Abstract
The early detection of symptoms and rapid testing are the basis of an efficient screening strategy to control COVID-19 transmission. The olfactory dysfunction is one of the most prevalent ...symptom and in many cases is the first symptom. This study aims to develop a machine learning COVID-19 predictive tool based on symptoms and a simple olfactory test, which consists of identifying the smell of an aromatized hydroalcoholic gel. A multi-centre population-based prospective study was carried out in the city of Reus (Catalonia, Spain). The study included consecutive patients undergoing a reverse transcriptase polymerase chain reaction test for presenting symptoms suggestive of COVID-19 or for being close contacts of a confirmed COVID-19 case. A total of 519 patients were included, 386 (74.4%) had at least one symptom and 133 (25.6%) were asymptomatic. A classification tree model including sex, age, relevant symptoms and the olfactory test results obtained a sensitivity of 0.97 (95% CI 0.91–0.99), a specificity of 0.39 (95% CI 0.34–0.44) and an AUC of 0.87 (95% CI 0.83–0.92). This shows that this machine learning predictive model is a promising mass screening for COVID-19.
Since the beginning of the COVID-19 pandemic and until September 2021, Spain suffered five waves of infection, the latter being related to the expansion of the Delta variant and with a high ...incidence. A vaccination campaign began in December 2020 and by the end of the fifth wave 77.3% of people had been fully vaccinated. Examining the changing dynamics of COVID-19 pandemic and its impact on outcomes among those hospitalized is essential. Our objective was to ascertain any differences in the characteristics and outcomes of hospitalized patients during that period compared to previous waves. We prospectively enrolled 200 consecutively admitted hospital patients from each wave and collected their clinical and demographic data from the medical records, including symptoms, comorbidities, deaths and whether they needed to be admitted to the Intensive Care Unit to receive assisted ventilation. We found that patients in the fifth wave were considerably younger than before, and the mortality rate fell from 22.5 to 2.0%. Admissions to the Intensive Care Unit decreased from 10 to 2%. Patients in the fifth wave had fewer comorbidities, and the age of the patients who died was higher than those who survived. Our results show a marked improvement in patient outcomes in the fifth wave, suggesting success of the vaccination campaign despite the explosion in cases due to the Delta variant.
Background: It has been suggested that psycho-social factors may be crucial in the development of climacteric symptoms.
Material and methods: In order to evaluate the effect of psycho-social and ...biological factors on menopausal symptoms, Greene (climacterical symptoms), Cooper (psychosomatic symptoms of stress), Smilkstein (family dysfunction), Duke-UNC (social support) and Israel (life events) tests were passed to 300 Chilean women between 40 and 59 years of age. Data were evaluated with ANOVA,
χ
2 and logistic regression using the Epi-info package.
Results: Perimenopausal women had a significant increase in stress and climacteric symptoms; however comparing with pre and postmenopausal women, tests for life events, family dysfunction or social support did not show any differences. A history of premenstrual syndrome was the main risk predictor f or climacteric symptoms (OR: 3.6, IC: 1.5–8.5;
P<0.03), followed by perimenopausal state (OR: 2.9, IC: 1.4–6.0;
P<0.001) and negative life events (OR: 2.3, IC: 1.0–5.3;
P<0.05). The psycho-social factors were predictors for anxiety and depression; on the other hand, perimenopausal state was a risk factor for somatic and vasomotor symptoms. During premenopause, women with regular cycles and vasomotor symptoms have more psychological symptoms and stress.
Conclusion: Climacteric symptoms that appear in the perimenopause are more intense in those women who have a biological predisposition such as premenstrual syndrome and are modulated by psycho-social factors.
Background: It has been suggested that hormonal changes and environmental alterations during the climacteric period are important in the development of psychological symptoms.
Objective: To evaluate ...the role of biological and psycho-social factors in the prevalence of climacteric symptoms.
Design: Open, cross-sectional, observational and descriptive study.
Material and methods: A total of 300 women between 40 and 59 years of age were evaluated using Greene scale for climacteric symptoms, Cooper questionnaire for psychosomatic symptoms of stress, Smilkstein family apgar for family dysfunction, Duke-UNC questionnaire for social support and Israel scale for vital events. All these tests have been previously validated in Spanish.
Results: Postmenopausal women do not have higher prevalence of psychological symptoms, they only have more vasomotor symptoms. Premenopausal women with vasomotor symptoms have more psychological and somatic symptoms and stress, independently of the vital events, family dysfunction or poor social support. Vasomotor symptoms in the premenopause are associated with increased risk of anxiety (OR: 3.7, IC: 1.4–9.7;
P<0.008), depression (OR: 8.1, IC: 2.5–26.4;
P<0.0005), somatic symptoms (OR: 14.9, IC: 3.4–65.3;
P<0.0003), sexual dysfunction (OR: 7.2, IC: 2.5–20.6;
P<0.0002) and stress (OR: 7.5, IC: 3.5–15.9;
P<0.0001). Negative vital events and family dysfunction increase in minor intensity the risk of anxiety, depression and stress.
Conclusion: In conclusion, psychological symptoms are frequent in the premenopause and are associated to vasomotor symptoms. This observation links psychological symptoms with menopausal transition and might suggest an organic base in their origin. The negative psycho-social environment is a factor that favours the development of these symptoms.
To assess the effect of the publication of the Women's Health Initiative (WHI) study on patients' and physicians' attitudes in relation to hormone therapy (HT).
A survey focused on the degree of ...knowledge and on the reactions to the WHI study was administered to 600 women allocated in two groups according to their socioeconomic status, high (HSES) or low (LSES). Additionally, 283 physicians were surveyed to determine their attitudes regarding HT after the publication of the WHI study. The rates of HT prescription before and after publication of the study were compared.
Among patients, HT use and knowledge of the WHI study were less common among women of lower socioeconomic status (LSES 16.7% v HSES 47.3%, and LSES 15.7% v HSES 67.3%; P < 0.0001). Of the women in the LSES group who were HT users and had knowledge on the subject of the WHI study (n = 30), 56.7% contacted their physicians and 6.6% abandoned HT. These rates were similar for women in the HSES group. Among physicians, 97.2% of physicians referred to being aware of the WHI study, and 64.7% modified their clinical approach. The main changes were that 21.5% applied more rigorous risk/benefit assessment, 20.1% lowered hormone dosage, 18.8% decreased continuous-combined therapy use, 12.1% shortened the duration of HT, 7.7% abandoned medroxyprogesterone or conjugated estrogen use, and 5.0% increased the use of transdermal estrogens, tibolone, or other alternatives. As for prescriptions, after the publication of the WHI study, there was an 8.6% drop in the rate of HT prescriptions. This decrease was more pronounced for prescriptions based on conjugated equine estrogen and medroxyprogesterone acetate. In contrast, prescription of transdermal estrogens and tibolone increased 5.2% and 16%, respectively.
There was a significant change in physicians' and patients' attitudes toward HT after publication of the WHI study.
It has been suggested that approximately 40% of women between 40 and 64 years of age cease their sexual activity. Our objective was to examine the reasons that sexual activity has stopped and to ...determine the effect that this behavior has on the marital stability of those middle-aged women.
A total of 534 healthy women between 40 and 64 years of age who were attending the Southern Metropolitan Health Service in Santiago, Chile, were asked to take part in the study.
The main reasons for sexual inactivity in middle-aged women were sexual dysfunction (49.2%), unpleasant personal relationship with a partner (17.9%), and lack of a partner (17.7%). These reasons vary with aging; in women younger than 45 years, the most frequent reason was erectile dysfunction (40.7%); in those between 45 and 59, low sexual desire (40.5%); and, in women older than 60 years, the lack of a partner (32.4%). Sexual inactivity did not affect marital stability because women without sexual relationships (68.2% of the entire sample) were married. Among the divorced women, female sexual dysfunction was responsible for only 11.7% of the separations.
Low sexual desire is the main reason for ceasing sexual activity. Nevertheless, stopping sexual relationships does not seem to be important in marital stability.
Objetivo. Aplicar y validar en una población chilena el "Indice de Función Sexual Femenina" establecido en el International Consensus Development Conference on Female Sexual Dysfunctions. Material y ...método. 383 mujeres sanas de 20 a 59 años con actividad sexual, beneficiarias del Centro de Salud "Carol Urzúa". Instrumento: cuestionario de 19 preguntas, agrupadas en seis dominios: deseo, excitación, lubricación, orgasmo, satisfacción y dolor. Análisis estadístico: Se utilizó ANOVA, Kruskall-Wallis, Chi cuadrado, regresión logística y alpha de Cronbach. Resultados. Edad media: 35,3±10,9 años, casadas (50,4%) o conviviente (17,0%), con educación media (48,2%). La consistencia interna del test fue buena (>0,70). La sexualidad logra su máxima expresión a los 35-40 años (puntaje: 29,1±4,9) para caer posteriormente (21,0±6,0), especialmente el deseo y excitación. Después de los 44 años se incrementa el riesgo de disfunción sexual (OR:3,6; IC: 2,1-6,3; p< 0,0001). La mayor educación y la estabilidad de pareja disminuyen el riesgo (OR: 0,45; IC:0,28-0,80; p< 0,005 y OR:0,58; IC:0,35-0,98; p< 0,05 respectivamente). Conclusiones. El Indice de Función Sexual Femenino es un instrumento sencillo de aplicar, con propiedades psicométricas adecuadas que permite evaluar la sexualidad en diferentes etapas de la vida. Es adecuado para estudios epidemiológicos y clínicosAim. To apply and validate in Chilean population "The Female Sexual Function Index" (International Consensus Development Conference on Sexual Female Dysfunctions). Design and methods. 383 sexually active healthy women between 20-59 years, beneficiaries of the Center of Health "Carol Urzúa". Instrument: questionnaire of 19 questions, contained in six domains: desire, arousal, lubrication, orgasm, satisfaction and pain. Statistical analysis: We used ANOVA, Kruskall-Wallis, squared Chi, logistical regression and Cronbach's alpha correlation coefficient. Results. Mean age: 35.3±10.9 years, married (50.4%) or cohabit (17.0%), with middle education (48.2%). The internal consistency of the test was good (>0.70). The sexuality achieves its maximum expression between 35-40 years (score: 29.1±4.9) and declines afterwards (21.0±6.0), especially desire and arousal. After 44 years old the risk of sexual disfunction increases (OR:3.6, IC: 2.1-6.3, p <0.0001). Education and having a stable couple decreases the risk (OR: 0.45, IC:0.28-0.80, p <0.005 and OR:0.58, IC:0.35-0.98, p <0.05; respectively). Conclusions. The Female Sexual Function Index is a simple applicable instrument with appropriate psicometric properties that allows us evaluate the sexuality in different stages of the life. It is adecuated for epidemiological and clinical studies
Abstract Fibromyalgia syndrome (FMS) is a disorder usually affecting middle aged women, who complain of diffuse musculoskeletal aches, pains or stiffness associated with tiredness, anxiety and poor ...sleep. Neurotransmission disorders linked both to pain perception as well as mood, sleep and cognition modulation are involved in FMS etiopathogenesys. Treatments that may be effective to decrease pain and fatigue include tricyclic antidepressants, dual reuptake inhibitors of serotonin/noradrenalin and pregabalin. The climacteric syndrome is a set of symptoms caused by the decline of ovarian hormone levels, which alters brain neurotransmission and provokes musculoskeletal pains, mood disorders, poor sleep quality and hot flushes. The hormone therapy reverses those symptoms and its risks are marginal if women's own hormones are used through transdermal route. Some antidepressants may be useful for patients with climacteric symptoms. We have found it surprising the epidemiological, etiopathogenic, symptomatic and therapeutic similarity between FMS and climacteric that could lead us to hypothesize that FMS is a part of the climacteric syndrome. However, the existence of FMS non-climacteric patients points out that hormone deficit is not the only physiopathological mechanism involved in this syndrome's etiopathogenesys. Nevertheless, it is likely that hormone disorders are involved in the symptoms genesis of most middle aged women with FMS. Keeping this in mind, we see the point in considering the use of HT in climacteric patients with FMS. Studies assessing the FMS clinical response to HT in a prospective manner and with the current diagnose criteria are still required.
To assess the beliefs of climacteric women regarding their health, menopause, and hormone replacement therapy (HRT).
Medical students asked to interview 526 healthy women, ranging from 40 to 64 years ...of age, between January and February of 2002. Of that number, 26 (4.9%) declined to participate in the interview. Thus, 500 women were interviewed about their beliefs and perceptions regarding their quality of life and health risks, as well as their opinions on menopause and HRT.
The mean age of the sample was 53.3 +/- 6.2 years; 83.4% were postmenopausal, and 18.8% were HRT users. Of the women interviewed, 38.6% believed that their health was good. Although 78.8% thought that cancer is the main cause of death, 64% of them considered themselves to be at high risk for cardiovascular disease and osteoporosis. Most (64%) believed that menopause deteriorates the quality of life and that it increases cardiovascular risk (52.4%) and osteoporosis (72.0%). The HRT users perceived that they had better health status (48.9% v 36.2%, P < 0.02) and smaller cardiovascular risk (54.3% v 66.3%, P < 0.04) than did the nonusers; however, they ignored the preventive effect of estrogens in osteoporosis.
Women believe that menopause deteriorates their health. The HRT users perceived themselves to be healthier and to have a smaller risk for cardiovascular disease.
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