La disfunción sexual femenina, un problema de salud infradiagnosticado

Màster d'Estudis de Dones, Gènere i Ciutadania, Universitat de Barcelona, Facultat de Geografia i Història, any: 2016-2017, Tutores: Carme Bertrán y Dolors JuvinyàEste trabajo de investigación es fruto del interés por querer aprender y dar respuesta a las numerosas dudas y reflexiones planteadas en consulta de fisioterapia. La fisioterapia es una ciencia de la salud definida por la Organización Mundial de la Salud (OMS) desde 1958 como la ciencia del tratamiento a través de medios físicos, ejercicio terapéutico, masoterapia y, según la Confederación Mundial por la Fisioterapia (WCPT), esta profesión sanitaria tiene como objetivo facilitar el desarrollo, mantención y recuperación de la máxima funcionalidad y movilidad del individuo o grupo de personas a través de su vida (WCPT, 2017). Trabajo como fisioterapeuta desde 1996 y estoy especializada en Suelo Pélvico y, sus disfunciones, desde el año 2007. Durante todos estos años he tenido la oportunidad de compartir mi tiempo de trabajo con mujeres que han confiado sus problemas de salud en mi experiencia profesional..

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio