Vivências amorosas em adolescentes

Dissertação apresentada à Universidade Fernando Pessoa como parte dos requisitos para a obtenção do grau de Mestre em Psicologia, ramo de Psicologia Clínica e da Saúde

Novel insights into the role of the GABAB receptor in depression and anxiety

The GABAB receptor is a functional heterodimer comprising the GABAB1 and GABAB2 subunits, with the GABAB1 subunit displaying two major isoforms, GABAB(1a) and GABAB(1b). Preclinical findings have strongly implicated the GABAB receptor in stress-related psychiatric disorders, however, the precise contribution of the GABAB receptor in depression and anxiety disorders remains unknown. Emerging data suggest that the interaction between adverse environmental conditions, such as early life stress, and a specific genetic composition can increase the risk to develop psychiatric disorders in adulthood. This thesis investigated the role of the GABAB receptor alone or in combination with early-life stress (maternal separation), in modulating antidepressant like and anxiety-related behaviours. Pharmacological blockade of the GABAB receptor with CGP52432 had antidepressant-like behavioural effects. Moreover, mice lacking the GABAB(1b) receptor subunit isoform exhibited antidepressant-like behaviours in adulthood but anxiety-like behaviour in early-life. In response to maternal separation, GABAB(1a)-/- mice exhibited early-life stress-induced anhedonia, a core symptom of depression, while GABAB(1b)-/- mice exhibited a more resilient phenotype. Moreover, when compared with wildtype or GABAB(1a)-/- mice, GABAB(1b)-/- mice that underwent maternal separation exhibited enhanced stressinduced neuronal activation in the hippocampus and in the nucleus accumbens (NAcc), a critical area for anhedonia thus suggesting that enhanced stress-induced neuronal activation in the hippocampus and NAcc in GABAB(1b)-/- mice may be important for their antidepressant-like phenotype and their resilience to stress-induced anhedonia. Pharmacological blockade of GABAB receptor and GABAB(1b) receptor subunit isoform loss of function increased adult hippocampal cell proliferation, thus suggesting that increased hippocampal neurogenesis could be a potential mechanism for the antidepressant-like effects of GABAB receptor antagonists and GABAB(1b) receptor subunit isoform disruption. Finally, this thesis investigated whether the expression of several genes involved in hippocampal neurogenesis or the antidepressant response were altered in the mouse hippocampus following chronic treatment with a GABAB receptor antagonist.

Novel roles for the GABAB receptor in anxiety and cocaine addiction

The GABAB receptor has been postulated as a possible drug target in the treatment of anxiety disorders and cocaine addiction. Indeed, a wealth of preclinical data is emerging that has shown that mice lacking functional GABAB receptors display a highly anxious behaviour across a range of behavioural models of anxiety. Additionally, novel compounds that act by altering the allosteric conformation of the GABAB receptor to a more active state; the GABAB receptor positive modulators, have been repeatedly demonstrated to have anxiolytic effects in animals. In addition to being a putative anxiolytic drug target, the GABAB receptor has been identified as a novel target for antiaddictive therapies. Indeed GABAB receptor positive modulators have been demonstrated to have anti-addictive properties across a broad variety of behavioural paradigms. Despite these findings, several gaps in our knowledge of the role played by the GABAB receptor in both anxiety and drug abuse disorder exist. The aim of this thesis was to use preclinical animal models in an effort to further probe the role played by the GABAB receptor in anxiety and addiction. Our studies initially examined the role played by the GABAB receptor in the neurodevelopmental processes underpinning of anxiety. Our studies demonstrated that treating mouse pups in early life with the GABAB receptor agonist baclofen produced an anxious phenotype in adult life, whereas treatment with the GABAB receptor antagonist CGP52432 produced no effects on adult behaviour. Further to this, we examined whether the anxious behaviour induced by early life blockade of the serotonin reuptake transporter was dependant on alterations in GABAB receptor function. Our studies however revealed no effect of early life selective serotonin reuptake inhibitor treatment on adult life baclofen sensitivity. The next issue addressed in this thesis is the characterization of the effects of a GABAB receptor positive modulator and a GABAB receptor antagonist in a behavioural model of conditioned fear behaviour. These novel classes of GABAB receptor ligands have been considerably less well characterized in this facet of preclinical anxiety behaviour than in terms of innate anxiety behaviour. Our study however revealed that the GABAB receptor positive modulator GS39783 and the GABAB receptor antagonist CGP52432 were without effect on the acquisition, expression or extinction of conditioned fear in our model. The next element of this thesis dealt with the characterization of a novel mouse model, the GABAB(2)- S892A mouse. This mouse has been engineered to express a form of the GABAB(2) receptor subunit wherein the function determining serine phosphorylation site cannot be phosphorylated. We initially tested this mouse in terms of its GABAB receptor function in adult life, followed by testing it in a battery of tests of unconditioned and learned anxiety behaviour. We also examined the behavioural and molecular responses of the GABAB(2)-S892A mouse to cocaine. All of our studies appear to show that the GABAB(2)-S892A mouse is indistinguishable from wildtype controls. The final aim of the thesis was to investigate the behavioural and molecular sensitivity of the GABAB(1) subunit isoform null mice, the GABAB(1a) -/- and GABAB(1b) -/- mice to cocaine. Our studies revealed that these mice display differing behavioural responses to cocaine, with the GABAB(1a) -/- mouse displaying a hypersensitivity to the acute locomotor effects of cocaine, while the GABAB(1b) -/- displayed blunted locomotor sensitisation to cocaine.

Dipeptidyl peptidase IV (DPP IV) and related molecules in type 2 diabetes

Dipeptidyl peptidase IV (DPP IV) is a widely distributed physiological enzyme that can be found solubilized in blood, or membrane-anchored in tissues. DPP IV and related dipeptidase enzymes cleave a wide range of physiological peptides and have been associated with several disease processes including Crohn's disease, chronic liver disease, osteoporosis, multiple sclerosis, eating disorders, rheumatoid arthritis, cancer, and of direct relevance to this review, type 2 diabetes. Here, we place particular emphasis on two peptide substrates of DPP IV with insulin-releasing and antidiabetic actions namely, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). The rationale for inhibiting DPP IV activity in type 2 diabetes is that it decreases peptide cleavage and thereby enhances endogenous incretin hormone activity. A multitude of novel DPP IV inhibitor compounds have now been developed and tested. Here we examine the information available on DPP IV and related enzymes, review recent preclinical and clinical data for DPP IV inhibitors, and assess their clinical significance.

Behavioral and psychological symptoms and cognitive decline in patients with amnestic MCI and mild AD: a two-year follow-up study.

BACKGROUND: Mild cognitive impairment (MCI) has been defined as a transitional state between normal aging and dementia. In many cases, MCI represents an early stage of developing cognitive impairment. Patients diagnosed with MCI do not meet the criteria for dementia as their general intellect and everyday activities are preserved, although minor changes in instrumental activities of daily living (ADL) may occur. However, they may exhibit significant behavioral and psychological signs and symptoms (BPS), also frequently observed in patients with Alzheimer's disease (AD). Hence, we wondered to what extent specific BPS are associated with cognitive decline in participants with MCI or AD. METHODS: Our sample consisted of 164 participants, including 46 patients with amnestic (single or multi-domain) MCI and 54 patients with AD, as well as 64 control participants without cognitive disorders. Global cognitive performance, BPS, and ADL were assessed using validated clinical methods at baseline and at two-year follow-up. RESULTS: The BPS variability over the follow-up period was more pronounced in the MCI group than in patients with AD: some BPS improve, others occur newly or worsen, while others still remain unchanged. Moreover, specific changes in BPS were associated with a rapid deterioration of the global cognitive level in MCI patients. In particular, an increase of euphoria, eating disorders, and aberrant motor behavior, as well as worsened sleep quality, predicted a decline in cognitive functioning. CONCLUSIONS: Our findings confirm a higher variability of BPS over time in the MCI group than in AD patients. Moreover, our results provide evidence of associations between specific BPS and cognitive decline in the MCI group that might suggest a risk of conversion of individuals with amnestic MCI to AD.

The role of self-presentation in adolescent health risk behaviours

Self-presentation has been identified as playing a key role in the perfonnance of various potentially hazardous health behaviours such as substance abuse, eating disorders and reckless behaviours (Leary, Tchividjian, & Kraxberger, 1994; Martin & Leary, 2001; Martin, Leary, & O'Brien, 2001). The present study investigated the role of selfpresentation on adolescent health-risk behaviours. Specifically, this study examined the prevalence of adolescent identified health-risk behaviours rooted in self-presentational motives in youths aged 13-18 years. The current study also identified the specific images associated with these behaviours desired by youth, and the targets of these behaviours. Also, the relationship between these behaviours, and several trait measures (social physique anxiety, public-self consciousness, fear of negative evaluations, selfpresentational efficacy) of self-presentation were examined. Finally, the gender differences in health risk behaviours and self-presentational concerns were examined. Participants in the present study were 96 adolescent students, 34 male and 62 female, recruited from various private schools across Southern Ontario. Students ranged in age from 13 to 18 years for both males (M age = 15.81 years, SD = 1.49) and females (M age = 14.89 years, SD = 1.17) and ranged from grades 8 through 13. Results of the current study suggested that Canadian adolescents between the ages of 13 and 18 years participated in health risk behaviours for self-presentational purposes. Drinking alcohol, skipping school, and performing stunts and dares were identified as the most common health risk behaviours performed for self-presentational purposes by both males and females. Appearing fun and cool were the most commonly reported desired images while appearing brave and mature were the least reported. The most desired target group cited was same sex friends, followed by other sex friends. Trait measures of self-presentational concerns identified females as being higher in public self-consciousness, and social physique anxiety than males. Males were found to be higher in self-presentational efficacy than females. The total number of health risk behaviours was predicted by selfpresentational efficacy and social physique anxiety for males, and social physique anxiety for females. Findings of the current study suggest that Canadian adolescents' health risk behaviours are rooted, in part, in self-presentational motives. Thus far, an educational approach to health interventions has been favoured and/or adopted by teachers, health promoters, and educators (Jessor, 1992). Implications of the current study suggest that although educational interventions are beneficial in presenting the associated risks with certain activities and/or behaviours, one reason this type of approach may be ineffective in changing adolescent behaviour over the long run is that it does not address the strong and prominent influences of interpersonal motives on health damaging behaviour. It is evident that social acceptance and public image are of importance to adolescents, and the desire to make the "right" impression and to achieve peer approval and acceptance often override health and safety concerns (Jessor, 1992). Thus, a self-presentational approach focusing on changing the images associated with the behaviours may be more successful at deterring adolescent health risk behaviours.

Weight-preoccupation, personality and depression in university students : an interactionist perspective

The present research was designed to examine Beck's (1983; 1987) cognitive diathesis-stress model of depression in a new context. Specifically, this cross-sectional study investigated whether Beck's cognitive-personality traits of sociotropy and autonomy interacted with a specific daily hassle/stressor, weightpreoccupation, in the prediction of depressed mood in women and men. Weightpreoccupation was chosen as the particular daily stressor, because, according to Kanner, Coyne, Schaeffer, and Lazarus (1981). concern about weight and physical appearance were two of the most troublesome daily hassles among university students. ContraIy to current stereotypes, men also express concerns with weight and appearance (Cash, Winstead, &, landi, 1986), in both the direction of weight loss and weight/muscle gain (Drewnowski &, Yee, 1987). Thus, unique to this study was the examination of weight-preoccupation in men, not only in the direction of weight loss, but also in the direction of weight and muscle gain. Two hundred and fifty-one undergraduates were administered the revised SociotropyAutonomy Scale (SAS), the Beck Depression Inventory (BDij, the Hassles and Uplifts Scale, the Eating Disorders Inventory (EDI), and the Restraint Scale (RS). Through a process of model building, a final model was devised in which depression (ie., BDI total scores) was regressed on personality (Le., SAS Sociotropy) and weight-preoccupation (i.e., Drive for Thinness, Body Dissatisfaction, and the Restraint Scale). Separate hierarchical multiple regression analyses, with BDI as the dependent variable, were carried out for each of the 2 3 weight-preoccupation variables. Results revealed a specific congruent interaction between weight,..preoccupation and personality. Specifically, drive for thinness and body dissatisfaction interacted with sociotropy to predict depressed mood in both women and men, but the interaction between sociotropy and the Restraint Scale was marginal. Findings suggested that weight-preoccupied women and men experienced depressed mood to the extent that they were characterized as more highly sociotropic. As predicted, personality (i.e., sociotropy), moderated the relationship between daily stress (i.e., weight-preoccupation) and depression. Thus, results revealed that the proposed diathesis-stress model seemed to operate in the same manner for women and men. Moreover, the examination of weightpreoccupation among men (i.e., in the direction of both weight loss and weight/muscle gain) further revealed that, when curvilinearity was taken into account, highly sociotropic men, who had a low desire to gain weight and muscle mass (i.e., most likely those who desired to lose weight), experienced higher levels of depressed mood than those who had a "medium" desire for weight and muscle gain. However, the highest levels of depressed mood was experienced by highly sociotropic men who were highly weight-preoccupied in the direction of wanting to gain weight and muscle mass. In addition, possible reasons for the present fmdings, as wen as iimitations and impiicalions for future research are discussed.

"Weathering a hidden storm" : an application of Andersen's behavioral model of health, and health services use for those with diagnosable anxiety disorder

"Weathering a Hidden Storm": An App~ication of Andersen's Behaviora~ Mode~ of Hea~th, and Hea~th Services Use for Those With Diagnosab~e Anxiety Disorder Research has primarily focused on depression and mood disorders, but little research has been devoted to an examination of mental health services use amongst those with diagnosable anxiety disorder (Wittchen et al., 2002; Bergeron et al., 2005). This study examined the possible predicting factors for mental health services utilization amongst those with identifiable anxiety disorder in the Canadian population. The methods used for this study was the application of Andersen's Behavioral Model of Health Services Use, where predisposing, need and enabling 111 characteristics were regressed on the dependent variable of mental health services use. This study used the Canadian Community Health Survey (cycle 1.2: Mental Health and Well- Being) in a secondary data analysis. Several multiple logistics models predicted the likelihood to seek and use mental health services. Predisposing characteristics of gender and age, Enabling characteristics of education and geographical location, and those with co-occurring mood disorders were at the greatest increased likelihood to seek and use mental health services.

Associations between Exposure to Socio-Cultural Influences in Proximal Environments and Weight Concerns among Urban-Dwelling Women

Résumé Les préoccupations et comportements alimentaires entourant le poids sont omniprésentes chez les jeunes adolescentes et femmes qui habitent dans les cultures occidentales où les formes corporelles sont orientées vers un idéal ultra-mince. L’objectif de cette étude est d’examiner si une plus grande exposition aux endroits faisant la promotion de la minceur est associée à des préoccupations pour le poids plus élevées chez les femmes. Cette étude fait partie d’un projet intitulé ¨Social, cultural, and economic disparities and disordered eating: Understanding the contribution of neighbourhood and individual level factors¨ (Gauvin, Steiger, & Brodeur, 2009). Un échantillon de 1288 femmes âgées entre 20 et 40 ans et résidant à Montréal depuis au moins 12 mois ont répondu à un sondage téléphonique. Des régressions logistiques ont comparé les femmes se situant dans le quintile le plus élevé des préoccupations de poids avec les femmes dans les autres quintiles en fonction de leur exposition 15 jours ou plus dans des endroits faisant la promotion de la minceur. De plus, une analyse de sensibilité a vérifié si l’association demeurait significative à d’autres niveaux d’exposition. Les facteurs confondants ont été contrôlés statistiquement. Les résultats démontrent qu’une fréquentation d’au moins 15 jours par mois d’endroits faisant la promotion de la minceur est associée à des préoccupations plus élevées pour le poids. Aussi, fréquenter ces lieux entre 15 et 20 jours/mois est aussi associé à des préoccupations de poids élevées. Des interventions de santé publique pourraient viser la diminution des pressions socioculturelles vers la minceur.

Comportements de contrôle de poids et consommation de tabac, d'alcool et de marijuana à l'adolescence : le rôle modérateur du soutien parental

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

Étude-pilote portant sur une intervention de groupe auprès de femmes souffrant d’hyperphagie boulimique et l’évaluation de ses effets potentiels

Cette étude porte sur une intervention de groupe basée sur la thérapie cognitivo-comportementale pour l’hyperphagie boulimique (HB), dont les effets potentiels sur la qualité de vie reliée au poids, la fréquence et la sévérité des crises de boulimie, les symptômes dépressifs, l’image corporelle et le poids corporel ont été mesurés, et le degré d’acceptation par les participantes a été documenté. Ainsi, 11 femmes avec un surplus de poids et répondant aux critères diagnostiques de l’HB ont été recrutées du printemps 2012 à l’hiver 2013, dans la région de Montréal. Le programme comportant huit séances hebdomadaires était dispensé par une nutritionniste et une psychothérapeute. La qualité de vie reliée au poids (Impact of Weight on Quality of Life), la fréquence des crises de boulimie (rappel des sept derniers jours), la sévérité des crises de boulimie (Binge Eating Scale), les symptômes dépressifs (Inventaire de Beck pour la dépression), l’insatisfaction corporelle (Body Shape Questionnaire) et le poids corporel ont été mesurés avant et à la fin de l’intervention. Puis, un questionnaire pour mesurer l’acceptation par les participantes était soumis au terme du programme. Le taux de participation aux séances était aussi colligé. Les résultats montrent que notre programme a permis une amélioration significative du score global de la qualité de vie reliée au poids de 8,4 ± 13,3, ainsi qu’en termes d’estime de soi et de travail. Aussi, une diminution significative de la fréquence des crises de boulimie de 2,1 ± 2,1 jours, de la sévérité des crises de boulimie dont le score a diminué de 10,9 ± 7,7, des symptômes dépressifs dont le score a diminué de 8,3 ± 5,7 et de l’insatisfaction corporelle dont le score a diminué de 32,8 ± 17,1, ont été observées. Toutefois, il n’y a pas eu de perte de poids au terme de l’intervention. Puis, le programme a été bien accepté par les participantes tel que démontré par le taux de participation aux séances de 93,8 % et la satisfaction mesurée par l’appréciation des divers éléments du programme de 4,6 sur 5 et la pertinence de ceux-ci de 4,8 sur 5. Ces données suggèrent que l’intervention de groupe semble être prometteuse pour améliorer les symptômes et conséquences de l’HB, à l’exception du poids.

Attitudes et comportements alimentaires des athlètes québécoises pratiquant un sport esthétique à un haut niveau : caractéristiques personnelles et comparaison à un groupe de contrôle

La pratique d’un sport de type esthétique est aujourd’hui considérée par plusieurs (Sundgot-Borgen & Torstveit, 2004; Thompson & Sherman, 2010) comme un facteur de risque à l’adoption d’attitudes et de comportements alimentaires inappropriés à l’égard de l’alimentation et de l’image corporelle (ACIAI) et ultimement au développement d’un trouble des conduites alimentaires (TCA). Les études actuelles portant sur cette problématique rapportent toutefois des résultats contradictoires. De plus, certains aspects méthodologiques associés notamment à l’hétérogénéité des échantillons limitent la portée interprétative de ces résultats. Afin de pallier les limites actuelles des écrits empiriques, cette thèse a pour but de tracer le portrait de la problématique des désordres alimentaires chez les jeunes athlètes québécoises de haut niveau en sport esthétique. Pour ce faire, un échantillon homogène de 145 adolescentes âgées de 12 à 19 ans a été constitué soit 52 athlètes de haut niveau et 93 non-athlètes. Les sports représentés sont le patinage artistique, la nage synchronisée et le ballet. À partir de cet échantillon, deux études sont réalisées. L’objectif de la première étude est de comparer l’intensité des ACIAI et la prévalence des TCA dans les deux groupes à l’aide de deux questionnaires soit le Eating Disorder Examination Questionnaire (EDE-Q) et le Eating Disorder Inventory-3 (EDI-3). Les résultats obtenus suggèrent qu’il n’y a pas de différence significative entre les athlètes et les non-athlètes de l’échantillon en ce qui a trait à l’intensité des ACIAI et à la prévalence des TCA. La deuxième étude est constituée de deux objectifs. Tout d’abord, comparer les deux groupes relativement aux caractéristiques personnelles suivantes : l’insatisfaction de l’image corporelle (IIC), le sentiment d’efficacité personnelle envers l’alimentation normative (SEP-AN) et l’image corporelle (SEP-IC), le perfectionnisme (P), l’ascétisme (As), la dysrégulation émotionnelle (DÉ) et le déficit intéroceptif (DI). De nature plus exploratoire, le second objectif de cette étude est de décrire et de comparer les caractéristiques personnelles qui sont associées aux ACIAI dans chacun des groupes. Afin de réaliser ces objectifs, deux autres questionnaires ont été utilisés soit le Eating Disorder Recovery Self-efficacy Questionnaire-f (EDRSQ-f) et le Body Shape Questionnaire (BSQ). En somme, les analyses indiquent que les athlètes de l’échantillon présentent des niveaux plus faibles de SEP-AN et de DÉ. Ce faisant, elles auraient moins confiance en leur capacité à maintenir une alimentation normative, mais réguleraient plus efficacement leurs émotions que les adolescentes non-athlètes. Une fois l’âge et l’indice de masse corporelle contrôlés, les résultats démontrent également que le SEP-AN et l’IIC contribuent à prédire dans chaque groupe les ACIAI tels que mesurés par la recherche de minceur. Le SEP-AN a aussi été associé dans les deux groupes à l’intensité des symptômes boulimiques. Les modèles obtenus diffèrent cependant quant aux variables prédictives principales. Chez les athlètes de l’échantillon, l’intensité des conduites boulimiques est associée à la DÉ alors qu’elle est davantage liée au DI chez les adolescentes non sportives. Enfin, en plus de discuter et de comparer l’ensemble de ces résultats aux autres travaux disponibles, les apports distinctifs de la thèse et les principales limites des études sont abordés. Des pistes sont également suggérées afin d’orienter les recherches futures et des implications cliniques sont proposées.

Influence of personality factors on the consumption of personal care products

This research was undertaken with the primary objective of explaining differences in consumption of personal care products using personality variables. Several streams of research reported were reviewed and a conceptual model was developed. Theories on the relationship between self concept and behaviour was reviewed and the need to use individual difference variables to conceptualize and measure the salient dimensions of the self were emphasized. Theories relating to social comparison, eating disorders, role of idealized media images in shaping the self-concept, evidence on cosmetic surgery and persuasibility were reviewed in the study. These came from diverse fields like social psychology, use of cosmetics, women studies, media studies, self-concept literature in psychology and consumer research, and marketing. From the review three basic dimensions, namely self-evaluation, self-awareness and persuasibility were identified and they were posited to be related to consumption. Several personality variables from these conceptual domains were identified and factor analysis confirmed the expected structure fitting the basic theoretical dimensions. Demographic variables like gender and income were also considered.It was found that self-awareness measured by the variable public self-consciousness explain differences in consumption of personal care products. The relationship between public self-consciousness and consumption was found to be most conspicuous in cases of poor self-, evaluation measured by self-esteem. Susceptibility to advertising also was found to explain differences in consumption.From the research, it may be concluded that personality variables are useful for explaining consumption and they must be used together to explain and understand the process. There may not be obvious and conspicuous links between individual measures and behaviour in marketing. However, when used in proper combination and with the help oftheoretical models personality offers considerable explanatory power as illustrated in the seventy five percent accuracy rate of prediction obtained in binary logistic regression.

Influence of personality factors on the consumption of personal care products

The study is significant from both an application perspective of marketing management as well as from an academic angle. The market for personal care products is a highly fragmented one, with intense competition for specific niche segments. It is well known in marketing literature that the bulk of the volume of sale is accounted for by the minority who are the heavy users. This study will help the marketers to identify the personality profile of such a group and understand how the interaction of personality factors at least partially explains differences in consumption. This knowledge might be useful for better segmentation using psychographic variables as well as for designing specific advertisement campaigns to target the vulnerable groups of customers. From a theoretical perspective, the research may contribute to understanding how specific personality variables and their interaction lead to differences in consumption. The knowledge corresponding to self theory, social comparison theory, persuasibility, evidence from psychology of eating disorders: these all may be integrated into a common frame work for explaining consumption of products having a social function.

Tratamiento de la ulcera venosa con escleroespuma versus manejo conservador

La úlcera venosa es una revelación clínica severa de la insuficiencia venosa crónica. Es la causa del 54-76% de las úlceras venosas de miembros inferiores. La ciencia médica ha generado diversos procedimientos en el manejo de esta patología, es así como a partir de conocimientos en fisiopatología de la ulceración venosa, se han aplicado procedimientos como opción de tratamiento. Objetivos: Valorar si el uso de rutina de la oclusión endoluminal con espuma guiada por ecografía del sistema venoso superficial insuficiente, en adicción al manejo convencional de la ulcera venosa (vendaje no compresivo, gasa vaselinada y curaciones) podría mejorar la tasa de curación a las 24 semanas de tratamiento. Diseño: Estudio clínico aleatorizado prospectivo de pacientes de la consulta externa de cirugía vascular del Hospital Occidente de Kennedy-Bogotá, durante el 01 de junio del 2011 hasta el 30 junio del 2012. Métodos: Un total de 44 pacientes con ulcera activa que cumplieron criterios de selección ingresaron al estudio, correspondientes a 48 extremidades con clasificación CEAP (C6), los pacientes fueron a aleatorizados a manejo convencional (control) o con manejo adicional de oclusión endoluminal con espuma eco-guiada. El objetivo principal fue el cierre de la ulcera a las 24 semanas. Resultados: La Curación de la ulcera a las 24 semanas de la aleatorización fue de 20 (83.3%) extremidades del grupo de oclusión endoluminal con espuma eco-guiada Vs 3(12.5%) para el grupo de control P: 0.0005 Discusión: Las tasas de curación de la ulcera luego de la oclusión endoluminal con espuma eco-guiada es muy superior al manejo convencional con curaciones y vendaje no compresivo, las tasa de curación son tan altas como las reportadas con sistemas de alta compresión y cirugía a las 24 semanas. La oclusión endoluminal eco-guiada es segura, mínimamente invasiva y clínicamente efectiva.