Genitourinary symptoms and sexual function in women with primary ovarian insufficiency.

OBJECTIVE: There are limited studies on urogenital symptoms in women who experience menopause before the age of 40 years due to primary ovarian insufficiency (POI) or bilateral oophorectomy (surgical POI). This study aimed to compare the urogenital symptoms, including sexuality, of women with POI to those without the condition. METHODS: This cross-sectional study conducted was in seven Latin American countries, in which postmenopausal women (with POI and non-POI) were surveyed with a general questionnaire, the Menopause Rating Scale (MRS) and the six-item Female Sexual Function Index (FSFI-6). The association of premature menopause with more urogenital symptoms and lower sexual function was evaluated with logistic regression analysis. RESULTS: Women with POI experience more urogenital symptoms (MRS urogenital score: 3.54 ± 3.16 vs. 3.15 ± 2.89, p < 0.05) and have lower sexual function (total FSFI-6 score: 13.71 ± 7.55 vs. 14.77 ± 7.57 p < 0.05) than women who experience menopause at a normal age range. There were no significant differences in symptoms when comparing women based on the type of POI (idiopathic or surgical). After adjusting for covariates, our logistic regression model determined that POI is associated with more urogenital symptoms (odds ratio [OR]: 1.38, 95% confidence interval [CI] 1.06-1.80) and lower sexual function (OR: 1.67, 95% CI 1.25-2.25). CONCLUSION: POI, whether idiopathic or secondary to bilateral oophorectomy, is associated with symptoms that affect vaginal and sexual health.

Large scale sampling of Mexican maize landraces for the presence of transgenes.

The presence and levels of transgenic maize in Mexico and the effect this could have on local landraces or closely related species such as teosinte has been the subject of several previous reports, some showing contrasting results. Cultural, social and political factors all affect maize cultivation in Mexico and although since 1998 there has been a moratorium on the commercial cultivation of transgenic maize, Mexico imports maize, mainly from the USA where transgenic cultivars are widely grown. Additionally extensive migration between rural areas in Mexico and the USA and customs of seed exchange between farmers may also play an unintentional role in the establishment of transgenic seed. A comprehensive study of all Mexican maize landraces throughout the country is not feasible, however this report presents data based on analysis of 3204 maize accessions obtained from the central region of Mexico (where permits have never been authorized for cultivation of transgenic maize) and the northern region (where for a short period authorization for experimental plots was granted). The results of the study confirm that transgenes are present in all the geographical areas sampled and were more common in germplasm obtained in the northern region. However, there was no evidence that regions where field trials had been authorized showed higher levels of transgene presence or that the morphology of seed lots harboring transgenic material was significantly modified in favor of expected transgenic phenotypes.

Association of bilateral oophorectomy and menopause hormone therapy with mild cognitive impairment: the REDLINC X study.

BACKGROUND: Dementia is a major public health problem. Estrogen is a regulator of the central nervous system and its deficit could be involved in cognitive decline in older women. OBJECTIVE: This study aimed to evaluate the association of bilateral oophorectomy, menopause hormone therapy (MHT) and other factors on mild cognitive impairment (MCI). METHOD: The case-control study included 941 otherwise healthy postmenopausal women aged 60 years and over from six Latin American countries. Personal and family data were recorded and MCI was assessed using the Montreal Cognitive Assessment test (MoCA). RESULTS: Average age, years of education and body mass index were 66.1 ± 5.8 years, 12.4 ± 5.0 years and 26.0 ± 4.3 kg/m2, respectively. A total of 30.2% had undergone bilateral oophorectomy and 40.3% had used MHT. A total of 232 women (24.7%) had MCI. The prevalence of MCI was higher in women with intact ovaries and non-MHT users as compared to MHT users (29.3% vs. 11.7% [odds ratio (OR) 0.32; 95% confidence interval (CI) 0.20-0.51]). Among oophorectomized women, MCI prevalence was higher among non-MHT users as compared to MHT users (45.2% vs. 12.8% [OR 0.18; 95% CI 0.10-0.32]). Logistic regression analysis determined that the variables associated with MCI were age >65 years (OR 1.69; 95% CI 1.20-2.38), parity (having >2 children; OR 1.69; 95% CI 1.21-2.37), bilateral oophorectomy (OR 1.56; 95% CI 1.09-2.24), hypertension (OR 1.41; 95% CI 1.01-1.96), being sexually active (OR 0.56; 95% CI 0.40-0.79), education >12 years (OR 0.46; 95% CI 0.32-0.65) and MHT use (OR 0.31; 95% CI 0.21-0.46). CONCLUSION: Age, parity, bilateral oophorectomy and hypertension are independent factors associated with MCI; contrary to this, higher educational level, maintaining sexual activity and using MHT are protective factors.

Muscle health in Hispanic women. REDLINC VIII.

Objectives: This study aimed to evaluate muscle strength and related factors in Hispanic women.Methods: We studied 593 women between 40 and 89 years old. The women were asked about personal and clinical information. The following instruments were applied: dynamometer (strength), Short Physical Performance Battery (physical performance), SARC-F (sarcopenia), International Physical Activity Questionnaire (physical activity), Menopause Rating Scale (quality of life), 36-item Short Form (general health), and Frailty (Fried's criteria).Results: Low muscle strength rises from 7.1% of women in their 40s to 79.4% in their 80s. Physical performance is low in 0.5% of the first group and rises to 60.5% in the second. The risk of sarcopenia increases significantly from 6.7% in younger women to 58.1% in older women. Frailty, which affects less than 1% of women under age 60 years, increases to 39.5% in their 80s. Sedentary lifestyle rises from 26% to 68.3%. Fragility impairs the quality of life and the perception of health (p < 0.0001). The deterioration of different tests of muscle function is significantly associated with age >70 years (OR 5-20) and with osteoarthritis (OR 4-9). Menopause before the age of 45 years increases the risk of sarcopenia (odds ratio 2.2; 95% confidence interval 1.2-4.0).Conclusion: With aging there is a decrease in muscle strength and an increase in frailty. This entails a decrease in the quality of life.

Clinical and nerve conduction features in Guillain-Barré syndrome associated with Zika virus infection in Cúcuta, Colombia.

BACKGROUND AND PURPOSE: Zika virus (ZIKV) infection has been associated with an increased incidence of Guillain-Barré syndrome (GBS) but the relative frequency of acute inflammatory demyelinating polyradiculoneuropathy (AIDP) and axonal GBS subtypes is controversial. METHODS: Twenty GBS patients diagnosed according to the Brighton criteria during the ZIKV outbreak in Cúcuta, Colombia, were evaluated clinically and electrophysiologically. The electrodiagnosis of GBS subtypes was made according to a recently described criteria set that demonstrated a high diagnostic accuracy on the basis of a single test. The electrophysiological features of 34 Italian AIDP patients were used as control. RESULTS: All patients had symptoms compatible with ZIKV infection before the onset of GBS and ZIKV infection was laboratory confirmed through a plaque reduction neutralization test (PRNT90 ) in 100% of patients. The median time from onset of ZIKV infection symptoms to GBS was 5 days (interquartile range 1-6 days). Cranial nerve palsy was present in 85% of patients (facial palsy in 75%, bulbar nerve involvement in 60%), autonomic dysfunction in 85%, and 50% of patients required invasive mechanical ventilation. AIDP was diagnosed in 70% of patients. 40% of nerves of AIDP patients showed a prevalent distal demyelinating involvement but this pattern was not different from the Italian AIDP patients without ZIKV infection. CONCLUSIONS: Guillain-Barré syndrome associated with ZIKV infection in Cúcuta is characterized by a high frequency of cranial nerve involvement, autonomic dysfunction and requirement of mechanical ventilation indicating an aggressive and severe course. AIDP is the most frequent electrophysiological subtype. Demyelination is prevalent distally but this pattern is not specific for ZIKV infection.

Derivaciones fecales y urinarias en un centro de atención especializado, México 2016 / Fecal and urinary derivations at a specialized attention center, Mexico 2016 / Derivações fecais e urinarias em um centro de atenção especializado, México 2016

Objetivo: Describir las características epidemiológicas de las derivaciones fecales y urinarias, las características demográficas de los pacientes ostomizados y las características de los productos utilizados en un Centro Especializado en Cuidado de Heridas y Ostomías de la Ciudad de México. Metodología: Estudio descriptivo, retrospectivo y transversal en el cual se revisaron los expedientes clínicos de personas ostomizadas atendidas durante el año 2016. Resultados: Se analizaron 143 expedientes. La media de edad fue de 56.3±15.2 años. El diagnóstico más común fue el cáncer de colon (27.8%). Las características presentes en mayor proporción fueron: colostomías descendentes (44.7%), regulares (56.6%), diámetro medio de 30±8 mm; ángulo de drenaje al centro (36.4%), de una boca (69.2%), sin marcaje quirúrgico (55.2%), mucosa viable (100%), planos (49.6%), efluente pastoso (51.0%). El 51.7% de los pacientes presentaron complicaciones estomales y el 54.5% complicaciones de la piel periestomal, las cuales fueron resueltas en el 68.0% de los casos, en un tiempo medio de 16.3± 11.5 días. Conclusión: Los resultados del presente estudio aportan evidencia respecto a la necesidad permanente de desarrollar profesionales de Enfermería especializados en terapia enterostomal e incorporarlos al Sistema Nacional de Salud como miembros indispensables del equipo multidisciplinario.

Objective: To describe the epidemiologic characteristics of fecal and urinary derivations, the demographic characteristics of ostomized patients, and the characteristics of utilized products, in a Specialized Center of Wounds and Ostomy Care in Mexico City. Methodology: This is a descriptive, retrospective, and transversal study in which, clinical registers of ostomized patients in 2016 were reviewed. Results: 143 registers were reviewed. The mean age was 56.3±15.2. The most common underlying diagnosis was colon cancer (27.8%). The most prevailing characteristics were: descending colostomy (44.7%), regular (56.6%), median diameter 30±8mm, angle of drainage at center (36.4%), one mouth (69.2%), without surgical mark (55.2%), viable mucous membrane (100%), planes (49.6%), and thick discharge (51.0%). Fifty one point seven percent of the patients showed stomal complications and 54.7% showed peristomal skin complications, which were further solved in 68.0% of these cases in a mean time of 16.3±11.5 days. Conclusion: The results of this study provided evidence regarding the permanent need to prepare enterostomal therapy specialized nursing professionals and incorporate them into the National Health System as indispensable members of the multidisciplinary teams.

Objetivo: Descrever as características epidemiológicas das derivações fecais e urinarias, características demográficas dos pacientes ostomizados e características dos produtos utilizados em um Centro Especializado em Cuidado de Feridas e Ostomias da Cidade do México. Metodologia: Estudo descritivo, retrospectivo e transversal onde se revisaram os expedientes clínicos de pessoas ostomizadas atendidas durante o ano de 2016. Resultados: Analisaram-se 143 expedientes. A média de idade foi de 56.3±15.2. O diagnóstico mais comum foi o câncer de cólon (27.8%). As características presentes em maior proporção foram: colostomias descendentes (44.7%), regulares (56.6%), diâmetro médio de 30±8 mm; ângulo de drenagem ao centro (36.4%), de uma boca (69.2%), sem marcação cirúrgica (55.2%), mucosa viável (100%), planos (49.6%), efluente pastoso (51.0%). O 51.7% dos pacientes apresentaram complicações estomacais e o 54.5% de complicações da pele periestomal, as quais foram resolvidas no 68.0% dos casos, em um tempo médio de 16.3±11.5 dias. Conclusão: Os resultados do presente estudo aportam evidência respeito à necessidade permanente de desenvolver profissionais de Enfermagem especializados em Terapia Enterostomal e incorporá-los ao Sistema Nacional de Saúde como membros indispensáveis da equipe multidisciplinar.

Type II diabetes mellitus and menopause: a multinational study.

BACKGROUND: Type II diabetes mellitus causes metabolic changes that may lead to early menopause and worsen climacteric symptoms. OBJECTIVES: To determine the risk factors for type II diabetes mellitus and assess the impact of this disease on the age of menopause and on climacteric symptoms. METHODS: A total of 6079 women aged between 40 and 59 years from 11 Latin American countries were requested to answer the Menopause Rating Scale and Goldberg Anxiety-Depression Scale. RESULTS: The prevalence of diabetes was 6.7%. Diabetes mellitus was associated with arterial hypertension (odds ratio (OR) 4.49; 95% confidence interval (CI) 3.47-5.31), the use of psychotropic drugs (OR 1.54; 95% CI 1.22-1.94), hormonal therapy (OR 1.46; 95% CI 1.11-1.92), ≥ 50 years of age (OR 1.48; 95% CI 1.17-1.86), overweight or obese (OR 1.47; 95% CI 1.15-1.89), and waist circumference ≥ 88 cm (OR 1.32; 95% CI 1.06-1.65). Factors associated with lower risk of diabetes were the use of hormonal contraceptives (OR 0.55; 95% CI 0.35-0.87), alcohol (OR 0.73; 95% CI 0.54-0.98) and living in cities > 2500 meters above sea level (OR 0.70; 95% CI 0.53-0.91) or with high temperatures (OR 0.67; 95% CI 0.51-0.88). In turn, diabetes tripled the risk of menopause in women under 45 years of age. Diabetes did not increase the risk of deterioration of quality of life due to climacteric symptoms. CONCLUSION: Menopause does not increase the risk of type II diabetes mellitus. Diabetes is associated with early menopause in women under 45 years of age.

Menopausal symptoms appear before the menopause and persist 5 years beyond: a detailed analysis of a multinational study.

OBJECTIVE: Few Latin American studies have described menopausal symptoms in detail by means of a standardized assessment tool. The objective of this study was to assess the prevalence and severity of menopausal symptoms and their impact over quality of life among mid-aged Latin American women. METHOD: In this cross-sectional study, 8373 otherwise healthy women aged 40-59 years from 12 Latin American countries were asked to fill out the Menopause Rating Scale (MRS) and a questionnaire containing personal sociodemographic data. Menopause status (pre-, peri- and postmenopausal) was defined according to the criteria of the Stages of Reproductive Aging Workshop. RESULTS: Of all the studied women, 90.9% had at least one menopausal symptom (complaint) that they rated. Muscle and joint discomfort, physical and mental exhaustion and depressive mood were highly prevalent and rated as severe-very severe (scores of 3 and 4), at a higher rate than vasomotor symptoms (15.6%, 13.8% and 13.7% vs. 9.6%, respectively). Of premenopausal women (40-44 years), 77.0% reported at least one rated complaint, with 12.9% displaying MRS scores defined as severe (> 16). The latter rate increased to 26.4% in perimenopausal, 31.6% in early postmenopausal and 29.9% among late postmenopausal women. As measured with the MRS, the presence of hot flushes increased the risk of impairment of overall quality of life in both premenopausal (odds ratio 12.67; 95% confidence interval 9.53-16.83) and peri/postmenopausal women (odds ratio 9.37; 95% confidence interval 7.85-11.19). CONCLUSION: In this large, mid-aged, female Latin American series, muscle/joint discomfort and psychological symptoms were the most prevalent and severely rated menopausal symptoms. The symptoms appear early in the premenopause, significantly impair quality of life and persist 5 years beyond the menopause.

Severe menopausal symptoms in mid-aged Latin American women can be related to their indigenous ethnic component.

BACKGROUND: Latin American women present more severe menopausal symptoms when compared to those from other regions of the world. Since this population is an ethnic blend of Caucasian and indigenous people, we sought to test the hypothesis that severe menopausal symptoms in Latin American women are associated with an indigenous origin. OBJECTIVE: To assess menopausal symptoms among two specific indigenous Latin American populations. METHOD: A total of 573 natural postmenopausal indigenous women aged 45-59 years (288 Quechua (Peru) and 285 Zenú (Colombia)) living in isolated communities were surveyed with a general questionnaire and the Menopause Rating Scale (MRS). RESULTS: The total MRS score was significantly higher among Quechua women as compared to Zenú ones (22.7 ± 5.7 vs. 14.7 ± 2.5, p < 0.0001); both figures were higher than those described for Hispanic or European populations. Quechua women presented more intense somatic and psychological symptoms as compared to Zenú (8.8 ± 2.3 vs. 5.3 ± 1.8; and 7.8 ± 2.4 vs. 3.2 ± 1.7, p < 0.0001); however, both indigenous groups presented similar intense urogenital symptoms (6.1 ± 1.6 vs. 6.2 ± 1.4, not significant). These differences persisted after adjusting for age, years since menopause onset and parity. The percentage of women presenting severe somatic and psychological symptoms significantly increased with aging among Quechua. This was not the case for Zenú women. More than 90% of indigenous women (Quechua and Zenú) at all age intervals presented severe urogenital scores, a percentage that is much higher than that described in the world literature. CONCLUSION: Severe menopausal symptoms found among Latin American women could be the result of their indigenous ethnic origin; the urogenital domain is the most affected.

Field performance of sugarcane (Saccharum sp.) plants derived from cryopreserved calluses.

This study compared the field performance of sugarcane plants originating from three different sources: control, non-cryopreserved embryogenic calluses, cryopreserved embryogenic calluses and macropropagated material of the same commercial hybrid. Several agronomic traits were evaluated on 100 plants per treatment over a 27-month period covering the growth of the stool and of the first ratoon. Significant differences between treatments were observed only during the first six months of field growth of sugarcane stools. Stems produced from in vitro cultured material, irrespective of their cryopreservation status, had a smaller diameter and a shorter height than those produced from macropropagated material. These differences disappeared by 12 months of stool field growth.

Maltrato de niños y adolescentes: una perspectiva internacional / Children and adolescents abuse: an international perspective

El descuidado y tratamiento abusivo de niños y adolescentes varía de una cultura a otra, pero se da en todas partes del mundo. El castigo corporal, la negligencia selectiva y el trabajo y la prostitución son quizás sus formas más comunes. Para combatir esos abusos es importante tener una idea más objetiva de cómo se valoran los niños y lo que constituye maltrato en las distintas culturas, incluída la propia. Tambien es necesario obtener datos fidediggnos sobre el problema e iniciar acciones internacionales que influyan en las l egislaciones nacionales sobre los derechos de niños y adolescentes

Meta-análisis neuroepidemiológico sobre síndromes agudos vasculares encefálicos (S.A.V.E.) del circuito posterior de un hospital general de la ciudad de Córdoba / Acute vasculoencephalic syndrome of the posterior circuit: neuroepidemiological metha-analysis in a General Hospital of Córdoba city

Este trabajo neuroepidemiológico se llevó a cabo en un grupo de pacientes diagnosticados en forma fehaciente como afecciones vasculares del encéfalo y del circuito Vértebro Basilar Cerebral Posterior. nuestro pacientes nos han permitido construir una visión ampliada del perfil clínico en relación a la topografía lesional y a los mecanismos fisiopatogénicos. Y no nos ajustamos sólo a lo prescripto en 1975 por el comité Ad Hoc. Nuestra propuesta ampliatoria se basa en considerar al circuito posterior sobre un eje que comprenda a las arterias Vertebral - Basilar - Cerebral posterior y bajo el concepto de las manifestaciones clínicas fundadas en las definiciones del Comité Ad Hoc para Stroke y los datos que se agregaron al integrar a la arteria Cerebral Posterior. La estrategia del Meta-análisis nos ha permitido desarrollar la idea de la importancia que poseen signos o síntomas CENTINELAS o de SOSPECHA en un grupo etareo de alto riesgo por ser gerontes y portadores de cardiopatías embolígenas, hipertensión arterial, dislipemias y/o diabetes. Descubrir a sospechosos con datos subclínicos o pausisintomáticos, dentro del perfil de sindromes vasculares agudos o crónicos y enmarcados en una filosofía que priorice el diagnóstico temprano para evitar la lesión estructural incapacitante, redundará en una más alta calidad de vida para el geronte y un mejor control sanitario para la tercera edad (AU)

Meta-análisis neuroepidemiológico sobre síndromes agudos vasculares encefálicos (S.A.V.E.) del circuito posterior de un hospital general de la ciudad de Córdoba / Acute vasculoencephalic syndrome of the posterior circuit: neuroepidemiological metha-analysis in a General Hospital of Córdoba city

Este trabajo neuroepidemiológico se llevó a cabo en un grupo de pacientes diagnosticados en forma fehaciente como afecciones vasculares del encéfalo y del circuito Vértebro Basilar Cerebral Posterior. nuestro pacientes nos han permitido construir una visión ampliada del perfil clínico en relación a la topografía lesional y a los mecanismos fisiopatogénicos. Y no nos ajustamos sólo a lo prescripto en 1975 por el comité Ad Hoc. Nuestra propuesta ampliatoria se basa en considerar al circuito posterior sobre un eje que comprenda a las arterias Vertebral - Basilar - Cerebral posterior y bajo el concepto de las manifestaciones clínicas fundadas en las definiciones del Comité Ad Hoc para Stroke y los datos que se agregaron al integrar a la arteria Cerebral Posterior. La estrategia del Meta-análisis nos ha permitido desarrollar la idea de la importancia que poseen signos o síntomas CENTINELAS o de SOSPECHA en un grupo etareo de alto riesgo por ser gerontes y portadores de cardiopatías embolígenas, hipertensión arterial, dislipemias y/o diabetes. Descubrir a sospechosos con datos subclínicos o pausisintomáticos, dentro del perfil de sindromes vasculares agudos o crónicos y enmarcados en una filosofía que priorice el diagnóstico temprano para evitar la lesión estructural incapacitante, redundará en una más alta calidad de vida para el geronte y un mejor control sanitario para la tercera edad

[Determination of genomic and replicative RNA of hepatitis C virus in patients treated with interferon]. / Determinación del RNA genómico y replicativo del virus de la hepatitis C en pacientes tratados con interferón.

We have investigated the presence of genomic and replicative RNA strands of hepatitis C virus in liver and serum. Eleven patients with proven chronic hepatitis C, received Interferon a2a 4,5 MU, three times a week during six months. RT-PCR was used with sense primer to detect the replicative strand and an antisense primer to identify genomic strand. Before treatment, genomic strands were present in liver and serum of all patients. Replicative strands were present in liver and serum in five and six cases, respectively. Seven out of eleven responded to treatment. In responders, genomic strands were absent in liver of 3 cases (43%) and replicative strands in liver of 4 (57%). In plasma genomic and replicative strands were absent in 5 (71%) and 7 (100%), respectively. In all non responders, genomic strands in liver and plasma remained present. Replicative strands in liver and plasma were present in 100% and 25%, respectively. Knodell score improved in 5 out of 7 responders and remained unchanged in 3 out of 4 non responders. In 2 out of 4 responders with genomic and replicative strands in liver, Knodell score remained unchanged or worse. In all non responders, genomic and replicative strands in liver were present and Knodell score remained unchanged or worse. Genomic and replicative strands in plasma tended to be negative after treatment in responders. Genomic strands in plasma remained present in non responders. Conversely, genomic and replicative strands in liver were present in all non responders. It seems to exist a relationship between genomic and replicative strands in liver and the same or worse Knodell score. After a follow up, it will be possible to determined whether responders who still present viral RNA in liver would be prone to a relapse.