Cluster Headache Presenting As Sinonasal Pathology in a Young Adult: A Diagnostic Odyssey.

Cluster headache is a debilitating primary headache disorder marked by severe, unilateral pain often accompanied by autonomic symptoms. We describe the case of a 20-year-old student who presented with excruciating peri-orbital pain localized to the right side, accompanied by ipsilateral nasal obstruction, a nasal spur, and a deviated nasal septum (DNS). The initial clinical picture strongly suggested sinonasal pathology, leading to investigations and treatments aimed at this presumed diagnosis. However, as the patient's symptoms persisted and evolved over time, with episodes of recurrent and intense pain associated with ipsilateral tearing, rhinorrhea, and ptosis, further evaluation was pursued. A comprehensive assessment, including detailed headache characteristics, neurological examination, and neuroimaging, ultimately revealed the diagnosis of cluster headache. This case emphasizes the diagnostic challenges associated with atypical presentations of cluster headaches, the importance of a meticulous clinical evaluation, and the need for early recognition to provide timely and effective interventions for these severely affected individuals.

Women's sexual health improvement: sexual quality of life and pelvic floor muscle assessment in asymptomatic women.

Introduction: Problems related to the quality of sexual life in gynecological practice are usually neglected. This study aimed to highlight the significance of this area of concern and evaluate the usefulness of tools, such as patient-reported outcomes (PROs) and pelvic floor examination, to improve women's sexual wellbeing and to identify predictors of poor quality of sexual life during the well-woman annual visit. Methods: A cross-sectional study was designed to examine 300 healthy women to determine whether the sexual quality of life (SQOL) questionnaire (on electronic devices) and pelvic floor muscle assessment (the vulva, anus, muscles, and periurethral (VAMP) protocol) of asymptomatic women during the annual bimanual examination (BME) help differentiate patients who would benefit from discussing sexual problems with a gynecologist. Dyspareunia was an exclusion criterion. Results: The majority of subjects experienced high sexual wellbeing (82.0% with SQOL score of ≥84), with a mean of 85.7 points. SQOL scores were lower for psychiatric disorders or symptoms (37.0% of subjects), although they did not correlate with age, BMI, parity, contraception use, history of vulvovaginal symptoms, neurosurgical/orthopedic problems, and rectal, bowel, or bladder symptoms. Patients with dyspareunia (16.0% of participants, although they denied it during the face-to-face consultation) had a 3.6 times higher prevalence of low or moderate quality of sexual life. The VAMP protocol score was low in asymptomatic women, 33.0% met positive criteria (VAMP+, NRS ≥3) for pelvic floor dysfunction (overactivity), although at borderline levels. VAMP+ was positively correlated with chronic pain and genitourinary symptoms, but neither with dyspareunia nor incontinence, and was unrelated to the SQOL score (p = 0.151). Conclusion: Women's sexual health is a global health priority. Finding a way to start a discussion with an asymptomatic patient is crucial to increasing patients' interest in disclosing a sexual health problem to be resolved. PROs or simple questions about sexual wellbeing direct the discussion mainly toward the at-risk group for sexual deterioration: those with mental health problems and women with dyspareunia. Dyspareunia is considered a predictor of decreased quality of sexual life, a major sexual disorder that should not be overlooked. Gynecological consultation should resolve concerns, identify the problem, and refer for professional sexual care if still needed.

Influential Social Determinants of Adherence to Preventive and Health Promotion Activities during Pregnancy and the First Year of Life: Systematic Review.

Effective monitoring throughout pregnancy and the first year of life is a crucial factor in achieving lower rates of maternal and infant mortality. Currently, research on socioeconomic factors that influence the lack of adherence to preventive and control measures during pregnancy and the first year of life is limited. The objective of this review is to examine the available evidence on social determinants that influence participation in health promotion and preventive activities throughout the pregnancy journey and in infants during their first year of life. We performed a systematic review of the literature searching in the major scientific databases (PubMed, Scopus, EMBASE, WOS, and Cochrane Library) for articles from February 2017 to May 2023 containing information on health inequities that impact participation in health promotion and preventive measures from pregnancy through the first year of an infant's life. A total of 12 studies were selected; these studies were performed in ten different countries on five different continents. The selected studies cover preventive measures during maternal care, vaccination, and immunization during pregnancy and the first year of life, newborn screening, and follow-up of the first 12 months of life. The social factors associated with low adherence to health promotion activities during pregnancy and the first year of life include education, income, ethnicity, place of residence, and family characteristics. Despite the diverse geographical distribution, it is observed that there are common social factors linked to a decrease in the adherence to preventive measures during pregnancy and in the early years of life.

Prevalence of falls among adult mothers in Saudi Arabia: a cross-sectional study.

BACKGROUND: The prevalence of falls among mothers (18-49 years old) in Saudi Arabia has been overlooked and understudied. Therefore, the study aimed to identify the 1-year prevalence, rate of falls, and consequent injuries among mothers in Saudi Arabia. METHODS: In this cross-sectional study, a self-administered online questionnaire, including sociodemographic data and questions related to the history of falls and consequent injuries during the past 12 months, was disseminated through social media in Saudi Arabia. RESULTS: A convenience sample of 986 mothers were voluntarily recruited for this study with a median age of 33 years and an interquartile range of 10 years. The 1-year prevalence of falls among mothers was 14.1 % (n = 139), and 52.5 % (n = 73/139) of the fallers experienced more than one fall. Among mothers who had experienced a fall, 25.4 % (n = 33/139) experienced a fall incident during pregnancy. The reported consequences of falls were pain in 37.4 % (n = 52/139), muscle and ligament injuries in 7.2 % (n = 10/139), and fractures in 2.2 % (n = 3/139) of participants. The study's findings indicate that asthma and high cholesterol level predicts the risk of falls in mothers. CONCLUSIONS: According to our convenience sampling, 14.1% of mothers had experienced one or more falls in the past 12 months. The increased prevalence of falls among this age group of women supports the idea that falls are not only an issue for the older adult population, but fall prevention strategies for this age range are also needed.

Can Vitality and Mental Health Influence Upper Extremity Pain? A Prospective Cohort Study of 1185 Female Hospital Nurses.

Musculoskeletal disorders of the upper extremity are among the most common occupational problems affecting nurses. The aim of this study was to analyze the prospective association between vitality and mental health and increased upper extremity pain intensity in female hospital nurses during a 1-year follow-up. A prospective cohort of 1185 female nurses from 19 hospitals in Denmark was conducted using baseline and 12-month follow-up questionnaires to identify potential associations between levels of vitality and mental health (SF-36 subscales) with pain intensity (0-10 scale) in the shoulder, elbow and hand/wrist regions. Associations were modeled using cumulative logistic regression. The fully adjusted model included the variables of age, baseline pain, body mass index, smoking status, years of occupation, leisure time physical activity level, number of daily patient transfers/handlings, as well as recognition and influence at work. The mean age was 48.3 (SD: 10.4) years. In the fully adjusted model, significant associations between low vitality levels and the odds of shoulder pain (OR = 1.96; 95%CI: 1.43-2.68) and hand/wrist pain (OR = 2.32; 95%CI: 1.58-3.42) were observed. Likewise, moderate levels of mental health was associated with increased odds of shoulder pain at follow-up (OR = 1.50; 95%CI: 1.16-1.93). These results provide an important incentive for nursing managers to assess vitality and mental health among hospital nurses and to consider this factor in prevention strategies to ensure good worker health and, by extension, high-quality care.

Evaluation and Medical Management of Chronic Pelvic Pain.

Chronic pelvic pain (CPP) is a challenging condition affecting an estimated 15% of females in the United States. Multiorgan system dysfunction results in the complex clinical pain presentation. Similar to other chronic pain syndromes, CPP is influenced by biopsychosocial factors and requires a multimodal approach for optimal pain management. This review summarizes the clinical evaluation and medical management of CPP with a comprehensive approach.

The relationship between personality traits and individual factors with perinatal depressive symptoms: a cross-sectional study.

BACKGROUND: Pregnancy is a crucial transition moment exposing women to potential mental health problems, especially depressive disturbances. Sociodemographic, pregnancy-related, and psychological factors have been related to depressive symptoms in the perinatal period. This study aims at (1) exploring personality and individual factors related with perinatal depressive symptoms, and (2) testing the mediating role of personality in the relation between characteristics of the woman's family of origin and depressive symptoms. METHODS: Women in the perinatal period admitted to the gynecology unit for motherhood-related routine assessments (n = 241) were included in the study. A survey on individual sociodemographic, clinical, and pregnancy-related factors was administered, also including the Edinburgh Postnatal Depression Scale (EPDS) and the BIG-5 personality test. RESULTS: Couple conflict and neuroticism were independent and directly correlated with EPDS total score (respectively: B = 2.337; p = .017; B = 0.303; p < .001). Neuroticism was a significant mediator of the relation between the presence of a psychiatric disorder diagnosis in participant's parents and the EPDS total score (indirect b = 0.969; BCCI95%=0.366-1.607). CONCLUSIONS: Couple relation and neuroticism traits are individual factors related to depressive symptoms in the perinatal period. The family of origin also plays an indirect role on perinatal depressive symptoms. Screening of these factors could lead to early recognition and more tailored treatments, ultimately leading to better outcome for the entire family.

Antibodies to SARS-CoV-2 in follicular fluids and their association with assisted reproduction.

Introduction: Every second woman suffering from infertility asks for medical help. There is public concern that vaccination-induced antibodies (Ab) are negatively associated with fertility. A recent study has demonstrated an association between SARS-CoV-2 vaccination and a lower pregnancy rate in the subsequent 60 days. Consequently, Ab could affect fertility success in assisted reproduction. Methods: To address this question, we compared fertilization outcomes of vaccinated (n=35) and nonvaccinated (n=34) women. Paired serum samples and multiple follicular fluids (FF) (up to 10 from the same donor) were collected during the course of assisted reproduction and characterized for oocyte quality, the presence of Ab and trace element concentrations. Results: The results showed a positive correlation of vaccination-induced neutralizing activity of SARS-CoV-2-Ab in serum and FF. On average, Ab concentrations in serum were higher than in the corresponding FF. However, wide variations in SARS-CoV-2 Ab titers were observed between different FF, correlating to trace element levels, even when retrieved from the same donor. Discussion: Overall, FF contents are highly variable, but no negative association was observed between Ab in serum or FF and fertilization success and oocyte development, supporting the safety of SARS-CoV-2 vaccination during assisted reproduction.

The stake of informing patients of the risk of hypofertility after chemotherapy for breast cancer.

Introduction: Too few women with invasive breast cancer are informed of the risk of hypofertility after chemotherapy. However, this risk can be prevented by offering gamete preservation by a specialized team. We believe that if more women were informed about gamete preservation, more of them would accept it. Objectives: The primary objective is to describe each step of the oncofertility care pathway from provision of information to gamete preservation. The secondary objective is to estimate the impact of not receiving information by determining the proportion of women who would have undergone gamete preservation if they had been informed. Method: 575 women aged 18-40 years treated with chemotherapy for breast cancer between 2012 and 2017 in the Ouest-Occitanie region (~3 million inhabitants) were included. We first constructed a multivariate predictive model to determine the parameters influencing the uptake of the offer of gamete preservation among women who were informed and then applied it to the population of uninformed women. Results: Only 39% of women were informed of the risks of hypofertility related to chemotherapy and 11% ultimately received gamete preservation. If all had been informed of the risk, our model predicted an increase in gamete preservation of 15.35% in the youngest women (<30 years), 22.88% in women aged between 30 and 35 years and zero in those aged ≥36 years. We did not find any association with the European Deprivation Index (EDI). Conclusion: Oncologists should be aware of the need to inform patients aged ≤ 35 years about gamete preservation. If all received such information, the impact in terms of gamete preservation would likely be major.

Acesso às práticas corporais/atividade física durante o ciclo da vida: relato de idosas aposentadas / Access to body practices/physical activity during the life cycle: report of retired elderly women

O objetivo foi verificar o acesso às práticas corporais/atividade física (PCAF) ao longo da vida de idosas aposentadas participantes de um grupo de PCAF. Trata-se de um estudo qualitativo com 16 mulheres idosas com idade entre 65 a 75 anos, selecionadas por conveniência, participantes de um grupo de PCAF de uma Unidade Básica de Saúde de Londrina, Paraná. As informações foram coletadas a partir de entrevistas com roteiro semiestruturado, conduzidas individualmente pelo profissional responsável pelo grupo. Os dados foram analisados por elementos da análise de conteúdo pelo sistema de categorias. Três categorias de análise foram consideradas: infância/adolescência; idade adulta; e terceira idade. Na infância/adolescência as mulheres relataram que não tiveram incentivo de seus pais, bem como não tiveram educação física na escola. Na fase adulta, a falta de tempo e de incentivo dos parceiros, além do desconhecimento de atividades ofertadas foram relatadas pelas mulheres. Somente a partir da terceira idade, especialmente após a aposentadoria, com a melhora da condição financeira e com o fato de terem maior tempo livre, as mulheres indicaram uma melhora no acesso, inclusive com a possibilidade da participação no grupo de PCAF. Em geral os resultados revelaram a dificuldade do acesso dessas mulheres às PCAF ao longo de suas vidas e reforçam a importância de ações e políticas públicas que busquem aumentar o incentivo e o acesso as PCAF ao longo da vida das mulheres

The objective was to verify the access to body practices/physical activity (BPPA) throughout the life of retired elderly women participating in a group of BPPA. This is a qualitative study with 16 elderly women aged between 65 and 75 years, selected for convenience, participants of a PCAF group at a Public Health Centre in Londrina, Brazil. The information was collected from interviews with a semi-structured script, which were conducted individually by the professional responsible for the group and analyzed from the content analysis by the category system. Three analysis categories were considered: childhood/adolescence; adulthood; and Old age. In childhood/adolescence, the women reported that they had no encouragement from their parents and had no physical education at school. In adulthood, lack of time and lack of encouragement from partners, in addition to the lack of knowledge of activities offered, were reported by women. Only from old age, especially after retirement, with the improvement of the financial condition and the fact of having more free time, the women indicated an improvement in the access to physical activity, including the possibility of participating in the PCAF group. In general, the results revealed the difficulty of these women's access to PCAF throughout their lives and reinforce the importance of public actions and policies that seek to increase incentives and access to PCAF throughout women's lives

Exploring the links between indoor air pollutants and health outcomes in South Asian countries: a systematic review.

Indoor air pollution (IAP) has adverse effects on the health of people, globally. The objective of this systematic review was to present the range of health problems studied in association with indoor air pollutants in South Asian countries. We searched five databases, including PubMed, Web of Science, Scopus, Google Scholar, and CAB Direct for articles published between the years 2000 and 2020. We retrieved 5,810 articles, out of which we included 90 articles in our review. Among South Asian countries, only five countries have published results related to relationship between indoor air pollutants and adverse health conditions. All studies have shown adversity of indoor air pollutants on human's health. We found indoor solid fuel burning as a key source of indoor air pollution in the included studies, while women and children were most affected by their exposure to solid fuel burning. More than half of the studies accounted particulate matter responsible for indoor air pollution bearing negative health effects. In the included studies, eyes and lungs were the most commonly affected body organs, exhibiting common symptoms like cough, breathing difficulty and wheezing. This might have developed into common conditions like respiratory tract infection, chronic obstructive pulmonary diseases and eye cataract. In addition to promote research in South Asian countries, future research should focus on novel digital ways of capturing effects of indoor air pollutants among vulnerable segments of the population. As a result of this new knowledge, public health agencies should develop and test interventions to reduce people's exposure levels and prevent them to develop adverse health outcomes.

Sexual dysfunction in the climacteric period and associated factors / Disfunção sexual no climatério e fatores associados

Abstract Objectives: to evaluate associated factors with sexual dysfunction among middle-aged women. Methods: cross-sectional and analytical study was carried out with climacteric women attended at a Family Health Strategy Unit in the city of Montes Claros, MG. Brazil. The eligible women answered a question form containing sociodemographic, behavioral, anthropometric, gynecological factors and sexuality. The Body Mass Index and waist circumference were used to assess nutritional status and metabolic risk. To evaluate quality of life and sexual performance the Menopause Rating Scale and the Sexual Quotient - Female Version were used, respectively. Bivariate analysis and hierarchical multiple regression were used to identify associated factors with sexual dysfunction in the climacteric period. Results: among 195 women, 29.6% had sexual dysfunction. The prevalence of unsatisfactory sexual performance was higher among women who reported moderate to severe climacteric symptoms (OR=2.47) and lower schooling level was also associated (OR=1.95). However, age at menarche below 12 years (OR=0.43) and non-white (OR=0.36) seem to have a protective effect for good sexual performance. Conclusion: the prevalence of sexual dysfunction was high and the level of schooling and climacteric symptomatology were associated factors with this outcome.

Resumo Objetivos: avaliar os fatores associados à disfunção sexual entre as mulheres de meia-idade. Métodos: estudo de corte transversal e analítico realizado com mulheres climatéricas atendidas em uma Unidade de Estratégia de Saúde da Família no município de Montes Claros-MG, Brasil. As mulheres elegíveis responderam a um formulário contendo questões sociodemográficas, comportamentais, antropométricas, fatores ginecológicos e sexualidade. Utilizou-se o Índice e Massa Corporal e a circunferência da cintura para avaliar o estado nutricional e risco metabólico. Para avaliar a qualidade de vida e o desempenho sexual foram utilizados a Menopause Rating Scale e o Quociente Sexual -Versão Feminina, respectivamente. Empregou-se análise bivariada e regressão múltipla hierarquizada para identificar fatores associados à disfunção sexual no climatério. Resultados: dentre 195 mulheres, 29,6% apresentaram disfunção sexual. A prevalência de desempenho sexual insatisfatório foi maior entre as mulheres que declararam sintomas climatéricos moderados a graves (OR = 2,47) e o menor grau de escolaridade (OR = 1,95). No entanto, a idade da menarca abaixo de 12 anos (OR = 0,43) e a cor de pele não branca (OR = 0,36) parecem ter efeito protetor para o bom desempenho sexual. Conclusão: a prevalência de disfunção sexual foi elevada e o nível de escolaridade e a sintomatologia climatérica foram fatores associados a esse resultado.

Atuação da terapia ocupacional com puérperas nas ações do núcleo de apoio à saúde da família / Occupational therapy practice with puerperal women in the actions of the family health support center

Resumo Introdução A Terapia Ocupacional atua na Atenção Básica em saúde e por meio do Núcleo de Apoio à Saúde da Família (Nasf), contribuindo com a integralidade no acompanhamento à saúde da população atendida pelo SUS (Sistema Único de Saúde). Entre as pessoas atendidas, encontram-se as mulheres no puerpério, período entre o parto e até seis e oito semanas seguintes, marcado por diversas mudanças para quem o vivencia. Objetivo Investigar a atuação das terapeutas ocupacionais com puérperas nas ações da Atenção Básica em Saúde no Nasf do Recife-PE. Método Estudo qualitativo de natureza exploratória, realizado entre abril e maio/2022, com oito terapeutas ocupacionais que trabalham no Nasf do Recife-PE. Como instrumento da pesquisa, utilizou-se um roteiro de entrevista semiestruturada e para análise a técnica do Discurso do Sujeito Coletivo. Resultados As profissionais relatam que a equipe Nasf apresenta defasagem na atuação com as puérperas por desconhecimento das possibilidades desta assistência por parte das Equipes de Saúde da Família. Apesar disso, realizam ações voltadas ao campo de atuação e ao núcleo de conhecimento da Terapia Ocupacional. Entre essas ações, estão as visitas domiciliares, atendimento individual e compartilhado, atendimento em grupos, apoio à amamentação, orientações às puérperas e à rede de apoio, atenção à saúde mental, orientações e retomada de papéis ocupacionais, estruturação de rotina e orientação ou apoio às atividades diárias. Conclusão A partir da compreensão da ocupação e desempenho ocupacional, a atuação da terapia ocupacional no Nasf representa benefícios à saúde de mulheres no puerpério.

Abstract Introduction Occupational Therapy works in Primary Care through the Family Health Support Center, collaborating to promote comprehensive health monitoring for the population served by SUS. Among the people assisted are women in the puerperium, the period between childbirth until the next six and eight weeks is marked by several changes for those who experience it. Objective To investigate the role of occupational therapists with postpartum women in Primary Care actions at Family Health Support Center in Recife-PE. Method A qualitative exploratory study, carried out between April and May 2022, with eight occupational therapists working in Recife-PE. As a research instrument, a semi-structured interview script was produced. For analysis, the Collective Subject Discourse technique was used. Results The professionals report difficulties to work as a team with postpartum women due to the lack of knowledge of the possibilities of assistance on the part of the Family Health Teams. Despite this, they carry out several actions aimed at the field of action and the core of knowledge of Occupational Therapy. Among the actions carried out are home visits, individual and shared care, group care, breastfeeding support, guidance to postpartum women and support network, mental health care, guidance and resumption of occupational roles, routine structuring and guidance or support for daily activities. Conclusion Based on the understanding of occupation and occupational performance, the practice of occupational therapists at team represents benefits to the health of women assisted during the puerperium.

Weight loss exercise prescription effects on obese female college students physical health / Efeito da prescrição de exercícios de emagrecimento na saúde física de estudantes universitárias obesas / Efecto de la prescripción de ejercicios para adelgazar en la salud física de estudiantes universitarias obesas

ABSTRACT Introduction The discussion about the impact on the physical and mental health of obese college students is a current issue. The implementation of "weight loss exercise prescription" seeks to discuss weight loss techniques and their effects, problems most faced by obese girls. Objective Explore the effect of sports intervention on the physical and mental health of obese female students. Methods 20 female college students with simple obesity were selected for an 18-week intervention experiment of fitness exercise associated with long-distance running. The physical and mental health of the volunteers was measured before and after the experiment for statistical analysis. Results After 18 weeks of exercise, it was observed that interpersonal sensitivity, depression, anxiety, and SCL-90 scores decreased significantly, indicating that the implementation of the exercise prescription had a positive impact on the mental health of obese girls. Across the study, compared to a single exercise method, associated aerobic exercise had a significant effect on improving BMI indicators, body weight, and body fat rate in obese adolescent girls. Conclusion By prescribing exercise for weight loss, one can significantly improve the cardiopulmonary function of obese college students and promote physical health, manifesting in the indices of vital capacity and cardiopulmonary function. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução A discussão sobre o impacto na saúde física e mental de estudantes universitárias obesas é um tema atual. Através da implementação da "prescrição de exercícios de emagrecimento", busca-se discutir tópicos sobre as técnicas de perda de peso e seus efeitos, problemas mais enfrentados pelas meninas obesas. Objetivo Explorar o efeito da intervenção esportiva sobre a saúde física e mental das estudantes obesas. Métodos 20 estudantes universitárias com obesidade simples foram selecionadas para uma experiência de intervenção de 18 semanas de exercício físico de aptidão física associada a corrida de longa distância. A saúde física e mental das voluntárias foi medida antes e depois do experimento para uma análise estatística. Resultados Após 18 semanas de exercícios observou-se que a sensibilidade interpessoal, a depressão, a ansiedade, e a pontuação de SCL-90 diminuíram significativamente, indicando que a implementação da prescrição de exercícios teve um impacto positivo sobre a saúde mental das meninas obesas. Através do estudo, comparado com um único método de exercício, o exercício aeróbico associado apresentou um efeito significativo na melhoria dos indicadores de IMC, no peso corporal e na taxa de gordura corporal das adolescentes obesas. Conclusão Através da prescrição de exercício para perda de peso, pode-se melhorar significativamente a função cardiopulmonar de estudantes universitárias obesas e promover a saúde física, resultado manifestado nos índices de capacidade vital e função cardiopulmonar. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción El debate sobre el impacto en la salud física y mental de las estudiantes universitarias obesas es un tema de la actualidad. A través de la aplicación de la "prescripción de ejercicios para adelgazar", se pretende debatir temas sobre las técnicas de adelgazamiento y sus efectos, los problemas a los que más se enfrentan las chicas obesas. Objetivo Explorar el efecto de la intervención deportiva sobre la salud física y mental de las estudiantes obesas. Métodos Se seleccionaron 20 estudiantes universitarias con obesidad simple para un ensayo de intervención de 18 semanas de ejercicio físico asociado a carreras de larga distancia. Para el análisis estadístico se midió la salud física y mental de los voluntarios antes y después del experimento. Resultados Tras 18 semanas de ejercicio se observó que las puntuaciones de sensibilidad interpersonal, depresión, ansiedad y SCL-90 disminuyeron significativamente, lo que indica que la aplicación de la prescripción de ejercicio tuvo un impacto positivo en la salud mental de las chicas obesas. En todo el estudio, en comparación con un único método de ejercicio, el ejercicio aeróbico asociado mostró un efecto significativo en la mejora de los indicadores del IMC, el peso corporal y el índice de grasa corporal en chicas adolescentes obesas. Conclusión Mediante la prescripción de ejercicio para la pérdida de peso, se puede mejorar significativamente la función cardiopulmonar de las estudiantes universitarias obesas y promover la salud física, resultado que se manifiesta en los índices de capacidad vital y función cardiopulmonar. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Utilizing a Video-Based Learning Platform for Teaching Breastfeeding Medicine.

The American Academy of Pediatrics (AAP) supports exclusive breastfeeding of infants. However, conversations surrounding breastfeeding can be sensitive in nature and cause discomfort for both learners and parents. Additionally, bedside teaching of breastfeeding medicine is a relatively large time commitment which can be difficult for learners rotating through busy delivery centers. These factors along with others have led to known knowledge gaps in medical students, residents, fellows, and even attending knowledge of skill-based breastfeeding competencies supported by the AAP. We aimed to address these gaps by creating a video-based breastfeeding education module working in collaboration with certified lactation consultants at the largest birthing center in Illinois, United States. This technical report describes the utilization of Panopto audio-visual software (Panopto Inc., Seattle, Washington, United States) to successfully create a video-based curriculum for teaching breastfeeding medicine.

Geographic inequalities in health intervention coverage - mapping the composite coverage index in Peru using geospatial modelling.

BACKGROUND: The composite coverage index (CCI) provides an integrated perspective towards universal health coverage in the context of reproductive, maternal, newborn and child health. Given the sample design of most household surveys does not provide coverage estimates below the first administrative level, approaches for achieving more granular estimates are needed. We used a model-based geostatistical approach to estimate the CCI at multiple resolutions in Peru. METHODS: We generated estimates for the eight indicators on which the CCI is based for the departments, provinces, and areas of 5 × 5 km of Peru using data from two national household surveys carried out in 2018 and 2019 plus geospatial covariates. Bayesian geostatistical models were fit using the INLA-SPDE approach. We assessed model fit using cross-validation at the survey cluster level and by comparing modelled and direct survey estimates at the department-level. RESULTS: CCI coverage in the provinces along the coast was consistently higher than in the remainder of the country. Jungle areas in the north and east presented the lowest coverage levels and the largest gaps between and within provinces. The greatest inequalities were found, unsurprisingly, in the largest provinces where populations are scattered in jungle territory and are difficult to reach. CONCLUSIONS: Our study highlighted provinces with high levels of inequality in CCI coverage indicating areas, mostly low-populated jungle areas, where more attention is needed. We also uncovered other areas, such as the border with Bolivia, where coverage is lower than the coastal provinces and should receive increased efforts. More generally, our results make the case for high-resolution estimates to unveil geographic inequities otherwise hidden by the usual levels of survey representativeness.

Effects of family planning service utilization determinants on unmet need incidents with generalized structural equation modeling.

BACKGROUND: One of the reasons for the lack of optimal achievement in terms of contraceptive use in Indonesia is the unmet need for family planning that has not been fully addressed. OBJECTIVE: This study aimed to determine the direct, indirect, and total effect of the determinants of family planning services utilization on the incidence of unmet need spacing and limiting in Indonesia to provide a basis for appropriate and effective program recommendations. STUDY DESIGN: This study used secondary data from the 2017 Indonesian Demographic and Health Survey with a cross-sectional design with 33,635 respondents who were married women aged 14 to 49 years. RESULTS: The results of the generalized structural equation modeling showed that the incidence of unmet need in Indonesia was 11.68%, consisting of unmet need spacing (4.86%) and unmet need limiting (6.82%). The quality of family planning services had a positive indirect effect on the incidence of unmet need spacing. The quality of family planning services also had a positive direct, indirect, and total effect on the incidence of unmet need limiting. Socioeconomic and demographic status variables had a negative direct effect on the incidence of unmet need spacing, whereas the indirect and the total effect were positive. The direct and total effect of socioeconomic and demographic status variables on the incidence of unmet need limiting were positive. The women's autonomy variable had a positive direct, indirect, and total effect on the incidence of unmet need spacing. Women's autonomy had positive indirect and total effect on the incidence of unmet needs limiting. The variable of access problems did not have a significant effect on the incidence of unmet need spacing and unmet need limiting. The ideal number of children had a negative direct and total effect on the incidence of unmet need spacing and unmet need limiting in Indonesia. CONCLUSION: The variables that have been shown to have a significant effect on the incidence of unmet needs were the quality of family planning services, socioeconomic and demographic status, women's autonomy, and the ideal number of children.

The relationship between high physical activity and premenstrual syndrome in Japanese female college students.

BACKGROUND: In recent years, moderate physical activity has attracted the attention of experts and women as a way to cope with premenstrual syndrome (PMS). Studies investigated the effects of exercise on PMS, but only a few reports focused on the relationship between physical activity, which included not only exercise but also routine bodily movements, and PMS. Therefore, the present study investigated the relationship between the amount of physical activity and PMS symptoms among sexually mature female students. METHODS: A total of 381 female university students in Japan were surveyed using a paper or web-based questionnaire with the same content. The questionnaire consisted of basic information, PMS symptoms, and physical activity based on the International Physical Activity Questionnaire (IPAQ). Participants were divided into two groups (≥ 3000 The Metabolic Equivalent of Task (MET)-minutes/week and < 3000 MET-minutes/week) based on their total physical activity as calculated using the IPAQ guidelines. The two groups were then compared in terms of the severity of their PMS physical and psychological symptoms as calculated based on the American College of Obstetricians and Gynecologists' PMS diagnostic criteria. The Wilcoxon's rank-sum test was used for statistical analyses. We then divided the participants based on the presence or absence of each symptom and used the chi-square test to compare the intergroup differences in ratios. The statistical significance level was set at p < 0.05. RESULTS: Those with total physical activity of ≥ 3000 MET-minutes/week had lower total PMS symptom scores (p < 0.01), physical symptom scores (p = 0.01), and psychological symptom scores (p = 0.01) compared with those with total physical activity of < 3000 MET-minutes/week. CONCLUSION: These results suggest that young women with high physical activity (≥ 3000 MET-minutes/week) have milder symptoms of PMS.

Fatores estressores no processo de desenvolvimento de neoplasias malignas em mulheres: uma revisão integrativa / Stressing factors in the development process of malignant neoplasms in women: an integrative review / Factores de estrés en el proceso de desarrollo de las neoplasias malignas en la mujer: una revisión integradora

A relação entre a origem de neoplasias e o estresse vem sendo objeto de estudo na literatura. Desde as primeiras investigações acerca da delimitação do gênero no processo do estresse é revelado ser mulher como uma variável significativa que leva ao adoecimento. O objetivo deste estudo é analisar na literatura se os fatores estressores vivenciados por mulheres influenciam no desenvolvimento de neoplasias malignas e identificar os fatores mais comuns associados a esse desenvolvimento. Trata-se de uma revisão integrativa realizada nas bases de dados SciELO, LILACS, BDENF, MEDLINE, e nas bibliotecas PubMed e BVS. Foram utilizados DeCS e MeSH para auxiliar na busca. Estabeleceram-se 11 artigos como corpus de análise que abordam a relação estresse-câncer em mulheres e sinalizaram estressores associados. Apesar da rede de estudos que apontam a relação do efeito do estresse no organismo e a ativação de componentes neuroendócrinos que impactam o surgimento de quadros neoplásicos, o entendimento da cadeia de reações químicas e resposta do metabolismo aos estímulos estressores ainda é complexo, demonstrando a necessidade da ampliação de estudos. É evidente a importância do acompanhamento ativo da saúde da mulher, além de atentar-se para minimizar fatores estressores e prevenir doenças relacionadas ao estresse.

The relationship between the origin of neoplasms and stress has been studied in the literature. Since the first investigations about the delimitation of gender in the stress process, being a woman has been revealed as a significant variable that leads to illness. The aim of this study is to analyze in the literature whether the stressors experienced by women influence the development of malignant neoplasms and to identify the most common factors associated with this development. This is an integrative review carried out in the SciELO, LILACS, BDENF, MEDLINE databases, and in the PubMed and VHL libraries. DeCS and MeSH were used to assist in the search. A total of 11 articles were established as a corpus of analysis that address the stress-cancer relationship in women and signaled associated stressors. Despite the network of studies that point to the relationship between the effect of stress on the body and the activation of neuroendocrine components that impact the appearance of neoplastic conditions, understanding the chain of chemical reactions and metabolism response to stressful stimuli is still complex, demonstrating the need to expand studies. The importance of actively monitoring women's health is evident, in addition to taking care to minimize stressors and prevent stress-related diseases.

La relación entre el origen de las neoplasias y el estrés ha sido estudiada en la literatura. Desde las primeras investigaciones sobre la delimitación del género en el proceso de estrés, ser mujer se ha revelado como una variable significativa que conduce a la enfermedad. El objetivo de este estudio es analizar en la literatura si los estresores experimentados por las mujeres influyen en el desarrollo de neoplasias malignas e identificar los factores más comunes asociados a este desarrollo. Esta es una revisión integradora, realizada en las bases de datos SciELO, LILACS, BDENF, MEDLINE, y en las bibliotecas PubMed y BVS. Se utilizaron DeCS y MeSH para ayudar en la búsqueda. Se establecieron 11 artículos como corpus de análisis que abordan la relación estrés-cáncer en mujeres y señalan estresores asociados. A pesar de la red de estudios que apuntan a la relación entre el efecto del estrés en el organismo y la activación de componentes neuroendocrinos que impactan en la aparición de condiciones neoplásicas, el conocimiento de la cadena de reacciones químicas y la respuesta del metabolismo a los estímulos estresantes es aún complejo, lo que demuestra que se necesita la ampliación de estudios. Queda evidente la importancia de monitorear activamente la salud de la mujer, además de minimizar los factores estresantes y prevenir enfermedades relacionadas con el estrés.

Predictive Factors for the Risk of Sexual Dysfunction in Climacteric Women: Population-based Study.

BACKGROUND: It is known that sexual problems increase with age but little is known about the predictors of female sexual dysfunction (FSD) in Brazilian climacteric women. AIM: To identify predictive factors for FSD in climacteric women. METHODS: This is a cross-sectional population-based study carried out through a household survey. OUTCOMES: The measures investigated were sociodemographic characteristics, depressive symptoms, level of physical activity, presence of FSD, self-rated health and sleep satisfaction. RESULT: A total of 381 climacteric, sexually active women were included, with a mean age of 55.04 (±7.21) years. The prevalence of FSD was 38.3%. All variables investigated were associated with FSD (P < .05). In the final model, the predictors for FSD were low satisfaction with sleep (OR 4.20; 95% CI 2.32-7.62), advanced age (OR 1.04; 95% CI 1.00-1.08), low education level (OR 0.90; 95% CI 0.85-0.97) and having a partner (OR 0.35; 95% CI 0.16-0.76). CLINICAL IMPLICATION: These aspects deserve attention from the health team to prevent and identify FSD early in life in climacteric women. STRENGTHS & LIMITATIONS: This study support existing data about risk factors for FSD in climacteric women. However, it is not possible to attribute causality to any of the correlates identified, which is a limitation of cross-sectional studies. CONCLUSION: Dissatisfaction with sleep, senility, insufficient income, low education, not having a partner, complaints of depression, and the worse perception of global health are predictive factors for FSD in climacteric women. Romano Marquez Reis SC, Martins Pinto J, Aparecida Porcatti de Walsh I, et al. Predictive Factors for the Risk of Sexual Dysfunction in Climacteric Women: Population-based Study. J Sex Med 2022;19:1546-1552.