BAKGRUND: Gynekologisk cancer och dess behandling påverkar hela kvinnan. Den sexuella hälsan påverkar både reproduktion och det sexuella umgänget. Lidandets alla tre former har en stor betydelse och kan skapa existentiella frågor. Stödet från anhöriga men även vårdpersonal har en stor betydelse för kvinnans hantering av sjukdomen. SYFTE: Att beskriva kvinnors upplevelser av hur den sexuella hälsan påverkas av gynekologisk cancer. METOD: Litteraturöversikt baserad på 14 artiklar med kvalitativ och kvantitativ ansats. RESULTAT: Ur analysen identifierades två huvudteman: en förändrad kropp, behov av support för ökat välbefinnande, med vardera två underteman. DISKUSSION: Sjuksköterskor ska erbjuda och vara öppna för samtal om sexuell hälsa, inte bara för de yngre med reproduktiva aspekter. Det professionella och sociala stödet kan både ge positiva och negativa aspekter. Ett stort lidande skapas för kvinnan som har och får diagnosen gynekologisk cancer, vilket skapar stora utmaningar där sjuksköterskan ska lindra lidandet i största mån. KONKLUSION: Kvinnor upplever stor minskad sexuell hälsa och minskad livskvalité. Samtalet om sexuell hälsa är svårt att ta upp med vårdpersonal. Socialt stöd har en betydande roll i kvinnans livskvalité. / BACKGROUND: Gynaecological cancer and its treatment affect the whole woman. Sexual health affects both reproduction and sexual intimacy. All three forms of suffering have great importance and can create existential questions. Support from relatives and healthcare professionals is essential for women to manage their disease. AIM: To describe women's experiences of how sexual health is affected by gynaecological cancer. METHOD: A literature review where qualitative and quantitative articles have been analyzed. RESULT: The analysis identified two main themes, a changed body, the need for support for increased well-being, with two sub-themes each. DISCUSSION: Nurses should offer and be open to conversations about sexual health, not just for the younger ones with reproductive aspects. Professional and social support can provide both positive and negative aspects. Grand suffering is created for the woman who has and is diagnosed with gynaecological cancer, which creates significant challenges where the nurse must alleviate the suffering to the greatest extent. CONCLUSION: Women experience significantly reduced sexual health and reduced quality of life. The conversation about sexual health is challenging to discuss with healthcare professionals. Social support plays a significant role in a woman's quality of life.

Bakgrund: Den gynekologiska undersökningen praktiseras vanligtvis i syfte för att bedöma och främja kvinnans reproduktiva hälsa. Den gynekologiska undersökningen omfattas av tre moment. Inledningsvis sker en undersökning av fortplantningsorganets yttre delar, därefter sker en undersökning av de inre delarna samt över buken. Syfte: Syftet med litteraturstudien var att belysa kvinnors erfarenheter av att genomgå en gynekologisk undersökning. Metod: För att besvara syftet, genomfördes en allmän litteraturstudie med stöd av en enkel form av innehållsanalys. Litteraturstudien efterföljdes genom en strukturerad informationssökning i tre omvårdnadsfokuserade databaser. Efter genomförd informationssökning, genomfördes granskning samt analys av valda kvalitativa och kvantitativa artiklar samt sammanställning av resultat.Resultat: Resultatet fördelades utifrån följande huvudkategorier: (1) Erfarenheter av obehag i samband med den gynekologiska undersökningen och (2) Erfarenheter av befrämjande faktorer relaterat till upplevelsen av den gynekologiska undersökningen. Konklusion: Det framkom att många kvinnor upplevde den gynekologiska undersökningen som obehaglig, där känslor som ångest, oro, rädsla, utlämnande, maktlöshet och misstro belyste en del av obehaget. Förekomst av adekvat information, ett gott bemötande samt god kommunikation var några faktorer som framkom som befrämjande till upplevelsen. För flera kvinnor ansågs det vara betydande att en sjuksköterska närvarade i samband med den gynekologiska undersökningen. / Background: The purpose of the gynecological examination is to evaluate and promote reproductive health among women. The gynecological examination is divided into three different stages, where the first stage includes an examination of the external parts of the female genital organs. Thereafter an examination of the internal parts of the organ and the abdomen are performed. Aim: The aim of the study was to illuminate women’s experiences of the gynecological examination. Method: A general literature study was used, with the guidance of a simple version of content analysis. The literature study was conducted through structured information retrieval in three databases focusing on nursing research. After the information retrieval was completed, a review and analysis was conducted on chosen qualitative and quantitative articles for further compilation of the result.  Result: The result was allocated into the following main categories: (1) Experiences of discomfort associated with the gynecological examination and (2) Experiences of promotive factors related to the experience of the gynecological examination. Conclusion: It was demonstrated that many women experience the gynecological examination as discomforting, where feelings of anxiety, worry, fear, exposure, loss of control and mistrust illuminated some of the discomfort. The incidence of adequate information, a good approach and communication were some factors that contributed to the experience. Some women found the presence of a nurse during the examination as substantial.

Syftet med uppsatsen är att belysa barnmorskors och sjuksköterskors erfarenheter av och förhållningssätt till att förmedla sexologisk information till kvinnor som drabbats av gynekologisk cancer. Vårdpersonal överlag upplever en stor utmaning i att förmedla sexuell information till människor som drabbats av cancer och tidigare forskningsresultat visar att många patienter aldrig får någon sexologisk information överhuvudtaget (Sheppard & Ely, 2008, Hughes, 2009 och Rasmusson et al, 2012). En kvalitativ metod med explorativ ansats valdes i form av semistrukturerade intervjuer för att den skapar en fördjupad förståelse för vad barnmorskor och sjuksköterskor själva tycker och har för erfarenhet av att prata om sexualitet med denna patientgrupp. Fem barnmorskor och fyra sjuksköterskor alla med minst ett års erfarenhet av att vårda kvinnor som drabbats av gynekologisk cancer deltog i studien. Under analysprocessen återkom ständigt betydelsen av kompetens och den gick att identifiera på tre nivåer; den individuella nivån, den organisatoriska nivån samt på den normativa nivån. När valda teoretiska perspektiv lades på de deskriptiva teman framträdde; individuell kompetens som förutsättning, organisatoriskt utrymme – individuellt eller kollektivt ansvar, patienters kön och ålder – betydelse för hur och av vem frågan tas upp och föreställningar om sjukdomsdiagnos och sexualitet. I studien framkom att intervjupersonerna uppfattar att sexualitet ska inkluderas i den holistiska omvårdnaden men möjligheten till sexologisk information för de cancerdrabbade kvinnorna påverkas av vårdpersonalens eget förhållningssätt till ämnet. En konsekvens av begränsat organisatoriska utrymmet är att den individuella kompetensen får liten betydelse. Hög ålder i kombination med sjukdom osynliggör sexualiteten. Vårdpersonal upplever svårigheter att prata om sexualitet i relation till sjukdom. Genom att synliggöra svårigheter på olika nivåer ges möjlighet till förändringar i att förmedla sexologisk information inom vården. / The aim of this paper is to highlight midwives and nurses' experiences and attitudes to discussing sexological information to women affected by gynecological cancer. In general, healthcare professionals find it a great challenge to convey sexual information to people affected by cancer. Previous research shows that many patients never receive any information of a sexual nature at all (Sheppard & Ely, 2008; Hughes, 2009 and Rasmusson et al, 2012). A qualitative method with an exploratory approach was chosen in the form of semi-structured interviews to gain a deeper understanding of what midwives and nurses themselves think and what they experience when talking about sexuality with their patients. Five midwives and four nurses, all with at least one year of experience caring for women affected by gynecological cancer participated in the study. During the analysis process the importance of competences arose frequently and three levels were identified; the individual level, the organisational level and the normative level. When the chosen theoretical perspective was applied to the descriptive themes emerged; individuals competences and knowledge, organisational environment - whether there is an individual or collective responsibility, the patient’s sex and age, how and by whom the question of sexuality is raised and beliefs about illness and sexuality. The study revealed that healthcare professionals see a need for sexuality to be included as part of the holistic nursing care process, but the possibility of sexological information for the affected women is affected by the nursing staff's own attitude to the subject. One consequence of limited organisational environments is that the individual competency may be of little importance. Both old age and illness can contribute to making sexuality invisible. Health professionals find it problematic to consider sexuality in relation to illness. By exposing these difficulties at various levels give us the opportunity to changes in the process of conveying sexological information as part of a comprehensive health care process.

Bakgrund: Varje år drabbas 1,3 miljoner kvinnor i världen av gynekologisk cancer. Gynekologisk cancer innefattar corpus-, cervix- och ovarialcancer. Prognosen och överlevnaden är god vid behandling av cancern. Behandlingsformer som används vid gynekologisk cancer kan innefatta kirurgi, strålning och cytostatika. De flesta kvinnor är sexuellt aktiva under sina liv och en konsekvens av behandling för gynekologisk cancer är att sexualiteten förändras, både ur ett fysiskt och psykiskt perspektiv. Syfte: Att beskriva kvinnors upplevelser av sexualitet efter gynekologisk cancer. Metod: Metaetnografi användes som analysmetod i denna kvalitativa metasyntes. PubMed och CINAHL användes till datainsamlingen. Artiklarna kvalitetsgranskades enligt Joanna Briggs granskningsmall. Resultatet i metasyntesen har baserats på 12 vetenskapliga artiklar. Resultat: Tre huvudteman fastställdes: Förändrad sexualitet, Kunskapsbrist hämmar sexualitet och Att vara kvinna, en upplevelse av skuld och tvång. Huvudtema Förändrad sexualitet följdes av tre underteman; komplikationer efter cancerbehandlingen påverkar sexualitet, Rädsla för negativ förändring och Lust och njutning, en tudelad upplevelse. Slutsats: Kvinnor upplevde negativa förändringar i sin sexualitet som följd av cancerbehandlingen. Vaginalsmärta som följd av behandlingen var den vanligaste komplikationen. Rädslan hade både fysiska- och psykiska orsaker till exempel att cancern skulle leda till återfall, spridning av cancern samt att bli lämnad av sin partner. Kvinnor upplevde en avsaknad av lust och njutning i samband med sexuell aktivitet. Att tillfredsställa sin partner var något som kvinnorna strävade efter trots minskad eller avsaknad av sexuell lust. Information från hälso- och sjukvården om sexualitet var något som kvinnorna saknade. Klinisktillämpbarhet: Examensarbetes resultat kan användas för att öka barnmorskor och övrig hälso- och sjukvårdspersonals förståelse för kvinnors sexualitet efter gynekologisk cancer och efterföljande behandling. Examensarbetet kan inspirera vårdgivarna att våga diskutera och informera om sexualitet för kvinnor som drabbats av gynekologisk cancer för att undvika att kvinnor ska uppleva skam och skuld eller leva sitt sexuella liv i ovisshet. / Background: Every year, 1.3 million women in the world are diagnosed with gynecological cancer. Gynecological cancer includes corpus-, cervix- and ovarian cancer. The prognosis and survival rates are good when treating the cancer. Treatments used for gynecological cancer may include surgery, radiation, and chemotherapy. Most women are sexually active throughout their lives, and the sexuality can be experienced and expressed both physically and psychologically. Aim: The purpose of the thesis was to explore women's experiences of sexuality after going through treatment for gynecological cancer. Method: Meta ethnography was used as the method of analysis in this qualitative meta synthesis. PubMed and CINAHL were the databases used for data collection. The articles were quality assessed according to the Joanna Briggs checklist. The result of the meta synthesis is a result of 12 scientific articles. Results: Three main themes were identified: Changes in sexuality, Lack of knowledge impede sexuality and being a woman, an experience of guilt and coercion. Main theme Changed Sexuality was followed by three sub-themes: complications after cancer treatment affect sexuality, Fear of negative change and Lust and Pleasure, an ambiguous experience. Conclusion: Women experienced negative changes in sexuality because of cancer treatment. Vaginal pain because of treatment was the most extensive change. The fear unfolded from different physical and psychological perspectives. The fear could express itself through the cancer's recurrence, spread and being left by their partner. The women´s experienced a lack of desire and pleasure in connection with the sexual activity. Satisfying their partner was something that the women´s strived for despite reduced or absent sexual desire. Information from the healthcare system about sexuality was something that the women were missing. Clinical applicability: The results of the thesis can be used to increase midwives' and other healthcare personnel's understanding of women's sexuality after going through gynecological cancer treatment. The thesis can inspire the midwives to dare to discuss and inform about sexuality for the women affected by gynecological cancer, to avoid the women experiencing shame and guilt or living their sexual life in uncertainty.

The study of gynecological resistance as an integral part of the slave community has frequently been ignored in studies of the plantation South. Slave women actively engaged in both collective and individual acts of gynecological resistance. This work, "Dat's one chile of mine you ain't never gonna sell: Gynecological Resistance in the Plantation Community", explores enslaved women's use of birth control, abortion, and infanticide as a means to gain personal autonomy and control over their bodies. This study seeks to forge a collective narrative about the secret practices of slave women, while attempting to give them a voice of their own. Relying primarily on the WPA slave narratives, as well as the Virginia Plantation records, this thesis first seeks to examine cases of gynecological resistance, as well as the motivations behind these acts. This thesis argues that enslaved women used gynecological resistance as a means to maintain some personal autonomy and control over their bodies, as well as the bodies of their children. The study illustrates that these individual acts became collective resistance, when the community worked to aid and protect women, who committed acts of gynecological resistance by keeping their secrets from the master. Finally, this thesis demonstrates how individual acts of resistance became collective, or day-to-day, in the forms of oral narratives about gynecological resistance that were passed along for the purposes of instruction. / Master of Arts

Bakgrund: Varje år insjuknar cirka 3000 kvinnor i gynekologisk cancer i Sverige, vilket innebär cancer i de kvinnliga könsorganen. Behandling mot gynekologisk cancer medför olika fysiska biverkningar. Sexuell hälsa är individuell och påverkas av faktorer som könsroller, njutning, könsidentitet och erotik. Sexuell lust, upphetsning och orgasm är delar av den sexuella hälsan. Sjuksköterskans roll innefattar personcentrerad vård med ett holistiskt perspektiv, där alla aspekter av patientens behov ingår, vilket innefattar den sexuella hälsan. Syfte: Syftet var att belysa upplevelsen av sexuell hälsa hos kvinnor som behandlats för gynekologisk cancer. Metod: Litteraturöversikten baserades på 11 kvalitativa artiklar som inhämtades från databaserna CINAHL Complete, Nursing and Allied health database och PubMed. Artiklarna som valdes att ingå i litteraturöversikten granskades i syfte att tematisera likheter och skillnader. Detta mynnade ut i litteraturöversiktens resultat. Resultat: Resultatet sammanställdes till fyra huvudteman som benämndes; Upplevelsen av ett förändrat sexuellt liv, En förändrad syn på sig själv, Förhållanden och En ny syn på sexuell hälsa. Under Upplevelsen av ett förändrat sexuellt liv identifierades två underteman; Den sexuella lusten och Den sexuella akten. Under En förändrad syn på sig själv identifierades Kvinnlighetens betydelse för kvinnan och Kroppsuppfattning som två underteman. Diskussion: En diskussion har förts kring metoden som användes i litteraturöversikten. Callista Roys adaptionsmodell, tidigare forskning och egna reflektioner har diskuterats i relation till litteraturöversiktens resultat för att stödja samt utöka förståelsen för resultatet. / Background: In Sweden approximately 3000 women fall ill in gynecological cancer each year. Gynecological cancer occurs in women’s genitals. Treatment for gynecological cancer can have different side effects. Sexual health is unique for each individual and is influenced by gender roles, identity, pleasure and erotism. Sexual desire, arousal and orgasm are segments of sexual health. The nurse’s role includes person centered care with a holistic perspective. All aspects of the patient’s needs should be included; therefore, sexual health should not be excluded.  Aim: The aim was to illustrate the experience of sexual health in women who have been treated for gynecological cancer. Method: The literature review was based on 11 qualitative studies collected from CINAHL Complete, Nursing and Allied health database and PubMed. The articles were reviewed in order to find similarities and differences. Results: The results were categorized into four main themes; The experience of a changed sexual life, An altered view on oneself, Relationship and A new view on sexual health. Within The experience of a changed sexual life two subthemes were identified; The sexual desire and The sexual act. Further on, two subthemes were identified in An altered view on oneself; The meaning of womanhood for women and Body image. Discussion: The chosen method for the literature review was discussed. To create understanding and support for the results Callista Roys adaptation model, previous research and our own thoughts were used to discuss the findings of the literature review.

Made available in DSpace on 2016-08-19T18:15:56Z (GMT). No. of bitstreams: 1 Erika Krogh.pdf: 139556 bytes, checksum: 216878ad89ff19e3e8bc335f8838580a (MD5) Previous issue date: 2008-10-25 / Introduction: A gynecological appointment in adolescence is usually surrounded by anxiety and ignorance for an adolescent. The lack of information and fear of new discoveries make that the adolescent delayed this first consultation. Objective: To identify determinant motivations for a gynecological appointment in adolescence. Method: Questionnaires were applied in the form of interview, in 45 female adolescents from 10 to 19 years in order to evaluate aspects related to knowledge and information to adolescents about the gynecologist and a gynecological appointment in the period from January to May of 2008. The participants were chosen at random from among the participants of Adolescentro - Vila Embratel. Results: The average age of adolescents was 14.5 years. The average age that patients seek medical care was 12.9 years. The menarche occurred between 10 to 12 years for most teenagers. Approximately 78% of the interviewees did not start sex life and 55.6% knew the area in which the gynecologist served, whereas only 37.8% had attended a gynecological consultation. The initiative of seeking medical care comes from the mothers in 82.4% of cases. The most quoted reason for the search by the gynecologist was routine gynecological. As the DST's and contraceptive methods, the adolescents who had a consultation, said to meet them at 100% and 70.6% respectively. Conclusion: It was concluded in this work that the demand for consultation on the initiative of a teenager is still very low, being the mother the determining factor for this search. The higher the education level, the family income and the knowledge of STD's, the greater the demand for a gynecological appointment. / Introdução: A consulta ginecológica na adolescência é geralmente cercada de ansiedade e desconhecimento para a adolescente. A falta de informação e o medo das novas descobertas fazem com que a adolescente protele esta primeira consulta. Objetivo: Identificar motivações determinantes para a consulta ginecológica na adolescência. Método: Foram aplicados questionários, na forma de entrevista, em 45 adolescentes do sexo feminino, de 10 a 19 anos , para avaliar aspectos relacionados ao conhecimento e informação das adolescentes sobre o ginecologista e a consulta ginecológica no período de janeiro a maio de 2008. As participantes foram escolhidas aleatoriamente, dentre as freqüentadoras do Adolescentro Vila Embratel. Resultados: A média de idade das adolescentes foi de 14,5 anos. A idade média que as pacientes buscaram atendimento ginecológico foi 12,9 anos. A menarca ocorreu entre 10 a 12 anos para a maior parte das adolescentes. Aproximadamente 78% das entrevistadas não iniciaram vida sexual e 55,6% conheciam a área em que atuava o ginecologista, sendo que somente 37,8% já compareceram a uma consulta ginecológica. A iniciativa de procurar atendimento ginecológico partiu das mães em 82,4% dos casos. O motivo de busca pelo ginecologista mais citado foi rotina ginecológica. Quanto as DST s e os métodos anticoncepcionais, as adolescentes que já foram a consulta, referiram conhecê-los em 100% e 70,6% respectivamente. Conclusão: Concluiu-se neste trabalho que a procura pela consulta ginecológica por iniciativa da adolescente ainda é muito baixa, sendo a mãe o fator determinante para essa busca. Quanto maior o nível de escolaridade, a renda familiar e o conhecimento das DST s, maior é a procura pelo atendimento ginecológico.

Submitted by Celso Magalhaes (celsomagalhaes@ufrrj.br) on 2017-08-24T11:18:26Z No. of bitstreams: 1 2016 - Joaquim Esquerdo Ferreira.pdf: 985948 bytes, checksum: c74866a4845a971211c74ba0d1a5b391 (MD5) / Made available in DSpace on 2017-08-24T11:18:26Z (GMT). No. of bitstreams: 1 2016 - Joaquim Esquerdo Ferreira.pdf: 985948 bytes, checksum: c74866a4845a971211c74ba0d1a5b391 (MD5) Previous issue date: 2016-06-22 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / The gynecological screening prior to TAI can be considered as a non-invasive technique, relatively simple, safe for the technician and for the animal, and provides quick and extremely important information for the best use of various hormones on the market for use in synchronization protocols of ovulation in cattle. It is important to emphasize the need for gynecological examination before the start of a hormonal protocol because of the risk of causing an abortion or embryonic loss due to prostaglandin that at some point should be administered during the protocol. Additionally, there is the option to choose which the most appropriate hormones to be used in the program, directing the protocols based to animal ovarian physiological status. This screening allows good results enabling the best use of this biotech, making the use of this biotech does not become a cake recipe, i.e. it is not used incorrectly and indiscriminately without criteria. To this end, it has been based on the pattern of cyclicity of the ovaries (presence of corpus luteum, mature follicles or absence of these structures), to increase conception and pregnancy rates by adjusting the protocol to ovarian function. Moreover, we must take into account the ovarian function and also an assessment of body condition score (BCS), along with age and lactation period of the animals before starting the TAI protocol. In this sense, it is very important the knowledge of the technician who will perform synchronization program of estrus and ovulation in bovine females. So that you can successfully execute gynecological and clinical examination of females to be submitted to this treatment. The application of a gynecological screening and carried out by a qualified technician in order to optimize the use of TAI protocols is essential, resulting in cheaper protocols with satisfactory results, in order to make solid and reliable technique / A realiza??o da triagem ginecol?gica previamente ? IATF apresenta-se como uma t?cnica n?o invasiva, relativamente simples, segura para o t?cnico e para o animal, e fornece informa??es r?pidas e extremamente importantes para o melhor uso dos diversos horm?nios dispon?veis no mercado para serem utilizados nos protocolos de sincroniza??o da ovula??o em bovinos. ? importante ressaltar a necessidade do exame ginecol?gico antes do in?cio de um protocolo hormonal devido ao risco de causar abortamento ou mesmo perda embrion?ria em fun??o da prostaglandina e o estradiol que em algum momento dever? ser administrada no decorrer do protocolo. Adicionalmente, tem se a op??o de escolher quais os horm?nios mais apropriados que ser?o utilizados no programa, direcionando os protocolos em fun??o do status fisiol?gico ovariano que o animal se encontra. Essa triagem permite bons resultados viabilizando o melhor emprego desta biot?cnica, evitando o uso da mesma de forma errada e indiscriminada, sem crit?rios. Para tal, basea-se no padr?o de ciclicidade dos ov?rios (presen?a de corpo l?teo, fol?culos maduros ou ainda aus?ncia destas estruturas), para incrementar as taxas de concep??o e de prenhez, ao ajustar o protocolo ? fun??o ovariana. Al?m de levar-se em considera??o a fun??o ovariana, preconiza-se tamb?m uma avalia??o do escore de condi??o corporal (ECC), juntamente com a idade e per?odo lactacional dos animais antes de se iniciar o protocolo. Nesse sentido, torna-se de suma import?ncia o conhecimento do t?cnico que ir? realizar um programa de sincroniza??o do estro e da ovula??o em f?meas bovinas, de maneira que o mesmo consiga executar com sucesso o exame ginecol?gico e cl?nico das f?meas que ser?o submetidas a esse tratamento. ? imprescind?vel a aplica??o de uma triagem ginecol?gica bem realizada por um t?cnico qualificado de maneira a otimizar a utiliza??o dos protocolos de IATF, resultando em protocolos de menor custos e com resultados satisfat?rios, com intuito de tornar a t?cnica vi?vel economicamente e ainda com a previs?o de resultados confi?veis para os produtores

Orientador: Márcia Guimarães da Silva / Resumo: Objetivo: O objetivo do presente estudo foi identificar determinantes do clearance da infecção pelo Papilomavírus Humano (HPV) em mulheres brasileiras em idade reprodutiva. Métodos: Trata-se de estudo de coorte denominado HPV-UNESP, no qual 1638 mulheres em idade reprodutiva foram recrutadas no período de setembro de 2012 e janeiro de 2013. Desse total, 544 mulheres positivas para a infecção pelo HPV participaram do seguimento longitudinal durante 30 meses, em mais 4 visitas. A infecção por HPV foi definida como detecção de qualquer um dos 36 genótipos testados pelo Linear Array Genotyping Test (Roche Molecular Systems, Inc.) e o desfecho de interesse foi o clearance da infecção, definido como a eliminação da infecção pelo HPV por, pelo menos, duas visitas consecutivas. Um questionário estruturado com 58 questões relativas à dados sociodemográficos, características comportamentais e ginecológicas foi aplicado em cada visita. Imediatamente após a entrevista, todas as mulheres realizaram exame ginecológico, no qual, após inserção de espéculo de Collins, não lubrificado, foi aferido o pH vaginal com fita (pH 4.0-7.0, Merck, Germany) no terço médio da parede vaginal. Para avaliação da microbiota vaginal, amostras foram coletadas com swab da parede vaginal e o padrão de microbiota foi classificado de acordo com os critérios de Nugent et al. (1991). O whiff test realizado por adição de solução de 10% de KOH ao conteúdo vaginal foi interpretado como positivo, negativo ou duvidoso. A... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Objective: The objective of the present study was to identify determinants of Human Papillomavirus (HPV) infection clearance in Brazilian women of reproductive age. Methods: This is a cohort study called HPV-UNESP, in which 1638 women of reproductive age were recruited from September 2012 to January 2013. Of this total, 544 women positive for HPV infection participated in longitudinal follow-up for 30 months, in 4 more visits. HPV infection was defined as detection of any of the 36 genotypes tested by the Linear Array Genotyping Test (Roche Molecular Systems, Inc.) and the outcome of interest was infection clearance, defined as the elimination of HPV infection by least two consecutive visits. A structured questionnaire with 58 questions regarding sociodemographic data, behavioral and gynecological characteristics was applied at each visit. Immediately after the interview, all women underwent a gynecological exam, in which, after insertion of the non-lubricated Collins speculum, the vaginal pH with tape (pH 4.0-7.0, Merck, Germany) was measured in the middle third of the vaginal wall. For vaginal microbiota evaluation, samples were collected with vaginal wall swab and the microbiota pattern was classified according to the criteria of Nugent et al. (1991). The whiff test performed by adding 10% KOH solution to the vaginal content was interpreted as positive, negative or doubtful. Endocervical samples were collected with cytobrush for molecular analysis of HPV, Chlamydia trachom... (Complete abstract click electronic access below) / Doutor

Darbo tikslas. Įvertinti šeimos gydytojų požiūrį į akušerinės – ginekologinės pagalbos paslaugas, teikiamas pirminėje sveikatos priežiūros grandyje. Uždaviniai. 1. Įvertinti šeimos gydytojų požiūrį į akušerinės – ginekologinės pagalbos organizavimo pokyčius. 2. Nustatyti šeimos gydytojų teikiamų akušerinės – ginekologinės pagalbos paslaugų apimtį pirminėje sveikatos priežiūros grandyje. 3. Nustatyti problemas, su kuriomis susiduria šeimos gydytojai, teikdami akušerinės – ginekologinės pagalbos paslaugas savo bendruomenės moterims. Tyrimo metodika. Tyrimo objektas: Kauno mieste dirbančių šeimos gydytojų požiūris į jų teikiamas akušerinės – ginekologinės pagalbos paslaugas. Tyrimo metodai: Anoniminė anketinė šeimos gydytojų apklausa. Anketa išplatinta visiems Kauno miesto šeimos gydytojams (n = 220). Atsakas – 90,9 proc. Statistinė duomenų analizė atlikta SPSS – 13 programa. Rezultatai. Moterų piktybinių navikų prevencijos vykdymo ir moterų raštingumo lytinės higienos ir šeimos planavimo klausimais priskyrimą šeimos medicinos institucijai teigiamai vertino 96 proc. visų respondentų, nėščiųjų stebėsenos - 58 proc., ginekologinių paslaugų - 64 proc. Privačiose pirminės sveikatos priežiūros įstaigose ( PSPĮ) dirbančių šeimos gydytojų teikiamų akušerinių – ginekologinių paslaugų apimtis (išskyrus klimakterinių simptomų diagnostiką) yra didesnė nei VŠĮ dirbančių šeimos gydytojų. Statistiškai reikšmingi skirtumai nustatyti teikiant šias paslaugas: tepinėlio iš gimdos kaklelio... [toliau žr. visą tekstą] / Aim of the study. To evaluate family physicians’ attitudes towards obstetric-gynecological services provided in primary health care settings. Objectives. 1. To evaluate family physicians’ attitudes towards changes in the organization of obstetric-gynecological servises. 2. To determine the extent of obstetric-gynecological services provided by family physicians in primary health care level. 3. To identify the problems family physicians encounter when providing obstetric-gynecological services . Methods. Anonymous questionnaire-based survey of family physicians was carried out in Kaunas city (n = 220). The response rate was 90.9%. Statistical data analysis was performed using SPSS v.13 software package. Results. The attribution of cancer prevention among women and women’s literacy in sexual hygiene- and family planning-related issues to the institution of family medicine was positively evaluated by 96% of respondents, the attribution of the monitoring of pregnant women – by 58% and the attribution of gynecological services – by 64% of respondents. The extent of obstetric-gynecological services (except for the diagnostics of menopausal symptoms) provided by family physicians working in private primary health care institutions (PHCI) exceeded that provided by family physicians working in public PHCI. Statistically significant differences were detected in the provision of the following services: cervical smear (a service provided by 82.2% of family physicians in private... [to full text]