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1.
Rev Med Suisse ; 19(833): 1270-1276, 2023 Jun 28.
Artigo em Francês | MEDLINE | ID: mdl-37378606

RESUMO

This article translates and synthesizes a reference guide containing iconographic material of the pre- and post-pubertal female external genitals with and without genital mutilation/cutting (FGM/C). The literature focuses on adults, whereas FGM/C are usually performed before the age of 15. Signs of FGM/C can be subtle and depend on the type of mutilation as well as the experience of the examiner. Published in 2022 and produced with the collaboration of 23 professionals, this illustrated guide "Female Genital Mutilation/Cutting in Children and Adolescents: Illustrated Guide to Diagnose, Assess, Inform and Report, https://link.springer.com/book/10.1007/978-3-030-81736-7 " is currently available in open access. It is aimed at facilitating the training of health professionals in making diagnosis, clinical management, and reporting to child safeguarding/law enforcement agencies, where required.


Cet article traduit et synthétise un guide de références contenant du matériel iconographique sur la vulve pré et postpubère avec et sans mutilation génitale féminine ou excision (MGF/E). La littérature disponible se concentre sur les adultes alors que les MGF/E sont généralement pratiquées avant l'âge de 15 ans. Les signes peuvent être subtils et dépendent du type de mutilation ainsi que de l'expérience de l'examinateur-ice. Paru en 2022 et réalisé grâce à la collaboration de 23 professionnel-les, « Female Genital Mutilation/Cutting in Children and Adolescents: Illustrated Guide to Diagnose, Assess, Inform and Report, https://link.springer.com/book/10.1007/978-3-030-81736-7 ¼ est disponible en libre accès. Il vise à former les professionnel-les à l'établissement de diagnostics, à une prise en charge adaptée, ainsi qu'au signalement auprès des organismes de protection de l'enfance, si nécessaire.


Assuntos
Circuncisão Feminina , Adulto , Feminino , Criança , Adolescente , Humanos , Pessoal de Saúde
2.
Blood Coagul Fibrinolysis ; 34(4): 250-253, 2023 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-37017006

RESUMO

Heavy menstrual bleeding is one of the most common causes of consultation in haematology. We present the clinical case of a 20-year-old woman referred by her gynaecologist due to heavy menstrual bleeding since menarche, complicated by iron deficiency anaemia. Haemostasis work-up was initially suggestive of a von Willebrand disease type 1. Genetic analyses by whole exome sequencing lead to a fortuitous discovery of haemophilia by identifying a heterozygous missense mutation in F8 , exon 8 c.1127T>G:p.Val376Gly, previously reported in a patient with mild haemophilia A. The bleeding phenotype worsened by concomitant low von Willebrand factor (VWF) due to VWF variants influencing VWF levels. Our case highlights how whole exome sequencing can help to correct an erroneous diagnosis and identify polymorphisms that eventually contribute to the overall haemostatic balance.


Assuntos
Hemofilia A , Hemostáticos , Menorragia , Feminino , Humanos , Fator VIII/genética , Fator de von Willebrand/genética , Menorragia/genética
3.
Contraception ; 123: 110004, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36914147

RESUMO

OBJECTIVES: To compare patient-reported pain, bleeding, and device safety between intrauterine contraceptive device (IUD) insertion procedures employing a suction cervical stabilizer or single-tooth tenaculum. STUDY DESIGN: This was a randomized, prospective, single-blinded study conducted at two centers, enrolling women aged 18 years or older, eligible for IUD insertion. The primary end point measure was patient-reported pain, measured on a 100-mm Visual Analogue Scale. Safety was assessed on the amount of bleeding, adverse events, and serious adverse events. RESULTS: One hundred women were randomized, 48 to the investigational device and 52 to control. There were no statistically significant differences between the groups in factors potentially associated with pain on IUD insertion. IUD insertion was successful in 94% of all subjects. Subjects in the investigational device group reported pain scores ≥14 points lower than in the control group at cervix grasping (14.9 vs 31.3; p < 0.001) and traction (17.0 vs 35.9; p < 0.001), and smaller differences in pain scores at the IUD insertion (31.5 vs 44.9; p = 0.021) and cervix-release (20.6 vs 30.9; p = 0.049) steps. Nulliparous women experienced the greatest pain differences to control. Mean blood loss was 0.336 (range 0.022-2.189) grams in the investigational device group and 1.336 (range 0.201-11.936) grams in the control group, respectively (p = 0.03 for the comparison). One adverse event (bruising and minor bleeding) in the investigational device group was considered causally related to the study device. CONCLUSIONS: The suction cervical stabilizer had a reassuring safety profile and its use was associated with significant reductions in pain during the IUD insertion procedure compared with standard single-tooth tenaculum use, particularly among nulliparous women. IMPLICATIONS: Pain can be an important barrier to greater use of IUD devices among prescribers and users, particularly nulliparous women. The suction cervical stabilizer may provide an appealing alternative to currently available tenacula, filling an important unmet need.


Assuntos
Anticoncepcionais , Dispositivos Intrauterinos , Feminino , Humanos , Estudos Prospectivos , Colo do Útero , Sucção/efeitos adversos , Método Duplo-Cego , Dor/etiologia , Dispositivos Intrauterinos/efeitos adversos
4.
BMC Res Notes ; 16(1): 35, 2023 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-36915205

RESUMO

OBJECTIVE: To evaluate if daily oral 75 µg of Desogestrel (DSG) for 3 months prior to the insertion of etonogestrel-releasing contraceptive implant (ENG-IMPLANT) might help reduce its premature discontinuation. RESULTS: A total of 66 women were randomized in the ENG-IMPLANT group (26) and in the DSG + ENG-IMPLANT group (40), respectively, in the Geneva University Hospitals and Basel University Hospital, from August 15th, 2016 through September 30th, 2019. In the DSG + ENG-IMPLANT group, patients were given a 3 months' supply of 75 µg of DSG before the insertion of the ENG-IMPLANT. All women were seen after 3 months for bleeding and satisfaction evaluation, and at 12 months post ENG-IMPLANT insertion. Higher levels of satisfaction at 12-months were found in the ENG-IMPLANT group compared to the DSG + ENG-IMPLANT group (8.5 ± 1.7 vs. 6.6 ± 2.9, p = 0.012). There were no statistically significant differences regarding tolerance (7.8 ± 2.5 vs 6.8 ± 2.6, p = 0.191) and contraceptive continuation (80% vs 72.4%, p = 0.544) between groups. CONCLUSION: DSG prior to insertion of the ENG-IMPLANT did not improve its continuation rate neither its satisfaction at 1 year. Trial registration NCT05174195. Retrospectively registered, the 30th December 2021.


Assuntos
Anticoncepcionais Femininos , Desogestrel , Humanos , Feminino , Levanogestrel , Fatores de Tempo
5.
J Paediatr Child Health ; 58(3): 382-387, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35000235

RESUMO

Paediatricians may face the notion of 'virginity' in various situations while caring for children and adolescents, but are often poorly prepared to address this sensitive topic. Virginity is a social construct. Despite medical evidence that there is no scientifically reliable way to determine virginity, misconceptions about the hymen and its supposed association with sexual history persist and lead to unethical practices like virginity testing, certificate of virginity or hymenoplasty, which can be detrimental to the health and well-being of females of all ages. The paediatrician has a crucial role in providing evidence-based information and promoting positive sexual education to children, adolescents and parents. Improving knowledge can help counter misconceptions and reduce harms to girls and women.


Assuntos
Hímen , Abstinência Sexual , Adolescente , Criança , Feminino , Humanos , Hímen/cirurgia , Pais , Pediatras , Comportamento Sexual
6.
Eur J Obstet Gynecol Reprod Biol ; 266: 77-82, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34600188

RESUMO

BACKGROUND AND PURPOSE: We aimed to examine epidemiological data and identify risk factors for sexual assault. This study included women seeking care at the Geneva University Hospitals emergency obstetrics and gynaecological unit. METHOD: Retrospective, sociodemographic, and clinical data were collected from the medical reports. RESULTS: We reviewed 836 medical charts and registered 92.8 women and girls per year who consulted the emergency department after sexual assault. The average age was 26 (±12) years, with a median of 23 years. Body lesions were reported in 525 patients (63%) and genital traumatic lesions were reported in 230 (28%) patients. Sexual assault by a stranger was reported in 436 cases (52%). Thirty percent of patients knew their aggressor. Aggressions were predominantly committed on the weekend, accounting for 367 cases (46%), with nearly two-thirds (65%, n = 474) occurring between 10 pm and 6 am. In total, 399 (48%) patients who were sexually assaulted reported having consumed alcohol and 102 (12%) reported having taken drugs prior to the aggression; 80 (10%) patients had consumed both and 286 (34%) had amnesia. Half of the sample sought and received medical care within 24 h from the time the aggression took place. CONCLUSION: Sexual assault risk factors in our study population in Geneva included use of drugs and alcohol, with amnesia. Future prevention and education interventions should target these areas.


Assuntos
Delitos Sexuais , Adulto , Feminino , Humanos , Gravidez , Encaminhamento e Consulta , Estudos Retrospectivos , Fatores de Risco , Comportamento Sexual
7.
Rev Med Suisse ; 17(755): 1798-1802, 2021 Oct 20.
Artigo em Francês | MEDLINE | ID: mdl-34669295

RESUMO

Progesterone (P4), a steroid primarily secreted by the corpus luteum, placenta and adrenal glands, plays an essential role on female reproductive function. Progestins (PS) are synthetic analogues of P4 with specific steroid receptor affinities. A progestin-only-pill (POP) with an antimineralocorticoid effect was recently marketed with a tolerance and safety profile superior to existing POPs. In contrast, PS with antiandrogenic properties used at high doses for the treatment of hirsutism have been associated with an increased meningioma risk. New clinical and fundamental data open paths for research into the therapeutic use of P4 in cognition, neuroprotection and bone.


La progestérone (P4), stéroïde sécrété principalement par le corps jaune, le placenta et les glandes surrénales, joue un rôle essentiel dans le contrôle de la fonction reproductive de la femme. Les progestatifs de synthèse (PS) sont des analogues avec des affinités spécifiques sur les divers récepteurs stéroïdiens. Une pilule progestative (POP) aux effets antiminéralocorticoïdes a récemment été commercialisée avec un profil de tolérance et de sécurité supérieur aux POP existants. En revanche, des PS aux propriétés antiandrogènes utilisés en forte dose pour le traitement de l'hirsutisme ont été associés à un risque accru de méningiome. De nouvelles données cliniques et fondamentales ouvrent de nouvelles voies de recherche sur l'utilisation thérapeutique de la P4 dans les champs de la cognition, de la neuroprotection et de l'os.


Assuntos
Ginecologia , Feminino , Humanos , Placenta , Gravidez , Progesterona , Progestinas/uso terapêutico
8.
Swiss Med Wkly ; 151: w20531, 2021 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-34318911

RESUMO

AIMS OF THE STUDY: Remote follow-up based on self-assessment plus a telephone call with a healthcare provider is a safe and reliable method for assessing the success of medical termination of pregnancy (mTOP) and can lead to an important reduction in costs. The aim of the study was to analyse its efficacy, acceptability and associated costs. METHODS: This was a retrospective comparative study analysing two follow-up protocols for home-based mTOP. A total of 201 women were included: 56 for a standard in-clinic follow-up and 145 for a remote follow-up based on self-assessment with a low-sensitivity urine pregnancy test and a questionnaire. The main outcome was the total number of outpatient consultations needed for each procedure and the associated costs (according to the Swiss tariff system); acceptability and satisfaction were assessed using questionnaires. RESULTS: Demand for home-based termination increased by 7.8% in the observation period. There was a reduction in diagnosis of retained products of conception, with a consequent decrease of follow-up consultations from 1.47 to 0.41 appointments per patient. A reduction of 38.9% in the average cost per patient (including supplementary follow-up appointments) was observed. Moreover, the remote alternative led to higher patient satisfaction (95.1% vs 55.0%) and acceptability (84.8%). The choice for long-acting reversible contraceptives was not affected by the removal of in-person consultation. CONCLUSION: A remote follow-up procedure is an acceptable and less costly alternative to hospital-based follow-up with a higher rate of acceptability and adherence by the studied population.


Assuntos
Aborto Induzido , Autoavaliação (Psicologia) , Feminino , Seguimentos , Hospitais Universitários , Humanos , Gravidez , Estudos Retrospectivos
9.
J Pediatr Adolesc Gynecol ; 34(6): 805-810, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33989802

RESUMO

STUDY OBJECTIVE: The FertiSTAT (fertility status awareness) tool provides personalized advice on reducing risk factors for infertility and seeking medical advice on the basis of lifestyle and reproductive profile. The aim of our research was to test the FertiSTAT tool in younger patients (14-24 years). A secondary objective was to screen for and evaluate knowledge of risk factors that affect fertility. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: Patients aged 14-24 years attending consultations at Geneva University Hospitals received a quantitative questionnaire before consultations. Questions covered lifestyle, gynecological history, perception of fertility, and pregnancy intent. We investigated respondents' beliefs with regard to risk factors for infertility through "true/false" questions. We selected questions relevant to our population from the original FertiSTAT questionnaire to calculate each respondent's FertiSTAT score. Scores ranged from "blue" (low risk, score 1) to "red" (risk of infertility, score 4). RESULTS: A total of 279 women aged 14-24 years were included. Nonpregnant patients had overall higher FertiSTAT scores (2.7 ± 0.8). Upon logistic regression analysis, with every additional FertiSTAT point, the odds of being pregnant at the time of survey decreased by 0.48. Risk factors for infertility and knowledge of these risk factors were equally distributed between pregnant and nonpregnant women. CONCLUSION: Our findings suggest FertiSTAT might be a useful tool in the younger population to whom we extended it, and highlight gaps in knowledge on risk factors for infertility. These findings are of interest when considering FertiSTAT as a starting point to discuss contraception and risk factors for infertility at an age at which risk mitigation would prove most effective in preserving future fertility.


Assuntos
Infertilidade , Saúde Sexual , Adolescente , Anticoncepção , Feminino , Fertilidade , Humanos , Gravidez , Comportamento Sexual
10.
BMJ Case Rep ; 14(3)2021 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-33664020

RESUMO

A 37-year-old woman, gravida 2 para 1, arrived in our emergency clinic at 16 2/7 weeks of a spontaneously conceived pregnancy for abdominal pain. She was on oral antibiotics for 2 days to treat a suspected urinary tract infection with no improvement. Blood tests, abdominal ultrasound and intrauterine fetus were all normal. She left our emergency unit with laxatives. Four days later, she returned to our clinic with severe abdominal pain. We repeated abdominal and foetal ultrasonography and identified a left para-uterine 7×5 cm mass. As adnexal torsion was suspected, we performed an emergency laparoscopy. At laparoscopy, we found a left haematosalpinx and realised a left salpingectomy. Histology confirmed the presence of a heterotopic pregnancy (HP). This case illustrates the importance of exploring the adnexa in a gravid woman presenting with abdominal pain in the first and early second trimesters. Although rare, excluding a HP may prevent a life-threatening haemorrhage.


Assuntos
Doenças Ovarianas , Gravidez Heterotópica , Adulto , Feminino , Idade Gestacional , Humanos , Gravidez , Gravidez Heterotópica/diagnóstico por imagem , Gravidez Heterotópica/cirurgia , Salpingectomia , Ultrassonografia
11.
Eur J Contracept Reprod Health Care ; 26(1): 62-72, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33155860

RESUMO

PURPOSE: The aim of this study is to identify the aspects associated with resistance to contraception, providing healthcare workers with the necessary tools to increase compliance with contraception and, ultimately, reduce the rate of voluntary abortions. MATERIAL AND METHODS: We performed a review of the literature published in Medline between 1st January 2000 and 31st July 2020. We included studies based on qualitative analyses, describing women's perception and attitudes towards contraception, including a population aged 15 years or older and conducted in either Europe or North America. RESULTS: A total of 23 articles were included in the study. Resistance to contraceptive uptake was most frequently due to ambivalence about pregnancy, with up to 54% of ambivalent women reporting not using any means of contraception, and communication issues with the partner and/or health care provider, with a positive association found between communication with the partner and contraceptive use (OR 1.07; p < .050). Additional barriers to contraceptive use were the quality of the relationship with the partner, the perception of the risk of becoming pregnant after unprotected sexual intercourse, and unfamiliarity with contraception. CONCLUSIONS: Family planning consultations should acknowledge the aspects that influence contraceptive uptake and address them as part of their consultations.


Assuntos
Comportamento Contraceptivo , Anticoncepção , Conhecimentos, Atitudes e Prática em Saúde , Aborto Induzido , Atitude , Serviços de Planejamento Familiar , Feminino , Acesso aos Serviços de Saúde , Humanos , Gravidez , Educação Sexual
12.
J Gynecol Obstet Hum Reprod ; 50(2): 102029, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33259962

RESUMO

Ovarian failure is a major long-term adverse event following gonadotoxic treatment of malignant diseases. Ovarian tissue cryopreservation can be offered in some conditions to preserve fertility. We report the case of a 13-year-old female with a diagnosis of acute myeloid leukemia, who presented with hypergonadotropic hypogonadism after unilateral ovariectomy for fertility preservation and before highly gonadotoxic treatment. Even though damage seemed only partial, this case suggests that the remaining contralateral ovarian function may be compromised after ovarian tissue cryopreservation, leading per se to a hypergonadotropic hypogonadism. Although indication of ovarian cryopreservation is not called into question in situations of highly gonadotoxic therapy, this procedure should only be performed after evaluation by a specialized multidisciplinary team and provided a solid indication.


Assuntos
Criopreservação , Preservação da Fertilidade , Hipogonadismo/etiologia , Ovariectomia , Adolescente , Feminino , Humanos , Leucemia Mieloide Aguda/terapia
13.
Sci Rep ; 10(1): 9666, 2020 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-32541810

RESUMO

The villous cytotrophoblastic cells have the ability to fuse and differentiate, forming the syncytiotrophoblast (STB). The syncytialisation process is essential for placentation. Nevertheless, the mechanisms involved in cell fusion and differentiation are yet to be fully elucidated. It has been suggested that cell surface glucose-regulated protein 78 (GRP78) was involved in this process. In multiple cancer cells, cell membrane-located GRP78 has been reported to act as a receptor binding to the active form of α2-macroglobulin (α2M*), activating thus several cellular signalling pathways implicated in cell growth and survival. We hypothesised that GRP78 interaction with α2M* may also activate signalling pathways in trophoblastic cells, which, in turn, may promote cell fusion. Here, we observed that α2M mRNA is highly expressed in trophoblastic cells, whereas it is not expressed in the choriocarcinoma cell line BeWo. We thus took advantage of forskolin-induced syncytialisation of BeWo cells to study the effect of exogenous α2M* on syncytialisation. We first demonstrated that α2M* induced trophoblastic cell fusion. This effect is dependent on α2M*-GRP78 interaction, ERK1/2 and CREB phosphorylation, and unfolded protein response (UPR) activation. Overall, these data provide novel insights into the signalling molecules and mechanisms regulating trophoblastic cell fusion.


Assuntos
Coriocarcinoma/genética , Proteínas de Choque Térmico/metabolismo , Trofoblastos/citologia , Neoplasias Uterinas/genética , alfa-Macroglobulinas/genética , Fusão Celular , Linhagem Celular , Coriocarcinoma/metabolismo , Proteína de Ligação ao Elemento de Resposta ao AMP Cíclico/metabolismo , Regulação para Baixo , Chaperona BiP do Retículo Endoplasmático , Feminino , Humanos , Sistema de Sinalização das MAP Quinases , Fosforilação , Gravidez , Transdução de Sinais , Trofoblastos/metabolismo , Resposta a Proteínas não Dobradas , Neoplasias Uterinas/metabolismo , alfa-Macroglobulinas/metabolismo
14.
Rev Med Suisse ; 16(691): 789-793, 2020 Apr 22.
Artigo em Francês | MEDLINE | ID: mdl-32320155

RESUMO

Transgender, non-binary and questioning teenagers are increasingly visible. However, they face barriers in accessing appropriate care that meet their needs, both specific and regarding their general health. Primary care physicians increasingly see them in consultations but often lack elements of communication and recent knowledge that is needed to accompany them and their close ones in their -individual trajectories. This article aims to answer this need and provides a synthesis about recent evidence and suggested communication approaches for primary care physicians, who play a central role for the health of all patients.


Les adolescents transgenres, non binaires ou en questionnement sont de plus en plus visibles et font face à de nombreux obstacles pour accéder à des soins appropriés, tant pour leurs besoins de santé spécifiques que généraux. Les médecins de premier recours les rencontrent au cabinet et peuvent manquer d'éléments de communication et de connaissances spécifiques récentes pour mener la consultation et accompagner ces personnes et leurs proches dans leurs trajectoires individuelles. Cet article propose une synthèse des éléments et des ressources utiles pour le médecin de premier recours, dont le rôle est ­central pour la santé de tous les patients.


Assuntos
Comunicação , Atenção Primária à Saúde/métodos , Encaminhamento e Consulta , Pessoas Transgênero , Transexualidade , Adolescente , Humanos
15.
J Pediatr Adolesc Gynecol ; 33(3): 260-263, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31726095

RESUMO

STUDY OBJECTIVE: To provide an objective quantification of the demographic characteristics and clinical findings related to female child and adolescent sexual abuse cases reported at the Geneva University Hospitals. DESIGN: Retrospective study. SETTING: Obstetrics and gynecology emergency unit. PARTICIPANTS: Female children (0-12 years old) and adolescents (13-20 years old) seeking primary care after sexual assault. INTERVENTIONS: None, observational study. MAIN OUTCOME MEASURES: Delay from assault to time of presentation to primary care presentation, type of perpetrators, and the presence gynecological and bodily lesions. RESULTS: Compared with children, a significantly higher proportion of adolescents presented to the hospital within 24 hours (134/289 (46.4%) vs 7/33 (21.2%); P = .006). Perpetrators were family members in 15/36 (41.7%) of children and in only 14/304 (4.6%) of adolescent patients (P < .00001); perpetrators were unfamiliar/nonrelated people in 8/36 (22.2%) of children and in 166/304 (54.6%) of adolescent patients (P < .0003). We did not find a significant difference between the 2 age groups with regard to the presence of gynecological lesions (15/35 (42.9%) of children and 91/298 (30.5%) of adolescent patients). However, we found a significant difference in the proportion of patients with bodily lesions such that 11/36 (30.6%) of children and 175/300 (58.3%) of adolescents (P = .002) were afflicted with bodily lesions. CONCLUSION: To our knowledge this is the first study to evaluate child and adolescent sexual abuse cases on the basis of real-life data collected in Switzerland. Our results highlight important differences in child and adolescent sexual assault in terms of delay in presentation to primary care, perpetrator's relation to the victim, and presence of bodily lesions. This study confirms that gynecological findings alone are not consistently present in the patients who seek primary care after sexual assault.


Assuntos
Abuso Sexual na Infância/estatística & dados numéricos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Exame Ginecológico/normas , Adolescente , Adulto , Distribuição por Idade , Criança , Abuso Sexual na Infância/diagnóstico , Pré-Escolar , Feminino , Hospitais Universitários/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Masculino , Gravidez , Estudos Retrospectivos , Suíça , Tempo para o Tratamento , Adulto Jovem
16.
Eur J Contracept Reprod Health Care ; 24(4): 288-293, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31169412

RESUMO

Objective: The aim of the study was to assess the acceptability of the intrauterine ball IUB Ballerine MIDI copper intrauterine device (IUD), using real-world data collected from users and physicians. Methods: In this retrospective, observational study, conducted in the French-speaking region of Switzerland, healthy women (n= 207) who had had an IUB Ballerine MIDI inserted ≥12 months before enrolment, and their physicians completed questionnaires relating to device insertion, user experience and outcome. Questions relating to current menstrual patterns, physical comfort and product satisfaction were only posed to women still using the device. Results: The mean age at insertion was 30.8 ± 7.2 years, with an average 14.2 ± 2.9 month lapse from time of insertion until study commencement. At the time of the study, 140 (67.6%) women were still using the device. The expulsion rate was 5.3% (n= 11) and the pregnancy rate was 1.4% (n= 3). Most of the women still using the device reported no to moderate pain or cramps (80.7%). The majority of women reported moderate to high (65.7%) satisfaction with the device, with 81.4% claiming they would recommend it to friends and relatives. Over 84.8% of physicians reported that the device was easy to insert, with no difficulties encountered during the procedure. Conclusions: The IUB Ballerine MIDI was demonstrated to be safe and acceptable in different clinical settings and risk groups among a socioeconomically and demographically diverse study population.


Assuntos
Atitude do Pessoal de Saúde , Dispositivos Intrauterinos de Cobre , Satisfação do Paciente , Médicos/psicologia , Adolescente , Adulto , Feminino , Humanos , Expulsão de Dispositivo Intrauterino , Satisfação do Paciente/estatística & dados numéricos , Gravidez , Taxa de Gravidez , Estudos Retrospectivos , Suíça , Saúde da Mulher , Adulto Jovem
17.
Int J Womens Health ; 11: 153-159, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30881144

RESUMO

OBJECTIVE: The aim of this study was to 1) evaluate the Swiss physicians' attitudes and beliefs on intrauterine device (IUD) use in multiparous and nulliparous women and 2) determine whether the woman's parity was a factor influencing the gynecologists' IUD practice. MATERIAL AND METHODS: The Global Survey questionnaire investigating IUD use was modified and adapted to the Swiss guidelines. A link to the online questionnaire was sent to gynecologists practicing in the French- and German-speaking parts of Switzerland. We defined IUD use as frequent whenever it was prescribed by gynecologists for 25% or more out of all women consulting for contraception. RESULTS: A total of 299/1,696 gynecologists completed the online questionnaire (17.6%). Frequent IUD prescription was found in 72.9% of multiparous and in 11.8% of nulliparous women. The most frequently reported barriers to IUD use in nulliparous women were as follows: concern over a painful insertion, difficulty of insertion, higher risk of perforation, pelvic inflammatory disease, changes in bleeding pattern, high cost, and risk of extrauterine pregnancy. The presence of such perceived obstacles was associated with less frequent IUD insertion in nulliparous women. CONCLUSION: The results of this study provide a valuable insight into the attitudes and opinions of Switzerland's gynecologists on the use of IUDs in nulliparous and multiparous women, showing that the women's parity is a factor influencing the physicians' attitudes and opinions. Further health education might help minimize the physicians' attitude discrepancies in IUD prescription to nulliparous and multiparous women.

18.
J Forensic Sci ; 64(4): 1119-1124, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30556905

RESUMO

In Geneva, examination of victims of sexual assault is performed by a gynecologist and a medical examiner. 48% of the victims file a complaint and we wanted to investigate the factors leading to file a complaint, those leading the Prosecutor to go to trial, and those influencing a conviction. Between 2006 and 2012, 676 victims of sexual assault were investigated (averaged age 26 year, mean 22). Information on injuries, perpetrators, and circumstances of the assault was collected and analyzed. The attacker being the ex-spouse or a friend and the presence of semen were factors leading to file a complaint. The assailant being a family member or ex-spouse and the presence of genital/anal lesions were factors influencing the Prosecutor. The presence of nongenital lesions, the assailant being known by the victim, influenced conviction. This study shows that the medical examiner plays a vital role in the investigation of cases of sexual assault.


Assuntos
Vítimas de Crime/legislação & jurisprudência , Vítimas de Crime/estatística & dados numéricos , Delitos Sexuais/legislação & jurisprudência , Delitos Sexuais/estatística & dados numéricos , Adulto , Médicos Legistas , Coleta de Dados , Feminino , Ginecologia , Humanos , Masculino , Médicos , Sêmen , Suíça/epidemiologia , Armas/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia , Adulto Jovem
19.
Rev Med Suisse ; 14(624): 1893-1897, 2018 Oct 24.
Artigo em Francês | MEDLINE | ID: mdl-30375790

RESUMO

Mycoplasma genitalium (MG) is a sexually transmitted pathogen with a poorly understood natural history. Often asymptomatic, it has been associated with urogenital conditions. The implementation of NAAT (Nucleic Acide Amplification Test) has not only improved the detection of MG, but also brought to light the emergence of antibiotic resistances, hence challenging the proposed treatment strategies and questioning the indication for systematic screening. This article summarizes current knowledge on MG among women, over viewing incidence, prevalence and clinical implications. It resumes the last guidelines in terms of screening and treatment.


Mycoplasma genitalium (MG) est un pathogène sexuellement transmissible souvent asymptomatique, dont la pathogénicité est méconnue. Source croissante d'intérêt car mieux détecté depuis l'implémentation des NAAT (Nucleic Acide Amplification Test), MG serait incriminé dans diverses pathologies uro-génitales. L'émergence des résistances aux antibiotiques est un enjeu de taille dans le traitement de l'infection et soulève le débat sur l'utilité d'un dépistage systématique. Cet article résume l'état des connaissances actuelles au sujet de MG chez la femme : son incidence, sa prévalence ainsi que ses implications cliniques. Il fait la synthèse des dernières recommandations en termes de dépistage et de traitement.


Assuntos
Infecções por Mycoplasma , Mycoplasma genitalium , Feminino , Humanos , Programas de Rastreamento , Infecções por Mycoplasma/diagnóstico , Infecções por Mycoplasma/epidemiologia , Infecções por Mycoplasma/terapia , Prevalência
20.
Rev Med Suisse ; 14(603): 843-848, 2018 Apr 18.
Artigo em Francês | MEDLINE | ID: mdl-29668148

RESUMO

Parents are often reluctant to discuss sexuality and romantic relationships with their teenagers. However, these discussions can have a strong impact on their children's health. Care providers can act as a reliable source of information to support parents in this task. Through repeated short interactions with their child over their adolescence, parents can cover most topics related to sexuality, based on teenagers' questions and the situations that they face (e.g. LGBT bullying at school). This article summarizes current best practice on how to facilitate parental dialogue with adolescents about sexuality and offer care providers guidance in transmitting this information to parents.


Les parents sont souvent réticents à parler de sexualité et de relations amoureuses avec leurs adolescents. Cependant, ces discussions ont un rôle majeur pour la santé de leurs enfants. Les professionnels de santé sont une source d'informations fiable et de soutien pour les parents dans cette démarche. De nombreuses interactions courtes durant les années de l'adolescence, entre parents et adolescents, basées sur des questions et des situations rencontrées permettent de couvrir les nombreuses thématiques liées à la sexualité. Cet article propose une aide pour les professionnels de santé afin d'informer les parents et les encourager à ouvrir le dialogue avec leurs enfants. Il résume les meilleures pratiques pour favoriser la communication avec des adolescents concernant la sexualité.

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