ABSTRACT
Desde la publicación de DSM-5, se ha vuelto más importante llevar a cabo un diagnóstico diferencial para distinguir a las personas con TEA de los trastornos de personalidad del grupo C. El objetivo de la presente investigación fue identificar un perfil de personalidad de sujetos con trastorno del espectro autista (TEA) utilizando el Inventario de Personalidad Multifásico de Minnesota (MMPI) para llevar a cabo dicho diagnóstico diferencial. La muestra del estudio consistió en un total de 178 sujetos divididos en cuatro grupos de comparación. El grupo TEA obtuvo un perfil de personalidad MMPI con un código característico 2-0 que era específico para esta muestra de personas con TEA leve, y puntuaciones más altas en las escalas 6, 7 y 8 en relación con las otras puntuaciones de la escala. Se identificó un perfil de personalidad MMPI específico para los sujetos con TEA que diferenció a este grupo de los otros grupos estudiados. (AU)
Since the publication of DSM-5, it has become more important to carry out a differential diagnosis to distinguish people with autism spectrum disorder (ASD) from cluster C personality disorders. The aim of the present research study was to identify a personality profile of adults with ASD using the Minnesota Multiphasic Personality Inventory (MMPI) in order to carry out this differential diagnosis. The study sample consisted of a total of 178 subjects divided into four groups for comparison purposes. The ASD group obtained a MMPI personality profile with a characteristic 2-0 code that was specific to this sample of people with mild ASD, and higher scores in scales 6, 7 and 8 relative to the other scale scores. A specific MMPI personality profile was identified for ASD subjects, which differentiated this group from the other groups studied. (AU)
Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Adult , Middle Aged , Autism Spectrum Disorder , Personality Disorders , Spain , Diagnosis, Differential , MMPI , Epidemiology, Descriptive , Cross-Sectional Studies , Retrospective StudiesABSTRACT
ABSTRACT Objective: To evaluate the correlation between the UCLA and Constant-Murley scores in the surgical treatment of rotator cuff tears and proximal humeral fractures (PHF). Methods: Retrospective study evaluating patients submitted to arthroscopic rotator cuff repair and surgical treatment of PHF with 2-year follow-up. Patients were evaluated by the UCLA and Constant-Murley scores in the preoperative period for the rotator cuff repairs, and 3, 6, 12 and 24 months after surgery for both diagnoses. Pearson's correlation coefficient (r) was calculated to measure the degree of correlation between the two clinical scales. Results: We evaluated 109 patients: 54 with rotator cuff tear and 55 with PHF. Twenty-four months after surgical treatment, the scores according to the UCLA and Constant-Murley scores were 32.6 ± 4.0 and 85.0 ± 12.0 for the rotator cuff tears and 30.3 ± 5.3 and 73.8 ± 13.9 for the PHF, demonstrating significant improvements in both, in relation to the initial evaluation (p < 0.001). The scales demonstrated high correlation (r = 0.88, p < 0.001). The scores obtained in the two scales showed high or very high correlation in all the postoperative clinical evaluations (r = 0.79-0.91, p < 0.001). The correlation was high in the preoperative evaluation (r = 0.73, p < 0.001). Conclusion: The UCLA and Constant-Murley scores presented high or very high correlation in the evaluation of surgical treatment of rotator cuff tears and PHF. The correlation in the preoperative evaluation was high.
RESUMO Objetivo: Avaliar a correlação entre as escalas da UCLA e de Constant-Murley no tratamento cirúrgico de roturas do manguito rotador e de fraturas da extremidade proximal do úmero (FEPU). Métodos: Estudo retrospectivo, que avaliou pacientes submetidos ao reparo do manguito rotador por via artroscópica e tratamento cirúrgico de FEPU com dois anos de seguimento. Os pacientes foram avaliados pelas escalas da UCLA e de Constant-Murley no período pré-operatório nas roturas do manguito rotador e após seis, 12 e 24 meses da cirurgia em ambos os diagnósticos. O coeficiente de correlação de Pearson (r) foi calculado para medir o grau de correlação entre as duas escalas clínicas. Resultados: Avaliamos 109 pacientes, 54 com rotura do manguito rotador e 55 com FEPU. Após 24 meses do tratamento cirúrgico, as pontuações pelas escalas da UCLA e da Constant-Murley foram de 32,6 ± 4,0 e 85,0 ± 12,0 nas roturas do manguito rotador e 30,3 ± 5,3 e 73,8 ± 13,9 nas FEPU, com melhoria significativa em ambas em relação à avaliação inicial (p < 0,001). As escalas demostraram alta correlação (r = 0,88, p < 0,001). Em todas as avaliações clínicas pós-operatórias as pontuações obtidas nas duas escalas se correlacionaram de modo alto ou muito alto (r = 0,79 a 0,91, p < 0,001). No pré-operatório a correlação foi alta (r = 0,73, p < 0,001). Conclusão: As escalas da UCLA e de Constant-Murley apresentam uma correlação alta ou muito alta na avaliação do tratamento cirúrgico das roturas do manguito rotador e das FEPU. No pré-operatório a correlação é alta.
Subject(s)
Humans , Male , Female , Arthroscopy , Rehabilitation , Shoulder , Shoulder Fractures , Weights and Measures , Rotator CuffABSTRACT
Se presentan aspectos esenciales del proceso de clasificación de los niveles de profundidad anestésica mediante señales electroencefalográficas. Se fundamenta el mencionado proceso desde un estudio exhaustivo que permitió precisar sus principales referentes. Finalmente, se realiza una caracterización de su estado actual, teniendo en cuenta los principales índices de profundidad anestésica y tipos de monitores comercializados.
Essential aspects of the classification process of anesthetic depth levels are presented by means of electroencefalographic signs. The abovementioned process is supported from an exhaustive study that allowed to specify its main aspects. Finally, a characterization of its current state is carried out, taking into account the main indexes of anesthetic depth and types of marketed displays.
Subject(s)
Environmental Monitoring , AnesthesiaABSTRACT
Se presentan aspectos esenciales del proceso de clasificación de los niveles de profundidad anestésica mediante señales electroencefalográficas. Se fundamenta el mencionado proceso desde un estudio exhaustivo que permitió precisar sus principales referentes. Finalmente, se realiza una caracterización de su estado actual, teniendo en cuenta los principales índices de profundidad anestésica y tipos de monitores comercializados(AU)
Essential aspects of the classification process of anesthetic depth levels are presented by means of electroencefalographic signs. The abovementioned process is supported from an exhaustive study that allowed to specify its main aspects. Finally, a characterization of its current state is carried out, taking into account the main indexes of anesthetic depth and types of marketed displays(AU)
Subject(s)
Humans , Male , Female , Anesthesia , Neurophysiological Monitoring , Preparation ScalesABSTRACT
Multiorgan failure remains one of the leading causes of late morbidity and mortality after severe trauma. In the early phase, it is related with an uncontrolled hyper-inflammation state, whereas in the late phase (>72 h), septic complications play a major role. We review the underlying pathophysiology, the evaluation with different scales and the clinical factors associated with multiorgan failure, as well as potential treatment options.
Subject(s)
Multiple Organ Failure/etiology , Wounds and Injuries/complications , Humans , Injury Severity Score , Multiple Organ Failure/diagnosis , Multiple Organ Failure/physiopathology , Multiple Organ Failure/therapyABSTRACT
INTRODUCTION: Acute bronchiolitis (AB) is a very common disease, with a high rate of seasonal hospitalization. Its management requires homogeneous clinical interpretations for which there are different approaches depending on the scales, none of which are properly validated today. OBJECTIVE: To create an AB severity scale (ABSS) and to validate it. MATERIAL AND METHOD: The development of a parameterized construct with a gradual cumulative score of respiratory rate, heart rate, respiratory effort, auscultation of wheezing and crackles, and the inspiration/expiration ratio. Also, the validation of the ABSS performed on patients diagnosed with AB, the reliability measured by observing the behavior of internal consistency, test-retest, external validity and inter-observer agreement. RESULTS: From a total of 290 measurements a Cronbach's reliability alpha of 0.83 was obtained; Kappa agreement index of 0.93 in the test-retest agreement, and Kappa index of 0.682 (α<0.05) for inter-observer agreement. CONCLUSIONS: The ABSS can be a reliable tool for measuring the severity of AB.
Subject(s)
Bronchiolitis/diagnosis , Severity of Illness Index , Acute Disease , Diagnostic Techniques, Respiratory System/standards , Humans , Infant , Infant, Newborn , Reproducibility of ResultsABSTRACT
OBJECTIVE: The aim of this study was to compare the predictive value of two clinical prognostic models, the Spanish score and the simplified Pulmonary Embolism Severity Index (sPESI), in an independent cohort of patients diagnosed of acute symptomatic pulmonary embolism (PE). METHODS: We performed a retrospective analysis of a cohort composed of 1447patients with acute symptomatic PE. The Spanish score and the sPESI were calculated for each patient according to different clinical variables. We assessed the predictive accuracy of these scores for 30-day mortality, and a composite of non fatal recurrent venous thromboembolism and non fatal major bleeding, using Cstatistic, which was obtained by means of logistic regression and ROC curves. RESULTS: Overall, 138 patients died (9.5%) during the first month of follow-up. Both scores showed an excellent predictive value for 30-day all-cause mortality (Cstatistic, 0.72 and 0.74), but the performance was poor for the secondary endpoint (Cstatistic, 0.60 and 0.59). The sPESI classified fewer patients as low risk (32% versus 62%; P<.001). Low-risk patients based on the sPESI had a lower 30-day mortality than those based on the Spanish score (1.1% versus 4.2%), while the 30-day rate of non fatal recurrent VTE or major bleeding was similar (2.2% versus 2.3%). CONCLUSIONS: Both scores provide excellent information to stratify the risk of mortality in patients treated of PE. The usefulness of these models for nonfatal adverse events is questionable. The sPESI identified low-risk patients with PE better than the Spanish score.
Subject(s)
Models, Biological , Prognosis , Pulmonary Embolism/mortality , Severity of Illness Index , Acute Disease , Aged , Aged, 80 and over , Anticoagulants/adverse effects , Embolectomy , Female , Follow-Up Studies , Hemorrhage/chemically induced , Hemorrhage/epidemiology , Hospital Mortality , Humans , Male , Middle Aged , Predictive Value of Tests , Pulmonary Embolism/drug therapy , Pulmonary Embolism/prevention & control , Pulmonary Embolism/surgery , ROC Curve , Recurrence , Retrospective Studies , Risk Assessment , Spain/epidemiology , Thrombolytic Therapy , Vena Cava Filters , Venous Thromboembolism/epidemiology , Venous Thromboembolism/therapyABSTRACT
El intento de suicidio en los pacientes diagnosticados con Trastorno Límite de la Personalidad (TLP) es la causa más frecuente de hospitalización en esta categoría clínica, los riesgos suicidas constituyen con frecuencia la presentación del padecimiento. Los pacientes recaen continuamente generando altos costos personales-familiares, de hospitalización en tratamientos, medicación e incapacidades laborales en personas económicamente activas, siendo el costo más alto, la pérdida de la vida humana. La Asociación Psiquiátrica Americana, en el Manual del DSM-IV, define el trastorno límite de la personalidad como: <