Franklin Escobar-Córdoba

Validación de la Escala de Somnolencia de Epworth

Objetivo Validar la escala de somnolencia de Epworth en Colombia (ESE-VC). Metodos Se tomaron individuos que acudieron a centros de sueno en Bogota, Pereira y Cali. Diseno: Ocho fases: Estudio piloto para evaluar comprension de la ESE version espanola; traduccion y retrotraduccion de la ESE original; prueba piloto para evaluar comprension (n=20); validacion de apariencia (expertos, n=18); consistencia interna (n=127); validez de criterio, concurrente y discriminante (n=150) con polisomnografia paralela; reproducibilidad (n=15) y sensibilidad al cambio (n=100). Resultados La ESE-VC tiene una adecuada consistencia interna (Alfa de Cronbach=0.85). Identifica sujetos con somnolencia severa, segun la patologia (K. Wallis Chi 2 =19,81, p=0.003). Discrimina los sujetos por severidad de apnea del sueno y anormalidad de la latencia de sueno (Chi 2 =5.391, p=0.1453) en forma clinicamente significativa y de la latencia de sueno con movimientos oculares rapidos (Chi 2 =9,015, p=0.0291). Es reproducible y sensible al cambio. Conclusiones : La ESE-VC es equiparable con la version original, adaptada a las condiciones de vida urbana de la poblacion adulta colombiana, confiable, valida y sensible a los cambios reportados, se correlaciona con la polisomnografia, en forma clinica y estadisticamente significativa.

Complaints of insomnia in hospitalized alcoholics

OBJECTIVE To estimate the prevalence of insomnia complaints in a population of alcoholics hospitalized in addiction clinics in Bogotá. METHOD Alcoholic patients hospitalized for detoxification in addiction clinics were recruited. DESIGN observational, descriptive and cross-sectional study. Data gathered by means of clinical interviews and measuring scales: Pittsburgh Sleep Quality Index and the Zung Self-rating Anxiety and Depression scales. RESULTS The prevalence of chronic insomnia complaints was 56.8% (33/58); anxiety symptoms 65.5% (38/58); depressive symptoms 75.9% (44/58) with variations in distribution by gender. CONCLUSION The prevalence of chronic insomnia complaints measured was found to be high in the population of hospitalized alcoholics. These patients deserve medical care and treatment for sleep disorders in their rehabilitation plan. Further research allowing the extension of the obtained results is needed.

Error aleatorio, sesgo y fraude en las publicaciones científicas

* Corresponding author: Cra 15a 120-74, Piso 6, Bogotá, Colombia. E-mail address: jheslavas@unal.edu.co (J. Eslava-Schmalbach). The purpose of a scientific publication is to provide the most truthful channel of communication between the authors that produce the research and the readers that intend to extrapolate that research to their respective populations. As expressed by Donald Miller in his last editorial, research fraud is a current and extremely concerning issue for scientific journals, for editorial teams and for for the authors themselves.1 However, there is a grey area between probabilistic error (random) and systematic error (due to inadequate methodology usually linked to the selection of subjects and/or variable measurements, among others) and fraud including plagiarism, fabrication of data and data manipulation or forgery.2 The latter type of fraud includes the intentional deviation in the design of the initial protocol in such a way that both random and systematic error may be used to accomplish the intentional deviation from the original protocol. This editorial focuses on establishing the boundaries separating these three aspects based on their intensity in the scientific publication, which jeopardize the credibility of the journals, of the authors and even of the publishing team, including the editors. Though the underlying assumption is that researchers act in good faith and that misinterpretation of random and systematic errors basically evidence the inadequate preparation or incompetence of the authors, as Steen said,3 there is also the possibility of acting in bad faith in the case of fraud. This situation is so evident that between 2000 and 2010, 788 articles were written and published in English, describing the results of research in humans or human-derived material.4 The principal author of the articles retracted for fraud has a history of committing fraud in other publications 53% of the time, while the principal author of articles retracted for error exhibited a repetitive conduct 18% of the time.5 This shows a deliberate attitude towards fraud. Figure 1 is a graphical representation of the potential impact on the truthfulness of the scientific publication as a result of random and systematic error and fraud. It depicts how the boundaries that separate random and systematic error from fraud may be indiscernible, and depending on the intentionality of the authors to introduce rather than avoid error, any type of error may turn into a form of fraud (Fig.1).

Latin American aspects of refusal to undergo court-ordered forensic psychiatric examination.

Purpose of review Forensic psychiatric examinations have gained increasing importance in many areas of the law. When individuals refuse to undergo court-ordered examinations of this kind, experts have to solve the tension between ethical and technical problems and judicial requirements. The purpose of this review is to obtain research information and standards related to refusal to undergo court-ordered forensic psychiatric examinations. Recent findings In Latin American countries, the literature on this subject is limited. The dominant position is that court-ordered examinations should be conducted even when the individual refuses to undergo examination, following technical and ethical considerations. Summary Experts should consider the mental competency of individuals and whether they pose a danger to themselves or others. In cases when the defendant refuses to undergo a court-ordered psychiatric examination, the expert, in collaboration with the judge, should decide upon an appropriate and reasonable means to conduct such an evaluation.

Sleep quality in an adult population exposed to the noise of El Dorado Airport, Bogotá, 2012

INTRODUCTION The airport of Bogotá lies within the city and its expansion could produce an increase in adverse effects on the health of the inhabitants of Fontibón and Engativá districts due to the noise it generates. OBJECTIVE To determine the prevalence of sleep disturbances and associated factors among residents of Fontibón exposed to this noise. MATERIALS AND METHODS A cross-sectional study design was used, involving a sample of 205 people aged 18 to 65, selected by means of stratified random sampling. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Descriptive statistics were carried out, as well as correlation tests between the different scales. RESULTS A total of 60% of the residents reported poor quality sleep (PSQI>5), with a mean PSQI of 7.19 (SD=3.931), and the following pathological interruptions were found: subjective sleep quality, 27%; sleep latency, 39%; sleep duration, 33%; habitual sleep efficiency, 37%; sleep alterations, 30%; diurnal dysfunction, 40%, and use of sleeping medication, 5%. According to the Epworth Sleepiness Scale (ESS>10), 28% of residents reported daytime somnolence. Regarding the prevalence of poor quality sleep according to the Pittsburgh Sleep Quality Index, 17% of those who reported not being able to sleep because of noise associated this with air traffic. A correlation was observed between the index and the scale ( r =0.329, CI 95%: 0.20-0.44). CONCLUSIONS Inhabitants of the district reported poor sleep quality due to exposure to noise, airport operations being one of the main generating sources. Noise mitigation strategies in the district need to be reviewed and the public health implications of the El Dorado Airport expansion should be considered.

Síndrome de Charles Bonnet: Presentación de dos casos

En este articulo se presentan dos casos de pacientes con el sindrome de Charles-Bonnet, entidad que tiende a ser subdiagnosticada en el ambito de la salud, dada su rareza y desconocimiento por parte del personal medico. A partir de estos casos se presentan las caracteristicas clinicas del sindrome y se brindan pautas para tener en cuenta en la fisiopatologia, evaluacion clinica, factores de riesgo, diagnostico diferencial y tratamiento

Calidad de vida en síndrome de apnea-hipopnea obstructiva del sueño (SAHOS)

El sindrome de apnea-hipopnea obstructiva del sueno (SAHOS) influye en la calidad de vida de las personas que lo padecen de manera diferente. Es importante medir esta repercusion, de forma objetiva, al momento de hacer el diagnostico y durante el tratamiento, porque puede mejorar la adherencia a este ultimo. A partir de diferentes estudios, se han creado escalas de medicion generales para las enfermedades y especificas para SAHOS, las cuales permiten evaluar diferentes dimensiones como los sintomas diurnos y nocturnos, la somnolencia diurna, las emociones y la repercusion de la enfermedad sobre las interacciones sociales de las personas y la percepcion del paciente frente al tratamiento establecido. Palabras clave: Sindromes de la apnea del sueno; Escalas; Calidad de vida

Clinical factors associated with extreme sleep apnoea [AHI>100 events per hour] in Peruvian patients: A case-control study-A preliminary report.

Purpose The severity of obstructive sleep apnoea (OSA) ranges from mild or moderate to severe sleep apnoea. However, there is no information available on the clinical characteristics associated with cases involving more than 100 events per hour. This is a preliminary report and our goal was to characterise the demographics and sleep characteristics of patients with Extreme OSA and compare with patients with sleep apnoea of lesser severity. We hypothesised that patients with Extreme OSA (AHI>100) is associated with an increased comorbidities and/or risk factors. Methods We carried out a case-control study on male patients with OSA who were seen in a private hospital in Lima, Peru between 2006 and 2012. Cases were identified if their apnoea/hypopnea index (AHI) was higher than 100 (Extreme OSA), and four controls were selected per case: two with 15–29 AHI and two with 30–50 AHI, matched according to case diagnosis dates. We evaluated demographic, past medical history, and oxygen saturation variables Results We identified 19 cases that were matched with 54 controls. In the multivariate model, only arterial hypertension, neck circumference, age, and over 10% in SatO2Hb≤90% in total sleep time (T90) were associated with Extreme OSA. Arterial hypertension had an OR=6.31 (CI95%: 1.71–23.23) of Extreme OSA. Each 5-cm increment in neck circumference was associated with an increase of OR=4.34 (CI95%: 1.32–14.33), while T90>10% had an OR=19.68 (CI95%: 4.33–89.49). Age had a marginal relevance (OR=0.95; CI95%: 0.92–0.99) Conclusion Our results suggest that arterial hypertension, neck circumference, and over 10% SatO2Hb≤90% in total sleep time were associated with a higher probability of Extreme OSA. We recommend investigators to study this population of Extreme OSA looking for an early diagnosis and the identification of prognostic factors in comparison with moderate to severe levels.

Apnea obstructiva del sueño y trastornos psiquiátricos

Resumen es: Introduccion: La apnea obstructiva del sueno es una de las alteraciones mas comunes del dormir, se caracteriza por colapsos recurrentes de la via aerea s...

Random Error, Bias and Fraud in Scientific Publications

Cra 15a 120-74, Piso 6, Bogota, Colombia. E-mail address: jheslavas@unal.edu.co (J. Eslava-Schmalbach).The purpose of a scientific publication is to provide the most truthful channel of communication between the authors that produce the research and the readers that intend to extrapolate that research to their respective populations. As expressed by Donald Miller in his last editorial, research fraud is a current and extremely concerning issue for scientific journals, for editorial teams and for for the authors themselves.