Incorporation and evaluation of serial concept maps for vertical integration and clinical reasoning in case-based learning tutorials: Perspectives of students beginning clinical medicine.

Background: Concept maps and case-based learning (CBL) are recognized and useful strategies to enhance undergraduate medical learning. However, research on the use of a mixed approach is limited. Aims: To incorporate serial concept mapping (CM) into CBL tutorials, to explore students' perspectives on the worth of the method to better understand patients' problems and elicit diagnoses, and to assess the student's learning. Methods: We designed a four-phase method of CBL that incorporated serial mapping to assist students in the process of knowledge construction regarding the underlying principles of the patients' present complaints, the recognition of disease patterns and the eliciting of diagnostic hypotheses. Students worked both individually and collaboratively. We used a questionnaire to explore the students' perspectives of the method and a score system to assess end-of-course performance. Results: The students perceived that serial CM was useful to integrate previous knowledge into new clinical information for case analysis and to elicit diagnoses. They also reported an increase in content-related knowledge. The end-of-course scores were high for most students. Conclusions: Novice medical students perceived serial CM in CBL tutorials as an effective strategy for learning. End-of-course examination scores indicated that they improved case analysis and clinical reasoning skills.

[Prevalence of smoking among Colombian adolescents]. / Prevalencia y factores asociados al consumo de cigarrillo tradicional, en adolescentes escolarizados.

BACKGROUND: Cigarette smoking is considered the most important preventable public health problem in developed countries, especially among adolescents. AIM: To determine the prevalence of cigarette smoking and associated factors in high school adolescents, from a Colombian city. MATERIAL AND METHODS: The self-administered global tobacco youth survey (GTYS) was answered by 831 teenagers aged 14 ± 2 years (54% females). For data analysis, proportions were calculated; for associations, binary and multivariable logistic regression was applied. RESULTS: Fourteen percent of respondents declared that they had consumed at least one cigarette during the last 30 days. The life-time prevalence of tobacco use was 27.1%. Being older than thirteen years old, father’s academic level and having a smoker mother were factors associated with smoking. CONCLUSIONS: The prevalence of smoking in these adolescents was high. Age over 13 years and a smoking mother were associated with the cigarette smoking.

Hearing loss symptoms and leisure noise exposure in university students in Barranquilla, Colombia. / Síntomas de hipoacusia y exposición al ruido recreativo en jóvenes universitarios, Barranquilla, Colombia.

PURPOSE: The aim of this study was to investigate the total weekly exposure to leisure noise among university students and to assess its association with self-reported symptoms of hypoacusis. METHODS: This is a cross-sectional survey. An online questionnaire based on the "Noise Exposure Questionnaire", plus 11 questions regarding hearing loss were sent to 730 randomly selected students. Participants self-reported time spent on different leisure noise activities and their subjective evaluation of the loudness of these activities, converted into equivalent noise levels, were used to estimate weekly noise exposure levels that were compared to occupational noise limits (> 85 dBA = hazardous). Inference statistics was applied to relate hearing symptoms and "likely or having some degree of hearing loss" with hazardous weekly leisure noise exposure levels. RESULTS: Ninety-three percent of the participants reported at least one hypoacusis symptom. The most frequent sound-related ear symptom was tinnitus (72%). Fifty-five percent of the individuals presented weekly exposure to noise >85 dBA. Symptoms of hearing loss were more prevalent in those exposed to weekly noise levels >85 dBA. CONCLUSION: This study suggests that there may be hearing loss caused by exposure to high levels of leisure noise in a large part of the study population. Health promotion of hearing conservation should be emphasized at university level. Objective repeated measurement of hearing acuity should be part of integral health services for the youth population.

OBJETIVO: Investigar la participación de estudiantes universitarios en actividades de ocio productoras de ruido y la relación entre los niveles de exposición semanal al ruido recreativo y síntomas de hipoacusia auto reportados, en la ciudad de Barranquilla, Colombia. MÉTODO: Se realizó un estudio transversal mediante encuesta virtual, basada en el Cuestionario de Exposición al Ruido, más 11 preguntas de síntomas auditivos, a una muestra aleatoria de 730 sujetos. El nivel de exposición semanal al ruido recreativo se estimó a partir del tiempo dedicado al total de actividades recreativas reportadas por los participantes y su evaluación subjetiva de la intensidad de ruido producida por cada actividad, transformada en niveles de ruido continuo equivalente. La asociación entre la exposición al ruido recreativo y la presencia de síntomas de hipoacusia se analizó mediante la prueba de Chi-cuadrado. RESULTADOS: El 93% de los participantes manifestó al menos un síntoma de hipoacusia y la mitad reportó cuatro o más. El síntoma más frecuente de hipoacusia asociada al ruido fue el tinnitus (72%). El 55% tenía una exposición semanal de ruido por encima de 85 dBA y en éstos la prevalencia de síntomas de hipoacusia fue mayor (p < 0.05). CONCLUSIÓN: Se sugiere la presencia de deterioro auditivo en gran parte la población universitaria, asociado con altas dosis de exposición semanal al ruido recreativo. Es necesario fortalecer los programas de promoción de la salud auditiva en la academia, y desde los servicios de salud, la valoración objetiva y periódica de la audición.

Prevention, diagnosis, and treatment of glucocorticoid induced osteoporosis by rheumatologists in a Latin-American city.

OBJECTIVES: To examine current practices for the diagnosis and therapy for glucocorticoid-induced osteoporosis (GIOP) in patients under treatment with corticosteroids at outpatient clinics of rheumatologists in a Colombian Caribbean city. METHODS: All patients noted to be using of glucocorticoids (GC) on an index consult from February to May 2004 were included in a descriptive cross sectional study. Criteria for inclusion of patients were to have had, at least, one previous visit to the service. We evaluated the study population for osteoporosis diagnosis, procedures, and treatment. RESULTS: Of the 121 patients included, 103 (85.1%) were female and 18 (14.9%) were male; 76 patients (62.8%) were under 50 years, and 45 (37.2%) were over 50 years. Main reasons for corticosteroid use were rheumatoid arthritis in 68 patients (56.2%) and systemic lupus erythematous (SLE) in 31 patients (25.6%). Diagnostic testing for osteoporosis was reported on 50.1% of patients. Peripheral dual energy x-ray absorptiometry was the most frequently used method (52.6%). Therapeutic agents for GIOP were used in 96 patients (79.3%), with Calcium plus Vitamin D (55.2%) the principal treatments prescribed. CONCLUSIONS: We found similar rates of diagnosis and treatment for GIOP to those reported in North America and Europe, although in this study treatment was mainly with calcium and vitamin D. There was a statistically significant relationship between being studied with any diagnostic method and being treated for GIOP. There may be undertreatment for GIOP in Latin America. Local interventions to improve care for patients in chronic use of steroids are needed.

Síntomas de hipoacusia y exposición al ruido recreativo en jóvenes universitarios, Barranquilla, Colombia / Hearing loss symptoms and leisure noise exposure in university students in Barranquilla, Colombia

RESUMEN Objetivo Investigar la participación de estudiantes universitarios en actividades de ocio productoras de ruido y la relación entre los niveles de exposición semanal al ruido recreativo y síntomas de hipoacusia auto reportados, en la ciudad de Barranquilla, Colombia. Método Se realizó un estudio transversal mediante encuesta virtual, basada en el Cuestionario de Exposición al Ruido, más 11 preguntas de síntomas auditivos, a una muestra aleatoria de 730 sujetos. El nivel de exposición semanal al ruido recreativo se estimó a partir del tiempo dedicado al total de actividades recreativas reportadas por los participantes y su evaluación subjetiva de la intensidad de ruido producida por cada actividad, transformada en niveles de ruido continuo equivalente. La asociación entre la exposición al ruido recreativo y la presencia de síntomas de hipoacusia se analizó mediante la prueba de Chi-cuadrado. Resultados El 93% de los participantes manifestó al menos un síntoma de hipoacusia y la mitad reportó cuatro o más. El síntoma más frecuente de hipoacusia asociada al ruido fue el tinnitus (72%). El 55% tenía una exposición semanal de ruido por encima de 85 dBA y en éstos la prevalencia de síntomas de hipoacusia fue mayor (p < 0.05). Conclusión Se sugiere la presencia de deterioro auditivo en gran parte la población universitaria, asociado con altas dosis de exposición semanal al ruido recreativo. Es necesario fortalecer los programas de promoción de la salud auditiva en la academia, y desde los servicios de salud, la valoración objetiva y periódica de la audición.

ABSTRACT Purpose The aim of this study was to investigate the total weekly exposure to leisure noise among university students and to assess its association with self-reported symptoms of hypoacusis. Methods This is a cross-sectional survey. An online questionnaire based on the "Noise Exposure Questionnaire", plus 11 questions regarding hearing loss were sent to 730 randomly selected students. Participants self-reported time spent on different leisure noise activities and their subjective evaluation of the loudness of these activities, converted into equivalent noise levels, were used to estimate weekly noise exposure levels that were compared to occupational noise limits (> 85 dBA = hazardous). Inference statistics was applied to relate hearing symptoms and "likely or having some degree of hearing loss" with hazardous weekly leisure noise exposure levels. Results Ninety-three percent of the participants reported at least one hypoacusis symptom. The most frequent sound-related ear symptom was tinnitus (72%). Fifty-five percent of the individuals presented weekly exposure to noise >85 dBA. Symptoms of hearing loss were more prevalent in those exposed to weekly noise levels >85 dBA. Conclusion This study suggests that there may be hearing loss caused by exposure to high levels of leisure noise in a large part of the study population. Health promotion of hearing conservation should be emphasized at university level. Objective repeated measurement of hearing acuity should be part of integral health services for the youth population.

[Prevalence of insomnia in adults aged 18 to 60 years and exposure to electromagnetic fields in households of Barranquilla, Colombia]. / Prevalencia de insomnio en adultos de 18 a 60 años de edad y exposición a campos electromagnéticos en hogares de Barranquilla, Colombia.

INTRODUCTION: Insomnia, a sleep disorder that affects both individual and public health, has not been studied in Barranquilla. Prior studies about the effects of exposure to electromagnetic fields on sleep disorders are controversial. OBJECTIVE: To estimate the prevalence of insomnia symptoms in adults aged 18 to 60 years and its relation to the presence and intensity of electromagnetic fields in two neighborhoods of Barranquilla, Colombia. MATERIALS AND METHODS: A cross-sectional study was carried out in 220 households located in two neighborhoods of Barranquilla, one with high exposure to radio and cell phone antennas and the other one with low exposure. After informed consent, a survey was applied among adults residing in 220 households to investigate the presence of insomnia symptoms, socio-demographic data and intake of medicines. When it was allowed, electromagnetic fields were measured with teslameters in bedrooms. The database was created in Excel™ and the data analysis was done with SPSS™, version 18. RESULTS: Insomnia, mainly of the mild type, was present in 74.5% of the total study population while 25.5% reported a normal sleep pattern. According to the sleeping test score we found a higher prevalence of insomnia in the neighborhood with greater exposure to radio antennas and cell towers (85.4%) than in the one with lower exposure (63.3%), prevalence ratio 1.34 (CI 95% 1.14-1.57). CONCLUSIONS: This study suggests a higher prevalence of insomnia among persons living in areas with higher exposure to electromagnetic fields where the number of radio antennas and cell towers was greater.

Factores de riesgo para la infección del sitio quirúrgico posapendicectomía. Estudio de casos y controles / Risk factors for surgical-site infection in the atlantic state, colombia. A case-control study

Resumen Objetivo: Evaluar la influencia de los determinantes sociodemográficos, clínicos y del servicio de salud sobre el riesgo de infección del sitio quirúrgico en pacientes apendicectomizados, en los hospitales del Atlántico, Colombia. Materiales y métodos: Estudio de casos y controles retrospectivo. Se revisaron los registros quirúrgicos de pacientes apendicectomizados entre 2009 y 2013. Muestra: 80 casos y 272 controles. Factores estudiados: sociodemográficos (edad, género, régimen de afiliación al sistema de salud); clínicos (antecedentes patológicos, hospitalizaciones previas, grado del apéndice); servicios (tiempos de espera, técnica quirúrgica, duración del procedimiento, profilaxis antibiótica, tiempo de estancia hospitalaria). Análisis: bivariable y multivariable. Se calcularon las razones de momios (OR), intervalos de confianza al 95 %, y pruebas de significancia estadística. Resultados: Luego del análisis multivariado, los factores de riesgo independientes fueron: edad mayor de 54 años (OR = 5,37); afiliación al régimen subsidiado del sistema general de seguridad social en salud (OR = 3,49) y el grado histopatológico del apéndice II, que incluye inflamación focal, ulceraciones del epitelio y microabscesos aislados en folículos linfáticos, (OR = 1,98). Conclusión: Este estudio aporta nueva evidencia de la multicausalidad de la infección nosocomial en pacientes sometidos a apendicectomía. Se destaca el rol de la desigualdad en salud como factor de riesgo importante, lo cual merece especial atención.

Abstract Objective: To evaluate sociodemographic, clinical and health-service-related determinants associated to surgical site infections in patients undergoing appendectomy in third level Hospitals, located in the Colombian Northern Region, from 2009 to 2013. Methods: Retrospective data was collected of hospital records from participating hospitals; 80 cases and 272 controls were compared regarding socio-demographic (age, gender, regime of affiliation to the social-security health system), clinical (comorbidity, prior hospitalization, degree of appendix), and healthcare-related variables (diagnostic time, preoperative time, operation duration, prophylaxis with antibiotics and hospital-stay length). Both bivariate and multivariate analysis were conducted. Odds Ratios, 95% confidence intervals were estimated; Besides, both X2-Test and T Student Tests were used to evaluate statistical significance. Results: Socio-demographic (age, affiliation to the subsidized-health-system), clinical (metabolic disease) and health-care related factors such as preoperative waiting time showed to be associated to surgical site infections, in the bivariate analysis. In the final regression model only age above 54 (OR= 5,37); subsidized affiliation to the social security system (3,49) and histopathological grade of appendix, which included focal inflammation, epithelial ulcers, and isolated micro-abscesses in lymphatic's follicles showed to be independent risk factors (OR= 1,98). Conclusion: This study adds new evidence on the multifactorial origin of post-surgery nosocomial infections and spotlights health inequality as a major risk factor that needs to be addressed.

Prevalencia y factores asociados al consumo de cigarrillo tradicional, en adolescentes escolarizados / Prevalence of smoking among Colombian adolescents

Background: Cigarette smoking is considered the most important preventable public health problem in developed countries, especially among adolescents. Aim: To determine the prevalence of cigarette smoking and associated factors in high school adolescents, from a Colombian city. Material and Methods: The self-administered global tobacco youth survey (GTYS) was answered by 831 teenagers aged 14 ± 2 years (54% females). For data analysis, proportions were calculated; for associations, binary and multivariable logistic regression was applied. Results: Fourteen percent of respondents declared that they had consumed at least one cigarette during the last 30 days. The life-time prevalence of tobacco use was 27.1%. Being older than thirteen years old, father’s academic level and having a smoker mother were factors associated with smoking. Conclusions: The prevalence of smoking in these adolescents was high. Age over 13 years and a smoking mother were associated with the cigarette smoking.

Prevalencia de insomnio en adultos de 18 a 60 años de edad y exposición a campos electromagnéticos en hogares de Barranquilla, Colombia / Prevalence of insomnia in adults aged 18 to 60 years and exposure to electromagnetic fields in households of Barranquilla, Colombia

Introducción. El insomnio, trastorno del sueño que afecta la salud individual y colectiva, no se ha estudiado en Barranquilla. Los estudios previos sobre la influencia de la exposición a campos electromagnéticos en los trastornos del sueño, son controversiales. Objetivo. Estimar la prevalencia de los síntomas de insomnio en adultos de 18 a 60 años de edad, y su relación con la presencia y la intensidad de campos electromagnéticos en dos barrios de Barranquilla, Colombia. Materiales y métodos. Se llevó a cabo un estudio transversal en 220 viviendas de dos barrios de Barranquilla, uno con una alta exposición a antenas de radio y telefonía móvil, y otro con muy poca exposición. Después de obtener el consentimiento informado, se hizo una encuesta a un adulto por vivienda para indagar sobre la presencia de síntomas de insomnio, los hábitos de sueño, los datos sociodemográficos, la cercanía a antenas de radio y telefonía móvil y el uso de medicamentos. Siempre que fue posible, se midieron los campos electromagnéticos en el dormitorio mediante teslámetros. Los datos se tabularon en Excel™ y se analizaron con el programa SPSS™, versión18. Resultados. Se observó que 164 (74,5 %) de los sujetos presentaban algún grado de insomnio, principalmente de tipo leve, en tanto que el 25,5 % restante tenía un patrón normal de sueño. Se encontró un porcentaje más alto de personas con insomnio en el barrio con mayor exposición a antenas de radio y telefonía móvil (85,4 %) que en el barrio con menor exposición (63,3 %), razón de prevalencias 1,34 (IC 95% 1,14-1,57). Conclusiones. Este estudio sugiere una mayor prevalencia de insomnio en los sujetos residentes en zonas con mayor exposición a radiaciones electromagnéticas, donde hay una gran concentración de antenas de radio y telefonía móvil.

Introduction: Insomnia, a sleep disorder that affects both individual and public health, has not been studied in Barranquilla. Prior studies about the effects of exposure to electromagnetic fields on sleep disorders are controversial. Objective: To estimate the prevalence of insomnia symptoms in adults aged 18 to 60 years and its relation to the presence and intensity of electromagnetic fields in two neighborhoods of Barranquilla, Colombia. Materials and methods: A cross-sectional study was carried out in 220 households located in two neighborhoods of Barranquilla, one with high exposure to radio and cell phone antennas and the other one with low exposure. After informed consent, a survey was applied among adults residing in 220 households to investigate the presence of insomnia symptoms, socio-demographic data and intake of medicines. When it was allowed, electromagnetic fields were measured with teslameters in bedrooms. The database was created in Excel™ and the data analysis was done with SPSS™, version 18. Results: Insomnia, mainly of the mild type, was present in 74.5% of the total study population while 25.5% reported a normal sleep pattern. According to the sleeping test score we found a higher prevalence of insomnia in the neighborhood with greater exposure to radio antennas and cell towers (85.4%) than in the one with lower exposure (63.3%), prevalence ratio 1.34 (CI 95% 1.14-1.57). Conclusions: This study suggests a higher prevalence of insomnia among persons living in areas with higher exposure to electromagnetic fields where the number of radio antennas and cell towers was greater.

El uso de los smartphones y las relaciones interpersonales de los jóvenes universitarios en la ciudad de Barranquilla (Colombia) / Influence of smartphones on interpaersonal relationships of university students in the city of Barranquilla (Colombia)

Objetivo: Analizar la relación entre el uso de los smartphones y las relaciones interpersonales de estudiantes universitarios en la ciudad de Barranquilla. Materiales y métodos: Estudio descriptivo transversal mediante encuesta anónima a 400 estudiantes en una universidad privada, seleccionados aleatoriamente. Variables estudiadas: frecuencia de revisión de mensajes y llamadas, conflicto en las relaciones con padres, amigos y pareja y el distanciamiento en las relaciones generado por el uso de excesivo del móvil. El conflicto en las relaciones se relacionó con las variables sociodemográficas y el perfil de uso de los smartphones. Resultados: El 80 % estaba suscrito a un plan de datos; el 53 % revisaba su smartphone cada 15 minutos o menos; el 66 % lo lleva a todas partes y el 52 % lo usaba en exceso. Las dos razones de uso más frecuentes fueron: mantenerse en contacto/diversión (22 %) y mantenerse en contacto/estudio (12.5 %). Las mujeres usaban más el celular y tenían más conflictos en sus relaciones que los hombres debido al uso excesivo; además, se sentían más molestas/ desplazadas cuando su interlocutor usaba el móvil en su presencia. La principal razón de conflictos por el uso del smartphone en la relación con otras personas fue la distracción. Conclusiones: En general los usuarios consideran que los smartphones afectan positivamente sus relaciones, aunque se presentan conflictos. Hay diferencias por sexo con respecto a la presentación de conflictos por el uso excesivo del móvil, predominante en las mujeres, quienes tienden a tolerar menos que este sea utilizado en su presencia.

Objective: To analyze the relation between the use of smartphones and interpersonal relationships among students at a private university located in city Barranquilla. Materials and methods: A cross sectional study was conducted among 400 randomly selected students. Data was collected regarding frequency of checking income mails and calls, conflict and impact on relationships with parents, partners and peers due to the use of smartphone. Both univariate and bivariate analysis was performed. Association of conflict with other variables regarding smartphone usage pattern and socio-demographic characteristics of users was estimated through odds ratios (OR). Statistical significance was tested by the Chi-square. Results: 80 % of the population subscribed to smartphone services, 53 % checked their smartphones every 15 minutes or less and 51 % reported an excessive use. It was observed that women have more conflicts and negative impacts on their relationships due to the excessive use of their smartphones; likewise they tend to feel more uncomfortable when other people use mobiles around, mainly because smart phone use drives attention away from conversation Conclusions: In general, students find smartphones to influence their relationships with others positively, despite some conflicts that may emerge. Conflicts with others showed to be sex related. Although women's use smartphones is more excessive than those of men, they become displeased when are others who use their mobile phones at their presence.

Factores asociados a la coinfección VIH/SIDA- tuberculosis Barranquilla (Colombia), 2003-2004 / Co infection VIH/SIDA-tuberculosis and associated factors Barranquilla (Colombia), 2003-2004

Objetivo general: Establecer la prevalencia y los factores asociados a la coinfección TBC/VIH-SIDA en adolescentes y adultos de la consulta externa y el servicio de hospitalización de las Instituciones Prestadoras de Servicios de Salud (IPS) de Barranquilla de julio de 2003 a junio de 2004. / Aim: To establish the prevalence of TB-HIV co-infection and its determinants among HIV-positiveadolescents and adults, attending outpatient and inpatient clinics of Barranquilla, from July 2003to June 2004.Methods: A cross-sectional study was held in 173 patients attending HIV/AIDS control programs.After patient informed consent, data was mainly obtained from secondary source (clinical histories)and in a lesser proportion from interviews. The variables studied were related to personal habits anddemographic, socio-economic and clinical characteristics. Both, univariate and bivariate analysiswas done in Epi-Info V6.04d.Results: Most patients were males of low socioeconomic status. Of 173 HIV-positives, 19 also hadtuberculosis, for a co-infection prevalence of 11 percent. Pulmonary tuberculosis was the predominantclinical form (17 cases). Bivariate analysis showed that TB-HIV co-infection was associated tothe presence of opportunistic infections (p=0.001), drug-abuse (p=0.026), body mass index under20 (p=0.042) and scarce use of antiretroviral therapy (p=0.0002). Although CD4+ T-lymphocytecount< 200/uL was found to be more common in patients with co-infection, association showed nostatistical significance.Conclusions: TB-HIV co-infection prevalence shown in this study was similar to that of someCaribbean and Latin-American countries but lower than in Jamaica. Contrary to other studies,pulmonary tuberculosis was predominant. Despite the factors associated to TB-HIV comorbidityare similar to those seen in TB and HIV independently, these study elicited evidence of the effect ofthe immunological deterioration and the non-use of antiretroviral therapy.

Factores de riesgo asociados a la depresión en pacientes de la consulta dermatológica en dos hospitales de la ciudad de Barranquilla (Colombia) / Associated risk factors to depression in dermatology care at hospitals in the city of Barranquilla (Colombia)

objetivos: Analizar los factores personales y familiares asociados a la depresión en los pacientes dela consulta externa dermatológica del Hospital Universidad del Norte y del Hospital Nazareth de laciudad de Barranquilla (Colombia).Resultados: Se encontró una fuerte asociación entre la presencia de depresión y los antecedentespersonales y familiares de la enfermedad, la evolución prolongada de la enfermedad dermatológica, laspérdidas laborales y afectivas, la presencia de enfermedad concomitante y la disfuncionalidad familiar.Conclusión: Los resultados sugieren que la depresión en los pacientes con trastornos dermatológicosestá asociada a la influencia de factores similares a los encontrados en la población general, a lo cualse añade el tiempo de evolución de la enfermedad dermatológica y la disfuncionalidad familiar.

Objectives: To analyze the association between personal and familiar factors and the presence ofdepression in dermatologic patients that attend the outpatient service at the Hospital Universidaddel Norte and the Hospital Nazareth in Barranquilla.Methods: A cross sectional study was designed within a population of 339 dermatology outpatients.The sample was selected by systematic sampling methods. Cases were defined as having some degreeof depression diagnosed by the Hamilton Rating Scale for Depression and controls as those who werenegative. Individual factors studied were: sex, marriage and economic status, length of evolution ofdermatological disorder, former history of depression, loss of job and loss of loved ones. Familiar factorsanalyzed were family history of psychiatric disorders, depression and familiar function. Data analysiswas computerized and the prevalence odds ratios (POR) and their confidence intervals werecalculated. The significance tests for association utilized were Chi-squared and Fisher.Results: Depression was associated to: personal and familiar background of depression, length ofevolution of the dermatological problem ...