Dealing with fibromyalgia in the family context: a qualitative description study.

Headings purpose: Fibromyalgia (FM) is a chronic, nondegenerative disease with important limitations in patients. Its average global prevalence is 1.78%, and women are more affected than men (3:1). Due to the lack of objective diagnostic tools, it is a complex medical condition that is frequently unseen by patients' relatives and doctors, which might nonetheless have a noticeable impact on the patient's entourage.Material and Methods: This qualitative descriptive study aimed to elicit family members' views on how FM affects their lives. It was conducted in two community health centers (one rural and one urban) from the Sagunto Health Department (Valencia Community, Spain). We included seven focus groups with 41 family members. We analyzed the data gathered with an inductive thematic semantic analysis approach using NVivo 12 software.Results: We identified four major themes: (1) fibromyalgia as a nosological entity or an invention that is always burdensome; (2) children and spouses as caregivers (or not); (3) adverse effects of fibromyalgia on the couple's sexual life; and (4) harmful consequences of FM on the family economy. The findings showed a negative impact of the disease within the family context. Family members face complex and changing roles and difficulties when living with women with fibromyalgia.Conclusions: Relatives' better understanding of the disease, greater acceptance of new family roles, and improvement of patients' work conditions are all interventions that may help reduce the negative impact of FM in the family context.

Vázquez Canales LDM, Aguilar García-Iturrospe E, and Pereiro Berenguer I. Impact of fibromyalgia in the family context. FISABIO Foundation Primary Care Research Journey, Generalitat Valenciana (Valencia, Spain). 25th November 2021. Awarded Best Research Project in Primary Care Year 2021.Vázquez Canales LDM, Aguilar García-Iturrospe E, and Pereiro Berenguer I. Qualitative approach in the impact of fibromyalgia in the family context. IV Autonomic Fibromyalgia Journey for professionals and patients. Organized by Sagunto Hospital (Sagunto, Spain). 15th May 2018.Vázquez Canales LDM, Aguilar García-Iturrospe E, and Pereiro Berenguer I. Research project about the Impact of fibromyalgia in the family context. National Spanish Conference about Family Medicine. Organized by the Spanish Family Medicine Society (Madrid, Spain). 6^th May 2017.Vázquez Canales LDM, Aguilar García-Iturrospe E, and Pereiro Berenguer I. Quantitative approach in the impact of fibromyalgia in the family context. III Autonomic Fibromyalgia Journey for Professionals and Patients. Organized by Sagunto Hospital (Sagunto, Spain). 2^nd October 2017.

Synthesis of new melatoninergic hexahydroindenopyridines.

Hexahydroindenopyridine (HHIP) is an interesting heterocyclic framework that contains an indene core similar to ramelteon. This type of tricyclic piperidines aroused our interest as potential melatoninergic ligands. Melatonin receptor ligands have applications in insomnia and depression. We report herein an efficient two-step method to prepare new HHIP by the reaction of an enamine with 3-bromopropylamine hydrobromide. Some synthesized compounds showed moderate affinity for melatonin receptors in the nanomolar or low micromolar range. Furthermore, the methylenedioxy HHIPs 2d (N-phenylacetamide) and 2f (N,N-diethylacetamide), exhibited high selectivity at MT1 or MT2 receptors, respectively, when compared with melatonin. It seems that the methylenedioxy group on the indene ring system and the N-acetamide substituent are important structural features to bind selectively MT1 or MT2 subtypes.

Family physicians' professional identity formation: a study protocol to explore impression management processes in institutional academic contexts.

BACKGROUND: Despite significant differences in terms of medical training and health care context, the phenomenon of medical students' declining interest in family medicine has been well documented in North America and in many other developed countries as well. As part of a research program on family physicians' professional identity formation initiated in 2007, the purpose of the present investigation is to examine in-depth how family physicians construct their professional image in academic contexts; in other words, this study will allow us to identify and understand the processes whereby family physicians with an academic appointment seek to control the ideas others form about them as a professional group, i.e. impression management. METHODS/DESIGN: The methodology consists of a multiple case study embedded in the perspective of institutional theory. Four international cases from Canada, France, Ireland and Spain will be conducted; the "case" is the medical school. Four levels of analysis will be considered: individual family physicians, interpersonal relationships, family physician professional group, and organization (medical school). Individual interviews and focus groups with academic family physicians will constitute the main technique for data generation, which will be complemented with a variety of documentary sources. Discourse techniques, more particularly rhetorical analysis, will be used to analyze the data gathered. Within- and cross-case analysis will then be performed. DISCUSSION: This empirical study is strongly grounded in theory and will contribute to the scant body of literature on family physicians' professional identity formation processes in medical schools. Findings will potentially have important implications for the practice of family medicine, medical education and health and educational policies.

[Impact of the Tobacco Law on the workplace: a follow up study of a cohort of workers in Spain 2005-2007]. / Impacto de la Ley del tabaco en el lugar de trabajo: estudio de seguimiento de una cohorte de trabajadores en España 2005-07.

OBJECTIVE: The aim of this study is to describe the changes caused by the Law on Tobacco and its consumption in workers who are active smokers. DESIGN: A post-intervention follow up study of a cohort of users. SETTING: Health Centres in Valencia and Majorca. PARTICIPANTS: Users who attended health centres. INTERVENTION: The field work consisted of each patient filling in a case report form with the requested information. MAIN MEASUREMENTS: The variables collected were, sex, place of work, education level, number of workers in the company, number of cigarettes smoked. They were told that on the following day they had to count the cigarettes smoked throughout the day, noting whether they had been smoked during or outside working hours. If they smoked during working hours, they reported whether it was inside or outside the workplace. On the following day they were telephoned to let us know the number of cigarettes smoked. This telephone call was repeated at six months and eighteen months. RESULTS: Smoking prevalence and the number of cigarettes smoked in the workplace has been reduced by 9% per month. The variables associated with compliance with the law were education level, the sex of the worker, and the size of the company. CONCLUSIONS: The coming into force of the Tobacco Law has been effective.

Tetrahydroisoquinolines as dopaminergic ligands: 1-Butyl-7-chloro-6-hydroxy-tetrahydroisoquinoline, a new compound with antidepressant-like activity in mice.

Three series of 1-substituted-7-chloro-6-hydroxy-tetrahydroisoquinolines (1-butyl-, 1-phenyl- and 1-benzyl derivatives) were prepared to explore the influence of each of these groups at the 1-position on the affinity for dopamine receptors. All the compounds displayed affinity for D(1)-like and/or D(2)-like dopamine receptors in striatal membranes, and were unable to inhibit [(3)H]-dopamine uptake in striatal synaptosomes. Different structure requirements have been observed for adequate D(1) or D(2) affinities. This paper details the synthesis, structural elucidation, dopaminergic binding assays, structure-activity relationships (SAR) of these three series of isoquinolines. Moreover, 1-butyl-7-chloro-6-hydroxy-tetrahydroisoquinoline (1e) with the highest affinity towards D(2)-like receptors (K(i) value of 66nM) and the highest selectivity (49-fold D(2) vs D(1)) by in vitro binding experiments was then evaluated in behavioral assays (spontaneous activity and forced swimming test) in mice. Compound 1e increased locomotor activity in a large dose range (0.04-25mg/kg). Furthermore, this lead compound produced reduction in immobility time in the forced swimming test at a dose (0.01mg/kg) that did not modify locomotor activity. The haloperidol (0.03mg/kg), a D(2) receptor preferred antagonist, blocked the antidepressant-like effect of compound 1e.

Relationship between vitamin D, osteoporotic fracture and falls. / Relación entre la concentración plasmática de vitamina D, fractura osteoporótica y caídas.

OBJECTIVE: Link low levels of vitamin D, osteoporotic fracture and falls. PATIENTS AND METHOD: Transversal observational study with the study variables of age, levels of vitamin D, osteoporotic fracture and falls. The study population was patients evaluated by the Rehabilitation Department, Hospital of Sagunto, from January 2013 to December 2014. RESULTS: Of the 242 patients who underwent vitamin D analysis, 70.6% showed levels under 30ng/ml. Forty-eight percent of the patients with below normal levels of vitamin D suffered a fracture, opposed to 32.4% patients with normal levels. Thus, controlling by age, patients with low levels of vitamin D are 4.8 times more likely to suffer a fracture than those with normal levels. Regarding falls, controlling by age, there is a higher risk of falling (adjusted OR 2.68) in those patients with low levels of vitamin D. CONCLUSIONS: Patients with low vitamin D levels are more likely to suffer falls and fractures.

Systematic Review of the profile of emergency contraception users.

UNLABELLED: Abastract Objective: to discern the profile of the Spanish Emergency Contraceptive users (EC). DESIGN: systematic review of contraceptive use in the Spanish population. DATA SOURCE: Spanish and international databases, between January 2006 - March 2011. KEYWORDS: Contraceptives, Postcoital pills, emergency contraception, levonorgestrel, data collection. STUDY SELECTION: original papers, letters to the editor in which stated aims were the description, prediction or measurement of variables related to EC use. Twenty-two papers were retrieved and fourteen were finally selected, all of which were descriptive. DATA EXTRACTION: manuscripts were evaluated by two independent reviewers. RESULTS: Women requesting EC have ages between 21-24 years, mostly single and university students; declare that they have not previously used EC, and attend an Emergency department, at weekends and within 48 hours following unprotected sexual intercourse. The reason is condom rupture. None of the studies reviewed measured alcohol and other drug consumption, the number of sexual partners, nor any of the studies performed a comparison with a group not using EC. CONCLUSIONS: lack of homogeneity and comprehensiveness of studied variables resulted in a limited profile of Spanish EC users. Further studies are needed with a more comprehensive approach if sexual health interventions are to be carried out in possible users.

Tetrahydroisoquinolines acting as dopaminergic ligands. A molecular modeling study using MD simulations and QM calculations.

A molecular modeling study on 16 1-benzyl tetrahydroisoquinolines (BTHIQs) acting as dopaminergic ligands was carried out. By combining molecular dynamics simulations with ab initio and density functional theory (DFT) calculations, a simple and generally applicable procedure to evaluate the binding energies of BTHIQs interacting with the human dopamine D2 receptor (D2 DR) is reported here, providing a clear picture of the binding interactions of BTHIQs from both structural and energetic viewpoints. Molecular aspects of the binding interactions between BTHIQs and the D2 DR are discussed in detail. A significant correlation between binding energies obtained from DFT calculations and experimental pKi values was obtained, predicting the potential dopaminergic effect of non-synthesized BTHIQs.

Systematic Review of the profile of emergency contraception users / Revisão sistemática do perfil de usuárias de contracepção de emergência / Revisión sistemática del perfil de usuarias de anticonceptivos de emergencia

Abastract Objective: to discern the profile of the Spanish Emergency Contraceptive users (EC). Design: systematic review of contraceptive use in the Spanish population. Data Source: Spanish and international databases, between January 2006 - March 2011. Keywords: Contraceptives, Postcoital pills, emergency contraception, levonorgestrel, data collection. Study selection: original papers, letters to the editor in which stated aims were the description, prediction or measurement of variables related to EC use. Twenty-two papers were retrieved and fourteen were finally selected, all of which were descriptive. Data extraction: manuscripts were evaluated by two independent reviewers. Results: Women requesting EC have ages between 21-24 years, mostly single and university students; declare that they have not previously used EC, and attend an Emergency department, at weekends and within 48 hours following unprotected sexual intercourse. The reason is condom rupture. None of the studies reviewed measured alcohol and other drug consumption, the number of sexual partners, nor any of the studies performed a comparison with a group not using EC. Conclusions: lack of homogeneity and comprehensiveness of studied variables resulted in a limited profile of Spanish EC users. Further studies are needed with a more comprehensive approach if sexual health interventions are to be carried out in possible users.

Resumo Objetivo: caracterizar o perfil das usuárias espanholas de contraceptivos de emergência (CE). Desenho: revisão sistemática do uso de contraceptivos na população espanhola. Fontes de dados: Bases de dados espanholas e internacionais entre janeiro de 2006 e março de 2011. Palavras-chave: Contraceptivos, Pílulas pós-coitais, contracepção de emergência, levonorgestrel, coleta de dados. Seleção do estudo: trabalhos originais, cartas ao editor nas quais o objetivo expresso fosse a descrição, predição o medida de variáveis relacionadas ao uso de CE. Vinte e dois artigos foram recuperados e quatorze foram finalmente selecionados, todos eles de tipo descritivo. Extração dos dados: os manuscritos foram avaliados por dois revisores independentes. Resultados: mulheres que demandaram CE tinham idades entre 21 a 24 anos, principalmente solteiras e estudantes universitárias; declaram não ter utilizado CE previamente, e se apresentam num Serviço de Emergência no final de semana, dentro das 48 horas seguintes a uma relação sexual não protegida. A razão explicitada é ruptura de preservativo. Nenhum dos estudos incluídos na revisão mediu uso de álcool ou outras drogas, ou numero de parceiros sexuais. Também não foram identificados estudos fazendo comparações com grupos que não utilizam CE. Conclusões: falta de homogeneidade e abrangência das variáveis estudadas resulta num perfil limitado das usuárias espanholas de CE. Mais estudos, com enfoques mais abrangentes, são necessários para levar a cabo intervenções de saúde em possíveis usuárias.

Resumen Objetivo: caracterizar el perfil de las usuarias españolas de Anticonceptivos de Emergencia (AE). Diseño: Revisión sistemática del uso de anticonceptivos en la población española. Fuentes de datos: Bases de datos españolas e internacionales entre enero de 2006 y marzo de 2011. Palabras clave: anticonceptivos, píldoras postcoitales, anticoncepción de emergencia, levonorgestrel, recolección de datos. Selección del estudio: artículos originales, cartas al editor en las que se establecía como objetivo la descripción, la predicción o la medida de variables relacionadas con el uso de AE. Veintidós artículos fueron recuperados de los cuales catorce fueron finalmente seleccionados, todos ellos descriptivos. Extracción de los datos : Los manuscritos fueron evaluados por dos revisores independientes. Resultados: Las mujeres que requieren AE tienen edades entre 21 a 24 años, principalmente solteras y estudiantes universitarias,; declaran que no han usado AE previamente y concurren a un departamento de Emergencia en los fines de semana durante las 48 horas después de tener relaciones sexuales sin protección. La razón esgrimida es la ruptura de preservativo. Ninguno de los estudios revisados midió el consumo de alcohol o drogas, o el número de parejas sexuales. Tampoco fueron identificados que comparasen con un grupo que no usa AE. Conclusión: La falta de homogeneidad y de amplitud de las variables estudiadas resultó en un perfil limitado de las usuarias españolas de AE. Se precisan estudios ulteriores con enfoques mas amplios si se desea realizar intervenciones de salud sexual en potenciales usuarias.

Structure-activity relationship of dopaminergic halogenated 1-benzyl-tetrahydroisoquinoline derivatives.

Two series of halogenated 1-benzyl-7-chloro-6-hydroxy-tetrahydroisoquinolines were prepared to explore the influence of each series on the affinity for dopamine receptors. All the compounds displayed a high affinity for D(1)-like and/or D(2)-like dopamine receptors in striatal membranes, although they were unable to inhibit [(3)H]-dopamine uptake in striatal synaptosomes. The halogen placed on the benzylic ring in 1-benzyl-THIQs, compounds of the series 1, 2'-bromobenzyl derivatives with K(i) values into the nanomolar range, and the series 2, 2',4'-dichlorobenzyl-THIQ homologues, proves to be an important factor to modulate affinity at dopamine receptor.