[Prenatal diagnosis of isolated otocefalia. Usefulness of three-dimensional ultrasound]. / Diagnóstico prenatal de otocefalia aislada. Utilidad de la ecografía tridimensional.

Otocephaly is a rare and lethal congenital malformation characterized by the presence of agnathia, microstomia, aglossia and synotia. Despite its frequent association with severe malformations, diagnosis in the few published cases is usually made at III trimester. In this case, three-dimensional ultrasound scan was performed in a Chinese primigravida with no remarkable personal nor familiar history since mandible was difficulty visualized with two-dimensional sonography at 21 weeks of gestation. Multiplanar and rendering mode showed the typical cervicofacial features of otocephaly without associated malformations. After parental counselling, they opted for termination of pregnancy and necropsy confirmed our prenatal findings. Our case shows the usefulness of three-dimensional ultrasound in assessing fetal cervicofacial pathology. Volumetric capture allows a delayed study of fetal anatomy and multiplanar mode offers the reconstruction of views whose achivement is difficult with conventional 2D ultrasound. Surface rendering provides excellent spatial vision and enables parents to understand the severity of the malformation thus helping with their decisions.

Fitoestrógenos –isoflavonas- y menopausia / Phytoestrogens –isoflavones- and menopause

En los últimos años, se ha producido un cambio radical en el interés y el estudio e investigación de las plantas medicinales. El aumento del consumo de productos fitoterápicos en Estados Unidos y algunos países europeos ha hecho que muchas de estas plantas se evalúen de modo mucho más científico y se compruebe si realmente existe una eficacia clínica mediante la realización de ensayos clínicos prospectivos y aleatorizados que confirmen estas observaciones. Se han revisado las publicaciones existentes sobre los efectos biológicos de los fitoestrógenos en seres humanos, incluidos sus efectos sobre los sofocos, el aparato cardiovascular, la osteoporosis, el cáncer y el aparato genitourinario; también se han incluido estudios epidemiológicos y estudios realizados en animales y líneas celulares. Al final, se llega a la conclusión de que los fitoestrógenos tienen una serie de efectos en los seres humanos, destacando la acción estrogénica débil sobre los sofocos en mujeres posmenopáusicas. Parece también que las isoflavonas tienen acción sobre los lípidos y las lipoproteínas

In recent years, there has been a radical change in the study, research and interest in medicinal plants. As a result of the increase in the consumption of phytotherapeutic products in the United States and some European countries, many of these plants are now being evaluated in a much more scientific way, and their possible clinical efficacy is being assessed through randomised, prospective clinical trials that confirm these observations. The existing literature concerning the biological effects of phytoestrogens in humans, including their effect on hot flashes, the cardiovascular system, osteoporosis, cancer and the genitourinary system has been reviewed. Epidemiological studies and studies performed in animals and cell lines have been also included. It has been concluded tha phytoestrogens have a series of effects on humans, particularly their weak estrogenic activity relative to hot flashes in postmenopausal women. Isoflavones also appear to have an effect on lipids and lipoproteins