Fertility Does not Quarantine: Coronavirus Disease 2019 Pandemic Impacts on in Vitro Fertilization Clinical Pregnancy Rates.

OBJECTIVE: To understand the impact of the coronavirus disease 2019 pandemic on in vitro fertilization (IVF) clinical pregnancy rates and analyze factors that may have influenced their outcome. METHODS: This was a retrospective observational study conducted at a tertiary-care Brazilian fertility center. All fresh IVF and embryo warming cycles performed from March 11 to December 31, 2018-2021 were analyzed, and their data were used to calculate fertilization, embryo cleavage, cycle cancellation, embryo transfer (ET), and clinical pregnancy rates. Statistical tests were used to evaluate the alterations found. Logistic regression models were used to explore the association of the categorical variables with the observed clinical pregnancy rates. Data from 2018 and 2019 (prepandemic) and 2020 and 2021 (pandemic) were grouped. RESULTS: A total of 756 cycles were analyzed (n = 360 prepandemic and n = 396 pandemic). The age group of the patients, fertilization rates, and cleavage rates did not have significant differences (p > 0.05). There was a reduction in the percentage of fresh IVF and an increase in embryo warming cycles (p = 0.005) during the pandemic. There was also an increase in fresh cycle cancellations (p < 0.001) and a reduction in ET rates (p < 0.001). The pandemic had a negative impact on clinical pregnancy rates (p < 0.001) especially due to the increase in fresh cycle cancellations (p < 0.001). CONCLUSION: Embryo warming cycles with subsequent frozen-thawed ET were presented as a viable alternative to continue assisted reproductive treatments against pandemic restrictions on fresh cycles, ensuring clinical pregnancy, albeit at a lower rate than that of the prepandemic period.

OBJETIVO: Compreender os impactos da pandemia de COVID-19 nas taxas de gravidez clínica em fertilização in vitro (FIV) e analisar fatores que possam ter influenciado seu resultado. MéTODOS: Foi realizado um estudo observacional retrospectivo em um centro brasileiro de reprodução assistida. Todos os ciclos de FIV com embriões frescos e descongelados realizados entre 11 de março e 31 de dezembro, 2018-2021 foram analisados, e seus dados utilizados para cálculo das taxas de fertilização, clivagem embrionária, cancelamento de ciclos, transferência de embriões (TE) e gravidez clínica. Testes estatísticos avaliaram significância das alterações encontradas e modelos de regressão logística exploraram associação das variáveis categóricas estudadas com as taxas de gravidez clínica observadas. Os dados de 2018 e 2019 (pré-pandemia) e 2020 e 2021 (pandemia) foram agrupados. RESULTADOS: Foram analisados um total de 756 ciclos (n = 360 na pré-pandemia e n = 396 na pandemia). A faixa etária das pacientes e as taxas de fertilização e de clivagem não tiveram alterações significativas (p > 0,05). Na pandemia, houve redução da porcentagem de ciclos de FIV com embriões frescos e aumento dos com descongelamento (p = 0,005). Também foi notado aumento das taxas de cancelamentos de ciclos com embriões frescos (p < 0,001) e redução do número de TEs (p < 0,001). A pandemia exerceu impacto negativo na taxa de gravidez clínica (p < 0,001), especialmente devido ao aumento de cancelamentos dos ciclos a fresco (p < 0,001). CONCLUSãO: Frente às limitações pandêmicas impostas aos ciclos com embriões frescos, os ciclos de descongelamento de embriões se apresentaram como alternativa viável à continuidade dos ciclos de FIV, garantindo gravidez clínica ainda que em taxas inferiores às do período pré-pandêmico.

Fertility Does not Quarantine: Coronavirus Disease 2019 Pandemic Impacts on in Vitro Fertilization Clinical Pregnancy Rates / Fertilidade não fica em quarentena: impacto da pandemia COVID-19 nas taxas de gravidez clínica em fertilização in vitro

Abstract Objective To understand the impact of the coronavirus disease 2019 pandemic on in vitro fertilization (IVF) clinical pregnancy rates and analyze factors that may have influenced their outcome. Methods This was a retrospective observational study conducted at a tertiary-care Brazilian fertility center. All fresh IVF and embryo warming cycles performed from March 11 to December 31, 2018-2021 were analyzed, and their data were used to calculate fertilization, embryo cleavage, cycle cancellation, embryo transfer (ET), and clinical pregnancy rates. Statistical tests were used to evaluate the alterations found. Logistic regression models were used to explore the association of the categorical variables with the observed clinical pregnancy rates. Data from 2018 and 2019 (prepandemic) and 2020 and 2021 (pandemic) were grouped. Results A total of 756 cycles were analyzed (n = 360 prepandemic and n = 396 pandemic). The age group of the patients, fertilization rates, and cleavage rates did not have significant differences (p > 0.05). There was a reduction in the percentage of fresh IVF and an increase in embryo warming cycles (p = 0.005) during the pandemic. There was also an increase in fresh cycle cancellations (p < 0.001) and a reduction in ET rates (p < 0.001). The pandemic had a negative impact on clinical pregnancy rates (p < 0.001) especially due to the increase in fresh cycle cancellations (p < 0.001). Conclusion Embryo warming cycles with subsequent frozen-thawed ET were presented as a viable alternative to continue assisted reproductive treatments against pandemic restrictions on fresh cycles, ensuring clinical pregnancy, albeit at a lower rate than that of the prepandemic period.

Resumo Objetivo Compreender os impactos da pandemia de COVID-19 nas taxas de gravidez clínica em fertilização in vitro (FIV) e analisar fatores que possam ter influenciado seu resultado. Métodos Foi realizado um estudo observacional retrospectivo em um centro brasileiro de reprodução assistida. Todos os ciclos de FIV com embriões frescos e descongelados realizados entre 11 de março e 31 de dezembro, 2018-2021 foram analisados, e seus dados utilizados para cálculo das taxas de fertilização, clivagem embrionária, cancelamento de ciclos, transferência de embriões (TE) e gravidez clínica. Testes estatísticos avaliaram significância das alterações encontradas e modelos de regressão logística exploraram associação das variáveis categóricas estudadas com as taxas de gravidez clínica observadas. Os dados de 2018 e 2019 (pré-pandemia) e 2020 e 2021 (pandemia) foram agrupados. Resultados Foram analisados um total de 756 ciclos (n = 360 na pré-pandemia e n = 396 na pandemia). A faixa etária das pacientes e as taxas de fertilização e de clivagem não tiveram alterações significativas (p > 0,05). Na pandemia, houve redução da porcentagem de ciclos de FIV com embriões frescos e aumento dos com descongelamento (p = 0,005). Também foi notado aumento das taxas de cancelamentos de ciclos com embriões frescos (p < 0,001) e redução do número de TEs (p < 0,001). A pandemia exerceu impacto negativo na taxa de gravidez clínica (p < 0,001), especialmente devido ao aumento de cancelamentos dos ciclos a fresco (p < 0,001). Conclusão Frente às limitações pandêmicas impostas aos ciclos com embriões frescos, os ciclos de descongelamento de embriões se apresentaram como alternativa viável à continuidade dos ciclos de FIV, garantindo gravidez clínica ainda que em taxas inferiores às do período pré-pandêmico.

Adequabilidade da assistência ao pré-natal em duas Unidades de Saúde em Curitiba, Paraná / Adequacy of prenatal care at two health units in Curitiba, Paraná

Este estudo objetivou avaliar a adequabilidade do pré-natal, conforme Protocolo Mãe Curitibana em uma Unidade Básica de Saúde com Programa Saúde da Família (PSF) e outra unidade de saúde tradicional (UBS), com estudo transversal, retrospectivo com dados dos prontuários cadastrados entre fevereiro de 2010 a janeiro de 2011. Foram excluídas as gestantes que apresentaram abortamento e abandono do pré-natal, totalizando 158 gestantes, sendo 79 da unidade PSF e o restante da UBS. A média do início do pré-natal foi de 11±6,26 semanas, e a análise das médias dos registros no pré-natal para o PSF e UBS foi de 10,39 e 8,82 nas consultas, 9,87 e 8,57 para pressão arterial, 1,04 e 1,22 no tipo sanguíneo, 2,17 e 1,86 para glicemia, 1,32 e 1,05 para HbsAg, 2,35 e 1,89 para parcial de urina e 2,64 e 2,22 para cultura de urina com diferenças estatisticamente significativas (p<0,05) entre as unidades. Observaram-se diferenças na adequabilidade da assistência pré-natal entre as unidades PSF e UBS, com melhor desempenho no PSF. Alguns procedimentos como a verificação de altura uterina, batimentos cardiofetais, exames de urina e VDRL estão aquém dos percentuais esperados, necessitando rever e aperfeiçoar as práticas dos profissionais de saúde na atenção pré-natal.

This study aimed to evaluate the adequacy of prenatal care according to Protocol Mother Curitibana in a primary care unit with the Family Health Program (PSF) and other traditional health unit (UBS). Cross-sectional study with retrospective data from medical records registered between February 2010 and January 2011. We excludedwomen who had abortions and abandonment of prenatal care, totaling 158 pregnant women, 79 unit PSF and the rest of UBS. The average onset of prenatal care was 11± 6.26 weeks, and mean analysis of prenatal records for PSF and UBS for pregnant women were 10.39 and 8.82 for consultations, 9.87 and 8.57 for blood pressure, 1.04 and 1.22 for blood type, 2.17 and 1.86 for glucose, 1.32 and 1.05 for HBsAg, 2.35 and 1.89 for Partial Urine and 2.64 and 2.22 for Urine Culture with statistically significant differences (p <0.05) between the units. This study found differences in the adequacy of prenatal care between PSF and traditional models UBS highlighting the best performance of the model PSF. It also identified some procedures like verification of uterine height growth, beats fetal cardiac and urine analysis and VDRL short of the expected percentage, requiring review and improve practices of health professionals in prenatal care

[Analysis of information sources about breast self examination available on the Internet]. / Análise das fontes de informação sobre os autoexames da mama disponíveis na Internet.

OBJECTIVE: To analyze the information about breast self examination available on the Internet. METHODS: A descriptive documental study was performed via a search on the Google® and Yahoo® websites using the phrase "breast self examination" in Portuguese, and the first 50 results from each site were analyzed using the criteria of the American Medical Association and Health on the Net. RESULTS: 68 sites were selected and analyzed. Most of the sites were in the commercial domain, six were governmental sites and five were Portuguese sites. More than half had restrictions regarding criteria of authority and authorship; 61% did not have contact details and 52.94% considered breast self exam as part of a set of measures; 26.47% had correct and complete evidence-based content; 33.82% had context references. Government WebPages of health or professional institutions had restrictions regarding content or presentation. CONCLUSIONS: The information about breast self exam is heterogeneous. Only a small number of websites were concerned about quality criteria, both in terms of construction and content. The bulk of the information available is not evidence-based and there is potentially dangerous information for the patient. It is necessary to improve the quality of websites dealing with breast self exam.

Análise das fontes de informação sobre os autoexames da mama disponíveis na Internet / Analysis of information sources about breast self examination available on the Internet

OBJETIVO: Avaliar as informações sobre autoexame da mama disponíveis ao público da internet. Método: Estudo descritivo documental, cujo universo foi composto pelos sites "Google®" e "Yahoo®", utilizando-se o descritor "autoexame de mama". Buscaram-se os 50 primeiros resultados. As páginas Web foram analisadas pelos critérios da American Medical Association e da Health on the Net. Resultados: Foram selecionadas e analisadas 68 páginas. A maioria dos sites era de domínio comercial, seis governamentais e cinco portugueses. Mais da metade tinham restrições quanto ao critério de autoridade e autoria; 61% não apresentavam meio de contato e 52,94% consideravam o autoexame como parte de um conjunto de medidas; 26,47% possuíam o conteúdo baseado em evidências, preciso e completo; 33,82% possuíam referências dos conteúdos. Páginas-Web governamentais, de instituições de saúde ou profissionais possuíam restrições com relação ao conteúdo ou apresentação. Conclusões: As informações sobre autoexame de mama são heterogêneas. Poucas páginas demonstraram preocupação com critérios de qualidade, tanto da construção quanto do conteúdo. A maior parte das informações não está baseada em evidências e que podem trazer danos ao paciente. Há necessidade de melhorar a qualidade das páginas Web que abordam o tema.

OBJECTIVE: To analyze the information about breast self examination available on the Internet. Methods: A descriptive documental study was performed via a search on the Google®and Yahoo® websites using the phrase "breast self examination" in Portuguese, and the first 50 results from each site were analyzed using the criteria of the American Medical Association and Health on the Net. Results: 68 sites were selected and analyzed. Most of the sites were in the commercial domain, six were governmental sites and five were Portuguese sites. More than half had restrictions regarding criteria of authority and authorship; 61% did not have contact details and 52.94% considered breast self exam as part of a set of measures; 26.47% had correct and complete evidence-based content; 33.82% had context references. Government WebPages of health or professional institutions had restrictions regarding content or presentation. Conclusions: The information about breast self exam is heterogeneous. Only a small number of websites were concerned about quality criteria, both in terms of construction and content. The bulk of the information available is not evidence-based and there is potentially dangerous information for the patient. It is necessary to improve the quality of websites dealing with breast self exam.

HIV prevalence among blood donors in a blood bank in Curitiba (Brazil).

There still is no cure for the acquired immunodeficiency syndrome (AIDS). Its etiologic agent is the human immunodeficiency virus (HIV), and transmission occurs through sexual relationships, contacts with blood, and vertically (mother to child). In this study, we sought to determine the prevalence of HIV among blood donors at a blood bank in Curitiba. We studied 213,666 blood donations made from March 1, 1992, to April 25, 1999. Each potential blood donor first answered a questionnaire, submitted to a clinical examination, and filled out a self-exclusion card. Blood was collected and analyzed only from the candidates approved by the first two criteria. Two tests were used to detect HIV: ELISA for screening, and Western-Blot for confirmation. The results were analyzed statistically by determining the 95% confidence interval. Of the total number of donors, 156,942 were men, and 56,724 were women. There were 319 cases of HIV infection (244 men, 75 women). There were no significant differences between genders, or among the different age groups, or between first-donation and repeated-donation donors. There was a significant predominance of HIV infection among single individuals compared to married, widowed, and other individuals. The same occurred among married and divorced individuals compared to widowed subjects. The prevalence of HIV among blood donors was 0.149% (0.155% among men and 0.132% among women). The frequency of HIV was statistically identical among new blood donors and repeat donors. A large number of HIV-infected married women was also observed.

HIV prevalence among blood donors in a blood bank in Curitiba (Brazil)

There still is no cure for the acquired immunodeficiency syndrome (AIDS). Its etiologic agent is the human immunodeficiency virus (HIV), and transmission occurs through sexual relationships, contacts with blood, and vertically (mother to child). In this study, we sought to determine the prevalence of HIV among blood donors at a blood bank in Curitiba. We studied 213,666 blood donations made from March 1, 1992, to April 25, 1999. Each potential blood donor first answered a questionnaire, submitted to a clinical examination, and filled out a self-exclusion card. Blood was collected and analyzed only from the candidates approved by the first two criteria. Two tests were used to detect HIV: ELISA for screening, and Western-Blot for confirmation. The results were analyzed statistically by determining the 95 confidence interval. Of the total number of donors, 156,942 were men, and 56,724 were women. There were 319 cases of HIV infection (244 men, 75 women). There were no significant differences between genders, or among the different age groups, or between first-donation and repeated-donation donors. There was a significant predominance of HIV infection among single individuals compared to married, widowed, and other individuals. The same occurred among married and divorced individuals compared to widowed subjects. The prevalence of HIV among blood donors was 0.149 (0.155 among men and 0.132 among women). The frequency of HIV was statistically identical among new blood donors and repeat donors. A large number of HIV-infected married women was also observed.