IntroductionSexuality is an often neglected area in patients with rheumatic disease. The aim of this study is to assess sexual functioning and quality of life in a group of married women with Systemic Sclerosis (SSc).MethodsThis is a horizontal study for descriptive and analytical purposes. Married women with SSc were interviewed about their sexual functioning and their quality of life.ResultsA total of ten patients who met the criteria have accepted to participate to the study. Their mean age was 52, 4± 8,2 years. Eight women thought that the disease had affected their sexual activity. All patients reported a decrease in the frequency of intercourse since the onset of their disease. Eight of the sample reported a diminished desire for a sexual relationship. The reasons were fatigue, altered body image and pain. The assessment of sexual functioning using the Female sexual function index (FSFI) showed a mean FSFI score at 14,2±7,8 with nine women scoring in the range associated with sexual dysfunction (SD) (<26). All the subscales were affected. Our patients reported a mean total score on WHOQOL-brief (World Health Quality of Life-Brief Version) of 60 out of 120 indicating a moderate altered quality of life. Depression has been identified as determinants of impaired sexual function.ConclusionThe prevalence of SD in women with SSc is high when a specific questionnaire is used to assess it. These results indicate that in daily practice, inquiring about sexuality and screening for depressive symptoms is indicated for every patient with SSc.
Les mines qui sont abandonnées avec leurs installations minières et métallurgiques constituent un exemple représentatif du transfert des éléments métalliques dans l’écosystème. Au Maroc, le site minier d’Aouli est drainé par l’oued Moulouya (l’unique oued de la région) d’une longueur de 520 km avec un bassin versant d’une superficie d’environ 50.000 km2. A travers ce travail, nous avons déterminé un certain nombre de paramètres chimiques afin de voir la destinée de certains métaux (Pb, Zn, Cu et Cd) issue de ce district minier abandonné. Les résultats ont montré que dans l’eau, dans les matières en suspension et dans les sédiments, il y a une contamination métallique due à la mine d’Aouli situé au niveau de la Haute Moulouya ; tandis qu’au niveau de la Basse Moulouya, l’affluent oued Za contribue à cette contamination par un apport anthropique qui résulte en une augmentation des teneurs en cadmium, plomb et zinc. L’effet de cette contamination externe est également mis en évidence par les caractères géochimiques d’une station témoin situé en amont de l’oued loin de toute influence minière. L’examen des rapports des différents éléments (Cd, Pb et Cu) par rapport au Zn dans les sédiments montre qu’ils sont préservés dans les sédiments en aval (Basse Moulouya). Par contre, au niveau de la Haute et la Moyenne Moulouya, on assiste à une diminution des rapports Cu/Zn et Cd/Zn et une augmentation du rapport Pb/Zn au niveau de la station S3; ce qui reflète l’effet de la mine d’Aouli. L’augmentation des rapports au niveau des stations S1 et S4 sont en relation avec la présence d’algues et qui jouent un rôle important dans la modification des teneurs en Zn dans les sédiments. L’étude de ces rapports a permis de confirmer que dans notre cas aucun effet notable dû aux apports des affluents n’est mis en évidence sur le contrôle des concentrations des éléments dans les sédiments de l’oued Moulouya. Cette particularité permet de suggérer que dans la cas de l’oued Moulouya la dilution physique est plus importante que la mobilisation chimique et permet d’expliquer le déclin en aval des concentrations des éléments métalliques.
BackgroundThe objective of this study was to compare the efficacy of biomarkers in assessing the risk of breast cancer recurrence in patients with node-negative or micrometastatic grade II breast cancer. Specifically, we compared risk assessments based on the St. Gallen clinicopathological criteria, Ki67 expression and urokinase plasminogen activator (uPA)/plasminogen activator inhibitor-1 (PAI-1) expression.MethodsThis retrospective study included 347 patients with breast cancer followed at Limoges University Hospital. The optimal cut-off for high Ki67 expression (Ki67hi) was established as 20%. The threshold for uPA and PAI-1 positivity was 3 ng/mg and 14 ng/mg, respectively.ResultsKi67 expression was lower in uPA/PAI-1-negative than in uPA/PAI-1-positive tumours (227 tumours; P = 0.04). The addition of Ki67 status to the St. Gallen criteria resulted in a 28% increase in the rate of identification of high-risk tumours with a potential indication for chemotherapy (P < 0.001). When considering uPA/PAI-1 levels together with the St Gallen criteria (including Ki67 expression), the number of cases identified as having a high recurrence risk with a potential indication for adjuvant chemotherapy increased by 20% (P < 0.001). Adjuvant chemotherapy was 9% less likely to be recommended by a multidisciplinary board when using the current criteria compared with using a combination of the St. Gallen criteria and Ki67 and uPA/PAI-1 status (P = 0.03).ConclusionsTaken together, our data show discordance among markers in identifying the risk of recurrence, even though each marker may prove to be independently valid.
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