Brazilian adaptation of the McLean Screening Instrument for Borderline Personality Disorder

Abstract Objective Borderline personality disorder (BPD) is a serious and extremely prevalent mental disorder. Early diagnosis is vital for treatment. However, there are no specific screening instruments validated for Brazilian Portuguese. This study aimed to adapt the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) to the Brazilian context. The MSI-BPD is a self-report instrument based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), that enables fast and reliable assessment of BPD, with measures of sensitivity (SN) and specificity (SP) similar to the diagnostic interview for the DSM-5 (Structured Clinical Interview for DSM-V Axis II Disorders [SCID-II]), taken as the gold standard. Methods Two independent translations, a synthesis version, back-translation, and analysis by experts were employed to create the final version of the instrument in Brazilian Portuguese. The translated instrument was administered to 1,702 adults aged 18-59 years to verify evidence of validity relating to content, internal structure, relationship with other variables, and reliability. Results The exploratory and confirmatory factor analyses show that the one-factor structure is adequate. The scale showed satisfactory internal consistency (Kuder-Richardson coefficient [KR-20] of Cronbach's alpha = 0.691) and good test-retest reliability (intraclass correlation coefficient [ICC] = 0.802). Logistic regression analysis using the Personality Inventory for the DSM-5-Brief Form (PID-5-BF) (DSM-5) as reference established an ideal cut-off point of eight symptoms, with adequate SN (0.79) and SP (0.75), similar to the original instrument. The area under the curve (AUC) was 0.830 (95% confidence interval: 0.802-0.858), with a positive predictive value of 89.2%. Conclusion The Brazilian version of the MSI-BPD has adequate psychometric properties for use as a BPD screening tool by clinicians.

Study on performance comparison between Brain Health System's clinic digital memory assessment and previously used assessments in dementia risk screening / 中华老年医学杂志

Objective:To study on performance comparison between clinic digital memory assessment and previously used assessments in dementia risk screening.To compare the performance comparison between Beijing Aging Brain Rejuvenation Initiative(BABRI)Brain Health System's Clinic Digital Memory Detection as study and Alzheimer Disease-8(AD8)and the Brief Community Screening Instrument for Dementia(BCSID)as controls, We calculated and evaluated the accuracy, sensitivity and specificity of screening Mild cognitive impairment(MCI)among these tests.Furthermore, BABRI Brain Health System was used to conduct a large sample brain health examination and early dementia screening to test the validity, adaptability and stability of the evaluation results by BABRI Brain Health System'Clinic Digital Memory Detection.Methods:Dataset 1 contained 669 elderly subjects from five communities in Beijing were recruited according to inclusion and exclusion standard.The diagnosis of MCI was based on the full set of neuropsychological scale and Petersen standard.Dataset 1 was used to compare the discriminant effect of BABRI Brain Health System'Clinic Digital Memory Detection as study versus AD8 and BCSID as controls.The sensitivity, specificity, positive predictive value, negative predictive value and Youden index of each measurement tool were calculated.Then, the receiver operator characteristic(ROC)curve was prepared to compare the discrimination ability of MCI between each measurement tool.While the area under the curve(AUC)of different tools was compared by Wald χ2 test.Dataset 2 contained 284 103 subjects from 16 communities in Beijing, which were used to test the applicability of large sample screening in BABRI Brain Health System. Results:77 patients with MCI were found among 666 people, and incidence rate was 11.56% using the full set of neuropsychological scales in dataset 1.Compared with the results of other tests, the sensitivity of BABRI Brain Health System to correctly distinguish MCI was 0.753, which was close to BCSID, and better than AD8.In addition, BABRI Brain Health System's Youden's index was 0.741 and AUC was 0.905, which suggested that the specificity, positive predictive value, negative predictive value and cognitive domain coverage of MCI screening were generally better in BABRI Brain Health System than in AD8 and BCSID.Finally, the Brain Health Examination results of 284, 000 people in dataset 2 showed that the high-risk detection rate of MCI(8.65%)of the tool for people over 50 years old under a large sample was quite close to the results of dataset 1(8.67%), indicating that the BABRI Brain Health System had high stability.Conclusions:BABRI Brain Health System has not only high sensitivity and specificity, but also wide cognitive field coverage and high stability.BABRI Brain Health System is suitable for large-scale brain health examination and dementia risk screening in grass-roots communities, and is worthy of popularization.

Evidence of the validity of a novel version of the computerized cognitive screening battery CompCog / Evidência de validade de uma nova versão da bateria computadorizada de rastreio cognitivo CompCog

ABSTRACT Although the availability of the computer-based assessment has increased over the years, neuropsychology has not carried out a significant paradigm shift since the personal computer's popularization in the 1980s. To keep up with the technological advances of healthcare and neuroscience in general, more efforts must be made in the field of clinical neuropsychology to develop and validate new and more technology-based instruments, especially considering new variables and paradigms when compared to paper and pencil tests. Objective: This study's objective was to produce concurrent validity evidence of the novel version of the computerized cognitive screening battery CompCog. Methods: Participants performed a traditional paper and pencil neuropsychological testing session and another session where CompCog was administrated. The data of a total of 50 young adult college students were used in the analyses. Results: Results have shown moderate and strong correlations between CompCog's tasks and their equivalents considering paper and pencil tests. Items clustered in agreement with the subtest division in a principal component analysis. Conclusions: The findings suggest that CompCog is valid for measuring the cognitive processes its tasks intend to evaluate.

RESUMO Embora a disponibilidade de instrumentos computadorizados para avaliação tenha aumentado ao longo dos anos, a neuropsicologia não passou por uma mudança significativa de paradigma desde a popularização do computador pessoal nos anos 1980. Para acompanhar os avanços tecnológicos da saúde e da neurociência em geral, mais esforços devem ser feitos no campo da neuropsicologia clínica para desenvolver e validar novos instrumentos de base mais tecnológica, especialmente considerando novas variáveis e paradigmas quando comparados aos testes de lápis e papel. Objetivo: O objetivo deste estudo foi produzir evidências de validade concorrente da nova versão da bateria computadorizada de rastreio cognitivo CompCog. Métodos: Os participantes passaram por uma sessão de avaliação neuropsicológica com testes tradicionais de lápis e papel e de outra sessão em que o CompCog foi administrado. Os dados do total de 50 jovens adultos universitários foram utilizados nas análises. Resultados: Os resultados mostraram correlações moderadas e fortes entre as tarefas do CompCog e seus equivalentes nos testes tradicionais. Uma análise de componentes principais mostrou que os itens formaram fatores em concordância com a divisão de subtestes da bateria. Conclusões: Os resultados sugerem que o CompCog é válido para medir os processos cognitivos que suas tarefas pretendem avaliar.

Análisis bibliométrico de las funciones ejecutivas de adultos mayores en Iberoamérica / Bibliometric analysis of executive functions of older adults in Ibero-America

RESUMEN Objetivos: a) Verificar la cantidad de estudios efectuados en Iberoamérica sobre función ejecutiva (FE) en adultos mayores; b) Identificar los instrumentos utilizados para medir las FE en adultos mayores durante los años 2009-2018. Material y métodos: Se efectuó un estudio bibliométrico sobre las FE en adultos mayores de Iberoamérica. La búsqueda de información se hizo en las base de datos Scopus y Scielo. Se consideraron estudios iberoamericanos publicados en idioma español y portugués, utilizándose ocho palabras clave y cinco indicadores registrados. Resultados: Se identificaron un total de 12 investigaciones originales en seis países iberoamericanos (España, Argentina, Chile, Colombia, Cuba, y Perú). La mayor cantidad de investigaciones relacionadas con FE en asultos mayores tuvo lugar en los periodos 2009-2010 y 2013-2014. En estos estudios, se han utilizado varios instrumentos con el Trail Making Test (TMT) y la Frontal Assessment Battery (FAB) como los de uso más frecuente. Conclusiones: Parece existir un interés limitado por investigar las FE en adultos mayores de Iberoamérica. La mayoría de los estudios idntificados en esta indagación utilizaron como tests cognitivos el TMT y la FAB.

SUMMARY Objectives: a) To verify the number of studies on executive functions (EF) in older adults carried out in Ibero-America; b) To identify the instruments used to measure EF in older adults during the years 2009-2018. Material and methods: A bibliometric study on EF in older adults in Latin America was carried out through the Scopus and Scielo databases. Studies published in Spanish and Portuguese languages using eight keywords and five registered indicators. Results: Between 2009 and 2018, a total of 12 original investigations have been carried out in six Iberoamerican countries (Spain, Argentina, Chile, Colombia, Cuba, and Peru). Most EF-related investigations were reported duing the 2010-2009 and 2013-2014 periods. Several instruments were used, the Trail Making Test and the Frontal Assessment Battery being the most frequent. Conclusions: There seems to be a limited interest in investigating EF in older adults in Ibero-America. Most of these studies identified in this inquiry used the TMT and the FAB as cognitive tests.

Evaluation of sensitivity and specificity of the INECO Frontal Screening and the Frontal Assessment Battery in mild cognitive impairment / Avaliação da sensibilidade e especificidade do teste de rastreio frontal do ineco e da bateria de avaliação frontal no comprometimento cognitivo leve

ABSTRACT. The Frontal Assessment Battery (FAB) and the INECO Frontal Screening (IFS) are two instruments frequently used to explore cognitive deficits in different diseases. However, studies reporting their use in patients with mild cognitive impairment (MCI) are limited. Objective: To compare the sensitivity and specificity of FAB and IFS in mild cognitive impairment (multiple-domain amnestic MCI subtype — md-aMCI). Methods: IFS and FAB were administered to 30 md-aMCI patients and 59 healthy participants. Sensitivity and specificity were investigated using the Receiver Operating Characteristic (ROC) analysis. Results: The area under the ROC curve (AUC) of IFS for MCI patients was .82 (sensitivity=0.96; specificity=0.76), whereas the AUC of FAB was 0.74 (sensitivity=0.73; specificity=0.70). Conclusions: In comparison to FAB, IFS showed higher sensitivity and specificity for the detection of executive dysfunctions in md-aMCI subtype. The use of IFS in everyday clinical practice would allow detecting the frontal dysfunctions in MCI patients with greater precision, enabling the early intervention and impeding the transition to more severe cognitive alterations.

RESUMO. A Bateria de Avaliação Frontal (FAB) e o teste de rastreio frontal do INECO (IFS) são dois instrumentos frequentemente utilizados para explorar déficits cognitivos em diferentes doenças. No entanto os estudos que relatam seu uso em pacientes com comprometimento cognitivo leve (MCI) são limitados. Objetivo: Comparar a sensibilidade e especificidade da FAB e IFS em comprometimento cognitivo leve (subtipo amnéstico de múltiplos domínios [md-aMCI]). Métodos: O IFS e FAB foram administrados a 30 pacientes md-aMCI e 59 participantes saudáveis. A sensibilidade e a especificidade foram exploradas usando a análise ROC. Resultados: A área sob a curva ROC (AUC) do IFS para pacientes com MCI foi de 0,82 (sensibilidade=0,96; especificidade=0,76), enquanto a AUC de FAB foi de 0,74 (sensibilidade=0,73; especificidade=0,70). Conclusões: Em comparação com o FAB, o IFS apresentou maior sensibilidade e especificidade para detecção de disfunções executivas no subtipo md-aMCI. O uso do INECO Frontal Screening (IFS) na prática clínica cotidiana, permitiria detectar com maior precisão as disfunções frontais em pacientes com deficiência cognitiva leve, possibilitando a intervenção precoce, impedindo a transição para alterações cognitivas mais graves.

Prevalence and burden of neuropathy among patients in the Eastern Visayas Regional Medical Center Family Medicine Diabetes Wellness Clinic

Introduction@#Diabetes Mellitus is a chronic non-communicable disease that has been increasing in prevalence worldwide. Preventing and treating diabetes and its complications have been a burden in the health care system. Diabetic neuropathy is its frequent complication and in the long run, is associated with a negative impact on the functioning and quality of life. Hence, its early detection can prevent and delay its sequelae and improve patients’ quality of life.@*Objective@#To determine the prevalence and burden of neuropathy among diabetic patients of Eastern Visayas Regional Medical Center (EVRMC) Family Medicine Diabetes Wellness Clinic@*Methods@#This was an analytical cross-sectional study. Patients at the EVRMC Family Medicine Diabetes Wellness Clinic from May to October 2020 were included. The Michigan Neuropathy Screening Instrument was used to diagnose diabetic neuropathy. Descriptive statistics, Chi-square test, and Fisher’s exact test were used to determine the association between socio-demographic profile and clinical characteristics among neuropathic patients.@*Results@#Two hundred ten patients were enrolled. Majority were female (66.7%), ≥60 years old (58.1%), with vocational/college degrees (37.1%), unemployed (75.2%), did not have glycemic control (80%), had diabetes for ≤5 years (57.1%), and took two maintenance medications (46.7%). Biguanide was the most common maintenance drug (70.5%). Among diabetic patients, 30.5% had neuropathy. Statistically significant associations were seen in ≥60 years old [OR 1.92, p=0.04], with vocational/ college degrees [OR 2.17, p=0.01], and with diabetes for 6-10 years [OR 2.42, p=0.01] and ≥20 years [OR 5.07, p=0.01.@*Conclusion@#Diabetes Mellitus was prevalent in elderly age group, female gender, with vocational/college degrees, and unemployed. Most had uncontrolled sugar, had diabetes for ≤5 years, and took two maintenance drugs. Only 30.5% had neuropathy. Diabetic patients ≥60 years old, had vocational/college degrees, and had longer duration of the disease had higher odds of having diabetic neuropathy.

Effects of combination therapy of calcium dobesilate dispersible and monosialotetrahex-osylganlioside sodium on serum inflammatory cytokines IL-6 and MCP-1 in elderly patients with painful diabetic peripheral neuropathy / 中国基层医药

Objective To observe the efficacy of combination therapy of calcium dobesilate dispersible and monosialotetrahexosylganlioside sodium on interleukin-6 (IL-6) and monocyte chemotactic protein-1 (MCP-1) in elderly patients with painful diabetic peripheral neuropathy.Methods From January 2012 to May 2017,in the Second People's Hospital of Lianyungang 70 patients of painful diabetic peripheral neuropathy,aged ≥60 years,were analyzed in this study.They were randomly divided into observation group (35 cases) and control group (35 cases).The observation group was treated with 40mg monosialotetrahexosylganlioside sodium dissolved in 250mL physiological saline,intravenous infusion per day,and oral calcium dobesilate dispersible 0.5g twice a day for two weeks.The control group was treated with methylcobalamin injection 0.5mg per day for two weeks.The clinical treatment effects and levels of IL-6 and MCP-1 were observed and compared between the two groups.Results After two weeks of treatment,the MDNS and MNSI scores of the observation group [(13.09 ± 5.38)points,(2.53 ± 1.19)points] were significantly lower than those of the control group [(18.31 ± 6.13) points,(4.19 ± 1.05) points,t =2.036,2.365,all P ＜ 0.05] and those before treatment [(21.26 ± 4.28) points,(5.40 ± 0.89) points,t =3.251,3.698,all P ＜ 0.05].The VAS-PI scores in the observation group [(6.24 ± 1.25) points,(4.13 ± 1.69) points] were significantly lower than those in the control group[(7.26 ± 1.28) points,(6.34 ± 2.65) points] at the first and second week (t =3.265,5.395,all P ＜ 0.05).The serum levels of inflammatory cytokines IL-6 and MCP-1 in the observation group [(15.16 ±0.88) ng/L,(157.19 ± 11.22) ng,/L] were significantly lower than those in the control group[(17.87 ± 1.19) ng/L,(198.21 ± 12.07)ng/L,t =2.152,1.365,all P ＜0.05]and those before treatment[(20.26 ± 1.05) ng/L,(260.44 ± 13.63) ng,/L,t =1.235,0.965,all P ＜ 0.05].Conclusion Combination of calcium dobesilate and mono-sialotetrahexosyl ganglioside may alleviate the sensory and pain sensations in patients with painful diabetic peripheral neuropathy,possibly by reducing the level of inflammatory cytokines IL-6 and MCP-1.

The Cognitive Telephone Screening Instrument (COGTEL): a reliable and valid tool for the assessment of cognitive functioning in the Brazilian elderly / Cognitive Telephone Screening Instrument (COGTEL): um instrumento fiável e válido na avaliação do funcionamento cognitivo em pessoas idosas brasileiras

Abstract Objectives: To study the reliability/stability of the Cognitive Telephone Screening Instrument (COGTEL) for the assessment of cognitive functions, and to investigate the concurrent validity (that is, the relationship between the COGTEL scores and external variables, such as level of education and MMSE results) in a pilot study of elderly persons residing in the community in the municipal regions of Apuí, Fonte Boa and Manaus (Amazonas, Brazil). Method: This pilot study included 90 elderly persons (29 men and 61 women) aged 60-85 years of age [68.2 (± 6.7)]. The COGTEL, the MMSE and socio-economic survey were applied in the form of two interviews, a week apart and under the same conditions. Results: The test-retest intraclass correlation coefficient of the COGTEL total score (and respective six subtests), MMSE and educational level ranged from acceptable to high (0.708 < R <0.946). There was a strong positive correlation between the total score of the COGTEL with the MMSE (r =0.682; p <0.001), as well as with educational level (r =0.604; p <0.001). Conclusion: This study presents preliminary evidence of the reliability/stability and concurrent validity of the COGTEL in the evaluation of cognitive functions in elderly persons residing in the community. The results of this study support the use of COGTEL as a short, reliable and valid instrument for analyzing differences in cognitive functioning in inter-individual studies with elderly persons.

Resumo Objetivo: Estudar a fiabilidade/estabilidade do "The Cognitive Telephone Screening Instrument" (COGTEL) na avaliação das funções cognitivas e investigar a validade concorrente (ou seja, a relação entre os escores do COGTEL com variáveis externas, tais como a educação e o resultado do MMSE), num estudo piloto em adultos idosos residentes na comunidade de Apuí, Fonte Boa e Manaus (Amazonas, Brasil). Método: O presente estudo piloto incluiu 90 adultos idosos (29 homens e 61 mulheres) com idades compreendidas entre os 60-85 anos de idade [68,2(±6,7)]. O COGTEL, o MMSE e o questionário socioeconômico foram aplicados sob forma de entrevista duas vezes, com uma semana de intervalo nas mesmas condições. Resultados: O coeficiente de correlação intraclasse no teste-reteste no escore total do COGTEL (e respectivos 6 subtestes), MMSE e nível educacional variou entre aceitável-a-elevado (0,708 < R < 0,946). Verificou-se uma correlação positiva entre o escore total do COGTEL com o MMSE (r=0,682; p<0,001), bem como, com o nível educacional (r=0,604; p<0,001). Conclusão: Este estudo apresenta evidências preliminares de fiabilidade/estabilidade e validade concorrente do COGTEL na avaliação das funções cognitivas em adultos idosos residentes na comunidade. Os resultados do presente estudo suportam a utilização do COGTEL como um instrumento breve, fiável e válido para analisar diferenças interindividuais no funcionamento cognitivo em estudos com adultos idosos.

Prevalence of peripheral neuropathy among diabetic patients in a tertiary care hospital

Introduction: The burden of diabetes mellitus (DM) is on the rise especially in developing countries like India. Due to its chronic nature DM tends to cause many debilitating complications and diabetic peripheral neuropathy (DPN) is one of them. The aim of this study is to determine the prevalence of DPN among patients attending a tertiary care hospital and to identify the determinants associated with it. Materials and methods: A cross-sectional study was conducted in diabetic patients attending a tertiary care hospital in Kancheepuram district of Tamil Nadu from May 2018 till September 2018. A total of 203 diabetic patients were asked to respond to the patient history version of Michigan neuropathy screening Instrument and examinations were conducted after obtaining consent from them. The data were analyzed in terms of descriptive statistics as well as bivariate analysis. Results: The prevalence of DPN using the MNSI history version and MNSI examination were found to be 31% and 24% respectively. The major determinants were found to be age more than 50 years (OR: 0.24, CI: 0.123- 0.467), P<0.00001, HbA1C > 6.5 (OR: 0.467, CI: 1.90 – 0.356, P= 0.05). Conclusions: This study showed that the prevalence of peripheral neuropathy among diabetic patients was 41.5% and the major determinants were age more than 50 years and poor HbA1C control. Early detection through routine screening and regular follow up examinations will reduce the burden of disability among diabetics and improve their quality of life significantly

Performance of the Pentagon Drawing test for the screening of older adults with Alzheimer's dementia / Desempenho do teste do desenho do pentágono para rastreio de idosos com demência de alzheimer

ABSTRACT. The Pentagon Drawing Test (PDT) is a common cognitive screening test. Objective: The aim of this study was to evaluate performance properties of a specific PDT scoring scale in older adults with Alzheimer's disease (AD) and healthy controls. Methods: A cross-sectional study of 390 elderly patients, aged 60 years or older with at least two years of education was conducted. All participants completed clinical and neuropsychological evaluations, including the Cambridge Cognitive Examination, the Mini-Mental State Examination (MMSE), and the Clock Drawing Test. All PDT were blindly scored with the scale of Bourke et al. Results: PDT analyses of the binary score on the MMSE (0 or 1 point) did not discriminate AD from controls (p = 0.839). However, when PDT was analyzed using the Bourke et al. scale, the two groups could be distinguished (p <0.001). PDT was not affected by education, showed sensitivity of 85.5% and specificity of 66.9%, discriminated different clinical stages of dementia, and correlated with the other cognitive tests (p <0.001). A 1-point difference on the Bourke et al. scale was associated with an odds ratio of 3.46 for AD. Conclusion: PDT can be used as a cognitive screen for suspected cases of dementia, especially AD, irrespective of educational level.

RESUMO. O teste do desenho do pentágono (PDT) é um teste de rastreio cognitivo simples. Objetivo: O objetivo deste estudo foi avaliar o desempenho de uma escala específica de pontuação da PDT em idosos com doença de Alzheimer (DA) e controles saudáveis. Métodos: Estudo transversal, com 390 idosos, com mais de 60 anos de idade, com pelo menos dois anos de escolaridade. Todos os participantes passaram por anamnese clínica e neuropsicológica, incluindo o Cambridge Cognitive Examination (CAMCOG), o Mini-Exame do Estado Mental (MEEM) e o Teste do Desenho do Relógio (TDR). A avaliação do PDT com a escala Bourke et al. foi feita de forma cega. Resultados: As análises PDT do escore binário do MEEM (0 e 1 ponto) não discriminaram DA dos controles (p = 0,839). Contudo, quando PDT foi avaliada pela escala Bourke et al., verificou-se diferenças estatisticamente significativa (p <0,001). A PDT não sofreu interferência da escolaridade, apresentando sensibilidade de 85,5% e especificidade de 66,9% para discriminar os diferentes estágios clínicos da demência. A escala também mostrou correlação com os testes cognitivos aplicados (p <0,001). Uma diferença de um ponto na escala Bourke et al. foi associada com OR (odds ratio) de 3,46 para DA. Conclusão: PDT pode ser utilizada como rastreio cognitivo para casos suspeitos de demência, especialmente DA, independentemente.

Clinical Study on Electronic Moxibustion in Treating Diabetic Peripheral Neuropathy / 上海针灸杂志

Objective To observe the clinical efficacy of electronic moxibustion in treating diabetic peripheral neuropathy due to liver-kidney deficiency. Method Ninety patients with diabetic peripheral neuropathy due to liver-kidney deficiency were randomized into a treatment group of 44 cases and a control group of 46 cases. The treatment group was intervened by acupoint therapy by warm electronic moxibustion, while the control group was intervened by foot bath with Chinese medication. For both groups, 10 treatment sessions were taken as a course of treatment, for 3 courses in total. Before and after the treatment, the whole blood viscosity, blood lipids, fasting blood glucose (FBG), glycosylated hemoglobin (GHb) and Michigan Neuropathy Screening Instrument (MNSI) were evaluated in the two groups. Result The whole blood viscosity indexes, blood lipids levels, FBG level and GHb level didn't show significant differences after the treatment in the two groups (P>0.05). The intra-group and inter-group comparisons of MNSI score showed significant differences after the treatment (P<0.01); there was a between-group difference in the change of MNSI score after the treatment (P<0.01). Conclusion Electronic moxibustion is an effective approach in treating diabetic peripheral neuropathy.

Observations on the Therapeutic Effect of Electronic Moxibustion on Diabetic Peripheral Neuropathy / 上海针灸杂志

Objective To investigate the clinical efficacy of electronic moxibustion in treating diabetic peripheral neuropathy (liver-kidney deficiency type).Methods Ninety patients with diabetic peripheral neuropathy (liver-kidney deficiency type) were randomized to a treatment group (44 cases) and a control group (46 cases).The treatment group received electronic moxibustion and the control group,Chinese herbal fumigation of feet.Both groups were treated 10 times as a course for a total of three courses.The TCM symptom total score and the Michigan Neuropathy Screening Instrument (MNSI) score were recorded in the two groups before and after treatment.The clinical therapeutic effects were compared between the two groups.Results There was a statistically significant pre-/post-treatment difference in the TCM symptom total score in both groups after one,two and three courses of treatment (P＜0.01).The TCM symptom total score improvement rate was (60.9±16.7)％ in the treatment group and (56.6±19.2)％ in the control group;there was a statistically significant difference between the two groups (P＜0.01).The total efficacy rate was 97.7％ in the treatment group and 95.7％ in the control group;there was no statistically significant difference between the two groups (P＞0.05).The pre-/post-treatment MNSI score difference value was (2.98±3.66) in the treatment group and (0.78±2.92) in the control group;there was a statistically significant difference between the two groups (P＜0.01).Conclusions Electronic moxibustion is an effective way to treat diabetic peripheral neuropathy.Its therapeutic effect is slightly better than that of Chinese herbal fumigation.

Identifying Psychological Distress in Elderly Seeking Health Care.

Background: Psychological distress in the elderly with various illness conditions often goes unrecognized. Since psychological distress is treatable, it is important to recognize it at the earliest to enhance recovery. This is an interim analysis of screening data of the elderly seeking health care in a hospital in India, with a focus on the 12-item General Health Questionnaire (GHQ-12), a screening instrument for psychological distress and a rationale for a higher cutoff score in help seeking elderly. Materials and Methods: A retrospective analysis of screening data of psychological distress using GHQ-12 in the elderly seeking care for neuropsychiatric conditions was carried out. Traditionally, ≥2 is considered positive for distress by GHQ-12. Receiver Operating Characteristic (ROC) curve was used to define new cutoff points for psychological distress. Results: At ≥2, 2443 (50%) of the elderly screened were recognized to be psychologically distressed. Using an ROC and optimum sensitivity and specificity measures, a cutoff score of ≥4 was observed to detect 30% of the elderly who had diagnosable mental health disorders. Female sex, illiteracy, and multiple co-morbidities were the factors that were associated with higher cutoff scores on GHQ-12 proposed here and psychiatric morbidity thereof. Conclusion: There is greater psychological distress among the elderly seeking health care. Hence, it is important to screen them and identify those at higher risk. Using a higher cutoff score with a standardized instrument like GHQ-12 indicated that it was statistically valid to identify those elderly with higher distress in a busy out-patient setting.

Correlation between ultrasonic feature of tibial nerve with Michigan neuropathy screening instrument scoring system in type 2 diabetic mellitus / 天津医药

Objective To examine the correlation between the ultrasonic feature of tibial nerve and the scores of Michi?gan neuropathy screening instrument(MNSI)in type 2 diabetic mellitus (T2DM) and to provide information for early diagno?sis of diabetic peripheral neuropathy(DPN). Methods Based on scores of MNSI, 95 cases of T2DM patients were divided into three different groups:group B(0-2.4 scores), C(2.5-4.4 scores)and D(≥4.5 scores). Ultrasound parameters of group A (n=30) were compared with group B (n=32), group C (n=31) and group D (n=32). These parameters includes nerves′s an?teroposterior dimension, transverse diameter, cross-sectional area and fasciculus echo, thescreen clothstructure, epineuri?um and the demarcation with neighbourhood structures. Correlation of MNSI with ultrasound performance of tibia nerve was also tested. Results Compared with group A, transverse diameter in group B did not show a obvious change, but anteropos?teror dimension, transverse diameter, cross-sectional area in group C, group D all increase.(P 0.05). There was a positive correlation between the nerves′s anteroposterior di?mension, transverse diameter, cross-sectional area with MNSI, rs were 0.656、0.657 and 0.681 respectively (P<0.05 in all three cases). Conclusion Certain correlation was observed between MNSI and tibial never ultrasonic feature in T2DM pa?tients;the higher MNSI scores , the greater chance of presence of abnormal sonographic features of tibial nerve.

lnvestigation of the refractive status of preschool children in Xiantao, Hubei Province / 国际眼科杂志(Guoji Yanke Zazhi)

AlM: To investigate the refractive status of the preschool children in Xiantao, Hubei Province in order to find out the abnormal refraction error beyond the physiological range. METHODS: ln this cross - sectional study, we investigated preschool children in kindergartens and the scattered ones were 12 716 ( 25 432 eyes ) ranging from 6mo ~ 6 years old. 1 581 children ( 3 162 eyes ) were diagnosed ametropia by Suresight refractive screening instrument, which were confirmed again after mydriasis optometry. RESULTS: The incidence rate of ametropia in preschool children in Xiantao was 12. 4%, and statistics showed no significant difference between boys and girls (P>0. 05), but had differences of morbility rate among each age group (P CONCLUSlON: The incidence rate of ametropia decreases with age increasing in the preschool children from 6mo~6 years old, which imply preschool children should have mydriasis optometry in order to find out amblyopia and other congenital eye disease.

Prevalencia de neuropatía periférica en diabéticos tipo 2 en el primer nivel de atención / Prevalence of peripheral neuropathy among primary care type 2 diabetic patients

Background: Neuropathy is a common complication of diabetic patients. Aim: To determine the prevalence of diabetic peripheral neuropathy in Type 2 diabetic patients attended at a family medicine unit. Material and Methods: Cross-sectional assessment of 348 type 2 diabetic patients aged 34-89 years (60% females) with a disease duration of 5 to 15 years. Peripheral neurological status was evaluated using The Michigan Neuropathy Screening Instrument, a tool that includes a self-assessment of symptoms and a physical examination. Results: Diabetic neuropathy was found in 240patients (69%). The prevalence in males and females was 72 and 67% respectively. The prevalence in patients with a disease duration of 5, 10 and 15 years, was 59, 69 and 77%, respectively. Fifty percent of patients with neuropathy complained of dry skin, 2% had ulcers, 43% had an abnormal perception of vibration and 29% had an abnormal monofilament test. Conclusions: The overall prevalence of peripheral neuropathy in this group of patients was 69% and was directly associated with the duration of the disease.

Alcohol Use Disorder Identification Test (AUDIT): explorando seus parâmetros psicométricos / Alcohol Use Disorder Identification Test (AUDIT): exploring its psychometric parameters

OBJETIVO: O presente estudo teve como objetivo conhecer evidências de validade e precisão do Alcohol Use Disorder Identification Test (AUDIT). MÉTODOS: Contou-se com uma amostra de conveniência (não probabilística) de 547 estudantes universitários de Fortaleza (CE), com idade média de 21,6 anos (dp = 4,86; amplitude de 18 a 53), a maioria do sexo masculino (51,5%), solteira (91,4%) e católica (62,5%). Os participantes responderam ao AUDIT e a perguntas demográficas. Procurando conhecer a estrutura fatorial, além de estatísticas descritivas, realizou-se uma Análise de Componentes Principais. Adicionalmente, a fim de avaliar a precisão do instrumento, efetuaram-se cálculos de alfa de Cronbach (consistência interna), correlações de r de Pearson e coeficiente de correlação intraclasse - ICC (precisão teste-reteste). RESULTADOS: De acordo com a análise de componentes principais com rotação oblimin, a estrutura bifatorial do AUDIT mostrou-se coerente, com todos os itens apresentando saturações satisfatórias, superior a -0,40-, tendo o Fator 1 explicado 47,5% da variância total com alfa de 0,84 e o Fator 2 explicado 11,6% da variância total com alfa de 0,69. Os resultados do teste-reteste indicaram correlação forte entre os dados obtidos na primeira (t1) e segunda (t2) aplicação (r tt = 0,94, p < 0,01), sem diferença significativa de médias nos dois tempos (m t1 = 0,37, dp = 0,49; m t2 = 0,34, dp2= 0,47; p > 0,05), com ICC satisfatório (0,96). CONCLUSÕES: Os achados apoiaram a adequação psicométrica do AUDIT, com as análises fatoriais exploratórias apontando como mais satisfatória a estrutura com dois fatores, bem como atestaram sua boa estabilidade temporal.

OBJECTIVE: This study aimed to know evidences of validity and reliability of the Alcohol Use Disorder Identification Test (AUDIT). METHODS: For this purpose, we considered 547 college students from Fortaleza (CE) with a mean age of 21.6 years (sd = 4.86, varying from 18 to 53), mostly male (51.5%), single (91.4%) and catholic (62.5%). The participants answered the AUDIT and demographic questions. Looking to know AUDIT's factorial structure, we carried out a principal component analysis. Additionally, in order to evaluate its reliability, we calculated Cronbach's alpha (internal consistency), Pearson correlation r and intraclass coefficient correlation - ICC (test-retest). Also, descriptive statistics were evaluated. RESULTS: According to the principal component analysis using oblimin rotation, the bifactorial structure of the AUDIT proved to be consistent, once all items showed satisfactory saturations exceeding -0.40-, with the first factor explaining 47.5% of the total variance with alpha of 0.84 and Factor 2 explaining 11.6% of the total variance with alpha of 0.69. The results of the test-retest showed strong correlation between data obtained in the first (t1) and in the second (t2) applications (r tt = 0.94, p < 0.01), with no significant difference between the means in both applications (m t1 = 0.37, sd = 0.49, = 0.34 m t2, dp2 = 0.47, p > 0.05) with satisfactory ICC (0.96). CONCLUSIONS: The findings support the psychometric adequacy of the AUDIT, with the exploratory factor analysis pointing as more satisfactory the structure with two factors, and also showing its good temporal stability.

Prodromal Questionnaire: translation, adaptation to Portuguese and preliminary results in ultra-high risk individuals and first episode psychosis / Questionário Prodromal: tradução, adaptação para o português e resultados preliminares em indivíduos de ultra-alto risco e primeiro episódio psicótico

OBJECTIVE: The Prodromal Questionnaire (PQ) is a 92-item self-report screening tool for individuals at ultra-high risk (UHR) to develop psychosis. This study aims to present the translation to Portuguese and preliminary results in UHR and first episode (FE) psychosis in a Portuguese sample. METHODS: The PQ was translated from English to Portuguese by two bilingual researchers from the research program on early psychosis of the Instituto de Psiquiatria HCFMUSP, São Paulo, Brazil (ASAS - "Evaluation and Follow up of Adolescents and Young Adults in São Paulo") and back translated by two other researchers. The study participants (n = 11-) were evaluated through the Portuguese version of the Prodromal Questionnaire (PQ) and SIPS. RESULTS: The individuals at UHR (n = 7) presented a lower score than first episode patients (n = 4). The UHR mean scores and standard deviation on Portuguese version of the PQ were: 13.0 ± 10.0 points on positive symptoms subscale, and FE patients: 33.0 ± 10.0. CONCLUSION: The UHR and FE patients' of this study presented PQ scores similar to the ones found in the literature; what suggests that it is possible to use the PQ in Brazilian help-seeking individuals as a screening tool.

OBJETIVO: O Questionário Prodromal (PQ) é um instrumento de triagem e autorrelato com 92 itens para indivíduos com ultra-alto risco (UHR) para desenvolver psicose. Este estudo tem como objetivo apresentar a tradução desse questionário para português e seus resultados preliminares em uma amostra brasileira de UHR e primeiro episódio (FE) psicótico. MÉTODOS: O PQ foi traduzido do inglês para o português por dois pesquisadores bilíngues do programa de pesquisa sobre psicose precoce do Instituto de Psiquiatria HCFMUSP, São Paulo, Brasil (ASAS "Avaliação e Acompanhamento de Adolescentes e Jovens Adultos em São Paulo") e retrotraduzido por dois outros pesquisadores. Os participantes (n = 11) do estudo foram avaliados por meio da versão em português do Questionário de Prodromal (PQ) e SIPS. RESULTADOS: Os indivíduos com UHR (n = 7) apresentaram menor pontuação do que os pacientes de primeiro episódio (n = 4). Os escores médios e desvio-padrão dos indivíduos de UHR na versão em português do PQ foram: 13,0 ± 10,0 pontos na subescala de sintomas positivos, e dos pacientes de primeiro episódio: 33,0 ± 10,0. CONCLUSÃO: Neste estudo os indivíduos de UHR e pacientes de FE apresentaram pontuação do PQ semelhantes às encontradas na literatura, o que sugere a possibilidade de usar a PQ como um instrumento de triagem em indivíduos brasileiros que apresentam comportamento de procura de ajuda.

SigN-PQ neuropathic pain questionnaire development and validation in English and Filipino languages

OBJECTIVES: This study aimed to develop and validate a simple questionnaire for chronic neuropathic pain that can be administered as a screening tool by general practitioners and internists in order to help them identify patients with probable neuropathic pain. METHODS: Following a development phase and a pilot study, the revised version of the screening tool which included eleven descriptors associated with neuropathic pain both in English and Filipino languages was validated on 120 consecutive patients with any type of pain except psychogenic pain, recruited in the out-patient clinics of six hospitals. The questionnaire was validated by assessing the sensitivity, specificity, positive and negative predictive value of each item and the overall questionnaire. The internal consistency of the questionnaire items was assessed using the Kuder-Richardson formula 20. RESULTS: Overall, the internal consistency of the SigN-PQ using the Kuder-Richardson formula 20 was 0.7837; the sensitivity was 91.89% with specificity of 80.22%, PV (+) was 65.38% and PV(-) was 96.0%. For the English version, the descriptors with the highest scores were burning (Sensitivity: 100%, Specificity: 93%) and electricity-like (Sensitivity: 100%, Specificity: 93%). For the Filipino version, mainit (burning) has the highest sensitivity of 88% with specificity of 82.6%, followed by gumagapang (tingling) with sensitivity of 86.96% and specificity of 85.42%. The sensation of saksak (stabbing) and hiwa (lancinating) have the lowest sensitivity, 60% and 54% respectively, although their specificity scores are high. Since this study is a validation of a screening tool for neuropathic pain, the investigators decided to choose descriptors with higher sensitivity. Thus, in the final version of the SignN-PQ, the descriptors saksak and hiwa were removed. CONCLUSION: The SigN-PQ Neuropathic Pain Questionnaire has a high overall sensitivity of 91.89% and specificity of 80.22%. The pain descriptors in the questionnaire are consistent with the descriptors cited in the literature. It is a valid screening instrument for neuropathic pain that can be easily incorporated in the daily practice of general practitioners and internists.

Reliability and validity of community screening interview for dementia-revised korean / 中华行为医学与脑科学杂志

Objective To test the reliable and valid of community screening interview for dementia-revised korean(CSID-K). Methods Study sample consisted of a dementia patient group and three control groups (depression, education, no-education), each of them was composed of 30 community residing elders in Korea. CSID-K was administered, and demographic characteristic, depression, and cognitive function were investigated. Results Split half reability (Guttmans'), internal consistency (Cronbach' s α), and inter-rater and test-retest (two weeks) reliabilities of the CSID-K were excellent. Scores on the CSID-K were significantly correlated with other measures for cognitive function. In addtion, scores on the CSID-K were significantly between the dementia patient group and three control groups. Conclusion CSID-K was a reliable and vaild instrument to screen dementia in Korean community residing old people. It could be used in clinical settings and for cross-cultural researches.