Sleep evaluation scales and questionaries: a review.

INTRODUCTION: Whenever a new scale is created or translated from another language, it must be validated, establishing its reliability for the new population where it will be used. Sleep quality concept is a construct that can be evaluated using self-report scales. Resulting elements vary depending on the individuals surveyed. This type of evaluation is mainly subjective and includes quantitative aspects such as sleep duration, number of awakenings, latency time, and qualitative aspects such as rest sensation, mood and oneiric content (Valencia, 2000). In the present study we made a critical review of the sleep scales designed for child, adolescent and adult populations that have been validated and the difficulties they might present. METHODOLOGY: Between September 2005 and May 2006 a bibliographical search was made within Pubmed, Ovid and the data base of the periodical and book library of the Ramon de la Fuente Muñiz National Institute of Psychiatry, using and combining the following key words: sleep, sleep questionnaire, sleep scale, sleep inventory, adolescent, adolescent sleep scale. The most relevant papers to our study were selected. The search was limited to Spanish and English articles, although there was no year or geographical origin limit. Articles that did not include clinimetrical data where excluded. CONCLUSIONS: Based on our bibliographical search and our discussion, we suggested the design and validation of a Spanish scale to evaluate adolescent population which avoids a time interval between awakening and the answering of the instrument in order to decrease recall bias.

Escalas y cuestionarios para evaluar el sueño: una revisión / Sleep evaluation scales and questionaries: a review

Introducción. Cuando se elabora una escala o se traduce de otro idioma se debe validar y establecer la confiabilidad del instrumento para poblaciones donde se desea utilizar. El concepto de calidad del sueño es un constructo que puede ser evaluado mediante escalas de autoinforme. Los elementos resultantes varían según los individuos encuestados. Este tipo de evaluación es fundamentalmente subjetiva e incluye aspectos cuantitativos como la duración del sueño, el número de despertares, el tiempo de latencia y aspectos cualitativos como la sensación de descanso, el estado de ánimo o el contenido onírico. En el presente trabajo se hace una revisión crítica de las escalas de sueño diseñadas para población infantil, adolescentes y adultos que han sido validadas y las dificultades que pueden presentar. Metodología. Entre septiembre de 2005 y mayo de 2006 se realizó una búsqueda en pubmed, ovid y base de datos de la bibliohemeroteca del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz utilizando y combinando las palabras clave: sleep, sleep questionnaire, sleep scale, sleep inventory, adolescent, adolescent sleep scale. De los artículos obtenidos se seleccionaron los más relevantes para el tema de interés. No se limitó la búsqueda por fecha de publicación, sólo se incluyeron artículos en inglés y en español; se incluyeron artículos que proporcionaban datos clinimétricos; sin embargo, esta circunstancia ha sido señalada en la presente revisión. Tampoco se excluyeron publicaciones por su origen geográfico. Conclusiones. Con base en la revisión y en la discusión sugerimos el diseño y validación de una escala en español para evaluar población adolescente y que además evite el intervalo de tiempo entre el despertar y el momento en que se contesta el instrumento con la finalidad de disminuir el sesgo de recuerdo (AU)

Introduction. Whenever a new scale is created or translated from another language, it must be validated, establishing its reliability for the new population where it will be used. Sleep quality concept is a construct that can be evaluated using self-report scales. Resulting elements vary depending on the individuals surveyed. This type of evaluation is mainly subjective and includes quantitative aspects such as sleep duration, number of awakenings, latency time, and qualitative aspects such as rest sensation, mood and oneiric content (Valencia, 2000). In the present study we made a critical review of the sleep scales designed for child, adolescent and adult populations that have been validated and the difficulties they might present. Methodology. Between September 2005 and May 2006 a bibliographical search was made within pubmed, ovid and the data base of the periodical and book library of the Ramon de la Fuente Muñiz National Institute of Psychiatry, using and combining the following keywords: sleep, sleep questionnaire, sleep scale, sleep inventory, adolescent, adolescent sleep scale. The most relevant papers to our study were selected. The search was limited to Spanish and English articles, although there was no year or geographical origin limit. Articles that did not include clinimetrical data where excluded. Conclusions. Based on our bibliographical search and our discussion, we suggested the design and validation of a Spanish scale to evaluate adolescent population which avoids a time interval between awakening and the answering of the instrument in order to decrease recall bias (AU)

[Zinc and epilepsy: is there a causal relation between them?]. / Zinc y epilepsia: existe una relación causal?

INTRODUCTION: Zinc is a fundamental trace element for an adequate nervous system function. It has been suggested that in the brain, a zinc homeostasis alteration may be associated with the genesis of epilepsy, although it is not yet determined if concentrations of zinc are a cause or a consequence of seizures. Another poorly studied aspect is the relationship between antiepileptic drugs and the neuronal zinc behaviour. DEVELOPMENT: We perform a systematic review of the literature to evaluate the role that zinc plays in epilepsy as well as the antiepileptic effect of zinc concentrations. Databases such as MEDLINE, EMBASE, SCISEARCH and LILACS were consulted from January 1974 to July 2005. All articles published in English and Spanish were considered. A manual review of the references present in each article was done in order to identify the articles that the electronic search may have not found itself. The title and abstract of the potential articles were analyzed before asking for the complete article. However, articles that seemed ambiguous were completely analyzed later to establish their relevance. CONCLUSIONS: Clinical research in epilepsy presented contradictory results. In fact, the reviewed studies, both animal and human, did not give enough evidence to determine if organic zinc variations are directly related to epilepsy. Most of them gave not statistically significant results.

[Changes in selenium levels in epilepsy]. / Alteración de la concentración de selenio en la epilepsia.

INTRODUCTION: It has been suggested that antiepileptic drug therapies deplete total body selenium stores and failure to give appropriate selenium supplementation, especially to patients receiving valproic acid during pregnancy may increase the risk of neural tube defects or other free radical mediated damage. Selenium is essential for the synthesis of selenoproteins, including glutathione peroxidase. AIMS: To review the present state of knowledge about selenium behaviour in people with epilepsy taking antiepileptic drugs and to develop guidelines for the appropriate use of selenium supplements. DEVELOPMENT: Databases such as Medline, Embase, Scisearch and Lilacs were consulted to have access to literature. A search in said databases was performed in order to find articles published from January 1966 to August 2004. All articles published in English and Spanish were considered. A manual review of the references present in each produced article was done in order to identify the articles that the electronic search may have not found itself. The title and abstract of the potential articles were analyzed before asking for the complete article. However, articles which seemed ambiguous were completely analyzed later to establish their relevance. CONCLUSIONS: There is insufficient evidence to fully evaluate the effect of selenium supplementation. The possible beneficial effects on pregnancy need to be evaluated in further studies.

Alteración de la concentración de selenio en la epilepsia / Changes in selenium levels in epilepsy

Introducción. Se ha sugerido que los tratamientos anticonvulsionantes disminuyen las reservas de selenio en el organismo y que no administrar suplementos de selenio, especialmente a las pacientes que reciben ácido valproico durante el embarazo, puede aumentar el riesgo de desarrollar defectos del tubo neural u otras alteraciones mediadas por radicales libres. El selenio es un oligoelemento esencial para la síntesis de selenoproteínas, incluida la glutatión peroxidasa. Objetivo. Realizar una revisión sistemática de la literatura para poder presentar el estado del conocimiento sobre el comportamiento del selenio en los pacientes con epilepsia en tratamiento anticonvulsionante y desarrollar unas recomendaciones para el uso adecuado de un suplemento de selenio. Desarrollo. Se consultaron las bases de datos Medline, Embase, Scisearch y Lilacs para acceder a la literatura, y se realizó una búsqueda para localizar artículos publicados entre enero de 1966 y agosto de 2004. Se tomaron todos los artículos publicados en inglés y español. Se realizó una revisión manual de las referencias presentadas en cada artículo con el fin de identificar los que no identificó la búsqueda electrónica. El título y el resumen de los artículos potencialmente útiles se analizaban antes de solicitar el artículo completo. Sin embargo, los artículos en los que éstos eran ambiguos para determinar su pertinencia también se analizaron en su totalidad. Conclusiones. No hay suficientes evidencias para evaluar el efecto de administrar un suplemento de selenio. El posible beneficio durante el embarazo requiere estudios más profundos

Introduction. It has been suggested that antiepileptic drug therapies deplete total body selenium stores and failure to give appropriate selenium supplementation, especially to patients receiving valproic acid during pregnancy may increase the risk of neural tube defects or other free radical mediated damage. Selenium is essential for the synthesis of selenoproteins, including glutathione peroxidase. Aims. To review the present state of knowledge about selenium behaviour in people with epilepsy taking antiepileptic drugs and to develop guidelines for the appropriate use of selenium supplements. Development. Databases such as Medline, Embase, Scisearch and Lilacs were consulted to have access to literature. A search in said databases was performed in order to find articles published from January 1966 to August 2004. All articles published in English and Spanish were considered. A manual review of the references present in each produced article was done in order to identify the articles that the electronic search may have not found itself. The title and abstract of the potential articles were analyzed before asking for the complete article. However, articles which seemed ambiguous were completely analyzed later to establish their relevance. Conclusions. There is insufficient evidence to fully evaluate the effect of selenium supplementation. The possible beneficial effects on pregnancy need to be evaluated in further studies

Neumotórax espontáneo. Revisión de 80 casos / Spontaneous pneumothorax

Se exponen los pricipales conceptos etiopatogénicos aceptados en la producción del neumotórax. Presentamos la revisión de 80 historias clínicas de pacientes portadores de neumotórax espontáneo tratados en nuestro hospital en los últimos 4 años. Exponemos datos estadísticos de interés como son incidencia por edad, sexo, raza, síntomas más frecuentes, etiología y tratamiento. Se analiza el resultado de las estadísticas expuestas. Se comentan los distintos métodos de tratamiento, haciéndose énfasis en la pleurotomía cerrada con aspiración como tratamiento básico inicial del neumotórax de más de un 25 porciento de colapso. Se exponen las indicaciones de la pleurotomía abierta (AU)