Machu Picchu - Perú
Paracas - Perú
Miraflores - Perú
Cataratas de Iguazu - Argentina
Parque Nacional Torres del Paine - Colombia
Chichén Itzá - México
Tazumal - El Salvador
Vieja Catedral de Managua - Nicaragua
Basilica de Nuestra Señora de los Angeles - Costa Rica
Basilica del Voto Nacional
Castillo de los Tres Reyes Magos del Morro - Cuba
Cristo Blanco - Brasil
  • Orozco LJ, Tristan M, Vreugdenhil MM, Salazar A. Hysterectomy versus hysterectomy plus oophorectomy for premenopausal women. Cochrane Database Syst Rev 2014 Jul 28;7:CD005638. Epub ahead of print

    Is it possible to publish when you have no data on hand? The answer is – YES. Amos Pines

    This search was aimed at comparing hysterectomy alone versus hysterectomy plus bilateral oophorectomy in women with benign gynecological conditions, with respect to rates of mortality or subsequent gynecological surgical interventions. Only one randomized, controlled trial comparing the benefits and risks of hysterectomy with or without oophorectomy was identified. The results of this pilot randomized, controlled trial have not been published and we have not been able to obtain the results. Therefore, no data could be included in this review.

  • Manson JE, Goldstein SR, Kagan R, et al. for the Working Group on Women’s Health and Well-Being in Menopause. Why the product labeling for low-dose vaginal estrogen should be changed. Menopause 2014;21:911-16

    This article, which was published in Menopause, does not have any Abstract. Since the discussed issue seems to be important, I offer a few lines from its text. Amos Pines

    This commentary summarizes the activities of several clinicians and researchers to encourage modifications to the labeling of low-dose vaginal estrogen. Leaders in the field are spearheading an effort to encourage consideration of alternative labeling. We believe that women would be better served by a modified label that more closely reflects the safety profile of low-dose vaginal estrogen and would actually enhance safety by emphasizing the key information that women and clinicians need to know about the products.

  • Legendre G, Ringa V, Panjo H, Zins M, Fritel X. Incidence and remission of urinary incontinence at midlife, a cohort study. BJOG 2014 Jul 24. Epub ahead of print

    Urinary incontinence (UI) is often considered to be an age-related disease that develops gradually as women grow older. This was a longitudinal cohort study (French GAZEL), including 4127 middle-aged women (aged 47–52 years at baseline) over an 18-year period (1990–2008). UI was defined as 'difficulty retaining urine'. The question was asked at baseline and repeated every 3 years over an 18-year period. Two groups (UI incidence and remission) were analyzed according to status at baseline (continent or incontinent). The annual incidence and remission rates for UI were 3.3% and 6.2%, respectively. High educational level (hazard ratio, HR = 1.28; 95% confidence interval ( CI) 1.05–1.55), parity, i.e. at least one baby versus no baby (HR = 1.64; 95% CI 1.19–2.27), menopause (HR = 5.44; 95% CI 4.47–6.63), weight gain, i.e. for each kilogram change in weight (HR = 1.00; 95% CI 1.00–1.02), onset of depressive symptoms (HR = 1.31; 95% CI 1.09–1.57) and impairment in health-related quality of life incidence (social isolation dimension, HR = 1.29; 95% CI 1.04–1.60 and energy dimension, HR = 1.41; 95% CI 1.17–1.70) were associated with an increased probability of UI. The factors associated with persistent UI were age (HR = 0.58; 95% CI 0.55–0.61), weight gain (HR = 0.99; 95% CI 0.98–0.99) and transition to menopausal status (HR = 1.54; 95% CI 1.19–1.99). The study suggests that, in our population of middle-aged women, age, menopause, weight gain, onset of depression and impaired health-related quality of life may promote UI.

  • Samaras N, Papadopoulou MA, Samaras D, Ongaro F. Off-label use of hormones as an antiaging strategy: a review. Clin Interv Aging 2014;9:1175-86

    One of the most important health-care needs is successful aging with less frailty and dependency. During the last 20 years, a multitude of anti-aging practices have appeared world-wide, aiming at retarding or even stopping and reversing the effects of aging on the human body. At present, women live one-third of their lives in a state of sex hormone deficiency. Men are also subject to age-related testosterone decline, but andropause remains frequently under-diagnosed and under-treated. Due to the decline of hormone production from gonads in both sexes, the importance of DHEA in steroid hormone production increases with age. However, DHEA levels also decrease with age. Also, growth hormone age-associated decrease may be so important that insulin growth factor-1 levels found in elderly individuals are sometimes as low as those encountered in adult patients with established deficiency. Skin aging as well as decreases in lean body mass, bone mineral density, sexual desire and erectile function, intellectual activity and mood have all been related to this decrease of hormone production with age. Great disparities exist between recommendations from scientific societies and actual use of hormone supplements in aging and elderly patients. In this review, actual data are presented on the effects of age-related hormone decline on the aging process and age-related diseases such as sarcopenia and falls, osteoporosis, cognitive decline, mood disorders, cardiovascular health and sexual activity. Information on the efficiency and safety of hormone replacement protocols in aging patients is provided.