RESUMO
INTRODUCTION: historically, surgical medical specialties are mostly male, a scenario which, in recent years, has undergone changes. In this sense, despite the relevance of the growth of female participation in the medical career, little is discussed about the distribution between genders of the main surgical medical specialties in the country. OBJECTIVE: discuss the process of feminization in surgical specialties in Brazil over the last few years, tracing a distribution profile of these specialties. METHODS: this is a retrospective and cross-sectional study with secondary data from the Censuses of Medical Demography in Brazil in the years 2011, 2013, 2015, 2018, 2020 and 2023, including the surgical specialties: Urology, Orthopedics and Traumatology, Thoracic Surgery, Neurosurgery, Digestive System Surgery, Cardiovascular Surgery, Hand Surgery, General Surgery, Head and Neck Surgery, Vascular Surgery, Plastic Surgery, Ophthalmology, Coloproctology, Otorhinolaryngology, Pediatric Surgery, and Gynecology and Obstetrics. RESULTS: males prevails in numbers, among the surgical specialties, however, with a lower growth rate compared to females. Specialties such as urology, orthopedics and traumatology and neurosurgery are mostly male, while gynecology and obstetrics are female. CONCLUSION: it is evident that female participation in the surgical medical field has increased significantly over the last few years.
Assuntos
Ortopedia , Especialidades Cirúrgicas , Criança , Humanos , Feminino , Masculino , Estudos Retrospectivos , Brasil , Estudos Transversais , FeminizaçãoRESUMO
Background: The uncontrolled multiplication of Sertoli cells causes Sertoli cell tumor or Sertolioma. Because of this, the level of estrogen in the bloodstream increases rapidly and approximately 25% of dogs with this tumor develop feminization syndrome. Testicular neoplasms are more common in dogs than cats, and are often found in elderly patients. This work aims to describe the clinical signs of the feminization syndrome and the treatment instituted in a canine diagnosed with sertolioma. Case: A 18-year-old male canine, 19.5 kg of body mass, with an increase in testicular volume for about 2 years, was treated at the University Veterinary Hospital. On clinical examination, a matte and brittle coat, alopecia on the hind limbs and gynecomastia were observed. Also noted, non-harmonious aspect of the scrotum, pendular foreskin, atrophied right testicle and hyperplastic left, scrotal hyperthermia and absence of pain. In addition, as a result of the hyperestrogenism resulting from the neoplasm, the paraneoplastic syndrome of feminization, the patient also presented galactorrhea, pendular foreskin, atrophy of the penis and the contralateral testicle, dermatopathies, such as bilateral symmetrical alopecia of the flanks, easily removable hair and variable hyperpigmentation. Rectal body temperature of 38.6°C, clear lung auscultation and muffled cardiac auscultation. The results of laboratory tests showed changes such as thrombocytopenia, platelet counts below the reference levels, platelet count of 163,000/uL. There were no alterations that represented metastases in the imaging exams, such as in the chest X-ray in three incidences and in the abdominal ultrasonography. Then, we opted for the surgical procedure of orchiectomy, with the traditional technique of three clamps, associated with total ablation of the scrotum. Samples were sent to the histopathology laboratory and the diagnosis of sertolioma was confirmed. At 10, 30 and 90 days after the operation, the patient was reassessed for possible recurrences or alterations, but there were no complications or recurrence after the procedure. Discussion: Neoplasms of the male reproductive system are common in dogs. Sertolioma is considered one of the most frequent neoplasms in elderly dogs and that results in systemic clinical signs. This is in line with the 18-year-old dog described in the present report. In addition, it may result in clinical signs resulting from hyperestrogenism resulting from the neoplasm that is called paraneoplastic feminization syndrome. The characteristics of this syndrome are: gynecomastia, galactorrhea, pendular foreskin, atrophy of the penis and contralateral testicle, associated with dermatopathies, such as symmetrical bilateral alopecia. All these clinical signs were present. The diagnosis is made through complete anamnesis, complete clinical examination and complementary examination such as ultrasound help in the presumptive diagnosis, but only with histopathology can it be confirmed. In the clinical approach, histopathology was performed to close the diagnosis. Treatment is behind orchiectomy and total ablation of the scrotum, which was performed in the reported case. The treatment of choice was easy to apply, in addition to improving the patient's quality of life, promoting rapid post-surgical healing and an early return to normal life. However, for the effectiveness of the technique, the early diagnosis and collaboration of tutors is fundamental.
Assuntos
Animais , Masculino , Cães , Tumor de Células de Sertoli/cirurgia , Tumor de Células de Sertoli/veterinária , Neoplasias Testiculares/veterinária , Feminização/veterinária , Orquiectomia/veterináriaRESUMO
O estudo da crescente feminização da área da Medicina de Família e Comunidade coloca na agenda de estudiosos a preocupação com os fatores e impactos dessa tendência nas trajetórias das carreiras das médicas, principalmente daquelas que estão exercendo suasatividades em áreas periféricas. O objetivo do estudo do qual resulta este artigo foi compreender como as médicas justificam suas escolhas e permanências no exercício da Medicina de Família e Comunidade, mesmo em contextos considerados potencialmente violentos. Realizamos uma investigação de caráter qualitativo, que dialogou com aspectos da cartografia, a partir de entrevistas realizadas com oito médicas de família que se fixaram em áreas de alta vulnerabilidade social em uma capital brasileira. A análise dos enunciados apontou para o gênero como o eixo marcador de diferença, destacando o empuxo exercido pela maternidade, o conceito gênero em sua dinâmica interseccional. Identificamos que a responsabilização pelo cuidado permanece impactando o processo decisório das mulheres, (re)definindo o equilíbrio entre vida pessoal/familiar e trabalho e (de)limitando as trajetórias de suas carreiras.
The growing trend of feminization of family practice raises scholars' concerns about the factors and effects of this trend on the trajectories of female medical careers, particularly those working in outlying areas. The aim of the study, from which this article results, was to understand how medical women justify their choices and permanence in the family practice career while working in contexts considered potentially violent. We carried out a qualitative study with cartographic aspects, based on interviews with eightfamily doctors who are settled in areas of high social vulnerability in a large city in Brazil. The analysis of the statements pointed to gender, in its intersectional dynamics, as the major axis of difference in the practice. Motherhood is highlighted ashaving a major impact on female professionals. Our study identified that the duty of care persists in impacting women's decision-making, (re) defining the balance between personal and family life and (de) limiting their career trajectories.
Assuntos
Trabalho , Medicina de Família e Comunidade , FeminizaçãoRESUMO
Resumo Este trabalho analisa a feminização da epidemia de HIV/aids no Brasil e a importância de considerar esse processo no planejamento de ações em saúde pública. A pesquisa foi desenvolvida por meio de revisão de literatura e estudo de dados oficiais do Ministério da Saúde. Os resultados mostram que ações eficazes no combate à infecção por HIV/aids entre as mulheres devem contemplar diferenças de gênero e condições socioculturais de cada região. O artigo ainda propõe que é imprescindível um processo amplo de educação em saúde, que abranja simultaneamente homens e mulheres e tenha foco no empoderamento e no cuidado de si e do outro.
Abstract This article analyzes the feminization of the HIV/aids epidemic in Brazil and the importance of considering this process when planning public health actions. This study is a literature review and also includes the analysis of official data from the Ministry of Health. The results show that effective actions to combat HIV/aids infection among women must take gender differences and the sociocultural conditions of each region into consideration. The need for a broad health education process for both men and women focusing on empowerment, self-care and caring for others can also be highlighted.
Resumen Este artículo analiza el proceso de feminización de la epidemia de HIV/sida en Brasil y su importancia en las acciones de planificación en la salud pública. La investigación parte de una revisión de la literatura y de datos oficiales del Ministerio de Salud de Brasil. Las acciones efectivas para combatir la infección por VIH/sida entre las mujeres deben abordar las diferencias de género y las condiciones socioculturales en cada región. Es esencial un amplio proceso de educación sanitaria, que abarque a las poblaciones masculinas y femeninas, centrándose en el empoderamiento, el autocuidado y el cuidado de los demás dentro de las relaciones establecidas.
Assuntos
Humanos , Masculino , Feminino , Síndrome da Imunodeficiência Adquirida , HIV , Prevenção de Doenças , Feminização , Planejamento em Saúde , Promoção da SaúdeRESUMO
Intersex has been reported regularly in wild populations of gonochoristic fish. The authors investigated the possible feminization of seahorses in a population of Hippocampus reidi in Brazil, as well as report a case of a brood pouch reduction after reproductive stimuli. The female seahorses of this population showed two kinds of morphological anomalies. The proportion of the animals affected in the study population was consistent and was uncorrelated with the sex ratio. The study indicates the changes in the sexual profile of the individual.
Assuntos
Smegmamorpha , Animais , Brasil , Estuários , Feminino , Feminização , Masculino , ReproduçãoRESUMO
Population aging in Brazil increases on a large scale due to declining fertility and mortality. This phenomenon can be influenced by several factors (demographic, biological and social), making them determinants for the health conditions of the elderly populations residing in different geographic areas. The present study aims to identify the functional limitation in elderlyresidents of urban and rural areas of Brazil. This is a descriptive epidemiological study with a quantitative approach. It was evidenced that the functional limitation for activities of daily living and instrumental activities of daily living are concentrated in the northeast region, mainly in the urban area. The following states presented the highest proportions of daily life activity limitation in urban areas: Alagoas (11.60%), Rio Grande do Norte (10.95%), Pernambuco (10.36%) and Paraíba (9.62%). For activities of daily living in the rural area were found in the states of Paraíba (12.19%), Maranhão (8.93%), Piauí (8.85%) and then Pernambuco (7.24%). Data from the functional limitation for instrumental activities of daily living again highlighted the Northeast region, with the states of Rio Grande do Norte (26.01%), Paraíba (25.96%), Maranhão (25.72%) and Alagoas (24.57%). Lastly, it was verified that the elderly woman exhibits greater proportions of functional limitation in relation to the elderly of the masculine sex, standing out again the northeastern region of the country.
Assuntos
Humanos , Masculino , Feminino , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Idoso/fisiologia , Feminização/mortalidade , Atividades Cotidianas , Envelhecimento/fisiologia , Estudos Epidemiológicos , Indicadores de Qualidade de Vida , Fertilidade/fisiologiaRESUMO
Introducción. Las mujeres transgénero encuentran frecuentemente problemas en ajus-tar su voz a la frecuencia femenina. Para favorecer el cambio vocal deseado por estos in-dividuos, se ofrecen dos técnicas: una quirúrgica (tiroplastía) y otra clínica (terapia vocal). Objetivo. Esta revisión integrativa pretende verificar las publicaciones científicas relacionadas con las dos técnicas, observando cuál reporta mayor efectividad. Método. Se realizó una búsqueda en bases de datos, considerando las palabras clave: Transsexual Persons AND Voice Feminization AND Thyroplasty OR Voice Training. Resultados. Nueve artículos corresponden a estudios observacionales y tres utiliza-ron una metodología cuasi experimental. Los grupos estudiados incluyen un amplio espectro etario. Ninguno de los estudios informa aspectos económicos de las inter-venciones. No existe evidencia de seguimiento a largo plazo. Conclusiones. La vía de tratamiento vocal con adición hormonal puede ser una primera línea, y en caso de no reportar mejoras, la cirugía aparece como otra opción.Recomendación. La recomendación es que se realice terapia vocal, que no im-plica riesgos significativos de complicaciones, siendo además un abordaje relativa-mente económico.
Introduction. Transsexual women frequently encounter problems in adjusting their voices to the characteristics of their new gender. In order to help in the change to the desired voice, two techniques are often used: the surgical (Thyroplasty) and clinical (Speech Therapy). Objective. The aim of this integrative study is to verify through scientific publications the relationship between the two techniques and observe which is the most effective.Method. A systematic database search was conducted considering the keywords: Transsexual Persons AND Voice Feminization AND Thyroplasty OR Voice Training.Results. Nine articles corresponded to observational studies and three used a qua-si-experimental methodology. The groups studied include a broad age spectrum and the quality of the evidence is low. No study reports economic aspects of the interven-tions. There is no evidence of long-term follow-up. Conclusions. The vocal treatment route with hormonal addition can be a first line, and, in case of not reporting improvements, surgery appears as another option.Recommendation. The recommendation is for Speech Therapy, which has no significant risks of complications and is relatively cheap.
Assuntos
Fonoterapia , Voz/fisiologia , Laringoplastia , Fala , Fonoterapia/métodos , Treinamento da Voz , Literatura de Revisão como Assunto , Assistência ao Convalescente , Feminização , Pessoas Transgênero , Identidade de GêneroRESUMO
Resumo Cirurgias de feminização facial, que visam tornar o rosto de mulheres transexuais mais feminino, alteram tecidos moles e duros. Tais procedimentos envolvem inúmeros aspectos éticos, desde a cobertura por planos de saúde e serviço público até o direito à mudança de nome. Há também consequências forenses, no que diz respeito à eventual necessidade de identificar pessoas submetidas a esse tipo de cirurgia. Essas consequências, embora importantes, são pouco consideradas em estudos científicos. Com isso, neste trabalho são analisados alguns aspectos éticos e forenses decorrentes de cirurgias de feminização facial.
Abstract Facial feminization surgeries, which aim to render transsexuals' facial features more feminine, alter soft and hard tissues. These procedures involve ethical issues such as health insurance and public service coverage, and the right to legal name change. Forensic consequences, concerning eventual need to identify individuals who underwent this surgery, are important and require scientific studies. In this article, we analyze some ethical and forensic aspects resulting from facial feminization surgeries.
Resumen Las cirugías de feminización facial que pretenden volver más femeninos los rostros de mujeres transexuales producen cambios en los tecidos blandos y duros. Tales procedimientos involucran muchos aspectos éticos, desde la cobertura del seguro de salud y del servicio público hasta las discusiones sobre el derecho al cambio de nombre. Hay también consecuencias forenses en lo que se refiere a las posibles necesidades de identificación de las personas que se someten a esta cirugía. A pesar de su importancia, estas consecuencias son poco abordadas en estudios científicos. Así, en este artículo se analizan algunos aspectos éticos y forenses derivados de las cirugías de feminización facial.