Bronchoscopist's perception of the quality of the single-use bronchoscope (Ambu aScope4™) in selected bronchoscopies: a multicenter study in 21 Spanish pulmonology services.

BACKGROUND: The disposable bronchoscope is an excellent alternative to face the problem of SARS-CoV-2 and other cross infections, but the bronchoscopist's perception of its quality has not been evaluated. METHODS: To evaluate the quality of the Ambu-aScope4 disposable bronchoscope, we carried out a cross-sectional study in 21 Spanish pulmonology services. We use a standardized questionnaire completed by the bronchoscopists at the end of each bronchoscopy. The variables were described with absolute and relative frequencies, measures of central tendency and dispersion depending on their nature. The existence of learning curves was evaluated by CUSUM analysis. RESULTS: The most frequent indications in 300 included bronchoscopies was bronchial aspiration in 69.3% and the median duration of these was 9.1 min. The route of entry was nasal in 47.2% and oral in 34.1%. The average score for ease of use, image, and aspiration quality was 80/100. All the planned techniques were performed in 94.9% and the bronchoscopist was satisfied in 96.6% of the bronchoscopies. They highlighted the portability and immediacy of the aScope4TM to start the procedure in 99.3%, the possibility of taking and storing images in 99.3%. The CUSUM analysis showed average scores > 70/100 from the first procedure and from the 9th procedure more than 80% of the scores exceeded the 80/100 score. CONCLUSIONS: The aScope4™ scored well for ease of use, imaging, and aspiration. We found a learning curve with excellent scores from the 9th procedure. Bronchoscopists highlighted its portability, immediacy of use and the possibility of taking and storing images.

Higher luteinizing hormone levels associated with antimüllerian hormone in postmenarchal daughters of women with polycystic ovary syndrome.

OBJECTIVE: To study the reproductive and metabolic differences between daughters of women with polycystic ovary syndrome (PCOSd) and control women (Cd) after menarche. DESIGN: Case-control study. SETTING: Clinical endocrinology unit. PATIENT(S): We studied 43 PCOSd and 28 Cd 1.5-6 years after menarche. INTERVENTION(S): Determination of anthropometry, pubertal development, hirsutism, oral glucose tolerance test, and GnRH analogue test. MAIN OUTCOME MEASURE(S): Ferriman score, sex steroids, gonadotropins, antimüllerian hormone (AMH), ovarian volumes, and glucose and insulin levels. RESULT(S): The groups were similar in chronologic, gynecologic, and menarchal ages and anthropometric variables. Ferriman score, ovarian volumes, and AMH were higher in PCOSd. Propensity score analysis showed that there were significant differences in LH, LH-FSH ratio, T and free androgen index, post-stimulated LH and LH-FSH ratio, and 2-hour insulin that could be attributed only to the fact of being a PCOS daughter. The generalized linear model showed that higher LH levels were positively associated with AMH and T levels. CONCLUSION(S): We found that higher LH, androgen, and insulin levels are present in PCOSd during the postmenarchal period, which may establish the basis for the development of PCOS during adulthood. Moreover, LH levels were associated with AMH levels, which supports that the neuroendocrine feedback proposed for AMH and LH is present in humans and that this feature is probably programed in utero, as recently shown in mice.

Potential dermal exposure to operators applying pesticide on greenhouse crops using low-cost equipment.

During pesticide application, operators are exposed to chemical products. Dermal exposure has been reported as the principal means of exposure for growers. In the present work, potential dermal exposure (PDE) has been assessed when using new low-cost equipment (a knapsack with a vertical spray boom) and compared to a hand-held spray lance, which is the equipment most widely used by growers in greenhouses. Two sprayers were used, a hand-held spray lance with four twin flat-fan nozzles and a knapsack fitted out with a vertical spray boom containing 3 pairs of twin flat-fan nozzles. Three applications were carried out and compared, one with the spray lance walking backwards (the reference application), and two with the spray boom - the first stopping at the turns and the second with no stopping. The patch method (19 position on the body) and tartrazine (the tracer) were used to assess de PDE. Each application tested was replicated three times. The results show that the knapsack with the vertical boom should not be used walking continuously along the greenhouse rows because the total PDE (1637.12mL 1000L-1) is greater than in the rest of the configurations tested. If the operator stops at the turns for a few seconds, allowing the previously sprayed droplet cloud to dissipate, the level of exposure decreases significantly (324.63mL 1000L-1), providing similar results to the reference application with the spray lance walking backwards (292.25mL 1000L-1).

History of religious delusions and psychosocial functioning among Mexican patients with paranoid schizophrenia.

The association between global functionality and religiosity among patients from developing and predominantly Catholic countries warrants attention. To compare religiosity and psychosocial functioning in Mexican schizophrenia patients with and without a history of religious delusions, seventy-four patients with paranoid schizophrenia were recruited. Patients with a history of religious delusions had more psychiatric hospitalizations and poorer psychosocial functioning compared with those without a history of religious delusions. No differences emerged between groups in the total scores of religiosity scales. A history of religious delusions rather than religiosity itself may have an influence on psychosocial functioning among Mexican patients with schizophrenia.

[Analysis of maternal deaths in Mexico occurred during 2009]. / Análisis de las muertes maternas en México ocurridas durante 2009.

BACKGROUND: Mexico reported 955 maternal deaths in 2011, with a ratio of 49 deaths per 100,000 live births. For 2015, the WHO commitment is to reduce the ratio to 22, equivalent to 415 maternal deaths. METHODS: it is a descriptive and retrospective study. In 1257 maternal deaths in 2009, we reviewed a sample of 173 records. Simple frequencies and percentages were calculated. RESULTS: direct causes of maternal death were preeclampsia-eclampsia, infection and obstetrical hemorrhage secondary to uterine atony, placental accreta and placenta previa. Fifteen patients died from abortion complications. Four patients died from extra-uterine pregnancy, because of delayed diagnosis and treatment. Indirect causes of maternal death were neoplasms, abdominal sepsis, vascular events, metabolic problems and heart disease; twenty-five patients died of atypical pneumonia and 11 more of influenza A H1N1. CONCLUSIONS: it is feasible to reduce maternal mortality by means of an adequate prenatal care, in quantity and quality of consultations, and avoiding high risk pregnancies caused by a history of obstetric factors and associated severe diseases. Influenza A H1N1 interrupted the downward trend in maternal mortality.

Introducción: en 2011 ocurrieron 955 defunciones maternas en México, 49.9 por 100 000 nacidos vivos. La meta de la Organización Mundial de la Salud para 2015 es reducir la tasa a 22.5: 560 defunciones anuales. Métodos: estudio descriptivo y retrospectivo de 1257 muertes maternas ocurridas en México durante 2009, con una muestra representativa de 173 expedientes. Se calcularon frecuencias simples y porcentajes. Resultados: las muertes maternas ocurrieron por causas directas como preeclampsia-eclampsia, infección y hemorragia obstétrica secundaria a atonía uterina, acretismo placentario y placenta previa. Quince mujeres tuvieron complicaciones por abortos. Cuatro murieron por embarazo extrauterino debido a diagnóstico y tratamiento tardíos. Las causas indirectas de la muerte materna fueron neoplasias, sepsis abdominal, eventos vasculares, problemas metabólicos y cardiopatías. Veinticinco pacientes fallecieron por neumonía atípica y 11 por influenza A H1N1. Conclusiones: es factible disminuir la mortalidad materna mediante suficientes consultas prenatales de calidad y evitar embarazos con riesgo alto por los antecedentes obstétricos y los padecimientos asociados. La influenza A H1N1 interrumpió la tendencia descendente de la mortalidad materna.

Factores, causas y perspectivas de la obesidad Infantil en México / Factors, causes and perspective of childhood obesity in Mexico

Este escrito comprende una revisión bibliográfica sobre la obesidad infantil en México desde el año 2000 a 2012. La obesidad constituye un problema de salud pública la cual recientemente ha alcanzado proporciones de epidemia en algunos países. Esta patología constituye el principal problema de malnutrición en el adulto y es una enfermedad que ha aumentado notoriamente en la población infantil, ya que se calcula que más de 40 millones de niños padecen sobrepeso u obesidad. Es un trastorno multifactorial en cuya etiopatogenia están implicados factores genéticos, metabólicos, psicosociales y ambientales, por lo que es difícil distinguir en cada caso en particular la importancia relativa de estos factores. La obesidad infantil es uno de los factores de riesgo vinculados al aumento de enfermedad cardiovascular en el adulto, junto con la hipertensión, hipercolesterolemia y diabetes tipo II; se ha identificado que un factor importante en el desarrollo de la obesidad infantil es la influencia de los medios electrónicos que promueven un estilo de vida básicamente sedentario...

This work is a review of the information about childhood obesity in Mexico from 2000 to 2012. Obesity is a public health problem, which has recently reached epidemic proportions in some countries. This pathology is the main problem of adult malnutrition and has dramatically increased in children, since it is estimated that over 40 million children have overweight or obesity. It involves several factors such as genetic, metabolic, psychosocial and environmental ones. As a result, it is difficult to distinguish their influence in different cases. However, a well-recognized factor in the development of childhood obesity is the media, which promotes a sedentary lifestyle. Childhood obesity is a risk factor associated with cardiovascular disease in adults, hypertension, hypercholesterolemia and diabetes Type II...

Estudio de traducción, adaptación y evaluación psicométrica del Inventario de Miedos FSSC-II en una muestra de estudiantes de educación media superior / Translation, adaptation and psychometric properties of the Fear Inventory FSCC-II in a Mexican sample of high school students

Normal fear is defined as a reaction to a real or imagined threat and is considered an integral and adaptive feature related to the primary function of survival. Nevertheless, when fear is intense and maladaptive, it may lose its role for survival and may progress in a phobic disorder with a negative impact for the individual who suffers it. According to some researchers, childhood and adolescence are the main life periods where phobias and other anxiety disorders develop. It is estimated that up to 50% of children and adolescents report one or more intense fears and more than 20% of these meet diagnostic criteria for specific phobias, frequently related to the development of future mental disorders during adulthood. In the assessment of fear, it is important to consider the evaluation of its intensity as well as its frequency among three main dimensions: the subjective dimension (including feelings and thoughts), the physical dimension (e.g., tachycardia and paleness) and the behavioral dimension (e.g., avoidant behaviors). So far, the main fear assessment methods include self-reports, observation and psychophysiological registers. In the area of mental health, the Fear Survey Schedule for Children II (FSSC-II) is the most widely used instrument for the assessment of fears in youth population. The cultural adaptation of an internationally instrument such as the FSSC-II brings the opportunity for subsequent comparison of investigation findings with other populations. The FSSC-II is an updated version of the original instrument as it includes other type of fears such as fear of war and/or AIDS designed to both children and adolescents. Since it is possible that some mental disorders in adulthood are conditioned by the presence of fears in early stages of life, it is important to have an objective characterization of the main fears in our culture. On this basis, adequate psychopathology prevention programs and treatment strategies can be designed and tested. In general, psychopathology is influenced by the cultural context and fears are not the exception as they tend to manifest differently from one cultural context to another. Therefore, the aim of the present work was to translate, culturally adapt and examine the psychometric properties of the FSSC-II in a Mexican sample of high school students. Method A total of 5030 high school students who accepted to participate in the study were recruited. Age ranged between 14 and 24 years old. The FSSC-II is composed of 78 items scored in a three-point Likert scale that assess frequency and intensity of different fears classified in five main dimensions: fear of death and danger, fear of the unknown, fear of failure or criticism, fear of animals and physical stress-medical fears. Before the enrollment procedure, the FSSC-II was adapted for Mexican population. First, translation-back translation was performed by two independent translators. Some items of the instrument were culturally adapted by consensus to reach the final version of the instrument. A principal component analysis with varimax rotation was performed to determine the construct validity of the instrument in Mexican population. Cronbach's alpha was used to determine the internal consistency of each domain and total score of the FSSC-II. All analyses were performed with the 10th version of the SPSS-X. Results A total of 2992 women and 2038 men participated. Mean age was of 16.43±1.2 years old. For the Mexican adaptation of the FSSC-II, 1 1.53% of the items (n=18) were culturally adapted. Factor analysis showed five factors for the instrument. These factors were consistent with those described in the original version: fear of death and danger, fear of animals or injuries, fear of failure or criticism, fear of the unknown and medical fears. Internal consistency of the FSSC-II was .96. Alpha coefficients for four dimensions were above .80, except the "medical fears" dimension (.70). Discussion The Spanish version of the FSSC-II among Mexican high school students showed adequate psychometric properties. The adaptation process implicated the modification of some items of the original instruments in order to reach a correct assessment of the proposed constructs of the instrument according to the predominant cultural patterns of Mexico. On the other hand, some items were not modified and were taken literally from either U.S. or Australian versions. Although more than 10% of the items were adjusted, the factor structure of the instrument remained congruent with the original version and the U.S version of the FSSC-II. The Mexican version was totally compatible with the five constructs found in the U.S. version; nevertheless it is important to remark that the content of the Mexican version was more compatible with the content of the items of the Australian version. Some of the inconsistencies found between the three versions may be the result of the subjects' age in the studies. The U.S. study included subjects with ages between 8 and 11 years, the Australian study included subjects between 7 and 18 years old, while our study included subjects with ages between 14 and 24 years old. The way children experience reality is not the same as that of adolescents or adults. It is possible to assume that the fears of children are more related to immediate, concrete stimuli, while the ones of adolescents and young adults are related to anticipatory or abstract stimuli. For example, the item of "Fear of being scolded by the principal" can be experienced by a child as something extremely dangerous and, therefore, the item will classify in the dimension "fear of death and danger" and not in the dimension of "fear of failure or criticism" where the answer of an adolescent or a young adult is most likely to be classified. Despite the disparities between the three versions, the FSSC-II showed high internal consistency values and an adequate percentage of explained variance in our sample. These results highlight the utility of the FSSC-II for the assessment of the frequency and intensity of fears in both adolescents and young adults in Mexico. It would be desirable to perform future studies among children.

El miedo es una emoción que se experimenta a lo largo de la vida y en ocasiones posibilita la adaptación. No obstante, el miedo puede tornarse desadaptativo y evolucionar hacia un trastorno fóbico que impacta negativamente en el individuo que lo padece. La infancia y la adolescencia son las etapas en las que típicamente inician las fobias, las cuales se han asociado al desarrollo de otros trastornos mentales en la vida adulta. En la evaluación del miedo es necesario evaluar tanto su intensidad como su frecuencia en tres dimensiones principales: la subjetiva, la física y la conductual. Los principales métodos de valoración del miedo han sido los autoinformes, la observación externa y los registros psicofisiológicos. En el área de la salud mental, la escala más utilizada para la evaluación de miedos en población juvenil es el Inventario de Miedos para Niños II (Fear Survey Schedule for Children II, FSSC-II). La adaptación cultural de un instrumento internacionalmente utilizado como éste brinda la oportunidad de realizar comparaciones subsecuentes de los hallazgos de investigación con otras poblaciones. Dado el impacto del miedo en el futuro desarrollo de trastornos mentales, es importante contar con una caracterización de los principales miedos en nuestra población para la elaboración de futuros programas preventivos y de tratamiento efectivos. De esta forma, el objetivo del presente estudio fue traducir al español, adaptar culturalmente y evaluar psicométricamente el Inventario de Miedos para Niños FSSC-II en una muestra de adolescentes y adultos jóvenes mexicanos. Método La muestra estuvo conformada por estudiantes de preparatoria de ambos sexos, entre 14 y 24 años de edad, que aceptaron participar en el estudio de manera anónima. Dos traductores independientes realizaron la traducción-retraducción y adaptación cultural del FSSC-II y posteriormente fue aplicado a los estudiantes. Se obtuvo la consistencia interna del instrumento mediante el alpha de Cronbach y la validez de constructo mediante un análisis de componentes principales. Resultados Se incluyeron 2992 mujeres y 2038 hombres, con una edad promedio de 16.43 años. El 11.53% de los reactivos de la versión original del FSSC-II se adaptaron para su uso en población mexicana. El análisis factorial mostró cinco factores agrupados de acuerdo con lo teóricamente esperado: miedo a la muerte o peligro, miedo a los animales o lesiones, miedo al fracaso escolar o a la crítica, miedo a lo desconocido y miedos médicos. Todos los factores del FSSC-II mostraron elevados valores de consistencia interna (>.80) con excepción del área de miedos médicos (.70). El alpha de la puntuación total de la escala fue de .96. Discusión La estructura de cinco factores del instrumento resultó congruente con la versión australiana original y la estadounidense, siendo compatible en su totalidad con la versión de Estados Unidos. No obstante, en cuanto al contenido de los reactivos, la versión mexicana del FSSC-II fue más similar a la versión australiana del instrumento. Estas inconsistencias pueden deberse a las diferencias de edades de las muestras sujetas a estudio, siendo distintas las realidades que vive un niño a las que vive un adolescente o un adulto joven. A pesar de estas divergencias, la alta consistencia interna y varianza explicada del instrumento muestran su utilidad para evaluar la frecuencia e intensidad de miedos en adolescentes y adultos jóvenes en nuestro país. Es deseable dirigir futuros estudios para evaluar a niños de menores edades.

[Analysis of dengue fever deaths in Mexico: 2009]. / Defunciones por dengue en México. Análisis del año 2009.

OBJECTIVE: to describe the dengue fever mortality. METHODS: a descriptive and retrospective study including 104 files reported deaths caused by dengue fever during 2009 to march 2010, was done. RESULTS: sixty (58 %) were women and 44 (42 %) men. An increased mortality between the ages of 11 and 40 years old (47 %) was observed. Colima was a state with high incidence of cases and Jalisco had the highest mortality. Thrombocytopenia was the rule (90.4 %) and in one third of the cases platelets were below 50,000/mm(3). A quarter of cases were associated with comorbility. The initial clinical manifestations included: bleeding, hypovolemia by depletion or hemorrhage, tachycardia, paleness, depressed level of consciousness and circulatory failure. The main cause of death was hypovolemic shock or sepsis. In 42 cases, severe dengue was considered. CONCLUSIONS: an association between the severity of dengue fever and mortality was observed. The main cause of mortality was a shock state.

[The dengue fever in Mexico. Knowledge for improving the quality in health]. / El dengue en México. Conocer para mejorar la calidad de la atención.

Dengue is a systemic infectious disease of viral etiology, transmitted by Aedes mosquitoes. It causes between 50 and 100 million cases annually over 100 countries. In most of the cases it presents as influenza-like illness or undifferentiated fever and more than 500,000 patients develop dengue hemorrhagic fever. In America, dengue fever is considered the most important resurgent disease and its hemorrhagic form is becoming more relevant, especially given the steady increase in the number of deaths. The first outbreaks of dengue in America were described in 1635. Since the apparition of dengue hemorrhagic fever, in 1962, it has been considered a public health problem because half of the population lives in endemic areas. The purpose of this paper is to carry a briefly review of the epidemiology, clinical features, pathophysiology, prevention and treatment of dengue fever, as well as create recommendations in order to improve the quality of care and decrease mortality in these patients.

Evaluación de constructos psicológicos positivos en población de habla hispana: El caso de las Creencias Acerca de Disfrutar la Vida / Evaluation of positive psychological constructs in Hispanic population: The case of Beliefs about Enjoying Life

Se evaluaron las propiedades psicométricas de la traducción al castellano del Inventario de Creencias acerca de Saborear la Vida (SBI). Método: 419 adultos de ambos sexos, estudiantes universitarios, de la población general, pacientes psiquiátricos o víctimas de violencia doméstica completaron el SBI; 319 respondieron también medidas de afectividad, bienestar, afrontamiento, depresión, desesperanza y culpa. Una sub muestra de 52 sujetos contestó nuevamente el SBI a los quince días de la primera aplicación. Resultados: Los coeficientes alpha de Cronbach del SBI fueron: total = 0.91; anticipación = 0.84; al momento = 0.75 y reminiscencia = 0.89. Las correlaciones entra la primera y segunda aplicación resultaron estadísticamente significativas y oscilaron entre 0.59 - 0.77 para el total y las subescalas. El SBI correlacionó positiva y significativamente con el afecto positivo, el bienestar general y la adaptación al estrés; e inversamente con el afecto negativo, la depresión, la desesperanza y la culpa. Se encontraron diferencias entre los grupos evaluados para las subescalas de “al momento”, “reminiscencia” y el total, con menores puntuaciones para los pacientes psiquiátricos vs. población general (F=9.80; gl=2; p<0.001; F=3.26; gl=2; p=0.039; F=5.90; gl=2; p=0.003, respectivamente). El análisis factorial mostró una estructura similar a la versión original en inglés. Conclusión: La versión en español del SBI es válida y confiable (AU)

The aim of this study was to evaluate the psychometric proper-ties of a Spanish translation of the Savoring Beliefs Inventory (SBI). Methods: 419 voluntary adults participated. Four samples were evaluated: university students, general population, psychiatric outpatients and domes-tic violence victims. All participants completed SBI; 319 subjects answer also measures of General Well Being Scale, Positive and negative affectivity, Depression, Hopelessness and guilt. A sub sample of 52 was retested fifteen days later. Results: Cronbach alphas for SBI were: total score = 0.91, anticipating subscale = 0.84, present moment subscale = 0.75, and past subscale= 0.89. SBI correlations between first and second application were significant, ranging from 0.59 to 0.77. SBI correlated directly and significantly with positive affect and general well being. Inverse significant correlations were found between SBI scores and negative affect, depression, hopelessness and guilt scores. Significant between-groups differences were found in SBI’s “present moment”, “past moment” and “total” scores among the general population and the psychiatric patients samples. Mean lower scores were found for the psychiatric population (F=9.80; gl=2; p=0.000; F=3.26; gl=2; p=0.039; F=5.90; gl=2;p=0.003, respectively). SBI factor analysis showed a similar grouping as the original English version. Conclusion: SBI Spanish version showed acceptable reliability and validity indicators among Hispanic population (AU)

Field evaluation of a self-propelled sprayer and effects of the application rate on spray deposition and losses to the ground in greenhouse tomato crops.

BACKGROUND: In the greenhouses of south-eastern Spain, plant protection products are applied using mainly sprayers at high pressures and high volumes. This results in major losses on the ground and less than uniform spray deposition on the canopy. Recently, self-propelled vehicles equipped with vertical spray booms have appeared on the market. In this study, deposition on the canopy and the losses to the ground at different spray volumes have been compared, using a self-propelled vehicle with vertical spray booms versus a gun sprayer. Three different spray volumes have been tested with a boom sprayer, and two with a spray gun. RESULTS: The vehicle with the vertical spray boom gave similar depositions to those made with the gun, but at lower application volumes. Also, the distribution of the vertical spray boom was more uniform, with lower losses to the ground. CONCLUSIONS: The vertical spray booms used in tomato crops improve the application of plant protection products with respect to the spray gun, reducing the application volumes and the environmental risks of soil pollution.

La crisis de una unidad médico psiquiátrica ante un intento suicida / The impact of patient suicide on psychiatric unit teams

El objetivo de este trabajo fue describir el impacto que produce la observación de una tentativa letal de suicida en los profesionales de la salud menta y los pacientes hospitalizados en una unidad médico psíquiátrica pública y de concentración, mediante un estudio de oportunidad con base en cuestionarios de opinión, evaluación breve de riesgo suicida y escalas de ideación suicida y desesperanza de Beck. Los resultados indican que los profesionales que observaron el suceso estuvieron más afectados que los que no; y sus principales necesidades fueron en torno a seguridad laboral y capacitación en un proceso ex profeso para la unidad. Por su parte, los pacientes mostraron mejoría a los quince días del evento aunque también presentaron un incremento significativo de desesperanza (7,3±5,74 vs. 14,88±2,26; t=4,20, gl=8, p=0.003) Se concluyó que la organización laboral juega un papel determinante en el impacto que tenga este tipo de eventos, que es más bien negativo y que abarca a pacientes y profesionales de la salud mental

Suicide attempts and suicides are fifty times more frequent at psychiatric hospitals. The aim of this work was to evaluate the impact of a lethal suicide attempt on both mental health professionals and patients attending a psychiatric centre. An opportunity study was made by means of opinion questionnaires, a brief suicide risk evaluation, and with both Beck´s suicide ideation and hopelessness scales. Results show that mental health professionals informed a medium training level to cope with this kind of events; those who observed a suicide attempt were more affected personally than those who did not; and their main needs were related to job security and a specific training to act when a suicide attempt occurs. Although patients showed a significant improvement fifteen days later, a clinical and statistical increase of hopelessness was also reported (7,3±5,74 vs. 14,88±2,26; t=4,20, gl=8, p=0.003). We can conclude that work organization plays a crucial role in the impact of suicide attempts, which is usually negative and affects both patients and mental health professionals

Dermatoglyphic study of positive and negative symptoms in schizophrenia

El estudio del conteo y forma de las huellas digitales (dermatografía) en la esquizofrenia ha sido extenso, pero recientemente se ha descrito un nuevo parámetro, que es la asimetría fluctuante. En este estudio se rela-cionaron los patrones dermatoglíficos con los síntomas positivos y negativos de la enfermedad en 72 pacientes con esquizofrenia, de acuerdo a los criterios diagnósticos del DSM-III-R, y en 72 sujetos controles. Los sujetos con esquizofrenia tuvieron cuentas menores de ondulaciones en los dedos de ambas manos. La asimetría fluctuante en la cuenta de las ondulaciones tipo a-b fue significativamente menor en los sujetos con esquizofrenia (0.50 vs 0.70, p<0.05). Se utilizó la Escala de Síntomas Positivos y Negativos para la Esquizofrenia (PANSS) para determinar la severidad de los síntomas. Los sujetos esquizofrénicos con predominio de síntomas negativos mostraron un menor conteo y una mayor asimetría fluctuante que aquellos sujetos esquizofrénicos con predominio de síntomas positivos.

Los conocimientos de los estudiantes de medicina y del personal médico relacionados con el síndrome depresivo / The knowledge of medicine students and medical personal on athe depressive syndrome

El objetivo de este estudio fue el de evaluar y comparar los conocimientos sobre el síndrome depresivo en los estudiantes de medicina, en los internos, en los residentes de medicina familiar y en los médicos familiares.Método: En un estudio de observación transversal comparativo se censó en una muestra a los grupos de pregrado y posgrado de la Unidad de Medicina Familiar con Hospital Psiquiátrico número 10 "Dr. Guillermo Dávila" y del Hospital General de Zona número 98 del Instituto Mexicano del Seguro Social (IMSS). Los reactivos del instrumento fueron seleccionados de las preguntas sobre depresión mayor de dos textos básicos de autoevaluación en psiquiatría.Resultados: Se estudiaron 40 estudiantes de medicina de pregrado, 33 internos de pregrado, 30 médicos residentes de medicina familiar y 30 médicos adscritos a medicina familiar. Los estudiantes de medicina de pregrado calificaron significativamente más alto que el resto de los grupos en el numero total de aciertos y en la escala de calificación del 1 al 100. Conclusión: Este trabajo sugiere la necesidad de actualizar continuamente a los médicos residentes y a los médicos adscritos a medicina familiar sobre este trastorno.

Prevalencia de los trastornos depresivos y su relación con el bajo aprovechamiento escolar en estudiantes de secundaria / Prevalence of depressive disorders and low academic achievement in junior high school students

Los trastornos depresivos, en especial el TDM y el TD, se presentan con una elevada prevalencia de hasta del 8 por ciento en poblaciones abiertas de adolescentes. Existe una gran variabilidad en los índices del padecimiento, probablemente relacionados a las características culturales y sociales específicas de las muestras, al incremento secular de la enfermedad, a la fuente de información y a la forma de evaluar la sintomatología depresiva. Estos padecimientos no sólo deterioran la salud de quienes los padecen sino también afectan su aprovechamiento y rendimiento escolar. Se realizó una entrevista semiestructurada a 40 adolescentes de una escuela secundaria en la ciudad de México, y se encontró una prevalencia de 12 por ciento de TDM y de 7.5 por ciento para el TD. Los adolescentes con trastornos internacionalizados presentaron calificaciones más bajas en español 6.3 (2.2) vs 8.0(1.7) [t=2.34, gl=28, P=0.24]; y en inglés 6.6 (1.6) vs 8.0=(1.6) [t= 2.23, gl=38, P=0.032] que los adolescentes sanos y con trastornos externalizados. Es necesario considerar los problemas de psicopatología, en especial los depresivos, al momento de evaluar el bajo aprovechamiento escolar

Los genes de los receptores a dopamina D2 y D4 distinguen la presencia clínica de tics en el trastorno obsesivo-compulsivo / Dopamine D2 and D4 receptor genes distinguish the clinica presence of tics in the obsessive-compulsive disorder

Se llevó a cabo un estudio de asociación alélica entre polimorfismos de los genes a los receptores a dopamina D2 (DRD2) y D4 (DRD4), en pacientes con trastornos obsesivos-compulsivo (TOC) con tics [TOC(+)] y sin tics [TOC(-)] motores o vocales. Se estudiaron 66 pacientes con TOC de acuerdo a los criterios del DSMIV (12 presentaron tics). Se tipificaron 54 sujetos controles. Los genotipos moleculares se determinaron por medio de la reacción en cadena de la polimerasa. Los pacientes con TOC(+) tuvieron mayor frecuencia del alelo Taql A2 (p=0.014) comparados con el grupo control, así como un exceso de individuos homocigotos A2A2 (p=0.001). La prevalancia de individuos con al menos una copia del alelo, así como la frecuencia total de alelos, del alelo mayor 7 del gene DRD4 fueron significativamente mayores en los pacientes TOC(+) comparados con los TOC(-) (91 por ciento vs 48 por ciento). El TOC(+) mostraron una frecuencia aumentada del alelo 7 del polimorfismo DRD4 que el TOC(-) (48 por ciento vs. 9 por ciento, p=0.018). Cuando ambos alelos se combinaban (al menos una copia del DRD2-A2 y una del DRD4-R7), los TOC(+) mostraban una mayor frecuencia de este haplotipo ((3.3 por ciento vs. 40 por ciento p= 0.016). El TOC con tics, podrían representar un subtipo genético/clínico de la enfermedad

Validez y confiabilidad de la Escala para la Evaluación de la Manía / Validity and confiability of Mania Rating Scale

El objetivo de este trabajo fue traducir al castellano y determinar la validez diagnóstica y concurrete, así como la confiabilidad, de la escala para la Evaluación de la Manía, de Young y cols(15). Metodología. Los pacientes procedían del Hospital Psiquiátrico Fray Bernardino Alvarez de la ciudad de México. Mediante una entrevista estructurada (la Entrevista Diagnóstica Internacional Compuesta, CIDI) se formaron dos grupos para el estudio: uno de 26 pacientes con diagnóstico de manía en el estado actual y otro, que funcionó como control y se intregró con 28 sujetos esquizofrénicos. A todos los sujetos se les aplicó la Escala para la Evaluación de la Manía, en dos ocasiones diferentes, por evaluadores independientes. Se determinó la consistencia interna del instrumento, así como el mejor punto de corte para el diagnósto, tomando como estándar de oro el diagnóstico del CIDI. Resultados. El alfa de Cronbach del instrumento fue de 0.84. La confiabilidad test-retest fue de 0.93. El mejor punto de corte del instrumento para fines diagnósticos se ubicó en los 28 puntos, con una sensibilidad de 96 por ciento y especificidad del 100 por ciento. Los puntajes obtenidos por los pacientes maníacos fueron significativamente mayores de los de los sujetos con esquizofrenia. Conclusión. La versión en castellano de la escala de evaluación de la manía tuvo comportamiento psicométrico adecuado, y puede ser utilizada con segurirdad en las investigaciones clínicas

Age of onset, gender and severity in obsessive-compulsive disorder. A study on a Mexican population

En el Instituto Mexicano de Psiquiatría (IMP) de la ciudad de México, que es una institución de atención de tercer nivel, evaluamos la edad de inicio, el género, la severidad y otra serie de caracteríticas demográficas de un grupo de 71 pacientes con el diagnóstico de trastorno obsesivo-compulsivo. En el presente trabajo los varones presentaron una edad de inicio significativamente más temprana que la de las mujeres. De la misma manera, también encontramos una correlación negativa entre la severidad total de los síntomas, la medida por medio de la escala Yale-Brown (versión en español) y la edad de inicio de la enfermedad (-0.31, p=0.01, n=61). Las obsesiones de agresión se asociaron con una mayor edad de inicio (29.5 ñ 14.3 n=9 vs 21.4 ñ 7.7 n=59, F6.56, p=0..01) mientras que las obsesiones de simetrìa con una menord edad de inicio (15.1 ñ 4.0 n=12 vs 24.1 ñ 9.2 n=56, F 10.8, p=0.001). La subescala de compulsione se incrementa cuando tenían obsesiones de agresión. Finalmente, los resultados se comparan con los reportados en la bibliografía, se sugieren algunas medidas que son necesarias para investigación en este campo