RESUMO
Objective: To report the first uterine transposition for fertility preservation in a patient with vulvar cancer.Case: A 26-year-old nulliparous patient with stage IIIB vulvar cancer, which was resected with adequate margins and bilateral inguinofemoral lymphadenectomy.Laparoscopic transposition of the uterus to the upper abdomen, outside of the scope of radiation was performed to preserve fertility and ovarian function. After the end of radiotherapy, the uterus was repositioned into the pelvis.Main Outcome Measure: Uterine and ovarian function preservation. Result: The patient recovered her menstrual cycles spontaneously 1 month after the reimplantation and exhibited normal variation in ovarian hormones.Twelve months after the surgery, the uterus was normal and there was no sign of recurrent disease. Conclusion: Uterine transposition might represent a valid option for fertility preservation in women who require pelvic radiotherapy. However, studies that assess its viability, effectiveness, and safety are required.
RESUMO
This study analyzes the strategies that farmers in the south of Chile use to face current labor shortages and identify the variables that determine each of these strategies. A multinomial logit model and odds ratios plots with predicted probabilities were applied to a sample of 384 farmers. Interviews and focus groups were applied to specific producers, professionals and public officials. The main results show that only 32.3% of farmers declared that labor shortage is a problem. Of this percentage 52% chose the strategy of paying better, 13.8% chose improve the workers' working conditions, 9.5% chose to mechanize, and 24.1% did not follow a strategy. The production of labor-intensive products (e.g., exportable fruit) determines the strategy of paying better; the farmer's educational level influences the strategy of improving the working conditions, and the farmer's age affects the strategy of mechanizing. However, the production of labor-intensive products exhibits the greater effect. The main disadvantage of the "pay better" strategy is that workers do not want to commit to their job.
O objetivo deste estudo foi analisar as estratégias utilizadas pelos agricultores do sul do Chile para enfrentar a escassez de mão de obra e identificar as variáveis que determinam cada uma dessas estratégias. Foram aplicados um modelo de logística multinomial e razões de chance com probabilidades previstas a uma amostra de 384 agricultores, além de entrevistas e grupos focais para determinados produtores, profissionais e funcionários públicos. Os principais resultados mostram que 32,3% dos produtores afirmaram que a escassez de mão de obra é um problema. Desse percentual, 52% optaram pela estratégia de melhorar a remuneração, 13,8% escolheram melhorar as condições de trabalho dos trabalhadores, 9,5% escolheram usinar e 24,1% não seguem nenhuma estratégia. A produção de culturas que requer mão de obra intensiva (por exemplo, a fruta exportável) escolhe a estratégia de melhorar o salário; o nível de escolaridade dos agricultores influencia a estratégia para melhorar as condições de trabalho; e a idade dos agricultores determina a estratégia de usinagem. No entanto, a produção de culturas com mão de obra intensiva apresenta o maior efeito. A principal desvantagem da estratégia de "melhores salários" é que os trabalhadores não querem se comprometer com o seu trabalho.
