Self-regulation model applied to menopause: a mixed-methods study

Objectives: Considering that bio-psycho-sociocultural variables influence menopause, this research aimed to assess the suitability of the self-regulation model in explaining the menopausal experience, and to explore differences among participants with different characteristics (e.g. health, sexual related) regarding menopause representations.Methods: Overall, 27 Portuguese women aged 40-65 years were assessed for sociodemographics, health, and sexual activity, as well as menopausal status and symptoms. Semi-structured in-depth interviews were conducted. A directed content analysis was performed, and the qualitative data presented. Afterward, the frequencies of the categories were analyzed through quantitative methods (Mann-Whitney U tests).Results: Aging was the most frequently mentioned feature regarding menopause Identity, whereas vasomotor symptoms were the most mentioned regarding Negative Consequences and menses cessation regarding Positive Consequences. Features related to Cause (hormonal changes) and Control (need for acceptance) of menopause were also identified. No differences were found in the frequency of menopause representations between women with different characteristics (e.g. with higher vs. lower vasomotor symptom severity).Conclusion: The suitability of the self-regulation model to explain these women's menopause experience was confirmed and the representations did not vary among participants with different characteristics. This research might help professionals and researchers in developing comprehensive interventions, based on this theoretical model.

Late-onset hypogonadism (LOH), masculinity and relationship and sexual satisfaction: are sexual symptoms of LOH mediators of traditional masculinity on relationship and sexual satisfaction?

Background Late-onset hypogonadism (LOH) is characterised by significant changes in the male life cycle, and may increase the likelihood of experiencing sexual difficulties. Further, it is assumed that traditional gender roles (masculinity) can affect the experience of sexual difficulties. The aim of this study was to evaluate the effect of masculinity on sexual symptoms of LOH, as well as on sexual and relational satisfaction.

METHODS

A community sample of 460 Portuguese men aged between 40 and 91 years (mean (± s.d.) 51.64 ± 8.03 years) was collected. Correlation and moderation analyses were conducted to investigate relationships among the variables being studied.

RESULTS

There was an association between the sexual symptoms of LOH, masculinity and sexual and relationship satisfaction. Moderation analysis revealed direct relationships between masculinity and sexual and relationship satisfaction, as well as direct relationships between sexual symptoms of LOH and sexual and relationship satisfaction. However, sexual symptoms of LOH did not significantly moderate the relationships between masculinity and sexual and relationship satisfaction.

CONCLUSIONS

These findings indicate the existence of a direct effect of both masculinity and sexual symptoms of LOH on sexual and relational satisfaction, although masculinity did not have an effect on sexual symptoms of LOH. The implications of these findings are discussed. Instrumentality as an indicator of masculinity was associated with relational and sexual satisfaction, suggesting the importance of involving a man's partner in sexual dysfunction interventions.

Magnetic resonance imaging-guided occult breast lesion localization and simultaneous sentinel lymph node mapping

Background

Radio-guided occult lesion localization is a valid technique for the diagnosis of suspicious non-palpable lesions. Here we determine the feasibility of pre-operative localization of occult suspect non-palpable breast lesions using radio-guided occult lesion localization, as well as for identifying the sentinel lymph node.

Methods

This is a descriptive study of data collected retrospectively. Pre-operative mapping of 34 breast lesions in 25 patients suspected of being malignant was performed using conventional imaging methods with a magnetic resonance imaging-guided radiopharmaceutical injection.

Results

The mean time required to perform the localization was 25 minutes. After resection of the lesions using a gamma probe, malignancy was confirmed in fifteen patients (60.0%), with nine invasive ductal carcinomas, two invasive lobular carcinomas, and four in situ ductal carcinomas The resection was confirmed by the complete removal of the radioactive material. The pathologic results and images were concordant in all but two cases, which were submitted for new magnetic resonance imaging examinations and surgery that confirmed the malignancies. Of the 15 patients with confirmed malignancies, 10 had sentinel lymph node resection. Of these, eight were negative for metastases, one had micro-metastases and one had confirmed metastases. Three patients had full axillary node dissection, with metastases found in only one. No side effects were observed with magnetic resonance-guided radiopharmaceutical injection.

Conclusions

The sentinel node occult lesion localization technique is a simple, reproducible and effective alternative approach to occult lesions compared to other methods, such as mammotomy and the hook-wire localization technique, for mapping suspect breast lesions and identifying lymph node metastasis.

In vitro and in vivo validation of stored swine erythrocyte viability to establish an experimental model of homologous red blood cell transfusion: a pilot study

Objective

To develop experimental models of erythrocyte transfusion, the first step is to ensure the viability of the red blood cells transfused. In this pilot study, we assessed the viability of transfused red blood cells with validation in vitro and in vivo of homologous swine erythrocytes stored for 14 days.

Methods

Blood collected from one Agroceres^® swine was stored in two red blood cell units. In vivo validation was performed by labeling the red blood cells with Na₂⁵¹CrO₄ and recovering the viable erythrocytes after 24 hours of infusion in one autologous and four homologous animals. In vitro validation was performed at baseline and after 14 days in sixteen red blood cell units by measuring hemoglobin, hematocrit, hemolysis index and free hemoglobin. A post-mortem splenectomy was performed to evaluate the splenic sequestration of erythrocytes, and the radioactivity of the supernatant samples was counted to evaluate intravascular hemolysis.

Results

After 14 days of storage, the red blood cell units had lower volumes and equivalent total concentrations of hemoglobin and hematocrit compared to human standards. The free hemoglobin concentration increased from 31.0±9.3 to 112.4±31.4mg/dL (p<0.001), and the hemolysis index increased from 0.1±0.1 to 0.5±0.1% (p<0.001). However, these tests were within the acceptable range for human standards. The percentage of radioactivity in supernatant samples was similar at baseline and after 24 hours, thus excluding significant hemolysis. No evidence of splenic sequestration of radioactive erythrocytes was found.

Conclusion

Swine red blood cells stored for 14 days are viable and can be used in experimental studies of transfusion. These validation experiments are important to aid investigators in establishing experimental models of transfusion.

Behavioral effects of endogenous or exogenous estradiol and progesterone on cocaine sensitization in female rats

Cocaine sensitization is a marker for some facets of addiction, is greater in female rats, and may be influenced by their sex hormones. We compared the modulatory effects of endogenous or exogenous estradiol and progesterone on cocaine-induced behavioral sensitization in 106 female rats. Ovariectomized female rats received progesterone (0.5 mg/mL), estradiol (0.05 mg/mL), progesterone plus estradiol, or the oil vehicle. Sham-operated control females received oil. Control and acute subgroups received injections of saline, while the repeated group received cocaine (15 mg/kg, ip) for 8 days. After 10 days, the acute and repeated groups received a challenge dose of cocaine, after which locomotion and stereotypy were monitored. The estrous cycle phase was evaluated and blood was collected to verify hormone levels. Repeated cocaine treatment induced overall behavioral sensitization in female rats, with increased locomotion and stereotypies. In detailed analysis, ovariectomized rats showed no locomotor sensitization; however, the sensitization of stereotypies was maintained. Only females with endogenous estradiol and progesterone demonstrated increased locomotor activity after cocaine challenge. Estradiol replacement enhanced stereotyped behaviors after repeated cocaine administration. Cocaine sensitization of stereotyped behaviors in female rats was reduced after progesterone replacement, either alone or concomitant with estradiol. The behavioral responses (locomotion and stereotypy) to cocaine were affected differently, depending on whether the female hormones were of an endogenous or exogenous origin. Therefore, hormonal cycling appears to be an important factor in the sensitization of females. Although estradiol increases the risk of cocaine sensitization, progesterone warrants further study as a pharmacological treatment in the prevention of psychostimulant abuse.

Retrospective evaluation of bone pain palliation after samarium-153-EDTMP therapy

PURPOSE: The aim of this study was to evaluate the degree of metastatic bone pain palliation and medullar toxicity associated with samarium-153-EDTMP treatment. METHODS: Seventy-three patients with metastatic bone pain having previously undergone therapy with samarium-153-EDTMP (1 mCi/kg) were retrospectively evaluated. Routine follow-up included pain evaluation and blood counts for 2 months after treatment. Pain was evaluated using a subjective scale (from 0 to 10) before and for 8 weeks after the treatment. Blood counts were obtained before treatment and once a week for 2 months during follow-up. Dosimetry, based upon the urinary excretion of the isotope, was estimated in 41 individuals, and the resulting radiation absorbed doses were correlated with hematological data. RESULTS: Reduction in pain scores of 75% to 100% was obtained in 36 patients (49%), with a decrease of 50% to 75%, 25% to 50%, and 0% to 25% in, respectively, 20 (27%), 10 (14%), and 7 (10%) patients. There was no significant relationship between the pain response and location of the primary tumor (breast or prostate cancer). Mild to moderate myelosuppression was noted in 75.3% of patients, usually with hematological recovery at 8 weeks. The mean bone marrow dose was 347 ± 65 cGy, and only a weak correlation was found between absorbed dose and myelosuppression (Pearson coefficient = .4). CONCLUSIONS: Samarium-153-EDTMP is a valuable method for metastatic bone pain palliation. A mild to moderate and transitory myelosuppression is the main toxicity observed after samarium therapy, showing a weak correlation with dosimetric measures.

Radioguided localisation of non-palpable breast lesions and simultaneous sentinel lymph node mapping

The authors report their experience with a new strategy for radioguided breast surgery that combines radioguided occult lesion localisation (ROLL) and sentinel lymph node (SLN) mapping. The study population comprised 38 women with non-palpable breast lesions suspicious for breast cancer (BI-RADS 4-5). On the day before surgery, 0.2 ml solution containing particles of dextran labelled with approximately 15 MBq of technetium-99m was injected under stereotaxic guidance by mammography. All patients underwent open surgical biopsy guided by gamma probe, radiographic control of the surgical specimen and frozen section analysis. The rate of confirmation of lesion removal was 100% and the rate of simultaneous SLN mapping was 97.3% (37/38). Eleven cases of infiltrating carcinoma and eight of ductal carcinoma in situ (DCIS) were diagnosed intraoperatively. In the first eight invasive lesions, the SLN was biopsied and complete axillary lymph node dissection was performed; in the three other invasive lesions and in two aggressive cases of DCIS, only the SLN was dissected. The intraoperative results of SLN analysis and the definitive histopathological examinations of the SLN were always negative. It is concluded that ROLL and SLN can be employed simultaneously when dextran is used as a tracer; this technique allows frozen section diagnosis and intra-operative node analysis, and has many advantages over the conventional two-step procedure.

Avaliação experimental do atordoamento da tireóide em camundongos

OBJETIVO: O atordoamento do tecido tireoidiano após doses diagnósticas de iodo-131 é descrito como causa de baixa captação e resposta insatisfatória a doses terapêuticas subseqüentes. O objetivo do presente trabalho foi desenvolver um modelo experimental do atordoamento tireoidiano pós-actínico. MATERIAIS E MÉTODOS: Um total de 63 camundongos recebeu dose equivalente de 45 Sv na tireóide, mediante irradiação com iodo-123. Esta dose é similar à estimada para os remanescentes tireoidianos após administração de 185 MBq (5 mCi) de iodo-131 para pesquisa de corpo inteiro. As medidas de captação tireoidiana de uma dose traçadora de iodo-131 foram efetuadas em subgrupos de nove animais, 2, 3, 5, 7, 12 e 26 dias após a irradiação. A captação nestes subgrupos foi correlacionada à de um grupo controle de nove animais não irradiados. RESULTADOS: A captação de iodo no grupo controle foi de 9,26%. Não foi observada variação significativa do valor médio de captação no período de tempo estudado. Houve aumento da variância das medidas efetuadas cinco dias após a irradiação, quando quatro dos nove animais apresentaram captação menor que 60% da média do grupo controle. CONCLUSÃO: Não houve queda sistemática da captação nos animais submetidos à dose de 45 Sv, notando-se, entretanto, tendência a maior flutuação na captação cinco dias após a irradiação. Estes achados podem ser decorrentes de diferenças interespécies ou podem indicar que o atordoamento com doses nesta faixa dependa de características individuais ou anormalidades funcionais prévias, que se somam ao efeito da radiação.

[Evaluation of inflammatory activity in chronic osteomyelitis. Contribution of scintigraphy with polyclonal antibodies]

BACKGROUND

Active chronic osteomyelitis or complicating osteomyelitis are difficult to be diagnosed by radiological imaging modalities, such as plain radiograph and CT. They frequently cause increased bone remodeling, leading to nonspecific uptake of Tc-99m-bone scan agents and gallium-67. New radiopharmaceuticals with greater infection avidity are being developed, including the nonspecific polyclonal immunoglobulin (IgG) labeled with technetium-99m. Tc-99m-IgG may be available as a ready to use kit, with no reported side effects, low patient absorbed radiation dose and low cost.

MATERIAL AND METHODS

23 bone segments with suspected active chronic osteomyelitis or violated bone osteomyelitis were studied by Tc-99m-IgG scintigraphy. All patients underwent standard three-phase bone scintigraphy using methylene diphosphonate (Tc-99m-MDP), gallium-67 scintigraphy and plain radiographs, compared with clinical evaluation and laboratory tests values.

RESULTS

Infection was found in 8 sites. Sensitivity and specificity for Tc-99m-MDP, gallium-67 and Tc-99m-IgG scintigraphy were, respectively, 88 and 36%, 75 and 73%, 88 and 82%.

CONCLUSION

Tc-99m-IgG may be usefull in the scintigraphic evaluation of osteomyelitis.

Disseminated Langerhans' cell histiocytosis and massive protein-losing enteropathy

Symptomatic involvement of the gastrointestinal (GI) tract as a prominent symptom in Langerhans' cell histiocytosis (LCH) is uncommon, occurring in less than 1 to 5% of all cases, even when the disease is in its disseminated form. Up to now, there have been reports of 18 cases of LCH with GI manifestations, including our 2 cases, with diarrhea (77.7%), protein-losing enteropathy (33.3%) and bloody stool being the most frequent findings. The authors present two patients with severe diarrhea and refractory hypoalbuminemia, and with the protein-losing enteropathy documented by Cr51-labeled albumin studies. A review of the literature indicated that the presence of GI symptoms is often associated with systemic disease as well as with poor prognosis, mainly under 2 years of age. Radioisotopes are useful for documenting protein loss in several diseases with high specificity and sensitivity, and their utilization in the cases reviewed here permitted diagnoses in 6 children, as well as improved therapeutic management.

[Current role of angiography in the study of liver diseases]

The Authors remember that also nowadays the angiographic studies for hepatic neoplasms is still interesting. These methods must be used after other less invasive screening methods, such as scintigraphy, ecotomography and computed tomography. Angiographic studies are essential in presurgical planning. Some angiographic studies of primitive hepatic neoplasms are presented.