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Resumen OBJETIVO: Determinar la frecuencia de aceptación y los factores asociados con la anticoncepción moderna posaborto en pacientes atendidas en un hospital público de Perú. MATERIALES Y MÉTODOS: Estudio observacional y transversal efectuado en pacientes en el posaborto inmediato atendidas de junio a diciembre de 2022 en el servicio de Urgencias del Hospital San Juan de Lurigancho, Lima, Perú, seleccionadas por conveniencia. Se utilizó un cuestionario validado. Se aplicó la prueba χ2 de Pearson con un nivel de significación del 5%. RESULTADOS: Se estudiaron 166 pacientes en el posaborto inmediato de las que el 94% (n = 156) aceptó algún método anticonceptivo moderno; el más frecuente fue el inyectable mensual (44.0%) y el menos aceptado el dispositivo intrauterino (0.6%). Los factores personales asociados con la aceptación del método anticonceptivo moderno fueron: edad (p < 0.01), no tener pareja (p < 0.001) y ésta estuviera de acuerdo con el anticonceptivo elegido (p < 0.001). Los factores institucionales asociados fueron: tiempo de la consejería en planificación familiar (p = 0.047), privacidad-confidencialidad de la consejería (p < 0.001) y satisfacción con la atención ofrecida durante la orientación (p = 0.026). CONCLUSIONES: La edad, carecer de pareja y estar de acuerdo con ésta acerca de la elección del método anticonceptivo posaborto junto con los factores institucionales (tiempo de consejería en planificación familiar, importancia de la privacidad-confidencialidad y percepción de la atención en consejería en planificación familiar) se asociaron, significativamente, con la aceptación de algún método anticonceptivo moderno posaborto.

Abstract OBJECTIVE: To determine the frequency of acceptance and factors associated with modern postabortion contraception in patients attended at a public hospital in Peru. MATERIALS AND METHODS: Observational and cross-sectional study conducted in immediate postabortion patients attended from June to December 2022 at the Emergency Department of the Hospital San Juan de Lurigancho, Lima, Peru, selected by convenience. A validated questionnaire was used. Pearson's test c2 was used with a significance level of 5%. RESULTS: We studied 166 patients in the immediate postabortion period, of whom 94% (n = 156) accepted some modern contraceptive method; the most common was the monthly injectable (44.0%) and the least accepted was the intrauterine device (0.6%). Personal factors associated with modern contraceptive method acceptance were age (p < 0.01), no partner (p < 0.001), and partner's agreement with the chosen contraceptive method (p < 0.001). Associated institutional factors were agreeing with the time of family planning counseling (p = 0.047), considering the importance of privacy-confidentiality of counseling (p < 0.001), and agreeing with the care offered during counseling (p = 0.026). CONCLUSIONS: Age, lack of a partner, and agreeing with the partner about the choice of postabortion contraceptive method along with institutional factors (time of family planning counseling, importance of privacy-confidentiality, and perception of care in family planning counseling) were significantly associated with acceptance of some modern postabortion contraceptive method.

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Introduction: Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. In Brazil, its incidence has increased, along with the lack of penicillin, the antibiotic of choice for congenital syphilis, from 2014 to 2017. During this period, children were treated with alternative drugs, but to date, data from the scientific literature do not recommend another antibiotic. Objective: To compare the progression, according to the established treatment, and evaluate the follow-up in health care facilities in Vila Velha (Espírito Santo) of children with congenital syphilis aged up to two years, born in Hospital Infantil e Maternidade Alzir Bernardino Alves ­ a reference in neonatology and low-risk pregnancy in the state at the time ­ from 2015 to 2016, when the hospital experienced a greater lack of penicillin. Methods: This is a retrospective cross-sectional observational study based on data from medical records of the hospital and other healthcare facilities in the city. We performed statistical analyses, per health district, of epidemiological and sociodemographic data, as well as those related to visits, their frequency, and clinical profile, according to the follow-up parameters proposed by the Ministry of Health at the time. Results: Medical records of 121 children were evaluated, presenting as the main findings: only 35% of the children completed the follow-up; among those treated with ceftriaxone, 55.2% completed the follow-up, and 100% of the children whose venereal disease research laboratory was greater than that of their mother at birth completed the follow-up. Of the symptomatic children at birth who remained or became symptomatic at follow-up, 58.8% used ceftriaxone. Conclusion: Among symptomatic children at birth, most of those treated with ceftriaxone remained symptomatic at follow-up. The Counseling and Testing Center was the most successful facility in the follow-up of these children. District 5 had the lowest success rate in the follow-up of these patients, and districts 1 and 2 showed the lowest rates of appropriate approach to congenital syphilis during follow-up. (AU)

Introdução: A sífilis é uma infecção sexualmente transmissível causada pela bactéria Treponema pallidum. No Brasil, sua incidência vem aumentando, acompanhada da falta de penicilina, antibiótico de escolha para a sífilis congênita, no período de 2014­2017. Nesse período, as crianças foram tratadas com medicamentos alternativos, porém dados da literatura científica até o momento não recomendam outro antibiótico. Objetivo: Comparar a evolução, de acordo com o tratamento instituído, e avaliar o acompanhamento nas unidades de saúde em Vila Velha (ES), até os dois anos de idade, das crianças com sífilis congênita nascidas no Hospital Infantil e Maternidade Alzir Bernardino Alves ­ referência em neonatologia e gravidez de baixo risco no estado na época ­ de 2015 a 2016, período em que houve maior falta de penicilina no hospital. Métodos: Estudo observacional do tipo transversal, retrospectivo, baseado em dados dos prontuários do hospital e outras Unidades de Saúde do município. Foram analisados estatisticamente, por região de saúde, dados epidemiológicos, sociodemográficos, bem como relativos às consultas, sua periodicidade e ao perfil clínico, de acordo com os parâmetros de seguimento propostos pelo Ministério da Saúde na época. Resultados: Avaliaram-se os prontuários de 121 crianças, obtendo-se como principais achados: somente 35% das crianças tiveram seguimento completo; das crianças tratadas com ceftriaxona, 55,2% tiveram seguimento completo, e 100% das crianças que tiveram VDRL maior que o da mãe no parto completaram o seguimento. Das crianças sintomáticas ao nascimento e que permaneceram ou ficaram sintomáticas no seguimento, 58,8% fizeram uso de ceftriaxona. Conclusão: Das crianças sintomáticas ao nascimento, as tratadas com ceftriaxona, em sua maioria, mantiveram-se sintomáticas no seguimento. O Centro de Testagem e Aconselhamento teve maior êxito no acompanhamento dessas crianças. A região 5 teve a menor taxa de êxito no seguimento desses pacientes, e as regiões 1 e 2 menor taxa de abordagem correta para sífilis congênita durante o seguimento. (AU)

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Objetivo: entender como mães vivenciaram o cuidado com seus filhos prematuros em casa em meio à pandemia da COVID-19. Método: estudo qualitativo, descritivo, desenvolvido entre janeiro e dezembro de 2021, mediante entrevistas remotas com 25 mães de prematuros, após um mês da alta hospitalar, com Análise de Conteúdo temática. Resultados: desvelaram-se preocupações maternas referentes ao cuidado com o filho na pandemia, além de influências do período pandêmico na rotina familiar; acompanhamento do seguimento das crianças nos serviços de saúde descontinuado; sobrecarga e medo. Esses aspectos podem expor o bebê a maior risco de alterações do seu desenvolvimento, bem como afetar a autoeficácia materna, uma vez que o receio das complicações decorrentes do nascimento pré-termo associou-se à angústia de possível contaminação pelo coronavírus. Conclusão: a prematuridade vivenciada em meio à pandemia COVID-19 repercutiu negativamente tanto no cotidiano da vida familiar como no acompanhamento de saúde do prematuro.

Objective: to understand how mothers experienced the care of their preterm infants at home in the midst of the COVID-19 pandemic. Method: qualitative, descriptive study, developed between January and December 2021, through remote interviews with 25 mothers of preterm infants, one month after hospital discharge, with thematic Content Analysis. Results: maternal reoccupations related to child care in the pandemic were revealed, as well as influences of the pandemic period on family routine; monitoring of children in discontinued health services; overload and fear. These aspects may expose the baby to a greater risk of developmental alterations, as well as affect maternal self-efficacy, since the fear of complications resulting from preterm birth was associated with the anguish of possible contamination by the coronavirus. Conclusion: the prematurity experienced in the midst of the COVID-19 pandemic had a negative impact both on the daily life of the family and on the health monitoring of preterm infants.

Objetivo: comprender cómo vivieron las madres el cuidado de sus hijos prematuros en el hogar en medio de la pandemia de COVID-19. Método: estudio cualitativo, descriptivo, desarrollado entre enero y diciembre de 2021, mediante entrevistas remotas a 25 madres de bebés prematuros, un mes después del alta hospitalaria, con Análisis de Contenido temático. Resultados: se revelaron preocupaciones maternas respecto al cuidado de los hijos durante la pandemia, además de las influencias del período pandémico en la rutina familiar; descontinuado el seguimiento de los niños en los servicios de salud; sobrecarga y miedo. Estos aspectos pueden exponer al bebé a un mayor riesgo de cambios en su desarrollo, así como afectar la autoeficacia materna, ya que el miedo a las complicaciones derivadas del parto prematuro se asocia a la angustia de una posible contaminación por el coronavirus. Conclusión: la prematuridad vivida en medio de la pandemia de COVID-19 tuvo un impacto negativo tanto en la vida familiar diaria como en el seguimiento de la salud de los bebés prematuros.

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INTRODUCTION: Post Intensive Care Syndrome is a recently studied syndrome that affects between 50% and 70% of patients admitted to the ICU, its detection is complex due to the great variety of affected components. OBJECTIVE: To determine the most widely used assessment instruments for the detection of post-intensive care syndrome, according to the evidence in the last 5 years. METHODOLOGY: A scoping review was carried out in the databases: Academic Search, ScienceDirect, Scielo, Biblioteca Virtual en Salud, Medline, and Springer Link, with terms «Postintensive care syndrome¼ and «Post-intensive care syndrome¼. This review included 22 articles that met the criteria of: research or review typology, English, Spanish or Portuguese language, with access to the full text and published between 2015 and 2020. CONCLUSIONS: Most of the instruments used to measure post-intensive care syndrome are divided according to the components of physical affectation (the Medical Research Council scale, the Katz index and the Barthel index); cognitive (Repeatable Battery for the Assessment of Neuropsychological Status, and the Montreal Cognitive Assessment test); and mental (Hospital Anxiety and Depression Scale, Beck's anxiety test, Depression Inventory Second Edition scale and Post Traumatic Stress Syndrome-14 scale). In addition, two tools were found that measure the event in its entirety with its three components, such as the Healthy Aging Brain Care Monitor and the Post-Intensive Care Syndrome Questionnaire.

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Background: Endoscopically visualized spine surgery has become an essential tool that aids in identifying and treating anatomical spine pathologies that are not well demonstrated by traditional advanced imaging, including MRI. These pathologies may be visualized during endoscopic lumbar decompression (ELD) and categorized into primary pain generators (PPG). Identifying these PPGs provides crucial information for a successful outcome with ELD and forms the basis for our proposed personalized spine care protocol (SpineScreen). Methods: a prospective study of 412 patients from 7 endoscopic practices consisting of 207 (50.2%) males and 205 (49.8%) females with an average age of 63.67 years and an average follow-up of 69.27 months was performed to compare the durability of targeted ELD based on validated primary pain generators versus image-based open lumbar laminectomy, and minimally invasive lumbar transforaminal interbody fusion (TLIF) using Kaplan-Meier median survival calculations. The serial time was determined as the interval between index surgery and when patients were censored for additional interventional and surgical treatments for low back-related symptoms. A control group was recruited from patients referred for a surgical consultation but declined interventional and surgical treatment and continued on medical care. Control group patients were censored when they crossed over into any surgical or interventional treatment group. Results: of the 412 study patients, 206 underwent ELD (50.0%), 61 laminectomy (14.8%), and 78 (18.9%) TLIF. There were 67 patients in the control group (16.3% of 412 patients). The most common surgical levels were L4/5 (41.3%), L5/S1 (25.0%), and L4-S1 (16.3%). At two-year f/u, excellent and good Macnab outcomes were reported by 346 of the 412 study patients (84.0%). The VAS leg pain score reduction was 4.250 ± 1.691 (p < 0.001). No other treatment during the available follow-up was required in 60.7% (125/206) of the ELD, 39.9% (31/78) of the TLIF, and 19.7% (12/61 of the laminectomy patients. In control patients, only 15 of the 67 (22.4%) control patients continued with conservative care until final follow-up, all of which had fair and poor functional Macnab outcomes. In patients with Excellent Macnab outcomes, the median durability was 62 months in ELD, 43 in TLIF, and 31 months in laminectomy patients (p < 0.001). The overall survival time in control patients was eight months with a standard error of 0.942, a lower boundary of 6.154, and an upper boundary of 9.846 months. In patients with excellent Macnab outcomes, the median durability was 62 months in ELD, 43 in TLIF, and 31 months in laminectomy patients versus control patients at seven months (p < 0.001). The most common new-onset symptom for censoring was dysesthesia ELD (9.4%; 20/206), axial back pain in TLIF (25.6%;20/78), and recurrent pain in laminectomy (65.6%; 40/61) patients (p < 0.001). Transforaminal epidural steroid injections were tried in 11.7% (24/206) of ELD, 23.1% (18/78) of TLIF, and 36.1% (22/61) of the laminectomy patients. The secondary fusion rate among ELD patients was 8.8% (18/206). Among TLIF patients, the most common additional treatments were revision fusion (19.2%; 15/78) and multilevel rhizotomy (10.3%; 8/78). Common follow-up procedures in laminectomy patients included revision laminectomy (16.4%; 10/61), revision ELD (11.5%; 7/61), and multilevel rhizotomy (11.5%; 7/61). Control patients crossed over into ELD (13.4%), TLIF (13.4%), laminectomy (10.4%) and interventional treatment (40.3%) arms at high rates. Most control patients treated with spinal injections (55.5%) had excellent and good functional outcomes versus 40.7% with fair and poor (3.7%), respectively. The control patients (93.3%) who remained in medical management without surgery or interventional care (14/67) had the worst functional outcomes and were rated as fair and poor. Conclusions: clinical outcomes were more favorable with lumbar surgeries than with non-surgical control groups. Of the control patients, the crossover rate into interventional and surgical care was 40.3% and 37.2%, respectively. There are longer symptom-free intervals after targeted ELD than with TLIF or laminectomy. Additional intervention and surgical treatments are more often needed to manage new-onset postoperative symptoms in TLIF- and laminectomy compared to ELD patients. Few ELD patients will require fusion in the future. Considering the rising cost of surgical spine care, we offer SpineScreen as a simplified and less costly alternative to traditional image-based care models by focusing on primary pain generators rather than image-based criteria derived from the preoperative lumbar MRI scan.

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Introduction: In Peru, optical microscopy with the thick smear test continues to be performed for the follow-up of malaria patients. This test is simple but it requires microscopic equipment and suitable staff to perform the reading of the samples. Studies suggest that the rapid OptiMAL-IT™ test is an option for follow-up. Objective: To evaluate the effectiveness of OptiMAL-IT™ as a follow-up test in malaria patients in endemic areas of Perú. Materials and methods: We conducted an observational, analytical cross-sectional study of diagnostic tests performed in patients with malaria. We selected all the patients attending different health facilities in the Peruvian departments of San Martín and Loreto who met the inclusion criteria. Optical microscopy with thick smear and OptiMAL-IT™ was used on days 2, 3, 7, and 14 for Plasmodium vivax and until day 21 of follow-up for Plasmodium falciparum. Percentages of correctly classified samples and predictive values were calculated, and the results were compared between the western jungle and the eastern jungle using Chi2 or Fisher's exact tests. Results: We registered 262 patients from San Martín and 302 from Loreto. The percentage of correctly classified cases and the negative predictive value were higher than 92.0% and 93,0%, respectively, from the third day of follow-up; no statistical differences were found in the results obtained from the western jungle and those from the eastern jungle. Conclusions: The OptiMAL-IT™ test would be effective as a follow-up test in patients diagnosed with malaria in endemic areas of Perú.

Introducción. En Perú, la microscopía óptica con gota gruesa continúa utilizándose en el seguimiento de los pacientes con malaria o paludismo. Esta prueba es sencilla, pero requiere de equipamiento microscópico y personal idóneo que realice la lectura de las muestras. Los estudios sugieren que la prueba rápida OptiMAL-IT™ es una opción para dicho seguimiento. Objetivo. Evaluar la efectividad de OptiMAL-IT™ como test de seguimiento en pacientes con malaria en áreas endémicas del Perú. Materiales y métodos. Se hizo un estudio observacional, transversal y analítico de pruebas diagnósticas en pacientes con malaria. Se seleccionó a todos los pacientes que cumplían con los criterios de inclusión, procedentes de diferentes establecimientos de salud de los departamentos peruanos de San Martín y Loreto. El diagnóstico se hizo mediante microscopía óptica con gota gruesa y la prueba rápida de diagnóstico inmunocromatográfico OptiMAL-IT™ en los días 2, 3, 7 y 14 para Plasmodium vivax y hasta el día 21 de seguimiento para Plasmodium falciparum. Se calculó el porcentaje de los correctamente clasificados y los valores predictivos, y se compararon los resultados de la selva occidental y la selva oriental mediante ji al cuadrado o prueba exacta de Fisher. Resultados. Se registraron 262 pacientes de San Martín y 302 de Loreto. Los porcentajes correctamente clasificados y el valor predictivo negativo fueron superiores a 92,0 y 93,0 %, respectivamente, a partir del tercer día de seguimiento; no se encontraron diferencias estadísticas en los resultados obtenidos en la Amazonía occidental y los de la oriental. Conclusiones. La prueba OptiMAL-IT™ sería efectiva como test de seguimiento en los pacientes con diagnóstico de malaria en áreas endémicas del Perú.

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Introducción. En Perú, la microscopía óptica con gota gruesa continúa utilizándose en el seguimiento de los pacientes con malaria o paludismo. Esta prueba es sencilla, pero requiere de equipamiento microscópico y personal idóneo que realice la lectura de las muestras. Los estudios sugieren que la prueba rápida OptiMAL-IT™ es una opción para dicho seguimiento. Objetivo. Evaluar la efectividad de OptiMAL-IT™ como test de seguimiento en pacientes con malaria en áreas endémicas del Perú. Materiales y métodos. Se hizo un estudio observacional, transversal y analítico de pruebas diagnósticas en pacientes con malaria. Se seleccionó a todos los pacientes que cumplían con los criterios de inclusión, procedentes de diferentes establecimientos de salud de los departamentos peruanos de San Martín y Loreto. El diagnóstico se hizo mediante microscopía óptica con gota gruesa y la prueba rápida de diagnóstico inmunocromatográfico OptiMAL-IT™ en los días 2, 3, 7 y 14 para Plasmodium vivax y hasta el día 21 de seguimiento para Plasmodium falciparum. Se calculó el porcentaje de los correctamente clasificados y los valores predictivos, y se compararon los resultados de la selva occidental y la selva oriental mediante ji al cuadrado o prueba exacta de Fisher. Resultados. Se registraron 262 pacientes de San Martín y 302 de Loreto. Los porcentajes correctamente clasificados y el valor predictivo negativo fueron superiores a 92,0 y 93,0 %, respectivamente, a partir del tercer día de seguimiento; no se encontraron diferencias estadísticas en los resultados obtenidos en la Amazonía occidental y los de la oriental. Conclusiones. La prueba OptiMAL-IT™ sería efectiva como test de seguimiento en los pacientes con diagnóstico de malaria en áreas endémicas del Perú.

Introduction: In Peru, optical microscopy with the thick smear test continues to be performed for the follow-up of malaria patients. This test is simple but it requires microscopic equipment and suitable staff to perform the reading of the samples. Studies suggest that the rapid OptiMAL-IT™ test is an option for follow-up. Objective: To evaluate the effectiveness of OptiMAL-IT™ as a follow-up test in malaria patients in endemic areas of Perú. Materials and methods: We conducted an observational, analytical cross-sectional study of diagnostic tests performed in patients with malaria. We selected all the patients attending different health facilities in the Peruvian departments of San Martín and Loreto who met the inclusion criteria. Optical microscopy with thick smear and OptiMAL-IT™ was used on days 2, 3, 7, and 14 for Plasmodium vivax and until day 21 of follow-up for Plasmodium falciparum. Percentages of correctly classified samples and predictive values were calculated, and the results were compared between the western jungle and the eastern jungle using Chi2 or Fisher's exact tests. Results: We registered 262 patients from San Martín and 302 from Loreto. The percentage of correctly classified cases and the negative predictive value were higher than 92.0% and 93,0%, respectively, from the third day of follow-up; no statistical differences were found in the results obtained from the western jungle and those from the eastern jungle. Conclusions: The OptiMAL-IT™ test would be effective as a follow-up test in patients diagnosed with malaria in endemic areas of Perú.

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This retrospective observational study aimed to analyze cases assisted at the Dentoalveolar Trauma Clinic of the School of Dentistry of the Federal University of Rio Grande do Sul (FO-UFRGS) from March 2015 to March 2018, according to the treatments performed on traumatized permanent teeth and the results after one year of follow-up. The sample was based on information collected from clinical records of 92 patients, referring to a) data before treatment, b) data on the diagnosis and proposed treatment, and c) data on the follow-up period. Descriptive and inferential statistical analyses were performed. Most patients were male (56.5%) and aged six to 11 (30.4%) and older than 18 (29.1%) years. The prevalent cause of trauma was falling, and 59% of patients were first assisted within 24 hours. The most frequent traumas were enamel and dentin fractures with and without pulp exposure (6.3%), lateral luxation (1.4%), and avulsion (1.9%). Endodontic treatment was usually performed on traumatized teeth (7.2%). Of the 92 patients, 58 returned for maintenance visits with a mean follow-up of one year. Most patients had successful treatments. Prompt care and patient follow-up were essential for the good prognosis of traumatized teeth.(AU)

O objetivo do presente estudo observacional retrospectivo foi analisar os casos atendidos na clínica de trauma dentoalveolar da Faculdade de Odontologia da Universidade Federal do Rio Grande do Sul (FO-UFRGS) no período de março de 2015 a março de 2018, de acordo com os tratamentos realizados em dentes permanentes traumatizados, assim como os resultados observados após 1 ano de seguimento. A amostra foi baseada na coleta de informações em prontuários clínicos de 92 pacientes, referentes a: a) dados anteriores ao tratamento; b) dados referentes ao diagnóstico e ao tratamento proposto; e c) dados referentes ao período de acompanhamento. Foi realizada análise estatística descritiva e inferencial. A maioria dos pacientes era do sexo masculino (56,5%), com idades entre 6 e 11 anos (30,4%) e mais de 18 anos (29,1%). A principal causa do trauma foi queda, sendo que 59% dos pacientes receberam o primeiro atendimento em 24 horas. Os traumas mais frequentes foram fratura de esmalte e dentina, com e sem exposição pulpar (6,3%), luxação lateral (1,4%) e avulsão (1,9%). O tratamento endodôntico foi frequentemente realizado nos dentes traumatizados (7,2%). Dos 92 pacientes, 58 retornaram para consultas de manutenção com um acompanhamento médio de 1 ano. A maioria dos pacientes apresentou sucesso após o tratamento. O atendimento no tempo correto, assim como o acompanhamento dos pacientes, foi fator fundamental para o bom prognóstico dos dentes traumatizados.(AU)

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High rates of relapses are common in eating disorder patients after achieving the status of remission. The lack of support after completing a treatment can contribute to relapse. Therefore aftercare programs are needed to maintain the benefits of treatment, to reduce the risk of relapse, and to stabilize patients' well-being. This paper describes the Internet-based aftercare program ACTUA (Continued Support for Eating Disorders) developed to support patients with bulimia nervosa in Mexico. ACTUA is an adaptation of the program EDINA (Internet-based maintenance treatment for eating disorders) which was developed and evaluated in Hungary. In this paper we first describe the intervention which consists of different modules including a monitoring and feedback tool, forums, and counseling chat with a clinician. In the second part, we report on first experiences following the introduction of the program in two treatment centers in Mexico (Monterrey and Mexico City). Fifteen patients participated in a semi-structured interview assessing perceived benefits of participating in ACTUA as well as barriers that prevented patients from joining the program. Implications for the implementation of Internet-based interventions in Mexico are discussed.

Las elevadas tasas de recaída son comunes en los pacientes con trastornos de la conducta alimentaria una vez que se les ha dado de alta de un tratamiento. La falta de apoyo después de terminado el tratamiento puede contribuir a las recaídas. Por lo tanto, los programas de seguimiento son necesarios para mantener los beneficios obtenidos en el tratamiento, para reducir el riesgo de recaídas y para estabilizar el bienestar de los pacientes. Este trabajo describe el programa de seguimiento en línea ACTUA (Apoyo Continuo para Trastornos Alimentarios), desarrollado para dar apoyo a pacientes con bulimia nerviosa en México. ACTUA es una adaptación del programa EDINA (Programa de seguimiento en línea para trastornos alimentarios), que fue desarrollado y evaluado en Hungría. En este trabajo se describe primero la intervención, que consiste en diferentes módulos, incluyendo una herramienta de monitorización y retroalimentación, foro y un chat con un clínico para obtener supervisión. En la segunda parte se reportan las primeras experiencias después de la introducción del programa en 2 centros de tratamiento en México (Monterrey y Ciudad de México). Quince pacientes participaron en una entrevista semi-estructurada, que evaluó la percepción de los beneficios obtenidos de participar en ACTUA, así como las barreras que impidieron que los pacientes participaran en el programa. Se discuten las implicaciones que tiene en México la implementación de un programa en línea.