Sexual dysfunction, depression, and marital dissatisfaction among Brazilian couples.

BACKGROUND: Health professionals treating sexual dysfunction and relational dissatisfaction recognize that they are multifactorial phenomena, and depression can be bidirectionally associated with both. AIM: The purpose of this study was to investigate sexual dysfunction in heterosexual couples in relation to the quality of their marital relationship and depression symptoms. METHODS: The sample consisted of 100 heterosexual couples recruited in Brazil. Both partners of each couple completed the Golombok-Rust Inventory of Sexual Satisfaction and the Golombok-Rust Inventory of Marital Satisfaction, which were translated and adapted, and the Beck Depression Inventory, which was validated for the Brazilian population. Both partners completed their questionnaires separately, and the couple's surveys were linked to preserve conjugal data for dyadic analysis. The Actor-Partner Interdependence Model was used to understand how sexual dysfunction in couples is related to depression and relationship quality among and between partners. RESULTS: Sexual dysfunction was found to be strongly associated with dissatisfaction in the relationship (husbands, ß = 0.57, P < 0.001; wives, ß = 0.60, P < 0.001), and a positive association was found between depressive symptoms and marital dissatisfaction (husbands, ß = .32, P < .001; wives ß = .40, P < .001). CLINICAL IMPLICATION: The results suggest that it is important for health professionals to be aware of the dyadic impact of struggles with both sex and the relationship and the presence of depression symptoms in patients who seek care for sexual complaints or depression and who are in a marital relationship. STRENGTHS AND LIMITATIONS: The different results found for men and women may shed light on the biopsychosocial dimensions of human sexuality. When treated as a purely physical experience, sex is myopic. In this study we demonstrated psychosocial aspects associated with gender and sexuality, and the partner's variables were found to have a greater impact on women than they did on the men. A limitation of this study is that the sample is not generalizable as it is not demographically representative of all socioeconomic groups in Brazil. Furthermore, the participants in this sample did not have clinical levels of depression, so the results cannot be extended to couples in which one or both spouses have depressive disorder. CONCLUSION: It was found that sexual dysfunction is strongly associated with the quality of the couple relationship, and that the quality of relationship plays a mediating role between depression and marital quality, especially for the women.

Incidence, clinical patterns, and risk factors of postpartum uterine diseases in dairy cows from high-altitude tropical herds.

The cow's uterus sustains bacterial contamination and active inflammation after calving as part of the normal physiological process of uterine involution. Although the definition, incidence, and risk factors for postpartum uterine diseases (PUD) have been documented in annual calving systems with high-producing cows on total mixed ration, the literature contains little information for other production systems. The objective of this study was to quantify the incidence risk and factors associated with metritis, clinical endometritis, and cytological endometritis in high-altitude tropical dairy herds in a pasture-based system. A total of 248 cows from 5 commercial dairy herds in northern Antioquia, Colombia, were enrolled in this prospective observational longitudinal cohort study. Data collection and PUD diagnosis were performed at d 0, 3, 10, 17, 24, 31, 38, 45, and 52 (±1) after parturition. Between 60 and 70 d, cows were systematically enrolled in a synchronization protocol, and herds were visited monthly for pregnancy diagnosis until 180 ±15 d. The multivariable logistic regression model of variables associated with PUD occurrence included (a) parity, season of calving, transition diet, and body condition score at calving; (b) blood calcium, phosphorus, and magnesium concentrations, and milk urea nitrogen, ß-hydroxybutyrate and fat-to-protein ratio; and (c) dystocia, retained placenta, and delayed uterine involution. The incidences of puerperal metritis, clinical metritis (MET), clinical endometritis (CE), and cytological endometritis (CYTO) were 2.8, 25, 29, and 26%, respectively. Retained placenta and dystocia were associated with MET, and MET was associated with CE. Low blood calcium concentration at calving was associated with CYTO. Overall, 51.2% of the cows suffered at least 1 category of PUD during the first 60 d postpartum (DPP). However, cows also suffered from different consecutive clinical events of PUD (MET, CE, and CYTO) during the follow-up period (0 to 180 ±15 DPP). These events could be grouped into 4 types (which were referred to as "clinical patterns") based on interactions between MET, CE, and CYTO.

Individual and combined effects of anovulation and cytological endometritis on the reproductive performance of dairy cows.

The objective was to evaluate the individual and combined effect of anovulation and cytological endometritis (CTE) on the reproductive performance of dairy cows. A total of 1,569 cows from 3 data sets were used. In data set 1, 403 Holstein cows from 5 dairies in New York were used. In data set 2, 750 Holstein cows from 2 dairies, one in Florida and one in California were used. In data set 3, 416 dairy cows, 165 Holsteins, 36 Jerseys, and 215 Holstein-Jersey crossbreeds from a grazing dairy in Florida were used. Cyclicity and CTE was determined at 35±3 (data set 2) or 49±3 d in milk (data sets 1 and 3). A variable (VarCycCTE) containing all 4 possible permutations between cyclicity (cyclic = Cyc; anovular = Anov) and CTE (present = CTE; absent = Healthy) was created. In the combined data set (sets 1, 2, and 3), pregnancy per artificial insemination (P/AI) diagnosed at 30 to 38 d after first AI was affected by VarCycCTE, with AnovCTE cows having decreased P/AI compared with CycHealthy cows (21.3 vs. 46.7%), whereas AnovHealthy (37.9%) and CycCTE cows (36.0%) had intermediate P/AI. Pregnancy per artificial insemination for the individual data sets and for pregnancy diagnosed at 63 to 74 d after artificial insemination followed a similar pattern. Pregnancy loss was not affected by VarCycCTE. Hazard of pregnancy up to 300 d in milk was affected by VarCycCTE in the combined data sets 1 and 2, with AnovCTE [hazard ratio (HR)=0.55], AnovHealthy cows (HR=0.71), and CycCTE (HR=0.8) having decreased hazard of pregnancy compared with CycHealthy cows. Median days open were 200, 159, 145, and 121 for AnovCTE, AnovHealthy, CycCTE, and CycHealthy, respectively. Hazard of pregnancy for the individual data sets followed a similar pattern. In summary, both anovulation and CTE were negatively associated with reproductive performance and, when combined, they had an additive negative effect.

Treating ocular toxoplasmosis: current evidence.

The current treatment of ocular toxoplasmosis is controversial. The mainstay of treatment has been pyrimethamine and sulphonamides with or without systemic corticosteroids, but the actual evidence that antibiotics have a beneficial effect in recurrent toxoplasmic retinochoroiditis is unsupported by randomised placebo controlled trials. Thus far there have only been three studies looking at the efficacy of antibiotic treatment, all of which were methodologically weak and two of which were perfomed more than 30 years ago. All studies reported adverse effects from treatment. There is an urgent need for further randomised, double blind, placebo controlled studies for lesions in all parts of the retina and to test the efficacy of adjunctive corticosteroid treatment.