Prevalencia de prediabetes y diabetes mellitus en la región de Zulia, Venezuela: resultados preliminares del estudio EVESCAM / Prevalence of prediabetes and diabetes mellitus in the Zulia region, Venezuela: preliminary results of the EVESCAM study

Determinar la prevalencia de prediabetes y de Diabetes Mellitus (DM) en el estado Zulia, Venezuela. Métodos: se realizó un estudio poblacional, aleatorio, descriptivo utilizando los datos del Estudio Venezolano de la Salud Cardiometabólica (EVESCAM) de la región zuliana incluyendo 525 sujetos adultos de ambos géneros. Se aplicó una encuesta sobre factores de riesgo, antecedentes de DM, se registró peso, talla, índice de masa corporal (IMC) kg/m2, circunferencia de cintura en cm (CC) y presión arterial. Se les tomó muestra de sangre para determinación de glucemia, perfil lipídico y prueba de tolerancia a la glucosa (PTG). Los resultados presentados en tablas y figuras utilizando promedios y desviación estándar, procesados con programa estadístico SSPS, la prevalencia fue calculada y ajustada por edad y sexo, fijando un valor alfa menor de 0,05 (P<0,05) como significativo. Resultados: En total 404 sujetos completaron la evaluación: 126 (31,1%) hombres y 278 (68,8 %) mujeres, con edad promedio de 49,6 ± 15,8 años, Glucemia basal: 108,5 ± 28,9 y PTG a las 2 horas 120,6 ± 37,2 mg/dl. La prevalencia de diabetes ajustada por edad y sexo resultó de 16,0%; 19,9% en hombres y 12,1% en mujeres (P = 0,029) y para Prediabetes 58,5%; 65,8% en hombres y 51,3% en mujeres (P= 0,005). Conclusiones: La población zuliana presentó elevada prevalencia de prediabetes y diabetes mellitus. Urge la necesidad de intervención a través de programas de prevención que detengan su avance(AU)

To determine the prevalence of prediabetes and Diabetes Mellitus (DM) in the State of Zulia, Venezuela. Methods: A clinical, randomized, descriptive study was conducted using data from the Venezuelan Cardio-Metabolic Health Study (EVESCAM) of the Zulian region, including 525 adults of both genders. A risk factors questionnaire, history of DM, weight, height, body mass index (BMI) kg/m2, waist circumference in cm (CC), and blood pressure were measured. Blood samples were taken to determine of Glycaemia, lipid profile, and glucose tolerance test (GTT). Results were presented in tables and figures using averages and standard deviation, analyzed with the software SSPS statistical program, prevalence was calculated and adjusted by age and sex, alpha value lower than 0.05 (P <0.05) was considered significant. Results: A total of 404 subjects completed the evaluation: 126 (31.1%) men and 278 (68.8%) women, with a mean age of 49.6 ± 15.8 years; baseline glycaemia were 108.5 ± 28,9 and GTT 120.6 ± 37.2 mg/dl. The age-standardized diabetes prevalence was 16.0%; 19.9% in men and 12.1% in women (P = 0.029); and the age-standarized prevalence of prediabetes was 58.5%; 65.8 in men and 51.3 in women (P =0.005). Conclusions: Zulia´s population presented a high prevalence of prediabetes and diabetes mellitus. To implement an intervention program to halt it´s progress is of urgent need(AU)

Las múltiples caras de la hospitalización parcial / The many faces of partial hospitalization

Se revisa el papel de la hospitalización parcial dentro del marco de la continuidad asistencial de los servicios de salud mental. A partir del análisis de cuatro casos ejemplificadores de las diversas opciones terapéuticas de estos programas, se cuestionan algunos mitos en relación con esta modalidad y se subrayan las evidencias establecidas con respecto a ésta. Asimismo, se identifican sus principales funciones y los aspectos fundamentales e idiosincráticos que caracterizan a este tipo de recursos.

This paper reviews partial hospitalization in the context of the continuum of care of mental health services. This is accomplished through the analysis of four case examples that illustrate different modalities offered by these programs. Myths about this treatment modality are discussed in light of available evidence. The principal functions, in addition to the fundamental and unique features characteristic of partial hospitalization are identified and discussed.

Discriminant efficiency of antisocial and borderline personality disorder criteria in Hispanic men with substance use disorders.

The authors examined the discriminant efficiency of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition ( DSM-IV ) criteria for borderline personality disorder (BPD) and antisocial personality disorder (APD). Subjects were 74 men admitted to an outpatient substance abuse program for monolingual Hispanic adults. All were reliably assessed with the Spanish-language version of the Diagnostic Interview for DSM-IV Personality Disorders. Conditional probabilities were calculated to determine the diagnostic efficiency and discriminant efficiency of BPD and APD symptoms. Twenty-five (34%) subjects met diagnostic criteria for BPD, and 16 (22%) met criteria for APD. The diagnostic co-occurrence of these disorders was statistically significant. Whereas the diagnostic efficiency of the BPD criterion set was comparable to that reported in other clinical studies, these criteria were not significantly more efficient in diagnosing BPD than APD. By contrast, the APD criteria were more efficient in diagnosing APD than BPD; this was true for both the "adult" and the "conduct disorder" APD criterion subsets. In male Hispanic outpatients with substance use disorders, BPD and APD show significant diagnostic overlap. The APD criteria are useful in discriminating these 2 disorders, whereas the BPD criteria are not. These findings have implications for the discriminant validity of the BPD and APD criteria and support the value of the conduct disorder criteria in predicting APD in adulthood.

The Spanish-Language Version of the Diagnostic Interview for DSM-IV personality disorders: development and initial psychometric evaluation of diagnoses and criteria.

We describe the development of the Spanish-Language Version of the Diagnostic Interview for DSM-IV Personality Disorders (S-DIPD-IV). Initial descriptive (frequency and gender distribution of personality disorders [PDs]) and psychometric findings (inter-rater reliability of diagnoses, internal consistency, and criteria inter-relatedness) are reported based on administration of the S-DIPD-IV to 95 adult monolingual Hispanic patients. The S-DIPD-IV had adequate inter-rater reliability for most PD (mean kappa =.83). Except for the significantly greater proportion of males diagnosed with antisocial PD, no significant gender differences in the distribution of PD were observed. Within-category inter-relatedness of PD criteria was evaluated by coefficient alpha and mean intercriterion correlations (MIC). Between-category criteria overlap was evaluated by intercategory mean intercriterion correlations between all pairs of PD (ICMIC). For PD criteria, alpha ranged .36 to .99 (mean =.75, median =.81), MIC ranged .07 to .95 (mean = .36), and ICMIC ranged.09 to.45 (mean = .24). Six PD (borderline, antisocial, narcissistic, avoidant, obsessive-compulsive, and depressive) had no instances in which their criteria sets correlated higher with those of other PD than their own. Two PD (histrionic and dependent PD) had some instances of overlap, and four PD (paranoid, schizotypal, schizoid, and passive-aggressive) had pervasive overlap with other PD criteria sets. These findings suggest the utility of the S-DIPD-IV for assessing PD in Spanish-speaking Hispanic outpatients. Our initial findings for this patient group suggest that, except for antisocial PD in males, specific PD diagnoses are not differentially distributed by gender. Moreover, except for cluster A PD, the criteria for specific PD tend to be more highly correlated within than across PD. The S-DIPD-IV appears to have utility to facilitate PD research with Hispanic groups.