Psychometric evaluation of the Hospital Anxiety and Depression Scale in Mexican adults with ischemic and hypertensive cardiomyopathy.

Background: Depression and anxiety are frequent comorbid conditions in cardiovascular diseases (CVDs); they are related to poor prognosis and higher mortality risk. Health providers need a clinical tool to identify these psychiatric conditions. The 14-item hospital anxiety and depression scale (HADS) is a screening tool used in patients with different medical conditions. Objective: The aim of this study was to evaluate the psychometric properties of the HADS Mexican Spanish version in a broad sample of Mexican patients with CVDs. Materials and Methods: A total of 953 individuals between 18 and 75 years old with ischemic or hypertensive cardiomyopathy were screened with the HADS Mexican Spanish version. Construct validity, internal consistency, and congruence coefficients of the scale were obtained. Results: The results showed two clear factors which correspond to the original two designated domains of the HADS, anxiety, and depression, with adequate reliability values (alpha > 0.80) and high congruence coefficients (> 0.90) when compared to the sample of other validation studies of the HADS. Conclusions: The present study adds evidence of the validity and reliability of the HADS to assess the presence of both depression and anxiety in Mexican patients with CVD. Its central contribution is that it demonstrates its capacity to differentiate the presence and severity of depression and anxiety in this population.

Antecedentes: La depresión y la ansiedad son afecciones comórbidas frecuentes en las enfermedades cardiovasculares; se relacionan con mal pronóstico y mayor riesgo de mortalidad. Los proveedores de salud requieren de una herramienta clínica para identificar estas condiciones psiquiátricas. La Escala de Ansiedad y Depresión Hospitalaria de 14 ítems (HADS) es una herramienta de detección utilizada en pacientes con diferentes afecciones médicas. Objetivo: Evaluar las propiedades psicométricas de la versión mexicana-española de la HADS en una amplia muestra de pacientes mexicanos con enfermedades cardiovasculares (ECV). Método: Un total de 953 individuos entre 18 y 75 años de edad con cardiomiopatía isquémica o hipertensiva se examinaron con la versión Mexicana en español de la HADS. Se obtuvieron la validez de constructo, la consistencia interna y los coeficientes de congruencia de la escala. Resultados: Los resultados mostraron dos factores que corresponden a los dos dominios designados originales de la HADS, ansiedad y depresión, con valores de confiabilidad adecuados (alfa > 0.80) y altos coeficientes de congruencia (> 0.90) en comparación con la muestra de otros estudios de validación de la HADS. Conclusiones: El presente estudio sustenta la validez y confiabilidad de la HADS para evaluar la presencia de depresión y ansiedad en pacientes Mexicanos con ECV. Su contribución central es su capacidad para diferenciar la presencia y la gravedad de la depresión y la ansiedad en esta población.

Psychometric evaluation of the Hospital Anxiety and Depression Scale in Mexican adults with ischemic and hypertensive cardiomyopathy / Evaluación psicométrica de la Escala de Ansiedad y Depresión Hospitalaria en adultos Mexicanos con cardiopatía isquémica e hipertensiva

Abstract Background: Depression and anxiety are frequent comorbid conditions in cardiovascular diseases (CVDs); they are related to poor prognosis and higher mortality risk. Health providers need a clinical tool to identify these psychiatric conditions. The 14-item hospital anxiety and depression scale (HADS) is a screening tool used in patients with different medical conditions. Objective: The aim of this study was to evaluate the psychometric properties of the HADS Mexican Spanish version in a broad sample of Mexican patients with CVDs. Materials and Methods: A total of 953 individuals between 18 and 75 years old with ischemic or hypertensive cardiomyopathy were screened with the HADS Mexican Spanish version. Construct validity, internal consistency, and congruence coefficients of the scale were obtained. Results: The results showed two clear factors which correspond to the original two designated domains of the HADS, anxiety, and depression, with adequate reliability values (alpha > 0.80) and high congruence coefficients (> 0.90) when compared to the sample of other validation studies of the HADS. Conclusions: The present study adds evidence of the validity and reliability of the HADS to assess the presence of both depression and anxiety in Mexican patients with CVD. Its central contribution is that it demonstrates its capacity to differentiate the presence and severity of depression and anxiety in this population.

Resumen Antecedentes: La depresión y la ansiedad son afecciones comórbidas frecuentes en las enfermedades cardiovasculares; se relacionan con mal pronóstico y mayor riesgo de mortalidad. Los proveedores de salud requieren de una herramienta clínica para identificar estas condiciones psiquiátricas. La Escala de Ansiedad y Depresión Hospitalaria de 14 ítems (HADS) es una herramienta de detección utilizada en pacientes con diferentes afecciones médicas. Objetivo: Evaluar las propiedades psicométricas de la versión mexicana-española de la HADS en una amplia muestra de pacientes mexicanos con enfermedades cardiovasculares (ECV). Método: Un total de 953 individuos entre 18 y 75 años de edad con cardiomiopatía isquémica o hipertensiva se examinaron con la versión Mexicana en español de la HADS. Se obtuvieron la validez de constructo, la consistencia interna y los coeficientes de congruencia de la escala. Resultados: Los resultados mostraron dos factores que corresponden a los dos dominios designados originales de la HADS, ansiedad y depresión, con valores de confiabilidad adecuados (alfa > 0.80) y altos coeficientes de congruencia (> 0.90) en comparación con la muestra de otros estudios de validación de la HADS. Conclusiones: El presente estudio sustenta la validez y confiabilidad de la HADS para evaluar la presencia de depresión y ansiedad en pacientes Mexicanos con ECV. Su contribución central es su capacidad para diferenciar la presencia y la gravedad de la depresión y la ansiedad en esta población.

Psychometric evaluation of the Hospital Anxiety and Depression Scale in Mexican adults with ischemic and hypertensive cardiomyopathy.

Background: Depression and anxiety are frequent comorbid conditions in cardiovascular diseases (CVDs); they are related to poor prognosis and higher mortality risk. Health providers need a clinical tool to identify these psychiatric conditions. The 14-item hospital anxiety and depression scale (HADS) is a screening tool used in patients with different medical conditions. Objective: The aim of this study was to evaluate the psychometric properties of the HADS Mexican Spanish version in a broad sample of Mexican patients with CVDs. Materials and Methods: A total of 953 individuals between 18 and 75 years old with ischemic or hypertensive cardiomyopathy were screened with the HADS Mexican Spanish version. Construct validity, internal consistency, and congruence coefficients of the scale were obtained. Results: The results showed two clear factors which correspond to the original two designated domains of the HADS, anxiety, and depression, with adequate reliability values (alpha > 0.80) and high congruence coefficients (> 0.90) when compared to the sample of other validation studies of the HADS. Conclusions: The present study adds evidence of the validity and reliability of the HADS to assess the presence of both depression and anxiety in Mexican patients with CVD. Its central contribution is that it demonstrates its capacity to differentiate the presence and severity of depression and anxiety in this population.

Antecedentes: La depresión y la ansiedad son afecciones comórbidas frecuentes en las enfermedades cardiovasculares; se relacionan con mal pronóstico y mayor riesgo de mortalidad. Los proveedores de salud requieren de una herramienta clínica para identificar estas condiciones psiquiátricas. La Escala de Ansiedad y Depresión Hospitalaria de 14 ítems (HADS) es una herramienta de detección utilizada en pacientes con diferentes afecciones médicas. Objetivo: Evaluar las ­propiedades psicométricas de la versión mexicana-española de la HADS en una amplia muestra de pacientes mexicanos con enfermedades cardiovasculares (ECV). Método: Un total de 953 individuos entre 18 y 75 años de edad con cardiomiopatía isquémica o hipertensiva se examinaron con la versión Mexicana en español de la HADS. Se obtuvieron la validez de constructo, la consistencia interna y los coeficientes de congruencia de la escala. Resultados: Los resultados mostraron dos factores que corresponden a los dos dominios designados originales de la HADS, ansiedad y depresión, con valores de confiabilidad adecuados (alfa > 0.80) y altos coeficientes de congruencia (> 0.90) en comparación con la muestra de otros estudios de validación de la HADS. Conclusiones: El presente estudio sustenta la validez y confiabilidad de la HADS para evaluar la presencia de depresión y ansiedad en pacientes Mexicanos con ECV. Su contribución central es su capacidad para diferenciar la presencia y la gravedad de la depresión y la ansiedad en esta población.

New genotypes of white spot syndrome virus (WSSV) and Taura syndrome virus (TSV) from the Kingdom of Saudi Arabia.

White spot syndrome virus (WSSV) and Taura syndrome virus (TSV) are highly pathogenic to penaeid shrimp and have caused significant economic losses in the shrimp culture industry around the world. During 2010 and 2011, both WSSV and TSV were found in Saudi Arabia, where they caused severe mortalities in cultured Indian white shrimp Penaeus indicus. Most outbreaks of shrimp viruses in production facilities can be traced to the importation of infected stocks or commodity shrimp. In an attempt to determine the origins of these viral outbreaks in Saudi Arabia, we performed variable number of tandem repeat (VNTR) analyses for WSSV isolates and a phylogenetic analysis for TSV isolates. From the WSSV genome, the VNTR in open reading frames (ORFs) 125 and 94 were investigated with PCR followed by DNA sequence analysis. The genotypes were categorized as {N125, N94} where N is the number of repeat units in a specific ORF, and the subscript indicates the ORF (i.e. ORFs 125 and 94 in this case). From 15 Saudi Arabia WSSV isolates, we detected 3 genotypes: {6125, 794}, {7125, del94}, and {8125, 1394}. The WSSV genotype of {7125, del94} appears to be a new variant with a 1522 bp deletion encompassing complete coding regions of ORF 94 and ORF 95 and the first 82 bp of ORF 93. For TSV genotyping, we used a phylogenetic analysis based on the amino acid sequence of TSV capsid protein 2 (CP2). We analyzed 8 Saudi Arabian isolates in addition to 36 isolates from other areas: SE Asia, Mexico, Venezuela and Belize. The Saudi Arabian TSV clustered into a new, distinct group. Based on these genotyping analyses, new WSSV and TSV genotypes were found in Saudi Arabia. The data suggest that they have come from wild shrimp Penaeus indicus from the Red Sea that are used for broodstock.

Characterization and molecular methods for detection of a novel spiroplasma pathogenic to Penaeus vannamei.

Traditionally, Spiroplasma spp. have only been isolated from the surfaces of flowers and other plant parts, from the guts and hemolymph of various insects, and from vascular plant fluids (phloem sap) and insects that feed on these fluids. In this article, we report the first pathogenic spiroplasma to be discovered in shrimp and the results of its characterization through histological evaluation, in situ hybridization assays, transmission electron microscopy, 16S rRNA sequence homology, and injection infectivity studies. In addition, molecular methods are described that were developed for the detection of this microorganism, which was determined to be the causative disease agent in Colombian farm-raised Penaeus vannamei suffering from high mortalities. Using standard histological methods and in situ hybridization assays, it was confirmed that P. vannamei was infected with this pathogenic spiroplasma. Histological analysis revealed systemic inflammatory reactions in affected organs/tissues. In an attempt to identify the bacteria, frozen infected P. vannamei samples, from the initial epizootic, were used to sequence the 16S rRNA gene and develop molecular detection methods. The 16S rRNA gene was amplified by PCR and then sequenced. The sequence data were analyzed using the GenBank BLAST search and the results revealed a 98% homology with Spiroplasma citri, a pathogen of citrus trees. The 16S rRNA sequence data were evaluated for development of unique PCR primers to the putative spiroplasma. Using PCR primers developed for the spiralin gene of Spiroplasma spp., a digoxigenin-labeled probe was developed and tested. This probe was species-specific, with no positive reactions or cross-reactivity occurring with other bacterial samples tested in this format.

Fecal samples as DNA source for the diagnosis of Necrotizing Hepatopancreatitis (NHP) in Penaeus vannamei broodstock.

Necrotizing Hepatopancreatitis (NHP) is a severe disease of cultivated penaeid shrimp caused by a pleomorphic, gram-negative, intracellular rickettsia-like bacterium. Current diagnostic methods for this disease are invasive, requiring dissection of the animal to perform histopathological analysis. In Colombia, NHP affects mainly broodstock, being a major cause of mortalities in maturation laboratories. In order to identify the presence of NHP without having to dissect the animal, we developed a PCR-based method using fecal samples as the DNA source. The DNA was extracted using a quick isolation protocol followed by amplification with primers specific for 16S ribosomal RNA gene sequences. To verify the sensitivity and specificity we analyzed samples from the same animal by PCR and in situ hybridization, and found 100% agreement. In addition, we amplified DNA extracted form paraffin blocks to confirm NHP diagnosis. PCR amplification from fecal samples and paraffin blocks yielded the expected 440 bp fragment. We conclude that PCR amplification from fecal samples is a valuable tool for the diagnosis of NHP in broodstock organisms, and that paraffin-fixed tissues can be used as a source of DNA for PCR amplification of NHP.