864 resultados para Perversão sexual Psicanálise lacaniana
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ABSTRACT OBJECTIVE To estimate the prevalence of sexual initiation and contraceptive use at the last sexual intercourse of Brazilian adolescents, according to sociodemographic features. METHODS The data were obtained from the Study of Cardiovascular Risks in Adolescents (ERICA), a national school-based cross-sectional study. We included 74,589 adolescents from 32 geographic strata (27 capitals and five sets of municipalities with more than 100,000 inhabitants of each of the five macro-regions of the Country). Information on sexual initiation and contraceptive use at the last sexual intercourse (male condom and oral contraceptive pill) has been used. We have estimated prevalence and confidence intervals (95%CI) considering sample weights according to sex, age, type of school, residence status, macro-region and capitals. RESULTS We observed that 28.1% (95%CI 27.0-29.2) of the adolescents had already initiated sexual life, with higher prevalence among those aged 17 years (56.4%, 95%CI 53.9-58.9), males (33.5%, 95%CI 31.8-35.2), studying at public schools (29.9%, 95%CI 28.5-31.4), and from the Northern region (33.9%, 95%CI 32.3-35.4), mainly from Macapa, Manaus, and Rio Branco. Among those who had started their sexual life, 82.3% (95%CI 81.1-83.4) reported the use of contraceptive methods at the last intercourse, and the prevalence of use was higher among adolescents aged 17 years (85.3%, 95%CI 82.7-87.6), females (85.2%, 95%CI 83.8-86.5) and those living in the Southern region (85.9%, 95%CI 82.9-88.5). Male condom was used by 68.8% (95%CI 66.9-70.7), with no difference by type of school or macro-regions; the contraceptive pill was used by 13.4% (CI95% 12.2-14.6), and more frequently used among women (24.7%, 95%CI 22.5-27,0) and 17-year-old adolescents (20.8%, 95%CI 18.2-23.6) from urban settings(13.7%, 95%CI 12.5-14.9) and from the Southern region (22.6%, 95%CI 19.0-26.8), and less often in the Northern region. CONCLUSIONS ERICA’s data analysis on sexuality and contraception shows heterogeneities in the prevalence of sexual initiation and use of contraceptive methods among Brazilian adolescents, depending on their age, where they live, and the type of school they study at. Younger adolescents and those living in the Northern region seem to be more vulnerable to the consequences of unprotected sexual intercourses.
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Applied and Environmental Microbiology, Vol. 73, No.4
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Masters Thesis Academic Year 2007/2008 - European Masters Degree in Human Rights and Democratization (E.MA) - European Inter-university Centre for Human Rights and Democratization (EIUC) -Faculdade de Direito, Universidade Nova de Lisboa (UNL)
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European Masters Degree in Human Rights and Democratisation Academic Year 2005/2006
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RESUMO: Objectivos 1. Avaliar a morbilidade urinria e sexual secundria braquiterapia prosttica com implante de I125. 2. Avaliar a influncia da hormonoterapia neoadjuvante e adjuvante na morbilidade urinria e sexual secundria braquiterapia(I125). 3. Avaliar a influncia da associao da radioterapia externa na morbilidade urinria e sexual secundria braquiterapia(I125). 4. Avaliar a morbilidade urinria dos doentes com contra-indicao relativa (prstatas volumosas, IPSS elevado).Material e mtodos De Setembro de 2000 a Dezembro de 2004 foram recrutados 204 doentes com o diagnstico de carcinoma da prstata localizado (T1 e T2) ou localmente avanado (T3) e expectativa de vida superior a 10 anos. Foram submetidos a braquiterapia, com implante transperineal de Iodo 125 (I125) em monoterapia ou combinada com hormonoterapia e/ou radioterapia externa (tratamento trimodal). Definiram-se diversos sub-grupos de pacientes, consoante algumas caractersticas habitualmente referidas como factores de risco para a morbilidade do tratamento de braquiterapia prosttica, com o objectivo de analisar a sua influncia sobre a morbilidade urinria e sexual: Grupo 1: Braquiterapia em monoterapia (MONO) versus braquiterapia associada a radioterapia externa (BCOMB) Grupo 2: Prstatas volumosas (>50ml) versus prstatas no volumosas (<50ml)Grupo 3: Braquiterapia associada a hormonoterapia (HORM) versus braquiterapia sem hormonoterapia (NHORM)Grupo 4: IPSS elevado versus IPSS baixo Avaliou-se a evoluo do IPSS, QoL, taxa de RTU-P e reteno urinria ps implante, e evoluo do BSFI durante todo o perodo de seguimento. Resultados Grupo 1: Para o grupo MONO o IPSS iniciou-se com 7.1, sofreu agravamento para 16.1 e 15.9 ao primeiro e terceiro meses. Aos 12 meses, o IPSS desceu para 10.1 enquanto que, aos 18 e 24 meses, o IPSS foi de 7.3 e 5.8. O grupo BCOMB iniciou com IPSS de 9.4. Sofreu agravamento ligeiro e pouco acentuado at aos 6 meses (IPSS de 14). A evoluo do IPSS foi, ento, flutuante com IPSS de 5.9 aos 12 meses e 9.5 aos 18 meses. Aos 24 meses apresentava IPSS de 6.7. A taxa de reteno urinria (6.4% e 0%) e de RTU-P (2.0% e 0%) foram semelhantes nos grupos MONO e BCOMB, respectivamente (p=0.375 e p=1). A evoluo da qualidade das ereces foi semelhante nos dois grupos excepto aos 6 meses em que MONO apresentou o valor 6 e BCOMB 3.7 (p=0.029). A percentagem de doentes potentes foi significativamente inferior nos primeiros 6 meses aps a braquiterapia para o grupo BCOMB relativamente ao grupo MONO: 36%74%; 33%73%; 33%75%. Aps os 6 meses os grupos foram homogneos. Grupo 2: O IPSS evoluiu nas prstatas <50ml e >50ml de 79 para 15-19 ao primeiro ms e 15-18 ao 3. ms. Apenas ao primeiro ms que as diferenas no IPSS foram significativas (p=0.061). Aps o 3. ms os dois grupos foram semelhantes: IPSS de 8 e 12 ao 12. ms e 5.7 e 6 ao 24. ms. As taxas de reteno urinria e de RTU-P foram semelhantes (p=0.054 e p=0.286) Grupo 3: A evoluo do IPSS, taxas de reteno urinria e de RTU-P foram sobreponveis em ambos os grupos. A evoluo da lbido, ereces, percentagem de doentes potentes, ejaculao, incmodo e satisfao foi significativamente inferior no grupo HORM relativamente ao grupo N HORM apenas ao primeiro ms (valores de p<0.0001; <0.0001; < 0.0001; 0.009 e 0.002 respectivamente) Grupo 4: A evoluo do IPSS nos doentes com IPSS elevado foi a seguinte: 22.17(0M); 19.5(1M); 20.5(3M); 15.3(6M); 15.7(12M); 11(18M); 8(24M) A evoluo do IPSS nos doentes com IPSS baixo foi a seguinte: 5.9(0M); 15.3(1M); 14.9(3M); 12.2(6M); 8.9(12M); 7.2(18M), 5.5(24M) As taxas de RTU-P (2.8% e 0%) e reteno urinria (5.1% e 5.9%) foram semelhantes em ambos os grupos de doentes (p=1). Concluses 1. A radioterapia intersticial da prstata com implante transperineal e ecoguiado de Iodo 125 frequentemente acompanhada de morbilidade urinria transitria e de intensidade moderada. A Morbilidade consiste em sintomatologia do aparelho urinrio baixo (LUTS lower urinary tract symptoms) que, na maioria dos doentes, sofre um agravamento mximo do primeiro ao 3. ms. Segue-se uma melhoria ligeira at ao 6. ms que mais acentuada da em diante. Por volta do 12. e 18. ms, a maior parte dos doentes apresenta sintomatologia urinria muito semelhante que apresentava antes do tratamento. Aps o 18. ms, os doentes mantm uma melhoria da sintomatologia urinria para alm da que apresentavam previamente ao implante. As taxas de reteno urinria e de resseco transuretral prosttica aps o implante de braquiterapia so muito baixas, inferiores a 10%. 2. A associao da braquiterapia prosttica com radioterapia externa adjuvante influencia a evoluo da sintomatologia urinria: o aparecimento da sintomatologia urinria mais lento, demorando 6 meses a atingir o seu valor mximo que, por sua vez, de intensidade menos acentuada do que quando a braquiterapia utilizada em monoterapia. 3. O volume prosttico superior a 50 ml no influencia a morbilidade urinria. 4. A teraputica hormonal, neoadjuvante e adjuvante, no influencia a sintomatologia urinria. 5. Os doentes com sintomatologia urinria prvia muito acentuada no sofrem agravamento da referida sintomatologia. Pelo contrrio, apresentam uma melhoria de sintomas urinrios desde o primeiro ms, e que se mantm ao longo dos 24 meses de seguimento, apresentando, no final deste perodo, sintomatologia urinria ligeira e muito inferior que apresentavam antes do implante. As taxas de reteno urinria e RTU-P aps a braquiterapia so semelhantes s que ocorrem nos doentes assintomticos previamente ao implante. 6. A vida sexual est preservada, em mais de 70% dos casos, ao fim dos 24 meses de seguimento. No entanto, imediatamente aps o primeiro ms de seguimento, ocorre uma diminuio ligeira da qualidade das ereces que se mantm, sem melhoria ou agravamento, durante todo o perodo de seguimento. A hormonoterapia afecta todos os parmetros da vida sexual, embora de forma apenas temporria. Aps a suspenso da teraputica hormonal este grupo de doentes recupera a actividade sexual e apresenta-se idntico ao grupo de doentes que no foram sujeitos a essa teraputica.----------------ABSTRACT: Objectives 1. To assess urinary and sexual morbility after prostatic brachytherapy with the implant of I125 seeds. 2. To assess the influence of neoadjuvant and adjuvant hormone therapy in urinary and sexual morbility after prostatic brachytherapy with the implant of I125 seeds. 3. To assess the effects, on urinary and sexual morbility, of associating external radiotherapy after prostatic brachytherapy with the implant of I125 seeds. 4. To assess the urinary morbility in patients with relative contraindications (voluminous prostates, high IPSS). Material and Methods From September, 2000 to December, 2004 a total of 204 patients were recruited with a diagnosis of localized (T1 and T2) or locally advanced (T3) carcinoma of the prostate and a life expectancy in excess of 10 years. The patients underwent brachytherapy with transperineal seed implant of iodine (I125) as a monotherapy or in combination with hormone therapy and/or external radiotherapy (trimodal treatment). With the aim of evaluating the treatments influence on urinary and sexual morbility, a number of patient sub-groups were defined in accordance with certain characteristics normally mentioned as morbility risk factors for prostatic brachytherapy treatment: Group 1: Brachytherapy as monotherapy (MONO) versus brachytherapy in combination with external radiotherapy (BCOMB) Group 2: Voluminous prostates (>50ml) versus non- voluminous prostates (<50ml) Group 3: Brachytherapy in combination with hormone therapy (HORM) versus brachytherapy without hormone therapy (NHORM)Group 4: High IPSS versus a low IPSS. The evolution of the IPSS, QoL, TURP rate and post-implant urinary retention as well as the BSFI were assessed throughout the entire follow-up period. Results Group 1: For the MONO group the IPSS began at 7.1, and then rose to 16.1 and 15.9 in the first and third months, respectively. At month 12, the IPSS had dropped to 10.1 and at month 18 and 24 the IPSS was registered at 7.3 and 5.8, respectively. The BCOMB group started out with an IPSS of 9.4. It underwent a slight and little-significant rise until month 6 (IPSS at 14). The evolution of the IPSS then began to fluctuate from an IPSS of 5.9 at month 12 and 9.5 at month 18. At month 24 we registered an IPSS of 6.7. The urinary retention rate (6.4% and 0%) and TURP rate (2.0% e 0%) were similar to those of the MONO and BCOMB groups, respectively (p=0.375 and p=1). The evolution regarding the quality of erections was similar for the two groups except at 6 months when the MONO group displayed a value of 6 and the BCOMB group 3.7 (p=0.029). The percentage of sexually potent patients was significantly lower in the first six months after brachytherapy for the BCOMB group when compared with the MONO group: 36%74%; 33%73%; 33%75%. After six months, the results became more consistent. Group 2: IPSS results evolved in <50ml and >50ml prostates from 79 to 15-19 in the first month and from 15-18 after the third month. It was only in the first month that the differences in the IPSS were significant (p=0.061). After the third month, the two groups displayed similar outcomes: IPSS 8 and 12 at month 12 and 5.7 and 6 at month 24. Urinary retention and TURP rates were similar (p=0.054 e p=0.286). Group 3: IPSS evolution and rates of urinary retention and TURP were identical in both groups. Figures regarding libido, erections, percentage of sexually potent patients, ejaculation, discomfort and sexual satisfaction were always significantly lower for the HORM group, when compared to the NHORM group in the first month only (values of p<0.0001; <0.0001; <0.0001; 0.009 e 0.002, respectively). Group 4: IPSS evolution in patients with a high IPSS was as follows: 22.17(0M); 19.5(1M); 20.5(3M); 15.3(6M); 15.7(12M); 11(18M); 8(24M) IPSS evolution in patients with a low IPSS was as follows: 5.9(0M); 15.3(1M); 14.9(3M); 12.2(6M); 8.9(12M); 7.2(18M), 5.5(24M)TURP rates (2.8% e 0%) and those for urinary retention (5.1% e 5.9%) were similar in both patient groups (p=1). Conclusions 1. Interstitial radiotherapy of the prostate with transperineal, ultrasound-guided implant of Iodine-125 seeds is often followed by transitory urinary morbility of moderate intensity. The morbility involves symptoms of the lower urinary tract which, in most cases are at their worst from the first to the third months. There is a slight improvement up to the sixth month, at which point improvement becomes more accentuated. Around months 12 or 18, most patients display urinary symptoms that are very similar to those noted before treatment. After month 18, patients urinary symptoms continue to improve past the point they displayed prior to the implant. Urinary retention rates and those for transurethral resection of the prostate are very low (below 10%), after brachytherapy seed implant. 2. The combination of prostatic brachytherapy and adjuvant external radiotherapy affects the evolution of urinary symptoms: the appearance of urinary symptoms is much slower, taking six months to peak, and is less intense than when brachytherapy is employed as the only means of treatment. 3. The fact that the prostate displays a volume greater than 50 ml does not influence urinary morbility. 4. Neoadjuvant and adjuvant hormone therapy do not influence urinary symptomology. 5. Patients with severe, preexisting symptoms of the urinary tract do not experience a worsening of those symptoms. On the contrary, they exhibit an improvement in urinary symptoms as of the first month. This improvement continues for the 24 months, after which patients display symptoms of the urinary tract that are slight and a noticeable improvement over the urinary complaints registered before the implant. Urinary retention and TURP rates subsequent to brachytherapy are similar to those registered for asymptomatic patients. 6. The patients sexual performance is maintained in more than 70% of the cases, as noted after 24 months of follow-up. However, immediately after the first follow-up month there is a lessening in the quality of erections that continues, without improving or worsening, for the whole follow-up period. Hormone therapy affects all the parameters of sexual performance, albeit temporarily. After suspending hormone therapy, this group recovered with regard to sexual performance, and showed itself to be identical to the group of patients that had not undergone hormone therapy.-------------------RESUM:Objectives 1. valuer la morbilit urinaire et sexuelle aprs la realisation la curiethrapie de la prostate avec implant de I125. 2. valuer l influence de la thrapie hormonale noadjuvante et adjuvante en ce qui concerne la morbilit urinaire et sexuelle aprs la ralisation de la curiethrapie (I125). 3. valuer linfluence de lassociation de la radiothrapie externe dans la morbilit urinaire et sexuelle aprs la ralisation de la curiethrapie (I125). 4. valuer la morbilit urinaire des malades avec des contre indications relatives (prostates volumineuses, IPSS lev). Matriel et mthodologie De Septembre 2000 Dcembre 2004, on a recrut 204 patients ayant pour diagnostique un carcinome de la prostate localis (T1 et T2) ou localement avanc (T3) et dont lexpectative de vie tait de plus de 10 ans. Ils ont t soumis au traitement de la curiethrapie avec limplantation transprinal de liode 125 (I125) en monothrapie ou en traitement combin avec une thrapie hormonale et/ou radiothrapie externe (traitement trimodale). Il y a eu plusieurs sous-catgories de patients, et cela dpend de quelques caractristiques normalement considres comme des facteurs risque en ce qui concerne la morbilit du traitement de la curiethrapie de la prostate, et lobjective tant danalyser son influence sur la morbilit urinaire et sexuelle. Groupe 1: Curiethrapie en traitement unique (MONO) par rapport la curiethrapie associe au traitement externe (BCOMB). Groupe 2: Prostates volumineuses (>50ml) par rapport au prostates qui ne sont pas volumineuses (<50ml). Groupe 3: Curiethrapie associe au traitement hormonale (HORM) par rapport la curiethrapie sans traitement hormonale (NHORM). Groupe 4: IPSS lev par rapport au IPSS diminu. Nous avons valu levolution du IPSS, Qualit de vie, le taux de RTU-P et la retention de lurine aprs limplant, BSFI pendant toute la priode du traitement. Rsultats Groupe 1: Pour le groupe MONO lIPSS a commen avec un taux de 7.1, et les patients ont souffert dun empirement allant jusqu 16.1 et 15.9 pendant le premier et le troisime mois. 12 mois aprs lIPSS diminua jusqu 10.1 18 mois le taux ft de 7.3 et 24 mois il diminua encore jusqu atteindre 5.8. Le groupe BCOMB commena avec un taux dIPSS de 9.4. Ils souffrirent un empirement lgr et peu accentu jusquaux 6 premiers mois (IPSS de 14). Lvolution de lIPSS tait fluctuante allant de 5.9 12 mois et 9.5 18 mois. 24 mois, lIPSS tait de 6.7. Le taux de retention de lurine (6.4% et 0%) et de la RTU-P (2.0% et 0%) taient simmilaires dans les groupes MONO et BCOMB respectivement (p=0.375 et p=1). L volution de la qualit des rections ft semblable dans les 2 groupes except le groupe MONO qui prsenta une valeure de 6 6 mois et le groupe BCOMB qui prsenta une valeure de 3.7 (p=0.029). Le pourcentage des malades sexuellement puissants a t significativement infrieur pendant les 6 premiers mois depuis la curiethrapie pour le groupe BCOMB si on le compare au groupe MONO: 36%74%; 33%73%; 33%75%. Aprs cette priode, les groupes erent des rsultats homognes. Groupe 2: L IPSS a volu dans les prostates <50ml et >50ml de 79 jusqu 15-19 pendant le premier mois et jusqu 15-18 au 3me mois. Cest seulement pendant le premier mois que les diffrences de lIPSS ont t significatives (p=0.061). Aprs le 3me mois les deux groupes ont eu des rsultats semblables: IPSS 8 et 12 12. mois et 5.7 et 6 24. mois. Le taux de retention de lurine et de la RTU-P ont t simmilaires (p=0.054 e p=0.286). Groupe 3: Levolution de l IPSS, les taux de retention de lurine et de la RTU-P pourraient se surposer pour les deux groupes. Lvolution de la libido, des rections, le pourcentage des malades sexuellements puissants, lincommodit et la satisfaction ont t toujours significativement infriures dans le groupe HORM par rapport au groupe NHORM ds le premier mois (valeurs de p <0.0001; <0.0001; < 0.0001; 0.009 et 0.002 respectivement) Groupe 4: Lvolution de l IPSS pour les malades ayant un IPSS lev ft ainsi: 22.17(0M); 19.5(1M); 20.5(3M); 15.3(6M); 15.7(12M); 11(18M); 8(24M)Lvolution de l IPSS pour les malades ayant un IPSS diminu ft ainsi:5.9(0M); 15.3(1M); 14.9(3M); 12.2(6M); 8.9(12M); 7.2(18M), 5.5(24M) Le taux de RTU-P (2.8% e 0%) et de retention de lurine (5.1% et 5.9%) ont t semblables dans les 2 groupes de malades (p=1). Conclusions 1. La radiothrapie interstitielle de la prostate avec implant transprinal de liode 125 est frquamment acompagne dune morbilit urinaire transitoire et dintensit modre. La morbilit consiste dune symptomatologie de lapparil urinaire infrieure qui, dans la plupart des malades, empire gravement du premier au troisime mois. La situation samliore lgrement jusquau 6me mois, lamlioration tant plus accentue partir de l. Autour du 12me jusquau 18me mois, la majorit des malades prsente une symptomatologie urinaire qui se ressemble beaucoup celle quils avaient avant le traitement. Aprs le 18me mois lamlioration de la symptomatologie urinaire est constante par rapport celle quils prsentaient avant limplant. Le taux de retention de lurine et de RTU-P aprs limplant de la curiethrapie sont trs basses, au dessus de 10%. 2. Lassociation de la curiethrapie de la prostate avec la radiothrapie externe adjuvante a une influence sur lvolution de la symptomatologie urinaire: lapparition des symptmes est plus lente, prenant jusqu 6 mois pour atteindre son niveau maximum, qui son tour, a une intensit moins accentue que lorsque la curiethrapie est utilise en monothrapie. 3. Le volume de la prostate suprieure 50 ml na pas dinfluence sur la morbilit urinaire. 4. La thrapie hormonale, noadjuvante et adjuvante, na pas dinfluence sur la symptomatologie urinaire. 5. Les malades ayant une symptomatologie urinaire pralable et trs accentue ne souffrent pas dempirement de leur situation. Au contraire, ils prsentent une amlioration des symptmes urinaires partir du premier mois et ceci se maintient tout au long des 24 mois que dure le traitement, ayant la fin de cette priode une symptomatologie urinaire lgre et beaucoup plus basse que celle quils prsentaient avant limplant. Le taux de retention de lurine et de la RTU-P aprs la curiethrapie est simmilaire celui que les malades qui nont pas de symptmes prsentent avant limplant. 6. La vie sexuelle est prserve dans plus du 70% des cas la fin de la priode de traitement (24 mois). Entretemps, immdiatement aprs le premier mois dtude, on note une lgre diminution de la qualit des rections qui se maintient sans amlioration ou empirement tout au long du traitement. Le traitement base dhormones affecte tous les paramtres de la vie sexuelle, mais de faon temporaire. Aprs la suspension de la thrapie hormonale ce groupe de malades rcupre lactivit sexuelle et se prsente de faon gale au groupe de malades qui nont pas t soumis ce traitement.
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In order to contribute to a better understanding of the forms of acquisition of hepatitis C virus (HCV) in Brazil, with special emphasis on sexual transmission, we determined the presence of HCV infection in regular partners and in non-sexual home communicants of blood donors seen at Fundao Pr-Sangue Hemocentro de So Paulo from January 1992 to July 1996. Of 154 blood donors with HCV infection (index cases), 111 had had regular partners for at least 6 months. Sixty-eight of 111 partners were evaluated for HCV infection. Of these, 8 (11.76%) were considered to have current or previous HCV infection; a history of sexually transmissible diseases and index cases with a positive HCV-RNA test were more prevalent among partners with HCV infection. Of the 68 index cases whose partners were studied, 56 had non-sexual home communicants. Of the total of 81 home communicants, 66 accepted to be evaluated for HCV infection. None of them was HCV-positive, suggesting that the high prevalence of HCV infection among partners may be attributed at least partially to sexual transmission.
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RESUMO O comportamento sexual dos jovens actualmente, uma das principais preocupaes da Sade Pblica internacional e nacional pela sua associao com vrias consequncias indesejveis que, directa ou indirectamente, afectam a sade e o bem-estar dos adolescentes, nomeadamente infeco pelo Vrus da Imunodeficincia Adquirida (VIH/SIDA), outras Infeces Sexualmente Transmissveis (ISTs) e gravidez indesejada. Os comportamentos sexuais de risco tm sido identificados como uma das principais causas associadas com a mortalidade, morbilidade e problemas sociais nos jovens. O presente trabalho tem como objectivos gerais aprofundar o conhecimento sobre a sexualidade e os comportamentos sexuais nos adolescentes portugueses escolarizados e identificar necessidades e factores relevantes para a Sade Sexual e preveno do VIH/SIDA nos adolescentes. Para a concretizao destes objectivos foram efectuados dois estudos, um quantitativo e outro qualitativo. O estudo quantitativo pretende descrever os conhecimentos, atitudes e prticas na rea da sexualidade com relevncia para a preveno do VIH/SIDA nos jovens e analisar as relaes entre os comportamentos sexuais adoptados e as variveis scio-demogrficas, as psicossociais e as dos contextos sociais do jovem (famlia, pares, escola e comunidade). A amostra utilizada composta por 3762 adolescentes que frequentavam o 8 e 10 ano de escolaridade e faz parte do estudo realizado em Portugal Continental em 2002 (Matos, Gonalves, Dias, & Aventura Social, 2003) da Rede Europeia Health Behaviours in School-aged Children (HBSC/OMS), da Organizao Mundial de Sade (Currie et al., 2004). O segundo estudo, qualitativo, prope-se identificar e aprofundar os factores e processos ligados proteco e ao risco individuais e do contexto ecolgico, visando compreender as dinmicas subjacentes aos conhecimentos, atitudes e comportamentos sexuais relevantes para a preveno do VIH/SIDA. Neste estudo foram realizados 12 grupos focais, utilizando uma amostra constituda por 72 adolescentes, 36 jovens do sexo feminino e 36 do sexo masculino, de seis escolas pblicas do ensino regular situadas em diferentes regies do pas. Nos resultados do estudo quantitativo, salienta-se a percentagem de adolescentes que refere j ter iniciado a actividade sexual, 23.7%. Relativamente idade da primeira relao sexual, 48.2% dos adolescentes refere ter tido a sua primeira experincia sexual entre os 12 e os 14 anos e 17.3% aos 11 anos ou menos. Quanto utilizao do preservativo, 29.9% dos jovens refere no o ter utilizado na ltima relao sexual. Os dados sugerem a existncia de diferenas de gnero e de idade relativamente aos conhecimentos, atitudes e comportamentos sexuais. Pelos resultados encontrados nas anlises de regresso logstica pode-se verificar que as variveis ter iniciado as relaes sexuais e no ter utilizado o preservativo, na ltima relao sexual, se associam significativamente com variveis individuais de nvel scio-demogrfico e pessoal e variveis relativas ao contexto social que rodeia os jovens (famlia, pares, escola e comunidade). Os resultados do estudo qualitativo sublinham que as questes ligadas sexualidade so complexas e que os conhecimentos, atitudes e comportamentos sexuais adoptados pelos jovens sofrem mltiplas influncias que se situam a vrios nveis, nomeadamente individual, familiar, interpessoal (pares), escolar e comunitrio. Os adolescentes identificaram diversos factores ligados proteco e ao risco nos diferentes nveis de anlise. Os resultados apontam tambm para que os factores e processos de risco e de proteco interagem entre si atravs de possveis relaes que reduzem ou aumentam a probabilidade do envolvimento em comportamentos de risco. Os resultados dos dois estudos sugerem que os adolescentes no podem ser considerados um grupo homogneo em relao aos conhecimentos, atitudes e comportamentos sexuais e relativos ao VIH/SIDA. Apontam tambm para a importncia das intervenes precoces, que envolvam os jovens como principais intervenientes no processo e os agentes de socializao (pares, pais, escola e comunidade), quer ao nvel da reduo dos factores ligados ao risco, quer ao nvel da promoo dos factores ligados proteco. A complementaridade encontrada na utilizao de diferentes metodologias parece funcionar como uma estratgia para aumentar o conhecimento e a compreenso das complexidades em que a sexualidade se desenvolve. Os resultados obtidos neste trabalho podero contribuir para o planeamento e implementao de programas de promoo de Sade Sexual e preveno de VIH/SIDA nos jovens, que reflictam as suas necessidades especficas, e consequentemente, permitam efectivos ganhos na sade juvenil.
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Mestrado em Estudos sobre as mulheres. As mulheres na sociedade e na cultura
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It is generally agreed that the hepatitis C virus (HCV) can be efficiently transmitted parenterally, although data on viral transmission by sexual or non-sexual intrafamilial contact are conflicting. Since data collection began in 1989, the first study dealt with the risk of sexual transmission among multiple sex partners. Other investigations followed, emphasizing that risk increases in specific groups such as patients co-infected with HIV and HBV, sex workers, homosexuals, illicit drug users and patients attended at sexually transmittable disease clinics. The question arises as to what might be the risk for monogamous heterosexuals in the general population, in which one of the partners has HCV? The literature provides overall rates that vary from zero to 27%; however, most studies affirm that the chances of sexual transmission are low or almost null, with rates for this mode fluctuating from zero to 3%. Intrafamilial transmission is strongly considered but inconclusive, since when mentioning transmission between sex partners within the same household, specific situations also should be considered, such as the sharing of personal hygiene items, like razorblades, toothbrushes, nail clippers and manicure pliers, which are important risk factors in HCV transmission. In this review, we discuss the hypotheses of sexual and/or intrafamilial transmission.
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In South Brazil the circulation of two HIV-1 subtypes with different characteristics represents an important scenario for the study of the impact of HIV-1 diversity on the evolution of the HIV-1 epidemic and AIDS disease. HIV-1 B, the predominant variant in industrialized countries and HIV-1 C, the most prevalent subtype in areas with rapid epidemic growth, are implicated in most infections. We evaluated blood samples from 128 antiretroviral (ARV) nave patients recruited at entry to the largest HIV outpatient service in Porto Alegre. Based on partial pol region sequencing, HIV-1 C was observed in 29%, HIV-1 B in 22.6% and, the recently identified CRF31_BC, in 23.4% of 128 volunteers. Other variants were HIV-1 F in 10% and other mosaics in 5.5%. In order to evaluate the association of socio-behavioral characteristics and HIV-1 subtypes, interviews and laboratory evaluation were performed at entry. Our data suggest an established epidemic of the three major variants, without any evidence of partitioning in either of the subgroups analyzed. However, anal sex practices were associated with subtype B, which could indicate a greater transmissibility of non-B variants by vaginal intercourse. This study provides baseline information for epidemiologic surveillance of the changes of the molecular characteristics of HIV-1 epidemics in this region.
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A braquiterapia prosttica de baixa taxa de dose considerada uma opo teraputica adequada para o carcinoma da prstata. habitualmente, apresentada como a melhor forma de preservar a funo erctil de entre os diversos tratamentos de carcinoma da prstata. Contudo, estudos recentes demonstram que, tambm a braquiterapia prosttica pode, no longo prazo, provocar algum grau de disfuno erctil (DE). As taxas de DE nas diversas sries publicadas, so muito variveis. Os resultados da influncia da dose de radiao, isoladamente (D90) ou quando incidindo sobre o feixe neurovascular ou o bulbo so contraditrios. O tipo de istopo utilizado no tem qualquer influncia sobre a DE. No entanto factores como a idade, a funo erctil pr-tratamento, a diabetes, a utilizao de radioterapia externa adjuvante e/ou hormonoterapia neoadjuvante podem condicionar os resultados obtidos. Otratamento da disfuno erctil deve ser efectuado com inibidores da fosfodiesterase, obtendo-se boas taxas de resposta. Podem surgir outras alteraes da funo sexual, nomeadamente, hematospermia, dor durante o orgasmo e alterao da intensidade do orgasmo.
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Overview and Aims: Several behavioral and biological factors can make adolescents particularly vulnerable to unwanted pregnancies and sexually transmitted diseases. The aim of this study was to evaluate sexual behavior and contraceptive use patterns of a population of adolescents. Study Design: Retrospective study. Population: 163 female adolescents attending an Adolescence Unit for the first time, during 2010. Methods: Analysis of clinical charts and assessment of demographic data, smoking and drinking habits, drug use, gynecologic and obstetric history, sexual behavior and contraceptive use. Results: The mean age was 16.04 years (1.32). 71.7% were students (of these, 70% had failed one or more years and were behind in their studies), 2.5% were working and 23.9% were neither studying or working. 95.1% had already had sexual intercourse and the mean age of first coitus was 14.53 years (1.24). There was a history of at least one previous pregnancy in 77.3% of the cases. Before the first appointment at the AU, the contraceptive methods used were: the pill (33.2%, but 41.3% of these reported inconsistent use), and the condom (23.9%, with inconsistent use in 28.3% of these cases). 19.6% did not use any contraceptive method.. After counseling at the AU, 54% of the teenagers chose the contraceptive implant and 35% preferred the pill. Adolescents who had already been pregnant preferred a long acting method (namely, the contraceptive implant)in 61.9% of cases; those who had never been pregnant decided to use an oral contraceptive in 67.6% of cases (p<0.001). Conclusions: After counseling the number of teenagers using contraception increased. In this population there were a high number of adolescents with a previous pregnancy. This factor seems to have influenced the choice of the contraceptive method, with most of these adolescents choosing a long-acting method.
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Assunto apoiado ao longo dos sculos e culturas em preconceitos morais, religiosos e mdicos, a sexualidade durante a gravidez e puerprio constitui ainda hoje motivo de grande ansiedade, condicionante da sexualidade do casal. Aproveitados pelas diferentes religies, culturas e polticas, alguns conceitos mantiveram-se inalterados at ao sculo passado, altura em que uma maior abertura para as questes sexuais na sociedade em geral, despertou na comunidade cientfica interesse pela sexualidade humana. Desde ento, vrios estudos tm contribudo para uma melhor compreenso da resposta sexual na gravidez e puerprio. Neste artigo efectuada uma reviso da literatura e uma reflexo sobre o conhecimento actual do tema.
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Dissertao para obteno do Grau de Doutor em Biologia
