RESUMO
Abstract Background: Levonorgestrel (LNG) is a progesterone receptor agonist used in both regular and emergency hormonal contraception; however, its effects on the endometrium as a contraceptive remain widely unknown and under public debate. Objective: To analyze the effects of LNG or mifepristone (MFP), a progesterone receptor antagonist and also known as RU-486, administered at the time of follicle rupture (FR) on endometrial transcriptome during the receptive period of the menstrual cycle. Methods: Ten volunteers ovulatory women were studied during two menstrual cycles, a control cycle and a consecutively treated cycle; in this last case, women were randomly allocated to two groups of 5 women each, receiving one dose of LNG (1.5 mg) or MFP (50 mg) the day of the FR by ultrasound. Endometrial biopsies were taken 6 days after drug administration and prepared for microarray analysis. Results: Genomic functional analysis in the LNG-treated group showed as activated the bio-functions embryo implantation and decidualization, while these bio-functions in the T-MFP group were predicted as inhibited. Conclusions: The administration of LNG as a hormonal emergency contraceptive resulted in an endometrial gene expression profile associated with receptivity. These results agree on the concept that LNG does not affect endometrial receptivity and/or embryo implantation when used as an emergency contraceptive.
Assuntos
Humanos , Feminino , Adulto , Adulto Jovem , Implantação do Embrião/efeitos dos fármacos , Mifepristona/farmacologia , Levanogestrel/farmacologia , Anticoncepcionais Hormonais Pós-Coito/farmacologia , Endométrio , Transcriptoma/efeitos dos fármacos , Ovulação , Fatores de Tempo , Mifepristona/administração & dosagem , Levanogestrel/administração & dosagem , Anticoncepcionais Hormonais Pós-Coito/administração & dosagemRESUMO
BACKGROUND: Levonorgestrel (LNG) is a progesterone receptor agonist used in both regular and emergency hormonal contraception; however, its effects on the endometrium as a contraceptive remain widely unknown and under public debate. OBJECTIVE: To analyze the effects of LNG or mifepristone (MFP), a progesterone receptor antagonist and also known as RU-486, administered at the time of follicle rupture (FR) on endometrial transcriptome during the receptive period of the menstrual cycle. METHODS: Ten volunteers ovulatory women were studied during two menstrual cycles, a control cycle and a consecutively treated cycle; in this last case, women were randomly allocated to two groups of 5 women each, receiving one dose of LNG (1.5 mg) or MFP (50 mg) the day of the FR by ultrasound. Endometrial biopsies were taken 6 days after drug administration and prepared for microarray analysis. RESULTS: Genomic functional analysis in the LNG-treated group showed as activated the bio-functions embryo implantation and decidualization, while these bio-functions in the T-MFP group were predicted as inhibited. CONCLUSIONS: The administration of LNG as a hormonal emergency contraceptive resulted in an endometrial gene expression profile associated with receptivity. These results agree on the concept that LNG does not affect endometrial receptivity and/or embryo implantation when used as an emergency contraceptive.
Assuntos
Anticoncepcionais Hormonais Pós-Coito/farmacologia , Implantação do Embrião/efeitos dos fármacos , Endométrio , Levanogestrel/farmacologia , Mifepristona/farmacologia , Transcriptoma/efeitos dos fármacos , Adulto , Anticoncepcionais Hormonais Pós-Coito/administração & dosagem , Feminino , Humanos , Levanogestrel/administração & dosagem , Mifepristona/administração & dosagem , Ovulação , Fatores de Tempo , Adulto JovemRESUMO
Faz-se um panorama do histórico da disponibilização da contracepção de emergência hormonal à base de levonorgestrel no Brasil, considerando a sua integração em políticas públicas de saúde via oferta gratuita...
Assuntos
Feminino , Humanos , Gravidez , Anticoncepcionais Hormonais Pós-Coito/provisão & distribuição , Anticoncepcionais Pós-Coito/provisão & distribuição , Política de Saúde , Anticoncepcionais Orais/provisão & distribuiçãoRESUMO
La anticoncepción de emergencia se refiere al uso de medicación o a la inserción de un dispositivo intrauterino de cobre para prevenir el embarazo luego de una relación sexual no protegida o del fallo de un método anticonceptivo, en una mujer que no desea el embarazo. De entre las alternativas farmacológicas del método, se estima que el uso de levonorgestrel prevendría el 50% de los embarazos. A partir de una viñeta clínica, en la cual se describe el caso de una paciente obesa que resultó embarazada luego de utilizar anticoncepción hormonal de emergencia tras una relación sexual no protegida, se realizó una búsqueda bibliográfica para establecer la efectividad del método en pacientes con esta característica (obesidad). La búsqueda identificó un metaanálisis que relacionó al triple la probabilidad de embarazo en pacientes con índice de masa corporal superior a 30 kg/m2 que utilizaron anticoncepción de emergencia hormonal. (AU)
Emergency contraception refers to the use of medication or the insertion of a copper intrauterine device to prevent pregnancy after the occurance of unprotected sex intercourse or failure of a contraceptive method in a woman who does not desire pregnancy. Among the pharmacological alternatives of the method it is estimated that the use of levonorgestrel prevents 50% of pregnancies. From a clinical vignette, in which the case of an obese patient who became pregnant using hormonal emergency contraception after unprotected sex intercourse is described, a literature search was conducted to establish the effectiveness of the method in patients with this feature (obesity). The search identified a metaanalysis that shows an incresed probability (threetimes) of pregnancy in patients with body mass index greater than 30 kg/m2 that used hormonal emergency contraception. Emergency contraception is less effective in women with obesity. (AU)
Assuntos
Humanos , Feminino , Gravidez , Adulto , Anticoncepcionais Hormonais Pós-Coito , Anticoncepcionais Sintéticos Pós-Coito , Obesidade/complicações , Gravidez/estatística & dados numéricos , Índice de Massa Corporal , Metanálise como Assunto , Fatores de Risco , Levanogestrel/administração & dosagem , Anticoncepcionais Pós-Coito , Dispositivos Intrauterinos de Cobre/estatística & dados numéricos , NorpregnadienosRESUMO
Objetivo: El presente estudio busca determinar el nivel de conocimientos e identificar las actitudes sobre la Anticoncepción Oral de Emergencia (AOE) en los internos de medicina del Hospital Nacional Arzobispo Loayza (HNAL). Materiales y Métodos: Un cuestionario estructurado se distribuyó a un total de 92 internos de medicina del HNAL. El cuestionario contenía tres dominios principales: características sociodemográficas, conocimiento sobre Anticoncepción Oral de Emergencia, y actitud hacia la AOE. Los participantes del estudio fueron seleccionados por muestreo por conveniencia. Los datos fueron introducidos y analizados con el programa SPSS versión 20.0. Los resultados se presentaron mediante estadística descriptiva. Resultados: Se encuestaron a 92 internos de medicina, de los cuales 58 (63 por ciento) alcanzaron un nivel de conocimiento medio sobre la Anticoncepción Oral de Emergencia, 18 (20 por ciento) obtuvieron un nivel de conocimiento alto y 16 (17 por ciento) un conocimiento bajo. En lo que respecta al nivel de actitud que tienen los internos sobre la AOE, 54 (58,7 por ciento) obtuvieron una actitud de indecisión, 20 (21,7 por ciento) una actitud de rechazo, y 18 (19,6 por ciento) una actitud de aceptación. Conclusiones: Un porcentaje considerable (80 por ciento) de internos de medicina obtuvo un nivel de conocimiento entre medio y bajo respecto a la Anticoncepción Oral de Emergencia. La actitud predominante fue la indecisión en 54 de los encuestados (58,7 por ciento) y sólo el 19,6 por ciento tienen una actitud de aceptación hacia la AOE. Tanto en el presente estudio como en publicaciones realizadas en otros países del mundo afirman que el nivel de conocimientos acerca de la Anticoncepción Oral de Emergencia en estudiantes del área salud es bajo.
Objective: To determine the level of knowledge and to identify attitudes towards Emergency Oral Contraception (EOC) in medicine interns of the Hospital Nacional Arzobispo Loayza (HNAL). Materials and Methods: A structured survey was distributed to a total of 92 HNAL medicine interns. The survey contained three main domains: sociodemographic characteristics; knowledge about Emergency Oral Contraception and attitude toward EOC. Study participants were selected by convenience sampling. Data was registered and analyzed using SPSS Version 20.0. Results were presented using descriptive statistics. Results: We surveyed 92 medical interns, of which 58 (63 per cent) obtained a medium level of knowledge about EOC, 18 (20 per cent) had a higher level of knowledge and 16 (17 per cent) had a low level of knowledge. Regarding the attitude towards EOC, 54 (58.7 per cent) medicine interns obtained attitude of indecision, 20 (21.7 per cent) attitude of rejection, 18 (19.6 per cent) attitude of acceptance. Conclusions: A significant percentage of medical interns obtained level of knowledge among middle and lower about Emergency Oral Contraception. The predominant attitude was indecision in 54 interns (58.7 per cent) and only 19.6 per cent had attitude of acceptance. Both this study and international publications agree that the level of knowledge in health students is low.
Assuntos
Masculino , Feminino , Humanos , Adulto Jovem , Adulto , Anticoncepcionais Hormonais Pós-Coito , Anticoncepcionais Orais Hormonais , Estudantes de Medicina , Internato e Residência , Estudos Transversais , Estudos de Avaliação como AssuntoRESUMO
Objetivo: Determinar la relación que existe entre el conocimiento nosográfico, las actitudes y las prácticas frente al uso de anticonceptivos orales de emergencia en los internos de medicina del Hospital Nacional Daniel Alcides Carrión. Diseño: Estudio descriptivo. Lugar: Hospital Nacional Daniel Alcides Carrión. Participantes: Internos de medicina que laboraron en el Hospital Nacional Daniel Alcides Carrión durante el año 2014. Intervención: Aplicación de una encuesta de conocimientos, actitudes y prácticas sobre anticoncepción de emergencia y características de filiación de los participantes. Resultados: De los 76 encuestados, el 82 por ciento presentó un nivel adecuado de conocimientos, 79 por ciento actitud adecuada y 40 por ciento prácticas adecuadas. Se encontró que si hay relación entre la actitud y las practicas frente a la anticoncepción oral. Conclusiones: No hay relación entre el nivel de conocimientos y la actitud, así como el nivel de conocimientos y las prácticas frente a la anticoncepción oral de emergencia. Sin embargo si hay relación estadísticamente significativa entre la actitud y las prácticas frente a este método anticonceptivo.
Objective: To determine the relationship between the nosographic knowledge, attitudes and practices regarding the use of emergency contraceptive pills in medicine interns of National Hospital Daniel Alcides Carrion. Design: Descriptive study. Location: National Hospital Daniel Alcides Carrion. Participants: Medicine interns who worked in the National Hospital Daniel Alcides Carrion during 2014. Intervention: Application of a survey of knowledge, attitudes and practices about emergency contraception and characteristics of affiliation of the participants. Results: Of the 76 respondents, 82 per cent had an adequate level of knowledge, 79 per cent and 40 per cent right attitude right practices. It was found that if there is relationship between attitude and practices versus oral contraception. Conclusions: There is no relationship between the level of knowledge and attitude as well as the level of knowledge and practices concerning oral emergency contraception. However, there is a statistically significant relationship between attitude and practices against birth control.
Assuntos
Masculino , Feminino , Humanos , Adulto Jovem , Adulto , Anticoncepcionais Hormonais Pós-Coito , Anticoncepcionais Orais Hormonais , Estudantes de Medicina , Internato e Residência , Estudos Transversais , Estudos de Avaliação como AssuntoRESUMO
A necessidade da elaboração do presente trabalho surge da problemática vivenciada na atuação junto a clientela feminina em unidade básica do serviço público saúde...