Do fibromyalgia patients benefit from cognitive restructuring and acceptance? An experimental study

Background and objectivesThe aim of this study was to clarify mechanisms of psychological fibromyalgia treatment by experimentally examining the effectiveness of its core elements. We assessed the effects of cognitive restructuring and acceptance on experimentally-induced heat and cold pain tolerance and pain intensity in fibromyalgia patients.MethodsCold and heat pain were induced in a sample of 60 fibromyalgia patients using a thermode. We conducted ANCOVAs to examine group differences in posttest scores, co-varying for pretest scores. The between-groups factor was the type of instruction provided (acceptance, cognitive restructuring, and a control condition). In addition, we controlled for pain sensitivity, age, and depression.ResultsWe found that acceptance and cognitive restructuring were superior to the control condition in increasing heat pain tolerance, but did not differ from one another. With respect to cold pain tolerance, cognitive restructuring was associated with increases in cold pain tolerance compared to the control condition, while acceptance did not differ either from the control condition or from cognitive restructuring.LimitationsFurther experimental research on chronic pain treatment mechanisms is needed, particularly research on individually tailoring treatment strategies according to patients characteristics. Conclusion: Results show that both, cognitive restructuring and acceptance instructions, enhance pain tolerance in fibromyalgia patients.     

Severity of individual obstruction events increases with age in patients with obstructive sleep apnea

BackgroundAge is a risk factor of obstructive sleep apnea (OSA). It has been shown that OSA progresses over time, although conflicting results have been reported. However, the effect of age on the severity of OSA and individual obstruction events has not been investigated within different OSA severity categories by taking the most prominent confounding factors (i.e., body mass index, gender, smoking, daytime sleepiness, snoring, hypertension, heart failure, and proportion of supine sleep) into account.MethodsPolygraphic data of 1090 patients with apnea–hypopnea index (AHI) ≥5 were retrospectively reanalyzed. The effect of age on the severity of OSA and obstruction events was investigated in general, within different OSA severity categories, and in different age groups (age <40, 40≤ age <50, 50≤ age <60, and age ≥60 years).ResultsIn the whole population, AHI and durations of apneas, hypopneas, and desaturations increased with increasing age (B ≥ 0.108, p ≤ 0.010). In more detailed analysis, AHI increased with age only in the moderate OSA category (B = 0.075, p = 0.022), although durations of apneas increased in mild and severe OSA categories (B ≥ 0.076, p ≤ 0.038). Furthermore, durations of hypopneas increased with age in mild and moderate OSA categories (B ≥ 0.105, p ≤ 0.038), and durations of desaturations (B ≥ 0.120, p ≤ 0.013) in all OSA severity categories. AHI was not statistically significantly different between the age groups, although durations of obstruction events tended to increase towards older age groups.ConclusionAs obstruction event severity was more strongly dependent on the age than it was dependent on AHI, considering the severity of obstruction events could be beneficial while estimating the long-term effects of the treatments and prognosticating the disease progression.     

Short QT syndrome presenting as syncope: How short is too short?

We report the case of a 52-year-old man who presented to our emergency department (ED) after three episodes of syncope in the seven hours before admission. During his stay in the ED he had recurrent ventricular tachycardia (VT) requiring external electrical cardioversion. A 12-lead electrocardiogram (ECG) showed a short QT (SQT) interval (270 ms, QTc 327 ms), with frequent R-on-T extrasystoles triggering sustained polymorphic VT. After exclusion of other precipitating causes, the patient was diagnosed as having SQT syndrome (SQTS) according to the Gollob criteria. To our knowledge, this is the first known documentation of an SQT-caused arrhythmic episode on a 12-lead ECG, as well as the first reported case of SQTS in Portugal. The patient received an implantable cardioverter-defibrillator and was discharged. At a follow-up assessment 14 months later he was symptom-free, interrogation of the device showed no arrhythmic events, and the ECG showed a QT interval of 320 ms (QTc 347 ms).     

Genetic variability and forensic efficiency of 39 microsatellite loci in the Li ethnic group from Hainan Island in the South China Sea

Abstract

Background: Investigation of allele and genotype frequencies of microsatellite loci in various populations is an essential pre-requisite in forensic application.

Aim: The present study obtained population genetic data and forensic parameters of 39 autosomal Short Tandem Repeats (STRs) loci from a Chinese Li ethnic group and estimated the genetic relationships between Li and other reference populations.

Subjects and methods: Thirty-nine STR loci, which include D19S433, D5S818, D21S11, D18S51, D6S1043, D3S1358, D13S317, D7S820, D16S539, CSF1PO, Penta D, D2S441, vWA, D8S1179, TPOX, Penta E, TH01, D12S391, D2S1338, FGA, D6S477, D18S535, D19S253, D15S659, D11S2368, D20S470, D1S1656, D22-GATA198B05, D8S1132, D4S2366, D21S1270, D13S325, D9S925, D3S3045, D14S608, D10S1435, D7S3048, D17S1290 and D5S2500, were amplified in two multiplex DNA-STR fluorescence detection systems for 189 unrelated healthy individuals of the Chinese Li ethnic group. The allele frequency distribution and several parameters commonly used in forensic science were statistically analysed.

Results: A total of 378 alleles were observed with corresponding allelic frequencies ranging from 0.0026–0.5899. The power of discrimination and power of exclusion ranged from 0.7569–0.9672 and 0.2513–0.7355, respectively. The power of exclusion (PE) ranged from 0.2580–0.7943 for trio paternity cases and 0.1693–0.5940 for duo paternity cases. The polymorphism information content (PIC) ranged from 0.5001–0.8611. The cumulative match probability across these 39 loci was 2.4242?×?10^?38.

Conclusion: The results indicate that 39 STR loci are polymorphic among the Li ethnic group in Hainan Island in the South China Sea. This set of polymorphic STR loci provide highly polymorphic information and forensic efficiency for forensic individual identification and paternity testing, as well as basic population data for population genetics and anthropological research.