[Use of intravenous urea in the treatment of the patinful crises of sickle cell anemia].
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Biomedical subjects
Publications and source records attributed to R Castro.
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The authors report a case of digestive hemorrhage secondary to isolated duodenal varicosities, in a patient with ethylic cirrhosis. The diagnosis done through optical fibroscope was confirmed by arteriography. The evolution was unfavorable. Lesions were corroborated by autopsy. A review of the literature is done, about the 22 cases already published. With the help of these cases to authors stress the points that can lead to the good diagnosis and what therapeutical management should be done.
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An analysis of the logic of one of the commonest health beliefs in rural areas of Mexico is made, taking as a starting point testimonies collected in the area of Ocuituco, in the state of Morelos. This belief suggests that a pregnant woman is in danger of having a harelipped baby during a solar eclipse. The importance of the knowledge about the logic of this kind of beliefs is discussed from a public health perspective. These beliefs are associated with specific forms of suffering and give way to particular preventive measures which must be taken into account if the efficacy of health programs is to be increased. The interrelation of these beliefs with other traditional elements (such as the "loss of the shadow" and the "hot-cold theory") is discussed. Also, some of the already existing interpretations of this belief which seek to link the "loss of the shadow" with the solar eclipse belief are reviewed. Finally, an alternative interpretation of this belief is made from a structuralist methodological perspective. This interpretation is grounded in the Nahuatl myth on the creation of the sun and the moon, and in an analysis of the nature of rabbits in the Nahuatl culture, according to historic secondary sources. It is suggested that the belief about the danger of a solar eclipse must be interpreted in connection to the "hot-cold theory", but not to the "loss of the shadow". This paper concludes by emphasizing the importance of this type of research within the public health field, as it enables us both to understand the underlying logic of this type of conceptions, and to reinforce the dialogue between modern and alternative medicine, so that the daily encounter between these two types of medicine can be facilitated.
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OBJECTIVE: To identify the critical points of the trajectories of the families of persons with AIDS which may serve as a basis to develop educational and support programs. THEORY AND METHODS: A qualitative investigation was conducted in 1995 in Ciudad Netzahualcóyotl, State of Mexico, Mexico. Rapid Assessment Procedures (RAP) were applied to determine the social, economic, demographic and cultural context of persons with HIV/AIDS in the community. Forty-six in-depth interviews were applied to persons with AIDS, their families and people from their social networks. RESULTS: The main aspects of the family response to the HIV/ AIDS are characterized, and it is demonstrated that it is possible to identify critical points in such a response which can be targeted through specific interventions. In Ciudad Netzahualcóyotl, a context of poverty, a migrating tradition, and gender social relations are the basis of the acceptance or rejection of persons with AIDS. The main finding refers to the ambiguos attitude, ranging from rejection to support, displayed by family members of persons with AIDS. This pattern varies according to the history and specific conditions of each family. CONCLUSIONS: Specific health interventions are proposed to support families with one or more persons with AIDS.
Parallel to the National Health Survey-II, in 1994 a qualitative study was conducted on the patterns and microsocial determinants of health services utilization. The study was conducted in eight urban areas from all over the country among middle class and middle-low class sectors. A total of 192 individual open-ended interviews and eight focus groups were completed among users of health services; 61 service providers both from public and private services were also interviewed. This paper reports the main findings regarding the users' perspective. The first part summarizes the conceptual and methodological design. The second part presents the results from the users' point of view. Individuals distinguish between "becoming sick" and "falling sick"; preventive measures are adopted when becoming sick, in order to avoid falling sick. Another finding refers to the population tendency to add up different and even contradictory curative paradigms, as opposed to the modern medical paradigm which tends to exclude any competing alternative knowledge. A third series of findings refers to the dilemmas that utilizing health services poses for the population, given the high costs, and the low quality that characterize these services, according to the users' point of view. This paper concludes with a series of recommendations for policies, aimed at improving the quality of the health services provided to the population.
This study presents the second part of the general results obtained by a qualitative study conducted within the National Health Survey II. The object of this study was to identify main patterns and micro-social determinants which affect the process of selection and utilization of health services in order to propose policies aimed at more equity, quality and efficiency in health service delivery. The study was conducted in urban areas among the middle and middle-low class sectors. A total of 192 individual open-ended interviews and eight focus groups were completed among health users in four cities. Also, 61 service providers both from public and private services were interviewed. Since a previous work reported findings related to health service users, this study focuses only on the results pertaining to health service providers. The first part briefly discusses the study design which allowed to explore the meaning that actors--health service providers--attach to their job and working conditions. The second part presents the main findings. The sense of economic and material precariousness with which health providers from public institutions do their work is among the most important results. Common conflicts between health service users and providers are also mentioned, mainly those which arise from the organizational problems of the health center and from the scarcity of the basic drug stock. The third part reports the main coincidences and divergences between health service users and providers. Some of the divergences may be the reason for the under-utilization of health services. The work concludes with a series of policy recommendations aimed at improving the quality and opportunity of health services provided by public institutions for the needs of the population.