Úlcera vulvar de Lipschütz: diagnóstico diferencial de la úlcera vulvar en la paciente adolescente

Lipschütz ulcer, or acute ulceration of vulva, is an infrequently reported form of genital ulceration that appears in the labia minora of adolescent girls. Clinical features include one or more acutely painful ulcers with a purulent base and raised edges, accompanied by systemic symptoms. Although recent reports have related Lipschütz ulcers with Epstein-Barr virus primary infection, the etiology is unknown and the diagnosis is often made by exclusion of other causes of acute genital ulceration. Consequently, careful differential diagnosis is of the utmost importance.     

Cálculo de la resistencia ósea en la menopausia

Mathematical model must be developed in postmenopausal women to study the physiological mechanism of internal remodelling of the bone, by taking into account isotropy and non-isotropy of bone tissues and the non-uniformity of the bone cross-section Tools and programs designed to communicate information from one computer expert system to another should be developed.     

Optimización del manejo de la mujer osteoporótica en la consulta de ginecología

Osteoporosis is a skeletal metabolic disorder characterized by compromised bone strength predisposing to an increased risk of low-impact fractures. This disorder is highly prevalent in postmenopausal women. Evaluation of bone mineral density, bone markers and osteoporosis risk factors allow to identify patients that may benefit from specific treatment to be identified. Vertebral fractures are common among postmenopausal women aged less than 65 years. The treatment of osteoporosis and osteopenia associated with a previous fracture should be based on adherence to potent drugs along with vitamin D and calcium supplements to prevent the hyperparathyroidism associated with low vitamin D levels.     

Recomendaciones de ingesta de omega-3 en los diferentes periodos de la vida de la mujer

The benefits of O3FA on cardiovascular risk factor control have been thoroughly investigated, yielding ample evidence of the benefits on cognitive and brain development in infants and anti-inflammatory actions in a number of diseases.     

Análisis inicial de eficiencia en la aplicación clínica de las nuevas recomendaciones para la prevención secundaria del cáncer de cuello de útero

Aim

To evaluate the efficiency of the application of the new cervical cancer screening recommendations sponsored by the Spanish Society of Obstetrics and Gynecology.

Material and methods

A total of 631 women, aged 30 years or older, who attended the Gynecology Unit of the Santa Cristina Hospital, Madrid, for cervical cancer screening underwent cervical cytology and DNA/human papilloma virus determination (Hybrid Capture 2).

Results

Analysis of the hospital's costs showed that the new prevention strategy generated an estimated saving of 198.47 € per woman undergoing cervical cancer screening.

Conclusions

The new cervical cancer screening recommendations sponsored by the Spanish Society of Gynecology and Obstetrics are highly efficient.     

Eficacia de la suplementación con L-arginina sobre la respuesta a la quimioterapia neoadyuvante en pacientes con cáncer de mama

Background

Breast cancer is the first cause of mortality from malignant neoplasms among women in Mexico. Neoadjuvant chemotherapy has a reported efficacy of approximately 70%; however, patients with inadequate response must undergo additional coadjuvant methods that negatively affect their quality of life. High concentrations of nitric oxide have shown cytotoxic and tumoricidal effects, thus favoring an adequate response to antineoplastic treatment. L-arginine is a nitric oxide precursor and therefore supplementation with this substance can augment nitric oxide synthesis and consequently its plasma concentration.

Objectives

To evaluate the efficacy of L-arginine supplementation in response to neoadjuvant chemotherapeutic treatment.

Materials and methods

We conducted a randomized clinical trial in which 30 g of L-arginine was administered in each neoadjuvant chemotherapy cycle. Plasma nitrite concentrations were determined before and after supplementation, as well as tumoral size before the start of antineoplastic treatment and after its completion. A chi-square test was performed to evaluate the association between the supplementation and adequate treatment response; plasma nitrites were evaluated by performing Student's T-tests.

Results

Forty-five patients were assessed, of whom 21 had an adequate response to antineoplastic treatment. No statistically significant association was found between supplementation and adequate response. Nitrite concentrations in plasma were significantly increased (p < 0.05) in patients receiving the supplement than in those who receiving placebo.

Conclusions

L-arginine supplementation can modulate nitric oxide synthesis and thus elevate plasma nitrite concentrations. However, this supplementation is not associated with an adequate response to neoadjuvant treatment; indeed, in this study, treatment response was lower than that reported in the literature, probably because the antineoplastic therapy was not tailored to specific tumoral characteristics.     

Étude observationnelle de la faisabilité et de la morbidité de l’hystérectomie vaginale ambulatoire : à propos de 30 cas

ObjectiveOutpatient surgery is nowadays a major evolution axis of the surgery in France. Outpatient vaginal hysterectomy is possible with the use of electrosurgical bipolar vessel sealing allowing the reduction of operative time and postoperative pain. Our aim was to study the feasibility and morbidity of outpatient vaginal hysterectomy by assessment of postoperative pain and satisfaction.Patients and methodsThirty patients were enrolled in this observational study. All patients underwent an outpatient vaginal hysterectomy with a standardized operative technic. Pain was evaluated by administering a 10 cm visual analogic scale (VAS) at the first and second postoperative days. The total duration of analgesic treatment was noticed. Patient's satisfaction was recorded at the postoperative visit one month after the intervention and by a telephonic interview.ResultsThe mean operative time was 59.3 (25–110) minutes and the mean uterine weight was 170.2 (60–710) grams. No intraoperative complications were reported. Among the thirty patients, 3 (10%) were not discharged the same day. At the first and second postoperative days, the VAS was 4.40 and 4.35 respectively. The mean total duration of analgesic's use was 5 days (3–8 days). Patients were very satisfied of medical care in 36.7% of cases (11/30), satisfied in 53.3% (16/30) and not much satisfied in 10% (3/30). In total, 83.3% (25/30) have agreed to repeat the procedure in the ambulatory sector.Discussion and conclusionOutpatient vaginal hysterectomy seems to be a possible and a safe technique with a high patient's satisfaction in France at the present time.