Diagnostic criteria for blepharospasm: A multicenter international study

Background: There are no widely accepted criteria to aid the physician in diagnosing BSP. Objective: To validate recently proposed diagnostic criteria for blepharospasm in a larger and geographically diverse population and to develop a screening system for blepharospasm. Methods: Video-recordings from 211 blepharospasm patients and 166 healthy/disease controls were examined by 8 raters. Agreement for presence of orbicularis oculi spasms, sensory trick, and increased blinking was measured by k statistics. Inability to voluntarily suppress the spasms was asked by the examiner but not captured in the video. Patients/controls were also requested to fill a self-administered questionnaire addressing relevant blepharospasm clinical aspects. The diagnosis at each site was the gold standard for sensitivity/specificity. Results: All the study items yielded satisfactory inter/intra-observer agreement. Combination of items rather than each item alone reached satisfactory sensitivity/specificity. The combined algorithm started with recognition of spasms followed by sensory trick. In the absence of a sensory trick, including “increased blinking” or “inability to voluntarily suppress the spasms” or both items yielded 88–92% sensitivity and 79–83% specificity. No single question of the questionnaire yielded high sensitivity/specificity. Serial application of the questionnaire to our blepharospasm and control subjects and subsequent clinical examination of subjects screening positive by the validated diagnostic algorithms yielded 78–81% sensitivity and 83–91% specificity. Conclusion: These results support the use of proposed diagnostic criteria in multi-ethnic, multi-center cohorts. We also propose a case-finding procedure to screen blepharospasm in a given population with less effort than would be required by examination of all subjects

Consumo de drogas y violencia laboral en mujeres que trabajan, un estudio multicéntrico: México, Perú, Brasil Consumo de drogas e violencia laboral em mulheres que trabalham, um estudo multicêntrico: México, Peru, Brasil Drug consumption and occupational violence in working women, a multicenter study: Mexico, Peru, Brazil

Los propósitos del estudio fueron: 1) Determinar la proporción de consumo de drogas de las mujeres que trabajan; 2) Identificar algunos factores de riesgo personales y laborales que puedan predecir el consumo de drogas; 3) Identificar la presencia de violencia laboral y su relación con el consumo de drogas; 4) Identificar diferencias y similitudes de consumo de drogas y violencia laboral en las mujeres de las tres comunidades de México (Monterrey), Perú (Lima) y Brasil (Rio de Janeiro). El estudio fue multicéntrico, descriptivo, correlacional y comparativo, con una muestra de 903 mujeres. En los resultados se observa que la proporción de consumo de alcohol en México fue del 11%, en Perú del 53% y en Brasil del 45%. El consumo de drogas ilícitas en México fue del 5% y en Perú del 6%. La presencia de violencia laboral fue del 16% en las mexicanas, 24% en las peruanas y 39% en las brasileñas.<br>Os propósitos do estudo foram: 1) Determinar a proporção de consumo de drogas entre mulheres que trabalham; 2) Identificar alguns fatores de risco pessoais e laborais que possam predizer o consumo de drogas; 3) Identificar a presença de violência laboral e sua relação com o consumo de drogas; 4) Identificar diferenças e semelhanças no consumo de drogas e violência laboral nas mulheres das três comunidades de México (Monterrey), Perú (Lima) e Brasil (Rio de Janeiro). O estudo foi multicêntrico, descritivo, correlacional e comparativo, com uma amostra de 903 mulheres. Nos resultados, observa-se que a proporção de consumo de álcool no México foi de 11%, no Peru de 53% e no Brasil de 45%. O consumo de drogas ilícitas no México foi de 5% e no Peru de 6%. A presença de violência laboral correspondeu a 16% das mexicanas, 24% das peruanas e 39% das brasileiras.<br>The purposes of the study were: 1) Determine the proportion of working women who consume drugs; 2) identify some occupational and personal risk factors that can predict drugs consumption; 3) identify the presence of occupational violence and its relation with drugs consumption; 4) identify differences and similarities in drugs consumption and occupational violence among women from three communities in Mexico (Monterrey), Peru (Lima) and Brazil (Rio de Janeiro). A multicenter, descriptive, correlational and comparative study was carried out, with a sample of 903 women. The results show that 11% of the participants in Mexico consume alcohol, 53% in Peru and 45% in Brazil. The consumption of illicit drugs corresponded to 5% in Mexico and 6% in Peru. The presence of occupational violence was found in 16% of the Mexican participants, 24% of the Peruvians and 39% of the Brazilians