Resumo em Espanhol:

Se describen los principales resultados del Tercer Estudio Nacional de Consumo de Drogas realizado en Chile por el Consejo Nacional para el Control de Estupefacientes (CONACE) entre el 1 de septiembre de 1998 y el 15 de enero de 1999, que utilizó el mismo diseño metodológico de los estudios primero y segundo, realizados en 1994 y 1996, y que amplió la muestra a 31 665 individuos que representaban a una población de 6 940 727 personas de 12 a 64 años de edad, de ambos sexos y de cinco niveles socioeconómicos, residentes en zonas urbanas de 62 comunas de las 13 regiones del país. Además, se comparan los resultados proporcionados por los tres estudios. El estudio de 1998 muestra que 17,5% de los chilenos han consumido alguna vez en la vida alguna de las tres drogas ilícitas de mayor uso en el país: marihuana (16,8%), pasta base (2,3%) y clorhidrato de cocaína (4,0%). La prevalencia del consumo de cualquiera de las tres drogas durante el último año fue de 5,3% y durante el último mes de 2,2%, predominando una vez más el consumo de marihuana. Con respecto a las drogas lícitas, 28,4% de los chilenos han consumido alguna vez en su vida ansiolíticos, 84,4% alcohol y 71,9% tabaco. La mayor parte de las personas que alguna vez consumieron drogas ilegales dejaron de hacerlo: 71,6, 64,1 y 66,8% en el caso de la marihuana, de la pasta base de cocaína y del clorhidrato de cocaína, respectivamente. Para las drogas legales, estos porcentajes fueron menores: 55,5% para los ansiolíticos, 16,0% para el alcohol y 34,5% para el tabaco. El consumo de drogas lícitas e ilícitas fue varias veces mayor en los hombres que en las mujeres, excepto el de ansiolíticos, que fue tres veces mayor en el sexo femenino que en el masculino. El consumo fue más frecuente entre los 19 y 25 años de edad. El consumo de drogas ilícitas fue más frecuente en los niveles socioeconómicos más altos y el de drogas lícitas en los más bajos. El percentil 50 de la edad de inicio en el consumo de drogas se situó en los 17 años para el alcohol, en los 15 para el tabaco, en los 30 para los ansiolíticos, en los 17 para la marihuana, en los 20 para la pasta base de cocaína y en los 21 para el clorhidrato de cocaína. La comparación de los resultados de los tres estudios realizados por el CONACE muestra que, tras el aumento del consumo de drogas lícitas registrado entre 1994 y 1996, se produjo una estabilización en 1998, mientras que para el consumo de drogas ilícitas hubo un ligero aumento entre 1996 y 1998, tras la ligera disminución observada entre 1994 y 1996.

Resumo em Inglês:

The principal results are presented here from the Third National Study of the Consumption of Drugs, which was carried out in Chile by the National Board for Narcotics Control between 1 September 1998 and 15 January 1999. The 1998 study used the same methodological design as the first and second studies, which were done in 1994 and 1996. The 1998 study expanded the sample to 31 665 individuals, who were representative of a population of 6 940 727 people from 12 to 64 years old, both sexes, and five socioeconomic levels and who were residents of urban areas in 62 commune administrative divisions of the 13 regions of the country. Results from the 1998 study are compared with those from 1996 and 1994. The 1998 study shows that 17.5% of Chileans have at some time in their life used one of the three illicit drugs most popular in the country: marijuana (16.8%), coca paste (2.3%), and cocaine hydrochloride (4.0%). The prevalence of use of any of the three drugs, mainly marijuana, during the preceding year was 5.3% and during the preceding month 2.2%. With respect to licit drugs, 28.4% of Chileans have at some time in their lives used antianxiety drugs, 84.4% of them have consumed alcohol, and 71.9% have used tobacco. Most of the people who once used illegal drugs have stopped doing so: 71.6% in the case of marijuana, 64.1% with coca paste, and 66.8% with cocaine hydrochloride. For legal drugs, the percentages were lower: 55.5% for anxiolytics, 16.0% for alcohol, and 34.5% for tobacco. The consumption of licit and illicit drugs was several times greater among men than among women, except for anxiolytics, whose use was three times greater among women. Drug use was more frequent among persons between 19 and 25 years old. Consumption of illegal drugs was more frequent at higher socioeconomic levels, and use of licit drugs was more common in the lower socioeconomic levels. The 50th percentile of the age of initiating drug use was 17 years for alcohol, 15 for tobacco, 30 for antianxiety agents, 17 for marijuana, 20 for coca paste, and 21 for cocaine hydrochloride. Comparing the results of the three studies shows that, after an increase in the use of licit drugs between 1994 and 1996, there was a stabilization in 1998. With illegal drugs there was a modest increase in consumption between 1996 and 1998, following a small reduction between 1994 and 1996.

Resumo em Espanhol:

El presente estudio se diseñó con el fin de conocer las condiciones en las que se realiza el control prenatal en la ciudad fronteriza de Tijuana, Baja California, México y de estudiar las posibles asociaciones entre ese tipo de atención y el resultado neonatal en términos de peso al nacer, estado de salud del neonato y prematuridad. Se seleccionaron siete hospitales que atienden a personas de diferentes estratos socioeconómicos y entre diciembre de 1993 y marzo de 1994 se entrevistó en ellos a 279 mujeres que cursaban las primeras 24 a 48 horas del puerperio. En la entrevista se recogieron datos sobre nivel socioeconómico; conceptos, actitudes y prácticas de las madres respecto de la salud obstétrica; percepción materna de acceso a los servicios de atención prenatal; calidad de las consultas de control prenatal (evaluada según la realización de pruebas de sangre y orina y la medición de la tensión arterial y del peso); y antecedentes ginecobstétricos y de salud de la madre. Se elaboró una base de datos con el paquete estadístico SPSS y se exploraron posibles asociaciones entre la atención prenatal como variable independiente y las diferentes variables dependientes mediante tablas de contingencia y la prueba de Fisher de dos colas.

Resumo em Inglês:

This study was intended to explore the conditions under which prenatal care is delivered in the border city of Tijuana, Baja California, Mexico, and to assess the possible associations between that care and neonatal results in terms of birthweight, health of the neonate, and prematurity. Seven hospitals serving persons from different socioeconomic strata were chosen, and between December 1993 and March 1994 interviews were conducted with 279 women who were in the first 24 to 48 hours of puerperium. During the interviews data were collected on socioeconomic level; the mothers' knowledge, attitudes, and practices concerning obstetric health; the mothers' perceptions of access to prenatal care; the quality of prenatal care visits (evaluated in terms of having blood and urine tested and weight and blood pressure measured); and the gynecological and obstetric and health history of the mother. A database was created using the SPSS statistics software package. Possible associations were explored, with prenatal care as the independent variable and various dependent variables, by means of contingency tables and a two-tailed Fisher's exact test. None of the neonates was premature, ill, or had a birthweight of <= 2 500 g. For this reason it was decided to divide the variable corresponding to birthweight into two groupings, <= 3 000 g and > 3 000 g. A significant (P < 0.00038) relationship was found between a lack of prenatal care and low birthweight. In addition, a lack of prenatal care was associated with: low family income; the mother's financial dependence on the father; the mother being in an unmarried relationship; little communication with the partner; having no medical insurance; an unwanted pregnancy; and giving delivery at the General Hospital. Out of the total sample of 279 women, 15 (5.4%) had received no prenatal care. None of these 15 women reported they had encountered difficulties that prevented them from obtaining prenatal care, but only 7 of those women answered that question. The prenatal care was of good quality in 190 of the cases (68%). Both the number and the timing of the prenatal visits were adequate in 142 of the cases (50%). The mother's having worked during pregnancy or before had a positive predictive value in terms of utilization of prenatal care services. Additional studies are needed to evaluate the possible relationship between domestic violence and the lack of prenatal care or a delay in seeking such care.

Resumo em Espanhol:

En este estudio se analiza la evolución de la resistencia a los antimicrobianos en 771 aislados de Shigella spp. obtenidos de un total de 9 195 coprocultivos efectuados entre 1990 y 1997 en un hospital infantil de Córdoba, Argentina. S. flexneri, responsable de 73% de las infecciones por Shigella, fue la especie más resistente. La frecuencia de la multirresistencia de S. flexneri a los tres antibacterianos más utilizados (ampicilina, trimetoprima-sulfametoxazol y cloranfenicol) aumentó de 10% en 1990 a 58% en 1997 (P < 0,001). Cuando se considera separadamente cada uno de ellos, la resistencia a la ampicilina aumentó de 60 a 100% (P < 0,001), la resistencia al cloranfenicol de 13 a 71% (P < 0,001) y la resistencia a la trimetoprima-sulfametoxazol de 79 a 84% (P = 0,22). Para S. sonnei, el aumento de la resistencia a la ampicilina (de 36% en 1990 a 54% en 1997) no fue estadísticamente significativo (P = 0,20), ni tampoco lo fue la disminución de la resistencia a la trimetoprima-sulfametoxazol, que pasó de 82% en 1990 a 55% en 1997 (P = 0,08); solo se detectaron dos aislados resistentes al cloranfenicol, uno en 1995 y otro en 1997, y dos con resistencia múltiple a los tres antibióticos. Consideramos obligatorio realizar pruebas de susceptibilidad en cada aislado clínico de Shigella, ya que permiten detectar cambios en el perfil de la resistencia y, con ello, adecuar el tratamiento empírico.

Resumo em Inglês:

This study analyzed the evolution of antimicrobial resistance in 771 isolates of Shigella spp. obtained from a total of 9 195 feces cultures done between 1990 and 1997 in a children's hospital in Córdoba, Argentina. S. flexneri, which was responsible for 73% of the Shigella infections, was the species with the greatest resistance. The frequency of S. flexneri resistance to the three antibiotics most used (ampicillin, trimethoprim-sulfamethoxazole, and chloramphenicol) increased from 10% in 1990 to 58% in 1997 (P < 0.001). Considering each of the drugs individually, the resistance to ampicillin increased from 60% to 100% (P < 0.001), the resistance to chloramphenicol from 13% to 71% (P < 0.001), and the resistance to trimethoprim-sulfamethoxazole from 79% to 84% (P = 0.22). For S. sonnei, the increase in resistance to ampicillin (from 36% in 1990 to 54% in 1997) was not statistically significant (P = 0.20), nor was the reduction in resistance to trimethoprim-sulfamethoxazole, which went from 82% in 1990 to 55% in 1997 (P = 0.08). Only two S. sonnei isolates were found that were resistant to chloramphenicol, one in 1995 and another in 1997; two S. sonnei isolates were found with resistance to all three antibiotics. We consider it essential to carry out susceptibility tests of each Shigella clinical isolate, to detect changes in the resistance profile and thus modify empiric treatment.