ABSTRACT
OBJECTIVES: Fibromyalgia is a prevalent disease of unknown aetiology and is difficult to diagnose. Despite the availability of the American College of Rheumatology criteria for diagnosis, it continues to be a challenge in the field of primary health care in terms of identifying individuals with susceptibility to developing the disease. The aim of this study is to design and validate a predictive model of fibromyalgia in subjects with a history of chronic pain. METHODS: This multicentre observational retrospective cohort study was performed on patients aged >18 years, who visited four primary health centres between 2017 and 2020, with a diagnosis of fibromyalgia or arthritis. The Bootstrapping resampling method was used for the validation of the model. RESULTS: A total of 198 subjects with fibromyalgia (93 with osteoarthritis, 20 with other types of arthritis, 4 with rheumatoid arthritis) and 120 without fibromyalgia (116 with osteoarthritis, 23 with other types of arthritis, 7 with rheumatoid arthritis) participated in the study. The predictive factors of the final model were self-reported age at onset of symptoms, first-line family history of neurological diseases, exposure to levels of stress, history of post-traumatic acute emotional stress, and personal history of chronic widespread pain prior to diagnosis, comorbidity, and pharmacological prescription during the year of diagnostic confirmation. The predictive capacity adjusted by Bootstrapping was 0.972 (95% CI: 0.955-0.986). CONCLUSIONS: The proposed model showed an excellent predictive capacity. The risk calculator designed from the predictive model allows health professionals to have a useful tool to identify subjects at risk of developing fibromyalgia.
Subject(s)
Arthritis, Rheumatoid , Chronic Pain , Fibromyalgia , Osteoarthritis , Humans , Fibromyalgia/diagnosis , Fibromyalgia/epidemiology , Fibromyalgia/complications , Retrospective Studies , Chronic Pain/diagnosis , Chronic Pain/epidemiology , Chronic Pain/etiology , Arthritis, Rheumatoid/diagnosis , Arthritis, Rheumatoid/epidemiology , Arthritis, Rheumatoid/complications , Osteoarthritis/complicationsABSTRACT
Selenoproteins are proteins that incorporate selenocysteine (Sec), a nonstandard amino acid encoded by UGA, normally a stop codon. Sec synthesis requires the enzyme Selenophosphate synthetase (SPS or SelD), conserved in all prokaryotic and eukaryotic genomes encoding selenoproteins. Here, we study the evolutionary history of SPS genes, providing a map of selenoprotein function spanning the whole tree of life. SPS is itself a selenoprotein in many species, although functionally equivalent homologs that replace the Sec site with cysteine (Cys) are common. Many metazoans, however, possess SPS genes with substitutions other than Sec or Cys (collectively referred to as SPS1). Using complementation assays in fly mutants, we show that these genes share a common function, which appears to be distinct from the synthesis of selenophosphate carried out by the Sec- and Cys- SPS genes (termed SPS2), and unrelated to Sec synthesis. We show here that SPS1 genes originated through a number of independent gene duplications from an ancestral metazoan selenoprotein SPS2 gene that most likely already carried the SPS1 function. Thus, in SPS genes, parallel duplications and subsequent convergent subfunctionalization have resulted in the segregation to different loci of functions initially carried by a single gene. This evolutionary history constitutes a remarkable example of emergence and evolution of gene function, which we have been able to trace thanks to the singular features of SPS genes, wherein the amino acid at a single site determines unequivocally protein function and is intertwined to the evolutionary fate of the entire selenoproteome.
Subject(s)
Biological Evolution , Phosphotransferases/genetics , Phosphotransferases/metabolism , Animals , Biomarkers , Eukaryota/genetics , Eukaryota/metabolism , Gene Duplication , Humans , Insecta , Phylogeny , Prokaryotic Cells/metabolism , Selection, Genetic , Selenium/metabolism , Selenoproteins/genetics , Selenoproteins/metabolism , Urochordata , VertebratesABSTRACT
Introducción: La asignatura Metodología de la Investigación Cualitativa en Salud se imparte a los estudiantes de tercer año de la Licenciatura en Enfermería en la modalidad de clase teórico-práctica como forma organizativa de la docencia. Ello recalca la importancia del trabajo independiente. Las insuficiencias con relación a éste inciden directamente en la asimilación y apropiación de los conocimientos de la asignatura. Objetivo: Elaborar una estrategia didáctica que contribuya al desarrollo del trabajo independiente correspondiente a la asignatura Metodología de la Investigación Cualitativa en Salud.Material y métodos: Se realizó una investigación de desarrollo, encaminada a perfeccionar el proceso docente educativo en la Facultad de Enfermería, de la Universidad de Ciencias Médicas de Camagüey, durante el curso escolar 2011-2012. Para el diagnóstico inicial se procedió al análisis de documentos: los planes de estudio y el programa de la asignatura. También se aplicaron encuestas a un grupo de estudiantes y al colectivo de profesores que imparten la asignatura. Una vez elaborada la estrategia se evaluó por criterio de expertos. Resultados y discusión: La estrategia pone a disposición de la comunidad académica un software educativo que relaciona los contenidos de la asignatura, lo que permitirá al estudiantado realizar las tareas docentes que se orientan en clases así como asimilar, consolidar y sistematizar los conocimientos con mayor facilidad.
Introduction: The subject Methodology of Qualitative Research in Health is taught to the students of the third year of the Bachelor in nursing in the form of theoretical and practical lesson as organizational way of teaching. This underscores the importance of self-employment. The shortcomings in relation to this affect directly the assimilation and appropriation of knowledge in the subject. Objective: To develop a teaching strategy that contributes to the development of self-employ ment for the subject Methodology of Qualitative Research in Health. Material aids and methods: A development research was made which aims at improving the educational teaching process in the Faculty of nursing from the University of Medical Sciences in Camagüey, during the 2011-2012 course. For an initial diagnosis the analyses of documents was made: the curriculum and the program of the course. Surveys were also applied to a group of students and the staff of teachers of the subject. Once the strategy was made it was evaluated through criteria of experts. Results and discussion: Strategy makes available to the academic community educational software that relates to the contents of the course, allowing students to perform teaching tasks which are assigned in lessons as well as assimilate, consolidate and systematize the knowledge easiest.