Male vs Female Lupus. A comparison of ethnicity, clinical features, serology and outcome over a 30 year period

Un estudi observacional de pacients amb LES, atesos al University College de London Hospital entre 1976 i 2005, es va dur a terme per revisar les diferències entre homes i dones amb lupus pel que fa a les característiques clíniques, serologia i resultats. 439 dones i 45 homes van ser identificats. L'edat mitjana al diagnòstic va ser de 29,3 anys (12,6), sense diferències significatives entre homes i dones. El sexe femení es va associar significativament amb la presència d'úlceres orals i Ig M ACA. No hi va haver diferències significatives en la comparació de les altres variables. Durant aquest període de seguiment de trenta anys, relativament poques diferències han sorgit al comparar les freqüències de les característiques clíniques i serològiques en homes y dones amb lupus.

Confirmatory factor analysis of an integrated model of psycopathology assessed with MMPI-2-RF and the MCMI-III

We presented an integrated hierarchical model of psychopathology that more accurately captures empirical patterns of comorbidity between clinical syndromes and personality disorders.In order to verify the structural validity of the model proposed, this study aimed to analyze the convergence between the Restructured Clinical (RC) scales and Personality scales (PSY-5) of the MMPI-2-RF and the Clinical Syndrome and Personality Disorder scales of the MCMI-III.The MMPI-2-RF and MCMI-III were administered to a clinical sample of 377 outpatients (167 men and 210 women).The structural hypothesiswas assessed by using a Confirmatory Factor Analytic design with four common superordinate factors. An independent-cluster-basis solution was proposed based on maximum likelihood estimation and the application of several fit indices.The fit of the proposed model can be considered as good and more so if we take into account its complexity.

Factores cognitivos en la fibromialgia: el papel del autoconcepto y de los conflicots relativos a la identidad en el tratamiento psicológico de la fibromialgia

La fibromialgia es un síndrome caracterizado por la presencia de dolor músculo-esquelético generalizado, difuso y crónico. La etiología es desconocida y es diagnóstico es exclusivamente clínico. Además hasta el momento el tratamiento se centra únicamente en la reducción de síntomas. Todas estas características influyen en gran medida en la vivencia que tienen estas pacientes de la enfermedad, así como en la imagen que tienen de sí mismas. Diversos autores han enfatizado la importancia de estudiar los fenómenos relacionados con la identidad en las situaciones de dolor crónico. En este informe se presentan los dos estudios realizados durante los cuatro años de beca en torno al estudio del autoconcepto y la identidad en mujeres con fibromialgia. Ambos estudios se enmarcan dentro de la Psicología de los Constructos Personales de George Kelly y utilizan la técnica de rejilla como principal instrumento de evaluación. En el primer estudio se realiza una comparación de las medidas de construcción del sí mismo y de estructura cognitiva entre un grupo de mujeres con fibromialgia (n = 30) y un grupo de mujeres sin fibromialgia (n = 30). Encontramos que las mujeres de nuestra muestra presentan una mayor discrepancia entre el “yo actual” y el “yo ideal”, una menor adecuación percibida en los otros y mayor probabilidad de presentar algún conflicto cognitivo. Estos resultados preliminares nos llevaron a plantearnos la relación entre estos factores cognitivos y el tratamiento. Por ello, el segundo estudio consiste en un estudio de casos en el que se realiza un tratamiento individualizado (terapia cognitivo-constructivista) con cada una de las participantes y se analizan en detalle, a través de un grupo de trabajo, estos factores cognitivos y su relación con la evolución del tratamiento. Este segundo estudio sigue en curso, por lo que se presentan sólo unos resultados preliminares.

Molecular method for the characterization of Coxiella burnetii from clinical and environmental samples: variability of genotypes in Spain

Background: Coxiella burnetii is a highly clonal microorganism which is difficult to culture, requiring BSL3 conditions for its propagation. This leads to a scarce availability of isolates worldwide. On the other hand, published methods of characterization have delineated up to 8 different genomic groups and 36 genotypes. However, all these methodologies, with the exception of one that exhibited limited discriminatory power (3 genotypes), rely on performing between 10 and 20 PCR amplifications or sequencing long fragments of DNA, which make their direct application to clinical samples impracticable and leads to a scarce accessibility of data on the circulation of C. burnetii genotypes. Results: To assess the variability of this organism in Spain, we have developed a novel method that consists of a multiplex (8 targets) PCR and hybridization with specific probes that reproduce the previous classification of this organism into 8 genomic groups, and up to 16 genotypes. It allows for a direct haracterization from clinical and environmental samples in a single run, which will help in the study of the different genotypes circulating in wild and domestic cycles as well as from sporadic human cases and outbreaks. The method has been validated with reference isolates. A high variability of C. burnetii has been found in Spain among 90 samples tested, detecting 10 different genotypes, being those adaA negative associated with acute Q fever cases presenting as fever of intermediate duration with liver involvement and with chronic cases. Genotypes infecting humans are also found in sheep, goats, rats, wild boar and ticks, and the only genotype found in cattle has never been found among our clinical samples. Conclusions: This newly developed methodology has permitted to demonstrate that C. burnetii is highly variable in Spain. With the data presented here, cattle seem not to participate in the transmission of C. burnetii to humans in the samples studied, while sheep, goats, wild boar, rats and ticks share genotypes with the human population.

Orofacial pain of cardiac origin: review literature and clinical cases

The most common types of orofacial pain originate at the dental or periodontal level or in the musculoskeletal structures. However, the patient may present pain in this region even though the source is located elsewhere in the body. One possible source of heterotopic pain is of cardiac origin. Objectives: Report two cases of orofacial pain of cardiac origin and review the clinical cases described in the literature. Study Design: Description of clinical cases and review of clinical cases. Results and conclusions: Nine cases of atypical pain of cardiac origin are recorded, which include 5 females and 4 males. In craniofacial structures, pain of cardiac origin is usually bilateral. At the craniofacial level, the most frequent location described is in the throat and jaw. Pain of cardiac origin is considered atypical due to its location, although roughly 10% of the cases of cardiac ischemia manifest primarily in craniofacial structures. Finally, the differential diagnosis of pain of odontogenic origin must be taken into account with pain of non-odontogenic origin (muscle, psychogenic, neuronal, cardiac, sinus and neurovascular pain) in order to avoid diagnostic errors in the dental practice as well as unnecessary treatments.

Genotypic comparison of Pantoea agglomerans plant and clinical strains

Pantoea agglomerans strains are among the most promising biocontrol agents for avariety of bacterial and fungal plant diseases, particularly fire blight of apple and pear. However, commercial registration of P. agglomerans biocontrol products is hampered because this species is currently listed as a biosafety level 2 (BL2) organism due to clinical reports as an opportunistichuman pathogen. This study compares plant-origin and clinical strains in a search for discriminating genotypic/phenotypic markers using multi-locus phylogenetic analysis and fluorescent amplified fragment length polymorphisms (fAFLP) fingerprinting.Results: Majority of the clinical isolates from culture collections were found to be improperly designated as P. agglomerans after sequence analysis. The frequent taxonomic rearrangements underwent by the Enterobacter agglomerans/Erwinia herbicola complex may be a major problem in assessing clinical associations within P. agglomerans. In the P. agglomerans sensu stricto (in the stricter sense) group, there was no discrete clustering of clinical/biocontrol strains and no marker was identified that was uniquely associated to clinical strains. A putative biocontrol-specific fAFLP marker was identified only in biocontrol strains. The partial ORF located in this band corresponded to an ABC transporter that was found in all P. agglomerans strains. Conclusion: Taxonomic mischaracterization was identified as a major problem with P.agglomerans, and current techniques removed a majority of clinical strains from this species. Although clear discrimination between P. agglomerans plant and clinical strains was not obtained with phylogenetic analysis, a single marker characteristic of biocontrol strains was identified whichmay be of use in strain biosafety determinations. In addition, the lack of Koch's postulate fulfilment, rare retention of clinical strains for subsequent confirmation, and the polymicrobial nature of P. agglomerans clinical reports should be considered in biosafety assessment of beneficial strains in this species