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Silva JSN, de Barros IML, Guimarães JAN, Cao D, Martins SM, de Carvalho TXM, de Farias RS, Lemke V, Mehran R, Pedrosa R. Beyond the GRACE ACS Score: Do We Need a Different Model for Men and Women after STEMI? Arq Bras Cardiol 2024; 121:e20230060. [PMID: 38716988 PMCID: PMC11098573 DOI: 10.36660/abc.20230060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 12/14/2023] [Accepted: 01/18/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Women, in comparison to men, experience worse outcomes after acute coronary syndrome (ACS). However, whether the female sex per se is an independent predictor of such adverse events remains unclear. OBJECTIVE This study aims to assess the association between the female sex and in-hospital mortality after ST-elevation myocardial infarction (STEMI). METHODS We conducted a retrospective cohort study by enrolling consecutive STEMI patients admitted to a tertiary hospital from January 2018 to February 2019. All patients were treated per current guideline recommendations. Multivariable logistic regression models were applied to evaluate in-hospital mortality using GRACE variables. Model accuracy was evaluated using c-index. A p-value < 0.05 was statistically significant. RESULTS Out of the 1678 ACS patients, 709 presented with STEMI. The population consisted of 36% women, and the median age was 61 years. Women were older (63.13 years vs. 60.53 years, p = 0.011); more often presented with hypertension (75.1% vs. 62.4%, p = 0.001), diabetes (42.2% vs. 27.8%, p < 0.001), and hyperlipidemia (34.1% vs. 23.9%, p = 0.004); and were less likely to undergo percutaneous coronary intervention (PCI) via radial access (23.7% vs. 46.1%, p < 0.001). In-hospital mortality rate was significantly higher in women (13.2% vs. 5.6%, p = 0.001), and the female sex remained at higher risk for in-hospital mortality (OR 2.79, 95% CI 1.15-6.76, p = 0.023). A multivariate model including age, sex, systolic blood pressure, cardiac arrest, and Killip class was 94.1% accurate in predicting in-hospital mortality, and the c-index was 0.85 (95% CI 0.77-0.93). CONCLUSION After adjusting for the risk factors in the GRACE prediction model, women remain at higher risk for in-hospital mortality.
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Affiliation(s)
- José Sergio Nascimento Silva
- Universidade de PernambucoPROCAPERecifePEBrasilUniversidade de Pernambuco – PROCAPE, Recife, PE – Brasil
- Hospital Agamenon MagalhãesRecifePEBrasilHospital Agamenon Magalhães, Recife, PE – Brasil
| | | | | | - Davide Cao
- Icahn School of Medicine at Mount SinaiNew YorkEUAIcahn School of Medicine at Mount Sinai, New York – EUA
| | - Sílvia Marinho Martins
- Universidade de PernambucoPROCAPERecifePEBrasilUniversidade de Pernambuco – PROCAPE, Recife, PE – Brasil
- Real Hospital Português de Beneficência em PernambucoRecifePEBrasilReal Hospital Português de Beneficência em Pernambuco – Realcor, Recife, PE – Brasil
| | | | - Rayssa Santana de Farias
- Universidade de PernambucoPROCAPERecifePEBrasilUniversidade de Pernambuco – PROCAPE, Recife, PE – Brasil
| | - Viviana Lemke
- Cardiocare Clínica CardiológicaCuritibaPRBrasilCardiocare Clínica Cardiológica, Curitiba, PR – Brasil
| | - Roxana Mehran
- Icahn School of Medicine at Mount Sinai ZenaMichael A Wiener Cardiovascular InstituteNew YorkEUAIcahn School of Medicine at Mount Sinai Zena and Michael A Wiener Cardiovascular Institute, New York – EUA
| | - Rodrigo Pedrosa
- Universidade de PernambucoPROCAPERecifePEBrasilUniversidade de Pernambuco – PROCAPE, Recife, PE – Brasil
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Galvão NMS, Matos SMAD, Almeida MDCCD, Gabrielli L, Barreto SM, Aquino EML, Schmidt MI, Amorim LDAF. Patterns of metabolic syndrome and associated factors in women from the ELSA-Brasil: a latent class analysis approach. CAD SAUDE PUBLICA 2023; 39:e00039923. [PMID: 38088734 PMCID: PMC10715568 DOI: 10.1590/0102-311xen039923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 08/26/2023] [Accepted: 09/18/2023] [Indexed: 12/18/2023] Open
Abstract
This study aimed to identify patterns of metabolic syndrome among women and estimate their prevalence and relationship with sociodemographic and biological characteristics. In total, 5,836 women were evaluated using baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Patterns of metabolic syndrome were defined via latent class analysis, using the following metabolic abnormalities as indicators: abdominal obesity, hyperglycemia, hypertension, hypertriglyceridemia, and reduced HDL cholesterol. The relationship between these patterns and individual characteristics was assessed using latent class analysis with covariates. Three patterns of metabolic syndrome were identified: high metabolic expression, moderate metabolic expression, and low metabolic expression. The first two patterns represented most women (53.8%) in the study. Women with complete primary or secondary education and belonging to lower social classes were more likely to have higher metabolic expression. Black and mixed-race women were more likely to have moderate metabolic expression. Menopausal women aged 50 years and older were more often classified into patterns of greater health risk. This study addressed the heterogeneous nature of metabolic syndrome, identifying three distinct profiles for the syndrome among women. The combination of abdominal obesity, hyperglycemia, and hypertension represents the main metabolic profile found among ELSA-Brasil participants. Sociodemographic and biological factors were important predictors of patterns of metabolic syndrome.
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Affiliation(s)
| | | | | | - Ligia Gabrielli
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil
| | - Sandhi Maria Barreto
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Estela M L Aquino
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil
| | - Maria Inês Schmidt
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
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Arruda GTD, Paines GP, Silva BRD, Pairé LX, Pivetta HMF, Braz MM, Virtuoso JF. Relationship Involving Sexual Function, Distress Symptoms of Pelvic Floor Dysfunction, and Female Genital Self-Image. Rev Bras Ginecol Obstet 2023; 45:e542-e548. [PMID: 37846187 PMCID: PMC10579922 DOI: 10.1055/s-0043-1772474] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 06/12/2023] [Indexed: 10/18/2023] Open
Abstract
OBJECTIVE To assess the relationship involving sexual function (SF), the distress symptoms caused by pelvic floor dysfunction (PFD), and female genital self-image (GSI). MATERIALS AND METHODS We assessed the GSI, SF and PFD distress symptoms by the Female Genital Self-Image Scale (FGSIS), the Female Sexual Function Index (FSFI), and the Pelvic Floor Distress Inventory (PFDI-20) respectively. Data were analyzed by multiple linear regression. RESULTS Among the 216 women (age: 50.92 ± 16.31 years) who participated in the study, 114 were sexually active in the previous 4 weeks. In the total sample (p < 0.001; adjusted R2 = 0.097) and among sexually active women (p = 0.010; adjusted R2 = 0.162), the distress symptoms caused by pelvic organ prolapse (POP) were related to the GSI. Among sexually active women, sexual desire also was related to the GSI (p < 0.001; adjusted R2 = 0.126). CONCLUSION The findings of the present study provide additional knowledge about female GSI and suggest that SF and POP distress symptoms should be investigated together with the GSI in the clinical practice.
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Affiliation(s)
| | - Gabrielle Peres Paines
- Departamento de Fisioterapia e Reabilitação, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - Bianca Rangel da Silva
- Departamento de Fisioterapia e Reabilitação, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - Lauren Xavier Pairé
- Departamento de Fisioterapia e Reabilitação, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | | | - Melissa Medeiros Braz
- Departamento de Fisioterapia e Reabilitação, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
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Alves RDS, Sousa LRM, de Moura JP, Gir E, Reis RK. Effectiveness of educational intervention among seropositive women about knowledge about HIV sexual transmission. Rev Bras Enferm 2023; 76:e20220371. [PMID: 37610951 PMCID: PMC10441211 DOI: 10.1590/0034-7167-2022-0371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 01/30/2023] [Indexed: 08/25/2023] Open
Abstract
OBJECTIVES to assess the effectiveness of a group and telephone educational intervention with seropositive women about knowledge about HIV sexual transmission prevention. METHODS a quasi-experimental before-and-after study, carried out with 151 women living with HIV in a Specialized Care Service in a Brazilian capital. The educational intervention was carried out in three moments, with the assessment being carried out before the first and after the last moment. RESULTS 97.4% of study participants were cisgender women aged between 18 and 58 years; 55.6% considered themselves brown; and 32.5% of interviewees had elementary school. Regarding knowledge about HIV sexual transmission, in 78.5% of items, there was an association (p<0.005) with increased participants' knowledge after receiving the intervention. CONCLUSIONS the educational intervention helped to increase the knowledge of women living with HIV about the sexual transmission of the infection.
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Affiliation(s)
| | | | | | - Elucir Gir
- Universidade de São Paulo. Ribeirão Preto, São Paulo, Brazil
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de Paula MBM, Queiroz ABA, Souza ÍEDO, Salimena AMDO, Parmejiani HP, Carvalho ALDO. Identity dimension of rural women and the sexual and reproductive health. Rev Bras Enferm 2023; 76:e20220298. [PMID: 37610950 PMCID: PMC10441208 DOI: 10.1590/0034-7167-2022-0298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 02/02/2023] [Indexed: 08/25/2023] Open
Abstract
OBJECTIVES to analyze the social representations of rural women about being a woman in the rural context and its implications for sexual and reproductive health. METHODS this is a descriptive qualitative study with data triangulation, based on the Theory of Social Representations, developed with 31 women who live in the rural context of Minas Gerais (MG/BR). An in-depth interview with a semi-structured script was conducted. A lexical analysis was performed with the help of the ALCESTE 2012 software. RESULTS the family relationship, especially the couple's, demonstrated subjectivities and was permeated by violence and normalized sexual practice. The imagery dimension of the ideal family seems to be responsible for exerting domination over rural women. FINAL CONSIDERATIONS rural women are subject to the norms and prescriptions of a patriarchal society. It is urgent to increase attention to sexual and reproductive health in an egalitarian and liberating way in order to minimize the consequences of machismo and conservatism.
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Lopes RLB, Ribeiro LC, Oliveira DMD. [Health promoted by social and community networks of low-income women]. CAD SAUDE PUBLICA 2023; 39:e00218022. [PMID: 37585906 PMCID: PMC10494697 DOI: 10.1590/0102-311xpt218022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/15/2023] [Accepted: 05/11/2023] [Indexed: 08/18/2023] Open
Abstract
Social and community networks constitute an important social determinant of health, especially in the poorer segments of civil society and in their struggles to guarantee the right to health care. This study sought to understand the social and community networks created by women living in a low-income community and their relationship with the development of health care in this social group. Semi-structured interviews were conducted with 11 women participating in a nongovernmental organization in the community, and the data were subjected to content analysis. The analysis highlighted four categories: the community as a large network, formed by multiple interconnected dynamic networks; the network of "aunts", women with an important role in the care of the community, treated as part of the family; the conversation circles, such as the rite of periodic meeting on the sidewalks, indicated as an important space that guarantees emotional stability and quality of life; and the benzedeiras with the use of medicinal plants, they are reference care within the community, providing disease prevention, health treatment, and referral to the health care unit when necessary. We concluded that the social and community networks created by the participants are important social determinants, and health facilities registered in the territory should value such networks.
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Mandache L. "I am going to break this logic of fear!": Activism and subversive care at the periphery of Fortaleza, Brazil. J Lat Am Caribb Anthropol 2023; 28:141-150. [PMID: 38505663 PMCID: PMC10947052 DOI: 10.1111/jlca.12676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 02/01/2023] [Accepted: 03/27/2023] [Indexed: 03/21/2024]
Abstract
Based on ethnographic work conducted between 2015 and 2022 at the periphery of Fortaleza, in Northeast Brazil, this article analyzes the work of community activists as a form of subversive care. Women activists, many of whom work for the local public clinics, as social workers with local NGOs, or as schoolteachers, challenge dominant narratives presented in the media and political discourses about their neighborhood as being poor and therefore violent. By establishing relationships of mutual trust with gang members and humanizing them, women activists "challenge the logic of fear" and maintain presence in areas controlled by the gangs to direct the economically vulnerable toward existing public resources. Activists' understanding of urban violence is informed by participation in collective action and living together with gang members and their families. These experiences lead activists to see urban violence as the symptom of systemic inequalities that require systemic changes.
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Affiliation(s)
- Luminiţa‐Anda Mandache
- Senior Lise Meitner Fellow, Center for Ethics and Poverty ResearchUniversity of SalzburgSalzburgAustria
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de Oliveira GMM, Wenger NK. Managing Women's Cardiovascular Diseases: It's Everyone's Job. Arq Bras Cardiol 2023; 120:e20230250. [PMID: 37341295 PMCID: PMC10263394 DOI: 10.36660/abc.20230250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023] Open
Affiliation(s)
| | - Nanette Kass Wenger
- Emory UniversitySchool of MedicineAtlantaGeorgiaEUAEmory University School of Medicine, Atlanta, Georgia – EUA
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Gamba FP, Siqueira BS, Tsuchiya RS, Tanaka TM, Grassiolli S. Impact of Roux-en-Y Gastric Bypass and Vertical Gastrectomy on weight loss: a retrospective and longitudinal study in the State of Paraná, Brazil. Rev Col Bras Cir 2023; 50:e20233431. [PMID: 36790229 PMCID: PMC10519702 DOI: 10.1590/0100-6991e-20233431-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 09/09/2022] [Indexed: 02/08/2023] Open
Abstract
AIM to compare the impact of Roux's Y Gastric Bypass (RYGB) and Sleeve Gastrectomy (SG) techniques on body weight reduction over 1 and 5 years after bariatric surgery in obese patients in the state of Paraná. METHODS longitudinal and retrospective study, conducted between January 2010 and December 2013, with 737 patients of both sexes submitted to RYGB or SG and evaluated in the preoperative, 1 and 5 years after bariatric surgery (BS). Age, height, body weight, Body Mass Index (BMI), biochemical and pressure parameters were recorded. RESULTS of the total of patients, men represented lower frequency, were slightly older, with higher body weight, BMI and worse metabolic and pressure conditions than women in pre-BS (p<0.05). Regardless of sex, RYGB and SG were effective in promoting body weight reduction and BMI in 1 and 5 years after BS; the RYGB technique had greater impact on these variables in both sexes (p<0.05). The highest percentage of lost weight was observed in women who underwent the RYGB technique in the first year after BS. Five years after BS, the RYGB technique promoted a higher rate of body weight reduction in men and women compared to the SG technique (p<0.05). CONCLUSION regardless of sex, the RYGB technique promotes a higher degree of body weight reduction and BMI over time compared to the SG; having its biggest impacts in the 1 year after BS, especially in women.
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Affiliation(s)
- Fernanda Pereira Gamba
- - Universidade Estadual do Oeste do Paraná, Programa de pós-graduação em biociências e saúde - Cascavel - PR - Brasil
| | - Bruna Schumaker Siqueira
- - Universidade Estadual do Oeste do Paraná, Programa de pós-graduação em biociências e saúde - Cascavel - PR - Brasil
| | | | | | - Sabrina Grassiolli
- - Universidade Estadual do Oeste do Paraná, Programa de pós-graduação em biociências e saúde - Cascavel - PR - Brasil
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Silva IA, Silva CM, Costa EM, Ferreira MDJ, Abuchaim EDSV. Continued breastfeeding and work: scenario of maternal persistence and resilience. Rev Bras Enferm 2023; 76:e20220191. [PMID: 36722647 PMCID: PMC9885363 DOI: 10.1590/0034-7167-2022-0191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 09/03/2022] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES to understand the challenges in mothers' daily life and strategies adopted to reconcile activities outside the home and continued breastfeeding. METHODS a cross-sectional, qualitative study. Theoretical-methodological assumptions were discursive practices and production of meanings in everyday life. Participants were 22 women from a specific social media group who had breastfed at least one child for >7 months. Data were collected between November 2020 and March 2021. RESULTS themes: Around the world of activities outside the home; Work environment: routines, opportunities and difficulties to maintain breastfeeding. FINAL CONSIDERATIONS women's experiences reveal a daily life with difficulties in reconciling the desire to breastfeed and the work scenario. Support network and adaptation to children's food routine were strategies adopted to minimize risks of weaning. The results show the need to consolidate policies to encourage continued breastfeeding in the labor market.
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Cader FA, Gavina C. Reducing Sex Disparities in STEMI Care and Outcomes: Turning the Tide for Women. Arq Bras Cardiol 2023; 120:e20220884. [PMID: 36790308 PMCID: PMC10389104 DOI: 10.36660/abc.20220884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- F. Aaysha Cader
- Departamento de CardiologiaIbrahim Cardiac Hospital & Research InstituteDhakaBangladeshDepartamento de Cardiologia - Ibrahim Cardiac Hospital & Research Institute, Dhaka – Bangladesh
| | - Cristina Gavina
- Departamento de Cardiologia e MedicinaHospital Pedro HispanoMatosinhosPortugalDepartamento de Cardiologia e Medicina - Hospital Pedro Hispano, ULS Matosinhos – Portugal
- Universidade do PortoPortoPortugalUniversidade do Porto, Porto - Portugal
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Oliveira JLD, Almeida JCPD, Pauli AJCD, Moitinho MR, Fiorati RC, Souza JD. Psychosocial impacts of the COVID-19 pandemic among settled women: A longitudinal study. Rev Lat Am Enfermagem 2023; 31:e3831. [PMID: 36888794 PMCID: PMC9991003 DOI: 10.1590/1518-8345.6123.3831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 09/01/2022] [Indexed: 03/08/2023] Open
Abstract
OBJECTIVE to analyze the psychosocial impacts of the COVID-19 pandemic among Brazilian women from rural settlements. METHOD this is a quantitative and longitudinal study conducted with 13 settled women. The data were collected between January 2020 and September 2021 using questionnaires on the perception of the social environment (quality of life, social support, self-efficacy), common mental disorder symptoms and sociodemographic aspects. The data were analyzed using descriptive statistics, cluster analysis and variance analysis. RESULTS intersecting vulnerability conditions were identified that possibly intensified the challenges arising from the pandemic. The Quality of Life physical domain fluctuated differently and inversely according to the mental disorder symptoms. As for the psychological domain, at the end of the segment, an increase over time was identified in the entire sample, as the women's perception was better than before the pandemic. CONCLUSION worsening of the participants' physical health deserves to be highlighted and, probably, it can be related to the difficulty accessing health services in this period as well as to the fear of contamination. Despite this, the participants were emotionally resilient throughout the period, including signs of improvement in terms of psychological aspects, suggesting a possible effect of the community organization of the settlement.
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Affiliation(s)
- Jaqueline Lemos de Oliveira
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Janaina Cristina Pasquini de Almeida
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Antonio Jose Correa de Pauli
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.,Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
| | - Mara Regina Moitinho
- Centro Nacional de Pesquisa em Energia e Materiais, Laboratório Nacional de Biorrenováveis, Campinas, SP, Brazil
| | - Regina Célia Fiorati
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Jacqueline de Souza
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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Oliveira CC, Vilela F, Braga C, Costa J, Marques J. ST-Segment Elevation Myocardial Infarction Differences between Genders - A Single Center Retrospective Analysis. Arq Bras Cardiol 2022; 120:e20211040. [PMID: 36629597 PMCID: PMC9833215 DOI: 10.36660/abc.20211040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 09/01/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Although outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary interventions (PCI) have improved, women show higher mortality. OBJECTIVES To assess gender differences in presentation, management and in-hospital mortality, at 30-days, 6-months and 1-year after STEMI. METHODS We retrospectively collected data from 809 consecutive patients treated with primary PCI and compared the females versus males at the local intervention cardiology database. The level of significance used was p<0.05. RESULTS Women were older than man (69,1±14,6 vs. 58,5±12,7 years; p<.001) with higher prevalence of age over 75 years (36.7% vs. 11.7%; p<.001), diabetes (30,6% vs. 18,5%; p=.001), hypertension (60.5% vs. 45.9%; p=.001), chronic kidney disease (3.4% vs. 0.6%; p=.010) and acute ischemic stroke (6.8% vs. 3.0%; p=.021). At presentation, women had more atypical symptoms, less chest pain (p=.014) and were more frequently in cardiogenic shock (p=.011)). Women had longer time until reperfusion (p=.001) and were less likely to receive optimal medical therapy (p<0.05). In-hospital mortality (p=.001), at 30-days (p<.001), 6-months (p<.001) and 1-year (16.4% vs. p<.001) was higher in women. The multivariate analysis identified age over 75 years (HR=4.25; 95% CI[1.67-10.77];p=.002), Killip class II (HR=8.80; 95% CI[2.72-28.41];p<.001), III (HR=5.88; 95% CI [0.99-34.80]; p=.051) and IV (HR=9.60; 95% CI[1.86-48.59];p=.007), Acute Kidney Injury (HR=2.47; 95% CI[1.00-6.13];p=.051) and days of hospitalization (HR=1.04; 95% CI[1.01-1.08];p=.030) but not female gender (HR=0.83; 95% CI[0.33-2.10];p=.690) as independent prognostic factors of mortality. CONCLUSIONS Compared to men, women with STEMI undergoing primary PCI have higher mortality rates. Women admitted for STEMI have a worse risk profile, are treated with a higher reperfusion time related with system delays and are less likely to receive the recommended therapy. Female gender was not an independent prognostic factor for mortality in the studied population.
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Affiliation(s)
- Cátia Costa Oliveira
- Serviço de CardiologiaHospital de BragaBragaPortugalServiço de Cardiologia, Hospital de Braga, Braga – Portugal,Escola de MedicinaUniversidade do MinhoBragaPortugalEscola de Medicina da Universidade do Minho, Braga – Portugal
| | - Filipe Vilela
- Escola de MedicinaUniversidade do MinhoBragaPortugalEscola de Medicina da Universidade do Minho, Braga – Portugal
| | - Carlos Braga
- Serviço de CardiologiaHospital de BragaBragaPortugalServiço de Cardiologia, Hospital de Braga, Braga – Portugal
| | - João Costa
- Serviço de CardiologiaHospital de BragaBragaPortugalServiço de Cardiologia, Hospital de Braga, Braga – Portugal
| | - Jorge Marques
- Serviço de CardiologiaHospital de BragaBragaPortugalServiço de Cardiologia, Hospital de Braga, Braga – Portugal
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Gimenez Ramos D. The 'Oscar curse' or the price of women's development. J Anal Psychol 2022; 67:261-274. [PMID: 35417581 DOI: 10.1111/1468-5922.12775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This article aims to reflect on the unconscious dynamics that sustain the shocking increase in feminicide in the world. It is observed that psychological and physical violence by the intimate partner has numerous facets, especially when the woman gains more or has more professional success than her partner. This violence can take a subtle form as rejection and betrayal in order to hurt the woman and destroy her self-esteem and success. Based on numerous studies and bibliography it is demonstrated that the main cause of violence by the intimate partner is the fear of the power of the feminine that has been present throughout history. Despite the evolution of women, historical violence reverberates in the 21st century as an intergenerational trauma causing great suffering in families and disturbances in interpersonal relationships.
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Santos EG, Roque L, Maya MC, Moreira RC, Lima FL, Correia MITD. PERCEPTION OF HARASSMENT AMONG FEMALE SURGEONS. Rev Col Bras Cir 2021; 48:e20213123. [PMID: 34468506 PMCID: PMC10683461 DOI: 10.1590/0100-6991e-20213123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION the attraction of women by Surgery has always existed. Although Surgery has been considered a specialty for men, several women chose it, despite gender bias issues that have persisted over many years. Several obstacles have impacted the practice of women surgeons, leading them to abandon the profession, while others, perhaps bearers of a stronger spirit, managed to overcome them, and won. OBJECTIVE to assess the rates of perception of harassment against female surgeons as a cause of difficulty and negative feelings related to the specialty. METHODS we conducted a quantitative and qualitative (personal accounts) research through a questionnaire via Google Forms® sent to all women surgeons registered in the Brazilian College of Surgeons and in a WhatsApp women surgeons' groups. The qualitative analysis was made with the Wordle® app. RESULTS from 821 questionnaires sent, we obtained 232 responses (28.2%). Harassment perception during training was 49.1% (n=114). From the women surgeons who perceived harassment, 56.1% reported having undergone different training than expected, with statistical significance (p<0.001). The question of having been treated differently due to being a woman also had an impact on harassment perception (77.2% harassed vs 47.5%; p<0.001). Physical (42.1% vs 6.8%) and emotional (92.1% vs 39.8%) threats were also different between groups. CONCLUSION women surgeons still report great harassment perception, both moral and sexual, which impacts their feelings about the specialty.
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Affiliation(s)
- Elizabeth G Santos
- - Hospital Universitário Clementino Fraga Filho - UFRJ, Membro da Comissão de Mulheres Cirurgiãs - CBC, FACS, PhD - Rio de Janeiro - RJ - Brasil
| | - Lia Roque
- - Universidade Federal do Rio de Janeiro, Membro da Comissão de Mulheres Cirurgiãs - CBC, PhD - Rio de Janeiro - RJ - Brasil
| | - Maria Cristina Maya
- - Universidade Federal do Rio de Janeiro, Membro da Comissão de Mulheres Cirurgiãs - CBC, PhD - Rio de Janeiro - RJ - Brasil
| | - Reni Cecilia Moreira
- - UNIBH, Membro da Comissão de Mulheres Cirurgiãs - CBC, ACS, Md, PhD - Belo Horizonte - MG - Brasil
| | - Fernanda Lage Lima
- - Universidade Federal do Acre, Secretaria de Estado de Saúde do Acre, Membro da Comissão de Mulheres Cirurgiã - Rio Branco - AC - Brasil
| | - M Isabel T D Correia
- - Universidade Federal de Minas Gerais, Membro da equipe Eterna, Rede Mater Dei, Membro da Comissão de Mulheres Cirurgiãs - CBC, FACS - Belo Horizonte - MG - Brasil
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Oliveira JC, Barros MPS, Barreto IDDC, Silva RC, Andrade VA, Oliveira ADM, Lima TCRM, Oliveira JC, Arcelino LAM, Oliveira LCS, Santana-Santos E, Almeida-Santos MA, Sousa AC, Barreto JAS. Access to Reperfusion Therapy and Mortality in Women with ST-Segment-Elevation Myocardial Infarction: VICTIM Register. Arq Bras Cardiol 2021; 116:695-703. [PMID: 33886713 PMCID: PMC8121383 DOI: 10.36660/abc.20190468] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 01/23/2020] [Accepted: 03/16/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Myocardial reperfusion is a fundamental part of the treatment for ST elevation myocardial infarction (STEMI) and is responsible for reducing morbidity and mortality in affected patients. However, reperfusion rates are usually lower and mortality rates higher in women compared to men. OBJECTIVES To evaluate the prevalence of the use of reperfusion therapies among women and men with STEMI in hospitals where percutaneous coronary intervention (PCI) is available in the state of Sergipe. METHODS This is a cross-sectional study that used data from the VICTIM Register. Patients diagnosed with STEMI admitted to the four hospitals (one public and three private) where PCI is available in the state of Sergipe were evaluated, from December 2014 to June 2018. A multivariate analysis with adjusted model using mortality as a dependent variable was made. In all analyses, the level of significance adopted was 5% (p < 0.05). RESULTS A total of 878 volunteers with a confirmed diagnosis of STEMI, of which 33.4% were women, were included in the study. Only 53.3% of the patients underwent myocardial reperfusion (134 women versus 334 men). Fibrinolysis was performed only in 2.3% of all patients (1.7% of women versus 2.6% of men; p = 0.422). The rate of primary PCI was lower (44% versus 54.5%; p = 0.003) and hospital mortality was higher (16.1% versus 6.7%; p < 0.001) in women than in men. CONCLUSION Women have significantly lower rates of primary PCI and higher hospital mortality. Reperfusion rates were low in both sexes and there was a clear underutilization of thrombolytic agents.
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Affiliation(s)
- Jussiely Cunha Oliveira
- Universidade Federal de SergipeNúcleo de Pós-Graduação em Ciências da SaúdeSão CristóvãoSEBrasilUniversidade Federal de Sergipe - Núcleo de Pós-Graduação em Ciências da Saúde, São Cristóvão, SE - Brasil.
- Universidade Federal de SergipeNúcleo de Pós-graduação em EnfermagemSão CristóvãoSEBrasilUniversidade Federal de Sergipe - Núcleo de Pós-graduação em Enfermagem, São Cristóvão, SE - Brasil.
| | - Mayse Pereira Souza Barros
- Universidade Federal de SergipeSão CristóvãoSEBrasilUniversidade Federal de Sergipe – Medicina, São Cristóvão, SE - Brasil.
| | - Ikaro Daniel de Carvalho Barreto
- Universidade Federal Rural de PernambucoNúcleo de Pós-graduação em biometria e estatística aplicadaRecifePEBrasilUniversidade Federal Rural de Pernambuco - Núcleo de Pós-graduação em biometria e estatística aplicada, Recife, PE - Brasil.
| | - Rubens Cruz Silva
- Universidade Federal de SergipeSão CristóvãoSEBrasilUniversidade Federal de Sergipe – Medicina, São Cristóvão, SE - Brasil.
| | - Volfanio Araújo Andrade
- Universidade Federal de SergipeSão CristóvãoSEBrasilUniversidade Federal de Sergipe – Medicina, São Cristóvão, SE - Brasil.
| | - André de Melo Oliveira
- Universidade Federal de SergipeSão CristóvãoSEBrasilUniversidade Federal de Sergipe – Medicina, São Cristóvão, SE - Brasil.
| | - Ticiane Clair Remacre Munareto Lima
- Universidade Federal de SergipeNúcleo de Pós-Graduação em Ciências da SaúdeSão CristóvãoSEBrasilUniversidade Federal de Sergipe - Núcleo de Pós-Graduação em Ciências da Saúde, São Cristóvão, SE - Brasil.
| | - Jeferson Cunha Oliveira
- Universidade Federal de SergipeNúcleo de Pós-Graduação em Ciências da SaúdeSão CristóvãoSEBrasilUniversidade Federal de Sergipe - Núcleo de Pós-Graduação em Ciências da Saúde, São Cristóvão, SE - Brasil.
- Hospital PrimaveraAracajuSEBrasilHospital Primavera, Aracaju, SE - Brasil.
| | - Larissa Andreline Maia Arcelino
- Universidade Federal de SergipeNúcleo de Pós-Graduação em Ciências da SaúdeSão CristóvãoSEBrasilUniversidade Federal de Sergipe - Núcleo de Pós-Graduação em Ciências da Saúde, São Cristóvão, SE - Brasil.
- Universidade Federal de SergipeHospital UniversitárioAracajuSEBrasilHospital Universitário da Universidade Federal de Sergipe (HU-UFS), Aracaju, SE - Brasil.
| | - Laís Costa Souza Oliveira
- Universidade Federal de SergipeNúcleo de Pós-Graduação em Ciências da SaúdeSão CristóvãoSEBrasilUniversidade Federal de Sergipe - Núcleo de Pós-Graduação em Ciências da Saúde, São Cristóvão, SE - Brasil.
- Hospital PrimaveraAracajuSEBrasilHospital Primavera, Aracaju, SE - Brasil.
| | - Eduesley Santana-Santos
- Universidade Federal de SergipeNúcleo de Pós-graduação em EnfermagemSão CristóvãoSEBrasilUniversidade Federal de Sergipe - Núcleo de Pós-graduação em Enfermagem, São Cristóvão, SE - Brasil.
| | - Marcos Antônio Almeida-Santos
- Universidade TiradentesPrograma de Pós-graduação em Saúde e AmbienteAracajuSEBrasilPrograma de Pós-graduação em Saúde e Ambiente da Universidade Tiradentes, Aracaju, SE - Brasil.
| | - Antônio Carlos Sousa
- Universidade Federal de SergipeNúcleo de Pós-Graduação em Ciências da SaúdeSão CristóvãoSEBrasilUniversidade Federal de Sergipe - Núcleo de Pós-Graduação em Ciências da Saúde, São Cristóvão, SE - Brasil.
- Universidade Federal de SergipeSão CristóvãoSEBrasilUniversidade Federal de Sergipe – Medicina, São Cristóvão, SE - Brasil.
- Fundação São LucasCentro de Ensino e PesquisaAracajuSEBrasilFundação São Lucas - Centro de Ensino e Pesquisa, Aracaju, SE - Brasil.
- Universidade Federal de SergipeHospital UniversitárioDivisão de CardiologiaSão CristóvãoSEBrasilUniversidade Federal de Sergipe - Divisão de Cardiologia do Hospital Universitário, São Cristóvão, SE - Brasil.
| | - José Augusto Soares Barreto
- Universidade Federal de SergipeNúcleo de Pós-Graduação em Ciências da SaúdeSão CristóvãoSEBrasilUniversidade Federal de Sergipe - Núcleo de Pós-Graduação em Ciências da Saúde, São Cristóvão, SE - Brasil.
- Universidade Federal de SergipeSão CristóvãoSEBrasilUniversidade Federal de Sergipe – Medicina, São Cristóvão, SE - Brasil.
- Fundação São LucasCentro de Ensino e PesquisaAracajuSEBrasilFundação São Lucas - Centro de Ensino e Pesquisa, Aracaju, SE - Brasil.
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Schmidt K, Lima ADS, Schmitt KR, Moraes MA, Schmidt MM. Stress in Women with Acute Myocardial Infarction: A Closer Look. Arq Bras Cardiol 2020; 115:649-657. [PMID: 33111864 PMCID: PMC8386975 DOI: 10.36660/abc.20190282] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 08/19/2019] [Accepted: 09/10/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Women seem to be more susceptible to psychosocial stress than men, and stress is associated with worse outcomes after acute myocardial infarction (AMI). OBJECTIVES To investigate whether the female gender is an independent predictor of risk for stress and to compare stress levels between women and men after AMI. METHODS Cross-sectional study of a case series. Patients aged 18 to 65 years who were treated for AMI at the study facility between January 2017 and June 2018 were eligible. The presence of stress was assessed using Lipp's Stress Symptoms Inventory for Adults (ISSL), which categorizes stress into four phases (alertness, resistance, near-exhaustion, and exhaustion), through a list of physical and psychological symptoms. Data were analyzed using SPSS Version 24.0. The significance level was set at p<0.05. RESULTS Of the 330 respondents, 89% of women and 70% of men experienced stress. The female gender was associated with nearly threefold higher odds of experiencing stress (EXP (B)2.79, p = 0.02). Regarding the phases of stress, women were more often in the near-exhaustion and exhaustion phases, while men were more often in the resistance phase. CONCLUSIONS This study showed that women are most often in the third and fourth phases of stress, i.e., in situations of long-standing psychosocial stress. These findings can assist in the development of gender-specific strategies for health promotion and disease prevention, aiming to minimize the effects of stress in this population.
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Affiliation(s)
- Karine Schmidt
- Instituto de CardiologiaPorto AlegreRSBrasilInstituto de Cardiologia, Porto Alegre, RS – Brasil
| | - Aline da Silva Lima
- Instituto de CardiologiaPorto AlegreRSBrasilInstituto de Cardiologia, Porto Alegre, RS – Brasil
| | - Kelly Rocha Schmitt
- Instituto de CardiologiaPorto AlegreRSBrasilInstituto de Cardiologia, Porto Alegre, RS – Brasil
| | - Maria Antonieta Moraes
- Instituto de CardiologiaPorto AlegreRSBrasilInstituto de Cardiologia, Porto Alegre, RS – Brasil
| | - Marcia Moura Schmidt
- Instituto de CardiologiaPorto AlegreRSBrasilInstituto de Cardiologia, Porto Alegre, RS – Brasil
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Gaino LV, de Almeida LY, de Oliveira JL, Nievas AF, Saint-Arnault D, de Souza J. The role of social support in the psychological illness of women. Rev Lat Am Enfermagem 2019; 27:e3157. [PMID: 31340345 PMCID: PMC6687359 DOI: 10.1590/1518-8345.2877.3157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 02/19/2019] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to analyze the relationship between perception of social support and emotional and physical symptoms associated with psychiatric conditions among women. METHOD a cross-sectional, quantitative study was carried out with a randomized random sample of 141 women attended at a Family Health Unit of the city of Ribeirão Preto/SP. A sociodemographic questionnaire, the Social Support Questionnaire and the Self-Report Questionnaire were used. RESULTS there was no association between sociodemographic characteristics and mental disorder, but between aspects such as low income and schooling. The exercise of professions culturally considered as of low prestige gave rise to some reflections related to gender inequality. There was a significant difference in the satisfaction scores between the women who reported or not the symptoms of tiredness and sadness and the number of supporters among those who reported or not the symptom of fatigue. Spouses and children were the most mentioned supporters, and having mental disorder was significantly associated with having no friends in the support network. CONCLUSION issues related to gender equity and satisfaction with social support are important aspects of care. For the promotion of mental health, efforts must be made to make women feel more connected and supported by the supporters available in their social environment.
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Affiliation(s)
| | - Letícia Yamawaka de Almeida
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão
Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em
Enfermagem, Ribeirão Preto, SP, Brasil
- Bolsista da Coordenação de Aperfeiçoamento de Pessoal de Nível
Superior (CAPES), Brasil
| | - Jaqueline Lemos de Oliveira
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão
Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em
Enfermagem, Ribeirão Preto, SP, Brasil
| | - Andreia Fernanda Nievas
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão
Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em
Enfermagem, Ribeirão Preto, SP, Brasil
| | | | - Jacqueline de Souza
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão
Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em
Enfermagem, Ribeirão Preto, SP, Brasil
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Palmeira CS, Mussi FC, Santos CASDT, Lima ML, Ladeia AMT, Silva LCDJ. Effect of remote nursing monitoring on overweight in women: clinical trial. Rev Lat Am Enfermagem 2019; 27:e3129. [PMID: 30916230 PMCID: PMC6432992 DOI: 10.1590/1518-8345.2651.3129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 11/13/2018] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE to evaluate the effect of remote nursing monitoring on the improvement of anthropometric measurements of overweight women. METHOD controlled, randomized clinical trial, carried out in a reference outpatient clinic for treatment of obesity. The baseline sample was composed of 101 women randomly assigned to two groups, 51 in the intervention group (IG) and 50 in the control group (CG). The IG received remote monitoring through telephone calls and conventional monitoring, and the CG received conventional monitoring. Women were assessed at the baseline and after three months of intervention. A paired t-test and analysis of covariance were used to evaluate intragroup differences in anthropometric measurements, and the statistical significance of 5% was adopted. Eighty one women completed the study. RESULTS in the intergroup comparison after the intervention, a reduction of 1.66 kg in the mean weight (p = 0.017) and of 0.66 kg/m2 in the mean BMI (p = 0.015) was found in the intervention group. There was a borderline statistically significant (p = 0.055) reduction of 2.5 cm in WC with in the intervention group. CONCLUSION the remote monitoring was beneficial in reducing anthropometric measurements. RBR-3hzdgv.
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Affiliation(s)
- Catia Suely Palmeira
- Universidade Federal da Bahia, Serviço Médico Universitário Rubens Brasil, Salvador, BA, Brazil
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de Freitas JP, Silvestri MPI, Fernandes CE, de Oliveira E. Evaluation of quality of sleep in women with stress urinary incontinence before and after surgical correction. Einstein (Sao Paulo) 2018; 16:eAO4205. [PMID: 29947643 PMCID: PMC6019242 DOI: 10.1590/s1679-45082018ao4205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 01/30/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the quality of sleep in women with urinary incontinence before and after sling surgery. METHODS A prospective study of case series of women with urodynamic diagnosis of stress urinary incontinence. To evaluate the subjective quality of sleep, two specific questionnaires were used and validated for the Portuguese Language: Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index. The questionnaires were applied before and 6 months after surgical repair. RESULTS When analyzing the Epworth Sleepiness Scale, there was an improvement in sleep quality (p=0.0401). For the Pittsburgh Sleep Quality Index, only for sleep disorder there was improvement in quality of sleep after surgery (p=0.0127). CONCLUSION Women with urinary incontinence, submitted to surgery with sling, showed improvement in both quality of sleep and sleep disorder.
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López MB, Lichtenberger A, Conde K, Cremonte M. Psychometric Properties of Brief Screening Tests for Alcohol Use Disorders during Pregnancy in Argentina. Rev Bras Ginecol Obstet 2017; 39:322-329. [PMID: 28609804 PMCID: PMC10416172 DOI: 10.1055/s-0037-1603744] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 03/15/2017] [Indexed: 10/19/2022] Open
Abstract
Background Considering the physical, mental and behavioral problems related to fetal alcohol exposure, prenatal clinical guides suggest a brief evaluation of alcohol consumption during pregnancy to detect alcohol intake and to adjust interventions, if required. Even if any alcohol use should be considered risky during pregnancy, identifying women with alcohol use disorders is important because they could need a more specific intervention than simple advice to abstain. Most screening tests have been developed and validated in male populations and focused on the long-term consequences of heavy alcohol use, so they might be inappropriate to assess consumption in pregnant women. Objective To analyze the internal reliability and validity of the alcohol screening instruments Alcohol Use Disorders Identification Test (AUDIT), Alcohol Use Disorders Identification Test - Consumption (AUDIT-C), Tolerance, Worried, Eye-Opener, Amnesia and Cut-Down (TWEAK), Rapid Alcohol Problems Screen - Quantity Frequency (RAPS-QF) and Tolerance, Annoyed, Cut-Down and Eye-Opener (T-ACE) to identify alcohol use disorders in pregnant women. Methods A total of 641 puerperal women were personally interviewed during the 48 hours after delivery. The receiver operating characteristics (ROC) curves and the sensitivity and specificity of each instrument using different cut-off points were analyzed. Results All instruments showed areas under the ROC curves above 0.80. Larger areas were found for the TWEAK and the AUDIT. The TWEAK, the T-ACE and the AUDIT-C showed higher sensitivity, while the AUDIT and the RAPS-QF showed higher specificity. Reliability (internal consistency) was low for all instruments, improving when optimal cut-off points were used, especially for the AUDIT, the AUDIT-C and the RAPS-QF. Conclusions In other cultural contexts, studies have concluded that T-ACE and TWEAK are the best instruments to assess pregnant women. In contrast, our results evidenced the low reliability of those instruments and a better performance of the AUDIT in this population.
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Affiliation(s)
- Mariana Beatriz López
- Centro Interdisciplinario de Investigaciones en Psicología Matemática y Experimental (Interdisciplinary Center of Mathematics and Experimental Psychology Research), Consejo Nacional de Investigaciones Científicas y Técnicas (National Council of Scientific and Technological Research, CONICET), Buenos Aires, Argentina
| | - Aldana Lichtenberger
- Instituto de Psicología Básica, Aplicada y Tecnología (Institute of Basic Applied Psychology and Technology); Universidad Nacional de Mar del Plata; CONICET, Buenos Aires, Argentina
| | - Karina Conde
- Instituto de Psicología Básica, Aplicada y Tecnología (Institute of Basic Applied Psychology and Technology); Universidad Nacional de Mar del Plata; CONICET, Buenos Aires, Argentina
| | - Mariana Cremonte
- Instituto de Psicología Básica, Aplicada y Tecnología (Institute of Basic Applied Psychology and Technology); Universidad Nacional de Mar del Plata; CONICET, Buenos Aires, Argentina
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Menezes MDPN, Oshima CTF, Filho LB, Gomes TS, Barrezueta LFM, Stávale JN, Gonçalves WJ. Canonical and noncanonical Wnt pathways: a comparison between endometrial cancer type I and atrophic endometrium in Brazil. SAO PAULO MED J 2011; 129:320-4. [PMID: 22069131 PMCID: PMC10868946 DOI: 10.1590/s1516-31802011000500007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2010] [Revised: 04/27/2011] [Accepted: 05/12/2011] [Indexed: 12/16/2022] Open
Abstract
CONTEXT AND OBJECTIVE The Wnt pathway is involved in tumorigenesis of several tissues. For this reason, we proposed to evaluate Wnt gene expression in endometrial cancer type I. DESIGN AND SETTING Cross-sectional study on materials gathered from the tissue bank of the Department of Pathology, Universidade Federal de São Paulo. METHODS Endometrial specimens were obtained from surgeries performed between 1995 and 2005 at São Paulo Hospital, Universidade Federal de São Paulo. The material was divided into two groups according to tissue type: Group A, atrophic endometrium (n = 15); and Group B, endometrial adenocarcinoma (n = 45). We compared the immunohistochemical expression of Wnt1, Frizzled-1 (FZD1), Wnt5a, Frizzled-5 (FZD5) and beta-catenin between endometrial cancer type I and atrophic endometrium. RESULTS Regarding Wnt1, FZD1 and Wnt5a expression, no significant association was observed between the groups. A significant association was observed between the groups in relation to FZD5 expression (P = 0.001). The proportion of FZD5-positive samples was significantly higher in group A (80.0%) than in group B (31.1%). Regarding the survival curve for FZD5 in group B, we did not find any significant association between atrophic endometrium and endometrial adenocarcinoma. We also did not find any significant association regarding beta-catenin expression (P = 1.000). CONCLUSION FZD5 is downregulated in endometrial adenocarcinoma, in comparison with atrophic endometrium.
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Affiliation(s)
- Marina de Pádua Nogueira Menezes
- Gynecological Oncology Sector, Department of Gynecology, Universidade Federal de São Paulo-Escola Paulista de Medicina, São Paulo, Brazil.
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