Aborto inseguro: determinantes sociais e iniquidades em saúde em uma população vulnerável, São Paulo, Brasil

This cross-sectional population-based study in a peripheral low-income community in São Paulo, Brazil, aimed to estimate the prevalence of unsafe abortion and identify the socio-demographic characteristics associated with it and its morbidity. The article discusses the study's results, based on univariate and multiple multinomial logistic regression analyses. The final regression models included: age at first intercourse 2 sex partners in the previous year (OR = 3.63); more live born children than the woman's self-reported ideal number (OR = 3.09); acceptance of the abortion due to insufficient economic conditions (OR = 4.07); black ethnicity/color (OR = 2.67); and low schooling (OR = 2.46), all with p 2 (OR = 3,63); número de filhos nascidos vivos > ideal (OR = 3,09); aceitação do aborto por falta de condições econômicas (OR = 4,07); etnia negra/cor preta (OR = 2,67); e escolaridade baixa (OR = 2,46), todos com p < 0,05. Foi utilizada na discussão uma abordagem voltada aos determinantes sociais da saúde, segundo conceito e modelo adotados pela WHO, e às iniquidades em saúde por esses geradas na ocorrência do aborto inseguro. Verificou-se que o aborto inseguro e características sociodemográficas são influenciados pelos determinantes sociais da saúde descritos, gerando nessa população iniquidades em saúde de proporções diversas.Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Epidemiology of unsafe abortion in a poverty stricken environment Favela Inajar de Souza, São Paulo, Brazil

This article compares the results of a survey carried out recently in a poverty stricken environment in São Paulo, Brazil - a country where abortion is illegal in most circumstances- to data from Cuba - where abortion is safe and legal, and data registries are reliable. A cross-sectional survey was conducted in a community in the north side of the city, called Favela Inajar de Souza, with the purpose of estimating the frequency of unsafe, clandestine abortions and identifying socio-demographic characteristics and morbidity related to abortion in a poor population. All women aged 15 to 54 years that lived in this community (Census) were interviewed for this survey. The Chi-Square Test and the Fisher exact test were used for categorical variables, and analysis of variance was used for numeric variables. Throughout the analysis, the statistical significance level of 5% (p<0.05) was adopted. A high number of unsafe abortions and a high rate of post-abortion complications were detected in the studied population - the community of Favela Inajar. With regard to induced abortions, the only common features between the two populations were age and civil status. As opposed to what happens in Cuba, the analysis of the data from Favela Inajar shows that there were statistically significant associations between unsafe abortion and: income, educational level, internal migration and ethnicity. These findings indicate that this population is particularly vulnerable to unsafe abortion in face of the several forms of structural violence present in Brazil, which produce social inequity. The performance of safe and legal abortion, as is the case in Cuba, would change this scenario. Legalization of abortion in Brazil would mostly benefit poor women.Procurou-se, neste trabalho, comparar os Resultados de Pesquisa recente, realizada em São Paulo, Brasil, país em que o aborto é ilegal em quase todas as circunstâncias, com dados referentes a Cuba, país onde o aborto é legal e seguro, dispondo de registros confiáveis. Essa pesquisa foi sediada em uma comunidade da Zona Norte da cidade de São Paulo, Favela Inajar de Souza: um estudo transversal que teve por objetivo estimar a freqüência de Abortos Inseguros, bem como determinar as características sociodemográficas e a morbidade associadas a tal ocorrência, em uma população em situação de pobreza. Foram entrevistadas todas as mulheres entre 15 e 54 anos residentes na comunidade (Censo). Na análise dos dados foram empregados o teste exato de Fisher e o teste qui-quadrado para as variáveis categóricas, e a análise de variância (ANOVA) para as variáveis numéricas. Em toda a análise adotou-se um nível de significância de 5%, com p < 0,05. Encontrou-se, na população estudada, Favela Inajar, um alto número de abortos inseguros e alta porcentagem de complicações pós-aborto. Em comum com Cuba, quanto ao Aborto Induzido foi observada semelhança de perfil somente em relação à Idade e ao Estado Civil. Nos Resultados foram constatadas também - contrariamente ao que ocorre em Cuba - associações estatisticamente significativas entre Aborto Inseguro e Renda/Escolaridade (baixas), Aborto Inseguro e Etnia/Cor, Aborto Inseguro e Não Apoio do Parceiro, e Aborto Inseguro e Migração Interna - o que torna essa população especialmente vulnerável ao aborto inseguro frente às violências estruturais, geradoras de iniqüidade, vigentes no Brasil. O aborto legal e seguro, tal como em Cuba, transformaria essa realidade. A legalização do aborto beneficiaria, sobretudo, as mulheres pobres.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de Medicina PreventivaUNIFESP, EPM, Depto. de Medicina PreventivaSciEL

Ab initio Molecular Dynamics in Adaptive Coordinates

We present a new formulation of ab initio molecular dynamics which exploits the efficiency of plane waves in adaptive curvilinear coordinates, and thus provides an accurate treatment of first-row elements. The method is used to perform a molecular dynamics simulation of the CO_2 molecule, and allows to reproduce detailed features of its vibrational spectrum such as the splitting of the Raman sigma+_g mode caused by Fermi resonance. This new approach opens the way to highly accurate ab initio simulations of organic compounds.Comment: 11 pages, 3 PostScript figure

Ab initio many-body calculation of excitons in solid Ne and Ar

Absorption spectra, exciton energy levels and wave functions for solid Ne and Ar have been calculated from first principles using many-body techniques. Electronic band structures of Ne and Ar were calculated using the GW approximation. Exciton states were calculated by diagonalizing an exciton Hamiltonian derived from the particle-hole Green function, whose equation of motion is the Bethe-Salpeter equation. Singlet and triplet exciton series up to n=5 for Ne and n=3 for Ar were obtained. Binding energies and longitudinal-transverse splittings of n=1 excitons are in excellent agreement with experiment. Plots of correlated electron-hole wave functions show that the electron-hole complex is delocalised over roughly 7 a.u. in solid Ar.Comment: 6 page

Multimessenger Universe with Gravitational Waves from Binaries

Future GW detector networks and EM observatories will provide a unique opportunity to observe the most luminous events in the Universe involving matter in extreme environs. They will address some of the key questions in physics and astronomy: formation and evolution of compact binaries, sites of formation of heavy elements and the physics of jets.Comment: 11 pages, two tables, White Paper submitted to the Astro-2020 (2020 Astronomy and Astrophysics Decadal Survey) by GWIC-3G Science Case Team (GWIC: Gravitational-Wave International Committee

Retroperitoneal pararenal isolated neurofibroma: report of a case and review of literature

The neurofibroma is a tumour of neural origin. This kind of neoplasm, though, is generally skin located. Rare cases in deep organs or in the peritoneal cavity are also reported in the literature. There are two types of neurofibromas, localized and diffuse; the latter is associated with von Recklinghausen disease and always occurs together with skin neurofibromas. Here we report the case of a 47-year-old man affected by retroperitoneal neurofibroma, but not associated with von Recklinghausen disease. A computed tomography (CT) scan described a retroperitoneal pararenal lesion with no clear involvement of adjacent viscera. We describe the diagnostic modality, treatment planning and the timing of treatment of this neoplasm, reviewing also the literature

Sailing as Stroke Rehabilitation Strategy

Stroke (brain attack), is a serious global public health problem and the main cause of many forms of disability. The majority of stroke survivors are mostly left with motor (muscle movement or mobility) impairments. Although remarkable developments have been made in drug treatment, post-stroke care continues to rely on rehabilitation interventions mostly. On the other hand, the presence of post-stroke depression has been associated with decreases in functional recovery, social activity and cognition. Therefore, this project aims to improve the quality of people’s lives after a stroke by introducing sailing as outdoor mobility rehabilitation. It is intended to increase the patients’ motivation and engagement in the rehabilitation process by a more enjoyable and relaxing intervention than the existing ones especially for long term periods. The project, based on a haptic system installed on the deck of NYTEC 28 sailing boat, aim to monitoring rehab process development in post-stroke during normal sailing activity

Technique of sentinel lymph node biopsy and lymphatic mapping during laparoscopic colon resection for cancer

BACKGROUND: The utility of lymph node mapping to improve staging in colon cancer is still under evaluation. Laparoscopic colectomy for colon cancer has been validated in multi-centric trials. This study assessed the feasibility and technical aspects of lymph node mapping in laparoscopic colectomy for colon cancer. METHODS: A total of 42 patients with histologically proven colon cancer were studied from January 2006 to September 2007. Exclusion criteria were: advanced disease (clinical stage III), rectal cancer, previous colon resection and contraindication to laparoscopy. Lymph-nodal status was assessed preoperatively by computed tomography (CT) scan and intra-operatively with the aid of laparoscopic ultrasound. Before resection, 2-3 ml of Patent Blue V dye was injected sub-serosally around the tumour. Coloured lymph nodes were marked as sentinel (SN) with metal clips or suture and laparoscopic colectomy with lymphadenectomy completed as normal. In case of failure of the intra-operative procedure, an ex vivo SN biopsy was performed on the colectomy specimen after resection. RESULTS: A total number of 904 lymph nodes were examined, with a median number of 22 lymph nodes harvested per patient. The SN detection rate was 100%, an ex vivo lymph node mapping was necessary in four patients. Eleven (26.2%) patients had lymph-nodal metastases and in five (45.5%) of these patients, SN was the only positive lymph node. There were two (18.2%) false-negative SN. In three cases (7.1%) with aberrant lymphatic drainage, lymphadenectomy was extended. The accuracy of SN mapping was 95.2% and negative predictive value was 93.9%. CONCLUSIONS: Laparoscopic lymphatic mapping and SN removal is feasible in laparoscopic colectomy for colon cancer. The ex vivo technique is useful as a salvage technique in case of failure of the intra-operative procedure. Prospective studies are justified to determine the real accuracy and false-negative rate of the technique

Experimental joint signal-idler quasi-distributions and photon-number statistics for mesoscopic twin beams

Joint signal-idler photoelectron distributions of twin beams containing several tens of photons per mode have been measured recently. Exploiting a microscopic quantum theory for joint quasi-distributions in parametric down-conversion developed earlier we characterize properties of twin beams in terms of quasi-distributions using experimental data. Negative values as well as oscillating behaviour in quantum region are characteristic for the subsequently determined joint signal-idler quasi-distributions of integrated intensities. Also the conditional and difference photon-number distributions are shown to be sub-Poissonian and sub-shot-noise, respectively.Comment: 7 pages, 6 figure