Sexual dysfunction worsens both the general and specific quality of life of women with irritable bowel syndrome. A cross-sectional study.

BACKGROUND: Irritable bowel syndrome (IBS) and sexual dysfunction (SxD) lowers quality of life (QOL) separately, but the effect of their overlap in unselected populations has not been studied. OBJECTIVE: To evaluate the QOL of IBS women with and without SxD and compare it with controls. METHODS: In this cross-sectional assessment, we studied 51 IBS women (Rome IV criteria) and 54 controls. SxD was determined using the female sexual function index questionnaire. QOL was evaluated by the Short Form 36 (SF-36) and IBS-QOL questionnaires. RESULTS: SxD prevalence was similar between IBS women (39.22%) and controls (38.89%). Compared with other groups, IBS patients with SxD showed lower scores in all domains as well as in the physical, mental summaries of the SF-36 and almost all domains (except for body image, food avoidance, and social reaction compared with IBS patients without SxD) and the total score of IBS-QOL. CONCLUSIONS: These findings show that SxD worsens both general and specific QOL of women with IBS. The consideration of SxD in patients with IBS will allow us to make a more effective diagnostic and therapeutic approach. Clinical trial registry in Mexico City General Hospital: DI/19/107/03/080. CLINICAL TRIALS REGISTRATION: NCT04716738.

Rectal tone and compliance affected in patients with fecal incontinence after fistulotomy.

AIM: To investigate the anal sphincter and rectal factors that may be involved in fecal incontinence that develops following fistulotomy (FIAF). METHODS: Eleven patients with FIAF were compared with 11 patients with idiopathic fecal incontinence and with 11 asymptomatic healthy subjects (HS). All of the study participants underwent anorectal manometry and a barostat study (rectal sensitivity, tone, compliance and capacity). The mean time since surgery was 28 ± 26 mo. The postoperative continence score was 14 ± 2.5 (95%CI: 12.4-15.5, St Mark's fecal incontinence grading system). RESULTS: Compared with the HS, the FIAF patients showed increased rectal tone (42.63 ± 27.69 vs 103.5 ± 51.13, P = 0.002) and less rectal compliance (4.95 ± 3.43 vs 11.77 ± 6.9, P = 0.009). No significant differences were found between the FIAF patients and the HS with respect to the rectal capacity; thresholds for the non-noxious stimuli of first sensation, gas sensation and urge-to-defecate sensation or the noxious stimulus of pain; anal resting pressure or squeeze pressure; or the frequency or percentage of relaxation of the rectoanal inhibitory reflex. No significant differences were found between the FIAF patients and the patients with idiopathic fecal incontinence. CONCLUSION: In patients with FIAF, normal motor anal sphincter function and rectal sensitivity are preserved, but rectal tone and compliance are impaired. The results suggest that FIAF is not due to alterations in rectal sensitivity and that the rectum is more involved than the anal sphincters in the genesis of FIAF.

Mortality risk from squamous cell skin cancer.

PURPOSE: To identify nonmelanoma skin cancer patients with squamous cell carcinoma (SCC) who are at greatest risk of disease-specific mortality. PATIENTS AND METHODS: Prospectively enrolled patients with a minimum of one pathologically confirmed skin SCC lesion, definitive treatment of the SCC lesion(s) resulting in no evidence of disease, and at least 2 months of follow-up after definitive treatment were eligible for the present longitudinal analysis. They received comprehensive clinical, pathologic evaluations and follow-up for patterns of failure and mortality. RESULTS: We enrolled 210 patients (187 men and 23 women) with a total of 277 skin SCC lesions and a median enrollment age of 68 years (range, 34 to 95 years). Median follow-up of surviving patients was 22 months. Three-year overall and disease-specific survival (DSS) rates were 70% and 85%, respectively. In univariate analyses, the clinical-pathologic factors associated with adverse DSS were local recurrence at presentation (P = .05), invasion beyond subcutaneous tissues (P = .009), perineural invasion (P = .002), lesion size (P = .0003), and depth of invasion (P = .05). Statistical models identified a homogeneous high-risk group of patients with lesions > or = 4 cm, perineural invasion, and deep invasion beyond subcutaneous structures. Three-year DSS was 100% for patients with no risk factors versus 70% for patients with at least one risk factor. CONCLUSION: Lesion size > or = 4 cm and histologic evidence of perineural invasion and deep invasion beyond subcutaneous structures were the clinical-pathologic factors most significantly associated with disease-specific mortality in skin SCC.

A fisioterapia respiratória e o processo de hospitalização criança-mãe / Respiratory physiotherapy and mother/child hospitalization

A maneira de abordar a criança no processo de saúde-doença tem mudado muito em decorrência de resultados de pesquisas nas áreas da saúde médica, humana e social. O processo de hospitalização nas unidades de enfermaria pediátrica não envolve somente a criança, mas também sua mãe que muitas vezes ao acompanhá-la, internando-se junto a ela, desestrutura totalmente uma família deixando em segundo plano seus outros filhos e marido. Para um melhor sucesso no tratamento fisioterápico e menor recidiva na internação dessas crianças, a relação mãe–filho precisa estar estabelecida e fortalecida, fazendo com que essa mãe adquira responsabilidades no seguimento do tratamento de seu filho, ajudando a mantê-lo sempre que possível em tratamento domiciliar e/ou ambulatorial, estando sempre mais presente na construção de um futuro mais esperançoso e, acima de tudo, melhorando a sua qualidade de vida(AU)

A fisioterapia respiratória e o processo de hospitalização criança-mãe / Respiratory physiotherapy and mother/child hospitalization

A maneira de abordar a criança no processo de saúde-doença tem mudado muito em decorrência de resultados de pesquisas nas áreas da saúde médica, humana e social. O processo de hospitalização nas unidades de enfermaria pediátrica não envolve somente a criança, mas também sua mãe que muitas vezes ao acompanhá-la, internando-se junto a ela, desestrutura totalmente uma família deixando em segundo plano seus outros filhos e marido. Para um melhor sucesso no tratamento fisioterápico e menor recidiva na internação dessas crianças, a relação mãeûfilho precisa estar estabelecida e fortalecida, fazendo com que essa mãe adquira responsabilidades no seguimento do tratamento de seu filho, ajudando a mantê-lo sempre que possível em tratamento domiciliar e/ou ambulatorial, estando sempre mais presente na construção de um futuro mais esperançoso e, acima de tudo, melhorando a sua qualidade de vida