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1.
Rev Bras Reumatol Engl Ed ; 57 Suppl 2: 467-476, 2017.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-28800969

RESUMEN

OBJECTIVE: To establish guidelines based on scientific evidence for the diagnosis of fibromyalgia. MATERIAL AND METHODS: Evidence collection was performed based on 9 questions regarding the diagnosis of fibromyalgia, structured using the Patient, Intervention or Indicator, Comparison and Outcome (P.I.C.O.), with searches in the main, primary databases of scientific information. After defining the potential studies to support the recommendations, they were graded according to evidence and degree of recommendation.


Asunto(s)
Fibromialgia/diagnóstico , Brasil , Medicina Basada en la Evidencia , Humanos , Reumatología , Sociedades Médicas
2.
Rev Bras Reumatol Engl Ed ; 57(2): 129-133, 2017.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-28343617

RESUMEN

INTRODUCTION: EpiFibro (Brazilian Epidemiological Study of Fibromyalgia) was created to study Fibromyalgia patients. Patients were included since 2011 according to the 1990 American College of Rheumatology Classification Criteria for Fibromyalgia (ACR1990). OBJECTIVES: To determine how many patients still fulfill the ACR1990 and the ACR2010 criteria in 2014; to determine the correlation between the impact of FM and to describe data on the follow-up evaluation. METHODS: This is a cross sectional study in a multicenter cohort of patients. The data was collected between 2013 and 2015. Physician included patients that fulfilled the ACR1990 criteria on the date of entry. The follow-up data were considered only for patients with at least two evaluations. A minimally significant change was considered to be a 30% variation of parameters scores. RESULTS: 810 patients' data were analyzed. Patients presented a mean age of 51.8±11.5 years old. There were 786 female. Most patients met both criteria. There was a greater fulfilling of the ACR2010. There was a moderate correlation between Polysymptomatic Distress Scale and Fibromyalgia Impact Questionnaire. Three hundred fourteen patients with more than one assessment were found, but 88 patients were excluded. Thus, 226 patients with one follow-up monitoring parameter were considered (Fibromyalgia Impact Questionnaire: 222; Polysymptomatic Distress Scale: 199; both: 195). The mean follow-up time was 9.1±7.5 months (1-44). Most patients became stable. CONCLUSION: InEpiFibro, most patients fulfill simultaneously the ACR1990 and ACR2010. A larger number of patients fulfill the ACR2010 at the time of the evaluation. There was a moderate correlation between the Polysymptomatic Distress Scale and the Fibromyalgia Impact Questionnaire. Most patients remained stable over time.


Asunto(s)
Fibromialgia/diagnóstico , Sistema de Registros/normas , Reumatología/normas , Adulto , Brasil/epidemiología , Estudios Transversales , Diagnóstico Diferencial , Femenino , Fibromialgia/clasificación , Fibromialgia/fisiopatología , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Guías de Práctica Clínica como Asunto , Índice de Severidad de la Enfermedad
3.
Clin Rheumatol ; 32(8): 1199-206, 2013 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-23604595

RESUMEN

The Fibromyalgia Impact Questionnaire (FIQ) was specifically developed to assess disease severity and functional ability in fibromyalgia patients. In 2009, a revised version of the FIQ was published, the FIQR; this version achieved a better balance among different domains (function, overall impact, symptoms). Here, we present the validity and reliability of the Brazilian version of the Revised Fibromyalgia Impact Questionnaire (FIQR). Female fibromyalgia patients (n = 106) completed an online survey consisting of the Short Form 36 (SF-36) questionnaire, the original FIQ, and the Brazilian Portuguese FIQR, which was translated by a standard method. Validity was established with correlational analyses between the FIQR, FIQ, and SF-36 items. Three domains were established for the FIQR (function, overall impact, symptoms), and their contribution for the SF-36 subscales was also scrutinized. The Brazilian FIQR validation process showed that the questions performed in a very similar way to the original English FIQR. The new questions in the FIQR symptoms domain (memory, balance, tenderness, and environmental sensitivity) revealed a significant impact in fibromyalgia (FM) patients. The Brazilian Portuguese FIQR demonstrated excellent reliability, with a Cronbach's alpha of 0.96. There was a gain on weight of the function domain and a decrease of the symptom domain, leading to a better balance among domains. The FIQR predicted a great number of SF-36 subscales, showing good convergent validity. The Brazilian Portuguese version of the FIQR was validated and found to be a reliable, easy-to-use, and score FM-specific questionnaire that should prove useful in routine clinical practice and FM-related research.


Asunto(s)
Fibromialgia/diagnóstico , Fibromialgia/fisiopatología , Encuestas y Cuestionarios , Adulto , Brasil , Femenino , Costos de la Atención en Salud , Humanos , Internet , Lenguaje , Persona de Mediana Edad , Dimensión del Dolor , Psicometría , Calidad de Vida , Análisis de Regresión , Reproducibilidad de los Resultados , Índice de Severidad de la Enfermedad , Perfil de Impacto de Enfermedad
4.
Rev Bras Reumatol ; 53(5): 382-7, 2013.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-24316893

RESUMEN

INTRODUCTION: Fibromyalgia syndrome (FS) is a common painful condition of the musculoskeletal system that is typically accompanied by several symptoms in other systems. In Brazil, the prevalence of FS is estimated at 2.5%. Here, we present the initial data from Epi-Fibro, a nationwide databank of FS patients seen in public and private settings. OBJECTIVE: The aims of this study were to assess how the diagnosis of FS was made, identify a set of clinical domains considered relevant by both clinicians and patients in cases of FS, analyse the impact of disease on patient quality of life, and compare the findings among patients of public and private services. METHODS: Based on the results of questionnaires, we analysed data corresponding to the first 500 women in the database. Questionnaires pertaining to demographic and clinical data and the Fibromyalgia Impact Questionnaire (FIQ), which was translated and validated for Brazilian patients, were completed by the clinicians and/or patients. RESULTS: Preliminary analysis of the EpiFibro databank revealed that female FS patients in Brazil reported a high impact of disease, as measured by the FIQ, a high prevalence of associated symptoms, and a low degree of education (consistent with the public health care in Brazil used mainly by the underserved). In addition, most patients perceived their pain as diffuse from the onset of disease. CONCLUSION: Depression and anxiety were seen as the main triggers of FM symptoms, but a significant proportion of the subjects perceived work strain as the initial trigger.We also observed a delay of a few years in seeking medical help and examination by a rheumatologist.


Asunto(s)
Fibromialgia , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Brasil , Bases de Datos Factuales , Femenino , Fibromialgia/diagnóstico , Fibromialgia/epidemiología , Humanos , Persona de Mediana Edad , Encuestas y Cuestionarios , Adulto Joven
5.
Rev. bras. reumatol ; 57(supl.2): s467-s476, 2017. tab, graf
Artículo en Inglés | LILACS | ID: biblio-899484

RESUMEN

Abstract Objective To establish guidelines based on scientific evidence for the diagnosis of fibromyalgia. Material and methods Evidence collection was performed based on 9 questions regarding the diagnosis of fibromyalgia, structured using the Patient, Intervention or Indicator, Comparison and Outcome (P.I.C.O.), with searches in the main, primary databases of scientific information. After defining the potential studies to support the recommendations, they were graded according to evidence and degree of recommendation.


Resumo Objetivo Estabelecer diretrizes baseadas em evidências científicas para o diagnóstico da fibromialgia. Material e métodos A coleta de evidências foi elaborada a partir de nove questões sobre diagnóstico da fibromialgia, estruturadas por meio do PICO (Paciente, Intervenção ou Indicador, Comparação e Outcome), com busca nas principais bases primárias de informação científica. Após definir os estudos potenciais para sustentação das recomendações, esses foram graduados pela força da evidência e grau de recomendação. Resultados e conclusões As questões resultaram em nove recomendações para o diagnóstico da fibromialgia com base nas evidências de literatura e na opinião dos experts que participaram do trabalho.


Asunto(s)
Humanos , Fibromialgia/diagnóstico , Reumatología , Sociedades Médicas , Brasil , Medicina Basada en la Evidencia
6.
Rev. bras. reumatol ; 57(2): 129-133, Mar.-Apr. 2017. tab, graf
Artículo en Inglés | LILACS | ID: biblio-844217

RESUMEN

Abstract Introduction: EpiFibro (Brazilian Epidemiological Study of Fibromyalgia) was created to study Fibromyalgia patients. Patients were included since 2011 according to the 1990 American College of Rheumatology Classification Criteria for Fibromyalgia (ACR1990). Objectives: To determine how many patients still fulfill the ACR1990 and the ACR2010 criteria in 2014; to determine the correlation between the impact of FM and to describe data on the follow-up evaluation. Methods: This is a cross sectional study in a multicenter cohort of patients. The data was collected between 2013 and 2015. Physician included patients that fulfilled the ACR1990 criteria on the date of entry. The follow-up data were considered only for patients with at least two evaluations. A minimally significant change was considered to be a 30% variation of parameters scores. Results: 810 patients’ data were analyzed. Patients presented a mean age of 51.8 ± 11.5 years old. There were 786 female. Most patients met both criteria. There was a greater fulfilling of the ACR2010. There was a moderate correlation between Polysymptomatic Distress Scale and Fibromyalgia Impact Questionnaire. Three hundred fourteen patients with more than one assessment were found, but 88 patients were excluded. Thus, 226 patients with one follow-up monitoring parameter were considered (Fibromyalgia Impact Questionnaire: 222; Polysymptomatic Distress Scale: 199; both: 195). The mean follow-up time was 9.1 ± 7.5 months (1–44). Most patients became stable. Conclusion: InEpiFibro, most patients fulfill simultaneously the ACR1990 and ACR2010. A larger number of patients fulfill the ACR2010 at the time of the evaluation. There was a moderate correlation between the Polysymptomatic Distress Scale and the Fibromyalgia Impact Questionnaire. Most patients remained stable over time.


Resumo Introdução: O EpiFibro (Estudo Epidemiológico Brasileiro de Fibromialgia) foi criado para estudar pacientes com fibromialgia. Foram incluídos pacientes desde 2011 de acordo com os critérios de classificação para a fibromialgia do American College of Rheumatology de 1990 (ACR1990). Objetivos: Determinar quantos pacientes ainda atendem aos critérios ACR1990 e ACR2010 em 2014; determinar a correlação entre o impacto da FM medido pelo Questionário de Impacto da Fibromialgia (FIQ) e pela Polysymptomatic Distress Scale (PDS) e descrever dados sobre a avaliação de seguimento. Métodos: Estudo transversal em uma coorte multicêntrica de pacientes. Os dados foram coletados entre 2013 e 2015. O médico incluiu pacientes que atenderam aos critérios ACR1990 no momento da entrada. Consideraram-se os dados de seguimento apenas dos pacientes com pelo menos duas avaliações. Uma variação de 30% nos escores dos parâmetros foi considerada uma alteração minimamente significativa. Resultados: Analisaram-se os dados de 810 pacientes. Os pacientes apresentaram média de 51,8 ± 11,5 anos. Havia 786 mulheres. A maior parte dos pacientes atendeu a ambos os critérios. Houve um maior atendimento aos critérios ACR2010. Houve uma correlação moderada entre a PDS e o FIQ. Encontraram-se 314 pacientes com mais de uma avaliação, mas 88 pacientes foram excluídos. Assim, foram considerados 226 pacientes com um parâmetro de monitoramento no seguimento. (FIQ: 222; PDS: 199; ambos: 195). O tempo médio de seguimento foi de 9,1 ± 7,5 meses (1 a 44). A maior parte dos pacientes tornou-se estável. Conclusão: No EpiFibro, a maior parte dos pacientes atendia simultaneamente ao ACR1990 e ao ACR2010. Uma maior quantidade de pacientes atendia ao ACR2010 no momento da avaliação. Houve uma correlação moderada. A maior parte dos pacientes manteve-se estável ao longo do tempo.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Reumatología/normas , Fibromialgia/diagnóstico , Sistema de Registros/normas , Índice de Severidad de la Enfermedad , Dimensión del Dolor , Brasil/epidemiología , Fibromialgia/clasificación , Fibromialgia/fisiopatología , Estudios Transversales , Estudios de Seguimiento , Guías de Práctica Clínica como Asunto , Diagnóstico Diferencial , Persona de Mediana Edad
7.
Gait Posture ; 34(2): 208-12, 2011 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-21602047

RESUMEN

Falls are a serious health problem for aged people, causing social and economic burden. Despite being an important determinant of balance, the positioning of the center of mass (COM) has not been evaluated as a risk factor for falls. This study examined the association between the percentage height of COM (%COM) and the risk of falls in the elderly. Healthy women aged 60 years and older were consecutively selected in a case-control study. Forty-eight individuals classified as "fallers" (having suffered two or more falls in the previous year) were the cases while 48 age and weight-matched women with one fall or no falls in the previous year were the controls ("non-fallers"). Body composition and bone mineral density (BMD) by DXA, 30-second chair stand test, abdominal circumference, Berg's balance scale and %COM using the reaction board method were evaluated in all participants. Body composition parameters were not significantly different between groups. Spine and hip BMD tended to be lower in the fallers, but the difference was significant only at the femoral neck (0.80±0.10g/cm(2) versus 0.87±0.76g/cm(2); p<0.01). Berg's balance scale scores were lower among fallers than non-fallers (p<0.05). Percentage height of COM was significantly higher among fallers (p<0.001) and this was associated with a higher number of fractures (p<0.05). Percentage height of COM is significantly higher in the elderly with frequent falls. Further work is needed in order to determine the value of board reaction measurements in a clinical setting to identify patients at high risk.


Asunto(s)
Accidentes por Caídas , Índice de Masa Corporal , Equilibrio Postural/fisiología , Anciano , Composición Corporal , Densidad Ósea , Estudios de Casos y Controles , Femenino , Humanos , Fuerza Muscular , Fracturas Osteoporóticas/fisiopatología , Factores de Riesgo , Fracturas de la Columna Vertebral/fisiopatología
8.
Rev. bras. reumatol ; 53(5): 382-387, set.-out. 2013. ilus, tab
Artículo en Portugués | LILACS | ID: lil-696060

RESUMEN

INTRODUÇÃO: A fibromialgia (FM) é uma condição dolorosa do sistema musculoesquelético, geralmente acompanhada de vários sintomas em outros sistemas, com uma prevalência no Brasil estimada em 2,5%. Apresentamos os dados iniciais do EpiFibro, um banco de dados nacional de pacientes com FM atendidos em serviços públicos e privados. OBJETIVO: Avaliar como é feito o diagnóstico da doença, identificar um conjunto de domínios clínicos considerados relevantes por médicos e por pacientes com FM, analisar o impacto da doença na qualidade de vida dos pacientes e comparar os achados entre pacientes de serviços público e privado. MÉTODOS: Foram analisadas as respostas das primeiras 500 mulheres nesse banco de dados. Esse banco de dados foi baseado em um questionário contendo dados demográficos e clínicos. O Fibromyalgia Impact Questionnaire (FIQ), traduzido e validado para o Brasil, foi preenchido pelos médicos e/ou pacientes. RESULTADOS: Uma análise preliminar do banco de dados EpiFibro revelou que as pacientes com FM no Brasil têm um alto impacto da doença avaliada pelo FIQ, uma alta prevalência de sintomas associados, um baixo grau de educação (um achado que pode ser explicado pelo fato de a saúde pública no Brasil ser usada principalmente por aqueles desfavorecidos socialmente) e a maioria percebe a sua dor como sendo difusa a partir do início da doença. CONCLUSÃO: Depressão e ansiedade são percebidas como as principais causas dos sintomas da FM, mas uma quantidade significativa considera o esforço no trabalho como o primeiro gatilho. Há um atraso de poucos anos em busca de ajuda médica e para chegar ao reumatologista.


INTRODUCTION: Fibromyalgia syndrome (FS) is a common painful condition of the musculoskeletal system that is typically accompanied by several symptoms in other systems. In Brazil, the prevalence of FS is estimated at 2.5%. Here, we present the initial data from Epi-Fibro, a nationwide databank of FS patients seen in public and private settings. OBJECTIVE: The aims of this study were to assess how the diagnosis of FS was made, identify a set of clinical domains considered relevant by both clinicians and patients in cases of FS, analyse the impact of disease on patient quality of life, and compare the findings among patients of public and private services. METHODS: Based on the results of questionnaires, we analysed data corresponding to the first 500 women in the database. Questionnaires pertaining to demographic and clinical data and the Fibromyalgia Impact Questionnaire (FIQ), which was translated and validated for Brazilian patients, were completed by the clinicians and/or patients. RESULTS: Preliminary analysis of the EpiFibro databank revealed that female FS patients in Brazil reported a high impact of disease, as measured by the FIQ, a high prevalence of associated symptoms, and a low degree of education (consistent with the public health care in Brazil used mainly by the underserved). In addition, most patients perceived their pain as diffuse from the onset of disease. CONCLUSION: Depression and anxiety were seen as the main triggers of FM symptoms, but a significant proportion of the subjects perceived work strain as the initial trigger.We also observed a delay of a few years in seeking medical help and examination by a rheumatologist.


Asunto(s)
Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Persona de Mediana Edad , Adulto Joven , Fibromialgia , Brasil , Bases de Datos Factuales , Fibromialgia/diagnóstico , Fibromialgia/epidemiología , Encuestas y Cuestionarios
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