RESUMO
BACKGROUND: Effective sexual health promotion programs need to be based on evidence; this study describes a set of sexual behavioral patterns, education and other subjects related to sexual life among 71th, 8th and 9th grade students in the State of Lara, Venezuela. METHODS: During 2003 to 2004 school period, 2070 students filled out the Global School Health Survey (GSHS)--a school based cross-sectional self-administered survey that explores, among other areas, sexual behavior. RESULTS: Students who responded that ever had intercourse, males 27% and females 3.8%; by grade, males 18.2% (7th) and 37.6 % (9th), and females 1.9% (7th) and 6.2% (9th). The group who had intercourse, 54.9% males and 25.3% females had it by age 12; 59% males and 78.6% females were sexually active in the past 12 months; 59.2% males and 43.2% females used condom in the last intercourse; and 48.3% males and 21.5% females has 2 or more sexual partners in their life. A disparity is present in school-based information, >63% for AIDS and <32% for sexual abuse. CONCLUSIONS: This study shows that a substantial number of students had sexual intercourse initiation at early age (<12), history of multiple sexual partners and low prevalence of condom use. An unbalanced coverage of information on AIDS and sexual abuse is highly prevalent in the school. However, the implementation and evaluation of comprehensive programs on healthy sexual life must take into account that still a majority of students report abstinence from sexual intercourse.
Assuntos
Adolescente , Criança , Feminino , Humanos , Masculino , Sexualidade/estatística & dados numéricos , Estudos Transversais , Comportamento Sexual/estatística & dados numéricos , Inquéritos e Questionários , Educação Sexual , VenezuelaRESUMO
This study reports on deaths due to acute rheumatic fever (ARF) and chronic rheumatic heart disease (CRHD) in Venezuela from 1955 to 1994. Census publications and other official sources provide the population data. Yearly age -and sex- specific mortality rates per 100,000 inhabitants were calculated and adjusted by the direct method to the WHO's standard population. The RF-adjusted mortality rate (AMR) declined: total from 7.68 to 1.08 (-85.9%); male from 7.53 to 0.84 (-88.8%); and female from 7.83 to 1.33 (-83.0%). In all cases female RF-AMRs were higher than male. There was a reduction of 88.5% in the ratio of RF deaths to cardiovascular deaths (ICD-6330-334,400-447; ICD-7330-334,400-447; ICD-8 390-438; ICD-9 390-438). ARF-AMR declined (-93.5%) as did CRHD-AMR (-85.1%). Proportional death by ARF and CRHD in patients 45 years old and younger increased. Venezuela experienced a continuous decline in RF-AMR from 1955 to the l980s, followed by a period of stabilization lasting until l994. The reduction could be the consequence of improvement in socioeconomic status and of RF prevention with penicillin, a standard practice in the health care system. The 1980s and 1990s RF-AMR stabilization could be associated with economic setbacks in Venezuela and changes in the agent's virulence patterns.
RESUMO
Death rates due to Ischemic Heart Disease (IHD) are widely used to assess regional and national cardiovascular health status. However, their validity is questionable, essentially because they are based on death certificates (DCs). The present study was conducted in the Greater Metropolitan Area of Barquisimeto (Lara State, Venezuela), from June 1991 to July 1992. The purpose was to establish the validity of the diagnosis of myocardial infarction in DCs of intrahospital deaths. Efforts were made to locate all clinical charts and any other relevant information. To validate the diagnosis of MI in the DC we used the MONICA project criteria. During the study period a total of 247 eligible DCs were recorded. Sufficient clinical information was located for 136 cases (55%). The results were as follows: definite MI - 62 cases (45.6%); probable MI - 31 cases (22.8%); and non MI - 43 cases (31.6%). These results may indicate an overestimation of MI death rates of about 32% [95% Confidence Interval = 23.8% - 39.4%]. Since these data are from a region with an organized cardiovascular health system, it is expected that the overestimation for the rest of the country may be even higher. Thus, in order to enhance quality and accuracy of DCs, it is necessary to develop a system to improve adherence to existing norms for filling out and processing such forms.
RESUMO
High serum cholesterol and LDL-cholesterol level and high blood pressure are risk factors for cardiovascular disease (CVD). CVD risk factors usually occur simultaneously, fact that enhance personal and population CVD risk. Data from interventional studies suggest that reducing CAD risk factors significantly lowered risk of CAD. Fluvastatin, a statine, has been used in hypercholesterolemic populations. We report on a clinical trial (random selection) of fluvastatin vs. placebo on hipercholesterolemic patients (total cholesterol > or = 240 mg/dl and/or low-density lipoprotein cholesterol (LDL-C) > or = 160 mg/dl) on treatment of mild to moderate high blood pressure. Forty Latin-American patients were randomized to placebo or 40 mg per day for 8 weeks of fluvastatin. Fluvastatin patients had a clinical and statistical significant reduction on total cholesterol (27.7%) and LDL-C (39.1%) Vs a non-significant reduction on the placebo group (6.9% total cholesterol and 9.1% LDL-C). One patient had elevated aspartate (AST) and alanine (ALT) aminotransferases (three times the local laboratory upper normal levels) associated with a chronic alcohol consumption, reverted 6 weeks after protocol completion. There was no important secondary effects; also there was no differences on this regard between placebo and verum group. Fluvastatin proved to be safe and well tolerated for this group of patients under a wide range of high blood pressure treatment.
Assuntos
Anticolesterolemiantes/uso terapêutico , Ácidos Graxos Monoinsaturados/uso terapêutico , Hipercolesterolemia/tratamento farmacológico , Hipertensão/complicações , Indóis/uso terapêutico , Colesterol/sangue , Terapia Combinada , Método Duplo-Cego , Terapia por Exercício , Feminino , Fluvastatina , Humanos , Hipercolesterolemia/sangue , Hipercolesterolemia/complicações , Hipercolesterolemia/terapia , Hipertensão/sangue , Hipertensão/dietoterapia , Hipertensão/terapia , Lipoproteínas HDL/sangue , Lipoproteínas LDL/sangue , Masculino , Pessoa de Meia-Idade , Triglicerídeos/sangueRESUMO
Stroke, the 5th. cause of death in Venezuela, has been associated to cerebral infarction. However, there is little information concerning lethality factors. 33 atherothrombotic subtype stroke patients, 31 (96%) Latino and 2(4%) white, were admitted into a prospective study to analyze the role of 11 mortality risk factors for those patients. A mortality relative risk (RR) > 1.5 or < 1 (protective) was considered clinically important if 1 was excluded from the 95% confidence interval (95%CI). The Mantel-Haenszel Chi-square procedure was use to test statistical significance (p < 0.05). Mortality RR for patients age 65 and over (RR = 2.95) and 4 year mortality RR for male patients (RR = 2.04) were clinically and statistically significant. History of high blood pressure was protective (RR = 0.62) probably due to good medical control. Cumulative mortality was higher than that of comparable studies, even from the first week of follow-up, reaching 67% at the 4th year.
Assuntos
Infarto Cerebral/mortalidade , Idoso , Idoso de 80 Anos ou mais , Distribuição de Qui-Quadrado , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Risco , Fatores de Risco , Análise de Sobrevida , Venezuela/epidemiologiaRESUMO
Con el objeto de determinar sus perfiles bioquímicos hormonales se estudiaron 21 pacientes portadores de una Hipertensión Arterial Esencial, respondedores a NIFEDIPINA (R) y 21 pacientes no respondieron (NR), cuyas características demográficas eran muy semejantes entre si. Se les determinaron: calcio sérico total (CaST), calcio Iónico sérico (Ca++) magnesio sérico (Mg++) fósforo sérico (Ps), igualmente se dosificó la excreción urinaria de estos electrolitos. También se estudio su sistema Renina-Angiotensina Aldosterona (RAA), dosificado la Actividad de Renina Plasmática (ARP), la Aldosterona Plasmática (AP) y los valores de Paratohormona (PTH). Se obtuvieron los siguientes resultados: En R encontramos Ca++ más bajo (p<0,001) CaST más bajo (p<0,05) y PTH más elevado (p<0,001), con una ARP más baja (p<0,001) que correlaciona directa y significativa con el Ca++ (p<0,001). En la orina se encontró un incremento en la excreción de calcio (p<0,001). En los NR en cambio, se observó un Mg++ más bajo (p<0,001) una AP más elevada (p<0,001) que correlacionó de manera inversa y significativa con la AP (Mg++/AP=P<0,001). Así mismo se encontró una excreción de Mg aumentada (P<0,001). a) Se separaron dos grupos, donde la fisiopatología de su hipertensión eran diferentes, en los R se caracterizó por alteraciones más evidentes del metabolismo del Calcio, en cambio en los NR las alteraciones eran más evidentes en el Magnesio. b) Estas alteraciones estaban íntimamente relacionadas con el Sistema RAA. c) El riñon debe jugar papel importante en estas alteraciones. d) Se plantea la posibilidad de que si conocemos algunas alteraciones Ca-Mg en un sujeto hipertenso podremos iniciar su terapia de manera más lógica, lo cual debe ser motivo de investigaciones posteriores