Dolor crónico: relación con sintomatología prefrontal y estrés percibido

ABSTRACT Objective: The quality of perceived stress coping in chronic pain is related to the performance of the prefrontal cortex as the main structure of control and coordination of superior behavior control. The present study explores the presence of prefrontal symptomatology, in the form of problems to manage cognition, emotions and behavior, and perceived stress in a sample of people suffering from chronic pain. Material and methods: We studied 78 participants with a diagnosis of chronic pain ranging in age from 27 to 81 years (mean 54.2 and d.t 13.4). Sociodemographic and clinical variables were analyzed together with the results in the 11-item Short Brief Pain Questionnaire (CBD) to assess the intensity and interference of pain, the Prefrontal Symptom Inventory (ISP), both in its complete version of 46 items and in the abbreviated of 20, and the 10-itme Perceived Scale of Perceived Stress (EEP). Results and discussion: Significant correlations between the prefrontal symptomatology and the intensity (r = 0.32) and the interference (r = 0.53) of the pain, as well as between the stress and the interference of the pain in the mood (r = 0.36). People report more painful feelings when they refer more cognitive and emotional management problems surrounding the environment. The general interference of pain is related to more motivational and attention problems, while the interference that the pain produces in the mood also increases the problems with executive and emotional control. A preliminary structural equation explaining the effect is proposed. Conclusion: The data suggest that the stress perceived by people with chronic pain depends on the inability of the prefrontal cortex to cope with a changing or threatening situation and this problem is fed back over and over as the person is less able to cope with the environment. Therefore, comprehensive treatment of chronic pain should include psychological interventions focused on coping with stress and cognitive optimization of skills related to prefrontal functioning.RESUMEN Objetivo: La calidad del afrontamiento del estrés percibido en el dolor crónico está relacionada con el rendimiento de la corteza prefrontal como estructura principal de control y coordinación de control superior de la conducta. El presente trabajo estudia la presencia de sintomatología prefrontal, en forma de problemas para gestionar la cognición, las emociones y el comportamiento, y de estrés percibido en una muestra de personas que sufren dolor crónico. Material y métodos: Se estudiaron 78 participantes con diagnóstico de dolor crónico con edades comprendidas entre 27 y 81 años (media 54,2 y d.t. 13,4). Se analizaron variables sociodemográficas y clínicas junto con los resultados en el Cuestionario Breve de Dolor (CBD) abreviado de 11 ítems para valorar la intensidad e interferencia de dolor, el Inventario de Síntomas Prefrontales (ISP), tanto en su versión completa de 46 ítems como en la abreviada de 20, y la Escala de Estrés Percibido (EEP) abreviada de 10 ítems. Resultados y discusión: Aparecen correlaciones significativas entre la sintomatología prefrontal y la intensidad (r = 0,32) y la interferencia (r = 0,53) del dolor, así como entre el estrés y la interferencia del dolor en el estado del ánimo (r = 0,36). Las personas declaran más sensación dolorosa cuando refieren más problemas de gestión cognitiva y emocional del entorno que las rodea. La interferencia general del dolor se relaciona con más problemas motivacionales y de atención, mientras que la interferencia que el dolor produce en el estado del ánimo incrementa, además, los problemas con el control ejecutivo y emocional. Se propone una ecuación estructural preliminar explicativa del efecto. Conclusión: Los datos sugieren que el estrés percibido por las personas con dolor crónico depende de la incapacidad de la corteza prefrontal para afrontar una situación cambiante o amenazante, y este problema se retroalimenta una y otra vez al ser la persona cada vez menos capaz de afrontar el ambiente. Por tanto, el tratamiento integral del dolor crónico debe incluir intervenciones psicológicas centradas en el afrontamiento del estrés y la optimización cognitiva de las habilidades relacionadas con el funcionamiento prefrontal

Aperture effects on the oxygen abundance determinations from CALIFA data

This paper aims at providing aperture corrections for emission lines in a sample of spiral galaxies from the Calar Alto Legacy Integral Field Area Survey (CALIFA) database. In particular, we explore the behavior of the log([OIII]5007/Hbeta)/([NII]6583/Halpha) (O3N2) and log[NII]6583/Halpha (N2) flux ratios since they are closely connected to different empirical calibrations of the oxygen abundances in star forming galaxies. We compute median growth curves of Halpha, Halpha/Hbeta, O3N2 and N2 up to 2.5R_50 and 1.5 disk R_eff. The growth curves simulate the effect of observing galaxies through apertures of varying radii. The median growth curve of the Halpha/Hbeta ratio monotonically decreases from the center towards larger radii, showing for small apertures a maximum value of ~10% larger than the integrated one. The median growth curve of N2 shows a similar behavior, decreasing from the center towards larger radii. No strong dependence is seen with the inclination, morphological type and stellar mass for these growth curves. Finally, the median growth curve of O3N2 increases monotonically with radius. However, at small radii it shows systematically higher values for galaxies of earlier morphological types and for high stellar mass galaxies. Applying our aperture corrections to a sample of galaxies from the SDSS survey at 0.02<=z<=0.3 shows that the average difference between fiber-based and aperture corrected oxygen abundances, for different galaxy stellar mass and redshift ranges, reaches typically to ~11%, depending on the abundance calibration used. This average difference is found to be systematically biased, though still within the typical uncertainties of oxygen abundances derived from empirical calibrations. Caution must be exercised when using observations of galaxies for small radii (e.g. below 0.5R_eff) given the high dispersion shown around the median growth curves.Comment: Accepted for publication in Ap

Similar incidence of coronavirus disease 2019 (COVID-19) in patients with rheumatic diseases with and without hydroxychloroquine therapy

Background Hydroxychloroquine is not efficacious as post-exposure prophylaxis against coronavirus disease 2019 (COVID-19). It is not known whether as pre-exposure prophylaxis it may prevent COVID-19. Objective To compare the incidence of COVID-19 in Spanish patients with autoimmune rheumatic diseases treated with and without hydroxychloroquine. Patients and methods Retrospective electronic record review, from February 27th to June 21st, 2020, of patients with autoimmune inflammatory diseases followed at two academic tertiary care hospitals in Seville, Spain. The cumulative incidence of confirmed COVID-19, by PCR or serology, was compared between patients with and without hydroxychloroquine as part of their treatment of autoimmune inflammatory diseases. Results Among 722 included patients, 290 (40%) were receiving hydroxychloroquine. During the seventeen-week study period, 10 (3.4% [95% CI: 1.7%-6.7%] cases of COVID-19 were registered among patients with hydroxychloroquine and 13 (3.0% [1.6%-5.1%]) (p = 0.565) in those without hydroxychloroquine. COVID-19 was diagnosed by PCR in four (1.4%, 95% CI 0.38%-3.5%) subject with hydroxychloroquine and six (1.4%, 95% CI 0.5%-3.0%) without hydroxychloroquine (p = 0.697). Three patients on hydroxychloroquine and four patients without hydroxychloroquine were admitted to the hospital, none of them required to be transferred to the intensive care unit and no patient died during the episode. Conclusions The incidence and severity of COVID-19 among patients with autoimmune rheumatic diseases with and without hydroxychloroquine was not significantly different.Instituto de Salud Carlos III I3SNSMinisterio de Ciencia, Innovación y Universidades CP18/0014

Ultraviolet through far-infrared spatially resolved analysis of the recent star formation in M81 (NGC 3031)

The recent star formation (SF) in the early-type spiral galaxy M81 is characterized using imaging observations from the far-ultraviolet to the far-infrared. We compare these data with models of the stellar, gas, and dust emission for subgalactic regions. Our results suggest the existence of a diffuse dust emission not directly linked to the recent star formation. We find a radial decrease of the dust temperature and dust mass density, and in the attenuation of the stellar light. The IR emission in M81 can be modeled with three components: (1) cold dust with a temperature = 18 ± 2 K, concentrated near the H II regions but also presenting a diffuse distribution; (2) warm dust with = 53 ± 7 K, directly linked with the H II regions; and (3) aromatic molecules, with diffuse morphology peaking around the H II regions. We derive several relationships to obtain total IR luminosities from IR monochromatic fluxes, and we compare five different star formation rate (SFR) estimators for H II regions in M81 and M51: the UV, H alpha, and three estimators based on Spitzer data. We find that the H alpha luminosity absorbed by dust correlates tightly with the 24 mu m emission. The correlation with the total IR luminosity is not as good. Important variations from galaxy to galaxy are found when estimating the total SFR with the 24 mu m or the total IR emission alone. The most reliable estimations of the total SFRs are obtained by combining the H alpha emission (or the UV) and an IR luminosity (especially the 24 mu m emission), which probe the unobscured and obscured SF, respectively. For the entire M81 galaxy, about 50% of the total SF is obscured by dust. The percentage of obscured SF ranges from 60% in the inner regions of the galaxy to 30% in the outer zones

The O3N2 and N2 abundance indicators revisited: improved calibrations based on CALIFA and Te-based literature data

The use of IFS is since recently allowing to measure the emission line fluxes of an increasingly large number of star-forming galaxies both locally and at high redshift. The main goal of this study is to review the most widely used empirical oxygen calibrations, O3N2 and N2, by using new direct abundance measurements. We pay special attention to the expected uncertainty of these calibrations as a function of the index value or abundance derived and the presence of possible systematic offsets. This is possible thanks to the analysis of the most ambitious compilation of Te-based HII regions to date. This new dataset compiles the Te-based abundances of 603 HII regions extracted from the literature but also includes new measurements from the CALIFA survey. Besides providing new and improved empirical calibrations for the gas abundance, we also present here a comparison between our revisited calibrations with a total of 3423 additional CALIFA HII complexes with abundances derived using the ONS calibration by Pilyugin et al. (2010). The combined analysis of Te-based and ONS abundances allows us to derive their most accurate calibration to date for both the O3N2 and N2 single-ratio indicators, in terms of all statistical significance, quality and coverage of the space of parameters. In particular, we infer that these indicators show shallower abundance dependencies and statistically-significant offsets compared to those of Pettini and Pagel (2004), Nagao et al. (2006) and P\'erez-Montero and Contini (2009). The O3N2 and N2 indicators can be empirically applied to derive oxygen abundances calibrations from either direct abundance determinations with random errors of 0.18 and 0.16, respectively, or from indirect ones (but based on a large amount of data) reaching an average precision of 0.08 and 0.09 dex (random) and 0.02 and 0.08 dex (systematic; compared to the direct estimations),respectively.Comment: 12 pages, 5 figures, accepted for publication in A&

Staging Parkinson’s Disease Combining Motor and Nonmotor Symptoms Correlates with Disability and Quality of Life

Malaltia de Parkinson; Qualitat de vidaEnfermedad de Parkinson; Calidad de vidaParkinson's Disease; Quality of LifeIntroduction. In a degenerative disorder such as Parkinson’s disease (PD), it is important to establish clinical stages that allow to know the course of the disease. Our aim was to analyze whether a scale combining Hoehn and Yahr’s motor stage (H&Y) and the nonmotor symptoms burden (NMSB) (assessed by the nonmotor symptoms scale (NMSS)) provides information about the disability and the patient’s quality of life (QoL) with regard to a defined clinical stage. Materials and Methods. Cross-sectional study in which 603 PD patients from the COPPADIS cohort were classified according to H&Y (1, stage I; 2, stage II; 3, stage III; 4, stage IV/V) and NMSB (A: NMSS = 0–20; B: NMSS = 21–40; C: NMSS = 41–70; D: NMSS ≥ 71) in 16 stages (HY.NMSB, from 1A to 4D). QoL was assessed with the PDQ-39SI, PQ-10, and EUROHIS-QOL8 and disability with the Schwab&England ADL (Activities of Daily Living) scale. Results. A worse QoL and greater disability were observed at a higher stage of H&Y and NMSB (). Combining both (HY.NMSB), patients in stages 1C and 1D and 2C and 2D had significantly worse QoL and/or less autonomy for ADL than those in stages 2A and 2B and 3A and 3B, respectively (; e.g., PDQ-39SI in 1D [n = 15] vs 2A [n = 101]: 28.6 ± 17.1 vs 7.9 ± 5.8; ). Conclusion. The HY.NMSB scale is simple and reflects the degree of patient involvement more accurately than the H&Y. Patients with a lower H&Y stage may be more affected if they have a greater NMS burden