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OBJECTIVE: To determine the family type, family structure in a group of patients with a diagnosis of substance abuse or dependence who were at a rehabilitation center for addiction during the period between August and October 2009. METHODS: Through a descriptive qualitative-interpretative methodology 10 patients who met inclusion criteria for substance dependence or abuse were studied. The fieldwork and transcripts were made for three months by non-participant observation, non-structured interviews and examination of patients' clinical history. RESULTS: Seven of the families interviewed were single-parent families with an unconventional organization on "gender roles". Single-parent families favored loneliness, difficulty in rule-setting, de-idealization of the place of the father in the family structure and a constant search for complicity. In the analysis by categories, we found that in 10 families in the study of individuals with addictions it is common to find family structure characteristics such as inadequate communication, lack of authority rules and limits, presence of triangulations, the lack of cohesion due to the existence of a disconnected relationship pattern and changed roles compared to conventional gender. The search for the affection of the mother at her emotional overload absence of roles and lack of father, raised by the separation of the couple, was found as an essential aspect underlying the addictive behavior. A pattern of parental abandonment is configured. CONCLUSION: The findings confirmed what has been mentioned by various authors regarding the characteristics of the family typology structure and personal factors in patients with addictions, in addition to their need for affection combined with the desire for the mother's presence. The family typology does not determine for itself the abuse of psychoactive substances, but the influence of other factors such as family structure, especially deficient affective interactions, which should be considered in the development of therapeutic strategies.

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Objetivo: Determinar la estructura y la tipología familiar de un grupo de pacientes con dependencia o abuso de sustancias que se encontraban en un centro de rehabilitación de adicciones durante el periodo comprendido entre agosto y octubre de 2009. Métodos: A través de una metodología descriptiva cualitativa-interpretativa, se estudió a 10 pacientes y sus familias que cumplían los criterios de inclusión por dependencia o abuso de sustancias; el trabajo de campo y las transcripciones se realizaron durante 3 meses mediante observación no participante, entrevista no estructurada y revisión de la historia clínica del paciente. Resultados: De las familias entrevistadas, siete eran monoparentales, con una organización no convencional respecto a «roles de género¼. La familia monoparental favorece la soledad, la dificultad para poner reglas, la desidealización del lugar del padre en la estructura familiar y la búsqueda de una complicidad constante. En el análisis por categorías, se concluyó que en las 10 familias del estudio de personas con adicciones son frecuentes características de la estructura familiar como la comunicación inadecuada, la ausencia de autoridad, reglas y límites, la presencia de triangulaciones, la falta de cohesión dada por la existencia de un patrón de relación desligado y el cambio de roles convencionales con respecto a género. La búsqueda del afecto de la madre ante su ausencia emocional por la sobrecarga en los roles y la falta del padre, suscitada por la separación de la pareja, se encontró como un aspecto esencial subyacente al comportamiento adictivo. Se configura un patrón de abandono parental. Conclusiones: Se confirma lo mencionado por diversos autores acerca de las características de la tipología y la estructura familiar encontradas en pacientes con adicciones, además de su necesidad de afecto junto con la premura por una figura maternal. La tipología familiar no determina por sí misma el abuso de sustancias psicoactivas, sino la influencia de otros factores como la estructura familiar, especialmente las interacciones afectivas deficientes, lo cual debe considerarse en el desarrollo de las estrategias terapéuticas.

Objective: To determine the family type, family structure in a group of patients with a diagnosis of substance abuse or dependence who were at a rehabilitation center for addiction during the period between August and October 2009. Methods: Through a descriptive qualitative-interpretative methodology 10 patients who met inclusion criteria for substance dependence or abuse were studied. The fieldwork and transcripts were made for three months by non-participant observation, non-structured interviews and examination of patients' clinical history. Results: Seven of the families interviewed were single-parent families with an unconventional organization on "gender roles". Single-parent families favored loneliness, difficulty in rule-setting, de-idealization of the place of the father in the family structure and a constant search for complicity. In the analysis by categories, we found that in 10 families in the study of individuals with addictions it is common to find family structure characteristics such as inadequate communication, lack of authority rules and limits, presence of triangulations, the lack of cohesion due to the existence of a disconnected relationship pattern and changed roles compared to conventional gender. The search for the affection of the mother at her emotional overload absence of roles and lack of father, raised by the separation of the couple, was found as an essential aspect underlying the addictive behavior. A pattern of parental abandonment is configured. Conclusion: The findings confirmed what has been mentioned by various authors regarding the characteristics of the family typology structure and personal factors in patients with addictions, in addition to their need for affection combined with the desire for the mother's presence. The family typology does not determine for itself the abuse of psychoactive substances, but the influence of other factors such as family structure, especially deficient affective interactions, which should be considered in the development of therapeutic strategies.

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PURPOSE: Legg-Calvé-Perthes disease is an idiopathic avascular necrosis of the femoral head. Although many surgical approaches to treat the late presentation of this pathology have been proposed, there are few reports about the early results of the double osteotomy procedure (femoral varus osteotomy combined with Salter innominate osteotomy). The purpose of this study was to describe the early results obtained with the double osteotomy in patients with late presentation of Legg-Calvé-Perthes disease. METHODS: Cross-sectional evaluation of ten patients intervened with double osteotomy. There were seven males and three females with a mean age of 9.2 +/- 1.7 years [standard deviation (SD)]. The average post-surgical time of evaluation was of 46.5 +/- 26.2 months. RESULTS: Of the ten evaluated patients, four had a Catterall III and six had a Catterall IV disease. According to Herring classification, three patients were Herring B and seven were Herring C. The epiphyseal extrusion average before and after the surgical procedure was 19.3 +/- 12.4 and 12.1 +/- 14.9%, respectively. In accordance with the Ratliff classification and Lloyd Roberts radiological results, the following were the postoperative clinical results: four good, five fair and one poor. Based on the Stulberg classification, there was one patient in class I, five in class II, three in class III and one in class IV. CONCLUSION: The surgical treatment for late Perthes disease with the best expected outcome is still a challenge. According to the resultsreported here, the double osteotomy could be considered as an alternative to treat this entity.

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Este es un equilibrio descriptivo retrospectivo-prospectivo, sobre el tratamiento quirúrgico de la Luxación Recidivante Anterior de Hombro, en el cual se compararon las técnicas de Magnuson, Bankart-Magnuson modificado (Hermida) y Dutoir-Roux con la cirugía de Bankart-Putti-Platt modificado (Rockwood), las cuales tienen en común que sólo reparan tejidos blandos, lo que hace estos 2 grupos comparables y no vicia los resultados. Los hallazgos demostraron que el procedimiento de Rockwood ofrece ventajas técnicas clínicas, económicas y de pronóstico sobre los anteriores. La Técnica de Bankart-Putti-Platt modificado (Rockwood), en conclusión, es buena opción para el tratamiento de la Luxación Recidivante Anterior de Hombro en nuestro medio

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