Population-based survey on menopausal symptoms and treatment use.

OBJECTIVE: This article aimed to study the use of menopausal hormone therapy (MHT) among Spanish perimenopausal and postmenopausal women, the presence of menopausal symptoms and the sources of information. METHODS: The epidemiological study using a survey included Spanish perimenopausal or postmenopausal women aged between 40 and 70 years in August 2021. RESULTS: A total of 1254 women were included. In the postmenopausal group, 86% reported one or more menopausal symptoms; the most frequent was vulvovaginal dryness (57%). Among the symptomatic women, 15.2% used some treatment. Vasomotor symptoms (p = 0.001), vulvovaginal atrophy (p < 0.001) and symptoms related to sexuality (p < 0.001) were associated with greater use of treatments; 2.5% of postmenopausal women used MHT. In the perimenopausal group, 75.1% were symptomatic, hot flashes being the most frequent. Only insomnia was related to greater use of some treatment (p = 0.021); 1.6% of perimenopausal women used MHT. The most common reason for women's rejection of MHT was the fear of side effects, especially cancer. The gynecologist was the most frequently used source of information. CONCLUSIONS: Although there is a high prevalence of symptoms, the use of MHT in Spanish perimenopausal and postmenopausal women is very low.

How Does Environmental Noise Impact Collaborative Activities at the Main Library of Tecnologico de Monterrey?

Environmental noise is an important social issue that directly affects the efficiency of the students. The aim of this study is to investigate how environmental noise generated in the library affects the performance at learning commons. For this study, the noise of the library was recorded and sixteen students of Tecnologico de Monterrey, were recruited. They were divided into four groups, and two collaborative activities were undertaken with and without noise. In both scenarios, the performance and the physiological reaction of students were investigated. The results showed that the students had a 4% higher performance in a quiet environment than in a noisy one, in the same way, the heart rate increased by 3.48% and the blink rate by 22.91%. Finally, the neural electrical activity was reduced by at least 3%. The findings of the present study suggest that collaborative work is difficult to undertake in noise scenarios such as learning commons, where no appropriated policies are established and followed. Cognitive performance is lower in noisy than in quiet conditions.

Causas de muerte fetal: Un revisión de 38 pacientes / Causes associated to fetal death: A review study of 38 women

INTRODUCCIÓN: La pérdida del embarazo que ocurre tras las veinte semanas de gestación, se denomina muerte fetal (MF); es un evento que causa un gran impacto psicoemocional en la pareja afectada. La literatura médica afirma que, en casi la mitad de estos casos, no hay una causa conocida. Las causas principales están relacionadas son: síndrome antifosfolípido obstétrico (SAF), otras alteraciones inmunológicas (OIA), otros factores que pueden causar infarto placentario por coagulación, rotura prematura de membranas, preeclampsia y trombosis en la circulación útero-placentaria. MÉTODOS: Revisamos cuidadosamente la historia clínica y los estudios inmunológicos de una cohorte de 38 pacientes que han sufrido MF. RESULTADOS: Treinta y ocho pacientes (edades 36-42 años) fueron estudiadas. En más de la mitad de los pacientes (57 %) se diagnosticó SAF. El hipotiroidismo autoinmune (26 %), el anticuerpo antinuclear (24 %) comprendió el grupo de OIA. Once de 38 pacientes mostraron diferentes mutaciones de trombofilias. La hiperhomocisteinemia estuvo presente en el 53 % de los pacientes. CONCLUSIÓN: Las alteraciones inmunológicas y la trombofilia se asociaron con una proporción significativa de nuestros casos de MF. El diagnóstico de las causas evitables es necesario para evitar complicaciones obstétricas en embarazos futuros

INTRODUCTION: Pregnancy loss that occurs after the twenty weeks of gestation, termed foetal death (FD), is a rare event of pregnancy causing great psycho-emotional impact on the affected couple. Medical literature states that in nearly half of these cases, there is no known cause. Leading, causes are related to obstetric antiphospholipid syndrome (APS), other immunological alterations (OIA), other factors that may cause clotting placental infarction, premature rupture of membranes, preeclampsia, and thrombosis in the utero-placental circulation with subsequent FD. METHODS: We carefully reviewed the complete medical records and immunological studies of a cohort of 38 patients that have suffered FD. RESULTS: Thirty-eight patients (ages 36 - 42 years) were studied. In more than half of the patients (57%) APS was diagnosed. Autoimmune hypothyroidism (26%), antinuclear antibody (24%) comprised the group of OIA. Eleven out of 38 patients showed different thrombophilia mutations. Hyperhomocysteinemia was present in 53% of patients. CONCLUSION: Immunological alterations and thrombophilia were associated with a significant proportion of our FD cases. Diagnosis of preventable causes of FD is necessary in order to avoid any obstetric complications in future pregnancies

Recommendations for a standardised educational program in robot assisted gynaecological surgery: Consensus from the Society of European Robotic Gynaecological Surgery (SERGS).

BACKGROUND: The Society of European Robotic Gynaecological Surgery (SERGS) aims at developing a European consensus on core components of a curriculum for training and assessment in robot assisted gynaecological surgery. METHODS: A Delphi process was initiated among a panel of 12 experts in robot assisted surgery invited through the SERGS. An online questionnaire survey was based on a literature search for standards in education in gynaecological robot assisted surgery. The survey was performed in three consecutive rounds to reach optimal consensus. The results of this survey were discussed by the panel and led to consensus recommendations on 39 issues, adhering to general principles of medical education. RESULTS: On review there appeared to be no accredited training programs in Europe, and few in the USA. Recommendations for requirements of training centres, educational tools and assessment of proficiency varied widely. Stepwise and structured training together with validated assessment based on competencies rather than on volume emerged as prerequisites for adequate and safe learning. An appropriate educational environment and tools for training were defined. Although certification should be competence based, the panel recommended additional volume based criteria for both accreditation of training centres and certification of individual surgeons. CONCLUSIONS: Consensus was reached on minimum criteria for training in robot assisted gynaecological surgery. To transfer results into clinical practice, experts recommended a curriculum and guidelines that have now been endorsed by SERGS to be used to establish training programmes for robot assisted surgery.

Resilience and related factors in urban, mid-aged Spanish women.

OBJECTIVE: To assess resilience and related factors among urban, mid-aged Spanish women. METHODS: This was a cross-sectional study performed in 227 women aged 40-65 years who filled out the 14-item Wagnild and Young Resilience Scale (WYRS-14), the Menopause Rating Scale (MRS) and a questionnaire containing personal sociodemographic data. RESULTS: For the whole sample, median (interquartile range) age and total WYRS-14 score were 52.4 (8.7) years and 79 (20.0) points, respectively. Resilience score was inversely related to non-working status, non-university studies, depressed mood, perimenopausal status, and higher MRS total scores (≥ 17). Using the 25th percentile of the obtained total WYRS-14 score as a cut-off value to define lower resilience (< 68.0 points), logistic regression analysis determined that low resilience was related to being unemployed, having depressed mood and being perimenopausal. Drinking less than 3 units/day of alcohol was significantly related to higher resilience. CONCLUSION: In this sample of urban, mid-aged Spanish women, low resilience (lower WYRS-14 scores) was related to unemployment status, depressed mood and severe menopausal symptoms.

Comparison of the behaviour of Brettanomyces bruxellensis strain LAMAP L2480 growing in authentic and synthetic wines.

Brettanomyces bruxellensis is the main microorganism responsible for the production of off-flavours in wine. Studies have been carried out in synthetic cultures using p-coumaric acid for the production of vinyl and ethylphenols. The results obtained have been extrapolated to authentic wine, but there is no evidence that this correlation will be correct. We studied the behaviour of B. bruxellensis native strain LAMAP L2480 in authentic wine and in a synthetic medium with a chemical composition similar to the authentic wine used in this study (basal synthetic wine + pH, ethanol and hydroxycinnamic acid concentrations of commercial wine). In some assays, B. bruxellensis has been studied using media containing 100 mg L(-1) p-coumaric acid, so we also used the same concentration added to the authentic and synthetic wines. The microorganism showed better growth in authentic wine, regardless of the presence of p-coumaric acid. In the case of synthetic wine, the addition of p-coumaric acid caused a delay in yeast growth and an increase in the production of volatile phenols. The coumarate decarboxylase activity did not show any difference regardless of the media and the presence of p-coumaric acid. Vinylphenol reductase showed higher activity when a higher concentration of p-coumaric acid was added in synthetic wine, but no change was observed in authentic wine.

Brain metastasis and carcinomatous meningitis from vulvar squamous cell carcinoma: case report.

BACKGROUND: Brain metastasis and carcinomatous meningitis from gynecological tumors are an uncommon event, usually related to choriocarcinoma, ovarian and cervical cancer. CASE: A 74-year-old woman was diagnosed with locally advanced vulvar squamous carcinoma. Initial therapy consisted of multiagent chemotherapy and vulvar, pelvis and groin irradiation. The patient subsequently developed widely spread metastatic disease including brain and meningeal metastases. CONCLUSION: The rising incidence of central nervous system metastasis in the last two decades is probably associated with treatment-related improvement in life expectancy. To our knowledge, this is the first case reported of brain metastases and meningeal carcinomatosis associated with vulvar squamous cell carcinoma.

Leiomatosis cutánea y uterina: síndrome de Reed / Cutaneous and uterine leiomyomatosis: Reed's syndrome

Los leiomiomas cutáneos son tumores poco frecuentes de músculo liso dérmico, habitualmente múltiples, que se asocian a leiomiomatosis uterina en algunos casos con carácter de herencia autosómica dominante. Se presenta el caso de una mujer de 45 años con leiomiomatosis cutánea y uterina múltiple (síndrome de Reed).

Significado pronóstico de la densidad microvascular en el cáncer de ovario: estudio de una serie de 74 casos / Prognostic value of microvascular density in ovarian cancer in a series of 74 patients

Introducción: La cuantificación de la angiogénesis, en teoría, podría ser un factor determinante del pronóstico de ciertos carcinomas, ya que determina la posibilidad de metastatizar por parte del tumor primario. Material y métodos: Se plantea un estudio retrospectivo sobre 74 pacientes con carcinoma de ovario en estadios I-IV (FIGO) y tratados en el Hospital Clínico San Carlos (Madrid) en el período 1985-1995. Se midió el índice angiogénico (determinación con anticuerpo monoclonal CD34, y cuantificación mediante un sistema digital de análisis de imagen Leika Q500IW con software propio), y se comparó el comportamiento de tumores con angiogénesis positiva y negativa en relación con los eventos de muerte y recidiva (estudio de regresión logística). El seguimiento mediano fue de 40,5 meses (rango, 3-105). Resultados: La angiogénesis es un parámetro cuantificable, y es un factor pronóstico independiente para el riesgo relativo de muerte y recidiva para todos los estadios de carcinoma de ovario (AU)

Determinaciones analíticas de la mujer anciana en ginecología / Biological-analitical determinations in the older woman

En esta revisión se hace un análisis de los cambios anatómicos, suelo pélvico, etc. en el envejecimiento femenino, de lo déficits hormonales y marcadores tumorales, ya que los procesos oncológicos tan frecuentes en la mujer postolmatérica y anciana (AU)

Fototerapia con luz ultravioleta B de banda angosta (UVB-NB) / Phototherapy with ultraviolet B light of narrow band (UVB-NB)

Se revisan las características, mecanismo de acción, ventajas, efectos adversos y usos de la Radiación UVB de Banda angosta (UVB-NB); se muestran las guías de tratamiento en general en psoriasis, en vitiligo, asi como en combinación con retinoides.

P53 overexpression predicts endometrial carcinoma recurrence better than HER-2/neu overexpression.

OBJECTIVE: to investigate the prognostic value of p53 and HER-2/neu overexpression in endometrial cancer. STUDY DESIGN: p53 and HER-2/neu immunostaining was performed in 114 paraffin-embedded specimens of endometrial cancer diagnosed and treated between 1990 and 1997. Nuclear p53 and membrane HER-2/neu immunostaining were used. RESULTS: p53 and HER-2/neu overexpression was observed in 17 cases (14.9%) and in 19 cases (16.7%), respectively. In univariate analysis p53 (P<0.001) and HER-2/neu (P=0.018) overexpression had a positive correlation with a high risk of recurrence. In multivariate analysis, age (P<0.001), FIGO stage (P<0.001), differentiation (P=0.013), non-endometrioid subtypes (P<0.001) and p53 overexpression (P<0.001), but not HER-2/neu overexpression, were independent prognostic indicators of recurrence. Simultaneous p53 and HER-2/neu overexpression made worse the prognostic (P<0.001). CONCLUSIONS: p53 overexpression was an independent predictor of recurrent disease in endometrial cancer. HER-2/neu overexpression had a more limited effect but enhance the effect of p53.

A comparison of epithelial membrane antigen overexpression in benign and malignant endometrium.

OBJECTIVE: The aim of this study was to analyze the value of epithelial membrane antigen (EMA) overexpression in benign and malignant endometrium and its prognostic significance. METHODS: EMA immunostaining was performed in 178 paraffin-embedded specimens including 105 endometrial cancers, 40 endometrial hyperplasias, and 33 benign endometriums. EMA immunostaining was correlated with traditional prognostic factors and progression-free survival in endometrial cancer specimens. RESULTS: EMA overexpression was observed more frequently in adenocarcinomas (60%) than in hyperplasias (15%) or benign endometrium (9.1%). EMA overexpression was observed in two patients with endometrial hyperplasia who progressed to carcinoma. In adenocarcinomas, EMA overexpression had a positive correlation with nonendometrioid subtypes (P = 0.012). In multivariate analysis, FIGO stage (P = 0.025) and EMA overexpression (P = 0.017) were independent prognostic factors for progression-free survival. CONCLUSIONS: EMA overexpression appears to be a marker of malignant transformation in the endometrium and it is an independent predictor of recurrent disease in endometrial cancer.

Blood pressure regulation in Alzheimer's disease.

Brain neurons which regulate blood pressure (BP), including the C-1 tonic vasomotor neurons, degenerate in Alzheimer's disease (AD). This study determines whether BP is decreased in AD. We reviewed records of three autopsy proven AD patients. Medical causes for decreased BP were investigated. Yearly averages for systolic (SBP), diastolic (DBP), mean arterial (AP) blood pressure and pulse pressure (PP) were calculated. BP in the year of diagnosis was compared to the sum of all BP in subsequent years. In addition, each yearly measurement through the course of AD was compared to its counterpart in the year of diagnosis. Three BP measurements were significantly decreased by from 6.9% to 15.9% in all patients when BP in the year of diagnosis was compared to the sum of each pressure in subsequent years. Sustained BP declines started in the third to fourth year after diagnosis of AD and continued for up to 9 years. The PP was decreased by 19.9% in one patient. There was a strong correlation between the number of C-1 neurons in these cases and their AP and SBP in the years after diagnosis. Hypothalamic phenylethanolamine N-methyltransferase activity was decreased by 63% in AD compared to control cases. Neurofibrillary tangles were found in the paraventricular nucleus of the hypothalamus in an AD case. We postulate that BP is altered in AD as neurons which regulate it degenerate.