Desigualdad social y niveles de discapacidad entre los mayores españoles

Se analizan factores socioeconómicos relacionados con desigualdad social en el nivel de discapacidad de la población española de 65 a 89 años nacida entre 1910 y 1944. Para ello se utilizan microdatos de cuatro ediciones de la Encuesta Nacional de Salud de España (ENSE): 1997, 2001, 2006 y 2011/12. Se presenta un indicador de discapacidad en escala continua basado en actividades de la vida diaria que se analiza en función de la edad, la cohorte de nacimiento, el nivel educativo (estatus socioeconómico), la estatura (estado nutricional neto) y la incidencia de condiciones crónicas cardiovasculares. Los resultados revelan diferencias de género y un gradiente socioeconómico de la discapacidad durante el proceso de envejecimiento. La brecha de género a favor de los hombres es mayor en los niveles educativas más bajos y desaparece entre los estratos socioeducativos más altos. Las diferencias socioeconómicas son mayores entre las mujeres antes de los 80 años y entre los hombres en edades comprendidas entre los 85 y los 89 años. La asociación positiva entre las condiciones crónicas cardiovasculares y la discapacidad se da tanto en hombres como en mujeres y deja de ser significativa entre los más mayores.

Recurrent varicose veins of the legs. Analysis of a social problem

The present study was aimed at assessing the experience of a single referral center with recurrent varicose veins of the legs (RVL) over the period 1993-2008. Among a total of 846 procedures for Leg Varices (LV), 74 procedures were for RVL (8.7%). The causes of recurrence were classified as classic: insufficient crossectomy (13); incompetent perforating veins (13); reticular phlebectasia (22); small saphenous vein insufficiency (9); accessory saphenous veins (4); and particular: post-hemodynamic treatment (5); incomplete stripping (1); Sapheno-Femoral Junction (SFJ) vascularization (5); post-thermal ablation (2). For the “classic” RVL the treatment consisted essentially of completing the previous treatment, both if the problem was linked to an insufficient earlier treatment and if it was due to a later onset. The most common cause in our series was reticular phlebectasia; when the simple sclerosing injections are not sufficient, this was treated by phlebectomy according to Mueller. The “particular” cases classified as 1, 2 and 4 were also treated by completing the traditional stripping procedure (+ crossectomy if this had not been done previously), considered to be the gold standard. In the presence of a SFJ neo-vascularization, with or without cavernoma, approximately 5 cm of femoral vein were explored, the afferent vessels ligated and, if cavernoma was present, it was removed. Although inguinal neo-angiogenesis is a possible mechanism, some doubt can be raised as to its importance as a primary factor in causing recurrent varicose veins, rather than their being due to a preexisting vein left in situ because it was ignored, regarded as insignificant, or poorly evident. In conclusion, we stress that LV is a progressive disease, so the treatment is unlikely to be confined to a single procedure. It is important to plan adequate monitoring during follow-up, and to be ready to reoperate when new problems present that, if left, could lead the patient to doubt the validity and efficacy of the original treatment.

Qualidade de vida e suporte social em doentes com esquizofrenia

A Esquizofrenia é considerada pela OMS como uma das dez doenças mais incapacitantes. Sendo uma perturbação complexa e de caráter crónico, gera prejuízos significativos na qualidade de vida dos pacientes. O interesse por este tema surge aquando da desinstitucionalização dos doentes psiquiátricos, contudo os avanços no tratamento desta patologia nem sempre vêm acompanhados de melhora na qualidade de vida, fator este que levou a ter também em consideração, aspetos psicossociais. Assim, pretende-se com este estudo contribuir para a compreensão do nível de satisfação com o suporte social e qualidade de vida destes doentes, comparando-os com indivíduos sem psicopatologia. A amostra é composta por 202 participantes, os quais se dividem em dois grupos, indivíduos com esquizofrenia, que frequentam hospitais na zona norte, centro e sul do país (n=101) e indivíduos sem psicopatologia (n=101), com idades compreendidas entre os 20 e os 75 anos. Os participantes responderam a um protocolo de investigação composto por quatro instrumentos: um questionário sociodemográfico; o WHOQOL-Bref, que avalia a qualidade de vida; a escala de satisfação com o suporte social; e a escala de afeto positivo e negativo. Os resultados principais evidenciam a pouca literatura existente, mostrando que existem diferenças significativas no que refere à qualidade de vida e satisfação com o suporte social entre os indivíduos com esquizofrenia e indivíduos sem patologia psiquiátrica, sendo que os valores mais baixos destas variáveis se concentram nos indivíduos com esquizofrenia. Para estes doentes, verificou-se que a qualidade de vida está positivamente correlacionada com o suporte social e com o afeto positivo, estando também correlacionada negativamente com o afeto negativo. Contudo, não se verificaram correlações da qualidade de vida com a escolaridade, o número de internamentos e o tempo de doença. A satisfação com o suporte social e o afeto positivo e negativo revelaram-se preditores de qualidade de vida nos indivíduos com esquizofrenia. No sentido de promover a melhoria da qualidade de vida destes doentes deverão ser tidas em consideração em vários contextos, intervenções psicossociais.

Ideolog?a y factor pol?tico

El trabajo presentado a continuaci?n, comprende el abordaje y an?lisis a los ejes de ideolog?a y factor pol?tico, enmarcados en una mirada psicoanal?tica. Para tales efectos, se realiza un acercamiento parcial al pensamiento lacaniano desde la ?ptica de una de las grandes Escuelas que lo han desarrollado: la Escuela lacaniana de Ljubljana, quien, analiza a trav?s de su quehacer, diferentes acontecimientos socio-pol?ticos, que tienen lugar en las sociedades contempor?neas, a la luz de los conceptos fundamentales de la teor?a psicoanal?tica. En este sentido, se menciona que se retornar? la obra y desarrollos te?ricos de uno de sus grandes expositores ante el mundo: el esloveno Slavoj Lizek, quien a trav?s de su trayecto como fil?sofo, soci?logo, psicoanalista y cr?tico cultural, ha integrado el pensamiento lacaniano con la compleja doctrina marxista y en este sentido ha logrado dilucidar un an?lisis pol?tico y una teor?a que se ilustra a trav?s de la cultura popular.

Innovation from below: dynamic capabilities of the territory as a source for new social ventures

Social innovation is a critical factor for the conception of new strategies to deal with increasingly complex social problems. Many of these initiatives are pursued at the local level and are based on the dynamic capabilities of a given territory. Through the analysis of the Cooperative Terra Chã, we assess whether dynamic capabilities of a territory can generate opportunities for social innovation and how they can be exploited by local communities. We observe that by using a integrated strategy for the management of the capabilities of a territory, new social ventures are able to cope with severe social issues that are not being adequately addressed by other stakeholders.

Financing social ventures by crowdfunding: The inflluence of entrepreneurs’ personality traits

Purpose – This research aims to understand the role played by social entrepreneurs’ personality traits on the choice between the traditional donation model and social crowdfunding (CF) to finance social projects. Design/methodology/approach – Social CF is examined as an instrument to capture funds for social projects, and the particular case of the Portuguese Social Stock Exchange (PSSE) is presented. The approach is quantitative in nature and the data were collected through a questionnaire that was emailed to non-governmental organizations in Portugal and founders of the projects listed on PSSE. Logistic regression was employed to predict the probability that a social entrepreneur would use PSSE rather than traditional financing. The predictor variables were based on the big five personality traits. Findings – Our investigation reveals that the agreeableness and neuroticism factors were not even considered in the results of the factorial analysis, which indicates the minor importance of these personality traits in the funding decisions of the Portuguese social entrepreneurs. The same applies to the factors of openness to new experiences and extraversion, which, although considered in the logistic analysis, showed no statistical significance. Finally, the conscientiousness personality trait seems to be the only factor that might explain the use of the PSSE platform.Originality/value – Studies on the profile of the social entrepreneurs that use CF for financing social projects are relatively rare, specifically in the context of Social Stock Exchange platforms. Additionally, there is a need to carry out more empirical evidence about the effect of social entrepreneurs’ personality traits on the decision to finance social projects through social CF platforms vis-a-vis the traditional donation model.

Determinación de factor reumatoide, pcr y vsg en cincuenta pacientes con artritis reumatoide que reciben terapia biológica en el Hospital José Carrasco Arteaga de la ciudad de Cuenca

La Terapia biológica aplicada a pacientes diagnosticados de Artritis Reumatoide ha demostrado tener buenos resultados paraclínicos en estudios realizados en otros países. Ejecutamos esta investigación para conocer mediante Laboratorio (PCR-VSG y FR), si dichos cambios se presentan en pacientes con AR que reciben tratamiento biológico en nuestro medio. Métodos: Se realizó un estudio cuasiexperimental, seleccionando al azar 50 pacientes con diagnóstico de Artritis Reumatoide sin enfermedad concomitante, que reciben tratamiento biológico en el Hospital José Carrasco de la Ciudad de Cuenca, se revisó en las Historias Clínicas los valores preterapéuticos de PCR, VSG y FR, luego se realizaron controles a partir de los 5 meses de inicio de la terapia biológica y se confrontaron resultados. El análisis incluyó Chi cuadrado, Valor p, Desvio Estándar y diferencia de medias. Resultados: De los 50 pacientes estudiados, el PCR fue positivo en el 100de pacientes antes y después de la Terapia biológica. Los valores de VSG fueron positivos preterapia en el 70y post-terapia en el 40, (p= 0.003). El FR fue positivo en el 84antes del tratamiento, luego del mismo el porcentaje de FR positivo fue 60, (p= 0.008). La media de los valores de PCR antes del tratamiento fue 12.8ñ14.2DE y luego del tratamiento 5.6 ñ 6.5DE (p= 0.002) la media para la VSG preterapia fue 33.4 ñ 21.3DE y post-terapia 17.2 ñ 6.7DE (p= 0,0001). Para el FR la media antes de la terapia fue 120.6 ñ 97.9 y luego de la terapia 100.2ñ 122.3DE (p= 0.360). Conclusiones: Los valores de PCR, VSG y FR de cincuenta pacientes con Artritis Reumatoide, presentaron un descenso significativo, luego de recibir tratamiento biológico en el Hospital José Carrasco Arteaga de la Ciudad de Cuenca

From social action to business action - A qualitative research on the professionalization process of a blogger: Case P.s. I Love Fashion -blog

Blogging is one of the most common forms of social media today. Blogs have become a powerful media and bloggers are settled stakeholders to marketers. Commercialization of the blogosphere has enabled an increasing number of bloggers professionalize and blog as a full-time occupation. The purpose of this study is to understand the professionalization process of a blogger from an amateur blogger to a professional actor. The following sub-questions were used to further elaborate the topic: What have been the meaningful events and developments fostering professionalization? What are the prerequisites for popularity in blogging? Are there any key success factors to acknowledge in order being able to make business out of your blog? The theoretical framework of this study was formed based on the two chosen focus areas for professionalization; social drivers and business drivers. The theoretical framework is based on literature from fields of marketing and social sciences, as well as previous research on social media, blogging and professionalization. The study is a qualitative case-study and the research data was collected in a semi-structured interview. The case chosen to this study is a lifestyle-blog. The writer of the case blog has been able to develop her blog to become a full-time professional blogger. Based on the results, the professionalization process of a blogger is not a defined process, but instead comprised of coincidental events as well as considered advancements. Success in blogging is based on the bloggers own motivation and passion for writing and expressing oneself in the form of a blog, instead of a systematic construction of a successful career in blogging. Networking with other bloggers as well as affiliates was seen as an important success factor. Popularity in the blogosphere and a high number of followers enable professionalization, as marketers actively seek to collaborate with popular bloggers with strong personal brands. Bloggers with strong personal brands are especially attractive due to their opinion leadership in their reference group. A blogger can act professionally either as entrepreneur or blogging for a commercial webpage. According to the results of this study, it is beneficial for the blogger’s professional development as well as career progress, to act on different operating models

A Multidimensional Approach to Social Support: the Questionnaire on the Frequency of and Satisfaction with Social Support (QFSSS)

The Questionnaire on the Frequency of and Satisfaction with Social Support (QFSSS) was designed to assess the frequency of and the degree of satisfaction with perceived social support received from different sources in relation to three types of support: emotional, informational, and instrumental. This study tested the reliability of the questionnaire scores and its criterion and structural validity. The data were drawn from survey interviews of 2042 Spanish people. The results show high internal consistency (values of Cronbach's alpha ranged from .763 to .952). The correlational analysis showed significant positive associations between QFSSS scores and measures of subjective well-being and perceived social support, as well as significant negative associations with measures of loneliness (values of Pearson's r correlation ranged from .11 to .97). Confirmatory factor analysis using structural equation modelling verified an internal 4-factor structure that corresponds to the sources of support analysed: partner, family, friends, and community (values ranged from .93 to .95 for the Goodness of Fit Index (GFI); from .95 to .98 for the Comparative Fit Index (CFI); and from .10 to .07 for the Root Mean Square Error of Approximation (RMSEA)). These results confirm the validity of the QFSSS as a versatile tool which is suitable for the multidimensional assessment of social support.

Qualidade e responsabilidade social: implementação de um sistema integrado na cooperativa terras de felgueiras

Dissertação de Mestrado em Gestão Integrada da Qualidade, Ambiente e Segurança

Estado metabólico previo de los pacientes con infarto agudo del miocardio del Instituto Salvadoreño del Seguro Social

Las enfermedades crónico-metabólicas se han vuelto en la actualidad en epidemias que afectan la calidad de vida, aumentando la morbilidad y mortalidad, entre ellos el Infarto Agudo del Miocardio (IAM), lo que trae como consecuencia el incremento en los costos en salud que implica el manejo de esta complicación. El objetivo de éste estudio fue valorar el estado metabólico previo de los pacientes que se encontraban adscritos o no a las Clínicas Metabólicas y que ingresaron con diagnóstico de infarto agudo del miocardio al Hospital Médico Quirúrgico del Instituto Salvadoreño del Seguro Social. Se trata de un estudio de tipo observacional descriptivo de corte transversal. Se determinó el estado metabólico previo que tenían los pacientes con diagnóstico de infarto agudo del miocardio, ya sea que hubieran tenido o no controles subsecuentes en Unidades Periféricas. Se tomaron en cuenta aquellos que se presentaron al Hospital Médico Quirúrgico de junio a agosto 2014, y la posterior evaluación de los expedientes en las unidades médicas periféricas, correspondientes a Clínicas Metabólicas en donde llevaron sus controles de: indice de masa corporal, presión arterial, glicemia y valores de lípidos. En conclusión podemos determinar, que el 100% de los pacientes que consultaron con un IAM son una población que se encuentra arriba de los 30 años con una incidencia entre 61-75 años con un total del 43%, dentro de éstos el sexo masculino tiene una ligera predominancia con un 57%, del total de estudiados, solo 43% pertenecían a clínicas metabólicas; encontrando alteraciones metabólicas considerables en la mayoría de ellos que pueden ser consideradas como desencadenantes del evento, así como, respuestas al estrés agudo que la condición proporciona, entre ellas podemos mencionar que al momento del IAM el 86% de la población se documentaron valores de glucosa en ayuno > 100mg/dL, 57% con TAG > 150mg/dL, colesterol total con un 62% en valores por arriba a los 200mg/dL y para los pacientes según sexos en la fracción HDL tan solo el 5% en mujeres y un 19% en hombres con valores arriba de 50 y 40 mg/dL respectivamente, considerando este como una variable a favor e incluso protectora para riesgo cardiovascular; en la medición de LDL el 71% se encontró superior a 100 mg/dL siendo este un factor altamente nocivo en el aumento del riesgo cardiovascular. En cuanto al significado clínico de los valores de presión arterial, en el evento agudo, tenemos que éstos valores se presentan con extremos que varían desde la hipotensión asociada al choque cardiogènico, hasta la hipertensión del edema agudo de pulmón, siendo estas fluctuaciones poco valorables para determinar el control previo de dicho componente. Por otra parte podemos establecer que la circunferencia abdominal se encuentra con mayor frecuencia por arriba de los valores esperados según sexo con un 67% frente a un 34% para valores inferiores a los esperados; además de encontrarse que según el IMC el 67% que consultaron con IAM tienen sobre peso y un 19% con obesidad grado 1. Dentro de la variable que más tuvo impacto en cuanto a su modificación “positiva” podríamos referirnos a la presión arterial, aunque los cambios no fueron impactantes, se consideran significativos, tomando en cuenta el apoyo en medidas farmacológicas. En cuanto al perfil lipídico de estos pacientes podemos mencionar que se encuentran niveles altos de Colesterol total y TAG, con niveles bajos de HDL según el sexo y altos de LDL, por lo que el riesgo cardiovascular fue superior y finalizó en un evento cardiovascular que genera un impacto socioeconómico importante.

Validez diagnóstica de la dermatoscopía en lesiones malignas en la consulta de dermatología del Hospital Amatepec del Instituto Salvadoreño del Seguro Social en el período de Agosto 2014-Agosto 2015

La dermatoscopía es una herramienta útil para el diagnóstico de lesiones malignas de piel. Estas lesiones han incrementado su incidencia y mortalidad a nivel mundial. El diagnóstico temprano de las lesiones de piel, principalmente el melanoma, es el factor pronóstico más importante. La precisión diagnóstica del examen clínico dermatológico, no se correlaciona bien con el diagnóstico patológico. La dermatoscopía ha venido a acercar las características clínicas con los hallazgos histopatológicos. La presente investigación tiene como objetivo estimar la validez de la dermatoscopía para el diagnóstico de lesiones malignas de piel en la consulta de dermatología de Hospital Amatepec y/o unidades de la red del Instituto Salvadoreño del Seguro Social ISSS. Se realizó un estudio descriptivo de corte transversal de correlación diagnóstica. Toda la consulta de lesión maligna de piel, fue evaluada por médico residente acompañado de dermatólogo, realizando examen dermatológico a simple vista con criterios ABCDE; luego una evaluación por dermatoscopía aplicando la lista de los 3 pasos; y toda lesión sugestiva de melanoma se evaluó con dermatoscopio utilizando la lista de 5 pasos. La biopsia tomada por dermatólogo y evaluada por patólogo. La validez de la dermatoscopía se observa en el incremento de su especificidad del 8% al 75% manteniendo la sensibilidad con respecto a la inspección visual simple. Recomendamos el uso de la dermatoscopía y continuar estudio de esta técnica en un diseño multicéntrico con médicos de familia. Las lesiones melanocíticas y amelanocíticas sospechosas de malignidad deben ser biopsiadas.

As relações da tríplice hélice no setor da carcinicultura do Rio Grande do Norte: uma análise a partir das abordagens da imersão social e da dependência de recursos

This work consists in a study of the Shrimp Industry in the state of Rio Grande do Norte, whose central issue relates to the understanding of how the Triple Helix (University, Government and the productive sector) interrelationship limits or expands the industry s innovation process. The study aims to understand how the Triple Helix relationship interferes in the innovation process of shrimp in Rio Grande do Norte. As the knowledge becomes the resource key for production methods, the generation of new technologies, new products and processes which demands joint and integrated action of the institutions comprising the Triple Helix: University, Government and productive sector, which possess the essential resources to innovate the process and can be maximized from cooperative relationships between the referred Institutions. Thus, in this work, it was sharply used the pioneering studies of Sabato and Botana (1968) regarding the cooperation relationship between the scientific-technological sphere, the governmental and the productive base, and studies on the Triple Helix approach, proposed by Etzkowitz and Leydesdorff (2000), in which the university has a key role in the process of technological and innovative development of countries and regions, and under which it is assigned to the very University - the character of the entrepreneurial institution, through the concept of entrepreneurial University. Aiming to overcome the criticism of Cooke (2005), regarding the limitations of the Triple Helix approach, in this study it was used - as analytical perspectives - the perspective of social immersion (Granovetter, 1985, 2005) and the theory of resources dependence (PFEFFER; SALANCIK, 1978). The analytical perspectives presented in here, despite of the different assumptions, are essential to eliminate the bias that one only approach can lead (ASTLEY; VAN DE VEM; 2007). The authors arguments focus on the fact that the integration is possible if the researcher acknowledged that different perspectives may have different descriptions of the same phenomenon. As a research strategy, this study is characterized as a study case, along with the proposed objectives - the qualitative method was used as an approach and, depending on the gathering of the sector s historical, a sectional longitudinal view approach was applied (VIEIRA, 2004). The primary and secondary data were used in order to understand the sector s evolutionary process and its inter-institutional relations - regarding the shrimp culture in Rio Grande do Norte - to promote the development, as the content was used for the technical analysis (BARDIN, 1977). The approach of social immersion and resources addiction dependence made it possible to understand that relationships are established within and between each sphere (university, government and productive sector) characterizing a network of low density relationships and strongly internal and external dependence. Based on the speech of Etzkowitz and Mello (2006), a successful Triple Helix strategy of innovation requires not only the involvement and commitment of the parts, within the institutional sphere and among them, but also the development of mechanisms to coordinate the multiple and complex interactions and interfaces, focusing on promoting both environment and context for innovation and learning; it can be acknowledge from study results that the shrimp in the State of the RN, although there are several institutional mechanisms to promote greater integration and technological development, has been presented disjointed - both internally and between the spheres - and under no legitimate practice when facing the innovational promotion and integration institutions. Due to those factors, the central institutions of the network are crucial to the promotion of innovations, spreading through their direct contacts the importance factor of the sustainable competitive activity in the world market and on the national level. However, it may be concluded, from the data, that the Triple Helix relations are interfering in a negative way on what concerns the promotion of innovations in the shrimp industry in RN

Integrating Environmental Justice and Social-Ecological Resilience for Successful Adaptation to Climate Change: Lessons from African American Communities on the Eastern Shore of the Chesapeake Bay

This research concerns the conceptual and empirical relationship between environmental justice and social-ecological resilience as it relates to climate change vulnerability and adaptation. Two primary questions guided this work. First, what is the level of resilience and adaptive capacity for social-ecological systems that are characterized by environmental injustice in the face of climate change? And second, what is the role of an environmental justice approach in developing adaptation policies that will promote social-ecological resilience? These questions were investigated in three African American communities that are particularly vulnerable to flooding from sea-level rise on the Eastern Shore of the Chesapeake Bay. Using qualitative and quantitative methods, I found that in all three communities, religious faith and the church, rootedness in the landscape, and race relations were highly salient to community experience. The degree to which these common aspects of the communities have imparted adaptive capacity has changed over time. Importantly, a given social-ecological factor does not have the same effect on vulnerability in all communities; however, in all communities political isolation decreases adaptive capacity and increases vulnerability. This political isolation is at least partly due to procedural injustice, which occurs for a number of interrelated reasons. This research further revealed that while all stakeholders (policymakers, environmentalists, and African American community members) generally agree that justice needs to be increased on the Eastern Shore, stakeholder groups disagree about what a justice approach to adaptation would look like. When brought together at a workshop, however, these stakeholders were able to identify numerous challenges and opportunities for increasing justice. Resilience was assessed by the presence of four resilience factors: living with uncertainty, nurturing diversity, combining different types of knowledge, and creating opportunities for self-organization. Overall, these communities seem to have low resilience; however, there is potential for resilience to increase. Finally, I argue that the use of resilience theory for environmental justice communities is limited by the great breadth and depth of knowledge required to evaluate the state of the social-ecological system, the complexities of simultaneously promoting resilience at both the regional and local scale, and the lack of attention to issues of justice.

Causas de descompensación glicémica en pacientes con diabetes tipo 2 en la clínica metabólica de llopango del Instituto Salvadoreño del Seguro Social.

A pesar de los beneficios ya demostrados de un buen control glicémico, la evidencia sugiere que la hemoglobina glicosilada de la mayoría de pacientes diabéticos tipo 2 no se encuentra dentro de metas. Se estima que en Estados Unidos solamente un tercio de los pacientes con diabetes mellitus tipo 2 (DM2) tienen una hemoglobina glicosilada menor de 7% que es lo que sugieren la mayoría de guías actuales. La población con diabetes mellitus tipo2 (DM2) es heterogénea, y múltiples factores afectan el control glicémico. La adherencia a conductas de autocuidado por parte del paciente, la asistencia de forma regular a sesiones educacionales de autocuidado, el auto monitoreo de la glicemia, y la asistencia a controles médicos se ha demostrado que tienen un efecto positivo en el resultado del tratamiento de la DM2. Mantener el peso corporal, la reducción de peso y el consumo de alimentos con bajo índice glucémico también causa mejoría en los parámetros metabólicos. Los agentes hipoglicemiantes orales son uno de los tratamientos más prescritos para un control intensivo de la glucosa. Sin embargo la no adherencia a estos es una de las principales causas de un mal control glicémico, por lo que se han realizado múltiples estudios tratando de dilucidar porque el paciente descontinúa su tratamiento encontrando que el 42.9% olvida tomar el medicamento, el 30.6% no entiende la importancia de tomar el medicamento y 26.5% lo hace por presentar hipoglicemia asociada. Este estudio es de tipo observacional, analítico de casos y controles definiendo al Control: pacientes con hemoglobina mayor de 7% durante su último control en el año 2013 y Caso: pacientes con hemoglobina menor de 7% durante su último control en el año 2013. La Población en estudio son los pacientes diabéticos tipo 2 de clínica metabólica de Ilopango. Tomando como muestra a todos los pacientes con diagnóstico de Diabetes Mellitus tipo 2 que cumplan con los criterios de inclusión. La información fue obtenida de la revisión de los expedientes de las clínicas metabólicas de la unidad médica de Ilopango en donde tienen un registro de aproximadamente 6000 pacientes de los cuales 2500 padecen de diabetes mellitus tipo 2, pero únicamente 825 pacientes cuentan con hemoglobina glicosilada de seguimiento, que fue la muestra. Se evaluaron algunos factores como determinantes en el control o descompensación de la AIc cuando se utiliza la medición de la variable del índice de masa corporal, el tener un IMC por arriba de 25 significo que el 90% de los pacientes estuvieron descompensados (OR: 8.797, IC 5.924, 13.18) con un valor de p=<0.0000001 comparada con aquellos pacientes que su IMC es por debajo de 25. Otro hallazgo encontrado fue el tener una patología asociada, como variable de descompensación de A1c (OR=6.996 IC=4.881, 10.16 p <0.0000001) incrementando en un 37% veces más la descompensación en esta variable no se consideró la severidad de la infección ni tampoco la etiología. Además se analizó como determinante de hemoglobina glicosilada mayor de 7%, el cumplimiento de la terapia que se indica a los pacientes, obteniéndose que para aquellos pacientes que cumplen la terapia indicada están más propensos a tener una hemoglobina glicosilada menor de 7% con una fracción prevenible del 4.34% (OR= 0.8229 IC= 0.6256- 1.082 p= 0.08111 ), como un factor protector asociado a los pacientes con DM, aunque estadísticamente no es significativo ya que tiene un valor de p= 0.08.