Weight stigma and allostatic load in adults: protocol for a scoping review.

INTRODUCTION: Weight-related stigma (WS) has been associated with adverse psychosocial and physical health effects. Despite the relationship between WS and allostatic load, there are no integrative reviews of this association. This scoping review aims to provide a comprehensive overview of the relationship between allostatic load biomarkers associated with WS by identifying gaps in this topic and proposing recommendations for future research. METHODS AND ANALYSIS: This protocol was guided by the methodological framework of Arksey and O'Malley and the Joanna Briggs Institute (JBI). The research questions were based on the population-concept-context framework. Studies in adults diagnosed as overweight or obese, exposed to WS and assessing the association between WS and biomarkers of allostatic load will be included. A search will be conducted in Medline (Ovid), PsycINFO (Ovid), Scopus (Elsevier), Cochrane Library (Wiley) and Google Scholar. The search strategy will be conducted in three stages, based on the JBI recommendation with the MESH terms "Social Stigma," "Weight Prejudice," "Biomarkers," "Allostasis," "Adults" and related terms. Data extraction will be done with a template adapted from JBI. The search strategy and selection process results will be presented in a flow chart and summarised in the text. The main results will be presented in a descriptive synthesis. ETHICS AND DISSEMINATION: Ethics review and approval are not required. The results will be disseminated through peer-reviewed publications, conferences, congresses or symposia.

Knowledge about COVID-19 in the General Population of Mexico

An analytical observational study was conducted to investigate the association between knowledge of COVID-19 in the general population of Mexico and sociodemographic variables of interest. A total of 758 adults between 18 and 74 years old (M = 37.3 SD = 12.6), of which 88.9% had higher education and 33.2% were health care workers, participated in an online questionnaire assessing disease knowledge and the COVID-5 item Fear Scale, which was adapted by the research team. The proportion of individuals with high knowledge about COVID-19 was found to be 41.0%. Participants with higher education and healthcare professionals demonstrated higher knowledge scores in comparison to those with primary and secondary education, as well as non-healthcare professionals (PR=1.25, 95%CI 1.05-1.48). In conclusion, that people with higher education and healthcare workers exhibited better knowledge scores regarding the disease, while high knowledge about COVID-19 was only associated with being a health professional.

Se realizó un estudio observacional analítico con el objetivo de explorar la asociación entre el conocimiento que tiene la población general de México sobre COVID-19 y las variables sociodemográficas de interés. Un total de 758 adultos entre 18 y 74 años (M=37,3 DE=12,6), 88,9% con educación superior y 33,2% trabajadores de la salud, diligenciaron un cuestionario en línea sobre conocimientos la enfermedad y la Escala de Temor a COVID-5, adaptada por el equipo de investigación. La proporción de conocimientos altos sobre COVID-19 fue del 41,0%. Las personas con educación superior y los profesionales de la salud presentaron puntajes de conocimientos altos en comparación con los que tenían primaria y secundaria y con los que no pertenecían al gremio de la salud RP = 1,25 IC 95% (1,05 - 1,48). Se concluye que las personas con escolaridad superior y los profesionales de la salud tienen mejores puntajes de conocimientos sobre la enfermedad, mientras que el conocimiento alto sobre COVID-19 solo se asoció con ser profesional de la salud.

Foi realizado um estudo observacional analítico com o objetivo de explorar a associação entre o conhecimento que tem a população geral de México sobre COVID-19 e as variáveis sociodemográficas de interesse. Um total de 758 adultos entre 18 e 74 anos (M=37,3 DE=12,6), 88,9% com ensino superior e 33,2% trabalhadores da saúde, responderam um questionário on-line sobre conhecimentos a doença e a Escala de Temor a COVID-5, adaptada pela equipe de pesquisa. A proporção de conhecimentos altos sobre COVID-19 foi do 41,0%. As pessoas com educação superior e os profissionais da saúde apresentaram pontuação de conhecimentos altos em comparação com os que tinham ensino básico e ensino médio e com os que não pertenciam aos profissionais da saúde RP = 1,25 IC 95% (1,05 - 1,48). Concluise que as pessoas com educação superior e os profissionais da saúde têm melhor pontuação de conhecimentos sobre a doença, enquanto que o conhecimento alto sobre COVID-19 só se associou com ser professional da saúde.

Confirmatory Factor Analysis, Internal Consistency, Gender Differential Item Functioning and Discriminant Validity of the Fear of COVID-5 Scale Amidst Emerging Adult University Students in Mexico.

The study aimed to perform confirmatory factor analysis, internal consistency, gender differential item functioning, and discriminant validity of the Fear of COVID-5 Scale in emerging adult students of a university in Mexico. Confirmatory factor analysis, internal consistency (Cronbach's alpha and McDonald's omega), and gender differential item functioning were estimated (Kendall tau b correlation). The Fear of COVID-5 Scale showed a one-dimension structure (RMSEA = 0.07, CFI = 0.98, TLI = 0.96, and SRMR = 0.02), with high internal consistency (Cronbach's alpha of 0.78 and McDonald's omega of 0.81), non-gender differential item functioning (Kendall tau b between 0.07 and 0.10), and significant discriminant validity (Higher scores for fear of COVID-19 were observed in high clinical anxiety levels). In conclusion, the Fear of COVID-5 Scale presents a clear one-dimension structure similar to a previous study.

Factors associated with the stigma-discrimination complex towards healthcare workers among university students during the coronavirus pandemic in Mexico / Factores asociados al complejo estigma-discriminación hacia trabajadores de la salud entre estudiantes universitarios durante la pandemia de coronavirus en México

Introduction: COVID-19-related stigma towards healthcare professionals negatively influences their job performance and well-being, however, this issue has not been sufficiently investigated. Objective: To determine the frequency and variables associated with COVID-19-related stigma toward health care workers in a university population in Mexico. Materials and methods: Cross-sectional study. An online questionnaire was sent to 1,054 students between 18 and 29 years of age. Demographic variables, religiosity, fear of COVID-19 and its association with COVID-19-related stigma-discrimination towards health workers (dependent variable) were analyzed. Bivariate analysis and a generalized linear model were performed to calculate adjusted prevalence ratios. Results: The proportion of high stigma-discrimination was 12.4% and was associated with high fear of COVID-19 RPa= 1.51 (95% CI 1.06 - 2.23). Conclusion: The findings highlight the importance of establishing programs to reduce COVID-19-related stigmatization towards healthcare professionals.

Introducción: El estigma relacionado con la COVID-19 hacia los profesionales de la salud influye negativamente en su desempeño laboral y bienestar, sin embargo, este tema no ha sido suficientemente investigado. Objetivo: Determinar la frecuencia y las variables asociadas al estigma relacionado con el COVID-19 hacia los trabajadores de la salud en una población universitaria de México. Materiales y métodos: Estudio transversal. Se envió un cuestionario en línea a 1.054 estudiantes de entre 18 y 29 años. Se analizaron variables demográficas, religión, miedo al COVID-19 y su asociación con el estigma-discriminación hacia el personal de salud relacionado con la COVID-19 (variable dependiente). Se realizó un análisis bivariado y un modelo lineal generalizado para calcular las razones de prevalencia ajustadas. Resultados: La proporción de estigma-discriminación alto fue de 12,4% y se asoció con miedo alto a la COVID-19 RPa=1,51 (IC=95% 1,06-2,23). Conclusión: Los hallazgos destacan la importancia de establecer programas para reducir la estigmatización relacionada con COVID-19 hacia los profesionales de la salud.

Individual factors associated with the consumption of illicit substances: a review of reviews.

INTRODUCTION: According to national studies, the use of illicit drugs is growing in Colombia. With this, the prevalence of substance use disorders and the set of health effects related to this practice also increases. Knowledge of the factors associated with the use of illicit drugs is necessary to guide the comprehensive care of the phenomenon. METHODS: This is a systematic review of reviews on factors associated with the consumption of illicit drugs with seven databases and evaluation of the quality of the manuscripts according to AMSTAR. RESULTS: Information was extracted from 38 reviews on individual factors associated with the use of illicit drugs. Demographic factors are associated with consumption through other factors. There is evidence of the association between mental and behavioural disorders and personality disorders. CONCLUSIONS: The likelihood of consumption of illicit substances and disorders due to their use is affected by a set of personal factors including sociodemographic characteristics, mental health conditions, sexual behaviour, legal drug use, age of onset and risk perception.

Factores Individuales Asociados al Consumo de Sustancias Ilícitas: Una Revisión de Revisiones / Individual Factors Associated with the Consumption of Illicit Substances: a Review of Reviews

RESUMEN Introducción: El consumo de drogas ilícitas está creciendo en Colombia según los estudios nacionales. Con ello también incrementa la prevalencia de los trastornos por uso de sustancias y del conjunto de afectaciones a la salud relacionadas con esta práctica. El conocimiento de los factores asociados al consumo de drogas ilícitas es necesario para orientar la atención integral del fenómeno. Métodos: Se trata de una revisión sistemática de revisiones sobre factores asociados al consumo de drogas ilícitas con siete bases de datos y evaluación de la calidad de los manuscritos de acuerdo con AMSTAR. Resultados: Se extrajo información de 38 revisiones sobre factores individuales asociados al consumo de drogas ilícitas. Los factores demográficos se asocian con el consumo con mediación de otros factores. Hay evidencia de la asociación entre trastornos mentales y del comportamiento y los trastornos de personalidad. Conclusiones: La probabilidad de consumo de sustancias ilícitas y de trastornos por su uso, se ve afectada por un conjunto de factores personales que incluyen características socio-demográficas, condiciones de salud mental, comportamiento sexual, el consumo de drogas legales, la edad de inicio y la percepción de riesgo.

ABSTRACT Introduction: According to national studies, the use of illicit drugs is growing in Colombia. With this, the prevalence of substance use disorders and the set of health effects related to this practice also increases. Knowledge of the factors associated with the use of illicit drugs is necessary to guide the comprehensive care of the phenomenon. Illicit drugs Methods: This is a systematic review of reviews on factors associated with the consumption of illicit drugs with seven databases and evaluation of the quality of the manuscripts according to AMSTAR. Results: Information was extracted from 38 reviews on individual factors associated with the use of illicit drugs. Demographic factors are associated with consumption through other factors. There is evidence of the association between mental and behavioural disorders and personality disorders. Conclusions: The likelihood of consumption of illicit substances and disorders due to their use is affected by a set of personal factors including sociodemographic characteristics, mental health conditions, sexual behaviour, legal drug use, age of onset and risk perception.

Factors Associated with Cyberbullying Victimisation among Colombian High-School Adolescents.

The study's purpose was to examine the prevalence and explore some factors associated with cyberbullying in high-school adolescents at ​​Santa Marta, Colombia. A cross-sectional study was designed, which participated in students between 13 and 17 years. Participants completed the item for being a victim of cyberbullying of the Youth Risk Behavior Survey for high school students designed by the Center for Disease Control of the United States. A total of 1462 students answered the questionnaire (M = 14.4 years, SD = 0.8). 19.6% (n = 287) reported lifetime cyberbullying victimisation. Cyberbullying victimisation was associated with post-traumatic stress disorder risk (OR = 2.05, 95%CI 1.51-2.79), lifetime cigarette smoking (OR = 1.91, 95%CI 1.42-2.57), female gender (OR = 1.68, 95%CI 1.25-2.26), family dysfunction (OR = 1.68, 95%CI 1.18-2.41), and poor-fair health condition (OR = 1.45, 95%CI 1.08-1.95). Being a victim of cyberbullying is frequent among Colombian high-school adolescents. It is associated with post-traumatic stress disorder risk, cigarette smoking, female gender, family dysfunction, and poor-fair general health condition. Longitudinal investigations are needed to measure better the dynamics of cyberbullying and the nature of such associations.

Psychometric Properties of an Instrument to Assess the Fear of COVID-19 in a Sample in Argentina: a Mixed Approach.

The FCV-19S was the first instrument designed to assess the severity of fear related to COVID-19 and has already been validated in many languages. The objective of this study was to evaluate the homogeneity and construct validity of the 5-item version of the FCV19S, using an online questionnaire in 599 people. The participants' age ranged from 18 to 65 years. Age, gender, marital status, educational level, employment status, and socioeconomic status were analyzed. In the evaluation process we assessed interitem correlation, item rest-correlation, confirmatory factor analysis: Root Mean Square Error of Approximation, Comparative Fix Index, Tucker-Lewis Index; internal consistency (Cronbach's alpha, McDonald's omega), and the Rasch model was assessed for learning more about the psychometric properties of the scale, which allows a detailed knowledge of the strengths and weaknesses of a scale. The FCV-5S has adequate psychometric indicators from the perspective of the Classical Theory of Items. The major limitations were using a self-reported measure and having a convenience sample not necessarily representative of the general population of Argentina.

Adaptation and psychometric evaluation of the Fear of COVID-19 Scale in the general Colombian population.

The study aimed to adapt and explore the psychometric performance of the Fear of COVID-19 Scale (FCV-19S) in the general Colombian population. The original FCV-19S is a 7-item scale that underwent an adaptation (Item 1 and 5 were deleted). From an online sample of 1,687 adults (59% female), exploratory and confirmatory factor analyses were performed for versions of the scale with 6 and 5 items. Cronbach's alpha and McDonald's omega were calculated. The confirmatory factor analysis showed that the 5-item scale (Fear of COVID-5) presented better indicators. In conclusion, the Fear of COVID-5 has acceptable performance in the Colombian population.

Validity of the Hospital Anxiety and Depression Scale (HADS) in primary care patients in Colombia.

OBJECTIVE: To assess the validity of the Hospital Anxiety and Depression Scale (HADS) for depression and anxiety screening in primary care patients in Colombia. METHODS: A criterion validity study was conducted with 243 adults that had completed the HADS and were later assessed using the MINI as a gold standard. Cronbach's alpha, McDonald's omega and factor structure were applied through confirmatory factor analysis (CFA). ROC curve analysis and Youden's statistic were used to determine the cut-off point. RESULTS: Cronbach's α was reported to be 0.85 and 0.82 for McDonalds' ω. CFA supported a two-factor solution demonstrating satisfactory fit. Root mean square error of approximation = 0.04, Comparative Fix Index (CFI) and Tucker-Lewis Index (TLI) = 0.97. For HADS-A, the cut-off point was determined as 6 associated with a sensitivity of 0.76, a specificity of 0.72 and Youden's index of 0.50. The ABC was 0.81. For HADS-D, the cut-off point was determined as 4 associated with a sensitivity of 0.78, a specificity of 0.74 and Youden's index of 0.53. The ABC was 0.82. CONCLUSION: The HADS is a valid and reliable instrument for anxiety and depression screening in adult patients of primary healthcare services in Colombia.

Validity of the Patient Health Questionnaire-9 (PHQ-9) for depression screening in adult primary care users in Bucaramanga, Colombia. / Validez del Cuestionario de salud del paciente-9 (PHQ-9) para cribado de depresión en adultos usuarios de Atención Primaria en Bucaramanga, Colombia.

The patient health questionnaire-9 (PHQ-9) is one of the most widely used self-report instruments in primary care. There is no criterion validity of the PHQ-9 in Colombia. The objective was to validate the PHQ-9 as a screening tool in primary care. A cross-sectional, scale criterion validity study was performed using as reference criterion the mini neuropsychiatric interview (MINI) in male and female adult users of primary care centres. We calculated the internal consistency and convergent and criterion validity of the PHQ-9 by analysing the receiver operating characteristics (ROC) and the area under the curve (AUC). We analysed 243 participants; 184 (75.7%) were female. The average age was 34.05 (median of 31 and SD = 12.47). Cronbach's α was 0.80 and McDonald's ω was 0.81. Spearman's Rho was 0.64 for HADS-D (P <0.010) and 0.70 for PHQ-2 (P <0.010). The AUC was 0.92 (95% CI 0.880-0.963). The optimal cut-off point of PHQ-9 was ≥7: sensitivity of 90.38 (95% CI: 81.41-99.36); specificity of 81.68 (95% CI: 75.93-87.42); PPV 57.32 (95% CI: 46.00-68.63); NPV 96.89 (95% CI: 93.90-99.88); Youden index 0.72 (95% CI: 0.62-0.82); LR+ 4.93 (95% CI: 3.61-6.74); LR- 0.12 (95% CI: 0.005-0.270). In sum, the Colombian version of PHQ-9 is a valid and reliable instrument for depression screening in primary care in Bucaramanga, with a cut-off point ≥7.

Validez del Cuestionario de salud del paciente-9 (PHQ-9) para cribado de depresión en adultos usuarios de Atención Primaria en Bucaramanga, Colombia / Validity of the Patient Health Questionnaire-9 (PHQ-9) for depression screening in adult primary care users in Bucaramanga, Colombia

RESUMEN El Cuestionario de salud del paciente-9 (PHQ-9) es uno de los instrumentos de autoinforme más utilizado en Atención Primaria (AP). No existe validez de criterio del PHQ-9 en Colombia. El objetivo fue realizar la validez de criterio del PHQ-9 como instrumento de cribado en AP. Se realizó un estudio trasversal de validez de criterio de una escala usando como criterio de referencia la minientrevista neuropsiquiátrica (MINI) en usuarios adultos de centros de AP de ambos sexos. Se calcularon la consistencia interna y la validez convergente y de criterio del PHQ-9 mediante el análisis de las características operativas del receptor (COR) y el área bajo la curva (ABC). Participaron 243 pacientes, 184 (75,7%) fueron de sexo femenino. El promedio de edad fue 34,05 (mediana 31 y DE = 12,47). El α de Cronbach fue 0,80 y ω de McDonald, 0,81. La rho de Spearman fue 0,64 para HADS-D (p < 0,010) y 0,70 para PHQ-2 (p < 0,010). El ABC fue 0,92 (IC del 95%, 0,880-0,963). El punto de corte óptimo del PHQ-9 fue ≥ 7: sensibilidad de 90,38 (IC del 95%: 81,41-99,36); especificidad de 81,68 (IC del 95%: 75,93-87,42); el VPP 57,32 (IC del 95%: 46,00-68,63); el VPN 96,89 (IC del 95%: 93,90-99,88); índice de Youden 0,72 (IC del 95%: 0,62-0,82; LR+ 4,93 (IC del 95%: 3,61-6,74); LR- 0,12 (IC del 95%: 0,005-0,270). En conclusión, la versión colombiana del PHQ-9 es un instrumento válido y confiable para el cribado de depresión en AP de Bucaramanga, con un punto de corte ≥ 7.

ABSTRACT The patient health questionnaire-9 (PHQ-9) is one of the most widely used self-report instruments in primary care. There is no criterion validity of the PHQ-9 in Colombia. The objective was to validate the PHQ-9 as a screening tool in primary care. A cross-sectional, scale criterion validity study was performed using as reference criterion the mini neuropsychiatric interview (MINI) in male and female adult users of primary care centres. We calculated the internal consistency and convergent and criterion validity of the PHQ-9 by analysing the receiver operating characteristics (ROC) and the area under the curve (AUC). We analysed 243 participants; 184 (75.7%) were female. The average age was 34.05 (median of 31 and SD = 12.47). Cronbach's α was 0.80 and McDonald's ω was 0.81. Spearman's Rho was 0.64 for HADS-D (P <0.010) and 0.70 for PHQ-2 (P <0.010). The AUC was 0.92 (95% CI 0.880-0.963). The optimal cut-off point of PHQ-9 was ≥7: sensitivity of 90.38 (95% CI: 81.41-99.36); specificity of 81.68 (95% CI: 75.93-87.42); PPV 57.32 (95% CI: 46.00-68.63); NPV 96.89 (95% CI: 93.90-99.88); Youden index 0.72 (95% CI: 0.62-0.82); LR+ 4.93 (95% CI: 3.61-6.74); LR- 0.12 (95% CI: 0.005-0.270). In sum, the Colombian version of PHQ-9 is a valid and reliable instrument for depression screening in primary care in Bucaramanga, with a cut-off point ≥ 7.

Stigmatisation associated with COVID-19 in the general Colombian population.

BACKGROUND: As the COVID-19 pandemic progresses, the fear of infection increases and, with it, the stigma-discrimination, which makes it an additional problem of the epidemic. However, studies about stigma associated with coronavirus are scarce worldwide. AIMS: To determine the association between stigmatisation and fear of COVID-19 in the general population of Colombia. METHOD: A cross-sectional study was carried out. A total of 1,687 adults between 18 and 76 years old (M = 36.3; SD = 12.5), 41.1% health workers, filled out an online questionnaire on Stigma-Discrimination and the COVID-5 Fear Scale, adapted by the research team. RESULTS: The proportion of high fear of COVID-19 was 34.1%; When comparing the affirmative answers to the questionnaire on stigma-discrimination towards COVID-19, it was found that the difference was significantly higher in the general population compared to health workers in most of the questions evaluated, which indicates a high level of stigmatisation in that group. An association between high fear of COVID-19 and stigma was evidenced in 63.6% of the questions in the questionnaire. CONCLUSION: Stigma-discrimination towards COVID-19 is frequent in the Colombian population and is associated with high levels of fear towards said disease, mainly people who are not health workers.

Validity of the patient health questionnaire-2 (PHQ-2) for the detection of depression in primary care in Colombia.

BACKGROUND: The PHQ-2 is a screening test for major depressive disorder (MDD) derived from PHQ-9, which has shown to be useful in the detection of cases of clinical significance in previous studies. The psychometric properties of PHQ-2 in the Colombian population are unknown. METHODS: PHQ-2 were assessed in 243 patients in general medical consultations using the Mini-International Neuropsychiatric Interview (MINI) as the gold standard. Internal consistency, convergent validity and criterion validity were calculated by analyzing the Receptor Operating Characteristics (ROC) and the area under the curve (AUC). RESULTS: Cronbach's alpha and McDonald's omega coefficients were 0.71. Spearman's rho coefficients for correlations with PHQ-9 and HADS-D scores were 0.63 and 0.59 (p<0.01). AUC was 0.89. The optimal cut point was ≥2 with the following indicators: sensitivity 0.87 specificity 0.74; Youden index 0.60; PPV 0.47; NPV 0.95; (LR+) 3.24; (LR-) 0.18 (95% CI 0.09-0.37). Kappa coefficient between PHQ-2 and MINI for depression was .458 and 0.46 for HADS-D. LIMITATIONS: Since this study was done with people attending hospital, which could has implications for the prevalence of depression, affecting the validity indicators of the instrument. CONCLUSIONS: PHQ-2 show an acceptable test performance in the context of the study. However, the test could yield a considerable amount of false positives that would require specialized evaluation to establish a reliable diagnosis.

Neurocognitive disorder due to neurosyphilis: a case report. / Trastorno neurocognitivo debido a neurosífilis: informe de un caso.

INTRODUCTION: Neurosyphilis is a chronic infectious disease caused by Treponema pallidum that can cause a great variety of neuropsychiatric signs and symptoms, which complicates its diagnosis. CASE DESCRIPTION: This case occurred in a 40-year-old man who consulted the Emergency Department because of a convulsion (de novo) which was related to a chronic condition of cognitive impairment and psychosis. The appropriate studies were performed for the diagnosis of neurosyphilis and the recommended treatment was initiated. The patient presented clinical improvement and was discharged. DISCUSSION: Positive VDRL serology results and imaging findings of marked cortical atrophy conducted to consider a late-stage parenchymatous neurosyphilis with serious cognitive impairment and associated psychosis. Treatment with crystalline penicillin was formulated, which reduced the intensity of the patient's symptoms; however, the patient's lack of interest to attend the check-ups significantly reduces his chances of an adequate recovery. CONCLUSIONS: Neurosyphilis must be suspected in patients with clinically evident neurological or psychiatric symptoms. Analysis of VDRL serology and neuroimaging studies are important as an initial evaluation of the patient and must be complemented with cognitive tests or mental examination to determine the state of cognitive impairment.

Trastorno neurocognitivo debido a neurosífilis: informe de un caso / Neurocognitive disorder due to neurosyphilis: a case report

RESUMEN Introducción: La neurosífilis es una enfermedad infecciosa crónica ocasionada por Treponema pallidum y puede producir una gran variedad de signos y síntomas neuropsiquiátricos, lo que complica su diagnóstico. Descripción del caso: Se presenta el caso de un paciente de 40 años que consultó al servicio de urgencias por una convulsión de novo, junto con un cuadro crónico de deterioro cognitivo y psicosis. Se le realizaron los estudios pertinentes para el diagnóstico de neurosífilis y se inició el tratamiento recomendado. El paciente presentó mejoría clínica y fue dado de alta. Discusión: Con resultados de serología VDRL positivos y hallazgos imagenológicos de atrofia cortical marcada, se consideró una neurosífilis parenquimatosa de tipo tardío, junto con franco deterioro cognoscitivo y psicosis. Se le dejó tratamiento con penicilina cristalina, que disminuyó la intensidad de los síntomas del paciente; sin embargo, el poco interés de este en asistir a sus controles disminuye sus probabilidades de una recuperación adecuada. Conclusiones: La neurosífilis se debe sospechar en pacientes con síntomas neurológicos o psiquiátricos clínicamente evidentes. El análisis de la serología de VDRL y los estudios de neuroimagen son importantes como evaluación inicial del paciente, que debe complementarse con pruebas cognitivas o examen mental para determinar el estado de deterioro cognitivo.

ABSTRACT Introduction: Neurosyphilis is a chronic infectious disease caused by Treponema pallidum that can cause a great variety of neuropsychiatric signs and symptoms, which complicates its diagnosis. Case description: This case occurred in a 40-year-old man who consulted the Emergency Department because of a convulsion (de novo) which was related to a chronic condition of cognitive impairment and psychosis. The appropriate studies were performed for the diagnosis of neurosyphilis and the recommended treatment was initiated. The patient presented clinical improvement and was discharged. Discussion: Positive VDRL serology results and imaging findings of marked cortical atrophy conducted to consider a late-stage parenchymatous neurosyphilis with serious cognitive impairment and associated psychosis. Treatment with crystalline penicillin was formulated, which reduced the intensity of the patient's symptoms; however, the patient's lack of interest to attend the check-ups significantly reduces his chances of an adequate recovery. Conclusions: Neurosyphilis must be suspected in patients with clinically evident neurological or psychiatric symptoms. Analysis of VDRL serology and neuroimaging studies are important as an initial evaluation of the patient and must be complemented with cognitive tests or mental examination to determine the state of cognitive impairment.

Individual Factors Associated with the Consumption of Illicit Substances: a Review of Reviews. / Factores Individuales Asociados al Consumo de Sustancias Ilícitas: Una Revisión de Revisiones.

INTRODUCTION: According to national studies, the use of illicit drugs is growing in Colombia. With this, the prevalence of substance use disorders and the set of health effects related to this practice also increases. Knowledge of the factors associated with the use of illicit drugs is necessary to guide the comprehensive care of the phenomenon. METHODS: This is a systematic review of reviews on factors associated with the consumption of illicit drugs with seven databases and evaluation of the quality of the manuscripts according to AMSTAR. RESULTS: Information was extracted from 38 reviews on individual factors associated with the use of illicit drugs. Demographic factors are associated with consumption through other factors. There is evidence of the association between mental and behavioural disorders and personality disorders. CONCLUSIONS: The likelihood of consumption of illicit substances and disorders due to their use is affected by a set of personal factors including sociodemographic characteristics, mental health conditions, sexual behaviour, legal drug use, age of onset and risk perception.