Carmen Villaverde Gutiérrez

Influence of exercise on mood in postmenopausal women.

AIM AND OBJECTIVE To evaluate the influence of an exercise programme on postmenopausal women with symptoms of anxiety and depression. BACKGROUND The menopause is a period of hormonal changes when mood variations are probably more severe than at any other period of womens lives. DESIGN Prospective study with control group and pre- and post-treatment measures, after six months treatment. Conducted at two healthcare clinics, in the province of Granada (Spain). METHODS A convenience sample of 60 postmenopausal women aged 60-70 years, with symptoms of depression and anxiety, was recruited. The women were randomly divided into two groups: (1) control group, no treatment (n = 30); (2) exercise group, which carried out a programme of mixed physical exercises with musical support (n = 30). All subjects answered questionnaires for the Hamilton Anxiety Scale and the Brink and Yesavage Geriatric Depression Scale before and after treatment. RESULTS In the exercise group, statistically significant improvements were observed in subjects with moderate and severe depression (18 and 22%, respectively) and in those with symptoms of anxiety. No such changes were observed in the control group. CONCLUSIONS A controlled programme of physical exercise for postmenopausal women alleviates symptoms of anxiety and depression, and its inclusion in primary healthcare programmes should be considered. RELEVANCE TO CLINICAL PRACTICE Menopausal women may benefit from physical exercise, which attenuates the effects of the physiological and psychological changes associated with the menopause and prevents pathologic changes.

Pilot study of sexual dysfunction in patients with psoriasis: influence of biologic therapy.

Background: Psoriasis is a chronic skin disease that affects 1 to 3% of the population in most industrialized countries. It is commonly associated with a variety of psychological problems including low self-esteem, depression, suicidal thoughts, and sexual dysfunction. Materials and Methods: We have performed a pilot study in which we have tried to assess the impact on sexual dysfunction in patients with psoriasis who have started treatment with biological therapy using validated indexes in Spanish: International Index of Erectile Function for men and female sexual function index in women. Results: Considering the men and women from our study, an improvement in FSFI by an average of 9.5 and 6.3 points is observed, respectively. Conclusion: We considered our series as a first step for a more detailed approach to the study of sexual function in patients with psoriasis.

Overweight obesity and cardiovascular risk in menopausal transition

INTRODUCTION the hormonal decline that is characteristic of the menopause, in conjunction with the associated weight gain, is considered a determinant factor of cardiovascular risk. OBJETIVE to examine weight status in relation to clinical symptoms during the menopausal transition, in women referred from primary care to an endocrinology specialist, to determine potential cardiovascular risk profiles. METHOD observational analytic cross-sectional study, conducted with data from medical records created at time of referral. STUDY POPULATION 805 women aged 40 years or older, a sufficient number of subjects and medical records for cardiovascular risk to be estimated. RESULTS hierarchic cluster analysis distinguished four clusters. The prevalence of obesity in each one exceeded 60%. The highest mean cardiovascular risk was observed in women who were older and presented obesity and hypertension. In younger age groups, the risk was low, rising to levels similar to those of the older women by the age of 65 years. CONCLUSION these results suggest that preventive and therapeutic monitoring of obesity and modifiable risk factors should be conducted during the menopausal transition, to reduce the risk attributable to these factors, a risk that increases with time.

Cafeína e esporte

A cafeina e considerada pela Organizacao Mundial daSaude como uma droga estimulante do sistema nervosocentral, juntamente com as anfetaminas, a nicotina e a co-caina. Sao denominadas drogas uma serie de substânciaspsicoativas que podem ser objeto de abuso. Todas sao ca-pazes de modificar uma ou varias funcoes do nosso orga-nismo.EFEITOS E MECANISMOS DE ACAOA cafeina (trimetilxantina) e uma droga psicotropica dogrupo dos estimulantes do sistema nervoso central. Emgeral, os seus efeitos sobre o organismo consistem em au-mentar o estado de alerta e reduzir a sensacao de fadiga,podendo aumentar a capacidade para realizar determina-das tarefas. A cafeina tambem possui efeitos reforcadoresque podem ser parcialmente devidos a ativacao do sistemadopaminergico. Outra acao importante da cafeina e o es-timulo a diurese, devido – entre outros mecanismos – aoaumento de glomerulos em funcionamento e do fluxo san-guineo renal, ao elevar o gasto cardiaco.Da mesma forma que outras xantinas, a cafeina possuiefeitos inotropicos, taquicardizantes, broncodilatadores eestimulantes da secrecao gastrica. Em doses maiores, pro-duz excitacao, ansiedade e insonia e em consumidores ha-bituais se desenvolve tolerância com necessidade de au-mentar o consumo para obter os efeitos iniciais. A inter-rupcao do uso produz uma sindrome de abstinencia comcefaleia, irritabilidade e letargia.Ao nivel celular, a cafeina e um antagonista competitivodos receptores de adenosina e provavelmente atua tambemdiretamente ao nivel de receptores, para potenciar a libera-cao do calcio do reticulo sarcoplasmatico, pelo desacopla-INTRODUCAOA cafeina, um alcaloide de xantina, foi identificada pelaprimeira vez no cafe. A descoberta dos seus efeitos parareduzir a fadiga e aumentar o estado de alerta e atribuida aum monge etiope. Este monge ouviu de um pastor sobre oefeito produzido pelas sementes do cafe nas suas cabras,decidindo preparar uma bebida com elas, para poder pas-sar a noite acordado em oracao.O habito de beber cafe se desenvolveu na Arabia duran-te os seculos XV e XVI, tendo sido introduzido na Europaocidental atraves da Turquia, no final do seculo XVI. Ocultivo do cafe teve inicio no Iemen, proximo a Meca, noseculo XIX, onde tambem se aperfeicoou a forma de pre-parar a bebida com o grao de cafe. Atualmente, a metadedo cafe produzido e cultivado em Sao Paulo, Brasil.Embora a sua popularidade seja indiscutivel, semprehouve divisao quanto aos efeitos beneficos do cafe. Osconsumidores habituais de cafe (cinco ou mais xicaras pordia) relatam que a abstencao causa-lhes irritabilidade, in-quietacao, nervosismo, cefaleia e dificuldade de rendimentono trabalho. Em um estudo duplo cego com cafeina e umplacebo, pode-se verificar que tais sintomas eram devidosa supressao da cafeina. A cafeina aumentou o estado dealerta, reduziu a irritabilidade e produziu uma sensacao desatisfacao, embora uma dose semelhante em individuos naoconsumidores habituais de cafe tenha produzido irritabili-dade, nervosismo e dispepsia. Desta forma, pode-se inter-pretar que o consumo habitual de grandes doses de cafeinaproduz tolerância e dependencia

The impact of therapy with TNF-blockers on health-related quality of life in rheumatoid arthritis patients. A pilot study

Abstract Introduction The aim of this pilot study was to evaluate the initial response to 16 weeks of treatment with infliximab and etanercept of disease activity and quality of life in a cohort of 37 patients with established rheumatoid arthritis. Patients and method Patients were selected from the Unit of Rheumatology in Hospital Clinico San Cecilio from Granada, refractory to conventional treatment with disease modifying antirheumatic drugs. To assess the disease activity, Disease activity score (DAS28) was used and the measurement of quality of life was evaluated with the Spanish version of the SF-36 Health Survey (SF-36) and the RA-specific questionnaire QoL Scale (Quality of Life in Rheumatoid Arthritis). Results Preliminary results show a significant decrease in inflammatory activity of the disease and consequently in HRQL scores. The comparison with the general reference population shows a deviation well below average, especially in the “physical function” dimension with a rising response pattern in all dimensions. The correlation between specific scores (QoL-RA scale) and generic ones (SF-36) for HQ-treatment also showed significance, especially with the physical aggregate. Discussion An important limitation of the present study is the number of patients and the duration of the treatment; despite this, improvements in functional parameters and quality of life are evident and remain roughly stable since the first weeks of treatment. This allows us to continue the study and increase the number of patients. Conclusions The preliminary results obtained with TNF-blockers after 16 weeks of treatment in RA objectively show the effectiveness of these drugs and also the perception by the patients of the effect on their quality of life.