Factors Associated With Fragility Fractures In Women Over 50 Years Of Age: A Population-based Household Survey [fatores Associados A Fraturas Por Fragilidade óssea Em Mulheres Acima De 50 Anos De Idade: Um Estudo De Base Populacional]

Purpose: To analyze the prevalence of and factors associated with fragility fractures in Brazilian women aged 50 years and older. Methods: This cross-sectional population survey, conducted between May 10 and October 31, 2011, included 622 women aged ≥50 years living in a city in southeastern Brazil. A questionnaire was administered to each woman by a trained interviewer. The associations between the occurrence of a fragility fracture after age 50 years and sociodemographic data, health-related habits and problems, self-perception of health and evaluation of functional capacity were determined by the χ2 test and Poisson regression using the backward selection criteria. Results: The mean age of the 622 women was 64.1 years. The prevalence of fragility fractures was 10.8%, with 1.8% reporting hip fracture. In the final statistical model, a longer time since menopause (PR 1.03; 95%CI 1.01-1.05; p<0.01) and osteoporosis (PR 1.97; 95%CI 1.27-3.08; p<0.01) were associated with a higher prevalence of fractures. Conclusion: These findings may provide a better understanding of the risk factors associated with fragility fractures in Brazilian women and emphasize the importance of performing bone densitometry.3511497502Instituto Brasileiro de Geografia e Estatística (IBGE) [Internet]., , http://censo2010.ibge.gov.br/resultados, Censo 2010: resultados [citado 2013 Fev 14]. Disponível emKanis, J.A., Odén, A., McCloskey, E.V., Johansson, H., Wahl, D.A., Cooper, C., A systematic review of hip fracture incidence and probability of fracture worldwide (2012) Osteoporos Int., 23 (9), pp. 2239-2256Hughson, J., Newman, J., Pendleton, R.C., Hip fracture management for the hospital-based clinician: A review of the evidence and best practices (2011) Hosp Pract (1995)., 39 (1), pp. 52-61Auron-Gomez, M., Michota, F., Medical management of hip fracture (2008) Clin Geriatr Med., 24 (4), pp. 701-719+ixPinheiro, M.M., Ciconelli, R.M., Martini, L.A., Ferraz, M.B., Clinical risk factors for osteoporotic fractures in Brazilian women and men: The Brazilian Osteoporosis Study (BRAZOS) (2009) Osteoporos Int., 20 (3), pp. 399-408Siqueira, F.V., Facchini, L.A., Hallal, P.C., The burden of fractures in Brazil: A population-based study (2005) Bone., 37 (2), pp. 261-266Pinheiro, M.M., Reis Neto, E.T., McHado, F.S., Omura, F., Yang, J.H.K., Szejnfeld, J., Risk factors for osteoporotic fractures and low bone density in pre and postmenopausal women (2010) Rev Saúde Pública., 44 (3), pp. 479-485Kanis, J.A., Johnell, O., Oden, A., Johansson, H., McCloskey, E., FRAX and the assessment of fracture probability in men and women from the UK (2008) Osteoporos Int., 19 (4), pp. 385-397Pinheiro, M.M., Eis, S.R., Epidemiology of osteoporotic fractures in Brazil: What we have and what we need (2010) Arq Bras Endocrinol Metabol., 54 (2), pp. 164-170FRAX: WHO Fracture Risk Assessment Tool [Internet]., , http://www.shef.ac.uk/FRAX/tool.aspx?country=55, Calculation tool [cited 2013 May 7]. Available fromLebrão, M.L., Duarte, Y.A.O., (2003) SABE-Saúde, bem-estar e envelhecimento-O projeto SABE no município de São Paulo: Uma abordagem inicial, , Brasília (DF): Organização Pan-Americana de Saúde(2008) Vigilância de fatores de risco e proteção para doenças crônicas não transmissíveis por entrevistas telefônicas (VIGITEL)., , http://portal.saude.gov.br/portal/arquivos/pdf/167_Q2008.pdf, Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde [Internet]. [citado 2013 Fev 14]. Disponível emGuralnik, J.M., Fried, L.P., Simonsick, E.M., Kasper, J.D., Lafferty, M.E., (1995) The women's health and aging study: Health and social characteristics of older women with disability., , editors. Bethesda: National Institute on Aging(NIH Pub. No. 95-4009)Altman, D.G., (1999) Practical statistics for medical research, , Boca Raton: Chapman & Hall/CRCBarros, A.J.D., Hirakata, V.N., Alternatives for logistic regression in cross-sectional studies: An empirical comparison of models that directly estimate the prevalence ratio (2003) BMC Med Res Methodol., 3, p. 21Baim, S., Leslie, W.D., Assessment of fracture risk (2012) Curr Osteoporos Rep., 10 (1), pp. 28-41(2010) Clinician's guide to prevention and treatment of osteoporosis, , National Osteoporosis Foundation. Washington, DC: National Osteoporosis FoundationBaccaro, L.F., McHado, V.S.S., Costa-Paiva, L., Sousa, M.H., Osis, M.J., Pinto-Neto, A.M., Treatment for menopausal symptoms and having health insurance were associated with a lower prevalence of falls among Brazilian women (2013) Maturitas., 75 (4), pp. 367-372Baccaro, L.F., McHado, V.S.S., Costa-Paiva, L., Souza, M.H., Osis, M.J., Pinto-Neto, A.M., Factors associated with osteoporosis in Brazilian women: A population-based household survey (2013) Arch Osteoporos., 8 (1-2), p. 138Kärkkäinen, M., Rikkonen, T., Kröger, H., Sirola, J., Tuppurainen, M., Salovaara, K., Association between functional capacity tests and fractures: An eight-year prospective population-based cohort study (2008) Osteoporos Int., 19 (8), pp. 1203-1210Recker, R., Lappe, J., Davies, K., Heaney, R., Characterization of perimenopausal bone loss: A prospective study (2000) J Bone Miner Res., 15 (10), pp. 1965-1973Ohta, H., Sugimoto, I., Masuda, A., Komukai, S., Suda, Y., Makita, K., Decreased bone mineral density associated with early menopause progresses for at least ten years: Cross-sectional comparisons between early and normal menopausal women (1996) Bone., 18 (3), pp. 227-231Gerdhem, P., Obrant, K.J., Bone mineral density in old age: The influence of age at menarche and menopause (2004) J Bone Miner Metab., 22 (4), pp. 372-375Portaria no 1101/GM, 12 junho 2002, , http://dtr2001.saude.gov.br/sas/PORTARIAS/Port2002/Gm/GM-1101.htm, Brasil. Ministério da Saúde [Internet]. [citado 2013 Fev 14]. Disponível em(2009) Indicadores sociodemográficos e de saúde no Brasil: 2009., , http://www.ibge.gov.br/home/estatistica/populacao/indic_sociosaude/2009/com_esca.pdf, Instituto Brasileiro de Geografia e Estatística (IBGE) [Internet]. Rio de Janeiro: IBGEEscassez e fartura: distribuição da oferta de equipamentos de diagnóstico por imagem no Brasil [citado 2013 Fev 14]. Disponível e

Urinary Incontinence Among Climateric Brazilian Women: Household Survey

Objective. To investigate the prevalence of stress urinary incontinence and its associated factors in perimenopause women using a population-based household survey. Methods. A descriptive, exploratory cross-sectional population-based study with secondary analysis of a population-based household survey on perimenopause and menopause was conducted among women living in the city of Campinas, Brazil. Through a sampling process, 456 women between 45 and 60 years old were selected. Complaints of urinary incontinence and related risk factors, such as age, socioeconomic status, education level, race, parity, smoking habits, body mass index, previous gynecological surgeries, menopausal status, and hormonal replacement therapy were explored. Data were collected through home interviews using an adapted version of the structured pre-tested questionnaire elaborated by the International Health Foundation, International Menopause Society and the American Menopause Society. Statistical analysis were performed using prevalence rates (CI 95%). Results. Thirty-five percent of the interviewees referred stress urinary incontinence. None of the sociodemographic factors studied was associated to the risk of urinary incontinence. In addition, parity did not significantly change the risk of urinary incontinence. Other factors, such as previous gynecological surgeries, body mass index, and smoking habits, were not associated with the prevalence of stress urinary incontinence. Also, menopausal status and hormonal replacement therapy did not change the risk of stress urinary incontinence. Conclusion. Though there was a high prevalence of stress urinary incontinence among perimenopause women, there was not found any associations with sociodemographic and reproductive factors.355428435Bortolotti, A., Bernardini, B., Colli, E., Di Benedetto, P., Giocoli Nacci, G., Landoni, M., Prevalence and risk factors for urinary incontinence in Italy (2000) Eur Urol, 37, pp. 30-35Brown, J.S., Grady, D., Ouslander, J.G., Herzog, A.R., Varner, R.E., Posner, S.F., Prevalence of urinary incontinence and associated risk factors in postmenopausal women (1999) Obstet Gynecol, 94, pp. 66-70. , Hert & Estrogen/Progestin Replacement Study (HERS) Research GroupBurgio, K.L., Mathews, K.A., Engel, B.T., Prevalence, incidence and correlates of urinary incontinence in healthy, middle-aged women (1991) J Urol, 146, pp. 1255-1259Comportamento sexual da população brasileira e percepção sobre o HIV/AIDS: Relatório final de pesquisa (1999), pp. 34-37. , Centro Brasileiro de Análise e Planejamento (CEBRAP), Ministério da Saúde-SPS-CNDST/HIV/AIDS. São PauloChiarelli, P., Brown, W., Mc Elduf, F.P., Leaking urine: Prevalence and associated factors in Australian women (1999) Neurourol Urodyn, 18, pp. 567-577Elving, L.B., Foldspang, A., Lam, G.W., Mommsen, S., Descriptive epidemiology of urinary incontinence in 3100 women age 30-59 (1989) Scand J Urol Nephrol, 125 (SUPPL.), pp. 37-43Fantl, J.A., Cardozo, L., Mc Clish, D.K., Estrogen therapy in the management of urinary incontinence in postmenopausal women: A meta-analisys (1994) Obstet Gynecol, 83, pp. 12-18. , First report of the Hormones and Urogenital Therapy CommiteeFantl, J.A., Bump, R.C., Robinson, D., Efficacy of estrogen supplementation in the treatment of urinary incontinece (1996) Obstet Gynecol, 88, pp. 745-749Guarisi, T., Pinto-Neto, A.M., Costa-Paiva, L.H.S., Pedro, A.O., Faúndes, A., Sintomas urinários e genitais em mulheres climatéricas (1998) J Bras Ginecol, 108, pp. 125-130Jaszmann, L., Epidemiology of climateric and postclimateric complaints (1973), pp. 22-24. , Van Keep PA, Lauritzen C, editors. Ageing and estrogens: front hormone research. Basel: KargerLaurenti, R., Mello-Jorge, M.L.P., Lebrão, M.L., Gotlieb, S.L.D., População: Recenseamento e estimativas (1987) Estatística de saúde., pp. 9-38. , editors. 2a ed. São Paulo: EPUMendonça, M., Reis, R.V., Macedo, C.B.M.S., Barbosa, K.S.R., Prevalência da queixa de incontinência urinária de esforço em pacientes atendidas no serviço de ginecologia do Hospital Júlia Kubitschek (1997) J Bras Ginecol, 107, pp. 153-155Moller, L.A., Lose, G., Jorgensen, T., The prevalence and bothersomeness of lower urinary tract symptons in women 40-60 years of age (2000) Acta Obstet Gynecol Scand, 79, pp. 298-305Thom, D.H., Brown, J.S., Reproductive and hormonal risk factors for urinary incontinence in later life: A review of the clinical and epidemiologic literature (1998) J Am Geriatr Soc, 46, pp. 1411-1417Van Geelen, J.M., Van de Weijer, P.H., Arnolds, H.T., Urogenital symptons and resulting discomfort in noninstitutionalized Dutch women aged 50-75 years (2000) Int Urogynecol J Pelvic Floor Dysfunct, 11, pp. 9-14Von Mühlen, D.G., Kritz-Silverstein, D., Barret-Connor, E., A community based study of menopause symptoms and estrogen replacement in older women (1995) Maturitas, 22, pp. 71-78Wilbur, J., Miller, A.M., Montgomery, A., Chandler, P., Sociodemographic characteristics, biological factors, an symptom reporting in midlife women (1998) Menopause, 5, pp. 43-5

Self-perception Of Sexual Life And Associated Factors: A Population Study Conducted In Women Aged 50 Or More Years [autopercepção De Vida Sexual E Fatores Associados: Estudo Populacional Em Mulheres Com 50 Anos Ou Mais]

Purpose: To evaluate the prevalence of women aged 50 years or more who are sexually active and their self-perception with respect to their sexual lives. Associated factors were also assessed. Methods: A cross-sectional, population-based, self-reported household survey involving 622 Brazilian women aged 50 years or more. Sociodemographic, clinical, and behavioral factors were evaluated. The sexual life self-perception was classified as very good, good, fair, poor, or very poor. Data were analyzed using the χ2 test, Fisher's exact test, and Poisson multiple regression analysis. Prevalence ratios and their 95% confidence intervals were also calculated. Results: Of the women in this sample, 228 (36.7%) reported having a sexual life and, of these, 53.5% classified it as very good or good, while 46.5% considered it fair, poor, or very poor. The bivariate analysis indicated that being postmenopausal (p=0.025) and using natural remedies to treat the menopause (p=0.035) were factors associated with the woman classifying their sexual lives as fair, poor, or very poor. Multiple regression analysis showed that more women who had used or were currently using natural remedies for the menopause scored their sexual lives as fair, poor, or very poor. Conclusions: More than half the women aged 50 years or more in this study were not sexually active. A poorer sexual life self-perception was associated with the use of natural remedies to treat menopausal symptoms. This may indicate a need to improve the way in which these women are evaluated and treated. Women's assessment of their own sexual lives may prove a useful tool in clinical practice.357295300Kaiser, F.E., Sexual function and the older woman (2003) Clin Geriatr Med., 19 (3), pp. 463-472(1981) Research on the menopause., , World Health Organization Scientific Group. Geneva: World Health Organization(Technical Report Series, 670)Wierman, M.E., Nappi, R.E., Avis, N., Davis, S.R., Labrie, F., Rosner, W., Endocrine aspects of women's sexual function (2010) J Sex Med., 7 (1 PART 2), pp. 561-585The 2012 hormone therapy position statement of: The North American Menopause Society (2012) Menopause., 19 (3), pp. 257-271. , North American Menopause SocietySturdee, D.W., Panay, N., Recommendations for the management of postmenopausal vaginal atrophy (2010) Climacteric., 13 (6), pp. 509-522. , International Menopause Society Writing GroupSimon, J.A., Identifying and treating sexual dysfunction in postmenopausal women: The role of estrogen (2011) J Womens Health (Larchmt)., 20 (10), pp. 1453-1465Valadares, A.L., Pinto-Neto, A.M., Osis, M.J., Conde, D.M., Sousa, M.H., Costa-Paiva, L., Sexuality in Brazilian women aged 40 to 65 years with 11 years or more of formal education: Associated factors (2008) Menopause., 15 (2), pp. 264-269Guthrie, J.R., Dennerstein, L., Taffe, J.R., Lehert, P., Burger, H.G., The menopausal transition: A 9-year prospective population-based study. The Melbourne Women's Midlife Health Project (2004) Climacteric., 7 (4), pp. 375-389McCoy, N.L., The McCoy Female Sexuality Questionnaire (2000) Qual Life Res., 9 (1 SUPPL.), pp. 739-745Rosen, R., Brown, C., Heiman, J., Leiblum, S., Meston, C., Shabsigh, R., The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function (2000) J Sex Marital Ther., 26 (2), pp. 191-208Dennerstein, L., Anderson-Hunt, M., Dudley, E., Evaluation of a short scale to assess female sexual functioning (2002) J Sex Marital Ther., 28 (5), pp. 389-397Valadares, A.L., Pinto-Neto, A.M., Osis, M.J., Sousa, M.H., Costa-Paiva, L., Conde, D.M., Prevalence of sexual dysfunction and its associated factors in women aged 40-65 years with 11 years or more of formal education: A population-based household survey (2008) Clinics (Sao Paulo)., 63 (6), pp. 775-782Valadares, A.L., Pinto-Neto, A.M., de Sousa, M.H., Osis, M.J., Sociocultural adaptation of the short personal experiences questionnaire (SPEQ) in Brazil (2010) Rev Bras Ginecol Obstet., 32 (2), pp. 72-76. , PortugueseBem, D.J., Self-perception: An alternative interpretation of cognitive dissonance phenomena (1967) Psychol Rev., 74 (3), pp. 183-200Ali, M.M., Fang, H., Rizzo, J.A., Body weight, self-perception and mental health outcomes among adolescents (2010) J Ment Health Policy Econ., 13 (2), pp. 53-63Paula, J.S., Leite, I.C., Almeida, A.B., Ambrosano, G.M., Pereira, A.C., Mialhe, F.L., The influence of oral health conditions, socioeconomic status and home environment factors on schoolchildren's self-perception of quality of life (2012) Health Qual Life Outcomes., 10, p. 6Maier, H., Smith, J., Psychological predictors of mortality in old age (1999) J Gerontol B Psychol Sci Soc Sci., 54 (1), pp. P44-P54Levy, B.R., Slade, M.D., Kunkel, S.R., Kasl, S.V., Longevity increased by positive self-perceptions of aging (2002) J Pers Soc Psychol., 83 (2), pp. 261-270(2007) Distribuição da população por sexo, segundo os grupos de idade:Campinas (SP)., , http://www.censo2010.ibge.gov.br/sinopse/webservice/frm_piramide.php?codigo=350950&corhomem=3d4590&cormulher=9cdbfc, Instituto Brasileiro de Geografia e Estatística [Internet]. [citado 2011 Mar 6]. Disponível emAltman, D.G., (1999) Practical statistics for medical research., , Boca Raton: Chapman & Hall/CRCJohnson, R.A., Wichern, D.W., (1982) Applied multivariate statistical analysis., , Upper Saddle River: Prentice HallBarros, A.J., Hirakata, V.N., Alternatives for logistic regression in cross-sectional studies: An empirical comparison of models that directly estimate the prevalence ratio (2003) BMC Med Res Methodol., 3, p. 21Lindau, S.T., Schumm, L.P., Laumann, E.O., Levinson, W., O'Muircheartaigh, C.A., Waite, L.J., A study of sexuality and health among older adults in the United States (2007) N Engl J Med., 357 (8), pp. 762-774Freeman, E.W., Sammel, M.D., Lin, H., Liu, Z., Gracia, C.R., Duration of menopausal hot flushes and associated risk factors (2011) Obstet Gynecol., 117 (5), pp. 1095-1104Col, N.F., Guthrie, J.R., Politi, M., Dennerstein, L., Duration of vasomotor symptoms in middle-aged women: A longitudinal study (2009) Menopause., 16 (3), pp. 453-457McLennan, A.H., Broadbent, J.L., Lester, S., Moore, V., Oral oestrogen and combined oestrogen/progestogen therapy versus placebo for hot flushes (2004) Cochrane Database Syst Rev., (4), pp. CD002978The role of soy isoflavones in menopausal health: Report of The North American Menopause Society/Wulf H. Utian Translational Science (2011) Menopause., 18 (7), pp. 732-753. , North American Menopause Society, Symposium in Chicago, IL (October 2010)Borrelli, F., Ernst, E., Alternative and complementary therapies for the menopause (2010) Maturitas., 66 (4), pp. 333-343Patisaul, H.B., Luskin, J.R., Wilson, M.E., A soy supplement and tamoxifen inhibit sexual behavior in female rats (2004) Horm Behav., 45 (4), pp. 270-277Patisaul, H.B., Dindo, M., Whitten, P.L., Young, L.J., Soy isoflavone supplements antagonize reproductive behavior and estrogen receptor alpha-and beta-dependent gene expression in the brain (2001) Endocrinology., 142 (7), pp. 2946-295

Free Informed Consent: The Experience Of Brazilian Researchers In The Area Of Fertility Regulation [consentimento Livre E Esclarecido: Experiência De Pesquisadores Brasileiros Na área Da Regulação Da Fecundidade.]

This study aimed to evaluate the experience of Brazilian researchers in relation to: assessment of the research protocol by a research ethics committee with the elaboration of a free informed term of consent (FITC) and the process of obtaining consent, as well as to verify whether the content and wording of the term of consent complies with Federal Ruling 196/96. Thirty-four researchers filled out a questionnaire and returned it by electronic mail. The vast majority of the respondents (91%) reported that the respective study protocol had been evaluated by a research ethics committee. More than half reported that they had received a previously prepared FITC; that consent from potential study subjects had been obtained by the researcher in charge; and that the subjects had received a copy of their signed FITC. Approximately one half of participants stated that the form of reimbursement of subjects was specified in the FITC, and 44% reported the same in relation to occasional damages resulting from the study. According to participants, in general the provisions of Ruling 196/96 had been met.20121622

Reproductive Variables And Risk Of Breast Cancer: A Case-control Study Carried Out In Brazil [variáveis Reproductivas E Risco Para Câncer De Mama: Estudo Caso-controle Desenvolvido No Brasil.]

The purposes of the study were to identify reproductive risk factors for breast cancer and to test the hypothesis that reproductive variables operate through a common factor: the number of times that the mammary tissue has been exposed to the endocrine changes of the ovulatory cycle. The study was conducted in Campinas, and was based on interviews with 348 women with breast cancer first diagnosed between October 1979 and August 1984. The control group consisted of 348 women with healthy breasts. The data were obtained in interviews in the home, which were conducted using a structured questionnaire that had been pretested. The data were analyzed by calculation of the odds ratio, Mantel's statistic, to determine the linear trend; by Cornfield's method to calculate the confidence intervals; and by logistic regression adjusted for paired data. It was found that nulliparity, not having breast-fed, and a high number of menstrual cycles were significantly associated with the risk of presenting the disease. In the multivariate analysis, which included all the women, the only variable associated with the risk of mammary cancer was no history of breast-feeding. When the nulliparas were excluded, logistic regression showed that higher age of the woman at her first delivery was significantly associated with breast cancer.11529310

Research On Contraception: Opinion Of Researchers, Subjects And Advocates Of Women Rights [pesquisa Em Contracepção: Opinião De Pesquisadores, Sujeitos E Defensoras Dos Direitos Das Mulheres.]

OBJECTIVE: To survey the opinion of researchers, women -- subjects of research-- and of advocates of women's rights about the meaning of "research" and "guinea pigs". METHODS: Researchers (11), women (18) and advocates (10) were interviewed. The study was qualitative and a thematic analysis was carried out. RESULTS: Participants experienced difficulty to explain what research meant and some were unable to do so. For the researchers and most of the women, subjects are not guinea pigs, because they have freedom of choice. Most of the advocates, however, said that subjects are guinea pigs, even when they consent to participate in a study. CONCLUSIONS: The difficulty experienced by researchers when explaining the meaning of research was surprising. The different opinions about "guinea pig" reflect the controversy about its meaning in research. Certainly the expression "guinea pig" does not apply to all studies however the different meanings identified should make researchers cautious about the ethical issues involved in their studies.50445145

Reproductive Variables And Risk Of Benign Breast Diseases. A Case-control Study [variáveis Reproductivas E Risco Para Doenças Benignas De Mama. Estudo Caso-controle.]

The purpose of the study was the identification of risk factors for benign breast diseases (BBD); 257 women with BBD diagnosed through pathological anatomy or cytology and a matched control for each were studied. Subjects were selected at The State University of Campinas Hospital and at a private clinic. To enter the study cases had to have a first diagnosis of BBD between October 1979 and August 1984. The following BBD were considered: dysplasia, fibroadenoma, cystic disease, papilloma and ductal ectasia. Reproductive variables were studied as risk factors, including menstrual ovulatory cycles. The date on which the BBD was diagnosed was defined as the index date. For controls, data were considered up to when they had reached the same age as the matched case on the occasion of her diagnosis. Nulliparity was a risk factor for BBD. First birth at or above age 30 was a protective factor. Women who had used contraceptive pills for two or more years had a significantly lower risk than those who had never used them. The number of menstrual ovulatory cycles was not found to be associated with the risk of BBD. The results obtained from the study of Brazilian women confirm some of the conclusions found in the literature, mainly those that associate some reproductive variables with the risk of BBD. A few of these variables are also confirmed as risk factors for breast cancer.This study identified risk factors for benign breast diseases (BBD) and 257 women with BBD diagnosed through pathological anatomy or cytology and a matched control for each were studied. Subjects were selected at the State University of Campinas Hospital, Brazil, and at a private clinic. To enter the study, cases were first diagnosed with BBD between October 1979-August 1984. The BBDs which were considered were: dysplasia, fibroadenoma, cystic disease, papilloma, and ductal ectasia. Reproductive variables were studied as risk factors and included menstrual ovulatory cycles. The date on which BBD was diagnosed was defined as the index date. For controls, data were considered up to when they had reached the same age as the matched case on the occasion of diagnosis. Nulliparity was a risk factor for BBD. First birth or age above 30 was a protective factor. Women who had used oral contraceptives for 2 or more years had a significantly lower risk than those who had never used them. The number of menstrual ovulatory cycles was not found to be associated with BBD risk. Results obtained from this study Brazilian women confirm some of the conclusions found in the literature, mainly those that associate some reproductive variables with the risk of BBD. A few of these variables are also confirmed as risk factors for breast cancer. (author's modified)24538739

Ideal Number Of Children As A Risk Factor For Tubal Ligation [número Ideal De Filhos Como Fator De Risco Para Laqueadura Tubária.]

The purpose of this paper was to evaluate the association between ideal number of children (INC) and female sterilization. A nested case-control study was performed through a secondary analysis of data from a cohort study on the reproductive health of women in Campinas, São Paulo, Brazil. A total of 3,878 women were included, 1,012 being sterilized (cases). The relationship between INC and number of live births (LB) was divided in two categories (INC > LB and INC < or = LB). The relative risks of performing tubal ligation were calculated (odds ratio) with their respective 95% confidence intervals for the relation INC/LB and all control variables. All predictor variables were included in a logistic regression model in order to identify the factors independently associated with female sterilization. The results showed that the risks of tubal ligation were higher among women with INC < or = LB, higher age, with partners, higher family income, more than two previous pregnancies, more deliveries, fewer abortions, and without paid work.2061565157

Emergency Contraception In Brazil: Facilitators And Barriers [anticoncepção De Emergência No Brasil: Facilitadores E Barreiras.]

A multi-centered qualitative study was conducted in Brazil, Chile, and Mexico to assess the acceptability of emergency contraception both among potential users and possible providers, authorities, and opinion-makers, and to identify (according to participants' perceptions) factors facilitating or hindering the method's use and the most appropriate strategies to disseminate information and provide the method. Data were collected through semi-structured interviews, group interviews, and discussion groups, which were tape-recorded and transcribed. A thematic analysis of this material was conducted. Acceptability of emergency contraception was high among participants, who also felt that there were no barriers towards its acceptance by the population. Participants felt that the method's acceptability would be greater if it were included in reproductive health programs, emphasizing its prescription for emergency situations. Participants highlighted that strategic components in Brazil would be training of providers and inclusion of the method in family planning services.1741031103