Validación de la Escala de Prácticas Espirituales con víctimas de violencia política en Chile / Validation of the Spiritual Practices Scale with victims of political violence in Chile

Resumen En este artículo se presenta la validación de una versión abreviada de la Escala de Prácticas Espirituales de Parsian y Dunning (2009). Para ello, se utilizó una muestra de personas adultas (n = 251, M = 60.85, DT = 13.40) víctimas de violencia política en Chile durante la dictadura cívico militar (1973-1990). Para valorar la estructura de la escala se realizó un Análisis Factorial Confirmatorio (AFC), se calculó el índice de fiabilidad (α = .85) y se valoró la validez convergente con una serie de correlaciones bivariadas entre variables. De acuerdo a lo esperado, el AFC informa un adecuado ajuste a la estructura unifactorial y los resultados dan cuenta de la relación significativa entre las prácticas espirituales y el crecimiento postraumático y entre las prácticas espirituales y la religiosidad. La relación entre estas dos últimas es media-baja (r = .29), lo cual permite concluir que, aunque relacionadas, son constructos diferentes. A partir del análisis de los datos, no se puede concluir que exista relación entre las prácticas espirituales con la edad y el nivel de ingresos. En conclusión, la versión abreviada de la Escala de Prácticas Espirituales presenta adecuados niveles de fiabilidad y validez, por lo que resulta recomendable para ser utilizada en la medición de prácticas espirituales, especialmente en aquellas poblaciones que no se adscriben a una fe teísta.

Abstract Spirituality, or what motivates the search for the sacred from particular and free positions, allows us to provide a framework from which to interpret the experience of loss and suffering, contributing in different ways to the resignification and re-authorship of people after the trauma. It is related to resilience, with that ability to overcome adverse events. It favors the mitigation of the negative effects of the traumatic event and fosters healthy and successful psychological development -despite the suffering caused by an external situation- by promoting the construction and redefinition of people's life purpose -one of the central components of human well-being-, being especially relevant in those who have been victims of trauma. Thus, spirituality can contribute to the reconfiguration of the narrative about the survived experience from practices that promote spiritual emotion such as the actions of meditating or praying, the latter considered as one of the mechanisms of self-revelation that is fundamental within the post traumatic growth process. Spirituality and religion maintain a complex interrelation that at times makes difficult the distinction between them. However, this distinction is especially sensitive and necessary when it comes to accounting for spirituality in people who do not profess a theistic faith. This is the case of a significant part of people with left-wing ideologies -who suffered some type of violence during the military dictatorships implanted from the second half of the 20th century in Latin America. Particularly in Chile, the civic-military dictatorship (1973-1990) was especially cruel with people of left-wing ideologies, many of them not ascribed to a belief of a theistic order. In this context, it is relevant to account for spiritual practices -differentiating them from religious beliefs- in relation to post-traumatic growth in people victims of political violence. For this objective we have proposed in this article the validation of the short version of the Parsian and Dunning (2009) Spiritual Practice Scale. For this purpose, we utilized a sample of adult people victims of political violence in Chile during the military dictatorship between 1973 and 1990 (n = 251, M = 60.85, DT = 13.40). To assess the structure of the scale, we estimated a confirmatory factor analysis (CFA). The reliability index was calculated (α = .85) and the convergent validity was assessed with a series of bivariate correlations between variables. As expected, the CFA reports an adequate adjustment to the unifactorial structure and the results show the significant relationship between spiritual practices and post-traumatic growth (r = .45), and between spiritual practices with religiosity (r = .29). Being the relationship between spiritual practices and religiosity medium-low, it allows us to conclude that although they are related, they are different constructs. From the analysis of the data, it cannot be concluded that there is a relationship between spiritual practices with age and income level. In conclusion, the short version of the Spiritual Practices Scale presents adequate levels of reliability and validity, so it is recommended to be used in the measurement of spiritual practices, especially in those populations that do not adhere to a theistic faith.

Indicadores de salud y bienestar social en población inmigrante y chilena: un estudio comparativo / Health and social well-being in immigrants and Chileans: a comparative study

Resumen En el presente estudio se comparan los niveles medios de salud y bienestar social de adultos nacidos en Chile (n = 155) e inmigrantes de nacionalidad colombiana (n = 166), peruana (n = 154) y venezolana (n = 180). Los resultados están en línea con la "hipótesis selectiva de la inmigración", pues se encontraron mayores niveles de salud (M inmigrantes = 40.35; Mchilenos = 38.93; t[203.579] = 2.745,p < .01) y bienestar social en inmigrantes (M = 88.62) que en chilenos (M = 85.42; t(190.778) = -3.197, p < .01). En general, en este trabajo se muestra el efecto negativo que tiene la percepción de discriminación sobre la salud, y el efecto positivo de las variables socioculturales de identidad endogrupal, enriquecimiento cultural y cercanía intergrupal sobre el bienestar social en personas inmigrantes.

Abstract This study compares the average health and social welfare levels of adults born in Chile (n = 155) and immigrants of Colombian (n = 166), Peruvian (n = 154), and Venezuelan (n = 180) nationality. The results are in line with the "selective hypothesis of immigration," since higher levels of health (Minmigrants = 40.35; Mchilenos = 38.93; t [203,579] = 2,745, p < .01) and social welfare were found in immigrants (M = 88.62) than in Chileans (M = 85.42; t (190,778) = -3,197, p < .01). In general, this work shows the negative effect that the perception of discrimination has on health, and the positive effect of the socio-cultural variables of endo-group identity, cultural enrichment, and inter-group closeness on the social welfare of immigrants.

Salud mental en población transgénero y género no conforme en Chile

Background: Transgender population is at a higher risk of suffering mental health problems than cisgender population (people whose sex and gender identity are in agreement) and other sexual minorities (gays, lesbians, and bisexuals), partly due to the greater stress that they suffer or for being victims of sexual prejudice. Aim: To describe positive and negative mental health indicators in a sample of transgender people living in Chile. Material and Methods: An intentional sample of 377 transgender individuals older than 18 years, living in the country's northern, center and southern zones were studied. Sociodemographic and well-being features, negative emotional symptoms, suicidal behavior, and substance consumption were assessed. Results: A precarious mental health was confirmed among participants. A high frequency of depression, ideation and suicide attempts, and high levels of depression, anxiety, and stress symptoms were identified. Also, a high frequency of substance abuse was found. These mental health indicators varied according to the sex assigned at birth and gender self-identification. Conclusions: Transgender people experience precariousness and vulnerability in their mental health.

Efectos de un programa recreativo-pedagógico en las capacidades coordinativas en escolares / Effects of a recreational-pedagogical program on coordinating capacities in school children

RESUMEN Los bajos niveles de coordinación diagnosticados en los niños pueden afectar su desarrollo motriz posterior y su rendimiento académico, por lo tanto, se justifica formular y evaluar programas de intervención, que mejoren sus capacidades coordinativas. El objetivo de este estudio fue determinar el efecto de un programa recreativo pedagógico sobre las capacidades coordinativas, de 64 estudiantes, tanto de género masculino como femenino, con edades entre los 6 y 7 años, en una Institución educativa colombiana. En la investigación efectuada, se utilizó una metodología de corte cuantitativo, con un diseño cuasi experimental-descriptivo; la información, se recolectó mediante el test de Capón, usado antes y después de aplicar el programa recreativo-pedagógico diseñado. El procesamiento de los datos, se efectuó con el software libre R. Los resultados permitieron establecer que, en promedio, las diferencias entre las puntuaciones acumuladas entre el pre-test y el pos-test en el grupo experimental, sí son significativas y atribuibles al mencionado programa. En conclusión, tal programa sí produce efectos positivos en las capacidades coordinativas de los participantes en el estudio.

ABSTRACT The low levels of coordination diagnosed in children can affect their subsequent motor development and their academic performance; therefore, it is justified to formulate and evaluate intervention programs that improve their coordinative capacities. The objective of this study was to determine the effect of a pedagogical recreational program on the coordinative abilities of 64 male and female students aged between 6 and 7 years in a Colombian educational institution. In the research carried out, a quantitative cut-off methodology with a quasi-experimental-descriptive design was used; the information was collected by means of the Capón test, used before and after applying the designed recreational-pedagogical program. The processing of the data was done with free software R. The results allowed to establish that, on average, the differences between the scores accumulated between the pre-test and the post-test in the experimental group are significant and attributable to the aforementioned program. In conclusion, such a program does have positive effects on the coordinative abilities of the study participants.

Medidas de salud mental y bienestar subjetivo en una muestra de hombres gays y mujeres lesbianas en Chile / Health and wellbeing of sexual minorities

Background: Most of the information in Chile about health and wellbeing of sexual minorities refers to risk behaviors. Aim: To assess health and wellbeing in a sample of Chilean homosexual men and women. Material and Methods: Spanish versions of the Satisfaction With Life Scale and Outcome Questionnaire-45 (OQ-45) were answered by 191 homosexual women and 256 homosexual men aged 18 to 67 years, from four Chilean cities. Results: Lesbian women have better levels of satisfaction with life and adjustment in personal relationships than homosexual men. Eight percent of respondents had suicidal thoughts in some moment of their life. Conclusions: The information gathered in this work could help in the development of mental health policies for sexual minorities.

Relation between HIV status, risky sexual behavior, and mental health in an MSM sample from three Chilean cities / Relación entre el estado de seropositividad al VIH, el comportamiento sexual arriesgado y la salud mental en una muestra de HSH de tres ciudades chilenas

ABSTRACT Objective To explore the association among HIV status; negative psychological symptoms (anxiety, depression, and hostility); and risky sexual behaviors (multiple sexual partners and unprotected sexual intercourse) in a Chilean sample of men who have sex with men (MSM). Methods This study had a cross-sectional design and a sample of 325 MSM whose ages ranged from 18 to 64 years (mean: 30.8; standard deviation: 9.8). Association tests (chi-squared) and group mean comparisons (Student’s t-tests and F-tests) were performed. Results No statistically significant differences were found for condom use or for the number of sexual partners between HIV-positive men and those who are not infected. In both groups, about 50% reported sexual encounters without condom use in the past six months. There were statistically significant differences in symptoms associated with depression between the two groups. Conclusions These results reveal the need to strengthen messages about the importance of condom use, as the only way to prevent HIV, and as a means of preventing HIV infection and reinfection, in national prevention and self-care programs for sexually active subjects. More studies are needed in Latin America to advance HIV prevention efforts for the MSM population. The data generated by this study can be used to inform the development of HIV prevention programming strategies and interventions targeting the MSM population in Latin America.

RESUMEN Objetivo Explorar la relación entre el estado con respecto a la infección por el VIH, los síntomas psicológicos negativos (ansiedad, depresión y hostilidad) y el comportamiento sexual arriesgado (varios compañeros sexuales y relaciones sexuales sin protección) en una muestra de hombres que tienen relaciones sexuales con otros hombres (HSH) de Chile. Métodos Este estudio tuvo un diseño transversal y una muestra de 325 HSH de 18 a 64 años (media: 30,8; desviación estándar: 9,8). Se efectuaron pruebas de asociación (ji al cuadrado) y comparaciones entre las medias grupales (prueba de la t de Student y prueba F). Resultados No se observaron diferencias estadísticamente significativas respecto del uso de preservativos o del número de compañeros sexuales entre los hombres seropositivos al VIH y los no infectados. En los dos grupos, más del 50 % refirió que había tenido algún encuentro sexual sin protección en los seis meses anteriores. Se observaron diferencias estadísticamente significativas entre los dos grupos en cuanto a los síntomas asociados a la depresión. Conclusiones Estos resultados muestran la necesidad de fortalecer los mensajes acerca de la importancia del uso de preservativos como la única manera de prevenir el VIH y como un medio de prevenir la infección y la reinfección por este virus, en los programas nacionales de prevención y autocuidado destinados a las personas sexualmente activas. Es necesario efectuar más estudios en América Latina para impulsar las medidas de prevención de la infección por el VIH orientadas a la población de HSH. Los datos generados por este estudio pueden servir para formular estrategias programáticas de prevención e intervenciones dirigidas a esta población en América Latina.

Next generation sequencing for molecular confirmation of hereditary sudden cardiac death syndromes / Confirmación diagnóstica molecular mediante secuenciación masiva de nueva generación ("next generation sequencing") en síndromes hereditarios de muerte súbita cardíaca

Hereditary sudden cardiac death syndromes comprise a wide range of diseases resulting from alteration in cardiac ion channels. Genes involved in these syndromes represent diverse mutations that cause the altered encoding of the diverse proteins constituting these channels, thus affecting directly the currents of the corresponding ions. In the present article we will briefly review how to arrive to a clinical diagnosis and we will present the results of molecular genetic studies made in Mexican subjects attending the SCD Syndromes Clinic of the National Institute of Cardiology of Mexico City.

Los síndromes hereditarios de muerte súbita cardíaca comprenden una amplia gama de enfermedades resultantes de la alteración en los canales iónicos cardíacos. Los genes implicados en estos síndromes presentan mutaciones que causan alteraciones de las diversas proteínas que constituyen estos canales y que, por lo tanto, afectan directamente a las diferentes corrientes iónicas. En el presente artículo se revisa brevemente la forma de llegar a un diagnóstico clínico de dichos síndromes y se presentan los resultados de los estudios genéticos moleculares realizados en sujetos mexicanos que asisten a la Clínica de Síndromes Hereditarios de Muerte Súbita del Instituto Nacional de Cardiología Ignacio Chávez.

Síndrome de Andersen-Tawil: una revisión del diagnóstico genético y clínico con énfasis en sus manifestaciones cardíacas / Andersen-Tawil syndrome: A review of its clinical and genetic diagnosis with emphasis on cardiac manifestations

El síndrome de Andersen-Tawil resulta de la alteración de canales de potasio, se hereda de forma autosómica dominante y se cataloga como el tipo 7 de los síndromes de QT largo congénitos. El gen afectado es el KCNJ2, el cual codifica la proteína Kir2.1 que forma el canal de potasio rectificador interno («inward rectifier¼). Este canal interviene en la estabilización del potencial de membrana en reposo y controla la duración del potencial de acción en el sistema musculoesquelético y cardíaco. En miocitos ventriculares, es un componente responsable de la rectificación de la corriente de potasio en la fase 3 del potencial de acción. Debido a que Kir2.1 está presente en el sistema musculoesquelético, corazón y cerebro, las alteraciones de esta proteína dan origen a las principales características del síndrome: parálisis flácida, arritmias ventriculares y alteraciones leves a moderadas en el desarrollo del esqueleto, especialmente en manos y pies. En la presente revisión se aborda esta enfermedad desde el punto de vista del diagnóstico clínico y molecular con énfasis en sus manifestaciones cardíacas.

The Andersen-Tawil syndrome is a cardiac ion channel disease that is inherited in an autosomal dominant way and is classified as type 7 of the congenital long QT syndromes. Affected gene is KCNJ2, which forms the inward rectifier potassium channel designated Kir2.1. This protein is involved in stabilizing the resting membrane potential and controls the duration of the action potential in skeletal muscle and heart. It also participates in the terminal repolarization phase of the action potential in ventricular myocytes and is a major component responsible for the correction in the potassium current during phase 3 of the action potential repolarization. Kir 2.1 channel has a predominant role in skeletal muscle, heart and brain. Alterations in this channel produce flaccid paralysis, arrhythmias, impaired skeletal development primarily in extremities and facial area. In this review we address the disease from the point of view of clinical and molecular diagnosis with emphasis on cardiac manifestations.

La Psicología Política como momento de la Psicología Social en Chile: desplazamientos conceptuales y temáticos / A Psicologia Política como momento da Psicologia Social no Chile: deslocamentos conceituais e temáticos / Political Psychology as a moment of Social Psychology in Chile: conceptual and thematic shifts

El artículo propone entender a la psicología política como un momento de la psicología social, que se articula de manera diferente con las dimensiones de "la política y lo político" a partir de los cambios históricos de la sociedad y teóricos de la disciplina. Esta perspectiva permite observar cómo buena parte de la investigación psicosocial no ha sido incluida en las definiciones tradicionales de psicología política aun cuando pueda ser referida a fenómenos políticos o sociales. En base a este enfoque, se ofrece una panorámica de los tópicos de investigación psicosocial desarrollados actualmente en Chile y una identificación de los desplazamientos temáticos que se producen al interior de cada uno de los núcleos temáticos expuestos...

O artigo propõe entender a psicologia política como um momento da psicologia social, que se articula de maneira diferente com as dimensões da "política e o político" a partir das mudanças históricas da sociedade e dos teóricos da disciplina. Esta perspectiva permite observar como boa parte da pesquisa psicossocial não tem sido incluída nas definições tradicionais da psicologia política, mesmo quando se refere a fenômenos políticos ou sociais. Com base neste enfoque, os autores oferecem um panorama dos tópicos da pesquisa psicossocial desenvolvidos atualmente no Chile, bem como uma identificação dos deslocamentos temáticos produzidos no interior de cada um dos núcleos temáticos expostos...

This article seeks to understand political psychology as a moment of social psychology which is articulated differently along the dimensions of "policy and politics" and the historical changes of society and theoretical changes in the discipline. This perspective allows us to observe to what extent psychosocial research has not been included in the traditional definition of political psychology, even though it may be referred to political or social phenomena. Based on this approach the article provides an overview of currently psychosocial research topics in Chile as well as the identification of thematic shifts occurred within each reviewed thematic core...

Some socioeconomic characteristics of acute myocardial infarction patients in the Instituto Nacional de Cardiología Ignacio Chávez. Comparison of two decades: 1954-1964 and 1997-2007 / Algunas características socioeconómicas de pacientes con infarto agudo del miocardio del Instituto Nacional de Cardiología Ignacio Chávez. Comparación de dos decenios: 1954-1964 y 1997-2007

Objective: The purpose of this study was to compare some social and economic conditions of patients with myocardial infarction (AMI), admitted to the Instituto Nacional de Cardiologia Ignacio Chavez (INC-ICh), in two decades: 1954-1964 vs. 1997-2007. Study design: an observational and retrospective study was carried out. Method: All discharged patients between 1997-2007 with AMI diagnosis according to International Statistical Classification of Disease 10th Revision codes I 21 - I 21.9 were included. Information about age, sex, marital status, socioeconomic level, occupation and current address were obtained from the patient's file. The findings were compared with a previous published paper from 1954-64. Results: The number of AMI cases increased five times between both decades, and significant changes were observed in occupational activity and in the socioeconomic level. Conclusions: Some social and economic factors have changed over the years; however, age and gender of patients with AMI are variables that did not showed significant changes: most young patients are male, and women are older when they have a fist AMI.

Objetivo: Comparar algunas características socioeconómicas de los pacientes con infarto agudo del miocardio (IAM), atendidos en el Instituto Nacional de Cardiología Ignacio Chávez, en dos decenios: 1954-1964 vs. 1997-2007. Métodos: Se incluyó a todos los pacientes egresados entre 1997 y 2007 con diagnóstico de IAM de acuerdo a la Clasificación Estadística Internacional de Enfermedades y Problemas Relacionados con la Salud, 10ª Revisión códigos I 21 a I 21.9. La información sobre edad, sexo, estado civil, clasificación socioeconómica, ocupación y domicilio actual se obtuvo de los expediente de los pacientes. Esta información se comparó con un estudio publicado que se llevó a cabo entre 1954 y 1964. Resultados: El número de pacientes con diagnóstico de IAM aumentó cinco veces entre dos decenios, se identificaron cambios significativos con respecto a la ocupación y clasificación socioeconómica. Conclusiones: Algunos factores sociales y económicos han cambiado, sin embargo, la edad y sexo de los pacientes con IAM son variables que no muestran cambios significativos: la mayoría de los pacientes jóvenes eran hombres.

Adaptación y Validación de la Escala de Orientación a la Dominancia social (SDO) en una Muestra Chilena / Adaptation and validation of the orientation scale to social dominance in a sample from Chile

Presentamos una adaptación de la escala de Dominancia Social de la que se estudian sus propiedades psicométricas en una muestra chilena. Adicionalmente, se relaciona con otras medidas y variables psicosociales relevantes (autoritarismo, nacionalismo, patriotismo, etc.), toda vez que se busca dar cuenta del fenómeno de invarianza de género y establecer si la escala se comporta siguiendo un patrón unifactorial o multifactorial . La muestra quedó conformada por 304 participantes y los resultados indican que se trataría de un instrumento fiable y válido para detectar la variable dominancia, en nuestro entorno social. Los resultados muestran mayor compatibilidad con la estructura de dos factores que con la original de carácter unifactorial y la se ratifica la hipótesis de invarianza de género.

We present an adaptation of Social Dominance Scale in order to study its psychometric properties in a Chilean sample, and to relate it to other relevant measures and psychosocial variables (authoritarianism, nationalism, patriotism, etc.). Its goal is to explain the phenomenon of gender invariance and to see if the scale behaves according to a standard univariate or multivariate structure . The sample was made up of 304 participants and theresults indicate that it would be a valid and reliable instrument for detecting the dominance in our social environment. The results show greater compatibility with the structure of two factors than with the original univariate model, and confirm the assumption of gender invariance.

Utilidad de las derivaciones paraesternales altas en el diagnóstico del Síndrome de Brugada / Utility of high parasternal electrocardiographic leads in the diagnosis of Brugada Syndrome

The use of high right precordial (HPL) leads to "unmask" Brugada syndrome (BrS) has been described by some groups. We report a family with three cases of BrS. In two, HPL were obtained by placing V1 to V3 electrodes on the first, second, and third right parasternal spaces, and V4 to V6 on the first, second, and third left parasternal spaces. A control group of 45 subjects without BrS was also studied. Compared with standard V1 and V2 leads, the abnormal repolarization pattern of the BrS was accentuated only in the BrS cases using HPL. In none of the control subjects alterations of the J point or ST segment were observed in HPL. These observations exemplify the relevance of HPL for the diagnosis of the BrS.

Avances recientes en la fisiopatología de la fibrilación auricular / Recent advances in the pathophysicology of atrial fibrillation

This review is a summary of the pathophysiology of atrial fibrillation (AF) and the progress in the understanding of this arrhythmia. The following factors should be considered in the genesis and maintenance of AF. The genetic factor is involved in cases of familial AF. Predisposing structural factors: atrial dilation, structural feature that allows the development of AF. Predisposing structural factors: the role of the Bachmann's bundle and frequency gradients between the left and right atrium. Electrophysiological factors: heterogeneous refractory periods favor the fibrillatory conduction. Triggers: abnormal electrical activity (ectopic foci). Modulating factors: autonomic nervous system. Increased vagal tone shortens atrial refractory periods, creating a greater dispersion of the refractory periods and the generation of reentries in the context of triggered activity. Finally, there are three types of atrial remodeling secondary to AF: structural, contractile, electrical. They are interrelated and contribute to maintaining the AF ("AF begets AF").

Prevalencia de síncope en una muestra de mujeres mexicanas residentes de la ciudad de México / Prevalence of syncope in a sample of Mexican women residents in Mexico City

OBJECTIVE: To identify the frequency of syncope in a sample of women regular residents of Mexico City. METHODS: Two hundred and twenty one women between 18 and 88 years old with voluntary participation were included in the study. Trained interviewers through a structured questionnaire obtained syncope information. Prevalence of syncope was obtained, and it's relation with: age, time since the last syncope and frequency of syncope in their live span was registered. RESULTS: Thirty eight percent informed they had suffered syncope, of them 50% had only one syncopal episode during their lives. The others had two or more episodes. Most women had their last syncope between 19 and 50 years of age. CONCLUSIONS: The frequency of syncope was a little higher than previous studies. This is a first approximation, which must be corroborated with larger studies with well population variability representation.

Mecanismo da síncope em nadadoras de elite / Mechanisms of syncope in female elite swimmers

Os atletas podem ter baixa tolerância ao ortostatismo. O mecanismo envolvido ainda não é bem conhecido. Nossa hipótese se baseia em que as mulheres nadadoras de alta performance desmaiam facilmente durante o teste de inclinação, tilt test (TT), provavelmente devido a um pobre controle barorreflexo. A frequencia cardíaca e as variabilidades da pressão arterial diastólica, a sensibilidade barorreflexa, a hemdinâmica cardíaca e a velocidade do fluxo cerebral foram analisadas durante o TT em um grupo de 8 mulheres...

Comparación de metoprolol versus clonazepam como tratamiento de primera intención en pacientes con síncope neurocardiogénico / Comparison of metoprolol vs clonazepam as a first treatment choice among patients with neurocardiogenic syncope

Objetivo: Comparar la eficacia de metoprolol versus clonazepam como tratamiento de primera intención en pacientes con síncope neurocardiogénico. Material y métodos: Se llevó a cabo estudio prospectivo, longitudinal y aleatorizado en el que se evaluó el efecto del metoprolol (50 mg dos veces al día) versus clonazepam (0.5 mg una vez al día) sobre la sintomatología asociada a los tres meses y la recurrencia de síncope a 12 meses. La distribución de los datos fue normal, el análisis estadístico se realizó por métodos paramétricos considerándose significancia estadística una p≤0.05. Resultados: De 54 pacientes, 32 fueron tratados con metoprolol y 22 con clonazepam. No hubo diferencias en las características basales entre ambos grupos. El número de síntomas por paciente se redujo en el grupo de metoprolol de 5.2±2.5 a 1.9±2.1 (p<0.001), y en el grupo de clonazepam de 5.5±2.5 a 1.5±2.2 (p<0.001). La recurrencia de síncope a los 12 meses fue de 10% en el primer grupo y de 5% en el grupo de clonazepam, sin diferencia estadísticamente significativa. Conclusiones: El tratamiento con metoprolol o clonazepam disminuye en forma significativa los síntomas de distonía neurovegetativa asociados y la recurrencia de síncope es similar con ambos tratamientos.

OBJECTIVE: We compared the effects of a metoprolol and clonazepam in patients with neurocardiogenic syncope. METHODS: We compared the effects of a metoprolol and clonazepam in a prospective, randomised trial in 54 patients. Patients were randomly assigned to metoprolol (starting dose 50 mg bid) or clonazepam (starting dose 0.5 mg qd). We assessed a primary combined endpoint of syncope and pre-syncope on a follow-up of 12 months. RESULTS: The primary combined endpoint of syncope and presyncope occurred in the metoprolol group in 3, 4, and 10% of patients at 3, 6, and 12 months respectively. In the clonazepam group it was no recurrence in the first 6 months, and 5% recurrence at 12 months follow-up (nonsignificant differences between groups). Clinical symptoms commonly associated with neurally mediated syncope were decreased similarly in both treatment groups, in the metoprolol group from 5.2+/-2.5 to 1.9+/-2.1 (p < 0.001) and in the clonazepam group from 5.5+/-2.5 to 1.5+/-2.2 (p<0.001). CONCLUSIONS: Pharmacological treatment of neurocardiogenic syncope with metoprolol or clonazepam resulted in similar prevention of syncope and presyncope. Both treatments decreased clinical symptoms but complete symptomatic resolution was rarely observed.

Estudio genético del síncope vasovagal asociado al polimorfismo Arg389Gly del receptor adrenérgico beta1 / Genetic study of the vasovagal syncope associated to the Arg389Gly polymorphism of the beta1 adrenergic receptor

The purpose of this study was to evaluate the correlation between the vasovagal syncope (VVS) and the beta1 adrenergic receptor polymorphism at the 389 position. Seventy individuals with VVS were selected. DNA was extracted from peripheral blood by salting out and subjected to the amplification-restriction test. Genotype identification was made by polyacrylamide gel electrophoresis. A higher frequency in genotype and allele frequencies were found in individuals with positive tilted table test respect individuals with negative test, as well as a marked preference of the GlyGly phenotype in women. Genotype Arg389Gly was the most frequent between individuals with positive response in passive phase with respect to those in the induced phase. When the genotype was analyzed based on the hemodynamic response (VASIS) a gradient is observed in the frequency of Arg389Gly with the highest major frequency in the cardio-inhibitory response followed by the mixed response, and finally the vasodepressor response. These results suggest that the SVV has a genetic component associated with the Arg389Gly polymorphism of the adrenergic receptor. The Gly allele has a high risk association and it is maintained in the population through heterozygosis.