Conhecimento sobre métodos anticoncepcionais por estudantes adolescentes

OBJECTIVE:To compare the knowledge of contraceptive methods as well as to identify factors associated with adequate knowledge among public and private school adolescents. METHODS: A cross-sectional study comprising 1,594 adolescents aged between 12 and 19 years old from 13 public and five private schools in the city of São Paulo city, Brazil, was carried out from June to December 2003. Schools were randomly selected and students filled out a questionnaire about sociodemographic, reproductive and contraceptive methods. The prevalence ratios were estimated with a 95% confidence interval for each question on their knowledge of contraceptive methods and by school group. Each question correctly answered received a half score, and the cut-off value was 50% of correct answers. Statistical tests utilized were Chi-square and Wilcoxon-Gehan tests and Poisson multiple regression model. RESULTS: Of all respondents, 61% were of females in both school groups. Most students had low socioeconomic condition in public schools while they had mostly high socioeconomic condition in private schools (pOBJETIVO: Comparar o conhecimento sobre métodos anticoncepcionais e identificar os fatores associados ao conhecimento adequado dos adolescentes de escolas públicas e privadas. MÉTODOS: Realizou-se estudo transversal, do qual participaram 1.594 adolescentes entre 12 e 19 anos, de 13 escolas públicas e cinco privadas do Município de São Paulo entre junho e dezembro de 2003. As escolas foram selecionadas aleatoriamente e os alunos responderam um questionário sobre características sociodemográficas, reprodutivas e métodos anticoncepcionais. As razões de prevalência foram calculadas com intervalo de confiança de 95% para cada questão sobre conhecimento de métodos e o tipo de escola. Atribuiu-se meio ponto para cada questão correta sobre conhecimento de anticoncepcionais, o ponto de corte foi 50% de acerto. Os testes estatísticos utilizados foram o qui-quadrado, o Wilcoxon-Gehan e a regressão múltipla de Poisson. RESULTADOS: Dentre os adolescentes, 61% eram do sexo feminino nos dois grupos de escolas. Predominou nível socioeconômico baixo nas escolas públicas e alto nas privadas (

Endogenous sexual steroids and gonadotrophins in women with or without endometrial carcinoma: a comparative clinical study

Objective:To analyze the levels of endogenous sexual steroids and gonadotrophin in women with and without endometrial cancer. Methodology:We developed a clinical comparative study on 20 postmenopausal women with endometrial cancer and 20 postmenopausal women without endometrial cancer. The age, the postmenopausal time and the index of body mass were used as matching variables. The plasma levels of the endogenous sexual steroids were measured using radioimmunoassay and immunoenzymatic methods. For the statistic analysis we used the Student's t test. Results: The levels of androstenedione (A), total testosterone (t) and free testosterone (TL) were higher in the women with endometrial cancer, and those of the luteinic hormone (LH) were significantly lower values in these women. We also observed that the ratio (E1/A) showed significantly lower in the group of women with cancer, while the ratio (E2/E1) did not present any differences between groups. Conclusions: We emphasize the potentiality of sexual steroids and gonadotrophins in the genesis of endometrial adenocarcinoma in postmenopausal women.Objetivo: analisar os níveis dos esteróides sexuais endógenos e gonadotrofinas em mulheres com e sem câncer de endométrio. Métodos: foi realizado estudo clínico-comparativo com 20 mulheres na pós-menopausa com câncer de endométrio e 20 mulheres na pós-menopausa, sem câncer de endométrio. A idade, o tempo de menopausa e o índice de massa corpórea foram utilizados como variáveis de emparelhamento. Os níveis plasmáticos dos esteróides sexuais endógenos foram medidos por métodos de radioimunoensaio e imunoenzimático. Para análise estatística utilizamos o teste t de Student. Resultados: os níveis de androstenediona (A), testosterona total (t) e testosterona livre (TL) foram mais elevados nas mulheres com câncer de endométrio e os níveis de hormônio luteinizante (LH) foram significativamente menores nessas mulheres. Também observamos que a razão (E1/A) mostrou valores significativamente menores no grupo de mulheres com câncer, ao passo que a razão (E2/E1) não apresentou diferenças nos dois grupos. Conclusões: destacamos a potencialidade dos esteróides sexuais e gonadotrofinas na gênese do adenocarcinoma de endométrio em mulheres na pós-menopausa.26727

[factors Associated With Condom Use And Knowledge About Std/aids Among Teenagers In Public And Private Schools In São Paulo, Brazil].

This study aimed to compare knowledge about STD/AIDS and identify the factors associated with adequate knowledge and consistent use of male condoms in teenagers from public and private schools in the city of São Paulo, Brazil. We selected 1,594 adolescents ranging 12 to 19 years of age in 13 public schools and 5 private schools to complete a questionnaire on knowledge of STD/AIDS and use of male condoms. Prevalence ratios were computed with a 95% confidence interval. The score on STD knowledge used a cutoff point corresponding to 50% of correct answers. Statistical tests were chi-square and Poisson multiple regression. Consistent use of male condoms was 60% in private and 57.1% in public schools (p > 0.05) and was associated with male gender and lower socioeconomic status. Female gender, higher schooling, enrollment in private school, Caucasian race, and being single were associated with higher knowledge of STDs. Teenagers from public and private schools have adequate knowledge of STD prevention, however this does not include the adoption of effective prevention. Educational programs and STD/AIDS awareness-raising should be expanded in order to minimize vulnerability.22315-2

Niveis plasmaticos de esteroides sexuais endogenos e gonadotrofinas em mulheres na pos-menopausa com e sem adenocarcinoma de endometrio

Orientadores: Gustavo Antonio de Souza, Aarão Mendes Pinto NetoDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências MédicasResumo: O aumento da expectativa de vida neste final de século observado, principalmente na população feminina, tomou ainda mais importante o estudo de fatores predisponentes ao câncer genital feminino na pós-menopausa, e dentre eles, o câncer de endométrio merece especial destaque pelo incremento de sua ocorrência. Com o objetivo de contribuir para o esclarecimento de fatores associados a esta neoplasia, foram analisados os níveis plasmáticos dos esteróides sexuais endógenos e gonadotrofinas em mulheres com e sem adenocarcinoma de endométrio. Foi realizado um estudo clínico descritivo comparativo com 20 mulheres na pós-menopausa com adenocarcinoma de endométrio e 20 mulheres na pós-menopausa sem adenocarcinoma de endométrio. A idade, o tempo de menopausa e o índice de massa corpórea foram utilizados como variáveis de emparelhamento. Os níveis plasmáticos de E1, A, SDHEA, T e TL foram dosados pelo método de radioimunoensaio e as dosagens de E2, FSH e LH pelo método de imunoenzimometricoensaio. As concentrações obtidas foram submetidas aos testes estatísticos de análise de variância e comparação de médias. Esta análise mostrou que os níveis E1 e E2 foram similares nos dois grupos e os níveis de androstenediona (A), testosterona total (T) e testosterona livre (TL) foram maiores nas mulheres com adenocarcinoma de endométrio, e os níveis de hormônio luteinizante (LH) foram significativamente menores nestas mulheres. Também observamos que a razão E1/A mostrou valores significativamente menores no grupo de mulheres com adenocarcinoma, enquanto que a razão E2/E1 não apresentou diferenças nos dois grupos. Por fim, a contribuição deste estudo é a de acrescentar a potencialidade da avaliação dos esteróides sexuais endógenos e gonadotrofinas, principalmente os androgênios e o LH, na genêse do câncer de endométrio em mulheres na pós-menopausaAbstract: The increase of life's expectancy observed in women population at the end of this century became more important the study of predisponent factors of women genital cancer at postmenopausal. Among these, the endometrial carcinoma deserves special eminence because of the increase of its occurrence. Thus, with the objective to contribute by clearing up factors associated to endometrial carcinoma, we analised steroids endogenous and gonadothrofines levels in these women. lt was accomplished by a descriptive and comparativa clinical study with 20 postmenopausal women with endometrial cancer and 20 postmenopausal women without endometrial carcinoma. Age, years since menopause and body mass index were used as matching variables. The plasmatic levels of endogenous steroids and gonadothrofines were measured using radio-immuno-assay and immuno-enzimometric-assay and the concentration obtained was submitted to statistical methods (anova and means comparation). This study showed that androstenedione (A), testosterone (T) and free testosterone (TL) levels were higher in women with endometrial carcinoma, and luteinizing hormone (LH) levels were significant lower in these women. lt was also observed that the ratio (E1/A) showed lower significant values in the group of the women with endometrial carcinoma. Another ratio (E2/E1) showed the same values in two groups. The objective of this study was to increase the evaluation's potency of steroids endogenous and gonadothrofines, mainly androgens and LH, in the genesis of endometrial carcinoma in postmenopausal womenMestradoTocoginecologiaMestre em Medicin

Sexualidade no climaterio : uma analise do inquerito populacional domiciliar em mulheres de 45 a 60 anos no municipio de Campinas

Orientador: Aarão Mendes Pinto NetoTese (doutorado) - Univesidade Estadual de Campinas, Faculdade de Ciencias MedicasResumo: O aumento da expectativa de vida, principalmente entre a população feminina neste final de século tornou os estudos sobre o climatério e suas implicações psicobiológicas e sociais, como a sexualidade, temas de grande interesse, pois são relacionados à melhoria da qualidade e do estilo de vida. Objetivos: Descrever alguns aspectos da sexualidade em mulheres climatéricas e as influências das características sociodemográficas e clínicas e da auto-percepção do estado de saúde. Sujeitos e métodos: Estudo descritivo, de corte transversal, associado a um inquérito populacional domiciliar em mulheres de 45 a 60 anos residentes em Campinas (SP), no Brasil. Foram selecionadas 456 mulheres, através de processo de amostragem, baseado em Censo Demográfico de 1991 do Instituto Brasileiro de Geografia e Estatística. Os dados foram coletados através de entrevistas domiciliares com questionários estruturados e pré-testados internacionalmente no Sudeste Asiático e nos Estados Unidos. Foram obtidas as,> estatísticas de posição (freqüências, médias e medianas) e riscos relativos (RR) ajustado por idade, com intervalo de confiança de 95%. Resultados: A maioria das mulheres iniciou sua vida sexual na adolescência e, continuou mantendo relações sexuais (68%) e obtendo prazer (86%) no climatério; com uma freqüência mediana, neste período da vida, de quatro relações/mês. Um terço da amostra estava em abstinência sexual nos últimos 12 meses, devido principalmente a falta de parceiro ou a doença deste (75%), e não causas relativas à mulher. A principal mudança na atividade sexual das mulheres foi a falta de interesse sexual (75%), não sendo importante a secura vaginal ou a dispareunia. As características associadas à precocidade do início da atividade sexual foram: a menor escolaridade (sem escolaridade com RR de 5,7) e o menor poder aquisitivo (classe D ou E com RR de 3,5). Em relação à manutenção da atividade sexual foi significativo ter parceiro estável e principalmente, estar casada (RR ajustado= 30,7), pertencer a classe A ou B (RR ajustado de = 3,3); ser não fumante (RR ajustado= 2,4), e estar usando TRH (RR ajustado= 1,8). A obtenção do prazer foi influenciada somente pela maior escolaridade (RR ajustado= 4,3 e pela autopercepção do bom estado de saúde (RR ajustado= 9,6). Conclusões: A atividade e o prazer sexual no climatério têm uma influência multifatorial, que passa por questões de condições socioeconômicas, culturais, clínicas, hábitos e educação sexual. A contribuição deste estudo é alertar os profissionais de saúde e pesquisadores, para melhor entendimento das ações não estritamente biológicas sobre o comportamento humano, neste caso em especial à sexualidade no climatério e, a maior atenção às queixas das mulheres e de seus parceirosAbstract: In this final century, the increase of life expectance mainly among female population made the climacteric study with their psychobiologycal and social implications like sexuality, important questiono This is significant because they are related to improve of life quality and style. Objectives: describe some sexuality aspects in climacteric women and the influence of the social and demographic characteristic, the clinical characteristic and the healthy state of self-perception. Methods: descriptive study, cross sectional associated with domicile population inquiry in women aged 45 to 60 inhabit in Campinas (SP), Brazil. A total of 456 women were carried out between randomization based in a 1991 demographic census from Instituto Brasileiro de Geografia e Estatíst1ca. The data were gathered from domicile interview through strucfured questionary intemationally te,sted in UEA and Asian Southeast. Were collected statistical position data (frequency, average and median value) and relative Fisk (RR) age adjusted, with 95% confidence interval. Results: The majority of women began their sexual life in adolescent period and keep on their sexual (68%) and achieving pleasure (86%) in climacteric stage; with fpur intercourse/month (median frequency value). A sample third was sexual absent in the last 12 month. The main factor was the lack of partner or presence of sick partner (75%) and not due to women factor. The significant change of women sexual aétivity was the absence of sexual attraction (75%), the vaginal dryness and coitus pain were not important. The early first intercourse associated characteristics were the less scholarship (RR 5,7) and the less acquisitive power (category O or E with RR 3,5). Regarding holding thesexual activity, was significant to have stable partner and mainly be married (RR 30,7), belong to A or 8 category (RR 3,3) using HTR (RR 1,8). The pleasure achievement was affected only by high scholarship (RR 4,3) and by good health self-perception (RR 9,6). Conclusion: The activity and the sexual pleasure in climacteric women have a many-sided influence that goes through social and economics issues, cultural questions, clinical conditions, habits and sexual education. The aim of this study was to contribute to. alert the health workers and searches, to gain knowledge not only through biological strict actions about human behavior, but specially to the climacteric sexuality and improve attention to the women and partner complainsDoutoradoTocoginecologiaDoutor em Medicin

Macroplastique Implantation System For The Treatment Of Female Stress Urinary Incontinence.

We evaluated the 12-month followup outcome of the Macroplastique (Uroplasty, Minneapolis, Minnesota) implantation system for the treatment of stress urinary incontinence caused by intrinsic sphincter deficiency using objective and subjective measures, including quality of life impact. A total of 21 consecutive women with a mean age of 47.4 years and a mean body mass index of 25.65 kg./m.2 in whom intrinsic sphincter deficiency was urodynamically diagnosed were enrolled in the study. Patients were preoperatively assessed by physical examination, quality of life questionnaire, Stamey grading of incontinence, pad use, pad weight test and urodynamic testing. Patients underwent periurethral injection under local anesthesia with the Macroplastique implantation system. The mean volume of silicone elastomers injected was 6.3 ml. As assessed by the King health questionnaire, patient quality of life improved in all domains and in most lower urinary tract symptoms. Patient satisfaction and subjective surgeon evaluation were assessed by Stamey incontinence grading. From patient point of view 12 (57.1%) considered themselves cured, 4 (19%) were improved and 5 (23.8%) had failure. According to subjective surgeon grading 8 patients (38.1%) were considered cured 6 (28.6%) were improved and 7 (33.3%) had failure. Pad use decreased from a mean of 4.38 to 1.29 units daily. According to the pad weight test 13 patients (62%) were dry, 4 (19%) were improved and 4 (19%) had failure. Urodynamic testing demonstrated that 8 patients (40%) were dry and 1 (5%) was improved. The Macroplastique implantation system proved to have an acceptable outcome for patient and surgeon. The procedure can be done with local anesthesia and without cystoscopic guidance.1692229-3

Uterine artery embolization for the treatment of symptomatic myomas in Brazilian women

CONTEXT: Uterine myomas are benign tumors that mostly occur in women of reproductive age at a frequency ranging from 20 to 25%. The symptoms are increased menstrual flow, pain and compressive signs. New treatments have been proposed and uterine artery embolization is one of them. OBJECTIVE: To evaluate the effects of treatment by embolization of the uterine artery, in women with symptomatic myomas. Uterine and dominant myoma volumes and the major symptoms were evaluated before treatment and 12 weeks later. TYPE OF STUDY: Open clinical trial. SETTING: A tertiary-care women's hospital. PARTICIPANTS: The study was conducted on 32 women with symptomatic single or multiple myomas of the uterine body, seen at the outpatient unit from May 2000 to September 2001. MAIN MEASUREMENTS: The patients were submitted to gynecological examination and abdominal and endovaginal pelvic ultrasonography, and the examinations were repeated 12 weeks after the first procedure. Uterine artery embolization using PVA (polyvinyl alcohol) particles of 355-700 µ was performed by catheterization of the right femoral artery in 30 women and by bilateral catheterization in two. RESULTS: Before embolization, the mean uterine volume of the 32 women was 455 cm³ and the mean volume of the dominant myoma was 150 cm³. Twelve weeks after embolization, the mean uterine volume was 256 cm³ and the mean volume of the dominant myoma was 91 cm³, with p < 0.01 in both cases. Twelve weeks after the treatment, all the women answered a questionnaire, which showed that 71% had improvement in menstrual regularity, 90% decreased menstrual volume and 81% shortened menstrual duration. The most frequent immediate post-procedure symptoms, established as complications, were pain (100%) and fatigue (34%). One woman had myoma degeneration and was submitted to myomectomy. CONCLUSION: The significant reduction in uterine and dominant myoma volume confirms the validity of the treatment of symptomatic myomas by the technique of uterine artery embolization in Brazilian women. There was significant reduction in menstrual flow and duration, as well as better cycle regularity in the women studied. The few adverse effects observed in the sample studied mainly involved pain immediately after embolization