Prevalencia e impacto del sangrado menstrual abundante en España: resultados de una encuesta nacional / Prevalence and impact of heavy menstrual bleeding in Spain: Results of a national survey

Antecedentes: El sangrado menstrual abundante (SMA) es un problema ginecológico frecuente. Los datos sobre su prevalencia en España y su impacto son limitados. Material y métodos: Encuesta realizada en España en mujeres de 23-49 años incluidas en un panel en línea voluntario. La encuesta abordó varios aspectos, incluidos las características y el impacto de la menstruación. La información se recogió mediante un cuestionario semiestructurado enviado por correo electrónico. Los resultados se ponderaron por edad y distribución geográfica. Resultados: Se obtuvieron datos de 1.206 mujeres de las 4.478 invitadas (26,9%), de las que 1.169 (96,9%) tenían la menstruación. El 32,7% (n=373) expresó tener «sangrado menstrual excesivo» (SME), lo que se asoció con una mayor frecuencia e intensidad de síntomas menstruales. También con un porcentaje superior de mujeres a las que la menstruación limita «bastante o mucho» (29,1% frente a 15,7% con sangrado normal/leve). Las relaciones sexuales fueron el ámbito más afectado (al 59% les limitaba «bastante o mucho»). El porcentaje de mujeres con afectación de los ámbitos analizados fue significativamente superior entre aquellas con SME, excepto para la vida familiar. El 67,5% de las mujeres con SME había acudido al médico por este motivo; el 19,8% seguía algún tratamiento específico. Conclusiones: En nuestra muestra de 1.206 mujeres de edad fértil, el 6,2% presentaba SMA (SME+limitación «bastante o mucho» de la vida diaria). El SME tiene un impacto importante en la vida diaria de la mujer. Dos de cada 3consultan al médico por este motivo.(AU)

Background: Heavy menstrual bleeding (HMB) is a common gynecological complaint. Data on its prevalence and impact in Spain are limited. Material and methods: A voluntary web-based survey was conducted in Spain among women aged 23–49. The survey covered several aspects of menstruation, including the characteristics and impact. The information was gathered using a semi-structured questionnaire sent by email. Results were weighted by age and geographic distribution. Results: Of the 4478 women invited to participate, 1206 (26.9%) responded, of whom 1169 (96.9%) were menstruating. 32.7% (n=373) said they experienced “excessive menstrual bleeding” (EMB), which was associated with increased frequency and intensity of menstrual symptoms as well as a higher percentage of women whose menstruation limited them “a lot or quite a lot” (29.1% vs. 15.7% with normal/light bleeding). Sexual intercourse was the domain most affected (59% were limited “a lot or quite a lot”). Except for family life, the impact on the domains analyzed was significantly higher among women with EMB. 67.5% of women with EMB had seen a doctor for this reason; 19.8% were receiving some type of treatment. Conclusions: In our sample of 1206 women of childbearing age, 6.2% had HMB (EMB+“a lot or quite a lot” of limitations of daily activities). Excessive menstrual bleeding has a major impact on the daily lives of women. Two out of 3see a doctor for this reason.(AU)

Histopathological and virological features of lung, heart and liver percutaneous tissue core biopsy in patients with COVID-19: A clinicopathological case series.

INTRODUCTION: Data on pathological changes in COVID-19 are scarce. The aim of this study was to describe the histopathological and virological findings of postmortem biopsies, and the existing clinical correlations, in people who died of COVID-19. MATERIALS AND METHODS: We performed postmortem needle core biopsies of the chest in 11 people who died of COVID-19 pneumonia. Tissue examination was done by light microscopy and real-time polymerase chain reaction (RTPCR). RESULTS: The age of the patients were between 61 to 94 years. Of the 11 postmortem chest biopsies, lung tissue was obtained in 8, myocardium tissue in 7, and liver tissue in 5. Histologically of lung, the main findings pertaining to the lung were diffuse alveolar damage in proliferative phase (n = 4, 50%), diffuse alveolar damage in exudative and proliferative phase (n = 3, 37.5%), diffuse alveolar damage in exudative (n=1; 12.5%) and acute pneumonia (n = 2, 25%). Necrotising pneumonia, acute fibrinous and organising pneumonia, and neutrophils were detected in one sample each (12.5%). Another case presented myocarditis. RT-PCR showed RNA of SARS-CoV-2 in 7 of the 8 lung samples (87.5%), 2 of the 7 myocardial tissue samples (28.6%), and 1 of the 5 liver tissue samples (20%). CONCLUSION: The postmortem examinations show diffuse alveolar damage, as well as acute or necrotising pneumonia. RT-PCR of SARS-CoV-2 was positive in most lung samples.

Sun protection among Spanish beachgoers: knowledge, attitude and behaviour.

This study aims to investigate the level of awareness on the risks related to sun exposure, attitude towards sun protection and sun protection behaviour in Spanish beachgoers. During the summer of 2009, trained assistants conducted a structured interview with 630 sunbathers at the beaches of Valencia, Spain, via administrating a questionnaire including the following: (a) general data (age, gender, education, profession), (b) "knowledge" and "attitude" items and (c) self-assessed sun sensitivity, sun exposure and sun protection characteristics. The health belief model was used to evaluate factors that may influence on engaging healthy behaviour. The median age was 30 (2-82) years; the M/F ratio was 0.60. Despite the widespread regular ("often" or "always", 80%) use of high (>15) sun-protective factor sunscreens, current recommendations on sun protection were not regularly followed, and a history of sunburns is very common (70%). At multivariate analysis, female gender, age, fair hair, freckles, all-day use of sunscreens and wearing sunglasses were independent factors associated with having sunburn history. A high knowledge and a fairly good attitude emerged (median scores, 6/7 and 22/30, respectively). Age class (p = 0.032), educational level (p < 0.0001), sunscreen use (p = 0.048) and adequate timing of the first application of sunscreens (p = 0.015) were predictors of awareness, while factors associated with a more favourable attitude were educational level (p < 0.0001) and regular use of hats (p = 0.001). Wrong beliefs mainly concern sunscreens (false safety); the attractiveness of a tanned look is the main unfavourable attitude. Physical and motivational barriers are common (80%). The findings by highlighting constitutional and psychosocial factors involved in unhealthy behaviour provide useful information to promote sun-safe interventions in this population.

Smoking, sun exposure, number of nevi and previous neoplasias are risk factors for melanoma in older patients (60 years and over).

BACKGROUND: Malignant melanoma risk factors have been studied in different geographical area populations. However, no study has focused on risk factors which are more frequently associated to the over 60's age group. METHODS: A case-control study was performed that included 160 patients age > or = 60 years diagnosed of cutaneous melanoma and 318 controls matched for age and sex. Both groups were assessed, by personal interview and physical examination, for different phenotype characteristics (hair and eye color, phototype), the presence of other cutaneous lesions (solar lentigines, actinic keratoses and nevi), degree and type of solar exposure and personal and family past history of cutaneous or non-cutaneous cancer. Differences were evaluated by contingency tables and univariate and multivariate logistic regression. RESULTS: Of 17 factors, those risk factors with a strong effect on the development of melanoma in the elderly were: fair eyes, severe sunburns, years of occupational sun exposure, smoking, > 50 melanocytic nevi and personal history of NMSC and other non-cutaneous neoplasias. CONCLUSIONS: Tobacco smoking is an independent risk factor for cutaneous melanoma in the elderly. Intense (both acute and chronic) sun exposure and constitutional features, such as tumor susceptibility (NMSC, non-cutaneous neoplasias, and multiple nevi) are also associated with melanoma risk. All these factors should help to better design educational campaigns in older people.

Sonography of the eye in children: imaging findings.

Real-time sonography is a well-accepted technique for evaluating abnormalities of the eye. Most previous reports on sonography of the eye have been in adults [1]. In this pictorial essay, we illustrate normal and abnormal findings of ocular sonography in children.