Resultados estandarizados del Montreal Cognitive Assessment (MoCA) para cribado neurocognitivo en población chilena / Standardized results of the Montreal Cognitive Assessment (MoCA) for neurocognitive screening in a Chilean population

Introducción: El envejecimiento poblacional implica un desafío para los países respecto a prevenir y detectar trastornos neurodegenerativos. El Montreal Cognitive Assessment (MoCA), test de cribado breve, de simple aplicación, válido y confiable, evalúa el estado cognitivo general, siendo útil en contextos de salud pública. El estudio busca normalizar y estandarizar el test MoCA para población chilena. Método: Se presenta estudio de validación para prueba diagnóstica de tipo descriptivo y correlacional, se evaluó a 526 sujetos, hombres y mujeres, de entre 18 y 90 años, sanos, del norte, centro y sur de Chile, analizando: el efecto de la edad, nivel educativo y sexo, para rendimiento de MoCA. Resultados: Se demuestra un efecto significativo de la edad y el nivel educativo sobre el rendimiento cognitivo general según MoCA. La edad, educación y sexo explican 1-7% de la varianza. El rendimiento cognitivo medio del total de la muestra fue de 24,04 ± 3,22, para un rango definido originalmente por el instrumento de 26 puntos sobre 30. Los adultos mayores con menor educación formal presentaron bajos resultados y menor rendimiento cognitivo. Se propone protocolo de evaluación de resultados en percentiles y puntuaciones por rango de edad y puntuación escalar normalizada individual. Discusión: Se presentan datos normativos de MoCA según las características sociodemográficas chilenas y puntos de corte propuestos para discriminar el rendimiento cognitivo normal de trastornos neurocognitivos según rangos de edad, ajustando los resultados al nivel educacional, la propuesta permitiría facilitar el uso del instrumento y disminuir la aparición de falsos positivos.(AU)

Introduction: Population ageing poses a challenge for countries in preventing and detecting neurodegenerative disorders. The Montreal Cognitive Assessment (MoCA), a short, simple, valid, and reliable screening test, assesses general cognitive status, and is useful in public health contexts. This study aims to normalise and standardise the MoCA test for the Chilean population. Method: We performed a descriptive, correlational validation study of the MoCA test, using a sample including 526 healthy individuals of both sexes, aged between 18 and 90 years, from the north, centre, and south of Chile. We analysed the effects of age, education level, and sex on MoCA performance. Results: Age and education level had a significant impact on general cognitive performance, as determined by MoCA score. Age, education, and sex account for 1-7% of variance. The mean (standard deviation) score for the total sample was 24.04 (3.22), whereas the normal range originally defined for the instrument is 26-30 points. Older adults with less formal education presented poorer results and lower cognitive performance. We propose a protocol for evaluating results by percentiles and scores for different age ranges, and an individual normalised scalar score. Discussion: We present normative data for the MoCA test in the Chilean population, and propose cut-off points for different age ranges to discriminate normal cognitive performance from neurocognitive disorders; results are adjusted for education level. This proposal would assist in the use of the test and reduce the rate of false positives.(AU)

Standardised results of the Montreal Cognitive Assessment (MoCA) for neurocognitive screening in a Chilean population.

INTRODUCTION: Population ageing poses a challenge for countries in preventing and detecting neurodegenerative disorders. The Montreal Cognitive Assessment (MoCA), a short, simple, valid, and reliable screening test, assesses general cognitive status, and is useful in public health contexts. This study aims to normalise and standardise the MoCA test for the Chilean population. METHOD: We performed a descriptive, correlational validation study of the MoCA test, using a sample including 526 healthy individuals of both sexes, aged between 18 and 90 years, from the north, centre, and south of Chile. We analysed the effects of age, education level, and sex on MoCA performance. RESULTS: Age and education level had a significant impact on general cognitive performance, as determined by MoCA score. Age, education, and sex account for 1%-7% of variance. The mean (standard deviation) score for the total sample was 24.04 (3.22), whereas the normal range originally defined for the instrument is 26-30 points. Older adults with less formal education presented poorer results and lower cognitive performance. We propose a protocol for evaluating results by percentiles and scores for different age ranges, and an individual normalised scalar score. DISCUSSION: We present normative data for the MoCA test in the Chilean population, and propose cut-off points for different age ranges to discriminate normal cognitive performance from neurocognitive disorders; results are adjusted for education level. This proposal would assist in the use of the test and reduce the rate of false positives.

Liaison psychiatry before and after the COVID-19 pandemic.

INTRODUCTION: the COVID-19 pandemic had an impact on hospital admissions. The clinical profiles of patients referred to liaison psychiatry teams (LPT) remained stable over the last few decades. We postulate changes in patient profiles due to the COVID-19 pandemic. MATERIALS AND METHODS: a total of 384 patients admitted to a tertiary care University Hospital in Madrid (Spain) and referred to LPTs were recruited. Patients referred 5 months before and after the first admission for COVID-19 were included. Clinical and sociodemographic characteristics were collected, and non-parametric hypothesis contrast tests were used to study possible differences between both periods. RESULTS: patients referred during the pandemic were significantly older (U = 2.006; p = .045), most of them were admitted to medical hospitalization units (χ2 (2) = 5.962; p = 015), and with a different reason for admission. There was an increase in the rate of adjustment disorders (χ2 (1) =7.893; p = 005) and delirium (χ2 (1) =9.413; p = 002), as well as psychiatric comorbidity (χ2 (2) = 9.930; p = .007), and a reduction in the proportion of patients treated for substance misuse (χ2 (5) = 19.152; p = .002). The number of deaths increased significantly (χ2 (1) = 6.611; p = .010). In persons over 65 years inappropriate prescription was significantly lower (χ2 (1) = 8.200; p = .004). CONCLUSIONS: the pandemic had an impact on the activity of the LPTs due to the change in the clinical profile and evolution of referred patients, maintaining standards of care that are reflected through prescription.

Standardized results of the Montreal Cognitive Assessment (MoCA) for neurocognitive screening in a Chilean population. / Resultados estandarizados del Montreal Cognitive Assessment (MoCA) para cribado neurocognitivo en población chilena.

INTRODUCTION: Population ageing poses a challenge for countries in preventing and detecting neurodegenerative disorders. The Montreal Cognitive Assessment (MoCA), a short, simple, valid, and reliable screening test, assesses general cognitive status, and is useful in public health contexts. This study aims to normalise and standardise the MoCA test for the Chilean population. METHOD: We performed a descriptive, correlational validation study of the MoCA test, using a sample including 526 healthy individuals of both sexes, aged between 18 and 90 years, from the north, centre, and south of Chile. We analysed the effects of age, education level, and sex on MoCA performance. RESULTS: Age and education level had a significant impact on general cognitive performance, as determined by MoCA score. Age, education, and sex account for 1-7% of variance. The mean (standard deviation) score for the total sample was 24.04 (3.22), whereas the normal range originally defined for the instrument is 26-30 points. Older adults with less formal education presented poorer results and lower cognitive performance. We propose a protocol for evaluating results by percentiles and scores for different age ranges, and an individual normalised scalar score. DISCUSSION: We present normative data for the MoCA test in the Chilean population, and propose cut-off points for different age ranges to discriminate normal cognitive performance from neurocognitive disorders; results are adjusted for education level. This proposal would assist in the use of the test and reduce the rate of false positives.

Metástasis pulmonares de origen desconocido / Lung metastases of unknown primary origin

No disponible

[Evaluation of the effectiveness of integrated psychological therapy in long-term evolution of patients with schizophrenia]. / Evaluación de la efectividad de la terapia psicológica integrada en la evolución a largo plazo de pacientes con esquizofrenia.

INTRODUCTION: Psychosocial therapy programs have been effective in relapse prevention, symptoms control, and functional improvement in patients with schizophrenia. Accordingly, and in addition to medication, they are currently an indicated therapy component. Therapy efficacy of the package used in this study was positive in short-term follow-ups and is now appropriate to analyze them four years later. METHOD: Clinical and social functioning effects of a psychosocial intervention package, consisting of psychoeducation and integrated psychological therapy (IPT) with patients, and psychoeducation, behavioral therapy and problem solving training with families, were studied in 20 out-patients with schizophrenia (using pre-treatment, post-treatment and four-year follow-up measures). RESULTS: Within groups results indicate a sustained improvement in the treatment group as compared to a 15 out-patients comparison group that received standard treatment. All participants were on stable regimens of antipsychotic medications. After the follow-up period, however, between groups differences tend to diminish. CONCLUSIONS: The overall findings indicated that this package has produced encouraging effects still apparent in the 4 year follow-up. However, the intervention procedure merits further investigation, and suggestions are made to keep a low-level, long-lasting psychosocial intervention, adapted to each patient's needs.

Evaluación de la efectividad de la terapia psicológica integrada en la evolución a largo plazo de pacientes con esquizofrenia / Evaluation of the effectiveness of integrated psychological therapy in long-term evolution of patients with schizophrenia

Introducción. Los programas de terapia psicosocial han resultado eficaces en la prevención de recaídas y en el control de los síntomas y la mejora funcional de pacientes con esquizofrenia, siendo una opción terapéutica indicada, además del tratamiento farmacológico. La eficacia del paquete terapéutico aquí utilizado ha confirmado tener efectos favorables en estudios de seguimiento a corto plazo y se somete de nuevo a comprobación 4 años después. Método. Se analizan los efectos clínicos y del funcionamiento social de 20 pacientes ambulatorios con esquizofrenia (con medidas postratamiento, postratamiento y seguimiento de 4 años) de un programa de intervención psicosocial grupal que incluye psicoeducación y la terapia psicológica integrada (IPT) junto a intervención familiar con psicoeducación, terapia conductual y entrenamiento en solución de problemas. Resultados. Los análisis intragrupo demuestran mejoría sostenida en el grupo de tratamiento, comparativamente con un grupo control de 15 pacientes que seguían un tratamiento estándar. Todos los pacientes fueron tratados con medicación antipsicótica. Tras el período de seguimiento, sin embargo, las diferencias intergrupos tienden a debilitarse. Conclusiones. Los hallazgos revelan que el paquete de intervención mantiene sus efectos favorables tras los 4 años de seguimiento. No obstante, el procedimiento de intervención requiere mayor estudio y se señala la conveniencia de mantener la intervención psicosocial indefinidamente, adaptándose a las necesidades de cada paciente (AU)

Prevalencia de anticuerpos de Leptospira y factores de riesgo en niños de escuelas del área norte del municipio de Ciego de Ávila / Prevalence of antibodies of Leptospira and risk factors in school children from the Northern area of the Ciego de Avila municipality

Se realizó un estudio de corte transversal para evaluar la prevalencia de la infección por Leptospira y los factores de riesgo en escolares del área norte del municipio de Ciego de Ávila provincia Ciego de Ávila, Cuba. Se estudiaron 370 niños entre 5 y 14 años de ambos sexos durante el año 1998. Se utilizaron como técnicas serológicas la hemoaglutinación y microaglutinación. A cada uno de los padres se le aplicó un cuestionario que recogía las variables objeto de la investigación. Los anticuerpos de Leptospira estuvieron presentes en el 15 por ciento de los niños estudiados, siendo más frecuente en el sexo femenino y en grupo de 10 a 14 años. Los factores de riesgo detectados fueron contactos directos con animales domésticos en la vivienda y presencia de ratas y/o ratones en las mismas; el 46 por ciento de los casos seropositivos presentaron episodios anteriores de morbilidad por infección respiratoria aguda y sepsis urinaria (AU)

[Prevalence and psychosocial patterns of alcohol consumption in Cantabria]. / Prevalencia y patrones psicosociales de consumo de alcohol en Cantabria.

This is a cross-sectional community survey directed to investigate aspects related ot the alcohol consumption of 1,816 persons, of 16-65 years of age, representative of the population of Cantabria. It was found, among other things, that 7% of the male and 23% of the female were abstinent, being the prevalence for excessive alcohol consumption of 14.36% for males and of 0.22% for females. We also found, especially among the younger age groups, a growing female incorporation into the masculine patterns of alcohol consumption. It was also analyzed in the study the characteristics of the patterns of alcohol consumption. We found, in this respect, for the different socio-demographic groups of this community, specific profiles of alcohol consumption.