Population and health in Latin America and the Caribbean: outstanding matters, new challenges

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Hydatidiform mole resulting from sexual violence

Background. Hydatidiform mole (HM) is characterized by abnormal proliferation of human trophoblast with producers functioning tissues of human chorionic gonadotropin. It can evolve with ovarian cysts tecalute��nicos, hypertension of pregnancy or hyperthyroidism. The incidence of HM is variable and its etiology poorly known, associated with nutritional factors, environmental, age, parity, history of HM, oral contraceptives, smoking, consanguinity or defects in germ cells. There is no reference in literature on HM resulting from sexual violence, objective of this report. Method. Description of two cases of HM among 1146 patients with pregnancy resulting from sexual violence treated at Hospital P��rola Byington, S��o Paulo, from July 1994 to August 2011. Results. The cases affected young, white, unmarried, low educated and low parity women. Sexual violence was perpetrated by known offenders unrelated to the victims, under death threat. Ultrasound and CT of the pelvis showed bulky uterus compatible with HM without myometrial invasion. One case was associated with theca lutein cysts. The two cases were diagnosed in the second trimester of pregnancy and evolved with hyperthyroidism. There was no hypertension, disease recurrence, metastasis or sexually transmitted infection. Conclusion. The incidence of HM was 1:573 pregnancies resulting from rape, within the range estimated for Latin American countries. Trophoblastic material can be preserved to identify the violence perpetrator, considering only the paternal HM chromosomes. History of sexual violence should be investigated in cases of HM in the first half of adolescence and women in a vulnerable condition. �� 2012 Drezzet et al; licensee BioMed Central Ltd.

Oral health-related quality of life and satisfaction before and after treatment with complete dentures in a Dental School in Brazil

Purpose: The aim of this study was to evaluate the impact of treatment with new complete dentures on oral health-related quality of life and satisfaction of edentulous patients attending the Prosthodontic Department in a Dental School in Brazil. Methods: A total of 70 edentulous subjects (37-86 years) treated by undergradute students at the Ara��atuba Dental School, University of State of S��o Paulo, were accessed. A specific questionnaire for edentulous patients (EDENT) based on the Oral Health Impact Profile (OHIP-EDENT) was applied to collect information on patient oral health-related quality of life. Questions related to the personal satisfaction of the edentulous patients with their complete dentures were also included. The patients were accessed before the treatment, and 3 months after receiving the new dentures. Results: After rehabilitation with new complete dentures, all domains of OHIP-EDENT showed significant improvements. There was also a significant improvement in patient satisfaction after placement of new complete dentures. Furthermore, it was possible to observe association between upper denture satisfaction and age. Conclusion: Conventional complete dentures may have a positive impact on oral health-related quality of life and satisfaction of edentulous patients. �� 2012 Japan Prosthodontic Society.

Sexual transmission of Toxoplasma gondii in sheep

Male sheep of reproductive age were distributed into three groups: GI, a sheep inoculated (oral) with 2.0��105 oocysts of the P strain of Toxoplasma gondii; GII, a sheep infected (subcutaneous) with 1.0��106 tachyzoites of the RH strain of T. gondii; and GIII, a sheep kept as a control (not infected). After the inoculation of the males, 12 breeding ewes, which were not pregnant and which were serologically negative for reproductive diseases (particularly toxoplasmosis), were distributed into three groups, synchronized, and subsequently exposed to natural mating with previously inoculated males. The distribution was as follows: five ewes that underwent natural mating with the GI male, five ewes that were exposed to natural mating with the GII male, and two ewes that were mated with the non-infected male (control). Serum samples of all the ewes were collected on days -30, -14, -7, -1, and 0 (days before natural mating) and on days 1, 3, 5, 7, 11, 14, and weekly until birth; the presence of serum antibodies against T. gondii was assessed by IFAT. Using a bioassay and PCR, T. gondii was isolated from the semen of the infected reproducing sheep before mating. Following natural mating, 5 of the 12 females displayed antibodies specific for T. gondii; of these animals, two of the ewes underwent natural mating with the male inoculated with oocysts (GI) and three with the male infected with tachyzoites (GII). One of the females that displayed antibodies specific to this coccidian and that underwent natural mating with the GII sheep had a macerated fetus on the 70th day following coverage. Using a bioassay after the birth, it was possible to isolate T. gondii from samples of the pool of tissues from the five females that seroconverted after natural mating and from their respective lambs. Using PCR, the DNA of T. gondii was isolated from the pool of tissues from one and two females exposed to natural mating with the reproductive males infected with the oocysts and tachyzoites, respectively. Using this technique, it was also possible to diagnose the presence of the parasite in the pool of tissues from the lambs of one female that underwent natural mating with the male sheep infected with oocysts. These results demonstrated the sexual transmission of T. gondii in the sheep species with consequent vertical transmission to their lambs. �� 2013 Elsevier B.V.

Preval��ncia das doen��as sexualmente transmiss��veis em mulheres profissionais do sexo do Munic��pio de Botucatu/SP

Funda����o de Amparo �� Pesquisa do Estado de S��o Paulo (FAPESP)

M��es adolescentes: estrutura e funcionamento familiar

P��s-gradua����o em Psicologia do Desenvolvimento e Aprendizagem - FC

Aids e uso de preservativos por adolescentes: an��lise da hist��ria individual e pr��ticas culturais

P��s-gradua����o em Psicologia do Desenvolvimento e Aprendizagem - FC

Diagn��stico citol��gico e molecular da infec����o pelo HPV em mulheres do munic��pio de Barcarena, Par��, Norte do Brasil

O HPV (Papilomav��rus humano) foi apontado pela OMS (Organiza����o Mundial de Sa��de - WHO) como principal fator de risco para o desenvolvimento do c��ncer de colo uterino, tornando-se assim um importante e grav��ssimo problema de sa��de p��blica, especialmente nos pa��ses subdesenvolvidos ou em desenvolvimento. A precocidade das atividades sexuais, m��ltiplos parceiros e sexo casual, o tabagismo, a imunossupress��o (por exemplo, na popula����o de pacientes aid��ticos), gravidez, doen��as sexualmente transmiss��veis pr��vias como herpes e clam��dia, al��m do n��o cumprimento das medidas j�� adotadas como preven����o de Doen��as Sexualmente Transmiss��veis (DST), como por exemplo, o simples uso de preservativos, est�� reconhecidamente associado �� incid��ncia da infec����o por HPV. Essa pesquisa teve como objetivo avaliar o desempenho diagn��stico das metodologias de citologia convencional (Exame de Papanicolau) em rela����o �� citologia em base l��quida, al��m de determinar a preval��ncia dos gen��tipos 16 e 18 do HPV em mulheres sem efeito citop��tico compat��vel com HPV e relacionar a presen��a de quadros inflamat��rios, associados ou n��o ao HPV, com dados epidemiol��gicos como idade, escolaridade, condi����o sociocultural de mulheres provenientes do munic��pio de Barcarena ��� Par�� ��� Brasil. Para tanto, participaram deste estudo, voluntariamente, 50 mulheres atendidas na Unidade de Sa��de de Barcarena ��� Par��, atrav��s de campanha para coleta de Exame de Papanicolau como m��todo de preven����o de c��ncer do colo do ��tero. Estas mulheres receberam informa����es referentes a todos os procedimentos realizados pelo corpo de sa��de deste estudo e aos resultados desta pesquisa e somente ap��s as volunt��rias terem assinado o Termo de Consentimento Livre e Esclarecido, as mesmas foram inclu��das para as coletas de amostras. As an��lises e os resultados dos testes de citologia de base l��quida e convencional foram realizados segundo a Classifica����o de Bethesda e revisados cegamente por dois citopatologistas. Para a an��lise estat��stca foi utilizado o teste exato de Fisher e o "Screening Test" visando determinar a especificidade/ sensibilidade dos m��todos, considerando significativo o valor de p ��� 0,05. Como resultado, observamos que o uso da citologia de base l��quida tem demonstrado uma s��rie de vantagens em rela����o �� citologia convencional. No diagn��stico molecular (PCR) foram observadas ocorr��ncias de HPV dos tipos 16 e 18 em 10% das mulheres atendidas. Dentre os casos que apresentaram PCR positivo para os tipos 16 ou 16/18 a maioria das mulheres tinham 27,4 anos de idade em m��dia; com maior escolaridade; que exercem atividades dom��sticas e rurais; e com ocorr��ncias de co-infec����o por agentes infecciosos causadores de outras doen��as sexualmente transmiss��veis. Os resultados obtidos neste estudo refor��am a import��ncia da manuten����o de campanhas gratuitas de preven����o do c��ncer de colo do ��tero como uma medida preventiva no combate desta doen��a, principalmente no Estado do Par�� onde, provavelmente, o perfil epidemiol��gico da doen��a est�� associado ��s grandes dist��ncias que as mulheres de comunidades ribeirinhas t��m que percorrer para realizar este exame de forma gratuita; ao tipo de atividade econ��mica da regi��o; ao preconceito local ainda existente com o exame; e ao grau de dificuldade de implementa����o de a����es efetivas de retorno das pacientes ��s consultas m��dicas ap��s a obten����o do resultado do exame e mesmo o encaminhamento para diagn��stico molecular dos casos positivos para les��es do tipo ASC-H e NIC I, II e III.

Epidemiologia da infec����o genital pelo Papilomav��rus humano (HPV) em popula����o feminina geral e popula����o carcer��ria

A infec����o genital pelo Papilomav��rus humano (HPV) �� considerada uma das doen��as sexualmente transmiss��veis (DSTs) mais comum, representando um importante problema na Sa��de P��blica, al��m de estar diretamente relacionado �� promo����o do c��ncer de colo uterino. Este estudo teve o intuito de investigar os aspectos epidemiol��gicos da infec����o genital pelo HPV em dois grupos distintos: mulheres de popula����o geral e mulheres encarceradas. Para tanto foi conduzido um estudo transversal anal��tico com 423 mulheres a partir dos 18 anos que se submeteram ao exame preventivo do c��ncer do colo uterino, sendo 233 mulheres da popula����o geral oriundas de uma unidade b��sica de sa��de da cidade de Bel��m do Par�� e 190 provenientes do Centro de Reeduca����o Feminino em Ananindeua no mesmo Estado, no per��odo de janeiro de 2008 a mar��o de 2010. Amostras da c��rvice uterina foram coletadas para a realiza����o da colpocitologia convencional e para a detec����o do DNA do HPV atrav��s da rea����o em cadeia da polimerase (PCR) mediada pelos oligonucleot��deos iniciadores universais MY9/11. Todas as mulheres responderam a um formul��rio cl��nico e epidemiol��gico. Entre as 423 mulheres analisadas, a preval��ncia geral de infec����o genital pelo HPV foi de 13,0% com varia����o entre 15,0% para a amostra geral e 10,5% para a carcer��ria. A faixa et��ria mais acometida foi a de 13 a 25 anos (19%) na amostra geral; e em mulheres com 45 anos ou mais (21,1%), nas carcer��rias. Anormalidades Colpocitol��gicas, situa����o conjugal, n��mero de parceiros sexuais novos, o uso de anticoncepcionais orais, hist��ria de DST e de sintomas genitais, al��m de tabagismo atual, foram fatores que se mostraram associados �� infec����o genital pelo HPV de maneira diferenciada entre amostras da popula����o geral e carcer��ria.

Dental fluorosis and its influence on children���s life

Funda����o de Amparo �� Pesquisa do Estado de S��o Paulo (FAPESP)

Sexualidade na internet: an��lise de blogs sobre sexualidade e educa����o sexual

Coordena����o de Aperfei��oamento de Pessoal de N��vel Superior (CAPES)

A produ����o cient��fica sobre diagn��stico de enfermagem NANDA no Brasil: revis��o integrativa da literatura-UNESP ��� Botucatu

Concern about the identity of nursing professionals has existed since Florence Nightingale. The exercise of the nursing profession must be based on scientific principles so that the actual health problems of a given community can be assessed and actions targeted at improving the population���s quality of life can be designed from such assessments. This problem assessment is referred to as Nursing Diagnosis. NANDA defines diagnosis as ���a clinical judgment about individual, family or community responses to actual or potential health problems/life processes. Nursing diagnosis provides the basis for selection of nursing interventions to achieve outcomes for which nurses are accountable���. The present study aimed at investigating the scientific production on Nursing Diagnosis (NANDA). This is an literature review. For data collection, an instrument that addressed the following items was used: identification of original articles and evaluation of their objectives, methodological characteristics, results and conclusion. In the present review, 15 articles that met the inclusion criteria were analyzed. They were all authored by nurses. Four articles addressed obstetrics, puerperium and neonatology, and the diagnosis of an unsatisfactory breastfeeding process was observed in 100% of cases. As regards chronic diseases, four articles were found, and two exclusively addressed diabetes, with a main diagnosis of an ineffective control of the therapeutic regimen. Three articles addressed the elderly, and the main diagnosis found was hindered mobility in more than 90% of cases. As regards, sexually transmitted diseases, one article was found with three diagnoses with 100% for disturbed sleep patterns, infection risk and ineffective protection. As to patients with sequelae, two articles were identified, and the diagnoses found were hindered physical mobility, with 100%; self-care deficit for... (Complete abstract click electronic access below)

Estudo dos fatores de risco e preval��ncia de cervicite por Chlamydia trachomatis em adolescentes do munic��pio de Botucatu, S��o Paulo

Some characteristics and behaviors, that are of young, as a tendency to rebel and take risks, deviating from the rules of society, makes it vulnerable to many detrimental aspects, such as may indiscriminate use of alcohol and drugs, practicing unsafe sex and having multiple partners, which cause, among another complications, sexually transmitted diseases (STD). The Chlamydia trachomatis causes chlamydial infection, is one of the most recurrent STD of the world. Several risk factors are already defined for Chlamydial infection, among them, age under 25 years old and sexual behavior of the risk. The objective was to determine the prevalence of Chlamydia infection cervicitis in adolescent females of the Botucatu, S��o Paulo, and risk factors associated with this infection. It is cross-sectional study, of the populational basis, performed together the nineteen basic health units of the Botucatu, S��o Paulo. The data were obtained through clinical interviews and gynecological examination on samples collected for laboratory analysis. The research of C. trachomatis was performed by polymerase chain reaction (PCR). This report presents preliminary data, which represent 19% of the sample checked. Were interviewed 37 adolescents with a mean age of 17 years (between 15th and 19th years old), average of years studied of the 8,19, 40% of the families lived on less than a minimum wage by person and 24,3% dosen���t has ownership of the house where they live. Mean age of first sexual intercourse of 14 years (between 12th and 16th years old), 24,3% regularly used condoms, 5,4% had a premature birth and 8,1% reported abortion. 75,7% had any complaints in the gynecological exam, pain in lower abdomen, the most prevalent. The prevalence of vulvovaginitis or vaginal flora altered was 54,1%. The prevalence of infection by C. trachomatis was 58%. Presence content was associated infection chlamydial and age... (Complete abstract click electronic access below)

Oficinas sobre sexualidade com adolescentes: um estudo de caso

Adolescents are commonly seen in a ���sexless��� way so that when the first sexual expressions appear in our young people they are permeated by worry and fear. In this context, the school spread the vision of sex and sexuality, as hazardous due to risks of sexually transmitted diseases and unwanted pregnancy. Thus, seeking to encourage reflection on the part of adolescents with regard to sexual life, workshops were developed with 15 students in a seventh grade student at a state school in the city of Jaboticabal, S��o Paulo. The findings of this research indicate that adolescents have conceptions of sexuality marked by repression, including the maintenance of sex roles traditionally established. The implementation of interventions in the form of workshops revealed that the group has become an area that favors the reconstruction and rebuilding of meanings through the questions and judgment of values and attitudes socially imposed.

Percep����o de adolescentes em rela����o a doen��as sexualmente transmiss��veis e m��todos contraceptivos

Introduction: sexually transmitted diseases (DST) can represent an important impact on teenager���s health due its consequences. Objective: to identify the perception and knowledge of teenagers about DST, its transmission forms and contraception. Methods: it was made a cross-sectional study type investigation, with 136 teenager students from a Technical Education Public Institution in a middle-sized city. It was used a tested instrument, self answered, with opened and closed questions about theme and sociodemographic data. The same data were stored and analyzed by Program Epi Info version 3.5.1. Results: 97,1% affirmed to know male condoms, 89,0% oral contraceptives, 87,5% female condoms, 74,3% postcoital contraceptives, 47,8% natural family planning methods, 41,9% hormonal injection, 33,1% intrauterine devices, 31,6% coitus interruptus and 1,5% other contraceptive methods. According with them, the information was gave principally on high school (46,1%), by friends or partners (20,3%), doctor (10,9%), television (10,2%). In relation to DST, 98,5% affirmed that diseases can be transmitted during coitus. The aids (91,2%) and herpes (72,8%) were the most cited diseases. Just 31,6% of teenagers affirmed that run the risk to acquire some DST, and 88,4% of them, due no use of condoms, 30,2% due their partner make relation with other people, 18% due have many sexual partners and 9,3% due other causes. Conclusion: even teenagers knowing many contraceptive methods and sexually transmitted diseases, the teenagers have not prevented theirselves yet. It���s necessary that the high school reinforce the use of contraceptive methods, because the school is an important source of educative information on health area.