Sexually transmitted infections associated with vulvovaginal symptoms in adolescents denying sexual activity

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.

Consideraciones metodológicas para evaluar la calidad de vida / Methodological considerations for evaluating quality of life

This paper reviews the methods and principles for quality of life assessment. The aging of the population and the improved survival of people with acute and chronic conditions have produced several levels of disability requiring long-term treatment and rehabilitation. In 1948 the World Health Organization defined health as not merely the absence of disease but rather a state of complete physical, mental, and social well being. This term evolved from its conceptual definition to the development of scales to measure the quality of life beyond physical status. Thus, quality of life assessment includes areas such as mental health, social support, and life satisfaction. It is recognized that the expectations, vitality, pain, disability, and personal experiences influence the perception of a person's general health. A composite measurement aimed to quantify health according to physical, mental, and social well being simultaneously would likely include people at clearly different points on the three different continua, but in the midranges of the composite. The multidimensionality problems and the level of subjectivity involved in the assessment of the quality of life require valid and reliable instruments. This paper present an inventory of 126 questionnaires aimed to measure the quality of life for several diseases and populations. A better understanding of the methods to assess the quality of life will allow the incorporation of these instruments in the comprehensive assessment of patients, into clinical trials, and for health services research.

Evaluación de la calidad de vida / Evaluation of the quality of life

This paper reviews the methods and principles for quality of life assessment. The aging of the population and the improved survival of people with acute and chronic conditions have produced several levels of disability requiring long-term treatment and rehabilitation. In 1948 the World Health Organization defined health as not merely the absence of disease but rather a state of complete physical, mental, and social well being. This term evolved from its conceptual definition to the development of scales to measure the quality of life beyond physical status. Thus, quality of life assessment includes areas such as mental health, social support, and life satisfaction. It is recognized that the expectations, vitality, pain, disability, and personal experiences influence the perception of a person's general health. A composite measurement aimed to quantify health according to physical, mental, and social well being simultaneously would likely find people at different points on the three different continua, but in the midranges of the composite. The multidimensionality problems and the level of subjectivity involved in the assessment of the quality of life require valid and reliable instruments. This paper present an inventory of 126 questionnaires aimed to measure the quality of life for several diseases and populations. A better understanding of the methods to assess the quality of life will allow the incorporation of these instruments in the comprehensive assessment of patients, into clinical trials, and for health services research.