Physical activity and sexual function in middle-aged women / Atividade física e função sexual em mulheres de meia idade

Objective To investigate the relationship between physical activity level and sexual function in middle-aged women. Methods A cross-sectional study with a sample of 370 middle-aged women (40-65 years old), treated at public health care facilities in a Brazilian city. A questionnaire was used containing enquiries on sociodemographic, clinical and behavioral characteristics: the International Physical Activity Questionnaire (IPAQ), short form, and the Female Sexual Function Index (FSFI). Results The average age of the women studied was 49.8 years (± 8.1), 67% of whom exhibited sexual dysfunction (FSFI ≤ 26.55). Sedentary women had a higher prevalence (78.9%) of sexual dysfunction when compared to active (57.6%) and moderately active (66.7%) females (p = 0.002). Physically active women obtained higher score in all FSFI domains (desire, arousal, lubrication, orgasm, satisfaction and pain) and total FSFI score (20.9), indicating better sexual function than their moderately active (18.8) and sedentary (15.6) counterparts (p <0.05). Conclusion Physical activity appears to influence sexual function positively in middle-aged women. .

Objetivo Avaliar uma possível relação existente entre a prática de atividade física e a função sexual em mulheres de meia idade. Métodos Estudo de corte transversal com 370 mulheres entre 40 e 65 anos, atendidas em unidades públicas de saúde em uma cidade brasileira de médio porte. Foi utilizado questionário para avaliar características sociodemográficas, clinicas e comportamentais, o IPAQ (International Physical Activity Questionnaire) para avaliar nível de atividade física e o FSFI (Female Sexual Function Index) para avaliar sexualidade. Resultados A média de idade das mulheres estudadas foi de 49.8 anos (± 8.1), 67% delas apresentaram algum grau de disfunção sexual (FSFI ≤ 26.55). Mulheres sedentárias apresentaram maior prevalência de disfunção sexual (78.9%) quando comparadas as mulheres ativas (57.6%) e moderadamente ativas (66.7%) (p = 0.002). Mulheres fisicamente ativas obtiveram maiores escores do FSFI total (20.9) e em todos os domínios (desejo, excitação, lubrificação, orgasmo, satisfação e dor) quando comparadas as moderadamente ativas com escore total de 18,8 e sedentárias de 15,6 (p <0.05), indicando melhor função sexual das fisicamente ativas quando comparadas as sedentárias. Conclusão A atividade física parece influenciar favoravelmente a função sexual de mulheres de meia idade. .

The utility of p16 INK4a and Ki-67 to identify high-grade squamous intraepithelial lesion in adolescents and young women.

Background: The repair of the immature squamous epithelium following HPV infection may mimic HSIL in adolescent women. Aim: to study the utility of p16 INK4a and Ki-67 in diagnosis of cervical squamous lesions in adolescents and young adults. Materials and Methods: In a cross-sectional study, the evaluation of p16 INK4a and Ki-67 immunohistochemistry was performed on 72 cervical biopsies of adolescents and young adults women diagnosed as negative for malignancy and intraepithelial lesion (NML) (n = 18) or positive for low grade (LSIL) (n = 31) and high grade (HSIL) (n = 23) squamous intraepithelial lesions in two references services in Fortaleza-Brazil. Data was evaluated using Fisher's test and Kappa index. Results: p16 INK4a was positive in 81% of HSIL, 19% of LSIL and in no NML (P < 0.0001). Ki-67 was positive in 74%, 32% and 5.5% of HSIL, LSIL and NML, respectively. p16 INK4a and Ki-67 in the diagnosis of HSIL showed high sensitivity and negative predictive value. Kappa index was very good for p16 INK4a (k = 0.72). Conclusions: In adolescents and young adults p16 INK4a alone or with Ki-67 represents important tool to reduce mistaken diagnosis of HSIL and to avoid overtreatment.

Marcadores imunoistoquímicos de lesões precursoras do câncer do colo uterino associadas ao HPV: o papel da proteína de supressão tumoral p16ink4a / Immunohistochemistry markers for lesions preceding HPV-induced cervical cancer: the role of tumoral suppression p16ink4a protein

A relação entre o HPV e as lesões intra-epiteliais escamosas cervicais está bem estabelecida. O mecanismo de ação que o vírus parece utilizar para causar a transformação está associado a dois genes do HPV, E6 e E7. O gene E7 tem um papel importante induzindo alterações na célula hospedeira associadas à proteína do retinoblastoma (pRb ) e o fator de transcrição E2F. Quando o fenômeno induzido pelo E7 do HPV ocorre, há expressão da proteína p16INK4a que pode ser detectada por imunoistoquímica. Recentes trabalhos mostram a importância do uso de p16INK4a como marcador de transformação celular induzida pelo HPV e a sua utilidade clínica na prática, principalmente ajudando no diagnóstico de lesões intra-epiteliais escamosas de alto grau em biópsias. Esta revisão pretende fornecer ao leitor uma idéia atualizada de como alguns marcadores celulares podem contribuir para o diagnóstico e o prognóstico das neoplasias intra-epiteliais cervicais.

The HPV and cervical squamous intra-epithelial neoplasia relation is established. The mechanisms used by the virus which causes the transformation of the squamous intra-epithelial are associated to the E6 and E7 HPV genes The E7 gene has an important role inducing the host cell changes which are related to the retinoblastoma protein and E2F transcription factor. When the phenomenon induced by the E7 occurs, there is the expression of the p16INK4a protein which can be detected by immunohistochemistry. Recent studies have shown the importance of the use of the p16INK4a as a marker for cellular transformation induced by HPV and its clinical use in practice, mainly helping in the diagnosis of high grade squamous intra-epithelial lesions in biopsies. This revision intends to provide to the reader an update to the understanding of how cellular markers can contribute to improve the differential diagnosis of the squamous intra-epithelial neoplasia and its prognosis.