Marcia de Toledo Blake

Characteristics of sexual violence against adolescent girls and adult women

BackgroundSexual violence is considered a serious violation of human rights which affects mainly young women and adolescents. There is little information about the conditions under which sexual offences occur. We evaluated characteristics of sexual violence against adolescent girls and adult women.MethodThis is a quantitative, retrospective, descriptive study of sexual violence against adolescent girls and adult women. Analyses were carried out on data collected from 1118 women, 546 adolescents (10-19 years) and 572 adults (≥ 20 years), with a complaint of rape treated at Hospital Pérola Byington, São Paulo, between 1994 and 1999. The age limit of the adolescent sample met the World Health Organization’s (WHO) criteria. We analyzed the type of sexual contact, degree of intimidation, perpetrator and activity of the victim during the approach.ResultsCrimes without penetration were five times more frequent in adolescents and use of threats of death or intimidation was common in both groups. Mental illness was more prevalent in adult victims and the majority of adolescent victims were aged <14 years. Uncle and stepfather perpetrators were more frequent among adolescents and partners or former intimate partners in adult women. In most cases the approach occurred in public places, although sex crimes at the perpetrator’s residence were more frequent amongst adolescents.ConclusionsAlthough children and adolescents require the same intervention measures and legal protection, a considerable proportion of adolescent sex offenders can face conditions similar to those of adult women.

Nutritional strategies of physically active subjects with muscle dysmorphia.

Background The aim of this study was to identify dietary strategies for physically active individuals with muscle dysmorphia based on a systematic literature review. Method References were included if the study population consisted of adults over 18 years old who were physically active in fitness centers. We identified reports through an electronic search ofScielo, Lilacs and Medline using the following keywords: muscle dysmorphia, vigorexia, distorted body image, and exercise. We found eight articles in Scielo, 17 in Medline and 12 in Lilacs. Among the total number of 37 articles, only 17 were eligible for inclusion in this review. Results The results indicated that the feeding strategies used by physically active individuals with muscle dysmorphia did not include planning or the supervision of a nutritionist. Diet included high protein and low fat foods and the ingestion of dietary and ergogenic supplements to reduce weight. Conclusion Physically active subjects with muscle dysmorphia could benefit from the help of nutritional professionals to evaluate energy estimation, guide the diet and its distribution in macronutrient and consider the principle of nutrition to functional recovery of the digestive process, promote liver detoxification, balance and guide to organic adequate intake of supplemental nutrients and other substances.

Hydatidiform mole resulting from sexual violence

Background Hydatidiform mole (HM) is characterized by abnormal proliferation of human trophoblast with producers functioning tissues of human chorionic gonadotropin. It can evolve with ovarian cysts tecaluteínicos, hypertension of pregnancy or hyperthyroidism. The incidence of HM is variable and its etiology poorly known, associated with nutritional factors, environmental, age, parity, history of HM, oral contraceptives, smoking, consanguinity or defects in germ cells. There is no reference in literature on HM resulting from sexual violence, objective of this report. Method Description of two cases of HM among 1146 patients with pregnancy resulting from sexual violence treated at Hospital Pérola Byington, São Paulo, from July 1994 to August 2011. Results The cases affected young, white, unmarried, low educated and low parity women. Sexual violence was perpetrated by known offenders unrelated to the victims, under death threat. Ultrasound and CT of the pelvis showed bulky uterus compatible with HM without myometrial invasion. One case was associated with theca lutein cysts. The two cases were diagnosed in the second trimester of pregnancy and evolved with hyperthyroidism. There was no hypertension, disease recurrence, metastasis or sexually transmitted infection. Conclusion The incidence of HM was 1:573 pregnancies resulting from rape, within the range estimated for Latin American countries. Trophoblastic material can be preserved to identify the violence perpetrator, considering only the paternal HM chromosomes. History of sexual violence should be investigated in cases of HM in the first half of adolescence and women in a vulnerable condition.