Ana M. Rodrigues

Gender and psychosocial context as determinants of fibromyalgia symptoms (fibromyalgia research criteria) in young adults from the general population

OBJECTIVE To quantify the prevalence of FM (FM research criteria), to describe its components-symptom severity score (SSS) and widespread pain index (WPI)-and to identify biopsychosocial predictors of the severity of SSS as well as WPI using a population-based sample of young adults. METHODS Participants were part of the 21-year-old follow-up of the EPITeen cohort, which was set up during the 2003-04 school year and comprised subjects born in 1990 attending schools in Porto, Portugal (n = 1719, 51.4% women). Data on biopsychosocial characteristics were collected, and FM-related information was gathered using the Fibromyalgia Survey Questionnaire. Sex-specific multivariate log-binomial regression coefficients (β) and 95% CI were used to quantify the associations between adverse biopsychosocial characteristics and high scores in SSS and WPI. RESULTS The overall point-prevalence of FM was 1.0%. Women scored significantly higher in SSS and WPI when compared with men. Global psychological distress was strongly and significantly associated with high scores in SSS in women and men (respectively, low sleep quality, β = 1.44, 95% CI 1.05, 1.84 and β = 1.19, 95% CI 0.78, 1.61; depressive symptoms, β = 1.64, 95% CI 1.23, 2.06 and β = 1.14, 95% CI 0.60, 1.70; eating disorders, β = 1.17, 95% CI 0.71, 1.63 and β = 1.15, 95% CI 0.52, 1.78). In women, adverse socioeconomic factors were predictors of high scores in SSS, whereas in men these contexts were significantly associated with high scores in WPI. CONCLUSION In young adulthood, psychological distress was particularly consistent in predicting SSS and may become useful as a red flag for the establishment of clinical disease.

The impact of osteoarthritis on early exit from work: results from a population-based study

BackgroundOsteoarthritis (OA) is a leading cause of pain and disability, which may be a source of productivity losses. The objectives of this study were to describe the impact of OA, namely through pain and physical disability, on early exit from work and to calculate its economic burden.MethodsWe analysed data from the national, cross-sectional, population-based EpiReumaPt study (Sep2011–Dec2013) in which 10,661 individuals were randomly surveyed in order to capture all cases of rheumatic diseases. We used all participants aged 50–64, near the official retirement age, who were clinically validated by experienced rheumatologists (n = 1286), including OA cases. A national database was used to calculate productivity values by gender, age and region, using the human capital approach. The impact of OA on the likelihood of early exit from work and the population attributable fractions used to calculate due economic burden (indirect costs) were obtained at the individual level by logistic regression. All results were based on weighted data.ResultsAlmost one third of the Portuguese population aged 50–64 had OA (29.7%; men: 16.2% and women: 43.5%) and more than half were out of paid work (51.8%). Only knee OA is associated with early exit from work (OR: 2.25; 95%CI: 1.42–3.59; p = 0.001), whereas other OA locations did not reach any statistical difference. Furthermore, we observed an association between self-reported longstanding musculoskeletal pain (OR: 1.55; 95%CI: 1.07–2.23; p = 0.02) and pain interference (OR: 1.35; 95%CI: 1.13–1.62; p = 0.001) with early exit from work. We also detected a clear relationship between levels of disability, measured by the Health Assessment Questionnaire (HAQ), and the probability of work withdrawal. The estimated annual cost of early exit from work attributable to OA was €656 million (€384 per capita; €1294 per OA patient and €2095 per OA patient out-of-work).ConclusionsIn this study, we observed an association between OA and early exit from work, largely dependent on pain and disability. This relationship translates into a meaningful economic burden amounting to approximately 0.4% of the national Gross Domestic Product (GDP). The high prevalence and the impact of this disabling chronic disease highlight the need to prioritize policies targeting early exit from work in OA.

Prince Pedro, A Case of Dynastic Disloyalty in Fifteenth Century Portugal?

Third son of John I (r. 1385–1433), the founder of the Portuguese Avis dynasty, and of Philippa of Lancaster (r. 1385–1415), infante Pedro died in 1449 in the battle of Alfarrobeira, fighting against his king and nephew Alphonse V, in whose name he had been regent. The circumstances of his death, but also of his accession to the regency in 1438, were controversial among his contemporaries, and remain so today among Portuguese historians. Costa-Gomes recently observed that modern (pre)conceptions have biased the debate and suggested we pay more attention to the perceptions of those involved in the events. Rodrigues uses contemporary sources to demonstrate that the conflict arose because different conceptions of loyalty and honor coexisted in the political societies of the Iberian monarchies. However, dynastic interests could recommend reconciliation, and women—especially Queen Isabel, Pedro’s daughter, and the duchess of Burgundy, Pedro’s sister, also named Isabel—helped to unite the estranged family members.

Pinus halepensis, Pinus pinaster, Pinus pinea and Pinus sylvestris Essential Oils Chemotypes and Monoterpene Hydrocarbon Enantiomers, before and after Inoculation with the Pinewood Nematode Bursaphelenchus xylophilus

Pinewood nematode (PWN), Bursaphelenchus xylophilus, is the causal agent of pine wilt disease, a serious threat to global forest populations of conifers, especially Pinus spp. A time‐course study of the essential oils (EOs) of 2‐year‐old Pinus halepensis, Pinus pinaster, Pinus pinea and Pinus sylvestris following inoculation with the PWN was performed. The constitutive and nematode inoculation induced EOs components were analyzed at both the wounding or inoculation areas and at the whole plant level. The enantiomeric ratio of optically active main EOs components was also evaluated. External symptoms of infection were observed only in P. pinaster and P. sylvestris 21 and 15 days after inoculation, respectively. The EO composition analysis of uninoculated and unwounded plants revealed the occurrence of chemotypes for P. pinaster, P. halepensis and P. sylvestris, whereas P. pinea showed a homogenous EO composition. When whole plants were evaluated for EO and monoterpene hydrocarbon enantiomeric chemical composition, no relevant qualitative and quantitative differences were found. Instead, EO analysis of inoculated and uninoculated wounded areas revealed an increase of sesquiterpenes and diterpenic compounds, especially in P. pinea and P. halepensis, comparatively to healthy whole plants EOs.