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Disfunção sexual feminina em idade reprodutiva: prevalência e factores associados
Get PDFObjetivos: A disfunção sexual feminina (DSF) é altamente prevalente, situando-se entre os 40% e 70% em Portugal, e traduz-se por uma alteração em qualquer uma das fases do ciclo de resposta sexual da mulher (desejo, excitação e orgasmo) ou ainda
por perturbações dolorosas associadas ao ato sexual. O presente estudo pretendeu estudar a prevalência da DSF numa amostra
de mulheres em idade reprodutiva, a prevalência dos diferentes subtipos de DSF e a existência de fatores associados.
Tipo de estudo: Tratou-se de um estudo observacional, transversal e analítico.
Local: Unidades de Saúde Familiar (USF) Novo Cuidar, Centro de Saúde de Fafe.
População: Mulheres entre os 18 e os 58 anos utentes da USF Novo Cuidar.
Métodos:A uma amostra aleatória de 346 utentes foi aplicado um questionário anónimo e confidencial de autorresposta. Usaram-se os testes Qui-Quadrado ou de Fisher para comparar proporções, o Odds Ratio para determinar a força de associação entre variáveis e os testes
t-Student e Mann-Whitney para testar a associação entre variáveis qualitativas e quantitativas (adotou-se um nível de significância de 0,05).
Resultados: A taxa de resposta foi de 86,4% e a prevalência de DSF foi de 77,2% (IC95% 72,0-82,7), tendo a perturbação do orgasmo sido o subtipo mais prevalente, 55,8% (IC95% 51,0-63,9). Foi encontrada uma associação entre a contraceção hormonal e a perturbação do desejo (p = 0,003). A aversão sexual foi estatisticamente relacionada com experiências sexuais indesejadas
prévias (p = 0,001).
Conclusões: A DSF em idade reprodutiva é muito prevalente apesar de apenas metade das mulheres a considerarem um problema.
Foram encontradas associações com alguns fatores que podem ter importância na vivência de uma sexualidade feliz pela mulher
The impact of GGH -401C>T polymorphism on cisplatin-based chemoradiotherapy response and survival in cervical cancer
Get PDFAIMS:
Cervical cancer is the third most frequent cancer in women worldwide, mostly treated with cisplatin-based chemoradiotherapy. Since it is known that folate metabolism might interfere with cisplatin effectiveness, we intended to study the influence of the Gamma Glutamyl Hydrolase -401C>T polymorphism in treatment response in cervical cancer.
METHODS:
We retrospectively reviewed the clinical data of 167 patients with bulky cervical cancer submitted to cisplatin-based chemoradiotherapy. The genotypes of GGH -401C>T SNP were determined by real-time PCR and statistical analysis was performed by χ(2) test and survival analysis.
RESULTS:
The genotypes of GGH-401C>T were significantly associated with the response to platinum-based chemoradiotherapy. Treatment response was higher in patients carrying the CC genotype, who presented a significant increased chance of treatment response (survival time in months/genotype: 91 for CC Vs 72 for CT/TT; p=0.035, log rank test). A Cox regression analysis accordingly showed that the presence of the T allele was significantly linked to a worse treatment response (HR=3.036; CI 95% 1.032-8.934, p=0.044).
CONCLUSIONS:
The results of our study suggested the potential interest of GGH -401C>T as a predictive factor of the outcome of cervical carcinoma treated with cisplatin-based chemoradiotherapy
Three-dimensional vs standard laparoscopy: comparative assessment using a validated program for laparoscopic urologic skills
Get PDFOBJECTIVE:
To compare the last generation of 3-dimensional imaging (3D) vs standard 2-dimensional imaging (2D) laparoscopy.
MATERIALS AND METHODS:
A prospective observational study was conducted during the 4th Minimally Invasive Urological Surgical Week Course held in Braga (Portugal) in April 2013. The course participants and faculty were asked to perform standardized tasks in the dry laboratory setting and randomly assigned into 2 study groups; one starting with 3D, the other with 2D laparoscopy. The 5 tasks of the European Training in Basic Laparoscopic Urological Skills were performed. Time to complete each task and errors made were recorded and analyzed. An end-of-study questionnaire was filled by the participants.
RESULTS:
Ten laparoscopic experts and 23 laparoscopy-naïve residents were included. Overall, a significantly better performance was obtained using 3D in terms of time (1115 seconds, interquartile range [IQR] 596-1469 vs 1299 seconds, IQR 620-1723; P = .027) and number of errors (2, IQR 1-3 vs 3, IQR 2-5.5; P = .001). However, the experts were faster only in the "peg transfer" task when using the 3D, whereas naïves improved their performance in 3 of the 5 tasks. A linear correlation between level of experience and performance was found. Three-dimensional imaging was perceived as "easier" by a third of the laparoscopy-naïve participants (P = .027).
CONCLUSION:
Three-dimensional imaging seems to facilitate surgical performance of urologic surgeons without laparoscopic background in the dry laboratory setting. The advantage provided by 3D for those with previous laparoscopic experience remains to be demonstrated. Further studies are needed to determine the actual advantage of 3D over standard 2D laparoscopy in the clinical setting
Tecnologia na melhoria contínua da gestão de stocks dos serviços farmacêuticos do Hospital de Braga
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Inflammatory Bowel Disease-Experience of a Pediatric Gastroenterology Unit
Get PDFInflammatory bowel disease, especially Crohn disease, had increased in the last five decades. We analyzed all the patients of our unit diagnosed with the disease between 2001-2012 but we just considered the patients who respected the Porto criteria to define IBD at presentation. We diagnosed 51 children and adolescents with the disease. Crohn disease was responsible for 62.7% of cases, ulcerative colitis for 31.4% and indeterminate colitis for 5.9%. Considering the 4 different periods of time (2001-2003/2004-2006/2007-2009 and 2010-2012), we observed and increase in the number of cases, but a decrease in the time from onset of symptoms to diagnosis.
Our medical approach with tumor necrosis factor antagonists was reserved for severe disease cases and to spare patients from adverse effects of purine analogues and corticosteroids. Mucosal healing and remission of the disease was achieved in all of the patients under biologic therapy and no serious or life-threating event was reported with their use
Plasticity of resting state brain networks in recovery from stress
Get PDFChronic stress has been widely reported to have deleterious impact in multiple biological systems. Specifically, structural and functional remodeling of several brain regions following prolonged stress exposure have been described; importantly, some of these changes are eventually reversible. Recently, we showed the impact of stress on resting state networks (RSNs), but nothing is known about the plasticity of RSNs after recovery from stress. Herein, we examined the "plasticity" of RSNs, both at functional and structural levels, by comparing the same individuals before and after recovery from the exposure to chronic stress; results were also contrasted with a control group. Here we show that the stressed individuals after recovery displayed a decreased resting functional connectivity in the default mode network (DMN), ventral attention network (VAN), and sensorimotor network (SMN) when compared to themselves immediately after stress; however, this functional plastic recovery was only partial as when compared with the control group, as there were still areas of increased connectivity in dorsal attention network (DAN), SMN and primary visual network (VN) in participants recovered from stress. Data also shows that participants after recovery from stress displayed increased deactivations in DMN, SMN, and auditory network (AN), to levels similar to those of controls, showing a normalization of the deactivation pattern in RSNs after recovery from stress. In contrast, structural changes (volumetry) of the brain areas involving these networks are absent after the recovery period. These results reveal plastic phenomena in specific RSNs and a functional remodeling of the activation-deactivation pattern following recovery from chronic-stress, which is not accompanied by significant structural plasticity