Angel Sánchez

The meaning of psychological symptoms: effectiveness of a group intervention with hypochondriacal patients

A group treatment for hypochondriasis was administered to 14 subjects. It was based on Barsky, Geringer and Wool (1988) [General Hospital Psychiatry, 10, 322-327] cognitive-behavioral formulation and presented as an educational course to explain the origins of an enhanced perception of somatic symptoms. Initially, one experimental group (N = 9) and a waiting list control (N = 8) were formed. Experimental subjects showed significant reductions in illness fears and attitudes, reported somatic symptoms and dysfunctional beliefs. Waiting-list controls also changed some illness attitudes, but showed no change in somatic symptoms and increased the number of visits to doctors. Experimental and control subjects differed on several change measures. Afterwards, part of the waiting list subjects (N = 5) received treatment. Overall, treatment was effective for the target measures and produced long-term positive effects on other fears, dysphoric mood and well-being. After treatment, subjects were significantly more extroverted, open and warm. The clinical impression was that treatment was not limited to less severe cases.

Gastroesophageal reflux symptoms during and after pregnancy: a longitudinal study.

BACKGROUND AND AIMS:Prevalence of gastroesophageal reflux symptoms (GERS) increases during pregnancy, but there are no longitudinal studies on western populations examining their incidence in each trimester. Our aim was to describe the natural history of GERS in pregnancy and to ascertain whether pregnancy might be associated with a higher risk of developing GERS 1 yr postpartum.METHODS:Pregnant women (<12 wk gestation) and age-matched controls were included. A telephone survey was conducted, covering pregnant women at 12, 24, and 36 wk of gestation and at 1 yr postpartum, using a validated questionnaire. Controls were interviewed at baseline and 21 months later.RESULTS:Data on 263 pregnant women were analyzed. Incidence of GERS was 25.8% (95% confidence interval [CI] 20.1–31.1%) in the first trimester, 24.3% (95% CI 18.1–30.6%) in the second, and 25.5% (95% CI 18.2–32.8%) in the third. Factors associated with developing GERS in the first trimester were South American origin (odds ratio [OR] 2.75, 95% CI 1.30–5.84) and prepregnancy occasional GERS (OR 3.00, 95% CI 1.35–6.66). Risk factors of GERS in the third trimester were cumulative weight gain during pregnancy (OR 1.18, 95% CI 1.04–1.32) and prepregnancy occasional GERS (OR 3.79, 95% CI 1.08–13.24). Incidence of frequent GERS at 1 yr postpartum was higher in pregnant versus control women (4.7% vs 1.3%, P < 0.05).CONCLUSIONS:Incidence of GERS is similar across the three trimesters of pregnancy. Accumulated weight gain during pregnancy is associated with a higher risk of GERS in the third trimester. Pregnancy might constitute a risk factor for developing GERS 1 yr postpartum.

Prevalence of Functional Gastrointestinal Disorders in Patients With Fibromyalgia and the Role of Psychologic Distress

BACKGROUND & AIMS Fibromyalgia is a rheumatologic disorder associated with somatic and psychologic conditions. Although fibromyalgia is associated with irritable bowel syndrome, its relationship with other functional gastrointestinal disorders (FGID) is unclear. We evaluated the prevalence of FGID in patients with fibromyalgia and the role of psychologic factors in this relationship. METHODS From a Spanish population, 100 patients with fibromyalgia and 100 matched controls completed the Rome II Integrative Questionnaire to assess the prevalence of FGID and the Symptom Checklist-90 Revised (SCL-90R) to evaluate psychologic distress. Patients completed the Fibromyalgia Impact Questionnaire to evaluate the overall impact of fibromyalgia and controls filled out the Chronic Widespread Pain Questionnaire to detect potential cases of fibromyalgia. RESULTS Ninety-three percent of the total study population was female, with a mean age of 50 years. We identified 6 cases of widespread pain among controls. The average Fibromyalgia Impact Questionnaire score for patients was 67.28 +/- 14.25. All gastrointestinal symptoms except for vomiting were more frequent in patients. Ninety-eight percent of patients with fibromyalgia had at least one FGID, compared with only 39% of controls. Fibromyalgia was correlated most highly with irritable bowel syndrome. Patients presented with significantly higher scores of psychologic distress than controls, especially those with fecal incontinence. CONCLUSIONS There is a prevalence of FGID in patients with fibromyalgia and a wider distribution of such symptoms along the gastrointestinal tract compared with controls. We propose that an increased degree of psychologic distress in these patients predisposes them to FGID, especially significant for anorectal syndromes.

Relativistic effects in Kronig-Penney models on quasiperiodic lattices

Abstract We study tunneling of Dirac particles through Kronig-Penney models on general lattices, computing their transmission coefficient. We subsequently focus our attention on the Fibonacci lattice as a typical example of a quasicrystal. We compare our results to the non-relativistic ones, and find a shrinkage of the spectrum similar to that of periodic systems.

NONLINEAR WAVE PROPAGATION IN DISORDERED MEDIA

We briefly review the state-of-the-art of research on nonlinear wave propagation in disordered media. The paper is intended to provide the non-specialist reader with a flavor of this active field of physics. Firstly, a general introduction to the subject is made. We describe the basic models and the ways to study disorder in connection with them. Secondly, analytical and numerical techniques suitable for this purpose are outlined. We summarize their features and comment on their respective advantages, drawbacks and applicability conditions. Thirdly, the Nonlinear Klein-Gordon and Schrodinger equations are chosen as specific examples. We collect a number of results that are representative of the phenomena arising from the competition between nonlinearity and disorder. The review is concluded with some remarks on open questions, main current trends and possible further developments.

On the regioselectivity in the reaction of aliphatic ketones and aromatic nitriles. Regiospecific synthesis of alkylarylpyrimidines

Abstract The reaction of aliphatic ketones with aliphatic or aromatic nitriles in the presence of trifluoromethanesulfonic anhydride has been shown to be a very useful method for the preparation of alkyl- and aryl-pirimidines. The reaction shows a high degree of regioselectivity that depends on the characteristics of the residues attached at the carbonyl group. The results from different branched symmetric and asymmetric ketones are shown. Molecular mechanics calculations permit an explanation and predict the results obtained. Regiospecific synthesis of alkyl aryl pyrimidines is described.

Discovering mechanistic insights by application of tandem ultrafast multidimensional NMR techniques.

Ultrafast multidimensional NMR acquisition techniques have shown promising capabilities in studies of dynamic systems in real time. The methods characteristics have permitted the focus to be on the mechanistic details of organic reactions. The tandem UF-TOCSY/HMBC sequence applied here combines both homonuclear and heteronuclear details and therefore provides complete information about the evolution of a dynamic reaction in real time. The methodology will be applied to find an explanation of the low reactivity of alicyclic ketones such as cyclohexanone in reactions with triflic anhydride and aliphatic nitriles, which leads to bicyclic pyrimidines.

Educating the ‘Worried Well’: Description of a Structured Programme and Implications for Treatment and Prevention

This paper describes the contents of a cognitive-behavioural treatment for hypochondriasis and health anxiety based on Barsky et al.s (1988) proposal. Five types of factors that may account for the enhanced experience of physical symptoms—selective and inadequate attention, muscle tension and bad breathing, environmental factors, stress and dysphoric mood and misinterpretation of somatic symptoms—were presented in the form of a group of educational training. Special emphasis was given to the form in which psychological information should be provided to initially resistant patients and to the contexts in which training should occur. The evidence obtained with an heterogeneous group of 14 subjects supports the utility of the programme, not only for target behaviours, but also for other related areas. Finally, the implications of this type of intervention for treatment and prevention are discussed.

Interference effects in soliton scattering by impurities

The authors present a comprehensive study of the effects of inhomogeneities on nonlinear excitation dynamics in different one-dimensional soliton-bearing systems. They theoretically analyse soliton scattering by one and two point-like impurities in the framework of the perturbed sine-Gordon, nonlinear Schrodinger and Korteweg-de Vries equations, and predict that interference effects arise in the form of an oscillatory dependence of the soliton reflection coefficient on the distance between impurities. The main factor responsible for this behaviour is the spectral density of the soliton radiation: the values of that distance which are integer multiples of the main wavelength radiated by the soliton upon collision with the inhomogeneities give rise to resonant scattering, with very little reflection. Their approximate analytical predictions explain previous numerical results concerning nonlinear lattices, and are further supported by new simulations that they have performed on the sine-Gordon system.

On the discrete Peyrard-Bishop model of DNA: stationary solutions and stability

As a first step in the search of an analytical study of mechanical denaturation of DNA in terms of the sequence, we study stable, stationary solutions in the discrete, finite, and homogeneous Peyrard-Bishop DNA model. We find and classify all the stationary solutions of the model, as well as analytic approximations of them, both in the continuum and in the discrete limits. Our results explain the structure of the solutions reported by Theodorakopoulos et al. [Phys. Rev. Lett. 93, 258101 (2004)] and provide a way to proceed to the analysis of the generalized version of the model incorporating the genetic information.