Abstract: In recent decades, the growing obesity epidemic in Mexico has become one of the most important public health challenges faced by the country. With support from the World Obesity Federation, we formed a working group in 2021 to identify and summarize priority actions that Mexico can take to face this epidemic. More than 1 000 health professionals joined the development and discussion process. Recommendations from previously published, high-level documents and guidelines were taken into account. In commemoration of World Obesity Day 2022, this statement is presented as input for health care professionals to develop actions to address obesity. The statement includes 10 recommendations that include population-level and individual-level actions. It emphasizes the importance of social participation, comprehensive interventions with a person- centered perspective, planetary sustainability, on improving education and communication campaigns, as well as fostering a built environment that promotes active living, and shielding prevention and control efforts from conflicts of interest. The statement calls for obesity to be treated seriously, based on scientific evidence, in a timely and comprehensive manner, employing a life-course and ethical approach that does not perpetuate weight stigma in society.

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Abstract The mayflies are insects widely known as indicators of aquatic quality in freshwater systems, they are abundant and diverse in tropical streams. In this study, it was determined the influence of physical, chemical and bacteriological characteristics on the Ephemeroptera assembly in a period of low precipitation in the Ocoa river of Meta department. There were 5,332 nymphs belonging to 4 families, 10 genera and 3 species. Three new genera records and one species are presented for Meta: Cloeodes, Zelusia, Lumahyphes and Americabaetis alphus. The genera Camelobaetidius and Varipes were found associated with conditions of contamination by organic matter and water mineralization. Likewise, Americabaetis, Thraulodes, Lumahyphes and Tricorythodes were associated with contamination conditions, especially with nitrites and nitrates. Nanomis, Cloeodes and Zelusia showed greater sensitivity to the contamination condition and were related to high percentages of dissolved oxygen in the water and they were in the sampling stations of the upper part in the river. It is important to mention that there were not Ephemeroptera in most of the stations associated with the urban area. That reflects their high sensitivity to polluting conditions at low precipitation period.

ABSTRACT Objective: To describe the Depression and Hopelessness in older adults belonging to community groups in the city of Chillán (Chile). Method: The study design is quantitative descriptive and transversal. A community census was carried out in a population of 78 older adults. Yesavage's Geriatric Depression Scale and Beck's Hopelessness Scale were applied. Results: According to the Yesavage scale, a level of mild depression was found in 24.4% followed by 9.0% of severe depression. When studying despair, mild despair was found in 56.4%, moderate in 23.1% and severe in 3.8%. Conclusion: 33.4% older adults have symptoms of depression and 83.3% some level of hopelessness. Therefore, it is important to encourage participation in community groups, as it is a protective factor that should be strengthened at this stage of life.

RESUMEN Objetivos: Describir la depresión y desesperanza en adultos mayores pertenecientes a agrupaciones comunitarias de la ciudad de Chillán (Chile). Metodología: El diseño del estudio es cuantitativo de tipo descriptivo y transversal. Se realizó un censo comunitario en una población de 78 adultos mayores. Se aplicó la Escala de depresión geriátrica de Yesavage y la Escala de desesperanza de Beck. Resultados: Según la escala de Yesavage se encontró un nivel de depresión leve en un 24,4%, seguido de un 9,0% de depresión severa. Al estudiar la desesperanza se encontró desesperanza leve en un 56,4%, moderada en un 23,1% y severa en un 3,8%. Conclusiones: El 33,4% de adultos mayores presenta síntomas de depresión y un 83,3% algún nivel de desesperanza, por lo que es importante incentivar la participación en agrupaciones comunitarias, ya que es un factor protector que se debe fortalecer en esta etapa de la vida.

Abstract Introduction: Chronic kidney disease affects the kidneys irreversibly, creating a great emotional impact on the patient and their family and social environment, and making changes in eating, physical and social habits, which disturb, in this way, their quality of life. Objective: To assess the quality of life of patients undergoing hemodialysis treatment in the commune of Chillán Viejo. Methods: A descriptive, cross-sectional, non-experimental study was conducted. It was implemented in a population of 62 patients undergoing hemodialysis treatment in Chile. The Kidney Disease and Quality of Life (KDQOL) survey, which presents satisfaction scores between 0 and 100, was used to assess quality of life in hemodialysis patients. Results: According to their average of achievement, the most affected dimensions are: general health (30.65 ± 21.81), physical role (23.15 ± 31.4), burden of kidney disease (25.46 ± 20,49), employment status (23.15 ± 35.97), cognitive function (22.59 ± 20.70) and quality of social relations (22.22 ± 23.13). Conclusions: It is important to implement educational and prevention activities aimed at patients who are on dialysis, so as to avoid possible complications associated with kidney disease and its comorbid diseases, reduce the deterioration of their quality of life and promote support for the patient and their family.

Resumen Introducción: La enfermedad renal crónica afecta a los riñones de forma irreversible, generando un gran impacto emocional en el paciente y su entorno familiar y social; determina cambios en los hábitos alimentarios, físicos y sociales perturbando, de esta manera, su calidad de vida. Objetivo: Valorar la calidad de vida de pacientes que se encuentran en tratamiento hemodialítico de la comuna de Chillán Viejo. Material y métodos: Diseño descriptivo, de corte transversal, no experimental. Fue implementado en una población de 62 pacientes en tratamiento de hemodiálisis en Chile. Se utilizó el cuestionario Kidney Disease and Quality of Life (KDQOL), que presenta puntajes de satisfacción entre 0 a 100, para evaluar calidad de vida en hemodializados. Resultados: Según sus medias de logros, las dimensiones más afectadas son: salud general (30,65 ±21,81), rol físico (23,15 ±31,4), carga de la enfermedad renal (25,46±20,49), situación laboral (23,15±35,97), función cognitiva (22,59±20,70) y calidad de las relaciones sociales (22,22±23,13).Conclusiones: Es importante poner en práctica actividades educativas y de prevención destinadas a pacientes que realizan diálisis, para evitar posibles complicaciones asociadas a la enfermedad renal y sus comórbidas, disminuir el deterioro de su calidad de vida y promover el apoyo al paciente y su familia.

Abstract Valproic acid is an antiepileptic drug with more than 50 years of clinical use. In the past decade, its anticancer effects were discovered. Analyses in groups of patients who used this drug for years have shown that it decreases the frequency of head and neck cancer. Recent studies show the anticancer effect of combining valproic acid with chemotherapy, biological therapy and antioxidant systems inhibitors, with exceptional results. In this review, we analyze the metabolism of valproic acid and its application against cancer.

Resumen El ácido valproico es un fármaco antiepiléptico con más de 50 años de uso clínico. En la década pasada se descubrieron sus efectos anticancerígenos. El análisis de grupos de pacientes que utilizaron este fármaco durante años ha mostrado que disminuye la frecuencia de cáncer de cabeza y cuello. Estudios recientes evidencian el efecto anticáncer al combinar el ácido valproico con la quimioterapia, terapia biológica e inhibidores de sistemas antioxidantes, con resultados excepcionales. En esta revisión se analiza el metabolismo del ácido valproico y su aplicación contra el cáncer.

Abstract Flora members of the Leguminosae family are crucial to the recuperation of degraded sites. The objective of this research was to characterize the catclaw plants present at the Sierra de Órganos National Park (Parque Nacional Sierra de Órganos, PNSO) both silviculturally and ecologically, which allows an adequate management of their population and makes it possible to determine their relevance in the vegetal succession process. The main catclaw populations were arranged in stands, and circular 500 m2 sites were established, with a sampling density of 5 %. The indices developed by Von Gadow and Füldner and by Pommerening were used to determine the spatial distribution of this species. An approximate density of 3 120 plants ha-1 was registered in 53 sampling sites; 79 % of these plants are catclaws, located within a range of 2 279 to 2 357 masl; 30 % of these were found at eastern exposures. Their average height and diameter were 106.62 cm and 2.11 cm, respectively. The index of Von Gadow and Füldner had a value of 0.264, and Pommerening’s index, of 1.282. This specie is mainly associated with the Opuntia, Acacia and Pinus genera. Catclaws at PNSO are non-invasive plants, as they cover only 4.76 % of the total surface area; they form compact, defined patches, and they occupy areas where other types of vegetation would not easily survive, such as mountainsides, the banks of intermittent streams and areas that have been subjected to overgrazing, where they fulfill a protective and soil-forming role.

Resumen Los integrantes florísticos de la familia Leguminosae son de suma importancia para la recuperación de sitios degradados. El presente trabajo tuvo como objetivo caracterizar silvícola y ecológicamente las plantas de gatuños presentes en el Parque Nacional Sierra de Órganos (PNSO), lo cual permitirá realizar un adecuado manejo de su población y determinar su importancia en el proceso de sucesión vegetal. Se rodalizaron las principales poblaciones de gatuños y se ubicaron sitios circulares de 500 m2, con una intensidad de muestreo de 5 %. Se utilizaron los índices de Füldner y Gadow y Pommerening para determinar la distribución espacial de las especies presentes. En 53 sitios de muestreo se registró una densidad aproximada de 3 120 plantas ha-1, de las cuales 79 % corresponde a “gatuños”, localizados entre los 2 279 y 2 357 msnm; de ellas, 30 % se encontraron en exposiciones este. Su altura y diámetro promedio fue de 106.62 cm y 2.1 cm, respectivamente. El índice de Füldner y Gadow tuvo un valor de 0.264 y el de Pommerening de 1.282. Se asocia principalmente con los géneros Opuntia, Acacia y Pinus. Los gatuños en el PNSO no son plantas invasoras, ya que solo cubren 4.76 % de la superficie total, forman manchones compactos y delimitados, además ocupan zonas donde otro tipo de vegetación no sobreviviría con facilidad, como son laderas, orillas de los arroyos intermitentes y áreas que estuvieron sometidas a sobre pastoreo, en las que cumplen un rol de protectoras y formadoras de suelo.

Objetivo: Determinar el efecto de las bebidas dietéticas en los niveles de glucosa e insulina en jóvenes estudiantes de medicina de la Universidad del Norte. Materiales y métodos: Se realizó un estudio experimental aleatorizado con una muestra de 16 estudiantes de sexo femenino de tercer semestre del programa de Medicina de la Universidad del Norte. Su participación fue voluntaria, previa firma del consentimiento informado. Se determinaron las variables antropométricas: peso, talla e índice cintura/ cadera. Se extrajo muestras para la determinación de la glucosa e insulina en ayunas. Posteriormente se distribuyeron aleatoriamente en dos grupos. Al grupo control se le suministró una gaseosa normal de 600cc y al grupo experimental, una gaseosa dietética de igual volumen. Al término de 2 horas se extrajeron nuevas muestras para determinar niveles de glucosa e insulina postprandiales. Se recolectaron los datos y se realizó el análisis estadístico utilizando el software IBM SPSS v22.0. Resultados: Se encontró una relación lineal positiva estadísticamente significativa entre los niveles de insulina (r = 0,908; p=0,002) y entre los índices HOMA (r= 0,913; p=0,002), HOMAR (r= 0,920;p=0,001), HOMA beta (r= 0,838;p=0,009)y OUICKI (r= 0,996;p=0,001) pre- y postprandial en el grupo que recibió la bebida dietética. Conclusiones: Los datos demuestran que los niveles de glucosa, insulina y el índice HOMA se comportan de forma lineal según el tipo de gaseosa consumido. No obstante se necesitan más estudios para determinar la interrelación entre dichas variables.

Objective: To determine the effect of diet sodas in glucose and insulin levels in young medical students from the Universidad del Norte. Materials and methods: A randomized experimental study with a sample of 16 female students with an average age of 18 years, belonging to the third semester of Medicine pro-gram at Universidad del Norte. The subject's participation was voluntary prior signature of informed consent. We assed the following anthropometric variables: weight, height, waist / hip ratio. Blood samples were obtainedfor determination of fasting glucose. We randomly divided the sample into two groups. The control group was provided a 600 cc of a regular soda, and the group experimental, an equal volume of diet soda. After 2 hours, new blood samples were taken in order to determine postprandial glucose and insulin levels. Data was collected and statistical analysis was performed using SPSS v22.0 software. Results: A statistically significant positive linear relationship between the levels of basal and postprandial insulin (r = 0.908; p = 0.002) and between pre and post-prandial HOMA index (r = 0.913;p = 0.002), HOMAR (r= 0,920;p=0,001), HOMA beta (r= 0,838;p=0,009), y OUICKI (r= 0,996; p=0,001) was found in the group receiving dietary drink. Conclusions: Data from this study show that the levels of glucose, insulin and HOMA index behave in lineal ways according to the type of soda consumed, however further studies are needed to determine the inter-relationship between these variables.

Schizophrenia is a severe psychiatric disorder that results in a significant disability for the patient. The disorder is characterized by impairment of the adaptive orchestration of actions, a cognitive function that is mainly dependent on the prefrontal cortex. This behavioral deficit, together with cellular and neurophysiological alterations in the prefrontal cortex, as well as reduced density of GABAergic cells and aberrant oscillatory activity, all indicate structural and functional deficits of the prefrontal cortex in schizophrenia. Among the several risk factors for the development of schizophrenia, stress during the prenatal period has been identified as crucial. Thus, it is proposed that prenatal stress induces neurodevelopmental alterations in the prefrontal cortex that are expressed as cognitive impairment observed in schizophrenia. However, the precise mechanisms that link prenatal stress with the impairment of prefrontal cortex function is largely unknown. Reelin is an extracellular matrix protein involved in the development of cortical neural connectivity at embryonic stages, and in synaptic plasticity at postnatal stages. Interestingly, down-regulation of reelin expression has been associated with epigenetic changes in the reelin gene of the prefrontal cortex of schizophrenic patients. We recently showed that, similar to schizophrenic patients, prenatal stress induces down-expression of reelin associated with the methylation of its promoter in the rodent prefrontal cortex. These alterations were paralleled with altered prefrontal cortex functional connectivity and impairment in prefrontal cortex-dependent behavioral tasks. Therefore, considering molecular, cellular, physiological and behavioral evidence, we propose a unifying framework that links prenatal stress and prefrontal malfunction through epigenetic alterations of the reelin gene.

Introduction Burnout syndrome is one of the most studied manifestations of job stress. The burnout concept was used by the first time in the area of psychology by Freudenberger in 1974. This psychologist defined it as a condition of fatigue or frustration that is produced by the commitment to a reason, lifestyle or relationship that does not produce the expected effort. Afterwards, Maslach and Jackson proposed three interrelated dimensions: emotional weariness (EW) which estimates the experience of emotional fatigue for the demands of work; the depersonalization (DP) which measures the answers of impersonal type and negative attitudes towards the patients; and the personal accomplishment (PA) which reflects the personal satisfaction and the competition in the practice of the daily work. These dimensions are joined in the Maslach Burnout Inventory (MBI) that is used to measure the afore mentioned syndrome. Several studies have demonstrated the presence of burnout syndrome among medical and paramedic personnel. The close contact with the patients and the work overload are the main reasons of this syndrome. In a multicentre study carried out among 248 doctors of the United States, 40% presented the syndrome with emotional detriment, which coincides with another study carried out with nurses attending patients with palliative care and marrow transplants. Also, in a study carried out among residents of internal medicine of the University of Washington, there was a prevalence of 76% of professional wear, with an autoperception of a lower quality in the professional care of the patients, after comparing them with non-affected residents. In Mexico, a study that investigated burnout level in a group of 450 medical practitioners, nurses and paramedics of 12 institutions revealed the following information: 10.9% presented emotional weariness, 19.6%, depersonalization, and 74.9, low personal accomplishment. Palmer et al. determined a general prevalence of 44% of the syndrome in anesthesiologists. The work overload and the conflict of values were variables that influenced the presence of this syndrome. At the Instituto Mexicano del Seguro Social, Aranda et al., carried out a study among family physicians, where the prevalence of burnout syndrome was 42.3%. Likewise, Cabrera et al., found that, out of 236 studied nurses, 92 (39%) had information compatible with burnout syndrome, with statistically significant differences for the age and the antiquity in the place after comparing them with nurses without burnout syndrome. The burnout syndrome was considered by the World Health Organization as work risk. Its trascendence is rooted in the impact it has in the labor relation between medical and/or paramedic personnel and the health institutions. For this reason, we considered it important to investigate the presence of this syndrome among the medical and paramedic personnel working at hospital of the Mexican social security. Material and Methods Design: Transversal comparative survey. Population: Of a total population of 240 workers of the health area assigned to a general hospital a sample of 160 was obtained that included doctors, nurses and medical assistants based on an average prevalence of the syndrome in 30%, with an alpha level of 0.05 and a power of 90%. Instrument of evaluation: The survey was based on the following sociodemographic and labor variables: age, marital status, academic level, labor antiquity, antiquity of adscript ion to the hospital, category, service and labor shift. To evaluate the burnout syndrome, the MBI questionnaire was used in its previously validated Spanish version. The afore mentioned instrument is an objective way of measuring and determining the burnout level that a person experiences, in its three subscales: EW, DP and PA. The survey consists of 22 items with a Likert type punctuation scale (0-6), of which 9 valued EW, 5, DP, and 8, PA. With regard to the EW, which values the sensation of being emotionally exhausted by the daily contact with people to whom it is necessary to attend as object of work, a punctuation of 27 or higher indicated a high level; between 19 and 26, moderated; and lower than 19, low. In the subscale DP, which measures the degree in which the response towards the patients is cold, distant and impersonal, punctuations above 10 indicated a high level; from 6 to 9, moderated; lower than 6, low. In the subscale PA, which values the feelings of competition and efficiency for the accomplishment of the work and the relation with the people who are being attended, values above 40 indicated personal high accomplishment; from 34 to 39, intermediate; and under 33, low. In the case of obtaining a low emotional depletion, a low depersonalization and a high personal accomplishment, it was considered that no burnout was present. In the rest of the cases, the presence of burnout syndrome was established. Compilation of the information: From August to December, 2005, the survey was applied to each of the workers, indicating them that they should answer and return it in a term not longer than five days. They were all informed previously about the general objectives of the study and its confidential and anonymous character. The head investigator integrated later on the database. Statistical tests: Descriptive and inferential statistics were carried out. The odds ratio and confidence intervals of 95% were calculated to measure the association between the sociodemographic and labor factors with the professional wear. Results Of 160 workers to whom the survey MBI was applied, only 146 returned it in a complete form. Regarding the frequency and the percentages of the three categories studied with the qualifications of low, average and high for every subscale that composes the burnout syndrome, it was observed that the highest evaluations fit the medical assistants. There was a 19.6% prevalence of burnout syndrome among the groups of doctors with at least one of three disturb subscales. Likewise, it was observed that all medical assistants had an alteration of a minimum of two subscales. The nursing personnel did not present information that constitutes a risk for the development of burnout syndrome. Only four sociodemographic and labor variables were found as risk factors for the presence of burnout syndrome, as well as their relation with each of the subscales composing it. When the variables compared age, labor antiquity and time of adscript ion in the service with each of the subscales of the burnout, we observed that depersonalization appeared in older workers and longer antiquity in the position and the lack of personal accomplishment in workers with longer time in the service. There were no statistically significant differences in the subscale of emotional weariness. Discussion In the last years, burnout syndrome has acquired special relevance, mainly because of the series of repercussions that it has in the labor and personal area. Numerous studies exist on the prevalence of this syndrome in different health professionals, but in present work incorporated medical assistants, since they are those who have the first contact with the patients in our institution.

Introducción El concepto de burnout fue utilizado por primera vez en el ámbito de la psicología por Freudenberger en el año de 1974. Este psicólogo lo definió como un estado de fatiga o frustración que se produce por la dedicación a una causa, forma de vida o relación que no produce el esperado esfuerzo. Más tarde, Maslach y Jackson propusieron tres dimensiones interrelacionadas: el cansancio emocional (CE), la despersonalización (DP) y la realización personal (RP). Estas dimensiones se integran en el cuestionario Maslach Burnout Inventory (MBI) que se utiliza para medir dicho síndrome. Material y métodos Diseño: Encuesta transversal comparativa. Población: Se entregó el cuestionario MBI a 160 trabajadores del área de la salud adscritos al Hospital General de Zona con Medicina Familiar 36 de la Ciudad de Cardel, Veracruz. Instrumento de evaluación: Se construyó una encuesta sobre las siguientes variables sociodemográficas y laborales: edad, estado civil, nivel académico, antigüedad laboral, antigüedad de adscripción al hospital, categoría, servicio y turno laboral. Para evaluar el síndrome de burnout se utilizó el cuestionario MBI en su versión en español. Dicho instrumento consta de 22 ítems con escala de puntuación tipo Likert (0-6), de los cuales 9 valoran CE, 5 la DP y 8 la RP. Recolección de la información: Durante el periodo comprendido de agosto a diciembre del 2006 se entregó el cuestionario a cada uno de los trabajadores de la salud. Pruebas estadísticas: Se realizó estadística descriptiva e inferencial. Se calculó la razón de momios e intervalos de confianza de 95% para medir la asociación entre los factores sociodemográficos y laborales con el desgaste profesional. Resultados De 160 trabajadores a quienes se les entregó el cuestionario MBI, sólo 146 lo regresaron en forma completa. En lo que respecta a la frecuencia y los porcentajes de las tres categorías estudiadas se observó que las evaluaciones más altas corresponden a las asistentes médicas. Hubo una prevalencia del síndrome de burnout entre el grupo de médicos del 19.6% con al menos una de las tres subescalas alteradas. Asimismo se observa que en todas las asistentes médicas hubo alteración de un mínimo de dos subescalas. Sólo se encontraron cuatro variables sociodemográficas y laborales como factores de riesgo para la presencia del síndrome de burnout, así como su relación con cada una de la subescalas que lo componen. Discusión Existen numerosos estudios sobre la prevalencia de este síndrome en diferentes profesionales de la salud, pero en el presente trabajo se incorpora a las asistentes médicas, ya que son quienes tienen un primer contacto con los pacientes en nuestra institución. Las cifras de prevalencia del síndrome de burnout reportadas por otros estudios realizados en México entre el personal médico van desde el 42.3% y 44% hasta 50%; en esta investigación la prevalencia fue menor y la dimensión de cansancio emocional es la más afectada. Entre las variables que se consideraron factores de riesgo en nuestro estudio se encuentra el estado civil. Asimismo, el trabajar en el turno vespertino y ofrecer sus servicio en la consulta externa también estuvieron relacionados con mayor predisposición al síndrome de burnout. Al igual que otros estudios, en esta investigación se encontró un mayor nivel de Burnout en profesionales con mayor edad. En lo que respecta a la DP y RP, éstas se presentaron en trabajadores cuya antigüedad laboral era mayor. En conclusión, la prevalencia del síndrome de burnout entre las asistentes médicas es muy alta y es necesario adoptar medidas para evitar el desarrollo de esta patología.

OBJECTIVE: To evaluate the usefulness of a questionnaire in primary health care services for establishing the diagnosis of epilepsy in children from 1 to 10 years old and for classifying their epileptic seizures. METHODS: This cross-sectional observational study was conducted in 2004. There were 204 children in the study (102 diagnosed with epilepsy and 102 without epilepsy). The children were randomly selected at the Regional Center of Epilepsies and the Vincent Corral Moscoso Hospital, which are both in the city of Cuenca, Ecuador. For the study, each child with epilepsy was matched with a child without epilepsy, in two age groups: 1 to 5 years old and 6 to 10 years old. Four students who were in their last academic year in the School of Medicine of Cuenca and who did not know the child's diagnosis utilized the questionnaire with a family member or other guardian of the child. The validity, sensitivity, specificity, positive predictive value, and negative predictive value of the questionnaire were calculated, with 95% confidence intervals (95% CIs). The clinical diagnosis carried out by specialists was used as the gold standard. RESULTS: The assessment showed that the questionnaire had good sensitivity (95.10%; 95% CI: 94.58%-95.61%) and good specificity (97.06%; 95% CI: 96.58%-97.59%). Validity was 96.08% (95% CI: 95.84%-96.36%), with a positive predictive value of 97.00% (95% CI: 96.48%-97.52%) and a negative predictive value of 95.19% (95% CI: 94.74%- 95.74%). The level of agreement in the classification of the epileptic seizures carried out by the neurologists and by the medical students who used the questionnaire was satisfactory for the generalized seizures (kappa = 0.67). Upon testing for interobserver agreement among the specialists, the kappa value for the diagnoses was 0.80 among the neurologists and 0.89 among the pediatricians. CONCLUSIONS: The diagnostic questionnaire that was assessed has good sensitivity and adequate specificity, and, after brief training, primary health care general practitioners can use it to help them diagnose epileptic seizures.

OBJETIVOS: Evaluar la utilidad de un cuestionario para establecer el diagnóstico de epilepsia en niños de 1 a 10 años de edad y clasificar las crisis epilépticas en los servicios de atención primaria. MÉTODOS: Estudio observacional transversal; participaron 204 niños de 1 a 10 años de edad (102 con diagnóstico de epilepsia y 102 sin epilepsia) escogidos al azar en el Centro Regional de Epilepsias y en el Hospital Vicente Corral Moscoso, ambos de la ciudad de Cuenca, Ecuador. Los niños fueron pareados por grupos de edad (de 1 a 5 y de 6 a 10 años). Cuatro estudiantes del último año de la Escuela de Medicina de esa ciudad que desconocían el diagnóstico del niño aplicaron el cuestionario a un familiar del niño o a su representante. Se evaluó el grado de discriminación diagnóstica (validez) del cuestionario, la sensibilidad, la especificidad y el valor diagnóstico de un resultado positivo o negativo, con un intervalo de confianza de 95% (IC95%). Como criterio de referencia se utilizó el diagnóstico clínico emitido por especialistas. RESULTADOS: La evaluación realizada demostró que el cuestionario de diagnóstico estudiado tiene buena sensibilidad (95,10%; IC95%: 94,58 a 95,61) y especificidad (97,06%; IC95%: 96,58 a 97,59). El índice de validez fue de 96,08 (IC95%: 95,84 a 96,36), con un valor pronóstico de un resultado positivo de 97,00% (IC95%: 96,48 a 97,52) y un valor pronóstico de un resultado negativo de 95,19% (IC95%: 94,74 a 95,74). El grado de concordancia de la clasificación de las crisis epilépticas realizadas por los neurólogos y los estudiantes de medicina que utilizaron el cuestionario fue satisfactorio para las crisis generalizadas (índice k: 0,67). Según la prueba de reproducibilidad de resultados entre observadores, el índice k para el diagnóstico de los neurólogos fue de 0,80 y para el diagnóstico de los pediatras de 0,89. CONCLUSIONES: El cuestionario de diagnóstico evaluado posee una buena sensibilidad y una adecuada especificidad y puede ayudar a los médicos generales, después de un breve entrenamiento, a diagnosticar las crisis epilépticas en los servicios de atención primaria.