[History of patients with pelvic floor dysfunction]. / Hechos históricos en pacientes con disfunción del piso pelviano.

OBJECTIVES: 1) To determine differences between sexes; 2) To determine differences by sex and age groups in symptom onset, time of evolution, clinical forms and probable associated causes. POPULATION AND SAMPLE: 83 consecutive patients with diagnosed PCP (X age = 50.9 SE 2.21). 25 males (30.1% x 51.2 years-old, SE 4.1) and 58 females (69.9%, X 50.8 years-old, SE 2.2). Patients with organic colon-rectum pathology (with the exception of hemorrhoidal pathology, proctologic surgery and active anus fissure) had been excluded. METHODS: Colonic Double-contrasted Rx, rectum-sigma endoscopy, and eventually a Colonofibroscopy Historic facts and syndromic protocol. Diagnosis criteria: 1) Perineal inspection: perineal contraction with pujo; 2) Rectal tact; 3) Ano-Rectum manometry with perfused system; 4) 150 ml Rectal balloon expulsion dynamic; 5) Utoreported signs and symptoms from a cuestionnaire ad hoc. Division into evolutive groups (continuous and intermittent). Division by age (< = 5, 5.1-25, > 25 years old). EXPERIMENT DESIGN: descriptive, comparative, correlation, prospective, simple blind. STATISTICS: Levene, descriptive, chi square, ANOVA, Kruskall-Wallis, Kendal tau b. RESULTS: 1) Difference in sex proportion was significative (p = 0.0001); 2) There were not differences between sexes in age media at the moment of the study (p = 0.92; 3) The continue evolutive form represented 77.1%, (p = 0.0001) but there weren't differences between sexes (p = 0.19) There weren't evolutive differences between age groups. (p = 0-78) 4) Age of onsec: x = 24.04 years-old, SE 2.02 (4-80 years-old), without differences between sexes (p = 0.16). 14.5% started before age of 5, 85% after that age, without differences between sexes (p = 0.07); 5) The time of evolution x = 26.7 years, SE 2.21, without differences between sexes (p = 0.25); 6) Potential causes were divides into tree categories: I "the patient doesn't remember associated facts" (30.1%, II: psychological or physical stress (39.8%), III: facts related to sexual trauma (30.1%). The differences (p = 0.0001); 7) Analyzed in general by sec, the most common cause was psychological-physical stress rather than sexual trauma in men, while among women sexual trauma was most common than psychological-physical stress (p = 0.03); 8) Analyzed by age groups: in the under 5 years-old group: main cause was "I don't remember". In 5.1-25-years-old group: sexual trauma; and psychological-physical stress was the main cause in > 25 years-old group (p 0.0001). CONCLUSIONS: 1) Women suffer from or consult much more frequently than man; 2) Once the disease is present, there would not be differences in age, age of onset, or time or evolution into proportions by sex; 3) The continue forms were the predominant ones; 4) The probable associated causes vary for each age group; 5) The sub-group "I don't remember" could represent in many cases a mismatch learning, but not constantly (there are cases of stress in familiar context); 6) In the subgroup "late childhood-adolescence" the predominant causes were traumatic experiences in erotic zones (rapping intent, sexual abuse, fantasies, elimination of parasites by the anus); 7) in the subgroup "older than 25 years-old" the predominant causes were physical stress, (violence, accidents, surgery) or emotional stress (familiar environment, social environment, affective losses). Some paradigmatic cases are presented. Anismus would be a complex situation involving an striated, voluntary, automatizated muscle (puborectalis) controlling independently genital-sexual, urinary and ano-rectal functions.

[Functional Dyspepsia and infection by Helicobacter pylori: a causal relation does not exist]. / Dispepsia funcional e infección por Helicobacter pylori: no existe relación causal.

UNLABELLED: The role of Helicobacter pylori (Hp) in Non Ulcer Dyspepsia (NUD) has been a controversial issue. OBJECTIVES: 1) To determine the frequency of Upper Gastrointestinal Endoscopy (UGE) in patients suffering NUD in whom endoscopy was indicated in our Service, 2) To determine the prevalence of infection by Hp in patients with NUD in whom endoscopy was done, 3) To find an association of clinical and historical facts among patients with and without Hp infection. POPULATION AND SAMPLE: 91 consecutive patients, free of esophageal or gastro-intestinal organic disease by endoscopic criteria from a total of 132, in a period of six months. 47 men (X age: 50.4 years, SE 2.6, SD 17.3) and 44 women (X age 49.7 years, SE 2.5, SD 16.8), Levene's Test p = 0.91. Descriptive, comparative and correlation, transverse simple-blind. METHODS: 1) two endoscopic biopsies for Hp (antrum and corpus), Rapid Hp Urease Test (modified Christensen protocol) with immediate and 6-hours later readings; 2) two samples for histopathologic diagnosis of Hp (antrum and corpus) with H&E, Giemsa or Warthin-Starring. STATISTICS: Levene Test for homogeneity of variance, descriptive statistic tests, ANOVA, chisquare, contingency coefficient, Pearson's "r", Run Tests. Alpha level = 0.05. RESULTS: 91 out 132 patients were included (69.9%). Prevalence was greater in men (p = 0.04). "Run Tests" for variables between 0.34 and 0.76, 45 patients were positives (+) for one or two methods (49.5%). There were significative differences between the means for variable "age" for the groups (+) and (-) at the moment of the study (+, mean age 45 years old, SE 2.4; negative tests, mean age 55 years old, SE 2.5, p = 0.005). Wide data dispersion (Coefficient of Pearson = 34.5%). There was association between age symptoms onset and positive tests (mean 40.4 years old, SE 2.6, Coefficient of Pearson 43%) and negative tests (mean 48.9 years old, SE 2.6, Coefficient of Pearson 36%) (p = 0.02). There were also association between age and + tests (p = 0.005). Non statistically significant differences were found between time of evolution of symptoms (p = 0.49), prevalence between sexes of symptoms (although nearly significant, p = 0.06), presence of unespecific pain (p = 0.16), ulcer-like pain (p = 0.46), plenty sensation, distension, satiety (p = 0.64) and differences by sex and age in symptoms (p = 0.55). CONCLUSIONS: 1) There would be an overestimation of UGE value in presumable dyspeptic patients, 2) Prevalence of infection agrees with the published values in equivalent populations in our country, 3) Pinfection prevalence was greater in men. 4) It could exist significative differences between age of symptoms onset in infected group (earlier symptoms) and means of age (younger infected people at the moment of this study), but there were very wide data dispersion), 5) Association between age and positiveness would be explained because it would be an accumulative phenomenon noted by us in a previous study 6) There wouldn't be enough evidence to consider Hp infection to be the cause of NUD.

Hechos históricos en pacientes con disfunción del piso pelviano. / [History of patients with pelvic floor dysfunction]

OBJECTIVES: 1) To determine differences between sexes; 2) To determine differences by sex and age groups in symptom onset, time of evolution, clinical forms and probable associated causes. POPULATION AND SAMPLE: 83 consecutive patients with diagnosed PCP (X age = 50.9 SE 2.21). 25 males (30.1

x 51.2 years-old, SE 4.1) and 58 females (69.9

, X 50.8 years-old, SE 2.2). Patients with organic colon-rectum pathology (with the exception of hemorrhoidal pathology, proctologic surgery and active anus fissure) had been excluded. METHODS: Colonic Double-contrasted Rx, rectum-sigma endoscopy, and eventually a Colonofibroscopy Historic facts and syndromic protocol. Diagnosis criteria: 1) Perineal inspection: perineal contraction with pujo; 2) Rectal tact; 3) Ano-Rectum manometry with perfused system; 4) 150 ml Rectal balloon expulsion dynamic; 5) Utoreported signs and symptoms from a cuestionnaire ad hoc. Division into evolutive groups (continuous and intermittent). Division by age (< = 5, 5.1-25, > 25 years old). Experiment design: descriptive, comparative, correlation, prospective, simple blind. STATISTICS: Levene, descriptive, chi square, ANOVA, Kruskall-Wallis, Kendal tau b. RESULTS: 1) Difference in sex proportion was significative (p = 0.0001); 2) There were not differences between sexes in age media at the moment of the study (p = 0.92; 3) The continue evolutive form represented 77.1

, (p = 0.0001) but there werent differences between sexes (p = 0.19) There werent evolutive differences between age groups. (p = 0-78) 4) Age of onsec: x = 24.04 years-old, SE 2.02 (4-80 years-old), without differences between sexes (p = 0.16). 14.5

started before age of 5, 85

after that age, without differences between sexes (p = 0.07); 5) The time of evolution x = 26.7 years, SE 2.21, without differences between sexes (p = 0.25); 6) Potential causes were divides into tree categories: I [quot ]the patient doesnt remember associated facts[quot ] (30.1

, II: psychological or physical stress (39.8

), III: facts related to sexual trauma (30.1

). The differences (p = 0.0001); 7) Analyzed in general by sec, the most common cause was psychological-physical stress rather than sexual trauma in men, while among women sexual trauma was most common than psychological-physical stress (p = 0.03); 8) Analyzed by age groups: in the under 5 years-old group: main cause was [quot ]I dont remember[quot ]. In 5.1-25-years-old group: sexual trauma; and psychological-physical stress was the main cause in > 25 years-old group (p 0.0001). CONCLUSIONS: 1) Women suffer from or consult much more frequently than man; 2) Once the disease is present, there would not be differences in age, age of onset, or time or evolution into proportions by sex; 3) The continue forms were the predominant ones; 4) The probable associated causes vary for each age group; 5) The sub-group [quot ]I dont remember[quot ] could represent in many cases a mismatch learning, but not constantly (there are cases of stress in familiar context); 6) In the subgroup [quot ]late childhood-adolescence[quot ] the predominant causes were traumatic experiences in erotic zones (rapping intent, sexual abuse, fantasies, elimination of parasites by the anus); 7) in the subgroup [quot ]older than 25 years-old[quot ] the predominant causes were physical stress, (violence, accidents, surgery) or emotional stress (familiar environment, social environment, affective losses). Some paradigmatic cases are presented. Anismus would be a complex situation involving an striated, voluntary, automatizated muscle (puborectalis) controlling independently genital-sexual, urinary and ano-rectal functions.

Dispepsia funcional e infección por Helicobacter pylori: no existe relación causal. / [Functional Dyspepsia and infection by Helicobacter pylori: a causal relation does not exist]

The role of Helicobacter pylori (Hp) in Non Ulcer Dyspepsia (NUD) has been a controversial issue. OBJECTIVES: 1) To determine the frequency of Upper Gastrointestinal Endoscopy (UGE) in patients suffering NUD in whom endoscopy was indicated in our Service, 2) To determine the prevalence of infection by Hp in patients with NUD in whom endoscopy was done, 3) To find an association of clinical and historical facts among patients with and without Hp infection. POPULATION AND SAMPLE: 91 consecutive patients, free of esophageal or gastro-intestinal organic disease by endoscopic criteria from a total of 132, in a period of six months. 47 men (X age: 50.4 years, SE 2.6, SD 17.3) and 44 women (X age 49.7 years, SE 2.5, SD 16.8), Levenes Test p = 0.91. Descriptive, comparative and correlation, transverse simple-blind. METHODS: 1) two endoscopic biopsies for Hp (antrum and corpus), Rapid Hp Urease Test (modified Christensen protocol) with immediate and 6-hours later readings; 2) two samples for histopathologic diagnosis of Hp (antrum and corpus) with H&E, Giemsa or Warthin-Starring. STATISTICS: Levene Test for homogeneity of variance, descriptive statistic tests, ANOVA, chisquare, contingency coefficient, Pearsons [quot ]r[quot ], Run Tests. Alpha level = 0.05. RESULTS: 91 out 132 patients were included (69.9

). Prevalence was greater in men (p = 0.04). [quot ]Run Tests[quot ] for variables between 0.34 and 0.76, 45 patients were positives (+) for one or two methods (49.5

). There were significative differences between the means for variable [quot ]age[quot ] for the groups (+) and (-) at the moment of the study (+, mean age 45 years old, SE 2.4; negative tests, mean age 55 years old, SE 2.5, p = 0.005). Wide data dispersion (Coefficient of Pearson = 34.5

). There was association between age symptoms onset and positive tests (mean 40.4 years old, SE 2.6, Coefficient of Pearson 43

) and negative tests (mean 48.9 years old, SE 2.6, Coefficient of Pearson 36

) (p = 0.02). There were also association between age and + tests (p = 0.005). Non statistically significant differences were found between time of evolution of symptoms (p = 0.49), prevalence between sexes of symptoms (although nearly significant, p = 0.06), presence of unespecific pain (p = 0.16), ulcer-like pain (p = 0.46), plenty sensation, distension, satiety (p = 0.64) and differences by sex and age in symptoms (p = 0.55). CONCLUSIONS: 1) There would be an overestimation of UGE value in presumable dyspeptic patients, 2) Prevalence of infection agrees with the published values in equivalent populations in our country, 3) Pinfection prevalence was greater in men. 4) It could exist significative differences between age of symptoms onset in infected group (earlier symptoms) and means of age (younger infected people at the moment of this study), but there were very wide data dispersion), 5) Association between age and positiveness would be explained because it would be an accumulative phenomenon noted by us in a previous study 6) There wouldnt be enough evidence to consider Hp infection to be the cause of NUD.