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Bibliographic Details
Main Author:	Leticia Rubio-García
Format:	Artículo científico
Language:	es
Published:	Instituto Mexicano del Seguro Social 2015
Subjects:	Medicina Acné Isotretinoína Síntomas depresivos
Online Access:	https://www.redalyc.org/articulo.oa?id=457744941009
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Isotretinoína y síntomas de depresión en pacientes con acné severo y recurrente Leticia Rubio-García Nancy Pulido-Díaz José Luis Jímenez-López Medicina Acné Isotretinoína Síntomas depresivos Introducción: a partir del uso de isotretinoína para el manejo del acné, se han publicado resultados controversiales en torno a una probable asociación entre esta y depresión. El objetivo de este estudio fue conocer si el uso de isotretinoína en pacientes con acné severo y recurrente (ASR) se asocia a depresión. Métodos: se incluyeron 22 pacientes con diagnóstico de ASR pertenecientes a la clínica de acné del Centro Médico Nacional La Raza. Se les aplicó el inventario de depresión de Beck (IDB-II) antes, durante (2 meses) y después del tratamiento con isotretinoína (4 meses), calculada a 0.5 mg/kg. Resultados: en las primeras mediciones se reportaron puntuaciones bajas de síntomas depresivos que disminuyeron aún más al final del tratamiento (mediana = 6.5 antes del tratamiento, 3 a los dos meses y 0 al final, con una p < 0.001). Conclusiones: el tratamiento con isotretinoína en esta muestra de pacientes con acné severo y recurrente no produjo aumento de síntomas depresivos, por el contrario los redujo de manera indirecta al mejorar su imagen corporal. 2015 artículo científico 0443-5117 https://www.redalyc.org/articulo.oa?id=457744941009 es http://www.redalyc.org/revista.oa?id=4577 Revista Médica del Instituto Mexicano del Seguro Social application/pdf Instituto Mexicano del Seguro Social Revista Médica del Instituto Mexicano del Seguro Social (México) Num.1 Vol.53

if (filemtime($filename) + $maxlifetime < time()) { unlink($filename); $count++; } } return $count; } /** * A function that is called internally when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ protected function saveSession($sessId, $data): bool { $sessFile = $this->path . '/sess_' . $sessId; if ($handle = fopen($sessFile, 'w')) { $return = false; // Lock the file for exclusive access to avoid issues with multiple // processes writing session simultaneously: if (flock($handle, LOCK_EX)) { $return = fwrite($handle, $data); // Make sure that there's no trailing data by truncating the file to // the correct length: ftruncate($handle, strlen($data)); fflush($handle); flock($handle, LOCK_UN); } fclose($handle); if ($return !== false) { return true; } } // If we got this far, something went wrong with the file output... // It is tempting to throw an exception here, but this code is called // outside of the context of exception handling, so all we can do is // echo a message.

// Anecdotal testing Today and Yesterday seems to indicate destroy() // is called by the garbage collector and everything is good. // Something to keep in mind though. return 0; } /** * Write function that is called when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ public function write($sessId, $data): bool { if ($this->writesDisabled) { return true; } return $this->saveSession($sessId, $data); } /** * A function that is called internally when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ abstract protected function saveSession($sessId, $data): bool; }

* * @return void */ public function writeClose() { // The assumption is that we're using PHP's ext/session. // session_write_close() will actually overwrite $_SESSION with an // empty array on completion -- which leads to a mismatch between what // is in the storage object and $_SESSION. To get around this, we // temporarily reset $_SESSION to an array, and then re-link it to // the storage object. // // Additionally, while you _can_ write to $_SESSION following a // session_write_close() operation, no changes made to it will be // flushed to the session handler. As such, we now mark the storage // object isImmutable. $storage = $this->getStorage(); if (! $storage->isImmutable()) { $_SESSION = $storage->toArray(true); session_write_close(); $storage->fromArray($_SESSION); $storage->markImmutable(); } } /** * Attempt to set the session name * * If the session has already been started, or if the name provided fails * validation, an exception will be raised. * * @param string $name * @return SessionManager * @throws Exception\InvalidArgumentException */ public function setName($name) { if ($this->sessionExists()) { throw new Exception\InvalidArgumentException( 'Cannot set session name after a session has already started'

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