Evaluación del conocimiento y manejo de la violencia basada en género desde la perspectiva de los ginecotocólogos y posgrados en la práctica clínica en Uruguay

Introducción: la violencia basada en género (VBG) es un grave problema de salud con cifras alarmantes. Las mujeres víctimas de VBG acuden a los centros de salud para ser atendidas por este y otros motivos, siendo en muchos casos el primer y único contacto de las mujeres con el sistema sanitario. El objetivo de este estudio es investigar acerca del nivel de formación, conocimientos, actuación y percepciones sobre la atención por parte de los ginecotocólogos y posgrados de Ginecotocología en casos de VBG en la práctica clínica diaria en nuestro medio. Método: se realizó un estudio descriptivo observacional de corte transversal de una muestra por conveniencia. Se encuestaron 143 profesionales, comprendiendo ginecotocólogos y posgrados de Ginecotocología en el período comprendido entre el 1 y el 30 de septiembre de 2019. Resultados: 9 de cada 10 de los profesionales refirieron no realizar o realizar pocas preguntas sobre VBG en la práctica clínica, y 80% no tiene claro sobre cuál es su rol en la detección de una víctima de VBG, siendo profesionales que asisten a un promedio de 20 a 60 mujeres semanalmente. Un tercio de los encuestados manifestaron tener menos de una hora de formación académica en VBG. Conclusión: existe escasa formación académica en esta temática. Se mostró que entender el papel del profesional en la detección de casos de VBG y la capacidad para responder apropiadamente están íntimamente relacionados con la capacidad de identificar la VBG en la práctica clínica diaria.

Introduction: Gender-based violence (GBV) is a serious health problem that accounts for alarming figures. Women victims of GBV come to health centers to be treated for this and other reasons, in many cases being this the first and only contact they have with the health system. The objective of this study is to find out the level of training, knowledge, actions, and perceptions regarding care by gynecologists and gynecology postgraduates in cases of gender-based violence seen during daily clinical practice in our setting. Method: A descriptive observational study was conducted, with a cross-sectional design and convenience sample. A total of 143 professionals were surveyed, including gynecologists and gynecology postgraduates, between September 1st and September 30th, 2019. Results: Nine out of ten professionals reported not asking or asking few questions about GBV in their clinical practice, and 80% were unclear about their role in detecting GBV victims, despite assisting an average of 20 to 60 women weekly. One-third of respondents reported having less than an hour of academic training in GBV. Conclusion: There is limited academic training in this area. The study showed that understanding the professionals' role in detecting GBV cases and their ability to respond appropriately to it are closely related to the ability to identify GBV in daily clinical practice.

Introdução: a violência baseada em gênero (VBG) é um grave problema de saúde com números alarmantes. As mulheres vítimas de VBG procuram os centros de saúde para tratamento por esse e outros motivos e, em muitos casos, esse é o primeiro e único contato que as mulheres têm com o sistema de saúde. O objetivo deste estudo é pesquisar o nível de formação, conhecimento, desempenho e percepções do atendimento por tocoginecologistas e pós-graduandos em Tocoginecologia nos casos de VBG na prática clínica diária. Métodos: foi realizado um estudo observacional descritivo de corte transversal com uma amostra de conveniência. Foram incluídos 143 profissionais, incluindo tocoginecologistas e pós-graduandos em Tocoginecologia no período entre 1º e 30 de setembro de 2019. Resultados: 9 em cada 10 profissionais relataram não fazer nenhuma ou poucas perguntas sobre a VBG na prática clínica, e 80% não tinham clareza sobre seu papel na identificação de uma vítima de VBG em sua prática, sendo profissionais que atendem uma média de 20 a 60 mulheres por semana. Um terço dos entrevistados relatou ter menos de uma hora de formação acadêmica em VBG. Conclusão: Há pouca formação acadêmica nessa área. A compreensão do papel do profissional na detecção de casos de VBG e a capacidade de responder adequadamente estão intimamente relacionadas à capacidade de identificar VBG na prática clínica diária.

Using an anatomic model to teach female stress incontinence to gynecologic residents‑in‑training: A prospective cohort study / Philippine Journal of Obstetrics and Gynecology

Background@#Stress urinary incontinence (SUI) is a complex condition with a multifactorial etiology that makes its concepts challenging to teach. This study aimed to assess the efficacy of simulation-based training (SBT) with an anatomic teaching model in improving the understanding of SUI among gynecologic residents-in-training. @*Objective@#The primary objective of this study was to evaluate the efficacy of SUI simulation-based teaching in enhancing the learning experience for gynecologic residents-in-training. The secondary objective was to gather feedback from participants with the intent to further enhance existing teaching methodologies.@*Materials and Methods@#This was a descriptive prospective study within a single institution, involving gynecologic residents-in-training. Participants were given an anatomic teaching tool to construct, followed by an SUI lecture. Pre- and posttest Multiple Choice Questions were administered to assess the efficacy of the teaching tool in improving the participants’ understanding of SUI. Frequency and percentages were used to describe the categorical variables, whereas continuous variables were described using mean and standard deviation. Paired t-test was used to compare the pre- and posttest scores. ANOVA was used to compare the pre- and posttest scores of participants by year level. A P < 0.05 is statistically significant. A separate Likert-scale questionnaire, to evaluate changes in participant’s self-assessment on learning, response to teaching content and resources, and overall feedback of the SBT was used.@*Results@#There were 50 gynecologic residents-in-training that were included in the study. The mean posttest score is significantly higher (6.4 vs. 3.48) than the pretest score, with a mean difference of 3.48. The mean posttest score is significantly different between the year levels with a P < 0.05, with senior residents-in-training performing best. Although participants with only gynecologic conferences as SUI reference performed best, the mean pre- and posttest scores were not statistically different with respect to SUI education exposure. With the use of an anatomic SUI model, the number of correct answers for questions pertaining to anatomy, physiology, and pathophysiology was consistently higher in the posttest scores as compared to the pretest scores but did not reach statistical significance. The majority of participants strongly agree to recommend the course to a colleague.@*Conclusion@#This study supports the use of simple, low-fidelity physical teaching tools in improving the understanding of SUI in gynecologic residents-in-training. Considering the ease of production, improved test scores, and participants’ enthusiasm, the incorporation of the anatomic teaching tool for its use in SUI education should be encouraged.

Sports gynecology: a new way to improve female athletes care and performance / Ginecología deportiva: una nueva forma de optimizar atención y el rendimiento de la deportist / Ginecologia do esporte: uma nova maneira de otimizar o cuidado e a performance da mulher atleta

ABSTRACT Introduction: Female participation in sports has reached a milestone in 1972 when a constitutional amendment was implemented to ensure equal opportunities for men and women. Since then, the percentage of participants in competitive sports has grown. In this context became necessary to understand menstrual cycle, contraceptive use, and its individual responses. Objective: To investigate menstrual cycle characteristics, physical and mood symptoms related to vaginal bleeding, and contraceptives used by Brazilian Olympic athletes. Also, to assess if these athletes relate that vaginal bleeding influences sportive performance, how they manage it and what can be changed to improve their health care and sportive performance. Additionally, we propose specialized female care by a gynaecologist specialized in sports medicine. Methods: Descriptive observational study was conducted from July to August 2016 and included 118 Brazilian Olympic female athletes, in menacme. The athletes completed a self-administered online questionnaire, adapted from Pre-Participation Gynaecological Examination of female athletes. Results: Participants practiced 28 different sports, mean age 27 ± 4.7 years. For 66% it was their first participation in an Olympic Game. Most used contraceptives (54%), mainly oral (61%). Most (76%) believed that vaginal bleeding influenced sports performance, and 63% preferred to compete after bleeding cessation. Fifty-eight percent would compete at preferred time of their cycle. Anxiety symptoms, bloating, increased appetite, depression, and dysmenorrhea were indicated by 52%. Among these, 49% reported that these symptoms deteriorated their sportive performance. Conclusion: Most in their first Olympic participation, Brazilian athletes used hormone contraceptives, mainly oral ones to manage and adapt their vaginal bleeding to the competition calendar because most of them referred those physical and mood symptoms deteriorated their sportive performance. The presence of a Sportive Gynaecologist as part of the Olympic Medical Staff highlighted the female athletes issues and helped them to improve sportive performance. Level of Evidence IV; Cross-sectional observational study

RESUMEN Introducción: La participación femenina en deportes alcanzó un hito en 1972, cuando se implementó una reforma constitucional para garantizar igualdad de oportunidades entre hombres y mujeres. Desde entonces, el porcentaje de participantes en deportes competitivos ha crecido. En este contexto, se hizo necesario comprender el ciclo menstrual, el uso de anticonceptivos y sus respuestas individuales. Objetivo: Investigar características del ciclo menstrual, síntomas físicos, estado de ánimo, quejas relacionadas con el sangrado vaginal y los métodos anticonceptivos utilizados por atletas olímpicas brasileñas. Evaluar si estas deportistas perciben influencia del sangrado vaginal en el rendimiento deportivo, cómo lo controlan y qué se puede cambiar para mejorar. Además, ofrecemos atención especializada por una ginecóloga especialista en medicina deportiva. Métodos: Estudio observacional, descriptivo, realizado de julio a agosto de 2016, que incluyó 118 atletas olímpicas brasileñas, en menacme. Las atletas respondieron un cuestionario en línea autoadministrado y adaptado titulado "Examen ginecológico previo a la participación". Resultados: Practicaban 28 deportes diferentes, con edad media = 27 ± 4,7 años. Para 66%, era su primera participación en un juego olímpico. Anticonceptivos usados r54%), principalmente orales (61%). La mayoría (76%) cree que el sangrado vaginal influye en el rendimiento deportivo y 63% prefirió competir después del. El 58% de los atletas competiría en su momento preferido de su ciclo. Los síntomas de ansiedad, hinchazón, aumento del apetito, depresión y dismenorrea fueron indicados por el 52%. Entre estas, 49% deterioró su rendimiento deportivo. Conclusión: En su primera participación olímpica, las atletas brasileñas utilizaron anticonceptivos hormonales, principalmente orales, para controlar y adaptar el sangrado vaginal al calendario de competición, ya que la mayoría relató que los síntomas físicos y anímicos perjudicaban su desempeño deportivo. La presencia de una Ginecóloga Deportiva como parte del Equipo Médico Olímpico destacó los problemas de las atletas y las ayudó a mejorar su rendimiento. Nivel de Evidencia IV; Estudio Observacional.

RESUMO Introdução: A participação feminina no esporte teve um marco importante em 1972, quando uma emenda constitucional foi implementada para garantir a igualdade de oportunidades para homens e mulheres. Desde então, o percentual de participantes em esportes competitivos tem crescido. Nesse contexto tornou-se necessário compreender sobre ciclo menstrual, uso de anticoncepcionais e suas respostas individuais. Objetivo: Investigar características do ciclo menstrual, sintomas físicos e de humor, queixas relacionadas ao sangramento vaginal e métodos contraceptivos usados por atletas olímpicas brasileiras. Avaliar se percebem influência do sangramento vaginal no desempenho esportivo, como elas o controlam e o que pode ser mudado para melhorar seus cuidados e desempenho esportivo. Além disso, propõe-se atendimento específico por ginecologista especializada em medicina esportiva. Métodos: Estudo observacional, descritivo, realizado de julho a agosto de 2016 que incluiu 118 atletas olímpicas brasileiras, na menacme. As atletas responderam a um questionário online autoaplicável e adaptado intitulado "Pre-Participation Gynaecological Examination". Resultados: As participantes praticavam 28 esportes diferentes, com média de idade = 27 ± 4,7 anos. Para 66%, foi a primeira participação em um evento olímpico. A maioria usava anticoncepcional (54%), principalmente oral (61%). A maioria (76%) acredita que o sangramento vaginal influencia o desempenho esportivo e 63% preferiam competir após o mesmo. 58% das atletas competiriam no momento preferido de seu ciclo. Sintomas de ansiedade, distensão abdominal, aumento do apetite, depressão e dismenorreia foram indicados por 52%. Entre esses, 49% deterioraram o desempenho esportivo. Conclusão: Em sua primeira participação olímpica, as atletas brasileiras utilizaram anticoncepcionais hormonais, principalmente orais, para controlar e adaptar o sangramento vaginal ao calendário de competição, pois a maioria referiu que os sintomas físicos e de humor prejudicaram o desempenho esportivo. A presença de uma Ginecologista Esportiva como parte da Equipe Médica Olímpica destacou os problemas das atletas femininas e as ajudou a melhorar o desempenho esportivo. Nível de Evidência IV; Estudo Observacional.

Novas disputas e intervenções no corpo feminino: fronteiras entre ginecologia e cirurgia plástica / New disputes and interventions in the female body: divisions between gynecology and plastic surgery

Resumo Este artigo analisa tensões e disputas entre o campo da ginecologia e da cirurgia plástica estética, especialidades autorizadas a realizar a cirurgia estética genital feminina no Brasil. Utiliza material documental, incluindo artigos científicos desde a década de 1990, e sites institucionais. Enquanto ginecologistas têm se mantido mais cautelosos com a prática, defendendo sua realização apenas quando há indicações funcionais, cirurgiões/ãs plásticos/as têm sido mais influentes na disseminação do procedimento, privilegiando a dimensão estética. Argumenta-se que, para além de disputas entre campos profissionais, esse fenômeno precisa ser entendido à luz da crescente ênfase no aprimoramento de si, via recursos biomédicos, e dos imperativos de gênero.

Abstract This article analyzes the tensions and disputes between the fields of gynecology and esthetic plastic surgery, the specialties which are authorized to perform aesthetic female genital surgeries in Brazil. Documentary materials are used, including scientific articles from the 1990s onward and institutional websites. While gynecologists have remained more cautious, recommending the surgery only for functional reasons, plastic surgeons have been more influential in publicizing these procedures and emphasizing the aesthetic dimension. Beyond professional disputes, we debate whether this phenomenon needs to be understood in light of the growing emphasis on self-improvement via biomedical resources and gender imperatives.

Síndrome de burnout em residentes de ginecologia e obstetrícia de uma maternidade-escola / Burnout syndrome in gynecology and obstetrics residents of a teaching maternity unit

RESUMO Introdução: Os médicos residentes constituem um grupo de risco para distúrbios emocionais e comportamentais, e isso pode levar à síndrome de burnout e interferir negativamente no atendimento prestado. Objetivo: Este estudo teve como objetivos identificar os estressores vivenciados por residentes de ginecologia e obstetrícia (GO) de uma maternidade-escola do Sul do Brasil e estimar a prevalência da síndrome de burnout entre eles. Método: Realizou-se a coleta de dados de agosto a dezembro de 2020 com 21 residentes. A coleta compreendeu duas etapas: na primeira, fez-se uma entrevista semiestruturada, por meio de um roteiro-guia, visando identificar os estressores vivenciados pelos residentes em GO. Na sequência, os participantes receberam um questionário autoaplicável que teve por objetivo medir o nível de burnout pautado no Maslach Burnout Inventory. Para análise dos dados qualitativos, adotou-se a metodologia discurso do sujeito coletivo. Para análise dos dados quantitativos, foi utilizada a descrição analítica dos dados. Resultado: Entre os estressores vivenciados pelos residentes, destacam-se: falta de acolhimento pela equipe multiprofissional ao ingressarem na residência; excessiva carga horária de trabalho; poucas horas de sono; o desafio de se tornarem responsáveis pelo próprio aprendizado; as várias abordagens terapêuticas por preceptores diferentes para um mesmo problema; sensação de insuficiência de conteúdo teórico durante a residência; culpa por não estudarem o quanto acreditam que deveriam; diminuição do tempo destinado ao lazer e à atividade física; alto nível de estresse; abalo emocional que a grande responsabilidade assumida acarreta; e falta de apoio psicológico. Dos 21 médicos residentes, a síndrome de burnout esteve presente em 57,1% dos participantes. Exaustão emocional foi a mais frequente dimensão (52,7%), seguida por despersonalização (33,3%) e baixa realização profissional (9,5%). Conclusão: Os estressores relatados apontam para necessidade de revisão da residência a fim de que consequências nefastas à saúde mental de residentes, como a síndrome de burnout e suas consequências, sejam prevenidas, diminuídas ou sanadas, de modo a evitar danos tanto para os residentes como para os pacientes por eles atendidos e para instituição de saúde. São propostas medidas profiláticas na busca de melhorias na qualidade de vida, na qualidade do atendimento e, talvez no aspecto mais importante: a mudança de foco, da residência centrada no serviço para a residência centrada no aprendiz.

ABSTRACT Introduction: Medical residents constitute a risk group for emotional and behavioral disorders, which can lead to Burnout Syndrome, negatively interfering with the care provided. Objective: To identify the stressors experienced by Gynecology and Obstetrics residents of a teaching maternity hospital in southern Brazil and estimate the prevalence of Burnout Syndrome among them. Method: Data was collected from August to December 2020 with 21 residents and comprised two stages: the first consisted of a semi-structured interview, using a guide script, aiming to identify the stressors experienced by the GO residents. Subsequently, the participants received a self-administered questionnaire that aimed to measure the level of Burnout based on the Maslach Burnout Inventory. Qualitative data analysis was performed using the Collective Subject Discourse methodology. Quantitative data analysis was performed using the analytical description of the data. Results: Among the stressors experienced by residents, the following stand out: lack of acceptance by the multidisciplinary team when entering the residency; excessive workload; lack of sleep; the challenge of becoming responsible for one's own learning; the various therapeutic approaches by different preceptors for the same problem; feeling of insufficient theoretical content during the residency; guilt for not studying as much as you believe you should; decreased time devoted to leisure and physical activity, high level of stress; emotional upheaval that the great responsibility assumed entails and lack of psychological support. Of the 21 resident physicians, Burnout Syndrome was present in 57.1% of the participants. Emotional exhaustion was the most frequent dimension (52.7%), followed by Depersonalization (33.3%) and Low professional achievement (9.5%). Conclusion: The reported stressors point to the need to review the residency so that harmful consequences to the mental health of students, such as Burnout syndrome and its consequences, are prevented, reduced or remedied, avoiding damage to the residents, their patients and the health care institution. Prophylactic measures are proposed in the search for improvements in the quality of life, the quality of care and, perhaps most importantly, the shift in focus from a service-centered residency to a learner-centered residency.

Prevalence and factors associated with anxiety, depression and burnout in gynecology and obstetrics residents during the COVID-19 pandemic

Abstract Objective: To determine the prevalence of anxiety, depression and burnout in residents of Gynecology and Obstetrics during COVID-19 pandemic in Brazil and its associated factors. Methods: Cross-sectional study involving all regions of Brazil, through the application of a sociodemographic questionnaire, the Hospital Anxiety and Depression Scale (HAD) and the Maslach Burnout Inventory (MBI-HSS) instrument. Multivariate analysis was performed after adjusting the Poisson model. Results: Among the 719 participating medical residents, screening was positive for anxiety in 75.7% and for depression in 49.8% of cases. Burnout syndrome was evidenced in 41.3% of the physicians studied. Those with depression are more likely to have anxiety (OR 0.797; 95%CI 0.687 - 0.925) and burnout syndrome (OR 0.847 95%CI 0.74 - 0.97). Residents with anxiety (OR 0.805; 95%CI 0.699 - 0.928) and burnout (OR 0.841; 95%CI 0.734 - 0.963) are more likely to have depression. Conclusion: High prevalence of anxiety, depression and burnout were found in residents of Gynecology and Obstetrics in Brazil, in addition to important correlations between anxiety-depression and depression-burnout.

Síndrome de leiomiomatose cutânea e uterina múltipla: relato de três casos clínicos / Multiple cutaneous and uterine leiomyomatosis syndrome: report of three clinical cases

A síndrome de Reed ocorre em mulheres com múltiplos leiomiomas cutâneos e leiomiomatose uterina. Relatam-se três casos de pacientes do sexo feminino, acompanhadas em hospital universitário, com pápulas e nódulos eritêmato-acas- tanhados dolorosos em membros superiores e tórax, agravados por frio, pressão e estresse, e associados a miomatose uterina. Foram realizados diversos tratamentos prévios, sem sucesso, tais como: aplicação de corticoterapia e toxina botulínica intralesional, bloqueadores de canais de cálcio, neuromoduladores e analgésicos orais. Foi, então, realizado tratamento cirúrgico, com melhora dos sintomas. O co- nhecimento e o esclarecimento dessa síndrome é fundamental para estabelecer a relação com miomatose uterina e câncer de células renais, para que, então, a partir da lesão de pele, se faça o rastreio das demais neoplasias, diagnóstico precoce e a educação em saúde.

Reed syndrome occurs in women with multiple cutaneous leiomyomas and uterine leiomyomatosis. We report the case of three female patients followed at a university hospital with painful erythematous-brown papules and nodules on the upper limbs and chest, aggravated by cold, pressure, stress, and associated with uterine myoma- tosis. Several previous unsuccessful treatments were performed, such as the applica- tion of corticotherapy and intralesional botulinum toxin, calcium channel blockers, neuromodulators, and analgesics. Surgical treatment was performed with the im- provement of symptoms. Knowledge and clarification of this syndrome are essential to establish a relationship between uterine myomatosis and renal cell neoplasm, so that, after the skin lesion, screening for other neoplasms, early diagnosis, and health education can be carried out.

Espiradenoma écrino en muslo de mujer: reporte de un caso

Introducción: El espiradenoma ecrino es un tumor anexial benigno raro que surge de las glándulas sudoríparas écrinas. Comúnmente se presenta como un nódulo de crecimiento lento en la parte superior del tronco y la región de la cabeza y el cuello, principalmente en el rango de edad de 15 a 35 años, sin predominio de género. Por lo general, se presentan como pequeños nódulos solitarios que pueden crecer varios centímetros, a menudo muy dolorosos. El diagnóstico de esta entidad es de suma importancia ya que puede albergar un componente maligno con desenlaces catastróficos, ya que pueden pasar desapercibidos por su gran parecido con lesiones benignas. Caso Clínico: Aquí presentamos el caso de una mujer 41 años que presentó una lesión cutánea de crecimiento similar a un papiloma en la cara externa de tercio superior del muslo, con el diagnóstico de espiradenoma écrino posterior a la extirpación.

Introduction: Eccrine spiradenoma is a rare, benign adnexal tumor arising from the eccrine sweat glands. It commonly presents as a slow-growing nodule on the upper trunk, and head and neck region, mostly in the age bracket of 15 - 35 years, with no gender preference. Typically, they present as small solitary nodules that can grow to several centimeters, often they are strikingly painful. The diagnosis of this entity is extremely important as it can harbour a malignant component with catastrophic outcomes wich may be missed due to its strong resemblance to benign lesions. Case Report: We present the case of a 41-year-old woman who presented with a papilloma-like growth on the upper lateral aspect of the thigh which was diagnosed as eccrine spiradenoma upon excision.

Diagnóstico del acceso a servicios de salud gineco-obstetra de las mujeres internas en establecimientos penitenciarios del Perú

Introducción: Resulta trascendental estudiar el acceso a la salud en diversos campos y sobre todo en poblaciones en estado de vulnerabilidad. Las mujeres internas se consideran un grupo de población especial, el aumento sostenido de la población penitenciaria, a nivel local y mundial, y el hecho de que los problemas de salud de las personas privadas de libertad suelen ser de mayor prevalencia que la de la población general, plantea la necesidad y el desafío de diseñar y establecer estrategias especiales en referencia a los modelos de atención necesarios para llevar a cabo las tareas de atención, prevención y promoción de la salud dentro de los establecimientos penitenciarios. Objetivo: El objetivo del estudio fue diagnosticar el acceso a los servicios de la salud gineco-obstetra en los establecimientos penitenciarios del Perú durante el año 2021. Metodología: El estudio tiene carácter descriptivo, transversal, se realizó en el ámbito penitenciario y abarca todos los establecimientos penitenciarios de las regiones del Perú con población penitenciaria femenina distribuidas en el territorio peruano durante el año 2021. Para la recolección de datos se aplicó la técnica documental de fuente secundaria, el instrumento en el cual se registró la información recogida fue la ficha documental. Resultados: Se encontró que, de 13 establecimientos penitenciarios de mujeres y 31 pabellones de mujeres, solo 15 (34,09 %) cuentan con servicio gineco-obstetra, mientras que 29 (65,91 %) no cuentan con servicio gineco-obstetra. Del total de la población penitenciaria estudiada (4360) internas, no todas recibieron al menos una atención gineco-obstetra durante el año 2021 Discusión: El acceso a los servicios gineco-obstetras en la población penitenciaria de mujeres del Perú se muestra restringida, colocando en situación de vulnerabilidad a las mujeres privadas de su libertad.

Introduction: It is transcendental to study access to health in various fields and especially in populations in a state of vulnerability. Women inmates are considered a special population group, the sustained increase in the prison population, locally and globally, and the fact that the health problems of persons deprived of liberty tend to be more prevalent than that of the population in general, it raises the need and the challenge of designing and establishing special strategies in reference to the care models necessary to carry out the tasks of care, prevention, and health promotion within prisons. Objective: The objective of the study was to detect access to gynecologist-obstetric health services in penitentiary establishments in Peru during the year 2021. Methods: The study is descriptive, cross, was carried out in the penitentiary setting and covers all the penitentiary establishments in the regions of Peru with a female penitentiary population distributed throughout the Peruvian territory during the year 2021. For data collection, the secondary source documentary technique, the instrument in which the information collected was lost was the documentary file. Results: It was found that 13 women's prisons and 31 women's pavilions, of which only 15 (34.09%) have gynecologist-obstetric service, while 29 (35.91%) do not have gynecologist-obstetric service. Of the total prison population studied, 4,360 inmates, not all of them received at least one gynecologist-obstetrician care during the year 2021. Discussion: Access to gynecologist-obstetric services in the women's prison population in Peru is restricted, placing women deprived of their liberty in a situation of vulnerability.

Significado de la indexación de la Revista Peruana de Ginecología y Obstetricia a Scopus

La Revista Peruana de Ginecología y Obstetricia (RPGO) ha obtenido su inclusión en la importante base de datos Scopus. En una rápida recopilación de la publicación de la revista, se recuerda la dedicación editorial de sus seis editores, cuatro de los cuales acababan de presidir la Sociedad Peruana de Obstetricia y Ginecología (SPOG). Los momentos iniciales de trabajo editorial fueron realizados manualmente, en máquinas de escribir y visitando la imprenta continuamente, así como a los patrocinadores. El compromiso de los Comités Directivos de SPOG para financiar la publicación y distribución de los ejemplares permitió la gradual indexación a bases de datos locales, regionales e internacionales. Su internalización se amplió desde la publicación de la RPGO en el Open Journal Systems (OJS), sistema informático donde se publica los artículos con puntualidad, calidad, incluyendo sus características editoriales y la Información para los Autores. Ahora la publicación es solo virtual, en español e inglés, con visibilidad e impacto de los artículos desde el inicio de la RPGO en 1955. Con datos actualizados del OJS sobre la RPGO, el número de visitas mensuales a los resúmenes llegan hasta 10 mil y las descargas mensuales de artículos en formato PDF hasta más de 9 mil. Y, en el ámbito de revistas científicas de ginecoobstetricia de América Latina y España en Scopus, destaca el índice h de la RPGO por Google Scholar Metrics, como una de las mejores. Al presente, y frente a los desafíos futuros, la actividad de la RPGO ha sido fortalecida, estableciendo un equipo editorial y herramientas que permiten la ya iniciada profesionalización de los procesos de la actividad editorial.

The Peruvian Journal of Gynecology and Obstetrics (RPGO, for its acronym in Spanish) has obtained its inclusion in the important Scopus database. A quick review of the journal's publication recalls the editorial dedication of its six editors, four of whom had just recently chaired the Peruvian Society of Obstetrics and Gynecology (SPOG, for its acronym in Spanish). The initial editorial work was carried out manually, on typewriters and continuously visiting the printing press, as well as the sponsors. The commitment of the SPOG Steering Committees to finance the publication and distribution of the issues allowed the gradual indexing to local, regional and international databases. Its internalization was expanded since the publication of the RPGO in the Open Journal Systems (OJS), a computer system where articles are published with punctuality, quality, including their editorial characteristics and the Information for Authors. Now the publication is only virtual, in English and Spanish, with visibility and impact of the articles since the beginning of the RPGO in 1955. With updated OJS data on the RPGO, the number of monthly visits to the abstracts reaches up to 10 thousand and monthly downloads of articles in PDF format reach more than 9 thousand. And, in the field of obstetrics and gynecology scientific journals in Latin America and Spain in Scopus, the h index of the RPGO by Google Scholar Metrics stands out as one of the best. At present, and facing future challenges, the activity of the RPGO has been strengthened, establishing an editorial team and tools that allow the already initiated professionalization of the processes of the editorial activity.

A Study of the Current Scenario of the Obstetrics and Gynecology Residency during the COVID-19 Pandemic / Um estudo do cenário atual da residência em obstetrícia e ginecologia durante a pandemia de COVID-19

Abstract Objective To analyze the impact of the COVID-19 pandemic on the residency of gynecology and obstetrics in São Paulo. Methods Cross-sectional study developed by representatives of residents of the Association of Gynecology and Obstetrics of the State of São Paulo (SOGESP, in the Portuguese acronym). Data were collected from questionnaires applied to gynecology and obstetrics residents registered on the SOGESP website in February 2022. The interviewees answered about the repercussions of the pandemic on medical residency and whether they had technical and psychological support during the period. Results A total of 247 questionnaires were collected from residents of gynecology and obstetrics. The residents had an age of 28.3 ± 3 years old, and most of them were female (88.4%). The displacement to COVID care was reported by 62.34% of the students, but only 35.6% reported completely adequate personal protective equipment and only 7.7% reported complete theoretical and technical instruction to support these patients. Almost all of the interviewees stated that the gynecology sector was the most affected. The majority of the interviewees considered that the second-year residents had the greatest loss, and more than half of the residents in the 1st and 2nd year said they wished to give up their residency during the pandemic. More than 80% of the residents reported online theoretical classes and/or presentation of articles, reinforcing the fact that virtual activities gained a greater space within the medical residency. Conclusion The pandemic impacted the residency in greater proportion in outpatient clinics and gynecological surgeries, also interfering with the physician's desire to continue with the program.

Resumo Objetivo Analisar o impacto pandemia de COVID-19 sobre a residência de ginecologia e obstetrícia do Estado de São Paulo. Métodos Estudo transversal desenvolvido por representantes dos residentes da Associação de Ginecologia e Obstetrícia do Estado de São Paulo (SOGESP). Foram coletados dados de questionários aplicados aos residentes de ginecologia e obstetrícia cadastrados no site da SOGESP em fevereiro de 2022. Os entrevistados responderam sobre repercussões da pandemia sobre a residência médica e se tiveram suporte técnico e psicológico durante o período. Resultados Foram levantados 247 questionários de residentes de ginecologia e obstetrícia. Os residentes apresentaram idade de 28,3 ± 3 anos, sendo a maioria do sexo feminino (88,4%). O deslocamento para "covidários" foi referido por 62,34% dos avaliados, porém somente 35,6% referiram equipamento de proteção individual completamente adequado e apenas 7,7% referiram instrução completa teórica e técnica para o suporte destes pacientes. Quase a totalidade dos entrevistados afirmou que o setor de ginecologia foi o mais afetado. A maioria dos entrevistados considerou que o os residentes do segundo ano foram os que tiveram maior prejuízo, sendo que mais da metade dos residentes do 1° e 2° ano afirmou ter desejado desistir da residência durante a pandemia. Mais de 80% dos residentes referiram aulas teóricas e/ou apresentação de artigos online, reforçando o fato de que as atividades virtuais ganharam um espaço maior dentro da residência médica. Conclusão A pandemia impactou nas residências em maior proporção nos ambulatórios e cirurgias ginecológicas, interferindo também sobre o desejo do médico de seguir com o programa.

Gestión del cuidado en obstetricia y ginecología: Una mirada integral / Care management in obstetrics and gynecology: A comprehensive look

RESUMEN Objetivo: Describir la gestión del cuidado en obstetricia y ginecología: Una mirada integral. Metodología: La investigación se desarrolló desde el paradigma cuantitativo, además se enmarcó desde un diseño documental-bibliográfico, mediante la indagación, recolección y análisis crítico documental y referencial bibliográfico, basándose en la exploración metódica, rigurosa y profunda de diversas fuentes documentales tales como investigaciones científicas, artículos y trabajos arbitrados, tesis, describiendo los hallazgos encontrados y permitiendo desarrollar el cuerpo teórico en relación al tema de estudio. Resultados: Se puede observar los múltiples factores que son considerados por las mujeres que acuden a los centros asistenciales, por ello deben ser orientadas de forma integral. En conclusión: La integración de los cuidados en obstetricia y ginecología, es una acción que contribuirá a un mejor desempeño y desarrollo de la mujer en estado de gestación, tanto de ella como del niño, en tal sentido de forma integral deben ser llevadas a cabo sus cuidados y consultas.

ABSTRACT Objective: To describe the management of care in obstetrics and gynecology: A comprehensive view. Methodology: The research was developed from the quantitative paradigm, also framed from a documentary-bibliographic design, through inquiry, collection and critical documentary analysis and bibliographic reference, based on the methodical, rigorous and deep exploration of various documentary sources such as scientific research, articles and refereed papers, theses, describing the findings found, allowing the development of the theoretical body in relation to the subject of study. Results: It is possible to observe the multiple factors that are considered by the women who come to the health care centers, for this reason they should be oriented in an integral way. In conclusion: The integration of care in obstetrics and gynecology is an action that will contribute to a better performance and development of the pregnant woman, both for her and the child, and her care and consultations should be carried out in an integral manner.

Exame físico em ginecologia / Physical examination in gynecology

O exame físico na prática ginecológica diuturna é o sustentáculo de uma perspectiva diagnóstica com vistas a uma abordagem individualizada, oportuna e humanizada da paciente. Lança mão de técnica semiótica clássica, inicialmente, após avaliação de sinais vitais, minuciosa inspeção ectoscópica, seguida de exame físico especial. E deverá ser realizado em ambiente adequadíssimo, sem nenhuma improvisação e ou adaptações não compatíveis, com a importância e a segurança garantidas por um exame físico de boa qualidade. O exame físico de mamas tem como objetivo primordial a identificação de nódulos mamários e, eventualmente, de tumores localmente avançados; e relativa tranquilidade é assegurada às pacientes quando ele é considerado normal. O exame físico vulvar permite a identificação de prolapso de órgãos pélvicos, neoplasia intraepitelial e/ou invasiva vulvar e distúrbios de desenvolvimento sexual, além de oferecer subsídios para a propedêutica da vulvodínea, sendo, principalmente, uma oportunidade para o diagnóstico em dermatologia vulvar, mesmo a vulva correspondendo a apenas 1% da pele feminina. O exame especular, um clássico da ginecologia, é indispensável para a triagem do câncer de colo uterino. Por fim, o toque genital, a despeito de sua subjetividade, permite a avaliação dos órgãos genitais internos.

Physical examination in daytime gynecological practice is the mainstay of a diagnostic perspective with a view to an individualized, timely and humanized approach to the patient; resorting to the classical semiotic technique, initially, after assessing vital signs, a thorough ectoscopic inspection, followed by a special physical examination; which should be carried out in a very suitable environment, without any improvisation or adaptations that are not compatible with the importance and safety guaranteed by a good quality physical examination. The primary objective of the physical examination of the breasts is to identify breast nodules and possibly locally advanced tumors; in addition to relative tranquility, assured to patients, when the respective exam is considered normal. Vulvar physical examination allows the identification of pelvic organ prolapse; vulvar intraepithelial and/or invasive neoplasia; sexual development disorders; in addition to offering subsidies for the propaedeutics of vulvodynia; and, above all, it is an opportunity for diagnosis in vulvar dermatology, even though the vulva accounts for only 1% of female skin. Specular examination, a classic in gynecology, is essential for screening for cervical cancer. Finally, the genital touch which, despite its subjectivity, allows the evaluation of the internal genital organs.

Clinical Simulation in the Training of Obstetrics and Gynecology Resident from the Perspective of Medical Residency Programs / A Simulação Clínica na Formação do Residente em Obstetrícia e Ginecologia na Perspectiva do Programa de Residência Médica

Abstract Objective This study analyzes the role of clinical simulation in internal medical residency programs (IMRP) in Obstetrics and Gynecology (OB/GYN), attributed by the supervisors, in the training of residents in the city of São Paulo (SP). Methods Cross-sectional descriptive, qualitative, and exploratory approach. Semi-structured interviews were performed with ten supervisors of Medical Residency programs in Obstetrics and Gynecology. Interviews were analyzed by means of content analysis under the thematic modality, starting with the core the role of clinical simulation in Obstetrics and Gynecology Medical Residency Programs. Results Supervisors view Clinical simulation as: a complementary tool for the teaching and learning process, a possibility of a safe teaching and learning environment, an opportunity to learn from mistakes, a support for professional practice committed to patient safety, a learning scenario for teamwork, a scenario for reflection on the work process in Obstetrics and Gynecology, a scenario for evaluative processes in the medical residency. Still according to supervisors, Clinical Simulation favors decision-making and encourages the resident participation in activities. Conclusion Supervisors recognize Clinical Simulation as a powerful pedagogical tool in the learning process of resident doctors in Obstetrics and Gynecology Residency Programs.

Resumo Objetivo O presente estudo analisa o papel da Simulação Clínica em programas de Residência Médica (PRM) de Obstetrícia e Ginecologia, atribuído pelos supervisores, na formação do residente no município de São Paulo (SP). Métodos Abordagem qualitativa, transversal, de natureza exploratória e descritiva. Foram realizadas entrevistas semiestruturadas com dez supervisores de programas de Residência Médica de Obstetrícia e Ginecologia. Para análise das entrevistas foi realizada análise de conteúdo na modalidade temática partindo do seguinte núcleo: o papel da simulação clínica nos Programas de Residência Médica de Obstetrícia e Ginecologia. Resultados A Simulação Clínica, na visão dos supervisores, emerge como: ferramenta complementar para o processo de ensino e aprendizagem; possibilidade de um ambiente de ensino e aprendizagem seguro; possibilidade de aprendizagem a partir do erro; suporte para prática profissional comprometida com a segurança do paciente; cenário de aprendizagem para o trabalho de equipe; cenário de reflexão sobre o processo de trabalho em Obstetrícia e Ginecologia; favorecimento na tomada de decisão; cenários de processos avaliativos na residência; e, por fim, estímulo à participação dos residentes nas atividades. Conclusão Os supervisores reconhecem a Simulação Clínica como uma ferramenta pedagógica potente no aprendizado dos médicos residentes em Obstetrícia e Ginecologia.

Prevenção do câncer de colo uterino em homens transgênero: desafios e novas perspectivas de rastreio / Prevention of cervical cancer in transgender men: challenges and new screening perspectives

O homem transgênero apresenta alta susceptibilidade às neoplasias de colo uterino devido à escassez de exames preventivos. O estudo objetiva levantar informações acerca dos desafios e estratégias para a promoção do rastreio e prevenção do câncer cervical em homens transgênero. Trata-se de uma revisão integrativa, desenvolvida em seis etapas a partir da pergunta norteadora: "Quais os desafios e estratégias atuais para a promoção do rastreio efetivo e prevenção de câncer de colo uterino em homens transgênero?". Utilizaram-se descritores combinados com operador booleano "cervical cancer" AND "transgender persons", e foram incluídos artigos completos de 2018 a 2022. Verificou-se que os desafios enfrentados incluem preconceito, despreparo profissional e susceptibilidade à disforia de gênero. Estudos mostraram benefícios relacionados ao uso de swabs vaginais autocolhidos para reduzir o impacto psicológico do exame Papanicolaou, com vistas a reduzir os desafios enfrentados por essa população, e a necessidade de implementar estratégias que aumentem a adesão aos serviços de saúde.

Transgender men are highly susceptible to cervical cancer due to the lack of preventive screening exams. This study aims to gather information about the challenges and strategies for promoting cervical cancer screening and prevention in transgender men. This is an integrative review, developed in six stages, based on the guiding question: "What are the current challenges and strategies for promoting effective screening and prevention of cervical cancer in transgender men?". Descriptors combined with Boolean operator "cervical cancer" AND "transgender persons" were used and full articles from 2018 to 2022 were included. It was found that the challenges faced include prejudice, professional unpreparedness and susceptibility to gender dysphoria. Studies have shown benefits related to the use of self-collected vaginal swabs to reduce the psychological impact of the Pap smear exam, aiming to reduce the challenges faced by this population and to implement strategies to increase adherence to health services.

Gestión del cuidado en obstetricia y ginecología: Una mirada integral / Care management in obstetrics and gynecology: A comprehensive look

Describir la gestión del cuidado en obstetricia y ginecología: Una mirada integral. Metodología: La investigación se desarrolló desde el paradigma cuantitativo, además se enmarcó desde un diseño documental-bibliográfico, mediante la indagación, recolección y análisis crítico documental y referencial bibliográfico, basándose en la exploración metódica, rigurosa y profunda de diversas fuentes documentales tales como investigaciones científicas, artículos y trabajos arbitrados, tesis.Describiendo los hallazgos encontrados, permitiendo desarrollar el cuerpo teórico en relación al tema de estudio. Resultados: Se puede observar los múltiples factores que son consideradas por las mujeres que acuden a los centros asistenciales, por ello deben ser orientadas de forma integral. En conclusión: La integración de los cuidados en obstetricia y ginecología, es una acción que contribuirá a un mejor desempeño y desarrollo de la mujer en estado de gestación, tanto de ella como del niño, de forma integral debe ser llevadas a cabo sus cuidados, consultas.

To describe the management of care in obstetrics and gynecology: A comprehensive view. Methodology: The research was developed from the quantitative paradigm, also framed from a documentary-bibliographic design, through inquiry, collection and critical documentary analysis and bibliographic reference, based on the methodical, rigorous and deep exploration of various documentary sources such as scientific research, articles and refereed papers, theses, describing the findings found, allowing the development of the theoretical body in relation to the subject of study. Results: It is possible to observe the multiple factors that are considered by the women who come to the health care centers, for this reason they should be oriented in an integral way. In conclusion: The integration of care in obstetrics and gynecology is an action that will contribute to a better performance and development of the pregnant woman, both for her and the child, and her care and consultations should be carried out in an integral manner

Exploration of centralized closed-loop management mode for gynecological day surgery / 中华医院管理杂志

Day surgery can effectively improve the utilization of medical resources. In October 2015, an obstetrics and gynecology hospital established a gynecological day surgery center to centrally manage gynecological day surgery and continuously optimize the management process. In July 2019, the hospital established an intelligent information platform for gynecological daytime surgery managemen. Based on this platform, the " evaluation-appointment-hospitalization-follow-up-chronic disease management" information management process was implemented, the " pre hospital-in hospital-post hospital" full process medical quality and safety monitoring was carried out to form a centralized closed-loop management mode for gynecological day surgery led by gynecologists. Under this management mode, the number of gynecological day surgeries in the hospital has increased from 2 866 cases in 2019 to 4 065 cases in 2021, providing convenient medical services and personalized chronic disease management services, and ensuring the quality and safety of gynecological day medical care, for reference for promoting the high-quality development of day surgeries in specialized hospitals.

Metrological analysis of SCI papers in Shanghai tertiary obstetrics and gynecology specialized hospitals from 2017 to 2021 / 中华医学科研管理杂志

Objective:Bibliometric analysis of SCI papers in Shanghai tertiary obstetrics and gynecology specialized hospitals from 2017 to 2021 was conducted to provide reference for further improving management measures and optimizing the quality of SCI papers in specialized hospitals.Methods:The Web of Science database was used to retrieve SCI papers published by tertiary obstetrics and gynecology specialized hospitals in Shanghai from 2017 to 2021. Based on bibliometric methods VOSviwer 1.6.17 and Scimago Graphica 1.0.23 was adopted to analyze the number, journals, domestic and international cooperation, and hot research areas.Results:2 721 papers were published by Shanghai Tertiary A obstetrics and Gynecology hospitals from 2017 to 2021. These papers published in 765 journals. The number of papers published and publication journals increased year by year. The number of papers and journals with an impact factor of 3~5 is the largest, accounting for 37.96% and 35.95% of the total number of papers and journals respectively. However, papers and journals with more than 10 points accounted for only 7.98% and 10.20% respectively. Scientific Reports, a comprehensive journal, published the largest number of papers. International cooperation is concentrated in the United States. Domestic cooperation is concentrated in universities and research institutions in Jiangsu, Zhejiang and Shanghai. The hot research areas focused on Oncology, Obstetrics & Gynecology, Genetics, Reproductive Biology and other basic medical fields.Conclusions:The number of papers published by Shanghai's tertiary obstetrics and gynecology specialized hospitals has increased year by year, but there are fewer highly influential journals. Domestic and international scientific research cooperation is limited to several institutions. The achievements in the field of basic research are far more than those in clinical research.

Application of cluster analysis to evaluate the scientific research performance evaluation index system of departments in an obstetrics and gynecology hospital / 中华医学科研管理杂志

Objective:The cluster analysis method was applied to evaluate the scientific research performance evaluation index system of departments in an obstetrics and gynecology hospital, and analyze the weaknesses of scientific research work of various departments, to provide a basis for the improvement of scientific research strength of departments.Methods:On the basis of the scientific research performance evaluation index system of departments in the obstetrics and gynecology hospital, the indicators and weights of the system were optimized through expert consultation, and the scientific research values from 2019 to 2021 were brought into the optimized scientific research performance evaluation index system to calculate the scientific research scores of each department, and then the cluster analysis method was applied to evaluate the index system.Results:Before and after the optimization of the scientific research performance evaluation index system of departments, the conformity with the discipline classification was 76.00% and 96.67% respectively ( P=0.039). In total of 30 departments were clustered into 4 categories: excellent (7), good (7), medium (4), and concerned (12). The average score of the total scientific research performance evaluation indicators of the 4 categories of departments was 15.022. The highest average score was for papers and monographs, and the lowest was for awards. Conclusions:This study applied the cluster analysis method to evaluate the scientific research performance evaluation index system of departments in the obstetrics and gynecology hospital and replaced quantitative indicators with quality indicators. It will optimize and improve the hospital hierarchical management methods, provide data support and classified guidance for the scientific research development of different categories of departments, and provide a reference basis for hospitals to formulate scientific research management policies such as achievement transformation, award, industry standard guidelines, etc.

Research progress in dialectical treatment of premature ovarian failure by Zhejiang TCM gynecology schools / 中国基层医药

In traditional Chinese medicine, premature ovarian failure is attributed to the menstrual diseases such as amenorrhea, infertility, premenopausal and postmenopausal syndromes. The Zhejiang TCM gynecology schools are good at dialectical treatment of the above menstrual diseases similar to premature ovarian failure, especially Gynecology of Xiaoshan Zhulin Temple, Gynecology of Haining Chen Mushan, Gynecology of Ningbo Song's Family and Gynecology of Hangzhou He's Family. This paper summarizes the characteristics and experience of the four Zhejiang TCM gynecology schools in the dialectical treatment of premature ovarian failure, which can be used for reference.