Aborto e saúde mental da mulher

The existence or the lack of alterations of mental health of women as consequence of abortion currently arises a lively debate, since, while there are convinced professionals defending its existence, others are completely opposed to it. In order to examine this issue we have evaluated some of most recent reviews considering they have contrasted methodological value, as well as some of the latest published articles. We can conclude that there is no post abortion syndrome as such, but there are secondary psychological disorders after abortion. Finally, we reflect about in which extent the feeling of guilt that woman may experiment for having aborted may influence the presentation or not of psychological disorders after the abortion act.La existencia o no de alteraciones de la salud mental de la mujer como consecuencia del aborto es algo que suscita en el momento actual un vivo debate, pues, junto a convencidos profesionales que defienden su existencia, otros se manifiestan totalmente opuestos a ello. Para abordar este tema hemos evaluado algunas de las más recientes revisiones que nos han parecido de calidad metodológica contrastada, así como también algunos de los últimos artículos publicados. Podemos concluir que no existe un síndrome posaborto como tal, pero sí trastornos psicológicos secundarios al aborto. Finalmente, reflexionamos sobre en qué medida el sentimiento de culpabilidad que la mujer pueda experimentar por haber abortado podría influir en la presentación o no de trastornos psicológicos tras el acto abortivo.A existência ou não de alterações da saúde mental da mulher como consequência do aborto é algo que suscita no momento atual um vivo debate, pois, junto a convencidos profissionais que defendem a sua existência, outros se manifestam totalmente opostos a isso. Para abordar este tema avaliamos algumas das mais recentes revisões que nos pareceram de qualidade metodológica comprovada, assim como também alguns dos últimos artigos publicados. Podemos concluir que não existe uma síndrome pós-aborto como tal, mas sim transtornos psicológicos secundários ao aborto. Finalmente, refletimos sobre em que medida o sentimento de culpabilidade que a mulher pode experimentar por haver abortado poderia influir na apresentação ou não de transtornos psicológicos após o ato abortivo.Medicin

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.Medicin

Influence of the COVID-19 pandemic confinement period on basic dietary and health habits in a sample of the Spanish population

Antecedentes y objetivos: Un hábito constituye una pauta de comportamiento diario de una persona que tiene cierta repetición en el tiempo. Mantener hábitos correctos de alimentación y salud influye directamente en el bienestar de los individuos. Recientemente, a causa de la pandemia del coronavirus COVID-19 -en lo que se ha denominado la primer ola- la realidad de la vida, del trabajo y de la relación de la población española se ha visto modificada de forma repentina. El objetivo del presente estudio consiste en determinar el impacto que ha producido el periodo de confinamiento sobre los hábitos de la población. Métodos: Se plantea un estudio observacional, descriptivo, trasversal mediante encuestas. Se diseñó un cuestionario “ad hoc” que exploraba un conjunto de variables, fundamentalmente, hábitos relacionados con la alimentación, las relaciones sociales y algunos aspectos emocionales. El cuestionario fue difundido durante un periodo de ocho semanas y fue implementado por una muestra de 519 personas, mediante un muestreo no probabilístico en bola de nieve. Resultados: Los resultados del estudio arrojan que en general los hábitos alimentarios se han visto favorecidos por el periodo de confinamiento. El disponer de un mayor tiempo para cocinar ha llevado a la población a consumir comida más casera de producción propia. Otro resultado a destacar es que las mujeres han sufrido durante el confinamiento más cargas emocionales y psicológicas que los hombres en todas las variables consideradas. De forma similar, las personas más jóvenes han sufrido más intensamente procesos emocionales durante el confinamiento que el grupo de mayores. Conclusiones: El período de confinamiento no ha perjudicado de forma significativa, la forma física de la población; aunque se han comprobado incrementos de peso y de ingesta de comida, también se ha observado un incremento del ejercicio físico y la adopción de prácticas nutricionales más saludables. El impacto más negativo se ha registrado en la esfera psicológica y la social, así como sobre los aspectos laborables y los estudios.Due to the COVID-19 coronavirus pandemic, the reality of life, work and relationships of the Spanish population has suddenly changed. The aim of this study was to determine the impact of the period of confinement on the behaviour of the population. The participants were people of Spanish nationality who did not have chronic or mental illnesses that could affect their diet or emotional state. The sample consisted of 519 people, from all over Spain, 351 participants were women and 168 men. Most of the sample was made up of subjects between 18 and 30 years old. We proposed an observational, descriptive, cross-sectional study using surveys. An ad hoc questionnaire was designed to explore a series of variables: eating habits, social relationships and some emotional aspects. The questionnaire was distributed for eight weeks using non-probabilistic snowball sampling. In general, eating behaviours were improved in the period of confinement. The population consumed more home-made food prepared by themselves. Women suffered more emotional and psychological burdens during confinement than men. Younger people suffered more intense emotional issues during confinement. The period of confinement did not significantly affect the physical condition of the population. The most negative impact was recorded on psychological and social variables, as well as on work and studies.Ciencias Experimentale

Identification of a microRNA signature for the diagnosis of fibromyalgia

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.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.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.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.The study was funded by the Fundación Universidad Católica de Valencia “San Vicente Mártir”(UCV) Research Grant Program (2011-011-02, 2011-011-04 and 2012-011-008) the Fundación Cátedra Umivale at the UCV and the 3D-Gene International Competition Award to EOMedicin

Microrna Expression Profile in Fibromyalgia Patients: A Pilot Matched Case Control Study

The objective of this study was to determine whether an association between an altered miRNAs expression profile and fibromyalgia exists.Medicin

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.Nutrición humana y dietétic

Comentarios al Proyecto de Ley Reguladora de los Derechos de la Persona ante el proceso final de la vida

El 17 de junio de 2011 se publicó en el Boletín Oficial de las Cortes Generales el Proyecto de Ley reguladora de los derechos de la persona ante el proceso final de la vida1. Esta iniciativa del Gobierno ha suscitado una fuerte controversia pública. En relación con ello, de forma conjunta, la Sociedad Española de Cuidados Paliativos (SECPAL), y la Organización Médica Colegial (OMC) sugirieron 36 alegaciones al Anteproyecto de Ley, que fueron remitidas al Ministerio de Sanidad, Política Social e Igualdad. Por su parte, la Comisión Permanente de la Conferencia Episcopal Española también aprobó una Declaración en la que alertaba sobre la posible deriva eutanásica que el texto en proceso de aprobación podía iniciar.Derech

La infección crónica por el gamma retrovirus xenotrópico relacionado con el virus de la leucemia murina (XMRV) en patología humana: ¿Realidad o artefacto de laboratorio?

El nuevo virus xenotrópico relacionado con el virus de la leucemia murina (XMRV), único gamma retrovirus identificado en humanos hasta la fecha, se aisló de especímenes de cáncer de próstata en el año 2006, y en el 2009 se asoció impactantemente con el síndrome de fatiga crónica (SFC), enfermedad debilitante de sintomatología compleja que cursa, frecuentemente, con alteraciones de la enzima antiviral ribonucleasa L (RNasa L), al igual que el cáncer de próstata hereditario. La imposibilidad de replicar estos hallazgos y la presencia de secuencias virales similares halladas en kits comerciales y preparaciones de polimerasas “hotstart” que contienen anticuerpos derivados de hibridomas plantean la posibilidad de que las secuencias amplificadas en los estudios iniciales del XMRV puedan corresponder a contaminaciones con ADN murino y que el nuevo XMRV no sea más que un artefacto creado por procesos de recombinación en el seno de un xenoinjerto. Sin embargo, una contaminación casual no permitiría explicar la desigual distribución de secuencias virales halladas entre pacientes y controles sanos, ni cómo fue posible hallar secuencias genómicas específicas humanas flanqueando las secuencias terminales repetidas largas (LTRs) virales del XMRV en tejidos de pacientes de cáncer de próstata. ¿Podría ser que además de un contaminante habitual de reactivos de laboratorio el XMRV fuese un gamma retrovirus humano genuino? El desarrollo de ensayos serológicos específicos y sensibles del XMRV combinados con rigurosos controles resultará indispensable para dar respuesta definitiva a esta importante pregunta.The new and only human gammaretrovirus identified to date: the xenotropic murine leukemia virus-related virus (XMRV) was isolated back in 2006 from prostate cancer specimens and strikingly associated to Chronic Fatigue Syndrome (CFS) in the year 2009. CFS is a multisymptom debilitating disease often showing an altered ribonuclease L (RNase L) enzyme activity, as it occurs in hereditary prostate cancer. The irreproducibility of these findings and the identification of related viral sequences in commercial kits and “hotstart” polymerase preparations containing hybridoma-derived antibodies suggest that the XMRV sequences found in the initial studies may correspond to murine DNA contaminations and that the XMRV might well be an artefact generated by recombination processes that took place within a xenograft. However, a random contaminating event cannot explain the unequal distribution of viral sequences found between patients and healthy controls, nor the presence of human genomic sequences flanking the XMRV long terminal repeats (LTRs) in prostate cancer specimens. Would it be possible that the XRMV is a frequent reagent contaminant but a human genuine gammaretrovirus as well? Highly specific and sensitive serologic assays combined with proper strict controls will be required to answer this important question.Medicin

Epidemiology and sociodemographic characterization of the fibromyalgia in Comunidad Valenciana

Fundamentos: La elevada prevalencia de la fibromial-gia y su clínica polipatológica supone un importante proble-ma de salud pública en España. El presente estudio tuvo por objeto realizar una aproximación a la epidemiología del sín-drome, con la finalidad de colaborar en el avance del cono-cimiento científico de las personas que sufren fibromialgia, en este caso mediante el análisis sociodemográfico de los pa-cientes en la Comunidad Valenciana (España).Métodos: Se realizó un estudio epidemiológico des-criptivo transversal, mediante extracción y análisis de va-riables epidemiológicas en fuentes oficiales de información sanitaria de la Comunidad Valenciana (Abucasis II, SIA, GAIA, SIP, SIE). El estudio presentó dos procesos de análi-sis 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 afecta-das de fibromialgia, utilizando una muestra de 9.267 perso-nas 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 tra-tamiento estadístico de los datos fue descriptivo univaria-ble, y realizado con valores porcentuales, de media, media-na 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 ele-vada 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 frecuen-cia y duración de sus bajas laborales. Conclusiones: La fibromialgia tiene una especial im-portancia 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 compara-tivamente con otros estudios. Observamos un importante menoscabo de las condiciones socioeconómicas y sociola-borales entre las personas con diagnóstico de fibromialgia.Background: The elevated prevalence of the fi-bromyalgia and its polypathologic clinic suppose an impor-tant Public Health problem in Spain. The purpose of this study was to carry out an approach of the syndrome’s epi-demiology, with the finality of collaborate in the scientific knowledge progress of the people who suffer fibromyal-gia, 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 epidemio-logical 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 charac-terization 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 valen-cian 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 di-sease 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 spe-cially affected women (it had it the 63% of the sample) and the average age of 54 years. Besides, people with fibromyal-gia presented low economic levels and laboural difficulties defined by low employment rate, the elevated unemploy-ment rate and the frequency and length of their work leaves.Conclusions: Fibromyalgia has a special epidemio-logical 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 sociodemo-graphic conditions between fibromyalgia diagnosed people.Medicin

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

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.Medicin