Youth tobacco use in Latin America: What is the real extent of the problem?

INTRODUCTION: Cigarette consumption among teenagers is one of the most critical health-related risk behaviors. METHOD: Prospective study carried out in seven sites of five Latin American countries (Argentina [Cordoba, N=958, Corrientes, N=1013], Brazil [Curitiba, N=650; Uruguaiana, N=997], Cuba [Havana, N=1004], Mexico [Veracruz, N=991] and Paraguay [Ciudad del Este, N=868]) with public-school adolescents (aged 12-19 years). Respondents were asked to answer the California Student Tobacco Survey. RESULTS: 6550 adolescents took part in the survey (average age: 14 years). 38.5% (N=2517) "tried smoking" and 37.5% started smoking before the age of 12. Sixty-one percent of adolescents think that cigarettes are easily accessible; 41.7% considered that smokers have more friends; 88% indicated knowledge of the harms of smoking one to five cigarettes per day; 58.9% would smoke new cigarette types with less harmful substances; 27.8% have already used e-cigarettes; 28% have smoked hookah. Fifty-seven point five percent have been, in the past seven days, in the same room with someone who was smoking a cigarette; and 30.5% indicated that there were not any no-smoking rules inside their homes. Identifiable risk factors were (logistic regression analysis): smoking cigarettes offered by friends, smoking cigarettes with less harmful substances, knowing what a hookah is, being in the same room with a smoker in the past week. Identifiable protective factors against tobacco use were: knowing the health risks caused by smoking hookah and to have their own room. CONCLUSION: Youth tobacco use in Latin America is a major public health concern, and tobacco control measures are highly needed.

[Choroidal tubercles in miliary tuberculosis]. / Tubérculos coroideos en la tuberculosis miliar.

OBJECTIVE/METHOD: We present 2 cases of miliary tuberculosis with choroidal tubercles. RESULTS/CONCLUSIONS: Miliary tuberculosis is a severe disease that may cause death in case of misdiagnosis, but might be resolved with an adequate mycobacterial therapy. The diagnosis was based on a combínation of findings and the presence of choroidal tubercles may play an important role in the final diagnosis and correct treatment.

Unhealthy eating behaviour in adolescents.

In recent years, eating disorders (Anorexia and Bulimia Nervosa) have increased and are appearing at increasingly younger ages. They affect predominantly adolescent females 12 to 25 years of age. The objective of this study of adolescents is to detect and discuss unhealthy eating behaviour, defined by either of two factors: (1) following a slimming diet not advised or supervised by any person trained in health care; or (2) eating very large quantities at irregular times, not related to anxiety or stress. A transversal study has been undertaken of 630 school children of 14-18 years of age (average: 15.9 years) in Cádiz (Andalucia, Spain), using an anonymous self-reporting questionnaire to collect data on personal and educational situation, on eating habits, on nutritive intake and knowledge of nutrition, and on dieting and physical exercise. The study has considered averages, ratios, statistical significance (chi2) and, as a measure of risk, the Disequality Ratio of Prevalence (DRP). Anomalous eating behaviour was detected in 46.3% (292), with females predominant by a ratio of 2:1. Comparing groups with anomalous and with normal eating habits, significant differences were detected in respect of: perception of body image (p < 0.001), frequency of weighing oneself (p < 0.05), periods of abstinence from eating (DRP 1.66; 95% confidence interval (CI): 1.66-2.37), provocation of vomiting (DRP 2.02; 95% CI: 1.13-3.65), use of laxatives (DRP 4.25: 95% CI: 1.08-9.63), and the exclusion of certain meals and types of food, mainly bread and cereals, fats and sugars. Conclusions are drawn on the substantial scale of unhealthy eating behaviour among adolescents in Cadiz. More adequate education on personal health and related social issues should be provided.

[Intentional homicides in the Genf canton (1971-1990)]. / Vorsätzliche Tötungsdelikte im Kanton Genf (1971-1990).

In the 20-year period from 1971 to 1990, 114 homicide victims have been autopsied by the Universitary Institute of Forensic Medicine in Geneva. The mean annual homicide rate was 1.5/100,000 population. The sex ratio was about 1.7 males for 1 female. The authors found 1.9 Swiss citizens for 1 foreigner. The victim's mean age was 38 years. The largest number of victims were found in the age group 20-39 years (42%). 58% of victims knew their offenders (familiars, friends and acquaintances), 11% did not know their offenders (strangers) while the relationship victim-offender remained unknown in 31% of the homicide cases of which only 16% have not been elucidated. Methods equally used were firearms and stabbing (71% of casts). Alcohol was present in the blood of 25% of the victims at rates varying between 0.7 and 3.61%. Homicides were more likely to occur in the evening and at night, during weekends and during the months of May, June, July, October and November. 50% of homicides took place at the victim's home, 8% at the offender's home and 42% outside lodgings.