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1.
Rev. esp. anestesiol. reanim ; 66(10): 528-532, dic. 2019. ilus
Artigo em Espanhol | IBECS-Express | ID: ibc-ET5-595

RESUMO

A pesar de la extendida y frecuente utilización del catéter de arteria pulmonar en nuestro medio para el manejo hemodinámico en pacientes críticos y particularmente en pacientes tras cirugía cardiaca, en la actualidad siguen planteándose dudas sobre la necesidad de su uso. Es preciso valorar el riesgo/beneficio de su colocación y tener en cuenta sus posibles complicaciones, que aun siendo poco frecuentes, pueden llegar a ser potencialmente graves. En este artículo exponemos una complicación muy poco frecuente ocurrida en nuestro centro sobre el uso del catéter de arteria pulmonar de la que no teníamos constancia hasta ahora. Se trata de una perforación del tabique interventricular y de la pared libre del ventrículo izquierdo debido a una acodadura firme del catéter de arteria pulmonar, que no fue sospechada ni diagnosticada salvo por la visión directa del corazón, tras la esternotomía, durante la cirugía cardiaca. La mejora de la seguridad del paciente implica reflexionar sobre el valor de los eventos adversos, de manera que al aumentar la conciencia de la situación y del mecanismo por el que se producen, pueda reducirse la probabilidad de repetición


Despite the widespread and frequent use in our setting of pulmonary artery catheters for haemodynamic management in critically ill patients, particularly after heart surgery, some experts continue to question the need for these devices. Clinicians need to weigh up the risks and benefits of pulmonary artery catheters placement and bear in mind the potential complications which, though rare, can be potentially fatal. We present a pulmonary artery catheters-related complication not hitherto described in the literature, involving perforation of the interventricular septum and left ventricular free wall caused by a kink in the pulmonary artery catheters that was not suspected, and only diagnosed by direct vision of the heart after pericardial opening. In the interest of patient safety, we must consider the impact of adverse events; improving our situational awareness and our understanding of the mechanisms behind such events can help reduce the likelihood of repetitions in the future

2.
Rev Esp Anestesiol Reanim ; 66(10): 528-532, 2019 Dec.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31587921

RESUMO

Despite the widespread and frequent use in our setting of pulmonary artery catheters for haemodynamic management in critically ill patients, particularly after heart surgery, some experts continue to question the need for these devices. Clinicians need to weigh up the risks and benefits of pulmonary artery catheters placement and bear in mind the potential complications which, though rare, can be potentially fatal. We present a pulmonary artery catheters-related complication not hitherto described in the literature, involving perforation of the interventricular septum and left ventricular free wall caused by a kink in the pulmonary artery catheters that was not suspected, and only diagnosed by direct vision of the heart after pericardial opening. In the interest of patient safety, we must consider the impact of adverse events; improving our situational awareness and our understanding of the mechanisms behind such events can help reduce the likelihood of repetitions in the future.

3.
Clin Genet ; 94(1): 153-158, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29604051

RESUMO

FMR1 premutation carriers (55-200 CGGs) are at risk of developing Fragile X-associated primary ovarian insufficiency as well as Fragile X-associated tremor/ataxia syndrome. FMR1 premutation alleles are also associated with a variety of disorders, including psychiatric, developmental, and neurological problems. However, there is a major concern regarding clinical implications of smaller CGG expansions known as intermediate alleles (IA) or gray zone alleles (45-54 CGG). Although several studies have hypothesized that IA may be involved in the etiology of FMR1 premutation associated phenotypes, this association still remains unclear. The aim of this study was to provide new data on the clinical implications of IA. We reviewed a total of 17 011 individuals: 1142 with primary ovarian insufficiency, 478 with movement disorders, 14 006 with neurodevelopmental disorders and 1385 controls. Similar IA frequencies were detected in all the cases and controls (cases 1.20% vs controls 1.39%, P = .427). When comparing the allelic frequencies of IA ≥ 50CGGs, a greater, albeit not statistically significant, number of alleles were detected in all the cohorts of patients. Therefore, IA below 50 CGGs should not be considered as risk factors for FMR1 premutation-associated phenotypes, at least in our population. However, the clinical implication of IA ≥ 50CGGs remains to be further elucidated.


Assuntos
Alelos , Grupo com Ancestrais do Continente Europeu/genética , Proteína do X Frágil de Retardo Mental/genética , Predisposição Genética para Doença , Variação Genética , Adulto , Feminino , Frequência do Gene , Estudos de Associação Genética , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Vigilância da População , Espanha , Adulto Jovem
4.
Cogn Emot ; 32(1): 207-214, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28107797

RESUMO

Task-irrelevant emotional expressions are known to capture attention, with the extent of "emotional capture" varying with psychopathic traits in antisocial samples. We investigated whether this variation extends throughout the continuum of psychopathic traits (and co-occurring trait anxiety) in a community sample. Participants (N = 85) searched for a target face among facial distractors. As predicted, angry and fearful faces interfered with search, indicated by slower reaction times relative to neutral faces. When fear appeared as either target or distractor, diminished emotional capture was seen with increasing affective-interpersonal psychopathic traits. However, moderation analyses revealed that this was only when lifestyle-antisocial psychopathic traits were low, consistent with evidence suggesting that these two facets of psychopathic traits display opposing relationships with emotional reactivity. Anxiety did not show the predicted relationships with emotional capture effects. Findings show that normative variation in high-level individual differences in psychopathic traits influence automatic bias to emotional stimuli.


Assuntos
Transtorno da Personalidade Antissocial/psicologia , Atenção , Emoções , Expressão Facial , Medo/psicologia , Adolescente , Adulto , Transtorno da Personalidade Antissocial/complicações , Ansiedade/complicações , Ansiedade/psicologia , Feminino , Humanos , Masculino , Tempo de Reação , Adulto Jovem
5.
Eur. j. psychiatry ; 31(2): 50-58, abr.-jun. 2017. tab
Artigo em Inglês | IBECS | ID: ibc-179724

RESUMO

Background and objective: To document the frequency of disability in a Psychiatry Memory Clinic (MC); to test the conjecture that there is an association between low cognitive performance and disability, even when controlling by dementia and clinically significant depression. Methods: A sample of 158 individuals referred to a Psychiatry MC were assessed with a full clinical protocol. Instruments used: Mini-Mental Status Examination (MMSE); Semantic verbal fluency; the Clock Drawing test; Katz Index; Lawton and Brody Scale. DSM-IV criteria were used for diagnosing depression and dementia. The statistical analysis included logistic regression models. Results: The frequency of disability was 71.6%. MMSE score was significantly associated with moderate-severe disability on instrumental activities of daily living (ADL's) (OR 0.83; 95%CI 0.72-0.96) and with social ADL's (OR 0.87; 95%CI 0.79-0.95)). Orientation, attention and language MMSE subscores were the cognitive domains most significantly associated with disability. Conclusions: Disability in patients referred to a Psychiatry MC with a heterogeneous clinical population is associated with low cognitive performance. The probability of having moderate-severe disability is related to the degree of impairment on MMSE global scores


No disponible


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Transtornos Cognitivos/epidemiologia , Transtornos Cognitivos/psicologia , Transtornos da Memória/psicologia , Pessoas com Deficiência Mental/psicologia , Idoso Fragilizado/psicologia , Saúde da Pessoa com Deficiência , Avaliação da Deficiência , Modelos Logísticos
6.
Dev Cogn Neurosci ; 15: 11-25, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26340451

RESUMO

Emotion regulation is the ability to recruit processes to influence emotion generation. In recent years there has been mounting interest in how emotions are regulated at behavioural and neural levels, as well as in the relevance of emotional dysregulation to psychopathology. During adolescence, brain regions involved in affect generation and regulation, including the limbic system and prefrontal cortex, undergo protracted structural and functional development. Adolescence is also a time of increasing vulnerability to internalising and externalising psychopathologies associated with poor emotion regulation, including depression, anxiety and antisocial behaviour. It is therefore of particular interest to understand how emotion regulation develops over this time, and how this relates to ongoing brain development. However, to date relatively little research has addressed these questions directly. This review will discuss existing research in these areas in both typical adolescence and in adolescent psychopathology, and will highlight opportunities for future research. In particular, it is important to consider the social context in which adolescent emotion regulation develops. It is possible that while adolescence may be a time of vulnerability to emotional dysregulation, scaffolding the development of emotion regulation during this time may be a fruitful preventative target for psychopathology.


Assuntos
Encéfalo/crescimento & desenvolvimento , Emoções/fisiologia , Transtornos Neurocognitivos/etiologia , Psicopatologia/métodos , Adolescente , Mapeamento Encefálico , Humanos , Córtex Pré-Frontal
7.
Epidemiol Psychiatr Sci ; 24(6): 503-11, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24905936

RESUMO

BACKGROUND: To test the hypothesis that cognitive impairment in older adults is associated with all-cause mortality risk and the risk increases when the degree of cognitive impairment augments; and then, if this association is confirmed, to report the population-attributable fraction (PAF) of mortality due to cognitive impairment. METHOD: A representative random community sample of individuals aged over 55 was interviewed, and 4557 subjects remaining alive at the end of the first year of follow-up were included in the analysis. Instruments used in the assessment included the Mini-Mental Status Examination (MMSE), the History and Aetiology Schedule (HAS) and the Geriatric Mental State (GMS)-AGECAT. For the standardised degree of cognitive impairment Perneczky et al's MMSE criteria were applied. Mortality information was obtained from the official population registry. Multivariate Cox proportional hazard models were used to test the association between MMSE degrees of cognitive impairment and mortality risk. We also estimated the PAF of mortality due to specific MMSE stages. RESULTS: Cognitive impairment was associated with mortality risk, the risk increasing in parallel with the degree of cognitive impairment (Hazard ratio, HR: 1.18 in the 'mild' degree of impairment; HR: 1.29 in the 'moderate' degree; and HR: 2.08 in the 'severe' degree). The PAF of mortality due to severe cognitive impairment was 3.49%. CONCLUSIONS: A gradient of increased mortality-risk associated with severity of cognitive impairment was observed. The results support the claim that routine assessment of cognitive function in older adults should be considered in clinical practice.

8.
Acta Psychiatr Scand ; 131(1): 29-39, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24893954

RESUMO

OBJECTIVE: To contrast the prevalence of mild cognitive impairment (MCI) as diagnosed using DSM-5 criteria (DSM5-MCI) with MCI as diagnosed using Petersen's criteria (P-MCI) and to explore the association of both with non-cognitive psychopathological symptoms (NCPS). METHOD: A two-phase epidemiological screening was implemented in a population-based sample of individuals aged 55+ (n = 4803). The Geriatric Mental State (GMS) was the main psychopathological instrument used, and AGECAT was used to make psychiatric diagnoses. Research psychiatrists diagnosed DSM5-MCI and P-MCI using operational criteria. Logistic regression models were then used to investigate the association of MCI with anxiety and depression and with NCPS. RESULTS: Weighted prevalence of DSM5-MCI and P-MCI was, respectively, 3.72% and 7.93% for the aged 65+. NCPS were common in both MCI categories, but negative-type symptoms such as 'anergia' and 'observed slowness' were considerably more frequent among persons with DSM5-MCI. Anxiety and depression diagnostic categories were associated with both P-MCI and DSM5-MCI, but affective-type symptoms were mainly associated with P-MCI. Some negative-type symptoms were inversely associated with P-MCI, and no association was observed with DSM5-MCI. CONCLUSION: The prevalence of DSM5-MCI was half that of P-MCI. Negative-type NCPS were more frequently and typically associated with DSM5-MCI.


Assuntos
Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/epidemiologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Disfunção Cognitiva/psicologia , Diagnóstico Diferencial , Feminino , Humanos , Estudos Longitudinais , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Prevalência , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Espanha/epidemiologia
9.
Acta Psychiatr Scand ; 124(5): 372-83, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21848704

RESUMO

OBJECTIVE: To calculate both the incidence rates and the lifetime risk (LTR) of dementia and Alzheimer's disease (AD). METHODS: A two-phase case-finding procedure was implemented in a cohort of 4057 cognitively intact individuals 55+ years of age living in Zaragoza, Spain, and followed-up at 2.5 and 4.5 years. Age- and sex-specific incidence rates were calculated. A mortality-adjusted, multivariate model was used to document LTRs. RESULTS: The incidence rate of dementia continued to rise after the age of 90 years, but was slightly lower than in North and West European studies. Only a tendency for an increased LTR with age was observed. Thus, LTR was 19.7% for a 65-year-old woman and 20.4% at the age of 85 years, the corresponding figures for AD being 16.7% and 17.6%. The LTR of AD was higher in women and was about twice as high among illiterate individuals when compared with individuals with higher educational levels. CONCLUSIONS: The incidence rate of dementia in this Southern European city was slightly lower than in previous studies in North-West Europe. LTR of dementia and AD seems to be slightly increased with age. The association of illiteracy with higher LTR of AD is intriguing.


Assuntos
Doença de Alzheimer/epidemiologia , Demência/epidemiologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Escolaridade , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores Sexuais , Espanha/epidemiologia
10.
Acta Neurol Scand ; 123(5): 316-24, 2011 May.
Artigo em Inglês | MEDLINE | ID: mdl-20636450

RESUMO

OBJECTIVES: To estimate dementia prevalence in Spain. MATERIALS AND METHODS: Nine probabilistic and geographically defined samples participated. A screening design based on the MMSE was implemented. Positively screened individuals underwent clinical evaluation. The total number of cases in Spain was estimated. Prevalence was confronted to that of other European countries. RESULTS: Five hundred and forty-six persons aged ≥75 participated, 49 had dementia (35 with Alzheimer's disease [AD], 10 with vascular dementia [VD], 4 other; 25 first diagnosed in the study). Age- and sex-adjusted prevalence and estimated nationwide cases were 7.5% (95% CI 5.4-9.7), 5.6 (95% CI 3.7-7.5) and 1.4 (95% CI 0.5-2.3), and 290,000 (95% CI 208,000-372,000), 214,000 (95% CI 141,000-288,000) and 54,000 (95% CI 20,000-88,000) for dementia, AD and VD, respectively. CONCLUSIONS: Dementia prevalence in Spain is comparable to other European populations, while a high number of undiagnosed cases live in the community. The potential impact of Mediterranean diet, hypertension control and decreasing vascular risk factors is discussed.


Assuntos
Demência/epidemiologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Demência/diagnóstico , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Programas de Rastreamento , Exame Neurológico , Prevalência , Fatores Sexuais , Espanha/epidemiologia
11.
Acta Psychiatr Scand ; 119(2): 107-16, 2009 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-19053966

RESUMO

OBJECTIVE: Clinical experience and recent population studies suggest that psychopathological, non-cognitive symptoms are both frequent and relevant in dementia. METHOD: A representative community sample (n = 4,803 individuals, 55 + years) was interviewed in a two-phase design. The Geriatric Mental Sate (GMS) was used for assessment and cases were diagnosed according to DSM-IV-TR criteria. RESULTS: The prevalence of non-cognitive symptoms (1 + symptoms) in cases of dementia (n = 223) was 90.1%, and negative-type symptoms were most frequently found. A GMS 'apathy-related symptom cluster' (anergia, restriction of activities and anhedonia) was significantly more frequent in the demented (55.6%) than in non-cases (0.7%; specificity = 99.2%). In both dementia of Alzheimer's type and vascular dementia, number of symptoms tended to be inversely related to severity of dementia, but psychopathological profiles differed. CONCLUSION: Non-cognitive, negative-type symptoms are very frequent in cases of dementia living in the community. They have powerful specificity in the distinction with non-cases, and might change current concepts of dementia.


Assuntos
Demência/epidemiologia , Demência/psicologia , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/epidemiologia , Doença de Alzheimer/psicologia , Comorbidade , Demência Vascular/epidemiologia , Demência Vascular/psicologia , Feminino , Avaliação Geriátrica/métodos , Avaliação Geriátrica/estatística & dados numéricos , Humanos , Entrevista Psicológica/métodos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Prevalência , Características de Residência , Índice de Gravidade de Doença , Distribuição por Sexo , Espanha/epidemiologia
12.
Acta Psychiatr Scand ; 116(4): 299-307, 2007 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17803760

RESUMO

OBJECTIVE: To compare the prevalence of dementia in two different time periods and two different studies. METHOD: Representative, random samples of the elderly (>65 years) in the Zaragoza Study or ZARADEMP-0 (n = 1080) completed the previous decade, and now in Wave I of the ZARADEMP Project or ZARADEMP-I (n = 3715) were interviewed. Standardized measures included the Geriatric Mental State and the History and Aetiology schedule. Cases of dementia were diagnosed according to DSM-IV criteria. RESULTS: Adjusted, global prevalence of dementia has not varied significantly: it was 5.2% (95% CI = 3.9-6.6) in ZARADEMP-0 and 3.9% (95% CI = 3.3-4.5) in ZARADEMP-I (prevalence ratio = 0.75; 95% CI = 0.56-1.02). However, the prevalence in ZARADEMP-I was significantly lower among men, particularly in all age groups between 70 and 84 years. CONCLUSION: Stability of the global prevalence of dementia in the elderly population has been documented. However, the decreased prevalence found in elderly men stimulated environmental hypotheses.


Assuntos
Demência/epidemiologia , Atividades Cotidianas/psicologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Demência/diagnóstico , Demência/psicologia , Avaliação da Deficiência , Feminino , Avaliação Geriátrica , Inquéritos Epidemiológicos , Humanos , Estudos Longitudinais , Masculino , Entrevista Psiquiátrica Padronizada , Fatores Sexuais , Espanha
13.
Neurología (Barc., Ed. impr.) ; 22(3): 138-146, abr. 2007. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-054706

RESUMO

Introducción. El objetivo de este trabajo es reanalizar estudios puerta a puerta sobre enfermedades neurológicas de los ancianos donde se estudiaron factores de riesgo vascular (FRV), describiendo sus características metodológicas y las prevalencias de los mismos. Métodos. Se identificaron las encuestas en dos fases, dirigidas a la obtención de prevalencias de ictus, demencias y parkinsonismos que obtuvieron en el cribado datos individuales de al menos tres de los FRV siguientes: hipertensión arterial (HTA), tabaquismo, diabetes mellitus e hipercolesterolemia. Se elaboró un cuestionario para la recogida de datos de cada estudio y se construyó una base de datos compartidos. Se cuantificaron y analizaron las prevalencias de FRV mediante regresión logística. Resultados. En total la población reanalizada, residente en siete áreas geográficas en 1994-2002, ascendió a 12.510 personas de 70 años y más. La información disponible en FRV era fundamentalmente autorreferida. La prevalencia de HTA autorreferida fue 25,7% en hombres y 44,2% en mujeres y la de HTA medida, 61 % y 71,9 %, respectivamente. Las poblaciones con tensión arterial (TA) obtenida mediante medición directa presentaban riesgos mayores (OR: 1,74; IC 95%: 1,51-2,01, y OR: 1,48; IC 95%: 1,33-1,64). Las prevalencias de diabetes, hipercolesterolemia y tabaquismo declaradas fueron 14,3, 23,3 y 8,5 %, respectivamente. Conclusiones. La prevalencia de FRV en ancianos españoles es alta, aunque la calidad de los datos es insuficiente para el estudio de su relación con la demencia, parkinsonismos y enfermedad cerebrovascular. Las diferencias entre la TA medida y la autorreferida sugieren la existencia de HTA no detectada y un amplio margen para la prevención


Introduction. The aim of this study was to re-analyze door-to-door studies on neurological diseases among the elderly, in which vascular risk factors (VRF) were studied, describing methodological characteristics and prevalence of VRF. Methods. The surveys were identified in two phases. They were aimed at ascertaining prevalence of stroke, dementias or Parkinsonisms and, at the time of individual screening, had collected data on at least three of the following VRF: arterial hypertension (AHT), smoking habit, diabetes mellitus and hypercholesterolemia. A questionnaire was drawn up to collect the data reported in each study, and a database was constructed. VRF prevalences were quantified and analyzed using logistic regression. Results. The total of the re-analyzed population was 12,510 persons aged 70 years and over, residents in seven geographic areas during the period 1994-2002. Information available on VRF was essentially self-reported. The prevalence of self-reported AHT was 25.7 % in men and 44.2 % in women, and that of measured AHT was 61 % and 71.9 %, respectively. Populations with arterial pressure obtained by direct measurement registered 138 higher risks (OR: 1.74; 95 % CI: 1.51-2.01, and OR: 1.48; 95% CI: 1.33-1.64). Reported prevalence of diabetes, hypercholesterolemia and smoking habit were 14.3 %, 23.3% and 8.5 %, respectively. Conclusions. There was a high prevalence of VRF among the Spanish elderly population. However, its relationship with dementia, Parkinsonisms and cerebrovascular disease could not be studied due to the poor quality of the VRF data. The differences between measured and self-reported arterial pressure suggest the existence of undetected AHT and wide scope for prevention


Assuntos
Masculino , Feminino , Idoso , Humanos , Transtornos Cerebrovasculares/epidemiologia , Diabetes Mellitus/epidemiologia , Inquéritos Epidemiológicos , Hipercolesterolemia/epidemiologia , Hipertensão/epidemiologia , Hipertensão/psicologia , Prevalência , Inquéritos e Questionários , Projetos de Pesquisa , Fatores de Risco , Tabagismo/epidemiologia , Espanha/epidemiologia , Doenças Vasculares/epidemiologia
14.
Neurologia ; 22(3): 138-46, 2007 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-17364251

RESUMO

INTRODUCTION: The aim of this study was to re-analyze door-to-door studies on neurological diseases among the elderly, in which vascular risk factors (VRF) were studied, describing methodological characteristics and prevalence of VRF. METHODS: The surveys were identified in two phases. They were aimed at ascertaining prevalence of stroke, dementias or Parkinsonisms and, at the time of individual screening, had collected data on at least three of the following VRF: arterial hypertension (AHT), smoking habit, diabetes mellitus and hypercholesterolemia. A questionnaire was drawn up to collect the data reported in each study, and a database was constructed. VRF prevalences were quantified and analyzed using logistic regression. RESULTS: The total of the re-analyzed population was 12,510 persons aged 70 years and over, residents in seven geographic areas during the period 1994-2002. Information available on VRF was essentially self-reported. The prevalence of self-reported AHT was 25.7 % in men and 44.2 % in women, and that of measured AHT was 61 % and 71.9 %, respectively. Populations with arterial pressure obtained by direct measurement registered 138 higher risks (OR: 1.74; 95 % CI: 1.51-2.01, and OR: 1.48; 95% CI: 1.33-1.64). Reported prevalence of diabetes, hypercholesterolemia and smoking habit were 14.3 %, 23.3% and 8.5 %, respectively. CONCLUSIONS: There was a high prevalence of VRF among the Spanish elderly population. However, its relationship with dementia, Parkinsonisms and cerebrovascular disease could not be studied due to the poor quality of the VRF data. The differences between measured and self-reported arterial pressure suggest the existence of undetected AHT and wide scope for prevention.


Assuntos
Transtornos Cerebrovasculares/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Diabetes Mellitus/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Hipercolesterolemia/epidemiologia , Hipertensão/epidemiologia , Hipertensão/psicologia , Masculino , Prevalência , Projetos de Pesquisa , Fatores de Risco , Fumar/epidemiologia , Espanha/epidemiologia , Inquéritos e Questionários , Doenças Vasculares/epidemiologia
18.
Psychosomatics ; 48(1): 46-53, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17209149

RESUMO

The Spanish Research Network in Liaison Psychiatry and Psychosomatics (REPEP) comprises 11 centers (nodes), and was one of the successful applicants in a very competitive call for a networking program for the National Institute of Health "Carlos III" project. This article describes its general objectives and strategic plans. Both qualitative and quantitative results support our statement that this "perspective" should help to enlarge what is presently a small specialty. Synergies in the network have been potentiated; an ambitious national study on depressive comorbidity in complex medical patients has been executed; and new research and training programs have been initiated.


Assuntos
Psiquiatria/organização & administração , Medicina Psicossomática/organização & administração , Encaminhamento e Consulta/organização & administração , Pesquisa/organização & administração , Especialização/tendências , Previsões , Necessidades e Demandas de Serviços de Saúde/tendências , Humanos , Psiquiatria/tendências , Medicina Psicossomática/tendências , Encaminhamento e Consulta/tendências , Pesquisa/tendências , Sociedades Médicas/organização & administração , Sociedades Médicas/tendências , Espanha
19.
Diabetologia ; 49(11): 2627-33, 2006 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-17019601

RESUMO

AIMS/HYPOTHESIS: Although several studies have reported on the association between diabetes and depression, none have used both formal psychiatric criteria and a prospective, population-based design. Therefore, it remains unclear whether diabetes is a risk factor for the development of depression. Moreover, it is not clear if this effect is influenced by other chronic diseases and functional disabilities. METHODS: A large (n=4,803) representative community-based study in Spanish elderly subjects (at least 55 years of age) was conducted. The presence of major depression was assessed by means of a standardised psychiatric diagnostic interview (Automated Geriatric Examination for Computer Assisted Taxonomy). Subjects underwent a baseline assessment and a follow-up assessment after 2 and 5 years to determine the incidence of depression. RESULTS: At baseline 597 subjects (12.5%) were identified as having diabetes. Prevalence and incidence of depression in cases of diabetes were 15.4% and 16.5% respectively. Diabetes was associated with an increased risk of prevalent (odds ratio [OR]=1.47; 95% CI: 1.16-1.83) and incident (OR=1.40; 95% CI: 1.03-1.90) depression. Controlling for potential confounders did not essentially change these findings (prevalent depression: OR 1.41, 95% CI: 1.08-1.83; incident depression: OR 1.26, 95% CI: 0.90-1.77). CONCLUSIONS/INTERPRETATION: In a large, representative prospective population-based sample using strict psychiatric criteria, we confirmed previous findings that diabetes is associated with an increased risk of depression. The effect on the incidence of depression suggests that diabetes may play a role in the development of depression in the elderly. The presence of comorbid medical diseases seems to decrease the effects of diabetes on the risk of prevalent depression, but to increase the risk of incident depression.


Assuntos
Transtorno Depressivo/epidemiologia , Complicações do Diabetes/psicologia , Idoso , Comorbidade , Complicações do Diabetes/epidemiologia , Feminino , Humanos , Incidência , Entrevistas como Assunto , Masculino , Entrevista Psiquiátrica Padronizada , Pessoa de Meia-Idade , Prevalência , Seguridade Social , Espanha/epidemiologia
20.
Br J Psychiatry ; 187: 35-42, 2005 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-15994569

RESUMO

BACKGROUND: Associations between physical health and depression are consistent across cultures among adults up to 65 years of age. In later life, the impact of physical health on depression is much more substantial and may depend on sociocultural factors. AIMS: To examine cross-national differences in the association between physical health and depressive symptoms in elderly people across western Europe. METHOD: Fourteen community-based studies on depression in later life in nine western European countries contributed to a total study sample of 22 570 respondents aged 65 years and older. Measures were harmonized for depressive symptoms (EURO-D scale), functional limitations and chronic physical conditions. RESULTS: In the majority of the participating samples, the association of depressive symptoms with functional disability was stronger than with chronic physical conditions. Associations were slightly more pronounced in the UK and Ireland. CONCLUSIONS: The association between physical health and depressive symptoms in later life is consistent across western Europe.


Assuntos
Depressão/etiologia , Nível de Saúde , Idoso , Idoso de 80 Anos ou mais , Doença Crônica/epidemiologia , Cognição , Comparação Transcultural , Depressão/epidemiologia , Avaliação da Deficiência , Europa (Continente)/epidemiologia , Feminino , Indicadores Básicos de Saúde , Humanos , Masculino , Escalas de Graduação Psiquiátrica
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