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1.
Int J Neural Syst ; 30(9): 2050045, 2020 Sep.
Article in English | MEDLINE | ID: mdl-32689842

ABSTRACT

Visual neuroprosthesis, that provide electrical stimulation along several sites of the human visual system, constitute a potential tool for vision restoration for the blind. Scientific and technological progress in the fields of neural engineering and artificial vision comes with new theories and tools that, along with the dawn of modern artificial intelligence, constitute a promising framework for the further development of neurotechnology. In the framework of the development of a Cortical Visual Neuroprosthesis for the blind (CORTIVIS), we are now facing the challenge of developing not only computationally powerful tools and flexible approaches that will allow us to provide some degree of functional vision to individuals who are profoundly blind. In this work, we propose a general neuroprosthesis framework composed of several task-oriented and visual encoding modules. We address the development and implementation of computational models of the firing rates of retinal ganglion cells and design a tool - Neurolight - that allows these models to be interfaced with intracortical microelectrodes in order to create electrical stimulation patterns that can evoke useful perceptions. In addition, the developed framework allows the deployment of a diverse array of state-of-the-art deep-learning techniques for task-oriented and general image pre-processing, such as semantic segmentation and object detection in our system's pipeline. To the best of our knowledge, this constitutes the first deep-learning-based system designed to directly interface with the visual brain through an intracortical microelectrode array. We implement the complete pipeline, from obtaining a video stream to developing and deploying task-oriented deep-learning models and predictive models of retinal ganglion cells' encoding of visual inputs under the control of a neurostimulation device able to send electrical train pulses to a microelectrode array implanted at the visual cortex.


Subject(s)
Blindness/rehabilitation , Cerebral Cortex , Deep Learning , Electrocorticography , Equipment Design , Image Interpretation, Computer-Assisted , Models, Theoretical , Retinal Ganglion Cells , Software Design , Visual Prosthesis , Humans
2.
Clin Microbiol Infect ; 22(8): 732.e1-8, 2016 Aug.
Article in English | MEDLINE | ID: mdl-27181408

ABSTRACT

It is important to know the spectrum of the microbial aetiology of prosthetic joint infections (PJIs) to guide empiric treatment and establish antimicrobial prophylaxis in joint replacements. There are no available data based on large contemporary patient cohorts. We sought to characterize the causative pathogens of PJIs and to evaluate trends in the microbial aetiology. We hypothesized that the frequency of antimicrobial-resistant organisms in PJIs has increased in the recent years. We performed a cohort study in 19 hospitals in Spain, from 2003 to 2012. For each 2-year period (2003-2004 to 2011-2012), the incidence of microorganisms causing PJIs and multidrug-resistant bacteria was assessed. Temporal trends over the study period were evaluated. We included 2524 consecutive adult patients with a diagnosis of PJI. A microbiological diagnosis was obtained for 2288 cases (90.6%). Staphylococci were the most common cause of infection (1492, 65.2%). However, a statistically significant rising linear trend was observed for the proportion of infections caused by Gram-negative bacilli, mainly due to the increase in the last 2-year period (25% in 2003-2004, 33.3% in 2011-2012; p 0.024 for trend). No particular species contributed disproportionally to this overall increase. The percentage of multidrug-resistant bacteria PJIs increased from 9.3% in 2003-2004 to 15.8% in 2011-2012 (p 0.008), mainly because of the significant rise in multidrug-resistant Gram-negative bacilli (from 5.3% in 2003-2004 to 8.2% in 2011-2012; p 0.032). The observed trends have important implications for the management of PJIs and prophylaxis in joint replacements.


Subject(s)
Arthritis, Infectious/epidemiology , Arthritis, Infectious/etiology , Prosthesis-Related Infections/epidemiology , Prosthesis-Related Infections/etiology , Aged , Aged, 80 and over , Anti-Bacterial Agents/pharmacology , Arthritis, Infectious/history , Arthroplasty/adverse effects , Bacteria/drug effects , Cohort Studies , Comorbidity , Drug Resistance, Bacterial , Female , Fungi/drug effects , History, 21st Century , Humans , Male , Middle Aged , Prosthesis-Related Infections/history , Spain/epidemiology
3.
Plant Dis ; 97(7): 994, 2013 Jul.
Article in English | MEDLINE | ID: mdl-30722557

ABSTRACT

Powdery mildew of mango is an important disease in Mexico's northern Sinaloa state. Identification of the causal fungal agent has been hindered by the absence of information regarding its teleomorph, as well as a detailed morphometric analysis of the anamorph and molecular characterization. The first symptoms of the disease appear in mango inflorescences of early February, and it subsequently affects young fruits. The disease progresses during March and early April, causing significant fruit abortion and a scabby appearance in a high percentage of fruits that remain attached to the trees. We observed the disease on inflorescences but not in leaves during our sampling period. Powdery mildew specimens were collected during 2011 and 2012 and included Kent and Keith varieties from commercial orchards, and creole materials from backyards of private residences in the Ahome and Fuerte Counties of northern Sinaloa, Mexico. Symptomatic inflorescences were analyzed morphologically. Conidiophores and conidia were prepared by touching the whitish lesions with clear adhesive tape, which was then placed over microscope slides with a drop of distilled water and observed under a compound microscope. The anamorph structures of the pathogen were measured. The mycelium was septate and ramified on the surface of the host, forming a dense coat of branching hyphae. The mycelium had a diameter of 2.5 to 8.7 µm; conidiophores (Pseudoidium type) emerged from the superficial mycelium, were unbranched, and consisted of 1 to 3 cells with conidia forming singly from the apex. The length of the conidiophores varied from 30.0 to 77.5 µm; the foot cell of the conidiophores was straight, 10.0 to 47.5 µm long and with a diameter of 5.0 to 15.5 µm across its midpoint. Conidia without fibrosin bodies were borne singly, and were ellipsoid/ovoid, 22.5 to 46.2 µm long and 15.0 to 27.5 µm wide. Eighty percent of the germ tubes were forked (lobed); the rest were simple, emerged from the end, and were occasionally on the side of the conidia. Germ tubes ranged from 2.0 to 7.2 µm at the midpoint. The surface of the conidia appeared smooth under the scanning electron microscope, and elliptical conidia appeared constricted at their ends; this, however, was not observed in the ovoid conidia. In both cases, the terminal end of the conidia was smooth. The teleomorph was not found. Molecular and phylogenetic analysis of the ITS rDNA (2) region showed that samples are closely related to specimens of Pseudoidium anacardii (1) (teleomorph: Erysiphe quercicola [4]) collected from mango trees in diverse countries. Measurements of somatic and asexual structures are in agreement with descriptions of P. anachardii (formerly known as Oidium mangiferae) from India (3). The nucleotide sequences derived from this research were deposited in GenBank (Accession Nos. JX893951 to JX893957). To our knowledge, this is the first report of P. anacardii associated to mango inflorescences in Sinaloa, Mexico. Due to the economic importance of powdery mildew of mango trees in Sinaloa, future research directions should focus on finding the teleomorph of the fungus to support its identity. References: (1) U. Braun and R. T. A. Cook CBS Biodiversity Series No. 11, 2012. (2) S. Limkaisang et al. Mycoscience 47:327, 2006. (3) O. Prakash and K. C. Srivastava. Mango diseases and their management. A World Review Today and Tomorrow Publishers. New Delhi, India, 1987. (4) S. Takamatsu et al. Mycol. Res. 111:809, 2007.

4.
Nutr Hosp ; 27(1): 252-5, 2012.
Article in Spanish | MEDLINE | ID: mdl-22566329

ABSTRACT

INTRODUCTION: It is well known that to improve the feeding of the students it would improve its health and wellbeing, contributing to the reduction of the risk of chronic diseases in adults. In Spain, this is especially important considering the data of prevalence of infantile obesity. OBJECTIVES: To know the number of users of school cafeterias in Spain as well as different considerations on its management, nutritional supervision and the number of special diets served to students with specific requirements due to pathologies or other causes. RESULTS: The II national Survey has been realized on school cafeterias: 7,710 used daily by 678,587 users. They provide near the 2.8% of special diets (allergies 38.9%, other pathologies 23.2%, religious causes 26.7% causes and celiac disease 11.1%). CONCLUSIONS: The numbers of prevalence of obesity and infantile overweight indicate that it is necessary to improve the diet of the students.


Subject(s)
Diet , Nutrition Surveys , Schools , Adolescent , Child , Child Nutrition Sciences , Diet Therapy/statistics & numerical data , Female , Humans , Male , Spain , Students
7.
An. pediatr. (2003, Ed. impr.) ; 74(3): 192-192[e1-e16], mar. 2011. ilu, tab, graf
Article in Spanish | IBECS | ID: ibc-88378

ABSTRACT

La importancia de la grasa en la dieta, y su papel en la prevención cardiovascular, es uno de los tópicos nutricionales mejor estudiados y, a pesar de ello, está en continua revisión. Ahora ya conocemos, en especial gracias a los estudios relacionados con la dieta mediterránea, que es más importante la calidad de la grasa que la cantidad de su ingesta. En ese sentido, la grasa saturada y la grasa trans están implicadas en el riesgo aterogénico, por lo que se recomienda que para el diseño de una dieta sana dichos nutrientes se deben sustituir por hidratos de carbono complejos o por grasas insaturadas, manteniendo el consumo de grasa saturada en < 10% y el de trans en < 1% de la ingesta calórica. Estudios poblacionales recientes, en especial el estudio de Kuopio y los trabajos realizados con el modelo de dieta mediterránea, están afianzando cada vez más la importancia de las grasas monoinsaturadas y poliinsaturadas como nutrientes claves para la prevención de las enfermedades crónicas de las sociedades modernas. Por otra parte, un tipo especial de ácidos grasos poliinsaturados, los de la serie omega 3 (n-3), están gradualmente convirtiéndose en nutrientes claves de una dieta sana, especialmente en niños. Por ello parece razonable que 4 sociedades, fuertemente implicadas en difundir los beneficios de la dieta como herramienta para prevenir las enfermedades cardiovasculares, desarrollen un consenso para difundir los nuevos conocimientos sobre la importancia de conseguir un aporte equilibrado y adecuado de grasa en la dieta de las poblaciones industrializadas. Esto justifica este documento realizado por un grupo de expertos de la Sociedad Española de Arteriosclerosis, la Sociedad Española de Medicina Familiar y Comunitaria, la Asociación Española de Pediatría, la Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediátrica y la Sociedad Española de Dietética y Ciencias de la Alimentación, en un esfuerzo porque resulte un trabajo multidisciplinar, orientado tanto a los adultos como a los niños en distintos tramos de edad (AU)


Although dietary fat and its role in cardiovascular prevention has been one of the most extensively studied nutritional topics, it continues to be an ever-expanding research area. Particularly thanks to studies on Mediterranean diet, we now know that fat quality is more relevant than the amount of fat we eat in the diet. Thus, saturated and trans fats have been found to increase the risk of atherogenic disease. This is why it is recommended to substitute complex carbohydrates or unsaturated fat for unsaturated and trans fats with the aim of reducing saturated and trans fat intake to <10% and <1%, respectively, of the total calorie intake. Recent population studies, particularly that conducted in Kuopio, Finland, and those on Mediterranean diet, stress the important role of monounsaturated and polyunsaturated fats as key nutrients in preventing cardiovascular disease in modern societies. Furthermore, a special type of polyunsaturated fatty acids, i.e. those of the omega-3 (n-3) series, is increasingly becoming essential nutrients for a healthy diet, especially in the case of children. Therefore, there is a rationale for four the Scientific Societies that are strongly committed to disseminate the benefits of a healthy diet in preventing cardiovascular disease, and to prepare a joint statement with the purpose of spreading improved knowledge on the importance of changing to a healthy diet with a well-balanced fat intake for industrialized populations. Accordingly, a multidisciplinary panel of experts from the following institutions has developed the present joint statement targeted at both adults and children of different ages: Spanish Society of Arteriosclerosis, Spanish Society of Family and Community Medicine, Spanish Association of Paediatrics, Spanish Society of Gastroenterology, Hepatology and Paediatric Nutrition and Dietetics, and Spanish Society for Food Sciences (AU)


Subject(s)
Humans , Male , Female , Child , Dietary Fats/adverse effects , Cardiovascular Diseases/epidemiology , Risk Factors , Risk Adjustment , Feeding Behavior , Fatty Acids, Monounsaturated/pharmacokinetics , Linoleic Acid/pharmacokinetics
8.
Clín. investig. arterioscler. (Ed. impr.) ; 23(supl.1): 1-36, mar. 2011. ilus, tab
Article in Spanish | IBECS | ID: ibc-128533

ABSTRACT

La importancia de la grasa en la dieta, y su papel en la prevención cardiovascular es uno de los tópicos nutricionales mejor estudiados y, a pesar de ello, está en continua revisión. Ahora ya conocemos, en especial gracias a los estudios relacionados con la dieta mediterránea, que es más importante la calidad de la grasa que la cantidad de su ingesta. En ese sentido, la grasa saturada y la grasa trans están implicadas en el riesgo aterogénico, por lo que se recomienda que para el diseño de una dieta sana dichos nutrientes se deben sustituir por hidratos de carbono complejos o por grasas insaturadas, manteniendo el consumo de grasa saturada en < 10% y el de trans en < 1% de la ingesta calórica. Estudios poblacionales recientes, en especial el estudio de Kuopio y los trabajos realizados con el modelo de dieta mediterránea, están afianzando cada vez más la importancia de las grasas monoinsaturadas y poliinsaturadas como nutrientes claves para la prevención de las enfermedades crónicas de las sociedades modernas. Por otra parte, un tipo especial de ácidos grasos poliinsaturados, los de la serie omega 3 (n-3), están gradualmente convirtiéndose en nutrientes claves de una dieta sana, especialmente en niños. Por ello parece razonable que 4 sociedades, fuertemente (..) (AU)


Although dietary fat and its role in cardiovascular prevention has been one of the most extensively studied nutritional topics, it continues to be an everexpading research area. Particularly thanks to studies on Mediterranean diet, we now know that fat quality is more relevant than the amount of fat we eat in the diet. Thus, saturated and trans fats have been found to increase the risk of atherogenic disease. This is why it is recommended (..) (AU)


Subject(s)
Humans , Dietary Fats/pharmacokinetics , Diet, High-Fat/adverse effects , Cardiovascular Diseases/physiopathology , Fatty Acids/metabolism , Fatty Acids, Monounsaturated/metabolism , Linoleic Acids/metabolism , Margarine
9.
An Pediatr (Barc) ; 74(3): 192.e1-16, 2011 Mar.
Article in Spanish | MEDLINE | ID: mdl-21345757

ABSTRACT

Although dietary fat and its role in cardiovascular prevention has been one of the most extensively studied nutritional topics, it continues to be an ever-expanding research area. Particularly thanks to studies on Mediterranean diet, we now know that fat quality is more relevant than the amount of fat we eat in the diet. Thus, saturated and trans fats have been found to increase the risk of atherogenic disease. This is why it is recommended to substitute complex carbohydrates or unsaturated fat for unsaturated and trans fats with the aim of reducing saturated and trans fat intake to <10% and <1%, respectively, of the total calorie intake. Recent population studies, particularly that conducted in Kuopio, Finland, and those on Mediterranean diet, stress the important role of monounsaturated and polyunsaturated fats as key nutrients in preventing cardiovascular disease in modern societies. Furthermore, a special type of polyunsaturated fatty acids, i.e. those of the omega-3 (n-3) series, is increasingly becoming essential nutrients for a healthy diet, especially in the case of children. Therefore, there is a rationale for four the Scientific Societies that are strongly committed to disseminate the benefits of a healthy diet in preventing cardiovascular disease, and to prepare a joint statement with the purpose of spreading improved knowledge on the importance of changing to a healthy diet with a well-balanced fat intake for industrialized populations. Accordingly, a multidisciplinary panel of experts from the following institutions has developed the present joint statement targeted at both adults and children of different ages: Spanish Society of Arteriosclerosis, Spanish Society of Family and Community Medicine, Spanish Association of Paediatrics, Spanish Society of Gastroenterology, Hepatology and Paediatric Nutrition and Dietetics, and Spanish Society for Food Sciences.


Subject(s)
Cardiovascular Diseases/prevention & control , Dietary Fats , Adolescent , Adult , Child , Dietary Fats/administration & dosage , Health Promotion , Humans , Infant, Newborn , Internationality , Nutritional Physiological Phenomena , Spain
10.
Nutr Hosp ; 22(2): 229-43, 2007.
Article in English | MEDLINE | ID: mdl-17416041

ABSTRACT

OBJECTIVE: to make recommendations on the approach to nutritional problems (malnutrition, cachexia, micronutrient deficiency, obesity, lipodystrophy) affecting HIV-infected patients. METHODS: these recommendations have been agreed upon by a group of expertes in the nutrition and care of HIV-infected patients, on behalf of the different groups involved in drafting them. Therefore, the latest advances in pathophysiology, epidemiology, and clinical care presented in studies published in medical journals or at scientific meetings were evaluated. RESULTS: there is no single method of evaluating nutrition, and diferent techniques--CT, MRI, and DXA--must be combined. The energy requirements of symptomatic patients increase by 20-30%. There is no evidence to support the increase in protein or fat intake. Micronutrient supplementation in only necessary in special circumstances (vitamin A in children and pregnant woman). Aerobic and resistance excercise is beneficial both for cardiovascular health and for improving lean mass and muscular strength. It is important to follow the rules of food safety at every stage in the chain. Therapeutic intervention in anorexia and cachexia must be tailored, by combining nutritional and pharmacological support (appetite stimulants, anabolic steroids, and, in some cases, testosterone). Artificial nutrition (oral supplementation, enteral or parenteral nutrition) is safe and efficacious, and improves nutritional status and response to therapy. In children, nutritional recommendations must be made early, and are a necessary component of therapy. CONCLUSION: appropriate nutritional evaluation and relevant therapeutic action are an essential part of the care of HIV-infected patients.


Subject(s)
HIV Infections/complications , Malnutrition/etiology , Malnutrition/therapy , Nutritional Support , Algorithms , HIV Infections/psychology , Humans , Nutritional Requirements
12.
Nutr Hosp ; 17(3): 122-7, 2002.
Article in Spanish | MEDLINE | ID: mdl-12149811

ABSTRACT

MAIN OBJECTIVES: The aims of the present study are: To carry out a systematic revision of the printed literature on beer consumption and its possible effects on human health. To analyze the possibility of applying techniques used in epidemiological studies considering meta-analysis as the most important element. Meta-analysis is a set of different statistical techniques that aim to get a quantitative and qualitative synthesis of the results of different independent studies on the same subject. METHODS: First we proceed to carry out the bibliographical search and compilation by means of the following Date-Bases: Medline, Embase and Toxline. Beer is used as key word, specifying the time period between January, 1998 and May, 2000. A total of 403 reference works are obtained and subjected to the corresponding criteria of inclusion and exclusion. RESULTS: The meta-analysis of the selected studies related to cardiovascular disease provides an OR of 0.89 (0.89-0.97) which shows that the group of risk falls ill in less cases than the non-exposed. CONCLUSIONS: Beer consumption: possible factor of cardiovascular protection. Nevertheless we must take this consideration with as much caution as possible. It is necessary to determine the effects of beer consumption on the Spanish population.


Subject(s)
Beer , Cardiovascular Diseases/prevention & control , Alcohol Drinking/epidemiology , Bibliometrics , Cardiovascular Diseases/epidemiology , Case-Control Studies , Cohort Studies , Confounding Factors, Epidemiologic , Epidemiologic Methods , Humans , Odds Ratio , Risk , Spain/epidemiology , Temperance
13.
Nutr Hosp ; 17(3): 154-8, 2002.
Article in Spanish | MEDLINE | ID: mdl-12149815

ABSTRACT

GOALS: The appropriate nutritional status of hospitalized patients bears a close relationship with the existence of specialized Clinical Nutrition and Dietetics units or departments at health centres. The presence at these units of professionals with specific training to carry out tasks in the sphere of nutrition and dietetics, as is the case of dietitians, implies and evident strengthening of their capacity and operation. The main goal of the present paper to identify the number of Nutrition and Dietetics Units in the leading Spanish hospitals and also the presence of graduates in dietetics or nutrition specialists. SCOPE: Spanish hospital installations selected from the national hospital index. RESULTS OF THE TRIAL: It can be inferred that the implementation of the said services is not as complete as might be desired, and the presence of specifically qualified professionals (dietitians or nutritionists) is even lower. In this context, one is struck by the growing number of outsourced catering services at Spanish hospitals and the hiring of dietitians by these private companies, often at the request of the hospital itself. CONCLUSIONS: All of the data obtained show an ever greater importance of dietitians in hospital nutrition, with an uneven geographical distribution and implementation in Spain because of the peculiar policy adopted by the health authorities with regard to the recognition of these professionals. In Spain, these departments continue to be scorned and the role of the dietitian ignored.


Subject(s)
Dietetics , Food Service, Hospital/supply & distribution , Nutritional Physiological Phenomena , Attitude of Health Personnel , Hospitals/classification , Hospitals/statistics & numerical data , Humans , Nutrition Disorders/epidemiology , Nutrition Disorders/etiology , Organizational Policy , Spain , Workforce
15.
Aten Primaria ; 18(7): 383-5, 1996 Oct 31.
Article in Spanish | MEDLINE | ID: mdl-8998300

ABSTRACT

OBJECTIVES: To find how much alcohol, tobacco and drugs adolescents consume and identify some linked socio-family variables. DESIGN: A crossover and descriptive study, with randomised sampling stratified by classrooms. SETTING: Secondary schools in the town of Lugo. PATIENTS AND OTHER PARTICIPANTS: 805 students of both sexes from the secondary schools. MEASUREMENTS AND RESULTS: We used a self-filled anonymous semiclosed questionnaire. 34.6% habitually consumed alcohol, of whom 43.3% had got drunk at least once in the previous 6 months and 7.1% on more than 13 occasions. 25.7% were habitual smokers. 12.3% had consumed cannabis; 10.1% tranquilisers; 7.5% amphetamines; 4.6% sleeping pills; 2.1% cocaine; 1.9% LSD; 1.5% heroin. Variables linked to consumption were: age, repeating the school year, considering him/herself a bad student, fighting, consumption by both parents, not doing sports, having more money and not having a good relationship with parents. CONCLUSIONS: Adolescent alcohol, tobacco and drug consumption is high and similar to other regions of Spain. Prevention strategies are needed, in the family, at school and in the media.


Subject(s)
Alcohol Drinking/epidemiology , Smoking/epidemiology , Substance-Related Disorders/epidemiology , Adolescent , Cross-Over Studies , Female , Humans , Male , Spain/epidemiology
16.
Rev Neurol ; 24(129): 554-7, 1996 May.
Article in Spanish | MEDLINE | ID: mdl-8681172

ABSTRACT

Transient global amnesia (AGT) is a well-defined syndrome of unknown aetiology. It is generally believed to be of vascular origin. Other theories suggest epilepsy or migraine as the cause. We studied the clinical features and associated risk factors in 24 patients with AGT, comparing them with two control groups with 24 people in each group, paired for age and sex. The first control group contained healthy individuals (CN) and the second patients with transient ischaemic attacks (AIT). Of the patients with AGT, 70% were women and 30% men. Their average age was 60 (range 14-76). The attacks were abrupt in onset in 100%. In 8% there was a recognisable trigger factor (driving, physical exercise, etc). The average duration was 7 hours. On study of the cardiovascular risk factors, it was found that 36% were hypertensive, 24% had cardiopathy, 12% had diabetes mellitus, 8% were smokers, 4% had polycythaemia, 16% had hyperlipidaemia, 4% were alcoholics. There was a history of migraine in 29%. No patient had a past history of epilepsy. Further investigation showed ECG changes in 12%. In 24% there were non-specific changes in the EEG. On cerebral CT scan there were lesions compatible with ischaemia in 12.5% of the patients. Levels of arterial hypertension were significantly higher in the AGT group as compared to the normal control group (Odds ratio 7.86; CI. 1.29-11.38). A past history of migraine was seen to be a risk factor associated with AGT as compared with both groups of controls (AGT/CN Odds ratio 9.47; CI 1.01-444.92; AGT/AIT Odds ratio > 1.72).


Subject(s)
Amnesia/physiopathology , Brain/physiopathology , Adolescent , Adult , Aged , Amnesia/diagnosis , Amnesia/etiology , Female , Humans , Ischemic Attack, Transient/complications , Ischemic Attack, Transient/physiopathology , Male , Middle Aged , Migraine Disorders/complications , Retrospective Studies , Risk Factors
17.
Aten Primaria ; 11(3): 127-32, 1993 Feb 28.
Article in Spanish | MEDLINE | ID: mdl-8453004

ABSTRACT

OBJECTIVE: To calculate the probable prevalence of mental illness in our clinics and to evaluate how it is detected by Primary Care (PC) doctors. DESIGN: Crossover study in two parts. SITE. Basauri Health Centre (Vizcaya). PARTICIPANTS: A sample made up of patients who attended the clinic without prior appointment during ten days in February and Marc, 1990. MAIN MEASUREMENTS AND RESULTS: In the first part, 10 PC doctors distributed the GHQ-28 questionnaire to 500 patients. In the second part, qualified staff administered the standardised psychiatric interview (SPI) to a sub-sample. 41.55% were possible psychiatric cases (GHQ-28 > 6). 17.94% were diagnosed by the doctors (SD) as psychiatric cases. Prevalences adjusted to the SPI were 19% and 21% for the GHQ-28 and SD respectively. CONCLUSIONS: The GHQ-28 obtained high sensitivity (0.82%) and low specificity (60%), which characterises it as a good screening test, but a bad diagnostic method. The doctors obtained low sensitivity (0.29) and high specificity (89.7%); thus underdiagnosing mental illness, but being more accurate in their diagnoses.


Subject(s)
Community Health Centers , Mental Disorders/epidemiology , Community Health Centers/statistics & numerical data , Female , Humans , Interview, Psychological , Male , Mental Disorders/diagnosis , Prevalence , Primary Health Care/statistics & numerical data , Socioeconomic Factors , Spain/epidemiology , Surveys and Questionnaires
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