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2.
Infectio ; 25(4): 207-211, oct.-dic. 2021. tab, graf
Artículo en Español | LILACS, COLNAL | ID: biblio-1286715

RESUMEN

Resumen Objetivo: Describir la proporción, características clínicas, demográficas y programáticas de casos fatales de coinfección TB/VIH de Cali-Colombia, en 2017. Material y Método: Estudio de corte transversal, con información de las bases de datos del programa de tuberculosis, las historias clínicas y unidades de análisis de mortalidad disponibles. Resultados: Se depuraron 257 casos fatales por TB, el 24,5% (63/257) falleció con coinfección TB/VIH. La mediana de edad fue 43 años (Rango Intercuartílico: 30-52), 73% (46/63) eran hombres, 76,2% (48/63) no pertenecían al régimen contributivo, 28,6% eran habitantes de calle. 81,2% (39/48) eran casos nuevos de TB, 76,6% (37/47), inició tratamiento; al 74,6% (47/63) se les realizó unidad de análisis de mortalidad. La presentación pulmonar fue frecuente (75,9%-44/58), en 60% de los registros se observó desnutrición (Índice de Masa Corporal <20), en 39,7% (25/63) dependencia al alcohol, tabaco o farmacodependencia. Conclusiones: La mortalidad asociada a TB/VIH es prevenible, pero en 2017 representó la cuarta parte de la mortalidad por TB en Cali. Hombres adultos con condiciones de vulnerabilidad social, diagnosticados en estados avanzados de enfermedad, fueron blanco de fatalidad. Mejorar los sistemas de información e integrar los programas de TB/VIH, deben ser estrategias prioritarias para la salud pública en Colombia.


Abstract Objective: To describe the proportion, clinical, demographic and programmatic characteristics of fatal cases of TB/HIV coinfection from Cali-Colombia, in 2017. Material and Method: Cross-sectional study, with information from the TB program databases, clinical records and mortality analysis units available. Results: 257 TB fatal cases were cleared in Cali in 2017, 24.5% (63/257) of these died with TB/HIV coinfection. The median age was 43 years (Interquartile Range: 30-52), 73% (46/63) were men, 76.2% (48/63) did not belong to the contributory health regimen, 28.6% were homeless. 81.2% (39/48) were new TB cases, 76.6% (37/47) started treatment; 74.6% (47/63) had mortality analysis register. Pulmonary presentation was frequent (75.9% -44 / 58), in 60% of the registries malnutrition was observed (Body Mass Index <20), in 39.7% (25/63), dependence on alcohol, tobacco or drug dependence was registered. Conclusions: Mortality associated with TB/HIV is preventable, but in 2017 it represented a quarter of the TB mortality in Cali. Adult men with conditions of social vulnerability, diagnosed in advanced stages of disease, were fatally targeted. Improving information systems and integrating TB/HIV programs should be priority strategies for public health in Colombia.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Tuberculosis , VIH , Índice de Masa Corporal , Infecciones por VIH , Salud Pública , Estudios Transversales , Mortalidad , Estrategias de Salud , Colombia , Vulnerabilidad Social , Desnutrición
3.
Estima (Online) ; 19(1): e0921, jan.-dez. 2021.
Artículo en Portugués | BDENF - Enfermería | ID: biblio-1280948

RESUMEN

Objetivo:descrever o processo de implementação da Rede de Atenção à Saúde em Lesões Cutâneas no município de Divinópolis − MG. Método: trata-se de um relato de experiência sobre a implementação de uma Rede de Atenção à Saúde em Lesões Cutâneas a partir do Programa de Educação Pelo Trabalho para Saúde (PET-Saúde/GraduaSUS), no período de maio de 2016 a abril de 2018. Participaram das ações professores e alunos de uma universidade pública e profissionais enfermeiros vinculados à Secretaria Municipal de Saúde do município. Resultados: foi possível implementar a Rede de Atenção à Saúde para prevenção e tratamento de lesões cutâneas de maneira estruturada e sistematizada. Foi estabelecido um fluxo de atendimento, supervisão de casos e acompanhamento clínico por meio da construção de um protocolo assistencial. Conclusão: a habilidade prática e o conhecimento científico de alunos e profissionais de saúde para o tratamento e manejo de lesões cutâneas foram desenvolvidos fortalecendo, assim, a tríade ensino-serviço-comunidade.


Objective: describe the process of implementing the Rede de Atenção à Saúde em Lesões Cutâneas (Health Care Network for Skin Injuries) in the municipality of Divinópolis - MG. Method: it is an experience report on the implementation of a Health Care Network for Skin Injuries from the Programa de Educação Pelo Trabalho para Saúde (PET-Saúde/GraduaSUS) (Education Through Work for Health Program), from May 2016 to April 2018. Teachers and students from a public university and professional nurses linked to the Municipal Health Secretariat of the municipality participated in the actions. Results: it was possible to implement the Health Care Network for the prevention and treatment of skin lesions in a structured and systematic way. A flow of care, case supervision and clinical follow-up was established through the construction of an assistance protocol. Conclusion: the practical skill and scientific knowledge of students and health professionals for the treatment and management of skin lesions were developed, thus strengthening the teaching-service-community triad.


Asunto(s)
Heridas y Lesiones , Relaciones Comunidad-Institución , Atención a la Salud , Accesibilidad a los Servicios de Salud
4.
Sex Med ; 9(5): 100435, 2021 Sep 09.
Artículo en Inglés | MEDLINE | ID: mdl-34509752

RESUMEN

INTRODUCTION: The G-spot, a putative erogenous area in the anterior vaginal wall, is a widely accepted concept in the mainstream media, but controversial in medical literature. AIM: Review of the scientific data concerning the existence, location, and size of the G-spot. METHODS: Search on Pubmed, Pubmed Central, Cochrane, clinicaltrials.gov and Google Scholar from inception to November 2020 of studies on G-spot's existence, location and nature. Surveys, clinical, physiological, imaging, histological and anatomic studies were included. MAIN OUTCOME MEASURE: Existence, location, and nature of the G-spot. RESULTS: In total, 31 eligible studies were identified: 6 surveys, 5 clinical, 1 neurophysiological, 9 imaging, 8 histological/anatomical, and 2 combined clinical and histological. Most women (62.9%) reported having a G-spot and it was identified in most clinical studies (55.4% of women); in 2 studies it was not identified in any women. Imaging studies had contradictory results in terms of its existence and nature. Some showed a descending of the anterior vaginal wall, that led to the concept of clitourethrovaginal complex. In anatomic studies, one author could systematically identify the G-spot, while another group did not find it. Studies on innervation of the vaginal walls did not systematically identify an area with richer innervation. CONCLUSION: The different studies did systematically agree on the existence of the G-spot. Among the studies in which it was considered to exist, there was no agreement on its location, size, or nature. The existence of this structure remains unproved. Vieira-Baptista P, Lima-Silva J, Preti M, et al. G-spot: Fact or Fiction?: A Systematic Review. Sex Med 2021;XX:XXXXXX.

5.
Sex Med ; 9(5): 100429, 2021 Sep 09.
Artículo en Inglés | MEDLINE | ID: mdl-34509753

RESUMEN

INTRODUCTION: Studies on characteristics of self-referred men with sexual interest in minors (SIM) and treatment approaches in this group of patients are still relatively rare. AIM: The aim of this exploratory pilot study was to investigate hypersexuality and impulsivity as 2 dynamic risk factors that could possibly change during treatment in self-referred men with SIM. METHODS: Data were collected at the "Kein Täter Werden (means: not become an offender)" network site in Hamburg. Using self-report questionnaires, the extent of hypersexuality and impulsivity was analyzed with the samples' pretreatment data via descriptive statistics and compared with nonclinical samples of other studies. The relation between hypersexuality and impulsivity was analyzed via Spearman's correlation coefficient with pretreatment data (N = 77). Intragroup analysis compared hypersexuality and impulsivity from pre- and posttreatment (n = 29). MAIN OUTCOME MEASURES: Hypersexual Behavior Inventory and Barratt Impulsiveness Scale Version 11. RESULTS: The degree of generalized impulsivity in the SIM group was comparable to that in nonclinical samples while the degree of hypersexuality was considerably higher than in nonclinical samples. Sixty-four percent of the participants were in the range of clinically relevant hypersexuality. Impulsivity and hypersexuality were weakly positively correlated with each other. During treatment hypersexuality significantly decreased while impulsivity did not differ significantly between before beginning treatment and after (partial) completion. CONCLUSION: Hypersexuality, but not impulsivity, was pronounced in the group of self-referred men with SIM and should be targeted in treatment. In order to improve treatment outcome regarding risk reduction in self-referred men with SIM, a focus on treatment approaches that were developed to treat hypersexuality can be expected to be effective while focusing on generalized impulsivity may be less relevant. Lampalzer U, Tozdan S, von Franqué F, et al. Hypersexuality and Impulsivity in Self-Referred Men With Sexual Interest in Minors: Are They Related? Do They Change During Treatment? An Exploratory Pilot Study. Sex Med 2021;XX:XXXXXX.

6.
Psychol Res ; 2021 Sep 12.
Artículo en Inglés | MEDLINE | ID: mdl-34510252

RESUMEN

PURPOSE: Obsessive and compulsive tendencies are known to occur in the general population and involve worry around specific concerns (obsessions) and an urge to resolve the concern with thoughts or behaviours (compulsions). Spontaneous, but not deliberate, mind wandering experiences (when attention turns to internal mentation), have been found to predict obsessive- compulsive tendencies [Seli, P., Risko, E.F., Purdon, C. & Smilek, D. (2017). Intrusive thoughts: linking spontaneous mind wandering and OCD symptomatology. Psychological Research, 81, 392-398. https://doi.org/10.1007/s00426-016-0756-3 ]. Recent cognitive theory suggests a particular role for future-oriented spontaneous thought in obsessive-compulsive (OC) symptoms. Thus, we hypothesised that future-oriented rather than past-oriented spontaneous mind wandering would predict OC symptoms, such that more future-oriented mind wandering would be associated with increases in OC symptoms. METHODS: In an online survey design (nonclinical sample of 104 adults), participants completed three measures: Mind wandering: Spontaneous (MW-S) and Deliberate (MW-D) (Carriere, Seli & Smilek, 2013); Involuntary Autobiographical Memory Inventory (Berntsen, Rubin & Salgado, 2015); and Dimensional Obsessive-Compulsive Scale (DOCS) (Abramowitz et al., 2010). We adopted a linear regression approach to examine our hypotheses. RESULTS: We provided the first replication of the finding that OC symptoms are predicted by the frequency of spontaneous (but not deliberate) mind wandering, with an underlying positive relationship. Additionally, we found that temporality of spontaneous thought had different predictive effects as a function of the dimension of OC symptoms (i.e., responsibility, unacceptable thoughts, need for symmetry/completeness). CONCLUSIONS: We found moderate support for our temporality hypothesis, which highlights how the construct of temporality can add to our understanding of OC symptoms. The present study also adds to recent conceptual debates regarding mind wandering. We suggest new cognitive and methodological approaches to enhance the understanding of obsessive-compulsive disorder, opening new avenues for clinical and experimental research.

7.
BMC Health Serv Res ; 21(1): 955, 2021 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-34511093

RESUMEN

BACKGROUND: Internationally, elective spinal surgery rates in workers' compensation populations are high, as are reoperation rates, while return-to-work rates following spinal surgery are low. Little information is available from Australia. The aim of this study was to describe the rates, costs, return to work and reoperation following elective spinal surgery in the workers' compensation population in New South Wales (NSW), Australia. METHODS: This retrospective cohort study used administrative data from the State Insurance Regulatory Authority, the government organisation responsible for regulating and administering workers' compensation insurance in NSW. These data cover all workers' compensation-insured workers in New South Wales (over 3 million workers/year). We identified a cohort of insured workers who underwent elective spinal surgery (fusion or decompression) between January 1, 2010 and December 31, 2018. People who underwent surgery for spinal fracture or dislocation, or who had sustained a traumatic brain injury were excluded. The main outcome measures were annual spinal surgery rates, cost of the surgical episode, cumulative costs (surgical, hospital, medical and physical therapy) to 2 years post-surgery, and reoperation and return-to-work rates 2 years post-surgery. RESULTS: There were 9343 eligible claims (39.1 % fusion; 59.9 % decompression); claimants were predominantly male (75 %) with a mean age of 43 (range 18 to 75) years. Spinal surgery rates ranged from 15 to 29 surgeries per 100,000 workers per year, fell from 2011-12 to 2014-15 and rose thereafter. The average cost in Australian dollars for a surgical episode was $46,000 for a spinal fusion and $20,000 for a decompression. Two years post-fusion, only 19 % of people had returned to work at full capacity; 39 % after decompression. Nineteen percent of patients underwent additional spinal surgery within 2 years of the index surgery, to a maximum of 5 additional surgeries. CONCLUSION: Rates of workers' compensation-funded spinal surgery did not rise significantly during the study period, but reoperation rates are high and return-to-work rates are low in this population at 2 years post- surgery. In the context of the poor evidence base supporting lumbar fusion surgery, the high cost, increasing rates, and the increased likelihood of poor outcomes in the workers' compensation population, we question the value of this procedure in this setting.


Asunto(s)
Reinserción al Trabajo , Indemnización para Trabajadores , Adolescente , Adulto , Anciano , Australia , Estudios de Cohortes , Humanos , Vértebras Lumbares , Masculino , Persona de Mediana Edad , Nueva Gales del Sur/epidemiología , Reoperación , Estudios Retrospectivos , Adulto Joven
8.
BMC Health Serv Res ; 21(1): 954, 2021 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-34511105

RESUMEN

BACKGROUND: There is emerging interest in person-centred care within a short-lived yet complex medical imaging encounter. This study explored this event from the viewpoint of patients referred for an imaging examination, with a focus on the person and their person-al space. METHODS: We used convenience sampling to conduct semi-structured interviews with 21 patients in a private medical imaging practice in Australia. The first phase of data analysis was conducted deductively, using the six elements of the person-centred, patient-journey framework of the Australian Commission on Safety and Quality in Healthcare: transition in; engagement; decisions; well-being; experience; and transition out. This was followed by inductive content analysis to identify overarching themes that span a patient's journey into, through and out of an imaging encounter. RESULTS: The transition-in phase began with an appointment and the first point of contact with the imaging department at reception. Engagement focused on patient-radiographer interactions and explanations to the patient on what was going to happen. Decisions related primarily to radiographers' decisions on how to conduct a particular examination and how to get patient cooperation. Participants' well-being related to their appreciation of gentle treatment; they also referred to past negative experiences that had made a lasting impression. Transitioning out of the imaging encounter included the sending of the results to the referring medical practitioner. Person-al vulnerabilities emerged as a cross-cutting theme. Patients' vulnerability, for which they needed reassurance, pertained to uncertainties about the investigation and the possible results. Healthcare professionals were vulnerable because of patient expectations of a certain demeanour and of pressure to perform optimal quality investigations. Lastly, patients' personal lives, concerns and pressures - their person-al 'baggage' - shaped their experience of the imaging encounter. CONCLUSION: To add value to the quality of the service they deliver, radiography practitioners should endeavour to create a person-al space for clients. Creating these spaces is complex as patients are not in a position to judge the procedures required by technical imaging protocols and the quality control of equipment. A reflective tool is proposed for radiographers to use in discussions with their team and its leaders on improving person-centred care and the quality of services in their practice.


Asunto(s)
Técnicos Medios en Salud , Personal de Salud , Australia , Humanos , Investigación Cualitativa , Radiografía
9.
Front Public Health ; 9: 728762, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34513793

RESUMEN

People constantly talk to one another about the past, and in so doing, they recount certain details while remaining silent about others. Collaborative or conversational remembering plays an important role in establishing shared representations of the past (e.g., the 911 attacks, Covid-19). According to the socially shared retrieval-induced forgetting (SS-RIF) effect, a listener will forget about relevant but unpracticed information during communication, due to intentional or unintentional selective retrieval of data by the speaker. The SS-RIF paradigm has been applied to explain how collective memory is shaped within the context of conversation/discourse. This study sought to determine if SS-RIF occurred only during face-to-face communication, or whether shared memories could be developed through other types of conversation quite common in modern society. We also investigated whether a level of social interaction in the real-world presence of others is a necessary condition for inducing SS-RIF, and if listeners experience different degrees of SS-RIF due to different levels of perceived social presence. We observed the SS-RIF phenomenon in listeners both in real life and video; the degree of forgetting was the same for the two conditions. These results indicate that social presence may not be associated with SS-RIF. Public silence affects the formation of collective memory regardless of the face-to-face presence of others, and thus physical presence is not necessary to induce SS-RIF.


Asunto(s)
COVID-19 , Relaciones Interpersonales , Comunicación , Humanos , SARS-CoV-2 , Estudiantes
10.
Rev Neurol ; 73(6): 194-200, 2021 Sep 01.
Artículo en Español | MEDLINE | ID: mdl-34515332

RESUMEN

INTRODUCTION: Cognitive reserve is the brain's capacity to actively overcome damage by means of pre-existing cognitive resources and compensatory processes. This capacity is enhanced by education, occupational attainment, learning languages and the habit of reading, among other important factors. This study aimed to investigate the psychometric properties of Rami et al's Cognitive Reserve Questionnaire in an Argentinian population. MATERIALS AND METHODS: The sample that participated in the study comprised 203 Argentinian adult volunteers from the general population (mean age, 66.1; standard deviation, 8.1). The Cognitive Reserve Questionnaire was administered together with the Montreal Cognitive Assessment. Confirmatory factor analysis was carried out to test the unidimensionality of the questionnaire. In addition, reliability was estimated by the categorical omega coefficient and associative validity was analysed by means of bivariate correlations. RESULTS: Factor analysis confirms the unidimensionality of the questionnaire with good fit indices. Items 5 (musical training) and 8 (intellectual games), however, show low factor loadings. The test has acceptable reliability, with a categorical omega coefficient = 0.72, although it should be noted that the average variance extracted (0.41) is below the recommended criterion of 0.5. Good associative validity is observed: r (200) = 0.4; p < 0.001. CONCLUSIONS: The Cognitive Reserve Questionnaire is an instrument with acceptable psychometric properties for use in an Argentinian population. More research is required to further investigate the low factor loadings of items 5 and 8 and to strengthen the evidence of reliability.

11.
Elife ; 102021 09 13.
Artículo en Inglés | MEDLINE | ID: mdl-34515634

RESUMEN

Phycobilisome (PBS) is the main light-harvesting antenna in cyanobacteria and red algae. How PBS transfers the light energy to photosystem II (PSII) remains to be elucidated. Here we report the in situ structure of the PBS-PSII supercomplex from Porphyridium purpureum UTEX 2757 using cryo-electron tomography and subtomogram averaging. Our work reveals the organized network of hemiellipsoidal PBS with PSII on the thylakoid membrane in the native cellular environment. In the PBS-PSII supercomplex, each PBS interacts with six PSII monomers, of which four directly bind to the PBS, and two bind indirectly. Additional three 'connector' proteins also contribute to the connections between PBS and PSIIs. Two PsbO subunits from adjacent PSII dimers bind with each other, which may promote stabilization of the PBS-PSII supercomplex. By analyzing the interaction interface between PBS and PSII, we reveal that αLCM and ApcD connect with CP43 of PSII monomer and that αLCM also interacts with CP47' of the neighboring PSII monomer, suggesting the multiple light energy delivery pathways. The in situ structures illustrate the coupling pattern of PBS and PSII and the arrangement of the PBS-PSII supercomplex on the thylakoid, providing the near-native 3D structural information of the various energy transfer from PBS to PSII.

12.
J Cell Biol ; 220(10)2021 Oct 04.
Artículo en Inglés | MEDLINE | ID: mdl-34515738

RESUMEN

Hepatocytes display a unique biaxial polarity with shared apical luminal connections between adjacent hepatocytes that merge into a network of bile canaliculi. Belicova et al. (2021. J. Cell Biol.https://doi.org/10.1083/jcb.202103003) discovered that hepatocyte apical membranes generate Rab35-dependent extensions that traverse the lumen and are essential for bile canalicular formation and maintenance.

13.
Nonlinear Dynamics Psychol Life Sci ; 25(4): 385-394, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34516941

RESUMEN

Since the pioneering work of Herbert A. Simon, bounded rationality (BR) constitutes a viable alternative to utility maximization in settings characterized by uncertainty about the possible emergence of novel events, missing information, and limitations to human reasoning. Because of its realism, BR gained consensus in organization and management studies. However, BR is a theory of individual decision-making. Substantial extensions are required in order to turn it into a tool to analyze collective decision processes. Following an intuition by the late Simon himself, we submit that organizations channel information flows in ways that alleviate human BR. Thus, analysis and reconstruction of their structure as well as differential degrees and qualities of individual BR within organizations is key to extend this concept to collective decision-making. In this special issue we collected contributions where instances of BR couple with interaction structures to yield collective behavior. Tools range from mathematical models to experimental settings to computational models, testifying to the value of multiple approaches and perspectives.


Asunto(s)
Cognición , Toma de Decisiones , Procesos de Grupo , Humanos , Relaciones Interpersonales , Solución de Problemas
14.
Sex Med ; 9(5): 100426, 2021 Sep 10.
Artículo en Inglés | MEDLINE | ID: mdl-34517208

RESUMEN

INTRODUCTION: Decreased libido in middle-aged and elderly men is often difficult to treat, and identifying the risk factors affecting decreased libido is important for the clinical management of decreased libido. However, limited information is available regarding specific risk factors in this population. AIM: The present study investigated the risk factors for decreased libido among middle-aged and elderly men. METHODS: Patients who attended our male andropausal outpatient clinic between 2009 and 2015 were enrolled. All patients completed a self-administered questionnaire, which included the Aging Male Symptoms (AMS) scale, International Prostate Symptom Score (IPSS), and Sexual Health Inventory for Men (SHIM). Information on waist size, body mass index, present illness, present use of any medication, and lifestyle habits were collected by each attending physician. Blood biochemical data such as free testosterone, total cholesterol, triglyceride, high density lipoprotein-cholesterol (HDL-Chol), and hemoglobin A1c values were assessed. Libido was assessed based on AMS scale question 17, and a score of 4 or higher was defined as severely decreased libido (severe group). MAIN OUTCOME MEASURE: The clinical factors associated with severely decreased libido were analyzed based on multiple regression analysis. RESULTS: A total of 292 subjects were included in the analysis, 111 (38%) of which belonged to the severe group. The mean age of study subjects was 66.2 years, and the mean FT value was 7.1 ± 2.2. Comparisons of each variable among the severe and not severe groups showed significant differences in older age, current cigarette smoking, AMS scale, IPSS, frequency of nocturnal voiding, SHIM score, and HDL-Chol value. Multivariate regression analysis revealed that current cigarette smoking, frequent nocturnal voiding, and a low SHIM score were the independent risk factors for severely decreased libido. Furthermore, the frequency of nocturnal voiding significantly increased with severity of decreased libido. CONCLUSION: Current cigarette smoking, frequent nocturnal voiding, and a low SHIM score were the independent risk factors for a severely low libido. K Shigehara, Y Kato, M Iijima, et al. Risk Factors Affecting Decreased Libido Among Middle-Aged to Elderly Men; Nocturnal Voiding is an Independent Risk Factor of Decreased Libido. Sex Med 2021;9:1-6.

15.
Sex Med ; 9(5): 100436, 2021 Sep 10.
Artículo en Inglés | MEDLINE | ID: mdl-34517209

RESUMEN

INTRODUCTION: In clinical consultations, men with erectile dysfunction do not always express personal, sexual, and interpersonal concerns. AIM: We explore whether the attenuated impact of erectile dysfunction may be explained by a regulation of negative affect that causes activation of the attachment system. METHODS: The study sample consisted of 69 men diagnosed with erectile dysfunction, mean (SD) age 56 (10.83) years. Participants completed self-reported questionnaires to assess erectile dysfunction severity, attachment style, sexual satisfaction, relationship satisfaction, and psychological symptoms. MAIN OUTCOME MEASURE: The moderating role of attachment between erectile dysfunction and sexual satisfaction, relationship satisfaction, and psychological distress was evaluated using multiple linear regression and moderation analysis. RESULTS: All men in the sample had high attachment avoidance, distributed between the dismissive-avoidant (69.6%) and fearful-avoidant (30.4%) substyles, but low levels of psychological symptoms. Despite their erectile dysfunction, 27 patients (39.1%) rated their sexual life as satisfactory, and 46 (66.7%) rated their relationship with their partner as satisfactory. Men with fearful-avoidant attachment reported feeling more sexual desire and less sexual satisfaction than men with dismissive-avoidant attachment. Multiple linear regression analysis showed that sexual satisfaction variance was explained by erectile dysfunction severity, attachment anxiety, and relationship satisfaction scores. Moderation analysis showed that attachment anxiety, but not relationship satisfaction, moderated the impact of erectile dysfunction on sexual satisfaction. CONCLUSION: The avoidance dimension of attachment, which tends to be high in patients with erectile dysfunction, involves deactivation of the sexual system in an effort to minimize the emotional distress associated with erectile dysfunction, which damages sexual and relationship intimacy and delays the decision to obtain professional help. The presence of high attachment avoidance and the moderating value of attachment anxiety allow us to propose specific treatments for these men. Maestre-Lorén F, Castillo-Garayoa JA, López-i-Martín X, et al. Psychological Distress in Erectile Dysfunction: The Moderating Role of Attachment. Sex Med 2021;9:100436.

16.
Spine (Phila Pa 1976) ; 46(19): 1295-1301, 2021 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-34517398

RESUMEN

STUDY DESIGN: Retrospective analysis. OBJECTIVE: To compare perioperative outcomes and hospitalization costs between patients undergoing primary or revision posterior cervical discectomy and fusion (PCDF). SUMMARY OF BACKGROUND DATA: While prior studies found differences in outcomes between primary and revision anterior cervical discectomy and fusion (ACDF), risk, and outcome profiles for posterior cervical revision procedures have not yet been elucidated. METHODS: Institutional records were queried for cases involving isolated PCDF procedures to evaluate preoperative characteristics and outcomes for patients undergoing primary versus revision PCDF between 2008 and 2016. The primary outcome was perioperative complications, while perioperative and resource utilization measures such as hospitalization length, required stay in the intensive care unit (ICU), direct hospitalization costs, and 30-day emergency department (ED) admissions were explored as secondary outcomes. RESULTS: One thousand one hundred twenty four patients underwent PCDF, with 218 (19.4%) undergoing a revision procedure. Patients undergoing revision procedures were younger (53.0 vs. 60.5 yrs), but had higher Elixhauser scores compared with the non-revision cohort. Revision cases tended to involve fewer spinal segments (3.6 vs. 4.1 segments) and shorter surgical durations (179.3 vs. 206.3 min), without significant differences in estimated blood loss. There were no significant differences in the overall complication rates (P = 0.20), however, the primary cohort had greater rates of required ICU stays (P = 0.0005) and non-home discharges (P = 0.0003). The revision cohort did experience significantly increased odds of 30-day ED admission (P = 0.04) and had higher direct hospitalization (P = 0.03) and surgical (P < 0.0001) costs. CONCLUSION: Complication rates, including incidental durotomy, were similar between primary and revision PCDF cohorts. Although prior surgery status did not predict complication risk, comorbidity burden did. Nevertheless, patients undergoing revision procedures had decreased risk of required ICU stay but greater risk of 30-day ED admission and higher direct hospitalization and surgical costs.Level of Evidence: 3.


Asunto(s)
Enfermedades de la Columna Vertebral , Fusión Vertebral , Vértebras Cervicales/cirugía , Discectomía/efectos adversos , Humanos , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/cirugía , Estudios Retrospectivos , Fusión Vertebral/efectos adversos , Resultado del Tratamiento
17.
Spine (Phila Pa 1976) ; 46(19): 1354-1361, 2021 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-34517405

RESUMEN

STUDY DESIGN: Observational multicenter study. OBJECTIVE: The aim of this study was to evaluate changes in pain during sexual activity after surgery for lumbar spinal stenosis (LSS). SUMMARY OF BACKGROUND DATA: There are limited data available on sexual function in patients undergoing surgery for LSS. METHODS: Data were retrieved from the Norwegian Registry for Spine Surgery. The primary outcome was change in pain during sexual activity at 1 year, assessed by item number eight of the Oswestry disability index questionnaire. Secondary outcome measures included Oswestry Disability Index, EuroQol-5D, and numeric rating scale scores for back and leg pain. RESULTS: Among the 12,954 patients included, 9908 (76.5%) completed 1-year follow-up. At baseline 9579 patients (73.9%) provided information about pain during sexual activity, whereas 7424 (74.9%) among those with complete follow-up completed this item. Preoperatively 2528 of 9579 patients (26.4%) reported a normal sex-life without pain compared with 4294 of 7424 patients (57.8%) at 1 year. Preoperatively 1007 (10.5%) patients reported that pain prevented any sex-life, compared with 393 patients (5.3%) at 1 year. At baseline 7051 of 9579 patients (73.6%) reported that sexual activity caused pain, and among these 3145 of 4768 responders (66%) reported an improvement at 1 year. A multivariable regression analysis showed that having a life partner, college education, and working until time of surgery were predictors of improvement in pain during sexual activity. Current tobacco smoking, pain duration >12 months, previous spine surgery, and complications occurring within 3 months were negative predictors. CONCLUSION: This study clearly demonstrates that a large proportion of patients undergoing surgery for LSS experienced an improvement in pain during sexual activity at 1 year.Level of Evidence: 2.


Asunto(s)
Estenosis Espinal , Descompresión Quirúrgica , Evaluación de la Discapacidad , Humanos , Vértebras Lumbares/cirugía , Dolor , Dimensión del Dolor , Estudios Prospectivos , Conducta Sexual , Estenosis Espinal/cirugía , Resultado del Tratamiento
19.
Curr Psychol ; : 1-12, 2021 Jan 08.
Artículo en Inglés | MEDLINE | ID: mdl-34522074

RESUMEN

Stress and allied difficulties are pervasive among school students in present times. This concern is further magnified in the Indian context with the large represention of young people in the population and limited resources to match. The present study aimed to evaluate the impact of a classroom based stress management training and gratitude journaling intervention (Flinchbaugh et al., 2012) among Indian adolescents. The intervention curriculum was adapted to suit the study context. A total of 238 students (57% males) from Grades 7-9 participated in this study. Participants were recruited from two schools, and their age ranged from 11 to 14 years. In each participating school, students were randomised at the classroom level into three intervention groups (Stress Management Training, Gratitude Journaling, combination of both), and one control group. Using a pre-test - post-test design, intervention impact on measures of well-being, life satisfaction, perceived stress, meaning, and engagement in the classroom was evaluated. Results suggested limited effectiveness of stress management training and gratitude journaling among participants in the present context. Plausible explanations for these findings are discussed. The study emphasizes the need for customised interventions to obtain optimal outcomes among diverse populations.

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