Elaboración de un cuestionario de detección de casos de violencia de odio en urgencias hospitalarias / Preparation of a questionnaire to detect cases of hate violence in emergency rooms

OBJETIVO: En el marco del proyecto SIVIVO se propuso la elaboración de una herramienta que facilitase la detección, el registro y la descripción de casos de violencia de odio y sus consecuencias sobre la salud. MÉTODO: Se utilizó el método Delphi a dos vueltas con personas expertas pertenecientes a los ámbitos clínico-asistencial, salud pública, investigación epidemiológica, académico, administración y organizaciones no gubernamentales para evaluar la pertinencia de diferentes ítems mediante una escala Likert de 1 a 5, y los resultados se presentan como medianas y coeficientes de variación. RESULTADOS: Las preguntas mejor valoradas, con puntaciones ≥4, y que componen la versión final del cuestionario, son las relativas a las características sociodemográficas de la víctima, el tipo de lesiones, la descripción del incidente, las motivaciones percibidas por la persona agredida, posibles evidencias de odio, la intención de denunciar y la percepción del personal sanitario del motivo de la agresión. El pilotaje mostró la adecuación de las preguntas finalmente seleccionadas. CONCLUSIONES: La incorporación sistemática de esta herramienta puede ayudar a conocer la magnitud y las características de la violencia de odio y su repercusión en la salud. Esta información permitiría elaborar estrategias de prevención e intervención dirigidas, especialmente, a los sectores de población más expuestos a este tipo de violencia

OBJECTIVE: In the context of the SIVIVO project, the development of a tool to facilitate the detection, recording and description of cases of hate violence and its consequences on health was proposed. METHOD: A two-round Delphi method was used with experts from clinical-care, public health, epidemiological, academic, administration and non-governmental organizations to assess the relevance of different items using a Likert scale, presenting the results with medians and coefficients of variation. RESULTS: The best evaluated questions, with scores equal to or greater than 4, and which make up the final version of the questionnaire are the relative socio-demographic characteristics of the victim, the injuries, description of the incident, the motivations perceived by the aggrieved person, possible evidence of hatred, the intention to denounce and the perception of the health personnel of the motive for the aggression. The piloting showed the adequacy of the questions that were finally selected. CONCLUSIONS: The systematic incorporation of this tool can help us to learn the magnitude and characteristics of hate violence and its impact on health. This information would allow the elaboration of prevention and intervention strategies aimed, specifically, at the sectors of the population most exposed to this type of violence

[Preparation of a questionnaire to detect cases of hate violence in emergency rooms]. / Elaboración de un cuestionario de detección de casos de violencia de odio en urgencias hospitalarias.

OBJECTIVE: In the context of the SIVIVO project, the development of a tool to facilitate the detection, recording and description of cases of hate violence and its consequences on health was proposed. METHOD: A two-round Delphi method was used with experts from clinical-care, public health, epidemiological, academic, administration and non-governmental organizations to assess the relevance of different items using a Likert scale, presenting the results with medians and coefficients of variation. RESULTS: The best evaluated questions, with scores equal to or greater than 4, and which make up the final version of the questionnaire are the relative socio-demographic characteristics of the victim, the injuries, description of the incident, the motivations perceived by the aggrieved person, possible evidence of hatred, the intention to denounce and the perception of the health personnel of the motive for the aggression. The piloting showed the adequacy of the questions that were finally selected. CONCLUSIONS: The systematic incorporation of this tool can help us to learn the magnitude and characteristics of hate violence and its impact on health. This information would allow the elaboration of prevention and intervention strategies aimed, specifically, at the sectors of the population most exposed to this type of violence.

[Acute intermittent porphyria and chronic transaminase elevation]. / Porfiria aguda intermitente y elevación crónica de las transaminasas.

Acute intermittent porphyria is an autosomal dominant inherited disorder resulting from a deficiency of porphobilinogen deaminase activity, the third enzyme in the heme biosynthesis pathway. This disease is uncommon, although the prevalence is higher in asymptomatic heterozygotic carriers; however, this prevalence is difficult to establish because of the absence of symptoms. Although acute intermittent porphyria is a multisystemic disease, its most common form of presentation is abdominal pain and neurological or mental symptoms, which can sometimes be due to precipitating factors such as reduced energy intake, smoking, alcohol, some drugs, and stress. Diagnosis can be made by testing urinary porphobilinogen levels, with subsequent measurement of enzyme activity and DNA testing. Treatment is based on prevention of porphyria attacks by avoiding precipitating factors and early administration of intravenous glucose or hemin therapy. We present the case of a patient diagnosed with acute intermittent porphyria based on study of chronic mild alanine aminotransferase (ALT) elevation.

Porfiria aguda intermitente y elevación crónica de las transaminasas / Acute intermittent porphyria and chronic transaminase elevation

La porfiria aguda intermitente es un trastorno hereditario autosómico dominante producido por un déficit en la actividad enzimática de la porfobilinógeno deaminasa, la tercera enzima en la síntesis del hemo. Se trata de una enfermedad rara, aunque los portadores heterocigotos asintomáticos tienen una prevalencia mayor, difícil de establecer dada la ausencia de clínica. Aunque la porfiria aguda intermitente es una enfermedad multisistémica, su presentación más frecuente es el dolor abdominal y los síntomas neurológicos o psiquiátricos, a veces debidos a algunos factores precipitantes, como la baja ingesta energética, el tabaco, el alcohol, algunos fármacos y el estrés. El diagnóstico se puede realizar midiendo el nivel de porfobilinógeno urinario, con posterior análisis de la actividad de la enzima defectuosa y estudio del ADN. El tratamiento se basa en la prevención de los ataques de porfiria, evitando los factores desencadenantes, y en la administración precoz de glucosa i.v. o tratamiento con hematina. Presentamos el caso de una paciente diagnosticada de porfiria aguda intermitente a partir del estudio de una elevación crónica leve de la GPT

Acute intermittent porphyria is an autosomal dominant inherited disorder resulting from a deficiency of porphobilinogen deaminase activity, the third enzyme in the heme biosynthesis pathway. This disease is uncommon, although the prevalence is higher in asymptomatic heterozygotic carriers; however, this prevalence is difficult to establish because of the absence of symptoms. Although acute intermittent porphyria is a multisystemic disease, its most common form of presentation is abdominal pain and neurological or mental symptoms, which can sometimes be due to precipitating factors such as reduced energy intake, smoking, alcohol, some drugs, and stress. Diagnosis can be made by testing urinary porphobilinogen levels, with subsequent measurement of enzyme activity and DNA testing. Treatment is based on prevention of porphyria attacks by avoiding precipitating factors and early administration of intravenous glucose or hemin therapy. We present the case of a patient diagnosed with acute intermittent porphyria based on study of chronic mild alanine aminotransferase (ALT) elevation