Síndrome de ov��rios polic��sticos: enfoque psicossocial

A síndrome dos ov��rios polic��sticos (SOP) �� um dist��rbio end��crino-ginecol��gico que se caracteriza, principalmente, por anovula����o cr��nica e hiperandrogenismo, afetando entre 5 a 10% das mulheres em idade reprodutiva. As principais manifesta����es da SOP incluem os seguintes sintomas: irregularidade menstrual, hirsutismo, infertilidade, acne, alopecia androgen��tica, obesidade e acantose nigricans. Esses sintomas apresentam- se de forma bastante heterog��nea, havendo diferen��as marcantes na sua preval��ncia e intensidade entre diferentes grupos de mulheres que apresentam SOP. Apesar da condi����o biol��gica, a SOP n��o �� apenas um problema f��sico, mas tamb��m psicossocial, interferindo e comprometendo a qualidade de vida das mulheres que a apresentam. A partir de uma revis��o da literatura, este estudo discute os aspectos psicossociais de mulheres com SOP, destacando o impacto dos sintomas na qualidade de vida relacionada com a sa��de. Considerando que cada mulher responde de forma singular aos sintomas que apresentam, destaca-se a import��ncia de incorporar a perspectiva individual da mulher com SOP ao seu contexto social. Nesse sentido, s��o discutidos achados de pesquisas utilizando abordagens metodol��gicas quantitativas e qualitativas, numa tentativa de melhor compreender a experi��ncia das mulheres diante da SOP. Os sintomas da SOP podem estar associados com a ocorr��ncia de ansiedade, disfun����es sexuais e sentimentos de inadequa����o ao papel feminino, como tamb��m podem desencadear sintomas depressivos e isolamento social, com comprometimento significativo da qualidade de vida. Os autores destacam a import��ncia do atendimento multidisciplinar para as mulheres com SOP, considerando essa condi����o como importante problema psicossocial. A aten����o aos aspectos psicossociais da SOP tem aumentado nos ��ltimos anos, no entanto, a produ����o cient��fica relacionada ainda �� escassa

��ndices de obesidade central e fatores de risco cardiovascular na síndrome dos ov��rios polic��sticos

Fundamento: A obesidade abdominal apresenta elevada preval��ncia em mulheres com síndrome dos ov��rios polic��sticos (SOP) e est�� associada a um aumento do risco cardiovascular. Objetivo: Verificar a acur��cia da circunfer��ncia da cintura (CC), da rela����o cintura-quadril (RCQ), da rela����o cinturaestatura (RCEST) e do ��ndice de conicidade (��ndice C), no que se refere �� detec����o de fatores de risco cardiovascular (FRCV) em mulheres com SOP. M��todos: Por meio de estudo transversal, foram alocadas 102 mulheres (26,5 �� 5 anos) com diagn��stico de SOP, de acordo com o consenso de Rotterdam. O colesterol total (CT), os triglicer��deos (TG), o LDL-colesterol (LDL-C), o HDLcolesterol (HDL-C), a glicemia de jejum, a glicemia ap��s teste oral de toler��ncia �� glicose (TOTG) e a press��o arterial (PA) foram avaliados em todas as pacientes, al��m das vari��veis antropom��tricas. Resultados: A rela����o cintura-estatura foi o marcador que apresentou correla����es positivas significativas com o maior n��mero de FRCV (PA, TG e glicemia ap��s TOTG), destacando-se ainda a correla����o negativa com HDL-C. Todos os marcadores antropom��tricos avaliados se correlacionaram positivamente com PA, enquanto CC e RCQ apresentaram correla����o positiva tamb��m com TG. No tocante �� acur��cia para detec����o de FRCV, os indicadores antropom��tricos considerados apresentaram taxas de sensibilidade superiores a 60%, com destaque para a RCEST, que apresentou sensibilidade superior a 70%. Conclus��o: A RCEST demonstrou ser o indicador antropom��trico com a melhor acur��cia para a predi����o de FRCV. Nesse sentido, prop��e-se a inclus��o desse par��metro de f��cil mensura����o na avalia����o cl��nica para o rastreamento de mulheres com SOP e FRCV----------------------ABSTRACT Background: Women with polycystic ovary syndrome (PCOS) present a high prevalence of abdominal obesity, which is associated with an increased cardiovascular risk. Objective: To verify the accuracy of the waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and the conicity index (CI) in the detection of cardiovascular risk factors (CVRF) in women with PCOS. Methods: The present transversal study allocated 102 women (26.5 �� 5 years) with a diagnosis of PCOS, according to the Rotterdam criteria. Total cholesterol (TC), triglycerides (TG), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), fasting glucose, glucose after the oral glucose tolerance test (OGTT) and blood pressure (BP) were evaluated in all patients, in addition to the anthropometric variables. Results: The WHtR was the marker that presented significant positive correlations with the highest number of CVRF (BP, TG and post-OGTT glucose), whereas there was a negative correlation with HDL-C. All the evaluated anthropometric markers were positively correlated with BP, whereas WC and WHR also presented a positive correlation with TG. Regarding the accuracy for the detection of CVRF, the anthropometric markers presented a sensibility > 60%, especially the WHtR, which had a sensibility > 70%. Conclusion: The WHtR showed to be the most accurate anthropometric indicator for the prediction of CVRF. In this sense, we propose the inclusion of this easily-measured parameter in the clinical assessment for the screening of women with PCOS and CVRF

Repercuss��es psico-sociais da síndrome dos ov��rios polic��sticos: estudo quali-quantitativo

BACKGROUND: Polycystic ovary syndrame (PCOS) has been shown to cause a reduction in quality of life. Little is known on the psychosocial aspects associated with PCOS, especially on women s own experiences regarding the syndrome. Therefore, the aim of this study was to analyze the psychosocial impact of PCOS by measuring the health-related quality of life and exploring the women s own experiences of PCOS. METHODS: A two-phase model of combination of quantitative and qualitative research approaches was conducted, a crass-sectional survey to pravide quantitative data on the quality of life and a qualitative approach to understand the women s experience in relation to the PC OS sympt?ms. For the first phase, 109 women with PC OS and 104 healthy contrais were evaluated with the 36-item short-form health survey (SF-36). Additionally, semi-structured interviews (n=30) were conducted to facilitate in-depth exploration of PC OS women s experience. RESUL TS: PCOS patients showed significant reductions in almost ali SF-36 domains of quality of life when compared with healthy contrais (physical function 76.5:!:20.5 and 84.6:!:15.9, respectively; physical rale function 56.4:!:43.3 and 72.6:!:33.3; general health 55.2:!:21.0 and 62.5:!:17.2; vitality 49.6:!:21.3 and 55.3:!:21.3; social function 55.3:!:32.4 and 66.2:!:26.7; emotional rale function 34.2:!:39.7 and 52.9:!:38.2; mental health 50.6:!:22.8 and 59.2:!:20.2). Thematic analysis revealed reports of feeling abnormal , sadness, afraid and anxiety. These feelings were related to four symptoms commonly experienced by women with PCOS: excess hair grawth; irregular or absent menstruation, infertility and obesity. CONCLUSIONS: Polycystic ovary syndrame impacts women both physically and psychosocially. Owing to this, women with PCOS need not only medical treatment for. the reproductive, esthetic and metabolic repercussions, but also the care of a multidisciplinary team, since PCOS is not just a physical condition, but also an important psychosocial problem that affects various aspects of a woman s life

HIV/AIDS e estilo de vida: par��metros imunol��gicos, virol��gicos, síndrome lipodistr��fica e sua rela����o com a pr��tica de exerc��cios

This descriptive study aimed to investigate the relationship between expression of immunological (TCD4 +) and virological (viral load) parameters, lipodystrophy syndrome and lifestyle variables of people living with HIV who underwent a program of physicalexercise. Initially, the sample was composed by 17 persons, recorded at the Department of Giselda Trigueiro Hospital Care (GTH), Natal-RN . With the passing of the stages of intervention (physical training program- PTP) the number of participants has changed (17, 9, 8 and 7) as the training phases (I, II, III and IV). Data collected were on total cholesterol, High Density Lipoprotein (HDL) and triglycerides. The % fat (% F), body mass index (BMI), waist-hip ratio (WHR), lean mass (LM), central fat (BF), total (TF) and peripheral (PF), weight and height were used to measure the morphological parameters. For control of variables (TCD4 +, viral load, Triglycerides, Cholesterol, HDL), the information contained in the blood tests every four months were investigated. After Phase I and II, it was used a structured interview. Then sampling was carried out considering the pre-and post-tests 1, 2, 3 and 4 (after 16, 32, 48 and 64 weeks of training, respectively). Daily, the intensity of the work was checked by the scale of perceived exertion for exercises adapted to resistance34. Procedures used were descriptive statistics (dispersion, absolute and relative frequencies, means, standard deviations and minimum and maximum values) as well as Spearman linear correlation adopting a significance level of p &#8804; 0.05. Positive changes were observed for TCD4 + and viral load in all phases of the PTP. For the morphological components, the loss of central subcutaneous fat (CSF) and total subcutaneous fat (TSF) for both sexes and the decrease in % BF among women were the most dramatic results after the training phase I. For men, results were more significant to % F and LM in Phases I and II and peripheral subcutaneous fat (PSF) declined in all phases of the exercise. As for women, results were more expressive for % F and TM in the phases I and II and the PSF decreased in all phases of the exercise. Whereas for women, the waist/hip ratio (WCQ) and 0% F decreased and showed a positive association with triglycerides (WHR r * 0.82, p 0.042, r 0.88 TSF *, p 0.019 and r 1.00 ** CSF, p <0.001) and among men with limb subcutaneous fat (LSF)* r 0.65, p 0.029). The PTP provided improvement in the health, self-esteem and quality of life, proving to be a possible strategy to positively influence the expression of immunological parameters (TCD4 +) and virological (viral load) and morphological components of people living with HIV causing no deleterious effects in these parameters

An��lise da variabilidade da frequ��ncia card��aca na síndrome dos ov��rios polic��sticos

Conselho Nacional de Desenvolvimento Cient��fico e Tecnol��gico

Avalia����o eletromiogr��fica dos m��sculos do assoalho p��lvico na síndrome dos ov��rios polic��sticos

Coordena����o de Aperfei��oamento de Pessoal de N��vel Superior

Efeitos do exerc��cio f��sico aer��bio na modula����o autonomica da frequ��ncia card��aca de mulheres com sindrome dos ov��rios policisticos

Conselho Nacional de Desenvolvimento Cient��fico e Tecnol��gico

Efeitos da eletroestimula����o do m��sculo vasto medial obl��quo em portadores de síndrome da dor patelofemoral: uma an��lise eletromiogr��fica

Funda����o de Amparo �� Pesquisa do Estado de S��o Paulo (FAPESP)

An��lise da fun����o dos m��sculos do quadril em portadores de síndrome da dor patelofemural

The Patellofemoral pain syndrome is defined as a fore or retro patellar pain and it has multifactorial etiology, where the bad patellar alignment is the most acceptable hypothesis. However proximal factors to the knee, as the debility of the muscles of the hip, have been demonstrated as a contributing factor to the appearing of that syndrome. Purpose: To evaluate if exists a relation between the hip muscles performance and the development of the SDPF. Methods: Thirty women took part in this study. They were divided in two groups; a control group (fifteen asymptomatic subjects) and an experimental group (fifteen subjects with the diagnosis of SDPF). The muscle performance was evaluated in an isokinetic dynamometer, where it was verified the peak torque (PT), PT to body weight, PT time and the agonist/antagonist relation. It was also analyzed the electromyographic activity of the middle gluteus. The data was analyzed by the not paired t test at a significance level of 5%. Results:. Didn t have significant difference to the PT of the abductor muscles (p = 0,46) and lateral rotators of the hip (p = 0,17) between groups. Also didn t have significant difference to the PT values by the body weight, to these muscle groups either (p = 0,10 e p = 0,11, respectively). Didn t have significant difference between the amplitude of the signal (p = 0,05) and the onset of medium gluteus (p = 0,25) between the groups. Conclusion: In the experimental conditions realized, the study didn t demonstrate a relation between performance the hip muscles behavior and the development of the SDPF

Efeito imediato da estimula����o el��trica neuromuscular seletiva do m��sculo VMO em pacientes com síndrome da dor femoropatelar

Patellofemoral pain syndrome (PFPS) is described as anterior or retropatellar pain knee in the absence of other pathologies and is frequently associated with dysfunction of the vastus medialis oblique (VMO). However, several studies have demonstrated the inability to selectively activate this muscle through exercise. To evaluate the effect of Neuromuscular Electrical Stimulation (NMES) selective VMO in women with syndrome. We evaluated thirty-eight women: twenty in the control group (24.15 �� 2.60 years) and eighteen diagnosed with PFPS (25.56 �� 3.55 years). Both groups were evaluated before and after a protocol of electro stimulation. To measure for comparing groups before and after treatment, we assessed the extensor torque concentric and eccentric knee through an isokinetic dynamometer, the intensity (Root Mean Square - RMS) and the onset of activation (onset) of VMO compared to the vastus lateralis (VL) in two types of exercise: open and closed kinetic chain. . Statistical analysis was performed using SPSS 15.0, with a significance level of 5%. Results: Our data showed an increase in the intensity of activation (RMS) of the VMO muscle after NMES in both study groups. During concentric contraction the RMS of the VMO before the NMES was 105.69 �� 32.26 &#956;V and after a single intervention was 122.10 �� 39.62 &#956;V (p = 0.048) for the control group. In the group with PPS, we found a similar behavior, with RMS of the VMO before NMES of 96.25 �� 18.83 &#956;V and 139.80 �� 65.88 &#956;V after the intervention (p = 0.0001). However, there was no evidence in the RMS value of VL muscle. The onset was calculated by subtracting the onset of VL by the onset of VMO. For the group with PFPS, the onset before the intervention was -0.007 �� 0.14 ms, indicating a delay of the VMO relative to VL, and after NMES was 0.074 �� 0.09 ms (p = 0.016), showing an activation previous VMO to VL. The same occurred for the control group. We also observed that NMES increased knee extensor power during the concentric contraction in both groups. Before the intervention the mean power was 28.97 �� 9.01 W for the PPS group and after NMES was 34.38 �� 7.61 W (p = 0.0001). Conclusion: We observed an increase in electromyographic activity of the VMO and also an anticipatory effect of this muscle

Sono e síndrome da fragilidade em idosos residentes em institui����es de longa perman��ncia

Introduction: The aging process causes quantitative and qualitative changes in sleeping. Such changes affects more than half of the adults above 65 years old, that live in the community and 70% of the institutionalized, a great negative impact in their quality of life. One of the pathological displays of aging, that share some characteristics with sleeping disorders and predict similar results, is the Frailty Syndrome, that characterize the most weakened and vulnerable elderly. The way sleeping disorders play a role in the frailty pathogeneses remains uncertain. Objective: Evaluate the relation between the sleeping and the frailty syndrome on institutionalized elderly. Methodology: A transversal study was performed with 69 elderly in institutions in the city of Jo��o Pessoa PB. Were used the Pittsburgh Sleeping Quality Index and actigraphy to subjective and objective variables, respectively, and questionnaires and specific tests to frailty phenotype variant (Fried Frailty Criteria). In the statistic analysis were used the Pearson correlation test, Chi Square and One-way ANOVA test, with Tukey-Krammer posttest. Subsequently, a Simple Linear Regression model was built. On every statistical analysis were considered a confidence interval of 95% and a p < 0,05. Results: The sample was characterized by the prevalence of the frail (49,3%), women (62,3%), single (50,7%) and 77,52 (��7,82).The frail elderly obtained the worst sleeping quality 10,37 (��4,31) (f = 4,15, p = 0,02), when compared with the non-frail. The sleep latency influenced more the frailty (R2 = 0,13, &#946; standard = 1,76, &#946; = 0,41, p = 0,001). Weren t found differences between the standard resting-activity variable and the frailty phenotype categories. Conclusion: Sleeping alterations, including bad sleeping quality, prolonged sleep latency, low sleep efficiency and day drowsiness, influenced the frailty in institutionalized elderly

Respostas fisiol��gicas durante teste de caminhada dos 6 minutos em mulheres com diferentes n��veis de adiposidade

Backgroud: Obesity is a major public health problem and is related to the low physical capacity when obese are compared to no-obese people, however the cause of this limitation is not completely understood. The measurement associated of physiological response to the telemetric 6MWT adds information of metabolic and respiratory system for diagnose of the functional limitation. Objective: Analyze physiological, metabolic and ventilatory responses in women with different body fat during the 6MWT. Methods: 32 women (8 non-obese, 8 Overweight, 8 Obese and 8 morbidly obese) were evaluated for anthropometry, lung function and exercise capacity. Results: Morbidly obese walked the shortest distance (400.2��38.7m), had lower VO2/Kg (12.75��3.20l/Kg/min) and lower R (0.74�� 0.11) in the 6MWT compared to other groups. Analyses of metabolic (VO2 and VCO2) and respiratory (VE, VT and BF) during the test did not identify differences between groups. The evaluation of cardiac function (O2 pulse) found higher values in the OM (12.3 �� 4.9ml/bat). Conclusion: The OM had worse performance in the 6MWT compared to other groups. The physical performance may be reduced in this population related to a protocol-dependent response because the speed of 6MWT is self-adjusted allows the individual himself select the intensity of the test, making it set at a speed where there is energy saving

An��lise de fatores cl��nico-demogr��ficos, psicol��gicos, hormonais e gen��ticos na síndrome da ard��ncia bucal e ardor bucal secund��rio

Coordena����o de Aperfei��oamento de Pessoal de N��vel Superior

Quando as mulheres se tornam m��es: a hist��ria reprodutiva feminina numa vis��o evolucionista

In this thesis we tested evolutionary hypotheses, with empirically collected data, in a sample composed of pregnant Brazilian women. We consider that during pregnancy and soon after the baby's birth fundamental reproductive decisions take place, given the complete feminine involvement with the reproduction phenomenon. The results are presented in four empirical articles related to the history of female reproduction. The topics approached were mate selection, the life-history theory, the strategies of parental investment and postpartum depression. Data collection was accomplished through interviews with pregnant women and after the baby s birth, with a sample composed of women from two income classes (low income and middle class), in Natal, Brazil. With respect to mate selection, the results suggest that a real situation of reproductive mate selection shows significant differences when compared to the results obtained in studies involving potential mate selection (Article I). Considering the life-history theory, we have partially confirmed the hypothesis of the father`s absence influencing the development of the young female syndrome (Article II). In regard to parental investment strategies and the decrease of fatherhood uncertainty, we identified a larger attribution of the baby's resemblance after birth with the father, confirming our hypothesis (Article III). The results related to postpartum depression occurrence partially support the hypothesis that it is an evolutionary adaptation (Article IV). This thesis is part of a consolidation movement of Evolutionary Psychology in Brazil and it presents results on female reproductive history hitherto unpublished.

Intera����es f��sicas e psicossociais em mulheres com fibromialgia

Fibromyalgia (FM) is a non-inflammatory rheumatic syndrome of unknown etiology, with symptoms of diffuse musculoskeletal pain and presence of specific anatomic sites called tender points. The symptoms are often associated with fatigue, sleep disturbances, morning stiffness, alterations in pain perception, anxiety and depression. Fibromyalgia exhibits a correlation between physical and behavioral symptoms, which have a negative influence on the quality of life of patients. Emotional skills are important factors since they are related to subjective well-being, personal productivity, social interaction and interpersonal relationships. We aim to describe the physical and psychosocial interactions in women with FM, showing the association between perceived social support and affect with symptoms of pain, functionality and mood. We will also describe a body representation of pain in women with FM. Data were collected over 3 years and the sample size ranged between studies. This is an exploratory cross-sectional study conducted with a convenience sample of 63 women with FM and 42 healthy women as a control group (CT), aged 20-76 years, recruited through spontaneous demand at Onofre Lopes University Hospital (HUOL) and the Clinical School of Physiotherapy of Universidade Potiguar (UNP). The Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory (BDI), Social Support Scale (MOS), Hamilton Anxiety Scale and Scale of Positive and Negative Affect Schedule (PANAS), in addition to pressure algometry were used. For data analysis, we used parametric and non-parametric tests and a general linear model with adjustment variables and analysis of variance. A significant difference was found between pain threshold and tolerance, functionality, depression, anxiety, social support, and positive and negative affect between the groups. Affective states and social support were associated with anxiety, depression and functionality. A body was drawn representing pain with higher incidences in trapeze, supraspinatus and second ribs. The reason for studying sensory aspects, affective behavior and social support in FM patients opens perspectives for scientific and clinical research of this syndrome. Women with chronic pain such as FM appear to have altered mood states, less social support and affective dysfunctions, influencing the other symptoms of the syndrome