Parental exposure to carcinogens and risk for childhood acute lymphoblastic leukemia, Colombia, 2000-2005.

INTRODUCTION: The objective of this study was to determine the risk factors for childhood acute lymphoblastic leukemia (ALL) and, in particular, the role of parental occupational exposure to carcinogenic and probably carcinogenic hydrocarbons before the child's conception. METHODS: For this case-control study, cases were children younger than 15 years who were newly diagnosed with ALL between January 2000 and March 2005 at 1 of 6 Colombian hospitals. An interview with both parents of 170 children (85 cases and 85 individually matched neighborhood controls) gathered information about each child's exposures and parental demographic and occupational characteristics, medical history, health risk behaviors, and pregnancy and birth history. A job-exposure matrix was used to classify parental exposure to hydrocarbons on the basis of the main industrial activity of each workplace where parents worked before (both parents) or during the index pregnancy (mother only). Conditional odds ratios and 95% confidence intervals were calculated by period of exposure (preconception, pregnancy, and childhood). RESULTS: The risk of childhood ALL was linked to 1) parental occupational exposure to hydrocarbons before conception, 2) parental smoking before conception, 3) maternal low socioeconomic status during pregnancy, and 4) higher maternal age (≥35 y) at the child's birth. CONCLUSION: These findings suggest an association between childhood ALL and parental occupational exposure to carcinogenic and probably carcinogenic hydrocarbons before conception. Outcomes depended on the parent exposed. Future research should investigate the additive or multiplicative role of other environmental sources of hydrocarbons.

[Evaluation of fine needle aspiration cytology in the diagnosis of cancer of the parotid gland]. / Evaluación de la citología por punción-aspiración con aguja fina en el diagnóstico de cáncer de la glándula parótida.

BACKGROUND: Fine needle aspiration (FNA) is commonly used in the study of neoplastic lesions of the parotid gland, however controversy exists regarding its diagnostic accuracy. OBJECTIVE: To evaluate the performance of FNA biopsy as compared to open surgical biopsy in the diagnosis of carcinoma of the parotid gland. MATERIAL AND METHOD: Forty-six patients with parotid masses from 7 health centres in Bucaramanga, Colombia were identified and included in the study. All patients underwent FNA and open surgical biopsy, with the latter considered the diagnostic gold standard. The FNA and final surgical histopathology were interpreted as either positive or negative for malignancy by pathologists blinded to the FNA outcome. Only standard histological stains were used. The data were compared in a contingency table and analyzed statistically to determine the accuracy of FNA to predict the surgical pathology according to standard measures. RESULTS: The mean age of patients was 52 +/- 16 years old and 59 % were female. Using FNA, 18 % of the initial diagnoses were found to be erroneous at final pathology. FNA had a sensitivity of 0.54, a specificity of 0.90, a PPV of 0.70, an NPV of 0.83, an LR+ of 5.92, an LR of 0.5, and kappa of 0.48 in the identification of parotid gland carcinoma from referral population with a disease prevalence of 28.3 %. CONCLUSIONS: In line with other previous studies, FNA biopsy alone was unreliable to diagnose parotid gland carcinoma. Its low sensitivity and LR indicates its limitations as a screening test; in addition its low kappa shows a modest correlation to the eventual diagnosis. Therefore, further critical examination of techniques and interpretation of parotid FNA are recommended. The development of new methods allowing a valid and precise diagnosis of this pathology and that, like the FNA, have low cost and ease of application is recommended.

[Reproducibility of serological tests for the diagnosis of Trypanosoma cruzi infection in pregnant women in an endemic area of Santander, Colombia]. / Reproducibilidad de pruebas serológicas para el diagnóstico de infección por Trypanosoma cruzi en mujeres embarazadas de una zona endémica de Santander, Colombia.

INTRODUCTION: The diagnosis of chronic Trypanosoma cruzi infection is supported by serological tests whose reproducibility has not been well documented. OBJECTIVE: To evaluate the reproducibility of the serological tests ELISA, IFAT and IHAT for the diagnosis of T. cruzi infection in pregnant women in an endemic zone in Santander. MATERIALS AND METHODS: Through an evaluation study of diagnostic technologies, the reproducibility of the serological tests ELISA, IFAT and IHAT was determined in serum and eluted blood from pregnant women living in an endemic area for Chagas' disease in Santander. The samples were selected by cross sectional sampling. The software Stata ™ version 10.0 was used for statistical analysis. By means of the comparison of the highest kappa coefficient of each technique, the test with the best reproducibility was determined. RESULTS: A total of 777 samples were tested. In serum, ELISA (cutoff point: 0.3), IFAT (cutoff point: 1/32) and IHAT (cutoff point: 1/16) had kappa coefficients greater than 0.8 (0.98, 95% CI: 0.93-1.00; 0.98, 95% CI: 0.92-1.00 and 0.88, 95% CI: 0.74-0.97, respectively); no statistically significant differences among the three tests were found (p> 0.05). For the blood eluates, kappa coefficients were below 0.8 (highest kappa: 0.55, 95% CI: 0.41-0.68). CONCLUSIONS: For the three serological tests using serum, the reproducibility determined by the kappa coefficient was perfect. Selecting any of them is useful for the diagnosis of T. cruzi infection. Given its simplicity and cost, the ELISA test is recommended for screening for this infection.

Validez de constructo de la escala NEI-VFQ-25 en una población colombiana / Validity of NEI-VFQ scale construct in a Colombian population

Objetivo: medir la validez de constructo de la escala NEI-VFQ-25 en una población colombiana con enfermedad ocular crónica. Métodos: se evaluó la tecnología diagnóstica mediante el Modelo Rasch. Se calculó una muestra para garantizar la estabilidad en la calibración de los ítems. Se incluyeron hombres y mujeres de 40-70 años de edad, con enfermedad ocular crónica bilateral, a quienes, previo consentimiento informado, se les aplicó, vía telefónica, la escala NEI-VFQ-25. Resultados: se entrevistaron 206 personas con edad promedio de 58,1 años, quienes presentaban glaucoma (21,7 por ciento), catarata (36,9 por ciento) o algún tipo de retinopatía (35,4 por ciento). Se eliminaron dos ítems del cuestionario original, por funcionamiento diferencial (DIF) y cuatro por ajuste al modelo. Se estandarizaron todas las preguntas a tres opciones de respuesta, y quedó una escala conformada por 17 ítems que cumplía con los criterios de validez de constructo. Conclusión: la escala NEI-VFQ mostró validez sustantiva, de contenido, generalización y estructural, en personas de 40 a 70 años con diagnóstico de glaucoma, catarata y retinopatía(AU)

Objective: to measure the validity of the NEI-VFQ-25 scale construct in a Colombian population with chronic ocular disease. Methods: the diagnostic technology was evaluated through Rasch model. A sample was estimated to guarantee the stability of item gaging. Forty to seventy years-old men and women, with chronic bilateral ocular disease, participated. After informed consent, they were applied the NEI-VFQ-25 scale by phone. Results: two hundred and six persons aged 58.1 years as average, who presented with glaucoma (21.7 percent), cataract (36.9 percent) or some type of retinopathy (35.4 percent). Two items were taken out of the original questionnaire because of differential functioning and four items due to model adjustment. All the questions were then standardized to have three response options, and finally the scale was made up of 17 items which met the validity criteria for construct. Conclusions: NEI-VFQ scale showed substantial, content, generalization and structural validity for application in 40 to 70 years old people with diagnosis of glaucoma, cataract and retinopathy(AU)

Impaired Parenting (00056) in Primiparous Mothers: Clinical Validation through Rasch Analysis / Deterioro parental (00056) en madres primíparas: validación clínica a través del análisis de Rasch / Deficiência na criação em mães primigestas: validação clínica por meio da Análise de Rasch

Introduction: A valid instrument is needed to establish a nursing diagnosis of impaired parenting and to conduct interventions. Objective: The purpose of this study is to validate the nursing diagnosis of impaired parenting using Rasch analysis with primiparous mothers up to24 years of age, during the first year of child rearing, and to compare the results of the clinical validation of that diagnosis using Rasch analysis and Fehring's method to clinically validatenursing diagnosis. Method: This was a cross-sectional study based on Rasch analysis, pursuant to Messick's construct validity guidelines. Results: Twenty-seven items representing 18 parenting-defining characteristics showed content, structural, substantive and generalized validity. Conclusion: Clinically validating nursing diagnosis using Rasch analysis makes it possible to establish dimensional diagnoses with construct validity.

Introducción. Es necesario un instrumento válido que permita establecer el diagnóstico de enfermería Deterioro Parental (00056), y poder realizar intervenciones. Objetivos. -Validar el diagnóstico de enfermería "Deterioro Parental" mediante análisis Rasch en madres primíparas hasta los 24 años de edad, durante el primer año de crianza. -Comparar resultados de la validación clínica del diagnóstico entre el análisis Rasch y el método Fehring de validación clínica. Métodos. Estudio corte transversal. Análisis Rasch, según lineamientos de validación de constructo según Messick. Resultados. Veintisiete ítems que representan 18 características definitorias mostraron validez de contenido, estructural, sustantiva y generalización. Conclusión. Validar clínicamente diagnósticos de enfermería mediante análisis Rasch, permite establecer diagnósticos dimensionales con validez de constructo.

Introdução: é necessário um instrumento válido para ser capaz de estabelecer um diagnóstico de enfermagem da maternidade com deficiência e realizar intervençóes. Objetivo: o objetivo do presente estudo é validar o diagnóstico da enfermagem na criação deficiente por meio da análise de Rasch em primigestas de até 24 anos de idade durante o primeiro ano da criação e para comparar os resultados da validação clínica desse diagnóstico usando a análise de Rasch e o método proposto por Fehring para a validação clínica do diagnóstico de enfermagem. Método: realizou-se um estudo transversal com base na análise de Rasch de acordo com as diretrizes de construto de Messick. Resultados: vinte e sete itens, que representam 18 características definidoras dos pais, mostraram uma validade de conteúdo, estrutural, substantiva e geral. Conclusão: Validar clinicamente diagnósticos de enfermagem por meio da análise de Rasch permite o estabelecimento de diagnósticos dimensionais com validade de construto.

Calidad De Vida En Estudiantes Universitarios. Evaluación De Factores Asociados / Quality of life In college students evaluation of associated factors

Determinar el nivel de calidad de vida en estudiantes universitarios de áreas de la salud y evaluar factores asociados. Métodos: Estudio de corte transversal. Se midieron variables sociodemográficas, nivel de actividad física con el International Physical Activity Questionnaire, dolor con el Formulario de Autoregistro del Dolor y calidad de vida con el Quality of Life Enjoyment and Satisfaction Questionnaire. Modelos de regresión lineal simple y múltiple evaluaron las asociaciones. Resultados: Participaron 237 estudiantes, 37,1% hombres, edad promedio de 20,6 ± 2,2 años. La prevalencia de actividad física vigorosa fue 8,4%, dolor agudo 18,3% y crónico 22,8%; la media de horas semanales de jornada académica 30,9 ± 10,7 horas y la calidad de vida osciló entre 33 y 75 / 100. El dolor agudo (β: -2.6), dolor crónico (β: -3.9) y horas semanales de jornada académica presencial (β: -0.07) se asociaron negativamente con la calidad de vida, solo la actividad física vigorosa fue positiva (β = 5.3). Conclusiones: Los factores evaluados son susceptibles de intervenir. Se requiere la implementación de programas dirigidos al fomento de la actividad física, la recreación y el deporte, como parte de un estilo de vida saludable que contribuya a mejorar la calidad de vida de los estudiantes universitarios...

To determine the level of quality of life in college students health areas and evaluate associated factors. Methods: Cross sectional study. Sociodemographic variables were measured, level of physical activity with the International Physical Activity Questionnaire, pain with Self Registration Form Pain and quality of life with the Quality of Life Enjoyment and Satisfaction Questionnaire. Models of simple and multiple linear regression assessed associations. Results: A total of 237 students, 37.1% male, mean age 20.6 ± 2.2 years. The prevalence of vigorous physical activity was 8.4%, 18.3% acute pain and chronic 22.8%, the average weekly hours of school day 30.9 ± 10.7 hours and quality of life ranged between 33 and 75/100. Acute pain (β:-2.6), chronic pain (β: -3.9) and hours per week of classroom academic day (β:-0.07) were negatively associated with quality of life, only vigorous physical activity was positive (β = 5.3). Conclusions: The factors evaluated are likely to intervene. It requires the implementation of programs aimed at promoting physical activity, recreation and sport, as part of a healthy lifestyle that contributes to improving the quality of life of college students...

Reproducibilidad de pruebas serológicas para el diagnóstico de infección por Trypanosoma cruzi en mujeres embarazadas de una zona endémica de Santander, Colombia / Reproducibility of serological tests for the diagnosis of Trypanosoma cruzi infection in pregnant women in an endemic area of Santander, Colombia

Introducción. El diagnóstico de infección por Trypanosoma cruzi en fase crónica se hace por medio de pruebas serológicas cuya reproducibilidad no está muy documentada. Objetivo. Evaluar la reproducibilidad de las pruebas serológicas ELISA, IFI y HAI para el diagnóstico de infección por T. cruzi en mujeres embarazadas de una zona endémica de Santander. Materiales y métodos. Mediante la evaluación de la tecnología diagnóstica se determinó la reproducibilidad de las pruebas serológicas ELISA, IFI y HAI en muestras de suero y elución sanguínea, seleccionadas mediante muestreo de corte transversal y pertenecientes a mujeres embarazadas de una zona endémica para enfermedad de Chagas en Santander. Se usó el software Stata, versión 10.0, para los análisis estadísticos. La prueba con la mejor reproducibilidad se determinó por medio de la comparación de los índices kappa más altos de cada técnica. Resultados. Se evaluaron 777 sueros y elución sanguíneas. En suero, la prueba ELISA (punto de corte=0,3), la IFI (punto de corte=1/32) y la HAI (punto de corte=1/16) presentaron índices kappa mayores de 0,8 (0,98, IC 95% : 0,93-1,00; 0,98, IC 95% : 0,92-1,00 y 0,88, IC 95% : 0,74-0,97, respectivamente); no se observaron diferencias estadísticamente significativas entre las tres pruebas evaluadas (p>0,05). Para la elución sanguínea, el índice kappa estuvo por debajo de 0,8 (valor kappa más alto: 0,55, IC 95% : 0,41-0,68). Conclusiones. Las tres pruebas serológicas presentaron reproducibilidad perfecta en suero, determinada mediante el índice kappa, por lo que cualquiera de ellas sería útil para establecer el diagnóstico de infección por T. cruzi . Por su simplicidad y su costo, la prueba ELISA se recomienda como prueba de elección para los programas de tamización de esta infección.

Introduction: The diagnosis of chronic Trypanosoma cruzi infection is supported by serological tests whose reproducibility has not been well documented. Objective: To evaluate the reproducibility of the serological tests ELISA, IFAT and IHAT for the diagnosis of T. cruzi infection in pregnant women in an endemic zone in Santander. Materials and methods: Through an evaluation study of diagnostic technologies, the reproducibility of the serological tests ELISA, IFAT and IHAT was determined in serum and eluted blood from pregnant women living in an endemic area for Chagas´ disease in Santander. The samples were selected by cross sectional sampling. The software Stata ™ version 10.0 was used for statistical analysis. By means of the comparison of the highest kappa coefficient of each technique, the test with the best reproducibility was determined. Results: A total of 777 samples were tested. In serum, ELISA (cutoff point: 0.3), IFAT (cutoff point: 1/32) and IHAT (cutoff point: 1/16) had kappa coefficients greater than 0.8 (0.98, 95% CI: 0.93-1.00; 0.98, 95% CI: 0.92-1.00 and 0.88, 95% CI: 0.74-0.97, respectively); no statistically significant differences among the three tests were found (p> 0.05). For the blood eluates, kappa coefficients were below 0.8 (highest kappa: 0.55, 95% CI: 0.41-0.68). Conclusions: For the three serological tests using serum, the reproducibility determined by the kappa coefficient was perfect. Selecting any of them is useful for the diagnosis of T. cruzi infection. Given its simplicity and cost, the ELISA test is recommended for screening for this infection.

[Effectiveness of the nursing interventions for the diagnosis "ineffective management of therapeutic regimen"]. / Eficacia de las intervenciones de enfermería para el diagnóstico "manejo inefectivo del régimen terapéutico".

OBJECTIVE: To evaluate the efficacy of domiciliary nursing interventions in the diagnosis of Ineffective Therapeutic Regimen Management in adults with chronic diseases. METHOD: A controlled clinical trial. We made the evaluation of the labels Treatment Behaviour: Illness or Injury and Knowledge: Treatment Regimen of the Nursing Outcomes Classifications. Participants were randomly assigned into two groups, the experimental group received the interventions recommended in the Nursing Interventions Classifications, and the control group received the usual care from the institution. The labels final results of two groups were compared with analysis of covariance. RESULTS: A difference of 1.1 points was found in the label Treatment Behaviour: Illness or Injury and of 1.5 points in the label Knowledge: Treatment Regimen when we compared the treatment and control group. CONCLUSION: The domiciliary nursing interventions are effective for the nursing diagnosis of Ineffective management of therapeutic regimen in adults with chronic diseases.

[Evaluation of endoscopic visualisation for identifying premalignant gastric lesions in a Columbian population using histopathology as a reference]. / Evaluación de la visualización por endoscopia en la identificación de lesiones gástricas premalignas en una población colombiana con prueba de referencia histopatológica.

AIM: To evaluate the performance of endoscopic visualization in the identification of premalignant gastric lesions, with histopathological examination of biopsy samples as a reference test, in Bucaramanga, Colombia. LOCATION: League for the Fight Against Cancer, Bucaramanga, Colombia. DESIGN: Diagnostic technology evaluation with cross-sectional sampling. MEASUREMENTS: We calculate the sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio (+), likelihood ratio (-), kappa index and the prevalence rate kappa. RESULTS: A total of 155 patients were studied, with a mean age of 45.43 (14.15) years and an approximate male:female ratio of 2:1. The endoscopic visualization had a sensitivity of 87.84%, a specificity of 55.56%, a positive predictive value of 64.36%, a negative predictive value of 83.33%, a likelihood ratio+of 1.98, a likelihood ratio-de 0.22 and a kappa index of 0.4272, in the identification of preneoplastic lesions of the stomach in a population with a disease prevalence of 47.74%. CONCLUSIONS: The endoscopic visualization of the gastrointestinal mucosa, allows a moderate and fast identification of early preneoplastic lesions, providing an opportunity of its early histopathological diagnosis.

Validez de constructo de un instrumento de enfermería para evaluar adherencia al tratamiento antihipertensivo / Construct validity of an instrument to assess patient adherence to antihypertensive treatment

Introducción: En enfermería, arte y la ciencia de cuidar, es importante el uso del proceso de enfermería a través de un lenguaje estandarizado. Por lo tanto, contar con etiquetas de resultados de enfermería validas, aplicadas pre y pos intervención, permite al profesional evaluar y demostrar el impacto de dichas intervenciones. Especialmente, en el manejo de problemas frecuentes en la población adulta como lo es la hipertensión arterial. Objetivo: Determinar la validez de constructo del resultado de enfermería "conducta terapéutica: enfermedad o lesión" (clasificación de resultado CRE 1609) para medir adherencia al tratamiento. Metodología: Se realizó un estudio de evaluación de tecnologías diagnósticas anidado en un estudio de corte transversal poblacional, realizado en el año 2010. Se evaluaron 166 personas con hipertensión arterial de estrato dos y tres de Bucaramanga. Mediante el análisis Rasch, se determinó la validez de constructo del resultado de enfermería "conducta terapéutica: enfermedad o lesión" (CRE 1609) para medir adherencia al tratamiento, tanto farmacológico como no farmacológico. Resultados: el resultado de enfermería es unidimensional, evalúa el constructo "adherencia"; las cinco opciones de respuestas originales se reagruparon en tres, para lograr una adecuada diferenciación en las opciones de respuestas, alcanzando así una buena confiabilidad (0.99) y separación de los ítems (8.90); además, los datos ajustaron al modelo Rasch (valores infit y outfit: >0.6 y <1.4) y los ítems no presentaron comportamiento diferencial por sexo (valor de p >0,05). Conclusión: el resultado de enfermería evaluado es un instrumento apropiado para medir la adherencia pues cuenta con validez de constructo (AU)

Introduction: In nursing, art and science of caring, is important to the use of the nursing process using a standardized language. Therefore, having valid nursing results labels, applied pre and pos intervention, allows the professional to evaluate and demonstrate the impact of such interventions. Especially in the management of common problems in the adult population such as high blood pressure. Objective: Determine the construct validity of the result of nursing "therapeutic conduct: illness or injury" (classification of result NOC 1609) to measure adherence to treatment. Methodology: Study of evaluation of diagnostic technologies nested in cross-sectional population study, carried out in the year 2010. 166 People with hypertension of stratum two and three of Bucaramanga were assessed. The construct validity of the result of nursing "therapeutic conduct: illness or injury" (NOC 1609) to measure adherence to treatment both pharmacological and non-pharmacological was determine using Rasch analysis. Results: The nursing outcome is one-dimensional, it assesses the construct 'adherence'; the five original answers options regrouped in three, to achieve adequate differentiation in the options of answers, thus reaching a good reliability (0.99) and separation of the items (8.90); In addition, data adjusted to the Rasch model (values infit and outfit: > 0.6 and <1.4) and there was no differential behavior by sex (P> 0.05). Conclusion: The result of nursing evaluated is an appropriate instrument to measure the adhesion because it has construct validity (AU)

Accuracy of physical examination in the detection of arteriovenous graft stenosis.

Physical examination has recently been demonstrated to detect vascular access stenosis in patients with arteriovenous fistulae. However, its accuracy in the identification of stenoses when compared with the gold standard (angiography) in patients with arteriovenous grafts has not been studied in a systematic fashion. We conducted a prospective study to examine the accuracy of physical examination in the detection of stenotic lesions when compared with angiography. Forty-three consecutive cases referred for an arteriovenous graft dysfunction were included in this analysis. Preprocedure physical examination was performed. The findings of the examination and diagnosis were recorded and secured in a sealed envelope. Angiography from the feeding artery to the right atrium was performed. The images were reviewed by an independent interventionalist with expertise in endovascular dialysis access procedures and the diagnosis was rendered. The reviewer was blinded to the physical examination. Cohen's Kappa was used as a measurement of the level of agreement beyond chance between the diagnosis made by physical examination and angiography. There was a strong agreement between the physical examination and the angiography in the diagnosis of vein-graft anastomotic stenosis (kappa = 0.52). The sensitivity and specificity for this lesion was 57% and 89%, respectively. There was a moderate agreement beyond chance regarding the diagnosis of intragraft (kappa = 0.43) and inflow stenoses (kappa = 0.40). The sensitivity and specificity for the intragraft and inflow stenosis was 100%, 73% and 33%, 73%; respectively. The findings of this study demonstrate that physical examination can assist in the detection and localization of stenoses in arteriovenous grafts.

Factores asociados con la irregularidad de la ingesta de Dapsona en pacientes con lepra: Dapsona en pacientes con lepra / Associated factors with irregular intake of Dapsone in leprosy patients

Introducción: Conocer los factores asociados al cumplimiento del tratamiento en pacientes con lepra, es muy importante para prevenir la resistencia del Mycobacterium leprae y garantizar la cura bacteriológica de estas personas. La prueba de orina para Dapsona, presente en el régimen autoadministrado, es un método sencillo para establecer la regularidad del tratamiento. Objetivo: Explorar los factores asociados a la irregularidad de la ingesta del tratamiento antileproso. Métodos: Estudio de corte transversal de los enfermos que recibieron tratamiento antileproso en un centro dermatológico. La irregularidad se estableció con la prueba de dapsonuria. Se consideró irregular el que presentó la prueba negativa. Las variables sospechosas de influir en la irregularidad se analizaron con regresión logística exacta. Resultados: En el modelo final del análisis multivariado se encontraron cinco variables asociadas, entre éstas sobresalen como factores de riesgo, la ausencia de discapacidad, OR 28.56 (IC90% 1.2-2.1) y la entrega de tratamiento para tiempos mayores a un mes, por cada mes OR 3.41 (IC90% 1.4-9.2) y como factor protector, la aceptación familiar de la enfermedad OR 0.008 (IC90% 0.001-0.24). Conclusión: Aunque es posible que el pequeño tamaño de muestra no haya permitido detectar algunos factores de riesgo informados en otras investigaciones, la mayoría de esos estudios no han realizado análisis multivariado por lo cual es posible que muchos de los factores informados en la literatura no tengan importancia. Salud UIS 2013; 45 (1): 7-14.

Introducción: To know the associated factors in the treatment compliance of leprosy patients is very important to prevent the appearance of Mycobacterium leprae resistance and achieve the bacteriological cure of these persons. The urine test for Dapsone, present in the self administered regimens, is a simple method to establish the regularity. Objective: To explore the factors associated with irregular intake of leprosy treatment. Methods: Cross sectional study of patients receiving leprosy treatment in a dermatology center. The irregularity was established with the dapsonuria test. It was considered irregular the patient with a negative dapsonuria test. Variables suspected of influencing the irregular intake were analyzed using exact logistic regression. Results: In the final multivariate model there were five associated variables, among which, the absence of disability OR 28.56( CI90% 1.2-2.1) and the provision of treatment for more than a month OR 3.41 (CI 90% 1.4-9.2) stand out as risk factors and as a protective factor, family acceptance of the disease OR 0.008 (CI 90% 0.001-0.24). Conclusion: Although it is possible that the small sample size did not allow to detect some risk factors reported in other investigations, most of those studies did not use a multivariate analysis, so it is possible too, that many of the factors reported in literature are irrelevant. Salud UIS 2013; 45 (1): 7-14.

Prevalencia de diagnósticos de enfermería en personas con VIH/SIDA / Prevalence of nursing diagnoses in people with HIV/AIDS

Introducción: La infección por el Virus de la Inmunodeficiencia Humana y el Síndrome de Inmunodeficiencia Adquirida se ha convertido en un problema de salud pública, es por ello que el cuidado de enfermería de las personas con esta enfermedad debe estar dirigido a los problemas reales y potenciales más frecuentes y prioritarios. Objetivo: Determinar la prevalencia de los diagnósticos de enfermería en personas con VIH/SIDA que reciben atención ambulatoria en instituciones de salud de Bucaramanga, Colombia. Métodos: Se realizó un estudio de corte transversal en adultos con VIH/SIDA que recibían atención ambulatoria en algunas instituciones de salud de Bucaramanga. Resultados: Se encontraron prevalencias para 79 diagnósticos, con un mínimo de 4 y un máximo de 46 diagnósticos por persona. Seis diagnósticos presentaron una prevalencia mayor del 50%, que fueron: riesgo de infección y riesgo de lesión con 98,9%, seguido por protección inefectiva con 96,7%, riesgo de deterioro de la integridad cutánea con 95,6%, deterioro del patrón del sueño con 57,1% y sedentarismo con 53,8%. Conclusiones: Esta investigación es una propuesta para que enfermería estandarice la atención brindada y sus planes de cuidado en las personas que viven con VIH/SIDA basándose en el proceso de enfermería y en el uso de lenguaje estandarizado. Se hace imperativa la necesidad de investigación en esta área con estudios sobre los diagnósticos más prevalentes (AU)

Introduction: Infection with Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome has become a public health problem, so the nursing care of people with this disease should be directed to the real problems and to the most common and main potentials. Objective: To determine the prevalence of nursing diagnoses in people with HIV / AIDS receiving outpatient care in health institutions in Bucaramanga, Colombia. Methods: A cross-sectional study in adults with HIV / AIDS who were receiving outpatient care in some health institutions in Bucaramanga. Results: Prevalences were found for 79 diagnoses, with a minimum of 4 and a maximum of 46 diagnoses per person. Six diagnoses had a prevalence greater than 50%, which were risk of infection and risk of injury with 98.9%, followed by ineffective protection with 96.7%, risk of impaired skin integrity with 95.6%, impaired sleep pattern 57.1% and 53.8% sedentary lifestyle. Conclusions: This research is a proposal to standardize the care provided nursing and care plans for people living with HIV / AIDS based on the nursing process and the use of standardized language. It is imperative the necessity for research in this area with studies of high prevalence (AU)

Accuracy of physical examination in the detection of arteriovenous fistula stenosis.

BACKGROUND AND OBJECTIVES: Physical examination has been highlighted to detect vascular access stenosis; however, its accuracy in the identification of stenoses when compared with the gold standard (angiography) has not been validated in a systematic manner. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A prospective study was conducted of 142 consecutive patients who were referred for an arteriovenous fistula dysfunction to examine the accuracy of physical examination in the detection of stenotic lesions when compared with angiography. The findings of a preprocedure physical examination and diagnosis were recorded and secured in a sealed envelope. Angiography from the feeding artery to the right atrium was then performed. The images were reviewed by an independent interventionalist who had expertise in endovascular dialysis access procedures and was blinded to the physical examination, and the diagnosis was rendered. Cohen's kappa was used as a measurement of the level of agreement beyond chance between the diagnosis made by physical examination and angiography. RESULTS: There was strong agreement between physical examination and angiography in the diagnosis of outflow (agreement 89.4%, kappa = 0.78) and inflow stenosis (agreement 79.6%, kappa = 0.55). The sensitivity and specificity for the outflow and inflow stenosis were 92 and 86% and 85 and 71%, respectively. There was strong agreement beyond chance regarding the diagnosis of coexisting inflow-outflow lesions between physical examination and angiography (agreement 79%, kappa = 0.54). CONCLUSIONS: The findings of this study demonstrate that physical examination can accurately detect and localize stenoses in a great majority of arteriovenous fistulas.

Bullying en adolescentes escolarizados: validación del diagnóstico de enfermería riesgo de violencia dirigida a otros / Bullying among adolescent attending school: validation of the nursing diagnosis risk of violence directed to others / Bullying em adolescentes escolarizados: validação do diagnóstico de enfermagem riesgo de violência dirigida a outros

La adolescencia es una etapa en la cual surgen una serie de cambios físicos, psicológicos y sociales, que contribuyen a la formación de la personalidad; la manera en que los adolescentes afrontan estos cambios se ve reflejada en los comportamientos de permisibilidad y violencia que ellos exteriorizan ante las diversas situaciones de la vida cotidiana. Objetivo: validar el diagnóstico de enfermería “riesgo de violencia dirigida a otros”, en adolescentes escolarizados. Método: estudio de corte transversal, donde la población eran adolescentes de una institución media educativa del municipio de Rionegro (Santander, Colombia). La variable principal fue “riesgo de violencia dirigida a otros”, la recolección de la información se hizo por medio de un instrumento de valoración de tamizaje del adolescente escolarizado. La validez clínica del diagnóstico, se realizó mediante análisis de factores y análisis Rasch. Resultados: la población conformada por 300 adolescentes, la mediana de edad fue de 14 años, el 58,67% correspondió al género femenino. Los ítems que ajustaron al modelo de análisis Rasch se encuentran con un INFIT que oscila entre 0,85 el menor y 1,24 el mayor, y el OUTFIT que oscila entre 0,65 el menor y 1,77 el mayor. Muestra que las mujeres son más agresoras que los varones, con una media de 1,53 de riesgo de violencia para las mujeres y una media de 1,03 para los hombres, con una probabilidad p=0,0006. Conclusión: validar clínicamente los diagnósticos de enfermería, aporta a la evidencia y el crecimiento de la profesión como ciencia del cuidado.

La adolescencia es una etapa en la cual surgen una serie de cambios físicos, psicológicos y sociales, que contribuyen a la formación de la personalidad; la manera en que los adolescentes afrontan estos cambios se ve reflejada en los comportamientos de permisibilidad y violencia que ellos exteriorizan ante las diversas situaciones de la vida cotidiana. Objetivo: validar el diagnóstico de enfermería “riesgo de violencia dirigida a otros”, en adolescentes escolarizados. Método: estudio de corte transversal, donde la población eran adolescentes de una institución media educativa del municipio de Rionegro (Santander, Colombia). La variable principal fue “riesgo de violencia dirigida a otros”, la recolección de la información se hizo por medio de un instrumento de valoración de tamizaje del adolescente escolarizado. La validez clínica del diagnóstico, se realizó mediante análisis de factores y análisis Rasch. Resultados: la población conformada por 300 adolescentes, la mediana de edad fue de 14 años, el 58,67% correspondió al género femenino. Los ítems que ajustaron al modelo de análisis Rasch se encuentran con un INFIT que oscila entre 0,85 el menor y 1,24 el mayor, y el OUTFIT que oscila entre 0,65 el menor y 1,77 el mayor. Muestra que las mujeres son más agresoras que los varones, con una media de 1,53 de riesgo de violencia para las mujeres y una media de 1,03 para los hombres, con una probabilidad p=0,0006. Conclusión: validar clínicamente los diagnósticos de enfermería, aporta a la evidencia y el crecimiento de la profesión como ciencia del cuidado.

A adolescência é uma etapa na qual surge uma serie de câmbios físicos, psicológicos e sociais, que contribuem à formação da personalidade; a maneira em que os adolescentes afrontam estes câmbios se vê refletida nos comportamentos de permissibilidade e violência que eles exteriorizam ante as diversas situações da vida cotidiana. Objetivo: validar o diagnostico de enfermaria “riscos de violência dirigida a outros”, em adolescentes escolarizados. Métodos: pesquisa de corte transversal, onde a povoação era adolescente duma instituição de escola de ensino médio do município de Rionegro (Santander, Colombia). A variável principal foi “risco de violência dirigida a outros”, a colheita da informação se fez por meio dum instrumento de valoração de seleção de adolescentes escolarizados. A validez clinica do diagnostico, realizou se mediante analise de fatores e analise Rasch. Resultados: A povoação conformada por 300 adolescentes, a mediana idade foi de 14 anos, o 58,67% correspondeu ao gênero feminino. Os itens que ajustaram o modelo de analise Rasch encontram se com um INFIT que oscila entre 0,85 o menor e 1,24 o maior, e o OUTFIT que oscila entre 0,65 o menor e 1,77 o maior. Mostra que as mulheres são mais agressoras que os varões, com uma meia de 1,53 de risco de violência para as mulheres e uma meia de 1,03 para os homens, com uma probabilidade p=0,0006. Conclusão: validar clinicamente os diagnósticos de enfermagem, aporta à evidencia e o crescimento da profissão como ciência do cuidado.

Eficacia de la intervención enfermera para cuidadores con cansancio del rol del cuidador / Effectiveness of nurse intervention in the case of carers wearing of its role

Introducción: El cuidado familiar de personas con enfermedad crónica ha emergido durante los últimos años como un importante problema social, generando cambios en las familias, donde se destaca la figura del cuidador principal quien es la persona familiar o cercana que se ocupa de brindar de forma prioritaria apoyo tanto físico como emocional a otro de manera permanente y comprometida el cual se convierte en un enfermo secundario ya que se ve expuesto a una elevada carga física y psíquica. Objetivo: determinar la eficacia de la intervención de enfermería apoyo al cuidador principal en cuidadores de enfermos crónicos con diagnóstico de enfermería cansancio del rol del cuidador. Métodos: Se realizó un ensayo clínico controlado, aleatorio, doblemente enmascarado. La población objeto fueron cuidadores principales de personas con enfermedades crónicas que recibieron atención en el Hospital Universitario de Santander; el tamaño de la muestra fue de 30 personas, los cuales fueron asignados aleatoriamente por bloques, y de los cuales 10 cuidadores fueron para el grupo intervenido y 20 para el grupo no intervenido, el análisis de datos se realizó por medio del análisis de covarianza y el número necesario para tratar. Resultados: se encontró un efecto de 0.5, estadísticamente significativo, en la etiqueta de resultado bienestar del cuidador al comparar el grupo control con el grupo intervenido y a favor de este último. Conclusiones: la intervención de enfermería realizada es eficaz para el diagnóstico de enfermería cansancio del rol del cuidador y tienen un importante impacto, demostrando que se obtienen resultados positivos cuando se aplican en un solo individuo(AU)

Introduction: The family care of persons presenting with a chronic disease appeared over past years as an important social problem leading to changes in families, where the role of the main carers is notable who is a family member or a relative offering in a priority way a permanent and involved a physical or emotional support to another person who became a secondary patient since is exposed to a high physical and psychic burden. Objective: To determine the effectiveness of nursing intervention related to the support to the main patient's carers wearing of its role. Methods: A double-blind, randomized, controlled and clinical trial of persons presenting with chronic diseases treated and cared in the University Hospital of Santander, Spain; sample included 30 persons who were random allocated to by blocks where 10 carers were in the intervention group and 20 for the non-intervention group; data analysis was made by covariance method and the number necessary to be treated. Results: There was an statistically significant effect of 0,5 in the result of carer wellbeing label comparing the control group with the intervention group one favoring this latter. Conclusions: The disease intervention carried out is effective for nursing diagnosis related to the role of a tired carer with an important impact, demonstrating that it is possible to achieve positive results when it is applied in an only subject(AU)

Gradiente dosis respuesta de las intervenciones de enfermería para el control del temor en gestantes / Dose-response gradient nursing interventions for the control of fear in pregnant women

Objetivo: Determinar el gradiente dosis- respuesta de las intervenciones de enfermería para el control del temor en gestantes. Método: Ensayo clínico controlado. Se realizó valoración inicial y medición de la etiqueta "control del temor" de la Clasificación de Resultados de Enfermería a mujeres embarazadas que asistieron a control prenatal; se conformaron tres grupos de los cuales dos grupos experimentales recibieron a nivel domiciliario las intervenciones recomendadas por la Clasificación de Intervenciones de Enfermería y el grupo control recibió los cuidados habituales de la institución. Se hizo una evaluación final para posterior análisis comparativo por covarianza. Resultados: el promedio del aumento para el grupo 1 con dos sesiones fue de 0.52 y para el grupo 2 con tres sesiones fue de 0.85 en la etiqueta control del temor. Conclusión: Las intervenciones de enfermería son eficaces para el control del temor en gestantes y a mayor número de sesiones de intervención son mejores los resultados(AU)

Objective: to determine the dose-response gradient nursing interventions for the control of fear in pregnant women. Methods: Controlled clinical trial. Initial assessment was performed and measures the label ¨fear control¨ of the Nursing Outcomes Classification pregnant women attending antenatal three groups were formed including two experimental groups received household level interventions recommended by the Classification Nursing Interventions and the control group received usual care from the institution. A final evaluation further comparative analysis of covariance. Results: The average increase in group 1 with two sessions was 0.52 and for the group 2 with three sessions was 0.85 on the label control of fear. Conclusion: The nursing intervention sessions are better the results(AU)

Aportes fisiológicos a la validez de criterio y constructo del diagnóstico de ansiedad según entrevista psiquiátrica y el State-Trait Anxiety Inventory (STAI) en una muestra de estudiantes universitarios colombianos / Physiological contributions to the validity of criterion and construct of the diagnosis of anxiety according to the psychiatric structured interview and the state-trait anxiety inventory (STAI) in a sample of Colombian university students

Introducción: Los trastornos de ansiedad son los más prevalentes en la población colombiana, según el último estudio de salud mental realizado en el país. Constituyen cuadros con manifestaciones cognitivas, emocionales y fisiológicas, cuyo diagnóstico se realiza con una gran variedad de herramientas. Método: A fin de contribuir a la validez de criterio y de constructo del diagnóstico de ansiedad en enfermería, según las características definitorias de la North American Nursing Diagnosis Association (NANDA), se aplicó el instrumento STAI Rasgo y Estado (State-Trait Anxiety Inventory), la entrevista psiquiátrica estructurada para los trastornos del eje I del DSM-IVR (SCID-I) y la evaluación de respuestas fisiológicas inducidas en 69 estudiantes universitarios. Resultados: La clasificación diagnóstica de ansiedad con criterios psiquiátricos evidenció respuestas fisiológicas inducidas por la aplicación de los cuestionarios del STAI y de la NANDA, coherentes con estados de activación fisiológica sugestivos de preparación frente a potenciales amenazas. Las respuestas fisiológicas encontradas pueden considerarse un elemento de criterio adicional y complementario al diagnóstico. Conclusión: Al no encontrar que las respuestas fisiológicas discriminaran significativamente los niveles de estado o rasgo de ansiedad por medio de la clasificación del STAI, en las condiciones del presente estudio, estos parámetros no deben ser considerados dentro de su validez de criterio o constructo...

Introduction: Anxiety disorders are the most prevalent disorders in the Colombian population, according to the latest study carried out in the country; these disorders present cognitive, emotional and physiological manifestations which are diagnosed using a variety of tools. Materials and Methods: The present study aims to contribute to the validity of criterion and construct of the diagnosis of anxiety in Nursing, according to the characteristics of NANDA, by the application of the State-Trait Anxiety Inventory, the psychiatric structured interview for disorders of axis I of DSM-IVR (SCID-I) and the evaluation of induced physiological responses in 69 university students. Results and Conclusions: The results led to the conclusion that the diagnostic classification of anxiety with psychiatric criteria demonstrated physiological responses induced by the application of the STAI and NANDA, coherent with states of physiological activation suggestive of preparation for potential threats. The physiological response may be considered an additional and complementary criterion to the diagnosis. We did not find that the physiological response discriminated significantly the levels of state or trait anxiety according to the STAI, in the conditions of the present study. Thus, these parameters should not be considered for the validity of criterion or construct...