Beneficios de un programa de ejercicio físico comunitario prescrito desde Atención Primaria en la salud de mujeres perimenopáusicas/menopaúsicas

ObjectiveTo measure the benefits of a physical exercise program in a community, through the modifications in quality of life, and perimenopausal–menopausal women physical condition.SettingThe participants were recruited in PC consultations from two health centers in Molina de Segura (Murcia).ParticipantsWomen between 40 and 70 years old, or under 40 of age diagnosed with early menopause.DesignQuasi-experimental study, non-randomized, controlled, open and single-center with 2 parallel branches to study.InterventionExperimental group: ACTIVA Bone Health Program for six months. Control: inactive.Main measurements in both groupsThe SF 36 questionnaire was used to measure the Quality of life.Physical conditionAerobic condition, flexibility, balance and strength measured with the mile, flamenco, flexibility box tests, and throwing the medicine ball, respectively. Physical activity level through the GPPAQ Questionnaire. Sociodemographic variables were collected and the adherence to the program was measured.ResultsThe quality of life improved in the intervention group compared to the control group, except «Body Pain» dimension (p = 0.412). As regards the intragroup level, all dimensions showed significant improvement except both «Physical Function» (p = 0.263) and «Body Pain» (p = 0.136). The physical capacities that benefited most were aerobic fitness, strength and balance.ConclusionsThe Active Bone Health Physical Exercise Program piloting showed benefits on participants’ physical and mental quality of life. In addition, it has been shown that performing a specific physical exercise for premenopausal–menopausal women improves their physical condition.     

Residuo posmiccional y síntomas de disfunción de vaciado en mujeres con prolapso de órganos pélvicos antes y después de la cirugía vaginal. Estudio de cohortes multicéntrico

ObjectivesThe present study evaluates the impact of vaginal surgery for pelvic organ prolapse (POP) on voiding dysfunction (VD) symptoms and post-void residual (PVR) one year after the intervention.Material and methodsEpidemiological, longitudinal, prospective study. Thirty-nine gynecology units included women with symptomatic POP grade 2 or higher according to the Pelvic Organ Prolapse Quantification (POP-Q) system, who would undergo surgery for vaginal prolapse (CIRPOP-IUE study). Sociodemographic and clinical variables were collected before and after the intervention. At both visits, patients completed the ‘Epidemiology of Prolapse and Incontinence Questionnaire’ (EPIQ) and ‘Pelvic Floor Distress Inventory’ (PFDI-20) questionnaire. PVR volume was measured by bladder catheterization immediately after spontaneous urination.ResultsVD symptoms were present in 50% cases before the intervention. PVR was measured in 277 women of which 116 (41.87%) were > 50 ml and 42/277 (15.2%) were > 100 ml. Objective and subjective reduction in VD symptoms was observed one year after the intervention. Mean PVR volume was reduced with statistical significance, from a mean (SD) of 66.4 (68.9) ml to 48.3 (51.3) ml. The number of patients who reported difficulty in emptying and sensation of incomplete emptying on the EPIQ and PFDI-20 questionnaires also decreased.ConclusionsIn general, improved voiding functions were observed in the CIRPOP-IUE study through a decrease in specific VD symptoms and a reduction in mean PVR volume.     

2019年中国40岁及以上女性家庭烹饪油烟暴露状况分析

目的 了解我国≥40岁女性家庭烹饪油烟的暴露现状及特征。方法 数据来源于2019-2020年中国居民慢性阻塞性肺疾病监测,采用多阶段分层整群随机抽样方法抽取全国31个省（自治区、直辖市）中125个监测县（区）的≥40岁常住居民,通过面对面询问调查收集人口统计学资料和家庭烹饪油烟暴露等相关信息。将家庭烹饪油烟暴露信息完整的女性37 164人作为研究对象,应用复杂加权分析方法,从烹饪时间、烹饪环境和自报烹饪油烟暴露分析不同特征女性家庭烹饪油烟暴露情况。结果 2019年我国≥40岁女性的每天做饭和经常做饭比例分别为83.9%（95%CI：82.1%~85.7%）和4.5%（95%CI：3.8%~5.2%）,其中每天做饭女性的日均做饭时长为1.8 h,日均做饭时长>2.0 h者占31.1%,做饭女性平均累计做饭年数为32.8年。做饭女性使用通风装置的比例为79.3%,厨房与起居室未分开的比例为3.2%。华南、西北地区女性厨房与起居室未分开比例分别为8.9%和7.2%,显著高于其他地区（P=0.036）。女性自报烹饪油烟暴露率为81.0%（95%CI：79.3%~82.7%）。乡村、年龄较大、文化程度较低、职业为农林牧渔水利业的女性,每天做饭比例、日均做饭时长、累计做饭年数、厨房与起居室未分开比例及自报烹饪油烟暴露率较高,做饭时使用通风装置的比例较低（均P<0.001）。结论 我国女性的家庭烹饪油烟暴露严重,仍有部分女性做饭时未采取任何通风措施,应重视女性尤其是社会经济地位较低女性的家庭烹饪油烟暴露及其健康危害。     

未绝经女性冠心病患者行冠脉介入治疗的临床特点分析

【摘要】　目的　探讨行经皮冠状动脉介入（PCI）治疗的未绝经女性冠心病患者的临床特点。方法　回顾性分析2014年1月至2018年12月于解放军总医院第一医学中心行首次PCI治疗的74例未绝经和109例绝经女性冠心病患者的临床资料。比较两组括患者术前一般情况,术中冠脉病变特征,术后1年内的主要心血管不良事件（MACE）发生情况的差异,分析影响术后MACE发生的危险因素。结果　未绝经组患者的高血压病患病率（41.9% vs 72.5%）、吸烟率(0 vs 13.8% )、低密度脂蛋白胆固醇水平(2.40±0.86 vs 2.71±0.95mmol/L)、甘油三酯水平(1.40±0.74 vs 1.69±0.97mmol/L)及总胆固醇水平(3.88±1.02 vs 4.39±1.05mmol/L)均低于绝经组（P均<0.05）。未绝经组患者自身免疫病患病率(14.9% vs 1.8%)、左心室射血分数(62.4±4.9 vs 60.0±5.4 )均高于绝经组（P均<0.05）。未绝经组左前降支(83.8% vs 67.9%)和左主干病变发生率(14.9% vs 4.6%)均高于绝经组（P均<0.05）。未绝经组PCI术后1年内主要不良心血管事件（MACE）的发生率高于绝经组[12.2%（9/74） vs 3.7%（4/109）,P<0.05]。多因素logistic回归分析显示,未绝经是女性冠心病患者PCI术后1个内发生MACE的独立危险因素（OR=3.635,95% CI 1.075～12.283,P=0.038）。结论　未绝经女性冠心病患者左前降支和左主干受累较多见,且经PCI治疗后1年内MACE的发生率较高。     

Accident vasculaire cérébral ischémique en rapport avec hématome coronaire spontané

Cardiovascular disease in women is a particularly complex pathology especially in the youngest population. The clinical presentation of acute coronary syndromes is sometimes misleading and does not necessarily point to the potential presence of cardiac disease given the frequent absence of cardiovascular risks. Such complexity results in delayed diagnosis, which worsens the outcome of myocardial infarction and generates complications related to the absence of coronary revascularization. We report the case of a patient who suffered an (undiagnosed) apical myocardial infarction that went undetected and was complicated by a voluminous intraventricular thrombus with embolus migration in the cerebral circulation resulting in an ischemic accident. The combination of these two pathologies make their therapeutic management particularly difficult. As widely reported in the literature, the outcome of myocardial infarction in women is poorer than in their male counterparts for a number of reasons. We can assume that in the youngest patients, another physiopathological mechanism is often involved, namely, the occurrence of hematoma and spontaneous coronary dissection. Diagnosis is often difficult even with coronary angiography diagnosis. As shown in the case reported here, initial examination results, if not thoroughly analyzed, may be erroneously interpreted as normal. It is also likely that the presence of hematoma or coronary wall dissection without any plaque rupture may negatively influence the outcome owing to the implementation of inappropriate treatments. In conclusion, in patients presenting with an ischemic cerebral accident, meticulous cardiac examination must be performed even in young women with no cardiovascular risk factors given that the occurrence of hematoma or coronary dissection may contribute to the formation of mural thrombi in the setting of myocardial infarction. Cardiac MRI seems to be particularly effective in the diagnosis of myocardial infarction complicated by the presence of intracavitary thrombi.     

组织多普勒评价健康肥胖女性左右心室功能

目的 探讨组织多普勒成像(TDI)技术评价我国健康肥胖女性左、右心室功能改变.方法 选择健康肥胖成年人140例,其中女性80例,以TDI技术测量其在二、三尖瓣瓣环收缩期、舒张早期和晚期峰值运动速度(Sm、Em和Am)和Em/Am,并计算各指标平均值(MSm、Mem、Mam和Mem/Am).结果 肥胖组和正常对照组在二、三尖瓣瓣环各取样点Sm、Em、Em/Am以及MSm、Mem、Mem/Am减低,Am、Mam升高.肥胖女性体重增加心功能进一步减低.肥胖女性较男性心功能减低更明显.结论 TDI技术显示成年健康肥胖女性左、右心室功能已出现异常改变,为肥胖女性左、右心室局部和整体功能的早期评价提供了理想的检测手段.     

Radiación ocupacional y embarazo: realidad o desinformación. Revisión en la literatura y actualización según guías clínicas vigentes

Exposure to ionizing radiation is a decisive factor in women's choice of entering the field of interventional radiology. This issue explains the low percentage of women in interventional radiology and the high number of women who take leave from work when they are pregnant even though they have no problems with their pregnancy.The current guidelines and legal framework regarding pregnancy and ionizing radiation from different national institutions are not in line with the scientific evidence. They establish recommendations based on disinformation and a need to protect the fetus that has not been scientifically validated. Lack of knowledge and lack of evidence-based information could contribute to gender-based inequality at work.This article reviews the evidence from the articles and clinical guidelines in PubMed, paying special attention to publications from the last five years (2015-2020). Additionally, it reports the results of an online survey of healthcare professionals exposed to radiation in their work.     

女性慢性咳嗽患者生活质量及尿失禁调查

目的 了解成年女性慢性咳嗽患者的生活质量和尿失禁状况.方法 以门诊就诊的慢性患者为对象,通过调查问卷的方式评估女性慢性咳嗽患者的生理、心理及社会功能的影响,并比较与男性患者的差异.结果 共入选288例慢性咳嗽患者,其中女性142例,平均年龄为(44.7±16.1)岁,病程为37(2～360)个月,男性146例,平均年龄为(41.3±14.3)岁,病程为24(2～480)个月.男性患者与女性患者在生理状况领域的平均得分差异无统计学意义(4.23±0.87 vs 4.15±0.82,P>0.05),心理健康领域(3.61±1.12 vs 3.69±1.00,P>0.05)及社会功能领域(3.85±1.18 vs 3.82±1.13,P>0.05)差异均无统计学意义.女性患者尿失禁发生率(71/142,50.0%)显著高于男性(3/146,2.1%),X2=86.7,P<0.01.结论 女性慢性咳嗽患者的生活质量受到严重影响,程度与男性类似,但尿失禁是女性患者的一个普遍问题.