Bad sleeping quality in patients receiving HAART

El manejo de un paciente infectado por el virus de inmunodefi ciencia humana (VIH) implica un enfoque multidisciplinario que incluya diversas esferas de la salud de la persona1. Sin embargo, en muchas oportunidades la evaluación se centra en marcadores meramente biológicos descuidando aspectos de índole psicológico y social que tendrían importante repercusión en la calidad de vida de estos pacientes. Dentro de ellos, las alteraciones del sueño (AS), son un factor a considerar, más aún cuando han demostrado tener un impacto negativo en la calidad de vida de las personas2, asimismo, un incremento de la probabilidad de desarrollo de diabetes mellitus, enfermedad cardiovascular y dolencias respiratorias.Revisión por pare

Low genitourinary tract risks in women living with the human immunodeficiency virus

This review analyzes the clinical associations between specific low genitourinary tract clinical circumstances in perimenopausal and postmenopausal women living with human immunodeficiency virus (WLHIV). Modern antiretroviral therapy (ART) improves survival and reduces opportunistic infections and HIV transmission. Despite appropriate ART, WLHIV may display menstrual dysfunction, risk of early menopause, vaginal microbiome alterations, vaginal dryness, dyspareunia, vasomotor symptoms and low sexual function as compared to women without the infection. They have increased risks of intraepithelial and invasive cervical, vaginal and vulvar cancers. The reduced immunity capacity may also increase the risk of urinary tract infections, side-effects or toxicity of ARTs, and opportunistic infections. Menstrual dysfunction and early menopause may contribute to the early onset of vascular atherosclerosis and plaque formation, and increased osteoporosis risks requiring specific early interventions. On the other hand, the association between being postmenopausal and having a low sexual function is significant and related to low adherence to ART. WLHIV deserve a specific approach to manage different low genitourinary risks and complications related to hormone dysfunction and early menopause

Type II diabetes mellitus and menopause: a multinational study

Background Type II diabetes mellitus causes metabolic changes that may lead to early menopause and worsen climacteric symptoms. Objectives To determine the risk factors for type II diabetes mellitus and assess the impact of this disease on the age of menopause and on climacteric symptoms. Methods A total of 6079 women aged between 40 and 59 years from 11 Latin American countries were requested to answer the Menopause Rating Scale and Goldberg Anxiety-Depression Scale. Results The prevalence of diabetes was 6.7%. Diabetes mellitus was associated with arterial hypertension (odds ratio (OR) 4.49; 95% confi dence interval (CI) 3.47 – 5.31), the use of psychotropic drugs (OR 1.54; 95% CI 1.22 – 1.94), hormonal therapy (OR 1.46; 95% CI 1.11 – 1.92), 50 years of age (OR 1.48; 95% CI 1.17 – 1.86), overweight or obese (OR 1.47; 95% CI 1.15 – 1.89), and waist circumference 88 cm (OR 1.32; 95% CI 1.06 – 1.65). Factors associated with lower risk of diabetes were the use of hormonal contraceptives (OR 0.55; 95% CI 0.35 – 0.87), alcohol (OR 0.73; 95% CI 0.54 – 0.98) and living in cities 2500 meters above sea level (OR 0.70; 95% CI 0.53 – 0.91) or with high temperatures (OR 0.67; 95% CI 0.51 – 0.88). In turn, diabetes tripled the risk of menopause in women under 45 years of age. Diabetes did not increase the risk of deterioration of quality of life due to climacteric symptoms. Conclusion Menopause does not increase the risk of type II diabetes mellitus. Diabetes is associated with early menopause in women under 45 years of age

Sexual Dysfunction Risk and Associated Factors in Young Peruvian University Women

This study was an MD thesis for N.E.V at the Faculty of Medicine of Universidad Nacional de Piura, Piura, Peru. Authors would like to thank the Consejo Nacional de Ciencia y Tecnología de Perú (CONCYTEC) for supporting data presentation as Oral Communication at the 14th World Congress of Gynecological Endocrinology, March 3, 2010, Florence, Italy.Consejo Nacional de Ciencia, Tecnología e Innovación Tecnológica - Concyte

Sedentary lifestyle in middle-aged women is associated with severe menopausal symptoms and obesity

Objective: The aim of the study was to evaluate the association between sedentary lifestyle and the severity of menopausal symptoms and obesity in middle-aged women. Methods: The Menopause Rating Scale, the Goldberg Anxiety and Depression Scale, and the Athens Insomnia Scale were administered to 6,079 Latin American women aged 40 to 59 years. Sedentary lifestyle was defined as fewer than three weekly, 30-minute periods of physical activity. Results: Sedentary women had more severe menopausal symptoms (total Menopause Rating Scale score: 9.576.71 vs 8.01-6.27 points, P<0.0001) and more depressive symptoms (Goldberg), anxiety (Goldberg), and insomnia (Athens Scale) compared with non-sedentary women. They also had greater mean waist circumference (86.2-12.3 vs 84.3-1.8cm, P<0.0001) and a higher prevalence of obesity (20.9% vs 14.3%, P<0.0001). Logistic regressionanalysisshowedthatbothobesity(odds ratio[OR]1.52;95%CI, 1.32-1.76)andseveremenopausalsymptoms (OR 1.28; 95% CI, 1.06-1.53), incluDing insomnia and depressive mood, were positively associated with a sedentary lifestyle.Havinga stablepartner(OR0.85;95%CI, 0.76-0.96), usinghormone therapy(OR0.75;95%CI, 0.64-0.87)and having a higher educational level (OR 0.66; 95% CI, 0.60-0.74) were negatively related to sedentary lifestyle. Conclusions: There was a high prevalence of sedentary lifestyle in this middle-aged Latin American female sample which was associated with more severe menopausal symptoms and obesity

Low sexual function is associated with menopausal status in mid-aged women with human immunodeficiency virus infection

OBJECTIVE: To assess the association between menopausal status and female sexual function among mid-aged women with human immunodeficiency virus (HIV) infection. METHODS: We carried out a cross-sectional study of 221 sexually active HIV-infected women ages 40 to 59 years, based on a secondary analysis of a three-hospital survey in Lima, Perú. We classified menopausal status according to Stages of Reproductive Aging Workshop criteria (STRAW+10); this exposure variable was categorized as binary (non-postmenopausal and postmenopausal) and-for exploratory analysis-as multinomial (pre-, peri-, and postmenopausal). We defined low sexual function (LSF) using the 6-item Female Sexual Function Index (total score ≤19). Socio-demographic and clinical variables were assessed, including age, used highly active antiretroviral therapy scheme, disease duration, depressive symptoms, and co-morbidities. We performed Poisson generalized linear models with a robust variance to estimate 95% confidence interval (CI), crude prevalence ratios (cPRs), and adjusted prevalence ratios (aPRs) by epidemiological and statistical approaches using nonparametric method of bias-corrected and accelerated bootstrap resampling with 1,000 repetitions. RESULTS: Studied women had a median age of 47.0 years (interquartile range: 7.5); 25.3% were premenopausal, 25.8% were perimenopausal, and 48.9% were postmenopausal. Also, 64.3% had LSF. The frequency of LSF was 53.6% in non-postmenopausal and 75.0% in postmenopausal women. Postmenopausal status was associated with LSF in both the crude (cPR = 1.39; 95% CI: 1.13-1.71) and the adjusted regression models (aPR = 1.38; 95% CI: 1.12-1.71). CONCLUSIONS: HIV-infected postmenopausal women have a higher prevalence of LSF than those non-postmenopausal ones, even when adjusting for multiple potential confounders.Revisión por pare

Obesity and its relation to depressive symptoms and sedentary lifestyle in middle-aged women

© 2014 Elsevier Ireland Ltd. All rights reserved.Background The prevalence of obesity increases during female mid-life and although many factors have been identified, data from Latin America is lacking. Objective To assess factors related to obesity among middle-aged women and determine the association with depressive symptoms, sedentary lifestyle and other factors.Methods A total of 6079 women aged 40-59 years of 11 Latin American countries were asked to fill out the Goldberg Anxiety and Depression Scale, the Menopause Rating Scale, the Athens Insomnia Scale, the Pittsburgh Sleep Quality Index and a general questionnaire containing personal socio-demographic data, anthropometric measures and lifestyle information. Obesity was defined as a body mass index (BMI) ≥30 kg/m2.Results Obesity was observed in 18.5% and sedentary lifestyle in 63.9%. A 55.5% presented vasomotor symptoms, 12.2% had severe menopausal symptoms and 13.2% used hormone therapy for the menopause. Prevalence of depres