Psychosocial Factors Associated With Vulvodynia.

OBJECTIVES: We set out to identify the psychosocial factors associated with vulvodynia and the effects on sexuality, mental health, and quality of life. MATERIALS AND METHODS: PubMed, LILACS, Embase, CINAHL, Web of Science, Scopus, and PsycINFO were searched in August 2023. Two authors selected and extracted the data independently. The risk of bias was assessed using the Newcastle-Ottawa Scale for Observational Studies. To rank the strength of evidence, the Grading of Recommendations Assessment, Development and Evaluation Working Group (GRADE) approach was utilized. RESULTS: A total of 3,182 articles were identified. Twenty-two observational studies (8 cohorts and 14 case-controls) met the eligibility criteria and were included, comprising 2,624 patients. Vulvodynia has been associated with psychological factors (anxiety and depression) and social factors (childhood exposure to physical and sexual abuse, posttraumatic stress, and domestic abuse). Concerning sexual function, the most frequent outcomes were dyspareunia and sexual dysfunction. Only one study assessed quality of life, which showed that women with chronic vulvar pain had greater difficulty performing physical activities and experienced negative moods and feelings. The assessment of the risk of bias showed that the average quality of studies was good to excellent. However, the studies failed to select the nonexposed cohort or control group to describe the results, and often, the study population was rather small, which made it impossible to carry out a meta-analysis. CONCLUSIONS: The certainty of evidence for the associations between anxiety and depression, vulvodynia, and sexual functioning suggests that combating these factors could improve overall quality of life in vulvodynia patients.

Mobile applications for sexual encounters accessed by men who have sex with men: Information on sexually transmitted infection.

We evaluated existing mobile applications (apps) on both Android and iOS (Apple) platforms that are used by men who have sex with men (MSM) to obtain sexual encounters. The word "gay" was used to search for apps in the Apple and Google Play virtual stores. The 10 most downloaded apps were analysed concerning safe sexual practices (SSP) messages. Out of 245 apps selected, 213 were evaluated - 102 for Android and 111 for iOS. Mostly social networks were accessed by MSM of which 112 allow access to people aged 14 and over. Most of the apps could be downloaded in more than two languages. Of the 10 most downloaded and evaluated apps, 5 had no HIV/STI and SSP messages, only 3 contained HIV/STI and SSP messages, and 2 had information about one or the other. Several social networking apps are available, however, there is no information on HIV/STI in the most accessed apps.

Use of dating sites and applications by women and their risk of sexually transmitted infections: a systematic review and meta-analysis protocol.

INTRODUCTION: The use of social networks has been increasing worldwide. Mobile websites and applications (apps) allow people to network more quickly and have more partners for sex. This can facilitate risky sexual behaviours, such as having multiple partners and unprotected sex, which can lead to a higher incidence of sexually transmitted infections. This systematic review/meta-analysis will assess the effects of the use of dating sites and apps by women on their level of engagement in risky sexual behaviours and their incidence of sexually transmitted infections. METHODS AND ANALYSIS: The Cochrane Central Controlled Trials Registry, ClinicalTrials.gov, MEDLINE, Embase, SciELO, Web of Science, Scopus and Cumulative Index to Nursing & Allied Health Literature will be searched for cross-sectional studies, clinical trials and observational studies published between January 1990 and July 2020. This systematic review and meta-analysis will include studies investigating the use of mobile apps by women, risky sexual behaviour and sexually transmitted infections. The outcome will be an increase in new cases of sexually transmitted infections and HIV among women using dating sites and apps. Three independent reviewers will select the studies and extract data from the original articles. The risk of bias will be assessed using the Cochrane risk of bias tool and Risk Of Bias in Non-randomized Studies of Interventions. Data synthesis will be performed using Review Manager software (RevMan V.5.2.3). To assess heterogeneity, we will compute the I2 statistic. In addition, a quantitative synthesis will be carried out if the included studies are sufficiently homogeneous. ETHICS AND DISSEMINATION: This study will be a review of the published data, and thus ethical approval is not required. The findings of this systematic review will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42019120494.

Impact of mobile applications on adherence to cancer treatment: a systematic review and meta-analysis protocol.

INTRODUCTION: The number of patients taking oral chemotherapy is increasing around the world. It is essential to maximise the adherence to oral chemotherapy to improve the overall survival and life expectancy of the patients. In this systematic review and meta-analysis, we aim to evaluate the effectiveness of mobile applications in improving the adherence to oral chemotherapy and adjuvant hormonal therapy in cancer survivors. METHODS AND ANALYSIS: MEDLINE, Embase, LILACS, clinicaltrials.gov, Scopus and the Cochrane Central Register of Controlled Trials will be searched for randomised or quasi-experimental studies published between January 2009 and July 2019. This systematic review and meta-analysis will include studies investigating the use of mobile applications by cancer survivors to aid adherence to oral chemotherapy and adjuvant hormonal therapy. Patient education, reminder tools, calendars, pillboxes and electronic reminders will not be evaluated. The primary outcome will be the improvement in adherence to anticancer drugs. The secondary outcomes will be an improvement in the overall survival and life expectancy, improved quality of life and control of cancer-related symptoms. Three independent reviewers will select the studies and extract data from the original publications. The risk-of-bias will be assessed using the Cochrane risk-of-bias tool. Data synthesis will be performed using the Review Manager software (RevMan V.5.2.3). To assess heterogeneity, we will compute the I2 statistics. Additionally, a quantitative synthesis will be performed if the included studies are sufficiently homogenous. ETHICS AND DISSEMINATION: This study will be a review of the published data, and thus, ethical approval is not required. Findings of this systematic review will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42018102172.

Assessment of mobile phone applications for care management in gynecology and obstetrics.

We identified mobile applications (apps) found on digital platforms (iTunes Store and Google Play) that addressed topics about gynecology and obstetrics.

Pain and quality of life in breast cancer patients

OBJECTIVE: To evaluate the influence of pain on quality of life in breast cancer patients. METHODS: A cross-sectional study of 400 patients, including 118 without metastasis, 160 with loco-regional metastasis and 122 with distant metastasis. The instruments used were the European Organization for Research and Treatment for Cancer Quality of Life Questionnaire-Core 30 and the Breast Cancer-specific 23 and short McGill Pain Questionnaire. RESULTS: In total, 71.7% of patients reported pain. The most frequent sensory descriptor used by patients was 'jumping.' In the evaluative dimension, the main descriptor chosen was troublesome. The Global Health self-assessment showed pain to be inversely correlated with quality of life: the group without metastasis had a mean score of 55.3 (SD=24.8) for those in pain, which rose to 69.7 (SD=19.2) for those without pain (p=0.001). Subjects with loco-regional metastasis had score of 59.1 (SD=21.3) when in pain, and those without pain had a significantly higher score of 72.4 (SD=18.6) (p<0.001). Patients from the distant metastasis group showed similar results with a mean score of 48.6 (SD=23.1) for those in pain and 67.6 (SD=20.4) for those without pain (p=0.002). Regarding the association of pain intensity and quality of life, patients with distant metastasis and intense pain had the worst scores for quality of life with a functional scale mean of 49.9 (SD=17.3) (p<0.009), a Symptom Scale score of 50.0 (SD=20.1) (p<0.001) and a Global Health Scale score of 39.7 (SD=24.7) (p<0.006). CONCLUSIONS: Pain compromises the quality of life of patients with breast cancer, particularly those with advanced stages of the disease.

Correlação entre vaginose bacteriana e desfechos obstétricos desfavoráveis em mulheres brasileiras / Correlation between bacterial vaginosis and adverse obstetric outcomes in Brazilian women

Infecções vaginais e mudanças na flora vaginal são prevalentes durante a gravidez e têm sido associadas com desfechos obstétricos adversos, tais como trabalho de parto prematuro, amniorrexe prematura e baixo peso ao nascer. Objetivos: Correlacionar a presença de vaginose bacteriana (VB) com desfecho obstétrico desfavorável em mulheres brasileiras com gravidez no terceiro trimestre. Métodos: O estudo prospectivo observacional foi conduzido avaliando microbiota vaginal por bacterioscopia (a fresco e Gram) usando swab vaginal obtido de mulheres grávidas entre a 26 e a 32a semanas de gestação. As mulheres foram monitoradas até o parto, e os dados de seu seguimento e os demográficos foram coletados por meio de um questionário autoaplicável. Resultados: Foi diagnosticada VB, com base nos critérios de Amsel e de Nugent, em 77 mulheres entre as 190, demonstrando prevalência de 42.5%. VB foi significativamente associada com maior risco de parto prematuro (risk ratio [RR], 2.89; 95% intervalo de confiança [IC], 2.35­3.56) e de baixo peso ao nascer (RR, 2.17; 95%IC, 1.61­2.92). A rotura prematura das membranas não foi associada com VB. Conclusão: Foi constatada alta frequência de VB entre as mulheres brasileiras grávidas no terceiro trimestre, e a BV correlacionou-se com piores prognósticos da gravidez. O rastreio rotineiro de mulheres grávidas pode permitir um tratamento precoce e a prevenção de algumas complicações obstétricas

Vaginal infections and modifications in the vaginal flora are very prevalent during pregnancy and have been associated with adverse obstetric outcomes, such as preterm labor, preterm premature rupture of membranes and low birth weight. Objective: To evaluate the prevalence and associations of bacterial vaginosis (BV) and pregnancy outcomes among Brazilian pregnant women in the third trimester. Methods: A prospective observational study was conducted assessing vaginal microbiota on bacterioscopy (wet mount and Gram stain), using vaginal swabs obtained from pregnant women between 26 and 32 weeks' gestation. The women were monitored until delivery, and their pregnancy outcome and demographic data were collected using an interviewer-administered questionnaire. Results: BV was assessed using both Amsel's criteria and Nugent's score in 77 of 190 women, resulting in the prevalence of 42.5%. BV was significantly associated with preterm labor (risk ratio [RR], 2.89; 95% confidence interval [CI], 2.35­3.56) and low birth weight (RR, 2.17; 95%CI, 1.61­2.92). Premature rupture of membranes was not associated with BV. Conclusion: BV was found to be very frequent among Brazilian pregnant women in the third trimester and correlated to unfortunate pregnancy outcomes. Regular screening of pregnant women may allow for early treatment and prevention of some obstetric complications.

Pain and quality of life in breast cancer patients.

OBJECTIVE: To evaluate the influence of pain on quality of life in breast cancer patients. METHODS: A cross-sectional study of 400 patients, including 118 without metastasis, 160 with loco-regional metastasis and 122 with distant metastasis. The instruments used were the European Organization for Research and Treatment for Cancer Quality of Life Questionnaire-Core 30 and the Breast Cancer-specific 23 and short McGill Pain Questionnaire. RESULTS: In total, 71.7% of patients reported pain. The most frequent sensory descriptor used by patients was 'jumping.' In the evaluative dimension, the main descriptor chosen was troublesome. The Global Health self-assessment showed pain to be inversely correlated with quality of life: the group without metastasis had a mean score of 55.3 (SD=24.8) for those in pain, which rose to 69.7 (SD=19.2) for those without pain (p=0.001). Subjects with loco-regional metastasis had score of 59.1 (SD=21.3) when in pain, and those without pain had a significantly higher score of 72.4 (SD=18.6) (p<0.001). Patients from the distant metastasis group showed similar results with a mean score of 48.6 (SD=23.1) for those in pain and 67.6 (SD=20.4) for those without pain (p=0.002). Regarding the association of pain intensity and quality of life, patients with distant metastasis and intense pain had the worst scores for quality of life with a functional scale mean of 49.9 (SD=17.3) (p<0.009), a Symptom Scale score of 50.0 (SD=20.1) (p<0.001) and a Global Health Scale score of 39.7 (SD=24.7) (p<0.006). CONCLUSIONS: Pain compromises the quality of life of patients with breast cancer, particularly those with advanced stages of the disease.

Prevalence of Sexual Dysfunction among Expectant Women.

Purpose To identify pregnancy as a causative factor of sexual dysfunction among expectant women. Methods A prospective study with 225 expectant mothers seen in the prenatal clinic of a federal university. Sexual function was evaluated by means of the Female Sexual Function Index (FSFI), and all domains were analyzed (desire, arousal, lubrication, orgasm, satisfaction, and pain). Initially, a univariate analysis of the sample was done. The averages for each domain according to the risk of sexual dysfunction (FSFI ≤ 26.5) were compared using the Student's t-test for independent samples. The strength of the correlation between sexual dysfunction and all sociodemographic, clinical and behavioral variables was measured by the Chi-Square (χ2) test. Then, odds ratios (ORs) and their confidence intervals were assigned to perform a bivariate analysis. Any p values less than 0.05 were considered significant. Results Approximately two-thirds of the women (66.7%) showed signs of risk of sexual dysfunction (FSFI ≤ 26.5). Within these cases, all sexual dysfunction domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) were found to be statistically significant (p < 0.001). The domains most affected were desire (2.67), satisfaction (2.71) and arousal (2.78). Conclusions Pregnancy appears to be an important causative factor of sexual dysfunction among pregnant women.

Prevalence of Sexual Dysfunction among Expectant Women / Prevalência de disfunção sexual entre mulheres grávidas

Abstract Purpose To identify pregnancy as a causative factor of sexual dysfunction among expectant women. Methods A prospective study with 225 expectant mothers seen in the prenatal clinic of a federal university. Sexual function was evaluated by means of the Female Sexual Function Index (FSFI), and all domains were analyzed (desire, arousal, lubrication, orgasm, satisfaction, and pain). Initially, a univariate analysis of the sample was done. The averages for each domain according to the risk of sexual dysfunction (FSFI ≤ 26.5) were compared using the Student’s t-test for independent samples. The strength of the correlation between sexual dysfunction and all sociodemographic, clinical and behavioral variables was measured by the Chi-Square (X2) test. Then, odds ratios (ORs) and their confidence intervals were assigned to perform a bivariate analysis. Any p values less than 0.05 were considered significant. Results Approximately two-thirds of the women (66.7%) showed signs of risk of sexual dysfunction (FSFI ≤ 26.5). Within these cases, all sexual dysfunction domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) were found to be statistically significant (p < 0.001). The domains most affected were desire (2.67), satisfaction (2.71) and arousal (2.78). Conclusions Pregnancy appears to be an important causative factor of sexual dysfunction among pregnant women.

Resumo Objetivo Identificar a gravidez como fator causador de disfunção sexual entre mulheres gestantes. Métodos Estudo prospectivo com 225 gestantes atendidas no ambulatório de prénatal de uma universidade federal. A função sexual foi avaliada por meio do Female Sexual Function Index (FSFI), e todos os domínios foram analisados (desejo, excitação, lubrificação, orgasmo, satisfação e dor). Inicialmente, uma análise univariada da amostra foi feita. As médias para cada domínio de acordo com o risco de disfunção sexual (FSFI ≤ 26,5) foram comparadas pelo teste t de Student para amostras independentes. A força da correlação entre a disfunção sexual e todas as variáveis sociodemográficas, clínicas e comportamentais foi medida pelo teste do qui-quadrado (X2). A partir desta perspectiva, foram aferidos os odds ratios (ORs) e seus respectivos intervalos de confiança para a análise bivariada. Quaisquer valores de p inferiores a 0,05 foram considerados significativos. Resultados Cerca de dois terços das mulheres (66,7%) mostraram sinais de risco de disfunção sexual (FSFI ≤ 26,5). Dentro destes casos, todos os domínios de disfunção sexual (desejo, excitação, lubrificação, orgasmo, satisfação e dor) foram estatisticamente significativos (p < 0,001). Os domínios mais afetados foram o desejo (2,67), a satisfação (2,71) e a excitação (2,78). Conclusões A gravidez parece ser um importante fator causador de disfunção sexual entre mulheres gestantes.