RESUMO
OBJECTIVES: To determine the accuracy of self-reported mammography use and generate a correction factor that adjusts for reporting errors among Mexican-American women. DESIGN: Self-reported mammography use was compared with a medical chart review. PARTICIPANTS: A random sample of 199 Mexican-American women aged 50-74 in southeast Texas. MAIN OUTCOME MEASURES: Self-reported mammography use for the preceding 2 years and mammography use determined by medical chart review. RESULTS: Positive and negative predictive values of mammography self-reports in the previous 2 years were 73.9 and 86.0%, respectively. The correction factor was 79.6%, or approximately 80% of the self-reported mammograms within the preceding 2 years could be verified through medical chart reviews. CONCLUSIONS: Mammography use rates among Mexican-American women were not as high as self-reports indicated. Estimates need to be adjusted downward by approximately 20%.
Assuntos
Neoplasias da Mama/diagnóstico , Neoplasias da Mama/etnologia , Comportamentos Relacionados com a Saúde/etnologia , Conhecimentos, Atitudes e Prática em Saúde , Mamografia/estatística & dados numéricos , Americanos Mexicanos/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Idoso , Neoplasias da Mama/psicologia , Feminino , Nível de Saúde , Humanos , Programas de Rastreamento/estatística & dados numéricos , Americanos Mexicanos/psicologia , Pessoa de Meia-Idade , Inquéritos e Questionários , Texas/epidemiologiaRESUMO
OBJECTIVES: To determine whether the adjunctive drugs antihistamine and corticosteroid improve immediate and long-term outcomes of acute otitis media (AOM). STUDY DESIGN: Children with AOM (3 mos-6 y) were enrolled in a randomized, double-blind, placebo-controlled trial. All 179 children received one dose of intramuscular ceftriaxone and were assigned to receive either chlorpheniramine maleate (0.35 mg/kg/d) and/or prednisolone (2 mg/kg/day) or placebo for 5 days. Main outcome measures were rate of treatment failure during the first 2 weeks, duration of middle ear effusion, and rate of recurrences of AOM to 6 months. RESULTS: Clinical outcomes and recurrence rates did not differ significantly with treatment. Children who received antihistamine alone had significantly longer duration of middle ear effusion (median, 73 days) than subjects in other treatment groups (median, 23 to 36 days, P=.04). Temporary normalization of tympanometric findings on day 5 occurred more frequently in the corticosteroid-treated group (P=.04). CONCLUSIONS: Five-day treatment with antihistamine or corticosteroid, in addition to antibiotic, did not improve AOM outcomes. Antihistamine use during an acute episode of OM should be avoided, since the drug may prolong the duration of middle ear effusion. The efficacy of 7- to 10-day treatment of AOM with corticosteroid, in addition to antibiotic, deserves further investigation.
Assuntos
Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios/uso terapêutico , Clorfeniramina/administração & dosagem , Clorfeniramina/uso terapêutico , Antagonistas dos Receptores Histamínicos H1/administração & dosagem , Antagonistas dos Receptores Histamínicos H1/uso terapêutico , Otite Média/tratamento farmacológico , Prednisolona/administração & dosagem , Prednisolona/uso terapêutico , Doença Aguda , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Ceftriaxona/administração & dosagem , Ceftriaxona/uso terapêutico , Criança , Pré-Escolar , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Seguimentos , Humanos , Lactente , Masculino , Estudos Prospectivos , Recidiva , Fatores de Tempo , Resultado do TratamentoRESUMO
BACKGROUND: Hispanic women and older women (age > or = 50 years) in general have been identified as populations of women who often underutilize Papanicolaou (Pap) smears. OBJECTIVE: To report the rates of cervical cancer screening in a group of older Mexican American women and to identify the correlates of having a Pap smear in the past three years. DATA SOURCE: The Mammography Use by Older Mexican-American Women Survey, a stratified area probability sample of 452 women ages 50-74 from three southeast Texas counties. Self-report data was collected with in-person interviews from 1997 to 1999. RESULTS: We found that 93.1% of the women reported at least one Pap smear in their lifetime and that 64.1% reported a Pap smear in the past three years. Odds of reporting a recent Pap smear was lower for older women (OR 0.51, 95% CI 0.32-0.82) and those below the poverty line (OR 0.52, 95% CI 0.33-0.82). The odds were higher for women who had a regular doctor for female care (OR 6.49, 95% CI 2.96-14.23) or a regular clinic or hospital source for female care (OR 5.50, 95% CI 2.55-11.89). Among these older Mexican-American women, cultural factors (language of interview, acculturation, fatalism) did not have a significant effect on screening use. CONCLUSION: Recent Pap smear use (64.1%) falls well below the year 2010 goal of 90%. Efforts need to be made to overcome barriers to Pap smear utilization for these women, such as providing access to female medical care.
Assuntos
Mamografia/estatística & dados numéricos , Programas de Rastreamento/estatística & dados numéricos , Americanos Mexicanos/psicologia , Teste de Papanicolaou , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Neoplasias do Colo do Útero/diagnóstico , Esfregaço Vaginal/estatística & dados numéricos , Fatores Etários , Idoso , Feminino , Pesquisas sobre Atenção à Saúde , Acessibilidade aos Serviços de Saúde , Humanos , Americanos Mexicanos/estatística & dados numéricos , Pessoa de Meia-Idade , Razão de Chances , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Autorrevelação , TexasRESUMO
This study assesses factors associated with incarceration history and HIV seropositivity among 1,700 out-of-treatment drug injectors recruited in Puerto Rico between 1989-1990 from health care centers, emergency rooms, copping areas, shooting galleries, bars, billiard rooms and street corners. Analysis links incarceration history with criminal involvement and chronic drug use. After controlling for sociodemographics and previously reported correlates of HIV status, regression analysis shows incarceration history significantly relates to HIV status. The only predictor of incarceration history not related to HIV status was illegal activity as a major source of income. Analysis emphasizes HIV prevention programs within the penal system
Assuntos
Adulto , Feminino , Humanos , Masculino , Abuso de Substâncias por Via Intravenosa/epidemiologia , Soropositividade para HIV/epidemiologia , Prisioneiros , Abuso de Substâncias por Via Intravenosa/complicações , Soropositividade para HIV/complicações , Modelos Logísticos , Porto Rico/epidemiologia , Fatores de RiscoRESUMO
This study compares the prevalence of human immunodeficiency virus (HIV) infection and HIV risk behaviors among 1,702 injection drug users (IDUs) recruited within four catchment areas in metropolitan San Juan (79.9 per cent male and 20.1 per cent female). To assess the impact of different antecedent variables on intercommunity risk differences, we constructed separate logistic regression models for each one of the catchment areas in the analysis. Old San Juan/Santurce has the highest rate of HIV seropositivity. Furthermore, Old San Juan/Santurce IDUs were more likely to have had incarceration experience, to report using drugs only by injection, and to have been injecting drugs for 16 years or more. Also, this group was more likely to report practicing prostitution and to have been diagnosed with sexually transmitted diseases (STDs) than their peers from the other sites. The need of preventive programs in specific communities within metropolitan urban areas is discussed
Assuntos
Adulto , Feminino , Humanos , Masculino , Abuso de Substâncias por Via Intravenosa/epidemiologia , Infecções por HIV/epidemiologia , Assunção de Riscos , Abuso de Substâncias por Via Intravenosa/complicações , Área Programática de Saúde , Infecções por HIV/complicações , Modelos Logísticos , Prevalência , Porto Rico/epidemiologia , Saúde da População UrbanaRESUMO
Although injection drug use (IDU) is the major risk category for HIV infection in Puerto Rico and injection drug users start their drug injection careers very young, there is little information related to drug injection patterns of young IDUs. In this paper we report on factors found to be associated with HIV seropositivity among 255 young IDUs (16-24 years old). Overall, 23.5 per cent subjects were HIV seropositive. Being 22 to 24 years old, having dropped out of school, having a history of incarceration, and having been diagnosed with STDs, and initiating drug use injection before 17 years of age were the factors significantly related to HIV seropositivity. Findings suggest that prevention programs should begin early in the development of youngsters. Special HIV and STD preventive programs for youngsters at risk of leaving school before completing high school should be a priority