Software para la categorización semiautomática de asociaciones libres sobre el bienestar de trabajadores habaneros / Software for semi-automatic categorization of free associations to promote the welfare of workers of Havana

RESUMEN Introducción: Especialistas de la Facultad de Psicología de la Universidad de La Habana propusieron el cuestionario sobre Bienestar Humano Personal, Laboral y Social (BHPLS), que se aplicó a 135 trabajadores cubanos de tres grupos sociolaborales. Dada la variedad de respuestas, se impuso un análisis de contenido (AC) para la Pregunta 1 del cuestionario. Objetivo: Proponer e implementar un software que permita la categorización semiautomática en un AC para dicha pregunta. Material y Métodos: Se utilizó el índice de concordancia Kappa para evaluar el acuerdo entre expertos respecto al esquema de categorías. Se implementó un software en el lenguaje de programación Python para cumplir el objetivo, considerando las funcionalidades de softwares similares. Resultados: Se implementó, validó y registró un software "BHPLS data processing-UH®" que permite establecer las categorías, cargar los datos, categorizarlos semiautomáticamente y guardar el resultado, entre otras funcionalidades. La categorización manual con estudiantes de Psicología obtuvo un índice de concordancia Kappa negativo (bajo acuerdo entre expertos), mientras que usando el software propuesto, se alcanzó un Kappa global 0.7871 con p=0.00 (alta concordancia y alta significación estadística). Además, se propuso un algoritmo para la unificación de las categorizaciones de expertos y se ejecutó un Análisis de Correspondencias (ANACOR) sobre la combinación de categorizaciones obtenidas. Conclusiones: Dada la alta concordancia alcanzada, se recomienda el uso del software por su adaptabilidad, facilidad de uso y la "humanización" del AC. El ANACOR permitió observar similitudes entre los grupos sociolaborales. Las funcionalidades del software pueden aplicarse para el procesamiento de asociaciones libres en otros escenarios.

ABSTRACT Introduction: Experts of the Faculty of Psychology of the University of Havana proposed the Personal, Labor and Social Human Well-being questionnaire (BHPLS, in Spanish), that was applied to 135 Cuban workers of three social and occupational groups. Given the variety of responses, a content analysis (CA) was used for Question 1 of the mentioned questionnaire. Objective: To present and implement a software that allows a semi-automatic categorization in a CA used for this question. Material and Methods: The Kappa index test was used to evaluate experts´ agreement with respect to category schemes. We implemented a software with the Python programming language to achieve our objective, considering other similar software functionalities. Results: We implemented, validated and registered the software BHPLS data processing-UH® that allows to set up a categories system, load the collected data, categorize associations in a semi-automatic way, and save the results, among other functionalities. This software was validated by Psychology students and, when they performed the manual categorization, a negative Kappa agreement index (low categorization agreement between experts) was obtained whereas using the proposed software, a global Kappa index of 0.7871 with p=0.00 (high and statistically significant categorization agreement between experts) was obtained. Besides, we proposed a unified algorithm for expert's categorizations, and carried out a Correspondence Analysis (ANACOR) on the basis of the categorizations achieved. Conclusions: According to the high concordance attained, we recommend the software due to its adaptability, ease of use, and "humanization'' of the process. The CA allowed us to observe similarities in social and occupational groups. The software functionalities can be applied for processing free associations in other scenarios.

There is an agreement between constipation referred and that documented by objective criteria? / Existe concordância entre constipação referida e constatada por critérios objetivos?

Abstract Introduction Chronic constipation is the most common digestive complaint at the doctor's office, with high prevalence in the population. However, many patients - and even those physicians not so familiar with pelvic floor disorders-define and consider constipation based on intestinal functionality and stool consistency. But symptoms of incomplete defecation, digital maneuvers, abdominal discomfort, and straining should not be overlooked. Objectives To investigate the correlation between constipation referred and documented through objective criteria in patients admitted on a daytime-nursing ward basis at the Hospital Santa Marcelina, São Paulo. Methodology This is a prospective study of a random sample of patients admitted on a daytime-ward hospitalization basis at Santa Marcelina Hospital to perform minor surgical procedures not related to functional disorders of the gastrointestinal tract in the period from September 2014 to June 2015; the only exclusion criterion was "not agreed to participate in the interview conducted by students of medicine at Santa Marcelina Medical School". Results 102 patients were randomly analyzed in the period considered (51% female) with a mean overall age of 48.6 (19-82) years. Constipation has been reported spontaneously by 17.6% of participants and denied by 82.4%. With the implementation of the Cleveland Clinic's criteria for the diagnosis of constipation, the compliance with the referred symptomatology was 88.9%; the same value was found with the use of the Rome III criteria (Kappa = 0.665). In addition, a higher incidence of constipation was observed in female patients (p = 0.002). Conclusion A higher incidence of constipation was observed in female participants, with no statistical difference with respect to age. Furthermore, a substantial agreement was found between constipation referred and constipation documented through objective criteria.

Resumo Introdução A constipação intestinal crônica representa a queixa digestiva mais comum no consultório com elevada prevalência na população. No entanto, frequentemente, os pacientes e mesmo os médicos, não tão afeitos com os distúrbios do assoalho pélvico, definem e consideram constipação baseados na funcionalidade intestinal e consistência das fezes. Entretanto, os sintomas de defecação incompleta, manobras digitais, desconforto abdominal e esforço evacuatório não devem ser negligenciados. Objetivos Verificar a correlação entre constipação intestinal referida e constatada através de critérios objetivos em pacientes internados em regime de enfermaria dia no Hospital Santa Marcelina, São Paulo. Metodologia Estudo prospectivo de amostra aleatória de pacientes internados em enfermaria dia do Hospital Santa Marcelina para realização de cirurgias de pequeno porte e não relacionadas a distúrbios funcionais de trato gastrintestinal no período entre setembro de 2014 e junho de 2015, cujo único critério de exclusão foi o não consentimento em participar da entrevista realizada pelos alunos do curso de medicina da Faculdade Santa Marcelina. Resultados Foram analisados de forma aleatória 102 pacientes no período sendo 51% do sexo feminino e média de idade global de 48,6 anos (19-82 anos). A constipação foi referida de forma espontânea em 17,6% e negada em 82,4%. Ao se utilizar o critério da Cleveland Clinic para constatar constipação houve uma concordância com o sintoma referido fora de 88,9%, com mesmo valor ao se utilizar os critérios de Roma III (Kappa = 0,665). Além disso, verificou-se maior incidência de constipação intestinal nos pacientes do sexo feminino (p = 0,002). Conclusão Verificou-se maior incidência de constipação no sexo feminino sem diferença estatística baseado na idade. Além disso, constatou-se concordância substancial entre a constipação referida e a documentada através de critérios objetivos.

Evaluation of RT-PCR and hemi-nested RT-PCR in brain samples from dogs with neurologic signs compatible with distemper / Avaliação das técnicas de RT-PCR e heminested RT-PCR em cérebros de cães com sinais neurológicos compatíveis com cinomose

The diagnostic value of RT-PCR and hemi-nested RT-PCR (hnRT-PCR) was compared in brain samples of dogs presenting neurological signs compatible with canine distemper. Samples of central nervous system (CNS) were collected from 68 dogs and tested by direct immunofluorescence test (RFID) and, independent of the results, they were stored at -20°C for at least three years. They were submitted to the RT-PCR and hnRT-PCR techniques aiming to determine the gene responsible for the viral nucleoprotein decoding. Fifty-nine samples were positive for RIFD, 40 for RT-PCR (Kappa = 0.358) and 54 for hnRT-PCR (Kappa = 0.740). All nine RIFD negative samples were also negative for RT-PCR and hnRT-PCR. In spite of the storage duration and proper sample conditions, the estimated accordance between hnRT-PCR and RIFD demonstrated that hnRT-PCR technique can be applied in retrospective studies...

Foi comparado o valor diagnóstico das técnicas de RT-PCR e heminested RT-PCR (hnRT-PCR) em amostras de cérebro de cães com sintomatologia nervosa compatível com cinomose. Fragmentos do sistema nervoso central (SNC) colhidos de 68 animais foram testados pela Imunofluorescência direta (IFD) e, independentemente do resultado, foram armazenados a -20°C por pelo menos três anos. Após esse período, foram submetidos a RT-PCR e a hnRT-PCR com oligonucleotídeos iniciadores direcionados ao gene codificador da nucleoproteína N. As proporções de resultados positivos/examinados foram: 59/68 para a IFD, 40/68 para a RT-PCR (Kappa = 0,358) e 54/68 quando associada à heminested PCR (Kappa = 0,740). Houve nove resultados negativos nas três técnicas empregadas. Os resultados do coeficiente Kappa entre a IFD e hnRT-PCR demonstram que apesar das condições de armazenamento, a hnRT-PCR pode ser utilizada em estudos retrospectivos...

Application of Kappa (κ) index in clinical training for eight-year program medical students / 中华医学教育探索杂志

Objective To screened out items with large proportion of technical analysis in obstetrics and gynecology physical examination by using statistical parameters Kappa index and to evaluate effect and clinical significance of Kappa index based on objective data and students' and teachers' subjective feeling.Methods We made Kappa index screening with double-blind method and established the Kappa index table for teachers and students.Students were randomly divided into conventional teaching group (n =26) and teaching reform group (n =29).Students in conventional teaching group traditionally followed the teacher to carry on the practice while those in teaching reform group received training according to the numerical value index and had examination after training.We paid attention to each student's weak points,provided personalized guidance and communicated with students actively.Results We found that it was uneasy for beginners to quickly grasp four step obstetrics palpation in-spection according to Kappa index.There were statistical differences in operation of gynecological physical examination between two groups (P =0.016).Conclusions Application of Kappa index can help us screen out skills in the operation suitable for training for eight-year program medical students.With quantitative evaluation,we can improve quality of clinical practice teaching in department of obstetrics and gynecology and guide educational reform.

Concordancia entre ecocardiografía prenatal y posnatal en pacientes con cardiopatías congénitas: Hospital de Niños Dorctor, Roberto Del Río / Concordance between prenatal and posnatal echocardiography in patients with congenital heart defect

Antecedentes: En Chile las malformaciones congénitas son la primera causa de mortalidad neonatal precoz, siendo las cardiopatías congénitas su principal factor. La incorporación de la ecocardiografía prenatal es de gran ayuda en su pesquisa precoz. Objetivos: Evaluar la ecocardiografía prenatal como prueba diagnóstica y su concordancia con la ecocardiografía posnatal. Métodos: Se analizaron embarazadas derivadas al Hospital de Niños Dr. Roberto del Río entre abril 2004 y abril 2008, por sospecha de cardiopatías congénitas con posterior control neonatal. Resultados: Se evaluaron 188 embarazadas tanto con diagnóstico de cardiopatía congénita como con ecocardiografía normal. La edad gestacional promedio de derivación fue de 32 semanas, siendo la principal causa la sospecha de cardiopatía congénita en el examen obstétrico de rutina. Como prueba diagnóstica se obtuvo una sensibilidad de 100 por ciento y especificidad de 40 por ciento con una moderada concordancia entre ésta y el examen postnatal. Como prueba diagnóstica la ecocardiografía prenatal, se obtuvo una sensibilidad de 100 por ciento y especificidad de 89 por ciento del examen, al ser evaluada como cardiopatías en general, con una muy buena concordancia entre ésta y el examen postnatal. Discusión: Existe una tardía derivación y diagnóstico prenatal de las cardiopatías congénitas a nivel nacional, siendo importante capacitar aún más a los obstetras que realizan este tamizaje. La ecocardiografía prenatal realizada en nuestro centro por cardiólogos es una confiable herramienta diagnóstica con una muy buena concordancia con la ecocardiografía posnatal.

Background: In Chile, congenital malformations are the first cause of early neonatal mortality, the congenital heart defects its the main factor. The incorporation of antenatal echocardiography is very helpful in your research early. Objectives: To evalúate prenatal echocardiography as a diagnosis test and their concordance with postnatal echocardiography. Methods: We analyzed pregnancy who were derived to the Hospital de Niños Dr. Roberto del Rio, between April 2004 and April 2008, where studied because suspicion of having congenital heart defects with subsequent neonatal control. Results: 188 pregnancy were evaluated either with a diagnosis of congenital heart defect or with normal echocardiography. The mean gestational age of derivation was 32 weeks, the main causes the suspicion of congenital heart defect on routine obstetric examination. When being studied as diagnosis test it was obtained a sensitivity of 100 percent and a specificity of 40 percent with a modérate concordance between both echocardiographies. When analyzing with the diagnosis test prenatal echocardiography, it was obtained a sensitivity of 100 percent and a specificity of 89 percent of the review, when evaluated as general heart defect, with a very good concordance between it and the postnatal examination. Discussion: There is a late referral and prenatal diagnosis of congenital heart defect at national level, being important to train obstetricians who perform this screening. Prenatal echocardiography performed by cardiologists at our center is a reliable diagnosis tool with a very good concordance with postnatal echocardiography.

Diagnóstico dermatológico: correlación entre médicos de atención primaria de salud y médicos dermatólogos / Diagnostic concordance between of primary care physicians and dermatologist

En Chile los médicos de Atención Primaria (AP) diagnostican y tratan gran cantidad de enfermedades de la piel. Sin embargo, muchos pacientes requieren ser referidos al Nivel Secundario para ser evaluados por especialistas. Objetivo: El presente estudio tiene como propósito analizar la concordancia del diagnóstico dermatológico realizado por los médicos de AP. Método: Se realizó un estudio retrospectivo en el que se incluyeron 1.478 pacientes referidos desde la AP a la Unidad de Dermatología en el Centro de Referencia de Salud (CRS) Cordillera entre enero de 2005 y enero de 2006. Se registraron sexo, edad, patología cutánea, época del año de la consulta y tiempo de espera para ser evaluados por dermatólogos. Para analizar la concordancia diagnóstico entre el médico general y el dermatólogo se utilizó el índice Kappa (IK), que se clasifica en seis categorías: sin acuerdo (KI < O), insignificante (O < KI > 0,2), discreto (0,21 < KI > 0,40), moderado (0,41 < KI > 0,60), sustancial (0,61 < KI > 0,80) y casi perfecto (0,81 < KI > 1,00). Resultados: La edad promedio de la muestra fue de 34.7 años. 63,8% de las consultas correspondieron a mujeres y 36,2% a varones. Los diagnósticos más frecuentes en la AP fueron: nevi (21,04%), verrugas virales (10,96%), dermatitis inespecífica (6,63%), acné (6,02%), dermatitis atópica (5,4%) y psoriasis (4,67%). Los diagnósticos más frecuentes en Dermatología fueron: nevi (13,80%), verrugas virales (8,19%), acné (6,09%), queratosis seborreico (5,63%) y psoriasis (3,92%). La concordancia diagnóstico (CD) global fue moderada (IK = 0,563), obteniéndose el más alto para acné (IK = 0,899) y alopecia (IK = 0,835), y el más bajo en queratosis seborreico (IK = 0,081) y melanoma (IK = 0,186). Conclusiones: La CD entre médicos de AP y dermatólogos es moderada. Es fundamentar elaborar estrategías...

In Chile, primary care (PC) physicians diagnose and treat large amount of skin diseases; however, a large number of patients are referred to the hospital to be en by dermatologists. Objective: The purpose of the present investigation was to analyse the accuracy of PC physicians in the skin diagnosis diseases. Method: A retrospective analysis of clinical data was performed including 1,478 patients requiring dermatology evaluation at the Dermatology Unit, Centro de Referencia de Salud (CRS) Cordillera, between January 2005 and January 2006. Information about skin disease, sex, age, season consultation and waiting time to see a dermatologist was collected. Kappa index (KI) was used to determine the clinic diagnostic accuracy between the PC physicians and the dermatologists. KI is classified in 6 categories: without agreement (KI < O), insignificant (O < KI > 0.2), discrete (0.21 < KI 0.40), moderate (0.41 < KI > 0.60), substantial (0.61 < KI 0.80) y almost perfect (0.81 < KI > 1.00). Results: The average of age was 34.7 years. 63.8% we females and 36.2% were males. The more frequent skin diagnosis in PC were: nevi (21.04%), warts (10.96%), nonspecific¡ dermatitis (6.63%), acne (6.02%), atopic dermatitis (5.4%) al psoriasis (4.67%). The more frequent skin diagnosis by the dermatologist was: nevi (13.80%), warts (8,19%), acne (6.09%) seborrheic keratosis (5.63%) and psoriasis (3.92%). The general diagnostic concordance (DC) was moderate (KI = 0.56: showing that the highest KI was observed for acne (KI = 0.899) and alopecia (KI = 0.835) and the lowest was for seborrheic keratosis (KI = 0.081) and melanoma (KI = 0.186). Conclusions: The diagnostic correlation between PC physician and dermatologists is moderate. More innovative strategies are needed to improve training in PC physicians to enhance their accurate skin diagnosis.

Qué podemos aprender de la revisión de los trabajos libres enviados al XLI congreso venezolano de cardiología? / What can we learn from the rewiew of the abstracts submitted to the XLI venezuelan congress of cardiology?

Se estudió el proceso de revisión de 118 resúmenes de trabajos recibidos para el XLI Congreso Venezolano de Cardiología. Fueron evaluados independientemente por tres pares de revisores, quienes desconocían los autores y la institución de origen, usando 15 criterios ("ítem"). Expresaron su opinión sobre la aplicabilidad de cada ítem mediante una escala de Likert: totalmente en desacuerdo (TD), en desacuerdo (D), de acuerdo (A) y totalmente de acuerdo (TA). Fueron cuantificadas de 1 a 4 respectivamente, generando un puntaje por criterio, el cual fue multiplicado por un factor de proporcionalidad que asignó pesos diferentes a cada ítem. La suma de los puntajes de ítem (PIs) produjo un puntaje total (PTN) que fue normalizado como % del puntaje máximo posible. Se estudió la variabilidad entre los revisores mediante análisis de correlación / regresión (C / R) y cálculo de índice Kappa. PTN promedio (236 evaluaciones) fue 63,71 + 17% (D. S.) (mínimo 25% y máximo 92,3%). Un 20% con puntajes < 50%, y 11% obtuvieron PTN > 80%. Los resúmenes fueron clasificados en grupos I a IV mediante el promedio de los PTN asignados por los dos revisores. C / R mostró R = 0,35 y R2 = 0,12, m = 0,44 y b = 37% para todos los pares. El análisis por pares mostró valores más satisfactorios para algunos (par 2 y 3) que para otros (par 5 y 6) y 0,15 (par 1 - 4). Los resultados sugieren que el proceso de revisión de los ítem y consensuado su interpretación por los revisores.

A study was carried out of the review process applied to 118 abstracts received by the XLI Venezuelan Congress of Cardiology. Abstracts were assessed independently by pairs of reviewers, blinded as to authors and institutions of origin, using 15 criteria ("items"). Reviews expressed their option about the applicability of each item by means of a Likert scale: Total Disagreement (TD), Disagreement (D), Agreement (A) and Total Agreement (TA). Responses were graded to 1-4, generating a criterion score, which was multiplied by a Proportionality Factor (PF) to assign a weight to each criterion. The sum of item Scores generated a Total Score (NTS) which was normalized as percentage of the maximum possible score. Variability among reviewers was assessed by a correlation/regression analysis (C/R) and by calculating the Kappa index. Mean NTS for all 118 abstracts (236 assessments) was 63.71 + 17% (SD) (min. 25% and max. 92.3%). For 20% of abstracts the NTS < 50% whereas only 11% obtained a NTS > 80%. Abstracts were classified into Groups I to IV on the basis of the mean NTS assigned by two reviewers. C / R yielded R = 0.35 and R2 = 0.12, m = 0.44 and b = 37% for all pairs. Reviews pairs assigned more satisfactory results for some (Pairs 2 - 3) That for others (Pair 5 - 6). The mean Kappa for all pairs was 0.13, ranging from 0.008 (pair 5 - 6) to 0.15 (pair 1 - 4). Our results suggest that the reviews process can be improved by modifying the text of items and by building consensus on its interpretation by reviewers.

Comparison of five different diagnostic criteria on metabolic syndrome applied during physical check-up programs among population aged 35-74,in Taiwan / 中华流行病学杂志

Objective To compare the differences of five diagnostic criteria used for metabolic syndrome (MS),issued by International Diabetes Federation (IDF),the National Cholesterol Education Program (ATPIII),America-Heart-Associatien (AHA),Chinese Medical Association Diabetes Branch (CDS) and The Taiwan Health Bureau (TAIWAN),during a physical check-up program among population aged 35-74 years,in Taiwan.Methods A total number of 28 408 people who had received physical checkup program first time at the MJ centers,were recruited from 2005 to 2007.The prevalence of MS and the degree of agreement were both calculated according to the five definitions and the results of MS components.Distributions and risk factor aggregation of the results were also analyzed.Results According to the five definitions (1)The range of age-adjusted prevalence of MS appeared to be 10.6%(CDS)23.6%(AHA),and were 13.4%(CDS)-27.6%(AliA)and 8.0%(CDS)-20.5%(IDF) for men and women respectively.(2) The range of five MS components were 22.5%(low-HDL-C)-39.7%(high FPG),with 22.3%of the total subjects presented at least 3 risk factors.In addition,0%(AHA),6.7%(TAIWAN),6.9%(ATP III),8.9%(IDF) and 14.9%(CDS) of the subjects diagnosed as MS-free,by the five criterions,also appeared of having≥3 risk factors.(3) Among all the MS subjects,the proportions of clinical symptom complex,having 5,4 and 3 MS components were 8.0%,29.5%and 62.5%respectively.The most common clinical symptoms complex of MS were obesity,hypertension and high FPG.(4) The MS diagnostic criteria of ATPIII,AHA and TAIWAN were in good accordance with Kappa index,showing 0.81-0.98 for the three criteria.CDS and IDF were in relatively weak agreementwhen comparing with other definitions with Kappa index showed as 0.35 and 0.62.Conclusion Our findings revealed big differences in the prevalence and aggregation of risk components on MS,when using the five definitions.We suggested that prospective cohort studies be planned to investigate the impact on cardiovascular disease morbidity and mortality so as to verify whies criterion might be suitable to the population in Taiwan,considering the possible bias.

Utility of Bile Duct Brush Cytology in Pancreaticobiliary Diseases: Prospective Comparative Study of Conventional Smear and MonoPrep2(TM) Liquid Based Cytology / 대한세포병리학회지

Bile duct brush cytology has been employed as a diagnostic tool for the evaluation of pancreatic and biliary tract strictures. The specificity of this method is high however, its sensitivity is quite low. A recent study employing liquid based cytology (LBC) reported results comparable to those achieved via conventional cytology. Therefore, we have attempted to prospectively evaluate the diagnostic utility of bile duct brush cytology in pancreaticobiliary diseases. A total of 46 cases with bile duct stricture were enrolled including 11 cases of benign stricture, 29 cases of bile duct carcinoma, 3 cases of gallbladder cancer, and 3 cases of pancreatic cancer. Both conventional smear and LBC using MonoPrep2(TM) system were conducted in each case. The cytological diagnosis of each case was classed into the following categories; benign, suspicious for malignancy, and malignancy. The diagnostic accuracy of both cytologic methods was investigated. LBC evidenced a high rate of material insufficiency (13/46), which was attributed to low cellularity. The kappa index of both cytological methods was 0.508. Cytological and tissue diagnoses were correlated in 25 cases conducted from biopsy or operation. The sensitivity, specificity, positive predictive value, and negative predictive value were 41.2% (7/17), 100% (8/8), 100% (7/7), and 44.4% (10/18) in conventional smear; 58.8% (10/17), 87.5% (7/8), 90.9% (10/11), and 50.0% (7/14) in LBC; and 94.1% (16/17), 87.5% (7/8), 94.1% (16/17), and 87.5% (7/8) in any one of both cytological methods, respectively. Based on these results, the sensitivity of LBC was found to be superior to that of conventional smear and we were able to obtain higher positive predictive value upto 94.1% by simultaneously conducting both cytologic methods.