Revictimization of violence suffered by those diagnosed with alcohol dependence in the general population.

OBJECTIVE: To verify the association between violence and alcohol dependence syndrome in sample populations. METHOD: Population-wide survey with multistage probabilistic sample. 3,744 individuals of both genders, aged from 15 to 75 years, were interviewed from the cities of São Paulo and Rio de Janeiro using the Composite International Diagnostic Interview (CIDI 2.1). RESULTS: In both cities, alcohol dependence was associated with the male gender, having suffered violence related to criminality, and having suffered familial violence. In both cities, urban violence, in more than 50% of cases, and familial violence, in more than 90% of cases, preceded alcohol dependence. The reoccurrence of traumatic events occurred in more than half of individuals dependent on alcohol. In São Paulo, having been diagnosed with PTSD is associated with violence revictimization (P = 0.014; Odds = 3.33). CONCLUSION: Alcohol dependence syndrome is complexly related to urban and familial violence in the general population. Violence frequently precedes alcoholism, but this relationship is dependent on residence and traumatic events. This vicious cycle contributes to perpetuating the high rates of alcoholism and violence in the cities. Politicians ordering the reduction of violence in the large metropolises can, potentially, reduce alcoholism and contribute to the break of this cycle.

Evaluación clínica de hidróxido de calcio en la prevención del dolor en dientes permanentes con pulpa necrótica / No disponible

El dolor postoperatorio como resultado de la terapia de conductos es un efecto colateral bastante frecuente en el tratamiento de dientes con pulpa necrótica sin fístula, que puede durar de horas a días, debido en parte a una reacción inflamatoria de la zona peri-radicular. Objetivo. Fue evaluar la eficacia clínica del hidróxido del calcio en la prevención del dolor en dientes permanentes con pulpa necrótica. Material y métodos. Se realizó un estudio en 80 pacientes de 18 a 45 años que requerían tratamiento endodóncico en piezas no vitales sin fístula. Resultados. Se observó que el uso del hidróxido reduce el dolor y la frecuencia de agudizaciones postoperatorias fue relativamente baja. El análisis estadístico realizado consistió en la aplicación de la prueba ji cuadrada (ᵡ2) para independencia en tablas de contingencia ayudados por el software SPSS versión 12. Conclusiones. Se concluye que el hidróxido de calcio como tratamiento en la prevención del dolor postoperatorio en pulpas necróticas sin fístula, no evita la sintomatología postoperatoria ya que existen otros factores que deben ser considerados y aunque son controlados dentro del tratamiento, pueden ser causa de la aparición del dolor entre citas (AU)

Postoperative pain as a result of the root canal therapy is a very frequent side effect in teeth with necrotic pulps without sinus tract that may last a few hours to several days during the endodontic treatment due to the inflammatory reaction in the periradicular area. Objective. The focus of this study was to evaluate the clinical efficacy of calcium hydroxide in preventing postoperative pain in teeth with necrotic pulps. Materials and Methods. Eighty different patients between 18 and 45 years old who required endodontic treatment in non-vital teeth without sinus tract. Results. It was observed that the frequency of postoperative pain exacerbation was relatively low. the statistical analysis was based on the Chi square test (ᵡ2), for the independence in contingency charts. Software SPSS versión 12 was used. Conclusión. This allows us to reach the conclusion that calcium hydroxide used as a treatment to prevent postoperative pain in necrotic pulps without sinus tract does not avoid postoperative symptomatology because there are other factors that should be taken into account and although they are under control within the treatment, it is possible that they influence over the occurrence of interappointment pain (AU)

The reliability of the Brazilian version of the Composite International Diagnostic Interview (CIDI 2.1).

The objective of the present study was to determine the reliability of the Brazilian version of the Composite International Diagnostic Interview 2.1 (CIDI 2.1) in clinical psychiatry. The CIDI 2.1 was translated into Portuguese using WHO guidelines and reliability was studied using the inter-rater reliability method. The study sample consisted of 186 subjects from psychiatric hospitals and clinics, primary care centers and community services. The interviewers consisted of a group of 13 lay and three non-lay interviewers submitted to the CIDI training. The average interview time was 2 h and 30 min. General reliability ranged from kappa 0.50 to 1. For lifetime diagnoses the reliability ranged from kappa 0.77 (Bipolar Affective Disorder) to 1 (Substance-Related Disorder, Alcohol-Related Disorder, Eating Disorders). Previous year reliability ranged from kappa 0.66 (Obsessive-Compulsive Disorder) to 1 (Dissociative Disorders, Maniac Disorders, Eating Disorders). The poorest reliability rate was found for Mild Depressive Episode (kappa = 0.50) during the previous year. Training proved to be a fundamental factor for maintaining good reliability. Technical knowledge of the questionnaire compensated for the lack of psychiatric knowledge of the lay personnel. Inter-rater reliability was good to excellent for persons in psychiatric practice.

The reliability of the Brazilian version of the Composite International Diagnostic Interview (CIDI 2.1)

The objective of the present study was to determine the reliability of the Brazilian version of the Composite International Diagnostic Interview 2.1 (CIDI 2.1) in clinical psychiatry. The CIDI 2.1 was translated into Portuguese using WHO guidelines and reliability was studied using the inter-rater reliability method. The study sample consisted of 186 subjects from psychiatric hospitals and clinics, primary care centers and community services. The interviewers consisted of a group of 13 lay and three non-lay interviewers submitted to the CIDI training. The average interview time was 2 h and 30 min. General reliability ranged from kappa 0.50 to 1. For lifetime diagnoses the reliability ranged from kappa 0.77 (Bipolar Affective Disorder) to 1 (Substance-Related Disorder, Alcohol-Related Disorder, Eating Disorders). Previous year reliability ranged from kappa 0.66 (Obsessive-Compulsive Disorder) to 1 (Dissociative Disorders, Maniac Disorders, Eating Disorders). The poorest reliability rate was found for Mild Depressive Episode (kappa = 0.50) during the previous year. Training proved to be a fundamental factor for maintaining good reliability. Technical knowledge of the questionnaire compensated for the lack of psychiatric knowledge of the lay personnel. Inter-rater reliability was good to excellent for persons in psychiatric practice.

[Go to the health center or go to the drug store? Pharmacy offices as a primary care resource]. / Ir al centro de salud o bajar a la farmacia? Las oficinas de farmacia como recurso de atención primaria.

OBJECTIVE: To find what the pharmacy office represents socially to the population that uses it most. DESIGN: Qualitative study. Analysis of the contents of two discussion groups. PARTICIPANTS: Women from 30 to 60 years old, urban residents of the Community of Madrid. MEASUREMENTS AND MAIN RESULTS: The pharmacy offices were identified by the user as a primary care resource which was accessible--both because of its closeness and opening hours--and trustworthy. They provided health care support for treating minor ailments ("assisted self-medication") and also advised on medical technicalities and use of medication. Users with potentially serious clinical pictures were referred from the pharmacy to the doctor. The images associated with "going to the doctor" lacked the nearness and familiarity of "dropping round to the pharmacy". CONCLUSIONS: Integrating pharmacy office pharmacists into a general primary care framework would improve the health of the general population.

Predicting the revolving door phenomenon among patients with schizophrenic, affective disorders and non-organic psychoses.

OBJECTIVE: The aim of the study was to identify the variables that predict the revolving door phenomenon in psychiatric hospital at the moment of a second admission. METHODS: The sample consisted of 3,093 patients who have been followed during 5 to 24 years after their first hospital admission due to schizophrenia, and affective or psychotic disorders. Those who had had four or more admissions during the study period were considered as revolving door patients. Logistic regression analyses were used to assess the impact of gender, age, marital status, urban conditions, diagnosis, mean period of stay on the first admission, interval between the first and second admissions on the patterns of hospitalization. RESULTS: The variables with the highest predictive power for readmission were the interval between first and second admissions, and the length of stay in the first admission. CONCLUSIONS: These data may help public health planners in providing optimal care to a small group of patients with more effective utilization of the available services.

¿Ir al centro de salud o bajar a la farmacia? Las oficinas de farmacia como recurso de atención primaria / Go to the health centre or drop round to the chemist's? pharmacy offices as a primary health care resource

Objetivo. Conocer las representaciones sociales que sobre la oficina de farmacia tiene la población más frecuentadora. Diseño. Estudio cualitativo. Análisis del discurso producido por 2 grupos de discusión. Participantes. Mujeres de 30-60 años, residentes urbanas de la Comunidad de Madrid. Mediciones y resultados principales. Las oficinas de farmacia son identificadas por el usuario como un recurso de atención primaria accesible -tanto por su cercanía como por sus horarios- y de confianza. En ellas se realiza una actividad asistencial de apoyo para el tratamiento de dolencias menores ('automedicación asistida'), y por otro lado se aconseja sobre tecnicismos médicos y sobre el uso de la medicación. Desde la farmacia se deriva al médico a los usuarios con cuadros potencialmente graves. Las imágenes asociadas a 'ir al médico' carecen de la cercanía y familiaridad que se asocia a 'bajar a la farmacia'. Conclusiones. La integración de los farmacéuticos de la oficina de farmacia dentro de un marco global de atención primaria supondría una mejora para la salud de la población (AU)

[Left ventricular function. Study during artificial ventilation with PEEP in the dog (author's transl)]. / La fonction ventriculaire gauche. Son étude au cours de la ventilation mécanique avec pression positive expiratoire finale chez le chien.

According to Powers et collaborators the hypothesis that intramyocardial vessels may be collapsed in artificially ventilated patient with added PEEP, could be arisen. So, myocardial ischemia may explain why in some of those ones there appear signs of left ventricular failure. To test whether this reasoning was correct we measured LVEDP in normal dogs submitted to increasing levels of PEEP up to 40 cm H2O. Our results seem to point towards the following conclusions: a) In normal dogs, Starling relation is not altered and remains within the same hypercontractility pattern. b) As PEEP increases, ventricular function remains within the same curve up to 30 cm H2O and jumps to a higher contractility curve at 40 cm H2O of PEEP. All of this would suggest that under our experimental conditions it does not seem reasonable to assume the existence of left ventricular failure due to PEEP influence.