Prevalence and risk factors of depression, anxiety, and stress in an Ecuadorian outpatient population with type II diabetes mellitus: A cross-sectional study (STROBE).

Type II diabetes mellitus (DM2) is a worldwide disease with an important economic and health impact. Currently, depression, anxiety and stress are common disorders among diabetic populations but their respective prevalence may well be underestimated. So far, Latin American countries have only reported limited information about the impact of mental diseases on DM2 outpatients. The objective of this study was to evaluate the prevalence and risk factors related to depression, anxiety, and stress among ambulatory DM2 populations from two third-level hospitals in Quito, Ecuador. A cross-sectional study based on a random sample was carried out in two hospitals. Patients were evaluated by the 21-item Depression, Anxiety and Stress Scale (DASS-21). In addition, a validated survey was used to grade socioeconomic, demographic, clinical, and comorbidity variables. Descriptive statistics and multiple logistic regression were used to analyze the data. Statistical analysis was performed by SPSS (version 22.0). STROBE guidelines were used for reporting this trial. A total of 208 adult patients with DM2 were included (women 58%; men 42%). The prevalence of depression, anxiety and stress was 31.7% (95% CI, 25.5-38.5%), 33.7% (95% CI, 27.3-40.5%), and 25.0% (95% CI, 19.3-31.5%), respectively. Male gender was associated with a decreased risk for depression (OR 0.39 [95% CI, 0.18-0.81]; P = .01), anxiety (OR 0.31 [95% CI, 0.16-0.65]; P = .002), and stress (OR 0.35 [95% CI, 0.15-0.77]; P = .009). A higher level of education was associated with low risk for depression (OR 0.23 [95% CI, 0.11-0.46]; P < .001), anxiety (OR 0.47 [95% CI, 0.25-0.90]; P = .02), and stress (OR 0.24 [95% CI, 0.12-0.49]; P = .001). In contrast, patients with DM2 complications were more likely to have depression (OR 2.96 [95% CI, 1.32-6.63]; P = .008) and anxiety (OR 2.56 [95% CI, 1.20-5.48]; P = .01). Finally, an income higher than the basic salary reduced the risk of depression alone (OR 0.39 [95% CI, 0.16-0.91]; P = .03). In conclusion, a high prevalence rate of depression, anxiety, and stress was found in the DM2 outpatient population. Thus, more tailored care surveillance for DM2 patients is needed considering the bio-psycho-social environment to provide an integral health management.

Faringoamigdalitis aguda: método para identificación rápida del estreptococcus pyogenes / Acute faringoamigdalitis: method for fast identification of estreptococcus pyogenes

Se realizó un estudio para determinar el valor de uno de los actuales métodos de detección rápida para el streptococcus pyogenes en aquellos pacientes que acuden a la consulta con un cuadro clínico de faringoamigdalitis exudativa comparándolo con el método estandar de confirmación que es el cultivo en agar sangre de cordero. Participaron del estudio 42 pacientes de los cuales 16 (38,1xciento) dieron positivo en el test de prueba, de los cuales 14 (33,3xciento) dieron positivo en el cultivo agar sangre de cordero. La sensibilidad de la prueba fue del 100xciento y la especificidad alcanzó el 93xciento, valores que están de acuerdo a los reportes bibliográficos. El valor de la prueba se demostró estadísticamente significativo por lo que se sugiere su uso en todos aquellos centros de salud que brindan atención de salud primaria y de emergencia para orientar adecuadamente el tratamiento y especialmente el uso de antibióticos.