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1.
Rev Colomb Psiquiatr ; 49(3): 187-193, 2020.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32888662

RESUMO

INTRODUCTION: Cotard's syndrome is a rare psychiatric condition. As a result, current information is mainly based on reports and case series. OBJECTIVE: To analyse the psychopathological characteristics and the grouping of the symptoms of the Cotard's syndrome cases reported in the medical literature. METHODS: A systematic review of the literature of all reported cases of Cotard's syndrome from 2005 to January 2018 was performed in the MEDLINE/PubMed database. Demographic variables and clinical characteristics of each case were collected. An exploratory factor analysis of the symptoms was performed. RESULTS: The search identified 86 articles, of which 69 were potentially relevant. After reviewing the full texts, 55 articles were selected for the systematic review, in which we found 69 cases. We found that the diagnosis of major depression (P<0.001) and organic mental disorder (P=0.004) were more frequent in the older group with Cotard's syndrome. An exploratory factor analysis extracted 3 factors: psychotic depression, in which it includes patients with delusions of guilt (0.721), suicidal ideas (0.685), delusions of damnation (0.662), nihilistic delusions of the body (0.642), depression (0.522), and hypochondriacal delusions (0.535); delusive-hallucinatory, with patients who presented delusions of immortality (0.566), visual hallucinations (0.545) and nihilistic delusions of existence (0.451), and mixed, with patients who presented nihilistic delusions of concepts (0.702), anxiety (0.573), and auditory hallucinations (0.560). CONCLUSIONS: The psychopathology of Cotard's syndrome is more complex than the simple association with the delusion of being dead, since it encompasses a factorial structure organised into 3 factors.

2.
Rev. cient. (Guatem.) ; 28(2): 36-44, 2019/07/05.
Artigo em Espanhol, Inglês | LILACS-Express | LILACS | ID: biblio-1006384

RESUMO

Se denomina uso inapropiado de los servicios de emergencia a la búsqueda de servicios de salud de manera urgente por parte de los pacientes que presentan una patología no urgente, cuyo problema de salud puede y debe ser atendido en el nivel primario o por consultorio externo. El objetivo planteado fue el de encontrar ciertas características que pudieran ser relevantes a la hora de hacer uso inapropiado de los servicios de emergencia. Estudio transversal analítico en el que se administró un cuestionario por medio de entrevista para realizar una encuesta a una muestra aleatoria de usuarios del servicio de emergencia del Hospital Nacional Guillermo Almenara que cumplían con los criterios de selección desde abril a noviembre del 2015. El análisis bivariante identificó siete variables significativas relacionadas al uso inapropiado, con OR [IC 95 %] y valor p: género femenino (1.49 [1.07, 2.08], p = .018), presencia de enfermedad crónica (0.50 [0.35. 0.72], p < .001), percepción de ausencia de equipos en nivel primario (2.56 [1.66, 3.94], p < .001), percepción de ausencia de especialistas en nivel primario (2.25 [1.43, 3.55], p < .001), autorreferencia (1.69 [1.12, 2.57], p = .012), percepción de que la atención del nivel terciario cuesta igual o menos (2.02 [1.42, 2.89], p < 0.001), encontrarse en el trabajo al momento de decidir acudir a emergencia (1.87 [1.12, 3.13], p = 0.015). El análisis multivariante identificó tres variables significativas, con ORaj [IC 95 %] y valor p: percepción de ausencia de equipos en nivel primario (2.21 [1.42, 3.44], p < .001), autorreferencia (1.72 [1.05, 2.77], p = .032) y percepción de menor costo (2.0 [1.35, 3.09], p = .001). La presencia de enfermedad crónica, la percepción de ausencia de equipos y de especialistas en nivel primario fueron las variables que se asociaron con mayor fuerza al uso inapropiado de los servicios de emergencia


Inappropriate use of emergency services is defined as the misuse of emergency room services for pathologies that could be attended as a non-urgent basis, either at an outpatient or in primary services. e purpose of this research was to find some characteristics associated with this misuse. Analytical cross-sectional study, in which a random sample of users of the emergency service of the National Hospital "Guillermo Almenara" who met the selection criteria from April to November 2015, was administered. e bivariate analysis identified seven significant variables related to the inappropriate use: female gender (OR = 1.49, 95% CI [1.07, 2.08], p = .018), presence of chronic disease (OR = 0.50, 95% CI [0.35, 0.72], p < .001), perception of absence of equipment at primary level (OR = 2.56, 95% CI [1.66, 3.94], p < .001), perception of absence of specialists at primary level (OR = 2.25, 95%CI [1.43, 3.55], p < .001), self-reference (OR = 1.69, 95% CI [1.12, 2.57], p = .012), perception that the tertiary level care costs equal or less (OR = 2.02, 95% CI [1.42, 2.89], p < .001), and being at work when deciding to go to emergency (OR = 1.87, 95% CI [1.12, 3.13], p = .015). e multivariate analysis identified three significant variables: perception of absence of equipment at primary level (Adj. OR = 2.21, IC95% [1.42, 3.44], p < .001), self-reference (Adj. OR = 1.72, 95% CI, [1.05, 2.77], p = .032), and lower cost perception (Adj. OR = 2.0, 95% CI [1.35, 3.09], p = .001). e presence of chronic disease, the perception of lack of equipment, and specialists at the primary level were the variables that were most strongly associated with the inappropriate use of emergency services

3.
An. Fac. Med. (Perú) ; 79(2): 138-143, abr.-jun. 2018. ilus, tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1011024

RESUMO

Introducción. Se sabe que las actitudes que tienen los médicos hacia las personas gais y lesbianas podrían influir en el tipo de calidad de atención de salud brindada. Sin embargo, es poca la información que tenemos en el Perú respecto a las actitudes que tienen los médicos frente a la homosexualidad. Los objetivos del estudio fueron determinar las actitudes hacia la homosexualidad y su relación con algunas variables en un grupo de médicos del Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú. Estudio de enfoque cuantitativo, aplicado e inductivo, de diseño observacional y transversal. Participaron 142 médicos de 24 a 60 años, 38% mujeres y 62% varones. Métodos. Se utilizó la Escala de Actitud hacia la Homosexualidad (EAH-10) y la Escala de Actitud Religiosa (EAR), además se recolectaron variables sociodemográficas. Resultados. La puntuación media de la EAH-10 fue de 23,32. 46 (32,4%) de los médicos mostraron actitudes intolerantes hacia a la homosexualidad, siendo éstas mayores en varones (p=0,005) y aquellos que mencionaron estar afiliados a una religión (católicos y protestantes/ evangélicos) (p=0,007). Se encontró en los varones una correlación lineal positiva entre la actitud religiosa y actitudes homofóbicas (r=0,343, p=0,001), y entre la edad y actitudes homofóbicas (r=0,204, p=0,015). El número de personas cercanas homosexuales conocidas mostró una relación negativa con las actitudes homofóbicas (r= 0,218, p=0,001). El análisis de regresión lineal multivariada mostró que el sexo masculino, el estado civil (divorciado/conviviente) y la EAR resultan asociadas con la EAH-10. Conclusiones. En la población de médicos analizada, se encontró en los varones una relación positiva significativa entre la actitud religiosa y actitudes homofóbicas, y entre la edad y actitudes homofóbicas. Además, se halló una relación negativa significativa entre el número de personas cercanas homosexuales conocidas y actitudes homofóbicas.


Introduction. It is known that doctors’ attitudes towards gay and lesbian people could influence the type and quality of health care provided. However, there is little information in Peru regarding the attitudes physicians have when facing homosexuality. The objectives of the study were to evaluate the attitudes towards homosexuality and its relationship with some variables in a group of physicians at the "Hospital Nacional Guillermo Almenara Irigoyen", Lima, Peru. Quantitative, applicative and inductive study approach. Observational and transversal design. Participated 142 physicians aged 24 to 60 years old, 38% female and 62% male. Methods. Attitude towards Homosexuality Scale (EAH-10) and Religious Attitude Scale (EAR), sociodemographic variables were also gathered. Results. The mean EAH-10 score was 23, 32. Forty-six (32,4%) physicians showed intolerant attitudes towards homosexuality, being these higher in male (p=0,005), catholic and protestant/evangelical (p=0,007). A positive linear correlation was found in men between religious attitude and homophobic attitudes (r=0,343, p=0,001), and between the age and homophobic attitudes (r=0,204, p=0,015). The number of close homosexual people known showed a negative correlation with the homophobic attitudes (r=-0,218, p=0,001). Multivariate linear regression analysis showed that male, marital status (divorced / cohabitant) and EAR are associated with EAH-10. Conclusions. In the analyzed population of physicians, a significant positive relation was found between religious attitude and homophobic attitudes, and between age and homophobic attitudes. Also, a significant negative relation was found between the number of close homosexual people known and homophobic attitudes.

6.
Rev. peru. epidemiol. (Online) ; 17(2): 1-6, mayo.-ago. 2013. graf, ilus
Artigo em Espanhol | LILACS, LIPECS | ID: lil-706063

RESUMO

Los grados de libertad representan un tema central en la estadística moderna, sin embargo su concepto se explica poco en los libros de texto. A pesar de que Gauss los usó por primera vez al estimar las distancias entre las estrellas, no aparece formalmente hasta los escritos de Gosset (Student) en 1908. El concepto de grados de libertad se puede entender desde un punto de vista geométrico, algebraico e incluso intuitivo. La geometría nos describe a los grados de libertad como espacios e hiperespacios de libertad através de los cuales una medida de resumen puede moverse y tomar diferentes valores. El punto de vista algebraico los describe como el número de ecuaciones que se establecen usando los datos. Ambos puntos de vista est n relacionados y ayudan a comprender con mayor profundidad el concepto de grados de libertad. La aplicaciones de los grados de libertad está n extendidas através de toda la estadstica, el calculo de la desviación estándar y la prueba t de Student son solo algunos ejemplos.


Degrees of freedom is a central topic in modern statistics, however is poor explained in textbooks. Gauss used it for first time in estimates of astronomic distances but it appears formally in Gosset (Student) manuscripts in 1908. Degrees of freedom can be understood from geometric, algebraic or even intuitive point of view. Geometrics shows degrees of freedom as spaces through a summary measure can move freely assuming different values. Algebra describes degrees of freedom as number of unknown variables in respect of number of equations we can establish using data. Both algebraic and geometric points of view are related and help us to understand better the meaning of degrees of freedom. Applications in statistics are widely spread but standard deviation and Student t are just some examples.


Assuntos
Estatística como Assunto , Liberdade
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