Opioids and fibromyalgia: frequency of use and factors associated with increased consumption in patients remitted to a tertiary care center.

BACKGROUND: Opioids are not recommended for fibromyalgia. OBJECTIVE: To investigate the frequency of opioid use in a large cohort of fibromyalgia patients and to identify factors associated with opioid consumption. METHODS: A retrospective, observational study of a large fibromyalgia cohort in a tertiary care center. We assessed fibromyalgia severity, functional capacity, anxiety, depression, drugs consumption and the patient's impression of change. We compared strong opioid consumers (SOC) and non-SOC. Inferential statistical and logistic regression analysis were used to identify factors associated with opioid consumption, and ANOVA for repeated measurements. RESULTS: We found a prevalence of 9.2% of SOC (100 patients) among 1087 patients in the cohort. During the last four years there was a significant increase on the incidence of SOC up to 12.8% (p = 0.004). There were no differences in demographic variables between SOC and non-SOC. Clinical variables were significantly more severe in SOC, and they consumed more non-opioid drugs (p < 0.0001). Opioid consumption was independently associated with other non-opioid drugs (Odds ratio 1.25, CI: 1.13-1.38), but not with the fibromyalgia severity. At three months, 62% of the patients had opioid withdrawal. There were no statistical differences in the fibromyalgia severity at the initial evaluation, or the patient's impression of change compared with those patients who continued opioids. Coping strategies were better in those patients who withdrew opioids (p = 0.044). CONCLUSIONS: We observed an increase in opioid prescriptions during the last four years. Opioid consumption was associated with concomitant use of non-opioid drugs, but it was not associated with fibromyalgia severity.

Recomendaciones prácticas sobre ejercicio físico durante el embarazo basadas en las principales guías de práctica clínica / Practical recommendations on physical exercise during pregnancy based on the main clinical practice guidelines

Las principales guías de actividad física/ejercicio durante el embarazo recomiendan que todas las mujeres embarazadas sin contraindicaciones médicas u obstétricas se mantengan activas físicamente durante la gestación, con el objetivo de conseguir beneficios para su salud y, al mismo tiempo, reducir la posibilidad de complicaciones durante el embarazo. El objetivo de este artículo fue extraer las recomendaciones prácticas sobre ejercicio físico durante el embarazo, de interés para el médico de atención primaria (AP), de las guías de práctica clínica de tres sociedades internacionales de obstetricia y ginecología de reconocido prestigio y gran influencia internacional en este tema, dos de ellas pioneras en la elaboración de este tipo de recomendaciones: el Colegio Americano de Obstetricia y Ginecología y la Sociedad Canadiense de Obstetricia y Ginecología; y el Real Colegio de Obstetras y Ginecólogos de Australia y Nueva Zelanda, junto con la publicada por la Sociedad Española de Ginecología y Obstetricia.(AU)

The main guidelines for physical activity/exercise during pregnancy recommend that all pregnant women without medical or obstetric contraindications remain physically active during pregnancy, in order to achieve health benefits and, at the same time, reduce the possibility of complications during pregnancy. The objective of this article was to extract the practical recommendations on physical exercise during pregnancy, of interest to the primary care physician, from the clinical practice guidelines of three international societies of Obstetrics and Gynecology of recognized prestige and great international influence on this subject, two of them pioneers in the elaboration of this type of recommendations: the American College of Obstetrics and Gynecology and the Society of Obstetricians and Gynaecologists of Canada; and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, together with the one published by the Spanish Society of Gynecology and Obstetrics.(AU)

[Practical recommendations on physical exercise during pregnancy based on the main clinical practice guidelines]. / Recomendaciones prácticas sobre ejercicio físico durante el embarazo basadas en las principales guías de práctica clínica.

The main guidelines for physical activity/exercise during pregnancy recommend that all pregnant women without medical or obstetric contraindications remain physically active during pregnancy, in order to achieve health benefits and, at the same time, reduce the possibility of complications during pregnancy. The objective of this article was to extract the practical recommendations on physical exercise during pregnancy, of interest to the primary care physician, from the clinical practice guidelines of three international societies of Obstetrics and Gynecology of recognized prestige and great international influence on this subject, two of them pioneers in the elaboration of this type of recommendations: the American College of Obstetrics and Gynecology and the Society of Obstetricians and Gynaecologists of Canada; and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, together with the one published by the Spanish Society of Gynecology and Obstetrics.

Prevalence of post-COVID-19 in patients with fibromyalgia: a comparative study with other inflammatory and autoimmune rheumatic diseases.

OBJECTIVES: To determine the prevalence and characteristics of post-COVID-19 (PC) in fibromyalgia (FM) patients. METHODS: Retrospective, multi-centric, observational study, comparing a group of FM patients (FM group) with another group of patients with other rheumatic diseases (RD group). COVID-19 diagnosis was established by positive polymerase chain reaction or antigen during acute infection or by positive antibodies thereafter. We considered PC diagnosis when symptoms remain after COVID-19. We collected the principal characteristics of COVID-19, the severity of fatigue, waking unrefreshed and cognitive impairment, and persistent symptoms. The American College of Rheumatology (ACR) criteria and the Combined Index of Severity in Fibromyalgia (ICAF) were collected in the FM group. RESULTS: RD group (n = 56) had more pneumonia (p = 0.001) and hospital admissions (p = 0.002), but the FM group (n = 78) had a higher number of symptoms (p = 0.002). The percentage of patients with PC was similar between groups (FM group 79.5%; RD group 66.1%, p = 0.081). FM group had more PC symptoms (p = 0.001), more impairment after COVID-19 (p = 0.002) and higher severity of fatigue, waking unrefreshed and cognitive impairment (p <  0.0001). Only loss of smell was more frequent in the FM group (p = 0.005). The FM group with PC (n = 29) showed more severity of the Combined Index of Severity in Fibromyalgia (ICAF) total score and physical factor after COVID-19, while emotional, coping factors and the ACR criteria did not change. CONCLUSIONS: The prevalence of PC in FM patients is similar to RD patients. In FM patients, the presence of PC does not appear to impact the severity of FM.

Mental Health, Quality of Life and Coping Strategies in Vulnerable Children During the COVID-19 Pandemic.

BACKGROUND: The coronavirus pandemic has led to a situation without precedent in modern history. The aim of this study is to analyse the consequences after one year of the pandemic on a group of children and adolescents assessed at the beginning of the pandemic in 2020 and to determine the most effective ways of psychologically coping with this pandemic. METHOD: Two different, but equivalent, groups with a total of 604 (study I, 2020) and 743 (study II, 2021) children and adolescents in residential care, foster families, kinship families or family strengthening programs in Spain were evaluated using the SDQ (mental health measure), KIDSCREEN-10 index (quality of life measure) and Kidcope (coping behaviour measure). An independent sample t-test and a decision tree analysis were used. RESULTS: The mental health of children and adolescents decreased by 9.7%, and Self-Perceived quality of life did not change after one year of the COVID-19 pandemic. Nonactive coping strategies predicted worse mental health and worse quality of life. Problem solving served as a protective factor. CONCLUSION: One year after, the COVID-19 pandemic has an effect on the psychological wellbeing of children and adolescents, and the consequences can be reduced if proper coping strategies are used.

Fluorescent organic particle doped polymer-based gel dosimeter for neutron detection.

The purpose of this work is to develop a material capable of detecting neutrons produced by photodisintegration in a linear accelerator for its medical use. In this study, we have developed a gel-like material doped with fluorescent organic particles. PPO at 1 wt% is used as primary dopant and POPOP as secondary one at 0.03 wt%. A set of four samples is produced, with boric acid concentrations of 0, 400, 800 and 1200 ppm. The viscoelastic properties of the material are characterized with rheological measurements, finding a gel-like behavior, i.e., a material that can keep its original shape if no stresses are applied, but can also be deformed by applying a moderate shear rate. Furthermore, the material was irradiated with gamma, electron, and neutron emission sources from 137Cs, 22Na, 60Co, 210Po, 90Sr and 241AmBe, and its response was measured in two different experimental settings, in two different institutions, for comparative purposes. From these measurements, one can clearly establish that the new material detects neutrons, electrons, and gammas within the MeV regions and below. Thus, our findings show that the developed material and its properties make it a promising technology for its use in a neutron detector.

Mental Health, Quality of Life and Coping Strategies in Vulnerable Children During the COVID-19 Pandemic / Salud Mental, Calidad de Vida y Estrategias de Afrontamiento de Niños Vulnerables Durante la Pandemia de la COVID-19

Background: The coronavirus pandemic has led to a situation withoutprecedent in modern history. The aim of this study is to analyse theconsequences after one year of the pandemic on a group of children andadolescents assessed at the beginning of the pandemic in 2020 and todetermine the most effective ways of psychologically coping with thispandemic. Method: Two different, but equivalent, groups with a total of604 (study I, 2020) and 743 (study II, 2021) children and adolescents inresidential care, foster families, kinship families or family strengtheningprograms in Spain were evaluated using the SDQ (mental health measure),KIDSCREEN-10 index (quality of life measure) and Kidcope (copingbehaviour measure). An independent sample t-test and a decision treeanalysis were used.Results: The mental health of children and adolescentsdecreased by 9.7%, and Self-Perceived quality of life did not change afterone year of the COVID-19 pandemic. Nonactive coping strategies predictedworse mental health and worse quality of life. Problem solving served asa protective factor. Conclusion: One year after, the COVID-19 pandemichas an effect on the psychological wellbeing of children and adolescents,and the consequences can be reduced if proper coping strategies are used.

Antecedentes: la pandemia del coronavirus no tiene precedentes en la historia moderna. El objetivo del estudio es analizar sus consecuencias tras un año de pandemiaen niños y adolescentes evaluados al inicio de la misma en 2020 y determinarlas estrategias de afrontamiento más eficaces para lidiar con la pandemia.Método: 2 grupos distintos pero equivalentes formados por 604 (estudioI, 2020) y 743 (estudio II, 2021) niños y adolescentes en acogimientoresidencial, acogimiento familiar (extensa y ajena) y en programas de fortalecimiento familiar en España fueron evaluados usando el SDQ (saludmental), KIDSCREEN-10 (calidad de vida) y Kidcope (afrontamiento). Se utilizó comparaciones de medias para muestras independientes y unanálisis de árbol de decisión. Resultados: la salud mental de niños yadolescentes ha disminuido un 9,7% mientras que la calidad de vida no hacambiado tras un año de pandemia. Las estrategias de afrontamiento pasivaspredijeron una peor salud mental y una peor calidad de vida. Estrategias desolución de problemas actuaron como un factor protector. Conclusiones: la pandemia de la COVID-19 tiene efectos tras el paso de un año en elbienestar psicológico de niños y adolescentes y sus consecuencias puedenreducirse con estrategias de afrontamiento apropiadas.

Caminar durante el embarazo: la actividad física preferida por las embarazadas / Walking during pregnancy: the physical activity preferred by pregnant women

Caminar durante el embarazo, la actividad física preferida entre las mujeres embarazadas, tiene múltiples beneficios para la salud del binomio materno - fetal en comparación con otras modalidades de actividad física. El no requerir tanto esfuerzo, la facilidad de ejecución, posibilidad de interacción social y de integrarse de manera muy significativa en algunas actividades, como los desplazamientos y las actividades ocupacionales, cuando a las embarazadas les es imposible realizar actividad física en su tiempo libre, son algunas de las ventajas que la convierten en la elegida por la mayor parte de las embarazadas. La falta de tiempo, las molestias físicas, la fatiga o la falta de energía, son algunos de los factores que impiden caminar a las gestantes. Dados los múltiples beneficios que tiene caminar para las embarazadas, las autoridades sanitarias deberían fomentar campañas de concienciación que promovieran la importancia de la práctica de actividad física por las mujeres embarazadas, entre las cuales, debería estar muy presente caminar.

Walking during pregnancy, the preferred physical activity among pregnant women, has multiple health benefits for the maternalfetal pairing compared to other forms of physical activity. Not requiring so much effort, the ease of execution, the possibility of social interaction and of integrating in a very significant way in some activities, such as travel and occupational activities, when it is impossible for pregnant women to perform physical activity in their free time, are some of the advantages that make it the one chosen by most pregnant women. Lack of time, physical discomfort, fatigue or lack of energy are some of the factors that prevent pregnant women from walking. Given the multiple benefits that walking has for pregnant women, health authorities should promote awareness campaigns that promote the importance of practicing physical activity by pregnant women, among whom walking should be very present.

Psychological Flexibility Is Key for Reducing the Severity and Impact of Fibromyalgia.

Fibromyalgia has a significant impact on the lives of patients; symptoms are influenced by psychological factors, such as psychological flexibility and catastrophizing. The objective of this study was to determine the importance of these variables in moderating the association between the severity and impact of fibromyalgia symptoms. A total of 187 patients from a general hospital population were evaluated using the Combined Index of Severity of Fibromyalgia (ICAF), the Fibromyalgia Impact Questionnaire (FIQ), the Acceptance and Action Questionnaire-II (AAQ-II), and the Pain Catastrophizing Scale (PCS). A series of multiple regression analyses were carried out using the PROCESS macro and decision tree analysis. The results show that psychological flexibility modulates the relation between severity and the impact of fibromyalgia symptoms. Catastrophism has residual importance and depends on the interaction with psychological flexibility. Interaction occurs if the severity of the disease is in transition from a mild to a moderate level and accounts for 40.1% of the variance in the sample. These aspects should be considered for evaluation and early intervention in fibromyalgia patients.

Pain is not the major determinant of quality of life in fibromyalgia: results from a retrospective "real world" data analysis of fibromyalgia patients.

OBJECTIVE: To identify correlates of quality of life (QoL) measured with the Quality of Life Scale (QOLS) in participants of a multidisciplinary day hospital treatment program for fibromyalgia (FM). METHODS: In this cross-sectional, observational study, "real world" data from 480 FM patients including socio-demographics, pain variables and questionnaires such as the SF-36, Beck Depression Inventory (BDI), Multiphasic Pain Inventory (MPI), SCL-90-R and others were categorized according to the components (body structure and function, activities and participation, personal factors, environmental factors) of the International Classification of Functioning (ICF). For every ICF component, a linear regression analysis with QOLS as the dependent variable was computed. A final comprehensive model was calculated on the basis of the results of the five independent analyses. RESULTS: The following variables could be identified as main correlates for QoL in FM, explaining 56% of the variance of the QOLS (subscale/questionnaire and standardized beta in parenthesis): depression (- 0.22), pain-related interference with everyday life (- 0.19), general activity (0.13), general health perception (0.11), punishing response from others (- 0.11), work status (- 0.10), vitality (- 0.11) and cognitive difficulties (- 0.12). Pain intensity or frequency was not an independent correlate. CONCLUSIONS: More than 50% of QoL variance could be explained by distinct self-reported variables with neither pain intensity nor pain frequency playing a major role. Therefore, FM treatment should not primarily concentrate on pain but should address multiple factors within multidisciplinary therapy.

Clinical impact of confinement due to the COVID-19 pandemic on patients with fibromyalgia: a cohort study.

OBJECTIVES: To our knowledge, the impact of the COVID-19 pandemic on fibromyalgia (FM) patients has not been studied before. FM patients often experience clinical impairment with stress. The aim of this study was to determine whether severity of FM increases because of confinement by the COVID-19 pandemic. METHODS: This prospective study includes patients from the Combined Index of Severity of Fibromyalgia (ICAF) cohort who met the 2010 ACR FM criteria. In this cohort, all patients have a periodical evaluation of their quality of life through two questionnaires, the ICAF, which assesses the ability to perform daily living activities, anxiety and depression, and through the Patient Global Impression of Change (PGIC), which assesses overall change after a therapeutical intervention. Pre- and post-confinement measurements were analysed. Inferential statistical analysis and ANOVA for repeated measurements were used. RESULTS: A total of 93 patients received a phone consultation, (95.5% females), mean (SD) age of 48.23 (8.38) years. Four patients were excluded as presenting COVID-19 and 51 (57%) completed the post-confinement ICAF. Following confinement, 25 (49%) patients got worse (group-worse) and 26 (51%) patients experienced no change or improved (group-stable). Comparisons between pre- and post-confinement ICAF did not show significant differences in both groups. Passive coping was significantly different in group-worse in pre-confinement evaluation. In the 80% of patients with passive coping predominance there were no changes in coping strategy. CONCLUSIONS: No clinical impairment due to COVID-19 confinement occurred. The perceived worsening among FM patients relies primarily on how patients cope with their disease, without a real impact on clinical manifestations.

Psychological Wellbeing of Vulnerable Children During the COVID-19 Pandemic / Bienestar Psicológico de Niños Vulnerables Durante la Pandemia del COVID-19

BACKGROUND: A pandemic disaster has specific effects on mental health, however, little is known about those specific effects in children and adolescents. Thus, the aim of this study is to describe the psychological impact of the COVID-19 pandemic on a sample of children and adolescents and to compare the results with previous national data and other studies to determine variations. METHOD: A total of 459 children and adolescents in residential care, foster families, kinship families, or family strengthening programs under SOS Children's Villages Spain were evaluated using the SDQ to measure internalizing and externalizing problems and using KIDSCREEN-10 index to measure heath related quality of life. An independent sample t-test, one-way ANOVA and the chi-square test were used. RESULTS: The children and adolescents in this study had worse psychological wellbeing than those in the 2017 Spanish reference, that is, before the COVID-19 outbreak. Quality of life remained the same. No differences between care modalities were found. CONCLUSION: It is necessary to monitor the mental health status of children and adolescents to prevent possible problems. Additionally, it is necessary to use well-known assessment instruments because it is essential to have a reference to other situations and populations

ANTECEDENTES: una pandemia tiene efectos concretos sobre la salud mental; sin embargo, dichos efectos son poco conocidos en niños y adolescentes. El objetivo de este estudio es describir el impacto psicológico de la COVID-19 en una muestra de niños y adolescentes y comparar los resultados con datos de referencia nacionales y otros estudios. MÉTODO: un total de 459 niños y adolescentes en acogimiento residencial, familias de acogida extensa y ajena y en programas de fortalecimiento familiar, atendidos por Aldeas Infantiles SOS España, fueron evaluados mediante el SDQ para determinar la presencia de problemas internalizantes y externalizantes y mediante el KIDSCREEN-10 para determinar su nivel de calidad de vida. Se utilizó comparaciones de medias para muestras independientes, ANOVA y Chi-cuadrado. RESULTADOS: los niños y adolescentes estudiados obtuvieron peores resultados en bienestar psicológico que los publicados como referencia nacional en España en 2017, antes del brote de la COVID-19. La calidad de vida no se ha visto afectada. No se han encontrado diferencias entre las modalidades de cuidado. CONCLUSIONES: es necesario evaluar la salud mental de los niños y adolescentes para prevenir posibles problemas. Adicionalmente, es necesario usar instrumentos bien conocidos que permitan comparar los resultados con otras situaciones y poblaciones

Psychological Wellbeing of Vulnerable Children During the COVID-19 Pandemic.

BACKGROUND: A pandemic disaster has specific effects on mental health, however, little is known about those specific effects in children and adolescents. Thus, the aim of this study is to describe the psychological impact of the COVID-19 pandemic on a sample of children and adolescents and to compare the results with previous national data and other studies to determine variations. METHOD: A total of 459 children and adolescents in residential care, foster families, kinship families, or family strengthening programs under SOS Children's Villages Spain were evaluated using the SDQ to measure internalizing and externalizing problems and using KIDSCREEN-10 index to measure heath related quality of life. An independent sample t-test, one-way ANOVA and the chi-square test were used. RESULTS: The children and adolescents in this study had worse psychological wellbeing than those in the 2017 Spanish reference, that is, before the COVID-19 outbreak. Quality of life remained the same. No differences between care modalities were found. CONCLUSION: It is necessary to monitor the mental health status of children and adolescents to prevent possible problems. Additionally, it is necessary to use well-known assessment instruments because it is essential to have a reference to other situations and populations.

Educational needs of patients with rheumatic and musculoskeletal diseases attending a large health facility in Austria.

INTRODUCTION: Patient education is an important part of the management of rheumatic and musculoskeletal diseases. Given that patients with diverse diseases do not have the same needs, it is crucial to assess the educational requirements of targeted groups to provide tailored educational interventions. The aim of our study was to assess educational needs of a large cohort of patients with different rheumatic and musculoskeletal diseases attending a health facility in Austria. METHODS: We assessed educational needs, via an online survey of patients with fibromyalgia (FMS), rheumatoid arthritis (RA), and ankylosing spondylitis (AS) recruited from an Austrian health-care facility, using the Austrian version of the Educational Needs Assessment Tool (OENAT). RESULTS: For our sample of 603 patients, AS (62%), RA (15%), and FMS (24%), there were no educational need differences for the domains of movements, disease process, and self-help measures. Patients with FMS had less need for pain management education and greater need for education about feelings, than other disease groups. Patients with RA had a greater need for education related to treatments than other groups, and patients with AS had a greater need for treatment education than patients with FMS. Patients with AS reported greater need for support system education than other patient groups. CONCLUSION: Educational needs vary by disease groups, suggesting that health-care professionals should assess disease-specific needs for education to provide optimal assistance in disease management for patients.

Self-forgiveness in fibromyalgia patients and its relationship with acceptance, catastrophising and coping.

OBJECTIVES: Forgiveness influences health through numerous mechanisms, but commonly it is thought to reduce stress, increase healthy behaviour, and promote social support, thereby positively impacting health and wellbeing. Self-forgiveness has been given considerable attention in relation to health and wellbeing. Fibromyalgia (FM) patients had lower forgiveness of others and self-forgiveness as compared to controls. The aim of this study is to explore the relationship of self-forgiveness (FS) with the impact and severity of FM, acceptance, catastrophising, and coping. METHODS: We evaluated 228 FM female patients who completed the Mauger Forgiveness Scale, the Combined Index of Severity in Fibromyalgia (ICAF) survey, the Chronic Pain Acceptance Questionnaire (CPAQ), and the Pain Catastrophising Scale (PCS). RESULTS: High self-forgiveness is related to high levels of active coping (r=.41) and acceptation (r=.38), and low self-forgiveness is related to emotional negative factors and catastrophising (r=-.56). Two factors (physical and emotional) were obtained. Lower FS is an emotional factor with negative emotion, catastrophising and a deficit in active coping. A decision-tree analysis showed a first node with ICAF Emotional scores and a second level with CPAQ and PCS scores as predictors. CONCLUSIONS: A notable lack of FS indicates a problem (distress and catastrophising) with the health aspects related to this syndrome. Acceptance could require a low negative emotional status. People with high FS were likely to increase acceptation as the positive component of acceptance in FS. This finding does not indicate an interest in maintaining problematic behaviours.

Structural Properties and Luminescence Characteristics of Eu3+ Doped Lithium Triborate (LiB3O5) Phosphors.

Lithium triborate LiB3O5:Eu has been prepared by precipitation assisted high-temperature solid state (PAS) reaction method using lithium hydroxide (LiOH), boric acid (H3BO3) and europium chloride (EuCl3). The as prepared powders were calcined at various temperatures. As prepared and calcined powders were characterized by X-ray diffraction (XRD), Scanning Electron Microscopy (SEM), Energy Dispersive X-ray Spectrometry (EDS), UV-Vis spectrometry and Photoluminescence (PL). The XRD profiles of the powder products revealed the presence of crystalline phase at 650 °C. Increasing bandgap with increasing dopant concentration was studied by UV-Vis spectra. The effect of dopant concentration on photoluminescence properties of LiB3O5 was also studied. The optimized Eu3+ dopant concentration for potential luminescent LiB3O5 phosphor was 0.25 mol%.

Empirical Grouping of Pain Zones in Fibromyalgia: A Preliminary Study.

OBJECTIVES: Widespread pain is important for the diagnosis of fibromyalgia (FM). For this purpose, the sum of pain regions obtained from a topographical distribution has been used to compute a Widespread Pain Index (WPI), but there is no empirical basis for choosing the regions. The aim of this study was to find an empirical distribution of the pain regions. MATERIALS AND METHODS: We evaluated 228 female patients with FM. They completed the Fibromyalgia Survey Questionnaire, Fibromyalgia Impact Questionnaire (FIQ), Combined Index of Severity in Fibromyalgia (ICAF), and Short Form-36 Health Survey. The pain regions of the WPI were grouped by the topographical distribution (WPIR) and compared with a new empirical distribution (WPIE) obtained through exploratory factor analysis. A decision- tree analysis was conducted to identify the optimal algorithm for selecting pain regions related to the severity of FM. RESULTS: The WPIE has a normal distribution compared with the WPIR. It also shows higher correlations with FM severity. From the factor analysis, 4 factors explain 48.5% of the variance. Two factors (emotional and physical) can conform to the decision-tree analysis using the dependent variables FIQ and ICAF. These factors are very congruent with the cutoff points previously proposed for FIQ and ICAF. The emotional factor is the first in the decision-tree. DISCUSSION: WPIE has a normal distribution and shows better predictive qualities than WPIR. The emotional factor is conceptualized as emotional because of the relative importance of the right hemisphere in negative emotions and pain. The physical factor could be responsible for the decreased ability to coordinate left-right stepping.

El índice de masa corporal como fenotipo en el perfil clínico y funcional en mujeres con osteoartritis de rodilla / Association between the functional impact of osteoarthritis and body mass index in women

Background: Obesity is associated with pain, reduction of function and quality of life in patients with osteoarthritis (OA). Aim: To describe the clinical profile of women with knee OA according to their body mass index (BMI). Material and Methods: Observational study in 308 women with knee OA. According to their BMI, they were classified as normal-weight, overweight and obese. The primary outcome measure was functionality evaluated with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Secondary outcomes were sleep quality evaluated using the Pittsburgh Sleep Quality Index (PSQI) and quality of life assessed with the European Quality of Life Five Dimension (EuroQol-5D). Results: WOMAC, PSQI and EuroQol-5D scores were significantly higher in obese women. Conclusions: Overweight and obese women with OA have more sleep disorders, reduction on functionality and quality of life compared to their normal weight counterparts.

Thermoluminescence from Cu Doped Lithium Tetraborate Irradiated with X-ray and γ Using 137Cs Radioactive Source.

Lithium tetraborate (Li2B4O7) pellets prepared by using water/solution assisted method were synthesized and characterized. Copper was used as doping material in order to enhance the Li2B4O7 thermoluminescent properties. For synthesis heating temperature parameters were defined at 750 °C for 2 hr, followed by 150 °C for another 2 hr. The materials were produced at five different Cu concentrations: 0.02, 0.04, 0.06, 0.08, and 0.1 wt%. The luminescent and morphological characterizations were performed by X-ray diffraction (XRD), Scanning electron microscope (SEM), Photoluminescence (PL), and Ultraviolet-visible spectroscopy (UV-Vis). XRD and SEM analysis of intrinsic and doped materials confirmed the obtained Li2B4O7 structure and show its morphology. XRD patterns of the Li2B4O7 matched a tetragonal crystal structure. Crystals of Li2B4O7 of an average size of 50 nm were obtained. The presence of the copper dopant was confirmed in crystals of Li2B4O7:Cu by SEM-EDS (energy dispersive spectroscopy X-ray). The emission spectrum of Cu doped Li2B4O7 showed a prominent peak at 367 nm, while the main UV-Vis absorption was observed from 240 nm to 300 nm due to Cu+ ion 3d10 → 3d9 4s transitions. The thermoluminescent (TL) response was studied for both γ radiation and X-ray. A 661.7 keV γ radiation using a 137Cs source at doses of 50, 100, 200, 300, 400 and 500 mGy was applied to Li2B4O7:Cu (0.1 wt%) pellets. An X-ray source was used at doses of 600, 800 and 1000 mGy to irradiate pellets of Li2B4O7:Cu (0.02, 0.04, 0.06, 0.08 and 0.1 wt%). A linear TL response was observed for both X-ray and γ radiation. The kinetic parameters were calculated using the peak shape method for the Li2B4O7:Cu (0.1 wt%).

Aracnoidits y quistes aracnoideos espinales múltiples. Revisión bibliográfica a propósito de un caso / ARACNOIDITIS AND MULTIPLE ARACNOID CYSTS : CASE REPORT AND REVISION OF THE LITERATURE

Los quistes aracnoideos son lesiones malformativas que contienen en su interior un líquido de características similares al líquido cefalorraquídeo. Constituyen alrededor del 1% de todos los procesos ocupantes de espacio a nivel intracraneal y, en menor número de casos pueden localizarse a nivel espinal. Presentamos una asociación de aracnoiditis espinal y posterior cavitación.

Arachnoid cysts are malformative lesions that contain a liquid with characteristics similar to cerebrospinal fluid. They constitute about 1% of all space-occupying processes at the intracranial level and, in a smaller number of cases, they can be located at the spinal level. We present an association of spinal arachnoiditis and posterior cavitation