Follicular Unit Excision in Patients of African Descent: A Skin-Responsive Technique.

BACKGROUND: Follicular unit excision is a favored minimally invasive hair transplantation method. However, it is suboptimal for many patients of African descent because of wide variations in hair and skin characteristics. OBJECTIVE: To evaluate the performance of a skin-responsive follicular unit excision device, which accommodates hair curliness, skin thickness, and firmness in patients of African descent. MATERIALS AND METHODS: The authors retrospectively evaluated patients who underwent scalp follicular unit (FU) excision using a skin-responsive technique at 7 multinational clinics. The preoperative donor grading for the anticipated difficulty used a scale with Class V indicating the highest degree of hair curliness, skin thickness, and firmness. RESULTS: Of 64 eligible patients (45 males and 19 females), 28 had Class V FU excision donor grades. The mean transection rate for all patients was 3%-6%, which was highest in class V patients. Skin thickness and firmness had a greater effect on the maximum transection rate than hair curliness. Only 19 or 18 G punches were used. CONCLUSION: The authors report consistence success of a new skin-responsive FU excision device for all patients of African descent with a mean graft transection rate of less than 10%. The findings support skin thickness and firmness as major influencers of graft attrition rate.

No-Shave Long Hair Follicular Unit Excision Using an All-Purpose Skin-Responsive Device.

Background: Current no-shave long hair-follicular unit excision (LH-FUE) techniques employ recesses (slots, notches, or grooves) in punch tips to reduce the long-hair shaft break rate (SBR) and graft transection rate (GTR). However, these methods demand advanced skills and extended procedure time. Objective: We aimed to evaluate a skin-responsive FUE technique without the use of recess-tipped punches, accommodating diverse hair and skin types in LH-FUE procedures. Methods and Materials: We retrospectively analyzed patients who underwent this technique using a UGraft Zeus device at five multinational clinics (Mexico, Colombia, India, United States, and Türkiye) from August 9, 2021, to April 11, 2023. Donor zones were pre-operatively graded for expected difficulty using the Sanusi FUE Scoring (SFS) Scale, ranging from class I (low difficulty) to V (high difficulty). Results: Among 152 patients (mean age, 46 years; 146 straight-wavy, 6 curly-coiled hair), most (n=107) were class I donors. The GTR ranged 2.2%-4.3%, and was highest in class IV donors and those with thick-firm scalps. The SBR was 12.2%, and the average graft excision rate (GER; speed) was 440 grafts/h. Only 19G and 18G punches were used. All patients were satisfied with the procedure, with 57.4% reporting that they were "very happy". Surgeon willingness to perform no-shave LH-FUE significantly increased from 1.25 to 4.20 (on a scale of 1-5) after adopting this device. SFS class, skin thickness, and firmness, more than hair curliness, influenced the GTR, SBR, torque, and punch movement duration. Conclusion: Our findings reveal consistent success in conducting no-shave LH-FUE using this skin-responsive device across diverse patients. Notably, success was achieved without recess-tipped punches, resulting in low GTR and SBR, along with a high GER and increased patient satisfaction. These outcomes suggest enhanced procedure speed and ease of use, contributing to a greater willingness among surgeons to adopt this technique.

Craving for menthol sweets: a case report. / Craving por mentolados: a propósito de un caso.

We describe a case of craving for menthol sweets in a 53-year-old woman with excessive consumption of menthol sweets (100 units/day). She was admitted with a history of rheumatoid arthritis, obesity, anxiety associated with onychophagia and pinching of the skin. Organic disorders were ruled out with paraclinical tests and in-hospital treatment was administered. At discharge, the patient's condition was stable, but because of exacerbated pain due to the rheumatological disease, she presented depressive symptoms, requiring her medication to be adjusted. CONCLUSIONS: The "food craving" and anxiety present pathophysiological similarities. Mints have different mechanisms or ways in which they can counteract or control these symptoms, including an increase in serotonin, binding to GABA-A receptors and stimulation of the nicotinic receptor in nerve cells.

Motor Dysfunction as a Prodrome of Parkinson's Disease.

BACKGROUND: Recognition of motor signs in the prodromal stage could help identify those at risk of developing Parkinson's disease (PD). OBJECTIVE: This study identified motor symptoms and signs in individuals suspected of having PD but who did not have a progressive reduction in the speed and amplitude of finger tapping or other physical signs indicative of bradykinesia. METHODS: 146 patients, who had symptoms or signs suggestive of PD, were serially evaluated by a movement disorder specialist, using the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III and video recordings. If the patients 'converted' to PD during follow-up, they were categorized as cases and compared with those who did not meet PD criteria during follow-up (non-cases). RESULTS: The 82 cases were more likely to have action dystonia or postural/action/rest tremor of a limb (OR 2.8; 95% CI 1.1-7.1; p = 0.02), a reduced blink rate at rest (OR 2.3; 95% CI 1.2-4.6; p = 0.01), anxiety (OR 8.9; 95% CI 2.6-31.1; p < 0.001), depression (OR 7.0; 95% CI 2.9-17.2; p < 0.001), or a frozen shoulder (OR 3.1; 95% CI 1.6-6.2) than the 64 'non-cases'.A reduction of the fast blink rate was common in patients who met the criteria for PD (p < 0.001). CONCLUSIONS: This study emphasizes that motor dysfunction is a component of the clinical prodrome seen in some patients with PD.

Craving por mentolados: a propósito de un caso

Se describe un caso de craving por dulces mentolados, una paciente de 53 arios con cuadro de consumo excesivo de dulces mentolados (100 unidades/día). Ingresó con el antecedente de artritis reumatoide, con obesidad, en estado de ansiedad asociado con onicofagia y pellizcos de la piel. Se descartó la organicidad mediante paraclínicos y se le dio asistencia hospitalaria. Al alta, la paciente estaba estable; sin embargo, por progresión del dolor por la enfermedad reumática, ha sufrido síntomas depresivos, por lo que ha requerido ajuste de la medicación. Conclusiones: El food craving y la ansiedad presentan similitudes fisiopatológicas. Las mentas tienen distintos mecanismos o modos en que pueden contrarrestar o controlar estos síntomas, entre los que está el aumento de serotonina, la unión a receptores GABA-A y la estimulación del receptor nicotínico en las células nerviosas.

We describe a case of craving for menthol sweets in a 53-year-old woman with excessive consumption of menthol sweets (100 units/day). She was admitted with a history of rheumatoid arthritis, obesity, anxiety associated with onychophagia and pinching of the skin. Organic disorders were ruled out with paraclinical tests and in-hospital treatment was administered. At discharge, the patient's condition was stable, but because of exacerbated pain due to the rheumatological disease, she presented depressive symptoms, requiring her medication to be adjusted. Conclusions: The "food craving" and anxiety present pathophysiological similarities. Mints have different mechanisms or ways in which they can counteract or control these symptoms, including an increase in serotonin, binding to GABA-A receptors and stimulation of the nicotinic receptor in nerve cells.

Epidemiología de la insuficiencia cardíaca / Epidemiology of heart failure

La insuficiencia cardíaca es una de las patologías que representa mayor impacto sanitario, debido a la variable complejidad clínica de los pacientes, los distintos recursos necesarios para su manejo, el gasto en salud asociado y el costo social que conlleva [1, 2]. La prevalencia de esta enfermedad suele mostrar ciertas diferencias según la región o país analizado y se encuentra condicionada en gran medida por las características metodológicas de los estudios, particularmente el número de personas seleccionadas entre la población general para estimar su frecuencia y el método diagnóstico utilizado: cuestionarios validados, examinación clínica adecuada a los pacientes y pruebas objetivas de disfunción cardíaca (por ejemplo, ecocardiogramas). En términos generales se ha estimado que la insuficiencia cardíaca afecta aproximadamente a entre veinte y treinta millones de personas en todo el mundo, con una franca tendencia a que el número de casos incidentes anuales siga incrementándose a lo largo del tiempo (AU)

Heart insufficiency is a of the pathologies it represents greater sanitary impact, due to the variable clinical complexity of the patients, the different resources necessary for its management, associated health expenditure and social cost that entails [1, 2]. The prevalence of this disease usually show certain differences according to the region or country analyzed and is conditioned in greatly measured by the characteristics methodological studies, particularly the number of selected people among general population to estimate their frequency and diagnostic method used: validated questionnaires, clinical examination adequate to the patients and objective tests of cardiac dysfunction (for example, echocardiograms). In general terms has been estimated that cardiac insufficiency affects approximately between twenty and thirty million of people around the world, with a clear tendency that the number of incident cases annual increases continue to long time

Prescripción de medicamentos y problemas en el proceso terapéutico / Prescription of medications and problems in the therapeutic process

La efectividad de los medicamentos es el grado de beneficio que pueden ofrecer en las condiciones habituales de práctica clínica. Para que este beneficio sea cercano a la eficacia, previamente demostrada en los ensayos clínicos, el uso de cualquier medicamento debe ser adecuado. Varios factores pueden influir en la utilización de los medicamentos, particularmente las cualidades con que se desarrolle el proceso de terapéutica razonada, por ser la secuencia lógica de pasos cuya finalidad es minimizar los errores de actuación, evitar la omisión de detalles críticos e individualizar las terapias; tabla. Cuando este procedimiento no es óptimo, la calidad de la atención médica disminuye y se afecta la posibilidad de alcanzar el beneficio deseado con un tratamiento.

Prevalencia de dieta vegetariana en estudiantes de la Universidad Internacional del Ecuador / Prevalence of vegetarian diet in University students International of Ecuador

La percepción de una dieta saludable difere entre individuos y es sumamente subjetiva. Para algunas personas, consiste en consumir alimentos de calidad que sean altos en nutrientes esenciales; o consideran está relacionada con una adecuada higiene al cocinar y consumir los alimentos; mientras que otras piensan que una dieta saludable consiste en eliminar parcialmente o totalmente los productos cárnicos. A estas últimas se les califca como vegetarianos [1, 2]. La adopción de este tipo de dieta no siempre es por razones de salud, debido a que también existen motivaciones ecológicas, religiosas, éticas o incluso sólo por moda. Mientras que en India un 35% de la población sigue una dieta vegetariana (debido a tradiciones culturales y religiosas), en el Reino Unido y los Estados Unidos se estima que el 3% de la población es vegetariana [3]. En Ecuador, a través de los grupos existentes en las redes sociales, habría aproximadamente una población de 10000 vegetarianos, pero no existen datos específcos acerca del porcentaje de la población que realmente opta por una dieta vegetariana

Antimaláricos en el tratamiento del lupus eritematoso / Antimalarials in the treatment of lupus erythematosus

De la evidencia disponible, la hidroxicloroquina puede ser preferible por tener un menor riesgo de toxicidad ocular y de efectos gastrointestinales [2] y una efcacia algo mayor que la cloroquina [7]. Considerando que el uso de estos antimaláricos en pacientes con lupus eritematoso (y otros cuadros autoinmunes) será cada vez mayor, los distintos profesionales médicos deben recordar que su empleo está contraindicado en sujetos con retinopatías preexistentes, trastornos sanguíneos y miastenia gravis, al tiempo de estar atentos al aparecimiento de efectos adversos serios como una cardiotoxicidad y neuromiotoxicidad (AU)

From the available evidence, hydroxychloroquine can be preferable for having a lower risk of ocular toxicity and effects Gastrointestinal [2] and an efcacia somewhat larger than chloroquine [7]. Whereas the use of these antimalarials in patients with lupus erythematosus (and other pictures autoimmune) will be increasing, the different medical professionals they must remember that their employment is contraindicated in subjects with pre-existing retinopathies, blood disorders and myasthenia gravis, while being attentive to the occurrence of adverse effects serious as a cardiotoxicity and neuromyotoxicity.

La investigación clínica y su evaluación ética / The investigation clinic and its ethical evaluation

La investigación científca y la ética se encuentran íntimamente relacionadas entre sí. Una investigación debe ser realizada por el bien de la sociedad y no solamente para satisfacer una curiosidad científca. Por tal motivo, la búsqueda del conocimiento nunca puede ser un justifcativo para afectar los derechos de los individuos que participan en una investigación clínica, ni para considerarlos simplemente como "objetos" biológicos. Sin embargo, en la historia existen antecedentes nefastos en los cuales se atentó contra la integridad, dignidad y bienestar de las personas, al someterlas a procedimientos y exposiciones de distinta índole. Casos como los experimentos nazis revelados durante el juicio de Nuremberg [1], el estudio Tuskegee sobre la síflis, ejecutado sobre una población socio-culturalmente vulnerable [2] y las exposiciones intencionales a gonorrea, síflis y chancroide en Guatemala [3], son graves ejemplos de lo que puede ocurrir cuando existe un irrespeto a los principios éticos de la investigación clínica

Scientific research and ethics are intimately found related to each other. A research must be done for the good of society and not only to satisfy a scientific curiosity. For this reason, the search for knowledge It can never be a justifcative to affect the rights of the individuals who participate in a clinical investigation, nor for consider them simply as Biological "objects" But nevertheless, in the history there are backgrounds harmful in which it was attempted against integrity, dignity and well-being of people, submit them to procedures and exhibitions of different nature. Cases like experiments Nazis revealed during the trial of Nuremberg [1], the Tuskegee study about syphilis, executed on a socio-culturally population vulnerable [2] and intentional exposures to gonorrhea, syphilis and chancroid in Guatemala [3], are serious examples of what It can happen when there is a disrespect for the ethical principles of clinical research

La falta de vacuna contra el virus del Ébola: otro caso de las enfermedades abandonadas por la lógica de mercado / Lack of vaccine against Ebola virus: another case of diseases abandoned by logic of market

El virus del Ébola se descubrió en 1976. Desde entonces, sus brotes epidémicos (con alta letalidad) estaban confinados a África, sin que en todo este tiempo se creara una vacuna eficaz [1]. Debieron pasar 38 años y ­sobre todo­ tuvo que ocurrir el aparecimiento de casos importados en los Estados Unidos y Europa, para que se desatara un elevado interés sanitario, científico y gubernamental, para aumentar los esfuerzos destinados a desarrollar vacunas y tratamientos eficaces

Ebola virus was discovered in 1976. Since then, its outbreaks epidemic (with high lethality) were confined to Africa without that in all this time will be created an effective vaccine [1]. They must have passed 38 years and - above all - had to occur the occurrence of cases imported into the United States and Europe, to unleash a high health interest, scientist and governmental, to increase efforts to develop effective vaccines and treatments

Los artículos científicos / Scientific articles

Las revistas son publicaciones periódicas que forman parte de los medios de comunicación impresos, si bien en la actualidad es común que algunas posean también versiones digitales (on-line) y que otras sean publicadas exclusivamente en Internet. Según su contenido y público al cual se dirigen es posible distinguir cuatro tipos principales de revistas: científicas, técnicas- especializadas, informativas y de entretenimiento. Las revistas científicas tienen como finalidad difundir el progreso de la ciencia y actualizar el conocimiento en determinadas áreas del saber. Esto implica que para que una revista pueda reconocerse como científica, su contenido debe estar formado fundamentalmente con artículos llamados científicos, es decir, aquellos que aportan"ciencia y conocimiento" y van dirigidos a un grupo lector específico: la comunidad científica. Es importante no confundir con una revista informativa, destinada a la población común y que publica noticias, reportajes o artículos, sobre ciencia, salud, avances médicos o tecnológicos, usando una redacción sencilla, de menor complejidad y profundidad, para que sean comprensibles por cualquier persona.

Magazines are periodicals that are part of the print media, although at present it is common for some to also have digital (online) versions and others to be published exclusively on the Internet. According to their content and public to which they are directed, it is possible to distinguish four main types of journals: scientific, technical-specialized, informative and entertainment. The scientific journals are intended to disseminate the progress of science and update knowledge in certain areas of knowledge. This implies that for a magazine to be recognized as a scientist, its content must be formed primarily with articles called scientists, that is, those that contribute "science and knowledge" and are aimed at a specific reading group: the scientific community. It is important not to confuse with an informative magazine, aimed at the common population and that publishes news, reports or articles, about science, health, medical or technological advances, using a simple writing, of less complexity and depth, so that they are understandable by any person

Heparinas de bajo peso molecular: revisión de la evidencia en sus principales indicaciones de uso / Low molecular weight heparins: a review of the evidence in its main indications of use

Las distintas heparinas de bajo peso molecular (HBPM) disponibles en terapéutica tienen un mecanismo de acción similar al de la heparina no fraccionada (HNF) pero con ventajas en el perfl farmacocinético. Diversos estudios han demostrado que las HBPM poseen una efcacia equivalente a la HNF para diversas indicaciones de uso, incluyendo prevención y tratamiento del tromboembolismo venoso, manejo del síndrome coronario agudo e infarto de miocardio. Algunas reacciones adversas como las complicaciones hemorrágicas y la trombocitopenia son menos frecuentes con las HBPM. Además, han mostrado tener una buena relación coste-efectividad en distintos escenarios clínicos. Es razonable asumir que no existen grandes diferencias en eficacia y seguridad entre las distintas HBPM.

The various low-molecular-weight heparins (LMWHs) available for therapeutic use have mechanisms of action which are similar to the mechanisms of unfractionated heparin (UH) but with pharmacokinetic advantages. Various studies showed that LMWHs have equivalent effcacy when compared with UH, in a variety of settings, including prophylaxis and treatment of VTE disease, and management of acute coronary syndrome and myocardial infarction. Adverse drug reactions as hemorrhagic complications and heparin-induced thrombocytopenia are less frequent with LMWHs. Moreover, LMWHs have a good cost-effectiveness in the clinical scenarios. It is reasonable to assume that there would not be large differences in effcacy and safety among different LMWHs.

Long-term effects of an educational intervention on self-medication and appropriate drug use in single-sex secondary public schools, Quito, Ecuador.

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT: *Self-medication is extensively practised in both developed and less-developed countries, sometimes inappropriately. *Educational intervention in secondary schools has been proven to be useful. *Most educational interventions in adolescent populations have focused on the reduction of addictive substance abuse. WHAT THIS STUDY ADDS: *Educational intervention can improve knowledge about self-medication and reduce misconceptions about diarrhoea, common cold and vitamins in an adolescent population. *A specific lecture followed by small working-group seminars produces better results than a general lecture alone in terms of 'knowledge' and 'attitude'. *The positive effects of the intervention are detectable even 1 year later. Yearly reinforcing interventions while in secondary school would allow long-lasting effects. AIM: Improving knowledge about rational drug use at an early age may be a good way to increase the population's awareness of health, medicines and self-medication. We set out to evaluate the short- and long-term effects of an educational intervention to promote rational drug use and self-medication in secondary school students. METHODS: A non-randomized, controlled clinical trial. The participants were 367 female students (10-13 years old) from two secondary public schools of the metropolitan district of Quito (Ecuador). The educational campaign had two components [a specific lecture (intervention and control schools) and subsequent small working group seminars (intervention school)] providing short and clear messages of five topics related to rational drug use. The main outcome measures were an increase in 'knowledge' short term (1 month) and long term (up to 1 year) after intervention and the relative risk (RR) reduction in misconceptions or wrong ideas about medicine use. RESULTS: The intervention group showed a significant increase in knowledge both short and long term and in comparison with the control group, mainly regarding oral rehydration salts preparation (+59.4%; P < 0.001), lack of multivitamin energizer action (+57.4%; P < 0.001), healthy growth effects (+53.3%; P < 0.001) and the perception that medicines' promotional activities do not teach how to take care of health (+54.0%; P < 0.001). A RR reduction in misconceptions about drugs was found short term and long term. The intervention group was less predisposed to consume antidiarrhoeals [RR = 0.75, 95% confidence interval (CI) 0.62, 0.92], cough suppressants (0.44, 95% CI 0.35, 0.55) and other medicines for the common cold (0.56, 95% CI 0.45, 0.70). Misconceptions concerning the benefits of multivitamin preparations were reduced in 73%; additionally, the intervention group showed a decrease in their consumption (43.9% basal; 25.3% short term and 25.6% long term; P < 0.001). CONCLUSION: It is possible to achieve a favourable modification of attitudes to appropriate use of medicines in a teenage population and this modification lasts at least 1 year. Continuous reinforcing interventions would allow better and long-lasting effects and could help to fill the gap in health education of the general population.

Coexistencia demmola hidatiforme parcial con feto vivo de termino / Hydatidiform mole coexisting live fetus partial term

Se describe el caso clínico de una paciente de 31 años de edad, natural de Oruro, tercigesta, con antecedente de cesárea previa, sin otro antecedente personal ni familiar, de importancia, con gestación de 37 semanas, ruptura prematura de membranas, a quien se le realiza cesárea, obteniéndose un recién nacido vivo, de sexo masculino, de término, con peso de 2550 gr y APGAR de 8 y 10. La placenta pesó 1266 gr; en ella se observa una zona, con múltiples estructuras vesiculares, en forma de "racimos de uva", con contenido citrino al corte, compatible con mola hidatiforme parcial, diagnóstico que se confirma posteriormente con estudio histopatológico. La evolución de la paciente fue satisfactoria cursando su puerperio quirúrgico en forma favorable, por lo que se le indica su alta médica, realizándose por consulta externa seguimiento y monitorización hormonal (HCG cuantitativa) por enfermedad trofoblástica gestacional, sin datos clínicos o bioquímicos de persistencia o recurrencia. Se revisó aspectos de su baja frecuencia, etiología, diagnóstico y conducta.

A clinical case is described of a 31-year-old native of Oruro, coursing her third pregnaney, history of previous cesarean, no other personal nor family history of clinical relevance, with a 37-week gestation, premature rupture of membranes; therefore, Caesarean section was performed, resulting in a live newborn, male, term with 2550 gr and APGAR of 8 and 10. The placenta weighed 1266 gr. macroscopically it showed an área with múltiple vesicular structures, in the form of grapes, citrine content upon cut, compatible with partial hydatidiform mole. This diagnosis was subsequently confirmed histopathologically. The evolution of the patient was satisfactory, completing her surgical postpartum favorably, according to her discharge, conducted by outpatient follow-up and hormonal monitoring (quantitative HCG) for gestational trophoblastic disease without clinical or biochemical persistence or recurrence. We reviewed aspeets of its low frequeney, etiology, diagnosis, and behavior.

Síndrome de brdaas amnioticas / Amniotic Band Syndrome

Se describe el caso de una paciente de 18 años de edad, natural de Cochabamba, primigesta, con 30 semanas de gestación, con antecedente de ruptura prematura de membranas de 1 mes, a quien se instituye tratamiento médico conservador, en el Hospital Materno Infantil "Germán Urquidi", de Cochabamba, por período de 13 días, donde se administra antibioticoterapia con ampicilina y gentamicina y se induce maduración pulmonar fetal con betametasona. Se realiza Examenes complementarios, ecografía, pruebas de bienestar fetal; presentando una evolución favorable, durante su internación. A pesar de ello la paciente y familiares solicitan su alta. Posterior a la misma (4 días después) reingresa al servicio, con signos clínicos de corioamnionítis y trabajo de parto, por lo que se decide interrumpir el embarazo mediante operación cesárea; dónde se obtiene un recién nacido vivo de sexo masculino, con alteraciones estructurales en extremidades superiores e inferiores, tipo "anillos de constricción", compatibles con Síndrome de Bridas Amnióticas, siendo la probable etiología la ruptura del amnios. Se revisó algunos aspectos de su baja frecuencia, factores de riesgo, diferentes hipótesis etiológicas, diagnóstico y conducta terapéutica.

We describe the case of a 18 years oíd primigrávida, native of Cochabamba, with 30 weeks of gestation, with a history of premature rupture of membranes dated 1 month ago, to whom conservative medical treatment was instituted, in the Materno Infantil "Germán Urquidi" Hospital of Cochabamba, for a period of 13 days, where antibiotic therapy was ad-ministered, pulmonary fetal maturation was induced; laboratory, ultrasound, and fetal wellbeing tests were applied, pre-senting a favorable evolution. The patient and family requested her discharge. Following the discharge, (4 days later) the patient was readmitted to the facility, with clinical signs of chorioamnionitis, and labor process, reason why it was decided to termínate the pregnancy by caesarean section; where a male new born was given birth, with structural changes in upper and lower extremities, like constriction bands, compatible with Amniotic Constriction Bands Syndrome, being the probable etiology of amnion rupture. We reviewed some aspects of its low prevalence, risk factors, different etiological hypotheses, diagnosis and therapeutic management.

Trastorno de ansiedad y menopausia quirúrgica / Anxiety and Surgical Menopause

Objetivo. Describir las manifestaciones psiquiátricas asociadas a menopausia quirúrgica posterior a histerectomía total. Método. Reporte de caso. Resultados. Se trata de una paciente de 52 años quien presenta trastorno de ansiedad y síndrome menopáusico posterior a la realización de histerectomía abdominal total con ooferectomía bilateral. Conclusiones. La evidencia actual no permite determinar causalidad entre menopausia y ansiedad; algunos factores de riesgo podrían asociarse con sicopatología. La terapia de remplazo hormonal sola o en combinación con inhibidores selectivos de la recaptación deserotonina podría ser efectiva en el control de síntomas psiquiátricos.