Estudio clínico multicéntrico doble-ciego de naproxen 1000 mg vs. piroxican en dosis única diaria matinal para el tratamiento de la osteoartritis de rodilla / Multicentric doble-blind clinical trial with naproxen 1000 mg versus piroxican once a day morning dosage in the treatment of knee osteoarthritis

Se estudiaron 109 pacientes adultos mayores de 50 años con Osteoartritis de rodilla en un protocolo clínico multicéntrico a doble-ciego con el objetivo de comparar: la eficacia y la seguridad del uso de una dosis diaria matinal de 1000 mg de Naproxen o de 20 mg de Piroxicam, por un período máximo de tratamiento de 6 semanas por vía oral. Se utilizaron parámetros cuantitativos y semicuatitativos para medir el dolor, volumen articular, amplitud de movimiento articular, eficacia clínica y efectos colaterales. Se administró Naproxen a 55 pacientes y Piroxicam a 54 pacientes, de edades que fluctuaron entre los 51 y 80 años y con predominancia del sexo feminino. Los resultados fueron excelentes y muy buenos en 29 casos (52.7 por ciento) y buenos en 12 casos (21.8 por ciento) en el grupo Naproxen. En el grupo Piroxicam los resultados fueron excelentes y muy buenos en 26 pacientes (48 por ciento) y buenos en 14 casos (25.9 por ciento). En 21 pacientes del grupo con Naproxen (38 por ciento) y en 25 pacientes del grupo Piroxicam (46 por ciento) se presentaron efectos secundarios predominantemente en el tracto gastrointestinal, pero que fueron de leve a moderada intensidad. Las diferencias entre ambos grupos no fueron estadísticamente significativas y por consiguiente, los resultados terapéuticos fueron similares con ambas drogas, notándose una tendencia ligeramente favorable en la disminución del dolos en el grupo con Naproxen. En conclusión la administración de ambas drogas, además de eficaz es bastante segura el uso de una dosis diaria de Naproxen se vuelve una alternativa recomendable.

[Peruvian demographic transition]. / Transicion demografica Peruana.

PIP: The demographic transition is conceptualized as the historic change from high to low fertility and mortality rates in a population. Peru's population was reduced by an estimated 80% as a result of new diseases, destruction of the economy, and the brutal regime of colonial exploitation after the Spanish conquest. From colonial times to the least the 1940s, Peru's principal population problem was the scarcity of manpower. The population grew at an annual rate of about .03% between 1650 and 1800, increasing to about 1.3% between 1876 and 1940. High fertility throughout the 19th century and a stabilization of mortality due to reduced incidence and deadliness of epidemics contributed to the increased growth rate. In the 1940s the process of demographic transition was initiated by abrupt declines in mortality. The crude death rate declined from 27/1000 in 1940 to 16/1000 in 1961 and 9/1000 in 1988, with the rate still declining. Fertility remained high and possibly increased slightly. The crude birth rate was estimated at 45/1000 in 1940 and 45.4/1000 in 1961. Improvements in infant and general mortality rates in developing countries like Peru result from diffusion of technological advances in prevention and control of diseases and improvement in health services rather than from changes in the economic and social structure. The 3rd phase of the demographic transition began with declines in fertility from 45.4/1000 in 1961 to 42.0/1000 in 1972 and 36.0/1000 in 1981. Despite declines, mortality and fertility continue to be elevated in Peru. The theory of demographic transition views the reduction of infant mortality, improvements in health and educational conditions and the condition of women, and more equitable income distribution as essential for a true decline in birth rates. In Peru, however, fertility has declined in a context of deteriorating living conditions and in the absence of effective family planning programs. The process of demographic transition must be accelerated, which will require improvements in education, income, and availability of sanitary services among other changes.^ieng