The Impact of Social Distancing Measures Due to COVID-19 Pandemic on Sexual Function and Relationship Quality of Couples in Greece.

INTRODUCTION: Recent studies have reported that the quarantine imposed in several countries around the world due to Covid-19 affected the sexual function and relationship quality. On the March 23, 2020 the Greek government imposed a national quarantine to contain the spread of the pandemic. The impact of such conditions on sexual function and relationship quality of couples is unknown. AIM: To investigate sexual function and relationship quality of couples during the quarantine. METHODS: An online anonymous survey was conducted one month post-impose of the quarantine, between the April 21 and the May 3, 2020. Adult respondents in a relationship completed a questionnaire including sociodemographic characteristics, structured inquiries regarding sexual activity and quality of relationship, anxiety level, and mood during the quarantine, as well as the IIEF and FSFI indices. OUTCOMES: Sexual function was assessed using the Greek versions of the FSFI and IIEF for females and males respectively. Sexual activity using 5 statements regarding frequency of sexual thoughts, masturbation, and intercourse, quality of intercourse and general estimation of the level of sexual function. Participants graded their level of agreement. Relationship quality was assessed using 5 questions regarding communication, company, understanding, tension and general estimation of companionship. Participants graded their level of agreement. Two additional statements were used in order to evaluate mood and the level of anxiety. RESULTS: A sum of 299 adult heterosexual participants in a relationship participated. Little or no negative impact on sexual function was reported. Increased anxiety and deficient mood were reported only for those with no access to their partner. Being in a steady relationship and living with their partner, but only for couples without children, resulted in satisfaction by sexual activity and enhanced emotional security. CONCLUSION: Sexual function and relationship quality appeared as not affected by the quarantine and by the measures of social distancing. Sotiropoulou P, Ferenidou F, Owens D, et al. The Impact of Social Distancing Measures Due to COVID-19 Pandemic on Sexual Function and Relationship Quality of Couples in Greece. Sex Med 2021;9:100364.

Sexual Response Models: Toward a More Flexible Pattern of Women's Sexuality.

INTRODUCTION: Recent research suggests that none of the current theoretical models can sufficiently describe women's sexual response, because several factors and situations can influence this. AIM: To explore individual variations of a sexual model that describes women's sexual responses and to assess the association of endorsement of that model with sexual dysfunctions and reasons to engage in sexual activity. METHODS: A sample of 157 randomly selected hospital employees completed self-administered questionnaires. MAIN OUTCOME MEASURES: Two models were developed: one merged the Master and Johnson model with the Kaplan model (linear) and the other was the Basson model (circular). Sexual function was evaluated by the Female Sexual Function Index and the Brief Sexual Symptom Checklist for Women. The Reasons for Having Sex Questionnaire was administered to investigate the reasons for which women have sex. RESULTS: Women reported that their current sexual experiences were at times consistent with the linear and circular models (66.9%), only the linear model (27%), only the circular model (5.4%), and neither model (0.7%). When the groups were reconfigured to the group that endorsed more than 5 of 10 sexual experiences, 64.3% of women endorsed the linear model, 20.4% chose the linear and circular models, 14.6% chose the circular model, and 0.7% selected neither. The Female Sexual Function Index, demographic factors, having sex for insecurity reasons, and sexual satisfaction correlated with the endorsement of a sexual response model. When these factors were entered in a stepwise logistic regression analysis, only the Female Sexual Function Index and having sex for insecurity reasons maintained a significant association with the sexual response model. CONCLUSION: The present study emphasizes the heterogeneity of female sexuality, with most of the sample reporting alternating between the linear and circular models. Sexual dysfunctions and having sex for insecurity reasons were associated with the Basson model.

Combined Case of Blood-Injury-Injection Phobia and Social Phobia: Behavior Therapy Management and Effectiveness through Tilt Test.

The efficacy of behavior therapy based mainly on real-life exposure situations as well as applied tension was examined for a combined case of blood-injury-injection (BII) phobia and social anxiety disorder. Treatment involved 28 behavior therapy sessions, while applied tension technique was also described and practiced. The specific contribution of social skills techniques, fantasy, and real-life situations exposure was examined in a single case design. The subject was a 39-year-old male with anxiety symptoms when confronting an audience, as well as symptoms of the autonomic nervous system (bradycardia and syncope), which were better explained by BII. All self-report measures regarding fear, social phobia, and anxiety were reduced after behavior therapy and remained maintained at followup, while BII decreased further after applied tension techniques. The contribution of behavior therapy to the overall outcome of the case is considered significant for many reasons that are discussed in the pape.

Takotsubo cardiomyopathy and QT interval prolongation: who are the patients at risk for torsades de pointes?

OBJECTIVES: QT interval prolongation is prevalent among patients with Takotsubo cardiomyopathy (TC), whereas torsades de pointes (TdP) has rarely been reported in these patients. We studied all peer-reviewed reports on TC-associated QT interval prolongation and all peer-reviewed reports on TC-associated TdP to characterize the clinical circumstances leading to TdP in patients with TC. METHODS: The literature search yielded 14 reports on TC-associated TdP and 26 reports on TC-associated QT interval prolongation. Overall, 15 patients with TC-associated TdP and 86 patients with TC-associated QT interval prolongation were reported. We systematically reviewed each report and recorded the risk factors for TdP as well as the clinical circumstances of TC. RESULTS: The prevalence of the male sex was higher among patients with TC-associated TdP relative to patients with TC-associated QT interval prolongation (26.7% vs 5.8%; P = .01). There was a trend in the mean maximal corrected QT interval being longer among patients with TC-associated TdP relative to patients with TC-associated QT interval prolongation (679.9 +/- 230.6 vs 555.9 +/- 63.8 milliseconds; P = .06). There were no differences between patients with TC-associated TdP and patients with TC-associated QT interval prolongation in mean age, maximal troponin levels, and lowest ejection fraction. Overall, 12 (80.0%) patients with TC-associated TdP had risk factors for TdP other than the female sex and systolic dysfunction, including suspicion of congenital long QT syndrome, bradycardia, hypokalemia, recent conversion from atrial fibrillation to sinus rhythm, and using QT prolonging agents. CONCLUSIONS: Men with TC-associated QT interval prolongation are at risk for TdP. Most patients with TC-associated TdP have risk factors for TdP other than the female sex and systolic dysfunction.

Presence of a sexual problem may not affect women's satisfaction from their sexual function.

INTRODUCTION: It has been proposed that women's sexual problems/dysfunctions, in the absence of personal and interpersonal distress, may have little clinical importance, as they may not necessarily affect women's sexual satisfaction. However, data are missing to support such interpretation. AIM: The objective of the present study was to examine whether the presence of a sexual problem necessary affects women's satisfaction with sexual function. METHOD: The study included 164 women who visited a general hospital because of symptoms not related to their sexual function and were asked to complete voluntarily and anonymously demographic data and two questionnaires. MAIN OUTCOME MEASURES: Women completed the Female Sexual Function Index (FSFI)--an instrument which evaluates women sexual function--and the Symptom Checklist of Sexual Function-women version (SCSF-w), a screening tool of women's self-perception of sexual function. RESULTS: Mean patients' age was 43 +/- 12.6 (18-72) years. According to the FSFI, 48.8% of the participants had a sexual dysfunction. However, based on their self-perception of sexual function (SCSF), 80.5% of the sample declared to be satisfied with their sexual function, despite the fact that 69.5% of them reported at least one sexual problem. Of all women, only 26.2% would like to talk about their sexual problem(s) with a doctor (57.4% of those who are "bothered" by their sexual symptoms). Logistic regression analysis revealed no association between any sexual dysfunction and women's satisfaction from their sexual function. CONCLUSION: Despite the presence of sexual problem(s), women may be satisfied with their sexual function, but half of those who are bothered would like to talk about it with their doctor. The presence of a sexual problem or its severity is not a determinant of women's help-seeking behavior. Such data strongly support current definitions of women's sexual dysfunction, where the presence of personal distress has been included as a crucial dimension.