A critical feminist discursive approach was used to explore how and to what ends women organized their talk about female genitals. Exploration and interpretation of how the eight women in this research used talk to orient their constructed positions for female genitals, within the dyad conversational sessions, was informed by the analytic concepts of interpretative repertoires, subject positioning and ideological dilemmas. Findings indicated that these women repeatedly drew on socially available information (e.g., fictional and non-fictional literature, media, family and friend, empirical research) regarding female genitals during their dyad discussions. Shared components in the womens accounts were organized into two opposing interpretative repertoires consistent with those identified in a selection of reviewed textual resources: powerful female genital repertoire and powerless female genital repertoire. The participants drew on both these repertoires when arguing and defending multiple, and often contradictory, subject positions on this topic. Although the women discursively demonstrated a strong pull toward a position that aligned with the powerful repertoire, their powerful subject positions were tenuous. This tenuousness may have been due to the sensitive nature of this topic, the rhetorical demands of the research conversations, and/or the untenability of an extremist position in either of the powerful or powerless female genital repertoires. Further, these women did not construct any new information in their talk regarding female genitals, thus suggesting that the female genital repertoires are discursively pervasive and constraining. This research contributes to our knowledge of talk regarding female genitals by illustrating how and to what ends women choose to organize, interpret and exclusively use existing discourses on this topic.

A critical feminist discursive approach was used to explore how and to what ends women organized their talk about female genitals. Exploration and interpretation of how the eight women in this research used talk to orient their constructed positions for female genitals, within the dyad conversational sessions, was informed by the analytic concepts of interpretative repertoires, subject positioning and ideological dilemmas. Findings indicated that these women repeatedly drew on socially available information (e.g., fictional and non-fictional literature, media, family and friend, empirical research) regarding female genitals during their dyad discussions. Shared components in the womens accounts were organized into two opposing interpretative repertoires consistent with those identified in a selection of reviewed textual resources: powerful female genital repertoire and powerless female genital repertoire. The participants drew on both these repertoires when arguing and defending multiple, and often contradictory, subject positions on this topic. Although the women discursively demonstrated a strong pull toward a position that aligned with the powerful repertoire, their powerful subject positions were tenuous. This tenuousness may have been due to the sensitive nature of this topic, the rhetorical demands of the research conversations, and/or the untenability of an extremist position in either of the powerful or powerless female genital repertoires. Further, these women did not construct any new information in their talk regarding female genitals, thus suggesting that the female genital repertoires are discursively pervasive and constraining. This research contributes to our knowledge of talk regarding female genitals by illustrating how and to what ends women choose to organize, interpret and exclusively use existing discourses on this topic.

Submitted by Ana Lúcia Torres (bfmhuap@gmail.com) on 2017-09-29T15:37:00Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) DISSERTAÇAO LUCIANO MEIRELES.pdf: 1043230 bytes, checksum: 20c7f97cfba9488935ee9dcde38c164c (MD5) / Approved for entry into archive by Ana Lúcia Torres (bfmhuap@gmail.com) on 2017-09-29T15:37:08Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) DISSERTAÇAO LUCIANO MEIRELES.pdf: 1043230 bytes, checksum: 20c7f97cfba9488935ee9dcde38c164c (MD5) / Made available in DSpace on 2017-09-29T15:37:08Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) DISSERTAÇAO LUCIANO MEIRELES.pdf: 1043230 bytes, checksum: 20c7f97cfba9488935ee9dcde38c164c (MD5) Previous issue date: 2013 / Instituto Nacional do Câncer / As infecções de corrente sanguínea (ICS) são complicações frequentes em pacientes com câncer. O objetivo deste estudo foi descrever as características epidemiológicas, clínicas e microbiológicas das ICS em pacientes com câncer ginecológico. Método: uma série de 311 episódios de ICS com comprovação microbiológica (ICS-CM) detectadas em 288 pacientes com câncer ginecológico assistidas no Hospital do Câncer II de janeiro/2002 a dezembro/2009. Para análise das variáveis categóricas, foram utilizados o teste do qui-quadrado ou o teste exato de Fisher e, para as variáveis contínuas, os testes t de Student, Mann-Whitney ou de regressão linear com cálculo do coeficiente de correlação (R2). P-valores ≤ 0,05 foram considerados estatisticamente significativos. Resultados: 205 (66%) episódios foram hospitalares; 85 (27%) comunitários, 13 (4%) relacionados à assistência à saúde e 8 (2,57%) corresponderam a neutropenia febril. As ICS secundárias foram mais frequentes (148; 47,58%) do que as primárias (141; 45,34%); dentre as secundárias, grande parte deveu-se a infecções urinárias (79; 53,4%). Dentre os 336 microrganismos isolados, os mais frequentes foram Escherichia coli (70; 20,83%), Staphylococcus aureus (66; 19,64%), staphylococcus coagulase negativo (SCN; 37; 11,01%), Klebsiella pneumoniae (33; 9,82%) e Pseudomonas aeruginosa (26; 7,74%). A prevalência global de microrganismos multirresistentes (MMR) foi 17,56% (59 MMR em 336 amostras): 11 (3,27%) amostras de S. aureus resistentes à oxacilina (MRSA), 14 (4,2%) amostras de gramnegativos entéricos resistentes às cefalosporinas de 3ª/4ª geração, 29 (8,63%) amostras de gramnegativos não fermentadores (GNNF) resistentes às cefalosporinas de 3ª/4ª geração, 5 (1,5%) amostras de GNNF resistentes aos carbapenemas. Em 224 (72%) episódios, o escore de Pitt foi ≥2. A mortalidade bruta foi 39,86% (114) com 57,89% (66) dos óbitos relacionados às ICS. Conclusão: as ICS são eventos associados a elevada mortalidade. Estes dados sugerem que as infecções urinárias, de evolução geralmente benigna na população geral, devem ser nas pacientes com câncer ginecológico, objeto de uma abordagem preventiva, diagnóstica e terapêutica mais cuidadosa. Estudos futuros, que avaliem os fatores determinantes para o óbito serão fundamentais para um melhor entendimento do prognóstico dessas pacientes / Bloodstream infections (BSI) are frequent complications in patients with cancer. The goal of this study was to describe the epidemiological, clinical and microbiological characteristics of these infections in patients with gynecological cancer. Method: a case-series of 311 episodes of laboratory-confirmed BSI detected in 288 patients with gynecological cancer assisted at Hospital do Cancer II from January 2002 to December 2009. Chi-squared test or Fisher's exact test were used for analysis of categorical variables and Student's t test, Mann-Whitney or linear regression with correlation coefficients (R2) were used with continuous variables. P-values ≤0.05 were considered statistically significant. Results: 205 (66%) BSI episodes were hospital-acquired; 85 (27%) community acquired; 13 (4%) healthcare-associated and 8 (2.57%) related to febrile neutropenia episodes. Secondary BSI episodes were more frequent (148; 47.58%) than primary cases (141; 45.34%); among the secondary BSI, many resulted from urinary tract infections (79; 53.4%). The most frequent agents among 336 microorganisms detected were Escherichia coli (70, 20.83%), Staphylococcus aureus (66, 19.64%), coagulase-negative Staphylococcus (CoNS; 37, 11.01%), Klebsiella pneumoniae (33, 9.82%) and Pseudomonas aeruginosa (26, 7.74%). The overall prevalence of multidrug resistant (MDR) agents were 17.56% (59 MDR in 336 isolates): 11 (3.27%) methicillin resistant S. aureus (MRSA) isolates, 14 (4.2%) enteric gram-negative isolates resistant to 3rd/4th generation cephalosporins, 29 (8.63%) non-fermentative gramnegative isolates resistant to 3rd/4th generation cephalosporins, 5 (1.5%) non-fermentative gramnegative isolates resistant to carbapenems. In 224 (72%) episodes had Pitt score ≥2. The crude mortality rate was 39.86% (114) with 57.89% (66) deaths were related to BSI. Conclusion: BSI are severe events associated with high mortality. These data suggest that urinary tract infection, mostly a nonthreatening illness in the general population, must have a special preventive, diagnostic and therapeutic approach in patients with gynecological cancer. Further studies assessing the factors predisposing to death will be necessary to a better understand of the prognosis in this population.

Made available in DSpace on 2014-10-09T12:42:20Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T13:59:41Z (GMT). No. of bitstreams: 0 / Tese (Doutoramento) / IPEN/T / Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP

Made available in DSpace on 2014-10-09T12:42:20Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T13:59:41Z (GMT). No. of bitstreams: 0 / A candidíase vaginal (CV) é uma doença causada por fungos do gênero Candida spp. que acomete milhares de mulheres no mundo. Estima-se que 75% das mulheres sofrerão CV pelo menos uma vez durante a vida fértil, 40 a 50% terão o segundo episódio e 5 a 8% sofrerão a forma recorrente, caracterizada pela ocorrência de quatro ou mais episódios durante um ano. O tratamento ainda permanece um desafio para as candidíases complicadas. A terapia fotodinâmica (TFD) é uma modalidade terapêutica que utiliza substâncias fotossensibilizadoras (FS) e uma fonte de luz, que juntas, produzem espécies reativas de oxigênio, tóxicas para micro-organismos e inofensivas para a célula animal hospedeira. O objetivo deste trabalho foi avaliar os efeitos antifúngicos e anti-inflamatórios da TFD mediada por azul de metileno (AM) e laser de emissao vermelha (LEV) no tratamento da CV em modelo animal. Fêmeas de camundongos BALB/c, com 6 a 10 semanas foram estrogenizadas e, 72h após, receberam via intravaginal 20μL de suspensão contendo 107 UFC/mL de C. albicans ATCC 90028. Cinco dias após, a TFD foi aplicada na vagina das fêmeas, utilizando AM 1000μM e laser (100mW, 660nm, energia de 36J por 6 min ou duas aplicações de 18J por 3min, com intervalo de 24h entre sessões). Após 0, 24 e 96h foram feitas lavagens vaginais para recuperação fúngica, cultivo microbiológico, eutanásia para remoção das vaginas e estudo histológico. Lâminas coradas por hematoxilina e eosina foram utilizadas para contagem da área de células inflamatórias (ACI), utilizando o programa ImageJ. Os resultados mostraram que TFD in vivo reduziu a carga fúngica em aproximadamente 1,6 log UFC/mL e, quando aplicada em duas sessões de 18J por 3min, diminuiu a ACI. A TFD mediada por LEV e AM 1000μM mostra-se como alternativa promissora para o desenvolvimento de novas modalidades terapêuticas para vaginites fúngicas. / Tese (Doutoramento) / IPEN/T / Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP