91 research outputs found
The Impact of Lockdown on Couples' Sex Lives
Background: the aim of this study was to perform an Italian telematics survey analysis on the changes in couples' sex lives during the coronavirus disease 2019 (COVID-19) lockdown. Methods: a multicenter cross sectional study was conducted on people sexually active and in stable relationships for at least 6 months. To evaluate male and female sexual dysfunctions, we used the international index of erectile function (IIEF-15) and the female sexual function index (FSFI), respectively; marital quality and stability were evaluated by the marital adjustment test (items 10-15); to evaluate the severity of anxiety symptoms, we used the Hamilton Anxiety Rating Scale. The effects of the quarantine on couples' relationships was assessed with questions created in-house. Results: we included 2149 participants. The sex lives improved for 49% of participants, particularly those in cohabitation; for 29% it deteriorated, while for 22% of participants it did not change. Women who responded that their sex lives deteriorated had no sexual dysfunction, but they had anxiety, tension, fear, and insomnia. Contrarily, men who reported deteriorating sex lives had erectile dysfunctions and orgasmic disorders. In both genders, being unemployed or smart working, or having sons were risk factors for worsening the couples' sex lives. Conclusion: this study should encourage evaluation of the long-term effects of COVID-19 on the sex lives of couples
Clinical and urodynamic findings in women affected by mixed urinary incontinence
The definition of mixed urinary incontinence (MUI) of the International Continence Society exclusively assesses patient-reported symptoms without consideration of physical and urodynamic results, what is inadequate to reliably predict the pathophysiology of the underlying pathology. We investigated and compared clinical and urodynamic findings in women with MUI and assessed predictive variables for the different MUI clinical presentations
Offâlabel long acting injectable antipsychotics in realâworld clinical practice: a cross-sectional analysis of prescriptive patterns from the STAR Network DEPOT study
Introduction: Information on the offâlabel use of LongâActing Injectable (LAI) antipsychotics in the real world is lacking. In this study, we aimed to identify the sociodemographic and clinical features of patients treated with onâ vs offâlabel LAIs and predictors of offâlabel Firstâ or SecondâGeneration Antipsychotic (FGA vs. SGA) LAI choice in everyday clinical practice. Method: In a naturalistic national cohort of 449 patients who initiated LAI treatment in the STAR Network Depot Study, two groups were identified based on offâ or onâlabel prescriptions. A multivariate logistic regression analysis was used to test several clinically relevant variables and identify those associated with the choice of FGA vs SGA prescription in the offâlabel group. Results: SGA LAIs were more commonly prescribed in everyday practice, without significant differences in their onâ and offâlabel use. Approximately 1 in 4 patients received an offâlabel prescription. In the offâlabel group, the most frequent diagnoses were bipolar disorder (67.5%) or any personality disorder (23.7%). FGA vs SGA LAI choice was significantly associated with BPRS thought disorder (OR = 1.22, CI95% 1.04 to 1.43, p = 0.015) and hostility/suspiciousness (OR = 0.83, CI95% 0.71 to 0.97, p = 0.017) dimensions. The likelihood of receiving an SGA LAI grew steadily with the increase of the BPRS thought disturbance score. Conversely, a preference towards prescribing an FGA was observed with higher scores at the BPRS hostility/suspiciousness subscale. Conclusion: Our study is the first to identify predictors of FGA vs SGA choice in patients treated with offâlabel LAI antipsychotics. Demographic characteristics, i.e. age, sex, and substance/alcohol use coâmorbidities did not appear to influence the choice towards FGAs or SGAs. Despite a lack of evidence, clinicians tend to favour FGA over SGA LAIs in bipolar or personality disorder patients with relevant hostility. Further research is needed to evaluate treatment adherence and clinical effectiveness of these prescriptive patterns
Comparing Long-Acting Antipsychotic Discontinuation Rates Under Ordinary Clinical Circumstances: A Survival Analysis from an Observational, Pragmatic Study
Background: Recent guidelines suggested a wider use of long-acting injectable antipsychotics (LAI) than previously, but naturalistic data on the consequences of LAI use in terms of discontinuation rates and associated factors are still sparse, making it hard for clinicians to be informed on plausible treatment courses. Objective: Our objective was to assess, under real-world clinical circumstances, LAI discontinuation rates over a period of 12 months after a first prescription, reasons for discontinuation, and associated factors. Methods: The STAR Network âDepot Studyâ was a naturalistic, multicentre, observational prospective study that enrolled subjects initiating a LAI without restrictions on diagnosis, clinical severity or setting. Participants from 32 Italian centres were assessed at baseline and at 6 and 12 months of follow-up. Psychopathology, drug attitude and treatment adherence were measured using the Brief Psychiatric Rating Scale, the Drug Attitude Inventory and the Kemp scale, respectively. Results: The study followed 394 participants for 12 months. The overall discontinuation rate at 12 months was 39.3% (95% confidence interval [CI] 34.4â44.3), with paliperidone LAI being the least discontinued LAI (33.9%; 95% CI 25.3â43.5) and olanzapine LAI the most discontinued (62.5%; 95% CI 35.4â84.8). The most frequent reason for discontinuation was onset of adverse events (32.9%; 95% CI 25.6â40.9) followed by participant refusal of the medication (20.6%; 95% CI 14.6â27.9). Medication adherence at baseline was negatively associated with discontinuation risk (hazard ratio [HR] 0.853; 95% CI 0.742â0.981; p = 0.026), whereas being prescribed olanzapine LAI was associated with increased discontinuation risk compared with being prescribed paliperidone LAI (HR 2.156; 95% CI 1.003â4.634; p = 0.049). Conclusions: Clinicians should be aware that LAI discontinuation is a frequent occurrence. LAI choice should be carefully discussed with the patient, taking into account individual characteristics and possible obstacles related to the practicalities of each formulation
Human Papillomavirus Infection and Vaginal Tape Exposure after Midurethral Sling: A Case Report
Midurethral tape placement is the gold standard procedure for stress urinary incontinence (SUI). Among reported complications, tape erosion is uncommon. Several risk factors have been postulated as causes of vaginal erosion, but none have been demonstrated. Cases of vaginal erosion caused by tape infections have been described, but none has been associated with human papillomavirus (HPV) infection. We report the first case of vaginal exposure in a woman who underwent a midurethral sling procedure for SUI after HPV colonization
Outcomes of transurethral resection of the prostate in unobstructed patients with concomitant detrusor underactivity
Aims The aim of the study was to evaluate the transurethral resection of the prostate (TURP) outcomes of unobstructed patients with detrusor underactivity (DUA), comparing the surgical results between obstructed and unobstructed males with concomitant DUA, at midterm follow-up. Methods This was an observational, prospective, comparative, nonrandomized study. Candidates to TURP underwent preoperative urodynamics (UD), with a diagnosis of DUA, were divided in two cohorts: Group A unobstructed men, group B males with bladder outlet obstruction (BOO). Males were evaluated yearly with uroflowmetry (UF), post-void residual (PVR), and bladder voiding efficiency (BVE), International Prostate Symptom Score (IPSS) questionnaire, visual analogic scale (VAS) for subjective assessment of the quality of life. The degree of the variation of maximum flow rate (Qmax), PVR, BVE, IPSS, VAS between baseline and follow-up (Delta) was evaluated. Results Patients in group A were 28 and in group B 23. Overall patient's mean +/- SD age was 63.37 +/- 12.41 years. Preoperative urodynamics characteristics: mean bladder contractility index (BCI) of 61.15 and 76.25 in group A and B, respectively; mean bladder outlet obstruction index (BOOI) of 17.25 and 50.15 in group A and group B, respectively. After surgery, overall patient group, group A, and group B showed a statistical improvement in IPSS score (P < .0001), Qmax (P < .0001), PVR (P < .0008), BVE (P < .03) and VAS (P < .0001). Conclusions BOO had an important impact on the degree of improvement of Qmax and PVR/BVE, while had a poor influence on lower urinary tract symptoms amelioration. The most relevant outcomes were found when BOO was associated with DUA, which was not a contraindication to surgery
âLife flourish againâ for San Lazzaro Hospital in Turin. More sustainable colour, less stress.
Physiopathology, diagnosis and therapy of TURP Syndrome.
In this article, the authors analyze a syndrome first described by Creevy in the
1940s, which may occur during a transurethral resection of the prostate (TURP).
The syndrome is characterized by cardiocirculatory and neurological problems due
to rapid changes in intravascular volume and plasma solute concentrations caused
by excess irrigating fluid absorption. This article reviews the available
literature and reports on the experience of our clinic, a specialist department
in the physiopathology, diagnosis, therapy and prevention of TURP syndrome
Linguistic translation and validation of the Arabic version of International Female Coital Incontinence Questionnaire (IFCI-Q)
Objectives: Aim of the study was to translate the International Female Coital Incontinence Questionnaire (IFCI-Q) into Arabic (Egyptian) and validate it into among Egyptian population complaining of coital urinary incontinence (CI). Methods: Original questionnaire has been translated and back-translated by an expert panel, to produce the Arabic version. A pilot study was performed to make sure the questionnaire was understandable. Sixty patients included in the study were divided into two groups: Group A comprised patients with CI, and Group B comprised females who attended the urology clinic for other complaints, without CI. Reliability of the Arabic IFCI-Q was evaluated for internal consistency using Cronbach alpha coefficient. Testâretest reliability was determined using the Weighted Cohenâs k-test. Discrimination validity was evaluated by comparing scores of patients with those of healthy females not complaining of CI using MannâWhitney test. Results: 83.3% of women of both groups (mean age: 43.1 ± 10.6 yrs [Group A], 38.9 ± 8 [Group B] yrs) reported OAB symptoms, 73.3% had stress urinary incontinence and 46.7% reported mixed urinary incontinence. Regarding Group A, 10 patients had CI during penetration, 12 during orgasm and 8 had both forms of CI. The comparison of the responses between Group A and Group B demonstrated a statistically difference (p < 0.00). The content validity was assessed by a panel of expert functional urologists. The Cronbachâs alpha coefficients for the total score were high (0.9â1), indicating high internal consistency. The difference between the two groups revealed an internal consistency of IFCI-Q of 0.563â0.851. The testâretest procedure revealed that the k-values of each item are very good. Conclusions: The Arabic version will allow utilizing this tool in a large population of Arabic-speaking countries, with different ethnic and demographic backgrounds
Is resiniferatoxin better than capsaicin? Literature review
During the last decade many authors addressed their interest to the study of molecules whose therapeutic target was the sensitive side of the micturition reflex, such as resiniferatoxin. It is a vanilloid agent, ultrapotent capsaicin analog, present in the latex of euphorbia resinifera. Despite sharing similar receptors, capsaicin and resiniferatoxin show dissimilar biological actions. Moreover, resiniferatoxin is less irritant than capsaicin and is effective in the treatment of patients with idiopathic detrusor instability or sensory urgency. A brief overview of the chemical structure of resiniferatoxin, the anatomical localisation and function of its receptors, the possible mechanisms of action, the differences with capsaicin and the clinical use of the molecule are provide
- âŠ