La violencia obstétrica: un fenómeno vinculado a la violación de los derechos elementales de la mujer / Obstetric violence: a phenomenon linked to the violation of the basic rights of women

ResumenEl presente artículo resulta de un trabajo de revisión bibliográfica en el que analizamos la violencia obstétrica como forma de violencia contra la mujer y de violación a los derechos humanos, con gran frecuencia ignorada, llegando a ser en ocasiones desestimado un tema de gran actualidad e interés para la bioética. La violencia obstétrica como violencia simbólica contra la mujer manifiesta la asimetría existente entre hombres y mujeres siendo imprescindible el desarrollo normativo encargado de regular el conjunto de prácticas en los procesos reproductivos de las mujeres a la par que permita alertar sobre la importancia del respeto de los derechos sexuales y reproductivos, definiendo a la salud sexual y reproductiva como una parte inalienable, integral e indivisible de los derechos humanos universales. No obstante los logros conseguidos desde estas iniciativas, las desigualdades de género siguen afectando los servicios de salud reproductiva en gran parte del mundo.

AbstractThe present article comes of a bibliographic review labour in which we analyse obstetric violence as a way of violence against women and as violation of the human rights, which are frequently ignored, sometimesbecomingrejecteda subject of greatcurrent interestfor bioethics. Obstetric violence as symbolic violence against women reveals the asymmetry which is between men and women and the legal development in charge of legislating the set of practices in the women reproductive processes is essential in order to alert about the importance of the respect of sexualand reproductive rights as an inalienable, comprehensible and indivisible of the universal human rights. Despite the achievements from these initiatives, gender inequalities still affect reproductive health services in large part of the world.

Surgical versus interventional procedures in patients with multivessel coronary artery disease

OBJECTIVE: This study examined the clinical characteristics, risk factors, indications and post-intervention complications of patients with multivessel coronary artery disease (CAD) submitted to either percutaneous transluminal coronary angioplasty (PTCA) and/or stent placement versus isolated coronary artery bypass grafting (CABG). BACKGROUND: Several studies have examined the relative safety and outcome of patients submitted to those interventional procedures compared to CABG. Limited information is available regarding that subject in Puerto Rico. METHODS: We performed a retrospective analysis of the clinical, angiographic, operative, interventional, post-operative and post-interventional data of patients submitted to those procedures in our institution from January 1998 to August 1998. There were 53 patients in the interventional group and 206 patients in the CAGB group. Comparison of quantitative variables by procedure was based on Student t test or Mann-Whitney-Wilcoxon test; categorical variables were compared using Pearson's chi-square or Fisher's exact test. RESULTS: There were no significant differences in age, body surface area, or cardiac risk factors. The most common pre-existing cardiovascular diagnosis was unstable angina. Three-vessel disease was the most common angiographic finding among CABG patients (61.7 percent). Two-vessel disease without left anterior descending coronary artery obstruction was significantly more common in the PTCA/Stent patients (58.5 percent). The vast majority (97.6 percent) of patients in the PTCA/Stent group and 52.4 percent of the CABG group had two-vessel intervention. A significantly higher frequency of complications occurred in the CABG group. However, the incidence of major complications, in both groups was not statistically different. Atrial arrhythmias were significantly more frequent in the CABG group. CONCLUSION: A larger prospective study should be conducted in order to corroborate these preliminary findings and seek effective solution to any identifiable problem.