Validation of the Brazilian 10-item Cervantes Scale for the assessment of menopausal symptoms.

Objective: To validate the 10-item Cervantes Scale (CS-10) among Brazilian women. Methods: This is a cross-sectional observational study involving women in the community aged 40-55 years in the Southern region of Brazil. They completed a general health, habits and socio-demographic questionnaire, the CS-10 and the Women's Health Questionnaire (WHQ). Women unable to understand the survey, not consenting to participate, or having incapacity imposing difficulties during the completion of the questionnaire were excluded. A Confirmatory Factor Analysis (CFA) was conducted with the AMOS 16.0 software. Chi-square of degrees of freedom (χ2/df), the Comparative Fit Index (CFI), the Tucker-Lewis Index (TLI) and the Root-Mean-Square Error of Approximation (RMSEA) were used as indices of goodness of fit. Cronbach's alpha coefficient was used for internal consistency. Results: A total of 422 women were included (premenopausal n=35, perimenopausal n=172, postmenopausal n=215). The CFA for the CS-10 showed a good fit (χ²/df=1.454, CFI=0.989; TLI=0.985; RMSEA=0.033; CI 90%=0.002-0.052; PCLOSE=0.921; Model p=0.049). Good reliability was established in CS-10 and WHQ (Cronbach's alpha=0.724). Postmenopausal women had higher total CS-10 scores (p≤0.0001), reflecting worse quality of life (QoL) related to menopause symptoms and confirming the greater symptomatology evaluated by high total scores for WHQ found in this population when compared to those in the premenopausal period (p=0.041). Conclusion: The CS-10 is a consistent tool for health-related QoL in Brazilian mid-aged women.

Uso de misoprostol em obstetrícia / Misoprostol use in obstetrics

PONTOS-CHAVE O misoprostol é um análogo da prostaglandina E1 (PGE1) que consta na Lista de Medicamentos Essenciais da Organização Mundial da Saúde (OMS) desde 2005 O Brasil possui uma das regulações mais restritivas do mundo relacionadas ao uso do misoprostol, estabelecendo que o misoprostol tem uso hospitalar exclusivo, com controle especial, e venda, compra e propaganda proibidas por lei Atualmente, o misoprostol é a droga de referência para tratamento medicamentoso nos casos de aborto induzido, tanto no primeiro trimestre gestacional quanto em idades gestacionais mais avançadas O misoprostol é uma medicação efetiva para o preparo cervical e indução do parto O misoprostol é um medicamento essencial para o manejo da hemorragia pós-parto

Factors Associated with the Chance of Carrying out a Primary Cesarean in a University Hospital / Fatores associados à chance de realização de cesariana primária em hospital universitário

Abstract Objective The present study seeks to identify the associated factors that increased primary cesarean delivery rates. Methods This was a cross-sectional study that evaluated the number of primary cesarean sections performed in the years 2006 and 2018 at the Hospital de Clínicas de Porto Alegre (HCPA, in the Portuguese acronym), through the collection of data from the medical records of the patients. Results Advanced maternal age, twin pregnancy, and higher body mass index (BMI) became more frequent in 2018 in comparison with 2006. To mitigate the impact of confounding in comparisons among groups, we made an adjustment by propensity scores and detected significant differences when comparing both age groups on twin pregnancy rates, gestational diabetes mellitus, and thyroid disease. Conclusion Data from the present study can be used to prevent and improve the management of morbidities, impacting on better outcomes in obstetrical practice.

Resumo Objetivo O presente estudo busca identificar os fatores associados que aumentam as taxas de partos cesáreos primários. Métodos Estudo transversal, avaliando o número de cesáreas primárias realizadas nos anos de 2006 e 2018 no Hospital de Clínicas de Porto Alegre (HCPA), por meio da coleta de dados nos prontuários das pacientes. Resultados Idade materna avançada, gravidez gemelar e índice de massa corporal (IMC) mais elevado tornaram-se mais frequentes em 2018. Para mitigar o impacto dos fatores de confusão nas comparações entre os grupos, fizemos um ajuste por escores de propensão e detectamos diferenças significativas nas taxas de gravidez gemelar, diabetes mellitus gestacional e doença da tireoide. Conclusão Os dados do presente estudo podem ser utilizados para prevenir e melhorar o manejo de morbidades, impactando em melhores resultados na prática obstétrica.

Factors Associated with the Chance of Carrying out a Primary Cesarean in a University Hospital.

OBJECTIVE: The present study seeks to identify the associated factors that increased primary cesarean delivery rates. METHODS: This was a cross-sectional study that evaluated the number of primary cesarean sections performed in the years 2006 and 2018 at the Hospital de Clínicas de Porto Alegre (HCPA, in the Portuguese acronym), through the collection of data from the medical records of the patients. RESULTS: Advanced maternal age, twin pregnancy, and higher body mass index (BMI) became more frequent in 2018 in comparison with 2006. To mitigate the impact of confounding in comparisons among groups, we made an adjustment by propensity scores and detected significant differences when comparing both age groups on twin pregnancy rates, gestational diabetes mellitus, and thyroid disease. CONCLUSION: Data from the present study can be used to prevent and improve the management of morbidities, impacting on better outcomes in obstetrical practice.

OBJETIVO: O presente estudo busca identificar os fatores associados que aumentam as taxas de partos cesáreos primários. MéTODOS: Estudo transversal, avaliando o número de cesáreas primárias realizadas nos anos de 2006 e 2018 no Hospital de Clínicas de Porto Alegre (HCPA), por meio da coleta de dados nos prontuários das pacientes. RESULTADOS: Idade materna avançada, gravidez gemelar e índice de massa corporal (IMC) mais elevado tornaram-se mais frequentes em 2018. Para mitigar o impacto dos fatores de confusão nas comparações entre os grupos, fizemos um ajuste por escores de propensão e detectamos diferenças significativas nas taxas de gravidez gemelar, diabetes mellitus gestacional e doença da tireoide. CONCLUSãO: Os dados do presente estudo podem ser utilizados para prevenir e melhorar o manejo de morbidades, impactando em melhores resultados na prática obstétrica.

Sarcopenia, obesity and sarcopenic obesity among community-dwelling and institutionalized older women in Caxias do Sul, Brazil / Sarcopenia, obesidade e obesidade sarcopênica em idosas da comunidade e institucionalizadas de Caxias do Sul, Brasil

INTRODUCTION: Sarcopenia, obesity, and sarcopenic obesity are considered risk factors for the health of the elderly, which may cause or worsen the reduction in functional capacity. OBJECTIVE: To determine the prevalence of sarcopenia, obesity, and sarcopenic obesity among community-dwelling and institutionalized female elderly in Caxias do Sul, Brazil. METHODS: Observational epidemiological study, with cross-sectional design. 423 elderly women (≥60 years old) institutionalized and community-dwellers, participated in the study. Sarcopenia was identified according to the criteria established by the European Working Group on Sarcopenia in Older People (EWGSOP). The gait speed test estimated low skeletal muscle mass (SMM) by bioimpedance, low handgrip strength using a hand dynamometer, and low physical performance. Obesity was defined as Body Mass Index ≥27.0kg/m² and sarcopenic obesity by the simultaneous occurrence of obesity and sarcopenia. The Chi-Square test was performed, with a 5% significance level. RESULTS: The overall prevalence of obesity was 53.9%. Sarcopenia was observed in 16.3% of the total sample, affecting 7.5% of the elderly in the community and 25.1% in institutions (p≤0.0001). Regarding sarcopenic obesity, 0.9% of the community and 3.8% of institutionalized elderly presented the dysfunction. Non-sarcopenic elderly women had a high prevalence of obesity. In the elderly of both groups, sarcopenia was more frequent in those with advanced age. CONCLUSION: Institutionalized elderly women had a higher prevalence of sarcopenia, emphasizing the importance of paying attention to the health of this population and highlighting the need for preventive measures.

INTRODUÇÃO: Sarcopenia, obesidade e obesidade sarcopênica são consideradas fatores de risco à saúde dos idosos, podendo ocasionar ou agravar a redução da capacidade funcional. OBJETIVO: Determinar a prevalência de sarcopenia, obesidade e obesidade sarcopênica entre idosas da comunidade e institucionalizadas de Caxias do Sul/RS. MÉTODOS: Estudo epidemiológico observacional, com delineamento transversal. Participaram do estudo 423 idosas (≥60 anos) institucionalizadas e da comunidade. A sarcopenia foi identificada conforme os critérios estabelecidos pelo Grupo de Trabalho Europeu sobre Sarcopenia em Idosos (EWGSOP), utilizando baixa massa muscular esquelética (MME) por bioimpedância, baixa força de preensão manual em dinamômetro manual e baixo desempenho físico no teste de velocidade de marcha. Identificou-se a obesidade pelo Índice de Massa Corporal ≥27,0kg/m² e a obesidade sarcopênica pelo diagnóstico simultâneo de obesidade e sarcopenia. Realizou-se o teste Qui-Quadrado e regressão de Poisson, com nível de significância de 5%. RESULTADOS: A prevalência geral de obesidade foi de 53,9%. 16,3% da amostra total apresentava sarcopenia, presente em 7,5% das idosas da comunidade e 25,1% das institucionalizadas (p≤0.0001). Referente a obesidade sarcopênica 0,9% da comunidade e 3,8% das institucionalizadas apresentaram a disfunção. Idosas não sarcopênicas apresentaram elevada prevalência de obesidade. Nas idosas de ambos os grupos, a sarcopenia foi mais frequente naquelas com idade avançada. CONCLUSÃO: Idosas institucionalizadas apresentaram maior prevalência de sarcopenia, acentuando a importância em atentar à saúde desta população e evidenciando a necessidade de medidas preventivas.

Leptin, ghrelin, & insulin levels and food intake in premenstrual syndrome: A case-control study.

OBJECTIVES: The objective of this study was to evaluate the relationship between food intake and serum levels of leptin and ghrelin in the luteal (LP) and follicular (FP) phases of the MC (menstrual cycle) in participants with and without PMS (premenstrual syndrome). METHODS: This was a case-control study with healthy participants aged 20-45 years with regular menstrual cycles (24-35 days) with and without PMS. After the Daily Record of Severity of Problems (DRSP) was filled out for two months (PMS diagnosis), a nutritional assessment was carried out based on twelve food intake records (for two menstrual cycles) to quantify food intake. RESULTS: Of the 69 participants analyzed, 35 experienced PMS and 34 did not experience PMS. For participants with PMS, calorie and carbohydrate intake was higher during LP than in FP (p = 0.004 and p = 0.003, respectively), whereas these changes were not observed in participants without PMS (p > 0.05). There were interactions between the groups and the MC phases (LP and FP) for the intake of calories (p = 0.028) and carbohydrates (p = 0.001). There was a marginal negative relationship between the levels of ghrelin and calorie intake in FP (rS = -0.314, p = 0.066) in the PMS group and a negative relationship between the levels of ghrelin and leptin in LP (rS = -0.490, p = 0.004) in the group without PMS. CONCLUSIONS: These results indicated a higher calorie and carbohydrate intake during LP in participants with PMS, in addition to the hypothesis that the roles of ghrelin and leptin in energy regulation may be different in participants with PMS compared to those without PMS.

Influência da utilização de métodos contraceptivos sobre as taxas de gestação não planejada em mulheres brasileiras / Influence of contraceptive use on unplanned pregnancy rates in Brazilian women

Este estudo teve como objetivo primário analisar a taxa de gestações não planejadas e sua relação com o uso de métodos contraceptivos no Brasil. Secundariamente, procurou-se identificar o impacto da pandemia por SARS-CoV-2 sobre o desejo reprodutivo e a utilização de contraceptivos. Foram entrevistadas mulheres entre 16 e 45 anos que tiveram pelo menos uma gestação, por meio de questionário on-line, em todas as regiões brasileiras. Foram analisados dados de 1.000 mulheres com média etária de 34,7 anos, paridade média de 1,69 filho e número médio de 2,01 gestações. Entre as mulheres, 62% referiram ter tido pelo menos uma gestação não planejada, com maior percentual entre as mulheres que utilizam o sistema público de saúde (65%) em relação ao sistema privado (55%). Entre as mulheres que referiram ao menos uma gestação não planejada, 46% usavam algum método contraceptivo na ocasião. O uso atual de métodos contraceptivos atingiu 81% das mulheres entrevistadas, sendo os contraceptivos orais utilizados por 31%, seguidos dos preservativos (20%), laqueadura tubária (10%) e métodos de longa ação (LARC, 9%). Entre as mulheres, 53% considerariam um LARC como modalidade contraceptiva, especialmente entre as que referiram esquecimento frequente de pílulas. Durante a pandemia, 7% das mulheres entrevistadas referiram suspender o uso de contraceptivos. Para 80%, não houve mudanças no planejamento reprodutivo durante a pandemia, porém observaram-se 10% de gestações não planejadas. Em conclusão, a menor adoção de métodos contraceptivos, aliada ao uso incorreto/ falha do método, associa-se a maiores taxas de gestações não planejadas. Métodos com maior índice de eficácia são considerados por mulheres que já experimentaram gestações não planejadas. Houve pequeno impacto da pandemia sobre o uso de métodos contraceptivos e sobre o planejamento reprodutivo.(AU)

Sleep quality and excessive daytime sleepiness in women with Premenstrual Syndrome.

OBJECTIVE: Examine the relationship between Premenstrual Syndrome (PMS) and sleep in different menstrual cycle phases. METHODS: Case-control survey conducted at the Primary Care Service and Clinical Research Center at Hospital de Clínicas de Porto Alegre with women aged between 18 and 45 years old. Women filled the Brazilian version of the Premenstrual Symptoms Screen Tool (PSST) for the screening of PMS; participants with positive screening completed the Daily Record of Severity of Problems (DRSP) to confirm PMS diagnosis. We applied the Pittsburg Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) Brazilian versions in the luteal phase (LP) and follicular phase (FP). RESULTS AND CONCLUSION: 69 women were characterized with PMS and 52 without PMS. The risk of poor sleep quality (SQ) was two times higher in women with PMS (p = .006; OR = 3.057; IC95% 1.44-6.45). An interaction between no PMS and LP was found in ESS (p = .014; generalized estimating equation - GEE - adjusted for multiple comparisons by the Bonferroni test and adjusted by age); besides that, women with PMS had greater scores in ESS (p = .022; GEE adjusted by age).

Premenstrual Syndrome and Female Sexual Function.

PURPOSE: To examine the relationship between Premenstrual Syndrome (PMS) and female sexual function (FSF) with the luteal (LP) and follicular phases (FP). METHOD: We performed a cross-sectional survey using the Female Sexual Function Index (FSFI) questionnaire in the LP and FP. We used the Brazilian's version of the Premenstrual Symptoms Screen Tool (PSST) and the Daily Record of Severity of Problems (DRSP) for diagnosis of PMS. RESULTS: There was no difference in the FSF between groups in both cycle phases. We found an association between LP and worst scores on FSFI. CONCLUSION: PMS does not affect FSF.