Mortalidade de mulheres em idade fértil no Brasil de 2006 a 2019: causas e tendências / Mortality of women of fertile age between 2006 and 2019: causes and trends / Mortalidad de mujeres en edad fértil entre 2006 y 2019: causas y tendencias

Resumo O objetivo deste estudo é analisar a tendência das principais causas de óbito de mulheres em idade fértil (MIF) no Brasil, por faixa etária, no período de 2006 a 2019. Utilizaram-se dados do Sistema de Informações sobre Mortalidade (SIM) e do Instituto Brasileiro de Geografia e Estatística (IBGE). As principais causas de morte de MIF (10 a 49 anos) foram classificadas por capítulos da Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde (CID-10). Posteriormente realizou-se análise de tendência temporal por meio de modelos de regressão polinomial das principais causas de morte de MIF segundo faixa etária. No Brasil, as maiores taxas de mortalidade por causas p/100 mil MIF deveram-se a neoplasias (25,34), doenças do aparelho circulatório (20,15), causas externas (18,69), doenças infecciosas e parasitárias (8,79) e doenças do aparelho respiratório (6,37). Para o período analisado, após padronização, as taxas de mortalidade por doenças do aparelho circulatório, do aparelho respiratório e infecciosas e parasitárias apresentaram tendência decrescente, com uma queda expressiva de 26,6% para as doenças do aparelho circulatório; já as taxas de mortalidade por causas externas e neoplasias registraram tendência crescente de 2006 a 2012 e decrescente de 2013 em diante. As causas externas e as neoplasias foram as principais causas de óbito, especialmente entre as mulheres mais jovens e com tendência crescente. Sendo este um importante problema de saúde pública, faz-se necessário planejar ações que otimizem os recursos e melhorem a qualidade de vida e saúde das mulheres.

Abstract The aim of this study is to analyze the trend of the main causes of death of women of reproductive age (WRA) in Brazil by age group from 2006 to 2019. Data used are from the Mortality Information System (SIM) and the Brazilian Institute of Geography and Statistics (IBGE) of Brazil. The main causes of death of WRA (10 to 49 years) were divided by chapters as per the International Statistical Classification of Diseases and Related Health Problems (ICD-10). Subsequently, a temporal trend analysis was performed using polynomial regression models for the main causes of death in WRA. In Brazil, the highest mortality rates by cause by 100,000 WRA occurred due to: neoplasms (25.34), diseases of the circulatory system (20.15), external causes (18.69), infectious and parasitic diseases (8.79) and respiratory system diseases (6.37). For the analyzed period, after standardization, the mortality rate due to diseases of the circulatory and respiratory systems, and infectious and parasitic conditions showed a decreasing trend, with a significant drop of 26.6% for diseases of the circulatory system; while external causes and neoplasms showed an increasing trend from 2006 to 2012 and decreasing from 2013 onwards. Identifying the main causes of death of WRA in each age group is required to guide the planning of actions to optimize resources and obtain better results in women's health.

Resumen El objetivo de este estudio es analizar la tendencia de las principales causas de muerte de mujeres en edad fértil (MEF) en Brasil por grupo de edad desde 2006 hasta 2019. Con datos del Sistema de Información de Mortalidad (SIM) y del Instituto Brasileiro de Geografía y Estadísticas (IBGE) de Brasil, las principales causas de muerte de MEF (10 a 49 años) fueron divididas por capítulos de la Clasificación Estadística Internacional de Enfermedades y Problemas Relacionados con la Salud (CIE-10). Luego se hizo un análisis de tendencia temporal mediante modelos de regresión polinomial de las principales causas de muerte en MEF. En Brasil, las mayores tasas de mortalidad por causa en MEF/100.000 mujeres ocurrieron por neoplasias (25,34), enfermedades del aparato circulatorio (20,15), causas externas (18,69), enfermedades infecciosas y parasitarias (8,79) y enfermedades del sistema respiratorio (6,37). Para el período analizado, después de la estandarización, la tasa de mortalidad por neoplasias y por enfermedades de los sistemas circulatorio, respiratorio e infeccioso y parasitario mostró una tendencia decreciente, con una caída significativa del 26,6 % para enfermedades del sistema circulatorio, mientras que las causas externas y neoplasias mostraron una tendencia creciente entre 2006 y 2012 y decreciente desde 2013 en adelante. Identificar las principales causas de muerte en MEF en cada grupo de edad orienta la planificación de acciones para optimizar recursos y obtener mejores resultados en la salud de la mujer.

Religion and non-marital fertility: A qualitative study of the perspectives and experiences of South African Muslim women

In light of the rising number of children born outside of formal marriage, there is increasing concern about the well-being of these mothers and children, especially since they mostly come from disadvantaged populations. This study aims to determine the role religion plays in the experience of non­marital fertility. This study draws on data from ten in-depth interviews with women in Durban, South Africa. The study found that women did not anticipate the negative impact of non­marital fertility prior to experiencing their first birth. The main reason contributing to the experience of non­marital fertility was the lack of sex education.Many women believed that Islam allowed only married women to use contraceptives because unmarried women are expected to practice celibacy and their religion advocates for a two-parent household. As a result, unmarried women with children found themselves often ostracised from their community. The study recommends a comprehensive sexual education regime to address the challenges associated with non-marital fertility. (Afr J Reprod Health 2022; 26[7]: 49-58).

Fertility desire and associated factors among people on antiretroviral treatment at a public health facility in Hawassa city, Southern Ethiopia

Background: Fertility desire is the plan of people to have a child or more children in the face of being diagnosed with HIV and plan to a commitment to implement the desire. Methods: An institutional-based cross-sectional study was conducted in Hawassa city public health facilities from May 09 ­July 07/07/2019. Four hundred (400) study participants were selected using a simple random sampling technique. Data were collected by using interviewer-administered pre-tested structured questionnaires and chart review. The collected data were entered into EPI data version 3.1 software and then transported to SPSS version 20 for cleaning and data analysis. Bivariate and multivariate logistic regression was used to identify associated factors at p<0.05 was taken as a significant value with a 95% confidence level. Results: A total of 400 clients were included in the study giving a response rate of 97 %. The overall fertility desire was 53.6 % (95%CI: 48.7%, 58.2%). Age, sexual practice in the last six months and discussing reproductive health with ART providers were significantly associated with fertility desire. Younger age was positively associated with fertility desire, age group (18-29), [Adjust odds ratio = 5.75 95%CI (2.85, 11.57)], age group (30-39), [Adjust odds ratio= 4.71 95%CI:(2.55, 8.71)] Sexual practice in the last six months [Adjust odds ratio = 3.00 95%1.46, 6.16)] and counseling reproductive health with ART provider [Adjust odds ratio = 3.10 95%CI:(1.86,5.15)] Conclusion: The prevalence of fertility desire in this study was higher than previous studies while factors associated with fertility desire were age, sexual practice in the last six months, and discussing reproductive health with ART providers

Provincial differentials of the effect of internal migration on teenage fertility in South Africa

This study investigated the association between internal migration and teenage fertility in South Africa. Data were from the 2007 and 2016 South African community surveys, N2007= 89800 and N2016=239733, age range 12 to 19, black teenagers= 81.5% and 89.4%, respectively. Results showed that between 2007 and 2016 internal migration levels decreased by 2% nationally, but increased for Gauteng, Western Cape and KwaZulu Natal provinces. Teenage fertility levels decreased in all provinces except the Northern Cape in the study period. In both years teenage fertility was observed at higher levels among girls that were older, heads of households, and who were in secondary schooling. Random-intercept multilevel binary logistic regression revealed that the risk of teenage fertility differed between more rural and urban provinces. In provinces that were predominantly rural the risk of teenage pregnancy increased as community-levels of internal migration increased while the risk decreased as internal migration increased in provinces that were predominantly urban. Findings suggest that the effects of internal migration on teenage pregnancy are largely dependent on the local context making it necessary to create interventions that are context-specific at sub-national levels.

Evaluation of fertility and embryo implantation in rats after the oral administration of Salvia officinalis (sage) extract / Evaluación de la fertilidad y la implantación de embriones en ratas después de la administración oral de extracto de Salvia officinalis (salvia)

SUMMARY: In Saudi Arabia, it is widely believed that women with reproductive problems can use the extract of the sage plant as a tea drink. This study was conducted to investigate the effects of this herb on the fertility of female rats and embryo implantation. Forty-eight Wistar virgin female rats were divided into four groups at random, with 12 rats in each group. The control group received distilled water orally. The three treatment groups received different concentrations of sage extract: 15, 60, or 100 mg/kg for 14 days before mating, then mated with a male and sacrificed on the 7th day of gestation, the uterine horns removed, and photographed. The total body weight of mothers, weight of uteri and ovaries and number of fetuses were determined. Ovarian and uteri tissues were cut into 5 µ sections and stained with hematoxylin and eosin. Serum FSH, LH were determined by the ELISA method. The present study showed that low dose of sage (15 mg/kg) have no effects on serum concentration levels of FSH and LH hormones, also has no effect on the number of growing follicles. The present study showed a significant differences (P≤0.05) in body weight, ovary and uterus weight in the groups treated with high doses of Salvia officinalis as compared to control group. Also a significant differences (P≤0.05) found in FSH, LH hormones. Histological study showed overall histomorphological structural configurations including growing and matured graafian follicular countable changes, besides a number of corpora lutea and regressed follicles in the treated groups with high doses of Salvia officinalis as compared to control group. The researchers concluded that the extract of the sage plant with high doses can stimulate the growth graafian follicles and improve fertility in female rats.

RESUMEN: En Arabia Saudita, se cree ampliamente que las mujeres con problemas reproductivos pueden usar el extracto de la planta de salvia como bebida de té. Este estudio se realizó para investigar los efectos de esta hierba sobre la fertilidad de las ratas hembra y la implantación del embrión. Se dividieron cuarenta y ocho ratas hembra vírgenes Wistar en cuatro grupos al azar, con 12 ratas en cada grupo. El grupo control recibió agua destilada por vía oral. Los tres grupos de tratamiento recibieron diferentes concentraciones de extracto de salvia: 15, 60 o 100 mg/kg durante 14 días antes del apareamiento, luego se aparearon con un macho y se sacrificaron el día 7 de gestación, se extrajeron los cuernos uterinos y se fotografiaron. Se determinó el peso corporal total de las madres, el peso del útero y los ovarios y el número de fetos. Los tejidos ováricos y uterinos se cortaron en secciones de 5 µ y se tiñeron con hematoxilina y eosina. FSH sérica, LH se determinaron por el método ELISA. El presente estudio mostró que dosis bajas de salvia (15 mg/kg) no tienen efectos sobre los niveles de concentración sérica de las hormonas FSH y LH, tampoco tienen efecto sobre el número de folículos en crecimiento. El presente estudio mostró diferencias significativas (P≤0,05) en el peso corporal, peso de ovario y útero en los grupos tratados con altas dosis de Salvia officinalis en comparación con el grupo control. También se encontraron diferencias significativas (P≤0,05) en las hormonas FSH, LH. El estudio histológico mostró configuraciones estructurales histomorfológicas generales que incluyen cambios contables en los folículos maduros (de Graaf) y en crecimiento, además de una cantidad de cuerpos lúteos y folículos en regresión en los grupos tratados con altas dosis de Salvia officinalis en comparación con el grupo de control. Los investigadores concluyeron que el extracto de la planta de salvia en altas dosis puede estimular el crecimiento de los folículos maduros y mejorar la fertilidad en ratas hembra.

Argentina's fertility regime (1980-2010): the end of the first demographic transition or an emergent second one? / O regime de fecundidade na Argentina (1980-2010): o fim da primeira transição demográfica ou uma segunda emergente? / El régimen de fecundidad en Argentina (1980-2010): ¿El final de la primera transición demográfica o una segunda emergente?

Abstract Argentina's fertility transition has exceptional characteristics. Compared to most Latin American countries, Argentina's fertility declined relatively early and, unlike fertility transitions in Western Europe, this decline did not lead to a high period of natural population growth. By the beginning of the twenty-first century, Argentina seemed to experience fertility stagnation despite women's increased formal education and labor force participation, and increased availability of contraceptives. Using the 1980, 1991, 2001, and 2010 Population Censuses, I demonstrate that fertility has continued its downward trend from 1980 to 2010. Changes in fertility behaviors are given by a decrease in the mean number of children per woman, but not by an increase in childlessness. However, there is evidence of postponement of childbearing. Results show that although Argentina is completing its first demographic transition, as it has not reached below-replacement fertility yet, this country could show signs of an emerging second demographic transition.

Resumo A transição da fecundidade na Argentina tem características excepcionais. Em comparação com a maioria dos países da América Latina, a fecundidade na Argentina diminuiu relativamente cedo e, diferentemente das transições de fecundidade na Europa Ocidental, esse declínio não levou a um período de alto crescimento natural da população. No início do século 21, a Argentina parecia experimentar uma estagnação da fecundidade, apesar do aumento da educação formal e da participação laboral das mulheres e de uma maior disponibilidade de contraceptivos. Utilizando os dados dos Censos Populacionais de 1980, 1991, 2001 e 2010, o presente trabalho mostra que a fecundidade continuou sua tendência de queda de 1980 a 2010. As mudanças no comportamento da fecundidade são dadas por uma diminuição no número médio de filhos por mulher, mas não por um aumento da nuliparidade. No entanto, há evidências de um adiamento da fecundidade. Os resultados mostram que, embora a Argentina esteja completando sua primeira transição demográfica, já que ainda não atingiu a fecundidade abaixo do nível de reposição, o país pode mostrar sinais de uma emergente segunda transição demográfica.

Resumen La transición de la fecundidad en Argentina tiene características excepcionales. Comparada con la mayoría de los países latinoamericanos, la fecundidad en Argentina disminuyó relativamente temprano y, a diferencia de las transiciones de fecundidad en Europa occidental, este descenso no condujo a un período de alto crecimiento natural de la población. A principios del siglo XXI, Argentina parecía experimentar un estancamiento de la fecundidad a pesar del aumento de la educación formal y de la participación laboral de las mujeres y de una mayor disponibilidad de anticonceptivos. Utilizando los Censos de Población de 1980, 1991, 2001 y 2010, demuestro que la fecundidad ha continuado su tendencia descendente desde 1980 hasta 2010. Los cambios en los comportamientos de fecundidad vienen dados por una disminución del número promedio de hijos por mujer, pero no por un aumento de la nuliparidad. Sin embargo, hay evidencia de un aplazamiento de la fecundidad. Los resultados muestran que, aunque Argentina está completando su primera transición demográfica, ya que aún no ha alcanzado una fecundidad por debajo del nivel de reemplazo, este país podría mostrar signos de una segunda transición demográfica emergente.

La fecundidad en Argentina a inicios del siglo XXI: ¿el fin de la meseta? El papel de la educación en los cambios / Fecundidade na Argentina no início do século 21: o fim do plateau? Efeitos da educação nas mudanças / Fertility in Argentina at the beginning of the 21st century: the end of the plateau? Effects of education on changes

Resumen El presente trabajo ofrece un análisis del comportamiento de la fecundidad desagregado por nivel de instrucción de la madre en Argentina en el siglo XXI y presta especial atención a la evolución de la fecundidad adolescente en el mismo período. A diferencia de lo acontecido en otros países de la región en las últimas dos décadas, donde el descenso de la fecundidad fue casi ininterrumpida, en la Argentina la fecundidad tuvo un comportamiento estable, similar a una meseta, desde comienzos del siglo XXI hasta 2014, a partir de cuando comenzó un descenso sostenido análogo al de sus países vecinos. Para este análisis se usan datos de las estadísticas vitales y de las estimaciones y proyecciones de población del INDEC, y para el análisis por nivel de instrucción, datos de las encuestas permanentes de hogares del INDEC y del Censo Nacional de Población y Vivienda de 2010. En el análisis se puede observar una importante brecha en los niveles de fecundidad entre las mujeres más y menos instruidas, principalmente en la fecundidad adolescente. Esta brecha es un reflejo de inequidad, dado que la alta fecundidad afecta sobre todo a las mujeres de los estratos sociales más vulnerables.

Resumo Este documento faz uma análise do comportamento da fecundidade na Argentina no século 21, desagregado por nível de escolaridade da mãe, com especial atenção à evolução da fecundidade na adolescência nesse período. Ao contrário do que aconteceu em outros países da região nas últimas duas décadas, onde a fecundidade diminuiu quase continuamente, na Argentina a fecundidade teve um comportamento estável, semelhante a um plateau, desde o início do século 21 até 2014, quando começou um declínio sustentado semelhante ao observado nos países vizinhos. Utilizamos dados de estatísticas vitais, estimativas e projeções da população do INDEC e, para a análise por nível de educação, dados das Pesquisas Domésticas do INDEC e do Censo Nacional da População e Habitação 2010. A análise mostra uma lacuna significativa nos níveis de fecundidade entre as mulheres mais e menos instruídas, principalmente na fecundidade adolescente. Esta lacuna é reflexo da desigualdade, uma vez que a alta fecundidade afeta principalmente as mulheres dos estratos sociais mais vulneráveis.

Abstract This paper presents an analysis of Argentina's fertility behavior disaggregated by level of education of the mother in the 21st century, and focuses on the evolution of adolescent fertility during the same period. Unlike what other countries from the region have experienced in the last two decades, where fertility decline occurred almost uninterruptedly, Argentina's fertility had a stable behavior, similar to a plateau, from the beginning of the 21st century until 2014. Since then, it began a sustained decline similar to that evidenced in neighboring countries. Data from vital statistics, INDEC population estimates and projections are used, and data from INDEC Household Surveys and the 2010 National Population and Housing Census are used for the analysis by education level. The analysis shows a significant gap in fertility levels between the most and least educated women, mainly in adolescent fertility. This gap is a reflection of inequity, given that high fertility rates mainly affect women from the most vulnerable social strata.

Fertility trends during successive novel infectious disease outbreaks: Zika and COVID-19 in Brazil / Tendências de fecundidade durante sucessivas epidemias de doenças infecciosas novas: Zika e COVID-19 no Brasil / Tendencias de fecundidad durante los sucesivos brotes de nuevas enfermedades infecciosas: Zika y COVID-19 en Brasil

This study aims to estimate fertility trends in Brazil in the 2010s and early 2020s during a period of back-to-back novel infectious disease outbreaks - Zika virus and COVID-19. We use Brazilian Ministry of Health and Association of Civil Registrar data from 2011-2021 to measure general fertility rates at the national and state levels. We also used seasonal ARIMA model to forecast fertility rates by month and state in 2021 and compared these forecasts with observed fertility rates. We find that fertility rates were steady over 2011-2015 with no statistically significant variation, followed by a sharp decline during the Zika outbreak in 2016 followed by a return to pre-Zika levels after the end of the epidemic. Furthermore, to evaluate the effect of the COVID-19 pandemic, we make comparisons with observed and forecast rates from 2020-2021, showing that declines were generally larger for observed than for forecast rates, yet statistically insignificant. We argue that the resurgence of the COVID-19 pandemic in 2021 might lead to further declines, as women might have not had enough time to adjust rebound from either the effects of the Zika epidemic. We also discuss the importance of timely availability of live births data during a public health crisis with immediate consequences for fertility rates.

O objetivo desta contribuição de dados é estimar as tendências de fecundidade no Brasil nos anos 2010 e início dos anos 2020 durante epidemias consecutivas de doenças infecciosas novas, ou seja, Zika vírus e COVID-19. Utilizamos dados do Ministério da Saúde e do Registro Civil Nacional de 2011-2021 para calcular as taxas mensais de fecundidade nos níveis nacional e estadual. Também utilizamos o modelo ARIMA sazonal para prever taxas de fecundidade por mês e por estado em 2021, e comparamos essas previsões com as taxas de fecundidade observadas. Encontramos que as taxas de fecundidade eram estáveis entre 2011 e 2015, sem variação significativa, seguido por um declínio abrupto durante o surto de Zika em 2016, e seguido por sua vez por um retorno aos níveis pré-Zika depois do fim da epidemia. Além disso, para avaliar o efeito da pandemia de COVID-19, comparamos as taxas observadas e previstas de 2020-2021, mostrando que as quedas geralmente eram maiores nas taxas observadas do que nas previstas, porém sem significância estatística. Argumentamos que o recrudescimento da pandemia de COVID-19 em 2021 poderá levar a mais quedas nas taxas, na medida em que as mulheres não tenham tido tempo suficiente para reagir e se ajustarem aos efeitos da epidemia de Zika. Também discutimos a importância da disponibilidade oportuna de dados sobre nascidos vivos durante uma crise de saúde pública com consequências imediatas para as taxas de fecundidade.

El objetivo de esta aportación de datos es estimar las tendencias de fecundidad en Brasil en la década de 2010 y principios de 2020, durante el período de brotes consecutivos de nuevas enfermedades infecciosas -ZIKV y COVID-19. Se usaron datos procedentes del Ministerio de Salud y del Registro Civil Nacional (ARPEN) desde 2011-2021 para calcular mensualmente las tasas de fecundidad en nivel nacional y en el estado. Se utilizó el ARIMA estacional para pronosticar las tasas de fecundidad por mes y estado en 2021, y se compararon estas predicciones con las tasas de fecundidad observadas. Encontramos que las tasas de fecundidad se mantuvieron estables entre 2011 y 2015, sin variaciones significativas, seguido de un fuerte descenso durante el brote de Zika en 2016, para posteriormente volver a los niveles anteriores al Zika tras el fin de la epidemia. Asimismo, con el fin de evaluar el efecto de la pandemia de COVID-19, hicimos comparaciones con lo observado y la previsión de tasas desde 2020-2021, que muestran que los descensos fueron en general mayores para los índices observados que para los previstos, aunque insignificantes desde el punto de vista estadístico. Sostenemos que el resurgimiento de la pandemia de COVID-19 en 2021 podría provocar nuevos descensos, ya que las mujeres podrían no haber tenido suficiente tiempo para adaptarse a los efectos de la epidemia de Zika. También se discute la importancia de disponer a tiempo de los datos de los nacidos vivos durante una crisis de salud pública con consecuencias inmediatas para las tasas de fecundidad.

Impact of a large dam on reproduction of a non-migratory teleost species, Acestrorhynchus lacustris (Characiformes: Acestrorhynchidae) / Impacto de uma grande barragem na reprodução de uma espécie de teleósteo não migradora, Acestrorhynchus lacustris (Characiformes: Acestrorhynchidae)

Abstract The release of water from the reservoir hypolimnion, lower concentration of oxygen and the anthropogenic regulation of the river flow, could affect the reproduction of fish, especially migratory species. However, little is known about the effects of these changes in water on non-migratory species. In this sense, the reproduction of Acestrohynchus lacustris was evaluated in two sections of São Francisco River, Minas Gerais, Brazil. Section 1, located immediately downstream from Três Marias Dam (18°09'31.65"S and 45°13'36.00"W) and section 2, located at the confluence of the São Francisco and the Abaeté Rivers (18°02'47.78"S and 45°10'57.95"W). For this, we obtained the physico-chemical parameters of water of each study section. Additionally, biometric data and biological indices of all specimens were measured. Fecundity and follicles diameters were measured in females. Temperature, dissolved oxygen and flow showed lower values in section 1. Fish captured in this section, had lower values of GSI in both sexes, and females presented decreased values of fecundity and follicles diameter. This species showed reproductive activity in the two sections analyzed, however, in section 1 where the temperature and dissolved oxygen presented significant lower values, the reproductive capacity of A. lacustris, was negatively affected.

Resumo A liberação de água do hipolímnio do reservatório, baixa concentração de oxigênio e a regulação antropogênica do fluxo do rio podem afetar a reprodução de peixes, principalmente espécies migradoras. No entanto, pouco se sabe sobre os efeitos dessas mudanças nas condições da água em espécies não migradoras. A reprodução de Acestrohynchus lacustris foi avaliada em duas seções do rio São Francisco. Seção 1, localizada imediatamente a jusante da barragem de Três Marias e seção 2, localizada na confluência dos rios São Francisco e Abaeté. Para isso, foram obtidos os parâmetros físico-químicos da água de cada seção do estudo. Além disso, dados biométricos e índices biológicos de todos os peixes capturados foram obtidos. Adicionalmente, nas fêmeas foram medidos os diâmetros dos folículos vitelogênicos e a fecundidade. Temperatura, oxigênio dissolvido e fluxo apresentaram valores mais baixos na seção 1. Os peixes capturados nesta seção apresentaram menores valores de IGS em ambos os sexos, e as fêmeas apresentaram menores valores de fecundidade e diâmetro dos folículos. Essa espécie apresentou atividade reprodutiva nas duas seções analisadas, porém, na seção 1, onde os parâmetros da água apresentam piores condições para o processo reprodutivo de peixes, a capacidade reprodutiva de A. lacustris foi afetada negativamente.

CRISPR/Cas9-mediated genome editing reveals 12 testis-enriched genes dispensable for male fertility in mice / 亚洲男科学杂志(英文版)

Gene expression analyses suggest that more than 1000-2000 genes are expressed predominantly in mouse and human testes. Although functional analyses of hundreds of these genes have been performed, there are still many testis-enriched genes whose functions remain unexplored. Analyzing gene function using knockout (KO) mice is a powerful tool to discern if the gene of interest is essential for sperm formation, function, and male fertility in vivo. In this study, we generated KO mice for 12 testis-enriched genes, 1700057G04Rik, 4921539E11Rik, 4930558C23Rik, Cby2, Ldhal6b, Rasef, Slc25a2, Slc25a41, Smim8, Smim9, Tmem210, and Tomm20l, using the clustered regularly interspaced short palindromic repeats /CRISPR-associated protein 9 (CRISPR/Cas9) system. We designed two gRNAs for each gene to excise almost all the protein-coding regions to ensure that the deletions in these genes result in a null mutation. Mating tests of KO mice reveal that these 12 genes are not essential for male fertility, at least when individually ablated, and not together with other potentially compensatory paralogous genes. Our results could prevent other laboratories from expending duplicative effort generating KO mice, for which no apparent phenotype exists.

Clinical outcomes analysis of fertility-preserving therapy for atypical endometrial hyperplasia and early endometrial carcinoma / 中华肿瘤杂志

Objective: To analyze the clinical efficacy of fertility-preserving therapy in patients with atypical endometrial hyperplasia (AEH) and early endometrial carcinoma (EC). Methods: The general condition, pathological type, treatment plan, tumor outcomes and pregnancy outcomes of 110 patients with AEH and EC treated with fertility-preserving therapy in Peking University People's Hospital from December 2005 to September 2019 were retrospectively analyzed. Kaplan-Meier and Log rank tests were used for survival analysis. Results: The response rate of 110 cases of AEH (62 cases) and EC (48 cases) was 94.5% (104/110) after fertility-preserving therapy. There were 93 cases (84.5%) achieved complete response and 11 cases (10.0%) achieved partial response, and the recurrence rate was 29.0% (27/93). The complete response rates of AEH and EC were 90.3% (56/62) and 77.1% (37/48), respectively, without significant difference (P=0.057). The recurrence rates of EC were significantly higher than that of AEH (40.5% vs 21.4%; P=0.022). Forty-one patients with complete response had pregnancy intention, the pregnancy rate was 70.7% (29/41), and the live birth rate was 56.1% (23/41). The live birth rate of AEH was 68.2% (15/22) and that of EC was 42.1% (8/19), the difference was statistically significant (P=0.032). The pathological type was related with the recurrence (P=0.044). Conclusions: Patients with AEH and EC can obtain high complete response rate and pregnancy rate after fertility-preserving therapy. The recurrence rate of EC is higher than that of AEH, while the live birth rate of AEH is higher than that of EC.

Tasa de fecundidad infantil y la paulatina no declaración de los progenitores en Costa Rica (2000-2019) / Infant fertility rate and the gradual non-declaration of parents in Costa Rica (2000-2019)

Resumen Introducción: la maternidad infantil debe evidenciarse por su propia naturalización social como producto de violaciones. Es relevante su estudio luego de aprobadas algunas leyes que buscan evitarla. Objetivo: analizar el comportamiento de la tasa de fecundidad en niñas entre 10 y 14 años en Costa Rica (2000-2019) y la edad de los perpetradores o «padres» en el marco de los aparatos ideológicos de Estado, desigualdad social y dentro de un contexto social conservador. Método: la información se extrajo de las bases de datos en línea del Instituto Nacional de Estadística y Censos. El abordaje es cuantitativo, con un estudio correlacional y no experimental de la población descrita en todo el país y en áreas geográficas pequeñas. Resultados: la fecundidad infantil ha disminuido entre los años 2000 y 2019. La edad estimada de embarazo es cuando se cumplen los 13 años. Se detectaron áreas geográficas con mayores niveles de fecundidad dentro y fuera del Gran Área Metropolitana. Se evidenció estadísticamente que algunas leyes han contribuido al aumento considerable de perpetradores no declarados luego de 2016. Todo esto fue validado por instituciones religiosas y los medios de comunicación lo pregonaron como positivo, a pesar de la jurisprudencia nacional e internacional. Conclusiones: esta información es trascendental para orientar las políticas públicas educativas y de salud desde el primer nivel de atención, con miras a promover los derechos reproductivos de las niñas.

Abstract Introduction: Child motherhood must be evidenced by the naturalization of this social fact itself, since it is the product of rape. The study of this phenomenon is relevant after the approval of some laws that seek to prevent it. Objective: to analyze of the fertility rate in girls between the ages 10 and 14 in Costa Rica (2000-2019) the age of the perpetrators or "parents" within the framework of ideological State apparatuses, social inequality, and a conservative social context. Method: The information was processed from the online databases of the Instituto Nacional de Estadística y Censos. The approach is quantitative, with a correlational and non-experimental study of the population of girls between 10 and 14 years of age throughout the country, as well as for small geographic areas. Results: Infant fertility has decreased between 2000 and 2019. The estimated age of pregnancy is at the age of 13. Geographical areas with higher fertility levels are detected, inside and outside the Metropolitan Area. It is statistically evidenced that these have contributed to the increase in undeclared perpetrators considerably after 2016. All this is validated by religious institutions and the media proclaim as positive, despite national and international jurisprudence. Conclusions: This information is essential to guide public educational and health promotion policies from the first level of care, which promote the reproductive rights of girls.

The Effect of Glyphosate on Human Sperm: In Vitro Approximation / Efecto del glifosato sobre los espermatozoides humanos: una aproximación in vitro

Introduction Glyphosate is an herbicide used to eradicate illicit crops; however, its use is controversial due to different health problems associated with it. The present study aims to evaluate the effects of glyphosate on human sperm in vitro. Methods Twenty-two semen samples from healthy normozoospermic men were included; 11 semen samples were incubated with Panzer (INVESA S.A., Antiquia, Colombia) and 11 with Roundup (Monsanto Company, MO, USA). The changes in motility and viability were observed. Functional seminal parameters were evaluated as well. Results The samples exposed to glyphosate showed less motility and viability; a decrease in the potential of the mitochondrial membrane was observed, and an increase in the lipoperoxidation of the membrane was evidenced. Conclusion Based on the present results, we concluded that glyphosate has cytotoxic potential for exposed people and may affect their fertility.

Introducción El glifosato es un herbicida utilizado ampliamente para la erradicación de cultivos ilícitos; sin embargo, su uso es polémico debido a diferentes problemas de salud asociados con él. El objetivo del presente estudio fue evaluar los efectos del glifosato sobre los espermatozoides humanos in vitro. Métodos Se incluyeron 22 muestras de semen de hombres sanos normozoospérmicos, de las cuales 11 se incubaron con Panzer y 11 con Roundup, y se evaluaron los cambios en la movilidad y la viabilidad espermática, además de valorar los parámetros seminales funcionales. Resultados Las muestras expuestas al glifosato presentaron una menor movilidad y viabilidad, una disminución en el potencial de la membrana mitocondrial, y un aumento en la lipoperoxidación de la membrana. Conclusiones El glifosato es potencialmente citotóxico para las personas que estén expuestas, y puede afectar su fertilidad.

Total mercury exposure risk and selenium content measuring on fishery products consumed by women of childbearing age from Bogota, Colombia / Riesgo de exposición a mercurio total y medición del contenido de selenio en productos de la pesca consumidos por mujeres en edad fértil de Bogotá, Colombia

Background: Dietary exposure to mercury in women of childbearing age could result in neurological effects on the fetus. A health risk assessment of total mercury by fishery products intake has not been conducted in this population group in Bogota, Colombia. On the other hand, it has been suggested that selenium content on fishery products may have a protective effect against mercury toxicity. Nevertheless, selenium content on fish species marketed in Bogota has not been determined. Objective: Exposure risk to total mercury and selenium content on fishery products consumed by women of childbearing age from Bogota, Colombia, were assessed. Methods: Total mercury and selenium concentrations for products available at fish stores and supermarkets were determined. The exposure risk to total mercury was estimated considering the intake of these products by women of childbearing age group. Results: Total mercury highest concentrations were 0.8166 mg/kg in mota (Calophysusmacropterus), and 0.6275 mg/kg in catfish (Pseudoplatystoma tigrinum). On the other hand, the highest selenium concentration was 0.6471 mg/kg in nicuro (Pimelodus blochii). Finally, it was established that for women of childbearing age group, health risk of exposure to total mercury due to mota intake exceeded by 8.56-fold the reference dose. Conclusions:Mota intake considerably increases exposure risk to total mercury on women of childbearing age from Bogota, Colombia. The selenium levels established in the fishery products assessed, except for catfish and mota, are theoretically suggestive of a protective effect of selenium against mercury toxicity. Consequently, continuous total mercury concentrations monitoring is required to protect health of women of childbearing age and the general population from Bogota, Colombia

Antecedentes: La exposición dietética al mercurio en mujeres en edad fértil podría provocar efectos neurológicos en el feto. En Bogotá, Colombia no se han realizado evaluaciones de riesgo por la exposición al mercurio total debido a la ingesta de productos de la pesca en este grupo de la población. Por otro lado, ha sido sugerido que el contenido de selenio en los productos de la pesca podría tener un efecto protector frente a la toxicidad por mercurio, sin embargo, el contenido de selenio en las especies de peces comercializadas en Bogotá, Colombia no ha sido determinado. Objetivo: Evaluar el riesgo de exposición al mercurio total y el contenido de selenio en los productos de la pesca consumidos por las mujeres en edad fértil de Bogotá, Colombia. Métodos: Se determinaron las concentraciones de mercurio total y selenio en distintos productos de la pesca disponibles en pescaderías y supermercados. El riesgo de exposición a mercurio total se estimó considerando la ingesta de estos productos por parte de un grupo de mujeres en edad fértil. Resultados: Las concentraciones más altas de mercurio total fueron de 0.8166 mg/kg en mota (Calophysus macropterus) y 0.6275 mg/kg en bagre (Pseudoplatystoma tigrinum). Por otro lado, la concentración más alta de selenio fue de 0.6471 mg/kg en nicuro (Pimelodus blochii). Finalmente, se estableció que el riesgo de exposición a mercurio total, debido a la ingesta de mota, excedió en 8.56 veces la dosis de referencia en el grupo de mujeres en edad fértil. Conclusiones: La ingesta de mota aumenta el riesgo de exposición al mercurio total en las mujeres en edad fértil de Bogotá, Colombia. Por otro lado, los niveles de selenio identificados en los productos evaluados, excepto en bagre y mota, teóricamente sugieren un posible efecto protector del selenio contra la toxicidad por mercurio. Considerando lo indicado, es necesario realizar un monitoreo continuo de las concentraciones de mercurio total en los productos de la pesca, con el fin de proteger la salud de las mujeres en edad fértil y de la población general de Bogotá, Colombia

La fecundidad en la ciudad de Rosario, Argentina: proyecciones y retroproyecciones de la tasa global de fecundidad y las tasas específicas de fecundidad / Fertility in Rosario City, Argentina: Projections and retro-projections of the global fertility rate and specific fertility rates

Resumen El estudio que da lugar al presente artículo surge a partir de los resultados obtenidos en el marco de un convenio de colaboración firmado por la Dirección General de Estadística de la Municipalidad de Rosario y la Escuela de Estadística de la Facultad de Ciencias Económicas y Estadística de la Universidad Nacional de Rosario. Entre sus objetivos, se plantea el de obtener pronósticos probabilísticos de la fecundidad para la Ciudad de Rosario. Para ello, con base en estadísticas vitales, estimaciones y proyecciones de población se construyen escenarios probables, pasados y futuros, tanto para la tasa global de fecundidad como para las tasas específicas de fecundidad. Los resultados de este estudio, basados en la aplicación de modelos probabilísticos de pronóstico, permiten conocer estructuras y tendencias, pasadas y futuras de la fecundidad, de modo que puedan generarse diagnósticos que sean de utilidad para la evaluación y gestión del sistema de salud o bien para el desarrollo de nuevas políticas públicas. Los resultados indican que Rosario tuvo, tiene y seguirá teniendo un cambio en los patrones de fecundidad más rápido y marcado que el promedio nacional. Si bien este hecho es esperable, en un contexto signado por los avances en la salud pública, que permiten acceder a más y mejor atención en salud reproductiva, la metodología aquí empleada se basa únicamente en la extrapolación de las tendencias, por ello la retroproyección debe ser analizada cuidadosamente. Con posterioridad, en la sección metodológica, se presentan los modelos probabilísticos de pronóstico que se emplean para la obtención de resultados.

Abstract The study that gives rise to this article arises from the results obtained in the framework of a collaboration agreement signed by the Statistical Office of Rosario City and the School of Statistics of the Faculty of Economic Sciences and Statistics (National University of Rosario). Among its objectives is to obtain probabilistic fertility forecasts for Rosario City. For this, based on vital statistics, estimates and population projections, probable scenarios, past and future, are constructed, both for the global fertility rate and the specific fertility rates. The results of this study, based on the application of probabilistic prognostic models, allow to know structures and trends, past and future, of fertility, so that diagnoses can be generated that are useful for the evaluation and management of the health system or good for the development of new public policies. The results indicate that Rosario had, has and will continue to have a change in fertility patterns faster and more marked than the national average. Although this fact is to be expected in a context marked by advances in public health (which allow access to more and better reproductive health care), the methodology used here is based solely on the extrapolation of trends, therefore, the backprojection must be carefully analyzed.

Cuatro años de experiencia en tratamiento médico del embarazo ectópico en el departamento de Paysandú / Four-year experience in medical treatment of ectopic pregnancy in the department of Paysandú / Quatro anos de experiência no tratamento de gravidez ectópica no departamento de Paysandú

Resumen: Introducción: en los últimos años se viene presentando un fenómeno de disminución en las defunciones vinculadas al embarazo ectópico gracias a los avances en el diagnóstico precoz, lo que a su vez abrió las puertas al tratamiento médico con metotrexate en pacientes seleccionadas. El objetivo del presente trabajo es reportar la experiencia del tratamiento con metotrexate en el departamento de Paysandú y determinar secundariamente la satisfacción de las usuarias frente a éste y su fertilidad posterior. Método: se presenta un estudio retrospectivo, observacional, de los embarazos ectópicos tubarios tratados con metotrexate en Paysandú, durante el período del 1º de enero de 2014 al 31 de diciembre de 2017, comprendiendo cuatro años. Se consideró fracaso del tratamiento médico cuando fue necesario tratamiento quirúrgico y se definió como fertilidad futura al tiempo que transcurrió hasta lograr una gestación intrauterina espontánea. Resultados: se registraron 67 embarazos ectópicos en cuatro años, 13 recibieron metotrexate intramuscular con un porcentaje de éxito de 69,2%. Se determinó una fertilidad posterior de 25%. Conclusiones: el uso de metotrexate en el embarazo ectópico se practica en Paysandú desde hace casi una década con buenos resultados y una buena aceptación por parte de las usuarias.

Summary: Introduction : In recent years there has been a decrease in deaths related to ectopic pregnancy, thanks to progress made in early diagnosis, which in turn allowed for medical treatment with methotrexate in selected patients. The study's first objective is to report the experience of methotrexate treatment in the Department of Paysandú and its secondary objective is to determine users' satisfaction towards this treatment and find about their subsequent fertility. Method: a retrospective, observational study is presented of tubal ectopic pregnancies treated with methotrexate in Paysandú, from January 1, 2014 to December 31, 2017, during a 4-year period. Failure of medical treatment was defined as the cases requiring surgical treatment and subsequent fertility was defined as the time it took to achieve a spontaneous intrauterine gestation. Results: 67 ectopic pregnancies were recorded in four years, 13 of which received intramuscular methotrexate with a success rate of 69.2%. Subsequent fertility was found to be 25%. Conclusions: methotrexate has been used to treat ectopic pregnancies in Paysandú for almost a decade, with good results and acceptable rates of user satisfaction.

Resumo: Introdução: nos últimos anos, observou-se uma diminuição dos óbitos relacionados à gravidez ectópica, graças aos avanços no diagnóstico precoce, que por sua vez abriram as portas para o tratamento médico com metotrexato em pacientes selecionadas. Objetivo: o objetivo deste trabalho é relatar a experiência do tratamento com metotrexato no Departamento de Paysandú e determinar secundariamente a satisfação das usuárias com o mesmo e sua consequente fertilidade. Métodos: apresenta-se um estudo retrospectivo e observacional de gestações ectópicas tubárias tratadas com metotrexato em Paysandú, durante o período de 1º de janeiro de 2014 a 31 de dezembro de 2017. Considerou-se como falha do tratamento médico quando o tratamento cirúrgico foi necessário e definiu-se fertilidade futura como o tempo decorrido até a obtenção de uma gravidez intrauterina espontânea. Resultados: foram registradas 67 gestações ectópicas em quatro anos, 13 receberam metotrexato intramuscular com taxa de sucesso de 69,2%. Uma fertilidade subsequente de 25% foi determinada. Conclusões: o uso do metotrexato na gravidez ectópica é praticado em Paysandú há quase uma década com bons resultados e boa aceitação pelas usuárias.