Integrated Network Analysis of Symptom Clusters Across Monkeypox Epidemics From 1970 to 2023: Systematic Review and Meta-Analysis.

BACKGROUND: The worldwide spread of monkeypox (mpox) has witnessed a significant increase, particularly in nonendemic countries. OBJECTIVE: We aimed to investigate the changing clinical symptoms associated with mpox from 1970 to 2023 and explore their interrelations. METHODS: In this systematic review and meta-analysis, 3 electronic databases were searched for English peer-reviewed studies conducted from January 1970 to April 2023 that reported any symptoms among confirmed mpox cases. We categorized the mpox epidemics into 3 periods: 1970-2002 (period 1, within the African region), 2003-2021(period 2, epidemics outside Africa), and 2022-2023 (period 3, worldwide outbreak). Following PRISMA guidelines, a meta-analysis was performed to estimate the pooled prevalence for each symptom. The correlation among symptoms was analyzed and visualized using network analysis. RESULTS: The meta-analysis included 61 studies that reported 21 symptoms in 720 patients from period 1, 39 symptoms in 1756 patients from period 2, and 37 symptoms in 12,277 patients from period 3. The most common symptom among patients from all 3 periods was rash (period 1: 92.6%, 95% CI 78.2%-100%; period 2: 100%, 95% CI 99.9%-100%; and period 3: 94.8%, 95% CI 90.9%-98.8%), followed by lymphadenopathy (period 1: 59.8%, 95% CI 50.3%-69.2%; period 2: 74.1%, 95% CI 64.2%-84.1%; and period 3: 61.1%, 95% CI 54.2%-68.1%). Fever (99%, 95% CI 97%-100%), enlarged lymph nodes (80.5%, 95% CI 75.4%-85.0%), and headache (69.1%, 95% CI 4%-100%) were the main symptoms in period 1, with a significant decrease in period 3: 37.9%, 31.2%, and 28.7%, respectively. Chills/rigors (73.3%, 95% CI 60.9%-85.7%), fatigue (68.2%, 95% CI 51.6%-84.8%), and dysphagia/swallowing difficulty (61.2%, 95% CI 10.5%-100%) emerged as primary new symptoms in period 2 and decreased significantly in period 3. Most other symptoms remained unchanged or decreased in period 3 compared to the former 2 periods. Nausea/vomiting had the highest degree of correlation (with 13 symptoms) and was highly positively correlated with lymphadenopathy (r=0.908) and conjunctivitis (r=0.900) in period 2. In contrast, rash and headache were 2 symptoms with the highest degree of correlation (with 21 and 21 symptoms, respectively) in period 3 and were highly positively correlated with fever (r=0.918 and 0.789, respectively). CONCLUSIONS: The manifestation of symptoms in patients with mpox has become more diverse, leading to an increase in their correlation. Although the prevalence of rash remains steady, other symptoms have decreased. It is necessary to surveil the evolving nature of mpox and the consequential changes in clinical characteristics. Epidemic countries may shift their focus on the potential association among symptoms and the high synergy risk. TRIAL REGISTRATION: PROSPERO Registration: CRD42023403282; http://tinyurl.com/yruuas5n.

Symptom content analysis of OSA questionnaires: time to identify and improve relevance of diversity of OSA symptoms?

STUDY OBJECTIVES: Obstructive sleep apnea (OSA) is a heterogeneous condition covering many clinical phenotypes in terms of the diversity of symptoms. Patient-based OSA screening questionnaires used in routine practice contain significantly varying contents that can impact the reliability and validity of the screening. We investigated to what extent common patient-based OSA screening questionnaires differ or overlap in their item content by conducting a rigorous, methodical, and quantified content overlap analysis. METHODS: We conducted an item content analysis of 11 OSA screening questionnaires validated in adult populations and characterized their overlap using a 4-step approach: (1) selection of OSA screening questionnaires, (2) item extraction and selection, (3) extraction of symptoms from items, and (4) assessment of content overlap with the Jaccard index (from 0, no overlap, to 1, full overlap). RESULTS: We extracted 72 items that provided 25 distinct symptoms from 11 selected OSA questionnaires. The overlap between them was weak (mean Jaccard index: 0.224; ranging from 0.138 to 0.329). All questionnaires contained symptoms of the "OSA symptom" dimension (eg, snoring or witnessed apneas). The STOP-BANG (0.329) and the Berlin (0.280) questionnaires exhibited the highest overlap content. Ten symptoms (40%) were investigated in only 1 questionnaire. CONCLUSIONS: The heterogeneity of content and the low overlap across these questionnaires reflect the challenges of screening OSA. The different OSA questionnaires potentially capture varying aspects of the disorder, with the risk of biased results in studies. Suggestions are made for better OSA screening and refinement of clinical OSA phenotypes. CITATION: Gauld C, Baillieul S, Martin VP, et al. Symptom content analysis of OSA questionnaires: time to identify and improve relevance of diversity of OSA symptoms? J Clin Sleep Med. 2024;20(7):1105-1117.

Definiciones conceptuales y operacionales de los indicadores del resultado Control de síntomas para pacientes con insuficiencia cardíaca en cuidados paliativos / Conceptual and operational definitions for the indicators of the nursing outcome classification: Symptom control in patients with heart failure in palliative care

OBJETIVO: Validar las definiciones conceptuales y operacionales de los indicadores de Control de síntomas (1608) para pacientes con enfermedades cardíacas en cuidados paliativos. MÉTODO: Las definiciones fueron establecidas por medio de revisión bibliográfica y fueron validadas por consenso entre enfermeros expertos. Se realizaron 2rondas de la metodología Delphi y un encuentro con expertos con el propósito de validar las definiciones de los indicadores y de la magnitud de respuesta para cada indicador. RESULTADOS: Las definiciones conceptuales y operacionales para los indicadores de Control de síntomas (1608) y para la magnitud de respuesta de cada indicador fueron validadas. CONCLUSIONES: Todas las definiciones conceptuales y operacionales de los 11 indicadores del resultado de enfermería Control de síntomas (1608) fueron validados por expertos. Se necesitan estudios de validación de contenido y clínica de este resultado de enfermería para verificar la capacidad de estos indicadores en medir la efectividad de las intervenciones de enfermería en la práctica clínica y pesquisa

OBJECTIVE: To validate conceptual and operational definitions of Symptom control (1608) indicators for patients with cardiac diseases in palliative care. METHOD: Definitions were established through a literature review and were validated by consensus among expert nurses. Two rounds of the Delphi method and a meeting with experts were carried out in order to validate the definitions for the indicators and for the magnitude of response for each indicator. RESULTS: Conceptual and operational definitions for Symptom control (1608) indicators and for the magnitude of response for each indicator were validated. CONCLUSIONS: All conceptual and operational definitions of 11 indicators of the nursing outcome Symptom control (1608) were validated by experts. Content and clinical validation studies remain necessary to verify the capacity of the indicators to measure the effectiveness of nursing interventions in clinical practice and research

Síndrome coronario agudo en mujeres desde la teoría del manejo del síntoma / Acute coronary syndrome in women from the theory of symptom management

OBJETIVO: Identificar los factores de riesgo para enfermedad cardiovascular y la experiencia del síntoma del Síndrome Coronario Agudo en las mujeres, según la teoría del Manejo del Síntoma. MÉTODO: Estudio observacional de corte transversal, participaron 81 mujeres con SCA atendidas en un Hospital Universitario en Colombia. Se analizaron variables sociodemográficas, factores de riesgo para enfermedad cardiovascular, acciones de respuesta ante los síntomas y la percepción, evaluaciòn y respuesta al síntoma a través de la aplicación del instrumento sobre la Experiencia del Síntoma en la Mujer con SCA. RESULTADOS: De los participantes el 80% superaron los 60 años de edad, en su mayoría con un nivel bajo de escolaridad y residencia urbana. El principal factor de riesgo fue la HTA y más del 50% referían sedentarismo, dislipidemia y dieta malsana. Las mujeres presentaron en promedio 10 síntomas atípicos por cada evento, destacándose el dolor o molestia en el pecho en un 85%. El 66,3 % definieron el origen del síntoma como un problema extracardíaco y 4 de cada 10 pacientes consideró las manifestaciones como insignificantes. El 16% tomó remedios caseros y el 25% esperaron que pasara la sintomatología sin buscar atención profesional. La relación entre el tiempo en asistir a consulta médica e ignorar los síntomas, presentó significancia estadística (p = 0,000). CONCLUSIONES: Las mujeres con SCA presentaron diversidad de síntomas, no percibieron la gravedad de sus manifestaciones y, por lo general, respondieron tardíamente ante los síntomas, factor relevante para la atención y tratamiento oportuno

OBJECTIVE: To identify the risk factors for cardiovascular disease and the experience of the symptom of Acute Coronary Syndrome (ACS) in women, according to the theory of Symptom Management. METHOD: Observational cross-sectional study, 81 women with ACS attended at a University Hospital in Colombia participated. Sociodemographic variables, risk factors for cardiovascular disease, response actions to symptoms and perception, evaluation and response to symptoms were analyzed through the instrument application on the Experience of the Symptom in Women with ACS. RESULTS: Of participants 80% were over 60 years old, the majority with a low level of education and urban residence. The main risk factor was hypertension and more than 50% of them reported sedentary lifestyle, dyslipidemia, and an unhealthy diet. Women presented an average of 10 atypical symptoms for each event, highlighting chest pain or discomfort in 85%. 66.3% defined the origin of the symptom as an extra-cardiac conditions and 4 out of 10 patients considered the manifestations as insignificant. 16% of the participants took home remedies and 25% of them waited the symptoms to improve without request professional attention. The relationship between time in attending medical consultation and ignoring the symptoms presents statistical significance (p = 0.000). CONCLUSIONS: Women with ACS presented a variety of symptoms, do not perceive the severity of its manifestations, and generally respond late to symptoms, a relevant factor for timely care and treatment

Características clínicas y evolutivas de la neumonía adquirida en la comunidad en pacientes hospitalarios / Clinical features and course of disease of community-acquired pneumonia in inpatients

INTRODUCCIÓN: la neumonía adquirida en la comunidad (NAC) sigue siendo una enfermedad frecuente en la edad pediátrica, encontrándose entre las primeras causas de mortalidad. El objetivo del estudio fue conocer la incidencia de las neumonías ingresadas y describir sus características. MATERIAL Y MÉTODOS: estudio descriptivo y retrospectivo que incluyó a los pacientes ingresados en el Servicio de Pediatría del Hospital Universitario Miguel Servet de Zaragoza (España), con el diagnóstico de NAC durante dos años para describir sus características clínicas, radiológicas, analíticas, demográficas y complicaciones. RESULTADOS: se registraron 248 casos de neumonía, con una media de edad de 37,60 ± 2,20 meses, siendo significativamente mayor en neumonías bacterianas típicas (41,98 ± 37,46) y atípicas (73,43 ± 41,28) frente a las víricas (23,30 ± 19,07) (p <0,0001 y p = 0,0004 respectivamente). La neumonía más frecuente fue la de probable origen neumocócico (47,6%; intervalo de confianza del 95% [IC 95]: 41,84 a 54,18) mientras que el agente identificado con más frecuencia el virus respiratorio sincitial (34,65%; IC 95: 26,93 a 43,26). La odds ratio de presentar patrón radiológico alveolar en neumonías bacterianas frente a víricas fue de 2,98 (IC 95: 1,50 a 5,91; p = 0,0013). El antibiótico más utilizado fue ampicilina intravenosa (62,87%), siendo la duración mayor en las neumonías típicas bacterianas. CONCLUSIÓN: la NAC que precisa ingreso hospitalario es más prevalente en niños menores de cuatro años; con una incidencia y complicaciones similares a las descritas en otras series. El diagnóstico etiológico y el consiguiente tratamiento antibiótico continúa siendo un reto difícil de alcanzar

INTRODUCTION: community-acquired pneumonia (CAP) remains a common disease in children and is one of the leading causes of death in this age group. The objective of our study was to estimate the incidence of hospital admission due to CAP and describe some of its characteristics. MATERIAL AND METHODS: we conducted a descriptive and retrospective study with inclusion of patients admitted to the Hospital Universitario Infantil Miguel Servet of Zaragoza with a diagnosis of CAP over a 2-year period to describe its clinical, radiological, laboratory, demographic characteristics and associated complications. RESULTS: we found records for 248 cases of pneumonia; the mean age was 37.6 ± 2.2 months and was significantly higher in cases of typical bacterial pneumonia (41.98 ± 37.46) or atypical pneumonia (73.43 ± 41.28) compared to viral pneumonia (23.30 ± 19.07) (p < 0.0001 and p = 0.0004, respectively). The most common type of pneumonia was of probable pneumococcal aetiology (47.6%; 95 CI: 41.84 to 54.18), and the most frequently identified causative agent was respiratory syncytial virus (34.65%; IC 95: 26.93 to 43.26). The odds ratio of presenting an alveolar radiographic pattern in bacterial pneumonia was 2.98 (95 CI: 1.50 to 5.91; p = 0.0013). The most frequently used antibiotic was intravenous ampicillin (62.87%), with longer duration of treatment in cases of bacterial pneumonia. CONCLUSION: CAP requiring hospital admission was most frequent in children aged less than 4 years, with an incidence and associated complications similar to those described in the previous literature. The aetiological diagnosis and subsequent selection of the optimal antibiotic therapy remain challenging

Estudio descriptivo de los trabajadores de servicios sanitarios de una dirección de atención primaria confinados por Covid-19 / Descriptive study of the health service workers of a Primary Care Department confined by Covid-19

OBJETIVO: La pandemia de la Covid-19 está poniendo a prueba la resistencia de los sistemas sanitarios. La preservación de los profesionales sanitarios es prioritaria siempre y especialmente ante situaciones de este tipo. La exposición de los profesionales frente a contactos sospechosos obliga en muchas ocasiones a su confinamiento. El objetivo fue conocer las características epidemiológicas de los profesionales de atención primaria que han precisado confinamiento. MÉTODOS: La investigación se llevó a cabo en el área de atención primaria Metropolitana Nord de Barcelona, desde el 17 de febrero al 3 de mayo de 2020. Participaron 1.418 profesionales que requirieron confinamiento debido a la epidemia por la Covid-19. Se registraron los motivos de confinamiento, sintomatología, tiempo de confinamiento y resultados de las pruebas PCR. Se realizó análisis descriptivo univariante. RESULTADOS: El 78,8% de los profesionales eran mujeres y la edad media de fue 45,2 años. El 67,8% fueron facultativos y enfermeras, en el 32,2% restante había diferentes profesionales asistenciales y no asistenciales. El 64,1% de la muestra presentó sintomatología compatible con Covid-19. Los participantes describieron múltiples síntomas durante el confinamiento. Se realizaron 1.050 pruebas diagnósticas RT-PCR resultando positivas en 323 casos, de los que 33 fueron en personas asintomáticas. CONCLUSIONES: El impacto de la epidemia por Covid-19 se adelanta en el personal sanitario respecto a la población general. La distribución de síntomas en profesionales sanitarios es similar a la de otros estudios en población general. Del total de profesionales que precisan confinamiento en el 22,7% se confirma el diagnóstico

OBJECTIVE: The Covid-19 pandemic is testing the resistance of health systems, the preservation of health professionals is a priority in processes of this type. The professionals' exposure to suspicious contacts often requires their confinement. The objective was to know the epidemiological characteristics of the primary care professionals who required confinement. METHODS: The research was carried out in the North Metropolitan Primary Care Area of Barcelona, from February 17 to May 3, 2020. 1,418 professionals who required confinement due to the epidemic by Covid-19 participated. The reasons for confinement, symptomatology, the confinement time and the results of PCR tests results were recorded. Univariate descriptive analysis was performed. RESULTS: 78.8% of the professionals were women and the mean age was 45.2 years. 67.8% were doctors and nurses, in the remaining 32.2% there were different healthcare and non-care professionals. 64.1% of the sample presented symptoms compatible with Covid-19. Participants described multiple symptoms during confinement. 1,050 diagnostic RT- PCR tests were performed, being positive in 323 cases, of which 33 were in asymptomatic people. CONCLUSIONS: The impact of the epidemic by Covid-19 is anticipated in health personnel compared to the general population. The distribution of symptoms in healthcare professionals is similar to that of other studies in the general population. Of the total number of professionals requiring isolation, 22.7% confirmed the diagnosis

Evaluación de un protocolo de derivación de enfermedad tiroidea en nuestra área sanitaria / Evaluation of a thyroid disease referral protocal in a health area of Madrid

Introducción. La colaboración entre niveles asistenciales es esencial en la atención a nuestros pacientes. La elaboración de protocolos forma parte de esta colaboración. Con nuestro estudio intentamos conocer el grado de adecuación de un protocolo de derivación entre niveles asistenciales. Métodos. Se realizó en Leganés (Madrid), con la colaboración de médicos de Atención Primaria, los endocrinólogos y el Servicio de Bioquímica del hospital. Tras la elaboración conjunta y difusión de un protocolo de derivación de enfermedad tiroidea, se evaluó la adecuación de la derivación entre niveles asistenciales. Resultados. Se evaluaron 284 partes interconsulta, con una derivación adecuada del 65% (51% por alteraciones analíticas, 42% por alteraciones morfológicas). El contenido del parte interconsulta fue adecuado en el 59% y de solicitud de ecografía en un 78%. El 16% de los pacientes seguidos en Endocrinología deberían haber sido devueltos a Atención Primaria. Conclusiones. Creemos que existe margen de mejora en el cumplimiento de la derivación tanto por atención especializada como por Atención Primaria (AU)

Introduction. The collaboration between healthcare levels is essential for our patients. The aim of this study is to determine the suitability of a referral protocol between the different healthcare levels. Methods. A collaboration study was carried out between general practitioners, endocrinologists, and the Department of Biochemistry. After creating the protocol together and implementing it, the suitability was evaluated. Results. A total of 284 referral sheets were evaluated, 65% were adequately sent, and 51% were referred due to laboratory abnormalities, 42% for morphological alterations, and 7% for both reasons. Just under three-quarters (72%) were referred in the normal way (adequacy 90.6%). The clinical information in the referral sheet was considered adequate in 59%, and the request for ultrasound was adequate in 78%. A significant number (16%) of patients should have been returned to Primary Care. Conclusions. It is considered that creating protocols is part of our task. The compliance with the protocol can be improved in Primary Care and specialised care (AU)

Sintomatología clínica residual y factores asociados en supervivientes de un fracaso multiorgánico: una hipoteca a largo plazo / Clinical residual symptomatology and associated factors in multiple organ failure survivors: a long-term mortgage

Objetivo. Evaluar la sintomatología clínica residual que puedan presentar los supervivientes de un fracaso multiorgánico (FMO) tras su alta de la Unidad de Cuidados Intensivos (UCI) e identificar aquellos factores que puedan estar asociados. Material y métodos. Fueron seleccionados de forma consecutiva en el estudio un total de 545 pacientes adultos con FMO a su ingreso. Se realizó una encuesta a los 6 y 12 meses tras el alta de una UCI médico-quirúrgica en España. Se realizó una encuesta telefónica sobre los síntomas clínicos presentes al alta de UCI. Resultados. Se realizó seguimiento a un total de 266 pacientes supervivientes al FMO; un 62,2% eran varones, la edad media fue de 60±18 años y un 67,8% eran pacientes médicos. Los síntomas más comunes presentados tras el alta hospitalaria fueron astenia (173; 76%), alteraciones en el sueño (112; 50%) y depresión (109; 48%). Conclusiones. El seguimiento reveló la presencia frecuente de síntomas clínicos «residuales» que persistieron al menos un año; de forma más notable, la artromialgia y la astenia. La presencia de síntomas depresivos tras los primeros 6 meses del alta poshospitalaria también fue común entre los pacientes supervivientes de FMO. La duración de la sintomatología se relacionó principalmente con una situación basal pobre a los 6 y 12 meses, un ingreso hospitalario largo y una puntuación de gravedad alta al ingreso en la UCI (AU)

Purpose. To evaluate which residual clinical symptoms multi-organ failure (MOF) patients may exhibit post discharge from Intensive Care Units (ICU) and to identify the associated factors that cause such symptoms. Material and methods. A total of 545 adult patients admitted to a medical & surgical ICU in Spain diagnosed with MOF on admission were included in the study. Follow up in the form of a telephone survey regarding the patients clinical symptoms were conducted at 6 and 12 months after discharge from ICU. Results. A total of 266 patients were followed up at both 6 and 12 months post ICU discharge; 62.2% were male; age 60±18 years; 67.8% medical patients. The most common symptoms to appear following hospital discharge included: asthenia (173; 76%), sleep disturbances (112; 50%) and depression (109; 48%). Conclusions. The study revealed frequent residual clinical symptoms persisting for almost a year post ICU discharge, most notably arthromyalgia and asthenia. Depression symptoms during the first 6 months post-hospital discharge were also common among multiple organ failure survivors. The presence of symptomatology over time was found to be related to a poor functional situation at 6 and12 months post ICU discharge, length of hospital stay and severity of illness score on ICU admission (AU)

Conocimientos previos de la mujer en la enfermedad coronaria: Un estudio fenomenológico / Previous knowledge of women in coronary heart disease: A phenomenological study

Introducción: La enfermedad coronaria posee unas características distintas en función del sexo en su presentación, diagnóstico o abordaje terapéutico. Objetivo: explorar los conocimientos previos que posee la mujer sobre la enfermedad coronaria. Metodología: Diseño cualitativo basado en la Fenomenología, en una muestra de 17 mujeres que padecían Cardiopatía Isquémica. La recogida de datos mediante entrevista semiestructurada. Para el análisis de los datos se utilizó el método de Giorgi. Resultados: Destacan un déficit de conocimientos previos sobre la enfermedad y el menosprecio de los síntomas iniciales. Conclusión: Existe un déficit de conocimientos previos por parte de la mujer sobre su enfermedad coronaria

Introduction: The coronary heart disease has different characteristics according to gender in aspects such as its presentation, diagnostic or therapeutic approach. Objective: to know the previous knowledge that women have as far as the coronary disease is concerned. Method: Phenomenological qualitative study in 17 women who suffered Ischemic Heart Disease. Data collection performed by means of semistructured interview. The Giorgi method was used to carry out this analysis. Results: The results prove a lack of previous knowledge and a contempt of the initial symptoms. Conclusion: There is a lack of previous knowledge in women on his coronary heart disease

Gender Differences in Depressive Symptom Profile: Results from Nationwide General Population Surveys in Korea

This study investigated gender differences in symptom profiles of major depressive disorder (MDD) in the Korean general population. Data were pooled from the series of nationwide Korean Epidemiologic Catchment Area surveys conducted in 2001, 2006 and 2011, respectively. Of the 18,807 participants, 507 (397 women and 110 men) were diagnosed with MDD within the prior 12 months. In agreement with previous studies, women with MDD appeared to be more vulnerable to experiencing atypical depressive episodes defined as depression with two or more symptoms of fatigue, increased appetite and hypersomnia (P < 0.001). In terms of individual symptoms, female gender was significantly related with higher prevalence of fatigue (P = 0.008), hypersomnia (P = 0.001), noticeable psychomotor retardation (P = 0.029) and suicidal attempts (P = 0.016) with adjustment for birth cohort effect, partner status, and employment status. In the same analysis, men with MDD appeared more vulnerable to decreased libido than women (P = 0.009). This is the first report to demonstrate gender differences in symptomatology of MDD in the general Korean population, and the results are comparable to previous investigations from western societies. Assumingly, the intercultural similarity in female preponderance to atypical depression might reflect the common biological construct underlying the gender difference in mechanism of MDD. In clinical settings, gender differences of MDD should be carefully considered, because these features could be related with treatment response and drug side effects.

Frequency of non-motor symptoms in Peruvian patients with Parkinson's disease / Frecuencia de síntomas no motores en pacientes peruanos con enfermedad de Parkinson

Introduction: Non-motor symptoms in Parkinson's disease are often not well recognized in clinical practice. Non-motor symptoms questionnaire (NMSQuest) is a simple instrument that allows patients or caregivers to report non-motor symptoms in a practical manner. Objective: We attempted to determine the prevalence of non-motor symptoms in three hundred Parkinson's disease outpatients. Results: The mean total non-motor symptoms was 12.41, ranging from 0 to 27 of a maximum of 30. At least one was present in 99.3% of patients. A progressive increase in mean total score was observed across each 5-year interval. Depression domain scored the most “positive” answers while urinary and anxiety /memory were secondly and thirdly most prevalent respectively. Conclusion: The large number of patients included in this study allowed evaluation of the occurrence of non-motor symptoms in early and advanced disease in addition to the relationship of these kinds of symptoms with progression of disease. .

Introducción: Los síntomas no motores en la enfermedad de Parkinson son frecuentes y no bien reconocidos en la práctica clínica. El Cuestionario de Síntomas No Motores (NMSQ) es un instrumento simple que permite a los pacientes o cuidadores reportarlos de una manera práctica. Objetivo: Intentamos determinar la prevalencia de síntomas no motores en trescientos pacientes con enfermedad de Parkinson. Resultados: El promedio total de SNM fue de 12.41 con un rango de 0 a 27 de un máximo de 30. Al menos uno estaba presente en el 99,35 de los pacientes. Un incremento progresivo del score promedio total se observa lo largo de intervalos de 5 años. Los síntomas más frecuentes fueron depresión, incontinencia urinaria y ansiedad respectivamente. Conclusión: La gran cantidad de pacientes evaluados permitió la evaluación de los SNM en fases tempranas y avanzadas de la enfermedad y la relación de los mismos con la progresión de la enfermedad .

Análisis factorial confirmatorio de la estructura del IDERE en muestras de varios países Iberoamericanos / Confirmatory factorial analysis of the IDERE structure in samples from several Iberian-American countries

Estudiar la estructura de un instrumento forma parte de la investigación de su validez interna, pues permite evaluar el grado en que los componentes de un test conforman el constructo que se quiere medir y sobre el que se basarán las interpretaciones. En un estudio preliminar del IDERE, se había encontrado una estructura factorial compleja que no fue prevista originalmente, por lo que el presente trabajo se propone investigar la validez factorial transcultural de diferentes modelos teóricos mediante Análisis Factorial Confirmatorio. La muestra no probabilística estuvo constituida por 1507 sujetos de tres países: 503 españoles, 330 cubanos y 674 mexicanos, con edades comprendidas entre los 18 y los 106 años. Para el análisis de los datos se empleó el programa AMOS 18.0. Se encontró que los modelos que obtienen mejor ajuste son los que consideran no sólo la distinción rasgo-estado, sino también la presencia-ausencia de depresión. En este sentido se valoró que un modelo de 3 factores, que considera la distinción depresión rasgo-estado en contraposición con un factor de ítems antagónicos a la depresión, parece el más apropiado teóricamente y el más fructífero con fines de investigación, pues apunta a la posibilidad de enriquecer las potencialidades diagnósticas del instrumento(AU)

Studying the structure of an instrument is part of the research and its internal validity since it allows for assessing the level whereby the components of a test make up the build intended to be gauged as all interpretations will be based on it. In a preliminary study of IDERE, a complex factorial structure that hadnt been originally foreseen was found, so this paper seeks to delve into the cross-cultural factorial validity of different theoretical models by means of Confirmatory Factorial Analysis. The non-probabilistic sample consisted of 1,507 individuals from three countries: 503 Spaniards, 330 Cubans and 674 Mexicans of ages between 18 and 106 years old. For data analysis, the AMOS 18.0 software was used. A finding indicated that better adjustments can be obtained if they take into account not only the feature-status distinction, but also the presence-absence of depression. In this sense, a three-factor model was appraised, considering the feature-status depression distinction in contraposition to a factor of antagonistic items related to depression. That seems to be the most theoretical appropriate and most fruitful tool for the sake of the research, since it opens up the possibility of enriching the instruments diagnostic potentials(AU)