The quality of sexual life in women with gynaecological cancers

Objectives

This cross-sectional study was conducted with the aim of determining the quality of sexual life and related factors in women with gynaecological cancers.

Methods

The study was conducted in the gynaecological oncology clinic of a state hospital. Women who were diagnosed with gynaecological cancers constituted the study population. Eighty married women who were diagnosed with cancer and who agreed to participate were included in the study. Data were collected by a personal data form, the Sexual Quality of Life (SQOL) Questionnaire-Female and the Multidimensional Scale of Perceived Social Support (MSPSS).

Results

The mean age of the women was 52.16 (SD 10.04). Of the patients, 61.3% had ovarian cancer, 22.5% endometrial cancer, and 13.8% cervical cancer and 56.3% had been diagnosed with cancer during the previous year. Sixty percent of the women were receiving cancer therapy. The mean score of MSPSS was 67.60 (SD 14.03), and SQOL was 52.50 (SD 22.87). Although there was no significant difference between mean SQOL according to individual and disease characteristics, a positive statistically significant relationship was detected between total and subdimension (family, friend and significant other) scores of MSPSS (p?Conclusions According to the results obtained from the study, it can be stated that the sexual quality of life of women with gynaecological cancers is moderate and social support, especially support from a significant person, may affect quality of sexual life positively.     

Obstructive sleep apnea is the triggering factor for massive hemoptysis

Purpose

The purpose of this study was to investigate the prevalence of obstructive sleep apnea (OSA) in patients with hemoptysis.

Methods

Files of patients who had undergone bronchial arterial embolization due to hemoptysis between 1 December 2009 and 2015 were evaluated and interviews of patients were conducted until 1 June 2016. Pittsburgh Sleep Quality Index (PSQI), STOP and STOP-BANG surveys were administered. OSA risk was determined with Berlin Questionnaire.

Results

Study group consisted of 53 patients and 58 control subjects. Mean age was 46.94 ± 14.36 and 41.97 ± 12.92 in patient and control group, respectively. Of these patients, seven had re-embolization procedure because of recurrence of hemoptysis. High OSA risk was more common among patients with hemoptysis (24.5%, n = 13) than the control group (8.6%, n = 5) (p = 0.023). Percentage of high risk OSA patients with massive hemoptysis, nonmassive hemoptysis, and control subjects was 29.7% (n = 11), 12.5% (n = 2), and 8.6% (n = 5), respectively (p = 0.022). There were more high OSA risk subjects among patients with idiopathic hemoptysis 44.4% (four out of nine), while 20.5% (nine out of 53) patients with a known etiology had high risk (p = 0.127). The number of patients with high OSA risk was also higher in patients who required a second embolization procedure (four out of seven, 57.1%), while 19.6% of patients without need for re-embolization had high risk (p = 0.031).

Conclusions

OSA is found to be a risk factor for hemoptysis and also may provoke massive hemoptysis. It seems reasonable to consider OSA as an underlying condition in idiopathic hemoptysis. OSA may contribute to embolization failure.

     

99mTc-HMPAO labelled leucocyte scintigraphy in the diagnosis of pelvic inflammatory disease

BACKGROUND: Scintigraphy using leucocytes labelled with 99mTc hexamethylpropyleneamine oxime (99mTc-HMPAO) is widely used for the localization of inflammatory foci and abscesses in cases of acute pelvic inflammatory disease, which is one of the serious health problems of women of child-bearing age. Early diagnosis and effective management of this condition can preserve fertility and prevent serious complications, such as peritonitis and sepsis. AIM: To evaluate the importance of scintigraphy using 99mTc-HMPAO labelled leucocytes in the early diagnosis of patients with pelvic inflammatory disease. METHODS: Fifteen women (mean age 29.2+/-8 years, range 25-46 years) with suspicion of pyogenic pelvic inflammatory disease based on gynaecological examinations, clinical findings and blood tests were included in this study. The patients received 555 MBq 99mTc-HMPAO labelled leucocytes, by injection, and were scanned by scintigraphy 0.5-1, 3 and 24 h later in the anterior abdominal projection. Ten of the patients were then evaluated by abdominal or transvaginal ultrasonography, four by computed tomography and two by both ultrasound and computed tomography. The final diagnosis was made by surgical intervention. RESULTS: Scintigraphy detected pelvic inflammatory disease in five of the patients. In three of them the disease was apparent on the scans taken at 0.5-1 h, and in the other two it was apparent at 3 h. There were no false negative results, and one false positive result. The scan accurately reflected the absence of pelvic inflammatory disease in nine patients showing non-pathological tracer uptake in the lower abdominal region. CONCLUSION: We showed that scintigraphy with 99mTc-HMPAO labelled leucocytes had a sensitivity of 100%, specificity of 90%, overall accuracy of 93%, positive predictive value of 83%, and negative predictive value of 100%. Therefore, we conclude that 99mTc-HMPAO labelled leucocyte scans provide a rapid and highly accurate method for diagnosing pelvic inflammatory disease in women of child-bearing age. This adds an important contribution to the diagnosis of infection and helps determine further operative or conservative treatment.     

Does Obesity Increase Sexual Dysfunction in Women?

This study was conducted to determine the prevalence of sexual dysfunction among women with obesity who are otherwise healthy and applied to the diet center of a hospital located in Ankara, the capital city of Turkey. The sample included 203 volunteers. Data were collected using the personal data form developed by the authors and the female sexual dysfunction inventory (FSFI). The mean age of the participants was 41.17 ± 8.38 years old. Of the participants, 48.7 % were elementary school graduates, 60.6 % were housewives, 64.0 % had the body mass index (BMI) score between 30.00 and 34.99, and the mean BMI score of the participants was 34.73 ± 4.86. Of the participants, 44.3 % stated that being over-weight had adversely affected their sexual life at a score of 6 points or more. Twenty point two of the participants received information regarding sexuality. It is remarkable that health care professionals were found to be the least frequently referred (3 %) resource regarding sexuality. The mean FSFI score of the participants was 27.36 ± 4.80. Severe dysfunction were observed in 12.8 % of the participants. Moreover, all domains of sexual function were dysfunctional. Female sexual function in the present study was not found correlated with several variables, such as the level of education, work status, menopausal status, and knowledge of sexuality. In conclusion, in order to improve women with obesity’s health and well-being diet to lose weight as well as sexual counseling are to be recommended.     

Mood disorder with mixed, psychotic features due to vitamin b12 deficiency in an adolescent: case report

ABSTRACT: Vitamin B12 is one of the essential vitamins affecting various systems of the body. Reports of psychiatric disorders due to its deficiency mostly focus on middle aged and elderly patients. Here we report a case of vitamin B 12 deficiency in a 16-year old, male adolescent who presented with mixed mood disorder symptoms with psychotic features. Chief complaints were "irritability, regressive behavior, apathy, crying and truancy" which lasted for a year. Premorbid personality was unremarkable with no substance use/exposure or infections. No stressors were present. The patient was not vegetarian. Past medical history and family history was normal. Neurological examination revealed glossitis, ataxia, rigidity in both shoulders, cog-wheel rigidity in the left elbow, bilateral problems of coordination in cerebellar examination, reduced swinging of the arms and masked face. Romberg's sign was present. Laboratory evaluations were normal. Endoscopy and biopsy revealed atrophy of the gastric mucosa with Helicobacter Pylori colonization. Schilling test was suggestive of malabsorbtion. He was diagnosed with Mood disorder with Mixed, Psychotic Features due to Vitamin B12 Deficiency and risperidone 0.5?mg/day and intramuscular vitamin B12 500 mcg/day were started along with referral for treatment of Helicobacter pylori. A visit on the second week revealed no psychotic features. Romberg's sign was negative and cerebellar tests were normal. Extrapyramidal symptoms were reduced while Vitamin B12 levels were elevated. Risperidone was stopped and parenteral Vitamin B12 treatment was continued with monthly injections for 3?months. Follow-up endoscopy and biopsy at the first month demonstrated eradication of H. pylori. He was followed monthly for another 6?months and psychiatric symptoms did not recur at the time of last evaluation. Despite limitations, this case may underline the observation that mood disorders with psychotic features especially with accompanying extrapyramidal symptoms lacking a clear etiology may be rare manifestation of vitamin B12 and/or folate deficiency in children and adolescents and be potentially amenable to treatment.     

Rosacea Fulminans in Pregnancy

Rosacea fulminans is a rare disease of unknown cause which occurs exclusively in women years after adolescence. Although the etiology is unknown, immunologic, hormonal, and vascular factors have been suggested. When rosacea fulminans occurs during pregnancy and in women taking oral contraceptive pills, hormonal factors may be a trigger. Rosacea fulminans is localized specifically to the face, with the chin, cheeks, and forehead bearing the brunt of the attack. A dull red, cyanotic erythema of all involved facial areas, extending beyond the inflammatory nodules, is typical. We present the case of a 31-year-old pregnant woman who had rosacea fulminans during the first trimester of her second pregnancy. She had multiple erythematous papules, pustules, nodules, and purulent discharging cysts on the face. Conventional therapeutic approaches with systemic corticosteroids were associated with clear improvement within 2 months, and subsequently only 0.75% metronidazole topical cream was used during the second trimester.