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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

Qualidade do sono em gestantes com sobrepeso
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Ribeiro, Meireluci Costa

; Nakamura, Mary Uchiyama

; Torloni, Maria Regina

; Scanavino, Marco de Tubino

; Forte, Bruna Maria Bernardi

; Mancini, Pedro Eduardo

; Mattar, Rosiane

Revista Brasileira de Ginecologia e Obstetrícia

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aug 2015, Volume 37 N. 8 Pages 359 - 365

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

<sec><title>OBJETIVO:</title> Comparar a qualidade do sono de gestantes com e sem sobrepeso no segundo e terceiro trimestres.</sec><sec><title>MÉTODOS:</title> Estudo transversal incluindo 223 gestantes com ≥14 semanas: 105 com sobrepeso (índice de massa corporal - IMC - pré-gestacional ≥25,0 km2) e 118 eutróficas (IMC 18,5-24,9 kg/m2) em acompanhamento pré-natal. A versão brasileira do questionário <italic>Pittsburgh Sleep Quality Index</italic> (PSQI-BR) foi utilizada para avaliação do sono. Testes do χ2 e <italic>t</italic> de Student foram utilizados para comparar diferenças entre os grupos; p<0,05 foi considerado significante.</sec><sec><title>RESULTADOS:</title> A maioria (65,9%) apresentou baixa qualidade de sono (escore total >5) e essa proporção foi significativamente mais alta entre as mulheres com sobrepeso (80/105), em comparação às eutróficas (67/118) (76,2 <italic>versus</italic> 56,8%, p=0,004). No 2º trimestre, essa proporção não alcançou significância estatística (72,5 <italic>versus</italic> 53,7%, p=0,06), mas o escore médio total do PSQI-BR foi mais alto entre aquelas com sobrepeso (7,0±3,8 <italic>versus</italic> 5,5±3,2, p=0,02). Nesse período, os escores médios de latência e qualidade subjetiva do sono foram significativamente mais altos entre as mulheres com sobrepeso (1,4±1,0 <italic>versus</italic> 1,0±0,9, p=0,02, e 1,3±0,8 <italic>versus</italic> 0,8±0,8, p=0,02, respectivamente). No 3º trimestre, a proporção de gestantes com baixa qualidade do sono foi mais alta entre as mulheres com sobrepeso, mas sem diferença significante (79,6 <italic>versus</italic> 60,8%, p=0,06). Nessa fase, o escore total do instrumento foi semelhante entre as mulheres com e sem sobrepeso (9,4±4,2 <italic>versus</italic> 8,3±4,6, p=0,2). No entanto, gestantes com sobrepeso apresentaram escores médios mais altos para distúrbios do sono (2,3±0,7 <italic>versus</italic> 2,0±0,8, p=0,04).</sec><sec><title>CONCLUSÃO:</title> Mulheres com sobrepeso pré-gestacional apresentaram sono mais comprometido do que as eutróficas, no segundo e terceiro trimestres da gravidez.</sec>

<sec><title>PURPOSE:</title> To compare sleep quality of overweight <italic>versus</italic> normal weight women in the second and third trimesters of pregnancy.</sec><sec><title>METHODS:</title> A cross-sectional study involving 223 women with 14 or more weeks of pregnancy, 105 of them overweight (pre-pregnancy body mass index - BMI - ≥25.0 kg/m2) and 118 of normal weight (BMI 18.5-24.9 kg/m2), attending the prenatal care clinic. The Brazilian version of the Pittsburgh Sleep Quality Index (PSQI-BR) questionnaire was used to evaluate sleep quality. The Student t-test and the chi-square test were used to compare differences between groups and a p value <0.05 was considered statistically significant.</sec><sec><title>RESULTS:</title> Most of the participants (67.7%) were poor sleepers (total score >5); this proportion was significantly higher among overweight (80/105) <italic>versus</italic> normal weight (67/118) women (76.2 <italic>versus</italic> 56.8%, p=0,004). During the second trimester, this difference did not reach statistical significance (72.5 <italic>versus</italic> 53.7%, respectively, p=0.06) but mean total PSQI-BR scores were significantly higher among overweight participants (7.0±3.8 <italic>versus</italic> 5.5±3.2, p=0.02). In the 2nd trimester, overweight women also had higher scores for sleep latency (1.4±1.0 <italic>versus</italic> 1.0±0.9, p=0.02) and subjective sleep quality (1.3±0.8 <italic>versus</italic> 0.8±0.8, p=0.02). In the third trimester, the proportion of women with poor sleep quality was significantly higher in the overweight group, but did not reach statistical significance (79.6 <italic>versus</italic> 60.8%, p=0.06). During this period, total mean scores were similar for women with and without excess weight (9.4±4.2 <italic>versus</italic> 8.3±4.6, p=0.2). However, overweight women had higher mean scores for sleep disturbance (2.3±0.7 <italic>versus</italic> 2.0±0.8, p=0.04).</sec><sec><title>CONCLUSION:</title> Overweight women had a poorer sleep quality than normal weight women in the second and third trimesters of pregnancy.</sec>

https://doi.org/10.1590/SO100-720320150005415 3848 downloads

Five cases of sexual addiction under Short-term Psychodynamic Group Psychotherapy
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Scanavino, Marco de Tubino

; Kimura, Cintia Mayumi Sakurai

; Messina, Bruna

; Abdo, Carmita Helena Najjar

; Tavares, Hermano

Archives of Clinical Psychiatry (São Paulo)

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2013, Volume 40 N. 5 Pages 208 - 209

Abstract: En | Text: En | PDF: En

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Severe compulsive sexual behaviors: a report on two cases under treatment
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Amaral, Maria Luiza Sant'Ana do

; Scanavino, Marco de Tubino

Brazilian Journal of Psychiatry

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jun 2012, Volume 34 N. 2 Pages 213 - 214

Abstract: En | Text: En | PDF: En

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O grupo de relacionamentos afetivo-sexuais seguros para portadores de transtorno mental grave
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Scanavino, Marco de Tubino

; Benatti, Edna Teresinha

; Sant, Renato Del

Brazilian Journal of Psychiatry

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sep 2011, Volume 33 N. 3 Pages 303 - 304

Abstract: Pt | Text: Pt | PDF: Pt

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Gravidez e Diabetes Gestacional: uma combinação prejudicial à função sexual feminina?
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Ribeiro, Meireluci Costa

; Nakamura, Mary Uchiyama

; Abdo, Carmita Helena Najjar

; Torloni, Maria Regina

; Scanavino, Marco de Tubino

; Mattar, Rosiane

Revista Brasileira de Ginecologia e Obstetrícia

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may 2011, Volume 33 N. 5 Pages 219 - 224

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

OBJETIVO: Comparar a funcao sexual de gravidas adultas saudaveis a de mulheres com Diabetes Mellitus Gestacional (DMG) no terceiro trimestre da gravidez. MÉTODOS: Estudo transversal com dois grupos de gestantes em acompanhamento pre-natal. Foram criterios de inclusao: idade materna .20 anos, idade gestacional .28 semanas, relacionamento heterossexual com o mesmo parceiro ha pelo menos 6 meses e ser alfabetizada. Os criterios de exclusao foram: presenca de intercorrencias clinicas e/ou obstetricas que contraindicassem atividade sexual; hipertensao arterial controlada por medicamentos; gravidez resultante de estupro; parceiro sexualmente indisponivel ou ausente no ultimo mes; internacao hospitalar no ultimo mes; uso de cremes vaginais nos ultimos 30 dias; gestacao gemelar; uso regular de alcool e/ou drogas ilicitas; uso de medicamentos que interferissem na funcao sexual. Oitenta e sete pacientes preencheram os criterios de selecao e participaram do estudo. Para avaliacao da funcao sexual destes grupos utilizou-se o questionario Quociente Sexual . Versao Feminina (QS-F). Testes X² e t de Student foram utilizados para comparar diferencas entre os grupos, com valores p<0,05 considerados estatisticamente significantes. A analise estatistica foi realizada com o software Instat 3. RESULTADOS: A idade gestacional media nos dois grupos era de 34 semanas. Nao foram detectadas diferencas significantes nos escores medios totais do QS-F nos dois grupos (62,5 saudaveis vs 62,8 DMG, p=0,9). Aproximadamente metade das participantes (47 e 47,5% das saudaveis e DMG, respectivamente, p=0,9) teve escores totais de ate 60 na escala do QS-F, o que indica comprometimento em algum dos dominios avaliados (desejo e satisfacao sexual, excitacao, orgasmo, dispareunia e vaginismo). CONCLUSÕES: A prevalencia de comprometimento do desempenho sexual foi alta em gestantes no terceiro trimestre, nao diferindo significativamente entre mulheres saudaveis e aquelas com DMG.

To compare the sexual function of healthy adult pregnant women with that of gestational diabetes patients (GDM) in the third trimester. METHODS: This cross-sectional study enrolled two groups of women managed antenatal care clinics. Inclusion criteria were: maternal age .20 years, gestational age at least 28 weeks, being in a heterosexual relationship with the same partner for at least 6 months, and being able to read. We excluded women with a medical recommendation for sexual abstinence due to clinical or obstetric disorders; hypertension controlled through medications; pregnancy resulting from rape; absent or sexually unavailable partner in the last month; hospital admission in the last month; use of vaginal creams in the last 30 days; multiple pregnancy, regular use of alcohol or illicit drugs or use of medications that can interfere with sexual function. Eighty-seven patients fulfilled the selection criteria and were included in the study. The Sexual Quotient . Feminine Version (QS-F) questionnaire was used to assess sexual function. Student's t and X² tests were used to compare differences between groups and p<0.05 was considered significant. RESULTS: The mean gestational age of the participants was 34 weeks. There were no significant differences in the mean QS-F scores between groups (62.5 healthy vs 62.8 GDM women, p=0.9). Approximately half the participants (47 and 47.5% of the healthy and GDM women, respectively, p=0.9) had total scores up to 60, indicative of dysfunction in one of the assessed domains (desire, sexual satisfaction, arousal, orgasm, dyspareunia and vaginismus). CONCLUSIONS: The prevalence of sexual dysfunction was high among women in the third trimester of pregnancy and did not differ significantly between healthy women and women with GDM.

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Sexual dysfunctions among people living with aids in Brazil
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Scanavino, Marco de Tubino

; Abdo, Carmita Helena Najjar

Clinics

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2010, Volume 65 N. 5 Pages 511 - 519

Abstract: En | Text: En | PDF: En

INTRODUCTION: Sexual dysfunction symptoms in patients with HIV have not been fully investigated in Brazil. OBJECTIVES: To investigate the association between sexual dysfunction symptoms and AIDS among participants in the Brazilian Sex Life Study. METHODS: The Brazilian Sex Life Study is a cross-sectional population study. The participants answered an anonymous self-responsive inquiry. It was applied to a population sample in 18 large Brazilian cities. Answers given by those who reported having AIDS (75) were compared with those who reported not having AIDS (control; 150). This was a case-control study nested in a cross-sectional population study. RESULTS: In females, AIDS was associated with "sexual inactivity over the last 12 months" and "does not maintain sexual arousal until the end of the sex act" (P < 0.05) after adjusting for race and thyroid disease. Compared to the control group, men with AIDS had more difficulty becoming sexually aroused (they required more help from their partner to begin the sex act, they required longer foreplay than they wished, they reported losing sexual desire before the end of the sex act, and they required longer to ejaculate than they desired) (P < 0.05). After adjusting for sexual orientation, sex hormone deficiency, depression, and alcoholism, only "does not have sexual desire," "have longer foreplay," and dyspareunia were associated with AIDS. DISCUSSION AND CONCLUSIONS: The results support the hypothesis that sexual dysfunctions are associated with AIDS. Men with AIDS need more time and stimulation to develop a sexual response, and a significant portion (37%) of women with AIDS reported sexual inactivity over the last 12 months.

2997 downloads Cited 1 time in SciELO

A integração das disciplinas de humanidades médicas na Faculdade de Medicina da USP: um caminho para o ensino
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Rios, Izabel Cristina

; Lopes Junior, Ademir

; Kaufman, Arthur

; Vieira, Joaquim Edson

; Scanavino, Marco de Tubino

; Oliveira, Reinaldo Ayer de

Revista Brasileira de Educação Médica

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mar 2008, Volume 32 N. 1 Pages 112 - 121

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

A integração curricular, atualmente, é apontada como importante estratégia de ensino, processo que envolve várias etapas, trabalho e compromisso de grupo. Este artigo relata a experiência de integração das disciplinas de humanidades médicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP). Ao longo de dois anos, constituiu-se um grupo composto pelas disciplinas da área de humanidades médicas, pesquisadores do Centro de Desenvolvimento da Educação Médica Professor Eduardo Marcondes (Cedem), alunos e professores de outras disciplinas interessados na área. Desenvolveu-se a integração temática e prossegue-se na integração metodológica.

Currently curricular integration is considered an important educational strategy, a process involving several stages, work and group commitment. This paper relates the experience of the Faculdade de Medicina da Universidade de São Paulo (FMUSP) of integrating medical humanities disciplines. During two years a group was composed involving professors of medical humanities disciplines, researchers from the Center of Development of Medical Education Professor Eduardo Marcondes (Cedem) as well as students and professors of other disciplines interested in this area. The thematic integration has already been concluded and the methodological integration is in process.

7342 downloads Cited 16 times in SciELO

Disfunção erétil: resultados do estudo da vida sexual do brasileiro
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Abdo, Carmita Helena Najjar

; Oliveira Jr, Waldemar Mendes de

; Scanavino, Marco de Tubino

; Martins, Fernando Gonini

Revista da Associação Médica Brasileira

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dec 2006, Volume 52 N. 6 Pages 424 - 429

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

OBJETIVO: Estimar a prevalência da disfunção erétil (DE) e fatores de risco associados em amostra da população brasileira. MÉTODOS: Estudo transversal com amostra de conveniência de 2.862 homens, maiores de 18 anos, por meio de questionário anônimo e auto-responsivo. A prevalência de DE na amostra foi obtida mediante questão global derivada diretamente da definição de DE. Os dados foram submetidos a testes Qui-quadrado e t de Student. Foram utilizadas análises de regressão logística para cálculos dos riscos. RESULTADOS: A prevalência encontrada de DE foi 45,1% (31,2% mínima, 12,2% moderada e 1,7% completa). Indivíduos com DE apresentaram comprometimento da auto-estima, dos relacionamentos interpessoais, menos relações sexuais por semana, mais relações extraconjugais, queixas de falta de desejo sexual e ejaculação rápida. Comparados aos homens com idades entre 18 e 39 anos, aqueles com 60 a 69 têm 2,2 (95% IC; 1,4-3,4; p < 0,01) mais risco para DE, enquanto para aqueles com 70 anos ou mais, a chance triplica (95% IC; 1,4-6,3; p < 0,01). Houve associação inversa entre nível educacional e risco para DE. Raça amarela, desemprego, alguma afiliação religiosa, história de tumor de próstata, hipertensão arterial sistêmica (HAS) e depressão aumentaram a chance para DE. CONCLUSÃO: A prevalência de DE é alta e comparável à de outros estudos. Homens com DE apresentam menos atividade sexual e prejuízo da qualidade de vida. Idade e condição socioeconômica precária agravam o risco para DE. Ações terapêuticas e preventivas devem ser implementadas para minimizar o impacto negativo desta condição, particularmente em países em desenvolvimento.

OBJETIVE: To estimate the prevalence of ED and related risk factors in a sample of the Brazilian male population. METHODS: Cross-sectional study was carried out with a convenience sample of 2,862 men, 18 years of age or older, using an anonymous self-administered questionnaire. ED prevalence in the sample was obtained by a general question which was directly derived from the ED definition. Data were submitted to chi-square or Student's t tests. Logistic regression analyses were used for risk factor calculations. RESULTS: The prevalence of ED was 45.1% (31.2% mild, 12.2% moderate and 1.7% complete). Subjects with ED presented lower self-esteem, hindered interpersonal relationships, fewer sexual intercourses per week, more extra-marital relationships, complaints of lack of libido and premature ejaculation. When compared with men aged 18-39 years, men aged 60-69 presented 2.2 higher risk of ED (95% CI; 1.4-3.4; p < 0.01), whereas men aged 70 or older presented 3.0 higher risk of ED (95% CI; 1.4-6.3; p < 0.01). Level of education was inversely proportional to risk of ED. Yellow race, unemployment, religious affiliation, prostate tumor, hypertension and depression were variables that increased ED risk. CONCLUSION: The prevalence of ED was high and comparable to that found in other studies. Subjects with ED suffer from less sexual activity and poorer quality of life. Age and lower socioeconomic level are directly proportional to ED risk. Therapeutic and preventive measures should be implemented to minimize the negative impact of this condition, especially in developing countries.

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