Background: Glycine inhibits the formation of advanced glycation end products that may cause central and peripheral neuronal damage, affecting also the auditory nerve. Aim: To evaluate the effect of glycine on auditory nerve conduction and hearing level among patients with type 2 diabetes mellitus and auditory neuropathy. Material and Methods: Twenty grams of oral glycine per day were administered during 6 months to 28 type 2 diabetic patients aged 58 ± 6 years, with auditory pathway neuropathy. Hearing tests and evoked otoacustic potentials were performed regularly. Fifteen diabetic patients aged 49 ± 8 years, without auditory nerve neuropathy did not receive glycine and were followed as a control group. Results: Among patients receiving glycine, a significant improvement in left ear audiometry at 125, 250 and 500 Hz and right ear audiometry at 500 Hz, was observed. Waves I, III and V (p= 0.02) of evoked otoacustic potentials improved significantly in the left ear and wave I in the right ear. Among controls, waves V and III of evoked otoacoustic potentials had a significant impairment in the left ear. Conclusions: There was an improvement in auditory evoked potentials in patients receiving glycine and an impairment in untreated control patients.

OBJECTIVE: To identify the factors associated with complaints of patients against physicians who work at general hospitals of the Mexican Institute of Social Security (MISS). MATERIAL AND METHODS: All the medical complaint files in a three-year period at the nine general hospitals of Mexico State MISS East District were examined. For each complaint filed, two control files were selected from the same hospital and clinical area. Associations were assessed using odds ratios and logistic regression. RESULTS: A total of 130 complaint cases and 260 controls were included. Seven out of 14 risk factors were selected: complications during hospitalization (OR 2.8, 95% CI 1.3-5.8), diagnostic error (OR 3.18, 95% CI 1.7-5.6), use of diagnostic tests (OR 3.7, 95% CI 1.2-11.3), insufficient information given by physicians (OR 2.64, 95% CI 1.22-5.7), voluntary hospital discharge (OR 7.2, 95% CI 2.22-23.6), lack of clinical monitoring during hospitalization (OR 19.12, 95% CI 2.25-162.6), and multiple vaginal revisions during labor (OR 5.17, 95% CI 1.5 17.07). Complaints were filed more often when there was a poor patient-physician relationship, deficient monitoring during labor, therapeutic error, and delay in surgery. Statistical significance was not attained. CONCLUSIONS: Complaints against Mexico State MISS hospital physicians were associated with diagnostic technical factors, as well as with the patients' perception of receiving deficient information and care during hospitalization

OBJETIVO: Identificar los factores asociados a la gestión de quejas contra los médicos que trabajan en hospitales generales del Instituto Mexicano del Seguro Social. MATERIAL Y MÉTODOS: Se revisaron las quejas presentadas y los expedientes clínicos correspondientes, en los nueve hospitales de la Delegación Estado de México Oriente, del Instituto Mexicano del Seguro Social. Por cada expediente clínico con queja se seleccionaron como controles dos expedientes sin queja, de la misma unidad y servicio. Se buscaron asociaciones por medio de razón de momios y regresión logística. RESULTADOS: Se incluyeron 130 expedientes motivo de queja y 260 expedientes control. Se identificaron siete factores asociados a queja de 14 investigados: complicaciones durante la atención RM 2.8 (IC 95% 1.3-5.8), error diagnóstico RM 3.18 (IC 95% 1.7-5.6), utilización de estudios de gabinete RM 3.7 (IC 95% 1.2-11.3), información deficiente por parte del médico RM 2.64 (IC 95% 1.2-5.7), alta voluntaria RM 7.2 (IC 95% 2.2-23.6), falta de vigilancia durante la hospitalización RM 19.12 (IC 95% 2.2-162.6) y revisiones vaginales múltiples durante el trabajo de parto RM 5.17 (IC 95% 1.5-17.07). Hubo tendencia a la presentación de quejas cuando se reportaron: mala relación médico-paciente, deficiente atención del trabajo de parto, error terapéutico y diferimiento de cirugía, sin significancia estadística. CONCLUSIONES: Las quejas contra médicos de hospitales del Instituto Mexicano del Seguro Social en el Estado de México se asocian con aspectos técnicos en el diagnóstico y con la percepción del derechohabiente de recibir información y vigilancia deficientes durante la hospitalización.

OBJECTIVE: To identify the factors associated with complaints of patients against physicians who work at general hospitals of the Mexican Institute of Social Security (MISS). MATERIAL AND METHODS: All the medical complaint files in a three-year period at the nine general hospitals of Mexico State MISS East District were examined. For each complaint filed, two control files were selected from the same hospital and clinical area. Associations were assessed using odds ratios and logistic regression. RESULTS: A total of 130 complaint cases and 260 controls were included. Seven out of 14 risk factors were selected: complications during hospitalization (OR 2.8, 95% CI 1.3-5.8), diagnostic error (OR 3.18, 95% CI 1.7-5.6), use of diagnostic tests (OR 3.7, 95% CI 1.2-11.3), insufficient information given by physicians (OR 2.64, 95% CI 1.22-5.7), voluntary hospital discharge (OR 7.2, 95% CI 2.22-23.6), lack of clinical monitoring during hospitalization (OR 19.12, 95% CI 2.25-162.6), and multiple vaginal revisions during labor (OR 5.17, 95% CI 1.5 17.07). Complaints were filed more often when there was a poor patient-physician relationship, deficient monitoring during labor, therapeutic error, and delay in surgery. Statistical significance was not attained. CONCLUSIONS: Complaints against Mexico State MISS hospital physicians were associated with diagnostic technical factors, as well as with the patients' perception of receiving deficient information and care during hospitalization

OBJETIVO: Identificar los factores asociados a la gestión de quejas contra los médicos que trabajan en hospitales generales del Instituto Mexicano del Seguro Social. MATERIAL Y MÉTODOS: Se revisaron las quejas presentadas y los expedientes clínicos correspondientes, en los nueve hospitales de la Delegación Estado de México Oriente, del Instituto Mexicano del Seguro Social. Por cada expediente clínico con queja se seleccionaron como controles dos expedientes sin queja, de la misma unidad y servicio. Se buscaron asociaciones por medio de razón de momios y regresión logística. RESULTADOS: Se incluyeron 130 expedientes motivo de queja y 260 expedientes control. Se identificaron siete factores asociados a queja de 14 investigados: complicaciones durante la atención RM 2.8 (IC 95% 1.3-5.8), error diagnóstico RM 3.18 (IC 95% 1.7-5.6), utilización de estudios de gabinete RM 3.7 (IC 95% 1.2-11.3), información deficiente por parte del médico RM 2.64 (IC 95% 1.2-5.7), alta voluntaria RM 7.2 (IC 95% 2.2-23.6), falta de vigilancia durante la hospitalización RM 19.12 (IC 95% 2.2-162.6) y revisiones vaginales múltiples durante el trabajo de parto RM 5.17 (IC 95% 1.5-17.07). Hubo tendencia a la presentación de quejas cuando se reportaron: mala relación médico-paciente, deficiente atención del trabajo de parto, error terapéutico y diferimiento de cirugía, sin significancia estadística. CONCLUSIONES: Las quejas contra médicos de hospitales del Instituto Mexicano del Seguro Social en el Estado de México se asocian con aspectos técnicos en el diagnóstico y con la percepción del derechohabiente de recibir información y vigilancia deficientes durante la hospitalización.

OBJECTIVE: To develop and validate a specific instrument to measure lifestyle of type 2 diabetes mellitus (DM2) patients. MATERIAL AND METHODS: A longitudinal, observational, prospective study was conducted between March 2001 and April 2002 at family medicine healthcare units of the Instituto Mexicano del Seguro Social (Mexican Institute of Social Security (MISS)) in Mexico State's East District. A self-administered instrument (instrument to measure diabetic lifestyles, IMEVID) was designed to measure the lifestyles of diabetic patients. It was submitted for review by a multidisciplinary group of experts who assessed its logical and content validity to measure the lifestyle in DM2 patients. The instrument was administered on two different days to 412 adult subjects with DM2. Some items were excluded on the basis of the frequency with which their answer choices were selected, as well as the item-total correlation, and the item's significant loads in several domains in factorial analysis. RESULTS: The sample population consisted of 389 (94.7 % response) subjects who completed the study. Intraclass correlation coefficients for logical and content validity were 0.91 and 0.95 respectively. After depuration of items, the instrument had 25 closed items grouped in 7 domains: nutrition, physical activity, tobacco consumption, alcohol consumption, information on diabetes, emotions, and therapeutic adherence. The global rating of the questionnaire had a Cronbach's alpha of 0.81 and a test-retest correlation coefficient of 0.84. CONCLUSIONS: The specific questionnaire IMEVID is the first to measure the lifestyle in subjects with DM2. It has logical validity, content validity, and a good level of consistency.

OBJETIVO: Construir y validar un instrumento específico para medir el estilo de vida en los pacientes con diabetes mellitus tipo 2. MATERIAL Y MÉTODOS: Entre marzo de 2001 y abril de 2002 se hizo un estudio observacional, longitudinal y prospectivo en unidades de medicina familiar de la delegación Estado de México Oriente, del Instituto Mexicano del Seguro Social. Se diseñó un instrumento de autoadministración, denominado instrumento para medir el estilo de vida en diabéticos, el cual fue sometido a revisión por un panel multidisciplinario de expertos para determinar su validez lógica y de contenido. Se aplicó el instrumento en dos días diferentes a 412 sujetos adultos con diabetes mellitus. Fueron depurados los ítems considerando la frecuencia de selección de sus opciones de respuesta, su correlación ítem-total y su carga significativa en los dominios durante el análisis factorial. RESULTADOS: Completaron el estudio 389 (94.7%) sujetos. Los coeficientes de correlación intra-clase para la validez lógica y de contenido fueron de 0.91 y 0.95, respectivamente. Después de la depuración de ítems se obtuvo un instrumento conformado por 25 preguntas cerradas, distribuidas en siete dominios: nutrición, actividad física, consumo de tabaco, consumo de alcohol, información sobre diabetes, emociones y adherencia terapéutica. El a de Cronbach para la calificación total fue de 0.81 y el coeficiente de correlación test-retest de 0.84. CONCLUSIONES: El instrumento para medir el estilo de vida en diabéticos es el primer cuestionario específico para sujetos con diabetes mellitus tipo 2 y tiene validez aparente, validez de contenido y buen nivel de consistencia.

OBJECTIVE: To develop and validate a specific instrument to measure lifestyle of type 2 diabetes mellitus (DM2) patients. MATERIAL AND METHODS: A longitudinal, observational, prospective study was conducted between March 2001 and April 2002 at family medicine healthcare units of the Instituto Mexicano del Seguro Social (Mexican Institute of Social Security (MISS)) in Mexico State's East District. A self-administered instrument (instrument to measure diabetic lifestyles, IMEVID) was designed to measure the lifestyles of diabetic patients. It was submitted for review by a multidisciplinary group of experts who assessed its logical and content validity to measure the lifestyle in DM2 patients. The instrument was administered on two different days to 412 adult subjects with DM2. Some items were excluded on the basis of the frequency with which their answer choices were selected, as well as the item-total correlation, and the item's significant loads in several domains in factorial analysis. RESULTS: The sample population consisted of 389 (94.7 % response) subjects who completed the study. Intraclass correlation coefficients for logical and content validity were 0.91 and 0.95 respectively. After depuration of items, the instrument had 25 closed items grouped in 7 domains: nutrition, physical activity, tobacco consumption, alcohol consumption, information on diabetes, emotions, and therapeutic adherence. The global rating of the questionnaire had a Cronbach's alpha of 0.81 and a test-retest correlation coefficient of 0.84. CONCLUSIONS: The specific questionnaire IMEVID is the first to measure the lifestyle in subjects with DM2. It has logical validity, content validity, and a good level of consistency.

OBJETIVO: Construir y validar un instrumento específico para medir el estilo de vida en los pacientes con diabetes mellitus tipo 2. MATERIAL Y MÉTODOS: Entre marzo de 2001 y abril de 2002 se hizo un estudio observacional, longitudinal y prospectivo en unidades de medicina familiar de la delegación Estado de México Oriente, del Instituto Mexicano del Seguro Social. Se diseñó un instrumento de autoadministración, denominado instrumento para medir el estilo de vida en diabéticos, el cual fue sometido a revisión por un panel multidisciplinario de expertos para determinar su validez lógica y de contenido. Se aplicó el instrumento en dos días diferentes a 412 sujetos adultos con diabetes mellitus. Fueron depurados los ítems considerando la frecuencia de selección de sus opciones de respuesta, su correlación ítem-total y su carga significativa en los dominios durante el análisis factorial. RESULTADOS: Completaron el estudio 389 (94.7%) sujetos. Los coeficientes de correlación intra-clase para la validez lógica y de contenido fueron de 0.91 y 0.95, respectivamente. Después de la depuración de ítems se obtuvo un instrumento conformado por 25 preguntas cerradas, distribuidas en siete dominios: nutrición, actividad física, consumo de tabaco, consumo de alcohol, información sobre diabetes, emociones y adherencia terapéutica. El a de Cronbach para la calificación total fue de 0.81 y el coeficiente de correlación test-retest de 0.84. CONCLUSIONES: El instrumento para medir el estilo de vida en diabéticos es el primer cuestionario específico para sujetos con diabetes mellitus tipo 2 y tiene validez aparente, validez de contenido y buen nivel de consistencia.