Population-based survey on menopausal symptoms and treatment use.

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

Computational modeling of the effect of five mutations on the structure of the ACE2 receptor and their correlation with infectivity and virulence of some emerged variants of SARS-CoV-2 suggests mechanisms of binding affinity dysregulation.

Interactions between the human angiotensin-converting enzyme 2 (ACE2) and the RBD region of the SARS-CoV-2 Spike protein are critical for virus entry into the host cell. The objective of this work was to identify some of the most relevant SARS-CoV-2 Spike variants that emerged during the pandemic and evaluate their binding affinity with human variants of ACE2 since some ACE2 variants can enhance or reduce the affinity of the interaction between the ACE2 and S proteins. However, no information has been sought to extrapolate to different variants of SARS-CoV-2. Therefore, to understand the impact on the affinity of the interaction between ACE2 protein variants and SARS-CoV-2 protein S variants, molecular docking was used in this study to predict the effects of five mutations of ACE2 when they interact with Alpha, Beta, Delta, Omicron variants and a hypothetical variant, which present mutations in the RBD region of the SARS-CoV-2 Spike protein. Our results suggest that these variants could alter the interaction of the Spike and the human ACE2 protein, losing or creating new inter-protein contacts, enhancing viral fitness by improving binding affinity, and leading to an increase in infectivity, virulence, and transmission. This investigation highlighted that the S19P mutation of ACE2 decreases the binding affinity between the ACE2 and Spike proteins in the presence of the Beta variant and the wild-type variant of SARS-CoV-2 isolated in Wuhan-2019. The R115Q mutation of ACE2 lowers the binding affinity of these two proteins in the presence of the Beta and Delta variants. Similarly, the K26R mutation lowers the affinity of the interaction between the ACE2 and Spike proteins in the presence of the Alpha variant. This decrease in binding affinity is probably due to the lack of interaction between some of the key residues of the interaction complex between the ACE2 protein and the RBD region of the SARS-CoV-2 Spike protein. Therefore, ACE2 mutations appear in the presence of these variants, they could suggest an intrinsic resistance to COVID-19 disease. On the other hand, our results suggested that the K26R, M332L, and K341R mutations of ACE2 expressively showed the affinity between the ACE2 and Spike proteins in the Alpha, Beta, and Delta variants. Consequently, these ACE2 mutations in the presence of the Alpha, Beta, and delta variants of SARS-CoV-2 could be more infectious and virulent in human cells compared to the SARS-CoV-2 isolated in Wuhan-2019 and it could have a negative prognosis of the disease. Finally, the Omicron variant in interaction with ACE2 WT, S19P, R115Q, M332L, and K341R mutations of ACE2 showed a significant decrease in binding affinity. This could be consistent that the Omicron variant causes less severe symptoms than previous variants. On the other hand, our results suggested Omicron in the complex with K26R, the binding affinity is increased between ACE2/RBD, which could indicate a negative prognosis of the disease in people with these allelic conditions.

Análisis psicométrico del inventario de síntomas prefrontales abreviado: evidencias de su validez y fiabilidad en la población general venezolana / Psychometric analysis of the prefrontal symptom inventory abbreviated: evidence of its validity and reliability in the general Venezuelan population

Introducción: Existen pocas herramientas para medir objetivamente las disfunciones de origen prefrontal autoinformadas por la población general. El inventario de síntomas prefrontales (ISP) es una prueba con excelentes propiedades psicométricas que permite dicha evaluación, y hasta el momento no se han realizado análisis robustos de su versión abreviada en castellano para Latinoamérica. Objetivo: Analizar las propiedades psicométricas del ISP abreviado, en términos de fiabilidad y validez en la población general dentro del contexto venezolano. Sujetos y métodos: Participaron 300 sujetos de población general. La estructura factorial del ISP abreviado se determinó a través del análisis factorial confirmatorio; la validez de constructo se evaluó a partir del contraste de grupos con/sin riesgo de deterioro cognitivo leve y la convergencia de puntuaciones con los dominios que componen la prueba cognitiva de Montreal (MoCA). Asimismo, se estimó la consistencia interna través de la omega de McDonald y el alfa de Cronbach. Resultados: Se contrastaron cinco modelos factoriales y se obtuvo una versión del ISP compuesta por 18 ítems, que presentó excelentes indicadores de bondad de ajuste: ?2 (132) = 200,057, p < 0,001, índice de ajuste comparativo = 0,955, índice de Tucker Lewis = 0,948, raíz cuadrática estandarizada de las medias residuales = 0,042, raíz cuadrática de la media del error de aproximación = 0,041; y consistencia interna (omega = 0,9; alfa = 0,89). Asimismo, se evidenciaron diferencias estadísticamente significativas entre grupos y correlaciones inversas con los apartados evaluados en la MoCA a excepción de la abstracción. Conclusión: El ISP-18 es una medida válida y confiable para ser utilizada en la población estudiada. Consistentemente, estudios previos dan cuenta de su versatilidad para que se use en investigación y en contextos de salud.(AU)

Introduction: Few tools exist to objectively measure dysfunctions of prefrontal origin self-reported by the general population. The Prefrontal Symptom Inventory (PSI) is a test with excellent psychometric properties that allows such assessment and so far, no robust analysis of its abbreviated version in Spanish for Latin America has been performed. Aims To analyze the psychometric properties of the abbreviated PSI in terms of reliability and validity in the general population in the Venezuelan context. Subjects and methods: 300 subjects from the general population participated. The factor structure of the abbreviated ISP was determined through confirmatory factor analysis (CFA); construct validity was assessed by contrasting groups with no risk of MCI and the convergence of scores with the domains that make up the Montreal Cognitive Assessment (MoCA). Likewise, internal consistency was estimated through McDonald’s w and Cronbach’s a. Results: Five factorial models were contrasted and a version of the PSI composed of 18 items was obtained, which presented excellent indicators of goodness of fit (c2 (132) = 200.057, p < 0.001, CFI=0.955, TLI=0.948, SRMR=0.042, RMSEA=0.041) and internal consistency (w = 0.90; a = 0.89). Likewise, statistically significant differences between groups and inverse correlations were evidenced with the sections evaluated in the MoCA except for abstraction. Conclusion: The PSI-18 is a valid and reliable measure to be used in the studied population. Consistently, previous studies show its versatility to be used in research and health contexts.(AU)

[Psychometric analysis of the prefrontal symptom inventory abbreviated: evidence of its validity and reliability in the general Venezuelan population]. / Análisis psicométrico del inventario de síntomas prefrontales abreviado: evidencias de su validez y fiabilidad en la población general venezolana.

INTRODUCTION: Few tools exist to objectively measure dysfunctions of prefrontal origin self-reported by the general population. The Prefrontal Symptom Inventory (PSI) is a test with excellent psychometric properties that allows such assessment and so far, no robust analysis of its abbreviated version in Spanish for Latin America has been performed. AIMS: To analyze the psychometric properties of the abbreviated PSI in terms of reliability and validity in the general population in the Venezuelan context. SUBJECTS AND METHODS: 300 subjects from the general population participated. The factor structure of the abbreviated ISP was determined through confirmatory factor analysis (CFA); construct validity was assessed by contrasting groups with no risk of MCI and the convergence of scores with the domains that make up the Montreal Cognitive Assessment (MoCA). Likewise, internal consistency was estimated through McDonald's ? and Cronbach's a. RESULTS: Five factorial models were contrasted and a version of the PSI composed of 18 items was obtained, which presented excellent indicators of goodness of fit (?2 (132) = 200.057, p < 0.001, CFI=0.955, TLI=0.948, SRMR=0.042, RMSEA=0.041) and internal consistency (? = 0.90; a = 0.89). Likewise, statistically significant differences between groups and inverse correlations were evidenced with the sections evaluated in the MoCA except for abstraction. CONCLUSION: The PSI-18 is a valid and reliable measure to be used in the studied population. Consistently, previous studies show its versatility to be used in research and health contexts.

TITLE: Análisis psicométrico del inventario de síntomas prefrontales abreviado: evidencias de su validez y fiabilidad en la población general venezolana.Introducción. Existen pocas herramientas para medir objetivamente las disfunciones de origen prefrontal autoinformadas por la población general. El inventario de síntomas prefrontales (ISP) es una prueba con excelentes propiedades psicométricas que permite dicha evaluación, y hasta el momento no se han realizado análisis robustos de su versión abreviada en castellano para Latinoamérica. Objetivo. Analizar las propiedades psicométricas del ISP abreviado, en términos de fiabilidad y validez en la población general dentro del contexto venezolano. Sujetos y métodos. Participaron 300 sujetos de población general. La estructura factorial del ISP abreviado se determinó a través del análisis factorial confirmatorio; la validez de constructo se evaluó a partir del contraste de grupos con/sin riesgo de deterioro cognitivo leve y la convergencia de puntuaciones con los dominios que componen la prueba cognitiva de Montreal (MoCA). Asimismo, se estimó la consistencia interna través de la omega de McDonald y el alfa de Cronbach. Resultados. Se contrastaron cinco modelos factoriales y se obtuvo una versión del ISP compuesta por 18 ítems, que presentó excelentes indicadores de bondad de ajuste: ?2 (132) = 200,057, p menor de 0,001, índice de ajuste comparativo = 0,955, índice de Tucker Lewis = 0,948, raíz cuadrática estandarizada de las medias residuales = 0,042, raíz cuadrática de la media del error de aproximación = 0,041; y consistencia interna (omega = 0,9; alfa = 0,89). Asimismo, se evidenciaron diferencias estadísticamente significativas entre grupos y correlaciones inversas con los apartados evaluados en la MoCA a excepción de la abstracción. Conclusión. El ISP-18 es una medida válida y confiable para ser utilizada en la población estudiada. Consistentemente, estudios previos dan cuenta de su versatilidad para que se use en investigación y en contextos de salud.

Social determinants in the access to health care for Chagas disease: A qualitative research on family life in the "Valle Alto" of Cochabamba, Bolivia.

INTRODUCTION: Chagas disease is caused by the Trypanosoma cruzi infection. It is a neglected tropical disease with considerable impact on the physical, psychological, familiar, and social spheres. The Valle Alto of Cochabamba is a hyperendemic region of Bolivia where efforts to control the transmission of the disease have progressed over the years. However, many challenges remain, above all, timely detection and health-care access. METHODS: Following the Science Shop process, this bottom-up research emerged with the participation of the civil society from Valle Alto and representatives of the Association of Corazones Unidos por el Chagas from Cochabamba. The aim of this study is to explore the social determinants in the living realities of those affected by Chagas disease or the silent infection and how families in the Valle Alto of Cochabamba cope with it. An interdisciplinary research team conducted a case study of the life stories of three families using information from in-depth interviews and performed a descriptive qualitative content analysis and triangulation processes. FINDINGS: Findings provide insights into social circumstances of the research subjects' lives; particularly, on how exposure to Trypanosoma cruzi infection affects their daily lives in terms of seeking comprehensive health care. Research subjects revealed needs and shared their experiences, thus providing an understanding of the complexity of Chagas disease from the socioeconomic, sociocultural, political, and biomedical perspectives. Results enlighten on three dimensions: structural, psychosocial, and plural health system. The diverse perceptions and attitudes toward Chagas within families, including the denial of its existence, are remarkable as gender and ethnocultural aspects. Findings support recommendations to various stakeholders and translation materials. CONCLUSIONS: Intersectional disease management and community involvement are essential for deciding the most appropriate and effective actions. Education, detection, health care, and social programs engaging family units ought to be the pillars of a promising approach.

Iodine-129 for determining the origin of salinity in groundwater in Pampanga, Philippines.

Assessing groundwater vulnerability from salinity contamination is vital and relevant to meet the increasing demand for freshwater. Iodine-129 (129I, half-life = 15.7 million years), a radioisotope of iodine, was used as an environmental tracer for the possible origin of salinization in groundwater (e.g., natural rock weathering, evaporated water, seawater, brine fossil water, contamination). In July 2017 (wet season), thirty-two (32) water samples were taken from production wells of different localities in Pampanga, a province in the Philippines that relies heavily on groundwater for freshwater sources. Hydrogeochemical (mainly Cl) and stable water isotopes (δ2H and δ18O) were able to identify seven samples potentially affected by seawater intrusion. The salinity origin of these samples was investigated using iodine-129 and iodine-127 isotopes by generating two graphs: 129I vs. chloride and 129I/127I ratio vs. 1/127I. 129I vs. Cl graph was capable of showing a clear distinction between different salinity origins. Five out of the seven samples were being affected by evaporated water, one sample from possible wastewater, and one sample from brine fossil water. A conceptual model was produced to summarize the results. Compiled end-members (e.g., natural brine, seawater, modern rain) were plotted in the 129I/127I ratio vs. 1/127I graph to show the interaction between two recharge sources. The results of this study will be helpful to the government, civil society, and other organizations for monitoring, policymaking, and management of the groundwater and the subsurface formations that will be crucial to continuously supply the freshwater needs of the present and future generation.

Progesterone in vitro increases growth, motility and progesterone receptor expression in third stage larvae of Toxocara canis.

The in vitro effect of progesterone in T. canis larvae on their enlargement and motility were evaluated, together to the possible presence of progesterone receptors (PRs). T. canis larvae were cultured in RPMI-1640 with different concentrations of progesterone (0, 20, 40, 80, 400 and 800 ng/mL). Enlargement and increases in motility were dependent on the concentration only from 0 to 80 ng/mL (p < 0.05). The mean percentage of PR + cells in newly obtained larvae as measured by flow cytometry was 8.16 ± 0.4. The number of PR + cells increased depending on concentration from 0 to 80 ng/mL (p < 0.001). Cells obtained from larvae stimulated at any of the studied hormone concentrations showed greater mean fluorescence intensity when compared to non-stimulated cells. Additionally, the expression and location of PR + cells were determined in the larvae. The sequence of an amplicon (420-bp) obtained by PCR from T. canis larvae showed 100% homology with a gene fragment that codes for the PR of the dog. PR + cells were immunolocated using confocal microscopy in the intestinal region of the larvae that had been recently obtained. The results of this study show that T. canis larvae can recognize and respond to the presence of progesterone through a molecule possibly able to bind it. Since we previously observed a similar response to prolactin, we suggest that both hormones could participate sequentially in the reactivation of T. canis larvae in pregnant bitches.

Choice of antiepileptic drugs affects the outcome in cancer patients with seizures

Background: Seizures in cancer patients may occur as a result of CNS primary or metastatic tumor, brain surgery, vascular disease, pharmacologic treatment (including chemotherapy), radiation therapy, or metabolic disorders. The aims of the study were to a) determine whether seizures in cancer patients have prognostic implications and b) study patient outcome based on the antiepileptic drug used. Method: This is a prospective comparative study that included adult cancer patients with and without seizures from May 2010 to November 2016 seen by the neuro-oncology unit at a cancer referral center. Variables included age, gender, oncologic characteristics, seizure features, treatment, and outcome. Parametric and non-parametric tests were used to compare groups, and Kaplan-Meier curves with the log-rank test were used to analyze survival. Cox multivariate regression tests were used to describe survival and compare groups. Results: A total of 823 patients were included; 419 (51%) patients had at least one seizure and were compared with 404 (49%) who did not experience seizures. Of the seizure group, 53% had brain metastases, 36% did not have a brain tumor, and 11% had a primary brain tumor. No survival differences were noted among patients with brain metastases or primary tumor with or without seizures. In the seizure group, 249 (59%) required only one antiepileptic drug, whereas 134 (32%) required 2 or more. A better overall survival was identified for patients prescribed carbamazepine (p = 0.02), lamotrigine (p = 0.015), levetiracetam (p = 0.03), and valproic acid (p = 0.009). Conclusions: Patients with primary or metastatic brain tumors have the same overall survival with or without seizures. However, patients with seizures not treated with antiepileptics exhibit worse overall survival

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Hipercementosis, una alteración de la estructura dentaria: recopilación bibliográfica / Hypercementosis, an alteration of the dental structure: bibliographic compilation

La hipercementosis se presenta como depósitos de cemento en la raíz de uno o más dientes. Siendo más frecuente en dientes que están sometidos a fuerzas de oclusión, particularmente en pacientes con enfermedad de Paget. El aumento de cemento se depositará en una banda que se encuentra situada alrededor del tercio apical de la raíz, es de ayuda útil realizar una evaluación radiográfi ca antes de una extracción dental (AU)

Hypercementosis occurs as cement deposits in the root of one or more teeth. Being more frequent in teeth that are subjected to occlusion forces or in patients with Paget's disease. The cement increase can be deposited in a band that can be found near the apical third of the root, it is a dental aid that a radiographic evaluation is made before a dental extraction (AU)

Choice of antiepileptic drugs affects the outcome in cancer patients with seizures.

BACKGROUND: Seizures in cancer patients may occur as a result of CNS primary or metastatic tumor, brain surgery, vascular disease, pharmacologic treatment (including chemotherapy), radiation therapy, or metabolic disorders. The aims of the study were to a) determine whether seizures in cancer patients have prognostic implications and b) study patient outcome based on the antiepileptic drug used. METHOD: This is a prospective comparative study that included adult cancer patients with and without seizures from May 2010 to November 2016 seen by the neuro-oncology unit at a cancer referral center. Variables included age, gender, oncologic characteristics, seizure features, treatment, and outcome. Parametric and non-parametric tests were used to compare groups, and Kaplan-Meier curves with the log-rank test were used to analyze survival. Cox multivariate regression tests were used to describe survival and compare groups. RESULTS: A total of 823 patients were included; 419 (51%) patients had at least one seizure and were compared with 404 (49%) who did not experience seizures. Of the seizure group, 53% had brain metastases, 36% did not have a brain tumor, and 11% had a primary brain tumor. No survival differences were noted among patients with brain metastases or primary tumor with or without seizures. In the seizure group, 249 (59%) required only one antiepileptic drug, whereas 134 (32%) required 2 or more. A better overall survival was identified for patients prescribed carbamazepine (p = 0.02), lamotrigine (p = 0.015), levetiracetam (p = 0.03), and valproic acid (p = 0.009). CONCLUSIONS: Patients with primary or metastatic brain tumors have the same overall survival with or without seizures. However, patients with seizures not treated with antiepileptics exhibit worse overall survival.

Progesterone inhibits the in vitro L3/L4 molting process in Haemonchus contortus.

We evaluated the direct effects of progesterone on the morphology, maturation and behavior of Haemonchus contortus larvae in vitro. The presence and location of possible progesterone receptors in these larvae were also determined. The addition of 8ng/mL of progesterone to larval cultures over 10days reduced larval enlargement, while the addition of 160ng/mL of the hormone increased the enlargement. Up to 62% and 65% of the H. contortus larvae molted from third-stage larvae (L3) to fourth-stage larvae (L4) when cultured in RPMI-1640 media without hormone for 5 and 10days, respectively. The addition of different progesterone concentrations (1, 8, 16, 80 and 160ng/mL) to the larval cultures significantly inhibited the molting process within the same periods. The addition of 8ng/mL or higher progesterone concentrations to the cultures significantly increased larval motility (p<0.05) compared with unstimulated larvae. Flow cytometry showed the expression of progesterone receptors (P4-R) in 15% of the cells from newly isolated H. contortus larvae. When the larvae were cultured for 5days in the presence of the hormone, the percentage of P4-R+ cells remained the same. In contrast, unstimulated larvae showed a significant reduction in the number of P4-R+ cells. Using confocal microscopy, a greater concentration of P4-Rs was immunolocated in the anterior portion of the alimentary tract of the larvae, suggesting that the cells in this region are targeted by the hormone. The results of the present study show that H. contortus larvae have possible P4-Rs and respond to this hormone by inhibiting their molting process, thereby suggesting the participation of progesterone in the larval arrest phenomenon.

Sexual health in Spanish postmenopausal women presenting at outpatient clinics.

OBJECTIVE: One of the most common complaints among postmenopausal women is a change in sexual drive. The aim of this study was to assess the current state of sexual health in Spanish postmenopausal women who present at outpatient gynecology clinics. METHOD: In this multicenter, observational, cross-sectional, questionnaire-based study, a survey was conducted that included 3026 Spanish postmenopausal women in a routine clinical setting in outpatient gynecology clinics at public and private institutions throughout Spain. We used the Women's Sexual Function questionnaire, which has been validated in Spain. RESULTS: In the multivariate analysis, we found that the best indicators of sexual health in postmenopausal women were a higher education (p < 0.001), working or previously worked (p < 0.001), a stable partner (p < 0.001), living in an urban area (p < 0.01), healthy habits and received information about menopause (p < 0.001). CONCLUSION: These results indicate that it is important to provide health education and information about menopause and the complaints associated with this period in a woman's life.

The in vitro effect of prolactin on the growth, motility and expression of prolactin receptors in larvae of Toxocara canis.

The in vitro effect of prolactin (PRL) on the growth and motility of Toxocara canis larvae was assessed. Additionally, the expression and location of prolactin receptors (PRL-Rs) were determined in the larvae. Larvae of T. canis were incubated with different concentrations of PRL for different periods of time. The stimulated larvae accelerated their enlargement and increased their motility. The mean percentage of PRL-R+ cells in non-stimulated larvae, measured by flow cytometry was 7.3±0.3%. Compared with non-stimulated larvae, the mean fluorescence intensity (p<0.05) increased in larvae incubated with 40ng/mL of PRL for 10 days. A 465-bp length fragment was amplified from larvae gDNA by PCR. The sequence of this fragment showed 99% similarity with the gene fragment that codes for the PRL-R of the domestic dog. A high concentration of PRL-Rs was immune-located in the posterior region of the larval intestine; therefore, the intestinal cells in this region were most likely the targets for this hormone. Based on these results, PRL-Rs were identified in T. canis larvae, and the in vitro stimulation with PRL increased the number of these receptors, accelerated the growth and modified the activity of larvae. All of the above suggest that T. canis larvae are evolutionarily adapted to recognize the PRL of their definitive host and furthermore might explain the reactivation of tissue-arrested larvae during the gestation of bitches, which does not occur in gestating females of other species.

[Neurological manifestations in patients with cancer: more than 17,000 reasons for consultation]. / Manifestaciones neurologicas en pacientes con cancer: mas de 17.000 motivos de consulta.

INTRODUCTION: Cancer is one of the leading causes of death in our population; neurologic manifestations are frequent and are associated with higher rates of morbidity and mortality. AIM: To describe the neurological manifestations in patients with cancer. PATIENTS AND METHODS: From January 2010 to December 2014 a database was created from patients with cancer, required a neuro-oncological assessment at a referral cancer center. RESULTS: 17,092 reasons for neuro-oncological consultation are described. Neoplasms most frequently associated with neurological manifestations were: breast cancer, hematologic malignancies, primary central nervous system tumors, lung cancer and gynecological malignancies. The most frequent neurological manifestations were: neuromuscular disease (including neuropathy), central nervous system metastasis, primary headaches, seizures, stroke and primary neurological tumors. CONCLUSION: It is important that neurologists, physicians and those involved in the management of patients with cancer recognize and get to know the neurological complications.

TITLE: Manifestaciones neurologicas en pacientes con cancer: mas de 17.000 motivos de consulta.Introduccion. El cancer es una de las primeras causas de muerte en nuestra poblacion. Las complicaciones neurologicas asociadas son frecuentes e incrementan significativamente la morbilidad y la mortalidad de estos pacientes. Objetivo. Describir las manifestaciones neurologicas en pacientes con cancer. Pacientes y metodos. Desde enero de 2010 hasta diciembre de 2014 se creo una base de datos de pacientes con cancer que merecian una valoracion por neurooncologia en un centro de referencia. Resultados. Se describen 17.092 motivos de consulta de neurooncologia. Las neoplasias que mas se relacionaron con manifestaciones neurologicas fueron: cancer de mama, neoplasias hematologicas, tumores primarios del sistema nervioso central, cancer de pulmon y neoplasias ginecologicas. Las manifestaciones neurologicas mas frecuentes fueron: afeccion neuromuscular, actividad tumoral en el sistema nervioso central, cefalea primaria, crisis convulsivas, enfermedad vascular cerebral y tumores neurologicos primarios. Conclusiones. Es importante que los neurologos, medicos de distintas areas de la medicina y personal paramedico, involucrados en el manejo de estos pacientes, reconozcan las complicaciones neurologicas de manera temprana.

Factors determining the use of hormonal therapy and phytotherapy in Spanish postmenopausal women.

OBJECTIVE: To identify women's sociodemographic and variables related to health care with the prescription of hormonal therapy (HT) and phytotherapy (PT) in Spanish postmenopausal women. METHOD: The survey consisted of a multicenter, observational, cross-sectional, questionnaire-based investigation and was conducted among 3022 postmenopausal women. RESULTS: Of all the women, 31.8% reported the use of systemic HT or PT sometime in their lives. Hot flushes and information received about menopause were the most important variables that influence HT and PT use, although far more intense symptoms were observed in those who were inclined to use HT. The use of HT or PT was more frequently reported among women with high levels of education, who came from private clinics and lived in urban areas. Women who had primary ovarian insufficiency or surgical menopause were inclined to use HT. CONCLUSION: Hot flushes and information received about menopause are the most important variables that influence HT and PT use.

A prospective study of DT56a (Femarelle®) for the treatment of menopause symptoms.

BACKGROUND: DT56a (Femarelle®) is a natural medication that contains a variety of phytoestrogens derived from tofu. Treatment with DT56a affects bones, vascular tissues and the nervous system in a manner similar to that of estrogen but DT56a acts as an estrogen antagonist in breast and uterine tissues. AIM: The objective of this study was to analyze the efficacy of DT56a in the reduction of menopause symptoms in Spanish women who participated in the Post Marketing Menopausal Symptoms International Survey (POMMSIS). PATIENTS AND METHODS: A total of 631 Spanish menopausal or perimenopausal women with vasomotor symptoms who took DT56a for 4 weeks participated in this study. This study was an observational, questionnaire-based investigation that consisted of a baseline questionnaire, a hot flushes daily diary and a feedback questionnaire. RESULTS: A statistically significant (p < 0.01) reduction in the number and intensity of hot flushes was experienced after 2 and 4 weeks of DT56a treatment. After 4 weeks of treatment with DT56a, 80.7% of the patients reported that their hot flushes were 'better' or 'much better'. The severity of hot flushes was also reduced by 38% in all study participants and by 36% in women who had experienced more than seven hot flushes per day initially, before treatment. CONCLUSION: Treatment with DT56a resulted in a significant reduction in the number and intensity of hot flushes in postmenopausal women, especially in those with frequent symptoms, and these effects were observed within the first month of treatment.