Factores sociodemográficos de las gestantes de un policlínico de Guantánamo, que interrumpieron voluntariamente el embarazo

Introducción: la interrupción voluntaria del embarazo -aborto inducido o provocado-, a pesar de ser una temática antigua, continúa siendo un problema social que afecta no solo a la mujer, sino también a la familia y la comunidad, en aspectos políticos, socioeconómicos, culturales y religiosos. Objetivo: caracterizar las interrupciones voluntarias del embarazo, según variables sociodemográficas en el Policlínico Universitario Hermanos Martínez Tamayo. Materiales y métodos: se realizó un estudio observacional, descriptivo, transversal en el Policlínico Universitario Hermanos Martínez Tamayo, del municipio Baracoa, provincia de Guantánamo, durante el año 2021. La muestra obtenida de 111 pacientes fue seleccionada por muestreo no probabilístico intencionado. El dato primario se obtuvo de la historia clínica individual y de encuestas realizadas a las pacientes. Resultados: se observó un predominio del grupo de edad de 20 a 24 años, con 36 pacientes (32,4 %). Las mujeres de zona urbana fueron la mayoría, con 79 (71,2 %). Respecto al estado civil, predominaron las solteras (56,7 %) y las divorciadas (19,8 %). El 36,9 % estaban en la universidad o contaban con nivel universitario y el 45,9 % eran de ocupación estudiante. Conclusiones: el tratamiento de algunos determinantes sociodemográficos en las características de las interrupciones voluntarias del embarazo, permite entender su variabilidad y su constitución como problema de salud en el Policlínico Universitario Hermanos Martínez Tamayo.

Introduction: the voluntary interruption of pregnancy -induced or provoked abortion- despite being an old issue, continues to be a social problem that affects not only women, but also family and community in political, socio-economic, cultural and religious aspects. Objective: to characterize the voluntary interruptions of pregnancy, according to socio-demographic variables in the University Polyclinic Hermanos Martinez Tamayo. Materials and methods: an observational, descriptive, cross-sectional study was carried out in the University Polyclinic Hermanos Martinez Tamayo, from the municipality of Baracoa, province of Guantanamo, during 2021. The sample obtained from 111 patients was selected by intentioned, non-probabilistic sampling. The primary data were obtained from the individual clinical records and from surveys carried out on the patients. Results: the age group between 20 and 24 years predominated with 36 patients (32.4%). Urban women were the majority 79 (71.2%). Regarding marital status single (56.7%) and divorced (19.8%) women predominated. 36.9% studied in the university or finished university studies, and 45.9% were students. Conclusions: the treatment of some socio-demographic determinants in the characteristics of pregnancy voluntary interruptions, allows us to understand its variability and its constitution as a health problem in the University Polyclinic Hermanos Martinez Tamayo.

A inter-relação do acidente de consumo e assistência à saúde: revisão integrativa / The interrelation of consumer accidents and health assistance: integrative review / La interrelación de los accidentes del consumidor y la asistencia a la salud: revisión integradora

Objetivo: Analisar a produção científica acerca da inter-relação entre consumidor, produto e assistência à saúde. Método: Trata-se de uma Revisão Integrativa da Literatura realizada nas bibliotecas e bases de dados: BVS, PubMed, Scielo e Portal de Periódicos CAPES. Foram arrolados dez estudos após a aplicação dos descritores não controlados: "consumidor/ consumer", "acidente / acident" combinados pelo operador booleano "AND" e dos respectivos critérios de inclusão e exclusão. Resultados: A análise dos estudos selecionados possibilitou que três categorias emergissem: Principais fatores que levam a ocorrência de acidentes de consumo; Métodos de prevenção dos acidentes de consumo; e, O papel da equipe de saúde na prevenção dos acidentes de consumo. Conclusão: Nesse viés, compreende-se a importância da articulação para estratégias de prevenção de acidentes de consumo, sobretudo, no que se refere ao promissor papel da equipe de saúde neste âmbito, no que tange à educação para prevenção e avaliações para aperfeiçoamento dos produtos.

Objective: to analyze the scientific production on the interrelationship between consumer, product and health. Method: this is an Integrative Literature Review carried out in the libraries and databases: VHL, PubMed, Scielo and Portal do Jornal CAPES. Two studies were found after application of two uncontrolled descriptors: "consumidor/ consumer", "acidente/acident" combined with the recommended Boolean operator "AND" and two respective inclusion and exclusion criteria. Results: When analyzing two selected studies, it is possible that three categories may arise: Main factors that lead to the occurrence of consumption accidents, Methods for the prevention of two consumption accidents, Or the role of the health team in the prevention of two consumption accidents. Conclusion: In this regard, it is understood the importance of articulation for consumer accident prevention strategies, especially not referring to the promising role of the health team in this area, not involving prevention education and evaluations for the improvement of two products

Objetivo: Analizar la producción científica sobre la interrelación entre consumidor, producto y cuidado a la salud. Método: Se trata de una Revisión Integrativa de Literatura realizada en las bibliotecas y bases de datos: BVS, PubMed, Scielo y Portal de Periódicos CAPES. Fueron registrados diez estudios tras la aplicación de los descriptores no controlados: "consumidor/ consumer", "acidente / acident", combinados por el operador booleano recomendado "AND" y los respectivos criterios de inclusión y exclusión. Resultados: El análisis de los estudios seleccionados permitió emerger tres categorías: Principales factores que conducen a la ocurrencia de accidentes de consumo, Métodos de prevención de accidentes de consumo, El papel del equipo de salud en la prevención de accidentes de consumo. Conclusión: En este contexto, se comprende la importancia de la articulación para las estrategias de prevención de accidentes del consumo, especialmente en lo que respecta al rol prometedor del equipo de salud en esta área, en lo que corresponda a la educación para la prevención y las evaluaciones para mejorar los productos.

Risk factors associated with provoked pulmonary embolism

BACKGROUND/AIMS: This study aimed to investigate the risk factors associated with provoked pulmonary embolism (PE). METHODS: This retrospective cohort study included 237 patients with PE. Patients that had transient risk factors at diagnosis were classified as having provoked PE, with the remaining patients being classified as having unprovoked PE. The baseline clinical characteristics and factors associated with coagulation were compared. We evaluated the risk factors associated with provoked PE. RESULTS: Of the 237 PE patients, 73 (30.8%) had provoked PE. The rate of respiratory failure and infection, as well as the disseminated intravascular coagulation score and ratio of right ventricular diameter to left ventricular diameter were significantly higher in patients with provoked PE than in those with unprovoked PE. The protein and activity levels associated with coagulation, including protein C antigen, protein S antigen, protein S activity, anti-thrombin III antigen, and factor VIII, were significantly lower in patients with provoked PE than in those with unprovoked PE. Multivariate analysis showed that infection (odds ratio [OR], 3.2; 95% confidence interval [CI], 1.4 to 7.4) and protein S activity (OR, 0.97; 95% CI, 0.95 to 0.99) were significantly associated with provoked PE. CONCLUSIONS: Protein S activity and presence of infection were important factors associated with provoked PE. We should pay attention to the presence of infection in patients with provoked PE.

Algunos peligros químicos y nutricionales del consumo de los alimentos de venta en espacios públicos / Some chemical and nutritional dangers of consuming food sales in public spaces

Los alimentos manufacturados y comercializados pueden contener peligros químicos por sustancias adicionadas intencionalmente como los aditivos que utiliza la industria, otros añadidos por el consumidor y contaminantes naturales como metales que se pueden obtener del aire en el espacio público; también se consideran peligrosos los cambios químicos que tienen algunos nutrientes como las grasas y los aceites (lípidos) y el uso excesivo de estas en la dieta. Algunos métodos de cocción empleados y el material de elaboración de los utensilios pueden llevar, a largo plazo, a desarrollar enfermedades crónicas y toxicidad. Este documento aborda aquellos alimentos y productos que se expenden en los espacios públicos, restaurantes, cafeterías y centros gastronómicos. Esta revisión no tiene intención de sancionar el expendio en espacios públicos, pero sí alertar sobre algunos métodos de cocción, el uso de aditivos alimentarios comúnmente utilizados y las prácticas alimentarias poco responsables, para concientizar al consumidor sobre los peligros.

Manufactured and marketed foods may contain chemical hazards intentionally spiked substances such as additives used by industry, others added by the consumer and natural contaminants such as metals that can get air in public spaces; chemical changes taking some nutrients such as fats and oils (lipids) and overuse of these in the diet are also considered hazardous. Some cooking methods employed and material processing utensils can lead to long term, developing chronic diseases and toxicity. This paper addresses those foods and products that are sold in public places, restaurants, cafes and gastronomic centers. This review does not intend to punish the dispensing in public spaces, but warn about some cooking methods, the use of food additives commonly used and little food practices responsible for consumer awareness about the dangers.

Behavioral changes in albino rats due to repetitive heat stress of moderate level.

Background: There are a number of studies showing the effect of severe heat stress on behaviour. Severe heat stress has been well reported to cause changes in activity level, attitude/mood, and behaviour. But, the effect of repetitive heat stress of moderate level on all these parameters has not been studied extensively. Aims & Objective: In the present study, the effect of repetitive heat stress of moderate level was assessed on activity level, attitude / mood, and behaviour (spontaneous and provoked) of adult albino male rats (wistar strain). Material and Methods: The experimental animals were subjected to repetitive heat stress for 4 hours daily, at 37±0.5ºC in a Biological Oxygen Demand (BOD) incubator (relative humidity 65-82%) for five consecutive days. Daily changes were assessed in activity level during and after heat exposure and in attitude / mood along with behaviour (both spontaneous and provoked) after heat exposure in experimental animals and compared with control animals. Results: There was increased restlessness during heat exposure and decreased level of activity after heat exposure in experimental animals. The mood of the experimental animals was depressed and the experimental animals kept them isolated and did not respond on provoking after heat stress. Conclusion: All the above observations confirmed that exposure to repetitive heat stress, even of moderate level, causes significant change in behaviour of male albino rats.

A interrupção da gravidez na adolescência: aspectos epidemiológicos numa maternidade pública no nordeste do Brasil / The interruption of pregnancy amongst adolescents: epidemiologic aspects in a public (stately run) maternity in northeast Brazil

O abortamento provocado é praticado amplamente pelas mulheres, em contexto clandestino, no Brasil, sendo considerado uma questão de saúde pública. Neste estudo, propõe-se a conhecer aspectos socio-demográficos, comportamentais, clínicos, complicações, e o tipo de abortamento praticado por adolescentes submetidas à curetagem uterina. Foi utilizada metodologia descritiva, através de entrevistas por meio de questionário estruturado no atendimento a 201 adolescentes com abortamento incompleto submetidas à curetagem uterina, em um hospital do Sistema Único de Saúde (SUS), em Maceió, Alagoas. Os principais determinantes para o abortamento foram: idade acima de dezesseis anos, com parceiro estável; pardas; não planejaram a gestação; desejavam a gestação, primigestas; idade gestacional menor que 15 semanas; raras complicações relacionadas ao abortamento, e utilizando a classificação da Organização Mundial da Saúde, observou-se abortamento provocado em 98,01 por cento dos casos. Entre os casos de abortamentos certamente provocados, 89,19 por cento reportaram o uso do misoprostol, o que reforça maior investimento público na assistência ao uso de métodos contraceptivos entre os adolescentes respeitando seus direitos sexuais e reprodutivos.

Comparison of Clinical and Imaging Characteristics and Outcomes between Provoked and Unprovoked Acute Pulmonary Embolism in Koreans

This study was performed to compare clinical and imaging parameters and prognosis of unprovoked pulmonary embolism (PE), provoked PE with reversible risk factors (provoked-rRF), and provoked PE with irreversible risk factors (provoked-iRF) in Koreans. Three hundred consecutive patients (mean age, 63.6 +/- 15.0 yr; 42.8% male) diagnosed with acute PE were included. The patients were classified into 3 groups; unprovoked PE, provoked-rRF, and provoked-iRF; 43.7%, 14.7%, and 41.7%, respectively. We followed up the patients for 25.4 +/- 33.7 months. Composite endpoint was all-cause mortality and recurrent PE. The provoked-iRF group had significantly higher all-cause mortality, mortality from PE and recurrent PE than the unprovoked and provoked-rRF groups (P 1.2 mg/dL; P 5 mg/L; P = 0.002; HR, 5.308; 95% CI, 1.824-15.447) and computed tomography (CT) obstruction index (P = 0.034; HR, 1.090; 95% CI, 1.006-1.181). In conclusion, provoked-iRF has a poorer prognosis than unprovoked PE and provoked-rRF. Renal insufficiency, high CRP, and CT obstruction index are poor prognostic factors in unprovoked PE.

Comparison of Clinical and Imaging Characteristics and Outcomes between Provoked and Unprovoked Acute Pulmonary Embolism in Koreans

This study was performed to compare clinical and imaging parameters and prognosis of unprovoked pulmonary embolism (PE), provoked PE with reversible risk factors (provoked-rRF), and provoked PE with irreversible risk factors (provoked-iRF) in Koreans. Three hundred consecutive patients (mean age, 63.6 +/- 15.0 yr; 42.8% male) diagnosed with acute PE were included. The patients were classified into 3 groups; unprovoked PE, provoked-rRF, and provoked-iRF; 43.7%, 14.7%, and 41.7%, respectively. We followed up the patients for 25.4 +/- 33.7 months. Composite endpoint was all-cause mortality and recurrent PE. The provoked-iRF group had significantly higher all-cause mortality, mortality from PE and recurrent PE than the unprovoked and provoked-rRF groups (P 1.2 mg/dL; P 5 mg/L; P = 0.002; HR, 5.308; 95% CI, 1.824-15.447) and computed tomography (CT) obstruction index (P = 0.034; HR, 1.090; 95% CI, 1.006-1.181). In conclusion, provoked-iRF has a poorer prognosis than unprovoked PE and provoked-rRF. Renal insufficiency, high CRP, and CT obstruction index are poor prognostic factors in unprovoked PE.

Abortamento provocado e o uso de contraceptivos em adolescentes / Provoked abortion and the use of contraceptives by adolescents

JUSTIFICATIVA E OBJETIVOS: A adolescência favorece as vivências da sexualidade. Com o uso incorreto dos métodos anticoncepcionais, resultando em gravidez não planejada e desfecho no abortamento provocado. Esse estudo objetivou descrever aspectos do comportamento sexual e reprodutivo e analisar o tipo de abortamento.MÉTODO: Aplicou-se um método descritivo por meio de questionário estruturado no atendimento a 201 adolescentes com abortamento incompleto submetidas à curetagem uterina, em hospital do Sistema Único de Saúde (SUS), em Maceió, AL, entre março de 2008 a abril de 2009.RESULTADOS: O desfecho da gravidez, quanto ao tipo de abortamento 1,99% abortamento espontâneo e 98,01% abortamento provocado, dados obtido através da classificação da Organização Mundial da Saúde (OMS). Destes, 81,59% são certamente provocados, 9,95%, provavelmente provocado; 6,47% são possivelmente provocados. Entre as adolescentes que assumiram a indução do aborto, 127 (77,44%) referiram o uso do misoprostol. O perfil com risco para provocarem o aborto, idade acima de 16 anos; com parceiro estável; mulatas; não usavam preservativos nas relações sexuais; média de idade de início de atividade sexual de 15 anos, não planejaram a gestação; desejavam a gravidez; primigestas; idade gestacional menor que 15 semanas.CONCLUSÃO: Recomenda-se maior investimento público na assistência ao uso de métodos contraceptivos entre os adolescentes respeitando seus direitos sexuais e reprodutivos, contribuindo assim, para a diminuição da incidência do abortamento, haja vista que as adolescentes estão engravidando e buscando o aborto como solução para gravidez não planejada.(AU)

BACKGROUND AND OBJECTIVES: Adolescence favours the coexistence of sexuality. The incorrect use of contraceptive methods results in unplanned pregnancy which leads towards provoked abortion. The very objective of this study is to describe sexual and reproductive behaviour aspects as well as to analyse the type of abortion in question.METHOD:A descriptive method carried out through interviews by means of a questionnaire was applied and it was duly structured for the data gathering from 201 adolescents facing incomplete abortion subjected to uterine curettage in hospitals which are part of the Stately Run Health Programme, in Maceió, Alagoas, Brazil, between the months of March 2008 and April 2009.RESULTS: The pregnancy data regarding the type of abortion reached the following numbers: 1.99% of spontaneous abortion and 98.01% of provoked abortion and the data was obtained through classified information from the World Health Organization. From the above cited data, 81.59% were certainly provoked; 9.95% were probably provoked; 6.47% were possibly provoked. Amongst the adolescents whom actually admitted the induction to abortion, 127 (77.44%) referred to and reported the use of misoprostol. The profiled adolescents running the risk of provoking abortion is aged above 15 years old; with a stable partner; they are mullatos; they did not use contraceptive methods during the sexual relationships; the average age for the beginning of their sexual activities was 15 years old; they did not plan gestation, but wished for pregnancy; they were first time pregnant females; with a gestational age below 15 weeks.CONCLUSION: It is hereby recommended a higher and major public investment in assistance programmes concerning the use of contraceptive methods amongst adolescents duly respecting their sexual and reproductive rights thus contributing towards the reduction of abortion incidence, considering the fact that the said adolescents are becoming pregnant and looking for abortion as a solution for their unplanned pregnancy.(AU)

Avaliação audiológica e de emissão otoacústica em indivíduos expostos a ruído e praguicidas / Audiologic and otoacoustic emission evaluation in individuals exposed to noise and plaguecides

Introdução: A perda auditiva induzida por ruído (PAIR) é estudada há muitos anos, e atualmente a literatura especializada estuda também a ação sinérgica dos produtos químicos. Objetivo: Pesquisar os achados audiológicos e EOAPD em trabalhadores expostos ao ruído ocupacional e a praguicidas, e comparar com os dados obtidos em indivíduos sem exposição a estes elementos insalubres. Método: Foram avaliados 51 indivíduos (102 orelhas), divididos em três grupos. O grupo I foi composto de 17 trabalhadores com exposição a ruído e praguicida, todos portadores de perda auditiva neurossensorial; grupo II por 17 trabalhadores com exposição a ruído e praguicidas com limiares audiométricos dentro dos padrões da normalidade (até 25 dBNA) e o grupo III por 17 indivíduos saudáveis sem alterações auditivas e sem exposição a ruído e praguicidas, grupo controle. Resultados: Na anamnese audiológica, considerando os grupos I e II observou-se que as principais queixas auditivas apresentadas pelos trabalhadores foram as de recrutamento (29,5%), zumbido (26,5%), alergia (23,5%) e hipertensão arterial (12%). Os achados da audiometria indicaram que os sujeitos da pesquisa não apresentaram perdas auditivas nas frequências de 500 Hz, 1 e 2 kHz, as perdas ocorreram nas frequências entre 3 e 8 kHz. Em relação as emissões otoacústicas produto de distorção (EOAPD), foi observado que os indivíduos do grupo III apresentaram maior incidência de respostas, quando comparados com os sujeitos dos grupos I e II. Conclusão: A análise dos resultados nos permitiu concluir que o teste de EOAPD representa uma importante ferramenta para o acompanhamento e prevenção da PAIR.

Introduction: The noise induced hearing loss (NIHL) has been studied for many years and today the specialized literature also studies the synergic action of chemicals. Objective: To research the audiologic findings and DPOAE in workers exposed to occupational noise and plaguecides and to compare them with data obtained in individuals without exposure to these harmful elements. Method: 51 individuals were evaluated (102 ears), divided into three groups. Group I was composed by 17 workers with exposure to noise and plaguecides, all with neurosensorial auditory loss; group II was composed by 17 workers with exposure to noise and plaguecides with audiometric thresholds within normality standards (up to 25 dBNA) and group III by 17 healthy individuals without auditory alterations and without exposure to noise and plaguecides, control group. Results: In the audiologic anamnesis, as for groups I and II, we observed that the main auditory complaints presented by the workers were those of recruitment (29.5%), tinnitus (26.5%), allergy (23.5%) and arterial hypertension (12%). The findings of the audiometry appointed that the research's individuals did not present with auditory losses in the frequencies of 500 Hz, 1 and 2 kHz, the losses occurred in the frequencies of 3 and 8 kHz. As for the distortion-product otoacoustic emissions (DPOAEs), we observed that the individuals in group III had a major incidence of responses when compared to those of groups I and II. Conclusion: The results analysis allowed us to conclude that the DPOAE test represents an important tool for follow up and prevention of NIHL.

The efficacy of rapid biophysical profile for assessment of fetal well-being / 대한산부인과학회잡지

OBJECT: The nonstress test(NST) and complete biophysical profile(BPP) were compared with the rapid biophysical profile(BPP) in order to evaluate the efficacy of the rapid BPP, namely, the combination of amniotic fluid index(AFI) and sound-provoked fetal movement(SPFM) detected by ultrasound, in predicting intrapartum fetal distress in high-risk pregnancies. STUDY DESIGN: From JAN 9th 2000, through JAN 5th 2001, the prospective study of diagnostic tests was conducted on a total of 91 high-risk singleton pregnancies, undergoing antepartum assessment both the standard NST and the new rapid BPP(including other indices of complete BPP). The diagnostic indices of the NST, rapid BPP and complete BPP were calculated in term of predicting intrapartum fetal distress. RESULT: The sensitivity, specificity, negative predictive value, and positive predictive value of NST were 50.00, 94.81, 96.05, and 42.86% respectively, and those of rapid BPP were 75.00, 98.53, 98.53, and 75.00%, and those of complete BPP were 83.33, 98.72, 98.72, and 83.33%, as well. In addition, the efficiency of NST, rapid BPP, and complete BPP were 91.57%, 97.22% and 97.62% respectively. CONCLUSIONS: The rapid BPP is an effective and reliable predictor of intrapartum fetal distress with high-risk pregnancies. Moreover, it may be inexpensive and less time-consuming method.

Studies for Pathogenesis of Fixed Drng Emptions Through the Change of Cytochrome p450 Isozymes / 대한피부과학회지

The reasons of same site recurrence in fixed drug eruptions (FDEs) remain to be clarified. Although the nature of antigen in FDE is unknown, drug metabolites could play a role for antigen formation. Cytochrome p450 isozymes (CYPs) are important enzymes for drug metabolism. This study was done to examine the role of CYPs in FDEs. Provoked lesion was compared with non-provoked lesion by the same drug on the same patient to overcome inter-individual variations of CYPs. The reverse transcriptase-polymerase chain reaction (RT-PCR) with primers for CYPs and the immunohistochemistry (IHC) with anti-CYPs, pancytokeratin, and leukocyte common antigen (LCA) antibodies were conducted. The causative drugs were different in 13 patients who conducted RT-PCR, and the result could not be analyzed by the cause. The levels of CYP2C8/19 and CYP2E1 mRNAs increased significantly in provoked lesions. The keratinocytes in cases of mefenamic acid-induced FDEs stained strongly with anti-CYP2C9 antibody not with the other three antibodies (CYP1A1, CYP2E1, and CYP3A4). The FDE cases from doxycycline, which is not metabolized by CYP2C9 enzyme, and those from chlormezanone did not react to anti-CYP2C9 antibody. The cells stained with CYP antibodies did not react with anti-LCA antibody but with anti-pancytokeratin antibody. The number of cells which reacted to anti-LCA antibody clearly increased in the provoked lesions, regardless of the cause. The above results suggest that CYPs may contribute the drug antigen formation and different levels of CYPs between provoked and non-provoked lesions can play a role for the same site recurrence of lesions in FDEs.