Regulaciones menstruales en adolescentes y factores de riesgo / Menstrual Regulation in Adolescents and Risk Factors

Introducción: el embarazo en la adolescencia y los abortos voluntarios, en los que las regulaciones menstruales tienen un sitio especial, son experiencias difíciles que afectan la salud integral, tanto de los padres, como la de sus hijos, familiares y de la sociedad. Objetivos: evaluar los factores de riesgo que incidieron en las adolescentes a las que se les realizaron regulaciones menstruales. Método: se realizó un estudio caso-control en adolescentes del municipio Calixto García, Provincia Holguín, en el período comprendido entre enero a diciembre de 2014. El universo de estudio comprendió a 57 adolescentes que acudieron al Servicio de Regulación Menstrual y la muestra estuvo integrada por 40 pacientes a las que se les realizó este proceder (grupo casos) y se parearon a 40 sin historia de embarazos y con igual edad (grupo control). Resultados: el 60% de los casos estudiados se encontraban con desvinculación estudio trabajo. El 60% iniciaron precozmente sus relaciones sexuales y el 55% tenían un comportamiento sexual inadecuado. El desconocimiento de las complicaciones de las regulaciones menstruales estuvo presente en el 65% y predominó la disfunción familiar en el 52,5%. El control de los factores de riesgo identificados pudo ocasionar una reducción igual al valor de fracción atribuible de 64% a 90% y la probabilidad que se realizaran regulaciones menstruales fue desde 1,7 a 11 veces. Conclusiones: se comportaron como factores de riesgo predominantes el inicio precoz de las relaciones sexuales, la promiscuidad, el desconocimiento de las complicaciones y las familias disfuncionales.

Introduction: teenage pregnancy and abortions volunteers, in which menstrual regulations have a special place, difficult experiences that affect the overall health of both parents and their children, family and society. Objectives: to assess the risk factors that influenced the adolescent who underwent menstrual regulations. Method: a case-control adolescents in the municipality Calixto Garcia, Holguin Province, in the period from January to December 2014 study was conducted. The study group comprised 57 adolescents who were attended the service of Menstrual Regulation and the sample consisted of 40 patients which were performed this procedure (cases group) and were matched to 40 with no history of pregnancy and the same age (control group). Results: 60% of the cases studied were untying study with work. 60% early started their sex and 55% had an inappropriate sexual behavior. Ignorance of the complications of menstrual regulations was present in 65% and family dysfunction prevailed in 52.5%. Control of identified risk factors could result in a reduction equal to the value attributable fraction of 64% to 90% and the likelihood that menstrual regulations were held was from 1.7 to 11 times. Conclusions: early beginning of sex, promiscuity, lack of knowledge on complications and dysfunctional families predominated as risk factors.

Analgesia acupuntural para la regulación menstrual en pacientes atendidas en el Policlínico Universitario "Josué País García" / Acupuncture analgesia for menstrual regulation in patients attended in "Josué País García" University Polyclinic

Se efectuó un estudio descriptivo y transversal de 60 pacientes, atendidas en la consulta de regulación menstrual del Policlínico Universitario "Josué País García" de Santiago de Cuba, desde abril hasta junio del 2009, con vistas a evaluar los resultados de la analgesia acupuntural empleada para tratar a estas féminas. Entre las variables analizadas figuraron: edad, escolaridad, ocupación, intensidad del dolor percibido, complicaciones y grado de satisfacción. Para resumir la información se emplearon las frecuencias absolutas y relativas (porcentaje). En la serie predominaron el grupo etario de 15-19 años, el nivel escolar preuniversitario, las estudiantes, el sangrado como la complicación más frecuente y el dolor moderado como el de mayor intensidad. Asimismo, prevaleció el tratamiento efectivo y existió una adecuada satisfacción por parte de las pacientes en cuanto al uso de la citada técnica.

A descriptive and cross-sectional study was carried out in 60 patients attended in the menstrual regulation department of "Josué País García" University Polyclinic of Santiago de Cuba, from April to June 2009, with the purpose of evaluating the results of acupuncture analgesia used to treat these females. Among the analyzed variables were age, education, occupation, severity of perceived pain, complications and satisfaction. To summarize the information the absolute and relative frequencies were used (percentage). The age group of 15-19 years, high school level, students, and bleeding as the most frequent complication and moderate pain as that of more severity predominated in the case material. Also, the effective treatment prevailed and there was an adequate satisfaction of the patients in the use of that technique.

Captación de adolescentes gestantes e interrupción del embarazo durante un quinquenio en la provincia de Santiago de Cuba / Prenatal visit of pregnant teenagers and interruption of pregnancy during a five year period in Santiago de Cuba province

Se realizó un estudio descriptivo y transversal de las adolescentes con captación de embarazo o interrupción de este, o ambos, en la provincia de Santiago de Cuba, durante el quinquenio 2007-2011, con vistas a caracterizarles según grupos etarios, métodos y procedimientos de interrupción de la gestación, y además determinar la razón captación e interrupción de embarazo, así como captación de embarazo y aborto provocado. Los resultados mostraron que el método más utilizado para interrumpir la gestación fue la regulación menstrual, con una tendencia descendente a emplearlo; en tanto se observó un ascenso del aborto provocado y el número de embarazos, con una cifra superior de interrupciones respecto a las captaciones. Se recomendó incrementar la labor educativa sobre salud sexual y reproductiva en los jóvenes y sus familiares, para así lograr disminuir la cantidad de embarazos en las adolescentes y las interrupciones de estos, de manera que mejore la calidad de vida de dicha población de féminas.

A descriptive and cross-sectional study of the adolescents under prenatal screening visits, and/or interruption of pregnancy, was carried out in Santiago de Cuba, during the five year period 2007-2011, aimed at characterizing them according to age groups, methods and interruption procedures for pregnancy, and also to determine the reason why the prenatal visit and pregnancy interruption occurred, as well as why prenatal visit and artificial abortion took place. The results showed that the most used method to interrupt pregnancy was the menstrual regulation, with a declining tendency to use it; meanwhile an increase of the artificial abortion and the number of pregnancies was observed, with a higher number of interruptions compared to the prenatal visits. It was recommended to increase the educational work on sexual and reproductive health in the youth and their relatives, so as to decrease the quantity of pregnancies in the adolescents and their interruptions, so that the life quality of this female population improves.

Comportamiento de la regulación menstrual en la adolescencia / Behavior of menstrual regulation in adolescence

Introducción: la práctica del aborto es uno de los temas de mayor controversia a finales del siglo xx y comienzos del XXI, pero no constituye nada nuevo, ha existido en cada cultura conocida, con o sin alfabeto escrito, primitiva o moderna. En los últimos años se reconoce el valor que tiene la evacuación del útero en el embarazo temprano mediante el método de regulación menstrual. Objetivo: describir el comportamiento de la regulación menstrual en la adolescencia del área de salud de Párraga. Métodos: estudio observacional descriptivo transversal. El universo estuvo constituido por un total de 370 adolescentes que acudieron a la consulta de Regulación Menstrual del Policlínico Párraga. La muestra fue de 360 pacientes; a todas se les aplicó el método de aspiración endometrial. Estas pacientes fueron seguidas en consulta evolutivamente a los siete días. Se analizaron las variables: edad, escolaridad, estado civil, antecedentes obstétricos, uso de método anticonceptivo previo y complicaciones inmediatas. Resultados: predominó el grupo de la adolescencia tardía con 220 casos. La edad de inicio de las relaciones sexuales fue de 14 a los 17 años con 249 (69,1 porciento) adolescentes y el motivo por el cual no usaban los métodos anticonceptivos fue por olvido en 183 (50,8 porciento) casos. Las complicaciones que más se presentaron fueron las reacciones vagales en 54 (15,0 porciento) pacientes. Conclusiones: gran número de adolescentes hacen uso de la regulación menstrual por ser menos peligrosa que el aborto, más rápido, prescindir de anestesia y de otras complicaciones

Introduction: abortion is one of the most controversial topics at the end of the 20th century and at the beginning of the 21st century. However, this is not a new situation since it has existed in every recognized culture, either primitive or modern, with or without written alphabet. In the last few years, the role of the menstrual regulation to empty the uterus in the early pregnancy has been recognized. Objective: to describe the behavior of the menstrual regulation method in adolescents from the health area of Parraga neighborhood. Methods: an observational, cross-sectional and descriptive study was conducted. The universe of study was 370 female adolescents, who went to the Menstrual Regulation Service in Parraga polyclinics. The final sample was made up of 360 patients who were performed the endometrial aspiration method. These patients were followed up for 7 days to observe their recovery. The following variables were under analysis: age, schooling, marital status, obstetric history, use of contraceptive methods and immediate complications. Results: the group of late adolescents with 220 cases predominated. The age of onset of sexual relations was 14 to 17 years, with 249 (69.1 percent) adolescents, and the main reason for not using some contraceptive method was they forgot to do it in 183 (50.8 percent) cases in this sample. The most frequent complications sere vagal reactions in 54 (15.0 percent) patients. Conclusions: a large number of female adolescents turn to menstrual regulation because it is a quicker, safer method than abortion, does not require anesthesia and has no further complications

Studies on zoapatle, II. Leucanthanolide, a novel sesquiterpene lactone from Montanoa leucantha ssp. leucantha.

PIP: A sesquiterpene lactone given the trivial name leucanthanolide, from the Mexican zoapatle plant (Montanoa leucantha), long used as an herbal remedy, was isolated and was found to have cytotoxicity but no uterine activity. The compound was isolated from the fraction containing zoapatanol, a substance being investigated for its ability to induce menses, abortion and labor. The compound has a molecular formula of C19H2606, a 5-membered lactone ring, an ester group, and a germacradienolide skeleton. It was evaluated for abortifacient activity in pregnant guinea pigs by intraperitoneal injection on day 22 of gestation. 3 of 5 animals had abnormal fetuses, but there was no evidence of early uterine activity. Cytotoxic testing in vitro was done on KB and P-388 test systems in cell culture. The ED50 of leucanthanolide was 0.57 mcg/ml (KB) and 0.93 (P-388). In comparison, the ethyl acetate fraction had an ED50 of 1.35 mcg/ml and 5.2 mcg/ml respectively.^ieng

Medical opinion on abortion in Jamaica: a national Delphi survey of physician, nurses, and midwives.

A national sample of 120 Jamaican physicians, public health nurses, and licensed midwives participated in a two-stage Delphi survey to identify medical opinion on proposed liberlization of Jamaica's abortion law, and to predict the likely impact of such legislative action on existing health and family planning services. More than 80 percent of the respondents favored legalization of abortion, and most supported changes in the health service delivery system to accommodate the expected demand. They believed that clandestine abortion, involving pharmacists and physicians, is already widely practiced.

PIP: In Jamaica, existing law declares the act of abortion to be a felony although the law is rarely if ever enforced. A pregnant woman who seeks abortion and anyone helping her to obtain one is subject to prosecution. Many doctors are unwilling to face the possibility of legal confrontation. The purposes of this study were to provide policymakers with an overview of attitudes and opinions of those who must implement policy on abortion, to identify a consensus of informed opinion among medical personnel concerning proposed changes in law or policy on abortion, and to elict judgments of the magnitude of illegal abortion as a public health problem. The Delphi survey method has many variations, but a common feature is the repeated interrogation of respondents on their expectations and understandings regarding a particular issue. During the 1st round of data gathering, 120 informants were interviewed at length regarding abortion. After analysis of Round 1 data, and informing participants of results, those participating had an opportunity to reconsider their previous answers and to clarify ambiguous responses. The natural sample for Round 1 consisted of 70 physicians, 16 public health nurses, and 34 licensed midwives. The sample for Round 2 consisted of 65 physicians and 37 nurses and midwives. Also sought were the views of 20 physicians, not included in the random sample, who had been outspoken on the abortion issue. Licensed physicians and pharmacists were reported to be the most active in performing illegal abortions. The incidence of complications was reported to be greater when the abortions were performed by pharmacists. The predicted effect of liberalization of abortion laws on the use of contraceptive methods was that interest in such use would be increased. But an increase in the number of abortions was anticipated if such legislation were passed. Most doctors were in favor of the procedure of ''menstrual extraction'' but believed it should be subject to the same controls as regular abortion. However, many thought that nurses and others might be permitted to use this method. Survey results showed that there is a very solid support in the 3 segments of the medical community for liberalization of the abortion laws and for modifications in health services to care for an increased demand for abortions. The danger of a rapidly expanding population with already inadequate resources was ranked as a top social problem. Since the practice of abortion among Jamaican women is already widespread, a nonrestrictive abortion law finds general support within the medical community. Government action to relax curbs on abortion is described as an evolutionary, not a revolutionary step.