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Rev. Assoc. Med. Bras. (1992) ; 68(6): 853-859, June 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1387148


SUMMARY OBJECTIVES: This study aimed to compare heart rate variability indices in early and late postmenopausal women and assess their correlation and prognostic value to predict late postmenopausal. METHODS: An observational and retrospective study was performed with the medical records of patients from Hospital das Clínicas, Faculdade de Medicina da Universidade de Sao Paulo between 2018 and 2019. We selected medical records of women with menopause, over 40 years old, which were divided into two groups, according to postmenopausal time, i.e., early and late postmenopausal. RESULTS: We analyzed data from 123 women (55 in the early and 68 in the late postmenopausal group). RRtri (triangular index) was lower in the late postmenopausal group (8.68 vs. 7.15, p=0.040). There was a significant weak negative correlation in SDNN, RRtri, and SD2 and postmenopausal time. RRtri presented the potential to predict late postmenopausal. CONCLUSION: The increase in postmenopausal time decreases global heart rate variability indices. The geometric index RRtri was significantly lower in late postmenopausal women and presented the potential to predict late postmenopausal.

Rev. Assoc. Med. Bras. (1992) ; 68(6): 759-764, June 2022. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1387168


SUMMARY OBJECTIVE: This study aimed to evaluate the knowledge of the obstetricians and gynecologists in the care of women victims of violence in the public health system and the existence of institutional mechanisms to support them. METHODS: A cross-sectional and observational study was conducted with an electronic questionnaire by physicians who provided care in the obstetrics and gynecology emergency unit of the public health system. This study aimed to identify the care for victims of violence who received the institutional mechanisms of support, the difficulties encountered in determining the appropriate care, and estimates of the prevalence of violence against women. RESULTS: Notably, 92 physicians responded to the questionnaire. Of these, 85% had already provided care in one or more cases of violence, and 60% believed that <20% of the women received adequate care in these cases, mainly due to the short-time frame of the consultation, lack of team preparation, and lack of institutional resources. A total of 61% of the participants believed that they were not prepared to provide adequate care in those cases. CONCLUSIONS: Most of the physicians interviewed, although reported to have sufficient knowledge to adequately treat victims of violence, did not provide such care due to lack of institutional support.

Rev. bras. ginecol. obstet ; 44(6): 621-628, June 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1394792


Abstract Breaking bad news is common in obstetrics and gynecology (ob-gyn). However, it is difficult, and few doctors receive training on how to deal with this situation. This narrative review aims to gather, analyze, and synthesize part of the knowledge on the area, focused on Ob-Gyn. Among the 16 selected articles, two are randomized controlled intervention studies, and most studies refer to obstetrics. The results found by us pointed out that simulation, feedback/debriefing, lectures, and protocols could improve doctors' performance in communicating bad news. For patients, the context and how the information is transmitted seem to impact more than the content of the news. Ob-Gyn doctors could benefit from specific protocols and education, given the specialty's particularities. There is a lack of evidence about the most effective way to conduct such training. Finding validated ways to quantify and classify studies' results in the area, which would allow for the objective analysis of outcomes, is one of the biggest challenges concerning this topic.

Resumo Dar más notícias é comum em obstetrícia e ginecologia. Porém, é difícil e poucos médicos recebem treinamento sobre como lidar com essa situação. Esta revisão narrativa tem como objetivo reunir, analisar e sintetizar parte do conhecimento sobre a área, com foco na obstetrícia. Dentre os 16 artigos selecionados, dois são estudos de intervenção randomizados e controlados, e a maioria dos estudos refere-se à obstetrícia. Os resultados encontrados ressaltaram que simulação, feedback/entrevistas, palestras e protocolos podem melhorar o desempenho dos médicos na comunicação de más notícias. Para os pacientes, o contexto e como as informações são transmitidas parecem ter maior impacto do que o conteúdo das notícias. Os obstetras e ginecologistas poderiam se beneficiar de cursos e protocolos específicos, dadas as particularidades da especialidade. Faltam evidências sobre a forma mais eficaz de realizar esse treinamento. Encontrar formas validadas de quantificar e classificar os resultados dos estudos na área, permitindo uma análise objetiva dos resultados, é um dos maiores desafios neste tema.

Rev. bras. ginecol. obstet ; 44(1): 25-31, Jan. 2022. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1365668


Abstract Objective The present study aimed to understand patient perception of the adverse effects of contraceptives to improve health care and adherence to treatment. Methods An online questionnaire was available for women in Brazil to respond to assess their perception of adverse effects and their relationship with contraceptive methods. Results Of all 536 women who responded, 346 (64.6%) reported current contraceptive use. One hundred and twenty-two (122-34.8%) women reported having already stopped using contraception because of the adverse effects. As for the contraceptive method used, the most frequent was the combined oral contraceptive (212-39.6%). When we calculated the relative risk for headache, there was a relative risk of 2.1282 (1.3425-3.3739; 95% CI), suggesting that the use of pills increases the risk of headache, as well as edema, in which a relative risk of 1.4435 (1.0177-2.0474; 95% CI) was observed. For low libido, the use of oral hormonal contraceptives was also shown to be a risk factor since its relative risk was 1.8805 (1.3527-2.6142; 95% CI). As for acne, the use of hormonal contraceptives proved to be a protective factor, with a relative risk of 0.3015 (0.1789-0.5082; 95% CI). Conclusion The choice of a contraceptive method must always be individualized, and the patients must be equal participants in the process knowing the expected benefits and harms of each method and hormone, when present.

Resumo Objetivo Este estudo é destinado a entender a percepção de pacientes sobre os efeitos adversos dosmétodos contraceptivos para aprimorar o atendimentomédico e a aderência das mulheres ao tratamento. Métodos Um questionário online foi disponibilizado para que mulheres no Brasil respondessem a fim de avaliar a sua percepção em relação aos efeitos adversos e a associação desses aos métodos contraceptivos. Resultados Das 536 mulheres que responderam, 346 (64,5%) alegaram uso atual de método contraceptivo. Cento e vinte e duas (122-34,8%) mulheres disseram que já haviam parado o uso de métodos contraceptivos devido aos seus efeitos adversos. Quanto ao método contraceptivo em uso, o mais frequentemente utilizado foi o contraceptivo hormonal oral combinado (212-39,6%). Quando calculamos o risco relativo para cefaleia, foi encontrado um risco relativo de 2,1282 (1,3425-3,3739; 95% intervalo de confiança [IC]), sugerindo que o uso das pílulas aumenta o risco de ocorrência desse efeito adverso, bem como de edema, cujo risco relativo foi de 1,4435 (1,0177-2,0474; 95% IC). Em relação à redução da libido, o uso de contraceptivo hormonal oral combinado foi também considerado um fator de risco, pois seu risco relativo foi 1,8805 (1,3527-2,6142; 95% IC). No que se refere à acne, o uso de contraceptivos hormonais demonstrou ser um fator de proteção, com risco relativo de 0,3015 (0,1789-0,5082; 95% IC). Conclusão A escolha de um método contraceptivo deve sempre ser individualizada, e as pacientes devem participar igualmente nesse processo sabendo dos benefícios e malefícios esperados de cada método e hormônio, quando presente.

Article in Chinese | WPRIM | ID: wpr-928100


This paper discussed the guiding significance of "disease-syndrome-symptom" mode in FU Qing-zhu's Obstetrics and Gynecology(FU Qing-zhu Nyu Ke) for dealing with ovulation disorder infertility caused by hyperprolactinemia(HPRL). FU Qing-zhu's Obstetrics and Gynecology(FU Qing-zhu Nyu Ke) concentrates on the disease entities, main symptoms, pathogenesis, and syndrome differentiation, based on which the prescriptions are prescribed. This reflects the "disease-syndrome-symptom" mode, with the core lying in the "combination of disease with syndrome". The contained Discussion on Menstruation Regulation(Tiao Jing Pian) and Discussion on Getting Pregnant(Zhong Zi Pian) have important reference significance for later doctors in the diagnosis and treatment of inferti-lity, and many prescriptions are still in use due to good effects. It is believed in traditional Chinese medicine(TCM) that HPRL results from kidney deficiency and liver depression, among which kidney deficiency is the main cause. Liver depression accelerates the onset of HPRL, so the kidney-tonifying and liver-soothing herbs were mainly selected. The "disease-syndrome-symptom" mode in FU Qing-zhu's Obstetrics and Gynecology(FU Qing-zhu Nyu Ke) sheds enlightenment on the diagnosis and treatment of ovulation infertility caused by HPRL, in that it is not confined to disease entity and syndrome type. The integration of "disease-syndrome-symptom" highlights the main complaint of patients and emphasizes the main pathogenesis, thus giving full play to the overall advantage of syndrome differentiation. For multiple diseases in FU Qing-zhu's Obstetrics and Gynecology(FU Qing-zhu Nyu Ke) such as infertility due to liver depression, infertility due to obesity, delayed menstruation, and irregular menstruation, although the typical lactation symptom of HPRL is not mentioned, the medication can still be determined according to the chief complaint, syndrome type, and symptoms and signs, making up for the defects of excessive reliance on serum biochemical indicators in modern Chinese medicine. We should learn its diagnosis and treatment thoughts of paying attention to liver, spleen, kidney, and heart, holism, and strengthening body resistance to eliminate pathogenic factors.

Female , Gynecology , Humans , Hyperprolactinemia/drug therapy , Infertility , Obstetrics , Ovulation , Pregnancy
Rev. méd. Minas Gerais ; 31: 31213, 2022.
Article in English, Portuguese | LILACS | ID: biblio-1372686


Introdução: a embolização de artérias uterinas (EAU) é uma opção terapêutica no tratamento de miomas uterinos sintomáticos; todavia, a dor pós-procedimento representa um grande desafio para essa técnica. Nesse contexto, o Bloqueio do Nervo Hipogástrico Superior (BNHS), já utilizado no tratamento de dor pélvica crônica associada à malignidade, apresenta-se como opção de intervenção intraprocedimento para melhorar a recuperação das pacientes e fomentar o uso da EAU na prática clínica. Objetivo: realizar uma revisão integrativa da literatura disponível sobre o BNHS no manejo de dor pós EAU. Métodos: bases de dados PubMed, The Cochrane Library, Lilacs e Medline foram avaliadas a partir da combinação dos termos "uterine artery embolization", "pain" e "superior hypogastric block". Foram incluídos estudos clínicos, disponíveis em texto completo, com pacientes adultas, submetidas à EAU, cujo objetivo era avaliar o uso do BNHS e seu impacto na dor pós-procedimento. Foram excluídos artigos de revisão, carta ao editor, e publicação em anais de congresso. Resultados: 8 artigos, em maior parte retrospectivos, indicaram consistência do BNHS em termos de sucesso terapêutico a curto prazo e redução da dor. Apenas uma complicação foi relatada, e evoluiu de forma satisfatória. Conclusões: BNHS tem potencial de aprimorar o manejo da dor após EAU, podendo impactar positivamente no tempo e na qualidade da recuperação, com redução da dor e consumo de opiodes no período pós-operatório. Esses benefícios valorizam o procedimento de embolização como uma alternativa a ser considerada no tratamento de leiomiomas sintomáticos para mulheres candidatas à preservação uterina.

Introduction: Uterine Artery Embolization (UAE) is a therapeutic option in the treatment of symptomatic uterine fibroids; however, post-procedure pain imposes as a great challenge in this technique. In this context, the Superior Hypogastric Nerve Block (SHNB), already used in the treatment of chronic pelvic pain associated with malignancy, presents itself as an option for intraprocedural intervention, to improve patients' recovery and to promote UAE in the clinical setting. Objective: to perform an integrative literature review about the effectiveness of SHNB in pain management after UAE. Methods: databases PubMed, The Cochrane Library, Lilacs and Medline were assessed using the combination of the terms "uterine artery embolization", "pain" and "superior hypogastric block". Clinical studies were included once available in full text, with adult patients submitted to UAE, whose objective was to evaluate the use of SHNB and its impact in post-procedure pain. Review articles, letters to the editor, and publication in conference proceedings were excluded. Results: 8 articles were found, most of them retrospective, indicated SHNB's consistency in terms of short-term therapeutic success and pain reduction. The single reported complication evolved satisfactorily. Conclusions: SHNB has the potential to improve pain management after UAE, which can positively impact recovery time and quality, with reduced pain and consumption of opioids in the postoperative period. Benefits like these can enhance the embolization procedure as an alternative to be considered for the treatment of symptomatic fibroids for women candidates for uterine preservation.

Pelvic Pain , Uterine Artery Embolization , Myoma , Radiology, Interventional , Gynecology , Anesthetics
Rev. bras. educ. méd ; 46(1):, 2022.
Article in English | LILACS-Express | LILACS | ID: biblio-1365610


Abstract: Introduction: Professionalism is an essential condition for the doctor's performance. The specialty of Gynecology and Obstetrics (GO) has been marked by a growing demand for disciplinary proceedings. Faced with this reality, the American College of Gynecology and Obstetrics (ACOG) recommended recording destructive or hostile behaviors that affect patient safety and the quality of care, remediate them and educate the clinical staff of institutions about it. Despite its importance for the training of future professionals, the lack of consensus about its definition and measurement methods make it difficult to implement targeted actions aimed at this purpose. Objective: This study´s objective was to know the senses and meanings attributed by Gynecology and Obstetrics (GO) residents to medical professionalism. Method: An exploratory, qualitative study was carried out through focal groups with 21 GO residents from Fortaleza, Ceará, Brazil. The analysis of content in the thematic modality supported the data analysis and the interpretation was supported by Symbolic Interactionism. Results: The senses and meanings attributed to professionalism by the residents were expressed in four topics: set of conducts for the benefit of the patient; doctor-patient relationship and relationship with the work team; set of professional attributes; and moral and ethical exercise of the profession. Conclusion: Professionalism is understood as a set of characteristics that include the comprehensive training of the physician, based on skills, scientific knowledge, values, technical skills, clinical reasoning, enabling the exercise of Medicine with respect, morals and ethics.

Resumo: Introdução: Profissionalismo é condição essencial para a atuação do médico. A especialidade de ginecologia e obstetrícia (GO) tem sido marcada por uma demanda crescente de processos disciplinares. Diante dessa realidade, o Colégio Americano de Ginecologia e Obstetrícia (ACOG) recomendou registrar comportamentos destrutivos ou hostis que afetem a segurança do paciente e a qualidade do cuidado, remediá-los e educar o corpo clínico de instituições sobre isso. Apesar da importância do profissionalismo para a formação dos futuros profissionais, a ausência de consenso sobre a definição e os modos de mensuração desse aspecto dificulta a implementação de ações direcionadas voltadas a esse fim. Objetivo: Este estudo teve como objetivo conhecer os sentidos e significados atribuídos pelos residentes de GO ao profissionalismo médico. Método: Realizou-se estudo exploratório, qualitativo, por meio de grupos focais, com 21 residentes de GO de Fortaleza, no Ceará, no Brasil. A análise de conteúdo na modalidade temática respaldou a análise dos dados, e a interpretação amparou-se no interacionismo simbólico. Resultado: Os sentidos e significados atribuídos pelos residentes ao profissionalismo expressaram-se em quatro temáticas: conjunto de condutas em benefício do paciente; relação médico-paciente e com a equipe de trabalho; conjunto de atributos profissionais; e exercício moral e ético da profissão. Conclusão: O profissionalismo é entendido como um conjunto de características que incluem a formação integral do médico, a partir de competências, conhecimentos científicos, valores, habilidades técnicas e raciocínio clínico, possibilitando o exercício da medicina com respeito, moral e ética.

Rev. bras. ginecol. obstet ; 43(12): 980-984, Dec. 2021. graf
Article in English | LILACS | ID: biblio-1357092


Abstract Introduction In the present study, we report a case of primary adenoid cystic carcinoma (ACC) of the Bartholin gland with high-grade transformation (HGT). Adenoid cystic carcinoma of the Bartholin gland is a rare tumor and HGT has only been reported in head and neck tumors. Case Report A 77-year-old woman with a non-ulcerated vulvar lesion on the topography of the right Bartholin gland. The patient was submitted to tumor resection followed by V-Y island flap and adjuvant radiotherapy. The histopathological examination revealed primary ACC of the Bartholin gland, with areas of HGT and extensive perineural invasion. The immunohistochemical study with p53 showed a diffuse and strong positive reaction in areas with HGT. After 24 months of follow-up, the patient presented distant metastases and died, despite having undergone to chemotherapy. Conclusion As far as we know, this case is the first description in the literature of HGT in ACC of the Bartholin gland, and HGT appears to be associated with tumor aggressiveness.

Resumo Introdução Este estudo relata o caso de um carcinoma adenoide cístico (CAC) de glândula de Bartholin com transformação de alto grau. O CAC de glândula de Bartholin é um tumor raro, e sua transformação de alto grau é relatada somente em tumores de cabeça e pescoço. Relato de caso Paciente de 77 anos de idade, do sexo feminino, com lesão vulvar não ulcerada na topografia da glândula de Bartholin direita. A paciente foi submetida a ressecção do tumor e realização de retalho em V-Y, seguidas de radioterapia adjuvante. O exame histopatológico revelou CAC primário de glândula de Bartholin, com áreas de transformação de alto grau e invasão perineural. O estudo imunohistoquímico com p53 mostrou reação positiva difusa e intensa em áreas com transformação de alto grau. Após 24 meses de seguimento, a paciente apresentou metástases à distância e faleceu, apesar de ter sido submetida a quimioterapia. Conclusão Pelo que sabemos, este caso é a primeira descrição na literatura de transformação de alto grau em CAC de glândula de Bartholin, e a transformação de alto grau parece estar associada à agressividade do tumor.

Humans , Female , Aged , Bartholin's Glands , Vulvar Neoplasms , Carcinoma, Adenoid Cystic/therapy , Radiotherapy, Adjuvant
Rev. bras. ginecol. obstet ; 43(11): 853-861, Nov. 2021. tab, graf
Article in English | LILACS | ID: biblio-1357073


Abstract Objective To evaluate the knowledge, attitudes, and behaviors regarding complementary and alternative medicine methods of patients who were admitted to gynecology outpatient clinics. Methods In the present survey, a questionnaire on complementary and alternative medicine practices was applied on 1,000 women (ages between 18 and 83 years old) who were admitted to the gynecology outpatient clinic of a tertiarymaternity hospital. Demographic features and knowledge, attitudes, and behaviors about these methods were inquired in face-to-face interviews. Results While 80.7% of the total participants thought that complementary and alternative medicine was beneficial, only 37.5% of them had used these methods previously. The rate of prior knowledge on this subject was of 59.7% and the source of information was physicians for 8.5% of the patients. However, 72.4% of all participants wanted to obtain information on these methods and 93.7% wanted to be informed by physicians. In the decision tree model, having knowledge about complementary and alternative medicine was the most effective factor determining its use (p<0.001). Phytotherapy was found to be the most used method, with 91.4%. The most preferred plant was onion (18.9%), and the most common reasons for herbal use were stress (15.4%) and fatigue (15.2%). Conclusion More than one-third of the patients who applied to the gynecology outpatient clinics used one of the complementary and alternativemedicine methods at least once. As gynecologists and obstetricians, we need to be more knowledgeable about these methods to provide correct guidance to our patients for accessing accurate and effective information.

Resumo Objetivo Avaliar o conhecimento, as atitudes e os comportamentos em relação aos métodos de medicina complementar e alternativa de pacientes internadas em ambulatórios de ginecologia. Métodos Na presente pesquisa, um questionário sobre práticas de medicina complementar e alternativa foi aplicado a 1.000 mulheres (idades entre 18 e 83 anos) que foram admitidas nos ambulatórios de ginecologia de uma maternidade terciária. Características demográficas e conhecimento, atitudes e comportamentos sobre esses métodos foram investigados em entrevistas pessoais. Resultados Enquanto 80,7% do total de participantes achavam que a medicina complementar e alternativa era benéfica, apenas 37,5% deles haviam usado esses métodos anteriormente. A taxa de conhecimento prévio sobre o assunto foi de 59,7% e a fonte de informação foi médica para 8,5% dos pacientes. No entanto, 72,4% de todos os participantes queriam obter informações sobre esses métodos e 93,7% queriam ser informados por médicos. No modelo de árvore de decisão, ter conhecimento sobre medicina complementar e alternativa foi o fator mais eficaz para determinar seu uso (p<0,001). A fitoterapia foi o método mais utilizado, com 91,4%. A planta preferida foi a cebola (18,9%), e osmotivos mais comuns para o uso de ervas foram estresse (15,4%) e fadiga (15,2%). Conclusão Mais de um terço das pacientes que se inscreveram no ambulatório de ginecologia utilizaram um dos métodos de medicina complementar e alternativa pelo menos uma vez. Como ginecologistas e obstetras, precisamos ter mais conhecimento sobre estes métodos a fimde fornecer orientações corretas aos nossos pacientes para o acesso a informações precisas e eficazes.

Humans , Female , Pregnancy , Adolescent , Adult , Aged , Aged, 80 and over , Young Adult , Complementary Therapies , Gynecology , Attitude , Health Knowledge, Attitudes, Practice , Surveys and Questionnaires , Ambulatory Care Facilities , Phytotherapy , Middle Aged
Femina ; 49(9): 572-576, 20211030. ilus
Article in Portuguese | LILACS | ID: biblio-1342327


A dismenorreia é a queixa ginecológica mais comum em mulheres jovens adultas, com um índice que varia entre 43% e 93% das mulheres que menstruam. A dismenorreia membranosa (DM), uma subclassificação da dismenorreia, é definida como a descida espontânea de tecido endometrial pela vagina, cursando com dor em có- lica intensa e súbita. O relato de caso descrito evidencia três episódios típicos de DM, com recorrência em três vezes distintas, após uso do mesmo anticoncepcional oral combinado de baixa dosagem. Esta publicação é importante para a comunidade científica devido à escassez de informações e artigos científicos publicados sobre o assunto, propondo a elucidação de alguns aspectos sobre o tema.(AU)

Dysmenorrhea is the most common gynecological complaint in young adult women, with an index that varies between 43% and 93% of women who menstruate. Membranous dysmenorrhea (MD) is a subclassification of dysmenorrhea and is defined as the spontaneous descent of endometrial tissue through the vagina, leading to severe and sudden colic pain. The case report described shows three typical episodes of MD, with recurrence three times after the use of the same low-dose combined oral contraceptive. This publication is important for the scientific community due to the scarcity of information and scientific articles published about this subject, proposing to elucidate some aspects about this theme.(AU

Humans , Female , Adult , Dysmenorrhea/complications , Dysmenorrhea/diagnosis , Dysmenorrhea/etiology , Dysmenorrhea/therapy , Progesterone/adverse effects , Women's Health , Contraceptives, Oral, Combined/adverse effects
Med. clín. soc ; 5(2)ago. 2021.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1386226


RESUMEN Introducción: La tasa de fecundidad adolescente (15-19 años) de América Latina y el Caribe (ALC), con un valor de 73,2 por mil, se destaca por ser muy elevada, comparada con 48,9 a nivel mundial y 52,7 en los países en desarrollo. Metodología: Es un estudio observacional, descriptivo y temporalmente retrospectivo. El muestreo es no probabilístico de casos consecutivos. La población accesible son mujeres entre 12 y 19 años que aceptaron la aplicación del implante subdérmico como método anticonceptivo que acuden en el espacio Ñangareko del Servicio de Ginecología y Obstetricia, en el periodo de 1 año (2019 - 2020). Resultados: Sobre los efectos adversos del implante subdérmico, el 79,4 % no nota cambios en el patrón menstrual, sin embargo, el 17,9 % tiene spotting y el 2,7 % amenorrea. El 5,4 % reporta cefalea, el 1,3 % informa alteración del humor o ansiedad. En cuanto a la tensión mamaria estuvo presente en el 0,4 % de los casos. El 4 % reportó dolor o irritación en la zona. Discusión: El uso del implante subdérmico ha demostrado ser un método seguro, de bajo coste, que no genera molestias ni efectos secundarios que hagan desistir a las mujeres de su uso, la seguridad de este método anticonceptivo está avalada por varias investigaciones sobre sus beneficios y seguridad.

ABSTRACT Introduction: The adolescent fertility rate (15-19 years) in Latin America and the Caribbean (LAC), with a value of 73.2 per thousand, stands out for being very high, compared to 48.9 worldwide and 52.7 in developing countries. Methods: It is an observational, descriptive and temporally retrospective study. The sampling is non-probabilistic of consecutive cases. The accessible population are women between 12 and 19 years of age who accepted the application of the subdermal implant as a contraceptive method who attended the Ñangareko space of the Gynecology and Obstetrics Service, in the period of 1 year (2019-2020). Results: Regarding the adverse effects of the subdermal implant, 79.4% did not notice changes in the menstrual pattern, however, 17.9% had spotting and 2.7% had amenorrhea. 5.4% report headache, 1.3% report mood disturbance or anxiety. Regarding breast tension, it was present in 0.4% of cases. 4% reported pain or irritation in the area. Discussion: The use of the subdermal implant has proven to be a safe, low-cost method that does not generate discomfort or side effects that make women give up its use, the safety of this contraceptive method is supported by several investigations on its benefits and safety.

Article in Spanish | LILACS-Express | LILACS | ID: biblio-1388669


Resumen Introducción: La pandemia de COVID-19 ha comportado una disminución de la consulta ginecológica al servicio de urgencia. Objetivo: Caracterizar las consultas en el servicio de urgencia ginecológica, evaluando la cantidad de hospitalizaciones, la necesidad de intervención quirúrgica y los factores de morbilidad, entre otros, comparado a la situación con la previa a la pandemia. Método: Se realizó un estudio de cohorte no concurrente de pacientes hospitalizadas tras una consulta espontánea al servicio de urgencia ginecológica entre las semanas 12 y 28 de 2019 y 2020 en el Hospital Clínico de la Pontificia Universidad Católica, en Santiago (Chile). Se determinaron distintos factores de morbilidad: diagnóstico de ingreso, intervención quirúrgica, complicación operatoria, días de hospitalización, hemoglobina/hematocrito de ingreso y necesidad de transfusión de unidades sanguíneas. Resultados: Hubo 511 consultas al servicio de urgencia entre las semanas 12 y 28 del año 2019, en comparación con 196 el año 2020. En 2019 fueron hospitalizadas 103 mujeres, y en 2020 ingresaron 72 (odds ratio [OR]: 2.3). Disminuyó el ingreso por aborto retenido (24 vs. 12; p = 0.01), mientras que aumentó el ingreso por metrorragia posmenopáusica (9 vs 22; p = 0.01). No hubo cambio en las intervenciones quirúrgicas realizadas (86.4% vs. 84.7%; p = 0.7). Aumentaron los días de hospitalización (2.3 vs. 3.1; p < 0.0001) y la necesidad de transfusión sanguínea (2 vs. 7; p = 0.02; OR: 5.4; intervalo de confianza: 1.09-26). Conclusiones: La pandemia de COVID-19 provocó una disminución en la consulta espontánea por patología ginecológica al servicio de urgencia, provocando un aumento en la relación consulta/ingreso y una mayor morbilidad en las pacientes hospitalizadas, caracterizada por una mayor necesidad de transfusión sanguínea y un aumento de los días de hospitalización.

Abstract Introduction: The COVID-19 pandemic has meant a decrease in gynecological visits to the emergency department. Objective: To characterize the attending in the gynecological emergency service, evaluating the amount of admissions, hospitalizations, need for surgical intervention, morbidity factors, among others, compared to the pre-pandemic situation. Method: A non-concurrent cohort study of hospitalized patients was carried out through a spontaneous attending to the gynecological emergency service between weeks 12 and 28 of 2019 and 2020 at the Hospital Clínico of the Pontificia Universidad Católica, in Santiago (Chile). Different morbidity factors were measured: admission diagnosis, surgical intervention, surgical complication, hospital stay, admission hemoglobin, and need for transfusion of blood units. Results: A total of 511 visitors to the emergency service were registered between weeks 12 and 28 of 2019, compared to 196 in 2020. In 2019 and 2020, 103 and 72 women were hospitalized respectively (odds ratio [OR]: 2.3). Admission for pregnancy loss decreased (24 vs. 12; p = 0.01), while admission for postmenopausal bleeding increased (9 vs. 22; p = 0.01). There was no change in the surgical interventions performed (86.4% vs. 84.7%; p = 0.7). The hospital stays increased (2.3 vs. 3.1; p < 0.0001) and the need for blood transfusion (2 vs. 7; p = 0.02; OR: 5.4; confidence interval: 1.09-26). Conclusions: The COVID-19 pandemic caused a decrease in spontaneous attending for gynecological pathology at the emergency service, causing an increase in the attend/admission ratio and greater morbidity in hospitalized patients characterized by a greater need for blood transfusion and an increase on the hospital stay.

Medicina (B.Aires) ; 81(6): 1036-1044, ago. 2021. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1365098


Resumen La enfermedad por coronavirus COVID-19 causada por el virus SARS-CoV-2 es en muchos casos grave. La pandemia ha demandado una gran organización y redistribución de infraestructura y recur sos médicos para la atención de pacientes con cáncer. El servicio de Ginecología del Hospital de Oncología Marie Curie es un centro monovalente dependiente del Gobierno de la Ciudad de Buenos Aires. Forma parte de la red de 33 hospitales públicos de la Ciudad y recibe derivaciones de otros hospitales de la red y de hospitales de la Provincia de Buenos Aires. A partir del 20 de marzo de 2020, cuando entró en vigor el decreto 260/20 que dispuso el aislamiento social, preventivo y obligatorio, se inició una nueva modalidad para la atención y prestaciones de nuestro hospital. En el Servicio de Ginecología del Hospital Marie Curie hemos desarrollado recomendaciones para el manejo de los tumores ginecológicos durante la pandemia por COVID-19. Elaboramos una guía basada en los datos actualizados y recursos disponibles entre los que se encuentran la guía del International Journal of Gynecological Cancer, la guía de la Sociedad Británica del Cáncer Ginecológico, las recomendaciones de la Asociación Argentina de Ginecología Oncológica, y la Guía de la Sociedad de Ginecología Oncológica Americana que proveen sugerencias y herramientas para la toma de decisiones con el objeto de reducir la morbilidad y mortalidad de las pacientes con cáncer ginecológico durante la pandemia por Coronavirus (COVID-19).

Abstract COVID-19 coronavirus disease is an often-severe illness caused by the SARS-CoV-2 virus. The pandemic has demanded a great organization and redistribution of infrastructure and medical resources for the care of patients with cancer. The Gynecology service of the Oncology Hospital of the City of Buenos Aires is a monovalent center dependent on the City of Buenos Aires. It is part of the network of 33 public hospitals in the City of Buenos Aires and receives referrals from other hospitals in the network and from hospitals in the Province of Buenos Aires. As of March 20, 2020, when decree 260/20 came into force, which established social, preventive and compulsory isolation, a new modality was started for the care and benefits of our hospital. In our Service of the Hospital de Oncología de la Ciudad de Buenos Aires we have developed recommendations for the management of gynecological tumors during the COVID-19. The guide we developed is based on up-to-date data and available resources and provides suggestions and tools for decision-making in order to reduce the morbidity and mortality of patients with gynecological cancer during the Coronavirus pandemic (COVID-19).

Rev. peru. ginecol. obstet. (En línea) ; 67(3): 00002, jul.-sep 2021. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1361086


RESUMEN La Ginecología y Obstetricia tiene una historia de raíces muy antiguas en el Perú, rica en hitos trascendentes, gracias a la inteligencia, talento y tesón de numerosos médicos que contribuyeron a formar el cuerpo científico y académico que hoy constituye parte importante de la medicina peruana. El objeto de este artículo es hacer una síntesis de aquella interesante y proficua historia para la memoria de los peruanos en general y de la orden médica nacional en particular.

ABSTRACT Gynecology and Obstetrics has a history of very ancient roots in Peru, rich in transcendent milestones, thanks to the intelligence, talent and tenacity of numerous doctors who contributed to the formation of the scientific and academic body that today represents an important part of Peruvian medicine. The purpose of this article is to make a synthesis of that interesting and profitable history for the memory of Peruvians in general and of the national medical order in particular.

Rev. peru. ginecol. obstet. (En línea) ; 67(3): 00004, jul.-sep 2021.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1361088


RESUMEN Se realiza una visión sucinta de la evolución de la ginecología en el Perú en los últimos 200 años. A continuación de la medicina y cirugía practicada por los habitantes en la era prehispánica, conocida por sus huacos y sitios arqueológicos, y después del desarrollo de la ginecología diagnóstica y operatoria con el uso sistemático del espéculo en el siglo XIX, que posibilitó intervenciones como el legrado uterino y la colpotomía posterior para el drenaje de abscesos pélvicos, la historia de la ginecología peruana se iniciaría en 1878, cuando Lino Alarco realizó la primera cirugía ginecológica por laparotomía, al extirpar un quiste tumoral de ovario. Néstor Corpancho, en su Servicio del Hospital de Santa Ana, fue el primero en realizar miomectomías por laparotomía, así como histerectomías. En 1879 se creó la Cátedra de Ginecología en la Facultad de Medicina de la Universidad Nacional Mayor de San Marcos, instalándose posteriormente el primer quirófano moderno en el Perú. En 1898, Constantino T. Carvallo inició la formación de brillantes ginecólogos, continuada más adelante con la formación escolarizada de especialistas y acceso a la información médica actualizada. La actual pandemia COVID-19 requiere vigilar la salud de la mujer a corto y largo plazo, las gestaciones y vida de los recién nacidos, mayor inversión en salud, profesionales capacitados en emergencias y salud centrada en la persona, investigar sobre enfermedades y su prevención, conocer más sobre genética, inmunología, síndrome metabólico y comorbilidades relacionadas (obesidad, hipertensión, diabetes mellitus), cómo prolongar la vida saludable, utilizar la nanotecnología, inteligencia artificial, robótica, y más.

ABSTRACT A brief overview of the evolution of gynecology in Peru in the last 200 years is done. Following the medicine and surgery practiced by the inhabitants in the pre-Hispanic era, known through their huacos and archeological sites, and after the development of diagnostic and operative gynecology with the systematic use of the speculum in the 19th century, which made possible interventions such as uterine curettage and posterior colpotomy for the drainage of pelvic abscesses, the history of Peruvian gynecology would begin in 1878, when Lino Alarco performed the first gynecological surgery by laparotomy to remove an ovarian tumor. Néstor Corpancho, in his service at the Hospital de Santa Ana, was the first to perform myomectomies by laparotomy, as well as hysterectomies. In 1879, the Chair of Gynecology was created in the Faculty of Medicine of the Universidad Nacional Mayor de San Marcos, and later the first modern operating room was installed in Peru. In 1898, Constantino T. Carvallo initiated the training of brilliant gynecologists, which was later continued with the schooling of specialists and access to updated medical information. Current COVID-19 pandemic requires monitoring of women's short and long term health, their gestations and newborns' lives, greater investment in health, trained professionals in emergency and person-centered health, research on diseases and their prevention, learn more about genetics, immunology, metabolic syndrome and related comorbidities (obesity, hypertension, diabetes mellitus), how to prolong healthy life, use nanotechnology, artificial intelligence, robotics, and more.

Rev. peru. ginecol. obstet. (En línea) ; 67(3): 00008, jul.-sep 2021.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1361092


RESUMEN La docencia en obstetricia y cirugía en el Perú empezó a principios del siglo XIX, por iniciativa de Hipólito Unanue. Cayetano Heredia y otros la estructuraron académicamente al crearse la Facultad de Medicina de la Universidad Nacional Mayorde San Marcos, en 1856. La cátedra de clínica ginecológica fue creada finalizando el siglo XIX, nombrándose como catedrático a Constantino T. Carvallo. En 1947 se fundó la Sociedad Peruana de Obstetricia y Ginecología (SPOG), con la finalidad de desarrollar la ciencia y la capacitación continua de especialistas en ginecología y obstetricia. Desde 1955, la Revista Peruana de Ginecología y Obstetricia es el medio de comunicación científica de la SPOG, que publica experiencias e investigaciones en la especialidad. El residentado en Obstetricia data de 1958 en la Maternidad de Lima y, entre 1961 y 1962, Abraham Ludmir comenzó el residentado escolarizado de obstetricia y ginecología en el Hospital Materno Infantil San Bartolomé. El continuo y rápido avance dado por la investigación científica, información y modernización de la tecnología en la especialidad ha ocasionado la aparición de varios capítulos relacionados a la patología de la mujer y el perinato, integradas en instituciones médicas que avanzan a diferente velocidad e importancia. La actual pandemia del coronavirus SARS-CoV-2 ha puesto en evidencia los problemas en la atención de salud nacional, ocasionando congestión hospitalaria, insuficiencia de equipos, medicamentos y recursos humanos, indicadores desfavorables de vigilancia, infecciones y muertes, lo que requerirá girar la gestión en salud. La docencia en medicina también se vio afectada, con conversión de la educación presencial a virtual, prohibición de atención presencial de estudiantes y docentes mayores, que recién retornarán a los hospitales. La educación médica, los avances científicos y tecnológicos y la visión de un mundo rápidamente cambiante deben originar nuevos planes curriculares para los estudiantes de medicina y residentes en la especialidad, para una apropiada atención en salud.

ABSTRACT The teaching of obstetrics and surgery in Peru began at the beginning of the 19th century, at the initiative of Hipólito Unanue. Cayetano Heredia and others structured it academically when the Faculty of Medicine of the Universidad Nacional Mayor de San Marcos was created in 1856. The chair of clinical gynecology was created at the end of the 19th century, appointing Constantino T. Carvallo as professor. In 1947, the Peruvian Society of Obstetrics and Gynecology (SPOG) was founded with the purpose of developing the science and continuous training of specialists in gynecology and obstetrics. Since 1955, The Peruvian Journal of Gynecology and Obstetrics is the scientific communication media of the SPOG, which publishes experiences and research in the specialty. The residency in Obstetrics dates back to 1958 at the Maternity Hospital of Lima and, between 1961 and 1962, Abraham Ludmir began the schooled residency in obstetrics and gynecology at the Hospital Materno Infantil San Bartolomé. The continuous and rapid progress given by scientific research, information and modernization of technology in the specialty has caused the emergence of several branches related to the pathology of women and perinates, integrated in medical institutions that advance at different speed and importance. The current SARS-CoV-2 coronavirus pandemic has highlighted the problems in national health care, resulting in hospital congestion, insufficient equipment, drugs and human resources, unfavorable indicators of surveillance, infections and deaths, which will require a change in health management. Teaching in medicine was also affected, with the conversion from classroom to virtual education, prohibition of on site care for students and senior teachers, who will be returning to the hospitals. Medical education, scientific and technological advances and the vision of a rapidly changing world must give rise to new curricular plans for medical students and residents in the specialty, for appropriate health care.

Curitiba; s.n; 20210416. 240 p. ilus.
Thesis in Portuguese | LILACS, BDENF | ID: biblio-1290535


Resumo: As enfermeiras atuantes na Atenção Primária à Saúde (APS) são habilitadas, capacitadas perante a lei e têm atribuições respaldadas na atenção à saúde das mulheres para promoverem o cuidado ginecológico. Faz-se necessário serem competentes para prover cuidado integral às mulheres, tornando-as protagonistas no cuidado recebido, as emponderando mediante conhecimentos, habilidades e atitudes para cuidar com qualidade e segurança, para acolher as necessidades da usuária em sua integralidade e promover cuidados baseados em evidências científicas. Assim, surgiu a inquietação no que tange à competência da enfermeira para realizar o cuidado ginecológico de enfermagem na APS com competência. Nesse sentido, elaborou-se a questão norteadora: Como desenvolver competência nas enfermeiras para atender as necessidades da mulher em sua integralidade durante o cuidado ginecológico na APS por meio da sistematização da assistência de enfermagem com base nas recomendações e diretrizes governamentais? Objetivo: Construir ações para promover o desenvolvimento de competência de enfermeiras no cuidado ginecológico à mulher na APS. Metodologia: Para delineamento metodológico deste estudo, utilizou-se a Pesquisa Convergente Assistencial, realizada na APS de um município da região metropolitana de Curitiba entre agosto e setembro de 2020. Contou com a participação de 31 enfermeiras que prestavam cuidado ginecológico direto e indireto. A coleta de dados se deu por meio de oficinas temáticas com apoio de um roteiro norteador e se utilizou, nesta etapa, o processo denominado Quatro Erres (Rs) proposto por Trentini e Paim. Para análise dos dados, foram seguidos os passos de John W. Creswell,apoiado com uso do software IRAMUTEQ®, pelo método da classificação hierárquica descendente. Resultados: Foram identificadas quatro classes distintas e para cada classe foi atribuída uma nomenclatura derivada da análise aprofundada, sendo denominadas: Classe 1 - "Conhecimento das competências para realização do cuidado ginecológico: facilidades e dificuldades"; Classe 2 - "Ambivalência para desenvolver as competências relacionadas ao cuidado ginecológico no processo de trabalho na saúde da mulher na APS: fatores satisfatórios e insatisfatórios"; Classe 3 - "O protagonismo e a autonomia da enfermeira para realizar o cuidado ginecológico com competência na consulta de enfermagem na APS"; e Classe 4 - "A percepção das enfermeiras sobre a importância da busca pelo conhecimento para cuidar com competência". Considerações finais: As enfermeiras compreendem a necessidade de integrar de forma convergente o saber-fazer-ser, para assim, atuar de forma autônoma e competentemente ao prestar o cuidado ginecológico com base em evidências científicas, garantindo qualidade no cuidado oferecido e visibilidade à profissão. O presente estudo alcançou o objetivo com a construção de Instruções Normativas para a consulta de enfermagem ginecológica na APS com competência, constituindo produto desta dissertação, indo ao encontro dos pressupostos do Programa de Mestrado e da Pesquisa Convergente Assistencial para fomentar melhorias no modo de cuidar, articulando pesquisa e prática profissional, de modo a ter enfermeiras competentes que agreguem valor à sociedade.

Abstract: Nurses working in Primary Health Care (PHC) are qualified, trained under the law and have attributions supported in women's health care to promote gynecological care. We understand that it is necessary to be competent to provide comprehensive care to women, making them protagonists in the care received, and empowering them. However, we understand that these professionals must have knowledge, skills and attitudes to care with quality and safety, as it welcomes the user's needs and promotes care based on scientific evidence. Thus, concern about the competence of the nurse to perform gynecological nursing care in PHC competently arose. In this sense, the guiding question was elaborated: How to develop competence in nurses to meet the needs of women in their entirety during gynecological care in PHC through the systematization of nursing care based on government recommendations and guidelines? Objective: Build actions to promote the development of nurses' competence in gynecological care for women in PHC. Methodology: For the methodological design of this study, we used the Convergent Care Research, carried out in the PHC of a municipality in the metropolitan region of Curitiba, between August and September 2020. It counted with the participation of 31 nurses, who provided direct and indirect gynecological care. Data collection took place through thematic workshops, with the support of a guiding script, and in this step the process called Quatro Erres (Rs) proposed by Trentini and Paim was used. For data analysis, the steps of John W. Creswell were followed, and it was supported with the use of the IRAMUTEQ® software, using the method of descending hierarchical classification. Results: Four distinct classes were identified; for each class, a nomenclature derived from the in-depth analysis was assigned, and they were called: Class 1 - "Knowledge of the skills to perform gynecological care: facilities and difficulties"; Class 2 - "Ambivalence to develop competencies related to gynecological care in the work process in women's health in PHC: satisfactory and unsatisfactory factors"; Class 3 - "The role and autonomy of the nurse to perform gynecological care with competence in the nursing consultation in PHC"; and Class 4 - "Nurses' perception of the importance of the search for knowledge to care competently". Final considerations: It was possible to show in this study that nurses understand the need to integrate know-how-to in a convergent way, in order to act autonomously and competently when providing gynecological care, based on scientific evidence, ensuring quality in the care offered and visibility to the profession. The present study achieved the objective with the construction of normative instructions for the consultation of gynecological nursing in PHC with competence, constituting the product of this dissertation, meeting the assumptions of the Master's Program and Convergent Care Research, to provoke improvements in the way of caring, articulating research and professional practice, in order to have competent nurses who add value to society.

Humans , Male , Female , Adult , Middle Aged , Primary Health Care , Professional Competence , Women's Health , Humanization of Assistance , Gynecology , Nursing Care
Rev. bras. ginecol. obstet ; 43(3): 178-184, Mar. 2021. tab, graf
Article in English | LILACS | ID: biblio-1251297


Abstract Objective The present study aimed to explore the opinion and ethical consideration of vulvovaginal aesthetics procedures (VVAPs) among health professionals and medical students in Saudi Arabia. Methods This is a cross-sectional study performed between January 2020 and April 2020. Data was collected through electronic media, WhatsApp, and emails. The results were analyzed by applying the Students t-test, and correlations were considered significant if they presented a p-value<0.05. Results There is significant demand to educate doctors, health professionals, medical students, and gynecologists for the VVAPs to have a solid foundation, justified indications, and knowledge about various aesthetic options. Although female doctors, medical students, young doctors, and gynecologists have more knowledge about VVAPs, all health professionals ought to be aware of recent trends in vulvovaginal aesthetics (VVA). The present analysis determined that VVA should be under the domain of gynecologists, rather than under that of plastic surgeons, general surgeons, and cosmetologists. Themajority of the participants considered that vaginal rejuvenation, "G-spot" augmentation, clitoral surgery, and hymenoplasty are not justifiable on medical grounds. Conclusion The decision to opt for different techniques for vaginal tightening and revitalization should be taken very carefully, utilizing the shared decision-making approach. Ethical aspects and moral considerations are important key factors before embarking in the VVAPs purely for cosmetic reasons. Further research is required to determine the sexual, psychological, and body image outcomes for women who underwent elective VVAPs. Moreover, medical educators must consider VVAPs as part of the undergraduate and postgraduate medical curriculum.

Humans , Female , Adult , Young Adult , Students, Medical , Vagina/surgery , Vulva/surgery , Practice Patterns, Physicians' , Health Personnel , Rejuvenation , Saudi Arabia , Cross-Sectional Studies , Surveys and Questionnaires , Electronic Health Records , Gynecology , Middle Aged
Rev. bras. med. fam. comunidade ; 16(43): 2992, 20210126. tab, graf
Article in Portuguese | LILACS, ColecionaSUS | ID: biblio-1292044


Introdução: De acordo com o Instituto Nacional do Câncer (INCA) a estimativa de novos casos de câncer do colo do útero (CCU) para o Estado do Espírito Santo, no triênio 2020-2022, é de 11,65 por 100.000 habitantes. Objetivos: Traçar o perfil clínico-epidemiológico das usuárias do serviço de atenção integral à saúde da mulher da policlínica da Universidade Vila Velha (UVV), a partir dos determinantes da consulta ginecológica, e correlacionar aos achados citológicos e histológicos. Métodos: Estudo de corte transversal, observacional e retrospectivo envolvendo 590 prontuários de pacientes, atendidas entre fevereiro de 2011 e julho de 2016 no serviço de atenção integral à saúde da mulher na policlínica/UVV. Resultados: A média de idade das mulheres incluídas nesse estudo foi de 39,5 anos (DP± 16,2). Os fatores de risco como estado civil e tempo de relacionamento conjugal, multiparidade, e uso de contraceptivos hormonais orais foram associados a maior chance de CCU. Associação estatística da variável idade não evidenciou risco de CCU. Conclusões: Os resultados vão de acordo com os preconizados pelo INCA e Ministério da Saúde. Isso reforça a importância da rastreabilidade na atenção primária e os fatores que interferem na mesma.

Introduction: According to the National Cancer Institute (INCA), the estimate of new cases of cervical cancer (CC) for the State of Espírito Santo, in the 2020-2022 period, is 11.65 per 100,000 inhabitants. Objectives: To trace the clinical-epidemiological profile of users of the comprehensive women's health care service at the University Vila Velha (UVV), based on the determinants of gynecological consultation, and to correlate with cytological and histological findings. Methods: Cross-sectional, observational and retrospective study involving 590 medical records of patients, attended between February 2011 and July 2016 at the comprehensive care service for women's health in the polyclinic/UVV. Results: The average age of women included in this study was 39.5 years (SD±16.2). Risk factors such as marital status and length of marital relationship, multiparity, and use of oral hormonal contraceptives were associated with an increased chance of CC. Statistical association of the age variable did not show a risk of CC. Conclusion: The results are in line with those recommended by INCA and the Ministry of Health. This reinforces the importance of traceability in primary care and the interfering factors.

Introducción: Según el Instituto Nacional del Cáncer (INCA), la estimación de nuevos casos de cáncer de cuello uterino (CC) para el Estado de Espírito Santo en el período 2020-2022 es de 11,65 por 100.000 habitantes. Objetivo: Trazar el perfil clínico-epidemiológico de las usuarias del servicio de atención integral de salud a la mujer de la policlínica Universitaria Vila Velha (UVV), a partir de los determinantes de la consulta ginecológica, y correlacionarlo con hallazgos citológicos e histológicos. Métodos: Estudio transversal, observacional y retrospectivo que involucró a 590 historias clínicas de pacientes, atendidas entre febrero de 2011 y julio de 2016 en el servicio de atención integral de salud de la mujer de la policlínica/UVV. Resultados: La edad promedia de las mujeres incluidas en este estudio fue de 39,5 años (DE ± 16,2). Los factores de riesgo como el estado civil y la duración de la relación matrimonial, la multiparidad y el uso de anticonceptivos hormonales orales se asociaron con una mayor probabilidad de CC. La asociación estadística de la variable edad no mostró riesgo de CC. Conclusiones: Los resultados están en línea con los recomendados por INCA y el Ministerio de Salud, lo que refuerza la importancia de la trazabilidad en la atención primaria y los factores que interfieren en ella.

Humans , Male , Female , Adult , Middle Aged , Young Adult , Uterine Cervical Neoplasms/diagnosis , Comprehensive Health Care , Uterine Cervical Neoplasms/epidemiology , Cross-Sectional Studies , Retrospective Studies , Risk Factors , Colposcopy
Article in Chinese | WPRIM | ID: wpr-911986


This article introduces two methodological articles published by the American College of Obstetricians and Gynecologists in September 2021 on their development of clinical practice guidelines and clinical expert consensus, focusing on the composition of the guidelines committee, declaration and management of conflicts of interest, and the detailed development process. On this basis, reflections and suggestions for the development of guidelines and consensus in obstetrics and gynecology in China are presented from the perspective of developing a handbook for standardized guideline development, registration and reporting of guidelines, use of available evidence, management of conflicts of interest, and regular evaluations of relevant published guidelines.