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1.
Arch Gynecol Obstet ; 293(4): 879-86, 2016 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-26319157

RESUMEN

PURPOSE: To achieve a better understanding of issues related to sexual function and quality of life (QOL) of women with cervical cancer before radiotherapy treatment. METHODS: A pilot study with 80 women with cervical cancer from Jan/2013 to Mar/2014. The outcome variables were sexual function assessed using the Female Sexual Function Index (FSFI) and QOL, assessed using the World Health Organization questionnaire. Independent variables were clinical and sociodemographic data. Statistical analysis was carried out using Student's t test, Mann-Whitney test, ANOVA and multiple linear regression. RESULTS: The mean age was 48.1 years, 57.5 % were premenopausal and 55 % had clinical stage IIIB. Thirty percent had been sexually active in the 3 months prior to their interviews. The main adverse events during sexual intercourse were bleeding (41.7 %), lack of pleasure (33.3 %), dyspareunia (25 %), and vaginal dryness (16.7 %). The 18 women who had been sexually active in the previous month showed significant sexual dysfunction (total mean FSFI score = 25.6). Advanced clinical stage, using any chronic medication and not having undergone surgery for cancer were negatively correlated with QOL. Higher family income, a longer duration of schooling and no smoking were positive correlated with QOL. CONCLUSIONS: One-third of women with cervical cancer were sexually active 3 months prior to their interviews, but have concomitant significant sexual dysfunction. Factors related to the disease are primarily responsible for the deterioration of sexual function. QOL is influenced not only by factors related to the cancer itself, but also by lifestyle habits, comorbidities, and sociodemographic characteristics.


Asunto(s)
Calidad de Vida/psicología , Conducta Sexual/psicología , Disfunciones Sexuales Fisiológicas/psicología , Disfunciones Sexuales Psicológicas/psicología , Neoplasias del Cuello Uterino/psicología , Adolescente , Adulto , Anciano , Brasil , Dispareunia/etiología , Dispareunia/psicología , Femenino , Humanos , Persona de Mediana Edad , Proyectos Piloto , Conducta Sexual/estadística & datos numéricos , Encuestas y Cuestionarios , Neoplasias del Cuello Uterino/radioterapia , Salud de la Mujer
2.
Ann Surg Oncol ; 22(8): 2540-50, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25572679

RESUMEN

PURPOSE: Although the safety of applying omentum to the female breast for total breast reconstruction is controversial, it has recently been used to treat certain mammary disorders as well. A systematic review was therefore conducted to analyze and establish the suitability and safety of applying omentum to the breast. METHODS: Covereing the interval from January 1984 to December 2013, we performed searches in MEDLINE, Embase, SciELO, and Google-Scholar for original articles describing the applicability of greater omentum to the breast and its clinical complications. RESULTS: Sixty observational articles with 985 women were chosen. The main clinical indications were total breast reconstruction after mastectomy due to breast cancer (45 studies), radiation damage (23 studies), and congenital Poland syndrome (4 studies). Altogether, 273 complications were identified among the 985 women treated. The most frequent was flap necrosis (26.74 %). The most serious was injury to the digestive system (1.10 %). There was a 35.48 % incidence of local breast cancer recurrence in eight observational studies on oncological risk. Seven of the eight included only women with advanced cancer. One of these studies reported the incidence and relapse time predominantly according to the primary tumor size. CONCLUSIONS: Although the oncological risk remains unclear, there was a high volume of complications that affected the digestive system. These findings suggest that omentum has well established applicability, but only for total breast reconstruction of huge defects, where muscular/myocutaneous or perforator flaps may be unsuitable.


Asunto(s)
Neoplasias de la Mama/cirugía , Mamoplastia/métodos , Recurrencia Local de Neoplasia/patología , Epiplón/trasplante , Síndrome de Poland/cirugía , Traumatismos por Radiación/cirugía , Femenino , Humanos , Mamoplastia/efectos adversos , Mastectomía , Estudios Observacionales como Asunto
3.
J Sex Med ; 11(5): 1262-70, 2014 May.
Artículo en Inglés | MEDLINE | ID: mdl-24612478

RESUMEN

INTRODUCTION: Female libido is multifactorial and complex. Declining estrogen levels in postmenopausal women affects vaginal function. AIM: The aim of this study was to evaluate female sexual function after using topical estrogen, testosterone, or polyacrylic acid as vaginal lubricants with K-Y jelly as a placebo lubricant. METHODS: This was a randomized controlled clinical trial on 80 postmenopausal women between 40 and 70 years of age with follow-up at the Menopause Clinic of the CAISM Unicamp. The women were randomized to treatment with topical vaginal estrogen, testosterone, polyacrylic acid, or oil lubricant alone, three times a week for a period of 12 weeks from November 2011 to January 2013. MAIN OUTCOME MEASURE: We used the Female Sexual Function Index (FSFI) to assess changes in sexual response at baseline, and after 6 and 12 weeks. RESULTS: After 12 weeks of treatment, polyacrylic acid and topical testosterone produced improvements in the FSFI domains of sexual desire, lubrication, satisfaction, reduced pain during intercourse, and total score compared with lubricant alone. Treatment with topical estrogen in comparison with lubricant alone showed an improvement in the FSFI field of desire. The intragroup analysis over the time of the treatment showed improvements in the fields of desire, lubrication, and reduced pain for polyacrylic acid, testosterone, and estrogen. Furthermore, women who used testosterone showed improvements over time in the fields of arousal, orgasm, and satisfaction. CONCLUSIONS: Treatment of postmenopausal women with symptoms of vaginal atrophy with polyacrylic acid, testosterone, and estrogen for 12 weeks produced improvements in self-reported female sexual function when compared with a placebo lubricant.


Asunto(s)
Resinas Acrílicas/administración & dosificación , Andrógenos/administración & dosificación , Estrógenos/administración & dosificación , Posmenopausia/efectos de los fármacos , Conducta Sexual/efectos de los fármacos , Testosterona/administración & dosificación , Administración Intravaginal , Adulto , Anciano , Celulosa/administración & dosificación , Celulosa/análogos & derivados , Moduladores de los Receptores de Estrógeno/uso terapéutico , Femenino , Glicerol/administración & dosificación , Humanos , Libido/efectos de los fármacos , Persona de Mediana Edad , Orgasmo/efectos de los fármacos , Fosfatos/administración & dosificación , Glicoles de Propileno/administración & dosificación , Cremas, Espumas y Geles Vaginales/administración & dosificación
4.
Int Urogynecol J ; 23(5): 639-45, 2012 May.
Artículo en Inglés | MEDLINE | ID: mdl-22411207

RESUMEN

INTRODUCTION AND HYPOTHESIS: Low socioeconomic factors may influence the development of stress urinary incontinence (SUI). Thus far, there is little research available on SUI in developing countries. We aimed to determine whether the prevalence of SUI in a northeastern Brazilian municipality was higher or lower than in the general female population. METHODS: Cross-sectional household cluster study of 1,180 climacteric women in the São Luís municipality (Maranhão state, Brazil) was conducted using a standardized questionnaire that was previously tested in a pilot study and administered by interviewers to obtain socioeconomic and cultural information, climacteric aspects, and life habits related to SUI. RESULTS: From this population, 15.34% (n = 181) had SUI; this prevalence did not change with age. More than half (57.92%) of the patients replied that they had not consulted a physician for their SUI. The presence of SUI was not associated with any socioeconomic or gynecological variables after multivariate analysis. CONCLUSIONS: The prevalence of SUI in São Luís was similar to the rates observed in the general global female population. Socioeconomic and gynecological variables were not associated with SUI.


Asunto(s)
Climaterio , Composición Familiar/etnología , Incontinencia Urinaria de Esfuerzo/etnología , Incontinencia Urinaria de Esfuerzo/epidemiología , Anciano , Brasil/epidemiología , Climaterio/fisiología , Estudios de Cohortes , Estudios Transversales , Femenino , Encuestas Epidemiológicas , Humanos , Persona de Mediana Edad , Análisis Multivariante , Prevalencia , Factores Socioeconómicos , Encuestas y Cuestionarios , Incontinencia Urinaria de Esfuerzo/fisiopatología
5.
J Sex Med ; 8(10): 2851-8, 2011 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-21810185

RESUMEN

INTRODUCTION: Female sexual function depends on biological, psychological, and sociocultural contexts. AIM: The objective of the present study was to evaluate the prevalence of low levels of functioning in each of the sexual function domains (desire, arousal, and orgasm) and the factors associated with these phenomena, as well as to assess the frequency of sexual activity in this same sample population. METHODS: A cross-sectional, population-based study was conducted using an anonymous self-response questionnaire completed by 378 Brazilian-born women of 40-65 years of age with 11 years or more of formal education. The evaluation instrument was based on the Short Personal Experiences Questionnaire. RESULTS: The prevalence of low sexual desire was 60.6%; low arousal, 37%; and low orgasmic function, 31.1%. Multiple regression analysis showed that having a sexual partner (prevalence ratio [PR] = 0.69, confidence interval [CI] = 0.53-0.90) and nervousness (PR = 1.33, CI = 1.01-1.75) were factors associated with low sexual desire. Aging (PR = 1.04, CI = 1.02-1.06), having a sexual partner (PR = 0.57, CI = 0.41-0.81), feeling well/excellent (PR = 0.59, CI = 0.41-0.85), and having hot flashes (PR = 1.47, CI = 1.01 = 2.15) were factors found to be associated with low sexual arousal. Having a sexual partner (PR = 0.55, CI = 0.42-0.71), feeling well/excellent (PR = 0.68, CI = 0.49-0.94), and having hot flashes (PR = 2.08, CI = 1.43 = 3.04) were factors found to be associated with low sexual orgasmic function. Having a sexual partner (PR = 0.47, CI = 0.38-0.58), feeling well/excellent (PR = 0.78, CI = 0.69-0.89), and having hot flashes (PR = 1.15, CI = 1.05-1.26) were factors found to be associated with a frequency of sexual activity of once a week or less. CONCLUSIONS: In this sample of middle-aged women, low sexual desire was the most prevalent sexual problem. These results highlight the importance of identifying and treating factors associated with each individual component of low female sexual function.


Asunto(s)
Disfunciones Sexuales Psicológicas/epidemiología , Adulto , Anciano , Brasil/epidemiología , Estudios Transversales , Femenino , Humanos , Libido , Persona de Mediana Edad , Orgasmo , Prevalencia , Conducta Sexual/psicología , Conducta Sexual/estadística & datos numéricos , Encuestas y Cuestionarios
6.
Arch Gynecol Obstet ; 284(6): 1523-31, 2011 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-21442259

RESUMEN

PURPOSE: To evaluate quality of life (QOL) in gynecologic cancer survivors after radiotherapy (RT), investigate the frequency of adverse events and demonstrate an association between these symptoms and QOL. METHODS: A prospective cohort study of 95 women aged 21-75 years undergoing RT for gynecologic cancer was carried out. QOL was assessed by the WHOQOL-BREF before, at 4 months, 1 year and 3 years after RT and adverse events were evaluated following RT by the (CTCAE) v 3.0 scale. QOL scores were assessed by the Wilcoxon signed rank test over time. Multiple linear regression analysis was used to identify predictors of QOL. RESULTS: The most frequent adverse events were pain (64.2%) and dyspareunia (45.9%). A significant increase in QOL scores was observed in the psychological domain, general health and overall QOL. Pain was negatively associated with the physical, psychological and social relationship domains (p < 0.01); dyspareunia with the physical and social relationship (p < 0.01); decreased sexual interest with the psychological (p < 0.01). Higher family income was positively associated with the psychological domain and general health (p < 0.01). CONCLUSIONS: Results suggested that QOL improved after RT in women with gynecologic cancer. Adverse events, such as pain, dyspareunia and decreased sexual interest had a negative impact on QOL.


Asunto(s)
Neoplasias de los Genitales Femeninos/radioterapia , Calidad de Vida/psicología , Radioterapia/efectos adversos , Sobrevivientes/psicología , Adulto , Anciano , Estudios de Cohortes , Dispareunia/etiología , Femenino , Estudios de Seguimiento , Neoplasias de los Genitales Femeninos/psicología , Humanos , Estudios Longitudinales , Persona de Mediana Edad , Dolor/etiología , Estudios Prospectivos , Encuestas y Cuestionarios , Adulto Joven
7.
J Orthop Sports Phys Ther ; 40(9): 582-8, 2010 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-20508328

RESUMEN

STUDY DESIGN: Cross-sectional study. OBJECTIVE: To evaluate the relationship between the occurrence of falls and muscle strength, flexibility, and balance in postmenopausal women with and without osteoporosis. BACKGROUND: Osteoporosis and falls are common problems encountered in the elderly. METHODS: A total of 133 women with and 133 without osteoporosis, aged 60 years or greater, were included in the study. Women were interviewed about clinical and social demographic characteristics and the occurrence of falls in the previous 12 months. The variables evaluated were presence of osteoporosis, muscle strength, flexibility, and balance. RESULTS: A significantly higher percentage of women with osteoporosis (51%) compared to those without osteoporosis (29%) had a history of at least 1 fall within the previous 12 months. There was a significant and inverse association between trunk extension strength and trunk flexion range of motion with falls. Logistic regression analyses showed that the variables associated with falls were trunk extension strength and presence of osteoporosis. Greater trunk extension strength was associated with a lower risk for falls (odds ratio, 0.97), while the presence of osteoporosis increased fall risk by a factor of 2.17. CONCLUSIONS: A greater percentage of women with postmenopausal osteoporosis had a history of 1 or more falls within the previous year and a higher risk of recurrent falls than women without osteoporosis. Muscle strength of the lumbar spine and the presence of osteoporosis are intrinsic factors associated with the risk of falls.


Asunto(s)
Accidentes por Caídas/estadística & datos numéricos , Fuerza Muscular/fisiología , Osteoporosis Posmenopáusica/fisiopatología , Equilibrio Postural/fisiología , Anciano , Estudios Transversales , Femenino , Humanos , Modelos Logísticos , Extremidad Inferior/fisiología , Región Lumbosacra/fisiología , Persona de Mediana Edad , Rango del Movimiento Articular/fisiología
8.
Rev Assoc Med Bras (1992) ; 56(1): 112-5, 2010.
Artículo en Portugués | MEDLINE | ID: mdl-20339796

RESUMEN

Human immunodeficiency virus (HIV) infection has increased considerably among middle-aged women. In this work we reviewed recent studies aimed at identifying possible factors related to HIV infection in climacteric women. Several associated factors are considered, such as: climacteric symptoms, partner's change in sexual behavior in face of new drugs, negotiation for use of condoms in sexual intercourse, risk behavior for HIV, global self-esteem and sexual self-esteem, history of sexual abuse, use of drugs, stereotypes of sex life in maturity, use of antiretroviral therapy and approach to sexual function.


Asunto(s)
Infecciones por VIH/etiología , Factores de Edad , Anciano , Femenino , Infecciones por VIH/epidemiología , Infecciones por VIH/psicología , Humanos , Persona de Mediana Edad , Factores de Riesgo , Asunción de Riesgos
9.
Maturitas ; 62(1): 85-90, 2009 Jan 20.
Artículo en Inglés | MEDLINE | ID: mdl-19100693

RESUMEN

OBJECTIVE: To evaluate quality of life (QoL) in women with postmenopausal osteoporosis, correlating the QUALEFFO 41 with the short-form health survey 36 (SF-36) and evaluated some factors that can influenced the QoL of women with osteoporosis. METHODS: A cross-sectional study was conducted in 220 postmenopausal women (ages ranging from 55 to 80 years). Of the total number, 110 women had osteoporosis and 110 women did not have osteoporosis and these women were age-matched (+/-3 years). Two questionnaires were administered to all subjects for evaluation of QoL: the quality of life questionnaire of the European foundation for Osteoporosis 41 (QUALEFFO 41) and the short-form health survey 36 (SF-36). For data analysis, a significance level of 5% was set (p<0.05). RESULTS: Clinical characteristics between the groups were similar, with statistically significant differences only in body mass index (BMI), race, school education, age at menopause and use of hormone therapy (HT) (p<0.001). Women with osteoporosis had a worse QoL both in the QUALEFFO 41 and in the SF-36, in all domains studied. Data was adjusted for BMI, race, school education and use of HT (p<0.001). There was a significant correlation between all domains in the QUALEFFO 41 questionnaire and their corresponding domains in the SF-36 (p<0.001). The only factors related to worse QoL were BMI>25 and sedentary lifestyle. In contrast, paid work was associated with a better QoL (CI=95%). CONCLUSION: Women with osteoporosis had an impaired QoL, especially relating to the physical, psychological and social aspects. The factors associated with QoL were obesity, sedentary lifestyle and paid work.


Asunto(s)
Osteoporosis Posmenopáusica/psicología , Calidad de Vida , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Estado de Salud , Humanos , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Apoyo Social
10.
Arch Gynecol Obstet ; 280(2): 177-81, 2009 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-19104824

RESUMEN

OBJECTIVE: To evaluate bone density and associated factors in women with premature ovarian failure (POF) compared to age-matched women with normal ovarian function. METHODS: A cross-sectional study of 50 patients with POF undergoing bone mineral densitometry was conducted, compared to 50 women paired by age who menstruated regularly. RESULTS: In women with POF, the mean bone mineral density measured was 1.22 g/cm(2) at the spine and 0.92 g/cm(2) at the femur, values which were significantly lower than in the control group (P < 0.0001). Factors directly associated with bone density of the lumbar spine were age and with bone density of the femur were BMI and reproductive age. CONCLUSION: Young women with POF have a decrease in lumbar spine and femoral bone density. Age, reproductive age and BMI were the factors associated with BMD. These women need early investigation and treatment to prevent bone loss and minimize fracture risk in the future.


Asunto(s)
Densidad Ósea , Insuficiencia Ovárica Primaria/fisiopatología , Adulto , Estudios Transversales , Femenino , Fémur/fisiopatología , Humanos , Vértebras Lumbares/fisiopatología , Adulto Joven
11.
Arch Gynecol Obstet ; 278(3): 215-23, 2008 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-18204933

RESUMEN

OBJECTIVE: To investigate the incidence of acute toxicity of radiotherapy, evaluate quality of life (QOL) and identify its predictors in a cohort of gynecologic cancer patients. METHODS: A longitudinal prospective study was conducted including 107 women between the ages of 18 and 75 years with cervical or endometrial cancer. Acute toxicity was evaluated according to the Common Toxicity Criteria and the Radiotherapy Oncology Group toxicity criteria. QOL was measured with World Health Organization's Quality of Life instrument-abbreviated version (WHOQOL-BREF) before and at completion of radiotherapy and during the first clinical follow-up visit. QOL scores were assessed by ANOVA for repeat measures. Percentage variation of QOL scores from the time before radiotherapy to the first clinical visit was compared with control variables by the Wilcoxon test. Multiple linear regression analysis was used to identify predictors of QOL. RESULTS: Ninety-five women completed the three QOL assessments. The incidence of acute toxicity was 93.5% and the most common complaint was lower gastrointestinal (79.6%). A significant increase in QOL scores was observed in the physical and psychological domains, as well as general health and overall QOL. Upper gastrointestinal toxicity (p = 0.043) and surgery (p = 0.027) negatively affected general health, while improvement in vaginal bleeding (p = 0.047) positively influenced general health. CONCLUSION: A high incidence of acute toxicity of radiotherapy was observed. At the completion of treatment, QOL improved in gynecologic cancer patients. Women with upper gastrointestinal toxicity and history of surgery are at risk for having a worse QOL.


Asunto(s)
Neoplasias Endometriales/radioterapia , Neoplasias del Cuello Uterino/radioterapia , Adolescente , Adulto , Anciano , Estudios de Cohortes , Femenino , Humanos , Estudios Longitudinales , Persona de Mediana Edad , Estudios Prospectivos , Calidad de Vida , Radioterapia Adyuvante/efectos adversos , Clase Social , Encuestas y Cuestionarios , Adulto Joven
12.
Arch Gynecol Obstet ; 278(3): 261-3, 2008 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-18491118

RESUMEN

There is a considerable body of new information on Gynecology and Obstetrics. To aid in keeping gynecologists updated, renowned periodicals publish review articles. Review articles enable the reader to obtain the best evidence for clinical or research issues from several individual articles. This enables the professional to make clinical decisions in the light of current knowledge. The different types of reviews and database that may be used for the elaboration of reviews are discussed in the present article. It is suggested that future reviews on Gynecology and Obstetrics include articles published in other idioms apart from English and that a larger number of database is researched. Thus, reviews will be not only more inclusive but more representative of the international literature.


Asunto(s)
Bases de Datos Factuales , Ginecología , Obstetricia , Literatura de Revisión como Asunto , Femenino , Humanos
13.
Rev Assoc Med Bras (1992) ; 54(4): 299-304, 2008.
Artículo en Portugués | MEDLINE | ID: mdl-18719786

RESUMEN

OBJECTIVE: To evaluate the perception of a group of women from Belo Horizonte, Minas Gerais, Brasil, with respect to menopause and its treatment. METHODS: A secondary analysis was performed on data from a population-based, cross sectional study carried out with 378 Brazilian born women between 40 and 65 years of age, with 11 years or more of formal education. Some women added spontaneous comments to the end of the questionnaire on sexuality handed out by research assistants and self-responded anonymously. There were those who provided comments at the end of the questionnaire and those who did not. The groups were compared with respect to sociodemographic and reproductive characteristics using Pearson's chi-square test. Comments were transcribed in their entirety to a computerized file for thematic content analysis, and units of meaning were identified and classified. RESULTS: Approximately one-third of the women (114/378) provided comments. Significantly more women with lower income levels provided comments as compared to those with higher income levels. The principal identified categories of analysis were: a) uncertainty and/or confusion, mainly with regard to anguish, stress and doubts about menopause; b) symptoms that lead to negative feelings, such as hot flushes, vaginal dryness and mood changes; and c) hormone replacement therapy, fears and perception of a lack of conviction in the physicians who prescribe it. CONCLUSION: The comments indicate that more attention must be given to the problems perceived in climacteric women with a special emphasis on those of the lower incomes levels.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Terapia de Reemplazo de Hormonas/psicología , Menopausia/efectos de los fármacos , Menopausia/psicología , Salud de la Mujer , Adulto , Anciano , Brasil , Distribución de Chi-Cuadrado , Estudios Transversales , Escolaridad , Femenino , Sofocos/fisiopatología , Humanos , Libido , Menopausia/fisiología , Persona de Mediana Edad , Posmenopausia/psicología , Calidad de Vida , Riesgo , Autoimagen , Encuestas y Cuestionarios , Resultado del Tratamiento
14.
Maturitas ; 56(2): 129-41, 2007 Feb 20.
Artículo en Inglés | MEDLINE | ID: mdl-16901660

RESUMEN

OBJECTIVE: The objective of this study was to evaluate gynecologists' knowledge of the WHI study, and its repercussions on their attitudes and practice 3 years after publication. DESIGN: A self-administered, anonymous questionnaire containing 19 questions was sent to 6000 gynecologists, members of the São Paulo Society of Obstetrics and Gynecology. RESULTS: The response rate was 24.2% (1453 completed questionnaires) with a sample error of 2.23% and confidence level of 95%. Although 95.9% of the respondents were aware of the WHI study, only 24.4% knew of all the other studies mentioned (HERS I, HERS II and Million Women Study). Although 84.6% stated that the results of the WHI study could not be extrapolated to other forms of HT, 23.1% and 25.2%, respectively, stopped prescribing CEE or MPA, 63.7% decreased the dose, 55.2% opted for drugs such as bisphosphonates, tibolone and SERMS, and 46.3% began to prescribe tranquilizers, isoflavone and other natural medications. Moreover, 59.2% agreed that HT should be used for only 4-5 years. Prescriptions decreased significantly for all indications (p<0.0001). The principal reason for physicians to discontinue HT in a patient was increased risk of breast cancer (62.3%), whereas, according to the physicians, the most important factor for the patients was fear of HT (80.3%). CONCLUSION: A high percentage of gynecologists in this study knew of the WHI study and followed its recommendations concerning cardiovascular prevention; consequently they changed their management of the treatment of postmenopausal women by restricting indications for HT and decreasing its duration of use and dose.


Asunto(s)
Actitud del Personal de Salud , Ginecología , Conocimientos, Actitudes y Práctica en Salud , Salud de la Mujer , Adulto , Anciano , Brasil , Terapia de Reemplazo de Estrógeno/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Osteoporosis Posmenopáusica/prevención & control , Pautas de la Práctica en Medicina , Encuestas y Cuestionarios , Recursos Humanos
15.
Arq Gastroenterol ; 43(2): 102-6, 2006.
Artículo en Portugués | MEDLINE | ID: mdl-17119663

RESUMEN

BACKGROUND: Fecal incontinence occurs more frequently in the female population and it becomes more prevalent with increasing age. There are few studies that have assessed the prevalence and severity of postmenopausal women. AIMS: To investigate fecal incontinence. PATIENTS AND METHODS: A cross-sectional study was performed on 100 postmenopausal women over the age of 45. Sociodemographic and clinical characteristics were evaluated, and a descriptive analysis of these characteristics was carried out. The prevalence of fecal incontinence was estimated. St. Mark's incontinence score was applied to study the severity of symptoms associated with fecal incontinence. The score was then categorized according to the tertile and symptom severity was classified as mild, moderate or severe incontinence. Bivariate and multivariate analyses were used to study the association between fecal incontinence and its likely determinants, employing the prevalence ratio. Confidence interval was set at 95%. RESULTS: The mean age of the patients was 58.9 +/- 5.9 years (range, 46-76 years). The prevalence rate was 15% for fecal incontinence. Of incontinent patients, 60% had mild incontinence. After multivariate analysis, factors associated with fecal incontinence was history of forceps delivery (prevalence ratio: 7.80; 95% confidence interval:2.38-25.55). CONCLUSIONS: The prevalence of fecal incontinence was high in postmenopausal women. Data suggest that most women presented mild fecal incontinence. The history of forceps delivery was associated with fecal incontinence.


Asunto(s)
Incontinencia Fecal/epidemiología , Posmenopausia , Anciano , Brasil/epidemiología , Métodos Epidemiológicos , Femenino , Humanos , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Factores Socioeconómicos
16.
Rev Assoc Med Bras (1992) ; 52(6): 413-8, 2006.
Artículo en Portugués | MEDLINE | ID: mdl-17242778

RESUMEN

OBJECTIVE: To identify factors associated with the intensity of hot flashes in 334 climacteric women living in Campinas, São Paulo, Brasil. METHODS: Secondary analysis of a data bank of a descriptive cross-sectional population-based study. Selection of 334 women reporting hot flashes aged 45-60 years was carried out through cluster sampling. Data were collected by home interviews using a structured, pre-tested questionnaire provided by the International Health Foundation/International Menopause Society and by the North American Menopause Society and adapted by the authors. Intensity of hot flashes was measured using the circulatory index. The variables analyzed were age, use of contraceptive methods and hormonal therapy, tubal ligation, body mass index, menopausal status, time since menopause, hysterectomy, bilateral oophorectomy and smoking. Statistical analysis was performed by using the median, absolute and relative frequencies according to the type of variable. The prevalence ratio (PR) was used to measure association. Bivariate analysis and multiple logistic regression with a 95% confidence interval (95% CI) were used to identify the factors associated with the intensity of hot flashes. RESULTS: Women with time since menopause of over 61 months (PR: 0.59; IC 95%: 0.39-0.88) had a significantly lower chance of presenting intense hot flashes while the antecedent of bilateral oophorectomy (PR: 1.95; IC 95%: 1.08-3.50) was significantly associated with the intensity of hot flashes. CONCLUSION: Both factors, time since menopause and bilateral oophorectomy, suggest hypoestrogenism as a common cause of more intense hot flashes. Women with these factors should receive specialized care to minimize the negative effects of hot flashes.


Asunto(s)
Climaterio/fisiología , Sofocos/epidemiología , Distribución por Edad , Brasil/epidemiología , Métodos Epidemiológicos , Femenino , Sofocos/etiología , Humanos , Menarquia , Persona de Mediana Edad , Posmenopausia/fisiología , Factores Socioeconómicos , Factores de Tiempo
17.
Rev Assoc Med Bras (1992) ; 52(4): 242-6, 2006.
Artículo en Portugués | MEDLINE | ID: mdl-16967142

RESUMEN

BACKGROUND: To evaluate the prevalence of habitual physical activity and cardiovascular risk in postmenopausal women. METHODS: A cross-sectional study was made of 162 women, aged 40-65 years, amenorrheic for at least 12 months, receiving care at the menopause clinic of CAISM/UNICAMP. The women verbally answered the International Physical Activity Questionnaire for assessment of physical activity levels. This instrument evaluates the frequency and duration of activities performed during transportation, at work, at home or in leisure- over the course of a normal week. Women were classified as sedentary, insufficiently active, active or very active. Laboratory tests were carried out to measure total serum cholesterol, high density lipoproteins and fasting glucose. Systolic and diastolic pressure was measured. RESULTS: The mean age of women in this study was 56.5 years and mean age at menopause was 46 years. Prevalence of physical activity was 83.3% of which 80.8% were classified as active, 2.5% as very active and 16.7% as insufficiently active. Principal activities were performed during transportation and while carrying out household chores. Only 38.3% of women had leisure-time physical activities. In the population, 87.7% of the women presented a Framingham score <10, considered of low cardiovascular risk. CONCLUSIONS: Postmenopausal women show a high prevalence of habitual physical activity and low adherence to physical exercise. Cardiovascular risk was low in the population studied. It is important to encourage these women to practice physical activity compatible with their physical condition, to orient and stimulate them to practice not only their habitual physical activity but also physical exercise.


Asunto(s)
Enfermedades Cardiovasculares/etiología , Ejercicio Físico/fisiología , Posmenopausia/fisiología , Adulto , Anciano , Enfermedades Cardiovasculares/sangre , Enfermedades Cardiovasculares/prevención & control , Colesterol/sangre , Estudios Transversales , Femenino , Encuestas Epidemiológicas , Humanos , Actividades Recreativas , Persona de Mediana Edad , Posmenopausia/sangre , Medición de Riesgo , Factores Socioeconómicos , Encuestas y Cuestionarios
18.
Menopause ; 23(7): 792-8, 2016 07.
Artículo en Inglés | MEDLINE | ID: mdl-27116462

RESUMEN

OBJECTIVE: Vaginal atrophy is a common chronic condition among postmenopausal women that can affect their quality of life. Recent studies have evaluated new treatment alternatives for vaginal atrophy; however, few therapeutic options have been thoroughly evaluated. This study aimed to compare the effectiveness and adverse effects of estrogen, testosterone, polyacrylic acid, and placebo lubricant for the treatment of postmenopausal women with vaginal atrophy. METHODS: We conducted a randomized clinical trial with 80 postmenopausal women aged between 40 and 70 years who were being followed up at the Menopause Clinic of CAISM UNICAMP between November 2011 and January 2013. Women were randomly assigned to topical vaginal treatment with estrogen, testosterone, polyacrylic acid, and placebo lubricant, three times a week for 12 weeks. We used the vaginal maturation index, pH, vaginal health score, vaginal flora, laboratory tests, and ultrasound to evaluate changes of vaginal atrophy at baseline and after 6 and 12 weeks of treatment. RESULTS: After a 12-week treatment with topical estrogen and testosterone compared with the lubricant, an increased percentage of participants had vaginal pH less than 5, increased vaginal score, and an increase in the number of lactobacilli. Treatment with topical estrogen improved the vaginal maturation index and showed increased levels of estradiol in three women. No changes were observed in the endometrial evaluation of all treatment groups. CONCLUSIONS: After a 12-week treatment with testosterone and estrogen compared with placebo lubrication, there was a significant improvement in vaginal trophism in postmenopausal women with vaginal atrophy.


Asunto(s)
Resinas Acrílicas/administración & dosificación , Estrógenos Conjugados (USP)/administración & dosificación , Estrógenos/administración & dosificación , Propionato de Testosterona/administración & dosificación , Vagina/patología , Enfermedades Vaginales/tratamiento farmacológico , Administración Intravaginal , Adulto , Anciano , Atrofia/tratamiento farmacológico , Femenino , Humanos , Concentración de Iones de Hidrógeno/efectos de los fármacos , Análisis de Intención de Tratar , Persona de Mediana Edad , Posmenopausia , Método Simple Ciego , Resultado del Tratamiento , Vagina/efectos de los fármacos , Cremas, Espumas y Geles Vaginales/administración & dosificación , Enfermedades Vaginales/patología
19.
Maturitas ; 85: 82-7, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26857885

RESUMEN

AIMS: There are few population-based studies evaluating the epidemiology of overactive bladder syndrome (OAB) in women, especially in the climacteric stage where there is a decrease in estrogen production. This study aimed to assess the prevalence of OAB and associated factors in climacteric Brazilian women. METHODS: A descriptive, exploratory, cross-sectional study was conducted between September 2012 and June 2013 with 749 women (a population-based household survey). The dependent variable was OAB, defined as the presence of urinary urgency, with or without urinary incontinence, and when there was no concomitant stress urinary incontinence. The independent variables were sociodemographic data, health related habits and problems, self-perception of health, and gynecological background. Statistical analysis was carried out by Chi-square test and Poisson regression using the backward selection criteria. RESULTS: Mean age was 52.5 (± 4.4) years. With regard to menopausal status, 16% were premenopausal, 16% perimenopausal and 68% postmenopausal. The prevalence of OAB was 7.8%. The vast majority of women had only urinary urgency. Only two women who responded to the interview reported urge incontinence. In the final statistical model, vaginal dryness (PR 1.75; 95% CI 1.13-2.69; p=0.012) and bilateral oophorectomy (PR 2.21; 95% CI 1.11-4.40; p=0.025) were associated with a greater prevalence of OAB. CONCLUSIONS: Health professionals should adopt a proactive behavior in surgically menopausal women and those with a history of genital atrophy to identify and treat OAB, thus contributing to an improved quality of life and healthier aging.


Asunto(s)
Menopausia/fisiología , Vejiga Urinaria Hiperactiva/epidemiología , Incontinencia Urinaria de Urgencia/epidemiología , Brasil/epidemiología , Estudios Transversales , Femenino , Humanos , Persona de Mediana Edad , Ovariectomía , Prevalencia , Factores de Riesgo , Vejiga Urinaria Hiperactiva/complicaciones , Incontinencia Urinaria de Urgencia/complicaciones
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