Safety liver profile of teriflunomide versus interferon ß in multiple sclerosis: Systematic review and indirect comparison meta-analysis.

OBJECTIVES: To compare the liver safety profile of interferon ß (IFN ß) and teriflunomide in patients with multiple sclerosis. METHODS: A network meta-analysis was carried out following the Cochrane Collaboration methodology. All trials comparing all types of IFN ß with teriflunomide, or disease-modifying drugs, or placebo in RRMS were included. An indirect comparison network meta-analysis within a Bayesian framework with STATA (version 13.0) was done for this study. RESULTS: The database searches yielded 284 titles, with 15 records as duplicates. One study was identified by manually searching. Thirteen articles were included in the systematic review. Twelve studies compared IFN ß (4203 patients) vs another DMT. Four studies evaluated the effectiveness and safety of teriflunomide (906 patients) vs another DMT. Six studies reported drug-induced liver injury as per the Hy's Law. However, only one study had a direct comparison and reported no cases of liver toxicity in either group, so it was not possible to estimate the OR. The indirect comparisons metanalysis shows that there was no statistically-significant difference between teriflunomide and IFN ß (OR 1.09, 95% CI 0.02-2.16). CONCLUSIONS: There were no significant difference when comparing IFN ß and teriflunomide in terms of liver failure or elevation of transaminases.

Capital social en áreas rurales: adaptación al español y validación factorial de una escala / Social capital in rural areas: adaptation to Spanish and factor validation of a scale

El capital social se considera un determinante estructural de desarrollo y bienestar social. Su componente cognitivo evalúa el grado de confianza de la población en sus sistemas de organización social, así como las interacciones comunitarias que estructuran respuestas sociales a los problemas sociales. Existen pocas escalas disponibles para la medición de este constructo. Este trabajo presenta los resultados de la adaptación al español y validación psicométrica de una escala para la medición de capital social en contextos rurales. Se adaptó al español la escala de capital social cognitivo de Wang. Se aplicaron 1200 cuestionarios a adultos en 12 veredas de Tierralta (Colombia) seleccionados con muestreo aleatorio simple estratificado. Se realizó análisis factorial de la escala a partir de una matriz de correlación policórica. El análisis factorial exploratorio sugiere la existencia de dos factores principales distribuidos así: 7 ítems para el factor 1 (confianza) (valor propio 3.23.) y 2 ítems para el factor 2 (desconfianza) (valor propio 1.40). Como fue observado por Wang, Q9 y Q10 parecen preguntas ambiguas que no aportan suficiente a ninguno de los factores. Se presenta la primera validación factorial al español de la escala de capital social de Wang en el contexto social de la Colombia rural.

Social capital is considered a structural determinant of social development and wellbeing. Its cognitive component assesses the degree of confidence of the population in their systems for social organization, as well as community interactions to coordinate social responses to social problems. There are few available scales for measuring this construct. This work presents the adaptation to Spanish and psychometric validation of a scale for measuring social capital in a rural setting. The Wang Social Cognitive Scale was also adapted to Spanish. 1200 questionnaires were applied to adults in 12 villages of the municipality of Tierra Alta, (Colombia) recruited by random sampling. Factor analysis of the scale was performed based on a polychoric correlation matrix. Exploratory factor analysis suggests the existence of two principal factors distributed as follows: 7 items for factor 1, trust (eigenvalue 3.23) and 2 items, for factor 2, distrust (eigenvalue 1.40). As observed by Wang, Q9 and Q10 could be ambiguous questions which do not contribute enough to either of the factors. The first factor validation to Spanish language of the Wang Social Capital Scale is presented in the social context of rural Colombia.

Cuestionamientos y requerimientos en la investigación de la calidad de vida en oncología / Questions and Requirements of Quality of Life Research in Oncology

Introducción: Durante las dos últimas décadas ha habido una explosión de estudios de evaluación de la calidad de vida. En este estudio se abordaron las principales estrategias metodológicas, entre ellas la elección del instrumento óptimo, propiedades psicométricas básicas y tiempos de evaluación de la calidad de vida. Objetivos: Proporcionar definiciones fundamentales útiles, describir las herramientas existentes y enunciar los desafíos en la interpretación de estudios de calidad de vida. Método: Se realizó una búsqueda narrativa de la literatura con la siguiente estrategia de búsqueda: “(‘Quality of Life’[MeSH] AND (‘Research’[MeSH] OR ‘Epidemiologic Research Design’[MeSH] OR ‘Health Services Research’[MeSH])) AND (‘Oncology Service, Hospital’[MeSH] OR ‘Medical Oncology’[MeSH])”. La indagación contempló el período comprendido entre 1966 y 2007. La estrategia de búsqueda fue adaptada a cada una de las bases de datos consultadas: Medline, Cochrane, LILACS y SciELO. Resultados: Se encontraron, por título y resumen, 189 artículos, a criterio de los autores, de los cuales fueron seleccionados 54 para esta revisión. No se obtuvieron cuatro artículos, por no tener acceso a los correspondientes journals. Conclusiones: La calidad de vida se ha convertido en un tema de interés para muchos investigadores en oncología, ya que no es suficiente con aumentar el tiempo de sobrevida, sino garantizar un estándar de calidad de vida generado a partir del tratamiento médico...

Introduction: During the last two decades, there has been an explosion of studies assessing the quality of life. Main methodological strategies have been addressed, including the optimal choice of instrument, basic psychometric properties and times of evaluation of quality of life. Objectives: To provide basic definitions and tools, to describe the existing tools, and to articulate the challenges of interpreting studies of quality of life. Methods: We conducted a narrative literature search with the following search strategy “(‘Quality of Life’[MeSH] AND (‘Research’[MeSH] OR ‘Epidemiologic Research Design’[MeSH] OR ‘Health Services Research’[MeSH])) AND (‘Oncology Service, Hospital’[MeSH] OR ‘Medical Oncology’ [MeSH]). The search comprised the period between 1966 and 2007. The search strategy was adapted to each of the searchable databases: Medline, Cochrane, LILACS and SciELO. Results: 189 articles were found by title and abstract, of which 54 were selected for this review. Four articles were not obtained for not having access to relevant journals. Conclusions: The quality of life has become a topic of interest to many researchers in oncology since it is not enough to increase survival time, inasmuch as a standard quality of life must ensue from the medical treatment as well...