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Introdução: A gravidez na adolescência é considerada um problema global de saú- de pública, visto que 11% dos nascimentos em todo o mundo são oriundos de gestações em mulheres adolescentes. A taxa de reincidência de gestação durante a adolescência é de 61%, no Brasil, em adolescentes entre 10 e 19 anos, e de 17% a 35%, nos Estados Unidos, sendo ainda maior em países subdesenvolvidos. Objeti- vo: Realizar um levantamento dos conteúdos científicos sobre o uso de métodos contraceptivos e da reincidência de gestações em mulheres adolescentes. Méto- dos: Trata-se de um artigo de revisão sistemática. A busca foi realizada nas bases de dados Cochrane, LILACS e PubMed, por meio das palavras-chave Adolescent e Contraception. Foram incluídos artigos em inglês, português e espanhol publica- dos entre 2010 e 2020. Resultados: Foram encontradas 526 publicações, tendo sido excluídas 113 por duplicidade, 234 após a leitura de título, 155 após a leitura de resumo e 14 após a leitura na íntegra. Fizeram parte desta revisão oito publicações. Discussão: A amostra total contou com 2.492 adolescentes, com idade majoritária entre 14 e 19 anos, as quais, em sua maioria, eram primíparas. Nos grupos de bai- xa escolaridade, havia menos conhecimento e uso de métodos contraceptivos de longa duração (LARCs) e mais tendência ao uso de métodos de curta duração ou a relações sexuais desprotegidas. Os métodos contraceptivos pós-parto mais uti- lizados apresentavam menos eficácia, principalmente o preservativo. Conclusão: A promoção do acesso aos métodos de alta eficácia, principalmente LARCs, e o acompanhamento por meio de entrevista motivacional são capazes de reduzir a reincidência gestacional em adolescentes.(AU)

Introduction: Adolescence pregnancy is considered a global public health problem since 11% of births worldwide are from pregnancies in adolescent women. The rate of a second pregnancy during adolescence is up to 61% in Brazil in adolescents bet- ween 10 and 19 years old and 17%-35% in the United States of America, being even higher in underdeveloped countries. Objective: To survey scientific content on the use of contraceptive methods and the recurrence of pregnancies in adolescent women. Methods: This is a systematic review article. The search was carried out in Cochrane, LILACS, and PubMed databases, using the keywords Adolescent and Contraception. Articles in En- glish, Portuguese and Spanish published between 2010 and 2020 were included. Results: We found 526 publications, of which 113 were excluded due to duplication, 234 excluded af- ter reading the title, 155 after reading the abstract, and 14 after reading the full text. Eight publications were part of this review. Discussion: The total sample was made of 2,492 ado- lescents, aged between 14 and 19 years old, most of whom were primiparous. In the less educated groups, there was less knowledge about contraception, less use of long-term con- traceptive methods (LARCs), and a greater tendency to use short-term methods or unprotected sex. The postpartum con- traceptive methods most used were those with the least ef- fectiveness, mainly the condom. Conclusion: The promotion of access to highly effective methods, mainly LARCs and follow- -ups through motivational interviews are capable of reducing gestational recurrence in adolescents.(AU)

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C1q nephropathy is a rare glomerulopathy characterized by mesangial deposition of the complement component C1q. These deposits can be isolated or associated with immunoglobulins or complement fractions, which are observed by immunofluorescence or immunohistochemical microscopy. In ultramicroscopy, dense mesangial deposits and alterations of the podocyte are observed. Clinically it presents as a nephrotic syndrome (NS) or by alterations of the urinalysis such as proteinuria and/or hematuria in children and young adults. In light microscopy, it is expressed with a morphological pattern of minimal change disease (MCD), mesangial proliferative glomerulonephritis or focal segmental glomerulosclerosis (FSGS). The NS during its evolution usually evolve in steroid resistance or steroid dependency, often requiring the association of immunosuppressants to obtain remission. We report a 14 years old male with a history of NS and its evolution under various treatments during a 12-year follow-up.

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C1q nephropathy is a rare glomerulopathy characterized by mesangial deposition of the complement component C1q. These deposits can be isolated or associated with immunoglobulins or complement fractions, which are observed by immunofluorescence or immunohistochemical microscopy. In ultramicroscopy, dense mesangial deposits and alterations of the podocyte are observed. Clinically it presents as a nephrotic syndrome (NS) or by alterations of the urinalysis such as proteinuria and/or hematuria in children and young adults. In light microscopy, it is expressed with a morphological pattern of minimal change disease (MCD), mesangial proliferative glomerulonephritis or focal segmental glomerulosclerosis (FSGS). The NS during its evolution usually evolve in steroid resistance or steroid dependency, often requiring the association of immunosuppressants to obtain remission. We report a 14 years old male with a history of NS and its evolution under various treatments during a 12-year follow-up.

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Introducción: Según imágenes de la urografía excretora, megauréter fue definido como la dilatación ureteral congénita o adquirida. El megauréter obstructivo primario (MOP) se origina por un segmento estenótico y adinámico del uréter distal, produciendo dilatación proximal. Material y método: Estudio de serie de casos de MOP con resolución quirúrgica entre 1996 y 2006, en Hospital Dr. Gustavo Fricke de Viña del Mar. Se analizaron características generales, tipo de cirugía y evolución de función renal. Resultados: Se encontraron 14 casos. Se utilizó la clasificación de Filadelfia (1976) y se adaptó el diagrama de flujo para manejo del megauréter de González y Rodríguez (1996). Se llegó al diagnóstico con ecografía antenatal (6/14 casos), en seguimiento de una infección del tracto urinario (4/14), en estudio de masa abdominal (3/14), y como hallazgo incidental (1/14). Hubo 8 niños y 6 niñas. Diez casos en uréter izquierdo y cuatro en uréter derecho. Cinco niños tuvieron la condición de riñón único. Respecto a la cirugía, en 11 pacientes se efectuó una derivación transitoria (ureterostomía) y sólo en 3 pacientes neoimplante urétero-vesical primario. Seis pacientes fueron operados dentro de los primeros 3 meses de edad. La función renal se conservó en rangos normales excepto en un caso que evolucionó a insuficiencia renal Discusión: La evolución de un megauréter es dinámica e individual, y es difícil predecir el resultado de cada caso, por lo que se recomienda el análisis conjunto de la clínica y los exámenes para diagnosticar y evaluar el estado de cada paciente portador de megauréter.

Introduction: According to images of excretor urogram, megaureter is defined as a congenital or acquired ureteral dilatation. Primary Obstructive Megaureter (POM) originates from an estenotic and a dynamic distal segment of the ureter, generating proximal dilatation. Material and methods: Study of case series in Hospital Dr. Gustavo Fricke, Viña del Mar, Chile. We included totality of POM’s cases with surgical resolution between 1996 and 2006. General characteristics, type of surgery, and evolution of renal function were analyzed. Results: We report 14 cases (8 male). We used the Philadelphia classification system (1976), and we adapted the management flowchart according to González and Rodríguez (1996). Diagnosis was made with prenatal ultrasound (6/14 cases), during follow-up of a urinary tract infection (4/14), in study of abdominal mass (3/14), and as incidental find (1/14). Ten cases were left and four rights. Five cases had the condition in a solitary kidney. In eleven cases an ureterosthomy was used, and in only in three patients we performed a primary ureterovesical neoimplant. Six patients of the series were operated before 3 months of age. At follow-up, renal function was conserved normal except for one case that evolved to renal insufficiency. Conclusion: Megaureter evolution is dynamic and individual, and it‘s difficult to predict the result of every case. Thorough analysis of every patient is recommended.

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Comparamos la filtración glomerular obtenida del Renograma con DTPA (DTPA-GFR) con el clearance de creatinina (CC) y con la filtración glomerular calculada por formula de Schwartz (Schwartz-GFR). El interés por la (DTPA-GFR) deriva de la dificultad de obtener un resultado confiable de (CC) en la población pediátrica. Se estudiaron 47 pacientes, edad promedio 7 a 3m (1m - 18a7m), entre sep-2001 y mayo-2005. En todos se obtuvo (DTPA-GFR), (Schwartz-GFR) y en 18 de ellos se realizó además (CC). Se compararon las tres mediciones, separando grupos etarios. La mejor correlación se obtuvo al comparar el (DTPA-GFR) con el (CC) Pearson = 0,895. La correlación de (Schwartz) con (CC) mostró valores algo menores Pearson = 0,857 y la menor correlación se encontró al comparar (DTPA-GFR) con (Schwartz-GFR) en menores de 3 años Pearson = 0,560. Se concluye que la medición de (DTPA-GFR), muestra una leve mejor correlación con el clearance de creatinina que la estimación por el método de Schwartz y que podría considerarse un parámetro adicional de utilidad para evaluar la función renal en lactantes en los cuales es difícil realizar un Clearance de Creatinina.

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No hay trasplantes de órganos y no hay órganos si no hay donantes. Esta es la conclusión fundamental tras analizar la experiencia en la procura de órganos para transplante, llevada a cabo por un médico especificamente destinado a esta función, en el Hospital Dr, Gustavo Fricke de Viña del Mar, entre el 1 de Enero de 1997 y el 30 de Junio de 1998. Con una casuística de 44 casos de donantes potenciales, se analizan los conceptos utilizados en la procura, estableciendo sus etapas, las patologías que permiten su iniciación y las contraindicaciones para ser donante, además de sus características de ocurrencia, horario, lugar dentro del Hospital y causales de pérdida de la donación. La falta de motivación y participación de los equipos médicos que laboran en los servicios en los que se producen los potenciales donantes, reafirma la necesidad de mejor información y coordinación, actividad que es mucho más productiva cuando es llevada a cabo por un médico especializado en la procura de órganos

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