Sexual dysfunction in women: population based epidemiological study.

Sexual dysfunction is defined as a disturbance of the processes that characterise the sexual response cycle or as pain associated with sexual intercourse. The objective of this epidemiological study, conducted in a representative sample of the population of women aged 20 and older in Casablanca, Morocco, is to determine the prevalence of sexual dysfunction in women. Criteria of sexual dysfunction followed classification by DSM-IV. The mean age of the sample (n = 728) was 36.76 +/- 12.67 years; 29% had no education, 78% pursued no professional activity; and 58% were married. The main results were that 26.6% had sexual dysfunction always or often during the 6 months before the study. The most common finding was hypoactive sexual desire disorder, and age, financial dependency, number of children, and sexual harassment were positively associated. The prevalence of remaining disorders resembled that found in the literature. Even though these women were aware about their disorder and its negative impact on their lives, only 17% of them asked for help.

[Frequency of improper diagnosis of hypertension]. / Fréquence des diagnostics abusifs de l'hypertension artérielle.

The aim of this work is to estimate the real prevalence of hypertension in a population declared hypertensive by general practitioners. This prospective study has lasted 30 months from October 1994 to March 1997). It has concerned 2,151 patients that had been declared hypertensive by general practitioners. Each patient had 2 visits at 15 days interval. During each visit the blood pressure (BP) is measured 4 times at 5 min interval with a mercury tensiometer. The patient remains supine for 20 min. Patients declared normotensive on these 8 measurements are controlled once every 6 months. Those that are declared hypertensive are distributed in 2 groups: the patients that have a systolic blood pressure (SBP) superior to 160 mm of mercury (mmHg) and/or diastolic blood pressure (DBP) superior to 95 mmHg are treated with the habitual follow-up. Those that have a SBP and DBP between 140-160 mmHg and 90-95 mmHg have a control visit at the end of the first and the third month. After this period patients whose BP remains between 140-160 mmHg and 90-95 mmHg have an ambulatory blood pressure measurement (ABPM). This study included 1,635 women and 516 men. Average age was 54 +/- 11 years. The average of 8 measurements of SBP/DBP was 148.3 +/- 22.5/93 +/- 13 mmHg. After 8 measurements, out of 2,151 patients, 37.8% (841 patients) were declared normotensive and 62.2% (1,337 patients) had a SBP and/or DBP > 140/90 mmHg. This group was controlled after one month and 3 months. A subgroup (254 patients) was declared normotensive, and the 588 patients whose BP remained between 140-160 mmHg and 90-95 mmHg had an ABPM : 481 (48%) were then declared normotensive and 307 (52%) were declared normotensive patients. After repeated controls, with the use of ABPM, only 37.3% were truly hypertensive. This study confirms that a long follow-up is necessary before labelling a patients as hypertensive. BP can remain abnormal for weeks and months. A large group of "hypertensive" patients are normotensive people with a white coat effect or so labelled because of errors in technique or the absence of a sufficient delay so that BP returns to normal.