Complications of clandestine abortions: a cross-sectional study at the Provincial General Hospital of Kananga in the Democratic Republic of Congo

Introduction: the complications of clandestine abortions are formidable throughout the world, particularly in Africa. This study aims to determine the epidemiological and therapeutic profile of the complications of clandestine abortions in the gynecology service of the Provincial Hospital of Kananga. Methods: this is a cross-sectional study conducted from the medical records of pregnant women who experienced the complications of clandestine abortions in the gynecology department of the Provincial Hospital of Kananga from January 01, 2015, to December 31, 2019. It is based on the no probabilistic sampling of suitability. We recorded 38 cases of 58 patients. Results: the frequency of complications of clandestine abortions is 65.51% with an average age of pregnant women of 27.86 (SD 3.23) years and 70% of pregnant women under 30 years old, nulliparity was more concerned in 34.21% (n=13). Pupil students and unemployed are more affected in 55.26% (n=21). Cervical dilation and curettage practiced by nurses led to more complications from clandestine abortions in 69.07% (n=26). Incomplete abortions are the complications most encountered in 1 case out of 3. The aspiration-curettage is established in 1 out of 3 cases, and the mortality rate linked to complications of clandestine abortion was 21.05% (n=8). Conclusion: complications of clandestine abortions constitute a real public health problem in the town of Kananga, incomplete abortions are most encountered and the mortality rate linked to these complications is serious.

Retained plastic instrument after 5 years of illegal abortion: a case report and literature review

The retained of a foreign body during a surgical procedure is defined by the forgetting of a material, left by inattention in the body of the patient during this act. It is a rare event but is responsible for high morbidity and mortality. Authors report a retained foreign body incidentally discovered during a caesarean section. The patient had performed an illegal abortion by endo-uterine instrument which was complicated by uterine perforation five years previously. She was pregnant at 37 weeks and presented to the emergency department for bleeding and diagnosed as placenta previa. The antecedent of abortion had not been informed because it is an illegal act in Madagascar. The plastic instrument was in the broad ligament in contact with the ureter and the uterine artery. Caesarean section, the removal of the catheter and postoperative recovery was uneventful. Foreign body retention remains a malpractice and the diagnosis must be made in the face of chronic pain in patients who have undergone surgery.

Análise do controverso funcionamento clandestino de avícolas no município de São Paulo

O Brasil possui legislação sanitária rigorosa na produção de alimentos, entretanto questões culturais frequentemente conflitam com as normas, como o abate clandestino de aves. Mesmo com toda a tecnologia empregada e rigor do sistema de inspeção brasileiro ainda verifica-se o consumo de aves provenientes desses abates. O presente estudo objetivou fazer uma análise crítica sobre a existência e funcionamento das "Avícolas" no município de São Paulo, identificar fatores facilitadores e discutir ações para mitigar os riscos sanitários dessa atividade. Utilizou-se abordagem qualitativa para análise de documentos e relatórios gerados nas rotinas de trabalho da Coordenação de Vigilância em Saúde da Prefeitura do Município de São Paulo e legislação vigente acerca do assunto. Estima-se aproximadamente 3900 estabelecimentos com condições estruturais e sanitárias irregulares, porém não há levantamentos e/ou registros. As aves não possuem procedência determinada ou certificações sanitárias. O ambiente é promíscuo e insalubre, situação agravada pela falta de cuidados dos colaboradores. Há eliminação irregular de resíduos do abate, ausência de programas de autocontrole e/ou boas práticas de fabricação. Concluiu-se que as Avícolas são informais, ilegais e clandestinas, impactam negativamente a Saúde Pública pela atividade desenvolvida em desacordo com as normas sanitárias, ambientais e trabalhistas.

Brazil has strict sanitary laws in food production. However, cultural issues often conflict with the rules, such as clandestine slaughter of birds. Even with all the technology employed and the rigor of the Brazilian inspection system, we still observe the consumption of poultry from these slaughters. This study aimed to critically analyze the existence and functioning of poultry in the city of São Paulo, to identify facilitating factors and to discuss actions to mitigate the health risks of this activity. A qualitative approach used to analyze documents and reports generated in the work routines of the Health Surveillance Coordination Oflice of the Municipality of São Paulo and current legislation on the subject. There are approximately 3900 establishments without structural and sanitary conditions are estimated, but there are no surveys and / or records. The birds have no specific provenance or sanitary certifications. The environment is promiscuous and unhealthy, a situation aggravated by the lack of care of employees. There is irregular disposal of slaughter residues, absence of self-control programs and / or good manufacturing practices. It was concluded that Poultry are informal, illegal and clandestine, negatively impact Public Health by the activity developed in disagreement with sanitary, environmental and labor standards.

Análise do controverso funcionamento clandestino de avícolas no município de São Paulo

O Brasil possui legislação sanitária rigorosa na produção de alimentos, entretanto questões culturais frequentemente conflitam com as normas, como o abate clandestino de aves. Mesmo com toda a tecnologia empregada e rigor do sistema de inspeção brasileiro ainda verifica-se o consumo de aves provenientes desses abates. O presente estudo objetivou fazer uma análise crítica sobre a existência e funcionamento das "Avícolas" no município de São Paulo, identificar fatores facilitadores e discutir ações para mitigar os riscos sanitários dessa atividade. Utilizou-se abordagem qualitativa para análise de documentos e relatórios gerados nas rotinas de trabalho da Coordenação de Vigilância em Saúde da Prefeitura do Município de São Paulo e legislação vigente acerca do assunto. Estima-se aproximadamente 3900 estabelecimentos com condições estruturais e sanitárias irregulares, porém não há levantamentos e/ou registros. As aves não possuem procedência determinada ou certificações sanitárias. O ambiente é promíscuo e insalubre, situação agravada pela falta de cuidados dos colaboradores. Há eliminação irregular de resíduos do abate, ausência de programas de autocontrole e/ou boas práticas de fabricação. Concluiu-se que as Avícolas são informais, ilegais e clandestinas, impactam negativamente a Saúde Pública pela atividade desenvolvida em desacordo com as normas sanitárias, ambientais e trabalhistas

Brazil has strict sanitary laws in food production. However, cultural issues often conflict with the rules, such as clandestine slaughter of birds. Even with all the technology employed and the rigor of the Brazilian inspection system, we still observe the consumption of poultry from these slaughters. This study aimed to critically analyze the existence and functioning of poultry in the city of São Paulo, to identify facilitating factors and to discuss actions to mitigate the health risks of this activity. A qualitative approach used to analyze documents and reports generated in the work routines of the Health Surveillance Coordination Office of the Municipality of São Paulo and current legislation on the subject. There are approximately 3900 establishments without structural and sanitary conditions are estimated, but there are no surveys and / or records. The birds have no specific provenance or sanitary certifications. The environment is promiscuous and unhealthy, a situation aggravated by the lack of care of employees. There is irregular disposal of slaughter residues, absence of 77 Higiene Alimentar - Vol.32 - nº 285/286 - Novembro/Dezembro de 2018 self-control programs and / or good manufacturing practices. It was concluded that Poultry are informal, illegal and clandestine, negatively impact Public Health by the activity developed in disagreement with sanitary, environmental and labor standards

Experimentação e aprendizagem na trajetória afetiva e sexual de jovens de uma favela do Rio de Janeiro, Brasil, com experiência de aborto clandestino / Experiment and learning in the affective and sexual life of young women from a favela in Rio de Janeiro, Brazil, with experience of clandestine abortion

Resumo Este artigo aborda o tema da iniciação sexual na adolescência, com foco nas narrativas de dez jovens com experiência de aborto induzido, moradoras de uma favela do Rio de Janeiro. A análise lança mão da descrição do processo de entrada na sexualidade como estratégia para elucidar o contexto da gravidez e do primeiro aborto clandestino na trajetória afetivo-sexual das jovens aqui entrevistadas. Considera-se a iniciação um domínio da sexualidade e da vida social que envolve socialização, interpretação de regras e significados, sistema de atitudes, formas de aproximação, controle e modelação dos afetos, das emoções e das relações de gênero. Os resultados mostraram que a diferença de idade entre os pares na iniciação amorosa sexual é significativa, clarificando o contexto em que ocorreram as decisões sobre métodos contraceptivos, gravidez e aborto. Notou-se que as adolescentes se submetem a difíceis decisões sobre sua sexualidade e reprodução, em um momento de vida em que ainda lhes falta experiência sexual e reprodutiva. A partir dos dados, demonstra-se a importância do fortalecimento de políticas públicas, discussões sobre gênero e direitos sexuais e reprodutivos na adolescência em diversos âmbitos da sociedade, como escola, família e demais instituições.

Abstract This paper discusses the topic of first sexual intercourse in adolescence focusing on the course of ten young girls with experience of induced abortion living in a favela in Rio de Janeiro. The analysis uses the description of the process of entry into sexuality as a strategy to elucidate the context of pregnancy and the first clandestine abortion in the affective-sexual path of girls interviewed. The first sexual intercourse is a realm of sexuality and social life involving socialization, interpretation of rules and meanings, system of attitudes, ways of approximation, control and modeling of affections, emotions and gender relationships. The results showed that the age difference between couples in sexual initiation is significant, clarifying the context in which decisions on contraceptive methods, pregnancy and abortion were held. We noted that adolescents subject to difficult decisions about their sexuality and reproduction at a time of life where they still lack sexual and reproductive experience. The data collected show the importance of strengthening of public policies, discussions on gender and adolescent sexual and reproductive rights in many spheres of society, such as schools, family and other institutions.

The Deceased's Body Destroyed in Exhumation of Clandestine Graves: Case Reports and Literature Review / 대한법의학회지

Exhumation in clandestine graves has to be done very carefully, since it is considered as a crime scene. Most such cases are related to a suspicious death and it is very important to search for human remains carefully. Before excavation, all operational procedures have to be planned in advance. Missing evidence or human errors can be avoided if each investigative team member works together with archaeological assistance and forensic pathologists. But in practice, it may be difficult to work according to established standard operational procedures because, in many cases, the clandestinely buried victims appear in unexpected areas or it is hard to locate the exact location of the site. Therefore, we present the following cases and hope that the general principles for exhuming a clandestine grave will be established so that they can be helpful in similar investigations in the future.

Del riesgo a la vulnerabilidad. Bases metodológicas para comprender la relación entre violencia sexual e infección por VIH/ITS en migrantes clandestinos

resumen está disponible en el texto completo

Summary In the past, the epidemic of Acquired Immune Deficiency Syndrome (AIDS) was not conceived originally as a public health problem, and was attributed instead to individuals enacting social roles related to lifestyles considered as transgressions from hegemonic sexuality (heterosexual, reproductive and monogamous). The epidemiological analysis was upheld by clinical notions which reinforced the stigma of population groups historically discriminated, such as homosexuals and the Afro-American population. The study of the epidemic based on the concept of risk gave rice to the category of groups at risk, so that the phenomenon was explained from a moral point of view, as it also became apparent that the deaths associated with AIDS were a consequence of sexual preferences. This then impeded the analysis of the epidemic from the standpoint of the structural components of public health. Once it was possible to isolate and identify the Human Immune Deficiency virus (HIV) as the causal agent of AIDS, the epidemiology ceased referring to risk groups and incorporated the notion of risk practices. Even though, in the beginning potential infection with HIV by means of bodily fluids, such as blood, semen, and uterine cervical fluid was recognized, the clinical discourse still reinforced the stigmatization of infected people. The only innovation was the invention of the sexual worker as a new likely victim of the epidemic. At this moment, epidemiology recognizes the importance of speaking about contexts of risk instead of groups or practices at risk. Notwithstanding, the global dynamics of the epidemic tends to reinforce the idea that migrants are a new group at risk. This implies going backwards in the conceptual thinking of HIV/ AIDS because it suggests that migrants are a new hazard for public health, just like homosexuals and commercial sex workers. The mobile populations play a role in the transmission of HIV, especially in regions where international borders are shared between countries with unequal economies. For this, it is necessary to consider that the infections of HIV exist in cultural, political, and economical contexts. In this kind of regions, the epidemic can not be analyzed thinking of migrants as the responsible actors in the prevalence growth. The human traffic and the sexual aggressions, for example, are social phenomena linked to the structural conditions of the geographical stations of the mobile populations. In addition, it is necessary to consider that the worldwide dynamics of poverty and migration are produced as a result of disintegration of rural economies (disasters, wars, structural poverty). The relation between migration and poverty can be focused as that of contexts of sexual violence and discrimination. This point of view allows for the exploration of the conditions of HIV/STD infection among persons whose dignity is less respected. The relationship between international clandestine migration and HIV/AIDS has been studied scarcely. With the aim of proposing a different epistemological focus for this problem, in this article we reflect on the possibility of analyzing the notion of vulnerability placing it in a category which takes into account the historical, cultural, social and economic contexts. We propose to analyze vulnerability as a condition that may be transformed in space and time, and that is socially diverse because of this. From this, it follows that vulnerability is acquired in the process of interaction between migrants and the societies through which they move in transit. In this sense, vulnerability can be expressed as a way of being and living, linked to social roles and the course of the personal lives of the people who accompany migrants at the time of their territorial migration. Thus vulnerability is modified according to the historical and social conditions of their places of origin, the places they pass through, and the places of their destination, but also varies according to age, sex, education and social norms which direct sexual identity, as well as the reasons migrants have for displacing themselves. This perspective also permits us to observe that in ethnographic terms, vulnerability can be studied by taking into account the social capital of the clandestine migrant which, when translated into terms of their access to social networks in the places of origin, transit and destination, may either bring them nearer to or further away from situations of isolation, depression and sexual violence. The concept of vulnerability that we propose allows for the explanation of the ruralization of the HIV/AIDS epidemic as a phenomenon related to four socio-historic aspects: poverty, disintegration of agricultural zones, sexual violence and clandestine migration to the United States. We also suggest to include the fact that the HIV/AIDS epidemic occurs in contexts where the violation of human rights is associated with sexual aggression, which can also cause new HIV/STD. For this reason, the impact of poverty acquires a specific influence on this process presenting itself as the way of life of the migrant who transfers him-herself without documents and without authorization and who is especially fragile because he/she faces circumstances in which he/she has no social power. We thus consider that in order to understand in depth the phenomenon concerning the vulnerability of populations who move without legal papers, it is necessary to include both the life histories of the individuals and a study of the social context in which these take place, as a mean of analyzing their vulnerability. The objective of this essay consists in demonstrating the instrumental potential of the concept of vulnerability and its methodological implications for the study of international clandestine migration, as well as sexual aggressions as indicators of violation of human rights and infection with HIV/STD, respectively.

Avaliação do teor de nitritos em lingüiças clandestinas obtidas no município de Petrópolis, RJ / Evaluation of the content of nitrites in meat obtained in the local government of Petrópolis, RJ

As lingüiças são produtos cárneos comercializados em grande escala em função do seu baixo valor comercial, acessível a todos os setores da sociedade, sendo facilmente encontrados em vários segmentos do mercado varejista. Nas feiras-livres , o comércio de alimentos de origem animal reside basicamente em produtos clandestinos processados sem critérios higiênico-sanitários e sem controle pelos órgãos de Saúde Pública, representando risco potencial para a saúde do consumidor. Com o objetivo de avaliar o teor de nitritos em lingüiças clandestinas foram obtidas 15 amostras em açougues e 15 em feiras-livres do município de Petrópolis, RJ. Os resultados demonstraram que 26,7 por cento do total de amostras continham teor de nitritos acima do limite preconizado pela legislação vigente, sendo que foi encontrada maior incidência naquelas coletadas em feiras-livres (40,0 por cento) do que nas coletadas em açougues (13,3 por cento). O tratamento estatístico dos resultados não demonstrou diferença estatisticamente significativa (P>0,05) entre as amostras obtidas em açougue e em feiras livres. Conclui-se que apesar de 73,3 por cento das amostras possuírem teores de nitrito dentro do limite previsto pela legislação, todas as lingüiças comercializadas nestes locais foram consideradas impróprias para consumo por possuírem origem desconhecida e pelas péssimas condições de comercialização. O consumo de tais produtos representa risco para o consumidor que têm preferência por alimentos caracterizados como “caseiros” ou “artesanais”, sendo necessário à intervenção dos órgãos de Saúde Pública.

The sausages are commercialized large-scale by easily dealing with a product of accessible commercial value to allthe sectors of the society being found in supermarkets, slaughterhouse, fair-free and grocery stores. In the case of the fair-free, the food commercialization of animal origin is carried through with minimum or no control on the part of the agencies of Public Health representing risk to the consumer to contract alimentary toxiinfection, not only for containing high text of nitritos, but also for the methods used in the processing of these sausages. With the objective to detect and to verify the text of nitritos in clandestine sausages in [air-free and açougues commercialized of the city of Petrópolis - Rio de Janeiro, they had been harvested and analyzed 30 samples. Also had been observed bad conditions the one that had been displayed these products during the commercialization. The results had shown that 26,65% of the total of sampies contained text of nitritos above of the current law, being that bigger prevalence in those harvested in fair-free (40%) of was found that in the harvested ones in slaughterhouse (13,3%). One concludes that although 73,35% of the samples to possess texts of nitrito foreseen by the legislation, all the sausages commercialized in these places are considered improper for consumption for possessing unknown origin and bad commercialization conditions. The consumption of such products represents risk to the people who has preference for homer foods, being necessary the intervention of the agencies of Public Health.