Reprodu??o & Climatério最新文献

Objective

the present study aims to understand the women's perception of the climacteric experience. Analyzing how is provided the nursing care for this audience.

Method

This is a qualitative study, developed in a Basic Health Unit (BHU), headquartered in the municipality of Crato‐CE. Participated in this study 17 women registered by UBS. Data collection was through a script of semiestruturada interview. Data was organized into thematic categories, being analyzed by the technique of content analysis.

Results

Data were organized into three thematic categories: Women's Concepts about climacteric and most prevalent symptoms; Climacteric Impact to Women's Health and Search to health services during this period. The most reported physiological changes were: hot flashes, headaches, insomnia, nausea and fatigue. Was showed that most of the women did not know the meaning of the word menopause, correlating the climacteric with menopause. It was noticed that most of them did not seek any professional assistance.

Conclusion

Was noted the need for establishment and implementation of specific strategies for women in climacteric period in UBS, not only through the expansion of services already covered, as well as the formulation of specific programs that make it possible to match current demand.

Objectives

Molecular alterations in the eutopic endometrium of women with endometriosis may be involved in the endometriosis‐related infertility. This study aimed to compare the differentially expressed genes (DEG) in eutopic endometrium of infertile women with endometriosis, infertile controls (IC; male and/or tubal factor) and fertile controls (FC) through RNA‐Seq.

Material and methods

Endometrial biopsies were obtained from 17 patiens (6 infertile women with endometriosis, 6 IC and 5 FC) during the implantation window. The RNA was extracted and the RNA‐Seq was performed at a HISEQ 2500 Illumina Platform, high output, paired end. Standardization and differential expression were conducted in the statistical R environment using DESeq2 package.

Results

The groups IC and FC were similar. No DEG has been identified comparing CF and endometriosis groups. Five DEGs (SCUBE1, CCL20, LGALS9 C, TRIM 29 e WNT11) were identified in the advanced endometriosis (EIII/IV) group, and 1 (KANSL1‐AS1) in the initial endometriosis (EI/II) group compared to FC. Two DEGs (KANSL1‐AS1 and VGLL3) were identified by comparing EI/II and EIII/IV groups.

Conclusions

These data suggest that the eutopic endometrium of infertile women with endometriosis, especially those with advanced disease, may be molecularly different from those of fertile women during the implantation window.

Objectives

to analyze the institutional violence against women in the parturition process in maternity hospitals linked to Stork Network of Fortaleza/Cascavel.

Material and Methods

This is a descriptive study with a quantitative approach, performed in eleven maternities, medium and high complexity of the network of health care of women in the state of Ceará, composed of 11 maternity hospitals, participated in the survey 3.765 transpelvic birth mothers who were in the accommodation units set of these institutions.

Results

About the sociodemographic characteristics of the study participants were between 20‐34 years (62.1%), in the case of emotional support that should be offered during delivery, the participants reported that they felt the presence of visits (82.9%) in relation to the attitudes that led to feelings of hesitation the participants said they felt security (89.4%).

Conclusions

The study demonstrates the importance of an appropriate humanized care through the structure and organization of maternal and child care proposed by the stork network.

Objective

Measure clinical competence for female climacteric diagnosis and treatment in physicians from a Mexican social security system.

Methods

Cross-sectional and multi-centric study in 78 physicians from five primary health care units from the Mexican Institute of Social Security in Guadalajara City, Jalisco, Mexico. We measured clinical competence with an instrument specially designed and validated (reliability p = 0.92 accord to Kuder–Richardson test). We obtained descriptive statistics and compared proficiency level accord to labor, demographic and academic characteristics using no-parametric statistic.

Results

Clinical competencies medians in five primary health care units were 8–21 points in a scale with maximum value of 108. We do not found significant differences to compare medical unit, gender, specialty, previous training in female climacteric symptoms, contract type, workshift and medical certifications (p > 0.05).

Conclusions

Climacteric clinical competence is null or very low in primary health care physicians from Guadalajara City. Educational interventions are required.

Objective

To investigate, through a questionnaire, the psychological and social aspects of infertile patients attended at the Infertility Ambulatory Clinic of Electro Bonini Hospital, in the city of Ribeirão Preto (SP).

Methods

Were interviewed 116 women who sought care for investigation and treatment of infertility. The results were analyzed to identify the social and psychological profiles of the patients.

Results

The main questions took into account the degree of sadness for not getting pregnant, their hope to get pregnant, if they had already been pregnant, if they had ever thought about adopting a child, withdrawal of treatment. The results were consistent with the data found in the literature. The biopsychosocial profile analysis revealed a strong degree of sadness and prejudice or social pressure for not getting pregnant. However, those women have great hope of getting pregnant and the vast majority doesn’t think of quitting treatment.

Conclusion

This study proves the pathological aspect that infertility causes in the lives of couples, especially women, since 75% reported that they feel unhappy or depressed for not being able to get pregnant. Multidisciplinary work, in that sense, plays an important role in understanding the intimate and deep emotional conflicts that infertility causes.

The preimplantation genetic diagnosis (PGD) is a tool that allows the selection of healthy embrios through gene and chromosome analysis, benefiting couples at risk. Like couples with recurrent miscarriage or family history of hereditary disease. Given the advance of the methodologies used in PGD this review aims to assemble information about the biopsy techniques, molecular biology and bioethical aspects of this practice. Therefore, it was possible collect the information like advantages, disadvantages, restrictions and indications referring to embryonic stage in which is made the removal of genetic material and molecular biology techniques used in genetic analysis. In addition, some bioethic questions that arise with the practice of PGD were verified as, for example, possible Eugenia. It was concluded that the analysis of trofoectoderme of embryos and the application of NGS technology is promising for the future of PGD, as well as the primordiality the creating laws governing and complete the gaps in the ethical and moral sense of this practice.

Oncofertility is an interdisciplinary interest field of recent development, which aims to merge the knowledge in oncology and reproductive medicine, with the help of assisted reproductive technologies, to develop strategies for gonadal function preservation and to offer the possibility of biological procreation to cancer survivors. Preservation strategies of female fertility in oncological patients currently accepted for routine practice are the cryopreservation of embryos and cryopreservation of mature oocytes. It happens that ovulation induction is mandatory for executing both strategies, and with it the theoretical risk of stimulation of estrogen‐dependent tumors growth and the postponement of anti‐neoplastic treatment. Random‐start ovarian stimulation protocols include the intention of minimizing the delay in onset of chemo‐radiotherapy and to block tumor growth, providing satisfactory results, similar to those obtained in the usual beginning protocols. This article presents the clinical guidelines of the Brazilian Society of Human Reproduction for ovulation induction in patients with estrogen‐dependent tumors.

Chorioangiomas are the most common benign placental tumors, with an estimated prevalence of 1%. Whilst small chorioangiomas usually remain asymptomatic and are of no clinical significance, larger tumors (>4 cm) can be associated with a variety of complications, ranging from fetal anemia to in-utero demise in up to 40% of cases. Despite size being a major determinant for the risk of complications, the degree of the chorioangioma's vascularity also seems to play a role. In fact, in selected cases, occluding the tumors vessels (e.g. with alcoholic instillation) appears to improve the prognosis due to the subsequent tumor ischemia. We present the case of a 40-year-old woman who at 29 weeks was found to have a large placental hypervascular mass (93 mm × 66 mm) and polyhydramnios, with an elevated peak systolic volume in the middle cerebral artery. She was given corticosteroids for fetal lung maturation, and throughout her admission both the volume of amniotic fluid stabilized and the peak systolic volume in the middle cerebral artery normalized, with changing of the ultrasonographic characteristics of the chorioangioma, with apparent progressive necrosis. At 34 weeks, a large subchorionic hematoma was found and, due to the risk of impending placental abruption, we opted to deliver by cesarean section, with a favorable outcome.

It is very important that the teacher seeks other educational resources beyond the textbook to work the human body and sexuality issues in Science lessons. Scientific magazines could be used as a reference source. This study analyzed as Ciência Hoje das Crianças magazine discusses the subject and its suitability as didactic and pedagogical support. The sample consisted of publications from January 2001 to December 2010. Body and sexuality were mentioned by 69% of the magazines, but only 15% of the magazines referred to sexuality. These issues were only 7% of total pages, and, in this small part, 89% of pages were related to body. There were 133 references: 113 about human body and 20 about sexuality. The results showed a limited approach to the biological body, concerned to physiology and anatomy of the organism and pathologic processes. As its readers are building their knowledge and principles, the discussion about sexuality would contribute to more informed and enlightened attitudes in adolescence.

Symptoms related to atrophy vulvovaginal have a negative impact on quality of life up to 50% of women after menopause. However, some refuse the use of estrogens that is the standard effective therapy due to negative publicity in recent years and other available alternatives therapies. This review assessed the effectiveness of hormonal treatments, herbal oral or topical use to relieve the symptoms of vaginal atrophy in women after menopause. We evaluated studies of Medline, Scopus, Cochrane Central Register of Controlled Trials using vagina, postmenopause, isoflavones, estrogen, syndrome genitourinária, vulvovaginal atrophy, clinical applications, as keywords. Review studies and randomized controlled trials were included in this study. The data showed that the systemic or local use of estrogens are the most appropriate, and the isoflavones only showed positive effects when used locally. Some non‐hormonal treatments such as moisturizing, lubricating and the use of vaginal laser are also suitable. Another possible treatment is ospemifene, a selective estrogen receptor modulator (SERM) on dyspareunia and vulvovaginal atrophy. Thus, the use of alternatives is beneficial for women with cancer risk related to estrogens.