Genitourinary Syndrome of Menopause: Epidemiology, Physiopathology, Clinical Manifestation and Diagnostic

Genitourinary syndrome of menopause (GSM) is a term used to define a compilation of signs and symptoms arising from decreased estrogenic stimulation of the vulvovaginal and lower urinary tract. Among 27-84% of women in postmenopausal are affected for symptoms of GSM, and these can unquestionably impair health, sexual function, consequently the quality of life of these women. The main signs and symptoms of GSM include, among others, burning, irritation, vulvovaginal dryness, dyspareunia, urinary symptoms of urgency, dysuria, or recurrent urinary tract infection. The diagnosis can be made through anamnesis, questionnaires, physical exams, and, sometimes, complementary exams. Objective vaginal assessment is essential and can be complemented by using the Vaginal Health Index (VHI), Vaginal Maturation Index (VMI), or vaginal pH measurement. The acknowledgment of this condition by health professionals is crucial for its identification and proper management and exclusion of other conditions that make a differential diagnosis with it.info:eu-repo/semantics/publishedVersio

Use of Moisturizers and Lubricants for Vulvovaginal Atrophy

The estrogen decrease in postmenopausal women results in functional and anatomical changes in the genitourinary tract. The most prevalent and bothersome symptoms are vaginal dryness, dyspareunia, and reduced lubrication, which can significantly affect the quality of life of these women, principally those who are sexually active. Hormonal therapy with local estrogens is generally considered the "gold standard." However, there are cases in which there are clinical concerns about its use or women opt for non-hormonal options. Thus, safe and effective non-hormonal options are needed to improve symptoms in these women. Moisturizers and lubricants are first-line therapy for breast cancer survivors.info:eu-repo/semantics/publishedVersio

Hormonal Approach for Postmenopausal Vulvovaginal Atrophy

Menopause is a physiological and progressive phenomenon secondary to decreased ovarian follicular reserve that significantly affects the genital tract. Although postmenopausal vulvovaginal atrophy primarily affects postmenopausal women, it is also seen in premenopausal women. The hypoestrogenic condition results in hormonal and anatomical changes, with the main symptoms, are dryness, burning and genital irritation, decreased lubrication, urinary urgency, dysuria, and recurrent urinary tract infections. This review aims to update hormone therapy for urogenital atrophy, both local and systemic, and discusses the importance of understanding and the need for active treatment of this condition. The main therapeutic objective is the relief of symptoms, and hormonal therapy (HT) is still the most effective choice for treating clinical manifestations, despite the side effects of its use. HT should be used in an individualized way to the needs of the women and appropriate to the stage in which she is menopausal, perimenopausal, or after menopause.info:eu-repo/semantics/publishedVersio

A survey of UK medical schools' arrangements for early patient contact

Background: Many U.K. medical schools have patient contact in the first two years of the undergraduate course. Aim: To compare the purposes and organization of early patient contact in UK medical schools and to relate these arrangements to the schools' curricular objectives. Methods: A telephone survey of lead educators in UK medicals schools. Categories of contact were plotted against phases of the course to discern patterns of organisation. Results: The quantity of contact varies considerably (four to 65 days). There is a pattern, with learning objectives around the social context of health and illness preceding skills based work and integrated clinical knowledge for practice coming later. Schools fall into three categories: close adherence to the preclinical/clinical split, with limited early contact acting as an introduction to social aspects of health; provision of substantial patient contact to maximize the integration of knowledge and skills; and transitional, with limited clinical goals. General practice provides between one third and one half of early patient contact. Conclusions: Arrangements meet the objectives set by each school and reflect differing educational philosophies. Change is toward more early contact. There appears to be no national guidance which supports a minimum quantity of patient contact or specific educational purpose in the early years of U.K. basic medical training

Using K-Means Algorithm for Description Analysis of Text in RSS News Format

This article shows the use of different techniques for the extraction of information through text mining. Through this implementation, the performance of each of the techniques in the dataset analysis process can be identified, which allows the reader to recommend the most appropriate technique for the processing of this type of data. This article shows the implementation of the K-means algorithm to determine the location of the news described in RSS format and the results of this type of grouping through a descriptive analysis of the resulting clusters

INSECTICIDE-TREATED BED NETS IN RONDÔNIA, BRAZIL: EVALUATION OF THEIR IMPACT ON MALARIA CONTROL

Mosquito nets treated with long-lasting insecticide (LLINs), when used in compliance with guidelines of the World Health Organization, may be effective for malaria vector control. In 2012, approximately 150,000 LLINs were installed in nine municipalities in the state of Rondônia. However, no studies have assessed their impact on the reduction of malaria incidence. This study analyzed secondary data of malaria incidence, in order to assess the impact of LLINs on the annual parasite incidence (API). The results showed no statistically significant differences in API one year after LLIN installation when compared to municipalities without LLINs. The adoption of measures for malaria vector control should be associated with epidemiological studies and evaluations of their use and efficiency, with the aim of offering convincing advantages that justify their implementation and limit malaria infection in the Amazon Region

Identification of a cytokine network sustaining neutrophil and Th17 activation in untreated early rheumatoid arthritis

© 2010 Cascão et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Introduction: Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease characterized by sustained synovitis. Recently, several studies have proposed neutrophils and Th17 cells as key players in the onset and perpetuation of this disease. The main goal of this work was to determine whether cytokines driving neutrophil and Th17 activation are dysregulated in very early rheumatoid arthritis patients with less than 6 weeks of disease duration and before treatment (VERA). Methods: Cytokines related to neutrophil and Th17 activation were quantified in the serum of VERA and established RA patients and compared with other very early arthritis (VEA) and healthy controls. Synovial fluid (SF) from RA and osteoarthritis (OA) patients was also analyzed. Results: VERA patients had increased serum levels of cytokines promoting Th17 polarization (IL-1b and IL-6), as well as IL-8 and Th17-derived cytokines (IL-17A and IL-22) known to induce neutrophil-mediated inflammation. In established RA this pattern is more evident within the SF. Early treatment with methotrexate or corticosteroids led to clinical improvement but without an impact on the cytokine pattern. Conclusions: VERA patients already display increased levels of cytokines related with Th17 polarization and neutrophil recruitment and activation, a dysregulation also found in SF of established RA. 0 Thus, our data suggest that a cytokine-milieu favoring Th17 and neutrophil activity is an early event in RA pathogenesis.This work was supported by a grant from Sociedade Portuguesa de Reumatologia/Schering-Plough 2005. RAM and RC were funded by Fundação para a Ciência e a Tecnologia (FCT) SFRH/BD/30247/2006 and SFRH/BD/40513/2007, respectively. MMS-C was funded by Marie Curie Intra-European Fellowship PERG-2008-239422 and a EULAR Young Investigator Award

CONHECIMENTOS DE UNIVERSITÁRIOS DA ÁREA DA SAÚDE SOBRE CONTRACEPÇÃO E PREVENÇÃO DE DOENÇAS SEXUALMENTE TRANSMISSÍVEIS

Human sexuality is an important component in the individual’s formation. Sexuality has experienced important changes during human history, such as people’s access to information. In this sense we want to investigate the university students’ knowledge in the area of health at the Federal del Ceará University, Colombia regarding behaviors about contraception and STD prevention, since these future professionals will be an important source of information for the population. Data was obtained between May and June 2005 using a questionnaire of 12 objective questions about sexual education, sexual life and knowledge about pregnancy and STD prevention. Regarding information about sex, family, friends and school were the main sources of information. When asked if HIV could be transmitted through oral sex, 87.5% answered correctly, by responding that yes. There is certain knowledge about sexuality among the students. Nevertheless, there is still a lack of preventive knowledge regarding sexual health.La sexualidad humana es un componente importante en la formación del individuo. Sufrió importantes modificaciones a lo largo de la existencia de la vida humana, como la mayor divulgación de informaciones. Buscamos investigar el conocimiento de los universitarios del área de salud de la Universidad Federal del Ceará referente a las conductas de contracepción y prevención de DST, puesto que estas son una importante fuente de información para la población. La colecta de datos tuvo lugar entre mayo y junio de 2005 por medio de un cuestionario objetivo compuesto de 12 preguntas, acerca de la educación sexual, sexualidad y conocimiento en la prevención del embarazo no deseado y de DST. En cuanto a la orientación sexual, la familia, los amigos y la escuela fueron las principales fuentes de información. Preguntados si la transmisión del VIH se produce a través de sexo oral, 87,5% respondió correctamente al afirmar la cuestión como verdadera. Percibimos cierto conocimiento sobre la sexualidad entre los estudiantes, no obstante todavía hay carencias sobre algunos aspectos preventivos de salud sexual.A sexualidade humana é um importante componente na formação do indivíduo. Esta sofreu importantes modificações ao longo da existência da vida humana, como uma maior divulgação de informações. Assim, buscamos investigar o conhecimento de universitários da área da saúde acerca das condutas de contracepção e prevenção de DST, já que estes são importante fonte de informação para a população. A coleta de dados ocorreu entre maio e junho de 2005 por meio de questionário objetivo com 12 questões, abordando dados relacionados à orientação sexual, sexualidade e conhecimento sobre prevenção de DST e gravidez indesejada. Quanto à orientação sexual a família, amigos e a escola foram as principais fontes de informação. Questionados se a transmissão do HIV ocorre através de sexo oral, 87,5% responderam corretamente ao afirmar a questão como verdadeira. Percebemos certo conhecimento sobre a sexualidade entre os universitários, porém ainda há carências sobre alguns aspectos preventivos da saúde sexua

Spatial heterogeneity of habitat suitability for Rift Valley fever occurrence in Tanzania: an ecological niche modelling approach

Despite the long history of Rift Valley fever (RVF) in Tanzania, extent of its suitable habitat in the country remains unclear. In this study we investigated potential effects of temperature, precipitation, elevation, soil type, livestock density, rainfall pattern, proximity to wild animals, protected areas and forest on the habitat suitability for RVF occurrence in Tanzania. Presence-only records of 193 RVF outbreak locations from 1930 to 2007 together with potential predictor variables were used to model and map the suitable habitats for RVF occurrence using ecological niche modelling. Ground-truthing of the model outputs was conducted by comparing the levels of RVF virus specific antibodies in cattle, sheep and goats sampled from locations in Tanzania that presented different predicted habitat suitability values. Habitat suitability values for RVF occurrence were higher in the northern and central-eastern regions of Tanzania than the rest of the regions in the country. Soil type and precipitation of the wettest quarter contributed equally to habitat suitability (32.4% each), followed by livestock density (25.9%) and rainfall pattern (9.3%). Ground-truthing of model outputs revealed that the odds of an animal being seropositive for RVFV when sampled from areas predicted to be most suitable for RVF occurrence were twice the odds of an animal sampled from areas least suitable for RVF occurrence (95% CI: 1.43, 2.76, p < 0.001). The regions in the northern and central-eastern Tanzania were more suitable for RVF occurrence than the rest of the regions in the country. The modelled suitable habitat is characterised by impermeable soils, moderate precipitation in the wettest quarter, high livestock density and a bimodal rainfall pattern. The findings of this study should provide guidance for the design of appropriate RVF surveillance, prevention and control strategies which target areas with these characteristics