The relationship between carotid intima-media thickness and cognitive function and depression in postmenopausal women.

Introduction: Atherosclerosis, cognitive impairment, and depression are common entities in postmenopausal patients. Our aim was to ascertain the relationship between the carotid intima-media thickness (IMT) and cognitive function and depression in postmenopausal women. Material and methods: This was an observational, cross-sectional, comparative study among postmenopausal women. A carotid artery ultrasound was performed, and the IMT was measured. Mental function was assessed with the mini-mental state examination (MMSE), and the presence of depression with the Hamilton Depression Rating Scale (HDRS). For statistical analysis the Mann-Whitney U test and Spearman correlation were used. Sensitivity, specificity, positive predictive value, negative predictive value, and odds ratio (OR) were calculated. Results: Seventy-five patients were studied. The median of age was 52 years (31-76), and the IMT was 1.1 mm (0.6-0.20). The HDRS score was 8.9 (1-21), and that of the MMSE was 29 (18-30). After dividing the group according to the presence or absence of depression, it was found that age and IMT were greater in the group with depression, and the MMSE score was greater in the group without depression. After dividing according to the MMSE score, age and HDRS score were significantly greater in the group with cognitive impairment. The intima-media thickness had an OR of 12.2 (2.6-58.0) for cognitive impairment and an OR of 5.2 (1.9-14.1) for depression. Conclusions: The intima-media thickness is associated with greater risk of cognitive impairment and depression.

[Clinical, obstetric and perinatal characteristics of Mexican pregnant women with COVID-19]. / Características clínicas, obstétricas y perinatales de embarazadas mexicanas con Covid-19.

Background: COVID-19 disease is the leading cause of maternal death in Mexico. The data published to date indicate that pregnancy favors severe forms of the disease. Objective: To describe the clinical, obstetric and perinatal characteristics of pregnant women with COVID-19 disease treated at the UMAE "Luis Castelazo Ayala" of the Instituto Mexicano del Seguro Social. Material and methods: Observational, cross-sectional and retrospective study of pregnant women with COVID-19 treated from March to December 2020. The epidemiological characteristics, complications and perinatal results were analyzed with descriptive and inferential statistics. Results: 133 patients included: 84.5% with mild disease, 8 % moderate and 8.5% severe and critical. Pre-existing comorbidities: obesity, diabetes and hypothyroidism. Main symptoms: cough, headache, fever, rhinorrhea and anosmia. In severe and critical cases, tachycardia, tachypnea, and hypoxemia were present. Lymphoneutropenia, hyperglycemia, and transaminasemia were seen in severe and critical forms. Fibrinogen and D dimer stayed unchanged. Preterm delivery, oligohydramnios, gestational hypertension, severe preeclampsia, and pneumonia were the main complications. 75% of the newborns without complications. Conclusions: The clinical behavior of the disease was mostly mild and even in moderate cases, and even in moderate as well as severe and complicated cases, the binomial results were favorable. There was no maternal death.

Introducción: la enfermedad COVID-19 en el embarazo es la primera causa de muerte materna en México, y se ha reportado que favorece las formas graves de la enfermedad. Objetivo: describir las características clínicas, obstétricas y perinatales de pacientes embarazadas con enfermedad COVID-19 atendidas en la UMAE "Luis Castelazo Ayala" del Instituto Mexicano del Seguro Social (IMSS). Material y métodos: estudio observacional, transversal y retrospectivo de pacientes embarazadas con COVID-19 atendidas de marzo a diciembre del 2020. Las características epidemiológicas, complicaciones y resultados perinatales se analizaron con estadística descriptiva e inferencial. Resultados: se incluyeron 133 pacientes: 84.5% presentaron enfermedad leve, 8% moderada y 8.5% severa y crítica. Las comorbilidades preexistentes fueron: obesidad, diabetes e hipotiroidismo. Los principales síntomas: tos, cefalea, fiebre, rinorrea y anosmia. En casos severos y críticos la taquicardia, taquipnea e hipoxemia estuvieron presentes. En las formas severa y crítica se observaron: linfoneutropenia, hiperglucemia y transaminasemia. El fibrinógeno y dímero D sin cambios. El parto pretérmino, el oligohidroamnios, la hipertensión gestacional, la preeclampsia severa y la neumonia fueron las principales complicaciones. El 75% de los recién nacidos no preentaron complicaciones. Conclusiones: el comportamiento clínico de la enfermedad fue, en su mayoría, leve, e incluso en los casos moderados así como en los severos y complicados los resultados del binomio fueron favorables. No hubo muerte materna ni se evidenció transmisión vertical.

Características clínicas, obstétricas y perinatales de embarazadas mexicanas con COVID-19 / Clinical, obstetric and perinatal characteristics of Mexican pregnant women with COVID-19

Introducción: la enfermedad COVID-19 en el embarazo es la primera causa de muerte materna en México, y se ha reportado que favorece las formas graves de la enfermedad. Objetivo: describir las características clínicas, obstétricas y perinatales de pacientes embarazadas con enfermedad COVID-19 atendidas en la UMAE "Luis Castelazo Ayala" del Instituto Mexicano del Seguro Social (IMSS). Material y métodos: estudio observacional, transversal y retrospectivo de pacientes embarazadas con COVID-19 atendidas de marzo a diciembre del 2020. Las características epidemiológicas, complicaciones y resultados perinatales se analizaron con estadística descriptiva e inferencial. Resultados: se incluyeron 133 pacientes: 84.5% presentaron enfermedad leve, 8% moderada y 8.5% severa y crítica. Las comorbilidades preexistentes fueron: obesidad, diabetes e hipotiroidismo. Los principales síntomas: tos, cefalea, fiebre, rinorrea y anosmia. En casos severos y críticos la taquicardia, taquipnea e hipoxemia estuvieron presentes. En las formas severa y crítica se observaron: linfoneutropenia, hiperglucemia y transaminasemia. El fibrinógeno y dímero D sin cambios. El parto pretérmino, el oligohidroamnios, la hipertensión gestacional, la preeclampsia severa y la neumonía fueron las principales complicaciones. El 75% de los recién nacidos no presentaron complicaciones. Conclusiones: el comportamiento clínico de la enfermedad fue, en su mayoría, leve, e incluso en los casos moderados así como en los severos y complicados los resultados del binomio fueron favorables. No hubo muerte materna ni se evidenció transmisión vertical.

Background: COVID-19 disease is the leading cause of maternal death in Mexico. The data published to date indicate that pregnancy favors severe forms of the disease. Objective: To describe the clinical, obstetric and perinatal characteristics of pregnant women with COVID-19 disease treated at the UMAE "Luis Castelazo Ayala" of the Instituto Mexicano del Seguro Social. Material and methods: Observational, cross-sectional and retrospective study of pregnant women with COVID-19 treated from March to December 2020. The epidemiological characteristics, complications and perinatal results were analyzed with descriptive and inferential statistics. Results: 133 patients included: 84.5% with mild disease, 8 % moderate and 8.5% severe and critical. Pre-existing comorbidities: obesity, diabetes and hypothyroidism. Main symptoms: cough, headache, fever, rhinorrhea and anosmia. In severe and critical cases, tachycardia, tachypnea, and hypoxemia were present. Lymphoneutropenia, hyperglycemia, and transaminasemia were seen in severe and critical forms. Fibrinogen and D dimer stayed unchanged. Preterm delivery, oligohydramnios, gestational hypertension, severe preeclampsia, and pneumonia were the main complications. 75% of the newborns without complications. Conclusions: The clinical behavior of the disease was mostly mild and even in moderate cases, and even in moderate as well as severe and complicated cases, the binomial results were favorable. There was no maternal death.

Differences in the neutrophil/lymphocyte ratio and the platelet/lymphocyte ratio in pregnant women with and without COVID-19.

OBJECTIVE: To determine the differences in the neutrophil/lymphocyte ratio (NLR) and the platelet/lymphocyte ratio (PLR) in pregnant women with and without COVID-19. METHODS: Observational, cross-sectional, retrospective, comparative, open, controlled study done from January to April 2021 at the UMAE Hospital de Gineco Obstetricia "Luis Castelazo Ayala" Instituto Mexicano del Seguro Social. Mexico City, Mexico: Patients were divided into those with a negative test for COVID-19 and those with a positive test, with the latter then being divided according to disease severity into mild, moderate, and severe groups. In all the NLR and PLR were calculated. Symptoms, vital signs, and oxygen saturation were documented. STATISTICAL ANALYSIS: Central tendency and dispersion measures, Kruskal-Wallis test, Mann-Whitney U test, and chi-squared test were used. Sensitivity, specificity, positive predictive value, negative predictive value, and odds ratio (OR) were calculated. RESULTS: Seventy-seven patients were included, 24 without COVID-19 and 53 with COVID-19. There were 33, 10, and 10 patients in the mild, moderate, and severe disease groups, respectively. There was no difference in NLR between the groups and the PLR was significantly higher in the severe disease group. With a 5.1 NLR cutoff point, between normal and those with severe disease, the sensitivity was 70% and specificity 63%, whilst with a 221 PLR cutoff point, the sensitivity was 90% and the specificity 83% (OR 45, 95% CI 4.40-461.7). CONCLUSION: PLR more than NLR was useful to detect pregnant patients with COVID-19 with severe disease.

Frequency of olfactory dysfunction in pregnant women with SARS-CoV-2 infection.

INTRODUCTION: In patients with COVID-19, olfactory dysfunction and anosmia have been reported, which in pregnant women occur in up to 24.2 %. OBJECTIVE: To know the frequency at which pregnant women with SARS-CoV-2 infection have olfactory dysfunction. METHODS: Age, gestational age, temperature, presence of nasal constipation or rhinorrhea, myalgia, headache, cough or chest pain were asked. Whether patients perceived and identified the scent of grape juice, coffee powder and menthol was evaluated. Central tendency and dispersion measures, frequencies and percentages were used. Sensitivity, specificity, positive and negative predictive value were calculated. Mann-Whitney's U-test and contrast of proportions were used for comparisons between groups. RESULTS: There was a higher proportion of women with cough, headache, dyspnea, myalgia, odynophagia, rhinorrhea, chest pain, and anosmia in SARS-CoV-2-positive women. In patients without COVID-19, 88.9 % detected each one of the scents; only 31.8 % of the positive group detected grapes scent, 47.7 % coffee and 59.1 % menthol, which had the highest percentages of sensitivity (40 %), specificity (21 %), positive predictive value (59 %) and negative predictive value (11 %). CONCLUSION: Olfactory dysfunction occurs in a significant percentage of pregnant women with COVID-19.

INTRODUCCIÓN: En pacientes con COVID-19 se ha reportado disfunción olfatoria y anosmia; en la mujer embarazada se presenta hasta en 24.2 %. OBJETIVO: Conocer la frecuencia con la que las mujeres embarazadas e infección por SARS-CoV-2 tienen disfunción olfatoria. MÉTODOS: Se preguntó edad, edad gestacional, temperatura, presencia de constipación nasal o rinorrea, mialgias, cefalea, tos o dolor torácico, además de evaluar si las mujeres percibían e identificaban el aroma de jugo de uva, café en polvo y mentol. Se utilizaron medidas de tendencia central y dispersión, frecuencias y porcentajes. Se calculó sensibilidad, especificidad, valor predictivo positivo y negativo. La U de Mann-Whitney y el contraste de proporciones sirvieron para las comparaciones entre los grupos. RESULTADOS: Hubo mayor proporción de mujeres con tos, cefalea, disnea, mialgias, odinofagia, rinorrea, dolor torácico y anosmia en mujeres positivas a SARS-CoV-2. De las pacientes sin COVID-19, 88.9 % detectó cada uno de los aromas; solo 31.8 % del grupo positivo detectó el aroma a uva, 47.7 % el de café y 59.1 % el de mentol, el cual tuvo los porcentajes más altos en sensibilidad (40 %), especificidad (21 %), valores predictivos positivo (59 %) y negativo (11 %). CONCLUSIÓN: la disfunción olfatoria se presenta en un porcentaje importante de las mujeres embarazadas con COVID-19.

Frecuencia de disfunción olfatoria en mujeres embarazadas con infección por SARS-CoV-2 / Frequency of olfactory dysfunction in pregnant women with SARS-CoV-2 infection

Resumen Introducción: En pacientes con COVID-19 se ha reportado disfunción olfatoria y anosmia; en la mujer embarazada se presenta hasta en 24.2 %. Objetivo: Conocer la frecuencia con la que las mujeres embarazadas e infección por SARS-CoV-2 tienen disfunción olfatoria. Métodos: Se preguntó edad, edad gestacional, temperatura, presencia de constipación nasal o rinorrea, mialgias, cefalea, tos o dolor torácico, además de evaluar si las mujeres percibían e identificaban el aroma de jugo de uva, café en polvo y mentol. Se utilizaron medidas de tendencia central y dispersión, frecuencias y porcentajes. Se calculó sensibilidad, especificidad, valor predictivo positivo y negativo. La U de Mann-Whitney y el contraste de proporciones sirvieron para las comparaciones entre los grupos. Resultados: Hubo mayor proporción de mujeres con tos, cefalea, disnea, mialgias, odinofagia, rinorrea, dolor torácico y anosmia en mujeres positivas a SARS-CoV-2. De las pacientes sin COVID-19, 88.9 % detectó cada uno de los aromas; solo 31.8 % del grupo positivo detectó el aroma a uva, 47.7 % el de café y 59.1 % el de mentol, el cual tuvo los porcentajes más altos en sensibilidad (40 %), especificidad (21 %), valores predictivos positivo (59 %) y negativo (11 %). Conclusión: la disfunción olfatoria se presenta en un porcentaje importante de las mujeres embarazadas con COVID-19.

Abstract Introduction: In patients with COVID-19, olfactory dysfunction and anosmia have been reported, which in pregnant women occur in up to 24.2 %. Objective: To know the frequency in which pregnant women with SARS-CoV-2 infection have olfactory dysfunction. Methods: Age, gestational age, temperature, presence of nasal constipation or rhinorrhea, myalgia, headache, cough or chest pain were asked. Whether patients perceived and identified the scent of grape juice, coffee powder and menthol was evaluated. Central tendency and dispersion measures, frequencies and percentages were used. Sensitivity, specificity, positive and negative predictive value were calculated. Mann-Whitney's U-test and contrast of proportions were used for comparisons between groups. Results: There was a higher proportion of women with cough, headache, dyspnea, myalgia, odynophagia, rhinorrhea, chest pain, and anosmia in SARS-CoV-2-positive women. In patients without COVID-19, 88.9 % detected each one of the scents; only 31.8 % of the positive group detected grapes scent, 47.7 % coffee and 59.1 % menthol, which had the highest percentages of sensitivity (40 %), specificity (21 %), positive predictive value (59 %) and negative predictive value (11 %). Conclusion: Olfactory dysfunction occurs in a significant percentage of pregnant women with COVID-19.

Relationship of vitamin D blood concentration with muscle mass and cognitive function in postmenopausal women.

INTRODUCTION: Low levels of vitamin D have been associated with muscle mass loss and cognitive function alteration. OBJECTIVE: To find out the relationship of vitamin D blood levels with muscle mass and cognitive function in postmenopausal women. MATERIALS AND METHODS: Ninety-nine postmenopausal women aged ≥ 50 years were studied. Calf circumference, and tricipital, bicipital, subscapular and suprailiac skinfolds were measured. Arm muscle area, bone-free arm muscle area, and muscle mass were calculated. The short physical performance battery (SPPB) was performed, and the sarcopenia rapid diagnostic questionnaire (SARC-F), as well as the Mini Mental State Examination (MMSE) were applied. A blood sample was taken to measure vitamin D blood concentration. For statistical analysis, Mann-Whitney's U-test and Spearman's correlation analysis were used. RESULTS: It was found that, the older the age, the higher the vitamin D levels, as well as higher SARC-F score. Vitamin D levels were negatively correlated with grip strength and SPPB. There was a negative correlation between vitamin D levels and MMSE global score. CONCLUSIONS: Vitamin D did not have a positive influence on muscle mass. A better MMSE performance was observed in those with lower vitamin D levels.

INTRODUCCIÓN: Las concentraciones bajas de vitamina D se han asociado con la pérdida de masa muscular y la alteración de la función cognitiva. OBJETIVO: Conocer la relación de la concentración sanguínea de vitamina D con la masa muscular y la función cognitiva en mujeres posmenopáusicas. MATERIALES Y MÉTODOS: Se estudiaron 99 mujeres posmenopáusicas ≥ 50 años. Se midió la circunferencia de la pantorrilla, los pliegues cutáneos tricipital, bicipital, subescapular y suprailíaco. Se calcularon: el área muscular del brazo, el área muscular libre de hueso y la masa muscular total. Se realizó la prueba corta de desempeño físico (PCDF), se aplicó el cuestionario de diagnóstico rápido de sarcopenia (SARC-F) y el Mini Examen del Estado Mental (MMSE). Se tomó una muestra de sangre para medir la concentración de vitamina D en sangre. Para el análisis estadístico se utilizó la prueba U de Mann-Whitney y análisis de correlación de Spearman. RESULTADOS: Se encontró que a mayor edad hubieron mayores concentraciones de vitamina D y mayor puntaje SARC-F. Las concentraciones de vitamina D se correlacionaron negativamente con la fuerza de agarre, la PCDF y la puntuación total del MMSE. CONCLUSIONES: La vitamina D no tuvo una influencia positiva sobre la masa muscular. Se observó un mejor desempeño en el MMSE en aquellas con concentraciones más bajas de vitamina D.

Relationship of the neutrophil/lymphocyte ratio with cardiovascular risk markers in premenopausal and postmenopausal women.

INTRODUCTION: Cardiovascular disease is more frequent in postmenopausal women. Atherosclerosis is associated with inflammation and the neutrophil/lymphocyte ratio (NLR) is a marker of inflammation whose behavior in postmenopause is unknown. AIM OF THE STUDY: To know the relationship of the NLR with cardiovascular risk markers in premenopausal and postmenopausal women. MATERIAL AND METHODS: Premenopausal and postmenopausal women were studied, in all of them a complete hemogram and the NLR, platelet/lymphocyte ratio (PLR) were calculated, also glucose and lipids levels were measured. In all of them subcutaneous and visceral fat, carotid intima-media thickness (IMT), epicardial fat were measured by ultrasound Also baseline and and after flow-mediated stimulus the arterial diameter, the pulsatility index and the resistive index of the brachial artery were measured by ultrasound. The results are reported with medians and intervals, Mann-Whitney U and Spearman correlation analysis were performed. RESULTS: Eighty two patients were recruited, 41 premenopausal and 41 postmenopausal. When comparing both groups there was no difference in glucose, lipids, NLR, PLR, carotid IMT, epicardial fat, subcutaneous fat, visceral fat or Doppler parameters of the brachial artery. CONCLUSION: NLR was not different between premenopausal and postmenopausal women but abnormal PLR was greater in those postmenopausal with vasomotor symptoms.

Glycosylated hemoglobin level in patients with and without surgical site infection after hysterectomy.

BACKGROUND: Surgical site infection (SSI) occurs in 11-12% of surgeries. The glycosylated hemoglobin (HbA1c) has been found to be significantly elevated in those who presented infection. OBJECTIVE: To compare the concentration of HbA1c between patients with and without SSI after hysterectomy. METHOD: In healthy, postoperative women with total abdominal (open) hysterectomy, the HbA1c serum concentration was measured (normal <5.7%) and the difference between those who presented SSI and other risk factors for SSI were compared with Mann Whitney U test was used. The HbA1c values were stratified as normal or abnormal and were contrasted with the presence or absence of SSI by means of X2. RESULTS: 27 women without SSI and 20 with SSI were studied. The preoperative glucose was and 88 (70-99) mg/dl and 86 (70-99) mg/dl for the groups with and without SSI respectively. The HbA1c was significantly higher in the group with ISQ 5.6% (5-8) vs. 6.5% (5.2-8.2). The sensitivity of HbA1c with cut point <5.7 was 80% and the specificity was 51.9%. CONCLUSION: HbA1c can serve as a prognostic criterion of ISQ.

ANTECEDENTES: La infección del sitio quirúrgico (ISQ) se presenta en el 11-12% de las cirugías. La hemoglobina glucosilada (HbA1c) se ha encontrado significativamente elevada en los pacientes que presentan infección. OBJETIVO: Comparar la concentración de HbA1c entre pacientes con y sin ISQ posterior a una histerectomía. MÉTODO: En mujeres sanas posoperadas de histerectomía total abdominal (abierta) se midió la concentración sérica de HbA1c (normal < 5.7%) y se comparó la diferencia entre las que presentaron ISQ y las que no. Se investigaron también otros factores de riesgo para ISQ. Se utilizó la prueba U de Mann Whitney. Los valores de HbA1c se estratificaron como normales o anormales, y se contrastaron con la presencia o no de ISQ por medio de la prueba ji al cuadrado. RESULTADOS: Se estudiaron 27 mujeres sin ISQ y 20 con ISQ. La glucosa preoperatoria fue de 88 (70-99) y 86 (70-99) mg/dl para los grupos con y sin ISQ, respectivamente. La HbA1c fue significativamente mayor en el grupo con ISQ (5.6%; 5-8) que en el grupo sin ISQ (6.5%; 5.2-8.2). La sensibilidad de la HbA1c con un punto de corte < 5.7 fue del 80% y la especificidad fue del 51.9%. CONCLUSIÓN: La HbA1c puede servir como criterio pronóstico de ISQ.

[Frequency of depression and burnout syndrome in Obstetrics and Ginecology residents]. / Frecuencia de depresión y síndrome de burnout en residentes de Ginecología y Obstetricia.

Introduction: According to the World Health Organization, depression is the most prevalent mental disorder and burnout syndrome can occur among individuals whose work involves care or assistance to people, and, given that residents may have heavy workloads, it is important to study burnout's frequency in them. Objective: To know the frequency of burnout syndrome and depression in Obstetrics and Gynecology (OB/GYN) residents. Methods: A prospective, observational, cross-sectional, and descriptive study was carried out in OB/GYN residents. Two instruments were applied: Beck Depression Inventory and Maslach Burnout Inventory, in order to assess depression and burnout, respectively. For the statistical analysis, it was used descriptive statistics, frequencies, measures of central tendency and dispersion, as well as Spearman correlation analysis. Results: 28 second-year residents, 33 from third-year, and 17 fourth-year residents were studied. In second-year residents, mild and moderate depression prevailed; in third year residents, moderate depression, and in fourth-year residents, minimal depression. Only second-year, and third-year residents presented burnout syndrome. Correlation between depression and burnout syndrome showed a rho = 0.591, p < 0.001. Conclusion: Depression is related to burnout syndrome in OB/GYN residents.

Introducción: de acuerdo con la Organización Mundial de la Salud, la depresión es el trastorno mental con mayor prevalencia y el síndrome de burnout o desgaste profesional es un síndrome que puede ocurrir entre individuos cuyo trabajo implica atención o ayuda a personas y, dado que los residentes pueden tener altas cargas de trabajo, es importante estudiar su frecuencia en ellos. Objetivo: conocer la frecuencia del síndrome de burnout y la depresión en residentes de la especialidad de Ginecología y Obstetricia. Material y métodos: se realizó un estudio prospectivo, observacional, transversal y descriptivo en residentes de la especialidad de Ginecología y Obstetricia. Se aplicaron dos instrumentos: el Inventario de depresión de Beck y el Inventario de burnout de Maslach, a fin de evaluar depresión y burnout, respectivamente. Para el análisis estadístico se utilizó estadística descriptiva, frecuencias, medidas de tendencia central y dispersión, así como análisis de correlación de Spearman. Resultados: se estudiaron 28 residentes de segundo grado, 33 de tercer grado y 17 de cuarto grado. En los de segundo grado hubo predominio de depresión leve y moderada; en los de tercer grado, moderada, y en los de cuarto grado, la mínima. Solo hubo síndrome de burnout en los de segundo y tercer grado. La correlación entre la depresión y el síndrome de burnout fue rho = 0.591, p < 0.001. Conclusión: la depresión está relacionada con el síndrome de burnout en residentes de Ginecología y Obstetricia.

Clinical and laboratory characteristics in gynecologic and obstetric patients with surgical site infection / Características clínicas y de laboratorio en pacientes ginecológicas y obstétricas con infección de sitio quirúrgico

BACKGROUND: The frequency of surgical site infection (SSI) is different according to the different hospitals and is not completely known in the hospital. OBJECTIVE: To describe the clinical and laboratory characteristics in gynecological and obstetric patients with SSI, as well as its frequency, associated risk factors and the most frequently isolated microorganism in cultures. MATERIAL AND MEHOTDS: Descriptive, cross-sectional, retrospective and observational study. The total number of SSI patients in the gynecology and obstetrics services were studied, consulting the database of the epidemiology service, clinical and electronic records; the data collection and the statistical analysis were carried out, reporting the results with means, standard deviations and percentages. RESULTS: In the 11,967 surgeries performed in 2017, SSI was detected in 110 gynecological patients and 249 obstetric patients. The relevant risk factors were obesity and previous abdominal surgeries. The most commonly isolated microorganism in cultures in both patients was Escherichia coli. CONCLUSIONS: The frequency of SSI was 2.4% for gynecological procedures and 3.3% for obstetric procedures, similar to that reported by the Centers for Disease Control and Prevention.

INTRODUCCIÓN: La frecuencia de infección de sitio quirúrgico (ISQ) es distinta según los hospitales. OBJETIVO: Describir las características clínicas y de laboratorio en pacientes ginecológicas y obstétricas con ISQ, así como su frecuencia, los factores de riesgo asociados y el microorganismo más frecuentemente aislado en los cultivos. MATERIAL Y MÉTODOS: Estudio descriptivo, transversal, retrospectivo y observacional. Se estudiaron todas las pacientes con ISQ en los servicios de ginecología y obstetricia, consultando la base de datos del servicio de epidemiología y los expedientes clínicos y electrónicos. Se llevó a cabo la recolección de la información y el análisis estadístico, reportando los resultados con medias, desviaciones estándar y porcentajes. RESULTADOS: En las 11,967 intervenciones quirúrgicas realizadas en 2017 se detectó ISQ en 110 pacientes ginecológicas y 249 pacientes obstétricas. Los factores de riesgo relevantes fueron obesidad y cirugías previas abdominales. El microorganismo más aislado en los cultivos en ambos tipos de pacientes fue Escherichia coli. CONCLUSIONES: La frecuencia de ISQ fue del 2.4% para los procedimientos ginecológicos y del 3.3% para los obstétricos, similar a lo referido por los Centers for Disease Control and Prevention de los Estados Unidos de Norteamérica.

Efecto de la frecuencia de aplicación de estrógenos locales sobre el grosor endometrial en mujeres posmenopáusicas.

INTRODUCTION: Conjugated estrogens, when used by the vaginal route for the relief of vaginal dryness and atrophy, can produce endometrial changes. OBJECTIVE: To know the effect of vaginal conjugated estrogens application frequency on endometrial thickness in postmenopausal women. METHOD: Seventy postmenopausal women with vaginal dryness who received conjugated estrogen cream (0.625 mg/1 g) for 12 weeks were studied. The women were divided according to application frequency as follows: group 1, twice-weekly (n = 35), and group 2, thrice-weekly (n = 35). At baseline and at end-of-treatment, vaginal cytology was examined to determine the estrogenic value, and an endovaginal ultrasound was performed to measure endometrial thickness. The comparison between groups was carried out with Mann Whitney's U-test, and the comparison between baseline and post-treatment values, with Wilcoxon's test. RESULTS: Of 70 recruited women, only 38 were studied, 19 in each group, paired by baseline estrogenic value. No difference was found between groups, neither at baseline nor after treatment, in the maturation index, estrogenic value or endometrial thickness. CONCLUSION: There were no differences in endometrial thickness between the conjugate estrogen cream different application frequencies.

INTRODUCCIÓN: Los estrógenos conjugados vía vaginal para aliviar la atrofia y sequedad vaginales pueden producir cambios endometriales. OBJETIVO: Conocer el efecto de la frecuencia de aplicación de estrógenos conjugados vía vaginal en el grosor endometrial en mujeres posmenopáusicas. MÉTODO: Se estudiaron 70 mujeres posmenopáusicas con sequedad vaginal que recibieron estrógenos conjugados en crema (0.625 mg/1 g) durante 12 semanas divididas de la siguiente manera según la frecuencia de aplicación: grupo 1, dos veces por semana (n = 35) y grupo 2, tres veces por semana (n = 35). Al inicio y final del tratamiento se determinó el valor estrogénico en la citología vaginal y se realizó ultrasonido endovaginal para medir el grosor endometrial. La comparación entre los grupos se realizó con U de Mann-Whitney y entre los valores pre y postratamiento con prueba de Wilcoxon. RESULTADOS: De 70 mujeres reclutadas solo se estudiaron 38 mujeres, 19 en cada grupo, pareadas por valor estrogénico inicial. No se encontró diferencia entre los grupos, ni antes ni después del tratamiento, en el índice de maduración, valor estrogénico ni grosor endometrial. CONCLUSIÓN: No hubo diferencias en el grosor endometrial entre las distintas frecuencias de aplicación de estrógenos conjugados en crema.

Efecto de la frecuencia de aplicación de estrógenos locales sobre el grosor endometrial en mujeres posmenopáusicas / Effect of local estrogen application frequency on endometrial thickness in postmenopausal women

Resumen Introducción: Los estrógenos conjugados vía vaginal para aliviar la atrofia y sequedad vaginales pueden producir cambios endometriales. Objetivo: Conocer el efecto de la frecuencia de aplicación de estrógenos conjugados vía vaginal en el grosor endometrial en mujeres posmenopáusicas. Método: Se estudiaron 70 mujeres posmenopáusicas con sequedad vaginal que recibieron estrógenos conjugados en crema (0.625 mg/1 g) durante 12 semanas divididas de la siguiente manera según la frecuencia de aplicación: grupo 1, dos veces por semana (n = 35) y grupo 2, tres veces por semana (n = 35). Al inicio y final del tratamiento se determinó el valor estrogénico en la citología vaginal y se realizó ultrasonido endovaginal para medir el grosor endometrial. La comparación entre los grupos se realizó con U de Mann-Whitney y entre los valores pre y postratamiento con prueba de Wilcoxon. Resultados: De 70 mujeres reclutadas solo se estudiaron 38 mujeres, 19 en cada grupo, pareadas por valor estrogénico inicial. No se encontró diferencia entre los grupos, ni antes ni después del tratamiento, en el índice de maduración, valor estrogénico ni grosor endometrial. Conclusión: No hubo diferencias en el grosor endometrial entre las distintas frecuencias de aplicación de estrógenos conjugados en crema.

Abstract Introduction: Conjugated estrogens, when used by the vaginal route for the relief of vaginal dryness and atrophy, can produce endometrial changes. Objective: To know the effect of vaginal conjugated estrogens application frequency on endometrial thickness in postmenopausal women. Method: Seventy postmenopausal women with vaginal dryness who received conjugated estrogen cream (0.625 mg/1 g) for 12 weeks were studied. The women were divided according to application frequency as follows: group 1, twice-weekly (n = 35), and group 2, thrice-weekly (n = 35). At baseline and at end-of-treatment, vaginal cytology was examined to determine the estrogenic value, and an endovaginal ultrasound was performed to measure endometrial thickness. The comparison between groups was carried out with Mann Whitney's U-test, and the comparison between baseline and post-treatment values, with Wilcoxon's test. Results: Of 70 recruited women, only 38 were studied, 19 in each group, paired by baseline estrogenic value. No difference was found between groups, neither at baseline nor after treatment, in the maturation index, estrogenic value or endometrial thickness. Conclusion: There were no differences in endometrial thickness between the conjugate estrogen cream different application frequencies.

Depression frequency in premenopausal and postmenopausal women / Frecuencia de depresión en mujeres premenopáusicas y posmenopáusicas

Background: It is known that hormonal changes influences mood, so the woman shows notorious hormonal changes in stages of her life. Objective: To determine the difference in the frequency of depression in premenopausal and postmenopausal women. Methods: We studied 371 premenopausal and postmenopausal women who didn't receive hormonal treatment and in which Hamilton depression scale was applied. Descriptive statistics, central tendency and dispersion measures were used. The comparison between the groups was with Student t test, and Chi squared test. Pearson's correlation analysis was done between age, body mass index and Hamilton scale score. In the postmenopausal women, the time since menopause was also correlated with Hamilton scale score. Results: Premenopausal women were predominantly healthy (46.6%). In perimenopausal women predominated minor depression (21.4%) and in postmenopausal women, major depression (59.3%). Conclusion: Postmenopausal women more frequently had a higher score than those premenopausal.

Introducción: se sabe que los cambios hormonales influyen en el estado de ánimo, la mujer presenta cambios hormonales notorios en etapas de su vida. Objetivo: determinar la diferencia en la frecuencia de depresión en mujeres premenopáusicas y posmenopáusicas. Métodos: se estudiaron 371 mujeres sin tratamiento hormonal y a quienes se les aplicó la escala de depresión de Hamilton. Se utilizó estadística descriptiva, medidas de tendencia central y dispersión. La comparación entre los grupos fue con las pruebas t de Student y Chi cuadrada. Mediante prueba de Pearson se correlacionó edad, índice de masa corporal y puntuación de la escala de Hamilton. En el grupo de posmenopáusicas además se correlacionó el tiempo desde la menopausia con la puntuación de la escala de Hamilton. Resultados: las mujeres premenopáusicas fueron predominantemente sanas (46.6%). En las perimenopáusicas predominaron puntuaciones compatibles con depresión menor (21.4%) y en las posmenopáusicas las de depresión mayor (59.3%). Conclusión: las mujeres posmenopáusicas presentaron con mayor frecuencia síntomas compatibles con depresión que las premenopáusicas.

Diferencia en el índice neutrófilos-linfocitos entre pacientes con síndrome de ovario poliquístico y sanas / Difference in neutrophil/lymphocyte index between patients with polycystic ovarian syndrome and healthy women

Resumen OBJETIVO: Determinar la correlación del índice neutrófilos-linfocitos entre mujeres sanas y con síndrome de ovario poliquístico con las concentraciones de glucosa, lípidos y andrógenos. MATERIALES Y MÉTODOS: Estudio descriptivo, retrospectivo, transversal y comparativo efectuado en el Hospital de Gineco-Obstetricia Luis Castelazo Ayala, entre julio de 2016 y febrero de 2019. Se estudiaron mujeres con síndrome de ovario poliquístico en quienes se cuantificaron: glucosa, lípidos, testosterona, androstenediona y sulfato de dehidroepiandrosterona. Con base en el reporte de la biometría hemática se calculó el índice neutrófilos-linfocitos. Los resultados se compararon con controles sanas estudiadas por infertilidad. Para el análisis estadístico se utilizó U de Mann-Whitney y análisis de correlación de Spearman. RESULTADOS: Se estudiaron 112 pacientes que se dividieron en dos grupos: el grupo 1 con síndrome de ovario poliquístico (n = 63) y grupo 2 mujeres sanas (n = 49). La mediana de la edad del grupo 1 fue 27 (14-39) la del grupo 2: 28 (16-41) años, sin diferencia estadísticamente significativa entre ambos ni entre los grupos en concentraciones de glucosa, colesterol y triglicéridos. El índice neutrófilos-linfocitos fue significativamente mayor en el grupo con síndrome de ovario poliquístico: 1.9 (0.9-7.4) vs 1.4 (0.8-3.9), p < 0.000, respectivamente. CONCLUSIÓN: El síndrome de ovario poliquístico se asocia con un proceso inflamatorio crónico y mayor riesgo cardiovascular.

Abstract OBJECTIVE: To determine the difference in the neutrophil/lymphocyte index between PCOS patients and healthy women. MATERIALS AND METHODS: Descriptive, retrospective, cross-sectional, comparative study. Women with PCOS were studied in which glucose, lipids, testosterone, androstenedione and dehydroepiandrosterone sulfate were measured, also a blood count was performed, and the neutrophil/lymphocyte index was calculated. The results were compared with healthy controls studied for infertility. For statistical analysis, Mann-Whitney U and Spearman correlation analysis were used. RESULTS: 112 patients divided as follows were studied: group I with PCOS (n = 63) and group II healthy women (n = 49). The median age was for group I: 27 (14-39) and group II: 28 (16-41) years without statistically significant difference between them, also there were not between the groups in the concentrations of glucose, cholesterol and triglycerides. The neutrophil/lymphocyte index was significantly higher in the group with PCOS, 1.9 (0.9-7.4) vs 1.4 (0.8-3.9), p < 0.000, respectively. CONCLUSION: PCOS is associated with a chronic inflammatory process that may confer greater cardiovascular risk.

Brachial and uterine arteries Doppler in healthy women and with preeclampsia / Doppler de las arterias uterinas y braquial en mujeres sanas y con preeclampsia

Objective: To compare the Doppler ultrasound parameters of the uterine and brachial arteries, between healthy pregnant women and pregnant women with preeclampsia. Methods: 102 pregnant women were studied in the third trimester, group I 83 healthy women and group II 19 patients with severe preeclampsia. All of them underwent Doppler ultrasound of the uterine arteries, measuring the pulsatility index (PI) and determining the presence of proto-diastolic notch. The PI and the arterial diameter were measured in the brachial artery before and after the hyperemic stimulus. Comparisons between the groups were performed with Student's t-test for independent samples and Mann-Whitney U and the comparison within each group with Student's t-test for related samples. Results: Gestational age was 35 ± 3 and 35 ± 2 weeks for group I and II, respectively. The proto-diastolic notch was present in 6 of 19 patients in group II (p < 0.001), the PI of uterine arteries was 0.68 ± 0.1 and 0.93 ± 0.3 for group I and II, respectively (p < 0.006). In the brachial artery, the arterial diameter after the hyperemic stimulus was significantly higher in women in group I (3.7 ± 0.5 mm and 3.5 ± 0.6 mm, p < 0.006). Conclusion: Preeclamptic women had higher PI of the uterine artery than the healthy ones; healthy women had greater arterial diameter after hyperemic stimulus than preeclamptic ones.

Objetivo: comparar los parámetros del ultrasonido Doppler de las arterias uterinas y braquial, entre mujeres embarazadas sanas y con preeclampsia. Métodos: se estudiaron 102 mujeres embarazadas del tercer trimestre, grupo I 83 mujeres sanas y grupo II 19 pacientes con preeclampsia severa. A todas ellas se les realizó ultrasonido Doppler de las arterias uterinas, midiendo el índice de pulsatilidad (IP) y determinando la presencia de muesca protodiastólica. En la arteria braquial previo y posterior al estímulo hiperémico se midieron el IP y el diámetro arterial. Las comparaciones entre los grupos se realizaron con prueba t de Student para muestras independientes y U de Mann-Whitney y la comparación dentro de cada grupo con prueba t de Student para muestras relacionadas. Resultados: la edad gestacional fue 35 ± 3 y 35 ± 2 semanas para el grupo I y II, respectivamente. La muesca proto-diastólica estuvo presente en 6 de 19 pacientes en el grupo II (p < 0.001), el IP de las arterias uterinas fue 0.68 ± 0.1 y 0.93 ± 0.3 para el grupo I y II respectivamente (p < 0.006). En la arteria braquial el diámetro arterial posterior al estímulo hiperémico fue significativamente mayor en las mujeres del grupo I (3.7 ± 0.5 mm y 3.5 ± 0.6 mm, p < 0.006). Conclusiones: las preeclámpticas tuvieron mayor IP de la arteria uterina que las sanas; las mujeres sanas tuvieron mayor diámetro arterial posterior al estímulo hiperémico que las preeclámpticas.

Frequency of presentation and characteristics of chronic pelvic pain at the gynecologic consultation / Frecuencia de presentación y características del dolor pélvico crónico en la consulta ginecológica

Background: Chronic pelvic pain (CPP) is a condition characterized by recurring pain in the lower part of the abdomen and it lasts at least six months. Objective: To know the frequency and characteristics of CPP in women from the gynecology consultation. Methods: Women that consecutively attended the gynecology external consultation were questioned about the presence of CPP. Those with CPP were requested to indicate the place where the pain was more intense, and to qualify its magnitude in an analog visual scale. Situations that modified the pain, as well as the medication used were investigated. The life disturbance was evaluated. Those patients with and without CPP were paired by age and compared with Student's t test for independent samples. Results: 711 women were studied, 132 (18.6%) fulfilled criteria for CPP. After comparing patients with and without CPP there were no significant differences between them. The maximum intensity of the pain was of 7.7 ± 1.7 and the most frequent localization was in hypogastrium (53.2%). The factor that more frequently alleviated the pain was to stay in bed (59.5%). Non-steroid anti-inflammatories were the most common medication (56.3%). The most frequent reason for consultation was hypermenorrhea (19.9%) and the most frequent diagnosis was uterine leiomyomatosis (15.1%). Conclusion: The frequency of CPP was similar to that reported by other groups.

Introducción: El dolor pélvico crónico (DPC) está caracterizado por dolor constante o recurrente en la parte baja del abdomen que dura al menos seis meses. Objetivo: Conocer la frecuencia de presentación y características del DPC en mujeres de la consulta de ginecología. Métodos: Se interrogó a mujeres que acudieron consecutivamente a la consulta externa de ginecología sobre la presencia de DPC. En aquellas con DPC se les pidió indicaran el sitio donde el dolor era más intenso, así como la magnitud del mismo en una escala visual análoga. Se interrogaron los factores que modificaban el dolor, así como la medicación utilizada. Se evaluó la afectación en su vida. Las pacientes con y sin DPC se parearon por edad y se compararon con prueba t de Student para muestras independientes. Resultados: Se estudiaron 711 mujeres, 132 (18.6%) cumplieron criterios para DPC. Al comparar a las mujeres pareadas con y sin DPC no hubo diferencias significativas. La máxima intensidad del dolor fue de 7.7 ± 1.7 y la localización más frecuente en hipogastrio (53.2%). El factor que más frecuentemente disminuía el dolor era el acostarse (59.5%). Los antiinflamatorios no esteroideos fueron los medicamentos más utilizados (56.3%), el motivo de consulta más frecuente fue la hipermenorrea (19.9%) y el diagnóstico más frecuente la miomatosis uterina (15.1%). Conclusión: La frecuencia de DPC fue semejante a lo reportado por otros grupos.

Uterine and ovary blood flow after uterine desarterialization / Efectos de la desarterialización uterina en el flujo sanguíneo uterino y ovárico

Background: The aim of this article is to compare the effect of uterine desarterialization (UD) and hypogastric arteries ligature (HAL) in uterine and ovarian blood flow indirectly measured with the pulsatility index (PI). Methods: Women in which UD or HAL was carried out for obstetric hemorrhage control were studied. Control group were puerperal women in which no UD or HAL was carried out. In all them uterine and ovarian blood flow was evaluated with the PI measured with Doppler ultrasound at 48 hours, 15 days and at 6 weeks after the procedure. Mann-Whitney U test was used for comparison between the groups and Wilcoxon test for comparisons inside each group. Results: Thirteen patients with UD, 11 with HAL and 10 without any procedure were studied. Uterine arteries PI, was significantly greater at 48 hr and at 15 days in the UD group and at 48 hr, 15 days and 6 weeks in the HAL group when compared with the control group. No differences were found in PI between UD and HAL groups. Ovarian PI was significantly greater in the groups with UD and HAL when compared with the control group at 48 hr, 15 days and 6 weeks, and lower in UD group when compared with HAL groups at 15 days and six weeks. Conclusions: Both procedures showed significant decrease in the uterine blood flow, but the ovarian flow was more restricted with HAL.

Introducción: el objetivo de este trabajo fue comparar el efecto de la desarterialización uterina (DAU) y la ligadura de arterias hipogástricas (LAH) en el flujo sanguíneo uterino y ovárico medido indirectamente con el índice de pulsatilidad (IP). Métodos: se estudiaron pacientes a las cuales se realizó DAU o LAH para control de hemorragia obstétrica y puérperas posparto (controles), en quienes no se había realizado procedimiento alguno. En todas se midió el IP en la arteria uterina y en el ovario con ultrasonido Doppler a las 48 horas, 15 días y 6 semanas de la cirugía o el parto. Para comparar los grupos entre sí se utilizó U de Mann-Whitney y al interior de cada grupo prueba de Wilcoxon. Resultados: se estudiaron 13 pacientes con DAU, 11 con LAH y 10 controles. El IP en las arterias uterinas fue mayor a las 48 horas y 15 días en el grupo con DAU y a las 48 horas, 15 días y seis semanas en el grupo con LAH, al compararlos con el control. No hubo diferencias en el IP entre el grupo con DAU y LAH. El IP ovárico fue significativamente mayor en los grupos con DAU y LAH al compararlo con el grupo control, a las 48 horas, 15 días y 6 semanas, y menor en el grupo con DAU al compararlo con el grupo con LAH a los 15 días y seis semanas. Conclusiones: ambos procedimientos disminuyeron significativamente el flujo sanguíneo uterino pero el flujo ovárico se restringió más con la LAH.

Sexual dysfunction prevalence in a group of pre- and postmenopausal Mexican women.

INTRODUCTION: To determine the prevalence of sexual dysfunction in pre and postmenopausal women. MATERIAL AND METHODS: A cross-sectional, descriptive, comparative study was done in climacteric women from 40 to 59 years of age. Female sexual function was evaluated with the female sexual function index (FSFI) on the day of consultation. The comparison between pre and postmenopausal women and between those with or without sexual dysfunction was done with Mann Whitney U test, χ2, and Spearman's correlation analysis was done. RESULTS: One hundred and ten women were studied, 55 were premenopausal (group 1) and 55 postmenopausal (group 2). The median of age in group 1 was 46 (40-58) years and in group 2 it was 53 (45-60) years. Premenopausal women had higher education level than postmenopausal women (p < 0.023). From those sexually active, 62.1% had sexual dysfunction. No statistically significant difference was found in education level, religion and marital status between women with or without sexual dysfunction. No difference in sexual dysfunction was found between premenopausal (62.1%) and postmenopausal (62.5%) women, but greater sexual dysfunction was found starting from 50 years age. Age negatively correlated with FSFI score (ρ = -0.324, p < 0.001). CONCLUSION: In postmenopausal women, those older had a greater impairment in sexual function.