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OBJECTIVE: In 2020, the COVID-19 pandemic brought a work and stress overload to healthcare workers, increasing their vulnerability to mental health impairments. In response, the authors created the COMVC-19 program. The program offered preventive actions and mental health treatment for the 22,000 workers of The Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP). This paper aims to describe its implementation and share what we have learned from this experience. METHODS: Workers were able to easily access the program through a 24/7 hotline. Additionally, a mobile phone app that screened for signs and symptoms of emotional distress and offered psychoeducation and/or referral to treatment was made available. Data from both these sources as well as any subsequent psychiatric evaluations were collected. RESULTS: The first 20 weeks of our project revealed that most participants were female, and part of the nursing staff working directly with COVID-19 patients. The most frequently reported symptoms were: anxiety, depression and sleep disturbances. The most common diagnoses were Adjustment, Anxiety, and Mood disorders. CONCLUSIONS: Implementing a mental health program in a multimodal intervention was feasible in a major quaternary public hospital. Our data also suggests that preventive actions should primarily be aimed at anxiety and depression symptoms, with a particular focus on the nursing staff.

https://doi.org/10.6061/clinics/2021/e2631

AMB Guidelines: COVID-19
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Ferreira, Lincoln Lopes

; Sampaio, Diogo Leite

; Chagas, Antonio Carlos Palandri

; Guimarães, Hélio Penna

; Hajjar, Ludhmila Abrahão

; Lobo, Suzana Margareth Ajeje

; Abdo, Carmita Helena Najjar

; Bonamigo Filho, José Luiz

; Bacha, Helio Arthur

; Moura, Robson Freitas de

; Bernardo, Wanderley Margues

Revista da Associação Médica Brasileira

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sep 2020, Volume 66 N. 9 Pages 1179 - 1179

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/1806-9282.66.9.1179 509 downloads

AMB Guidelines: COVID –19
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Ferreira, Lincoln Lopes

; Sampaio, Diogo Leite

; Chagas, Antonio Carlos Palandri

; Guimarães, Hélio Penna

; Hajjar, Ludhmila Abrahão

; Lobo, Suzana Margareth Ajeje

; Abdo, Carmita Helena Najjar

; Bonamigo Filho, José Luiz

; Bacha, Helio Arthur

; Moura, Robson Freitas de

; Bernardo, Wanderley Marques

Revista da Associação Médica Brasileira

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2020, Volume 66 Suppl. 2 Pages 17 - 21

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/1806-9282.66.s2.17 1235 downloads

Is testosterone involved in low female sexual desire?
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Abdo, Carmita H. N.

Archives of Endocrinology and Metabolism

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jun 2019, Volume 63 N. 3 Pages 187 - 189

Abstract: En | Text: En | PDF: En

https://doi.org/10.20945/2359-3997000000153 1842 downloads

Função e disfunção sexual na depressão: uma revisão sistemática
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Gonçalves, Walter dos Santos

; Gherman, Bruno Rabinovici

; Abdo, Carmita Helena Najjar

; Nardi, Antonio Egidio

; Appolinário, Jose Carlos Borges

Jornal Brasileiro de Psiquiatria

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jun 2019, Volume 68 N. 2 Pages 110 - 120

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo Revisar sistematicamente as informações disponíveis acerca da função sexual e/ou disfunção sexual em pacientes com transtorno depressivo maior (TDM) e/ou distimia (DIS). Métodos Foi realizada uma busca sistematizada na base eletrônica Medline por estudos que avaliavam a função/disfunção sexual em pacientes com TDM e DIS. Foram incluídos estudos publicados até junho de 2017. Artigos relevantes presentes nas referências dos artigos foram pesquisados manualmente e incluídos nesta revisão. Resultados Vinte estudos foram elegíveis para análise. Foi observada uma grande diversidade de resultados decorrente da heterogeneidade dos delineamentos empregados e devido aos diferentes métodos de avaliação utilizados. De forma geral, os dados provenientes demonstraram uma redução das principais funções sexuais em pacientes com TDM e DIS, tais como: libido (31%-32%), drive (31%-87%), excitação (29%-85%), ereção (18%-46%), lubrificação (18%-79%) e orgasmo (26%-81%). Aumento de libido (15%-22%) também foi descrito em alguns estudos. Conclusão A disfunção sexual é altamente prevalente na DIS e no TDM. Foram notadas diversas alterações de funcionamento sexual na população estudada. Discrepâncias acerca de suas prevalências podem ter ocorrido devido às variadas metodologias de análise utilizadas nos estudos.

ABSTRACT Objective To review the available data on the evaluation of sexual function and/or sexual dysfunction in patients with major depressive disorder (MDD) and/or Dysthymia (DYS) without pharmacological and psychotherapeutic treatment. Methods A systematic electronic search was conducted in the Medline database for studies that evaluated sexual function/dysfunction in patients with MDD and DYS. We included studies published up to June 2017. Relevant articles present in the articles references were manually searched and included in this review. Results Twenty studies were eligible for analysis. It was observed a variety of results due to the heterogeneity of the studies and due to the different evaluation methods used. In general, the data from these studies demonstrated a reduction of the main sexual functions in patients with MDD and DYS such as: libido (31%-32%), drive (31%-87%), arousal (29%-85%), erection (18%-46%), lubrication (18%-79%) and orgasm (26%-81%). Increased libido (15%-22%) has also been described in some studies. Conclusion Sexual dysfunction is highly prevalent in DYS and in MDD. Several sexual functioning alterations were observed in this study population. Prevalence discrepancies may have occurred due to the varied methodologies used in the studies.

https://doi.org/10.1590/0047-2085000000234 4500 downloads

Sexual function in female juvenile idiopathic arthritis patients
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Pitta, Ana Claudia

; Ferreira, Gabriela Ribeiro Viola

; Tomioka, Renato Bussadori

; Lourenço, Daniela Mencaroni Rodrigues

; Kozu, Katia

; Aikawa, Nadia Emi

; Sallum, Adriana Maluf Elias

; Campos, Lucia Maria Arruda

; Abdo, Carmita Helena Najjar

; Pereira, Rosa Maria Rodrigues

; Baracat, Edmund Chada

; Bonfá, Eloisa

; Silva, Clovis Artur

Advances in Rheumatology

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2019, Volume 59 elocation 13

Abstract: En | Text: En | PDF: En

Abstract Objective: To evaluate sexual function female adolescents and young adults with juvenile idiopathic arthritis (JIA) and healthy controls. Methods: After exclusion, 21 female adolescent and young JIA patients and 25 healthy controls were selected for this study. Sexual function was assessed by the Sexual Quotient Questionnaire for Females (SQQ-F) score, which is a validated tool and adapted for Brazilian Portuguese language. Demographic data, JIA clinical/laboratory parameters and treatment were also assessed. Results: The median current age [26.5 (17-38.1) vs. 29.3 (19.7-35.8) years, p = 0.700)] as well as age at the first sexual activity [18 (14-30) vs. 17 (10-24) years, p = 0.158] were similar in JIA patients and healthy controls. The median of SQQ-F score was alike in both groups [75.9 (50-92) vs. 78.2 (58-94), p = 0.529], as well as frequencies of sexual dysfunction (14% vs. 12%, p = 1.000). The frequencies of all sexual domains (desire/sexual fantasies, desire/interest, arousal/foreplay, arousal/lubrication, arousal/in tune with partner, penetration/relaxation, pain/penetration, desire/involvement, orgasm and general satisfaction scores) were similar in JIA patients and healthy controls (p > 0.05). Conclusions: To our knowledge, this was the first study using a validated sexual score in a chronic arthritis population suggesting a low frequency of overall sexual dysfunction in young JIA patients. Future multicenter studies with a large sample will be necessary to confirm this finding.

https://doi.org/10.1186/s42358-019-0058-8 532 downloads

Sexual compulsivity, anxiety, depression, and sexual risk behavior among treatment-seeking men in São Paulo, Brazil
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Scanavino, Marco D.T.

; Ventuneac, Ana

; Abdo, Carmita H.N.

; Tavares, Hermano

; Amaral, Maria L.S.

; Messina, Bruna

; Reis, Sirlene C.

; Martins, João P.L.B.

; Parsons, Jeffrey T.

Brazilian Journal of Psychiatry

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dec 2018, Volume 40 N. 4 Pages 424 - 431

Abstract: En | Text: En | PDF: En

Objective: There is a lack of studies on negative mood states and sexual risk behavior in men of all sexual orientations who seek treatment for excessive sexual behavior (ESB). We aim to examine sexual compulsivity (SC), anxiety, depression, and sexual risk behavior in a treatment-seeking sample of men and controls. Methods: We enrolled 88 (37 [42%] gay or bisexual and 51 [58%] heterosexual) ESB outpatients and 64 controls. Assessments included the Sexual Compulsivity Scale (SCS), the Beck Anxiety Inventory (BAI), the Beck Depression Inventory (BDI), and sexual risk behaviors. Results: Compared to controls, ESB outpatients showed increased SC, anxiety, and depression, which were correlated. Regarding sex with casual partners, ESB outpatients reported more sexual intercourse, a greater number of partners, more anal intercourse, and unprotected anal intercourse. Anxiety, depression, and SC were associated with protected vaginal intercourse with a main partner, whereas they were associated with unprotected anal intercourse with a casual partner. Depression was associated with unprotected vaginal intercourse with a casual partner. Condomless anal intercourse was predicted by SC and was also reported by the heterosexual ESB outpatients (36%). Conclusion: The data contribute to the field by providing information on men of all sexual orientations who are searching for mental healthcare. The connections among these psychopathological factors and sexual risk behavior have implications for public health, clinicians, and research.

https://doi.org/10.1590/1516-4446-2017-2476 2394 downloads

10.

Sexual function, anxiety and depression in women with benign breast disease. A case-control study
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Fairbanks, Flávia

; Andres, Marina Paula

; Caldeira, Priscila

; Abdo, Carmita

; Podgaec, Sergio

Revista da Associação Médica Brasileira

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oct 2017, Volume 63 N. 10 Pages 876 - 882

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Introdução: A disfunção sexual é altamente prevalente, afetando 40% da população feminina. A incidência de tal disfunção é conhecida por ser maior entre as mulheres com câncer de mama e pacientes com ansiedade e depressão. No entanto, existem poucos dados sobre a prevalência de disfunção sexual entre mulheres com doença benigna da mama (BBD). Objetivo: Avaliar a incidência de disfunção sexual, depressão e ansiedade em mulheres com BBD, em comparação a mulheres saudáveis. Método: Avaliamos a incidência de disfunção sexual em 60 pacientes com doença benigna da mama (fibroadenomas, cistos mamários, dor mamária e tumor phyllodes) e 69 mulheres saudáveis (grupo controle). As participantes completaram o Questionário de Quociente Sexual para Mulheres (SQQ-F), o Inventário de Depressão de Beck e o Inventário de Ansiedade de Beck. A análise estatística revelou que a depressão e a ansiedade eram comparáveis entre os grupos BBD e controle (10,3 vs. 20,3% e 38,7 vs. 34,3%, respectivamente, p>0,05). O escore médio de SQQ-F (65,6±22,7 vs. 70,1±16,8; p>0,05) e a disfunção sexual (33,3 vs. 25,4%; p=0,324) foram semelhantes entre os grupos BBD e controle. Conclusão: Não encontramos diferenças entre mulheres com BBD e mulheres saudáveis em termos de incidência de disfunção sexual, ansiedade e depressão. No entanto, dada a alta prevalência dessa condição, é importante avaliar a qualidade de vida sexual, bem como a qualidade de vida global, em mulheres com BBD.

Summary Introduction: Sexual dysfunction is highly prevalent, affecting 40% of the female population. The incidence of such dysfunction is known to be higher among women with malignant breast disease and in patients with depression or anxiety. However, there are few data regarding the prevalence of sexual dysfunction among women with benign breast disease (BBD). Objective: To evaluate the incidence of sexual dysfunction, depression and anxiety among women with BBD, in comparison with that observed for healthy women. Method: We evaluated the incidence of sexual dysfunction in 60 patients with benign breast disease (fibroadenomas, breast cysts, breast pain and phyllodes tumor) and 69 healthy women (control group). Participants completed the Sexual Quotient Questionnaire for Females (SQQ-F), the Beck Depression Inventory and the Beck Anxiety Inventory. Statistical analysis revealed that depression and anxiety were comparable between BBD and control groups (10.3 vs. 20.3% and 38.7 vs. 34.3%, respectively, p>0.05). The mean SQQ-F score (65.6±22.7 vs. 70.1±16.8; p>0.05) and sexual dysfunction (33.3 vs. 25.4%; p=0.324) were similar between BBD and control groups. Conclusion: We found no differences between women with BBD and healthy women in terms of the incidence of sexual dysfunction, anxiety and depression. Nevertheless, given the high prevalence of this condition, it is important to assess sexual quality of life, as well as overall quality of life, in women with BBD.

https://doi.org/10.1590/1806-9282.63.10.876 5113 downloads

11.

Analysis of sexual function of patients with dermatomyositis and polymyositis through self-administered questionnaires: a cross-sectional study
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Souza, Fernando Henrique Carlos de

; Araújo, Daniel Brito de

; Silva, Clovis Artur

; Miossi, Renata

; Abdo, Carmita Helena Najjar

; Bonfá, Eloisa

; Shinjo, Samuel Katsuyuki

Revista Brasileira de Reumatologia

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apr 2017, Volume 57 N. 2 Pages 134 - 140

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Introdução: Até o presente momento, não há descrições na literatura da avaliação ginecológica e da função sexual em pacientes do sexo feminino com dermatomiosite (DM) e polimiosite (PM). Objetivos: Avaliar a função sexual em pacientes do sexo feminino com DM/PM. Casuística e métodos: Estudo transversal unicêntrico em que 23 pacientes (16 DM e sete PM), entre 18 e 40 anos, foram comparadas com 23 mulheres saudáveis, com a mesma faixa etária. As características sobre a função sexual foram obtidas por meio da aplicação dos questionários Female Sexual Quotient (FSQ) e Female Sexual Function Index (FSFI) validados para a língua portuguesa do Brasil. Resultados: A média de idade das pacientes foi comparável à dos controles (32,7 ± 5,3 vs. 31,7 ± 6,7 anos), assim como a distribuição de etnia e da classe socioeconômica. Quanto às características ginecológicas, pacientes e controles saudáveis não apresentaram diferenças em relação à idade na menarca e às porcentagens de dismenorreia, menorragia, síndrome pré-menstrual, dor no meio do ciclo, secreção mucocervical e corrimento vaginal. O escore de pontuação do FSQ, assim como todos os domínios do questionário do FSFI (desejo, excitação, lubrificação, orgasmo e satisfação), estavam significantemente diminuídos nas pacientes comparativamente com os controles, 60,9% das pacientes apresentavam algum grau de disfunção sexual. Conclusões: Este foi o primeiro estudo que identificou disfunção sexual nas pacientes com DM/PM. Assim, uma abordagem multidisciplinar é essencial para pacientes com miopatias inflamatórias idiopáticas para fornecer medidas de prevenção e cuidados para sua vida sexual e propiciar uma melhor qualidade de vida das pacientes e de seus parceiros.

Abstract Introduction: To date, there are no descriptions in the literature on gynecologic and sexual function evaluation in female patients with dermatomyositis (DM) and polymyositis (PM). Objective: To assess sexual function in female patients with DM/PM. Patients and methods: This is a monocentric, cross-sectional study in which 23 patients (16 DM and 7 PM), with ages between 18 and 40 years, were compared to 23 healthy women of the same age group. Characteristics on sexual function were obtained by applying the questionnaires Female Sexual Quotient (FSQ) and Female Sexual Function Index (FSFI) validated for the Brazilian Portuguese language. Results: The mean age of patients was comparable to controls (32.7 ± 5.3 vs. 31.7 ± 6.7 years), as well as the distribution of ethnicity and socioeconomic class. As for gynecological characteristics, patients and healthy controls did not differ with respect to age at menarche and percentages of dysmenorrhea, menorrhagia, premenstrual syndrome, pain at mid-cycle, mucocervical secretion, and vaginal discharge. The FSQ score, as well as all domains of the FSFI questionnaire (desire, arousal, lubrication, orgasm and satisfaction), were significantly decreased in patients vs. controls, with 60.9% of patients showing some degree of sexual dysfunction. Conclusions: This was the first study to identify sexual dysfunction in patients with DM/PM. Therefore, a multidisciplinary approach is essential for patients with idiopathic inflammatory myopathies, in order to provide prevention and care for their sexual life, providing a better quality of life, both for patients and their partners.

https://doi.org/10.1016/j.rbre.2016.11.002 3073 downloads

12.

Aspectos da atividade sexual precoce
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Lara, Lucia Alves da Silva

; Abdo, Carmita Helena Najjar

Revista Brasileira de Ginecologia e Obstetrícia

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may 2015, Volume 37 N. 5 Pages 199 - 202

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.1590/SO100-720320150005207 10992 downloads

13.

Perceptions about penis size among supposedly healthy 40 to 60-year-old Brazilian men: a cross-sectional pilot study
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Reis, Margareth de Mello Ferreira dos

; Glina, Sidney

; Abdo, Carmita Helena Najjar

Sao Paulo Medical Journal

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apr 2015, Volume 133 N. 2 Pages 84 - 90

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

CONTEXTO E OBJETIVO:Muitos homens buscam tratamento médico com a queixa de que seus pênis são muito pequenos (curtos), quando na verdade não são (não são casos de micropênis). O objetivo do presente estudo foi avaliar a satisfação com o próprio corpo e vida sexual e a prevalência de disfunção erétil entre homens que não estavam buscando aconselhamento médico ou psicológico.TIPO DE ESTUDO E LOCAL:Estudo transversal, em um hospital privado filantrópico em São Paulo, Brasil.MÉTODOS:Neste estudo, 300 homens doadores de sangue, com idade entre 40 e 60 anos, responderam um questionário, em privacidade, sobre sua vida sexual e satisfação com o próprio corpo. Eles também foram rastreados para disfunção erétil por meio do questionário International Index of Erectile Function.RESULTADOS:Sete homens (2,3%) disseram estar insatisfeitos com o tamanho de seus pênis (achavam que era pequeno), e entre estes, um tinha disfunção erétil leve. Entretanto, nenhum deles procurou aten-dimento médico. Entre esses sete, somente dois estavam com índice de massa corporal normal, três estavam com sobrepeso e dois eram obesos.CONCLUSÃO:A prevalência de insatisfação com o tamanho do pênis foi pequena. Entre os sete homens insatisfeitos, apenas um tinha disfunção erétil, leve, e todos se sentiam potentes.

CONTEXT AND OBJECTIVE:Many men seek medical treatments complaining that their penises are too small (short) when in fact they are not (they are not cases of micropenis). The objective of the present study was to evaluate men's satisfaction with their own bodies and sex life and the prevalence of erectile dysfunction, among men who were not seeking medical or psychological advice.DESIGN AND SETTING:Cross-sectional study in a private, philanthropic hospital in São Paulo, Brazil.METHODS:In this study, 300 male blood donors aged between 40 and 60 years old answered a questionnaire, in privacy, about their sex life and their satisfaction with their own bodies. They were also screened for erectile dysfunction by means of the International Index of Erectile Function questionnaire.RESULTS:Seven men (2.3%) reported that they were dissatisfied with their penis size (they thought that it was small), and among these, one was found to have mild erectile dysfunction. However, none of them had sought medical attention. Among these seven, only two had normal body mass index; the other five were overweight (three) or obese (two).CONCLUSION:The prevalence of dissatisfaction with penis size was low. Among the seven dissatisfied men, only one had erectile dysfunction, of mild type, and all of them felt potent.

https://doi.org/10.1590/1516-3180.2013.7710008 9735 downloads

14.

A new sexual revolution
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Abdo, Carmita Helena Najjar

einstein (São Paulo)

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jun 2014, Volume 12 N. 2 Pages 11 - 12

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/S1679-45082014ED3182 6901 downloads

15.

Benefits and risks of testosterone treatment for hypoactive sexual desire disorder in women: a critical review of studies published in the decades preceding and succeeding the advent of phosphodiesterase type 5 inhibitors
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Reis, Sandra Léa Bonfim

; Abdo, Carmita H.N.

Clinics

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apr 2014, Volume 69 N. 4 Pages 294 - 303

Abstract: En | Text: En | PDF: En

With advancing age, there is an increase in the complaints of a lack of a libido in women and erectile dysfunction in men. The efficacy of phosphodiesterase type 5 inhibitors, together with their minimal side effects and ease of administration, revolutionized the treatment of erectile dysfunction. For women, testosterone administration is the principal treatment for hypoactive sexual desire disorder. We sought to evaluate the use of androgens in the treatment of a lack of libido in women, comparing two periods, i.e., before and after the advent of the phosphodiesterase type 5 inhibitors. We also analyzed the risks and benefits of androgen administration. We searched the Latin-American and Caribbean Health Sciences Literature, Cochrane Library, Excerpta Medica, Scientific Electronic Library Online, and Medline (PubMed) databases using the search terms disfunção sexual feminina/female sexual dysfunction, desejo sexual hipoativo/female hypoactive sexual desire disorder, testosterona/testosterone, terapia androgênica em mulheres/androgen therapy in women, and sexualidade/sexuality as well as combinations thereof. We selected articles written in English, Portuguese, or Spanish. After the advent of phosphodiesterase type 5 inhibitors, there was a significant increase in the number of studies aimed at evaluating the use of testosterone in women with hypoactive sexual desire disorder. However, the risks and benefits of testosterone administration have yet to be clarified.

https://doi.org/10.6061/clinics/2014(04)11 4533 downloads

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