NSAIDs Prescription Prevalence after a Cardiovascular Event Related Hospitalization in Medicaid Beneficiaries from Puerto Rico.

OBJECTIVE: Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed for pain and inflammation. NSAIDs are associated with serious adverse effects and cardiovascular (CV) risks that include myocardial infarction, stroke and heart failure. In the period of time immediately after a CV event, modification to the drug therapy regimen and lifestyle habits should be instituted to decrease morbidity and mortality. The objective of this study is to measure the prevalence of NSAIDs prescribing in the immediate 90 days after a CV-related hospitalization in Medicaid beneficiaries in Puerto Rico. METHODS: Hospitalization claims were used to identify beneficiaries with a CVrelated hospitalization during the study period, and pharmacy claims were used to evaluate the occurrence of NSAIDs prescribing post-discharge. RESULTS: A total of 4,195 beneficiaries with at least one CV-related hospitalization were identified. Out of these beneficiaries, 774 (18.5%) had at least one pharmacy claim for an NSAID post discharge, and 401 (9.6%) had at least one pharmacy claim for an NSAID within 90 days post-discharge. The average time span between the discharge date and the first NSAID claim was 135 days. CONCLUSION: Almost 20% of all beneficiaries who were hospitalized for a CV event received an NSAID during the study period, with 10% of patients receiving it during the immediate 90 days post-discharge. It represents a major challenge for our healthcare system, as it may reflect unawareness on the impact of proved evidence in clinical decision making.

Allergy to goat's and sheep's milk in a population of cow's milk-allergic children treated with oral immunotherapy.

BACKGROUND: Cow's milk oral immunotherapy (CMOIT) is a recognized treatment for persistent cow's milk (CM) allergy. However, further data are necessary on tolerance to milk from other mammals. OBJECTIVE: To describe the clinical and immunologic features of goat's and sheep's milk (GSM) allergy in patients who tolerated CM after CMOIT. METHODS: Fifty-eight CM-allergic patients who successfully underwent CMOIT in our department were evaluated using skin prick test (SPT), specific immunoglobulin (Ig) E determination, enzyme-linked immunoassay (ELISA), and controlled oral challenge to assess allergy to GSM. Statistical analysis was carried out to identify markers of allergy to GSM. RESULTS: Fifteen of 58 (25.9%) patients were allergic to either goat's or sheep's milk or to both, as confirmed by a controlled positive oral challenge. Forty-seven percent of all positive oral challenges were classified as anaphylactic reactions. Specific IgE to CM casein, goat's whole milk, and sheep's whole milk was 13.2, 18.0, and 21.4 kU(A)/l in the group of GSM-allergic patients and 6.6, 6.5, and 6.5 kU(A) /l in the GSM-non-allergic patients (p < 0.05). Decision-making cut-off points based on sIgE for diagnosing symptomatic GSM allergy could not be determined. ELISA inhibition assays showed limited cross-reactivity (up to 77.2%) between CM casein and GSM casein in the group of GSM-allergic patients in contrast with almost 100% in GSM-not-allergic patients. CONCLUSION: We found a high prevalence (26%) of allergy to GSM in our population of CM-allergic children treated with oral immunotherapy. Therefore, tolerance to GSM should be assessed in order to provide accurate nutritional advice and minimize life-threatening accidental intake. Specific IgE to CM casein, goat's and sheep's whole milk is a good marker of this allergy. Although CM oral immunotherapy is a specific treatment for CM allergy, it may not be effective against allergy to the milk of other mammals.

Prevalence and incidence of systemic sclerosis: A systematic review and meta-analysis.

OBJECTIVE: Systemic sclerosis (SSc) is a rare debilitating autoimmune disease of the connective tissue. This study aimed to assess the recent prevalence and incidence of SSc across the world. METHODS: Using a systematic search strategy, PubMed/MEDLINE and EMBASE were searched to identify relevant studies published between 2006 and 2016. Two reviewers independently evaluated studies for inclusion based on inclusion/exclusion criteria and performed data extraction. The review was conducted and reported following the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. The pooled prevalence of SSc was calculated by meta-analysis using a random-effects model. RESULTS: There were 1364 references retrieved using the initial searching strategy, and 20 epidemiological publications were selected for data extraction. The identified studies reported prevalence ranging from 3.8 per 100 000 in Taiwan to 50 per 100 000 in the USA. The prevalence was 23 per 100 000 (95% CI: 16-29 per 100 000; 18 studies) in a pooled sample of 11 574 individuals. Incidence rate of SSc ranges from 0.77 per 100 000 person-years in the Netherlands to 5.6 per 100 000 person-years in the USA. SSc predominates in females with higher prevalence and incidence rates. It is important to note that different methodologies were used to derive these numbers so comparisons were made with caution. CONCLUSION: This review provides an assessment of the current estimates of disease prevalence and incidence of SSc. The epidemiological burdens of SSc vary among different regions of the world. The epidemiological data need to be interpreted with caution considering the methodological differences in deriving these estimates.

A reconstructed database of historic bluefin tuna captures in the Gibraltar Strait and Western Mediterranean.

This data paper presents a reconstruction of a compilation of a small but consistent database of historical capture records of bluefin tuna (Thunnus thynnus; BFT hereafter) from the Gibraltar Strait and Western Mediterranean (Portugal, Spain and Italy). The compilation come from diverse historical and documentary sources and span the time interval from 1525 to 1936 covering a period of 412 years. There is a total of 3074 datum, which reach up to 67.83% of the total implying a 32.17% of missing data. However, we have only reconstructed the captures for the time interval 1700-1936 and we provide these reconstructions only for this time interval and for 9 out of 11 series due to the scarcity and inhomogeneity of the two oldest capture time series. This reconstructed database provides an invaluable opportunity for fisheries and marine research as well as for multidisciplinary research in climate change.

Prophylaxis for opioid-induced constipation in elderly long-term care residents: a cross-sectional study of Medicare beneficiaries.

BACKGROUND: Opioid analgesics are effective therapeutic agents for malignant and nonmalignant pain, but their use is often compromised by unwanted adverse effects on the central nervous system and gastrointestinal (GI) tract. These adverse effects include sedation, respiratory depression, nausea and vomiting, reduction in biliary and pancreatic secretions, decreased GI motility, increased GI transit time, and subsequent constipation. OBJECTIVE: The goal of this study was to determine national estimates of laxative use, with and without concurrent opioids, in the long-term care (LTC) population and to determine factors associated with laxative underuse among elderly LTC residents receiving opioids. METHODS: This cross-sectional study was conducted in LTC facilities in the United States. Medicare beneficiaries participating in the Medicare Current Beneficiary Survey (MCBS) aged >or=65 years residing at least 1 month in a nursing home or assisted living facility in 2001 were considered eligible. Monthly and annual measures of laxative and opioid use were developed to estimate prevalence of drug use in the LTC population. Multivariable logistic regression was used to determine factors associated with the use of laxatives. RESULTS: Among our sample of 867 MCBS beneficiaries (mean [SD]age, 85.0 [7.7] years), 281 (32%) received at least 1 opioid at some time during 2001. Of these 281 patients, 186 (66%) were administered at least 1 laxative at any time of the year. We found that the mean monthly prevalence of concurrent opioid and laxative use was 55% (476/867). There was a low prevalence of as-needed laxative and opioid use; 96% of resident-months were identified as scheduled bowel regimen administrations, and 89% of resident-months with opioid use had >or=3 opioid administrations. The results of the multivariable analysis showed that white, female, and currently married patients spend 227% (P < 0.007), 52% (p < 0.008), and 39% (P < 0.02), respectively, more months with at least 1 administration of a laxative and an opioid than their counterpart nonwhite, male, unmarried patients, Comorbidities were not associated with laxative prophylaxis. CONCLUSION: Although laxatives are widely recommended in patients taking opioids, only 66% of elderly LTC residents in this study received this standard of care.

Validation of a method for identifying nursing home admissions using administrative claims.

BACKGROUND: Currently there is no standard algorithm to identify whether a subject is residing in a nursing home from administrative claims. Our objective was to develop and validate an algorithm that identifies nursing home admissions at the resident-month level using the MarketScan Medicare Supplemental and Coordination of Benefit (COB) database. METHODS: The computer algorithms for identifying nursing home admissions were created by using provider type, place of service, and procedure codes from the 2000 - 2002 MarketScan Medicare COB database. After the algorithms were reviewed and refined, they were compared with a detailed claims review by an expert reviewer. A random sample of 150 subjects from the claims was selected and used for the validity analysis of the algorithms. Contingency table analysis, comparison of mean differences, correlations, and t-test analyses were performed. Percentage agreement, sensitivity, specificity, and Kappa statistics were analyzed. RESULTS: The computer algorithm showed strong agreement with the expert review (99.9%) for identification of the first month of nursing home residence, with high sensitivity (96.7%), specificity (100%) and a Kappa statistic of 0.97. Weighted Pearson correlation coefficient between the algorithm and the expert review was 0.97 (p < 0.0001). CONCLUSION: A reliable algorithm indicating evidence of nursing home admission was developed and validated from administrative claims data. Our algorithm can be a useful tool to identify patient transitions from and to nursing homes, as well as to screen and monitor for factors associated with nursing home admission and nursing home discharge.

Vasculitis inducida por cocaína-levamisol con manifestaciones cutáneas, articulares y abdominales: reporte de caso / Cocaine-levamisole induced vasculitis with cutaneous, joint and abdominal manifestations: case report

Resumen El levamisol es un antiparasitario de uso veterinario que actualmente es empleado para aumentar el volumen y la potencia de la cocaína. La mezcla de estas dos sustancias puede causar un cuadro caracterizado por lesiones propias de la cocaína, como la afección del cartílago septal con perforación del tabique nasal, y vasculitis cutánea de pequeños vasos con afectación de los pabellones auriculares y del cartílago nasal, afección conocida como vasculitis inducida por cocaína-levamisol (VICOL) que puede avanzar a necrosis e incluso ulceraciones cutáneas, asociadas a agranulocitosis, artralgias y glomerulonefritis . En el presente artículo se describe el caso de un paciente con historia de consumo de sustancias en quien se encontraron lesiones purpúricas palpables en miembros superiores, tronco, pabellones auriculares y miembros inferiores. Se consideró una clínica sugestiva de VICOL dado el antecedente de consumo de sustancias. En el proceso diagnóstico se descartaron entidades como la vasculitis por anticuerpos contra el citoplasma de los neutrófilos (ANCAs) y crioglobulinemia, entre otras posibles afecciones. Se llevó a cabo un tratamiento con esteroides y con ello presentó una respuesta adecuada, pero luego recurrieron los síntomas, particularmente abdominales, los cuales se consideraron asociados con vasculitis. Se le brindó manejo adicional con ciclofosfamida y nuevos pulsos de esteroides, con que se logró el control total de los síntomas. A través este caso se resaltan entonces los ejercicios diagnósticos y clínicos en la vasculitis cocaína- levamisol, y se sugiere la consideración de los síntomas abdominales como posible componente del cuadro vasculítico.

Abstract Levamisole is an antiparasitic agent for veterinary use. Currently it is used to increase the volume and potency of cocaine. Levamisole and cocaine combined result in the septum nasal perforation and small-vessel vasculitis in the ears and nasal cartilage. These findings are known as cocaine levamisole-induced vasculitis and can progress to necrosis and even skin ulceration, which is associated with agranulocytosis, arthralgia, and glomerulonephritis. This article describes the case of a patient with a history of substance abuse in whom palpable purpuric lesions were found in the upper and lower limbs, trunk, and ears. A clinical condition suggestive of vasculitis induced by cocaine-levamisole was considered, given the history of substance consumption. In the diagnostic process, entities such as Anti-neutrophil Cytoplasmic Antibodiy (ANCA) vasculitis and cryoglobulinemia, among other possible conditions, were ruled out. Steroid treatment was carried out, to which the patient had an adequate response, but then symptoms recurred, particularly abdominal, which were associated with vasculitis. Additional management with cyclophosphamide and new steroid pulses were provided, and with those symptom control was achieved. In this case report highlights the diagnostic and clinical exercises in cocaine levamisole vasculitis and is suggested the consideration of abdominal symptoms as a possible component of the vasculitis flare.

Superior Efficacy and Safety of a Nonemulsive Variant of the NGcGM3/VSSP Vaccine in Advanced Breast Cancer Patients.

NGcGM3 ganglioside is a tumor-specific antigen expressed in human breast tumors. The NGcGM3/VSSP vaccine, consisting in very small-sized proteoliposomes (VSSP) obtained by the incorporation of NGcGM3 into the outer membrane protein complex of Neisseria meningitidis, has been previously tested in a Phase II trial in patients with metastatic breast cancer (MBC) but emulsified with Montanide ISA 51. An Expanded Access study was carried out in MBC patients aiming to find if a nonemulsive formulation of NGcGM3/VSSP, without Montanide ISA 51, could be more safe and effective. A total of 104 patients were vaccinated with the nonemulsive formulation (900 µg), subcutaneously (SC), or with the emulsive formulation (200 µg), intramuscularly (IM). An intent-to-treat analysis of efficacy was performed with all patients, and 93 patients were split off according to the site of metastases (visceral/nonvisceral). Of note, SC-treated patients exhibited a superior median overall survival (OS) than IM-treated patients (23.6 vs. 8.2 months; log rank P = 0.001). Even though in the subset of patients with nonvisceral metastases SC vaccination duplicated the median OS compared to the alternative option (31.6 vs. 16.5 months), this difference did not reach statistical significance (log rank P = 0.118). Curiously, in patients with visceral metastases, the advantage of the nonemulsive formulation was more apparent (median OS 21.0 vs. 6.2 months; log rank P = 0.005). The vaccine was safe for both formulations.

Prevalencia de dentición funcional en ancianos mexicanos / Prevalence of functional teeth in Mexican elderly

Objetivo: Determinar la prevalencia de dentición funcional (DF) y su distribución a través de diversas variables clínicas, sociodemográficas y socioeconómicas de una muestra de ancianos mexicanos. Material y métodos En un estudio transversal se incluyeron 139 adultos de 60 años y más de 2 asilos y un club de ancianos de la ciudad de Pachuca, Hidalgo, México. La variable dependiente fue la dentición funcional; operacionalmente categorizada como: 0 = sujetos con menos de 21 dientes presentes en la boca y 1 = sujetos con 21 o más dientes en la boca, excluyendo prótesis. Las variables sociodemográficas, socioeconómicas y conductuales se recogieron a través de un cuestionario. Las variables clínicas fueron recabadas por un examinador capacitado y estandarizado. El análisis se realizó utilizando pruebas no paramétricas en Stata. Resultados El promedio de edad fue de 79,06 +/- 9,78. La mayoría de los sujetos incluidos fueron mujeres (69,1 por ciento). La prevalencia de dentición funcional fue de 10,1 por ciento. En el análisis bivariado observamos lo siguiente: los sujetos con DF tuvieron menor edad (p < 0,05); entre las mujeres se observó mayor prevalencia de DF (p < 0,05); las personas con pareja presentaron más alto porcentaje de DF (p < 0,05); la prevalencia de DF fue diferente a través de los tipos de asilamiento (p < 0,05). Conclusiones Los datos sugieren una baja prevalencia de dentición funcional en esta muestra de adultos mayores. Este estudio demuestra que la DF varía en función de variables sociodemográficas.

Objective: To determine the prevalence of functional teeth (FT) and their distribution using clinical, demographic, and socioeconomic variables in a sample of Mexican elderly. Material and methods This cross-sectional study of 139 adults aged 60 years and older was conducted in two nursing homes and one club in Pachuca, Hidalgo, Mexico. The dependent variable was FT, and participants were operationally categorised as 0 (having less than 21 teeth) or 1 (having 21 or more teeth). Those categorised as 1 comprised the FT group. Sociodemographic, socioeconomic, and behavioural variables were collected using a questionnaire. Clinical variables were collected by a trained examiner using a standardised examination. Analysis was performed using non-parametric tests in Stata. Results The mean age was 79.06 +/- 9.78 years. Most (69.1 percent) of the participants were women. The prevalence of FT was 10.1 percent. In the bivariate analysis, it was observed that the FT group was younger (p < .05), women displayed a greater prevalence of FT than men (p < .05), as did those involved in a relationship compared to being single (p < .05), and FT prevalence differed by type of isolation (p < .05). Conclusions The prevalence of FT is low among nursing home residents and club members, and it varies with age, sex, relationship status, and type of isolation.

Pasta with unripe banana flour: physical, texture, and preference study.

Banana is a starchy food that contains a high proportion of undigestible compounds such as resistant starch and nonstarch polysaccharides. Products with low glycemic response such as pasta are considered favorable to health. The objective of this study was to use unripe banana flour to make spaghetti with low-carbohydrates digestibility and evaluate its physical and texture characteristics, as well as consumer preference. Formulations with 100% durum wheat semolina (control) and formulations with 3 semolina: banana flour ratios (85: 15, 70: 30, and 55: 45) were prepared for spaghetti processing. The use of banana flour decreased the lightness and diameter of cooked spaghetti, and increased the water absorption of the product. Hardness and elasticity of spaghetti were not affected by banana flour, but adhesiveness and chewiness increased as the banana flour level in the blend rose. Spaghettis prepared in the laboratory (control and those with banana flour) did not show differences in preference by consumers. In general, the preference of spaghettis with different banana flour level was similar. The addition of a source of undigestible carbohydrates (banana flour) to spaghetti is possible without affecting the consumer preference.

IL-2/neuroantigen fusion proteins as antigen-specific tolerogens in experimental autoimmune encephalomyelitis (EAE): correlation of T cell-mediated antigen presentation and tolerance induction.

The purpose of this study was to assess whether the Ag-targeting activity of cytokine/neuroantigen (NAg) fusion proteins may be associated with mechanisms of tolerance induction. To assess this question, we expressed fusion proteins comprised of a N-terminal cytokine domain and a C-terminal NAg domain. The cytokine domain comprised either rat IL-2 or IL-4, and the NAg domain comprised the dominant encephalitogenic determinant of the guinea pig myelin basic protein. Subcutaneous administration of IL2NAg (IL-2/NAg fusion protein) into Lewis rats either before or after an encephalitogenic challenge resulted in an attenuated course of experimental autoimmune encephalomyelitis. In contrast, parallel treatment of rats with IL4NAg (IL-4/NAg fusion protein) or NAg lacked tolerogenic activity. In the presence of IL-2R(+) MHC class II(+) T cells, IL2NAg fusion proteins were at least 1,000 times more potent as an Ag than NAg alone. The tolerogenic activity of IL2NAg in vivo and the enhanced potency in vitro were both dependent upon covalent linkage of IL-2 and NAg. IL4NAg also exhibited enhanced antigenic potency. IL4NAg was approximately 100-fold more active than NAg alone in the presence of splenic APC. The enhanced potency of IL4NAg also required covalent linkage of cytokine and NAg and was blocked by soluble IL-4 or by a mAb specific for IL-4. Other control cytokine/NAg fusion proteins did not exhibit a similar enhancement of Ag potency compared with NAg alone. Thus, the IL2NAg and IL4NAg fusion proteins targeted NAg for enhanced presentation by particular subsets of APC. The activities of IL2NAg revealed a potential relationship between NAg targeting to activated T cells, T cell-mediated Ag presentation, and tolerance induction.

Chondrocyte cloning in aging and osteoarthritis of the hip cartilage: morphometric analysis in transgenic mice expressing bovine growth hormone.

An arthritic disorder resembling human osteoarthritis occurs in transgenic mice expressing the fusion gene coding for bovine growth hormone (bGH). In these animals, we performed a morphometric evaluation of cellular density, clonal density and the relationship between both parameters in articular cartilage. These parameters were determined in the femoral head of bGH (+) mice at 1, 6 and 12 months of age and compared to values in the control mice. The transgenic mouse showed a reduction in cellular density of the superficial and middle zones of the articular cartilage with age. In the uncalcified cartilage at 6 and 12 months of age, cellular density was significantly lower in age-matched transgenic mice than in the control group. In the former, the changes in cellular density were accompanied by a gradual reduction in the clonal density in the superficial and middle zones. The clonal density/cellular density ratio was similar in transgenic mice and the control group at 12 months of age. These findings indicate that these transgenic mice develop an osteoarthritic process characterized by loss of cellularity and a gradual decline in chondrocyte cloning in the superficial and middle zones.

Efectos adversos asociados al tratamiento con factor de transferencia: ciudad de La Habana, 2004 / Adverse drug effects associated to the treatment of patients with transfer factor. City of Havana, 2004

El factor de transferencia (Hebertrans) constituye un inmunoestimulante que se emplea en una amplia gama de enfermedades. Su seguridad ha sido evaluada en los ensayos clínicos pre-registro, pero no así en investigaciones poscomercialización, por tal motivo se realizó un estudio observacional y multicéntrico de vigilancia activa, en pacientes tratados con factor de transferencia en 11 hospitales de la Ciudad de La Habana , para identificar los eventos presentados durante el tratamiento, así como clasificarlos según su causalidad y gravedad. La información fue recogida por el médico inmunólogo de cada hospital y supervisada por el farmacoepidemiólogo hospitalario. Durante el tratamiento se obtuvo información de 387 pacientes y se reportaron 133 eventos en 86 casos (22,2 por ciento). Los más frecuentes fueron fiebre, dolor y eritema en el sitio de la inyección, cefalea y diarrea; el 92,5 por ciento de los eventos observados fueron leves. El 27,8 por ciento se clasificó como definitivamente provocados por el fármaco, estos últimos relacionados con la vía de administración. El factor de transferencia resultó un medicamento seguro en los pacientes observados

Efectos adversos asociados al tratamiento con factor de transferencia: ciudad de La Habana, 2004 / Adverse drug effects associated to the treatment of patients with transfer factor. City of Havana, 2004

El factor de transferencia (Hebertrans) constituye un inmunoestimulante que se emplea en una amplia gama de enfermedades. Su seguridad ha sido evaluada en los ensayos clínicos pre-registro, pero no así en investigaciones poscomercialización, por tal motivo se realizó un estudio observacional y multicéntrico de vigilancia activa, en pacientes tratados con factor de transferencia en 11 hospitales de la Ciudad de La Habana , para identificar los eventos presentados durante el tratamiento, así como clasificarlos según su causalidad y gravedad. La información fue recogida por el médico inmunólogo de cada hospital y supervisada por el farmacoepidemiólogo hospitalario. Durante el tratamiento se obtuvo información de 387 pacientes y se reportaron 133 eventos en 86 casos (22,2 por ciento). Los más frecuentes fueron fiebre, dolor y eritema en el sitio de la inyección, cefalea y diarrea; el 92,5 por ciento de los eventos observados fueron leves. El 27,8 por ciento se clasificó como definitivamente provocados por el fármaco, estos últimos relacionados con la vía de administración. El factor de transferencia resultó un medicamento seguro en los pacientes observados(AU)

Depresión en el adulto mayor con enfermedad crónica / Depression in elderly patient with chronic disease

Introducción: la depresión es uno de los trastornos frecuentes en el adulto mayor. Objetivo: identificar las características de la misma en pacientes senescentes con enfermedad crónica. Material y métodos: encuesta poblacional, transversal, con aplicación de escala que identificó grados de depresión en derecho habientes del Instituto Mexicano del Seguro Social ­mayores de 65 años y con enfermedad crónica­. Variables: sexo, estado civil, dependencia física y económica, composición familiar, escolaridad y ocupación. Se contrastaron las diferencias con pruebas no paramétricas. Resultados: se estudiaron 123 pacientes (51 hombres y 72 mujeres) 20.5% no tuvo depresión, 32.5% depresión leve, 44.5% depresión media y 2.5% depresión severa. Al contrastar los deprimidos con los no deprimidos, no se encontraron diferencias significativas en cuanto a sexo, estado civil, dependencia económica, escolaridad, ocupación y patología de fondo. Se observó significancia estadística en cuanto a la dependencia física, con énfasis en el grupo que cursó con depresión media y leve (p<0.001). Discusión: la única característica que parece tener relación con la depresión es la dependencia física. No se logró demostrar la presencia de otros factores estudiados.

Introduction: the depression, in the older patient is a frequent disease, it is more frequent in female with loss of the personal autonomy and economic dependence. Objective: Identify the characteristics and type of depression in the older patient, with chronic illness. Material and methods: survey poblacional, transversal, applying scale to identify degrees of depression, in patient affiliated to the Social Security, with 65 years or more both sexs and with chronic illness. Sex, civil state, economic and physical dependence, family composition, school degree, and occupation were studied; 51 male (41.5%) and 72 female (58.5%), according to the scale utilized in the patients didn't have depression; 40 (32.5%) of the patients had light, 55 (44.5%) moderate depression and 3 (2.5%) severe depression. Upon resisting patients depressed with the not depressed, no significant difference were founds for sex, civil state, economic dependence, school degree, occupation and pathology. It was found statistical significance in the physical dependence, with emphasis at moderate depression and light depression (p<0.001). Discussion: the only factor that could have relation with the depression is the physical dependence, it was not achieved to show that the other factors be presents.