Latent tuberculous infection among foreign-born individuals applying to shelters in the metropolitan area of Milan.

SETTING: Screening for latent tuberculous infection (LTBI) of groups at high risk of active tuberculosis (TB) is a key component of the End TB Strategy. OBJECTIVE: To conduct a retrospective descriptive analysis of LTBI rates among foreign-born individuals applying to shelters in the metropolitan area of Milan, Italy. DESIGN: All foreign-born individuals registering for accommodation centres in the city of Milan from November 2009 to April 2017 were screened for active TB and LTBI. Individuals aged <36 years with a tuberculin skin test (TST) induration of >10 mm were offered confirmatory testing with QuantiFERON®-TB Gold In-Tube (QFT-GIT). RESULTS: Of the 2666 TST-positive migrants aged <36 years who underwent LTBI confirmation testing, 1322 (49.6%) tested negative, 1339 (50.2%) were positive and five (0.2%) had indeterminate results. In the multivariate analysis, TB incidence in the country of origin and age were significantly associated with QFT-GIT positivity. Although estimated TB incidence in Eritrea, Morocco and Romania was 100/100 000 person-years (py), the probability of being QFT-GIT-positive in individuals from these countries were not statistically significantly different from individuals from countries with TB incidence > 250/100 000 person-years. CONCLUSION: Our data showed a high proportion of LTBI among individuals coming from intermediate TB burden countries.

Isoniazid preventive treatment: predictors of adverse events and treatment completion.

SETTING: Villa Marelli Institute (VMI), Niguarda Ca'Granda Hospital, Milan, Italy. BACKGROUND: A recent report on the fatal side effects of isoniazid preventive therapy (IPT) from the United States has re-ignited discussion on the safety of this intervention. OBJECTIVE: To evaluate IPT feasibility, treatment completion and adverse events (AE) and their determinants under field conditions. METHODS: Data from consecutive subjects undergoing IPT at the VMI were recorded in an electronic database from 1992 to 2009. Logistic regression analysis was performed to detect completion and AE determinants. RESULTS: A total of 11,963 patients were included in the study. AE (odds ratio [OR] 2.70, 95%CI 2.22-3.28) and human immunodeficiency virus positive status (OR 5.20, 95%CI 2.10-12.93) were the main determinants of treatment interruption among Italians, while social weakness (no housing/job; OR 2.88, 95%CI 2.43-3.42), AEs (OR 1.33, 95%CI 1.15-1.53, 2.22-3.28) and screening in undocumented subjects (OR 1.20, 95%CI 1.01-1.44) prevailed among foreigners. Age was the main determinant of transaminase increase (OR 1.03, 95%CI 1.03-1.04), as were AEs of the gastrointestinal (OR 1.02, 95%CI 1.02-1.03), central nervous (OR 1.02, 95%CI 1.02-1.05) and peripheral nervous systems (OR 1.04, 95%CI 1.02-1.05). CONCLUSION: This analysis demonstrates the feasibility and safety of IPT, with determinants of interruption and AEs being predictable and addressable.

[Impact of domestic violence on reproductive and neonatal health]. / Impacto de la violencia doméstica sobre la salud reproductiva y neonatal.

BACKGROUND: Domestic violence can have an important influence on mother and child health. AIM: To assess the consequences of remote and actual, emotional or physical, domestic violence on the reproductive and newborn health in pregnant women. MATERIAL AND METHODS: A longitudinal epidemiological observation from an Urban Primary Health Care Center from Valdivia, Chile, in 1998. Two cohorts were studied: Pregnant women that experienced domestic violence (index group) and pregnant women not exposed to domestic violence (control group). Women were followed during pregnancy and at labor. The newborn was also assessed. RESULTS: The index group had a higher relative risk (RR) for impending abortion (RR 1.44, 95% confidence interval (CI): 1.07-1.93), hypertensive syndrome of pregnancy (RR 1.5, 95% CI: 1.18-1.96), intrahepatic cholestasis (RR 1.5, 95% CI: 1.1-1.94). Women that experienced violence during pregnancy had a higher risk of urinary tract infection (RR 2.88, 95% CI: 1.28-6.43), intrauterine growth retardation (RR 3.7, 95% CI: 1.77-7.93) and intrahepatic cholestasis. Newborns from the index group had lower weight, size and gestational age. CONCLUSIONS: Domestic violence is associated with hypertension during pregnancy and intrauterine growth retardation. The incorporation of bio-psychological evaluation and monitoring systems could attenuate the consequences of domestic violence.

Ocular hypertension: 12 years' follow-up.

A retrospective 12-year study on 35 patients having IOP values higher than 21 mmHg in repeated tonometric curves with no clinical glaucomatous-type signs was carried out with the aim of discovering the incidence of the eyes which evolved towards the glaucomatous disease, to evaluate the role of the preventive therapy and to observe how response to the ibopamine provocation test (which assesses outflow pathway compromission) was modified with time. The data obtained showed that, in 39.13% of the eyes, there was an evolution towards the disease. The ibopamine test was positive at time "0" (study begins) in 48.14% in the evolutive eyes and in 66.66% of the eyes which remained stable, while, at time "12" (study ends), almost all of the eyes (92-95%) had become positive. The role of precociously initiated ocular hypotensive therapy concurring with the test positivity is put in evidence.

[Domestic violence and sexuality]. / Violencia doméstica y sexualidad.

BACKGROUND: Women's reproductive health is closely related to the conditions in which intercourse is carried out with the sexual partner. Physical and emotional abuse is expressed as loss of bonds, reduction in self esteem and deterioration in interpersonal relationships. AIM: To assess the effects of domestic violence on pregnant women attitudes towards sexual relations with their partners, and to critically analyze the dependence of these variables on biosociodemographic factors, socioeconomic status and family functioning. MATERIAL AND METHODS: Sixty three pregnant women with a domestic violence background (index group) and 43 women without such background (control group) were subjected to a structured survey including questions about biosociodemographic variables, socioeconomic status, family relations, couple interactions and questions about attitudes towards sexual relations. RESULTS: Domestic violence was caused by the woman's partner or ex partner in 73% of cases. A greater family dysfunction and disturbance in the couple's relation was observed in the index group (p < 0.05). Association tests and multiple correspondence analysis did not show a clear correspondence between variables related to a woman's attitude towards sex relations and the risk of domestic violence. CONCLUSIONS: This quantitative methodology was unable to identify the reasons, interpretations and meanings that women with a background of violence, give to features associated with their sexuality.

[What, how much and when the university student drinks]. / Qué, cuánto y cuándo bebe el estudiante universitario.

The aim of this work was to define the epidemiological profile of alcohol ingestion and its associated risks, in university students. A social survey about drinking habits was performed to a random sample of 528 students, aged 17 to 26 years old, 54% male, from Austral University. Eighty two percent of males and 79% of females drink alcoholic beverages. They mainly consume beer and strong spirits. Their main consumption is occasional, during parties or celebrations. Thirty percent of males and 15% of females had three or more inebriations during the last year. Nine percent of males and 3% of females can be considered as problem drinkers. Student that drink alcohol have lower grades that teetotalers. It is concluded that alcohol consumption is frequent among students.

[Sexual behavior and contraceptive practices among university students]. / Comportamiento sexual y prácticas anticonceptivas del estudiante universitario.

The aim of this work was to study the knowledge, opinions and sexual behaviour of a sample of 464 students from the Universidad Austral de Chile. Results show that 78% of male and 41% of female students have had a sexual intercourse and that 78% of males and 72% of females with an active sexual life use contraceptive methods. The principal reasons to avoid the use of these methods are the irregularity of sexual intercourse and the reduction in pleasure. Most students think that these methods are harmful for their health but they should be used. The use of contraceptive methods increase with the frequency of sexual relations and university experience, but first year students use them more frequently than second year students. Most students know several contraceptive methods, but their knowledge about mechanisms of action is inadequate or distorted. Likewise, more than 50% think that it is possible to prevent pregnancy after a sexual intercourse. It is concluded that most sexually active students use contraceptive methods, but inappropriately. Stereotypes, myths and lack of information are influencing their sexual and contraceptive practices, showing incoherence between their knowledge and behavior. A possible explanation could be a scarce influence of high school and religion on their sexual formation.

PIP: A random sample of 464 students of the University Austral of Chile were surveyed concerning their sexual practices and contraceptive usage. 78% of the male and 41% of the female students had had sexual intercourse. Among male and female students respectively, 21% and 19% had regular sexual relations, 33% and 24% had sporadic relations, and 24% and 20% were not sexually active at the time of the survey. 78% of sexually active males and 72% of sexually active females had ever used contraception. 57% had ever used condoms, 56% withdrawal, and 35% oral contraceptives (OCs). Among the 27% of sexually active students who had never used contraception, 78% cited sporadic relations and 39% reduction in sexual pleasure as reasons for nonuse. Use of contraception increased regularly with age, from 68% of sexually active students under 21 to 85% among students over 23 years old. It increased with frequency of intercourse, from 72% of those with sporadic relations to 91% of those having intercourse weekly or more often. There was no statistically significant relationship between religious background and contraceptive usage. The proportions believing specific contraceptive methods to be harmful to health were 65% for OCs, 53% for IUDs, 29% for injectables, and 19% for spermicides. 69% stated it is always necessary to use contraception. Two-thirds of the sexually active students knew more than three methods. 49% believed that vaginal washing after coitus could prevent pregnancy.

[University students and sex: what they think, what they know, what they do]. / El estudiante universitario frente al sexo: que piensa, que sabe, que hace?

Using the social survey technique, a random sample of 464 students from the Universidad Austral answered a structured questionnaire about behavior and attitudes towards sex. Results show that the majority of students have had sexual experiences. Men and women differ significantly in motivations and age at the start of their sexual activity, stability of their relationships, first sexual partner and emotional experiences. Sexual behavior is associated with age, years of university studies and geographical origin. On the contrary this behavior is weakly influenced by religion or family. Premarital sexual intercourse is accepted by the majority of students. Knowledge about sexual physiology and contraception is scarce in 30 to 80% of students. It is concluded that, since a great number of students have an active sexual life along with little knowledge in this topic, the University has to assume an active role in the sexual education of students.

Valoración del estado nutricional en escolares de la ciudad de Valdivia y su relación con hábitos dietarios y estilo de vida / Valuation of nutritional status in students of Valdivia City and its connection with food habits and way of living

Se presentan los resultados de un estudio realizado en una población escolar de 518 estudiantes de la ciudad de Valdivia, correspodiente a grupos etáreos de 10-18 años de edad, se valora el estado nutricional y su correlación con hábitos dietarios y estilo de vida. Se logra establecer que el 6.9% de la población estudiada presentó algún grado de desnutrición y el 44.4% alteraciones por exceso. El mayor porcentaje de alteraciones por exceso se encontró en escolares de sexo femenino, predominando en el grupo de adolescentes entre 14 y 18 años. La mayor parte de los escolares poseían conocimientos insuficientes o inadecuados acerca de las propiedades y valor calórico de los alimentos consumidos; ésto se correlacionó directamente con alteraciones nutricionales, sean éstas por déficit o exceso de ingesta. Analizado el estado nutricional en relación con actividad física, se concluyó que existe una correlación directa entre mayor ingesta calórica, actividad sedentaria y manifestaciones nutricionales por exceso de ingesta. El problema general de salud y sicosocial, se ve de marcada importancia, revelando la necesidad de iniciar a breve plazo, acciones y programas específicos especialmente orientados a la prevención de este tipo de alteraciones y por ende a mejorar la calidad de vida de la población escolar

Post-coital contraceptive use by adolescents: analysis of contraceptive behaviour before and after.

PIP: A sample of 339 girls aged 13-19 who requested postcoital contraception from the Centri Educazione Matrimoniale e Prematrimoniale in Milan between 1983 and 1987 is analyzed in terms of contraceptive behavior. The majority were aged 16-19, although 8.8% were 15. 75.5% had had their 1st sexual experience between age 17 and 19. 43% had relied on withdrawal; 20% had used no contraceptive; and 51.2% had used condoms, and broken or improperly used condoms accounted for 36.8% of the requests for postcoital contraception. 41% came to the Center within 3 months of commencing sexual activity. 50% returned to the Center to request contraceptives; in 78% of the cases they chose the pill. Several cogent facts about adolescents' knowledge and attitudes emerged from the analysis. Many of the girls had only vague or inaccurate knowledge of reproductive physiology and menstruation. Many considered contraception unnecessary because they had intercourse only occasionally. Many feared the side effects of contraceptives. Adolescents often do not use contraceptives because they fear that their parents will find out. Others fear going to a gynecologist, and often the girls say that the boys do not want to use a condom.^ieng

Estimulacion sensorial programada en lactantes de bajo nivel socioeconomico. / Programed sensorial stimulation in infants of low socio-economical back-ground

Se estudiaron dos grupos de ninos sanos de bajo nivel socio-economico, beneficiarios del Servicio de Salud de Valdivia, desde su nacimiento hasta el primer ano de vida con el fin de probar la eficacia de la aplicacion de un programa de estimulacion temprana. Para ello un grupo permanecio en sus condiciones ambientales habituales y el otro recibio el programa de estimulacion. Al comparar los coeficientes de desarrollo de ambos grupos aplicando un analisis de regresion minimo cuadratica se encontraron diferencias significativas entre los valores de ambos grupos siendo mayores los indices de coeficiente de desarrollo en el grupo de estudio, sin embargo el incremento del coeficiente de desarrollo no fue significativamente distinto entre los dos grupos. Con respecto a variables de crecimiento como peso, talla, perimetro craneano no hubo diferencias en el incremento en los ninos estudiados