Prevalencia de violencia de género en mujeres fumadoras en un ámbito de atención primaria de la Ciudad de Buenos Aires: estudio de corte transversal / Prevalence of gender violence in female smokers at a primary care level in Buenos Aires city: cross sectional study

INTRODUCCION: Argentina tiene una de las prevalencias de tabaquismo femenino más altas en Latinoamérica: 22,4% en mujeres adultas y 27,3% en adolescentes. El tratamiento de la dependencia al tabaco es una medida de control costo-efectiva, pero diferentes estudios internacionales demuestras una menor efectividad en mujeres y relacionan dichos resultados adversos con diversos determinantes psicosociales, entre ellos la violencia de género.OBJETIVO: Describir las prevalencias de posibles determinantes psicosociales y de características del consumo de tabaco en mujeres fumadoras asistidas en un consultorio de cesación tabáquica, perteneciente a un ámbito de atención primaria.METODOS: Se realizó un estudio de corte transversal con 194 fumadoras elegidas sistemáticamente. Para la detección de violencia de género, se aplicó un instrumento desarrollado por la Federación Internacional de Planificación Familiar. Para la detección de trastornos mentales no psicóticos, se recurrió al cuestionario de autoinformación (SRQ). También se exploraron datos demográficos, de la conducta adictiva y la autopercepción del estado de salud.RESULTADOS: La prevalencia de violencia de género hallada fue del 68,6%. La violencia emocional y la física fueron las modalidades más reportadas: 89,3% y 48,1%, respectivamente. Las mujeres con violencia basada en género reportaron una peor percepción del estado de su salud, mayores puntajes en los tests de Fagerstr¸m y SRQ-20, y una situación de empleo inestable. El análisis de regresión logística mostró una asociación positiva solo con las dos últimas variables.CONCLUSIONES: La prevalencia de violencia de género en la muestra fue muy alta, presentando asociaciones positivas con el resultado del test SRQ-20 y una situación de empleo inestable. El resultado fue similar al que demuestra la bibliografía internacional.

INTRODUCTION: Argentina has one of the highest female smoking prevalence in Latin America: 22.4% and 27.3% among adults and adolescents respectively. Smoking cessation treatment is a cost-effective control meassure, but several researches show that it is less effective in women and relate adverse outcomes to different psycho-social determinants like gender violence.OBJECTIVE: To describe prevalence of possible psycho-social determinants and characteristics of tobacco consumption in female smokers assisted at a primary care level.METHODS: A cross-sectional study was conducted, including 194 female smokers in a systematic sample. An instrument developed by the International Planned Parenthood Federation was used to detect gender violence. To explore mental health, a self-report questionnaire (SRQ) was applied. The study also evaluated demographic data, addictive behavior, and self-perception of health status.RESULTS: The prevalence of gender violence was 68.6%. Emotional (89.3%) and physical (48.1%) violence were the most reported types. Women suffering gender violence reported a worse perception of health status, higher scores in the Fagerstr¸m Test and the SRQ-20, as well as an unstable employment situation. The logistic regression showed a positive relationship only with the last two variables.CONCLUSIONS: The gender violence prevalence of the sample was very high, having positive associations with the result of the SRQ-20 and the unstable employment situation. The result was similar to that shown by the international literature.

Prevalencia de violencia de género en mujeres fumadoras en un ámbito de atención primaria de la Ciudad de Buenos Aires: estudio de corte transversal / Prevalence of gender violence in female smokers at a primary care level in Buenos Aires city: cross sectional study

INTRODUCCION: Argentina tiene una de las prevalencias de tabaquismo femenino más altas en Latinoamérica: 22,4% en mujeres adultas y 27,3% en adolescentes. El tratamiento de la dependencia al tabaco es una medida de control costo-efectiva, pero diferentes estudios internacionales demuestras una menor efectividad en mujeres y relacionan dichos resultados adversos con diversos determinantes psicosociales, entre ellos la violencia de género.OBJETIVO: Describir las prevalencias de posibles determinantes psicosociales y de características del consumo de tabaco en mujeres fumadoras asistidas en un consultorio de cesación tabáquica, perteneciente a un ámbito de atención primaria.METODOS: Se realizó un estudio de corte transversal con 194 fumadoras elegidas sistemáticamente. Para la detección de violencia de género, se aplicó un instrumento desarrollado por la Federación Internacional de Planificación Familiar. Para la detección de trastornos mentales no psicóticos, se recurrió al cuestionario de autoinformación (SRQ). También se exploraron datos demográficos, de la conducta adictiva y la autopercepción del estado de salud.RESULTADOS: La prevalencia de violencia de género hallada fue del 68,6%. La violencia emocional y la física fueron las modalidades más reportadas: 89,3% y 48,1%, respectivamente. Las mujeres con violencia basada en género reportaron una peor percepción del estado de su salud, mayores puntajes en los tests de Fagerstr÷m y SRQ-20, y una situación de empleo inestable. El análisis de regresión logística mostró una asociación positiva solo con las dos últimas variables.CONCLUSIONES: La prevalencia de violencia de género en la muestra fue muy alta, presentando asociaciones positivas con el resultado del test SRQ-20 y una situación de empleo inestable. El resultado fue similar al que demuestra la bibliografía internacional.

INTRODUCTION: Argentina has one of the highest female smoking prevalence in Latin America: 22.4% and 27.3% among adults and adolescents respectively. Smoking cessation treatment is a cost-effective control meassure, but several researches show that it is less effective in women and relate adverse outcomes to different psycho-social determinants like gender violence.OBJECTIVE: To describe prevalence of possible psycho-social determinants and characteristics of tobacco consumption in female smokers assisted at a primary care level.METHODS: A cross-sectional study was conducted, including 194 female smokers in a systematic sample. An instrument developed by the International Planned Parenthood Federation was used to detect gender violence. To explore mental health, a self-report questionnaire (SRQ) was applied. The study also evaluated demographic data, addictive behavior, and self-perception of health status.RESULTS: The prevalence of gender violence was 68.6%. Emotional (89.3%) and physical (48.1%) violence were the most reported types. Women suffering gender violence reported a worse perception of health status, higher scores in the Fagerstr÷m Test and the SRQ-20, as well as an unstable employment situation. The logistic regression showed a positive relationship only with the last two variables.CONCLUSIONS: The gender violence prevalence of the sample was very high, having positive associations with the result of the SRQ-20 and the unstable employment situation. The result was similar to that shown by the international literature.

[Screening colorectal cancer. Perception and behavior of the population]. / Rastreo del cáncer colorrectal. Conocimiento y actitud de la población.

There is strong evidence favoring colorectal cancer screening. Preliminary data suggests that it is not included in routine practice with the adequate frequency. We intended to recognize in a Health Care System (HCS) that provides the needed resources, the facilitators and barriers related with the implementation of this preventive practice, how many individuals have carried out one procedure and what this preventive activity predicts. A telephone survey was administered to a sample of affiliates from an HCS that serves employees of the University of Buenos Aires; 132 completed the questionnaire (70% response rate). Facilitators obtained an affirmative response in a 64 to 97%, and barriers from 11 to 27%. In the latter category a special subgroup (39%) was afraid of adverse events, and there was a feeling of embarrassment in others (30%); 33% of respondents had carried out a screening procedure, mainly FOBT 27, sigmoidoscopy 11 and colonoscopy 20. A majority (95%) stated that they "would do the procedure if doctors recommend it", or "not do it unless my doctor advises to do it" (87%). Answering affirmatively that "physicians will do the best for their patients" was associated with having had a CRC screening test, OR 1.55 (95% CI: 1.02-2.37) p: 0.04. Studied individuals showed good predisposition for colorectal cancer screening, but to put it into practice, medical advice seems to be a prominent determinant.

Rastreo del cáncer colorrectal: Conocimiento y actitud de la población / Screening colorectal cancer: Perception and behavior of the population

El rastreo de cáncer colorrectal (CCR) cuenta con fuertes evidencias en su favor. Datos preliminares indican que a pesar de ello no se lleva a cabo con la frecuencia adecuada. Se intenta aquí determinar, dentro de un Sistema de Salud que cuenta con los recursos necesarios, los elementos que facilitan o generan barreras para concretar esta práctica preventiva, cuántos individuos lo ponen en práctica y qué predice esta conducta. Se realizó una encuesta telefónica a los afiliados de una Obra Social de empleados de la Universidad de Buenos Aires, de los que 132 completaron el cuestionario (tasa de respuesta 70%). Los elementos considerados facilitadores del rastreo obtuvieron respuestas afirmativas en el 64 a 97%, mientras que los que definían barreras un 11 a 27%. En este último grupo, una categoría diferenciada la constituía el miedo a los efectos adversos: 39%, y el sentimiento de vergüenza relacionado con los procedimientos: 30%. Un 33% de los encuestados tenían hecho un método de rastreo, mayoritariamente de sangre oculta (27), sigmoideoscopía (11) y colonoscopía (20). Una mayoría afirmó que "se haría el procedimiento si el médico se lo recomendara" (95%), o "no se lo haría excepto que su médico se lo aconseje" (87%). Contestar afirmativamente que "los médicos hacen lo mejor para los pacientes" se asoció con haberse hecho un método de rastreo de CCR, OR 1.55 (IC 95%: 1.02-2.37) p: 0.04. El grupo de individuos estudiado parece bien predispuesto para el rastreo del CCR, la recomendación médica sería aquí un determinante prominente para ponerlo en práctica.

There is strong evidence favoring colorectal cancer screening. Preliminary data suggests that it is not included in routine practice with the adequate frequency. We intended to recognize in a Health Care System (HCS) that provides the needed resources, the facilitators and barriers related with the implementation of this preventive practice, how many individuals have carried out one procedure and what this preventive activity predicts. A telephone survey was administered to a sample of affiliates from an HCS that serves employees of the University of Buenos Aires; 132 completed the questionnaire (70% response rate). Facilitators obtained an affirmative response in a 64 to 97%, and barriers from 11 to 27%. In the latter category a special subgroup (39%) was afraid of adverse events, and there was a feeling of embarrassment in others (30%); 33% of respondents had carried out a screening procedure, mainly FOBT 27, sigmoidoscopy 11 and colonoscopy 20. A majority (95%) stated that they "would do the procedure if doctors recommend it", or "not do it unless my doctor advises to do it" (87%). Answering affirmatively that "physicians will do the best for their patients" was associated with having had a CRC screening test, OR 1.55 (95% CI: 1.02-2.37) p: 0.04. Studied individuals showed good predisposition for colorectal cancer screening, but to put it into practice, medical advice seems to be a prominent determinant.

Gonyautoxin: new treatment for healing acute and chronic anal fissures.

PURPOSE: The mayor symptoms of chronic anal fissure are permanent pain, intense pain during defecation that lasts for hours, blood in the stools, and sphincter cramps. It is subsequent to formation of fibrosis infiltrate that leads to an increased anal tone with poor healing tendency. This vicious circle leads to fissure recurrence and chronicity. This study was designed to show the efficacy of gonyautoxin infiltration in healing patients with anal fissures. METHODS: Gonyautoxin is a paralyzing phytotoxin produced by dinoflagellates. Fifty recruited patients received clinical examination, including proctoscopy and questionnaire to evaluate the symptoms. Anorectal manometries were performed before and after toxin injection. Doses of 100 units of gonyautoxin in a volume of 1 ml were infiltrated into both sides of the anal fissure in the internal anal sphincter. RESULTS: Total remission of acute and chronic anal fissures were achieved within 15 and 28 days respectively. Ninety-eight percent of the patients healed before 28 days with a mean time healing of 17.6 +/- 9 days. Only one relapsed during 14 months of follow-up. Neither fecal incontinence nor other side effects were observed. All patients showed immediate sphincter relaxation. The maximum anal resting pressures recorded after two minutes decreased to 56.2 +/- 12.5 percent of baseline. CONCLUSIONS: Gonyautoxin breaks the vicious circle of pain and spasm that leads to anal fissure. This study proposes gonyautoxin anal sphincter infiltration as safe and effective alternative therapeutic approach to conservative, surgical, and botulinum toxin therapies for anal fissures.

The gonyautoxin 2/3 epimers reduces anal tone when injected in the anal sphincter of healthy adults.

The primary clinical symptom of Paralytic Shellfish Poisoning is acute paralytic illness produced by paralyzing toxins. Paralytic shellfish poison is formed by a mixture of phycotoxins and their toxicity is due to its reversible binding to a receptor site on the voltage-gated sodium channel on excitable cells, thus blocking neuronal transmission. We studied the effect of the gonyautoxin 2/3 epimers by local infiltration in the anal internal sphincter of healthy voluntary adults in order to reduce anal tone. The toxin was injected after prior clinical evaluation, anoscopy and anorectal manometry. Post injection clinical examination, electromyography and anorectal manometry were performed. Resting and voluntary contraction pressures were measured and the anorectal inhibitory and anocortical reflexes were tested by manometry. Blood and urine samples were obtained from each participant, and hemogram, basic metabolic panel, and urinalysis were done both before and one week after the injection. This study shows, for the first time, that gonyautoxin 2/3 reduces the anal tone by relaxing the anal sphincters in 100 % of the participants. Manometric recordings showed a significant decrease in anal maximal voluntary contraction pressure after the toxin injection, dropping to 55.2+/-6.2 % and 47.0+/-6.8% (Mean Value+/-Std.Dev.) of the baseline values at 2 minutes and at 24 hours respectively after the injection. Post-injection electromyography showed that activity of the muscle was abolished. We conclude that local administration of gonyautoxin 2/3 to the anal sphincter produces immediate relaxation and a statistically significant decrease in the anal tone (p <0.001).

The Gonyautoxin 2/3 epimers reduces anal tone when injected in the anal sphincter of healthy adults

The primary clinical symptom of Paralytic Shellfish Poisoning is acute paralytic illness produced by paralyzing toxins. Paralytic shellfish poison is formed by a mixture of phycotoxins and their toxicity is due to its reversible binding to a receptor site on the voltage-gated sodium channel on excitable cells, thus blocking neuronal transmission. We studied the effect of the gonyautoxin 2/3 epimers by local infiltration in the anal internal sphincter of healthy voluntary adults in order to reduce anal tone. The toxin was injected after prior clinical evaluation, anoscopy and anorectal manometry. Post injection clinical examination, electromyography and anorectal manometry were performed. Resting and voluntary contraction pressures were measured and the anorectal inhibitory and anocortical reflexes were tested by manometry. Blood and urine samples were obtained from each participant, and hemogram, basic metabolic panel, and urinalysis were done both before and one week after the injection. This study shows, for the first time, that gonyautoxin 2/3 reduces the anal tone by relaxing the anal sphincters in 100 % of the participants. Manometric recordings showed a significant decrease in anal maximal voluntary contraction pressure after the toxin injection, dropping to 55.2 ± 6.2 % and 47.0 ± 6.8 % (Mean Value ± Std.Dev.) of the baseline values at 2 minutes and at 24 hours respectively after the injection. Post-injection electromyography showed that activity of the muscle was abolished. We conclude that local administration of gonyautoxin 2/3 to the anal sphincter produces immediate relaxation and a statistically significant decrease in the anal tone (p <0.001)..