Pensamiento catastrófico ante el dolor: presencia en una población de migrañosos / Pain catastrophising in a population of patients with migraine

INTRODUCCIÓN: El pensamiento catastrófico (PC) hace referencia a un tipo de respuesta cognitiva y emocional negativa ante el dolor y se considera que contribuye a su cronificación. Pretendemos evaluar su presencia en una población de pacientes migrañosos. MÉTODOS: Pacientes atendidos en una unidad de cefaleas de un hospital terciario (enero-junio de 2015). Se recogieron datos sociodemográficos y características de la migraña. Se midió el PC mediante la versión española de la Pain Catastrophizing Scale (PCS). Se comparó la presencia de PC en pacientes con migraña crónica y episódica y su correlación con las medidas de impacto (Escala HIT-6), de depresión y ansiedad (Escala Hospitalaria de Ansiedad y Depresión [HADS]) y la presencia de uso excesivo de medicación. RESULTADOS: Se incluyeron 96 pacientes (16 varones y 80 mujeres). Sesenta y siete (69,8%) con migraña crónica y 29 (30,2%) con migraña episódica. El 85,4% presentó un impacto de la migraña al menos moderado (HIT-6 ≥ 56), el 24% superó el punto de corte para la ansiedad y el 9,4% para depresión. El 34,4% de la muestra superó el punto de corte de la PCS. En el grupo de pacientes con PC, mayor puntuación en la escala HADS-ansiedad (p < 0,001), HADS-depresión (p < 0,001) y HIT-6 (p < 0,001). CONCLUSIONES: El PC es frecuente en pacientes con migraña. Se relaciona con la severidad de la misma y la asociación a ansiedad y depresión. Su presencia parece no incrementar la cronificación de la migraña ni el uso excesivo de medicación sintomática

INTRODUCTION: Catastrophic thought refers to a negative cognitive and emotional response to pain, and is thought to contribute to pain chronification. We aimed to evaluate pain catastrophising PC in a population of patients with migraine. METHODS: We collected sociodemographic data and clinical data on migraine from patients attended at a tertiary hospital headache unit between January and June 2015. PC was measured with the Spanish-language version of the Pain Catastrophizing Scale (PCS). We compared presence of PC in patients with episodic and chronic migraine, and its correlation with clinical impact (measured by the Headache Impact Test-6 [HIT-6] scale), comorbid depression and anxiety (measured with the Hospital Anxiety and Depression Scale [HADS]), and the presence of medication overuse. RESULTS: The study included 96 patients (16 men and 80 women); 67 (69.8%) were diagnosed with chronic migraine and 29 (30.2%) with episodic migraine. Migraine impact was at least moderate (HIT-6 ≥ 56) in 85.4% of cases, and 24% exceeded the cut-off point for anxiety and 9.4% for depression. A total of 34.4% presented PC. Patients with chronic migraine scored higher than those with episodic symptoms on the HADS for anxiety (P < .001) and depression (P < .001) and on the HIT-6 (P < .001). CONCLUSIONS: PC is common among patients with migraine. It is related to migraine severity and to comorbid anxiety and depression. PC does not appear to increase the likelihood of migraine chronification or medication overuse

Pain catastrophising in a population of patients with migraine. / Pensamiento catastrófico ante el dolor: presencia en una población de migrañosos.

INTRODUCTION: Catastrophic thought refers to a negative cognitive and emotional response to pain, and is thought to contribute to pain chronification. We aimed to evaluate pain catastrophising PC in a population of patients with migraine. METHODS: We collected sociodemographic data and clinical data on migraine from patients attended at a tertiary hospital headache unit between January and June 2015. PC was measured with the Spanish-language version of the Pain Catastrophizing Scale (PCS). We compared presence of PC in patients with episodic and chronic migraine, and its correlation with clinical impact (measured by the Headache Impact Test-6 [HIT-6] scale), comorbid depression and anxiety (measured with the Hospital Anxiety and Depression Scale [HADS]), and the presence of medication overuse. RESULTS: The study included 96 patients (16 men and 80 women); 67 (69.8%) were diagnosed with chronic migraine and 29 (30.2%) with episodic migraine. Migraine impact was at least moderate (HIT-6≥56) in 85.4% of cases, and 24% exceeded the cut-off point for anxiety and 9.4% for depression. A total of 34.4% presented PC. Patients with chronic migraine scored higher than those with episodic symptoms on the HADS for anxiety (P<.001) and depression (P<.001) and on the HIT-6 (P<.001). CONCLUSIONS: PC is common among patients with migraine. It is related to migraine severity and to comorbid anxiety and depression. PC does not appear to increase the likelihood of migraine chronification or medication overuse.

Effect of size disparity on the structure and dynamics of the small component in concentrated binary colloidal mixtures.

We determined, using confocal microscopy, the structure and dynamics of the small component in concentrated binary colloidal mixtures with moderate and large size ratios and different compositions of Polymethyl methacrylate particles. We show that when increasing the content of small spheres at fixed total volume fraction, a transition in the local environment of the small particles is observed, from a mixed environment of other small and large particles to a local environment of only small particles. The transition is rather abrupt for moderate size ratios, while it becomes particularly broad for large size ratios. This can be associated with the improved ability of the small particles to pack in between the large particles for larger size ratios. The dynamics reflect the transition with an increase of the mobility observed at intermediate mixing. This increase becomes particularly pronounced for large size ratios, leading to diffusive dynamics of the small particles, in agreement with predictions of theories of the glass transition in binary hard-sphere mixtures. The composition at which the fastest dynamics are observed is apparently independent of the size ratio.

Valoración integral enfermera al paciente geriátrico con patología quirúrgica urológica / No disponible

Los tumores urológicos son los más habituales entre la población de mayores de 70 años. En el paciente geriátrico, la evaluación preoperatoria es fundamental, pero la clasificación de riesgo ASA no ha sido específicamente diseñada para evaluar pacientes de edad avanzada. La reserva funcional y los síndromes geriátricos son aspectos a valorar en el paciente que va a ser intervenido quirúrgicamente

Urological tumours are the most frequent among population over 70 years of age. Preoperative evaluation is of pivotal importance for elderly people, but ASA has not been specifically designed to evaluate elderly patients

Personality traits in patients with cluster headache: a comparison with migraine patients.

BACKGROUND: Cluster headache (CH) has been associated with certain personality traits and lifestyle features, but there are few studies assessing personality profiles in CH. We aimed to analyze personality traits in patients with CH, and to compare them with those found in migraine. METHODS: We included all consecutive patients with CH attending 5 outpatient offices between January and December 2013. Personality traits were evaluated using the Salamanca screening test, a validated inventory assessing 11 personality traits grouped in 3 clusters. We analyzed the test results in this population, and compared them with those of a migraine population previously assessed with the same test. RESULTS: Eighty patients with CH (75 men, 5 women; mean age, 43.2 ± 9.9 years) were recruited. The reference population consisted of 164 migraine patients (30 men, 134 women; mean age 36.4 ± 12.7 years). In CH patients, the most frequent personality traits were anancastic (52.5 %), anxious (47.5 %), histrionic (45 %), schizoid (42.5 %), impulsive (32.5 %) and paranoid (30 %). When compared to migraine patients, paranoid (p < 0.001; χ2 test), and schizoid traits (p = 0.007; χ2 test) were significantly more prevalent in CH patients. In logistic regression analysis the paranoid trait was significantly associated with CH (p = 0.001; OR: 3.27, 95 % CI [1.66-6.43]). CONCLUSION: According to the Salamanca screening test, personality traits included in cluster A (odd or eccentric disorders) are more prevalent in CH patients than in a population of migraineurs. Larger studies are needed to determine whether certain personality traits are related to CH.

Impulsivity among migraine patients: Study in a series of 155 cases. / Impulsividad en pacientes migrañosos: estudio en una serie de 155 casos.

INTRODUCTION: Impulsivity is a psychological phenomenon that has not been extensively studied in headache patients. We aim to assess the presence of impulsivity in patients with chronic migraine (CM) and medication overuse (MO). PATIENTS: All patients examined in an outpatient headache clinic between January 2013 and March 2014 were included. Episodic migraine, CM, and MO were diagnosed according to ICHD-III beta criteria. We prospectively gathered demographic and clinical characteristics. Mood disorders were evaluated using the Hospital Anxiety and Depression Scale (HADS) and impulsiveness was assessed with the Plutchik impulsivity scale. RESULTS: A total of 155 patients were included (22 men, 133 women). The mean age (SD) was 38.2 (11.7) years (range, 18-70); 104 patients (67.1%) presented CM and, among them, 74 (71.1%) had MO. Of the patient total, 28.4% met criteria for anxiety, 7.1% for depression and 16.1% for impulsivity. The CM group showed higher scores for HADS-anxiety (8.5 [SD 4.5] vs. 6.4 [SD 3.6], p=0.003) and HADS-depression (4.4 [4.3] vs. 1.9 [2.3], p<0.001). Among CM cases only, scores for HADS-anxiety (9.3 [4.4] vs. 6.8 [4.3], p=0.01) and HADS-Depression (5.1 [4.6] vs. 2.7 [2.9], p=0.002) were higher in patients who also had MO. We found no associations between Plutchik scale scores or presence of impulsivity with either CM or MO. CONCLUSION: Impulsivity is a common trait in our population of migraine patients, but unlike mood disorders, it is not correlated with either CM or MO.

Correlación entre las lesiones desmielinizantes y el deterioro de las funciones ejecutivas en una muestra de pacientes mexicanos con esclerosis múltiple / Correlation between demyelinating lesions and executive function decline in a sample of Mexican patients with multiple sclerosis

Antecedentes: La esclerosis múltiple (EM) se caracteriza por una gran diversidad de síntomas neurológicos de entre los cuales el deterioro cognitivo recientemente ha cobrado una especial relevancia. Hasta el momento la evidencia acerca de una correlación entre las características de las lesiones y el deterioro cognitivo específico aún no es concluyente. Objetivo: Analizar si existe una correlación entre las características de las lesiones desmielinizantes y el desempeño de las funciones ejecutivas básicas en estos pacientes. Pacientes y métodos: Se incluyeron 21 pacientes adultos con puntaje de 0-5 en la escala de Kurtzke, sin exacerbaciones de la enfermedad en los 3 meses previos a la evaluación. Se les aplicaron las pruebas de Stroop y elWisconsin Card Sorting Test (WCST). La localización de las lesiones fue determinada por resonancia magnética a través de un observador experto y cegado. Resultados: Las lesiones desmielinizantes se distribuyeron con mayor frecuencia en los lóbulos occipitales y frontales. En el Stroop se observó que a medida que se incrementa la demanda cognitiva en cada sección de la prueba, aumentan el tiempo de reacción y el número de errores. En el WCST, un 33,33% presentó un deterioro medio a moderado. No se encontró una relación entre la lesiones desmielinizantes –localización, tamaño y suma total– y los puntajes de las pruebas aplicadas. Conclusión: En la explicación del deterioro cognitivo en la EM se deben considerar no solo las lesiones desmielinizantes, sino también otros factores biológicos, psicológicos y sociales (AU)

Background: Multiple Sclerosis (MS) is characterised by several neurological symptoms including cognitive impairment, which has recently been the subject of considerable study. At present, evidence pointing to a correlation between lesion characteristics and specific cognitive impairment is not conclusive. Objective: To investigate the presence of a correlation between the characteristics of demyelinating lesions and performance of basic executive functions in a sample of MS patients. Patients and methods: We included 21 adult patients with scores of 0 to 5 on the Kurtzke scale and no exacerbations of the disease in at least 3 months prior to the evaluation date. They completed the Stroop test and the Wisconsin Card Sorting Test (WCST). The location of the lesions was determined using magnetic resonance imaging (MRI) performed by a blinded expert in neuroimaging. Results: Demyelinating lesions were more frequently located in the frontal and occipital lobes. The Stroop test showed that as cognitive demand increased on each of the sections in the test, reaction time and number of errors increased. On the WCST, 33.33% of patients registered as having moderate cognitive impairment. No correlation could be found between demyelinating lesion characteristics (location, size, and number) and patients’ scores on the tests. Conclusion: Explanations of the causes of cognitive impairment in MS should examine a variety of biological, psychological, and social factors instead of focusing solely on demyelinating lesions (AU)

[Correlation between demyelinating lesions and executive function decline in a sample of Mexican patients with multiple sclerosis]. / Correlación entre las lesiones desmielinizantes y el deterioro de las funciones ejecutivas en una muestra de pacientes Mexicanos con esclerosis múltiple.

BACKGROUND: Multiple Sclerosis (MS) is characterised by several neurological symptoms including cognitive impairment, which has recently been the subject of considerable study. At present, evidence pointing to a correlation between lesion characteristics and specific cognitive impairment is not conclusive. OBJECTIVE: To investigate the presence of a correlation between the characteristics of demyelinating lesions and performance of basic executive functions in a sample of MS patients. PATIENTS AND METHODS: We included 21 adult patients with scores of 0 to 5 on the Kurtzke scale and no exacerbations of the disease in at least 3 months prior to the evaluation date. They completed the Stroop test and the Wisconsin Card Sorting Test (WCST). The location of the lesions was determined using magnetic resonance imaging (MRI) performed by a blinded expert in neuroimaging. RESULTS: Demyelinating lesions were more frequently located in the frontal and occipital lobes. The Stroop test showed that as cognitive demand increased on each of the sections in the test, reaction time and number of errors increased. On the WCST, 33.33% of patients registered as having moderate cognitive impairment. No correlation could be found between demyelinating lesion characteristics (location, size, and number) and patients' scores on the tests. CONCLUSION: Explanations of the causes of cognitive impairment in MS should examine a variety of biological, psychological, and social factors instead of focusing solely on demyelinating lesions.

Short communication: Detection of Shiga toxin-producing Escherichia coli (STEC) in healthy cattle and pigs in Lima, Peru.

The aim of this study was to determine the prevalence of Shiga toxin-producing Escherichia coli (STEC) in cattle and pigs as a possible STEC reservoir in Lima, Peru. One hundred and fourteen cattle and 112 pigs from 10 and 4 farms, respectively, were studied. Five E. coli colonies per culture were studied by a multiplex real-time PCR to identify Shiga toxin-producing (stx1, stx2, eaeA), enterotoxigenic (lt, st), enteropathogenic (eaeA), enteroinvasive (ipaH), enteroaggregative (aggR), and diffusely adherent E. coli (daaD). Shiga toxin-producing E. coli were isolated from 16 cattle (14%) but none from pigs. stx1 was found in all bovine isolates, 11 of which also carried eaeA genes (69%); only 1 sample had both stx1 and stx2. Thirteen stx-positive strains were classified as Shiga-toxigenic (81%) using an enzymatic immunoassay, 2 STEC strains were from serogroup O157 (13%), and 7 were sorbitol negative (44%). Enteropathogenic E. coli were detected more frequently in cattle (18%, 20/114) than in pigs (5%, 6/112). To our knowledge, this is the first study on the prevalence of STEC in farms animals in Peru using molecular methods. Further studies are needed in a large number of farms to determine the relevance of these findings and its consequences for public health.

Rapid and sensitive detection of African horse sickness virus by real-time PCR.

A highly sensitive and specific TaqMan-MGB real-time RT-PCR assay has been developed and standardised for the detection of African horse sickness virus (AHSV). Primers and MGB probe specific for AHSV were selected within a highly conserved region of genome segment 7. The robustness and general application of the diagnostic method were verified by the detection of 12 AHSV isolates from all of the nine serotypes. The analytical sensitivity ranged from 0.001 to 0.15 TCID(50) per reaction, depending on the viral serotype. Real-time PCR performance was preliminarily assessed by analysing a panel of field equine samples. The same primer pair was used to standardise a conventional RT-PCR as an affordable, useful and simple alternative method in laboratories without access to real-time PCR instruments. The two techniques present novel tools to improve the molecular diagnosis of African horse sickness (AHS).

[Psychiatric symptoms in Cushing syndrome: a clinical case]. / Síntomas psiquiátricos en el síndrome de Cushing: un caso clínico.

A patient with Cushing's syndrome presented psyquiatric manifestations that were diagnosed and treated before diagnosis of Cushing's syndrome. These manifestations were unspecific, unstable and they responded to etiologic treatment but they didn't to syntomatic treatment. This case demonstrates the importance to make a through search for organic factors when there are changes in physical appearance and psyquiatric features are changing through the evolution.

Pyridazines. XIII. Synthesis of 6-aryl-5-oxygenated substituted-3(2H)-pyridazinones and evaluation as platelet aggregation inhibitors.

Several 6-aryl-5-oxygenated substituted pyridazinones have been synthesized and evaluated in vitro for inhibition of platelet aggregation induced by adenosine 5'-diphosphate (ADP), thrombin and collagen. All the tested compounds (except 8 and 9) inhibited platelet aggregation in a dose-dependent manner. The IC50 of the most active substance, compound 2b, was around 60 microM against ADP and collagen as inducers. The inhibition of platelet aggregation caused by test compounds was dependent on the level of oxidation of the function at the 5-position, with the order of IC50 values being R-OH (2a, b, 5) < R-CHO (6, 7) < < R-COOH (8, 9). None of the tested compounds increased the intracellular levels of cAMP, indicating a lack of inhibitory activity on cAMP phosphodiesterase (PDE III) in intact cells. These results suggest that the group present at the 5 position of 6-aryl-5-substituted pyridazinones determines the platelet aggregation-inhibitory activity, and that a mechanism other than PDE inhibition is responsible for this effect.