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1.
BMC Pregnancy Childbirth ; 24(1): 353, 2024 May 13.
Article in English | MEDLINE | ID: mdl-38741050

ABSTRACT

INTRODUCTION: Non-consented care, a form of obstetric violence involving the lack of informed consent for procedures, is a common but little-understood phenomenon in the global public health arena. The aim of this secondary analysis was to measure the prevalence and assess change over time of non-consented care during childbirth in Mexico in 2016 and 2021, as well as to examine the association of sociodemographic, pregnancy-, and childbirth-factors with this type of violence. METHODS: We measured the prevalence of non-consented care and three of its variations, forced sterilization or contraception, forced cesarean section, and forced consent on paperwork, during childbirth in Mexico for 2016 (N = 24,036) and 2021 (N = 19,322) using data from Mexico's cross-sectional National Survey on the Dynamics of Household Relationships (ENDIREH). Weighted data were stratified by geographical regions. We performed adjusted logistic regression analyses to explore associations. RESULTS: The national prevalence of non-consented care and one of its variations, pressure to get a contraceptive method, increased from 2016 to 2021. A decrease in the prevalence was observed for forced contraception or sterilization without knowledge, forcing women to sign paperwork, and non-consented cesarean sections nationally and in most regions. Women between the ages of 26 and 35 years, married, cohabiting with partner, living in urban settings, who do not identify as Indigenous, and who received prenatal services or gave birth at the Mexican Institute of Social Security (IMSS) facilities experienced a higher prevalence of non-consented care. Being 26 years of age and older, living in a rural setting, experiencing stillbirths in the last five years, having a vaginal delivery, receiving prenatal services at IMSS, or delivering at a private facility were significantly associated with higher odds of reporting non-consented care. CONCLUSION: While a decrease in most of the variations of non-consented care was found, the overall prevalence of non-consented care and, in one of its variations, pressure to get contraceptives, increased at a national and regional level. Our findings suggest the need to enforce current laws and strengthen health systems, paying special attention to the geographical regions and populations that have experienced higher reported cases of this structural problem.


Subject(s)
Cesarean Section , Humans , Female , Mexico/epidemiology , Pregnancy , Adult , Cross-Sectional Studies , Prevalence , Cesarean Section/statistics & numerical data , Young Adult , Parturition , Adolescent , Informed Consent/statistics & numerical data , Delivery, Obstetric/statistics & numerical data , Surveys and Questionnaires , Sterilization, Reproductive/statistics & numerical data , Contraception/statistics & numerical data
2.
BMC Vet Res ; 19(1): 154, 2023 Sep 13.
Article in English | MEDLINE | ID: mdl-37705013

ABSTRACT

BACKGROUND: This study aimed to compare the feasibility and practicality of the ovariohysterectomy (OHE) technique in cats with or without a spay hook with respect to the incision size, surgical time, surgical variables, and intra- and postoperative pain. Twenty-nine female cats underwent OHE using a spay hook (spay hook group [SHG], n = 15) or without using a spay hook (control group [CG], n = 14) to achieve the ovaries and cervix. Physiological parameters were monitored during the intraoperative period, and postoperative pain was assessed using a multidimensional composite and visual analogue pain scales. RESULTS: The SHG had a significantly shorter operative time than the CG. The variables in the intraoperative period showed no statistically significant difference between both groups, as well as the early postoperative pain. CONCLUSIONS: Less invasive OHE using a spay hook could potentially be a viable and feasible technique when performed by an inexperienced surgeon with appropriate training, especially in sterilisation campaigns, reducing the time to perform the procedure and increasing the number of animals spayed per time.


Subject(s)
Cat Diseases , Hysterectomy , Animals , Cats/surgery , Female , Hysterectomy/adverse effects , Hysterectomy/veterinary , Operative Time , Ovary , Pain, Postoperative/veterinary , Sterilization, Reproductive/veterinary
3.
Int. j. cardiovasc. sci. (Impr.) ; 35(3): 423-429, May-June 2022. tab, graf
Article in English | LILACS | ID: biblio-1375648

ABSTRACT

Abstract Pericardial agenesis is a rare congenital anomaly found predominantly in men, and its complete form is extremely rare and difficult to diagnose. This report describes the case of a pregnant patient with complete pericardial agenesis in which mode of delivery and sterilization raised debate among specialists.


Subject(s)
Humans , Female , Pregnancy , Adult , Pericardium/abnormalities , Delivery, Obstetric , Pericardium/diagnostic imaging , Sterilization, Reproductive , Echocardiography
4.
J Int Bioethique Ethique Sci ; Vol. 32(4): 127-149, 2022 Mar 09.
Article in French | MEDLINE | ID: mdl-35485044

ABSTRACT

One of the biggest issues faced by lawmakers in the news revolves around the question of how to deal with the scientific discoveries uncovered by new technologies. Scientific developments in the field of health awaken, in human beings, the desire to try to go beyond nature, and developments in the field of sexual and reproductive health not only challenge the laws of nature itself, but also the laws put in place by humanity. Among the advances in the field of human contraception, we highlight voluntary sterilization, used throughout the world as a 99% effective contraceptive measure. In Brazil, voluntary sterilization was formalized by the Family Planning Law which imposed, among other restrictions, the need for the consent of another person for its realization. It is a violent imposition, in the service of control over the bodies, on the part of the State. This control is notably imposed on the woman’s body, thus reducing her autonomy, which is the basis of her dignity. That said, the purpose of this article is to question the foundations on which the adoption of such a limitation of bodily self-determination is based and justified. For this, the legal-philosophical contributions of authors Ronald Dworkin and Jürgen Habermas will be examined, in the light of bioethics. The focus of the questions will be on the analysis of the ways in which Brazil and France have welcomed the process of voluntary sterilization, and what have been the most important consequences of this legalization.


Subject(s)
Family Planning Services , Sterilization, Reproductive , Brazil , Female , France , Humans
5.
Hist Sci ; 60(1): 18-40, 2022 03.
Article in English | MEDLINE | ID: mdl-29644879

ABSTRACT

Scholars such as Nancy Leys Stepan, Alexandra Minna Stern, Marius Turda and Aaron Gillette have all argued that the rejection of coerced sterilization was a defining feature of "Latin" eugenic theory and practice. These studies highlight the influence of neo-Lamarckism in this development not only in Latin America but also in parts of Europe in the first half of the twentieth century. This article builds upon this historiographical framework to examine an often-neglected site of Latin American eugenic knowledge production: Chile. By focusing on Chilean eugenicists' understandings of environment and coerced sterilization, this article argues that there was no uniquely Latin objection to the practice initially. In fact, Chilean eugenicists echoed concerns of eugenicists from a variety of locations, both "mainstream" and Latin, who felt that sterilization was not the most effective way to ensure the eugenic improvement of national populations. Instead, the article contends that it was not until the implementation of the 1933 German racial purity laws, which included coerced sterilization legislation, that Chilean eugenicists began to define their objections to the practice as explicitly Latin. Using a variety of medical texts which appeared in popular periodicals as well as professional journals, this article reveals the complexity of eugenic thought and practice in Chile in the early twentieth century.


Subject(s)
Eugenics , Sterilization, Reproductive , Chile , Eugenics/history , Europe , Humans , Sterilization , Sterilization, Reproductive/history
6.
Anim. Reprod. (Online) ; 19(2): e20220029, mai. 2022. tab, ilus
Article in English | VETINDEX | ID: biblio-1393189

ABSTRACT

Capybaras are the primary hosts of Amblyomma sculptum tick, vectors of Rickettsia rickettsia bacteria, and the zoonotic agent of Brazilian Spotted Fever (BSF). In this context, contraceptive methods have been suggested for population control in order to reduce the number of free-ranging capybaras cohabiting with humans in urban and rural areas and acting as disease amplifiers. To maintain the group's expected behavior and social hierarchy, sterilization techniques that preserve the gonads are recommended. On 126 female capybaras in the Brazilian state of São Paulo, a new surgical technique named "Passos Nunes" uterine horn ligature was performed after adequate general anesthesia. It achieved effective surgical sterilization, with an incision length of about 3 cm in the periumbilical linea alba, cranial to the pubis. After entering the abdominal cavity, the urinary bladder is pulled laterally to access the uterine horns and the cervix. The uterine horn is folded up, forming a strap; the distal portion of the strap is ligated and its distal end sectioned. The exact process is performed on the opposite horn. After the surgical procedure, the musculature is sutured in a sultan pattern and the subcutaneous tissue with a horizontal mattress pattern. The skin is sutured in a separate simple format, using nylon 2.0 for all steps. The wide exposure of the uterine horns facilitates the confirmation of pregnancy, allowing the surgeon to choose between salpingo hysterectomy or ligature of the uterine horns. The present study presents a new technique of surgical sterilization that can be used in female free-ranging mammals in which maintenance of the gonads is recommended, and births of offspring should not occur.(AU)


Subject(s)
Animals , Rodentia/surgery , Sterilization, Reproductive/veterinary , Sterilization, Tubal/methods
7.
Cad Saude Publica ; 36(10): e00096919, 2020.
Article in Portuguese | MEDLINE | ID: mdl-33084831

ABSTRACT

Contraception is essential for women to be able to regulate their fertility, exercising a key dimension of reproductive rights. However, little is known about how women deal with this challenge in Brazil's largest city, São Paulo. To fill this gap, the population survey Ouvindo Mulheres: Contracepção no Município de São Paulo was conducted with a probabilistic sample of 4,000 women 15 to 44 years of age living in this city in 2015. This article presents the prevalence of contraceptive practice and analyzes factors associated with lack of contraception use and with types of contraceptives. Prevalence of contraception was estimated for women with at least one heterosexual relation in the 12 months prior to the interview and who were not pregnant. Logistic regression was used to verify factors associated with lack of contraception use, and the CHAID model was used to identify associations with the types of contraceptives used. Prevalence of contraception was 84.8% (95%CI: 83.2-86.3). The most prevalent contraceptives were the pill and condoms. Factors associated with lack of contraceptive use were religion (Pentecostal), number of children (fewer than 3), not having used contraceptives in the first sexual relation, not having a partner, and not having had sex in the previous month. Number of children and woman's age were the first two levels of discrimination of the types of contraceptives used. Prevalence of contraception was high, but maintaining a concentration in two methods: historically, female sterilization and the pill prevailed, nowadays, the pill and condoms do. New hormonal contraceptives should be incorporated by the Brazilian Unified National Health System (SUS), besides promoting the use of long-acting methods such as IUDs.


A contracepção é fundamental para que as mulheres possam regular sua fecundidade, exercendo uma das dimensões dos direitos reprodutivos. No entanto, desconhecemos como elas enfrentam esse desafio na maior cidade do Brasil, São Paulo. Para preencher essa lacuna, o inquérito populacional Ouvindo Mulheres: Contracepção no Município de São Paulo foi realizado junto a uma amostra probabilística de 4 mil mulheres com 15 a 44 anos de idade, residentes nessa cidade, em 2015. Neste artigo, apresenta-se a prevalência da prática contraceptiva, analisam-se os fatores associados ao não uso de contracepção e aos tipos de contraceptivos em uso. A prevalência da anticoncepção foi estimada para mulheres com, pelo menos, uma relação heterossexual nos 12 meses anteriores à entrevista e que não estavam grávidas. Regressão logística foi utilizada para verificar fatores associados ao não uso de contracepção, e o modelo CHAID, para identificar associações aos tipos de contraceptivo em uso. A prevalência da anticoncepção foi 84,8% (IC95%: 83,2-86,3). Os contraceptivos mais prevalentes foram pílula e preservativo masculino. Associaram-se ao não uso de anticoncepção, religião (Pentecostal), número de filhos (menos do que 3), não ter usado contraceptivo na primeira relação sexual, não ter parceiro e não ter tido relação sexual no mês anterior. O número de filhos tidos e a idade da mulher foram os dois primeiros níveis de discriminação dos tipos de contraceptivo utilizados. A prevalência da anticoncepção é alta, mas mantém-se a concentração em dois métodos: anteriormente, laqueadura e pílula, agora, pílula e preservativo masculino. É necessário incorporar novos contraceptivos hormonais no Sistema Único de Saúde (SUS) e promover o uso de métodos de longa duração como o DIU.


La contracepción es fundamental para que las mujeres puedan regular su fecundidad, ejerciendo una de las dimensiones de sus derechos reproductivos. No obstante, desconocemos cómo enfrentan este desafío en la mayor ciudad de Brasil, São Paulo. Para resolver esta cuestión, se realizó la encuesta poblacional Ouvindo Mulheres: Contracepção no Município de São Paulo, mediante una muestra probabilística de 4 mil mujeres de 15 a 44 años de edad, residentes en esa ciudad en 2015. En este artículo se presenta la prevalencia de la práctica contraceptiva, se analizan los factores asociados con el no uso de métodos anticonceptivos, así como los tipos de contraceptivos en uso. La prevalencia de la anticoncepción se estimó en mujeres con por lo menos una relación heterosexual, en los 12 meses anteriores a la entrevista, y que no estaban embarazadas. Se utilizó la regresión logística para verificar factores asociados al no uso de contracepción y el modelo CHAID para identificar asociaciones respecto a los tipos de contraceptivo en uso. La prevalencia de la anticoncepción fue 84,8% (IC95%: 83,2-86,3). Los contraceptivos más prevalentes fueron la píldora y el condón. Se asociaron al no uso de anticonceptivos: religión (Pentecostal), número de hijos (menos de 3), no haber usado contraceptivo en la primera relación sexual, no tener pareja y no haber tenido relaciones sexuales durante el mes anterior. El número de hijos y la edad de la mujer fueron los dos primeros niveles de discriminación de los tipos de contraceptivo utilizados. La prevalencia de la anticoncepción es alta, pero se mantiene la concentración en dos métodos: anteriormente, ligadura y píldora, ahora, píldora y condón. Es necesario incorporar nuevos contraceptivos hormonales en el Sistema Único de Salud (SUS), así como promover el uso de métodos de larga duración como el DIU.


Subject(s)
Contraception , Contraceptive Agents , Brazil , Child , Contraception Behavior , Female , Humans , Pregnancy , Sterilization, Reproductive
8.
Ci. Rural ; 50(9): e20200053, July 29, 2020. tab, ilus
Article in English | VETINDEX | ID: vti-28955

ABSTRACT

Groups of capybaras (Hydrochoerus hydrochaeris) are currently frequent inhabitants of urban areas. The species participates in the transmission cycle of Brazilian spotted fever (BSF), a zoonosis that is caused by the bacteria R. rickettsii and transmitted by vector ticks. This has led to discussions on strategies to decrease the presence of this rodent through contraceptive methods and euthanasia, thus reducing their capacity to carry and transport ticks, which would be an important contribution to public health. Two condominiums and one business establishment in the interior of the state of São Paulo were used as case studies in the present investigation. All areas were classified by the Endemic Control Superintendence as risk areas for the transmission of BSF and presented the specie of ticks A. sculptum and A. dubitatum The objective of this study was to carry out sterilization procedures with animals that presented seropositive results for BSF. A total of 85 surgical procedures were conducted on immune capybaras, with authorization from DeFau/SMA-SP. For all procedures the animals were anesthetized with ketamine hydrochloride combined with xylazine and morphine. Two alpha males isolated themselves from the group after the vasectomy procedure, returning to their hierarchical position after 5 to 14 days. Population monitoring in the areas should be maintained indefinitely and conducting annual serological management until the natural death of these individuals. Tubal ligation, vasectomy and salpingo-oophorectomy were demonstrated to be simple and low-risk procedures in capybaras. These techniques assist in the population control of this species in enclosed areas with risk of BSF transmission, thus decreasing the need for euthanasia.(AU)


Grupos de capivaras (H. hydrochaeris) são atualmente habitantes frequentes de áreas urbanas. A espécie participa do ciclo de transmissão da febre maculosa brasileira (FMB), uma zoonose causada pela bactéria R. rickettsii e transmitida por carrapatos vetoriais. Isso levou a discussões sobre estratégias para diminuir a presença desse roedor por meio de métodos contraceptivos e eutanásia, reduzindo sua capacidade de carrear e transportar carrapatos, o que seria uma importante contribuição para a saúde pública. Dois condomínios e um estabelecimento comercial no interior de São Paulo foram utilizados como estudos de caso na presente investigação. Todas as áreas foram classificadas pela Superintendência de Controle Endêmico como áreas de risco para a transmissão da FMB e apresentaram a espécie do carrapato A. sculptum e A. dubitatum. O objetivo deste estudo foi realizar procedimentos de esterilização com animais que apresentaram resultados soropositivos para a FMB. Foram realizados 85 procedimentos cirúrgicos em capivaras imunes, com autorização do DeFau / SMA-SP. Para todos os procedimentos, os animais foram anestesiados com cloridrato de cetamina combinado com xilazina e morfina. Dois machos alfa se isolaram do grupo após o procedimento de vasectomia, retornando à sua posição hierárquica após 5 a 14 dias. O monitoramento populacional nas áreas deve ser mantido indefinidamente e conduzindo-se o manejo sorológico anual até a morte natural desses indivíduos. Foi possível demonstrar que a ligação tubária, vasectomia e salpingo-ooforectomia são procedimentos de baixo risco em capivaras. Essas técnicas auxiliam no controle populacional desta espécie em áreas fechadas e com risco de transmissão de FMB, diminuindo a necessidade de eutanásia.(AU)


Subject(s)
Animals , Reproduction , Rodentia , Sterilization, Reproductive/veterinary , Rocky Mountain Spotted Fever/prevention & control , Population Control/methods
9.
Med Hist ; 64(2): 173-194, 2020 04.
Article in English | MEDLINE | ID: mdl-32284633

ABSTRACT

This article examines female sterilisation practices in early twentieth-century Rio de Janeiro, Brazil. It argues that the medical profession, particularly obstetricians and psychiatrists, used debates over the issue to solidify its moral and political standing during two political moments of Brazilian history: when the Brazilian government separated church and state in the 1890s and when Getúlio Vargas's authoritarian regime of the late 1930s renewed alliances with the Catholic church. Shifting notions of gender, race, and heredity further shaped these debates. In the late nineteenth century, a unified medical profession believed that female sterilisation caused psychiatric degeneration in women. By the 1930s, however, the arrival of eugenics caused a divergence amongst physicians. Psychiatrists began supporting eugenic sterilisation to prevent degeneration - both psychiatric and racial. Obstetricians, while arguing that sterilisation no longer caused mental disturbances in women, rejected it as a eugenic practice in regard to race. For obstetricians, the separation of sex from motherhood was more dangerous than any racial 'impurities', both phenotypical and psychiatric. At the same time, a revitalised Brazilian Catholic church rejected eugenics and sterilisation point blank, and its renewed ties with the Vargas regime blocked the medical implementation of any eugenic sterilisation laws. Brazilian women, nonetheless, continued to access the procedure, regardless of the surrounding legal and medical proscriptions.


Subject(s)
Catholicism/history , Eugenics/history , Obstetrics/history , Physicians/history , Religion and Medicine , Sterilization, Reproductive/history , Brazil , Eugenics/legislation & jurisprudence , Female , Gender Identity , History, 19th Century , History, 20th Century , Humans , Mental Disorders/etiology , Mental Disorders/history , Physician's Role/history , Physicians/ethics , Political Systems/history , Psychiatry/history , Sex Characteristics , Sterilization, Reproductive/ethics , Sterilization, Reproductive/legislation & jurisprudence , Sterilization, Reproductive/psychology
10.
Am J Obstet Gynecol ; 223(2): 234.e1-234.e8, 2020 08.
Article in English | MEDLINE | ID: mdl-32087147

ABSTRACT

BACKGROUND: Improved patient outcomes and satisfaction associated with enhanced recovery after surgery protocols have increasingly replaced traditional perioperative anesthesia care. Fast-track surgery pathways have been extensively validated in patients undergoing hysterectomies, yet the impact on fertility-sparing laparoscopic gynecologic operations, particularly those addressing chronic pain conditions, has not been examined. OBJECTIVE: The objective of the study was to determine the effects of enhanced recovery after surgery pathway implementation compared with conventional perioperative care in women undergoing laparoscopic minimally invasive nonhysterectomy gynecologic procedures. STUDY DESIGN: We conducted a retrospective cohort study of women undergoing uterine-sparing laparoscopic gynecologic procedures for benign conditions (tubal/adnexal pathology, endometriosis, or leiomyomas) during a 24 month period before and after enhanced recovery after surgery implementation at a tertiary care center. We compared immediate perioperative outcomes and 30 day complications. The primary outcome was same-day discharge rates. Factors influencing unplanned admissions, postoperative pain, sedation, nausea, and vomiting represented secondary analyses. RESULTS: A total of 410 women (enhanced recovery after surgery, n = 196; conventional perioperative care, n = 214) met inclusion criteria. Following enhanced recovery after surgery implementation, same-day discharge rates increased by 9.4% (P = .001). Reductions in postoperative pain and nausea/vomiting represented the primary driving factor behind lower unplanned admissions. Higher preoperative antiemetic medication administration in the enhanced recovery after surgery group resulted in a 57% reduction in postanesthesia care unit antiemetics (P < .001). Total perioperative narcotic medication use was also significantly reduced by 64% (P < .001), and the enhanced recovery after surgery cohort still demonstrated significantly lower postanesthesia unit care pain scores at hours 2 and 3 (P < .001). A 19 minute shorter postanesthesia care unit stay was noted in the enhanced recovery after surgery cohort (P = .036). Increased same-day discharge did not lead to higher postoperative complications or changes in 30 day emergency department visits or readmissions in patients with enhanced recovery after surgery. CONCLUSION: Enhanced recovery after surgery implementation resulted in increased same-day discharge rates and improved perioperative outcomes without affecting 30 day morbidity in women undergoing laparoscopic minimally invasive nonhysterectomy gynecologic procedures.


Subject(s)
Enhanced Recovery After Surgery , Genital Diseases, Female/surgery , Gynecologic Surgical Procedures/methods , Hospitalization/statistics & numerical data , Laparoscopy/methods , Patient Discharge/statistics & numerical data , Pelvic Pain/surgery , Adult , Anesthesia Recovery Period , Denervation/methods , Endometriosis/surgery , Female , Humans , Infertility, Female/surgery , Leiomyoma/surgery , Middle Aged , Minimally Invasive Surgical Procedures , Ovarian Cysts/surgery , Pain, Postoperative/epidemiology , Postoperative Nausea and Vomiting/epidemiology , Prophylactic Surgical Procedures/methods , Retrospective Studies , Salpingo-oophorectomy , Sterilization, Reproductive/methods , Uterine Myomectomy/methods , Uterine Neoplasms/surgery , Young Adult
11.
Pesqui. vet. bras ; Pesqui. vet. bras;40(2): 134-140, Feb. 2020. tab, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1098442

ABSTRACT

Inadequate exposure of the female reproductive system to steroids in uterine developmental periods can partially inhibit the development of endometrial glands in dogs. However, the effects of steroids on the formed glands functionality remain unknown, as well as the possible occurrence of endometrial fibrosis. This study aimed to evaluate the secretory activity of endometrial glands in prebubertal female dogs submitted to a protocol of partial ablation of the uterine adenogenesis. Sixteen females of non-specific breed were distributed into two groups; MPA (n=8), females that received applications of medroxyprogesterone acetate every 3 weeks; and C (n=8) untreated control females. Ovariohysterectomy was performed in all animals at the age of 6 months and evaluated the uterine horns by histological and histochemistry exams. The secretion intensity (degrees 1-4) was evaluated using periodic acid-Schiff (PAS) and alcian blue (AB) pH 2.5. Histological evaluation was performed using Masson's trichrome and toluidine blue. Only degree 1 and 2 marks for PAS were observed in both groups, with no difference of uterine secretion intensity between the groups regarding the degrees found. However, the MPA group revealed higher intensity of uterine secretion compared to group C (p<0.05). Staining with AB pH 2.5 also revealed only degree 1 and 2 marks in both groups, with no statistically significance between them. Masson's trichrome staining revealed no marks in the periglandular region in both groups. A higher among of mast cells was observed in the myometrial region of the uterus in both groups. Prepubertal female dogs with partial ablation of the uterine adenogenesis present minimal uterine secretory activity, absence of periglandular fibrosis and increased presence of mast cells in the myometrium compared to endometrium.(AU)


A exposição inadequada do sistema reprodutor feminino a esteróides em períodos do desenvolvimento uterino pode inibir parcialmente o desenvolvimento das glândulas endometriais em cães. Entretanto, não se conhece os efeitos dos esteróides sobre a funcionalidade das glândulas formadas, bem como a possível ocorrência de fibrose endometrial. Objetivou-se avaliar a atividade secretória das glândulas endometriais de cadelas pré-púberes submetidas a protocolo de ablação parcial da adenogênese uterina. Foram utilizadas 16 fêmeas, sem-raça-definida, distribuídas nos grupos MPA (n=8), fêmeas que receberam aplicações de acetato de medroxiprogesterona a cada 3 semanas, e C (n=8), fêmeas controle não tratadas. Aos seis meses de idade, foi realizada ovariohisterectomia em todos os animais, e avaliados os cornos uterinos pelo exame histológico e de histoquímica. Para avaliar a intensidade de secreção (graus 1-4), foram utilizadas periodic acid-Schiff e alcian blue (AB) pH 2,5. Para a avaliação histológica foram utilizados tricrômico de Masson e azul de toluidina. Apenas marcações graus 1 e 2 foram observadas para PAS em ambos os grupos, sem diferença na intensidade de secreção uterina entre grupos com relação aos graus encontrados. Entretanto, o grupo MPA apresentou maior intensidade de secreção uterina em relação ao grupo C (p<0,05). Com relação ao AB pH 2,5, em ambos os grupos também foram encontradas apenas marcações de graus 1 e 2, sem diferença estatística entre grupos. Não foram observadas marcações para a coloração de tricrômico de Masson na região periglandular, em ambos os grupos. Foi observada maior quantidade de mastócitos presentes no útero na região do miométrio, em ambos os grupos. Conclui-se que cadelas pré-púberes com ablação parcial da adenogênese uterina apresentam mínima atividade secretória uterina, ausência de fibrose periglandular e maior presença de mastócitos no miométrio em relação ao endométrio.(AU)


Subject(s)
Animals , Female , Dogs , Sterilization, Reproductive/veterinary , Uterus/anatomy & histology , Uterus/physiology , Cervix Mucus , Medroxyprogesterone Acetate , Dogs/physiology , Endometrial Ablation Techniques/veterinary , Ovariectomy/veterinary , Models, Animal , Hysterectomy/veterinary
12.
Rev. Bras. Med. Fam. Comunidade (Online) ; 15(42): 2082-2082, 20200210. ilus
Article in Portuguese | Coleciona SUS, LILACS | ID: biblio-1097401

ABSTRACT

Introdução: O planejamento reprodutivo deve levar em conta as condições de vidas das pessoas e garantir que possam decidir sobre sua reprodução de forma livre e esclarecida. Objetivo: Avaliar a atividade de educação em saúde no processo de aconselhamento contraceptivo para esterilização cirúrgica. Metódos: Trata-se de um estudo observacional descritivo, tipo inquérito. A pesquisa ocorreu no Centro Municipal de Especialidades Médicas da cidade de São Carlos, estado de São Paulo, com a participação dos usuários da atenção básica que manifestaram desejo pela esterilização cirúrgica e compareceram na atividade de educação em saúde, no período de setembro a dezembro de 2016. A coleta de dados foi por meio de questionário estruturado aplicado pelos pesquisadores ao término das atividades de educação em saúde. As respostas das questões foram armazenadas no programa Microsoft Excel 2010 para calcular frequências absolutas, relativas e médias. A análise dos dados quantitativos permitiu a interpretação descritiva das informações. Resultados: Foram realizadas seis atividades de educação em saúde com participação de 45 indivíduos, 26 mulheres (58%) e 19 homens (42%). A idade média das mulheres e dos homens foi 31,4 e 37,5 anos, respectivamente. A maioria tinha dois filhos vivos com o atual parceiro. Os motivos alegados para esterilização cirúrgica foram número suficiente de filhos, questões financeiras desfavoráveis e problemas de saúde da mulher. As dúvidas sobre métodos contraceptivos e procedimentos cirúrgicos foram problematizadas durante educação em saúde e nenhuma nova dúvida surgiu quando os participantes foram entrevistados. Após a educação em saúde, dois casais mostraram-se interessados pela mudança da laqueadura tubária para vasectomia. Chamou à atenção de duas mulheres o dispositivo intrauterino e o contraceptivo hormonal transdérmico, mas mantiveram a escolha pelo método definitivo. Conclusão: As atividades de educação em saúde permitiram aos usuários esclarecimentos de dúvidas sobre a esterilização cirúrgica e reflexão sobre a possibilidade de mudanças para outros métodos contraceptivos.


Introduction: Reproductive planning must take into account people's living conditions and ensure that they can decide on their reproduction in a free and informed manner. Objective: To evaluate the health education activity in the contraceptive counseling process for surgical sterilization. Methods: This is a descriptive observational survey study. The research took place at the Municipal Center of Medical Specialties of the city of São Carlos, state of São Paulo, with the participation of primary care users who expressed a desire for surgical sterilization and attended the health education activity, from September to December 2016. Data collection it was through a structured questionnaire applied by researchers at the end of health education activities. The answers to the questions were stored in the Microsoft Excel 2010 program to calculate absolute, relative and average frequencies. The analysis of quantitative data allowed the descriptive interpretation of the information. Results: Six health education activities were conducted with the participation of 45 individuals, 26 women (58%) and 19 men (42%). The average age of women and men was 31.4 and 37.5 years, respectively. Most had two children alive with the current partner. Alleged reasons for surgical sterilization were sufficient numbers of children, unfavorable financial issues, and women's health problems. Doubts about contraceptive methods and surgical procedures were problematized during health education and no new questions arose when participants were interviewed. After health education, two couples were interested in switching from tubal ligation to vasectomy. Two women caught the attention of the intrauterine device and the transdermal hormonal contraceptive, but maintained the choice of the definitive method. Conclusion: Health education activities allowed users to clarify doubts about surgical sterilization and reflect on the possibility of changes to other contraceptive methods.


Introdutión: La planificación reproductiva debe llevar en cuenta las condiciones de vida de las personas y garantizar que puedan decidir sobre su reproducción de forma libre y clara. Objetivo: Evaluar la actividad de la educación en salud en el proceso de asesoramiento contraceptivo para la esterilización quirúrgica. Método: Este es un estudio descriptivo de encuesta observacional. La investigación tuvo lugar en el Centro Municipal de Especialidades Médicas de la ciudad de São Carlos, estado de São Paulo, con la participación de usuarios de atención básica que expresaron su deseo de esterilización quirúrgica y asistieron a la actividad de educación sanitaria, de septiembre a diciembre de 2016. Recopilación de datos a través de un cuestionario estructurado aplicado por investigadores al final de las actividades de educación sanitaria. Las respuestas a las preguntas se almacenaron en el programa Microsoft Excel 2010 para calcular las frecuencias absolutas, relativas y medias. El análisis de datos cuantitativos permitió la interpretación descriptiva de la información. Resultados: Fueron realizadas seis actividades de educación en salud con 45 individuos, 26 del sexo femenino (58%) y 19 masculino (42%). La edad media de ambos sexos fue de 31,4 y 37,5 años respectivamente. La mayoría tenía dos hijos vivos con el actual compañero. Los motivos alegados para la esterilización quirúrgica fueron el número suficiente de hijos, dificultades financieras y problemas de salud de la mujer. Las dudas sobre los métodos contraceptivos y procedimientos quirúrgicos fueron problematizadas durante la educación sanitaria y ninguna duda surgió cuando se entrevistó los participantes. Después de la educación en salud, dos parejas se mostraron interesados por cambiar la ligadura de trompas para vasectomía. Dos mujeres se interesaron por el dispositivo intrauterino y el contraceptivo hormonal transdérmico, pero al final mantuvieron la opción por el método definitivo. Conclusión: Las actividades de educación sanitaria permitieron a los usuarios esclarecimiento de dudas sobre la esterilización quirúrgica y reflexión sobre las posibilidades de cambios para otros métodos anticonceptivos.


Subject(s)
Humans , Male , Female , Sterilization, Reproductive , Health Education , Counseling
13.
Pesqui. vet. bras ; 40(2): 134-140, fev. 2020. tab, ilus
Article in English | VETINDEX | ID: vti-30461

ABSTRACT

Inadequate exposure of the female reproductive system to steroids in uterine developmental periods can partially inhibit the development of endometrial glands in dogs. However, the effects of steroids on the formed glands functionality remain unknown, as well as the possible occurrence of endometrial fibrosis. This study aimed to evaluate the secretory activity of endometrial glands in prebubertal female dogs submitted to a protocol of partial ablation of the uterine adenogenesis. Sixteen females of non-specific breed were distributed into two groups; MPA (n=8), females that received applications of medroxyprogesterone acetate every 3 weeks; and C (n=8) untreated control females. Ovariohysterectomy was performed in all animals at the age of 6 months and evaluated the uterine horns by histological and histochemistry exams. The secretion intensity (degrees 1-4) was evaluated using periodic acid-Schiff (PAS) and alcian blue (AB) pH 2.5. Histological evaluation was performed using Masson's trichrome and toluidine blue. Only degree 1 and 2 marks for PAS were observed in both groups, with no difference of uterine secretion intensity between the groups regarding the degrees found. However, the MPA group revealed higher intensity of uterine secretion compared to group C (p<0.05). Staining with AB pH 2.5 also revealed only degree 1 and 2 marks in both groups, with no statistically significance between them. Masson's trichrome staining revealed no marks in the periglandular region in both groups. A higher among of mast cells was observed in the myometrial region of the uterus in both groups. Prepubertal female dogs with partial ablation of the uterine adenogenesis present minimal uterine secretory activity, absence of periglandular fibrosis and increased presence of mast cells in the myometrium compared to endometrium.(AU)


A exposição inadequada do sistema reprodutor feminino a esteróides em períodos do desenvolvimento uterino pode inibir parcialmente o desenvolvimento das glândulas endometriais em cães. Entretanto, não se conhece os efeitos dos esteróides sobre a funcionalidade das glândulas formadas, bem como a possível ocorrência de fibrose endometrial. Objetivou-se avaliar a atividade secretória das glândulas endometriais de cadelas pré-púberes submetidas a protocolo de ablação parcial da adenogênese uterina. Foram utilizadas 16 fêmeas, sem-raça-definida, distribuídas nos grupos MPA (n=8), fêmeas que receberam aplicações de acetato de medroxiprogesterona a cada 3 semanas, e C (n=8), fêmeas controle não tratadas. Aos seis meses de idade, foi realizada ovariohisterectomia em todos os animais, e avaliados os cornos uterinos pelo exame histológico e de histoquímica. Para avaliar a intensidade de secreção (graus 1-4), foram utilizadas periodic acid-Schiff e alcian blue (AB) pH 2,5. Para a avaliação histológica foram utilizados tricrômico de Masson e azul de toluidina. Apenas marcações graus 1 e 2 foram observadas para PAS em ambos os grupos, sem diferença na intensidade de secreção uterina entre grupos com relação aos graus encontrados. Entretanto, o grupo MPA apresentou maior intensidade de secreção uterina em relação ao grupo C (p<0,05). Com relação ao AB pH 2,5, em ambos os grupos também foram encontradas apenas marcações de graus 1 e 2, sem diferença estatística entre grupos. Não foram observadas marcações para a coloração de tricrômico de Masson na região periglandular, em ambos os grupos. Foi observada maior quantidade de mastócitos presentes no útero na região do miométrio, em ambos os grupos. Conclui-se que cadelas pré-púberes com ablação parcial da adenogênese uterina apresentam mínima atividade secretória uterina, ausência de fibrose periglandular e maior presença de mastócitos no miométrio em relação ao endométrio.(AU)


Subject(s)
Animals , Female , Dogs , Sterilization, Reproductive/veterinary , Uterus/anatomy & histology , Uterus/physiology , Cervix Mucus , Medroxyprogesterone Acetate , Dogs/physiology , Endometrial Ablation Techniques/veterinary , Ovariectomy/veterinary , Models, Animal , Hysterectomy/veterinary
14.
Saúde Soc ; 29(1): e200016, 2020.
Article in Portuguese | LILACS | ID: biblio-1101907

ABSTRACT

Resumo Denúncias graves de efeitos colaterais sofridos por mulheres em vários países (Estados Unidos, nações da Europa e Brasil) desvelaram controvérsias na difusão de um dispositivo permanente para controle reprodutivo, designado Essure, pelo laboratório farmacêutico Bayer. Este trabalho busca compreender a circulação internacional e a introdução desse artefato biomédico no Brasil, a partir de pesquisa documental em sites de agências regulatórias, do laboratório farmacêutico e da divulgação pública feita por hospitais no país, associados ao Sistema Único de Saúde, para convocarem mulheres para o procedimento. Trata-se de primeira aproximação ao tema para se inquirir sobre as condições sociais da implantação do dispositivo em usuárias desses serviços de saúde no período em que ele esteve disponível no país, de 2009 a 2017. Apresentado como um dispositivo seguro, inócuo e de fácil manejo clínico, a promessa de um objeto permanente que impediria a gravidez sem necessidade de recorrer ao método cirúrgico foi vendida pela Bayer ao staff médico como solução simples, prática e moderna de controle reprodutivo. O percurso do dispositivo no Brasil evidencia certo entusiasmo médico com a nova técnica, não acompanhado de monitoramento clínico de longo prazo, principalmente quando as mulheres passaram a demandar a sua retirada em razão de muitas sequelas e efeitos colaterais dele decorrentes.


Abstract Recently, there have been serious reports of side effects suffered by women in various countries (United States, European countries and Brazil), revealing controversies surrounding Bayer's widespread use of a permanent reproductive control device over the last decade: Essure. This article analyzes the international circulation and the introduction of this biomedical artifact in Brazil. This documentary research investigated websites of regulatory agencies, the aforementioned pharmaceutical laboratory, public disclosure made by hospitals in the country, associated with the Brazilian National Health System. This is the first approach to the subject that questions the social conditions of the implementation of Essure in users of these health services when it was available in the country, from 2009 until 2017. This permanent contraceptive method was presented as a safe and easy-to-use clinical management device. The promise of a permanent object that would prevent pregnancy without surgery was sold by Bayer to medical staff as a simple, practical and modern reproductive control solution. Its circulation in Brazil shows medical enthusiasm for the new technique, which was not accompanied by long-term clinical monitoring, even as women began to demand its withdrawal due to the many sequelae and resulting side effects.


Subject(s)
Humans , Female , Sterilization, Reproductive , Sterilization, Tubal , Unified Health System , Contraception , Reproductive Rights , Drug-Related Side Effects and Adverse Reactions , Reproductive Health
15.
Cad. Saúde Pública (Online) ; 36(10): e00096919, 2020. tab, graf
Article in Portuguese | LILACS, Sec. Est. Saúde SP | ID: biblio-1132827

ABSTRACT

Resumo: A contracepção é fundamental para que as mulheres possam regular sua fecundidade, exercendo uma das dimensões dos direitos reprodutivos. No entanto, desconhecemos como elas enfrentam esse desafio na maior cidade do Brasil, São Paulo. Para preencher essa lacuna, o inquérito populacional Ouvindo Mulheres: Contracepção no Município de São Paulo foi realizado junto a uma amostra probabilística de 4 mil mulheres com 15 a 44 anos de idade, residentes nessa cidade, em 2015. Neste artigo, apresenta-se a prevalência da prática contraceptiva, analisam-se os fatores associados ao não uso de contracepção e aos tipos de contraceptivos em uso. A prevalência da anticoncepção foi estimada para mulheres com, pelo menos, uma relação heterossexual nos 12 meses anteriores à entrevista e que não estavam grávidas. Regressão logística foi utilizada para verificar fatores associados ao não uso de contracepção, e o modelo CHAID, para identificar associações aos tipos de contraceptivo em uso. A prevalência da anticoncepção foi 84,8% (IC95%: 83,2-86,3). Os contraceptivos mais prevalentes foram pílula e preservativo masculino. Associaram-se ao não uso de anticoncepção, religião (Pentecostal), número de filhos (menos do que 3), não ter usado contraceptivo na primeira relação sexual, não ter parceiro e não ter tido relação sexual no mês anterior. O número de filhos tidos e a idade da mulher foram os dois primeiros níveis de discriminação dos tipos de contraceptivo utilizados. A prevalência da anticoncepção é alta, mas mantém-se a concentração em dois métodos: anteriormente, laqueadura e pílula, agora, pílula e preservativo masculino. É necessário incorporar novos contraceptivos hormonais no Sistema Único de Saúde (SUS) e promover o uso de métodos de longa duração como o DIU.


Abstract: Contraception is essential for women to be able to regulate their fertility, exercising a key dimension of reproductive rights. However, little is known about how women deal with this challenge in Brazil's largest city, São Paulo. To fill this gap, the population survey Ouvindo Mulheres: Contracepção no Município de São Paulo was conducted with a probabilistic sample of 4,000 women 15 to 44 years of age living in this city in 2015. This article presents the prevalence of contraceptive practice and analyzes factors associated with lack of contraception use and with types of contraceptives. Prevalence of contraception was estimated for women with at least one heterosexual relation in the 12 months prior to the interview and who were not pregnant. Logistic regression was used to verify factors associated with lack of contraception use, and the CHAID model was used to identify associations with the types of contraceptives used. Prevalence of contraception was 84.8% (95%CI: 83.2-86.3). The most prevalent contraceptives were the pill and condoms. Factors associated with lack of contraceptive use were religion (Pentecostal), number of children (fewer than 3), not having used contraceptives in the first sexual relation, not having a partner, and not having had sex in the previous month. Number of children and woman's age were the first two levels of discrimination of the types of contraceptives used. Prevalence of contraception was high, but maintaining a concentration in two methods: historically, female sterilization and the pill prevailed, nowadays, the pill and condoms do. New hormonal contraceptives should be incorporated by the Brazilian Unified National Health System (SUS), besides promoting the use of long-acting methods such as IUDs.


Resumen: La contracepción es fundamental para que las mujeres puedan regular su fecundidad, ejerciendo una de las dimensiones de sus derechos reproductivos. No obstante, desconocemos cómo enfrentan este desafío en la mayor ciudad de Brasil, São Paulo. Para resolver esta cuestión, se realizó la encuesta poblacional Ouvindo Mulheres: Contracepção no Município de São Paulo, mediante una muestra probabilística de 4 mil mujeres de 15 a 44 años de edad, residentes en esa ciudad en 2015. En este artículo se presenta la prevalencia de la práctica contraceptiva, se analizan los factores asociados con el no uso de métodos anticonceptivos, así como los tipos de contraceptivos en uso. La prevalencia de la anticoncepción se estimó en mujeres con por lo menos una relación heterosexual, en los 12 meses anteriores a la entrevista, y que no estaban embarazadas. Se utilizó la regresión logística para verificar factores asociados al no uso de contracepción y el modelo CHAID para identificar asociaciones respecto a los tipos de contraceptivo en uso. La prevalencia de la anticoncepción fue 84,8% (IC95%: 83,2-86,3). Los contraceptivos más prevalentes fueron la píldora y el condón. Se asociaron al no uso de anticonceptivos: religión (Pentecostal), número de hijos (menos de 3), no haber usado contraceptivo en la primera relación sexual, no tener pareja y no haber tenido relaciones sexuales durante el mes anterior. El número de hijos y la edad de la mujer fueron los dos primeros niveles de discriminación de los tipos de contraceptivo utilizados. La prevalencia de la anticoncepción es alta, pero se mantiene la concentración en dos métodos: anteriormente, ligadura y píldora, ahora, píldora y condón. Es necesario incorporar nuevos contraceptivos hormonales en el Sistema Único de Salud (SUS), así como promover el uso de métodos de larga duración como el DIU.


Subject(s)
Humans , Female , Pregnancy , Child , Contraception , Contraceptive Agents , Sterilization, Reproductive , Brazil , Contraception Behavior
16.
Med Anthropol ; 38(8): 680-694, 2019.
Article in English | MEDLINE | ID: mdl-31821029

ABSTRACT

This article explores the role of aesthetics in the construction and perception of what constitutes healthy reproduction and reproductive practices. I draw on women's reproductive experiences and navigations within a racialized gendered hierarchy. Processes and procedures related to the governance and measurements of reproduction and reproductive health shape these navigations. Focusing on Black women's experiences, I analyze the ways in which values, sensibilities, and affect connected to particular appearances and arrangements influence reproductive decision-making, reproductive health, and family constructions - what I refer to as aesthetics politics.


Subject(s)
Black People , Politics , Reproduction , Women's Health , Body Image , Brazil , Contraception , Female , Humans , Racism , Sterilization, Reproductive
17.
PLoS One ; 14(2): e0212520, 2019.
Article in English | MEDLINE | ID: mdl-30779779

ABSTRACT

The sterile insect technique (SIT) may offer a means to control the transmission of mosquito borne diseases. SIT involves the release of male insects that have been sterilized by exposure to ionizing radiation. We determined the effects of different doses of radiation on the survival and reproductive capacity of local strains of Aedes aegypti and Ae. albopictus in southern Mexico. The survival of irradiated pupae was invariably greater than 90% and did not differ significantly in either sex for either species. Irradiation had no significant adverse effects on the flight ability (capacity to fly out of a test device) of male mosquitoes, which consistently exceeded 91% in Ae. aegypti and 96% in Ae. albopictus. The average number of eggs laid per female was significantly reduced in Ae. aegypti at doses of 15 and 30 Gy and no eggs were laid by females that had been exposed to 50 Gy. Similarly, in Ae. albopictus, egg production was reduced at doses of 15 and 25 Gy and was eliminated at 35 Gy. In Ae. aegypti, fertility in males was eliminated at 70 Gy and was eliminated at 30 Gy in females, whereas in Ae. albopictus, the fertility of males that mated with untreated females was almost zero (0.1%) in the 50 Gy treatment and female fertility was eliminated at 35 Gy. Irradiation treatments resulted in reduced ovary length and fewer follicles in both species. The adult median survival time of both species was reduced by irradiation in a dose-dependent manner. However, sterilizing doses of 35 Gy and 50 Gy resulted in little reduction in survival times of males of Ae. albopictus and Ae. aegypti, respectively, indicating that these doses should be suitable for future evaluations of SIT-based control of these species. The results of the present study will be applied to studies of male sexual competitiveness and to stepwise evaluations of the sterile insect technique for population suppression of these vectors in Mexico.


Subject(s)
Aedes/radiation effects , Fertility/radiation effects , Mosquito Control/methods , Animals , Infertility , Insecta , Male , Mexico , Mosquito Vectors , Radiation Dosage , Radiation, Ionizing , Radiotherapy Dosage , Sexual Behavior, Animal/radiation effects , Sterilization, Reproductive/methods
18.
Lancet Glob Health ; 7(2): e227-e235, 2019 02.
Article in English | MEDLINE | ID: mdl-30683240

ABSTRACT

BACKGROUND: The rise in contraceptive use has largely been driven by short-acting methods of contraception, despite the high effectiveness of long-acting reversible contraceptives. Several countries in Latin America and the Caribbean have made important progress increasing the use of modern contraceptives, but important inequalities remain. We assessed the prevalence and demand for modern contraceptive use in Latin America and the Caribbean with data from national health surveys. METHODS: Our data sources included demographic and health surveys, multiple indicator cluster surveys, and reproductive health surveys carried out since 2004 in 23 countries of Latin America and the Caribbean. Analyses were based on sexually active women aged 15-49 years irrespective of marital status, except in Argentina and Brazil, where analyses were restricted to women who were married or in a union. We calculated contraceptive prevalence and demand for family planning satisfied. Contraceptive prevalence was defined as the percentage of sexually active women aged 15-49 years who (or whose partners) were using a contraceptive method at the time of the survey. Demand for family planning satisfied was defined as the proportion of women in need of contraception who were using a contraceptive method at the time of the survey. We separated survey data for modern contraceptive use by type of contraception used (long-acting, short-acting, or permanent). We also stratified survey data by wealth, area of residence, education, ethnicity, age, and a combination of wealth and area of residence. Wealth-related absolute and relative inequalities were estimated both for contraceptive prevalence and demand for family planning satisfied. FINDINGS: We report on surveys from 23 countries in Latin America and the Caribbean, analysing a sample of 212 573 women. The lowest modern contraceptive prevalence was observed in Haiti (31·3%) and Bolivia (34·6%); inequalities were wide in Bolivia, but almost non-existent in Haiti. Brazil, Colombia, Costa Rica, Cuba, and Paraguay had over 70% of modern contraceptive prevalence with low absolute inequalities. Use of long-acting reversible contraceptives was below 10% in 17 of the 23 countries. Only Cuba, Colombia, Mexico, Ecuador, Paraguay, and Trinidad and Tobago had more than 10% of women adopting long-acting contraceptive methods. Mexico was the only country in which long-acting contraceptive methods were more frequently used than short-acting methods. Young women aged 15-17 years, indigenous women, those in lower wealth quintiles, those living in rural areas, and those without education showed particularly low use of long-acting reversible contraceptives. INTERPRETATION: Long-acting reversible contraceptives are seldom used in Latin America and the Caribbean. Because of their high effectiveness, convenience, and ease of continuation, availability of long-acting reversible contraceptives should be expanded and their use promoted, including among young and nulliparous women. In addition to suitable family planning services, information and counselling should be provided to women on a personal basis. FUNDING: Wellcome Trust, Pan American Health Organization.


Subject(s)
Condoms/statistics & numerical data , Contraception Behavior/statistics & numerical data , Contraceptive Agents/administration & dosage , Intrauterine Devices/statistics & numerical data , Long-Acting Reversible Contraception/statistics & numerical data , Sterilization, Reproductive/statistics & numerical data , Adolescent , Adult , Age Factors , Caribbean Region , Contraception, Postcoital/statistics & numerical data , Contraceptives, Oral/therapeutic use , Drug Implants/therapeutic use , Educational Status , Female , Health Surveys , Healthcare Disparities , Humans , Income , Indigenous Peoples , Latin America , Logistic Models , Middle Aged , Natural Family Planning Methods/statistics & numerical data , Needs Assessment , Rural Population , Spermatocidal Agents/therapeutic use , Young Adult
19.
Rev. bras. estud. popul ; 36: e0103, 2019. graf
Article in English | LILACS | ID: biblio-1098834

ABSTRACT

Fertility transition occurred in a short period of time in Brazilian the absence of family planning programs, and most noticeable, in a context of illegality in the provision of means of fertility self-regulation. These events did not happen without consequences. Based in the literature and facts registered during that time, the paper first discusses how the resistance to the implementation of family planning programs from the 1960s to the 1980s have contributed to the unbalanced contraceptive method mix in the 1990's. Secondly, the paper will discuss problems around contraceptive data collection in the National Health Survey, and, performing an adjustment of the data, we analyze trends in the use of contraceptive methods from 1986 to 2013, showing that method mix continues to be very concentrated in the same two methods, an even more outdated scheme, with the daily pill exchanging first place with female sterilization. Finally, the paper discusses some fertility characteristics associated with the outdated contraceptive mix, still prevailing at the end of fertility transition, arguing that this could be avoided or minimized if policies and laws are based in reproductive rights of all people only.


A transição da fecundidade ocorreu de maneira rápida no Brasil na ausência de programas de planejamento familiar e, mais impressionante, em um contexto de ilegalidade na provisão dos meios para a autorregulação da fecundidade. Esses eventos não ocorreram sem consequências. Com base na literatura e nos fatos registrados durante esse período, o artigo discute, primeiro, como a resistência à implementação de programas de planejamento familiar nas décadas de 1960 a 1980 contribuiu para o mix contraceptivo obsoleto, já nos anos 1990. Em segundo lugar, abordando os problemas em torno da coleta de dados de contracepção na Pesquisa Nacional de Saúde e fazendo um ajuste nos dados, são analisadas as tendências na prevalência contraceptiva de 1986 a 2013, mostrando que o mix de métodos continua muito concentrado nos mesmos dois métodos, um regime ainda mais obsoleto, com a pílula diária trocando de lugar com a esterilização feminina. Por fim, são discutidas algumas características da fecundidade associadas ao mix contraceptivo obsoleto, que ainda prevalece no final da transição da fecundidade. Argumenta-se que isso poderia ser evitado ou minimizado se políticas e leis fossem baseadas apenas nos direitos reprodutivos de todas as pessoas.


La transición de la fecundidad se dio rápidamente en Brasil en ausencia de programas de planificación familiar y, más sorprendentemente, en un contexto de ilegalidad en la provisión de los medios para la autorregulación de la fecundidad. Esos eventos no ocurrieron sin consecuencias. Con base en la literatura y los hechos registrados durante ese período, el artículo analiza primero cómo la resistencia a la implementación de programas de planificación familiar en los años sesenta a ochenta resultó en el mix de contraceptivos obsoleto de los noventa. En segundo lugar, analizando los problemas relacionados con la recopilación de datos de la Encuesta Nacional de Salud, y ajustándolos, se analizan las tendencias en la prevalencia de los anticonceptivos de 1986 a 2013, lo que demuestra que el mix de métodos sigue estando muy centrado en los mismos dos métodos, un régimen aún más obsoleto, con la píldora diaria intercambiando el primer lugar con la esterilización femenina. Finalmente, se discuten algunas características de fecundidad asociadas con el mix anticonceptivo obsoleto, que aún prevalecen al final de la transición de fecundidad. Se argumenta que esto podría evitarse o minimizarse si las políticas y leyes se basaran en los derechos reproductivos de todas las personas.


Subject(s)
Humans , Female , Adult , Sterilization, Reproductive , Brazil , Data Collection , Contraception , Reproductive Behavior , Family Development Planning , Censuses , Health Policy
20.
Vet. Not. (Online) ; 24(2): 44-56, jun.-dez. 2018. ilus
Article in English | VETINDEX | ID: biblio-1502496

ABSTRACT

É crescente o número de animais errantes nos grandes centros urbanos, sendo a população de felinos bastante significativa. A esterilização pré púbere promove de forma precoce a incapacidade reprodutiva do animal; reduz o desenvolvimento de patologias relacionadas ao trato reprodutivo, além de outras vantagens. Entretanto a anestesia em animais pré púberes ainda é um desafio e o uso de opióides nestes pacientes tem sido questionado devido a ocorrência de hipotensão em alguns casos. Sendo assim tornam-se necessários estudos para verificar as consequências do uso de opióides nestes animais. Portanto, o presente estudo teve como objetivo avaliar a eficiência do uso de Tramadol em gatas pré-púberes submetidas à ovariosalpingohisterectomia. Foram utilizadas oito fêmeas da espécie felina, com idade entre dois e quatro meses. As gatas foram divididas aleatoriamente em dois grupos (grupo Controle e grupo Tramadol), constituídos de 4 animais cada. Durante o trans operatório foram avaliadas a temperatura corporal, frequência respiratória, frequência cardíaca e saturação de oxigênio e pressão arterial não invasiva. Foram aferidos imediatamente antes da administração das drogas anestésicas (T0 – Controle) e a cada 4 minutos durante o transoperatório de 20 minutos (T4, T8, T12,T16, T20); os parâmetros de frequência cardíaca; frequência respiratória, temperatura corporal, nível de saturação de oxigênio e pressão arterial sistólica (PAS). O grupo Tramadol apresentou valores de frequência cardíaca e respiratória inferiores quando comparados com os obtidos no grupo Controle nos períodos de T0 até o T8. Em todos os momentos analisados a temperatura corporal e saturação de oxigênio não revelaram diferença significativa entre os dois grupos; sendo que os valores se mantiveram entre 35,6°C a 37,7°C e 78,5% a 90,25% respectivamente. Neste estudo foi possível concluir que o Tramadol foi eficiente na analgesia após esterilização...


The number of wandering animals in large urban centers is increasing, and the cat population is quite significant. Pre-pubertal sterilization promotes early reproductive failure of the animal; reduces the development of pathologies related to the reproductive tract, in addition of other advantages. However, anesthesia in prepubertal animals is still a challenge and the usage of opioids in those patient has been questioned due to the occurrence of hypotension in some cases. Accordingly, it is necessary further studies to verify the consequences of the use of opioids in these animals. Therefore, the present study had as objective to evaluate the effectiveness of the use of Tramadol in prepubescent queens submitted to ovariohisterectomy. Eight females of the feline species, aged between two and four months, were used. The queens were randomly divided into two groups (Control group and Tramadol group), consisting of four animals each. During the transoperative period, body temperature, respiratory rate, heart rate and oxygen saturation, and noninvasive blood pressure had been monitored. They have been measured immediately prior to administration of anesthetic drugs (T0 – Control) and every 4 minutes during 20 minute of transoperative period (T4, T8, T12, T16, T20); heart rate parameters; respiratory rate, body temperature, oxygen saturation level and systolic blood pressure (SBP). The Tramadol group presented lower values – of heart rate and respiratory rate when compared to those obtained in the Control group in the periods from T0 to T8. In all analyzed moments body temperature and oxygen saturation did not reveal significant difference between the two groups; with values – between 35.6° C and 37.7° C and 78.5% and 90.25%, respectively. In this study it was possible to conclude that Tramadol was efficient in analgesia after surgical sterilization of prepubertal cats, without causing significant hypotension.


Subject(s)
Female , Animals , Infant, Newborn , Cats , Analgesia/methods , Analgesia/veterinary , Hysterectomy/veterinary , Ovariectomy/veterinary , Tramadol/adverse effects , Tramadol/therapeutic use , Analgesics, Opioid/adverse effects , Sterilization, Reproductive/veterinary , Hypotension/veterinary
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