. Na América Latina, o estudo DENSA realizado na Colômbia, no Equador e na Venezuela apontou índice de 53,4% para os três países em conjunto 4 . Recentemente foram conduzidos estudos acerca das dificuldades de ereção na população brasileira [5][6][7][8] . Realizado em três regiões do país, o Estudo do Comportamento Sexual (ECOS) encontrou 46,2% de DE (31,5% mínima, 12,1% moderada e 2,6% completa) 5 . Outros dois estudos realizados na região Nordeste encontraram índices de 39,5% e 40%, respectivamente 6,7 . Apesar de não ser letal, a DE compromete o bem-estar e a qualidade de vida, bem como pode indicar a existência de doenças subjacentes, sobretudo aquelas relacionadas ao sistema cardiovascular [8][9][10][11][12] .Já são bem conhecidos os fatores de risco mais comumente correlacionados à DE: hipertensão arterial sistêmica, diabetes mellitus, cardiopatias, tabagismo, consumo excessivo de álcool, obesidade, doenças prostáticas, depressão e idade 1,4,5,9,[13][14][15][16][17][18][19][20] . Fatores socioeconômicos, tais como baixa renda e baixo grau de escolaridade, desemprego e estado civil solteiro têm sido também associados à presença de dificuldades de ereção 1,4,5,[14][15][16][17]19 .A prevalência e os fatores de risco de uma determinada doença, quando estimados por meio de estudos populacionais, possibilitam ações preventivas e terapêuticas mais dirigidas no combate a essa dada condição 5 . O presente estudo analisa dados coletados em localidades pertencentes às cinco regiões do Brasil e investiga o papel que as características sociodemográficas, as doenças e os hábitos de vida exercem sobre o risco para a ocorrência e a manutenção de DE em homens de nosso País. MÉTODOS
Analysis of the associated factors classified in order of importance and analysis of the characteristics of the sexual relationships provide additional information to currently available data on the traditional concepts of HSDD.
Introduction The number of women with gestational diabetes mellitus (GDM) is growing worldwide in parallel with the obesity epidemic. The diagnosis of GDM leads to substantial modifications in the daily routine of these women, and these adjustments could potentially affect their sexual function. There are no previous studies on the sexual function of patients with GDM. Aim The aim of this study was to investigate the sexual function of patients with GDM in comparison with healthy pregnant women at the same gestational age. Methods Brazilian women in the third trimester of pregnancy with and without GDM were invited to participate in this cross-sectional study while waiting for their antenatal care visits at a single public tertiary teaching institution between March and December 2010. The Brazilian version of the Female Sexual Function Index (FSFI) questionnaire was used to assess sexual function. Main Outcome Measures Desire, arousal, lubrication, orgasm, sexual satisfaction, and pain during and after coitus in the last 4 weeks, measured according to a standardized and validated questionnaire. Results A total of 87 participants were enrolled (43 healthy women and 44 with GDM). There were no significant differences in the sociodemographic characteristics of both groups. The total FSFI scores of GDM patients was 21.0 ± 9.59 compared with 22.3 ± 9.17 for healthy women (P = 0.523). Difficulty in desire was the most common sexual dysfunction symptom in both groups, being reported by 42% and 50% of GDM and healthy women, respectively (P = 0.585). Conclusion The sexual function of Brazilian patients with GDM does not differ significantly from that of healthy pregnant women at the same gestational age.
Epidemiological, behavioral, and clinical data on sexual compulsivity in Brazil are very limited. This study sought to adapt and validate the Sexual Compulsivity Scale (SCS), the 22-item version of the Compulsive Sexual Behavior Inventory (CSBI-22), and the Hypersexual Disorder Screening Inventory (HDSI) for use in Brazil. A total of 153 participants underwent psychiatric assessment and completed self-reported measures. The adaptation process of the instruments from English to Portuguese followed the guidelines of the International Society for Pharmacoeconomics and Outcomes Research. The reliability and validity of the HDSI criteria were evaluated and the construct validity of all measures was examined. For the SCS and HDSI, factor analysis revealed one factor for each measure. For the CSBI-22, four factors were retained although we only calculated the scores of two factors (control and violence). All scores had good internal consistency (alpha >.75), presented high temporal stability (>.76), discriminated between patients and controls, and presented strong (ρ > .81) correlations with the Sexual Addiction Screening Test (except for the violence domain = .40) and moderate correlations with the Impulsive Sensation Seeking domain of the Zuckerman Kuhlman Personality Questionnaire (ρ between .43 and .55). The sensitivity of the HDSI was 71.93 % and the specificity was 100 %. All measures showed very good psychometric properties. The SCS, the HDSI, and the control domain of the CSBI-22 seemed to measure theoretically similar constructs, as they were highly correlated (ρ > .85). The findings support the conceptualization of hypersexuality as a cluster of problematic symptoms that are highly consistent across a variety of measures.
A integração curricular, atualmente, é apontada como importante estratégia de ensino, processo que envolve várias etapas, trabalho e compromisso de grupo. Este artigo relata a experiência de integração das disciplinas de humanidades médicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP). Ao longo de dois anos, constituiu-se um grupo composto pelas disciplinas da área de humanidades médicas, pesquisadores do Centro de Desenvolvimento da Educação Médica Professor Eduardo Marcondes (Cedem), alunos e professores de outras disciplinas interessados na área. Desenvolveu-se a integração temática e prossegue-se na integração metodológica.
Sexual dysfunctions in HIV-positive men are associated with an increase in risky sexual behavior and decreased adherence to antiretroviral drug regimens. Because of these important public health issues, we reviewed the literature on the pathophysiology, associated factors and clinical management of sexual dysfunction in HIV-positive men. The goal was to investigate the current research on these issues. Literature searches were performed in June 2011 on PubMed, Web of Science, and PsycInfo databases with the keywords “AIDS” and “sexual dysfunction” and “HIV” and “sexual dysfunction”, resulting in 54 papers. Several researchers have investigated the factors associated with sexual dysfunction in HIV-positive men. The association between sexual dysfunction and antiretroviral drugs, particularly protease inhibitors, has been reported in many studies. The lack of standardized measures in many studies and the varying study designs are the main reasons that explain the controversial results. Despite some important findings, the pathophysiology of sexual dysfunction in the HAART era still not completely understood. Clinical trials of testosterone replacement therapy have shown the treatment to be beneficial to the improvement of sexual dysfunctions related to hypogonadism. However, there are not enough psychological intervention studies to make conclusions regarding the therapeutic effects of psychotherapy.
Artigo originalResumo OBJETIVO: Comparar a função sexual de grávidas adultas saudáveis à de mulheres com Diabetes Mellitus Gestacional (DMG) no terceiro trimestre da gravidez. MÉTODOS: Estudo transversal com dois grupos de gestantes em acompanhamento pré-natal. Foram critérios de inclusão: idade materna ≥20 anos, idade gestacional ≥28 semanas, relacionamento heterossexual com o mesmo parceiro há pelo menos 6 meses e ser alfabetizada. Os critérios de exclusão foram: presença de intercorrências clínicas e/ou obstétricas que contraindicassem atividade sexual; hipertensão arterial controlada por medicamentos; gravidez resultante de estupro; parceiro sexualmente indisponível ou ausente no último mês; internação hospitalar no último mês; uso de cremes vaginais nos últimos 30 dias; gestação gemelar; uso regular de álcool e/ou drogas ilícitas; uso de medicamentos que interferissem na função sexual. Oitenta e sete pacientes preencheram os critérios de seleção e participaram do estudo. Para avaliação da função sexual destes grupos utilizou-se o questionário Quociente Sexual -Versão Feminina (QS-F). Testes χ 2 e t de Student foram utilizados para comparar diferenças entre os grupos, com valores p<0,05 considerados estatisticamente significantes. A análise estatística foi realizada com o software Instat 3. RESULTADOS: A idade gestacional média nos dois grupos era de 34 semanas. Não foram detectadas diferenças significantes nos escores médios totais do QS-F nos dois grupos (62,5 saudáveis vs 62,8 DMG, p=0,9). Aproximadamente metade das participantes (47 e 47,5% das saudáveis e DMG, respectivamente, p=0,9) teve escores totais de até 60 na escala do QS-F, o que indica comprometimento em algum dos domínios avaliados (desejo e satisfação sexual, excitação, orgasmo, dispareunia e vaginismo). CONCLUSÕES: A prevalência de comprometimento do desempenho sexual foi alta em gestantes no terceiro trimestre, não diferindo significativamente entre mulheres saudáveis e aquelas com DMG. Abstract PURPOSE:To compare the sexual function of healthy adult pregnant women with that of gestational diabetes patients (GDM) in the third trimester. METHODS: This cross-sectional study enrolled two groups of women managed antenatal care clinics. Inclusion criteria were: maternal age ≥20 years, gestational age at least 28 weeks, being in a heterosexual relationship with the same partner for at least 6 months, and being able to read. We excluded women with a medical recommendation for sexual abstinence due to clinical or obstetric disorders; hypertension controlled through medications; pregnancy resulting from rape; absent or sexually unavailable partner in the last month; hospital admission in the last month; use of vaginal creams in the last 30 days; multiple pregnancy, regular use of alcohol or illicit drugs or use of medications that can interfere with sexual function. Eighty-seven patients fulfilled the selection criteria and were included in the study. The Sexual Quotient -Feminine Version (QS-F) questionnaire was used to assess sexual function. Stud...
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