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INTRODUCTION: Management of the patient with cirrhosis of the liver that requires surgical treatment has been relatively unexplored. In Mexico, there is currently no formal stance or expert recommendations to guide clinical decision-making in this context. AIMS: The present position paper reviews the existing evidence on risks, prognoses, precautions, special care, and specific management or procedures for patients with cirrhosis that require surgical interventions or invasive procedures. Our aim is to provide recommendations by an expert panel, based on the best published evidence, and consequently ensure timely, quality, efficient, and low-risk care for this specific group of patients. RESULTS: Twenty-seven recommendations were developed that address preoperative considerations, intraoperative settings, and postoperative follow-up and care. CONCLUSIONS: The assessment and care of patients with cirrhosis that require major surgical or invasive procedures should be overseen by a multidisciplinary team that includes the anesthesiologist, hepatologist, gastroenterologist, and clinical nutritionist. With respect to decompensated patients, a nephrology specialist may be required, given that kidney function is also a parameter involved in the prognosis of these patients.

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BACKGROUND: Pituitary adenomas (PA) are neoplasms of pituitary adenohypophyseal cell lineage, which are the third most common cause of brain tumors among adults. Due to hormone secretion, PAs are closely related to metabolic syndrome (MetS). However, the relationship between these two entities has been scarcely studied to date. PURPOSE: This paper aims to evaluate changes in the metabolic status of patients with PA before and after surgical treatment and to look for differences in metabolic outcomes among patients according to the adenoma type and the surgery success rate. METHODS: We assessed patients with PA who went through transsphenoidal surgery for its treatment, documenting metabolic parameters before and after surgery, analyzed whole sample changes, and then stratified them according to adenoma type (nonfunctioning, somatotroph, lactotroph, and corticotroph), and surgery success (total resection, near-total resection, partial resection, subtotal resection). RESULTS: A total of 214 patients were enrolled for this study. The prevalence of MetS with AACE criteria went from 51.52% before surgery to 28.99% after surgery (P < 0.001). Hyperglycemia (HG) was the most beneficial component; it went from 56% pre-surgery to 40.51% post-surgery (P = 0.03). The total resection group had the best improvement, with a significant decrease of prevalence in MetS from 83 to 16% (P < 0.001), and every component, except hypoalphalipoproteinemia (HA): obesity went from 96 to 67% (P < 0.001), arterial hypertension (AH) 59 to 24% (P < 0.001), HG 74 to 23% (P < 0.001), and hypertriglyceridemia (HTG) from 81 to 54% (P < 0.001). According to MetS prevalence, there was no difference in the improvement according to PA type. CONCLUSION: Surgical treatment in patients with PA is associated with MetS improvement.

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Point-of-care ultrasound (POCUS) refers to the use of ultrasound imaging through pocket-sized sonographic devices at the patient's bedside, to make a diagnosis or direct a procedure and immediately answer a clinical question. Its goal is to broaden the physical examination, not to replace conventional ultrasound studies. POCUS has evolved as a complement to physical examination and has been adopted by different medical specialties, including hepatology. A narrative synthesis of the evidence on the applications of POCUS in hepatology was carried out, describing its usefulness in the diagnosis of cirrhosis of the liver, metabolic dysfunction-associated steatotic liver disease (MASLD), decompensated cirrhosis, and portal hypertension. The review also encompasses more recent applications in the hemodynamic evaluation of the critically ill patient with cirrhosis of the liver, patients with other liver diseases, as well as in the ultrasound guidance of procedures. POCUS could make up part of the daily clinical practice of gastroenterologists and hepatologists, simplifying the initial evaluation of patients and optimizing clinical management. Its accessibility, ease of use, and low adverse event profile make POCUS a useful tool for the properly trained physician in the adequate clinical setting. The aim of this review was to describe the available evidence on the usefulness of POCUS in the daily clinical practice of gastroenterologists and hepatologists.

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INTRODUCTION AND AIMS: Posttransplantation diabetes mellitus (PTDM) is a serious long-term complication that has a negative impact on graft and patient survival. The purpose of the present study was to describe the incidence of PTDM in a Mexican cohort and evaluate its association with a previous family history of diabetes (FHD). METHODS: A retrospective single-center cohort study was conducted on patients undergoing liver transplantation (LT). The primary outcome was time from LT to PTDM. The diagnosis of PTDM was established using the ADA criteria. A mediation analysis that used adjusted Cox regression models and considered pretransplant prediabetes a mediator was performed, to determine the total effect and direct effect of FHD on PTDM. RESULTS: A total of 152 patients were included, with a median follow-up time of 41 months; 19.2% (n = 29) had pretransplant diabetes. During the follow-up time, 15% of patients developed PTDM (n = 23), with an incidence rate of 4.71 cases/100 person-years. PTDM was significantly higher in patients with FHD, compared with those with no FHD (8.72 cases/100 person-years vs 2.04 cases/100 person-years, respectively; p = 0.001). The adjusted hazard ratio of PTDM for FHD was 4.14 (95% CI 1.60-10.7), p = 0.005) and 3.48 (95% CI 1.35-9.01, p = 0.010), when further controlled for pretransplant prediabetes. CONCLUSION: The occurrence of PTDM was similar to that reported in most international studies. As with type 2 diabetes, family history plays an important role in the development of PTDM, even after accounting for pretransplant prediabetes. Patients with FHD should undergo a stricter metabolic program.

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The first clinical guidelines on hepatic encephalopathy were published in 2009. Almost 14 years since that first publication, numerous advances in the field of diagnosis, treatment, and special condition care have been made. Therefore, as an initiative of the Asociación Mexicana de Gastroenterología A.C., we present a current view of those aspects. The manuscript described herein was formulated by 24 experts that participated in six working groups, analyzing, discussing, and summarizing the following topics: Definition of hepatic encephalopathy; recommended classifications; epidemiologic panorama, worldwide and in Mexico; diagnostic tools; conditions that merit a differential diagnosis; treatment; and primary and secondary prophylaxis. Likewise, these guidelines emphasize the management of certain special conditions, such as hepatic encephalopathy in acute liver failure and acute-on-chronic liver failure, as well as specific care in patients with hepatic encephalopathy, such as the use of medications and types of sedation, describing those that are permitted or recommended, and those that are not.

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There are a few studies suggesting that the hippocampus is involved in the regulation of impulsivity, and which attempt to explain drug seeking behavior in addiction. In addition, cannabinoid receptor 1 (CB1R) is highly expressed in the hippocampus (HPP). To further understand the potential role of the hippocampal CB1R in impulsive and drug seeking behaviors, we characterized impulsivity in adolescent and adult male rats, by means of a delay discounting task (DDT) by evaluating preference and seeking motivation for alcohol (10 % v/v) consumption, and analyzing CB1R expression in CA1, CA3 and the dentate gyrus (DG) of the HPP as well as in the medial prefrontal cortex (mPFC). Our results show that adolescent rats display more impulsive choices than adult rats in the DDT. The k value is statistically higher in adolescents, further supporting that they are more impulsive. Besides, adolescent rats have higher forced and voluntary alcohol consumption and display a higher alcohol conditioned place preference (CPP) vs. adult rats. In addition, CB1R expression in CA3 and the DG is higher in adolescent vs. adult rats. Our data further support the role of the hippocampus in impulsivity with the potential involvement of the endocannabinoid system, considering that CB1R in CA3 and DG is higher in adolescents, who display impulsivity and alcohol seeking and consumption.

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BACKGROUND: Pituitary adenomas are benign tumors located in the anterior hypophysis. Its appearance is associated with the development of parameters related to metabolic syndrome; therefore, surgical treatment could reduce associated morbimortality. METHODS: Pre- and post-surgical MRI, using the Hardy-Wilson and Knosp classification, and clinical data according to the American Association of Clinical Endocrinology (AACE) criteria for metabolic syndrome: all the patients were followed-up until 208.57 days were reviewed on 217 consecutive patients with pituitary surgery. RESULTS: Seventy-four patients were included in this study. There was a significant reduction in tumor size in mm3 [average pre- and post-surgery respectively: 12,362 mm3 (±12,397); 3,910 mm3 (±7,160)], (p < 0.0001). This was confirmed by the Hardy-Wilson and Knosp classification, where most patients went from grade IV C (33.7%) to grade 0 (12.1%), IA (20.2%), IIB (21.36%), and IIC (16.2%); as well as from grade 4 (24.3%) to grade 0 (45.9%), respectively. After surgery, there were statistically significant reductions in total serum levels of glucose [average pre- and post-surgery, respectively: 116 mg/dL (±26.9); 90 mg/dL (±10.2)], (p < 0.001), triglycerides [average pre- and post-surgery, 240 mg/dL (±102); 171 mg/dL (±60.5)], (p = 0.001); and HDL-c [average pre- and post-surgery, respectively: 39 mg/dL (±11.8); 44.6 mg/dL (±8.4)], (p = 0.029). The other parameters remained unchanged. CONCLUSION: This is the first study to demonstrate the relationship between the presence of pituitary adenoma and significative changes in serum glucose, triglycerides and c-HDL related to metabolic syndrome.

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INTRODUCTION AND AIMS: The risk factors for fatty liver disease are frequent in the Mexican population and the available studies appear to underestimate its prevalence. Our aims were to know the prevalence of metabolic (dysfunction) associated fatty liver disease (MAFLD) in an open population and determine the clinical and sociodemographic characteristics, nutritional status, physical activity level, and prevalence of metabolic syndrome, in the affected population. MATERIALS AND METHODS: Volunteers from the general public were invited to take part in the study. Three separate questionnaires were applied to 1) determine the sociodemographic characteristics and health status of the participants, 2) evaluate the quality of their diet, and 3) to evaluate their level of physical activity. The participants underwent somatometry, laboratory tests, liver ultrasound, and FIB-4 index determination, and transition elastography (FibroScan®) was carried out on all subjects with signs suggestive of liver fibrosis that agreed to undergo the procedure. The statistical analysis was carried out using SPSS for Windows, version 22, software. RESULTS: A total of 585 volunteers were studied, resulting in a prevalence of MAFLD of 41.3%, a predominance of men above 50 years of age, poor dietary habits, and sedentary lifestyle. Male sex, obesity, metabolic syndrome, and elevated ALT were risk factors for the disease and 40% of those affected had advanced fibrosis. CONCLUSIONS: The prevalence of MAFLD in our population is one of the highest in the world. The conditioning factors of the disease can be modified. Therefore, public policies that redirect the current trend are required.

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Introducción: Las metástasis a distancia de tumores primarios a cuerdas vocales son poco frecuentes. Las metástasis a laringe con mayor frecuencia corresponden a melanomas y carcinomas, afectando principalmente a la región supraglótica. Las metástasis a cabeza y cuello de los carcinomas de células renales (CCR) tienen una incidencia de 14-16%. Se presenta el caso de un paciente con metástasis de carcinoma de células claras renal a cuerdas vocales, cuya importancia recae en que es un caso poco frecuente y no existen reportes similares en el país. Paciente masculino, 57 años, con disfonía de 3 meses de evolución. Nasofibroscopía evidencia lesión polipoídea en cuerda vocal y ventrículo izquierdo. Se realiza microcirugía laríngea, enviando muestra a biopsia diferida, resultando lesión metastásica de CCR células claras. Evaluado por nefrología, se pesquisa tumor renal izquierdo sugerente de CCR. Las metástasis de neoplasias remotas a laringe son infrecuentes. Se considera al CCR el tercero en frecuencia respecto a neoplasias infraclaviculares. Éstas se pueden presentar hasta 10 años después del tratamiento del primario. Se recomienda seguimiento a largo plazo y énfasis a nuevos síntomas en región de cabeza y cuello, teniendo en consideración antecedente de CCR en pacientes con disfonía y lesiones polipoídeas en cuerdas vocales.

Introduction: The metastasis of distant site primary tumors to the vocal cords is infrequent. The most frequent source of metastasis to the larynx is melanomas and carcinomas, mainly affecting the supraglottic region. The metastasis to the head and neck of renal cell carcinomas (RCC) has an incidence of 14-16%. To present a case of metastasis of clear renal cell carcinoma to the vocal cords, since it is very infrequent, and there are no similar reports in the country. A male patient, 57 years old, presenting dysphonia for a duration of 3 months. Nasofibroscopy showed a polypoid lesion in the left vocal cord and ventricle. Larynx microsurgery was performed, and a sample was sent for biopsy, which reported a metastatic lesion of RCC clear cells. When assessed by nephrology, a left renal tumor is found, suggesting RCC. The metastasis of distant site neoplasias are infrequent. RCC is considered the third in frequency concerning to infraclavicular neoplasias. These can present up to 10 years after the treatment of the primary. Long term follow-up is recommended, and an emphasis on new symptoms in the head and neck region, considering the history of RCC in patients with dysphonia and polypoid lesions in vocal cords.

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Los tumores de calota en pacientes pediátricos poseen múltiples etiologías. Dentro de las causas pseudotumorales, las infecciones juegan un rol importante, siendo la osteomielitis por Bartonella henselae (Enfermedad por Arañazo de Gato) una posibilidad diagnóstica rara, pero que debe ser estudiada y descartada. Se presenta el caso de una lactante de 1 año, con lesión expansiva de calota, a nivel frontal derecho, hipervascularizada e infiltrativa. Se realizó estudio con ultrasonido, tomografía cerebral y cintigrama óseo. Se realizó resección quirúrgica completa de la lesión, con preservación de la duramadre y zona fontanelar, además de un cuidadoso trato con el seno sagital superior. Evolucionó sin complicaciones perioperatorias. El resultado de la biopsia fue compatible con proceso inflamatorio crónico, osteomielitis supurada. Tinción de Warthin Starry positiva sugerente de Bartonella henselae. Se descartó etiología tuberculosa y fúngica. Serología positiva para Bartonella henselae. La paciente completó antibioticoterapia, azitromicina y cotrimoxazol, con evolución clínica favorable.

Calvarial tumors in pediatric patients have multiple etiologies. Among the pseudotumoral causes, infections play an important role, being Bartonella henselae osteomyelitis (Cat Scratch Disease) a rare diagnostic possibility, but it should be studied and ruled out. We present the case of a 1 year old infant, with an expansive lesion of the calvaria, at right frontal level, hypervascularized and infiltrative. Ultrasound, brain tomography and bone scintigram were performed. Complete surgical resection of the lesion was performed, with preservation of the dura mater and fontanel area, in addition to a careful treatment with the superior sagittal sinus. The patient evolved without perioperative complications. The biopsy result was compatible with a chronic inflammatory process, suppurative osteomyelitis. Positive Warthin Starry stain suggestive of Bartonella henselae. Tuberculous and fungal etiology was ruled out. Positive serology for Bartonella henselae. The patient completed antibiotic therapy, azithromycin and cotrimoxazole, with favorable clinical evolution.

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The approach to and management of critically ill patients is one of the most versatile themes in emergency medicine. Patients with cirrhosis of the liver have characteristics that are inherent to their disease that can condition modification in acute emergency treatment. Pathophysiologic changes that occur in cirrhosis merit the implementation of an analysis as to whether the overall management of a critically ill patient can generally be applied to patients with cirrhosis of the liver or if they should be treated in a special manner. Through a review of the medical literature, the available information was examined, and the evidence found on the special management required by those patients was narratively synthesized, selecting the most representative decompensations within chronic disease that require emergency treatment.

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RESUMEN Los desechos derivados del proceso de perforación en las plataformas marinas petroleras pueden dejar hasta 200 000 toneladas de residuos de perforación en los ecosistemas marinos. El principal agente contaminante son los lodos de perforación petrolera (LPPs), que son usados para enfriar y lubricar la broca de perforación, además de contrarrestar fuerzas de presión y posibles fugas de hidrocarburos. Se sabe que los LPPs tienen un efecto contaminante y tóxico observándose alteraciones en los ecosistemas y efectos adversos en organismos invertebrados marinos, debidos principalmente a la presencia de barita y trazas de metales pesados. En este trabajo se realizaron experimentos de exposición hiperagudos con mezclas completas de lodos de perforación base agua (WBM) a máximos niveles de concentración en colonias de Hydractinia symbiolongicarpus. Los resultados mostraron cambios significativos (p < 0,001) en la morfología de los pólipos inmediatamente después del contacto con WBM, con un incremento 1,5 veces en el diámetro del pólipo y una retracción en la longitud de los tentáculos del 75 %. Después de la exposición (fase de recuperación), se observó una disminución de biomasa a las 72 h con pérdida del 50 % de los pólipos y una reducción de la mata estolonal cercana al 50 % (p < 0,01). Efectos similares han sido reportados en otras especies de cnidarios, como los corales, donde se observó retracción de pólipos y zonas expuestas de exoesqueleto. La exposición a WBM genera irritación tisular en exposición directa y en casos severos pérdida de biomasa.

ABSTRACT Wastes derived from the drilling process on offshore oil platforms can leave up to 200 000 tons of cuttings in marine ecosystems. The principal pollutants in cuttings are drilling muds (DM). The DM are used to cool and lubricate the drill bit, counteract pressure forces and possible hydrocarbon leaks. DM contaminate the marine environment and have toxic adverse effects upon marine invertebrate organisms, mainly due to the presence of barite and traces of heavy metals. In this research, hyperacute exposure experiments were performed with complete mixtures of water-based drilling muds (WBM) at maximum concentration levels in Hydractinia symbiolongicarpus colonies. Results showed significant changes (p < 0.001) in polyp morphology immediately after contact with WBM, with a 1.5-fold increase in its diameter and a 75 % of retraction in the length of the tentacles. A biomass loss was observed after exposure (recovery phase). Near 50 % of polyps and stolonal mat were bioabsorbed with statistical significance (p < 0.01) at 72 h. Similar effects have been reported in other species of cnidarians, such as corals, where there is retraction of polyps and exoskeleton exposed areas also observed. Exposure to WBM generates tissue irritation and extreme cases loss of biomass.

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Resumen La relación de pareja es una dimensión central de la vida de las personas que repercute en su felicidad y bienestar. Este tema es de interés para diversas disciplinas, teniendo un amplio recorrido en investigación, y ha sido abordado desde diferentes paradigmas y perspectivas de estudio. Con el objetivo de analizar las investigaciones llevadas a cabo sobre relaciones de pareja desde el año 2000 al 2018, se revisan 83 publicaciones localizadas tras una búsqueda exhaustiva en las principales bases de datos. Los resultados apuntan a que la mayoría de las investigaciones optan por una metodología exclusivamente cuantitativa, tienden a emplear instrumentos ya validados, cuentan con muestras de hasta 250 participantes y abordan temas clásicos como la satisfacción, la sexualidad o la comunicación en pareja. La información aportada permite obtener una visión global del tema de estudio y está encaminada a poder replicar, proponer nuevas o ampliar las investigaciones ya realizadas.

Abstract Couple relationships, as the fundamental basis of family relationships, is a crucial dimension within the lives of people that also impacts on their happiness and well-being. These relationships are underpinned by mutual caring and attachment bonds, which, properly developed, entail a source of emotional and social support. This support also contributes to build the identity, improve the social competence, and, ultimately, strengthen own and family well-being. This topic is likely to arouse the interest at a social and scientific level and is addressed from several disciplines such as Psychology, Sociology, Pedagogy, or Social Work. This interest has provided this topic with a broad overview in the related research, being addressed from different paradigms and study prospects. This study is aimed at analyzing the research conducted on couple relationships from 2000 to 2018 in Spanish-speaking countries. Therefore, we present a systematic review of 83 scientific publications retrieved after an extensive search in the main databases (WOS, SCOPUS, Dialnet Plus, Redalyc, and ISOC) and the search engine Google Scholar. Specifically, the study specifies the dimensions and variables that have been the subject of study among these relationships, their objectives and methods (with particular emphasis on the instruments used), and the sample type and size the authors deemed necessary. In addition to the year of publication and the geographical delimitation, it was also included as criteria the publication format (only scientific papers) and papers with a Social Sciences content with topics not related to violence. Results suggest that most researchers follow an entirely quantitative methodology, tend to use validated instruments, have samples up to 250 participants, and address traditional topics such as satisfaction, sexuality, and communication in couples. Also, the predominant trend is to focus on a single thematic content, being lower the presence of studies addressing the interaction between two topics (e.g., satisfaction and communication), and even least common those studies that extend the dimensions analyzed to three or more. Regarding the content, the papers reviewed confirm the thinking that the couple's well-being and their satisfaction has a multicausal nature, which goes beyond the couple, since it includes the influence of the couple's social and cultural context. In this regard, specific socio-demographic characteristics such as having children, gender, and relationship duration seem to have a greater impact and arouse more interest than others. To complement this work, it is also included other topics usually related to how the couples are shaped and the satisfaction perceived, such as, for example, the fear of intimacy and anxiety, the sense of humor, the psychological well-being, and living with a positive family context. Furthermore, the publications addressed allow to locate emerging topics, such as the use of technology and its impact on the couple relationships, and also reveal the absence of studies integrating new structures of couple relationships, like polyamory. In conclusion, this review helps to get a general overview of the topic studied in order to suggest further research or expand the research already conducted. Similarly, the information provided encourages researchers to replicate the studies analyzed with different samples (location, age, sample size, etc.) and with more ambitious methodological design given that, though exceptionally, there are results which buck against the current predominant trends, and to complement this study focused on Spanish-speaking research with English, French and Portuguese publications.

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Liver transplantation is a lifesaving treatment that improves survival and quality of life. The procedure requires adequate transplant candidate selection carried out by a multidisciplinary team. Psychosocial evaluation is a necessary part of recipient selection and its primary aims are to identify problems and psychosocial needs of the patient and his/her family, to improve transplantation outcomes. Different psychosocial conditions are considered risk factors for morbidity and mortality after transplantation. The presence of those factors per se is not an absolute contraindication, thus adequate evaluation promotes equal access to healthcare, improves results, and optimizes resources. The present review provides an overview of and guidelines for the most important psychosocial issues during the pretransplantation phase.

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Vibrio mimicus is a Gram-negative bacterium that is closely related to V. cholerae and causes gastroenteritis in humans due to contaminated fish consumption and seafood. This bacterium was isolated and identified from 238 analyzed samples of sea water, oysters, and fish. Twenty strains were identified as V. mimicus according to amplification of the vmhA gene, which is useful as a marker of identification of the species. The production of lipases, proteases, and nucleases was detected; 45% of the strains were able to produce thermonucleases and 40% were capable of producing hydroxamate-type siderophores, and the fragment of the iuT gene was amplified in all of the V. mimicus strains. Seventy-five percent of V. mimicus strains showed cytopathic effect on Chinese hamster ovary (CHO) cells and destruction of the monolayer, and 100% of the strains were adherent on the HEp-2 cell line with an aggregative adherence pattern. The presence of virulence factors in V. mimicus strains obtained from fishery products suggests that another member of the Vibrio genus could represent a risk to the consumer due to production of different metabolites that allows it to subsist in the host.

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INTRODUCTION: Cirrhosis of the liver is a serious public health problem worldwide, with regional variations determined by cultural factors and economic development. AIM: To know the characteristics of the social, cultural, and economic factors of the patients with cirrhosis of the liver in Veracruz. MATERIALS AND METHODS: A multicenter, retrolective, relational research study was conducted on patients with cirrhosis of the liver at five healthcare institutions in Veracruz. The variables analyzed were etiology, age, sex, civil status, educational level, occupation, and income. Descriptive and inferential statistics were utilized, and statistical significance was set at a P<.05. The Windows IBM-SPSS version 25.0 program was employed. RESULTS: A total of 182 case records of patients with cirrhosis of the liver were included. The etiologic factors were chronic alcohol consumption (47.8%), viral disease (28.5%), nonalcoholic fatty liver disease (NAFLD) (8.79%), autoimmune liver disease (4.4%), cholestasis (1.64%), and cryptogenic liver disease (8.8%). Mean patient age was 66.14±13.91, with a predominance of men (58.79%). In comparing the socioeconomic and cultural factors related to etiology, secondary and tertiary education and singleness were statistically significant in male alcoholics (P<.05), viral diseases and NAFLD were significantly associated with women with no income (P<.05), cryptogenic liver disease was significantly associated with women (P<.05), and cholestasis and autoimmune liver disease were not significantly associated with any of the factors. CONCLUSIONS: The study results revealed the influence of socioeconomic and cultural factors related to the different causes of cirrhosis of the liver in our environment.

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TITLE: Disfunción de barrera y síndrome de Guillain-Barré como exponentes del daño endotelial en la COVID-19.

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INTRODUCCIÓN: La cantidad de pacientes asmáticos que asisten al sistema público de salud es cada vez mayor, no obstante, la tasa de adherencia al tratamiento es muy baja, siendo los adolescentes quienes presentan mayor porcentaje de abandono al tratamiento, inasistencia a sus controles y gran conflicto decisional (CD). El OBJETIVO de este estudio fue evaluar el efecto de la aplicación de consejerías sobre el CD en relación al tratamiento del asma y el nivel de control de su enfermedad. MATERIALES Y MÉTODOS: Estudio pre-experimental que reclutó a 32 niños asmáticos entre 10 a 14 años de edad del policlínico respiratorio infantil del hospital Carlos Van Buren de Valparaíso. Solo 15 niños estuvieron dispuestos a participar en el estudio quienes completaron la totalidad de las sesiones de consejería. Para determinar el grado de CD de su patología, se aplicó la Escala de Conflicto Decisional de Ottawa; y para el nivel del control del asma, se usó la Escala Global Initiative for Asthma (GINA). RESULTADOS: La edad media del grupo de niños fue de 12,06 ± 1,16 años. Finalizada la intervención, el nivel de control de asma se mantuvo y la media del CD disminuyó de 34,05 ± 4,59 a 18,02 ± 3,01 puntos (p < 0,05; t de Student para muestras pareadas). Un 73,3% de los pacientes disminuyó su nivel de conflicto decisional. CONCLUSIÓN: Las consejerías de apoyo decisional demostraron tener efectos positivos en la población estudiada.

INTRODUCTION: The number of asthmatic patients attending the public health system is increasing. However, the rate of adherence to treatment is very low. Adolescents have the largest percentage of abandonment to treatment, lack of control and a great decisional conflict (DC). The OBJECTIVE of this study was to evaluate the effect of the application of counseling on the DC in relation to asthma treatment and the level of control of their disease. MATERIALS AND METHODS: Pre-experimental study that recruited 32 asthmatic children from 10 to 14 years-old, from the children's respiratory outpatients clinic of Carlos Van Buren hospital in Valparaíso, Chile. Only 15 children were willing to participate in the study and completed all of the counseling sessions. To determine the degree of DC of its pathology, the Ottawa Decision Conflict Scale was applied; and for the Asthma Control level, the Global Initiative for Asthma Scale (GINA) was used. RESULTS: Mean children age was 12.06 ± 1.16 years-old. After the intervention, the level of Asthma Control was maintained and the mean of the DC decrease from 34.05 ± 4.59 to 18.02 ± 3.01 points (p < 0.05; paired Student's t-test). 73.3% of the patients lowered their level of decisional conflict. CONCLUSION: The counseling of decision support proved to have positive effects on the population studied.

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