ABSTRACT
INTRODUCTION: Prevention programs have not achieved the expected results in preventing mortality from breast and cervical cancer in Mexico. Therefore, we propose a complementary strategy. METHODOLOGY: An educational strategy for high school students in Mexico (2011-2013) was designed (longitudinal design, two measurements and a single intervention). The postintervention assessment included: 1) knowledge acquired by students about cancer prevention and 2) The performance of the student as a health promoter in their household. The strategy was based on analysis of cases and developed in three sessions. An assessment tool was designed and validated (Test-Retest). The levels of knowledge according to the qualifications expected by chance were determined. Wilcoxon test compared results before and after intervention. RESULTS: An assessment instrument with 0.80 reliability was obtained. 831 high school students were analyzed. Wilcoxon rank-sum test showed a significant learning after the intervention (Z = - 2.64, p = 0.008) with improvement of levels of knowledge in a 154.5%. 49% of students had a good performance as health promoters. CONCLUSIONS: The learning in preventive measures is important to sensitize individuals to prevention campaigns against cancer. This strategy proved to improve the level of knowledge of students in an easy and affordable way.
ABSTRACT
Introducción. La coccidioidomicosis es una enfermedad endémica con una mortalidad inferior al 1%. Objetivo. Evaluar los factores de riesgo para mortalidad en pacientes con coccidioidomicosis diseminada (CMD) y describir los casos fatales. Métodos. Estudio de casos (fatales) y controles (no fatales) realizado entre enero de 2006 a diciembre de 2011. Se analizaron los factores de riesgo para desarrollo de CMD fatal. Se utilizó la prueba de Haldane para proporciones y se calculó la razón de momios con intervalo de confianza al 95% con el programa SPSS 15.0. Resultados. Se analizaron 20 casos de CMD, de los cuales 5 fueron fatales. La insuficiencia renal crónica y el trasplante renal se presentaron más frecuentemente en pacientes con CMD fatal. El 40% de los casos con CMD no fatal eran portadores del VIH. La anemia de 10 g/dl de hemoglobina o menos fue un hallazgo constante en CMD fatal. Conclusiones. En este estudio no se encontró diferencia significativa entre los factores de riesgo para CMD fatal y no fatal. Sin embargo, los pacientes que fallecieron tuvieron un curso de menos de 6 meses y presentaron anemia con hemoglobina de 10 g/dl o menos. Todos desarrollaron pulmón de shock con membranas hialinas. La CMD puede presentarse en forma atípica sin patología pulmonar. Se debe investigar la posibilidad de CMD en pacientes con patrón pulmonar de lesiones de tipo miliar, sobre todo en aquellos con deficiencia inmunológica y que habitan áreas endémicas (AU)
Introduction: Coccidioidomycosis is an endemic disease that has a mortality rate of less than 1%. Aim: To evaluate the risk factors for mortality in patients with disseminated coccidioidomycosis (DCM) and describe the fatal cases. Method: Fatal cases and non-fatal controls were studied between January 2006 and December 2011. Risk factors leading to fatal DCM were analysed. The Haldane test was used for propor- tions and the odds ratio was calculated with a confidence interval of 95% with the SPSS 15.0 programme. Results: Twenty cases of DCM were analysed, of which 5 were fatal. Chronic renal insufficiency and renal transplant were the most frequent conditions in patients with fatal DCM. 40% of non- fatal cases of DCM were HIV carriers. Anaemia of 10 g/dL or less of haemoglobin was a constant feature of fatal DCM cases. Conclusions: No significant difference in risk factors for fatal or non-fatal DCM was found. However, patients who died had a disease course of less than 6 months and anaemia of 10 g/dL or less. All developed shock lung with hyaline membranes. DCM can present atypically, with no pulmonary pathology. A diagnosis of DCM should be considered in patients with a pulmonary pattern of miliary type lesions, especially when the patient has an immunological deficiency and/or lives in areas endemic for coccidioidomycosis (AU)
