Predicting the onset of major depression in primary care: international validation of a risk prediction algorithm from Spain.

BACKGROUND: The different incidence rates of, and risk factors for, depression in different countries argue for the need to have a specific risk algorithm for each country or a supranational risk algorithm. We aimed to develop and validate a predictD-Spain risk algorithm (PSRA) for the onset of major depression and to compare the performance of the PSRA with the predictD-Europe risk algorithm (PERA) in Spanish primary care. METHOD: A prospective cohort study with evaluations at baseline, 6 and 12 months. We measured 39 known risk factors and used multi-level logistic regression and inverse probability weighting to build the PSRA. In Spain (4574), Chile (2133) and another five European countries (5184), 11 891 non-depressed adult primary care attendees formed our at-risk population. The main outcome was DSM-IV major depression (CIDI). RESULTS: Six variables were patient characteristics or past events (sex, age, sex×age interaction, education, physical child abuse, and lifetime depression) and six were current status [Short Form 12 (SF-12) physical score, SF-12 mental score, dissatisfaction with unpaid work, number of serious problems in very close persons, dissatisfaction with living together at home, and taking medication for stress, anxiety or depression]. The C-index of the PSRA was 0.82 [95% confidence interval (CI) 0.79-0.84]. The Integrated Discrimination Improvement (IDI) was 0.0558 [standard error (s.e.)=0.0071, Zexp=7.88, p<0.0001] mainly due to the increase in sensitivity. Both the IDI and calibration plots showed that the PSRA functioned better than the PERA in Spain. CONCLUSIONS: The PSRA included new variables and afforded an improved performance over the PERA for predicting the onset of major depression in Spain. However, the PERA is still the best option in other European countries.

[Occupation and bladder tumor. Results of a study of incident cases]. / Ocupación y tumor vesical. Resultados de un estudio de casos incidentes.

Presentation of the results from the occupation analysis in a study of incident cases of vesical tumour over a 16-year interval (1975-1991) conducted in La Rioja Autonomous Community. Out of the 557 cases identified, occupation was found in 455, 151 of them are farmers (33.18%), 71 are in the industrial sector (15.60%), and 233 in the services sector (51.20%). Percentage of individuals affected by production sectors according to 1985 data are 1.22% farmers, 0.3% industrial sector and 0.6% services sector.

[Incidence of upper urothelial tumor in the Autonomous Community of La Rioja in 1976-1991]. / Incidencia del tumor de urotelio alto en la Comunidad Autónoma de La Rioja en el período 1976-1991.

Study of the incidence rate of upper urothelium tumours between 1976 and 1991 among the population of the autonomous community La Rioja. A study by age, sex and time intervals, totalling 32 cases, is conducted. A greater incidence in males, and between 1987-1991 in terms of time, is observed. With regard to location of the upper urothelium tumour, a significant difference is found between right and left ureters and right and left renal pelvis. In 14 cases, an associated vesical carcinoma was noted (RR = 5338.9 with 95% CI from 2668.5 to 10681.4).

[Complete separation between epididymis and testis associated with cryptorchism. Presentation of a case and review of the literature]. / Desunión completa epidídimo testicular asociada a criptorquidia. Presentación de un caso y revisión de la literatura.

We report a case of complete separation of the epididymis and testis discovered during surgery for cryptorchidism. The epididymis was found in the scrotum and the testis in the inguinal canal. Although this malformation has been reported sporadically, the incidence in patients with cryptorchidism may be higher. These cases support the hypothesis that testicular descent is guided by the tail of the epididymis.