Caracterización del Comportamiento Sexual y Reproductivo y Acceso A los Servicios de Salud, de los Estudiantes de la Facultad de Ciencias Médicas de la Universidad de Cuenca / Characterization of Sexual and Reproductive Behavior and Access to Health Services, of the Students of the Faculty of Medical Sciences of the University of Cuenca

ANTECEDENTES: La población universitaria es principal-mente joven y por lo tanto expuesta a factores que puede generar efectos adversos en salud sexual y re-productiva, que conllevan a un bajo rendimiento académico e inclusive a la deserción estudiantil. OBJETIVO: Caracterizar el comportamiento sexual y re-productivo y las necesidades en salud de los en estudiantes de la Facultad de Ciencias Médicas de la Universidad de Cuenca. METODOLOGÍA: Tipo de estudio descriptivo. Universo: 3 265 estudiantes de la Facultad de Ciencias Médicas de la Universidad de Cuenca, en el período lectivo septiembre 2014- Febrero 2015. Muestra: fue aleatorizada por conglomerados (carrera y cursos) en las tres escue-las de la facultad de Ciencias Médicas. RESULTADOS: De los estudiantes encuestados, el 44.7% fueron de la escuela de medicina de 27.7% de enfermería, 27.7% tecnología médica; 68.6% mujeres y 31.4% varones, con una edad media de 21 años para ambos grupos; la mayoría son solteros 87.7%, mestizos 94.1% y heterosexuales 97.2%, que residen en zona urbana 81.5%. El 45.7% de las mujeres y el 70.1% de los varones son sexualmente activos, 15% son padres de familia, el 81,6% ha usado un método anticonceptivo MAC, sin embargo el uso consistente es de 55.1%. 66.2% de los encuestados ha acudido a un médico el último año; el 77.3% maneja suficiente información para la prevención de un embarazo y el 79.7% para la prevención de ITS. CONCLUSIONES: Pese a que los estudiantes tienen in-formación en sexualidad y acceden a los servicios de salud, los efectos adversos en salud sexual y reproduc-tiva son identificados como un problema que conlleva a deserción estudiantil y bajo rendimiento académico. Las principales soluciones para combatir los efectos adversos, incluyen: mejorar la calidad de información, fortalecer el acceso a servicios integrales de salud, generar espacios saludables.

OBJECTIVE: To characterize sexual and reproductive be-havior and health needs of students in the Faculty of Medical Sciences of the University of Cuenca. METHOD: descriptive study type. Universe: 3265 students of the Faculty of Medical Sciences of the University of Cuenca, in the academic year in September 2014 in February 2015. Sample: was randomized by cluster (ca-reer and courses) in the three schools of the Faculty of Medical Sciences. RESULTS: Of all the surveyed students, 44.7% were from medical school, nursing 27.7%, 27.7% medical technology; 68.6% female and 31.4% male, with a mean age of 21 years; most are unmarried 87.7%, 94.1% are heterosexual, mestizos 97.2% residing in urban areas 81.5%. 45.7% of the women and 70.1% of males are sexually active, 15% are parents, 81.6% have used a contraceptive, however the consistent use of contra-ceptives is 55.1%. 66.2% of respondents have visited a doctor last year; 77.3% handle sufficient information for the prevention of pregnancy and 79.7% for STD prevention. CONCLUSIONS: Although students have information on sexuality and access to health services, adverse effects on sexual and reproductive health are identified as a problem that leads to student dropout and low aca-demic performance. The main solutions to combat the adverse effects include: improving the quality of infor-mation, enhance access to comprehensive health ser-vices, generating healthy spaces.

Exploring The Obesity Paradox In Atrial Fibrillation. AFBAR (Atrial Fibrillation Barbanza Area) Registry Results.

INTRODUCTION AND OBJECTIVES: Previous studies have described an inverse relationship between obesity and adverse events in a variety of conditions. Our aim was to investigate the relationship between obesity and prognosis in patients with atrial fibrillation. METHODS: We studied 746 patients who were prospectively included, between January and April 2008, in the AFBAR (Atrial Fibrillation in BARbanza area) registry. Patients were categorized into 3 body mass index groups using baseline measurements: normal (< 25 kg/m2), overweight (25-30 kg/m2), and obese (≥30 kg/m2). Survival free from the composite endpoint hospitalization for cardiovascular causes or all-cause mortality was compared across the 3 body mass index groups. A multivariable Cox proportional hazard regression was also performed to determine the independent effect of obesity as well as overweight, with respect to normal body mass index as a reference category, regarding the study endpoint. Median follow-up time was 36 (28-36) months. RESULTS: 49.3% were obese and 38.2% had overweight. The composite endpoint rate was 70.9%, 67.5%, and 57.6% for obese, overweight, and normal weight patients, respectively (log rank test; p=0.02). An inverse association of obesity with a favorable prognosis persisted even after multivariable adjustment: hazard ratio 0.668; 95% confidence interval 0.449-0.995; p=0.047. Hazard ratio of overweight, however, was 0.741; 95% confidence interval: 0.500-1.098; p=0.096. CONCLUSIONS: Obesity, defined as a body mass index ≥ 30 kg/m2, is associated with better prognosis in a community-based cohort of patients with atrial fibrillation.