Comportamento do aborto induzido entre jovens em situação de pobreza de ambos os sexos – Favela México 70, São Paulo, Brasil, 2013 / Induced abortion behavior among young people in poverty of both sexes ‐ Favela Mexico 70, Sao Paulo, Brazil, 2013

Objetivo: Identificar o papel do aborto induzido no comportamento reprodutivo de jovens da favela México 70 comparado com resultados obtidos em inquérito anterior na favela Inajar de Souza, 2007. Método: O presente inquérito foi delineado de sorte a entrevistar todos os jovens de 15 a 24 anos residentes na Favela México 70, em São Vicente (SP). A maioria dos jovens (94%) aceitou responder ao questionário. Foram entrevistadas 455 mulheres e 339 homens. Dentre esses, haviam iniciado a vida sexual 327 e 253, respectivamente. A análise, em um primeiro momento, refere‐se ao total de entrevistados e, posteriormente, apenas àqueles com vida sexual ativa. Na determinação do comportamento diferencial, por sexo, recorreu‐se ao teste qui‐quadrado no caso de variáveis qualitativas e ao teste t de Student para as quantitativas. Fixou‐se um p<=0,05. Resultados: Tendo‐se como ponto de referência outro inquérito feito, nos mesmos moldes metodológicos, na favela Inajar de Souza em 2007, os achados mais relevantes, entre outros importantes, foram o da baixa prevalência de mulheres com aborto induzido e uma alta taxa de recorrência à contracepção de emergência. Conclusão: É imprescindível que se desenvolvam estudos que aprofundem o conhecimento dos efeitos advindos da automedicação de contraceptivos, incluindo o contraceptivo de emergência, mesmo que esses contribuam para a redução de abortos induzidos.

Objective: Identify the role of induced abortion on reproductive behavior of young slum Mexico 70 compared to results obtained in previous investigation in the slum Inajar de Souza, 2007. Method: This survey was designed to interview all young people 15‐24 years old, living in the slum Mexico 70, in the municipality of São Vicente in Sao Paulo. The vast majority of young people (94%) agreed to answer the questionnaire. Altogether they were interviewed 455 women and 339 men. Among them, they had started sex life 327 and 253, respectively. The analysis, at first, refers to the total number of interviewees and then only to those with an active sexual life. In determining the differential behavior by sex, appealed to the chi‐square test for qualitative variables and the Student t test for quantitative. Has set itself a p<=0.05. Results: Having as reference another survey in the same methodological manner in Inajar slum Souza in 2007, among other important, the most important findings, were the low prevalence of women with induced abortion and a high rate of recurrence of emergency contraception. Conclusion:It is essential to develop studies to deepen knowledge of the effects arising from the self‐medication of contraceptives, including emergency contraception, even if these contribute to the reduction of induced abortions.

Social determinants of health: from the concept to the practice in outcomes of unintended pregnancies which result in induced abortion / Determinantes sociais da saúde: do conceito à prática em desfechos de gestações não pretendidas que resultam em aborto provocado

The present research is a continuation of another one previously developed about unsafe abortion, associated socio-demographic characteristics and morbidity, and goes further in its analysis of the social determinants of health that influence this occurrence, generating inequities in health. This study compared data of three groups of 51 women (total of 153) submitted to induced abortion, as per situation and site of the procedure: one with “unsafe abortion” (Slum), one with “legal and safe” induced abortion (Public hospital) and a third group with “illegal and safe” induced abortion (Private clinics with appropriate standard of care). Univariate and multiple analyses of multiple multinomial logistic regression analyses were performed for the three categories with Private as reference. In the final model, the variables that proved to have a statistically significant association with induced abortion (CI=95%; p<0.05) were: income, level of schooling, ethnicity/color and place of birth for Slum and, for the Hospital location, the variable ethnicity lost significance. Morbidity, resulting from the outcome, showed a highly significant discrepancy between the first sample (Slum), with 94.12% of women who reported post-abortion complications, and the other two samples (Hospital and Private) in which no case of complication was identified or reported. A critical analysis was also made on the influence of the social determinants of health implied in abortion in all samples, and on the degree of inequity generated in each one (intra-group) and among them. We aimed to better understand social determinants of health concepts in practice. Proposals of action/intervention related to the “entry points” and findings were also suggested.

A presente pesquisa dá continuidade a outra previamente desenvolvida sobre aborto inseguro, características sociodemográficas associadas e morbidade e aprofunda a análise sobre determinantes sociais da saúde que influenciam essa ocorrência e geram iniquidades em saúde. Este estudo comparou três grupos de 51 mulheres, 153 ao todo, com aborto provocado: um grupo com aborto provocado “inseguro” aborto inseguro (Favela), outro com aborto provocado “legal e seguro” (Hospital Público) e um terceiro com aborto provocado “ilegal e seguro” feito em clínicas particulares (Particular). Na análise dos dados, foram efetuadas análises univariadas e múltipla de regressão logística multinomial para as três categorias de aborto provocado, relacionadas por local, tendo como referência o local Particular. No modelo final as variáveis que mostraram associação estatisticamente significativa (p<0,05; IC: 95%) com aborto provocado foram: renda, escolaridade, etnia/cor e origem para o local Favela. Para o local Hospital a variável etnia perdeu a significância. A morbidade resultante dos resultados mostrou uma discrepância altamente significativa entre a primeira amostra (Favela), com 94,12% das mulheres que declararam complicações pós-aborto e as outras duas amostras (Hospital e Particular), nas quais nenhum caso de complicações foi referido ou identificado. Foi efetuada, então, análise crítica sobre a influência dos determinantes sociais da saúde implicados na ocorrência do aborto provocado nas três amostras e o grau de iniquidades por eles gerado em cada uma delas e entre elas. Com isso, pretendemos entender como usar melhor os conceitos de determinantes sociais da saúde na prática. Foram sugeridas também propostas de ação/intervenção relacionadas aos “pontos de entrada” pertinentes aos achados.

Prevalence and sociodemographic characteristics of women with induced abortion in a population sample of São Paulo, Brazil.

OBJECTIVES: This study aims at estimating the prevalence of women with induced abortion among women of childbearing age (15-49 years) who had any previous pregnancy, in the city of Sao Paulo, Brazil, in the last quarter of 2008, and identifying the Sociodemographic Characteristics (SC) associated with it. METHODS: A cross-sectional survey was carried out. The dependent variable was dichotomized as: no abortion and induced abortion. The independent variables were: age, paid work/activity, familial monthly income, schooling, marital status, contraceptive use and number of live births. Statistical analysis was performed using log-binomial regression models with approximation of Poisson to estimate the Prevalance Ratios (PR). RESULTS: Of all women with any previous pregnancy (n = 683), 4.5% (n = 31) reported induced abortion. The final multivariate model showed that having now between 40 and 44 years (PR = 2.76, p = 0.0043), being single (PR = 2.79, p = 0.0159), having 5 or more live births (PR = 3.97, p = 0.0013), current oral contraception or IUD use (PR = 2.70, p = 0.454) and using a "non effective" (or of low efficacy) contraceptive method (PR = 4.18, p = 0.0009) were sociodemographic characteristics associated with induced abortion in this population. CONCLUSIONS: Induced abortion seems to be used to limit fertility, more precisely after having reached the desired number of children. The inadequate use or non-use of effective contraceptive methods, and / or the use of contraceptives " non effective", exposed also the women to the risk of unintended pregnancies and, therefore, induced abortions. In addition, when faced with a pregnancy, single women were more likely to have an abortion than married women.

The effect of the new traffic law on drinking and driving in São Paulo, Brazil.

OBJECTIVE: To present data on drinking and driving in the city of São Paulo, Brazil, and the effects of the new traffic law (Law 11,705) introduced in 2008. METHODS: A cross-sectional study was performed using a questionnaire and passive breath test data to study the prevalence of drinking and driving and the association of drinking and driving with background characteristics and drinking patterns on two separate occasions. The data were gathered from 2007 to 2009 through roadside surveys conducted on busy public roads. Four thousand two-hundred thirty-four (4234) drivers were approached, before and after prohibition, from the south, north, east, and west regions of the city of São Paulo, located in southeastern Brazil, including cars, motorcycles, and utility vehicles. A total of 3854 (91%) consented to participate in the survey and answered the questionnaire. Out of this group, 3229 (84%) agreed to take the passive breathalyzer test. RESULTS: Logistic regression analyses controlling for gender and age was used to predict a positive breath test (above 0.2g/l) and the impact of the new law. These analyses indicated that, after the passage of the new traffic law, there was a 45% decrease in driver behavior with positive breathalyzer results. Having a pattern of alcohol consumption of at least once a week and the habit of drinking and driving are risks for a positive breathalyzer. CONCLUSIONS: Despite the decline in the frequency of motorists driving under the influence of alcohol, traffic-related injuries and deaths, after the new law, other measures for a public policy related to alcohol should be considered based on scientific evidence, consistency of action, clear goals, community support, and greater reliability in the laws.

Drinking and driving in southeastern Brazil: results from a roadside survey study.

OBJECTIVE: The objective of this study is to present data from a roadside survey study on drinking and driving and alcohol consumption in southeastern Brazil. METHODS: A cross-sectional roadside survey study using a questionnaire and breathalyzer data is the method used to determine the prevalence of drinking and driving and to examine whether socio-demographic characteristics and drivers' behavior, attitude and alcohol consumption predicted positive blood alcohol content (BAC). The data were gathered from 2005 to 2007 through roadside surveys conducted on high volume public roads in four cities in southeastern Brazil. A total of 4182 randomly selected drivers took part in the research. Of these drivers, 3488 (83.4%) completed the questionnaire and agreed to take a breath test. RESULTS: Overall, 24.6% of drivers had a detectable blood alcohol concentration (BAC) and 15.9% had a BAC above the legal limit (0.6g/l) at the time of the study. Logistic regression controlling for locale (city), sex, age and marital status was used to predict whether each driver would present a positive breath test. Socio-demographic characteristics, driving behaviors and attitudes, and alcohol consumption patterns were included as predictors. These analyses indicated that those who believed drinking and driving was a serious offense were about two-thirds as likely to have a positive breath test, and that drivers reporting a pattern of regular alcohol use were three times as likely to have a positive breath test. CONCLUSIONS: These findings indicate that drinking and driving is relatively common in Brazil, and that it occurs considerably more frequently than similar surveys suggest, is the case in other countries.

[Induced abortion: a comparison between married and single women residing in the city of São Paulo in 2008]. / Aborto induzido: uma comparação entre mulheres casadas e solteiras residentes na cidade de São Paulo em 2008.

The scope of this study was to evaluate the association between having had an induced abortion and marital status (being single or legally married) in women residing in the city of São Paulo. This analysis is derived from a broader population survey on abortion conducted in 2008. In this study we focus on the subset of 389 single and legally married women between 15 and 49 years of age. Logistic regression models were used to evaluate the association between induced abortion and being single or married, monitoring age, education, income, number of live births, contraceptive use and acceptance of the practice of abortion. Being single was the only characteristic associated with having had an induced abortion, in other words, when faced with a pregnancy single women were four times more likely to have an abortion than married women (OR=3.9; p=0.009).

Prevalence and characteristics of women with induced abortion--Favela México 70, São Vicente-São Paulo.

In Brazil, abortion is among the leading causes of maternal mortality. Research has shown that abortion is practiced clandestinely by women of all social classes, but has unequal consequences depending on social inclusion, producing risks to poor women. Although the issue has been widely explored in the past 20 years, there is a lack of data about low-income women. Thus, the present study aims to estimate the prevalence of women with induced abortion. Women from a population-based household survey in low-income sectors of São Vicente, São Paulo were recruited. Women of childbearing age from 15 to 49 years were eligible. The evaluation of the prevalence ratios for women with induced abortion was performed by using generalized linear models, with Poisson log-link function and robust variance to approximate the binomial. The most frequent variables that influenced reporting of abortion were: "always accept this practice" (95% CI 2.98-11.02), followed by "not having a child born alive" (95% CI 1.35-19.78), having "two to five live births" (95% CI 1.42-14.40), "having 'six or more live births" (95% CI 1.35-19.78), "age at interview" (95% CI 1.01-1.07) and "income" < R$ 484.97' (95% CI 1.04-2.96). A widespread campaign about the practice of abortion, which can raise awareness among women in favor of the cause, especially among those in low-income strata is necessary to prevent unnecessary deaths.

Brief motivational interview and educational brochure in emergency room settings for adolescents and young adults with alcohol-related problems: a randomized single-blind clinical trial.

OBJECTIVE: To evaluate the effectiveness of brief motivational interviewing and an educational brochure when delivered in emergency room to reduce alcohol abuse and related problems among adolescents and young adults. METHOD: A randomized single-blind clinical trial with a three-month follow-up was carried out at three emergency rooms from October 2004 to November 2005; subjects assessed were 16-25 years old treated for alcohol related events up to 6 hours after consumption. Socio-demographic data, quantity, frequency and negative consequences of alcohol consumption, motivation to change habits and future risk perception were evaluated. Statistical analysis was performed on subjects who completed follow-up (completers). ANCOVA model was used to analyze the difference between the intervention groups with statistical significance level α = 5% and confidence interval (CI) of 95%. RESULTS: 186 subjects formed the initial sample, being 175 included and randomized to the educational brochure group (n = 88) or motivational interviewing group (n = 87). Follow-up assessment was performed in 85.2% of the sample. No significant difference between groups was observed. However, significant reductions (p < 0.01) in related problems and alcohol abuse were found in both groups. CONCLUSION: In this sample a reduction of alcohol use and related problems was observed. Preliminary data indicate that controlled clinical trials with motivational interviewing, educational brochure and nonintervention should be of future interest among Brazilian adolescent populations.

Alcohol dependence: analysis of factors associated with retention of patients in outpatient treatment.

AIMS: To identify factors associated with retention in treatment of alcohol-dependent individuals and to compare treatment retention between men and women. METHODS: Analysis of the treatment attendance records and baseline characteristics of 833 men and 218 women who undertook to attend follow-up treatment in an alcoholism treatment centre. RESULTS: Retention after 4 weeks of treatment is more likely to occur among those using adjuvant medication (the most frequent of which was disulfiram), those presenting severe alcoholism and those who are older and tend to be frequent drinkers. There was no gender difference regarding treatment retention. CONCLUSION: Such results suggest possibilities for developing specific strategies to reduce the risk of early dropout from treatment.

Endogenous Oestradiol but Not Testosterone Is Related to Coronary Artery Disease in Men Sex hormones and coronary artery disease

Men die of coronary artery disease more often (CAD) than women. There is evidence that testosterone is either neutral or has a beneficial effect on male cardiovascular disease. The role ofoestrogens in male CAD has been less studied. This study was carried out with the purpose of evaluating the relationship between sex hormones levels and coronary artery disease.Designer: Case-control study.Participants: Men (aged 40-70) submitted to coronary angiography. A 70% occlusion of at least one major coronary artery defined the cases; subjects with ¡Ü 50% occlusion constituted the control group.Measurements: Blood samples were collected for total testosterone, oestradiol, LH, FSH, SHBG, lipid profile and albumin measurements. Bioavailable and free testosterone, FAI and FEI were calculated. Oestradiol and total testosterone levels were examined as terciles, based on the wholestudy population. Results: Of the 140 patients included, 72 were cases and 68 were controls. The baseline characteristics of the two groups were similar, except for the older age and lower LDL-C in the cases. Oestradiol and FEI but not total, bioavailable and free testosterone and FAI correlated positively with CAD. After adjustments for potential confounders oestradiol remained statistically significant. Theprevalence of CAD was significantly higher in the 3rd than in the 1st tercile of oestradiol.

Factors associated with nipple trauma in the maternity unit.

OBJECTIVE: To identify factors associated with nipple trauma in women breastfeeding exclusively in a maternity unit. METHODS: This was a case-control study that recruited 146 recently-delivered mothers in rooming-in wards: 73 cases, defined as women with nipple trauma, and 73 controls, defined as women free from this pathology. Women breastfeeding exclusively were tested daily for a diagnosis of nipple injury, identified using a magnifying glass. Sociodemographic, obstetric and neonatal variables were studied. A logistic regression model was used for statistical analysis. RESULTS: Cases and controls proved to be comparable in terms of their sociodemographic variables, although the women with nipple trauma were more likely not to be living with a partner. The following variables were found to be factors associated with nipple trauma: primiparity (OR 3.16; 95%CI 1.19-8.42), not living with a partner (OR 3.25; 95%CI 1.18-8.93), turgid and/or engorged breasts (OR 12.31; 95%CI 4.48-33.78), semi-protruding and/or malformed nipples (OR 4.69; 95%CI 1.50-14.62), and depigmentation of nipples (OR 13.98; 95%CI 4.43-44.06). CONCLUSION: Primiparity, not living with a partner, turgid and/or engorged breasts, semi-protruding and/or malformed nipples, and depigmentated nipples are associated with nipple trauma.

Brief report: A socio-demographic profile of multiparous teenage mothers.

OBJECTIVE: Delineate a socio-demographic profile of multiparous teenage mothers at a public hospital in Brazil. METHOD: This is a cross-sectional study consisting of 915 interviews with teenage girls, including 170 multiparous subjects whose babies were born alive. RESULTS: The multiparous teenage mothers had the following average characteristics: 17.8 years old; first pregnancy at 16 years; beginning of sexual life at 14.2 years; dropped out of school at 13.6 years; attended school for 6 years with only 10% still attending school when they were interviewed; 87.4% had prenatal exams; monthly income was reported to be 0.3% less than the national minimum salary. CONCLUSION: Teenage mothers are in need of better social, educational, and health care in order to have a greater chance of a positive motherhood experience, thereby creating a better, healthier environment for their children.

Frequency and characteristics of induced abortion among married and single women in São Paulo, Brazil.

This article presents the results of a study in the city of São Paulo, Brazil, aimed at estimating the frequency of induced abortion among women 15 to 49 years of age. The objective was to characterize the occurrence of induced abortion by comparing the ideal number of children, age, and contraceptive use between married and single women. Based on random sampling, 1,749 interviews were held, including 764 married women, 658 single women, and 327 with other marital status. The analysis included: mean number of abortions per woman by analysis of variance and proportions of abortions and pregnancy, using the chi-square test. The mean abortion rate for married women (45 per thousand) did not differ statistically from that of single women. However, the pregnancy rate was much lower in single women, and when single women became pregnant they used abortion more frequently; while fewer than 2% of pregnancies in married women ended in induced abortions, among single women the abortion rate exceeded 18%. Therefore, the priority in the reproductive health field should be to invest in the supply and dissemination of appropriate contraceptive methods for women's early sexually active life.

Fatores associados à sintomatologia depressiva numa coorte urbana de idosos / Depressive symptomatology and its associated factors in an urban cohort of elderly

Objetivo: Analisar a associação, em uma coorte urbana de idosos, entre sintomatologia depressiva e outros indicadores de capacidade funcional com a mortalidade após 15 anos de seguimento. Métodos: Foram estudados os casos de 1.667 idosos (≥ 65 anos) residentes em Vila Clementino, na cidade de São Paulo, por meio de uma avaliação multidimensional da capacidade funcional e dos atestados de óbito referentes a mortes ocorridas entre 1991 (início do estudo) e abril de 2006. Na análise univariada foram calculadas as razões de chances e sua significância estatística foi avaliada pelo intervalo de confiança (95%). Na análise múltipla foi empregada a regressão logística. Resultados: Entre os idosos estudados, 21,1% eram deprimidos em 1991. Na análise univariada, as maiores proporções de deprimidos foram observadas entre indivíduos do sexo feminino, com mais de 80 anos, analfabetos, viúvos ou solteiros, com alto nível de dependência física e de déficit cognitivo, usuários demais medicamentos e entre os que morreram no período de seguimento de 15 anos. Na análise múltipla, controlando-se por sexo e idade, a presença de dependência física e o fatode ser usuário de mais medicamentos foram os principais preditores da ocorrência de depressão. Conclusões: A ocorrência de sintomatologia depressiva parece estar diretamente relacionada aos níveis de incapacidade física observados entre os idosos.

Introduction: The process of population aging in Brazil has been fast and intense, increasing the prevalence of chronic diseases and psychological and mental problems, mainly depression,which is associated with functional losses of the aged one. Objective: To analyse the association between depressive symptomatology and other indicators of functional capacity, and with mortality after 15 years of follow-up, in an urban cohort of elderly. Methods: 1667 aged (≥ 65 years-old) residents in Clementino Village in São Paulo city were studied through a multidimensional evaluation of the functional capacity, as well as the death certificate of the deaths occurred between 1991 (beginning of the study) and April of 2006. In univaried analysis we calculated odds ratio and its significance statistics was evaluated by the reliable interval (95%). The logisticregression was used in the multiple analysis. Results: 21,1% of the elderly were depressed in 1991. In univaried analysis the highest ratios of depressed people were found in the feminine sex, aged older than 80 years-old, illiterates, widowers or bachelors, high level of physical dependence, cognitive deficit, users of more medicines and among those who died in the period of 15 years. In multivaried analysis, controlling by sex and age, physical dependence and the users of more medicines are associated to depression. Conclusions: The worse levels of disability answer, by an expressive way, to the occurrence of depressive symptomatology between the aged ones.

Factors associated with death by tuberculosis in the eastern part of São Paulo city, 2001.

OBJECTIVE: To identify factors associated with death from TB, evaluating TB cases reported for 2001 in the city of São Paulo (specifically in the neighborhoods of Cidade Tiradentes, Guaianazes, Itaquera and São Mateus) and comparing those evolving to death with those evolving to cure. METHODS: We investigated all deaths in which TB was given as the principal cause (n = 48), analyzing medical charts and conducting home visits to interview the caregiver(s). In parallel, we investigated 96 TB cases in which the patient had been discharged after a cure had been achieved. Patients with HIV were excluded from both groups. RESULTS: There were no differences between the two groups in terms of the clinical form of tuberculosis, laboratory test confirmation of the diagnosis and type of treatment. Death from TB was found to be associated, in a statistically significant manner, with being male, being over 50 years of age, having had less than 3 years of schooling, suffering from alcoholism and being unemployed. The logistic regression showed that the variables presenting the strongest associations with death from TB were suffering from alcoholism and being over 50, whereas being a new treatment and being employed were found to be protective. The combination of suffering from alcoholism, being unemployed and being over 50 increased the chance of evolving to death by 25 times (95%CI: 6.43-97.20). CONCLUSION: Ongoing education of health professionals, prompt epidemiological interventions and efficient patient referral systems could improve the indices related to this disease.

[Levels of exposure to organochlorine pesticides in open-air dump dwellers]. / Grau de exposição a praguicidas organoclorados em moradores de aterro a céu aberto.

OBJECTIVE: To estimate the degree of internal exposure to organochlorine pesticides (persistent organic pollutants, POP) among inhabitants of an open-air dump. METHODS: This was an observational study with simultaneous measurement and control, in which the criterion for subjects was that they dwelled in an area contaminated by POP and the effect of such contamination was the concentration of such substances into the blood. The study population consisted of 238 people living on an open-air dump in Pil es, in the municipality of Cubatão, SP, Brazil, and the control population was formed by 258 people, also resident in that municipality, in the Cota 200 district. The following pesticides were analysed: hexachlorobenzene (HCB), p-p'DDT, p-p'DDE, p-p'DDD, o-p'DDT, a HCH (hexachlorocyclohexane); b HCH; g HCH; aldrin; dieldrin; endrin; heptachlor; heptachlor-epoxy and mirex. RESULTS: The average blood level of HCB in Pil es was 4.66 g/l, which was 155 times higher than the average for Cota 200 (0.03 g/l). In Pil es the average blood concentration of total DDT was 3.71 g/l, which was twice the level found in Cota 200 (1.85 g/l). Total HCH presented blood concentrations that were six times greater in Pil es (0.84 g/l versus 0.13 g/l). CONCLUSIONS: A positive association was shown between dwelling in Pil es and the presence of POP in the blood, with much higher risks than in localities without the presence of these contaminants.

Grau de exposiçäo a praguicidas organoclorados em moradores de aterro a céu aberto / Levels of exposure to organochlorine pesticides in open-air dump dwellers

OBJETIVO: Estimar o grau de exposiçäo interna aos praguicidas organoclorados (POP) dos moradores de um atêrro a céu aberto. MÉTODOS: Estudo observacional, de aferiçäo simultânea e controlado, cujo fator de estudo foi residir em área contaminada por POP e o efeito foi a concentraçäo sanguínea dessas substâncias. A populaçäo de estudo foi de 238 pessoas residentes em um aterro a céu aberto (Pilöes), no município de Cubatäo, SP; e a populaçäo de controle ficou dimensionada em 258 pessoas, também residentes no mesmo município (Cota 200). Foram analisados os praguicidas HCB, p-p'DDT, p-p'DDE, p-p'DDD, o-p'DDT, a HCH; b HCH; g HCH; Aldrin; Dieldrin; Endrin; Heptaclor; Heptaclor-epoxi e Mirex.RESULTADOS: Os teores médios sangüíneos de HCB em Pilöes foram de 4,66 µg/L, 155 vezes maior que a média na Cota 200 (0,03 µg/L). Em Pilöes, os teores médios de DDT total foram de 3,71 µg/L, duas vezes maior do que na Cota 200 (1,85 µg/L) e o HCH total apresentou concentraçöes sangüíneas seis vezes maiores em Pilöes, 0,84 µg/L, contra 0,13 µg/L. CONCLUSOES: Evidenciou-se associaçäo positiva entre residir em Pilöes e apresentar teores sangüíneos de POP, com risco muitas vezes maior quando comparado a localidades sem a presença desses contaminantes

Prevalência do uso de medicamentos na gravidez e relações com as características maternas / Prevalence of use of medicines during pregnancy and its relationship to maternal factors

Há no Brasil crescente utilização de medicamentos industrializados, inclusive durante o ciclo reprodutivo feminino. Na gestação os efeitos dos medicamentos no feto pode resultar em toxicidade com possíveis lesões irreversíveis. Nesse sentido, foi verificada a prevalência do uso de medicamentos, durante a gravidez, na população estudada e sua relação com as características maternas, grupos farmacológicos e fonte de indicação. Métodos - Foram avaliadas, quanto ao uso de medicamentos, 1.620 mulheres que deram à luz em cinco hospitais de atendimento público, privado ou conveniado, da cidade de São Paulo, de julho a setembro de 1993. Os dados referentes ao uso de medicamentos e de outras variáveis foram coletados, por meio de entrevista estruturada, no intervalo de 30 dias consecutivos junto às puérperas. Resultados e Conclusões - A relação entre escolaridade materna e atendimento hospitalar revelou desigualdade social no acesso aos diversos tipos de serviço de assistência ao parto. A prevalência do uso de pelo menos um medicamento foi de 97,6 por cento, com média de 4,2 medicamentos por mulher. A prevalência do uso de medicamentos por indicação médica e por automedicação foi de 94,9 por cento e 33,5 por cento, respectivamente. As medicações mais usadas, excluindo-se as vitaminas, sais minerais e vacinas, foram os analgésicos, antiácidos, antieméticos e antiespasmódicos. Usuárias com maior uso de medicamentos tiveram as seguintes características: acima de 29 anos de idade, casada, terceiro grau completo, atividade remunerada e acesso aos serviços privados de saúde. A assistência médica desempenhou papel facilitador no acesso ao uso de medicamentos durante o período gestacional. As mulheres deveriam ser conscientizadas dos riscos em potencial a que expõem seus fetos ao fazerem uso de tantas medicações. O pré-natalista deveria repensar seu papel diante desta problemática.