Effects of a physical self-care support program for patients with fibromyalgia: A randomized controlled trial.

BACKGROUND: The effects of stretching exercises in fibromyalgia (FM) deserves further study. OBJECTIVE: To evaluate the effectiveness of a Physical Self-Care Support Program (PSCSP), with emphasis on stretching exercises, in the treatment of FM. METHODS: Forty-five women with FM were randomized to the PSCSP (n= 23) or to a control group (n= 22). The PSCSP consisted of weekly 90-minute learning sessions over 10 weeks, providing instructions on wellness, postural techniques, and active stretching exercises to be done at home. The control group was monitored through 3 medical appointments over 10 weeks and included in a waiting list. The primary outcomes were the Fibromyalgia Impact Questionnaire (FIQ), the Visual Analogue Scale (VAS) for pain, and the Sit and Reach Test (SRT) at the end of the study. RESULTS: Nineteen and 21 patients completed the trial in PSCSP and control groups, respectively. After 10 weeks, the PSCSP group showed significantly better FIQ (difference between adjusted means, -13.64, 95% CI, -21.78 to -5.49, P= 0.002) and SRT scores (7.24 cm, 3.12 to 11.37, P= 0.001) than the control group, but no significant difference in pain VAS (-1.41, -3.04 to 0.22, P= 0.088). Analysis using multiple imputation (MI) and delta-adjusted MI for missing outcomes rendered similar results. CONCLUSIONS: A PSCSP emphasizing stretching exercises significantly improved FIQ and SRT scores, and may be a helpful therapy for FM.

Can the snapping sound discriminate true from false penile fractures? Bayesian analysis of a case series of consecutively treated penile fracture patients.

Some patients with clinically diagnosed penile fracture actually have a false fracture (no tunica albuginea tear found at surgery). Although previous reports indicate that these patients often do not report hearing a snapping sound (henceforth sound) at injury, there are no studies of the sound's role in this differential diagnosis. To assess if the sound's absence increased the likelihood of intraoperatively diagnosing a false fracture, we retrospectively analyzed 65 consecutive clinically diagnosed penile fracture patients between January 2008 and December 2017, using surgical diagnosis of penile fracture as outcome variable and sound as main predictor, including as covariates age, presentation delay, immediate detumescence after injury, and whether injury occurred during sexual intercourse. Fifty-six patients had penile fracture (86.2%), and most (40, 71.4%) reported the sound, whereas two of the nine patients with false fracture reported the sound (22.2%, p = 0.007, Fisher's exact test). Bayesian logistic regression revealed that the sound was associated with surgical diagnosis of penile fracture (relative odds ratio = 4.25), and the probability of penile fracture fell from 92 to 74% when the sound was not reported among patients injured during intercourse experiencing immediate detumescence. This study followed PROCESS (Preferred Reporting of Case Series in Surgery) guidelines.

Tailoring Electrospun Poly(l-lactic acid) Nanofibers as Substrates for Microfluidic Applications.

Novel microfluidic substrates based on electrospun poly(l-lactic acid) (PLLA) membranes were developed to increase the limited range of commercially available paper substrates, commonly used for the fabrication of microfluidic paper-based analytical devices. PLLA's advantageous properties include biodegradability, biocompatibility, ease of being processed in various tailored morphologies, and cost effectiveness, among others. Oriented and nonoriented electrospun PLLA membranes were fabricated using electrospinning and the influence of fiber orientation, addition of hydrophilic additives, and plasma treatments on the morphology, physicochemical properties, and capillary flow rates were evaluated and compared with the commercial Whatman paper. In addition, a proof-of-concept application based on the colorimetric detection of glucose in printed PLLA and paper-based microfluidic systems was also performed. The results show the potential of PLLA substrates for the fabrication of portable, disposable, eco-friendly, and cost-effective microfluidic systems with controllable properties that can be tailored according to specific biotechnological application requirements, being a suitable alternative to conventional paper-based substrates.

[Liver transplantation in hemophilia A. Report of one case]. / El trasplante de hígado es un procedimiento plausible, efectivo y seguro en pacientes con hemofilia. Caso clínico.

Due to blood derivative requirements, many patients with hemophilia were exposed to Hepatitis C virus infection (HCV) before the availability of HCV testing. We report a 46-year-old male with Hemophilia A with a hepatitis virus C infection since 2004 causing a cirrhosis. Due to a hepatopulmonary syndrome, he received a liver allograph using a factor VIII replacement protocol, after eradicating the virus C. He had a good postoperative evolution, and no more factor VIII was required after transplantation until his last assessment.

El trasplante de hígado es un procedimiento plausible, efectivo y seguro en pacientes con hemofilia: caso clínico / Liver transplantation in hemophilia A: report of one case

Due to blood derivative requirements, many patients with hemophilia were exposed to Hepatitis C virus infection (HCV) before the availability of HCV testing. We report a 46-year-old male with Hemophilia A with a hepatitis virus C infection since 2004 causing a cirrhosis. Due to a hepatopulmonary syndrome, he received a liver allograph using a factor VIII replacement protocol, after eradicating the virus C. He had a good postoperative evolution, and no more factor VIII was required after transplantation until his last assessment.

A novel spot test based on digital images for determination of methanol in biodiesel.

Methanol is used in transesterification reaction for biodiesel production, being an important quality parameter to evaluate the purity of the final product. Methanol concentrations higher than 0.20% (m/m) reduce the biofuel efficiency. The Brazilian, United States, and European standards recommend the reference method based on gas chromatography with flame ionization detection, which involves a time-consuming procedure and requires high-cost equipment. In this work, it is proposed a simple and low cost spot test based on digital images acquired with a smartphone camera for the determination of methanol in biodiesel. The procedure was based on the oxidation of methanol to formaldehyde and subsequent reaction with Schiff reagent, resulting in a violet product. Analytical signals were based on the reflected radiation measured on the G channel (RGB system), which refers to the complementary color of the reaction product. Linear responses were obtained within 20-500 mg kg-1 and 500-2000 mg kg-1 methanol for 600 and 150 µL of sample aqueous extracts, respectively. The coefficient of variation (n = 10) and the limit of detection (99.7% confidence level) were estimated as 4.8% and 10 mg kg-1 (600 µL of sample), respectively. The procedure requires only 75 µg of potassium permanganate, 6 mg of oxalic acid, and 1.5 mg of p-rosaniline and generates ca. 1.2 mL of residue per determination. The results agreed with those obtained by the reference procedure at the 95% confidence level, demonstrating that the proposed method is an alternative for routine analysis of the biofuel.

Aqueous shunt versus trabeculectomy for treatment of glaucoma. / Derivación acuosa versus trabeculectomía para el manejo del glaucoma.

INTRODUCTION: Aqueous shunt has emerged as an alternative technique to trabeculectomy, which is considered the standard treatment for glaucoma surgery. Currently, it is mainly indicated after failure of trabeculectomy or in some types of glaucoma with high risk of failure. However, there is still controversy regarding its effectiveness compared to trabeculectomy. METHODS: We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS: We identified five systematic reviews including nine studies overall, of which four were randomized trials. We concluded that aqueous shunt might increase the qualified success compared to trabeculectomy, but it is not clear whether it has any effect on the rest of the critical outcomes for decision-making because the certainty of the evidence is very low.

INTRODUCCIÓN: La derivación acuosa ha surgido como una técnica alternativa a la trabeculectomía, la cual se considera el tratamiento estándar para cirugía de glaucoma. Actualmente, su principal indicación es en el glaucoma con trabeculectomía fallida o en algunos tipos de glaucoma con alto riesgo de fracaso. Sin embargo, aún existe controversia con respecto a su efectividad en comparación con la trabeculectomía. MÉTODOS: Realizamos una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES: Identificamos cinco revisiones sistemáticas que en conjunto incluyeron nueve estudios primarios, de los cuales, cuatro corresponden a ensayos aleatorizados. Concluimos que la derivación acuosa podría aumentar el éxito calificado en comparación con la trabeculectomía, pero que no está claro si tiene algún efecto sobre el resto de los desenlaces críticos para la toma de decisión, porque la certeza de la evidencia es muy baja.

Is Ahmed valve superior to Baerveldt implant as an aqueous shunt for the treatment of glaucoma? / ¿Es la válvula Ahmed superior al implante Baerveldt como derivación acuosa para el manejo del glaucoma?

INTRODUCTION: Aqueous shunt has emerged as an alternative technique to trabeculectomy, considered the standard for glaucoma surgery. Currently, it is mainly indicated after failure of trabeculectomy or in glaucoma with high risk of failure. The Ahmed valve and the Baerveldt implant are the most commonly used aqueous shunts. However, it is not clear whether there are differences between them. METHODS: To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS: We identified five systematic reviews including 10 studies overall, of which two were randomized trials. We concluded the Ahmed valve probably achieves a lower decrease in intraocular pressure, might lead to less qualified success and probably needs more reinterventions than the Baerveldt implant. Regarding safety profile, the Ahmed valve is not clearly superior or inferior to the Baerveldt implant.

INTRODUCCIÓN: La derivación acuosa ha surgido como una técnica alternativa a la trabeculectomía, considerada la cirugía de elección en pacientes con glaucoma. Actualmente, se considera que la principal indicación de esta técnica es ante el fracaso de la trabeculectomía o en tipos de glaucoma que tienen alto riesgo de fracasar. La válvula Ahmed y el implante Baerveldt son las derivaciones acuosas más utilizadas. Sin embargo, no está claro cuáles son las diferencias entre estas dos alternativas. MÉTODOS: Para responder esta pregunta utilizamos Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud a nivel mundial, la cual es mantenida mediante búsquedas en múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, reanalizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES: Identificamos cinco revisiones sistemáticas que en conjunto incluyeron 10 estudios primarios, de los cuales dos son ensayos aleatorizados. Concluimos que la válvula Ahmed probablemente logra una menor disminución de la presión intraocular; podría lograr un menor éxito calificado y probablemente necesita más reintervenciones que el implante Baerveldt. Respecto al perfil de seguridad, la válvula Ahmed no se presenta claramente superior ni inferior al implante Baerveldt.

The effect of the H-1 scaling factors τ and ω on the structure of H in the single-step procedure.

BACKGROUND: The single-step covariance matrix H combines the pedigree-based relationship matrix [Formula: see text] with the more accurate information on realized relatedness of genotyped individuals represented by the genomic relationship matrix [Formula: see text]. In particular, to improve convergence behavior of iterative approaches and to reduce inflation, two weights [Formula: see text] and [Formula: see text] have been introduced in the definition of [Formula: see text], which blend the inverse of a part of [Formula: see text] with the inverse of [Formula: see text]. Since the definition of this blending is based on the equation describing [Formula: see text], its impact on the structure of [Formula: see text] is not obvious. In a joint discussion, we considered the question of the shape of [Formula: see text] for non-trivial [Formula: see text] and [Formula: see text]. RESULTS: Here, we present the general matrix [Formula: see text] as a function of these parameters and discuss its structure and properties. Moreover, we screen for optimal values of [Formula: see text] and [Formula: see text] with respect to predictive ability, inflation and iterations up to convergence on a well investigated, publicly available wheat data set. CONCLUSION: Our results may help the reader to develop a better understanding for the effects of changes of [Formula: see text] and [Formula: see text] on the covariance model. In particular, we give theoretical arguments that as a general tendency, inflation will be reduced by increasing [Formula: see text] or by decreasing [Formula: see text].

How to face a patient with benzodiazepine dependence in primary health care? Strategies for withdrawal. / ¿Cómo afrontar un paciente con dependencia a benzodiacepinas en atención primaria? Estrategias para la deshabituación.

Benzodiazepines are widely used in primary health care, and their prolonged use is an important problem given the medical consequences particularly in older adults, such as dependence, cognitive impairment, and risk of falls, among others. Primary care doctors generally have few tools to help with managing withdrawal from benzodiazepines. We conducted a review of the best available evidence on practical strategies to avoid dependence at the time of the initial prescription, and to help the patient with prolonged and probably dependent use. We found ten relevant systematic reviews showing evidence in favor of the use of multifaceted prescription strategies, gradual dose reduction, standardized letters, standardized counseling, pharmacotherapy and cognitive behavioral psychotherapy. For benzodiazepine withdrawal, a simple strategy that can be effective and long-lasting is to inform patients of the need to reduce consumption, giving them in writing the withdrawal guideline, indicating the possible effects of withdrawal and its solution. Given the available evidence, an integrated and step-by-step model is proposed for the management of the benzodiazepine user, from prescription to withdrawal.

Las benzodiacepinas son fármacos ampliamente utilizados en atención primaria de salud. Su uso prolongado se ha convertido en un problema relevante dadas las consecuencias médicas que ocasionan, especialmente en adultos mayores. Entre otras, estas son: dependencia, deterioro cognitivo y riesgo de caídas. Además, los médicos que trabajan en atención primaria cuentan con pocas herramientas para ayudar al paciente en su deshabituación. Se realizó una búsqueda y revisión de la mejor evidencia disponible sobre estrategias prácticas para el médico no especialista en adicciones, para evitar la dependencia al momento de la prescripción inicial y en el paciente con uso prolongado y probablemente dependiente. Se encontraron 10 revisiones sistemáticas relevantes que mostraron evidencia a favor del uso de estrategias multifacéticas en la prescripción, disminución progresiva, cartas y consejería estandarizadas, farmacoterapia y psicoterapia cognitiva conductual. Una estrategia sencilla, eficaz y duradera para prescribir benzodiacepinas es informar al paciente de la necesidad de reducir su consumo, dándole por escrito la pauta de retirada, señalando sus posibles efectos y su solución. Debido a la evidencia disponible, se propone un modelo integrado y escalonado para el manejo del paciente usuario de benzodiacepinas, desde su prescripción hasta su descontinuación.

Is mytomicyn better than 5-fluorouracil as antimetabolite in trabeculectomy for glaucoma? / ¿Es la mitomicina C superior al 5-fluorouracilo como antimetabolito en la trabeculectomía para el glaucoma?

INTRODUCTION: Trabeculectomy is considered the standard for glaucoma surgery. Postoperative scarring is one the factors associated with surgery failure. Different antimetabolites have been used in order to reduce this risk, particularly 5-fluorouracil and mitomycin C. Although both are considered effective, it is not clear if they are different in terms of success of trabeculectomy and adverse effects. METHODS: To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS: We identified four systematic reviews including 17 studies overall, of which 12 were randomized trials. We concluded mitomycin C might be more effective in reducing intraocular pressure and increasing qualified success compared to 5-fluorouracil. However, its use might be associated to a higher risk of complications.

INTRODUCCIÓN: La trabeculectomía es considerada la intervención de elección en pacientes con glaucoma con indicación de manejo quirúrgico. Dentro de los factores asociados al fracaso de este tratamiento se encuentra la cicatrización postoperatoria. Para disminuir este factor se han usado distintos antimetabolitos, en particular el 5-fluorouracilo y la mitomicina C. Si bien ambos se consideran efectivos, no está claro si existen diferencias entre ambos en relación al éxito de la trabeculectomía y los efectos adversos. MÉTODOS: Para responder esta pregunta utilizamos Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante búsquedas en múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, reanalizamos los datos de los estudios primarios, realizamos un metanálisis, preparamos tablas de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES: Identificamos cuatro revisiones sistemáticas que en conjunto incluyen 17 estudios primarios, de los cuales, 12 corresponden a ensayos aleatorizados. Concluimos que el uso de mitomicina C podría lograr una mayor disminución de la presión intraocular e incrementar la tasa de éxito calificado en comparación con el 5-fluorouracilo. Sin embargo, su uso podría asociarse a una mayor incidencia de complicaciones.

Diarrea poscolecistectomía: ¿un problema frecuente? / Postcholecystectomy diarrhea is a frequent problem?

Resumen Introducción: La colecistectomía laparoscópica es una de las intervenciones quirúrgicas más frecuentes en nuestro país. La diarrea poscolecistectomía es una entidad poco reconocida, con una prevalencia descrita entre el 0,9 y 35,6%, sin embargo, en Chile esto no ha sido claramente definido. Objetivo: Determinar la prevalencia y características de la diarrea poscolecistectomía laparoscópica electiva en una muestra de pacientes chilenos. Material y métodos: Se aplicó una encuesta telefónica estructurada sobre consistencia y frecuencia de deposiciones, entre 4 y 6 meses después de la intervención, a los pacientes adultos operados de colecistectomía laparoscópica electivamente entre diciembre de 2014 y marzo de 2015. Se definió como «diarrea poscolecistectomía¼ la presencia de deposiciones líquidas o inusualmente disgregadas que hubiesen comenzado posteriormente a la intervención y se estableció el término de «diarrea prolongada¼ como la duración de síntomas mayor de 4 semanas. Resultados: Se encuestó a 100 pacientes (73% de mujeres). La prevalencia global de diarrea poscolecistectomía fue del 35% (n = 35). La prevalencia de pacientes con diarrea prolongada fue del 15% (n = 15). En el grupo con diarrea prolongada, se observó resolución completa de esta en el 57% de los pacientes (n = 8) en un plazo medio de 99 ± 29 días. Conclusión: La diarrea poscolecistectomía es una entidad frecuente en nuestra población, con una alta prevalencia dentro de los primeros 28 días posteriores a la intervención. En la mayoría de los pacientes se resuelve en los primeros 6 meses.

Abstract Introduction: Laparoscopic cholecystectomy (LC) is one of the most common surgical procedures in our country. Postcholecystectomy diarrhea is an unrecognized entity, with a reported prevalence between 0.9 and 35.6%, nonetheless in Chile this has not been clearly defined. Objective: To determine the prevalence and characteristics of diarrhea following elective laparoscopic cholecystectomy in our institution. Material and methods: A structured questionnaire about consistency and defecation frequency was applied to adult patients summited to an elective LC between December 2014 and February 2015, by a telephone survey within 4 and 6 months after the surgical procedure. Postcholecystectomy diarrhea was defined as the presence of liquid or unusually disrupted faecal material beginning after LC. Persistent diarrhea was established when diarrhea continued for a period longer than four weeks. Results: One hundred patients were included (73% women). The overall prevalence of postcholecystectomy diarrhea was 35% (n = 35). The prevalence of patients with persistent diarrhea was 15% (n = 15). In the group of patients with persistent diarrhea, complete resolution was observed on 57% of the cases (n = 8) within an average period of 99 ± 29 days. Conclusion: Post cholecystectomy diarrhea is a frequent condition in our population, with a high prevalence within the first 28 days after LC. In most patients it resolved within 6 months.

Is device-modified trabeculectomy better than classic surgery for treatment of glaucoma? / ¿Es mejor la trabeculectomía modificada con dispositivo o la cirugía clásica para el manejo del glaucoma?

Several techniques have emerged as complement or replacement for trabeculectomy, the standard surgery for glaucoma. Device-modified trabeculectomy is a recently developed technique whose results compared to the classical technique have not been fully defined. To answer this question, we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We identified eight systematic reviews including 34 studies overall. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. We concluded device-modified trabeculectomy probably leads to greater overall success rate and may decrease intraocular pressure more than classical surgery. In addition, this technique would probably have a better safety profile than standard trabeculectomy.

En los últimos años, diversas técnicas han surgido como complemento o reemplazo para la trabeculectomía, cirugía estándar en el manejo del glaucoma. La trabeculectomía modificada con dispositivo es una técnica reciente cuyos resultados en comparación con la técnica clásica aún no han sido del todo definidos. Para responder esta pregunta utilizamos Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante búsquedas en múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Identificamos ocho revisiones sistemáticas que en conjunto incluyen 34 estudios aleatorizados. Extrajimos los datos desde las revisiones identificadas, reanalizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos tablas de resumen de los resultados utilizando el método GRADE. Concluimos que la trabeculectomía modificada con dispositivo probablemente se asocia a un mayor éxito completo y que podría disminuir la presión intraocular más que la cirugía clásica. Además, está técnica probablemente tendría un mejor perfil de seguridad que la terapia estándar.

Systematic genotyping of groups of cows to improve genomic estimated breeding values of selection candidates.

BACKGROUND: Extending the reference set for genomic predictions in dairy cattle by adding large numbers of cows with genotypes and phenotypes has been proposed as a means to increase reliability of selection decisions for candidates. METHODS: In this study, we explored the potential of increasing the reliability of breeding values of young selection candidates by genotyping a fixed number of first-crop daughters of each sire from one or two generations in a balanced and regular system of genotyping. Using stochastic simulation, we developed a basic population scenario that mimics the situation in dual-purpose Fleckvieh cattle with respect to important key parameters. Starting with a reference set consisting of only genotyped bulls, we extended this reference set by including increasing numbers of daughter genotypes and phenotypes. We studied the effects on model-derived reliabilities, validation reliabilities and unbiasedness of predicted values for selection candidates. We also illustrate and discuss the effects of a selected sample and an unbalanced sampling of daughters. Furthermore, we quantified the role of selection with respect to the influence on validation reliabilities and contrasted these to model-derived reliabilities. RESULTS: In the most extended design, with 200 daughters per sire genotyped from two generations, single nucleotide polymorphism (SNP) effects were estimated from a reference set of 420,000 cows and 4200 bulls. For this design, the validation reliabilities for candidates reached 80 % or more, thereby exceeding the reliabilities that were achieved in traditional progeny-testing designs for a trait with moderate to high heritability. We demonstrate that even a moderate number of 25 genotyped daughters per sire will lead to considerable improvement in the reliability of predicted breeding values for selection candidates. Our results illustrate that the strategy applied to sample females for genotyping has a large impact on the benefits that can be achieved.

Avaliação de dor e qualidade de vida de pacientes com fibromialgia / Evaluation of pain and quality of life of fibromyalgia patients

RESUMO JUSTIFICATIVA E OBJETIVOS: Sabe-se que a fibromialgia é uma síndrome musculoesquelética caracterizada por dor crônica e generalizada. Considerando que a dor é um sintoma que traz implicações diretas na vida dos pacientes acometidos, o objetivo deste estudo foi avaliar a dor e a qualidade de vida de pacientes com fibromialgia para melhor compreender a correlação entre essas variáveis. MÉTODOS: Estudo transversal com 45 mulheres, com idade entre 30 e 55 anos, em tratamento estável no último mês que antecedeu a seleção, sendo excluídas as que estavam em tratamento fisioterapêutico, faziam uso de recursos auxiliares da marcha e/ ou tinham doenças reumatológicas autoimunes ou relevantes comorbidades sem controle. A avaliação foi realizada através de ficha de entrevista, Questionário de Impacto da Fibromialgia, Índice de Dor Generalizada e escala analógica visual. Os dados foram analisados através dos testes de Correlação de Pearson e t de Student, aceitando-se níveis de significância estatística acima de 95%. RESULTADOS: foram observados elevados valores no Questionário de Impacto da Fibromialgia, Índice de Dor Generalizada e escala analógica visual além de uma correlação linear entre os índices de dor e qualidade de vida. CONCLUSÃO: A dor está associada à diminuição da qualidade de vida de fibromiálgicos.

ABSTRACT BACKGROUND AND OBJECTIVES: It is known that fibromyalgia is a musculoskeletal syndrome characterized by chronic and widespread pain. Considering that pain has direct implications on affected patients' lives, this study aimed at evaluating pain and quality of life of fibromyalgia patients to better understand the correlation between such variables. METHODS: Cross-sectional study with 45 females aged between 30 and 55 years, in stable treatment in the month previous to selection, being excluded those under physiotherapeutic treatment, using walking aids and/or with autoimmune rheumatologic diseases or relevant uncontrolled comorbidities. Patients were evaluated with interview records, Fibromyalgia Impact Questionnaire, Widespread Pain Index and visual analog scale. Data were analyzed by Pearson Correlation and Student t tests, with statistical significance above 95%. RESULTS: There have been high scores in Fibromyalgia Impact Questionnaire, Widespread Pain Index and visual analog scale, in addition to linear correlation between pain scores and quality of life. CONCLUSION: Pain is associated to impaired quality of life of fibromyalgia patients.

A simple method to separate base population and segregation effects in genomic relationship matrices.

BACKGROUND: Genomic selection and estimation of genomic breeding values (GBV) are widely used in cattle and plant breeding. Several studies have attempted to detect population subdivision by investigating the structure of the genomic relationship matrix G. However, the question of how these effects influence GBV estimation using genomic best linear unbiased prediction (GBLUP) has received little attention. METHODS: We propose a simple method to decompose G into two independent covariance matrices, one describing the covariance that results from systematic differences in allele frequencies between groups at the pedigree base (G A (*) ) and the other describing genomic relationships (G S) corrected for these differences. Using this decomposition and Fst statistics, we examined whether observed genetic distances between genotyped subgroups within populations resulted from the heterogeneous genetic structure present at the base of the pedigree and/or from breed divergence. Using this decomposition, we tested three models in a forward prediction validation scenario on six traits using Brown Swiss and dual-purpose Fleckvieh cattle data. Model 0 (M0) used both components and is equivalent to the model using the standard G-matrix. Model 1 (M1) used G S only and model 2 (M2), an extension of M1, included a fixed genetic group effect. Moreover, we analyzed the matrix of contributions of each base group (Q) and estimated the effects and prediction errors of each base group using M0 and M1. RESULTS: The proposed decomposition of G helped to examine the relative importance of the effects of base groups and segregation in a given population. We found significant differences between the effects of base groups for each breed. In forward prediction, differences between models in terms of validation reliability of estimated direct genomic values were small but predictive power was consistently lowest for M1. The relative advantage of M0 or M2 in prediction depended on breed, trait and genetic composition of the validation group. Our approach presents a general analogy with the use of genetic groups in conventional animal models and provides proof that standard GBLUP using G yields solutions equivalent to M0, where base groups are considered as correlated random effects within the additive genetic variance assigned to the genetic base.

Amisulpride augmentation for clozapine-refractory positive symptoms: additional benefit in reducing hypersialorrhea.

One-third to half of patients taking clozapine suffer from refractory symptoms despite adequate treatment. Among other adverse effects, clozapine-induced hypersalivation (CIH) occurs in approximately half of all patients. This is a case of a 30-year-old male with refractory schizophrenia; in this patient, the remission of residual positive symptoms, as well as the reduction of CIH, was achieved by treatment with clozapine augmented with amisulpride.

Enlarging a training set for genomic selection by imputation of un-genotyped animals in populations of varying genetic architecture.

BACKGROUND: The most common application of imputation is to infer genotypes of a high-density panel of markers on animals that are genotyped for a low-density panel. However, the increase in accuracy of genomic predictions resulting from an increase in the number of markers tends to reach a plateau beyond a certain density. Another application of imputation is to increase the size of the training set with un-genotyped animals. This strategy can be particularly successful when a set of closely related individuals are genotyped. METHODS: Imputation on completely un-genotyped dams was performed using known genotypes from the sire of each dam, one offspring and the offspring's sire. Two methods were applied based on either allele or haplotype frequencies to infer genotypes at ambiguous loci. Results of these methods and of two available software packages were compared. Quality of imputation under different population structures was assessed. The impact of using imputed dams to enlarge training sets on the accuracy of genomic predictions was evaluated for different populations, heritabilities and sizes of training sets. RESULTS: Imputation accuracy ranged from 0.52 to 0.93 depending on the population structure and the method used. The method that used allele frequencies performed better than the method based on haplotype frequencies. Accuracy of imputation was higher for populations with higher levels of linkage disequilibrium and with larger proportions of markers with more extreme allele frequencies. Inclusion of imputed dams in the training set increased the accuracy of genomic predictions. Gains in accuracy ranged from close to zero to 37.14%, depending on the simulated scenario. Generally, the larger the accuracy already obtained with the genotyped training set, the lower the increase in accuracy achieved by adding imputed dams. CONCLUSIONS: Whenever a reference population resembling the family configuration considered here is available, imputation can be used to achieve an extra increase in accuracy of genomic predictions by enlarging the training set with completely un-genotyped dams. This strategy was shown to be particularly useful for populations with lower levels of linkage disequilibrium, for genomic selection on traits with low heritability, and for species or breeds for which the size of the reference population is limited.