Sexually transmitted infections associated with vulvovaginal symptoms in adolescents denying sexual activity Infecciones de transmisión sexual asociadas a síntomas vulvovaginales en adolescentes que niegan vida sexual activa

OBJECTIVE: To identify clinical, laboratory and ultrasonographic evidence of a probable sexually transmitted infection associated with vulvovaginal symptoms in adolescents denying sexual activity. MATERIAL AND METHODS: The medical records of female adolescents, aged 10-18 years were reviewed. These women received first-time medical care for vulvovaginitis, between 1995 and 1999 at Hospital Infantil de México Federico Gómez, (Children's Hospital). Comparisons between groups were performed, as appropriate, by the unpaired Student's t-test, the Z test or the chi-square test; statistically significant differences were set at a two-tailed p<0.05. Odds ratios with 95% confidence intervals were calculated. RESULTS: Of 258 adolescents with vulvovaginitis, 53 (20.5%) had a sexually transmitted microorganism and 52 of them denied ever having sexual activity. Age, education and socioeconomic level, development of sexual characters, and presence of menstruation did not differ between patients with and without sexually transmitted infections. The presence of sexually transmitted infections was associated with lower abdominal pain, abnormally colored vaginal discharge, a positive urine culture, and an abdominal ultrasonographic evidence, compatible with pelvic inflammatory disease (ultrasonographic odds ratio 144.8; 95% CI 51.0 to 411.3). CONCLUSIONS: There is an association between sexually transmitted infections in young women with vulvovaginitis and lower abdominal pain, abnormally colored vaginal discharge, a positive urine culture, and an abdominal ultrasonographic evidence compatible with pelvic inflammatory disease.<br>OBJETIVO: Identificar datos clínicos, de laboratorio y ultrasonográficos que permitan el diagnóstico de una infección de transmisión sexual asociada a síntomas vulvovaginales en las pacientes adolescentes que niegan vida sexual activa. MATERIAL Y MÉTODOS: Se revisaron los expedientes de las adolescentes de 10 a 18 años de edad que requirieron atención médica de primera vez por vulvovaginitis entre 1995 y 1999 en el Hospital Infantil de México Federico Gómez. Las comparaciones entre grupos se llevaron a cabo con la prueba t de Student, la prueba de Z, o la de ji-cuadrada. Se utilizó un valor de p<0.05 para establecer diferencias estadísticamente significativas. Se calcularon razones de momios con intervalos de confianza de 95%. RESULTADOS: De 258 adolescentes, en 53 (20.5%) se identificó un microrganismo de transmisión sexual y 52 de ellas negaron tener vida sexual activa. No hubo diferencias estadísticas entre los dos grupos de adolescentes en cuanto a la edad, los años de estudio, el nivel socioeconómico, la maduración sexual y la presencia de menarquia. El dolor abdominal en los cuadrantes inferiores, la coloración anormal de la secreción vaginal, un cultivo urinario positivo y un estudio ultrasonográfico abdominal compatible con enfermedad pélvica inflamatoria estuvieron asociados con infección de transmisión sexual. Con el estudio ultrasonográfico se obtuvo una razón de momios de 144.8 (intervalo de confianza 95% 51.0 a 411.3). CONCLUSIONES: Se demostró una asociación entre infección de transmisión sexual en adolescentes con vulvovaginitis y dolor abdominal bajo, secreción vaginal anormal, urocultivo positivo y un estudio ultrasonográfico compatible con enfermedad pélvica inflamatoria

Salud auto-referida y desigualdades sociales, ciudad de Buenos Aires, Argentina, 2005 Self-rated health and social inequalities, Buenos Aires, Argentina, 2005

La salud auto-referida es un indicador de calidad de vida. ¿Cuál es el impacto de las características socioeconómicas a nivel individual y a nivel de la vecindad, consideradas simultáneamente, en el estado de salud auto-referida a nivel individual? Diseño de análisis multinivel con dos niveles: individual y vecindad. Las fuentes de información fueron: Encuesta Nacional de Factores de Riesgo (muestreo probabilístico multietápico) y Censo Poblacional. La regresión lineal muestra que mayores niveles de educación, de ingresos y de categoría laboral se relacionan con mejor salud auto-referida; y el aumento de la edad con peor salud. En el análisis multinivel, a medida que la proporción de individuos con educación inferior aumentaba en la fracción censal, aumentaba también la proporción de individuos con peor salud auto-referida. Mejorar la salud general de la población requerirá estrategias y acciones que disminuyan los niveles de desigualdad social en sus múltiples dimensiones, individual y de vecindad.<br>Self-rated health is a quality-of-life indicator. This study investigates the impact of individual-level and neighborhood-level socioeconomic characteristics, considered simultaneously, on the state of self-rated health at the individual level in Buenos Aires, Argentina. The study employs a two-level (individual and neighborhood) multilevel analysis, and the data sources were the 2005 Argentina National Risk Factor Survey (multistage probabilistic sample) and the 2001 Population Census. Linear regression shows that higher schooling and income, as well as occupational category, are related to better self-rated health, and increasing age with worse health. In the multilevel analysis, an increase in the proportion (per census tract) of individuals with less schooling was associated with an increase in the proportion of individuals with worse self-rated health. Improving the general health of the population requires strategies and action that reduce the levels of social inequalities in their multiple dimensions, including the individual and neighborhood levels

Tradução e adaptação cultural do Questionário Aberdeen para Veias Varicosas Translation and cultural adaptation of Aberdeen Varicose Veins Questionnaire

CONTEXTO: Atualmente há um crescente interesse por instrumentos de avaliação em saúde produzidos e validados em todo o mundo. Apesar disso, ainda não temos no Brasil instrumentos que avaliem o impacto da doença venosa crônica na vida de seu portador. Para utilização dessas medidas torna-se necessária a realização da tradução e da adaptação cultural ao idioma em questão. OBJETIVO: Traduzir e adaptar culturalmente para a população brasileira o Aberdeen Varicose Veins Questionnaire (AVVQ- Brasil). MÉTODOS: O processo consistiu de duas traduções e duas retrotraduções realizadas por tradutores independentes, da avaliação das versões seguida da elaboração de versão consensual e de pré-teste comentado. RESULTADOS: Os pacientes do pré-teste eram do sexo feminino, com média de idade de 49,9 anos, média de tempo de resposta 7,73 minutos, que variou entre 4,55 minutos (tempo mínimo) a 10,13 minutos (tempo máximo). Escolaridade: 20% analfabetismo funcional, 1º grau completo e 2º grau completo; 30% 1º grau incompleto; e 10% 3º grau completo. Gravidade clínica 40% C3 e C6S, 10% C2 e C5, havendo cinco termos incompreendidos na aplicação. CONCLUSÕES: A versão na língua portuguesa do Aberdeen Varicose Veins Questionnaire está traduzida e adaptada para uso na população brasileira, podendo ser utilizada após posterior análise de suas propriedades clinimétricas.<br>BACKGROUND: Currently there is a growing interest in health assessment tools produced and validated throughout the world. Nevertheless, it is still inadequate the number of instruments that assess the impact of chronic venous disease in the life of its bearer. To use these measures it is necessary to accomplish the translation and cultural adaptation to the language in question. OBJECTIVE: Translate to Portuguese and culturally adapted for the Brazilian population the Aberdeen Varicose Veins Questionnaire (AVVQ-Brazil). METHODS: The process consisted of two translations and two back-translations performed by freelance translators, then the evaluation versions of the development of consensual version and commented pretest. RESULTS: The patients in the pre-test were female, mean age 49.9 years, average response time of 7.73 minutes, which ranged from 4.55 minutes (minimum) to 10.13 minutes (maximum time). Education: 20% functional illiteracy and first and second complete degrees; 30% first incomplete degree, and 10% third complete degree. Clinical severity: 40% C3 and C6s, 10% C2 and C5, with five misunderstood terms in the application. CONCLUSION: The Portuguese version of the Aberdeen Varicose Veins Questionnaire has been translated and adapted for use in the Brazilian population, and can be used after further analysis of their clinimetric properties, which is underway

Targeted therapy in patients with PIK3CA-related overgrowth syndrome

International audienc