Management of hypoactive sexual desire dysfunction at a specialized service in women's sexual health.

Hypoactive sexual desire dysfunction (HSDD) is prevalent among women. This retrospective cohort study aimed to verify the results of the strategies used by Gynecologists and Obstetricians (Ob-gyn) residents in the management of female HSDD. For this, we conducted a data collection of patient medical records of women with HSDD from the Human Sexuality Studies outpatient clinic of the Human Reproduction Center, Department of Gynecology and Obstetrics of FMRP-USP, from 2005 to 2019. Among the 437 women included, 361 (82.6%) answered the question concerning the effect of the protocol to which they were submitted, whereas 234 (64.8%) reported improvements in sexual desire. The univariate model showed that patients without chronic pelvic pain were 19.0% less likely to report improvements in HSDD than those with chronic pelvic pain (p = 0.03). Patients without depression and without orgasmic dysfunction were, respectively 32% and 23% more likely to show improvements in their HSDD than those who had depression or orgasmic dysfunction (respectively p = 0.001, p = 0.008). However, the multivariate model did not identify any associations. The assistance regarding HSDD by the Ob-gyn resident in training to deal with female sexual complaints may be effective in improving sexual complaints.

Lymphomas affecting the submandibular glands / Linfomas que afectan las glándulas submandibulares

Background: Lymphomas affecting the submandibular glands are very uncommon and few reports are currentlyavailable in the literature. Therefore, the aim of the current study is to describe the clinical and microscopic fea-tures of an original series of lymphomas affecting the submandibular glands.Material and Methods: The pathology files of two institutions were searched for lymphoma cases affecting thesubmandibular glands. The original hematoxylin and eosin, and immunohistochemical slides were revised by apathologist for diagnosis confirmation following the revised 4th edition of the World Health Organization classification of tumours of haematopoietic and lymphoid tissues. Clinical data regarding age, sex, clinical manifestation,treatment, follow-up and status at last appointment were retrieved from the patients’ medical charts.Results: During the period investigated, 16 cases were included in the study. Females predominated (10:6) with amean age of 57.8 years-old. Tumors usually presented as asymptomatic swellings. MALT lymphoma representedthe most common subtype, followed by diffuse large B cell lymphoma and follicular lymphoma. Three patientsdied, one of them affected by plasmablastic lymphoma, one by DLBCL and one by MALT lymphoma.Conclusions: Low-grade B cell lymphomas predominate in the submandibular glands, but DLBCL and other sub-types may also be rarely diagnosed in this salivary gland.(AU)

Mucormycosis-induced hypercalcemia: a case report.

Hypercalcemia is a vital laboratory marker because it can show underlying severe diseases like cancer and infections. Of all the causes of hypercalcemia, primary hyperparathyroidism, and malignancies are the most common, but granulomatous diseases, such as certain fungal infections, can also be the cause. Here we describe the case of a 29-year-old woman, an insulin-dependent diabetic, found unconscious and tachypneic at home. In the emergency room, the medical team diagnosed diabetic ketoacidosis (DKA) and acute kidney injury (AKI). During hospitalization, despite resolving acidemia, persistent hypercalcemia attracted attention. Laboratory tests showed decreased parathyroid hormone (PTH) levels, confirming non-PTH-dependent hypercalcemia. Computed tomography (CT) of the chest and abdomen demonstrated no alterations, but an upper digestive endoscopy revealed an ulcerated and infiltrative lesion in the stomach. A biopsy showed a granulomatous infiltrate due to mucormycosis infection. The patient received liposomal amphotericin B for 30 days and isavuconazonium for two months. Serum calcium levels improved during treatment. Inquiry of the etiology of hypercalcemia should begin with the PTH assay; high levels are consistent with hyperparathyroidism; low levels, with calcium or vitamin D intoxication, malignancies, prolonged immobilization, and granulomatous diseases. In the latter cases, the overproduction of 1-alpha-hydroxylase by the granulomatous tissue increases the conversion of 25(OH)vitamin D into 1-25(OH)vitamin D, which causes the intestinal absorption of calcium. We have described the first hypercalcemia related to mucormycosis infection in a young diabetic patient, although case presentations associate other fungal infections with elevated serum calcium.

Gambling, cryptocurrency, and financial trading app marketing in English Premier League football: A frequency analysis of in-game logos.

Background & aims: The gamblification of UK football has resulted in a proliferation of in-game marketing associated with gambling and gambling-like products such as cryptocurrencies and financial trading apps. The English Premier League (EPL) has in response banned gambling logos on shirt-fronts from 2026 onward. This ban does not affect other types of marketing for gambling (e.g., sleeves and pitch-side hoardings), nor gambling-like products. This study therefore aimed to assess the ban's implied overall reduction of different types of marketing exposure. Methods: We performed a frequency analysis of logos associated with gambling, cryptocurrency, and financial trading across 10 broadcasts from the 2022/23 EPL season. For each relevant logo, we coded: the marketed product, associated brand, number of individual logos, logo location, logo duration, and whether harm-reduction content was present. Results: There were 20,941 relevant logos across the 10 broadcasts, of which 13,427 (64.1%) were for gambling only, 2,236 (10.7%) were for both gambling and cryptocurrency, 2,014 (9.6%) were for cryptocurrency only, 2,068 (9.9%) were for both cryptocurrency and financial trading, and 1,196 (5.7%) were for financial trading only. There were 1,075 shirt-front gambling-associated logos, representing 6.9% of all gambling-associated logos, and 5.1% of all logos combined. Pitch-side hoardings were the most frequent marketing location (52.3%), and 3.4% of logos contained harm-reduction content. Discussion & Conclusions: Brand logos associated with gambling, cryptocurrency, and financial trading are common within EPL broadcasts. Approximately 1 in 20 gambling and gambling-like logos are subject to the EPL's voluntary ban on shirt-front gambling sponsorship.

Safer gambling and consumer protection failings among 40 frequently visited cryptocurrency-based online gambling operators.

OBJECTIVE: Online gambling has increased the accessibility and range of gambling products available to people all over the world. This trend has been particularly noticeable in the United Kingdom. Cryptocurrency-based gambling is a new, largely unregulated, way to gamble online, which uses mostly anonymous blockchain-based technologies, such as Bitcoin. The present research investigated consumer protection features of 40 frequently visited and U.K.-accessible cryptocurrency-based online gambling operators. METHOD: A content analysis was performed by visiting all 40 cryptocurrency-based online operators and recording their safer gambling and consumer protection practices. Coded features included aspects of the sign-up process, features of any safer gambling pages, customer support practices, and Identity verification. RESULTS: Results revealed significant failings in the account registration process; none of the operators verified the identity of new users, and 35% required only an email or no personal information for sign-up. Overall, 37.5% of operators offered no safer gambling tools and a further 20% offered only one. Additionally, 64.7% of operators continued to email promotional material after being informed of a user's impaired control when gambling. Less than half of the analyzed operators held a valid license (47.5%), and none of the operators with an available deposit page required identity verification before enabling deposits. CONCLUSIONS: These results highlight the potential risks for young and vulnerable individuals, especially when a lack of identity verification is paired with the inherent anonymity of cryptocurrencies. Furthermore, it emphasizes the need for greater policy and research attention toward cryptocurrency-based online gambling. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Does Photobiomodulation Affects CK10 and CK14 in Oral Mucositis Radioinduced Repair?

The mechanisms of action of photobiomodulation (PBM) in oral mucositis (OM) are not completely elucidated. To enlighten the role of PBM in the evolution of epithelial maturity in OM ulcers, the present study evaluated the effect of PBM with red (λ) wavelength of 660 nanometers (nm) and infrared of 780 nm in radio-induced OM wounds on the tongue of rats, eight and twenty days after irradiation with single dose of 20 Gy. The percentage area corresponding to positive staining for cytokeratin 10 (CK10) and 14 (CK14) proteins was evaluated in the epithelial area of the lesions, using an immunohistochemical technique (IHC), 8 and 20 days after the induction of lesions, and compared with an untreated control group. CK10 was significantly more expressed in the group treated with 660 nm PBM. CK14 did not show quantitative differences between the groups evaluated. However, whereas in the groups treated with PBM, CK14 was already restricted to the basal layer of the epithelium, as expected in healthy epithelia, in control group it was also expressed in upper layers of the epithelium. In this work, PBM was able to improve epithelial maturity of the repaired OM wound, especially in the 660 nm group.

Comparison of Sexual Dysfunction in Women Who Were or Were Not Victims of Sexual Violence.

The victims of sexual violence may develop FSD. This retrospective study examined the characteristics of women victims of sexual abuse who had FSD who attended a tertiary hospital from 2004 to 2017. Patients were divided in two groups: women who were victims of sexual violence and women who were not victims (controls). One thousand and ten women (60.4%) presented with FSD and 610 of them were eligible for inclusion, 134 (21.97%) reported they were victims of sexual violence, and the abuser was mostly someone close to the victim (92.31%). Depression was more prevalent in the women who were victims (32.1% vs. 18.3%; p<0.05), 74.0% vs. 59.8% had hypoactive sexual desire disorder (HSDD) (p<0.05), 20.3% of victims vs. 7.19% of controls (p<0.05) had primary anorgasmia, and 51.15% of the victims and 39.61% of controls reported anorgasmia. The victims reported a lower sex drive (39.6% vs. 52.3%), and reduced arousal (48.8% vs. 61.3%; all p<0.05). More of the victims than controls reported that their partners had engaged in an extramarital relationship (19.0% vs. 9.25%, p<0.05).

Liquid biopsy of atherosclerosis using protoporphyrin IX as a biomarker.

Protoporphyrin IX (PPIX), a derivative of hematoporphyrin, can accumulate in rapidly growing tissues, including tumors and atherosclerotic plaques. The objective of this study is to employ PPIX fluorescence to detect the changes in blood caused by the formation of atheromatous plaques in arteries; this measurement can function as a liquid biopsy. For this purpose twenty four rabbits were randomly divided into groups: control group (CG)--fed with a normal diet, and an experimental group (EG)--fed with a hypercholesterolemic diet (1% cholesterol). Blood samples were collected before (0 time) and after 22, 43, 64 days to measure biochemical factors. The aortas were removed after 22, 43 and 64 days to assess the atherosclerotic plaques. PPIX was extracted from the blood and fluorescence was measured in the 550-750 nm range from samples that were excited at 405 nm. Aminolevulinic acid (ALA) was administered intravenously to increase the PPIX fluorescence intensity in the arteries and consequently in the liquid biopsy of the atherosclerotic plaques. The results have shown that the PPIX fluorescence increased as the atheromatous plaques grew. The aorta fluorescence and the PPIX fluorescence increased in the animals in the experimental group that received ALA. PPIX that accumulates in atheromatous plaques transfers to the blood and can be analyzed by extracting porphyrin from total blood. Therefore, this method can aid in the early diagnosis of atherosclerosis with high sensitivity.

Abordagem do derrame pleural parapneumônico em um hospital universitário: onde estamos e para onde devemos ir / Parapneumonic pleural effusion approach in an university hospital: where we are and where we should go

Introdução: o derrame pleural em crianças com pneumonia bacteriana; ocorre em até 50 por cento das vezes. Objetivo: avaliar a abordagem do derrame pleural parapneumônico nos úlimos cinco anos no Hospital das Clínicas da UFMG. Metodologia: análise retrospectiva dos prontuários de todos os pacientes submetidos à toracocentese, drenagem pleural ou videotoracoscopia no período de janeiro de 2002 a julho de 2007. Resultados: foram estudados 21 pacientes, 71,4 por cento do sexo masculino e idade média de 70,4 meses. Um terço dos pacientes foi encaminhado do interior do estado. A maioria (86 por cento) apresentava comorbidades. A duração da internação variou entre quatro e cinquenta dias, média de 16,4 dias. Os procedimentos realizados foram drenagem pleural direta (42,8 por cento), toracocentese seguida de drenagem (28,6 por cento) e apenas toracocentese (28,6 por cento). Nos dois primeiros grupos, não houve diferença significativa quanto ao tempo de internação. ideotoracoscopia foi realizada em quatro pacientes, em média 11,5 dias após o início da pneumonia. A penas dois de seis pacientes com sinais de organização à ultrasonografia foram submetidos à videotoracoscopia. O tempo médio de permanência com dreno de tórax foi de 8,8 dias. As médias da duraço da internação e da permanência do dreno foram significativamente mais baixas nos pacientes procedentes de Belo Horizonte(p=0,01). Não foram encontradas associações entre tipo de procedimento, tempo decorrido para realização destes e duração da internação. Conclusões: a duração da internação hospitalar dos pacientes aqui observados foi mais prolongada do que o relatado na literatura. Ressalta-se a importância de se reavaliar o papel da videotoracoscopia na redução da morbidade e duração da internação desses pacientes.

Vaginose bacteriana: aspectos microbiológicos e terapêutica com imidazólicos / Bacterial Vaginosis: microbiological and therapeutics aspects with imidazoles

Os autores apresentm os aspectos microbiológicos conhecidos que envolvem a fisiopatologia e diagnóstico da vaginose bacteriana, uma afecção comum que acomete mulheres em idade reprodutiva e que se manifesta clinicamente com o corrimento vaginal de odor desagradável. Posteriormente apresentam e discutem a eficácia dos imidazólicos utilizados para o seu tratamento, ressaltando as controvérsias e os problemas decorrentes da utilização desses medicamentos na prática clínica.