Relationship Between Weight and Severity of Fibromyalgia.

Fibromyalgia is a chronic pain syndrome with diffuse pain, muscle weakness, and other symptoms. A relationship between the severity of symptoms and obesity has been observed. Objective: To determine the relationship between weight and the severity of fibromyalgia. Material and Methods: 42 patients with fibromyalgia were studied. BMI and fibromyalgia severity are classified weight by FIQR. Results: The mean age was 47.3 ± 9.4 years, 78% presented severe and extreme fibromyalgia, and 88% were overweight or obese. There was a positive correlation between the severity of the symptoms and the BMI (r = 0. 309). The reliability test for FIQR presented a Cronbach's α of 0.94. Conclusion: About 80% of the participants do not show controlled symptoms, and their prevalence of obesity is high, observing a positive correlation between both.

[Burnout syndrome in medical residents at the General Hospital of Durango, México]. / Síndrome de burnout en médicos residentes del Hospital General de Durango, México.

BACKGROUND: The burnout syndrome is commonly spread among health workers and students, due to the excessive demands they feel on their workspaces. Depersonalization, emotional exhaustion and personal accomplishment are the areas assessed. METHODS: To determine the prevalence of burnout syndrome in medical residents at the General Hospital of Durango; a descriptive, prolective, cross-sectional study was designed and applied to residents of different specialties of the General Hospital of Durango who agreed to participate, the "Maslach Burnout Inventory" was applied. RESULTS: We surveyed 116 residents, 43.1 % (50) women and 56.89 % (66) men. The overall prevalence was 89.66 % (95 % CI: 82.63- 94.54). Affected in a single area the 48.28 % (95 % CI: 38.90-57.74), in two areas the 35.34 % (95 % CI: 26.69-44.76) and in the three areas 6.03 % (95 % CI: 2.46-12.04). Stratified by areas, high emotional exhaustion was 41.38 % (95 % CI: 32.31-50.90), high depersonalization in 54.31 % (95 % CI: 44.81-63.59), and low personal accomplishment 41.38 % (95 % CI: 32.31-50.90). CONCLUSIONS: The prevalence is higher than the reported. The most frequently affected is depersonalization, followed by emotional exhaustion and finally the personal accomplishment. In the areas of Gynecology and obstetrics, Internal medicine, Pediatrics and Orthopedics, the 100 % of the residents are affected.

Introducción: el síndrome de burnout es frecuente en los trabajadores de la salud y educación debido a que se sienten presionados por las excesivas demandas en su espacio de trabajo. Se evalúan tres esferas: despersonalización, agotamiento emocional y realización personal. Métodos: para determinar la prevalencia del síndrome de burnout en los médicos residentes del Hospital General de Durango SSD, se diseñó un estudio descriptivo, transversal, prolectivo y se aplicó el cuestionario Maslach Burnout Inventory a los residentes de las diferentes especialidades del Hospital General de Durango SSD que aceptaron participar. Resultados: se encuestó a 116 residentes, el 43.1 % (50) mujeres y el 56.89 % (66) hombres. La prevalencia general fue de 89.66 % (IC 95 %: 82.63-94.54). Afectados en una esfera el 48.28 % (IC 95 %: 38.90-57.74), en dos esferas el 35.34 % (IC 95 %: 26.69-44.76) y en las tres esferas el 6.03 % (IC 95 %: 2.46-12.04). En las tres esferas, el agotamiento emocional alto fue del 41.38 % (IC 95 %: 32.31-50.90), alta despersonalización en el 54.31 % (IC 95 %: 44.81-63.59) y baja realización personal en el 41.38 % (IC 95 %: 32.31-50.90). Conclusiones: la prevalencia se encuentra por arriba de la reportada. La mayor frecuencia de afectados fue la de despersonalización, seguida por agotamiento emocional y al final la de realización personal. En las especialidades de ginecología y obstetricia, medicina interna, pediatría y ortopedia los residentes se encuentran afectados en el 100 % de su población.

[Comparison of the diagnostic utility from visual inspection with acetic acid and cervical cytology]. / Comparación de la utilidad diagnóstica entre la inspección visual con acido acético y la citología cervical.

BACKGROUND: In Mexico, cervical cancer is the second leading cause of death in women after breast cancer. The human papillomavirus is associated with intraepithelial lesions, detected up to 99.7% of cervical carcinomas. Despite being easy to detect is a condition that many women suffer. OBJECTIVE: To determine the diagnostic utility of the visual inspection with acetic acid of the uterine cervix compared with the cervical cytology. PATIENTS AND METHOD: Study of diagnostic tests. The study was realized in the Centro de Atención Materno Infantil y Planificación Familiar of the Instituto de Investigación Científica, Durango, Mexico, research of the Juárez University of the State of Durango, from August 23, 2005 to November 13, 2006. 1,521 participants were examined who went consecutively to opportune detection of cervical cancer. One doctor practiced the test of acetic acid and cervical cytology to them, and one digital photograph, which was evaluated by three inter-observers triple blind. Those that was positive to anyone of these tests, were remitted to colposcopy and/or biopsy; also to 10% of selected negative population randomly was realized this procedure. Sensitivity, specificity, positive and negative predictive values and exactitude were determined. For the agreement inter-observer index of Kappa was used. RESULTS: Sensitivity, specificity, values predictive positive, negative and exactitude for the visual inspection with acetic acid were 20, 97, 5 and 99%, respectively. For the cervical cytology were of 80, 99, 57 and 99%, respectively. The force of agreement between the interobservant was poor. CONCLUSIONS: In this study cervical cytology was more useful than visual inspection with acetic acid to detect dysplasias or cervical cancer opportunely, due to detect all the positive true cases confirmed by biopsy.

[Prevalence of hypokalemia in patients with methylprednisolone pulse therapy]. / Prevalencia de hipokalemia en pacientes tratados con pulsos de metilprednisolona.

OBJECTIVE: To determine the prevalence of hypokalemia in patients with methylprednisolone pulse therapy. DESIGN: We carried out a descriptive, cross-sectional study. MATERIAL AND METHODS: We enrolled 110 outpatients who received pulse doses of 1 g of intravenous methylprednisolone for three consecutive days. Demographic variables, serum electrolytes and an electrocardiogram were documented. RESULTS: The study group consisted of 31 men (28.2%) and 79 women (71.8%). Average age was 40 +/- 13.6 years. Mild hypokalemia was present in 19 patients (17.27% [95% CI 9.75-24.79]); moderate potassium levels were found in just one patient 0.9% [IC 95 0.023-4.96]); no cases of severe hypokalemia occurred. Total prevalence was 18.18% (95% CI 10.5-25.8). There were no significant electrocardiographic changes. DISCUSSION AND CONCLUSION: Mild and moderate hypokalemia was 18.18% without clinical or electrocardiographic consequences. Since there were no cases of severe hypokalemia, close monitoring of potassium levels should be restricted to those patients with other risk factors.

[Risk factors associated with trigger finger. Case-control study]. / Factores de riesgo asociados a tenosinovitisestenosante. Estudio de casos y controles.

OBJECTIVE: We undertook this study to identify risk factors in our population associated with trigger finger. The study was conducted at the Instituto Mexicano del Seguro Social, UMAE 21, Monterrey, Nuevo Leon, Mexico. METHODS: This was a case-control, retrospective, and observational study. There were 250 patients in each group. For cases, patients who were operated on for trigger finger from March 2006 to August 2006 were included. Controls included patients admitted to the Emergency Department with hand injuries that fulfilled the selection criteria. Risk factors analyzed were diabetes, hypertension, smoking, sex, age, weight, and 19 different occupations. RESULTS: Mean age of the cases was 52 years (SE +/- 14.19 years) with a median and mode of 53 years. The right hand was the most common with the middle, thumb, ring, index and little fingers, respectively. A significant statistical relationship was found: females (OR 7.57, 95% CI 5.07-11.31); diabetes (OR 3.72, 95% CI 2.43-5.70); obesity (OR 1.49, 95% CI 1.02-2.19). With regard to occupation, a statistical relationship was found: homemaker (OR 2.44, 95% CI 1.62-3.69); seamstress (OR 4.8, 95% CI 1.3-21.6); and secretary (OR 2.74, 95% CI 1.38-5.52). CONCLUSIONS: Trigger finger is a common pathology in our population and is more frequent in women >53 years old. It may be related to diabetes, body mass index (obesity) and certain occupations such as secretary, seamstress and homemaker.

Factores de riesgo asociados a tenosinovitisestenosante: estudio de casos y controles / Risk factors associated with trigger finger: case-control study

OBJECTIVE: We undertook this study to identify risk factors in our population associated with trigger finger. The study was conducted at the Instituto Mexicano del Seguro Social, UMAE 21, Monterrey, Nuevo Leon, Mexico. METHODS: This was a case-control, retrospective, and observational study. There were 250 patients in each group. For cases, patients who were operated on for trigger finger from March 2006 to August 2006 were included. Controls included patients admitted to the Emergency Department with hand injuries that fulfilled the selection criteria. Risk factors analyzed were diabetes, hypertension, smoking, sex, age, weight, and 19 different occupations. RESULTS: Mean age of the cases was 52 years (SE +/- 14.19 years) with a median and mode of 53 years. The right hand was the most common with the middle, thumb, ring, index and little fingers, respectively. A significant statistical relationship was found: females (OR 7.57, 95% CI 5.07-11.31); diabetes (OR 3.72, 95% CI 2.43-5.70); obesity (OR 1.49, 95% CI 1.02-2.19). With regard to occupation, a statistical relationship was found: homemaker (OR 2.44, 95% CI 1.62-3.69); seamstress (OR 4.8, 95% CI 1.3-21.6); and secretary (OR 2.74, 95% CI 1.38-5.52). CONCLUSIONS: Trigger finger is a common pathology in our population and is more frequent in women >53 years old. It may be related to diabetes, body mass index (obesity) and certain occupations such as secretary, seamstress and homemaker.

Prevalencia de osteoporosis y osteopenia en mujeres oriundas de la ciudad de Durango, México, de 50 y más años de edad diagnosticadas por DEXA en antebrazo / Prevalence of osteoporosis and osteopenia among women over fifty years of age, from the city of Durango, Mexico, diagnosed by forearm-DEXA

Objetivo: Conocer la prevalencia de osteopenia y osteoporosis medida por absorciometría dual de rayos X en antebrazo en una muestra poblacional de mujeres de 50 y más años de edad oriundas de la ciudad de Durango, México. Material y métodos: Se realizó un estudio descriptivo transversal, donde participaron 258 mujeres de 50 y más años de edad, seleccionadas de forma aleatoria en la zona urbana de la ciudad de Durango, Durango, México, en quienes se evaluó la densidad mineral ósea por absorciometría dual de rayos X en el tercio distal del antebrazo dominante. Resultados: En la muestra poblacional estudiada se encontró osteoporosis en 13.65% (IC 95% 9.6-18.5) y osteopenia en 30.12% (IC 95% 24.5-36.2). El criterio para establecer dichos diagnósticos se basó en la clasificación de acuerdo con los criterios de la Organización Mundial de la Salud. En relación con las características de las mujeres con osteoporosis incluidas en el estudio, el promedio de edad, peso, talla e índice de masa corporal fue de 65 años, 60.5 kg, 147.8 cm y 28.3 kg/m2, respectivamente. Conclusiones: La osteoporosis y la osteopenia en la muestra estudiada guardan una prevalencia relativamente alta en relación directa con la edad. Lo anterior extrapolado a la población sugiere la necesidad de adoptar medidas preventivas que abatan el problema, considerando particularmente el aumento en la expectativa de vida.

OBJECTIVE: To estimate the prevalence of osteopenia and osteporosis using distal forearm dual-energy X-ray absorptiometry among a random sample of women of 50 years or older living in the city of Durango, Mexico. MATERIAL AND METHODS: 258 women participated in a cross-sectional study fielded at the Osteoporosis Clinic of Durango. Bone mineral density was determined by dual-energy X-ray absorptiometry. Scanning was performed on the distal third of the dominant forearm. Diagnosis of osteopenia and osteoporosis was based on the WHO criteria. RESULTS: Osteoporosis was diagnosed in 13.65% (95%CI: 9.6-18.5) and osteopenia in 30.12% (95% CI: 24.5-36.2) of participants. Mean age, weight, height and body mass index were 65 years, 60.5 kg, 147.8 cm and 28.3 kg/m2 respectively. CONCLUSIONS: Osteoporosis and osteopenia were a common diagnosis given the mean age of our sample. These results can be extrapolated to the general population thereby suggesting the need for preventive measures to decrease disease prevalence, especially considering the increase in life expectancy.

[Prevalence of osteoporosis and osteopenia among women over fifty years of age, from the city of Durango, Mexico, diagnosed by forearm-DEXA]. / Prevalencia de osteoporosis y osteopenia en mujeres oriundas de la ciudad de Durango, México, de 50 y más años de edad diagnosticadas por DEXA en antebrazo.

OBJECTIVE: To estimate the prevalence of osteopenia and osteporosis using distal forearm dual-energy X-ray absorptiometry among a random sample of women of 50 years or older living in the city of Durango, Mexico. MATERIAL AND METHODS: 258 women participated in a cross-sectional study fielded at the Osteoporosis Clinic of Durango. Bone mineral density was determined by dual-energy X-ray absorptiometry. Scanning was performed on the distal third of the dominant forearm. Diagnosis of osteopenia and osteoporosis was based on the WHO criteria. RESULTS: Osteoporosis was diagnosed in 13.65% (95%CI: 9.6-18.5) and osteopenia in 30.12% (95% CI: 24.5-36.2) of participants. Mean age, weight, height and body mass index were 65 years, 60.5 kg, 147.8 cm and 28.3 kg/m2 respectively. CONCLUSIONS: Osteoporosis and osteopenia were a common diagnosis given the mean age of our sample. These results can be extrapolated to the general population thereby suggesting the need for preventive measures to decrease disease prevalence, especially considering the increase in life expectancy.

[Prevalence of allergic rhinitis in Durango, Mexico]. / Prevalencia de rinitis alérgica en la ciudad de Durango, México.

BACKGROUND: Allergic rhinitis has become the most frequent chronic disease of upper airways and its prevalence is increasing importantly in countries with systems of western life. OBJECTIVE: To determine the prevalence of allergic rhinitis and its subtypes in inhabitants of Durango, Mexico. MATERIAL AND METHODS: Through a descriptive, cross-sectional study, 1,320 inhabitants of Durango were studied. They were chosen randomly and accepted voluntarily to participate. A modification of the Middleton diary symptom questionnaire was used as a tool to determine the prevalence. RESULTS: The prevalence of allergic rhinitis in the general population was of 7.6% (95% CI 6.2-9.2). The prevalence of seasonal rhinitis was of 5.5% (95% CI 4.4-6.9), of perennial rhinitis, 2.1% (95% CI 1.4-3.0), for medical diagnosis, 4.3% (95% CI 3.4-5.8), and for survey, 3.3% (95% CI 2.4-4.4). The highest frequency was found in persons of 5-9 years old (12.5%) and in women (5.1%). CONCLUSIONS: The prevalence of allergic rhinitis in Durango, Mexico, is similar to the national mean prevalence, but lower than that reported in developed countries.