Menopause symptoms in women infected with HIV: Prevalence and associated factors

Objective. To evaluate the prevalence and factors associated with menopause symptoms in HIV-infected women.

Methods. A cross-sectional study of two groups of women was conducted: 96 with HIV and 155 without HIV. Women aged 40 years or older, non-users of hormone therapy in the last 6 months and native Brazilians were included. The prevalence of menopause symptoms was calculated according to the studied variables. Symptoms were grouped into six categories: vasomotor, psychological, genitourinary, weight gain, palpitations and insomnia. The generalized estimating equation model was applied to identify the factors associated with menopause symptoms in all women and for HIV-infected women only.

Results. The mean (±standard deviation) age of women with and without HIV was 48.9 ± 7.4 and 51.0 ± 8.7 years (p = 0.07), respectively. The median age at menopause for HIV-infected women was 47.5 years. Menopause symptoms were more frequent in HIV-infected women, highlighting psychological and vasomotor symptoms. HIV infection was associated with menopause symptoms (odds ratio (OR) = 1.65, p = 0.03), as well as age ranging from 45 to 54 years (OR = 1.77, p = 0.01), higher parity (OR = 2.38, p = 0.01) and self-perception of health as fair/poor (OR = 2.07, p < 0.01). Among HIV-infected women, the likelihood of presenting symptoms decreased in those aged 55 or older (OR = 0.16, p = 0.03) and increased in retired women (OR = 2.61, p = 0.02).

Conclusion. Menopause symptoms were common in HIV-infected women. HIV infection was independently associated with menopause symptoms, whereas age and being retired were associated with the occurrence of these symptoms in HIV-infected women.     

Self-criticism,negative automatic thoughts and postpartum depressive symptoms: the buffering effect of self-compassion

ABSTRACT

Objective: This study aimed to explore the direct and indirect effects of self-criticism on postpartum depressive symptoms, through postpartum cognitions, and analyse the moderating role of self-compassion in this relationship.

Background: Self-criticism and self-compassion are associated with postpartum depression. However, further research is needed to understand how these mechanisms operate in the development/maintenance of depressive symptoms.

Methods: 686 women in the postpartum period (up to 12 months after birth) recruited in-person and online answered a cross-sectional survey.

Results: The effect of self-criticism on postpartum depressive symptoms occurred sequentially, increasing the frequency of negative automatic thoughts and subsequently the metacognitive appraisal of these thoughts. Self-compassion had a moderating effect only on the relation between self-criticism and postpartum cognitions. The effect of self-criticism on postpartum cognitions decreased in the presence of higher self-compassion.

Conclusion: This study emphasises the negative effect of a self-critical thinking style and of a negative appraisal of thought’s content on depression symptoms. Moreover, this work underscores the buffering role of self-compassion in the relationship between self-criticism and postpartum cognitions. These results highlight the need to address the reduction of self-criticism and the promotion of self-compassion strategies to deal with postpartum cognitions, in order to prevent and treat postpartum depressive symptoms.     

Internal Procidentia of the Rectum — Treatment and Results

Thirty-nine patients, 34 women and 5 men, with internal procidentia have been studied regarding symptomatology and results of treatment. Nineteen women have been operated upon. The most common indication for operation was anal incontinence. Twenty patients have been treated conservatively with bulk laxatives. In the operated group, 11 were symptom-free, 5 had recurrences, 2 had unchanged symptoms and one patient was worse because of rectovaginal fistula. The 5 recurrences were operated upon according to the techniques of Graham and Moschcowitz (4, 5). One of the conservatively treated patients developed a rectal prolapse in the followup period.     

潍坊市部分围绝经期妇女相关症状与性生活情况调查

[目的]了解围绝经期妇女相关症状、性生活状况，为今后更有针对性地开展围绝经期预防保健工作提供依据。[方法]对2007年9月至2008年5月就诊于潍坊市某高等学校门诊的180名40～60岁妇女进行调查。[结果]调查的180人中，已绝经的占37．78％。自然绝经者所占比例，40～45岁为14．29％，46～50岁为21．43％，51～55岁为65．91％，56-60岁为90．00％；绝经时年龄为（49±5）岁。调查180人中，已出现更年期症状的占82．22％。更年期症状发生率，40-45岁为66．67％，46-50岁为95．24％，51～55岁为75．00％，56～60岁为70．00％（P〈0．01），出现更年期症状时的年龄为（47±5）岁。出现更年期症状的148例中，64．87％有潮热出汗，66．22％有烦躁易怒，44．60％有阴道干燥，43．92％有疲乏失眠，16．89％有心慌，12．84％有骨关节肌肉痛，18．92％有性欲下降，接受激素治疗的占18．92％。[结论]更年期妇女的相关症状主要是烦躁易怒、潮热出汗、阴道干燥、疲乏失眠、性欲下降。70％以上有性生活。     

Transient lower oesophageal sphincter relaxations play an insignificant role in gastro-oesophageal reflux to the proximal oesophagus.

Gastro-oesophageal reflux to the proximal oesophagus may cause atypical symptoms of gastro-oesophageal reflux disease (GORD). The motor abnormalities underlying reflux into the proximal oesophagus are still unclear. The aim of this study was to analyse the oesophageal motility during reflux into the proximal oesophagus in a group of healthy subjects and in patients with atypical symptoms of GORD. We concentrated particularly on lower oesophageal sphincter (LOS) activity and transient lower oesophageal sphincter relaxations (TLOSRs). Ten patients (7M, 3F, age 25-51 years) with mild oesophagitis (Savary-Miller grade I-II) and 10 healthy subjects (6M, 4F, age 23-54 years) underwent a 24-h dual pH-metric and manometric recording, using an electronic portable device. This recorded distal and proximal oesophageal pH values, oesophageal body and LOS motility. GORD patients had more distal and proximal reflux (DR and PR) compared with healthy controls (DR P < 0.001; PR P < 0.05). TLOSRs were the most frequent event during reflux into the distal oesophagus, whereas TLOSR frequency was much lower during reflux to the proximal oesophagus in GORD patients and in healthy controls (P < 0.05 and P < 0.01 vs. distal reflux, respectively). A significant relationship between TLOSRs and distal refluxes was present but no relationship with proximal reflux was detected. We conclude that TLOSRs are much less frequent during reflux to the proximal oesophagus than distal oesophageal reflux in patients with mild GORD suffering from atypical manifestations. The mechanism of acid reflux to the proximal oesophagus is unclear.     

Hot flushes in women with breast cancer: state of the art and future perspectives

Although not life-threatening, vasomotor symptoms might have a detrimental effect on quality of life and represent a major determinant of poor therapeutic compliance in breast cancer patients. Limitations of hormonal therapies have fostered the use of non-estrogenic pharmacological agents, which mainly include centrally acting compounds, antidepressant drugs, serotonin-norepinephrine reuptake inhibitors and serotonin reuptake inhibitors. Integrating therapeutic tools have recently come from a wide range of heterogeneous approaches varying from phytoestrogens use to ganglion block. We herein critically review the most updated evidence on the available treatment options for management of vasomotor symptoms. The need for a patient-oriented approach following systematic evaluation of the presence and degree of vasomotor disturbances is also discussed and future perspectives in therapeutics are summarized.     

Perceived discrimination from management and musculoskeletal symptoms among New York City restaurant workers

Abstract

Background: Compared with other restaurant hazards, organizational stressors are an understudied topic. Among organizational stressors, discrimination from management (DFM) appears widespread.

Objective: Objectives were to assess the prevalence and links between musculoskeletal symptoms (MSSs) in three anatomical regions and five sources of DFM.

Methods: A cross-sectional, interviewer-administered survey among restaurant workers was used. Participants were randomly selected by type and geographic distribution.

Results: Eighty-four percent of workers reported having MSSs in at least one anatomical region. The prevalence of severe MSSs was 24·9%. The strongest association between DFM and frequency of MSSs was “upper extremities.” The strongest association between DFM and severity of MSSs was “any anatomical location.” Thirty-four percent of restaurant workers reported DFM; age was the most prevalent source of DFM.

Conclusions: In general, associations between DFM and MSSs were stronger by frequency than severity. The largest number of significant associations by sources of DFM was language and age.     

特发性基底节钙化26例临床分析

目的探讨特发性基底节钙化的临床特点与头部CT表现，防止漏诊及误诊。方法回顾性分析26例特发性基底节钙化的临床特点与头部CT的表现。结果（1）26例病例均为散发；（2）临床表现主要为癫痫发作、锥体外系症状、进行性痴呆、头昏失眠等，亦可无临床表现，血清钙、磷均正常；（3）头颅CT主要表现为对称性双侧基底节钙化，MRI诊断阳性率不高。结论特发性基底节钙化的临床表现无特异性。在排除其他可引起基底节钙化的相关疾病的基础上，头颅CT及实验室检查对本病诊断有重要意义，尤其对无症状者更有意义。