Successful use of tralokinumab for the treatment of atopic dermatitis on the genitals.

BACKGROUND: Genital involvement in atopic dermatitis(AD) can have a significant impact on the patient's quality of life. However, inspection of genital areas is not usually conducted during routine examination and patients may be reluctant to inform the clinician or show this area. OBJECTIVE: to evaluate the efficacy of tralokinumab in AD patients with genital involvement. METHODS: Adult patients with moderate/severe AD and genital involvement receiving tralokinumab have been analyzed. Primary endpoints were EASI, DLQI, PP-NRS, genital-IGA (g-IGA) and genital itching (GI) at week 16. RESULTS: out of 48 patients with moderate/severe AD under treatment with tralokinumab, 12 patients (25%) showed a genital involvement. Seven patients reported itching in the genital area (58%), while none reported a positive history of genital infections. Median scores at T0 were EASI 17.5, PP-NRS 8 and DLQI 14. After 16 weeks of treatment, we observed a median EASI of 3, a median PP-NRS of 1 and a median DLQI of 1. Finally, concerning the genital response, after 16 weeks of treatment, we observed a statistically significant decrease in mean GI and g-IGA scores. CONCLUSION: despite the small size of our sample, tralokinumab can be considered as a valid treatment option for AD with genital involvement.

The condition-dependence of male genital size and shape.

The male genitals of internal fertilisers evolve rapidly and divergently, and sexual selection is generally responsible for this. Many sexually selected traits are condition-dependent-with their expression dependent upon the resources available to be allocated to them-as revealed by genetic or environmental manipulations of condition. However, it is not clear whether male genitals are also condition-dependent. Here we manipulate condition in two ways (via inbreeding and diet) to test the condition-dependence of the genital arch of Drosophila simulans. We found that genital size but not genital shape suffered from inbreeding depression, whereas genital size and shape were affected by dietary manipulation of condition. The differential effects of these treatments likely reflect underlying genetic architecture that has been shaped by past selection: inbreeding depression is only expected when traits have a history of directional selection, while diet impacts traits regardless of historical selection. Nonetheless, our results suggest genitals can be condition-dependent like other sexually selected traits.

Toe stimulation improves tactile perception of the genitals.

The human body is represented in a topographic pattern in the primary somatosensory cortex (S1), and genital representation is displaced below the toe representation. However, the relationship between the representation of the genitals and toe in S1 remains unclear. In this study, tactile stimulation was applied to the big toe in healthy subjects to observe changes in tactile acuity in the unstimulated genital area, abdomen, and metacarpal dorsal. Then tactile stimulation was applied to the right abdomen and metacarpal dorsal to observe changes in tactile acuity in bilateral genitals. The results revealed that tactile stimulation of the big toe led to a reduction in the 2-point discrimination threshold (2PDT) not only in the stimulated big toe but also in the bilateral unstimulated genitals, whereas the bilateral abdomen and metacarpal dorsal threshold remained unchanged. On the other hand, tactile stimulation of the abdomen and metacarpal dorsal did not elicit 2-point discrimination threshold changes in the bilateral genitals. Cortical and subcortical mechanisms have been proposed to account for the findings. One explanation involves the intracortical interaction between 2 adjacent representations. Another possible explanation is that the information content of a specific body part is broadly distributed across the S1. Moreover, exploring the links between human behaviors and changes in the cerebral cortex is of significant importance.

[Balanoposthitis in the clinical practice of a urologist and dermatovenereologist: an interdisciplinary problem].

Balanoposthitis is a common inflammatory disease of the male genitals, which occurs more often in uncircumcised men. The cause of balanoposthitis can be an infectious, inflammatory or autoimmune process, as well as traumatization. In most cases, after proper intimate hygiene and the use of neutral moisturizers, the symptoms of balanoposthitis are completely stopped. In the case of torpid course of balanoposthitis and in the absence of improvement after drug therapy, it is necessary to exclude the malignant process. In the review article, the authors present the data of modern scientific research on the qualitative and quantitative composition of the microbiome in balanoposthitis. Differences in the composition of the microbiome were revealed in patients with balanoposthitis and healthy patients from the control group with excess foreskin. It was found that in patients with balanoposthitis, a impaired in hydration of the skin of the glans penis was revealed. Staphylococcus warneri and Prevotella bivia are the most common species associated with balanoposthitis and positively correlate with the severity of the disease. Candida infection, as an etiological factor of balanoposthitis, often occurs in children and may be associated with diaper rash. The prevalence of Gardnerella vaginalis as a pathogen in the male urogenital tract has not been fully studied. Currently, there are no reliable scientific studies that make it possible to attribute G. vaginalis to the etiological factor of balanoposthitis in men. However, it should be borne in mind that balanoposthitis may have a polymicrobial and synergistic etiology with the participation of G. vaginalis and anaerobic bacteria in the lower genital tract of men. The review article is clearly illustrated with clinical examples of the disease from the personal practice of the authors.

Pharmacological Treatments for Localized Provoked Vulvodynia: A Scoping Review.

Introduction: Localized provoked vulvodynia (LPV) is a chronic pain condition without an identifiable cause that is localized to a portion of the vulva and provoked by pressure or touch. LPV is a commonly occurring but poorly understood condition lacking consensus on management. Method: This scoping review used Arksey and O'Malley's approach to identify and evaluate literature published between 2010 and 2023 that addressed the question: What is the current evidence on the efficacy or effectiveness of pharmacological treatments in the management of LPV? Results: This review evaluated 18 papers reporting on the efficacy or effectiveness of oral, topical, and injectable medications. Seven of the studies were randomized controlled trials. Oral gabapentin and oral desipramine showed some improvement in sexual function compared to placebo. Small sample sizes and methodological issues limited confidence in interpreting findings. Pain was reduced in descriptive studies of tricyclic antidepressants, milnacipran, injectable anesthetics, and botulinum toxin. Where pain did not improve with treatment, some oral medications improved participants' mood and sexual function. Some topical agents may be effective in reducing peripherally mediated neuropathic pain. Botulinum toxin was the most well-studied injectable but yielded mixed outcomes related to pain, quality of life, and sexual function. Conclusion: There is a lack of convincing evidence to draw conclusions about the efficacy or effectiveness of pharmacological therapies for LPV. The breadth of therapies for treating LPV warrants the development of evidence-based, consensus guidelines for measuring treatment outcomes and improving comparisons across studies. Recommendations for research include addressing methodological shortcomings and diversifying the participant pool to increase the generalizability of findings.

Relapsing subcutaneous nodules of the penis in a pediatric patient.

A 14-year-old boy presented with a history of non-tender, subcutaneous coalescing nodules located on the ventral-lateral aspects of the penis shaft for one year. Laboratory investigations for blood count and autoimmunity were within normal limits. Complete excision was performed, and on histology, the dermis showed necrobiotic material composed of altered collagen bundles, surrounded by a palisade of histiocytes and scattered lymphocytes, thus allowing a diagnosis of subcutaneous granuloma annulare. Only 18 published cases reported penile granuloma annulare. Medical management was advocated in 7/18 cases, either as a first-line or adjuvant therapy where surgery was not radical. Three patients received high-potency local steroids: two cases underwent adjuvant sessions of intralesional triamcinolone, and one patient received pentoxifylline orally. Surgery should be considered a second-line option since 5/8 of treated cases eventually recurred. The pentoxifylline-treated case witnessed a relapse after drug discontinuation, while topical steroids lead to complete recovery without relapses.

Factores de riesgo asociados a defectos congénitos de genitales externos y gónadas masculinas

Introducción: Los defectos congénitos del tracto urogenital se encuentran entre las anomalías más encontradas en el feto o neonato, lo que da una idea de su extraordinaria importancia clínica, unido a las escasas investigaciones en la provincia Camagüey, sobre factores de riesgo asociados a los defectos congénitos de genitales externos y gónadas masculinas. Objetivo: Determinar los factores de riesgo asociados a defectos congénitos de genitales externos y gónadas masculinas. Métodos: Se realizó un estudio correlacional del tipo retrospectivo en el Hospital Pediátrico Eduardo Agramonte Piña en el periodo de enero de 2013 a diciembre de 2020. El universo se conformó por los 96 pacientes que fueron intervenidos quirúrgicamente por presentar defectos congénitos de los genitales externos y gónadas masculinas. Para determinar la asociación de los factores de riesgo con la aparición de defectos congénitos se empleó la prueba de independencia, en caso de p<0,05 se consideró asociación significativa. Para medir la magnitud de la asociación estadística entre las variables se utilizó el coeficiente Phi, se consideró mientras más fuerte a uno fuera su valor, más correlacionadas se encontraron las variables estudiadas. Resultados: La criptorquidia fue la forma clínica con mayor número de pacientes, seguida de la hipospadias y la hidrocele. La asociación entre los padres trabajadores agrícolas y la hipospadias y la criptorquidia con padres trabajadores industriales, resultaron significativas. El hecho que la madre fuera fumadora pasiva, constituyó una variable con asociación significativa, tanto para la aparición de hipospadias como de criptorquidia. El ser fumadora pasiva fue el factor de riesgo que tuvo mayor correlación con la aparición de los defectos congénitos. Conclusiones: Existieron factores de riesgo con asociación significativa a la aparición de defectos congénitos de genitales externos y gónadas masculinas.

Introduction: Congenital defects of the urogenital tract are among the anomalies most found in the fetus or neonate, which gives an idea of ​​their extraordinary clinical importance, together with the few investigations in the Camagüey province, on risk factors associated with congenital defects of external genitalia and male gonads. Objective: To determine the risk factors associated with congenital defects of the external genitalia and male gonads. Methods: A retrospective correlational study was carried out at the Eduardo Agramonte Piña Pediatric Hospital from January 2013 to December 2020. The universe was made up of the 96 patients who underwent surgery for presenting congenital defects of the external genitalia and male gonads. To determine the association of the risk factors with the appearance of congenital defects, the independence test was used; in case of p<0.05, a significant association was considered. To measure the magnitude of the statistical association between the variables, the Phi coefficient was used, it was considered that the stronger its value was, the more correlated the studied variables were found. Results: Cryptorchidism was the clinical form with the highest number of patients, followed by hypospadias and hydrocele. The association between farm worker parents and hypospadias and cryptorchidism with industrial worker parents was significant. The fact that the mother was a passive smoker was a variable with a significant association, both for the appearance of hypospadias and cryptorchidism. Being a passive smoker was the risk factor that had the highest correlation with the appearance of birth defects. Conclusions: There were risk factors with a significant association with the appearance of congenital defects of the external genitalia and male gonads.

Complicações pós-operatórias associadas a exenteração pélvica em mulheres com câncer ginecológico: revisão integrativa / Postoperative complications associated with pelvic exenteration in women with gynecological cancer: an integrative review / Complicaciones postoperatorias asociadas a la exenteración pélvica en mujeres con cáncer ginecológico: revisión integradora

RESUMO Objetivo: identificar as principais complicações advindas da cirurgia de exenteração pélvica em câncer ginecológico e o desfecho do óbito hospitalar após o procedimento cirúrgico. Método: revisão integrativa da literatura considerando 23 artigos publicados de 2012 a 2020 nas bases de dados LILACS e IBECS. Os descritores utilizados foram genital cancer, gynecological cancer, pelvic exenteration, exenteration, postoperative complications, surgical complications, death (idioma inglês), combinados através de conectores booleanos AND ou OR. Resultados: constatou-se aplicabilidade cirúrgica para câncer do colo uterino, útero, ovário, vaginal e vulvar; idade associada a comorbidades (diabetes e hipertensão); a exenteração pélvica total predominante; tempo médio de cirurgia e de institucionalização elevados em decorrência de infecções. Considerações finais: a pesquisa possibilita a melhoria da assistência de saúde prestada no pré, peri e pós-operatório de EP enquanto elucida os principais problemas resultantes desta cirurgia, suas estratificações e manejos.

ABSTRACT Objective: to identify the main complications arising from the pelvic exenteration surgery in gynecological cancer and the in-hospital death outcome after the surgical procedure. Method: an integrative literature review considering 23 articles published from 2012 to 2020 in the LILACS and IBECS databases. The descriptors used were the following: genital cancer, gynecological cancer, pelvic exenteration, exenteration, postoperative complications, surgical complications and death, combined by means of the AND or OR Boolean connectors. Results: surgical applicability was verified for cervical, uterine, ovarian, vaginal and vulvar cancer; age was associated with comorbidities (diabetes and hypertension); total pelvic exenteration was predominant; and there were high mean surgical and hospitalization times due to infections. Contributions to the area: this research enables improvements in the health care provided in the PE pre-, peri- and post-operative periods, as it elucidates the main problems resulting from this surgery, their stratifications and management options.

RESUMEN Objetivo: identificar las principales complicaciones derivadas de la cirugía de exenteración pélvica en tumores ginecológicos y el desenlace de fallecimiento intrahospitalario después del procedimiento quirúrgico. Método: revisión integradora de la literatura en la que se consideraron 23 artículos publicados en las bases de datos LILACS e IBECS entre 2012 y 2020. Se utilizaron los siguientes descriptores: genital cancer, gynecological cancer, pelvic exenteration, exenteration, postoperative complications, surgical complications y death (idioma inglés), combinados por medio de conectores booleanos AND u OR. Resultados: se detectó lo siguiente: aplicabilidad quirúrgica para cáncer de cuello uterino, útero, ovario, vagina y vulva; edad asociada a comorbilidades (diabetes e hipertensión); predominio de exenteración pélvica total; elevado tiempo promedio de cirugía; e internación por infecciones. Aportes al área: este trabajo de investigación permite mejorar la atención de la salud provista en los períodos pre-, peri- y post-operatorios de la EP, puesto que deja en claro los principales problemas derivados de esta cirugía, sus estratificaciones y opciones de manejo.

Nevo epidérmico verrucoso inflamatório linear e diagnóstico diferencial com a psoríase linear: a respeito de um caso / Inflammatory linear verrucous epidermal nevus and differential diagnosis with linear psoriasis: about a case

Nevo epidérmico verrucoso inflamatório linear e diagnóstico diferencial com a psoríase linear: a respeito de um caso RELATO DE CASOMaria Isabel Muniz Zemero1, Maria Amélia Lopes dos Santos1, Alena Margareth Darwich Mendes1, Carla Andrea Avelar Pires1,O nevo epidérmico verrucoso inflamatório linear (NEVIL) é uma variedade clínica rara de nevo epidérmico verrucoso, que se manifesta no início da infância, como lesões inflamatórias de superfície ceratósica, que coalescem e se distribuem em faixa, acompanhando as linhas de Blaschko. Faz diagnóstico diferencial com a psoríase linear, sendo difícil a diferenciação, dado os aspectos clínicos e histopatológicos comuns aos dois, enfantizando-se a necessidade de conhecer as características específicas de cada um. O objetivo deste relato é demonstrar uma afecção relativamente rara, descrita em uma menina de 5 anos, evoluindo desde os primeiros dias de vida com placas papuloceratósicas dispostas linearmente, acompanhadas de sinais inflamatórios e áreas erosadas ocupando grandes lábios, períneo e face interna e superior da coxa esquerda. Também pápulas e placas ceratósicas na região cervical posterior e borda lateral externa da planta do pé esquerdo, ascendendo ao longo da região posterior deste membro. Os critérios clínicos e histopatológicos corroboram o diagnóstico de NEVIL na diferenciação com a psoríase linear, ressaltando a importância do estabelecimento de critérios/ ferramentas que auxiliem na diferenciação destas duas dermatoses visando agilizar o diagnóstico, otimizar o tratamento e minimizar o desconforto para esses pacientes. O acompanhamento a longo prazo dos portadores é sugerido pela possibilidade ainda que mínima de malignização do NEVIL. (AU)

Inflammatory linear verrucous epidermal nevus and differential diagnosis with linear psoriasis: about a caseCASE REPORTMaria Isabel Muniz Zemero1, Maria Amélia Lopes dos Santos1, Alena Margareth Darwich Mendes1, Carla Andrea Avelar Pires1,Inflammatory Linear Verrucous Epidermal Nevus (ILVEN) is a rare clinical variety of verrucous epidermal nevus that manifests in early childhood as inflammatory lesions of keratosis surface, which coalesce and spread in band, following Blaschko lines. It makes a differential diagnosis with Linear Psoriasis; it is difficult to differentiate them given the clinical and histopathological aspects common to both, emphasizing the need to know the specific characteristics of each. The purpose of this report is to demonstrate a relatively rare affection, expressed in a 5-year-old girl, evolving from the first days of life with papulokeratosic plaques arranged linearly, followed by inflammatory signs and eroded areas, placed linearly, overtaking labia majora, perineum, the inner and upper face of the left thigh. Also, the patient showed keratotic papules and plaques in the posterior cervical region and external lateral border of the left foot plant, ascending along the posterior region of this limb. The clinical and histopathological criteria corroborate the diagnosis of ILVEN in differentiation with linear psoriasis, emphasizing the importance of establishing criteria/instruments to assist in distinguishing these two dermatoses in order to expedite the diagnosis, to optimize the treatment and minimize patients' discomfort. Long-term follow-up of patients with this disease is suggested due to the possibility, albeit minimal, of ILVEN malignancy. (AU)

Psychometric properties of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) on Chilean women / Propiedades psicométricas del instrumento Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) en mujeres chilenas

Abstract Introduction: Pelvic floor dysfunctions have an impact on women's sexual function. A Chilean study found that 74% of women have pelvic floor dysfunctions, but there is no validated tool for them. Objective: To evaluate the psychometric properties of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) for assessing sexual function in Chilean women with pelvic floor dysfunctions. Methods: Cross-sectional study of psychometrics in 217 women with pelvic floor dysfunction, age 18 or older, and sexually active (last 6 months). Non-probability, convenience sampling. Tool: PISQ-12. Experts checked content validity, construct validity with confirmatory factor analysis, reliability with Cronbach's alpha, and discriminating capacity with Pearson and McDonald's omega. Results: Population is mainly perimenopausal, highly educated with no income and with urinary incontinence (89.4%). Psychometric analysis supports a three-factor structure: sexual response, female sexual problems, and male sexual problems, with a good (α= 0.85), acceptable (α= 0.73), and poor (α= 0.63) reliability, respectively, but McDonald's omega was acceptable for all three. These were related to age (rs: -0.33), education (rs: 0.36), number of pregnancies (rs: -0.18) and vaginal births (rs: -0.25). Conclusions: PISQ-12 is valid and reliable for measuring sexual dimension and problems. Age, education, and number of pregnancies and vaginal births are moderately correlated to sexual response.

Resumen Introducción: Las disfunciones del piso pélvico impactan la función sexual de mujeres que la padecen. En un estudio chileno un 74% de las mujeres presentó disfunción sexual sin tener un instrumento validado para esta población. Objetivo: Evaluar las propiedades psicométricas del Pelvic Organ Prolapse Urinary Incontinence Sexual Questionnaire (PISQ-12) para medir la función sexual en mujeres chilenas con disfunciones del piso pélvico. Métodos: Estudio transversal psicométrico de 217 mujeres con disfunción del piso pélvico, igual /mayor a 18 años, sexualmente activas (últimos 6 meses). Muestreo no probabilístico de conveniencia. Cuestionario: PISQ-12. Se realizó juicio de expertos para validez de contenido, análisis factorial confirmatorio para validez de constructo y el α de Cronbach para confiabilidad y capacidad discriminativa con Pearson y ω de McDonald. Resultados: Población principalmente perimenopáusica, alta escolaridad sin ingresos y con Incontinencia Urinaria (89.4%). El análisis psicométrico apoyó una estructura de tres factores: respuesta sexual, limitaciones sexuales femeninas y limitaciones sexuales masculinas, con confiabilidad buena (α= 0.85) aceptable (α= 0.73) y pobre (α= 0.63), respectivamente, aunque el ω de McDonald mostró valores aceptables para los tres. Éstos se relacionaron con edad (rs: -0.33), escolaridad (0.36), número de embarazos (-0.18) y partos vaginales (-0.25). Conclusiones: El PISQ-12 es válido y confiable, midiendo la dimensión sexual y limitaciones sexuales. La edad, escolaridad, número de embarazos y partos vaginales se correlaciona con la respuesta sexual en intensidad moderada.

Práticas de autocuidado e os efeitos colaterais imediatos em mulheres com câncer ginecológico em braquiterapia / Prácticas de autocuidado y los efectos colaterales inmediatos en mujeres con cáncer ginecológico en braquiterapia / Self-care practices and immediate side effects in women with gynecological cancer in brachytherapy

Objetivo: revelar os efeitos colaterais imediatos e as práticas de autocuidado adotadas por mulheres com câncer ginecológico submetidas à braquiterapia. Método: pesquisa narrativa, realizada com 12 mulheres, no Sul do Brasil, entre dezembro/2018 e janeiro/2019, incluindo entrevista semiestruturada submetida à análise de conteúdo. Resultados: da análise emergiram três categorias temáticas: Cuidados orientados e adotados pelas mulheres em braquiterapia pélvica; Efeitos colaterais imediatos percebidos pelas mulheres em braquiterapia pélvica; Cuidados não orientados pelos profissionais da saúde. Os cuidados orientados pelas enfermeiras mais relatados pelas mulheres foram dilatação vaginal, uso de ducha e lubrificante vaginal, consumo de chá, higienização e guarda do dilatador vaginal. Os efeitos colaterais mais citados nas entrevistas foram alterações urinárias e intestinais na pele e mucosas. Conclusão: evidencia-se que a atenção de enfermagem em braquiterapia deve priorizar cuidados para prevenir e controlar as alterações geniturinárias e tegumentares, incluindo práticas de autocuidado.

Objective: to reveal the immediate side effects and self-care practices adopted by women with gynecological cancer submitted to brachytherapy. Method: narrative research, conducted with 12 women, in southern Brazil, between December/2018 and January/2019, including semi-structured interviews submitted to content analysis. Results: three thematic categories emerged from the analysis: Care oriented and adopted by women in pelvic brachytherapy; Immediate side effects perceived by women in pelvic brachytherapy; Care not guided by health professionals. The care provided by the nurses most reported by the women was vaginal dilation, use of a shower and vaginal lubricant, tea consumption, cleaning, and storage of the vaginal dilator. The side effects most frequently mentioned in the interviews were urinary and intestinal changes in the skin and mucous membranes. Conclusion: nursing care in brachytherapy must prioritize care to prevent and control genitourinary and cutaneous changes, including self-care practices.

Objetivo: revelar los efectos colaterales inmediatos y las prácticas de autocuidado adoptadas por mujeres con cáncer ginecológico sometidas a la braquiterapia. Método: investigación narrativa, realizada con 12 mujeres, en el Sur de Brasil, entre diciembre/2018 y enero/2019, incluyendo entrevista semiestructurada sometida al análisis de contenido. Resultados: del análisis surgieron tres categorías temáticas: Cuidados orientados y adoptados por las mujeres en braquiterapia pélvica; Efectos colaterales inmediatos percibidos por las mujeres en braquiterapia pélvica; Cuidados no orientados por los profesionales de la salud. Los cuidados orientados por las enfermeras más relatados por las mujeres fueron dilatación vaginal, uso de ducha y lubrificante vaginal, consumo de té, higienización y guarda del dilatador vaginal. Los efectos colaterales más citados en las entrevistas fueron alteraciones urinarias e intestinales en la piel y mucosas. Conclusión: se observa que la atención de enfermería en braquiterapia debe priorizar cuidados para prevenir y controlar las alteraciones genitourinarias y pigmentarias, incluyendo prácticas de autocuidado.

Fitoterapia como intervenção em saúde da mulher: revisão integrativa da literatura / Fitoterapia como intervención en la salud de la mujer: una revisión integradora de la literatura / Phytotherapy as an intervention in women's health: an integrative literature review

RESUMO Objetivo: revisar as publicações científicas disponíveis na literatura que descrevem a fitoterapia como intervenção em saúde da mulher. Método: revisão integrativa da literatura nas bases MEDLINE, CINAHL, Scopus e PUBMED. Adotou-se a questão nordeadora: "Quais evidências disponíveis na literatura descrevem a utilização da fitoterapia como intervenção em saúde da mulher?". Os descritores utilizados foram: "Phytotherapy"; "Complementary Therapies"; "Women's Health". O processo de busca e levantamento dos dados ocorreu em novembro e dezembro de 2018, no município de Redenção-Ceará. Resultados: foram analisados nove artigos, três relataram sobre plantas medicinais utilizadas no tratamento da menopausa, três sobre infertilidade, um sobre infecções ginecológicas e dois sobre distúrbios hormonais. Conclusão: os estudos científicos acerca das plantas medicinais ainda são poucos, sendo fundamental a necessidade de mais estudos e pesquisas acerca da fitoterapia utilizada no tratamento das doenças ginecológicas.

RESUMEN: Objetivo: revisar las publicaciones científicas disponibles en la literatura que describen a la fitoterapia como intervención en la salud de la mujer. Método: revisión integradora de la literatura realizada en las bases de datos MEDLINE, CINAHL, Scopus y PUBMED. Se adoptó la siguiente pregunta guía: "¿Qué evidencias se ofrecen en la literatura que describan el uso de la fitoterapia como intervención en la salud de la mujer?". Se utilizaron los siguientes descriptores: "Phytotherapy"; "Complementary Therapies"; "Women's Health". El proceso de búsqueda y levantamiento de datos tuvo lugar en noviembre y diciembre de 2018, en el municipio de Redenção-Ceará. Resultados: se analizaron nueve artículos; tres de ellos analizaron las plantas medicinales utilizadas en el tratamiento de la menopausia, tres la infertilidad, uno las infecciones ginecológicas, y dos los trastornos hormonales. Conclusión: la cantidad de estudios científicos acerca de las plantas medicinales todavía es escasa, por lo que resulta fundamental realizar más estudios e investigaciones acerca de la fitoterapia utilizada en el tratamiento de las enfermedades ginecológicas.

ABSTRACT Objective: to review the scientific publications available in the literature that describe phytotherapy as intervention in women's health. Method: an integrative literature review conducted in the MEDLINE, CINAHL, Scopus, and PUBMED databases. The following guiding question was adopted: "What evidence available in the literature describes the use of phytotherapy as intervention in women's health?" The descriptors used were the following: "Phytotherapy"; "Complementary Therapies"; "Women's Health". The process of surveying and gathering data took place in November and December 2018, in the city of Redenção, state of Ceará, Brazil. Results: nine articles were analyzed, three of which discussed medicinal plants used to treat menopause, three infertility, one gynecological infections, and two hormonal disorders. Conclusion: scientific studies on medicinal plants are still scarce, and the need for further studies and research on phytotherapy used in the treatment of gynecological diseases is essential.

Vidas após a cirurgia de redesignação sexual: sentidos produzidos para gênero e transexualidade / Life after sexual reassignment surgery: significance for gender and transsexuality

Resumo O Processo Transexualizador é o principal serviço direcionado à saúde trans-específica no Brasil, o qual oferta aquisições como hormonioterapia e cirurgias de redesignação sexual à população trans. Neste artigo, analisaram-se os sentidos produzidos em torno do procedimento cirúrgico, da nova genitália, sobre gênero e transexualidade entre mulheres que realizaram cirurgia de redesignação sexual no Hospital Universitário Cassiano Antônio de Moraes (HUCAM), localizado em Vitória, Estado do Espírito Santo, Brasil. Foi realizada pesquisa qualitativa com entrevistas narrativas gravadas em áudio, e realizada análise de conteúdo. Foram selecionadas 09 participantes a partir da metodologia bola de neve. Conclui-se que as cirurgias estão relacionadas à busca pela humanização dos corpos. As compreensões sobre ser mulher não se limitaram a um estatuto biológico para os gêneros. A transexualidade foi apresentada como uma experiência de transição entre os gêneros. A cirurgia de redesignação sexual foi apontada como estratégia para a construção de um corpo em consonância com a experiência das participantes nas relações sociais de gênero, cujo sucesso é avaliado sob signos de beleza, prazer e passabilidade.

Abstract The Transsexualization Process is the main service directed to trans-specific health in Brazil, which provides services such as hormone therapy and sexual reassignment surgeries to the trans population. In this article, the significance surrounding the surgical procedure, the new genitalia, gender and transsexuality among women who underwent sexual reassignment surgery at the Cassiano Antônio de Moraes University Hospital (HUCAM), located in Vitória, Espírito Santo State, Brazil, was analyzed. Qualitative research was carried out, narrative interviews were recorded, and thematic content analysis was performed. The sample was composed of 9 participants selected by snowball sampling. The conclusion drawn is that the surgeries are related to the search for the humanization of bodies. The comprehension about being a woman was not limited to a biological status for gender. Transsexuality was presented as a transitional experience between genders. The sexual reassignment surgery was seen as a strategy of corporal correction in line with expectations about social relationships in gender by participants, the success of which is evaluated from the standpoint of beauty, pleasure and passability.

Elefantiasis vulvar por filarias / Vulvar Elephantiasis by Filarias

En el año 2000, había más de 120 millones de personas infectadas por filarias en el mundo; unos 40 millones están desfiguradas e incapacitadas por la enfermedad. La infestación de los ganglios linfáticos por el parásito Wuchereira bancrofti, es la causa más frecuente del linfedema secundario. Se presenta un caso inusual de elefantiasis vulvar por filariasis. Se analizan las alternativas terapéuticas que incluyen el tratamiento farmacológico y quirúrgico, con el fin de considerar esta última como un tratamiento paliativo más que curativo tanto para el linfedema como para la cirugía reconstructiva(AU)

In 2000, there were more than 120 million people infected by filarias in the world; some 40 million are disfigured and disabled by the disease. Infestation of the lymph nodes by Wuchereira bancrofti parasite is the most frequent cause of secondary lymphoedema. An unusual case of vulvar elephantiasis due to filariasis is reprted in this paper. The therapeutic alternatives that include pharmacological and surgical treatment are analyzed, in order to consider the latter as a palliative rather than a curative treatment both for lymphedema and for reconstructive surgery(AU)

Papilomatosis hirsutoide de la vulva / Hirsutoide papillomatosis of the vulva

Resumen:La papilomatosis hirsutoide de la vulva, es una alteración en el área genital que puede ocasionar confusión en cuanto a la etiología de la misma; la cual debe tenerse presente en caso de encontrarse en alguna persona evaluada en la Clínica Médico Forense, ya que esta condición ha sido relacionada con el virus del Papiloma Humano, siendo que en los últimos estudios realizados en diferentes países se ha logrado determinar que la misma no tiene relación con la presencia del virus del Papiloma Humano. En el presente artículo se ahonda en el tema, en cuanto a la morfología que presenta esta alteración, así como lo que han concluido los estudios y la forma de abordarlo al momento de la valoración médico legal.

Abstract:The hirsutoide papillomatosis of the vulva, is an alteration in the genital area that can cause confusion as to the etiology of the same; which should be considered in case of being in someone assessed at the Forensic Medical Clinic, since this condition has been linked to the human papilloma virus, being that in recent studies conducted in different countries has been determined that the same It is unrelated to the presence of human papilloma virus.In this article delves into the subject, in terms of morphology having this disorder and what studies have been completed and how to address it when the forensic evaluation.

Desórdenes del desarrollo sexual y cirugía correctiva / Disorders of sexual development and corrective surgery

El desarrollo de las gónadas está determinado por los cromosomas sexuales y autosomas, estas producen hormonas que dirigen la formación de los genitales internos y externos. Los desórdenes en la diferenciación sexual se presentan cuando hay anormalidades en cromosomas, en el desarrollo gonadal o en la actividad o producción de hormonas. La presente revisión tiene como objetivo la recopilación de información que comprende los desordenes del desarrollo sexual que podrían presentar los niños al nacimiento y la posterior cirugía de corrección. Se desarrolla brevemente la anatomía normal tanto del sistema genitourinario masculino como el femenino, presentando las similitudes y diferencias. La sexualidad de las personas está determinada por el sexo cromosómico, sexo gonadal, sexo genital y sexo social, con base en estos determinantes se establece el procedimiento quirúrgico más adecuado. La investigación se enfoca en la cirugía de feminización, en la cual, se efectúa una reducción de clítoris, separación de vagina y uretra; además de una vaginoplastía. Actualmente, los resultados de la cirugía correctiva son los más óptimos, sin embargo, gran cantidad de estudios indica que no todas las personas que se someten a ellas están satisfechas con los resultados obtenidos refiriéndose a función sexual.

Gonadal development is determined by sexual chromosomes and autosomes, which produce hormones that direct the formation of internal and external genitals. Disorders in sexual differentiation appear when abnormalities in chromosomes, gonadal development or activity or production of hormones are present. This investigation is a review of research about disorders in sexual development present in children at birth and the following correction surgery. Also, it includes information concerning the normal anatomy of male and female genitourinary system, showing similarities and differences between them. People’s sexuality is determined by the chromosome sex, gonadal sex, genital sex and social sex. Based on these factors, physicians can determine the best surgical procedure for the patient. This investigation is focused on feminization surgery, in which a reduction of clitoris is done. After this, a separation of the vagina and urethra is also performed to then finalize with a vaginoplasty. Nowadays, the results of the correction surgery are the best that can be done, however, several studies indicate that not all patients are fulfilled with the results.

Déficit de 21-hidroxilasa: aspectos actuales / Deficiency of 21-hydroxylase: current aspects

La hiperplasia suprarrenal congénita (HSC) es una de las alteraciones autosómicas recesivas más frecuentes, caracterizada por un defecto enzimático en la síntesis de cortisol, la causa es en el 95% de los casos, la deficiencia de la enzima 21-hidroxilasa (21-OH). La 17-OH progesterona, precursor del cortisol, presenta valores elevados, marcadores del diagnóstico. Esta enfermedad presenta diferentes formas clínicas: las clásicas o graves comienzan desde el período neonatal, con síntomas debidos al exceso de andrógenos suprarrenales como virilidad y ambigüedad de los genitales externos de las niñas afectadas. En más del 70% de los casos se asocia con pérdida salina (deficiencia de aldosterona), potencialmente letal en varones que no se diagnostican precozmente. Resumimos las diferentes formas de presentación de la deficiencia de 21-OH, y describimos el diagnóstico y tratamiento. Los programas de detección precoz evitan la asignación incorrecta de sexo en la recién nacida y pueden salvar la vida de los varones con formas graves y pérdida salina. Comentamos el diagnóstico genético-molecular del CYP21A2 (cromosoma 6p 21.3). Revisamos las directrices futuras para el estudio y el tratamiento de esta enfermedad, incluyendo diversos tratamientos como la hormona de crecimiento, los antagonistas de las gonadotropinas y otros. El diagnóstico y tratamiento prenatales del feto femenino afectado son posibles, y los resultados son alentadores. Comentamos también, el abordaje hacia la transición y edad adulta, y la relevancia del control de la mujer con HAC durante la gestación.

Congenital adrenal hyperplasia (CAH) is one of the most frequent autosomal recessive disorders. It is characterized by a deficiency of an enzyme involved in cortisol synthesis and in 95% of patients the cause is 21-hydroxylase deficiency. A diagnostic marker is elevated levels of 17-hydroxyprogesterone, a precursor of cortisol. CAH has several clinical forms, and classical or severe forms manifest in the neonatal period with symptoms due to excess adrenal androgen production such as virilization and ambiguity of the external genitalia in affected girls. In more than 70% of patients, there is associated salt wasting (aldosterone deficiency), which can be fatal in males without an early diagnosis. We summarize the various forms of presentation of 21-hydroxylase deficiency and describe diagnosis and treatment. Screening programs avoid incorrect sex assignment in the newborn and can save the lives of males with severe forms and salt wasting. We discuss the genetic-molecular diagnosis of CYP21A2 (chromosome 6p 21.3). We review future recommendations for the study and management of this disease, including several treatments such as, growth hormone, and gonadotrophin antagonists. Prenatal diagnosis and treatment in affected female fetuses are feasible and the results are encouraging. We also discuss the management of the transition to adulthood and the importance of follow-up of women with CAH during pregnancy.

Characteristics of Female Genital Opportunistic Infection Who Infected with Human Immunodeficiency Virus / 中华医院感染学杂志

OBJECTIVE To investigate the characteristics of female genital opportunistic infection patients who infected with human immunodeficiency virus(HIV) and to provide reference for early diagnosis and treatment of HIV infection.METHODS The clinical data of 116 patients with HIV,including female genital symptoms and general condition collected from Jan 2007 to Dec 2008 were analyzed retrospectvely.These patients were all from the Central African Republic.RESULTS Among these 116 patients with HIV,89 patients(76.72%)had infective changes in the female genitals,and 68 patients(58.62%) had two to four diseases simultaneously.Among these infections,the most infection was chronic infection in the basin behaved chronic ache in the basin and infertility,then were vulvovaginal candidiasis,acute pelvic inflammatory disease,and trichomonal vaginitis and cervicitis.The CD4+ cell counts of 67 patients decreased,and the CD8+ cell counts of 31 patients decreased,of which 35 patients were accompanied with chronic dissipative symptoms among these patients.CONCLUSIONS HIV can descend human immunity,the patients can suffer with female genital oppprtunistic infection easily and should be paid more attention to in the eary stage.

A survey on external genital organ diseases among 1822 young men in Beijing / 中华全科医师杂志

The external genital organs were examined in 1822 male military recruiters from 2004 to 2008 in Beijing.The prevalence of redundant prepuce was 67.07%.that of phimosis was 2.36%and that of moderate to severe varicocele Writs 1.43%.Among all examinees 68(3.73%)recruiters failed physical examination due to phimosis or moderate to severe vailcocelel.We suggest a joint effort should be made by community health centers and urological specialists to check up genital organs of male youngsters,and health education should be provided in schools,so early cure would be possible and qualification rate of recruiters could be raised.