ResumenSe han reportado bajas tasas de adherencia al tratamiento de enfermedades crónicas (50%). Asimismo, los factores psicosociales estarían relacionados con la adherencia al tratamiento. Con el propósito de identifi car la relación que existe entre factores psicosociales y la adherencia al tratamiento de la DM2 en usuarios del sistema de salud pública chileno, se diseñó un estudio no experimental transversal correlacional (n = 50, edad promedio 60,76 años). Se autoadministraron encuestas para evaluar estrés y estilo de afrontamiento, sintomatología depresiva, percepción de apoyo social y adherencia al tratamiento. 40% de los pacientes presenta valores de hemoglobina glicosilada (Hb1Ac) mayores a 9%, mientras que un 66% de los participantes presenta desde moderados a altos niveles de estrés. En promedio durante los últimos 7 días los participantes han cumplido con la dieta general en 4,37 días, han consumido frutas y verduras en 3,14 días y han realizado exámenes de glicemia en 1,1 días. Existe una correlación directa entre el estrés y la hemoglobina glicosilada. El apoyo social y la sintomatología depresiva no se asociaron con la adherencia al tratamiento pero sí con el estrés. Se confi rman pobres cifras de adherencia, y la asociación entre alto estrés y altos índices de Hb1Ac.Palabras clave: Diabetes mellitus tipo 2, adherencia al tratamiento, estrés, sintomatología depresiva, estilos de afrontamiento AbstractIt is estimated that rates of non-adherence to chronic diseases are around 50%. International studies have reported some psychosocial factors related to treatment adherence. The purpose of the present study was to detect the relationship between psychosocial factors and treatment adherence in a sample of Type 2 Diabetics subjects from a public health institution. To this end, a non -experimental transversal correlational study was designed with a 50 DM2 subjects sample, which average age was 60,76 years old. Self-report measures of stress level, coping style, depressive symptoms, social support perception and treatment adherence, were obtained. The results revealed that 40% of participants had glycosylated hemoglobin over 9%, and 66% of them shown moderate to high stress levels. In average during the last 7 days, the participants have accomplished the diet 4,37 days, consumed fruits and vegetables 3,14 days and took glycemia test in 1,1 days. There is a direct correlation between the stress level and concentrations of glycosylated hemoglobin. Unlike stress, social support and depressive symptomatology was not associated with treatment adherence. These results confi rm low levels of treatment adherence and high rates of stress in DM2 patients, as well as its association with high levels of glycosylated hemoglobin. Key words: Type 2 diabetes mellitus, treatment adherence, psychological stress, depression, copying styleEste estudio se enmarca en la etapa de pilotaje del proyecto del Fondo Nacional de Investigación y Desarrollo en Salud, FONIS Nº SA07I20071, que lleva por título "Factores psicosociales aso...

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Oncologic resections of the second and third portions of the duodenum (D2 and D3) via partial duodenectomy can pose a challenging clinical problem. The duodenum must be repaired primarily or reconstructed. We have adopted a method of reconstruction using a Roux-en-Y duodenojejunostomy (D-J) in patients with extensive duodenal wall loss. We report our results in the first series of these cases. A retrospective review of patients who underwent post partial duodenectomy with reconstruction between June 2004 and March 2014 was performed. Five patients underwent partial duodenectomy with reconstruction. Two had resection for extrinsic tumors (colonic adenocarcinoma). Three had intrinsic duodenal tumors (one tubular adenoma, one adenocarcinoma and one gastrointestinal stromal tumor). All patients were reconstructed via retrocolic Roux-en-Y D-J. Mean estimated blood loss was 470 mL with median length of stay of 11 days. Post-operative complications included three intra-abdominal abscesses, one superficial wound infection and one gastrointestinal bleed. There were no anastomotic leaks, injuries to the ampulla of Vater or mortalities. In conclusion, partial duodenectomy of lateral D2/D3 with Roux-en-Y D-J is a relatively safe and effective alternative to partial duodenectomy with primary repair or pancreaticoduodenectomy for certain tumors of the duodenum.