A truncating variant of RAD51B associated with primary ovarian insufficiency provides insights into its meiotic and somatic functions.

Primary ovarian insufficiency (POI) causes female infertility by abolishing normal ovarian function. Although its genetic etiology has been extensively investigated, most POI cases remain unexplained. Using whole-exome sequencing, we identified a homozygous variant in RAD51B -(c.92delT) in two sisters with POI. In vitro studies revealed that this variant leads to translation reinitiation at methionine 64. Here, we show that this is a pathogenic hypomorphic variant in a mouse model. Rad51bc.92delT/c.92delT mice exhibited meiotic DNA repair defects due to RAD51 and HSF2BP/BMRE1 accumulation in the chromosome axes leading to a reduction in the number of crossovers. Interestingly, the interaction of RAD51B-c.92delT with RAD51C and with its newly identified interactors RAD51 and HELQ was abrogated or diminished. Repair of mitomycin-C-induced chromosomal aberrations was impaired in RAD51B/Rad51b-c.92delT human and mouse somatic cells in vitro and in explanted mouse bone marrow cells. Accordingly, Rad51b-c.92delT variant reduced replication fork progression of patient-derived lymphoblastoid cell lines and pluripotent reprogramming efficiency of primary mouse embryonic fibroblasts. Finally, Rad51bc.92delT/c.92delT mice displayed increased incidence of pituitary gland hyperplasia. These results provide new mechanistic insights into the role of RAD51B not only in meiosis but in the maintenance of somatic genome stability.

¿Quién es el receptor de intervenciones sociosanitarias y cuáles son sus necesidades? / Who is the user of socio-health interventions and what are their needs?

Las intervenciones sociosanitarias incluyen las actuaciones y cuidados destinados a atender las necesidades de las personas que a causa de su edad, enfermedad o discapacidad, han sufrido merma en su autonomía personal. Orientadas hacia el logro de una mejora en la calidad de vida de las personas en esa situación, tratan de atender a las personas de una forma integral. Intervenir en esas situaciones supone ofrecer las ayudas técnicas, los cambios ambientales, de costumbres y sociales así como el cuidado personal necesarios para mejorar su calidad de vida y potenciar sus capacidades y bienestar. Los avances científicos y cambios demográficos y sociales han condicionado una modificación en el perfil de los receptores de intervenciones sociosanitarias, destacando la longevidad, la cronicidad de los procesos y el envejecimiento del cuidador informal. El objetivo de este trabajo es caracterizar a la persona que recibe las intervenciones sociosanitarias y reflexionar sobre cuáles son sus necesidades. Para ello se ha llevado a cabo una revisión de estudios biomédicos mediante búsquedas bibliográficas en ScienceDirect así como documentación institucional nacional relativas a personas en situación de dependencia y sus cuidadores familiares. Las personas que precisan ayuda sociosanitaria constituyen una población heterogénea en cuanto a sus necesidades. Tanto la persona con discapacidad como su cuidador informal precisan ser consideradas objeto de interés y atención

Socio-health interventions include performance and care intended to attend to the needs of people who have suffered a decrease in their personal autonomy because of their age, illness or disability. Oriented towards achieving an improvement in the quality of life of people in that situation, they try to meet the requirements of people in an integrated way. To intervene in those situations involves providing technical aids and environmental, custom and social changes as well as personal care needed to improve their quality of life and enhance their skills and well-being. Scientific advances and demographic and social changes have determined a change in the profile of socio-health interventions’ receivers, highlighting longevity, chronicity of processes and aging of the informal caregiver. The aim of this work is to characterize the person receiving the social-health interventions and to reflect on what their needs are. To do this we have conducted a biomedical studies’ review through literature searches at ScienceDirect as well as a review of national institutional documentation related to people in dependent situations and their family caregivers. People who need socio-health help establish a heterogeneous population in respect of their needs. Both the person with disabilities and their informal caregiver need to be considered as an object of interest and attention

Impact of acid mine drainages on surficial waters of an abandoned mining site.

Weathering of sulphide minerals produces a great variety of efflorescences of soluble sulphate salts. These minerals play an important role for environmental pollution, since they can be either a sink or a source for acidity and trace elements. This paper aims to characterise surface waters affected by mining activities in the Sierra Minera of Cartagena-La Union (SE, Spain). Water samples were analysed for trace metals (Zn, Cd, Pb, Cu, As and Fe), major ions (Na(+), K(+), Ca(2+) and Mg(2+)) and anions (F(-), Cl(-), NO3 (-), CO3 (2-), SO4 (2-)) concentrations and were submitted to an "evaporation-precipitation" experiment that consisted in identifying the salts resulting from the evaporation of the water aliquots sampled onsite. Mineralogy of the salts was studied using X-ray diffraction and compared with the results of calculations using VISUAL MINTEQ. The study area is heavily polluted as a result of historical mining and processing activities that has produced large amount of wastes characterised by a high trace elements content, acidic pH and containing minerals resulting from the supergene alteration of the raw materials. The mineralogical study of the efflorescences obtained from waters shows that magnesium, zinc, iron and aluminium sulphates predominate in the acid mine drainage precipitates. Minerals of the hexahydrite group have been quantified together with minerals of the rozenite group, alunogen and other phases such as coquimbite and copiapite. Calcium sulphates correspond exclusively to gypsum. In a semiarid climate, such as that of the study area, these minerals contribute to understand the response of the system to episodic rainfall events. MINTEQ model could be used for the analysis of waters affected by mining activities but simulation of evaporation gives more realistic results considering that MINTEQ does not consider soluble hydrated salts.

[Who is the user of socio-health interventions and what are their needs?]. / ¿Quién es el receptor de intervenciones sociosanitarias y cuáles son sus necesidades?

Socio-health interventions include performance and care intended to attend to the needs of people who have suffered a decrease in their personal autonomy because of their age, illness or disability. Oriented towards achieving an improvement in the quality of life of people in that situation, they try to meet the requirements of people in an integrated way. To intervene in those situations involves providing technical aids and environmental, custom and social changes as well as personal care needed to improve their quality of life and enhance their skills and well-being. Scientific advances and demographic and social changes have determined a change in the profile of socio-health interventions' receivers, highlighting longevity, chronicity of processes and aging of the informal caregiver. The aim of this work is to characterize the person receiving the social-health interventions and to reflect on what their needs are. To do this we have conducted a biomedical studies' review through literature searches at ScienceDirect as well as a review of national institutional documentation related to people in dependent situations and their family caregivers. People who need socio-health help establish a heterogeneous population in respect of their needs. Both the person with disabilities and their informal caregiver need to be considered as an object of interest and attention.

Análisis del manejo de fracturas ocultas de escafoides mediante la realización precoz de resonancia magnética / Analysis of the management of occult fractures of the scaphoid through early magnetic resonance imaging

Introducción. Nuestro objetivo es valorar la utilidad de la resonancia magnética (RM) en el diagnóstico de las fracturas ocultas de escafoides, mostrando las ventajas y el coste comparativo frente al protocolo de seguimiento tradicional. Material y método. El protocolo de actuación tradicional en nuestro centro consistía en inmovilización y revisiones clínico-radiológicas periódicas (radiología convencional y tomografía computarizada en la fase final del proceso). En el nuevo protocolo, si en el primer control del traumatólogo (10 días post-traumatismo) la radiología convencional seguía siendo negativa se realizaba un protocolo limitado de RM de muñeca (coronal T1 y T2-supresión grasa). Se valoraron los hallazgos visualizados en RM, el tiempo de inmovilización del paciente, el coste económico de ambos protocolos y la dosis de radiación recibida. Resultados. Se incluyeron 33 casos de pacientes con sospecha clínica de fractura de escafoides y radiología negativa. En 13 pacientes la RM fue negativa. En 12 se confirmó el diagnóstico de fractura de escafoides, 6 asociadas a otra afección. En 8 se diagnosticó otro proceso. El coste del nuevo protocolo fue de 131.06€ por paciente y de 114.41 o 151.06€ para el tradicional, según las revisiones necesarias. Se redujo la dosis de radiación al eliminar la realización de sucesivas exploraciones radiológicas. Conclusiones. El nuevo protocolo mejora el manejo de estos pacientes, reduciendo el tiempo de inmovilización, mejorando la rigidez articular y disminuyendo el periodo de baja laboral. Permite el diagnóstico de otras lesiones radiológicamente ocultas. El coste es similar e incluso inferior en algunos casos, y la irradiación es menor (AU)

Introduction. We aimed to evaluate the usefulness of magnetic resonance imaging (MRI) in the diagnosis of occult fractures of the scaphoid and to determine the advantages and cost in comparison with the traditional follow-up protocol. Material and method. The traditional approach at our center consisted of immobilization and periodic clinical and radiological follow-up (plain-film X-rays and computed tomography in the final phase of the process). The new protocol called for a limited MRI study consisting of coronal T1- and T2-weighted fat suppression sequences if the findings at plain-film X-rays continued to be negative at the first follow-up examination with the traumatologist (10 days after trauma). We evaluated the MRI findings, the time the patient was immobilized, the cost of each protocol, and the dose of radiation received. Results. We included 33 cases of patients with clinically suspected fractures of the scaphoid and negative findings on plain-film X-rays. In 13 patients, the MRI findings were negative. In 12 patients, the MRI findings confirmed the diagnosis of a fracture of the scaphoid, which was associated with other pathology in 6 cases. In 8 patients, another pathological process was diagnosed. The cost of the new protocol was €131.06 per patient; the cost of the traditional protocol was €114.41 or €151.06 per patient, depending on the follow-up studies required. The new protocol reduced the dose of radiation by eliminating successive radiologic studies. Conclusions. The new protocol improved the management of these patients, reducing the time of immobilization, improving joint rigidity, and reducing the time off work. The limited MRI study makes it possible to diagnose other radiologically occult lesions. The cost of the new protocol is similar to that of the traditional protocol and even lower in some cases. The new protocol results in a reduction in the dose of radiation (AU)

[Analysis of the management of occult fractures of the scaphoid through early magnetic resonance imaging]. / Análisis del manejo de fracturas ocultas de escafoides mediante la realización precoz de resonancia magnética.

INTRODUCTION: We aimed to evaluate the usefulness of magnetic resonance imaging (MRI) in the diagnosis of occult fractures of the scaphoid and to determine the advantages and cost in comparison with the traditional follow-up protocol. MATERIAL AND METHOD: The traditional approach at our center consisted of immobilization and periodic clinical and radiological follow-up (plain-film X-rays and computed tomography in the final phase of the process). The new protocol called for a limited MRI study consisting of coronal T1- and T2-weighted fat suppression sequences if the findings at plain-film X-rays continued to be negative at the first follow-up examination with the traumatologist (10 days after trauma). We evaluated the MRI findings, the time the patient was immobilized, the cost of each protocol, and the dose of radiation received. RESULTS: We included 33 cases of patients with clinically suspected fractures of the scaphoid and negative findings on plain-film X-rays. In 13 patients, the MRI findings were negative. In 12 patients, the MRI findings confirmed the diagnosis of a fracture of the scaphoid, which was associated with other pathology in 6 cases. In 8 patients, another pathological process was diagnosed. The cost of the new protocol was €131.06 per patient; the cost of the traditional protocol was €114.41 or €151.06 per patient, depending on the follow-up studies required. The new protocol reduced the dose of radiation by eliminating successive radiologic studies. CONCLUSIONS: The new protocol improved the management of these patients, reducing the time of immobilization, improving joint rigidity, and reducing the time off work. The limited MRI study makes it possible to diagnose other radiologically occult lesions. The cost of the new protocol is similar to that of the traditional protocol and even lower in some cases. The new protocol results in a reduction in the dose of radiation.

Epidemiología de gestión de la morbilidad psiquiátrica atendida en los hospitales españoles / No disponible

Introducción: Para una correcta planificación enSalud Mental es fundamental conocer la carga asistencialhospitalaria derivada de los ingresos psicopatológicos,por ello abordamos el estudio de la realidad psiquiátricahospitalaria española.Objetivo: Analizar los episodios hospitalarios psiquiátricosen España y las variables sociodemográficasy clínicas asociadas a estos.Material y métodos: Estudio epidemiológico descriptivode la morbilidad en psicopatología hospitalaria,bajo un diseño ecológico. Se analizan todos los ingresospsiquiátricos de los hospitales del Sistema Nacional deSalud (SNS) del año 2002 (69.413 altas), utilizandocomo fuentes de información el Conjunto Mínimo deDatos al Alta Hospitalaria (CMBDAH) y los GruposRelacionados por el Diagnóstico (GRD).Resultados y discusión: Se evidencian diferencias enfunción del sexo (principalmente psicopatológicas y deestancia hospitalaria) y se constata, mediante indicadoresmultivariantes, la diversidad en cuanto a carga asistencialy a la gestión que de los episodios de hospitalizaciónrealizan las diferentes comunidades(AU)

Introduction: According to a correct Mental Healthplanning, to know the hospital assistance load derivedfrom the psychiatric admissions is required. Thus, westudied the psychiatric hospitalization reality in Spain.Objective: To analyse the psychiatric hospitalizationepisodes in Spain, and its clinical and social-demographicvariables associated.Material and methods: Epidemiologic descriptivestudy of the morbidity in psychopathology hospitalization,within an ecological design. The analysis of all thepsychiatric admissions in the National Health SystemHospitals (SNS) for the year 2002 was effected (69,413admissions), using the Minimum Basic Data Set at HospitalDischarge (CMBDAH) and Diagnosis RelatedGroups (DRG’s), as sources of information.Results and discussion: Differences in terms of sexare showed (mainly, psycho-pathologic and hospitalstay), and the diversity as for assistance load and for themanagement of the hospitalization episodes conductedby the different autonomous regions is noted, by meansof multivariate indicators(AU)

Molecular characterization of the black Aspergillus isolates responsible for ochratoxin A contamination in grapes and wine in relation to taxonomy of Aspergillus section Nigri.

This work examines ochratoxigenic mycobiota in grapes by ap-PCR analysis sequence analysis of the ITS and IGS regions and ability to produce OTA. A comparison was also made with many reference strains of Aspergillus section Nigri. Based on ap-PCR profiles, derived from two microsatellite primers, three main groups were obtained by UPGMA cluster analysis corresponding to A. carbonarius, A. niger and A. tubingensis. The cophenetic correlation values corresponding to ap-PCR UPGMA analysis revealed a higher genetic variability in A. niger and A. tubingensis than in A. carbonarius. In addition, no genotypical differences could be established between OTA producers and nonproducers in all species analysed. Phylogenetic relationships inferred from ITS and IGS sequences are, mostly, congruent with earlier works. A. niger and A. tubingensis strains were closely related, but not identical, and they clustered into two distinct groups within the A. niger aggregate. Sequence analysis also showed genetic divergences between strains of A. foetidus and the rest of the Aspergillus section Nigri. Additionally, the phylogenetic analysis was consistent in separating a new group of ochratoxigenic strains, frequently isolated from grapes, named A. tubingensis-like. All strains of A. carbonarius analysed by sequence analysis had identical ITS and IGS sequences confirming the lack of significant genetic variability within this important ochratoxigenic species.

Metástasis endotraqueales de carcinoma colorrectal / No disponible

La existencia de metástasis endotraqueales (ME) de carcinomas de origen no pulmonar es rara. Las manifestaciones clínicas más comunes son hemoptisis, tos y disnea, aunque no es raro encontrarlas como hallazgo casual en el curso de una broncoscopia. Las neoplasias que con mayor frecuencia se asocian a estas lesiones metastásicas son las derivadas de mama, colon y riñón. Su hallazgo supone un estado avanzado de la enfermedad, aunque la supervivencia está en función del tipo de tumor primario, la existencia de lesiones concomitantes y las características del paciente. Por lo tanto el tratamiento debe individualizarse. En el caso de las ME de carcinoma colorrectal (CCR) recomendamos la realización de una broncoscopia preopcratoria pues es posible encontrar lesiones en el árbol traqueobronquial que influyan en el pronóstico y tratamiento de la enfermedad (AU)

Existence of endotracheal metastases (EM) of non-pulmonary origin cancer is rare. The most common clinical manifestations are hemoptysis, cough and dyspnea, although it is not rare to find it as a casual finding during a bronchoscope examination. The neoplasms that are most frequently associated to these lesions are those derived from the breast, colon and kidney. When they are found, it means that there is an advanced stage of the disease, although survival is based on the type of primary tumor, existence of common commitment lesions and the characteristics of the patient. Thus, the treatment should be individualized. In the case of colorectal carcinoma (CRC) EM, we recommend performing a pre-operative bronchoscopy since lesions that influence the prognoses and treatment of the disease may be found in the trachea and bronchial tree (AU)

Mycobiota and mycotoxin producing fungi from cocoa beans.

The present study reports on the natural mycobiota occurring in cocoa beans, paying special attention to the incidence of fungal species that are potential producers of mycotoxins. The results show that predominant fungi were different species of the genus Aspergillus belonging to section Flavi and Nigri. Of the 214 strains of Aspergillus section Flavi collected from cocoa beans, 120 were identified as A. flavus and 94 as A. tamarii. Of Aspergillus section Nigri 138 strains were isolated, with 132 belonging to A. niger aggregate and 6 to A. carbonarius species. Potential ability to produce aflatoxins (AFs) B1, B2, G1 and G2, cyclopiazonic acid (CPA) and ochratoxin A (OTA) was studied by isolate culture followed by HPLC analysis of these mycotoxins in the culture extracts. Results indicated that 64.1% and 34.2% of the A. flavus strains produced AFs and CPA, respectively. Most of the A. flavus strains presented moderate toxigenicity with mean levels of AFs ranging from 100 ng g(-1) to 1000 ng g(-1). All the CPA-producing strains of A. flavus were highly toxigenic producing >30 microg g(-1) of CPA. Furthermore, 98% of A. tamarii strains produced CPA and over 50% of them were highly CPA toxigenic. With respect to OTA-producing fungi, a high percentage of black aspergilli strains (49.2%) were able to produce OTA. Additionally, most of the OTA-producing isolates were of moderate toxigenicity, producing amounts of OTA from 10 microg g(-1) to 100 microg g(-1). These results indicate that there is a possible risk factor posed by AFs, CPA and OTA contamination of cocoa beans, and consequently, cocoa products.

Metástasis en colon de un carcinoma lobulillar de mama / No disponible

No disponible

Diagnóstico citológico de las recidivas tumorales de ameloblastoma: Presentación de dos casos clínicos / Ameloblastoma. Diagnosis by means of FNAB. Report of two cases

Introducción: Los ameloblastomas son los tumores odontogénicos más frecuentes del maxilar. A pesar de su aspecto citohistológico de benignidad, se comportan como tumores invasivos, recidivantes y con posibilidad de metastatizar. La P.A.A.F. es una prueba rápida e incruenta que proporciona un diagnóstico prequirúrgico evitando, en ocasiones, tomas biópsicas destinadas al diagnóstico. Presentamos las características citológicas de dos casos de recidiva yugal de ameloblastoma de rama mandibular diagnosticados por PAAF, así como su correlación citohistológica. Casos clínicos: Dos pacientes, una mujer de 36 años y un varón de 62 años, que acuden por tumoración mandibular de escasos meses de evolución. En ambos casos, la primera aproximación diagnóstica fue junto a los estudios radiológicos el estudio histológico de la masa tumoral. Tras la extirpación terapeútica,ambos casos recidivaron. El diagnóstico de las recidivas fueestablecido citológicamente mediante PAAF.Las extensiones citológicas mostraron un fondo granular con aislados macrófagos y células multinucleadas gigantes y una abundante celularidad epitelial de aspecto basaloide dispuesta en grupos cohesivos configurando imágenes de empalizada periférica, así como pequeños grupos de células de metaplasia escamosa. Discusión: La PAAF se considera como un método diagnóstico rápido, incruento y fiable en el diagnóstico del ameloblastoma. La citología de estos tumores revela los componentes de la lesión que, en general, son suficientes para llegar al diagnóstico de ameloblastoma, especialmente en casos de recidiva

Introduction: Ameloblastomas are the most frequent odontogenic tumors of the maxilla. In spite of their benign cytohistological appearance, they behave as invasive recurring tumors, with the possibility of metastasis. FNAB is a rapid, blood less test that provides a pre-surgical diagnosis, thus, on occasions avoiding the need for diagnostic biopsies. We present the cytological characteristics of two cases of jugal recurrences of mandibular ameloblastomas diagnosed by FNAB, as well as their cytohistological correlation. Clinical cases: Two patients, a 36-year-old woman, and a 62-year-old male who both attended with mandibular swelling of a few months evolution. In both cases the first diagnostic approximation was the histological study of the tumoral mass,together with the radiological studies. Following therapeuticextirpation both cases recurred. The diagnosis of the recurrences was established cytologically by means of FNAB. The cytologic smears revealed a granular background with isolated macrophages and giant multinucleate cells and an abundant epithelial cellularity of basaloid appearance arranged in cohesive groups forming images of peripheral palidasing, as well as small groups of squamous metaplastic cells. Discussion: FNAB is considered to be a rapid, blood less and reliable method for the diagnosis of ameloblastoma. The cytology of these tumors reveals components of the lesion that, in general, are sufficient for the diagnosis of ameloblastoma, especially incases of recurrence

Ameloblastoma. Diagnosis by means of FNAB. Report of two cases.

INTRODUCTION: Ameloblastomas are the most frequent odontogenic tumors of the maxilla. In spite of their benign cytohistological appearance, they behave as invasive recurring tumors, with the possibility of metastasis. FNAB is a rapid, bloodless test that provides a pre-surgical diagnosis, thus, on occasions avoiding the need for diagnostic biopsies. We present the cytological characteristics of two cases of jugal recurrences of mandibular ameloblastomas diagnosed by FNAB, as well as their cytohistological correlation. CLINICAL CASES: Two patients, a 36-year-old woman, and a 62-year-old male who both attended with mandibular swelling of a few months evolution. In both cases the first diagnostic approximation was the histological study of the tumoral mass, together with the radiological studies. Following therapeutic extirpation both cases recurred. The diagnosis of the recurrences was established cytologically by means of FNAB. The cytologic smears revealed a granular background with isolated macrophages and giant multinucleate cells and an abundant epithelial cellularity of basaloid appearance arranged in cohesive groups forming images of peripheral palidasing, as well as small groups of squamous metaplastic cells. DISCUSSION: FNAB is considered to be a rapid, bloodless and reliable method for the diagnosis of ameloblastoma. The cytology of these tumors reveals components of the lesion that, in general, are sufficient for the diagnosis of ameloblastoma, especially in cases of recurrence.

[Localized fibrous tumors of the pleura: clinical and surgical evaluation]. / Tumores fibrosos de localización pleural: valoración clinicoquirúrgica.

Solitary fibrous tumors of the pleura are uncommon and mainly arise in the pleura itself. Such tumors are generally asymptomatic and slow-growing. We report a series of 10 cases (8 men and 2 women with a mean age of 58.6 years) treated over a period of 54 months. The tumors were classified histologically as benign or malignant according to the criteria used by England. The treatment of choice was complete resection of the tumor. Six posterolateral thoracotomies and 4 video-assisted resections were performed. Histology showed a mixture of fibroblast-like cells and collagenous stroma. Sarcomatous degeneration was observed in the excised tumor of 1 patient. The patients were followed for a mean of 23.9 months. We conclude that although fibrous tumors of the pleura are considered benign histologically, complete resection and follow up for all patients are recommended.

[Hepatic steatosis associated with heterozygotic familial hypobetalipoproteinemia]. / Esteatosis hepática asociada a hipobetalipoproteinemia familiar heterocigótica. Presentación de un caso.

Fatty liver disease is now recognized as a major health burden, due to the greater number of cases that are being diagnosed. This trend could partly be explained by the increased use of liver ultrasonography in asymptomatic patients for various reasons, mainly persistent transaminase elevation. The most commonly reported risk factors associated with fatty liver disease are chronic alcohol intake, obesity, type 2 diabetes mellitus, hyperlipidemia, and some drugs. When these factors have been ruled out in a patient with a fatty liver, less frequent causes such as certain inherited metabolic disorders should be considered. Familial hypobetalipoproteinemia is characterized by an alteration of apolipoprotein B (apo B) synthesis, leading to the secretion of truncated forms of the protein, which in turn leads to a marked reduction in excretion of very low-density lipoproteins from the liver and consequently to lipid deposits, especially triglycerides, in the hepatocytes. We report the case of a 23-year-old man who met the diagnostic criteria for heterozygous familial hypobetalipoproteinemia. He presented with mild transaminase elevation and fatty liver. Total cholesterol, low-density lipoprotein cholesterol, very low-density lipoprotein cholesterol and apo B were below normal limits, while levels of high-density lipoprotein cholesterol were normal. Lipid profile determination and liver ultrasonography of first and second-degree relatives were also performed. Molecular studies of the index case revealed an unaffected apo B gene.

Detección de trastornos psicopatológicos en atención primaria: resultados de un estudio epidemiológico en una consulta ambulatoria / Detection of psychopathologic disorders in Primary Care: results of an epidemiological study in a general practic clinic

El estudio que se presenta fue realizado sobre una población que consultaba con su médico de familia en una consulta ambulatoria del INSALUD. Fueron entrevistados 1.160 individuos entre los 15 y los 75 años de edad para obtener información sobre su estado mental. Los datos fueron recogidos con el Cuestionario de Salud General (GHQ-28) y una encuesta de variables sociodemográficas y de salud que incluía todos los factores que podían, en líneas generales, jugar un papel de importancia en la salud mental del sujeto. La prevalencia de trastornos mentales en el estudio fue del 40,10 por ciento. Factores como sexo, edad, estado civil, lugar de nacimiento, profesión, situación laboral, tratamiento psiquiátrico, nivel de estrés, nivel educativo y utilización de los servicios de salud, mostraron una asociación significativa con el nivel de salud mental. Además de calcular la probable prevalencia de trastornos mentales, tratamos de evaluar cómo ésta era detectada por los médicos de Atención Primaria. También se evaluaron los resultados obtenidos en cada una de las cuatro subescalas del test GHQ-28. Con estos datos se configuró un perfil de riesgo de padecer un trastorno psiquiátrico. Finalmente se realizó un despistaje de trastornos relacionados con el alcohol mediante el CAGE test y de alteraciones cognitivas mediante el MMSE test (AU)