Self-perceived cognitive function and neuropsychological performance in women with fibromyalgia

BACKGROUND: Cognitive dysfunction is a common complain in patients with fibromyalgia (FM). Aim: To assess the perceived cognitive function and cognitive performance in women with FM. MATERIAL AND METHODS: Cross-sectional study including 100 women with FM (FMG) and 100 healthy controls (CG). Self-perceived cognitive functioning was evaluated using the Functional Assessment of Cancer Therapy Cognition scale (FACT-Cogv3). The neuropsychological performance was assessed with the Trail Making Test (TMT-A, TMT-B), Digit Span test (DS), Barcelona test (DS-F/B) and the Frontal Assessment Battery (FAB-E), Spanish version test. Results: The mean scores of all cognitive self-perception factors and all neuropsychological tests were lower in the FMG (p < 0.001). Over 90% of the FMG took longer than the population mean (P50) to complete the TMT-A and TMT-B tests, while in the CG, 1/3 took longer than the P50 in both tests. The minimum expected scores for the DS-F and DS-B tests were not achieved by 40 and 9% of FMG participants, respectively. According to FAB-E, 54% and 24% of FMG were categorized as fronto-subcortical deficit and fronto-subcortical dementia, respectively. CONCLUSIONS: Women with FM have a higher perception of cognitive dysfunction and lower cognitive performance in objective tests than healthy women. More research is needed to explore the clinical, psychosocial, and sociodemographic characteristics that predispose to cognitive deficits in this group of patients.

ANTECEDENTESA: La disfunción cognitiva es una queja común en pacientes con fibromialgia (FM). Objetivo: Investigar la función cognitiva percibida y el desempeño cognitivo en mujeres chilenas con FM. MATERIAL Y MÉTODOS: Estudio transversal incluyendo a 100 mujeres con FM (GFM) y 100 mujeres como controles sanos (GC). El funcionamiento cognitivo autopercibido se evaluó mediante la prueba Functional Assessment of Cancer Therapy Cognition scale (FACT-Cogv3). El rendimiento neuropsicológico se evaluó mediante las pruebas Trail Making Test (TMT-A, TMT-B) y Digit Span test (DS), Barcelona test (DS-F/B) y la prueba Frontal Assessment Battery, versión española (FAB-E). RESULTADOS: Las puntuaciones medias de todos los factores de autopercepción cognitiva y todas las pruebas neuropsicológicas fueron significativamente menores en el GFM. Para TMT-A y TMT-B, más del 90% del GFM tardó más que la media poblacional (P50) para completar las pruebas, mientras que en el GC aproximadamente 1/3 requirió más tiempo que el P50 en ambas pruebas. Un 40 y 9% del GFM no obtuvo la puntuación mínima esperada para las pruebas DS-F y DS-B, respectivamente. Según FAB-E, el 54% y 24% del GFM se clasificó como déficit fronto-subcortical y demencia fronto-subcortical, respectivamente. Conclusiones: Las mujeres con FM tienen una mayor percepción de disfunción cognitiva y menor rendimiento cognitivo en pruebas objetivas que mujeres sanas. Se necesita más investigación para explorar las características clínicas, psicosociales y sociodemográficas que predisponen a los déficits cognitivos en este grupo de pacientes.

Self-perceived cognitive function and neuropsychological performance in women with fibromyalgia.

BACKGROUND: Cognitive dysfunction is a common complain in patients with fibromyalgia (FM). AIM: To assess the perceived cognitive function and cognitive performance in women with FM. MATERIAL AND METHODS: Cross-sectional study including 100 women with FM (FMG) and 100 healthy controls (CG). Self-perceived cognitive functioning was evaluated using the Functional Assessment of Cancer Therapy Cognition scale (FACT-Cogv3). The neuropsychological performance was assessed with the Trail Making Test (TMT-A, TMT-B), Digit Span test (DS), Barcelona test (DS-F/B) and the Frontal Assessment Battery (FAB-E), Spanish version test. RESULTS: The mean scores of all cognitive self-perception factors and all neuropsychological tests were lower in the FMG (p < 0.001). Over 90% of the FMG took longer than the population mean (P50) to complete the TMT-A and TMT-B tests, while in the CG, 1/3 took longer than the P50 in both tests. The minimum expected scores for the DS-F and DS-B tests were not achieved by 40 and 9% of FMG participants, respectively. According to FAB-E, 54% and 24% of FMG were categorized as fronto-subcortical deficit and fronto-subcortical dementia, respectively. CONCLUSIONS: Women with FM have a higher perception of cognitive dysfunction and lower cognitive performance in objective tests than healthy women. More research is needed to explore the clinical, psychosocial, and sociodemographic characteristics that predispose to cognitive deficits in this group of patients.

Human mesenchymal stem cells for the management of systemic sclerosis. Systematic review.

INTRODUCTION: Sistemic Sclerosis (SSc) is a heterogeneous autoimmune disease with a high rate of progression and therapeutic failure, and treatment is a challenge, new therapeutic proposals being needed, being mesenchymal stem cells (MSCs) considered as alternative therapy for SSc for its immunomodulatory capacity. We evaluated the efficacy and safety of human MSC (hMSC) in patients with SSc through a systematic literature review (SLR). METHODS: SLR (PRISMA guideline) on MEDLINE/OVID, LILACS, EMBASE, and Cochrane/OVID bases (until July 2020, without limits). All types of clinical studies were considered: patients ≥18 years old with SSc and treatment with hMSC. EXCLUSION CRITERIA: animal models, autologous/allogenic hematopoietic stem cell transplants, narrative reviews, letters to the editor. MeSH and "Key word" terms were used. The level of evidence and the quality rating were rated [Joanna Briggs Institute (JBI) lists]. Registration in PROSPERO repository (ID CRD42020185245) The Synthesis Without Meta-analysis (SWiM) guideline was followed. RESULTS: We initially identified 508 articles, of which 11 were finally included (8 case series and 3 case reports). The 11 articles included 101 patients (85 female, age range 18-75 years). The level of evidence was mostly 4 (JBI); the quality of evidence was met (≥50% of JBI items). SWiM showed that vascular skin involvement (digital ulcers, necrosis, and gangrene) and associated pain were the predominant outcomes, while improvements were found in almost all cases. One patient died in the first month, and the frequency of complications was low. Expanded hMSCs were used in 24 patients and other cell sources in the remaining patients. CONCLUSION: There is too little reported data to reach definite conclusions about the use of hMSC in SSc. Further studies with better epidemiological designs are needed to evaluate the benefit of hMSCs in SSc patients.

Unstimulated whole salivary flow in Sjögren's Syndrome: systematic literature review and meta-analysis.

BACKGROUND: Sjögren's Syndrome compromises the exocrine function, producing xerostomia and xerophthalmia. It can appear as an isolated condition or associated with other autoimmune diseases (polyautoimmunity). The Unstimulated Salivary Flow rate (UWSF) is used to quantify saliva production. There is no objective evidence to differentiate the values in patients with Sjögren's versus healthy people or patients with non-Sjögren's sicca. The objective of the present review was to evaluate the UWSF in patients with Sjögren's syndrome in comparison to controls (healthy and non-Sjögren's sicca patients). METHODS: A systematic literature review was carried out (PRISMA guidelines). Analytical observational studies of cases and controls, cross-sectional studies, cohort studies and randomized clinical trials (including healthy controls) were considered. The Medline/OVID, Lilacs, Embase, and Cochrane/OVID databases were consulted. MeSH, DeCS, keywords, and Boolean operators were used. The meta-analysis (RevMan 5.2) was done through the random-effects model [mean difference (MD)]. Level and quality of evidence were evaluated by the Oxford Center Levels of Evidence and Joanna Brigs list respectively. RESULTS: Thirty-two articles were included (20 were case-control studies, 6 were cross-sectional, 2 prospective cohort, 2 retrospective cohort, and 2 studies were abstracts) and 28 were meta-analyzed. The unstimulated whole salivary flow rate in the Sjögren's group was lower than in controls (healthy and patients with non-Sjögren Sicca syndrome) (MD-0.18 ml/min; 95% CI, - 0.24 to - 0.13; chi2-P-value < 0.00001). Heterogeneity was 97% and there was publication bias (funnel plot). The level of evidence was mostly 3 or 4. The quality of evidence was met (97% of items valued). CONCLUSION: For the first time, the unstimulated whole salivary flow rate is found to be lower in patients with Sjögren's syndrome compared to controls (healthy and non-SS sicca) through a meta-analysis. TRIAL REGISTRATION: PROSPERO CRD42020211325 .

Unstimulated whole salivary flow in Sjögren's Syndrome: systematic literature review and meta-analysis

Abstract Background: Sjögren's Syndrome compromises the exocrine function, producing xerostomia and xerophthalmia. It can appear as an isolated condition or associated with other autoimmune diseases (polyautoimmunity). The Unstimulated Salivary Flow rate (UWSF) is used to quantify saliva production. There is no objective evidence to differentiate the values in patients with Sjögren's versus healthy people or patients with non-Sjögren's sicca. The objective of the present review was to evaluate the UWSF in patients with Sjögren's syndrome in comparison to controls (healthy and non-Sjögren's sicca patients). Methods: A systematic literature review was carried out (PRISMA guidelines). Analytical observational studies of cases and controls, cross-sectional studies, cohort studies and randomized clinical trials (including healthy controls) were considered. The Medline/OVID, Lilacs, Embase, and Cochrane/OVID databases were consulted. MeSH, DeCS, keywords, and Boolean operators were used. The meta-analysis (RevMan 5.2) was done through the random-effects model [mean difference (MD)]. Level and quality of evidence were evaluated by the Oxford Center Levels of Evidence and Joanna Brigs list respectively. Results: Thirty-two articles were included (20 were case-control studies,6 were cross-sectional,2 prospective cohort,2 retrospective cohort, and2 studies were abstracts) and 28 were meta-analyzed. The unstimulated whole salivary flow rate in the Sjögren's group was lower than in controls (healthy and patients with non-Sjögren Sicca syndrome) (MD-0.18 ml/min; 95% CI, −0.24 to −0.13; chi2-P-value <0.00001). Heterogeneity was 97% and there was publication bias (funnel plot). The level of evidence was mostly3 or 4. The quality of evidence was met (97% of items valued). Conclusion: For the first time, the unstimulated whole salivary flow rate is found to be lower in patients with Sjögren's syndrome compared to controls (healthy and non-SS sicca) through a meta-analysis. (AU)

Técnica de recolección del flujo salival no estimulado en el diagnóstico de pacientes con síndrome de Sjögren: unificando conceptos. Una revisión sistemática de la literatura / Unstimulated whole saliva flow collection technique in the diagnosis of patients with Sjögren's syndrome: Unifying concepts. A systematic literature review

RESUMEN El síndrome de Sjögren (SS) es una enfermedad autoinmune que compromete la función de las glándulas exocrinas, produciendo xerostomía y xeroftalmia. El método utilizado para cuantificar la disfunción glandular salival es el flujo salival no estimulado (FSNE). Describir las principales técnicas de recolección del FSNE en pacientes con SS. Revisión sistemática de la literatura (guías PRISMA) de estudios observacionales tipo casos y controles, cohorte y corte transversal que incluyeran pacientes con síntomas secos y diagnóstico de SS por criterios clasificatorios internacionales, que fueran comparados con una población de referencia sana o con síntomas secos no Sjögren y en los cuales se reportara la técnica y el valor del FSNE como desenlace principal. Para la calificación del nivel y calidad de la evidencia se utilizaron las guías Oxford y el Joanna Briggs Institute. Veintinueve artículos fueron incluidos, con una población total de 2.730 pacientes: 1.397 casos y 1.333 controles. La técnica más frecuentemente reportada fue la de Navazesh por recogida espontánea de drenaje durante 5 min. El punto de corte más frecuentemente encontrado fue 0,1 ml/min. Por primera vez se describen, a través de una revisión sistemática de la literatura, las principales técnicas utilizadas para evaluar el FSNE en individuos con SS cuando se comparan con personas sanas o con síndrome seco no SS, resaltando que es una técnica validada, no invasiva, reproducible y de bajo costo.

ABSTRACT Introduction: Sjögren's syndrome (SS) is an autoimmune disease that compromises the function of exocrine glands, producing xerostomia and xerophthalmia. The method used to quantify saliva gland dysfunction is by unstimulated whole saliva flow (UWSF).To describe the main UWSF techniques in patients with SS. Systematic review of the literature (following PRISMA guidelines) of results that include analytical observational studies of case-control, cohort, and cross-sectional studies that include patients with sicca symptoms and diagnosis of SS by international classification criteria, which were compared with healthy subjects or those with non-Sjögren sicca symptoms, and in which the technique and the value of the UWSF was reported as the main outcome. Qualification of the level and quality of the evidence was obtained using the Oxford and Joanna Briggs Institute guidelines. A total of 29 articles were included, with total population of 2,730 patients: 1,397 cases and 1,333 controls. The most frequently reported technique was that of Navazesh by spontaneous drainage collection for 5 min. The most frequent cut-off point found was 0.1ml/min. For the first time in the literature, and by using a systematic review of the literature, a description is presented of the main techniques used to evaluate UWSF in individuals with SS when compared with healthy people or with sicca non-SS syndrome, highlighting that it is a valid, non-invasive, reproducible, and low cost technique.

Establishing an acquisition and processing protocol for resting state networks with a 1.5 T scanner: A case series in a middle-income country.

OBJECTIVE: The aim of this study was to characterize the capability of detection of the resting state networks (RSNs) with functional magnetic resonance imaging (fMRI) in healthy subjects using a 1.5T scanner in a middle-income country. MATERIALS AND METHODS: Ten subjects underwent a complete blood-oxygen-level dependent imaging (BOLD) acquisition on a 1.5T scanner. For the imaging analysis, we used the spatial independent component analysis (sICA). We designed a computer tool for 1.5 T (or above) scanners for imaging processing. We used it to separate and delineate the different components of the RSNs of the BOLD signal. The sICA was also used to differentiate the RSNs from noise artifact generated by breathing and cardiac cycles. RESULTS: For each subject, 20 independent components (IC) were computed from the sICA (a total of 200 ICs). From these ICs, a spatial pattern consistent with RSNs was identified in 161 (80.5%). From the 161, 131 (65.5%) were fit for study. The networks that were found in all subjects were: the default mode network, the right executive control network, the medial visual network, and the cerebellar network. In 90% of the subjects, the left executive control network and the sensory/motor network were observed. The occipital visual network was present in 80% of the subjects. In 39 (19.5%) of the images, no any neural network was identified. CONCLUSIONS: Reproduction and differentiation of the most representative RSNs was achieved using a 1.5T scanner acquisitions and sICA processing of BOLD imaging in healthy subjects.

Arginine and glutamate levels in the gingival crevicular fluid from patients with chronic periodontitis.

The objectives of this study were to determine arginine and glutamate levels in the gingival crevicular fluid (GCF) of adult chronic periodontitis patients versus periodontally healthy controls, and to compare two kinds of microdialysis probes: normal and U-shaped probes. The analysis of GCF components was developed to improve the diagnosis of periodontal disease (PD). Proteolysis in the periodontal tissues increases the concentration of amino acids (aa) in the GCF and the levels of these aa may reveal PD features and stages. GCF samples were collected by microdialysis in situ from 5 periodontally affected sites (probing depth >or=5 mm, clinical attachment loss >or=3 mm) in 14 adult chronic periodontitis patients and from 14 adult periodontally healthy controls. Capillary zone electrophoresis coupled to laser induced fluorescence detection was used to measure concentration of arginine and glutamate in the GCF. Data were analyzed statistically by ANOVA and Tukey's post-hoc tests (á=0.05). Arginine concentration was increased (p<0.001) and glutamate concentration was decreased (p<0.001) in chronic periodontitis patients as compared to controls. There were no significant differences (p=0.069) between the normal and U-shaped probes. In conclusion, the increase of arginine and decrease of glutamate concentration in GCF were associated to the presence of periodontitis, and might be used as markers to recognize periodontally susceptible subjects as well as to evaluate the treatment course.

Arginine and glutamate levels in the gingival crevicular fluid from patients with chronic periodontitis

The objectives of this study were to determine arginine and glutamate levels in the gingival crevicular fluid (GCF) of adult chronic periodontitis patients versus periodontally healthy controls, and to compare two kinds of microdialysis probes: normal and U-shaped probes. The analysis of GCF components was developed to improve the diagnosis of periodontal disease (PD). Proteolysis in the periodontal tissues increases the concentration of amino acids (aa) in the GCF and the levels of these aa may reveal PD features and stages. GCF samples were collected by microdialysis in situ from 5 periodontally affected sites (probing depth >5 mm, clinical attachment loss >3 mm) in 14 adult chronic periodontitis patients and from 14 adult periodontally healthy controls. Capillary zone electrophoresis coupled to laser induced fluorescence detection was used to measure concentration of arginine and glutamate in the GCF. Data were analyzed statistically by ANOVA and Tukey's post-hoc tests (?=0.05). Arginine concentration was increased (p<0.001) and glutamate concentration was decreased (p<0.001) in chronic periodontitis patients as compared to controls. There were no significant differences (p=0.069) between the normal and U-shaped probes. In conclusion, the increase of arginine and decrease of glutamate concentration in GCF were associated to the presence of periodontitis, and might be used as markers to recognize periodontally susceptible subjects as well as to evaluate the treatment course.

Os objetivos deste estudo foram determinar os níveis de arginina e glutamato no fluido gengival crevicular (FGC) em pacientes com periodontite crônica contra controles saudáveis e comparar dois tipos de cânulas de microdiálise: normais e em forma de U. A análise dos componentes do FGC desenvolveu-se para melhorar o diagnóstico da doença periodontal (DP). A proteólise dos tecidos periodontais aumenta a concentração de aminoácidos (aa) no FGC e os níveis destes aa podem revelar as características e estágios da DP. Amostras de FGC foram obtidas pela técnica de microdiálise in situ de cinco zonas com o periodonto afetado (profundidade de sondagem >5 mm, perda da inserção clínica >3 mm) em 14 pacientes adultos com periodontite crônica e 14 controles saudáveis. Para medir a concentração de arginina e glutamato no GFC, usou-se a técnica de eletroforese capilar com detecção de fluorescência induzida por laser. Nos pacientes com periodontite crônica, a concentração de arginina aumentou significantemente (p<0.001), enquanto a de glutamato diminuiu significantemente (p<0.001) em comparação aos controles. Não houve diferenças significantes (p=0.069) entre as cânulas normais e as cânulas em forma de U. Conclui-se que o aumento da concentração de arginina e diminuição de glutamato no FGC estavam associados à presença de periodontite, e podem ser usados como marcadores para identificar pacientes suscetíveis à periodontite bem como avaliar a evolução do tratamento.

Niveles extracelulares de glutamato y aspartato en el fluido gingival en la periodontitis / Extracellular glutamate and aspartate levels in the gingival crevicular fluid of periodontitis patients

El objetivo de este trabajo fue comparar los niveles extracelulares de glutamato y aspartato en el fluido del surco gingival (GCF) de personas adultas, en la periodontitis crónica localizada inducida por placa (PCIP) y la gingivitis inducida por placa (GIP). La enfermedad periodontal produce cambios inflamatorios en los tejidos de sostén de las piezas dentales afectadas. El análisis químico del GCF, con diferentes métodos de colección y análisis, ha sido usado para determinar la presencia de algunos elementos inflamatorios que aparecen en la enfermedad periodontal, tales como diversas enzimas, aminoácidos, etc.Las muestras del GCF se tomaron con la técnica de microdiálisis en las zonas dentales con PCIP con una profundidad del surco > 3 mm; pérdida de soporte > 2mm y en las zonas dentales con GIP en el mismo paciente (n=10) Total de muestras: 100. Para medir el glutamato y aspartato en el GCF se usó la técnica de electroforesis capilar acoplada a laser con detección inducida por fluorescencia (CZE-LIFD). Los resultados mostraron que en los dientes con PCIP el glutamato disminuyó (p<0.05) y el aspartato aumentó (p< 0.02) en comparación con los dientes con GIP.

The objective of this work was to compare glutamate and aspartate levels in periodontal chronic localized disease (PCIP) and dental zones with gingivitis (GIP) in the gingival crevicular fluid (GCF). Periodontal inflammation produces histological changes, increase of blood irrigation and also increase of subgingival fluid. GCF was recognized as an inflammatory exudes derived from the periodontal tissue. Different methods to collect and analyze GCF samples had been used to identify some substances in the GCF, such as the proteinglycans metabolite, to be a possible marker of active periodontal disease. A combination of microdialysis in situ in dental zones with PCIP (probing depth > 3 mm; attachment level > 2 mm) and dental zones with GIP (n=10), total samples: 100, and capillary zone electrophoresis coupled to a laser induced fluorescence detection (CZE-LIFD) was used to measure extracellular concentrations of amino acids: glutamate and aspartate in the GCF in adult patients The results showed that glutamate decrease (p<0.05) and aspartate increase (p<0.02) in PCIP disease zones compared with dental zones with GIP. We observed chemical in vivo evidence that differentiate the GIP zones and PCIP zones.