal. Objetivo. Conocer la relacion de la funcionalidad del subsistema conyugal y el nivel de conocimiento de la pareja del paciente con DM2 en el control de su enfermedad. Metodos. Estudio observacional, transversal, descriptivo, en 140 pacientes con DM2 de la unidad HGZ + MF #1, La Paz, Baja California Sur, de la consulta externa de medicina familiar. Se realizo encuesta sobre la funcionalidad del subsistema conyugal y sobre el nivel de conocimiento a la pareja del paciente con DM2 y se evaluo el control glucemico en el expediente electronico. Se aplico estadistica descriptiva para variables demograficas y x2 para la correlacion de variables de estudio. Resultados. De los 140 pacientes se observo un adecuado control glucemico en el 62,5 %. La relacion de control glucemico y funcionalidad del subsistema conyugal no fue estadisticamente significativa (p= 1,477, IC 95 % 0,591-3,696); con el nivel de conocimientos sobre DM2 en la pareja tampoco fue estadisticamente significativa (p= 0,545, IC 95 % 0,339-2,577). Conclusion. En esta serie no se encontro relacion entre nivel de conocimientos sobre DM2 en el subsistema conyugal funcional o con disfuncion moderada, y el control metabolico. EnglishBackground. Diabetes mellitus 2 (DM2) is the most prevalent disease in Mexico. To avoid the complications of this, it is necessary to have a good glycemic control. For this the participation of the family is of paramount importance being the conjugal subsystem the first subsystem support. Objective. To know the relationship of the functionality of the conjugal subsystem and the level of knowledge of the couple of the patient with DM2 in the control of their disease. Methods. Observational, transversal study, descriptive study, in 140 patients with DM2 from the HGZ + MF # 1 unit, La Paz, Baja California Sur, from the external query of family medicine. The survey was conducted the survey on the functionality of the marital subsystem and level of knowledge to the couple of the patient with DM2 and the glycemic control in the electronic file was evaluated. Descriptive statistics were applied for demographic variables and x2, for the correlation of study variables. Results. Of the 140 patients, an adequate glycemic control was observed in 62.5%, with the glycemic control relationship with the functionality of the conjugal subsystem was not significant (p=1,477, 95% CI 0,591-3.696), and with the level of knowledge about DM2 in the non-significant couple (p=0.545, 95% CI 0.339-2.577). Conclusion. In this series, no relationship was found between level of knowledge about DM2 in the functional or moderate dysfunctional subsystem, and metabolic control.

Introduccion La percepcion de las pacientes sobre la atencion del parto humanizado es importante para identificar y evitar datos que sugieran violencia obstetrica, que es toda conducta, accion u omision realizada por personal de la salud que afecte el cuerpo y los procesos reproductivos de las mujeres, expresada en un trato deshumanizado. Objetivo Conocer el nivel de percepcion de parto humanizado en las pacientes en periodo de puerperio en el servicio de ginecoobstetricia del Hospital General de Zona No. 1 del Instituto Mexicano del Seguro Social. Material y metodos Estudio observacional en 190 pacientes en -puerperio inmediato. Se midieron variables demograficas y se -analizo el nivel de percepcion de parto humanizado (inadecuado: 18-32 puntos; regular: 35-53; adecuado: 54-72). Se utilizaron estadistica descriptiva y medidas de asociacion. Se recabo el consentimiento informado por escrito de las participantes y fue autorizado con el numero de registro R-2018-301-020. Resultados La percepcion global de parto humanizado fue inadecuada en el 56.8%, regular en el 34.7% y adecuada en el 8.4%. Conclusion La percepcion de parto humanizado en las pacientes que estan en puerperio inmediato en nuestro hospital es inadecuada, ya que no se les proporcionaron la orientacion adecuada, la informacion sobre el manejo del dolor, la eleccion de la posicion del trabajo de parto ni la posibilidad de que un acompanante estuviera presente durante el proceso. Background The patient’s perception of humanized childbirth care is important to identify and avoid data suggestive of obstetric violence, which is all conduct, action or omission, performed by health personnel that affect the body and the reproductive processes of women, expressed in dehumanized treatment. Objective To know the level of perception of humanized childbirth in patients in the postpartum period in the OB-Gyn Service at the Hospital General de Zona No. 1 from the Instituto Mexicano del Seguro Social. Material and methods Observational study in 190 patients in the immediate puerperium. Demographic variables were measured and the level of perception of humanized delivery was analyzed (inadequate: 18-32 points; regular: 35-53 points; adequate: 54-72 points). Descriptive statistics and association measures were used. Informed written consent of the participants was signed and authorized with the registration number R-2018-301-020. Results The overall perception of humanized delivery was inadequate in 56.8%, regular in 34.7% and adequate in 8.4%. Conclusion The perception of humanized childbirth in patients who are in immediate postpartum in our hospital is inappropriate, since they were not provided with the appropriate guidance, information on pain management, choosing a position of labor, and having the possibility that a companion is present during the process.

espanolIntroduccion: De acuerdo con la OMS, la lactancia materna exclusiva (LME) consiste en dar al lactante unicamente leche materna: no otros liquidos ni solidos, ni siquiera agua, excepto soluciones de rehidratacion. Aun cuando se conocen los beneficios al lactante por parte de la madre, existe abandono de esta. Objetivo: Conocer los principales factores que influyen en la madre para el abandono de la lactancia. Material y metodos: Estudio observacional, transversal, descriptivo a 90 madres derechohabientes, en el HGZ +MF No. 1 en La Paz, Baja California Sur. Se realizo, previa firma de consentimiento informado, la encuesta de Nino y colaboradores que mide factores asociados al abandono precoz de la lactancia materna con 20 items agrupados en variables sociodemograficos maternos y socio dependientes. Se utilizo estadistica descriptiva para variables demograficas y χ2 para asociacion; todas las participantes firmaron consentimiento informado. Resultados: El 48.4% son madres trabajadoras. Los factores maternos asociados al abandono de la LME fueron: el inicio de actividades de las madres (9.9%), enfermedad del nino (8.8%), que el lactante no queda satisfecho, queda con hambre (6.6%), enfermedad de la madre con utilizacion de farmacos excretados por leche materna (5.5%), rechazo del nino al pecho (4.4%), falta de leche (4.4%), otros motivos (14.3%). Conclusion: Los factores maternos asociados al abandono de la LME que influyeron en este estudio fueron inicio de actividades de la madre, enfermedad del lactante, que el nino no queda satisfecho, queda con hambre. EnglishIntroduction: According to WHO, exclusive breastfeeding consists of giving the infant only breast milk: no other liquids or solids, not even water, except rehydration solutions. Even when the benefits to the nursing mother are known, there is abandonment of the mother. Objective: To know the main factors that influences the mother, for the abandonment of breastfeeding. Material and methods: Observational, cross-sectional, descriptive study of 90 eligible mothers, in the HGZ +MF No. 1 in La Paz, Baja California Sur. The survey by Nino et al is carried out after signing the informed consent, which measures factors associated with the early abandonment of breastfeeding with 20 items grouped into maternal and socio-dependent socio-demographic variables. Descriptive statistics were used for demographic variables and χ2 for association; all participants signed informed consent. Results: 48.4% are working mothers. The maternal factors associated with the abandonment of EB were: the initiation of activities of the mothers (9.9%), illness of the child (8.8%), that the infant was not satisfied, left hungry (6.6%), illness of the mother with use of drugs excreted through breast milk (5.5%), rejection of the child to the breast (4.4%), lack of milk (4.4%), other reasons (14.3%). Conclusion: The maternal factors associated with the abandonment of EBF that influenced this study were the initiation of activities of the mother, illness of the infant that the child is not satisfied, is left hungry.

The patient’s perception of humanized childbirth care is important to identify and avoid data suggestive of obstetric violence, which is all conduct, action or omission, performed by health personnel that affect the body and the reproductive processes of women, expressed in dehumanized treatment.To know the level of perception of humanized childbirth in patients in the postpartum period in the OB-Gyn Service at the Hospital General de Zona No. 1 from the Instituto Mexicano del Seguro Social.Observational study in 190 patients in the immediate puerperium. Demographic variables were measured and the level of perception of humanized delivery was analyzed (inadequate: 18-32 points; regular: 35-53 points; adequate: 54-72 points). Descriptive statistics and association measures were used. Informed written consent of the participants was signed and authorized with the registration number R-2018-301-020.The overall perception of humanized delivery was inadequate in 56.8%, regular in 34.7% and adequate in 8.4%.The perception of humanized childbirth in patients who are in immediate postpartum in our hospital is inappropriate, since they were not provided with the appropriate guidance, information on pain management, choosing a position of labor, and having the possibility that a companion is present during the process.La percepción de las pacientes sobre la atención del parto humanizado es importante para identificar y evitar datos que sugieran violencia obstétrica, que es toda conducta, acción u omisión realizada por personal de la salud que afecte el cuerpo y los procesos reproductivos de las mujeres, expresada en un trato deshumanizado.Conocer el nivel de percepción de parto humanizado en las pacientes en periodo de puerperio en el servicio de ginecoobstetricia del Hospital General de Zona No. 1 del Instituto Mexicano del Seguro Social.Estudio observacional en 190 pacientes en -puerperio inmediato. Se midieron variables demográficas y se -analizó el nivel de percepción de parto humanizado (inadecuado: 18-32 puntos; regular: 35-53; adecuado: 54-72). Se utilizaron estadística descriptiva y medidas de asociación. Se recabó el consentimiento informado por escrito de las participantes y fue autorizado con el número de registro R-2018-301-020.La percepción global de parto humanizado fue inadecuada en el 56.8%, regular en el 34.7% y adecuada en el 8.4%.La percepción de parto humanizado en las pacientes que están en puerperio inmediato en nuestro hospital es inadecuada, ya que no se les proporcionaron la orientación adecuada, la información sobre el manejo del dolor, la elección de la posición del trabajo de parto ni la posibilidad de que un acompañante estuviera presente durante el proceso.

espanolIntroduccion. Los medicos becarios ingresan a un sistema de salud donde se someten a jornadas laborales prolongadas, disrupciones en los periodos de sueno-vigilia, ingresos economicos limitados, habitos alimenticios inadecuados. Son situaciones que pueden impactar negativamente en el estado de animo y con alta probabilidad de presentar un trastorno de ansiedad. Objetivo. Conocer si existe relacion entre los episodios graves y el trastorno de ansiedad en medicos becarios del Hospital General de Zona Medicina Familiar No.1, La Paz, Baja California Sur, Mexico. Material y metodos. Se realizo estudio observacional y trasversal en 95 medicos becarios con firma de consentimiento informado. Se aplico la Escala de Ansiedad de Hamilton y la Escala de Episodios Graves de Thomas Holmes. Se realizo estadistica descriptiva y medidas de asociacion. Se tomaron en cuenta los principios de Belmont, Declaracion de Helsinki y Ley General de Salud. Resultados. El 52,6 % de los entrevistados corresponden al sexo masculino, edad media de 28,02 (DE 4,8) anos. No hubo asociacion significativa de la presencia de ansiedad con sexo, edad y tipologia familiar. En cuanto a la asociacion de las variables episodios graves y ansiedad, esta es estadisticamente significativa (p= 0,001, IC 95 % 0,000-0,001). Conclusion. De acuerdo con la Escala de Episodios Graves, se presentaron en mayor porcentaje como crisis moderada. En cuanto a la presencia de ansiedad, solo el 13,7 % curso con un cuadro de ansiedad moderada-grave. Existe asociacion entre la presencia de episodios graves y la de ansiedad. EnglishIntroduction. Medical scholars enter in a health system where they undergo for prolonged working hours, periods of sleep-wake disruption, limited economic income, and inadequate eating habits. These situations can negatively impact their mood with a high probability of develop an anxiety disorder. Objective. To know if there is a relationship between critical events and anxiety disorder in medical scholars at the General Hospital of Family Medicine Zone No.1, La Paz, Baja California Sur, Mexico. Material and methods. An observational and cross-sectional study was conducted in 95 Medical Scholars, Hamilton´s anxiety scale and Thomas Holmes´s critical events scale, both were applied. Descriptive statistics and association measures were performed. All signed an informed consent letter. Belmont´s principles, Helsinki´s Declaration and The Mexican Government’s Law of General Health were taken account. Results. 52.6% of the interviewees were Males, age 28.02 (SD 4.8) years. There was no significant association to the presence of anxiety with sex, age and family typology. Regarding the association of the variables: critical events and anxiety, this is statistically significant (p = 0.001, CI 95% 0.000-0.001). Conclusion. According to the critical events scales, they were presented in higher percentage as moderate or mild crisis. Regarding the presence of anxiety, only 13.7% had a moderatesevere anxiety event. There is an association between critical events and the presence of anxiety

Objetivo: determinar el control metabólico de pacientes con diabetes mellitus tipo 2 atendidos en Diabetimss y en consultorios de medicina familiar. Métodos: estudio transversal analítico, se analizaron 243 expedientes; se valoró la tasa de control metabólico de los pacientes con diabetes mellitus tipo 2 en la consulta de medicina familiar así como en Diabetimss. Se realizó estadística descriptiva para variables demográficas y χ2 de Pearson para determinar diferencias estadísticas entre grupos. Resultados: de los 243 expedientes, 54.3% fue del grupo Diabetimss y 45.7%, de la consulta de medicina familiar, la edad fue de 54.11 ±10.86 vs 63.83 ± 12.03 años, glucosa en ayuno de 128.61 ±45.63 vs 150.27 ± 55.24 (p= 0.001, ic 0.000-0.000), triglicéridos 154.20 ±90.96 vs 176.86 ±88.05 (p= 0.001, ic 1.377-3.865) y HbA1c 6.84 ± 1.52 vs 7.93 ±2.26 (p= 0.001 ic 0.526-1.656). Conclusión: existió descontrol metabólico en la población estudiada, independientemente del contexto de consulta. Se detectaron valores altos en los niveles de colesterol, hdl, ldl y triglicéridos, se presentaron diferencias estadísticamente significativas en ambos grupos.

espanolLa diabetes mellitus tipo 2 es una enfermedad cronica degenerativa con alta tasa de mortalidad en Mexico. Sin embargo, solo una pequena proporcion de pacientes tiene buen control. Para promover el cambio de habitos que lleven a una mejora en el control metabolico, el Instituto Mexicano del Seguro Social ofrece a sus pacientes el programa DiabetIMSS. Objetivo. Evaluar el adecuado control metabolico en pacientes incluidos y no incluidos en el programa DiabetIMSS. Material y metodos. Estudio observacional, transversal. Se recolectaron datos de glucosa en ayuno, hemoglobina glucosilada, colesterol, trigliceridos, presencia de glucosuria e indice de masa corporal a 191 pacientes diagnosticados de diabetes mellitus tipo 2: 94 del programa DiabetIMSS, que fueron comparados con 97 pacientes de consulta externa de Medicina Familiar. Se utilizo estadistica descriptiva y medidas de asociacion. Resultados. De 191 pacientes, 94 asistieron al programa DiabetIMSS y 97 a consulta externa de Medicina Familiar. Se encontro un mejor control en hemoglobina glucosilada y ausencia de glucosuria en el grupo DiabetIMSS. El indice de masa corporal fue mayor en pacientes de DiabetIMSS. Conclusion. Los pacientes del grupo DiabetIMSS alcanzaron cifras cercanas a las metas esperadas en comparacion a los de la consulta externa. EnglishDiabetes mellitus type 2 is a chronic degenerative disease with a high mortality rate in Mexico. However, only a small proportion of patients have good control. To promote the change of habits that lead to an improvement in metabolic control, the Mexican Social Security Institute offers its patients the DiabetIMSS program. Objective. To evaluate the adequate metabolic control in patients included and not included in the DiabetIMSS program. Material and methods. Observational, cross-sectional study. Fasting glucose, glycosylated hemoglobin, cholesterol, triglycerides, glycosuria and body mass index data were collected in 191 patients diagnosed with type 2 diabetes mellitus. 94 of the DiabetIMSS Program and compared with 97 outpatients of Family Medicine. Descriptive statistics and association measures were used. Results. Of 191 patients, 94 attended the DiabetIMSS program and 97 attended outpatient Family Medicine. Better control was found in glycosylated hemoglobin and absence of glucosuria in the DiabetIMSS group. The body mass index was higher in DiabetIMSS patients. Conclusion. The patients of the DiabetIMSS group reached figures close to the better goals compared to those of the External Consultation.

espanolObjetivos. Determinar si existe relacion entre la flexibilidad familiar y la presencia de depresion en medicos becarios del Hospital General de Zona y Medicina Familiar numero 1. Instituto Mexicano del Seguro Social, Baja California Sur. Mexico. Material y metodos. Se realizo un estudio observacional, transversal y descriptivo. Se evaluo a 86 medicos becarios con firma de consentimiento informado, 44 internos de pregrado y 42 residentes de Medicina Familiar. Se realizo una encuesta con datos demograficos, inventario de Beck y FACES III. Resultados. Encontramos predominio del 96,5 % de familias urbanas. De acuerdo a los servicios con los que cuenta la familia y por el desarrollo de la misma existe un predominio de las modernas sobre las tradicionales (53,5 % y 46,5 %, respectivamente). La presencia de depresion fue del 9,3 %. En la poblacion estudiada se encontro un predominio de familias relacionada flexible, semirrelacionada caotica y aglutinada caotica del 17 % cada una. Se encontro significacion estadistica entre depresion y tipo de familia de acuerdo a su desarrollo; las relaciones de presencia de depresion con las demas variables no fueron estadisticamente significativas. Conclusiones. Se encontro en el presente estudio que ha aumentado la cantidad de mujeres en los cursos de Medicina, con familias urbanas y con cambio hacia familias modernas. Existe una probable relacion entre la depresion, la flexibilidad y tipologia familiar de acuerdo a su desarrollo, por lo que se puede decir que en este estudio se encontro que en la familia caotica moderna se tiene mayor probabilidad de desarrollar depresion. EnglishObjectives. To determine if there is a relation between familial flexibility and presence of depression in scholarship physicians of the General Hospital Area and Familial Medicine Unit No. 1. Instituto Mexicano del Seguro Social, Baja California Sur. Mexico. Material and methods. A cross-sectional, descriptive, observational study was conducted. After signing an informed consent, 86 physicians, who were scholarship holders were evaluated (44 pregraduate interns and 42 residents of Family Medicine). A survey was made using demographic data, Beck inventory and FACES III. Results. We found a predominance of 96.5 % urban families. In accordance with the services the family has available and for its development, there is a predominance of the modern over traditional ones (53.5 % and 46.5 %, respectively). Presence of depression was 9.3 %. In the population studied, there was a predominance of flexible related, semirelated chaotic and agglutinated chaotic families of 17 % each one. A statistical significance was found between depression and type of family in accordance with its development, the relations of presence of depression with the other variables were not statistically significant. Conclusions. The present study showed that the number of women in the Medical courses with urban families and with change towards modern families has increased. There is a probable relation between depression, flexibility and family type in accordance with its development. Thus, it can be stated that it was found that there is a greater likelihood of developing depression in the modern chaotic family in this study.

espanolEl embarazo conlleva cambios fisiologicos y emocionales que pueden afectar a la dinamica familiar. Algunos aspectos psicosociales no favorecen la adaptacion al embarazo, pueden causar cambios emocionales y generar manifestaciones ansiosas y depresivas. Objetivo general. Conocer la relacion del embarazo de alto riesgo con la dinamica familiar y el subsistema conyugal. Material y metodo. Estudio observacional en 30 pacientes embarazadas con riesgo obstetrico alto que se encontraban viviendo con su pareja. Se evaluaron por medio del test APGAR familiar y el subsistema conyugal. Se utilizo estadistica descriptiva para variables demograficas y chi2 para asociacion. Resultados. De acuerdo con la tipologia familiar, 73,3 % nucleares, 66,7 % modernas, 83,3 % integradas, 100 % urbanas y 50 % son empleadas. El 93,3 % de las familias son funcionales (APGAR) y segun el subsistema familiar, 90 % fueron funcionales. No se encontro asociacion estadisticamente significativa entre riesgo obstetrico y APGAR familiar (p=0,121, IC 95 % 0,106-0,118). Tampoco se encontro asociacion estadisticamente significativa entre el riesgo obstetrico y el subsistema conyugal (p=0,475, IC 95 % 0,694-0,712). Conclusion. No se encontro relacion del embarazo de alto riesgo con la dinamica familiar ni con el subsistema conyugal. EnglishPregnancy leads to physiological and emotional changes that can affect family dynamics. Some psychosocial aspects do not favor the adaptation to pregnancy and can cause emotional changes, generating anxious and depressive manifestations. Course objective. To know the relation of the high risk pregnancy with the family dynamics and the marital subsystem. Material and method. Observational study in 30 pregnant patients with high obstetric risk who were living with their partner. They were evaluated by the family APGAR test and the marital subsystem. Descriptive statistics were used for demographic variables and chi2 for association. Results. According to the family typology, 73.3% nuclear, 66.7% modern, 83.3% integrated, 100% urban and 50% are employed. 93.3% of the families are functional (APGAR) and according to the family subsystem, 90% were functional. No significance was found between obstetric risk and family APGAR (p = 0.1.21, 95% CI 0.106-0.118). As between the obstetric risk and the marital subsystem, no significance was found, finding p = 0.475, 95% CI 0.694-0.712. Conclusion. No high-risk pregnancy relationship was found with family dynamics or with the marital subsystem

espanolIntroduccion. La diabetes mellitus tipo 2 (DM2) es la principal causa de enfermedad renal cronica (ERC). Los pacientes diabeticos pueden presentar funcion renal disminuida o una ERC en evolucion. Es importante implementar las guias de practica clinica (GPC) para mejorar la calidad de la practica medica. Objetivos. Identificar el apego de la GPC para la deteccion oportuna de ERC en pacientes con DM2 en la atencion primaria. Material y metodos. Estudio observacional de 90 expedientes de pacientes con DM2. Se determino apego a la GPC de al menos 80 %, se evaluaron variables demograficas y la tasa de filtrado glomerular (TFG). Se utilizo Chi cuadrada de Pearson y Kruskal-Wallis. Resultados. Edad 60,27 (DE 11,74), 62,2 % sexo femenino. El apego a la GPC fue de 61,2 %. Se encontro sobrepeso y obesidad grado I de manera similar (27,8 % apego y no apego). Se analizo la TFG: el mayor porcentaje de pacientes se encontraron en etapa I. Cabe mencionar que en un 33 % no se realizo el calculo de filtrado glomerular. Conclusiones. El grado de apego a la GPC para la deteccion oportuna de ERC en pacientes con DM2 es menor a lo esperado. Existe un descontrol de los niveles de glucosa al igual que en aquellos que no hay apego a la GPC. EnglishBackground. DM2 is the main cause of chronic kidney disease (CKD). Diabetic patients may have decreased renal function or an evolving ER. It is important to implement CPGs to improve the quality of medical practice. Objectives. To identify the attachment of the CPG for the timely detection of CKD in patients with DM2 in primary care. Material and methods. Observational study of 90 records of patients with DM2. We determined adherence to the CPG ≥ 80%, demographic variables and GFR were evaluated. Chi square from Pearson and Kruskal-Wallis was used. Results. Age 60.27 ± 11.74, 62.2% female. The adherence to the CPG was 61.2%. In relation to BMI, overweight and Obesity grade I were found in a similar way (27.8% attachment and non-attachment). The GFR was analyzed, the highest percentages of patients were found in stage I. It should be mentioned that in 33% the calculation was not performed of glomerular filtration. Conclusions. The degree of attachment to the CPG for the timely detection of CKD in patients with DM2 is lower than expected. There is a lack of control of glucose levels as well as in those with no adherence to CPG.