Lactoferrin gene polymorphisms associated with clinical mastitis in Honduran Holstein inheritance cows.

BACKGROUND: Lactoferrin (LTF) is an iron-binding glycoprotein found in milk and other exocrine secretion with antibacterial activity proposed as an alternative to mastitis treatment or prevention. LTF has been proposed as a candidate gene for mastitis resistance selection. The aim of this paper was to assess LTF promotor to explore variations with potential association to mastitis resistance in dairy cows from Honduras. METHODS: A resequencing of promotor and Exon I of LTF gene in extreme mastitis susceptibility cows (126 Holstein and Holstein crossbred) was performed. RESULTS: Eight polymorphisms were found in promotor region, four of them were novel variations. Two were important by frequency among extreme groups, but a polymorphism in - 421 A/T position was significantly (P = 0.0188) associated to mastitis susceptibility. CONCLUSION: Results support the key role of regulatory region of LTF gene. Some candidate genes are proposed in association with mastitis traits and implications are discussed.

European Academy of Neurology guideline on the management of medication-overuse headache.

BACKGROUND: The frequent use of medication to treat migraine attacks can lead to an increase in migraine frequency and is called medication-overuse headache (MOH). METHODS: Based on the available literature in this guideline, the first step in patient management is education and counselling. RESULTS: Patients with MOH should be managed by a multidisciplinary team of neurologists or pain specialists and behavioral psychologists. Patients in whom education is not effective should be withdrawn from overused drugs and should receive preventive treatment with drugs of proven efficacy. Patients with MOH in whom preventive treatment is not effective should undergo drug withdrawal. Drug intake can be abruptly terminated or restricted in patients overusing simple analgesics, ergots or triptan medication. In patients with long-lasting abuse of opioids, barbiturates or tranquilizers, slow tapering of these drugs is recommended. Withdrawal can be performed on an outpatient basis or in a daycare or inpatient setting.

The headache under-response to treatment (HURT) questionnaire, an outcome measure to guide follow-up in primary care: development, psychometric evaluation and assessment of utility.

BACKGROUND: Headache disorders are both common and burdensome but, given the many people affected, provision of health care to all is challenging. Structured headache services based in primary care are the most efficient, equitable and cost-effective solution but place responsibility for managing most patients on health-care providers with limited training in headache care. The development of practical management aids for primary care is therefore a purpose of the Global Campaign against Headache. This manuscript presents an outcome measure, the Headache Under-Response to Treatment (HURT) questionnaire, describing its purpose, development, psychometric evaluation and assessment for clinical utility. The objective was a simple-to-use instrument that would both assess outcome and provide guidance to improving outcome, having utility across the range of headache disorders, across clinical settings and across countries and cultures. METHODS: After literature review, an expert consensus group drawn from all six world regions formulated HURT through item development and item reduction using item-response theory. Using the American Migraine Prevalence and Prevention Study's general-population respondent panel, two mailed surveys assessed the psychometric properties of HURT, comparing it with other instruments as external validators. Reliability was assessed in patients in two culturally-contrasting clinical settings: headache specialist centres in Europe (n = 159) and primary-care centres in Saudi Arabia (n = 40). Clinical utility was assessed in similar settings (Europe n = 201; Saudi Arabia n = 342). RESULTS: The final instrument, an 8-item self-administered questionnaire, addressed headache frequency, disability, medication use and effect, patients' perceptions of headache "control" and their understanding of their diagnoses. Psychometric evaluation revealed a two-factor model (headache frequency, disability and medication use; and medication efficacy and headache control), with scale properties apparently stable across disorders and correlating well and in the expected directions with external validators. The literature review found few instruments linking assessment to clinical advice or suggested actions: HURT appeared to fill this gap. In European specialist care, it showed utility as an outcome measure across headache disorders. In Saudi Arabian primary care, HURT (translated into Arabic) was reliable and responsive to clinical change. CONCLUSIONS: With demonstrated validity and clinical utility across disorders, cultures and settings, HURT is available for clinical and research purposes.

A consensus protocol for the management of medication-overuse headache: Evaluation in a multicentric, multinational study.

INTRODUCTION: The management of medication-overuse headache (MOH) is often difficult and no specific guidelines are available as regards the most practical and effective approaches. In this study we defined and tested a consensus protocol for the management of MOH on a large population of patients distributed in different countries. SUBJECTS AND METHODS: The protocol was based on evidence from the literature and on consolidated expertise of the members of the consensus group. The study was conducted according to a multicentric interventional design with the enrolment of 376 MOH subjects in four centres from Europe and two centres in Latin America. The majority of patients were treated according to an outpatient detoxification programme. The post-detoxification follow-up lasted six months. RESULTS: At the final evaluation, two-thirds of the subjects were no longer overusers and in 46.5% of subjects headache had reverted back to an episodic pattern of headache. When comparing the subjects who underwent out-patient detoxification vs those treated with in-patient detoxification, both regimens proved effective, although the drop-out rate was higher in the out-patient approach. CONCLUSIONS: The present findings support the effectiveness and usability of the proposed consensus protocol in different countries with different health care modalities.

Disability, anxiety and depression associated with medication-overuse headache can be considerably reduced by detoxification and prophylactic treatment. Results from a multicentre, multinational study (COMOESTAS project).

OBJECTIVE: The objective of this article is to investigate whether headache-related disability, depression and anxiety can be reduced by detoxification and prophylactic treatment in patients with medication-overuse headache (MOH). METHODS: Patients with MOH were included from six centres in Europe and Latin America in a seven-month cohort study. Before and six months after treatment, the degree of disability was measured by the Migraine Disability Assessment (MIDAS) questionnaire, while anxiety and depression were measured by the Hospital Anxiety and Depression Scale (HADS). RESULTS: A total of 694 patients with MOH were included, of whom 492 completed the study. Headache days were reduced by 58.4% from 23.6 to 9.8 days per month at six months ( P < 0.001). The MIDAS score was reduced by 57.1% from baseline 59.9 to 25.7 ( P < 0.001). Number of patients with depression was reduced by 50.7% from 195 to 96 and number of those with anxiety was reduced by 27.1% from 284 to 207 (both P < 0.001). CONCLUSIONS: Disability, depression and anxiety were considerably reduced in patients with MOH by detoxification and prophylactic treatment. This emphasises the urgent need for increased awareness about avoiding overuse of headache medications and demonstrates that not only headache frequency but also disability are remarkably improved by adequate intervention.

Simplified risk-prediction for benchmarking and quality improvement in emergency general surgery. Prospective, multicenter, observational cohort study.

BACKGROUND AND AIMS: Emergency General Surgery (EGS) conditions account for millions of deaths worldwide, yet it is practiced without benchmarking-based quality improvement programs. The aim of this observational, prospective, multicenter, nationwide study was to determine the best benchmark cutoff points in EGS, as a reference to guide improvement measures. METHODS: Over a 6-month period, 38 centers (5% of all public hospitals) attending EGS patients on a 24-h, 7-days a week basis, enrolled consecutive patients requiring an emergent/urgent surgical procedure. Patients were stratified into cohorts of low (i.e., expected morbidity risk <33%), middle and high risk using the novel m-LUCENTUM calculator. RESULTS: A total of 7258 patients were included; age (mean ± SD) was 51.1 ± 21.5 years, 43.2% were female. Benchmark cutoffs in the low-risk cohort (5639 patients, 77.7% of total) were: use of laparoscopy ≥40.9%, length of hospital stays ≤3 days, any complication within 30 days ≤ 17.7%, and 30-day mortality ≤1.1%. The variables with the greatest impact were septicemia on length of hospital stay (21 days; adjusted beta coefficient 16.8; 95% CI: 15.3 to 18.3; P < .001), and respiratory failure on mortality (risk-adjusted population attributable fraction 44.6%, 95% CI 29.6 to 59.6, P < .001). Use of laparoscopy (odds ratio 0.764, 95% CI 0.678 to 0.861; P < .001), and intraoperative blood loss (101-500 mL: odds ratio 2.699, 95% CI 2.152 to 3.380; P < .001; and 500-1000 mL: odds ratio 2.875, 95% CI 1.403 to 5.858; P = .013) were associated with increased morbidity. CONCLUSIONS: This study offers, for the first time, clinically-based benchmark values in EGS and identifies measures for improvement.

Evaluation of sludge from paper recycling as bedding material for broilers.

Several materials have been used as bedding substrates in broiler production. In this work, the sludge from paper recycling was tested for its potential use as litter material and was compared with wood shavings. Moisture content, apparent density, and water-holding capacity were measured and characterized in both materials. Later, 192 male broiler chickens were distributed among 16 experimental pens, 8 of which contained wood shavings as bedding material and 8 of which contained the sludge. Growth rate, consumption, tonic immobility, gait score, breast lesions, foot pad dermatitis, hock burn, tibial dyschondroplasia, and metatarsal thickness were determined in the birds. Although the moisture content of the sludge was high, it decreased strongly after 7 d of drying, reaching lower values than those of wood shavings. In general, few differences were found between the materials in terms of bird performance and welfare and only the incidence of hock burn was higher in the sludge than in the wood shavings. Although further research is needed, sludge from paper recycling is a possible alternative to traditional bedding materials because it achieves most of the requirements for broiler bedding materials and does not show negative effects on the birds.

Recommendations for headache service organisation and delivery in Europe.

Headache disorders are a major public-health priority, and there is pressing need for effective solutions to them. Better health care for headache-and ready access to it-are central to these solutions; therefore, the organisation of headache-related services within the health systems of Europe becomes an important focus. These recommendations are the result of collaboration between the European Headache Federation and Lifting The Burden: the Global Campaign against Headache. The process of development included wide consultation. To meet the very high level of need for headache care both effectively and efficiently, the recommendations formulate a basic three-level model of health-care organisation rationally spread across primary and secondary health-care sectors, taking account of the different skills and expertise in these sectors. They recognise that health services are differently structured in countries throughout Europe, and not always adequately resourced. Therefore, they aim to be adaptable to suit these differences. They are set out in five sections: needs assessment, description of the model, adaptation, standards and educational implications.

[Perivascular epithelioid tumors: Utility of the positron emission tomography with 18F-fluorodesoxyglucose (PET-TAC FDG) in their staging and follow-up]. / Tumor epitelioide perivascular uterino. Utilidad de la tomografía por emisión de positrones con (18)F-fluordesoxiglucosa en su estadificación y seguimiento.

Perivascular epithelioid tumors (PEComas) are a rare group of mesenchymal neoplasms with an unpredictable natural history and uncertain malignant potential. Uterine involvement and their association with tuberous sclerosis are typical for these tumors. We present a case of a 40-year old patient who was incidentally diagnosed of a uterine PEComa and serial studies of PET-CT with FDG were performed for staging and therapeutic response assessment. FDG PET-CT proved to be a valuable tool for detecting unsuspected pulmonary metastases and defining the reassessment of the patient after chemotherapy. The findings suggest that since this is a rare tumor, which does not always have benign behaviour, PET-CT may be a useful diagnostic imaging procedure for staging and clinical monitoring of patients who suffer this type of tumors.

[Fibrous dysplasia of the bone. Contribution of nuclear medicine in the diagnosis of suspicion of sarcomatous degeneration]. / Displasia fibrosa ósea. Aportación de la Medicina Nuclear al diagnóstico de sospecha de degeneración sarcomatosa.

Fibrous dysplasia (FD) is a relatively frequent benign disease of the bone in which there is a maturation disorder of the bone-forming mesenchyme where the lamellar bone marrow is replaced with abnormal fibrous tissue. Its diagnosis is often an accidental finding when X-ray studies or bone scans are performed for other reasons since it is usually asymptomatic. There may be complications such as deformities, pathological fractures and exceptionally malignant transformation. The differential diagnosis between malignancy and FD can be complicated and lead to late diagnosis when sarcomatous degeneration already exists. In this context, the positron tomography with (18)F-fluorodeoxyglucose (FDG-PET) may be useful in the monitoring of this condition. We present two cases of patients diagnosed of FD with suspicion of malignization of their bone lesions who were referred to Nuclear Medicin.

Validity and reliability of the Migraine-Treatment Optimization Questionnaire.

Our aim was to establish the validity and reliability of a patient-rated Migraine Treatment Optimization Questionnaire (M-TOQ) in primary care. Patients who met International Classification of Headache Disorders, 2nd edn criteria for migraine completed a 19-item questionnaire containing candidate items for the M-TOQ, and three questionnaires designed to test convergent/construct validity [Migraine Disability Assessment Scale (MIDAS), Headache Impact Test (HIT)-6 and Migraine-Specific Quality of Life Scale (MSQoL)]. A 15-item (M-TOQ-15) and a five-item (M-TOQ-5) questionnaire were derived. Two hundred and fifty-three adult patients were recruited. Five treatment optimization domains were identified: functioning, rapid relief, consistency of relief, risk of recurrence and tolerability; with Cronbach alphas of 0.70-0.84. The Cronbach alpha for M-TOQ-15 was 0.85, and it correlated well with MIDAS, HIT-6 and MSQoL (r = 0.33-0.44). The Cronbach alpha for M-TOQ-5 was 0.66, and it also correlated well with the three questionnaires (r = 0.33-0.41). The utility of the M-TOQ for assessing treatment benefit in research (M-TOQ-15) and primary care (M-TOQ-5) should be further validated.

Proposals for new standardized general diagnostic criteria for the secondary headaches.

Headache classification is a dynamic process through clinical testing and re-testing of current and proposed criteria. After publication of the second edition of the International Classification of Headache Disorders (ICHD-II), need arose for revisions in the classification of medication overuse headache and chronic migraine. These changes made apparent a further need for broader revisions to the standard formulation of diagnostic criteria for the secondary headaches. Currently, the fourth criterion makes impossible the definitive diagnosis of a secondary headache until the underlying cause has resolved or been cured or greatly ameliorated by therapy, at which time the headache may no longer be present. Given that the main purpose of diagnostic criteria is to enable a diagnosis at the onset of a disease in order to guide treatment, this is unhelpful in clinical practice. In the present paper we propose maintaining a standard approach to the secondary headaches using a set of four criteria A, B, C and D, but we construct these so that the requirement for resolution or successful treatment is removed. The proposal for general diagnostic criteria for the secondary headaches will be entered into the internet-based version of the appendix of ICHD-II. During 2009 the Classification Committee will apply the general criteria to all the specific types of secondary headaches. These, and other changes, will be included in a revision of the entire classification entitled ICHD-IIR, expected to be published in 2010. ICHD-IIR will be printed and posted on the website and will be the official classification of the International Headache Society. Unfortunately, it will be necessary to translate ICHD-IIR into the many languages of the world, but the good news is that no major changes to the headache classification are then foreseen for the next 10 years. Until the printing of ICHD-IIR, the printed ICHD-II criteria remain in place for all other purposes. We issue a plea to the headache community to use and study these proposed general criteria for the secondary headaches in order to provide more evidence for their utility-before their incorporation in the main body of the classification.

Evolution in the resistance of Mycobacterium tuberculosis to anti-tuberculosis drugs in Nicaragua.

SETTING: Nicaragua, a country where the DOTS strategy has been successfully implemented since 1984. OBJECTIVE: To estimate the prevalence and trends of Mycobacterium tuberculosis resistance to first-line anti-tuberculosis drugs. DESIGN: A prospective national survey carried out in 2004 according to the standardised model developed by the World Health Organisation and the International Union Against Tuberculosis and Lung Disease. RESULTS: A total of 423 M. tuberculosis strains were studied. Among the 320 strains evaluated for initial resistance, 13.1% displayed resistance to any drug, lower than the 1998 figure of 15.6%. Overall initial resistance to isoniazid (INH), rifampicin (RMP) and multidrug resistance (MDR) was respectively 6.6%, 0.9% and 0.6%. Initial resistance was higher in older age groups. Overall acquired resistance was 35.9% (n = 103); resistance to INH was 29.3% and to RMP 8.9%, while MDR was 7.9%. The acquired MDR rate was clearly higher in Category I failures (44.4%) than in relapses (3.8%) and retrieved defaulters (2.7%). All resistance rates found in this study were lower than those detected in 1998. CONCLUSION: This study shows low rates of resistance and MDR and a downward trend in all rates, undoubtedly related to the proper implementation of the National Tuberculosis Programme.

Salmonella detection in feces during broiler rearing and after live transport to the slaughterhouse.

Eggs and poultry meat are a common source of human salmonellosis. Contamination of poultry or poultry meat may occur throughout the production chain. Nevertheless, in Spain, noncontaminated broiler meat may be sold for human consumption from 2011. The aims of this study were as follows: (i) assess Salmonella detection from feces samples during the rearing and (ii) assess the influence of live transport to the slaughterhouse on Salmonella detection. During this study, 65 flocks were sampled at weekly intervals from the first day of rearing until slaughter. Samples of feces were taken from the litter using 5 pairs of cellulose sock swabs attached to boots and applied over the length of the house. To assess Salmonella detection rates before and after live transport to the slaughterhouse, feces samples were collected. Before loading, feces with 5 pairs of cellulose sock swabs were taken as described above. After transport, 2 pooled feces samples were taken directly from the truck (200 to 300 g each). All samples were analyzed in accordance with ISO 6579:2002 (Annex D). Results showed that regardless of whether broiler flocks arrived at the farm already shedding the bacteria in feces or they were infected during rearing, both groups described the same detection pattern, with the highest detection in feces at 14th day of rearing (50.5 and 34.5%, respectively). Moreover, Salmonella Enteritidis was the most prevalent serotype isolated during rearing (66.7%), followed by Salmonella Virchow (13.7%), Salmonella Hadar (9.4%), and Salmonella Ohio (2.8%). On the other hand, before loading and after transport to the slaughterhouse, 15.4 and 41.2% of feces samples collected were determined positive, respectively. In addition, a change in the serotype pattern was also observed. Salmonella Enteritidis remains the most prevalent serotype isolated (54.5%). Salmonella Hadar doubled the excretion rates (39.3%), and Salmonella Virchow and Salmonella Ohio were not isolated after transport.

Biofilm development capacity of Salmonella strains isolated in poultry risk factors and their resistance against disinfectants.

Prevention of Salmonella contamination of poultry products requires detailed knowledge of the most important risk factors associated with its presence in the production system. The aim of this study was to identify the risk factors for Salmonella contamination in 44 broiler and 51 layer farms and determine the biofilm development capacity of the strains isolated. Then, glutaraldehyde (50% vol/vol), formaldehyde (37% vol/vol), and hydroxide peroxide (35% vol/vol) were applied to evaluate their capacity to remove Salmonella, biofilm and nonbiofilm strains, isolated from each risk factor in an artificial contamination test in field conditions. Samples of feces, dust, surfaces, meconium, delivery-box liners, water tank, water dispensers, litter, vectors (rodents, flies, and beetles), and surfaces of the slaughter trucks were taken throughout the rearing period. All samples were analyzed in accordance with ISO 6579:2002 (Annex D). To evaluate biofilm development, a screening method based on the fluorescence of Salmonella colonies on calcofluor agar plates was used. In the artificial contamination test, the chemical solutions were prepared at a concentration of 1.0% and applied at exact times (1, 15, or 60 min). Our results showed that the most important risk factors for Salmonella contamination were dust, surfaces, and feces. Moreover, day-old broiler chicks reached the farm highly contaminated, and wild carriers played an important role in the recirculation of Salmonella in laying hen houses. The serotype most commonly isolated from each risk factor was Salmonella enteritidis, and irrespective of the origin of different serotypes, around 50% were able to produce biofilm. Finally, the use of glutaraldehyde, formaldehyde, and peroxygen at a concentration of 1.0% in field conditions are inadequate for Salmonella elimination irrespective of the serotype, the biofilm development capacity, and the disinfectant contact time.

Update on radioguided surgery: from international consensus on sentinel node in head and neck cancer to the advances on gynaecological tumors and localization of non-palpable lesions. / Actualización en cirugía radioguiada: del consenso internacional en ganglio centinela de cabeza y cuello a los avances en tumores ginecológicos y localización de lesiones no palpables.

The aim of this review is to provide an updated perspective on different fields of radioguided surgery. With reference to the sentinel lymph node biopsy in oral squamous cell carcinoma, we present the results of the interactive debate held at the recent Congress of our specialty about the more relevant aspects of the London Consensus. Drainage peculiarities and indications according to the current guidelines on gynaecological tumours, endometrial and cervical cancer, are detailed and new scenarios for nuclear medicine physicians are presented; robotic surgery and hybrid tracers, for instance. Moreover, the notable growth in radioguided surgery indications for non-palpable lesions, widely used in mammary pathology, make it advisable to update two procedures which have shown satisfying results, such as the solitary pulmonary nodule and the osteoid osteoma.

Consensus for tinnitus patient assessment and treatment outcome measurement: Tinnitus Research Initiative meeting, Regensburg, July 2006.

There is widespread recognition that consistency between research centres in the ways that patients with tinnitus are assessed and outcomes following interventions are measured would facilitate more effective co-operation and more meaningful evaluations and comparisons of outcomes. At the first Tinnitus Research Initiative meeting held in Regensburg in July 2006 an attempt was made through workshops to gain a consensus both for patient assessments and for outcome measurements. It is hoped that this will contribute towards better cooperation between research centres in finding and evaluating treatments for tinnitus by allowing better comparability between studies.

Crossover, double-blind clinical trial comparing almotriptan and ergotamine plus caffeine for acute migraine therapy.

In this randomized, double-blind, crossover clinical trial, adult patients treated two migraine attacks: one with almotriptan 12.5 mg and the other with ergotamine 2 mg plus caffeine 200 mg. Treatment with almotriptan was associated with a significantly greater proportion of patients achieving 2-h pain free (20.9% vs. 13.7%; P < 0.05) and 2-h pain relief (57.7% vs. 44.5%; P < 0.01) compared with ergotamine plus caffeine therapy; significant differences were not seen at 1 h. Rates for sustained pain free and sustained pain free plus no adverse events (AEs) also were significantly greater after almotriptan treatment than after the use of ergotamine plus caffeine (P < 0.05). Almotriptan was associated with a significantly lower rate of photophobia at 90 min (P < 0.05), phonophobia at 60, 90, and 120 min (P < 0.05 to <0.01), and nausea and vomiting at 90 and 120 min (P < 0.01) compared with ergotamine plus caffeine. A significantly greater proportion of patients were more satisfied with almotriptan than with ergotamine plus caffeine (P < 0.05). Sixteen patients reported adverse events during almotriptan treatment and 27 patients reported AEs during the ergotamine plus caffeine therapy. Most AEs were mild-to-moderate and did not result in treatment-related discontinuations. In conclusion, almotriptan was associated with significantly greater efficacy for treating migraine compared with ergotamine plus caffeine, was generally well tolerated and was associated with greater rate of treatment satisfaction.

Time course of adverse events most commonly associated with topiramate for migraine prevention.

The efficacy, safety and tolerability of topiramate has been demonstrated in three large multicenter, randomized, double-blind, placebo-controlled trials. To characterize the time course of adverse events (AEs) that led to treatment discontinuation in >/=2% of patients who received topiramate 100 mg/day during three pivotal, multicenter, randomized, double-blind, placebo-controlled, and 26-week trials. The pooled population comprised all randomized patients who reported safety data during the double-blind phase (topiramate 100 mg/day, n = 386; placebo n = 372), which consisted of a 4-week titration period and a 22-week maintenance period. Incidence, time to onset, and cumulative mean rate of AEs were assessed. Overall, AEs led to treatment discontinuation in 24.9% of patients receiving topiramate 100 mg/day and 11.0% receiving placebo (P < 0.001). AEs leading to discontinuation during the double-blind phase in > or =2% of patients included paresthesia (8.0% discontinued), any cognitive symptoms (7.3% discontinued), fatigue (4.7% discontinued), insomnia (3.4% discontinued), nausea (2.3% discontinued), loss of appetite, anxiety, and dizziness (2.1% discontinued because each AE). Most AEs began during the titration period. Paresthesia, any cognitive symptoms, nausea, and loss of appetite occurred at a higher rate in the topiramate group than in the placebo group (P < 0.01). AEs leading to discontinuation of topiramate are probably to occur during dose titration. If a patient has not experienced one of these AEs within the first 6 weeks of initiating topiramate 100 mg/day, these AEs are unlikely to occur.

[Impact of several illnesses on health related quality of life on workers]. / Impacto de distintas enfermedades en la calidad de vida relacionada con la salud (CVRS) en una población laboral.

UNLABELLED: FOUNDATION AND OBJECTIVE: To make a comparative study of the degree of impact of different diseases in the health related quality of life (HRQoL) of workers. MATERIAL AND METHODS: A questionnaire including the measure of HRQoL SF-36, was sent by mail and fulfilled by employees of the Pfizer company in Spain. Differences in the impact in HRQoL between subjects with and without several characteristics, with less or more degree of work productivity and with and without antecedents of several diseases and current treatment, were assessed by means of statistical tests of U Mann-Whitney and Kruskal-Wallis. RESULTS: In a sample of 399 valuable subjects, 35.8+/-6.5 years (mean+/-standard deviation), with a 63.7% of men, worst HRQoL scores in the Physical Summary Component of SF-36 were observed among subjects with history of some disease (52.6+/-5.9 days versus 55.9+/-2.6), migraine (46.2+/-5.9 versus 54.7+/-4.1), musculoskeletal (49.7+/-7.2 versus 53.9+/-5.1) and digestive diseases (51.5+/-6.6 versus 54.1+/-4.9), and/or taking some current treatment (50.2+/-6.4 versus 55.0+/-4.4); p <0.05 for all comparisons. In the Physical Summary Component of SF-36 worst HRQoL scores were observed among subjects with history of some disease (51.4+/-7.1 versus 53.4+/-5.9), digestive (49.9+/-8.3 versus 52.5+/-6.3) and mental disorders (46.0+/-8.8 versus 52.4+/-6.4); p <0.05 for all comparisons. CONCLUSIONS: The impact of the disease in the HRQoL was associated to the type of pathological antecedents, being migraine that hit more negatively in the Physical Health, and mental disorders in the Mental Health.