Plant-Based Diets versus the Mediterranean Dietary Pattern and Their Socio-Demographic Determinants in the Spanish Population: Influence on Health and Lifestyle Habits.

BACKGROUND: Plant-based diets are becoming more and more widespread among the Spanish population, progressively replacing the Mediterranean dietary pattern. Different studies have shown the motivations for adherence to these diets, and others have highlighted some health advantages and disadvantages. PURPOSE OF THE STUDY: Further studies are needed to define the socio-demographic determinants that influence the choice of a plant-based diet and to study the relationship that the choice of dietary pattern has on the health and lifestyle habits of the population. METHODS: A descriptive, cross-sectional study was conducted on the Spanish population. The NutSo-HH questionnaire, developed and validated by the research team, was used to gather socio-demographic, nutritional, social, and lifestyle information through non-probabilistic snowball sampling. RESULTS: The questionnaire was completed by 22,181 Spanish citizens, of whom only 19,211 were of interest to the study. The socio-demographic variables gender, age, educational level, income level, and place of residence do not seem to influence the prevalence of a plant-based diet (n = 1638) compared to a Mediterranean diet (n = 17,573). People following a vegetarian or vegan diet have a lower BMI, and they consume less fried food, fast food, and ultra-processed dishes and fewer energy drinks or sugary beverages. They also do more exercise and sleep longer hours, smoke less, and consume alcohol less frequently. However, there seem to be more diagnosed eating disorders among people who follow a plant-based diet than those who follow a Mediterranean diet. CONCLUSIONS: People who adopt a plant-based diet tend to exhibit healthier lifestyle patterns and consume fewer foods that are detrimental to their health. However, it is essential for such dietary choices to be supervised by healthcare professionals to mitigate the risk of maladaptive behaviors evolving into eating disorders.

Analysis of the influence of educational level on the nutritional status and lifestyle habits of the young Spanish population.

Aim: This study aims to analyze some nutrition and health habits of young people and the impact of educational attainment on health. Methods: An observational, descriptive, and cross-sectional study was carried out using surveys. Using non-probabilistic snowball sampling, a previously validated questionnaire was disseminated through networks, collecting a sample of 9,681 people between 18 and 30 years old. Comparative analyses between groups were obtained by clustering and the corresponding statistical tests. Results: The results showed how young people with higher education generally have a lower BMI, a higher healthy nutrition index, less frequent consumption of sugary drinks, and less smoking than their peers with basic education. These healthier habits are reflected in the higher self-perceived health status of the higher-educated group. While for all the educational levels analyzed, the minutes of physical activity practice are above the 150 min recommended by the WHO. Conclusion: Our findings suggest that young people's education level is of fundamental importance for health, particularly for nutritional habits. In general, the lifestyle habits of the young Spanish population are healthy, but there is a need for improvement in those aspects related to nutrition and food.

The Influence of Socio-Economic Factors on Diet and Active Lifestyle in the Spanish Female Population.

A balanced diet and healthy social habits are two pillars on which the health of the population is based. Therefore, the efforts of the health system should be aimed at prevention. To this end, it is important to know the prevalence of these habits in different population groups and how they vary according to socioeconomic variables. This is an observational, descriptive, cross-sectional study using surveys. A questionnaire was designed to explore a set of variables related to diet and an active lifestyle and was validated through a pilot study and a nominal group. Dissemination was carried out online through social networks by means of non-probabilistic snowball sampling, obtaining a sample of 14.784 women aged between 18 and 45 years. Bivariate comparative analyses were performed using the Mann-Whitney method and the principal component analysis (PCA) method of dimensionality reduction was used to study the relationships between ordinal numerical variables. Results indicate that nutrition was influenced by the age of the sample; adult women have better nutrition than younger women, although they are more sedentary and do less sport. Women with higher education and a medium-high income have better nutrition and healthier lifestyles and a lower BMI and higher self-perceived health status than women with basic education and a lower income. It was concluded that a higher level of income and a higher level of education generally lead to a healthier lifestyle. Spanish women aged 18-45 years need to make changes in their nutrition and lead a more active life.

Living Alone: Associations with Diet and Health in the Spanish Young Adult Population.

Eating together as a family has important health benefits, as the diet is more balanced and of a higher quality. Eating together is also a factor in the prevention of diet-related diseases. The promotion of family and shared meals is currently a public health strategy. The aim of this research was to study the eating habits of the Spanish young adult population and their impact on health. An observational, descriptive, cross-sectional study was carried out using surveys. A questionnaire was designed and validated to explore a set of variables related to food and health. The dissemination was carried out through social networks by means of an online form, using non-probabilistic snowball sampling to obtain a sample of 17,969 subjects aged between 18 and 45 years. We found statistically significant differences between people living in a family home compared to people living outside a family home in the healthy eating index for the Spanish population, fish consumption, and fried food consumption. This suggests that the nutrition of people living in a family home is healthier, although their BMI is higher. People living together have a statistically higher healthy eating index value than people living alone; consume fast food, fried food, and ultra-processed food less frequently; and eat fish more often. On the other hand, people who live in a family home or are accompanied are more likely to have a sedentary lifestyle and are less physically active. It was concluded that people living alone have a worse healthy eating index than those living with company, which seems to indicate that nutritional interventions should pay attention to people living alone as a variable to be taken into account in future analyses.

Analysis of the Influence of Socio-Demographic Variables and Some Nutrition and Lifestyle Habits on Beverage Consumption in the Spanish Population.

Beverages and drinks play a significant role in maintaining the integral health of individuals. The aim of this study is to discover the pattern of beverage consumption in different groups of the Spanish population and to investigate its relationship with other nutritional variables and habits. To achieve the objectives, an observational, descriptive and cross-sectional study was conducted. For data collection, a questionnaire was designed and validated that explored different beverage and food consumption variables as well as socio-demographic and lifestyle variables. The instrument was disseminated, among the Spanish young adult population, through snowball sampling using social networks, collecting a sample of 17,541 valid surveys. Bivariate comparative analyses and correlation analyses were performed, and finally, the principal component analysis (PCA) method was used in order to study the relationships between variables related to drinking and health. The main results show significant differences in the pattern of beverage consumption between the socio-demographic variables of sex, age and educational level, as well as between different areas of Spain, while the PCA model shows the relationship between the consumption of sugar-sweetened beverages with the Healthy Nutrition Index of the population and sport practice. Based on the results of the study, the following conclusions were reached: the beverage consumption pattern of the Spanish population is affected by socio-demographic variables. Healthier drinking habits affect the nutrition and health of the population.

[Epidemiology and sociodemographic characterization of the fibromyalgia in Comunidad Valenciana]. / Epidemiología y caracterización sociodemográfica de la fibromialgia en la Comunidad Valenciana.

OBJECTIVE: The elevated prevalence of the fibromyalgia and its polypathologic clinic suppose an important Public Health problem in Spain. The purpose of this study was to carry out an approach of the syndrome's epidemiology, with the finality of collaborate in the scientific knowledge progress of the people who suffer fibromyalgia, in this case, through the sociodemographic analysis of Comunidad Valenciana patients, in Spain. METHODS: It was done an epidemiologic descriptive transversal study, by extractions and analysis of epidemiological variables in official resources of health information of Comunidad Valenciana (Abucasis II, SIA, GAIA, SIP, SIE). The study presented two different analysis processes: the first one was the exam of the fibromyalgia prevalence evolution of the whole Comunidad Valenciana, considering the totality of diagnosed people between 2012 and 2016. The second one, supposed the sociodemographic characterization of people who are affected with fibromyalgia, using a sample of 9,267 people with active diagnostic of the disease in one of the 25 health department of the valencian public system, observing variables such as age, sex, origin, asistenciality, labour activity and economic level. The datum statistic treatment was descriptive univariable and it was made with percentage values of means, median and mode. The confidence interval for the average when required was set at 95 percent. RESULTS: Fibromyalgia was an elevated prevalence disease in Comunidad Valenciana (3.7%) in the study's period, establishing itself above the world media prevalence studied, Europe or Spain. What is more, it presented a special gravity in the male prevalence. Its evolution reflected a growth year-to-year of the order of 28 percent, with an average incidence rate of 5.39 new cases per thousand inhabitants / year. It specially affected women (it had it the 63% of the sample) and the average age of 54 years. Besides, people with fibromyalgia presented low economic levels and laboural difficulties defined by low employment rate, the elevated unemployment rate and the frequency and length of their work leaves. CONCLUSIONS: Fibromyalgia has a special epidemiological importance in Comunidad Valenciana, with a high prevalence and incidence. In its basic sociodemography we found an elevated percent of women with ages between 51 and 70 years, but also, we find a male prevalence of special consideration comparatively with other studies. We observe an important reduce of the socioeconomic and sociodemographic conditions between fibromyalgia diagnosed people.

OBJETIVO: La elevada prevalencia de la fibromialgia y su clínica polipatológica supone un importante problema de salud pública en España. El presente estudio tuvo por objeto realizar una aproximación a la epidemiología del síndrome, con la finalidad de colaborar en el avance del conocimiento científico de las personas que sufren fibromialgia, en este caso mediante el análisis sociodemográfico de los pacientes en la Comunidad Valenciana (España). METODOS: Se realizó un estudio epidemiológico descriptivo transversal, mediante extracción y análisis de variables epidemiológicas en fuentes oficiales de información sanitaria de la Comunidad Valenciana (Abucasis II, SIA, GAIA, SIP, SIE). El estudio presentó dos procesos de análisis diferenciados: el primero fue el examen de la evolución de la prevalencia de la fibromialgia en toda la Comunidad Valenciana, considerando a la totalidad de las personas diagnosticadas entre 2012 y 2016. El segundo supuso la caracterización sociodemográfica de las personas afectadas de fibromialgia, utilizando una muestra de 9.267 personas con diagnóstico activo de la enfermedad en uno de los 25 departamentos de salud del sistema público valenciano, observando variables tales como edad, sexo, procedencia, asistencialidad, actividad laboral y nivel económico. El tratamiento estadístico de los datos fue descriptivo univariable, y realizado con valores porcentuales, de media, mediana y moda. El intervalo de confianza para la media, cuando fue requerido, se estableció en el 95 por ciento. RESULTADOS: La fibromialgia fue una enfermedad de elevada prevalencia en la Comunidad Valenciana (3,7%) en el periodo de estudio, situándose por encima de las prevalencias medias estudiadas en el mundo, Europa o España. Presentó además una especial gravedad en la prevalencia masculina. Su evolución reflejó un crecimiento interanual del orden del 28 por ciento, con una tasa de incidencia media de 5,39 nuevos casos por cada mil habitantes/año. Afectó especialmente a las mujeres (63 por ciento de la muestra) y la edad media fue de 54 años. Además, las personas con fibromialgia presentaron bajos niveles económicos y dificultades laborales definidas por la baja tasa de empleo, la elevada tasa de paro y la frecuencia y duración de sus bajas laborales. CONCLUSIONES: La fibromialgia tiene una especial importancia epidemiológica en la Comunidad Valenciana, con alta prevalencia e incidencia. En su sociodemografía básica encontramos un porcentaje elevado de mujeres en edades comprendidas entre los 51 y los 70 años, pero también una prevalencia masculina de especial consideración comparativamente con otros estudios. Observamos un importante menoscabo de las condiciones socioeconómicas y sociolaborales entre las personas con diagnóstico de fibromialgia.

Epidemiología y caracterización sociodemográfica de la fibromialgia en la Comunidad Valenciana / Epidemiology and sociodemographic characterization of the fibromyalgia in Comunidad Valenciana

FUNDAMENTOS: La elevada prevalencia de la fibromialgia y su clínica polipatológica supone un importante problema de salud pública en España. El presente estudio tuvo por objeto realizar una aproximación a la epidemiología del síndrome, con la finalidad de colaborar en el avance del conocimiento científico de las personas que sufren fibromialgia, en este caso mediante el análisis sociodemográfico de los pacientes en la Comunidad Valenciana (España). MÉTODOS: Se realizó un estudio epidemiológico descriptivo transversal, mediante extracción y análisis de variables epidemiológicas en fuentes oficiales de información sanitaria de la Comunidad Valenciana (Abucasis II, SIA, GAIA, SIP, SIE). El estudio presentó dos procesos de análisis diferenciados: el primero fue el examen de la evolución de la prevalencia de la fibromialgia en toda la Comunidad Valenciana, considerando a la totalidad de las personas diagnosticadas entre 2012 y 2016. El segundo supuso la caracterización sociodemográfica de las personas afectadas de fibromialgia, utilizando una muestra de 9.267 personas con diagnóstico activo de la enfermedad en uno de los 25 departamentos de salud del sistema público valenciano, observando variables tales como edad, sexo, procedencia, asistencialidad, actividad laboral y nivel económico. El tratamiento estadístico de los datos fue descriptivo univariable, y realizado con valores porcentuales, de media, mediana y moda. El intervalo de confianza para la media, cuando fue requerido, se estableció en el 95 por ciento. RESULTADOS: La fibromialgia fue una enfermedad de elevada prevalencia en la Comunidad Valenciana (3,7%) en el periodo de estudio, situándose por encima de las prevalencias medias estudiadas en el mundo, Europa o España. Presentó además una especial gravedad en la prevalencia masculina. Su evolución reflejó un crecimiento interanual del orden del 28 por ciento, con una tasa de incidencia media de 5,39 nuevos casos por cada mil habitantes/año. Afectó especialmente a las mujeres (63 por ciento de la muestra) y la edad media fue de 54 años. Además, las personas con fibromialgia presentaron bajos niveles económicos y dificultades laborales definidas por la baja tasa de empleo, la elevada tasa de paro y la frecuencia y duración de sus bajas laborales. CONCLUSIONES: La fibromialgia tiene una especial importancia epidemiológica en la Comunidad Valenciana, con alta prevalencia e incidencia. En su sociodemografía básica encontramos un porcentaje elevado de mujeres en edades comprendidas entre los 51 y los 70 años, pero también una prevalencia masculina de especial consideración comparativamente con otros estudios. Observamos un importante menoscabo de las condiciones socioeconómicas y sociolaborales entre las personas con diagnóstico de fibromialgia

BACKGROUND: The elevated prevalence of the fibromyalgia and its polypathologic clinic suppose an important Public Health problem in Spain. The purpose of this study was to carry out an approach of the syndrome's epidemiology, with the finality of collaborate in the scientific knowledge progress of the people who suffer fibromyalgia, in this case, through the sociodemographic analysis of Comunidad Valenciana patients, in Spain. METHODS: It was done an epidemiologic descriptive transversal study, by extractions and analysis of epidemiological variables in official resources of health information of Comunidad Valenciana (Abucasis II, SIA, GAIA, SIP, SIE). The study presented two different analysis processes: the first one was the exam of the fibromyalgia prevalence evolution of the whole Comunidad Valenciana, considering the totality of diagnosed people between 2012 and 2016. The second one, supposed the sociodemographic characterization of people who are affected with fibromyalgia, using a sample of 9,267 people with active diagnostic of the disease in one of the 25 health department of the valencian public system, observing variables such as age, sex, origin, asistenciality, labour activity and economic level. The datum statistic treatment was descriptive univariable and it was made with percentage values of means, median and mode. The confidence interval for the average when required was set at 95 percent. RESULTS: Fibromyalgia was an elevated prevalence disease in Comunidad Valenciana (3.7%) in the study's period, establishing itself above the world media prevalence studied, Europe or Spain. What is more, it presented a special gravity in the male prevalence. Its evolution reflected a growth year-to-year of the order of 28 percent, with an average incidence rate of 5.39 new cases per thousand inhabitants / year. It specially affected women (it had it the 63% of the sample) and the average age of 54 years. Besides, people with fibromyalgia presented low economic levels and laboural difficulties defined by low employment rate, the elevated unemployment rate and the frequency and length of their work leaves. CONCLUSIONS: Fibromyalgia has a special epidemiological importance in Comunidad Valenciana, with a high prevalence and incidence. In its basic sociodemography we found an elevated percent of women with ages between 51 and 70 years, but also, we find a male prevalence of special consideration comparatively with other studies. We observe an important reduce of the socioeconomic and sociodemographic conditions between fibromyalgia diagnosed people

Fibromialgia: prevalencia, perfiles epidemiológicos y costes económicos / Fibromyalgia: Prevalence, epidemiologic profiles and economic costs

La fibromialgia es una enfermedad crónica idiopática que ocasiona dolor musculoesquelético generalizado, hiperalgesia y alodinia. La presente revisión pretende aproximarse a la epidemiología general de la fibromialgia de acuerdo con los más recientes estudios publicados, identificar la prevalencia general de la enfermedad a nivel mundial, sus perfiles epidemiológicos básicos y los costes económicos que ocasiona, con interés específico en el caso de España y de la Comunidad Valenciana. La fibromialgia afecta como promedio a un 2,10% de la población mundial; al 2,31% de la europea; al 2,40% en la población española y al 3,69% de la población en la Comunidad Autónoma Valenciana. Supone una dolorosa pérdida de la calidad de vida de las personas que la presentan y los costes económicos son enormes: en el caso español se han estimado en más de 12.993 millones de euros anuales (AU)

Fibromyalgia is an idiopathic chronic condition that causes widespread musculoskeletal pain, hyperalgesia and allodynia. This review aims to approach the general epidemiology of fibromyalgia according to the most recent published studies, identifying the general worldwide prevalence of the disease, its basic epidemiological profiles and its economic costs, with specific interest in the Spanish and Comunidad Valenciana cases. Fibromyalgia affects, on average, 2.10% of the world's population; 2.31% of the European population; 2.40% of the Spanish population; and 3.69% of the population in the Comunidad Valenciana. It supposes a painful loss of the quality of life of the people who suffer it and the economic costs are enormous: in Spain is has been estimated at more than 12,993 million euros annually (AU)

Fibromyalgia: Prevalence, epidemiologic profiles and economic costs. / Fibromialgia: prevalencia, perfiles epidemiológicos y costes económicos.

Fibromyalgia is an idiopathic chronic condition that causes widespread musculoskeletal pain, hyperalgesia and allodynia. This review aims to approach the general epidemiology of fibromyalgia according to the most recent published studies, identifying the general worldwide prevalence of the disease, its basic epidemiological profiles and its economic costs, with specific interest in the Spanish and Comunidad Valenciana cases. Fibromyalgia affects, on average, 2.10% of the world's population; 2.31% of the European population; 2.40% of the Spanish population; and 3.69% of the population in the Comunidad Valenciana. It supposes a painful loss of the quality of life of the people who suffer it and the economic costs are enormous: in Spain is has been estimated at more than 12,993 million euros annually.

Identification of a microRNA signature for the diagnosis of fibromyalgia.

BACKGROUND: Diagnosis of fibromyalgia (FM), a chronic musculoskeletal pain syndrome characterized by generalized body pain, hyperalgesia and other functional and emotional comorbidities, is a challenging process hindered by symptom heterogeneity and clinical overlap with other disorders. No objective diagnostic method exists at present. The aim of this study was to identify changes in miRNA expression profiles (miRNome) of these patients for the development of a quantitative diagnostic method of FM. In addition, knowledge of FM patient miRNomes should lead to a deeper understanding of the etiology and/or symptom severity of this complex disease. METHODS: Genome-wide expression profiling of miRNAs was assessed in Peripheral Blood Mononuclear Cells (PBMCs) of FM patients (N=11) and population-age-matched controls (N=10) using human v16-miRbase 3D-Gene microarrays (Toray Industries, Japan). Selected miRNAs from the screen were further validated by RT-qPCR. Participating patients were long term sufferers (over 10 years) diagnosed by more than one specialist under 1990 American College of Rheumatology criteria. RESULTS: Microarray analysis of FM patient PBMCs evidenced a marked downregulation of hsa-miR223-3p, hsa-miR451a, hsa-miR338-3p, hsa-miR143-3p, hsa-miR145-5p and hsa-miR-21-5p (4-fold or more). All but the mildest inhibited miRNA, hsa-miR-21-5p, were validated by RT-qPCR. Globally, 20% of the miRNAs analyzed (233/1212) showed downregulation of at least 2-fold in patients. This might indicate a general de-regulation of the miRNA synthetic pathway in FM. No significant correlations between miRNA inhibition and FM cardinal symptoms could be identified. However, the patient with the lowest score for mental fatigue coincided with the mildest inhibition in four of the five miRNAs associated with the FM-group. CONCLUSIONS: We propose a signature of five strikingly downregulated miRNAs (hsa-miR223-3p, hsa-miR451a, hsa-miR338-3p, hsa-miR143-3p and hsa-miR145-5p) to be used as biomarkers of FM. Validation in larger study groups is required before the results can be transferred to the clinic.

Lack of evidence for retroviral infections formerly related to chronic fatigue in Spanish fibromyalgia patients.

BACKGROUND: The etiology of fibromyalgia and chronic fatigue syndrome (FM/CFS) is currently unknown. A recurrent viral infection is an attractive hypothesis repeatedly found in the literature since it would explain the persistent pain and tiredness these patients suffer from. The initial striking link of two distinct orphan retroviruses: the gamma retroviruses murine leukemia virus (MLV)-related virus and the delta retrovirus T-lymphotropic virus type 2 (HTLV-2) to chronic fatigue have not been confirmed to date. RESULTS: Genomic DNA (gDNA) from 75 fibromyalgia patients suffering from chronic fatigue and 79 age-matched local healthy controls were screened for the presence of MLV-related and HTLV-2 related proviral sequences. The XMRV env gene was amplified in 20% of samples tested (24% patients/15% healthy controls). Unexpectedly, no PCR amplifications from independent gDNA preparations of the same individuals were obtained. None of the positive samples showed presence of contaminating murine sequences previously reported by other investigators, neither contained additional regions of the virus making us conclude that the initial env amplification came from spurious air-driven amplicon contaminants. No specific HTLV-2 sequences were obtained at any time from any of the 154 quality-controlled gDNA preparations screened. CONCLUSIONS: Previous associations between MLV-related or HTLV-2 retrovirus infection with chronic fatigue must be discarded. Thus, studies showing positive amplification of HTLV-2 sequences from chronic fatigue participants should be revised for possible undetected technical problems.To avoid false positives of viral infection, not only extreme precautions should be taken when nested-PCR reactions are prepared and exhaustive foreign DNA contamination controls performed, but also consistent amplification of diverse regions of the virus in independent preparations from the same individual must be demanded.The fact that our cohort of patients did not present evidence of any of the two types of retroviral infection formerly associated to chronic fatigue does not rule out the possibility that other viruses are involved in inciting or maintaining fibromyalgia and/or chronic fatigue conditions.

The safety of magnetic resonance imaging in patients with programmable implanted intrathecal drug delivery systems: a 3-year prospective study.

BACKGROUND: It is common clinical practice to perform magnetic resonance imaging (MRI) in patients with indwelling programmable intrathecal drug delivery (IDD) systems, although the safety of the procedure has never been documented. We performed a single-center, 3-year, prospective evaluation in patients with a programmable implanted IDD to assess patient discomfort, IDD technical failures, and adverse effects during and after exposure to MRI. METHODS: Forty-three consecutive patients with an implanted programmable IDD system (SynchroMed® EL Implantable Infusion Pump, Model 8626L-18, and SynchroMed® II Model 8637-20, 8637-40; Medtronic, Inc., Minneapolis, MN) requiring a scheduled MRI evaluation were studied during a 3-year period. All MRI scans were performed with a 1.5-tesla clinical use magnet and a specific absorption rate of no more than 0.9 W/kg. Radiograph control was used to confirm postexposure pump rotor movement and detect system dislocations. IDD system failures, patient satisfaction, and discomfort were recorded. RESULTS: None of the patients experienced signs of drug overinfusion that could lead to hemodynamic, respiratory, or neurologic alterations. Radiologic evaluation after MRI revealed no spatial displacements of the intrathecal catheter tip or body pump, and programmer telemetry confirmed the infusion recovery. Patients' satisfaction after the procedure was high. CONCLUSION: Performing an MRI scan with the proposed protocol in patients with an implanted Medtronic programmable IDD system resulted in virtually no technical or medical complications.

Dolor crónico

Guía de actuación clínica en Atención Primaria que contiene los siguientes apartados : introducción, definición y clasificación, criterios diagnósticos, valoración inicial y seguimiento, distribución de las actividades de registro, tratamiento, criterios de interconsulta y/o derivación al especialista correspondiente, criterios de buen control, evaluación por indicadores, puntos clave, tablas y algoritmos. También incluye una guía de consulta rápida.

Magnetic resonance imaging in patients with spinal neurostimulation systems.

BACKGROUND: The safety of performing magnetic resonance imaging (MRI) in patients with spinal cord stimulation (SCS) systems needs to be documented. A prospective in vivo study in patients with SCS, exploring the changes produced by MRI and the associated side effects, was performed. METHODS: After ethics committee approval and patient consent, 31 consecutive patients with SCS at different spinal levels requiring a scheduled MRI evaluation were studied during an 18-month period. All MRIs were performed with a 1.5-T clinical use magnet and a specific absorption rate of no more than 0.9 W/kg. Frequency tables were used for the descriptive study, whereas comparative evaluations were made with the chi-square test for qualitative variables and single-factor analysis of variance for quantitative variables. RESULTS: The mean patient age was 49 +/- 9.5 yr; 67.7% were women (n = 21), and 32.3% were men (n = 10). None of the patients experienced hemodynamic, respiratory, or neurologic alterations. Reported changes were as follows: increased temperature in the generator's area (n = 2, 6.5%); increased in the intensity of the stimulation (n = 1, 3.2%); impedance greater than 4,000 Omega on several of the electrodes in the leads (n = 1, 3.2%); telemetry not possible (n = 2, 6.5%). Radiologic evaluation after MRI revealed no spatial displacements of the SCS leads in any case. CONCLUSION: Under the conditions of the described protocol, MRI in patients with SCS systems resulted in few complications. None of the recorded problems were serious, and in no case were patients harmed or the systems reprogrammed. Maximum patient satisfaction was reported in all cases.

Oral ketamine for the treatment of type I complex regional pain syndrome.

Ketamine has been shown to be effective in the treatment of neuropathic pain. We present a case of severe complex regional pain syndrome type 1 that was treated with oral ketamine. The response and tolerability of this preparation suggest that further study is warranted.

Tratamiento farmacológico del trastorno del sueño en la fibromialgia / No disponible

La fibromialgia es una patología crónica y compleja que provoca dolor muscular generalizado que puede llegar a ser invalidante, asociado a mal descanso nocturno y fatigabilidad, y que afecta a las esferas biológica, psicológica y social de los pacientes. Además su elevada prevalencia hace de ella un problema sanitario de primera magnitud. Dificultad añadida supone el que sus criterios diagnósticos únicamente sean clínicos y que su etiopatogenia todavía no haya sido aclarada, lo que dificulta aún más su estudio y por supuesto su abordaje terapéutico. Los múltiples síntomas que acompañan a esta enfermedad, su elevada incidencia y el desconocimiento de su etiología y tratamiento adecuados enfatizan la necesidad de un abordaje multidisciplinar, donde el equipo asistencial, incluido el farmacéutico, promoverá el uso racional de las medidas farmacológicas y fomentará aquellas medidas no farmacológicas que mejoren la calidad de vida del enfermo de fibromialgia (AU)

Fibromyalgia is a chronic and complex pathology that provokes muscular pain which may become invalidant, associated to a badly night rest and fatigue that affects the biological, psychological and social environment of the patients. Its high prevalence makes fibromyalgia a first magnitude sanitary problem. The fact that its diagnostic criteria be only clinical, and that its aetiopathogenesis has not yet been clarified, makes it difficult its study and therapeutical approach. A multidisciplinary approach is necessary because of the multiple symptoms, the high number of cases and the low knowledge of the etiology and the satisfactory treatment. The care team, including pharmacist, will promote the rational use of the pharmacological and the not pharmacological measures that improve de quality of life (AU)