Female Sexual Function and Its Association with the Severity of Menopause-Related Symptoms.

The aim of this study was to examine female sexual functioning and its association with the impact of the symptoms of menopause among Spanish postmenopausal women. A total of 182 postmenopausal women (65.59 ± 7.93 years) participated in this cross-sectional study. The female sexual function index (FSFI) and the menopause rating scale (MRS) were used to analyze sexual function and severity of menopausal symptoms, respectively. Age, education, area of residence, occupation, and depression (Hospital Anxiety and Depression Scale) were considered as possible confounders. The results of a linear multivariate regression analysis showed that the severity of urogenital menopause-related symptoms was associated with lower values in the FSFI total score and the lubrication, satisfaction, arousal, and orgasm domains. These last three subscales were also linked to severe psychological impact, while the MRS total score was only related to the desire domain. Regarding confounders, being younger, working, and residing in a rural area were all linked to better sexual function. All effect sizes were large (adjusted R2 > 0.35). In conclusion, after controlling for possible confounders, postmenopausal women who experience a severe impact of menopausal symptoms endure poorer sexual function, particularly when said symptoms are urogenital or psychological in nature.

Effects of Pilates on fall risk factors in community-dwelling elderly women: A randomized, controlled trial.

OBJECTIVE: the main objective was to analyze the effects that an exercise programme based on the Pilates method would have on balance confidence, fear of falling, and postural control among women ≥60 years old. METHODS: a total of 110 women (69.15 ± 8.94 years) participated in this randomized, controlled trial that took place in Jaén (Spain). The participants were randomly assigned to either a control group (n = 55), which received no intervention, or to a Pilates group (n = 55), which carried out an exercise programme based on the Pilates method in 60-minute sessions for 12 weeks. The Falls Efficacy Scale-International and the activity-specific balance confidence scale were respectively used to assess fear of falling and balance confidence in performing activities of daily living. Postural control was evaluated using a stabilometric platform. RESULTS: Regarding balance confidence, the Pilates group showed higher values compared to the control group (77.52 ± 18.27 vs 72.35 ± 16.39, Cohen's d = 0.030). Women in the Pilates group showed lower fear of falling, compared to those of the control group (22.07 ± 5.73 vs 27.9 ± 6.95, Cohen's d = 0.041). Finally, concerning static balance, participants of the Pilates group experienced statistically significant improvements on the velocity and anteroposterior movements of the centre of pressure with eyes open and closed respectively (Cohen's d = 0.44 and 0.35 respectively). CONCLUSION: A 12-week Pilates training programme has beneficial effects on balance confidence, fear of falling and postural stability, in elderly women.

The female sexual function index: reliability and validity in Spanish postmenopausal women.

OBJECTIVE: To examine the reliability and validity of the Spanish version of the Female Sexual Function Index (FSFI) and its ability to discriminate between women with and without female sexual dysfunction (FSD) among Spanish postmenopausal women. METHODS: A total of 152 postmenopausal women completed the Spanish version of FSFI. Internal consistency, test-retest reliability, and construct validity (exploratory factor analysis) were analyzed. Concurrent and divergent validity were assessed using a visual analog scale for overall satisfaction with sexual life and the Hospital Anxiety and Depression Scale, respectively. To determine the ability and the accuracy of the FSFI total score in discriminating between women with and without FSD, a receiver-operating characteristic curve analysis was performed. RESULTS: Factor analysis suggested a three-factor structure (explained variance 77.77%). The Spanish FSFI showed substantial-to-excellent test-retest reliability, with good internal consistency in the FSFI total score (Cronbach's alpha = 0.964), and also in its three dimensions. The FSFI total and domains scores showed strong (r > 0.50) and significant correlations (P < 0.01) with overall satisfaction with sexual life (concurrent validity), and low correlations with anxiety and depression (divergent validity). The Spanish FSFI total score and dimensions were significantly able to discriminate between women with and without FSD (P < 0.05), with an optimal cut-off point of <24.95 for the FSFI total score (64.15% sensitivity and 75.76% specificity). CONCLUSIONS: The Spanish FSFI is a valid and reliable instrument for assessing and discriminating for FSD among Spanish postmenopausal women.

Comparación de la efectividad de la pulsioximetría y el electrocardiograma fetal en las situaciones de riesgo de pérdida de bienestar fetal / Comparison of the effectiveness of fetal pulse oximetry and fetal electrocardiogram in intrapartum risk of loss of fetal well- being

Objetivo. Evaluar la eficacia de la pulsioximetría y el electrocardiograma fetal en la conducción del parto con registro de frecuencia cardíaca fetal compatible con riesgo de pérdida del bienestar fetal (RPBF).Sujetos y métodosSe trataba de un estudio experimental aleatorizado abierto con dos brazos; en uno se aplicó la técnica de la pulsioximetría y en el otro la técnica STAN®. En cada grupo se incluyó a 40 gestantes con feto único, gestación a término, en presentación cefálica y registro cardiotocográfico (RCTG) compatible con RPBF. Se analizaron las variables: tasa total de cesáreas, indicaciones basadas en el RPBF y las repercusiones en el equilibrio ácido-base neonatal.ResultadosNo se han obtenido diferencias significativas en cuanto a la tasa de cesáreas (el 47,5 frente al 40%; p=0,33) ni a la indicación por RPBF (el 32,5 frente al 37,5%; p=0,41). Tampoco en los resultados neonatales.ConclusionesLa utilización de la pulsioximetría y STAN(R)21, como métodos auxiliares del RCTG; no han demostrado ser superiores en lo que se refiere a descenso de la tasa de cesáreas o mejoría del bienestar fetal (AU)

Objective. To evaluate the effectiveness of pulse oximetry and fetal electrocardiogram in the management of labor with fetal heart rate patterns associated with a risk of loss of fetal well-being.Subjects and methodsWe performed an open, randomized, experimental trial with two groups: pulse oximetry was used in one group and the STAN® technique was used in the other. Each group included 40 women with single, term pregnancies in cephalic presentation and fetal heart rate patterns associated with a risk of loss of fetal well-being. The overall cesarean section rate, indications of risk of fetal distress, and neonatal acid-base balance were evaluated.ResultsNo significant differences were found in the rate of cesarean section (47.5 vs 40%; P=.33), indications of risk of fetal distress (32.5 vs 37.5%; P=.41), or neonatal outcomes.ConclusionsThe use of pulse oximetry and STAN(R)21, as auxiliary methods to cardiotocographic recording, showed no superiority in reducing the cesarean section rate or improving neonatal outcomes (AU)

Embarazo ectópico: de la cirugía de urgencia al tratamiento médico. Evolución de la terapéutica en nuestro centro / Ectopic pregnancy: from emergency surgery to medical treatment. Changing trends in treatment in our center

Objetivo: Analizar la evolución de las distintasmodalidades en el tratamiento del embarazoectópico durante los últimos 9 años.Material y métodos: Se realizó un estudioretrospectivo de 355 casos de embarazo ectópicotratados en el Hospital Universitario Virgen de lasNieves durante el período comprendido entre 1998y 2006. Se analizaron los cambios ocurridos en lasdistintas actitudes terapéuticas durante ese intervalo.Resultados: El tratamiento médico se inició en139 (39,15%) casos, con una tasa de fracasos del10,07%. El tratamiento quirúrgico se realizó en 230(60,85%) mujeres: en 121 casos se practicó cirugíala paroscópica y en 109 una laparotomía.Conclusiones: La cirugía laparoscópica es en laactualidad la primera opción terapéutica en elembarazo ectópico tubárico, a pesar de que enestos últimos años se ha demostrado la seguridad yeficacia del tratamiento médico, posibilitando unaactitud menos agresiva

Objective: To analyze changing trends in themanagement of ectopic pregnancy in the previous9 years.Material and methods: We performed aretrospective study of 355 patients with ectopicpregnancy treated at the Virgen de las NievesUniversity Hospital from 1998 to 2006. Wereviewed and analyzed changes in treatment trendsover this 9-year period.Results: Medical treatment was initiated in 139patients (39.15%), with a failure rate of 10.07%.Surgery was performed in 230 women (60.85%).Of these, laparoscopy was performed in 121 andlaparotomy in 109.Conclusions: Laparoscopic surgery is currently thefirst-line therapeutic option in the management oftubal ectopic pregnancy. However, in the last fewyears, medical treatment has been shown to be safeand effective, allowing a less invasive approach