[Clinical and electromyographic findings in patients with diabetic polyneuropathy]. / Manifestaciones clínicas y alteraciones electroneuromiográficas en pacientes con diabetes tipo 2 y polineuropatía.

BACKGROUND: Diabetic neuropathy represents a polyneuropathy with electrophiosiological alterations. Electroneuromyography (NMD) plays an important role in the evaluation of patient with diabetes mellitus type 2 (DM2) and doubtful neuropathy. OBJECTIVE: To determine clinical manifestations in patients with distal symmetrical sensory polyneuropathy (DSSP) and to correlate them with electromyographic alterations. MATERIAL AND METHODS: Transversal, analytical study. 138 patients over 18 years old, with DM2 and PSSD were selected. They underwent physical examination, laboratory studies and electromyography (EM) with 4-channel Nicolet electromyograph. Measures of central tendency and their dispersion were analyzed; data normality with Kolmogorov-Smirnov; Student's t test and Spearman's correlation. RESULTS: Thalar hyperkeratosis was the most frequent clinical finding in 103 (74%) patients. The most frequent symptoms were paresthesia in 132 (95.7%) patients and tingling in 93 (67.4%) patients. Exploration of superficial sensitivity determined neuropathy in 42 (30.4%) patients finding greater insensitivity in the medial plantar nerve territory. In the EM, the nerve with the greatest absent response was the left lateral plantar nerve in 51 (59%) patients. A significant correlation (p < 0.05) was found between the variables of EM with age, years of evolution and levels of glycated hemoglobin A1c. CONCLUSIONS: The higher the lack of glycemic control, the chronobiology of the patient and the time of illness, the greater the electromyographic affection.

INTRODUCCIÓN: la neuropatía diabética representa una polineuropatía con alteración electrofiosiológica. La electroneuromiografía (ENM) desempeña un papel importante en la evaluación del paciente con diabetes mellitus tipo 2 (DM2) y neuropatía dudosa. OBJETIVO: determinar las manifestaciones clínicas en pacientes con polineuropatía sensitiva simétrica distal (PSSD) y correlacionarlas con alteraciones electroneuromiográficas. MATERIAL Y MÉTODOS: estudio transversal, analítico. Se seleccionaron 138 pacientes mayores de 18 años, con DM2 y PSSD. Se les realizó exploración física, estudios de laboratorio y ENM con electromiógrafo Nicolet de 4 canales. Se analizaron las medidas de tendencia central y su dispersión; normalidad de datos con Kolmogorov-Smirnov; t de Student y correlación de Spearman. RESULTADOS: la hiperqueratosis talar fue el hallazgo clínico más frecuente en 74% de los pacientes. Los síntomas más frecuentes fueron parestesias en 95.7% y hormigueo en 67.4%. La exploración de sensibilidad superficial determinó neuropatía en 30.4%, encontrando mayor insensibilidad en el territorio del nervio plantar medial. En la ENM, el nervio con mayor respuesta ausente fue el plantar lateral izquierdo en 59%. Se encontró correlación significativa (p < 0.05) entre las variables electroneuromiograficas con la edad, años de evolución y niveles de hemoglobina glucosilada A1c (HbA1c). CONCLUSIONES: a mayor descontrol glucémico, cronobiología del paciente y tiempo del padecimiento, mayor es la afección electroneuromiográfica.

Prevalencia mundial de la diabetes mellitus tipo 2 y su relación con el índice de desarrollo humano

Objetivo. Evaluar la relación entre la prevalencia de diabetes mellitus tipo 2 (DM2) y el índice de desarrollo humano (IDH) por región del mundo en el período 2010–2015. Método. Se utilizaron los datos de la Federación Internacional de Diabetes para la prevalencia de DM2 (2010–2015) y el IDH del Programa de las Naciones Unidas para el Desarrollo. Se analizaron correlaciones lineales de Spearman entre el IDH y la prevalencia de DM2 y se hicieron regresiones lineales para estimar la relación entre ambos. Resultados. Se observó que a menor IDH menores son las prevalencias de DM2, y a mayor IDH, mayores son las prevalencias de DM2. A nivel mundial, el IDH explica 8,6% de la varianza de la prevalencia de DM2 (P < 0,0001) y que este comportamiento fue diferente en cada región del mundo. Conclusiones. El IDH puede influir en la prevalencia de DM2, aunque la relación depende de cada país, región y año analizado.

Objective. To evaluate the relationship between the prevalence of type 2 diabetes mellitus (DM2) and the Human Development Index (HDI), by region of the world in the period 2010-2015. Method. International Diabetes Federation data were used for DM2 prevalence (2010-2015), together with HDI data (United Nations Development Program). Spearman linear correlations between HDI data and DM2 prevalence were analyzed, and linear regressions were done to estimate the relationship between the two. Results. It was observed that lower HDI scores corresponded to lower DM2 prevalence rates, and higher HDI scores to higher DM2 prevalence. At the global level, the HDI explains the 8.6% variance of DM2 prevalence (P < 0.0001) and shows that the situation was different in each region of the world. Conclusions. While HDI score may be associated with DM2 prevalence, the relationship between them differs from region to region and from country to country, and depends on the particular year analyzed.

Objetivo. Avaliar a relação entre a prevalência de diabetes mellitus tipo 2 (DM2) e o índice de desenvolvimento humano (IDH) por região do mundo no período de 2010 a 2015. Métodos. Foram utilizados dados da Federação Internacional de Diabetes para a prevalência da DM2 (2010–2015) e o IDH do Programa das Nações Unidas para o Desenvolvimento. Foram analisadas as correlações lineares de Spearman entre o IDH e a prevalência de DM2 e feitas regressões lineares para estimar a relação entre ambos. Resultados. Observou-se que quanto mais baixo o IDH, menores são as prevalências de DM2, e quanto mais alto o IDH, maiores são prevalências de DM2. Ao nível mundial, o IDH explica 8,6% da variança da prevalência de DM2 (P < 0,0001) e este comportamento difere em cada região do mundo. Conclusões. O IDH pode influir na prevalência de DM2, embora a relação dependa de cada país, região e ano analisados.

[Effect of the DiabetIMSS program on cardiovascular risk, blood pressure and HDL cholesterol in patients with metabolic syndrome]. / Efecto de DiabetIMSS sobre el riesgo cardiovascular, la tensión arterial y el colesterol-HDL en pacientes con síndrome metabólico.

OBJECTIVE: The aim of this paper is to evaluate the effect of the DiabetIMSS program on cardiovascular risk, blood pressure and HDL cholesterol in patients with metabolic syndrome. METHODS: Quasi-experimental intervention study. Non-probabilistic convenience sampling. 35 subjects in the educational strategy one year were included. The following variables were collected: age, gender, smoking, total cholesterol, HDL cholesterol, systolic and diastolic blood pressure; cardiovascular risk calculator based on Framingham is calculated. Descriptive and inferential statistical percentages with Student t test was used. RESULTS: There was an increase in the proportion of subjects increased their subsequent figures HDL cholesterol intervention, there by generating an increase of protective factor (p < 0.05). Because of the blood pressure a marked improvement in all ranges of blood pressure (p < 0.05) was presented. CONCLUSIONS: The educational strategy for the control of diabetic patients presented a favorable performance in HDL-cholesterol and blood pressure, reducing the risk of cardiovascular patients.

Objetivo: evaluar el efecto del programa DiabetIMSS sobre el riesgo cardiovascular, la tensión arterial y colesterol-HDL en pacientes con síndrome metabólico. Métodos: estudio de intervención cuasiexperimental. Muestreo no probabilístico por conveniencia. Se incluyeron 35 sujetos que participaron en la estrategia educativa de un año de duración. Se recolectaron las siguientes variables: edad, género, tabaquismo, colesterol total, HDL, TA sistólica y diastólica; se calculó el riesgo cardiovascular con calculadora basada en Framingham. Se utilizó estadística descriptiva con porcentajes e inferencial con t de Student. Resultados: hubo una elevación de la proporción de sujetos que incrementaron sus cifras del colesterol-HDL posterior a la intervención, generando, por ende, un incremento del factor protector (p < 0.05). En razón de las cifras tensionales, se presentó una mejoría notable en todos los rangos de presión arterial (p < 0.05). Conclusiones: la estrategia educativa para el control del paciente diabético presentó un comportamiento favorable en el colesterol-HDL y tensión arterial, disminuyendo el riesgo cardiovascular de los pacientes.

[Global prevalence of type 2 diabetes mellitus and its relationship with the Human Development IndexPrevalência mundial da diabetes mellitus tipo 2 e sua relação com o índice de desenvolvimento humano]. / Prevalencia mundial de la diabetes mellitus tipo 2 y su relación con el índice de desarrollo humano.

OBJECTIVE: To evaluate the relationship between the prevalence of type 2 diabetes mellitus (DM2) and the Human Development Index (HDI), by region of the world in the period 2010-2015. METHOD: International Diabetes Federation data were used for DM2 prevalence (2010-2015), together with HDI data (United Nations Development Program). Spearman linear correlations between HDI data and DM2 prevalence were analyzed, and linear regressions were done to estimate the relationship between the two. RESULTS: It was observed that lower HDI scores corresponded to lower DM2 prevalence rates, and higher HDI scores to higher DM2 prevalence. At the global level, the HDI explains the 8.6% variance of DM2 prevalence (P < 0.0001) and shows that the situation was different in each region of the world. CONCLUSIONS: While HDI score may be associated with DM2 prevalence, the relationship between them differs from region to region and from country to country, and depends on the particular year analyzed.

OBJETIVO: Avaliar a relação entre a prevalência de diabetes mellitus tipo 2 (DM2) e o índice de desenvolvimento humano (IDH) por região do mundo no período de 2010 a 2015. MÉTODOS: Foram utilizados dados da Federação Internacional de Diabetes para a prevalência da DM2 (2010­2015) e o IDH do Programa das Nações Unidas para o Desenvolvimento. Foram analisadas as correlações lineares de Spearman entre o IDH e a prevalência de DM2 e feitas regressões lineares para estimar a relação entre ambos. RESULTADOS: Observou-se que quanto mais baixo o IDH, menores são as prevalências de DM2, e quanto mais alto o IDH, maiores são prevalências de DM2. Ao nível mundial, o IDH explica 8,6% da variança da prevalência de DM2 (P < 0,0001) e este comportamento difere em cada região do mundo. CONCLUSÕES: O IDH pode influir na prevalência de DM2, embora a relação dependa de cada país, região e ano analisados.

Prevalencia mundial de la diabetes mellitus tipo 2 y su relación con el índice de desarrollo humano / Global prevalence of type 2 diabetes mellitus and its relationship with the Human Development Index / Prevalência mundial da diabetes mellitus tipo 2 e sua relação com o índice de desenvolvimento humano

RESUMEN Objetivo Evaluar la relación entre la prevalencia de diabetes mellitus tipo 2 (DM2) y el índice de desarrollo humano (IDH) por región del mundo en el período 2010-2015. Método Se utilizaron los datos de la Federación Internacional de Diabetes para la prevalencia de DM2 (2010-2015) y el IDH del Programa de las Naciones Unidas para el Desarrollo. Se analizaron correlaciones lineales de Spearman entre el IDH y la prevalencia de DM2 y se hicieron regresiones lineales para estimar la relación entre ambos. Resultados Se observó que a menor IDH menores son las prevalencias de DM2, y a mayor IDH, mayores son las prevalencias de DM2. A nivel mundial, el IDH explica 8,6% de la varianza de la prevalencia de DM2 (P < 0,0001) y que este comportamiento fue diferente en cada región del mundo. Conclusiones El IDH puede influir en la prevalencia de DM2, aunque la relación depende de cada país, región y año analizado.

ABSTRACT Objective To evaluate the relationship between the prevalence of type 2 diabetes mellitus (DM2) and the Human Development Index (HDI), by region of the world in the period 2010-2015. Method International Diabetes Federation data were used for DM2 prevalence (2010-2015), together with HDI data (United Nations Development Program). Spearman linear correlations between HDI data and DM2 prevalence were analyzed, and linear regressions were done to estimate the relationship between the two. Results It was observed that lower HDI scores corresponded to lower DM2 prevalence rates, and higher HDI scores to higher DM2 prevalence. At the global level, the HDI explains the 8.6% variance of DM2 prevalence (P < 0.0001) and shows that the situation was different in each region of the world. Conclusions While HDI score may be associated with DM2 prevalence, the relationship between them differs from region to region and from country to country, and depends on the particular year analyzed.

RESUMO Objetivo Avaliar a relação entre a prevalência de diabetes mellitus tipo 2 (DM2) e o índice de desenvolvimento humano (IDH) por região do mundo no período de 2010 a 2015. Métodos Foram utilizados dados da Federação Internacional de Diabetes para a prevalência da DM2 (2010-2015) e o IDH do Programa das Nações Unidas para o Desenvolvimento. Foram analisadas as correlações lineares de Spearman entre o IDH e a prevalência de DM2 e feitas regressões lineares para estimar a relação entre ambos. Resultados Observou-se que quanto mais baixo o IDH, menores são as prevalências de DM2, e quanto mais alto o IDH, maiores são prevalências de DM2. Ao nível mundial, o IDH explica 8,6% da variança da prevalência de DM2 (P < 0,0001) e este comportamento difere em cada região do mundo. Conclusões O IDH pode influir na prevalência de DM2, embora a relação dependa de cada país, região e ano analisados.

La educación en el tratamiento del paciente con diabetes / Education in the treatment of the diabetes patient

Para enfrentar la diabetes mellitus, el Programa Institucional de Prevención y Atención al Paciente Diabético Diabet IMSS se inició en 2008 en el Instituto Mexicano del Seguro Social. Está integrado por un equipo multidisciplinario orientado a prevenir o retrasar la aparición de complicaciones al mejorar el control metabólico;esto además tiene como objetivo incrementar la supervivencia, mejorar la calidad de vida, incrementar la satisfacción y usar con eficiencia los recursos públicos...

[Parity and menarche as risk factors for osteoporosis in postmenopausal women]. / Paridad y menarquia como factores de riesgo para osteoporosis en mujeres posmenopáusicas.

BACKGROUND: Worldwide studies, even in our country, have thrown discrepant results about the relation between osteoporosis, parity and age of menarche. OBJECTIVE: To investigate the relation of osteoporosis in postmenopausal mexican women with multiparity and age of menarche. PATIENTS AND METHOD: Transversal, retrospective and analytical study. Non-probabilistic sampling technique was performing with users women of the IMSS in San Luis Potosí. Reproductive history and age of menarche were obtained by the addition of these items to the previously validated Albrand questionnaire. Women were divided into groups according to the number of pregnancies in: normal parity (0 to 3 childbirths) conformed by 112 patients (46%) and multiparity (> or = 4 pregnancies), 131 women (54%). In relation to menarche with an average of 12.98 years, from this number we divided them in: early menarche (before the age of 13) and late menarche (at 13 years of age or after). It was measured bone mineral density with dual distal forearm x-ray absorptiometry to all patients. RESULTS: 243 women were studied, with an average of age of 55.92, rank 31 to 80 years. Using the criteria, of the World Health Organization, 18% of posmenopausal women had osteoporosis, 39% had osteopenia and 41% had bone normality. No association was found between the number of deeds and osteoporosis. Additionally we observed that the women who had 4 or more children were older than the other women. average 57.42 against 54.16. Also there was significant negative correlation (r = -0.43) between age and densitometry. In addition we found that an age greater to 13 years in the appearance of the menarche was related to osteoporosis (OR 4.46; p = 0.035). CONCLUSIONS: In posmenopausal women a menarche at the age of 13 years or after is a risk factor for osteoporosis.

[Impact of an educational institutional program in the control of the diabetic patient]. / Impacto de un programa institucional educativo en el control del paciente diabético.

OBJECTIVE: to assess the impact of an educational institutional program in the control of type 2 diabetic patient. METHODS: intervention educational study, with quasi-experimental and self-controlled subjects. A convenience non-probabilistic sample was used including 151 patients from the program for the integral care of diabetic patients. Demographic variables: gender, age, type of insurance, somatometric and metabolic profile. The assistance to a one-year length, educational program was necessary. Descriptive and inferential parametric statistics were used. RESULTS: 106 women and 45 men, with age range between 15 and 87 years, and with an average of 57.22 ± 11.47, were studied. A significant decrease in body mass index, waist circumference, venous glucose fasting and post-prandial values, cholesterol, systolic blood pressure, triglycerides and glycosylated hemoglobin (t Student semi-detached, p < 0.05) was observed. There were no changes in diastolic blood pressure (p = 0.334). CONCLUSIONS: one year afterwards, the strategy based on education for the control of the diabetic patient shown a favorable pattern in most of somatometric and metabolic parameters. We suggest to extend this study over a longer period to determine if the effects persist over time.

Objetivo: evaluar el impacto de un programa institucional educativo en el control del paciente diabético tipo 2. Métodos: estudio de intervención educativa cuasi experimental y sujetos como su propio control. Muestreo no probabilístico por conveniencia. Se incluyeron 151 pacientes del programa para la atención integral del paciente diabético. Variables demográficas: Género, edad, tipo de aseguramiento, somatometría y perfil metabólico. Se aplicó un programa educativo de un año de duración. Se utilizó estadística descriptiva e inferencial paramétrica. Resultados: se estudiaron 106 mujeres y 45 hombres cuyo rango de edad iba de 15 a 87 años, con una media de 57.22 ± 11.47. Se observó una disminución significativa en su índice de masa corporal, perímetro de cintura, glucosa venosa en ayuno, glucosa posprandial, colesterol, tensión arterial sistólica, triglicéridos y hemoglobina glucosilada (t de Student pareada, p < 0.05). No hubo cambios en la tensión arterial diastólica (p = 0.334). Conclusiones: la estrategia educativa para el control del paciente diabético presentó un comportamiento favorable en la mayoría de los parámetros somatométricos y metabólicos a un año de seguimiento. Se sugiere que se extienda el estudio a un periodo mayor para determinar si los efectos perduran con el tiempo.

[Parity and menarche as risk factors of osteoporosis in postmenopausal Mexican women]. / Paridad y menarquia como factores de riesgo de osteoporosis en mujeres posmenopáusicas mexicanas.

BACKGROUND: At the moment the studies lead at world-wide level and even in our country have thrown discrepant results about the relation between osteoporosis, parity and age of menarche. OBJECTIVE: To investigate the relation of osteoporosis in postmenopausal Mexican women with multiparity and age of menarche. PATIENTS AND METHOD: A retrospective and analytical cross-sectional study, with a non-probabilistic sampling technique in women rightful claimants of the IMSS, San Luis Potosi. In all of them the bone mineral density was measured with X-ray dual absorptiometry in the distal forearm. Reproductive history and age of menarche were obtained by the addition of these items to the previously validated Albrand questionnaire. Women were divided into groups according to the number of pregnancies in: normal parity (0 to 3 childbirths) conformed by 112 patients (46%) and multiparity (> or = 4 pregnancies), 131 women (54%). In relation to menarche with an average of 12.98 years, from this number we divided them in: early menarche (< 13 yrs) and late menarche (> or = 13 yrs). RESULTS: 243 women were studied, with an average of age of 55.92, rank 31 to 80 years. Using the criteria of the World Health Organization, 18% of postmenopausal women had osteoporosis, 39% had osteopenia and 43% had bone normality. No association was found between the number of pregnancies and osteoporosis. Additionally we observed that the women who had four or more children were older than the other women, average 57.42 against 54.16. Also there was significant negative correlation (r = -0.43) between age and densitometry. We found that an age greater to 13 years in the appearance of the menarche was related to osteoporosis (OR 4.46, p: 0.035). CONCLUSIONS: In postmenopausal women a menarche older than 13 years is a risk factor for osteoporosis.

[Sensitivity and specificity of a utility model of the detection of diabetic neuropathy]. / Sensibilidad y especificidad de un modelo de utilidad para la detección de neuropatía diabética.

OBJECTIVE: To determine whether a utility model can be used with acceptable sensitivity and specificity for the diagnosis of diabetic peripheral neuropathy (DPN). METHODS: Cross sectional study, non-probability sampling, in 381 type 2 diabetic patients with diabetic foot risk. To determine the DPN, it was evaluated the protective sensation in 10 sites on the foot. It was a positive diagnosis if three or more points showed insensitivity at the touch of the skin with Semmes-Weinstein monofilament (SWM). Monofilament was compared to the utility model (MMU); the diagnostic methods of application were the same for both. RESULTS: Mean age was 62 years, 11 years of development of DM, mean body mass index of 29 kg/m2, average glucose 129 mg/dL (78-264 mg/dL). With sensitivity of 73.68%, 97.67% of specificity, positive predictive value 77.78%, negative predictive value 97.10%, the positive likelihood ratio was 31.59 and the negative likelihood ratio 0.27. CONCLUSION: Currently, diagnostic devices for tactile sensory loss are not readily available in our country; therefore, the results of this research will help to make the diagnosis of the MMU timely, inexpensive and easily accessible.

[Correlation of metabolic syndrome components in older Mexican women]. / Correlación de los componentes del síndrome metabólico en mujeres Mexicanas mayores de 60 años.

BACKGROUND: In woman aged over 60 years, body changes occur and might cause insulin resistance and metabolic syndrome. OBJECTIVE: To determine the relationship between the components of metabolic syndrome, insulin resistance and body mass index in women over 60 years, attended at the Geriatric Services in the Dr. Ignacio Morones Prieto Hospital in San Luis Potosi, Mexico. MATERIAL AND METHOD: We performed an observational, descriptive and transversal study with non-probability sampling, selecting 61 women aged 60 years attended from 2006 to 2008, who have measured the body mass index (BMI), insulin resistance and homeostasis model (HOMA2), and identifying the components of metabolic syndrome according to the criteria of the World Health Organization. We used descriptive and inferential statistics with r Pearson and Chi Square. RESULTS: The mean age was 68 years. The average HOMA2 were 1.4 and 75 percentile 1.9. The prevalence of metabolic syndrome was present in 23%. The association test with a p < 0.05 was considered significant for metabolic syndrome dysglucemia and obesity, but not for other components of metabolic syndrome. The triglycerides level correlated with insulin resistance (r = 0.325, p = 0.011), insulin resistance with glucose (r = 0.535, p = 0.000) and insulin resistance with BMI (r = 0.282, p = 0.28). CONCLUSIONS: It is important to properly define the components for the presence of metabolic syndrome in older women due to not all who qualify as obese have metabolic syndrome, and neither all the metabolic syndrome are associated with insulin resistance. The single alteration of one of the components of metabolic syndrome is not sufficient to cause insulin resistance.

[Reliability of the modified albrand questionnaire to diagnose osteoporosis]. / Confiabilidad del cuestionario de Albrand modificado para el diagnóstico de osteoporosis.

BACKGROUND: A considerable amount of Mexican women will be in menopausal status, though it won't be possible to carry out densitometry to all of them. Developing a risk-factor--based instrument to screen those who would need it is advisable. OBJECTIVE: To ascertain the sensitivity and specificity of the Albrand questionnaire, which could be used to identify risk factors for osteoporosis. MATERIAL AND METHOD: A cross-sectional study with a non-probabilistic sampling technique was used to include 906 menopausal women. All women answered a modified and previously validated version of Albrand questionnaire; Cronbach's alpha was 0.83. Eight risk factors for osteoporosis were analyzed; each risk factor had a different weight and the total score per patient was calculated. All underwent lower arm densitometry. RESULTS: Peripheral densitometry revealed that 166 patients had osteoporosis and 740 did not. The global prevalence of osteoporosis was 18.3%; the cut-off value was set in > or =4 points. The Albrand questionnaire had 55% sensitivity and 79% specificity; the positive predictive value was 39% and the negative predictive value was 90%. CONCLUSION: Albrand questionnaire has acceptable sensitivity and specificity and it could be useful for screening menopausal women who would need densitometry tests. Applying the instrument would reduce costs of osteoporosis detection.

Correlación del monitoreo glucémico entre el método visual y computarizado pre y post capacitación / Correlation ot blood glucose monitoring with reactive strips and central laboratory after and before training

Introducción: El monitoreo de la glucosa se obtiene del cambio en la tinción de la zona de una tira reactiva. La educación en diabetes incluye el conocimiento de las mediciones en sangre capilar. Objetivo: Conocer si la capacitación a enfermeras influye en la precisión del monitoreo de glucemia en ayunas. Material y método: Estudio transversal, observacional, descriptivo, comparativo, de intervención educativa en 116 pacientes diabéticos hospitalizados. Las determinaciones se realizaron en forma ciega por enfermería, antes y después de la capacitación en días diferentes, y las muestras de sangre venosa por el personal del laboratorio. Resultados: Su distribución por sexo fue 22 mujeres y 25 hombres en el grupo pre-intervención y 30 mujeres y 39 hombres en el grupo post-intervención. El coeficiente de correlación fue de 0.45 entre las muestras de glucosa por tira reactiva y las de laboratorio antes de la intervención educativa y de 0.77 después de la intervención educativa. El 11% de los pacientes descontrolados metabólicamente quedaban sin diagnosticarse por imprecisión del método con tira visual; después de la intervención educativa disminuyó a 8%. La diferencia de los valores promedios obtenidos por laboratorio y por tira reactiva fue significativa (p<0.05) en los dos grupos. Conclusiones: Los resultados de la correlación que existe entre los resultados de glucemia por laboratorio y con tira reactiva visuales baja y coincide con lo reportado en la literatura, pero mejora con la intervención educativa hacia el personal involucrado en su determinación.

Introduction: The results of capillary glucose testing are obtained by especific zone strip tincture. The current use of accurate blood glucose monitor are even more used nowadays, so, health diabetes team education is a priority. Frequently on clinical practice there are not correlation between visual test strips and reference laboratory. Objective: To know the correlation between different glucose monitoring according hospital educational intervention program training. Methods: Transversal, comparative, intervention study Visual testing monitoring before and after educational intervention program were compared with central laboratory results. We use t-student and Parson's "r" correlation test. Results: 116 hospitalized subjects were studied. 52 women and 64 male correlation coefficient was 0.45 between visual strips and referral laboratory and 0.77 after education intervention. Difference in values obtained from reactive strip and laboratory tests was significative (<0.05) in both groups. Conclusions: This study shows that correlation between results of both tests is low and it is related to the existing evidence found in the literature review, and it is improved after the introduction of the education (training) program.

Características y manejo de la urolitiasis en pacientes que acuden a un hospital general / Characteristic and managing of the urolitiasis in patient that attend to a general hospital

Introducción: la urolitiasis es un padecimiento común en la práctia clínica diaria, cuyo tratamiento médico puede dirigirse a la disolución del cálculo existente y a la prevención de la formación de otros nuevos. En nuestro medio, la litiasis representa una causa importante de atención con aproximadamente mil consultas por año. Objetivo: reconocer las características de la litiasis, así como el tratamiento utilizado con más frecuencia en los pacientes con esta afección. Material y método: estudio retrospectivo, transversal, observacional y descriptivoárealizado en un hospital general. Resultados: se incluyeron 64 pacientes: 37 hombres y 27mujeres, la edad promedio: 4l.9 años. El 6 por ciento de los sujetos del estudio tenía antecedentes familiares de urolitiasis. El dolor fue el síntoma principal; se localizaba en el abdomen y pelvis en 29 pacientes (45 por ciento). Los síntomas secundarios más frecuentes fueron: hematuria y disuria. La localización del lito predominó en el uréter izquierdo (55 por ciento). Del grupo de pacientes, 19 (30 por ciento) tuvieron recidivas. Conclusiones: la tercera parte de los pacientes ingresó debido a urolitiasis recidivante y a ninguno se le habían realizado pruebas o exámenes del metabolismo del calcio, físicos ó químicos del lito. Su tratamiento fue exclusivamente quirúrgico, sin ninguna forma de intervención médica en un problema esencialmente metabólico. Se propuso el abordaje multidisciplinario por parte de los servicios de: endocrinología, urología, medicina interna. En la actualidad está en proceso un protocolo de manejo conjunto que se reportar en el año 2002.