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OBJECTIVE: To discuss theoretical and practical aspects of sexually transmitted diseases, AIDS, and psychoactive substances in adolescence, focusing on a holistic and multiprofessional approach. METHODS: Review of national and international literature on concepts, classifications, social and cultural, clinical, therapeutic and preventive aspects of sexually transmitted diseases/AIDS, as well as the use of psychoactive substances, with the aim of pointing out problem-solving alternatives. RESULTS: Adolescents do not show resilient behavior and are vulnerable to environmental hazards. For this reason, preventive actions and intervention for the control of sexually transmitted diseases/AIDS and use or abuse of psychoactive substances among adolescents are a priority. According to the World Health Organization, one out of 20 adolescents acquires sexually transmitted disease in the world every year and, more than 7,000 are infected by HIV every day, totaling 2.6 millions a year. This scenario results from unprotected sex and from the interaction between sexually transmitted diseases and psychoactive substances, especially alcohol. CONCLUSIONS: It is crucial that health care providers consider magnitude, transcendence, vulnerability and feasibility as well as the set of interactions among substance, individual, and his/her social and cultural environment when the multifocal and holistic approach is used. This requires the formation of a support and protection network, involving the family, physicians, community, and adolescents. The major element in this network, though, are the adolescent themselves, who can overcome their conflicts, aiming at a healthy and longer life.
RESUMO
PURPOSE: To study the predischarge exercise testing importance in determining prognosis after acute myocardial infarction (AMI). PATIENTS AND METHODS: Treadmill exercise testing was performed in 50 stable and without complications patients with AMI, just before hospital discharge; there were 43 men and 7 women, mean age of 53.6 +/- 9.3 years. It was used the modified Naughton protocol and there were no casualties during the exercise testing. Patients were followed up for a mean period of 22.2 +/- 7.7 months. RESULTS: The test was positive in 32% of the patients, abnormal (inadequate blood pressure, heart rate response or arrhythmia) in 36% and normal in 42%. During the first year of follow-up, eleven patients presented with a serious cardiac event. There was one cardiovascular death, 6 patients with unstable angina, 2 reinfarctions and 7 patients had a coronary bypass revascularization. The cumulative risk for these events at one year after myocardial infarction was 50% in patients with a positive exercise test, and 5% in those with a normal exercise test (p less than 0.005). CONCLUSION: The predischarge exercise testing proved to be a simple and safe method to determine prognosis after acute myocardial infarction, identifying a high risk group early after the acute event.
