Validación del índice de Lattinen para la evaluación del paciente con dolor crónico

Background and objectives: the Lattinen Index (LI) is a widely used tool for pain assessment in Spanish speaking countries, both in clinical practice and research. Nevertheless, despite its extensive use, no validation of the Spanish language version of the questionnaire has been published yet. This study intends to validate LI as a tool for measuring chronic pain. Materials and methods: a multicentre, cross-sectional, non-interventional study, including 283 chronic pain patients (> 3 months duration), from 6 different centres, was performed. Validity and reliability analysis were performed in order to validate the IL. On a first visit patients completed the IL questionnaire and other conventional pain scales (Visual Analogic Scale [VAS], McGill Pain Questionnaire and three Likert scales evaluating Analgesic Consumption, Functional Ability, and Hours of Sleep), which acted as gold standards validity measurements. A sub-set of 83 patients, with stable clinical characteristics, was asked to retake the initial tests after 15 days, to measure test-retest reliability. Results: a statistically significant positive correlation was found between the total IL score and the degree of pain measured by VAS. The measurements from the individual items in the questionnaire: Pain intensity, Pain frequency, Analgesic consumption, Functional Ability and Hours of Sleep correlated from moderately to strongly, with the respective gold standards measurements. Internal consistency and test-retest assays showed coefficient values of: alpha > 0.7 and intraclass correlation > 0.85, respectively. Conclusions: IL validity was established both for the overall score as for the individual dimensions, proving a correlation with standard measurements. Reliability of IL was demonstrated with the results from internal consistency and test-retest analysis, which indicated a high homogeneity between items.Fundamentos y objetivo: el índice de Lattinen (IL) es una herramienta muy utilizada para la evaluación del dolor en el mundo hispanoparlante, tanto en la práctica clínica como en trabajos de investigación. Sin embargo, hasta la fecha, no existía en la literatura ninguna validación del cuestionario. El presente estudio pretende abordar la validación del IL al castellano como instrumento de evaluación del dolor crónico. Materiales y métodos: se realizó un estudio multicéntrico, transversal, no intervencionista, incluyendo datos de 283 pacientes con dolor crónico (> 3 meses de duración) en el cual se analizó la validez y fiabilidad del Índice de Lattinen para su validación. En una primera visita, los pacientes cumplimentaron el cuestionario del IL junto con otras escalas habituales de valoración del dolor (Escala Visual Analógica [EVA], Cuestionario de Dolor McGill y tres escalas de Likert para el Consumo de Analgésicos, Grado de Incapacidad y Horas de Sueño), seleccionadas como medidas de referencia o gold standard para el análisis de validez. Un subgrupo de 83 pacientes con características clínicas estables fue citado para retomar las pruebas iniciales en un análisis de Test-Retest para comprobar la estabilidad temporal de las respuestas iniciales. Resultados: se estableció una relación positiva estadísticamente significativa entre la puntuación total obtenida con el IL y el grado de intensidad del dolor, medido a través de la escala EVA. Los distintos ítems del cuestionario, por separado: Intensidad del dolor, Frecuencia del dolor, Consumo de analgésicos, Grado de incapacidad y Horas de sueño; mostraron una correlación entre moderada y alta con las medidas gold standard de referencia equivalentes. Los análisis de consistencia interna y temporal mostraron coeficientes alfa > 0,7 y coeficiente de correlación intraclase > 0,85, respectivamente. Conclusiones: la validez del IL quedó probada tanto para la puntuación global como para las puntuaciones por dimensiones, al correlacionarse estas con las medidas estándar respectivas. Asimismo, se confirmó la fiabilidad del IL a través de los resultados del análisis de consistencia interna y de consistencia temporal, indicativos de una alta homogeneidad de los ítems

Preventive conservation of monuments based on DELPHI method and fuzzy logic

Preventive conservation requires identification, evaluation, and prioritization of the maintenance and restoration of cultural heritage under different hazards. The degradation of monuments is due to the effects caused by different agents (earthquakes, floods, weathering, pollution agents, anthropogenic fac-tors) that produce total or partial losses of architectonic elements or their altera-tions. The conservation degree of each monument depends on the vulnera bility, and its index is an indirect function of the level of deterioration, whereas the hazards depend on the localization and its environment conditions, social de-velopment and anthropogenic agents. RIVUPH and Art-Risk are Spanish pro-jects based on the analysis of environmental risk in historical cities and models to assess vulnerability and lives of buildings in order to improve the preventive conservation of monuments with similar characteristics. For this purpose, two different approaches have been evaluated: DELPHI method and Fuzzy Logic, where both tools are based on the opinion of experts in the field. The vulnerability analysis of three churches of Seville (Spain) have been studied to assess the monuments’ conservation degree. Both models (DELPHI and Fuzzy Logic) are able to forecast the necessities of restoration overlapping different scenario

Intake of dehydrated nopal (Opuntia ficus indica) improves bone mineral density and calciuria in adult Mexican women

Background: The intake of dehydrated nopal (DN) at a high stage of maturity along with high calcium content could improve bone mineral density (BMD) and calciuria and thus prevent osteoporosis. Objective: To evaluate the effect of calcium intake from a vegetable source (DN) on BMD and calciuria covering a 2-year period in menopausal and non-menopausal women with low bone mass (LBM). Methods: The study was quasi-experimental, blinded, and randomized, and included 131 Mexican women aged 35–55. Urinary calcium/creatinine index (CCI) was determined; BMD was analyzed on lumbar spine and total hip regions. Four groups were studied: Control group (CG), women with normocalciuria and a minimum dose of DN; experimental group 1 (EG1), women with hypercalciuria and a minimum dose of DN; experimental group 2 (EG2), women with hypercalciuria, and a maximum dose of DN; and normal group (NG) for reference in BMD. Results: After the first semester of treatment, calciuria levels in women from both experimental groups returned to normal, remaining constant for the rest of the treatment. The percentage difference in BMD increased in the total hip region in the CG (pre 4.5% and post 2.1%) and EG2 (pre 1.8% and post 2.5%) groups significantly in comparison to NG and EG1, which exhibited a significant decrease in their BMD. BMD increased only for the lumbar region in the EG2 group (premenopausal). Conclusion: The use of a vegetable calcium source such as nopal improves BMD in women with LBM in the total hip and lumbar spine regions principally in the premenopausal women, maintaining constant and normal calciuria levels