ABSTRACT This study aims to investigate the possible association between neutrophil/lymphocyte and platelet/lymphocyte ratio in women with HIV, undergoing antiretroviral treatment, with HPV coinfection. This is a cross-sectional study with HIV positive women; their biological samples were collected for laboratory tests (complete blood count) and oncotic cytology for detection of HPV DNA, by PCR-Nested (PGMY and GP primers). Viral load and CD4 and CD8 T-cells counts were obtained from medical records. The data were analyzed, comparing the two groups: those with coinfection and those without it. From 82 HIV seropositive women, 50% exhibited HPV coinfection and 12.2% of coinfected patients had cervical cell alterations. Quantification of viral load, CD4 and CD8 T-cells count, CD4 / CD8 ratio and neutrophil/lymphocyte (NLR) and platelet/lymphocyte (PLR) ratio presented significant differences between groups (p<0.05). The predicting power of NLR and PLR in differentiating HIV/HPV coinfection which demonstrated differences between groups (AUC of 0.882 and 0.776 for NLR and PLR, respectively). There is a relation between the neutrophil/lymphocyte and platelet/lymphocyte ratio with HIV/HPV coinfection in women undergoing antiretroviral treatment, suggesting a state of greater and persistent systemic inflammation, reflecting as a biomarker for screening and monitoring these patients. neutrophillymphocyte neutrophil lymphocyte plateletlymphocyte platelet treatment crosssectional cross sectional complete count DNA PCRNested PCR Nested PGMY primers. primers . primers) CD Tcells T cells records analyzed it 8 50 122 12 2 12.2 alterations (NLR (PLR p<0.05. p005 p p<0.05 0 05 (p<0.05) HIVHPV AUC 0882 882 0.88 0776 776 0.77 respectively. respectively respectively) inflammation 5 1 12. p00 p<0.0 (p<0.05 088 88 0.8 077 77 0.7 p0 p<0. (p<0.0 08 0. 07 7 p<0 (p<0. p< (p<0 (p< (p

Dans l’imaginaire social, il est courant de penser que la femme éprouve des sentiments nobles lorsqu’elle met au monde un enfant. Cependant, l’expérience clinique montre que la maternité peut être une période de malaise intense, exprimée sous forme de conflits, de symptômes et de détresse. Cet article essaie de montrer, par le biais des réflexions théoriques et des présentations de vignettes cliniques, que le cycle grossesse-puerpérale est un processus dans lequel la femme est exposée à quelque chose de traumatisant capable de provoquer en elle un désordre psychique

In the social imaginary, there is a widespread fantasy in which woman is taken of noble feelings when giving birth to a child. However, clinical experience teaches that motherhood can be a time of intense malaise, expressed in the form of conflicts, symptoms and distress. This paper tries to show, through theoretical reflections and presenting clinical vignettes, that the pregnancy-puerperal cycle is a process in which women are exposed to traumatic experiences that are capable of disorganizing them psychically.

Gemäß der sozialen Vorstellung soll es üblich sein, dass eine Frau edle Gefühle entwickelt, wenn sie ein Kind empfängt. Die klinische Erfahrung lehrt jedoch, dass die Mutterschaft eine Zeit intensiven Unwohlseins sein kann, ausgedrückt in Form von Konflikten, Symptomen und Leiden. Dieser Artikel versucht aufzuzeigen, mittels theoretischer Überlegungen und der Beschreibung klinischer Vignetten, dass der Zyklus zwischen Schwangerschaft und Wochenbett ein Prozess ist, während dem die Frau einer traumatischen Erfahrung ausgesetzt ist, die sie psychisch desorganisieren kann.

No imaginário social é comum a fantasia de que a mulher é tomada de sentimentos nobres ao receber um filho. Entretanto, a experiência clínica ensina que a maternidade pode ser um momento de intenso mal-estar, expresso sob a forma de conflitos, sintomas e angústia. O presente artigo procura mostrar, por meio de reflexões teóricas e apresentações de vinhetas clínicas, que o ciclo gravídico-puerperal é um processo em que a mulher está exposta a vivenciar algo da ordem do traumático capaz de desorganizá-la psiquicamente.

En el imaginario social, es común la fantasía de que la mujer es colmada de sentimientos nobles al recibir a un hijo. Sin embargo, la experiencia clínica enseña que la maternidad puede ser un momento de intenso malestar, expresado en forma de conflictos, síntomas y angustia. El presente artículo busca mostrar, mediante reflexiones teóricas y presentaciones de viñetas clínicas, que el ciclo embarazo-puerperio es un proceso en que la mujer está expuesta a vivir experiencias de orden traumático capaces de desorganizarla psíquicamente.

No Brasil, as taxas de cesariana são bastante elevadas, principalmente nos serviços privados, estando provavelmente associadas a fatores socioeconômicos e culturais. O objetivo deste estudo foi descrever as características socioeconômicas, demográficas, culturais e reprodutivas de puérperas e os determinantes da decisão por parto cesáreo em duas unidades do sistema de saúde suplementar do Estado do Rio de Janeiro. A população foi composta por 437 puérperas que tiverem partos vaginais ou cesarianos nas duas unidades selecionadas. Os dados foram coletados por meio de entrevistas com as mães e consulta aos prontuários. Através de regressão logística não condicional, avaliaram-se os fatores associados à decisão por cesariana como via de parto, seguindo os modelos hierárquicos estabelecidos em três momentos definidos: no início, ao longo da gestação e no momento do parto. Observou-se que, embora 70% das entrevistadas não relatassem preferência inicial pela cesariana, 90% apresentaram esse tipo de parto. Verificou-se que, independente do desejo inicial da gestante, a interação com o serviço de saúde resultou na cesariana como via final de parto. Trabalhos educativos direcionados às gestantes e à população geral e mudanças no modelo de assistência ao parto podem ser estratégias promissoras para a reversão desse quadro.

Cesarean section rates are very high in Brazil mainly in private hospitals, probably due to socioeconomic and cultural factors. The objective of this study was to describe socioeconomic, demographic, cultural and reproductive characteristics of women in the postpartum period and the factors that had determined their decision for caesarean section in two units of the supplementary health care system of the State of Rio de Janeiro. The study population was composed of 437 women that had vaginal or caesarean childbirths in the two selected units. Data were collected by means of interviews with mothers and consultation of hospital records. The factors associated with the decision for cesarean section as mode of delivery were evaluated using non-conditional logistic regression analysis and following the hierarchic models established at three definite moments. Although 70% of the women had no initial preference for cesarean section, 90% of them had this mode of birth. It was verified that, despite their initial desire, the interaction with the health services resulted in cesarean section as mode of birth. Educative actions directed to pregnant women and to the public at large as well as changes in the childbirth care model can be promising strategies for reverting this picture.

No Brasil, as taxas de cesariana são bastante elevadas, principalmente nos serviços privados, estando provavelmente associadas a fatores socioeconômicos e culturais. O objetivo deste estudo foi descrever as características socioeconômicas, demográficas, culturais e reprodutivas de puérperas e os determinantes da decisão por parto cesáreo em duas unidades do sistema de saúde suplementar do Estado do Rio de Janeiro. A população foi composta por 437 puérperas que tiverem partos vaginais ou cesarianos nas duas unidades selecionadas. Os dados foram coletados por meio de entrevistas com as mães e consulta aos prontuários. Através de regressão logística não condicional, avaliaram-se os fatores associados à decisão por cesariana como via de parto, seguindo os modelos hierárquicos estabelecidos em três momentos definidos: no início, ao longo da gestação e no momento do parto. Observou-se que, embora 70% das entrevistadas não relatassem preferência inicial pela cesariana, 90% apresentaram esse tipo de parto. Verificou-se que, independente do desejo inicial da gestante, a interação com o serviço de saúde resultou na cesariana como via final de parto. Trabalhos educativos direcionados às gestantes e à população geral e mudanças no modelo de assistência ao parto podem ser estratégias promissoras para a reversão desse quadro.

Cesarean section rates are very high in Brazil mainly in private hospitals, probably due to socioeconomic and cultural factors. The objective of this study was to describe socioeconomic, demographic, cultural and reproductive characteristics of women in the postpartum period and the factors that had determined their decision for caesarean section in two units of the supplementary health care system of the State of Rio de Janeiro. The study population was composed of 437 women that had vaginal or caesarean childbirths in the two selected units. Data were collected by means of interviews with mothers and consultation of hospital records. The factors associated with the decision for cesarean section as mode of delivery were evaluated using non-conditional logistic regression analysis and following the hierarchic models established at three definite moments. Although 70% of the women had no initial preference for cesarean section, 90% of them had this mode of birth. It was verified that, despite their initial desire, the interaction with the health services resulted in cesarean section as mode of birth. Educative actions directed to pregnant women and to the public at large as well as changes in the childbirth care model can be promising strategies for reverting this picture.