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1.
Sex Reprod Healthc ; 13: 51-57, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28844358

RESUMO

OBJECTIVE: To explore perceptions and experiences among youth who underwent structured questions about violence victimization and alcohol consumption when visiting Swedish youth clinics. METHODS: This study is part of a larger research project examining the effect of including routine inquiry about violence victimization and alcohol consumption for youth visiting youth clinics. Fifteen youth with experiences of victimization and/or risk drinking (AUDIT-C≥5) were interviewed. Content analysis was used. RESULTS: The findings were grouped into three main categories: The first; "Disclosure - talking about violence" reflected the participants' experiences of being asked about victimization. Participants were in favor of routine inquiry about violence victimization, even when questions caused distress. The questions helped participants reflect on prior victimization and process what had happened to them. The second; "Influence on the life situation" demonstrated that many of the participants still were effected by prior victimization, but also how talking about violence sometimes led to the possibility of initiating change such as leaving a destructive relationship or starting therapy. In the third; "One's own alcohol consumption in black and white" participants considered it natural to be asked about alcohol consumption. However, most participants did not consider their drinking problematic, even when told they exceeded guidelines. They viewed risk drinking in terms of immediate consequences rather than in quantity or frequency of alcohol intake. CONCLUSION: Routine inquiry about violence victimization and risk drinking at youth clinics was well received. Questions about violence helped participants to interpret and process prior victimization and sometimes initiated change.


Assuntos
Consumo de Bebidas Alcoólicas , Instituições de Assistência Ambulatorial , Atitude , Revelação , Privacidade , Violência , Adaptação Psicológica , Adolescente , Adulto , Bullying , Vítimas de Crime/psicologia , Feminino , Humanos , Masculino , Percepção , Privacidade/psicologia , Pesquisa Qualitativa , Fatores de Risco , Assunção de Riscos , Estresse Psicológico , Suécia , Adulto Jovem
2.
J Interpers Violence ; : 886260516681878, 2016 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-27909178

RESUMO

Youth is a period in life when the risk of violence victimization is high and association between victimization and ill health is well established. Youth rarely reveal violence victimization to health professionals if not directly asked but favor health professionals asking about victimization. The study's primary aim was to examine health outcomes in young women being routinely asked about violence victimization and offered subsequent support, compared with controls, at 12-month follow-up. Secondary aims were to examine to what extent routine inquiry altered the consultation and re-victimization rates during the study period. A randomized controlled intervention study was conducted at Swedish youth health centers. Participants assigned to the intervention group were asked structured questions about violence. Victimized participants received empowering strategies and were offered further counseling. Participants in the control group completed questionnaires about victimization after the visit. Both groups answered questions about sociodemographics and health, constructed from validated instruments. A questionnaire was administered to all participants 12 months after baseline. Of 1,445 eligible young women, 1,051 (73%) participated, with 54% of the participants completing the 12-month follow-up. Lifetime violence victimization was reported by 53% in the intervention group and 60% in the control group, ns. There were no significant differences in health outcomes, between baseline and 12-month follow-up, within either group or between groups. Re-victimization rates were 16% in the intervention group and 12% in the control group, ns. Of victimized young women in the intervention group, 14% wanted and received further counseling. Routine inquiry about violence victimization and empowering strategies were feasible within ordinary consultations at youth health centers but did not demonstrate improved health outcomes at 12-month follow-up compared with controls. Questions about violence led to a high degree of disclosure, and 14% of victimized young women in the intervention group received further counseling as a result.

3.
Scand J Public Health ; 44(6): 611-8, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27289105

RESUMO

AIM: The aim of this study was to analyse risk and binge drinking at 12-month follow-up in young women with risk drinking who received motivational interviewing compared with controls. METHODS: Young women attending Swedish youth health centres were randomised into intervention or control groups. The intervention group members were asked about their alcohol consumption by a midwife/social worker using the Alcohol Use Disorders Identification Test Consumption. A score of ⩾5 was used as the cut-off value for risk drinking. Participants with risk drinking in the intervention group received motivational interviewing within the same visit. Participants in the control group had a regular visit with a midwife/social worker and answered the same questions about alcohol consumption in a questionnaire after their visit. A questionnaire with the same questions was administered to participants 12 months after baseline. RESULTS: Of 1445 eligible young women, 1051 (73%) consented to randomisation and were enrolled in the study. The follow-up rate was 54%. There was a significant decrease in risk- and binge drinking, from baseline to follow-up, in both the intervention and the control groups. Generalised estimating equation analyses demonstrated no significant effect between groups. Of participants who did not have risk drinking at baseline, about 20% in both groups had developed high-risk drinking by the 12-month follow-up. CONCLUSIONS NO SIGNIFICANT DIFFERENCES IN RISK DRINKING BETWEEN YOUNG WOMEN WHO RECEIVED MOTIVATIONAL INTERVIEWING AND CONTROLS WERE FOUND THERE WAS A LARGE INTRA-INDIVIDUAL MOBILITY IN YOUNG WOMEN'S RISK DRINKING BEHAVIOUR THIS HIGHLIGHTS THE IMPORTANCE OF FINDING RELIABLE SCREENING TOOLS THAT CAN CAPTURE THE MOBILITY IN DRINKING BEHAVIOUR IN YOUTH MORE RESEARCH IS NEEDED BEFORE RECOMMENDATIONS CAN BE MADE.


Assuntos
Consumo de Bebidas Alcoólicas/psicologia , Entrevista Motivacional , Assunção de Riscos , Adolescente , Serviços de Saúde do Adolescente , Adulto , Consumo de Bebidas Alcoólicas/prevenção & controle , Feminino , Humanos , Inquéritos e Questionários , Suécia , Resultado do Tratamento , Adulto Jovem
4.
Eur J Public Health ; 26(5): 861-867, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-26743590

RESUMO

PURPOSE: The association between victimisation and adverse health in children is well established but few studies have addressed the effect of victimisation, especially multiple victimisations, in older adolescents and young adults. The aim of this study was to assess self-reported health in young women (15-22 years) victimised to one or more types of violence, compared with non-victimised. METHODS: Young women visiting youth health centres in Sweden answered a questionnaire constructed from standardised instruments addressing violence victimisation (emotional, physical, sexual and family violence), socio-demographics, substance use and physical and mental health. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and attributable risk (AR) were assessed. RESULTS: Of 1051 women (73% of eligible women), 25% were lifetime victims of one type of violence and 31% of two or more types of violence. Sexual-minority young women were more victimised than heterosexual women. Violence victimisation increased the risk for adverse health outcomes, especially evident for those multiply victimised. Victims of two or more types of violence had AOR 11.8 (CI 6.9-20.1) for post-traumatic stress symptoms, 6.3 (CI 3.9-10.2) for anxiety symptoms and 10.8 (CI 5.2-22.5) for suicide ideation. The AR of victimisation accounted for 41% of post-traumatic stress symptoms, 30% of anxiety symptoms and 27% of suicide ideation. Stratified analyses showed that lower economic resources did not influence health negatively for non-victimised, whereas it multiplicatively reinforced ill-health when combined with violence victimisation. CONCLUSION: Violence victimisation, and particularly multiple victimisations, was strongly associated with mental ill-health in young women, especially evident in those with low economic resources.


Assuntos
Bullying , Vítimas de Crime/psicologia , Violência Doméstica/psicologia , Nível de Saúde , Saúde Mental/estatística & dados numéricos , Adolescente , Adulto , Feminino , Humanos , Razão de Chances , Fatores de Risco , Fatores Socioeconômicos , Inquéritos e Questionários , Suécia , Adulto Jovem
5.
Appl Neuropsychol Child ; 5(2): 97-106, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-25671288

RESUMO

This preliminary study explored if a collaborative and therapeutic approach (CTA) could reduce self-reported psychiatric symptoms (Beck Youth Inventories [BYI]) in children referred for neuropsychological assessment. Participants included 11 children (M(age )= 12.4 years) receiving CTA, 11 (M(age) = 12.6 years) receiving parent support, and 9 (M(age) = 12.3 years) remaining on a waiting list. Contrary to both comparison groups, the CTA group reported fewer psychiatric symptoms on most BYI subscales after intervention, and this decrease was sustained for the Anger and Anxiety subscales at 6-month follow-up. Findings support a potential effectiveness of CTA in the neuropsychological assessment of children in a child psychiatric setting.


Assuntos
Adaptação Psicológica/fisiologia , Transtornos de Ansiedade/diagnóstico , Ansiedade/diagnóstico , Transtornos do Comportamento Infantil/diagnóstico , Depressão/diagnóstico , Adolescente , Criança , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Autoimagem , Inquéritos e Questionários , Fatores de Tempo
6.
Artigo em Inglês | MEDLINE | ID: mdl-26416241

RESUMO

OBJECTIVES: To address the associations between emotional, physical and sexual violence, specifically multiple violence victimisation, and sexual ill health and sexual risk behaviours in youth, as well as possible gender differences. METHODS: A cross-sectional population-based survey among sexually experienced youth using a questionnaire with validated questions on emotional, physical, and sexual violence victimisation, sociodemographics, health risk behaviours, and sexual ill health and sexual risk behaviours. Proportions, unadjusted/adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. RESULTS: The participants comprised 1192 female and 1021 male students aged 15 to 22 years. The females had experienced multiple violence (victimisation with two or three types of violence) more often than the males (21% vs. 16%). The associations between multiple violence victimisation and sexual ill health and sexual risk behaviours were consistent for both genders. Experience of/involvement in pregnancy yielded adjusted ORs of 2.4 (95% CI 1.5-3.7) for females and 2.1 (95% CI 1.3-3.4) for males, and early age at first intercourse 2.2 (95% CI 1.6-3.1) for females and 1.9 (95% CI 1.2-3.0) for males. No significantly raised adjusted ORs were found for non-use of contraceptives in young men or young women, or for chlamydia infection in young men. CONCLUSIONS: Several types of sexual ill health and sexual risk behaviours are strongly associated with multiple violence victimisation in both genders. This should be taken into consideration when counselling young people and addressing their sexual and reproductive health.


Assuntos
Vítimas de Crime/estatística & dados numéricos , Violência por Parceiro Íntimo/estatística & dados numéricos , Saúde Reprodutiva/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Doenças Sexualmente Transmissíveis/epidemiologia , Adolescente , Comportamento do Adolescente/psicologia , Intervalos de Confiança , Vítimas de Crime/psicologia , Estudos Transversais , Feminino , Humanos , Violência por Parceiro Íntimo/psicologia , Masculino , Razão de Chances , Distribuição por Sexo , Comportamento Sexual/psicologia , Parceiros Sexuais , Doenças Sexualmente Transmissíveis/psicologia , Suécia/epidemiologia , Adulto Jovem
7.
J Interpers Violence ; 30(10): 1671-86, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25186966

RESUMO

The World Health Organization has declared that violence is a global public health problem. The prevalence of violence exposure among adults with intellectual and unspecific disabilities has been demonstrated in several studies, whereas only a few articles on people with sensory disabilities have been published. The aim of this study was to investigate the prevalence and risk for exposure to physical violence, psychological offence, or threats of violence in people with physical and/or sensory disabilities, compared with people with no such disabilities, controlling for socioeconomic data. Data from a public health survey were analyzed. A nationally representative sample of women and men aged 16 to 84 years had answered a questionnaire. In the present study, the whole sample, comprised of 25,461 women and 21,545 men, was used. Women with auditory disabilities were generally more often violence exposed than non-disabled women, whereas men with physical disabilities were more often violence exposed than non-impaired men. Some age groups among both women and men with visual disabilities had higher prevalence rates than women and men without disabilities. The adjusted odds ratios (ORs) were significantly higher among the auditory impairment group for exposure to physical (OR = 1.4, confidence interval [CI] = [1.1, 1.9]) and psychological (OR = 1.4, CI = [1.1, 1.8]) violence among women. Men with physical disabilities had raised odds ratios for physical violence (OR = 1.7, CI = [1.2, 2.4]) and psychological violence (OR = 1.4, CI = [1.0, 2.0]) compared with the non-disabled group. Both men and women with a physical or sensory disability showed higher odds of being exposed to violence than men and women without a disability. The results indicated that socioeconomic situation, smoking, and hazardous drinking strengthened the association between impairment and violence.


Assuntos
Pessoas com Deficiência/psicologia , Pessoas com Deficiência/estatística & dados numéricos , Exposição à Violência/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Inquéritos Epidemiológicos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Adulto Jovem
8.
BMC Public Health ; 14: 715, 2014 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-25018145

RESUMO

BACKGROUND: Violence victimization among youth is recognized as a public health problem. The objective was to analyze the risk pattern of emotional, physical, and sexual abuse during the past 12 months by gender, sociodemographic factors, health risk behaviors, and exposure to abuse before the age of 15, among young men and women attending youth health centers in Sweden. METHODS: A cross-sectional survey was conducted using a nationally representative sample of youth health centers. A total of 2,250 young women and 920 young men aged 15-23 completed a self-administered questionnaire. Odds ratios (OR) and adjusted odds ratios (AOR) with 95% CI were calculated. RESULTS: A consistent and strong association was noted between exposure to all types of violence during the past year and victimization before the age of 15 for all types of violence for both women and men. The only exceptions were childhood sexual victimization and sexual violence during the past year for men. Younger age was associated with all violence exposure for the women and with emotional violence for the men. For the women, drug use was associated with all types of violence, while the association with hazardous alcohol use and not living with parents was restricted to physical and sexual violence exposure, present smoking was restricted to emotional and physical violence exposure, and partnership and living in urban areas were restricted to sexual violence. For men, not being partnered, hazardous alcohol consumption, and drug use meant increased risk for physical violence, while smoking and living in urban areas were associated with sexual violence. After adjustment, immigration had no association with violence exposure. CONCLUSIONS: Violence victimization in young men and women is often not a single experience. Findings underline the importance of early interventions among previously abused youth.


Assuntos
Maus-Tratos Infantis/estatística & dados numéricos , Vítimas de Crime/estatística & dados numéricos , Adolescente , Serviços de Saúde do Adolescente , Instituições de Assistência Ambulatorial , Estudos Transversais , Demografia , Feminino , Humanos , Masculino , Razão de Chances , Pais , Fatores de Risco , Inquéritos e Questionários , Suécia/epidemiologia , Adulto Jovem
9.
Acta Obstet Gynecol Scand ; 92(1): 109-15, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22913404

RESUMO

OBJECTIVE: To compare the prevalence of anal incontinence and dyspareunia in women with or without obstetric sphincter injury after standardizing the suture technique. DESIGN: Retrospective case-control study. SETTING: Regional hospital, Sweden. POPULATION: 305 women with an obstetric sphincter injury and 297 women with spontaneous vaginal delivery. METHODS: In order to standardize and improve the repairing skills of sphincter injuries, collaboration between obstetricians and colorectal surgeons was begun in 2000. Inner and external sphincters were repaired in two layers with continuous monofilament polidioxane sutures. The participating women received a questionnaire with validated questions on anal incontinence, dyspareunia and quality of life. The follow-up time was 15 months to 8 years. MAIN OUTCOME MEASURES: Anal incontinence, dyspareunia and quality of life. RESULTS: Of the sphincter group, 72% returned the questionnaire, as did 67% in the control group. Significantly more women in the sphincter group suffered from incontinence of flatus and loose stool compared to controls (p < 0.05). There was no significant difference of incontinence of solid stool, soiling, or fecal urgency between the groups. The quality of life questions showed no significant difference between the groups. In the sphincter group, there was significantly more superficial coital pain compared to controls (p= 0.02). Significantly more women with complete sphincter injury reported anal incontinence than women with a partial sphincter injury. CONCLUSION: In spite of increased rate of anal incontinence and dyspareunia after anal sphincter rupture, there was no statistically significant reduction in the women's quality of life.


Assuntos
Canal Anal/lesões , Parto Obstétrico/efeitos adversos , Dispareunia/psicologia , Incontinência Fecal/psicologia , Complicações do Trabalho de Parto/psicologia , Qualidade de Vida , Adulto , Dispareunia/epidemiologia , Episiotomia/estatística & dados numéricos , Incontinência Fecal/epidemiologia , Feminino , Humanos , Gravidez , Resultado da Gravidez , Prevalência , Inquéritos e Questionários , Suécia/epidemiologia
10.
BMC Public Health ; 12: 411, 2012 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-22716027

RESUMO

BACKGROUND: Violence victimization represents a serious risk factor for health related symptoms, for both men and women. The aim of this study was to evaluate the long-term effects of violence exposure in late adolescence and early adulthood on adult health, physical as well as mental, using a long-term prospective population-based study, with a follow up of 9, 19, and 26 years. METHODS: The primary data source is a longitudinal panel from one of the longest running social science surveys in the world, the Swedish Level-of-Living surveys (LNU). We analyzed three cohorts, individuals aged 15-19 in 1974 and 1981, and individuals aged 18-19 in 1991 which were followed up 2000. Structured interviews on childhood, family relationships, life-events, living conditions, health history and status, working conditions, behavioral, psychosocial, and demographic variables were repeatedly used in all cohorts. RESULTS: Multivariate models of violence exposures in adolescence in the 1974-91 cohorts as predictors of adult health in 2000 are reported for both men and women. Women exposed to violence had raised odds ratios for ill health, measured as heavy illness burden, and poor self rated health, after controlling for possible confounders. No such associations were found for men. CONCLUSIONS: This study's findings provide additional empirical support for the importance of policies and practices to identify and prevent violence exposure in adolescence and young adulthood and to supply treatments for adolescence exposed to violence and above all the young women.


Assuntos
Nível de Saúde , Violência , Adolescente , Adulto , Feminino , Seguimentos , Humanos , Masculino , Estudos Prospectivos , Pesquisa Qualitativa , Medição de Risco , Suécia , Fatores de Tempo , Adulto Jovem
12.
Int J Public Health ; 56(1): 89-96, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20617453

RESUMO

OBJECTIVES: To analyse the association between violence against mothers and the health of their children as reported by the mothers. METHODS: The data originate from a multistage sampling health-questionnaire survey, distributed to a representative sample of women in Sweden. The health of 283 children (aged 0-18 years), as reported by women who had been exposed to violence at home or outside home during the past 12 months, was compared with that of 4,664 children of non-exposed mothers. RESULTS: Odds ratios regarding most registered physical symptoms showed that children of violence-exposed mothers had a significant higher risk of ill health than children of non-exposed mothers. Regarding psychological symptoms and learning difficulties, the odds were raised for girls for most symptoms, but not for boys. A twofold increase in health-care utilisation and an overall general increase in the risk of pharmaceutical consumption were shown for both girls and boys of exposed mothers. CONCLUSIONS: This population-based study shows an increased risk of poorer health amongst boys and girls aged 0-18 years, as reported by mothers exposed to violence.


Assuntos
Violência Doméstica/psicologia , Nível de Saúde , Deficiências da Aprendizagem/epidemiologia , Relações Mãe-Filho , Mães/psicologia , Adolescente , Mulheres Maltratadas/psicologia , Mulheres Maltratadas/estatística & dados numéricos , Estudos de Casos e Controles , Criança , Pré-Escolar , Violência Doméstica/estatística & dados numéricos , Feminino , Inquéritos Epidemiológicos , Humanos , Lactente , Recém-Nascido , Deficiências da Aprendizagem/psicologia , Masculino , Mães/estatística & dados numéricos , Razão de Chances , Inquéritos e Questionários , Suécia , Violência
14.
Acta Obstet Gynecol Scand ; 88(5): 528-35, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19353335

RESUMO

OBJECTIVE: The WHO describes violence as a global public health problem. In contrast to domestic violence, violence against youth has been little explored. Our aims were to investigate the prevalence and gender differences in relation to emotional, physical and sexual abuse among young men and women attending youth health centers in Sweden, the current adverse effects of the abuse and the perpetrators of the abuse. DESIGN: Cross-sectional study. SETTING: Nationally representative youth health centers in Sweden. POPULATION AND METHODS: In total, 2,250 women and 920 men aged 15-23 years answered a validated questionnaire about emotional, physical and sexual abuse. RESULTS: A total of 33% (CI: 31-35) of the young women and 18% (CI: 16-21) of the young men had been exposed to emotional abuse during the past year. For physical abuse, 18% (CI: 17-20) of the women and 27% (CI: 24-30) of the men stated that they had been abused during the past year. The gender differences for sexual abuse were pronounced, with 14% (CI: 12-15) of the young women and 4.7% (CI: 3.3-6.0) of the men stating that they had been abused during the past 12 months. The young women reported more severe adverse effects from all types of abuse and were more often abused by a person close to them. CONCLUSIONS: The exposure to violence among young people is alarming and presents prominent gender differences, and should be taken into serious consideration as it is a matter of health, democracy and human rights.


Assuntos
Mulheres Maltratadas/psicologia , Mulheres Maltratadas/estatística & dados numéricos , Delitos Sexuais/psicologia , Delitos Sexuais/estatística & dados numéricos , Violência/psicologia , Violência/estatística & dados numéricos , Adolescente , Estudos Transversais , Violência Doméstica/psicologia , Violência Doméstica/estatística & dados numéricos , Feminino , Humanos , Masculino , Prevalência , Fatores Sexuais , Inquéritos e Questionários , Suécia/epidemiologia , Adulto Jovem
15.
Brain Stimul ; 2(1): 41-9, 2009 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20633402

RESUMO

BACKGROUND: Vagus nerve stimulation (VNS) is approved for the adjunctive treatment of both refractory epilepsy and treatment-resistant depression. This study assessed the effect of VNS on fertility, teratogenicity, and neonatal morbidity in rabbits. METHODS: Ten female New Zealand white rabbits (test animals) were implanted with the VNS device. Ten additional female rabbits (surgical controls) received nonfunctional devices. Four additional female rabbits served as untreated controls and 10 male rabbits served for siring purposes. Test rabbits received VNS at 1 mA, 30 Hz, 500 microseconds, 30 seconds ON, 5 minutes OFF. Rabbits mated and were randomly assigned into 2 groups: those killed on day 28 and those proceeding through parturition. Groups were compared by using a 1-way analysis of variance with a Newman-Keuls Multiple Comparison post-hoc test. Differences between control and test animals were considered statistically significant if P

Assuntos
Feto , Efeitos Tardios da Exposição Pré-Natal , Estimulação do Nervo Vago/efeitos adversos , Animais , Depressão/terapia , Eletrodos Implantados/efeitos adversos , Epilepsia/terapia , Feminino , Fertilidade/fisiologia , Feto/anormalidades , Feto/anatomia & histologia , Feto/fisiologia , Humanos , Masculino , Projetos Piloto , Gravidez , Coelhos , Distribuição Aleatória , Estimulação do Nervo Vago/instrumentação , Estimulação do Nervo Vago/métodos
16.
Clin J Pain ; 23(7): 598-604, 2007 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17710010

RESUMO

OBJECTIVE: To correlate changes in vestibular pain thresholds to general pain thresholds in a subgroup of women with provoked vestibulodynia taking part in a treatment study. METHODS: Thirty-five women with provoked vestibulodynia were randomized to 4 months' treatment with either electromyographic biofeedback (n=17) or topical lidocaine (n=18). Vestibular and general pressure pain thresholds (PPTs) were measured and the health survey Short Form-36 (SF-36) was filled out before treatment and at a 6-month follow-up. Subjective treatment outcome and bodily pain were analyzed. Thirty healthy women of the same age served as controls for general PPTs and SF-36. RESULTS: No differences in outcome measures were observed between the 2 treatments. Vestibular pain thresholds increased from median 30 g before to 70 g after treatment in the anterior vestibule (P<0.001) and from median 20 to 30 g in the posterior vestibule (P<0.001). PPTs on the leg and arm were lower in the patients as compared with controls both before and at the 6-month follow-up. Patients reporting total cure were 3/35; 25/35 were improved. The number of patients who frequently reported of other bodily pain was reduced after the treatment. The patients had lower scores for SF-36 (General Health, Vitality) before treatment, which was restored at the 6-month follow-up. DISCUSSION: Treating provoked vestibulodynia by either topical lidocaine or electromyographic biofeedback increased vestibular pain thresholds, reduced dyspareunia, and improved bodily pain. The patients showed a general hypersensitivity to pressure pain compared with controls and in this study the hypersensitivity did not seem to be affected by treating the superficial dyspareunia.


Assuntos
Hiperalgesia/diagnóstico , Hiperalgesia/terapia , Manejo da Dor , Limiar da Dor , Dor/diagnóstico , Vulvite/diagnóstico , Vulvite/terapia , Adolescente , Adulto , Feminino , Humanos , Medição da Dor , Síndrome , Resultado do Tratamento
17.
Acta Obstet Gynecol Scand ; 85(11): 1360-7, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-17091418

RESUMO

BACKGROUND: To evaluate the efficacy of electromyographic biofeedback and topical lidocaine treatment for women with vulvar vestibulitis. METHODS: A prospective randomized study where 46 women with vulvar vestibulitis were randomized to receive either electromyographic biofeedback or topical lidocaine treatment for four months. Assessments with vulvar pressure pain thresholds and questionnaires regarding quality of life, psychosocial adjustments, and sexual functioning were made before treatment, after treatment, and at six- and 12-month follow-ups. Nonparametric statistical methods were used to analyze differences in outcomes. RESULTS: Nine women (9/46) dropped out during the treatment period. Both treatments showed significantly improved values for vestibular pressure pain thresholds, quality of life measurements, and sexual functioning at the 12-month follow-up. No differences were found between the two treatment groups. No severe side effects were reported. CONCLUSIONS: Four months' treatment with electromyographic biofeedback and topical lidocaine gave statistically significant improvements on vestibular pain measurements, sexual functioning, and psychosocial adjustments at the 12-month follow-up. No differences in outcome between the two treatments were observed but a larger sample may be needed to obtain significance. The treatments were well tolerated but the compliance to the electromyographic biofeedback training program was low. A combination of both treatments could potentially benefit many women with vulvar vestibulitis.


Assuntos
Anestésicos Locais/uso terapêutico , Biorretroalimentação Psicológica , Eletromiografia , Lidocaína/uso terapêutico , Vulvite/terapia , Adaptação Psicológica , Administração Tópica , Adolescente , Adulto , Dispareunia/terapia , Feminino , Humanos , Medição da Dor , Qualidade de Vida , Comportamento Sexual , Ajustamento Social
18.
Pharmacol Biochem Behav ; 85(2): 428-34, 2006 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17112570

RESUMO

Non-peptidic delta opioid receptor agonists are being evaluated for a wide range of clinical applications; however, the clinical utility of piperazinyl benzamide delta agonists such as SNC80 may be limited by convulsant activity. The purpose of the present study was to evaluate the electroencephalographic and convulsant activity produced by a high dose of 10 mg/kg SNC80 IM in rhesus monkeys. EEG and behavioral activity were examined in four adult male rhesus monkeys after IM administration of SNC80. Monkeys were seated in a standard primate restraint chair, and EEG activity was recorded using an array of 16 needle electrodes implanted subcutaneously in the scalp in a bipolar (scalp-to-scalp) montage in a longitudinal direction, with bilateral frontal, central, temporal, and occipital leads. Behavior was recorded using video monitoring equipment. Initially, all monkeys were tested with 10 mg/kg SNC80, which is a relatively high dose 3-10-fold greater than doses necessary to produce a variety of other behavioral effects. Behavioral convulsions and EEG seizures were observed in one of the four monkeys. In this monkey, neither behavioral convulsions nor EEG seizures were observed when a lower dose of 3.2 mg/kg was administered nine weeks later or when the same dose of 10 mg/kg SNC80 was administered one year later. These results suggest that IM administration of SNC80 is less potent in producing convulsant effects than in producing other, potentially useful behavioral effects (e.g. antinociception) in rhesus monkeys.


Assuntos
Benzamidas/farmacologia , Eletroencefalografia/efeitos dos fármacos , Piperazinas/farmacologia , Receptores Opioides delta/agonistas , Convulsões/induzido quimicamente , Animais , Macaca mulatta , Masculino
19.
J Clin Neurophysiol ; 22(4): 275-8, 2005 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-16093900

RESUMO

The exact cause of narcolepsy-cataplexy syndrome remains unclear; however, the recent discovery of hypocretin deficiency in the lateral hypothalamus of narcoleptic patients has increased our understanding of its etiology. The authors performed masseter reflex, tibial F response, and blink reflex excitability studies during and between attacks in a 66-year-old man with status cataplecticus. Masseter reflex and F responses were inhibited while the blink reflex R2 component was enhanced during attacks, suggesting either hyperexcitability or disinhibition of pontine and/or medullary interneurons but hypoexcitability of pontine and spinal motor neurons during cataplexy.


Assuntos
Piscadela/fisiologia , Tronco Encefálico/fisiopatologia , Cataplexia/fisiopatologia , Idoso , Estimulação Elétrica , Eletroencefalografia/métodos , Humanos , Masculino , Reflexo/fisiologia , Fases do Sono/fisiologia , Nervo Tibial/fisiopatologia
20.
Lakartidningen ; 102(12-13): 938-40, 942, 2005.
Artigo em Sueco | MEDLINE | ID: mdl-15887639

RESUMO

Earlier studies have indicated that patients with chronic pain often have experienced physical abuse, but only a small number of population studies have demonstrated an association between abuse and chronic pain. During 1997 a population study was made in northern Sweden. Close to 15,000 people from 18-85 years of age answered a questionnaire about public health issues, including four questions about physical abuse and threats. In the present study the association between answers to these four questions and the other health questions were analyzed for men and women from 18-44 years. Almost 8% of the women and 10% of the men had been subjected to violence or threats during the past year, with higher figures for younger men and women. A strong association between violence/threats and most of the other health issues was found for both men and women. The association remained after controlling for various socioeconomic variables as well as smoking, although with somewhat lower odds ratios.


Assuntos
Nível de Saúde , Morbidade , Saúde Pública , Violência , Adolescente , Adulto , Idoso , Violência Doméstica/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Dor/etiologia , Dor/psicologia , Transtornos Psicofisiológicos/etiologia , Transtornos Psicofisiológicos/psicologia , Fatores Socioeconômicos , Maus-Tratos Conjugais/psicologia , Inquéritos e Questionários , Violência/psicologia
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