BackgroundThe relationship between users and health services is considered essential to strengthen the quality of care. However, the Lesbian, Gay, Bisexual, and Transgender population suffer from prejudice and discrimination in access and use of these services. This study aimed to identify the difficulties associated with homosexuality in access and utilization of health services.MethodA systematic review conducted using PubMed, Cochrane, SciELO, and LILACS, considering the period from 2004 to 2014. The studies were evaluated according to predefined inclusion and exclusion criterias. Were included manuscripts written in English or Portuguese, articles examining the Lesbian, Gay, Bisexual, and Transgender population’s access to health services and original articles with full text available online.ResultsThe electronic databases search resulted in 667 studies, of which 14 met all inclusion criteria. Quantitative articles were predominant, showing the country of United States of America to be the largest producer of research on the topic. The studies reveal that the homosexual population have difficulties of access to health services as a result of heteronormative attitudes imposed by health professionals. The discriminatory attendance implies in human rights violations in access to health services.ConclusionsThe non-heterosexual orientation was a determinant factor in the difficulties of accessing health care. A lot must still be achieved to ensure access to health services for sexual minorities, through the adoption of holistic and welcoming attitudes. The results of this study highlight the need for larger discussions about the theme, through new research and debates, with the aim of enhancing professionals and services for the health care of Lesbian, Gay, Bisexual, and Transgender Persons.

IntroductionThe objective was to analyze rates of stroke-related mortality and incidence of hospital admissions in Brazilians aged 15 to 49 years according to region and age group between 2008 and 2012.MethodsSecondary analysis was performed in 2014 using data from the Hospital and Mortality Information Systems and the Brazilian Institute of Geography and Statistics. Stroke was defined by ICD, 10th revision (I60–I64). Crude and standardized mortality (WHO reference) and incidence of hospital admissions per 100,000 inhabitants, stratified by region and age group, were estimated. Absolute and relative frequencies; and linear regression were also used. The software used was Stata 11.0.ResultsThere were 35,005 deaths and 131,344 hospital admissions for stroke in Brazilians aged 15–49 years old between 2008 and 2012. Mortality decreased from 7.54 (95% CI 7.53; 7.54) in 2008 to 6.32 (95% CI 6.31; 6.32) in 2012 (β = -0.27, p = 0.013, r2 = 0.90). During the same time, incidence of hospital admissions stabilized: 24.67 (95% CI 24.66; 24.67) in 2008 and 25.11 (95% CI 25.10; 25.11) in 2012 (β = 0.09, p = 0.692, r2 = 0.05). There was a reduction in mortality in all Brazilian regions and in the age group between 30 and 49 years. Incidence of hospitalizations decreased in the South, but no significant decrease was observed in any age group.ConclusionWe observed a decrease in stroke-related mortality, particularly in individuals over 30 years old, and stability of the incidence of hospitalizations; and also regional variation in stroke-related hospital admission incidence and mortality among Brazilian young adults.

Hypertensive elderly patients present decreased heart rate variability and decreased parasympathetic modulation when compared to normotensive elderly.

IntroductionChylothorax is a lymphatic extravasation into pleural cavity and its incidence is 0.25%-5.3% in children undergoing cardiac surgery.ObjectiveTo evaluate the incidence of chylothorax in pediatrics patients operated, linking it in each surgical intervention. Evaluate treatment types and efficiency.MethodsRetrospective study using medical records of children undergoing cardiac surgery in the Hospital do Coração between 2004 and 2014. For statistical analysis, qualitative variables by absolute frequency and relative frequency; quantitative variables, by median of 25 and 75 percentiles, as they did not present normal distribution (Shapiro-Wilk, P<0.05). The Chi-square test was used for the association between type of treatment and result. The adopted confidence level was 95%.ResultsIncidence of chylothorax was 2.1% (0.9% in intracardiac surgery, 1.7% correction of patent ductus arteriosus and aortic coarctation, 8.3% Glenn's surgery, 11.8% total cavopulmonary surgery and 3% in others). Among treatments, fasting associated with total parenteral nutrition (TPN) resolved 51% of the cases. Hypoglossal diet had failed treatment and surgical referral in 22% of the cases. Fasting with TPN associated with octreotide had success in the treatment of chylothorax in a period exceeding 15 days in 78% of cases, and 3.7% were referred for surgery.ConclusionAccording to the results, incidence of chylothorax was 2.18%. Treatment with fasting and TPN leads to resolutions in 86.5%, and the association with octreotide was successful in 85.1% of cases, showing an efficient option, while the treatment with hypoglossal diet had therapeutic failure in 22% of the cases in which it was used.

Background: About 7% of rape cases in Brazil result in pregnancy.Overall, Brazilian women are unaware of the right to legal interruption of pregnancy after rape, so they delay in applying the procedure to get a legal abortion or at the end they try to abort in a condition that may be unsafe. Objective:To analyse factors associated with the leadtime to have a legal abortion after rape.Methods: This is a cross-sectional study. The data were collected from electronical medical records of 1,270 women who requested legal abortion in a public hospital in São Paulo during the period of 1994 to 2013. The variables age, education, race, marital status, religion, form of intimidation, vulnerable condition, perpetrator of sexual violence, number of perpetrators, and police report were analysed in relation to gestational age, according to multiple multinomial logistic regression models. Results BackgroundSexual crimes particularly affect vulnerable young females and may be associated with physical trauma, mortality, sexual disorders, unwanted pregnancy, and psychological consequences. Damages to reproductive health include increased risk of infertility, anogenital cancer, and sexually transmitted diseases (STDs) [1]. In addition to representing a public health problem in developing countries, the subject of discussing the conflict of interrupting an unwanted pregnancy, as a consequence of a rape or not, requires a well informed decision making proccess, covering the scope of legal, moral, religious, social, and cultural aspects that are linked to it [2].Emerging data on violence against females around the world suggest that in some countries, one in five female suffer rape or attempted rape in their lifetime. Recent research on the behaviour, attitudes, and sexual experiences of young people in areas of Africa, Asia, and Latin America revealed that between 5 and 20% of females' first sexual experience was forced. Regardless of whether they have access to contraception, a forced sexual act is usually unprotected, exposing females not only to unwanted pregnancy but also to STDs, including HIV [3].In Brazil, about 7% of rape cases resulted in pregnancy. Under Brazilian law, the victim of this type of violence has the right to abort. However, 67.4% of females who were pregnant after being raped didn't get the access to legal abortion in a The delay verified in the decision to search for legal termination of pregnancy cannot be attributed to or explained by the cost of abortion in Brazil. The Brazilian Unified Health System (SUS) ensures full and free coverage for abortion in these cases, regardless of the woman has any sort of health insurance. Therefore, the females who have participated in this study did not face any financial barriers to make legal abortion.According to the Allan Guttmacher Institute, the highest rates of abortions were observed between 1995 and 2008 mainly in those regions where laws against abortion are more rigid. In 2008, an average of 28 women per thousand carried out an abortion, indicating a...

Background: The quality of life (QoL) of patients with endometriosis and infertility was assessed in different stages and correlated with the clinical features of the cases. Methods: The present study was a cross-sectional study; 106 women were included, divided in two endometriosis groups (Grade I/II, 26 women, and Grade II/IV, 74 women). All participants attended the Endometriosis and Infertility

Background:The study aimed to analyze the association between pubertal development stages and adiposity in children and adolescents. Methods: Cross-sectional study conducted in 2007 in Florianópolis, Brazil, with 2339 schoolchildren 32 aged 8 to 14 years old (1107 males). The outcome (adiposity) was evaluated using Z score and 33 percentilee values > = 85 of four skinfolds (triceps, subscapular, suprailiac and calf) and waist 34 circumference. Total body adiposity (Z score of the sum of skinfolds), central adiposity (Z score 35 of waist circumference) and peripheral adiposity (Z scores of triceps and calf skinfolds) were 36 estimated. Pubertal development stages was self-assessed according to Tanner stages of development. Thirty-seven Children and adolescents were classified according to tertiles of age for each pubertal development stages 38 stage -early, normal and late. Statistical analysis was performed using univariate and 39 multivariate Poisson regression models. Results: Children and adolescent from both sexes with early pubertal development stages presented higher prevalence of central adiposity (waist circumference), with adjusted prevalence ratio (CI 95%) of 2.21 (1.12; 4.35) for males and 2.18 (1.04; 4.57) for females (reference group: normal pubertal development stages). Among females, there was a reduction in the prevalence of excess adiposity with decreased occurrence of early pubertal development stages. There was a strong relationship between adiposity and pubertal development stages. Conclusions: Excess adiposity was higher in both sexes for those with early pubertal development stages.

Heart rate variability seems to be a promising, non-invasive tool for early diagnosis of autonomic dysfunction in breast cancer and detection of cardiovascular impairments at cancer diagnosis. Cardiac autonomic modulation is inversely associated with breast cancer staging.