Base de dados : MEDLINE
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[PMID]:29370220
[Au] Autor:Jayaweera RT; Ngui FM; Hall KS; Gerdts C
[Ad] Endereço:Ibis Reproductive Health, Oakland, California, United States of America.
[Ti] Título:Women's experiences with unplanned pregnancy and abortion in Kenya: A qualitative study.
[So] Source:PLoS One;13(1):e0191412, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Safe and legal abortions are rarely practiced in the public health sector in Kenya, and rates of maternal mortality and morbidity from unsafe abortion is high. Little is known about women's experiences seeking and accessing abortion in informal settlements in Nairobi, Kenya. METHODS: Seven focus group discussions were conducted with a total of 71 women and girls recruited from an informal settlement in Nairobi. The interview guide explored participants' perceptions of unplanned pregnancy, abortion, and access to sexual and reproductive health information in their community. Thematic analysis of the focus group transcripts was conducted using MAX QDA Release 12. RESULTS: Participants described a variety of factors that influence women's experiences with abortion in their communities. According to participants, limited knowledge of sexual and reproductive health information and lack of access to contraception led to unplanned pregnancy among women in their community. Participants cited stigma and loss of opportunities that women with unplanned pregnancies face as the primary reasons why women seek abortions. Participants articulated stigma as the predominant barrier women in their communities face to safe abortion. Other barriers, which were often interrelated to stigma, included lack of education about safe methods of abortion, perceived illegality of abortion, as well as limited access to services, fear of mistreatment, and mistrust of health providers and facilities. CONCLUSIONS: Women in informal settlements in Nairobi, Kenya face substantial barriers to regulating their fertility and lack access to safe abortion. Policy makers and reproductive health advocates should support programs that employ harm reduction strategies and increase women's knowledge of and access to medication abortion outside the formal healthcare system.
[Mh] Termos MeSH primário: Aborto Induzido
Gravidez não Planejada
[Mh] Termos MeSH secundário: Aborto Induzido/psicologia
Acesso à Informação
Adolescente
Adulto
Comportamento Contraceptivo
Feminino
Grupos Focais
Educação em Saúde
Acesso aos Serviços de Saúde
Seres Humanos
Comportamento de Busca de Informação
Quênia
Gravidez
Gravidez não Planejada/psicologia
Comportamento Reprodutivo
Estigma Social
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180126
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191412


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[PMID]:29193167
[Au] Autor:Yao H; Chan CHY; Chan CLW
[Ad] Endereço:Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong.
[Ti] Título:Childbearing importance: A qualitative study of women with infertility in China.
[So] Source:Res Nurs Health;41(1):69-77, 2018 02.
[Is] ISSN:1098-240X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The primary goal of this study was to examine and describe the importance of childbearing as perceived by infertile women in the Chinese familial and social context. We adopted a qualitative descriptive method and conducted semi-structured interviews with female patients diagnosed with infertility. Participants were recruited at a high-volume fertility clinic in Tianjin, China. Fifteen women with a diagnosis of infertility were interviewed for 60-90 min. Data were analyzed by thematic analysis. Two themes supported the importance of childbearing for Chinese women with infertility: childbearing as natural law, and childbearing for relational harmony. Childbearing as natural law referred to intrinsic forces to seek a child, including (i) achieving motherhood and womanhood and (ii) experiencing a developmental transition with childbearing as a landmark. Relational harmony included three primary factors: (i) to maintain marital quality by preventing marital failure and rejuvenating an unsatisfactory marital relationship; (ii) to fulfill both authoritative and reciprocal filial piety; (iii) to build a sense of normalcy within family and social networks. In summary, infertility resulted in loss of motherhood, womanhood, and a smooth developmental transition. Moreover, it threatened relationship harmony in the marriage, family, and social life. These insights on the value of childbearing in the Chinese context can inform healthcare professionals in identify infertility-related demands and developing relevant psychosocial services for people with infertility.
[Mh] Termos MeSH primário: Adaptação Psicológica
Infertilidade Feminina/psicologia
Comportamento Reprodutivo/psicologia
Estresse Psicológico
[Mh] Termos MeSH secundário: Adulto
China
Feminino
Seres Humanos
Meia-Idade
Pesquisa Qualitativa
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM; N
[Da] Data de entrada para processamento:171202
[St] Status:MEDLINE
[do] DOI:10.1002/nur.21846


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[PMID]:28333354
[Au] Autor:Hammarberg K; Collins V; Holden C; Young K; McLachlan R
[Ad] Endereço:Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne 3004, Australia.
[Ti] Título:Men's knowledge, attitudes and behaviours relating to fertility.
[So] Source:Hum Reprod Update;23(4):458-480, 2017 Jul 01.
[Is] ISSN:1460-2369
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The increasingly common practice in high-income countries to delay childbearing to the fourth and fifth decades of life increases the risk of involuntary childlessness or having fewer children than desired. Older age also increases the risk of age-related infertility, the need for ART to conceive, and obstetric and neonatal complications. Existing research relating to childbearing focusses almost exclusively on women, and in public discourse declining fertility rates are often assumed to be the result of women delaying childbearing to pursue other life goals such as a career and travel. However, evidence suggests that the lack of a partner or a partner willing to commit to parenthood is the main reason for later childbearing. OBJECTIVE AND RATIONALE: To better understand men's contributions to childbearing decisions and outcomes, the literature pertaining to men's fertility-related knowledge, attitudes and behaviours was reviewed. SEARCH METHODS: The electronic databases of Medline, Embase and PsycINFO were searched to identify investigations of men's knowledge, attitudes and behaviours relating to fertility, infertility, reproductive health or childbearing using relevant fertility keyword search terms. Studies were included if they had investigated factors associated with men's fertility-related knowledge, attitudes and behaviours, had been conducted in a high-income country and were published in an English language peer-reviewed journal between January 2005 and August 2016. OUTCOMES: The search yielded 1349 citations. Of these, 47 papers representing 43 unique studies were included in the review. Where response rate was reported, it ranged between 13 and 94%. Studies varied in terms of research design; inclusion and exclusion criteria; recruitment strategies; adequacy of sample size; recruitment and retention rates and data collection tools. However, findings were consistent and indicate that men almost universally value parenthood, want and expect to become fathers, and aspire to have at least two children. Yet most men have inadequate knowledge about the limitations of female and male fertility and overestimate the chance of spontaneous and assisted conception. Perceptions of ideal circumstances in which to have children included being in a stable and loving relationship, having completed studies, secured a permanent job and a dependable income, having achieved personal maturity, and having a partner who desires children and is 'suitable' as a potential co-parent. Although all studies were conducted in high-income countries, between-country social and cultural differences may have influenced the findings relating to attitudes. WIDER IMPLICATIONS: Men aspire to parenthood as much as women do but have limited knowledge about the factors that influence fertility. The gap between ideal biological and ideal social age for having children appears to be widening, narrowing the time frame in which parenthood can be achieved. This may lead to unfulfilled parenthood aspirations. The findings can inform government policies and public education strategies aimed to support childbearing during the most fertile years, reduce the personal and societal cost of infertility and ART use, and allow people to fulfil their parenthood goals.
[Mh] Termos MeSH primário: Fertilidade
Conhecimentos, Atitudes e Prática em Saúde
Infertilidade/psicologia
Homens/psicologia
Comportamento Reprodutivo/psicologia
[Mh] Termos MeSH secundário: Tomada de Decisões
Feminino
Alfabetização em Saúde
Seres Humanos
Masculino
Pais/psicologia
Saúde Reprodutiva/educação
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171025
[Lr] Data última revisão:
171025
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170324
[St] Status:MEDLINE
[do] DOI:10.1093/humupd/dmx005


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[PMID]:28322775
[Au] Autor:Luke B
[Ad] Endereço:Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, East Lansing, MI. Electronic address: lukeb@msu.edu.
[Ti] Título:Pregnancy and birth outcomes in couples with infertility with and without assisted reproductive technology: with an emphasis on US population-based studies.
[So] Source:Am J Obstet Gynecol;217(3):270-281, 2017 Sep.
[Is] ISSN:1097-6868
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Infertility, defined as the inability to conceive within 1 year of unprotected intercourse, affects an estimated 80 million individuals worldwide, or 10-15% of couples of reproductive age. Assisted reproductive technology includes all infertility treatments to achieve conception; in vitro fertilization is the process by which an oocyte is fertilized by semen outside the body; non-in vitro fertilization assisted reproductive technology treatments include ovulation induction, artificial insemination, and intrauterine insemination. Use of assisted reproductive technology has risen steadily in the United States during the past 2 decades due to several reasons, including childbearing at older maternal ages and increasing insurance coverage. The number of in vitro fertilization cycles in the United States has nearly doubled from 2000 through 2013 and currently 1.7% of all live births in the United States are the result of this technology. Since the birth of the first child from in vitro fertilization >35 years ago, >5 million babies have been born from in vitro fertilization, half within the past 6 years. It is estimated that 1% of singletons, 19% of twins, and 25% of triplet or higher multiples are due to in vitro fertilization, and 4%, 21%, and 52%, respectively, are due to non-in vitro fertilization assisted reproductive technology. Higher plurality at birth results in a >10-fold increase in the risks for prematurity and low birthweight in twins vs singletons (adjusted odds ratio, 11.84; 95% confidence interval, 10.56-13.27 and adjusted odds ratio, 10.68; 95% confidence interval, 9.45-12.08, respectively). The use of donor oocytes is associated with increased risks for pregnancy-induced hypertension (adjusted odds ratio, 1.43; 95% confidence interval, 1.14-1.78) and prematurity (adjusted odds ratio, 1.43; 95% confidence interval, 1.11-1.83). The use of thawed embryos is associated with higher risks for pregnancy-induced hypertension (adjusted odds ratio, 1.30; 95% confidence interval, 1.08-1.57) and large-for-gestation birthweight (adjusted odds ratio, 1.74; 95% confidence interval, 1.45-2.08). Among singletons, in vitro fertilization is associated with increased risk of severe maternal morbidity compared with fertile deliveries (vaginal: adjusted odds ratio, 2.27; 95% confidence interval, 1.78-2.88; cesarean: adjusted odds ratio, 1.67; 95% confidence interval, 1.40-1.98, respectively) and subfertile deliveries (vaginal: adjusted odds ratio, 1.97; 95% confidence interval, 1.30-3.00; cesarean: adjusted odds ratio, 1.75; 95% confidence interval, 1.30-2.35, respectively). Among twins, cesarean in vitro fertilization deliveries have significantly greater severe maternal morbidity compared to cesarean fertile deliveries (adjusted odds ratio, 1.48; 95% confidence interval, 1.14-1.93). Subfertility, with or without in vitro fertilization or non-in vitro fertilization infertility treatments to achieve a pregnancy, is associated with increased risks of adverse maternal and perinatal outcomes. The major risk from in vitro fertilization treatments of multiple births (and the associated excess of perinatal morbidity) has been reduced over time, with fewer and better-quality embryos being transferred.
[Mh] Termos MeSH primário: Fertilização In Vitro
Infertilidade/terapia
Resultado da Gravidez
[Mh] Termos MeSH secundário: Anormalidades Congênitas
Criopreservação
Transferência Embrionária
Feminino
Hospitalização
Seres Humanos
Idade Materna
Sobrepeso/complicações
Gravidez
Complicações na Gravidez
Gravidez Múltipla
Nascimento Prematuro
Comportamento Reprodutivo
Injeções de Esperma Intracitoplásmicas
Gêmeos Monozigóticos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170322
[St] Status:MEDLINE


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[PMID]:28320139
[Au] Autor:Stieglbauer K; Pichler R; Topakian R
[Ad] Endereço:Consultant Neurologist in Private Practice, Linz, Austria. Electronic address: stieglbauer@aol.at.
[Ti] Título:10-year-outcomes after rituximab for myasthenia gravis: Efficacy, safety, costs of inhospital care, and impact on childbearing potential.
[So] Source:J Neurol Sci;375:241-244, 2017 Apr 15.
[Is] ISSN:1878-5883
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Rituximab (RTX) has emerged as an attractive off-label treatment option for patients with myasthenia gravis (MG) refractory to other immune therapies. However, data on long-term outcome after RTX for MG are still scarce. Here we present the 10-year outcomes [median (range) 10.1 (6.7-11.2) years] with respect to efficacy, safety, costs of inhospital care, and impact on childbearing potential in all four MG patients treated by one of the authors with RTX. In all patients, RTX led to sustained clinical improvement and eventual tapering of other immune therapies. RTX was well tolerated, and complications were not observed. After the start of RTX, annual costs for hospital admissions were markedly reduced compared to costs in the year preceding RTX. Under close clinical observation, two patients had uncomplicated pregnancies giving birth to a healthy child. With regard to its efficacy, excellent tolerance, lack of complications, low frequency of repeat infusions and pending patent expiry in many countries, RTX appears to compare favourably with other immune therapies used for MG. Multicentre trials and registries are urgently needed to further address long-term safety issues and clarify the efficacy and role of RTX in managing MG.
[Mh] Termos MeSH primário: Hospitalização/economia
Fatores Imunológicos/uso terapêutico
Miastenia Gravis/tratamento farmacológico
Miastenia Gravis/economia
Comportamento Reprodutivo/fisiologia
Rituximab/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Autoanticorpos/sangue
Estudos de Coortes
Feminino
Seres Humanos
Imunoglobulinas Intravenosas
Meia-Idade
Miastenia Gravis/imunologia
Miastenia Gravis/psicologia
Receptores Proteína Tirosina Quinases/imunologia
Receptores Colinérgicos/imunologia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Autoantibodies); 0 (Immunoglobulins, Intravenous); 0 (Immunologic Factors); 0 (Receptors, Cholinergic); 4F4X42SYQ6 (Rituximab); EC 2.7.10.1 (MUSK protein, human); EC 2.7.10.1 (Receptor Protein-Tyrosine Kinases)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170705
[Lr] Data última revisão:
170705
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170322
[St] Status:MEDLINE


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[PMID]:28277356
[Au] Autor:Pryor J; Patrick SW; Sundermann AC; Wu P; Hartmann KE
[Ad] Endereço:Department of Pediatrics, the Mildred Stahlman Division of Neonatology, the Vanderbilt Center for Health Services Research, the Department of Health Policy, the Vanderbilt Center for Addiction Research, the Institute for Medicine and Public Health, the Department of Biostatistics, and the Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, Tennessee.
[Ti] Título:Pregnancy Intention and Maternal Alcohol Consumption.
[So] Source:Obstet Gynecol;129(4):727-733, 2017 Apr.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate whether women planning a pregnancy are less likely to use alcohol in early pregnancy than those with unintended pregnancies. METHODS: Right From the Start (2000-2012) is a prospective, community-based pregnancy cohort. Maternal demographic, reproductive, and behavioral data were collected in telephone interviews at enrollment (mean±standard deviation 48±13 days of gestation) and later in the first trimester (mean±standard deviation 85±21 days of gestation). Alcohol consumption characteristics were included in the interviews. We used logistic regression to investigate the association of pregnancy intention with alcohol use. RESULTS: Among 5,036 women, 55% reported using alcohol in the first trimester with 6% continuing use at the first-trimester interview. Pregnancy was planned by 70% of participants. Alcohol use occurred in 55% and 56% of intended and unintended pregnancies, respectively (P=.32). Adjusting for confounders, women with intended pregnancies were 31% less likely to consume any alcohol in early pregnancy (adjusted odds ratio [OR] 0.69, 95% confidence interval [CI] 0.60-0.81) or binge drink (adjusted OR 0.68, 95% CI 0.54-0.86). Most women, regardless of intention, stopped or decreased alcohol consumption in early pregnancy. CONCLUSION: The majority of women, irrespective of intention, stopped or decreased drinking after pregnancy recognition. This suggests promoting early pregnancy awareness could prove more effective than promoting abstinence from alcohol among all who could conceive.
[Mh] Termos MeSH primário: Consumo de Bebidas Alcoólicas
Intenção
Serviços Preventivos de Saúde
Comportamento Reprodutivo/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Consumo de Bebidas Alcoólicas/epidemiologia
Consumo de Bebidas Alcoólicas/prevenção & controle
Consumo de Bebidas Alcoólicas/psicologia
Estudos de Coortes
Feminino
Promoção da Saúde/métodos
Seres Humanos
Gravidez
Primeiro Trimestre da Gravidez/psicologia
Gravidez não Planejada/psicologia
Serviços Preventivos de Saúde/métodos
Serviços Preventivos de Saúde/organização & administração
Serviços de Saúde Reprodutiva/estatística & dados numéricos
Comportamento de Redução do Risco
Tennessee/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:171110
[Lr] Data última revisão:
171110
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170310
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000001933


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[PMID]:28119158
[Au] Autor:Elliott B; Muir C; deCatanzaro D
[Ad] Endereço:Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Ontario L8S 4K1, Canada.
[Ti] Título:Sources of variance within and among young men in concentrations of 17ß-estradiol and testosterone in axillary perspiration.
[So] Source:Physiol Behav;173:23-29, 2017 May 01.
[Is] ISSN:1873-507X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The most potent estrogen, 17ß-estradiol (E ), and its precursor, testosterone (T), play critical roles in mammalian reproductive processes. Evidence indicates that these steroids are present in bioactive form in the excretions of many male mammals. It has been demonstrated that small lipophilic steroids such as E can be absorbed by proximate females from male excretions, arriving in the uterus, brain, and other organs where there are estrogen receptors. We took repeated samples of axillary perspiration from men aged 20-30years during vigorous exercise. Both steroids were consistently measurable, with concentrations that ranged from values comparable to those in facial perspiration and urine of both men and women to values that greatly exceeded concentrations observed in any other substrate of men and women. Inter-individual variance in axillary E was positively correlated with the extent of intimate experience with women, as assessed by a questionnaire, but unrelated to subjective measures of stress, exercise habits, or phytoestrogen content of diet. In addition, higher levels of axillary E were observed in participants when samples were collected by a female (as compared to a male) experimenter. These data are concordant with an hypothesis that male excretion of sex steroids could exert pro-reproductive influences on proximate females.
[Mh] Termos MeSH primário: Axila
Estradiol/secreção
Exercício/fisiologia
Comportamento Reprodutivo/psicologia
Sudorese/fisiologia
Testosterona/secreção
[Mh] Termos MeSH secundário: Adulto
Seres Humanos
Masculino
Estatística como Assunto
Inquéritos e Questionários
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
3XMK78S47O (Testosterone); 4TI98Z838E (Estradiol)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170630
[Lr] Data última revisão:
170630
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170126
[St] Status:MEDLINE


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[PMID]:28085935
[Au] Autor:van Roode T; Sharples K; Dickson N; Paul C
[Ad] Endereço:Department of Preventive and Social Medicine, University of Otago Medical School, Dunedin, New Zealand.
[Ti] Título:Life-Course Relationship between Socioeconomic Circumstances and Timing of First Birth in a Birth Cohort.
[So] Source:PLoS One;12(1):e0170170, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: This study examines the influence of socioeconomic circumstances in childhood (childhood SES) and adulthood (adult SES) on timing of first birth by age 37. METHODS: A longitudinal study of a 1972-1973 New Zealand birth cohort collected information on socioeconomic characteristics from age 3-32 and reproductive histories at 21, 26, 32 and 38; information on first birth was available from 978 of the original 1037. Relative Risks (RR) and 95% Confidence Intervals (CI) were calculated using Poisson regression to examine first live birth prior to age 21, from 21-25, from 26-31, and from 32-37, by socioeconomic characteristics at different ages. RESULTS: Overall, 68.5% of men had fathered a child and 75.9% of women had given birth, by age 37; with overall differences in parenthood to age 31 for men, and 37 for women evident by childhood SES. While parenthood by age 20 was strongly associated with lower childhood SES for both sexes, first entry into motherhood from 32-37 was more likely with higher adult SES at age 32 (RR = 1.8, 95% CI 1.1-3.0 for medium and RR = 1.9, 95% CI 1.1-3.3 for high compared with low). Education also differientated age at parenthood, with those with higher education more likely to defer fatherhood past age 31, and motherhood past age 25 followed by a period of increased likelihood of motherhood for women with higher levels of education from age 32-37 (RR = 1.4, 95% CI 0.87-2.2 and RR = 1.7, 95% CI 1.1-2.6 for medium and high respectively compared with low). CONCLUSIONS: SES varies across the lifecourse, and SES at the time has the strongest association with first births at that time. Low childhood SES drives adolescent parenthood, with resulting cumulative differences in parenthood past age 30. Those with more education and higher adult SES are deferring parenthood but attempt to catch up in the mid to late thirties.
[Mh] Termos MeSH primário: Idade Materna
Idade Paterna
Comportamento Reprodutivo/psicologia
Fatores Socioeconômicos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Fatores Etários
Criança
Pré-Escolar
Escolaridade
Família/psicologia
Feminino
Seres Humanos
Estudos Longitudinais
Masculino
Nova Zelândia
Distribuição de Poisson
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170818
[Lr] Data última revisão:
170818
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170114
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0170170


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[PMID]:27931006
[Au] Autor:Bayraktar S; Arun B
[Ad] Endereço:Department of Medical Oncology, Memorial Medical Center, Istanbul, Turkey. Electronic address: soley.bayraktar@memorial.com.tr.
[Ti] Título:BRCA mutation genetic testing implications in the United States.
[So] Source:Breast;31:224-232, 2017 Feb.
[Is] ISSN:1532-3080
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BRCA mutation carriers have a very high risk of breast and ovarian cancer by age 70, in the ranges 47%-66% and 40%-57%, respectively. Additionally, women with BRCA mutation-associated breast cancer also have an elevated risk of other or secondary malignancies. Fortunately, the breast and ovarian cancer outcome for BRCA1/2 mutation carriers is at least as good as for non-carriers with chemoprevention, prophylactic surgeries and appropriate use of therapies. Therefore, identification of those who might have a mutation is important so that genetic counseling, testing, screening and prevention strategies can be applied in a timely manner. This article reviews the impact of genetic testing in general, timing of genetic testing after diagnosis and prior knowledge of mutation status in BRCA carriers with newly diagnosed breast cancer. Additionally, risk-reducing surgeries including the prophylactic contralateral mastectomy, and bilateral salpingo-oophorectomy and the sensitivity of BRCA-defective breast cancer cell lines to differential chemotherapeutic agents will be discussed.
[Mh] Termos MeSH primário: Neoplasias da Mama/genética
Neoplasias da Mama/prevenção & controle
Genes BRCA1
Genes BRCA2
Testes Genéticos
Neoplasias Ovarianas/prevenção & controle
[Mh] Termos MeSH secundário: Neoplasias da Mama/diagnóstico
Neoplasias da Mama/psicologia
Quimioprevenção
Feminino
Terapia de Reposição Hormonal
Seres Humanos
Mutação
Ovariectomia
Mastectomia Profilática
Comportamento Reprodutivo
Estados Unidos
Conduta Expectante
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170901
[Lr] Data última revisão:
170901
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161209
[St] Status:MEDLINE


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[PMID]:27915483
[Au] Autor:Raziano VT; Smoots AN; Haddad LB; Wall KM
[Ad] Endereço:a Department of Epidemiology , Emory University , Atlanta , GA , USA.
[Ti] Título:Factors associated with sterilization among HIV-positive US women in an urban outpatient clinic.
[So] Source:AIDS Care;29(5):612-617, 2017 May.
[Is] ISSN:1360-0451
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:This cross-sectional study sought to determine factors associated with sterilization among HIV-positive US women. HIV-positive women aged 18-45 completed an Audio Computer Assisted Self Interview (ACASI) questionnaire. Chi-square tests and multivariable logistic regression evaluated factors associated with sterilization. The median age of the 187 participants was 37, the majority had at least a high school education, and 88% were African American. Nearly a quarter (22%) of women had undergone sterilization at an average age of 25; of these women, 71% cited their HIV-positive status as an important factor in deciding to have a tubal ligation, 22% expressed desire for future children, 32% reported sterilization regret, and 20% reported feeling pressure to undergo sterilization. In multivariable analysis, factors significantly associated with sterilization included non-African American race, no desire for future pregnancy, having heard of any birth control methods making it harder to get pregnant in the future, belief that women should take a break from hormonal methods every few years, and having had a child born with HIV. While almost a quarter of this HIV-positive group was sterilized, many during the height of the early HIV epidemic, a large proportion of sterilized women expressed sterilization regret. Counseling messages for sterilized HIV-positive women should be sensitive to the fact that women may have regret regarding a decision that, in some cases, may historically have been part of provider recommendations to prevent vertical transmission of HIV. Improved knowledge about contraceptive options such as the IUD and implant is needed among HIV-positive women.
[Mh] Termos MeSH primário: Emoções
Infecções por HIV/transmissão
Transmissão Vertical de Doença Infecciosa/prevenção & controle
Esterilização Tubária/psicologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Instituições de Assistência Ambulatorial
Anticoncepção
Estudos Transversais
Feminino
Infecções por HIV/psicologia
Conhecimentos, Atitudes e Prática em Saúde
Seres Humanos
Meia-Idade
Motivação
Comportamento Reprodutivo
Inquéritos e Questionários
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170615
[Lr] Data última revisão:
170615
[Sb] Subgrupo de revista:IM; X
[Da] Data de entrada para processamento:161206
[St] Status:MEDLINE
[do] DOI:10.1080/09540121.2016.1255710



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