RESUMO
Background: Relieving vulvar pain caused by atrophy in postmenopausal women is a challenge in our clinical practice. We know more and more about the vulva, its anatomy and physiology and we are realizing that it is different from the vagina. The importance of the vulvar approach in the management of vulvar or vestibular pain (VP) due to atrophy in postmenopausal women is becoming increasingly important. A panel of experts from several Spanish scientific societies (Spanish Menopause Society, AEEM; Spanish Federation of Sexology Societies, FESS; Spanish Society of Primary Care Physicians, SEMERGEN; and the Spanish Society of Gynecology and Obstetrics) held a meeting to discuss treatment recommendations for women with vulvar and VP based on the best available evidence, creating a report to describe grades of recommendations.
Assuntos
Pós-Menopausa , Vulvodinia , Feminino , Humanos , Menopausa , Dor , Gravidez , Vulva , Vulvodinia/terapiaRESUMO
Since the first documented autochthonous transmission of chikungunya virus in the Caribbean island of Saint Martin in 2013, the infection has been reported within the Caribbean region as well as North, Central and South America. The risk of autochthonous transmission of chikungunya virus becoming established in Spain may be elevated due to the large numbers of travellers returning to Spain from countries affected by the 2013 epidemic in the Caribbean and South America, as well as the existence of the Aedes albopictus vector in certain parts of Spain. We retrospectively analysed the laboratory diagnostic database of the National Centre for Microbiology, Institute of Health Carlos III (CNM-ISCIII) from 2008 to 2014. During the study period, 264 confirmed cases, of 1,371 suspected cases, were diagnosed at the CNM-ISCIII. In 2014 alone, there were 234 confirmed cases. The highest number of confirmed cases were reported from the Dominican Republic (n = 136), Venezuela (n = 30) and Haiti (n = 11). Six cases were viraemic in areas of Spain where the vector is present. This report highlights the need for integrated active case and vector surveillance in Spain and other parts of Europe where chikungunya virus may be introduced by returning travellers.
Assuntos
Febre de Chikungunya/diagnóstico , Vírus Chikungunya/isolamento & purificação , Febre/etiologia , Viagem , Aedes/virologia , Animais , Febre de Chikungunya/epidemiologia , Febre de Chikungunya/virologia , Vírus Chikungunya/genética , Surtos de Doenças , República Dominicana , Feminino , Haiti , Humanos , Insetos Vetores/virologia , Masculino , RNA Viral , Estudos Retrospectivos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Vigilância de Evento Sentinela , Espanha/epidemiologia , VenezuelaRESUMO
INTRODUCTION: Although there is literature on sexuality in gender dysphoria, few studies have been done prior to genital sex reassignment surgery (SRS). AIMS: To evaluate the perception of sexual QoL in gender-dysphoric patients before genital SRS and the possible factors associated to this perception. METHODS: The final sample consisted of 67 male-to-female and 36 female-to-male gender-dysphoric adults consecutively attended in a gender unit who had not undergone genital SRS; 39.8% was receiving cross-sex hormonal treatment, and 30.1% had undergone breast augmentation or reduction. Sexual QoL was assessed using the sexual activity facet of the World Health Organization Quality of Life (WHOQOL)-100. Sociodemographic (age, gender, partner relationship) and clinical data (being on hormonal treatment and having undergone any breast surgery) were recorded from the clinical records. Depressive symptoms were assessed using the negative feelings facet of the WHOQOL-100. Personality was assessed using the Revised NEO-Five Factor Inventory. MAIN OUTCOME MEASURES: Sexual QoL, negative feelings, hormonal treatment, partner relationship, personality. RESULTS: The mean score of the sexual facet was 10.01 (standard deviation = 4.09). More than 50% of patients rated their sexual life as "poor/dissatisfied" or "very poor/very dissatisfied," around a quarter rated it as "good/satisfied" or "very good/very satisfied," and the rest had a neutral perception. Three variables were significantly associated with a better sexual QoL: less negative feelings (ß = -0.356; P < 0.001), being on hormonal treatment (ß = 0.216; P = 0.018), and having a partner (ß = 0.206; P = 0.022). Age, sex, having undergone some breast surgery, and personality factors were not associated with their perception. CONCLUSION: This study indicates that before genital SRS, about half of gender-dysphoric subjects perceived their sexual life as "poor/dissatisfied" or "very poor/very dissatisfied." Moreover, receiving hormonal treatment, low negative feelings, and having a partner are related to a better subjective perception of sexual QoL.
Assuntos
Hormônios Esteroides Gonadais/uso terapêutico , Qualidade de Vida/psicologia , Comportamento Sexual/psicologia , Pessoas Transgênero/psicologia , Transexualidade/psicologia , Adaptação Psicológica , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação Pessoal , Autoimagem , Cirurgia de Readequação Sexual/métodos , Apoio Social , Inquéritos e Questionários , Transexualidade/tratamento farmacológico , Transexualidade/cirurgiaRESUMO
The 2023 monkeypox (mpox) epidemic was caused by a subclade IIb descendant of a monkeypox virus (MPXV) lineage traced back to Nigeria in 1971. Person-to-person transmission appears higher than for clade I or subclade IIa MPXV, possibly caused by genomic changes in subclade IIb MPXV. Key genomic changes could occur in the genome's low-complexity regions (LCRs), which are challenging to sequence and are often dismissed as uninformative. Here, using a combination of highly sensitive techniques, we determine a high-quality MPXV genome sequence of a representative of the current epidemic with LCRs resolved at unprecedented accuracy. This reveals significant variation in short tandem repeats within LCRs. We demonstrate that LCR entropy in the MPXV genome is significantly higher than that of single-nucleotide polymorphisms (SNPs) and that LCRs are not randomly distributed. In silico analyses indicate that expression, translation, stability, or function of MPXV orthologous poxvirus genes (OPGs), including OPG153, OPG204, and OPG208, could be affected in a manner consistent with the established "genomic accordion" evolutionary strategies of orthopoxviruses. We posit that genomic studies focusing on phenotypic MPXV differences should consider LCR variability.
Assuntos
Mpox , Orthopoxvirus , Poxviridae , Humanos , Monkeypox virus/genética , Genômica , Mpox/genéticaRESUMO
Filoviruses, amongst the most lethal of primate pathogens, have only been reported as natural infections in sub-Saharan Africa and the Philippines. Infections of bats with the ebolaviruses and marburgviruses do not appear to be associated with disease. Here we report identification in dead insectivorous bats of a genetically distinct filovirus, provisionally named Lloviu virus, after the site of detection, Cueva del Lloviu, in Spain.
Assuntos
Quirópteros/virologia , Reservatórios de Doenças , Ebolavirus/isolamento & purificação , Doença pelo Vírus Ebola/veterinária , Animais , Sequência de Bases , DNA Viral/análise , Surtos de Doenças , Ebolavirus/genética , Genoma , Doença pelo Vírus Ebola/patologia , Doença pelo Vírus Ebola/virologia , Pulmão/patologia , Pulmão/virologia , Dados de Sequência Molecular , Filogenia , Espanha , Baço/patologia , Baço/virologiaRESUMO
Emerging infectious diseases are one of the most important global health challenges because of their impact on human and animal health. The vector-borne West Nile virus (WNV) is transmitted between birds by mosquitos, but it can also infect humans and horses causing disease. The local circulation of WNV in Spain has been known for decades, and since 2010, there have been regular outbreaks in horses, although only six cases were reported in humans until 2019. In 2020, Spain experienced a major outbreak with 77 human cases, which was followed by 6 additional cases in 2021, most of them in the Andalusian region (southern Spain). This study aimed to characterize the genomes of the WNV circulating in wild-trapped mosquitoes during 2020 and 2021 in Andalusia. We sequenced the WNV consensus genome from two mosquito pools and carried out the phylogenetic analyses. We also compared the obtained genomes with those sequenced from human samples obtained during the outbreak and the genomes obtained previously in Spain from birds (2007 and 2017), mosquitoes (2008) and horses (2010) to better understand the eco-epidemiology of WNV in Spain. As expected, the WNV genomes recovered from mosquito pools in 2020 were closely related to those recovered from humans of the same outbreak. In addition, the strain of WNV circulating in 2021 was highly related to the WNV strain that caused the 2020 outbreak, suggesting that WNV is overwintering in the area. Consequently, future outbreaks of the same strain may occur in in the future.
Assuntos
Culicidae , Vírus do Nilo Ocidental , Humanos , Animais , Cavalos , Vírus do Nilo Ocidental/genética , Filogenia , Espanha/epidemiologia , Mosquitos Vetores , Genômica , Surtos de DoençasRESUMO
To ascertain the presence of West Nile virus (WNV), we sampled mosquitoes in 2006 in locations in southern Spain where humans had been infected. WNV genomic RNA was detected in 1 pool from unfed female Culex pipiens mosquitoes. Phylogenetic analysis demonstrated that this sequence cannot be assigned to previously described lineages of WNV.
Assuntos
Culex/virologia , Evolução Molecular , Vírus do Nilo Ocidental/classificação , Vírus do Nilo Ocidental/genética , Aedes/virologia , Animais , Linhagem Celular , Chlorocebus aethiops , Feminino , Humanos , Filogenia , RNA Viral/análise , RNA Viral/isolamento & purificação , Análise de Sequência de DNA , Espanha/epidemiologia , Células Vero , Febre do Nilo Ocidental/epidemiologia , Febre do Nilo Ocidental/transmissão , Febre do Nilo Ocidental/virologia , Vírus do Nilo Ocidental/isolamento & purificação , Vírus do Nilo Ocidental/patogenicidadeRESUMO
We report the first human case of West Nile virus (WNV) lineage 2 infection imported to Spain by a traveler returning from Romania. Serum, cerebrospinal fluid and urine samples were analyzed and West Nile virus infection was identified by PCR and serological tests. The patient developed fever, diarrhea and neurological symptoms, accompanied by mild pancreatitis, described previously in very few cases as a complication of WNV infection and by alithiasic cholecystitis. Viral RNA was detected in urine until 30 days after the onset of symptoms and neutralizing antibodies were detected at very low titers. The phylogenetic analysis in a fragment of the NS5 gene of the virus showed a homology with sequences from WNV lineage 2 belonging to the monophyletic Central/Southern European group.
Assuntos
Anticorpos Antivirais/sangue , Doenças Transmissíveis Importadas/virologia , Gastroenteropatias/virologia , Doenças do Sistema Nervoso/virologia , Febre do Nilo Ocidental/complicações , Vírus do Nilo Ocidental/genética , Anticorpos Neutralizantes/sangue , Doenças Transmissíveis Importadas/complicações , Doenças Transmissíveis Importadas/diagnóstico , Surtos de Doenças , Humanos , Masculino , Pessoa de Meia-Idade , Filogenia , RNA Viral/urina , Romênia , Espanha , Proteínas não Estruturais Virais/genética , Febre do Nilo Ocidental/diagnóstico , Vírus do Nilo Ocidental/classificaçãoRESUMO
OBJECTIVES: To determine whether actively addressing sexuality in a gynaecological consultation with menopausal patients improves the diagnosis of sexual problems. STUDY DESIGN: A multi-centre analytical cross-sectional study was conducted at 12 Spanish hospitals. In gynaecological consultations the usual medical histories were taken, except that, initially, issues relating to sexuality were omitted, unless the patients raised them. Then, after 5min, gynaecologists offered the possibility of talking about sexuality and asked about possible sexual problems. Main outcome measures Observed prevalence of sexual problems. RESULTS: A total of 256 postmenopausal women participated in the study. Of them, 12.1% reported a sexual problem during the first 5 minutes of the interview. The prevalence of patients with a sexual problem increased by 35.9% (from 12.1% to 48.0%) when they were asked about sexuality after 5min (p<0.0001). The main factors associated with having a sexual problem were genitourinary syndrome of menopause (GSM) and having a stable sexual partner. CONCLUSIONS: Asking postmenopausal women about sexuality in gynaecological consultations is an important tool that increases the number of diagnoses of sexual problems. Gynaecologists should routinely ask about sexuality.
Assuntos
Pós-Menopausa/fisiologia , Disfunções Sexuais Fisiológicas/epidemiologia , Saúde Sexual , Idoso , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Parceiros Sexuais , SexualidadeRESUMO
Breast cancer is the most common cancer in women. As survival rates are increasing, the long-term health problems of survivors now need attention. Many survivors develop sexual disorders as a consequence of either the side-effects of treatment or induced menopause. A panel of experts from various Spanish scientific societies (Spanish Menopause Society, SMS; Federación Española de Sociedades de Sexología, FESS; Sociedad Española de Médicos de Atención Primaria, SEMERGEN; and Sociedad Española de Oncología Médica) met to develop recommendations for the management of sexual health in breast cancer survivors based on the best evidence available. The main recommendation is that sexuality must be considered by a multidisciplinary team as an integral part of treatment, to improve the quality of life of breast cancer survivors.
Assuntos
Neoplasias da Mama , Sobreviventes de Câncer/psicologia , Saúde Sexual , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/psicologia , Feminino , Humanos , Menopausa/psicologia , Qualidade de Vida , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Fisiológicas/psicologia , Disfunções Sexuais Fisiológicas/terapia , EspanhaRESUMO
We report one laboratory-confirmed coinfection by dengue type 4 and Plasmodium falciparum imported to Spain from Haiti. Diagnosis was made by real-time polymerase chain reaction (RT-PCR), serology, quantitative buffy coat, and thick blood smear. In areas where both infections are present, diagnosis of both diseases should be considered because a delay in the treatment of malaria could be fatal.
Assuntos
Coinfecção , Vírus da Dengue/isolamento & purificação , Dengue/diagnóstico , Malária Falciparum/diagnóstico , Plasmodium falciparum/isolamento & purificação , Adulto , Dengue/complicações , Dengue/tratamento farmacológico , Feminino , Humanos , Malária Falciparum/complicações , Malária Falciparum/tratamento farmacológicoRESUMO
Sexual health has been defined as "the state of physical, emotional and social wellbeing related to sexuality. However, there are medical, psychological and social reasons that complicate full sexual health that are frequently not attended to sufficiently. The objective of this guide will be to analyze the factors that impact the sexual health of men and women over 50 and to provide recommendations for the most appropriate diagnostic and therapeutic measures for this age group. A panel of experts from various Spanish scientific societies related to sexual health (Spanish Menopause Society, SMS; Asociación Española de Andrología, Medicina Sexual y Reproductiva, ASESA; Federación Española de Sociedades de Sexología, FESS; and Sociedad Española de Médicos de Atención Primaria SEMERGEN) met to reach a consensus on these issues and to decide the optimal timing and methods based on the best evidence available.
Assuntos
Consenso , Saúde Reprodutiva , Disfunções Sexuais Fisiológicas/terapia , Disfunções Sexuais Psicogênicas/terapia , Idoso , Dispareunia/diagnóstico , Dispareunia/terapia , Disfunção Erétil/diagnóstico , Disfunção Erétil/terapia , Feminino , Humanos , Masculino , Saúde do Homem , Pessoa de Meia-Idade , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Psicogênicas/diagnóstico , Espanha , Saúde da MulherRESUMO
We report the characterization of three novel flaviviruses isolated in Spain. Marisma Mosquito virus, a novel mosquito borne virus, was isolated from Ochlerotatus caspius mosquitoes; Spanish Ochlerotatus flavivirus and Spanish Culex flavivirus, two novel insect flaviviruses, were isolated from Oc. caspius and Culex pipiens, respectively. During this investigation, we designed a sensitive RT-nested polymerase chain reaction method that amplifies a 1019bp fragment of the flavivirus NS5 gene and could be directly used in clinical or environmental samples for flavivirus characterization and surveillance. Analysis of the sequence generated from that amplicon contains enough phylogenetic information for proper taxonomic studies. Moreover, the use of this tool allowed the detection of additional flavivirus DNA forms in Culex, Culiseta, and Ochlerotatus mosquitoes.
Assuntos
Culicidae/virologia , Flavivirus/classificação , Insetos Vetores/virologia , Filogenia , Proteínas não Estruturais Virais/genética , Animais , Sequência de Bases , Culex/virologia , Feminino , Flavivirus/genética , Flavivirus/isolamento & purificação , Infecções por Flavivirus/transmissão , Masculino , Dados de Sequência Molecular , Ochlerotatus/virologia , Reação em Cadeia da Polimerase , RNA Viral/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Análise de Sequência de DNA , Espanha/epidemiologiaRESUMO
West Nile virus lineage 1 (similar to the strains obtained from golden eagles in Spain, 2007) and Usutu virus (similar to the strains obtained from Culex pipiens in Spain, 2006) were detected in pools from Culex perexiguus collected in southern Spain in 2008 and 2009, respectively. This is the first detection and isolation of West Nile virus lineage 1 from mosquitoes in Spain.
Assuntos
Culex/virologia , Flavivirus/isolamento & purificação , Vírus do Nilo Ocidental/isolamento & purificação , Animais , Flavivirus/classificação , Espanha , Especificidade da Espécie , Vírus do Nilo Ocidental/classificaçãoRESUMO
The presence of viruses in arthropods in Spain has been studied over 5 years. Flaviviruses similar to cell-fusing agent, sequences of a flavivirus related to those transmitted by mosquitoes, and a phlebovirus similar to Naples and Toscana viruses were detected. Their potential human or animal pathogenicity should be studied.