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[PMID]:29253857
[Au] Autor:Burgueño E; Carlos S; Lopez-Del Burgo C; Osorio A; Stozek M; Ndarabu A; Muamba P; Tshisuaka P; De Irala J
[Ad] Endereço:CEFA-Monkole, Kinshasa, Democratic Republic of the Congo.
[Ti] Título:Forced sexual intercourse and its association with HIV status among people attending HIV Voluntary Counseling and Testing in a healthcare center in Kinshasa (DRC).
[So] Source:PLoS One;12(12):e0189632, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Sexual violence, an HIV determinant, is an integrated behavior in the D.R.Congo. We aimed to analyze the prevalence of forced sexual intercourse (FSI) among people receiving HIV Voluntary Counseling and Testing in a hospital in Kinshasa, and its association with socio-demographics, behaviors and HIV status. METHODOLOGY: Case-control study (2010-2012). Two-hundred and seventy-four cases with a new HIV+ test and 1,340 controls with an HIV- test were interviewed about HIV-related knowledge, attitudes and behaviors, including FSI. RESULTS: Thirty-four percent of the participants declared having had FSI (38% of women and 32% of men). Being a woman, aged 25-49 and reporting multiple sexual partners were associated with reporting FSI. For men, being single was protective against FSI; and cohabiting, having a high socioeconomic status, and alcohol consumption increased the odds. For women, being single, divorced/separated and widow was associated with reporting FSI. A significant positive association was found between FSI and an HIV positive test. CONCLUSION: Among our Congolese population, FSI was strongly associated with HIV infection and it was also associated with alcohol consumption and multiple sexual partnerships, other key HIV determinants. These behaviors need to be identified as potential risk factors of FSI during counseling interventions. Researchers, practitioners and decision-makers should work together to get violence prevention integrated into health, social and educational policies.
[Mh] Termos MeSH primário: Coito
Infecções por HIV/epidemiologia
Estupro
[Mh] Termos MeSH secundário: Adolescente
Adulto
Estudos de Casos e Controles
Aconselhamento
República Democrática do Congo/epidemiologia
Feminino
Infecções por HIV/diagnóstico
Soropositividade para HIV
Comportamentos Relacionados com a Saúde
Conhecimentos, Atitudes e Prática em Saúde
Seres Humanos
Masculino
Meia-Idade
Prevalência
Fatores de Risco
Comportamento Sexual/psicologia
Parceiros Sexuais
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171219
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189632


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[PMID]:29300723
[Au] Autor:Ethier KA; Kann L; McManus T
[Ad] Endereço:Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, CDC.
[Ti] Título:Sexual Intercourse Among High School Students - 29 States and United States Overall, 2005-2015.
[So] Source:MMWR Morb Mortal Wkly Rep;66(5152):1393-1397, 2018 Jan 05.
[Is] ISSN:1545-861X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Early initiation of sexual activity is associated with having more sexual partners, not using condoms, sexually transmitted infection (STI), and pregnancy during adolescence (1,2). The majority of adolescents initiate sexual activity during high school, and the proportion of high school students who have ever had sexual intercourse increases by grade; black students are more likely to have ever had sexual intercourse than are white students (3). The proportion of high school students overall who had ever had sexual intercourse did not change significantly during 1995-2005 (53.1% to 46.8%) (Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, unpublished data). To assess whether changes have occurred in recent years in the proportion of high school students who have ever had sexual intercourse, CDC examined trends overall and by grade, race/ethnicity, and sex among U.S. high school students, using data from the 2005-2015 national Youth Risk Behavior Surveys (YRBSs) and data from 29 states* that conduct the YRBS and have weighted data. Nationwide, the proportion of high school students who had ever had sexual intercourse decreased significantly overall and among 9th and 10th grade students, non-Hispanic black (black) students in all grades, and Hispanic students in three grades. A similar pattern by grade was observed in nearly half the states (14), where the prevalence of ever having had sexual intercourse decreased only in 9th grade or only in 9th and 10th grades; nearly all other states saw decreases in some or all grades. The overall decrease in the prevalence of ever having had sexual intercourse during 2005-2015 is a positive change in sexual risk among adolescents (i.e., behaviors that place them at risk for human immunodeficiency virus, STI, or pregnancy) in the United States, an overall decrease that did not occur during the preceding 10 years. Further, decreases by grade and race/ethnicity represent positive changes among groups of students who have been determined in previous studies to be at higher risk for negative outcomes associated with early sexual initiation, such as greater numbers of partners, condom non-use, teen pregnancy, and STI (1-3). More work is needed to understand the reasons for these decreases and to ensure that they continue.
[Mh] Termos MeSH primário: Coito
Estudantes/psicologia
[Mh] Termos MeSH secundário: Adolescente
Coito/psicologia
Feminino
Seres Humanos
Masculino
Assunção de Riscos
Instituições Acadêmicas
Estudantes/estatística & dados numéricos
Inquéritos e Questionários
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180119
[Lr] Data última revisão:
180119
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180105
[St] Status:MEDLINE
[do] DOI:10.15585/mmwr.mm665152a1


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[PMID]:29016638
[Au] Autor:Westercamp N; Mehta SD; Jaoko W; Okeyo TA; Bailey RC
[Ad] Endereço:Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois, United States of America.
[Ti] Título:Penile coital injuries in men decline after circumcision: Results from a prospective study of recently circumcised and uncircumcised men in western Kenya.
[So] Source:PLoS One;12(10):e0185917, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Penile coital injuries are one of the suggested mechanisms behind the increased risk of HIV among uncircumcised men. We evaluated the prevalence and correlates of self-reported penile coital injuries in a longitudinal community-based cohort of young (18-24 years old), newly circumcised and uncircumcised men in Western Kenya. METHODS: Self-reported penile coital injuries were assessed at baseline, 6, 12, 18 and 24 months of follow-up, and were defined as scratches, cuts or abrasions during sex, penile soreness during sex, and skin of the penis bleeding during sex. Associations between penile coital injuries, circumcision, sexual satisfaction, and other covariates were estimated with mixed effect models. RESULTS: Between November 2008 and April 2010 3,186 participants were enrolled (1,588 into circumcision group and 1,598 as age-matched controls). Among 2,106 (66%) participants sexually active at baseline, 53% reported any penile injury, including 44% scratches, cuts or abrasions; 32% penile pain/soreness; and 22% penile bleeding. In multivariable modeling, risk was lower for circumcised men than uncircumcised men for scratches, cuts and abrasions (aOR = 0.39; 95% CI 0.34-0.44); penile pain/soreness (aOR = 0.58; 95% CI 0.51-0.65), penile bleeding (aOR = 0.53; 95% CI 0.46-0.62), and any penile coital injuries (aOR = 0.47; 95%CI 0.42-0.53). Other significant risk factors included increasing age, history of STIs and genital sores, and multiple sex partners, while condom use was protective. Coital injuries were significantly associated with lower levels of sexual satisfaction in longitudinal analyses (scratches, cuts or abrasions: aOR = 0.87, 95% CI: 0.76-0.98; penile pain/soreness: aOR = 0.82, 95% CI: 0.72-0.93; and penile bleeding: aOR = 0.65, 95% CI: 0.55-0.76). CONCLUSIONS: Self-reported penile coital injuries were common and decreased significantly following circumcision. Improving sexual experience through the removal of a potential source of sexual discomfort may resonate with many men targeted for circumcision services. The role of penile coital injuries in sexual satisfaction, HIV, HSV-2, and as a motivator for seeking circumcision services should be explored further.
[Mh] Termos MeSH primário: Hemorragia/fisiopatologia
Orgasmo/fisiologia
Dor/fisiopatologia
Pênis/lesões
[Mh] Termos MeSH secundário: Adolescente
Estudos de Casos e Controles
Circuncisão Masculina/educação
Coito/fisiologia
Preservativos/utilização
Feminino
Seres Humanos
Quênia
Masculino
Pênis/fisiologia
Fatores Sexuais
Pele/lesões
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171011
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0185917


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[PMID]:28767298
[Au] Autor:Griffith R
[Ad] Endereço:Senior Lecturer in Health Law, College of Health Science, Swansea University.
[Ti] Título:Consenting to sexual activity.
[So] Source:Br J Community Nurs;22(8):409-411, 2017 Aug 02.
[Is] ISSN:1462-4753
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Engaging in sexual activity is an essential Human Right protected under article 12 of the European Convention on Human Rights ( Council of Europe, 1950 ) and should be free from state interference. District nurses, however, often express concern over the possibility that adults with acquired brain injury or a learning disability cannot give a real consent to participate in sexual activity and so should be prevented from doing so. In this article Richard Griffith reviews the case law in relation to the capacity to consent to sexual activity.
[Mh] Termos MeSH primário: Coito
Tomada de Decisões
Competência Mental/legislação & jurisprudência
Avaliação em Enfermagem
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Masculino
Autonomia Pessoal
Reino Unido
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170912
[Lr] Data última revisão:
170912
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170803
[St] Status:MEDLINE
[do] DOI:10.12968/bjcn.2017.22.8.409


  5 / 6520 MEDLINE  
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[PMID]:28580070
[Au] Autor:McArdle BJ; Wille MA; Hollowell CM
[Ad] Endereço:Division of Urology, Cook County Health and Hospitals System, Chicago, IL, USA.
[Ti] Título:Isolated Spongy Urethral Rupture from Abrupt Coital Distractive Force.
[So] Source:J Radiol Case Rep;11(2):23-27, 2017 Feb.
[Is] ISSN:1943-0922
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The classic presentation of penile fracture is a cracking or snap sound, with sharp pain, immediate detumescence, swelling, deformation and ecchymosis. A penile fracture involves rupture of the tunica albuginea of one or both corpora cavernosa. Concomitant urethral rupture is reported to occur in 10% to 20% of penile fracture cases. Isolated urethral injury without penile fracture is extremely rare. We report the first case of isolated pendulous urethral rupture from an abrupt coital distractive force. We include a literature review and discussion of isolated urethral trauma secondary to sexual intercourse. Retrograde urethrography rendered a stunning clinical image which was integral to the diagnosis and management of this patient's injury.
[Mh] Termos MeSH primário: Uretra/diagnóstico por imagem
Uretra/lesões
[Mh] Termos MeSH secundário: Adulto
Coito
Diagnóstico Diferencial
Seres Humanos
Masculino
Ruptura
Uretra/cirurgia
Procedimentos Cirúrgicos Urológicos Masculinos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170606
[St] Status:MEDLINE
[do] DOI:10.3941/jrcr.v11i2.2907


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[PMID]:28542221
[Au] Autor:Lau HH; Huang WC; Su TH
[Ad] Endereço:Department of Medicine, Mackay Medical College; Department of Obstetrics and Gynecology, Mackay Memorial Hospital; Mackay Medicine, Nursing and Management College, Taipei, Taiwan.
[Ti] Título:Urinary leakage during sexual intercourse among women with incontinence: Incidence and risk factors.
[So] Source:PLoS One;12(5):e0177075, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Coital incontinence is an under-reported disorder among women with urinary incontinence. Women seldom voluntarily report this condition, and as such, related data remains limited and is at times conflicting. AIMS AND OBJECTIVES: To investigate the incidence and quality of life in women with coital incontinence and to determine associated predictors. METHODS: This observational study involved 505 sexually active women attending the urogynecologic clinic for symptomatic urinary incontinence at a tertiary medical center. All of the patients were consulted about the experience of coital incontinence and completed evaluations including urodynamics, and valid questionnaires including the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, the Urogenital Distress Inventory and the Incontinence Impact Questionnaire. RESULTS: Of these women, 281 (56%) had coital incontinence, while 224 (44%) did not. Among women with coital incontinence, 181 (64%) had urodynamic-proven stress incontinence, 29 (10%) had mixed incontinence, and 15 (5%) had detrusor overactivity. Only 25 (9%) sought consultation for this disorder before direct questioning. Fifty percent (84/281) of the women rarely or sometimes had incontinence during coitus, while 33% (92/281) often had incontinence, and 17% (48/281) always had incontinence. The frequency of coital incontinence was not different regarding the types of incontinence (p = 0.153). Women with mixed incontinence had the worst sexual quality of life and incontinence-related symptom distress. Based on univariate analysis, higher body mass index (OR 2.47, p = 0.027), and lower maximal urethral closure pressure (≤ 30 cmH2O) (OR 4.56, p = 0.007) were possible predictors for coital incontinence. Multivariate analysis showed lower MUCP was independently significant predictors (OR3.93, p = 0.042). CONCLUSIONS: The prevalence of coital intercourse in urinary incontinence women was high. Coital incontinence in these women was associated with abnormal urodynamic diagnosis and urethral dysfunction.
[Mh] Termos MeSH primário: Coito
Incontinência Urinária/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Coito/fisiologia
Coito/psicologia
Feminino
Seres Humanos
Incidência
Meia-Idade
Análise Multivariada
Qualidade de Vida
Fatores de Risco
Inquéritos e Questionários
Centros de Atenção Terciária
Uretra/fisiopatologia
Incontinência Urinária/fisiopatologia
Incontinência Urinária/psicologia
Urodinâmica
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170526
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0177075


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[PMID]:28539177
[Au] Autor:Pinkerton JV; Bushmakin AG; Komm BS; Abraham L
[Ad] Endereço:University of Virginia Health System, Charlottesville, VA, United States.
[Ti] Título:Relationship between changes in vulvar-vaginal atrophy and changes in sexual functioning.
[So] Source:Maturitas;100:57-63, 2017 Jun.
[Is] ISSN:1873-4111
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Conjugated estrogens/bazedoxifene (CE/BZA) has demonstrated benefit in vulvar-vaginal atrophy (VVA, part of genitourinary syndrome of menopause) and the sexual function domain of the Menopause-specific Quality of Life (MENQOL) questionnaire. The study's objective was to determine the relationship of VVA symptoms and clinical parameters with MENQOL sexual functioning in postmenopausal women receiving VVA treatment. STUDY DESIGN: Post hoc analysis data were derived from the 12-week SMART-3 trial, which evaluated CE/BZA's effect on VVA in nonhysterectomized postmenopausal women (aged 40-65 years) experiencing one or more moderate to severe VVA symptoms (dryness, itching/irritation, pain with intercourse) and vaginal pH>5.0 (N=664). MAIN OUTCOME MEASURES: Repeated measures models were used to determine relationships of VVA symptoms and clinical parameters (vaginal pH, parabasal/superficial cells) with sexual functioning; sensitivity analyses were performed to check assumptions of linearity. RESULTS: VVA symptoms showed an approximately linear relationship with sexual functioning. A 1-point improvement in pain on intercourse (which has a large effect size [ES]=0.85) corresponded to medium improvement (ES=0.57) in MENQOL sexual functioning. Equivalent improvements (in terms of ES) in dryness and itching/irritation corresponded to small to medium (ES=0.35) and small (ES=0.27) improvements in sexual functioning, respectively. The same ES improvement in clinical parameters corresponded to small-trivial improvements in sexual functioning. CONCLUSIONS: VVA symptoms have an approximately linear relationship with sexual functioning. Sexual functioning was most improved when pain on intercourse was reduced. Similar magnitudes of improvements in other VVA symptoms were linked with smaller, though potentially beneficial, improvements in sexual functioning. Changes in clinical parameters had only small or trivial associations with sexual functioning. Trial registration number NCT00238732.
[Mh] Termos MeSH primário: Atrofia/patologia
Disfunções Sexuais Fisiológicas/patologia
Vagina/patologia
Doenças Vaginais/patologia
Vulva/patologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Atrofia/tratamento farmacológico
Coito
Método Duplo-Cego
Feminino
Seres Humanos
Indóis/uso terapêutico
Meia-Idade
Dor
Pós-Menopausa
Prurido
Qualidade de Vida
Moduladores Seletivos de Receptor Estrogênico/uso terapêutico
Disfunções Sexuais Fisiológicas/tratamento farmacológico
Doenças Vaginais/tratamento farmacológico
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Indoles); 0 (Selective Estrogen Receptor Modulators); Q16TT9C5BK (bazedoxifene)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171108
[Lr] Data última revisão:
171108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170526
[St] Status:MEDLINE


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[PMID]:28530499
[Au] Autor:Glynn TR; Operario D; Montgomery M; Almonte A; Chan PA
[Ad] Endereço:1 Department of Psychology, University of Miami , Coral Gables, Florida.
[Ti] Título:The Duality of Oral Sex for Men Who Have Sex with Men: An Examination Into the Increase of Sexually Transmitted Infections Amid the Age of HIV Prevention.
[So] Source:AIDS Patient Care STDS;31(6):261-267, 2017 Jun.
[Is] ISSN:1557-7449
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Several studies suggest that the increase in sexually transmitted infections (STIs) among men who have sex with men (MSM) could be due, in part, to human immunodeficiency virus (HIV) risk reduction strategies, which include engaging in oral sex over anal sex. The aims of this study were to evaluate oral sex behaviors and STI diagnoses and to investigate the potential dual role of oral sex as being protective for HIV, yet perpetuating STI transmission among MSM. We analyzed records from 871 MSM presenting to the Rhode Island STI Clinic between 2012 and 2015. We compared outcomes in men engaging in two HIV protective oral sex behaviors: (1) HIV/STI outcomes by men engaging only in oral sex versus those that did not, and (2) HIV/STI outcomes by men engaging in condomless oral sex with 100% condom use for all other sex acts versus those that did not. Men engaging in HIV protective oral sex behaviors were more likely to be HIV negative compared to men not engaging in them (99% vs. 93%, p < 0.01). In contrast, there was no significant difference in STI diagnoses between those that engaged in HIV protective oral sex behaviors and those that did not. The findings provide evidence to support the unique duality of oral sex: decreased risk for HIV and perpetuation of STI risk. Promotion of routine STI testing, including extragenital sites, is critical to address STI prevention among MSM. In the age of HIV prevention, addressing the ambiguous risks of discrete sex acts would be beneficial for both HIV and STI prevention education for MSM.
[Mh] Termos MeSH primário: Preservativos/utilização
Infecções por HIV/prevenção & controle
Redução do Dano
Homossexualidade Masculina
Assunção de Riscos
Comportamento Sexual
Doenças Sexualmente Transmissíveis/epidemiologia
Doenças Sexualmente Transmissíveis/transmissão
[Mh] Termos MeSH secundário: Adulto
Coito
Preservativos/estatística & dados numéricos
Seres Humanos
Masculino
Meia-Idade
Rhode Island
Sexo Seguro
Doenças Sexualmente Transmissíveis/diagnóstico
Adulto Jovem
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170630
[Lr] Data última revisão:
170630
[Sb] Subgrupo de revista:IM; X
[Da] Data de entrada para processamento:170523
[St] Status:MEDLINE
[do] DOI:10.1089/apc.2017.0027


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[PMID]:28525565
[Au] Autor:Shakya HB; Fariss CJ; Ojeda C; Raj A; Reed E
[Ti] Título:Social Network Clustering of Sexual Violence Experienced by Adolescent Girls.
[So] Source:Am J Epidemiol;186(7):796-804, 2017 Oct 01.
[Is] ISSN:1476-6256
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We used data on 3,139 female social network friendship dyads from 3 waves of the National Longitudinal Study of Adolescent to Adult Health (wave I: 1994-1995; wave II: 1996; and wave IV: 2007-2008) to assess whether friends' reports of experiencing sexual violence (SV) and friends' substance use risk scores predicted whether adolescents and young adults would experience SV themselves. We also used longitudinal analyses to test the associations of combined wave-I and -II risk factors with wave-IV reports of SV and of combined wave-I and -II SV with network connectivity at wave II. After adjustment for a participant's substance use risk score, each 1-point increase in a friend's substance use risk score increased a respondent's odds of experiencing SV by 1.19 (95% confidence interval: 1.03, 1.36). Having a friend who reported SV increased a respondent's odds of reporting SV by 1.95 (95% confidence interval: 1.25, 3.07), although not after we included school-level fixed effects. Having a friend who experienced SV in adolescence did however increase the respondent's odds of reporting SV as a young adult by 1.54 (95% confidence interval: 1.00, 2.37). Respondents who reported SV by wave II had less network connectedness at wave II. Experiences of SV and substance use within adolescent girls' friendship networks are linked to risk for SV into young adulthood, which suggests that network-focused SV prevention and intervention approaches may be warranted.
[Mh] Termos MeSH primário: Delitos Sexuais
Apoio Social
[Mh] Termos MeSH secundário: Adolescente
Coito
Feminino
Inquéritos Epidemiológicos
Seres Humanos
Estudos Longitudinais
Fatores de Risco
Delitos Sexuais/etnologia
Delitos Sexuais/psicologia
Delitos Sexuais/estatística & dados numéricos
Transtornos Relacionados ao Uso de Substâncias/epidemiologia
Transtornos Relacionados ao Uso de Substâncias/psicologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170520
[St] Status:MEDLINE
[do] DOI:10.1093/aje/kwx154


  10 / 6520 MEDLINE  
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[PMID]:28423044
[Au] Autor:Korse NS; Veldman AB; Peul WC; Vleggeert-Lankamp CLA
[Ad] Endereço:Department of Neurosurgery, Leiden University Medical Center, Leiden, the Netherlands.
[Ti] Título:The long term outcome of micturition, defecation and sexual function after spinal surgery for cauda equina syndrome.
[So] Source:PLoS One;12(4):e0175987, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Cauda equina syndrome (CES) is a rare neurologic complication of lumbar herniated disc for which emergency surgical decompression should be undertaken. Despite the common belief that the restoration of functions that are affected by CES can take several years postoperatively, follow up seldom exceeds the first year after surgery. Long term outcome of especially micturition, defecation and sexual function-which are by definition affected in CES-are unknown. The aim of this study is to evaluate 1) postoperative long term outcome of micturition, defecation and sexual function in CES patients 2) attitude of patients towards received hospital care with regard to (recovery of) these functions. METHODS: CES patients were selected by screening the records of all patients operated on lumbar herniated disc in our university hospital between 1995-2010. A questionnaire was sent to the selected CES patients evaluating current complaints of micturition, defecation and sexual function and attitude towards delivered care with focus on micturition, defecation and sexual function. RESULTS: Thirty-seven of 66 eligible CES patients were included (response rate 71%, inclusion rate 56%). Median time after surgery was 13.8 years (range 5.8-21.8 years). Dysfunction at follow up was highly prevalent: 38% micturition dysfunction, 43% defecation dysfunction and 54% sexual dysfunction. Younger age at presentation was associated with sexual dysfunction at follow up: for every year younger at presentation, odds ratio for sexual dysfunction at follow up was 1.11 (p = 0.035). Other associations with outcome were not identified. Two-third of the CES patients wished their neurosurgeon had given them more prognostic information about micturition, defecation and sexual function. CONCLUSION: The presented data demonstrate that dysfunction of micturition, defecation and sexual function are still highly prevalent in a large number of CES patients even years postoperatively. These alarming follow up data probably have a devastating effect on personal perceived quality of life, which should be studied in more detail. CES patients communicate a clear demand for more prognostic information. The presented figures enable clinicians to inform their CES patients more realistically about long term postoperative outcome of micturition, defecation and sexual function after surgical intervention.
[Mh] Termos MeSH primário: Deslocamento do Disco Intervertebral/cirurgia
Vértebras Lombares/cirurgia
Polirradiculopatia/cirurgia
Qualidade de Vida/psicologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Coito/fisiologia
Descompressão Cirúrgica/métodos
Defecação/fisiologia
Feminino
Seres Humanos
Deslocamento do Disco Intervertebral/patologia
Deslocamento do Disco Intervertebral/fisiopatologia
Deslocamento do Disco Intervertebral/psicologia
Vértebras Lombares/patologia
Vértebras Lombares/fisiopatologia
Masculino
Meia-Idade
Polirradiculopatia/patologia
Polirradiculopatia/fisiopatologia
Polirradiculopatia/psicologia
Estudos Prospectivos
Resultado do Tratamento
Micção/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170505
[Lr] Data última revisão:
170505
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170420
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0175987



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