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BACKGROUND: The present study aimed to describe the evolution of hemodynamic parameters over time of patients with invasive placentation during their third trimester who were delivered via cesarean section and subsequently underwent obstetric hysterectomy under epidural anesthesia. METHODS: A prospective, descriptive, longitudinal, 11-month cohort study of 43 patients aged between 18 and 37 years who presented with invasive placentation. Minimal invasive monitoring was placed before the administration of epidural anesthesia for hemodynamic parameter tracking during the cesarean section. After delivery, the patients underwent an obstetric hysterectomy. Blood loss, hemodynamic parameters, and coagulation were managed via goal-directed therapy. Parameters were compared via repeated measures ANOVA and effect size estimation (Cohen's d). RESULTS: The mean age of the patients was 29.2 ± 3.4 years and was moderately overweight. They had minor cardiac index variance (P=NS, no significance), vascular systemic resistance index (NS), heart rate (P=NS), and median arterial pressure (P=NS). Differences were observed in the stroke volume index (P=0.015) due to moderately higher values (d = 0.3, P=0.016) in the middle of the surgery. Patients had lower cardiac index (d = -0.36, NS) and cardiac workload requirements (d = -0.29, P=0.034) toward the completion of surgery. CONCLUSION: Patients who are in their third trimester and who subsequently underwent obstetric hysterectomy under epidural anesthesia had modest surgical hemodynamic variance and reduced cardiac workload requirements toward the end of the surgery.
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Neglected tropical diseases (NTDs) share certain traits: they are parasitic infections, prevailing in tropical environments and affecting marginalized sectors of the population. Six NTDs - ascariasis, cysticercosis, echinococcosis, hookworm infection, onchocerciasis and trichuriasis - all of them endemic in Latin America and the Caribbean (LAC), are analysed in this work. This review aims to discuss key information on the function of excretory/secretory (E/S) proteins from these parasites in their infectivity, pathogeny and diagnosis. The modulation of the host immune system to favour the permanence and survival of the parasite is also discussed. An updated knowledge on the function of E/S molecules in endemic parasitoses in LAC may lead to new approaches for the clinical management and diagnosis of these diseases. In turn, this could allow us to optimize their treatment and make it more affordable - a relevant goal given the economic constraints that the region is facing.
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Doenças Endêmicas , Proteínas de Helminto/fisiologia , Helmintíase/epidemiologia , Sistema Imunitário/parasitologia , Doenças Negligenciadas/parasitologia , Animais , Região do Caribe/epidemiologia , Gerenciamento Clínico , Helmintíase/imunologia , Helmintíase/parasitologia , Interações Hospedeiro-Parasita , Humanos , América Latina/epidemiologia , Doenças Negligenciadas/epidemiologia , Doenças Negligenciadas/imunologia , Medicina TropicalRESUMO
BACKGROUND: The programmed death (PD-1) inhibitor pembrolizumab has been recently approved for the treatment of advanced melanoma. We evaluated the clinical activity of pembrolizumab in melanoma patients treated under the Spanish Expanded Access Program. METHODS: Advanced melanoma patients who failed to previous treatment lines were treated with pembrolizumab 2 mg/kg every three weeks. Patients with brain metastases were not excluded if they were asymptomatic. Data were retrospectively collected from 21 centers in the Spanish Melanoma Group. RESULTS: Sixty-seven advanced melanoma patients were analyzed. Most patients were stage M1c (73.1%), had high LDH levels (55.2%) and had ECOG PS 1 or higher (59.7%). For cutaneous melanoma patients, median overall survival was 14.0 months; the 18-month overall survival rate was 47.1%. Overall response rate was 27%, including three patients with complete responses (6.5%). Median response duration was not reached, with 83.3% of responses ongoing (3.5 m+ to 20.4 m+). From ten patients included with brain metastases, four (40%) had an objective response, two (20%) of them achieved a complete response. Significant prognostic factors for overall survival were LDH level, ECOG PS and objective response. There were no serious adverse events. CONCLUSION: Although this was a heavily pretreated cohort, pembrolizumab activity at the approved dose and schedule was confirmed in the clinical setting with long-term responders, also including patients with brain metastases.
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Anticorpos Monoclonais Humanizados/uso terapêutico , Antineoplásicos/uso terapêutico , Melanoma/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Intervalo Livre de Doença , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Melanoma/mortalidade , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Terapia de Salvação/métodos , Espanha , Resultado do TratamentoRESUMO
This study determined whether clinical salt-sensitive hypertension (cSSHT) results from the interaction between partial arterial baroreceptor impairment and a high-sodium (HNa) diet. In three series (S-I, S-II, S-III), mean arterial pressure (MAP) of conscious male Wistar ChR003 rats was measured once before (pdMAP) and twice after either sham (SHM) or bilateral aortic denervation (AD), following 7 days on a low-sodium (LNa) diet (LNaMAP) and then 21 days on a HNa diet (HNaMAP). The roles of plasma nitric oxide bioavailability (pNOB), renal medullary superoxide anion production (RMSAP), and mRNA expression of NAD(P)H oxidase and superoxide dismutase were also assessed. In SHM (n=11) and AD (n=15) groups of S-I, LNaMAP-pdMAP was 10.5±2.1 vs 23±2.1 mmHg (P<0.001), and the salt-sensitivity index (SSi; HNaMAP-LNaMAP) was 6.0±1.9 vs 12.7±1.9 mmHg (P=0.03), respectively. In the SHM group, all rats were normotensive, and 36% were salt sensitive (SSi≥10 mmHg), whereas in the AD group â¼50% showed cSSHT. A 45% reduction in pNOB (P≤0.004) was observed in both groups in dietary transit. RMSAP increased in the AD group on both diets but more so on the HNa diet (S-II, P<0.03) than on the LNa diet (S-III, P<0.04). MAP modeling in rats without a renal hypertensive genotype indicated that the AD*HNa diet interaction (P=0.008) increases the likelihood of developing cSSHT. Translationally, these findings help to explain why subjects with clinical salt-sensitive normotension may transition to cSSHT.
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This study determined whether clinical salt-sensitive hypertension (cSSHT) results from the interaction between partial arterial baroreceptor impairment and a high-sodium (HNa) diet. In three series (S-I, S-II, S-III), mean arterial pressure (MAP) of conscious male Wistar ChR003 rats was measured once before (pdMAP) and twice after either sham (SHM) or bilateral aortic denervation (AD), following 7 days on a low-sodium (LNa) diet (LNaMAP) and then 21 days on a HNa diet (HNaMAP). The roles of plasma nitric oxide bioavailability (pNOB), renal medullary superoxide anion production (RMSAP), and mRNA expression of NAD(P)H oxidase and superoxide dismutase were also assessed. In SHM (n=11) and AD (n=15) groups of S-I, LNaMAP-pdMAP was 10.5±2.1 vs 23±2.1 mmHg (P<0.001), and the salt-sensitivity index (SSi; HNaMAP−LNaMAP) was 6.0±1.9 vs 12.7±1.9 mmHg (P=0.03), respectively. In the SHM group, all rats were normotensive, and 36% were salt sensitive (SSi≥10 mmHg), whereas in the AD group ∼50% showed cSSHT. A 45% reduction in pNOB (P≤0.004) was observed in both groups in dietary transit. RMSAP increased in the AD group on both diets but more so on the HNa diet (S-II, P<0.03) than on the LNa diet (S-III, P<0.04). MAP modeling in rats without a renal hypertensive genotype indicated that the AD*HNa diet interaction (P=0.008) increases the likelihood of developing cSSHT. Translationally, these findings help to explain why subjects with clinical salt-sensitive normotension may transition to cSSHT.
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High pressure processing (HPP) technology was used to modify the structural composition of sugarcane bagasse. The effect of pressure (0, 150 and 250 MPa), time (5 and 10 min) and temperature (25 and 50 °C) as well as the addition of phosphoric acid, sulfuric acid and NaOH during the HPP treatment were assessed in terms of compositional analysis of the lignocellulosic fraction, structural changes and crystallinity of the bagasse. The effect of HPP pretreatment on the bagasse structure was also evaluated on the efficiency of the enzymatic hydrolysis of bagasse. Results showed that 68.62 and 45.84% of the hemicellulose fraction was degraded by pretreating at 250 MPa with sulfuric and phosphoric acids, respectively. The removal of lignin (54.10%) was higher with the HPP-NaOH treatment. The compacted lignocellulosic structure of the raw bagasse was modified by the HPP treatments and showed few cracks, tiny holes and some fragments flaked off from the surface. Structural changes were higher at 250 MPa and 50 °C. The X ray diffraction (XRD) patterns of the raw bagasse showed a major diffraction peak of the cellulose crystallographic 2θ planes ranging between 22 and 23°. The distribution of the crystalline structure of cellulose was affected by increasing the pressure level. The HPP treatment combined with NaOH 2% led to the higher glucose yield (25 g/L) compared to the combination of HPP with water and acids (>5 g/L). Results from this work suggest that HPP technology may be used to pretreat sugarcane bagasse.
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Celulose/química , Pressão , Saccharum/química , Celulase/metabolismo , Celulose/metabolismo , Hidrólise , Lignina/química , TemperaturaRESUMO
There is no index or criterion of aortic barodenervation, nor can we differentiate among rats that have suffered chronic sham, aortic or sino-aortic denervation. The objective of this study was to develop a procedure to generate at least one quantitative, reproducible and validated index that precisely evaluates the extent of chronic arterial barodenervation performed in conscious rats. Data from 79 conscious male Wistar rats of about 65-70 days of age with diverse extents of chronic arterial barodenervation and used in previous experiments were reanalyzed. The mean arterial pressure (MAP) and the heart rate (HR) of all rats were measured systematically before (over 1 h) and after three consecutive iv bolus injections of phenylephrine (PHE) and sodium nitroprusside (SNP). Four expressions of the effectiveness of barodenervation (MAP lability, PHE ratio, SNP ratio, and SNP-PHE slope) were assessed with linear fixed models, three-level average variance, average separation among levels, outlier box plot analysis, and overlapping graphic analysis. The analysis indicated that a) neither MAP lability nor SNP-PHE slope was affected by the level of chronic sodium intake; b) even though the Box-Cox transformations of both MAP lability [transformed lability index (TLI)] and SNP-PHE slope [transformed general sensitivity index (TGSI), {((3-(ΔHRSNP-ΔHRPHE/ΔMAPSNP-ΔMAPPHE))-0.4-1)/-0.04597}] could be two promising indexes, TGSI proved to be the best index; c) TLI and TGSI were not freely interchangeable indexes for this purpose. TGSI ranges that permit differentiation between sham (10.09 to 11.46), aortic (8.40 to 9.94) and sino-aortic (7.68 to 8.24) barodenervated conscious rats were defined.
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Animais , Masculino , Ratos , Aorta/inervação , Estado de Consciência , Denervação/métodos , Pressorreceptores/efeitos dos fármacos , Aorta/fisiologia , Pressão Sanguínea/fisiologia , Frequência Cardíaca/fisiologia , Nitroprussiato/farmacologia , Fenilefrina/farmacologia , Ratos WistarRESUMO
There is no index or criterion of aortic barodenervation, nor can we differentiate among rats that have suffered chronic sham, aortic or sino-aortic denervation. The objective of this study was to develop a procedure to generate at least one quantitative, reproducible and validated index that precisely evaluates the extent of chronic arterial barodenervation performed in conscious rats. Data from 79 conscious male Wistar rats of about 65-70 days of age with diverse extents of chronic arterial barodenervation and used in previous experiments were reanalyzed. The mean arterial pressure (MAP) and the heart rate (HR) of all rats were measured systematically before (over 1 h) and after three consecutive iv bolus injections of phenylephrine (PHE) and sodium nitroprusside (SNP). Four expressions of the effectiveness of barodenervation (MAP lability, PHE ratio, SNP ratio, and SNP-PHE slope) were assessed with linear fixed models, three-level average variance, average separation among levels, outlier box plot analysis, and overlapping graphic analysis. The analysis indicated that a) neither MAP lability nor SNP-PHE slope was affected by the level of chronic sodium intake; b) even though the Box-Cox transformations of both MAP lability [transformed lability index (TLI)] and SNP-PHE slope [transformed general sensitivity index (TGSI), {((3-(ΔHR(SNP)-ΔHR(PHE)/ΔMAP(SNP)-ΔMAP(PHE)))(-0.4)-1)/-0.04597}] could be two promising indexes, TGSI proved to be the best index; c) TLI and TGSI were not freely interchangeable indexes for this purpose. TGSI ranges that permit differentiation between sham (10.09 to 11.46), aortic (8.40 to 9.94) and sino-aortic (7.68 to 8.24) barodenervated conscious rats were defined.
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Aorta/inervação , Estado de Consciência , Denervação/métodos , Pressorreceptores/efeitos dos fármacos , Animais , Aorta/fisiologia , Pressão Sanguínea/fisiologia , Frequência Cardíaca/fisiologia , Masculino , Nitroprussiato/farmacologia , Fenilefrina/farmacologia , Ratos , Ratos WistarRESUMO
INTRODUCTION AND OBJECTIVES: In Puerto Rico, it has been established that although coronary disease is the leading cause of death, the population has a lower incidence of coronary disease than in the continental United States. In addition, the severity of the disease is less aggressive in terms of a lower incidence of ventricular tachycardia and sudden death. One factor that could contribute to the lower incidence of coronary disease in Puerto Rico is that our population might have lower total plasma homocysteine concentrations (tHcys) than in the continental United States. Our main objective was to measure tHCys in the Puerto Rican population with atherosclerotic cardiovascular disease (ACD). METHODS: We randomly measured tHcys concentrations in seventy Puerto Rican patients who were hospitalized at the Cardiovascular Center of Puerto Rico and the Caribbean (UPR Division). RESULTS: The mean tHCys concentration in these patients is similar to those reported for the Framingham study when adjusted by age (11.2 vs. 11.8 micromol/l). In the Puerto Rican population, males had a higher tHcys concentration than females (11.7 vs 9.5 micromol/l, p = 0.07). In addition, we did not see an increase of tHcys concentrations in diabetic patients when compared with non-diabetics (10.1 vs. 11.2 micromol/l, p = 0.74). We did not see a direct correlation between tHcys concentrations and heart condition as measured by coronary angiography (normal = 11.1 micromol/l, light = 10.5 micromol/l, moderate = 10.9 micromol/l, severe = 10.5 micromol/l; Kruskal-Wallis = 0.45) either. CONCLUSION: These results suggest that tHcys concentration is not a good predictor of the seriousness of ACD in the Puerto Rican patient population.
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Homocisteína/sangue , Isquemia Miocárdica/sangue , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/epidemiologia , Porto RicoRESUMO
BACKGROUND: In Puerto Rico, it has been established that although coronary heart disease is the leading cause of death, the population has a lower incidence of coronary disease than the continental United States. In addition, the severity of the disease is less aggressive in terms of a lower incidence of ventricular tachycardia and sudden death. A factor in the lower incidence of coronary disease in Puerto Rico could be a lower total plasma homocysteine concentration (tHcys) in our population. METHODS: We randomly measured tHcys concentrations in seventy-two Hispanic patients who were hospitalized for coronary angiography at the Cardiovascular Center of Puerto Rico and the Caribbean (UPR Division). RESULTS: The mean tHCys concentration in our patient population is similar than that reported for the Framingham study when adjusted by age (11.2 mumol/L vs. 11.8 mumol/L). In the Puerto Rican population, males had a higher tHcys concentration than females but this difference was not statistically significant (10.9 mumol/L vs. 9.4 mumol/L, p = 0.09). In addition, we did not see an increase of tHcys concentrations in diabetic patients when compared with nondiabetics (10.1 mumol/L vs. 10.3 mumol/L, p = 0.73). Neither we saw a direct correlation between tHcys concentrations and atherosclerosis as measured by coronary angiography (normal = 10.9 mumol/L, mild = 8.6 mumol/L, moderate = 10.9 mumol/L, severe = 10.5 mumol/L; ANOVA = 0.29). CONCLUSIONS: These results suggest that tHcys concentration is not a good predictor of atherosclerotic coronary disease in our patient population.
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Doença da Artéria Coronariana/sangue , Homocisteína/sangue , Angiografia , Área Programática de Saúde , Cromatografia Líquida de Alta Pressão , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Porto Rico/epidemiologia , Índice de Gravidade de DoençaRESUMO
Highly active antiretroviral therapy (HAART) is the standard treatment for infection with human immunodeficiency virus (HIV). The most common HAART regimen consists of the combination of at least one protease inhibitor (PI) with two nucleoside reverse transcriptase inhibitors (NRTIs). Contrary to PIs, NRTIs require intracellular activation from the parent compound of their triphosphate moiety to suppress HIV replication. Simultaneous intracellular determination of two NRTI triphosphates is difficult to accomplish due to their relatively small concentrations in peripheral blood mononuclear cells (PBMCs), requiring large amounts of blood from HIV-positive patients. Recently, we described a method to determine intracellular zidovudine triphosphate (ZDV-TP) concentrations in HIV-infected patients by using solid-phase extraction and tandem mass spectrometry. The limit of quantitation (LOQ) for ZDV-TP was 0.10 pmol, and the method was successfully used for the determination of ZDV-TP in HIV-positive patients. In this study, we enhanced the aforementioned method by the simultaneous quantitation of ZDV-TP and lamivudine triphosphate (3TC-TP) in PBMCs from HIV-infected patients. The LOQ for 3TC-TP was 4.0 pmol, with an interassay coefficient of variation and an accuracy of 7 and 12%, respectively. This method was successfully applied to the simultaneous in vivo determination of the ZDV-TP and 3TC-TP pharmacokinetic profiles from HIV-infected patients receiving HAART.
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Fármacos Anti-HIV/sangue , Citidina Trifosfato/sangue , Infecções por HIV/tratamento farmacológico , Lamivudina/sangue , Nucleotídeos de Timina/sangue , Zidovudina/sangue , Fármacos Anti-HIV/uso terapêutico , Cromatografia por Troca Iônica , Citidina Trifosfato/análogos & derivados , Didesoxinucleotídeos , Infecções por HIV/sangue , Humanos , Lamivudina/análogos & derivados , Lamivudina/metabolismo , Lamivudina/uso terapêutico , Padrões de Referência , Zidovudina/análogos & derivados , Zidovudina/metabolismo , Zidovudina/uso terapêuticoRESUMO
In recent years, several hypotheses have emerged to explain the toxicologic activity of particulate matter. Organic compounds, ultrafine particles, biologic components, and transition metals are some of the constituents that reportedly exert some type of adverse effect on human health. A considerable fraction of the urban particulate matter consists of carbon compounds, which originate mostly from anthropogenic sources. The toxicity of organic fractions from particulate matter have been mainly evaluated by considering their mutagenic activity. This research expands on the toxicologic profile of organic compounds adsorbed to particulate matter, specifically in Puerto Rico, by using the cytotoxic neutral red bioassay (NRB). The NRB uses normal human epidermal keratinocytes or other types of cells to measure the effect on cell viability when exposed to organic compounds associated to the particles in the air. We validated the NRB for particulate matter by using a standard reference material (SRM 1649). We used the NRB to determine toxicologic differences of extracts between an urban industrialized site with anthropogenic activity versus a coastal region with less human activity. The cytotoxicity associated with organic compounds in particulate matter collected at the urban industrialized site was detected in both the particulate matter (3/4) 10 microm in aerodynamic diameter (PM(10)) and particulate matter (3/4) 100 microm in aerodynamic diameter (PM(100)). Greater toxic effects were observed in PM(10) extracts than in PM(100) extracts, but PM(10) toxic effects were not significantly different from those in PM(100). The extracts from the industrialized site were more cytotoxic than the extracts from coastal reference site, although in the summer, extracts from both sites were significantly cytotoxic to normal human epidermal keratinocytes. In addition, the nonpolar extracts of both PM(10) and PM(100) exerted the greatest cytotoxicity, followed by the polar, and, finally, the moderately polar extract. This study demonstrates that extracts from the Guaynabo industrialized site were more toxic than similar extracts obtained from a reference coastal site in Fajardo, Puerto Rico.
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Poluentes Atmosféricos/efeitos adversos , Técnicas de Cultura de Células , Corantes , Monitoramento Ambiental , Humanos , Indústrias , Queratinócitos/efeitos dos fármacos , Queratinócitos/patologia , Vermelho Neutro , Compostos Orgânicos/efeitos adversos , Tamanho da Partícula , Testes de Toxicidade/métodosRESUMO
Nucleoside reverse transcriptase inhibitors (NRTIs) used against the human immunodeficiency virus (HIV) need to be activated intracellularly to their triphosphate moiety to inhibit HIV replication. Intracellular concentrations of these NRTI triphosphates, especially zidovudine triphosphate (ZDV-TP), are relatively low (low numbers of femtomoles per 10(6) cells) in HIV-infected patient peripheral blood mononuclear cells. Recently, several methods have used either high-performance liquid chromatography (HPLC) or solid-phase extraction (SPE) coupled with radioimmunoassay to obtain in vivo measurements of ZDV-TP. The limit of detection (LOD) by these methods ranged from 20 to 200 fmol/10(6) cells. In this report, we describe the development of a method to determine intracellular ZDV-TP concentrations in HIV-infected patients using SPE and HPLC with tandem mass spectrometry for analysis. The LOD by this method is 4.0 fmol/10(6) cells with a linear concentration range of at least 4 orders of magnitude from 4. 0 to 10,000 fmol/10(6) cells. In hispanic HIV-infected patients, ZDV-TP was detectable even when the sampling time after drug administration was 15 h. Intracellular ZDV-TP concentrations in these patients ranged from 41 to 193 fmol/10(6) cells. The low LOD obtained with this method will provide the opportunity for further in vivo pharmacokinetic studies of intracellular ZDV-TP in different HIV-infected populations. Furthermore, this methodology could be used to perform simultaneous detection of two or more NRTIs, such as ZDV-TP and lamivudine triphosphate.
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Fármacos Anti-HIV/sangue , Infecções por HIV/sangue , Monócitos/metabolismo , Nucleotídeos de Timina/sangue , Zidovudina/análogos & derivados , Adulto , Idoso , Calibragem , Células Cultivadas , Cromatografia Líquida de Alta Pressão , Didesoxinucleotídeos , Feminino , Humanos , Masculino , Espectrometria de Massas , Pessoa de Meia-Idade , Nucleotídeos/sangue , Padrões de Referência , Zidovudina/sangueRESUMO
One of the basic foundations for the operation of health programs is the social participation of the population in actions going from planning to evaluation, promotion and control of actions related with their own health. In the work, we present the results of a preliminary and partial evaluation of an ongoing autopromoting health project in the communities of Lázaro Cárdenas and Las Limas, in the Municipality of Simojovel, Chiapas, México. The basic goal of this work is to identify factors derived from the relations of localities with the State and, on the other hand, from socioeconomic conditions of the populations, which favor or hinder the development of social participation in their own health projects. This is a comparative study, type before and after, within and between localities, intended to measure the effect of a health program with community participation in two communities having divergent relations with the State. For this, we carried out a socioeconomic and prevalent morbidity survey before and after the implementation of social participation in health actions. We also characterized social participation in health actions and identified the type of State intervention in the localities through governmental programs and institutions. The results convey the notion that the health program contributes to enhance hygienic sanitary conditions of the population and decrease the frequency of such ailments as diarrhea and parasitic diseases; social participation is more active in Lázaro Cárdenas than in Las Limas. State interventions in the communities are given through social programs and institutions in a mandatory way, with no opportunity for community participation in decision-making. The conclusion is that the demographic organization of the community and autopromotion favor the participation in health actions, while the presence of the State through political repression and actions delivered through social programs promote dependence and paternalism, hindering the ample social participation in actions for health.
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Participação da Comunidade , Planejamento em Saúde , Promoção da Saúde , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , México , Pessoa de Meia-Idade , Fatores SocioeconômicosRESUMO
This work contains the results of a study on the prevalence of family drug consumption. In our country, self medication should be considered a public health problem due to the population's lack of medical education. Nevertheless, this problem has not been properly studied. For this reason, we completed an exploratory study in an urban population of Cuernavaca, Morelos, México. Its purpose was to gather information about the situation of drug consumption and self medication. A survey was given to 373 domestic groups from the Carolina neighborhood in Cuernavaca. These groups were selected through systematic and probabilistic sampling. A total of 1,537 individuals of all ages were surveyed with an average of four participants per domestic group. Thirty one per cent of those surveyed had consumed drugs during the two weeks prior to the survey. Of these consumers, 53.3 per cent did it through self medication, and 64.9 per cent of them were females. If classified by age group, the highest consumer rate, 7.6 per cent, belonged to the users between 25 to 44 years. If the classification is done by sex and age, women between 25 to 44 years consumed more antibiotics and analgesics which were obtained over the counter. Among the surveyed population, the consumption of medicines was done primarily through self medication, mostly administered by women, and most frequently consumed by infants under one year of age. This phenomenon occurred regardless of the availability and accessibility of public and private health services. The data collected do make us identify women as a fundamental element in the consumption of drugs and self medication.(ABSTRACT TRUNCATED AT 250 WORDS)
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Automedicação/estatística & dados numéricos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Escolaridade , Feminino , Humanos , Lactente , Masculino , México , Pessoa de Meia-Idade , População UrbanaRESUMO
PIP: Adolescent reproductive behavior in selected countries is analyzed using data from a variety of published sources. Some common characteristics of adolescent fertility are identified, and the effects of educational status and residential characteristics on adolescent fertility are noted. Other topics considered include age at menarche, contraceptive usage, personality, family relationships, and peer relationships. (SUMMARY IN ENG AND FRE)^ieng