Medicina Clínica y Social
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Hantavirus en pediatría: tres formas de presentación
Get PDFThe Hantavirus genus, which belongs to the Bunyaviridae family, is a virus transmitted by aerosolization of feces from infected rodents belonging to the Muridae family. This virus can cause two types of conditions: hemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome (HPS). Knowing the different types of presentation is important for the therapeutic approach. Three pediatric cases of hantavirus disease, confirmed by specific IgM, with different presentations and evolutions, are presented, with the intention of alerting about the pathology and forms of presentation. All cases come from an endemic area for hantavirus, in Paraguay. Case 1: pulmonary syndrome: schoolchild with fever, cough, respiratory distress, interstitial pneumonia, decreased oxygen saturation. Admitted to intermediate care room, with oxygen and support measures. Good evolution and discharged after 7 days. Case 2: Cardiopulmonary syndrome: Preschooler with cough, dyspnea, arterial hypotension. 90% O2 saturation. Admitted to ICU, ARM, with pulmonary hypertension, with antibiotics until serology and cultures return. Discharged after 6 days Case 3: Hemorrhagic fever with renal syndrome: Older infant patient, with history of fever, general malaise. Admitted with generalized purpuric lesions, edematous, hypotensive, stuporous. With progressive acute renal failure. No response to supportive treatments. Died on day 7. The disease caused by hantavirus can have various expressions and can be fatal. The origin of the patients must be taken into account and included in the differential diagnoses.El género Hantavirus, que pertenece a la familia Bunyaviridae es un virus transmitido por aerosolización de excretas de roedores infectados, pertenecientes a la familia Muridae. Este virus puede causar dos tipos de afecciones: la fiebre hemorrágica con síndrome renal (FHSR) y el síndrome pulmonar por hantavirus (SPH). Conocer los diferentes tipos de presentación es importante para el abordaje terapéutico. Se presentan tres casos pediátricos, de enfermedad por hantavirus, confirmados por IgM específica, con presentaciones y evoluciones diferentes, con la intención de alertar de la patología y formas de presentación. Todos los casos provenientes de zona endémica para hantavirus, en Paraguay. Caso 1: síndrome pulmonar: escolar con fiebre, tos, dificultad respiratoria, neumonía intersticial, saturación de oxígeno disminuida. Ingresó a sala de cuidados intermedios, con oxígeno y medidas de soporte. Buena evolución y alta a los 7 días. Caso 2: síndrome cardiopulmonar: prescolar con tos, disnea, hipotensión arterial. 90% de saturación O2. Se ingresó a UTIP, ARM, con hipertensión pulmonar, con antibióticos hasta retorno de serología y cultivos. Alta a los 6 días Caso 3: fiebre hemorrágica con síndrome renal: paciente lactante mayor, con historia de fiebre, malestar general. Ingresó con lesiones purpúricas generalizadas, edematosa, hipotensa, estuporosa. Con insuficiencia renal aguda progresiva. Sin respuesta a tratamientos de soporte, Falleció al 7 día. La enfermedad causada por hantavirus puede tener diversas expresiones y puede ser mortal. Se debe estar atento a la procedencia de los pacientes e incluir en los diagnósticos diferenciales
The Distance to Mental Health Services and the Use of Public Transportation: A Challenge for Timely Care
Get PDFAccess to mental health services is a crucial issue in healthcare worldwide, particularly in low- and middle-income countries, such as Paraguay. Factors such as geographical distance to care centers and availability of public transportation can significantly influence how quickly a person receives treatment. This editorial draws on findings from a study conducted at the Hospital de Clínicas of the National University of Asunción, which analyzed the relationship between distance to psychiatric services, use of public transportation, and duration of untreated mental disorders (1).
Effective treatment of mental disorders depends on timely and continuous access to specialized services. However, physical distance from health centers and limited public transportation options often delay treatment, exacerbate symptoms, and diminish the quality of life. In this study, it was found that, although the average distance to the hospital was 10 km, there was no significant relationship between distance and the severity of anxiety or depression symptoms. Nevertheless, patients who spent more time traveling reported higher levels of anxiety, indicating that it is the duration of the journey, rather than the distance itself, that impacts anxiety levels (2,3).
Access to mental health services, particularly in urban areas, depends heavily on public transportation. In the aforementioned study by Márquez (1), 45.2% of the patients relied on public transport to reach the hospital, and most had to take two buses. A small percentage required more connections, leading to long and exhausting trips. These findings highlight how public transportation quality and availability directly affect access to mental health services, a trend also observed in studies from other countries, where inadequate transport is a major barrier to timely mental healthcare (4).
Research has consistently shown that inefficient public transportation is a significant obstacle in accessing psychiatric care. In areas where transportation is limited or expensive, the likelihood of seeking treatment drops dramatically (5). This issue is particularly pressing in rural areas, where people often travel long distances without access to regular public transportation or emergency psychiatric services, which adds another layer of difficulty in receiving adequate care.
The duration of untreated mental disorders is a critical factor for symptom severity. This study found a correlation between delayed diagnosis and the severity of depression symptoms, reinforcing existing evidence that untreated mental health issues tend to worsen over time, increasing the burden on both patients and the healthcare system. The phenomenon known as "distance decay," which refers to the decreasing likelihood of seeking medical care as the distance to health services increases, has been documented in numerous studies (5).
Given these findings, it is imperative to consider strategies for improving access to mental health services. One potential solution is to decentralize psychiatric care, allowing rural and disadvantaged communities to receive quality care without having to travel long distances. Establishing community mental health centers in peripheral areas, staffed with trained personnel, and equipped with telehealth capabilities could ease the strain on urban hospitals and ensure earlier access to treatment (5,6).
Moreover, enhancing the public transportation infrastructure is essential for improving access to mental health services. Implementing policies that subsidize transportation costs for patients, such as free or reduced-fare bus passes for medical appointments, could help mitigate barriers related to transportation (7). In some countries, such measures have successfully improved mobility and healthcare access for vulnerable populations, suggesting that similar policies in Paraguay can yield comparable benefits.
Ultimately, access to mental health services should not depend on geographical location or reliable transportation. Distance and transportation barriers are avoidable obstacles that, if properly addressed, can reduce the duration of untreated mental disorders and substantially improve the quality of life of affected individuals. Achieving this will require coordinated efforts among health authorities, urban planners, and policymakers to ensure that public transportation is accessible and that mental health services are available to all, regardless of location.
Access to mental health services is a basic right and ensuring efficient provision is crucial for the well-being of the population. As the mental health systems in Paraguay and other low- and middle-income countries continue to evolve, addressing barriers such as distance and transportation must be a priority. Only then can it be guaranteed that all citizens, regardless of where they live, have access to the mental health care they need.Access to mental health services is a crucial issue in healthcare worldwide, particularly in low- and middle-income countries, such as Paraguay. Factors such as geographical distance to care centers and availability of public transportation can significantly influence how quickly a person receives treatment. This editorial draws on findings from a study conducted at the Hospital de Clínicas of the National University of Asunción, which analyzed the relationship between distance to psychiatric services, use of public transportation, and duration of untreated mental disorders (1).
Effective treatment of mental disorders depends on timely and continuous access to specialized services. However, physical distance from health centers and limited public transportation options often delay treatment, exacerbate symptoms, and diminish the quality of life. In this study, it was found that, although the average distance to the hospital was 10 km, there was no significant relationship between distance and the severity of anxiety or depression symptoms. Nevertheless, patients who spent more time traveling reported higher levels of anxiety, indicating that it is the duration of the journey, rather than the distance itself, that impacts anxiety levels (2,3).
Access to mental health services, particularly in urban areas, depends heavily on public transportation. In the aforementioned study by Márquez (1), 45.2% of the patients relied on public transport to reach the hospital, and most had to take two buses. A small percentage required more connections, leading to long and exhausting trips. These findings highlight how public transportation quality and availability directly affect access to mental health services, a trend also observed in studies from other countries, where inadequate transport is a major barrier to timely mental healthcare (4).
Research has consistently shown that inefficient public transportation is a significant obstacle in accessing psychiatric care. In areas where transportation is limited or expensive, the likelihood of seeking treatment drops dramatically (5). This issue is particularly pressing in rural areas, where people often travel long distances without access to regular public transportation or emergency psychiatric services, which adds another layer of difficulty in receiving adequate care.
The duration of untreated mental disorders is a critical factor for symptom severity. This study found a correlation between delayed diagnosis and the severity of depression symptoms, reinforcing existing evidence that untreated mental health issues tend to worsen over time, increasing the burden on both patients and the healthcare system. The phenomenon known as "distance decay," which refers to the decreasing likelihood of seeking medical care as the distance to health services increases, has been documented in numerous studies (5).
Given these findings, it is imperative to consider strategies for improving access to mental health services. One potential solution is to decentralize psychiatric care, allowing rural and disadvantaged communities to receive quality care without having to travel long distances. Establishing community mental health centers in peripheral areas, staffed with trained personnel, and equipped with telehealth capabilities could ease the strain on urban hospitals and ensure earlier access to treatment (5,6).
Moreover, enhancing the public transportation infrastructure is essential for improving access to mental health services. Implementing policies that subsidize transportation costs for patients, such as free or reduced-fare bus passes for medical appointments, could help mitigate barriers related to transportation (7). In some countries, such measures have successfully improved mobility and healthcare access for vulnerable populations, suggesting that similar policies in Paraguay can yield comparable benefits.
Ultimately, access to mental health services should not depend on geographical location or reliable transportation. Distance and transportation barriers are avoidable obstacles that, if properly addressed, can reduce the duration of untreated mental disorders and substantially improve the quality of life of affected individuals. Achieving this will require coordinated efforts among health authorities, urban planners, and policymakers to ensure that public transportation is accessible and that mental health services are available to all, regardless of location.
Access to mental health services is a basic right and ensuring efficient provision is crucial for the well-being of the population. As the mental health systems in Paraguay and other low- and middle-income countries continue to evolve, addressing barriers such as distance and transportation must be a priority. Only then can it be guaranteed that all citizens, regardless of where they live, have access to the mental health care they need
Percepción de Soledad y Autoestima como Predictores de la Salud Mental en Adultos: Un Estudio en un País Sudamericano
Get PDFIntroduction: The presence of mental health problems among adults in Ecuador underscores the need to identify potential predictors of their occurrence. This study aimed to examine the impact of loneliness perception and self-esteem as potential predictors of mental health problems in a sample of Ecuadorian adults. Methods: A descriptive, correlational, predictive, and cross-sectional study was conducted with a sample of 1,293 Ecuadorian adults aged 18 to 63 years, of whom 42.3% were men and 57.7% were women. Results: Loneliness and self-esteem levels were found to be moderate, while the prevalence of mental health problems was low. Loneliness showed a positive moderate correlation with somatization, whereas self-esteem displayed a slight negative correlation with depression. Both loneliness and self-esteem emerged as significant predictors of these conditions. Conclusions: Loneliness and self-esteem influence the development and progression of specific mental health problems, such as somatization and depression, highlighting their relevance in interventions aimed at promoting mental health.Introducción: la presencia de problemas de salud mental en adultos en Ecuador destaca la necesidad de identificar posibles predictores de su incidencia. En este sentido, el objetivo de la investigación fue determinar el impacto de la percepción de soledad y la autoestima como posibles predictores de problemas de salud mental en una muestra de adultos ecuatorianos. Métodos: se llevó a cabo un estudio descriptivo, correlacional, predictivo y transversal con una muestra de 1,293 adultos ecuatorianos entre 18 y 63 años. El 42,3 % eran hombres y el 57,7 % mujeres. Resultados: los niveles de soledad y autoestima fueron moderados, mientras que la presencia de problemas de salud mental fue baja. La soledad se correlacionó de manera positiva y moderada con la somatización, mientras que la autoestima se correlacionó de forma negativa y leve con la depresión. Además, la soledad y la autoestima resultaron ser predictores significativos de estas condiciones. Conclusiones: la soledad y la autoestima influyen en la aparición y curso de problemas específicos de salud mental, como la somatización y la depresión, lo que subraya la importancia de considerarlos en intervenciones orientadas a la promoción de la salud mental
Evaluation of an educational intervention on arbovirus prevention at basic school no. 1973 "Costa Alegre" in the city of Coronel Oviedo, year 2024.
Get PDFIntroducción: Las arbovirosis son un serio problema de salud pública mundial por su elevada prevalencia y concentración en regiones tropicales y subtropicales. Son transmitidas principalmente por el Aedes aegypti y pueden generar cuadros de leves a graves. Objetivo: Evaluar el impacto de una intervención educativa en la prevención de arbovirosis en la Escuela Costa Alegre de Coronel Oviedo durante 2024. Metodología: Se realizó un estudio cuasiexperimental, longitudinal, con estudiantes de cuarto a sexto grado entre julio y setiembre de 2024. Se aplicó un cuestionario validado por Vivas, compuesto por 10 preguntas de conocimiento (puntaje 0–1) y 6 de habilidades (escala Likert). Como material didáctico se utilizó la cartilla de prevención de la Organización Panamericana de la Salud. Los datos se analizaron con Stata 16. Resultados: En el pretest, el 27% presentó conocimientos insuficientes y el 73% suficientes; en el postest, el 99% alcanzó conocimientos suficientes y solo el 1% insuficientes. La prueba de McNemar evidenció un aumento significativo de respuestas correctas tras la intervención (p < 0.001). En habilidades, el test de Wilcoxon mostró una mejora moderada pero significativa (p < 0.05), reflejando cambios positivos en prácticas preventivas como limpieza del entorno, uso de repelentes y control de recipientes con agua. Conclusión: La intervención educativa produjo mejoras notables en conocimientos y habilidades de prevención, confirmando su efectividad como estrategia escolar de promoción de la salud. Se recomienda replicar esta experiencia en otros contextos y explorar metodologías complementarias que fortalezcan la sostenibilidad de las prácticas preventivas a largo plazoIntroduction: Arbovirosis represent a major global public health concern due to their high prevalence and concentration in tropical and subtropical regions. They are mainly transmitted by Aedes aegypti and may cause clinical manifestations ranging from mild to severe. Objective: To evaluate the impact of an educational intervention on arbovirosis prevention at Costa Alegre School in Coronel Oviedo during 2024. Materials and Methodology: A longitudinal quasi-experimental study was conducted among fourth, fifth, and sixth-grade students between July and September 2024. A validated questionnaire developed by Vivas was applied, consisting of 10 knowledge questions (scored 0–1) and 6 skills questions assessed with a Likert scale. The Pan American Health Organization’s arbovirosis prevention booklet was used as educational material. Data were analyzed with Stata 16. Results: In the pretest, 27% of students demonstrated insufficient knowledge and 73% sufficient knowledge; in the post-test, sufficient knowledge increased to 99% and insufficient knowledge decreased to 1%. The McNemar test revealed a statistically significant increase in correct responses after the intervention (p < 0.001). Regarding skills, the Wilcoxon test indicated a moderate but significant improvement (p < 0.05), reflecting positive changes in preventive practices such as household cleaning, use of repellents, and control of water containers. Conclusion: The educational intervention significantly improved students’ knowledge and prevention skills, confirming its effectiveness as a school-based health promotion strategy. Replication in other educational and community settings is recommended to evaluate its long-term impact and applicability. Future studies should explore complementary strategies to strengthen learning and promote sustainable preventive practice
Difficult treatment of superinfected with pseudomonas aeruginosa verrucous leishmaniasis
Get PDFLeishmaniasis is an endemic pathology produced by protozoans of the genus Leishmania, of which there are different species, which can affect skin, mucous membranes and /or viscera.
We report the case of a 53-year-old male with erythematous violaceous plaque with verrucous borders, net limits in the thorax and back of 10 years of evolution, with a diagnosis of verrucous leishmaniasis, in whom systemic treatment was made with two different drugs and cryotherapy, with excellent result.
La leishmaniasis es una patología endémica producida por protozoarios del género Leishmania, de los cuales existen diferentes especies, pudiendo afectar piel, mucosas y/o vísceras.
Presentamos el caso de un varón indígena de 53 años con placa eritemato violácea de bordes verrucosos, límites netos, localizada en tórax y espalda de 10 años de evolución, con diagnóstico de leishmaniasis verrucosa, en quien se hizo tratamiento sistémico con dos drogas diferentes y crioterapia, con excelente resultado
Patterns and Trends of Antimicrobial Resistance in Staphylococcus aureus Isolated in a Private Laboratory in Paraguay from 2020 to 2024
Get PDFIntroducción: Staphylococcus aureus, un patógeno de preocupación mundial con capacidad de desarrollar resistencia antimicrobiana, motivo que exige vigilancia continua. Objetivo: El objetivo fue determinar patrones y tendencias de resistencia antimicrobiana de S. aureus aislados de secreciones purulentas de pacientes atendidos en un laboratorio privado de Paraguay entre el 2020 y 2024. Metodología: Estudio descriptivo y retrospectivo, se emplearon datos de la base de datos electrónica de un laboratorio privado para análisis estadístico de variables como susceptibilidad antimicrobiana de S. aureus en pedidos de cultivo de secreción purulenta entre 2020-2024. Resultados: Se aisló S. aureus en el 28,6 % (220/770). El 56,8 % (n=125) fueron resistentes a meticilina. El 61,5 % (n=88) provenían de pacientes ambulatorios. Se observó correlación moderada entre la resistencia a meticilina y a ciprofloxacina (R2=0.709) y eritromicina (R2=0.705). Los aislamientos mostraron resistencia a eritromicina (66 %), ciprofloxacina (34 %), clindamicina (32 %) y gentamicina (19 %), pero fueron 100 % sensibles a trimetoprima-sulfametoxazol y vancomicina. Entre los patrones de multirresistencia destacaron la co-resistencia a eritromicina-ciprofloxacina (37,5 %). Conclusión: La resistencia creciente a eritromicina, ciprofloxacina y clindamicina limita su uso en tratamientos empíricos y destaca la importancia de mejorar las estrategias de vigilancia epidemiológica.
Introduction: Staphylococcus aureus, a pathogen of global concern, has the ability to develop antimicrobial resistance, a factor that demands continuous surveillance. Objective: The objective was to determine the patterns and trends of antimicrobial resistance of S. aureus isolated from purulent secretions of patients attended at a private laboratory in Paraguay between 2020 and 2024. Methodology: This was a descriptive, retrospective study that used data from the electronic database of a private laboratory for the statistical analysis of variables such as antimicrobial susceptibility of S. aureus, from purulent secretion culture requests between 2020 and 2024. Results: S. aureus was isolated in 28.6% (220/770). Of these, 56.8% (n=125) were resistant to methicillin. A total of 61.5% (n=88) of the isolates were from outpatients. A moderate correlation was observed between methicillin resistance and resistance to ciprofloxacin (R²=0.709) and erythromycin (R²=0.705). The isolates showed resistance to erythromycin (66%), ciprofloxacin (34%), clindamycin (32%), and gentamicin (19%), but were 100% susceptible to trimethoprim-sulfamethoxazole and vancomycin. Among the multidrug resistance patterns in methicillin-resistant S. aureus, co-resistance to erythromycin-ciprofloxacin (37.5%) stood out. Conclusion: The increasing resistance to erythromycin, ciprofloxacin, and clindamycin limits their use in empirical treatments and highlights the importance of improving epidemiological surveillance strategies
Professional exhaustion syndrome in health personnel of a public hospital in the Department of Ñeembucu
Get PDFIntroducción: El sindrome de agotamiento profesional (SAP) o Burnout es un desgaste mental y físico transversal a cualquier profesión y muy prevalente en la labor médica, merece una atención especial ya que el SAP puede propiciar un detrimento en la calidad de las funciones profesionales prestadas y afectar la salud mental del personal sanitario. Objetivo: Describir las dimensiones del sindrome de agotamiento profesional en el personal de salud en un Hospital público del Departamento de Ñeembucú en el año 2024. Metodología: Estudio observacional, descriptivo, transversal, desde abril hasta septiembre del 2024 de una muestra por conveniencia donde se incluyó a personal sanitario del Hospital Regional de Pilar, se excluyeron a los administrativos. Se aplicó el instrumento estándar; Maslach Burnout Inventory Human Services Survey (MBI-HSS) para el estudio del SAP en sus dimensiones; agotamiento emocional (AE), despersonalización (DESP)y realización personal (RP). Una puntuación alta de las dimensiones AE y DESP y baja de la RP conforman el SAP. Las variables contínuas se expresar como medias y desviación estándar, y las categóricas como frecuencias absolutas y relativas. Resultados: De un total de 82 participantes, la edad media fue de 37 años (± 9), con predominancia femenina 61(74,39% ). Unos 31(37,80%) participantes presentaron SAP, de los cuales predominó en las mujeres; 25/31(80,6%). La mayor proporción de participantes fueron médicos; 45(54,87%), de estos presentaban los tres criterios de SAP; 17(20,73%) participantes. Presentaron mayormente agotamiento emocional 14/31(45,16%) participantes, seguido de despersonalización 10/31(32,25%) participantes. Conclusión: En la población estudiada el agotamiento emocional es la dimensión afectada con mayor frecuencia con predominancia del personal médico femenino.Introduction: Burnout syndrome is a mental and physical wear and tear that cut across any profession and is very prevalent in medical work, it deserves special attention since PAS can lead to a detriment in the quality of the professional functions provided and affect the mental health of health personnel. Objective: To describe the dimensions of professional burnout syndrome in health personnel in a public hospital in the Department of Ñeembucú in the year 2024. Methodology: Observational, descriptive, cross-sectional study, from April to September 2024 of a convenience sample where health personnel from the Regional Hospital of Pilar were included and administrative staff were excluded. The standard instrument was applied; Maslach Burnout Inventory Human Services Survey (MBI-HSS) for the study of PAS in its dimensions; emotional exhaustion (EA), depersonalization (DESP) and personal fulfillment (PR). A high score of the AE and DESP dimensions and a low PR score make up the SAP. The continuous variables are expressed as means and standard deviation, and the categorical variables as absolute and relative frequencies. Results: Of a total of 82 participants, the mean age was 37 years (± 9), with a predominance of 61 (74.39%) females. About 31 (37.80%) participants had PAS, of which women predominated; 25/31(80,6%). The largest proportion of participants were physicians; 45 (54.87%), of these presented the three criteria of PAS; 17 (20.73%) participants. Emotional exhaustion was mostly presented by 14/31 (45.16%) participants, followed by depersonalization 10/31 (32.25%) participants. Conclusion: In the population studied, emotional exhaustion is the most frequently affected dimension and with a predominance of female medical personnel
Beyond the Rash: The Neuropsychiatric Impact of Measles and the Urgency of Prevention
Get PDFEstimado editor:
El pasado 7 de agosto de 2025, la Dirección General de Vigilancia de la Salud del Ministerio de Salud Pública de Paraguay emitió una alerta epidemiológica por sarampión, tras la confirmación de cuatro casos en el departamento de San Pedro, todos ellos sin antecedentes de vacunación documentada (1). El último brote con transmisión autóctona en el país se registró en 1998. Más recientemente, en 2023, se notificó un caso confirmado de fuente de infección desconocida, que no generó casos secundarios (1). Esta señal de alarma no es un hecho aislado: se enmarca en un contexto global de reemergencia del virus, favorecido por las brechas en la cobertura vacunal, la circulación internacional de personas y la complacencia que a veces se instala cuando una enfermedad ha sido declarada eliminada en un país. La rápida diseminación y el riesgo de brotes secundarios en comunidades vulnerables invitan a replantear una pregunta que, pese a décadas de evidencia científica, sigue sin recibir suficiente atención en el discurso público: ¿continuamos subestimando al sarampión como una enfermedad meramente febril y exantemática?
Estimado editor:
El pasado 7 de agosto de 2025, la Dirección General de Vigilancia de la Salud del Ministerio de Salud Pública de Paraguay emitió una alerta epidemiológica por sarampión, tras la confirmación de cuatro casos en el departamento de San Pedro, todos ellos sin antecedentes de vacunación documentada (1). El último brote con transmisión autóctona en el país se registró en 1998. Más recientemente, en 2023, se notificó un caso confirmado de fuente de infección desconocida, que no generó casos secundarios (1). Esta señal de alarma no es un hecho aislado: se enmarca en un contexto global de reemergencia del virus, favorecido por las brechas en la cobertura vacunal, la circulación internacional de personas y la complacencia que a veces se instala cuando una enfermedad ha sido declarada eliminada en un país. La rápida diseminación y el riesgo de brotes secundarios en comunidades vulnerables invitan a replantear una pregunta que, pese a décadas de evidencia científica, sigue sin recibir suficiente atención en el discurso público: ¿continuamos subestimando al sarampión como una enfermedad meramente febril y exantemática
Construct validity of the PHQ-9 in university students in Colombia: A Rasch analysis approach
Get PDFIntroduction: The Patient Health Questionnaire 9 (PHQ-9) is one of the most widely used screening instruments for major depressive episodes. However, there are no published studies on Rasch-type analysis of the PHQ-9 among Spanish-speaking university students. Objective: To evaluate the psychometric properties of the PHQ-9 in university students using Rasch-type models and to assess possible biases of the items according to gender. Methods: This cross-sectional observational study evaluated the psychometric performance of the PHQ-9 in health sciences students at the University of Cartagena (Colombia). A random sampling stratified by academic program, semester, and sex was used, obtaining a sample of 550 participants (9 excluded for incomplete responses). Participants signed an informed consent, and the study was approved by an ethics committee. Rasch analysis was used to assess model fit, differential item functioning, dimensionality, local independence, and reliability. Adequate internal consistency (a=0.83, w=0.89) and factorial validity were found. Results: A cross-sectional study was conducted with 550 health science students from Colombian university. The data were analyzed using a Rasch model, in which the following psychometric characteristics were verified: 1) differential item functioning, 2) dimensionality and local independence, and 3) overall fit. Only item 2 showed a tendency toward differential functioning. Conclusions: One-dimensionality and local independence of the items, moderate reliability, and good general fit were found, although there was a gap between the degree of depression measured by the PHQ-9 and the participants\u27 responses. The Spanish version of the PHQ-9 for Colombian university students showed adequate item-level psychometric properties for screening for major depressive episodes.Introduction: The Patient Health Questionnaire 9 (PHQ-9) is one of the most widely used screening instruments for major depressive episodes. However, there are no published studies on Rasch-type analysis of the PHQ-9 among Spanish-speaking university students. Objective: To evaluate the psychometric properties of the PHQ-9 in university students using Rasch-type models and to assess possible biases of the items according to gender. Methods: This cross-sectional observational study evaluated the psychometric performance of the PHQ-9 in health sciences students at the University of Cartagena (Colombia). A random sampling stratified by academic program, semester, and sex was used, obtaining a sample of 550 participants (9 excluded for incomplete responses). Participants signed an informed consent, and the study was approved by an ethics committee. Rasch analysis was used to assess model fit, differential item functioning, dimensionality, local independence, and reliability. Adequate internal consistency (a=0.83, w=0.89) and factorial validity were found. Results: A cross-sectional study was conducted with 550 health science students from Colombian university. The data were analyzed using a Rasch model, in which the following psychometric characteristics were verified: 1) differential item functioning, 2) dimensionality and local independence, and 3) overall fit. Only item 2 showed a tendency toward differential functioning. Conclusions: One-dimensionality and local independence of the items, moderate reliability, and good general fit were found, although there was a gap between the degree of depression measured by the PHQ-9 and the participants\u27 responses. The Spanish version of the PHQ-9 for Colombian university students showed adequate item-level psychometric properties for screening for major depressive episodes
Consumo de prebióticos y probióticos y su relación con la presencia del síndrome metabólico y/o marcadores de riesgo asociados en pacientes ambulatorios
Get PDFIntroduction: The global prevalence of Metabolic Syndrome (MS) has been increasing in recent years, constituting a challenge for public health. There is scientific evidence that demonstrates positive effects of prebiotics and probiotics in the prevention and treatment of MS and associated risk markers.
Objectives: We aimed to evaluate the consumption of prebiotics and probiotics and its relationship with the presence of MS, and associated risk markers in outpatients in the period from September to October 2022.
Materials and Methods: Analytical, cross-sectional observational study, with primary data, carried out on 70 patients, obtained by non-probabilistic sampling. Anthropometric, biochemical, body composition, blood pressure, and level of physical activity variables were recorded to determine the presence of MS and its risk markers.
Results: The sample consisted of 54 female subjects and 16 male subjects. The average age was 38.63 ±12.15 years. Only 29% of the subjects consumed the recommended daily amount of inulin every day. Significant differences were found between the consumption of prebiotics with nutritional status and skeletal muscle mass, with a lower proportion of overweight and greater skeletal muscle mass observed in those who consumed prebiotics.
Conclusion: The consumption of prebiotics could exert a protective effect in overweight patients and, in relation to the presence of MS, in those patients who have a family history of arterial hypertension. Likewise, a positive relationship was found between the consumption of prebiotics and skeletal muscle mass.Introducción: La prevalencia mundial de Síndrome Metabólico (SM) ha ido aumentando en los últimos años, constituyendo un reto para la salud pública. Existen evidencias científicas que demuestran efectos positivos de los prebióticos y probióticos en la prevención y tratamiento del SM y marcadores de riesgo asociados.
Objetivos: Evaluar el consumo de prebióticos y probióticos y su relación con la presencia de SM y marcadores de riesgo asociados en pacientes ambulatorios en el periodo de setiembre a octubre 2022.
Materiales y Métodos: Estudio observacional analítico, de corte transversal, con datos primarios, realizado en 70 pacientes, obtenido por muestreo no probabilístico, por conveniencia. Se registraron variables antropométricas, bioquímicas, de composición corporal, presión arterial, y nivel de actividad física, para determinar la presencia de SM y sus marcadores de riesgo.
Resultados: La muestra estuvo constituida por 54 sujetos del sexo femenino y 16 del sexo masculino. La edad promedio fue de 38,63 ±12,15 años. El 29 % consumió todos los días la cantidad diaria recomendada de inulina. Se encontró diferencias significativas entre el consumo de prebióticos con el estado nutricional y la masa muscular esquelética, observándose menor proporción de sobrepeso y mayor masa muscular esquelética en los que consumen prebióticos.
Conclusión: El consumo de prebióticos podría ejercer un efecto protector en pacientes con sobrepeso y con relación a la presencia de SM, y en aquellos pacientes que presenten antecedentes patológicos familiares de hipertensión arterial. Asimismo, se encontró una relación positiva entre el consumo de prebióticos y la masa músculo esquelética