SEXUAL FUNCTION AND QUALITY OF LIFE IN WOMEN: A CROSS SECTIONAL STUDY Objective: To compare the relationship between sexual function and quality of life (QOL) in women. Type of study: Cross-sectional study. Setting: Bahia, Brazil Participants: High school educated women who were members of a fitness club. Methods: Sexually active non-pregnant women between 18 and 60 years of age were invited to participate in this study. A questionnaire on sociodemographic and clinical information was administered along with the Female Sexual Function Index. Quality of life was evaluated using the SF-36 questionnaire. SF-36 scores of women with and without sexual were compared using the independent t test. Results: The sample included 375 physically active women with a mean age of 34.6±10.0 years. Sexual dysfunction was found in 21.1%. In all domains of the SF-36 women with dysfunction had lower mean scores (p≤0.01 for emotional aspects and p<0.01 for other domains). We observed differences in mean scores in mental health, physical, emotional aspects and social aspects respectively, (59.6±18.7), (72.6±33.1), (67.1±38.7) and (69.2±22.8) for women with sexual dysfunction and in the median scores (72.1±16.8), (85.1±26.6), (78.6±34.4) and (80.7±21.9) for women with adequate sexual function (p<0,01for all). Conclusion: Sexual Dysfunction had a negative impact on QOL in women in this population.

ResumoIntrodução: Devido às mudanças anatômicas que a gestação, o parto e a multiparidade causam nos músculos do assoalho pélvico (MAP) esses são fatores de risco para distúrbios do assoalho pélvico. Essas alterações podem levar a disfunção sexual ou a alteração da percepção da autoimagem genital. Objetivo: Verificar a relação dos tipos e número de parto com a função sexual e a autoimagem genital feminina. Materiais e Métodos: Estudo observacional, de corte transversal. Foram analisadas 384 mulheres na faixa etária de 18 a 60 anos, sexualmente ativas, matriculadas em academias. Os critérios de exclusão envolvem as participantes com dificuldades de compreensão dos instrumentos e o preenchimento inadequado dos questionários. Os questionários FSFI (Female Sexual Function Index), FGSIS (Female Genital Self-Image Scale) e os dados sociodemográficos foram autoaplicáveis. O FGSIS possui uma variação na pontuação de 7 a 28, no qual escores mais altos indicam uma autoimagem genital positiva e o FSFI -considera-se disfunção sexual o escore ≤ 26. As variáveis categóricas (tipo e número de parto) foram apresentadas em frequências, e a relação do FSFI e FGSIS foi feita pelo teste t independente considerado um p≤0,05. Resultados: 384 mulheres com média da idade de 34,9±10,1 anos e IMC de 24,1±3,5 kg/m2. O FSFI apresentou alteração nos domínios desejo e excitação, já os escores do FGSIS não tiveram influencia do número e tipo de parto. Conclusão: Os resultados mostraram que o número e o tipo de parto apresenta uma relação com a função sexual feminina diminuída, o que não foi demonstrado com relação a autoimagem genital. AbstractIntroduction: Due to the anatomical changes that pregnancy, childbirth and multiparity cause in the pelvic floor muscles (PFMs), these are risk factors for pelvic floor disorders. These changes can lead to sexual dysfunction or alteration of the perception of genital self-image. Objective: To investigate the relationship between types and number of births and sexual function and female genital self-image. Materials and Methods: Observational cross-sectional study. We analyzed 384 women aged 18-60 years, sexually active, enrolled in gyms. The exclusion criteria involved participants who have difficulty in understanding the instruments. The FSFI (Female Sexual Function Index), FGSIS (Female Genital Self-Image Scale) questionnaires and the sociodemographic data were self-reported. Higher FGSIS scores -which can range from 7 to 28 -were considered indicative of positive genital self-image and FSFI scores under 26 were considered indicative of sexual dysfunction score. Categorical variables (number and type of births) were presented in frequency and the association of FSFI and FGSIS was taken by independent t-test, p = 0.05 considered. Results: 384 women with a mean age of 34.9 ± 10.1 years and BMI of 24.1 ± 3.5 kg / m2 were evaluated. The FSFI showed changes in desire and arousal domains and the FGSIS scores did not suffer influence of the number and type of deliveries. Conclusion: The results showed that th...

a b s t r a c t a r t i c l e i n f o Article history:Received 17 April 2016Accepted 13 January 2017 Available online 30 March 2017Objective: Fibrous hyperplasia is frequently treated by surgical incision with a scalpel associated with removal of chronic trauma. However, hemostasis of the surgical wound is specially difficult for patients with hemorrhagic disorders or those undergoing antithrombotic therapy without the suturing of the wound borders. High-power LASER have been applied as a useful tool in the management of soft tissue lesions. Therefore, the present study aimed to present a prospective case series of fibrous hyperplasia treated using a high-power diode LASER.Methods: Fifteen patients with fibrous hyperplasia were enrolled in this study. LASER irradiation was performed using an 808 nm diode LASER with an optical fiber of 600 µm, at a power of 2.0W to 3.5W (average 2.96W), in a continuous-wave mode. The treatment performance of fibrous hyperplasia using a high-power diode LASER was determined by evaluating the pain, postoperative functional alterations, edema, secondary infection and bleeding.Results: Diode LASER surgery proved to be effective and presented a good performance in the treatment of fibrous hyperplasia. Conclusions Cirurgia oralObjetivo: Hiperplasia fibrosa é frequentemente tratada pela excisão cirúrgica com bisturi associado com a remoção do trauma crônico. Entretanto, hemostasia da ferida cirúrgica é especialmente dificultada em pacientes com desordens hemorrágicas ou aqueles submetidos a terapia anticoagulante sem sutura das bordas das feridas cirúrgicas. LASER de alta intensidade tem sido utilizados como uma ferramenta útil no manejo de lesões de tecidos moles. Portanto, o presente estudo objetiva-se a apresentar uma série de casos prospectivo no tratamento da hiperplasia fibrosa utilizando o LASER de diodo de alta intensidade.Métodos: Quinze pacientes com hiperplasia fibrosa foram envolvidos no estudo. A aplicação do LASER foi realizada utilizando um LASER de diodo de 808nm com uma fibra óptica de 600μm, em uma potência de 2.0W a 3.5W (média 2.96W), em modo continuo. A eficácia do tratamento da hiperplasia fibrosa utilizando LASER de diodo de alta intensidade foi determinada pela avaliação da dor, alterações funcionais pós-operatórias, edema, infecção secundária e sangramento.Resultados: O LASER cirúrgico de diodo provou ser efetivo e apresentou bom resultado no tratamento da hiperplasia fibrosa.Conclusões: Ensaios clínicos randomizados devem ser realizados comparando LASER de diodo e outros sistemas de LASER com a cirurgia convencional e eletrocautério no manejo da hiperplasia fibrosa e outras lesões orais.

The cycle ergometer has been proposed during the early mobilization of critically ill patients to improve muscle strength and reduce the length of stay. Although this strategy consists of greater complexity, there is no evidence that it is superior to the usual treatment. This study aims to explore the hypothesis that the use of a cycle ergometer, during early mobilization, increases functional performance after cardiac surgery, compared to active exercise. This is a randomized-controlled study that included patients undergoing valve heart surgery or coronary artery bypass grafting from June to December 2016. Patients initiate the exercise with cycle ergometer or received the usual treatment (assisted active exercise) on the first day after surgery. Both interventions were performed twice a day, without imposing a load, and a mean duration of 15 minutes, while the patients remained in the intensive care unit (ICU). The primary outcome was defined as walking speed, assessed after discharge from the ICU, measured by a blind evaluator for the patient’s allocation group. Considering this was an exploratory and preliminary study, we opted for protocol analysis, excluding patients who did not complete the exercises as a way to optimize the potential generation of hypothesis for efficacy. One hundred and eighty-seven patients completed all phases os the study (intervention and evaluation), in a total of 85 in the cycle ergometer group (CyG), and 102 in the control group (CG). In the cycle ergometer group, 18 patients had the intervention discontinued against 6 in the control group. There was no difference in the number of sessions between the groups (2.8±1.9 in CyG vs 3.2±1.5 p= 0.25). According to the BORG scale, the cycle ergometer generated a greater perception of effort (9.9±2.7 vs 8.21±1.8; p = 0.009) and promoted a better increase in respiratory rate (3.2±4.5 vs 0.3±6.1 ipm, p = 0.02). However, the walking speed did not differ between groups (0.44 ± 0.23 vs 0.47 ± 0.21 m/s; p= 0.34). Despite imposing a higher level effort, the use of cycle ergometer during the early mobilization in the ICU does not promote an increase in functional capacity when compared to active assisted exercise in patients’ underground cardiac surgery.   O cicloergômetro vem sendo proposto durante a mobilização precoce de pacientes críticos a fim de melhorar força muscular e reduzir tempo de internamento. Embora essa estratégia consista em maior complexidade, não existe comprovação de que esta seja superior ao tratamento usual. O objetivo deste estudo foi o de explorar a hipótese de que a utilização de cicloergômetro, durante a mobilização precoce, incrementa o desempenho funcional após cirurgia cardíaca, comparado ao exercício ativo. Este foi um estudo controlado, envolvendo pacientes submetidos a cirurgia cardíaca valvar e/ou revascularização miocárdica no período de junho a dezembro de 2016. Os pacientes foram randomizados, no primeiro dia após a cirurgia, para exercícios com cicloergômetro ou tratamento usual (exercício ativo assistido). Ambas as intervenções foram realizadas duas vezes ao dia, sem imposição de carga, com duração média de 15 minutos, enquanto os pacientes permaneciam na unidade de terapia intensiva (UTI). O desfecho primário foi definido como velocidade de marcha, avaliada após a alta da UTI, mensurada por um avaliador cego para o grupo de alocação do paciente. Em se considerando este um estudo exploratório e preliminar, como forma de otimizar a potencial geração de hipótese para eficácia, optou-se pela análise por protocolo, excluindo os pacientes que não completaram os exercícios. Cento e oitenta e sete pacientes concluíram todas as etapas de intervenção e avaliação, totalizando 85 no grupo cicloergômetro (GCi) e 102 no grupo controle (GC). No grupo cicloergômetro, 18 pacientes tiveram a intervenção descontinuada contra 6 do grupo controle. Não houve diferença no número sessões entre os grupos (2,8±1,9 no GCi vs 3,2±1,5 p= 0,25). De acordo com escala de BORG, o cicloergômetro gerou maior percepção de esforço (9,9±2,7 vs 8,21±1,8; p = 0,009) e promoveu maior elevação da frequência respiratória (3,2±4,5 vs 0,3±6,1 ipm, p = 0,02). No entanto, a velocidade de marcha não apresentou diferença entre os grupos (0,44 ± 0,23 vs 0,47 ± 0,21 m/s; p = 0,34). A despeito de impor maior nível de esforço, a utilização de cicloergômetro durante a mobilização precoce em UTI não promove incremento de capacidade funcional quando comparado ao exercício ativo assistido livre em pacientes submetidos à cirurgia cardíaca.cardiac surgery.

Objective: To analyze postoperative mobility after cardiac surgery. Methods: Observational study in patients, aged ≥ 18 years, undergoing myocardial revascularization and/or valvular heart surgery, hospitalized in a Brazil hospital. The data collection took place between April 2016 and March 2017. On admission to the ward, patients received a calibrated pedometer. They were asked to use the device during five consecutive days, yet only three days of full use were analyzed. Results: Analyzed were data of 87 individuals with mean age of 58.70 ± 12.59 years, 52 (59.8%) of them were males. Regarding surgery, 53 (60.9%) underwent myocardial revascularization. The median number of steps was 738 (185-1,557), which showed a weak and inverse correlation with the length of stay in the intensive care unit (r = -0.3 / p = 0.02), however, it was not statistically significant when related to clinical and surgical data. Male patients had a better mobility when compared to patients of the female sex (p = 0.04). Conclusions: Individuals who had a longer stay in the intensive care unit, as well as females, had a lower mobility in the ward. The mobility did not show a relation with intra-and postoperative factors.