Comunicación con padres, comportamiento sexual e indicadores de abuso sexual en jóvenes mexicanos con discapacidad visual / Communication with parents, sexual behavior, and indicators of sexual abuse in mexican young people with visual disabilities

Resumen La investigación tuvo dos objetivos: 1) describir el patrón de conducta sexual, indicadores de abuso y nivel de comunicación con padres y con madres, en una muestra de jóvenes mexicanos con discapacidad visual, realizando comparaciones por sexo y debut sexual, y 2) analizar la relación entre la comunicación con padres, el uso del preservativo y la presencia de relaciones sexuales forzadas. Se utilizó un diseño transversal-descriptivo-correlacional-observacional. Participaron voluntariamente 64 jóvenes entre 12 y 26 años de edad. Se aplicaron individualmente cinco instrumentos: 1) Perfil sociodemográfico, 2) Datos familiares y antecedentes de la discapacidad, 3) Patrón de conducta sexual, 4) Escala de comunicación sexual con padres y 5) Escala de comunicación sexual con madres. 70% de los participantes habían tenido relaciones sexuales, 50% tuvo su primera relación antes de los 18 años, 70% no utilizó algún método anticonceptivo. El 41.5% reportó haber tenido tres o más parejas sexuales, 28% un embarazo, 14.6% un aborto, 4.9% una infección de transmisión sexual, 22% indicó haber sufrido abuso sexual en su primera relación y el 14% en subsecuentes. La mayoría contestó que nunca o casi nunca han conversado con sus padres sobre los temas evaluados, y con sus madres lo han hecho con poca frecuencia. Se discute la necesidad de desarrollar más investigaciones y programas preventivos para disminuir situaciones de riesgo en jóvenes con discapacidad.

Abstract The research had two objectives: 1) to describe the pattern of sexual behavior, indicators of abuse and level of communication with parents and mothers, in a sample of young Mexican visually impaired, making comparisons by sex and sexual debut, and 2) to analyze the relationship between communication with parents, condom use and the presence of forced sex. A correlational-descriptive-observational cross-sectional design was used. Participated 64 young people between 12 and 26 years old. Five instruments are applied individually: 1) socio-demographic profile, 2)familyfacts and background of disability, 3) sexual behavior pattern, 4) Scale of sexual communication with parents and 5) Scale of sexual communication with mothers. 70% of participants had had sex, 50% had their first sexual intercourse before age 18, 70% did not use any contraceptive method. 41.5% reported having had three or more sexual partners, 28% pregnancy, an abortion, 14.6%, 4.9% sexually transmitted infection, 22% reported having been sexually abused in their first relationship and 14% in subsequent. Most said they never or almost never talked with their parents about the issues evaluated, and their mothers have done infrequently. The need to develop more research and prevention programs to reduce risk situations young people with disabilities is discussed.

The natural history of liver metastases from colorectal cancer

Background. The optimal treatment for patients with liver metastases from colorectal cancer is surgical resection. However, fewer than 10 percent of these patients will be amenable to this surgery. The aim of this study is to ascertain the natural history of a group of untreated patients, and to evaluate simultaneously in another group whether or not the administration os systemic chemotherapy modifies this natural history. Methods. From January 1986 to september 1996, 77 patients with liver metastases from colorectal cancer biopsy proven or documented by means of a CT scan or a liver ultrasound were retrospectively analysed. The group was divided according to treatment as follows: Group A, untreated patients, and Group B, those patients who received chemotherapy (5-FU 450 mg/m²/days 1-5 of the first week and thereafter weekly)+leucovorin 20 mg/m² on the same days as 5-FU. The end points were patterns of recurrence and survival evaluated by means of the Mann- Withney test and the Kaplan-Meier method. Results. There were 41 females and 36 males in the study. Their median age was 59 years (range, 30-80). The primary tumor was located in the rectum in 44, in the sigmoid, 20, cecum, 9, descending colon, 2, hepatic flexure, 1 and transverse colon, 1. Forty-nine patients had metachronous and 28 had synchronous liver metastases. In group A, wich was made up of 45 patients, 41 developed extrahepatic metastatic disease, and their median survival rate was 13 month (range, 3-57). In group B, including 32 patients, 29 developed extrahepatic metastatic disease, and their median survival rate was 15 months (range, 4-60). There were no differences in overall survival in both groups (p=1.00). All patients in both groups died of the metastatic disease. Conclusion. The natural history of patients with liver metastases from colorectal cancer is towards progressive hepatic and extrahepatic metastatic disease. The administration of systemic chemotherapy did not modify the natural course of the disease