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INTRODUCTION AND HYPOTHESIS: Almost 20% of women will suffer from sexual abuse at some point in their lives. This is a known risk factor for developing chronic pelvic pain (CPP), which is a major health problem worldwide. We conducted a pilot study in a Gynecology Outpatient Clinic to find the correlation between these two clinical entities and provide better evidence for their diagnosis and treatment. METHODS: A semi-structured interview for the evaluation of sexual violence in women (EVS) was used as a screening tool and a complement to routine gynecological examination to identify patients suffering from sexual abuse. Patients included were also assessed for comorbidities, including CPP, and other coexisting mental health problems. RESULTS: Of the 61 patients screened, 33 (54.1%) had pelvic pain. Also, 11 patients (18%) had suffered sexual abuse at some point in their lives, which was only disclosed when the specific interview was performed. Ten patients (90.8%) out of 11 that had been sexually abused also had pelvic pain. This was found to be statistically significant in this sample (p = 0.008) with a more than 11-fold greater risk of having pelvic pain (OR, 11.7; 95% CI, 1.4-98.7). Most patients did not have psychological violence (77%) but those that did (23%) had a seven-fold greater risk of having pelvic pain (OR, 7.4; 95% CI, 1.5-36.9). CONCLUSION: Specific tools should intentionally be used for evaluating sexual abuse and chronic pelvic pain, since a strong correlation exists between these two entities and they are seldom reported by patients.
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Ginecologia , Delitos Sexuais , Instituições de Assistência Ambulatorial , Feminino , Humanos , Dor Pélvica , Projetos Piloto , Inquéritos e QuestionáriosRESUMO
Silicone oil (SO) emulsification is a significant concern in vitreoretinal surgery, leading to various complications. Despite the high prevalence of SO emulsification within the eye, there is currently no standardized method for its early detection. The recent introduction of widefield (WF) imaging and ultra-WF (UWF) imaging with navigated central and peripheral optical coherence tomography (OCT) techniques have shown promising results in providing high-resolution images of the peripheral vitreous, vitreoretinal interface, retina, and choroid. This enhanced visualization capability enables the early identification of emulsified SO droplets, facilitating a proactive therapeutic approach, and mitigating associated adverse events. This comprehensive literature review aims to provide an updated overview of the topic, focusing on the role of WFimaging and UWF imaging and navigated central and peripheral swept-source OCT (SS-OCT) in the early detection and management of SO emulsification. The review discusses the current understanding of SO emulsification, its associated complications, and the limitations of existing detection methods. In addition, it highlights the potential of WF and UWF imaging and peripheral OCT as advanced imaging modalities for improved visualization of SO emulsification. This review serves as a valuable resource for clinicians and researchers, providing insights into the latest advancements in the field of vitreoretinal surgery and the promising role of WF imaging and UWF imaging and navigated central and peripheral SS-OCT in the management of SO.
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PURPOSE: To assess central and peripheral retinal and choroidal diseases using ultra-widefield (UWF) fundus imaging in combination with navigated central and peripheral cross-sectional and three-dimensional (3D) swept source optical coherence tomography (SS-OCT) scans. METHODS: Retrospective study involving 332 consecutive patients, with a nearly equal distribution of males and females. The mean age of patients was 52 years (range 18-92 years). Average refractive error was -3.80 D (range +7.75 to -20.75 D). RESULTS: The observations in this study demonstrate the efficacy of peripheral navigated SS-OCT in assessing various ocular conditions. The technology provides high-quality images of the peripheral vitreous, vitreoretinal interface, retina, and choroid, enabling visualization of vitreous floaters and opacities, retinal holes and tears, pigmented lesions, and peripheral retinal degenerations. 3D OCT scans enhance the visualization of these abnormalities and improve diagnostic and therapeutic decisions. CONCLUSION: Navigated central and peripheral cross-sectional and 3D SS-OCT scans offer significant complementary benefits in the assessment and management of retinal diseases. Their addition to UWF imaging provides a comprehensive view of central and peripheral ocular structures, aiding in early detection, precise anatomical measurements, and objective monitoring of disease progression. In addition, this technology serves as a valuable tool for patient education, a teaching tool for trainees, and documentation for medico-legal purposes.
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PURPOSE: Risk functions can help general practitioners identify patients at high cardiovascular risk, but overprediction inevitably leads to a disproportionate number of patients being targeted for treatment. To assess predicted cardiovascular risk, we analyzed the 10-year performance of the original and REGICOR Framingham coronary risk functions in nondiabetic patients. METHODS: Ours was a longitudinal, observational study of a retrospective cohort of patients observed for 10 years in primary care practices in Badajoz, Spain. Our cohort comprised 447 nondiabetic patients aged 35 to 74 years who had no evidence of cardiovascular disease and were not on lipid-lowering or antihypertensive therapy. We assessed the patients' 10-year coronary risk measurement from the time of their recruitment. We also estimated the percentage of patients who were candidates for antihypertensive and lipid-lowering therapy. RESULTS: The actual incidence rate of coronary events was 6.7%. The original Framingham equation overpredicted risk by 73%, whereas the REGICOR Framingham function underpredicted risk by 64%. The Brier scores were 0.06364 and 0.06093 (P = .365) for the original Framingham and REGICOR Framingham functions, respectively, and the remaining discrimination and calibration parameters were also highly similar for both functions. The original Framingham function classified 14.8% of the population as high risk and the REGICOR Framingham function classified 6.9%. The proportions of patients who, according to the original Framingham and REGICOR functions, would be candidates for lipid-lowering therapy were 14.3% and 6.7%, and for antihypertensive therapy they were 12.5% and 7.8%, respectively. CONCLUSION: The original Framingham equation overestimated coronary risk whereas the REGICOR Framingham function underestimated it. The original Framingham function selected a greater percentage of candidates for antihypertensive and lipid-lowering therapy.
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Doença das Coronárias/epidemiologia , Medição de Risco/métodos , Adulto , Idoso , Anticolesterolemiantes/uso terapêutico , Anti-Hipertensivos/uso terapêutico , Feminino , Indicadores Básicos de Saúde , Humanos , Hiperlipidemias/tratamento farmacológico , Hiperlipidemias/epidemiologia , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Incidência , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Razão de Chances , Valor Preditivo dos Testes , Curva ROC , Estudos Retrospectivos , Fatores de Risco , Espanha/epidemiologiaRESUMO
Reovirus is known to have an anticancer effect in both the preclinical and clinical assays. Current evidence suggests that the reovirus-mediated impact on tumor growth depends on the activation of specific antitumor immune responses. A feasible explanation for the oncolytic effects and immune system activation is through the expression of the fusogenic reovirus protein. In this work, we evaluated the in vivo antitumor effects of the expression of fusogenic protein p10 of avian reovirus (ARV-p10). We used chitosan nanoparticles (CH-NPs) as a vehicle for the ARV-p10 DNA in murine B16 melanoma models both in vitro and in vivo. We confirmed that ARV-p10 delivery through a chitosan-based formulation (ARV-p10 CH-NPs) was capable of inducing cell fusion in cultured melanoma cells, showing a mild cytotoxic effect. Interestingly, intratumor injection of ARV-p10 CH-NPs delayed tumor growth, without changing lymphoid populations in the tumor tissue and spleen. The injection of chitosan nanoparticles (CH-NPs) also delayed tumor growth, suggesting the nanoparticle itself would attack tumor cells. In conclusion, we proved that in vitro ARV-p10 protein expression using CH-NPs in murine melanoma cells induces a cytotoxic effect associated with its cell fusion. Further studies are necessary for establishing a protocol for efficient in vivo DNA delivery of fusion proteins to produce an antitumoral effect.