Relationship between hypertension, diabetes and proteinuria in rural and urban households in Yemen.

Little information is available on the meanings of proteinuria in low-resource settings. A population-based, cross-sectional survey was performed in Yemen on 10 242 subjects aged 15-69 years, stratified by age, gender and urban/rural residency. Hypertension is defined as systolic blood pressure (BP) of 140 mm Hg and/or diastolic BP of 90 mm Hg, and/or self-reported use of antihypertensive drugs; diabetes is diagnosed as fasting glucose of 126 mg dl(-1) or self-reported use of hypoglycaemic medications; proteinuria is defined as +1 at dipstick urinalysis. Odds ratios (ORs) for associations were determined by multivariable logistic regression models. Prevalence (weighted to the Yemen population aged 15-69 years) of hypertension, diabetes and proteinuria were 7.5, 3.7 and 5.1% in urban, and 7.8, 2.6 and 7.3% in rural locations, respectively. Proteinuria and hypertension were more prevalent among rural dwellers (adjusted ORs 1.56; 95% confidence limit (Cl) 1.31-1.86, and 1.23; 1.08-1.41, respectively), diabetes being less prevalent in rural areas (0.70; 0.58-0.85). Differently from hypertension and diabetes, proteinuria was inversely related with age. Most importantly, 4.6 and 6.1% of urban and rural dwellers, respectively, had proteinuria in the absence of hypertension and diabetes. The approach of considering kidney damage as a consequence of hypertension and diabetes might limit the effectiveness of prevention strategies in low-income countries.

The impact of fine-tuning of optical recognition system on database reliability.

Although optical reading systems are important tools to transfer data from a paper form to electronic databases, the impact of system fine-tuning on the final error rate is not usually considered. At the end of a multi-step process involving paper form design training of operators, and fine-tuning procedure, the final rate of error can be reduced from 0.65% to 0.05%. Fine-tuning should be introduced as a standard procedure while using optical reading systems.

[Social adaptation of patients with recurrent depressive episodes]. / Adattamento sociale in pazienti con episodi depressivi ricorrenti.

A catamnestic study has been carried out in 45 patients with "major affective disturbance" precedents so as to ascertain the possible presence of a "residual syndrome" or a personality "at risk" for depressive disease emerging during so-called interval periods. Special attention is paid to examination of social adaptation in these periods. The instruments employed for the investigation, apart from the clinical conversation and documentation relating to prior admissions were: APDI (record of personal data in the case of adults), the Hamilton Scale, the B.P.R.S. (Brief Psychiatric Rating Scale), the S.A.S. (Scale of Social Adaptation) and Rorschach's Psychodiagnosis. The results obtained evidence a series of more or less marked, but always present psychic disturbances characterising the interval period, with problems of adaptation both to working activity and to social relations, especially in the extra-familial environment. These disturbances are attributable in part to a personality at risk and in part to an authentic residual syndrome.

[Major depression and "deterioration" of intellectual function]. / Depressione maggiore e "deterioramento" delle funzioni intellettive.

Forty five subjects with major depression or bipolar disorder were studied during the symptom-free period using the Wechsler and Rorschach tests. The tests revealed a reduced capacity to utilise data obtained by analysis and to integrate them by the organisation of complex thought processes as well as frequent loss of contact with reality. This finding seems to demonstrate that the apparently symptom-free periods of depression often display alterations in the capacity for thought.