Prevalencia de depresión posparto y factores asociados en usuarias de un hospital público de Acapulco, Guerrero, México / Prevalence of postpartum depression and its associated factors in users of a public hospital at Acapulco, Guerrero, Mexico

Resumen OBJETIVO: Estimar la prevalencia de depresión posparto y los factores asociados en usuarias del Hospital General Progreso, Acapulco, Guerrero, México. MATERIALES Y MÉTODOS: Estudio prospectivo, observacional y transversal de serie de casos. El instrumento para medir la depresión fue un cuestionario que incluyó la Escala de Depresión Posnatal de Edimburgo (EPDS por sus siglas en inglés). Además, a las pacientes se les preguntaron sus datos sociodemográficos, antecedentes de control prenatal, historial obstétrico, atención del parto y otros datos relacionados con su pareja. Mediante análisis bivariado y multivariado se estimaron los factores asociados con la depresión posparto. RESULTADOS: Se analizaron 485 pacientes con media de edad de 24.6 años y límites de 14 y 43 años. La prevalencia de depresión posparto fue de 16%. En el modelo final del análisis multivariado los factores asociados con la depresión posparto fueron: complicaciones en el parto (IC95%:1.61-6.54), antecedente de alcoholismo antes del embarazo (IC95%:1.17- 3.30) y recibir apoyo emocional del esposo durante el embarazo (IC95%: 0.17-0.68). CONCLUSIONES: El antecedente de consumo de bebidas alcohólicas, previo al embarazo, y tener alguna complicación del parto, fueron indicios de posible aparición de depresión posparto. Quienes la padecieron tuvieron la referencia temprana a los servicios de Psicología. La pareja debe estar informada que su apoyo emocional ayuda a reducir el riesgo de depresión posparto en la paciente.

Abstract OBJECTIVE: To estimate the prevalence of postpartum depression and associated factors in users of the Hospital General Progreso, Acapulco, Guerrero, Mexico. MATERIALS AND METHODS: Prospective, observational, cross-sectional case series study. The instrument to measure depression was a questionnaire that included the Edinburgh Postnatal Depression Scale (EPDS). In addition, patients were asked about their sociodemographic data, prenatal control history, obstetric history, delivery care and other data related to their partner. Factors associated with postpartum depression were estimated by bivariate and multivariate analyses. RESULTS: We analyzed 485 patients with a mean age of 24.6 years and cut-offs of 14 and 43 years. The prevalence of postpartum depression was 16%. In the final multivariate analysis model, the factors associated with postpartum depression were: delivery complications (CI95%:1.61-6.54), history of alcoholism before pregnancy (CI95%:1.17- 3.30) and receiving emotional support from husband during pregnancy (CI95%: 0.17-0.68). CONCLUSIONS: A history of alcoholic beverage consumption prior to pregnancy and having some complication of childbirth were indicative of possible occurrence of postpartum depression. Those who suffered from it had early referral to psychology services. The couple should be informed that their emotional support helps to reduce the risk of postpartum depression in the patient.

The clinical application of enteroscopies in China:a national survey in 2017 / 中华消化内镜杂志

Objective To investigate the clinical application of enteroscopies in China, and to further provide evidence for popularization and promotion of enteroscopies. Methods The survey was designed between January 1st , 2017 and July 31th , 2017 with pre-survey in Guangdong Province between May 1st , 2017 and July 31st , 2017. It was conducted in Chinese mainland between August 30th , 2017 and December 30th , 2017. Data were collected through the online survey and reality survey at 385 hospitals. A total of 373 hospitals gave feedbacks and 7 hospitals were unqualified for further analysis after data checking, so 366 hospitals were included for final analysis, with a responding rate of 95. 1％. Information on practice status of hospitals with enteroscopies and enteroscopists were collected. The chi-squared test was used for comparison of data between eastern and central and western regions. Results The hospitals owning enteroscopies accounted for 47. 0％ ( 172/366 ) , 154/172 ( 89. 5％) were tertiary referral hospitals, 112/172 ( 65. 1％) established enteroscopy units, and 84/172 ( 48. 8％) owned X-ray exclusive for enteroscopy. The proportion of enteroscopists with senior title was 40. 3％ (50/124), female enteroscopists accounted for 42. 7％ ( 53/124 ) . Most enteroscopists aged 31-40 ( 50. 8％) and 41-50 years ( 27. 4％) . 43. 0％ ( 74/172) hospitals employed only 1-2 enteroscopists. The diagnostic cases per year were less than 50 cases in 51. 2％ hospitals ( 88/172) . The therapeutic cases per year were less than 10 cases in 51. 7％hospitals ( 89/172 ) . Nineteen of 124 ( 15. 3％) of enteroscopists didn' t receive standard training. The number of hospitals performing enteroscopies in eastern regions was higher than that in central and western regions [111(51. 6％) VS 61(40. 4％), P=0. 034]. The training background of enteroscopists in eastern regions was better than that in central and western regions. Untrained endoscopists accounted for 10. 5％ in eastern regions, while those accounted for 22. 9％ in central and western regions with significant difference ( P=0. 031 ) . Conclusion Low number of patients treated and shortage of enteroscopists are obvious in Chinese mainland, especially in central and western regions. Standard training of enteroscopists is impending.

Evaluation of sixteen personality factor questionnaire to establish Personality Characteristics Questionnaire and post personality model of nurses / 中国实用护理杂志

Objective To understand the personality characteristics of excellent and generalnurses, extract personality characteristics from excellent nurses, and to establish Personality Characteristics Questionnaire and post personality model of nurses, and explore influencing factors of nurses personality characteristicsfor providing a theoretical reference in selection and training of nurses. Methods A total of 523 staff nurses from one class 3-A hospital general hospitalsin Shandong province were investigated with Sixteen Personality Factor Questionnaire(16PF). Results Excellent nurses possessed higher dominance, rule-consciousness, social boldness, shrewdness, perfectionism and lower apprehension than general nurses (t=-2.54-2.92, P<0.05), then six personality characteristics were extracted from excellent nurses to establish Personality Characteristics Questionnaire and post personality model of nurses; The difference was statistically significant in perfectionism with different age, work experience, and professional title in excellent of nurses (F=4.04-7.36, P < 0.05). Conclusions 16PF is suitable for evaluating personality characteristics of nurses, the personality characteristics questionnaire and post personality model can be used as selection criteria for new nurses.

The Influence of Vertebral Fracture on the Functional Disability of Patients with Rheumatoid Arthritis

The aim of the present study was to identify the influence of vertebral fracture (VF) on the functional disability in patients with rheumatoid arthritis (RA). This study consecutively enrolled 100 female patients aged 50 yr or older with RA. All participants underwent lateral imaging of the thoracolumbar spine by simple radiography to identify any VFs. They also completed questionnaires via interview regarding demographics, medical history, and disease outcomes including functional disability. We used univariate analysis to evaluate associations between functional disability and VF, and made multivariate logistic regression models to test independent effect of the presence of VF, the number of VFs, and the severity of VF on functional disability. Among the 100 RA patients, 47 had at least one VF, but 34 of them were asymptomatic that they had experienced a fracture. The multiple VFs > or = 3 (OR, 8.95; 95% CI, 1.77-44.15, P = 0.01) and moderate or severe VF (OR, 3.38; 95% CI, 1.26-9.04, P = 0.02) were related to disability in univariate analysis. The multiple VFs > or = 3 (OR, 6.13; 95% CI, 1.02-36.94, P = 0.048) was associated with functional disability of RA patients after adjusting various confounders and it was mainly in walking and arising. The VF might be an important factor which affects functional disability in RA patients.

Psychological research patients of 8-12 years with cleft of lip and/or palate* / 重庆医学

Objective To investigate the pyschological states and behavior habits of school-age children with cleft of lip and /or palate .Methods 50 children at the age of 8-12 with cleft of lip before the first operation and their parents and 50 normal control children were tested with SAS (social anxiety scale) ,SEC(self esteem scale) ,and CBCL(children behavior checklist) .Results The rate of abnormal tested by CBCL (children behavior checklist)-parent in patients was 22% ,was higher than that in normal 8% (χ2 =3 .85 ,P<0 .05) .The scores of SAS in patients was higher than those in control (t=5 .29 ,P<0 .01) .Conclusion School-age chil-dren with cleft of lip and/or palate had obvious psychological and behavioral problems ,thus ,corresponding nursing and health edu-cation should be applied .

The value of the gastroesophageal reflux disease questionnaire score for acid exposure prediction in gastroesophageal reflux disease patients / 中华消化杂志

Objective To evaluate whether the gastroesophageal reflux disease (GERD) questionnaire (GerdQ) symptom score could reflect the acid exposure indicated by 24-hour esophageal pH monitoring in patients with GERD, and to further validate the clinical application value of GerdQ.Methods From November 2008 to March 2010, 134 GERD patients from outpatient department with heartburn and acid reflux symptoms were enrolled.All the patients had undergone endoscopy examination, 24-hour esophageal pH monitoring and GerdQ scoring.According to 24-hour esophageal pH monitoring result, acid exposure group and none acid exposure group was divided by the percentage of time that pH was lower than 4 over 4.2% or DeMeester score over 14.72, the difference of GerdQ score was assessed.The receiver operating characteristic (ROC) curve of GerdQ score was drawn according to DeMeester score and the percentage of time that pH was lower than 4 as the gold standard.With SPSS 17.0 statistical software, the ratio was compared with the u test and Chi-square test, comparison between groups with t test.Results The BMI of acid exposure group was higher than that of none acid exposure group(t= 2.365, P= 0.019).The GerdQ score of acid exposure group (8.51± 2.34) was significantly higher than that of none acid exposure group (6.67 ± 2.79), the difference was statistically significant (t = 4.002, P = 0.000) .ROC curve was drawn according to DeMeester score over 14.72 as gold standard; the area under curve (AUC) was 0.70.When the critical value of GerdQ score was 7.5, Youden index was up to 0.3365, the sensitivity of diagnosis was 0.6909 and specificity was 0.6454.The percentage of time that PH was lower than 4 over 4.2% as the gold standard, the AUC of GerdQ score was 0.663.When the critical value of GerdQ score was 7.5, Youden index was up to 0.2790, the sensitivity of diagnosis was 0.6600 and specificity was 0.6190.Conclusions GerdQ score greater than 7.5 can better reflect acid exposure at the lower esophageal.There is stronger association between GerdQ score with the DeMeester acid exposure score over 14.72 than with the percentage of time that pH lower than 4 over 4.2% as the critical value for acid exposure.Obesity may aggravate the transient lower esophageal sphincter relaxation leading to occurrence of GERD symptoms.

Reliability and validity of adapted simplified Chinese version of the scoliosis research society-22 (SRS-22) questionnaire / 第二军医大学学报

Objective: To evaluate the validity and reliability of adapted simplified Chinese Version of the Scoliosis Research Society-22 (SRS-22) questionnaire. Methods: The English version of the SRS-22 was translated into simplified Chinese and was subjected to cross-culture adaptation; the final version of the simplified Chinese SRS-22 questionnaire was a consensus reached by an expert committee. Then the simplified Chinese version SRS-22 questionnaire and 36-Item Short Form Health Survey (MOS SF-36) questionnaire were used to survey 87 patients with adolescent idiopathic scoliosis who had been surgically treated; 63 patients (72.4%) responded to the SRS-22 questionnaire. The average age of these patients (6 male, 57 female) was (17.7±3.1) years (range, 14.3-23.8 years). Fifty-six of the 63 patients returned the MOS SF-36 questionnaire. The 2 indicators of reliability were Cronbach's α of internal consistency and intraclass correlation coefficient(ICC). Concurrent validity of the SRS-22 questionnaire was measured by comparing with domains of the SF-36 questionnaire, which was reflected by Pearson correlation coefficient (r). Results: The Cronbach α values for 4 domains (function/activity, pain, self-image/appearance, and mental health) were all higher than 0.7; and the Cronbach α value for satisfaction of management domain was acceptable. The intraclass correlation coefficients for function/ activity, pain, self-image/appearance, mental health, and satisfaction domain were 0.74, 0.78, 0.86, 0.81 and 0.84, respectively, demonstrating a satisfactory reproducibility. For the concurrent validity, 3 domains had excellent correlation, 10 had good correlation, and 21 had moderate correlation. Conclusion: The adapted simplified Chinese Version of the SRS-22 questionnaire has satisfactory reliability and concurrent validity, and might be suitable for post-operation clinical evaluation of Chinese adolescent patients with scoliosis.

The understanding of cancer pain by medical doctors and its therapeutic status in Shanghai-a survey in 2007 / 肿瘤

Objective:To investigate the understanding of cancer pain by medical doctors and its therapeutic status in Shanghai. Methods:We recruited 1 982 medical physicians from 106 secondary and tertiary hospitals in Shanghai city from January to March in 2007. The understanding and the therapeutic status of cancer pain were investigated by conducting a questionnaire survey and the results were statistically analyzed.Rusults:There were 52.3% physicians who believed that they understand the treatment protocol of the Three-step Analgesic Ladder regimen. The rate increased by 21.6 percentage point compared with the results in 1999. The understanding degree of oncologists was significantly better than non-oncologists. There were 16.8% physicians giving the correct answers on the three main principles of the dosage titration in analgesic management. The correct rate of oncologists was significantly higher than that of non-oncologists. Opium with strong analgesic effect had become the first choice for severe cancer pain, and the use of pethidine (Dolantin) for severe cancer pain decreased significantly.The pain was significantly relieved in 74.8% patients. The pain-relieving rate increased by 25.4 percentage point compared with the results in 1999. There were 81.1% medical doctors confirming the effect of pain treatment and among them oncologists were more optimistic to therapeutic outcome than others. There were 93.3% physicians who agreed that it was necessary to carry out the standardized training of cancer pain treatment and the requirement of non-oncologists were much emergent. The over-strict controls by the hospitals and the regulations were the main obstacles for using analgesic drugs.Conclusion:The understanding of medical doctors and the diagnostic and therapeutic levels of cancer pain were improved significantly compared with those in 1999. But more training of cancer pain treatment are still required to publicize the standardized therapy and overcome the obstacles of using analgesic drug.

Survey on Physiological and Psychological Symptoms of Drug Abusers under Rehabilitation Period Through Labor / 中国康复理论与实践

@#Objective To investigate the physiological and psychological symptoms of drug abusers under rehabilitation period through labor.Methods A self-designed clinical symptoms questionnaire and Eysenck Personality Questionaire (EPQ) were used to evaluate 1 004 drug abusers under rehabilitation period through labor, and the related symptoms were analyzed.Results The mainly physiological symptoms were fatigue, forgetfulness, aching pain of joints, arrhythmia and discomfort of limbs, and the mainly psychological symptoms are drug craving, insomnia and anxiety. The mean scores of P and E were higher in those who had the drug craving symptoms ( P<0.01), and the mean scores of N were higher in those who had the insomnia or anxiety symptoms ( P<0.01).Conclusion The mainly physiological symptoms of drug abusers under rehabilitation period through labor are fatigue, forgetfulness, aching pain of joints, arrhythmia and discomfort of limbs, which are probably caused by the unbalance of the nervous and internal secretive systems, and the plastisity of the nervous system. The psychological symptoms may due to the effect of morphine and the personality of the drug abusers.

Reality of Urinary Incontinence in Patients with Parkinson's Disease

PURPOSE: The study was performed to identify the reality of urinary incontinence (UI) and to evaluate the risk factors developing UI for the patients with Parkinson's disease. MATERIALS AND METHODS: This was the cross-sectional study with interviews using structured questionnaires. The subjects who were 72 patients(male 20, female 52) and their mean age is 70.07+/-20.06(range 54~86) with Parkinson's disease visited the Neurology clinic, from September to November 2005, at one university hospital located in Jeju island. RESULTS: Subjects with restricted mobility were 45, and 13 were in first stage of Hoehn & Yahr stage, 31 were in second stage, 28 were in third stage. Fifty three(73.6%) subjects had experienced UI. Mixed UI was in 32 (44.4%), stress UI 12(16.7%), and urge UI 9(12.5%), respectively. As for risk factors developing UI, female had 1.62 times(OR=1.62, 95% CI=0.47~5.66) more than male, age of 80~86 had 3.20 times(OR=3.20, 95% CI=0.65~15.69) more than age of 54~69, subjects with restricted mobility had 2.75 times(OR=2.75, 95% CI=0.80~9.43) more than subjects without restricted mobility. Group without regular exercise had 2.9 times more than group with regular exercise(OR=2.90, 95% CI=0.92~9.22). Cognitive impairment group had 1.98 times more than normal mental status group(OR=1.98, 95% CI=0.39~9.97). Second stage had 4.91 times(OR=4.91, 95% CI=0.55~43.53) and third stage had 5.68 times(OR=5.68, 95% CI=00.64~50.73) more than first stage in Hoehn and Yahr stage. CONCLUSION: There is a high prevalence(73.6%) of UI in patients with Parkinson's diseases. Mixed UI was the most common type of incontinence. Risk factors developing UI were higher in female, older group, restricted mobility group, group without regular exercise, cognitive impairment group andhigher Hoehn and Yahr stage.

Validação para língua portuguesa de duas escalas para avaliação de hábitos e qualidade de sono em crianças / Language validation of two scales to evaluate sleep quality in children

OBJETIVO: Apresentar a validação para língua portuguesa das escalas de avaliação do sono: "Inventário dos hábitos de sono para crianças pré-escolares" e "Questionário sobre o comportamento do sono". MÉTODOS: Inicialmente as escalas foram traduzidas para português, após receberam tradução reversa, em reunião de consenso foi avaliada a melhor versão. As escalas foram aplicadas em dois grupos de crianças (controle e com epilepsia). Os pacientes com epilepsia foram estratificados pela gravidade através da classificação de Engel. Os escores obtidos foram comparados entre si e relacionados com a gravidade da epilepsia. RESULTADOS: A escala "Inventário dos hábitos de sono para crianças pré-escolares" evidenciou maior incidência de alterações na rotina da hora de dormir, na ritmicidade do sono e de separação dos pais no grupo com epilepsia refratária. Crianças com epilepsia controlada apresentaram hábitos do sono mais saudáveis (p < 0,05). A aplicação do "Questionário sobre o comportamento do sono" evidenciou alterações na qualidade do sono no grupo com epilepsia (p < 0,001). Quanto maior a refratariedade da epilepsia pior a qualidade do sono (p < 0,001). CONCLUSÃO: Disponibilizamos através da validação para língua portuguesa questionários para avaliação de distúrbios do sono na infância. A aplicação destes questionários demonstrou a influência exercida pela epilepsia com crises não controladas na qualidade do sono.

OBJECTIVE: Validation to Portuguese of the questionaries: Sleep Habits Inventory for Preschool Children and Sleep Behavior Questionaire. METHODS: The English version of the questionnaires was translated and back translated independently by two professionals, after that the best version was choose. The Portuguese version was applied in two groups of children: patients with epilepsy and a control group. Patients with epilepsy were classified according to Engel score. Results obtained on both groups were related to epilepsy refractoriness. RESULTS: Sleep Habits Inventory for Preschool Children applied in children between 2-6 years of age showed that patients with refractory epilepsy have a major incidence of disorders in the sleep rhythm and routines. Furthermore, they also have more problems to be separated from parents. Children with well controlled epilepsy have more incidence of health sleep habits (p < 0,05). The score of Sleep Behavior Questionnaire applied in children between 7-14 years of age showed significant difference among children with epilepsy (47,52 ± 10,9) and controls (30,52 ± 3,75) (p < 0,001). Refractory epilepsies related with worse sleep quality (p < 0.001). CONCLUSION: Two questionnaires that evaluate sleep habits were translated and validated to be used in Portuguese. Application of these questionnaires in controls and in children with epilepsy showed that uncontrolled epilepsy influences quality of sleep.

Difference of Physical Symptoms, PWI and JCQ according to Sasang Constitutions for Industrial Workers

PURPOSE: This study was conducted to analyze industrial workers' stresses from physical symptoms, PWI, JCQ and tasks in classification of Sasang constitutions. METHOD: Data were collected from industrial workers in J Province from May 2003 to June 2003. Questionnaires were distributed and collected on the day of their physical examination. Collected data were analysed through chi2-test. RESULT: Health-related characteristics showed that most of smokers and drinkers were Taeumins and this result was statistically significant. Physical symptoms related to constitutions indicated that GI and neurologic symptoms are significantly more frequent in Soeumin. The percentage of subjects with moderate risk was high in order of Soyangin, Taeumin and Soeumin while the percentage of subjects with high risk was high in order of Soeumin, Taeumin and Soyangin. CONCLUSION: Through this study, Lee Jae Ma's theory was be confirmed compatible with disease characteristics. However, research with more various subjects and variables needs to be made.

Effects of Interparental Discords on 7-year-old Children's Problem Behaviors / 中国心理卫生杂志

Objective:To explore the effects of interparentnl discords on 7-year-old children's problem behav- iors,and discuss the reasons of some associations between them.Methods:Questionaires from parents were seperate- ly used to assess frequency of interparental discords and children's problem behaviors.Results:The total score of inter- parental discord (2.35?0.44) predicted children's anxiety withdrawal,and physical complains (?=0.23,0.22, 0.20,P

A Study Of The Midazolam Dosage On Conscious Sedation At The Department Of The Oral And Maxillofacial Surgery

Korean version of the Geriatric Social Readjustment Questionnaire: cross-cultural comparison between Koreans and Americans in the perception of life events

The purpose of this study was to construct a Korean version of the Geriatric Social Readjustment Questionnaire (K-GSRQ), to investigate its applicability to the elderly and to compare cross-cultural differences in the perception of the life events between Koreans and Americans. The K-GSRQ consists of 33 items. Most of the life events considered as crucial in old age were similar in ranking in comparison between Koreans and Americans. Some differences in ranking can be attributed to the differences in Socio-cultural backgrounds. The K-GSRQ was applied to controls, neurotic cases and cases with physical illnesses. The result suggest that the Korean version of the Geriatric Social Readjustment Questionnaire is applicable for the study of the health status of the elderly in Korea.

Reliability and validity of adapted simplified Chinese version of the Scoliosis Research Society-22 (SRS-22) Questionnaire / 第二军医大学学报

Objective:To evaluate the validity and reliability of adapted simplified Chinese Version of the Scoliosis Research Society-22(SRS-22)questionnaire.Methods:The English version of the SRS-22 was translated into simplified Chinese and was subjected to cross-culture adaptation;the final version of the simplified Chinese SRS-22 questionnaire was a consensus reached by an expert committee.Then the simplified Chinese version SRS-22 questionnaire and 36-Item Short Form Health Survey(MOS SF-36)questionnaire were used to survey 87 patients with adolescent idiopathic scoliosis who had been surgically treated;63 patients(72.4%)responded to the SRS-22 questionnaire.The average age of these patients(6 male,57 female)was(17.7?3.1)years(range,14.3-23.8 years).Fifty-six of the 63 patients returned the MOS SF-36 questionnaire.The 2 indicators of reliability were Cronbach's ? of internal consistency and intraclass correlation coefficient(ICC).Concurrent validity of the SRS-22 questionnaire was measured by comparing with domains of the SF-36 questionnaire,which was reflected by Pearson correlation coefficient(r).Results:The Cronbach ? values for 4 domains(function/activity,pain,self-image/appearance,and mental health)were all higher than 0.7;and the Cronbach ? value for satisfaction of management domain was acceptable.The intraclass correlation coefficients for function/activity,pain,self-image/appearance,mental health,and satisfaction domain were 0.74,0.78,0.86,0.81 and 0.84,respectively,demonstrating a satisfactory reproducibility.For the concurrent validity,3 domains had excellent correlation,10 had good correlation,and 21 had moderate correlation.Conclusion:The adapted simplified Chinese Version of the SRS-22 questionnaire has satisfactory reliability and concurrent validity,and might be suitable for post-operation clinical evaluation of Chinese adolescent patients with scoliosis.