Disfunciones sexuales femeninas en atención primaria: una realidad oculta / Female sexual dysfunction in primary health care: a hidden reality

Objetivo: Detectar la disfunción sexual femenina y su relación con las distintas etapas de la vida en atención primaria. Material y método: Estudio longitudinal, observacional, abierto y multicéntrico, utilizando el cuestionario validado sobre salud y disfunción sexual femenina (SyDSF). Resultados: Se recogieron 403 cuestionarios de los 638 entregados en los 4 centros de salud participantes en el estudio. Salud sexual: satisfacción sexual, bastante, mucho o muchísimo el 75%; interés por el sexo, algo, un poco o nada el 77,17%; sensaciones placenteras, a veces, casi nunca o nunca el 70,22%; excitación durante la relación, bastante, mucho o muchísimo el 75,7%; dolor durante la relación, nada el 89,03%; alcanza el orgasmo, casi siempre o siempre el 53,59%, dificultades sexuales en pareja, nunca o casi nunca el 84,62%; prescindirían de las relaciones sexuales, nunca o casi nunca el 33,29%, a veces o a menudo el 49,22%; deprimida y nerviosa por problemas sexuales, nunca o casi nunca el 13,15%, a veces o a menudo 82,88%. Desencadenantes de problemas sexuales: enfermedad (síndrome ansioso-depresivo) el 38,61%, embarazo el 20,79%, nacimiento de un hijo el 18,32%, anticonceptivos el 21,78%, toma de fármacos 5,94%, violencia doméstica el 3,47%, problemas de pareja el 35,15%. Más de una causa de las anteriores (17,33%). Conclusiones: Las disfunciones sexuales femeninas son frecuentes y tienen un importante impacto en el contexto sociofamiliar y de pareja de las mujeres, de manera que cuando se presenta una mujer con disfunción sexual en atención primaria se debe indagar acerca de conflictos vitales, de salud, personales o de pareja y realizar un abordaje integral (AU)

Objetive: To detect female sexual dysfunction and its association with the different phases of life in primary health care. Material and method: We performed a longitudinal, observational, open, multicenter study, using a validated questionnaire on female sexual health and dysfunction. Results: Of the 638 questionnaires delivered to the 4 participating health centers, 403 were completed. Sexual health: sexual satisfaction, fair, quite a lot, or a lot 75%; interested in sex, somewhat, a bit, or not at all 77.17%; pleasurable sensations, sometimes, hardly ever, or never 70.22%; excitement during sexual relations, quite a lot or a lot 75.7%; pain during sexual relations, no pain at all 89.03%; reaching orgasm, always or almost always 53.59%; sexual problems in the couple, never or hardly ever 84.62%; would go without sexual relations, never or hardly ever 33.29%, sometimes or often 49.22%; depressed or nervous due to sexual problems, never or hardly ever 13.15%, sometimes or often 82.88%. Causes of sexual problems: illness (anxiety-depression syndrome) 38.61%; pregnancy 20.79%; birth of a child 18.32%; contraceptives 21.78%; taking medication 5.94%; domestic violence 3.45%; problems in the relationship with the partner: 35.15%. More than one of the previous causes (17.33%). Conclusions: Female sexual dysfunction is frequent and has a deep impact on women's relation-ships. Consequently when treating women with sexual dysfunction, primary care physicians should adopt an integral approach and investigate health and personal conflicts, as well as relationship difficulties in the couple (AU)

[Captopril in single doses in the treatment mild-moderated arterial hypertension]. / Captopril en dosis única en el tratamiento de la hipertensión arterial ligera-moderada.

The effect of single dose (50 mg) Captopril (C) used either alone or associated to diuretics (50 mg hydrochlorothiazide -HCTI) in the treatment of mild-moderate essential arterial hypertension was studied in a multicentric study. Eighty eight patients were chosen. After a minimum of 4 month follow-up period 53.4% responded (BDP less than 95 mm Hg) to single dose C (group 1:47 patients), 89.77% to 50 mg C in single dose together with 50 mg HTIT (group 2: 32 patients), 95.45% of two 50 mg doses of C and 50 mg HCIT (group 3: 5 patients), and 97.72% responded to 3 doses of C and 50 mg of HCTI (group 4: 2 patients). The decrease in blood pressure values was statistically significant (p, 000, Wilcoxon test) in groups 1 and 2, having a mean decrease in blood pressure (BP) of 14%. In group 1 (n = 42) the SBP which initially was 165.72 +/- 11.32, decreased to 148.28 +/- 11.5 and the DBP decreased from 101.55 +/- 5.68 to 87.28 +/- 6.59. In group 2 (n = 32) the SBP decreased from 173.50 +/- 14.08 to 152.44 +/- 20.8 and the DBP from 103.34 +/- 5.29 to 87.47 +/- 6.39. The response to monotherapy could not be statistically correlated either to early essential hypertension or to the patients age. Treatment was discontinued in three cases due to the secondary effects, cough, ageusia and nervousness, showing the remaining patients a good tolerance. No changes were observed in the analytical parameters. This study shows the usefulness and tolerance of single dose C as the initial treatment of mild to moderate essential hypertension.