Traducción y análisis de validez de contenido del instrumento Opening Minds Scale for Healthcare Practitioners (OMS-HC) para la evaluación del estigma hacia la enfermedad mental en profesionales de la salud en Chile / Translation and content analysis of the Opening Minds Scale for Healthcare Practitioners (OMS-HC) for the assessment of stigma towards mental illness in health care professionals in Chile

INTRODUCCIÓN: Las personas con enfermedades mentales con frecuencia experimentan estigma por parte de profesionales de la salud, por lo que es necesario disponer de instrumentos para evaluar el estigma e implementar acciones para reducirlo. Este manuscrito describe el proceso de traducción y validación de contenido en Chile del instrumento Opening Minds Scale for Healthcare Practitioners (OMS-HC), para la evaluación del estigma en profesionales de la salud hacia personas con enfermedad mental desarrollado originalmente en Canadá. MÉTODO: Se realizó la traducción y análisis de validación de contenido, incluyendo etapas de traducción inglés-castellano y traducción inversa por traductora profesional, triangulación, y finalmente consulta a expertos para evaluación de validez de contenido según Índice de Validez de Contenido (IVC) con 10 expertos de investigación, academia, y experto por experiencia en salud mental. Se consideró aceptables ítems con IVC entre 0,51-0,99. RESULTADOS: Del total de 20 ítems del cuestionario, dos fueron evaluados con IVC menor al establecido, relacionados con constructos "hope" y "compassion", propios del marco teórico-modelo de Recovery, base del instrumento. Los dos ítems fueron re-evaluados con autores originales para adaptarlos procurando fidelidad al constructo, en un proceso iterativo con expertos. CONCLUSIONES: Se presenta la traducción del instrumento Opening Minds Scale for Healthcare Practitioners (OMS-HC) adaptado al castellano y con análisis de su validación de contenido, consistente de 20 ítems para evaluación del estigma hacia personas con enfermedades mentales en profesionales de la salud, posibilitando nuevos estudios que analicen su validez de criterio, y la exploración de su utilidad a nivel local.

INTRODUCTION: People with mental illnesses frequently experience stigma from health care professionals, which is why it is an urge to count with adequate assessments to evaluate stigma to address it. This manuscript describes the process of language translation and content validation in Chile of the Opening Minds Scale for the assessment of stigma against people with mental illnesses in Healthcare Practitioners (WHO-HC), originally developed in Canada. METHODS: Language translation and content validation analysis were performed, including English-Spanish translation and reverse translation by professional translator, item triangulation by researchers, and content validity analysis of the translated questionnaire by expert evaluation based on the Content Validity Index (CVI), including 10 experts in academia, research, and one expert by experience. Items rated with CVI 0.51-0.99 were considered acceptable. RESULTS: From the total of 20 items of the questionnaire, two were rated with lower CVI than acceptable, specifically related to the constructs "hope" and "compassion", part of the theoretical framework of Recovery in which the questionnaire is based on. The two items were re-evaluated including original authors to adapt them seeking fidelity to the foundational constructs, through an iterative process with experts. CONCLUSIONS: The translation of the Opening Minds Scale for Healthcare Practitioners (WHO-HC) is presented, adapted to Spanish in Chile after content analysis, consisting of 20 items for the evaluation of stigma towards people with mental illness in health professionals, enabling the development of new studies to analyze criterion validity, and the exploration of feasibility and utility at the local level.

Urban areas, human health and technosols for the green deal.

Authors aim to carry out a bibliographic review as an initial approach to state of the art related to the quality of urban soils, as well as its possible link with human health. This concern arises from the need to highlight the consequences that soil could face, derived from the growth and aging of the population, as well as its predicted preference for urban settlement. Urban development may pose a challenge to the health of urban soils, due to degradative processes that it entails, such as land take, sealing, contamination or compaction. A healthy soil is the one which maintains the capacity to support ecosystem services, so it can provide numerous benefits to human health and well-being (carbon sequestration, protection against flooding, retention and immobilization of pollutants and a growth media for vegetation and food production). This article addresses threats facing urban soils, the strategies put forward by the European Union to deal with them, as well as the issues that require further attention. Greening cities could be a consensual solution, so authors analyze whether soils of cities are ready for that challenge and what resources need to maintain soil ecosystem functions. This review proposes to use made by waste Technosols for a sustainable green city. Although the use of Technosols as a type of soil is very recent, the interest of the scientific community in this field continues to grow.

Inflammatory bowel disease in Mexico: Epidemiology, burden of disease, and treatment trends. / Epidemiología, carga de la enfermedad y tendencias de tratamiento de la enfermedad inflamatoria intestinal en México.

INTRODUCTION AND AIMS: There is no systematized information for determining/monitoring the burden of inflammatory bowel disease in Mexico. The aim of the present study was to estimate the annual burden of inflammatory bowel disease on the Mexican National Healthcare System, by number of patients seen, hospitalizations, and specific deaths, stratified into age groups. MATERIALS AND METHODS: Utilizing specific databases of the Mexican National Healthcare System registries coded as ICD-10: K50 and K51, we retrieved and analyzed the data corresponding to the patients seen and hospitalized in 2015, stratified by age group, as well as the specific deaths. Treatment trends among physicians were also examined. RESULTS: In 2015, 5,009 women (8.1) and 4,944 men (8.4) with Crohn's disease received medical attention (prevalence of cases seen) and 35.1% of those patients were ≥50years of age. In that same period, 17,177 women (27.7) and 15,883 men (26.9) with ulcerative colitis were seen and 31.6% of those patients were ≥50years of age. The hospitalized cases (prevalence of hospitalized cases) were 1,097 patients (0.91) with Crohn's disease and 43.7% of those patients were ≥50years of age; and 5,345 patients (4.42) with ulcerative colitis and 47.6% of those patients were ≥50years of age. Deaths (specific mortality rate) were: 32 women (0.52) and 36 men (0.50) due to Crohn's disease, and 267 women (4.31) and 186 men (3.15) due to ulcerative colitis. CONCLUSIONS: Inflammatory bowel disease is a burden on the health of Mexican adults and the Mexican National Healthcare System, and it is expected to increase over the next 15years.

Oral status, quality of life, and anxiety and depression in hemodialysis patients and the effect of the duration of treatment by dialysis on these variables.

This study aimed is to evaluate the oral health status, quality of life, anxiety and depression among hemodialysis patients and to analyze the effect of the duration of dialysis on these variables. 120 patients on hemodialysis and 120 control subjects underwent oral examination, periodontal evaluation, xerostomia study using a Visual Analogue Scale (VAS), sialometry evaluation; quality of life (QOL) using the OHIP-14 questionnaire and anxiety/depression. Bleeding index, CPTIN, clinical attachment level, and probing depth were significantly higher in the hemodialysis group than the control group (p < 0.001). VAS scores were higher in patients on hemodialysis with significant differences in 6 of the 8 domains (p ≤ 0.05). Unstimulated whole saliva was significantly lower in hemodialysis patients than control subjects (p < 0.001). OHIP-14 scores showed significantly poorer QOL in patients on hemodialysis than control subjects (p = 0.042). Hemodialysis patients presented greater depression and anxiety than control (p < 0.001). Periodontal health was worse among the patients who had been in treatment >10 years, xerostomia and sialorrea was worse in patients treated for 5-9.9, and >10 years, QOL was worse in patients who had spent <1 year; depression and anxiety was greater among those treated for 1-2.9 years. In conclusion, Oral health, QOL, anxiety and depression are worse in patients on hemodialysis, and oral health deteriorates as the time spent in dialysis lengthens, but patients in treatment for <3 years presented the poorest QOL and the greatest anxiety and depression.

Inserção do lúdico como facilitador da hospitalização na infância: percepção dos pais / Insertion of play as facilitator of hospitalization in childhood: parental perception

Objetivo: conhecer a percepção dos pais quanto a inserção de atividades lúdicas durante a internaçãohospitalar da criança. Métodos: estudo qualitativo, descritivo e exploratório, realizado de outubro adezembro de 2012 em um hospital no Brasil. Foram entrevistados seis pais de crianças internadas. Aentrevista ocorreu em duas etapas: inicialmente, as crianças foram abordadas de forma lúdicadurante os cuidados de enfermagem. Após foram realizadas entrevistas semiestruturadas com os pais.O estudo foi aprovado pelo Comitê de Ética e Pesquisa sob o número 083/2012. Resultados: da análisesurgiram dois eixos temáticos: as dificuldades encontradas pelas crianças durante o período deinternação hospitalar, e, os benefícios da inserção de atividades lúdicas durante a hospitalização.Considerações finais: com a utilização de atividades lúdicas, conclui-se que essas são capazes detornar o ambiente hospitalar menos ameaçador, possibilitando resgatar sorrisos e alegria de sercriança.

Objective: to know the perception of the parents regarding the insertion of play activities duringthe hospitalization of the child. Methods: qualitative, descriptive and exploratory study, carried outfrom October to December 2012 in a hospital in Brazil. Parents of six hospitalized children wereinterviewed. The interview was made in two stages: first, the children were raised in a playful,during nursing care. After, semi-structured interviews with the parents were conducted. The studywas approved by the Research Ethics Committee with number 083/2012. Results: two theme fromthe analysis emerged: the difficulties faced by children during the hospitalization, and the benefitsof inclusion of recreational activities during hospitalization. Final considerations: with the use ofrecreational activities, we can conclude that they are able to make the hospital environment leastthreatening, enabling rescue smiles and the joy of being a child.

Body composition prediction equations based on deuterium oxide dilution method in Mexican children: a national study.

BACKGROUND/OBJECTIVES: Obesity and undernutrition co-exist in many regions of Mexico. However, accurate assessments are difficult because epidemiological data on body composition are not available. The aim of this study was to facilitate assessments of body composition in Mexican school children of different geographical regions and ethnicity by developing equations for bioelectrical impedance and anthropometry based on deuterium oxide dilution. SUBJECTS/METHODS: We evaluated 336 subjects (143 belonged to six major indigenous groups) from Northern, Central and Southern Mexico. We measured height (Ht), weight (Wt), tricipital skinfold (Tricp-SKF) and resistance (R) based on a bioimpedance analysis (BIA). Fat-free mass (FFM) and fat mass (FM) were estimated from measurements of total body water with the deuterium dilution technique. RESULTS: The final BIA equation was FFM (kg)=0.661 × Ht²/R+0.200 × Wt-0.320. The R² was 0.96; the square root of the mean square error (SRMSE) was 1.39 kg. The final anthropometric equation was FM (kg)=-1.067 × sex+0.458 × Tricp-SKF+0.263 × Wt-5.407. The R² was 0.91; SRMSE was 1.60 kg. The BIA equation had a bias of 0.095 kg and precision of 1.43 kg. The anthropometric equation had a bias of 0.047 kg and precision of 1.58 kg. CONCLUSIONS: We validated two equations for evaluating body composition in Mexican indigenous and non-indigenous children and youth from three main regions of the country. These equations provided reliable estimates and will promote a better understanding of both obesity and undernutrition.

The efficacy of direct tissue fluorescence visualization in screening for oral premalignant lesions in general practice: an update.

OBJECTIVE: The aim of this communication is to revise papers published on autofluorescence imaging, a non-invasive technique that is used to identify neoplastic oral cavity lesions. METHODS: A literature search was performed, using the PubMed database and the key words 'autofluorescence' and 'Velscope', limiting the search to papers in English or Spanish published from 2002 to June 2009. RESULTS: The Velscope(®) system has a sensitivity of 98-100% and specificity of 94-100%. Autofluoresence is a supplementary tool used in the diagnosis of oral cancer, although other more reliable and robust studies are needed for confirmation. CONCLUSIONS: There is insufficient evidence to demonstrate that its use as an adjunct to conventional oral screening provides additional benefit to conventional oral cancer screening alone.

Local immune responsiveness following intravaginal challenge with Candida antigen in adult women at different stages of the menstrual cycle.

Recurrent vulvovaginal candidiasis (RVVC) is a significant problem in women of childbearing age and is most often caused by Candida albicans that asymptomatically colonizes mucosal tissues. Although some form of local immune dysfunction is postulated to precipitate bouts of RVVC, the normal protective vaginal host response to C. albicans is poorly understood. In an effort to stimulate the natural adaptive response to yeast in healthy women without a history of VVC, commercial Candida skin test antigen was introduced intravaginally and changes in cytokines/immunomodulators were monitored in vaginal lavage fluid pre- and post-antigen challenge. In an earlier pilot study using small numbers of women without controlling for stages of the menstrual cycle, we reported elevated cytokines in vaginal secretions of antigen challenged women. The present study, however, that employed a similar design in a large number of women during each stage of the menstrual cycle showed no evidence of local immune stimulation, including changes in Th and proinflammatory cytokines, IgE, histamine, and prostaglandin, despite a natural modulation of vaginal cytokines over the course of the menstrual cycle. Taken together, these results suggest that either some form of vaginal immunoregulation/tolerance is evident in response to yeast or that more advanced clinical designs are required to detect the normal protective vaginal response to C. albicans.

[Fulminating myocarditis: myocardial recovery after circulatory assistance]. / Myocardite fulminante: récupération myocardique après assistance circulatoire.

The clinical expression of acute myocarditis is variable from paucisymptomatic to fulminating forms which are usually lethal within days. The latter presentation takes the form of very acute cardiac failure. During this phase, the severity of myocardial dysfunction may be such that death ensues. However, if the patient survives, paradoxically, these forms have a better long-term prognosis with complete recovery of myocardial function being possible after the acute phase. The authors report a typical case of fulminating myocarditis with electromechanical dissociation, which recovered completely after a period of circulatory assistance. This case illustrates the rapidity of deterioration of the haemodynamic status and the importance of organ dysfunction despite early management. In a review of the literature, the authors found about 150 reported cases of acute myocarditis treated with circulatory assistance. In the best series, about half the patients were weaned off the circulatory assistance without having to undergo cardiac transplantation. However, the potential recovery of myocardial function is difficult to predict.

Growth inhibition of Candida albicans by human vaginal epithelial cells.

Vulvovaginal candidiasis (VVC) is a common mucosal infection caused by Candida species in women of childbearing age. Although acute VVC affects a large number of women and is often precipitated by hormonal fluctuations involving high estrogen levels, recurrent VVC (RVVC) affects another 5%-10% of women without any known predisposing factors. We have recently reported that vaginal epithelial cells from nonhuman primates and mice inhibit the growth of Candida albicans in vitro, which may represent an innate host defense mechanism against C. albicans at the vaginal mucosa. In the present study, we show that vaginal epithelial cells collected from healthy women with no history of VVC also exhibit anti-Candida activity, with no differences in activity at various stages of the menstrual cycle. Women diagnosed with RVVC, on the other hand, have reduced epithelial cell anti-Candida activity. These results are further evidence that vaginal epithelial cells provide an innate host resistance mechanism against Candida and that reduced activity may contribute to RVVC.

Hepatocellular carcinoma and hepatic cirrhosis in Mexico: a 25 year necroscopy review.

BACKGROUND/AIMS: Hepatocellular carcinoma (HCC) is a common form of cancer which is found throughout the world. In recent years, the rates of HCC seem to have increased in European and North American countries. Herein, a retrospective review of necroscopy records over a 25-year period was undertaken in order to determine the incidence of HCC in a Mexican population. METHODOLOGY: A retrospective review of necroscopy records was performed to determine the incidence of HCC and then to determine the presence or absence of associated cirrhosis in these cases. The tumor/cirrhosis relationship was determined by computing the TC/T and TC/C indexes. RESULTS: Of 12556 autopsies studied, 73 cases of histologically proven HCC were reported, representing a total necropsy carcinoma incidence of 0.59%. Fifty-five cases were associated with cirrhosis (0.43%), and 18 were not (0.14%). HCC was two times more common in males (67%) than in females (33%), with a ratio of 2:1. During this period, the necropsy incidence of HCC rose steadily to twice its original level (1965-69 incidence 0.35%; 1985-89 incidence 0.69%). The necropsy incidence of cirrhosis was 4% (329 males, 185 females). The overall TC/T index was 75% (87% for males and 50% for females). The overall TC/C index was 10.7% (13% for males and 6.4% for females). CONCLUSIONS: There was a two-fold increase in the incidence of HCC in the Mexican population studied over a 25-year period. HCC was associated with cirrhosis in the majority of cases. HCC was two times more common in males than in females in patients with cirrhosis; in patients without cirrhosis, the ratio was 1:1. The incidence of cirrhosis was 4%, which remained unchanged with the passage of time.

[Cystic tumors of the pancreas]. / Tumores quísticos del páncreas.

Cystic tumors of the pancreas are rare, accounting for only 10 to 15% of cystic lesions of the pancreas and 1% of malignant neoplasms. They can be benign or malignant and well circumscribed and localized. Their identification, the differential diagnosis and treatment are difficult and one example is that up to a third of them may be confused with pseudocysts. The most important are serous microcystic cystadenomas, mucinous cystadenomas, mucinous cystadenocarcinomas, mucin-producing adenocarcinomas and adenocarcinomas associated to pseudocyst or to simple cyst. The most useful studies for diagnosis are ultrasound, computed axial tomography, endoscopic retrograde cholangiopancreatography, guided punction of the cyst with study of the fluid, and biopsy. The choice of the type of treatment depends on the variety of the tumor. The localization and extension, the surgical risk, the experience of the surgeon and the institutional resources. The prognosis of these tumors is better than that of ductal adenocarcinoma, even if they are malignant.

Tuberculosis skin testing in pregnancy: trends in a population.

BACKGROUND: A change has recently been noted in the epidemiology of tuberculosis in the United States. Multiple factors, including human immunodeficiency virus (HIV) infection, increases in the homeless population, and immigration, are cited as causes for an increased prevalence. The population of pregnant women in New Orleans exhibits several of these risk factors and may be compared with a previous description of this group reported in 1983. METHODS: All patients requesting obstetric care at the Medical Center of Louisiana at New Orleans from January 1994 to April 1995, were offered tuberculosis skin testing during their initial outpatient clinic visit. A skin test was considered positive if there was 10 mm of induration (5 mm in HIV-positive patients) at 48 hours. Other information collected included HIV status and ethnic group. This group was compared with a group of patients tested in 1981 and 1982. RESULTS: The study included 1621 patients, who underwent testing and had available results. The only significant risk factor for a positive skin test in 1994 was Hispanic ethnicity. Hispanics are the most recent immigrants to the New Orleans area. In 1983 Asians were at highest risk and were the newest immigrants to the city. HIV status was insignificant as a predictor of skin test conversion. CONCLUSIONS: Pregnant women at highest risk for tuberculosis in this urban center are recent immigrants to the United States. This is consistent with data reported by the Centers for Disease Control and Prevention from other locales. Efforts should be made to ensure that recently immigrated pregnant women receive skin testing as part of their obstetric care.

Asbestos-related diseases. Algorithm for forensic pathological diagnosis.

The pathological diagnosis and proof of asbestos causation in environmental-occupational diseases is based on a spectrum of increasingly sophisticated determinations with greater confidence in detection of asbestos bodies and fibers. These include the following: pathology (histology) and/or thick smears of lung, microincineration, bulk chemical digestion, and electron beam instruments. The requisites of medical and forensic asbestos causation differ, and do not always require the full range of these analytical techniques. The need and significance of some of these determinations, as expressed in number of asbestos bodies and fibers, may be related in many cases to the evidence of asbestosis; to the gross and microscopic pathological findings (asbestosis, lung carcinoma, mesothelioma); the exposure history (type, duration, intensity, and period of latency); and nature of the asbestos mineral. An algorithm for the forensic pathological diagnosis of asbestosis and of asbestos-related diseases is proposed.

Cortisone induced alterations of costal cartilage in single and in parabiosed rats.

Cortisone-treated Buffalo rats have been parabiosed with untreated controls of the same age. The optical and electron microscopy, including histochemistry, of costal cartilage of these rats has been compared with that in single cortisone treated rats, single controls, and control parabiosed with control rats, at 14 and 28 days after parabiosis. Single cortisone-treated rats, in comparison to controls, have shown the greatest alteration in cellular morphology and in the extracellular matrix both at 14 and at 28 days. Cortisone-treated parabiosed rats demonstrate a gradation of these alterations. Cellular alterations include enhancement of lipid and glycogen deposition concrurently with the presence of numerous large cytoplasmic vacuoles containing beaded irregularly-shaped filaments, banded or unbanded collagen-like fibrils, and/or electron dense lamellar bodies. In the extracellular matrix, matrix vesicles, amianthoid fibers, randomly oriented unbanded fibrillar materials, and filament-like materials are most prominent in the single cortisone-treated rats and they are progressively less prominent in the cortisone-treated parabiosed rats, and in the parabiosed and single controls. Calcification of the extracellular matrix follows a similar pattern and is observed initially in pericellular halos of the single cortisone and in cortisone-treated rats parabiosed with controls. Histochemical techniques have shown that chondroitin sulfate is less demonstrable in the single cortisone and in the cortisone-treated parabiosed rats than it is in the single or parabiosed controls at 14 days but, at 28 days, all untreated or treated rats, single or parabiosed are basically comparable. Glycoproteins are prominent in the single cortisone-treated rats both at 14 and at 28 days and, at these same times, they are progressively less prominent in the cortisone-treated parabiosed rats and in the single or parabiosed controls. Many of the cortisone induced alterations in costal cartilage are suggestive of enhancement of the aging process.