Abstract OBJECTIVE: To assess the long-term treatment of pelvic pain with levonorgestrel in women with endometriosis who wish to postpone pregnancy and preserve their fertility. MATERIALS AND METHODS: Ambispective study, with drug intervention, longitudinal and descriptive case series. Study parameters: measurement of pain intensity at 12, 24 and 36 months after placement of a single goserelin implant (Zoladex 10.6 mg, AstraZeneca AB, Gärtunavägen). At the return of menstruation, an intrauterine device containing levonorgestrel (Mirena Bayer AG, Leverkusen) was inserted. The intensity of pelvic pain was measured with the Numerical Pain Scale (NPS). RESULTS: Fourteen patients were studied of whom five reported pain: four with intensity 1 and one with intensity 3. The rest of the patients reported no pain. All patients reported subjective general relief at 12 months follow-up. CONCLUSIONS: Levonorgestrel administered intrauterine may be an alternative for the long-term pain-free treatment of patients with endometriosis who wish to postpone pregnancy. Controlled, randomized studies with a truly representative sample size are needed to confirm the findings.

Resumen OBJETIVO: Valorar el tratamiento a largo plazo del dolor pélvico con levonorgestrel en mujeres con endometriosis que desean posponer el embarazo y preservar su fertilidad. MATERIALES Y MÉTODOS: Estudio ambispectivo, con intervención medicamentosa, longitudinal y descriptivo de serie de casos. Parámetros de estudio: medición de la intensidad del dolor a los 12, 24 y 36 meses posteriores a la colocación de un implante único de goserelina (Zoladex de 10,6 mg, AstraZeneca AB, Gärtunavägen). Al retorno de la menstruación se colocó un dispositivo intrauterino con levonorgestrel (Mirena Bayer AG, Leverkusen). La intensidad del dolor pélvico se midió con la Escala Numérica del Dolor (Escala ENA). RESULTADOS: Se estudiaron 14 pacientes de las que 5 refirieron dolor: 4 con intensidad 1 y una con intensidad 3. El resto de las pacientes no refirió dolor. Todas las pacientes refirieron alivio general subjetivo a los 12 meses de seguimiento. CONCLUSIONES: El levonorgestrel administrado por vía intrauterina puede ser una alternativa para mantener, a largo plazo, sin dolor a pacientes con endometriosis que desean posponer el embarazo. Para confirmar lo aquí encontrado hacen falta estudios controlados, con asignación al azar y con un tamaño de muestra realmente representativo.

Background: Loxoscelism is an important public health problem in Chile and South America, due to the higher rate of cutaneous-visceral involvement. The diagnosis of loxoscelism is mostly clinical without established diagnostic criteria. There is little evidence to support any treatment used in this condition. Aim: To characterize the clinical features and epidemiology of loxoscelism among patients consulting at the Emergency and Dermatology Services of a clinical hospital between 2013 and 2017. Material and Methods: Review of medical records of patients registered in the electronic clinical record system with a confirmed diagnosis of loxoscelism. Epidemiological, clinical, laboratory tests and treatment variables were analyzed. Results: We reviewed data from 200 patients. Ninety-four percent presented cutaneous loxoscelism and 5.5% cutaneous-visceral loxoscelism. Systemic symptoms were present in 73% of patients with cutaneous-visceral loxoscelism. Patients who developed systemic symptoms had an 18 times higher risk of developing cutaneous-visceral loxoscelism. Laboratory abnormalities were more common in patients with cutaneous-visceral loxoscelism. Not all patients with hematuria had cutaneous-visceral loxoscelism. Most patients required analgesia. Anti-loxosceles serum was not used in any patient. Conclusions: Many questions remain to be answered regarding the diagnosis and treatment of the disease. Studies are required to validate diagnostic criteria for loxoscelism, predictors for visceral involvement and response to treatment.

ABSTRACT Currently, some quinoline-based anticancer drugs are successful repurposed for treatment of bacterial infections. This study assessed the antibacterial activity of the new anticancer compound 4,7-dichloro-2-quinolinemethylacrylate (AQM) against bacteria of both clinical and agricultural interest, and also determined the influence of some metal cations (Fe3+, Mn2+, Zn2+, Na+, Mg2+, Co2+ and Ni2+) on the AQM photophysics. The synthesis of AQM was carried out by the reported method. The antibacterial activity of AQM on Pectobacterium carotovorum subsp. carotovorum (Pcc), Ralstonia solanacearum, Klebsiella pneuminiae, Pseudomonas syringae, Staphylococcus aureus y Bacillus sp., was evaluated using the spectrophotometric method of broth microdilution. At 125 ppm, AQM produced growth inhibition of 51.7% in Pcc, and a bacteriostatic effect in S. aureus and Bacillus sp., but no effect was seen against the other bacteria. In addition, fluorescence quenching of AQM solution induced only by Fe3+ ion, and not by the other metal cations, was confirmed. These results postulate that AQM could be a molecule with potential application in antibacterial therapy or in the fluorometric detection of Fe3+ ions.

Abstract: Introduction: Diabetic ketoacidosis (DKA) is the main cause of morbidity and mortality in children with type 1 diabetes mellitus (T1DM) due to clinical and biochemical alterations associated, cerebral edema as one of the most critical because of the high mortality rates and long-term neurological se quelae. Objective: To analyze the clinical characteristics and complications of patients with DKA ad mitted to a pediatric intensive care unit. Patients and Methods: Retrospective study of DKA patients treated at the Hospital Clínico, Pontificia Universidad Católica de Chile (UPCPUC) between 2000 and 2015. Demographic characteristics, clinical manifestations, biochemical alterations, treatment, complications, and prognosis were assessed. Patients with T1DM onset were compared with those patients already diagnosed with diabetes, analyzing variables according to distribution. Results: 46 DKA events were identified, 67% of them were the first episode of DKA. 66% of patients already diagnosed with diabetes were admitted due to poor adherence to treatment. The main symptoms described were: 63% polydipsia, 56% polyuria, 48% vomiting, 39% weight loss and 35% abdominal pain, and mean blood sugar levels of 522 mg/dL, pH 7.17, and plasma osmolality of 305 mOsm/L. 89% of patients received insulin infusion, and 37% presented hypokalemia. No episodes of cerebral edema or deaths were registered. Conclusions: Most of the DKA admissions were due to T1DM onset. In the group of patients already diagnosed with diabetes, the poor adherence to treatment was the main cause of decompensation. There were no serious complications or deaths associated with DKA management during the studied period. Early diagnosis and proper and standardized treatment contributed to reducing morbidity and mortality in children with DKA.

Resumen: Introducción: La cetoacidosis (CAD) es la principal causa de morbimortalidad en niños con diabetes mellitus tipo 1 (DM1) debido a las alteraciones bioquímicas asociadas, siendo el más temido el edema cerebral, con altas tasas de mortalidad y secuelas neurológicas a largo plazo. Objetivo: caracterizar el perfil clínico y las complicaciones de pacientes con CAD ingresados en una unidad de paciente crítico pediátrico. Pacientes y método: Revisión retrospectiva de pacientes con CAD atendidos en el Hospital Clínico de la Pontificia Universidad Católica de Chile (UPCPUC) entre los años 2000 y 2015. Se evaluaron características demográficas, manifestaciones clínicas, alteraciones bioquímicas, tratamiento, complicaciones y pronóstico. Se compararon pacientes con debut de DM1 versus diabé ticos conocidos, analizándose variables según distribución. Resultados: Se identificaron 46 episodios de CAD. El 67% de éstos correspondió a un debut de DM1. El 66% de los diabéticos conocidos in gresaron por mala adherencia al tratamiento. Los principales síntomas de presentación fueron: 63% polidipsia, 56% poliuria, 48% vómitos, 39% pérdida de peso y 35% dolor abdominal, con medias de Glicemia 522 mg/dL, pH 7,17 y osmolaridad plasmática 305 mOsm/L. El 89% recibió insulina en infusión. El 37% presentó hipokalemia. No se registraron episodios de edema cerebral ni muertes. Conclusiones: La mayoría de los ingresos por CAD correspondió a debut de DM1. En el grupo de diabéticos conocidos, la mala adherencia al tratamiento fue la principal causa de descompensación. No se presentaron complicaciones graves ni muertes asociadas al manejo de la CAD durante el perío do estudiado. El diagnóstico precoz y el tratamiento adecuado y estandarizado pudieran contribuir a reducir la morbilidad y mortalidad en niños con CAD.

ABSTRACT Diethyl 2-((4-nitroanilino)methylene)malonate [4-NANM-E] is an important molecule owing to its role of precursor in the multistage synthesis of several quinoline derivatives possessing biological activities such as antiviral, immunosuppressive, anticancer and photoprotector. This molecule is usually synthesized by a nucleophilic vinyl substitution (SNV) between 4-nitroaniline and diethylethoxymethylene malonate (EMA). Although several procedures are available to synthesize 4-NANM-E in liquid phase, more convenient method is necessary to synthesize in less reaction time and at room temperature. In this study, it is demonstrated that equimolar amounts of EMA and 4-nitroaniline dissolved in alcoholic KOH react within a few seconds at room temperature to produce 4-NANM-E which is purified by simple filtration after acidification with aqueous HCl and washing with alcohol. The reaction has the yield varying at the range 45-53% when it occurs in ethanol, 2-propanol, 2-butanol or 2-pentanol. Therefore, this synthesis method is an excellent alternative to produce 4-NANM-E on an industrial scale.

ABSTRACT The maize weevil, Sitophilus zeamais, is an economic important pest in stored grains, thus alternative and safe methods of control are required. In this study, the effect of plant powders on mortality of the maize weevil, final weight of corn kernels, number of perforated corn kernel, and weight of waste material were evaluated in laboratory conditions. Powder obtained from four plant species [Ruta graveolens (ruda), Urtica dioica (ortiga), Ambrosia arborescens (marco) y Buddleja globosa (matico)] was evaluated used at 5% w/w and then compared to a conventional insecticide (Malathion used as positive control) and to a negative control, to which no application was made. For this purpose, 150 g of kernels were used and infested with 20 adult weevils, which were treated with 7.5 g of the respective plant powder. Experiment was carried out in a completely randomized design. The ruda and marco caused percentage of mortality on the maize weevil of 53.35 and 41.65%, respectively, suggesting that these plant species could be used in combination with other management strategies in stored grains. However, studies dealing with effect of different concentrations are required in order to optimize their use.

RESUMEN El gorgojo del maíz, Sitophilus zeamais, es una plaga de importancia económica en granos almacenados por lo que se requieren métodos de control alternativos y seguros. En el presente estudio se evaluó el efecto de polvos vegetales sobre la mortalidad del gorgojo del maíz, el peso final de los granos de maíz, número de granos perforados, peso del material de desecho bajo condiciones de laboratorio. Se evaluaron los polvos obtenidos de cuatro especies de plantas [Ruta graveolens (ruda), Urtica dioica (ortiga), Ambrosia arborescens (marco) y Buddleja globosa (matico)] al 5% p/p y fueron comparadas con el uso de un insecticida convencional (Malathion usado como control positivo) y con un control negativo, al cual no se le hizo ningún tipo de aplicación. Para ello fueron usados 150 g de granos de maíz e infestados con 20 gorgojos adultos, los cuales fueron tratados con 7,5 g del polvo vegetal respectivo. El ensayo fue conducido en un diseño completamente aleatorizado. La ruda y el marco provocaron porcentajes de mortalidad sobre el gorgojo del maíz de 53,35 y 41,65%, respectivamente, lo cual sugiere que estas especies de planta podrían ser usadas en combinación con otras estrategias de manejo en granos almacenados. Sin embargo, se requieren hacer estudios que evalúen el efecto de diferentes concentraciones de modo a optimizar su uso.

The thyroid nodule is a frequent cause of primary care consultation. The prevalence of a palpable thyroid nodule is approximately 4-7%, increasing up to 67% by the incidental detection of nodules on ultrasound. The vast majority are benign and asymptomatic, staying stable over time. The clinical importance of studying a thyroid nodule is to exclude thyroid cancer, which occurs in 5 to 10% of the nodules. The Board of SOCHED (Chilean Society of Endocrinology and Diabetes) asked the Thyroid Study Group to develop a consensus regarding the diagnostic management of the thyroid nodule in Chile, aimed at non-specialist physicians and adapted to the national reality. To this end, a multidisciplinary group of 31 experts was established among university academics, active researchers with publications on the subject and prominent members of scientific societies of endocrinology, head and neck surgery, pathology and radiology. A total of 14 questions were developed with key aspects for the diagnosis and subsequent referral of patients with thyroid nodules, which were addressed by the participants. In those areas where the evidence was insufficient or the national reality had to be considered, the consensus opinion of the experts was used through the Delphi methodology. The consensus was approved by the SOCHED board for publication.

La osteoporosis es una patología que afecta el sistema esquelético y se caracteriza por una baja densidad mineral ósea y un deterioro estructural del tejido óseo. Esta enfermedad está asociada con un alto riesgo de fracturas que comprometen seriamente la calidad de vida. La incidencia de osteoporosis es actualmente mayor debido al aumento de la esperanza de vida en el mundo. Numerosas investigaciones con respecto a nuevas estrategias de tratamiento han sido desarrolladas y tienen como objetivo inhibir la resorción ósea excesiva o aumentar la formación de hueso. Entre los tratamientos más prometedores están denosumab, un anticuerpo monoclonal que ejerce su acción contra el activador del receptor del ligando NF-kappa B, una citoquina clave de los osteoclastos; odanacatib, un inhibidor específico de la proteasa catepsina K de los osteoclastos; y anticuerpos monoclonales contra las proteínas antiesclerostina, la glucógeno sintasa quinasa-3b y dickkopf-1, dos inhibidores endógenos de la formación de hueso. En esta revisión se analizan y se revisan los conceptos actuales de las nuevas terapias.

Osteoporosis is a skeletal system pathology characterised by low bone mineral density and tissue structural deterioration. This condition is associated with high fracture risk that severely compromises quality of life. Osteoporosis incidence is becoming more significant with increasing lifespan worldwide. Novel treatment strategies have been developed that aim to inhibit excessive bone resorption and/or increase bone formation. The most promising novel treatments include: denosumab, a monoclonal antibody for receptor activator of NF-kB ligand, a key osteoclast cytokine; odanacatib, a specific inhibitor of the osteoclast protease cathepsin K; and antibodies against the proteins sclerostin, GKS-3b and dickkopf-1, two endogenous inhibitors of bone formation. This review discusses these new therapies.

Introduction: Etiologic diagnosis in patients with end-stage cardiomyopathy can be challenging. A large number of patients remain undiagnosed despite a thorough evaluation, so they are classified as idiopathic dilated cardiomyopathies. Objectives: To describe the etiology of cardiomyopathy in heart transplant recipients according to pretransplant clinical diagnosis and its degree of agreement with the anatomopathological diagnosis of the explanted heart. Methods: We performed a retrospective analysis of consecutively transplanted patients in a high complexity hospital of the Autonomous City of Buenos Aires from 2003 to the end of 2013. An agreement analysis between pretransplantation clinical diagnosis and anatomopathological diagnosis of the explanted heart was done using the kappa coefficient. Results: One-hundred patients with mean age of 49.7 ± 12.5 years at the time of transplantation and median ejection fraction of 26.6% were analyzed. The most common pretransplant clinical diagnosis was idiopathic dilated cardiomyopathy (37%), followed by ischemic-necrotic cardiomyopathy (32%) and Chagas cardiomyopathy (10%). The most common histopathological diagnoses were ischemic-necrotic cardiomyopathy (35%), hypertrophic cardiomyopathy (10%), Chagas cardiomyopathy (10%) and myocarditis (8%); a causal diagnosis was not reached in 25% of cases (idiopathic dilated cardiomyopathy). The kappa coefficient was 0.64 (CI 0.52-0.76). Conclusions: Approximately one third of patients reach transplantation without an etiologic diagnosis. Anatomopathological analysis allows identifying the cause in more than half of these patients. Although the correlation between pretransplant diagnosis and pathological anatomy was statistically adequate, a significant percentage of patients could benefit from a more specific etiologic diagnosis, which may have prognostic, therapeutic and/or family assessment implications.

Introducción: El diagnóstico etiológico en pacientes con miocardiopatías en estadio avanzado puede ser un desafío. Un gran número de pacientes permanecen sin diagnóstico a pesar de una evaluación exhaustiva, por lo que quedan rotuladas como miocardiopatías dilatadas idiopáticas. Objetivos: Describir la etiología de la miocardiopatía en pacientes receptores de trasplante cardíaco según el diagnóstico clínico pretrasplante y su grado de concordancia con el diagnóstico anatomopatológico del corazón explantado. Material y métodos: Se realizó un análisis retrospectivo de pacientes consecutivos trasplantados en un hospital de alta complejidad de la Ciudad Autónoma de Buenos Aires desde 2003 hasta fines de 2013. Se efectuó un análisis de concordancia entre el diagnóstico clínico pretrasplante y el diagnóstico anatomopatológico del corazón explantado utilizando el coeficiente kappa. Resultados: Se analizaron 100 pacientes con una edad media en el momento del trasplante de 49,7 ± 12,5 años y una mediana de fracción de eyección del 26,6%. El diagnóstico clínico pretrasplante más frecuente fue el de miocardiopatía dilatada idiopática (37%), seguida por la miocardiopatía isquémico-necrótica (32%) y la miocardiopatía chagásica (10%). Entre los diagnósticos histopatológicos más frecuentes se encontraron el de miocardiopatía isquémico-necrótica (35%), de miocardiopatía hipertrófica (10%), de miocardiopatía chagásica (10%) y de miocarditis (8%); no se arribó a un diagnóstico causal en el 25% (miocardiopatía dilatada idiopática). El resultado del coeficiente kappa fue de 0,64 (IC 0,52-0,76). Conclusiones: Aproximadamente un tercio de los pacientes llegan al trasplante sin un diagnóstico etiológico. El análisis anatomopatológico permite identificar la causa en más de la mitad de estos pacientes. A pesar de que la concordancia entre el diagnóstico pretrasplante y la anatomía patológica fue estadísticamente buena, un porcentaje importante de pacientes podría beneficiarse con un diagnóstico etiológico más preciso, que podría tener implicaciones pronósticas, terapéuticas y/o en la evaluación de familiares.

Las algas marinas han sido ampliamente estudiadas por investigadores del área de los productos naturales con el fin de encontrar agentes antitumorales y desarrollar nuevos agentes terapéuticos contra el cáncer. Los extractos crudos del alga roja marina Digenia simplex presentan un potente efecto antimitótico en líneas celulares cancerosas, por lo tanto es de suma importancia determinar las sustancias responsables de esta actividad. Para lograr este objetivo, se realizó un fraccionamiento cromatográfico del extracto etanólico de Digenia simplex guiado por evaluaciones de actividad antimitótica sobre la línea celular Jurkat (linfoma mieloide humano). Adicionalmente, se efectuó un ensayo de citotoxicidad de la fracción más activa obtenida. Para el fraccionamiento del extracto se utilizó cromatografía en columna con fase normal y cromatografía en capa delgada preparativa. Para el ensayo de citotoxicidad se utilizó el método de viabilidad celular por exclusión de colorante vital azul de tripano. Se obtuvo una fracción de naturaleza polar, que mostró actividad antimitótica y citotóxica. Esta fracción se comportó en forma similar al fármaco antineoplásico Colcemid.

Marine algae have been widely studied by natural products chemists in the search of antitumor agents and the development of new therapeutic agents against cancer. Extracts of the red alga Digenia simplex display a powerful antimitotic effect in cancer cell lines. Therefore, it is of extreme importance to determine what substances are responsible of this activity. In order to achieve this objective, the ethanol extract of Digenia simplex was subject to chromatographic fractionation guided by evaluation of antimitotic activity on the Jurkat cell line (human myeloid lymphoma). Additionally, the most active fraction obtained was tested for cytotoxicity. Normal phase column chromatography and preparatory thin layer chromatography were used for extract fractionation. Cytotoxicity was assessed by cellular viability methods, determining cellular viability by the exclusion of the vital dye trypan blue. A cytotoxic and antimitotic fraction of polar nature was obtained. This fraction behaved in a similar way to the antineoplasic drug Colcemid.

El desarrollo de las investigaciones en bioprospección marina requiere el fortalecimiento de los inventarios de organismos marinos, lo que implica una clasificación taxonómica exhaustiva de los mismos. La clasificación de las esponjas marinas es compleja desde el punto de vista morfológico y se facilita con el uso de información quimiotaxonómica basada en la composición de sus esteroles. El presente estudio describe la composición de esteroles libres de la esponja Mycale laevis, recolectada en la Bahía de Cispatá (Córdoba, Colombia). A partir del extracto metanólico de la esponja M. laevis, se obtiene el subextracto de diclorometano, que se fracciona mediante cromatografía en columna sobre sílica gel, eluyendo con mezclas de hexano-acetato de etilo con aumento gradual de la polaridad. La obtención de la fracción mayoritaria (Rf = 0.77, sílica gel/ hexano-acetato de etilo 1:1) y su análisis por cromatografía de gases acoplada a espectrometría de masas (CG-EM), permite la identificación de 9 esteroles monohidroxilados con núcleos esteroidales Δ0, Δ5 y Δ7 . Los estanoles (núcleo Δ0) son los más abundantes en la fracción esterólica, con el 71.7 % del total de compuestos presentes. Estos resultados contribuyen a los estudios quimiotaxonómicos de esponjas marinas pertenecientes a la familia Mycalidae.

The development of marine bioprospection research requires to fortify of marine organisms inventories, which also implies their exhaustive taxonomic classification. From the morphological point of view, the classification of marine sponges is a complex procedure and it is facilitated with the use of chemotaxonomic information based on the composition of its sterols. This study describes the free sterols composition of the Mycale laevis sponge, collected in the Cispatá Bay (Córdoba, Colombia). The subextract of dichloromethane is obtained from the methanol extract of the sponge; this subextract is fractionated through chromatography in column on silica gel, using hexane-ethyl acetate mixtures with a gradual increase of the polarity as a mobile phase. The obtention of the majoritary fraction (Rf = 0.77, silica gel /hexane: ethyl acetate 1:1) and its analysis by means of gas chromatography coupled to mass spectrometry (GC-MS), allows the identification of 9 monohydroxylated sterols with nuclei steroidal Δ0,Δ5 and Δ7 sterols. Stanols (nucleus Δ0) are the most abundant in the sterolic fraction with 71.7% of the total of the present compounds. These results contribute to chemotaxonomics studies marine sponges in the Mycalidae family.

En las últimas décadas, la búsqueda de sustancias antineoplásicas en organismos marinos y especialmente en algas marinas, muestra resultados promisorios en el desarrollo de fármacos antitumorales. Entre estas algas se encuentra Digenia simplex, la cual contiene una fracción química en su extracto etanólico con potente efecto antimitótico y citotóxico. Para dilucidar la estructura molecular de los compuestos constituyentes de ésta fracción bioactiva, se realiza un análisis por resonancia magnética nuclear (RMN), y cromatografía de gases acoplada a espectrometría de masas (CG-EM) de los derivados trimetilsililéteres (derivados TMS). El análisis permite inferir la presencia de una mezcla de compuestos, tales como: azúcares libres, ácidos grasos, nitrilos alifáticos, aminas secundarias alifáticas y monoacilgliceroles.

In last decades, antineoplasic substances have been found in marine organisms and especially in marine seaweeds, showing promissory results in antitumor drug development. Among these organisms is the seaweed Digenia simplex, which bears a biologically active fraction with a powerful antimitotic and cytotoxic effect, contained in its ethanol extract. In order to elucidate molecular structure of constituent compounds from this bioactive fraction, nuclear magnetic resonance (NMR) and Gas Chromatography coupled to Mass Spectrometry (GC-MS) analysis was conducted. A compounds mixture, such as: free sugars, fatty acids, aliphatic nitriles, aliphatic secondary amines and monoacylglycerols, were found from this analysis.

OBJECTIVES: To investigate the prevalence of common mental disorders in groups with a high percentage of families who have been displaced by armed conflict and political instability and are living in urban slum areas on the outskirts of Sincelejo, a city in the department of Sucre, Colombia. METHODS: A cross-sectional study was conducted, with two-stage random cluster sampling, in slum neighborhoods of Sincelejo that contain a high percentage of displaced persons. A household survey of persons 18 years old or older was used to determine the presence of common mental disorders-psychosomatic disorders, anxiety, and depression-in the population studied. A score of 7 or more on the first 20 questions of the Self-Reporting Questionnaire (SRQ) of the World Health Organization was used to determine the presence of a common mental disorder. We searched for associations among the studied variables (age group, gender, type of health care card, and length of residence in the neighborhood) and among those variables and the score on the SRQ. The chi-square test was used, with statistical significance set at 0.05. Logistic regression was carried out with all the related variables. RESULTS: The prevalence of common mental disorders in the adult population of the neighborhoods studied was 27.2% (95% confidence interval (95% CI) = 24.0% to 30.0%); 13.6% (95% CI = 11.4% to 16.1%) of the population surveyed had problems with excessive alcohol consumption. There was an association between the prevalence of common mental disorders and the type of health care card used (odds ratio = 1.66 for persons using the health care card for displaced persons versus persons using other types of health care cards). In addition, there was an association between the prevalence of common mental disorders and gender (OR = 1.78 for women); this association remained after adjusting for other explanatory variables. CONCLUSIONS: Using the study criteria (type of health care card and length of time living in the slum area), it was difficult to separate the displaced persons from other persons living in the same slum areas, and thus to measure the prevalence of common mental disorders among just the displaced persons. The prevalence of common mental disorders in the urban population studied showed a statistical association with the type of health care card, which in turn determined the level of access to public health services. This association between the type of health care card held and the prevalence of common mental disorders is strong enough to justify providing mental health care services to persons who have the health care card for displaced persons.

OBJETIVOS: Investigar la prevalencia de trastornos mentales comunes en grupos con un alto porcentaje de familias desplazadas que viven en barrios marginales urbanos en Sincelejo (Sucre), Colombia. MÉTODOS: Se realizó un estudio transversal con muestreo aleatorio bietápico por conglomerados en barrios considerados marginales de Sincelejo que contienen un alto porcentaje de población desplazada. Se realizó una encuesta domiciliaria para determinar la presencia de trastornos mentales comunes -trastornos psicosomáticos, ansiedad y depresión- en la población estudiada. Se fijó como valor discriminatorio para determinar la presencia de un trastorno mental común en personas de 18 años o más una puntuación de 7 en las 20 primeras preguntas del Cuestionario de declaración de síntomas (Self-Reporting Questionnaire, SRQ) de la Organización Mundial de la Salud. Se buscaron asociaciones entre las variables recogidas (grupo de edad, sexo, tipo de carné sanitario y tiempo de residencia en el barrio), y entre ellas y la puntuación obtenida en el SRQ. Se utilizó la prueba de ji al cuadrado, con un valor de significación estadística de 0,05, y se realizó una regresión logística con todas las variables relacionadas. RESULTADOS: Se encontró una prevalencia de 27,2% (intervalo de confianza de 95% [IC95%]: 24,0% a 30,0%) de trastornos mentales comunes en la población adulta de los barrios estudiados. En general, 13,6% (IC95%: 11,4% a 16,1%) de la población encuestada reconoció tener problemas de consumo excesivo de alcohol. Se encontró una asociación entre la prevalencia de trastornos mentales comunes y el tipo de carné usado para acceder a la atención de salud (razón de posibilidades [RP]: 1,66 para el carné de desplazado frente a cualquiera de los otros dos) y el sexo (RP: 1,78 para mujeres frente a hombres); dicha asociación persistió aun después del ajuste en función de las demás variables explicativas. CONCLUSIÓN: La prevalencia de trastornos mentales comunes en las poblaciones urbanas valoradas mostró una asociación estadística con el tipo de carné, del cual depende a su vez el acceso a los servicios públicos de salud. Dicha asociación es lo suficientemente alta para justificar la prestación de cuidados de salud mental a esta población. Aunque no se consiguió identificar adecuadamente la población desplazada en el grupo estudiado y, por tanto, medir en ella con el SRQ la prevalencia puntual de trastornos mentales comunes, los diferentes sistemas de acceso a la salud en Colombia, que contemplan un acceso determinado para los desplazados, parecen asociarse con la prevalencia de estos trastornos en barrios periféricos urbanos.