Explore the vast range of titles available.

Background:Fibromyalgia (FM) is one of the most common causes of chronic widespread pain. Although pain is the most distinctive feature of this syndrome, FM is characterized by a complex polysymptomatology that also comprises fatigue, sleep disturbances and other functional symptoms that negatively affect the overall quality of life. Since FM can negatively affect personal well-being, self-image and interpersonal relationship, it can also impact sexual functioning and pleasure. When interrogated regarding sexuality, female FM patients answer that it is important for their quality of life and, for the majority of them, it appears as a physical, psychological, emotional and relational need. For these reason, women require support and understanding from both their partners and health care professionals. In this context, the availability of a simple and rapidly administered questionnaire, such as the Qualisex, for the evaluation of sexual disfunction on these patients might be considered an acceptable method of communication of this sensitive issue.Objectives:The aim of this study was to evaluate sexual disfunctions in a large cohort of FM women through Qualisex questionnaire, which has been originally created for French patients with rheumatoid arthritis and recently adapted and validated to Italian language for FM patients.Methods:In this cross-sectional study, consecutive women with a diagnosis of FM (2016 ACR criteria) referring to our out-patients Fibromyalgia Clinic were asked to answer an anonymous online survey, including demographic characteristics, medical and pharmacological history, Hospital Anxiety and Depression Scale (HADS) and Qualisex questionnaire for sexual dysfunction.Results:The cohort enrolled in this study was composed by 489 FM women, median age 50. The results of the univariate analysis showed a worse sexual functioning in women with lower educational level, housekeepers and retired patients but also in women who referred a concomitant diagnosis of chronic pelvic pathology or a psychiatric disorder. Among women who were in an active relationship, the referred sexual understanding with the partner was inversely associated with sexual functioning. Finally, the consumption of drugs known to be associated with a reduction of sexual desire resulted significantly associated with a worse sexual functioning (Table 1). The multivariate linear model showed a significant influence of the presence of a partner in women’s life, the referred sexual understanding and the use of drugs associated with a reduction of sexual desire on women’s quality of life (Table 2).Conclusion:Qualisex questionnaire represents a good test to detect the impaired sexuality in FM female patients, to establish a more correct intervention, pharmacological, psychotherapeutic (single or couple) and supportive, reducing the destructive circle that FM and poor sexual quality determine. Different aspects contribute to sexual dysfunction, with an important impact of FM on sexual quality and consequently a worsening of FM symptoms.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of Interests:None declared.

Fibromyalgia (FM) is a chronic syndrome clinically characterized by widespread musculoskeletal pain associated with symptoms like fatigue, sleep disturbances and cognitive impairment. Prevalence is higher in females but the 2010/2011 and 2016 revisions of the American College of Rheumatologist (ACR) criteria reduced prevalence differences and the actual female:male ratio is approximately 3:1. Even if in the last years some studies have been conducted regarding gender differences in FM, disease severity is still assessed using questionnaires, such as the Revised Fibromyalgia Impact Questionnaire (FIQR), designed for female patients and validated through a predominantly female sample. Aim of this pilot study was to compare the 21 items of the FIQ-R among male and female patients in order to evaluate the possible existence of a gender bias. In this case control study, all the consecutive patients with a diagnosis of FM (2016 ACR criteria) referring to our out-patients Fibromyalgia Clinic between May 2020 and December 2022 were asked to answer an online survey, including demographic characteristics, disease variables and the Italian version of the FIQR. Among the 544 patients that compiled the questionnaire, 78 patients, 39 males and 39 females matched for age and disease duration, were consecutively enrolled in order to compare their total FIQR score and the different domains scores. The univariate analysis of the FIQR scores, taking account of the total score and of the different domains of FIQR, showed that total scores and physical function domain scores were significantly higher in females compared to males. No significant differences emerged between the two groups regarding overall impact domain score and symptoms domain score. Among the 21 items of the FIQR, the female group obtained significantly higher scores answering the questions FIQR1 (brush or comb your hair), FIQR4 (vacuum, scrub, or sweep floors), FIQR5 (lift and carry a bag full of groceries), FIQR7 (change bed sheets), FIQR9 (go shopping for groceries) and FIQR21 (sensitivity to loud noises, bright lights, odors, cold). The results of our pilot study showed that female patients obtain significantly higher scores in the FIQR total score and in the physical function domain score, in particular in 5 out of the 9 sub-items of the FIQR physical function domain. These preliminary results indicate that the use of the FIQR as a severity index in male patients probably underestimates the disease impact in this group. In order to confirm these results the sample needs to be increased but it seems reasonable to conclude that the assessment of disease impact should be diversified, taking gender differences into account. [1]Marques A.P., Santo A.S.D.E, Berssaneti A.A., Matsutani L.A., Yuan S.L.K. Prevalence of fibromyalgia: literature review update. Rev Bras ReumatolEngl Ed.2017,57, 356-363. [2]Galvez-Sánchez C.M., Reyes Del Paso G.A. Diagnostic Criteria for Fibromyalgia: Critical Review and Future Perspectives. J Clin Med. 2020, 9, 1219. [3]Cabo-Meseguer A., Cerdá-Olmedo G., Trillo-Mata J.L. Fibromyalgia: Prevalence, epidemiologic profiles and economic costs. Med Clin (Barc).2017,149, 441-448. [3]Branco J.C., Bannwarth B., Failde I., AbelloCarbonell J., Blotman F., Spaeth M., Saraiva F., Nacci F., Thomas E., Caubère J.P., Le Lay K., Taieb C., Matucci-Cerinic M. Prevalence of fibromyalgia: a survey in five European countries. Semin Arthritis Rheum. 2010, 39, 448-53. NIL. None Declared. Table 1Significant differences in FIQR total, domains and single question scores based onsexScoreM (39)F (39)p-valueFIQR Total58.8 (23.5)70.3 (14.7).035FIQR Physicalfunction14.8 (8.2)20.1 (5.1).003FIQR1 Brush or comb your hair2.4 (3.3)4.3 (2.9).006FIQR4Vacuum, scrub, or sweep floors5.2 (3.6)7.5 (2.2).005FIQR5Lift and carry a bag full of groceries6.4 (3.1)8.3 (1.6).002FIQR7 Change bed sheets4.7 (3.6)7.1 (2.7).001FIQR9 Go shopping for groceries4.9 (3.3)6.7 (2.4).012FIQR21Sensitivity to loud noises, bright lights, odors, cold6.2 (2.7)7.9 (1.6).005

BackgroundFibromyalgia (FM) is a common chronic widespread pain condition, also characterized by fatigue, sleep and mood disorders, with higher prevalence in women. Sexual function is an important feature in people’s well-being; its alterations include decreased sex drive, sexual satisfaction, orgasm, and arousal, as well as increased genital pain. Emerging but still too few studies observed a higher prevalence of sexual dysfunction in FM, especially related to depression.ObjectivesThe aim of this study was to evaluate sexual dysfunctions in a large cohort of FM women through Qualisex questionnaire, used in other rheumatic diseases but not yet validated for FM.MethodsWe consecutively enrolled women affected by FM (ACR 2016) referring to our out-patient clinic. Demographic and clinical examination as well as evaluation of severity of FM symptoms (R-FIQ, SSS and WPI) were assessed for each patient. Moreover, Hospital Anxiety and Depression Scale (HADS) and questionnaire for sexual dysfunction-Qualisex were anonymously administered. Qualisex questionnaire is composed by 10 questions on different items of sexual life with higher scores suggestive of greater negative impact of FM on sexual life.ResultsThe cohort was composed by 373 FM female patients, median age 49,1. Qualisex questionnaire was validated with Cronbach’s alpha test (0,878), median value 5,3. Women with lower grade of education (p=0,002), married (p<0,001) and with lower sexual feeling with partner (p<0,001) showed higher values of Qualisex. Menopause status, drug assumption and comorbidity did not influence patients’ sexual quality. High values of HADS-A and HADS-D showed a positive correlation with Qualisex Total (p<0,001 r=0,312; p<0,001 r=0,542 respectively) as well as high values of VAS pain, VAS fatigue and VAS dryness (p<0,001 r=0,438; p<0,001 r=0,375; p<0,001 r=0,70 respectively). Relationship duration also presented a positive correlation (p<0,001 r=0,202). Multivariate analysis observed a significantly influence of relationship duration, VAS pain, fatigue and dryness, HADS-A/D, R-FIQ and all specific items of Qualisex, on Qualisex Total correcting for patients’ age (p<0,001).ConclusionQualisex questionnaire represents a good test to evaluate sexual disorders in FM women. Different aspects contribute to sexual dysfunction both from a psychological (anxiety, depression, loss of self-esteem, decreased sexually attraction) and a physical (pain, fatigue etc..) point of view with an important impact of FM on sexual life and consequently a worsening of FM symptoms. Over a demotivation feeling, inability to live a “normal everyday life”, the reduced sexual function contributes to a bad quality of life. Other studies are needed to analyze which interventions, pharmacological and non (physical activity, psychotherapy), could improve the sexual aspect in the global contest of FM and to investigate this important aspect in FM male patients.References[1]Bazzichi L, Giacomelli C, Rossi A, Sernissi F, Scarpellini P, Consensi A, Bombardieri S. Fibromyalgia and sexual problems. Reumatismo. 2012 Sep 28;64(4):261-7.[2]Matarín Jiménez TM, Fernández-Sola C, Hernández-Padilla JM, Correa Casado M, Antequera Raynal LH, Granero-Molina J. Perceptions about the sexuality of women with fibromyalgia syndrome: a phenomenological study. J Adv Nurs. 2017 Jul;73(7):1646-1656.[3]Priori R, Giardina F, Gioia C, Iannuccelli C, Villa M, Gattamelata A, Conti F, Di Franco M, Curcio G. Cultural adaptation and preliminary validation of the Qualisex questionnaire for its use in patients with Sjögren’s syndrome and fibromyalgia in Italy. Clin Exp Rheumatol. 2022 Dec;40(12):2470-2471Table 1FM (n=373)Age (yrs), media ± SD49,1 ± 10,4Menopause, n (%)185 (49.6)Age menopause (yrs), media ± SD48,7 ± 7,3Replacement therapy, n (%)69 (18.3)Sexual relationship duration (yrs), media ± SD18,2 ± 11,7Qualisex TOTAL5,3 ± 2,7HADS A, media ± SD11,9 ± 4,3HADS D, media ± SD9,5 ± 4,1VAS dryness (0-10), media ± SD5,6 ± 3,4VAS pain (0-10), media ± SD6,8 ± 2,7VAS fatigue (0-10), media ± SD7,9 ± 1,9Figure 1.Acknowledgements:NIL.Disclosure of InterestsNone Declared.

BackgroundAlexithymia describes the difficults of people in identifying, differentiating and articulating emotions of others and themselves and in discriminating those from bodily sensations, with a limited fantasy and a concrete, externally oriented cognitive style.1 A high prevalence of alexithymia has been found in patients with a variety of health conditions, including SLE.2 Previous authors identified mood states2 and quality of life3 as the main factors related to alexithymia in Systemic Lupus Erythematosus (SLE).ObjectivesAim of our study was to assess the impact of clinical, immunological, psycho-social factors on the presence of alexithymia in Systemic Lupus Erythematosus (SLE).MethodsWe consecutively enrolled 104 patients in a cross-sectional study. Alexithymia was assessed using the Toronto Alexithymia scale (TAS-20). We also evaluated symptoms of mood disorders using BDI and HAM-H, quality of life using MOS-SF36, sleep disorders with PSQI and physical activity using IPAQ.ResultsThe mean (standard deviation) TAS-20 score was 49.5 (15.6). The prevalence of alexithymia (TAS-20 ≥61) was 28%. Alexithymic patients (TAS-20 ≥61) were significantly older (p 0.0005), presented more severe depressive and anxiety symptoms (p<0.0001), a higher score of sleep disorders (p<0.0001), a reduced Facit-Fatigue score (p 0.0007), reduced SF-36 mental and physical component summary scores (p 0.0001 and 0.004) and increased daily sedentary time (p 0.002). In the multiple logistic regression analysis the variables associated to the presence of alexithymia were age (OR 1.07, p 0.02) and the score of depressive symptoms (OR 1.15, p 0.02).ConclusionsAbout a third of SLE patients presented a dysfunctional processing of emotion. It is necessary to carefully consider the symptoms of mood disorders to optimise SLE patient management.References[1] Taylor GJ, Bagby RM. Measurement of alexithymia. Recommendations for clinical practice and future research. Psychiatr Clin North Am. 1988Sep;11(3):351–66[2] Vadacca M, Bruni R, Terminio N, Sambataro G, Margiotta D, Serino FM, Afeltra A. Alexithymia, mood states and pain experience in systemic lupus erythematosus and rheumatoid arthritis. Clin Rheumatol. 2014;33(10):1443–50.3.[3] Barbosa F, Mota C, Alves M, Alcântara C, Rossiñol B, Patrício P, Barbosa A, Ferreira C. Alexithymia in systemic lupus erythematosus patients. Ann N Y Acad Sci. 2009Sep;1173:227–34Disclosure of InterestNone declared

BackgroundPatients with Systemic Lupus Erythematosus (SLE) present an increased incidence of Cardio-Vascular Events (CVE) compared to general population, and the difference with healthy subjects is particularly evident in young SLE women.ObjectivesThe aim of this study is to assess the predictive ability of established 10 years CV risk models in SLEMethodsA retrospective analysis of two Italian SLE prospective cohorts was performed. SLE patients without previous CVE, with age ≥25 years, a minimum continuative follow-up of 10 years and sufficient data to calculate the 10 years risk scores were enrolled. The 10 years CVE risk scores were calculated at the first observation and all CVE were prospectively recorded in the following 10 years. We calculated the following scores: the QRisk3, the Framingham CV disease 10 years score, the HeartScore (Europe Low Risk) and the SLE CV Risk Score proposed by Petri et al. Discriminatory ability for CV risk prediction was estimated by the area under the receiver operating characteristic curve. Hosmer-Lemeshov (HL) tests was used to evaluate calibration comparing the observed versus expected number of eventsResultsAnalysis was performed on 131 SLE patients (mean baseline age of 37±11 years). We observed 10 CVE during the 10 years follow-up from baseline (3 acute coronary syndrome, 4 stroke, 1 transitory ischaemic attack and 2 peripheral artery disease). The AUC values were 0.75 (95% CI 0.55–0.94) for QRisk3, 0.66 (0.45–0.88) for Framingham score, 0.62 (0.41–0.82) for the HeartScore and 0.7 (95% CI 0.55–0.85) for the SLE CV risk score. The p values of HL test were 0.8 for Qrisk3 and SLE CV score and 0.4 for Framingham score and HeartScore, suggesting a good model fit for all the CV risk scores. Considering scores with better discriminative ability and calibration, 20% of CVE were observed with Qrisk3 score lower then 3.6% and with SLE CV risk score between 6% and 8%. Discriminative ability and calibration were not improved by multiplying by 2 the Framingham score and the HeartScore.ConclusionsThe available CV risk scores demonstrate a moderate predictive ability of 10 years CVE in SLE. We observed a better model fit for QRisk3 and SLE CV risk score. Nevertheless, a considerable proportion of patients, with very low predicted CV risk, developed CVE during follow-up.References[1] Petri MLS. Systemic lupus erythematosus Cardiovascular Risk Equation. [Abstract]. Arthritis Rheum2012;64.[2] Urowitz MB, Ibañez D, Su J, et al. Modified Framingham Risk factor score for systemic lupus erythematosus. J Rheumatol2016;43:875–9.Disclosure of InterestNone declared

This study examined the associations between internalizing and externalizing symptoms during early adolescence and the subsequent development of Major Depressive Disorder. The role that temperament plays in predisposing individuals to these particular pathways was also examined. Temperament at approximately age 12 was used to produce a risk-enriched subsample of 243 (124 female) participants. Data was collected in four waves over 6–7 years roughly corresponding to ages 13, 15, 17 and 19. Participants were excluded from the study, prior to the first wave, based on current or prior depressive, substance-use, or eating disorders. Logistic regression analyses revealed that internalizing symptoms and social-externalizing problems were significant risk pathways to the development of depression. Moreover, mediation analyses revealed that high temperamental negative emotionality, high affiliation, low effortful control, and low surgency were significant vulnerability factors for depression via the internalizing symptom pathway, whereas low effortful control was the only significant predictor for depression via the social-externalizing problem pathway. As such, high levels of effortful control acted as a protective factor for the development of depression across both symptom pathways, suggesting that is may be an important target for prevention strategies.

Fil: Martinez Peralta, Liliana A.. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Microbiología. Centro Nacional de Referencia para el Sida; Argentina

Fibromyalgia (FM) is a common rheumatic disease characterized by chronic widespread pain, sleep and mood disorders. A higher prevalence of FM in women compared with men is well known, although the specific differences in clinical manifestations related to gender are still poorly defined. Brain-Derived Neurotrophic Factor (BDNF) is an endogenous growth factor that gained attention for its potential as biomarker of several diseases, including FM and depression. The aims of this study were to investigate gender-related difference among males and females affected by FM in clinical manifestations, depressive features and BDNF serum level, evaluating also the diagnostic potential of the latter. We consecutively enrolled adult patients affected by FM (ACR 2016) referring to our out-patient clinic. Each subject underwent clinical and answered to questionnaires for the severity of FM symptoms (Revised Fibromyalgia Impact Questionnaire, R-FIQ) and depressive symptoms (Beck Depression Inventory-II, BDI-II). We collected blood samples from a subgroup of patients of both sexes, matched for age, for BDNF serum level dosage through ELISA. BDNF levels were assessed also in a control group, matched for sex and age. The cohort was composed by 201 FM patients (172 F, 29 M), mean age 49.13. Females showed higher values of R-FIQ total score (p=0,0005) as well the specific items of the R-FIQ for pain (p=0,013), fatigue (p=0,014), memory problems (p=0,007), tenderness to touch (p<0,0001), balance problems (p<0,0001) and sensitivity to environmental stimuli (p=0,012) when compared with males (fig. 1). There was no difference in BDI-II between males and females, but notably male patients reported a significantly higher frequency of coexisting depressive disorder (p=0,038) (fig. 2). Serum BDNF levels were evaluated in 40 FM patients and 40 healthy controls (HC) (F:M 1:1). BDNF levels were significantly lower in FM patients compared with HC (p<0,0001). Among FM patients, BDNF levels were lower in males compared with females (p<0,0001) (fig.3). BDNF did not correlate with any clinical and clinimetric parameter. BDNF showed a good diagnostic performance (AUC=0,89, CI95%=0,82-0,9630, p<0,0001) (fig. 4). At a cut-off value <6,47 ng/dl, BDNF showed a specificity of 75% and a sensibility of 92,31%,(CI 95%=79,68-97.35) for FM identification (LR=3,692). FM clinical manifestations are strongly dependant from gender. While females present a more severe disease and a higher burden of symptoms, mood disorders tend to be a major characteristic of males with FM. Reduced BDNF serum levels have been reported as typical of depressive disorders. Our findings of lower BDNF levels in male FM patients compared to females support this hypothesis. BDNF have potential as biomarker of the disease and should be validated in larger cohorts. [1]Sarzi-Puttini et al. Nature Reviews 2020 [2]Colucci-D'Amato et al. Int J Molecular Sciences 2020 [3]Nugraha et al. Rheumatol Int 2012 [4]Schmitt et al. Ann Med 2016 [5]Melchior et al. Neuroscience 2016 [6]Stefani et al. Neuroscience Letters 2012 None declared [Display omitted]

Due to the wide dissemination of bovine leukemia virus (BLV) infection among dairy cattle, control and eradication programs based on serological detection of infected cattle and subsequent culling face a major economic task. In Argentina, genetic selection of cattle carrying alleles of the bovine leukocyte antigen (BoLA) DRB3.2 gene associated with BLV-infection resistance, like *0902, emerges as the best additional tool toward controlling virus spread. A potential risk in expanding or segregating BoLA selected populations of cattle is that it might increase susceptibility to other common viruses. Special concern raises the strong association found between low proviral load and low antibody titer against major BLV structural proteins. This phenomenon might depend on host genetic factors influencing other viruses requiring, unlike BLV, strong and long-lasting humoral immune response to prevent infection. In this study, we demonstrate that there is no association among neutralizing antibody titers against foot and mouth disease virus, bovine viral diarrhea virus, or bovine herpesvirus type 1 and polymorphism of the BoLA DRB3.2 gene. Conversely, there is strong association between BoLA DRB3.2*0902 and low antibody titers against 2 BLV structural proteins—env gp51 and gag p24—to date, the best BLV resistance marker. There is also significant association between low antibody titers against gp51 and p24 and BoLA DRB3.2*1701 and low antibody titers against p24 and BoLA DRB3.2*1101 or 02. Our data suggest that increasing BoLA-selected BLV-resistant cattle or segregating BoLA-associated alleles to BLV susceptibility would not affect the resistance or the predisposition to bovine viral diarrhea virus, bovine herpesvirus type 1, or foot and mouth disease virus infection.