Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 28
Filter
1.
J Sex Med ; 2024 Jun 06.
Article in English | MEDLINE | ID: mdl-38842258

ABSTRACT

BACKGROUND: Hormonal contraceptive use has been related to adverse effects, including impacts on sexual function and sexual satisfaction, although the difference in the effects on sexual function with the use of hormonal vs nonhormonal contraceptive methods remains controversial. AIM: In this study we sought to compare the prevalence of dyspareunia, sexual function, sexual satisfaction, quality of life, anxiety, and depression between women using hormonal, nonhormonal, or no contraceptive methods and to compare these outcomes between the most frequently used contraceptive methods. METHODS: This cross-sectional study included sexually active women of reproductive age who were stratified into 3 groups: women using hormonal, nonhormonal, or no contraceptive methods. Based on the use of questionnaires administered to the study participants, we compared sexual function in the 3 groups and more specifically among users of oral contraceptives, copper and hormonal intrauterine devices, and barrier methods. OUTCOMES: Participants completed 4 questionnaires to assess sexual function (Female Sexual Function Index), sexual satisfaction (Sexual Quotient-Feminine Version), quality of life (12-item Medical Outcomes Short Form Health Survey), and anxiety and depression (Hospital Anxiety and Depression Scale). RESULTS: This study included 315 women classified into 3 groups on the basis of contraceptive use: 161 in the hormonal contraceptives group (median [interquartile range] age, 24 [23-28] years), 97 in the nonhormonal contraceptives group (age 26 [23-30] years), and 57 in the no contraceptive methods group (age 28 [24-35] years). Dyspareunia prevalence showed no difference between the groups. In the quality of life domain, compared with women in the nonhormonal contraceptive group, women in the hormonal contraceptive group were younger and had lower sexual function satisfaction, reduced arousal, and heightened pain (P < .05), as well as higher anxiety and depression levels (P = .03, for both), increased pain (P = .01), and poorer overall health (P = .01). No difference was found between these groups in other quality of life domains. Regarding contraceptive methods, women using copper intrauterine devices had better sexual function, including higher rates of arousal and lower anxiety, than women using oral contraceptives (P < .05). CLINICAL IMPLICATIONS: The results of this study highlight worse sexual function and sexual satisfaction and higher levels of anxiety and depression in women using hormonal contraceptive methods than in women using nonhormonal methods. STRENGTHS AND LIMITATIONS: The findings of this study strengthen the evidence of differences in sexual function between women using oral contraceptives and those using copper intrauterine devices. Sexual function was also compared among users of oral contraceptives, copper and hormonal intrauterine devices, and barrier methods. However, less frequently used contraceptive methods, such as hormonal injections and vaginal rings, could not be compared in this sample. CONCLUSION: Women using hormonal contraceptive methods were younger, had lower sexual function and satisfaction, and experienced higher anxiety and depression levels than women using nonhormonal contraceptive methods.

2.
Neurourol Urodyn ; 42(5): 1101-1110, 2023 06.
Article in English | MEDLINE | ID: mdl-37042223

ABSTRACT

OBJECTIVE: To assess the efficacy of vaginal electrical stimulation (VS) versus transcutaneous tibial nerve electrical stimulation (TTNS) in women with overactive bladder syndrome (OAB). MATERIAL AND METHODS: Sixty-nine patients were randomized to receive 12 sessions of VS versus TTNS, or no treatment (control group-CG), over 6 weeks. OAB impact according to international consultation on incontinence questionnaire overactive bladder module (ICIQ-OAB), symptoms discomfort scores and voiding diaries were evaluated at baseline, 6 weeks and 1-month post-treatment. RESULTS: Both TTNS (mean difference = -4.2; 95% confidence interval [CI] = -6.5 to -1.9) and VS (-3.8; -6.0 to -1.6) were associated with significant reduction of ICIQ-OAB scores, as well as discomfort sensation (-3.9; -6.2 to -1,7; p < 0.001 for the TTNS and -2.8; -5.0 to -0.6; p = 0.01 for the VS) at 6 weeks when compared to CG (p < 0.001). ICIQ-OAB score remained low only in the TTNS group when compared to the CG (-3.6; -6.0 to -1.2/p = 0.00) 1 month after treatment. Discomfort symptoms improved in both active groups when compared to CG (TTNS [-3.2; -5.2 to -1.2; p < 0.001] and VS groups [-2.6; -4.7 to -0.6; p = 0.01]). No statistically differences were found in primary outcomes comparing TTNS and VS Secondary analysis showed significant improvement in urinary urgency incontinence episodes (UUI) in both TTNS and VS, but CG. UUI episodes were still reduced in the VS group and urgency in the TTNS group 1-month post-treatment. CONCLUSION: Short-term interventions (6 weeks) of TTNS and VS were both effective in treating women with OAB. TTNS provided residual effects at one-month postintervention on ICIQ-OAB score.


Subject(s)
Transcutaneous Electric Nerve Stimulation , Urinary Bladder, Overactive , Urinary Incontinence , Humans , Female , Urinary Bladder, Overactive/therapy , Urinary Bladder, Overactive/complications , Treatment Outcome , Transcutaneous Electric Nerve Stimulation/adverse effects , Urinary Incontinence/therapy , Electric Stimulation , Tibial Nerve/physiology , Quality of Life
3.
Neurourol Urodyn ; 37(1): 346-353, 2018 01.
Article in English | MEDLINE | ID: mdl-28464434

ABSTRACT

AIMS: To assess the effects of a Pilates exercise program compared to conventional pelvic floor muscle training (PFMT) protocol on pelvic floor muscle strength (PFMS) in patients with post-prostatectomy urinary incontinence. METHODS: Patients were randomized into three treatment groups (G1: Pilates, G2: electrical stimulation combined with PFMT, and G3: control group). Duration of therapy was 10 weeks. Baseline assessment included the 24 h pad-test and the ICI-Q questionnaire. PFMS was measured using a manometric perineometry device at baseline and 4 months after radical prostatectomy (RP). The level of significance was P < 0.05. RESULTS: One hundred twenty three patients were randomized and 104 patients completed the study protocol (G1: n = 34; G2: n = 35; G3: n = 35). Post-treatment assessment showed statistically significant improvements in maximum strength in G2, increased endurance in G1 and G2, and increment of muscle power in all three groups (P < 0.05). However, there were no significant differences in the mean changes of maximum strength, endurance, and muscle power between groups after treatment (P > 0.05). G1 and G2 achieved a higher number of fully continent patients than G3 (P < 0.05). At the end of treatment, 59% of patients in G1, 54% in G2, and 26% in G3 were continent (no pads/day). CONCLUSIONS: Improvements in PFMS parameters were distinct among active treatment groups versus controls, but did not predict recovery of urinary continence at final assessment. The Pilates method promoted similar outcomes in the proportion of fully continent patients when compared to conventional PFMT 4 months after RP.


Subject(s)
Exercise Movement Techniques , Muscle Strength/physiology , Pelvic Floor/physiopathology , Prostatectomy/adverse effects , Urinary Incontinence/therapy , Aged , Female , Humans , Male , Middle Aged , Prostate/surgery , Urinary Incontinence/etiology , Urinary Incontinence/physiopathology
4.
Rev Soc Bras Med Trop ; 49Suppl 1(Suppl 1): 3-60, 2016 Dec.
Article in English | MEDLINE | ID: mdl-27982292

ABSTRACT

Chagas disease is a neglected chronic condition with a high burden of morbidity and mortality. It has considerable psychological, social, and economic impacts. The disease represents a significant public health issue in Brazil, with different regional patterns. This document presents the evidence that resulted in the Brazilian Consensus on Chagas Disease. The objective was to review and standardize strategies for diagnosis, treatment, prevention, and control of Chagas disease in the country, based on the available scientific evidence. The consensus is based on the articulation and strategic contribution of renowned Brazilian experts with knowledge and experience on various aspects of the disease. It is the result of a close collaboration between the Brazilian Society of Tropical Medicine and the Ministry of Health. It is hoped that this document will strengthen the development of integrated actions against Chagas disease in the country, focusing on epidemiology, management, comprehensive care (including families and communities), communication, information, education, and research .


Subject(s)
Chagas Disease , Consensus , Brazil/epidemiology , Chagas Disease/diagnosis , Chagas Disease/epidemiology , Chagas Disease/therapy , Chagas Disease/transmission , Humans
5.
Epidemiol Serv Saude ; 25(spe): 7-86, 2016 06.
Article in Portuguese | MEDLINE | ID: mdl-27869914

ABSTRACT

Chagas disease is a neglected chronic condition that presents high morbidity and mortality burden, with considerable psychological, social, and economic impact. The disease represents a significant public health issue in Brazil, with different regional patterns. This document presents the evidence that resulted in the Brazilian Consensus on Chagas Disease. The objective was to review and standardize strategies for diagnosis, treatment, prevention, and control of Chagas disease in the country, based on the available scientific evidence. The consensus is based on collaboration and contribution of renowned Brazilian experts with vast knowledge and experience on various aspects of the disease. It is the result of close collaboration between the Brazilian Society of Tropical Medicine and the Ministry of Health. This document shall strengthen the development of integrated control measures against Chagas disease in the country, focusing on epidemiology, management, comprehensive care (including families and communities), communication, information, education, and research.


Subject(s)
Chagas Disease/diagnosis , Chagas Disease/therapy , Neglected Diseases/diagnosis , Neglected Diseases/therapy , Brazil/epidemiology , Chagas Disease/mortality , Chagas Disease/transmission , Chronic Disease , Consensus , Disease Management , Humans , Neglected Diseases/mortality , Neglected Diseases/prevention & control , Public Health , Tropical Medicine
6.
Epidemiol. serv. saúde ; 25(spe): 7-86, abr.-jun. 2016. tab, graf
Article in Portuguese | LILACS, Sec. Est. Saúde SP | ID: lil-792990

ABSTRACT

A doença de Chagas é uma condição crônica negligenciada com elevada carga de morbimortalidade e impacto dos pontos de vista psicológico, social e econômico. Representa um importante problema de saúde pública no Brasil, com diferentes cenários regionais. Este documento traduz a sistematização das evidências que compõe o Consenso Brasileiro de Doença de Chagas. O objetivo foi sistematizar estratégias de diagnóstico, tratamento, prevenção e controle da doença de Chagas no país, de modo a refletir as evidências científicas disponíveis. Sua construção fundamentou-se na articulação e contribuição estratégica de especialistas brasileiros com conhecimento, experiência e atualização sobre diferentes aspectos da doença. Representa o resultado da estreita colaboração entre a Sociedade Brasileira de Medicina Tropical e o Ministério da Saúde. Espera-se com este documento fortalecer o desenvolvimento de ações integradas para enfrentamento da doença no país com foco em epidemiologia, gestão, atenção integral (incluindo famílias e comunidades), comunicação, informação, educação e pesquisas.


Chagas disease is a neglected chronic condition that presents high morbidity and mortality burden, with considerable psychological, social, and economic impact. The disease represents a significant public health issue in Brazil, with different regional patterns. This document presents the evidence that resulted in the Brazilian Consensus on Chagas Disease. The objective was to review and standardize strategies for diagnosis, treatment, prevention, and control of Chagas disease in the country, based on the available scientific evidence. The consensus is based on collaboration and contribution of renowned Brazilian experts with vast knowledge and experience on various aspects of the disease. It is the result of close collaboration between the Brazilian Society of Tropical Medicine and the Ministry of Health. This document shall strengthen the development of integrated control measures against Chagas disease in the country, focusing on epidemiology, management, comprehensive care (including families and communities), communication, information, education, and research.


Subject(s)
Humans , Male , Female , Chagas Disease/diagnosis , Chagas Disease/prevention & control , Chagas Disease/epidemiology , Brazil , Consensus Development Conference , Chagas Disease/therapy , Chagas Disease/transmission
7.
Neurourol Urodyn ; 35(5): 615-21, 2016 06.
Article in English | MEDLINE | ID: mdl-25809925

ABSTRACT

AIMS: To verify the efficacy of a Pilates exercise program compared to conventional pelvic floor muscle exercise (PFME) protocol in the conservative treatment of post-prostatectomy urinary incontinence (PPUI). METHODS: Baseline assessment was performed four weeks postoperatively and included 24 hr pad test, bladder diary, and the ICIQ-SF. Patients were randomised into three groups: Pilates (G1), PFME combined with anal electrical stimulation (G2), and a control group (G3). Both treatment groups had to perform 10 weekly treatment sessions. Primary outcomes were mean reduction of daily pads and mean reduction of ICIQ-SF score four months after surgery. The significance level was set at P < 0.05. RESULTS: 85 patients completed the study. Differences between treatment groups (G1 and G2) in terms of mean reduction in daily pad usage, 24 hr pad test, and ICIQ-SF scores were not statistically significant (P > 0.05). The control group differed from G1 in daily pad usage (P = 0.01) and ICIQ-SF score (P = 0.0073). Intergroup comparisons revealed that 57.7% of the volunteers in G1 and 50% of the individuals from G2 no longer used pads by the end of the treatment period (P = 0.57). In the control group, 22.6% were not using pads four months after surgery, with statistical difference compared to G1 (P < 0.05). CONCLUSIONS: The Pilates exercise program proved to be as effective as conventional PFME to speed up continence recovery in PPUI. It also achieved a higher rate of fully continent patients when compared to the control group in the short-term. Neurourol. Urodynam. 35:615-621, 2016. © 2015 Wiley Periodicals, Inc.


Subject(s)
Exercise Movement Techniques , Exercise Therapy , Pelvic Floor/physiopathology , Prostatectomy/adverse effects , Urinary Incontinence/therapy , Aged , Clinical Protocols , Conservative Treatment/methods , Humans , Male , Middle Aged , Treatment Outcome , Urinary Incontinence/etiology , Urinary Incontinence/physiopathology
8.
Rev. Soc. Bras. Med. Trop ; 49(Suppl 1): 3-60, 2016.
Article in English | Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1066767

ABSTRACT

Chagas disease is a neglected chronic condition with ahigh burden of morbidity and mortality. It has considerable psychological, social, and economic impacts. The disease represents a significant public health issue in Brazil, with different regional patterns. This document presents the evidence that resulted in the Brazilian Consensus on Chagas Disease. The objective was to review and standardize strategies for diagnosis, treatment, prevention, and controlof Chagas disease in the country, based on the available scientific evidence. The consensus is based on the articulation and strategic contribution of renowned Brazilian experts with knowledge and experience on various aspects of the disease. It is the result of a close collaboration between the Brazilian Society of Tropical Medicine and the Ministry of Health...


Subject(s)
Delivery of Health Care , Brazil , Consensus , Diagnosis , Chagas Disease , Epidemiology , Therapeutics
9.
Int Braz J Urol ; 38(5): 661-6, 2012.
Article in English | MEDLINE | ID: mdl-23131506

ABSTRACT

AIMS: To assess pelvic floor muscle (PFM) strength in women with stress urinary incontinence (SUI) and urge urinary incontinence (UUI). MATERIALS AND METHODS: 51 women were prospectively divided into two groups, according to the symptoms as SUI (G1 = 22) or UUI (G2 = 29). Demographic data, such as number of pads/ 24 hours, number of micturations/ 24 hours and nocturia, delay time of urgent void (i.e., the time period for which an urgent void could be voluntarily postponed), number of parity and vaginal deliveries were obtained using a clinical questionnaire. Objective urine loss was evaluated by 60-min. Pad Test, subjective urine stream interruption test (UST) and visual survey of perineal contraction. Objective evaluations of PFM were performed in all patients (vaginal manometry). RESULTS: Median of age, mean number of pads / 24 hours, nocturia and warning time were significantly higher in UUI comparing to SUI group. During UST, 45.45% in G1 and 3.44%, in G2, were able to interrupt the urine stream (p < 0.001). The 60-min. Pad Test was significantly higher in G2 compared to G1 women (2.7 ± 2.4 vs 1.5 ± 1.9 respectively, p = 0.049). Objective evaluation of PFM strength was significantly higher in the SUI than in the UUI patients. No statistical difference was observed regarding other studied parameters. CONCLUSION: Pelvic floor muscle weakness was significantly higher in women with UUI when compared to SUI.


Subject(s)
Muscle Strength/physiology , Pelvic Floor/physiopathology , Urinary Incontinence, Stress/physiopathology , Urinary Incontinence, Urge/physiopathology , Diagnostic Techniques, Urological , Female , Humans , Middle Aged , Muscle Contraction/physiology , Pain Measurement , Perineum/physiopathology , Prospective Studies , Time Factors , Urination/physiology
10.
Int. braz. j. urol ; 38(5): 661-666, Sept.-Oct. 2012. tab
Article in English | LILACS | ID: lil-655993

ABSTRACT

AIMS: To assess pelvic floor muscle (PFM) strength in women with stress urinary incontinence (SUI) and urge urinary incontinence (UUI). MATERIALS AND METHODS: 51 women were prospectively divided into two groups, according to the symptoms as SUI (G1 = 22) or UUI (G2 = 29). Demographic data, such as number of pads/ 24 hours, number of micturations/ 24 hours and nocturia, delay time of urgent void (i.e., the time period for which an urgent void could be voluntarily postponed), number of parity and vaginal deliveries were obtained using a clinical questionnaire. Objective urine loss was evaluated by 60-min. Pad Test, subjective urine stream interruption test (UST) and visual survey of perineal contraction. Objective evaluations of PFM were performed in all patients (vaginal manometry). RESULTS: Median of age, mean number of pads / 24 hours, nocturia and warning time were significantly higher in UUI comparing to SUI group. During UST, 45.45% in G1 and 3.44%, in G2, were able to interrupt the urine stream (p < 0.001). The 60-min. Pad Test was significantly higher in G2 compared to G1 women (2.7 ± 2.4 vs 1.5 ± 1.9 respectively, p = 0.049). Objective evaluation of PFM strength was significantly higher in the SUI than in the UUI patients. No statistical difference was observed regarding other studied parameters. CONCLUSION: Pelvic floor muscle weakness was significantly higher in women with UUI when compared to SUI.


Subject(s)
Female , Humans , Middle Aged , Muscle Strength/physiology , Pelvic Floor/physiopathology , Urinary Incontinence, Stress/physiopathology , Urinary Incontinence, Urge/physiopathology , Diagnostic Techniques, Urological , Muscle Contraction/physiology , Pain Measurement , Prospective Studies , Perineum/physiopathology , Time Factors , Urination/physiology
11.
Semina cienc. biol. saude ; 31(1): 53-61, jan.-jun.2010. ilus
Article in Portuguese | LILACS | ID: lil-669820

ABSTRACT

O climatério representa a fase em que ocorrem modificações no trato uroginecológico, como a diminuição da força muscular do assoalho pélvico e turgidez uretral. É sugerido que músculos sadios são volumosos e isso os capacita a suportar as paredes da vagina tão bem como prover uma ação esfincteriana, favorecendo o fechamento e a continência uretral. É plausível que o suprimento de sangue associado a músculos fortes promoverá a saúde do epitélio na área, estimulando a lubrificação vaginal adequada e o retardo das mudanças atróficas da idade. O objetivo deste estudo foi verificar a força muscular do assoalho pélvico entre mulheres saudáveis jovens e climatéricas, buscando identificar as alterações existentes nesta musculatura. O estudo foi composto por 49 mulheres dividas em dois grupos: Grupo 1 composto por mulheres (N=24) com média de idade de 29,33 anos e o grupo 2 composto por mulheres (N=25) com média de idade de 51,8 anos, submetidas a avaliação da força muscular do assoalho pélvico por meio de palpação bidigital e perineometria. O presente estudo não identificou diferenças significativas da força de pressão muscular do assoalho pélvico pela perineometria entre os grupos estudados. Na avaliação pela palpação bidigital, notou-se uma capacidade maior de contração voluntária e sustentação desta contração nas mulheres com faixa etária entre 25 a 35 anos..


The menopause represents a stage in life when modifications in the urogynecological tract occur as a decrease in the muscle strength of the pelvic floor and urethral turgidity. It is suggested that healthy muscles are thick and this enables them to support the vagina walls as well as provide a sphincteral action, favoring the closing and urethral continence. It is possible that the blood supply associated to strong muscles will promote the health of the epithelium in the area, stimulating the adequate vaginal lubrication and the delay of atrophic changes due to the age. The purpose of this study was to verify the muscle strength of the pelvic floor among healthy young and climateric women, in order to identify the existing alterations in this musculature. The study consisted of 49 women divided in two groups: Group 1 consisting of women (N=24) with an average age of 29.33 years old and Group 2, consisting of women (N=25) with an average age of 51.8 years old, submitted to the evaluation of the muscle strength of the pelvic floor by means of bidigital palpation and perineometry. Significant differences were not identified concerning the pelvic floor muscle strength by means of the perineometry in the studied groups. As for the bidigital palpation evaluation, a larger capacity of voluntary contraction and sustained maintenance of this contraction in 25 to 35-years old women was observed..


Subject(s)
Humans , Male , Female , Adult , Pelvic Floor , Muscle Strength , Perineum
12.
Rev. bras. cardiol. (Impr.) ; 24(2): 128-130, mar.-abr. 2011.
Article in Portuguese | LILACS | ID: lil-594187

ABSTRACT

Relata-se o caso de uma paciente de 38 anos, com quadro de insuficiência cardíaca (IC) 30 dias após o parto, tratada de forma convencional. Houve necessidade de mudanças na terapia medicamentosa devido a efeitos colaterais e resposta inadequada da pressão arterial. Discutiram-se, à luz da medicina baseada em evidências, as diversas associações medicamentosas e sua segurança, nos casos de cardiomiopatia periparto (CMPP).


This case study addresses a 38-year-old patient who developed heart failure thirty days after delivery. She received conventional treatment, but changeswere required due to adverse effects and inadequate blood pressure response. In the light of evidencebasedmedicine, various drug combinations andtheir safety are discussed, for cases of peripartum cardiomyopathy.


Subject(s)
Humans , Female , Adult , Cardiomyopathy, Dilated/complications , Pregnancy Complications, Cardiovascular/therapy , Drug Utilization , Heart Failure/complications , Risk Factors
13.
Int Urogynecol J ; 21(4): 395-9, 2010 Apr.
Article in English | MEDLINE | ID: mdl-20052573

ABSTRACT

INTRODUCTION AND HYPOTHESIS: Vaginal weight cone (VWC) versus assisted pelvic floor muscle training (APFMT) in the treatment of urinary incontinence (UI) in women. METHODS: One hundred three incontinent women were randomly distributed into two groups: group G1 (n = 51) treated with VWC and G2 (n = 52), APFMT. The following parameters were performed initially and after treatment: (1) clinical questionnaire, (2) visual analogue scale (VAS), (3) 60-min pad test, and (4) subjective and objective assessment of pelvic floor muscle (PFM). RESULTS: There was a significant decrease in nocturia and urine loss after treatment in both groups (p < 0.05). In VAS, there was a significant improvement of all parameters in both groups (p < 0.05). The pad test showed significant decrease in both groups (p < 0.05). There was a significant increase of PFM strength in both groups (p < 0.05). CONCLUSION: There was no difference between groups treated with VWC and APFMT.


Subject(s)
Exercise Therapy/methods , Urinary Incontinence/therapy , Exercise Therapy/instrumentation , Female , Humans , Middle Aged , Single-Blind Method , Treatment Outcome
14.
Cad. psicanál. (Rio J., 1982) ; 25(28): 19-44, 2009.
Article in Portuguese | LILACS | ID: lil-599141

ABSTRACT

Neste artigo são retomadas brevemente as considerações freudianas acerca do mal-estar da civilização para se refletir a clínica contemporânea. Mediante a incidência crescente de pacientes cujo mal-estar apresenta-se pelo vazio do sentimento de Eu e o excesso de roupagens narcísicas, propõe-se o trabalho analítico no registro de uma matriz parental como um modelo necessário.


Some Freudian considerations about the discontent of civilization are briefly resumed in this article to iluminate the contemporary psychoanalytical clinic. To cope with the increasing affluence of patients which discontent is enacted by the feeling of emptiness dressed in narcissistic costumes a parental matrix model of analytical performance is proposed as necessary.


Subject(s)
Narcissism , Psychoanalysis
15.
Cad. psicanál. (Rio J., 1982) ; 25(28): 19-44, 2009.
Article in Portuguese | Index Psychology - journals | ID: psi-48654

ABSTRACT

Neste artigo são retomadas brevemente as considerações freudianas acerca do mal-estar da civilização para se refletir a clínica contemporânea. Mediante a incidência crescente de pacientes cujo mal-estar apresenta-se pelo vazio do sentimento de Eu e o excesso de roupagens narcísicas, propõe-se o trabalho analítico no registro de uma matriz parental como um modelo necessário. (AU)


Some Freudian considerations about the discontent of civilization are briefly resumed in this article to iluminate the contemporary psychoanalytical clinic. To cope with the increasing affluence of patients which discontent is enacted by the feeling of emptiness dressed in narcissistic costumes a parental matrix model of analytical performance isproposed as necessary. (AU)


Subject(s)
Narcissism , Psychoanalysis
16.
Pediatr Transplant ; 10(3): 311-5, 2006 May.
Article in English | MEDLINE | ID: mdl-16677354

ABSTRACT

The selection of donors for living donor liver transplantation (LDLT) is one of the most important features in this kind of surgery. The aim of this study is to describe our initial experience in the donor evaluation process. From December 2001 to January 2005, 104 donors were evaluated for 70 recipients (65 potential donors were evaluated for 39 adult recipients, and 39 donors for 31 pediatric recipients). Only 30 donors were able to donate: 13 for the adult group, and 17 for the pediatric one. In general, the utilization rate of potential donors was 28.8% (30/104). For the adult patients, 65 potential donors were seen to perform 13 LDLT, which represents a utilization rate of potential donors of 20%. For the pediatric patients, this rate was 43.6%. The exclusion criteria were clinical in 22 cases (21%), anatomical in 13 cases (13%), psychosocial in nine cases (9%), and others in 12 (12%). Death of recipients led to exclusion 18 of donors (17%). Thirty-three percent of adults and 55% of pediatric recipients who had at least one potential donor to start the evaluation process were able to identify a living donor. In conclusion, the first limit for LDLT is the rigorous donor evaluation.


Subject(s)
Liver Diseases/therapy , Liver Transplantation/methods , Living Donors , Tissue and Organ Procurement/methods , Adolescent , Adult , Brazil , Child , Developing Countries , Humans , Program Evaluation , Time Factors
17.
Cad. psicanál. (Rio J., 1982) ; 22(25): 15-36, 2006.
Article in Portuguese | LILACS | ID: lil-498872

ABSTRACT

Este artigo pretende discutir, de forma sintética, se a Psicanálise, desde Freud, Klein e seus continuadores, se fez, ou se faz, como um saber à parte, isolado dos demais ramos do conhecimento sobre a natureza humana e o relacionamento social. Articulando os dois eixos permanentes de tensão intra-psíquica (pulsão da vida vs. pulsão de morte) e inter psíquica (indivíduo vs. sociedade), convida à reflexão autocrítica sobre a ética na Psicanálise enquanto um campo de construção e de compartilhamento das diferenças.


Subject(s)
Ethics , Psychoanalysis
18.
Cad. psicanál. (Rio J., 1982) ; 22(25): 15-36, 2006.
Article in Portuguese | Index Psychology - journals | ID: psi-32613

ABSTRACT

Este artigo pretende discutir, de forma sintética, se a Psicanálise, desde Freud, Klein e seus continuadores, se fez, ou se faz, como um saber à parte, isolado dos demais ramos do conhecimento sobre a natureza humana e o relacionamento social. Articulando os dois eixos permanentes de tensão intra-psíquica (pulsão da vida vs. pulsão de morte) e inter psíquica (indivíduo vs. sociedade), convida à reflexão autocrítica sobre a ética na Psicanálise enquanto um campo de construção e de compartilhamento das diferenças(AU)


Subject(s)
Ethics , Psychoanalysis
19.
Semina cienc. biol. saude ; 26(1): 21-30, jan.-jun. 2005. tab
Article in Portuguese | LILACS | ID: lil-429346

ABSTRACT

Na paciente submetida ao tratamento cirúrgico do câncer de mama, o estigma da doença, a mutilição, a estética, a limitação nas atividades da vida diária após a cirurgia, a rotina de exames, o tratamento e das seqüelas de curto e médio prazo não são os únicos problemas apresentados. A ausência ou alteração da mama traz efeitos físicos, psicossociais, sexuais e emocionais que irão afetar diretamente a qualidade de vida dessas pacientes. Este estudo teve por objetivo verificar a qualidade de vida em mulheres mastectomizadas atendidas pelo serviço de fisioterapia da Universidade Estadual de Londrina. Utilizou-se o questionário de qualidade de vida específico para pacientes mastectomizadas, desenvolvido pelo ambulatório de fisioterapia em ginecologia e obstetrícia da Universidade Estadual de Londrina em 2003, aplicado em dois momentos. Notou-se uma diferença estatisticamente significativa na comparação entre a qualidade de vida pré e pós-tratamento fisioterápico (p<0,05). Observou-se que houve melhora da qualidade de vida das pacientes atendidas pela clínica de fisioterapia indicando que o tratamento fisioterápico, conservador, de baixo custo possui benefícios na reabilitação da paciente mastectomizada, sendo necessário mais estudos com uma população maior para afirmaçåo dos resultados.


Subject(s)
Quality of Life , Physical Therapy Specialty , Mastectomy
20.
Article in English | MEDLINE | ID: mdl-15645148

ABSTRACT

The aim of this study was to assess pelvic floor muscle (PFM) strength and perception and its correlation with stress urinary incontinence (SUI). One hundred and one women were divided into two groups according to the presence (G1=51 patients) or absence (G2=50 patients) of SUI. Subjective [urine stream interruption test (UST), visual survey of perineal contraction and transvaginal digital palpation to assess pelvic muscle contraction] and objective evaluations of pelvic floor muscles in all patients were performed (vaginal manometry). During the UST, 25.5% of G1 patients and 80% of G2 patients were able to interrupt the urine stream (p<0.05). Digital evaluation of pelvic muscular contraction showed higher strength in G2 than in G1 patients (p<0.0001). Perineometer evaluation of PFM strength was significantly higher in the continent group (p<0.001). Pelvic floor muscle weakness in incontinent patients demonstrates the importance of functional and objective evaluation of this group of muscles.


Subject(s)
Muscle Contraction/physiology , Pelvic Floor/physiopathology , Urinary Incontinence/physiopathology , Adult , Female , Follow-Up Studies , Humans , Manometry/methods , Middle Aged , Pressure , Prospective Studies , Severity of Illness Index , Single-Blind Method , Vagina/physiopathology
SELECTION OF CITATIONS
SEARCH DETAIL
...