Síntomas climatéricos y calidad de vida mediante índice de Kupperman-Blatt y escala de Cervantes / Climacteric Symptoms and Quality of Life according to the Kupperman-Blatt Index and the Cervantes Scale

Introducción: Durante el climaterio o perimenopausia se reflejan una serie de síntomas asociados a la disminución progresiva de las secreciones hormonales de estrógeno y progesterona, estas deficiencias provocan diversos síntomas de orden somático, vasomotor, sexual y psicológico que perjudican la calidad de vida en general de las mujeres, además de las alteraciones en el ciclo menstrual. Objetivo: Determinar la severidad de los síntomas climatéricos en mujeres perimenopáusicas mediante el índice de Kupperman-Blatt y la Escala de Cervantes. Métodos: Se trató de un estudio de corte cuantitativo, tipo descriptivo, observacional, y correlacional, en pacientes que asistían al Centro de Salud Las Moras, en el Departamento de Huánuco, Distrito Huánuco Perú. La muestra estuvo conformada por 60 mujeres que cumplieron con los criterios de inclusión. Se aplicaron el Índice Menopáusico de Kupperman-Blatt y la Escala de calidad de vida de Cervantes. Resultados: La evaluación global del Índice Menopáusico de Kupperman-Blatt clasificó a 55 por ciento de las pacientes con intensidad de síntomas leve, seguido de 35 por ciento en pacientes que declararon no tener síntomas. Esto se correspondió en la Escala de calidad de vida de Cervantes con 45 por ciento en pacientes clasificadas con compromiso leve de su calidad de vida, seguido de 40 por ciento con mediano compromiso de calidad de vida. Conclusiones: Con un nivel de significancia de p < 0,05, se demostró que durante la etapa climatérica ambos test presentan una correlación positiva, entre la intensidad de la sintomatología medida con el Índice Menopáusico de Kupperman-Blatt y la calidad de vida valorada con la Escala de Cervantes(AU)

Introduction: During climacteric or perimenopause, a series of symptoms are reflected in association with a progressive decrease in estrogen and progesterone hormone secretion. These deficiencies cause diverse somatic, vasomotor, sexual and psychological symptoms that impair the general quality of life of women, in addition to alterations in their menstrual cycle. Objective: To determine the severity of climacteric symptoms in perimenopausal women, using the Kupperman-Blatt index and the Cervantes scale. Methods: This was a quantitative, descriptive, observational and correlational study with patients attending Las Moras health center, Huanuco Department, Huanuco District, Peru. The sample consisted of 60 women who met the inclusion criteria. The Kupperman-Blatt Menopausal Index and the Cervantes Quality of Life Scale were applied. Results: According to the global assessment using the Kupperman-Blatt Menopausal Index, 55 percent of the patients were classified as presenting mild symptom intensity, followed by 35 percent of patients who reported no symptoms. This values were consistent with the Cervantes Quality of Life scale, with 45 percent of patients classified as presenting mild compromise of their quality of life, followed by 40 percent with medium compromise of quality of life. Conclusions: With a significance level of P<0.05, it was demonstrated that, during the climacteric stage, both tests present a positive correlation, regarding the intensity of the symptoms measured with the Kupperman-Blatt Menopausal Index and the quality of life assessed with the Cervantes scale(AU)

The use of homeopathy and flower therapy as an aid in the treatment of climacteric symptoms: an integrative review

Climacteric is characterized as the set of symptoms that usually start in the period of transition from the reproductive phase to female senility, and directly impacts woman's quality of life. Currently, the treatments approved by the FDA for this pathology mainly involve the use of antidepressants and hormone replacement, both having side effects. Clinical studies carried out in 2002, showed an increased risk of breast cancer, and other pathologies related to the prolonged use of these drugs. The impact ofthe studies resulted in a greater interest in complementary and alternative medicines (CAMs), such as the use of homeopathy and flower remedies for the treatment of climacteric symptoms. This abstract aims to present an integrative review on the use of homeopathy and flower remedies in the treatment of climacteric symptoms, in order to identify it main scientific evidence. For this, metodology consisted of research in the databases Web of Science, Google Scholar, HomeoIndex, LILACS and SciELO. The inclusion criteria were original human studies, totally available, and published in the last 10 years in Portuguese, English and Spanish, presenting the use of floral remedies or homeopathic treatment. The main homeopathic medicines used were Lachesis mutus, Belladona, Sepia officinalis, Sanguinaria canadensis and Sulfur. The main flower remedies were Cherry plum, Agrimony, Gentian, Walnut, Olive and Larch. The findings in this review demonstrate a positive outcome trend in favor of the effectiveness of these practices through the studies evaluated, encouraging the expansion of new designs and research that fully contemplate the principles of these practices. Thus, this work contributes to the advancement in the understanding of each one of these rationalities, making this work a source of consultation for health professionals and for future research, resulting in a strengthening of CAMs in the field of health.

Histomorphometry of Bone Microarchitecture in Rats Treated with Vitamin D and Bisphosphonate in the Management of Osteoporosis / Histomorfometria da microarquitetura óssea em ratas tratadas com vitamina D e bisfosfonato no manejo da osteoporose

Abstract Objective To verify how the combined administration of alendronate (ALN) and vitamin D3 (VD) acts on the bone microarchitecture in rats with glucocorticoid-induced osteoporosis. Methods The experiment used 32 90-day-old female Wistar rats weighing between 300 and 400g. The induction of osteoporosis consisted of intramuscular administration of dexamethasone at a dose of 7.5 mg/kg of body weight once a week for 5 weeks, except for the animals in the control group. The animals were separated into the following groups: G1 (control group without osteoporosis), G2 (control group with osteoporosis without treatment), G3 (group with osteoporosis treated with ALN 0.2 mg/kg), G4 (group with osteoporosis treated with VD 10,000UI/500μL), and G5 (group with osteoporosis treated with ALN þ VD). The right femurs of the rats were fixed in 10% buffered formaldehyde, decalcified, and processed for inclusion in paraffin. Histological sections were stained with hematoxylin-eosin for histomorphometric analysis. Cortical thickness and medullary cavity were measured in cross-sections. Results There was a statistical difference (p< 0.05) between groups G3 and G5 compared with the positive control group (G2), both related to the measurement of cortical thickness and to the total diameter of the bone. In the evaluation of the spinal area, only the G3 group has shown to be statistically different from the G2 group. Conclusion Concomitant treatment with daily ALN and weekly VD is effective in preventing glucocorticoid-induced bone loss. However, there was no difference between the therapy tested and treatment with ALN alone.

Resumo Objetivo Verificar como a administração conjunta de alendronato de sódio (ALN) e vitamina D3 (VD) atua na microarquitetura óssea em ratas com osteoporose induzida por glicocorticoide. Métodos O experimento utilizou 32 ratas da linhagem Wistar, com peso médio de 300 a 400g, com 90 dias de vida. A indução da osteoporose consistiu na administração de dexametasona na dose de 7,5 mg/kg de peso corporal, por via intramuscular, 1 vez por semana durante 5 semanas, à exceção dos animais do grupo controle. Os animais foram distribuídos nos seguintes grupos: G1 (grupo controle sem osteoporose), G2 (grupo controle com osteoporose sem tratamento), G3 (grupo com osteoporose tratado com ALN 0,2 mg/kg), G4 (grupo com osteoporose tratado com VD 10.000UI/500μL) e G5 (grupo com osteoporose tratado com ALN þ VD). Os fêmures direitos das ratas foram fixados em formol a 10% tamponado, descalcificados e processados para inclusão em parafina. Os cortes histológicos foram corados com hematoxilina-eosina para análise histomorfométrica. A espessura cortical e a cavidade medular foram medidas em cortes transversais. Resultados Houve diferença estatística (p< 0,05) entre os grupos G3 e G5 em relação ao grupo controle positivo (G2), tanto em relação à medida da espessura cortical quanto em relação ao diâmetro total do osso. Na avaliação da área medular, apenas o grupo G3 se mostrou estatisticamente diferente do grupo G2. Conclusão O tratamento concomitante com ALN diário e VD semanal é eficaz para prevenir a perda óssea induzida por glicocorticoide. No entanto, não houve diferença entre esta terapia testada e o tratamento apenas com o ALN.

El significado de la menopausia para un grupo de mujeres chilenas atendidas en el sistema público de salud / The significance of menopause for Chilean women attending primary health care centers

BACKGROUND: Menopause connects a biological event with social representations related to aging AIM: To assess the meaning of menopause in a group of Chilean women attending primary health care. MATERIALS AND METHODS: Secondary analysis of a descriptive qualitative study of in-depth interviews to explore the meaning of menopause in fifteen women aged 55 to 71 years who experienced menopause between 2 and 29 years before. Data were collected using the method proposed by the Grounded Theory. Guba's criteria of scientific rigor were used. RESULTS: Relational analysis shows that menopause divides the life cycle of women into two stages related with the possibility of having children, which is heavily influenced by the cultural significance of menopause. CONCLUSIONS: Women perceive that menopause is a natural stage and that it is the end of a period focused on tasks related to reproduction and motherhood. However, that "normality" includes a suffering process, loaded with negative cultural beliefs about menopause passed down for generations.

Atitudes e conhecimentos de idosos sobre intercurso sexual no envelhecimento / Attitudes and knowledge of older adults about sexual intercourse in aging / Actitudes y conocimientos de ancianos sobre relaciones sexuales en el envejecimiento

A sexualidade no processo de envelhecer é um fenômeno que precisa ser compreendido de forma sistematizada. Dada a amplitude de possibilidades em discussões acerca da sexualidade, o presente estudo focou no intercurso sexual no envelhecimento. Assim, o objetivo traçado foi compreender as atitudes e os conhecimentos de idosos de um município do agreste de Pernambuco sobre o intercurso sexual no envelhecimento. Foi utilizado o método quantitativo descritivo, com instrumento de coleta e de análise dos dados a escala ASKAS (Aging Sexual Knowledge and Attitudes Scale) aplicada à amostra de 150 participantes de ambos os sexos. Os resultados evidenciaram que a maioria dos entrevistados compreende que práticas sexuais podem trazer benefícios psicológicos. Apesar disso, a maior parte dos participantes, tanto das mulheres quanto dos homens, indicaram que o interesse sexual inevitavelmente desaparece depois dos 65 anos. As mulheres da amostra, como já era esperado, mostraram-se mais afetadas por tabus e proibições quanto à realização de desejos sexuais, consideraram o sexo como algo perigoso e alegaram vergonha para demonstrar interesse sexual, o que aponta para a necessidade de uma discussão de gênero.(AU)

The sexuality in the process of aging is a phenomenon that should be understood in a systematic way. Given the number of possibilities surrounding sexuality, our study focused on sexual intercourses. Therefore, we aimed to understand the attitudes and the knowledge of the older adults from a municipality in the agreste of the state of Pernambuco about to sexual intercourse during aging. We used both quantitative and descriptive methods and the ASKAS (Aging Sexual Knowledge and Attitudes Scale) scale to collect and analyze the data of 150 participants of both sexes. The results showed that most people interviewed understand that sexual intercourses can bring some psychological benefits. Despite this, most of them pointed that sexual interest inevitably disappears after the 65 years of age. The women interviewed, as expected, were more affected by taboos and prohibition related to sexual desires, considering sex as a danger and being ashamed of showing sexual interest for their partner, pointing to the need of an open discussion on the topic.(AU)

La sexualidad en el proceso de envejecimiento es un fenómeno que necesita ser entendido sistemáticamente. De la amplitud de posibilidades que permite la discusión sobre la sexualidad, el presente estudio se centró en las prácticas sexuales. Su objetivo fue comprender las actitudes y el conocimiento que los ancianos de un municipio de agreste de Pernambuco (Brasil) tenían sobre las relaciones sexuales durante el envejecimiento. Se utilizó el método descriptivo cuantitativo, con un instrumento de recopilación y análisis de datos con la escala ASKAS (Aging Sexual Knowledge and Attitudes Scale) aplicada a la muestra de 150 participantes de ambos sexos. Los resultados mostraron que la mayoría de los entrevistados entienden que las prácticas sexuales pueden traer beneficios psicológicos. Sin embargo, la mayoría de los participantes, tanto mujeres como hombres, indicaron que el interés sexual desaparece inevitablemente después de los 65 años. Como se esperaba, las mujeres de la muestra se vieron más afectadas por los tabúes y las prohibiciones sobre el cumplimiento de los deseos sexuales, consideraron que el sexo era peligroso y alegaron vergüenza para demostrar interés sexual, lo que señala la necesidad de una discusión de género.(AU)

Effect of "Natural Polypill", Xuezhikang on Serum Cholesterol Metabolism Markers in Early Menopausal Women with Hypercholesterolemia / 中国结合医学杂志

OBJECTIVE@#To analyze the effect of Xuezhikang on the markers of the serum lipid levels of cholesterol synthesis and absorption in early menopausal women with hypercholesterolemia, and preliminarily explore its lipid-lowering mechanism.@*METHODS@#A total of 90 early menopausal women with hypercholesterolemia were enrolled from December, 2014 to May, 2016 from Beijing Anzhen Hospital, Capital Medical University, who were randomly allocated to receive Xuezhikang (1200 mg/d, orally) or atorvastatin (10 mg/d, orally) according to a random number table. Serum levels of some related biomarkers, including cholesterol synthesis markers (squalene, dihydrocholesterol, dehydrocholesterol, and lathosterol), and absorption markers (campesterol, stigmasterol, and sitosterol) as well as safety indices were obtained at baseline and after 8 weeks of the intervention.@*RESULTS@#Eight weeks after treatment, both Xuezhikang and atorvastatin significantly reduced the levels of total cholesterol, triglycerides, low density cholesterol compared to baseline (all P<0.01). Xuezhikang significantly reduced the levels of squalene, dehydrocholesterol and lathosterol compared to baseline (all P<0.01), but atorvastatin only significantly reduced the level of squalene (P<0.01), compared to baseline. All cholesterol absorption markers showed no significant differences before and after treatment (P>0.05), however, a more obvious downward trend was shown in the Xuezhikang group. In addition, all the safety indices showed no significant differences between the two groups. Although the creatinekinase level in the Xuezhikang group was significantly higher, it remained within the safe range.@*CONCLUSIONS@#Xuezhikang may have more comprehensive effects on the markers of cholesterol synthesis and metabolism in early menopausal women with hypercholesterolemia through ergosterol and flavonoids in its "natural polypill."

Alterations in haematological and clotting profile of post-menopausal women in Benin City, Nigeria

Background: The cessation of ovarian functions at menopause and the accompanying decline in the production of ovarian steroid hormones creates a unique set of health concerns for women. Reductions in sex steroid levels, particularly oestrogen, have been associated with various diseases and conditions, including bleeding disorders, coronary heart disease (CHD), osteoporosis, cognitive dysfunction, urinary incontinence, hot flushes, and mood changes, among others. Objective: To determine changes in haemorheological and clotting profile in post-menopausal women. Methods: Two hundred participants comprising one hundred and fifty post-menopausal women and fifty healthy pre-menopausal control subjects were studied. The investigations carried out include whole blood viscosity, plasma viscosity, fibrinogen concentration, Prothrombin time (PT), Activated partial thromboplastin time with kaolin (APTTK) levels and complete blood count using standard methods. Results: The mean age (p=0.01), platelet count (p= 0.013), neutrophil (p= 0.03), neutrophil to lymphocyte ratio (p= 0.045) and platelet to lymphocyte ratio (p=0.044) in postmenopausal women were significantly higher while lymphocyte count (p= 0.004) was significantly lower in postmenopausal compared to premenopausal women. Similarly, plasma oestradiol (p= 0.001), plasma viscosity (p= 0.03), relative blood viscosity (p= 0.03), whole blood viscosity (p= 0.03) and PTTK(p= 0.04) were significantly lower among postmenopausal women compared to premenopausal control subjects. Conclusion: Relative plasma viscosity correlated positively with age. There were significantly lower levels of haemorheological and clotting profile in post-menopausal women. These changes may be due to age or a decline in circulating oestrogen levels.

Attitude and knowledge of women between 45 and 65 years on menopause syndrome at the university college hospital, Ibadan, Nigeria

This research was designed to find out the attitude and knowledge of women between 45 and 65 years on menopause syndrome and its management. The study was conducted in University College Hospital located in Ibadan North Local Government of Oyo state. A self-designed forced-choice questionnaire was distributed to 100 women using random sampling technique. Furthermore, our study showed that most women view the onset of menopause positively and that few seek treatment. They report relatively low prevalence of menopausal symptoms, with the most significant being irregular menstrual cycles and increased blood pressure and urinary tract infections. Furthermore, our study revealed that 41% of the participants had no idea why their menstrual period stopped, while why 60% of the women had no idea what could be done to reduce menopausal symptoms. This study reveals a low level of awareness about menopausal syndrome and more should be done. (Afr J Reprod Health 2022; 26[5]: 57-62).

The North-East Moroccan physicians' management of menopause: Prescription vs. nonprescription of hormonal treatment

This study examined the management of North-East Moroccan physicians of menopause. The poll was carried out on a representative sample of physicians in the Nador region. The sample included gynecologists and general practitioner physicians in both public and private medical sectors. The survey contained focused and open-ended questions on the good knowledge or not of physicians about menopause, their patient population, their prescribing practices, their perceptions, and the different medical approaches to managing the symptoms of menopause. Among the general practitioners interviewed, only 16% of physicians are very knowledgeable about the management of menopause and only 3 physicians have followed continuous training. The others have mainly acquired their information from the internet, medical journals, and scientific magazines. Only one-third of physicians interviewed prescribe menopausal hormonal treatment in this region. The treatment is mainly prescribed to cope with hot flashes (97.1%) and menstrual cycle disruption (85.7%). Others are in favor of non-hormonal treatments and advise women to change their bad daily habits to relieve symptoms. In this region of Morocco, hormonal treatment for menopause is not very common and the majority of general practitioners are not familiar with menopause. (Afr J Reprod Health 2022; 26[6]:116-124).

Prevalence of cervical cancer in Ain Defla region (Algeria)

The high rate of cervical cancer in Algeria and the absence of organized screening programs are well shown in this study, which aims to determine the prevalence of cervical cancer and describe the risk factors associated with this alarming prevalence. This retrospective study is based on data collected from medical records and A questionnaire was developed to assess the risk factors (such as: parity, age at first marriage, smoking, oral contraceptive, and Hormonal status) of cervical cancer among the participants. Face to Face interview were conducted with the participants. The result obtained from this study revealed that cervical cancer occupies the fourth place of cancer in the Wilaya of Ain Defla (4,71 %); the results confirm the effect of several risk factors such as early marriage age (below 20 years: 46.66 %), multiparity (53.33%), menopause (66.66 %); taking contraception (53.33%) and smoking in the development of this pathology. The adoption of an early and annual screening program in our region would be very important to us. In addition, the interest of annual screening is to raise women's awareness of this pathology, particularly in isolated regions. (

Temporal trend and contributing factors of depressive symptoms in Chinese menopausal women: analysis based on CHARLS panel data / 南方医科大学学报

OBJECTIVE@#To understand the temporal trend of and the factors affecting depressive symptoms in Chinese menopausal women to provide evidence for the development of prevention and treatment strategies.@*METHODS@#CHARLS data were used to select menopausal women aged 45-60 years. Complete values of the key variables were screened and missing values were removed to obtain the cross-sectional data of the years 2011 (n=4318), 2013 (n=4200), 2015 (n=3930), and 2018 (n= 4147). The panel data were matched by the cross-sectional data, and a total of 5040 cases with complete record of the follow-up data were obtained for the 4 years to constitute a balanced short panel dataset with n=1260 and T=4. The prevalence and temporal trend of depressive symptoms in the menopausal women were analyzed based on the panel data. The random-effects Logit model with a panel dichotomous choice model was used to explore the factors affecting depressive symptoms in the menopausal women.@*RESULTS@#The prevalence of depressive symptoms in the menopausal women calculated based on the panel data was 35.9%, 33.1%, 36.7% and 43.7% in the 4 years, respectively, showing no statistically significant changes in the temporal trend (APC=3.25%, P=0.183). The results of the random-effects Logit model analysis showed that living in the urban area (OR=0.570, 95%CI: 0.457-0.710), a high education level (OR=0.759, 95%CI: 0.655-0.879), and having a spouse (OR=0.363, 95% CI: 0.236-0.558) were associated with a decreased incidence of depressive symptoms, while poor self-reported health (OR= 2.704, 95% CI: 2.152-3.396), disability (OR=1.457, 95%CI: 1.087-1.954), chronic disease (OR=1.407, 95% CI: 1.179-1.680), falls in the last two years (OR=2.028, 95% CI: 1.613-2.550), abnormal sleep duration (OR=2.249, 95% CI: 1.896-2.664), and dissatisfaction with life (OR=4.803, 95% CI: 3.757-6.140) were associated with an increased incidence of depressive symptoms.@*CONCLUSION@#The prevalence of depressive symptoms is relatively high in menopausal women in China. Measures should be taken to ensure that the menopausal women living in rural areas, with low education level, without spouse, with a poor self-reported health status, disability, chronic diseases, falls in recent two years, abnormal sleep time and dissatisfaction with life have access to psychological health care services and interventions.

Acupuntura en el control de los síntomas de la menopausia / Control of menopause symptoms with acupuncture

Objetivo: establecer la efectividad de la acupuntura en el control de los síntomas de la menopausia. Materiales y métodos:se seleccionaron menopaúsicas sanas entre 48 y 57 años que presentaban síntomas relacionados con la menopausia que no recibían terapia hormonal. El tratamiento consistió en 24 sesiones de acupuntura y se evaluó la intensidad de los síntomas con el puntaje del índice de Kupperman antes de iniciar y a las 4 y 8 semanas después de iniciadas las sesiones de acupuntura. Resultados: en 50 menopáusicas con edad promedio de 53,4 +/- 3,2 años después de 4 y 8 semanas de tratamiento no se observaron diferencias estadísticamente significativas en la intensidad de calorones, sudoración, trastorno del sueño, depresión, vértigo, cefalea, artralgia, palpitaciones, debilidad y síntomas vaginales (p = ns). El valor promedio de índice de Kupperman inicial fue de 30,6 +/- 4,7 puntos, el cual aumentó a 32,1 +/- 5,6 puntos a las cuatro semanas para luego alcanzar un valor de 31,1 +/- 4,8 puntos a las 8 semanas. No se demostraron diferencias significativas en los valores promedio de la escala a las 4 (p = 0,150) y 8 semanas (p = 0,596). Conclusión: la acupuntura no es efectiva para controlar los síntomas causados por la menopausia, por lo que no es una alternativa de la terapia de reemplazo hormonal.

Objective: to establish the effectiveness of acupuncture in controlling menopause symptoms. Materials and Methods: healthy menopausal women aged 48 to 57 years, experiencing menopause-related symptoms, not receiving hormone therapy, were selected. The treatment consisted of 24 acupuncture sessions evaluating symptoms severity using the Kupperman index score before initiation of therapy and at 4 and 8 weeks after undergoing acupuncture therapy. Results: no statistically significantdifferences were observed in 50 menopausal women with mean age of 53.4 +/- 3.2 years after 4 and 8 weeks undergoing acupuncture therapy regarding the severity of hot flashes, sweating, sleep disorder, depression, vertigo, headache, arthralgia, palpitations, weakness and vaginal symptoms (p = ns). The mean initial Kupperman index score was 30.6 +/- 4.7, which increased to 32.1 +/- 5.6 at four weeks and then reached a value of 31.1 +/- 4.8 at 8 weeks. No significant differences were demonstrated in the mean scale values at 4 (p = 0.150) and 8 weeks (p = 0.596). Conclusion: acupuncture is not effective in controlling symptoms caused by menopause, so it is not an alternative to hormone replacement therapy.

Apneia obstrutiva do sono em mulheres na transição menopausa e pós menopausa: estudo populacional em Pindamonhangaba - SP / A obstructive sleep apnea in women in menopause and post-menopause transition: a population-based study in Pindamonhangaba - SP

Introdução: A transição menopausal é um período onde ocorre diminuição na produção de hormônios femininos devido ao envelhecimento ovariano. Com essa queda dos níveis hormonais, ocorre uma série de sintomas desconfortáveis, dentre eles os distúrbios do sono. A Apnéia Obstrutiva do Sono (AOS) é caracterizada por episódios repetidos de colapso parcial ou completo das vias aéreas durante o período de sono, que resulta em eventos respiratórios denominados apnéias (obstrução completa) ou hipopneias (obstrução parcial). É um problema altamente prevalente, com dificuldades para o diagnóstico, pois o exame para rastreio é a polissonografia, que possui alto custo e complexidade. Objetivos: estimar a incidência e a prevalência de Apnéia Obstrutiva do Sono (AOS), bem como os possíveis fatores associados e comparar resultados da Poligrafia Respiratória Domiciliar com o questionário de Berlin. Método: em 2007 foi realizado um estudo transversal que coletou dados clínicos e epidemiológicos de 875 mulheres de 35 a 65 anos cadastradas na Estratégia de Saúde da Família de Pindamonhangaba. Em 2014 foi realizado um novo estudo, que coletou dados clínicos e epidemiológicos de 1200 mulheres, sendo 657 que participaram do estudo anterior 543 novas participantes. Para avaliação de características sugestivas de AOS foi aplicado o Berlin Questionnaire (BQ) e foi realizado também em parte da amostra o exame de Poligrafia Respiratória domiciliar (PRD), para comparação dos resultados com os questionários de rastreamento de AOS. Resultados: A prevalência de AOS com base no BQ nas mulheres do presente estudo foi de 60,5%. A incidência de AOS foi de 52,6%, e os fatores associados incluíram apenas a circunferência abdominal acima de 80 cm, indicando que a obesidade é um importante fator associado a AOS. Com relação a PRD, foi encontrada prevalência de 57,6% utilizando os critérios da American Academy Sleep Association. Conclusão: Houve alta prevalência e incidência de AOS na população estudada e a prevalência de AOS pela PRD foi de 57,6%.

Introduction: The menopausal transition is a period where there is a decrease in the production of female hormones due to ovarian aging. With this drop in hormone levels, a number of uncomfortable symptoms occur, including sleep disorders. Obstructive Sleep Apnea (OSA) is characterized by repeated episodes of partial or complete airway collapse during sleep, resulting in respiratory events called apneas (complete obstruction) or hypopneas (partial obstruction). It is a highly prevalent problem, with difficulties in diagnosis, as the screening test is polysomnography, which is expensive and complex. Objectives: to estimate the incidence and prevalence of Obstructive Sleep Apnea (OSA), as well as the possible associated factors, and to compare the results of Home Respiratory Polygraphy with the Berlin questionnaire. Method: in 2007 a cross-sectional study was carried out that collected clinical and epidemiological data from 875 women aged 35 to 65 years enrolled in the Family Health Strategy of Pindamonhangaba. In 2014, a new study was carried out, which collected clinical and epidemiological data from 1200 women, 657 of whom participated in the previous study, 543 new participants. To assess characteristics suggestive of OSA, the Berlin Questionnaire (BQ) was applied and part of the sample was also submitted to the Home Respiratory Polygraphy (PRD) exam, in order to compare the results with the OSA screening questionnaires. Results: The prevalence of OSA based on BQ in the women in the present study was 60.5%. The incidence of OSA was 52.6%, and associated factors included only waist circumference above 80 cm, indicating that obesity is an important factor associated with OSA. Regarding PRD, a prevalence of 57.6% was found using the criteria of the American Academy Sleep Association. Conclusion: There was a high prevalence and incidence of OSA in the population studied and the prevalence of OSA by PRD was 57.6%.

Repercussions of circulatory electrical stimulation on quality of life, lubrication and pelvic floor muscles: a pilot study / Repercussões da eletroestimulação circulatória na qualidade de vida, lubrificação e musculatura pélvica: um estudo piloto

Abstract Introduction: The climacteric is one of the transition periods in the life cycle of women between the reproductive and non-reproductive phase, and it is characterized by various metabolic, psychological and social changes, either by psychic disorders or sexual dysfunctions promoting changes in quality of life. Objective: To analyze the repercussions of electrical stimulation on quality of life, lubrication and myoelectric activity of pelvic floor muscles in postmenopausal women. Methods: This was a pilot study in which the sample consisted of ten menopausal volunteers aged 48-60 years. We used the Female Sexual Function Index questionnaire to determine the improvement in lubrication and the WHOQOL-BREF questionnaire to assess quality of life. The pelvic floor muscles were evaluated by electromyography with an intracavitary electrode. The protocol used was: phasic contraction evaluated by three contractions of two seconds and six of rest; three tonic contractions for ten seconds with ten-second rest; and endurance for thirty seconds. The intervention was performed by another researcher, through circulatory stimulation with the Dualpex 961 Quark®. Results: Electromyography after circulatory stimulation showed statistically significant results with an increase in Fast Fourier Transform in tonic and phasic contractions, obtaining a positive effect on the perception and awareness of contractions due to increased blood flow. Also, there was improvement in lubrication and quality of life in all areas. Conclusion: Circulatory stimulation had repercussions on pelvic floor muscles in menopausal women in both muscle physiology and lubrication, with an influence on the quality of life of volunteers.

Resumo Introdução: O climatério constitui um dos períodos de transição no ciclo vital da mulher entre a fase reprodutiva e a não reprodutiva, caracterizado por várias alterações metabólicas e psicológicas, seja por distúrbios psíquicos ou disfunções sexuais, promovendo alterações na qualidade de vida. Objetivo: Analisar as repercussões da eletroestimulação na qualidade de vida, lubrificação e atividade mioelétrica dos músculos do assoalho pélvico em mulheres menopausadas. Métodos: Trata-se de um estudo piloto no qual a amostra foi composta por dez voluntárias em menopausa com idade entre 48 e 60 anos. Para avaliar a melhora da lubrificação foi utilizado o questionário Female Sexual Function Index. Quanto à qualidade de vida, utilizou-se o questionário WHOQOL-bref. Já para a avaliação dos músculos do assoalho pélvico, utilizou-se a eletromiografia com eletrodo intracavitário. O protocolo utilizado foi: contração fásica avaliada por três contrações de dois segundos e seis de repouso; três contrações tônicas sustentadas por dez segundos com repouso de dez segundos; endurance durante trinta segundos. A intervenção foi realizada por outra pesquisadora, através de estimulação circulatória com o aparelho Dualpex 961 Quark®. Resultados: A eletromiografia pós-estimulação circulatória obteve resultados significativos, com aumento na Fast Fourier Transform nas contrações tônicas e fásicas, obtendo efeito positivo na percepção e conscientização das contrações devido ao aumento do fluxo sanguíneo. Houve, também, melhora na lubrificação e na qualidade de vida em todos os domínios. Conclusão: A estimulação circulatória apresentou repercussões nos músculos do assoalho pélvico em mulheres menopausadas tanto na fisiologia muscular quanto na lubrificação, influenciando a qualidade de vida das voluntárias.

Clustering of behavioral risk factors for chronic noncommunicable diseases in climacteric women

ABSTRACT Objective To estimate the prevalence of clustering of behavioral risk factors for chronic non-communicable diseases, as well as the associated factors in climacteric women. Methods This is a cross-sectional, analytical study, with random selection of climacteric women, aged between 40 and 65 years, and registered in Family Health Strategy units. The dependent variable was clustering of three or more behavioral risk factors for chronic non-communicable diseases. The definition of associated variables was made after Poisson multiple regression analysis with robust variance. Results We evaluated 810 women, and 259 (32.0%) had a clustering of risk factors. The main risk behaviors were physical inactivity and low fruit consumption. The variables associated with clustering of behavioral factors were age group 52-65-years, marital status without a partner, overweight/obesity, moderate to severe anxiety and depression symptoms. Conclusion There was a considerable prevalence of women with three or more behavioral risk factors for chronic non-communicable diseases. Demographic variables and those related to health conditions were shown to be associated. Considering the results recorded, health services must provide differentiated care policies to climacteric women, seeking to alleviate high morbidity and mortality of chronic non-communicable diseases.

Association of dietary patterns, number of daily meals and anthropometric measures in women in age of menopause

ABSTRACT Objective: To investigate the association of dietary patterns, number of daily meals and anthropometric measures among women in age of menopause. Subjects and methods: This was a transversal study with 320 women over 50 years old from Caxias do Sul, Brazil. The outcomes were body mass index (BMI) and waist circumference (WC). Multiple linear regression was performed. Results: Three dietary patterns: regional, fruits and vegetables, and common Brazilian was identified by Principal Component Analysis. After adjustment, higher adoption of the regional dietary pattern was associated with increased BMI (β = 0.56 [CI95% = 0.03-1.08], p = 0.037) and WC (β = 1.28 [CI95% = 0.17-2,55], p = 0.047). The highest number of meals per day (>=5/day) was associated with reduced BMI (β = -1.18 [CI95% = -2.30 to -0.05], p = 0.041) and WC (β = -2.77 [CI95% = -5.41 to -0.13], p = 0.039), and a mid-afternoon snack BMI (β = -2.16 [CI95% = -3.66 to -0.65], p = 0.005) and WC (β = -5.76 [CI95% = -9.29 to -2.23], p = 0,001). The regional dietary pattern was inversely associated with have five or more meals per day (β = -0.51 [CI95% = -0.84 to -0.18], p = 0.002) and have a mid-afternoon snack (β = -0.63 [CI95% = -1.07 to -0.18], p = 0.006). The fruit and vegetables dietary pattern was positively associated with have five or more meals per day (β = 0.35 [CI95% = 0.02-0.69], p = 0.034). Conclusion: The regional dietary pattern has resulted in higher BMI and WC measures and contributes to decreased meals per day, behavior associated with higher anthropometric measures.